Objective To investigate the optimal glycated haemoglobin （HbAlc） cut off points and evaluate the impact of HbAlc on diabetes and pre-diabetes in middle-aged and elderly population. Methods Subjects were recruited f...Objective To investigate the optimal glycated haemoglobin （HbAlc） cut off points and evaluate the impact of HbAlc on diabetes and pre-diabetes in middle-aged and elderly population. Methods Subjects were recruited from Shanghai Changfeng Study. A total of 1 973 community-based participants （age_〉45） without known diabetes underwent oral glucose tolerance test （OG3-r） by using a 75-g oral glucose load and HbAlc was measured by using high performance liquid chromatography （HPLC）. Subjects were classified as normal glucose tolerance （NGT）, pre-diabetes（impaired glucose regulation, IGR） and new diagnosed diabetes （NDD） per 1999 WHO criteria. Two tests are compared with receiver operating characteristic curve （ROC）. Results Among 1973 subjects, 271 （13.7%） were diagnosed as NDD and 474 （24.0%） as IGR by using OGTT. HbAlc was 5.7%_＋0.7% in this population. Use of 6.5% as the HbAIC cutoff point has sensitivity of 38.7% and specificity of 98.5%. We recommend 6.0% as a better cutoff value for diagnosis of diabetes in this population （AUC 0.829, 95% CI 0.798-0.860, P〈0.001） with its sensitivity and specificity as 66.1% and 86.8%. For IGR, the results showed low sensitivity （44.9%） and specificity （66.7%） with an AUC of 0.571 for HbAlc when 5.8% was used as the cutoff point. Participants detected with HbAlc_〉6.0% were associated with nearly the same metabolic characteristics, including body mass index （BMI）, blood pressure, lipid profile and urine albumin-creatinine ratio （uACR） compared with diabetic subjects detected by OGTT. Conclusion The optimum HbAlc cutoff point for diabetes in our study population was lower than ADA criteria, and HbAlc may not be used to identify IGR.展开更多
BACKGROUNDYoung people with type 1 diabetes in low-and-middle income countries facemany challenges in accessing care, with various essential supplies needed forsurvival and long-term health.AIMTo study insulin deliver...BACKGROUNDYoung people with type 1 diabetes in low-and-middle income countries facemany challenges in accessing care, with various essential supplies needed forsurvival and long-term health.AIMTo study insulin delivery devices and glycated haemoglobin (HbA1c) testing.METHODSA survey was conducted in 2019 of leading diabetes centres in 41 countriessupported by the Life for a Child Program. The survey covered numerous aspectsconcerning availability and costs at all levels of the health system, local usagepatterns and attitudes, obstacles, and other aspects.RESULTSThirty-seven countries returned the survey (90.2% response rate). Key findingsincluded: Syringe use was most common (83.1%), followed by insulin pens(16.7%) and pumps (0.2%). 48.6% of public health systems did not providesyringes, even with a co-payment. Use of suboptimal syringe/needlecombinations was common. Needles were generally reused in almost all countries(94.3%, n = 35). Aside from donated supplies, there was variable access to HbA1ctesting within public health facilities, and, when available, patients often had tocover the cost. Provision was further compromised by numerous problemsincluding stock-outs, and challenges with understanding the test, equipmentmaintenance, and refrigeration.CONCLUSIONLarge gaps exist for adequate access to appropriate insulin delivery devices andHbA1c testing. Public health systems in low-and-middle income countries shouldincrease affordable provision. There are also needs for specific health professional training and diabetes education;elimination of customs duties and taxes;development of inexpensive, robust HbA1c testing methods that do not requirerefrigeration of testing supplies;differential pricing schemes;and other solutions.展开更多
The effects of temperature,pH and long-term storage on the secondary structure and conformation changes of bovine haemoglobin（bHb） were studied using circular dichroism（CD） and ultraviolet-visible（UV-vis） spectr...The effects of temperature,pH and long-term storage on the secondary structure and conformation changes of bovine haemoglobin（bHb） were studied using circular dichroism（CD） and ultraviolet-visible（UV-vis） spectroscopies.Neural network software was used to deconvolute the CD data to obtain the fractional content of the five secondary structures.The storage stability of bHb solutions in pH 6,7 and8 buffers was significantly higher at 4 ℃ than at 23 ℃ for the first 3 days.A complete denaturation of bHb was observed after 40 days irrespective of storage temperature or pH.The bHb solutions were also exposed to heating and cooling cycles between 25 and 65 ℃ and structural changes were followed by UVvis and CD spectroscopies.These experiments demonstrated that α-helix content of bHb decreased steadily with the increasing temperature above 35 ℃ at all pH values.The loss in a-helicity and gain in random coil conformations was pH-dependent and the greatest under alkaline conditions.Furthermore,there was minimal recovery of the secondary structure content upon cooling to 25 ℃.The use of bHb as a model drug is very common and this study elucidates the significance of storage and processing conditions on its stability.展开更多
Objectives To detect whether persisting or transient glucose metabolism disorder is responsible for admission hyperglycemia in patients with acute myocardic infarction （AMI）. Methods Two groups of patients were enro...Objectives To detect whether persisting or transient glucose metabolism disorder is responsible for admission hyperglycemia in patients with acute myocardic infarction （AMI）. Methods Two groups of patients were enrolled： AMI group and control group. Fasting plasma glucose, 2 hours plasma glucose, glycated albumin（GA） and glycated haemoglobin （ HbA1 c） were measured at baseline in both groups and 30 days after AMI attack in AMI group. Results （ 1 ） There were no significant differences in baseline characteristics between both groups; （2） Compared with the control group, the levels of GA and HbA1 c in AMI group at baseline were significantly higher. （ 3 ） At 30 day follow-up in AMI group, both FBG and 2hPG decreased to normal values, HbA1 c did not change, but only GA kept on increasing. Conclusions Hyperglycemia on admission in patients with AMI resulted from both preexisting metabolic disorder and stress reaction as well. GA is the only indicator that could recall the exaggeration of glucose metabolic disorder during AMI attack at 30 day follow-up. （ S Chin J Cardiol 2009; 10（4） ： 186 -189）展开更多
BACKGROUND Fixed ratio combinations(FRCs)of analogue basal insulin and glucagon-like peptide-1 receptor agonists are a newer addition to the therapeutic armamentarium for the management of type 2 diabetes mellitus.The...BACKGROUND Fixed ratio combinations(FRCs)of analogue basal insulin and glucagon-like peptide-1 receptor agonists are a newer addition to the therapeutic armamentarium for the management of type 2 diabetes mellitus.They reduce treatment complexity by combining two injectables in a single daily injectable,thus potentially improving adherence and persistence.Clinicians wanting to use FRCs would need to choose between members of the class.AIM To describe and contrast the glycated haemoglobin reduction of two FRCs of analogue basal insulin and glucagon like peptide-1 receptor agonist in adults with type 2 diabetes mellitus.METHODS The following Population,Intervention,Comparison,Outcome question was used for the primary analysis:Among adult patients with type 2 diabetes mellitus[P],what is the effect of iGlarLixi[I]compared to IDegLira[C]for bringing about glycaemic control(as measured by reduction in glycosylated haemoglobin)[O]?The Prisma Statement was used as a guideline for framing this systematic review.We searched PubMed,EMBASE and Cochrane library databases and Clinicaltrials.gov using various keywords and medical search headings related to type 2 diabetes mellitus,iGlarlixi,IDegLira and glycated haemoglobin A1c.RESULTS All 14 studies identified by the systematic search met the primary efficacy endpoint of reduction in glycated haemoglobin.There were no head-to-head studies between the FRCs of iGlarlixi and IDegLira,and we therefore did an indirect comparison based on a common comparator of insulin glargine U100.Both iGlarLixi and IDegLira effectively reduce glycated haemoglobin when compared to insulin glargine U100.However,using indirect comparisons,IDegLira had a greater haemoglobin A1c reducing ability(0.6%vs 0.3%).The indirect comparison is limited by the differences between the studies;the fasting blood glucose targets were slightly higher for iGlarLixi studies when compared to the IDegLira studies(4.0-5.0 mmol/L and 4.4-5.6 mmol/L),and the IDegLira study used a greater average dose of insulin glargine when compared to the iGlarLixi studies(66 U/d vs 40 U/d).CONCLUSION Both iGlarLixi and IDegLira effectively reduce glycated haemoglobin.Indirect comparisons,using insulin glargine as the common comparator,suggest that IDegLira reduces glycated haemoglobin to a greater extent than iGlarLixi.However,given the limitations of indirect comparisons,robust head to head studies and real-world data would better inform clinician choice and clinical practice guidelines.展开更多
One of the difficulties in creating a blood substitute on the basis of human haemoglobin(Hb) is the toxic nature of Hb when it is outside the safe environment of the red blood cells.The plasma protein haptoglobin(Hp) ...One of the difficulties in creating a blood substitute on the basis of human haemoglobin(Hb) is the toxic nature of Hb when it is outside the safe environment of the red blood cells.The plasma protein haptoglobin(Hp) takes care of the Hb physiologically leaked into the plasma-it binds Hb and makes it much less toxic while retaining the Hb’s high oxygen transporting capacity.We used Electron Paramagnetic Resonance(EPR) spectroscopy to show that the protein bound radical induced by H2O2 in Hb and Hp-Hb complex is formed on the same tyrosine residue(s),but,in the complex,the radical is found in a more hydrophobic environment and decays slower than in unbound Hb,thus mitigating its oxidative capacity.The data obtained in this study might set new directions in engineering blood substitutes for transfusion that would have the oxygen transporting efficiency typical of Hb,but which would be non-toxic.展开更多
Background: Anaemia is a common medical disorder in pregnancy especially in developing countries. Iron deficiency anaemia during pregnancy may be associated with adverse pregnancy outcomes Objectives: To?determine the...Background: Anaemia is a common medical disorder in pregnancy especially in developing countries. Iron deficiency anaemia during pregnancy may be associated with adverse pregnancy outcomes Objectives: To?determine the cord blood haemoglobin and the correlation between maternal haemoglobin concentration and perinatal outcome at the University of Port Harcourt Teaching Hospital. Materials and Methods: This was a prospective cross-sectional study of 155 pregnant women who presented at the labour ward of the department of Obstetrics and Gynaecology from October 1, 2018 to December 31, 2018. Blood sample was collected from the women in labour into ethylenediamine tetra-acetic acid (EDTA) bottles, red blood cell haemoglobin was determined. Umbilical cord blood sample was also collected at delivery and red cell haemoglobin was done. Socio-demographic characteristics, risk factors and perinatal outcome were obtained, entered into a spreadsheet and analyzed using SPSS 22.0. Bivariate logistic regression analysis was performed for multivariate analysis and statistical significance was considered at p Results: The mean age of the women was 31.08 ± 4.39 years, the mean maternal haemoglobin concentration was 11.54 ± 1.86 g/dl while the mean umbilical cord haemoglobin concentration was 12.92 ± 1.92 g/dl. Majority (86.45%) of the women were compliant with the prescribed haematinics. Moderate anaemia was observed in 17.42% of the women, followed by mild anaemia (15.48%) and severe anaemia (1.29%) respectively. Maternal complications were observed in 24.5% of women. There was a significant association between maternal haemoglobin concentration and cord blood haemoglobin concentration (p = 0.001). However, the study did not show an association between parity, mode of delivery, birth weight, Apgar scores, gestational age and maternal haemoglobin concentration (p > 0.05). Conclusion: The mean Haemoglobin in our newborns was less than previously reported values. Cord blood haemoglobin decreases significantly with decreasing maternal haemoglobin, thus there is a linear relationship between maternal and cord blood haemoglobin.展开更多
Background: There is scarcity of data on the actual frequency of routine blood work-up for patients on maintenance haemodialysis and how this affects the achievement of therapeutic goals in sub-Saharan Africa. This st...Background: There is scarcity of data on the actual frequency of routine blood work-up for patients on maintenance haemodialysis and how this affects the achievement of therapeutic goals in sub-Saharan Africa. This study aimed to review these in a referral hospital in Cameroon. Methods: A prospective hospital-based cohort study carried out from November 2019 to April 2020 including patients on maintenance haemodialysis in Douala general hospital. Patients were followed during 6 months to determine the frequency of monitoring of haemoglobin, serum calcium and phosphorus. Targeted values for haemoglobin were ≥10 g/dL, 80 - 100 mg/L for serum calcium and 25 - 45 mg/L for serum phosphorus. Pearson correlation test was used to define the correlation between monitoring frequencies and blood values at the end of the study. Results: For all 154 patients included in the study, the median frequency of monitoring for haemoglobin was once every 8 week (IQR: 6 - 12) and once every 12 weeks (IQR: 8 - 24) for serum calcium and phosphorus. The proportion of patients who achieved haemoglobin, serum calcium and phosphorus targets at the end of the study were 27.4%, 63% and 74% respectively. No correlation was found between the frequency of monitoring and the haemoglobin, serum phosphorus and calcium levels at the end of the study. Conclusion: The frequency of monitoring of serum haemoglobin, calcium and phosphorus by patients in this study was low with a high prevalence of patients not achieving target value.展开更多
Introduction: One of the biological markers for monitoring glycaemic control in diabetic patients is glycated protein. The definition of a reference method to improve the accuracy of measurement tools is necessary. Th...Introduction: One of the biological markers for monitoring glycaemic control in diabetic patients is glycated protein. The definition of a reference method to improve the accuracy of measurement tools is necessary. The aim of our study was to assess the glycemic control of diabetic patients based on glycated hemoglobin. Patients and Method: This is a descriptive cross-sectional study conducted in April 2021 at the national university hospital center (CNHU-HKM) of Cotonou. All patients who consulted during the period and who gave their consent were included. After collecting the blood samples according to the classical standards of the pre-analytical phase, we measured the blood glucose level and the HbA1c. Results: The mean blood glucose level of the patients was 1.52 ± 0.16 g/L with extremes of 0.80 g/L and 3.5 g/L. The mean HbA1c proportion was 8.39% ± 0.60% with a minimum and maximum value of 5.40% and 16% respectively. We also noted that the mean body mass index (BMI) of the patients was 28.61 ± 1.46 Kg/m<sup>2</sup> with extremes of 17.50 Kg/m<sup>2</sup> and 46.02 Kg/m<sup>2</sup>. Oral anti diabetic and hygienic-dietary measures were used by 44 patients (80%) and hygienic-dietary measures (HDM) only used by 9.09%. A frequency of 87.53% of patients had at least one degenerative complication. Retinopathy was the most observed degenerative disease (36.36%) followed by cardiovascular disease (25.45%). Conclusion: This study showed that there is a poor correlation between fasting blood glucose and glycated haemoglobin levels, which could be due to several biological and clinical reasons. It also showed that despite the respect of hygienic dietary measures and a well conducted treatment, it is difficult to obtain a satisfactory glycemic balance in obese patients.展开更多
Introduction: Intraoperative blood loss remains as a concern for all surgeons. Proper estimation of intraoperative blood loss is critical and can be challenging, especially if the blood is mixed with other fluids such...Introduction: Intraoperative blood loss remains as a concern for all surgeons. Proper estimation of intraoperative blood loss is critical and can be challenging, especially if the blood is mixed with other fluids such as tumescent fluid in liposuction cases. In such cases, proper estimation of intraoperative blood loss will lead to fewer mistakes in fluid resuscitation. In this article, Tallquist Haemoglobin Scale was tried to estimate intraoperative blood loss in liposuction. Objectives: Proper estimation of intraoperative blood loss in liposuction cases. Method: Tallquist Haemoglobin Scale will be tried to estimate the approximate intraoperative blood loss in liposuction cases using a mathematical formula that considers total fluid loss, patient’s preoperative haemoglobin and the reading from Tallquist kit. Results: Tallquist Haemoglobin Scale can be considered as a valid method for proper estimation of intraoperative blood loss in liposuction cases, the thing that will lead to correct fluid resuscitation and fewer complications. Conclusion: Proper estimation of intraoperative blood loss leads to fewer mistakes in fluid resuscitation and fewer related complications of under or overcorrection. Tallquist Haemoglobin scale is a trusted, cheap and fast method for proper estimation of intraoperative blood loss in liposuction cases.展开更多
Background: Diabetes mellitus is a common disease and it is a major cause of morbidity;several studies indicate that diabetes is a likely under reported cause of death. Chromium’s is important trace element to contro...Background: Diabetes mellitus is a common disease and it is a major cause of morbidity;several studies indicate that diabetes is a likely under reported cause of death. Chromium’s is important trace element to control diabetes mellitus and metabolism of carbohydrate, lipid and protein. Objective: The purpose of this study was to understand the relationship between serum chromium, with HbA1c, Total cholesterol and Triglycerides among type 2 diabetes patients among diabetic patients. Methodology: This is cross-sectional study done in Jabber Abu Ezz Centre for treatment and care of diabetics in Khartoum—Sudan. Four hundred subjects were enrolled in this study;one hundred subjects were normal healthy as control group, and three hundred subjects diabetic patient type 2 as test group;demographic and biochemical data were collected;serum chromium, Glycosylated Haemoglobin (HbA1c), Total cholesterol Triglycerides, were determined by using NYCOCARD READER II, spectrophotometer (Biosystem 310) and spectrophotometer 210-VGP. Result: In this study there is significant parameters level means of FBS HbA1c, Total Cholesterol, Triglycerides and Chromium of the test groups when compared with healthy control groups subjects (P = 0.001, 0.018, 0.01, 0.011, 0.004), respectively. Significant negative correlation is between FBS, HbA1c, Total Cholesterol, Triglycerides and Chromium (r = ?0.555, P value = 0.003), (r = ?0.668, P value = 0.002), (r = ?0.335, P value = 0.004) and (r = ?0.774, P value = 0.002) respectively. Conclusion: There was significant correlation between serum Chromium level with fasting blood sugaer, Glycosylated Haemoglobin (HbA1c), Total cholesterol and Triglycerides among type 2 diabetes patients.展开更多
Glutathionyl-haemoglobin (Hb-SSG) is a minor form of haemoglobin characterized by the presence of a disulfide bond between the β-93 cysteine residue and the thiol group of glutathione. Hb-SSG is naturally present in ...Glutathionyl-haemoglobin (Hb-SSG) is a minor form of haemoglobin characterized by the presence of a disulfide bond between the β-93 cysteine residue and the thiol group of glutathione. Hb-SSG is naturally present in the erythrocytes at levels comparable to those of glycated haemoglobin and can be measured by MALDI mass spectrometry on very small samples of erythrocytes from peripheral blood. Since Hb-SSG has been recognized as a sensitive biomarker of oxidative stress in several degenerative diseases (diabetes, hyperlipidemia, kidney disease) and in healthy workers exposed to glutathione-depleting toxic agents such as butadiene, we have measured for the first time the levels of Hb-SSG in two groups: healthy heavy cigarette smokers and overweight-obese. For both classes of subjects, the measured levels (6.4%±1.7%, n=30 for smokers;3.0%±0.8%, n=20 for overweight-obese) are in the upper 97thpercentile of those measured in the Italian general population. Levels in smokers show a small, yet statistically significant dependence on the level of smoking addiction (>20 cig./day vs. ￡20 cig./day: 7.0% ± 1.4% vs. 5.7% ± 1.1%;p < 0.05). This biomarker thus adds to those presently available to rationally assess the extent of biological damage caused by tobacco smoking.展开更多
Objectives:This study used Deinococcus radiodurans,which is extremely resistant to oxidative damage,genotoxic chemicals,high levels of ionising and ultraviolet radiation and drying,and its Vitreoscilla haemoglobin(vgb...Objectives:This study used Deinococcus radiodurans,which is extremely resistant to oxidative damage,genotoxic chemicals,high levels of ionising and ultraviolet radiation and drying,and its Vitreoscilla haemoglobin(vgb)gene-cloned recombinant with the vgb−recombinant strain as a control.In addition to the conditions wherein bacteria have an optimum Cr(Ⅲ)biosorption capacity,the contribution of the vgb gene to the biosorption ability of the bacteria has been investigated by providing the organism with a more oxygenic environment.Methods:Bacteria were produced and metal stock solution was prepared.To determine the Cr(Ⅲ)removal capacities of wild and recombinant D.radiodurans strains,the residual metal concentration in aqueous media at the beginning and after biosorption was determined in Atomic Absorption Spectrophotometer.Some optimal conditions were created for the biosorption conditions to occur.Conclusions:The optimisation tests showed that Cr(Ⅲ)reached the highest biosorption capacity within 15 minutes at a metal concentration of 2,000 ppm,30°C,pH 5.0 and 150 rpm stirring speed in all the three bacteria.The vgb gene had no significant contribution to the biosorption capacity.展开更多
A 12-week feeding trial was conducted to evaluate the effects of replacing fish meal by chicken haemoglobin powder in largemouth bass diets.Four isonitrogenous(48%)and isolipidic(12%)diets were formulated to replace 0...A 12-week feeding trial was conducted to evaluate the effects of replacing fish meal by chicken haemoglobin powder in largemouth bass diets.Four isonitrogenous(48%)and isolipidic(12%)diets were formulated to replace 0%(control),9.80%,19.61%and 29.41%of fish meal with chicken haemoglobin powder.Each diet was fed to triplicate groups of fish(initial weight:49.50±0.07 g)twice daily.The fish specific growth rate was significantly reduced when diet replacement level was up to 19.61%,which may be related to the feed intake and apparent digestibility coefficient of protein and amino acids.Meanwhile,the feed efficiency ratio and protein efficiency ratio were not significantly decreased until the replacement level up to 29.41%.The activity of CCP was significantly reduced when 19.61%of fish meal was replaced.Meanwhile,the activity of lysozyme and serum protein content was significantly altered in fish fed with the diets up to 29.41%replacement.Additionally,the red blood cell count and haemoglobin content was significantly decreased when the replacement level was up to 19.61%.In overall,the diet with 9.80%of chicken haemoglobin powder was more suitable for largemouth bass.展开更多
The study was conducted at the Estonian Forensic Science Institute in 2008-2014 as continuous part of our previous study of alcohol and premature death in Estonian men.Autopsy data from 504 cases of male deaths (ages ...The study was conducted at the Estonian Forensic Science Institute in 2008-2014 as continuous part of our previous study of alcohol and premature death in Estonian men.Autopsy data from 504 cases of male deaths (ages 19-79) were collected and blood and urine samples for glycated haemoglobin (HbA1c),liver enzymes and alcohol concentration were analysed.The aim of our research was to find undiagnosed diabetes and diabetes risk cases postmortem on the basis of increased values of HbAlc.HbA1c was within the reference value 4.8%-5.9% (29-42 mmol/mol),in 88.1% (n =444) of cases,below reference value in 2.4% (n =12),in the risk group of diabetes,HbA1c 6.0%-6.4% (42-46 mmol/mol) was within 5.8% (n =29),and HbA1c result of ≥6.5% (48 mmol/mol) manifested in 3.8% (n =19) of cases.The higher the age,the more cases with HbA1c value ≥6.0% (42 mmol/mol) occurred.In the group of external causes of death (n =348),the HbAlc value of ≥6.5% (48 mmol/mol) HbA1c occurred in four cases.The HbA1c value was ≥6.5% (48 mmol/mol) in 78.9% of 156 cases when the cause of death was disease,of which 58% were cardiovascular diseases.The prevalence of diabetes and diabetes risk was found lower compared to population-based study,as majority of the deceased were young and middle-aged males and no females were included.In the case of poisoning with narcotic substances,HbA1c was within the reference range.A negative correlation occurred between alcohol intoxication and HbA1c value.A positive correlation between ALT and HbA1c was found-the higher stage of liver damage correlated with the higher HbA1c level.展开更多
基金supported by grants from National Key Technologies R&D Program (Grant No. 2008 BAI52B03 to X. Gao)the National Key Technologies R&D Program (Grant No. 2009BAI80B01 to H. Lin)the Major Project of Subject Construction of Shanghai Bureau of Health (Grant No.08GWZX0203 to X. Gao)
文摘Objective To investigate the optimal glycated haemoglobin （HbAlc） cut off points and evaluate the impact of HbAlc on diabetes and pre-diabetes in middle-aged and elderly population. Methods Subjects were recruited from Shanghai Changfeng Study. A total of 1 973 community-based participants （age_〉45） without known diabetes underwent oral glucose tolerance test （OG3-r） by using a 75-g oral glucose load and HbAlc was measured by using high performance liquid chromatography （HPLC）. Subjects were classified as normal glucose tolerance （NGT）, pre-diabetes（impaired glucose regulation, IGR） and new diagnosed diabetes （NDD） per 1999 WHO criteria. Two tests are compared with receiver operating characteristic curve （ROC）. Results Among 1973 subjects, 271 （13.7%） were diagnosed as NDD and 474 （24.0%） as IGR by using OGTT. HbAlc was 5.7%_＋0.7% in this population. Use of 6.5% as the HbAIC cutoff point has sensitivity of 38.7% and specificity of 98.5%. We recommend 6.0% as a better cutoff value for diagnosis of diabetes in this population （AUC 0.829, 95% CI 0.798-0.860, P〈0.001） with its sensitivity and specificity as 66.1% and 86.8%. For IGR, the results showed low sensitivity （44.9%） and specificity （66.7%） with an AUC of 0.571 for HbAlc when 5.8% was used as the cutoff point. Participants detected with HbAlc_〉6.0% were associated with nearly the same metabolic characteristics, including body mass index （BMI）, blood pressure, lipid profile and urine albumin-creatinine ratio （uACR） compared with diabetic subjects detected by OGTT. Conclusion The optimum HbAlc cutoff point for diabetes in our study population was lower than ADA criteria, and HbAlc may not be used to identify IGR.
基金We thank the survey respondents in all countries for their time and insights. Thecentres were: The Endocrine Center (Azerbaijan), Bangladesh Institute of Research andRehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM)(Bangladesh), Centro Vivir con Diabetes (Bolivia), CHU Yalgado Ouedraogo (BurkinaFaso), PNILMCNT - MSPLS (Burundi), Clinique Diabetique de Bangui (CentralAfrican Republic), MEMISA Belgique en RDC (Democratic Republic of Congo),Aprendiendo a Vivir (Dominican Republic), FUVIDA (Ecuador), Central HealthLaboratory (Eritrea), Ethiopian Diabetes Association (Ethiopia), Komfo AnokyeTeaching Hospital (Ghana), Asociacion Creciendo con Diabetes (Guatemala), GuyanaDiabetic Association (Guyana), FHADIMAC (Haiti), Diacare, Ahmedabad (India),Diabetes Association of Jamaica (Jamaica), Ganta United Methodist Hospital (Liberia),Diabetes Society of Maldives (Maldives), Santé Diabète (Mali), AMLCD (Mauritania),Federacion Mexicana de Diabetes (Mexico), Patan Hospital (Nepal), Lagos UniversityTeaching Hospital (Nigeria), Choe Kyong Tae Endocrine Research (North Korea),National Institute of Child Health (Pakistan), Cardinal Santos Medical Center(Philippines), Maison Bleue du Diabète (Republic of Congo), Rwandan Diabetes Association (Rwanda), Diabetes Association of Sri Lanka (Sri Lanka), St. LuciaDiabetes and Hypertension Association (St Lucia), National Republican EndocrinologyCentre (Tajikistan), Tanzanian Diabetes Association (Tanzania), Centre ATD dePrévention du Diabète (Togo), St Francis Hospital (Uganda), Endocrinological andDiabetes Association of Uzbekistan (Uzbekistan), and Hue Central Hospital (Vietnam).We also thank Jayanthi Maniam for assistance in submitting the manuscript.
文摘BACKGROUNDYoung people with type 1 diabetes in low-and-middle income countries facemany challenges in accessing care, with various essential supplies needed forsurvival and long-term health.AIMTo study insulin delivery devices and glycated haemoglobin (HbA1c) testing.METHODSA survey was conducted in 2019 of leading diabetes centres in 41 countriessupported by the Life for a Child Program. The survey covered numerous aspectsconcerning availability and costs at all levels of the health system, local usagepatterns and attitudes, obstacles, and other aspects.RESULTSThirty-seven countries returned the survey (90.2% response rate). Key findingsincluded: Syringe use was most common (83.1%), followed by insulin pens(16.7%) and pumps (0.2%). 48.6% of public health systems did not providesyringes, even with a co-payment. Use of suboptimal syringe/needlecombinations was common. Needles were generally reused in almost all countries(94.3%, n = 35). Aside from donated supplies, there was variable access to HbA1ctesting within public health facilities, and, when available, patients often had tocover the cost. Provision was further compromised by numerous problemsincluding stock-outs, and challenges with understanding the test, equipmentmaintenance, and refrigeration.CONCLUSIONLarge gaps exist for adequate access to appropriate insulin delivery devices andHbA1c testing. Public health systems in low-and-middle income countries shouldincrease affordable provision. There are also needs for specific health professional training and diabetes education;elimination of customs duties and taxes;development of inexpensive, robust HbA1c testing methods that do not requirerefrigeration of testing supplies;differential pricing schemes;and other solutions.
基金the University of Greenwich for financial support
文摘The effects of temperature,pH and long-term storage on the secondary structure and conformation changes of bovine haemoglobin（bHb） were studied using circular dichroism（CD） and ultraviolet-visible（UV-vis） spectroscopies.Neural network software was used to deconvolute the CD data to obtain the fractional content of the five secondary structures.The storage stability of bHb solutions in pH 6,7 and8 buffers was significantly higher at 4 ℃ than at 23 ℃ for the first 3 days.A complete denaturation of bHb was observed after 40 days irrespective of storage temperature or pH.The bHb solutions were also exposed to heating and cooling cycles between 25 and 65 ℃ and structural changes were followed by UVvis and CD spectroscopies.These experiments demonstrated that α-helix content of bHb decreased steadily with the increasing temperature above 35 ℃ at all pH values.The loss in a-helicity and gain in random coil conformations was pH-dependent and the greatest under alkaline conditions.Furthermore,there was minimal recovery of the secondary structure content upon cooling to 25 ℃.The use of bHb as a model drug is very common and this study elucidates the significance of storage and processing conditions on its stability.
基金Suppored by Science and Technol ogy Planning Project of Guangdong Province,China (2007B031505009)Science and Technology Planning project of Guangdong Province,China(2006B36008007)
文摘Objectives To detect whether persisting or transient glucose metabolism disorder is responsible for admission hyperglycemia in patients with acute myocardic infarction （AMI）. Methods Two groups of patients were enrolled： AMI group and control group. Fasting plasma glucose, 2 hours plasma glucose, glycated albumin（GA） and glycated haemoglobin （ HbA1 c） were measured at baseline in both groups and 30 days after AMI attack in AMI group. Results （ 1 ） There were no significant differences in baseline characteristics between both groups; （2） Compared with the control group, the levels of GA and HbA1 c in AMI group at baseline were significantly higher. （ 3 ） At 30 day follow-up in AMI group, both FBG and 2hPG decreased to normal values, HbA1 c did not change, but only GA kept on increasing. Conclusions Hyperglycemia on admission in patients with AMI resulted from both preexisting metabolic disorder and stress reaction as well. GA is the only indicator that could recall the exaggeration of glucose metabolic disorder during AMI attack at 30 day follow-up. （ S Chin J Cardiol 2009; 10（4） ： 186 -189）
文摘BACKGROUND Fixed ratio combinations(FRCs)of analogue basal insulin and glucagon-like peptide-1 receptor agonists are a newer addition to the therapeutic armamentarium for the management of type 2 diabetes mellitus.They reduce treatment complexity by combining two injectables in a single daily injectable,thus potentially improving adherence and persistence.Clinicians wanting to use FRCs would need to choose between members of the class.AIM To describe and contrast the glycated haemoglobin reduction of two FRCs of analogue basal insulin and glucagon like peptide-1 receptor agonist in adults with type 2 diabetes mellitus.METHODS The following Population,Intervention,Comparison,Outcome question was used for the primary analysis:Among adult patients with type 2 diabetes mellitus[P],what is the effect of iGlarLixi[I]compared to IDegLira[C]for bringing about glycaemic control(as measured by reduction in glycosylated haemoglobin)[O]?The Prisma Statement was used as a guideline for framing this systematic review.We searched PubMed,EMBASE and Cochrane library databases and Clinicaltrials.gov using various keywords and medical search headings related to type 2 diabetes mellitus,iGlarlixi,IDegLira and glycated haemoglobin A1c.RESULTS All 14 studies identified by the systematic search met the primary efficacy endpoint of reduction in glycated haemoglobin.There were no head-to-head studies between the FRCs of iGlarlixi and IDegLira,and we therefore did an indirect comparison based on a common comparator of insulin glargine U100.Both iGlarLixi and IDegLira effectively reduce glycated haemoglobin when compared to insulin glargine U100.However,using indirect comparisons,IDegLira had a greater haemoglobin A1c reducing ability(0.6%vs 0.3%).The indirect comparison is limited by the differences between the studies;the fasting blood glucose targets were slightly higher for iGlarLixi studies when compared to the IDegLira studies(4.0-5.0 mmol/L and 4.4-5.6 mmol/L),and the IDegLira study used a greater average dose of insulin glargine when compared to the iGlarLixi studies(66 U/d vs 40 U/d).CONCLUSION Both iGlarLixi and IDegLira effectively reduce glycated haemoglobin.Indirect comparisons,using insulin glargine as the common comparator,suggest that IDegLira reduces glycated haemoglobin to a greater extent than iGlarLixi.However,given the limitations of indirect comparisons,robust head to head studies and real-world data would better inform clinician choice and clinical practice guidelines.
基金supported by the Biomedical EPR Facility of the University of Essexgranted by the EPSRC funded UK National Service for Computational Chemistry Software(NSCCS,1996-2017)Imperial College London。
文摘One of the difficulties in creating a blood substitute on the basis of human haemoglobin(Hb) is the toxic nature of Hb when it is outside the safe environment of the red blood cells.The plasma protein haptoglobin(Hp) takes care of the Hb physiologically leaked into the plasma-it binds Hb and makes it much less toxic while retaining the Hb’s high oxygen transporting capacity.We used Electron Paramagnetic Resonance(EPR) spectroscopy to show that the protein bound radical induced by H2O2 in Hb and Hp-Hb complex is formed on the same tyrosine residue(s),but,in the complex,the radical is found in a more hydrophobic environment and decays slower than in unbound Hb,thus mitigating its oxidative capacity.The data obtained in this study might set new directions in engineering blood substitutes for transfusion that would have the oxygen transporting efficiency typical of Hb,but which would be non-toxic.
文摘Background: Anaemia is a common medical disorder in pregnancy especially in developing countries. Iron deficiency anaemia during pregnancy may be associated with adverse pregnancy outcomes Objectives: To?determine the cord blood haemoglobin and the correlation between maternal haemoglobin concentration and perinatal outcome at the University of Port Harcourt Teaching Hospital. Materials and Methods: This was a prospective cross-sectional study of 155 pregnant women who presented at the labour ward of the department of Obstetrics and Gynaecology from October 1, 2018 to December 31, 2018. Blood sample was collected from the women in labour into ethylenediamine tetra-acetic acid (EDTA) bottles, red blood cell haemoglobin was determined. Umbilical cord blood sample was also collected at delivery and red cell haemoglobin was done. Socio-demographic characteristics, risk factors and perinatal outcome were obtained, entered into a spreadsheet and analyzed using SPSS 22.0. Bivariate logistic regression analysis was performed for multivariate analysis and statistical significance was considered at p Results: The mean age of the women was 31.08 ± 4.39 years, the mean maternal haemoglobin concentration was 11.54 ± 1.86 g/dl while the mean umbilical cord haemoglobin concentration was 12.92 ± 1.92 g/dl. Majority (86.45%) of the women were compliant with the prescribed haematinics. Moderate anaemia was observed in 17.42% of the women, followed by mild anaemia (15.48%) and severe anaemia (1.29%) respectively. Maternal complications were observed in 24.5% of women. There was a significant association between maternal haemoglobin concentration and cord blood haemoglobin concentration (p = 0.001). However, the study did not show an association between parity, mode of delivery, birth weight, Apgar scores, gestational age and maternal haemoglobin concentration (p > 0.05). Conclusion: The mean Haemoglobin in our newborns was less than previously reported values. Cord blood haemoglobin decreases significantly with decreasing maternal haemoglobin, thus there is a linear relationship between maternal and cord blood haemoglobin.
文摘Background: There is scarcity of data on the actual frequency of routine blood work-up for patients on maintenance haemodialysis and how this affects the achievement of therapeutic goals in sub-Saharan Africa. This study aimed to review these in a referral hospital in Cameroon. Methods: A prospective hospital-based cohort study carried out from November 2019 to April 2020 including patients on maintenance haemodialysis in Douala general hospital. Patients were followed during 6 months to determine the frequency of monitoring of haemoglobin, serum calcium and phosphorus. Targeted values for haemoglobin were ≥10 g/dL, 80 - 100 mg/L for serum calcium and 25 - 45 mg/L for serum phosphorus. Pearson correlation test was used to define the correlation between monitoring frequencies and blood values at the end of the study. Results: For all 154 patients included in the study, the median frequency of monitoring for haemoglobin was once every 8 week (IQR: 6 - 12) and once every 12 weeks (IQR: 8 - 24) for serum calcium and phosphorus. The proportion of patients who achieved haemoglobin, serum calcium and phosphorus targets at the end of the study were 27.4%, 63% and 74% respectively. No correlation was found between the frequency of monitoring and the haemoglobin, serum phosphorus and calcium levels at the end of the study. Conclusion: The frequency of monitoring of serum haemoglobin, calcium and phosphorus by patients in this study was low with a high prevalence of patients not achieving target value.
文摘Introduction: One of the biological markers for monitoring glycaemic control in diabetic patients is glycated protein. The definition of a reference method to improve the accuracy of measurement tools is necessary. The aim of our study was to assess the glycemic control of diabetic patients based on glycated hemoglobin. Patients and Method: This is a descriptive cross-sectional study conducted in April 2021 at the national university hospital center (CNHU-HKM) of Cotonou. All patients who consulted during the period and who gave their consent were included. After collecting the blood samples according to the classical standards of the pre-analytical phase, we measured the blood glucose level and the HbA1c. Results: The mean blood glucose level of the patients was 1.52 ± 0.16 g/L with extremes of 0.80 g/L and 3.5 g/L. The mean HbA1c proportion was 8.39% ± 0.60% with a minimum and maximum value of 5.40% and 16% respectively. We also noted that the mean body mass index (BMI) of the patients was 28.61 ± 1.46 Kg/m<sup>2</sup> with extremes of 17.50 Kg/m<sup>2</sup> and 46.02 Kg/m<sup>2</sup>. Oral anti diabetic and hygienic-dietary measures were used by 44 patients (80%) and hygienic-dietary measures (HDM) only used by 9.09%. A frequency of 87.53% of patients had at least one degenerative complication. Retinopathy was the most observed degenerative disease (36.36%) followed by cardiovascular disease (25.45%). Conclusion: This study showed that there is a poor correlation between fasting blood glucose and glycated haemoglobin levels, which could be due to several biological and clinical reasons. It also showed that despite the respect of hygienic dietary measures and a well conducted treatment, it is difficult to obtain a satisfactory glycemic balance in obese patients.
文摘Introduction: Intraoperative blood loss remains as a concern for all surgeons. Proper estimation of intraoperative blood loss is critical and can be challenging, especially if the blood is mixed with other fluids such as tumescent fluid in liposuction cases. In such cases, proper estimation of intraoperative blood loss will lead to fewer mistakes in fluid resuscitation. In this article, Tallquist Haemoglobin Scale was tried to estimate intraoperative blood loss in liposuction. Objectives: Proper estimation of intraoperative blood loss in liposuction cases. Method: Tallquist Haemoglobin Scale will be tried to estimate the approximate intraoperative blood loss in liposuction cases using a mathematical formula that considers total fluid loss, patient’s preoperative haemoglobin and the reading from Tallquist kit. Results: Tallquist Haemoglobin Scale can be considered as a valid method for proper estimation of intraoperative blood loss in liposuction cases, the thing that will lead to correct fluid resuscitation and fewer complications. Conclusion: Proper estimation of intraoperative blood loss leads to fewer mistakes in fluid resuscitation and fewer related complications of under or overcorrection. Tallquist Haemoglobin scale is a trusted, cheap and fast method for proper estimation of intraoperative blood loss in liposuction cases.
文摘Background: Diabetes mellitus is a common disease and it is a major cause of morbidity;several studies indicate that diabetes is a likely under reported cause of death. Chromium’s is important trace element to control diabetes mellitus and metabolism of carbohydrate, lipid and protein. Objective: The purpose of this study was to understand the relationship between serum chromium, with HbA1c, Total cholesterol and Triglycerides among type 2 diabetes patients among diabetic patients. Methodology: This is cross-sectional study done in Jabber Abu Ezz Centre for treatment and care of diabetics in Khartoum—Sudan. Four hundred subjects were enrolled in this study;one hundred subjects were normal healthy as control group, and three hundred subjects diabetic patient type 2 as test group;demographic and biochemical data were collected;serum chromium, Glycosylated Haemoglobin (HbA1c), Total cholesterol Triglycerides, were determined by using NYCOCARD READER II, spectrophotometer (Biosystem 310) and spectrophotometer 210-VGP. Result: In this study there is significant parameters level means of FBS HbA1c, Total Cholesterol, Triglycerides and Chromium of the test groups when compared with healthy control groups subjects (P = 0.001, 0.018, 0.01, 0.011, 0.004), respectively. Significant negative correlation is between FBS, HbA1c, Total Cholesterol, Triglycerides and Chromium (r = ?0.555, P value = 0.003), (r = ?0.668, P value = 0.002), (r = ?0.335, P value = 0.004) and (r = ?0.774, P value = 0.002) respectively. Conclusion: There was significant correlation between serum Chromium level with fasting blood sugaer, Glycosylated Haemoglobin (HbA1c), Total cholesterol and Triglycerides among type 2 diabetes patients.
文摘Glutathionyl-haemoglobin (Hb-SSG) is a minor form of haemoglobin characterized by the presence of a disulfide bond between the β-93 cysteine residue and the thiol group of glutathione. Hb-SSG is naturally present in the erythrocytes at levels comparable to those of glycated haemoglobin and can be measured by MALDI mass spectrometry on very small samples of erythrocytes from peripheral blood. Since Hb-SSG has been recognized as a sensitive biomarker of oxidative stress in several degenerative diseases (diabetes, hyperlipidemia, kidney disease) and in healthy workers exposed to glutathione-depleting toxic agents such as butadiene, we have measured for the first time the levels of Hb-SSG in two groups: healthy heavy cigarette smokers and overweight-obese. For both classes of subjects, the measured levels (6.4%±1.7%, n=30 for smokers;3.0%±0.8%, n=20 for overweight-obese) are in the upper 97thpercentile of those measured in the Italian general population. Levels in smokers show a small, yet statistically significant dependence on the level of smoking addiction (>20 cig./day vs. ￡20 cig./day: 7.0% ± 1.4% vs. 5.7% ± 1.1%;p < 0.05). This biomarker thus adds to those presently available to rationally assess the extent of biological damage caused by tobacco smoking.
基金This study was supported by Inonu University Scientific Research Projects Coordination Unit(project number:2012-192).
文摘Objectives:This study used Deinococcus radiodurans,which is extremely resistant to oxidative damage,genotoxic chemicals,high levels of ionising and ultraviolet radiation and drying,and its Vitreoscilla haemoglobin(vgb)gene-cloned recombinant with the vgb−recombinant strain as a control.In addition to the conditions wherein bacteria have an optimum Cr(Ⅲ)biosorption capacity,the contribution of the vgb gene to the biosorption ability of the bacteria has been investigated by providing the organism with a more oxygenic environment.Methods:Bacteria were produced and metal stock solution was prepared.To determine the Cr(Ⅲ)removal capacities of wild and recombinant D.radiodurans strains,the residual metal concentration in aqueous media at the beginning and after biosorption was determined in Atomic Absorption Spectrophotometer.Some optimal conditions were created for the biosorption conditions to occur.Conclusions:The optimisation tests showed that Cr(Ⅲ)reached the highest biosorption capacity within 15 minutes at a metal concentration of 2,000 ppm,30°C,pH 5.0 and 150 rpm stirring speed in all the three bacteria.The vgb gene had no significant contribution to the biosorption capacity.
基金This work was financially supported by China Agricultural Research System(CARS-46).
文摘A 12-week feeding trial was conducted to evaluate the effects of replacing fish meal by chicken haemoglobin powder in largemouth bass diets.Four isonitrogenous(48%)and isolipidic(12%)diets were formulated to replace 0%(control),9.80%,19.61%and 29.41%of fish meal with chicken haemoglobin powder.Each diet was fed to triplicate groups of fish(initial weight:49.50±0.07 g)twice daily.The fish specific growth rate was significantly reduced when diet replacement level was up to 19.61%,which may be related to the feed intake and apparent digestibility coefficient of protein and amino acids.Meanwhile,the feed efficiency ratio and protein efficiency ratio were not significantly decreased until the replacement level up to 29.41%.The activity of CCP was significantly reduced when 19.61%of fish meal was replaced.Meanwhile,the activity of lysozyme and serum protein content was significantly altered in fish fed with the diets up to 29.41%replacement.Additionally,the red blood cell count and haemoglobin content was significantly decreased when the replacement level was up to 19.61%.In overall,the diet with 9.80%of chicken haemoglobin powder was more suitable for largemouth bass.
基金This work was supported by the Estonian Science Founda-tion[grant number 0098P].
文摘The study was conducted at the Estonian Forensic Science Institute in 2008-2014 as continuous part of our previous study of alcohol and premature death in Estonian men.Autopsy data from 504 cases of male deaths (ages 19-79) were collected and blood and urine samples for glycated haemoglobin (HbA1c),liver enzymes and alcohol concentration were analysed.The aim of our research was to find undiagnosed diabetes and diabetes risk cases postmortem on the basis of increased values of HbAlc.HbA1c was within the reference value 4.8%-5.9% (29-42 mmol/mol),in 88.1% (n =444) of cases,below reference value in 2.4% (n =12),in the risk group of diabetes,HbA1c 6.0%-6.4% (42-46 mmol/mol) was within 5.8% (n =29),and HbA1c result of ≥6.5% (48 mmol/mol) manifested in 3.8% (n =19) of cases.The higher the age,the more cases with HbA1c value ≥6.0% (42 mmol/mol) occurred.In the group of external causes of death (n =348),the HbAlc value of ≥6.5% (48 mmol/mol) HbA1c occurred in four cases.The HbA1c value was ≥6.5% (48 mmol/mol) in 78.9% of 156 cases when the cause of death was disease,of which 58% were cardiovascular diseases.The prevalence of diabetes and diabetes risk was found lower compared to population-based study,as majority of the deceased were young and middle-aged males and no females were included.In the case of poisoning with narcotic substances,HbA1c was within the reference range.A negative correlation occurred between alcohol intoxication and HbA1c value.A positive correlation between ALT and HbA1c was found-the higher stage of liver damage correlated with the higher HbA1c level.
