scholarly journals Early vascular aging risk assessment in patients with metabolic syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Salasyuk ◽  
S Nedogoda ◽  
I Barykina ◽  
V Lutova ◽  
E Popova
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Risk Assessment ◽  
Metabolic Syndrome ◽  
Vascular Aging ◽  
Clinical Markers ◽  
Cvd Risk ◽  
Vascular Age

Abstract Background Metabolic syndrome (MetS) and abdominal obesity are one of the most common CVD risk factors among young and mature patients. However, the currently used CVD risk assessment scales may underestimate the CV risk in people with obesity and MS. Early vascular aging rather than chronological aging can conceptually offer better risk prediction. MetS, as accumulation of classical risk factors, leads to acceleration of early vascular aging. Since an important feature of MetS is its reversibility, an adequate risk assessment and early start of therapy is important in relation to the possibilities of preventing related complications. Purpose To derive a new score for calculation vascular age and predicting EVA in patients with MetS. Methods Prospective open cohort study using routinely collected data from general practice. The derivation cohort consisted of 1000 patients, aged 35–80 years with MetS (IDF,2005 criteria). The validation cohort consisted of 484 patients with MetS and carotid-femoral pulse wave velocity (cfPWV) values exceeding expected for average age values by 2 or more SD (EVA syndrome). Results In univariate analysis, EVA was significantly correlated with the presence of type 2 diabetes and clinical markers of insulin resistance (IR), body mass index (BMI), metabolic syndrome severity score (MetS z-score), uric acid (UA) level, hsCRP, HOMA-IR, total cholesterol (TC), triglycerides (TG), heart rate (HR), central aortic blood pressure (CBP), diastolic blood pressure (DBP). Multiple logistic regression shown, that presence of type 2 diabetes and IR were associated with greater risk of EVA; the odds ratios were 2.75 (95% CI: 2.34, 3.35) and 1.57 (95% CI: 1.16, 2.00), respectively. In addition, the risk of having EVA increased by 76% with an increase in HOMA-IR by 1 unit, by 17% with an increase in hsCRP by 1 mg/l, by 4% with an increase in DBP by 1 mm Hg, and by 1% with each 1 μmol / L increase in the level of UA. The area under the curve for predicting EVA in patients with MetS was 0,949 (95% CI 0,936 to 0,963), 0,630 (95% CI 0,589 to 0,671), 0,697 (95% CI 0,659 to 0,736) and 0,686 (95% CI 0,647 to 0,726), for vascular age, calculated from cfPWV, SCORE scale, QRISK-3 scale and Framingham scale, respectively. Diabetes mellitus and clinical markers of IR (yes/no), HOMA-IR and UA level were used to develop a new VAmets score for EVA prediction providing a total accuracy of 0.830 (95% CI 0,799 to 0,860). Conclusion cfPWV at present the most widely studied index of arterial stiffness, fulfills most of the stringent criteria for a clinically useful biomarker of EVA in patients with MetS. Although, parallel efforts for effective integration simple clinical score into clinical practice have been offered. Our score (VAmets) may accurately identify patients with MetS and EVA on the basis of widely available clinical variables and classic cardiovascular risk factors can prioritize using of vascular age in routine care. ROC-curves for predicting EVA in MetS Funding Acknowledgement Type of funding source: None

scholarly journals Evaluation of a 10-week lifestyle and weight management programme on cardiovascular disease risk factors in a group of people living with obesity referred from a specialist bariatric clinic

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
A Harris ◽  
D Keegan ◽  
S Seery ◽  
D Dunne ◽  
Z Mc Crudden ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Lifestyle Modification ◽  
Interdisciplinary Team ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Risk Factor Reduction

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Health Service Executive Health and Wellbeing, Saolta University Healthcare Group OnBehalf Croí the West of Ireland Cardiac Foundation, Galway, Ireland and the National Institute for Prevention and Cardiovascular Health Introduction People living with obesity are at an increased risk of cardiovascular disease (CVD). While development of obesity is multifactorial, lifestyle modification is fundamental to obesity treatment and risk factor reduction. We sought to measure the effects of a structured lifestyle modification programme on the physical and mental health of people living with obesity. Purpose This study investigated the impact of a 10-week, community based, lifestyle modification programme on CVD risk factors in people living with obesity (BMI ≥35kg/m2 with a co-morbidity or BMI ≥40kg/m2) who were referred from a specialist bariatric service. Methods Delivered by an interdisciplinary team (Nurse, Dietitian & Physiotherapist) the programme included weekly group-based exercise sessions and health promotion workshops. A wide range of topics were addressed in workshops, including nutrition, food labels, emotional eating, physical activity, sedentary behaviour, stress management and CVD risk factor reduction. Outcomes were measured at initial and end of programme assessments. Results 1122 people participated in the intervention between 2013 and 2019 with 78% (n = 877) completing the programme. At initial assessment 26.7% of participants had a diagnosis of type 2 diabetes; 37.3% were at high or very high risk of CVD; 44.7% were hypertensive and 31.4% had a history of depression. Mean BMI was 47.0kg/m2 with 56.4% of participants having a BMI >45kg/m2. The intervention had significant positive impacts on key outcomes such as psychosocial health, lipid profiles, blood pressure, adiposity and cardiovascular fitness. One of the most significant outcomes observed was the improvement in psycho-social health. Scores of anxiety and depression, assessed using the HADS, decreased by 1.5 and 2.2 points respectively (p <0.001). Mean EQ-VAS score increased by 11 points (p <0.001). There were significant changes in total cholesterol levels with a mean reduction in total cholesterol from 4.69mmol/l to 4.54mmol/l (p <0.001) and LDL cholesterol from 2.79mmol/l to 2.64mmol/l (p <0.001). There were also significant improvements in blood pressure with mean systolic blood pressure reducing by 15.7mmHg (p <0.001) and diastolic blood pressure reducing by 1.4mmHg (p <0.001). For people with type 2 diabetes, there was an increase in those achieving the recommended HbA1c target (<53mmol/l) from 47.6% to 57.4% (p <0.001). Mean reduction in bodyweight was 2.0kg (p <0.001), with 27.2% achieving a weight loss of >3% of initial bodyweight. The percentage of participants achieving the recommended physical activity guidelines increased by 31% (p <0.001). Conclusions A lifestyle modification programme delivered by an interdisciplinary team, aimed at individuals living with obesity, is not only acceptable to participants but also significantly reduces CVD risk factors. These findings should influence the design of future programmes and healthcare policies in Ireland and abroad.

The metabolic syndrome: setting the scene. The cons

2007 ◽  
Vol 4 (2_suppl) ◽  
pp. S4-S6 ◽  
Author(s):  
Naveed Sattar
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Metabolic Syndrome ◽  
Elevated Blood ◽  
Diabetes Screening ◽  
Cvd Risk ◽  
Treatment Benefit ◽  
The Metabolic Syndrome

Conclusion: Metabolic syndrome is conceptually useful. It has encouraged thought about the pathology of diabetes and cardiovascular disease, has facilitated research and has brought together cardiologists and diabetologists. But the criteria are neither needed nor additive for CVD risk assessment or diabetes screening or prediction. Neither are they needed to determine treatment benefit. Better options would be to measure and target established risk factors such as lipids, smoking and elevated blood pressure. We should also be thinking about obesity and its prevention, and to do this we need changes in food, activity and fiscal environments.

scholarly journals Circulating Proprotein Convertase Subtilisin/Kexin Type 9 Levels and Cardiometabolic Risk Factors: A Population-Based Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Jie Shi ◽  
Xiaoyong Li ◽  
Weiwei Zhang ◽  
Yixin Niu ◽  
Ning Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Cardiometabolic Risk ◽  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
Population Based ◽  
Low Hdl

Aims: To evaluate the prospective association of circulating PCSK9 levels with the cardiometabolic risk profiles (high LDL-cholesterol, high triglycerides, low HDL-cholesterol, hypertension, type 2 diabetes, and metabolic syndrome).Methods: A population-based prospective study was conducted among 7,104 Chinese individuals (age 56.2 ± 7.5 years; 32.0% men). Circulating PCSK9 levels were measured using ELISA.Results: Circulating PCSK9 levels were higher in women than men (286.7 ± 90.1 vs. 276.1 ± 86.4 ng/ml, p < 0.001). And circulating PCSK9 was positively correlated with LDL-cholesterol, total cholesterol, and triglycerides both in men and women (all p < 0.001). The positive correlation between PCSK9 and waist circumference, fasting glucose, insulin resistance, systolic blood pressure, diastolic blood pressure and C-reactive protein (all p < 0.01) was observed in women only. According to Cox regression analysis, circulating PCSK9 was positively associated with incidence of high LDL-cholesterol both in men (HR 1.33, 95% CI 1.09–1.65, p < 0.001) and women (HR 1.36, 95% CI 1.12–1.69, p < 0.001). Moreover, PCSK9 was significantly associated with incident high triglycerides (HR 1.31, 95% CI 1.13–1.72, p < 0.001), hypertension (HR 1.28, 95% CI 1.08–1.53, p = 0.011), type 2 diabetes (HR 1.34, 95% CI 1.09–1.76, p = 0.005), and metabolic syndrome (HR 1.30, 95% CI 1.11–1.65, p = 0.009) per SD change in women only. No statistically significant association was observed between circulating PCSK9 and incidence of low HDL-cholesterol (p > 0.1).Conclusions: Elevated circulating PCSK9 was significantly associated with cardiometabolic risk factors and independently contributed to the prediction of cardiometabolic risks in women.

scholarly journals Early vascular aging in patients with metabolic syndrome: features of the course and diagnosis

2021 ◽  
Vol 2 (1) ◽  
pp. 50-62
Author(s):  
S. V. Nedogoda ◽  
A. S. Salasyuk ◽  
I. N. Barykina ◽  
V. O. Lutova ◽  
E. A. Popova
Keyword(s):  
Metabolic Syndrome ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Clinical Score ◽  
Routine Care ◽  
Vascular Aging ◽  
Clinical Markers ◽  
Vascular Age

Purpose: identifying the causes of early vascular aging (EVA) in patients with metabolic syndrome (MetS), assessing the relationship between vascular age and various metabolic disorders, the severity of metabolic syndrome , tissue and circulating risk markers, the severity of non-infectious inflammation, and derive a new score for calculation vascular age and predicting early vascular aging in patients with metabolic syndrome.Materials and methods: а total of 750 patients aged 35 to 80 years with metabolic syndrome were examined. Early vascular aging syndrome was detected in 484 patients with metabolic syndrome and carotid-femoral pulse wave velocity (cfPWV) values exceeding expected for average age values by 2 or more SD.Results: Multiple logistic regression shown, that presence of type 2 diabetes and IR were associated with greater risk of early vascular aging, the risk of having early vascular aging increased by 76% with an increase in HOMA-IR by 1 unit, by 17% with an increase in carotid-femoral pulse wave velocity by 1 mg/l, by 4% with an increase in DBP by 1 mm Hg, and by 1% with each 1 pmol / L increase in the level of UA. For vascular age, calculated from carotid-femoral pulse wave velocity, SCORE scale, QRISK-3 scale and Framingham scale, respectively. Diabetes mellitus and clinical markers of IR (yes/no), HOMA-IR and UA level were used to develop a new VAmets score for EVA prediction providing a total accuracy of 0.830 (95% CI 0,799 to 0,860).Conclusion: parallel efforts for effective integration simple clinical score into clinical practice have been offered. Our score (VAmets) may accurately identify patients with metabolic syndrome and early vascular aging on the basis of widely available clinical variables and classic cardiovascular risk factors can prioritize using of vascular age in routine care.

scholarly journals Effect of tofogliflozin on arterial stiffness in patients with type 2 diabetes: prespecified sub-analysis of the prospective, randomized, open-label, parallel-group comparative UTOPIA trial

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Naoto Katakami ◽  
◽  
Tomoya Mita ◽  
Hidenori Yoshii ◽  
Toshihiko Shiraiwa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Conventional Treatment ◽  
Mixed Effects ◽  
Mixed Effects Models ◽  
Open Label ◽  
Parallel Group ◽  
History Of

Abstract Background Tofogliflozin, an SGLT2 inhibitor, is associated with favorable metabolic effects, including improved glycemic control and serum lipid profile and decreased body weight, visceral adipose tissue, and blood pressure (BP). This study evaluated the effects of tofogliflozin on the brachial-ankle pulse wave velocity (baPWV) in patients with type 2 diabetes (T2DM) without a history of apparent cardiovascular disease. Methods The using tofogliflozin for possible better intervention against atherosclerosis for type 2 diabetes patients (UTOPIA) trial is a prospective, randomized, open-label, multicenter, parallel-group, comparative study. As one of the prespecified secondary outcomes, changes in baPWV over 104 weeks were evaluated in 154 individuals (80 in the tofogliflozin group and 74 in the conventional treatment group) who completed baPWV measurement at baseline. Results In a mixed-effects model, the progression in the right, left, and mean baPWV over 104 weeks was significantly attenuated with tofogliflozin compared to that with conventional treatment (– 109.3 [– 184.3, – 34.3] (mean change [95% CI] cm/s, p = 0.005; – 98.3 [– 172.6, – 24.1] cm/s, p = 0.010; – 104.7 [– 177.0, – 32.4] cm/s, p = 0.005, respectively). Similar findings were obtained even after adjusting the mixed-effects models for traditional cardiovascular risk factors, including body mass index (BMI), glycated hemoglobin (HbA1c), total cholesterol, high-density lipoprotein (HDL)-cholesterol, triglyceride, systolic blood pressure (SBP), hypertension, smoking, and/or administration of drugs, including hypoglycemic agents, antihypertensive agents, statins, and anti-platelets, at baseline. The findings of the analysis of covariance (ANCOVA) models, which included the treatment group, baseline baPWV, and traditional cardiovascular risk factors, resembled those generated by the mixed-effects models. Conclusions Tofogliflozin significantly inhibited the increased baPWV in patients with T2DM without a history of apparent cardiovascular disease, suggesting that tofogliflozin suppressed the progression of arterial stiffness. Trial Registration UMIN000017607. Registered 18 May 2015. (https://www.umin.ac.jp/icdr/index.html)

scholarly journals The effects of metformin plus sulfonylurea therapy on clinical features of the metabolic syndrome

2010 ◽  
Vol 63 (9-10) ◽  
pp. 611-615 ◽  
Author(s):  
Branka Koprivica ◽  
Teodora Beljic-Zivkovic ◽  
Tatjana Ille
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Body Mass Index ◽  
Waist Circumference ◽  
Glycemic Control ◽  
Body Mass ◽  
Combined Therapy

Introduction. Insulin resistance is a well-known leading factor in the development of metabolic syndrome. The aim of this study was to evaluate metabolic effects of metformin added to sulfonylurea in unsuccessfully treated type 2 diabetic patients with metabolic syndrome. Material and methods. A group of thirty subjects, with type 2 diabetes, secondary sulfonylurea failure and metabolic syndrome were administered the combined therapy of sulfonylurea plus metformin for six months. Metformin 2000 mg/d was added to previously used sulfonylurea agent in maximum daily dose. Antihypertensive and hypolipemic therapy was not changed. The following parameters were assessed at the beginning and after six months of therapy: glycemic control, body mass index, waist circumference, blood pressure, triglycerides, total cholesterol and its fractions, homeostatic models for evaluation of insulin resistance and secretion (HOMA R, HOMA B) and C- peptide. Results. Glycemic control was significantly improved after six months of the combined therapy: (fasting 7.89 vs. 10.61 mmol/l. p<0.01; postprandial 11.12 vs. 12.61 mmol/l. p<0.01, p<0.01; glycosylated hemoglobin 6.81 vs. 8.83%. p<0.01). the body mass index and waist circumference were significantly lower (26.7 vs. 27.8 kg/m2, p<0.01 and 99.7 vs. 101.4 cm for men, p<0.01; 87.2 vs. 88.5 for women, p<0.01). Fasting plasma triglycerides decreased from 3.37 to 2.45 mmol/l (p<0.001) and HOMA R from 7.04 to 5.23 (p<0.001). No treatment effects were observed on blood pressure, cholesterol, and residual insulin secretion. Conclusion. Administration of metformin in type 2 diabetes with metabolic syndrome decreased cardiovascular risk factors by reducing glycemia, triglycerides, BMI, central obesity and insulin resistance.

scholarly journals Prevalence and Risk Factors of Prolonged QTc Interval among Chinese Patients with Type 2 Diabetes

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Xiang Li ◽  
Hui Ren ◽  
Zhang-rong Xu ◽  
Yan-jun Liu ◽  
Xiao-pin Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Waist Circumference ◽  
Qt Interval ◽  
Postprandial Glucose ◽  
Chinese Patients ◽  
Qtc Interval ◽  
Fasting Insulin

Objectives. The aim of this study was to evaluate the prevalence and the risk factors of prolonged QTc interval among Chinese patients with type 2 diabetes.Methods. The retrospective study included 3156 outpatients from the Diabetes Centre, the 306th Hospital of PLA, during the period from September 2003 to June 2010. QT interval was measured manually in the 12-lead conventional electrocardiogram. The QT interval corrected for heart rate (QTc) was calculated using Bazett’s formula. Additional demographic and laboratory data were also collected. Potential risk factors of prolonged QTc interval were assessed using multivariable regression.Results.The prevalence of prolonged QTc interval among Chinese patients with type 2 diabetes was 30.1%. Height (OR 0.156, 95% CI 0.032~0.748), waist circumference (OR 1.025, 95% CI 1.010~1.040), diastolic blood pressure (OR 1.016, 95% CI 1.007~1.026), postprandial glucose (OR 1.040, 95% CI 1.022~1.059), fasting insulin (OR 1.014, 95% CI 1.003~1.025), and presence of microalbuminuria (OR 1.266, 95% CI 1.033~1.551) were significant risk factors.Conclusions. The prevalence of prolonged QTc interval among Chinese patients with type 2 diabetes is high. Risk factors for prolongation of QTc interval were low height, high waist circumference, increasing diastolic blood pressure levels, high postprandial glucose levels, high fasting insulin levels, and presence of microalbuminuria.

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