Es, most commonly foot infections [47]. There are several proposed explanations for

Es, most commonly foot infections [47]. There are several proposed explanations for the increased rate of respiratory and other infections among Aboriginal CAL120 web patients including overcrowding, social disadvantage, poor living conditions, and limited access to care, education and resources to assist with management of diabetes and other chronic health problems such as high smoking rates [45,47]. A high BMI was independently associated with incident hospitalization with any infection in our diabetic patients. Obesity is known to have adverse effects on immune function and to increase susceptibility to infections such as pneumonia [48], a relationship that was independent of other diabetes-related variables such as HbA1c and vascular complications in our cohort. The association between systolic blood pressure at FDS1 entry and subsequent hospitalization with community-acquired pneumonia is likely to reflect the strengthening association between chronic cardiac disease associated with hypertension such as heart failure and pneumonia observed in population-based studies [49,50]. Since triglyceride-rich lipoproteins are hypothesized to be a component of the innate host immune response to bacterial infections [51], the inverse association between fasting 1655472 serum triglycerides and incident pneumonia could mean that this contribution to immunity is attenuated in patients with relatively low triglyceride levels. The associations between recent prior infection-related hospitalization and any incident infection as well as pneumonia and cellulitis are consistent with the observation that patients with diabetes are at increased risk of recurrent community-acquired infections [7]. An alternative explanation is that some diabetic patients, including those with a heavy burden of complications and co-morbidities, are vulnerable to recurrent severe infections. Statins are frequently used for lipid-lowering in patients with diabetes but also have modulatory effects on innate and adaptive immune systems and anti-inflammatory effects, and may help to counteract undesirable effects of sepsis on the coagulation system [13]. There is some evidence suggesting that statins may have a beneficial role in the prevention and treatment of infection [13?15], but this was not confirmed by a meta-analysis of randomized placebo-controlled trials of statin therapy [16]. The only published study to have demonstrated a lower risk of pneumonia in adult diabetic patients treated with statins used the United Kingdom General Practice Research Database [18]. Only a very small percentage of patients (1.9 ) were taking statin therapy at the time (between 1987 and 2001), the diagnosis of pneumonia was made by the general practitioner at first attendance, and there were very few confounding variables available for incorporation in multivariate analysis. We found statin therapy was not protective for hospitalization for infection amongst our cohort of 3PO chemical information well-characterized community-based patients with type 2 diabetes, which is consistent with the evidence from the general population metaanalysis [16]. Our study had limitations. First, the observed differences in IRR between diabetic and non-diabetic samples may have been due, in part, to between-group differences in healthcare-seeking behaviour and/or the treating physician’s threshold for hospitalization. Perceptions of diabetes as an important co-morbidity may have made infection-related admission of FDS patients more likely compared to tho.Es, most commonly foot infections [47]. There are several proposed explanations for the increased rate of respiratory and other infections among Aboriginal patients including overcrowding, social disadvantage, poor living conditions, and limited access to care, education and resources to assist with management of diabetes and other chronic health problems such as high smoking rates [45,47]. A high BMI was independently associated with incident hospitalization with any infection in our diabetic patients. Obesity is known to have adverse effects on immune function and to increase susceptibility to infections such as pneumonia [48], a relationship that was independent of other diabetes-related variables such as HbA1c and vascular complications in our cohort. The association between systolic blood pressure at FDS1 entry and subsequent hospitalization with community-acquired pneumonia is likely to reflect the strengthening association between chronic cardiac disease associated with hypertension such as heart failure and pneumonia observed in population-based studies [49,50]. Since triglyceride-rich lipoproteins are hypothesized to be a component of the innate host immune response to bacterial infections [51], the inverse association between fasting 1655472 serum triglycerides and incident pneumonia could mean that this contribution to immunity is attenuated in patients with relatively low triglyceride levels. The associations between recent prior infection-related hospitalization and any incident infection as well as pneumonia and cellulitis are consistent with the observation that patients with diabetes are at increased risk of recurrent community-acquired infections [7]. An alternative explanation is that some diabetic patients, including those with a heavy burden of complications and co-morbidities, are vulnerable to recurrent severe infections. Statins are frequently used for lipid-lowering in patients with diabetes but also have modulatory effects on innate and adaptive immune systems and anti-inflammatory effects, and may help to counteract undesirable effects of sepsis on the coagulation system [13]. There is some evidence suggesting that statins may have a beneficial role in the prevention and treatment of infection [13?15], but this was not confirmed by a meta-analysis of randomized placebo-controlled trials of statin therapy [16]. The only published study to have demonstrated a lower risk of pneumonia in adult diabetic patients treated with statins used the United Kingdom General Practice Research Database [18]. Only a very small percentage of patients (1.9 ) were taking statin therapy at the time (between 1987 and 2001), the diagnosis of pneumonia was made by the general practitioner at first attendance, and there were very few confounding variables available for incorporation in multivariate analysis. We found statin therapy was not protective for hospitalization for infection amongst our cohort of well-characterized community-based patients with type 2 diabetes, which is consistent with the evidence from the general population metaanalysis [16]. Our study had limitations. First, the observed differences in IRR between diabetic and non-diabetic samples may have been due, in part, to between-group differences in healthcare-seeking behaviour and/or the treating physician’s threshold for hospitalization. Perceptions of diabetes as an important co-morbidity may have made infection-related admission of FDS patients more likely compared to tho.