scholarly journals Relationship between metabolic syndrome components in patients with resistant arterial hypertension

2021 ◽  
Vol 11 (6) ◽  
pp. 199-208
Author(s):  
I. P. Shmakova ◽  
S. A. Panina ◽  
P. A. Shishova
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Body Mass Index ◽  
Arterial Hypertension ◽  
Density Lipoprotein ◽  
Resistant Arterial Hypertension

Metabolic syndrome (MS) is a complex of interrelated pathological conditions based on insulin resistance, obesity, dyslipoproteinemia, arterial hypertension (AH). MS is a predictor of the cardiovascular disease, type 2 diabetes mellitus (DM), cancer and premature death. The incidence of type 2 diabetes increases with age and is 25.2% among the elderly. The prevalence of prediabetes or metabolic syndrome was approximately three times higher. Heart failure is another important cause of morbidity and mortality from the cardiovascular disease. Recent studies have shown that the incidence of hospitalizations for heart failure (adjusted for age and gender) was twice as high in patients with diabetes compared with patients without diabetes. Patients with hypertension and abdominal obesity (AO) have an increased risk of various complications: type 2 diabetes -5-9 times, stroke - 7 times, coronary heart disease - 4 times and mortality - 2 times. Objective: To analyze the relationship between the components of the metabolic syndrome in patients with resistant arterial hypertension (RAH). Materials and methods. A retrospective analysis of case histories of 120 patients, including 52 men (43.33%) and 68 women (56.67%) with a diagnosis of RAH and signs of MS. The presence of concomitant pathology, the level of office arterial pressure, pulse pressure (PP) were calculated; body weight, height with calculation of body mass index (BMI); waist circumference (WC), the levels of low-density lipoprotein (LDL) and high-density lipoprotein (HDL), triglycerides (TG), and plasma glucose were studied. Student's criterion was used to assess the degree of significance of the differences, p≤0.05 was taken as the critical level of significance. Pearson's correlation coefficient was used. Disorders of carbohydrate metabolism among patients with MS and RAH is 67.50%, of which type 2 diabetes makes 50.83%, impaired glucose tolerance - 16.67%. Patients with impaired carbohydrate metabolism are 2 times more likely to have complications of hypertension and lower HDL. Women with MS and RAH were significantly older than men and more often had concomitant pathology: morbid obesity (p <0.05), type 2 diabetes mellitus (p <0.05), chronic cerebral ischemia (p <0.05), higher body mass index (p <0.01). Strong correlation between WC and BMI (r = 0.707; p˂0.001), weak direct correlations between WC and PP (r = 0.231; p˂0.05) and WC and TG (r = 0.221; p˂0.05), weak feedback between WC and age (r = -0.188; p˂0.05), and for men direct correlations between WC and TG were confirmed (r = 0.454; p˂0.001), BMI and TG (r = 0.454, p˂0.002).

scholarly journals Metabolic syndrome in patients with type 2 diabetes and atherosclerotic cardiovascular disease: a post hoc analyses of the EMPA-REG OUTCOME trial

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
João Pedro Ferreira ◽  
Subodh Verma ◽  
David Fitchett ◽  
Anne Pernille Ofstad ◽  
Sabine Lauer ◽  
...  
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Trial Registration ◽  
World Health ◽  
Atherosclerotic Cardiovascular Disease ◽  
Renal Outcomes ◽  
Outcome Trial

Abstract Background Patients with type 2 diabetes (T2D) and metabolic syndrome (MetS) are at greater cardiovascular risk than those with T2D without MetS. In the current report we aim to study the characteristics, cardio-renal outcomes and the effect of empagliflozin in patients with MetS enrolled in the EMPA-REG OUTCOME trial. Methods A total of 7020 patients with T2D and atherosclerotic cardiovascular disease were treated with empagliflozin (10 mg or 25 mg) or placebo for a median of 3.1 years. The World Health Organization MetS criteria could be determined for 6985 (99.5%) patients. We assessed the association between baseline MetS and multiple cardio-renal endpoints using Cox regression models, and we studied the change in the individual component over time of the MetS using mixed effect models. Results MetS at baseline was present in 5740 (82%) patients; these were more often white and had more often albuminuria and heart failure, had lower eGFR and HDL-cholesterol, and higher blood pressure, body mass index, waist circumference, and triglycerides. In the placebo group, patients with MetS had a higher risk of all outcomes including cardiovascular death: HR = 1.73 (95% CI 1.01–2.98), heart failure hospitalization: HR = 2.64 (95% CI 1.22, 5.72), and new or worsening nephropathy: HR = 3.11 (95% CI 2.17–4.46). The beneficial effect of empagliflozin was consistent on all cardio-renal outcomes regardless of presence of MetS. Conclusions A large proportion of the EMPA-REG OUTCOME population fulfills the criteria for MetS. Those with MetS had increased risk of adverse cardio-renal outcomes. Compared with placebo, empagliflozin improved cardio-renal outcomes in patients with and without MetS. Trial registration Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT 01131676

scholarly journals Chronic heart failure in patients with type 2 diabetes mellitus: prevalence, prognosis

2015 ◽  
Vol 6 (1) ◽  
pp. 16-23
Author(s):  
S. V Kakorin ◽  
I. A Averkova ◽  
A. M Mkrtumyan
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Chronic Heart Failure ◽  
Carbohydrate Metabolism ◽  
The Status ◽  
Treatment Prognosis

The article presents a literature review of prevalence, prognosis and treatment of overt tactics of chronic heart failure (CHF) in patients with type 2 diabetes mellitus (T2DM). Diabetes and heart failure acquire the status of the epidemic of the XXI century and require health care costs for prevention and treatment of these diseases. Application of modern pharmacological preparations and instrumental treatment of cardiovascular disease (CVD) increases life expectancy and improves the quality of life of patients with CHF as with normal carbohydrate metabolism (UO), and with type 2 diabetes. However, the risk of cardiovascular mortality (CAS) in patients with type 2 diabetes, compared to having a normal carbohydrate metabolism remains unchanged. The rapidly growing population of patients with type 2 diabetes will soon change this in recent years to improve representation treatment prognosis of cardiovascular disease. Violation of myocardial remodeling in type 2 diabetes is caused by a combination of factors associated with diabetic cardiomyopathy. Reduction of the metabolic activity of cardiomyocytes insufficient glucose transport into cells, endothelial dysfunction, diabetic macro and microangiopathy myocardial fibrosis leading to disruption of filling the left ventricle (LV) and the development of chronic heart failure.Insulin resistance (IR) and compensatory hyperinsulinemia (GI) play a key role in the pathogenesis of type 2 diabetes. With effective treatment of chronic heart failure by cardiologists in patients with type 2 diabetes, affecting therapy with insulin resistance should be mandatory.

scholarly journals Association Between Pulse Index and Metabolic syndrome in Individuals with Type 2 Diabetes Mellitus: Outcome of a Twelve-Weeks Therapeutic Exercise

2009 ◽  
pp. 10-15
Author(s):  
Ade Fatai Adeniyi ◽  
Arinola O Sanya ◽  
A A Fasanmade ◽  
B Tijjani ◽  
A E Uloko
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Type 2 Diabetes Mellitus ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Cardiovascular Fitness ◽  
Therapeutic Exercises

Background and Objective: Metabolic syndrome (MS) is an entity with clustering of cardiovascular risk factors and is associated with Type 2 Diabetes Mellitus (T2DM). Low level cardiovascular fitness is also associated with risk of T2DM. An association between Pulse Index (PI) and MS requires further description. This study sought to determine the association between PI and components of MS. Methods: Seventy-seven participants/subjects aged 48.6±6.52 years with T2DM were enrolled into the study at Aminu-Kano Teaching Hospital, Kano, Nigeria. PI and components of MS including Fasting Blood Glucose (FBG), Glycosylated Haemoglobin (HBAlc), High-Density Lipoprotein (HDL-CHOL), Triglycerides (TRIG.), Blood Pressure (BP) and obesity were assessed before and after twelve-week therapeutic exercises. Results: Inverse correlations were obtained for PI and each ofFBG (r=-0.45), HBAlc (r=-0.52), TRIG (r=-0.26), BP(r=-0.43/-0.32), Waist Circumference (r=-0.53), BMI (r=-0.79), blood pressure (r=-0.43/-0.32) except HDL-CHOL (r= 0.67), (P< 0.05 for all the subjects/participants). Conclusions: Low-levels of PI were associated with poor glycaemia, hypertension, obesity and dyslipidaemia. Therapeutic exercises aimed at improving cardiovascular fitness may have significant improvement on MS. which in turn aids the prevention of both T2DM and cardiovascular diseases. Keywords: Type 2 Diabetes Mellitus, Cardiovascular fitness, aerobic exercises, Pulse Index'

scholarly journals 459 Evaluation of LDL-C reductions by siRNA treatment with inclisiran in patients with diabetes mellitus, metabolic syndrome or neither

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
R. Scott Wright ◽  
David Kallend ◽  
Kausik K Ray ◽  
Lawrence Leiter ◽  
Wolfgang Koenig ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Controlled Trial ◽  
Atherosclerotic Cardiovascular Disease ◽  
Double Blind ◽  
Sirna Treatment ◽  
Patients With Diabetes

Abstract Aims Patients with diabetes (DM) and metabolic syndrome (MS) have elevated risks for atherosclerotic cardiovascular disease (ASCVD). Aggressive LDL-C lowering reduces risks. Inclisiran, a new siRNA, lowers LDL-C and was evaluated in patients with Type 2 diabetes (DM), metabolic syndrome (MS) without DM or neither (N) in the ORION-10 trial. Methods ORION-10 was a double-blind, randomized, placebo controlled trial evaluating inclisiran in 1561 patients with ASCVD on maximally tolerated therapy for lowering LDL-C. 781 inclisiran (INC) participants and 780 placebo (P) patients received 1.5 mL SQ tx at Days 1, 90, then every 6 months until Day 540. We evaluated the time adjusted change in LDL-C from baseline after Days 90–540 in DM (n = 702), MS (n = 455) and N participants (n = 404). Results There were no differences in baseline demographics and background therapies between INC and P. Statins were utilized in 89.8% INC and 88.7% of P. High intensity statins were utilized in 67.2% of INC and 68.8% of P; ezetimibe in 10.2% of NC and 9.5% of P participants. INC reduced LDL-C by − 54.4% (−58.3, −50.6 95% CI) in DM, (P &lt; 0.001), −58.6% (−62.3, −54.8), P &lt; 0.001 in-MS and −56.0% (−60.2, −51.7), in N subjects P &lt; 0.001 (see Figure). Conclusions Inclisiran potently and durably reduces LDL-C across patients with DM, MS and those with neither, demonstrating potent efficacy and durability across glycaemic categories. Inclisiran may also represent a potent LDL-C lowering treatment for those with DM and MS.

scholarly journals Type 2 Diabetes Mellitus and Chronic Heart Failure with Midrange and Preserved Ejection Fraction: A Focus on Serum Biomarkers of Fibrosis

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
D. A. Lebedev ◽  
E. A. Lyasnikova ◽  
E. Yu Vasilyeva ◽  
A. Yu Babenko ◽  
E. V. Shlyakhto
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Clinical Manifestations ◽  
Type I ◽  
Procollagen Type ◽  
Galectin 3

As myocardial fibrosis might be an important contributor to the association of diabetes mellitus with left ventricular (LV) dysfunction and chronic heart failure (HF), we investigated the profile of some proinflammatory, profibrotic biomarkers in patients with type 2 diabetes mellitus (T2DM) at various stages of the cardiovascular disease continuum from absence of clinic since and symptoms to HF with preserved (HFpEF) and midrange ejection fraction (HFmrEF). Material and Methods. Sixty-two patients with T2DM (age 60 [55; 61]), 20 patients without clinical manifestations of HF and 2 groups with clinical manifestations of stable HF, 29 patients with HFpEF, and 13 patients with HFmrEF, were included in the study. The control group consisted of 13 healthy subjects and normal BMI. All patients underwent transthoracic echocardiography, laboratory assessment of N-terminal fragment of the brain natriuretic peptide (Nt-proBNP), highly sensitive C-reactive protein (hsCRP), soluble suppression of tumorigenesis-2 (sST2), galectin-3, C-terminal propeptide of procollagen type I (PICP), N-terminal propeptide of procollagen type III (PIIINP), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of matrix proteinase-1 (TIMP-1). Results. Patients with HFmrEF had higher values of LV volumetric parameters, indexed parameters of LV myocardial mass (LVMM), and higher concentrations of Nt-proBNP (all p < 0.05 ). The concentrations of galectin-3 were greater in patients with HFpEF and HFmrEF compared to patients without HF ( p = 0.01 and p = 0.03 , respectively). PICP and PICP/PIIINP ratio were greater in patients with HFmrEF compared to patients with HFpEF ( p = 0.043 and p = 0.033 , respectively). In patients with T2DM and HF, a relationship was found between galectin-3 and LVMM/body surface area ( r = − 0.58 , p = 0.001 ), PIIINP, TIMP-1, and LV end-diastolic volume ( r = − 0.68 and p = 0.042 and r = 0.38 and p = 0.02 , respectively). Conclusion. The dynamics at various stages of the cardiovascular disease continuum in the serum fibrosis markers may reflect an increase in fibrotic and decrease in antifibrotic processes already at the preclinical stage of HF. At the same time, the changes found in the circulating procollagen levels may indicate a shift in balance towards type I collagen synthesis in HFmrEF compared with HFpEF.

scholarly journals Insights Into the Controversial Aspects of Adiponectin in Cardiometabolic Disorders

2020 ◽  
Vol 52 (10) ◽  
pp. 695-707
Author(s):  
Emilio Antonio Francischetti ◽  
Rômulo Sperduto Dezonne ◽  
Cláudia Maria Pereira ◽  
Cyro José de Moraes Martins ◽  
Bruno Miguel Jorge Celoria ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Type 2 Diabetes Mellitus ◽  
Overweight And Obesity ◽  
Adiponectin Receptors ◽  
Circulating Levels

AbstractIn 2016, the World Health Organization estimated that more than 1.9 billion adults were overweight or obese. This impressive number shows that weight excess is pandemic. Overweight and obesity are closely associated with a high risk of comorbidities, such as insulin resistance and its most important outcomes, including metabolic syndrome, type 2 diabetes mellitus, and cardiovascular disease. Adiponectin has emerged as a salutary adipocytokine, with insulin-sensitizing, anti-inflammatory, and cardiovascular protective properties. However, under metabolically unfavorable conditions, visceral adipose tissue-derived inflammatory cytokines might reduce the transcription of the adiponectin gene and consequently its circulating levels. Low circulating levels of adiponectin are negatively associated with various conditions, such as insulin resistance, type 2 diabetes mellitus, metabolic syndrome, and cardiovascular disease. In contrast, several recent clinical trials and meta-analyses have reported high circulating adiponectin levels positively associated with cardiovascular mortality and all-cause mortality. These results are biologically intriguing and counterintuitive, and came to be termed “the adiponectin paradox”. Adiponectin paradox is frequently associated with adiponectin resistance, a concept related with the downregulation of adiponectin receptors in insulin-resistant states. We review this contradiction between the apparent role of adiponectin as a health promoter and the recent evidence from Mendelian randomization studies indicating that circulating adiponectin levels are an unexpected predictor of increased morbidity and mortality rates in several clinical conditions. We also critically review the therapeutic perspective of synthetic peptide adiponectin receptors agonist that has been postulated as a promising alternative for the treatment of metabolic syndrome and type 2 diabetes mellitus.

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