scholarly journals Vasopressin, from Regulator to Disease Predictor for Diabetes and Cardiometabolic Risk

2016 ◽  
Vol 68 (Suppl. 2) ◽  
pp. 24-28 ◽  
Author(s):  
Olle Melander
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Water Intake ◽  
Plasma Osmolality ◽  
Premature Mortality ◽  
High Water ◽  
Cardiovascular Complications ◽  
Cardiometabolic Disease ◽  
The Metabolic Syndrome

Background: Type 2 diabetes and its cardiovascular disease complications are the major public health threats of our century. Although physical activity and dietary changes are the cornerstones in prevention of diabetes, their broad implementation is not elementary and other complementary lifestyle regimens are needed. Summary: Vasopressin (VP) is the main regulator of body water homeostasis, and at insufficient water intake, normal plasma osmolality can be maintained by increased pituitary VP secretion through VP-2 receptor mediated renal water reabsorption. During the last 6 years several independent studies have shown that high circulating VP, measured by the stable VP marker copeptin, predicts development of type 2 diabetes as well as the metabolic syndrome, cardiovascular disease and premature mortality. Interestingly, VP stimulates adrenocorticotrophic hormone, and as a consequence cortisol secretion, through pituitary VP-1B receptors, which could explain why the 25% of the middle-aged population with high circulating VP have a mild Cushing's syndrome-like phenotype. In rats, high VP results in deterioration of glucose tolerance whereas low VP, obtained by high water intake, ameliorates the VP associated dysmetabolic state, suggesting that the relationship between high VP and risk of diabetes and cardiometabolic disease in humans may be causal and reversible by increasing water intake. Key Messages: With the emerging evidence that high VP, which is present in 25% of the population, is an independent risk factor for diabetes and cardiometabolic disease, VP reduction through water supplementation appears as an attractive candidate intervention to prevent diabetes and its cardiovascular complications.

scholarly journals The Vasopressin System in the Risk of Diabetes and Cardiorenal Disease, and Hydration as a Potential Lifestyle Intervention

2018 ◽  
Vol 72 (Suppl. 2) ◽  
pp. 21-27 ◽  
Author(s):  
Sofia Enhörning ◽  
Olle Melander
Keyword(s):  
Type 2 Diabetes ◽  
Water Intake ◽  
Kidney Diseases ◽  
Urine Volume ◽  
Plasma Osmolality ◽  
Premature Mortality ◽  
Urine Osmolality ◽  
High Plasma ◽  
Effective Prevention

Background: Type 2 diabetes, chronic kidney disease (CKD) and its cardiovascular complications are increasing as health problems worldwide. These diseases are interrelated with overlapping occurrence and once diabetes is established, the risk of cardiorenal disease is dramatically elevated. Thus, a search for unifying modifiable risk factors is key for effective prevention. Summary: Elevated fasting plasma concentration of vasopressin, measured with the marker copeptin, predicts new onset type 2 diabetes as well as renal function decline. Furthermore, we recently showed that increased plasma copeptin concentration independently predicts the development of both CKD and other specified kidney diseases. In consequence, high copeptin is an independent risk factor for cardiovascular disease and premature mortality in both diabetes patients and in the general population. Vasopressin is released when plasma osmolality is high, and the easiest way to lower plasma vasopressin and copeptin concentration is to increase water intake. In a human water intervention experiment with 1 week of 3 L/day increased water intake, the one third of the participants with the greatest copeptin reduction (water responders) were those with a phenotype of low water intake (high habitual plasma copeptin and urine osmolality, and low urine volume). The water-responders had a copeptin reduction of 41% after 1 week of increased water intake compared to a control week; in contrast, a 3% reduction occurred in the other two thirds of the study participants. Among water responders, increased water intake also induced a reduction in fasting glucagon concentration. Key Messages: Elevated copeptin, a measure of vasopressin, is a risk marker of metabolic and cardiorenal diseases and may assist in the detection of individuals at higher risk for these diseases. Furthermore, individuals with high copeptin and other signs of low water intake may experience beneficial glucometabolic effects of increased water intake. Future randomized control trials investigating effects of hydration on glucometabolic and renal outcomes should focus on individuals with signs of low water intake including high plasma copeptin concentration.

scholarly journals Cardiovascular disease prevalence in type 2 diabetes – an analysis of a large German statutory health insurance database

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maximilian Gabler ◽  
Silke Geier ◽  
Lukas Mayerhoff ◽  
Wolfgang Rathmann
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Health System ◽  
Cardiovascular Complications ◽  
Population Based ◽  
Stratified Sample ◽  
Icd 10 ◽  
Definition Of ◽  
Observation Period

Abstract Background The aim of this study was to determine the prevalence of cardiovascular disease in persons with type 2 diabetes mellitus (T2D) in Germany. Methods A claims database with an age- and sex-stratified sample of nearly 4 million individuals insured within the German statutory health system was used. All patients aged ≥18 years with T2D documented between 1 January 2015 and 31 December 2015 and complete retrospective documentation of ≥5 years (continuous enrollment in the German statutory health system) before 2015 were selected based on a validated algorithm. Cardiovascular disease (CVD) events were identified based on ICD-10 and OPS codes according to a previous clinical study (EMPA-REG OUTCOME trial). Results The prevalence of T2D in Germany in 2015 was 9.9% (n = 324,708). Using a narrow definition of CVD, the 6-year observation period prevalence of CVD was estimated as 46.7% [95% CI: 46.52%;46.86%]. Applying a wider CVD definition, the proportion of T2D patients who showed a history of CVD was 57.1% [95% CI: 56.9%;57.24%]. The prevalence of CVD in patients with T2D ranged from 36.3 to 57.1%, depending on the observation period and definition of CVD. Conclusions The results underline the need for a population-based registration of cardiovascular complications in T2D.

scholarly journals Cardiovascular Disease Prevalence in Type 2 Diabetes – An Analysis of A Large German Statutory Health Insurance Database

2020 ◽  
Author(s):  
Maximilian Gabler ◽  
Silke Geier ◽  
Lukas Mayerhoff ◽  
Wolfgang Rathmann
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Health System ◽  
Cardiovascular Complications ◽  
Population Based ◽  
Stratified Sample ◽  
Icd 10 ◽  
Definition Of ◽  
Observation Period

Abstract Background The aim of this study was to determine the prevalence of cardiovascular disease in persons with type 2 diabetes mellitus (T2D) in Germany. Methods A claims database with an age- and sex-stratified sample of nearly 4 million individuals insured within the German statutory health system was used. All patients aged ≥ 18 years with T2D documented between 1 January 2015 and 31 December 2015 and complete retrospective documentation of ≥ 5 years (continuous enrollment in the German statutory health system) before 2015 were selected based on a validated algorithm. Cardiovascular disease (CVD) events were identified based on ICD-10 and OPS codes according to a previous clinical study (EMPA-REG OUTCOME trial).Results The prevalence of T2D in Germany in 2015 was 9.9% (n=324,708). Using a narrow definition of CVD, the 6-year observation period prevalence of CVD was estimated as 46.7% [95% CI: 46.52%;46.86%]. Applying a wider CVD definition, the proportion of T2D patients who showed a history of CVD was 57.1% [95% CI: 56.9%;57.24%]. The prevalence of CVD in patients with T2D ranged from 36.3% to 57.1%, depending on the observation period and definition of CVD.Conclusions The results underline the need for a population-based registration of cardiovascular complications in T2D.

scholarly journals Evaluate the effects of metabolic syndrome in adolescents and children

2020 ◽  
Vol 7 (3) ◽  
pp. 287-292
Author(s):  
Rui-Min Jia ◽  
Xiao-Ning Yan ◽  
Jing Sun
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Obese Children ◽  
The Metabolic Syndrome ◽  
Disease Outcomes ◽  
High Prevalence ◽  
Underlying Pathophysiology

AbstractThe metabolic syndrome (MS) in adolescents and children can cause serious consequences that lead researchers to pay efforts to study in such area. Presently, MS definition is still not standardized. Different versions of MS definition have been used by numerous studies, which may be a problem to identify MS and then to predict and prevent clinical diseases. The pediatric literature shows that insulin resistance and obesity might be the key underlying pathophysiology of MS to cause many related diseases. High prevalence of MS is in overweight and obese children and adolescents. This article focuses on such above issues and also effects of MS on two main disease outcomes: cardiovascular disease and type 2 diabetes.

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