Type 2 diabetes mellitus(T2DM)and post-transplant diabetes mellitus(PTDM)share a common pathophysiology.However,diabetes mellitus is a complex disease,and T2DM and PTDM have different etiologies.T2DM is a metabolic di...Type 2 diabetes mellitus(T2DM)and post-transplant diabetes mellitus(PTDM)share a common pathophysiology.However,diabetes mellitus is a complex disease,and T2DM and PTDM have different etiologies.T2DM is a metabolic disorder,characterized by persistent hyperglycemia,whereas PTDM is a condition of abnormal glucose tolerance,with variable onset after organ transplant.The KCNQ1 and KCNJ11 gene encode potassium channels,which mediate insulin secretion from pancreatic b-cells,and KCN gene mutations are correlated with the development of diabetes.However,no studies have been carried out to establish an association between KCNQ1 and KCNJ11 gene polymorphisms and T2DM and PTDM.Therefore,our study was aimed at the identification of the role of KCNQ1 and KCNJ11 gene polymorphisms associated with T2DM and the risk of developing PTDM in the Asian Indian population.We have carried out a caseecontrol study including 250 patients with T2DM,250 control subjects,42 patients with PTDM and 98 subjects with non-PTDM.PCR-RFLP analysis was carried out following the isolation of genomic DNA from EDTA-blood samples.The results of the present study reveal that two single nucleotide polymorphisms(rs2283228 and rs5210,of the KCNQ1 and KCNJ11 genes,respectively)are associated with both T2DM and PTDM.The results of our study suggest a role of KCNQ1 and KCNJ11 gene variants in the increased risk of T2DM and PTDM in the Asian Indian population.展开更多
South Asians have a high prevalence of coronary heart disease(CHD) and suffer from early-onset CHD compared to other ethnic groups. Conventional risk factors may not fully explain this increased CHD risk in this popul...South Asians have a high prevalence of coronary heart disease(CHD) and suffer from early-onset CHD compared to other ethnic groups. Conventional risk factors may not fully explain this increased CHD risk in this population. Indeed, South Asians have a unique lipid profile which may predispose them to premature CHD. Dyslipidemia in this patient population seems to be an important contributor to the high incidence of coronary atherosclerosis. The dyslipidemia in South Asians is characterized by elevated levels of triglycerides, low levels of high-density lipoprotein(HDL) cholesterol, elevated lipoprotein(a) levels, and a higher atherogenic particle burden despite comparable low-density lipoprotein cholesterol levels compared with other ethnic subgroups. HDL particles also appear to be smaller, dysfunctional, and proatherogenic in South Asians. Despite the rapid expansion of the current literature with better understanding of the specific lipid abnormalities in this patient population, studies with adequate sample sizes are needed to assess the significance and contribution of a given lipid parameter on overall cardiovascular risk in this population. Specific management goals and treatment thresholds do not exist for South Asians because of paucity of data. Current treatment recommendations are mostly extrapolated from Western guidelines. Lastly, large, prospective studies with outcomes data are needed to assess cardiovascular benefit associated with various lipid-lowering therapies(including combination therapy) in this patient population.展开更多
For a long time Indians have remained a mystery to people not only in America but also in other parts of the world.The little that is known about them certainly makes people want to know a great deal more. Indian'...For a long time Indians have remained a mystery to people not only in America but also in other parts of the world.The little that is known about them certainly makes people want to know a great deal more. Indian's unique culture,customs and values are exciting the immense interest of all. Under such circumstances the novel"! Heard the Owl Call My Name"written by Margaret Craven achieves much popularity and captures great attention of all. The focus of this paper is on the cultural conflict and reconciliation between Indians and the non-native people.展开更多
Endothelial dysfunction is the postulated link between coronary artery disease （CAD） and erectile dysfunction （ED）. Brachial artery flow-mediated vasodilatation （FMD） is a non-invasive surrogate marker for endot...Endothelial dysfunction is the postulated link between coronary artery disease （CAD） and erectile dysfunction （ED）. Brachial artery flow-mediated vasodilatation （FMD） is a non-invasive surrogate marker for endothelial function assessment. Despite Asian Indians representing a considerable global CAD burden, data on FMD and ED in these patients are lacking. Of the 225 patients undergoing coronary angiography, 72% had ED （assessed using the International Index of Erectile Function （IIEF-5） questionnaire）; ED was moderate to severe in 61% of the patients. ED patients had a higher incidence of severe and diffuse angiographic CAD, a greater number of coronary vessels involved and a lower mean brachial artery FMD （6.40%±4.60% vs. 9.10%±4.87%, P〈0.001） compared to non-ED patients. A progressive reduction in FMD was noted with increasing severity of ED. Impaired FMD （ ≤ 5.5%） was twice as common in ED patients （52% vs. 24% without ED）. Patients with impaired FMD had higher ED prevalence （85% vs. 62%） and lower mean I IEF-5 scores compared to those with normal FMD. Impaired FMD was a significant ED predictor independent of other risk factors （odds ratio, 2.33; 95% confidence interval： 0.59-9.23; P=0.03）. An inverse correlation between FMD and ED severity was observed （r=-0.22; P=0.004）. ED is common among Asian Indians with angiographically documented CAD. Patients with ED have impaired FMD independent of other risk factors, suggesting that endothelial dysfunction is the underlying pathophysiology. Urologists and cardiologists need to be aware of the association between ED, CAD and endothelial dysfunction.展开更多
Background and Aims: Psychometric hepatic encephalop-athy score(PHES)is used widely for diagnosis of minimal hepatic encephalopathy(MHE).This prospective study aimed to determine the utility of the inhibitory control ...Background and Aims: Psychometric hepatic encephalop-athy score(PHES)is used widely for diagnosis of minimal hepatic encephalopathy(MHE).This prospective study aimed to determine the utility of the inhibitory control test(ICT)for the diagnosis of MHE.Additionally,the efficacy of rifaximin and lactulose for reversal of MHE was evaluated.Methods:A total of 180 eligible cirrhotic patients underwent testing for MHE.When PHES was ≤ ?5 and ICT lures were ≥ 14,MHE was diagnosed.The 108 patients with MHE were randomized to three groups for treatment with either lactulose,rifaximin,or placebo.Treatment outcomes were measured at the end of 3 months.Results: The 108 patients with MHE diagnosed by PHES and/or ICT accounted for 60%.The diagnosis of MHE was made by both ICT and PHES positivity in 56 patients,by abnormal ICT and normal PHES in 37 patients,and by abnor-mal PHES and normal ICT in 15 patients.For diagnosis of MHE,ICT had sensitivity of 78.87%,specificity of 66.06%with 60.22%positive predictive value and 82.76%negative predictive value.An area under the curve value of 0.724(95%CI: 0.653–0.788)was obtained for diagnosis of MHE.Reversal of MHE was seen in 71.42%,70.27%and 11.11%of patients in the rifaximin,lactulose and placebo arms(p < 0.001).Rifaximin showed better tolerability compared to lactulose.Conclusions: For the diagnosis of MHE,ICT is a simple tool but has lower sensitivity and better specificity than PHES.Rifaximin is as efficacious as lactulose in the treat-ment of MHE and better tolerated.展开更多
AIM:To assess the predisposition for cardiovascular diseases among young Asian Indians by anthropometric data analysis.METHODS:One hundred and thirty males and 329 females aged between 15 and 26 years,attending health...AIM:To assess the predisposition for cardiovascular diseases among young Asian Indians by anthropometric data analysis.METHODS:One hundred and thirty males and 329 females aged between 15 and 26 years,attending health care check-ups at VIT University,were included in this study.Their body mass index,systolic and diastolic blood pressure,waist circumference,waist-to-hip ratio,pulse rate and pressure,along with mean arterial pressure,were measured and the data analyzed as per World Health Organization guidelines.RESULTS:Based on the analysis,54% of the male population was found to be predisposed to cardiovascular disease.Of these,approximately 40% were at highest possible risk,with greater than threshold values of body mass index,waist circumference and waist-to-hip ratio.Females were found to have lower risk.Both genders showed significant correlation(P < 0.0001) between body mass index and waist circumference.Waist-to-hip ratio correlated significantly only in males with the former index whereas it correlated significantly with waist circumference in both genders.Receiver operating curve analysis,when performed,showed optimal sensitivity and specificity for body mass index and waist circumference.CONCLUSION:The above results indicate that seeds of cardiovascular disease may have been sown at a young age in Asian Indian populations.Interventional measures are advised to prevent accelerated atherosclerosis leading to premature cardiovascular disease.展开更多
<strong>Background:</strong> <span style="font-family:""><span style="font-family:Verdana;">Prenatal exposure to alcohol and tobacco are both associated with increased ...<strong>Background:</strong> <span style="font-family:""><span style="font-family:Verdana;">Prenatal exposure to alcohol and tobacco are both associated with increased risk for adverse outcomes. American Indians experience disproportionate rates of adverse birth outcomes. The Indian people living in the Great Plains Area of the Indian Health Services have increased exposure to alcohol and smoking during pregnancy. This study aims to assess the relationship between prenatal alcohol and tobacco exposure and early hospitalization in a rural Tribal Nation. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">We used data from the prospective Safe Passage Study on pregnancies and hospitalizations within the first year of life. The relationship between time to hospitalization and prenatal tobacco/alcohol exposure, maternal demographics, post-traumatic stress disorder and depression were evaluated. The analysis utilized Chi-square tests. Kaplan-Meier curves were used to estimate the likelihood of hospitalization during the first year of life by substance use category. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">From a sample of </span><span style="font-family:Verdana;">432 infants, we identified 260 (60.2%) who had a hospitalization. We found </span><span style="font-family:Verdana;">no significant effect from </span></span><span style="font-family:Verdana;">that </span><span style="font-family:Verdana;">if mother drank, amount drank, amoun</span><span style="font-family:Verdana;">t smoked or if mother smoked, on the risk of hospitalization. We did identify an effect for exposure to alcohol or smoking and age to hospitalization. Exposure was associated with younger age at hospitalization. However, after controlling for mother</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s age, this effect was not significant. Mother</span><span style="font-family:Verdana;">’</span><span style=展开更多
There have been controversies over differing opinions in the source of the American Indians. In this paper, the writer criticized the so-called classical theory that the remote ancestors of the American Indians entere...There have been controversies over differing opinions in the source of the American Indians. In this paper, the writer criticized the so-called classical theory that the remote ancestors of the American Indians entered America from Asia through the Bering Straits 14,000 ~ 20,000 years ago, worn their “clothes” and carried kindling during the late Paleolithic, no matter how by “boat” across the Bering Sea or by foot through a “Bering Land Bridge” which might once link up Asia and North America during glacial period;and independently proposed a new hypothesis that American Indians might be originated from the Western Rift Valley of North America. On the basis of locus distribution of American ancient human’s remnants, the writer pointed out that American ancient humans might be first originated at Yukon Territory of Canada within the Western Rift Valley of North America (the Basin & Range Province), and then migrated south ward (Yukon Territory → Mojave Desert → Mexico → Peru → Chile). Moreover, American Indians would have long been a presence for 40,000 years, or even 100,000 ~ 200,000 years in the American continents. So far, the logical basis which American Indians came from Asia 14,000 ~ 20,000 years ago was crushed, and derived two inferences: 1) American Indians might be originated from the Western Rift Valley of North America;2) Only the Eskimo might be the mover eastward from Asia, because of their gene B.展开更多
Cardiovascular diseases (CVD) are the leading cause of mortality necessitating its early detection. The emergence of newer subclinical biomarkers in addition to the known cardiometabolic risk factors may play an impor...Cardiovascular diseases (CVD) are the leading cause of mortality necessitating its early detection. The emergence of newer subclinical biomarkers in addition to the known cardiometabolic risk factors may play an important role in early detection of CVD risk. In the present study, 74 adult females (30 -?75 y) with metabolic syndrome (MS) were selected and additional biochemical parameters such as C-reactive protein (CRP) and Homocysteine (Hcy) levels were analyzed. The average body mass index (BMI) and waist circumference of subjects were found to be 30 kg/m2 and99 cmrespectively. Mean LDL levels were found to be much higher than normal (139 mg/dl) while the HDL levels were low (41.5 mg/dl). The average fasting blood sugar and insulin levels were within the normal range. However, 40.5% females had serum Hcy levels >13.2 μmol/l and 59.5% women had CRP levels >3 mg/L indicating increased risk of CVD. Higher Hcy levels were associated with hyperinsulinemia (p < 0.01) and hyperglycemia (p < 0.05), indicating predilection for glucose intolerance. CRP levels showed significant negative correlation with HDL (p < 0.05), indicating a predilection for glucose intolerance. The present study reports overall more than 40% MS women are classified as high risk group using the Western standards. Limited data on normal levels of inflammatory biomarkers are available for Asian Indians. The study results indicate the importance of Hcy and CRP values among females having metabolic syndrome, known to be at a high risk of CVD.展开更多
基金We are grateful to the ICMR for providing the SRF scholarship to Imran Ali Khan MohammedThis work was funded by the Indian Council of Medical Research(Sanction no.5-3-8-39-2007,RHN).
文摘Type 2 diabetes mellitus(T2DM)and post-transplant diabetes mellitus(PTDM)share a common pathophysiology.However,diabetes mellitus is a complex disease,and T2DM and PTDM have different etiologies.T2DM is a metabolic disorder,characterized by persistent hyperglycemia,whereas PTDM is a condition of abnormal glucose tolerance,with variable onset after organ transplant.The KCNQ1 and KCNJ11 gene encode potassium channels,which mediate insulin secretion from pancreatic b-cells,and KCN gene mutations are correlated with the development of diabetes.However,no studies have been carried out to establish an association between KCNQ1 and KCNJ11 gene polymorphisms and T2DM and PTDM.Therefore,our study was aimed at the identification of the role of KCNQ1 and KCNJ11 gene polymorphisms associated with T2DM and the risk of developing PTDM in the Asian Indian population.We have carried out a caseecontrol study including 250 patients with T2DM,250 control subjects,42 patients with PTDM and 98 subjects with non-PTDM.PCR-RFLP analysis was carried out following the isolation of genomic DNA from EDTA-blood samples.The results of the present study reveal that two single nucleotide polymorphisms(rs2283228 and rs5210,of the KCNQ1 and KCNJ11 genes,respectively)are associated with both T2DM and PTDM.The results of our study suggest a role of KCNQ1 and KCNJ11 gene variants in the increased risk of T2DM and PTDM in the Asian Indian population.
基金Supported by The American Heart Association Beginning Grant--in--Aid,No.14BGIA20460366the American Diabetes Association Clinical Science and Epidemiology award,No.1-14-CE-44the Baylor College of Medicine Center for Globalization Award
文摘South Asians have a high prevalence of coronary heart disease(CHD) and suffer from early-onset CHD compared to other ethnic groups. Conventional risk factors may not fully explain this increased CHD risk in this population. Indeed, South Asians have a unique lipid profile which may predispose them to premature CHD. Dyslipidemia in this patient population seems to be an important contributor to the high incidence of coronary atherosclerosis. The dyslipidemia in South Asians is characterized by elevated levels of triglycerides, low levels of high-density lipoprotein(HDL) cholesterol, elevated lipoprotein(a) levels, and a higher atherogenic particle burden despite comparable low-density lipoprotein cholesterol levels compared with other ethnic subgroups. HDL particles also appear to be smaller, dysfunctional, and proatherogenic in South Asians. Despite the rapid expansion of the current literature with better understanding of the specific lipid abnormalities in this patient population, studies with adequate sample sizes are needed to assess the significance and contribution of a given lipid parameter on overall cardiovascular risk in this population. Specific management goals and treatment thresholds do not exist for South Asians because of paucity of data. Current treatment recommendations are mostly extrapolated from Western guidelines. Lastly, large, prospective studies with outcomes data are needed to assess cardiovascular benefit associated with various lipid-lowering therapies(including combination therapy) in this patient population.
文摘For a long time Indians have remained a mystery to people not only in America but also in other parts of the world.The little that is known about them certainly makes people want to know a great deal more. Indian's unique culture,customs and values are exciting the immense interest of all. Under such circumstances the novel"! Heard the Owl Call My Name"written by Margaret Craven achieves much popularity and captures great attention of all. The focus of this paper is on the cultural conflict and reconciliation between Indians and the non-native people.
文摘Endothelial dysfunction is the postulated link between coronary artery disease （CAD） and erectile dysfunction （ED）. Brachial artery flow-mediated vasodilatation （FMD） is a non-invasive surrogate marker for endothelial function assessment. Despite Asian Indians representing a considerable global CAD burden, data on FMD and ED in these patients are lacking. Of the 225 patients undergoing coronary angiography, 72% had ED （assessed using the International Index of Erectile Function （IIEF-5） questionnaire）; ED was moderate to severe in 61% of the patients. ED patients had a higher incidence of severe and diffuse angiographic CAD, a greater number of coronary vessels involved and a lower mean brachial artery FMD （6.40%±4.60% vs. 9.10%±4.87%, P〈0.001） compared to non-ED patients. A progressive reduction in FMD was noted with increasing severity of ED. Impaired FMD （ ≤ 5.5%） was twice as common in ED patients （52% vs. 24% without ED）. Patients with impaired FMD had higher ED prevalence （85% vs. 62%） and lower mean I IEF-5 scores compared to those with normal FMD. Impaired FMD was a significant ED predictor independent of other risk factors （odds ratio, 2.33; 95% confidence interval： 0.59-9.23; P=0.03）. An inverse correlation between FMD and ED severity was observed （r=-0.22; P=0.004）. ED is common among Asian Indians with angiographically documented CAD. Patients with ED have impaired FMD independent of other risk factors, suggesting that endothelial dysfunction is the underlying pathophysiology. Urologists and cardiologists need to be aware of the association between ED, CAD and endothelial dysfunction.
文摘Background and Aims: Psychometric hepatic encephalop-athy score(PHES)is used widely for diagnosis of minimal hepatic encephalopathy(MHE).This prospective study aimed to determine the utility of the inhibitory control test(ICT)for the diagnosis of MHE.Additionally,the efficacy of rifaximin and lactulose for reversal of MHE was evaluated.Methods:A total of 180 eligible cirrhotic patients underwent testing for MHE.When PHES was ≤ ?5 and ICT lures were ≥ 14,MHE was diagnosed.The 108 patients with MHE were randomized to three groups for treatment with either lactulose,rifaximin,or placebo.Treatment outcomes were measured at the end of 3 months.Results: The 108 patients with MHE diagnosed by PHES and/or ICT accounted for 60%.The diagnosis of MHE was made by both ICT and PHES positivity in 56 patients,by abnormal ICT and normal PHES in 37 patients,and by abnor-mal PHES and normal ICT in 15 patients.For diagnosis of MHE,ICT had sensitivity of 78.87%,specificity of 66.06%with 60.22%positive predictive value and 82.76%negative predictive value.An area under the curve value of 0.724(95%CI: 0.653–0.788)was obtained for diagnosis of MHE.Reversal of MHE was seen in 71.42%,70.27%and 11.11%of patients in the rifaximin,lactulose and placebo arms(p < 0.001).Rifaximin showed better tolerability compared to lactulose.Conclusions: For the diagnosis of MHE,ICT is a simple tool but has lower sensitivity and better specificity than PHES.Rifaximin is as efficacious as lactulose in the treat-ment of MHE and better tolerated.
文摘AIM:To assess the predisposition for cardiovascular diseases among young Asian Indians by anthropometric data analysis.METHODS:One hundred and thirty males and 329 females aged between 15 and 26 years,attending health care check-ups at VIT University,were included in this study.Their body mass index,systolic and diastolic blood pressure,waist circumference,waist-to-hip ratio,pulse rate and pressure,along with mean arterial pressure,were measured and the data analyzed as per World Health Organization guidelines.RESULTS:Based on the analysis,54% of the male population was found to be predisposed to cardiovascular disease.Of these,approximately 40% were at highest possible risk,with greater than threshold values of body mass index,waist circumference and waist-to-hip ratio.Females were found to have lower risk.Both genders showed significant correlation(P < 0.0001) between body mass index and waist circumference.Waist-to-hip ratio correlated significantly only in males with the former index whereas it correlated significantly with waist circumference in both genders.Receiver operating curve analysis,when performed,showed optimal sensitivity and specificity for body mass index and waist circumference.CONCLUSION:The above results indicate that seeds of cardiovascular disease may have been sown at a young age in Asian Indian populations.Interventional measures are advised to prevent accelerated atherosclerosis leading to premature cardiovascular disease.
文摘<strong>Background:</strong> <span style="font-family:""><span style="font-family:Verdana;">Prenatal exposure to alcohol and tobacco are both associated with increased risk for adverse outcomes. American Indians experience disproportionate rates of adverse birth outcomes. The Indian people living in the Great Plains Area of the Indian Health Services have increased exposure to alcohol and smoking during pregnancy. This study aims to assess the relationship between prenatal alcohol and tobacco exposure and early hospitalization in a rural Tribal Nation. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">We used data from the prospective Safe Passage Study on pregnancies and hospitalizations within the first year of life. The relationship between time to hospitalization and prenatal tobacco/alcohol exposure, maternal demographics, post-traumatic stress disorder and depression were evaluated. The analysis utilized Chi-square tests. Kaplan-Meier curves were used to estimate the likelihood of hospitalization during the first year of life by substance use category. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">From a sample of </span><span style="font-family:Verdana;">432 infants, we identified 260 (60.2%) who had a hospitalization. We found </span><span style="font-family:Verdana;">no significant effect from </span></span><span style="font-family:Verdana;">that </span><span style="font-family:Verdana;">if mother drank, amount drank, amoun</span><span style="font-family:Verdana;">t smoked or if mother smoked, on the risk of hospitalization. We did identify an effect for exposure to alcohol or smoking and age to hospitalization. Exposure was associated with younger age at hospitalization. However, after controlling for mother</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s age, this effect was not significant. Mother</span><span style="font-family:Verdana;">’</span><span style=
文摘There have been controversies over differing opinions in the source of the American Indians. In this paper, the writer criticized the so-called classical theory that the remote ancestors of the American Indians entered America from Asia through the Bering Straits 14,000 ~ 20,000 years ago, worn their “clothes” and carried kindling during the late Paleolithic, no matter how by “boat” across the Bering Sea or by foot through a “Bering Land Bridge” which might once link up Asia and North America during glacial period;and independently proposed a new hypothesis that American Indians might be originated from the Western Rift Valley of North America. On the basis of locus distribution of American ancient human’s remnants, the writer pointed out that American ancient humans might be first originated at Yukon Territory of Canada within the Western Rift Valley of North America (the Basin & Range Province), and then migrated south ward (Yukon Territory → Mojave Desert → Mexico → Peru → Chile). Moreover, American Indians would have long been a presence for 40,000 years, or even 100,000 ~ 200,000 years in the American continents. So far, the logical basis which American Indians came from Asia 14,000 ~ 20,000 years ago was crushed, and derived two inferences: 1) American Indians might be originated from the Western Rift Valley of North America;2) Only the Eskimo might be the mover eastward from Asia, because of their gene B.
文摘Cardiovascular diseases (CVD) are the leading cause of mortality necessitating its early detection. The emergence of newer subclinical biomarkers in addition to the known cardiometabolic risk factors may play an important role in early detection of CVD risk. In the present study, 74 adult females (30 -?75 y) with metabolic syndrome (MS) were selected and additional biochemical parameters such as C-reactive protein (CRP) and Homocysteine (Hcy) levels were analyzed. The average body mass index (BMI) and waist circumference of subjects were found to be 30 kg/m2 and99 cmrespectively. Mean LDL levels were found to be much higher than normal (139 mg/dl) while the HDL levels were low (41.5 mg/dl). The average fasting blood sugar and insulin levels were within the normal range. However, 40.5% females had serum Hcy levels >13.2 μmol/l and 59.5% women had CRP levels >3 mg/L indicating increased risk of CVD. Higher Hcy levels were associated with hyperinsulinemia (p < 0.01) and hyperglycemia (p < 0.05), indicating predilection for glucose intolerance. CRP levels showed significant negative correlation with HDL (p < 0.05), indicating a predilection for glucose intolerance. The present study reports overall more than 40% MS women are classified as high risk group using the Western standards. Limited data on normal levels of inflammatory biomarkers are available for Asian Indians. The study results indicate the importance of Hcy and CRP values among females having metabolic syndrome, known to be at a high risk of CVD.
