A novel method for evaluating human carotid artery elasticity: Possible detection of early stage atherosclerosis in subjects with type 2 diabetes

2008 ◽  
Vol 196 (1) ◽  
pp. 391-397 ◽  
Author(s):  
Hisashi Okimoto ◽  
Yasushi Ishigaki ◽  
Yoshihiro Koiwa ◽  
Yoshinori Hinokio ◽  
Takehide Ogihara ◽  
...  
2014 ◽  
Vol 13 (1) ◽  
pp. 39 ◽  
Author(s):  
Li Zhang ◽  
Ji-Kai Yin ◽  
Yun-You Duan ◽  
Xi Liu ◽  
Lei Xu ◽  
...  

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e046183
Author(s):  
Xiyun Ren ◽  
Jian Gao ◽  
Tianshu Han ◽  
Changhao Sun

ObjectiveThis study aimed to investigate the association between the trajectories of energy consumption at dinner versus breakfast and the risk of type 2 diabetes (T2D).DesignCohort study.SettingThe study was conducted in China.ParticipantsA total of 10 727 adults, including 5239 men and 5488 women, with a mean age of 42.7±11.2 years and a mean follow-up time of 9.1 years, met the study criteria and completed a questionnaire about energy intake and diabetes status from the China Health and Nutrition Survey in 1997–2011.Primary outcome measuresParticipants were divided into subgroups based on the trajectories of the ratio of energy consumption at dinner versus breakfast. Cox multivariate regression models were used to explore the associations between different trajectories and the risk of T2D after adjustment for confounders and their risk factors. Mediation analysis was performed to explore the intermediary effect of triacylglycerol (TG), total cholesterol (TC), uric acid (UA) and apolipoprotein B (ApoB) between the trajectories and the risk of T2D.ResultsFor energy consumption at dinner versus breakfast, compared with a low-stable trajectory, the adjusted HR of T2D in low-increasing from early-stage trajectory was 1.29 (95% CI 1.04 to 1.60). TG, TC, UA and ApoB were significantly higher in low-increasing from early-stage trajectory than other trajectories and play partial regulation roles between trajectories and T2D.ConclusionsThis study emphasised the harmful effect of a gradual increase in the ratio of energy consumption at dinner versus breakfast from early stage on the development of T2D and partially mediated by TG, TC, UA and ApoB, highlighting that it is necessary to intake more energy at breakfast compared with dinner to prevent T2D in adults.


2021 ◽  
Vol 12 ◽  
pp. 204062232110269
Author(s):  
Yipin Zhao ◽  
Huawei Wang ◽  
Dazhi Ke ◽  
Wei Deng ◽  
Yingying Ji ◽  
...  

Background and Aims: Studies have shown that dipeptidyl peptidase-4 (DDP-4) inhibitors have anti-atherosclerotic effects. However, in the PROLOGUE study, sitagliptin failed to slow the progression of carotid intima-media thickness (CIMT) relative to conventional therapy. We conducted a post hoc analysis of the PROLOGUE study and compared the effects of sitagliptin and conventional therapy on changes in CIMT in subgroups with or without hyperuricemia. Methods: The PROLOGUE study was a randomized controlled trial of 442 patients with type 2 diabetes mellitus (T2DM). Patients were randomized to receive sitagliptin added therapy or conventional therapy. Based on the serum uric acid levels of all study populations in the PROLOGUE study, we divided them into hyperuricemia subgroup ( n = 104) and non-hyperuricemia subgroup ( n = 331). The primary outcome was changed in carotid intima-media thickness (CIMT) parameters compared with baseline during the 24 months treatment period. Results: In the hyperuricemia subgroup, compared with the conventional therapy group, the changes in the mean internal carotid artery (ICA)-IMT and max ICA-IMT at 24 months were significantly lower in the sitagliptin group [−0.233 mm, 95% confidence interval (CI) (−0.419 to 0.046), p = 0.015 and −0.325 mm, 95% CI (−0.583 to −0.068), p = 0.014], although there was no significant difference in the common carotid artery CIMT. Conclusion: The results of our analysis indicated that sitagliptin attenuated the progression of CIMT than conventional therapy in T2DM and hyperuricemia patients.


2021 ◽  
Vol 22 (15) ◽  
pp. 7797
Author(s):  
Joseph A. M. J. L. Janssen

For many years, the dogma has been that insulin resistance precedes the development of hyperinsulinemia. However, recent data suggest a reverse order and place hyperinsulinemia mechanistically upstream of insulin resistance. Genetic background, consumption of the “modern” Western diet and over-nutrition may increase insulin secretion, decrease insulin pulses and/or reduce hepatic insulin clearance, thereby causing hyperinsulinemia. Hyperinsulinemia disturbs the balance of the insulin–GH–IGF axis and shifts the insulin : GH ratio towards insulin and away from GH. This insulin–GH shift promotes energy storage and lipid synthesis and hinders lipid breakdown, resulting in obesity due to higher fat accumulation and lower energy expenditure. Hyperinsulinemia is an important etiological factor in the development of metabolic syndrome, type 2 diabetes, cardiovascular disease, cancer and premature mortality. It has been further hypothesized that nutritionally driven insulin exposure controls the rate of mammalian aging. Interventions that normalize/reduce plasma insulin concentrations might play a key role in the prevention and treatment of age-related decline, obesity, type 2 diabetes, cardiovascular disease and cancer. Caloric restriction, increasing hepatic insulin clearance and maximizing insulin sensitivity are at present the three main strategies available for managing hyperinsulinemia. This may slow down age-related physiological decline and prevent age-related diseases. Drugs that reduce insulin (hyper) secretion, normalize pulsatile insulin secretion and/or increase hepatic insulin clearance may also have the potential to prevent or delay the progression of hyperinsulinemia-mediated diseases. Future research should focus on new strategies to minimize hyperinsulinemia at an early stage, aiming at successfully preventing and treating hyperinsulinemia-mediated diseases.


2017 ◽  
Vol 125 (09) ◽  
pp. 598-602 ◽  
Author(s):  
Zihang Wang ◽  
Yuhong Zhang ◽  
Weiwei Liu ◽  
Benli Su

AbstractThe present study aimed to evaluate the diagnostic value of echocardiography in measuring the thickness of epicardial adipose tissue (EAT) of the patients of type 2 diabetes mellitus (T2DM) and its correlation with the intimal-medial thickness of the carotid artery (cIMT) to investigate the relationship between EAT and cIMT. 68 patients of T2DM were enrolled and were divided into 2 groups: group of T2DM with duration≤10 years (35 cases) and group of T2DM with duration>10 years (33 cases). And 30 healthy subjects were enrolled as the control group. The thickness of EAT and cIMT were measured by echocardiography and high-frequency ultrasonography. The thickness of EAT and IMT of the carotid artery of 2 type 2 diabetic groups (duration≤10 years and>10 years) were significantly higher than that of the control group (all p<0.05), and the thickness of EAT and cIMT of the group of T2DM with duration>10 years were significantly higher than that of the group of T2DM with duration≤10 years (p<0.05). In univariate analysis, the thickness of EAT was positively and significantly associated with age (r=0.412, p<0.05), BMI (r=0.566, p<0.05), waist circumference (r=0.475, p<0.05), LDL (r=0.425, p<0.05), TG (r=0.496, p<0.05), duration of diabetes (r=0.384, p<0.05) and cIMT (r=0.456, p<0.05). In multiple stepwise regression analyses, age, BMI and IMT of carotid artery were appeared to be significantly associated with EAT (p<0.05 for all). In conclusion, routine screening of EAT and cIMT by ultrasonography in type 2 diabetic patients helps us to predict cardiovascular risks and prevent further development of cardiovascular complications.


2018 ◽  
Vol 6 (01) ◽  
pp. 50-55 ◽  
Author(s):  
Xin Zhao ◽  
Xiao-Mei Zhang ◽  
Ning Yuan ◽  
Xiao-Feng Yu ◽  
Li-Nong Ji

Abstract Objective To identify correlations of bone mineral density (BMD) and bone metabolism indices with the urine albumin to creatinine ratio (ACR) as an indicator of nephropathy in Chinese patients with type 2 diabetes (T2D). Methods In this retrospective analysis, 297 patients with T2D were divided into 3 groups according to the urine ACR. Patients’ data were analyzed to identify associations of general conditions, blood glucose level, lipid levels, and uric acid level with BMD and bone metabolism indices. Results BMD at every location tested (femoral neck, trochanter, inside hip, Ward’s triangle, total hip, and lumbar vertebrae) was negatively correlated with the urine ACR (all p<0.05). Osteocalcin, beta-C-terminal telopeptide (β-CTX), and procollagen type 1 N- peptide (P1NP) were positively correlated with urine ACR (all p<0.05). Finally, 25-hydroxyvitamin D [25(OH)D] was negatively correlated with urine ACR (p<0.05). Multiple regression analysis with adjustment for age, body mass index, disease duration, and other clinical measurements revealed no significant correlation between urine ACR and BMD measurements or β-CTX (p>0.05). However, significant correlations remained between urine ACR and osteocalcin, P1NP, and 25(OH)D (p<0.05). The same results were obtained for postmenopausal women specifically, with the exception of a significant correlation between the ACR and β-CTX (p<0.05). Conclusion In the early stage of diabetic nephropathy, BMD changes and bone transformation acceleration may occur, and the acceleration of bone transformation may occur before the change in BMD. Therefore, it is important to monitor bone metabolism indices in the early stage of diabetic nephropathy in T2D patients.


2021 ◽  
Vol 65 (5) ◽  
pp. 45-50
Author(s):  
E Praskurnichiy ◽  
E Ionova ◽  
I Begunova ◽  
A Knyazev

Purpose: Study of structural and morphological features of atherosclerotic lesions of large main vessels (carotid arteries) in type 2 diabetes mellitus. Material and methods: The study included 78 patients. Exclusion criteria: age under 40 years, pregnancy, acute infectious diseases, as well as chronic diseases within less than 2 weeks from the onset of complete clinical and laboratory remission, severe cardiac (LVEF < 30 %) and renal (blood creatinine > 300 mmol/l) insufficiency, alcohol abuse or drug dependence. There were 44 men (56.4 %) and 34 women (43.6 %) in the group surveyed. Coronary heart disease was detected in 54 (69.2 %) individuals, 24 (30.8 %) of the examined individuals had no signs of coronary heart disease; 19 (24.4 %) people had a history of stroke, 18 (23 %) people — myocardial infarction. 42 people (53.8 %) had dyscirculatory encephalopathy of various degrees, 34 (43.6 %) had hypertension, 42 patients had carbohydrate metabolism disorders, 12 (15.3 %) patients had type 2 diabetes, and 30 (38.4 %) patients had metabolic syndrome. Three groups of subjects were formed. The group of people without metabolic syndrome included 48 people (61.5 % of the total number of examined). The group of people with metabolic syndrome without type 2 diabetes included 18 individuals (23.1 % of the total number of examined). The group of people with type 2 diabetes included 12 individuals (15.4 % of the total number of examined). The examination of patients included: physical examination; laboratory diagnostics; electrocardiography; transthoracic echocardiography; multislice computed tomography with angiocontrast. Results: 78 patients were found to have different density of atherosclerotic plaques. There were no differences in volume among the groups of people surveyed. In patients with type 2 diabetes, there is a decrease in the lipid-fibrous component and an increase in the density of atherosclerotic plaque. Conclusion: Multislice computed tomography can detect various forms of vascular damage, the progression of the process, and assess the severity of structural and morphological manifestations of atherosclerosis in type 2 diabetes and metabolic syndrome at an early stage.


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