Publications by authors named "Uazman Alam"

Introduction: Pain phenomenology in patients with fibromyalgia syndrome (FMS) shows considerable overlap with neuropathic pain. Altered neural processing leading to symptoms of neuropathic pain can occur at the level of the spinal cord, and 1 potential mechanism is spinal disinhibition. A biomarker of spinal disinhibition is impaired H-reflex rate-dependent depression (HRDD).

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Purpose: An increased prevalence of peripheral polyneuropathy (PN) in Parkinson's disease (PD) associated with greater functional impairment has previously been reported. A possible cause has been suggested as levodopa therapy. The aim of this real-world study was to assess the prevalence and the characteristics of PN in PD and to investigate the putative association between PN and oral levodopa.

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  • SGLT2 inhibitors and GLP-1 receptor agonists are diabetes treatments that may also lower the risk of pneumonia and severe sepsis in type 2 diabetes patients.
  • A study using electronic medical records analyzed the effects of these drugs versus traditional glucose-lowering therapies and found significant reductions in pneumonia and sepsis risk.
  • The findings suggest that both treatments could improve overall health outcomes beyond glucose control, but more research is needed to understand their full impact.
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  • Non-alcoholic fatty liver disease (NAFLD) is linked to higher rates of liver and obesity-related cancers, prompting researchers to investigate the protective effects of aspirin and other anti-platelet drugs on these cancers.
  • A study analyzed medical records of adults with NAFLD to compare the cancer incidence between those taking antiplatelet medication for at least a year versus those who weren't, following them for five years.
  • Results indicated that antiplatelet use significantly lowered the risk of obesity-related cancers, including hepatocellular carcinoma (HCC), breast, pancreatic, and colorectal cancers, with aspirin alone showing a major decrease in HCC incidence.
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Aim: A bidirectional relationship exists between obstructive sleep apnoea (OSA) and type 2 diabetes (T2D). We aimed to examine the cumulative impact of having both OSA and T2D on patient outcomes, relative to having either condition alone.

Materials And Methods: Using TriNetX, a global federated research network (n = 128 million), we undertook two retrospective cohort studies, using time-to-event analysis.

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  • Metformin, the most commonly prescribed medication for type 2 diabetes, is associated with gastrointestinal (GI) adverse events that can limit its use in patients.
  • A systematic review and meta-analysis of 21 studies aimed to determine the prevalence of these GI adverse events, finding that diarrhea (6.9%) and bloating (6.2%) were the most common issues.
  • Extended release (XR) metformin was shown to have lower incidences of GI issues, suggesting it's better tolerated than the immediate release (IR) formulation.
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Aims: Atrial fibrillation (AF) and diabetes mellitus (DM) are both associated with adverse clinical events, but the associations have not been fully elucidated, particularly with concomitant insulin use. This study aimed to analyse the associations between adverse events and DM, as well as adverse events and sole insulin use.

Materials And Methods: Our analysis included individuals with AF from the prospective Global Registry on Long-Term Oral Anti-Thrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF) registry with 3-year follow-up.

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Resting energy expenditure (REE) and metabolic fuel utilization (carbohydrate or fat) proxied by respiratory quotient (RQ) from indirect calorimetry enables more precise measurement of energy needs and fat oxidation capacity. The study compared the effectiveness of providing energy expenditure information during diet and exercise weight intervention versus standard of care (SOC) on weight loss outcomes. Fifty-two participants with obesity were recruited from a specialist weight loss service, randomized 1:1 to intervention (INT) or SOC only.

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Introduction: Painful idiopathic distal sensory polyneuropathy (IDSP) and fibromyalgia syndrome (FMS) are cryptogenic chronic pain syndromes. The contribution of small fibre pathology (SFP) in FMS remains controversial. This study aims to quantify small nerve pathology in participants with IDSP and FMS and identify relationships of SFP with sensory phenotypes.

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Background: Tirzepatide, a novel dual agonist of glucagon-like-peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), has demonstrated greater magnitude of weight loss compared to semaglutide in a phase 3 clinical trial. However, the effect of tirzepatide on incidence of type 2 diabetes (T2D) in individuals with overweight and obesity, and the effect on major adverse cardiovascular outcomes in individuals with pre-existing T2D, remains unknown.

Methods: We performed a retrospective cohort study of anonymised electronic medical records using the TriNetX network (TriNetX LLC, Cambridge, MA, USA) a global federated database.

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Background: There is a growing burden of non-obese people with diabetes mellitus (DM). However, their cardiovascular risk (CV), especially in the presence of cardiovascular-kidney-metabolic (CKM) comorbidities is poorly characterised. The aim of this study was to analyse the risk of major CV adverse events in people with DM according to the presence of obesity and comorbidities (hypertension, chronic kidney disease, and dyslipidaemia).

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  • The study investigates the relationship between metabolic syndrome (MetS) components and the risk of micro- and macrovascular diseases in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).
  • It used a retrospective cohort analysis of patient records, comparing those with hepatic steatosis and MetS components to those without, looking at how increasing numbers of MetS factors affect disease risk.
  • Results show that MASLD, especially with multiple MetS components, significantly increases the risk for both microvascular (like neuropathy and retinopathy) and macrovascular (like heart attacks and strokes) diseases, with specific MetS factors linked to different levels of risk.
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Aims: To develop a standardised, automated protocol for detecting protein gene product 9.5 (PGP9.5) positive intra-epidermal nerve fibres (IENFs) in skin biopsies, transitioning from the established manual technique to an automated platform.

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Psoriatic arthritis (PsA) is an inflammatory joint and entheseal disease associated with significant personal and public health burden. PsA has a prevalence of up to 1%, affecting ~20% of people suffering with psoriasis. PsA is frequently accompanied by metabolic syndrome (MetS), and both conditions are characterised by a chronic pro-inflammatory state, with several key cytokines in PsA (interleukin (IL)-17 and IL-23) also elevated in those with MetS.

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Purpose: Antiplatelet therapy is used for the primary and secondary prevention of thrombotic diseases such as acute coronary syndrome (ACS). These patients are more vulnerable to infections, as such, strategies are required to mitigate these risks.

Methods: We conducted a retrospective cohort study using TriNetX, a global federated health research network that includes both inpatient and outpatient electronic medical records from health care organizations worldwide.

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Introduction: From 2008 and following the withdrawal of rosiglitazone, obligatory cardiovascular outcomes trials are performed for glucose lowering drugs introduced to the market to ensure their cardiovascular (CV) safety. Paradoxically, these studies have demonstrated CV safety but also shown additional cardio-reno-vascular protection of some therapeutic agents. Additionally, nonsteroidal mineralocorticoid receptor antagonists (ns-MRA) have emerged as novel drugs for cardio - and renoprotection in type 2 diabetes (T2D) and chronic kidney disease (CKD).

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  • Cardiac autonomic neuropathy (CAN) is a serious complication in diabetes that can lead to cardiovascular events, but it's not commonly diagnosed due to time constraints.
  • A study explored using AI and deep learning to analyze retinal images from diabetic patients for diagnosing CAN, successfully applying techniques like ResNet 18 and Multiple Instance Learning.
  • The results showed high accuracy, with the AI model identifying 93% of CAN cases and 89% of non-CAN cases, particularly excelling in distinguishing severe CAN stages, indicating a promising diagnostic tool for clinical practice.
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Cardiovascular autonomic neuropathy (CAN) is an under-recognised yet highly prevalent microvascular complication of diabetes. CAN affects approximately 20% of people with diabetes, with recent studies highlighting the presence of CAN in prediabetes (impaired glucose tolerance and/or impaired fasting glucose), indicating early involvement of the autonomic nervous system. Understanding of the pathophysiology of CAN continues to evolve, with emerging evidence supporting a potential link between lipid metabolites, mitochondrial dysfunction and genetics.

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  • - Sodium-glucose cotransporter 2 inhibitors (SGLT2is) not only help lower glucose levels in type 2 diabetes (T2D) patients but also provide significant heart and kidney benefits, especially in preventing heart failure hospitalizations and cardiovascular deaths.
  • - A study analyzed over 480,000 heart failure patients without diabetes, comparing those on SGLT2is with others on different treatments, finding that SGLT2is significantly lowered the risk of developing T2D.
  • - The reduction in T2D incidence was most notable among patients with prediabetes, with dapagliflozin showing a stronger effect than empagliflozin in preventing new cases of diabetes.
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  • The study evaluated the link between SGLT2 inhibitors and GLP-1 receptor agonists in relation to gout occurrence among type 2 diabetes patients using real-world data.
  • A cohort study was conducted, where patients on metformin or insulin with either SGLT2i or GLP-1Ra were matched based on characteristics and assessed over five years for gout incidence.
  • Results indicated that SGLT2i use significantly reduced gout incidence compared to control groups, whereas GLP-1Ra showed no significant difference, suggesting that SGLT2i might be a better option for preventing gout in these patients.
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Objective: To evaluate the relationship between fasting plasma glucose (FPG) and 2-hour postload plasma glucose (2hPG) measured during an oral glucose tolerance test, and the risk of developing diabetes in Chinese adults.

Methods: We followed 3,094 participants without diabetes, categorizing them based on their oral glucose tolerance test (OGTT) results into low post load (2hPG ≤ FPG) and high post load (2hPG > FPG) at baseline. We monitored the incidence of diabetes, incidence of prediabetes, disease progression from prediabetes to diabetes and disease reversal from prediabetes to normal glucose tolerance (NGT) over an average of 3.

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