Influence of glucometric 'dynamical' variables on duodenal-jejunal bypass liner (DJBL) anthropometric and metabolic outcomes.

Background: The endoscopically implanted duodenal-jejunal bypass liner (DJBL) is an attractive alternative to bariatric surgery for obese diabetic patients. This article aims to study dynamical aspects of the glycaemic profile that may influence DJBL effects.

Methods: Thirty patients underwent DJBL implantation and were followed for 10 months.

Detrended Fluctuation Analysis in the prediction of type 2 diabetes mellitus in patients at risk: Model optimization and comparison with other metrics.

Complexity analysis of glucose time series with Detrended Fluctuation Analysis (DFA) has been proved to be useful for the prediction of type 2 diabetes mellitus (T2DM) development. We propose a modified DFA algorithm, review some of its characteristics and compare it with other metrics derived from continuous glucose monitorization in this setting. Several issues of the DFA algorithm were evaluated: (1) Time windowing: the best predictive value was obtained including all time-windows from 15 minutes to 24 hours.

New insights from continuous glucose monitoring into the route to diabetes.

Aim: Type 2 diabetes mellitus (T2DM) is preceded by a period of impaired glucoregulation. We investigated if continuous glucose monitoring system (CGMS) (1) could improve our capacity to predict the development of T2DM in subjects at risk. (2) Find out if impaired fasting glucose/impaired glucose tolerance differentiation through CGMS would also elucidate differences in clinical phenotypes.

Delay in the Detrended Fluctuation Analysis Crossover Point as a Risk Factor for Type 2 Diabetes Mellitus.

Detrended Fluctuation Analysis (DFA) measures the complexity of a glucose time series obtained by means of a Continuous Glucose Monitoring System (CGMS) and has proven to be a sensitive marker of glucoregulatory dysfunction. Furthermore, some authors have observed a crossover point in the DFA, signalling a change of dynamics, arguably dependent on the beta-insular function. We investigate whether the characteristics of this crossover point have any influence on the risk of developing type 2 diabetes mellitus (T2DM).

Glucose time series complexity as a predictor of type 2 diabetes.

Background: Complexity analysis of glucose profile may provide valuable information about the gluco-regulatory system. We hypothesized that a complexity metric (detrended fluctuation analysis, DFA) may have a prognostic value for the development of type 2 diabetes in patients at risk.

Methods: A total of 206 patients with any of the following risk factors (1) essential hypertension, (2) obesity or (3) a first-degree relative with a diagnosis of diabetes were included in a survival analysis study for a diagnosis of new onset type 2 diabetes.

Glucose series complexity in hypertensive patients.

Nonlinear methods have been applied to the analysis of biological signals. Complexity analysis of glucose time series may be a useful tool for the study of the initial phases of glucoregulatory dysfunction. This observational, cross-sectional study was performed in patients with essential hypertension.

Glucose series complexity at the threshold of diabetes.

Background: One of the earliest signs of dysfunction in a complex system is the simplification of its output. A well-accepted method to measure this phenomenon is detrended fluctuation analysis (DFA). Herein, we evaluated the usefulness of DFA at the threshold of type 2 diabetes mellitus (T2DM).

Cystatin C as a predictor of mortality and cardiovascular events in a population with chronic kidney disease.

Background. We examine whether cystatin C, a surrogate marker of renal function, could identify patients with chronic kidney disease (CKD) with an increased risk of renal disease progression, death, or cardiovascular events. Methods.

Association between urinary albumin excretion and both central and peripheral blood pressure in subjects with insulin resistance.

Background: Central blood pressure (cBP) predicts cardiovascular events. Regarding subclinical organ damage, the relationship between urinary albumin excretion (UAE) and cBP is rather unknown.

Objective: We aimed to determine whether cBP is related to UAE, and if this relationship is stronger than that observed with peripheral blood pressure (pBP).

Cystatin C is associated with the metabolic syndrome and other cardiovascular risk factors in a hypertensive population.

Serum cystatin C has been associated with cardiovascular disease. We investigated whether cystatin C concentration is associated with the metabolic syndrome and with other cardiovascular risk factors in a hypertensive population. In this cross-sectional study, we prospectively included 611 essential hypertensive patients during a 12-month period.

Differences in complexity of glycemic profile in survivors and nonsurvivors in an intensive care unit: a pilot study.

Objective: To investigate glycemic dynamics and its relation with mortality in critically ill patients. We searched for differences in complexity of the glycemic profile between survivors and nonsurvivors in patients admitted to a multidisciplinary intensive care unit.

Design: Prospective, observational study, convenience sample.

The route to diabetes: Loss of complexity in the glycemic profile from health through the metabolic syndrome to type 2 diabetes.

Aims: In many physiologic systems, the evolution from health to disease correlates with a loss of complexity in the system's output. We analyze the difference in complexity of the glycemic profile in healthy volunteers (H), patients with the metabolic syndrome (MS), and patients with type 2 diabetes mellitus (DM).

Methods: We measured interstitial fluid glucose every 5 minutes for 3 days in 10 H, 10 MS, and 10 DM.

A randomized trial of citalopram versus placebo in outpatients with asthma and major depressive disorder: a proof of concept study.

Background: The prevalence of asthma has increased in recent years and depression is common in this population. Minimal data are available on the treatment of depressed asthma patients.

Methods: Ninety adults with asthma and current major depressive disorder were randomized to receive citalopram or placebo for 12 weeks.

Development of chronic kidney disease and cardiovascular prognosis in essential hypertensive patients.

The existence of a significant percentage of treated hypertensive patients presenting a diminished renal function has been recently described. Mild renal function abnormalities are recognized as powerful predictors of cardiovascular morbidity and mortality. However, longitudinal data demonstrating this association are lacking.

Hypertensive renal damage in metabolic syndrome is associated with glucose metabolism disturbances.

Recent evidence highlights the relationship between metabolic syndrome (MS) and increased risk of cardiovascular (CV) diseases. Mild renal function abnormalities are associated with an enhanced CV risk, considered to be due to the presence of associated risk factors. Hence, MS and renal abnormalities could be linked and contribute to augment CV risk.