المؤلفون: Kata Čulina, Martina Tomić, Tomislav Bulum, Aleksej Medić, Ivan Šoša, Kristina Ivanišević, Tomislav Jukić

المصدر: Life, Vol 14, Iss 6, p 655 (2024)

مصطلحات موضوعية: corneal hysteresis, corneal resistance factor, cataract surgery, preoperative and postoperative astigmatism, Science

الوصف: This study aimed to investigate the impact of the cornea’s biomechanical properties, corneal hysteresis (CH), and corneal resistance factor (CRF) on postoperative astigmatism after cataract surgery and determine the other factors that influence it. Forty eyes of 40 patients (13M/27F; the median age of 74) were included in this prospective study, underwent 2.75 mm incision cataract surgery, and were followed for 30 days. Visits were scheduled at baseline before surgery (V0), the 1st (V1), the 7th (V2), and the 30th (V3) postoperative days. The main parameters estimated and analyzed with Statistica® 14.0.1 were CH, CRF, astigmatism diopter, and axis. Following the cataract surgery, the CH did not significantly change during the study visits (p = 0.109). However, there was a significant change in the CRF from baseline during the study visits (per protocol set) (p = 0.002). After a slight but insignificant increase from V0 to V1, post hoc analysis found a significant decrease in the mean CRF from V1 to V2 (p = 0.049) with no substantial change from V2 to V3. According to the post hoc analysis, the median astigmatism diopter increased significantly only from V0 to V1 (p = 0.001) and slightly but not significantly decreased to the end of the study with the achievement of a near-baseline value. The main predictors for the final astigmatism diopter (R2 = 0.898) obtained by stepwise regression analysis were its values at V0, V1, and V2 (p < 0.001). The CRF at V1 was marginally significant, with a negative parameter estimate of −0.098303 (p = 0.0623). In conclusion, there was no correlation between preoperative CH and CRF and postoperative astigmatism using 2.75 mm incision cataract surgery. However, the final astigmatism diopter’s main predictors were its baseline values before cataract surgery, the first, and the seventh postoperative days.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2075-1729/14/6/655Test; https://doaj.org/toc/2075-1729Test

الوصول الحر: https://doaj.org/article/87728b869f524c9287d58cf18e7d214dTest

المؤلفون: Vesna Đermanović Dobrota, Neva Brkljačić, Angelika Tičinović Ivančić, Maja Čavlović, Tomislav Bulum, Martina Tomić

المصدر: Metabolites, Vol 14, Iss 1, p 59 (2024)

مصطلحات موضوعية: carotid artery stenosis, atherosclerosis, type 2 diabetes, ankle brachial index, Microbiology, QR1-502

الوصف: Type 2 diabetes mellitus (T2DM) significantly increases the risk of atherosclerotic cardiovascular disease. Ankle brachial index (ABI) and carotid artery stenosis are non-invasive indicators of generalized atherosclerosis. This study aimed to explore the risk factors for ABI and carotid artery stenosis and discover which factors simultaneously influence both conditions in T2DM. The study included a total of 101 patients with T2DM. ABI was performed via Doppler ultrasound, and both common carotid arteries were examined via ultrasound to obtain the percentage of carotid artery stenosis. A negative correlation was noted between the ABI and the percentage of carotid artery stenosis ( p = 0.043). ABI correlated significantly negatively with waist circumference ( p = 0.031), total cholesterol ( p = 0.003), low-density lipoprotein (LDL) cholesterol ( p = 0.003), and C-reactive protein (CRP) ( p = 0.017), whereas the percentage of carotid artery stenosis correlated with the smoking habit ( p = 0.017) and CRP ( p = 0.042). The best model for predicting the ABI value (R 2 = 0.195) obtained from stepwise regression analysis included waist circumference, LDL cholesterol, triglycerides, and CRP, while the best model for the percentage of the carotid artery stenosis (R 2 = 0.112) included smoking and CRP. CRP influenced the ABI value with a negative parameter estimate of −0.008962 ( p = 0.053) and the percentage of the carotid artery stenosis with a positive parameter estimate of 0.443655 ( p = 0.006) relative to a one-unit change of it, presenting the negatively significant impact of CRP on the association between carotid artery stenosis and low ABI. Our results suggest that CRP is the most important risk factor that connects ABI and carotid artery stenosis, which are important non-invasive indicators of generalized atherosclerosis in T2DM.

العلاقة: https://www.mdpi.com/2218-1989/14/1/59Test; https://doaj.org/toc/2218-1989Test; https://doaj.org/article/2afdf6826ae24e36930a639004fd7c0cTest

الإتاحة: https://doi.org/10.3390/metabo14010059Test
https://doaj.org/article/2afdf6826ae24e36930a639004fd7c0cTest

المؤلفون: Igor Petriček, Dina Lešin Gaćina, Martina Tomić, Tomislav Bulum, Iva Bešlić, Sania Vidas Pauk

المصدر: Journal of Clinical Medicine, Vol 13, Iss 9, p 2473 (2024)

مصطلحات موضوعية: post-blink blur time, dry eye disease, visual function, diagnostic tests, ocular surface, tears, Medicine

الوصف: Background: Dry eye disease (DED) stands out as one of the most common eye conditions encountered in clinical settings. This study aimed to determine the diagnostic ability and feasibility of post-blink blur time (PBBT) in detecting patients with DED symptoms. Methods: The study included 200 subjects, 100 with and 100 without DED symptoms defined by the Schein questionnaire, who underwent assessment of DED signs [visual acuity, PBBT, conjunctival hyperemia, lid-parallel conjunctival folds—LIPCOF, tear film break-up time—TBUT, fluorescein corneal staining, and meibum score]. Results: DED subjects had a lower PBBT than controls (p < 0.001), with subjective (6 (1–45) s vs. 8 (1–70) s) and objective (6 (2–33) s vs. 8 (2–50) s) PBBT measurements being similar between repeats. The correlations between subjective and objective PBBT measurements were significantly positive (R = 0.873, p < 0.001). Subjective PBBT was negatively related to the Schein questionnaire (R = −0.217, p = 0.002), conjunctival hyperemia (R = −0.105, p = 0.035), and corneal staining (R = −0.153, p = 0.031), while positively related to the TBUT (R = 0.382, p < 0.001) and meibum score (R = 0.106, p = 0.033). Logistic regression analysis showed DED symptoms were significantly associated with subjective PBBT (AOR 0.91, p = 0.001), TBUT (AOR 0.79, p < 0.001), meibum score (AOR 0.65, p = 0.008), LIPCOF (AOR 1.18, p = 0.002) and corneal staining (AOR 1.14, p = 0.028). Conclusions: Subjective self-reported PBBT is a reliable and non-invasive screening test for evaluating time-wise changes in visual acuity and detecting a tear film dysfunction.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2077-0383/13/9/2473Test; https://doaj.org/toc/2077-0383Test

الوصول الحر: https://doaj.org/article/b757569d8c104d36af6439c531ea5148Test

المؤلفون: Martina Tomić, Romano Vrabec, Spomenka Ljubić, Ingrid Prkačin, Tomislav Bulum

المصدر: Journal of Clinical Medicine, Vol 13, Iss 9, p 2496 (2024)

مصطلحات موضوعية: diabetic retinopathy, fundus examination, systemic risk factors control, blood pressure, prevention, Medicine

الوصف: Background: Diabetic retinopathy (DR) is the most common cause of preventable blindness among working-age adults. This study aimed to evaluate the impact of the regularity of fundus examinations and risk factor control in patients with type 2 diabetes (T2DM) on the prevalence and severity of DR. Methods: One hundred and fifty-six T2DM patients were included in this cross-sectional study. Results: In this sample, the prevalence of DR was 46.2%. Patients with no DR mainly did not examine the fundus regularly, while most patients with mild/moderate nonproliferative DR (NPDR) underwent a fundus examination regularly. In 39.7% of patients, this was the first fundus examination due to diabetes, and 67% of them had sight-threatening DR (STDR). Diabetes duration (p = 0.007), poor glycemic control (HbA1c) (p = 0.006), higher systolic blood pressure (SBP) (p < 0.001), and diastolic blood pressure (DBP) (p = 0.002) were the main predictors of DR. However, the impact of SBP (AOR 1.07, p = 0.003) and DBP (AOR 1.13, p = 0.005) on DR development remained significant even after adjustment for diabetes duration and HbA1c. The DR prevalence was higher in patients with higher blood pressure (≥130/80 mmHg) than in those with target blood pressure (p = 0.043). None of the patients with target blood pressure had STDR. The peaks in SBP and DBP were observed in T2DM with DR and the first fundus examination due to diabetes. Conclusions: In this T2DM sample, DR prevalence was very high and strongly related to blood pressure and a lack of regular fundus examinations. These results indicate the necessity of establishing systematic DR screening in routine diabetes care and targeting blood pressure levels according to T2DM guidelines.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2077-0383/13/9/2496Test; https://doaj.org/toc/2077-0383Test

الوصول الحر: https://doaj.org/article/7f91bee4433644e083daeaf1b16ad6cdTest

المؤلفون: Tomislav Bulum, Neva Brkljačić, Angelika Tičinović Ivančić, Maja Čavlović, Ingrid Prkačin, Martina Tomić

المصدر: Biomedicines, Vol 12, Iss 2, p 381 (2024)

مصطلحات موضوعية: smoking, type 2 diabetes, atherosclerosis, peripheral artery disease, transcutaneous oxygen pressure, Biology (General), QH301-705.5

الوصف: Type 2 diabetes mellitus (T2DM) significantly increases the risk of peripheral artery disease (PAD), and diabetes is the leading cause of nontraumatic amputations. This study investigated the risk factors for transcutaneous oxygen pressure (TcPO2) in T2DM, a noninvasive method to quantify skin oxygenation and the underlying microvascular circulation. The study included 119 T2DM patients (91 male/28 female). TcPO2 measurements were conducted with the Tina TCM4 Series transcutaneous monitor (Radiometer, Copenhagen, Sweden) and skin electrodes. Patients with TcPO2 < 40 mmHg were younger (p = 0.001), had significantly higher systolic blood pressure (SBP) (p = 0.023), glycated hemoglobin (HbA1c) (p = 0.013), fasting plasma glucose (fPG) (p = 0.038), total cholesterol (p = 0.006), LDL cholesterol (p = 0.004), and had more frequent smoking habits (p = 0.001) than those with TcPO2 ≥ 40 mmHg. The main predictors for the TcPO2 value (R2 = 0.211) obtained via stepwise regression analysis were age, smoking, SBP, HbA1c, fPG, and total and LDL cholesterol. Among all the listed predictors, smoking, HbA1c, and LDL cholesterol were found to be the most significant, with negative parameter estimates of −3.051310 (p = 0.0007), −2.032018 (p = 0.0003), and −2.560353 (p = 0.0046). The results of our study suggest that in association with other risk factors, smoking is the main predictor for lower TcPO2 in T2DM.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2227-9059/12/2/381Test; https://doaj.org/toc/2227-9059Test

الوصول الحر: https://doaj.org/article/83d36d349b68476b975800e9e34b7378Test

المؤلفون: Martina Tomić, Romano Vrabec, Đurđica Hendelja, Vilma Kolarić, Tomislav Bulum, Dario Rahelić

المصدر: Biomedicines, Vol 12, Iss 1, p 34 (2023)

مصطلحات موضوعية: diabetic retinopathy, screening, slit-lamp fundoscopy, fundus camera, artificial intelligence, Biology (General), QH301-705.5

الوصف: Our study aimed to assess the role of a hand-held fundus camera and artificial intelligence (AI)-based grading system in diabetic retinopathy (DR) screening and determine its diagnostic accuracy in detecting DR compared with clinical examination and a standard fundus camera. This cross-sectional instrument validation study, as a part of the International Diabetes Federation (IDF) Diabetic Retinopathy Screening Project, included 160 patients (320 eyes) with type 2 diabetes (T2DM). After the standard indirect slit-lamp fundoscopy, each patient first underwent fundus photography with a standard 45° camera VISUCAM Zeiss and then with a hand-held camera TANG (Shanghai Zhi Tang Health Technology Co., Ltd.). Two retina specialists independently graded the images taken with the standard camera, while the images taken with the hand-held camera were graded using the DeepDR system and an independent IDF ophthalmologist. The three screening methods did not differ in detecting moderate/severe nonproliferative and proliferative DR. The area under the curve, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, kappa (ĸ) agreement, diagnostic odds ratio, and diagnostic effectiveness for a hand-held camera compared to clinical examination were 0.921, 89.1%, 100%, 100%, 91.4%, infinity, 0.11, 0.86, 936.48, and 94.9%, while compared to the standard fundus camera were 0.883, 83.2%, 100%, 100%, 87.3%, infinity, 0.17, 0.78, 574.6, and 92.2%. The results of our study suggest that fundus photography with a hand-held camera and AI-based grading system is a short, simple, and accurate method for the screening and early detection of DR, comparable to clinical examination and fundus photography with a standard camera.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2227-9059/12/1/34Test; https://doaj.org/toc/2227-9059Test

الوصول الحر: https://doaj.org/article/bcdc9ab80bbf4f6081d4eaef9426d75fTest

المؤلفون: Velimir Altabas, Jelena Marinković Radošević, Lucija Špoljarec, Stella Uremović, Tomislav Bulum

المصدر: Biomedicines, Vol 11, Iss 11, p 3051 (2023)

مصطلحات موضوعية: endothelial progenitor cells, diabetes, diabetes complications, diabetes treatment, Biology (General), QH301-705.5

الوصف: Diabetes is one of the leading chronic diseases globally with a significant impact on mortality. This condition is associated with chronic microvascular and macrovascular complications caused by vascular damage. Recently, endothelial progenitor cells (EPCs) raised interest due to their regenerative properties. EPCs are mononuclear cells that are derived from different tissues. Circulating EPCs contribute to regenerating the vessel’s intima and restoring vascular function. The ability of EPCs to repair vascular damage depends on their number and functionality. Diabetic patients have a decreased circulating EPC count and impaired EPC function. This may at least partially explain the increased risk of diabetic complications, including the increased cardiovascular risk in these patients. Recent studies have confirmed that many currently available drugs with proven cardiovascular benefits have beneficial effects on EPC count and function. Among these drugs are also medications used to treat different types of diabetes. This manuscript aims to critically review currently available evidence about the ways anti-diabetic treatment affects EPC biology and to provide a broader context considering cardiovascular complications. The therapies that will be discussed include lifestyle adjustments, metformin, sulphonylureas, gut glucosidase inhibitors, thiazolidinediones, dipeptidyl peptidase 4 inhibitors, glucagon-like peptide 1 receptor analogs, sodium-glucose transporter 2 inhibitors, and insulin.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2227-9059/11/11/3051Test; https://doaj.org/toc/2227-9059Test

الوصول الحر: https://doaj.org/article/d764425dfa854115aae241833b2148b4Test

المؤلفون: Dinko Šoić, Jerko Štambuk, Marko Tijardović, Toma Keser, Gordan Lauc, Tomislav Bulum, Marijana Vučić Lovrenčić, Sandra Vučković Rebrina, Martina Tomić, Mislav Novokmet, Lea Smirčić-Duvnjak, Olga Gornik

المصدر: Frontiers in Endocrinology, Vol 14 (2023)

مصطلحات موضوعية: LC-MS, N-glycosylation, type 1 diabetes complications, complement component (C3), glycopeptides, Diseases of the endocrine glands. Clinical endocrinology, RC648-665

الوصف: AimChanges in N-glycosylation have been described in numerous diseases and are being considered as biomarkers of ongoing pathological condition. Previous studies demonstrated the interrelation of N-glycosylation and type 1 diabetes (T1D), particularly linking serum N-glycan changes with complications accompanying the disease. Moreover, the role of complement component C3 in diabetic nephropathy and retinopathy has been implicated, and C3 N-glycome was found to be altered in young T1D patients. Therefore, we investigated associations between C3 N-glycan profiles and albuminuria and retinopathy accompanying T1D, as well as glycosylation connection with other known T1D complication risk factors.Research design and methodsComplement component C3 N-glycosylation profiles have been analyzed from 189 serum samples of T1D patients (median age 46) recruited at a Croatian hospital centre. Using our recently developed high-throughput method, relative abundances of all six of the C3 glycopeptides have been determined. Assessment of C3 N-glycome interconnection with T1D complications, hypertension, smoking status, estimated glomerular filtration rate (eGFR), glycaemic control and duration of the disease was done using linear modelling.ResultsSignificant changes of C3 N-glycome in severe albuminuria accompanying type 1 diabetes were observed, as well as in T1D subjects with hypertension. All except one of the C3 glycopeptides proved to be associated with measured HbA1c levels. One of the glycoforms was shown to be changed in non-proliferative T1D retinopathy. Smoking and eGFR showed no effect on C3 N-glycome. Furthermore, C3 N-glycosylation profile was shown to be independent of disease duration.ConclusionThis study empowered the role of C3 N-glycosylation in T1D, showing value in distinguishing subjects with different diabetic complications. Being independent of the disease duration, these changes may be associated with the disease onset, making C3 N-glycome a potential novel marker of the disease progression and severity.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fendo.2023.1101154/fullTest; https://doaj.org/toc/1664-2392Test

الوصول الحر: https://doaj.org/article/76ef09323a1d4b40af492af36c42a050Test

المؤلفون: Tomislav Bulum, Marijana Vučić Lovrenčić, Jadranka Knežević Ćuća, Martina Tomić, Sandra Vučković-Rebrina, Lea Duvnjak

المصدر: Biomedicines, Vol 11, Iss 9, p 2561 (2023)

مصطلحات موضوعية: autoimmune diabetes in adults, autoimmunity, glutamic acid decarboxylase autoantibodies, Biology (General), QH301-705.5

الوصف: Aims: Our study aimed to investigate the relationship between three autoantibodies and their combination with anthropometric and metabolic components and microvascular complications in patients with latent autoimmune diabetes in adults (LADA). Methods: Our study included 189 LADA patients divided into four subgroups according to the autoantibodies present: glutamic acid decarboxylase autoantibodies (GADA) only; zinc transporter-8 autoantibodies (ZnT8A)+GADA; insulinoma-associated-2 autoantibodies (IA-2)+GADA; and ZnT8+IA-2+GADA. Results: Compared to GADA positivity only, patients with ZnT8+GADA positivity and ZnT8+IA-2+GADA positivity had a shorter diabetes duration and lower body mass index (BMI); patients with ZnT8+GADA positivity were younger and showed an increase in glomerular filtration rate, while those with ZnT8+IA-2+GADA positivity had lower C-peptide and lower insulin resistance measured with HOMA2-IR. In a multiple regression analysis, ZnT8 positivity was associated with lower BMI (p = 0.0024), female sex (p = 0.0005), and shorter duration of disease (p = 0.0034), while IA-2 positivity was associated with lower C-peptide levels (p = 0.0034) and shorter diabetes duration (p = 0.02). No association between antibody positivity and microvascular complications of diabetes, including retinopathy, neuropathy, and microalbuminuria, as well as with variables of glucose control and β-cell function were found. Conclusion: The results of our study suggest that ZnT8 and IA-2 autoantibodies are present in a significant number of LADA patients and associated with clinical and metabolic characteristics resembling classic type 1 diabetes. Due to increased LADA prevalence, earlier identification of patients requiring frequent monitoring with the earlier intensification of insulin therapy might be of special clinical interest.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2227-9059/11/9/2561Test; https://doaj.org/toc/2227-9059Test

الوصول الحر: https://doaj.org/article/b0416b94472a437e9b137e6aca398837Test

المؤلفون: Tomislav Bulum, Martina Tomić, Romano Vrabec, Neva Brkljačić, Spomenka Ljubić

المصدر: Biomedicines, Vol 11, Iss 8, p 2242 (2023)

مصطلحات موضوعية: type 2 diabetes, diabetic retinopathy, risk factors, systolic blood pressure, diastolic blood pressure, Biology (General), QH301-705.5

الوصف: Background and aims: Diabetic retinopathy (DR) is a microvascular complication of diabetes and represents the leading cause of blindness in working-age adults. The aim of this study was to investigate the risk factors for DR in patients with type 2 diabetes (T2DM) with and without diabetic nephropathy (DN). Methods: A total of 160 patients with T2DM were included in the study. Photodocumented retinopathy status was determined according to the EURODIAB protocol. Renal function was determined using creatinine-based estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR). Binary univariate and multiple logistic regression analyses were performed to determine the main predictors of DR. Results: The prevalence of DR in this studied sample was 46.3%. No significant correlation was observed between DR and age, body mass index, serum lipids, and renal function. Binary logistic regression analysis (no DR/DR) showed that longer diabetes duration (p = 0.008), poor glycemic control (HbA1c) (p = 0.008), higher systolic blood pressure (p = 0.001), and diastolic blood pressure (p = 0.003) were the main predictors of DR in patients with T2DM. However, the influence of systolic blood pressure (AOR = 1.06, p = 0.004) and diastolic blood pressure (AOR = 1.12, p = 0.007) on DR development remained significant even after adjustment for diabetes duration and HbA1c. Conclusions: Our results suggest that systolic and diastolic blood pressure are independent risk factors for DR in patients with T2DM.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2227-9059/11/8/2242Test; https://doaj.org/toc/2227-9059Test

الوصول الحر: https://doaj.org/article/17c3e285ccec4bdb90425b33f8500353Test