Search

Background:Better identification of high-risk individuals of type 2 diabetes mellitus (T2DM) for focused delivery of preventive measures requires risk prediction models using novel predictors. We evaluated the predictive value of long-term variability of systolic blood pressure (SBPV), which was recently reported to be associated with T2DM incidence, if added to a model with conventional T2DM predictors in a Japanese cohort study.Methods:A cohort of 3017 Japanese individuals (2446 male, 571 female) ages 36-65 years were followed from 2007 to 2019. Root-mean-square error (RMSE) and slope of systolic blood pressure (SBP) change regressed on year were calculated per individual using SBP values obtained consecutively from 2003 to 2007 to represent SBPV. An initial Cox model included age, sex, smoking status, regular exercise, family history of diabetes, body mass index (BMI), baseline SBP, blood levels of triglycerides (TG), high-density lipoprotein cholesterol (HDLC) and fasting blood glucose (FBG), and backward elimination was used for variable selection. The c-statistics, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were used to compare the performance of prediction models without (Model 1) and with SBPV (Model 2).Results:During 9.8-year (median) follow-up, 135 developed T2DM. We confirmed that RMSE was significantly associated with T2DM incidence independent of other variables used in a conventional model. Backwards elimination procedure selected BMI, TG, HDLC, FBG, SBP RMSE, and SBP slope for the final model (Table 1). Although the c-indices were not statistically different between Model 1 (0.77) and Model 2 (0.78) as well as the NRI (7.1%), the IDI was statistically significant (0.8%, p<0.05).Conclusions:The present study revealed that long-term variability of SBP slightly improved the predictive value of T2DM if added to a conventional prediction model.

The purpose of this study was to identify novel autoantigens that react with specific serum autoantibodies in patients with glaucoma.

OBJECTIVE To evaluate the association of long-term intraocular pressure (IOP) fluctuation and visual field (VF) progression in patients with glaucoma and low IOP. METHODS Four hundred eight eyes with IOPs below 18 mm Hg after a triple procedure (phacoemulsification, posterior chamber intraocular lens implantation, and trabeculectomy) were included in this study. Measurements of IOP and VF were taken for at least 3 years after surgery. Based on the SD in postoperative IOPs, the sample was split into 2 groups (group 1: SD ≤2; group 2: SD >2). Change in VF at each test location was defined as a change in threshold sensitivity of 1 dB per year or higher, with P≤.01; pointwise linear regression analysis was applied. MAIN OUTCOME MEASURES Intraocular pressure and VF progression. RESULTS The groups showed no differences in IOPs through the follow-up period and in the VF defect score 3 months after surgery. After 13 years, more patients with progressive VF deterioration were detected in group 2 than in group 1. CONCLUSION Our results showed that larger long-term IOP fluctuation was associated with a progressive increase in the VF deterioration even though patients with glaucoma maintained their IOPs after the triple procedure. APPLICATION TO CLINICAL PRACTICE The SD of long-term IOP should be less than 2 in patients with glaucoma, even if their IOPs drop below 18 mm Hg. TRIAL REGISTRATION clinicaltrials.gov Identifier: LOCATOR="http://clinicaltrials.gov/show/NCT00428740">NCT00428740Arch Ophthalmol.2007;125(8):1010-1013--

AbstractForty-one healthy volunteers were recruited for a study to compare the intraocular pressure (IOP)-lowering efficacy and side effects of 2 dorzolamide and 1 brinzolamide. In a randomized double-blind design, one eye received one drop of 2 dorzolamide and the other eye received one drop of 1 brinzolamide. The IOP and side effects were evaluated by Goldmann applanation tonometry and slit lamp biomicroscopy before administration, and 3, 7 and 14 days after the initial administration of eyedrops. The IOP decreased significantly from baseline for both drugs (p < 0.05). However, there were no statistically significant differences between 2 dorzolamide and 1 brinzolamide either before or after eyedrop administration (p > 0.05). The most frequent side effect was ocular pain in the case of 2 dorzolamide and blurred vision in 1 brinzolamide. The results suggested that 2 dorzolamide and 1 brinzolamide have similar IOP-lowering efficacies with different side effectsCopyright © 2001 S. Karger AG, Basel

AbstractFifty-two eyes of 26 healthy volunteers were recruited for evaluating the effects of 0.005% latanoprost on optic nerve head (ONH) and peripapillary retinal blood flow. In a randomized double-blind design, one eye received one drop of 0.005% latanoprost and its fellow eye received one drop of a placebo eyedrop. Intraocular pressure (IOP), ONH and peripapillary retinal blood flow were measured with Heidelberg retinal flowmetry (HRF) before, 2 and 24 h after administration of eyedrops. IOP was decreased significantly in latanoprost-treated eyes at 2 and 24 h after administration (p < 0.05). In the volume, flow or velocity of ONH and peripapillary retina, there were no significant changes from the baseline values at 2 and 24 h after latanoprost administration in either latanoprost-treated eyes or their fellow eyes (p > 0.05). No significant differences were found in the measured quantities between latanoprost-treated eyes and their fellow eyes at each time point (p > 0.05). This result may suggest that 0.005% latanoprost in healthy subjects does not have any adverse effect on ONH and peripapillary retinal blood flow.Copyright © 1999 S.Karger AG, Basel