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Comparison of the effects of empagliflozin and glimepiride on endothelial function in patients with type 2 diabetes: A randomized controlled study. PLoS One 2022; 17:e0262831. [PMID: 35171918 PMCID: PMC8849516 DOI: 10.1371/journal.pone.0262831] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 12/12/2021] [Indexed: 11/19/2022] Open
Abstract
Patients with type 2 diabetes who have cardiovascular disease and are receiving empagliflozin have a lower rate of primary composite cardiovascular outcomes. In contrast, glimepiride increases cardiovascular hospitalization when combined with metformin. Here, we assessed the effects of empagliflozin and glimepiride on endothelial function using flow-mediated dilation (FMD). In this prospective, open-label, randomized, parallel-group study, 63 patients with type 2 diabetes received metformin and insulin glargine U100 for 12 weeks. This was followed by additional treatment with empagliflozin or glimepiride for 12 weeks. The primary outcome was the change in the FMD measurement (ΔFMDs) at 24 weeks of additional treatment. Secondary outcomes comprised changes in metabolic markers and body composition. The empagliflozin group (n = 33) and glimepiride group (n = 30) showed no significant differences in ΔFMDs (empagliflozin, −0.11 [95%CI: -1.02, 0.80]%; glimepiride, −0.34 [95%CI: -1.28, 0.60]%; P = 0.73). Additionally, changes in glycated hemoglobin were similar between the two groups. However, a significant difference in body weight change was observed (empagliflozin, −0.58 [95%CI: -1.60, 0.43] kg; glimepiride, 1.20 [95%CI: 0.15, 2.26] kg; P = 0.02). Moreover, a body composition analysis revealed that body fluid volume significantly decreased after empagliflozin treatment (baseline, 35.8 ± 6.8 L; after 12 weeks, −0.33 ± 0.72 L; P = 0.03). Hence, although empagliflozin did not improve endothelial function compared with glimepiride for patients with type 2 diabetes, it did decrease body fluid volumes. Thus, the coronary-protective effect of empagliflozin is not derived from endothelial function protection, but rather from heart failure risk reduction.
Trial registration: This trial was registered on September 13, 2016; UMIN000024001.
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Skrypnik D, Skrypnik K, Pelczyńska M, Sobieska M, Tinkov AA, Suliburska J, Bogdański P. The effect of Plantago major supplementation on leptin and VEGF-A serum levels, endothelial dysfunction and angiogenesis in obese women - a randomised trial. Food Funct 2021; 12:1708-1718. [PMID: 33502416 DOI: 10.1039/d0fo01878c] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Obesity is associated with increased serum leptin level, endothelial dysfunction and angiogenesis. In vitro studies have shown that vascular endothelial growth factor (VEGF) synthesis is increased by leptin. Animal studies revealed the effectiveness of Plantago supplementation treatment of obesity. The study aim was to evaluate the effect of Plantago major supplementation on serum leptin and VEGF blood concentration, endothelial dysfunction and angiogenesis in obese women. Seventy-two obese women received oral Plantago major supplement (Plantago group, n = 35) or placebo (placebo group, n = 37) for 12 weeks. At baseline and after completion, anthropometric and body composition measurements were performed, and blood samples were collected. Serum concentrations of leptin, VEGF-A, adiponectin, tumour necrosis factor α and soluble intercellular adhesion molecule have been determined. At completion, the leptin level was higher in the Plantago group (39 781.55 ± 20 360.73 pg ml-1) compared to both the baseline (36 138.71 ± 25 401.51 pg ml-1) and placebo group (30 502.81 ± 19 003.18 pg ml-1). Also, leptin concentration in the Plantago group at completion correlated positively with an increase in VEGF-A level (R = 0.45), and baseline VEGF-A level correlated negatively with the increase in leptin concentration (R = -0.47). Plantago major supplementation increases leptin serum level, enhances leptin influence on VEGF-A serum level increase and by this mechanism may intensify endothelial dysfunction and angiogenesis in obese women.
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Affiliation(s)
- Damian Skrypnik
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznań University of Medical Sciences, Szamarzewskiego St 84, 60-569 Poznań, Poland.
| | - Katarzyna Skrypnik
- Department of Human Nutrition and Dietetics, Poznań University of Life Sciences, Wojska Polskiego St 31, 60-624 Poznań, Poland
| | - Marta Pelczyńska
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznań University of Medical Sciences, Szamarzewskiego St 84, 60-569 Poznań, Poland.
| | - Magdalena Sobieska
- Department of Physiotherapy, Chair for Physiotherapy and Rehabilitation, Poznań University of Medical Sciences, 28. Czerwca 1956r St 135/147, 61-545 Poznań, Poland
| | - Alexey A Tinkov
- Department of Medical Elementology, Peoples' Friendship University of Russia (RUDN University), Moscow 117198, Russia. and Laboratory of Biotechnology and Applied Bioelementology, Yaroslavl State University, Yaroslavl 150003, Russia and Laboratory of Molecular Dietology, IM Sechenov First Moscow State Medical University, Moscow 119146, Russia
| | - Joanna Suliburska
- Department of Human Nutrition and Dietetics, Poznań University of Life Sciences, Wojska Polskiego St 31, 60-624 Poznań, Poland
| | - Paweł Bogdański
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznań University of Medical Sciences, Szamarzewskiego St 84, 60-569 Poznań, Poland.
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Impact of low-intensity resistance and whole-body vibration training on aortic hemodynamics and vascular function in postmenopausal women. Hypertens Res 2019; 42:1979-1988. [DOI: 10.1038/s41440-019-0328-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/31/2019] [Accepted: 08/20/2019] [Indexed: 12/13/2022]
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Wan J, Zhou P, Wang D, Liu S, Yang Y, Hou J, Li W, Wang P. Impact of Normal Weight Central Obesity on Clinical Outcomes in Male Patients With Premature Acute Coronary Syndrome. Angiology 2019; 70:960-968. [PMID: 30871333 DOI: 10.1177/0003319719835637] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There is a lack of studies that evaluate the association between normal weight central obesity and subsequent outcomes in patients with premature acute coronary syndrome (ACS). We evaluated 338 consecutive male patients (aged ≤ 55 years) with premature ACS. The primary outcomes were all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE). We compared the hazard ratios (HRs) in patients with and without normal weight central obesity using multivariable Cox proportional hazard models. All-cause mortality (16.8%) of patients with normal weight central obesity was much higher than those (7.1%) without normal weight central obesity (P = .008). The incidence of MACCE in patients with and without normal weight central obesity were 40.7 and 23.6% (P = .001), respectively. After multivariable adjustment, the risks of all-cause mortality and MACCE were significantly higher in patients with normal weight central obesity than those without normal weight central obesity (adjusted HR: 1.83; 95% confidence interval [CI]: 1.04-3.31; P = .004 and adjusted HR: 1.62; 95% CI: 1.18-2.27; P = .017, respectively). In conclusion, the risks of all-cause mortality and MACCE were significantly higher in male patients with premature ACS with normal weight central obesity than in those without normal weight central obesity.
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Affiliation(s)
- Jindong Wan
- 1 Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, People's Republic of China.,2 Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, People's Republic of China
| | - Peng Zhou
- 1 Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, People's Republic of China.,2 Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, People's Republic of China
| | - Dan Wang
- 1 Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, People's Republic of China.,2 Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, People's Republic of China
| | - Sen Liu
- 1 Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, People's Republic of China.,2 Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, People's Republic of China
| | - Yi Yang
- 1 Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, People's Republic of China.,2 Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, People's Republic of China
| | - Jixin Hou
- 1 Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, People's Republic of China.,2 Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, People's Republic of China
| | - Wenzhang Li
- 1 Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, People's Republic of China.,2 Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, People's Republic of China
| | - Peijian Wang
- 1 Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, People's Republic of China.,2 Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, Sichuan, People's Republic of China
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The Different Effects of BMI and WC on Organ Damage in Patients from a Cardiac Rehabilitation Program after Acute Coronary Syndrome. BIOMED RESEARCH INTERNATIONAL 2015; 2015:942695. [PMID: 26247035 PMCID: PMC4515515 DOI: 10.1155/2015/942695] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 02/16/2015] [Indexed: 02/07/2023]
Abstract
One of the purposes of cardiac rehabilitation (CR) after acute coronary syndrome (ACS) is to monitor and control weight of the patient. Our study is to compare the different obesity indexes, body mass index (BMI), and waist circumference (WC), through one well-designed CR program (CRP) with ACS in Guangzhou city of Guangdong Province, China, in order to identify different effects of BMI and WC on organ damage. In our work, sixty-one patients between October 2013 and January 2014 fulfilled our study. We collected the vital signs by medical records, the clinical variables of body-metabolic status by fasting blood test, and the organ damage variables by submaximal exercise treadmill test (ETT) and ultrasonic cardiogram (UCG) both on our inpatient and four-to-five weeks of outpatient part of CRP after ACS. We mainly used two-tailed Pearson's test and liner regression to evaluate the relationship of BMI/WC and organ damage. Our results confirmed that WC could be more accurate than BMI to evaluate the cardiac
function through the changes of left ventricular structure on the CRP after ACS cases. It makes sense of early diagnosis, valid evaluation, and proper adjustment to ACS in CRP of the obesity individuals in the future.
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Joris PJ, Zeegers MP, Mensink RP. Weight loss improves fasting flow-mediated vasodilation in adults: a meta-analysis of intervention studies. Atherosclerosis 2014; 239:21-30. [PMID: 25568949 DOI: 10.1016/j.atherosclerosis.2014.12.056] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 11/07/2014] [Accepted: 12/09/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Obesity is associated with vascular endothelial dysfunction. Effects of weight loss on endothelial function are however not clear. Therefore, we performed a meta-analysis to quantify effects of weight loss on flow-mediated vasodilation (FMD) of the brachial artery, a measurement of endothelial function. METHODS Studies with experimental (RCTs) and quasi-experimental designs published before June 2014 were identified by a systematic search. Changes in FMD were defined as the difference between measurements before and after the study. For RCTs, changes were corrected for those in the no-weight loss control group. Summary estimates of weighted mean differences (WMDs) in FMD and 95% confidence intervals (CIs) were calculated using random-effect meta-analyses. The impact of subject characteristics, type of weight-loss treatment, and dietary composition on changes in FMD was also investigated. RESULTS Four RCTs involving 265 subjects were included. Weight loss increased FMD vs. control by 3.29% (95% CI: 0.98-5.59%; P = 0.005; mean weight loss: 8.6 kg). A total of 1517 subjects participated in 33 studies with 49 relevant study arms. It was estimated that each 10 kg decrease in body weight increased fasting FMD by 1.11% (95% CI: 0.47-1.76%; P = 0.001). Effects were more pronounced when participants had coexisting obesity-related morbidities. Also, effects may be larger when subjects received low-fat diets or weight-reduction regimens including exercise therapy or weight-loss medication. CONCLUSION Weight loss significantly improves fasting FMD in adults, which is a risk marker for cardiovascular disease. Effects may depend on subject characteristics, type of weight-loss treatment, and dietary composition.
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Affiliation(s)
- Peter J Joris
- Department of Human Biology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands; Top Institute of Food and Nutrition (TIFN), Wageningen, The Netherlands.
| | - Maurice P Zeegers
- Department of Complex Genetics, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Ronald P Mensink
- Department of Human Biology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands; Top Institute of Food and Nutrition (TIFN), Wageningen, The Netherlands.
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Narumi T, Arimoto T, Funayama A, Kadowaki S, Otaki Y, Nishiyama S, Takahashi H, Shishido T, Miyashita T, Miyamoto T, Watanabe T, Kubota I. Prognostic importance of objective nutritional indexes in patients with chronic heart failure. J Cardiol 2013; 62:307-13. [PMID: 23806549 DOI: 10.1016/j.jjcc.2013.05.007] [Citation(s) in RCA: 166] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 04/23/2013] [Accepted: 05/08/2013] [Indexed: 01/27/2023]
Abstract
BACKGROUND Although malnutrition indicates an unfavorable prognosis in some clinical settings, the association between nutritional indexes and outcomes for patients with chronic heart failure (CHF) is unclear. METHODS AND RESULTS All the previously established objective nutritional indexes were evaluated. The controlling nutritional status score (CONUT), prognostic nutritional index (PNI), and geriatric nutritional risk index (GNRI) were determined for 388 consecutive patients with CHF (mean age 69.6±12.3 years). The prevalence of malnutrition in this cohort was 60-69%. Patients were followed prospectively, with the endpoints being death due to a cardiovascular event or re-hospitalization. There were 130 events, including 33 deaths and 97 re-hospitalizations, during a mean follow-up period of 28.4 months. Patients experiencing cardiovascular events showed impaired nutritional status, higher CONUT scores, lower PNI scores, and lower GNRI scores, compared with those who did not experience cardiovascular events. CONUT score [hazard ratio 40.9, 95% confidence interval (CI) 10.8-154.8], PNI score (hazard ratio 6.4, 95% CI 5.4-25.1), and GNRI score (hazard ratio 11.6, 95% CI 3.7-10.0) were independently associated with cardiovascular events. Kaplan-Meier analysis showed that there was a significantly higher incidence of cardiovascular events in patients who were malnourished than in those who were not. CONCLUSION Malnutrition was common in patients with CHF. Evaluation of nutritional status may provide additional prognostic information in patients with CHF.
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Affiliation(s)
- Taro Narumi
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan
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Matsuzawa Y, Sugiyama S, Sugamura K, Sumida H, Kurokawa H, Fujisue K, Konishi M, Akiyama E, Suzuki H, Nakayama N, Yamamuro M, Iwashita S, Jinnouchi H, Kimura K, Umemura S, Ogawa H. Successful Diet and Exercise Therapy as Evaluated on Self-Assessment Score Significantly Improves Endothelial Function in Metabolic Syndrome Patients. Circ J 2013; 77:2807-15. [DOI: 10.1253/circj.cj-13-0549] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yasushi Matsuzawa
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
- Division of Cardiology, Yokohama City University Medical Center
| | - Seigo Sugiyama
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
- Jinnouchi Hospital
| | - Koichi Sugamura
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
| | - Hitoshi Sumida
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
| | - Hirofumi Kurokawa
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
| | - Koichiro Fujisue
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
| | - Masaaki Konishi
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
- Division of Cardiology, Yokohama City University Medical Center
| | - Eiichi Akiyama
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
- Division of Cardiology, Yokohama City University Medical Center
| | - Hiroyuki Suzuki
- Division of Cardiology, Yokohama City University Medical Center
| | - Naoki Nakayama
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
- Division of Cardiology, Yokohama City University Medical Center
| | - Megumi Yamamuro
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
| | - Satomi Iwashita
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
| | | | - Kazuo Kimura
- Division of Cardiology, Yokohama City University Medical Center
| | - Satoshi Umemura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine
| | - Hisao Ogawa
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
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Luo W, Guo Z, Hu X, Zhou Z, Mingwu, Zhang L, Liu J. A prospective study on association between 2 years change of waist circumference and incident hypertension in Han Chinese. Int J Cardiol 2012; 167:2781-5. [PMID: 22871264 DOI: 10.1016/j.ijcard.2012.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2011] [Revised: 04/10/2012] [Accepted: 07/19/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Few prospective studies on association between waist circumference and hypertension have taken account of the dynamic change of WC, which caused by lifestyle modification. METHODS After a baseline investigation, we conducted the first and the second follow-up assessments for subjects after 2 and 5 years, respectively. The difference value (D-value, the value at the first follow-up minus the value at baseline) in WC was calculated to evaluate 2 years change of WC. The association between 2 years change of WC and incident hypertension was analyzed by using Cox proportional hazards regression model. RESULTS Among 2778 participants free of hypertension at baseline and the first follow-up, 660 (23.8%) subjects developed hypertension over a period of 5 years (between the first and the second follow-up assessments). In both genders, the incidence density and HRs of hypertension were all increased with WC D-value regardless of their abdominal obesity status at baseline. Compared with participants who were non-abdominal obese both at baseline and first follow up, hypertension risk was higher in subjects who were abdominal obese both at baseline and the first follow-up, and in subjects who were non-abdominal obese at baseline but with abdominal obesity at the first follow up. CONCLUSIONS WC dynamic change was associated with incident hypertension, and more WC reduction was associated with more hypertension risk decrease.
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Affiliation(s)
- Wenshu Luo
- Department of Public Health, Medical College of Soochow university, SuZhou, JiangSu 215123, China
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