We talk to Roman Topór-Mądry, MD, chairman of the PAS Committee on Public health, and Tomasz Zdrojewski, MD, from the Jagiellonian University’s Public Health Institute, coauthors of the first Report on Diabetes in Poland, about counting the number of diabetics and data-gathering techniques.
Natalia Marek-Trzonkowska and Piotr Trzonkowski of the Medical University of Gdańsk talk about trust, coordination, and creative conflicts – in the first of a series of interviews with scientists who are partners both at work and in life.
I n t r o d u c t i o n: RANTES regulates leukocyte recruitment to areas affected by the inflammatory process. Microvesicles (MVs) belong to a subpopulation of extracellular vesicles and show proangiogenic potential by transferring bioactive molecules to target cells.
Obj e c t i v e s: The aim of this study was to determine the relationship between circulating proangiogenic factors (MVs and RANTES) and diabetes complications in patients with different severities of diabetic retinopathy (DR). CCR5 (CD195) receptors transported by annexin V-labeled MVs were also investigated. Patients and Methods: Diabetic patients (n = 61), among whom 35 had confirmed DR classified according to guidelines, and controls (n = 25) were included. MVs were isolated by centrifugation and analyzed using flow cytometry, RANTES was assessed by ELISA.
R e s u l t s: T h e study group diff ered from the control group with respect to BMI, age, heart rate and systolic blood pressure. Additionally, glucose and creatinine concentrations were signifi cantly increased: 5.30 [5.09–5.62] vs. 9.38 [7.48–11.55] (p<0.0001) mmol/l and 74.59 [64–84] vs. 89.00 [77.11–105.44] μmol/l (p = 0.0005), respectively. RANTES concentrations were significantly increased in diabetic patients compared to those of controls (15.5 (9.7–18.1) vs. 8.9 (0.9–14.6) μg/ml (p = 0.011)), and RANTES concentration significantly increased with respect to nonproliferative DR progression. Moreover, the number of CCR5-positive MVs was significantly increased in patients with heavy nonproliferative diabetic retinopathy (HNPDR) compared to those with soft nonproliferative DR (SNPDR): 1178 [836–2254] vs. 394 [275–799] counts/μl.
C o n c l u s i o n s: Correlation of RANTES concentrations with the stage of nonproliferative DR and the statistically significant dependence of CCR5-positive MVs with disease progression suggest that MVs and RANTES can be considered new biomarkers.
I n t r o d u c t i o n: Peripheral arterial occlusive disease (PAOD) is a disease with worldwide increasing occurrence. Diabetic patients are greatly exposed on the risk of PAOD and its complications. The aim of the study was to check the influence of preoperative HbA1C on the outcomes of patients with diabetes undergoing PAOD related endovascular treatment.
M a t e r i a l a n d Me t h o d s: The study was conducted among 59 patients with PAOD referred from the diabetic foot outpatient for endovascular treatment. They were included in one-year observation based on follow-up visits in 1, 3, 6 and 12 months after angioplasty and divided into 2 groups basing on their preoperative glycaemia. Th e clinical condition of the lower limbs was assessed by use of the Rutherford classification, ankle-brachial index (ABI) and toe-brachial index (TBI). Changes in patients’ quality of life (QoL) were also evaluated.
R e s u l t s: Reintervention within 12 months were less frequent in patients with HbA1C ≤8.0% than in HbA1C >8.0% patients (9.09% vs. 35.48%, p = 0.03). TBI of the treated limb was lower in patients with elevated than in patients with proper glycaemia at 6 month [0.2 (0.0–0.38) vs. 0.38 (0.31–0.46); p <0.008] and 12 month follow-up [0.17 (0.0–0.27) vs. 0.32 (0.25–0.38); p <0,001]. The rate of healed ulcerations after 6 months was higher in patients HbA1C ≤8.0% (45.0% vs. 16.13%; p = 0.02) and they had significantly greater improvement of QoL.
C on c l u s i o n: Results of this study shows that preoperative level of glycaemia is an important factor for long-term prognosis in diabetic patients with PAOD. Elevated HbA1C level decreases significantly long-term improvement of QoL in DM patients undergoing endovascular treatment.