THU0381 MANAGEMENT OF CARDIOVASCULAR COMORBIDITY IN PSORIATIC ARTHRITIS IN THE ROUTINE CLINICAL PRACTICE: A COMPARATIVE STUDY OF METHOTREXATE OR APREMILAST AS MONOTHERAPY AND COMBINED

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 424-425
Author(s):  
N. Barbarroja Puerto ◽  
I. Arias de la Rosa ◽  
C. Torres-Granados ◽  
M. D. C. Abalos-Aguilera ◽  
G. G. Ignacio ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Disease Activity ◽  
Lipid Profile ◽  
Combined Therapy ◽  
Routine Clinical Practice ◽  
Research Support ◽  
Number Of Patients

Background:The presence of cardiovascular disease in psoriatic arthritis (PsA) is of particular concern, as it is considered the leading cause of mortality in PsA. Thus, it is essential to recognize those appropriate therapies that could target this comorbidity, reducing the risk of cardiovascular disease and metabolic alterations.Objectives:To evaluate the efficacy of methotrexate (MTX) and apremilast as monotherapies or in combination, in the clinical manifestations of the disease and the reduction of cardiovascular risk factors in PsA.Methods:Prospective longitudinal study in 30 PsA patients diagnosed according to CASPAR criteria: 10 patients were treated with MTX (12 ± 2,58 mg/week), 10 patients with apremilast (60 mg/day) and 10 were treated with combined therapy for 6 months, recruited in the routine clinical practice at the Reina Sofia Hospital of Cordoba and University Hospital of Jaen, Spain. Clinical and analytical parameters were collected at baseline and after 6 months of treatment: lipid profile (cholesterol, HDL, LDL, TG, ApoA and ApoB), glucose and insulin, body surface area (BSA) affected by psoriasis, number of tender and swollen joints, DAS28, DAPSA, VAS, CRP and ESR.The presence of cardiometabolic risk factors such as metabolic syndrome (MetSyn) was evaluated according to National Cholesterol Education Program (NCEP) adult treatment panel III (ATP III) criteria, meeting 3 of the following characteristics: abdominal obesity (men (>102 cm); women (>88 cm), TG > 150 mg/dL, HDL (men (<40 mg/dL); women (<50 mg/dL), blood pressure > 130/85 mmHg, glucose levels > 110 mg/dL). Insulin resistance (HOMA-IR > 2,5), body mass index (BMI), ApoB/ApoA ratio, atherogenic index (AI) and SCORE (age, gender, cholesterol, HDL, smoking habit and diabetes) were also studied.Results:Apremilast or MTX monotherapies caused a moderate reduction of the clinical inflammatory markers (CRP and ESR) and disease activity (VAS, DAPSA and DAS28) after 6 months of treatment. On the other hand, while apremilast significantly reduced the affected BSA, MTX had no significant effect. All those parameters were more significantly reduced after the combined treatment (MTX+ apremilast).Apremilast monotherapy significantly improved alterations in the lipid profile (reducing cholesterol and LDL levels, ApoB/ApoA ratio and AI), insulin resistance and decreased BMI, thus reducing the number of patients with MetSyn. MTX monotherapy treatment had no positive effect on these parameters. None of the treatments had significant effects on SCORE values.The beneficial effects of apremilast on the lipid profile were mitigated after the combination with MTX. Nevertheless, the number of patients with MetSyn decreased even more after the combined therapy of MTX with apremilast compared to apremilast monotherapy.Conclusion:1) In patients with moderate disease activity, treatment with apremilast monotherapy might have some advantages compared to the MTX monotherapy, since it can decrease the percentage of BSA with psoriasis, the lipid profile alteration, IR and weight, thus improving the cardiovascular risk profile. 2) Combined therapy (MTX+ apremilast) can induce a deeper reduction in the disease activity compared to the monotherapies, maintaining, in turn, the positive effects of apremilast on the cardiovascular risk.Funded by ISCIII (PI17/01316 and RIER RD16/0012/0015) co-funded with FEDER.Disclosure of Interests:Nuria Barbarroja Puerto Grant/research support from: ROCHE and Pfizer., Speakers bureau: ROCHE and Celgene., Iván Arias de la Rosa: None declared, Carmen Torres-Granados: None declared, Maria del Carmen Abalos-Aguilera: None declared, Gómez García Ignacio: None declared, Isabel Añón Oñate: None declared, María José Pérez Galán: None declared, Desiree Ruiz: None declared, Alejandra M. Patiño-Trives: None declared, María Luque-Tévar: None declared, Eduardo Collantes Estevez Grant/research support from: ROCHE and Pfizer, Speakers bureau: ROCHE, Lilly, Bristol and Celgene, Chary Lopez-Pedrera Grant/research support from: ROCHE and Pfizer., Alejandro Escudero Contreras Grant/research support from: ROCHE and Pfizer, Speakers bureau: ROCHE, Lilly, Bristol and Celgene., María Dolores López Montilla Speakers bureau: Celgene

scholarly journals The impact of obesity on cardiovascular disease risk factor

2018 ◽  
Vol 10 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Arun Kumar
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Sodium Intake ◽  
Action Plan ◽  
Saturated Fat ◽  
The World

Obesity has emerged as the most potential cardiovascular risk factor and has raised concern among public and their health related issues not only in developed but also in developing countries. The Worldwide obesity occurrence has almost has gone three times since 1975. Research suggests there are about 775 million obese people in the World including adult, children, and adolescents. Nearly 50% of the children who are obese and overweight in Asia in are below 5 years. There is a steep incline of childhood obesity when compared to 1971 which is not only in developed countries but also in developing countries. A considerable amount of weight gain occurs during the transition phase from adolescence to young adulthood. It is also suggested that those adultswho were obese in childhood also remained obese in their adulthood with a higher metabolic risk than those who became obese in their adulthood. In India, the urban Indian female in the age group of 30-45 years have emerged as an 〝at risk population” for cardiovascular diseases. To understand how obesity can influence cardiovascular function, it becomes immense important to understand the changes which can take place in adipose tissue due to obesity. There are two proposed concepts explaining the inflammatory status of macrophage. The predominant cause of insulin resistance is obesity. Epidemiological and research studies have indicated that the pathogenesis of obesity-related metabolic dysfunction involves the development of a systemic, low-grade inflammatory state. It is becoming clear that targeting the pro-inflammatory pathwaymay provide a novel therapeutic approach to prevent insulin resistance, particularly in obesity inducedinsulin resistance. Some cost effective interventions that are feasible by all and can be implemented even in low-resource settings includes - population-wide and individual, which are recommended to be used in combination to reduce the greatest cardiovascular disease burden. The sixth target in the Global NCD action plan is to reduce the prevalence of hypertension by 25%. Reducing the incidence of hypertension by implementing population-wide policies to educe behavioral risk factors. Reducing cigarette smoking, body weight, blood pressure, blood cholesterol, and blood glucose all have a beneficial impact on major biological cardiovascular risk factors. A variety of lifestyle modifications have been shown, in clinical trials, to lower bloodpressure, includes weight loss, physical activity, moderation of alcohol intake, increased fresh fruit and vegetables and reduced saturated fat in the diet, reduction of dietary sodium intake, andincreased potassium intake. Also, trials of reduction of saturated fat and its partial replacement by unsaturated fats have improved dyslipidaemia and lowered risk of cardiovascular events. This initiative driven by the Ministry of Health and Family Welfare, State Governments, Indian Council of Medical Research and the World Health Organization are remarkable. The Government of India has adopted a national action plan for the prevention and control of non-communicable diseases (NCDs) with specific targets to be achieved by 2025, including a 25% reduction inoverall mortality from cardiovascular diseases, a 25% relative reduction in the prevalence of raised blood pressure and a 30% reduction in salt/sodium intake. In a nutshell increased BMI values can predict the nature of obesity and its aftermaths in terms inflammation and other disease associated with obesity. It’s high time; we must realize it and keep an eye on health status in order to live long and healthy life.

scholarly journals Influence of methyltestosterone postmenopausal therapy on plasma lipids, inflammatory factors, glucose metabolism and visceral fat: a randomized study

2006 ◽  
Vol 154 (1) ◽  
pp. 131-139 ◽  
Author(s):  
Lenora M Camarate S M Leão ◽  
Mônica Peres C Duarte ◽  
Dalva Margareth B Silva ◽  
Paulo Roberto V Bahia ◽  
Cláudia Medina Coeli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Postmenopausal Women ◽  
Fat Mass ◽  
Visceral Fat ◽  
Increased Risk

Background: There has been a growing interest in treating postmenopausal women with androgens. However, hyperandrogenemia in females has been associated with increased risk of cardiovascular disease. Objective: We aimed to assess the effects of androgen replacement on cardiovascular risk factors. Design: Thirty-seven postmenopausal women aged 42–62 years that had undergone hysterectomy were prospectively enrolled in a double-blind protocol to receive, for 12 months, percutaneous estradiol (E2) (1 mg/day) combined with either methyltestosterone (MT) (1.25 mg/day) or placebo. Methods: Along with treatment, we evaluated serum E2, testosterone, sex hormone-binding globulin (SHBG), free androgen index, lipids, fibrinogen, and C-reactive protein; glucose tolerance; insulin resistance; blood pressure; body-mass index; and visceral and subcutaneous abdominal fat mass as assessed by computed tomography. Results: A significant reduction in SHBG (P < 0.001) and increase in free testosterone index (P < 0.05; Repeated measures analysis of variance) were seen in the MT group. Total cholesterol, triglycerides, fibrinogen, and systolic and diastolic blood pressure were significantly lowered to a similar extent by both regimens, but high-density lipoprotein cholesterol decreased only in the androgen group. MT-treated women showed a modest rise in body weight and gained visceral fat mass relative to the other group (P < 0.05), but there were no significant detrimental effects on fasting insulin levels and insulin resistance. Conclusion: This study suggests that the combination of low-dose oral MT and percutaneous E2, for 1 year, does not result in expressive increase of cardiovascular risk factors. This regimen can be recommended for symptomatic postmenopausal women, although it seems prudent to perform baseline and follow-up lipid profile and assessment of body composition, especially in those at high risk of cardiovascular disease.

THU0003 ALTERED DNA METHYLATION AND DIFFERENTIAL EXPRESSION OF GENES INFLUENCING CARDIOVASCULAR RISK AND IMMUNITY IN CD4+ T CELLS FROM SUBJECTS WITH PSORIATIC ARTHRITIS.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 214.1-214
Author(s):  
I. Arias de la Rosa ◽  
M. D. López Montilla ◽  
J. Rodríguez ◽  
E. Ballester ◽  
C. Torres-Granados ◽  
...  
Keyword(s):  
Gene Expression ◽  
Risk Factors ◽  
Insulin Resistance ◽  
Dna Methylation ◽  
T Cells ◽  
Cardiovascular Risk ◽  
Research Support ◽  
Insulin Resistant ◽  
Genome Wide ◽  
Differentially Methylated Genes

Background:Cardiovascular risk factors are increased in Psoriatic Arthritis (PsA). In fact, around 60% out of PsA patients display insulin resistance (IR), a hallmark of metabolic syndrome, which might significantly contribute to the cardiovascular disease. Latest studies suggested that inflammatory and metabolic disorders may be under epigenetic control, including DNA methylation. DNA methylation is an unexplored area in the field of PsA.Objectives:To study the alterations in the genome-wide DNA methylation profile of CD4+T cells from PsA patients and its relationship with its pathology and the risk of cardiovascular comorbidity.Methods:Twenty healthy controls (HC) and 20 PsA patients were included in the study. PsA patients were classified into insulin resistant and non-insulin resistant according to HOMA-IR index. CD4+T lymphocytes were isolated from peripheral blood by positive immunomagnetic selection. The Illumina Infinium MethylationEPIC Beadchip was used to obtain DNA methylation profiles across approximately 850,000 CpGs (TSS1500, TSS200, 5UTR, 3UTR, first exon, gene body). Beta values (β) estimating methylation levels were obtained at each CpG site, and differentially methylated genes (DMG) between PsA and HC were identified. Functional classification of these genes was carried out through gene ontology analysis (PANTHER database). Gene expression analysis of the selected genes was also evaluated by RT-PCR. Vascular parameters including carotid intima-media thickness (cIMT) and endothelial function was analyzed by ecodoppler and periflux respectively.Results:The genome-wide methylation analysis identified 112 DMGs including 41 hypomethylated and 71 hypermethylated. These differentially methylated genes were enriched with several signaling pathways and disease categories including immune response, metabolic processes, oxidative stress, vascular and inflammatory pathways. The altered gene expression of selected genes with altered methylation levels in PsA was also validated. Correlation and association analysis of these DMGs with clinical and analytical variables, cardiovascular risk factors and endothelial microvascular function revealed that the degree of methylation of these genes was significantly associated with cIMT (IGF1R, NDRG3, SMYD3, HLA-DRB1, WDR70), arterial pressure (METT5D1, NRDG3, ADAM17, SMYD3, WNK1, CBX1), insulin resistance (AKAP13, SEMA6D, PLCB1), altered lipid profile and atherogenic index (MYBL1, METT5D1, MAN2A1, SLC1A7, SEMA6D, PLCB1, TLK1, SDK1, CBX1), inflammation (MYBL1, NDUFA5, METT5D1, SEMA6D, PLCB1, TLK1), and endothelial dysfunction (ADAMST10, GPCPD1, CCDC88A). In addition, this analysis also identified 435 DMGs including 280 hypomethylated and 155 hypermethylated in CD4+T cells from IR-PsA vs non IR-PsA patients. Between these two groups of PsA patients, CHUK, SERINC1, RUNX1, TTYH2, TXNDC11, FAF1, BICD1, SCD5, PDE5A, FAS, NFIA and GRP75 displayed the most significantly altered methylation, suggesting the role of these genes in the metabolic complications associated with PsA.Conclusion:These findings help our understanding of the pathogenesis of PsA and advance epigenetic studies in regards to this disease and the cardiometabolic comorbidities associated. Funded by ISCIII (PI17/01316 and RIER RD16/0012/0015) co-funded with FEDER.Disclosure of Interests:Iván Arias de la Rosa: None declared, María Dolores López Montilla Speakers bureau: Celgene, Javier Rodríguez: None declared, Esteban Ballester: None declared, Carmen Torres-Granados: None declared, Carlos Perez-Sanchez: None declared, Maria del Carmen Abalos-Aguilera: None declared, Gómez García Ignacio: None declared, Desiree Ruiz: None declared, Alejandra M. Patiño-Trives: None declared, María Luque-Tévar: None declared, Eduardo Collantes-Estévez Grant/research support from: ROCHE and Pfizer., Speakers bureau: ROCHE, Lilly, Bristol and Celgene., Chary Lopez-Pedrera Grant/research support from: ROCHE and Pfizer., Alejandro Escudero Contreras Grant/research support from: ROCHE and Pfizer, Speakers bureau: ROCHE, Lilly, Bristol and Celgene., Nuria Barbarroja Puerto Grant/research support from: ROCHE and Pfizer., Speakers bureau: ROCHE and Celgene.

scholarly journals High prevalence of obesity in rheumatoid arthritis patients: association with disease activity, hypertension, dyslipidemia and diabetes, a multi-center study

2019 ◽  
Vol 59 (1) ◽  
Author(s):  
Maria Fernanda Brandão de Resende Guimarães ◽  
Carlos Ewerton Maia Rodrigues ◽  
Kirla Wagner Poti Gomes ◽  
Carla Jorge Machado ◽  
Claiton Viegas Brenol ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Disease Activity ◽  
Cardiovascular Risk Factors ◽  
Laboratory Data ◽  
Premature Cardiovascular Disease ◽  
Prevalence Of Obesity ◽  
The Mean

Abstract Introduction Rheumatoid arthritis (RA) is a well-documented independent risk factor for cardiovascular disease. Obesity may provide an additional link between inflammation and accelerated atherosclerosis in RA. Objective To evaluate the association between obesity and disease parameters and cardiovascular risk factors in RA patients. Method Cross-sectional study of a cohort of RA patients from three Brazilian teaching hospitals. Information on demographics, clinical parameters and the presence of cardiovascular risk factors was collected. Blood pressure, weight, height and waist circumference (WC) were measured during the first consultation. Laboratory data were retrieved from medical records. Obesity was defined according to the NCEP/ATPIII and IDF guidelines. The prevalence of obesity was determined cross-sectionally. Disease activity was evaluated using the DAS28 system (remission < 2.6; low 2.6–3.1; moderate 3.2–5.0; high > 5.1). Results The sample consisted of 791 RA patients aged 54.7 ± 12.0 years, of whom 86.9% were women and 59.9% were Caucasian. The mean disease duration was 12.8 ± 8.9 years. Three quarters were rheumatoid factor-positive, the mean body mass index (BMI) was 27.1 ± 4.9, and the mean WC was 93.5 ± 12.5 cm. The observed risk factors included dyslipidemia (34.3%), type-2 diabetes (15%), hypertension (49.2%) and family history of premature cardiovascular disease (16.5%). BMI-defined obesity was highly prevalent (26.9%) and associated with age, hypertension and dyslipidemia. Increased WC was associated with diabetes, hypertension, dyslipidemia and disease activity. Conclusion: Obesity was highly prevalent in RA patients and associated with disease activity.

Glucocorticoids and insulin resistance: old hormones, new targets

1999 ◽  
Vol 96 (5) ◽  
pp. 513-523 ◽  
Author(s):  
Robert C. ANDREWS ◽  
Brian R. WALKER
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Insulin Sensitivity ◽  
Cardiovascular Risk Factors ◽  
Therapeutic Strategy ◽  
Clinical Syndrome ◽  
Glucocorticoid Action ◽  
Novel Therapeutic

Insulin resistance has been proposed as a mediator of the association between risk factors for cardiovascular disease in the population. The clinical syndrome of glucocorticoid excess (Cushing's syndrome) is associated with glucose intolerance, obesity and hypertension. By opposing the actions of insulin, glucocorticoids could contribute to insulin resistance and its association with other cardiovascular risk factors. In this review, we describe briefly the known mechanisms of insulin resistance and highlight the potential mechanisms for the effect of glucocorticoids. We then discuss factors which modulate the influence of glucocorticoids on insulin sensitivity; this highlights a novel therapeutic strategy to manipulate glucocorticoid action which may prove to be a useful tool in treating subjects with insulin resistance. Finally, we describe evidence from human studies that glucocorticoids make an important contribution to the pathophysiology of insulin resistance in the population.

scholarly journals STUDY OF SERUM LIPID PROFILE IN REPRODUCTIVE AND POST MENOPAUSAL WOMEN.

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Dr. Chanchal Shrivastav ◽  
Dr. Akshay Berad ◽  
Dr. Paras Arvindbhai Parekh
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Lipid Profile ◽  
Serum Lipid ◽  
Reproductive Age ◽  
Age Group ◽  
Menopausal Women ◽  
Post Menopausal

According to WHO estimates, 16.7 million people around the globe die of cardiovascular disease each year. Economic transition, urbanization, industrialization and globalization bring about life style changes that promote heart disease. High blood pressure, high cholesterol and obesity are likely to become more prevalent in developing countries. Increased energy intake and sedentary lifestyle are also responsible for heart disease. The presence of one or more cardiovascular risk factors like high levels of TC, LDL, TG, glucose, insulin, BMI and a decreased HDL have been found to increase the progression of prehypertension to hypertension. Prehypertension increases the risk of MI and CAD. The present study was   undertaken to know serum lipid profile changes in reproductive and postmenopausal women. Total 60 Subjects of age group 20-45years (reproductive), 46-60years (postmenopausal) female volunteered for our study. During the study period, BMI, Lipid profile, parameters were recorded in all the subjects. In BMI, TC, LDL, VLDL, TG, is gradually increased, HDL is gradually decreased from reproductive age women to post menopausal women. Dyslipidemia occurs due to multifactorial reasons like physical activity, life style, diet, smoking, alcohol consumption, ethnicity and genetic makeup. Post-menopausal women are at increased risk of developing cardiovascular disease due to change in the lipid pattern and loss of cardioprotective effect of estrogen. Predicting the factors affecting the lipid profile in post-menopausal women, adopting strategies to control these mechanisms by modifying the relative risk factors during menopausal transition may improve the cardiovascular risk profile in these women. Keyword:  Lipid profile, Menopause, Reproductive age group.

scholarly journals Lipids in preeclampsia: pathogenic parallels to atherosclerosis

2020 ◽  
Vol 26 (2) ◽  
pp. 163-169
Author(s):  
V. I. Shcherbakov ◽  
Ya. V. Polonskaya ◽  
E. V. Kashtanova ◽  
A. V. Shirinskaya
Keyword(s):  
Oxidative Stress ◽  
Risk Factors ◽  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Fetal Development ◽  
Open Questions ◽  
History Of ◽  
Lipid Spectrum ◽  
Stress Activation

Preeclampsia (PE) is one of the most common and serious complications of pregnancy. In women with a history of PE the risk of cardiovascular disease is increased, and atherosclerosis can be induced even during fetal development. The exact mechanisms by which PE increases future cardiovascular risk are unknown, although multiple similarities between mechanisms responsible for cardiovascular disease and PE are reported. Risk factors for PE, such as obesity, insulin resistance, thrombophilia, changes in the lipid spectrum are similar to those for atherosclerosis, which allows us to compare these two conditions to clarify the specifics and is important for understanding the pathogenesis of both pathologies. PE, as well as atherosclerosis, manifests as endothelial dysfunction, abnormal immune function, oxidative stress, activation of inflammation, changes in lipid metabolism. Recent studies have provided a broader understanding of the problem, although there are still many open questions. The etiology and pathogenesis of these diseases, their possible relationship are not fully understood. The article provides a summary of possible common mechanisms of PE and atherosclerosis.

scholarly journals P473 Ustekinumab and vedolizumab influence on cardiovascular risk factors in patients with Inflammatory Bowel Disease

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S462-S463
Author(s):  
C Amiama Roig ◽  
C Suárez Ferrer ◽  
J Poza Cordón ◽  
J L Rueda García ◽  
M Sánchez Azofra ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Cardiovascular Risk ◽  
Lipid Profile ◽  
Cardiovascular Risk Factors ◽  
Bowel Disease ◽  
Clinical Remission ◽  
Number Of Patients ◽  
Inflammatory Bowel ◽  
One Year

Abstract Background Chronic inflammatory diseases, including the Inflammatory Bowel Disease (IBD), show an increased risk in the development of atherosclerotic cardiovascular disease and coronary microvascular dysfunction at an early age. AntiTNF α have proven to be effective in reducing the cardiovascular risk in these malaises, nevertheless due to their mechanism of action, we cannot determine whether such efficacy is due to an adequate inflammation control or due to the specific cytokine blockade, which plays an important role in both the inflammation and the atherogenic process. Taking this into account, our hypothesis assesses whether using other anti-inflammatory therapies, such as Ustekinumab and Vedolizumab, would achieve a decrease in cardiovascular risk. Methods In this observational and retrospective study, we collected cardiovascular risk factors(CVRFs) in 46 patients, immediately before starting Ustekinumab or Vedolizumab and a year after, taking into account if patients were in clinical remission or not. The CVRFs included were: body mass index (BMI), arterial hypertension, triglycerides values, lipid profile, albumin and C-reactive protein. Results 46 patients were included, 33(71.74%) with Crohn and 13(28.26%) with Ulcerative Colitis. Of the total number of patients 25(54.35%) were treated with Ustekinumab and 21(45.65%) with Vedolizumab. During the follow-up, only one patient(0.02%) presented a new cardiovascular event. Paired student’s t-test were used for data analysis in both treatment groups, comparing the values of the different CVRFs at the baseline and after one year of treatment. When comparing these values according to clinical remission at one year, no statistically significant differences were observed for any of them. BMI and weight values were |24.49(DE 4.58) vs 24.93(DE 4.74) p=0,71| and |70.76kg(DE 13.86) vs 71.38kg(DE 13.33) p=0,85| respectively. As for hypertension, no relevant changes were observed, representing 15.22% of the population at the beginning and 17.39% after one year of treatment. The differences observed in blood glucose values were|86.23(81.87–90.6)mg/dL vs 89.87mg/dL(84.72–95.01) p=0,27|. Regarding the lipid profile, the total cholesterol values were 158.58mg/dL(DE 36.5) and 168.69mg/dL(DE 32.72) p=0.18. HDL at the beginning 44.67mg/dL(DE 11.69) and after one year 47.43mg/dL(DE 10.19) p=0.28 and triglycerides values of 126.65mg/dL(DE 56.38) and 133.5mg/dL(DE 60.95) p=0,61. Albumin levels|4.08g/dL(DE 0.39) vs 4.27g/dL(DE 0.27)|did show significant differences (p=0,01). Conclusion Patients treated with Vedolizumab or Ustekinumab do not present a significative reduction in the cardiovascular risk after one year regardless of clinical remission.

Insulin resistance and cardiovascular disease

2002 ◽  
Vol 2 (1_suppl) ◽  
pp. S9-S11 ◽  
Author(s):  
Markku Laakso
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Insulin Resistance Syndrome ◽  
Plasminogen Activator Inhibitor 1 ◽  
Factors Associated

Insulin resistance is characterised by a decreased rate of insulin-mediated glucose uptake and is associated with adverse changes in cardiovascular risk factors, such as high triglyceride levels, low levels of high-density lipoprotein cholesterol, raised blood pressure, obesity and increased levels of plasminogen activator inhibitor 1. The term `insulin resistance syndrome' (IRS) is used to describe the complex of factors associated with insulin resistance that is found in patients both with and without type 2 diabetes. Although the presence of insulin resistance syndrome is generally considered to be a risk factor for cardiovascular disease, there is a lack of definitive evidence for a causal link. Recently, however, a statistical method known as factor analysis has been applied to the cluster of cardiovascular risk factors associated with IRS. This has been able to show that the `insulin resistance factor' (high plasma insulin and glucose levels, body mass index, waist-to-hip ratio and triglyceride levels) predicted coronary heart disease events in elderly non-diabetic men as well as in patients with type 2 diabetes. Therefore, treatment of insulin resistance whether by pharmacological (eg. thiazolidinediones) or nonpharmacological means has the potential to offer both improvements in glycaemic control and in cardiovascular events.

scholarly journals SUN-575 Levels of Nesfatin-1 in Adolescents, and Its Association with Body Mass Index and Risk of Cardiovascular Disease

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Karla Paola Gutierrez ◽  
Carlos Kornhauser ◽  
Armando Gómez ◽  
Claudia Luevano-Contreras ◽  
Mary Fafutis-Morris ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Lipid Profile ◽  
Cardiovascular Risk Factors ◽  
Statistical Tests ◽  
Normal Weight ◽  
Control Group ◽  
Cross Sectional ◽  
Obese Adolescents

Abstract Nesfastin-1 is a recently discovered anorexigenic neuropeptide, which seems to follow the signaling pathway of melanocortin, and is involved in cardiovascular regulation (1). It is expressed in several tissues, including pancreatic islet cells, the central nervous system, In subcutaneous and visceral fat tissue, among others (2). There are few and controversial data that assess the levels of nesfatin-1 and its relationship with the cardiovascular disease. The aim of this study was to evaluate the serum levels of nesfatin-1 in adolescents with different metabolic status and BMI and its association with cardiovascular risk factors (glucose, lipid profile). Material and methods: This cross-sectional study included adolescents between 15 and 19 years old, classified in 3 groups according to BMI and HOMA-IR: adolescents with normal weight without metabolic alterations (n ​​= 30), metabolically healthy obese (MHO) n = 30 and metabolically unhealthy obese adolescents (MUO) n = 42. Anthropometric measurements were performed, a fasting blood sample was taken to quantify glucose, lipid profile and creatinine. Insulin and nesfatin-1 concentrations were measured by ELISA. Statistical tests employed were Kruskal Wallis, Spearman correlation. Results: the group of adolescents MUO had higher levels of total-C (p&lt;0.0002); triglycerides (p&lt;0.00001) compared to the control and MHO; higher levels of nesfatin-1 (p=0.0002) and lower levels of HDL-C (p&lt;0.002) compared to the control group. A positive correlation was between nesfatin-1 and BMI (p&lt;0.001), triglycerides (p&lt;0.027), and HOMA-IR (p&lt;0.025) and negative correlation with HDL-C (p&lt;0.026) Conclusion: Our results show that metabolically unhealthy obese adolescents have higher concentrations of nesfatin-1, showing an association with traditional cardiovascular risk factors, which could lead to the development of cardiovascular disease. Nothing to disclose GK, KC, GOA, LCC, FMM, GA, GSME Sources of research support: Grant University of Guanajuato (DAIP 302/2018) References: (1) Oh-I et al., Nature. 2006; 443:709–712. (2) Stengel A et al., Regulatory Peptides. 2010; 163:18–23

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