1
|
Saleh C. Comment on Bažadona et al. The Interconnection between Carotid Intima-Media Thickness and Obesity: Anthropometric, Clinical and Biochemical Correlations. Medicina 2023, 59, 1512. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:981. [PMID: 38929598 PMCID: PMC11205296 DOI: 10.3390/medicina60060981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/05/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
In a recently published paper in Medicina, Bažadona et al [...].
Collapse
|
2
|
Wu Y, Xiang HJ, Yuan M. An L-shaped relationship between dietary vitamin K and atherosclerotic cardiovascular disease. Clin Nutr ESPEN 2024; 61:385-392. [PMID: 38777459 DOI: 10.1016/j.clnesp.2024.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 03/14/2024] [Accepted: 03/27/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND AND AIMS Few studies link vitamin K intake with incident atherosclerotic cardiovascular disease (ASCVD), and the specific mechanism remains uncertain. We aimed to evaluate the relationship between dietary vitamin K and ASCVD. METHODS This study used cross-sectional data from people over 20 years old who took part in the National Health and Nutrition Examination Survey (NHANES) between 2013 and 2018. Vitamin K intake was assessed using a 24-h dietary review. The Patient Medical Conditions Questionnaire was used to assess ASCVD. The stability of the outcomes was evaluated using cubic spline models with restricted parameters and logistic regression, while subgroup analyses were also performed. RESULTS There were 14,465 participants, with 9.78% (1415/14,465) who diagnosed with ASCVD. Compared with individuals with lower vitamin K intake Q1 (≤39.0 ug/day), the adjusted OR values for dietary vitamin K intake and ASCVD in Q2 (39.1-70.8 ug/day), Q3 (70.9-131.0 mg/day), and Q4 (≥131.1 ug/day) were 0.88 (95% CI: 0.74-1.04, p = 0.134), 0.77(95% CI: 0.65-0.93, p = 0.005), and 0.78 (95% CI: 0.65-0.95, p = 0.013), respectively. The association between dietary vitamin K intake and ASCVD showed an L-shaped curve (nonlinear, p = 0.006). The OR for ASCVD in participants with vitamin K intake <127.1ug/day was 0.996 (95% CI: 0.993-0.998, p = 0.002). CONCLUSIONS The relationship between dietary vitamin K intake and ASCVD was L-shaped curve in US adults, the inflection point was roughly 127.1 ug/day.
Collapse
Affiliation(s)
- Yue Wu
- Department of Cardiovascular Medicine, People's Hospital of Xiangxi Tujia and Miao Autonomous Prefecture, The First Affiliated Hospital of Jishou University, Jishou 416000, China
| | - Hong-Ju Xiang
- Department of Cardiovascular Medicine, People's Hospital of Xiangxi Tujia and Miao Autonomous Prefecture, The First Affiliated Hospital of Jishou University, Jishou 416000, China
| | - Min Yuan
- Department of Neurology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China.
| |
Collapse
|
3
|
Longo M, Caruso P, Scappaticcio L, Maiorino MI, Bellastella G, Capuano A, Esposito K, Giugliano D. Two years with GIOIA 'Effects of gliflozins and gliptins on markers of cardiovascular damage in type 2 diabetes': A prospective, multicentre, quasi-experimental study on sodium-glucose cotransporter 2 and dipeptidyl peptidase-4 inhibitors in diabetes clinical practice. Diabetes Obes Metab 2024; 26:1492-1501. [PMID: 38234208 DOI: 10.1111/dom.15451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/13/2023] [Accepted: 12/21/2023] [Indexed: 01/19/2024]
Abstract
AIM To assess and compare the metabolic and vascular effectiveness of sodium-glucose cotransporter 2 inhibitors (SGLT-2i) and dipeptidyl peptidase-4 inhibitors (DPP-4i) in the clinical practice of patients with type 2 diabetes in Italy. MATERIALS AND METHODS GIOIA is a 2-year prospective, multicentre, quasi-experimental study that enrolled patients with type 2 diabetes initiating SGLT-2i or DPP-4i for inadequate glycaemic control [glycated haemoglobin (HbA1c) >7%] between March 2018 and March 2021. The primary endpoints were changes in markers of organ damage [carotid intima-media thickness (CIMT), albuminuria, myocardial function] and HbA1c from baseline to year 2. RESULTS In total, 1150 patients were enrolled in the study (SGLT-2i n = 580, DPP-4i n = 570). Patients initiated on SGLT-2i were younger (about 6 years) and heavier (about 11 kg), had higher HbA1c level (1% more), more albuminuria and cardiovascular events (16% more) than patients initiated on DPP-4i. CIMT and echocardiographic parameters were not significantly different. Propensity score matching yielded two groups, each consisting of 155 patients with diabetes with similar baseline characteristics. Despite a significant similar reduction in HbA1c levels in both groups (-0.8%), more patients on SGLT-2i had regression of CIMT and albuminuria (22% and 10%, respectively, p < .001 vs. DPP-4i); more patients on DPP-4i had progression of CIMT and albuminuria (23% and 28%, respectively, p < .001 vs. SGLT-2i). Left ventricular ejection fraction improved slightly (3%, p = .043) on SGLT-2i only. CONCLUSIONS In a real-world setting, both SGLT-2i and DPP-4i improve glycaemic control persisting after 2 years of treatment, with a robust effect on both CIMT and albuminuria regression for SGLT-2i as compared with DPP-4i in the propensity score matching.
Collapse
Affiliation(s)
- Miriam Longo
- Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Diabetes, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Paola Caruso
- Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Diabetes, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Lorenzo Scappaticcio
- Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Diabetes, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Maria Ida Maiorino
- Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Diabetes, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Giuseppe Bellastella
- Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Diabetes, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Annalisa Capuano
- Section of Pharmacology 'L. Donatelli', Department of Experimental Medicine, University of Campania 'Luigi Vanvitelli', Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy
| | - Katherine Esposito
- Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Diabetes, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Dario Giugliano
- Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Diabetes, University of Campania 'Luigi Vanvitelli', Naples, Italy
| |
Collapse
|
4
|
Mita T, Katakami N, Okada Y, Yoshii H, Osonoi T, Nishida K, Shiraiwa T, Kurozumi A, Taya N, Wakasugi S, Sato F, Ishii R, Gosho M, Shimomura I, Watada H. Continuous glucose monitoring-derived time in range and CV are associated with altered tissue characteristics of the carotid artery wall in people with type 2 diabetes. Diabetologia 2023; 66:2356-2367. [PMID: 37750893 PMCID: PMC10627957 DOI: 10.1007/s00125-023-06013-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 08/07/2023] [Indexed: 09/27/2023]
Abstract
AIMS/HYPOTHESIS Previous studies have suggested that glucose variability may accelerate atherosclerosis progression in people with type 2 diabetes. Current guidelines recommend assessing glycaemic control using continuous glucose monitoring (CGM), which provides a comprehensive glycaemic profile to supplement HbA1c measurement. However, the association between CGM-derived metrics and atherosclerosis progression is not entirely clear. METHODS This exploratory study used baseline data and data obtained after 104 weeks from an ongoing prospective, multicentre, observational study. Six hundred study participants with type 2 diabetes and no apparent history of symptomatic cardiovascular disease underwent CGM and ultrasonographic atherosclerosis measurements of the carotid arteries, including the intima-media thickness (IMT) and grey-scale median (GSM), at baseline and 104 weeks. Non-invasive ultrasonic tissue characterisation of the carotid artery wall or plaque using the GSM reflects vascular composition. Multivariate regression models were used to analyse the association between CGM-derived indices, mainly time in range (TIR) and CV, and changes in carotid atherosclerosis index values. RESULTS Over the 104-week study period, there were modest increases in mean IMT (from 0.759±0.153 to 0.773±0.152 mm, p<0.001) and thickened-lesion GSM (from 43.5±19.5 to 53.9±23.5 units, p<0.001), but no significant changes in common carotid artery maximum-IMT (from 1.109±0.442 to 1.116±0.469 mm, p=0.453) or mean GSM (from 48.7±19.3 to 49.8±20.8 units, p=0.092). In a linear regression model with adjustment for possible atherosclerotic risk factors, including HbA1c, TIR and CV at baseline were significantly associated with the annual change in mean GSM (regression coefficient per 10% increase in TIR 0.52; 95% CI 0.06, 0.98; Hochberg-adjusted p value 0.038; regression coefficient per 1% increase in CV -0.12; 95% CI -0.22, -0.02; Hochberg-adjusted p value 0.038). TIR and CV at baseline were also significantly associated with the annual change in thickened-lesion GSM (regression coefficient per 10% increase in TIR 0.95; 95% CI 0.12, 1.79; Hochberg-adjusted p value 0.038; regression coefficient per 1% increase in CV -0.19; 95% CI -0.36, -0.01; Hochberg-adjusted p value 0.038). Participants who achieved target CGM-derived metrics at baseline, as proposed by an international consensus, showed significant annual changes in mean GSM compared with those who did not (0.94±6.88 vs -0.21±6.19 units/year, p=0.007). CONCLUSIONS/INTERPRETATION TIR and CV were significantly associated with changes in the tissue characteristics of the carotid artery wall. TRIAL REGISTRATION University Hospital Medical Information Network Clinical Trials Registry, number UMIN000032325.
Collapse
Affiliation(s)
- Tomoya Mita
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yosuke Okada
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hidenori Yoshii
- Department of Medicine, Diabetology & Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | | | | | | | - Akira Kurozumi
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Naohiro Taya
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Satomi Wakasugi
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Fumiya Sato
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ryota Ishii
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masahiko Gosho
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| |
Collapse
|
5
|
Katakami N, Mita T, Yoshii H, Shiraiwa T, Yasuda T, Okada Y, Kurozumi A, Hatazaki M, Kaneto H, Osonoi T, Yamamoto T, Kuribayashi N, Maeda K, Yokoyama H, Kosugi K, Ohtoshi K, Hayashi I, Sumitani S, Tsugawa M, Ryomoto K, Kato K, Nakamura T, Kawashima S, Sato Y, Watada H, Shimomura I. Tofogliflozin long-term effects on atherosclerosis progression and major clinical parameters in patients with type 2 diabetes mellitus lacking a history of cardiovascular disease: a 2-year extension study of the UTOPIA trial. Cardiovasc Diabetol 2023; 22:143. [PMID: 37349722 PMCID: PMC10286339 DOI: 10.1186/s12933-023-01879-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/05/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND This study aimed to assess the long-term effects of tofogliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, on atherosclerosis progression and major clinical parameters in patients with type 2 diabetes lacking an apparent history of cardiovascular disease. METHODS This was a prospective observational 2-year extension study of the "Using TOfogliflozin for Possible better Intervention against Atherosclerosis for type 2 diabetes patients (UTOPIA)" trial, a 2-year randomized intervention study. The primary endpoints represented changes in the carotid intima-media thickness (IMT). Secondary endpoints included brachial-ankle pulse wave velocity (baPWV) and biomarkers for glucose metabolism, lipid metabolism, renal function, and cardiovascular risks. RESULTS The mean IMT of the common carotid artery (IMT-CCA) significantly decreased in both the tofogliflozin (- 0.067 mm, standard error 0.009, p < 0.001) and conventional treatment groups (- 0.080 mm, SE 0.009, p < 0.001) throughout the follow-up period; however, no significant intergroup differences in the changes (0.013 mm, 95% confidence interval (CI) - 0.012 to 0.037, p = 0.32) were observed in a mixed-effects model for repeated measures. baPWV significantly increased in the conventional treatment group (82.7 ± 210.3 cm/s, p = 0.008) but not in the tofogliflozin group (- 17.5 ± 221.3 cm/s, p = 0.54), resulting in a significant intergroup difference in changes (- 100.2 cm/s, 95% CI - 182.8 to - 17.5, p = 0.018). Compared to the conventional treatment group, tofogliflozin significantly improved the hemoglobin A1c and high-density lipoprotein cholesterol levels, body mass index, abdominal circumference, and systolic blood pressure. The frequencies of total and serious adverse events did not vary significantly between the groups. CONCLUSIONS Tofogliflozin was not associated with improved inhibition of carotid wall thickening but exerted long-term positive effects on various cardiovascular risk factors and baPWV while showing a good safety profile.
Collapse
Affiliation(s)
- Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871 Japan
- Department of Metabolism and Atherosclerosis, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Tomoya Mita
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421 Japan
| | - Hidenori Yoshii
- Department of Medicine, Diabetology & Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center, Koto-ku, Tokyo, 136-0075 Japan
| | - Toshihiko Shiraiwa
- Shiraiwa Medical Clinic, 4-10-24 Hozenji, Kashiwara, Osaka 582-0005 Japan
| | - Tetsuyuki Yasuda
- Department of Endocrinology and Metabolism, Osaka Police Hospital, 10-31, Kitayama-Cho, Tennoji-ku, Osaka, 543-0035 Japan
| | - Yosuke Okada
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555 Japan
| | - Akira Kurozumi
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555 Japan
| | - Masahiro Hatazaki
- Department of Diabetes and Endocrinology, Osaka General Medical Center, 3-1-56, Bandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558 Japan
| | - Hideaki Kaneto
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192 Japan
| | - Takeshi Osonoi
- Nakakinen Clinic, 745-5, Nakadai, Naka, Ibaraki 311-0113 Japan
| | - Tsunehiko Yamamoto
- Diabetes and Endocrinology, Kansai Rosai Hospital, 3-1-69, Inabaso, Amagasaki, Hyogo Japan
| | | | - Kazuhisa Maeda
- Kitasenri Maeda Clinic, 4-119, Furuedai, Suita, Osaka 565-0874 Japan
| | - Hiroki Yokoyama
- Jiyugaoka Medical Clinic, West 6, South 6-4-3, Obihiro, Hokkaido 080-0016 Japan
| | - Keisuke Kosugi
- Kosugi Medical Clinic, 3-9, Tamatsukurimoto-Cho, Tennoji-ku, Osaka, 543-0014 Japan
| | - Kentaro Ohtoshi
- Otoshi Medical Clinic, 8-47, KakudachoOsaka Kita-ku, Osaka, 530-0017 Japan
| | - Isao Hayashi
- Hayashi Clinic, 3-9-23, Koshienguchi, Nishinomiya, Hyogo 663-8113 Japan
| | - Satoru Sumitani
- Center for Diabetes and Endocrinology, Nippon Life Hospital, 2-1-54 Enokojima, Nishi-ku, Osaka, 550-0006 Japan
- Present Address: Department of Diabetology and Endocrinology, Pref Osaka Saiseikai Izuo Hospital, 3-4-5 Kitamura, Taisho, Osaka 551-0032 Japan
| | - Mamiko Tsugawa
- Department of Endocrinology and Metabolism, Ikeda Municipal Hospital, 3-1-18, Jonan, Ikeda, Osaka 563-8510 Japan
- Present Address: Department of Diabetes and Endocrinology, Meiwa Hospital, 4-31 Agenaruo, Nishinomiya, Hyogo 663-8186 Japan
| | - Kayoko Ryomoto
- Center for Diabetes Mellitus, Osaka Rosai Hospital, 1179-3 Nagasone-Cho, Kita-ku, Sakai, Osaka 591-8025 Japan
| | - Ken Kato
- Diabetes Center, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka, 540-0006 Japan
| | - Tadashi Nakamura
- Department of Internal Medicine, Kawasaki Hospital, 3-3-1, Higashiyamacho, Kobe Hyogo-ku, Hyogo, 652-0042 Japan
| | - Satoshi Kawashima
- Kanda Naika Clinic, 5-21-3, Hannancho, Osaka Abeno-ku, Osaka, 545-0021 Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, 45 Shinanomachi Shinjuku-ku, Tokyo, 160-8582 Japan
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421 Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871 Japan
| |
Collapse
|
6
|
Cao Z, Liu Y, Wang Y, Leng P. Research progress on the role of PDGF/PDGFR in type 2 diabetes. Biomed Pharmacother 2023; 164:114983. [PMID: 37290188 DOI: 10.1016/j.biopha.2023.114983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/10/2023] Open
Abstract
Platelet-derived growth factors (PDGFs) are basic proteins stored in the α granules of platelets. PDGFs and their receptors (PDGFRs) are widely expressed in platelets, fibroblasts, vascular endothelial cells, platelets, pericytes, smooth muscle cells and tumor cells. The activation of PDGFR plays a number of critical roles in physiological functions and diseases, including normal embryonic development, cellular differentiation, and responses to tissue damage. In recent years, emerging experimental evidence has shown that activation of the PDGF/PDGFR pathway is involved in the development of diabetes and its complications, such as atherosclerosis, diabetic foot ulcers, diabetic nephropathy, and retinopathy. Research on targeting PDGF/PDGFR as a treatment has also made great progress. In this mini-review, we summarized the role of PDGF in diabetes, as well as the research progress on targeted diabetes therapy, which provides a new strategy for the treatment of type 2 diabetes.
Collapse
Affiliation(s)
- Zhanqi Cao
- Department of Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Yijie Liu
- Department of Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Yini Wang
- Department of Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Ping Leng
- Department of Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao 266003, China.
| |
Collapse
|
7
|
Wu CZ, Huang LY, Chen FY, Kuo CH, Yeih DF. Using Machine Learning to Predict Abnormal Carotid Intima-Media Thickness in Type 2 Diabetes. Diagnostics (Basel) 2023; 13:diagnostics13111834. [PMID: 37296685 DOI: 10.3390/diagnostics13111834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/16/2023] [Accepted: 05/20/2023] [Indexed: 06/12/2023] Open
Abstract
Carotid intima-media thickness (c-IMT) is a reliable risk factor for cardiovascular disease risk in type 2 diabetes (T2D) patients. The present study aimed to compare the effectiveness of different machine learning methods and traditional multiple logistic regression in predicting c-IMT using baseline features and to establish the most significant risk factors in a T2D cohort. We followed up with 924 patients with T2D for four years, with 75% of the participants used for model development. Machine learning methods, including classification and regression tree, random forest, eXtreme gradient boosting, and Naïve Bayes classifier, were used to predict c-IMT. The results showed that all machine learning methods, except for classification and regression tree, were not inferior to multiple logistic regression in predicting c-IMT in terms of higher area under receiver operation curve. The most significant risk factors for c-IMT were age, sex, creatinine, body mass index, diastolic blood pressure, and duration of diabetes, sequentially. Conclusively, machine learning methods could improve the prediction of c-IMT in T2D patients compared to conventional logistic regression models. This could have crucial implications for the early identification and management of cardiovascular disease in T2D patients.
Collapse
Affiliation(s)
- Chung-Ze Wu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 11031, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
| | - Li-Ying Huang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Department of Medical Education, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 24352, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 24352, Taiwan
| | - Fang-Yu Chen
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 24352, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 24352, Taiwan
| | - Chun-Heng Kuo
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 24352, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 24352, Taiwan
| | - Dong-Feng Yeih
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 24352, Taiwan
- Division of Cardiology, Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 24352, Taiwan
| |
Collapse
|
8
|
Association between dietary patterns and carotid intima-media thickness: cross-sectional analysis of ELSA-Brasil study. Eur J Nutr 2023; 62:1623-1633. [PMID: 36725718 DOI: 10.1007/s00394-023-03097-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/18/2023] [Indexed: 02/03/2023]
Abstract
PURPOSE We aimed to perform a cross-sectional evaluation of the association between dietary patterns and carotid intima-media thickness (cIMT), using baseline data from the Brazilian Longitudinal Study of Adult Health. METHODS The participants with measurement of the cIMT were included (n = 9,624). cIMT was evaluated in a continuous way and categorized as < 75th and ≥ 75th and ≤ 0.9 mm and > 0.9 mm. Dietary patterns (DPs) were identified by principal component factor analysis. Linear and logistic regression models were used to evaluate the association between cIMT and DPs. RESULTS Three DPs were derived. For each unit increase in the convenience DP score, the odds for cIMT ≥ 75th increased by 13% (OR 1.13; 95% CI 1.05: 1.22) and for cIMT > 0.9 mm increased by 14% (OR 1.14; 95% CI 1.07: 1.22) in the fully adjusted model. In contrast, each unit increase in the prudent DP score decreased by 8% the odds of having cIMT ≥ 75th (OR 0.92; 95% CI 0.86: 0.98) and by 11% of cIMT > 0.9 mm (OR 0.89; 95% CI 0.84: 0.95). Furthermore, each increase in the convenience DP score was associated with increase in the cIMT (β 0.01; 95% CI 0.01: 0.02), while each increase in the prudent DP score was associated with decrease in the cIMT (β -0.01; -0.01; -0.01) in linear regression models. CONCLUSIONS Our results demonstrate that those individuals with adherence to the convenience dietary pattern are more likely to have high cIMT, while those with adherence to a prudent dietary pattern have lower odds for this characteristic.
Collapse
|
9
|
Katakami N, Mita T, Maeda N, Sato Y, Watada H, Shimomura I. Evaluation of the effect of tofogliflozin on the tissue characteristics of the carotid wall—a sub-analysis of the UTOPIA trial. Cardiovasc Diabetol 2022; 21:19. [PMID: 35123483 PMCID: PMC8817596 DOI: 10.1186/s12933-022-01451-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/25/2022] [Indexed: 11/30/2022] Open
Abstract
Background Since sodium-glucose cotransporter 2 (SGLT2) inhibitors have a pleiotropic antiatherogenic effect, they are expected to attenuate the progression of atherosclerosis. However, whether SGLT2 inhibitors affect the tissue characteristics of the human arterial wall remains unclear. This study aimed to evaluate the effects of tofogliflozin, a selective SGLT2 inhibitor, on the tissue characteristics of the human arterial wall in type 2 diabetes (T2DM) patients without apparent cardiovascular disease (CVD). Methods The present study was a post hoc analysis based on data obtained from the Using Tofogliflozin for Possible Better Intervention against Atherosclerosis for Type 2 Diabetes Patients (UTOPIA) trial, which was a multicenter prospective, randomized, open-label, blinded-endpoint study conducted to evaluate the efficacy of tofogliflozin in preventing the progression of atherosclerosis in patients with T2DM. We evaluated the longitudinal change in the ultrasonic tissue characteristics of the carotid wall using gray-scale median (GSM), an established index of ultrasonic tissue characteristics. The right and left intima-medial areas were delineated, and the GSM values were evaluated (right GSM-CCA and left GSM-CCA). The average values of the right and left carotid arteries were defined as “mean GSM-CCA value.” Results In a mixed-effects model for repeated measures, mean GSM-CCA, along with the right and left GSM-CCA values, did not significantly change in either the tofogliflozin (n = 168) or conventional treatment group (n = 169). In addition, the tofogliflozin and conventional treatment groups did not significantly differ regarding the change of the mean GSM-CCA (mean difference [95% CI] − 1.24[− 3.87, 1.38], P = 0.35), along with the right (mean difference [95% CI] − 2.33[− 5.70, 1.05], P = 0.18) and the left GSM-CCA (mean difference [95% CI] − 0.29 [− 3.53, 2.95], P = 0.86) values. Similar findings were obtained even after adjusting for traditional cardiovascular risk factors and/or the administration of drugs at baseline. Conclusions The tissue characteristics of the carotid arterial wall did not change in either the tofogliflozin or conventional treatment group during the 104-week treatment period, and there was no significant difference between the treatment groups. Clinical trial registration UMIN000017607 (https://www.umin.ac.jp/icdr/index.html) Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01451-6.
Collapse
|
10
|
Sameeh MY, Khowdiary MM, Nassar HS, Abdelall MM, Amer HH, Hamed A, Elhenawy AA. Thiazolidinedione Derivatives: In Silico, In Vitro, In Vivo, Antioxidant and Anti-Diabetic Evaluation. Molecules 2022; 27:molecules27030830. [PMID: 35164095 PMCID: PMC8838189 DOI: 10.3390/molecules27030830] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/21/2022] [Accepted: 01/23/2022] [Indexed: 02/04/2023] Open
Abstract
This work aimed to synthesize a new antihyperglycemic thiazolidinedione based on the spectral data. The DFT\B3LYP\6-311G** level of theory was used to investigate the frontier molecular orbitals (FMOs), chemical reactivity and map the molecular electrostatic potentials (MEPs) to explain how the synthesized compounds interacted with the receptor. The molecular docking simulations into the active sites of PPAR-γ and α-amylase were performed. The in vitro potency of these compounds via α-amylase and radical scavenging were evaluated. The data revealed that compounds (4–6) have higher potency than the reference drugs. The anti-diabetic and anti-hyperlipidemic activities for thiazolidine-2,4-dione have been investigated in vivo using the alloxan-induced diabetic rat model along with the 30 days of treatment protocol. The investigated compounds didn’t show obvious reduction of blood glucose during pre-treatments compared to diabetic control, while after 30 days of treatments, the blood glucose level was lower than that of the diabetic control. Compounds (4–7) were able to regulate hyperlipidemia levels (cholesterol, triglyceride, high-density lipoproteins and low- and very-low-density lipoproteins) to nearly normal value at the 30th day.
Collapse
Affiliation(s)
- Manal Y. Sameeh
- Chemistry Department, Faculty of Applied Science, Umm El Qura Branch, Makkah 24211, Saudi Arabia; (M.Y.S.); (M.M.K.)
| | - Manal M. Khowdiary
- Chemistry Department, Faculty of Applied Science, Umm El Qura Branch, Makkah 24211, Saudi Arabia; (M.Y.S.); (M.M.K.)
- Applied Surfactant Laboratory, Egyptian Petroleum Research Institute, Nasr City, Cairo 11727, Egypt
| | - Hisham S. Nassar
- Department of Chemistry, Faculty of Science and Arts in Al-Mukhwah, Al-Baha University, Al Bahah 65311, Saudi Arabia;
- Chemistry Department, Faculty of Science, Al-Azhar University, Nasr City, Cairo 11884, Egypt; (M.M.A.); (A.H.)
| | - Mahmoud M. Abdelall
- Chemistry Department, Faculty of Science, Al-Azhar University, Nasr City, Cairo 11884, Egypt; (M.M.A.); (A.H.)
| | - Hamada H. Amer
- Department of Animal Medicine and Infectious Diseases, Faculty of Veterinary Medicine, University of Sadat City, Sadat City 32958, Egypt; or
- Department of Chemistry, Turabah University College, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Abdelaaty Hamed
- Chemistry Department, Faculty of Science, Al-Azhar University, Nasr City, Cairo 11884, Egypt; (M.M.A.); (A.H.)
| | - Ahmed A. Elhenawy
- Department of Chemistry, Faculty of Science and Arts in Al-Mukhwah, Al-Baha University, Al Bahah 65311, Saudi Arabia;
- Chemistry Department, Faculty of Science, Al-Azhar University, Nasr City, Cairo 11884, Egypt; (M.M.A.); (A.H.)
- Correspondence: or ; Tel.: +966-59-9044526
| |
Collapse
|
11
|
Sameeh MY, Khowdiary MM, Nassar HS, Abdelall MM, Alderhami SA, Elhenawy AA. Discovery Potent of Thiazolidinedione Derivatives as Antioxidant, α-Amylase Inhibitor, and Antidiabetic Agent. Biomedicines 2021; 10:24. [PMID: 35052707 PMCID: PMC8773338 DOI: 10.3390/biomedicines10010024] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 12/28/2022] Open
Abstract
This work aimed to synthesize safe antihyperglycemic derivatives bearing thiazolidinedione fragment based on spectral data. The DFT theory discussed the frontier molecular orbitals (FMOs), chemical reactivity of compounds, and molecular electrostatic potential (MEP) to explain interaction between thiazolidinediones and the biological receptor. α-amylase is known as the initiator-hydrolysis of the of polysaccharides; therefore, developing α-amylase inhibitors can open the way for a potential diabetes mellitus drug. The molecular docking simulation was performed into the active site of PPAR-γ and α-amylase. We evaluated in vitro α-amylase's potency and radical scavenging ability. The compound 6 has the highest potency against α-amylase and radical scavenging compared to the reference drug and other members. They have been applied against anti-diabetic and anti-hyperlipidemic activity (in vivo) based on an alloxan-induced diabetic rat model during a 30-day treatment protocol. The most potent anti hyperglycemic members are 6 and 11 with reduction percentage of blood glucose level by 69.55% and 66.95%, respectively; compared with the normal control. Other members exhibited moderate to low anti-diabetic potency. All compounds showed a normal value against the tested biochemical parameters (CH, LDL, and HDL). The ADMET profile showed good oral bioavailability without any observed carcinogenesis effect.
Collapse
Affiliation(s)
- Manal Y. Sameeh
- Chemistry Department, Faculty of Applied Science, Alleeth University Collage, Umm Al-Qura University, Makkah 24211, Saudi Arabia;
| | - Manal M. Khowdiary
- Chemistry Department, Faculty of Applied Science, Alleeth University Collage, Umm Al-Qura University, Makkah 24211, Saudi Arabia;
- Applied Surfactant Laboratory, Egyptian Petroleum Research Institute, Nasr City 11727, Cairo, Egypt
| | - Hisham S. Nassar
- Department of Chemistry, Faculty of Science and Arts in Al-Mukhwah, Al-Baha University, Al-Mukhwah 65311, Saudi Arabia; (H.S.N.); (S.A.A.)
- Chemistry Department, Faculty of Science, Al-Azhar University, Nasr City 11884, Cairo, Egypt;
| | - Mahmoud M. Abdelall
- Chemistry Department, Faculty of Science, Al-Azhar University, Nasr City 11884, Cairo, Egypt;
| | - Suliman A. Alderhami
- Department of Chemistry, Faculty of Science and Arts in Al-Mukhwah, Al-Baha University, Al-Mukhwah 65311, Saudi Arabia; (H.S.N.); (S.A.A.)
| | - Ahmed A. Elhenawy
- Department of Chemistry, Faculty of Science and Arts in Al-Mukhwah, Al-Baha University, Al-Mukhwah 65311, Saudi Arabia; (H.S.N.); (S.A.A.)
- Chemistry Department, Faculty of Science, Al-Azhar University, Nasr City 11884, Cairo, Egypt;
| |
Collapse
|
12
|
Liver fibrosis is associated with carotid atherosclerosis in patients with liver biopsy-proven nonalcoholic fatty liver disease. Sci Rep 2021; 11:15938. [PMID: 34354193 PMCID: PMC8342487 DOI: 10.1038/s41598-021-95581-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/26/2021] [Indexed: 12/12/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is related to subclinical atherosclerosis. However, whether the severity of the disease (or which histopathological component) is associated with subclinical atherosclerosis remains controversial. This study aimed to investigate the association between the histopathological severity of NAFLD and carotid intima-media thickness (CIMT) in Japanese patients with liver biopsy-proven NAFLD. Maximum-CIMT (max-CIMT) was measured as an index of carotid atherosclerosis in 195 biopsy-proven NAFLD patients. A significant association was observed between the severity of fibrosis (but not steatosis, inflammation, and ballooning) and max-CIMT. Older age, male gender, hypertension, and advanced fibrosis were independently linked to max-CIMT ≥ 1.2 mm. The prevalence of max-CIMT ≥ 1.2 mm was significantly higher in the advanced fibrosis group than in the non-advanced fibrosis group (75.4% versus 44.0%; p < 0.01). Non-invasive liver fibrosis markers and scoring systems, including fibrosis-4 index, NAFLD fibrosis score, hyaluronic acid, and Wisteria floribunda agglutinin positive Mac-2-binding protein, demonstrated that the diagnostic performance for max-CIMT ≥ 1.2 mm was similar to that of biopsy-based fibrosis staging. In conclusion, advanced fibrosis is significantly and independently associated with high-risk CIMT. Non-invasive fibrosis markers and scoring systems could help estimate the risk of atherosclerosis progression in patients with NAFLD.
Collapse
|
13
|
Sasaki N, Maeda R, Ozono R, Nakano Y, Higashi Y. Association of Flow Parameters and Diameter in the Common Carotid Artery with Impaired Glucose Metabolism. J Atheroscler Thromb 2021; 29:654-666. [PMID: 34011802 PMCID: PMC9135665 DOI: 10.5551/jat.62790] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Diameter, intima-media thickness (IMT), and flow parameters, including resistance index (RI) and pulsatility index (PI), in the common carotid artery (CCA) are markers of arterial remodeling, atherosclerosis, and vascular resistance, respectively. We investigated the differences among these markers in association with plasma glucose level, serum insulin level, and insulin resistance in participants without cardiovascular disease. METHODS CCA parameters (including the CCA interadventitial diameter and mean IMT at the time of 75-g oral glucose tolerance testing) were assessed in 4218 participants. RI and PI were assessed in 3380 of these participants. To assess plasma glucose and serum immunoreactive insulin profiles during oral glucose tolerance testing, we used the total areas under the curves (AUCglu and AUCins, respectively). We used the homeostasis model assessment of insulin resistance (HOMA-IR) and the Matsuda index to assess insulin resistance. Insulin secretion was assessed with the HOMA-β. RESULTS AUCglu was significantly associated with CCA interadventitial diameter (β=0.048, P<0.001), RI (β=0.144, P<0.001), and PI (β=0.103, P<0.001) but not with mean IMT. AUCins (β=-0.064, P<0.001) and HOMA-β (β=-0.054, P<0.001) were significantly and negatively associated with CCA interadventitial diameter, but not with mean IMT. Both HOMA-IR and Matsuda index were significantly associated with RI and PI. CONCLUSIONS These findings indicate that all CCA parameters except IMT are associated with impaired glucose metabolism in patients without cardiovascular disease.
Collapse
Affiliation(s)
- Nobuo Sasaki
- Health Management and Promotion Center, Hiroshima Atomic Bomb Casualty Council
| | - Ryo Maeda
- Health Management and Promotion Center, Hiroshima Atomic Bomb Casualty Council
| | - Ryoji Ozono
- Department of General Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yukiko Nakano
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| |
Collapse
|
14
|
Zhang H, Bai Z, Zhu L, Liang Y, Fan X, Li J, Wen H, Shi T, Zhao Q, Wang Z. Hydrogen sulfide donors: Therapeutic potential in anti-atherosclerosis. Eur J Med Chem 2020; 205:112665. [DOI: 10.1016/j.ejmech.2020.112665] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/09/2020] [Accepted: 07/12/2020] [Indexed: 12/15/2022]
|
15
|
Vlasschaert C, Goss CJ, Pilkey NG, McKeown S, Holden RM. Vitamin K Supplementation for the Prevention of Cardiovascular Disease: Where Is the Evidence? A Systematic Review of Controlled Trials. Nutrients 2020; 12:E2909. [PMID: 32977548 PMCID: PMC7598164 DOI: 10.3390/nu12102909] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/09/2020] [Accepted: 09/18/2020] [Indexed: 02/07/2023] Open
Abstract
Matrix gla protein (MGP) is an important vitamin K-dependent inhibitor of vascular calcification. High levels of uncarboxylated, dephosphorylated MGP have been associated with vascular calcification and are responsive to vitamin K treatment. In this systematic review, we summarize the available evidence examining whether vitamin K supplementation improves surrogate measures of cardiovascular disease including artery and valve calcification, atherosclerosis and artery stiffening. Data from controlled trials of adults were obtained by searching Ovid MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and the Web of Science Core Collection. We identified nine randomized controlled trials for review, including trials of vitamin K1 or vitamin K2 supplementation, that assessed a surrogate measure of cardiovascular disease including arterial calcification, atherosclerosis or arterial stiffening. For each trial, the risk of bias was assessed applying Cochrane Collaboration methodology. The findings indicate that vitamin K does not consistently prevent progression of calcification, atherosclerosis or arterial stiffness. There may be some benefit in people with calcification at study entry. Studies were heterogenous, with relatively short follow-up and outcome measures were varied. While vitamin K supplementation clearly improves the carboxylation of dephosphoylated MGP, its role in mitigating vascular calcification is uncertain, based on current evidence.
Collapse
Affiliation(s)
- Caitlyn Vlasschaert
- Department of Medicine, Queen’s University, Kingston, ON K7L 3V6, Canada; (C.V.); (C.J.G.); (N.G.P.)
| | - Chloe J. Goss
- Department of Medicine, Queen’s University, Kingston, ON K7L 3V6, Canada; (C.V.); (C.J.G.); (N.G.P.)
| | - Nathan G. Pilkey
- Department of Medicine, Queen’s University, Kingston, ON K7L 3V6, Canada; (C.V.); (C.J.G.); (N.G.P.)
| | - Sandra McKeown
- Bracken Health Sciences Library, Queen’s University, Kingston, ON K7L 2V5, Canada;
| | - Rachel M. Holden
- Department of Medicine, Queen’s University, Kingston, ON K7L 3V6, Canada; (C.V.); (C.J.G.); (N.G.P.)
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON K7L 3V6, Canada
| |
Collapse
|
16
|
Yu X, Bian B, Huang J, Yao W, Wu X, Huang J, Wang J, Yang Q, Ning X. Determinants of carotid intima-media thickness in asymptomatic elders: a population-based cross-sectional study in rural China. Postgrad Med 2020; 132:544-550. [PMID: 32297560 DOI: 10.1080/00325481.2020.1757266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: To examine the mean carotid intima-media thickness (CIMT) and potentially relevant determinants of increased CIMT in elders. Method: Stroke-free and cardiovascular disease-free residents aged ≥65 years were recruited in a low-income population in China. B-mode ultrasonography was performed to measure CIMT. Results: A total of 1039 individuals (47.9% men) were recruited. The mean CIMT value was 0.60 (SD: 0.09) mm. The mean CIMT was 24.07 (SEM: 6.52) µm greater in men than in women (P < 0.001) and 28.29 (SEM: 7.47) µm greater in patients with hypertension than in those without hypertension (P < 0.001). Moreover, the mean CIMT increased by 1.53 (SEM: 0.49) µm for each 1-year increase in age (P = 0.002). However, the mean CIMT decreased by 5.55 (SEM: 2.40) μm and 6.45 (SEM: 2.62) μm for every 1-mmol/L increase in triglyceride concentration and the high-density lipoprotein cholesterol: low-density lipoprotein cholesterol ratio, respectively (P < 0.05). However, high triglyceride level was negatively associated with mean CIMT only among individuals without metabolic syndrome (P = 0.036). Discussion: These findings suggest that there is an urgent need to delay atherosclerosis progression and reduce the stroke burden by managing hypertension, especially for men. Moreover, to decrease the stroke burden in rural China, caution is advised regarding lipid-lowering treatment in elderly patients without metabolic syndrome.
Collapse
Affiliation(s)
- Xuefang Yu
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin, China
| | - Bo Bian
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin, China
| | - Jinyong Huang
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin, China
| | - Wei Yao
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin, China
| | - Xianming Wu
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin, China
| | - Jingjing Huang
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital , Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute , Tianjin, China.,Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin Neurological Institute , Tianjin, China
| | - Qing Yang
- Department of Cardiology, Tianjin Medical University General Hospital , Tianjin, China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital , Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute , Tianjin, China.,Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin Neurological Institute , Tianjin, China
| |
Collapse
|
17
|
Katakami N, Mita T, Yoshii H, Shiraiwa T, Yasuda T, Okada Y, Torimoto K, Umayahara Y, Kaneto H, Osonoi T, Yamamoto T, Kuribayashi N, Maeda K, Yokoyama H, Kosugi K, Ohtoshi K, Hayashi I, Sumitani S, Tsugawa M, Ryomoto K, Taki H, Nakamura T, Kawashima S, Sato Y, Watada H, Shimomura I. Tofogliflozin does not delay progression of carotid atherosclerosis in patients with type 2 diabetes: a prospective, randomized, open-label, parallel-group comparative study. Cardiovasc Diabetol 2020; 19:110. [PMID: 32646498 PMCID: PMC7350187 DOI: 10.1186/s12933-020-01079-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/02/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND This study aimed to investigate the preventive effects of tofogliflozin, a selective sodium-glucose cotransporter 2 (SGLT2) inhibitor, on atherosclerosis progression in type 2 diabetes (T2DM) patients without apparent cardiovascular disease (CVD) by monitoring carotid intima-media thickness (IMT). METHODS This prospective, randomized, open-label, blinded-endpoint, multicenter, parallel-group, comparative study included 340 subjects with T2DM and no history of apparent CVD recruited at 24 clinical units. Subjects were randomly allocated to either the tofogliflozin treatment group (n = 169) or conventional treatment group using drugs other than SGLT2 inhibitors (n = 171). Primary outcomes were changes in mean and maximum common carotid IMT measured by echography during a 104-week treatment period. RESULTS In a mixed-effects model for repeated measures, the mean IMT of the common carotid artery (mean-IMT-CCA), along with the right and left maximum IMT of the CCA (max-IMT-CCA), significantly declined in both the tofogliflozin (- 0.132 mm, SE 0.007; - 0.163 mm, SE 0.013; - 0.170 mm, SE 0.020, respectively) and the control group (- 0.140 mm, SE 0.006; - 0.190 mm, SE 0.012; - 0.190 mm, SE 0.020, respectively). Furthermore, the tofogliflozin and the conventional treatment group did not significantly differ in the progression of the mean-IMT-CCA (mean change (95% CI) 0.008 (- 0.009, 0.025) mm, P = 0.34), along with the right (mean change (95% CI) 0.027 (- 0.005, 0.059) mm, P = 0.10) and the left max-IMT-CCA (mean change (95% CI) 0.020 (- 0.030, 0.070), P = 0.43). Similar findings were obtained even after adjusting for traditional CV risk factors and/or administration of drugs at baseline. Relative to the control treatment effects, tofogliflozin significantly reduced the HbA1c, blood glucose level, body weight/body mass index, abdominal circumference, and systolic blood pressure, and significantly increased the HDL-C. The total and serious adverse events incidences did not significantly vary between the treatment groups. CONCLUSIONS/INTERPRETATION No IMT changes were observed between the tofogliflozin and the conventional treatment groups. However, tofogliflozin is a safe and effective treatment option for managing primary CVD risk factors in this population. Clinical Trial Registration UMIN000017607 ( https://www.umin.ac.jp/icdr/index.html ).
Collapse
Affiliation(s)
- Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. .,Department of Metabolism and Atherosclerosis, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Tomoya Mita
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hidenori Yoshii
- Department of Medicine, Diabetology & Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center, Koto-ku, Tokyo, 136-0075, Japan
| | - Toshihiko Shiraiwa
- Shiraiwa Medical Clinic, 4-10-24 Hozenji, Kashiwara City, Osaka, 582-0005, Japan
| | - Tetsuyuki Yasuda
- Department of Diabetes and Endocrinology, Osaka Police Hospital, 10-31, Kitayama-cho, Tennoji-ku, Osaka, 543-0035, Japan
| | - Yosuke Okada
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
| | - Keiichi Torimoto
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
| | - Yutaka Umayahara
- Department of Diabetes and Endocrinology, Osaka General Medical Center, 3-1-56, Bandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Hideaki Kaneto
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Takeshi Osonoi
- Nakakinen Clinic, 745-5, Nakadai, Naka City, Ibaraki, 311-0113, Japan
| | - Tsunehiko Yamamoto
- Diabetes and Endocrinology, Kansai Rosai Hospital, 3-1-69, Inabaso, Amagasaki City, Hyogo, Japan
| | | | - Kazuhisa Maeda
- Kitasenri Maeda Clinic, 4-119 Furuedai, Suita, Osaka, 565-0874, Japan
| | - Hiroki Yokoyama
- Jiyugaoka Medical Clinic, West 6, South 6-4-3, Obihiro, Hokkaido, 080-0016, Japan
| | - Keisuke Kosugi
- Kosugi Medical Clinic, 3-9, Tamatsukurimoto-cho, Tennoji-ku, Osaka, 543-0014, Japan
| | - Kentaro Ohtoshi
- Otoshi Medical Clinic, 8-47, Kakudacho, Osaka Kita-ku, Osaka, 530-0017, Japan
| | - Isao Hayashi
- Hayashi Clinic, 3-9-23 Koshienguchi, Nishinomiya, Hyogo, 663-8113, Japan
| | - Satoru Sumitani
- Center for Diabetes and Endocrinology, Nippon Life Hospital, 2-1-54 Enokojima, Nishi-ku, Osaka, 550-0006, Japan
| | - Mamiko Tsugawa
- Department of Endocrinology and Metabolism, Ikeda Municipal Hospital, 3-1-18, Jonan, Ikeda, Osaka, 563-8510, Japan
| | - Kayoko Ryomoto
- Center for Diabetes Mellitus, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Hideki Taki
- Diabetes Center, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan
| | - Tadashi Nakamura
- Department of Internal Medicine, Kawasaki Hospital, 3-3-1, Higashiyamacho, Kobe Hyogo-ku, Hyogo, 652-0042, Japan
| | - Satoshi Kawashima
- Kanda Naika Clinic, 5-21-3, Hannancho, Osaka Abeno-ku, Osaka, 545-0021, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, 45 Shinanomachi Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | | |
Collapse
|
18
|
Katakami N, Matsuoka T, Shimomura I. Clinical utility of carotid ultrasonography: Application for the management of patients with diabetes. J Diabetes Investig 2019; 10:883-898. [PMID: 30884192 PMCID: PMC6626964 DOI: 10.1111/jdi.13042] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 03/12/2019] [Accepted: 03/13/2019] [Indexed: 02/06/2023] Open
Abstract
Carotid ultrasonography is a non-invasive, simple and inexpensive modality to assess the severity of atherosclerosis. This article reviews related articles, summarizes the rationale for the application of carotid ultrasonography in clinical practice, and addresses the features and the limitations of carotid ultrasonography in cardiovascular risk prediction. Numerous large studies have confirmed that various carotid ultrasound measures, such as carotid intima-media thickness, the presence or absence of carotid plaque, plaque number and plaque area, can be independent predictors of cardiovascular diseases in individuals with and without diabetes mellitus. Furthermore, many studies showed that the use of carotid intima-media thickness (especially maximum intima-media thickness, including plaque thickness) and/or carotid plaque in addition to traditional risk factors significantly improved the prediction of the occurrence of cardiovascular diseases, while controversy remains. Several studies showed that the progression of carotid intima-media thickness also can be a surrogate end-point of cardiovascular events. However, the accumulated evidence has not been sufficient. Further study with sufficient power should be carried out. As plaque disruption, which plays a crucial role in the pathogenesis of cardiovascular events, is dependent on the content of lipid in the atheroma and the thickness of the fibrous cap, tissue characterization of a plaque might be useful for determining its fragility. Interestingly, recent studies have shown that ultrasonic tissue characterization of carotid lesions could improve the prediction ability of future cardiovascular diseases. Thus, carotid ultrasonography is a useful modality for better clinical practice of atherosclerosis in patients with diabetes.
Collapse
Affiliation(s)
- Naoto Katakami
- Department of Metabolic MedicineOsaka University Graduate School of MedicineSuitaJapan
- Department of Metabolism and AtherosclerosisOsaka University Graduate School of MedicineSuitaJapan
| | - Taka‐aki Matsuoka
- Department of Metabolic MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Iichiro Shimomura
- Department of Metabolic MedicineOsaka University Graduate School of MedicineSuitaJapan
| |
Collapse
|
19
|
Khanna NN, Jamthikar AD, Araki T, Gupta D, Piga M, Saba L, Carcassi C, Nicolaides A, Laird JR, Suri HS, Gupta A, Mavrogeni S, Kitas GD, Suri JS. Nonlinear model for the carotid artery disease 10-year risk prediction by fusing conventional cardiovascular factors to carotid ultrasound image phenotypes: A Japanese diabetes cohort study. Echocardiography 2019; 36:345-361. [PMID: 30623485 DOI: 10.1111/echo.14242] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 12/04/2018] [Indexed: 12/11/2022] Open
Abstract
MOTIVATION This study presents a novel nonlinear model which can predict 10-year carotid ultrasound image-based phenotypes by fusing nine traditional cardiovascular risk factors (ethnicity, gender, age, artery type, body mass index, hemoglobin A1c, hypertension, low-density lipoprotein, and smoking) with five types of carotid automated image phenotypes (three types of carotid intima-media thickness (IMT), wall variability, and total plaque area). METHODOLOGY Two-step process was adapted: First, five baseline carotid image-based phenotypes were automatically measured using AtheroEdge™ (AtheroPoint™ , CA, USA) system by two operators (novice and experienced) and an expert. Second, based on the annual progression rates of cIMT due to nine traditional cardiovascular risk factors, a novel nonlinear model was adapted for 10-year predictions of carotid phenotypes. RESULTS Institute review board (IRB) approved 204 Japanese patients' left/right common carotid artery (407 ultrasound scans) was collected with a mean age of 69 ± 11 years. Age and hemoglobin were reported to have a high influence on the 10-year carotid phenotypes. Mean correlation coefficient (CC) between 10-year carotid image-based phenotype and age was improved by 39.35% in males and 25.38% in females. The area under the curves for the 10-year measurements of five phenotypes IMTave10yr , IMTmax10yr , IMTmin10yr , IMTV10yr , and TPA10yr were 0.96, 0.94, 0.90, 1.0, and 1.0. Inter-operator variability between two operators showed significant CC (P < 0.0001). CONCLUSIONS A nonlinear model was developed and validated by fusing nine conventional CV risk factors with current carotid image-based phenotypes for predicting the 10-year carotid ultrasound image-based phenotypes which may be used risk assessment.
Collapse
Affiliation(s)
- Narendra N Khanna
- Department of Cardiology, Indraprastha Apollo Hospitals, New Delhi, India
| | - Ankush D Jamthikar
- Department of Electronics and Communication Engineering, Visvesvaraya National Institute of Technology, Nagpur, India
| | - Tadashi Araki
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Deep Gupta
- Department of Electronics and Communication Engineering, Visvesvaraya National Institute of Technology, Nagpur, India
| | - Matteo Piga
- Department of Rheumatology, University Clinic and AOU of Cagliari, Cagliari, Italy
| | - Luca Saba
- Department of Radiology, University of Cagliari, Cagliari, Italy
| | - Carlo Carcassi
- Department of Genetics, University of Cagliari, Cagliari, Italy
| | - Andrew Nicolaides
- Department of Vascular Surgery, Imperial College, London, UK.,Vascular Diagnostic Center, University of Cyprus, Nicosia, Cyprus
| | - John R Laird
- Heart and Vascular Institute, Adventist Health St. Helena, St Helena, California
| | | | - Ajay Gupta
- Department of Radiology and Feil Family Brain and Mind Research Institute, Weill Cornell Medical Center, New York, New York
| | - Sophie Mavrogeni
- Cardiology Clinic, Onassis Cardiac Surgery Center, Athens, Greece
| | - George D Kitas
- Arthritis Research UK Centre for Epidemiology, Manchester University, Manchester, UK.,Director of Research & Development-Academic Affairs, Dudley Group NHS Foundation Trust, Dudley, UK
| | - Jasjit S Suri
- Stroke Monitoring and Diagnostic Division, AtheroPointTM, Roseville, California
| |
Collapse
|
20
|
Tanaka A, Kawaguchi A, Oyama JI, Ishizu T, Ito H, Fukui J, Kondo T, Kuroki S, Nanasato M, Higashi Y, Kaku K, Inoue T, Murohara T, Node K. Differential effect of concomitant antidiabetic agents on carotid atherosclerosis: a subgroup analysis of the PROLOGUE study. Heart Vessels 2018; 34:375-384. [PMID: 30284018 DOI: 10.1007/s00380-018-1275-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 09/28/2018] [Indexed: 11/28/2022]
Abstract
Accumulated evidence shows that some antidiabetic agents attenuate the progression of carotid atherosclerosis assessed as intima-media thickness (IMT). Although some studies have demonstrated an inhibitory effect of dipeptidyl peptidase-4 inhibitors on carotid IMT progression, in the PROLOGUE study sitagliptin failed to slow progression relative to conventional therapy for 24 months. We hypothesized that differences in the concomitant antidiabetic agents between the groups have influenced the progression of carotid IMT. We performed a post hoc analysis of the PROLOGUE study using subgroups stratified by concomitant antidiabetic agents. Although no subgroup with any combination of agents in the overall patients showed a significant difference between sitagliptin group and conventional therapy group in the changes from baseline in mean common carotid artery (CCA)-IMT at 24 months, a significant attenuation of mean CCA-IMT progression was observed in the sitagliptin group relative to conventional therapy group only in three combination subgroups aged < 70 years, namely no thiazolidinedione; no thiazolidinedione or biguanide; and no thiazolidinedione, biguanide or α-glucosidase inhibitor, even after adjustment for multiple confounding factors. In the three subgroups, no significant difference between sitagliptin group and conventional therapy group in the changes from baseline in HbA1c at 24 months was detected. Our data suggest that some concomitant agents, whose prescription frequencies were increased in the conventional therapy group, may have masked the inhibitory effect of sitagliptin on carotid IMT progression in the PROLOGUE study.
Collapse
Affiliation(s)
- Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan.
| | | | - Jun-Ichi Oyama
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Tomoko Ishizu
- Department of Clinical Laboratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroshi Ito
- Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Akita, Japan
| | - Jun Fukui
- Division of Cardiology, Hokusho Central Hospital, Sasebo, Japan
| | - Taizo Kondo
- Department of Cardiovascular Medicine, Gifu Prefectural Tajimi Hospital, Tajimi, Japan
| | | | - Mamoru Nanasato
- Cardiovascular Center, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan
| | - Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Kohei Kaku
- Department of General Internal Medicine, Kawasaki Medical School, Kurashiki, Japan
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan.
| |
Collapse
|
21
|
Furuhashi M, Yuda S, Muranaka A, Kawamukai M, Matsumoto M, Tanaka M, Moniwa N, Ohnishi H, Saitoh S, Shimamoto K, Miura T. Circulating Fatty Acid-Binding Protein 4 Concentration Predicts the Progression of Carotid Atherosclerosis in a General Population Without Medication. Circ J 2018; 82:1121-1129. [PMID: 29445067 DOI: 10.1253/circj.cj-17-1295] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Fatty acid-binding protein 4 (FABP4), which is expressed in both adipocytes and macrophages, is secreted from the cells and acts as an adipokine. An elevated circulating FABP4 level is associated with insulin resistance and atherosclerosis.Methods and Results:We investigated the causative association between FABP4 level and progression of atherosclerosis in subjects of the Tanno-Sobetsu Study, a population-based cohort. In 281 subjects without medication (male/female: 109/172) in the year 2010 or 2013, the carotid intima-media thickness (CIMT) assessed using carotid ultrasonography was significantly correlated with age, adiposity, blood pressure, renal dysfunction and levels of cholesterol, triglycerides, fasting glucose, HbA1c and FABP4 (r=0.331, P<0.001). Multiple regression analysis demonstrated that age, sex and FABP4 concentration were independent predictors of CIMT. A total of 78 (male/female: 29/49) of the 156 subjects in 2010 underwent carotid ultrasonography again in 2013. The change in CIMT each year during that 3-year period (mean±SD: 3.8±22.3 µm/year) was positively correlated with basal levels of high-sensitivity C-reactive protein (hsCRP) (r=0.231, P=0.046) and FABP4 (r=0.267, P=0.018) in 2010. After adjustment for age, sex and hsCRP level, the basal FABP4 level was independently associated with the change in CIMT per year. CONCLUSIONS FABP4 concentration is an independent predictor of the progression of carotid atherosclerosis.
Collapse
Affiliation(s)
- Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Satoshi Yuda
- Devision of Cardiology, Cardiovascular Center, Teine Keijinkai Hospital
| | - Atsuko Muranaka
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Mina Kawamukai
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Megumi Matsumoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Marenao Tanaka
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Norihito Moniwa
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Hirofumi Ohnishi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Department of Public Health, Sapporo Medical University School of Medicine
| | - Shigeyuki Saitoh
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Department of Nursing, Division of Medical and Behavioral Subjects, Sapporo Medical University School of Health Sciences
| | | | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| |
Collapse
|
22
|
Kim KH, Song IG, Kwon TG, Park JB, Kim KS, Kim WS, Bae JH. Impact of different antihypertensives on carotid arterial wall thickness. J Clin Hypertens (Greenwich) 2018; 20:248-254. [DOI: 10.1111/jch.13189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 10/11/2017] [Accepted: 10/20/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Ki-Hong Kim
- Department of Cardiology; Konyang University Hospital; Daejeon Korea
| | - In Geol Song
- Department of Cardiology; Konyang University Hospital; Daejeon Korea
| | - Taek-Geun Kwon
- Department of Cardiology; Konyang University Hospital; Daejeon Korea
| | - Jeong Bae Park
- Department of Cardiology; Cheil General Hospital; Dankook University; Seoul Korea
| | - Kee-Sik Kim
- Department of Cardiology; Daegu Catholic University Medical Center; Daegu Korea
| | - Wuon-Shik Kim
- Korea Research Institute of Standards and Science; Daejeon Korea
| | - Jang-Ho Bae
- Department of Cardiology; Konyang University Hospital; Daejeon Korea
| |
Collapse
|
23
|
Guan Y, Yu C, Shi M, Ni J, Wu Y, Gu H, Bai L, Liu J, Tu J, Wang J, Ning X. The association between elevated fasting plasma glucose levels and carotid intima-media thickness in non-diabetic adults: a population-based cross-sectional study. Oncotarget 2017; 8:111053-111063. [PMID: 29340036 PMCID: PMC5762304 DOI: 10.18632/oncotarget.22302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 10/12/2017] [Indexed: 12/11/2022] Open
Abstract
We assessed the association between the mean carotid intima-media thickness (CIMT) and fasting plasma glucose (FPG) levels in a low-income population in rural China. Adults aged ≥45 years without a history of diabetes, stroke, or cardiovascular disease were recruited. All participants were categorized into four groups according to FPG level. A total of 3509 participants were analyzed in this study. In the univariate analysis, sex, age, education level, hypertension, central obesity, current smoking, alcohol consumption, and higher levels of FPG, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were associated with mean CIMT and frequency of increased CIMT. FPG levels were significantly associated with mean CIMT; each 1-mmol/L increase in FPG resulted in a 2.75-μm increase in mean CIMT when adjusted by age, sex, education level, current smoking status, alcohol consumption, hypertension, and the levels of TC, TG, HDL-C, and LDL-C (P = 0.044). However, the association between FPG and the frequency of increased CIMT disappeared after adjusting by covariates. These findings indicate that FPG is an independent determinant of mean CIMT in a non-diabetic population. Management and control of FPG levels is crucial for preventing atherosclerosis in populations with high stroke risks in China.
Collapse
Affiliation(s)
- Yalin Guan
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Changshen Yu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Min Shi
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
| | - Jingxian Ni
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
| | - Yanan Wu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
| | - Hongfei Gu
- Department of Neurology, Tianjin Haibin People's Hospital, Tianjin, China
| | - Lingling Bai
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
| | - Jie Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China.,Central of Clinical Epidemiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China.,Central of Clinical Epidemiology, Tianjin Medical University General Hospital, Tianjin, China
| |
Collapse
|
24
|
Katakami N, Mita T, Yoshii H, Shiraiwa T, Yasuda T, Okada Y, Umayahara Y, Kaneto H, Osonoi T, Yamamoto T, Kuribayashi N, Maeda K, Yokoyama H, Kosugi K, Ohtoshi K, Hayashi I, Sumitani S, Tsugawa M, Ohashi M, Taki H, Nakamura T, Kawashima S, Sato Y, Watada H, Shimomura I. Rationale, Design, and Baseline Characteristics of the Utopia Trial for Preventing Diabetic Atherosclerosis Using an SGLT2 Inhibitor: A Prospective, Randomized, Open-Label, Parallel-Group Comparative Study. Diabetes Ther 2017; 8:999-1013. [PMID: 28864997 PMCID: PMC5630549 DOI: 10.1007/s13300-017-0292-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Sodium-glucose co-transporter-2 (SGLT2) inhibitors are anti-diabetic agents that improve glycemic control with a low risk of hypoglycemia and ameliorate a variety of cardiovascular risk factors. The aim of the ongoing study described herein is to investigate the preventive effects of tofogliflozin, a potent and selective SGLT2 inhibitor, on the progression of atherosclerosis in subjects with type 2 diabetes (T2DM) using carotid intima-media thickness (IMT), an established marker of cardiovascular disease (CVD), as a marker. METHODS The Study of Using Tofogliflozin for Possible better Intervention against Atherosclerosis for type 2 diabetes patients (UTOPIA) trial is a prospective, randomized, open-label, blinded-endpoint, multicenter, and parallel-group comparative study. The aim was to recruit a total of 340 subjects with T2DM but no history of apparent CVD at 24 clinical sites and randomly allocate these to a tofogliflozin treatment group or a conventional treatment group using drugs other than SGLT2 inhibitors. As primary outcomes, changes in mean and maximum IMT of the common carotid artery during a 104-week treatment period will be measured by carotid echography. Secondary outcomes include changes in glycemic control, parameters related to β-cell function and diabetic nephropathy, the occurrence of CVD and adverse events, and biochemical measurements reflecting vascular function. CONCLUSION This is the first study to address the effects of SGLT2 inhibitors on the progression of carotid IMT in subjects with T2DM without a history of CVD. The results will be available in the very near future, and these findings are expected to provide clinical data that will be helpful in the prevention of diabetic atherosclerosis and subsequent CVD. FUNDING Kowa Co., Ltd. CLINICAL TRIAL REGISTRATION UMIN000017607.
Collapse
Affiliation(s)
- Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
- Department of Metabolism and Atherosclerosis, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Tomoya Mita
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hidenori Yoshii
- Department of Medicine, Diabetology and Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center, Koto-ku, Tokyo, 136-0075, Japan
| | - Toshihiko Shiraiwa
- Shiraiwa Medical Clinic, 4-10-24 Hozenji, Kashiwara City, Osaka, 582-0005, Japan
| | - Tetsuyuki Yasuda
- Department of Endocrinology and Metabolism, Osaka Police Hospital, 10-31, Kitayama-cho, Tennoji-ku, Osaka, 543-0035, Japan
| | - Yosuke Okada
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
| | - Yutaka Umayahara
- Department of Diabetes and Endocrinology, Osaka General Medical Center, 3-1-56, Bandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Hideaki Kaneto
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Takeshi Osonoi
- Nakakinen Clinic, 745-5, Nakadai, Naka City, Ibaraki, 311-0113, Japan
| | - Tsunehiko Yamamoto
- Diabetes and Endocrinology, Kansai Rosai Hospital, 3-1-69, Inabaso, Amagasaki city, Hyogo, Japan
| | | | - Kazuhisa Maeda
- Kitasenri Maeda Clinic, 4-119, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Hiroki Yokoyama
- Jiyugaoka Medical Clinic, West 6, South 6-4-3, Obihiro, Hokkaido, 080-0016, Japan
| | - Keisuke Kosugi
- Kosugi Medical Clinic, 3-9, Tamatsukurimoto-cho, Tennoji-ku, Osaka, 543-0014, Japan
| | - Kentaro Ohtoshi
- Otoshi Medical Clinic, 8-47, Kakudacho, Osaka Kita-ku, Osaka, 530-0017, Japan
| | - Isao Hayashi
- Hayashi Clinic, 3-9-23 Koshienguchi, Nishinomiya, Hyogo, 663-8113, Japan
| | - Satoru Sumitani
- Center for Diabetes and Endocrinology, Nissay Hospital, 6-3-8, Itachibori, Nishi-ku, Osaka, 550-0012, Japan
| | - Mamiko Tsugawa
- Department of Endocrinology and Metabolism, Ikeda Municipal Hospital, 3-1-18, Jonan, Ikeda, Osaka, 563-8510, Japan
| | - Makoto Ohashi
- Center for Diabetes Mellitus, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Hideki Taki
- Diabetes Center, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan
| | - Tadashi Nakamura
- Department of Internal Medicine, Kawasaki Hospital, 3-3-1, Higashiyamacho, Kobe Hyogo-ku, Hyogo, 652-0042, Japan
| | - Satoshi Kawashima
- Kanda Naika Clinic, 5-21-3, Hannancho, Osaka Abeno-ku, Osaka, 545-0021, Japan
| | - Yasunori Sato
- Department of Global Clinical Research, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan
| | - Hirotaka Watada
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| |
Collapse
|
25
|
Ferreira JP, Kearney Schwartz A, Watfa G, Zohra L, Felblinger J, Boivin JM, Bracard S, Hossu G, Verger A, Joly L, Zannad F, Rossignol P, Benetos A. Memory Alterations and White Matter Hyperintensities in Elderly Patients With Hypertension: The ADELAHYDE-2 Study. J Am Med Dir Assoc 2017; 18:451.e13-451.e25. [PMID: 28279605 DOI: 10.1016/j.jamda.2017.01.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 01/18/2017] [Indexed: 01/18/2023]
Abstract
OBJECTIVES The longitudinal ADELAHYDE-2 study aims to identify the factors associated with cognitive impairment/decline and white matter hyperintensities burden. METHODS Longitudinal single-center study comprising two visits separated by approximately 7 years. A total of 131 patients completed the two visits. The primary outcome was global memory composite scale, while the secondary outcome was white matter hyperintensities (WMH/Fazekas scale) load. RESULTS Global memory at visit 2 (V2) was largely influenced by age, smoking status, glycated hemoglobin, and history of stroke already present at visit 1 (V1). These variables accounted for ∼51% of the memory alterations at V2. WMH at V2 was likely influenced by age, left ventricular hypertrophy, diabetes mellitus, carotid intima-media thickness, and body mass index at V1. These findings accounted for ∼37% of the WMH changes at V2. Increase in pulse wave velocity from V1 to V2 showed a trend for association with memory deterioration (adjusted estimates = 0.06; P = .067), whereas smoking and increase in systolic blood pressure (trend) were associated with an increment in WMH (adjusted estimates = 0.49; P = .047 and adjusted estimates = 0.01; P = .08, respectively). On the other hand, angiotensin-converting enzyme inhibitor/angiotensin receptor blockers and statins (trend) were likely to be protective (adjusted estimates for angiotensin-converting enzyme inhibitor/angiotensin receptor blockers = -0.49; P = .049, and adjusted estimates for statins = -0.46; P = .055). CONCLUSIONS Several readily identifiable factors are associated with memory deterioration and WMH, many of which are potentially modifiable. Interventions aimed to control these risk factors need to be tested prospectively in order to assess their cognitive protective value.
Collapse
Affiliation(s)
- João Pedro Ferreira
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France; Department of Physiology and Cardiothoracic Surgery, Cardiovascular Research and Development Unit, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Anna Kearney Schwartz
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France; Service de Gériatrie, CHRU de Nancy, Nancy, France
| | | | - Lamiral Zohra
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France
| | - Jacques Felblinger
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France; INSERM, U947, IADI, Nancy, F-54000, France, Département de Neuroradiologie Diagnostique et Interventionnelle, Pôle Imagerie, Centre Hospitalier Universitaire de Nancy, Nancy, France
| | - Jean-Marc Boivin
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France
| | - Serge Bracard
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France; Département de Neuroradiologie Diagnostique et Interventionnelle, Centre Hospitalier Universitaire de Nancy, Nancy, France
| | - Gabriella Hossu
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France; INSERM U1116, Université de Lorraine, Nancy, France; U947, INSERM, Nancy, France
| | - Antoine Verger
- CHRU Nancy, Nuclear Medicine & Nancyclotep Experimental Imaging Platform, Nancy, France
| | - Laure Joly
- Service de Gériatrie, CHRU de Nancy, Nancy, France; INSERM U1116, Université de Lorraine, Nancy, France
| | - Faiez Zannad
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France; INSERM U1116, Université de Lorraine, Nancy, France
| | - Patrick Rossignol
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France; INSERM U1116, Université de Lorraine, Nancy, France
| | - Athanase Benetos
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France; Service de Gériatrie, CHRU de Nancy, Nancy, France; INSERM U1116, Université de Lorraine, Nancy, France.
| |
Collapse
|
26
|
Tanaka A, Murohara T, Taguchi I, Eguchi K, Suzuki M, Kitakaze M, Sato Y, Ishizu T, Higashi Y, Yamada H, Nanasato M, Shimabukuro M, Teragawa H, Ueda S, Kodera S, Matsuhisa M, Kadokami T, Kario K, Nishio Y, Inoue T, Maemura K, Oyama JI, Ohishi M, Sata M, Tomiyama H, Node K. Rationale and design of a multicenter randomized controlled study to evaluate the preventive effect of ipragliflozin on carotid atherosclerosis: the PROTECT study. Cardiovasc Diabetol 2016; 15:133. [PMID: 27619983 PMCID: PMC5020545 DOI: 10.1186/s12933-016-0449-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 09/03/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus is associated strongly with an increased risk of micro- and macro-vascular complications, leading to impaired quality of life and shortened life expectancy. In addition to appropriate glycemic control, multi-factorial intervention for a wide range of risk factors, such as hypertension and dyslipidemia, is crucial for management of diabetes. A recent cardiovascular outcome trial in diabetes patients with higher cardiovascular risk demonstrated that a SGLT2 inhibitor markedly reduced mortality, but not macro-vascular events. However, to date there is no clinical evidence regarding the therapeutic effects of SGLT2 inhibitors on arteriosclerosis. The ongoing PROTECT trial was designed to assess whether the SGLT2 inhibitors, ipragliflozin, prevented progression of carotid intima-media thickness in Japanese patients with type 2 diabetes mellitus. METHODS A total of 480 participants with type 2 diabetes mellitus with a HbA1c between 6 and 10 % despite receiving diet/exercise therapy and/or standard anti-diabetic agents for at least 3 months, will be randomized systematically (1:1) into either ipragliflozin or control (continuation of conventional therapy) groups. After randomization, ipragliflozin (50-100 mg once daily) will be added on to the background therapy in participants assigned to the ipragliflozin group. The primary endpoint of the study is the change in mean intima-media thickness of the common carotid artery from baseline to 24 months. Images of carotid intima-media thickness will be analyzed at a central core laboratory in a blinded manner. The key secondary endpoints include the change from baseline in other parameters of carotid intima-media thickness, various metabolic parameters, and renal function. Other cardiovascular functional tests are also planned for several sub-studies. DISCUSSION The PROTECT study is the first to assess the preventive effect of ipragliflozin on progression of carotid atherosclerosis using carotid intima-media thickness as a surrogate marker. The study has potential to clarify the protective effects of ipragliflozin on atherosclerosis. Trial registration Unique Trial Number, JPRN/UMIN000018440 ( https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000021348 ).
Collapse
Affiliation(s)
- Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Isao Taguchi
- Department of Cardiology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan
| | - Kazuo Eguchi
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Makoto Suzuki
- Cardiology Department, Kameda Medical Center, Kamogawa, Japan
| | - Masafumi Kitakaze
- Department of Clinical Medicine and Development, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yasunori Sato
- Department of Global Clinical Research, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tomoko Ishizu
- Department of Clinical Laboratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Mamoru Nanasato
- Cardiovascular Center, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan
| | - Michio Shimabukuro
- Department of Cardio-Diabetes Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Kuramoto, Japan
| | - Hiroki Teragawa
- Department of Cardiovascular Medicine, JR Hiroshima Hospital, Hiroshima, Japan
| | - Shinichiro Ueda
- Department of Clinical Pharmacology and Therapeutics, University of the Ryukyus, Nishihara, Japan
| | - Satoshi Kodera
- Department of Cardiology, Asahi General Hospital, Chiba, Japan
| | - Munehide Matsuhisa
- Diabetes Therapeutics and Research Center, Tokushima University, Tokushima, Japan
| | - Toshiaki Kadokami
- Department of Cardiovascular Medicine, Saiseikai Futsukaichi Hospital, Chikushino, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Yoshihiko Nishio
- Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan
| | - Koji Maemura
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Jun-Ichi Oyama
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | | | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan.
| | | |
Collapse
|
27
|
Ferreira JP, Girerd N, Bozec E, Machu JL, Boivin JM, London GM, Zannad F, Rossignol P. Intima-Media Thickness Is Linearly and Continuously Associated With Systolic Blood Pressure in a Population-Based Cohort (STANISLAS Cohort Study). J Am Heart Assoc 2016; 5:JAHA.116.003529. [PMID: 27312804 PMCID: PMC4937282 DOI: 10.1161/jaha.116.003529] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Carotid intima-media thickness (cIMT) is a noninvasive marker of cardiovascular risk. The cIMT may be increased in patients with harmonisation, but little is known regarding the functional form of the association between blood pressure (BP) and cIMT in hypertensive and nonhypertensive persons. We aimed to define the shape of the association between BP and cIMT. METHODS AND RESULTS We studied cIMT and ambulatory BP monitoring data from a single-center, cross-sectional, population-based study involving 696 adult participants from the STANISLAS cohort, a familial longitudinal cohort from the Nancy region of France. Participants with a history of hypertension were more likely to have a cIMT >900 μm and had higher mean cIMT (both P<0.001). The risk of cIMT >900 μm increased linearly with higher 24-hour and daytime systolic BP in participants both with and without history of hypertension. The relationship between systolic BP and the risk of cIMT >900 μm was not dependent on hypertension status (all P for interaction >0.10). In multivariable analysis adjusted on cardiovascular risk factors, each 5-mm Hg increase in systolic BP was associated with an 8-μm increase in cIMT (β=8.249 [95% CI 2.490-14.008], P=0.005). In contrast, the association between diastolic BP and cIMT was weaker and not significant. CONCLUSIONS Systolic BP is linearly and continuously associated with higher cIMT in both hypertensive and nonhypertensive persons, suggesting a detrimental effect of BP on the vascular tree prior to overt hypertension. Similarly, it suggests a detrimental effect of BP at the higher end of the normal range in treated hypertensive patients. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov/. Unique identifier: NCT01391442.
Collapse
Affiliation(s)
- João Pedro Ferreira
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Université de Lorraine, CHRU de Nancy, Nancy, France F-CRIN INI-CRCT, Nancy, France Cardiovascular Research and Development Unit, Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Portugal
| | - Nicolas Girerd
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Université de Lorraine, CHRU de Nancy, Nancy, France F-CRIN INI-CRCT, Nancy, France
| | - Erwan Bozec
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Université de Lorraine, CHRU de Nancy, Nancy, France F-CRIN INI-CRCT, Nancy, France
| | - Jean Loup Machu
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Université de Lorraine, CHRU de Nancy, Nancy, France F-CRIN INI-CRCT, Nancy, France
| | - Jean-Marc Boivin
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Université de Lorraine, CHRU de Nancy, Nancy, France F-CRIN INI-CRCT, Nancy, France
| | - Gérard M London
- F-CRIN INI-CRCT, Nancy, France Department of Nephrology, Manhès Hospital, Fleury Mérogis, Paris, France Department of Pharmacology, Georges Pompidou European Hospital, National Institute of Health and Medical Research U970, Paris, France
| | - Faiez Zannad
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Université de Lorraine, CHRU de Nancy, Nancy, France F-CRIN INI-CRCT, Nancy, France
| | - Patrick Rossignol
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Université de Lorraine, CHRU de Nancy, Nancy, France F-CRIN INI-CRCT, Nancy, France
| |
Collapse
|
28
|
Mita T, Katakami N, Shiraiwa T, Yoshii H, Onuma T, Kuribayashi N, Osonoi T, Kaneto H, Kosugi K, Umayahara Y, Yamamoto T, Matsumoto K, Yokoyama H, Tsugawa M, Gosho M, Shimomura I, Watada H. Sitagliptin Attenuates the Progression of Carotid Intima-Media Thickening in Insulin-Treated Patients With Type 2 Diabetes: The Sitagliptin Preventive Study of Intima-Media Thickness Evaluation (SPIKE): A Randomized Controlled Trial. Diabetes Care 2016; 39:455-64. [PMID: 26822324 DOI: 10.2337/dc15-2145] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 12/08/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The effect of additional treatment with oral hypoglycemic agents on the progression of atherosclerosis remains unknown in insulin-treated patients with type 2 diabetes mellitus (T2DM). We assessed the effects of sitagliptin, a dipeptidyl peptidase 4 inhibitor, on carotid intima-media thickness (IMT) in T2DM. RESEARCH DESIGN AND METHODS This prospective, randomized, open-label, blinded end point, multicenter, parallel-group, comparative study included 282 insulin-treated patients with T2DM free of a history of apparent cardiovascular diseases who were recruited at 12 clinical units and randomly allocated to either the sitagliptin group (n = 142) or the control group (n = 140). The primary outcomes were changes in mean and maximum IMT of the common carotid artery measured by echography at the end of a 104-week treatment period. RESULTS Sitagliptin had a more potent glucose-lowering effect compared with the conventional treatment (-0.5 ± 1.0% vs. -0.2 ± 0.9%; P = 0.004), without increasing hypoglycemic episodes or body weight. Changes in the mean and left maximum IMT, but not right maximum IMT, of the common carotid arteries were significantly greater after sitagliptin treatment compared with conventional treatment (-0.029 [SE 0.013] vs. 0.024 [0.013] mm [P = 0.005]; -0.065 [0.027] vs. 0.022 [0.026] mm [P = 0.021]; -0.007 [0.031] vs. 0.027 [0.031] mm [P = 0.45], respectively). Over 104 weeks, sitagliptin, but not conventional treatment, significantly reduced the mean IMT and left maximum IMT of common carotid arteries relative to the baseline. CONCLUSIONS Sitagliptin attenuated the progression of carotid IMT in insulin-treated patients with T2DM free of apparent cardiovascular disease compared with conventional treatment.
Collapse
Affiliation(s)
- Tomoya Mita
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan Department of Atherosclerosis and Metabolism, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | | | - Hidenori Yoshii
- Department of Medicine, Diabetology & Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center, Koto-ku, Tokyo, Japan
| | - Tomio Onuma
- Department of Medicine, Diabetology & Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center, Koto-ku, Tokyo, Japan
| | | | | | - Hideaki Kaneto
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | | | | | | | | | - Hiroki Yokoyama
- Department of Internal Medicine, Jiyugaoka Medical Clinic, Obihiro, Hokkaido, Japan
| | | | - Masahiko Gosho
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | | |
Collapse
|
29
|
Byrkjeland R, Stensæth KH, Anderssen S, Njerve IU, Arnesen H, Seljeflot I, Solheim S. Effects of exercise training on carotid intima-media thickness in patients with type 2 diabetes and coronary artery disease. Influence of carotid plaques. Cardiovasc Diabetol 2016; 15:13. [PMID: 26801098 PMCID: PMC4724125 DOI: 10.1186/s12933-016-0336-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 01/14/2016] [Indexed: 02/08/2023] Open
Abstract
Background Carotid intima-media thickness (cIMT) holds prognostic information for future cardiovascular disease and is associated with the extent of coronary atherosclerosis. We investigated the effect of exercise on cIMT progression in patients with both type 2 diabetes and coronary artery disease (CAD). Methods Patients with type 2 diabetes and CAD (n = 137) were randomized to exercise training or standard follow-up. The 12 month exercise program contained 150 min weekly of combined aerobic and resistance training. High-resolution ultrasonography of the distal part of the common carotid artery (CCA) was performed to measure cIMT before and after the intervention. The CCA and the carotid bulb were scanned for the presence of atherosclerotic plaques. Differences in changes between the randomized groups were calculated by one-way ANCOVA. Results In the total population no difference in changes of cIMT from baseline to 12 months was observed between the exercise group and controls [−0.016 mm (95 % CI −0.037 to 0.006) vs. −0.007 mm (95 % CI −0.029 to 0.015), p = 0.57]. However, there was a significant interaction between the effect of exercise training and the presence of carotid plaques (p = 0.013), and significant reduced cIMT was demonstrated in the exercise group compared with controls in patients without identified carotid plaques (n = 65) [−0.034 mm (95 % CI −0.060 to 0.008) vs. 0.013 mm (95 % CI −0.011 to 0.038), p = 0.010]. Conclusion One year of exercise training in patients with type 2 diabetes and CAD did not significantly change cIMT progression. However, in patients without identified carotid plaques, beneficial effect of exercise training on cIMT progression was demonstrated.
Collapse
Affiliation(s)
- Rune Byrkjeland
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, PO box 4956, Nydalen, 0424, Oslo, Norway. .,Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway. .,Faculty of Medicine, University of Oslo, Oslo, Norway.
| | | | - Sigmund Anderssen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
| | - Ida U Njerve
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, PO box 4956, Nydalen, 0424, Oslo, Norway. .,Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway. .,Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Harald Arnesen
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, PO box 4956, Nydalen, 0424, Oslo, Norway. .,Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway. .,Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Ingebjørg Seljeflot
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, PO box 4956, Nydalen, 0424, Oslo, Norway. .,Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway. .,Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Svein Solheim
- Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, PO box 4956, Nydalen, 0424, Oslo, Norway. .,Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway.
| |
Collapse
|
30
|
Mita T, Katakami N, Yoshii H, Onuma T, Kaneto H, Osonoi T, Shiraiwa T, Kosugi K, Umayahara Y, Yamamoto T, Yokoyama H, Kuribayashi N, Jinnouchi H, Gosho M, Shimomura I, Watada H. Alogliptin, a Dipeptidyl Peptidase 4 Inhibitor, Prevents the Progression of Carotid Atherosclerosis in Patients With Type 2 Diabetes: The Study of Preventive Effects of Alogliptin on Diabetic Atherosclerosis (SPEAD-A). Diabetes Care 2016; 39:139-48. [PMID: 26628419 DOI: 10.2337/dc15-0781] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 10/05/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Recent experimental studies have shown that dipeptidyl peptidase 4 (DPP-4) inhibitors have antiatherosclerotic benefits in glucagon-like peptide 1-dependent and -independent manners. The current study investigated the effects of alogliptin, a DPP-4 inhibitor, on the progression of carotid atherosclerosis in patients with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS This prospective, randomized, open-label, blinded-end point, multicenter, parallel-group, comparative study included 341 patients with T2DM free of a history of apparent cardiovascular diseases recruited at 11 clinical units and randomly allocated to treatment with alogliptin (n = 172) or conventional treatment (n = 169). Primary outcomes were changes in mean common and maximum intima-media thickness (IMT) of the carotid artery measured by carotid arterial echography during a 24-month treatment period. RESULTS Alogliptin treatment had a more potent glucose-lowering effect than the conventional treatment (-0.3 ± 0.7% vs. -0.1 ± 0.8%, P = 0.004) without an increase of hypoglycemia. Changes in the mean common and the right and left maximum IMT of the carotid arteries were significantly greater after alogliptin treatment than after conventional treatment (-0.026 mm [SE 0.009] vs. 0.005 mm [SE 0.009], P = 0.022; -0.045 mm [SE 0.018] vs. 0.011 mm [SE 0.017], P = 0.025, and -0.079 mm [SE 0.018] vs. -0.015 mm [SE 0.018], P = 0.013, respectively). CONCLUSIONS Alogliptin treatment attenuated the progression of carotid IMT in patients with T2DM free of apparent cardiovascular disease compared with the conventional treatment.
Collapse
Affiliation(s)
- Tomoya Mita
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan Department of Metabolism and Atherosclerosis, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hidenori Yoshii
- Department of Medicine, Diabetology & Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Tomio Onuma
- Department of Medicine, Diabetology & Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Hideaki Kaneto
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | | | | | | | | | | | - Hiroki Yokoyama
- Internal Medicine, Jiyugaoka Medical Clinic, Hokkaido, Japan
| | | | | | - Masahiko Gosho
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, Tokyo, Japan Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | | |
Collapse
|
31
|
Kim CS, Kim SK, Araneta MRG, Lee EJ, Barrett-Connor E, Huh KB. Can increased visceral adiposity without body weight changes accelerate carotid atherosclerosis in South Korean participants with type 2 diabetes? J Diabetes Complications 2015; 29:1085-91. [PMID: 26231803 DOI: 10.1016/j.jdiacomp.2015.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 06/10/2015] [Accepted: 06/12/2015] [Indexed: 11/25/2022]
Abstract
AIMS Type 2 diabetes mellitus (T2DM) and visceral obesity are associated with each other and with cardiovascular diseases. We determined whether increased visceral adiposity without weight gain was associated with sex-specific accelerated carotid atherosclerosis in South Koreans with T2DM. METHODS From 2003 to 2012, we recruited 280 participants with T2DM for the Seoul Metabolic Syndrome cohort who had body weight, visceral fat thickness (VFT), and carotid intima-media thickness (CIMT) measured at intervals of 2years. According to VFT change, sex-specific quartiles of clinical characteristics and changes of CIMT were determined. Logistic regression models predicted the odds of the progression of CIMTs in each quartile. RESULTS During 2years of observation, VFTs fell by 5.2±13.5mm in men (P<0.001) and 3.4±10.5mm in women (P<0.001). Progression of CIMT was only significant for women's maximal CIMT (0.031±0.145mm, P=0.012), while significant improvements in HbA1c were found (0.9%; P<0.001 in both sexes). There were no significant differences in clinical characteristics, or in progression of CIMT in men or women according to 2-year quartiles of VFT change. CONCLUSIONS Our results do not suggest that increased visceral adiposity without body weight changes impacts the CIMT progression in South Korean men or women with T2DM.
Collapse
Affiliation(s)
- Chul Sik Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea; Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, U.S
| | - Soo-Kyung Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Maria Rosario G Araneta
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, U.S
| | - Eun Jig Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
| | - Elizabeth Barrett-Connor
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, U.S..
| | - Kab Bum Huh
- Huh's Diabetes Center and the 21st Century Diabetes and Vascular Research Institute, Seoul, Korea.
| |
Collapse
|
32
|
Zhao Y, Wong N. Should adults with type 2 diabetes be screened for atherosclerotic cardiovascular disease? F1000Res 2015; 4:F1000 Faculty Rev-1167. [PMID: 26937273 PMCID: PMC4752024 DOI: 10.12688/f1000research.6625.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2015] [Indexed: 11/24/2022] Open
Abstract
Diabetes mellitus is associated with greater risks for cardiovascular diseases (CVD). Multiple noninvasive screening tools for CVD including cardiac CT, carotid intima-media thickness test, myocardial perfusion imaging have been examined in those with diabetes, but the prognostic value of these tests vary and issues remain regarding their cost-benefit ratios, potential harms of radiation, and how they fit into screening algorithms for CVD. We discuss in this report the needs and criteria for screening tests and summarize the evidence from observational studies and clinical trials. We also explore whether there should be more sensitive screening modalities to better detect both short and long-term cardiovascular risk among asymptomatic patients with diabetes.
Collapse
Affiliation(s)
- Yanglu Zhao
- Heart Disease Prevention Program, Division of Cardiology, C240, Medical Sciences, University of California, Irvine, CA, 92697, USA
| | - Nathan Wong
- Heart Disease Prevention Program, Division of Cardiology, C240, Medical Sciences, University of California, Irvine, CA, 92697, USA
| |
Collapse
|
33
|
Yokoyama H, Araki S, Kawai K, Hirao K, Oishi M, Sugimoto K, Sone H, Maegawa H, Kashiwagi A. Pioglitazone treatment and cardiovascular event and death in subjects with type 2 diabetes without established cardiovascular disease (JDDM 36). Diabetes Res Clin Pract 2015; 109:485-92. [PMID: 26261056 DOI: 10.1016/j.diabres.2015.06.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 05/23/2015] [Accepted: 06/28/2015] [Indexed: 01/26/2023]
Abstract
AIMS The protective association of pioglitazone with cardiovascular events and death was investigated over 6-years in large-scale type 2 diabetic subjects without established cardiovascular disease in a primary care setting. METHODS A six-year observational cohort study including 2864 subjects with type 2 diabetes without established cardiovascular disease was performed. The primary endpoint was a composite of first occurrence of cardiovascular disease or death. The effect of pioglitazone use at a baseline year with a Cox proportional hazard model and the time-dependent use in each one-year examination interval with a pooled logistic regression model were analyzed. RESULTS Baseline use of pioglitazone (n=493) did not show a statistically protective effect on the primary endpoint (n=175), although it tended to reduce the risk (adjusted hazard ratio 0.67 [95% CI: 0.43-1.05]). However, pooled logistic regression analysis indicated a significant protective association of pioglitazone with the primary endpoint (0.58 [0.38 to 0.87] and cardiovascular disease (0.54 [0.33-0.88]), independent of concurrent levels of blood glucose, blood pressure, lipids, albuminuria, and renal function. In particular, this protective association was observed in those with diabetic nephropathy regardless of the daily dose of pioglitazone. Among a total of 898 subjects who took pioglitazone during the period, 43% experienced a discontinuation at least once; however, serious adverse effects were rare. CONCLUSIONS This observational study indicated a protective association of pioglitazone with cardiovascular disease and death in type 2 diabetic subjects without established vascular disease, particularly those with nephropathy.
Collapse
Affiliation(s)
- H Yokoyama
- Jiyugaoka Medical Clinic, Internal Medicine, Obihiro, Japan.
| | - S Araki
- Shiga University of Medical Science, Department of Medicine, Otsu, Shiga, Japan
| | - K Kawai
- Kawai Clinic, Tsukuba, Japan
| | - K Hirao
- HEC Science Clinic, Yokohama, Japan
| | | | | | - H Sone
- Department of Internal Medicine, Niigata University Faculty of Medicine, Japan
| | - H Maegawa
- Shiga University of Medical Science, Department of Medicine, Otsu, Shiga, Japan
| | - A Kashiwagi
- Shiga University of Medical Science, Department of Medicine, Otsu, Shiga, Japan
| |
Collapse
|
34
|
Santos IS, Alencar AP, Rundek T, Goulart AC, Barreto SM, Pereira AC, Benseñor IM, Lotufo PA. Low Impact of Traditional Risk Factors on Carotid Intima-Media Thickness: The ELSA-Brasil Cohort. Arterioscler Thromb Vasc Biol 2015; 35:2054-9. [PMID: 26183615 DOI: 10.1161/atvbaha.115.305765] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 07/07/2015] [Indexed: 01/13/2023]
Abstract
OBJECTIVE There is little information about how much traditional cardiovascular risk factors explain common carotid artery intima-media thickness (CCA-IMT) variance. We aimed to study to which extent CCA-IMT values are determined by traditional risk factors and which commonly used measurements of blood pressure, glucose metabolism, lipid profile, and adiposity contribute the most to this determination in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort baseline. APPROACH AND RESULTS We analyzed 9792 individuals with complete data and CCA-IMT measurements. We built multiple linear regression models using mean left and right CCA-IMT as the dependent variable. All models were stratified by sex. We also analyzed individuals stratified by 10-year coronary heart disease risk and, in separate, those with no traditional risk factors. Main models' R(2) varied between 0.141 and 0.373. The major part of the explained variance in CCA-IMT was because of age and race. Indicators of blood pressure, lipid profile, and adiposity that most frequently composed the best models were pulse pressure, low-density lipoprotein/high-density lipoprotein ratio, and neck circumference. The association between neck circumference and CCA-IMT persisted significant even after further adjustment for vessel sizes and body mass index. Indicators of glucose metabolism had smaller contribution. CONCLUSIONS We found that >60% of CCA-IMT were not explained by demographic and traditional cardiovascular risk factors, which highlights the need to study novel risk factors. Pulse pressure, low-density lipoprotein/high-density lipoprotein ratio, and neck circumference were the most consistent contributors.
Collapse
Affiliation(s)
- Itamar S Santos
- From the Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário (I.S.S., A.C.G., I.M.B., P.A.L.), Instituto de Matemática e Estatística (A.P.A.), and Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina (A.C.P.), Universidade de São Paulo, São Paulo, Brazil; Department of Neurology, University of Miami Miller School of Medicine, FL (T.R.); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (S.M.B.).
| | - Airlane P Alencar
- From the Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário (I.S.S., A.C.G., I.M.B., P.A.L.), Instituto de Matemática e Estatística (A.P.A.), and Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina (A.C.P.), Universidade de São Paulo, São Paulo, Brazil; Department of Neurology, University of Miami Miller School of Medicine, FL (T.R.); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (S.M.B.)
| | - Tatjana Rundek
- From the Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário (I.S.S., A.C.G., I.M.B., P.A.L.), Instituto de Matemática e Estatística (A.P.A.), and Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina (A.C.P.), Universidade de São Paulo, São Paulo, Brazil; Department of Neurology, University of Miami Miller School of Medicine, FL (T.R.); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (S.M.B.)
| | - Alessandra C Goulart
- From the Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário (I.S.S., A.C.G., I.M.B., P.A.L.), Instituto de Matemática e Estatística (A.P.A.), and Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina (A.C.P.), Universidade de São Paulo, São Paulo, Brazil; Department of Neurology, University of Miami Miller School of Medicine, FL (T.R.); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (S.M.B.)
| | - Sandhi M Barreto
- From the Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário (I.S.S., A.C.G., I.M.B., P.A.L.), Instituto de Matemática e Estatística (A.P.A.), and Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina (A.C.P.), Universidade de São Paulo, São Paulo, Brazil; Department of Neurology, University of Miami Miller School of Medicine, FL (T.R.); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (S.M.B.)
| | - Alexandre C Pereira
- From the Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário (I.S.S., A.C.G., I.M.B., P.A.L.), Instituto de Matemática e Estatística (A.P.A.), and Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina (A.C.P.), Universidade de São Paulo, São Paulo, Brazil; Department of Neurology, University of Miami Miller School of Medicine, FL (T.R.); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (S.M.B.)
| | - Isabela M Benseñor
- From the Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário (I.S.S., A.C.G., I.M.B., P.A.L.), Instituto de Matemática e Estatística (A.P.A.), and Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina (A.C.P.), Universidade de São Paulo, São Paulo, Brazil; Department of Neurology, University of Miami Miller School of Medicine, FL (T.R.); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (S.M.B.)
| | - Paulo A Lotufo
- From the Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário (I.S.S., A.C.G., I.M.B., P.A.L.), Instituto de Matemática e Estatística (A.P.A.), and Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina (A.C.P.), Universidade de São Paulo, São Paulo, Brazil; Department of Neurology, University of Miami Miller School of Medicine, FL (T.R.); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (S.M.B.)
| |
Collapse
|
35
|
Strang AC, van Wijk DF, Mutsaerts HJMM, Stroes ESG, Nederveen AJ, Rotmans JI, Rabelink TJ, Box FMA. Guideline treatment results in regression of atherosclerosis in type 2 diabetes mellitus. Diab Vasc Dis Res 2015; 12:126-32. [PMID: 25589481 DOI: 10.1177/1479164114559511] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Efficacy of guideline cardiovascular disease prevention regimens may differ between patients with or without type II diabetes mellitus. We therefore compared change in carotid artery wall dimensions in type II diabetes mellitus and non-type II diabetes mellitus patients with a history of a major cardiovascular disease event, using magnetic resonance imaging. METHODS Thirty type II diabetes mellitus patients and 29 age- and sex-matched non-diabetes mellitus patients with a history of stroke or myocardial infarction and a carotid artery stenosis (15%-70%) were included. In all patients, treatment was according to cardiovascular risk management guidelines. At baseline and follow-up, carotid artery vessel wall dimensions were measured using 1.5 T magnetic resonance imaging. RESULTS After 2 years of follow-up, total wall volume of the carotid artery in type II diabetes mellitus patients decreased by 9.6% (p = 0.016). In contrast, stabilization rather than regression of carotid artery wall dimensions was observed in non-diabetes mellitus patients over a 2-year period. Body mass index was identified as a predictor of total wall volume decrease. CONCLUSIONS Guideline treatment arrests atherogenesis in non-diabetes mellitus patients and even decreases vessel wall dimensions in type II diabetes mellitus patients. Baseline body mass index predicts cardiovascular disease prevention efficacy expressed as decrease in total wall volume. These data emphasize the importance of optimal cardiovascular-prevention, particularly in diabetes patients with a high body mass index.
Collapse
Affiliation(s)
- Aart C Strang
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Diederik F van Wijk
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Erik S G Stroes
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Aart J Nederveen
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Joris I Rotmans
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ton J Rabelink
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Frieke M A Box
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
36
|
Nakade Y, Toyama T, Furuichi K, Kitajima S, Miyajima Y, Fukamachi M, Sagara A, Shinozaki Y, Hara A, Shimizu M, Iwata Y, Oe H, Nagahara M, Horita H, Sakai Y, Kaneko S, Wada T. Impact of kidney function and urinary protein excretion on intima-media thickness in Japanese patients with type 2 diabetes. Clin Exp Nephrol 2015; 19:909-17. [PMID: 25644676 DOI: 10.1007/s10157-015-1088-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 01/18/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND Carotid echo indexes [intima-media thickness (IMT)] are commonly used surrogate markers for cardiovascular disease; however, the impacts of chronic kidney disease (CKD) on changes in IMT are unclear. We examined associations between CKD and IMT in participants with and without type 2 diabetes through longitudinal analysis. METHODS In total, 424 subjects were enrolled in this study. IMT was measured as per carotid echo indexes. Relationships between IMT and risk factors were analyzed using multiple linear regression analysis, in which we defined IMT as the dependent variable and atherosclerosis-related factors (age, sex, systolic pressure, total cholesterol, body mass index, estimated glomerular filtration rate (eGFR), uric acid, smoking index, number of antihypertensive drugs, statin use, urinary protein levels, past cardiovascular event, glycated hemoglobin, and diabetes duration) as independent variables. RESULTS The study population was composed of 70.3 % male subjects. Participants with diabetes accounted for 64.4 % of the total population. The mean follow-up duration was 2.2 ± 1.5 years. Alterations in IMT tended to be associated with systolic blood pressure (+10 mmHg) (β = -0.0084, p = 0.09) and eGFR (+10 mL/min/1.73 m(2)) (β = -0.0049, p = 0.06) in all participants. In participants without diabetes, alterations in IMT were associated with eGFR (+10 mL/min/1.73 m(2)) (β = -0.0104, p = 0.03) and tended to be associated with systolic blood pressure (+10 mmHg) (β = 0.0094, p = 0.06). No significant relationships were found in participants with diabetes. CONCLUSION Low eGFR was associated with progression of carotid thickness independent of common cardiovascular risk factors in non-diabetic participants.
Collapse
Affiliation(s)
- Yusuke Nakade
- Clinical Laboratory, Kanazawa University Hospital, Kanazawa, Japan.,Department of Laboratory Medicine, Kanazawa University Hospital, Kanazawa, Japan
| | - Tadashi Toyama
- Division of Nephrology, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Kengo Furuichi
- Division of Nephrology, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
| | - Shinji Kitajima
- Division of Nephrology, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Yoshiyasu Miyajima
- Clinical Laboratory, Kanazawa University Hospital, Kanazawa, Japan.,Department of Laboratory Medicine, Kanazawa University Hospital, Kanazawa, Japan
| | - Mihiro Fukamachi
- Clinical Laboratory, Kanazawa University Hospital, Kanazawa, Japan
| | - Akihiro Sagara
- Division of Nephrology, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Yasuyuki Shinozaki
- Division of Nephrology, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Akinori Hara
- Division of Nephrology, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Miho Shimizu
- Division of Nephrology, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Yasunori Iwata
- Division of Nephrology, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.,Department of Laboratory Medicine, Kanazawa University Hospital, Kanazawa, Japan
| | - Hiroyasu Oe
- Clinical Laboratory, Kanazawa University Hospital, Kanazawa, Japan
| | - Mikio Nagahara
- Clinical Laboratory, Kanazawa University Hospital, Kanazawa, Japan
| | - Hiroshi Horita
- Clinical Laboratory, Kanazawa University Hospital, Kanazawa, Japan
| | - Yoshio Sakai
- Clinical Laboratory, Kanazawa University Hospital, Kanazawa, Japan.,Department of Laboratory Medicine, Kanazawa University Hospital, Kanazawa, Japan
| | - Shuichi Kaneko
- Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Takashi Wada
- Clinical Laboratory, Kanazawa University Hospital, Kanazawa, Japan.,Division of Nephrology, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.,Department of Laboratory Medicine, Kanazawa University Hospital, Kanazawa, Japan
| |
Collapse
|
37
|
Kim KY, Hong JA, Hwang HW, Lee SH, Park JR, Yu SH, Kang JG, Ryu OH, Lee SJ, Hong EG, Kim DM, Yoo JM, Ihm SH, Choi MG, Yoo HJ, Kim CS. Effects of the Serum Adiponectin to Tumor Necrosis Factor-α (TNF-α) Ratio on Carotid Intima-Media Thickness in Newly Diagnosed Type 2 Diabetic Patients. J Lipid Atheroscler 2015. [DOI: 10.12997/jla.2015.4.1.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Kwang Youn Kim
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, Korea
| | - Jung Ae Hong
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, Korea
| | - Ha Won Hwang
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, Korea
| | - Sun Ho Lee
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, Korea
| | - Ju Ri Park
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, Korea
| | - Sung Hoon Yu
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, Korea
| | - Jun Goo Kang
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, Korea
| | - Ohk Hyun Ryu
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, Korea
| | - Seong Jin Lee
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, Korea
| | - Eun Gyung Hong
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, Korea
| | - Doo-Man Kim
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, Korea
| | - Jae Myung Yoo
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, Korea
| | - Sung Hee Ihm
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, Korea
| | - Moon Gi Choi
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, Korea
| | - Hyung Joon Yoo
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, Korea
| | - Chul Sik Kim
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, Hallym University, Korea
| |
Collapse
|
38
|
Mita T, Katakami N, Shiraiwa T, Yoshii H, Onuma T, Kuribayashi N, Osonoi T, Kaneto H, Kosugi K, Umayahara Y, Yamamoto T, Matsumoto K, Yokoyama H, Tsugawa M, Gosho M, Shimomura I, Watada H. Rationale, design, and baseline characteristics of a clinical trial for prevention of atherosclerosis in patients with insulin-treated type 2 diabetes mellitus using DPP-4 inhibitor: the Sitagliptin Preventive study of Intima-media thickness Evaluation (SPIKE). Diabetol Metab Syndr 2014; 6:35. [PMID: 24607023 PMCID: PMC3973974 DOI: 10.1186/1758-5996-6-35] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 02/26/2014] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, is currently used to achieve glycemic targets in patients with type 2 diabetes mellitus (T2DM). The addition of DPP-4 inhibitors to ongoing insulin therapy is expected to reduce insulin dosage, leading to a reduction in the frequency of hypoglycaemia and/or weight gain. Recent studies have demonstrated potential anti-atherosclerotic effects for DPP-4 inhibitors. The aim of the present ongoing study is to assess the effects of sitagliptin on the progression of atherosclerosis in patients with insulin-treated T2DM using carotid intima-media thickness (IMT), an established marker of cardiovascular disease. METHODS AND DESIGN The Sitagliptin Preventive study of Intima media thickness Evaluation (SPIKE) is a prospective, randomized, open-label, blinded-endpoint, multicenter, parallel-group, comparative study. Between February 2012 and September 2012, 282 participants who failed to achieve glycemic control despite insulin therapy were recruited at 12 clinics and randomly allocated to the sitagliptin group (n = 142) or the control group (n = 140). Primary outcomes are changes in maximum and mean IMT of the common carotid artery after 24-month treatment period measured by carotid arterial echography. Secondary outcomes include changes in glycemic control, parameters related to beta-cell function and diabetic nephropathy, occurrence of cardiovascular events and adverse events such as hypoglycaemia, and biochemical markers of vascular function. DISCUSSION The present study is designed to assess the effects of sitagliptin on the progression of carotid IMT. Results will be available in the near future, and the findings are expected to provide new strategy to prevent atherosclerosis in patients with insulin-treated T2DM. CLINICAL TRIAL REGISTRATION UMIN000007396.
Collapse
Affiliation(s)
- Tomoya Mita
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
- Department of Metabolism and Atherosclerosis, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Toshihiko Shiraiwa
- Shiraiwa Medical clinic, 4-10-24 Houzenji, Kashiwara, Osaka 582-0005, Japan
| | - Hidenori Yoshii
- Department of Medicine, Diabetology & Endocrinology Juntendo Tokyo Koto Geriatric Medical Center, Shinsuna 3-3-20, Koto-ku, Tokyo 136-0075, Japan
| | - Tomio Onuma
- Department of Medicine, Diabetology & Endocrinology Juntendo Tokyo Koto Geriatric Medical Center, Shinsuna 3-3-20, Koto-ku, Tokyo 136-0075, Japan
| | | | - Takeshi Osonoi
- Naka Memorial Clinic, 745-5, Nakadai, Naka City, Ibaraki 311-0113, Japan
| | - Hideaki Kaneto
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Keisuke Kosugi
- Osaka Police Hospital, 10-31 Kitayamacho, Tennoji-ku, Osaka 543-0035, Japan
| | - Yutaka Umayahara
- Osaka General Medical Center, 3-1-56 Bandai-Higashi, Sumiyoshi-ku, Osaka 558-8558, Japan
| | - Tsunehiko Yamamoto
- Kansai Rosai Hospital, 3-1-69 Inabasou, Amagasaki-shi, Hyogo 660-8511, Japan
| | - Kazunari Matsumoto
- Diabetes Center, Sasebo Chuo Hospital, 15 Yamato-cho, Sasebo, Nagasaki 857-1195, Japan
| | - Hiroki Yokoyama
- Jiyugaoka Medical Clinic, Internal Medicine, West 6, South 6-4-3, Obihiro 080-0016, Hokkaido, Japan
| | - Mamiko Tsugawa
- Ikeda Municipal Hospital, 3-1-18, Jonan, Ikeda, Osaka 563-8510, Japan
| | - Masahiko Gosho
- Unit of Biostatistics, Advanced Medical Research Center, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
| |
Collapse
|
39
|
Parildar H, Gulmez O, Cigerli O, Dogruk Unal A, Erdal R, Guvener Demirag N. Carotid Artery Intima Media Thickness and HsCRP; Predictors for Atherosclerosis in Prediabetic Patients? Pak J Med Sci 2013; 29:495-9. [PMID: 24353563 PMCID: PMC3809219 DOI: 10.12669/pjms.292.3133] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 11/10/2012] [Accepted: 02/03/2013] [Indexed: 01/30/2023] Open
Abstract
Objective: We aimed to assess carotid intima media thickness (CIMT) and serum high-sensitivity C-reactive protein (hs-CRP) levels as estimated markers of subclinical atherosclerosis and inflammation in prediabetic patients. Methodology: One hundred and ten patients were defined as prediabetic and seventy-six subjects (age and sex matched) were assigned as control group in our cross sectional study. Bilateral CIMT measurements and hs-CRP levels were evaluated. Results: The prevalance of hypertension, hyperlipidemia, angiotensin receptor blockers and antihyperlipidemic medication use were statistically higher in the prediabetic group. Serum hs-CRP levels, left, right and maximum CIMT were statistically higher among prediabetics compared to control group. There was a positive, significant correlation between left, right, maximum CIMT and fasting blood glucose, HbA1c, hs-CRP levels and BMI. Conclusion: Recognising and focusing on the intervention of prediabetic state as early as possible and identifying the susceptible patients who may benefit from more aggressive preventive therapy is an important issue of primary prevention of diabetes and cardiovascular diseases.
Collapse
Affiliation(s)
- Hulya Parildar
- Hulya Parildar, MD, Department of Family Medicine, Baskent University Istanbul Hospital, Istanbul, Turkey
| | - Oyku Gulmez
- Oyku Gulmez, MD, Department of Cardiology, Baskent University Istanbul Hospital, Istanbul, Turkey
| | - Ozlem Cigerli
- Ozlem Cigerli, MD, Department of Family Medicine, Baskent University Istanbul Hospital, Istanbul, Turkey
| | - Asli Dogruk Unal
- Asli Dogruk Unal, MD, Department of Endocrinology and Metabolism, Baskent University Istanbul Hospital, Istanbul, Turkey
| | - Rengin Erdal
- Rengin Erdal. MD, Department of Family Medicine, Baskent University, Ankara, Turkey
| | - Nilgun Guvener Demirag
- Nilgun Guvener Demirag, MD, Department of Endocrinology and Metabolism, Baskent University Istanbul Hospital, Istanbul, Turkey
| |
Collapse
|
40
|
Okayama KI, Mita T, Gosho M, Yamamoto R, Yoshida M, Kanazawa A, Kawamori R, Fujitani Y, Watada H. Carotid intima-media thickness progression predicts cardiovascular events in Japanese patients with type 2 diabetes. Diabetes Res Clin Pract 2013; 101:286-92. [PMID: 23835494 DOI: 10.1016/j.diabres.2013.06.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 05/25/2013] [Accepted: 06/10/2013] [Indexed: 11/29/2022]
Abstract
AIMS The aim of this retrospective study was to investigate the relationship between progression of carotid intima-media thickness (cIMT) and cardiovascular events in Japanese patients with type 2 diabetes mellitus (T2DM) and free of history of cardiovascular events. METHODS Patients with T2DM (n=342) without history of cardiovascular events whose cIMT was assessed more than twice by ultrasonography were recruited and followed up for cardiovascular events. RESULTS During a mean follow-up of 7.6 years, 56 (16.4%) cardiovascular events (27 coronary events and 29 cerebrovascular events) were recorded. Multivariate analysis with the Cox proportional hazard model identified cIMT progression as a significant determinant of cardiovascular events, with a hazard ratio (HR) of 2.24 (95% confidence interval; CI, 1.25-4.03, P<0.01), in addition to baseline cIMT. The Kaplan-Meier curves also showed significantly higher event rate in patients with high cIMT progression compared with those with low cIMT progression (log-rank χ(2)=6.65; P<0.01). Furthermore, the combination of high baseline cIMT and high cIMT progression was a significant predictor of cardiovascular events. CONCLUSION Our findings suggest that cIMT progression, in addition to baseline cIMT, is a predictor of cardiovascular events in patients with T2DM without history of cardiovascular events, and that the combination of cIMT progression and baseline cIMT has a strong predictive power for such events.
Collapse
Affiliation(s)
- Kaede Ishikawa Okayama
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Katakami N, Mita T, Yoshii H, Onuma T, Kaneto H, Osonoi T, Shiraiwa T, Kosugi K, Umayahara Y, Yamamoto T, Yokoyama H, Kuribayashi N, Jinnouchi H, Gosho M, Watada H, Shimomura I. Rationale, design, and baseline characteristics of a trial for the prevention of diabetic atherosclerosis using a DPP-4 inhibitor: the Study of Preventive Effects of Alogliptin on Diabetic Atherosclerosis (SPEAD-A). J Atheroscler Thromb 2013; 20:893-902. [PMID: 23965491 DOI: 10.5551/jat.18333] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Alogliptin, an efficacious inhibitor of DPP-4 that improves glycemic control, as well as the pancreatic beta-cell function, is now increasingly used to accomplish glycemic targets in type 2 diabetic patients. Interestingly, recent experimental studies have shown that alogliptin exerts anti-atherosclerotic effects in GLP-1-dependent and -independent manners. The aim of the present ongoing study is to investigate the preventive effects of alogliptin on the progression of atherosclerosis in type 2 diabetic subjects using the carotid intima-media thickness (IMT), an established marker of cardiovascular disease. METHODS AND RESULTS The Study of Preventive Effects of Alogliptin on Diabetic Atherosclerosis (SPEAD-A) is a prospective, randomized, open-label, blinded-endpoint, multicenter, parallel-group, comparative study. Between March 2011 and March 2012, 341 participants were recruited at 11 clinical sites, and were randomly allocated either to an alogliptin treatment group (172 patients) or a conventional treatment group (169 patients). The primary outcomes are the changes in the maximum and mean IMT of the common carotid artery during a 24-month treatment period, as measured by carotid arterial echography. The secondary outcomes include the changes in glycemic control, parameters related to beta-cell function and diabetic nephropathy, the occurrence of cardiovascular events and adverse events and biochemical measurements reflecting vascular function. CONCLUSIONS This is the first study to address the effects of DPP-4 inhibitors on the progression of changes in the carotid IMT, with the patients without DPP-4 inhibitor treatment serving as a control group. The results will be available soon, and these findings are expected to provide clinical data that will be helpful in the prevention of diabetic atherosclerosis and subsequent cardiovascular disease.
Collapse
Affiliation(s)
- Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Katakami N. Pathophysiology and early diagnosis of diabetic macroangiopathy. Diabetol Int 2013. [DOI: 10.1007/s13340-013-0130-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
43
|
Katakami N, Kaneto H, Shimomura I. Carotid ultrasonography: A potent tool for better clinical practice in diagnosis of atherosclerosis in diabetic patients. J Diabetes Investig 2013; 5:3-13. [PMID: 24843729 PMCID: PMC4025224 DOI: 10.1111/jdi.12106] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 04/03/2013] [Accepted: 04/08/2013] [Indexed: 12/17/2022] Open
Abstract
Cardiovascular disease (CVD) remains the main cause of death in diabetic patients, and once it has developed, diabetic patients have a worse outcome as compared with non‐diabetic patients. One reason for this is the difficulty of early diagnosis of atherosclerotic change in these patients. Although cardiovascular risk assessment based on conventional risk factors is recommended for predicting cardiovascular risk, validation studies showed only moderate performance. In contrast, it is unrealistic to screen for subclinical or silent atherosclerosis by sophisticated modalities, such as myocardial perfusion scintigraphy, coronary computed tomography angiography or conventional angiography in all diabetic patients, as these tests are limited by the potential of significant adverse effects, technical difficulty, availability and high cost. Therefore, a non‐invasive and inexpensive tool for risk prediction of subclinical atherosclerosis is required for identifying individuals at high risk of CVD. Recently, a number of studies have shown close associations between carotid atherosclerosis and cerebrovascular or coronary artery disease. Carotid ultrasonography has allowed clinicians to visualize the characteristics of the carotid wall and lumen surfaces to quantify the severity of atherosclerosis. Carotid intima‐media thickness (IMT) is an especially useful marker of the progression of atherosclerosis throughout the body, and is an excellent predictor of cardiovascular events. As a simple and non‐invasive procedure, measurement of carotid IMT is one of the most appropriate screening methods to specify high‐risk individuals in subjects with and without diabetes. Therefore, it is expected that carotid ultrasonography will become a potent tool for better clinical practice of atherosclerosis in diabetic patients.
Collapse
Affiliation(s)
- Naoto Katakami
- Departments of Metabolic Medicine Osaka University Graduate School of Medicine Suita Osaka Japan ; Departments of Metabolism and Atherosclerosis Osaka University Graduate School of Medicine Suita Osaka Japan
| | - Hideaki Kaneto
- Departments of Metabolic Medicine Osaka University Graduate School of Medicine Suita Osaka Japan
| | - Iichiro Shimomura
- Departments of Metabolic Medicine Osaka University Graduate School of Medicine Suita Osaka Japan
| |
Collapse
|
44
|
Touboul PJ, Grobbee DE, den Ruijter H. Assessment of subclinical atherosclerosis by carotid intima media thickness: technical issues. Eur J Prev Cardiol 2012; 19:18-24. [PMID: 22801066 DOI: 10.1177/2047487312448990] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Carotid intima-media thickness assessed by ultrasonography of carotid arteries is a safe, non-expensive, feasible and accurate method for detecting early signs of atherosclerosis and carotid intima-media thickness and change in carotid intima-media thickness over time reflect cardiovascular disease risk. Technical aspects impact on the measurement, variability and interpretation of carotid intima-media thickness. These include device aspects, inter- and intra-sonographer variability and the ultrasound protocol used. The mean common carotid intima-media thickness and the mean maximum common carotid intima-media thickness are the most widely used carotid intima-media thickness measurements. Common carotid intima-media thickness values of around 0.5 mm are considered 'normal' in young adults. Values are higher in men than in women, in African-Americans than Caucasians and increase with age. Carotid intima-media thickness values at or above the 75th percentile of a reference population indicate increased cardiovascular risk. Guidelines differ in their recommendations for the use of carotid intima-media thickness measurements for risk assessment in primary prevention because evidence suggesting that it improves upon conventional risk scores is inconsistent. Carotid intima-media thickness is frequently used in clinical trials as a surrogate endpoint for cardiovascular events on the assumption that regression or slowed progression of carotid intima-media thickness, induced by cardiovascular risk interventions, reflects a reduction in cardiovascular events. However, further data are required to confirm this linear relationship. No international guidelines exist on the use of carotid intima-media thickness as a research tool. Quality control in acquisition, measurement and interpretation of carotid intima-media thickness are important considerations and the carotid intima-media thickness protocol used should be determined by the research question under investigation.
Collapse
|
45
|
Bots ML, Sutton-Tyrrell K. Lessons from the past and promises for the future for carotid intima-media thickness. J Am Coll Cardiol 2012; 60:1599-604. [PMID: 22999720 DOI: 10.1016/j.jacc.2011.12.061] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 12/06/2011] [Accepted: 12/17/2011] [Indexed: 11/30/2022]
Abstract
Carotid intima-media thickness (CIMT) measurements have been used in cardiovascular research for more than 2 decades. There is a wealth of evidence showing that CIMT can be assessed in a reproducible manner and that increased CIMT relates to unfavorable risk factor levels and atherosclerosis elsewhere in the arterial system and to the risk of vascular events. Change in CIMT over time can be readily assessed, and trials showed that the rate of change is modifiable by treatment. Several issues important for the cardiovascular research community and its application in clinical practice are still outstanding. Promising future areas for CIMT measurements are: 1) application in studies among children and adolescents; 2) use of CIMT trials positioned decisively before the start of a morbidity and mortality trial; and 3) the use of CIMT measurement in risk stratification in those with an intermediate 10-year risk estimate.
Collapse
Affiliation(s)
- Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
| | | |
Collapse
|
46
|
Napoli N, Zardi E, Strollo R, Arigliani M, Daverio A, Olearo F, Tosi D, Dicuonzo G, Scarpa F, Pedone C, Tegue Simo HH, Mottini G, Pozzilli P. Increased carotid thickness in subjects with recently-diagnosed diabetes from rural Cameroon. PLoS One 2012; 7:e41316. [PMID: 22916106 PMCID: PMC3423396 DOI: 10.1371/journal.pone.0041316] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 06/20/2012] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND We have recently shown a high prevalence of diabetes and obesity in rural Cameroon, despite an improved lifestyle. Diabetes in rural Africa remains underdiagnosed and its role in increasing risk of atherosclerosis in these populations is unknown. We investigated the prevalence of carotid atherosclerosis and cardiovascular risk factors in a population of subjects with recently-diagnosed diabetes from rural Cameroon. METHODOLOGY/PRINCIPAL FINDINGS In a case-control study, carotid intima-media thickness (IMT) was measured in 74 subjects with diabetes (diagnosed <2 years), aged 47-85 and 109 controls comparable for age and sex. Subjects were recruited during a health campaign conducted in April 2009. Blood glucose control (HbA1c, fasting blood glucose) and major cardiovascular risk factors (complete lipid panel, blood pressure) were also measured. Mean carotid IMT was higher in subjects with diabetes than healthy controls at each scanned segment (common, internal carotid and bulb) (P<0.05), except the near wall of the left bulb. Vascular stiffness tended to be higher and pressure-strain elastic modulus of the left carotid was increased in subjects with diabetes than controls (P<0.05), but distensibility was similar between the two groups. At least one plaque >0.9 mm was found in 4%, 45.9% and 20% of diabetic subjects at the common, bulb or internal carotid, respectively. Only 25% of patients had an HbA1c<7%, while over 41.6% presented with marked hyperglycemia (HbA1c>9%). The prevalence of diabetic subjects with abnormal levels of LDL-cholesterol, triglycerides, HDL-cholesterol or blood pressure was 45%, 16.6%, 15% and 65.7%, respectively. CONCLUSIONS Carotid thickness is increased in subjects with diabetes from a rural area of Cameroon, despite the relatively recent diagnosis. These findings and the high rate of uncontrolled diabetes in this population support the increasing concern of diabetes and cardiovascular diseases in African countries and indicate the need for multifaceted health interventions in urban and rural settings.
Collapse
Affiliation(s)
- Nicola Napoli
- Endocrinology & Diabetes, Campus Bio-Medico University of Rome, Rome, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Zhao B, Liu Y, Zhang Y, Chen Y, Yang Z, Zhu Y, Zhan W. Gender difference in carotid intima-media thickness in type 2 diabetic patients: a 4-year follow-up study. Cardiovasc Diabetol 2012; 11:51. [PMID: 22583598 PMCID: PMC3398844 DOI: 10.1186/1475-2840-11-51] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Accepted: 05/14/2012] [Indexed: 11/15/2022] Open
Abstract
Background Different population studies have reported gender difference in carotid intima-media thickness (CIMT), which is proved to be a risk factor of cardiovascular diseases. However, few longitudinal researches examine this gender difference in type 2 diabetes mellitus (T2DM) patients. Therefore, we prospectively analyzed CIMT in T2DM patients over a 4-year follow-up period. Methods 355 T2DM patients (mean age 59 years; 54.9% women) were included in the present study. CIMT were measured using Color Doppler ultrasound. CIMT was measured at baseline (CIMT) in 2006 and at follow-up in 2010. Biochemical and clinical measurements were collected at baseline. Results Mean value of CIMT1 and CIMT2 were 0.740 ± 0.148 mm and 0.842 ± 0.179 mm, respectively. Men had higher CIMT than women both at baseline and at follow-up (CIMT1: 0.762 ± 0.149 vs 0.723 ± 0.146 mm, P = 0.0149; CIMT2: 0.880 ± 0.189 vs 0.810 ± 0.164 mm, P = 0.0002). Mean annual progression of CIMT (dCIMT) was 0.025 ± 0.022 mm/year. dCIMT was larger in men than in women (0.030 ± 0.025 vs 0.022 ± 0.019 mm, P = 0.0006). In multiple regression analyses, age was an independent risk factor of CIMT in both genders, while dCIMT was associated with age only in men. Conclusions Gender difference in CIMT was confirmed in T2DM patients. Moreover, impact of ageing on CIMT progression only existed in men, which might be the reason that gender difference in CIMT increased with age.
Collapse
Affiliation(s)
- Bo Zhao
- Department of Ultrasonography, Ruijin Hospital, Shanghai Jiaotong University Medical School, 197 Ruijin 2nd Road, Shanghai 200025, People's Republic of China
| | | | | | | | | | | | | |
Collapse
|
48
|
Algorithms to measure carotid intima-media thickness in trials: a comparison of reproducibility, rate of progression and treatment effect. J Hypertens 2012; 29:2181-93. [PMID: 21918474 DOI: 10.1097/hjh.0b013e32834b0eba] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Current ultrasound protocols to measure carotid intima-media thickness (CIMT) in trials differ considerably. The best CIMT protocol would be one that combines high reproducibility, a large and precise estimate of the rate of CIMT progression and a large and precise estimate of the treatment effect. We performed a post-hoc analysis to determine the best algorithm for determining CIMT using data from the METEOR study, a randomized double-blind, placebo-controlled study of the effect of rosuvastatin on CIMT progression in 984 low coronary heart disease risk individuals with increased CIMT. METHODS CIMT information was collected from two walls (near and far wall), three segments (common carotid, bifurcation and internal carotid artery), five different angles (for the right carotid artery - 60, 90, 120, 150, and 180 degrees on the Meijer's carotid arc; for the left - 300, 270, 240, 210, and 180 degrees) of two sides (left and right carotid artery), resulting in possibly (2 × 3 × 5 × 2 =) 60 measurements. On the basis of combinations of these measurements, we built 66 different ultrasound protocols to estimate a CIMT for each individual (22 protocols for mean common CIMT, 44 protocols for mean maximum CIMT). For each protocol we assessed reproducibility [intraclass correlation (ICC), mean difference of duplicate scans], 2-year progression rate in the placebo group with its corresponding standard error and treatment effect (difference in CIMT progression between rosuvastatin and placebo) and its corresponding standard error. RESULTS Data of duplicate ultrasound examinations at baseline and end of study were available for 688 participants (70% of 984). The ICC based on duplicate baseline examinations ranged from 0.81 to 0.95. CIMT progression rates in the placebo group ranged from 0.0046 to 0.0177 mm/year, with SE ranging from 0.00134 to 0.00337. Treatment effects ranged from 0.0141 to 0.0388 mm/year. The protocols with highest reproducibility, highest CIMT progression/precision ratio and highest treatment effect/precision ratio were those measuring both near and far wall for at least two angles. CONCLUSION Ultrasound protocols that include CIMT measurements at multiple angles of both near and far wall give the best balance between reproducibility, rate of CIMT progression, treatment effect and their associated precision in this low-risk population with subclinical atherosclerosis.
Collapse
|
49
|
Peters SA, den Ruijter HM, Bots ML. Attenuation of Rate of Change in Carotid Intima-Media Thickness by Lipid-Modifying Drugs. Am J Cardiovasc Drugs 2011; 11:253-63. [DOI: 10.2165/11591960-000000000-00000] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
50
|
Peters SAE, Grobbee DE, Bots ML. Carotid intima–media thickness: a suitable alternative for cardiovascular risk as outcome? ACTA ACUST UNITED AC 2011; 18:167-74. [PMID: 21568017 DOI: 10.1177/1741826710389400] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Surrogate markers for cardiovascular disease might be of great value in observational research, clinical trials, and clinical practice. Carotid intima-media thickness (CIMT) is probably the most commonly used marker for atherosclerotic disease as an alternative for cardiovascular morbidity and mortality. A suitable marker for atherosclerosis, however, should meet several criteria before it can be validly used. METHODS AND RESULTS We reviewed the literature following a set of criteria for a surrogate marker. These include a comparison with a 'gold standard'; adequate reproducibility; cross-sectional relations with established risk factors and prevalent disease; relations with severity of atherosclerosis elsewhere in the arterial system; relations with the occurrence with future events; ability for a biomarker to change over time; ability to be affected by interventions over time; and relations between change over time in biomarker level and change in risk. A large number of studies from a variety of populations provide evidence for the validity of CIMT as a suitable measure of atherosclerotic disease. Data on the relation between change in CIMT and change in risk, however, is much sparser. CONCLUSION CIMT progression meets the criteria of a surrogate for cardiovascular disease endpoints and may be considered as a valid alternative for cardiovascular events as outcome. Further studies should examine the association between changes in CIMT and changes in risk for future events.
Collapse
Affiliation(s)
- Sanne A E Peters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, The Netherlands.
| | | | | |
Collapse
|