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Serum Vitamin D Associated with Insulin Secretory Function in Impaired Fasting Glucose Subjects

Journal of Biosciences and Medicines 2019年第1期7卷 83-98页

作者： A. K. M. Shahidur Rahman Md. Arifuzzaman Sohel Farjana Rahman Bhuiyan Fahad Al Shatil Ashrafee Md. Kabir Hossain syed fazlul islam Mohammad Ibrahim Ali Rahelee Zinnat Department of Nephrology Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh Department of Biochemistry & Cell Biology Bangladesh University of Health Sciences (BUHS) Dhaka Bangladesh Department of Urology Dhaka Medical College Hospital Dhaka Bangladesh

Background: Impaired fasting glucose (IFG) is a prediabetic condition and is a high-risk state for developing diabetes and associated complications. The aim of this study was to explore the association of vitamin D with insulin secretory function among the IFG subjects. Materials and Methods: This was a prospective cross-sectional study conducted in the Department of Biochemistry and Cell Biology, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh;from June 2016 to May 2017, on forty-six (46) IFG subjects. Serum blood glucose was measured by glucose-oxidase method, Fasting serum lipid profile (Total cholesterol, TG and HDL-c);liver enzyme like alanine aminotransferase (ALT) was measured by enzymatic-colorimetric method;Serum creatinine was measured by colorimetric kinetic method;Serum Insulin and vitamin D [25(OH)D] were measured by ELISA method;insulin secretory capacity (HOMA%B) and insulin sensitivity (HOMA%S) were calculated by Homeostasis Model Assessment (HOMA) using HOMA-CIGMA software. Results: Among 46 IFG subjects, 22 (47.8%) were male and rest 24 (52.2%) were female and their mean age was 40 (±8) years. Mean fasting serum glucose level of the study subjects was 6.33 (±0.23) mmol/l and mean postprandial serum glucose level was 7.23 (±0.41) mmol/l. Mean serum vitamin D level of the study subjects was 26.54 (±8.83) ng/ml. Mean HOMA%S, HOMA%B and HOMA%IR of the total study subjects were 48.34 (±16.70), 102.16 (±23.13) and 2.28 (±0.70) respectively. Insulin secretory capacity (HOMA%B) was significantly higher (p = 0.047) in the subjects having higher vitamin D [25(OH)D level ≥ 20 ng/ml] compared to the subjects having lower vitamin D [25(OH)D levels Conclusion: High prevalence of hypovitaminosis D exists among IFG subjects. Vitamin D is associated with insulin secretory function in IFG subjects. Population based prospective studies using larger sample size should be done to confirm the results.

关键词： Impaired Fasting Glucose (IFG) Insulin Secretory Capacity Insulin Sensitivity Prediabetes Vitamin D

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Incidence, Risk Factors and Short Term Outcome of Acute Kidney Injury among Patients with Acute Coronary Syndrome

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Journal of Biosciences and Medicines 2020年第5期8卷 177-188页

作者： Md. Kabir Hossain Muhammad Rafiqul Alam Asia Khanam A. K. M. Shahidur Rahman Rafi Nazrul islam syed fazlul islam Mohammad Kamrul Ahsan S. K. Mamun-Ar-Rashid Tanvir Rahman Md. Nazmul Hasan Department of Nephrology Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh Department of Nephrology & Dialysis BIRDEM General Hospital Dhaka Bangladesh Holy Family Red Crescent Medical College Hospital (HFRCMCH) Dhaka Bangladesh Department of Medicine Khulna Medical College Hospital Khulna Bangladesh Department of Nephrology United Hospital Limited Dhaka Bangladesh Department of Cardiology Ad-din Medical College Hospital Dhaka Bangladesh

Background: Cardio-renal syndrome is the leading cause of death globally. Acute kidney injury (AKI) is a major complication among patients admitted in Coronary Care Unit (CCU) with acute coronary syndrome (ACS). AKI in ACS patients is associated with higher morbidity, mortality and prolong hospital stay. Objective: To determine the incidence, risk factors and short term outcome of acute kidney injury (AKI) among the patients admitted in CCU with ACS. Methods: This cross sectional study was conducted at Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2013 to December 2013. Following selection criteria a total of two hundred (200) patients with ACS were studied. AKI was defined according to the KDIGO guideline and further categorized by RIFLE criteria. Data of patients with AKI and those without AKI were analyzed and compared by statistical tests. Results: Majority of the study patients were male (79.5%). AKI was developed in 40 of the 200 study patients (20.0%). The mean (±SD) age of the study patients was 60.1 ± 11.1 years in patients with AKI and 55.9 ± 10.1 years in patients without AKI. Our data analysis showed that older age (>65 years), diabetes mellitus, dyslipidemia and smoking were significantly correlated to the development of AKI. Mortality was significantly high in AKI group (7.15%) compared to no AKI group (1.25%). Out of 27 patients who achieved renal recovery most (80.8%) belonged to risk class. Severity of AKI showed significant effect on renal recovery and final outcome. Conclusion: This study demonstrated that, incidence of AKI among patients with ACS was 20%. Elderly patients, diabetes mellitus, dyslipidemia, and exposure to smoking were significantly associated with development of AKI in ACS.

关键词： Acute Kidney Injury (AKI) Acute Coronary Syndrome (ACS) Cardio-Renal Syndrome

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