scholarly journals A metformin hatása a vérzsírértékekre, illetve a szív és érrendszeri kockázatra sztatinkezelésben nem részesülő 2-es típusú cukorbetegekben

2019 ◽  
Vol 160 (34) ◽  
pp. 1346-1352 ◽  
Author(s):  
Zoltán Kender ◽  
Jan Benedikt Groener ◽  
Péter Reismann ◽  
Stefan Kopf

Abstract: Introduction: Some meta-analyses suggested a positive effect of metformin therapy on lipid parameters, but the potential beneficial effect of metformin on cardiovascular risk in type 2 diabetes is not entirely clear. Aim: We investigated the effect of metformin therapy on lipid parameters and cardiovascular risk in patients with type 2 diabetes. Method: In a cross-sectional, monocentric study, 102 patients with type 2 diabetes without lipid-lowering medication were analysed for lipid profile and cardiovascular risk (United Kingdom Prospective Diabetes Study Risk Calculator) depending on metformin therapy. The patients were divided into two subgroups regarding with (n = 52) or without metformin therapy (n = 50). Results: Patients with metformin therapy had significantly lower total cholesterol and LDL cholesterol levels than patients without metformin (p<0.01 and p<0.05). This effect was independent from glucose control. No intrinsic effect of metformin could be found on systolic blood pressure, HDL cholesterol, triglycerides, and long-term cardiovascular risk using a multivariable risk assessment score. Conclusion: Metformin therapy has beneficial effects on cholesterol levels without improving cardiovascular risk in patients with type 2 diabetes. Orv Hetil. 2019; 160(34): 1346–1352.

2021 ◽  
Vol 1 (4) ◽  
pp. 307-314
Author(s):  
Toni Prasetia ◽  
Firhat Esfandiari ◽  
Sandhy Arya Pratama ◽  
Ikbal Zaenur Ridwan

ABSTRACT: RELATIONSHIP BETWEEN SYSTOLIC BLOOD PRESSURE AND HDL CHOLESTEROL LEVELS IN TYPE 2 DIABETES MELLITUS PATIENTS IN ARAFAH CLINIC, CENTRAL LAMPUNG Background: Hypertension is a major risk factor for type 2 Diabetes Mellitus, hypertension can make cells insensitive to insulin, so blood sugar levels can also be disrupted. Dyslipidemia causes constriction in blood vessels or atherosclerosis which can aggravate hypertension or diabetes mellitus. Meanwhile, the function of HDL in transporting bad cholesterol also causes blood vessels to dilate due to increased NO production. Objective: To find out the relationship between systolic blood pressure and HDL cholesterol levels in type 2 diabetes mellitus patients at the Arafah Clinic, Central Lampung, 2020. Method: This type of research used in this research is descriptive-analytic with cross-sectional design. The sampling technique was total sampling. Respondents in this study were patients with Type 2 Diabetes Mellitus at the Arafah Clinic in Central Lampung in 2020 Results: Based on the results of the chi-square statistical test, it was found that there was no relationship with the results of p = 0.898 (p> 0.05). Conclusion: There is no correlation between systolic blood pressure and HDL cholesterol levels in type 2 diabetes mellitus patients at the Arafah Clinic, Central Lampung in 2020. Keywords: Diabetes Mellitus type 2, Systolic Blood Pressure, HDL   INTISARI: HUBUNGAN TEKANAN DARAH SISTOLIK DENGAN KADAR KOLESTEROL HDL PADA PASIEN DIABETES MELLITUS TIPE 2 DI KLINIK ARAFAH LAMPUNG TENGAH Latar Belakang: Hipertensi merupakan faktor risiko utama untuk terjadinya Diabetes Melitus tipe 2, hipertensi dapat membuat sel tidak sensitif terhadap insulin, maka kadar gula di dalam darah juga dapat mengalami gangguan. Dislipidimia menyebabkan terjadinya penyempitan dalam pembuluh darah atau aterosklerosis yang dapat memperberat kondisi hipertensi ataupun diabetes mellitus. Sedangkan fungsi HDL mengangkut kolesterol jahat juga menyebabkan pembuluh darah bisa berdilatasi karena produksi NO yang meningkat.Tujuan: Untuk mengetahui Hubungan Antara Tekanan Darah Sistolik dengan Kadar HDL Kolesterol pada pasien Diabetes Melitus tipe 2 di Klinik Arafah Lampung Tengah Tahun 2020.Metode: Jenis penelitian yang digunakan dalam penelitian ini adalah deskriptif analitik dengan desain cross sectional. Teknik pengambilan sampel berupa total sampling. Responden dalam penelitian ini adalah pasien Diabetes Melitus tipe 2 di Klinik Arafah Lampung Tengah.Hasil: Berdasarkan hasil uji statistic chi-square didapatkan tidak terdapat hubungan dengan hasil p=0,898 (p>0,05).Kesimpulan: Tidak terdapat Hubungan Antara Tekanan Darah Sistolik dengan Kadar HDL Kolesterol pada pasien Diabetes Melitus tipe 2 di Klinik Arafah Lampung Tengah tahun 2020. Kata Kunci     : Diabetes Melitus tipe 2, Tekanan Darah Sistolik, HDL


FEBS Letters ◽  
2003 ◽  
Vol 545 (2-3) ◽  
pp. 103-104 ◽  
Author(s):  
B Zietz ◽  
H Herfarth ◽  
G Paul ◽  
A Ehling ◽  
U Müller-Ladner ◽  
...  

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Josep Franch-Nadal ◽  
Manel Mata-Cases ◽  
Irene Vinagre ◽  
Flor Patitucci ◽  
Eduard Hermosilla ◽  
...  

The objective of this cross-sectional study was to assess differences in the control and treatment of modifiable cardiovascular risk factors (CVRF: HbA1c, blood pressure [BP], LDL-cholesterol, body mass index, and smoking habit) according to gender and the presence of cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM) in Catalonia, Spain. The study included available data from electronic medical records for a total of 286,791 patients. After controlling for sex, age, diabetes duration, and treatment received, both men and women with prior CVD had worse cardiometabolic control than patients without previous CVD; women with prior CVD had worse overall control of CVRFs than men except for smoking; and women without prior CVD were only better than men at controlling smoking and BP, with no significant differences in glycemic control. Finally, although the proportion of women treated with lipid-lowering medications was similar to (with prior CVD) or even higher (without CVD) than men, LDL-cholesterol levels were remarkably uncontrolled in both women with and women without CVD. The results stress the need to implement measures to better prevent and treat CVRF in the subgroup of diabetic women, specifically with more intensive statin treatment in those with CVD.


Diabetologia ◽  
2021 ◽  
Author(s):  
Christina Kohlmorgen ◽  
Stephen Gerfer ◽  
Kathrin Feldmann ◽  
Sören Twarock ◽  
Sonja Hartwig ◽  
...  

Abstract Aims/hypothesis People with diabetes have an increased cardiovascular risk with an accelerated development of atherosclerosis and an elevated mortality rate after myocardial infarction. Therefore, cardioprotective effects of glucose-lowering therapies are of major importance for the pharmacotherapy of individuals with type 2 diabetes. For sodium–glucose cotransporter 2 inhibitors (SGLT2is), in addition to a reduction in blood glucose, beneficial effects on atherosclerosis, obesity, renal function and blood pressure have been observed. Recent results showed a reduced risk of worsening heart failure and cardiovascular deaths under dapagliflozin treatment irrespective of the diabetic state. However, the underlying mechanisms are yet unknown. Platelets are known drivers of atherosclerosis and atherothrombosis and disturbed platelet activation has also been suggested to occur in type 2 diabetes. Therefore, the present study investigates the impact of the SGLT2i dapagliflozin on the interplay between platelets and inflammation in atherogenesis. Methods Male, 8-week-old LDL-receptor-deficient (Ldlr−/−) mice received a high-fat, high-sucrose diabetogenic diet supplemented without (control) or with dapagliflozin (5 mg/kg body weight per day) for two time periods: 8 and 25 weeks. In a first translational approach, eight healthy volunteers received 10 mg dapagliflozin/day for 4 weeks. Results Dapagliflozin treatment ameliorated atherosclerotic lesion development, reduced circulating platelet–leucocyte aggregates (glycoprotein [GP]Ib+CD45+: 29.40 ± 5.94 vs 17.00 ± 5.69 cells, p < 0.01; GPIb+lymphocyte antigen 6 complex, locus G+ (Ly6G): 8.00 ± 2.45 vs 4.33 ± 1.75 cells, p < 0.05) and decreased aortic macrophage infiltration (1.31 ± 0.62 vs 0.70 ± 0.58 ×103 cells/aorta, p < 0.01). Deeper analysis revealed that dapagliflozin decreased activated CD62P-positive platelets in Ldlr−/− mice fed a diabetogenic diet (3.78 ± 1.20% vs 2.83 ± 1.06%, p < 0.01) without affecting bleeding time (85.29 ± 37.27 vs 89.25 ± 16.26 s, p = 0.78). While blood glucose was only moderately affected, dapagliflozin further reduced endogenous thrombin generation (581.4 ± 194.6 nmol/l × min) × 10−9 thrombin vs 254.1 ± 106.4 (nmol/l × min) × 10−9 thrombin), thereby decreasing one of the most important platelet activators. We observed a direct inhibitory effect of dapagliflozin on isolated platelets. In addition, dapagliflozin increased HDL-cholesterol levels. Importantly, higher HDL-cholesterol levels (1.70 ± 0.58 vs 3.15 ± 1.67 mmol/l, p < 0.01) likely contribute to dapagliflozin-mediated inhibition of platelet activation and thrombin generation. Accordingly, in line with the results in mice, treatment with dapagliflozin lowered CD62P-positive platelet counts in humans after stimulation by collagen-related peptide (CRP; 88.13 ± 5.37% of platelets vs 77.59 ± 10.70%, p < 0.05) or thrombin receptor activator peptide-6 (TRAP-6; 44.23 ± 15.54% vs 28.96 ± 11.41%, p < 0.01) without affecting haemostasis. Conclusions/interpretation We demonstrate that dapagliflozin-mediated atheroprotection in mice is driven by elevated HDL-cholesterol and ameliorated thrombin–platelet-mediated inflammation without interfering with haemostasis. This glucose-independent mechanism likely contributes to dapagliflozin’s beneficial cardiovascular risk profile. Graphical abstract


2020 ◽  
Author(s):  
Elena Succurro ◽  
Teresa Vanessa Fiorentino ◽  
Sofia Miceli ◽  
Maria Perticone ◽  
Angela Sciacqua ◽  
...  

<b>Objective</b>: Most, but not all studies suggested that women with type 2 diabetes have higher relative risk (RR) for cardiovascular disease (CVD) than men. More uncertainty exists on whether the RR for CVD is higher in prediabetic women compared to men. <p><b>Research Design and Methods</b>: In a cross-sectional study, in 3540 normal glucose tolerant (NGT), prediabetic, and diabetic adults, we compared the RR for prevalent non-fatal CVD between men and women. In a longitudinal study including 1658 NGT, prediabetic, and diabetic adults, we compared the RR for incident major adverse outcomes, including all-cause death, coronary heart disease, and cerebrovascular disease events after 5.6 years follow-up. </p> <p><b>Results:</b> Women with prediabetes and diabetes exhibited greater relative differences in BMI, waist circumference, blood pressure, total, LDL and HDL cholesterol, triglycerides, fasting glucose, hsCRP, and white blood cell count than men with prediabetes and diabetes when compared with their NGT counterparts. We found a higher RR for prevalent CVD in diabetic women (RR 9.29; 95% CI 4.73-18.25; <i>P</i><0.0001) than in men (RR 4.56; 95% CI 3.07-6.77; <i>P</i><0.0001), but no difference in RR for CVD was observed comparing prediabetic women and men. In the longitudinal study, we found that diabetic, but not prediabetic women have higher RR (RR 5.25; 95% CI 3.22-8.56; <i>P</i><0.0001) of incident major adverse outcomes than their male counterparts (RR 2.72; 95% CI 1.81-4.08; <i>P</i><0.0001).</p> <p><b>Conclusions:</b> This study suggests that diabetic, but not prediabetic, women have higher RR for prevalent and incident major adverse outcomes than men. </p>


2008 ◽  
Vol 11 (5) ◽  
pp. 505-516 ◽  
Author(s):  
Nicole Y. Souren ◽  
Maurice P. Zeegers ◽  
Rob G. J. H. Janssen ◽  
Anja Steyls ◽  
Marij Gielen ◽  
...  

AbstractInsulin resistance and obesity are underlying causes of type 2 diabetes and therefore much interest is focused on the potential genes involved. A series of anthropometric and metabolic characteristic were measured in 240 MZ and 112 DZ twin pairs recruited from the East Flanders Prospective Twin Survey. Microsatellite markers located close to ABCC8, ADIPOQ, GCK, IGF1, IGFBP1, INSR, LEP, LEPR, PPARγ and the RETN gene were genotyped. Univariate single point variance components linkage analyses were performed using two methods: (1) the standard method, only comprising the phenotypic and genotypic data of the DZ twin pairs and (2) the extended method, also incorporating the phenotypic data of the MZ twin pairs. Suggestive linkages (LOD > 1) were observed between the ABCC8 marker and waist-to-hip ratio and HDL-cholesterol levels. Both markers flanking ADIPOQ showed suggestive linkage with triglycerides levels, the upstream marker also with body mass and HDL-cholesterol levels. The IGFBP1 marker showed suggestive linkage with fat mass, fasting insulin and leptin levels and the LEP marker showed suggestive linkage with birth weight. This study suggests that DNA variants in ABCC8, ADIPOQ, IGFBP1 and LEP gene region may predispose to type 2 diabetes. In addition, the two methods used to perform linkage analyses yielded similar results. This was however not the case for birth weight where chorionicity seems to be an important confounder.


2008 ◽  
Vol 25 (3) ◽  
pp. 333-340 ◽  
Author(s):  
N. P. E. Kadoglou ◽  
F. Iliadis ◽  
N. Angelopoulou ◽  
D. Perrea ◽  
C. D. Liapis ◽  
...  

2021 ◽  
Author(s):  
Emanuela Orsi ◽  
Giuseppe Penno ◽  
Anna Solini ◽  
Enzo Bonora ◽  
Cecilia Fondelli ◽  
...  

Abstract Background. Atherogenic dyslipidaemia has been implicated in the residual risk for cardiovascular morbidity and mortality, which remains despite attainment of LDL cholesterol goals especially in individuals with type 2 diabetes. However, its relationship with all-cause death has not been sufficiently explored. This analysis evaluated the independent association of increased triglycerides and triglyceride:HDL cholesterol ratio (TG:HDL) and decreased HDL cholesterol with total mortality and the possible modifying effect of gender in a large cohort of patients with type 2 diabetes.Methods. This observational, prospective study enrolled 15,773 patients in 19 Diabetes Clinics throughout Italy in the years 2006-2008. Triglycerides and total and HDL cholesterol were measured by colorimetric enzymatic methods. Vital status was retrieved on 31 October 2015 for 15,656 patients (99.3%). Participants were stratified by quartiles of triglycerides, HDL cholesterol, and TG:HDL.Results. There were 3,602 deaths over a follow-up 7.42±2.05 years (31.0 x 1,000 person-years). In the unadjusted analyses, the highest TG:HDL (but not triglyceride) and the lowest HDL cholesterol quartile were associated with increased death rate and mortality risk. When sequentially adjusting for confounders, including total, LDL, or non-HDL cholesterol and lipid-lowering treatment, mortality risk was significantly higher in the highest triglyceride (hazard ratio 1.167 [95% confidence interval 1.055-1.291], p=0.003) and TG:HDL (1.192 [1.082-1.314], p<0.0001) and the lowest HDL cholesterol (1.232 [1.117-1.360], p<0.0001) quartile, though the association of triglycerides and HDL cholesterol disappeared after further adjustment for each other. Interaction with gender was significant only for HDL cholesterol (p=0.0009). The relationship with death was stronger for triglycerides in males and HDL cholesterol in females, with these associations remaining significant even after adjustment for HDL cholesterol (1.161 [1.019-1.324], p=0.025, for the highest vs the lowest triglyceride quartile) and triglycerides (1.366 [1.176-1.587], p<0.0001, for the lowest vs the highest HDL cholesterol quartile).Conclusions. In patients with type 2 diabetes, higher triglycerides and TG:HDL and lower HDL cholesterol were independently associated with increased all-cause mortality, with a modifying effect of gender for triglycerides and HDL cholesterol. These data suggest that atherogenic dyslipidaemia, especially TG:HDL, may serve as predictor of all-cause death in these individuals.


2021 ◽  
Author(s):  
Ane KM Néri ◽  
Geraldo B da S Junior ◽  
Gdayllon C Meneses ◽  
Alice MC Martins ◽  
Elizabeth De F Daher ◽  
...  

Aim: To investigate the association between cardiovascular risk and biomarkers in patients with Type 2 diabetes (T2DM). Methods: Cross-sectional study, with evaluation of traditional and new biomarkers (serum FGF-23, Syndecan-1 – Sdc-1 and vascular cell adhesion molecule-1 – VCAM-1 and urinary VEGF and kidney injury molecule-1 – KIM-1) and risk scores (Framingham-FRS and UK Prospective Diabetes Study – UKPDS). Results: 128 diabetics were included, with predominance of high risk by FRS and low risk by UKPDS. There was an independent association of VCAM-1 and VEGF with higher risk by FRS-lipids and UKPDS. Conclusion: There was an independent association of VCAM-1 and VEGF with higher cardiovascular risk, showing a subclinical endothelial dysfunction in T2DM. The inclusion of novel biomarkers to risk scores may increase accuracy when assessing cardiovascular risk of diabetic individuals.


2020 ◽  
Author(s):  
Yu Togashi ◽  
Jun Shirakawa ◽  
Daisuke Miyashita ◽  
Mayu Kyohara ◽  
Tomoko Okuyama ◽  
...  

Abstract Background: Little is known about the association between abdominal aortic calcification (AAC) and the risk of cardiovascular disease (CVD) among patients with diabetes. This study evaluated the cross-sectional association between AAC and CVD morbidity in patients with type 2 diabetes. Methods: This retrospective cross-sectional study enrolled 285 inpatients with type 2 diabetes. The lateral view of an abdominal X-ray image obtained while each subject was in a standing position was examined, and the AAC score and AAC length, corresponding to the area of calcific deposits in the anterior and posterior aortic wall for the L1-4 and L1-5 regions, respectively, were measured. The associations between the AAC scores and lengths and the presence of coronary artery disease (CAD), cerebral infarction (CI), and peripheral artery disease (PAD) were then assessed. The correlation between the AAC grades and other clinical factors were also evaluated. Results: The degree of AAC was significantly correlated with a higher prevalence of CAD and CI but not PAD after adjustments for cardiovascular risk factors. The AAC score was inversely correlated with BMI, and both the AAC score and the AAC length were correlated with the Fib-4 index; these correlations persisted after adjustments for cardiovascular risk factors and BMI, although AAC was not associated with ultrasonography-diagnosed fatty liver. Conclusion: AAC is associated with CAD and CI morbidity in patients with type 2 diabetes. AAC grading also predicts the Fib-4 index, a hepatic fibrosis marker, suggesting a novel potential predictor of liver disease that is independent of cardiovascular risk factors and obesity.


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