scholarly journals Diabetes and Obesity

2021 ◽  
Vol 6 (4) ◽  
pp. 1-1
Author(s):  
Daphne Owens ◽  
◽  
Gerald H Tomkin

Obesity and Diabetes are leading causes of cardiovascular disease and mortality. They are closely linked because of insulin resistance. Hypertension and dyslipidaemia together with poor exercise drive atherosclerosis. Early treatment of blood sugar, dyslipidaemia and hypertension reverse the atherosclerosis process. Bariatric surgery and low calorie diets have in recent years been shown to reverse or improve blood sugars lipids and blood pressure. The risk of premature myocardial infarction and death should no longer be the desired outcome.

2018 ◽  
Vol 10 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Arun Kumar

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.


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 ◽  
...  

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.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Christian Herder ◽  
Markku Peltonen ◽  
Per-Arne Svensson ◽  
Maren Carstensen ◽  
Peter Jacobson ◽  
...  

Introduction: Adiponectin has anti-inflammatory, insulin-sensitising and atheroprotective effects in rodents. Although serum adiponectin is uniformly downregulated in obesity, its clinical relevance in humans seems more complex. It is not known whether changes in circulating adiponectin predict type 2 diabetes, cardiovascular disease, cancer and mortality in an obese population. Hypothesis: We hypothesised that adiponectin levels are upregulated substantially after weight loss following bariatric surgery and that pronounced increases of adiponectin should offer better protection for individuals against type 2 diabetes. In addition, findings for type 2 diabetes should be compared to associations with cardiovascular disease, myocardial infarction, stroke, cancer and mortality. Methods: Serum concentrations of total adiponectin were measured in 3,223 participants of the Swedish Obese Subjects (SOS) Study (1,533 in the bariatric surgery group: 229 with gastric bypass, 1056 with vertical banded gastroplasty, 248 with adjustable gastric banding; 1,690 in the control group without surgery) at study baseline and after 2 years. Hazard ratios (HR) and 95% confidence intervals (CI) per 1 standard deviation (SD) of 2-year changes (concentration at year 2 - concentration at baseline) in adiponectin were calculated for incident type 2 diabetes, cardiovascular disease, myocardial infarction, stroke, cancer and mortality in the combined surgery group. Numbers of cases were 93, 122, 78, 55, 82 and 179, respectively. Median follow-up times ranged from 10 years for diabetes up to 16 years for mortality. Results: Mean (SD) levels of adiponectin at baseline were 7,453 (4,150) ng/ml in the combined surgery group and 8,247 (4,846) ng/ml in the control group. During the first 2 years of follow-up, adiponectin levels increased in the surgery group by 4,850 (5,387) ng/ml (parallel to a loss of 24% of body weight) and decreased slightly by 270 (2,650) ng/ml in the control group (parallel to a slight gain of 0.1% body weight). The degree of correlation between changes in adiponectin and weight loss in kg was more pronounced in the surgery groups compared with the control group (p=0.001 for interaction). Two-year increases in adiponectin in the surgery group were associated with decreased risk of type 2 diabetes (HR [95% CI] 0.61 [0.38-0.98], adjusted for baseline data for age, sex, BMI, lipids, blood pressure, alcohol consumption, smoking, anti-hypertensive drugs, glucose, insulin), but not with cardiovascular disease, myocardial infarction, stroke, cancer and mortality (adjusted HR between 0.89 and 1.05). Conclusions: Weight loss after bariatric surgery is paralleled by a substantial increase in circulating adiponectin. The degree of upregulation of adiponectin is associated with protection against future type 2 diabetes, but not with the incidence of cardiovascular outcomes, cancer or mortality.


2017 ◽  
Vol 4 (1) ◽  
pp. 5-8
Author(s):  
T.V. Ashcheulova ◽  
O.A Kochubiei O.A ◽  
T.G. Ovrakh

PREVENTIVE CARDIOLOGY, PRECLINICAL DIAGNOSES: OLD PROBLEMS – NEW APPROACHESAshcheulova T.V., Kochubiei O.A., Ovrakh T.GThe article discusses the new Guidelines on cardiovascular disease prevention in clinical practice (2016) which summarized novel approaches of detection of such risk factors as overweigh, obesity, abdominal obesity, smoking, dyslipidemia (cholesterolemia, triglyceridemia), blood pressure (BP) levels, glucose, insulin, insulin resistance, inflammatory markers, such as c-reactive protein, which can be widely used in practice.KeyWords: Cardiovascular disease, preventive cardiology, risk assessment and stratification, strategy for prevention of cardiovascular diseases. ПРЕВЕНТИВНА КАРДІОЛОГІЯ, ДОКЛІНІЧНА ДІАГНОСТИКА: СТАРІ ПРОБЛЕМИ - НОВІ ПІДХОДИАщеулова Т.В., Кочубєй О.А., Оврах Т.Г. У статті розглядаються нові рекомендації з профілактики серцево-судинних захворювань в клінічній практиці (2016 г.), що узагальнюють нові підходи виявлення таких факторів ризику, як надмірна маса тіла, ожиріння, абдомінальне ожиріння, куріння, дисліпідемія (холестеринемія, тригліцеридемія),  артеріальний тиск (АТ), рівень глюкози, інсуліну, резистентність до інсуліну, запальні маркери, такі як С-реактивний білок, які можуть знайти широке застосування у практичній охороні здоров’я.Ключові слова: Серцево-судинні захворювання, профілактична кардіологія, оцінка і стратифікація ризику, стратегія профілактики серцево-судинних захворювань. ПРЕВЕНТИВНАЯ КАРДИОЛОГИЯ, ДОКЛИНИЧЕСКАЯ ДИАГНОСТИКА: СТАРЫЕ ПРОБЛЕМЫ - НОВЫЕ ПОДХОДЫАщеулова Т.В., Кочубей О.А., Оврах Т.Г. В статье рассматриваются новые рекомендации по профилактике сердечно-сосудистых заболеваний в клинической практике (2016 г.), обобщены новые подходы выявления таких факторов риска, как избыточная масса тела, ожирение, абдоминальное ожирение, курение, дислипидемия (холестеринемия, гипертриглицеридемия), повышение артериального давления, уровень глюкозы, инсулина, резистентность к инсулину, маркеры воспаления, такие как С-реактивный белок, которые могут найти широкое применение в практическом здравоохранении.Ключевые слова: сердечно-сосудистые заболевания, профилактическая кардиология, оценка и стратификация риска, стратегия профилактики сердечно-сосудистых заболеваний. 


2018 ◽  
Vol 73 (2) ◽  
pp. 106-112 ◽  
Author(s):  
Daniel Antonio de Luis ◽  
Susana García Calvo ◽  
Juan Jose Lopez Gomez ◽  
Olatz Izaola ◽  
David Primo ◽  
...  

Introduction: Omentin-1 might play a role in the pathogenesis of insulin resistance and obesity. The aim of the present study was to evaluate the influence of weight loss after biliopancreatic diversion on serum omentin-1 concentrations. Material and Methods A Caucasian population of 24 morbid obese patients was analyzed before and after 12 months of a biliopancreatic diversion surgery. Biochemical and anthropometric evaluation were realized at basal visit and at 12 months. Body weight, fat mass, waist circumferences, blood pressure, fasting blood glucose, fasting insulin, insulin resistance (HOMA-IR), lipid concentrations and omentin-1 were measured. Results: After bariatric surgery and in both gender groups (males vs. females); BMI, weight, fat mass, waist circumference, blood pressure, glucose , total cholesterol, LDL cholesterol, triglycerides, HOMA-IR and fasting insulin decreased in a statistical manner from basal values. Omentin-1 levels increased after bariatric surgery and in both gender the improvement was similar (males vs. females); (delta: –87.1 ± 19.0 ng/dL; p = 0.02 vs. –93.8 ± 28.1 ng/dL; p = 0.03). In the multiple regression analysis adjusted by age and sex; BMI kg/m2 (Beta –0.32: 95% CI –3.98 to –0.12) and insulin UI/L (Beta –0.41: 95% CI –8.38 to –0.16) remained in the model with basal omentin-1 levels as dependent variable. The regression model with post-surgery omentin-1 levels as dependent variable showed as independent variables BMI kg/m2 (Beta –0.13: 95% CI –7.69 to –0.09) and insulin UI/L (Beta –0.24: 95% CI –5.69 to –0.08), too. Conclusion: This study showed a significant increase in omentin-1 levels after weight loss secondary biliopancreatic diversion surgery. A weak negative correlation with BMI and basal insulin levels was detected.


2019 ◽  
Vol 20 (7) ◽  
pp. 1658 ◽  
Author(s):  
Hatem Maamoun ◽  
Shahenda Abdelsalam ◽  
Asad Zeidan ◽  
Hesham Korashy ◽  
Abdelali Agouni

Physical inactivity and sedentary lifestyle contribute to the widespread epidemic of obesity among both adults and children leading to rising cases of diabetes. Cardiovascular disease complications associated with obesity and diabetes are closely linked to insulin resistance and its complex implications on vascular cells particularly endothelial cells. Endoplasmic reticulum (ER) stress is activated following disruption in post-translational protein folding and maturation within the ER in metabolic conditions characterized by heavy demand on protein synthesis, such as obesity and diabetes. ER stress has gained much interest as a key bridging and converging molecular link between insulin resistance, oxidative stress, and endothelial cell dysfunction and, hence, represents an interesting drug target for diabetes and its cardiovascular complications. We reviewed here the role of ER stress in endothelial cell dysfunction, the primary step in the onset of atherosclerosis and cardiovascular disease. We specifically focused on the contribution of oxidative stress, insulin resistance, endothelial cell death, and cellular inflammation caused by ER stress in endothelial cell dysfunction and the process of atherogenesis.


2021 ◽  
Vol 3 (2) ◽  
pp. 08-13
Author(s):  
Ervina Julien Sitanggang

Introduction: Cardiovascular disease is the number one cause of death globally with an incidence of adolescents and young adults in Indonesia as many as 153.705 cases. Central obesity is associated with the risk of cardiovascular disease due to increase in fasting blood glucose levels, cholesterol and triglyceride levels, and blood pressure. Aims: to determine the correlation between waist circumference and fasting blood glucose levels, triglyceride levels, and blood pressure in young adults. Method: This analytic study with a cross-sectional approach involved 53 young adult subjects (18-25 years old). Waist circumference is measured using a tape measure. Blood sugar and triglyceride levels were measured using Cobas® 6000 analyzer machine from blood samples of subjects after fasting for 8-12 hours. Blood pressure data are obtained by measurement using aneroid sphygmomanometer. Results: In this study, the mean waist circumference of the research subjects was 77,4 cm. No correlation was found between waist circumference and fasting blood sugar levels (p = 0,159). However, a positive correlation was found between waist circumference and triglyceride levels (p = 0,008; r = 0,332), between waist circumference and systolic blood pressure (p = 0,049; r = 0,230), and between waist circumference and diastolic blood pressure (p = 0,017; r = 0,293). Conclusion: waist circumference is positively correlated with triglyceride levels and blood pressure, but does not correlate with fasting blood sugar levels.


Biomolecules ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. 286 ◽  
Author(s):  
Abdelsalam ◽  
Korashy ◽  
Zeidan ◽  
Agouni

Endothelial dysfunction is a key feature of cardiovascular disorders associated with obesity and diabetes. Several studies identified protein tyrosine phosphatase (PTP)-1B, a member of the PTP superfamily, as a major negative regulator for insulin receptor signaling and a novel molecular player in endothelial dysfunction and cardiovascular disease. Unlike other anti-diabetic approaches, genetic deletion or pharmacological inhibition of PTP1B was found to improve glucose homeostasis and insulin signaling without causing lipid buildup in the liver, which represents an advantage over existing therapies. Furthermore, PTP1B was reported to contribute to cardiovascular disturbances, at various molecular levels, which places this enzyme as a unique single therapeutic target for both diabetes and cardiovascular disorders. Synthesizing selective small molecule inhibitors for PTP1B is faced with multiple challenges linked to its similarity of sequence with other PTPs; however, overcoming these challenges would pave the way for novel approaches to treat diabetes and its concurrent cardiovascular complications. In this review article, we summarized the major roles of PTP1B in cardiovascular disease with special emphasis on endothelial dysfunction and its interplay with insulin resistance. Furthermore, we discussed some of the major challenges hindering the synthesis of selective inhibitors for PTP1B.


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