OBJECTIVE: To assess the association of circulating levels of C-reactive protein, a sensitive systemic marker of inflammation, with different components of the metabolic syndrome. RESEARCH DESIGN AND METHODS: Total cholesterol (TC), HDL cholesterol, triglycerides, uric acid, BMI , and prevalence of diabetes and hypertension were assessed in 747 men and 956 women aged 18-89 years who were participating in the population-based National Health and Nutrition Survey, which was carried out in former West Germany in 1987-1988. RESULTS: There was a statistically significant positive crude correlation between C-reactive protein and TC (R = 0.19), TG (R = 0.29), BMI (R = 0.32), glucose (R = 0.11), and uric acid (R = 0.14) (all P or =4 features of the metabolic syndrome were 1.11, 1.27, and 2.16 mg/l, respectively, with a statistically highly significant trend (P < 0.0001). CONCLUSIONS: The data suggest that a variety of features of the metabolic syndrome are associated with a systemic inflammatory response.

https://care.diabetesjournals.org/content/diacare/23/12/1835.full.pdf

Association between C-reactive protein and features of the metabolic syndrome: a population-based study.

https://www.ajkd.org/article/S0272-6386(01)97368-8/pdf

Quality of life in end-stage renal disease patients.

The objective of the present study is to review hemorheological disorders in diabetes mellitus. Several key hemorheological parameters, such as whole blood viscosity, erythrocyte deformability, and aggregation, are examined in the context of elevated blood glucose level in diabetes. The erythrocyte deformability is reduced, whereas its aggregation increases, both of which make whole blood more viscous compared to healthy individuals. The present paper explains how the increased blood viscosity adversely affects the microcirculation in diabetes, leading to microangiopathy.

/pdf/hemorheological-disorders-in-diabetes-mellitus-4hhzmtdf9g.pdf

Hemorheological Disorders in Diabetes Mellitus

Several lines of evidence support the notion that elevated blood viscosity may predispose to insulin resistance and type 2 diabetes mellitus by limiting delivery of glucose, insulin, and oxygen to metabolically active tissues. To test this hypothesis, the authors analyzed longitudinal data on 12,881 initially nondiabetic adults, aged 45-64 years, who were participants in the Atherosclerosis Risk in Communities (ARIC) Study (1987-1998). Whole blood viscosity was estimated by using a validated formula based on hematocrit and total plasma proteins at baseline. At baseline, estimated blood viscosity was independently associated with several features of the metabolic syndrome. In models adjusted simultaneously for known predictors of diabetes, estimated whole blood viscosity and hematocrit predicted incident type 2 diabetes mellitus in a graded fashion (P(trend (linear)) < 0.001): Compared with their counterparts in the lowest quartiles, adults in the highest quartile of blood viscosity (hazard ratio = 1.68, 95% confidence interval: 1.53, 1.84) and hematocrit (hazard ratio = 1.63, 95% confidence interval: 1.49, 1.79) were over 60% more likely to develop diabetes. Therefore, elevated blood viscosity and hematocrit deserve attention as emerging risk factors for insulin resistance and type 2 diabetes mellitus.

/pdf/blood-viscosity-and-hematocrit-as-risk-factors-for-type-2-4kovuzpuqs.pdf

Blood Viscosity and Hematocrit as Risk Factors for Type 2 Diabetes Mellitus The Atherosclerosis Risk in Communities (ARIC) Study

Objectives: The aim of the study was to assess Health Related Quality of Life (HRQOL) of elderly patients on renal replacement therapy (RRT) of our region, and to identify socio-demographic and clinical variables which influence it. We also attempted to compare HRQOL of transplant patients, with that of chronic hemodialysis patients. Design: Cross-sectional study. Setting: Institutional Hospital Nephrology Unit Patients: All patients from 9 of the 10 hemodialysis centres in our region, aged 65 years or more, who had been on RRT (chronic hemodialysis and kidney transplantation) for at least three months, showing no cognitive problems, were included. The sample included 124 patients. Interventions: These patients participated in a structured interview using two generic HRQOL questionnaires: Sickness Impact Profile and SF-36 Health Survey. Karnofsky Scale, Comorbidity Index, socio-demographic and clinical data, were also collected. Results: The median age was 71 years (range 65–75); 55.6% of the patients were male; 19.8% of the sample were transplant patients and 80.2%, hemodialysis patients (only 2% on renal transplant waiting list); 69.2% had a low-intermediate socio-economic level, 52.9% had elementary studies, and 10.6% lived alone. Transplant patients had higher HRQOL than hemodialysis patients. Women had lower HRQOL than men. A higher economic level, higher educational level, higher Karnofsky Performance Scale, and lower Comorbidity Index score, were associated with higher HRQOL. Conclusions: The good HRQOL of elderly transplant patients, in comparison with hemodialysis patients, is an important reason for advising kidney transplants in elderly patients. Economic and educational levels, functional status and comorbidity are variables wich influence the HRQOL of these patients.

Health-Related Quality of Life (HRQOL) in End Stage Renal Disease (ESRD) patients over 65 years

Out of 69 patients who were kidney transplanted from 1963 to 1978, 33 patients were alive with a functioning graft in 1988. Of these, 94% completed a questionnaire for the assessment of the quality of life. The total life situation was considered very good by 16%, good by 48%, medium by 29% and difficult by 6%. Nine patients (eight males) had a total of 16 children after the transplantation. There were 72% who were working full-time and the family income was acceptable for most of the patients. No patients had major psychological problems. Our conclusion is that this group of transplanted patients almost all reported a good quality of life and were almost fully rehabilitated in the second and third decade after their transplantation.

Quality of Life after Kidney Transplantation. A 10–22 Years Follow-Up

Baseline serum prolactin (PRL) was found to be similar in 35 men with untreated essential hypertension (149 ± 2/98 ± 1 mmHg; means ± s.e.) and 44 healthy normotensive men (126 ± 1/80 ± 1 mmHg), all 40 years old. A correlation between baseline PRL and aldosterone was found in the normotensive (r=0.53

Decreased Central Dopaminergic Activity in Essential Hypertension

Cardiovascular and sympathoadrenal effects of short-term oral treatment with beta 1-blockade (atenolol, 50 mg, administered two times) and beta 2-blockade (ICI 118,551, 50 mg, administered three times) were compared with placebo during actual flying in subjects with flight phobia (n = 34). beta 1-Blockade lowered resting blood pressure and heart rate and prevented a heart rate response but not a blood pressure response to this psychologic stress. beta 2-Blockade minimally lowered resting heart rate and prevented a heart rate response, but it failed to lower resting blood pressure or blood pressure response to the stress. Plasma epinephrine increased with all three treatments and more with beta 1-blockade than with placebo. Plasma norepinephrine decreased with administration of beta 2-blockade. Thus neither beta 1- nor beta 2-blockade prevents an increase in blood pressure during acute flight phobia stress. Increased plasma epinephrine seems to be the sympathetic variable that is closest related to this increase in blood pressure. Norepinephrine may be less consistently related to the blood pressure rise during flight phobia stress as shown by the decrease in plasma norepinephrine with administration of beta 2-blockade.

Effects of β1‐ and β2‐blockade on blood pressure and sympathetic responses to flight phobia stress

BackgroundIn a previous study we found that elevated blood viscosity was linked to the insulin resistance syndrome, and we proposed that high blood viscosity may increase insulin resistance. That study was based on calculated viscosity.ObjectiveTo determine whether directly measured whole-blood visc

Whole-blood viscosity and the insulin-resistance syndrome.

Effect of sodium depletion on plasma renin concentration before and during adrenergic β-receptor blockade with propranolol in normotensive man

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