Q95152032
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The study focused on the changes in C-peptide, glycemia, insulin concentration, and insulin resistance according to LDL-cholesterol concentration ranges. The metabolic profile of individuals in the Czech Republic (n = 1840) was classified by quartiles of LDL-cholesterol into four groups with the following ranges: 0.46-2.45 (n = 445), 2.46-3.00 (n = 474), 3.01-3.59 (n = 459), and 3.60-7.18 mmol/l (n = 462). The level of glucose, C-peptide, insulin, and area of parameters during OGTT and HOMA IR were compared with a relevant LDL-cholesterol range. The evaluation involved correlations between LDL-cholesterol and the above parameters, F-test and t-test. Generally, mean values of glucose homeostasis-related parameters were higher with increasing LDL-cholesterol levels, except for mean HOMA IR values which rapidly increased (2.7-3.4) between LDL-cholesterol ranges of 3.00-3.59 and 3.60-7.18 mmol/l. Glucose, C-peptide, insulin concentrations, and the area of parameters reached greater changes especially after glucose load during OGTT (p ≤ 0.001). Considerable changes were already observed for the above parameters between groups with LDL-cholesterol ranges of 2.46-3.00 and 3.01-3.59 mmol/l. HOMA IR increased with higher LDL-cholesterol concentrations, but the differences in mean values were not statistically significant. Most important differences appeared in glucose metabolism at LDL-cholesterol concentrations of 3.60-7.18 mmol/l in comparison to LDL-cholesterol lower ranges. In particular, the areas of C-peptide, glucose, and insulin ranges showed statistically significant differences between all groups with growing LDL-cholesterol ranges. The variances of HOMA IR statistically differed between groups created according to LDL-cholesterol concentrations ranges.
- MeSH
- C-peptid * krev MeSH
- dospělí MeSH
- glukózový toleranční test MeSH
- inzulin * krev MeSH
- inzulinová rezistence * MeSH
- krevní glukóza * analýza metabolismus MeSH
- LDL-cholesterol * krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
Na interním oddělení naší nemocnice jsme se setkali s, na první pohled, velmi paradoxním případem hypokalémie. Tato práce reflektuje důležitost propojení a spolupráce jednotlivých odborností v případě významné diskrepance mezi klinickým stavem pacienta a výsledky jeho laboratorních vyšetření. Stejně tak je snahou této kazuistiky demonstrovat kruciální vliv preanalytické fáze na výsledek laboratorního vyšetření a následné léčby. Rovněž chceme povzbudit k zamyšlení se nad všemi možnými mechanismy na úrovni fyziologie a patofyziologie buněčného metabolismu, přestupu iontů mezi extracelulárním a intracelulárním prostorem, jejich vztahů, regulačních mechanismů a důsledků, které tyto změny mohou vyvolávat až na úrovni celého organismu. To vše zasazujeme do kontextu dostupnosti POCT (Point Of Care Testing) vyšetření pro oddělení, která se setkávají s kriticky nemocnými nebo jinak komplikovanými pacienty
In the department of internal medicine of our hospital we encountered, at first sight, a very paradoxical case of hypokalemia. This paper reflects the importance of interconnection and cooperation of individual specialties in the case of a significant discrepancy between the clinical condition of a patient and the results of his laboratory tests. Similarly, this case study aims to demonstrate the crucial influence of the preanalytical phase on the outcome of laboratory tests and subsequent treatment. We also want to encourage reflection on all the possible mechanisms at the level of physiology and pathophysiology of cellular metabolism, ion transfer between extracellular and intracellular space, their relationships, regulatory mechanisms and the consequences that these changes may induce up to the level of the whole organism. We place all this in the context of the availability of POCT examinations for departments that encounter critically ill or otherwise complicated patients.
- MeSH
- chronická myeloidní leukemie komplikace MeSH
- chybná diagnóza * MeSH
- hypokalemie * diagnóza etiologie MeSH
- leukocytóza MeSH
- lidé MeSH
- odběr vzorku krve MeSH
- point of care testing MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- kazuistiky MeSH
The relationship between glycaemia and lipoprotein metabolism has not been completely clarified, and slight differences may be found between local authors, trials and evaluated parameters. Therefore this cross-sectional study investigated fasting cholesterol and glucose levels along with the determination of atherogenic index in a cohort of healthy individuals from the Czech Republic in relation to their fasting C-peptide levels. Data were collected between 2009 and 2018 and a total of 3189 individuals were stratified by C-peptide reference range (260-1730 pmol/l) into three groups - below (n = 111), within (n = 2952) and above (n = 126). Total, HDL, LDL cholesterol and atherogenic index were used to compare lipoprotein levels by relevant C-peptide concentrations. Participants using the supplements to affect lipid or glycaemia metabolism were excluded from this study. The evaluation of blood parameters in a fasting state included correlations between C-peptide and cholesterols, differences of variances (F-test) and the comparison of lipoprotein mean values (t-test) between the groups created by the C-peptide reference range. Mean values of total (4.9, 5.1, 5.3 mmol/l), LDL (2.6, 3.1, 3.4 mmol/l) cholesterol and atherogenic index (2.1, 2.8, 3.7) were higher with increasing C-peptide levels, whereas HDL was inversely associated with fasting C-peptide concentration. A positive and negative correlation between atherogenic index (rxy = 0.36) and HDL level (rxy = -0.36) with C-peptide values was found. Differences of HDL, LDL and atherogenic index were, in particular, recorded between the groups below and above the reference range of C-peptide (p ≤ 0.001). Considerable differences (p ≤ 0.001) were also observed for the same lipoprotein characteristics between the groups above and within the C-peptide reference. Generally, the type of cholesterol is crucial for the evaluation of specific changes concerning the C-peptide range. Lipoprotein concentrations differ in relation to C-peptide - not only below and above the physiological range, but also inside and outside of it.
- MeSH
- ateroskleróza epidemiologie metabolismus MeSH
- C-peptid * analýza metabolismus MeSH
- dospělí MeSH
- krevní glukóza analýza metabolismus MeSH
- LDL-cholesterol analýza metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- omezení příjmu potravy krev metabolismus MeSH
- průřezové studie statistika a číselné údaje MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- senioři MeSH
- Publikační typ
- práce podpořená grantem MeSH
The study focused on changes or cut-offs of glycaemia, insulin resistance and body mass index within the C-peptide reference range (260-1730 pmol/l). The metabolic profile of individuals in the Czech Republic without diabetes (n = 3186) was classified by whiskers and quartiles of C-peptide into four groups with the following ranges: 290-510 (n = 694), 511-710 (n = 780), 711-950 (n = 720) and 951-1560 pmol/l (n = 673). Fasting levels of glucose, insulin, HOMA IR (Homeostasis Model Assessment for Insulin Resistance) and BMI (body mass index) were compared by a relevant C-peptide range. Participants taking medication to control glycaemia were excluded. The evaluation involved correlations between C-peptides and the above parameters, F-test and t-test. Changes in glucose levels (from 5.3 to 5.6 mmol/l) between the groups were lower in comparison to insulin, which reached relatively greater changes (from 4.0 to 14.2 mIU/l). HOMA IR increased considerably with growing C-peptide concentrations (0.9, 1.5, 2.2 and 3.5) and BMI values showed a similar trend (28.3, 31.0, 33.6 and 37.4). Considerable changes were observed for insulin (5.2 mIU/l, 57.8%) and HOMA IR (1.3, 61.3%) between groups with C-peptide ranges of 711-950 and 951-1560 pmol/l. Although correlations involving C-peptide, insulin, glucose and BMI seemed to be non-significant (up to rxy = 0.25), the mean values of insulin, HOMA IR and BMI showed statistically significant changes between all groups with various C-peptide concentrations (p ≤ 0.001). Generally, most important differences appeared in glucose metabolism and body mass index between C-peptide ranges of 711-950 and 951-1560 pmol/l. Absolute and relative changes of C-peptide concentrations are possible to use for the assessment of glucose regulatory mechanism. The spectrum of investigated parameters could be a useful tool to prevent the risks linked with the alterations of glycaemia.
- MeSH
- bazální metabolismus MeSH
- C-peptid * analýza MeSH
- dospělí MeSH
- glukózový toleranční test MeSH
- index tělesné hmotnosti MeSH
- inzulin lidský analýza MeSH
- inzulinová rezistence MeSH
- krevní glukóza analýza MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- senioři MeSH
- statistika jako téma MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- senioři MeSH
- Publikační typ
- klinická studie MeSH
- práce podpořená grantem MeSH
