BACKGROUND Type 2 diabetes mellitus(T2DM)often leads to vascular complications,such as albuminuria.The role of insulin autoantibodies(IAA)and their interaction with D-dimer in this context remains unclear.AIM To inves...BACKGROUND Type 2 diabetes mellitus(T2DM)often leads to vascular complications,such as albuminuria.The role of insulin autoantibodies(IAA)and their interaction with D-dimer in this context remains unclear.AIM To investigate the characteristics of IAA and its effect on albuminuria in T2DM patients.METHODS We retrospectively analyzed clinical data from 115 T2DM patients with positive IAA induced by exogenous insulin,and 115 age-and sex-matched IAA-negative T2DM patients as controls.Propensity scores were calculated using multivariate logistic regression.Key variables were selected using the least absolute shrinkage and selection operator(LASSO)algorithm.We constructed a prediction model and analyzed the association between IAA and albuminuria based on demographic and laboratory parameters.RESULTS The IAA-positive group had significantly higher D-dimer levels[0.30(0.19-0.55)mg/L vs 0.21(0.19-0.33)mg/L,P=0.008]and plasma insulin levels[39.1(12.0-102.7)μU/mL vs 9.8(5.5-17.6)μU/mL,P<0.001]compared to the IAA-negative group.Increases in the insulin dose per weight ratio,diabetes duration,and urinary albumin-to-creatinine ratio(UACR)were observed but did not reach statistical significance.The LASSO model identified plasma insulin and D-dimer as key factors with larger coefficients.D-dimer was significantly associated with UACR in the total and IAA-positive groups but not in the IAA-negative group.The odds ratio for D-dimer elevation(>0.5 g/L)was 2.88(95%confidence interval:1.17-7.07)in the IAA-positive group(P interaction<0.05).CONCLUSION D-dimer elevation is an independent risk factor for abnormal albuminuria and interacts with IAA in the development of abnormal albuminuria in T2DM patients.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for...BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for assessing this risk.In Gabon,early implementation of anticoagulation therapy and D-dimer testing has been crucial in managing COVID-19.This study hypothesizes that elevated Ddimer levels are linked to increased COVID-19 severity.AIM To determine the impact of D-dimer levels on COVID-19 severity and their role in guiding clinical decisions.METHODS This retrospective study analyzed COVID-19 patients admitted to two hospitals in Gabon between March 2020 and December 2023.The study included patients with confirmed COVID-19 diagnoses and available D-dimer measurements at admission.Data on demographics,clinical outcomes,D-dimer levels,and healthcare costs were collected.COVID-19 severity was classified as non-severe(outpatients)or severe(inpatients).A multivariable logistic regression model was used to assess the relationship between D-dimer levels and disease severity,with adjusted odds ratios(OR)and 95%CI.RESULTS A total of 3004 patients were included,with a mean age of 50.17 years,and the majority were female(53.43%).Elevated D-dimer levels were found in 65.81%of patients,and 57.21%of these experienced severe COVID-19.Univariate analysis showed that patients with elevated D-dimer levels had 3.33 times higher odds of severe COVID-19(OR=3.33,95%CI:2.84-3.92,P<0.001),and this association remained significant in the multivariable analysis,adjusted for age,sex,and year of collection.The financial analysis revealed a substantial burden,particularly for uninsured patients.CONCLUSION D-dimer predicts COVID-19 severity and guides treatment,but the high cost of anticoagulant therapy highlights the need for policies ensuring affordable access in resource-limited settings like Gabon.展开更多
BACKGROUND Neonatal sepsis is a serious health problem,with high morbidity and mortality during the first 28 days of life.Clinical diagnosis at presentation is challenging due to the nonspecific signs and symptoms.Alt...BACKGROUND Neonatal sepsis is a serious health problem,with high morbidity and mortality during the first 28 days of life.Clinical diagnosis at presentation is challenging due to the nonspecific signs and symptoms.Although blood culture is the gold standard for diagnosis,it is not always positive.AIM To evaluate the diagnostic and prognostic utility of D-dimer and heparin-binding protein(HBP)in neonatal sepsis.METHODS This prospective case-control study included 90 neonates in two groups:A sepsis group(n=45)and a control group(n=45)without sepsis.Sepsis group was further subdivided based on blood culture results into proven sepsis(n=28 culturepositive sepsis)and suspected sepsis(n=17 culture-negative sepsis).All neonates underwent complete history taking,thorough clinical examination and investigations[complete blood count,C-reactive protein(CRP),liver and kidney function tests,plasma D-dimer and HBP].RESULTS Levels of CRP,D-dimer and HBP were significantly higher in the sepsis group compared to the controls.At a cutoff value above 517.9 ng/mL,D-dimer outperformed CRP and HBP in distinguishing sepsis group from controls with 95.6%sensitivity and 97.8%specificity.D-dimer was also a better prognostic marker than the neonatal sequential organ failure assessment(nSOFA)for predicting mortality,with 100%sensitivity and 92.5%specificity vs 80%sensitivity and 82.5%specificity.There was a significant positive correlation between CRP,D-dimer and HBP.CONCLUSION D-dimer demonstrated superior diagnostic accuracy compared to CRP and HBP in predicting sepsis,and demonstrated superior prognostic accuracy compared to nSOFA in predicting the outcome of neonatal sepsis.展开更多
Objective: To investigate the expression and diagnostic value of D-dimer, CRP, and IL-6 in children with Mycoplasma pneumonia. Methods: A total of 100 children diagnosed with Mycoplasma pneumonia from the pediatric de...Objective: To investigate the expression and diagnostic value of D-dimer, CRP, and IL-6 in children with Mycoplasma pneumonia. Methods: A total of 100 children diagnosed with Mycoplasma pneumonia from the pediatric department of the First Affiliated Hospital of Shaoyang University, admitted between November 2023 and June 2024, were selected for the study. According to the severity of the condition, they were divided into two groups: a mild group (50 cases) and a severe group (50 cases). After treatment, they were further divided into an effective group (63 cases) and a non-effective group (37 cases) based on the treatment outcomes, to compare their diagnostic values. Results: The levels of D-dimer, CRP, IL-6, length of hospital stay, fever resolution time, cough resolution time, and the time for lung rales to disappear were higher in the severe group than in the mild group (P < 0.05). The levels of D-dimer, CRP, and IL-6 in the non-effective group were higher than those in the effective group (P < 0.05). In this study, using pathological results as the “gold standard,” it was found that the positive detection rate for the combined detection of D-dimer, CRP, and IL-6 was higher than the detection rate for each of D-dimer, CRP, and IL-6 alone, suggesting that the combined diagnosis had a higher positive detection rate (P < 0.05). Compared with D-dimer, CRP, and IL-6, the combined sensitivity, specificity, and accuracy were all higher (P < 0.05). Conclusion: D-dimer, CRP, and IL-6 are closely related to Mycoplasma pneumonia in children and can serve as auxiliary diagnostic tools for Mycoplasma pneumonia in children, offering significant value.展开更多
Objective To investigate the mechanisms of electroacupuncture （EA） at ＂Baihui＂ （百会 GV 20） and ＂Shuigou＂ （水沟 GV 26） for treating cerebral infarction. Methods Forty healthy SD rats were randomly divided in...Objective To investigate the mechanisms of electroacupuncture （EA） at ＂Baihui＂ （百会 GV 20） and ＂Shuigou＂ （水沟 GV 26） for treating cerebral infarction. Methods Forty healthy SD rats were randomly divided into model group （n = 10）, EA group （n = 10）, normal group （n = 10）, and sham operation group （n = 10）. The model of acute cerebral infarction was established by blocking the middle cerebral artery with an intraluminal thread. EA was applied at ＂Baihui＂ （百会 GV 20） and ＂Shuigou＂ （水沟GV 26） in the rats of EA group after the models were developed. The contents of D-dimer （D-D） and fibrinogen （Fib） were measured in each group. Results The contents of D-D and Fib increased signifi- cantly in model group as compared with normal and sham operation groups, respectively （P〈0.01）, and they decreased significantly in EA group as compared with model group （P〈0.01）. Conclusion EA can ob-viously decrease the contents of D-D and Fib, improve abnormal fibrinolysis, lower blood viscosity and ameliorate cerebral blood circulation in the rats with acute cerebral infarction.展开更多
文摘BACKGROUND Type 2 diabetes mellitus(T2DM)often leads to vascular complications,such as albuminuria.The role of insulin autoantibodies(IAA)and their interaction with D-dimer in this context remains unclear.AIM To investigate the characteristics of IAA and its effect on albuminuria in T2DM patients.METHODS We retrospectively analyzed clinical data from 115 T2DM patients with positive IAA induced by exogenous insulin,and 115 age-and sex-matched IAA-negative T2DM patients as controls.Propensity scores were calculated using multivariate logistic regression.Key variables were selected using the least absolute shrinkage and selection operator(LASSO)algorithm.We constructed a prediction model and analyzed the association between IAA and albuminuria based on demographic and laboratory parameters.RESULTS The IAA-positive group had significantly higher D-dimer levels[0.30(0.19-0.55)mg/L vs 0.21(0.19-0.33)mg/L,P=0.008]and plasma insulin levels[39.1(12.0-102.7)μU/mL vs 9.8(5.5-17.6)μU/mL,P<0.001]compared to the IAA-negative group.Increases in the insulin dose per weight ratio,diabetes duration,and urinary albumin-to-creatinine ratio(UACR)were observed but did not reach statistical significance.The LASSO model identified plasma insulin and D-dimer as key factors with larger coefficients.D-dimer was significantly associated with UACR in the total and IAA-positive groups but not in the IAA-negative group.The odds ratio for D-dimer elevation(>0.5 g/L)was 2.88(95%confidence interval:1.17-7.07)in the IAA-positive group(P interaction<0.05).CONCLUSION D-dimer elevation is an independent risk factor for abnormal albuminuria and interacts with IAA in the development of abnormal albuminuria in T2DM patients.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for assessing this risk.In Gabon,early implementation of anticoagulation therapy and D-dimer testing has been crucial in managing COVID-19.This study hypothesizes that elevated Ddimer levels are linked to increased COVID-19 severity.AIM To determine the impact of D-dimer levels on COVID-19 severity and their role in guiding clinical decisions.METHODS This retrospective study analyzed COVID-19 patients admitted to two hospitals in Gabon between March 2020 and December 2023.The study included patients with confirmed COVID-19 diagnoses and available D-dimer measurements at admission.Data on demographics,clinical outcomes,D-dimer levels,and healthcare costs were collected.COVID-19 severity was classified as non-severe(outpatients)or severe(inpatients).A multivariable logistic regression model was used to assess the relationship between D-dimer levels and disease severity,with adjusted odds ratios(OR)and 95%CI.RESULTS A total of 3004 patients were included,with a mean age of 50.17 years,and the majority were female(53.43%).Elevated D-dimer levels were found in 65.81%of patients,and 57.21%of these experienced severe COVID-19.Univariate analysis showed that patients with elevated D-dimer levels had 3.33 times higher odds of severe COVID-19(OR=3.33,95%CI:2.84-3.92,P<0.001),and this association remained significant in the multivariable analysis,adjusted for age,sex,and year of collection.The financial analysis revealed a substantial burden,particularly for uninsured patients.CONCLUSION D-dimer predicts COVID-19 severity and guides treatment,but the high cost of anticoagulant therapy highlights the need for policies ensuring affordable access in resource-limited settings like Gabon.
基金Supported by National Liver Institute,Menoufia University,and Damietta General Hospital,Damietta,Egypt.
文摘BACKGROUND Neonatal sepsis is a serious health problem,with high morbidity and mortality during the first 28 days of life.Clinical diagnosis at presentation is challenging due to the nonspecific signs and symptoms.Although blood culture is the gold standard for diagnosis,it is not always positive.AIM To evaluate the diagnostic and prognostic utility of D-dimer and heparin-binding protein(HBP)in neonatal sepsis.METHODS This prospective case-control study included 90 neonates in two groups:A sepsis group(n=45)and a control group(n=45)without sepsis.Sepsis group was further subdivided based on blood culture results into proven sepsis(n=28 culturepositive sepsis)and suspected sepsis(n=17 culture-negative sepsis).All neonates underwent complete history taking,thorough clinical examination and investigations[complete blood count,C-reactive protein(CRP),liver and kidney function tests,plasma D-dimer and HBP].RESULTS Levels of CRP,D-dimer and HBP were significantly higher in the sepsis group compared to the controls.At a cutoff value above 517.9 ng/mL,D-dimer outperformed CRP and HBP in distinguishing sepsis group from controls with 95.6%sensitivity and 97.8%specificity.D-dimer was also a better prognostic marker than the neonatal sequential organ failure assessment(nSOFA)for predicting mortality,with 100%sensitivity and 92.5%specificity vs 80%sensitivity and 82.5%specificity.There was a significant positive correlation between CRP,D-dimer and HBP.CONCLUSION D-dimer demonstrated superior diagnostic accuracy compared to CRP and HBP in predicting sepsis,and demonstrated superior prognostic accuracy compared to nSOFA in predicting the outcome of neonatal sepsis.
文摘Objective: To investigate the expression and diagnostic value of D-dimer, CRP, and IL-6 in children with Mycoplasma pneumonia. Methods: A total of 100 children diagnosed with Mycoplasma pneumonia from the pediatric department of the First Affiliated Hospital of Shaoyang University, admitted between November 2023 and June 2024, were selected for the study. According to the severity of the condition, they were divided into two groups: a mild group (50 cases) and a severe group (50 cases). After treatment, they were further divided into an effective group (63 cases) and a non-effective group (37 cases) based on the treatment outcomes, to compare their diagnostic values. Results: The levels of D-dimer, CRP, IL-6, length of hospital stay, fever resolution time, cough resolution time, and the time for lung rales to disappear were higher in the severe group than in the mild group (P < 0.05). The levels of D-dimer, CRP, and IL-6 in the non-effective group were higher than those in the effective group (P < 0.05). In this study, using pathological results as the “gold standard,” it was found that the positive detection rate for the combined detection of D-dimer, CRP, and IL-6 was higher than the detection rate for each of D-dimer, CRP, and IL-6 alone, suggesting that the combined diagnosis had a higher positive detection rate (P < 0.05). Compared with D-dimer, CRP, and IL-6, the combined sensitivity, specificity, and accuracy were all higher (P < 0.05). Conclusion: D-dimer, CRP, and IL-6 are closely related to Mycoplasma pneumonia in children and can serve as auxiliary diagnostic tools for Mycoplasma pneumonia in children, offering significant value.
基金subsidized by the research project item of the Department of Educationin Hubei Province:No.D200516006
文摘Objective To investigate the mechanisms of electroacupuncture （EA） at ＂Baihui＂ （百会 GV 20） and ＂Shuigou＂ （水沟 GV 26） for treating cerebral infarction. Methods Forty healthy SD rats were randomly divided into model group （n = 10）, EA group （n = 10）, normal group （n = 10）, and sham operation group （n = 10）. The model of acute cerebral infarction was established by blocking the middle cerebral artery with an intraluminal thread. EA was applied at ＂Baihui＂ （百会 GV 20） and ＂Shuigou＂ （水沟GV 26） in the rats of EA group after the models were developed. The contents of D-dimer （D-D） and fibrinogen （Fib） were measured in each group. Results The contents of D-D and Fib increased signifi- cantly in model group as compared with normal and sham operation groups, respectively （P〈0.01）, and they decreased significantly in EA group as compared with model group （P〈0.01）. Conclusion EA can ob-viously decrease the contents of D-D and Fib, improve abnormal fibrinolysis, lower blood viscosity and ameliorate cerebral blood circulation in the rats with acute cerebral infarction.
