Medicina

Editorial

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3 pages, 203 KiB

Open AccessEditorial

Diabetes, Hypertension and Cardiovascular Disease: Clinical Insights, Mechanisms and Pharmacotherapies

by Ming-Jui Hung

Medicina 2024, 60(4), 566; https://doi.org/10.3390/medicina60040566 - 30 Mar 2024

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Abstract

Cardiovascular disease (CVD) is a serious issue demanding world attention, not only because of its role in increased mortality, but also in conjunction with the aging population and growing prevalence of other co-morbidities, such as hypertension, diabetes, etc [...] Full article

(This article belongs to the Special Issue Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights, Mechanisms, and Pharmacotherapies)

Research

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19 pages, 1814 KiB

Open AccessArticle

The Role Played by Novel Inflammatory Markers in Assessment of Peripheral Artery Disease

by Viviana Onofrei, Adrian Crișan, Cristina Andreea Adam, Dragos Traian Marius Marcu, Mihai Ștefan Cristian Haba, Laura Carina Tribus, Alexandr Ceasovschih, Irina Mihaela Eșanu, Antoneta Dacia Petroaie, Radu Crișan-Dabija, Maria-Magdalena Leon-Constantin, Carmen Cumpăt and Florin Mitu

Medicina 2023, 59(9), 1557; https://doi.org/10.3390/medicina59091557 - 28 Aug 2023

Cited by 1 | Viewed by 1101

Abstract

Background and Objectives: Atherosclerosis is a multifactorial process in which inflammatory markers have both therapeutic and prognostic roles. Recent studies bring into question the importance of assessing new inflammatory markers in relation to the severity of peripheral artery disease (PAD), such as [...] Read more.

Background and Objectives: Atherosclerosis is a multifactorial process in which inflammatory markers have both therapeutic and prognostic roles. Recent studies bring into question the importance of assessing new inflammatory markers in relation to the severity of peripheral artery disease (PAD), such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-C-reactive protein ratio (LCR). Materials and Methods: We conducted a retrospective and descriptive study including 652 patients with PAD, who were divided into two groups according to the severity of the ankle–brachial index value: mild and moderate obstruction (257 patients) and severe obstruction (395 patients). We evaluated demographics, anthropometric data and clinical and paraclinical parameters in relation to the novel inflammatory biomarkers mentioned above. Results: Weight (p = 0.048), smoking (p = 0.033), the number of cardiovascular risk factors (p = 0.041), NLR (p = 0.037), LCR (p = 0.041) and PLR (p = 0.019), the presence of gangrene (p = 0.001) and the number of lesions detected via peripheral angiography (p < 0.001) were statistically significant parameters in our study. For the group of patients with severe obstruction, all three inflammatory biomarkers were statistically significantly correlated with a serum low-density lipoprotein–cholesterol level, the number of cardiovascular risk factors, rest pain, gangrene and a risk of amputation. In addition, directly proportional relationships were found between NLR, PLR and the number of stenotic lesions (p = 0.018, p = 0.016). Also, NLR (area under the curve <AUC> = 0.682, p = 0.010) and PLR (AUC = 0.692, p = 0.006) were predictors associated with a high risk of amputation in patients with an ABI < 0.5. Conclusions: in our study, we demonstrated the importance of assessing inflammatory markers in relation to the presence of cardiovascular risk factors through the therapeutic and prognostic value demonstrated in PAD. Full article

(This article belongs to the Special Issue Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights, Mechanisms, and Pharmacotherapies)

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13 pages, 504 KiB

Open AccessArticle

Effectiveness and Safety of Dabigatran Reversal with Idarucizumab in the Taiwanese Population: A Comparison Based on Eligibility for Inclusion in Clinical Trials

by Jhih-Wei Dai, Chien-Ho Wang, Chan-Lin Chu and Shu-Chen Liao

Medicina 2023, 59(5), 881; https://doi.org/10.3390/medicina59050881 - 04 May 2023

Cited by 4 | Viewed by 1527

Abstract

Background and Objectives: The effectiveness and safety of idarucizumab for the reversal of the effects of dabigatran have been proven. However, there remains a paucity of literature comprehensively investigating outcomes in real-world patients. This is especially true when comparing patients who were eligible [...] Read more.

Background and Objectives: The effectiveness and safety of idarucizumab for the reversal of the effects of dabigatran have been proven. However, there remains a paucity of literature comprehensively investigating outcomes in real-world patients. This is especially true when comparing patients who were eligible for inclusion in the RE-VERSE AD trial with patients who were ineligible. As the prescription of dabigatran has become increasingly popular, the generalizability of the results to real-world populations has come into question due to the broad variability of real-world patients receiving dabigatran. Our study aimed to identify all patients who were prescribed idarucizumab and examined how effectiveness and safety varied among those patients who were eligible and ineligible for the trial. Materials and Methods: This retrospective cohort study analyzed the largest medical database in Taiwan. We enrolled all patients who were prescribed and received idarucizumab from when it became available in Taiwan up until May 2021. A Total of 32 patients were included and analyzed, and they were further divided into subgroups based on their eligibility for inclusion in the RE-VERSE AD trial. Multiple outcomes were evaluated, including successful hemostasis rate, complete reversal efficacy of idarucizumab, 90-day thromboembolic events, intra-hospital mortality, and adverse event rate. Results: In our study, we found that 34.4% of real-world cases of idarucizumab use were ineligible for the RE-VERSE AD trials. The eligible group had higher successful hemostasis rates (95.2% vs. 80%) and anticoagulant effect reversal rates compared to the ineligible group (73.3% vs. 0%). The mortality rates were 9.5%, compared to 27.3% in the ineligible group. Few adverse effects (n = 3) and 90-day thromboembolic events (n = 1) were observed in either group. Among the ineligible cases, all acute ischemic stroke patients (n = 5) received definite, timely treatments without complications. Conclusions: Our study demonstrated the real-world effectiveness and safety of idarucizumab infusion for trial-eligible patients and all acute ischemic stroke patients. However, although it seems to be effective and safe, idarucizumab appears to be less effective in other trial-ineligible patients. Despite this result, our study provides further evidence for extending the applicability of idarucizumab in real-world scenarios. Our study suggests that idarucizumab can be a safe and effective option for reversing the anticoagulant effect of dabigatran, particularly for eligible patients. Full article

(This article belongs to the Special Issue Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights, Mechanisms, and Pharmacotherapies)

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14 pages, 604 KiB

Open AccessArticle

Associations of Three-Dimensional Anthropometric Body Surface Scanning Measurements and Coronary Artery Disease

by Ning-I Yang, Li-Tang Kuo, Chin-Chan Lee, Ming-Kuo Ting, I-Wen Wu, Shuo-Wei Chen and Kuang-Hung Hsu

Medicina 2023, 59(3), 570; https://doi.org/10.3390/medicina59030570 - 15 Mar 2023

Cited by 1 | Viewed by 1387

Abstract

Background and Objectives: The relationship between three-dimensional (3D) scanning-derived body surface measurements and biomarkers in patients with coronary artery disease (CAD) were assessed. Methods and Methods: The recruitment of 98 patients with CAD confirmed by cardiac catheterization and 98 non-CAD patients [...] Read more.

Background and Objectives: The relationship between three-dimensional (3D) scanning-derived body surface measurements and biomarkers in patients with coronary artery disease (CAD) were assessed. Methods and Methods: The recruitment of 98 patients with CAD confirmed by cardiac catheterization and 98 non-CAD patients were performed between March 2016 and December 2017. A health questionnaire on basic information, life style variables, and past medical and family history was completed. 3D body surface measurements and biomarkers were obtained. Differences between the two groups were assessed and multivariable analysis performed. Results: It was found that chest width (odds ratio [OR] 0.761, 95% confidence interval [CI] = 0.586–0.987, p = 0.0399), right arm length (OR 0.743, 95% CI = 0.632–0.875, p = 0.0004), waist circumference (OR 1.119, 95% CI = 1.035–1.21, p = 0.0048), leptin (OR 1.443, 95% CI = 1.184–1.76, p = 0.0003), adiponectin (OR 0.978, 95% CI = 0.963–0.994, p = 0.006), and interleukin 6 (OR 1.181, 95% CI = 1.021–1.366, p = 0.0254) were significantly associated with CAD. The combination of biomarker scores and body measurement scores had the greatest area under the curve and best association with CAD (area under the curve of 0.8049 and 95% CI = 0.7440–0.8657). Conclusions: Our study suggests that 3D derived body surface measurements in combination with leptin, adiponectin, and interleukin 6 levels may direct us to those at risk of CAD, allowing a non-invasive approach to identifying high-risk patients. Full article

(This article belongs to the Special Issue Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights, Mechanisms, and Pharmacotherapies)

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12 pages, 2093 KiB

Open AccessArticle

Optimal Heart Rate Control Improves Long-Term Prognosis of Decompensated Heart Failure with Reduced Ejection Fraction

by Ming-Lung Tsai, Shu-I Lin, Yu-Cheng Kao, Hsuan-Ching Lin, Ming-Shyan Lin, Jian-Rong Peng, Chao-Yung Wang, Victor Chien-Chia Wu, Chi-Wen Cheng, Ying-Hsiang Lee, Ming-Jui Hung and Tien-Hsing Chen

Medicina 2023, 59(2), 348; https://doi.org/10.3390/medicina59020348 - 12 Feb 2023

Cited by 3 | Viewed by 1636

Abstract

Background and Objectives: An elevated heart rate is an independent risk factor for cardiovascular disease; however, the relationship between heart rate control and the long-term outcomes of patients with heart failure with reduced ejection fraction (HFrEF) remains unclear. This study explored the long-term [...] Read more.

Background and Objectives: An elevated heart rate is an independent risk factor for cardiovascular disease; however, the relationship between heart rate control and the long-term outcomes of patients with heart failure with reduced ejection fraction (HFrEF) remains unclear. This study explored the long-term prognostic importance of heart rate control in patients hospitalized with HFrEF. Materials and Methods: We retrieved the records of patients admitted for decompensated heart failure with a left ventricular ejection fraction (LVEF) of ≤40%, from 1 January 2005 to 31 December 2019. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure (HHF) during follow-up. We analyzed the outcomes using Cox proportional hazard ratios calculated using the patients’ heart rates, as measured at baseline and approximately 3 months later. The mean follow-up duration was 49.0 ± 38.1 months. Results: We identified 5236 eligible patients, and divided them into five groups on the basis of changes in their heart rates. The mean LVEFs of the groups ranged from 29.1% to 30.6%. After adjustment for all covariates, the results demonstrated that lesser heart rate reductions at the 3-month screening period were associated with long-term cardiovascular death, HHF, and all-cause mortality (p for linear trend = 0.033, 0.042, and 0.003, respectively). The restricted cubic spline model revealed a linear relationship between reduction in heart rate and risk of outcomes (p for nonlinearity > 0.2). Conclusions: Greater reductions in heart rate were associated with a lower risk of long-term cardiovascular death, HHF, and all-cause mortality among patients discharged after hospitalization for decompensated HFrEF. Full article

(This article belongs to the Special Issue Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights, Mechanisms, and Pharmacotherapies)

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10 pages, 623 KiB

Open AccessArticle

Obesity Paradox among Heart Failure with Reduced Ejection Fraction Patients: A Retrospective Cohort Study

by Osama Abo Alrob, Sowndramalingam Sankaralingam, Sayer Alazzam, Buthaina Nusairat, Muhammad Qattoum and Mohammad B. Nusair

Medicina 2023, 59(1), 60; https://doi.org/10.3390/medicina59010060 - 28 Dec 2022

Cited by 3 | Viewed by 2019

Abstract

Background and Objectives: There is consensus on the negative effects of obesity on the development of heart failure. However, several studies have suggested that obesity may have paradoxical survival benefits in heart failure patients. Therefore, the aim of this study is to investigate [...] Read more.

Background and Objectives: There is consensus on the negative effects of obesity on the development of heart failure. However, several studies have suggested that obesity may have paradoxical survival benefits in heart failure patients. Therefore, the aim of this study is to investigate whether the obesity paradox exists in heart failure with reduced ejection fraction (HFrEF) patients in Jordan. Materials and Methods: In this retrospective cohort study, data were retrieved from electronic hospital records of heart failure patients admitted to King Abdullah University Hospital between January 2010 and January 2020. Patients were divided into five BMI (kg/m²) subgroups: (1) Less than 25.0, (2) Overweight 25.0–29.9, (3) Obese Class I 30.0–34.9, (4) Obese Class II 35.0–39.9, and (5) Obese Class III ≥40.0. Changes in patients’ clinical and echocardiographic parameters over one year were analyzed. Results: Data of a total of 297 patients were analyzed to determine the effect of obesity on heart failure. The mean age was 64.6 ± 12.4 years, and most patients (65.7%) were male. Among several co-morbidities, diabetes mellitus and hypertension were the most common and were present in 81.8% and 81.1% of patients, respectively. Over all patients, there was no significant change in EF after 1 year compared to baseline. However, only patients in the Obese Class I group had a statistically significant improvement in EF of 38.0 ± 9.81% vs. 34.8 ± 6.35% (p = 0.004) after 1 year. Importantly, among non-diabetic individuals, only Obese Class I patients had a significant (p < 0.001) increase in EF after 1 year compared to other BMI subgroups, a feature that was not observed among patients with diabetes. On the other hand, only Obese Class I patients with hypertension had a significant improvement (p < 0.05) in EF after 1 year compared to other BMI subgroups, a feature that was not observed among patients without hypertension. Conclusions: Our study demonstrates an inverted U-shaped relationship between BMI and EF such that patients with mild obesity (i.e., Obese Class I) had significant improvement in EF compared to those having a lower and higher BMI. We, therefore, suggest the existence of the obesity paradox among HFrEF patients in Jordan. Full article

(This article belongs to the Special Issue Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights, Mechanisms, and Pharmacotherapies)

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12 pages, 1377 KiB

Open AccessArticle

Subendocardial Viability Ratio Predictive Value for Cardiovascular Risk in Hypertensive Patients

by Viviana Aursulesei Onofrei, Alexandr Ceasovschih, Razvan Constantin Anghel, Mihai Roca, Dragos Traian Marius Marcu, Cristina Andreea Adam, Ovidiu Mitu, Carmen Cumpat, Florin Mitu, Adrian Crisan, Cristian Mihai Stefan Haba and Bogdan Artene

Medicina 2023, 59(1), 24; https://doi.org/10.3390/medicina59010024 - 22 Dec 2022

Cited by 10 | Viewed by 2042

Abstract

Background: The subendocardial viability ratio (SEVR), also known as the Buckberg index, is a parameter of arterial stiffness with indirect prognostic value in assessing long-term cardiovascular risk. Materials and Methods: We conducted a prospective cohort study on 70 patients with uncomplicated [...] Read more.

Background: The subendocardial viability ratio (SEVR), also known as the Buckberg index, is a parameter of arterial stiffness with indirect prognostic value in assessing long-term cardiovascular risk. Materials and Methods: We conducted a prospective cohort study on 70 patients with uncomplicated hypertension admitted to a county medical reference hospital. We analyzed demographics, laboratory data, arterial stiffness parameters and cardiovascular risk scores (SCORE and Framingham risk scores) and aimed to identify paraclinical parameters associated with increased cardiovascular risk. Results: Of the arterial stiffness parameters, SEVR correlates statistically significantly with age, central and peripheral systolic blood pressure, as well as with heart rate. SEVR seems to have prognostic value among hypertensive patients by increasing the risk of major cardiovascular events assessed by SCORE and Framingham risk scores. SEVR correlates statistically significantly with serum fibrinogen (p = 0.02) and hemoglobin (p = 0.046). Between pulse wave velocity and lipid parameters (p = 0.021 for low-density lipoprotein cholesterol <LDL> and p = 0.030 for triglycerides) a statistically significant relationship was found for the study group. The augmentation index of the aorta also correlated with serum LDL-cholesterol (p = 0.032) and the hemoglobin levels (p = 0.040) of hypertensive patients. Conclusions: Age, abdominal circumference and Framingham score are independent predictors for SEVR in our study group, further highlighting the need for early therapeutic measures to control risk factors in this category of patients. Full article

(This article belongs to the Special Issue Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights, Mechanisms, and Pharmacotherapies)

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Review

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12 pages, 305 KiB

Open AccessReview

A Review and Meta-Analysis of the Safety and Efficacy of Using Glucagon-like Peptide-1 Receptor Agonists

by En-Hao Hu, Ming-Lung Tsai, Yuan Lin, Tien-Shin Chou and Tien-Hsing Chen

Medicina 2024, 60(3), 357; https://doi.org/10.3390/medicina60030357 - 21 Feb 2024

Cited by 1 | Viewed by 1256

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been used to reduce glucose levels in patients with type 2 diabetes mellitus since 2005. This meta-analysis discusses the mechanisms and potential benefits of several GLP-1 RAs. In particular, this meta-analysis focuses on the safety and [...] Read more.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been used to reduce glucose levels in patients with type 2 diabetes mellitus since 2005. This meta-analysis discusses the mechanisms and potential benefits of several GLP-1 RAs. In particular, this meta-analysis focuses on the safety and associations with weight loss, glucose reduction, cardiovascular outcomes, heart failure, and renal outcomes of GLP-1 RAs to determine their benefits for patients with different conditions. In terms of glycemic control and weight loss, semaglutide was statistically superior to other GLP-1 RAs. In terms of cardiovascular outcomes, 14 mg of semaglutide taken orally once daily and 1.8 mg of liraglutide injected once daily reduced the incidence of cardiovascular death, whereas other GLP-1 RAs did not provide similar benefits. Moreover, semaglutide was associated with superior outcomes for heart failure and cardiovascular death in non-diabetic obesity patients, whereas liraglutide worsened heart failure outcomes in diabetic patients with a reduced ejection fraction. Additionally, semaglutide, dulaglutide, and liraglutide were beneficial in terms of composite renal outcomes: These GLP-1 RAs were significantly associated with less new or persistent macroalbuminuria, but not with improved eGFR deterioration or reduced requirement for renal replacement therapy. However, GLP-1 RAs may benefit patients with type 2 diabetes mellitus or obesity. Full article

(This article belongs to the Special Issue Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights, Mechanisms, and Pharmacotherapies)

12 pages, 702 KiB

Open AccessReview

Urinary microRNA in Diabetic Kidney Disease: A Literature Review

by Chin-Chan Lee, Chia-Chun Chen, Cheng-Kai Hsu, Yih-Ting Chen, Chun-Yu Chen, Kai-Jie Yang, Ming-Jui Hung and I-Wen Wu

Medicina 2023, 59(2), 354; https://doi.org/10.3390/medicina59020354 - 13 Feb 2023

Cited by 4 | Viewed by 2119

Abstract

Diabetic kidney disease is the most common primary disease of end-stage kidney disease globally; however, a sensitive and accurate biomarker to predict this disease remains awaited. microRNAs are endogenous single-stranded noncoding RNAs that have intervened in different post-transcriptional regulations of various cellular biological [...] Read more.

Diabetic kidney disease is the most common primary disease of end-stage kidney disease globally; however, a sensitive and accurate biomarker to predict this disease remains awaited. microRNAs are endogenous single-stranded noncoding RNAs that have intervened in different post-transcriptional regulations of various cellular biological functions. Previous literatures have reported its potential role in the pathophysiology of diabetic kidney disease, including regulation of Transforming Growth Factor-β1-mediated fibrosis, extracellular matrix and cell adhesion proteins, cellular hypertrophy, growth factor, cytokine production, and redox system activation. Urinary microRNAs have emerged as a novel, non-invasive liquid biopsy for disease diagnosis. In this review, we describe the available experimental and clinical evidence of urinary microRNA in the context of diabetic kidney disease and discuss the future application of microRNA in routine practice. Full article

(This article belongs to the Special Issue Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights, Mechanisms, and Pharmacotherapies)

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12 pages, 338 KiB

Open AccessReview

Relationship between Inflammation and Vasospastic Angina

by Ming-Yow Hung and Ming-Jui Hung

Medicina 2023, 59(2), 318; https://doi.org/10.3390/medicina59020318 - 09 Feb 2023

Cited by 4 | Viewed by 2151

Abstract

Coronary artery spasm (CAS) is a dynamic coronary stenosis causing vasospastic angina (VSA). However, VSA is a potentially lethal medical condition with multiple presentations, including sudden cardiac death. Despite investigations to explore its pathogenesis, no single mechanism has been found to explain the [...] Read more.

Coronary artery spasm (CAS) is a dynamic coronary stenosis causing vasospastic angina (VSA). However, VSA is a potentially lethal medical condition with multiple presentations, including sudden cardiac death. Despite investigations to explore its pathogenesis, no single mechanism has been found to explain the entire process of VSA occurrence. The roles of elevated local and systemic inflammation have been increasingly recognized in VSA. Treatment strategies to decrease local and systemic inflammation deserve further investigation. Full article

(This article belongs to the Special Issue Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights, Mechanisms, and Pharmacotherapies)

Other

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13 pages, 1351 KiB

Open AccessCase Report

Hypoglycemic Effect of an Herbal Decoction (Modified Gangsimtang) in a Patient with Severe Type 2 Diabetes Mellitus Refusing Oral Anti-Diabetic Medication: A Case Report

by Sungjun Joo, Hyonjun Chun, Jisu Lee, Seungmin Seo, Jungmin Lee and Jungtae Leem

Medicina 2023, 59(11), 1919; https://doi.org/10.3390/medicina59111919 - 30 Oct 2023

Cited by 1 | Viewed by 1218

Abstract

There is growing interest in alternative therapies for type 2 diabetes mellitus (T2DM) because some patients refuse to receive conventional therapies. In East Asia, herbal medicines are often used to treat T2DM, and modified Gangsimtang (mGST) is prescribed to treat a condition called [...] Read more.

There is growing interest in alternative therapies for type 2 diabetes mellitus (T2DM) because some patients refuse to receive conventional therapies. In East Asia, herbal medicines are often used to treat T2DM, and modified Gangsimtang (mGST) is prescribed to treat a condition called wasting thirst (消渴), which resembles T2DM. This study reported the treatment of hyperglycemia using herbal medicines without oral hypoglycemic agents or insulin therapy. Case presentation: A 36-year-old man with obesity was diagnosed with T2DM four years prior to hospitalization and experienced blood glucose level reduction from 22.2–27.8 mmol/L (400–500 mg/dL) to 5.6–11.1 mmol/L (100–200 mg/dL) by using herbal medicines. He visited D Korean Medicine Hospital with chronic polydipsia and general weakness as chief complaints. He was diagnosed with T2DM on the basis of a hemoglobin A1c level of 11.7% and 2 h postprandial blood glucose level of >25.0 mmol/L (450 mg/dL). Moreover, he was diagnosed with a “dual deficiency of qi and yin” (氣陰兩虛) because of ordinary symptoms (素證). During his 30-day inpatient treatment, the patient received mGST 120 mL thrice daily; as a result, his postprandial blood glucose level decreased from 25.3 mmol/L (455 mg/dL) to 8.6 mmol/L (154 mg/dL), polydipsia decreased (visual analog scale score decreased from six to one), and triglyceride levels decreased from 11.7 mmol/L (1031 mg/dL) to 2.0 mmol/L (174 mg/dL). Plasma glucose levels remained stable for 6 months after the treatment, and no adverse events were observed over 200 days. We administered an herbal decoction to decrease plasma glucose levels without using oral hypoglycemic agents or insulin. Conclusions: Herbal decoctions such as mGST can reduce hyperglycemia in patients with T2DM who refuse conventional therapy. Full article

(This article belongs to the Special Issue Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights, Mechanisms, and Pharmacotherapies)

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18 pages, 5126 KiB

Open AccessSystematic Review

Effectiveness and Safety of Fufang Danshen Dripping Pill (Cardiotonic Pill) on Blood Viscosity and Hemorheological Factors for Cardiovascular Event Prevention in Patients with Type 2 Diabetes Mellitus: Systematic Review and Meta-Analysis

by Minji Wi, Yumin Kim, Cheol-Hyun Kim, Sangkwan Lee, Gi-Sang Bae, Jungtae Leem and Hongmin Chu

Medicina 2023, 59(10), 1730; https://doi.org/10.3390/medicina59101730 - 27 Sep 2023

Cited by 1 | Viewed by 2421

Abstract

Background and Objectives: Diabetes can cause various vascular complications. The Compounded Danshen-Dripping-Pill (CDDP) is widely used in China. This study aimed to analyze the effectiveness and safety of CDDP in the blood viscosity (BV) with type 2 diabetes mellitus (T2DM). Materials and [...] Read more.

Background and Objectives: Diabetes can cause various vascular complications. The Compounded Danshen-Dripping-Pill (CDDP) is widely used in China. This study aimed to analyze the effectiveness and safety of CDDP in the blood viscosity (BV) with type 2 diabetes mellitus (T2DM). Materials and Methods: We conducted a systematic search of seven databases from their inception to July 2022 for randomized controlled trials that used CDDP to treat T2DM. To evaluate BV, we measured low shear rate (LSR), high shear rate (HSR), and plasma viscosity (PV). Homocysteine and adiponectin levels were also assessed as factors that could affect BV. Results: We included 18 studies and 1532 patients with T2DM. Meta-analysis revealed that CDDP significantly reduced LSR (mean difference [MD] −2.74, 95% confidence interval [CI] −3.77 to −1.72), HSR (MD −0.86, 95% CI −1.08 to −0.63), and PV (MD −0.37, 95% CI −0.54 to −0.19) compared to controls. CDDP also reduced homocysteine (MD −8.32, 95% CI −9.05 to −7.58), and increased plasma adiponectin (MD 2.72, 95% CI 2.13 to 3.32). Adverse events were reported less frequently in the treatment groups than in controls. Conclusions: CDDP is effective in reducing BV on T2DM. However, due to the poor design and quality of the included studies, high-quality, well-designed studies are required in the future. Full article

(This article belongs to the Special Issue Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights, Mechanisms, and Pharmacotherapies)

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