Weight loss drug’s heart benefits extend to people with heart failure, study finds

The anti-obesity medication semaglutide may help to prevent heart attacks and other major adverse cardiac events among overweight people who have cardiovascular disease, whether or not they also have heart failure, according to a new study led by UCL’s Professor John Deanfield.

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Mpox epidemic disinformation debunked

An mpox outbreak spreading across several African countries, which the World Health Organization has called a global emergency, has caused a spike in online disinformation about the viral disease.

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Fast Track Courts, 15 days Trial: West Bengal CM Mamata Banerjee writes to PM Modi on rape cases

Kolkata: In response to the nationwide outrage over the rape and murder of a postgraduate trainee at RG Kar Medical College in Kolkata, West Bengal Chief Minister Mamata Banerjee has urged the central government to introduce national legislation and establish fast-track courts for handling rape cases. 

Urging the central government to bring in central legalization and set up fast-track courts for ”sensitive” issues, to ensure fast speedy trial, West Bengal Mamata Banerjee on Thursday wrote a letter to Prime Minister Narendra Modi in the wake of the national outrage over the RG Kar medical hospital incident where a second year trainee doctor was raped and murdered. 

According to an ANI report, As the nation fumes over the RG Kar medical hospital incident, igniting discussions and protests on crime against women in India, West Bengal Chief Minister Mamata Banerjee in a letter to PM Modi wrote, “I wish to bring your kind attention to the regular and increasing occurrence of rape cases throughout the country and in many cases, rapes with murder are committed.”

Also Read:Kolkata Doctor Death Case: West Bengal Governor calls emergency meeting after Harbhajan Singh’s letter

Mamata, in the letter, mentioned that such “sensitive” issues need to be addressed comprehensively through stringent central legalization prescribing exemplary punishment against the persons involved in such dastardly crimes.

The Bengal Chief Minister suggested setting up of “fast track special courts” to deal with such cases, which need a speedy trial.

“To ensure justice, trial in such cases should preferably be completed within 15 days,” the letter further read, news agency ANI reported.

”It is horrifying to see that almost 90 cases of rapes occur daily throughout the country. This shakes the confidence and conscience of the society and the nation,” Banerjee said.

The chief minister emphasised that it is the bounden duty” for all of us to put an end to it so that the women feel safe and secure”, reports UNI.

The West Bengal Chief Minister is facing criticism from opposition leaders, including BJP’s Anil K Antony, who has called for her resignation. 

Earlier, BJP leader Anil K Antony on Friday demanded the resignation of West Bengal Chief Minister Mamata Banerjee. He alleged that atrocities against women are high in West Bengal despite the state being ruled by a woman chief minister.

“West Bengal is a state with a woman Chief Minister but when it comes to atrocities against women, West Bengal has become the state with one of the highest number of cases. In the last few months, we have seen what happened in Sandeshkhali, and now in Kolkata. There are allegations as well as proof coming out that the police have been trying to tamper with evidence and protect people involved in this kind of heinous incident,” Anil K Antony told ANI.

“Law and order in the state is non-existent. Both the police department and the health ministry are under the Chief Minister and both ministries are not functioning. BJP demands that the CM should resign for the safety and well-being of the citizens of India,” he added.

On August 9, a postgraduate trainee doctor was raped and murdered on duty at RG Kar Medical College in Kolkata, which has led to nationwide strikes and protests by the medical fraternity.

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NBE Notifies On Documents Submission For employment before joining NBE courses by 2023 admission session trainees, details

New Delhi- The National Board of Examinations in Medical Sciences (NBEMS) through a notice, has informed about the Submission of details regarding employment before joining NBEMS courses by the NBEMS trainees of 2023 admission session.

Earlier, the NBE asked the NBEMS trainees of the 2023 admission session to complete their self-appraisal for registration with NBEMS to pursue their respective allotted NBEMS courses.

As per the notice, trainees who have completed their self-appraisal and are now provisionally registered with NBEMS, are required to update & declare their last employment details through the link available in Trainee Login at OPJR, if they were employed in any Government Institution or organization before the joining of NBEMS course.

Also Read: NBE notifies on Self-appraisal for Trainee Registration in 2023 Admission Session, details

Along with this, trainees are also required to update the said information by selecting “No” in the said last employment declaration form, if they were not employed in any Government Institution or organization before the joining of NBEMS course.

All the provisionally registered trainees of the 2023 admission session should provide this information & upload the required documents, latest by 15th September 2024. With this, the candidate will be solely responsible for the accuracy and authenticity of all the information provided in the self-appraisal form and documents submitted. If any discrepancy or misrepresentation is found in all the information given in the form, the candidate will be terminated by NBEMS without any prior notice or opportunity and the course will also be cancelled.

Meanwhile, after submission of the information by the trainee, the concerned trainee’s hospital or institute is also required to authenticate and verify the same through the link available in the Hospital Login at OPJR.

NBEMS has introduced a Self-Appraisal by candidates for seeking registration with NBEMS as NBEMS trainees to pursue NBEMS courses.

This self-appraisal is meant to determine the eligibility of candidates for registration with NBEMS as trainees after they join the NBEMS-accredited institutions allotted through centralized merit-based counselling. This will be available for candidates who have successfully joined NBEMS courses in the 2023 admission session onwards.

To view the notice, click the link below

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‘Threatened for not doing North Bengal lobbying’: West Bengal Medical College Principals allege threats at IMA meeting

Kolkata: Amid the nationwide protest and administrative changes against the brutal rape and murder of the Postgraduate medico at RG Kar Medical College and Hospital, Heads of various medical colleges disclosed shocking information during a virtual meeting convened by the Bengal branch of the Indian Medical Association (IMA) on Wednesday. 

The meeting was convened to address the growing concerns within the medical community, and all heads of various medical colleges were called upon to attend. During the meeting, the heads of the medical colleges expressed their strong concerns about the safety and security of medical professionals, especially women. 

Around 15 principals of various government medical colleges attended the meeting and shared shocking information that had happened over the past months or years across medical colleges in the state. The attendees emphasized the need for constructive measures to ensure the protection and dignity of medical professionals and pledged to work together to find the right path forward.

Also read- Kolkata Rape-Murder Case: AIIMS doctors call off strike after Supreme Court appeal

Sharing the events that occurred during the meeting, the action committee of IMA West Bengal issued a press release which mentioned that a woman principal recounted that a junior doctor officiating as a member of the penal and ethical committee of the West Bengal Medical Council threatened her for not doing the bidding of the “north Bengal lobby”, purportedly named after their alma mater North Bengal Medical College and Hospital.

During the discussion, she revealed that the doctor had aggressively confronted her via phone call and called her a “bastard” due to her perceived inaction. The medical community expressed disbelief that such language was used and questioned how they could expect justice when such behaviour was allowed to go unchecked. It was further noted that this incident had reached the highest levels of medical administration, yet no disciplinary action was taken.

“We have zero expectation of justice when even a medical college principal does not feel safe at her workplace. What shocked us even more is the non-action from Swasthya Bhawan (the state health department headquarters) despite being informed by the principal (about what she faced). It is evident that the health department is run by power-hungry, blindfolded officials whose only worry is their next posting,” stated the press release. 

Moreover, the current state of the medical education system was also criticized in the meeting with reports of exam papers being leaked before exams, students using mobile devices to cheat with the help of AI tools like ChatGPT.

A head of a medical college in North Bengal alleged that a faculty member had distributed exam questions to students before the examination. In response to these widespread issues, a teacher from North Bengal Teaching Hospital was removed as an invigilator in the middle of an exam. The teacher was later transferred to a remote area to prevent further influence.

Similarly, a principal of a suburban medical college pointed out that the 2024 exam papers showed a high degree of similarity and recommended that exams held this year be reviewed given the fact that at least 40% of the answer sheets were identical. 

Further, the association named two young doctors who were allegedly part of the lobby and mentioned at least one instance of an allegedly politically motivated transfer of a teacher from north Bengal to Kolkata.

“Such mass oppression can only happen when a large part of the system is corrupt and operates like an efficient cartel,” added the association.  

Also read- Ex-colleague moves HC seeking ED probe into alleged financial irregularities by Former RG Kar Principal

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AIIMS Patna Notifies On Documents, Fees Submission for MBBS 2024 Admission

Patna- All India Institute of Medical Sciences (AIIMS), Patna through a notice has released detailed guidelines for candidates willing to take admission to MBBS in AIIMS Patna.

Through the notice, it has been informed that students reporting at AIIMS Patna for admission to MBBS should bring certain Original documents with two sets of self-attested Xerox copies. Of these, candidates have to bring the original copy of the following documents-

ORIGINAL DOCUMENTS

1 10th Mark Sheet.

2 10th Passing Certificate.

3 12th Mark Sheet.

4 12th Passing Certificate.

5 Migration Certificate issued by University/ Board last attended

Along with this, candidates also need to carry the following documents-

1 NEET Registration Slip (provided by NTA).

2 NEET Admit Card (provided by NTA).

3 NEET Score Card/ Rank letter (provided by NTA).

4 Seat Allotment Letter (provided by MCC).

5 Relieving Letters in Original from earlier Institutions where allotted and reported (If applicable)

6 Five recent Passport-size coloured photographs.

7 Identity Proof of Self & Guardian (Aadhar Card/Election Card/Passport/PAN card).

8 Caste Certificate (in case of SC/ST/OBC/EWS Candidates) issued by competent authority for admission in Central Govt. College/Institute. The OBC/EWS certificates issued from 1st April 2023 (inclusive) to the start of reporting of Round-1 of the MBBS 2024 counselling schedule as notified by MCC will be considered valid.

9 PwBD Certificate (wherever required) by a duly constituted and authorized Medical Board from Centres identified as per MCC.

10 Undertaking & Declaration by the candidate(softcopyis attached herewith ).

11 Signed Notarized Affidavit by parent and student regarding rules to be followed by students, securing admission at AIIMS Patna.

Along with the documents, candidates also have to pay ₹ 5,856 as admission fee and ₹ 8,100 as mess charges (for 2 months) at AIIMS Patna. Meanwhile, if any MBBS student vacates/surrenders the confirmed seat, the penalty imposed will be ₹ 3, 00,000/-.

Candidates need to report with the documents and fees to E-Classroom, Administrative Building, AIIMS Patna for MBBS admission from Monday to Friday: 09:30 AM to 05:00 PM and Saturday: 09:30 AM to 01:00 PM. However, for gazetted holidays and off days, the timing is from 11:00 AM to 04:00 PM.

It is to be noted that the students may be prepared for an additional day of stay, as it may take 1-2 days to complete the admission formalities including the medical examination of the candidate, therefore, all the candidates are advised to plan their journey well before time to make the admission process complete and it is also advised not to report on the last date as it will cause difficulty in fulfilling the requisite necessary formalities of admission process, the notice informed.

To view the notice, click the link below

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Consumption of Red and processed meat consumption may increase risk of type 2 diabetes, finds large study

Meat consumption, particularly consumption of processed meat and unprocessed red meat, is associated with a higher type 2 diabetes risk, an analysis of data from 1.97 million participants, published today in The Lancet Diabetes and Endocrinology, has found.

Global meat production has increased rapidly in recent decades and meat consumption exceeds dietary guidelines in many countries. Earlier research indicated that higher intakes of processed meat and unprocessed red meat are associated with an elevated risk of type 2 diabetes, but the results have been variable and not conclusive.

Poultry such as chicken, turkey, or duck is often considered to be an alternative to processed meat or unprocessed red meat, but fewer studies have examined the association between poultry consumption and type 2 diabetes.

To determine the association between consumption of processed meat, unprocessed red meat and poultry and type 2 diabetes, the team led by researchers at the University of Cambridge used the global InterConnect project to analyse data from 31 study cohorts in 20 countries. Their extensive analysis took into account factors such as age, gender, health-related behaviours, energy intake and body mass index.

The researchers found that the habitual consumption of 50 grams of processed meat a day – equivalent to 2 slices of ham – is associated with a 15% higher risk of developing type 2 diabetes in the next 10 years. The consumption of 100 grams of unprocessed red meat a day – equivalent to a small steak – was associated with a 10% higher risk of type 2 diabetes.

Habitual consumption of 100 grams of poultry a day was associated with an 8% higher risk, but when further analyses were conducted to test the findings under different scenarios the association for poultry consumption became weaker, whereas the associations with type 2 diabetes for each of processed meat and unprocessed meat persisted.

Professor Nita Forouhi of the Medical Research Council (MRC) Epidemiology Unit at the University of Cambridge, and a senior author on the paper, said:

“Our research provides the most comprehensive evidence to date of an association between eating processed meat and unprocessed red meat and a higher future risk of type 2 diabetes. It supports recommendations to limit the consumption of processed meat and unprocessed red meat to reduce type 2 diabetes cases in the population.

While our findings provide more comprehensive evidence on the association between poultry consumption and type 2 diabetes than was previously available, the link remains uncertain and needs to be investigated further.”

InterConnect uses an approach that allows researchers to analyse individual participant data from diverse studies, rather than being limited to published results. This enabled the authors to include as many as 31 studies in this analysis, 18 of which had not previously published findings on the link between meat consumption and type 2 diabetes. By including this previously unpublished study data the authors considerably expanded the evidence base and reduced the potential for bias from the exclusion of existing research.

Lead author Dr Chunxiao Li, also of the MRC Epidemiology Unit, said:

“Previous meta-analysis involved pooling together of already published results from studies on the link between meat consumption and type 2 diabetes, but our analysis examined data from individual participants in each study. This meant that we could harmonise the key data collected across studies, such as the meat intake information and the development of type 2 diabetes.

Using harmonised data also meant we could more easily account for different factors, such as lifestyle or health behaviours, that may affect the association between meat consumption and diabetes. “

Professor Nick Wareham, Director of the MRC Epidemiology Unit, and a senior author on the paper said:

“InterConnect enables us to study the risk factors for obesity and type 2 diabetes across populations in many different countries and continents around the world, helping to include populations that are under-represented in traditional meta-analyses.

Most research studies on meat and type 2 diabetes have been conducted in USA and Europe, with some in East Asia. This research included additional studies from the Middle East, Latin America and South Asia, and highlighted the need for investment in research in these regions and in Africa.

Using harmonised data and unified analytic methods across nearly 2 million participants allowed us to provide more concrete evidence of the link between consumption of different types of meat and type 2 diabetes than was previously possible.”

Reference:

Li, C et al. Meat consumption and incident type 2 diabetes: a federated meta-analysis of 1·97 million adults with 100,000 incident cases from 31 cohorts in 20 countries. Lancet Diabetes Endocrinol.; 20 August 2024. DOI:10.1016/S2213-8587(24)00179-7

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Tirzepatide may significantly delay diabetes progression among adults with pre-diabetes and obesity: Study

Tirzepatide may reduce risk of developing type 2 diabetes by 94% among adult patients with pre-diabetes and obesity finds a phase lll study over a 3-year period.

Eli Lilly and Company announced positive topline results from the SURMOUNT-1 three-year study (176-week treatment period) evaluating the efficacy and safety of tirzepatide (Zepbound® and Mounjaro®) once weekly for long-term weight management and delay in progression to diabetes in adults with pre-diabetes and obesity or overweight. Weekly tirzepatide injections (5 mgi, 10 mg, 15 mg) significantly reduced the risk of progression to type 2 diabetes by 94% ii among adults with pre-diabetes and obesity or overweight compared to placebo. Additionally, treatment with tirzepatide resulted in sustained weight loss through the treatment period, with adults on the 15 mg dose experiencing a 22.9% ii average decrease in body weight compared to 2.1% for placebo in adults with pre-diabetes and obesity or overweight at the end of the treatment period.

“Obesity is a chronic disease that puts nearly 900 million adults worldwide at an increased risk of other complications such as type 2 diabetes,” said Jeff Emmick, M.D., Ph.D., senior vice president, product development, Lilly. “Tirzepatide reduced the risk of developing type 2 diabetes by 94% and resulted in sustained weight loss over the three-year treatment period. These data reinforce the potential clinical benefits of long-term therapy for people living with obesity and pre-diabetes.”

Tirzepatide was evaluated in 1,032 adults who had pre-diabetes at randomization and obesity or overweight for a treatment period of 176 weeks, followed by a 17-week off-treatment period (193 weeks in total). Results from the SURMOUNT-1 phase 3 study’s primary analysis at 72 weeks in all participants were published in the New England Journal of Medicine in 2022.

In a key secondary endpoint, tirzepatide led to a significant reduction in the risk of progression to type 2 diabetes in adults with pre-diabetes and obesity or overweight from baseline to week 176 (p<0.0001, controlled for type 1 error). For the efficacy estimandii, pooled doses of tirzepatide achieved significant results, demonstrating a 94% reduction in risk of progression to type 2 diabetes compared to placebo up to week 176. For the treatment-regimen estimandiii, pooled doses of tirzepatide resulted in a significant 93% reduction in risk of progression to type 2 diabetes compared to placebo up to week 176.

In an additional key secondary endpoint, tirzepatide (10 mg and 15 mg) led to statistically significant weight reduction compared to placebo in adults with pre-diabetes and obesity or overweight from baseline to week 176 (p<0.001, controlled for type 1 error). For the efficacy estimandii, adults taking tirzepatide achieved average weight reductions of 15.4% (5 mgi), 19.9% (10 mg) and 22.9% (15 mg) compared to placebo (2.1%) at week 176. For the treatment-regimen estimandiii, adults taking tirzepatide achieved average weight reductions of 12.3% (5 mg i), 18.7% (10 mg) and 19.7% (15 mg) compared to placebo (1.3%) at week 176.

During the 17-week off-treatment follow-up period, those who had discontinued from tirzepatide began to regain weight and had some increase in the progression to type 2 diabetes, resulting in an 88% reduction (p<0.0001, controlled for type 1 error) in the risk of progression to type 2 diabetes compared to placebo.

The overall safety and tolerability profile of tirzepatide over the 193-week study was consistent with the previously published primary results at 72 weeks in SURMOUNT-1 and other tirzepatide clinical studies conducted for chronic weight management. The most frequently reported adverse events were typically gastrointestinal-related and generally mild to moderate in severity. The most common gastrointestinal-related adverse events for patients treated with tirzepatide were diarrhea, nausea, constipation and vomiting.

Tirzepatide, a GIP and GLP-1 receptor agonist, works by activating the two hormone receptors. GLP-1 is a regulator of appetite and caloric intake. Nonclinical studies suggest the addition of GIP may further contribute to the regulation of food intake. Tirzepatide decreases calorie intake, and the effects are likely mediated by affecting appetite. In addition, tirzepatide stimulates insulin secretion in a glucose-dependent manner. Tirzepatide increases insulin sensitivity in patients with type 2 diabetes mellitus and these effects can lead to a reduction of blood glucose.

These topline results provide evidence for reduced risk of progression to type 2 diabetes and long-term maintenance of weight loss with tirzepatide in adults with pre-diabetes and obesity or overweight. Detailed results will be submitted to a peer-reviewed journal and presented at ObesityWeek 2024, which will take place November 3-6.

About SURMOUNT-1

SURMOUNT-1 (NCT04184622) was a multi-center, randomized, double-blind, parallel, placebo-controlled trial comparing the efficacy and safety of tirzepatide 5 mg, 10 mg and 15 mg to placebo as an adjunct to a reduced-calorie diet and increased physical activity in adults without type 2 diabetes who have obesity, or overweight with at least one of the following comorbidities: hypertension, dyslipidemia, obstructive sleep apnea (OSA) or cardiovascular disease. The 1,032 participants who had pre-diabetes at study commencement remained enrolled in SURMOUNT-1 for an additional 104 weeks of treatment following the initial 72-week completion date to evaluate the impact on body weight and potential differences in progression to type 2 diabetes at three years of treatment with tirzepatide compared to placebo.

About tirzepatide

Tirzepatide is a once-weekly GIP (glucose-dependent insulinotropic polypeptide) receptor and GLP-1 (glucagon-like peptide-1) receptor agonist. Tirzepatide is a single molecule that activates the body’s receptors for GIP and GLP-1, which are natural incretin hormones. Both GIP and GLP-1 receptors are found in areas of the human brain important for appetite regulation. Tirzepatide has been shown to decrease food intake and modulate fat utilization. Studies of tirzepatide in chronic kidney disease (CKD) and in morbidity/mortality in obesity (MMO) are also ongoing. Lilly submitted data for tirzepatide in moderate-to-severe obstructive sleep apnea (OSA) and obesity to the U.S. Food and Drug Administration (FDA) and other global regulatory agencies earlier this year. Lilly plans to submit data for tirzepatide in heart failure with preserved ejection fraction (HFpEF) and obesity to the U.S. FDA and other global regulatory agencies later this year.

Tirzepatide was approved by the U.S. FDA as Mounjaro® for adults with type 2 diabetes to improve glycemic control on May 13, 2022, and as Zepbound® for adults with obesity (a BMI of 30 kg/m2 or greater) or those who are overweight (a BMI of 27 kg/m2 or greater) who also have a weight-related comorbid condition on November 8, 2023. Tirzepatide is also commercialized as Mounjaro® in some global markets outside the U.S. for adults with obesity or those who are overweight who also have a weight-related comorbid condition.

Tirzepatide is the only approved GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) treatment for chronic weight management. Both Mounjaro® and Zepbound® should be used as an adjunct to diet and exercise.

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High-Intensity Statin Therapy Shows No Diabetes Difference for CAD Patients, LDL-C Impacts Outcome: LODESTAR Trial Analysis

Korea: In a recent post-hoc analysis of the LODESTAR randomized clinical trial, researchers found that high-intensity statin therapy for patients with coronary artery disease (CAD) did not significantly alter the incidence of new-onset diabetes mellitus (NODM) between rosuvastatin and atorvastatin. This study sheds light on the nuanced effects of different statin types on diabetes risk when LDL cholesterol (LDL-C) levels are aggressively controlled.

“A difference in the effect of statin type on NODM was noted when LDL-C levels were reduced to below 70 mg/dL,” the researchers wrote in Cardiovascular Diabetology.

The impact of rosuvastatin compared to atorvastatin on new-onset diabetes mellitus in patients undergoing high-intensity statin therapy for coronary artery disease (CAD) has yet to be fully understood. Myeong-Ki Hong, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, and colleagues aimed to evaluate the risk of NODM in patients with CAD treated with rosuvastatin compared to atorvastatin in the randomized LODESTAR trial.

In the LODESTAR trial, CAD patients were randomly assigned to receive either rosuvastatin or atorvastatin through a 2-by-2 factorial design. This post-hoc analysis compared the 3-year incidence of NODM between the two treatments in the as-treated population, focusing specifically on those undergoing high-intensity statin therapy.

The study revealed the following findings:

  • Among 2932 patients without diabetes mellitus at baseline, 2377 were included in the as-treated population analysis.
  • In the as-treated population with high-intensity statin therapy, the incidence of NODM was not significantly different between the rosuvastatin and atorvastatin groups (11.4% versus 8.8%, hazard ratio [HR] = 1.32).
  • When the risk of NODM with rosuvastatin versus atorvastatin was assessed according to the achieved low-density lipoprotein cholesterol (LDL-C) level, the risk of NODM began to increase at an LDL-C level below 70 mg/dL.
  • The incidence of NODM was significantly greater in the rosuvastatin group than in the atorvastatin group when the achieved LDL-C level was < 70 mg/dL (13.9% versus 8.0%; HR = 1.79).

In the post-hoc analysis of the LODESTAR trial, the incidence of new-onset diabetes mellitus was similar between rosuvastatin and atorvastatin for CAD patients undergoing high-intensity statin therapy. However, the risk of NODM appeared to be influenced by the efficacy of LDL-C reduction.

“Specifically, when LDL-C levels were below 70 mg/dL, the rosuvastatin group showed a significantly higher risk of NODM than the atorvastatin group. Conversely, when LDL-C levels were 70 mg/dL or higher, there was no significant difference in NODM risk between the two statin treatments,” the researchers concluded.

Reference:

Hong, SJ., Lee, YJ., Kang, W.C. et al. Effect of rosuvastatin versus atorvastatin on new-onset diabetes mellitus in patients treated with high-intensity statin therapy for coronary artery disease: a post-hoc analysis from the LODESTAR randomized clinical trial. Cardiovasc Diabetol 23, 287 (2024). https://doi.org/10.1186/s12933-024-02386-w

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Proteinuria clinically useful predictive marker for developing ocular motor cranial nerve palsy : Study

Large-scale population study researchers have observed a significant association of proteinuria detected by dipstick with the incidence of oculomotor CNP. The authors want to show that urine protein level could be used as a new clinical marker to predict the development of CNP through this large-scale population study. These results were published by Juha Lee and colleagues in a paper in Scientific Reports.

Knowing the relationship between proteinuria and oculomotor CNP will be important in mechanisms underlying CNP development and formulation of preventive strategies. Proteinuria, easily detectable by a simple urine dipstick test, has already been related to several systemic diseases but not with CNP. Therefore, the present nationwide population-based cohort study using the data of the National Health Insurance Service of Korea was conducted to examine this possible relationship.

In this research, the data spanned from the NSC database of Korea’s NHIS from 2009 to 2018. An explicit temporal relationship between proteinuria and CNP development was adopted with a one-year time lag. The participants included those aged 20 or older with newly diagnosed proteinuria in 2009, while those with pre-existing conditions of CNP or with missing data and who are newly diagnosed with CNP, or who died within one year, were excluded. Proteinuria levels ranged from negative to trace or between 1+ to 4+. For the assessment of the association of proteinuria level with the risk of oculomotor CNP incidence, Cox proportional hazard regression analysis was conducted.

Key Findings

Out of the total cohort, 5,807 individuals (0.14%) were diagnosed with oculomotor CNP, while 4,047,205 served as the control group.

Proteinuria and CNP Risk: After adjusting for comorbidities, the hazard ratios (HRs) for developing oculomotor CNP were:

  • 1+ proteinuria: HR 1.449 (95% CI 1.244–1.687)

  • 2+ proteinuria: HR 2.081 (95% CI 1.707–2.538)

  • 3+ proteinuria: HR 1.960 (95% CI 1.322–2.904)

  • 4+ proteinuria: HR 3.011 (95% CI 1.507–6.014)Subgroup Analysis: The risk was higher in younger patients (under 40 years) with an HR of 1.547 (P=0.0242) and in those with diabetes mellitus (DM) with an HR of 1.763 (P=0.04).

A strong positive correlation was found between the incidence of oculomotor CNP and the presence and degree of proteinuria. In particular, the risk increased with higher levels of proteinuria, underlining that urine protein level is likely to be a predictive marker for CNP.This relationship comes out maximum in young age groups and patients with diabetes and might indicate that these groups need closer monitoring.

In this large cohort study, the importance of proteinuria as a predictor for oculomotor CNP is underscored. Routine clinical screening for proteinuria might help in the identification of individuals at higher risk for CNP and thus allow early interventions of preventive strategies. Further studies are needed to clarify the mechanisms underlying the proteinuria-CNP link and eventually to develop approaches aimed at a reduction of this risk.

Reference:

Lee, J., Han, K., Yoo, J., Park, K.-A., & Oh, S. Y. (2024). Proteinuria and risk of ocular motor cranial nerve palsy: a nationwide population-based study. Scientific Reports, 14(1), 1–10. https://doi.org/10.1038/s41598-024-62576-0

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