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Feitosa ADDM, Barroso WKS, Mion Junior D, Nobre F, Mota-Gomes MA, Jardim PCBV, Amodeo C, Oliveira AC, Alessi A, Sousa ALL, Brandão AA, Pio-Abreu A, Sposito AC, Pierin AMG, Paiva AMGD, Spinelli ACDS, Machado CA, Poli-de-Figueiredo CE, Rodrigues CIS, Forjaz CLDM, Sampaio DPS, Barbosa ECD, Freitas EVD, Cestario EDES, Muxfeldt ES, Lima Júnior E, Campana EMG, Feitosa FGAM, Consolim-Colombo FM, Almeida FAD, Silva GVD, Moreno Júnior H, Finimundi HC, Guimarães ICB, Gemelli JR, Barreto-Filho JAS, Vilela-Martin JF, Ribeiro JM, Yugar-Toledo JC, Magalhães LBNC, Drager LF, Bortolotto LA, Alves MADM, Malachias MVB, Neves MFT, Santos MC, Dinamarco N, Moreira Filho O, Passarelli Júnior O, Vitorino PVDO, Miranda RD, Bezerra R, Pedrosa RP, Paula RBD, Okawa RTP, Póvoa RMDS, Fuchs SC, Lima SGD, Inuzuka S, Ferreira-Filho SR, Fillho SHDP, Jardim TDSV, Guimarães Neto VDS, Koch VHK, Gusmão WDP, Oigman W, Nadruz Junior W. Brazilian Guidelines for In-office and Out-of-office Blood Pressure Measurement - 2023. Arq Bras Cardiol 2024; 121:e20240113. [PMID: 38695411 DOI: 10.36660/abc.20240113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/19/2024] Open
Affiliation(s)
- Audes Diogenes de Magalhães Feitosa
- Universidade Federal de Pernambuco (UFPE), Recife, PE - Brasil
- Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Recife, PE - Brasil
- Instituto de Assistência, Pesquisa e Ensino em Saúde (IAPES), Recife, PE - Brasil
| | | | - Decio Mion Junior
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Fernando Nobre
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP - Brasil
| | - Marco Antonio Mota-Gomes
- Centro Universitário CESMAC, Maceió, AL - Brasil
- Hospital do Coração de Alagoas, Maceió, AL - Brasil
- Centro de Pesquisas Clínicas Dr. Marco Mota, Maceió, AL - Brasil
| | | | - Celso Amodeo
- Hcor, Associação Beneficente Síria, São Paulo, SP - Brasil
| | | | | | - Ana Luiza Lima Sousa
- Faculdade de Enfermagem da Universidade Federal de Goiás (UFG), Goiânia, GO - Brasil
| | | | - Andrea Pio-Abreu
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Andrei C Sposito
- Universidade Estadual de Campinas (UNICAMP), Campinas, São Paulo - Brasil
| | | | | | | | | | | | - Cibele Isaac Saad Rodrigues
- Pontifícia Universidade Católica de São Paulo, Faculdade de Ciências Médicas e da Saúde,Sorocaba, SP - Brasil
| | | | | | | | | | | | - Elizabeth Silaid Muxfeldt
- Universidade Federal do Rio de Janeiro (UFRJ), Hospital Universitário Clementino Fraga Filho - Programa de Hipertensão Arterial Resistente (ProHArt), Rio de Janeiro, RJ - Brasil
- Instituto de Educação Médica (IDOMED) - Universidade Estácio de Sá, Rio de Janeiro, RJ - Brasil
| | | | | | - Fabiana Gomes Aragão Magalhães Feitosa
- Universidade Federal de Pernambuco (UFPE), Recife, PE - Brasil
- Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Recife, PE - Brasil
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, PE - Brasil
| | | | - Fernando Antônio de Almeida
- Pontifícia Universidade Católica de São Paulo, Faculdade de Ciências Médicas e da Saúde,Sorocaba, SP - Brasil
| | - Giovanio Vieira da Silva
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | | | | | | | | | | | | | - José Marcio Ribeiro
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, MG - Brasil
- Hospital Felício Rocho, Belo Horizonte, MG - Brasil
| | | | | | - Luciano F Drager
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Luiz Aparecido Bortolotto
- Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (Incor/FMUSP), São Paulo, SP - Brasil
| | | | - Marcus Vinícius Bolívar Malachias
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, MG - Brasil
- Fundação Educacional Lucas Machado (FELUMA), Belo Horizonte, MG - Brasil
| | | | - Mayara Cedrim Santos
- Universidade Federal de Pernambuco (UFPE), Recife, PE - Brasil
- Instituto de Assistência, Pesquisa e Ensino em Saúde (IAPES), Recife, PE - Brasil
| | - Nelson Dinamarco
- Colegiado de Medicina - Universidade Estadual de Santa Cruz (UESC), Ilhéus, BA - Brasil
| | | | | | | | | | - Rodrigo Bezerra
- Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Recife, PE - Brasil
- Laboratório de Imunopatologia Keizo Asami da Universidade Federal de Pernambuco, Recife, PE - Brasil
| | | | | | | | | | - Sandra C Fuchs
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brasil
| | | | - Sayuri Inuzuka
- Unidade de Hipertensão Arterial - NIPEE - LHA/UFG, Goiânia, GO - Brasil
| | | | | | | | | | - Vera Hermina Kalika Koch
- Instituto da Criança e do adolescente do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Waléria Dantas Pereira Gusmão
- Centro Universitário CESMAC, Maceió, AL - Brasil
- Universidade Estadual de Ciências da Saúde de Alagoas (UNCISAL), Maceió, AL - Brasil
| | - Wille Oigman
- Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ - Brasil
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Delgadillo-Centeno JS, Grover-Páez F, Hernández-González SO, Ramos-Zavala MG, Cardona-Müller D, López-Castro A, Pascoe-González S. Cinnamomum cassia on Arterial Stiffness and Endothelial Dysfunction in Type 2 Diabetes Mellitus: Outcomes of a Randomized, Double-Blind, Placebo-Controlled Clinical Trial. J Med Food 2023. [PMID: 37262194 DOI: 10.1089/jmf.2022.0089] [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: 06/03/2023] Open
Abstract
Cinnamomum cassia is a medicinal plant whose use has demonstrated benefits on body weight, blood pressure, glucose, and lipids. This study aimed to evaluate the effect of C. cassia on arterial stiffness and endothelial dysfunction (ED) in patients with type 2 diabetes mellitus (T2DM). A randomized, double-blind, placebo-controlled clinical trial was carried out in 18 subjects aged 40-65 years, with a diagnosis of T2DM of one year or less since diagnosis and treated with Metformin 850 mg daily. Patients were randomly assigned to receive either C. cassia or a placebo in 1000 mg capsules, thrice a day, before each meal for 12 weeks. At baseline and after 12 weeks of intervention, brachial-ankle pulse wave velocity and Flow Mediated Dilation were measured, as well as body weight, body mass index (BMI), blood pressure (BP), fasting glucose (FG), glycated hemoglobin A1c (HbA1c), total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, and very low density lipoprotein cholesterol, respectively, triglycerides, creatinine, and transaminases. The Mann-Whitney U test for differences between groups and the Wilcoxon signed-rank test for intragroup differences were used, and a P ≤ .05 was considered statistically significant. After C. cassia administration, statistically significant reductions in body weight (81.4 ± 10.4 kg vs. 79.9 ± 9.0 kg, P = .037), BMI (30.6 ± 4.2 kg/m2 vs. 30.1 ± 4.2 kg/m2, P = .018), and HbA1c (53 ± 5.4 mmol/mol vs. 45 ± 2.1 mmol/mol, P = .036) were observed. No changes statistically significant on arterial stiffness, ED, FG, BP, and lipids were observed. C. cassia administration decreases body weight, BMI, and HbA1c without statistically significant changes on arterial stiffness, ED, FG, BP, and lipids. CTR Number: NCT04259606.
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Affiliation(s)
- Jesús S Delgadillo-Centeno
- Instituto de Terapéutica Experimental y Clínica (INTEC), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara, Jalisco, México
| | - Fernando Grover-Páez
- Instituto de Terapéutica Experimental y Clínica (INTEC), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara, Jalisco, México
| | - Sandra O Hernández-González
- Unidad de Investigación Biomédica 02. Instituto Mexicano del Seguro Social (IMSS), Centro Médico Nacional de Occidente, Unidad Médica de Alta Especialidad (UMAE), Hospital de Especialidades, Guadalajara, Jalisco, México
| | - María G Ramos-Zavala
- Instituto de Terapéutica Experimental y Clínica (INTEC), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara, Jalisco, México
| | - David Cardona-Müller
- Instituto de Terapéutica Experimental y Clínica (INTEC), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara, Jalisco, México
| | - Alicia López-Castro
- Unidad de Investigación Biomédica 02. Instituto Mexicano del Seguro Social (IMSS), Centro Médico Nacional de Occidente, Unidad Médica de Alta Especialidad (UMAE), Hospital de Especialidades, Guadalajara, Jalisco, México
| | - Sara Pascoe-González
- Instituto de Terapéutica Experimental y Clínica (INTEC), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara, Jalisco, México
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3
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Influence of Blood Compressibility on Pulse Wave Propagation Properties Based on Elastic Thin-Walled Tube Theory. PHYSICAL ACTIVITY AND HEALTH 2023. [DOI: 10.5334/paah.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
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Dong Z, Zhao Y, Chen Y, Liu Z, Song H, Li H, Shi D, Zhou C, Zhou J, Liu R. Evaluating Atherosclerosis of the Abdominal Aorta in Rabbits Using 2-D Strain Imaging. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:2199-2206. [PMID: 35953348 DOI: 10.1016/j.ultrasmedbio.2022.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/05/2022] [Accepted: 05/22/2022] [Indexed: 06/15/2023]
Abstract
After establishment of an animal model of atherosclerosis, speckle tracking imaging was performed to analyze the correlation between ultrasound characteristics and pathological manifestations. Rabbits were divided into the normal control (NC) and atherosclerosis (AS) groups. Rabbits in the AS group were subjected to ultrasound-guided balloon injury of the abdominal aorta and fed a high-fat diet for 16 wk. Rabbits in the NC group were fed a normal diet for the same period. After 16 wk, all animals underwent serological tests, ultrasound and speckle tracking circumferential strain analysis. In the AS group, 28 hypo-echoic plaques had formed. The circumferential strain of six segments at the short axis of plaques in the AS group was lower than that in the NC group (p < 0.001), and global circumferential strain (GCS) in the AS group was significantly reduced compared with the NC group (p < 0.001). In the AS group, the area ratio of type I to type III collagen fibers was smaller than that in the NC group. The GCS of atherosclerotic plaques was positively correlated with the area ratio of type I to type III collagen fibers in plaques (r = 0.7181, p < 0.001). In conclusion, there is a significant positive correlation between the decreased circumferential strain and the decreased area ratio of type I to type III collagen fibers in hypo-echoic plaques.
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Affiliation(s)
- Zhizhi Dong
- Department of Ultrasound, First College of Clinical Medical Sciences, China Three Gorges University & Yichang Central People's Hospital, Yichang, China; Central Laboratory, First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang, China
| | - Yun Zhao
- Medical College of China Three Gorges University, Yichang, China
| | - Yue Chen
- Department of Ultrasound, First College of Clinical Medical Sciences, China Three Gorges University & Yichang Central People's Hospital, Yichang, China; Central Laboratory, First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang, China
| | - Zulin Liu
- Department of Ultrasound, First College of Clinical Medical Sciences, China Three Gorges University & Yichang Central People's Hospital, Yichang, China
| | - Haiying Song
- Department of Ultrasound, First College of Clinical Medical Sciences, China Three Gorges University & Yichang Central People's Hospital, Yichang, China
| | - Hao Li
- Department of Gastrointestinal Surgery, First College of Clinical Medical Sciences, China Three Gorges University & Yichang Central People's Hospital, Yichang, China
| | - Douzi Shi
- Department of Ultrasound, First College of Clinical Medical Sciences, China Three Gorges University & Yichang Central People's Hospital, Yichang, China; Central Laboratory, First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang, China
| | - Chang Zhou
- Department of Ultrasound, First College of Clinical Medical Sciences, China Three Gorges University & Yichang Central People's Hospital, Yichang, China
| | - Jun Zhou
- Department of Ultrasound, First College of Clinical Medical Sciences, China Three Gorges University & Yichang Central People's Hospital, Yichang, China
| | - Rong Liu
- Department of Ultrasound, First College of Clinical Medical Sciences, China Three Gorges University & Yichang Central People's Hospital, Yichang, China.
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Inserra F, Forcada P, Castellaro A, Castellaro C. Chronic Kidney Disease and Arterial Stiffness: A Two-Way Path. Front Med (Lausanne) 2021; 8:765924. [PMID: 34888327 PMCID: PMC8650118 DOI: 10.3389/fmed.2021.765924] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 09/30/2021] [Indexed: 12/14/2022] Open
Abstract
The kidney-heart relationship has raised interest for the medical population since its vast and complex interaction significantly impacts health. Chronic kidney disease (CKD) generates vascular structure and function changes, with significant hemodynamic effects. The early arterial stiffening in CKD patients is a consequence of the interaction between oxidative stress and chronic vascular inflammation, leading to an accelerated deterioration of left ventricular function and alteration in tissue perfusion. CKD amplifies the inflammatory cascade's activation and is responsible for altering the endothelium function, increasing the vascular tone, wall thickening, and favors calcium deposits in the arterial wall. Simultaneously, the autonomic imbalance, and alteration in other hormonal systems, also favor the overactivation of inflammatory and fibrotic mediators. Thus, hormonal disarrangement also contributes to structural and functional lesions throughout the arterial wall. On the other hand, a rise in arterial stiffening and volume overload generates high left ventricular afterload. It increases the left ventricular burden with consequent myocardial remodeling, development of left ventricular hypertrophy and, in turn, heart failure. It is noteworthy that reduction in glomerular mass of renal diseases generates a compensatory glomerular filtration overdriven associated with large-arteries stiffness and high cardiovascular events. Furthermore, we consider that the consequent alterations of the arterial system's mechanical properties are crucial for altering tissue perfusion, mainly in low resistance. Thus, increasing the knowledge of these processes may help the reader to integrate them from a pathophysiological perspective, providing a comprehensive idea of this two-way path between arterial stiffness and renal dysfunction and their impact at the cardiovascular level.
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Affiliation(s)
- Felipe Inserra
- Advisor of Academic Vice-Rectory Department, Maimonides University, Buenos Aires, Argentina.,Master Vascular Mechanics and Arterial Hypertension, Postgraduate Department, Hypertension, Austral University, Buenos Aires, Argentina
| | - Pedro Forcada
- Master Vascular Mechanics and Arterial Hypertension, Postgraduate Department, Hypertension, Austral University, Buenos Aires, Argentina.,Non-Invasive Vascular Labs, CardioArenales and Diagnóstico Integral Médico (DIM) Prevención Cardiovascular, Buenos Aires, Argentina
| | - Agustina Castellaro
- Pediatric Medicine of Prof. Dr. Juan P Garrahan Hospital, Buenos Aires, Argentina
| | - Carlos Castellaro
- Master Vascular Mechanics and Arterial Hypertension, Postgraduate Department, Hypertension, Austral University, Buenos Aires, Argentina.,Department of Nephrology, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC) Hospital, Buenos Aires, Argentina
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Takemoto R, Uchida HA, Toda H, Okada K, Otsuka F, Ito H, Wada J. Total vascular resistance, augmentation index, and augmentation pressure increase in patients with peripheral artery disease. Medicine (Baltimore) 2021; 100:e26931. [PMID: 34397939 PMCID: PMC8360418 DOI: 10.1097/md.0000000000026931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 07/21/2021] [Indexed: 01/04/2023] Open
Abstract
Peripheral arterial disease (PAD) is one of major vascular diseases which frequently coexists with coronary arterial disease and cerebrovascular disease. The patients with PAD have a poor prognosis when it progresses. A new blood pressure testing device enables to simultaneously measure brachial blood pressure (BP), central BP, and several vascular parameters, with easy and non-invasive, in a short time. Here, we aimed to evaluate these arterial stiffness parameters in patients with PAD.In this study, 243 consecutive patients who were suspected of having PAD and referred to our hospital from September 2016 to June 2019, were registered. Several parameters, such as brachial BP, central BP, aortic pulse wave velocity (aPWV), total vascular resistance (TVR), augmentation index (AI) and augmentation pressure (AP), were determined by Mobil-O-Graph. Ankle-brachial pressure index (ABI) was used to define PAD (ABI ≤ 0.9 as PAD). The relationship between PAD and central BP, aPWV, TVR, AI, or AP were investigated.One hundred sixty-two patients (67%) were categorized as the PAD group and 81 patients (33%) as the non-PAD group. In the PAD group, the systolic brachial BP and central systolic BP were significantly higher than those in the non-PAD group (138 ± 24 mmHg vs 131 ± 19 mmHg, P < .05, 125 ± 22 mmHg vs 119 ± 18 mmHg, P < .05, respectively). TVR, AI, and AP were significantly higher in the PAD group (1785 ± 379 dyn s/cm5 vs 1661 ± 317 dyn s/cm5, P < .05, 26.2 ± 13.0% vs 22.2 ± 13.3%, P < .05, 13.5 ± 9.4 mmHg vs 10.7 ± 7.2 mmHg, P < .05, respectively). No significant differences in diastolic BP, central diastolic BP, and aPWV were found between the groups. Multivariate logistic regression analysis revealed that PAD was significantly associated with TVR, AI, and AP (P < .05, respectively).TVR/AP/AI were significantly higher in the PAD group than in the non-PAD group.
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Affiliation(s)
- Rika Takemoto
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Ultrasound Diagnostics Center, Okayama University Hospital, Okayama, Japan
| | - Haruhito A. Uchida
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hironobu Toda
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Ken Okada
- Department of Medical Support, Okayama University Hospital, Okayama, Japan
| | - Fumio Otsuka
- Ultrasound Diagnostics Center, Okayama University Hospital, Okayama, Japan
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Jun Wada
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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7
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Lamacchia O, Sorrentino MR. Diabetes Mellitus, Arterial Stiffness and Cardiovascular Disease: Clinical Implications and the Influence of SGLT2i. Curr Vasc Pharmacol 2021; 19:233-240. [PMID: 32183678 DOI: 10.2174/1570161118666200317150359] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 12/20/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is a rapidly evolving global health issue associated with a markedly increased risk of cardiovascular (CV) morbidity and mortality. The hyperglycaemic milieu contributes to the development of CV complications via several pathological pathways, leading to increased arterial stiffness (AS), that can be considered as a predictor of CV events in patients with diabetes. The measurement of AS is increasingly used for the clinical assessment of patients. Several methodologies were used in extensive population studies to assess AS; the most commonly used is the pulse wave velocity (PWV). The cardio-ankle vascular index (CAVI) was developed to measure AS; it is not affected by blood pressure at the time of measurement and shows stable values in healthy persons for years. There are several potential pharmacological and non-pharmacological interventions aiming to reduce AS. Recent evidence from clinical trials suggests that newer antidiabetic drugs do not only exert glycaemic-lowering properties but also decrease CV risk. In this context, sodium glucose cotransporter- 2 inhibitors (SGLT2i) ( empagliflozin, canagliflozin and dapagliflozin) significantly reduced the risk of CV and all-cause mortality (only EMPA-REG OUTCOME study) and hospitalization for heart failure in patients with T2DM with established CV disease and/or with CV risk factors. Improved endothelial function and AS probably represents one of the mechanisms by which these drugs exert their beneficial effects. The present review aimed both to describe the association between AS and T2DM and to discuss the effectiveness of SGLT2i on vascular endothelial dysfunction and AS.
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Affiliation(s)
- Olga Lamacchia
- Unit of Endocrinology, Department of Medical and Surgical Sciences, University of Foggia, via Luigi Pinto, 1, 71122 Foggia, Italy
| | - Maria Rosaria Sorrentino
- Unit of Endocrinology, Department of Medical and Surgical Sciences, University of Foggia, via Luigi Pinto, 1, 71122 Foggia, Italy
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8
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Karasek D, Spurna J, Macakova D, Cibickova L, Krystynik O, Kucerova V, Ulehlova J, Slavik L. Hypertriglyceridemic Waist in Patients with Type 2 Diabetes: Its Relationship to Selected Markers of Vascular Damage. Metab Syndr Relat Disord 2021; 19:393-400. [PMID: 34096797 DOI: 10.1089/met.2021.0019] [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: 11/13/2022] Open
Abstract
Background: To evaluate the association between hypertriglyceridemic waist (HTGW), a promising marker of visceral adiposity and cardiovascular (CV) risk, and different indicators of vascular damage in type 2 diabetes (T2D) patients. Methods: This case-control study included 161 patients with T2D (91 males, 70 females) and 40 healthy controls (24 males, 16 females). HTWG was defined as waist circumference >90 cm in men or >85 cm in women and triglyceride concentrations >2 mmol/L. In addition to anthropometric and metabolic parameters, markers of endothelial dysfunction, namely von Willebrand factor (vWF) and plasminogen activator inhibitor-1 (PAI-1), were assessed. Arterial stiffness parameters were examined using the SphygmoCor system. Results: Individuals with T2D and HTGW showed the highest elevation of PAI-1 levels and significantly increased vWF levels compared with healthy controls. No significant differences in arterial stiffness markers were observed between T2D individuals. Age and, for several markers, systolic and/or diastolic blood pressure were identified as the main predictors for arterial stiffness, whereas PAI-1 and vWF levels were predicted by metabolic parameters. Conclusions: HTGW represents increased CV risk in T2D patients, mainly due to endothelial damage. The presence of HTGW had no significant effect on arterial stiffness compared with other T2D individuals.
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Affiliation(s)
- David Karasek
- 3rd Department of Internal Medicine-Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic, Olomouc, Czech Republic
| | - Jaromira Spurna
- 3rd Department of Internal Medicine-Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic, Olomouc, Czech Republic
| | - Dominika Macakova
- 3rd Department of Internal Medicine-Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic, Olomouc, Czech Republic
| | - Lubica Cibickova
- 3rd Department of Internal Medicine-Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic, Olomouc, Czech Republic
| | - Ondrej Krystynik
- 3rd Department of Internal Medicine-Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic, Olomouc, Czech Republic
| | - Veronika Kucerova
- Department of Clinical Biochemistry, University Hospital Olomouc, Czech Republic, Olomouc, Czech Republic
| | - Jana Ulehlova
- Department of Hemato-Oncology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic, Olomouc, Czech Republic
| | - Ludek Slavik
- Department of Hemato-Oncology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic, Olomouc, Czech Republic
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Hirotsu C, Betta M, Bernardi G, Marques-Vidal P, Vollenweider P, Waeber G, Pichot V, Roche F, Siclari F, Haba-Rubio J, Heinzer R. Pulse wave amplitude drops during sleep: clinical significance and characteristics in a general population sample. Sleep 2021; 43:5715731. [PMID: 31978212 PMCID: PMC7355400 DOI: 10.1093/sleep/zsz322] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/06/2019] [Indexed: 11/13/2022] Open
Abstract
Study Objectives To explore the clinical significance of pulse wave amplitude (PWA)-drops during sleep as a biomarker for cardiometabolic disorders and describe their main characteristics in a general population sample. Methods Cross-sectional study of HypnoLaus cohort, in which 2162 individuals underwent clinical assessment and in-home full polysomnography. PWA-drops were derived from photoplethysmography and processed using a validated automated algorithm. Associations between PWA-drop features (index, mean duration, and mean area under the curve [AUC]) with hypertension, diabetes, and previous cardiovascular (CV) event were analyzed using multivariable-adjusted logistic regression. Results Two thousand one hundred forty-nine participants (59 ± 11 years, 51% women, 9.9% diabetes, 41.3% hypertension, 4.4% CV event) were included. Mean ± standard deviation (SD) of PWA-drop index, duration, and AUC during sleep were 51.0 ± 20.3 events/hour, 14.0 ± 2.7 seconds, and 527±115 %seconds, respectively. PWA-drop index was lower in women and decreased with age, while its mean duration and AUC increased in men and elderly. Overall, lower PWA-drop index, longer duration and greater AUC were associated with increased odds of hypertension, diabetes, or CV event after adjustment for confounders. Participants in the lowest quartile of mean duration-normalized PWA-drop index had a significantly higher odds ratio (OR) of hypertension (OR = 1.60 [1.19–2.16]), CV event (OR = 3.26 [1.33–8.03]), and diabetes (OR = 1.71 [1.06–2.76]) compared to those in the highest quartile. Similar results were observed for mean AUC-normalized PWA-drop index regarding hypertension (OR = 1.59 [1.19–2.13]), CV event (OR = 2.45 [1.14–5.26]) and diabetes (OR = 1.76 [1.10–2.83]). Conclusions PWA-drop features during sleep seem to be an interesting biomarker independently associated with cardiometabolic outcomes in the general population.
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Affiliation(s)
- Camila Hirotsu
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland (Institution where the work was performed)
| | - Monica Betta
- IMT School for Advanced Studies Lucca, Lucca, Italy
| | | | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Gérard Waeber
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Vincent Pichot
- University Hospital of Saint-Étienne, Clinical and Exercise Physiology, Saint-Étienne, France
| | - Frederic Roche
- University Hospital of Saint-Étienne, Clinical and Exercise Physiology, Saint-Étienne, France
| | - Francesca Siclari
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland (Institution where the work was performed)
| | - Jose Haba-Rubio
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland (Institution where the work was performed)
| | - Raphael Heinzer
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland (Institution where the work was performed).,Pulmonary Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland
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10
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Sanchez RA, Sanchez MJ, Ramirez AJ. Renal Function, Albumin-Creatinine Ratio and Pulse Wave Velocity Predict Silent Coronary Artery Disease and Renal Outcome in Type 2 Diabetic and Prediabetic Subjects. Curr Hypertens Rev 2020; 17:131-136. [PMID: 33305706 DOI: 10.2174/1573402116999201210194817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/15/2020] [Accepted: 07/07/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Silent coronary heart disease is frequently undetected in type 2 diabetes mellitus (DM2) and pre-diabetes determined by glucose intolerance (GI). Pulse wave velocity (PWV) and albumin-creatinine ratio (ACR) have been considered markers of cardiovascular mortality, coronary heart disease and chronic renal failure. AIM To evaluate the incidence of coronary artery disease (CAD) and the relationship between urinary albumin-creatinine ratio, glomerular filtration rate (GFR) and PWV in type 2 DM with silent CAD. METHODS We analyzed 92 individuals (44 male), 49 (60±7y) type 2 DM non-insulin dependents and 43 prediabetics (43±4y), with Grade I-II hypertension and no symptoms of CAD. All type 2 DM patients were under antidiabetic treatment with A1C hemoglobin between 5.5 and 6.5%. Every patient underwent a myocardial perfusion SPECT scan. In those subjects with ischemic patterns, coronary angiography was performed. In addition, PWV, glomerular filtration rate, and ACR were evaluated. STATISTICS mean±SEM, and ANOVA among groups. RESULTS 48.59% of DM2 and 25.58% of GI patients had silent coronary artery had silent coronary artery disease and higher ACR, PWV and reduced GFR. Higher ACR and PWV and reduced GFR. DM2 and GI showed a negative relationship between GFR and ACR. Moreover, this relation was also observed in different levels of GFR (>60 ml/min and <60ml.min (p<0.05) in patients with CAD, suggesting a cardio-renal interaction in DM2. CONCLUSION Higher PWV, lower GFR and ACR predict the incidence of CAD in DM2. Dysglycemic individuals also represent a group of higher risk for coronary artery disease with similar predictors as in DM2. Diabetic and prediabetics still develop renal microalbuminuria. Thus, PWV seems to represent a reliable marker of renal impairment and coronary artery disease.
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Affiliation(s)
- Ramiro A Sanchez
- Hypertension and Metabolic Unit, Favaloro Foundation, Buenos Aires, Argentina
| | | | - Agustin J Ramirez
- Hypertension and Metabolic Unit, Favaloro Foundation, Buenos Aires, Argentina
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11
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Kim JM, Kim SS, Kim IJ, Kim JH, Kim BH, Kim MK, Lee SH, Lee CW, Kim MC, Ahn JH, Kim J. Arterial stiffness is an independent predictor for risk of mortality in patients with type 2 diabetes mellitus: the REBOUND study. Cardiovasc Diabetol 2020; 19:143. [PMID: 32962704 PMCID: PMC7510263 DOI: 10.1186/s12933-020-01120-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 09/12/2020] [Indexed: 12/21/2022] Open
Abstract
Background This study aimed to evaluate the benefit of brachial-ankle pulse wave velocity (baPWV) as a noninvasive marker of arterial stiffness for the prediction of all-cause and cause-specific mortality in patients with type 2 diabetes. Methods This multicenter prospective observational study analyzed 2308 patients with type 2 diabetes between 2008 and 2018. The patients were categorized according to the quartiles of baPWV. Cause of mortality was determined using death certificates and patient clinical records. We estimated proportional mortality rates from all causes, cardiovascular, cancer, and other causes among adults with diabetic status according to their baPWV. Cox regression models were used to estimate hazard ratios (HRs). Results There were 199 deaths (8.6%) in the study population during a median follow-up duration of 8.6 years. When baPWV was assessed as quartiles, a significantly higher risk of all-cause mortality (HR = 5.39, P < 0.001), cardiovascular-mortality (HR = 14.89, P < 0.001), cancer-mortality (HR = 5.42, P < 0.001), and other-cause mortality (HR = 4.12, P < 0.001) was found in quartile 4 (Q4, ≥ 1830 cm/s) than in quartiles 1–3 (Q1–3). Adding baPWV to baseline model containing conventional risk factors such as age, sex, diabetes duration, body mass index, glycated hemoglobin, systolic blood pressure, glomerular filtration rate, smoking, and insulin improved the risk prediction for all-cause (net reclassification index (NRI) = 49%, P < 0.001) and cause-specific (cardiovascular NRI = 28%, P = 0.030; cancer NRI = 55%, P < 0.001; other-cause NRI 51%, P < 0.001) mortality. Conclusion This long-term, large-scale, multicenter prospective observational cohort study provide evidence that increased arterial stiffness, as measured by baPWV, predicts the risk of all-cause and cause-specific mortality in type 2 diabetes, supporting the prognostic utility of baPWV. Trial registration Clinical Research Information Service (CRIS), KCT 0005010. Retrospectively Registered May 12, 2020. https://cris.nih.go.kr/cris/search/search_result_st01.jsp?seq=16677
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Affiliation(s)
- Jeong Mi Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-ro, Seo-gu, Busan, 49241, South Korea
| | - Sang Soo Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-ro, Seo-gu, Busan, 49241, South Korea.
| | - In Joo Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-ro, Seo-gu, Busan, 49241, South Korea.
| | - Jong Ho Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-ro, Seo-gu, Busan, 49241, South Korea.,Department of Internal Medicine, Isam Hospital, Busan, South Korea
| | - Bo Hyun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-ro, Seo-gu, Busan, 49241, South Korea
| | - Mi Kyung Kim
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Soon Hee Lee
- Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Chang Won Lee
- Department of Internal Medicine, Busan St. Mary's Hospital, Catholic University of Pusan, Busan, South Korea
| | - Min Chul Kim
- Department of Internal Medicine, Ilsin Christian Hospital, Busan, South Korea
| | - Jun Hyeob Ahn
- Department of Internal Medicine, Good Moonhwa Hospital, Busan, South Korea
| | - Jinmi Kim
- Department of Biostatistics, Clinical Trial Center, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
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12
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Turusheva A, Frolova E, Kotovskaya Y, Petrosyan Y, Dumbadze R. Association Between Arterial Stiffness, Frailty and Fall-Related Injuries in Older Adults. Vasc Health Risk Manag 2020; 16:307-316. [PMID: 32764951 PMCID: PMC7381780 DOI: 10.2147/vhrm.s251900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 06/30/2020] [Indexed: 01/11/2023] Open
Abstract
Purpose This study was conducted to investigate the relationships between arterial stiffness, frailty and fall-related injuries among community-dwelling older adults. Materials and Methods A cross-sectional study of a random sample of older adults aged 60 years and older was conducted. Main study parameters: arterial stiffness was measured by the determining the cardio-ankle vascular index (CAVI); Frailty status was defined using a 7-item frailty screening scale, developed in Russia. This questionnaire included question about falls and fall-related injuries. Orthostatic test and anthropometric tests were done. Medical history (comorbidity, medications), the Osteoporosis Self-assessment Tool (OST), nutritional, physical, cognitive and functional status were evaluated. Results The study population included 163 people aged 60–89 years. The average predicted value of CAVI in women aged 60–69 was 9.13 ± 0.13, in men, 9.49 ± 0.05; in women aged 70–79, it was 9.49 ± 0.16, in men, 9.73 ±0.11; in women aged 80 and older it was 10.04 ±0.18, in men, 10.24 ±0.10 units. The CAVI above the predicted value was associated with fall-related injuries even after adjustment for age, sex, use of β-blockers (BBs), history of stroke, and region of residence with the odds ratio 3.52 (95% CI: 1.03 −12.04). Conclusion Our study revealed an independent association between arterial stiffness and fall-related injuries in older adults over 60 years. The findings suggest that clinicians, especially geriatricians, should pay attention to arterial stiffness of patients with fall-related injuries. Similarly, the patients with CAVI above age-predicted value should be evaluated for risk of falls for prevention of fall-related injuries. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/4G5FYK8dZWY
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Affiliation(s)
- Anna Turusheva
- The North-Western State Medical University Named After I.I. Mechnikov, St. Petersburg, Russia
| | - Elena Frolova
- The North-Western State Medical University Named After I.I. Mechnikov, St. Petersburg, Russia
| | - Yulia Kotovskaya
- Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Yurij Petrosyan
- The North-Western State Medical University Named After I.I. Mechnikov, St. Petersburg, Russia
| | - Rauli Dumbadze
- The North-Western State Medical University Named After I.I. Mechnikov, St. Petersburg, Russia
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13
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Mendes-Pinto D, Rodrigues-Machado MDG. Applications of arterial stiffness markers in peripheral arterial disease. J Vasc Bras 2019; 18:e20180093. [PMID: 31236104 PMCID: PMC6579524 DOI: 10.1590/1677-5449.009318] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 01/04/2019] [Indexed: 11/21/2022] Open
Abstract
Arterial stiffness has been analyzed in many different population groups with the objective of identifying cardiovascular risk early and performing specific therapeutic interventions. Increased arterial stiffness affects the capacity of the aorta and elastic arteries to adapt to pressure variations during the cardiac cycle. The main markers of arterial stiffness are pulse wave velocity (PWV), augmentation index (AIx) and central aortic pressure. They can be measured noninvasively. Patients with coronary disease or on hemodialysis who have elevated PWV or AIx have increased mortality. The association with peripheral arterial disease has been studied little. The objective of this review is to demonstrate the applicability and utility of assessing measures of arterial stiffness in patients with peripheral arterial disease.
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Affiliation(s)
- Daniel Mendes-Pinto
- Departamento de Cirurgia Vascular, Hospital Felício Rocho, Belo Horizonte, MG, Brasil.,Faculdade Ciências Médicas de Minas Gerais - FCMMG, Belo Horizonte, MG, Brasil
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14
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Yafei S, Elsewy F, Youssef E, Ayman M, El-Shafei M. Fibroblast growth factor 21 association with subclinical atherosclerosis and arterial stiffness in type 2 diabetes. Diabetes Metab Syndr 2019; 13:882-888. [PMID: 30641825 DOI: 10.1016/j.dsx.2018.12.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 12/18/2018] [Indexed: 01/11/2023]
Abstract
AIM To evaluate the association of serum FGF21 with subclinical atherosclerosis and pulse wave velocity, a marker of arterial stiffness, in type 2 diabetes Egyptian patients. PATIENTS AND METHODS Fasting serum FGF21 was measured in 120 type 2 diabetes patients without clinical atherosclerotic cardiovascular disease (mean age 51.1 ± 7.7 years; 63.3 women). In addition to basic laboratory tests, serum adiponectin and ultrasonographic examination of CIMT, ankle brachial index (ABI) and carotid-femoral pulse wave velocity (cfPWV) were performed. RESULTS Patients with subclinical atherosclerosis have higher serum FGF21 than those without (218 ± 66.8 pg/mL Vs 170 ± 43.1 pg/mL, P < 0.001). FGF21 correlated positively with CIMT and cfPWV (P < 0.001) regardless of patient gender. In logistic regression analysis, circulating FGF21 was found to be an independent predictor for subclinical atherosclerosis (P = 0.023) in addition to dyslipidemia, hypertension and adiponectin. FGF21 was also found to be an independent determinant of cfPWV in stepwise multiple regression analysis. ROC curve analysis was done and cutoff high risk FGF21 level of 184 pg/mL for the prediction of subclinical atherosclerosis with a sensitivity and specificity of 66.7%. CONCLUSIONS Serum FGF21 levels correlated with carotid intima media thickness and predict subclinical atherosclerosis. Serum FGF21 is also correlated positively with cfPWV and arterial stiffness in type 2 diabetes patients.
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Affiliation(s)
- Saeed Yafei
- Diabetes & Metabolism Unit, Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Internal Medicine Department, Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen.
| | - Fathy Elsewy
- Diabetes & Metabolism Unit, Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - Eman Youssef
- Diabetes & Metabolism Unit, Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - Mohammed Ayman
- Cardiology and Angiology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - Mohamed El-Shafei
- Radiodiagnosis Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
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15
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Spurná J, Karásek D, Kubíčková V, Goldmannová D, Krystyník O, Schovánek J, Zadražil J. Relationship of Selected Adipokines with Markers of Vascular Damage in Patients with Type 2 Diabetes. Metab Syndr Relat Disord 2018; 16:246-253. [PMID: 29717906 DOI: 10.1089/met.2017.0179] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In this study we compared levels of selected adipokines between patients with type 2 diabetes (T2D) and healthy individuals and we determined their relationship with early vascular damage markers. METHODS Seventy-seven subjects: 56 patients with T2D (34 men and 22 women) and 21 healthy controls (8 men and 13 women) were examined in this cross-sectional study. Selected adipokines [adiponectin, adipocyte fatty acid-binding protein (A-FABP), fibroblast growth factor 21 (FGF-21), C1q/TNF-related protein 9 (CTRP-9), and allograft inflammatory factor-1 (AIF-1)] with possible cardiovascular impact were measured in all participants. To identify markers of vascular damage von Willebrand factor (vWF), plasminogen activator inhibitor-1 (PAI-1) and arterial stiffness parameters were examined in all the subjects. RESULTS When compared with healthy controls, T2D had significantly higher levels of A-FABP [50.0 (38.1-68.6) vs. 28.6 (23.6-32.9) ng/mL, P < 0.0001] and lower levels of adiponectin [5.9 (4.3-9.0) vs. 11.3 (8.7-14.8) μg/mL, P < 0.0001]. Differences in other adipokines were not statistically significant. Adiponectin level correlated negatively with vWF levels (ρ = -0.29, P < 0.05) and PAI-1 (ρ = -0.36, P < 0.05) and A-FABP positively with vWF (ρ = 0.61, P < 0.05) and PAI-1 (ρ = 0.47, P < 0.05) and augmentation index (ρ = 0.26, P < 0.05). Multivariate regression analysis showed independent association between A-FABP and vWF (b = 0.24, P < 0.05). CONCLUSIONS Patients with T2D have significantly higher levels of A-FABP and lower levels of adiponectin. These adipokines correlate with indicators of vascular damage and could contribute to cardiovascular risk in patients with T2D. A-FABP may participate in direct endothelium damage.
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Affiliation(s)
- Jaromíra Spurná
- 1 Department of Internal Medicine III-Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc , Olomouc, Czech Republic .,2 Faculty of Medicine and Dentistry, Palacky University Olomouc , Olomouc, Czech Republic
| | - David Karásek
- 1 Department of Internal Medicine III-Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc , Olomouc, Czech Republic .,2 Faculty of Medicine and Dentistry, Palacky University Olomouc , Olomouc, Czech Republic
| | - Veronika Kubíčková
- 2 Faculty of Medicine and Dentistry, Palacky University Olomouc , Olomouc, Czech Republic .,3 Department of Clinical Biochemistry University Hospital Olomouc , Olomouc, Czech Republic
| | - Dominika Goldmannová
- 1 Department of Internal Medicine III-Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc , Olomouc, Czech Republic .,2 Faculty of Medicine and Dentistry, Palacky University Olomouc , Olomouc, Czech Republic
| | - Ondřej Krystyník
- 1 Department of Internal Medicine III-Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc , Olomouc, Czech Republic .,2 Faculty of Medicine and Dentistry, Palacky University Olomouc , Olomouc, Czech Republic
| | - Jan Schovánek
- 1 Department of Internal Medicine III-Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc , Olomouc, Czech Republic .,2 Faculty of Medicine and Dentistry, Palacky University Olomouc , Olomouc, Czech Republic
| | - Josef Zadražil
- 1 Department of Internal Medicine III-Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc , Olomouc, Czech Republic .,2 Faculty of Medicine and Dentistry, Palacky University Olomouc , Olomouc, Czech Republic
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