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  • Wiley  (3)
  • Ma, Ronald C.W.  (3)
  • 1
    Online Resource
    Online Resource
    Circulating branched‐chain amino acids and incident heart failure in type 2 diabetes: The Hong Kong Diabetes Register
    Wiley ; 2020
    In:  Diabetes/Metabolism Research and Reviews Vol. 36, No. 3 ( 2020-03)
    Details
    In: Diabetes/Metabolism Research and Reviews, Wiley, Vol. 36, No. 3 ( 2020-03)
    Abstract: Levels of branched‐chain amino acids (BCAAs, namely, isoleucine, leucine, and valine) are modulated by dietary intake and metabolic/genetic factors. BCAAs are associated with insulin resistance and increased risk of type 2 diabetes (T2D). Although insulin resistance predicts heart failure (HF), the relationship between BCAAs and HF in T2D remains unknown. Methods In this prospective observational study, we measured BCAAs in fasting serum samples collected at inception from 2139 T2D patients free of cardiovascular‐renal diseases. The study outcome was the first hospitalization for HF. Results During 29 103 person‐years of follow‐up, 115 primary events occurred (age: 54.8 ± 11.2 years, 48.2% men, median [interquartile range] diabetes duration: 5 years [1‐10] ). Patients with incident HF had 5.6% higher serum BCAAs than those without HF (median 639.3 [561.3‐756.3] vs 605.2 [524.8‐708.7] μmol/L; P = .01). Serum BCAAs had a positive linear association with incident HF (per‐SD increase in logarithmically transformed BCAAs: hazard ratio [HR] 1.22 [95% CI 1.07‐1.39] ), adjusting for age, sex, and diabetes duration. The HR remained significant after sequential adjustment of risk factors including incident coronary heart disease (1.24, 1.09‐1.41); blood pressure, low‐density lipoprotein cholesterol, and baseline use of related medications (1.31, 1.14‐1.50); HbA 1c , waist circumference, triglyceride, and baseline use of related medications (1.28, 1.11‐1.48); albuminuria and estimated glomerular filtration rate (1.28, 1.11‐1.48). The competing risk of death analyses showed similar results. Conclusions Circulating levels of BCAAs are independently associated with incident HF in patients with T2D. Prospective cohort analysis and randomized trials are needed to evaluate the long‐term safety and efficacy of using different interventions to optimize BCAAs levels in these patients.
    Type of Medium: Online Resource
    ISSN: 1520-7552 , 1520-7560
    URL: Issue
    URL: Article
    DOI: 10.1002/dmrr.v36.3
    DOI: 10.1002/dmrr.3253
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2001565-3
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  • 2
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    Online Resource
    Glycaemia control and the risk of hospitalisation for infection in patients with type 2 diabetes: Hong Kong Diabetes Registry
    Wiley ; 2017
    In:  Diabetes/Metabolism Research and Reviews Vol. 33, No. 8 ( 2017-11)
    Details
    In: Diabetes/Metabolism Research and Reviews, Wiley, Vol. 33, No. 8 ( 2017-11)
    Abstract: Infection occurs more commonly in diabetic patients compared with the general population and is an under‐recognised but important morbidity in patients with diabetes. We examined the impact of glycaemic control on hospitalisation for infection in a large prospective cohort of Chinese adults with type 2 diabetes. Methods Between July 1994 and June 2014, 22 846 patients with type 2 diabetes underwent detailed assessment of metabolic control and diabetes complications. Patients were followed for occurrence of infection requiring hospitalisation as identified using discharge diagnosis codes. Results Over a median follow‐up of 4.8 years, 20.3% of patients were hospitalised for any infection type, with respiratory tract, genitourinary tract, and skin being the most commonly affected sites. In multivariate Cox regression, time‐dependent HbA1c was associated with all‐site infection (hazard ratio [HR] 1.07 [95% confidence interval {CI}:1.05‐1.09, P   〈  0.001]), genitourinary tract infection (HR 1.09 [95% CI: 1.04‐1.14] , P   〈  0.001), and skin infection (HR 1.16 [95% CI 1.12‐1.21]. P   〈  0.001), but not infection of respiratory tract, and was independent of age, gender, disease duration, smoking, body mass index, glomerular filtration rate, haemoglobin, history of stroke, congestive heart failure, coronary heart disease, peripheral artery disease, diabetic neuropathy and cancer, and baseline drug use. Against an arbitrary HbA1c interval of 〉 7.0‐8.0% (53‐64 mmol/mol), patients with HbA1c ≤6.0% (42 mmol/mol) and 〉 8.0% (64 mmol/mol) had excess risks of infection‐related hospitalisation adjusted for other factors. Conclusions In patients with type 2 diabetes, burden of serious infection is high. In the diabetic population, a U‐shape relationship between glycaemia and infection‐related hospitalisation was detected.
    Type of Medium: Online Resource
    ISSN: 1520-7552 , 1520-7560
    URL: Issue
    URL: Article
    DOI: 10.1002/dmrr.v33.8
    DOI: 10.1002/dmrr.2923
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2001565-3
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  • 3
    Online Resource
    Online Resource
    Interactive effects of testosterone and the androgen receptor CAG repeat length polymorphism on cardiovascular‐renal events and mortality in men with diabetes
    Wiley ; 2019
    In:  Diabetes/Metabolism Research and Reviews Vol. 35, No. 1 ( 2019-01)
    Details
    In: Diabetes/Metabolism Research and Reviews, Wiley, Vol. 35, No. 1 ( 2019-01)
    Abstract: Current evidence relating testosterone to cardiovascular disease and mortality is inconclusive. Cellular effects of testosterone are mediated by androgen receptor and longer receptor gene CAG repeat length correlates with reduced transcriptional activity. We investigated the independent and interactive association of total testosterone and CAG repeat length with incident cardiovascular disease (CVD), chronic kidney disease (CKD) and mortality in Chinese men with type 2 diabetes. Materials and methods From March 2008 and February 2009, 474 men with diabetes underwent structured clinical assessment including genotyping for CAG repeat length. Patients were followed for new‐onset CVD, CKD defined by estimated glomerular filtration rate 〈 60 mL/min/1.73m 2 , and death until 31 May 2015. Results In this cohort (mean age: 58.6 years, disease duration: 15.4 years), CAG repeat number ranged from 11 to 32 with median of 23, and 9.3% had low testosterone. Over follow‐up of 5.8 years, 49 (10.3%) men had CVD, 139 (29.3%) had CKD, and 43 (9.1%) died. In multivariate Cox regression adjusted for age, duration of diabetes, and cardiometabolic risk factors, both total testosterone and interaction term of total testosterone × CAG repeat were associated with all‐cause death with respective hazard ratios 1.63 ( P  = 0.002) and 0.98 ( P  = 0.004). Total testosterone and CAG repeat were not related to incident CVD or CKD. Conclusions Among men with type 2 diabetes, high total testosterone was associated with increased mortality in the presence of shorter CAG repeat length but decreased mortality in those with long CAG repeats.
    Type of Medium: Online Resource
    ISSN: 1520-7552 , 1520-7560
    URL: Issue
    URL: Article
    DOI: 10.1002/dmrr.v35.1
    DOI: 10.1002/dmrr.3081
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2001565-3
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