1.The results of glycemic control among patients undergoing insulin therapy
Enkhtuul B ; Batjargal B ; Narkhajid G ; Ankhlan B ; Anudari B ; Azzaya S ; Altaisaikhan Kh ; Oyunbold B
Diagnosis 2025;114(3):70-78
Background:
The discovery of insulin over a century ago significantly advanced the treatment of diabetes mellitus (DM). Effective glycemic control in patients on insulin therapy is influenced by a variety of factors. While developed countries have transitioned fully to insulin analogs, abandoning recombinant insulin, Mongolia
lacks comprehensive research on how different insulin formulations influence glycemic control. This gap highlights the need for targeted improvements in therapy effectiveness and service quality.
Materials and methods:
The cross-sectional study was conducted at the Central Hospital of the Mongolian National University of Medical Sciences, including 183 diabetic patients aged 18-65 years. Participants were managed by
endocrinologists and participated in a survey consisting of 44 questions alongside physical
measurements. Data were 78 analyzed using SPSS version 25, with a significance threshold of p<0.05.
Results:
The study population had a mean age of 56.7 ± 11.0 years, with 55.2% (n=101) males. The mean duration of diagnosed DM was 12.6 ± 6.33 years, and the mean duration since the initiation of insulin therapy was 6.77 (1-24) years. The mean glycated hemoglobin (HbA1c) was 10.5%, with 87.4% of the participants categorized under poor glycemic control and only 5.5% maintaining optimal levels. Insulin usage was predominantly recombinant (60.7%), with analogue at 32.2%, and mixed regimens at 7.1%. Usage of insulin pens was reported by 43.2% of the participants. The daily insulin dosage ranged from 10 to 71 units, averaging 37.2 ± 13.7 units. Multivariate logistic regression analysis confirmed that inadequate knowledge about insulin therapy is an independent risk factor (OR; 95% CI = 1.48; 1.21
10.32). When adjusting for confounding factors, the average glycated hemoglobin (HbA1c) levels in the group with inadequate knowledge was significantly higher (11.8%) compared to the group with adequate knowledge, where it was significantly lower (10.2%).
Conclusion
The use of analog insulin among patients with type 2 diabetes undergoing insulin therapy is relatively low
(32%), and glycemic control is poor (87%). Therefore, it is necessary to increase the use of analog insulin and improve glycemic control. Inadequate knowledge about insulin therapy negatively affects glycemic
control in patients with type 2 diabetes (OR; 95% CI = 1.48; 1.21-10.32). Therefore, it is essential to enhance patients’ knowledge.
2.A Study on the Detection of Human Papillomavirus (HPV) Strains Among Women Aged 30 and Above in Dalanzadgad, Umnugovi Province
Anudari A ; Amgalan B ; Uranchimeg N ; Otgonjargal D
Mongolian Journal of Health Sciences 2025;90(6):63-66
Background:
In Mongolia, 7,244 new cancer cases were registered in 2023, of which 5.9% (425 cases) were cervical
cancer. The prevalence of cervical cancer is 14.5 per 10,000 populations. In Ömnögovi province, 597 cancer cases were
recorded in 2023, and 18.5% of them were cervical cancer. The cervical cancer screening coverage in Ömnögovi province
was 45.6% in 2023.
Aim:
To identify the types of human papillomavirus (HPV) among women aged 30 years and above in Dalanzadgad
soum.
Materials and Methods:
A cross-sectional study design was used. We included 100 women aged 30 years and above in
Dalanzadgad soum. HPV genotyping was performed using polymerase chain reaction (PCR) among women diagnosed
with cervical erosion. A 44-item questionnaire was also administered to assess the risk factors for cervical cancer.
Results:
HPV was detected in 41% of participants, while 59% tested negative. Among the participants, 25 had one genotype,
13 had two genotypes, and 3 had three genotypes. Among the 41 women who tested positive, 49% had high-risk
genotypes. A total of 20 HPV genotypes were identified, including 16 high-risk and 4 low-risk types. Of the HPV-positive
women, 65.9% were married, and 58.5% had only one lifetime sexual partner. In addition, 78% of participants reported
never having undergone cervical cytology screening prior to this study.
Conclusion
In Dalanzadgad soum, 2 out of every 5 women are at risk of HPV infection, and among those infected, 1 out
of 2 carry a high-risk HPV genotype.
3.Chronic kidney disease and serum NT-proBNP level
Sodgerel B ; Anudari I ; Buyandelger J ; Pilmaa Yo ; Gantogtokh D ; Yesukhei E ; Bilguun E ; Nyam-Erdene N ; Yundendash D ; Munkhbayar S ; Bolormaa Do ; Sarangerel Ga ; Munkhzul D ; Batbold B ; Sodnomtsogt L
Mongolian Medical Sciences 2024;210(4):9-17
Background:
Serum natriuretic peptide (NT-proBNP) is a critical biomarker for diagnosing left ventricular
dysfunction. Heart failure is the leading cause of mortality in chronic kidney disease (CKD),
emphasizing the need for its early detection and prognosis.
Objective:
This study aimed to determine the serum NT-proBNP levels in participants with CKD and
establish a cut-off value for predicting heart failure.
Methods:
A descriptive cross-sectional study was conducted from April 1 to July 1,2024. This study
received approval from the Ethics Committee of the Institute of Medical Sciences (Approval
No.24/01). A total of 117 CKD patients hospitalized in the Nephrology and Endocrinology
Department of the third state hospital were enrolled based on predefined inclusion and
exclusion criteria. Data were collected using questionnaires, laboratory and heart ultrasound
test results. Serum NT-proBNP levels were measured using a rapid immunofluorescence
quantitative analyzer. Data were analyzed with SPSS 26.0.
Results:
The mean age of the 117 participants was 57.9 ± 14.7 years, with 51.3% being male. The
mean serum NT-proBNP level was 7686 ± 12149 pg/mL. Statistically significant differences
were observed in serum creatinine, sodium, calcium, CKD stage, and arterial hypertension
between genders (p<0.05). NT-proBNP levels in hemodialysis patients differed significantly
between heart failure and non-heart failure groups (p<0.05). Significant differences were
also found in hemoglobin, serum albumin, NT-proBNP levels, and CKD stages (p<0.05).
NT-proBNP correlated significantly with risk factors such as hemodialysis, diabetes, and decreased systolic blood pressure (p<0.0001). A weak inverse relationship was noted
between systolic blood pressure and NT-proBNP (R² = 0.16). The NT-proBNP cut-off value
for predicting heart failure was 3027 pg/mL, with an AUC of 61.7% (sensitivity: 74.5%,
specificity: 55%).
Conclusion
Serum NT-proBNP levels are elevated in CKD patients regardless of heart
failure. The established cut-off value for NT-proBNP in CKD patients to detect heart failure
was 3027 pg/mL, with moderate diagnostic utility (AUC = 61.7%).
4.Clinical Significance of BNP and NT-proBNP in Chronic Kidney Disease
Anudari I ; Buyandelger J ; Munkhzul D ; Sodgerel B
Mongolian Medical Sciences 2024;210(4):53-60
Chronic kidney disease (CKD) is a global health issue characterized by a gradual loss of kidney
function over time. As the disease progresses, it leads to an increased risk of cardiovascular
complications, which are the leading cause of morbidity and mortality in CKD patients.
B-type natriuretic peptide (BNP) and its inactive fragment, N-terminal pro b-type natriuretic
peptide (NT-proBNP), are biomarkers widely used in the diagnosis and management of heart
failure. Their role in CKD, however, is complex due to the overlapping pathophysiological
mechanisms between cardiac and renal dysfunctions. This literature review aims to explore
the diagnostic and prognostic value of BNP and NT-proBNP in patients with CKD, highlighting
their clinical relevance, the impact of renal function on their levels, and potential therapeutic
implications. The review focuses on studies published in the last decade, examining the
clinical applications, outcomes, and challenges associated with using BNP and NT-proBNP
as biomarkers in CKD patients.
5.The prevalence of dyslipidemia and the risk factor for cardiovascular disease
Pilmaa Yo ; Anudari B ; Buyandelger J ; Bayaraa T ; Sodgerel B ; Batbold B
Mongolian Medical Sciences 2023;205(4):84-90
Cardiovascular diseases related death rates have been declining over, but during the two decades,
mortality and morbidity attributable by cardiovascular diseases are continuously taking the first place
among the leading causes of morbidity and deaths among the population. Statistics show that >4
million people die each year from cardiovascular disease (CVD) causes in Europe. The World Health
Organization reports that in less developed and developing countries, obesity and mortality are
expected to continue to increase, depending on the age of the population and the characteristics of
lifestyle.
Dyslipidaemia is characterized by elevated low-density lipoprotein cholesterol (LDL-C) and decreased
high-density lipoprotein cholesterol (HDL-C) and is a known risk factor for development and progression of atherosclerosis in CAD.
Dyslipidemia and hypertension are major risk factors for cardiovascular disease (CVD) and account
for more than 80% of deaths and disability in low- and middle-income countries. Increased serum
levels of total cholesterol (TC), triglycerides (TG), high-density lipid (HDL)-cholesterol and decreased
low-density lipid (LDL)-cholesterol are known to be associated with major risk factors for CVD. The
Framingham study and others that followed could show that HDL-C is an independent cardiovascular
risk factor and that the increase of HDL-C of only 10 mg·L(-1) leads to a risk reduction of 2-3%. A
recent meta-analysis, including 302.430 subjects from 68 long-term prospective studies, supported the
importance of HDL-C measurement in the risk assessment for CAD.
However, data about the relationship between cardiovascular disease and lipid profile among
Mongolian adult are rare in the literature. In recent years, rapid urbanization, unhealthy diet, increased
life expectancy and lifestyle changes have led to an increased rate of CVD around the world.
6.Lipoprotein (A) biomarkers for clinical practice
Sodgerel B ; Anudari I ; Buyandelger J
Mongolian Medical Sciences 2022;202(4):38-47
A lot of factors can cause coronary heart disease and ischemic stroke including external risk factors such as tobacco, alcohol consumption, decreased physical activity, obesity while arterial maintenance, high blood sugar, increased LDL are internal risk factors. We can reduce our external risk factors by changing our lifestyle. Recent studies have shown increased blood Lp(a) levels are independent risk factor for cardiovascular disease. After 1987, the number of publications has increased since the cDNA homology sequence of Lp(a) and plasminogen 2 was identified. Lp(a) is protein complex consisting from apolipoprotein, phospholipid, free cholesterol, cholesterol esters and tryglyceride. Apoliprotein is a lipid that binds with lipoprotein. Lipoproteins have water-soluble and fat-soluble parts, and those parts bind to lipids and are transported in the bloodstream.How is elevated Lp(a) a risk factor for cardiovascular disease? How much does lowering Lp(a) reduce CVD risk factors? If high Lp(a) concentrations are present, mitigation measures are outlined below.
Result Analysis
Print
Save
E-mail