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Clinical Conference Lipid-lowering drug atorvastatin as an adjunct in the management of diabetic macular edema. 2004
Gupta A, Gupta V, Thapar S, Bhansali A. · Department of Ophthalmology, Postgraduate Institute of Education and Research, Chandigarh, India. · Am J Ophthalmol. · Pubmed #15059707 No free full text.
Abstract: PURPOSE: To determine the efficacy of the lipid-lowering drug atorvastatin in reducing retinal hard exudates and subfoveal lipid migration after focal/grid laser photocoagulation in clinically significant macular edema in patients with diabetes with elevated serum lipids. DESIGN: Randomized case trial. METHODS: Thirty patients with type 2 diabetes with clinically significant macular edema, dyslipidemia, and hard exudates of grade 4 and above were assessed in an institutional setting. All patients were subjected to strict metabolic control within 4 to 6 weeks of enrollment. In addition, 15 patients in group A received atorvastatin, a 3-hydroxy-3-methylglutaryl coenzyme A inhibitor; 15 members of group B did not receive any lipid-lowering therapy. All received laser photocoagulation after a metabolic control period and were followed up for a minimum of 18 weeks. The outcome measures were reduction in hard exudates, subfoveal lipid migration, status of macular edema, and visual acuity. RESULTS: The study included 21 men and nine women with noninsulin-dependent diabetes mellitus who could achieve good metabolic control within 4 to 6 weeks of inclusion in the study. All patients had elevated serum lipids at baseline. Ten (66.6%) of 15 patients in treatment group A and two (13.3%) of 15 patients in control group B showed reduction in hard exudates (P =.007). None of the patients in group A and five (33.3%) of 15 in group B showed subfoveal lipid migration after laser photocoagulation (P =.04). Regression of macular edema was seen in nine eyes in group A and five in group B (P =.27). None of the eyes in group A and three eyes in group B showed worsening of visual acuity (P =.22). CONCLUSION: Oral atorvastatin therapy in patients with type 2 diabetes with dyslipidemia reduces the severity of hard exudates and subfoveal lipid migration in clinically significant macular edema and could be an important adjunct in the management of clinically significant macular edema.
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Article Prevalence of metabolic syndrome in an Indian urban population. 2004
Gupta R, Deedwania PC, Gupta A, Rastogi S, Panwar RB, Kothari K. · Department of Medicine, Monilek Hospital and Research Centre, Jawahar Nagar, Jaipur 302004, India. · Int J Cardiol. · Pubmed #15458693 No free full text.
Abstract: OBJECTIVES: To determine prevalence of the metabolic syndrome using United States Adult Treatment Panel-3 (ATP-3) guidelines in an urban Indian population. METHODS: Randomly selected adults >20 years were studied using stratified sampling. Target study sample was 1800 with population proportionate distribution (men 960, women 840). Evaluation of anthropometric variables, blood pressure, fasting blood glucose and lipids was performed. Subjects (1123; response 62.4%) were examined, fasting blood samples were available in 1091 (532 men, 559 women) and analysed for prevalence of metabolic syndrome. Atherosclerosis risk factors were determined using the current guidelines. Metabolic syndrome was diagnosed when any three of the following were present: central obesity, raised triglycerides >/=150 mg/dl (>/=1.7 mmol/l), low high-density lipoprotein (HDL) cholesterol, blood pressure >/=130/>/=85 mm Hg, and diabetes or fasting glucose >110 mg/dl (>6.1 mmol/l). Intergroup comparisons were performed using t-test or chi-square test. RESULTS: Metabolic syndrome was present in 345 (31.6%) subjects; prevalence was 122 (22.9%) in men and 223 (39.9%) in women (p<0.001); the age-adjusted prevalence was 24.9%, 18.4% in men and 30.9% in women. There was a significant age-related increase in its prevalence (Mantel-Haenzel chi(2) for trend p<0.05). Prevalence of components of metabolic syndrome in men and women was: central obesity (waist, men >102 cm, women >88 cm) in 116 (25.6%) and 246 (44.0%); low HDL cholesterol (men<40 mg/dl, <1.0 mmol/l), women<50 mg/dl, <1.3 mmol/l) in 292 (54.9%) and 504 (90.2%); high triglycerides >/=150 mg/dl (>/=1.7 mmol/l) in 172 (32.3%) and 160 (28.6%); and impaired fasting glucose or diabetes in 90 (16.9%) and 90 (16.1%). The prevalence of physical inactivity, hypertension, hypercholesterolemia (>/=200 mg/dl, >/=5.2 mmol/l) and high LDL cholesterol (>/=130 mg/dl, >/=3.4 mmol/l) was greater in the metabolic syndrome group in both men and women (p<0.05). CONCLUSIONS: There is a high prevalence of metabolic syndrome in an urban Indian population. Focus of cardiovascular prevention should be at this high-risk group.
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