Cardiometabolic Risk In Patients Research Articles

Cardiovascular risk in patients with acromegaly vs. non-functioning pituitary adenoma following pituitary surgery: an active-comparator cohort study.

Given the increased cardio-metabolic risk in patients with acromegaly, this study compared cardiovascular outcomes, mortality, and in-hospital outcomes between patients with acromegaly and non-functioning pituitary adenoma (NFPA) following pituitary surgery. This was a nationwide cohort study using data from hospitalized patients with acromegaly or NFPA undergoing pituitary surgery in Switzerland between January 2012 and December 2021. Using 1:3 propensity score matching, eligible acromegaly patients were paired with NFPA patients who underwent pituitary surgery, respectively. The primary outcome comprised a composite of cardiovascular events (myocardial infarction, cardiac arrest, ischemic stroke, hospitalization for heart failure, unstable angina pectoris, cardiac arrhythmias, intracranial hemorrhage, hospitalization for hypertensive crisis) and all-cause mortality. Secondary outcomes included individual components of the primary outcome, surgical re-operation, and various hospital-associated outcomes. Among 231 propensity score-matched patients with acromegaly and 491 with NFPA, the incidence rate of the primary outcome was 8.18 versus 12.73 per 1,000 person-years (hazard ratio [HR], 0.64; [95% confidence interval [CI], 0.31-1.32]). Mortality rates were numerically lower in acromegaly patients (2.43 vs. 7.05 deaths per 1,000 person-years; HR, 0.34; [95% CI, 0.10-1.17]). Individual components of the primary outcome and in-hospital outcomes showed no significant differences between the groups. This cohort study did not find an increased risk of cardiovascular outcomes and mortality in patients with acromegaly undergoing pituitary surgery compared to surgically treated NFPA patients. These findings suggest that there is no legacy effect regarding higher cardio-metabolic risk in individuals with acromegaly once they receive surgical treatment.

Continuous glucose monitoring for glycaemic control and cardiovascular risk reduction in patients with type 2 diabetes not on insulin therapy: A clinical trial.

To evaluate the impact of the Dexcom G6 continuous glucose monitoring (CGM) device on glycaemic control and cardiometabolic risk in patients with type 2 diabetes mellitus (T2DM) at high cardiovascular risk who are not on insulin therapy. Adults with T2DM with glycated haemoglobin (HbA1c) >7% and body mass index (BMI) ≥30 kg/m2 not using insulin were enrolled in a two-phase cross-over study. In phase 1, CGM data were blinded, and participants performed standard glucose self-monitoring. In phase 2, the CGM data were unblinded, and CGM, demographic and cardiovascular risk factor data were collected through 90 days of follow-up and compared using paired tests. Forty-seven participants were included (44% women; 34% Black; mean age 63 years; BMI 37 kg/m2; HbA1c 8.4%; 10-year predicted atherosclerotic cardiovascular disease risk 24.0%). CGM use was associated with a reduction in average glucose (184.0 to 147.2 mg/dl, p < .001), an increase in time in range (57.8 to 82.8%, p < .001) and a trend towards lower glucose variability (26.2 to 23.8%). There were significant reductions in HbA1c, BMI, triglycerides, blood pressure, total cholesterol, diabetes distress and 10-year predicted risk for atherosclerotic cardiovascular disease (p < .05 for all) and an increase in prescriptions for sodium-glucose cotransporter 2 inhibitors (36.2 to 83.0%) and glucagon-like peptide-1 receptor agonists (42.5 to 87.2%, p < .001 for both). Dexcom G6 CGM was associated with improved glycaemic control and cardiometabolic risk in patients with T2DM who were not on insulin. CGM can be a safe and effective tool to improve diabetes management in patients at high risk for adverse cardiovascular outcomes.

Современные представления об ассоциации неалкогольной жировой болезни печени и сердечно-сосудистой патологии

Aim. Based on current literature data, to evaluate the association between non-alcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVD), to consider the pathophysiological mechanisms underlying this relationship, and to indicate methods for reducing cardiometabolic risk in patients with NAFLD. Key points. NAFLD occupies a leading position in the structure of chronic liver diseases, is one of the manifestations of metabolic syndrome and is closely associated with CVD. The relationship between the prevalence of NAFLD and CVD has been established in numerous studies. CVD is significantly more severe in patients with NAFLD. A number of meta-analyses have documented a direct association between NAFLD and cardiovascular mortality. Many pathophysiological mechanisms of development of these two diseases coincide. Some molecular changes that play an important role in NAFLD are also involved in the formation of CVD. Patients with NAFLD often have atherosclerosis, which also underlies the formation of CVD. Conclusion. All modern international and Russian recommendations for the management of patients with NAFLD pay significant attention to the advisability of CVD screening and the need to reduce cardiometabolic risk in patients with NAFLD through lifestyle modification (optimizing diet, weight loss, increasing physical activity), using statin medications, ursodeoxycholic acid and ademetionine. Keywords: non-alcoholic fatty liver disease, liver steatosis, steatohepatitis, cardiovascular diseases, prevalence, risk factors.

Body Composition Evaluation and Clinical Markers of Cardiometabolic Risk in Patients with Phenylketonuria.

Cardiovascular diseases are the main cause of mortality worldwide. Patients with phenylketonuria (PKU) may be at increased cardiovascular risk. This review provides an overview of clinical and metabolic cardiovascular risk factors, explores the connections between body composition (including fat mass and ectopic fat) and cardiovascular risk, and examines various methods for evaluating body composition. It particularly focuses on nutritional ultrasound, given its emerging availability and practical utility in clinical settings. Possible causes of increased cardiometabolic risk in PKU are also explored, including an increased intake of carbohydrates, chronic exposure to amino acids, and characteristics of microbiota. It is important to evaluate cardiovascular risk factors and body composition in patients with PKU. We suggest systematic monitoring of body composition to develop nutritional management and hydration strategies to optimize performance within the limits of nutritional therapy.

Is the 1mg-dexamethasone suppression test a precise marker of glucocorticoid excess and cardiometabolic risk in patients with adrenal incidentalomas?

To analyze if the 1mg-dexamethasone suppression test (DST) is a reliable marker of glucocorticoid excess and cardiometabolic risk in patients with adrenal incidentalomas (AIs). Cross-sectional study of patients with nonfunctioning adrenal incidentalomas (NFAIs, defined by cortisol post-DST ≤ 1.8 µg/dL) and patients with autonomous cortisol secretion (ACS, defined by cortisol post-DST > 1.8 µg/Dl). The urinary steroid profile (USP) was determined by gas chromatography coupled to mass spectrometry. Both groups were matched by sex, age and body mass index. Forty-nine patients with AIs (25 with ACS and 24 with NFAI) were included. As a whole, AIs showed a high excretion of β-cortolone, tetrahydro-11-deoxycortisol (THS), α-cortolone, α-cortol, tetrahydrocortisol (THF) and tetrahydrocortisone (THE). A positive yet modest correlation between post-DST cortisol and total excretion of glucocorticoid metabolites (r = 0.401, P = 0.004) was observed, with the stronger being observed with total THS (r = 0.548, P < 0.001) and THF (r = 0.441, P = 0.002). Some of the metabolites that were elevated in patients with AIs, were higher in patients with ACS-related comorbidities than in those without comorbidities. Post-DST cortisol showed a fair diagnostic accuracy for the prediction of ACS-related comorbidities (AUC 0.767 [95% CI 0.634-0.882]). However, post-DST diagnostic accuracy improved when combined with urinary cortisone, α-cortol, THS and serum DHEAS (0.853 [0.712‒0.954]). The DST has a positive, but modest, correlation with urinary glucocorticoid excretion. Similarly, the diagnostic accuracy of the DST for the prediction of ACS-related comorbidities is only fair, but it may be improved if combined with the results of the USP and serum DHEAS. This is the first study aimed to evaluate if 1mg-dexamethasone suppression test (DST) is a reliable marker of glucocorticoid excess and cardiometabolic risk in patients with adrenal incidentalomas (AIs) and if urinary steroid profile was measured by GS-MS could improve such a prediction. We found a positive yet modest correlation between post-DST cortisol and total excretion of glucocorticoid metabolites, with the stronger being observed with total tetrahydro-11-deoxycortisol (THS) and tetrahydrocortisol. Post-DST cortisol showed a fair diagnostic accuracy for the prediction of ACS-related comorbidities (AUC 0.767). However, post-DST diagnostic accuracy improved when combined with urinary cortisone, α-cortol, THS and serum DHEAS (0.853).

Adiponectin-leptin ratio as a marker of cardio-metabolic risk in Indian children and youth with type 1 diabetes.

Adiponectin/leptin ratio (ALR) is a promising novel marker of cardio-metabolic risk in patients with metabolic syndrome. Our aim was to study theassociation of adiponectin-leptin ratio with markers of obesity and adiposity and also to assess its usefulness as a marker of increased cardiometabolic risk (CMR) in Indian children and youth with type 1 diabetes mellitus. This observational study included 79 children and youth with type 1 diabetes (T1DM) (10-21 years) having disease duration>6months. Demographic data and laboratory findings were obtained from patients' records. Patients with ALR<1 were categorised as having increased CMR and those with ALR>1 were categorised as having no CMR. ALR showed a significant negative correlation with body mass index (BMI), waist and hip circumference and body fat percentage (p<0.05). Body fat percentage was the single most important predictor of ALR. Children and youth with increased CMR had higher weight, BMI, waist and hip circumferences and body fat percentage as compared to those with no CMR (p<0.05). In T1DM children with dyslipidemia, ALR was significantly lower as compared to those without dyslipidemia (p<0.05). ALR may be a useful marker for adiposity and increased cardiometabolic risk in Indian children and youth with type 1 diabetes mellitus.

The cardiometabolic risk in patients with non-functioning adrenal incidentaloma: an observational, retrospective and propensity score matched study

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Comprehensive Assessment of Cardiometabolic Risk in Patients with Chronic Obstructive Pulmonary Disease and Obesity

Background: Currently, comorbid patients with chronic obstructive pulmonary disease (COPD) and obesity are becoming increasingly common in clinical practice. The objective of this study was to conduct a comparative analysis of indicators of various types of body metabolism (carbohydrate, lipid, adipokine profile) in COPD patients with obesity and normal body weight. Methods and Results: The study included 86 patients with COPD (GOLD 3-4, group D). The diagnosis of COPD was established in accordance with GOLD, revision 2021.The patients were divided into two groups. Group 1 consisted of 43 COPD patients with NBW [31(72.7%) men and 12(27.3%) women aged 43 to 75 years (mean age of 62.40 ± 8.83 years)] and Group 2 consisted of 43 COPD patients with obesity [32(77.27%) men and 11(22.73%) women aged 48 to 72 years (mean age of 62.94 ± 5.96 years)]. All patients underwent an analysis of the composition of the body by the bioelectrical impedance method. Blood levels of total cholesterol (TC), triglycerides (TG), HDL-C, and LDL-C were determined by the enzymatic colorimetric method. The glucose level was determined by the glucose oxidant method. The serum adipokine levels (leptin, adiponectin, resistin), as well as testosterone and immunoreactive insulin, were determined using ELISA. To assess insulin resistance, the HOMA-IR index was calculated. To determine cardiovascular risk, the visceral adiposity index (VAI) was calculated according to the formula, which considers body mass index, triglycerides, HDL-C, and waist circumference. The level of HDL-C was significantly lower (P=0.0000)), and the levels of TC (P=0.0479), LDL-C (P=0.0020), glucose (P=0.0020), immunoreactive insulin (P=0.0000), and HOMA-IR index (P=0.0000), were significantly higher in Group 2 than in Group 1. As for the content of adipose tissue hormones, the leptin level was significantly higher in Group 2 (P=0.0000) than in Group 1, while there were no statistically significant differences between groups in the level of resistin (P=0.4996). The adiponectin level was significantly lower in Group 2 than in Group 1 (P&lt;0.0001). The VAI level in Group 2 was significantly higher than in Group 1 (2.13±1.56 and 1.18±0.41, respectively, P=0.0002). In contrast, the testosterone level was significantly lower in Group 2 than in Group 1 (10.59±6.94 nmol/l and 20.02±12.25 nmol/l, respectively, P=0.0000). Conclusion: The high metabolic activity of adipose tissue in patients with COPD and obesity is directly related to the progression of comorbid conditions.

Visceral Adiposity Index as an Indicator of Cardiometabolic Risk in Patients with Congenital Adrenal Hyperplasia.

Aim: To evaluate the cardiometabolic risk in patients with CAH (21 (OH) enzyme deficiency) on the basis of the visceral adiposity index (VAI), which indicates dysfunction of the visceral adipose tissue (VAT). Materials and Methods: A total of 41 patients and 38 body mass index (BMI), age, and gender-matched healthy controls (HC) were included. The patients' and HCs' age, gender, waist circumference (WC), BMI information and total cholesterol (TC), high-density lipoprotein (HDL), triglyceride (TG) values, smoking, and medication history were obtained from medical charts. Weight, height, WC, and blood pressure levels were measured. Patients' and HCs' BMI, Framingham risk scores (FRS), VAI and Ferriman-Gallwey scores were calculated. The patients' and HCs' age, gender TC, HDL, and TG, androstenedione, dehydroepiandrosterone sulfate (DHEASO4), 17 hydroxyprogesterone (17(OH)P) values, smoking, and medication history were obtained from medical charts. Body fat and muscle mass levels were measured with Tanita T 6360. Results: Gender distribution, mean age, and BMI of patients with CAH were 34/7, 30 ± 8, 27 ± 5.4; HC subjects 30/8, 30 ± 6, 27 ± 3.8 (P = 0.9, 0.6, 0.9, respectively). The VAI values of patients with a diagnosis of CAH 3.7 (2.3-6.9) were found to be significantly higher than those of HC patients 2.5 (1.8-3.9; P = 0.02). The mean glucocorticoid doses of the patients were 17 ± 9 mg/day. The glucocorticoid dose level was determined as independent risk factor on the FRS (P = 0.03, β = 0.04) and VAI (P = 0.018, β = 0.17). Conclusion: Glucocorticoid dose optimization should be done more carefully to improve metabolic and cardiovascular outcomes in CAH patients.

ODP444 The Effect of Glucocorticoid Therapy on Cardio-Metabolic Risk in Patients with Multiple Sclerosis

Abstract Multiple sclerosis (MS) often requires usage of glucocorticoids (GC). Excess of GC may affect muscles, which increases mortality. This study evaluates the effect of GC therapy on muscles and cardiovascular disease (CVD) risk factors in patients with MS. Methods 45 patients (55.5% women), 37.8 (20-45) years, were examined. 51% of patients received GC (methylprednisolone 3000-5000 mg, 3-5 days). MS duration was 5.9±1.2 years, the assessment by EDSS - 3.3±1.2. Muscle tissue was assessed by bioimpedance analysis, a chair-rising test, dynamometry. Glucose and lipid metabolism, blood pressure (BP), body mass index (BMI), waist circumference (WC),physical activity were evaluated. Statistical analysis was carried out using "Statistica 10. 0". Normal distribution was tested by the Shapiro–Wilks test, p&amp;gt;0. 05. А Mann-Whitney U-test, a t-test,χ2 test were used,p&amp;lt;0. 05. Results Patients with GC had significantly higher BMI (28.56±5. 02 vs 22.87±3.49 kg/m2), WC (98 (66-123) vs 79.9±5.27cm), lower muscle mass (36.4 (35-38) vs 40.75±2. 02 kg). A negative correlation between GC dose and a grip strength of the dominant hand among men was noted (r=-0.88, p&amp;lt;0. 0001). A normal WС was identified in 52% of patients. Comparing with others received GC, they had a lower level of low-density lipoproteins (1.35±0.39 vs 1.39(1-3,32) mmol/l), systolic BP (132.3±15.7 vs 141 (100-165)) and better handgrip strength (40 (25-47) vs 27±7.3 daN). Conclusions The negative effect of GC on cardiometabolic parameters in all patients with MS and muscle strength in men was confirmed. Metabolic healthier patients probably have a resistance to GC side effects, which may be determined genetically. It is promising for finding protective factors against GC. Presentation: No date and time listed

Effects of Camellia tea and herbal tea on cardiometabolic risk in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials.

Evidence for the anti-diabetic actions of camellia and herbal tea in diabetic patients has not been summarized. Several data sources were searched for randomized trials assessing the effect of different teas on cardiometabolic risk factors in T2D subjects. Two independent reviewers extracted relevant data and assessed the risk of bias. Results were summarized using mean differences (MDs) based on a random model. Sixteen studies (19 trials, N=832) fulfilled the eligibility criteria. Mean differences were measured for body weight, body mass index, fasting blood glucose, glycosylated hemoglobin, a homeostatic model for insulin resistance, high and low-density lipoproteins, triglycerides, and systolic and diastolic blood pressure. No effects on total cholesterol and waist circumference were observed when either camellia or herbal tea was consumed. Tea produced moderate regulatory effects on adipose, glycemic control, lipid profiles, and blood pressure. In terms of efficacy, camellia and herbal teas yield different benefits in regulating metabolism. This discovery has some implications for clinical research and drug development. However, more high-quality trials are needed to improve the certainty of our estimates.

Should antidiabetic medicines be considered to reduce cardiometabolic risk in patients with serious mental illness?

Substantially reduced life expectancy for people with serious mental illness compared with the general population is primarily driven by physical health issues, of which cardiovascular disease is the leading cause. In this narrative review, we examine the evidence base for use of metformin and other antidiabetic agents as a means for reducing this excess cardiometabolic disease burden. Evidence from randomised controlled trials (RCTs) suggests substantial potential for metformin to prevent or manage weight gain and glycaemic impairment induced by atypical antipsychotic medications, whereas the impact of metformin on other cardiometabolic risk factors is less consistent. Evidence from RCTs also suggests potential benefits from glucagon-like peptide-1 receptor agonists (GLP-1RAs), particularly for addressing cardiometabolic risk factors in people using atypical antipsychotic medications, but this is based on a small number of trials and remains an emerging area of research. Trials of both metformin and GLP-1RAs suggest that these medications are associated with a high prevalence of mild-moderate gastrointestinal side effects. The heterogeneous nature of participant eligibility criteria and of antipsychotic and antidiabetic drug regimens, alongside short trial durations, small numbers of participants and paucity of clinical endpoints as trial outcomes, warrants investment in definitive trials to determine clinical benefits for both metformin and GLP-1RAs. Such trials would also help to confirm the safety profile of antidiabetic agents with respect to less common but serious adverse effects. The weight of RCT evidence suggests that an indication for metformin to address antipsychotic-induced weight gain is worth considering in Australia. This would bring us into line with other countries.

A retrospective study on the association between urine metanephrines and cardiometabolic risk in patients with nonfunctioning adrenal incidentaloma

Several studies argued that cardiovascular evaluation of patients with nonfunctioning adrenal incidentaloma is of particular importance. Therefore, we aimed to evaluate the possibility of stratifying the cardiometabolic risk using metanephrine levels in this setting of patients. A retrospective cross-sectional study was designed, collecting data of metanephrine values in 828 patients with nonfunctioning adrenal incidentaloma, referred to our Division within the University of Turin between 2007 and 2021. The univariate analysis showed associations between urine metanephrines and cardiometabolic variables/parameters, particularly considering the noradrenaline metabolite. At the univariate regression, normetanephrine was associated with metabolic syndrome (OR = 1.13, p = 0.002), hypertensive cardiomyopathy (OR = 1.09, p = 0.026), microalbuminuria (OR = 1.14, p = 0.024), and eGFR < 60 mL/min/1.73 m2 (OR = 1.11, p = 0.013), while metanephrine was associated with microalbuminuria (OR = 1.50, p = 0.008). At multivariate regression, considering all major cardiovascular risk factors as possible confounders, normetanephrine retained a significant association with metabolic syndrome (OR = 1.10, p = 0.037). Moreover, metanephrine retained a significant association with the presence of microalbuminuria (OR = 1.66, p = 0.003). The present study showed a further role for metanephrines in the cardiovascular risk stratification of patients with nonfunctioning adrenal incidentaloma. Individuals with high levels of these indirect markers of sympathetic activity should be carefully monitored and may benefit from an aggressive treatment to reduce their additional cardiometabolic burden.

Magnesium Supplementation Is Associated with a Lower Cardio-Metabolic Risk in Patients Submitted to Bariatric Surgery.

Literature has demonstrated an inverse relation between magnesium (Mg) consumption and development of type 2 diabetes mellitus (T2DM), hypertension (HT), and dyslipidemia. After bariatric surgery (BS), micronutrients deficiencies are common, it being important to ensure appropriate supplementation. There is no recommendation about Mg supplementation and to our knowledge, its effect has not been studied to date. Our aim was to evaluate the effect of Mg supplementation in cardio-metabolic risk factors on post-bariatric patients. A retrospective observational study of patients with obesity who underwent BS was performed. Data was assessed preoperatively and yearly (4-year follow-up). A total of 3363 patients were included. In the first year of follow-up, 79.8% (n = 2123) of the patients were supplemented with Mg, with evidence of slightly decreased percentages in the following years. Mg deficiency (serum Mg < 1.52mEq/L) was more common among patients who were not supplemented during each year of follow-up (p < 0.05). Among those who underwent Mg supplementation, the percentage of T2DM, HT, or low-density lipoprotein cholesterol (LDL-C) > 130mg/dL was significantly lower. In the first year post-surgery, the supplementation group had a lower risk of T2DM (OR = 0.545, p < 0.0001), LDL-C > 130mg/dL (OR = 0.612, p < 0.0001), and HT (OR = 0.584, p < 0.0001). The OR for having these metabolic comorbidities persisted lower during the 4years' follow-up. Patients who had Mg deficiency had higher prevalence of T2DM and HT. Mg supplementation seems to have a protective effect on the development of T2DM, HT, and LDL-C > 130mg/dL in post-bariatric patients.

An observational retrospective study on the association of urine metanephrine levels with cardiometabolic risk in patients with nonfunctioning adrenal incidentaloma

An observational retrospective study on the association of urine metanephrine levels with cardiometabolic risk in patients with nonfunctioning adrenal incidentaloma

Remission of diabetes and cardiometabolic risk in patients after 5 years of bariatric surgery: A case-control study

The treatment of obesity and diabetes involves weight loss and metabolic control. Therefore, this study aimed to evaluate the remission of diabetes mellitus (T2DM) and the reduction of cardiometabolic risk (CR), in patients with obesity and T2DM, after five years of Bariatric Surgery (BS) and followed up in the Public Healthcare System (PHS). This is an observational, retrospective, and analytical study, single-center, with pre-diabetes or T2DM, with five years or more of conventional treatment (CT, n = 38) or BS (n = 33). Socioeconomic, lifestyle, anthropometric, biochemical, drugs intake, cardiovascular, and glycemic parameters were evaluated. The baseline characteristics of the BS and CT samples were similar. The study consisted predominantly of women (91.6%) and had a mean age of 46.1 ± 9.0 years. The BS group waited an average of 28.3 ± 24.4 months prior to surgery, and 93.9% had a gastric bypass. Compared to the CT group, the BS group had a higher level of educational achievement (p = 0.001), a higher prevalence of social drinkers (p = 0.006), and a higher BMI (p < 0.001). After five years, 22 patients (66,7%) of the BS group had complete remission of T2DM and 20 (60,6%) had remission of CR (both p < 0.0001). In the CT group 1 (2,6%) and 7 (18.4%) had remission of T2DM and CR respectively. BS is superior to CT for achieving remission of pre-diabetes/T2DM, reducing CR, and anthropometric markers in patients with obesity. • Bariatric surgery can promote long-term remission of diabetes. • Bariatric surgery was able to reduce cardiovascular risk. • Bariatric surgery was able to reduce cardiometabolic risk. • Bariatric surgery promotes the reduction of biochemical, hemodynamic, and anthropometric parameters.

Cardiometabolic risk in patients with first episode of schizophrenia

Cardiometabolic risk in patients with first episode of schizophrenia

Izazovi u laboratorijskoj dijagnostici autonomne sekrecije kortizola kod pacijenata sa adrenalnim incidentalomima

Adrenal incidentalomas are unexpectedly identified adrenal masses without prior suspicion of the existence of adrenal disease. The majority of adrenal incidentalomas are benign adrenal adenomas (80-90%), and they are non-functioning adrenocortical adenomas in more than 70% of cases. Mild hypercortisolemia is the most common finding in hormonally active adrenal incidentalomas. It is defined as autonomous cortisol secretion in up to 15% of patients. Despite a lot of research that anticipated higher cardiometabolic risk in patients with autonomous cortisol secretion, there is still no clear consensus on biochemical criteria for an autonomous cortisol secretion diagnosis in patients with adrenal incidentalomas. This review delineates the advantages and limitations of different laboratory tests recommended for the diagnosis of autonomous cortisol secretion in adrenal incidentalomas.

Epicardial fat as an imaging biomarker in the assessment of cardiometabolic risk in patients with type 1 diabetes with a duration of over 15 years

Epicardial fat as an imaging biomarker in the assessment of cardiometabolic risk in patients with type 1 diabetes with a duration of over 15 years

Chronodisruption and diet associated with increased cardiometabolic risk in coronary heart disease patients: the CORDIOPREV study

Individuals with evening chronotypes are prone to suffer chronodisruption and display worse lifestyle habits than morning-types, exhibiting higher cardiovascular diseases (CVD). However, it is unknown whether CVD patients, who are evening chronotypes, have higher cardiometabolic risk than morning-types. This study explored whether individual chronotypes were associated with cardiometabolic risk in patients from the CORDIOPREV study (n=857). We also investigated whether potential associations were moderated by long-term consumption of two healthy diets (Mediterranean and Low-fat diets). This population was classified into chronotypes using the Morningness-Eveningness Questionnaire. Seven-day daily rhythms in wrist temperature (T), rest-activity (A) and position (P) were recorded in a subset of patients (n=168), and an integrative variable TAP was determined. Metabolic Syndrome (MetS) was determined at baseline, and metabolic and inflammation markers were measured at baseline and yearly during the 4 years of follow-up. Differences in several lifestyle factors were analyzed according to chronotype. At all times, evening-types had higher triglycerides, C-reactive protein and homocysteine and lower high density lipoprotein cholesterol than morning-types (P < 0.05). Evening-types had a higher prevalence of MetS (OR 1.58 IC 95% [1.10 - 2.28], P = 0.01). Moreover, they were more sedentary, displayed less and delayed physical activity and ate and slept later. In addition, evening-types had lower amplitude, greater fragmentation, lower robustness and less stable circadian pattern at TAP (P < 0.01), all related to a less healthy circadian pattern. In conclusion, evening-types with CVD had higher cardiometabolic risk and less robust circadian-related rhythms than morning-types, regardless of the nutritional intervention.