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Exact(5)
It has never been entirely clear, however, whether glycaemia serves as a mediator of adverse outcomes or merely as a marker of illness.
Jesse Roth (New York, NY) suggested that, rather than IR, hyperinsulinemia should be considered the major mediator of adverse outcome, with hyperinsulinemia the underlying characteristic of all syndromes of IR (1).
Epidemiologic and physiologic data suggest that higher blood glucose levels are associated with worse outcomes, but whether glucose is simply a marker of the severity of underlying illness or a mediator of adverse outcomes is unclear.
TGFβ is a powerful mediator of adverse cardiac remodeling and fibrosis primarily via Smad-dependent induction of collagen expression as well as differentiation of fibroblasts to the myofibroblast phenotype which exhibits increased secretory, migratory, and proliferative properties and express the contractile protein ASMA [ 15- 18].
The finding of a relationship between severe hypoglycemia and adverse outcome, but that the two do not "always happen in close proximity" (14), has led to the suggestion that hypoglycemia may be a marker rather than a mediator of adverse outcome.
Similar(54)
It remains unclear whether delays in care and the transfer process itself are mediators of adverse outcomes or whether heightened mortality among transferred patients is merely the result of confounding by acute illness or chronic comorbidity or both.
Those who were willing to provide more information participated in survey B, which measured potential mediators of adverse outcomes, and in 2 structured interviews (results to be reported elsewhere).
Furthermore, inflammation is thought to act as a mediator of the adverse health effects caused by lead exposure.
Korytkowski noted the far later occurrence of mortality than of hypoglycemia, leading to the "open question": what was the mediator of the adverse outcome?
For example, vitamin D can down-regulate interleukin 6, an important mediator of the adverse effect of maternal infection during pregnancy on neural development in the fetus.
These findings suggest that left ventricular dysfunction, rather than myocardial ischaemia, is the more important mediator of the adverse prognosis indicated by elevation of OPG in ACS.
Related(20)
mediator of harmful
mediator of various
mediator of metabolic
mediator of ethnic
mediator of immune
mediator of glutamate
mediator of TGF-β
mediator of programmed
mediator of cardiac
mediator of sepsis-induced
mediator of intracellular
mediator of local
mediator of visfatin
mediator of trigeminal
mediator of antimetamorphic
mediator of canonical
mediator of obesity-induced
mediator of developmental
mediator of cAMP
mediator of pro-inflammatory
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