ACTA ENDOCRINOLOGICA (BUC)

Context. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a novel biomarker for cardiovascular diseases (CVD) risk estimation with high specificity for vascular inflammation. Few studies have investigated Lp-PLA2 levels in patients with metabolic syndrome (MetS) and obstructive sleep apnea syndrome (OSAS). Objective. This study aimed to evaluate the role of Lp-PLA2 levels as a marker of vascular inflammation that contributes to cardiometabolic dysfunction in patients with MetS and OSAS. Design. This is a prospective case-control study. Subjects and Methods. 83 men were enrolled. Following anthropometric measurements, laboratory analysis and overnight sleep study, patients were divided into three groups: MetS, OSAS with/without MetS. Serum Lp-PLA2 levels were determined by ELISA method. Results. Serum Lp-PLA2 levels were statistically significant among the three groups and were higher in OSAS with MetS group than those without MetS. A significant positive relationship between increased Lp-PLA2 level and CRP (C-reactive protein) and apnea–hypopnea index (AHI) was found. Average oxygen saturation (AvO2) and the lowest oxygen saturation were negatively correlated with Lp-PLA2. The number of desaturation events, oxygen desaturation index, AvO2, AHI and CRP were significant predictors of Lp-PLA2. Conclusions. Lp-PLA2 levels are associated with OSAS severity and might play an important role in predicting CVD in OSAS with/without MetS

Context. Despite the available evidence showing the vital role of glycemic control in the management of type 2 diabetes, a significant proportion of patients are not achieving a good glycemic control. Objective. Here we present the results of the Diabetes Unmet Need with basal insulin Evaluation (DUNE) study for patients enrolled in Romanian centers with the aim to describe the proportion of participants who achieved individualized HbA1c targets at 12 weeks following basal insulin therapy initiation. Design. Prospective, observational study. Subjects and Methods. 355 consecutive adults with type 2 diabetes, who were newly initiated with basal insulin therapy (Newly initiated group) or had been treated for less than 12 months with basal insulin prior to study enrollment (Previously initiated group) were enrolled and followed for 12 weeks. Results. The individualized HbA1c target was achieved by 22.7% of the patients in the Newly initiated group and by 25.0% of the patients in the Previously initiated group. During the study period, in the Newly initiated group mean basal insulin dose increased from 16.2 U at baseline to 27.6 U at 12 weeks. In the Previously initiated group, the insulin dose increased from 27.4 U at baseline to 33.1 U at 12 weeks. In both groups, 9.7% and 12.8% of the patients reported at least 1 episode of symptomatic hypoglycemia. Conclusions. In real-world settings, despite insulin initiation a large number of patients fail to achieve their individualized glycemic targets. One of the reasons appeared to be linked to the insufficient basal insulin titration.

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