Adipokines and inflammatory markers in elderly subjects with high risk of type 2 diabetes and cardiovascular disease

Chronic low-grade inflammation associated with cardiovascular disease and type 2 diabetes (T2D) may be ameliorated with exercise and/or diet. High levels of physical activity and/or cardiorespiratory fitness are associated with reduced risk of low-grade inflammation. Both aerobic and resistance exercise have been found to improve inflammatory status, with the majority of evidence suggesting that aerobic exercise may have broader anti-inflammatory effects. In particular, aerobic exercise appears to improve the balance between pro- and anti-inflammatory markers. Improvement in inflammatory status is most likely to occur in persons with elevated levels of pro-inflammatory markers prior to intervention. A number of dietary factors, including fiber-rich foods, whole grains, fruits (especially berries), omega-3 fatty acids, antioxidant vitamins (eg, C and E), and certain trace minerals (eg, zinc) have been documented to reduce blood concentrations of inflammatory markers. Anti-inflammatory foods may also help mitigate the pro-inflammatory postprandial state that is particularly evident after ingestion of meals high in saturated fat. Intensive lifestyle interventions involving both exercise and diet appear to be most effective. For the most part, anti-inflammatory effects of exercise and diet are independent of weight loss. Thus overweight and obese men and women, who are most likely to have a pro-inflammatory profile, do not necessarily have to normalize body mass index to improve inflammatory status and reduce risk of type 2 diabetes and cardiovascular disease.

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Urinary albumin and 8-oxo-7,8-dihydroguanosine as markers of mortality and cardiovascular disease during 19 years after diagnosis of type 2 diabetes – A comparative study of two markers to identify high risk patients

Redox Biology ◽

10.1016/j.redox.2017.06.005 ◽

2017 ◽

Vol 13 ◽

pp. 363-369 ◽

Cited By ~ 9

Author(s):

Kasper Broedbaek ◽

Rasmus Køster-Rasmussen ◽

Volkert Siersma ◽

Frederik Persson ◽

Henrik E. Poulsen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

High Risk ◽

Comparative Study ◽

Urinary Albumin ◽

High Risk Patients ◽

Risk Patients

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PDB38 Budget IMPACT Analysis of Empagliflozin for the Treatment of Patients with Type 2 Diabetes Mellitus and High Risk or Established Atherosclerotic Cardiovascular Disease in Greece

Value in Health ◽

10.1016/j.jval.2020.08.635 ◽

2020 ◽

Vol 23 ◽

pp. S512

Author(s):

C. Tzanetakos ◽

G. Gourzoulidis ◽

N. Papanas ◽

G. Papageorgiou ◽

G. Karpouzos ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Type 2 Diabetes Mellitus ◽

High Risk ◽

Impact Analysis ◽

Budget Impact ◽

Budget Impact Analysis ◽

Atherosclerotic Cardiovascular Disease

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Treatment with anagliptin, a DPP-4 inhibitor, decreases FABP4 concentration in patients with type 2 diabetes mellitus at a high risk for cardiovascular disease who are receiving statin therapy

Cardiovascular Diabetology ◽

10.1186/s12933-020-01061-0 ◽

2020 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Masato Furuhashi ◽

Ichiro Sakuma ◽

Takeshi Morimoto ◽

Yukimura Higashiura ◽

Akiko Sakai ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Type 2 Diabetes Mellitus ◽

High Risk ◽

Statin Therapy

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An evaluation of lipid profile and pro-inflammatory cytokines as determinants of cardiovascular disease in those with diabetes: a study on a Mexican American cohort

Scientific Reports ◽

10.1038/s41598-021-81730-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Amna Tahir ◽

Perla J. Martinez ◽

Fayyaz Ahmad ◽

Susan P. Fisher-Hoch ◽

Jennifer L. Gay ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Early Diagnosis ◽

Lipid Profile ◽

Heart Attack ◽

Mexican Americans ◽

Inflammatory Markers ◽

Fasting Blood Glucose ◽

Low Grade

AbstractSedentary life styles coupled with high-calorie diets and unhealthy social habits such as smoking, have put an ever-increasing number of people at risk of cardiovascular disorders (CVD), worldwide. A concomitant increase in the prevalence of type 2-diabetes (hyperglycemia), a risk factor for CVD, has further contributed towards escalating CVD-related mortalities. The increase in number of cases of type 2-diabetes underscores the importance of early diagnosis of cardiovascular disease in those with diabetes. In this work, we have evaluated the sensitivity and specificity of dyslipidemia and proinflammatory cytokines to be used as biomarkers for predicting the risk of CVD in those with diabetes. We hypothesize that interplay between dyslipidemia and diabetes-induced low-grade inflammation in those with type 2-diabetes increases the risk of CVD. A total of 215 participants were randomly recruited from the Cameron County Hispanic Cohort (CCHC). Of these, 99% were Mexican Americans living on Texas-Mexico border. Levels of cytokines, adipokines and lipid profile were measured. Cardiovascular disease (CVD) for this study was defined as prior diagnosis of heart attack, angina and stroke, while diabetes was defined by fasting blood glucose (FBG) of > 100 mg/dL and HbA1c of > 6.5, in accordance with American Diabetes Association (ADA) guidelines. Depending on type and distribution of data, various statistical tests were performed. Our results demonstrated higher rates of heart attack (14% vs 11.8%) and stroke (19.8% vs 10%) in those with diabetes as compared to non-diabetes. The odds of having a heart attack were eight times higher in the presence of elevated triglycerides and pro-inflammatory markers (TNFα and IL6) as compared to presence of pro-inflammatory markers only. The odds for heart attack among those with diabetes, increased by 20 fold in presence of high levels of triglycerides, TNFα, and IL6 when coupled with low levels of high-density lipid cholesterol (HDL-C). Lastly, our analysis showed that poorly controlled diabetes, characterized by HbA1c values of > 6.5 increases the odds of stroke by more than three fold. The study quantifies the role of lipid profile and pro-inflammatory markers in combination with standard risk factors towards predicting the risk of CVD in those with type 2-diabetes. The findings from the study can be directly translated for use in early diagnosis of heart disease and guiding interventions leading to a reduction in CVD-associated mortality in those with type 2-diabetes.

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Prescribing paradigm shift? Applying the 2019 European Society of Cardiology-led guidelines on ‘diabetes, pre-diabetes, and cardiovascular disease’ to assess eligibility for sodium-glucose co-transporter-2 inhibitors or glucagon-like peptide-1 receptor agonists as first-line monotherapy (or add-on to metformin monotherapy) in type 2 diabetes in Scotland

10.2337/figshare.12167802.v1 ◽

2020 ◽

Author(s):

Caparrotta Thomas M ◽

Blackbourn Luke AK ◽

McGurnaghan Stuart J ◽

Chalmers John ◽

Lindsay Robert ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

High Risk ◽

European Society ◽

Metformin Monotherapy ◽

Drug Naïve ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1 ◽

European Society Of Cardiology

Objective: In 2019, the European Society of Cardiology led and released new guidelines for diabetes’ cardiovascular risk management, reflecting recent evidence of cardiovascular disease (CVD) reduction with sodium-glucose co-transporter-2 inhibitors (SGLT-2i) and some glucagon-like peptide-1 receptor agonists (GLP1RA) in type 2 diabetes (T2D). A key recommendation is that all those with T2D who are (anti-hyperglycaemic) drug-naïve or on metformin monotherapy should be CVD-risk-stratified and an SGLT-2i or GLP1RA initiated in all those at high or very high risk, irrespective of glycated haemoglobin. We assessed the impact of these guidelines in Scotland were they introduced as is. Research Design and Methods: Using a nationwide diabetes register in Scotland, we did a cross-sectional analysis, employing variables in our register for risk stratification at 1 January 2019. We were conservative in our definitions, assuming the absence of a risk factor where data were not available. The risk classifications were applied to those drug-naïve or metformin monotherapy people and the anticipated prescribing change calculated. Results: Of the 265,774 people with T2D in Scotland, 53,194 (20.0% of T2D) were drug-naïve and 56,906 (21.4%) were on metformin monotherapy. Of these, 74.5% and 72.4% respectively were estimated as at least high risk given the guideline risk definitions. Conclusion: Thus, 80,830 (30.4%) of all those with T2D (n=265,774) would start one of these drug classes according to table 7 and figure 3 of the guideline. The sizeable impact on drug budgets, enhanced clinical monitoring and the trade-off with reduced CVD-related healthcare costs will need careful consideration.

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