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Vitamin D levels in subjects with or without chronic kidney disease among Veterans with diabetes in North East United States

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World Journal of Diabetes 2017年第7期8卷 346-350页

作者： Subhashini Yaturu Barbara Youngberg Sonya Zdunek WJB Dorn va Medical Center/USC School of Medicine Former Research Assistant at stratton va mc at albany stratton va mc at albany

AIM To evaluate the prevalence of vitamin D deficiency and its relation to diabetes and kidney disease in Veterans residing in the North East United States(VISN 2). METHODS In this retrospective study, we used data from the computerized patient record system at stratton Veterans Administration Medical Center at albany, NY(VHA) for those patients who had 25-hydroxyvitamin D levels and 1,25(OH) vitamin D levels measured between 2007 and 2010. We collected demographic information including age, sex, body mass index and race; clinical data including diabetes, hypertension and CAD; and laboratory data including calcium, creatinine and parathyroid hormone(PTH)(intact). Vitamin D deficiency is defined as a serum 25-hydroxyvitamin D level of less than 20 ng/mL(50 nmol/L), and insufficiency is defined as a serum 25-hydroxyvitamin D level of 20 to 30 ng/mL(50 to 75 nmol/L). RESULTS Data was available for approximately 68000 subjects. We identified 64144 subjects for analysis after exclusion of duplicates. Among them, 27098 had diabetes. Themean age of subjects with diabetes was 68 ± 11 with a mean body mass index(BMI) of 32 ± 7 and duration of diabetes of 5.6 ± 3.2 years. The mean 25(OH) vitamin D level among subjects with diabetes was 27 ± 11.6. There was no significant difference in 25(OH) vitamin D levels between subjects with diabetes and glomerular filtration rate(e-GFR) vated PTH-intact. Of the 64144 subjects, 580 had end-stage renal disease. Of those, 407 had diabetes and 173 did not. Vitamin D levels in both groups were in the insufficiency range and there was no significant difference irrespective of presence or absence of diabetes. Subjects with vitamin D levels less than 20 ng/mL had a higher BMI and elevated PTH, and higher HbA 1C levels compared to those with vitamin D levels more than 20 ng/mL. CONCLUSION We conclud

关键词： Vitamin D Type 2 diabetes Men Chronic kidney disease End stage renal disease

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Preoperative physiological esophageal assessment for anti-reflux surgery:A guide for surgeons on high-resolution manometry and pH testing

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World Journal of Gastroenterology 2021年第16期27卷 1751-1769页

作者： Michael Yodice Alexandra Mignucci Virali Shah Christopher Ashley Micheal Tadros Department of Gastroenterology Albany Medical CollegeAlbanyNY 12208United States Section of Gastroenterology Stratton VA Medical CenterAlbanyNY 12208United States Department of Gastroenterology Albany Medical CenterSchenectadyNY 12309United States

Gastroesophageal reflux disease (GERD) is one of the most commonlyencountered digestive diseases in the world, with the prevalence continuing toincrease. Many patients are successfully treated with lifestyle modifications andproton pump inhibitor therapy, but a subset of patients require more aggressiveintervention for control of their symptoms. Surgical treatment with fundoplicationis a viable option for patients with GERD, as it attempts to improve the integrityof the lower esophageal sphincter (LES). While surgery can be as effective asmedical treatment, it can also be associated with side effects such as dysphagia,bloating, and abdominal pain. Therefore, a thorough pre-operative assessment iscrucial to select appropriate surgical candidates. Newer technologies arebecoming increasingly available to help clinicians identify patients with true LESdysfunction, such as pH-impedance studies and high-resolution manometry(HRM). Pre-operative evaluation should be aimed at confirming the diagnosis ofGERD, ruling out any major motility disorders, and selecting appropriate surgicalcandidates. HRM and pH testing are key tests to consider for patients with GERDlike symptoms, and the addition of provocative measures such as straight legraises and multiple rapid swallows to HRM protocol can assess the presence ofunderlying hiatal hernias and to test a patient’s peristaltic reserve prior tosurgery.

关键词： Gastroesophageal reflux disease Fundoplication High resolution manometry pH-impedance Anti-reflux surgery Pre-operative assessment

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Insulin therapies: Current and future trends at dawn

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World Journal of Diabetes 2013年第1期4卷 1-7页

作者： Subhashini Yaturu Endocrinology Section Stratton VA Medical Center Albany NY 12208 United States

Insulin is a key player in the control of hyperglycemia for type 1 diabetes patients and selective individuals in patients of type 2 diabetes. Insulin delivery systems that are currently available for the administration of insulin include insulin syringes, insulin infusion pumps, jet injectors and pens. The traditional and most predictable method for the administration of insulin is by subcutaneous injections. The major drawback of current forms of insulin therapy is their invasive nature. To decrease the suffering, the use of supersonic injectors, infusion pumps, sharp needles and pens has been adopted. Such invasive and intensive techniques have spurred the search for alternative, more acceptable methods for administering insulin. Several non-invasive approaches for insulin delivery are being pursued. The newer methods explored include the artificial pancreas with closedloop system, transdermal insulin, and buccal, oral and pulmonary routes. This review focuses on the new concepts that are being explored for use in future.

关键词： Diabetes Insulin therapy Insulin delivery systems Oral insulin Transdermal insulin Inhaled insulin

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Aspirin resistance in young men with Type 2 diabetes

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Journal of Diabetes Mellitus 2014年第1期4卷 72-76页

作者： Subhashini Yaturu Emmy Dier Huadong Cui Shaker Mousa Endocrinology and Metabolism Stratton VA Medical Center Albany USA The Pharmaceutical Research Institute Albany College of Pharmacy and Health Sciences Rensselaer NY USA

Objective: Aspirin resistance (AR) or poor response to aspirin is said to be high among subjects with diabetes and more so in patients with poor glycemic control. The aim of our study was to evaluate the prevalence of AR among subjects with diabetes with moderate glycemic control and its association with inflammatory markers and cytokines. Design: This is a single-center open-label prospective clinical study. Methods: The study included 142 young male veterans (mean age of 49years) with Type 2 diabetes, with HbA1C of 7.7 ± 1.1. Urinary 11-dehydro-thromboxane beta-2 (11DhTx2) concentrations measured by immunoassay are the primary outcome measures. Results: Urinary 11DhTxB2 levels ≥ 1500 pg/mg of creatinine is considered as AR. Approximately 53% of subjects had AR. There are no significant differences in the clinical parameters, such as age, history of hypertension or BMI, waist to hip ratio;as well as biochemical parameters, such as HbA1C, lipid parameters or serum creatinine, between subjects with or without AR. Levels of 11DhTxB2 /cre correlated with history of CAD, abdominal fat content and IL-6 levels (p various associated risk factors.

关键词： Aspirin Aspirin Resistance Type 2 Diabetes Men CRP IL-6 Adiponectin Body Composition Abdominal Fat

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Visfatin levels are low in subjects with type 2 diabetes compared to age-matched controls

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Journal of Diabetes Mellitus 2012年第4期2卷 373-377页

作者： Subhashini Yaturu Jared Davis LaTonya Franklin Runhua Shi Prasanna Venkatesh Sushil K. Jain Department of Medicine Stratton VA Medical Center/AMC Albany USA Department of Research Overton Brooks VA Medical Center Shreveport USA Louisiana State University Health Sciences Center Shreveport USA Overton Brooks va Medical Center/LSUHSC Shreveport USA

Background: Visceral adiposity correlates strongly with insulin resistance and components of metabolic syndrome. Visfatin is preferentially produced by human visceral adipose tissue. Objective: The objective of this study was to evaluate the relationship between circulating levels of visfatin and other adipocytokines in patients with type 2 diabetes (DM) compared to the age-matched control subjects without DM. Methods: Anthropometric parameters, lipid profiles, high-sensitivity CRP (hs-CRP), insulin resistance [HOMA-IR], and levels of visfatin, TNF-α, and resistin were evaluated in 55 subjects with diabetes and 56 age matched control subjects without diabetes. Results: The visfatin levels were significantly lower in subjects with diabetes (p < 0.0001). Visfatin levels correlated strongly with resistin and CRP. We noted negative correlation of visfatin levels with BMI, triglycerides and glucose. Conclusion: These data suggest that visfatin may be a marker of subclinical inflammatory state.

关键词： Visfatin Adiponectin Resistin Diabetes Insulin Resistance TNF-α BMI Metabolic Syndrome Visceral Adiposity

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Oral bisphosphonates improve the bone mineral density in men with diabetes with or without thiazolidinediones

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Journal of Diabetes Mellitus（糖尿病） 2011年第4期

作者： Subhashini Yaturu Jared Davis Section of Endocrinology and Metabolism stratton va Medical Center albany USA Overton Brooks va Medical Center Shreveport USA.

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Higher Prevalence of Prostate Cancer among Veterans with Type 2 Diabetes

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Journal of Diabetes Mellitus 2017年第4期7卷 316-320页

作者： Subhashini Yaturu Nagwa Benyamin Barbara Youngberg Michael Marchese Dorn va Medical Center/USC School of Medicine Columbia SC USA

Background: Diabetes mellitus and cancer are common conditions. Based on epidemiological evidence, American Diabetes Association (ADA) and the American Cancer Society (ACS) concluded that patients with diabetes are at a higher risk for cancers in their joint position statement. That statement includes a meaningful association between cancer and diabetes;common risk factors for both;possible biological links between the two and also whether the diabetes therapy alters risk or prognosis of cancer. Additional comments included lack of association or evidence between diabetes and cancers such as lung cancer and lymphomas;and reduced risk of prostate cancer among subjects with type 2 diabetes. It was also stated that some cancers such as liver, pancreas, colon and rectum, breast, bladder and endometrial cancers. Since prevalence of diabetes is more than 25% among Veterans, our aim of this study was to evaluate the prevalence of various cancers among Veterans with type 2 diabetes at albany, NY. Methods: In a single center, retrospective chart review study was carried out using computerized patient records, after the Institutional Review Board and Research and development review board at Veterans health administration at stratton va mc at albany, New York. Using CPT codes and verification by review of clinical and laboratory information, the study was carried out. The information collected include the BMI, smoking status, duration of diabetes, medications used, other medical problems such as hypertension, atherosclerotic cardiovascular disease, various cancers;laboratory data included HbA1C, eGFR, Creatinine and lipid parameters. Results: The study identified 6777 subjects with type 2 diabetes with a mean age of 61 ± 10 and BMI of 32.6 ± 6. Total of 1046 subjects identified with cancers, after exclusion of skin cancers. The most common cancers among Veterans with type 2 DM are prostate cancer, colon cancer, bladder cancer and Lung Cancer. Other cancers include renal cell c

关键词： Diabetes Cancer Prostate Cancer Colon Cancer Kung Cancer

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