Background: The ambulatory arterial stiffness index (AASI) is a non-invasive surrogate marker of arterial stiffness; however, the relative contributions of hemodynamic, cardiometabolic, and renal factors to the AASI remain incompletely understood. This study aimed to identify the independent clinical factors associated with the AASI. Methods: This retrospective cross-sectional study included 290 individuals aged 18–65 years who underwent ABPM between 2020 and 2024. Participants were classified as hypertensive or normotensive based on ABPM criteria. Hemodynamic parameters, cardiometabolic indices, and renal biomarkers, including the urine albumin-to-creatinine ratio (uACR), were assessed. Results: Associations between the AASI and clinical variables were evaluated using the following correlation analyses and hierarchical multivariable linear regression models: Model 1-1b (hemodynamic), Model 2 (hemodynamic plus cardiometabolic) and Model 3 (hemodynamic plus cardiometabolic plus renal). The AASI was significantly higher in hypertensive individuals compared with normotensive controls. In correlation analyses, the AASI was positively associated with age, systolic blood pressure parameters, atherogenic lipid indices, and uACR and negatively associated with diastolic blood pressure parameters and the estimated glomerular filtration rate (eGFR). In multivariable regression analyses, age, maximum systolic blood pressure, and maximum diastolic blood pressure remained independently associated with the AASI across models. uACR was also independently associated with the AASI in the fully adjusted model. Conclusions: The AASI is primarily associated with hemodynamic load and age-related vascular changes. Among non-hemodynamic factors, albuminuria demonstrated the strongest association with the AASI after multivariable adjustment. These findings suggest the potential clinical value of the AASI as a practical marker for early cardiorenal risk assessment using routine ABPM data.
Background: Chronic low-grade inflammation contributes to early glucose dysregulation, but comparative evidence on complete blood count-derived inflammatory indices in prediabetes remains limited. This study aimed to compare the associations of five complete blood count-derived inflammatory indices with prediabetes and to assess their discriminative performance. Methods: In this retrospective cross-sectional study, 255 adults (128 with prediabetes and 127 with normoglycemia) were identified from 12,540 individuals screened at the internal medicine outpatient clinics of a university hospital. The neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, systemic immune-inflammation index, and systemic inflammation response index were compared between groups. Adjusted logistic regression, hierarchical regression, and receiver operating characteristic curve analyses were performed. Results: All indices except the monocyte-to-lymphocyte ratio were significantly higher in the prediabetes group (all p < 0.001). Among the evaluated indices, the neutrophil-to-lymphocyte ratio showed the strongest association with prediabetes, with the largest standardized odds ratio (2.691; 95% confidence interval, 1.839–3.938) and the highest explanatory power (Nagelkerke R2 = 0.326). Its addition to the base model significantly improved model fit (likelihood ratio χ2 = 33.62, p < 0.001), and the association remained significant after adjustment for body mass index, C-reactive protein, and lipid parameters. It also yielded the highest area under the curve (0.714). Conclusions: In this cross-sectional analysis, the neutrophil-to-lymphocyte ratio showed the most robust independent association with prediabetes among the evaluated complete blood count-derived inflammatory indices. However, the overall discriminative performance was modest, supporting the use of these indices as adjunctive rather than standalone screening markers.
Familial Mediterranean fever (FMF) is an autoinflammatory disease with autosomal recessive inheritance, associated with mediterranean fever gene mutation, characterized by recurrent episodes of fever, serositis, and arthritis. Colchicine is the gold standard treatment but has a narrow therapeutic index. A 19-year-old male with FMF presented with abdominal pain, weakness, nausea, and vomiting after accidental ingestion of approximately 100 colchicine tablets in a suicide attempt. He developed multi-organ dysfunction, including acute kidney injury (creatinine: 2.33 mg/dL), hepatotoxicity (aspartate aminotransferase: 678 U/L), rhabdomyolysis (creatine kinase: 9996 U/L), and severe pancytopenia (white blood cell count: 710/μL, platelet count: 15,000/μL). Neurological complications included decreased consciousness, apathetic speech, and ataxia. The patient was managed in the intensive care unit with aggressive supportive therapy including intravenous hydration, broad-spectrum antibiotics, and granulocyte colony-stimulating factor (filgrastim) for bone marrow suppression. After 4 days, pancytopenia resolved, and organ functions gradually improved. The patient made a complete recovery. This case demonstrates that survival is possible even after extremely high-dose colchicine ingestion with appropriate supportive care. Close monitoring and patient education are crucial in FMF management to prevent toxicity.