scholarly journals The effect of surgery on fat mass, lipid and glucose metabolism in mild primary hyperparathyroidism

2018 ◽  
Vol 7 (8) ◽  
pp. 941-948 ◽  
Author(s):  
Kristin Godang ◽  
Karolina Lundstam ◽  
Charlotte Mollerup ◽  
Stine Lyngvi Fougner ◽  
Ylva Pernow ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Glucose Metabolism ◽  
Primary Hyperparathyroidism ◽  
Cardiovascular Risk Factors ◽  
Outcome Measures ◽  
Fat Mass ◽  
Lipid Lowering ◽  
Mild Primary Hyperparathyroidism ◽  
Over Time

Context Mild primary hyperparathyroidism has been associated with increased body fat mass and unfavorable cardiovascular risk factors. Objective To assess the effect of parathyroidectomy on fat mass, glucose and lipid metabolism. Design, patients, interventions, main outcome measures 119 patients previously randomized to observation (OBS; n = 58) or parathyroidectomy (PTX; n = 61) within the Scandinavian Investigation of Primary Hyperparathyroidism (SIPH) trial, an open randomized multicenter study, were included. Main outcome measures for this study were the differences in fat mass, markers for lipid and glucose metabolism between OBS and PTX 5 years after randomization. Results In the OBS group, total cholesterol (Total-C) decreased from mean 5.9 (±1.1) to 5.6 (±1.0) mmol/L (P = 0.037) and LDL cholesterol (LDL-C) decreased from 3.7 (±1.0) to 3.3 (±0.9) mmol/L (P = 0.010). In the PTX group, the Total-C and LDL-C remained unchanged resulting in a significant between-group difference over time (P = 0.013 and P = 0.026, respectively). This difference was driven by patients who started with lipid-lowering medication during the study period (OBS: 5; PTX: 1). There was an increase in trunk fat mass in the OBS group, but no between-group differences over time. Mean 25(OH) vitamin D increased in the PTX group (P < 0.001), but did not change in the OBS group. No difference in parameters of glucose metabolism was detected. Conclusion In mild PHPT, the measured metabolic and cardiovascular risk factors were not modified by PTX. Observation seems safe and cardiovascular risk reduction should not be regarded as a separate indication for parathyroidectomy based on the results from this study.

scholarly journals Effect of Surgery on Cardiovascular Risk Factors in Mild Primary Hyperparathyroidism

2009 ◽  
Vol 94 (7) ◽  
pp. 2255-2261 ◽  
Author(s):  
Jens Bollerslev ◽  
Thord Rosen ◽  
Charlotte L. Mollerup ◽  
Jörgen Nordenström ◽  
Marek Baranowski ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Primary Hyperparathyroidism ◽  
Cardiovascular Risk Factors ◽  
Mild Primary Hyperparathyroidism

Abstract 14466: Characterisation of Recent Trends in Cardiovascular Risk Factors in Younger Patients With Ischaemic Stroke

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Aditya Bhat ◽  
Gary Gan ◽  
David Makarious ◽  
Elizabeth Tan ◽  
Henry Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Ischaemic Stroke ◽  
Cardiovascular Risk Factors ◽  
Transient Ischaemic Attack ◽  
Lipid Lowering ◽  
Younger Patients ◽  
Young Stroke ◽  
Ischaemic Attack ◽  
Over Time

Introduction: Strokes in the young are associated with a disproportionately large economic and social impact in addition to their clinical effects. Standard Modifiable Cardiovascular Risk Factors (SMuRFs; hypercholesterolaemia, hypertension, diabetes mellitus and smoking) are key drivers of cardiovascular disease including strokes, however recent temporal trends in the young stroke population have not been characterised. Hypothesis: The proportion of patients with non-SMuRFs are on the rise in a cohort of younger patients with ischaemic stroke/transient ischaemic attack. Methods: Consecutive patients aged <65 years with clinical and/or radiological diagnosis of ischaemic stroke or transient ischaemic attack in a tertiary referral centre (2013-2017) were retrospectively appraised. The demographic and clinical comorbidities of these patients were assessed including their SMuRF profile. The prevalence over time and clinical associations of patients with no SMuRFs were studied and compared to patients with SMuRFs. Results: Of 487 patients (53.49±9.13yrs, 60% men) analysed, 23% did not have SMuRFs. The proportion of “non-SMuRF” patients increased over time (see Figure; p<0.01) and this trend was not influenced by age (p=0.48) or gender (p=0.68). The presence of SMuRFs was not associated with in-hospital outcomes, however patients without SMuRFs were significantly less likely to be discharged on blood pressure (p<0.01) and lipid-lowering therapies (p=0.03). Conclusions: The proportion of young stroke patients without SMuRFs is substantial and has increased over time. Our findings highlight the need for further research to better understand the mechanisms underlying stroke development in this population and whether less risk factor treatment of this population could impact longer term outcomes.

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.

scholarly journals Significance of extended sports cardiology screening of elite handball referees

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249923
Author(s):  
Orsolya Kiss ◽  
Mate Babity ◽  
Attila Kovacs ◽  
Judit Skopal ◽  
Hajnalka Vago ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Lifestyle Changes ◽  
Lipid Lowering ◽  
Composition Analysis ◽  
Lipid Lowering Therapy ◽  
Premature Ventricular Contractions ◽  
Holter Ecg

The significance of cardiology screening of referees is not well established. Cardiovascular risk factors and diseases were examined in asymptomatic Hungarian elite handball referees undergoing extended screening: personal/family history, physical examination, 12-lead ECG, laboratory tests, body-composition analysis, echocardiography, and cardiopulmonary exercise testing. Holter-ECG (n = 8), blood pressure monitorization (n = 10), cardiac magnetic resonance imaging (CMR; n = 27) and computer tomography (CCT; n = 4) were also carried out if needed. We examined 100 referees (age: 29.6±7.9years, male: 64, training: 4.3±2.0 hours/week), cardiovascular risk factors were: positive medical history: 24%, overweight: 10%, obesity: 3%, dyslipidaemia: 41%. Elevated resting blood pressure was measured in 38%. Stress-ECG was positive due to ECG-changes in 16%, due to elevated exercise blood pressure in 8%. Echocardiography and/or CMR identified abnormalities in 19%. A significant number of premature ventricular contractions was found on the Holter-ECG in two cases. The CCT showed myocardial bridge or coronary plaques in one-one case. We recommended lifestyle changes in 58%, new/modified antihypertensive or lipid-lowering therapy in 5%, iron-supplementation in 22%. By our results, a high percentage of elite Hungarian handball referees had cardiovascular risk factors or diseases, which, combined with physical and psychological stress, could increase the possibility of cardiovascular events. Our study draws attention to the importance of cardiac screening in elite handball referees.

Abstract P373: Trends in Cardiovascular Risk Factors by Clinical Definitions of Prediabetes

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Caroline Liu ◽  
Kathryn Foti ◽  
Elizabeth Selvin
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Nutrition Examination Survey ◽  
Risk Factor Management ◽  
Health And Nutrition ◽  
High Prevalence ◽  
Definition Of ◽  
And Control ◽  
Over Time

Introduction: There are five different definitions of prediabetes currently used in clinical practice. How cardiovascular risk may differ by these different definitions of prediabetes and whether trends in cardiovascular risk in persons with prediabetes have changed over time is largely uncharacterized. Hypothesis: We expect the prevalence of cardiovascular risk factors will vary by prediabetes definition and will be highest among those who meet clinical definitions with higher cutoff values. We hypothesize awareness, treatment and control of hypertension and hypercholesterolemia have increased over time among those with prediabetes. Methods: We analyzed data for adults ages ≥ 20 years from the 1999-2014 National Health and Nutrition Examination Survey (NHANES). We used calibrated HbA1c and FPG values to estimate prediabetes prevalence. We examined the prevalence and trends of hypertension and hypercholesterolemia among those who met each clinical definition of prediabetes, as well as awareness, treatment, and control. Results: The prevalence of prediabetes by each definitions remained stable across survey years. The prevalence, awareness, treatment, and control of hypertension and hypercholesterolemia by clinical definition modestly increased over time. Conclusion: The prevalence of hypertension and hypercholesterolemia was higher among individuals who met HbA1c-based definitions of prediabetes than other measures and was highest when more restrictive criteria for prediabetes were used. Awareness, treatment, and control of cardiovascular risk factors increased over time by any definition, but the high prevalence of cardiovascular risk factors highlights the need for improvement in risk factor management in people with prediabetes.

scholarly journals Maternal vomiting during early pregnancy and cardiovascular risk factors at school age: the Generation R Study

2019 ◽  
Vol 11 (2) ◽  
pp. 118-126 ◽  
Author(s):  
Sunayna Poeran - Bahadoer ◽  
Vincent W. V. Jaddoe ◽  
Olta Gishti ◽  
Iris J. Grooten ◽  
Oscar H. Franco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Fat Mass ◽  
Early Pregnancy ◽  
Hyperemesis Gravidarum ◽  
Gynoid Fat ◽  
Total Body ◽  
Fat Mass Ratio

AbstractBackground:Evidence suggests that low birth weight and fetal exposure to extreme maternal undernutrition is associated with cardiovascular disease in adulthood. Hyperemesis gravidarum, a clinical entity characterized by severe nausea and excess vomiting leading to a suboptimal maternal nutritional status during early pregnancy, is associated with an increased risk of adverse pregnancy outcomes. Several studies also showed that different measures related to hyperemesis gravidarum, such as maternal daily vomiting or severe weight loss, are associated with increased risks of adverse fetal pregnancy outcomes. Not much is known about long-term offspring consequences of maternal hyperemesis gravidarum and related measures during pregnancy. We examined the associations of maternal daily vomiting during early pregnancy, as a measure related to hyperemesis gravidarum, with childhood cardiovascular risk factors.Methods:In a population-based prospective cohort study from early pregnancy onwards among 4,769 mothers and their children in Rotterdam, the Netherlands, we measured childhood body mass index, total fat mass percentage, android/gynoid fat mass ratio, preperitoneal fat mass area, blood pressure, lipids, and insulin levels. We used multiple regression analyses to assess the associations of maternal vomiting during early pregnancy with childhood cardiovascular outcomes.Results:Compared with the children of mothers without daily vomiting during early pregnancy, the children of mothers with daily vomiting during early pregnancy had a higher childhood total body fat mass (difference 0.12 standard deviation score [SDS]; 95% confidence interval [CI] 0.03–0.20), android/gynoid fat mass ratio (difference 0.13 SDS; 95% CI 0.04–0.23), and preperitoneal fat mass area (difference 0.10 SDS; 95% CI 0–0.20). These associations were not explained by birth characteristics but partly explained by higher infant growth. Maternal daily vomiting during early pregnancy was not associated with childhood blood pressure, lipids, and insulin levels.Conclusions:Maternal daily vomiting during early pregnancy is associated with higher childhood total body fat mass and abdominal fat mass levels, but not with other cardiovascular risk factors. Further studies are needed to replicate these findings, to explore the underlying mechanisms and to assess the long-term consequences.

Sign in / Sign up

Export Citation Format

Share Document