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Wisnu W, Alwi I, Nafrialdi N, Pemayun TGD, Pantoro NI, Wijaya CN, Tahapary DL, Tarigan TJE, Subekti I. The Effects of Anti-thyroid Drugs on Lipoproteins and Insulin Resistance in Graves' Disease: A Randomized Clinical Trial. J Lipid Atheroscler 2024; 13:358-370. [PMID: 39355401 PMCID: PMC11439756 DOI: 10.12997/jla.2024.13.3.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 03/04/2024] [Accepted: 04/16/2024] [Indexed: 10/03/2024] Open
Abstract
Objective Graves' disease (GD) is characterized by thyroid overactivity. Anti-thyroid drugs (ATDs), such as propylthiouracil (PTU) and methimazole (MMI), are commonly used for GD treatment, and studies have suggested a link between these drugs and elevated lipoprotein levels. However, data on their effects on lipoproteins, insulin resistance, or low-density lipoprotein receptor (LDL-R) levels are lacking, both in Indonesia and in other countries. This study investigated changes in lipoproteins, LDL-R, and insulin resistance markers with ATD treatment. Methods This study is a secondary analysis of a randomized clinical trial entitled "The Differential Effects of Propylthiouracil and Methimazole as Graves' Disease Treatment on Vascular Atherosclerosis Markers" conducted in Jakarta, Indonesia. Thirty-seven newly diagnosed GD patients received MMI or PTU for 3 months. Results After 3 months of ATD treatment, LDL-R levels significantly decreased compared to baseline (197 vs. 144 ng/mL, p<0.001), while most lipoproteins, including TC, LDL-C, HDL-C, non-HDL-C, the cholesterol ratio, and the LDL-C/HDL-C ratio, increased. Unexpectedly, neither the PTU nor MMI groups showed an increased dyslipidemia prevalence. Although body mass index increased significantly and fasting plasma glucose decreased slightly, no significant post-treatment change in insulin resistance was observed. The study received ethical approval from the Ethics Committee of the Faculty of Medicine, Universitas Indonesia (ref KET-784/UN.2.F1/ETIK/PPM.00.02/2019) and was registered on clinicaltrials.gov (NCT05118542). Conclusion ATD treatment for GD led to a significant increase in total cholesterol, LDL-cholesterol, and high-density lipoprotein-cholesterol levels, along with a reduction in LDL-R levels. Both PTU and MMI showed similar effects. These findings provide valuable insights into the effects of ATDs on lipoproteins and insulin resistance in GD patients. Trial Registration ClinicalTrials.gov Identifier: NCT05118542.
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Affiliation(s)
- Wismandari Wisnu
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
- Metabolic Disorder, Cardiovascular and Aging Research Center, Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Idrus Alwi
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Nafrialdi Nafrialdi
- Department of Pharmacology and Therapeutics, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Tjokorda Gde Dalem Pemayun
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine Diponegoro University, Dr. Kariadi General Hospital, Semarang, Indonesia
| | - Nico Iswanto Pantoro
- Metabolic Disorder, Cardiovascular and Aging Research Center, Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Calysta Nadya Wijaya
- Metabolic Disorder, Cardiovascular and Aging Research Center, Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Dicky Levenus Tahapary
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
- Metabolic Disorder, Cardiovascular and Aging Research Center, Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Tri Juli Edi Tarigan
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
- Metabolic Disorder, Cardiovascular and Aging Research Center, Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Imam Subekti
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
- Metabolic Disorder, Cardiovascular and Aging Research Center, Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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Mansoori A, Ghiasi Hafezi S, Ansari A, Arab Yousefabadi S, Kolahi Ahari R, Darroudi S, Eshaghnezhad M, Ferns G, Ghayour-Mobarhan M, Esmaily H, Effati S. Serum Zinc and Copper Concentrations and Dyslipidemia as Risk Factors of Cardiovascular Disease in Adults: Data Mining Techniques. Biol Trace Elem Res 2024:10.1007/s12011-024-04288-0. [PMID: 38956010 DOI: 10.1007/s12011-024-04288-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024]
Abstract
This study aimed to examine the relationship between serum cholesterol levels and the ratio of zinc (Zn) and copper (Cu) in the blood serum and the incidence of cardiovascular disease (CVD). In Phase I of the study, 9704 individuals between the age of 35 and 65 years were recruited. Phase II of the cohort study comprised 7561 participants who completed the 10-year follow-up. The variables which were measured at the baseline of the study included gender, age, systolic blood pressure (SBP), diastolic blood pressure (DBP); biochemical parameters including serum Cu, Zn, copper-zinc ratio (Cu/Zn), zinc-copper ratio (Zn/Cu); fasted lipid profile consisting of triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL) as well as fasting serum glucose, and triglycerides-glucose (TyG) index. Decision tree (DT) and logical regression (LR) models were applied to examine the relationship between the aforementioned factors and CVD. CVD was diagnosed in 837 individuals (378 males and 459 females) out of 7561 participants. According to the LR models, SBP, TC, HDL, age, Zn/Cu, and TyG index for males and SBP, age, TyG index, HDL, TC, Cu/Zn, and Cu for females had the highest correlation with CVD (p-value ≤ 0.033). Based on the DT algorithm, 88% of males with SPB < 129.66 mmHg, younger age (age < 53 years), TyG index < 9.53, 173 ≤ TC < 187 mg/dL, and HDL ≥ 32 mg/dL had the lowest risk of CVD. Also, 98% of females with SBP < 128 mmHg, TyG index < 9.68, age < 44, TC < 222 mg/dL, and HDL ≥ 63.7 mg/dL had the lowest risk of CVD. It can be concluded that the Zn/Cu for men and Cu/Zn for women, along with dyslipidemia and SBP, could significantly predict the risk of CVD in this cohort from northeastern Iran.
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Affiliation(s)
- Amin Mansoori
- Department of Applied Mathematics, Faculty of Mathematical Sciences, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Somayeh Ghiasi Hafezi
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Arina Ansari
- Student Research Committee, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Sahar Arab Yousefabadi
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Rana Kolahi Ahari
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Susan Darroudi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Vascular and endovascular surgery research center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Eshaghnezhad
- Department of Applied Mathematics, Faculty of Basic Sciences, Shahid Sattari University of Aeronautical Science and Technology, Tehran, Iran
| | - Gordon Ferns
- Division of Medical Education, Brighton and Sussex Medical School, Brighton, UK
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
- Social Determinants of Health Research Center, Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Sohrab Effati
- Department of Applied Mathematics, Faculty of Mathematical Sciences, Ferdowsi University of Mashhad, Mashhad, Iran.
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Yin C, Hou Q, Qi Q, Han Q, Wang X, Wu S, Li K. Triglyceride-Glucose Index Predicts Major Adverse Cardiovascular and Cerebrovascular Events in Patients with Atrial Fibrillation. Int Heart J 2024; 65:373-379. [PMID: 38749753 DOI: 10.1536/ihj.23-413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
This study aimed to explore the relationship between the trajectory of the triglyceride-glucose (TyG) index and the occurrence of major adverse cardiovascular and cerebrovascular events (MACCE) in patients with atrial fibrillation (AF).This prospective study included 1979 patients with AF, who were initially selected from the Kailuan study. Patients of AF were split into four groups according to the value of TyG index. The clinical endpoint was MACCE, including myocardial infarction and ischemic stroke. Cox proportional hazard models were employed to examine the hazard ratio (HR) and 95% confidence interval (CI) for MACCE in various trajectory groups.The mean age of all patients with AF was 67.65 ± 11.15 years, and 1752 (88.53%) were male. Over a median follow-up duration of 5.31 years, in total 227 MACCE were recorded. MACCE cumulative incidence in Quartile 4 (26.96%) was significantly higher than those in other quartiles (P = 0.023). Multivariate Cox proportional hazards regression analysis showed that a higher TyG index (Quartile 4) was significantly and positively linked to MACCE in patients with AF (P = 0.023, HR: 2.103; 95% CI: 1.107-3.994).The evaluated TyG index is significantly associated with an increased risk of MACCE in patients with AF.
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Affiliation(s)
- Chunhui Yin
- Department of Cardiology, Tangshan Gongren Hospital
| | | | | | - Quanle Han
- Department of Cardiology, Tangshan Gongren Hospital
| | - Xiaoyao Wang
- College of Life Sciences, Hebei Normal University
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital
| | - Kangbo Li
- School of Clinical Medicine, North China University of Science and Technology
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin
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Bodaghi AB, Ebadi E, Gholami MJ, Azizi R, Shariati A. A decreased level of high-density lipoprotein is a possible risk factor for type 2 diabetes mellitus: A review. Health Sci Rep 2023; 6:e1779. [PMID: 38125279 PMCID: PMC10731824 DOI: 10.1002/hsr2.1779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/19/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction Type 2 diabetes mellitus (T2DM) is characterized primarily by dyslipidemia and hyperglycemia due to insulin resistance. High-density lipoprotein (HDL) play a significant role in preventing the incidence of dyslipidemia and its complications. HDL has different protective functions, such as reducing oxidation, vascular inflammation, and thrombosis; additionally, its anti-diabetic role is one of the most significant recent discoveries about HDL and some of its constituent lipoproteins. Methods This research reviews ongoing studies and preliminary investigations into the assessment of relation between decreased level of HDL and T2DM. Results The levels of HDL and its functions contribute to glucose hemostasis and the development of T2DM through four possible mechanisms, including insulin secretion by beta cells, peripheral insulin sensitivity, non-insulin-dependent glucose uptake, and adipose tissue metabolic activity. Additionally, the anti-oxidant properties of HDL protect beta cells from apoptosis caused by oxidative stress and inflammation induced by low-density lipoprotein, which facilitate insulin secretion. Conclusion Therefore, HDL and its compositions, especially Apo A-I, play an important role in regulating glucose metabolism, and decreased levels of HDL can be considered a risk factor for DM. Different factors, such as hypoalphalipoproteinemia that manifests as a consequence of genetic factors, such as Apo A-I deficiency, as well as secondary causes arising from lifestyle choices and underlying medical conditions that decrease the level of HDL, could be associated with DM. Moreover, intricate connections between HDL and diabetic complications extend beyond glucose metabolism to encompass complications like cardiovascular disease and kidney disease. Therefore, the exact interactions between HDL level and DM should be evaluated in future studies.
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Affiliation(s)
- Ali Bayat Bodaghi
- Student Research CommitteeKhomein University of Medical SciencesKhomeinIran
- Molecular and Medicine Research CentreKhomein University of Medical SciencesKhomeinIran
| | - Erfan Ebadi
- Student Research CommitteeKhomein University of Medical SciencesKhomeinIran
- Molecular and Medicine Research CentreKhomein University of Medical SciencesKhomeinIran
| | - Mohammad Javad Gholami
- Student Research CommitteeKhomein University of Medical SciencesKhomeinIran
- Molecular and Medicine Research CentreKhomein University of Medical SciencesKhomeinIran
| | - Reza Azizi
- Molecular and Medicine Research CentreKhomein University of Medical SciencesKhomeinIran
| | - Aref Shariati
- Molecular and Medicine Research CentreKhomein University of Medical SciencesKhomeinIran
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Martínez-Marroquín Y, Meaney A, Samaniego-Méndez V, Nájera N, Ceballos G, Fernández-Barros C, Meaney E. The TG/HDL-c Lipid Ratio as a Cardiovascular Risk Marker in a Mexican Urban Middle-Class Population: Do We Need a Risk Score Tailored for Mexicans? J Clin Med 2023; 12:6005. [PMID: 37762944 PMCID: PMC10531773 DOI: 10.3390/jcm12186005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/28/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION Risk scores are essential in primary prevention to detect high-risk patients. The most common scores exclude hypertriglyceridemia and abdominal obesity in their risk assessment. We examined the triglyceride/HDL-cholesterol (TG/HDL-c) ratio as a cardiovascular (CV) risk marker in a middle-class urban Mexican population sample. AIM Our aim was to test the concept of a scoring system reflecting Mexican population characteristics. METHODS A total of 2602 healthy adults from the Lindavista primary prevention program were considered, evaluating gender, age, blood pressure, smoking, body mass index, waist circumference, lipid profile, and fasting glucose. According to the abnormality, a score from -3 to +3 was assigned. RESULTS The summation of eleven variables yielded the Lindavista score (LS), which was calibrated versus the TG/HDL ratio and ACC ASCVD Risk Estimator Plus score to determine its correlation with risk categories. The TG/HDL-c ratio had a linear correlation with LS and high-risk ACC ASCVD categories. CONCLUSIONS Compared with LS and TG/HDL-c, the ACC ASCVD system underestimates the high-risk category. The high prevalence of obesity and lipid triad in the Mexican population requires a scale that considers those traits. The TG/HDL-c ratio is a practical, easy, and economical instrument to categorize risk in Mexicans.
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Affiliation(s)
| | - Alejandra Meaney
- Cardiovascular Unit, Hospital Regional “1° de Octubre”, ISSSTE, Lindavista, Mexico City 07760, Mexico
| | - Virginia Samaniego-Méndez
- Cardiovascular Unit, Hospital Regional “1° de Octubre”, ISSSTE, Lindavista, Mexico City 07760, Mexico
| | - Nayelli Nájera
- Laboratorio de Investigación Cardiometabólica Integral, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (N.N.); (G.C.)
| | - Guillermo Ceballos
- Laboratorio de Investigación Cardiometabólica Integral, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (N.N.); (G.C.)
| | | | - Eduardo Meaney
- Laboratorio de Investigación Cardiometabólica Integral, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (N.N.); (G.C.)
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Zachariah JP, Pena S, Lupo PJ, Putluri N, Penny DJ, Richard MA. Effect of exogenous l-carnitine on aortic stiffness in dyslipidemic adolescents: Design of a quadruple-blind, randomized, controlled interventional trial. Contemp Clin Trials Commun 2023; 34:101174. [PMID: 37448910 PMCID: PMC10338141 DOI: 10.1016/j.conctc.2023.101174] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 05/22/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Background Atherosclerotic cardiovascular disease (ASCVD) risk factors including vascular remodeling leading to hypertension and dyslipidemia are prevalent among children and adolescents. Conflicting observational and Mendelian randomization data suggest endogenous carnitine may affect arterial stiffness and lipid traits. Because of this, we developed a study to evaluate the causal role for carnitine in arterial stiffness at a point when the lifecourse trajectory to hypertension can be modified. Methods This study is a mechanistic, double-blinded, randomized control trial (RCT) in 166 adolescents with dyslipidemia for the effect of 6 months of maximum dose 3 g daily oral l-carnitine supplementation (CS+) versus placebo (CS-) on aortic stiffness measured as carotid-femoral pulse wave velocity (CFPWV) and pulse pressure (PP); lipid concentrations (total cholesterol, HDL-C, triglycerides, and LDL-C) and serum fatty acid oxidation biomarkers by metabolomic analysis. Conclusions The simultaneous evaluation of endogenous carnitine genetic effects and exogenous l-carnitine supplementation may facilitate future therapies for youth with cardiometabolic derangement to arrest atherosclerotic changes.
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Affiliation(s)
- Justin P. Zachariah
- Section of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Sandra Pena
- Section of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Philip J. Lupo
- Section of Hematology-Oncology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Nagireddy Putluri
- Department of Molecular and Cellular Biology, Dan L. Duncan Comprehensive Cancer Center, Advanced Technology Core, Alkek Center for Molecular Discovery, Baylor College of Medicine, Houston, TX, USA
| | - Daniel J. Penny
- Section of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Melissa A. Richard
- Section of Hematology-Oncology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
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Surugiu R, Burdusel D, Ruscu MA, Cercel A, Hermann DM, Cadenas IF, Popa-Wagner A. Clinical Ageing. Subcell Biochem 2023; 103:437-458. [PMID: 37120476 DOI: 10.1007/978-3-031-26576-1_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Ageing is generally characterised by the declining ability to respond to stress, increasing homeostatic imbalance, and increased risk of ageing-associated diseases . Mechanistically, the lifelong accumulation of a wide range of molecular and cellular impairments leads to organismal senescence. The aging population poses a severe medical concern due to the burden it places on healthcare systems and the general public as well as the prevalence of diseases and impairments associated with old age. In this chapter, we discuss organ failure during ageing as well as ageing of the hypothalamic-pituitary-adrenal axis and drugs that can regulate it. A much-debated subject is about ageing and regeneration. With age, there is a gradual decline in the regenerative properties of most tissues. The goal of regenerative medicine is to restore cells, tissues, and structures that are lost or damaged after disease, injury, or ageing. The question arises as to whether this is due to the intrinsic ageing of stem cells or, rather, to the impairment of stem-cell function in the aged tissue environment. The risk of having a stroke event doubles each decade after the age of 55. Therefore, it is of great interest to develop neurorestorative therapies for stroke which occurs mostly in elderly people. Initial enthusiasm for stimulating restorative processes in the ischaemic brain with cell-based therapies has meanwhile converted into a more balanced view, recognising impediments related to survival, migration, differentiation, and integration of therapeutic cells in the hostile aged brain environment. Therefore, a current lack of understanding of the fate of transplanted cells means that the safety of cell therapy in stroke patients is still unproven. Another issue associated with ischaemic stroke is that patients at risk for these sequels of stroke are not duly diagnosed and treated due to the lack of reliable biomarkers. However, recently neurovascular unit-derived exosomes in response to Stroke and released into serum are new plasma genetic and proteomic biomarkers associated with ischaemic stroke. The second valid option, which is also more economical, is to invest in prevention.
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Affiliation(s)
- Roxana Surugiu
- Experimental Research Centre for Normal and Pathological Aging, University of Medicine and Pharmacy of Craiova, Craiova, Romania
- University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Daiana Burdusel
- Experimental Research Centre for Normal and Pathological Aging, University of Medicine and Pharmacy of Craiova, Craiova, Romania
- University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Mihai-Andrei Ruscu
- Experimental Research Centre for Normal and Pathological Aging, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Andreea Cercel
- Stroke Pharmacogenomics and Genetics Group, Sant Pau Hospital Institute of Research, Barcelona, Spain
| | - Dirk M Hermann
- Experimental Research Centre for Normal and Pathological Aging, University of Medicine and Pharmacy of Craiova, Craiova, Romania
- University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Israel Fernandez Cadenas
- Stroke Pharmacogenomics and Genetics Group, Sant Pau Hospital Institute of Research, Barcelona, Spain
| | - Aurel Popa-Wagner
- Experimental Research Centre for Normal and Pathological Aging, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
- University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
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Muacevic A, Adler JR, Hameed A. Correlation of Insulin Resistance With Short-Term Outcome in Nondiabetic Patients With ST-Segment Elevation Myocardial Infarction. Cureus 2022; 14:e33093. [PMID: 36721561 PMCID: PMC9884116 DOI: 10.7759/cureus.33093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Obviously, hyperglycemia and insulin resistance (IR) are common in patients with acute ST-segment elevation myocardial infarction (STEMI). Additionally, IR is a substantial risk factor for cardiovascular diseases. The study aims to evaluate the association between IR and short-term outcomes of acute STEMI patients without diabetes mellitus in the form of reperfusion success, the occurrence of heart failure, the development of arrhythmias, and mortality. METHOD A cross-sectional study was done from August 2021 to December 2021 in two cardiology centers in Al-Sadr Teaching hospital and Basrah Oil hospital in Basrah, Southern Iraq. Sixty-one nondiabetic hospitalized patients with acute STEMI were included in the study. Twenty-five (41%) of them received thrombolytics and 36 (59%) were managed with percutaneous transluminal coronary angioplasty. From each patient, a fasting blood sample was taken for calculation of the Homeostasis Model Assessment for IR (HOMA-IR) and triglyceride glucose index (TyG) index. The patients were evaluated within 1-week for (reperfusion success, echocardiography for calculation of the ejection fraction (EF), arrhythmias, and mortality), and within 4-weeks for mortality. RESULTS Within the tertile 3 of the HOMA-IR and TyG index, significant higher 4-week mortality (35% and 30%, respectively). Pearson correlation also showed significant and negative correlations between both HOMA-IR and TyG index values and EF. While reperfusion success, arrhythmias, and 1-week mortality did not correlate significantly with both HOMA-IR and TyG index. CONCLUSION IR as defined by HOMA-IR and TyG index was significantly associated with poor outcomes in patients with acute STEMI in the form of EF<55 and 4-week mortality.
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Jeans MR, Ghaddar R, Vandyousefi S, Landry MJ, Gray MJ, Leidy HJ, Whittaker TA, Bray MS, Davis JN. Distinct racial and ethnic metabolic syndrome characteristics: A comparative assessment in low-income children 7-10 years of age. Pediatr Obes 2022; 17:e12925. [PMID: 35560860 DOI: 10.1111/ijpo.12925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/28/2022] [Accepted: 04/13/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Pediatric MetS prevalence varies due to lack of consensus on evaluative criteria and associated thresholds, with most not recommending a diagnosis <10 years. However, MetS risk components are becoming evident earlier in life and affect races and ethnicities disproportionately. OBJECTIVES To compare the prevalence of MetS based on existing definitions and elucidate racial- and ethnic-specific characteristics associated with MetS prevalence. METHODS The baseline and follow-up samples included 900 and 557 children 7-10 years, respectively. Waist circumference, BMI percentile, blood pressure, fasting plasma glucose (FPG), insulin, triglycerides, and high-density lipoprotein cholesterol (HDL-C) were measured. Agreement between MetS definitions was quantified via kappa statistics. MetS and risk factor prevalence and the predictability of metabolic parameters on MetS eight months later was evaluated via logistic regression. McFadden pseudo-R2 was reported as a measure of predictive ability, and the Akaike information criterion evaluated fit of each model. RESULTS The baseline sample was 55.0% male and 71.6% Hispanic, followed by non-Hispanic White (NHW) (17.3%) and non-Hispanic Black (NHB) (11.1%), with an average age of 9.2 years. MetS prevalence ranged from 7.6% to 21.4%, highest in Hispanic (9.0%-24.0%) and lowest in NHB children (4.0%-14.0%). Highest agreement was between Ford et al. and Cook et al. definitions (K = 0.88) and lowest agreements were consistently with the International Diabetes Federation criteria (K ≤ 0.57). Compared to NHW children, Hispanic children had higher odds for MetS (OR: 1.7; p = 0.03) and waist circumference, HDL-C, and FPG risk factors (p < 0.05), while NHB children had higher odds for the FPG risk factor (p ≤ 0.007) and lower odds for the plasma triglycerides risk factor (p = 0.002), across multiple MetS definitions. In longitudinal analyses, HDL-C was the strongest independent predictor of MetS in Hispanic and NHW children (p < 0.001 and p < 0.01, respectively), while plasma triglycerides was the strongest independent predictor of MetS in NHB children (p < 0.05). CONCLUSIONS MetS prevalence was high in children ≤10 years, and proposed criteria are susceptible to racial and ethnic bias, diagnosing some populations more than other populations with high cardiovascular risk. Earlier preventative measures should be imposed in clinical settings, accounting for racial and ethnic differences, to mitigate disease onset.
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Affiliation(s)
- Matthew R Jeans
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, Texas, USA
| | - Reem Ghaddar
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, Texas, USA
| | - Sarvenaz Vandyousefi
- Department of Medicine, New York University Grossman Medical Center, New York, New York, USA
| | - Matthew J Landry
- Stanford University, School of Medicine, Stanford Prevention Research Center, Palo Alto, California, USA
| | - Megan J Gray
- Department of Pediatrics, Dell Medical Center, The University of Texas at Austin, Austin, Texas, USA
| | - Heather J Leidy
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, Texas, USA.,Department of Pediatrics, Dell Medical Center, The University of Texas at Austin, Austin, Texas, USA
| | - Tiffany A Whittaker
- Department of Educational Psychology, College of Education, The University of Texas at Austin, Austin, Texas, USA
| | - Molly S Bray
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, Texas, USA
| | - Jaimie N Davis
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, Texas, USA
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González-González JG, Violante-Cumpa JR, Zambrano-Lucio M, Burciaga-Jimenez E, Castillo-Morales PL, Garcia-Campa M, Solis RC, González-Colmenero AD, Rodríguez-Gutiérrez R. HOMA-IR as a predictor of Health Outcomes in Patients with Metabolic Risk Factors: A Systematic Review and Meta-analysis. High Blood Press Cardiovasc Prev 2022; 29:547-564. [PMID: 36181637 DOI: 10.1007/s40292-022-00542-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/14/2022] [Indexed: 10/07/2022] Open
Abstract
INTRODUCTION There exists clinical interest in the following question: Is there an association between HOMA-IR and the risk of developing metabolic diseases? AIMS Assessing the association between high values of HOMA-IR with the incidence of T2DM, MACE, essential hypertension, dyslipidemia, NASH, and cancer in healthy participants and participants with a component of metabolic syndrome. METHODS Databases were searched by an experienced librarian to find eligible studies. Observational cohort studies enrolling healthy adults and adults with metabolic syndrome components that evaluated HOMA as a marker of IR were considered for inclusion. Eligibility assessment, data extraction and risk of bias assessment were performed independently and in duplicate. Baseline characteristics of patients, cutoff values of HOMA-IR to predict metabolic events were extracted independently and in duplicate. RESULTS 38 studies (215,878 participants) proved eligible. A higher HOMA-IR value had a significant effect on the risk of developing T2DM (HR 1.87; CI 1.40-2.49), presenting non-fatal MACE (HR 1.46; CI 1.08-1.97) and hypertension (HR 1.35; CI 1.15-1.59). No association was found regarding cancer mortality and fatal MACE with higher HOMA-IR values, there was not enough information to carry out a meta-analysis to establish an association between higher values of HOMA with cancer incidence, dyslipidemia, and NASH. CONCLUSIONS High values of HOMA were associated with an increased risk of diabetes, hypertension, and non-fatal MACE; yet, not for cardiovascular or cancer mortality. More research is needed to determine the value of the HOMA index in metabolic and cardiovascular outcomes. PROSPERO REGISTRATION NUMBER CRD42020187645.
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Affiliation(s)
- José G González-González
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Knowledge and Evaluation Research Unit, Mayo Clinic, 201 W. Center St, Rochester, MN, 55902, USA.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Jorge R Violante-Cumpa
- Division of Endocrinology, Internal Medicine Department, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Ave. Gonzalitos y Madero s/n 64460, Monterrey, Nuevo León, México.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Miguel Zambrano-Lucio
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Erick Burciaga-Jimenez
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Patricia L Castillo-Morales
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Mariano Garcia-Campa
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Ricardo César Solis
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Alejandro D González-Colmenero
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - René Rodríguez-Gutiérrez
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico. .,Knowledge and Evaluation Research Unit, Mayo Clinic, 201 W. Center St, Rochester, MN, 55902, USA. .,Division of Endocrinology, Internal Medicine Department, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Ave. Gonzalitos y Madero s/n 64460, Monterrey, Nuevo León, México. .,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.
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11
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Chikoti S, Najiya U, Sumanlatha G, Jahan P. Cytokine gene variants of TNF-α and IL-10 in the propensity of type 2 diabetes in south Indian population. J Diabetes Complications 2022; 36:108304. [PMID: 36148706 DOI: 10.1016/j.jdiacomp.2022.108304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/14/2022] [Accepted: 09/02/2022] [Indexed: 10/14/2022]
Abstract
Chronic inflammation plays an important role in type 2 diabetes mellitus (T2DM), a common endocrinological pro-inflammatory disorder associated with insulin resistance. The objective of the present study is to see individual and combined effect of TNF-α (rs361525, rs1800629) and IL-10 (rs1800872, rs1800896) genes on T2DM susceptibility The genotyping was carried out in 200 T2DM patients and 200 healthy controls by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) using suitable primers. The results shown that TNF-α (GA of rs361525 & rs1800629) and IL-10 (AA of rs1800872 & GA of rs1800896) genes are significantly linked with T2DM development. The presence of AA-GA genotype combination for both TNF-α and IL-10 genes were elevating the risk of T2DM. Moreover, individuals bearing haplotypes AAAA, AACA and AAAG experience the increased risk of T2DM. Furthermore, gene-gene interaction analysis shown that TNF-α (GA of rs361525 & rs1800896) gene redundantly confer 3.4-fold elevated risk for T2DM. In gene-environment interaction, GA of TNF-α -1800896, W/H ratio and TG/HDL ratio were redundantly interacted each other and increase the risk of T2DM by 67-times. In conclusion, our results reveal that there is a significant association between foresaid TNF-α, IL-10 gene promoter polymorphisms and T2DM development. To the best of our knowledge this study is the first of its kind in the literature reporting the epistatic association of TNF-α (rs1800629G/A) gene with TG/HDL ratio and W/H ratio over IL-10 gene polymorphisms for T2DM susceptibility among south Indians.
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Affiliation(s)
- Swetha Chikoti
- Department of Genetics, Osmania University, Hyderabad, India
| | - Umme Najiya
- Department of Genetics, Osmania University, Hyderabad, India
| | | | - Parveen Jahan
- School of Sciences, Maulana Azad National Urdu University, Hyderabad, India.
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12
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Insulin resistance in children. Curr Opin Pediatr 2022; 34:400-406. [PMID: 35796641 DOI: 10.1097/mop.0000000000001151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Insulin resistance (IR) is a clinical condition due to the decline in the efficiency of insulin promoting glucose uptake and utilization. The aim of this review is to provide an overview of the current knowledge on IR in children, focusing on its physiopathology, the most appropriate methods of measurement of IR, the assessment of risk factors, the effects of IR in children, and finally giving indications on screening and treatment. RECENT FINDINGS IR has evolved more and more to be a global public health problem associated with several chronic metabolic diseases. SUMMARY Detecting a correct measurement method and specific risk predictors, in order to reduce the incidence of IR, represents a challenging goal.
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Shi D, Wang L, Cong H. Association between Triglycerides to High-Density Lipoprotein Cholesterol Ratio and Death Risk in Diabetic Patients with New-Onset Acute Coronary Syndrome: A Retrospective Cohort Study in the Han Chinese Population. Rev Cardiovasc Med 2022; 23:190. [PMID: 39077180 PMCID: PMC11273665 DOI: 10.31083/j.rcm2306190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/07/2022] [Accepted: 04/15/2022] [Indexed: 07/31/2024] Open
Abstract
Background and Aims The incidence of diabetes mellitus has reached an alarming level. Cardiovascular disease (CVD) is the leading cause of mortality in diabetic patients. However, the association between ratio and survival outcomes in patients with diabetes mellitus (DM) and new-onset acute coronary syndrome (ACS) remains unknown. This study aimed to assess the association between the TG/HDLC ratio and the risk of death in diabetic patients with new-onset acute coronary syndrome in the Han Chinese population. Methods Data in this study were retrospectively collected from January 2016 to December 2016 from patients with type 2 diabetes mellitus (T2DM) and new-onset ACS in Tianjin Chest Hospital. Patients were classified according to the baseline TG/HDLC ratio. Kaplan-Meier survival curves were used to demonstrate survival outcomes. Univariate and multivariate Cox proportional risk regression analyses were used to evaluate the hazard ratios and 95% confidence intervals (CIs) for the risk of death. Subgroup analysis was used to determine the presence of any interaction. Results In total, 152 patients died, 98 of them from heart disease. The Kaplan-Meier survival curve showed that there were no significant differences for both all-cause and cardiac mortality between Median 1 and Median 2 in log-rank test. Multivariate Cox regression analyses revealed that the adjusted hazard ratio increased significantly (p < 0.05) with increasing median TG/HDLC for not only all-cause mortality and cardiac death, but also nonfatal stroke, fatal stroke and fatal MI. The association between the TG/HDLC ratio and the risks of all-cause mortality and cardiac death in diabetic patients with new-onset ACS was similar among subgroups (p > 0.05). Conclusions An elevated TG/HDLC ratio (TG/HDLC > 1.522) is associated with an increased risk of all-cause and cardiac death risks in diabetic patients with new-onset ACS. Therefore, TG/HDLC ratio may be a beneficial parameter to evaluate the prognosis of this high-risk population.
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Affiliation(s)
- Dongdong Shi
- Clinical College of Thoracic Medicine, Tianjin Medical University, 300070 Tianjin, China
| | - Le Wang
- Department of Cardiology, Tianjin Chest Hospital, 300222 Tianjin, China
| | - Hongliang Cong
- Department of Cardiology, Tianjin Chest Hospital, 300222 Tianjin, China
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14
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Fillmore N, Hou V, Sun J, Springer D, Murphy E. Cardiac specific knock-down of peroxisome proliferator activated receptor α prevents fasting-induced cardiac lipid accumulation and reduces perilipin 2. PLoS One 2022; 17:e0265007. [PMID: 35259201 PMCID: PMC8903264 DOI: 10.1371/journal.pone.0265007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/18/2022] [Indexed: 11/19/2022] Open
Abstract
While fatty acid metabolism is altered under physiological conditions, alterations can also be maladaptive in diseases such as diabetes and heart failure. Peroxisome Proliferator Activated Receptor α (PPARα) is a transcription factor that regulates fat metabolism but its role in regulating lipid storage in the heart is unclear. The aim of this study is to improve our understanding of how cardiac PPARα regulates cardiac health and lipid accumulation. To study the role of cardiac PPARα, tamoxifen inducible cardiac-specific PPARα knockout mouse (cPPAR-/-) were treated for 5 days with tamoxifen and then studied after 1–2 months. Under baseline conditions, cPPAR-/- mice appear healthy with normal body weight and mortality is not altered. Importantly, cardiac hypertrophy or reduced cardiac function was also not observed at baseline. Mice were fasted to elevate circulating fatty acids and induce cardiac lipid accumulation. After fasting, cPPAR-/- mice had dramatically lower cardiac triglyceride levels than control mice. Interestingly, cPPAR-/- hearts also had reduced Plin2, a key protein involved in lipid accumulation and lipid droplet regulation, which may contribute to the reduction in cardiac lipid accumulation. Overall, this suggests that a decline in cardiac PPARα may blunt cardiac lipid accumulation by decreasing Plin2 and that independent of differences in systemic metabolism a decline in cardiac PPARα does not seem to drive pathological changes in the heart.
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Affiliation(s)
- Natasha Fillmore
- Laboratory of Cardiac Physiology, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
- Department of Pharmaceutical Sciences, North Dakota State University, Fargo, North Dakota, United States of America
- * E-mail:
| | - Vincent Hou
- Laboratory of Cardiac Physiology, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Junhui Sun
- Laboratory of Cardiac Physiology, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Danielle Springer
- Murine Phenotyping Core, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Elizabeth Murphy
- Laboratory of Cardiac Physiology, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
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15
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Al-Naemi A. Establishing a Reference Interval for an Estimate of Peripheral Insulin Resistance in a Group of Iraqi People. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background and aims: Insulin resistance (IR) is the cornerstone in pathophysiology of T2DM. Identifying people with IR can slow the progress to diabetes. Triglyceride and glucose index (TyG index) is a simple tool to assess IR without insulin measurement. This study aims at establishing the reference interval for TyG index in apparently healthy Iraqis. Material and method: This study involved (77) apparently healthy adults (41 men and 36 women) in Mosul, Iraq. Fasting Serum lipids, glucose and insulin were measured and BMI was calculated. The modified TyG index was calculated and compared to other surrogate measures of IR and its reference interval was calculated. Results: TyG index values were normally distributed and significantly correlated with HOMA-IR, Mc-Auley index, QUICKI, and triglycerides/ HDL-c index (r= 0.322, p= 0.004; r=-0.68, p<0001; r= -0.29, p=0.01; r=0.84, p<0.0001respectively). ANOVA and PostHoc Duncan’s analyses revealed significant differences in mean TyG between (lean people) and (overweight and obese subjects), (p=0.02). BMI- based TyG reference intervals were calculated as (4.11- 4.91) and (4.25- 5.05) respectively. This is the first study in Iraq to set a reference interval for TyG index. Values should be interpreted according to BMI.
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Causal Inference of Carnitine on Blood Pressure and potential mediation by uric acid: A mendelian randomization analysis. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2021; 11:200120. [PMID: 34901954 PMCID: PMC8640447 DOI: 10.1016/j.ijcrp.2021.200120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 02/07/2023]
Abstract
Background Dietary change alters blood pressure (BP) but the specific causal dietary elements are unclear. Given previous observational data suggesting serum carnitine or uric acid affect BP, we investigated the role of serum carnitine and serum uric acid concentrations on BP, and considered mediation by lipids and insulin resistance using two-sample bi-directional Mendelian randomization (MR) analysis. Methods We performed MR to characterize bi-directional causal relationships of carnitine or uric acid on cardiometabolic traits. We performed two-sample MR using genome-wide association summary data from separate large-scale genomic analyses of carnitine, uric acid, BP, lipids, and glycemic traits. We used inverse variance weighted (IVW) meta-analysis and MR Egger regression to test for causal relations in the absence and presence of pleiotropy, respectively, and performed sensitivity analyses to identify confounders and intermediates. Results In our analysis, carnitine was directly, causally associated with systolic BP (IVW effect = 0.2, causal p-value = 0.03) but not diastolic BP (IVW causal p = 0.1). Our findings additionally support direct and indirect relationships of carnitine on TG and on uric acid. No causal associations of carnitine were found with glycemic traits. Uric acid was not associated with BP, nor TG. Conclusion Two-sample bi-directional MR demonstrated an unconfounded causal effect of carnitine, but not uric acid, on systolic but not diastolic BP, suggesting a role of carnitine in arterial stiffness. Carnitine, but not uric acid, also has direct and indirect effects on TG but are independent of the causal effect of carnitine on systolic BP.
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Nickel NP, Galura GM, Zuckerman MJ, Hakim MN, Alkhateeb H, Mukherjee D, Austin ED, Heresi GA. Liver abnormalities in pulmonary arterial hypertension. Pulm Circ 2021; 11:20458940211054304. [PMID: 34707859 PMCID: PMC8544777 DOI: 10.1177/20458940211054304] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/13/2021] [Indexed: 12/17/2022] Open
Abstract
Pulmonary arterial hypertension (PAH) is a cardiopulmonary disease with high mortality. In recent years, it has been recognized that PAH is a multi-organ system disease, involving the systemic circulation, kidneys, skeletal muscles, and the central nervous system, among others. Right heart failure produces congestive hepatopathy, a disease state that has direct consequences on liver biochemistry, histology, and systemic glucose and lipid metabolism. This article aims to summarize the consequences of congestive hepatopathy with an emphasis on liver biochemistry, histology, and PAH-targeted therapy. Furthermore, PAH-specific changes in glucose and lipid metabolism will be discussed.
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Affiliation(s)
- Nils P. Nickel
- Division of Pulmonary and Critical Care Medicine, Texas Tech
University Health Sciences Center, El Paso, TX, USA
| | - Gian M. Galura
- Division of Gastroenterology, Texas Tech University Health
Sciences Center, El Paso, TX, USA
| | - Marc J. Zuckerman
- Division of Gastroenterology, Texas Tech University Health
Sciences Center, El Paso, TX, USA
| | - M. Nawar Hakim
- Department of Pathology, Texas Tech University Health Sciences
Center, El Paso, TX, USA
| | - Haider Alkhateeb
- Division of Cardiovascular Medicine, Texas Tech University
Health Sciences Center, El Paso, TX, USA
| | - Debabrata Mukherjee
- Division of Cardiovascular Medicine, Texas Tech University
Health Sciences Center, El Paso, TX, USA
| | - Eric D. Austin
- Division of Pediatric Pulmonary Medicine, Vanderbilt University,
Nashville, TN, USA
| | - Gustavo A. Heresi
- Division of Pulmonary and Critical Care Medicine, Cleveland
Clinic, OH, USA
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Cirillo M, Boddi M, Coccia ME, Attanasio M, Fatini C. Ectopic Fat Depots and Cardiometabolic Burden: A Possible Dangerous Liaison in Women Planning Assisted Reproduction. J Family Reprod Health 2021; 15:118-124. [PMID: 34721601 PMCID: PMC8520667 DOI: 10.18502/jfrh.v15i2.6453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: We evaluated cardiometabolic burden in women planning assisted reproduction in order to identify subgroups at higher risk of pregnancy complications and cardiovascular disease. Materials and methods: In this cross-sectional study we investigated 60 infertile women with BMI≥25 kg/m2 referred to the Center for Assisted Reproduction. All women underwent metabolic, anthropometric parameters and ultrasound evaluation of ectopic fat depots. Results: All women had waist ≥80 cm. We found that 93.3% of women had pathological subcutaneous, 58.3% visceral and 80% para-perirenal fat; all women had fatty liver. Visceral fat and severity of steatosis were significantly related to the presence of metabolic syndrome (OR =5.7; p=0.03).A significant negative correlation between low HDL-c and para-perirenal fat (p<0.0001), a significant positive correlation with fasting plasma glucose and para-perirenal fat (p=0.001) were found. We observed a significant positive correlation between visceral fat and hs-CRP (p=0.002), HOMA-IR (p=0.04) and triglycerides (p=0.002), a significant negative correlation with HDL-c (p=0.05). Conclusion: This study by highlighting a clinically "dangerous liaison" between ectopic fat depots and metabolic/inflammatory markers, might permit to identify women with a worse metabolic phenotype and encourage lifestyle changes for improving their general and reproductive health together.
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Affiliation(s)
- Michela Cirillo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
| | - Maria Boddi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Monica Attanasio
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
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Diaz A, Muñoz-Arenas G, Venegas B, Vázquez-Roque R, Flores G, Guevara J, Gonzalez-Vergara E, Treviño S. Metforminium Decavanadate (MetfDeca) Treatment Ameliorates Hippocampal Neurodegeneration and Recognition Memory in a Metabolic Syndrome Model. Neurochem Res 2021; 46:1151-1165. [PMID: 33559829 DOI: 10.1007/s11064-021-03250-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 01/02/2021] [Accepted: 01/19/2021] [Indexed: 02/07/2023]
Abstract
The consumption of foods rich in carbohydrates, saturated fat, and sodium, accompanied by a sedentary routine, are factors that contribute to the progress of metabolic syndrome (MS). In this way, they cause the accumulation of body fat, hypertension, dyslipidemia, and hyperglycemia. Additionally, MS has been shown to cause oxidative stress, inflammation, and death of neurons in the hippocampus. Consequently, spatial and recognition memory is affected. It has recently been proposed that metformin decavanadate (MetfDeca) exerts insulin mimetic effects that enhance metabolism in MS animals; however, what effects it can cause on the hippocampal neurons of rats with MS are unknown. The objective of the work was to evaluate the effect of MetfDeca on hippocampal neurodegeneration and recognition memory in rats with MS. Administration of MetfDeca for 60 days in MS rats improved object recognition memory (NORt). In addition, MetfDeca reduced markers of oxidative stress and hippocampal neuroinflammation. Accompanied by an increase in the density and length of the dendritic spines of the hippocampus of rats with MS. We conclude that MetfDeca represents an important therapeutic agent to treat MS and induce neuronal and cognitive restoration mechanisms.
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Affiliation(s)
- Alfonso Diaz
- Faculty of Chemical Sciences, Benemerita Autonomous University of Puebla, Puebla, Pue, Mexico
| | - Guadalupe Muñoz-Arenas
- Faculty of Chemical Sciences, Benemerita Autonomous University of Puebla, Puebla, Pue, Mexico
| | - Berenice Venegas
- Faculty of Biological Sciences, Benemerita Autonomous University of Puebla, Puebla, Pue, Mexico
| | - Rubén Vázquez-Roque
- Laboratory of Neuropsychiatry, Institute of Physiology, Benemerita Autonomous University of Puebla, Puebla, Pue, Mexico
| | - Gonzalo Flores
- Laboratory of Neuropsychiatry, Institute of Physiology, Benemerita Autonomous University of Puebla, Puebla, Pue, Mexico
| | - Jorge Guevara
- Department of Biochemistry, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | | | - Samuel Treviño
- Faculty of Chemical Sciences, Benemerita Autonomous University of Puebla, Puebla, Pue, Mexico.
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Weighted gene co-expression network analysis to identify key modules and hub genes related to hyperlipidaemia. Nutr Metab (Lond) 2021; 18:24. [PMID: 33663541 PMCID: PMC7934476 DOI: 10.1186/s12986-021-00555-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 02/24/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The purpose of this study was to explore the potential molecular targets of hyperlipidaemia and the related molecular mechanisms. METHODS The microarray dataset of GSE66676 obtained from patients with hyperlipidaemia was downloaded. Weighted gene co-expression network (WGCNA) analysis was used to analyse the gene expression profile, and the royal blue module was considered to have the highest correlation. Gene Ontology (GO) functional and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were implemented for the identification of genes in the royal blue module using the Database for Annotation, Visualization and Integrated Discovery (DAVID) online tool (version 6.8; http://david.abcc.ncifcrf.gov ). A protein-protein interaction (PPI) network was established by using the online STRING tool. Then, several hub genes were identified by the MCODE and cytoHubba plug-ins in Cytoscape software. RESULTS The significant module (royal blue) identified was associated with TC, TG and non-HDL-C. GO and KEGG enrichment analyses revealed that the genes in the royal blue module were associated with carbon metabolism, steroid biosynthesis, fatty acid metabolism and biosynthesis pathways of unsaturated fatty acids. SQLE (degree = 17) was revealed as a key molecule associated with hypercholesterolaemia (HCH), and SCD was revealed as a key molecule associated with hypertriglyceridaemia (HTG). RT-qPCR analysis also confirmed the above results based on our HCH/HTG samples. CONCLUSIONS SQLE and SCD are related to hyperlipidaemia, and SQLE/SCD may be new targets for cholesterol-lowering or triglyceride-lowering therapy, respectively.
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Abdulwahab DA, El-Missiry MA, Shabana S, Othman AI, Amer ME. Melatonin protects the heart and pancreas by improving glucose homeostasis, oxidative stress, inflammation and apoptosis in T2DM-induced rats. Heliyon 2021; 7:e06474. [PMID: 33748504 PMCID: PMC7970364 DOI: 10.1016/j.heliyon.2021.e06474] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/11/2020] [Accepted: 03/05/2021] [Indexed: 02/08/2023] Open
Abstract
Cardiomyopathy and pancreatic injury are health issues associated with type 2 diabetes mellitus (T2DM) and are characterized by elevated oxidative stress, inflammation and apoptosis. Melatonin (MLT) is a hormone with multifunctional antioxidant activity. The protective effects of MLT on the heart and pancreas during the early development of diabetic cardiomyopathy and pancreatic injury were investigated in male Wistar rats with T2DM. MLT (10 mg/kg) was administered daily by gavage for 15 days after diabetic induction. Treatment of diabetic rats with MLT significantly normalized the levels of serum glucose, HbA1-c, and the lipid profile and improved the insulin levels and insulin resistance compared with diabetic rats, affirming its antidiabetic effect. MLT significantly prevented the development of oxidative stress and sustained the levels of glutathione and glutathione peroxidase activity in the heart and pancreas of diabetic animals, indicating its antioxidant capacity. Additionally, MLT prevented the increase in proinflammatory cytokines and expression of Bax, caspase-3 and P53. Furthermore, MLT enhanced the anti-inflammatory cytokine IL-10 and antiapoptotic protein Bcl-2. MLT controlled the levels of troponin T and creatine kinase-MB and lactate dehydrogenase activity, indicating its anti-inflammatory and antiapoptotic effects. Histological examinations confirmed the protective effects of MLT on T2DM-induced injury in the myocardium, pancreas and islets of Langerhans. In conclusion, the protective effects of melatonin on the heart and pancreas during the early development of T2DM are attributed to its antihyperglycemic, antilipidemic and antioxidant influences as well as its remarkable anti-inflammatory and antiapoptotic properties.
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Affiliation(s)
| | | | - Sameh Shabana
- Faculty of Science, Mansoura University, Mansoura, Egypt
| | - Azza I. Othman
- Faculty of Science, Mansoura University, Mansoura, Egypt
| | - Maggie E. Amer
- Faculty of Science, Mansoura University, Mansoura, Egypt
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Chávez-Castillo M, Ortega Á, Duran P, Pirela D, Marquina M, Cano C, Salazar J, Gonzalez MC, Bermúdez V, Rojas-Quintero J, Velasco M. Phytotherapy for Cardiovascular Disease: A Bench-to-Bedside Approach. Curr Pharm Des 2021; 26:4410-4429. [PMID: 32310044 DOI: 10.2174/1381612826666200420160422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 04/13/2020] [Indexed: 11/22/2022]
Abstract
At present, cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, and global trends suggest that this panorama will persist or worsen in the near future. Thus, optimization of treatment strategies and the introduction of novel therapeutic alternatives for CVD represent key objectives in contemporary biomedical research. In recent years, phytotherapy-defined as the therapeutic use of whole or minimally modified plant components-has ignited large scientific interest, with a resurgence of abundant investigation on a wide array of medicinal herbs (MH) for CVD and other conditions. Numerous MH have been observed to intervene in the pathophysiology of CVD via a myriad of molecular mechanisms, including antiinflammatory, anti-oxidant, and other beneficial properties, which translate into the amelioration of three essential aspects of the pathogenesis of CVD: Dyslipidemia, atherosclerosis, and hypertension. Although the preclinical data in this scenario is very rich, the true clinical impact of MH and their purported mechanisms of action is less clear, as large-scale robust research in this regard is in relatively early stages and faces important methodological challenges. This review offers a comprehensive look at the most prominent preclinical and clinical evidence currently available concerning the use of MH in the treatment of CVD from a bench-to-bedside approach.
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Affiliation(s)
- Mervin Chávez-Castillo
- Psychiatric Hospital of Maracaibo, Maracaibo, Venezuela,Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Ángel Ortega
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Pablo Duran
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Daniela Pirela
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - María Marquina
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Climaco Cano
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Juan Salazar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | | | - Valmore Bermúdez
- Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla, Colombia
| | - Joselyn Rojas-Quintero
- Pulmonary and Critical Care Medicine Department, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Manuel Velasco
- Clinical Pharmacology Unit, School of Medicine José María Vargas, Central University of Venezuela, Caracas,
Venezuela
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23
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Aslam M, Mishra BK, Goyal S, Siddiqui AA, Madhu SV. Family history of diabetes determines the association of HOMA-IR with fasting and postprandial triglycerides in individuals with normal glucose tolerance. J Clin Lipidol 2021; 15:227-234. [PMID: 33334713 DOI: 10.1016/j.jacl.2020.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/26/2020] [Accepted: 11/03/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Individuals with family history of diabetes carry nearly double the risk of diabetes than those without. However, the mechanism for this increased risk of diabetes in them is not fully understood. OBJECTIVE To study fasting and postprandial triglyceride levels in individuals with normal glucose tolerance (NGT) who had family history of diabetes and to ascertain their association with insulin resistance. METHODS Fasting triglyceride levels and HOMA-IR were compared in 671 NGT individuals with and without a family history of diabetes. A standardized fat challenge test was also done in one tenth of individuals of each group and postprandial triglyceride responses were compared between them. Association of HOMA-IR with fasting and postprandial triglyceride levels was ascertained through pearson's coefficient of correlation. RESULTS Individuals with family history of diabetes had significantly higher HOMA-IR (P < 0.001) and significantly higher postprandial triglyceride AUC (P = 0.04) after standardized fat meal despite having similar fasting triglyceride levels (P = 0.51) as those without family history of diabetes. Fasting as well as postprandial triglyceride levels significantly correlated with HOMA-IR (r = 0.35, P < 0.001 and r = 0.39, P = 0.04) only in those with a positive family history of diabetes but not in those without. Triglyceride levels mediated the associations of BMI (Δ β = -0.053) and waist circumference (Δ β = -0.075) with HOMA-IR. CONCLUSION Triglyceride levels, both in the fasting and the postprandial state are associated with insulin resistance in NGT individuals with a family history of diabetes but not in those without.
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Affiliation(s)
- Mohammad Aslam
- Department of Endocrinology, Centre for Diabetes Endocrinology & Metabolism, University College of Medical Sciences (University of Delhi) & GTB Hospital, Delhi, India
| | - Brijesh Kumar Mishra
- Department of Endocrinology, Centre for Diabetes Endocrinology & Metabolism, University College of Medical Sciences (University of Delhi) & GTB Hospital, Delhi, India
| | - Sandeep Goyal
- Department of Endocrinology, Centre for Diabetes Endocrinology & Metabolism, University College of Medical Sciences (University of Delhi) & GTB Hospital, Delhi, India
| | - Azaz Ahmad Siddiqui
- Department of Endocrinology, Centre for Diabetes Endocrinology & Metabolism, University College of Medical Sciences (University of Delhi) & GTB Hospital, Delhi, India
| | - Sri Venkata Madhu
- Department of Endocrinology, Centre for Diabetes Endocrinology & Metabolism, University College of Medical Sciences (University of Delhi) & GTB Hospital, Delhi, India.
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O'Neill BJ. Effect of low-carbohydrate diets on cardiometabolic risk, insulin resistance, and metabolic syndrome. Curr Opin Endocrinol Diabetes Obes 2020; 27:301-307. [PMID: 32773574 DOI: 10.1097/med.0000000000000569] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW An obesity epidemic has resulted in increasing prevalence of insulin resistance, hyperinsulinemia, metabolic syndrome (MetS), and cardiovascular disease (CVD). The Diet-Heart Hypothesis posited that dietary fat is the culprit. Yet dietary fat reduction has contributed to the problem, not resolved it. The role of hyperinsulinemia, the genesis of its atherogenic dyslipidemia and systemic inflammation in CVD and its reversal is reviewed. RECENT FINDINGS Overnutrition leads to weight gain and carbohydrate intolerance creating a vicious cycle of insulin resistance/hyperinsulinemia inhibiting fat utilization and encouraging fat storage leading to an atherogenic dyslipidemia characterized by hypertriglyceridemia, low HDL, and small dense LDL. The carbohydrate-insulin model better accounts for the pathogenesis of obesity, MetS, and ultimately type 2 diabetes (T2DM) and CVD. Ketogenic Diets reduce visceral obesity, increase insulin sensitivity, reverse the atherogenic dyslipidemia and the inflammatory biomarkers of overnutrition. Recent trials show very high adherence to ketogenic diet for up to 2 years in individuals with T2DM, reversing their metabolic, inflammatory and dysglycemic biomarkers as well as the 10-year estimated atherosclerotic risk. Diabetes reversal occurred in over 50% and complete remission in nearly 8%. SUMMARY Therapeutic carbohydrate-restricted can prevent or reverse the components of MetS and T2DM.
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Affiliation(s)
- Blair J O'Neill
- Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
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25
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Yoshino M, Kayser BD, Yoshino J, Stein RI, Reeds D, Eagon JC, Eckhouse SR, Watrous JD, Jain M, Knight R, Schechtman K, Patterson BW, Klein S. Effects of Diet versus Gastric Bypass on Metabolic Function in Diabetes. N Engl J Med 2020; 383:721-732. [PMID: 32813948 PMCID: PMC7456610 DOI: 10.1056/nejmoa2003697] [Citation(s) in RCA: 159] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Some studies have suggested that in people with type 2 diabetes, Roux-en-Y gastric bypass has therapeutic effects on metabolic function that are independent of weight loss. METHODS We evaluated metabolic regulators of glucose homeostasis before and after matched (approximately 18%) weight loss induced by gastric bypass (surgery group) or diet alone (diet group) in 22 patients with obesity and diabetes. The primary outcome was the change in hepatic insulin sensitivity, assessed by infusion of insulin at low rates (stages 1 and 2 of a 3-stage hyperinsulinemic euglycemic pancreatic clamp). Secondary outcomes were changes in muscle insulin sensitivity, beta-cell function, and 24-hour plasma glucose and insulin profiles. RESULTS Weight loss was associated with increases in mean suppression of glucose production from baseline, by 7.04 μmol per kilogram of fat-free mass per minute (95% confidence interval [CI], 4.74 to 9.33) in the diet group and by 7.02 μmol per kilogram of fat-free mass per minute (95% CI, 3.21 to 10.84) in the surgery group during clamp stage 1, and by 5.39 (95% CI, 2.44 to 8.34) and 5.37 (95% CI, 2.41 to 8.33) μmol per kilogram of fat-free mass per minute in the two groups, respectively, during clamp stage 2; there were no significant differences between the groups. Weight loss was associated with increased insulin-stimulated glucose disposal, from 30.5±15.9 to 61.6±13.0 μmol per kilogram of fat-free mass per minute in the diet group and from 29.4±12.6 to 54.5±10.4 μmol per kilogram of fat-free mass per minute in the surgery group; there was no significant difference between the groups. Weight loss increased beta-cell function (insulin secretion relative to insulin sensitivity) by 1.83 units (95% CI, 1.22 to 2.44) in the diet group and by 1.11 units (95% CI, 0.08 to 2.15) in the surgery group, with no significant difference between the groups, and it decreased the areas under the curve for 24-hour plasma glucose and insulin levels in both groups, with no significant difference between the groups. No major complications occurred in either group. CONCLUSIONS In this study involving patients with obesity and type 2 diabetes, the metabolic benefits of gastric bypass surgery and diet were similar and were apparently related to weight loss itself, with no evident clinically important effects independent of weight loss. (Funded by the National Institutes of Health and others; ClinicalTrials.gov number, NCT02207777.).
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Affiliation(s)
- Mihoko Yoshino
- From the Center for Human Nutrition (M.Y., B.D.K., J.Y., R.I.S., D.R., K.S., B.W.P., S.K.) and the Department of Surgery (J.C.E., S.R.E.), Washington University School of Medicine, St. Louis; and the Departments of Medicine (J.D.W., M.J.), Pharmacology (J.D.W., M.J.), Pediatrics (R.K.), and Computer Science and Engineering (R.K.), University of California San Diego, San Diego
| | - Brandon D Kayser
- From the Center for Human Nutrition (M.Y., B.D.K., J.Y., R.I.S., D.R., K.S., B.W.P., S.K.) and the Department of Surgery (J.C.E., S.R.E.), Washington University School of Medicine, St. Louis; and the Departments of Medicine (J.D.W., M.J.), Pharmacology (J.D.W., M.J.), Pediatrics (R.K.), and Computer Science and Engineering (R.K.), University of California San Diego, San Diego
| | - Jun Yoshino
- From the Center for Human Nutrition (M.Y., B.D.K., J.Y., R.I.S., D.R., K.S., B.W.P., S.K.) and the Department of Surgery (J.C.E., S.R.E.), Washington University School of Medicine, St. Louis; and the Departments of Medicine (J.D.W., M.J.), Pharmacology (J.D.W., M.J.), Pediatrics (R.K.), and Computer Science and Engineering (R.K.), University of California San Diego, San Diego
| | - Richard I Stein
- From the Center for Human Nutrition (M.Y., B.D.K., J.Y., R.I.S., D.R., K.S., B.W.P., S.K.) and the Department of Surgery (J.C.E., S.R.E.), Washington University School of Medicine, St. Louis; and the Departments of Medicine (J.D.W., M.J.), Pharmacology (J.D.W., M.J.), Pediatrics (R.K.), and Computer Science and Engineering (R.K.), University of California San Diego, San Diego
| | - Dominic Reeds
- From the Center for Human Nutrition (M.Y., B.D.K., J.Y., R.I.S., D.R., K.S., B.W.P., S.K.) and the Department of Surgery (J.C.E., S.R.E.), Washington University School of Medicine, St. Louis; and the Departments of Medicine (J.D.W., M.J.), Pharmacology (J.D.W., M.J.), Pediatrics (R.K.), and Computer Science and Engineering (R.K.), University of California San Diego, San Diego
| | - J Christopher Eagon
- From the Center for Human Nutrition (M.Y., B.D.K., J.Y., R.I.S., D.R., K.S., B.W.P., S.K.) and the Department of Surgery (J.C.E., S.R.E.), Washington University School of Medicine, St. Louis; and the Departments of Medicine (J.D.W., M.J.), Pharmacology (J.D.W., M.J.), Pediatrics (R.K.), and Computer Science and Engineering (R.K.), University of California San Diego, San Diego
| | - Shaina R Eckhouse
- From the Center for Human Nutrition (M.Y., B.D.K., J.Y., R.I.S., D.R., K.S., B.W.P., S.K.) and the Department of Surgery (J.C.E., S.R.E.), Washington University School of Medicine, St. Louis; and the Departments of Medicine (J.D.W., M.J.), Pharmacology (J.D.W., M.J.), Pediatrics (R.K.), and Computer Science and Engineering (R.K.), University of California San Diego, San Diego
| | - Jeramie D Watrous
- From the Center for Human Nutrition (M.Y., B.D.K., J.Y., R.I.S., D.R., K.S., B.W.P., S.K.) and the Department of Surgery (J.C.E., S.R.E.), Washington University School of Medicine, St. Louis; and the Departments of Medicine (J.D.W., M.J.), Pharmacology (J.D.W., M.J.), Pediatrics (R.K.), and Computer Science and Engineering (R.K.), University of California San Diego, San Diego
| | - Mohit Jain
- From the Center for Human Nutrition (M.Y., B.D.K., J.Y., R.I.S., D.R., K.S., B.W.P., S.K.) and the Department of Surgery (J.C.E., S.R.E.), Washington University School of Medicine, St. Louis; and the Departments of Medicine (J.D.W., M.J.), Pharmacology (J.D.W., M.J.), Pediatrics (R.K.), and Computer Science and Engineering (R.K.), University of California San Diego, San Diego
| | - Rob Knight
- From the Center for Human Nutrition (M.Y., B.D.K., J.Y., R.I.S., D.R., K.S., B.W.P., S.K.) and the Department of Surgery (J.C.E., S.R.E.), Washington University School of Medicine, St. Louis; and the Departments of Medicine (J.D.W., M.J.), Pharmacology (J.D.W., M.J.), Pediatrics (R.K.), and Computer Science and Engineering (R.K.), University of California San Diego, San Diego
| | - Kenneth Schechtman
- From the Center for Human Nutrition (M.Y., B.D.K., J.Y., R.I.S., D.R., K.S., B.W.P., S.K.) and the Department of Surgery (J.C.E., S.R.E.), Washington University School of Medicine, St. Louis; and the Departments of Medicine (J.D.W., M.J.), Pharmacology (J.D.W., M.J.), Pediatrics (R.K.), and Computer Science and Engineering (R.K.), University of California San Diego, San Diego
| | - Bruce W Patterson
- From the Center for Human Nutrition (M.Y., B.D.K., J.Y., R.I.S., D.R., K.S., B.W.P., S.K.) and the Department of Surgery (J.C.E., S.R.E.), Washington University School of Medicine, St. Louis; and the Departments of Medicine (J.D.W., M.J.), Pharmacology (J.D.W., M.J.), Pediatrics (R.K.), and Computer Science and Engineering (R.K.), University of California San Diego, San Diego
| | - Samuel Klein
- From the Center for Human Nutrition (M.Y., B.D.K., J.Y., R.I.S., D.R., K.S., B.W.P., S.K.) and the Department of Surgery (J.C.E., S.R.E.), Washington University School of Medicine, St. Louis; and the Departments of Medicine (J.D.W., M.J.), Pharmacology (J.D.W., M.J.), Pediatrics (R.K.), and Computer Science and Engineering (R.K.), University of California San Diego, San Diego
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Vinciguerra F, Tumminia A, Baratta R, Ferro A, Alaimo S, Hagnäs M, Graziano M, Vigneri R, Frittitta L. Prevalence and Clinical Characteristics of Children and Adolescents with Metabolically Healthy Obesity: Role of Insulin Sensitivity. Life (Basel) 2020; 10:life10080127. [PMID: 32731619 PMCID: PMC7459932 DOI: 10.3390/life10080127] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 02/06/2023] Open
Abstract
Obesity represents a major risk factor for metabolic disorders, but some individuals, "metabolically healthy" (MHO), show less clinical evidence of these complications, in contrast to "metabolically unhealthy" (MUO) individuals. The aim of this cross-sectional study is to assess the prevalence of the MHO phenotype in a cohort of 246 overweight/obese Italian children and adolescents, and to evaluate their characteristics and the role of insulin resistance. Homeostasis model assessment-insulin resistance (HOMA-IR), insulin sensitivity index (ISI), insulinogenic index (IGI) and disposition index (DI) were all calculated from the Oral Glucose Tolerance Test (OGTT). MHO was defined by either: (1) HOMA-IR < 2.5 (MHO-IRes), or (2) absence of the criteria for metabolic syndrome (MHO-MetS). The MHO prevalence, according to MHO-MetS or MHO-IRes criteria, was 37.4% and 15.8%, respectively. ISI was the strongest predictor of the MHO phenotype, independently associated with both MHO-IRes and MHO-MetS. The MHO-MetS group was further subdivided into insulin sensitive or insulin resistant on the basis of HOMA-IR (either < or ≥ 2.5). Insulin sensitive MHO-MetS patients had a better metabolic profile compared to both insulin resistant MHO-MetS and MUO-MetS individuals. These data underscore the relevance of insulin sensitivity to identifying, among young individuals with overweight/obesity, the ones who have a more favorable metabolic phenotype.
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Affiliation(s)
- Federica Vinciguerra
- Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy; (F.V.); (A.T.); (M.H.); (M.G.); (R.V.)
| | - Andrea Tumminia
- Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy; (F.V.); (A.T.); (M.H.); (M.G.); (R.V.)
| | - Roberto Baratta
- Diabetes, Obesity and Dietetic Center, Garibaldi-Nesima Medical Center, 95122 Catania, Italy;
| | - Alfredo Ferro
- Bionformatic Unit, Department of Clinical and Experimental Medicine, University of Catania, 95125 Catania, Italy; (A.F.); (S.A.)
| | - Salvatore Alaimo
- Bionformatic Unit, Department of Clinical and Experimental Medicine, University of Catania, 95125 Catania, Italy; (A.F.); (S.A.)
| | - Maria Hagnäs
- Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy; (F.V.); (A.T.); (M.H.); (M.G.); (R.V.)
- Center for Life Course Health Research, University of Oulu, 90570 Oulu, Finland
- Rovaniemi Health Center, 96200 Rovaniemi, Finland
| | - Marco Graziano
- Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy; (F.V.); (A.T.); (M.H.); (M.G.); (R.V.)
| | - Riccardo Vigneri
- Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy; (F.V.); (A.T.); (M.H.); (M.G.); (R.V.)
- Institute of Crystallography, Structural Chemistry and Biosystems, CNR-ICCSB, Catania Section, 95126 Catania, Italy
| | - Lucia Frittitta
- Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy; (F.V.); (A.T.); (M.H.); (M.G.); (R.V.)
- Diabetes, Obesity and Dietetic Center, Garibaldi-Nesima Medical Center, 95122 Catania, Italy;
- Correspondence: ; Tel.: +39-0957598702; Fax: +39-095472988
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Nowrouzi-Sohrabi P, Tabrizi R, Rezaei S, Jafari F, Hessami K, Abedi M, Jalali M, Keshavarzi P, Shahabi S, Kolahi AA, Carson-Chahhoud K, Sahebkar A, Safiri S. The effect of voglibose on metabolic profiles in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of clinical trials. Pharmacol Res 2020; 159:104988. [PMID: 32504833 DOI: 10.1016/j.phrs.2020.104988] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/12/2020] [Accepted: 05/29/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The effect of voglibose on metabolic homeostasis is not well characterized. Therefore, we conducted a systematic review and meta-analysis of clinical trials assessing the effect of voglibose on metabolic profile in patients with type 2 diabetes mellitus (T2DM). METHODS Systematic searches were conducted in PubMed, Scopus, Embase, Google Scholar, Web of Science and Cochrane Library to identify clinical trials assessing the effects of voglibose supplementation on cardio-metabolic profile from incept up to 29 July 2019. Data was pooled using fixed- or random-effect models and weighted mean difference (WMD) as the effect size. RESULTS Eight clinical trials from 1094 reports, were eligible for inclusion. Pooled findings identified significant reductions in hemoglobin A1c (HbA1c) (WMD= -0.27; 95 %CI -0.49 to -0.05; P = 0.01; I2 = 64.8 %) and an increase in LDL-cholesterol levels (WMD=5.97 mg/dl, 95 % CI 0.88, 11.06, P = 0.02; I2 = 0.0 %). However, no evidence of effect for voglibose intake on T2DM patients was observed for: fasting blood sugar (FBS) (WMD -7.43 mg/dl; 95 %CI -16.56 to 1.71; P = 0.110; I2 = 69.3 %), serum insulin (WMD= -0.15 μU/mL; 95 %CI -0.89 to 0.60; P = 0.70; I2 = 0.0 %), total-cholesterol (WMD=2.82 mg/dl, 95 %CI -2.36 to 8.01, P = 0.70; I2 = 49.7 %), triglycerides (WMD= -7.07 mg/dl, 95 %CI -21.76 to 7.62, P = 0.34; I2 = 0.0 %), HDL-cholesterol levels (WMD= -2.10 mg/dl, 95 %CI -4.48 to 0.27, P = 0.08; I2 = 0.0 %,), body mass index (BMI) (WMD=0.09 kg/m2, 95 %CI -0.70 to 0.87; P = 0.87; I2 = 0.0 %), body weight (WMD= -0.42 kg, 95 %CI -0.84 to 0.00; P = 0.05; I2 = 0.0 %), and adiponectin levels (WMD = 0.32 μg/mL, 95 %CI -0.74 to 1.38; P = 0.55; I2 = 0.0 %). CONCLUSIONS The current meta-analysis identified a decrease in HbA1c and an increase in LDL-cholesterol with administration of voglibose. However, no significant effect was observed on FBS, insulin, bodyweight, BMI, adiponectin, triglycerides, total- and HDL-cholesterol levels.
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Affiliation(s)
- Peyman Nowrouzi-Sohrabi
- Department of Biochemistry, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Tabrizi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahla Rezaei
- School of Nutrition and Food Sciences, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Jafari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Hessami
- Maternal-Fetal Medicine Research Center, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Abedi
- Department of Pharmaceutical Nanotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Jalali
- Nutrition Research Center, Student Research Committee, Shiraz University of Medical Sciences, Iran
| | - Pedram Keshavarzi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kristin Carson-Chahhoud
- Australian Centre for Precision Health, School of Health Sciences, University of South Australia, Australia
| | - Amirhossein Sahebkar
- Halal Research Center of IRI, FDA, Tehran, Iran; Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Saeid Safiri
- Social Determinants of Health Research Center, Department of Community Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
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Dzięgielewska-Gęsiak S, Stołtny D, Brożek A, Muc-Wierzgoń M, Wysocka E. Are insulin-resistance and oxidative stress cause or consequence of aging. Exp Biol Med (Maywood) 2020; 245:1260-1267. [PMID: 32469639 DOI: 10.1177/1535370220929621] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
IMPACT STATEMENT Insulin resistance is associated with oxidative stress leading to cardiovascular diseases. However, little research has been performed examining elderly individuals with or without insulin-resistance. We demonstrate that antioxidant defense systems alone is not able to abrogate insulin action in elderly individuals at high risk for atherosclerosis, whereas the combined oxidant-antioxidant markers (thiobarbituric acid-reacting substances (TBARS), Cu,Zn-superoxide dismutase (SOD-1), and total antioxidant status (TAS)) might be more efficient and perhaps produce better clinical outcome. In fact, a decrease in oxidative stress and strong interaction between antioxidant defense can be seen only among insulin-resistant elderly individuals. This is, in our opinion, valuable information for clinicians, since insulin-resistance is considered strong cardiovascular risk factor.
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Affiliation(s)
| | - Dorota Stołtny
- Department of Internal Medicine, Medical University of Silesia in Katowice, Bytom 41-902, Poland
| | - Alicja Brożek
- Department of Clinical Biochemistry and Laboratory Medicine, Poznan University of Medical Sciences, Poznan 60-806, Poland
| | - Małgorzata Muc-Wierzgoń
- Department of Internal Medicine, Medical University of Silesia in Katowice, Bytom 41-902, Poland
| | - Ewa Wysocka
- Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan 60-569, Poland
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Chen Z, Chen G, Qin H, Cai Z, Huang J, Chen H, Wu W, Chen Z, Wu S, Chen Y. Higher triglyceride to high-density lipoprotein cholesterol ratio increases cardiovascular risk: 10-year prospective study in a cohort of Chinese adults. J Diabetes Investig 2020; 11:475-481. [PMID: 31325411 PMCID: PMC7078082 DOI: 10.1111/jdi.13118] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 07/16/2019] [Accepted: 07/18/2019] [Indexed: 02/05/2023] Open
Abstract
AIMS/INTRODUCTION A higher ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) is considered as the independent risk index of cardiovascular (CV) events. However, cohort studies regarding this correlation are rarely reported, especially in the Chinese population. The aim of present study was to explore the relationship of the TG/HDL-C ratio with CV risks among Chinese adults during 10-year follow-up period. MATERIALS AND METHODS We carried out a prospective study using data obtained from 96,542 individuals in Kailuan, who were grouped through the median value (0.8533) of the TG/HDL-C ratio. Adverse outcomes mainly referred to major CV events. We used the person-years incidence and cumulative incidence to predict the morbidity. The risk of CV events was estimated through Cox proportional hazard models. RESULTS The mean age of the cohort was 51.5 ± 12.6 years, and 79.6% of participants were men. During a median follow-up period of 9.75 years, 5,422 major CV events occurred, including 1,312 myocardial infarction cases and 4,228 stroke cases. The cumulative incidence of myocardial infarction, stroke and total CV events was 1.36% (range 1.29-1.43%), 4.38% (range 4.25-4.51%) and 5.62% (range 5.47-5.76%), respectively. Compared with low the TG/HDL-C ratio (≤0.8533) group, the high TG/HDL-C ratio (>0.8533) group had higher morbidity of CV events. The hazard ratio of total CV events, stroke and myocardial infarction was 1.19 (95% CI 1.12-1.26), 1.11 (95% CI 1.03-1.18) and 1.50 (95% CI 1.33-1.70), respectively. Furthermore, the TG/HDL-C ratio and major CV events had a line-shaped relationship with each other. CONCLUSIONS Among the Chinese population, a higher TG/HDL-C ratio is correlated with an increased risk of major CV events.
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Affiliation(s)
- Zekai Chen
- Shantou University Medical CollegeShantouChina
- Department of CardiologySecond Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | | | - Hailun Qin
- Shantou University Medical CollegeShantouChina
- Department of CardiologySecond Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Zefeng Cai
- Shantou University Medical CollegeShantouChina
- Department of CardiologySecond Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Jianhuan Huang
- Shantou University Medical CollegeShantouChina
- Department of CardiologySecond Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Haojia Chen
- Shantou University Medical CollegeShantouChina
- Department of CardiologySecond Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Weiqiang Wu
- Department of CardiologySecond Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Zhichao Chen
- Department of CardiologySecond Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Shouling Wu
- Department of CardiologyKailuan HospitalNorth China University of Science and TechnologyTangshanChina
| | - Youren Chen
- Department of CardiologySecond Affiliated Hospital of Shantou University Medical CollegeShantouChina
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Iqbal J, Jahangir Z, Al-Qarni AA. Microsomal Triglyceride Transfer Protein: From Lipid Metabolism to Metabolic Diseases. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1276:37-52. [DOI: 10.1007/978-981-15-6082-8_4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Liu X, Yang Y, Kang F, Li J, Zhou M, Ma X, Yu T, Zhang T, Xue F. Cardiovascular Disease Risk Across a Spectrum of Adverse Plasma Lipid Combinations by Gender and Glycemic Status. Am J Cardiol 2019; 124:702-708. [PMID: 31311663 DOI: 10.1016/j.amjcard.2019.05.058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/14/2019] [Accepted: 05/20/2019] [Indexed: 01/17/2023]
Abstract
High triglycerides (TG), low high-density lipoprotein cholesterol (HDL-C) and high non-HDL-C levels are risk factors for cardiovascular disease (CVD). It is unclear whether the combinations of their adverse changes are related with CVD risk in different gender and diabetes status, particularly in Chinese population. This study aims to evaluate the CVD risk associated with different adverse lipid combinations. A total of 38,989 participants from Chinese Multicenter Longitudinal Health Management Cohorts (mean age 42 years; 62% male) without baseline CVD were followed up for incident CVD from 2007 to 2015. Participants with various combinations of baseline TG, non-HDL-C, and HDL-C levels within- or out of range according to Adult Treatment Panel III were grouped into 8 distinct lipid categories. Cox models estimated the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of different lipid categories for CVD. After multivariable adjustment, a low level of HDL-C combined with either a high level of non-HDL-C alone or TG alone were associated with increased CVD risk with adjusted HRs (95% CIs) of 1.77 (1.36 to 2.30) and 2.08 (1.30 to 3.34) in male participants. Diabetic participants with high non-HDL-C and low HDL-C levels (adjusted HR 2.93, 95% CI 1.15 to 7.46), and non-diabetic participants with high TG and low HDL-C levels (adjusted HR 1.73, 95% CI 1.33 to 2.26) had greater risk of incident CVD. These relations remained significant when limited analysis to participants with normal LDL-C levels of <3.4 mmol/L, indicating the various combinations of out-of-range lipid profiles other than LDL-C are associated with different CVD risk and the associations depend on gender and glycemic status.
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Affiliation(s)
- Xiaojuan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China; Healthcare Big Data Institute of Shandong University, Jinan, China
| | - Yachao Yang
- Health Management Center, Weihai Municipal Hospital, Weihai, China
| | - Fengling Kang
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China; Healthcare Big Data Institute of Shandong University, Jinan, China
| | - Jiqing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China; Healthcare Big Data Institute of Shandong University, Jinan, China
| | - Miao Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China; Healthcare Big Data Institute of Shandong University, Jinan, China
| | - Xiaotian Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China; Healthcare Big Data Institute of Shandong University, Jinan, China
| | - Tao Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China; Healthcare Big Data Institute of Shandong University, Jinan, China
| | - Tao Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China; Healthcare Big Data Institute of Shandong University, Jinan, China
| | - Fuzhong Xue
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China; Healthcare Big Data Institute of Shandong University, Jinan, China.
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Wang S, Li G, Zuo H, Yang H, Ma L, Feng J, Niu Y, Ma L, Liu S, Qi T, Liu X. Association of insulin, C-peptide and blood lipid patterns in patients with impaired glucose regulation. BMC Endocr Disord 2019; 19:75. [PMID: 31307454 PMCID: PMC6631747 DOI: 10.1186/s12902-019-0400-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 04/11/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To investigate any associations between blood glucose (BG) and lipid levels in patients with different glucose tolerance statuses, including type 2 diabetes (T2DM) and impaired glucose regulation (IGR) cases as well as normal glucose tolerance (NGT) individuals. METHODS A total of 354 participants were recruited to this study including 174 in the T2DM group, 112 in the IGR group and 68 in the NGT group. We compared BG, insulin and C-peptide (CP), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) serum levels during a 3 h oral glucose tolerance test (OGTT) in the 3 groups. RESULTS Basic overall HbA1c serum concentration percentages were 5.52, 6.33 and 9.76% for the NTG, IGR and T2DM cases. During the OGTT, insulin secretion in the IGR group was almost double that of the T2DM group. CP levels were highest in the IGR patients and OGTT related BG concentrations were highest in the T2DM group followed by IGR, but in the IGR group hyperglycemia was less pronounced than in T2DM patients (P < 0.001). Compared to the NGT group, TC, TG and LDL-C serum concentrations were significantly higher (P ≤ 0.001) and HDL-C concentrations were significantly lower (P ≤ 0.001) in IGR and T2DM cases compared to the NTG group. CONCLUSIONS IGR led to similar unfavorable blood lipid patterns compared with T2DM patients and an imbalance of insulin and CP serum concentrations during an OGTT.
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Affiliation(s)
- Shujin Wang
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Guohong Li
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Hong Zuo
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Hua Yang
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Lei Ma
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Jia Feng
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Yu Niu
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Liming Ma
- Department of Clinical laboratory, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Songfang Liu
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Ting Qi
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Xufeng Liu
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
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Tagi VM, Giannini C, Chiarelli F. Insulin Resistance in Children. Front Endocrinol (Lausanne) 2019; 10:342. [PMID: 31214120 PMCID: PMC6558106 DOI: 10.3389/fendo.2019.00342] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/13/2019] [Indexed: 12/28/2022] Open
Abstract
Insulin resistance (IR) is a pathological condition strongly associated with obesity. However, corticosteroids or growth hormone therapy and genetic diseases may affect insulin sensitivity lifelong. In obese children and adolescents of any age there is an evident association between IR and an increased prevalence of type 2 diabetes (T2D) and other elements contributing to the metabolic syndrome, leading to a higher cardiovascular risk. Therefore, early diagnosis and interventions in the attempt to prevent T2D when glycemia values are still normal is fundamental. The gold standard technique used to evaluate IR is the hyperinsulinemic euglycemic clamp, however it is costly and difficult to perform in clinical and research sets. Therefore, several surrogate markers have been proposed. Although the treatment of insulin resistance in children is firstly targeted to lifestyle interventions, in selected cases the integration of a pharmacological intervention might be taken into consideration. The aim of this review is to present the current knowledge on IR in children, starting with an outline of the recent evidences about the congenital forms of deficiency in insulin functioning and therefore focusing on the physiopathology of IR, its appropriate measurement, consequences, treatment options and prevention strategies.
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Chen TC, Lee RA, Tsai SL, Kanamaluru D, Gray NE, Yiv N, Cheang RT, Tan JH, Lee JY, Fitch MD, Hellerstein MK, Wang JC. An ANGPTL4-ceramide-protein kinase Cζ axis mediates chronic glucocorticoid exposure-induced hepatic steatosis and hypertriglyceridemia in mice. J Biol Chem 2019; 294:9213-9224. [PMID: 31053639 DOI: 10.1074/jbc.ra118.006259] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 05/01/2019] [Indexed: 01/01/2023] Open
Abstract
Chronic or excess glucocorticoid exposure causes lipid disorders such as hypertriglyceridemia and hepatic steatosis. Angptl4 (angiopoietin-like 4), a primary target gene of the glucocorticoid receptor in hepatocytes and adipocytes, is required for hypertriglyceridemia and hepatic steatosis induced by the synthetic glucocorticoid dexamethasone. Angptl4 has also been shown to be required for dexamethasone-induced hepatic ceramide production. Here, we further examined the role of ceramide-mediated signaling in hepatic dyslipidemia caused by chronic glucocorticoid exposure. Using a stable isotope-labeling technique, we found that dexamethasone treatment induced the rate of hepatic de novo lipogenesis and triglyceride synthesis. These dexamethasone responses were compromised in Angptl4-null mice (Angptl4-/-). Treating mice with myriocin, an inhibitor of the rate-controlling enzyme of de novo ceramide synthesis, serine palmitoyltransferase long-chain base subunit 1 (SPTLC1)/SPTLC2, decreased dexamethasone-induced plasma and liver triglyceride levels in WT but not Angptl4-/- mice. We noted similar results in mice infected with adeno-associated virus-expressing small hairpin RNAs targeting Sptlc2. Protein phosphatase 2 phosphatase activator (PP2A) and protein kinase Cζ (PKCζ) are two known downstream effectors of ceramides. We found here that mice treated with an inhibitor of PKCζ, 2-acetyl-1,3-cyclopentanedione (ACPD), had lower levels of dexamethasone-induced triglyceride accumulation in plasma and liver. However, small hairpin RNA-mediated targeting of the catalytic PP2A subunit (Ppp2ca) had no effect on dexamethasone responses on plasma and liver triglyceride levels. Overall, our results indicate that chronic dexamethasone treatment induces an ANGPTL4-ceramide-PKCζ axis that activates hepatic de novo lipogenesis and triglyceride synthesis, resulting in lipid disorders.
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Affiliation(s)
- Tzu-Chieh Chen
- From the Department of Nutritional Sciences & Toxicology.,the Metabolic Biology Graduate Program, and
| | - Rebecca A Lee
- From the Department of Nutritional Sciences & Toxicology.,the Endocrinology Graduate Program, University of California-Berkeley, Berkeley, California 94720-3104
| | - Sam L Tsai
- From the Department of Nutritional Sciences & Toxicology
| | | | - Nora E Gray
- From the Department of Nutritional Sciences & Toxicology.,the Metabolic Biology Graduate Program, and
| | - Nicholas Yiv
- From the Department of Nutritional Sciences & Toxicology
| | | | - Jenna H Tan
- From the Department of Nutritional Sciences & Toxicology
| | - Justin Y Lee
- From the Department of Nutritional Sciences & Toxicology
| | - Mark D Fitch
- From the Department of Nutritional Sciences & Toxicology
| | | | - Jen-Chywan Wang
- From the Department of Nutritional Sciences & Toxicology, .,the Metabolic Biology Graduate Program, and.,the Endocrinology Graduate Program, University of California-Berkeley, Berkeley, California 94720-3104
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Ida S, Kaneko R, Murata K. Efficacy and safety of pemafibrate administration in patients with dyslipidemia: a systematic review and meta-analysis. Cardiovasc Diabetol 2019; 18:38. [PMID: 30898163 PMCID: PMC6429757 DOI: 10.1186/s12933-019-0845-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 03/13/2019] [Indexed: 12/27/2022] Open
Abstract
Background Using a meta-analysis of randomized controlled trials (RCTs), this study aimed to investigate the efficacy and safety of pemafibrate, a novel selective peroxisome proliferator-activated receptor α modulator, in patients with dyslipidemia. Methods A search was performed using the MEDLINE, Cochrane Controlled Trials Registry, and ClinicalTrials.gov databases. We decided to employ RCTs to evaluate the effects of pemafibrate on lipid and glucose metabolism-related parameters in patients with dyslipidemia. For statistical analysis, standardized mean difference (SMD) or odds ratio (OR) and 95% confidence intervals (CIs) were calculated using the random effect model. Results Our search yielded seven RCTs (with a total of 1623 patients) that satisfied the eligibility criteria of this study; hence, those studies were incorporated into this meta-analysis. The triglyceride concentration significantly decreased in the pemafibrate group (SMD, − 1.38; 95% CI, − 1.63 to − 1.12; P < 0.001) than in the placebo group, with a reduction effect similar to that exhibited by fenofibrate. Compared with the placebo group, the pemafibrate group also showed improvements in high-density and non-high-density lipoprotein cholesterol levels as well as in homeostasis model assessment for insulin resistance. Furthermore, the pemafibrate group showed a significant decrease in hepatobiliary enzyme activity compared with the placebo and fenofibrate groups; and, total adverse events (AEs) were significantly lower in the pemafibrate group than in the fenofibrate group (OR, 0.60; 95% CI, 0.49–0.73; P < 0.001). In contrast, the low-density lipoprotein cholesterol level was significantly higher in the pemafibrate group than in the placebo (P = 0.006) and fenofibrate (P < 0.001) groups. Conclusions The lipid profile significantly improved in the pemafibrate group than in the placebo group. In addition to the pemafibrate group having an improved lipid profile, which was comparable with that of the fenofibrate group, the AEs were significantly lower than in the fenofibrate group and an improvement in hepatobiliary enzyme activity was also recognized. However, we believe that actual clinical data as well as long-term efficacy and safety need to be investigated in the future. Electronic supplementary material The online version of this article (10.1186/s12933-019-0845-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Satoshi Ida
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-2, Funae, 1-Chome, Ise-shi, Mie, 516-8512, Japan.
| | - Ryutaro Kaneko
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-2, Funae, 1-Chome, Ise-shi, Mie, 516-8512, Japan
| | - Kazuya Murata
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-2, Funae, 1-Chome, Ise-shi, Mie, 516-8512, Japan
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Ortega R, Grandes G, Sanchez A, Montoya I, Torcal J. Cardiorespiratory fitness and development of abdominal obesity. Prev Med 2019; 118:232-237. [PMID: 30414943 DOI: 10.1016/j.ypmed.2018.10.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/30/2018] [Accepted: 10/20/2018] [Indexed: 01/20/2023]
Abstract
Both, cardiorespiratory fitness and abdominal obesity are independently associated with developing cardiovascular disease and its risk factors. However, the relationship between both attributes is unclear. We examine the relationship between cardiorespiratory fitness and the risk of developing abdominal obesity, and secondarily, other adiposity measures. Retrospective observational study of a cohort of 1284 sedentary patients, who had participated in a clinical trial of physical activity promotion carried out in Spain (2003-2007). At baseline, they were free of cardiovascular disease, hypertension, diabetes, dyslipidemia and/or abdominal obesity, with an indirect VO2max measurement, were 19-80 years old, 62% women, and had completed the two year follow-up. The exposure factor was cardiorespiratory fitness categorized as high, moderate or low, according to tertiles of VO2max values. The main outcome measure was the risk of developing abdominal obesity, as defined by waist circumference >102 (men) and >88 (women) cm. Secondary outcomes were the risk of developing: general obesity, excess body fat, and their combination ("defined" obesity). At two years, 10.5% of the participants had developed abdominal obesity: 6.1% in the high cardiorespiratory fitness tertile, 9.7% in the moderate tertile (adjusted odds ratio, 1.20; 95% confidence interval 0.68-2.10), and 15.7% in the low tertile (adjusted odds ratio, 2.29; 95% confidence interval 1.34-3.91). Moreover, 2.2% of participants in the high cardiorespiratory fitness tertile developed "defined" obesity as did 5.4% in the low tertile (adjusted odds ratio, 2.90; 95% confidence interval 1.15-7.29). Low cardiorespiratory fitness levels are associated with a higher risk of developing abdominal and "defined" obesity.
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Affiliation(s)
- Ricardo Ortega
- Santa Barbara Primary Care Centre, Castilla-La Mancha Health Service, Esparteros 6, E-45006 Toledo, Spain.
| | - Gonzalo Grandes
- Primary Care Research Unit of Bizkaia, Basque Health Service (BHS), Luis Power 18, E-48014 Bilbao, Spain
| | - Alvaro Sanchez
- Primary Care Research Unit of Bizkaia, Basque Health Service (BHS), Luis Power 18, E-48014 Bilbao, Spain
| | - Imanol Montoya
- Primary Care Research Unit of Bizkaia, Basque Health Service (BHS), Luis Power 18, E-48014 Bilbao, Spain
| | - Jesús Torcal
- Basauri-Ariz Primary Care Centre, BHS, Nagusia, E-48970 Basauri, Spain
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Mahdavi S, Jenkins DJA, El-Sohemy A. Genetic variation in 9p21 is associated with fasting insulin in women but not men. PLoS One 2018; 13:e0202365. [PMID: 30138332 PMCID: PMC6107190 DOI: 10.1371/journal.pone.0202365] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 08/01/2018] [Indexed: 12/13/2022] Open
Abstract
Background Single nucleotide polymorphisms (SNPs) in the 9p21 region have been associated with cardiovascular disease (CVD), but previous studies have focussed on older populations. The objective of this study was to determine the association between 9p21 genotypes and biomarkers of CVD risk in young adults from different ethnocultural groups. Methods Subjects were 1,626 participants aged 20–29 years from the Toronto Nutrigenomics and Health Study. Fasting blood was collected to measure glucose, insulin, c-reactive protein and serum lipids, as well as to isolate DNA for genotyping subjects for five SNPs in 9p21. Analyses were conducted for the entire population and separately for women (n = 1,109), men (n = 517), Caucasians (n = 771), East Asians (n = 561) South Asians (n = 175) and Others (n = 119). ANOVA and ANCOVA were used to examine if 9p21 genotypes were associated with biomarkers of CVD risk. Results In the entire group, the risk alleles of rs10757278 and rs2383206 were associated with higher mean insulin (p = 0.01). Risk alleles for rs4977574, rs10757278, rs2383206, rs1333049 and rs10757274 were associated with higher serum insulin in women (p = 0.008, p = 0.008, p = 0.0003, p = 0.002, and p = 0.001, respectively), but not in men (p = 0.41, p = 0.13, p = 0.31, p = 0.34, and 0.35, respectively). The association between 9p21 and insulin remained significant among women not taking hormonal contraceptives (HC), but was not significant among women taking HCs. Conclusion Our findings suggest that 9p21 genotypes may play a role in the development of insulin resistance in early adulthood among women, but not men, and the effects appear to be attenuated by HC use.
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Affiliation(s)
- Sara Mahdavi
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - David J. A. Jenkins
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, Risk Factor Modification Centre and Division of Endocrinology and Metabolism, St. Michael's Hospital, St. Michael's Health Centre, Toronto, Ontario, Canada
| | - Ahmed El-Sohemy
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
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Bodhini D, Mohan V. Mediators of insulin resistance & cardiometabolic risk: Newer insights. Indian J Med Res 2018; 148:127-129. [PMID: 30381534 PMCID: PMC6206760 DOI: 10.4103/ijmr.ijmr_969_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Indexed: 01/08/2023] Open
Affiliation(s)
- Dhanasekaran Bodhini
- Dr. Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, WHO Collaborating Centre for Noncommunicable Diseases Prevention & Control, IDF Centre of Excellence in Diabetes Care & ICMR Centre for Advanced Research on Diabetes, Chennai 600 086, Tamil Nadu, India
| | - Viswanathan Mohan
- Dr. Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, WHO Collaborating Centre for Noncommunicable Diseases Prevention & Control, IDF Centre of Excellence in Diabetes Care & ICMR Centre for Advanced Research on Diabetes, Chennai 600 086, Tamil Nadu, India
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Kosmas CE, Silverio D, Tsomidou C, Salcedo MD, Montan PD, Guzman E. The Impact of Insulin Resistance and Chronic Kidney Disease on Inflammation and Cardiovascular Disease. CLINICAL MEDICINE INSIGHTS-ENDOCRINOLOGY AND DIABETES 2018; 11:1179551418792257. [PMID: 30083062 PMCID: PMC6071166 DOI: 10.1177/1179551418792257] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 07/07/2018] [Indexed: 12/13/2022]
Abstract
There is extensive evidence showing that insulin resistance (IR) is associated
with chronic low-grade inflammation. Furthermore, IR has been shown to increase
the risk for cardiovascular disease (CVD), even in nondiabetic patients, and is
currently considered as a “nontraditional” risk factor contributing to CVD by
promoting hypertension, oxidative stress, endothelial dysfunction, dyslipidemia,
and type 2 diabetes mellitus. However, chronic kidney disease (CKD) is also
considered a state of low-grade inflammation. In addition, CKD is considered an
IR state and has been described as an independent risk factor for the
development of CVD, as even early-stage CKD is associated with an estimated 40%
to 100% increase in CVD risk. There is also strong evidence indicating that
inflammation per se plays a crucial role in both the initiation and progression
of CVD. Given the above, the combined effect of IR and CKD may significantly
increase the risk of inflammation and CVD. This review aims to focus on the
complex interplay between IR, CKD, inflammation, and CVD and will present and
discuss the current clinical and scientific data pertaining to the impact of IR
and CKD on inflammation and CVD.
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Affiliation(s)
- Constantine E Kosmas
- Division of Cardiology, Department of Medicine, Mount Sinai Hospital, New York, NY, USA
| | - Delia Silverio
- Cardiology Clinic, Cardiology Unlimited PC, New York, NY, USA
| | - Christiana Tsomidou
- Department of Medicine, General Clinic of Piraeus "Hippocrates", Piraeus, Greece
| | - Maria D Salcedo
- Cardiology Clinic, Cardiology Unlimited PC, New York, NY, USA
| | - Peter D Montan
- Cardiology Clinic, Cardiology Unlimited PC, New York, NY, USA
| | - Eliscer Guzman
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA
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Adiels M, Chapman MJ, Robillard P, Krempf M, Laville M, Borén J. Niacin action in the atherogenic mixed dyslipidemia of metabolic syndrome: Insights from metabolic biomarker profiling and network analysis. J Clin Lipidol 2018; 12:810-821.e1. [DOI: 10.1016/j.jacl.2018.03.083] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/19/2018] [Accepted: 03/22/2018] [Indexed: 01/26/2023]
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Matsuba I, Matsuba R, Ishibashi S, Yamashita S, Arai H, Yokote K, Suganami H, Araki E. Effects of a novel selective peroxisome proliferator-activated receptor-α modulator, pemafibrate, on hepatic and peripheral glucose uptake in patients with hypertriglyceridemia and insulin resistance. J Diabetes Investig 2018; 9:1323-1332. [PMID: 29603684 PMCID: PMC6215940 DOI: 10.1111/jdi.12845] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 01/17/2018] [Accepted: 03/21/2018] [Indexed: 12/20/2022] Open
Abstract
AIMS/INTRODUCTION Pemafibrate is a novel selective peroxisome proliferator-activated receptor-α modulator with potent triglyceride-lowering and high-density lipoprotein cholesterol-raising effects. We showed that pemafibrate decreased the homeostatic model assessment for insulin resistance in patients with dyslipidemia. To investigate how pemafibrate improves insulin sensitivity, we used a hyperinsulinemic-euglycemic clamp technique to determine the splanchnic and peripheral glucose uptake in patients with hypertriglyceridemia and insulin resistance. MATERIALS AND METHODS A total of 27 patients with hypertriglyceridemia and insulin resistance were randomly assigned to receive pemafibrate (0.4 mg/day, b.i.d.) or placebo treatment for 12 weeks. The hyperinsulinemic-euglycemic clamp test combined with oral glucose loading was carried out at weeks 0 and 12 to evaluate the splanchnic and peripheral glucose uptake. RESULTS Pemafibrate, but not the placebo, significantly increased the splanchnic glucose uptake rate from baseline (19.6 ± 5.9% with P = 0.005 and 2.1 ± 7.4% with P = 0.78, respectively), although no significant difference between the groups was observed (P = 0.084). Conversely, peripheral glucose uptake rate was not significantly altered. Pemafibrate, compared with the placebo, significantly decreased plasma triglycerides (-61.4 ± 16.4% vs -2.5 ± 41.4%, P = 0.001), free fatty acids (-24.8 ± 23.2% vs 2.0 ± 26.8%, P = 0.016) and gamma-glutamyl transpeptidase (-30 ± 46 vs 10 ± 19 U/L, P = 0.009) levels, and significantly increased fibroblast growth factor 21 (457.7 ± 402.1 vs -41.7 ± 37.4 pg/mL, P = 0.007) levels. CONCLUSIONS Pemafibrate increased splanchnic glucose uptake from baseline in patients with hypertriglyceridemia.
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Affiliation(s)
| | - Ren Matsuba
- Department of Internal Medicine, Division of Metabolism and Endocrinology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Shizuya Yamashita
- Department of Community Medicine and Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.,Rinku General Medical Center, Osaka, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Koutaro Yokote
- Department of Clinical Cell Biology and Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hideki Suganami
- Clinical Data Science Department, Kowa Company, Ltd., Tokyo, Japan
| | - Eiichi Araki
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Chapman MJ, Orsoni A, Robillard P, Therond P, Giral P. Duality of statin action on lipoprotein subpopulations in the mixed dyslipidemia of metabolic syndrome: Quantity vs quality over time and implication of CETP. J Clin Lipidol 2018; 12:784-800.e4. [PMID: 29574070 DOI: 10.1016/j.jacl.2018.02.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 12/28/2017] [Accepted: 02/02/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Statins impact the metabolism, concentrations, composition, and function of circulating lipoproteins. OBJECTIVE We evaluated time course relationships between statin-mediated reduction in atherogenic apolipoprotein B (ApoB)-containing particles and dynamic intravascular remodeling of ApoAI-containing lipoprotein subpopulations in the mixed dyslipidemia of metabolic syndrome. METHODS Insulin-resistant, hypertriglyceridemic, hypercholesterolemic, obese males (n = 12) were treated with pitavastatin (4 mg/d) and response evaluated at 6, 42, and 180 days. RESULTS Reduction in low-density lipoprotein (LDL) cholesterol, ApoB, and triglycerides (TGs) was essentially complete at 42 days (-38%, -32%, and -35%, respectively); rapid reduction equally occurred in remnant cholesterol, ApoCII, CIII, and E levels (day 6; -35%, -50%, -23%, and -26%, respectively). Small dense LDLs (LDL4 and LDL5 subpopulations) predominated at baseline and were markedly reduced on treatment (-29% vs total LDL mass). Cholesteryl ester (CE) transfer protein activity and mass decreased progressively (-18% and -16%, respectively); concomitantly, TG depletion (up to -49%) and CE enrichment occurred in all high-density lipoprotein (HDL) particle subpopulations with normalization of CE/TG mass ratio at 180 days. ApoAI was redistributed from LpAI to LpAI:AII particles in HDL2a and HDL3a subpopulations; ApoCIII was preferentially depleted from LpAI:AII-rich particles on treatment. CONCLUSION Overall, statin action exhibits duality in mixed dyslipidemia, as CE transfer protein-mediated normalization of the HDL CE/TG core lags markedly behind subacute reduction in elevated levels of atherogenic ApoB-containing lipoproteins. Normalization of the HDL neutral lipid core is consistent with enhanced atheroprotective function. The HDL CE/TG ratio constitutes a metabolomic marker of perturbed HDL metabolism in insulin-resistant states, equally allowing monitoring of statin impact on HDL metabolism, structure, and function.
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Affiliation(s)
- M John Chapman
- National Institute for Health and Medical Research (INSERM), Pitié-Salpêtrière University Hospital, Paris, France; Department of Endocrinology-Metabolism, Pitié-Salpêtrière University Hospital, Paris, France; Pierre et Marie Curie University-Paris 6, Paris, France.
| | - Alexina Orsoni
- National Institute for Health and Medical Research (INSERM), Pitié-Salpêtrière University Hospital, Paris, France; Service de Biochimie, AP-HP, HUPS, Bicetre University Hospital, Le Kremlin Bicetre, France
| | - Paul Robillard
- National Institute for Health and Medical Research (INSERM), Pitié-Salpêtrière University Hospital, Paris, France
| | - Patrice Therond
- Service de Biochimie, AP-HP, HUPS, Bicetre University Hospital, Le Kremlin Bicetre, France; EA 7357, Paris-Sud University and Paris-Saclay University, Chatenay-Malabry, France
| | - Philippe Giral
- INSERM UMR1166 and Cardiovascular Prevention Units, ICAN-Institute of CardioMetabolism and Nutrition, AP-HP, Pitie-Salpetriere University Hospital, Paris, France
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Yang SH, Du Y, Li XL, Zhang Y, Li S, Xu RX, Zhu CG, Guo YL, Wu NQ, Qing P, Gao Y, Cui CJ, Dong Q, Sun J, Li JJ. Triglyceride to High-Density Lipoprotein Cholesterol Ratio and Cardiovascular Events in Diabetics With Coronary Artery Disease. Am J Med Sci 2017; 354:117-124. [PMID: 28864368 DOI: 10.1016/j.amjms.2017.03.032] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 03/07/2017] [Accepted: 03/20/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND It has been demonstrated that an elevated ratio of triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) is a risk factor of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM) and is also found to be associated with cardiovascular events (CVEs) in the general population. However, its prognostic value in patients with T2DM along with CAD remains to be determined. MATERIALS AND METHODS A total of 1,447 consecutive patients with T2DM with angiographic-proven stable CAD were enrolled in the present study and followed-up for an average of 20.3 months. The characteristics of all patients including fasting lipid profile were obtained at baseline and multivariate Cox proportional hazards models were constructed using log TG/HDL-C as a predictor variable. The relationships between CVEs and total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-HDL-C, TC/HDL-C, LDL-C/HDL-C and apolipoprotein B/ apolipoprotein AI (apoB/apoAI) were also explored. RESULTS Compared with patients without CVEs, the ones who experienced CVEs had a higher TG/HDL-C ratio. Univariable regression revealed a significant association of log TG/HDL-C with CVEs (hazard ratio = 2.5, P = 0.015). After adjusting for multiple traditional risk factors of cardiovascular disease, the association was still found (hazard ratio = 2.47, P = 0.047). Moreover, results suggested that the ratios of non-HDL-C, TC/HDL-C, LDL-C/HDL-C and apoB/apoAI were not predictors for CVEs in T2DM. CONCLUSIONS In our primary study, data suggested that elevated TG/HDL-C value might be a useful predictor for future CVEs in Chinese patients with T2DM with stable CAD. Further study is needed to confirm our findings.
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Affiliation(s)
- Sheng-Hua Yang
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Ying Du
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Xiao-Lin Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yan Zhang
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Sha Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Rui-Xia Xu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Cheng-Gang Zhu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yuan-Lin Guo
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Na-Qiong Wu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Ping Qing
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Ying Gao
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Chuan-Jue Cui
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Qian Dong
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Jing Sun
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Jian-Jun Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
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Hetherington-Rauth M, Bea JW, Lee VR, Blew RM, Funk J, Lohman TG, Going SB. Comparison of direct measures of adiposity with indirect measures for assessing cardiometabolic risk factors in preadolescent girls. Nutr J 2017; 16:15. [PMID: 28231807 PMCID: PMC5324258 DOI: 10.1186/s12937-017-0236-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 02/13/2017] [Indexed: 01/18/2023] Open
Abstract
Background Childhood overweight and obesity remains high, contributing to cardiometabolic risk factors at younger ages. It is unclear which measures of adiposity serve as the best proxies for identifying children at metabolic risk. This study assessed whether DXA-derived direct measures of adiposity are more strongly related to cardiometabolic risk factors in children than indirect measures. Methods Anthropometric and DXA measures of adiposity and a comprehensive assessment of cardiometabolic risk factors were obtained in 288, 9–12 year old girls, most being of Hispanic ethnicity. Multiple regression models for each metabolic parameter were run against each adiposity measure while controlling for maturation and ethnicity. In addition, regression models including both indirect and direct measures were developed to assess whether using direct measures of adiposity could provide a better prediction of the cardiometabolic risk factors beyond that of using indirect measures alone. Results Measures of adiposity were significantly correlated with cardiometabolic risk factors (p < 0.05) except fasting glucose. After adjusting for maturation and ethnicity, indirect measures of adiposity accounted for 29-34% in HOMA-IR, 10-13% in TG, 14-17% in HDL-C, and 5-8% in LDL-C while direct measures accounted for 29-34% in HOMA-IR, 10-12% in TG, 13-16% in HDL-C, and 5-6% in LDL-C. The addition of direct measures of adiposity to indirect measures added significantly to the variance explained for HOMA-IR (p = 0.04). Conclusion Anthropometric measures may perform as well as the more precise direct DXA-derived measures of adiposity for assessing most CVD risk factors in preadolescent girls. The use of DXA-derived adiposity measures together with indirect measures may be advantageous for predicting insulin resistance risk. Trial registration NCT02654262. Retrospectively registered 11 January 2016.
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Affiliation(s)
- Megan Hetherington-Rauth
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, 85721, USA. .,College of Agriculture and Life Sciences, Department of Nutritional Sciences, University of Arizona, Shantz Building, PO Box 210038, 1177 E. 4th Street, Tucson, AZ, 85721-0034, USA.
| | - Jennifer W Bea
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, 85721, USA.,Departments of Medicine, University of Arizona, Tucson, AZ, 85721, USA.,University of Arizona Cancer Center, Tucson, AZ, 85724, USA
| | - Vinson R Lee
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, 85721, USA
| | - Robert M Blew
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, 85721, USA
| | - Janet Funk
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, 85721, USA.,Departments of Medicine, University of Arizona, Tucson, AZ, 85721, USA
| | - Timothy G Lohman
- Department of Physiology, University of Arizona, Tucson, AZ, 85721, USA
| | - Scott B Going
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, 85721, USA
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The Prevalence of Metabolic Syndrome and Its Components among People with Type 2 Diabetes in the Ho Municipality, Ghana: A Cross-Sectional Study. Int J Chronic Dis 2017; 2017:8765804. [PMID: 28293668 PMCID: PMC5331170 DOI: 10.1155/2017/8765804] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 01/20/2017] [Accepted: 01/24/2017] [Indexed: 01/10/2023] Open
Abstract
The cooccurrence of diabetes mellitus and metabolic syndrome potentiates the cardiovascular risk associated with each of the conditions; therefore characterizing metabolic syndrome among people with type 2 diabetes is beneficial for the purpose of cardiovascular disease prevention. This study aims at evaluating the prevalence of metabolic syndrome and its components among 162 patients with type 2 diabetes attending the diabetic clinic of the Ho Municipal Hospital, Ghana. Data obtained included anthropometric indices, blood pressure, serum lipids, glucose, and sociodemographics and clinical information. The overall prevalence of metabolic syndrome among the study population was 43.83%, 63.58%, and 69.14% using the NCEP-ATP III, the WHO, and the IDF criteria, respectively. The most predominant component among the study population was high blood pressure using the NCEP-ATP III (108 (66.67%)) and WHO (102 (62.96)) criteria and abdominal obesity (112 (69.14%)) for IDF criteria. High blood pressure was the most prevalent component among the males while abdominal obesity was the principal component among the females. In this population with type 2 diabetes, high prevalence of metabolic syndrome exists. Gender vulnerability to metabolic syndrome and multiple cluster components were skewed towards the female subpopulation with type 2 diabetes.
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Quispe R, Martin SS, Jones SR. Triglycerides to high-density lipoprotein-cholesterol ratio, glycemic control and cardiovascular risk in obese patients with type 2 diabetes. Curr Opin Endocrinol Diabetes Obes 2016; 23:150-6. [PMID: 26863278 DOI: 10.1097/med.0000000000000241] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW This article provides an update on the role of the triglyceride to high-density lipoprotein-cholesterol (triglyceride/HDL-C) ratio in the setting of obesity-related insulin resistance and type 2 diabetes mellitus. RECENT FINDINGS Insulin resistance and type 2 diabetes mellitus are well-established risk factors for cardiovascular diseases, and are commonly associated with metabolic abnormalities such as hypertriglyceridemia, low HDL-C and presence of small, dense low-dense lipoprotein (LDL) particles. Mounting evidence suggests that the triglyceride/HDL-C ratio is a marker of insulin resistance, although this relationship might vary as a function of ethnicity and sex. The triglyceride/HDL-C ratio has also been shown to correlate with other atherogenic lipid measurements, such as triglyceride-rich lipoproteins, remnant cholesterol and small dense LDL particles. Recent epidemiologic studies have shown that the triglyceride/HDL-C ratio associates with cardiovascular risk, mainly because of its association with insulin resistance. Finally, triglyceride/HDL-C can also be a marker of glycemic control, especially in obese patients with type 2 diabetes mellitus. SUMMARY The triglyceride/HDL-C integrates information on triglyceride-rich lipoproteins, insulin resistance and glycemic control. Future studies may better define its specific clinical role.
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Affiliation(s)
- Renato Quispe
- aJohns Hopkins Ciccarone Center for the Prevention of Heart Disease bWelch Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Nayak BS, Jagessar A, Mohammed Z, Rampersad J, Ramkissoon S, Biswah S, Mohammed A, Maraj A, Rampersad C. Evaluation of N-terminal pro-B-type natriuretic peptide and high-sensitivity C-reactive protein relationship with features of metabolic syndrome in high-risk subgroups for cardiovascular disease. Int J Appl Basic Med Res 2015; 5:190-4. [PMID: 26539369 PMCID: PMC4606579 DOI: 10.4103/2229-516x.165369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aim: This study evaluating N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and high-sensitivity C-reactive protein (hs-CRP) relationship with features of the metabolic syndrome (MS) in high risk subgroups for cardiovascular disease (CVD) in Trinidad. Materials and Methods: The sample population consisted of 160 subjects, 78 of whom were African and 82 East Indian attending medical outpatient clinics of regional health authority hospitals of Trinidad. Results: Systolic blood pressure, triglycerides, glucose and insulin as well as NT-pro-BNP were elevated among the East Indian sub-population, with only systolic blood pressure being significantly elevated among the African sub-population. NT-pro-BNP and hs-CRP demonstrated significant correlations with respect to the majority of independent risk factors inclusive of Adult Treatment Panel III and American Association of Clinical Endocrinologists defined criteria for MS. NT-pro-BNP demonstrated stronger association among the East Indian sub-population as compared to that of the African sub-population. Conclusions: Our study showed that the East Indian subgroup was more at risk for CVD as evidenced by the fulfillment of the criteria for diagnosis of MS and therefore NT-pro-BNP and hs-CRP can be deemed a suitable marker for MS.
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Affiliation(s)
- Bijoor Shivananda Nayak
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Avinas Jagessar
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Zaryd Mohammed
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Jarryd Rampersad
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Solange Ramkissoon
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Shivonne Biswah
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Amisha Mohammed
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Aneela Maraj
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Christina Rampersad
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
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Tsuruya K, Yoshida H, Nagata M, Kitazono T, Iseki K, Iseki C, Fujimoto S, Konta T, Moriyama T, Yamagata K, Narita I, Kimura K, Kondo M, Asahi K, Kurahashi I, Ohashi Y, Watanabe T. Impact of the Triglycerides to High-Density Lipoprotein Cholesterol Ratio on the Incidence and Progression of CKD: A Longitudinal Study in a Large Japanese Population. Am J Kidney Dis 2015; 66:972-83. [PMID: 26145254 DOI: 10.1053/j.ajkd.2015.05.011] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 05/05/2015] [Indexed: 11/11/2022]
Abstract
BACKGROUND The impact of the triglycerides to high-density lipoprotein cholesterol (TG:HDL-C) ratio on chronic kidney disease (CKD) is unclear. STUDY DESIGN Longitudinal cohort study. SETTING & PARTICIPANTS 124,700 participants aged 39 to 74 years in the Japanese Specific Health Check and Guidance System, including 50,392 men, 74,308 women, 102,900 without CKD, and 21,800 with CKD. PREDICTOR Quartiles of TG:HDL-C ratio. OUTCOMES & MEASUREMENTS Changes in estimated glomerular filtration rate (eGFR) and urinary protein excretion during the 2-year study period. Incident CKD in participants without CKD, and progression of CKD in participants with CKD. RESULTS In the entire study population, higher quartile of TG:HDL-C ratio at baseline was significantly associated with greater decline in eGFR and increase in urinary protein excretion during the 2-year study period, even after adjustment for confounding factors. A higher ratio was associated with higher risk of incident CKD in participants without CKD and higher risk of rapid decline in eGFR and increase in urinary protein excretion in participants with CKD. Higher TG:HDL-C ratio was more strongly associated with decline in eGFR (P for interaction = 0.002) and with incident CKD (P for interaction = 0.05) in participants with diabetes than without diabetes. LIMITATIONS Short observation period and single measurement of all variables. CONCLUSIONS A higher TG:HDL-C ratio affects the decline in eGFR and incidence and progression of CKD in the Japanese population.
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Affiliation(s)
- Kazuhiko Tsuruya
- Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan.
| | - Hisako Yoshida
- Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masaharu Nagata
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kunitoshi Iseki
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | - Chiho Iseki
- Dialysis Unit, University Hospital of the Ryukyus, Okinawa, Japan
| | - Shouichi Fujimoto
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | - Tsuneo Konta
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | - Toshiki Moriyama
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | - Kunihiro Yamagata
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | - Ichiei Narita
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | - Kenjiro Kimura
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | - Masahide Kondo
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | - Koichi Asahi
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | | | - Yasuo Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Tokyo, Japan
| | - Tsuyoshi Watanabe
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
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Lin X, Zhang X, Guo J, Roberts CK, McKenzie S, Wu WC, Liu S, Song Y. Effects of Exercise Training on Cardiorespiratory Fitness and Biomarkers of Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc 2015; 4:JAHA.115.002014. [PMID: 26116691 PMCID: PMC4608087 DOI: 10.1161/jaha.115.002014] [Citation(s) in RCA: 423] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Guidelines recommend exercise for cardiovascular health, although evidence from trials linking exercise to cardiovascular health through intermediate biomarkers remains inconsistent. We performed a meta-analysis of randomized controlled trials to quantify the impact of exercise on cardiorespiratory fitness and a variety of conventional and novel cardiometabolic biomarkers in adults without cardiovascular disease. METHODS AND RESULTS Two researchers selected 160 randomized controlled trials (7487 participants) based on literature searches of Medline, Embase, and Cochrane Central (January 1965 to March 2014). Data were extracted using a standardized protocol. A random-effects meta-analysis and systematic review was conducted to evaluate the effects of exercise interventions on cardiorespiratory fitness and circulating biomarkers. Exercise significantly raised absolute and relative cardiorespiratory fitness. Lipid profiles were improved in exercise groups, with lower levels of triglycerides and higher levels of high-density lipoprotein cholesterol and apolipoprotein A1. Lower levels of fasting insulin, homeostatic model assessment-insulin resistance, and glycosylated hemoglobin A1c were found in exercise groups. Compared with controls, exercise groups had higher levels of interleukin-18 and lower levels of leptin, fibrinogen, and angiotensin II. In addition, we found that the exercise effects were modified by age, sex, and health status such that people aged <50 years, men, and people with type 2 diabetes, hypertension, dyslipidemia, or metabolic syndrome appeared to benefit more. CONCLUSIONS This meta-analysis showed that exercise significantly improved cardiorespiratory fitness and some cardiometabolic biomarkers. The effects of exercise were modified by age, sex, and health status. Findings from this study have significant implications for future design of targeted lifestyle interventions.
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Affiliation(s)
- Xiaochen Lin
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI (X.L., W.C.W., S.L.)
| | - Xi Zhang
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN (X.Z., Y.S.)
| | - Jianjun Guo
- Center for the Youth Sport Research and Development, China Institute of Sport Science, Beijing, China (J.G.)
| | - Christian K Roberts
- Geriatrics, Research, Education and Clinical Centers, VA Greater Los Angeles Healthcare System, Los Angeles, CA (C.K.R.)
| | - Steve McKenzie
- Department of Kinesiology, Center for Physical Activity in Wellness and Prevention, Indiana University-Purdue University at Indianapolis, IN (S.M.K.)
| | - Wen-Chih Wu
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI (X.L., W.C.W., S.L.) Division of Cardiology and Veterans Affairs Medical Center, Department of Medicine, Alpert Medical School, Brown University, Providence, RI (W.C.W., S.L.)
| | - Simin Liu
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI (X.L., W.C.W., S.L.) Division of Cardiology and Veterans Affairs Medical Center, Department of Medicine, Alpert Medical School, Brown University, Providence, RI (W.C.W., S.L.) Division of Endocrinology, Department of Medicine, Rhode Island Hospital, Providence, RI (S.L.)
| | - Yiqing Song
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN (X.Z., Y.S.)
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Kavey REW. Combined dyslipidemia in childhood. J Clin Lipidol 2015; 9:S41-56. [PMID: 26343211 DOI: 10.1016/j.jacl.2015.06.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 05/21/2015] [Accepted: 06/05/2015] [Indexed: 01/19/2023]
Abstract
Combined dyslipidemia (CD) is now the predominant dyslipidemic pattern in childhood, characterized by moderate-to-severe elevation in triglycerides and non-high-density lipoprotein cholesterol (non-HDL-C), minimal elevation in low-density lipoprotein cholesterol (LDL-C), and reduced HDL-C. Nuclear magnetic resonance spectroscopy shows that the CD pattern is represented at the lipid subpopulation level as an increase in small, dense LDL and in overall LDL particle number plus a reduction in total HDL-C and large HDL particles, a highly atherogenic pattern. In youth, CD occurs almost exclusively with obesity and is highly prevalent, seen in more than 40% of obese adolescents. CD in childhood predicts pathologic evidence of atherosclerosis and vascular dysfunction in adolescence and young adulthood, and early clinical cardiovascular events in adult life. There is a tight connection between CD, visceral adiposity, insulin resistance, nonalcoholic fatty liver disease, and the metabolic syndrome, suggesting an integrated pathophysiological response to excessive weight gain. Weight loss, changes in dietary composition, and increases in physical activity have all been shown to improve CD significantly in children and adolescents in short-term studies. Most importantly, even small amounts of weight loss are associated with significant decreases in triglyceride levels and increases in HDL-C levels with improvement in lipid subpopulations. Diet change focused on limitation of simple carbohydrate intake with specific elimination of all sugar-sweetened beverages is very effective. Evidence-based recommendations for initiating diet and activity change are provided. Rarely, drug therapy is needed, and the evidence for drug treatment of CD in childhood is reviewed.
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Affiliation(s)
- Rae-Ellen W Kavey
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA.
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