scholarly journals PDB1 LITERATURE REVIEW OF THE IMPACT OF OBESITY ON CARDIOVASCULAR OUTCOMES IN THE GENERAL POPULATION AND IN PATIENTS WITH TYPE-2 DIABETES

2009 ◽  
Vol 12 (3) ◽  
pp. A96-A97
Author(s):  
J Smith-Palmer ◽  
A Kalsekar ◽  
KS Boye ◽  
G Goodall
2009 ◽  
Vol 2 ◽  
pp. CMED.S3479 ◽  
Author(s):  
Jayne Palmer ◽  
Anupama Kalsekar ◽  
Kristina Boye ◽  
Gordon Goodall

Objectives There is an established causal link between obesity and cardiovascular outcomes. The aim of this review was to determine whether an independent relationship exists between anthropometric measurements of weight (typically body mass index [BMI]) and cardiovascular outcomes (e.g. angina, myocardial infarction, congestive heart failure, stroke, and mortality due to cardiovascular disease) in the general population and in patients with type 2 diabetes. Methods A review of the medical literature published between 1988 and May 2008 was conducted using the PubMed, EMBASE, Cochrane and Center for Review and Dissemination databases. Studies longer than 12 months, with ≥500 adult subjects and published in English were included. Results In studies conducted in general populations there was an overall trend towards increased risk for adverse cardiovascular outcomes with increasing BMI. The nature and strength of this relationship varied according to the measurement used (e.g. BMI, waist circumference, waist-to-hip ratio) and the population studied, with notable differences observed in Asian/Asia-Pacific compared with European or North American-based studies. However, data from diabetes-specific populations are limited. Conclusions In general, the degree of being overweight or obese was associated with an elevated risk of adverse cardiovascular events and mortality. Although inextricable links exist between obesity, type 2 diabetes and cardiovascular disease in the general population, the extent to which findings can be extrapolated to a diabetes-specific population is limited.


2021 ◽  
Vol 9 (1) ◽  
pp. e001413
Author(s):  
Jonathan Yap ◽  
Kamalesh Anbalakan ◽  
Wan Ting Tay ◽  
Daniel Ting ◽  
Carol Yim Cheung ◽  
...  

IntroductionDiabetes mellitus is a growing public health epidemic in Asia. We examined the impact of type 2 diabetes, glycemic control and microvascular complications on mortality and cardiovascular outcomes in a multiethnic population-based cohort of Asians without prior cardiovascular disease.Research design and methodsThis was a prospective population-based cohort study in Singapore comprising participants from the three major Asian ethnic groups: Chinese, Malays and Indians, with baseline examination in 2004–2011. Participants with type 1 diabetes and those with cardiovascular disease at baseline were excluded. Type 2 diabetes, Hemoglobin A1c (HbA1c) levels and presence of microvascular complications (diabetic retinopathy and nephropathy) were defined at baseline. The primary outcome was all-cause mortality and major adverse cardiovascular events (MACEs), defined as a composite of cardiovascular mortality, myocardial infarction, stroke and revascularization, collected using a national registry.ResultsA total of 8541 subjects were included, of which 1890 had type 2 diabetes at baseline. Subjects were followed for a median of 6.4 (IQR 4.8–8.8) years. Diabetes was a significant predictor of mortality (adjusted HR 1.74, 95% CI 1.45 to 2.08, p<0.001) and MACE (adjusted HR 1.64, 95% CI 1.39 to 1.93, p<0.001). In those with diabetes, higher HbA1c levels were associated with increased MACE rates (adjusted HR (per 1% increase) 1.18, 95% CI 1.11 to 1.26, p<0.001) but not mortality (p=0.115). Subjects with two microvascular complications had significantly higher mortality and MACE compared with those with only either microvascular complication (adjusted p<0.05) and no microvascular complication (adjusted p<0.05).ConclusionDiabetes is a significant predictor of mortality and cardiovascular morbidity in Asian patients without prior cardiovascular disease. Among patients with type 2 diabetes, poorer glycemic control was associated with increased MACE but not mortality rates. Greater burden of microvascular complications identified a subset of patients with poorer outcomes.


2021 ◽  
Author(s):  
Emilia Erningwati Akoit ◽  
Moses Glorino Rumambo Pandin

Abstract Background: Diabetes Mellitus (DM) is one of the chronic non-communicable diseases that has currently been very common, in particular Diabetes Mellitus type 2 that threatens public health. It has been included in the category of the six biggest causes of worldwide death, but self-control of treatment and obedience to self-care is still low. One of the influencing factors is related to the lack of knowledge. Providing ongoing health education is one of the solutions or efforts to strengthen knowledge in type 2 diabetes. The aim was to identify the various health education methods currently used by nurses and their impacts on type 2 DM. The method used is a literature review. The literature was searched on data based on Scopus, Web of Science, SAGE, CINAHL with the keywords methods or interventions, education, health, nursing, and type 2 Diabetes Mellitus. Fifteen (15) pieces of literature were considered to meet the criteria inclusion. Results: Three (3) types of health education methods used by nurses were identified: 1). Direct health education refers to providing education by nurses to patients through training, coaching, interviews, Focus Group Discussion (FGD), and home visits; 2). Indirect Health Education - using mobile phones; 3). The mix of direct health education and the use of mobile phone-based applications is carried out with the application of mobile health technology and nurse health coaching. The impact of providing health education by nurses to type 2 diabetic patients: increasing of knowledge, behavioral change on preventing diabetes complications, increasing self-efficacy, increasing self-care activities (diet management, physical activity, monitoring blood sugar levels, and foot care). Conclusion: various methods of health education carried out by nurses currently have a positive impact on improving and increasing self-care management and efforts to prevent complications in type 2 diabetes.


2021 ◽  
Vol 12 ◽  
pp. 204201882110342
Author(s):  
Jian L. Yeo ◽  
Emer M. Brady ◽  
Gerry P. McCann ◽  
Gaurav S. Gulsin

Diabetes mellitus represents a global health concern affecting 463 million adults and is projected to rapidly rise to 700 million people by 2045. Amongst those with type 2 diabetes (T2D), there are recognised differences in the impact of the disease on different sex and ethnic groups. The relative risk of cardiovascular complications between individuals with and without T2D is higher in females than males. People of South Asian heritage are two to four times more likely to develop T2D than white people, but conversely not more likely to experience cardiovascular complications. Differences in the pathophysiological responses in these groups may identify potential areas for intervention beyond glycaemic control. In this review, we highlight key differences of diabetes-associated cardiovascular complications by sex and ethnic background, with a particular emphasis on South Asians. Evidence assessing therapeutic efficacy of new glucose lowering drugs in minority groups is limited and many major cardiovascular outcomes trials do not report ethnic specific data. Conversely, lifestyle intervention and bariatric surgery appear to have similar benefits regardless of sex and ethnic groups. We encourage future studies with better representation of women and ethnic minorities that will provide valuable data to allow better risk stratification and tailored prevention and management strategies to improve cardiovascular outcomes in T2D.


2011 ◽  
Vol 140 (5) ◽  
pp. S-891
Author(s):  
Maria Stepanova ◽  
Brian P. Lam ◽  
Youssef Younossi ◽  
Manirath K. Srishord ◽  
Zobair M. Younossi

2022 ◽  
Vol 8 ◽  
Author(s):  
Amber de Haan ◽  
Fariba Ahmadizar ◽  
Peter J. van der Most ◽  
Chris H. L. Thio ◽  
Zoha Kamali ◽  
...  

Background:Serum calciprotein particle maturation time (T50), a measure of vascular calcification propensity, is associated with cardiovascular morbidity and mortality. We aimed to identify genetic loci associated with serum T50 and study their association with cardiovascular disease and mortality.Methods:We performed a genome-wide association study of serum T50 in 2,739 individuals of European descent participating in the Prevention of REnal and Vascular ENd-stage Disease (PREVEND) study, followed by a two-sample Mendelian randomization (MR) study to examine causal effects of T50 on cardiovascular outcomes. Finally, we examined associations between T50 loci and cardiovascular outcomes in 8,566 community-dwelling participants in the Rotterdam study.Results:We identified three independent genome-wide significant single nucleotide polymorphism (SNPs) in the AHSG gene encoding fetuin-A: rs4917 (p = 1.72 × 10−101), rs2077119 (p = 3.34 × 10−18), and rs9870756 (p = 3.10 × 10−8), together explaining 18.3% of variation in serum T50. MR did not demonstrate a causal effect of T50 on cardiovascular outcomes in the general population. Patient-level analyses revealed that the minor allele of rs9870756, which explained 9.1% of variation in T50, was associated with a primary composite endpoint of all-cause mortality or cardiovascular disease [odds ratio (95% CI) 1.14 (1.01–1.28)] and all-cause mortality alone [1.14 (1.00–1.31)]. The other variants were not associated with clinical outcomes. In patients with type 2 diabetes or chronic kidney disease, the association between rs9870756 and the primary composite endpoint was stronger [OR 1.40 (1.06–1.84), relative excess risk due to interaction 0.54 (0.01–1.08)].Conclusions:We identified three SNPs in the AHSG gene that explained 18.3% of variability in serum T50 levels. Only one SNP was associated with cardiovascular outcomes, particularly in individuals with type 2 diabetes or chronic kidney disease.


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