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1. Kidney and Cardiovascular Effects of Canagliflozin According to Age and Sex: A Post Hoc Analysis of the CREDENCE Randomized Clinical Trial

Author

Perkovic, Vlado, Mahaffey, Kenneth W., Agarwal, Rajiv, Bakris, George, Brenner, Barry M., Cannon, Christopher P., Charytan, David M., de Zeeuw, Dick, Greene, Tom, Jardine, Meg J., Heerspink, Hiddo J.L., Levin, Adeera, Meininger, Gary, Neal, Bruce, Pollock, Carol, Wheeler, David C., Zhang, Hong, Zinman, Bernard, Jardine, Meg, Li, Nicole, Kolesnyk, Inna, Aizenberg, Diego, Pecoits-Filho, Roberto, Cherney, David, Obrador, Gregorio, Chertow, Glenn, Chang, Tara, Hawley, Carmel, Ji, Linong, Wada, Takashi, Jha, Vivekanand, Lim, Soo Kun, Lim-Abrahan, Mary Anne, Santos, Florence, Chae, Dong-Wan, Hwang, Shang-Jyh, Vazelov, Evgueniy, Rychlík, Ivan, Hadjadj, Samy, Krane, Vera, Rosivall, László, De Nicola, Luca, Dreval, Alexander, Nowicki, Michał, Schiller, Adalbert, Distiller, Larry, Górriz, Jose L., Kolesnyk, Mykola, David, Wheeler, C., Guerrero, Rodolfo Andres Ahuad, Albisu, Juan Pablo, Alvarisqueta, Andres, Bartolacci, Ines, Berli, Mario Alberto, Bordonava, Anselmo, Calella, Pedro, Cantero, Maria Cecilia, Cartasegna, Luis Rodolfo, Cercos, Esteban, Coloma, Gabriela Cecilia, Colombo, Hugo, Commendatore, Victor, Cuadrado, Jesus, Cuneo, Carlos Alberto, Cusumano, Ana Maria, Douthat, Walter Guillermo, Dran, Ricardo Dario, Farias, Eduardo, Fernandez, Maria Florencia, Finkelstein, Hernan, Fragale, Guillermo, Fretes, Jose Osvaldo, Garcia, Nestor Horacio, Gastaldi, Anibal, Gelersztein, Elizabeth, Glenny, Jorge Archibaldo, Gonzalez, Joaquin Pablo, Colaso, Patricia del Carmen Gonzalez, Goycoa, Claudia, Greloni, Gustavo Cristian, Guinsburg, Adrian, Hermida, Sonia, Juncos, Luis Isaias, Klyver, Maria Isabel, Kraft, Florencia, Krynski, Fernando, Lanchiotti, Paulina Virginia, Leon de la Fuente, Ricardo Alfonso, Marchetta, Nora, Mele, Pablo, Nicolai, Silvia, Novoa, Pablo Antonio, Orio, Silvia Ines, Otreras, Fabian, Oviedo, Alejandra, Raffaele, Pablo, Resk, Jorge Hector, Rista, Lucas, Papini, Nelson Rodriguez, Sala, Jorgelina, Santos, Juan Carlos, Schiavi, Lilia Beatriz, Sessa, Horacio, Casabella, Tomas Smith, Ulla, Maria Rosa, Valdez, Maria, Vallejos, Augusto, Villarino, Adriana, Visco, Virginia Esther, Wassermann, Alfredo, Zaidman, Cesar Javier, Cheung, Ngai Wah, Droste, Carolyn, Fraser, Ian, Johnson, David, Mah, Peak Mann, Nicholls, Kathy, Packham, David, Proietto, Joseph, Roberts, Anthony, Roger, Simon, Tsang, Venessa, Raduan, Roberto Abrão, Costa, Fernando Augusto Alves da, Amodeo, Celso, Turatti, Luiz Alberto Andreotti, Bregman, Rachel, Sanches, Fernanda Cristina Camelo, Canani, Luis Henrique, Chacra, Antônio Roberto, Borges, João Lindolfo Cunha, Vêncio, Sérgio Alberto Cunha, Franco, Roberto Jorge da Silva, d’Avila, Domingos, Portes, Evandro de Souza, de Souza, Pedro, Deboni, Luciane Mônica, Fraige Filho, Fadlo, Neto, Bruno Geloneze, Gomes, Marcus, Kohara, Suely Keiko, Keitel, Elizete, Saraiva, Jose Francisco Kerr, Lisboa, Hugo Roberto Kurtz, Contieri, Fabiana Loss de Carvalho, Milagres, Rosângela, Junior, Renan Montenegro, de Brito, Claudia Moreira, Hissa, Miguel Nasser, Sabbag, Ângela Regina Nazario, Noronha, Irene, Panarotto, Daniel, Filho, Roberto Pecoits, Pereira, Márcio Antônio, Saporito, Wladmir, Scotton, Antonio Scafuto, Schuch, Tiago, de Almeida, Roberto Simões, Ramos, Cássio Slompo, Felício, João Soares, Thomé, Fernando, Hachmann, Jean Carlo Tibes, Yamada, Sérgio, Hayashida, Cesar Yoiti, Petry, Tarissa Beatrice Zanata, Zanella, Maria Teresa, Andreeva, Viktoria, Angelova, Angelina, Dimitrov, Stefan, Genadieva, Veselka, Genova-Hristova, Gabriela, Hristozov, Kiril, Kamenov, Zdravko, Koundurdjiev, Atanas, Lozanov, Lachezar, Margaritov, Viktor, Nonchev, Boyan, Rangelov, Rangel, Shinkov, Alexander, Temelkova, Margarita, Velichkova, Ekaterina, Yakov, Andrian, Aggarwal, Naresh, Aronson, Ronnie, Bajaj, Harpreet, Chouinard, Guy, Conway, James, Cournoyer, Serge, DaRoza, Gerald, De Serres, Sacha, Dubé, François, Goldenberg, Ronald, Gupta, Anil, Gupta, Milan, Henein, Sam, Khandwala, Hasnain, Leiter, Lawrence, Madore, François, McMahon, Alan, Muirhead, Norman, Pichette, Vincent, Rabasa-Lhoret, Remi, Steele, Andrew, Tangri, Navdeep, Torshizi, Ali, Woo, Vincent, Zalunardo, Nadia, Montenegro, María Alicia Fernández, Gonzalo Godoy Jorquera, Juan, Fariña, Marcelo Medina, Gajardo, Victor Saavedra, Vejar, Margarita, Chen, Nan, Chen, Qinkai, Gan, Shenglian, Kong, Yaozhong, Li, Detian, Li, Wenge, Li, Xuemei, Lin, Hongli, Liu, Jian, Lu, Weiping, Mao, Hong, Ren, Yan, Song, Weihong, Sun, Jiao, Sun, Lin, Tu, Ping, Wang, Guixia, Yang, Jinkui, Yin, Aiping, Yu, Xueqing, Zhao, Minghui, Zheng, Hongguang, Mendoza, Jose Luis Accini, Arcos, Edgar, Avendano, Jorge, Diaz Ruiz, Jorge Ernesto Andres, Ortiz, Luis Hernando Garcia, Gonzalez, Alexander, Triana, Eric Hernandez, Higuera, Juan Diego, Malaver, Natalia, de Salazar, Dora Inés Molina, Rosero, Ricardo, Alexandra Terront Lozano, Monica, Cometa, Luis Valderrama, Valenzuela, Alex, Vargas Alonso, Ruben Dario, Villegas, Ivan, Yupanqui, Hernan, Bartaskova, Dagmar, Barton, Petr, Belobradkova, Jana, Dohnalova, Lenka, Drasnar, Tomas, Ferkl, Richard, Halciakova, Katarina, Klokocnikova, Vera, Kovar, Richard, Lastuvka, Jiri, Lukac, Martin, Pesickova, Satu, Peterka, Karel, Pumprla, Jiri, Rychlik, Ivan, Saudek, Frantisek, Tesar, Vladimir, Valis, Martin, Weiner, Pavel, Zemek, Stanislav, Alamartine, Eric, Borot, Sophie, Cariou, Bertrand, Dussol, Bertrand, Fauvel, Jean-Pierre, Gourdy, Pierre, Klein, Alexandre, Le Meur, Yannick, Penfornis, Alfred, Roussel, Ronan, Saulnier, Pierre-Jean, Thervet, Eric, Zaoui, Philippe, Burst, Volker, Faghih, Markus, Faulmann, Grit, Haller, Hermann, Jerwan-Keim, Reinhold, Maxeiner, Stephan, Paschen, Björn, Plassmann, Georg, Rose, Ludger, Gonzalez Orellana, Ronaldo Arturo, Haase, Franklin Paul, Moreira Diaz, Juan Pablo, Ramirez Roca, Luis Alberto, Sánchez Arenales, Jose Antonio, Sanchez Polo, José Vicente, Juarez, Erick Turcios, Csecsei, Gyongyi, Csiky, Botond, Danos, Peter, Deak, Laszlo, Dudas, Mihaly, Harcsa, Eleonora, Keltai, Katalin, Keresztesi, Sandor, Kiss, Krisztian, Konyves, Laszlo, Major, Lajos, Mileder, Margit, Molnar, Marta, Mucsi, Janos, Oroszlan, Tamas, Ory, Ivan, Paragh, Gyorgy, Peterfai, Eva, Petro, Gizella, Revesz, Katalin, Takacs, Robert, Vangel, Sandor, Vasas, Szilard, Zsom, Marianna, Abraham, Oomman, Bhushan, Raju Sree, Deepak, Dewan, Edwin, Fernando M., Gopalakrishnan, Natarajan, Gracious, Noble, Hansraj, Alva, Jain, Dinesh, Keshavamurthy, C.B., Khullar, Dinesh, Manisha, Sahay, Peringat, Jayameena, Prasad, Narayan, Satyanarayana, Rao K., Sreedhar, Reddy, Sreelatha, Melemadathil, Sudhakar, Bhimavarapu, Chandra Vyasam, Ramesh, Bonadonna, Riccardo, Castellino, Pietro, Ceriello, Antonio, Chiovato, Luca, De Cosmo, Salvatore, Derosa, Giuseppe, Di Carlo, Alberto, Di Cianni, Graziano, Frascà, Giovanni, Fuiano, Giorgio, Gambaro, Giovanni, Garibotto, Giacomo, Giorda, Carlo, Malberti, Fabio, Mandreoli, Marcora, Mannucci, Edoardo, Orsi, Emanuela, Piatti, Piermarco, Santoro, Domenico, Sasso, Ferdinando Carlo, Serviddio, Gaetano, Stella, Andrea, Trevisan, Roberto, Veronelli, Anna Maria, Zanoli, Luca, Akiyama, Hitoshi, Aoki, Hiromi, Asano, Akimichi, Iitsuka, Tadashi, Kajiyama, Shizuo, Kashine, Susumu, Kawada, Toshio, Kodera, Takamoto, Kono, Hiroshi, Koyama, Kazunori, Kumeda, Yasuro, Miyauchi, Shozo, Mizuyama, Kazuyuki, Niiya, Tetsuji, Oishi, Hiroko, Ota, Satoshi, Sakakibara, Terue, Takai, Masahiko, Tomonaga, Osamu, Tsujimoto, Mitsuru, Wakasugi, Masakiyo, Wakida, Yasushi, Watanabe, Takayuki, Yamada, Masayo, Yanagida, Kazuhiro, Yanase, Toshihiko, Yumita, Wataru, Gaupsiene, Egle, Kozloviene, Dalia, Navickas, Antanas, Urbanaviciene, Egle, Abdul Ghani, Rohana, Kadir, Khalid Abdul, Ali, Norsiah, Che Yusof, Mohd Daud, Gan, Chye Lee, Ismail, Mastura, Kong, Wei Yen, Lam, Swee Win, Lee, Li Yuan, Loh, Chek Loong, Manocha, Anita Bhajan, Ng, Kee Sing, Ahmad, Nik Nur Fatnoon Nik, Ratnasingam, Vanassa, Shudim, Saiful Shahrizal Bin, Vengadasalam, Paranthaman, Abraira Munoz, Luis David, Salazar, Melchor Alpizar, Cruz, Juan Baas, Soto, Mario Burgos, Ramos, Jose Chevaile, Wong, Alfredo Chew, Correa Rotter, Jose Ricardo, Escalante, Tonatiu Diaz, Enriquez Sosa, Favio Edmundo, Lozano, Fernando Flores, Flota Cervera, Luis Fernando, Baron, Paul Frenk, Ballesteros, Cecilia Garcia, Gomez Rangel, Jose David, Herrera Jimenez, Luis Enrique, Irizar Santana, Sergio Saul, Flores, Fernando Jimenez, Molina, Hugo Laviada, Luna Ceballos, Rosa Isela, del Campo Blanco, Belia Martin, Franco, Guadalupe Morales, Moreno Loza, Oscar Tarsicio, Rocha, Cynthia Mustieles, Vera, Gregorio Obrador, Castellanos, Ricardo Orozco, Calcaneo, Juan Peralta, Reyes Rosano, Miguel Angel, Pattzi, Hiromi Rodriguez, Guzman, Juan Rosas, Rucker Joerg, Isabel Erika, Saavedra Sanchez, Sandra Berenice, Sanchez Mijangos, Jose Hector, Sanson, Pablo Serrano, Tamayo y Orozco, Juan Alfredo, Chavez, Eloisa Tellez, Cepeda, Alejandro Valdes, Carrillo, Luis Venegas, Mesa, Juan Villagordoa, Escobedo, Rolando Zamarripa, Baker, John, Noonan, Paul, Scott, Russell, Walker, Robert, Watson, Edward, Williams, Michael, Young, Simon, Abejuela, Zaynab, Agra, Jeimeen, Aquitania, Grace, Caringal, Clodoaido, Comia, Rhea Severina, Santos, Lalaine Delos, Gomez, Olivert, Jimeno, Cecilia, Tan, Gerry, Tolentino, Marsha, Yao, Christy, Yap, Yvette Ethel, Lallaine Ygpuara, Ma. Dovie, Bijata-Bronisz, Renata, Hotlos, Lucyna, Januszewicz, Andrzej, Kaczmarek, Barbara, Kaminska, Anna, Lazuka, Lech, Madej, Andrzej, Mazur, Stanislaw, Mlodawska-Choluj, Dorota, Nowicki, Michal, Orlowska-Kowalik, Grazyna, Popenda, Grazyna, Rewerska, Barbara, Sowinski, Dariusz, Angelescu, Liliana Monica, Anghel, Veronica, Avram, Rodica-Ioana, Busegeanu, Mihaela-Magdalena, Cif, Adriana, Cosma, Dana, Crisan, Carmen, Demian, Luiza Despina, Ferariu, Ioana Emilia, Halmagyi, Ildiko, Hancu, Nicolae, Munteanu, Mircea, Negru, Doru, Onaca, Adriana Gabriela, Petrica, Ligia, Popa, Amorin Remus, Ranetti, Aurelian-Emil, Serafinceanu, Cristian, Toarba, Cristina, Agafyina, Alina, Barbarash, Olga, Barysheva, Olga, Chizhov, Daniil, Dobronravov, Vladimir, Glinkina, Irina, Grineva, Elena, Khirmanov, Vladimir, Kolmakova, Elena, Koroleva, Tatiana, Kvitkova, Liudmila, Marasaev, Viacheslav, Mkrtumyan, Ashot, Morugova, Tatiana, Nagibovich, Galina, Nagibovich, Oleg, Nedogoda, Sergei, Osipova, Irina, Raskina, Tatiana, Samoylova, Yulia, Sazonova, Olga, Shamkhalova, Minara, Shutemova, Elena, Shwartz, Yuriy, Uriasyev, Oleg, Vorobyev, Sergey, Zateyshchikova, Anna, Zateyshshikov, Dmitry, Zykova, Tatyana, Antic, Slobodan, Djordjevic, Miodrag, Kendereski, Aleksandra, Lalic, Katarina, Lalic, Nebojsa, Popovic-Radinovic, Vesna, Babikova, Jana, Benusova, Olga, Buganova, Ingrid, Culak, Jan, Dzupina, Andrej, Dzuponova, Jana, Fulop, Peter, Ilavska, Adriana, Martinka, Emil, Ochodnicka, Zuzana, Pella, Daniel, Smatanova, Iveta, Ahmed, Fayzal, Badat, Aysha, Breedt, Johannes, Distiller, Lawrence, Govender, Vimladhevi, Govender, Ravendran, Joshi, Mukesh, Jurgens, Jaco, Latiff, Gulam, Lombard, Landman, Mookadam, Mohamed, Ngcakani, Nomangesi, Nortje, Hendrik, Oosthuizen, Helena, Pillay-Ramaya, Larisha, Prozesky, Hans, Reddy, Jeevren, Rheeder, Paul, Seeber, Mary, Cho, Young Min, Jeong, In-Kyung, Kim, Sin Gon, Kim, Yeong Hoon, Kwon, Hyuk-Sang, Kwon, Min Jeong, Lee, Byung-Wan, Lee, JungEun, Lee, Moon-Kyu, Nam, Moon-Suk, Oh, Kook-Hwan, Park, Cheol- Young, Park, Sun-Hee, Yoon, Kun Ho, Garcia, Pere Alvarez, Mercadal, Luis Asmarats, Barrios, Clara, Castro, Fernando Cereto, Guldris, Secundino Cigarran, Lopez, Marta Dominguez, Egido de los Rios, Jesus, Fresnedo, Gema Fernandez, Serrano, Antonio Galan, Garcia, Isabel, Gonzalez Martinez, Francisco Javier, Jodar Gimeno, Jose Esteban, Mendoza, Manuel Lopez, Marin, Tamara Malek, Portillo, Cristobal Morales, Munar Vila, Maria Antonia, Torres, Manuel Muñoz, Iglesias, Javier Nieto, Perez, Jonay Pantoja, Vera, Merce Perez, Portoles Perez, Jose M., Quesada Simón, María Angustias, Canonge, Rafael Simo, Gonzalez, Alfonso Soto, Riera, Manel Terns, Tinahones Madueno, Francisco Jose, Plaza, Mercedes Velo, Chang, Chwen-Tzuei, Chuang, Lee-Ming, Hsia, Te-Lin, Hsieh, Chang-Hsun, Lin, Chih-Ching, Lu, Yung- Chuan, Sheu, Wayne H-H, Barna, Olga, Bilyk, Svitlana D., Botsyurko, Volodymyr, Dudar, Iryna, Fushtey, Ivan, Godlevska, Olga, Golovchenko, Oleksandr, Gyrina, Olga, Kazmirchuk, Anatoliy, Komisarenko, Iuliia, Korzh, Oleksii, Kravchun, Nonna, Legun, Oleg, Mankovskyy, Borys, Martynyuk, Liliya, Mostovoy, Yuriy, Pashkovska, Nataliia, Pererva, Larysa, Pertseva, Tetyana, Samoylov, Oleksandr, Smirnov, Ivan, Svyshchenko, Yevgeniya, Tomashkevych, Halyna, Topchii, Ivan, Tryshchuk, Nadiya, Tseluyko, Vira, Vizir, Vadym, Vlasenko, Maryna, Zlova, Tetiana, Zub, Liliia, Abusnana, Salah, Railey, Mohamed, Abouglila, Kamal, Ainsworth, Paul, Ali, Zishan, Arutchelvam, Vijayaraman, Barnard, Maria, Bellary, Srikanth, Davies, Emyr, Davies, Mark, Davies, Simon, Dawson, Alison, El Kossi, Mohsen, English, Patrick, Fraser, Donald, Gnudi, Luigi, Gunstone, Anthony, Hall, Timothy, Hanif, Wasim, Jackson, Alan, Johnson, Andrew, Joseph, Franklin, Krishnan, Singhan, Kumwenda, Mick, MacDougall, Iain, Nixon, Paul, O'Hare, Joseph, Philip, Sam, Ramtoola, Shenaz, Saxena, Manish, Sennik, Davesh, Simon, Godwin, Singh, Baldev, Stephens, Jeffrey, Strzelecka, Anna, Symonds, Rehan, Turner, Wayne, Wahba, Mona, Wakeling, John, Wheeler, David, Winocour, Peter, Abdallah, Joseph, Abdullah, Raied, Abramowitz, Matthew, Acosta, Idalia, Aiello, Joseph, Akright, Laura, Akyea-Djamson, Ayim, Alappan, Rajendran, Alicic, Radica, Al-Karadsheh, Amer, Allison, Dale Crawford, Arauz-Pacheco, Carlos, Arfeen, Shahabul, Arif, Ahmed, Arvind, Moogali, Atray, Naveen, Awad, Ahmed, Barnhill, Peggy, Barranco, Elizabeth, Barrera, Carlos, Beacom, Matthew, Behara, Venkata, Belo, Diogo, Bentley-Lewis, Rhonda, Berenguer, Ramon, Bermudez, Lidia, Bernardo, Marializa, Biscoveanu, Mihaela, Bowman-Stroud, Cynthia, Brandon, Donald, Brusco, Osvaldo, Busch, Robert, Canaan, Yamil, Chilito, Alicia, Christensen, Tom, Christiano, Cynthia, Christofides, Elena, Chuateco, Caroucel, Cohen, Kenneth, Cohen, Robert, Cohen-Stein, Debbie, Cook, Charles, Coyne, Daniel, Daboul, Nizar, Darwish, Riad, Daswani, Adarsh, Deck, Kenneth, Desouza, Cyrus, Dev, Devasmita, Dhillon, Monika, Dua, Sohan, Eder, Frank, Elosegui, Ana Maria, El-Shahawy, Mohamed, Ervin, John, Esquenazi, Alberto, Evans, John, Fishbane, Steven, Frias, Juan, Galindo-Ramos, Eugenia, Galphin, Claude, Ghazi, Adline, Gonzalez, Enrique, Gorson, David, Gowda, Anupama, Greco, Barbara, Grubb, Stephen, Gulati, Rakesh, Hammoud, Jamal, Handelsman, Stuart, Hartman, Israel, Hershon, Kenneth, Hiser, Daniel, Hon, George, Jacob, Radu, Jaime, Maria, Jamal, Aamir, Kaupke, Charles, Keightley, Gerald, Kern, Elizabeth, Khanna, Rakhi, Khitan, Zeid, Kim, Sun, Kopyt, Nelson, Kovesdy, Csaba, Krishna, Gopal, Kropp, Jeffrey (Jay), Kumar, Amrendra, Kumar, Jayant, Kumar, Neil, Kusnir, Jorge, Lane, Wendy, Lawrence, Mary, Lehrner, Lawrence, Lentz, John, Levinson, Dennis, Lewis, Derek, Liss, Kenneth, Maddux, Andreas, Maheshwari, Hiralal, Mandayam, Sreedhar, Marar, Isam, Mehta, Bhasker, Middleton, John, Mordujovich, Jorge, Moreda, Ramon, Moustafa, Moustafa, Trenche, Samuel Mujica, Narayanan, Mohanram, Narvarte, Javier, Nassar, Tareq, Newman, George, Nichol, Brian, Nicol, Philip, Nisnisan, Josier, Nossuli, A. Kaldun, Obialo, Chamberlain, Olelewe, Sarah, Oliver, Michael, O'Shaughnessy, Andrew, Padron, John, Pankhaniya, Rohit, Parker, Reginald, Patel, Devesh, Patel, Gnyandev, Patel, Nina, Pavon, Humberto, Perez, Armando, Perez, Carlos, Perlman, Alan, Pettis, Karlton, Pharr, Walter, Phillips, Andrea, Purighalla, Raman, Quesada-Suarez, Luis, Ranjan, Rajiv, Rastogi, Sanjeev, Reddy, Jakkidi, Rendell, Marc, Rich, Lisa, Robinson, Michael, Rodriguez, Hector, Rosas, Sylvia, Saba, Fadi, Sankaram, Rallabhandi, Sarin, Ravi, Schreiman, Robert, Scott, David, Sekkarie, Mohamed, Sensenbrenner, John, Shakeel, Muhammad, Shanik, Michael, Shaw, Sylvia, Smith, Stephen, Solomon, Richard, Sprague, Amy, Spry, Leslie, Suchinda, Pusadee, Sultan, Senan, Surampudi, Prasanth, Sussman, Sherry, Tan, Anjanette, Terrelonge, Antonio, Thompson, Michael, Trespalacios, Fernando, Trippe, Bruce, Trueba, Pilar, Twahirwa, Marcel, Updegrove, John, Van Buren, Peter, Vannorsdall, Mark, Varghese, Freemu, Velasquez-Mieyer, Pedro, Ventrapragada, Sailaja, Vukotic, Goga, Wadud, Khurram, Warren, Mark, Watson, Henry, Watts, Ronald, Weiner, Daniel, Welker, James, Welsh, Jean, Williams, Shelley, Zaniewski-Singh, Michelle, Yi, Tae Won, Smyth, Brendan, Di Tanna, Gian Luca, Arnott, Clare, Cardoza, Kathryn, and Kang, Amy

Published
2023
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2. Gut microbiota and diabetes remission after metabolic surgery

Author

Polovina Snežana, Šumarac-Dumanović Mirjana, Kendereški Aleksandra, Zorić Svetlana, Stamenković-Pejković Danica, Jeremić Danka, Micić Dušan, and Micić Dragan

Subjects
Medicine
Abstract

Humans carry up to 200 bacterial species in the gastrointestinal tract. Important contribution of these genes is in carbohydrate degradation. The main task of the gut microbiota is digestion of food. The dominant gut bacteria are degradates of complex polysaccharides and releasing SCFA which are the sources for energy, cholesterol synthesis and gluconeogenesis. The mutual interaction of gut microbiota and host immune system is necessary for maintaining their symbiotic relationship. Microbial compositions differ in different metabolic conditions. Firmicutes are dominant in obese subjects while Akkermansia muciniphila which protect against adiposity, low grade inflammation in adipose tissue and insulin resistance is reduced in this population. Intestinal dysbiosis is associated with insulin resistance and diabetes type 2. Betaproteobacteria was highly enriched in diabetic population. The ratio of Bacteriodetes to Firmicutes and the Bacteroides-Prevotella group to the C.coccoides-E.rectale group are reduced. Gastrointestinal rearrangements after RYGB promote substantial changes on the gut microbiota. Gut microbota manipulation in favor of Akkermansia spp. may contribute in antidiabetic effect of metformin and could be potential treatment for T2D. Changes in gut bacteria after RYGB (Roux-en-Y gastric bypass) alter the body weight independent of other effects of bariatric/metabolic surgery. Mechanism for diabetes remission after bariatric surgery is still not clear. Besides change in incretin secretion and bile acid recirculation, potential mechanism is change of gut microbiota content. Possible improvement of glucose regulation following bariatric surgery may be related to butyrate and propionate production by some bacteria species, which influence glucose metabolism independently of bile acids recirculation.

Published
2018

3. Metabolic surgery and obesity related comorbidities

Author

Polovina Snežana, Micić Dušan, Bjelović Miloš, Šumarac-Dumanović Mirjana, and Kendereški Aleksandra

Subjects
bariatric surgery, obesity, comorbidity, fatty liver, sleep apnea syndromes, hypertension, neoplasms, Medicine (General), R5-920
Abstract

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Published
2018
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4. Non-surgical complications following bariatric surgery

Author

Polovina Snežana, Micić Dragan, Micić Dušan, Šumarac-Dumanović Mirjana 0000-0002-6216, Kendereški Aleksandra, Micić J., Stamenković-Pejković Danica, Cvijović Goran, Zorić S., Jeremić D., and Bjelović Miloš

Subjects
anaemia and bariatric surgery, bone and bariatric surgery, fertility and bariatric surgery, addiction and bariatric surgery, Medicine
Abstract

Bariatric surgery is the most efficient treatment for obesity and comorbidities. This treatment modality is the most potent for weight reduction with long-term weight maintenance and positive metabolic effects. The effect on weight loss and possible side effect depends of type of surgery. Micro and macronutrient deficiencies can occur after malapsorptive procedures. Iron deficiency occurs in almost half of patients following RYGB (Roux-en-Y gastric bypass). The main causes of iron deficiency are insufficient meat ingestion and lack of hydrochloric acid after removal of pylorus. B12 deficiency occured 6 months after RYGB in patients with oral supplementation of B12. Bone turnover increased three months after RYGB, and the levels of bone turnover markers increased 200% in next 12-18 months. Impaired vitamin D absorption leads to decreased calcium absorption and secondary hyperparathyroidism with lower bone mineral density. After the bariatric surgery, testosterone level becomes higher and all sexual quality indicators improving. Malapsorptive procedures with nutritive deficiency can cause oligo-astenozooteratospermia and male infertility. Due to the same reason pregnancy is not recommended in the first year bariatric surgery. Possible side effect of pregnancy within 12 months after surgery is fetal growth retardation. There is twice higher incidence for developing alcohol or other addition after bariatric surgery then in non-operated obese patients. The frequency of depressive episodes and suicide attempt is higher after bariatric surgery.

Published
2017
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5. Pseudopseudohypoparathyroidism or Albright hereditary osteodistrophy like syndrome 1

Author

Stamenković-Pejković Danica, Gligić Ana, Cvijović Goran, Zorić Svetlana, Jeremić Danka A., Polovina Snežana, Kendereški Aleksandra, Micić Dragan, and Šumarac-Dumanović Mirjana

Subjects
pseudopseudohypoparathyroidism, albright hereditary osteodystrophy, albright hereditary osteodystrophy like syndrome, gnas 1 gene, Medicine
Abstract

Introduction: pseudohypoparathyroidism (PHP) is hormone resistance syndrome described for the first time in 1942 by Albright et al. All this patients had high levels of the PTH and specific skeletal deformities which were later termed as Albright hereditary osteodystrophy (AHO). The PTH requires the alpha subunit of G protein for its action. GNAS1 gene encodes the alpha subunit of the G protein and molecular defects in this gene lead to the occurrence of at least four different forms of this syndrome. Pseudopseudohypoparathyroidism (PPHP) is a form of PHP which is characterized by physical features of AHO without any evidence of PTH resistance. Albright hereditary osteodystrophy like syndrome (AHO like syndrome) has some common characteristics with AHO but is not connected with the molecular defect in the GNAS 1 gene. Case outline: we reported the case of the female patient with the phenotypic characteristics of AHO (brachydactyly, short stature, mild degree of intelectual deficit and genu varum) but without any evidence of PTH resistance. PPHP occurs mainly in families with PHP 1a and it is inherited from the father which is not the case with our patient. There is a theoretical possibility that the mutation of the GNAS 1 gene occurred de novo but without genetic testing the 2q37 deletion and AHO like syndrome can not be excluded. Conclusion: in same cases of PPHP the diagnosis of AHO like syndrome should be considered but the only way to make the precise diagnosis is the genetic testing as it was in our case.

Published
2016
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6. Use of continuous subcutaneous insulin infusion by a portable insulin pump during pregnancy in women with type 1 diabetes mellitus

Author

Zorić Svetlana, Micić Dragan, Kendereški Aleksandra, Šumarac-Dumanović Mirjana, Cvijović Goran, Pejković Danica, Cvetković Miloš, Ljubić Aleksandar, and Dukanac-Stamenković Jelena

Subjects
pregnancy, diabetes mellitus, type 1, insulin infusion systems, blood glucose, pregnancy outcome, Medicine (General), R5-920
Abstract

Background/aim: Diabetes mellitus is associated with an increased risk for neonatal morbidity and mortality. One of the most important goals in treating pregnancies complicated with diabetes is keeping glucose level within the normal range, especially in the first trimester. A portable insulin pump for continuous subcutaneous insulin infusion (CSII) represents the best form of therapy for patients with type 1 diabetes mellitus during pregnancy. The aim of our study was to evaluate the effects of therapy with a portable insulin pump for continuous subcutaneous insulin infusion during the first trimester of pregnancy on the quality of glycoregulation and pregnancy outcome in women with type 1 diabetes mellitus. Methods. A total of 17 newly diagnosed pregnant women with type 1 diabetes mellitus were treated with CSII therapy for three months. The parameters of glycoregulation (hemoglobin A, glycosylated - HbA1c, mean blood glucose value in daily profiles - MBG, daily requirement for insulin - IJ/kg BM), lipid levels, blood pressure and renal function were estimated before and after the therapy. These parameters were correlated with parameters of pregnancy outcome: fetal weight, APGAR score, duration of pregnancy. Results. There was a significant improvement in HbA1c (8.94±1.62 vs. 6.90±1.22 %, p < 0.05), MBG (9.23±2.22 vs. 6.41±1.72 mmol/l, p < 0.01), and daily requirement for insulin (0.66±0.22 vs. 0.55±0.13 IJ/kg BM, p < 0.05) during the CSII therapy. There were significant correlations between fetal weight and HbA1c (r = -0.60, p < 0.05), triglyceride levels (r = −0.63, p < 0.01), and the number of pregnancies (r = −0.62, p < 0.01), as well as between APGAR score and MBG (r = −0.52, p < 0.05) and cholesterol levels (r = −0.65, p < 0,01) before a portable insulin pump was applicated. Conclusions. There was a significant improvement in the quality of glycoregulation during CSII therapy in the pregnant women with type 1 diabetes mellitus. The quality of glycoregulation in the moment of conception was the important factor for pregnancy outcome.

Published
2006
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7. Age and body mass related changes of cardiovascular risk factors in women with polycystic ovary syndrome

Author

Macut Đuro P., Micić Dragan D., Parapid Biljana, Cvijović Goran, Šumarac-Dumanović Mirjana S., Kendereški Aleksandra S., Milić Nataša M., Tulić Lidija, Muharemagić Azra, Zorić Svetlana, and Pejković Danica

Subjects
polycystic ovary syndrome, cardiovascular diseases, risk factors, age factors, body mass index, insulin resistance, lipids, blood pressure, glucose tolerance test, Medicine (General), R5-920
Abstract

Polycystic ovary syndrome (PCOS) is considered a metabolic disorder closely related to obesity, insulin resistance (IR), hyperinsulinemia and unfavorable lipid profile, all increasing the risk for the occurrence of cardiovascular diseases. The aim of this study was to assess age and body mass index (BMI) related changes of cardiovascular risk factors in 90 women with PCOS. The cut-off age point was 30 years and for BMI 27.8 kg/m2. In all patients systolic and diastolic blood pressure (BP), metabolic parameters comprising values of glucose and insulin during oral glucose tolerance test (OGTT), and basal lipid values were determined. Significant increase in blood pressure (BP) indices, basal insulin values and insulin resistance (IR) assessed by HOMA model were observed with aging and the increase of BMI, while the parameters of glucose metabolism, total cholesterol and triglycerides were significantly elevated only with aging. However, the correlation between the indices of arterial blood pressure, and lipid and glucose metabolism parameters occurred only in patients over 30 years of age, pointing to the causative relation and the consequent deterioration of IR and lipid profile with aging, influencing cardiovascular function in women with PCOS.

Published
2002
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11. Sekrecija insulina i insulinska senzitivnost perifernih tkiva pre i nakon radikalnog lečenja primarnog hiperparatireoidizma

Author

Micić, Dragan, Žarković, Miloš, Kendereški, Aleksandra, Hajduković, Zoran, Cvijović, Goran M., Micić, Dragan, Žarković, Miloš, Kendereški, Aleksandra, Hajduković, Zoran, and Cvijović, Goran M.

Abstract

Uvod i cilj: Prethodno je uočeno postojanje insulinske rezistencije i povećana prevalenca oštećene tolerancije na glikozu i tipa 2 dijabetesa kod pacijenata sa primarnim hiperparatireoidizmom. Efekat paratireoidektomije na insulinsku senzitivnost je praćen kontraverznim nalazima u zavisnosti od metode koja je korištena za procenu insulinske senzitivnosti: nije bilo promene kada su korišteni HOMA i QUICKI dok je Minimalnim modelom pokazano značajno poboljšanje insulinske senzitivnosti.Cilj ovog rada je bio da se proceni insulinska senzitivnost pre i nakon paratireoidektomije kod pacijenata sa PHPT putem euglikemijskog hiperinsulinemijskog klampa. Materijal i metode: Kod 44 pacijenta sa PHPT i 11 zdravih kontrola komparabilne starosti i indeksa telesne mase procenjivali smo insulinsku senzitivnost (pomoću tehnike klampa, HOMA IR i ISI indeksa), insulinsku sekreciju (putem površine pod krivom za glikemije i insulinemije tokom OGTTa i izračunavajući akutni insulinski odgovor iz podataka dobijenih IVGTTom), lipidni profil i nivo hsCRP kao marker hronične inflamacije. Rezultati: Pre operacije vrednosti M indeksa i HOMA IR su ukazivale na postojanje insulinske rezistencije kod pacijenata sa PHPT. Nije bilo razlike u M indeksu (3.74±1.89 vs 4.62±2.27, p >0.05), HOMA IR (2.94±1.39 vs. 3.29±0.81, p > 0.05), AUC glikoze (863.0±261.3 vs 842.3±165.5, p>0.05), AUC insulina (7068.7±4159.0 vs 7229.6±2581.7, p>0.05), ISI (4.73±2.77 vs 4.25±2.94, p>0.05) i AIR (47.89±32.05 vs. 38.96±21.20, p>0.05) izmeĎu pacijenata sa PHPT i zdravih kontrola. Došlo je do značajnog poboljšanja insulinske senzitivnosti nakon operacije al ii preoperativna i postoperativna vrednost M indeksa se nisu razlikovale od zdravih kontrola. Nije uočena promena u HOMA IR, AUC za glikozu i insulin ISI i AIR, lipidima i hsCRP nakon operacije. Zaključak: Dobili smo značajno poboljšanje insulinske senzitivnosti nakon paratireoidektomije kod pacijenata sa PHPT koristeći klamp tehniku. Postoperativno nije do došlo do zn, Background and Aims: Previous studies demonstrated insulin resistance and increased prevalence of impaired glucose tolerance and type 2 diabetes mellitus in patients with primary hyperparathyroidism (PHPT). The effect of curative parathyroidectomy on insulin sensitivity was associated with conflicting results depending on which method for measuring the insulin sensitivity has been used. There was no improvement using HOMA and QUICKI while minimal model demonstrated significant improvement in insulin sensitivity. The aim of our study was to evaluate the insulin sensitivity before and after parathyroidectomy in patients with PHPT using a euglycemic clamp. Material i methods: Forty-four patients with PHPT and eleven age and body mass index matched healthy controls participated in study protocol. We measured insulin sensitivity using euglycemic clamp technique, HOMA IR and ISI. Insulin secretion was evaluated using area under the curve for glucose and insulin during OGTT and calculating the acute insulin response durin IVGTT. Also, lipid profile and hsCRP were evaluated Results: Before surgery M values and HOMA IR suggest insulin resistance in patients with PHPT. There was no difference in M index (3.74±1.89 vs 4.62±2.27, p >0.05), HOMA IR (2.94±1.39 vs. 3.29±0.81, p > 0.05), AUC glucose (863.0±261.3 vs 842.3±165.5, p>0.05), AUC insulin (7068.7±4159.0 vs 7229.6±2581.7, p>0.05), ISI (4.73±2.77 vs 4.25±2.94, p>0.05) and AIR (47.89±32.05 vs. 38.96±21.20, p>0.05) between patients with PHPT and HC. There was significant improvement in insulin sensitivity after parathyroidectomy but both preoperative and postoperative M values were not significantly different in comparison to HC. There were no significant changes in HOMA IR, AUC glucose, AUC insulin, ISI and AIR before and after therapy, as well in lipid and hsCRP levels. Conclusion: we observed significant improvement in insulin sensitivity after parathyroidectomy in patients with PHPT. There was no difference in parameters

Published
2016

12. Ventilatory anaerobic threshold six months after RYGB

Author

Polovina, Snezana, primary, Nedeljekovic, Ivana, additional, Bajec, Djordje, additional, Sumarac-Dumanovic, Mirjana, additional, Radenkovic, Dejan, additional, Kendereški, Aleksandra, additional, Gregoric, Pavle, additional, Cvijovic, Goran, additional, Micic, Dusan, additional, Zoric, Svetlana, additional, Stamenkovic-Pejkovic, Danica, additional, Milin-Lazovic, Jelena, additional, Jeremic, Danka, additional, Gligic, Ana, additional, and Micic, Dragan, additional

Published
2016
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13. NEHIRURŠKE KOMPLIKACIJE HIRURŠKOG LEČENJA GOJAZNOSTI.

Author

Polovina, Snežana, Micić, Dragan, Micić, Dušan, Dumanović, Mirjana Šumarac, Kendereški, Aleksandra, Micić, J., Pejković, Danica Stamenković, Cvijović, Goran, Zorić, S., Jeremić, D., and Bjelović, Miloš

Subjects
FETAL growth retardation, BONE density, BARIATRIC surgery, GASTRIC bypass, WEIGHT loss, FETAL surgery
Abstract

Copyright of Medical Gazette / Medicinski Glasnik is the property of Specijalna bolnica za bolesti stitaste zlezde i bolesti metabolizma Zlatibor and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2017

14. SHBG and testosterone are associated with inflammation in obese men

Author

Milin-Lazović, Jelena, primary, Polovina, Snežana, additional, Šumarac-Dumanović, Mirjana, additional, Stamenković-Pejković, Danica, additional, Jeremić, Danka, additional, Cvijović, Goran, additional, Zorić, Svetlana, additional, Kendereški, Aleksandra, additional, and Micić, Dragan, additional

Published
2013
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15. PSEUDOPSEUDOHIPOPARATIREOIDIZAM ILI ALBRAJTOVA HEREDITARNA OSTEODISTROFIJA LIKE SYNDROME.

Author

Stamenković-Pejković, Danica, Gligić, Ana, Cvijović, Goran, Zorić, Svetlana, A., Danka Jeremić, Polovina, Snežana, Kendereški, Aleksandra, Micić, Dragan, and Šumarac-Dumanović, Mirjana

Abstract

Copyright of Medical Gazette / Medicinski Glasnik is the property of Specijalna bolnica za bolesti stitaste zlezde i bolesti metabolizma Zlatibor and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2016
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21. GOJAZNOST I METABOLIČKI SINDROM.

Author

Kendereški, Aleksandra

Abstract

Metabolički sindrom je predmet velikog interesovanja, klinički je važan i još uvek je koncept u evoluciji. Nastaje nagomilavanjem masnog tkiva u metabolički predisponiranih osoba. I mada nastaje kompleksnom interakcijom genetskih faktora i faktora sredine, nesumnjivo je da su prekomerni unos hrane i fizička neaktivnost glavni uzročni faktori. Gojaznost zauzima centralno mesto, ali nije apsolutno neophodna u patogenezi metaboličkog sindroma. I dok je sa evolucijske tačke gledišta potpuno jasno ne samo zašto nastaje metabolički sindrom, već i zašto poprima epidemijske razmere, na molekularnom nivou patogeneza nije sasvim razjašnjena. Dokazana je međutim uloga i mehanizam delovanja slobodnih masnih kiselina i adipokina u patogenezi insulinske rezistencije, i hroničnog niskoaktivnog metaboličkog zapaljenja odnosno metaboličkog sindroma. Svoje mesto u patogenezi metaboličkog sindroma ima i genetsko programiranje, narušavanje cirkadijalnog ritma, starenje, a moguće i disregulacija 11 beta hidroksidehidrogenaze 1. Mada je bilo osporavanja, nesumnjiv klinički značaj metaboličkog sindroma je u predviđanju dugoročnog i korekciji kratkoročnog rizika za kardiovaskularane bolesti i diabetes mellitus tip 2. Redukcija telesne težine je najbolji način prevencije i lečenja metaboličkog sindroma. Značaj metaboličkog sindroma je u predviđanju: 1. kratkoročnog 2. dugoročnog 3. dugoročnog, i korekciji kratkoročnog 4. kratkoročnog, i korekciji dugoročnog rizika za razvoj kardiovaskularnih bolesti i šećerne bolesti tipa 2. [ABSTRACT FROM AUTHOR]

Published
2012

22. MENOPAUZALNI POLNI HORMONI I DISTRIBUCIJA MASNOG TKIVA U GOJAZNIH ŽENAc.

Author

Jeremić, Danka, Šumarac Dumanović, Mirjana, Polovina, Snežana, Stamenković Pejković, Danica, Milin Lazović, Jelena, Cvijović, Goran, Zorić, Svetlana, Kendereški, Aleksandra, and Micić, Dragan

Abstract

Copyright of Medical Gazette / Medicinski Glasnik is the property of Specijalna bolnica za bolesti stitaste zlezde i bolesti metabolizma Zlatibor and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2012

23. Primena kontinuirane supkutane infuzije insulina samonosećom insulinskom pumpom kod trudnica sa tipom 1 dijabetesa.

Author

Zorić, Svetlana, Micić, Dragan, Kendereški, Aleksandra, Šumarac-Dumanović, Mirjana, Cvijović, Goran, Pejković, Danica, Cvetković, Miloš, Ljubić, Aleksandar, and Dukanac-Stamenković, Jelena

Subjects
*DIABETES, *PREGNANCY, *INSULIN pumps, *THERAPEUTICS, *GLUCOSE
Abstract

Background/Aim. Diabetes mellitus is associated with an increased risk for neonatal morbidity and mortality. One of the most important goals in treating pregnancies complicated with diabetes is keeping glucose level within the normal range, especially in the first trimester. A portable insulin pump for continuous subcutaneous insulin infusion (CSII) represents the best form of therapy for patients with type 1 diabetes mellitus during pregnancy. The aim of our study was to evaluate the effects of therapy with a portable insulin pump for continuous subcutaneous insulin infusion during the first trimester of pregnancy on the quality of glycoregulation and pregnancy outcome in women with type 1 diabetes mellitus. Methods. A total of 17 newly diagnosed pregnant women with type 1 diabetes mellitus were treated with CSII therapy for three months. The parameters of glycoregulation (hemoglobin A, glycosylated -- HbA1c, mean blood glucose value in daily profiles - MBG, daily requirement for insulin -- IJ/kg BM), lipid levels, blood preassure and renal function were estimated before and after the therapy. These parameters were correlated with parameters of pregnancy outcome: fetal weight, APGAR score, duration of pregnancy. Results. There was a significant improvement in HbA1c (8.94±1.62 vs. 6.90±1.22%, p < 0.05), MBG (9.23±2.22 vs. 6.41±1.72 mmol/l, p < 0.01), and daily requirement for insulin (0.66±0.22 vs. 0.55±0.13 IJ/kg BM, p < 0.05) during the CSII therapy. There were significant correlations between fetal weight and HbA1c (r = -0.60, p < 0.05), triglyceride levels (r = -0.63, p < 0.01), and the number of pregnancies (r = -0.62, p < 0.01), as well as between APGAR score and MBG (r = -0.52, p < 0.05) and cholesterol levels (r = -0.65, p < 0,01) before a portable insulin pump was applicated. Conclusions. There was a significant improvement in the quality of glycoregulation during CSII therapy in the pregnant women with type 1 diabetes mellitus. The quality of glycoregulation in the moment of conception was the important factor for pregnancy outcome. [ABSTRACT FROM AUTHOR]

Published
2006
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24. Sekrecija insulina i insulinska senzitivnost perifernih tkiva pre i nakon radikalnog lečenja primarnog hiperparatireoidizma

Author

Cvijović, Goran M., Micić, Dragan, Žarković, Miloš, Kendereški, Aleksandra, and Hajduković, Zoran

Subjects
insulin secretion, primarni hiperparatireoidizam, insulin sensitivity, primary hyperparathyroidism, insulinska senzitivnost, sekrecija insulina
Abstract

Uvod i cilj: Prethodno je uočeno postojanje insulinske rezistencije i povećana prevalenca oštećene tolerancije na glikozu i tipa 2 dijabetesa kod pacijenata sa primarnim hiperparatireoidizmom. Efekat paratireoidektomije na insulinsku senzitivnost je praćen kontraverznim nalazima u zavisnosti od metode koja je korištena za procenu insulinske senzitivnosti: nije bilo promene kada su korišteni HOMA i QUICKI dok je Minimalnim modelom pokazano značajno poboljšanje insulinske senzitivnosti.Cilj ovog rada je bio da se proceni insulinska senzitivnost pre i nakon paratireoidektomije kod pacijenata sa PHPT putem euglikemijskog hiperinsulinemijskog klampa. Materijal i metode: Kod 44 pacijenta sa PHPT i 11 zdravih kontrola komparabilne starosti i indeksa telesne mase procenjivali smo insulinsku senzitivnost (pomoću tehnike klampa, HOMA IR i ISI indeksa), insulinsku sekreciju (putem površine pod krivom za glikemije i insulinemije tokom OGTTa i izračunavajući akutni insulinski odgovor iz podataka dobijenih IVGTTom), lipidni profil i nivo hsCRP kao marker hronične inflamacije. Rezultati: Pre operacije vrednosti M indeksa i HOMA IR su ukazivale na postojanje insulinske rezistencije kod pacijenata sa PHPT. Nije bilo razlike u M indeksu (3.74±1.89 vs 4.62±2.27, p >0.05), HOMA IR (2.94±1.39 vs. 3.29±0.81, p > 0.05), AUC glikoze (863.0±261.3 vs 842.3±165.5, p>0.05), AUC insulina (7068.7±4159.0 vs 7229.6±2581.7, p>0.05), ISI (4.73±2.77 vs 4.25±2.94, p>0.05) i AIR (47.89±32.05 vs. 38.96±21.20, p>0.05) izmeĎu pacijenata sa PHPT i zdravih kontrola. Došlo je do značajnog poboljšanja insulinske senzitivnosti nakon operacije al ii preoperativna i postoperativna vrednost M indeksa se nisu razlikovale od zdravih kontrola. Nije uočena promena u HOMA IR, AUC za glikozu i insulin ISI i AIR, lipidima i hsCRP nakon operacije. Zaključak: Dobili smo značajno poboljšanje insulinske senzitivnosti nakon paratireoidektomije kod pacijenata sa PHPT koristeći klamp tehniku. Postoperativno nije do došlo do značajne promene u drugim pokazateljima insulinske senzitivnosti, paramtrima insulinske sekrecije, lipidima i hsCRP. Background and Aims: Previous studies demonstrated insulin resistance and increased prevalence of impaired glucose tolerance and type 2 diabetes mellitus in patients with primary hyperparathyroidism (PHPT). The effect of curative parathyroidectomy on insulin sensitivity was associated with conflicting results depending on which method for measuring the insulin sensitivity has been used. There was no improvement using HOMA and QUICKI while minimal model demonstrated significant improvement in insulin sensitivity. The aim of our study was to evaluate the insulin sensitivity before and after parathyroidectomy in patients with PHPT using a euglycemic clamp. Material i methods: Forty-four patients with PHPT and eleven age and body mass index matched healthy controls participated in study protocol. We measured insulin sensitivity using euglycemic clamp technique, HOMA IR and ISI. Insulin secretion was evaluated using area under the curve for glucose and insulin during OGTT and calculating the acute insulin response durin IVGTT. Also, lipid profile and hsCRP were evaluated Results: Before surgery M values and HOMA IR suggest insulin resistance in patients with PHPT. There was no difference in M index (3.74±1.89 vs 4.62±2.27, p >0.05), HOMA IR (2.94±1.39 vs. 3.29±0.81, p > 0.05), AUC glucose (863.0±261.3 vs 842.3±165.5, p>0.05), AUC insulin (7068.7±4159.0 vs 7229.6±2581.7, p>0.05), ISI (4.73±2.77 vs 4.25±2.94, p>0.05) and AIR (47.89±32.05 vs. 38.96±21.20, p>0.05) between patients with PHPT and HC. There was significant improvement in insulin sensitivity after parathyroidectomy but both preoperative and postoperative M values were not significantly different in comparison to HC. There were no significant changes in HOMA IR, AUC glucose, AUC insulin, ISI and AIR before and after therapy, as well in lipid and hsCRP levels. Conclusion: we observed significant improvement in insulin sensitivity after parathyroidectomy in patients with PHPT. There was no difference in parameters of insulin secretion before and after parathyroidectomy in patients with PHPT.

Published
2016

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