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Arena R, Daugherty J, Bond S, Lavie CJ, Phillips S, Borghi-Silva A. The combination of obesity and hypertension: a highly unfavorable phenotype requiring attention. Curr Opin Cardiol 2018; 31:394-401. [PMID: 27070650 DOI: 10.1097/hco.0000000000000294] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Body habitus is a key lifestyle characteristic whose current status and future projections are disconcerting. The percentage of the global population who are either overweight or obese has substantially increased, with no indication that any country has a solution to this issue. Hypertension is a key unfavorable health metric that, like obesity, has disastrous health implications if left uncontrolled. Poor lifestyle characteristics and health metrics often cluster together to create complex and difficult to treat phenotypes. Excess body mass is such an example, creating an obesity-hypertension phenotype, which is the focus of this review. RECENT FINDINGS An increased risk for hypertension is clearly linked to obesity, indicating that the two conditions are intimately linked. The cascade of obesity-induced pathophysiologic adaptations creates a clear path to hypertension. Adopting a healthy lifestyle is a primary intervention for the prevention as well as treatment of the obesity-hypertension phenotype. SUMMARY The obesity-hypertension phenotype is highly prevalent and has disastrous health implications. A primordial prevention strategy, focused on lifelong healthy lifestyle patterns, is the optimal approach for this condition. For those individuals already afflicted by the obesity-hypertension phenotype, interventions must aggressively focus on weight loss and blood pressure control.
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Affiliation(s)
- Ross Arena
- aDepartment of Physical Therapy and the Integrative Physiology Laboratory, College of Applied Health Sciences bDepartment of Biomedical and Health Information Sciences, College of Applied Science, University of Illinois, Chicago, Illinois cDepartment of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine; New Orleans, Louisiana, USA dCardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, São Paulo, Brazil
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Hou JS, Wang CH, Lai YH, Lin YL, Kuo CH, Subeq YM, Hsu BG. Negative Correlation of Serum Adiponectin Levels With Carotid–Femoral Pulse Wave Velocity in Patients Treated With Hemodialysis. Biol Res Nurs 2018; 20:462-468. [DOI: 10.1177/1099800418768887] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Purpose: The aim of this study was to evaluate the relationship between serum adiponectin levels and carotid–femoral pulse wave velocity (cfPWV) in hemodialysis (HD) patients. Method: Blood samples were obtained from 120 HD patients. cfPWV was measured with a validated tonometry system (SphygmoCor; AtCor Medical, West Ryde, Australia). Serum adiponectin levels were measured using a commercially available enzyme-linked immunosorbent assay kit. Results: By univariate linear analysis of cfPWV in HD patients, we found that diabetes ( r = .281, p = .002), pre-HD body weight ( r = .194, p = .033), post-HD body weight ( r = .192, p = .036), waist circumference ( r =.210, p = .022), and body fat mass ( r = .194, p = .034) were positively correlated, whereas adiponectin level ( r = −.254, p = .005) was negatively correlated with cfPWV in HD patients. Multivariate forward stepwise linear regression analysis showed that diabetes (β = .274, p = .006) and adiponectin level (β = −.215, p = .016) were independent predictors of cfPWV in HD patients. Moreover, post-HD body weight (β = −.274, p = .041), waist circumference (β = −.311, p < .001), logarithmically transformed triglyceride level (log-TG; β = −.186, p = .031), and log-glucose (β = −.225, p = .008) were negatively associated with adiponectin levels in HD patients after multivariable forward stepwise linear regression analysis. Conclusions: Among HD patients, serum adiponectin level was inversely associated with cfPWV level, and post-HD body weight, waist circumference, log-TG, and log-glucose were negatively associated with adiponectin level.
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Affiliation(s)
- Jia-Sian Hou
- Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| | - Chih-Hsien Wang
- Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Yu-Hsien Lai
- Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Yu-Li Lin
- Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Chiu-Huang Kuo
- Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Yi-Maun Subeq
- Department of Nursing, National Taichung University of Science and Technology, Taipei, Taiwan
| | - Bang-Gee Hsu
- Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
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Bäckdahl J, Andersson DP, Eriksson-Hogling D, Caidahl K, Thorell A, Mileti E, Daub CO, Arner P, Rydén M. Long-Term Improvement in Aortic Pulse Wave Velocity After Weight Loss Can Be Predicted by White Adipose Tissue Factors. Am J Hypertens 2018; 31:450-457. [PMID: 29177471 DOI: 10.1093/ajh/hpx201] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 11/20/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Arterial stiffness, measured by pulse wave velocity (PWV), is linked to obesity, cardiovascular disease, and all-cause mortality. Short-term weight loss improves PWV, but the long-term effects are unknown. We investigated the effect of pronounced long-term weight loss on PWV and whether anthropometric/metabolic parameters and/or white adipose tissue (WAT) phenotype could predict this change in PWV. METHODS Eighty-two obese subjects were examined before and 2 years after Roux-en-Y gastric bypass. Analyses included anthropometrics, routine clinical chemistry, and hyperinsulinemic-euglycemic clamp. Arterial stiffness was measured as aortic PWV (aPWV) using the Arteriograph device. WAT mass and distribution were assessed by dual-X-ray absorptiometry. Baseline visceral and subcutaneous WAT samples were obtained to measure adipocyte cell size. Transcriptomic profiling of subcutaneous WAT was performed in a subset of subjects (n = 30). RESULTS At the 2-year follow-up, there were significant decreases in body mass index (39.4 ± 3.5 kg/m2 vs. 26.6 ± 3.4 kg/m2; P < 0.0001) and aPWV (7.8 ± 1.5 m/s vs. 7.2 ± 1.4 m/s; P = 0.006). Multiple regression analyses showed that baseline subcutaneous adipocyte volume was associated with a reduction in aPWV (P = 0.014), after adjusting for confounders. Expression analyses of 52 genes implicated in arterial stiffness showed that only one, COL4A1, independently predicted improvements in aPWV after adjusting for confounders (P = 0.006). CONCLUSIONS Bariatric surgery leads to long-term reduction in aPWV. This improvement can be independently predicted by subcutaneous adipocyte volume and WAT COL4A1 expression, which suggests that subcutaneous WAT has a role in regulating aPWV. CLINICAL TRIALS REGISTRATION Trial Number NCT01727245 (clinicaltrials.gov).
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Affiliation(s)
- Jesper Bäckdahl
- Department of Medicine (H7), Karolinska Institutet, C2-94, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Daniel P Andersson
- Department of Medicine (H7), Karolinska Institutet, C2-94, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Daniel Eriksson-Hogling
- Department of Medicine (H7), Karolinska Institutet, C2-94, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Kenneth Caidahl
- Department of Molecular Medicine and Surgery, Karolinska Institutet, C8:27, Karolinska University Hospital, Solna, Stockholm, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anders Thorell
- Department of Clinical Science, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden
- Department of Surgery, Ersta Hospital, Stockholm, Sweden
| | - Enrichetta Mileti
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Carsten O Daub
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Peter Arner
- Department of Medicine (H7), Karolinska Institutet, C2-94, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Mikael Rydén
- Department of Medicine (H7), Karolinska Institutet, C2-94, Karolinska University Hospital, Huddinge, Stockholm, Sweden
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Nicoll R, Henein MY. Caloric Restriction and Its Effect on Blood Pressure, Heart Rate Variability and Arterial Stiffness and Dilatation: A Review of the Evidence. Int J Mol Sci 2018; 19:E751. [PMID: 29518898 PMCID: PMC5877612 DOI: 10.3390/ijms19030751] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 02/27/2018] [Accepted: 03/02/2018] [Indexed: 02/07/2023] Open
Abstract
Essential hypertension, fast heart rate, low heart rate variability, sympathetic nervous system dominance over parasympathetic, arterial stiffness, endothelial dysfunction and poor flow-mediated arterial dilatation are all associated with cardiovascular mortality and morbidity. This review of randomised controlled trials and other studies demonstrates that caloric restriction (CR) is capable of significantly improving all these parameters, normalising blood pressure (BP) and allowing patients to discontinue antihypertensive medication, while never becoming hypotensive. CR appears to be effective regardless of age, gender, ethnicity, weight, body mass index (BMI) or a diagnosis of metabolic syndrome or type 2 diabetes, but the greatest benefit is usually observed in the sickest subjects and BP may continue to improve during the refeeding period. Exercise enhances the effects of CR only in hypertensive subjects. There is as yet no consensus on the mechanism of effect of CR and it may be multifactorial. Several studies have suggested that improvement in BP is related to improvement in insulin sensitivity, as well as increased nitric oxide production through improved endothelial function. In addition, CR is known to induce SIRT1, a nutrient sensor, which is linked to a number of beneficial effects in the body.
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Affiliation(s)
- Rachel Nicoll
- Department of Public Health and Clinical Medicine and Heart Centre, Umea University, 901 87 Umea, Sweden.
| | - Michael Y Henein
- Department of Public Health and Clinical Medicine and Heart Centre, Umea University, 901 87 Umea, Sweden.
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Bäckdahl J, Rydén M. Bariatric surgery helps to reduce blood pressure - insights from GATEWAY trial. Cardiovasc Res 2018; 114:e19-e21. [PMID: 29481648 DOI: 10.1093/cvr/cvy008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Jesper Bäckdahl
- Department of Medicine (H7), C2-94, Karolinska Institutet, Karolinska University Hospital, Huddinge, 141 86 Stockholm, Sweden
| | - Mikael Rydén
- Department of Medicine (H7), C2-94, Karolinska Institutet, Karolinska University Hospital, Huddinge, 141 86 Stockholm, Sweden
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Affiliation(s)
- Paul Welsh
- From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom
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Son WM, Kim DY, Kim YS, Ha MS. Effect of Obesity on Blood Pressure and Arterial Stiffness in Middle-Aged Korean Women. Osong Public Health Res Perspect 2017; 8:369-372. [PMID: 29354393 PMCID: PMC5749481 DOI: 10.24171/j.phrp.2017.8.6.02] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 11/02/2017] [Accepted: 11/05/2017] [Indexed: 12/12/2022] Open
Abstract
Objectives Our study aims to provide basic scientific data on the importance of obesity management in middle-aged Korean women by analyzing its effects on blood pressure and arterial stiffness. In addition, we examined the correlations of these two parameters. Methods The study participants were 40 middle-aged female volunteers, who were classified into obesity group (n = 20) and normal weight group (n = 20). Statistical analysis was performed using independent t-test and the Pearson correlation coefficient was used to correlate blood pressure and arterial stiffness. Results This study evaluated the systolic blood pressure, diastolic blood pressure, and pulse wave velocity (PWV). These results were higher in the obesity group than the normal weight group. Furthermore, blood pressure and arterial stiffness (PWV, augmentation pressure) were static correlated. Conclusion Obesity is closely related to blood pressure and arterial stiffness. Therefore, indices for blood pressure and arterial stiffness may play a vital role in predicting and preventing obesity and its sequelae.
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Affiliation(s)
- Won-Mok Son
- Department of Physical Education, Pusan National University, Busan, Korea
| | - Do-Yeon Kim
- Department of Physical Education, Pusan National University, Busan, Korea
| | - You-Sin Kim
- Department of Leisure Sports, Jung-Won University, Chungbuk, Korea
| | - Min-Seong Ha
- Department of Physical Education, Pusan National University, Busan, Korea
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Aortic propagation velocity does not correlate with classical aortic stiffness parameters in healthy individuals. Anatol J Cardiol 2017; 18:340-346. [PMID: 29083326 PMCID: PMC5731283 DOI: 10.14744/anatoljcardiol.2017.7306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective: Aortic stiffness is an important cardiovascular risk marker, which can be determined using different noninvasive techniques. Aortic propagation velocity (APV) has recently been established as a novel echocardiographic parameter of aortic stiffness. This study aimed to investigate the association between APV and the classical echocardiography-derived aortic stiffness parameters, aortic distensibility (AD) and aortic strain (AS), in a group of otherwise healthy individuals. Methods: In total, 97 consecutive healthy subjects were recruited in this observational study. APV was measured using color M-mode echocardiography from the suprasternal window in the descending aorta. AS and AD were calculated using clinical blood pressure and the M-mode echocardiography-derived aortic diameters. Correlation analyses were performed between cardiovascular risk factors related to increased aortic stiffness (age, obesity, and blood pressure) and measured stiffness parameters (APV, AS, and AD). Correlation analyses were also performed among the measured stiffness parameters. Results: Good correlation of age, blood pressure, and BMI with AS and AD was observed. One-on-one correlation of age, blood pressure, and BMI with APV was not observed. No correlation was observed between APV and AS (r=–0.05, p=0.6) or between APV and AD (r=–0.17, p=0.8). Conclusion: Although APV has been proposed as a novel and practical echocardiographic parameter of aortic stiffness, especially in patients with coronary artery disease, correlations between classical stiffness parameters (AS and AD) and APV were absent in healthy individuals at low–intermediate risk. The clinical and research applicability of APV should be further evaluated.
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Childhood body mass index and blood pressure in prediction of subclinical vascular damage in adulthood: Beijing blood pressure cohort. J Hypertens 2017; 35:47-54. [PMID: 27648721 DOI: 10.1097/hjh.0000000000001118] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Atherosclerosis and arterial stiffness predict cardiovascular morbidity and mortality. We aimed to investigate the influence of BMI and blood pressure (BP) in childhood, and change in BMI and BP, on the development of subclinical atherosclerosis and arterial stiffness in adulthood. METHODS The study consisted of 1252 individuals aged 27-42 years who had 2-10 measurements of BMI and BP from childhood. In the final survey (2010-2011), subclinical markers of vascular damage, including carotid intima-media thickness (cIMT), carotid-femoral pulse wave velocity (cfPWV), and brachial-ankle pulse wave velocity (baPWV), were measured. RESULTS Pearson correlation analyses showed that BMI and BP in childhood and adulthood, and also cumulative and incremental values from childhood to adulthood, were all significantly associated with adult cIMT, cfPWV, and baPWV in males and in females (all P < 0.05). In the multivariate logistical analyses, for both sexes, childhood BMI and systolic BP (SBP) predicted high cIMT in adulthood, and childhood SBP predicted high cfPWV and high baPWV in adulthood. However, these associations were largely attenuated and became nonsignificant after additional adjustment for adult BMI and SBP, except that childhood SBP showed a borderline significant association with high cfPWV in adulthood for males. In addition, for both sexes, incremental BMI and SBP from childhood to adulthood predicted high cIMT in adulthood, and incremental SBP predicted high cfPWV and high baPWV in adulthood, independent of childhood values. CONCLUSION The adverse influence of high BMI and high BP on subclinical vascular damage begins in childhood. This study enhances the importance of early prevention and lifelong treatment of excessive weight and elevated BP.
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The relationship between obesity and hypertension: an updated comprehensive overview on vicious twins. Hypertens Res 2017; 40:947-963. [DOI: 10.1038/hr.2017.75] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/07/2017] [Accepted: 04/14/2017] [Indexed: 02/07/2023]
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Gomez-Sanchez L, Garcia-Ortiz L, Patino-Alonso MC, Recio-Rodriguez JI, Rigo F, Martí R, Agudo-Conde C, Rodriguez-Sanchez E, Maderuelo-Fernandez JA, Ramos R, Gomez-Marcos MA. Adiposity measures and arterial stiffness in primary care: the MARK prospective observational study. BMJ Open 2017; 7:e016422. [PMID: 28963288 PMCID: PMC5623460 DOI: 10.1136/bmjopen-2017-016422] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The cardiovascular risk of obesity is potentially increased by arterial stiffness. OBJECTIVE To assess the relationship of adiposity measures with arterial stiffness in Caucasian adults with intermediate cardiovascular risk. SETTING Six Spanish health centres. PARTICIPANTS We enrolled 2354 adults (age range, 35-74 years; mean age, 61.4±7.7 years, 61.9% male). METHODS This is a cross-sectional study that analyses data from the baseline visit of the improving interMediAte RisK management (MARK) study. The main outcome variables were body mass index (BMI), waist-to-height ratio (WHtR), Clínica Universidad de Navarra-body adiposity estimation (CUN-BAE) body fat percentage and body roundness index (BRI). Vascular function was assessed by the cardio-ankle vascular index (CAVI) with the VaSera device; brachial-ankle pulse wave velocity (baPWV) was determined using a validated equation. RESULTS The mean adiposity measures were a BMI of 29.2±4.4, WHtR of 0.61±0.07, CUN-BAE of 35.7±1.7 and BRI of 5.8±1.7. The mean stiffness measures were a CAVI of 8.8±1.2 and baPWV of 14.9±2.5. In multiple linear regression analyses, all adiposity measures were negatively associated with CAVI and baPWV (p<0.01 for all) after adjustment for possible factors of confusion. The proportion of CAVI variability via the adiposity measures were 5.5% for BMI, 5.8% for CUN-BAE, 3.8% for WHtR and 3.7% for BRI. These were higher among diabetic, obese, younger (≤62 years) and non-hypertensive subjects who had similar activity and sedentary profiles. CONCLUSIONS Adiposity measures are negatively associated with arterial stiffness measures. The percentage of variation in CAVI explained by its relation to the different measures of adiposity ranges from 5.8% (CUN-BAE) to 3.7% (BRI). In the case of baPWV, it oscillates between 0.7% (CUN-BAE and BMI) and 0.1% (WHtR). TRIAL REGISTRATION NUMBER NCT01428934.
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Affiliation(s)
- Leticia Gomez-Sanchez
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Luis Garcia-Ortiz
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Maria C Patino-Alonso
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Department of Statistics, University of Salamanca, Salamanca, Spain
| | - Jose I Recio-Rodriguez
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - Fernando Rigo
- San Agustín Health Center, Illes Balears Health Service (IBSALUT), Palma of Mallorca, Spain
| | - Ruth Martí
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Girona, Spain
- Institut d'Investigació Biomèdica of Girona Dr. Josep Trueta (IDBGI), Girona, Spain
| | - Cristina Agudo-Conde
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Emiliano Rodriguez-Sanchez
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Jose A Maderuelo-Fernandez
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Rafel Ramos
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Girona, Spain
- Institut d'Investigació Biomèdica of Girona Dr. Josep Trueta (IDBGI), Girona, Spain
- Departament of Ciències Mèdiques, Universitat de Girona, Girona, Spain
| | - Manuel A Gomez-Marcos
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
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Hudson L, Kinra S, Wong I, Cole TJ, Deanfield J, Viner R. Is arterial stiffening associated with adiposity, severity of obesity and other contemporary cardiometabolic markers in a community sample of adolescents with obesity in the UK? BMJ Paediatr Open 2017; 1:e000061. [PMID: 29637110 PMCID: PMC5862218 DOI: 10.1136/bmjpo-2017-000061] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/27/2017] [Accepted: 06/29/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) prediction is problematic within groups of obese adolescents as measures such as adiposity and metabolic markers lack validation. Pulse wave velocity (PWV), a proxy for arterial stiffening, is a potential way to contemporaneously capture adolescents at greater risk of CVD. OBJECTIVES To investigate associations between PWV and 1) adiposity and 2) other conventional metabolic factors in a community sample of (>95th centile body mass index (BMI)). DESIGN AND SETTING Cross-sectional measurement and analysis in a hospital-based research centre drawn from a community sample of adolescents recruited to an obesity intervention at baseline. PATIENTS 174 adolescents (12-19 years) with obesity (>95th centile BMI). 37% were male, while 66 (38%) were white, 53 (30%) black, 36 (21%) South Asian, 19 (11%) mixed/other. Participants with endocrine, genetic causes of obesity and chronic medical conditions (excluding asthma) were excluded. MEASURES BMI z-score (zBMI), waist z-score, fat mass index (FMI: measured using bioimpedance), sagittal abdominal dimension (SAD), cardiometabolic blood tests and resting blood pressure (BP) were collected. Carotid-radial PWV was measured by a single operator. RESULTS PWV was associated with age but not pubertal stage. PWV was positively associated with adiposity (zBMI: coefficient 0.44 (95% CI 0.08 to 0.79); FMI: coefficient 0.05 (95% CI 0.00 to 0.10); waist z-score: coefficient 0.27 (95% CI 0.00 to 0.53); SAD: coefficient 0.06 (95% CI: 0.00 to 0.12)). There was no association between PWV and BP, and few associations with cardiometabolic bloods. Associations between PWV and adiposity measures were robust to adjustment in multivariable models except for SAD. Participants with zBMI >2.5 SD and >3.5 SD had greater average PWV but overlap between groups was large. CONCLUSIONS In our sample, increasing adiposity was positively associated with arterial stiffness, however partitioning by severity was not reliable. Lack of associations between BP, cardiometabolic bloods and arterial stiffness questions the reliability of these factors for predicting CVD risk in adolescents with obesity.
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Affiliation(s)
- Lee Hudson
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Sanjay Kinra
- London School of Hygiene and Tropical Medicine, London, UK
| | - Ian Wong
- UCL School of Pharmacy, London, UK
| | - Tim J Cole
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - John Deanfield
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Russell Viner
- UCL Great Ormond Street Institute of Child Health, London, UK
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63
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Martini D, Rossi S, Biasini B, Zavaroni I, Bedogni G, Musci M, Pruneti C, Passeri G, Ventura M, Di Nuzzo S, Galli D, Mirandola P, Vitale M, Dei Cas A, Bonadonna RC, Del Rio D. Claimed effects, outcome variables and methods of measurement for health claims proposed under European Community Regulation 1924/2006 in the framework of protection against oxidative damage and cardiovascular health. Nutr Metab Cardiovasc Dis 2017; 27:473-503. [PMID: 28434807 DOI: 10.1016/j.numecd.2017.01.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIMS The high number of negative opinions from the European Food Safety Authority (EFSA) to the requests for authorization of health claims is largely due to the design of human intervention studies, including the inappropriate choice of outcome variables (OVs) and of their methods of measurement (MMs). The present manuscript reports the results of an investigation aimed to collect, collate and critically analyse the information in relation to claimed effects, OVs and MMs, in the context of protection against oxidative damage and cardiovascular health compliant with Regulation 1924/2006. METHODS AND RESULTS Claimed effects, OVs and the related MMs were collected from EFSA Guidance documents and applications for authorization of health claims under Articles 13.5 and 14. The OVs and their MMs were evaluated only if the claimed effect was sufficiently defined and was considered beneficial by EFSA. The collection, collation and critical analysis of the relevant scientific literature consisted in the definition of the keywords, the PubMed search strategies and the creation of databases of references. The critical analysis of the OVs and their MMs was performed on the basis of the literature review and was aimed at defining the appropriateness of OVs and MMs in the context of the specific claimed effects. CONCLUSIONS The information provided in this document could serve to EFSA for the development of further guidance on the scientific requirements for health claims, as well as to the stakeholders for the proper design of human intervention studies aimed to substantiate such health claims.
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Affiliation(s)
- D Martini
- The Laboratory of Phytochemicals in Physiology, Department of Food and Drug, University of Parma, Parma, Italy
| | - S Rossi
- The Laboratory of Phytochemicals in Physiology, Department of Food and Drug, University of Parma, Parma, Italy
| | - B Biasini
- The Laboratory of Phytochemicals in Physiology, Department of Food and Drug, University of Parma, Parma, Italy
| | - I Zavaroni
- Department of Medicine and Surgery, Division of Endocrinology, University of Parma, Italy; Azienda Ospedaliera Universitaria of Parma, Parma, Italy
| | - G Bedogni
- Clinical Epidemiology Unit, Liver Research Center, Basovizza, Trieste, Italy
| | - M Musci
- Department of Food and Drug, University of Parma, Parma, Italy
| | - C Pruneti
- Department of Medicine and Surgery, Clinical Psychology Unit, University of Parma, Medical School Building, Parma, Italy
| | - G Passeri
- Department of Medicine and Surgery, Building Clinica Medica Generale, University of Parma, Parma, Italy
| | - M Ventura
- Department of Chemistry, Life Sciences and Environmental Sustainability, Laboratory of Probiogenomics, University of Parma, Parma, Italy
| | - S Di Nuzzo
- Department of Medicine and Surgery, Section of Dermatology, University of Parma, Parma, Italy
| | - D Galli
- Department of Medicine and Surgery, Sport and Exercise Medicine Centre (SEM), University of Parma, Parma, Italy
| | - P Mirandola
- Department of Medicine and Surgery, Sport and Exercise Medicine Centre (SEM), University of Parma, Parma, Italy
| | - M Vitale
- Department of Medicine and Surgery, Sport and Exercise Medicine Centre (SEM), University of Parma, Parma, Italy
| | - A Dei Cas
- Department of Medicine and Surgery, Division of Endocrinology, University of Parma, Italy; Azienda Ospedaliera Universitaria of Parma, Parma, Italy
| | - R C Bonadonna
- Department of Medicine and Surgery, Division of Endocrinology, University of Parma, Italy; Azienda Ospedaliera Universitaria of Parma, Parma, Italy
| | - D Del Rio
- The Laboratory of Phytochemicals in Physiology, Department of Food and Drug, University of Parma, Parma, Italy.
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64
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The systolic–diastolic difference in carotid stiffness is increased in type 2 diabetes. J Hypertens 2017; 35:1052-1060. [DOI: 10.1097/hjh.0000000000001298] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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65
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Espeland MA, Luchsinger JA, Baker LD, Neiberg R, Kahn SE, Arnold SE, Wing RR, Blackburn GL, Bray G, Evans M, Hazuda HP, Jeffery RW, Wilson VM, Clark JM, Coday M, Demos-McDermott K, Foreyt JP, Greenway F, Hill JO, Horton ES, Jakicic JM, Johnson KC, Knowler WC, Lewis CE, Nathan DM, Peters A, Pi-Sunyer X, Pownall H, Wadden TA, Rapp SR. Effect of a long-term intensive lifestyle intervention on prevalence of cognitive impairment. Neurology 2017; 88:2026-2035. [PMID: 28446656 DOI: 10.1212/wnl.0000000000003955] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 02/21/2017] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To assess whether an average of 10 years of lifestyle intervention designed to reduce weight and increase physical activity lowers the prevalence of cognitive impairment among adults at increased risk due to type 2 diabetes and obesity or overweight. METHODS Central adjudication of mild cognitive impairment and probable dementia was based on standardized cognitive test battery scores administered to 3,802 individuals who had been randomly assigned, with equal probability, to either the lifestyle intervention or the diabetes support and education control. When scores fell below a prespecified threshold, functional information was obtained through proxy interview. RESULTS Compared with control, the intensive lifestyle intervention induced and maintained marked differences in weight loss and self-reported physical activity throughout follow-up. At an average (range) of 11.4 (9.5-13.5) years after enrollment, when participants' mean age was 69.6 (54.9-87.2) years, the prevalence of mild cognitive impairment and probable dementia was 6.4% and 1.8%, respectively, in the intervention group, compared with 6.6% and 1.8%, respectively, in the control group (p = 0.93). The lack of an intervention effect on the prevalence of cognitive impairment was consistent among individuals grouped by cardiovascular disease history, diabetes duration, sex, and APOE ε4 allele status (all p ≥ 0.50). However, there was evidence (p = 0.03) that the intervention effect ranged from benefit to harm across participants ordered from lowest to highest baseline BMI. CONCLUSIONS Ten years of behavioral weight loss intervention did not result in an overall difference in the prevalence of cognitive impairment among overweight or obese adults with type 2 diabetes. CLINICALTRIALSGOV IDENTIFIER NCT00017953 (Action for Health in Diabetes). LEVEL OF EVIDENCE This study provides Class II evidence that for overweight adults with type 2 diabetes, a lifestyle intervention designed to reduce weight and increase physical activity does not lower the risk of cognitive impairment.
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Affiliation(s)
| | | | - Laura D Baker
- Author affiliations are provided at the end of the article
| | | | - Steven E Kahn
- Author affiliations are provided at the end of the article
| | | | - Rena R Wing
- Author affiliations are provided at the end of the article
| | | | - George Bray
- Author affiliations are provided at the end of the article
| | - Mary Evans
- Author affiliations are provided at the end of the article
| | - Helen P Hazuda
- Author affiliations are provided at the end of the article
| | | | | | - Jeanne M Clark
- Author affiliations are provided at the end of the article
| | - Mace Coday
- Author affiliations are provided at the end of the article
| | | | - John P Foreyt
- Author affiliations are provided at the end of the article
| | - Frank Greenway
- Author affiliations are provided at the end of the article
| | - James O Hill
- Author affiliations are provided at the end of the article
| | | | - John M Jakicic
- Author affiliations are provided at the end of the article
| | | | | | - Cora E Lewis
- Author affiliations are provided at the end of the article
| | - David M Nathan
- Author affiliations are provided at the end of the article
| | - Anne Peters
- Author affiliations are provided at the end of the article
| | | | - Henry Pownall
- Author affiliations are provided at the end of the article
| | | | - Stephen R Rapp
- Author affiliations are provided at the end of the article
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66
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Abstract
Aortic stiffness (AS) is an important predictor of cardiovascular morbidity in humans. The present review discusses the possible pathophysiological mechanisms of AS and focuses on a survey of different therapeutic modalities for decreasing AS. The influence of several nonpharmacological interventions is described: decrease body weight, diet, aerobic exercise training, music, and continuous positive airway pressure therapy. The effects of different pharmacological drug classes on AS are also discussed: antihypertensive drugs-renin-angiotensin-aldosterone system drugs, beta-blockers, alpha-blockers, diuretics, and calcium channel blockers (CCBs)-advanced glycation end product cross-link breakers, statins, oral anti-diabetics, anti-inflammatory drugs, vitamin D, antioxidant vitamins, and endothelin-1 receptor antagonists. All of these have shown some effect in decreasing AS.
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67
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Skilton MR, Yeo SQ, Ne JYA, Celermajer DS, Caterson ID, Lee CMY. Weight loss and carotid intima-media thickness-a meta-analysis. Obesity (Silver Spring) 2017; 25:357-362. [PMID: 28026904 DOI: 10.1002/oby.21732] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 10/19/2016] [Accepted: 11/08/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Obesity is a risk factor for clinical cardiovascular disease, putatively via increased burden of atherosclerosis. It remains contentious as to whether weight loss in people with obesity is accompanied by a reduction in intima-media thickness, a noninvasive marker of subclinical atherosclerosis, consistent with a lowering of risk of cardiovascular events. METHODS A systematic literature search was performed to identify all surgical and nonsurgical weight loss interventions that reported intima-media thickness. A meta-analysis was undertaken to obtain pooled estimates for change in intima-media thickness. RESULTS From the 3,197 articles screened, 9 studies were included in the meta-analysis, with a total of 393 participants who lost an average of 16 kg (95% CI 9.4-22.5) of body weight over an average follow-up of 20 months. The pooled mean change in carotid intima-media thickness was -0.03 mm (95% CI -0.05 to -0.01), which was similar between surgical and nonsurgical interventions. CONCLUSIONS In people with obesity, weight loss was associated with a reduction in carotid intima-media thickness, consistent with a lowering in risk of cardiovascular events.
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Affiliation(s)
- Michael R Skilton
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Si Qin Yeo
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Jia Yi Anna Ne
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - David S Celermajer
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Ian D Caterson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Crystal Man Ying Lee
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
- School of Public Health, Curtin University, Perth, Western Australia, Australia
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68
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Abstract
The aorta is a blood vessel that provides a low-resistance path for blood flow directed from the heart to peripheral organs and tissues. However, the aorta has another central hemodynamic function, whereby the elastic nature of the aortic wall provides a significant biomechanical buffering capacity complementing the pulsatile cardiac blood flow, and this is often referred to as Windkessel function. Stiffening of the arterial wall leads to fundamental alterations in central hemodynamics, with widespread detrimental implications for organ function. In this Recent Highlights article, we describe recent contributions in ATVB that have highlighted the novel mechanisms and consequences of arterial stiffness and the clinical conditions in which arterial stiffness occurs, with a focus on advancements in the field.
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Affiliation(s)
- Alicia N. Lyle
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA, United States of America
| | - Uwe Raaz
- Molecular and Translational Vascular Medicine, Department of Cardiology and Pneumology, Heart Center at the University Medical Center Göttingen, Göttingen, Germany
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69
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Joris PJ, Plat J, Kusters YH, Houben AJ, Stehouwer CDA, Schalkwijk CG, Mensink RP. Diet-induced weight loss improves not only cardiometabolic risk markers but also markers of vascular function: a randomized controlled trial in abdominally obese men. Am J Clin Nutr 2017; 105:23-31. [PMID: 27881395 DOI: 10.3945/ajcn.116.143552] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 10/19/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Many trials assessing effects of dietary weight loss on vascular function have been performed without no-weight loss control groups and in individuals with obesity-related morbidities. Usually a limited set of vascular function markers has been investigated. OBJECTIVE The objective of this study was to examine effects of diet-induced weight loss on various vascular function markers and differences between normal-weight and abdominally obese men at baseline and after weight reduction. DESIGN Twenty-five healthy, normal-weight men (waist circumference: <94 cm) and 54 abdominally obese men (waist circumference: 102-110 cm) participated. Abdominally obese participants were randomly allocated to a dietary weight-loss or a no-weight loss control group. Individuals from the weight-loss group followed a calorie-restricted diet for 6 wk to obtain a waist circumference <102 cm followed by a weight-maintenance period of 2 wk. The control group maintained their habitual diet and physical activity levels. The primary outcome was the change in brachial artery flow-mediated vasodilation (FMD). RESULTS Compared with the control group, FMD did not change in the weight-loss group, but carotid-to-femoral pulse wave velocity tended to decrease by 0.5 m/s (P = 0.065). The retinal arteriolar caliber increased by 5 μm (P < 0.001) and the arteriolar-to-venular ratio by 0.02 (P < 0.01). Soluble endothelial selectin and soluble intercellular adhesion molecule concentrations decreased (P < 0.001). Also, total cholesterol, low-density lipoprotein cholesterol, triacylglycerol, glucose, insulin, C-peptide, homeostasis model assessment of insulin resistance, and blood pressure improved (P < 0.05 for all variables). Except for FMD, these markers differed at baseline between normal-weight and abdominally obese men but became comparable after weight loss. CONCLUSIONS In abdominally obese men, dietary weight loss targeting a waist circumference of <102 cm improved retinal microvascular caliber, plasma biomarkers of microvascular endothelial function, and the more conventional cardiometabolic risk markers. Aortic stiffness tended to decrease, but FMD was not changed. This trial was registered at clinicaltrials.gov as NCT01675401.
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Affiliation(s)
- Peter J Joris
- Departments of Human Biology, NUTRIM (School of Nutrition and Translational Research in Metabolism) and .,Top Institute of Food and Nutrition, Wageningen, Netherlands
| | - Jogchum Plat
- Departments of Human Biology, NUTRIM (School of Nutrition and Translational Research in Metabolism) and
| | - Yvo Ham Kusters
- Internal Medicine, CARIM (School for Cardiovascular Diseases), Maastricht University Medical Center, Maastricht, Netherlands; and.,Top Institute of Food and Nutrition, Wageningen, Netherlands
| | - Alfons Jhm Houben
- Internal Medicine, CARIM (School for Cardiovascular Diseases), Maastricht University Medical Center, Maastricht, Netherlands; and
| | - Coen DA Stehouwer
- Internal Medicine, CARIM (School for Cardiovascular Diseases), Maastricht University Medical Center, Maastricht, Netherlands; and
| | - Casper G Schalkwijk
- Internal Medicine, CARIM (School for Cardiovascular Diseases), Maastricht University Medical Center, Maastricht, Netherlands; and
| | - Ronald P Mensink
- Departments of Human Biology, NUTRIM (School of Nutrition and Translational Research in Metabolism) and.,Top Institute of Food and Nutrition, Wageningen, Netherlands
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Cardoso CRL, Salles GF. Aortic Stiffness as a Surrogate Endpoint to Micro- and Macrovascular Complications in Patients with Type 2 Diabetes. Int J Mol Sci 2016; 17:E2044. [PMID: 27929441 PMCID: PMC5187844 DOI: 10.3390/ijms17122044] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 11/27/2016] [Accepted: 11/29/2016] [Indexed: 12/22/2022] Open
Abstract
Increased aortic stiffness has been recognized as a predictor of adverse cardiovascular outcomes in some clinical conditions, such as in patients with arterial hypertension and end-stage renal disease, in population-based samples and, more recently, in type 2 diabetic patients. Patients with type 2 diabetes have higher aortic stiffness than non-diabetic individuals, and increased aortic stiffness has been correlated to the presence of micro- and macrovascular chronic diabetic complications. We aimed to review the current knowledge on the relationships between aortic stiffness and diabetic complications, their possible underlying physiopathological mechanisms, and their potential applications to clinical type 2 diabetes management.
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Affiliation(s)
- Claudia R L Cardoso
- Department of Internal Medicine, School of Medicine and University Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Rodolpho Rocco 255, Cidade Universitária, Rio de Janeiro-RJ 21941-901, Brazil.
| | - Gil F Salles
- Department of Internal Medicine, School of Medicine and University Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Rodolpho Rocco 255, Cidade Universitária, Rio de Janeiro-RJ 21941-901, Brazil.
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71
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Weiss EP, Albert SG, Reeds DN, Kress KS, McDaniel JL, Klein S, Villareal DT. Effects of matched weight loss from calorie restriction, exercise, or both on cardiovascular disease risk factors: a randomized intervention trial. Am J Clin Nutr 2016; 104:576-86. [PMID: 27465384 PMCID: PMC4997297 DOI: 10.3945/ajcn.116.131391] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 06/13/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Weight loss from calorie restriction (CR) and/or endurance exercise training (EX) is cardioprotective. However CR and EX also have weight loss-independent benefits. OBJECTIVE We tested the hypothesis that weight loss from calorie restriction and exercise combined (CREX) improves cardiovascular disease (CVD) risk factors more so than similar weight loss from CR or EX alone. DESIGN Overweight, sedentary men and women (n = 52; aged 45-65 y) were randomly assigned to undergo 6-8% weight loss by using CR, EX, or CREX. Outcomes were measured before and after weight loss and included maximal oxygen consumption (VO2max), resting blood pressure, fasting plasma lipids, glucose, C-reactive protein, and arterial stiffness [carotid-femoral pulse wave velocity (PWV) and carotid augmentation index (AI)]. Values are means ± SEs. RESULTS Reductions in body weight (∼7%) were similar in all groups. VO2max changed in proportion to the amount of exercise performed (CR, -1% ± 3%; EX, +22% ± 3%; and CREX, +11% ± 3%). None of the changes in CVD risk factors differed between groups. For all groups combined, decreases were observed for systolic and diastolic blood pressure (-5 ± 1 and -4 ± 1 mm Hg, respectively; both P < 0.0008), total cholesterol (-17 ± 4 mg/dL; P < 0.0001), non-HDL cholesterol (-16 ± 3 mg/dL; P < 0.0001), triglycerides (-18 ± 8 mg/dL; P = 0.03), and glucose (-3 ± 1 mg/dL; P = 0.0003). No changes were observed for HDL cholesterol (P = 0.30), C-reactive protein (P = 0.10), PWV (P = 0.30), or AI (P = 0.84). These changes would be expected to decrease the lifetime risk of CVD from 46% to 36%. CONCLUSION Matched weight losses from CR, EX, and CREX have substantial beneficial effects on CVD risk factors. However, the effects are not additive when weight loss is matched. This trial was registered at clinicaltrials.gov as NCT00777621.
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Affiliation(s)
- Edward P Weiss
- Department of Nutrition and Dietetics, and Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO; and
| | - Stewart G Albert
- Division of Endocrinology, School of Medicine, Saint Louis University, St. Louis, MO
| | - Dominic N Reeds
- Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO; and
| | | | | | - Samuel Klein
- Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO; and
| | - Dennis T Villareal
- Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO; and Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine and Michael E DeBakey Veterans Affairs Medical Center, Houston, TX
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72
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Wijkman M, Länne T, Östgren CJ, Nystrom FH. Aortic pulse wave velocity predicts incident cardiovascular events in patients with type 2 diabetes treated in primary care. J Diabetes Complications 2016; 30:1223-8. [PMID: 27400814 DOI: 10.1016/j.jdiacomp.2016.06.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 06/06/2016] [Accepted: 06/07/2016] [Indexed: 10/21/2022]
Abstract
AIMS The aim was to evaluate the predictive value of aortic pulse wave velocity (aPWV) on incident cardiovascular events in patients with type 2 diabetes without previous cardiovascular disease who were treated in primary care, after adjustment for traditional risk factors. METHODS We measured aPWV in 627 patients who participated in the epidemiological study CARDIPP (Cardiovascular Risk Factors in Patients with Diabetes-a Prospective Study in Primary Care; ClinicalTrials.gov identifier NCT01049737) and who did not have previously known myocardial infarction or stroke. The outcome variable was a composite endpoint consisting of cardiovascular mortality, hospitalization for myocardial infarction and hospitalization for stroke. RESULTS During a median follow-up time of almost eight years, the unadjusted HR per each increment of aPWV by 1m/s was 1.239 (95% CI 1.114-1.379, P<0.001) for the primary endpoint. Following adjustments for age, sex, diabetes duration, office systolic blood pressure, resting heart rate, total cholesterol, HbA1c, estimated glomerular filtration rate and smoking status, the adjusted hazard ratio was 1.142 (95% CI 1.003-1.301, P=0.044). CONCLUSIONS In primary preventive patients with type 2 diabetes treated in primary care, aPWV predicted a composite outcome of incident cardiovascular events independently of diabetes-specific and traditional risk factors.
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Affiliation(s)
- Magnus Wijkman
- Department of Internal Medicine and Department of Medical and Health Sciences, Linköping University, 601 74 Norrköping, Sweden.
| | - Toste Länne
- Department of Medical and Health Sciences, Linköping University, 581 83 Linköping, Sweden.
| | - Carl Johan Östgren
- Department of Medical and Health Sciences, Linköping University, 581 83 Linköping, Sweden.
| | - Fredrik H Nystrom
- Department of Medical and Health Sciences, Linköping University, 581 83 Linköping, Sweden.
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73
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Association of worsening arterial stiffness with incident heart failure in asymptomatic patients with cardiovascular risk factors. Hypertens Res 2016; 40:173-180. [DOI: 10.1038/hr.2016.116] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 07/25/2016] [Accepted: 08/04/2016] [Indexed: 11/09/2022]
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74
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Ye C, Pan Y, Xu X, Su S, Snieder H, Treiber F, Kapuku G, Wang X. Pulse wave velocity in elastic and muscular arteries: tracking stability and association with anthropometric and hemodynamic measurements. Hypertens Res 2016; 39:786-791. [PMID: 27334066 DOI: 10.1038/hr.2016.67] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 04/27/2016] [Accepted: 05/05/2016] [Indexed: 01/26/2023]
Abstract
Pulse wave velocity (PWV) has been used as a measurement for arterial stiffness, a predictor of cardiovascular risk. Tracking describes the stability of a measurement over time. The purpose of this study was to evaluate the tracking stability of carotid-femoral (cfPWV), carotid-radial (crPWV) and carotid-distal (cdPWV) PWV in young adults and their associations with anthropometric and hemodynamic measurements. cfPWV, crPWV and cdPWV were measured by tonometric (SphygmoCor) technique in 531 subjects (aged 23.7±4.9 with 42.9% African Americans and 49.9% females). Out of these subjects, 142 subjects had all these 3 PWV measurements evaluated again during their next visit with an average follow-up time of 2 years. In the tracking analysis on the data from the 142 subjects, cfPWV displayed moderate to relatively high tracking ability (r=0.61, P<0.001), whereas crPWV and cdPWV only displayed low to moderate tracking coefficients (r=0.29 and r=0.36 respectively, P<0.001). In the association test on the data from the 531 subjects, all three PWV measurements showed significant correlations with age and obesity related measurements. cfPWV displayed stronger correlations with these parameters. In addition, all three PWVs showed significant correlations with systolic blood pressure, diastolic blood pressure, mean arterial pressure and pulse pressure with the exception that no correlation existed between crPWV and pulse pressure. The higher tracking ability of cfPWV and its higher association with obesity related measurements highlights the importance of using cfPWV compared with crPWV and cdPWV for research and clinical settings.
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Affiliation(s)
- Chengcheng Ye
- Medical College of Georgia, Georgia Regents University, Augusta, GA, USA
| | - Yue Pan
- Department of Pediatrics, Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA
| | - Xiaojing Xu
- Department of Pediatrics, Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA
| | - Shaoyong Su
- Department of Pediatrics, Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA
| | - Harold Snieder
- Department of Pediatrics, Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA.,Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Frank Treiber
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Gaston Kapuku
- Department of Pediatrics, Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA
| | - Xiaoling Wang
- Department of Pediatrics, Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA
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75
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Effect of weight loss induced by energy restriction on measures of arterial compliance: A systematic review and meta-analysis. Atherosclerosis 2016; 247:7-20. [DOI: 10.1016/j.atherosclerosis.2016.01.042] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 01/13/2016] [Accepted: 01/26/2016] [Indexed: 12/16/2022]
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76
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Lipids and bariatric procedures Part 2 of 2: scientific statement from the American Society for Metabolic and Bariatric Surgery (ASMBS), the National Lipid Association (NLA), and Obesity Medicine Association (OMA) 1. Surg Obes Relat Dis 2016; 12:468-495. [DOI: 10.1016/j.soard.2016.01.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 01/08/2016] [Indexed: 12/17/2022]
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77
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Jia G, Habibi J, Aroor AR, Martinez-Lemus LA, DeMarco VG, Ramirez-Perez FI, Sun Z, Hayden MR, Meininger GA, Mueller KB, Jaffe IZ, Sowers JR. Endothelial Mineralocorticoid Receptor Mediates Diet-Induced Aortic Stiffness in Females. Circ Res 2016; 118:935-943. [PMID: 26879229 DOI: 10.1161/circresaha.115.308269] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 02/12/2016] [Indexed: 12/13/2022]
Abstract
RATIONALE Enhanced activation of the mineralocorticoid receptors (MRs) in cardiovascular tissues increases oxidative stress, maladaptive immune responses, and inflammation with associated functional vascular abnormalities. We previously demonstrated that consumption of a Western diet (WD) for 16 weeks results in aortic stiffening, and that these abnormalities were prevented by systemic MR blockade in female mice. However, the cell-specific role of endothelial cell MR (ECMR) in these maladaptive vascular effects has not been explored. OBJECTIVE We hypothesized that specific deletion of the ECMR would prevent WD-induced increases in endothelial sodium channel activation, reductions in bioavailable nitric oxide, increased vascular remodeling, and associated increases in vascular stiffness in females. METHODS AND RESULTS Four-week-old female ECMR knockout and wild-type mice were fed either mouse chow or WD for 16 weeks. WD feeding resulted in aortic stiffness and endothelial dysfunction as determined in vivo by pulse wave velocity and ex vivo by atomic force microscopy, and wire and pressure myography. The WD-induced aortic stiffness was associated with enhanced endothelial sodium channel activation, attenuated endothelial nitric oxide synthase activation, increased oxidative stress, a proinflammatory immune response and fibrosis. Conversely, cell-specific ECMR deficiency prevented WD-induced aortic fibrosis and stiffness in conjunction with reductions in endothelial sodium channel activation, oxidative stress and macrophage proinflammatory polarization, restoration of endothelial nitric oxide synthase activation. CONCLUSIONS Increased ECMR signaling associated with consumption of a WD plays a key role in endothelial sodium channel activation, reduced nitric oxide production, oxidative stress, and inflammation that lead to aortic remodeling and stiffness in female mice.
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Affiliation(s)
- Guanghong Jia
- Diabetes and Cardiovascular Research Center, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA
| | - Javad Habibi
- Diabetes and Cardiovascular Research Center, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA
| | - Annayya R Aroor
- Diabetes and Cardiovascular Research Center, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA
| | - Luis A Martinez-Lemus
- Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA.,Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, 65212, USA
| | - Vincent G DeMarco
- Diabetes and Cardiovascular Research Center, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA.,Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO, 65212, USA
| | | | - Zhe Sun
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, 65212, USA
| | - Melvin R Hayden
- Diabetes and Cardiovascular Research Center, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA
| | - Gerald A Meininger
- Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, 65212, USA
| | | | - Iris Z Jaffe
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA 02111, USA
| | - James R Sowers
- Diabetes and Cardiovascular Research Center, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA.,Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, 65212, USA
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78
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Tomiyama H, Matsumoto C, Shiina K, Yamashina A. Brachial-Ankle PWV: Current Status and Future Directions as a Useful Marker in the Management of Cardiovascular Disease and/or Cardiovascular Risk Factors. J Atheroscler Thromb 2016; 23:128-46. [DOI: 10.5551/jat.32979] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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79
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Horta BL, Schaan BD, Bielemann RM, Vianna CÁ, Gigante DP, Barros FC, Ekelund U, Hallal PC. Objectively measured physical activity and sedentary-time are associated with arterial stiffness in Brazilian young adults. Atherosclerosis 2015; 243:148-54. [PMID: 26386211 PMCID: PMC4678284 DOI: 10.1016/j.atherosclerosis.2015.09.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 08/28/2015] [Accepted: 09/03/2015] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To examine the associations between objectively measured physical activity and sedentary time with pulse wave velocity (PWV) in Brazilian young adults. METHODS Cross-sectional analysis with participants of the 1982 Pelotas (Brazil) Birth Cohort who were followed-up from birth to 30 years of age. Overall physical activity (PA) assessed as the average acceleration (mg), time spent in moderate-to-vigorous physical activity (MVPA - min/day) and sedentary time (min/day) were calculated from acceleration data. Carotid-femoral PWV (m/s) was assessed using a portable ultrasound. Systolic and diastolic blood pressure (SBP/DBP), waist circumference (WC) and body mass index (BMI) were analyzed as possible mediators. Multiple linear regression and g-computation formula were used in the analyses. RESULTS Complete data were available for 1241 individuals. PWV was significantly lower in the two highest quartiles of overall PA (0.26 m/s) compared with the lowest quartile. Participants in the highest quartile of sedentary time had 0.39 m/s higher PWV (95%CI: 0.20; 0.57) than those in the lowest quartile. Individuals achieving ≥30 min/day in MVPA had lower PWV (β = -0.35; 95%CI: -0.56; -0.14). Mutually adjusted analyses between MVPA and sedentary time and PWV changed the coefficients, although results from sedentary time remained more consistent. WC captured 44% of the association between MVPA and PWV. DBP explained 46% of the association between acceleration and PWV. CONCLUSIONS Physical activity was inversely related to PWV in young adults, whereas sedentary time was positively associated. Such associations were only partially mediated by WC and DBP.
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Affiliation(s)
| | - Beatriz D Schaan
- EndocrineDivision, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Internal Medicine, Facultyof Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Renata Moraes Bielemann
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil; Department of Nutrition, Federal University of Pelotas, Brazil
| | | | | | - Fernando C Barros
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | - Ulf Ekelund
- Medical Research Council, Epidemiology Unit, University of Cambridge, United Kingdom; Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Pedro Curi Hallal
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil
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80
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Aortic Stiffness and Cardiovascular Risk in Women with Previous Gestational Diabetes Mellitus. PLoS One 2015; 10:e0136892. [PMID: 26309121 PMCID: PMC4550237 DOI: 10.1371/journal.pone.0136892] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 08/09/2015] [Indexed: 01/09/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is a significant risk factor for cardiovascular disease (CVD) in later life, but the mechanism remains unclear. The aim of the study was to investigate indices of glucose metabolism, dyslipidemia, and arterial stiffness (as measured by pulse wave velocity (PWV)), in women with and without a history of GDM, using both the old WHO and new IADPSG diagnostic criteria, at 5 years after the index pregnancy. Dyslipidemia and PWV were used as surrogate markers for CVD risk. The population-based prospective cohort included 300 women from the original STORK study. All participants had an oral glucose tolerance test (OGTT) during pregnancy. Five years later, the OGTT was repeated along with dual-energy x-ray absorptiometry, lipid analysis, and PWV analysis. Measurements were compared between those women who did and did not have GDM based on both the WHO and IADPSG criteria. We found that women with GDM based on the old WHO criteria had higher CVD risk at 5 years than those without GDM, with markedly elevated PWV and more severe dyslipidemia (higher triglycerides (TG)/HDL cholesterol ratio). After adjusting for known risk factors, the most important predictors for elevated PWV and TG/HDL-C ratio at 5-year follow-up were maternal age, BMI, GDM, systolic blood pressure, and indices of glucose metabolism in the index pregnancy. In conclusion, we found a higher risk for CVD, based on the surrogate markers PWV and TG/HDL-C ratio, at 5-year follow-up in women diagnosed with GDM in the index pregnancy when using the old WHO diagnostic criteria.
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81
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Schmidt AM. The growing problem of obesity: mechanisms, consequences, and therapeutic approaches. Arterioscler Thromb Vasc Biol 2015; 35:e19-23. [PMID: 25995044 DOI: 10.1161/atvbaha.115.305753] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Ann Marie Schmidt
- From the Department of Medicine, New York University School of Medicine, NY.
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82
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Petersen K, Blanch N, Keogh J, Clifton P. Weight Loss, Dietary Intake and Pulse Wave Velocity. Pulse (Basel) 2015; 3:134-40. [PMID: 26587462 DOI: 10.1159/000435792] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
We have recently conducted a meta-analysis to determine the effect of weight loss achieved by an energy-restricted diet with or without exercise, anti-obesity drugs or bariatric surgery on pulse wave velocity (PWV) measured at all arterial segments. Twenty studies, including 1,259 participants, showed that modest weight loss (8% of the initial body weight) caused a reduction in PWV measured at all arterial segments. However, due to the poor methodological design of the included studies, the results of this meta-analysis can only be regarded as hypothesis generating and highlight the need for further research in this area. In the future, well-designed randomised controlled trials are required to determine the effect of diet-induced weight loss on PWV and the mechanisms involved. In addition, there is observational evidence that dietary components such as fruit, vegetables, dairy foods, sodium, potassium and fatty acids may be associated with PWV, although evidence from well-designed intervention trials is lacking. In the future, the effect of concurrently improving dietary quality and achieving weight loss should be assessed in randomised controlled trials.
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Affiliation(s)
- Kristina Petersen
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
| | - Natalie Blanch
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
| | - Jennifer Keogh
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
| | - Peter Clifton
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
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83
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Oliveras A, Segura J, Suarez C, García-Ortiz L, Abad-Cardiel M, Vigil L, Gómez-Marcos MA, Sans Atxer L, Martell-Claros N, Ruilope LM, de la Sierra A. Modification over time of pulse wave velocity parallel to changes in aortic BP, as well as in 24-h ambulatory brachial BP. J Hum Hypertens 2015; 30:186-90. [PMID: 26108366 DOI: 10.1038/jhh.2015.62] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 05/04/2015] [Accepted: 05/12/2015] [Indexed: 01/22/2023]
Abstract
Arterial stiffness as assessed by carotid-femoral pulse wave velocity (cfPWV) is a marker of preclinical organ damage and a predictor of cardiovascular outcomes, independently of blood pressure (BP). However, limited evidence exists on the association between long-term variation (Δ) on aortic BP (aoBP) and ΔcfPWV. We aimed to evaluate the relationship of ΔBP with ΔcfPWV over time, as assessed by office and 24-h ambulatory peripheral BP, and aoBP. AoBP and cfPWV were evaluated in 209 hypertensive patients with either diabetes or metabolic syndrome by applanation tonometry (Sphygmocor) at baseline(b) and at 12 months of follow-up(fu). Peripheral BP was also determined by using validated oscillometric devices (office(o)-BP) and on an outpatient basis by using a validated (Spacelabs-90207) device (24-h ambulatory BP). ΔcfPWV over time was calculated as follows: ΔcfPWV=[(cfPWVfu-cfPWVb)/cfPWVb] × 100. ΔBP over time resulted from the same formula applied to BP values obtained with the three different measurement techniques. Correlations (Spearman 'Rho') between ΔBP and ΔcfPWV were calculated. Mean age was 62 years, 39% were female and 80% had type 2 diabetes. Baseline office brachial BP (mm Hg) was 143±20/82±12. Follow-up (12 months later) office brachial BP (mm Hg) was 136±20/79±12. ΔcfPWV correlated with ΔoSBP (Rho=0.212; P=0.002), Δ24-h SBP (Rho=0.254; P<0.001), Δdaytime SBP (Rho=0.232; P=0.001), Δnighttime SBP (Rho=0.320; P<0.001) and ΔaoSBP (Rho=0.320; P<0.001). A multiple linear regression analysis included the following independent variables: ΔoSBP, Δ24-h SBP, Δdaytime SBP, Δnighttime SBP and ΔaoSBP. ΔcfPWV was independently associated with Δ24-h SBP (β-coefficient=0.195; P=0.012) and ΔaoSBP (β-coefficient= 0.185; P=0.018). We conclude that changes in both 24-h SBP and aoSBP more accurately reflect changes in arterial stiffness than do office BP measurements.
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Affiliation(s)
- A Oliveras
- Hypertension Unit, Department of Nephrology, Hospital Universitari del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - J Segura
- Hypertension Unit, Hospital 12 de Octubre, Madrid, Spain
| | - C Suarez
- Department of Internal Medicine, Hospital La Princesa, Madrid, Spain
| | - L García-Ortiz
- Health Center La Alamedilla, IBSAL (Institute of Biomedical Research of Salamanca), Salamanca, Spain
| | - M Abad-Cardiel
- Hypertension Unit, Department of Internal Medicine, Hospital Clínico San Carlos, Madrid, Spain
| | - L Vigil
- Hospital de Móstoles, Madrid, Spain
| | - M A Gómez-Marcos
- Health Center La Alamedilla, IBSAL (Institute of Biomedical Research of Salamanca), Salamanca, Spain
| | - L Sans Atxer
- Hypertension Unit, Department of Nephrology, Hospital Universitari del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - N Martell-Claros
- Hypertension Unit, Department of Internal Medicine, Hospital Clínico San Carlos, Madrid, Spain
| | - L M Ruilope
- Hypertension Unit, Hospital 12 de Octubre, Madrid, Spain
| | - A de la Sierra
- Department of Internal Medicine, Hospital Mútua Terrassa, University of Barcelona, Barcelona, Spain
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84
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Affiliation(s)
- Peter M Nilsson
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
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