Cardiometabolic Risk Factors In Patients Research Articles

Plasma amino acids pecularities and cardiometabolic risk factors in patients with coronary artery disease and atrial fibrillation

Studies targeting small molecule metabolites (amino acids, sugars, nucleotides, lipids) in connections with gut microbiota metabolites that impact the host metabolome give a possibility to define a special metabolic signature of different diseases. Plasma amino acids (AA) profile is known to be a new promising biomarker for the screening of coronary artery disease (CAD) pathogenesis connected with gut dysbiosis. The aim of our study was to estimate the spectrum of plasma amino acids in CAD patients with atrial fibrillation (AF) and to check their connections with the gut microbiota metabolites. 300 patients were divided into three groups: CAD – 149 patients with CAD but without arrhythmias, CAD+AF – 123 patients with CAD and AF paroxysm and control group– 28 patients without CAD and arrhythmias. Plasma AA level was detected by ion exchange liquid column chromatography. Significant changes in the content of plasma Glutamate, Glutamine, Glycine, Alanine, Valine and Tyrosine and combinations Isoleucine+Leucine/Valine, Glycine+Serine, Glycine/Methionine, Phenylalanine/Tyrosine, Glutamine/Glutamate in CAD+AF patients were detected. A strong reliable connection between plasma AA spectrum and gut microbiota metabolites trimethylamine, trimethylamine-N-oxide and total amount of fecal short chain fatty acids was determined. The highly validated plasma AA combinations Isoleucine – Glycine (area under ROC-curve 0.8122) and Phenylalanine – Glycine (area under ROC-curve 0.8061) that can be used as the early markers of AF paroxysm in CAD patients were proposed. Keywords: atrial fibrillation, cardiometabolic risk factors, coronary artery disease, gut microbiota metabolites, plasma amino acids

Cardiometabolic risk factors in patients with type 2 diabetes and sarcopenia

Aim. To analyze risk factors for sarcopenia in atherosclerosis involvement of target organs in patients with type 2 diabetes (T2D).Material and methods. The study included 84 patients with T2D, divided into groups according to the 2019 criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). All patients were surveyed using a 36-item short-form health survey (SF-36), Sarcopenia and Quality of Life (SarQoL), Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls (SARC-F), grip test, 4-meter walk test, bioelectrical impedance analysis, 24-hour blood pressure monitoring and cardiac ultrasound. Differences were considered significant at p<0,05.Results. Patients with sarcopenia have lower levels of fat, muscle, cell mass, appendicular mass index, fluid, protein, and minerals. In the group with sarcopenia, higher levels of total cholesterol, low-density lipoprotein cholesterol, glycated hemoglobin, and hypocalcemia were detected. Triglyceride levels were high in those with presarcopenia. In the same group, unstable blood pressure, increased myocardial mass and severe lower limb atherosclerosis were recorded.Conclusion. Sarcopenia is one of the important medical and social problems and is accompanied by unfavorable outcomes. The combination of sarcopenia and T2D can contribute to the rapid development of macro- and microangiopathy and increase the cardiovascular risk.

Association of NFKB1 gene polymorphism (rs28362491) with cardiometabolic risk factor in patients undergoing coronary angiography.

Genetic and environmental factors are involved in the pathogenesis of cardiovascular diseases (CVDs). The aim of the study was to investigate between the genotype of the NFKB1 gene and the cardiometabolic risk factor in patients undergoing coronary angiography. This cross-sectional study was conducted on 462 adults (male and women) aged between 35 and 75 years who referred to Afshar Hospital for coronary angiography in 2021- 2022. The polymerase chain reaction restriction fragment length polymorphism method was used to detect the genotype of rs28362491. Biochemical parameters were measured using commercial kits. Gensini and Syntax scores were calculated using the angiography result to assess the extent of coronary artery stenosis. We used multivariate logistic regression analysis to examine the relationship between genotype variants and cardiometabolic risk factors. There was no association between variant genotypes and abnormally levels of serum alanine aminotransferase (ALT) (P value=0.51), aspartate aminotransferase (AST) (P value=0.99), triglyceride (TG) (P value=0.48), total cholesterol (P value=0.79), low density lipoprotein-cholestero (LDL-C) (P value=0.31), high-density lipoprotein-cholesterol (HDL-C) (P value=0.53), fast blood sugar (FBS) (P value=0.39), systolic blood pressure (P value=0.14), diastolic blood pressure (P value=0.64), Gensini score (P value=0.48) and syntax score (P value=0.74) in the crude model even after adjustment for confounding factors. We found no association between the ATTG polymorphism and cardiometabolic risk factors in patients who had coronary angiography. Further investigations are needed to assess the association between variants of 28362491 and cardiometabolic markers.

Screening and prevalence of cardiometabolic risk factors in patients with severe mental illness: A multicenter cross-sectional cohort study in the Netherlands

BackgroundDue to increased cardiometabolic risks and premature mortality in people with severe mental illness (SMI), monitoring cardiometabolic health is considered essential. We aimed to analyse screening rates and prevalences of cardiometabolic risks in routine mental healthcare and its associations with patient and disease characteristics. MethodsWe collected screening data in SMI from three mental healthcare institutions in the Netherlands, using most complete data on the five main metabolic syndrome (MetS) criteria (waist circumference, blood pressure, HDL-cholesterol, triglycerides, fasting blood glucose) within a 30-day timeframe in 2019/2020. We determined screened patients' cardiometabolic risks and analysed associations with patient and disease characteristics using multiple logistic regression. ResultsIn 5037 patients, screening rates ranged from 28.8% (waist circumference) to 76.4% (fasting blood glucose) within 2019–2020, and 7.6% had a complete measurement of all five MetS criteria. Older patients, men and patients with psychotic disorders had higher odds of being screened. Without regarding medication use, risk prevalences ranged from 29.6% (fasting blood glucose) to 56.8% (blood pressure), and 48.6% had MetS. Gender and age were particularly associated with odds for individual risk factors. Cardiometabolic risk was present regardless of illness severity and did generally not differ substantially between diagnoses, in−/outpatients and institutions. ConclusionsDespite increased urgency and guideline development for cardiometabolic health in SMI last decades, screening rates are still low, and the MetS prevalence across screened patients is almost twice that of the general population. More intensive implementation strategies are needed to translate policies into action to improve cardiometabolic health in SMI.

Intermittent energy restriction vs. continuous energy restriction on cardiometabolic risk factors in patients with metabolic syndrome: a meta-analysis and systematic review.

This is a systematic review and meta-analysis to compare the efficacy of intermittent energy restriction (IER) vs. continuous energy restriction (CER) on weight loss, body composition, blood pressure, and other cardiometabolic risk factors in patients with metabolic syndrome (MetS) risk factors. We searched and screened PubMed, Embase, Cochrane Library, and Web of Science from inception to May 8, 2022 for randomized controlled trials. Two review authors independently selected studies, extracted data, assessed quality and risk of bias and cross-checked extracts to resolve discrepancies when required. We expressed effect size as mean difference (MD) and 95% confidence interval (CI). The major outcome was the improvement of MetS risk factors, including changes in waist circumference (WC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-c), blood pressure (BP), and fasting plasma glucose (FPG) levels. The secondary outcomes were body weight (BW), body mass index (BMI), body fat (BF), fat free mass (FFM), hip circumference (HC), fasting insulin (FINs), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-c). The meta-analysis included 16 articles (20 trials) with a total of 1,511 participants. All studies had a low risk of bias for random sequence generation. The IER and CER intervention equally improved MetS risk factors WC (MD = -0.47, 95% CI [-1.19, 0.25]), TG (MD = -0.02 mmol/L, 95% CI [-0.11, 0.07]), FPG (MD = -0.02 mmol/L, 95% CI [-0.10, 0.05]) and BP (systolic blood pressure: MD = 0.93 mmHg, 95% CI [-2.74, 4.61]; diastolic blood pressure: MD =1.15 mmHg, 95% CI [-0.24, 2.55]), but HDL-c (MD = 0.03 mmol/L, 95% CI [0.01, 0.05]) was significant improved in IER when compared with CER. For second outcomes, BW (MD = -0.8 kg, 95% CI [-1.26, -0.33]), BF (MD = -0.75 kg, 95% CI [-1.73, -0.13]) and FFM (MD = -0.49 kg, 95% CI [-0.92, -0.05]) were also significant improved in IER, and not for other outcomes. Both IER and CER could improve MetS biomarkers, but IER was more effective than CER in the improvement of HDL-c only. For secondary outcomes, IER was also more effective for BW, BF and FFM, but there were no differences in effects for other outcomes.

Age- and sex-specific differences in the association of serum osteocalcin and cardiometabolic risk factors in type 2 diabetes

BackgroundSerum osteocalcin levels are closely related to metabolic syndrome and cardiovascular disease. This study aimed to investigate the relationship between serum osteocalcin levels and cardiometabolic risk factors in patients with type 2 diabetes (T2D) according to age and sex.MethodsThis cross-sectional study included 1500 patients with T2D (991 men and 509 women) aged ≥ 18 years old. The age- and sex-specific disparities in glycemic and lipid control, as well as cardiometabolic risk factors were evaluated.ResultsThe levels of serum osteocalcin were significantly higher in women aged > 50 years compared with women aged ≤ 50 years (15.6 ± 6.5 ng/mL vs. 11.3 ± 4.5 ng/mL, p < 0.0001). However, this was lower in men aged > 50 years than men aged ≤ 50 years (12.2 ± 4.2 ng/mL vs. 12.9 ± 4.3 ng/mL, p = 0.0081). We performed correlation analyses of serum osteocalcin and cardiometabolic parameters. Serum osteocalcin concentrations were negative associated with FBG and HbA1c levels in women and men ≤ 50 years old, but not in men aged > 50 years old. Serum osteocalcin were negatively correlated with TG and positively correlated with HDL-C and LDL-C only in men aged ≤ 50 years. In binary logistic regression analysis, serum osteocalcin levels were associated with multiple cardiovascular risk factors, as follows: overweight/obese (odds ratio [OR], 0.944; 95% confidence interval [CI], 0.9–0.991, p = 0.02) in men aged > 50 years; high HbA1C and high FBG in women and men aged ≤ 50 years, but not in men aged > 50 years; after adjustment for confounding factors, high TG (OR, 0.905; 95% CI 0.865–0.947, p < 0.0001), metabolic syndrome (OR, 0.914; 95% CI 0.874–0.956, p < 0.0001), and low high-density lipoprotein cholesterol (OR, 0.933; 95% CI, 0.893–0.975, p = 0.002) were seen in men aged ≤ 50 years only.ConclusionsSerum osteocalcin level has significant relationships with cardiometabolic risk factors and several age- and sex-related differences in patients with T2D. Decreased serum osteocalcin levels are associated with a worse cardiometabolic risk profile.

Abstract P106: Prevalence of Cardiometabolic Risk Factors in Patients With versus Without Cancer: Insights From a Large US Healthcare System

Background: Although cardiometabolic dysfunction is associated with an increased risk of cancer, the prevalence of cardiometabolic risk factors in patients with and without cancer remains less well-established. Therefore, we aimed to examine the prevalence and association of cardiometabolic risk factors in patients with versus without cancer who do not have established atherosclerotic cardiovascular disease (ASCVD). Methods: Data of ∼1.1 million patients aged 18+ years in the Houston Methodist Learning Health System Outpatient Registry was utilized to identify patients with and without cancer with cardiometabolic risk factors including hyperlipidemia, diabetes mellitus (DM), obesity and hypertension using the ICD-10 codes. Patients with prevalent ASCVD were excluded. Age-adjusted prevalence of cardiometabolic risk factors was calculated and multivariate logistic regression models were utilized to determine the association between cardiometabolic factors and risk of cancer. Results: A total of 76,312 (7.8%) patients with cancer and 897,408 (92.2%) patients without cancer were included. Compared with patients without cancer, patients with cancer had increased age-adjusted prevalence of hypertension (38.4% vs 33.4%), obesity (30.7% vs 29.6%), hyperlipidemia (26.0% vs 22.0%) and DM (13.9% vs 11.0%). Compared with patients without cancer, patients with cancer had significantly increased odds of hyperlipidemia (OR 1.32 [1.30, 1.34]), hypertension (OR 1.82 [1.79, 1.85]) and DM (OR 1.42 [1.39, 1.45]). Conversely, obese patients were less likely to have cancer (OR 0.96 [0.95, 0.98]) compared with patients without cancer. Conclusion: Amongst patients without established ASCVD, increased prevalence of cardiometabolic risk factors is observed in patients with cancer versus without cancer. Strategies optimizing cardiometabolic health such as routine screening, monitoring, evaluation, and management of these factors should be prioritized to curtail adverse cardiovascular and cancer outcomes.

Pro-inflammatory diet, cardio-metabolic risk factors and risk of type 2 diabetes: A cross-sectional analysis using data from RaNCD cohort study

BackgroundInflammation and cardiometabolic risk factors can be involved in developing type 2 diabetes mellitus (T2DM). This study aimed to investigate and compare the association between a pro-inflammatory diet and cardiometabolic risk factors in patients with T2DM and non-T2DM cases.MethodsIn this cross-sectional population-based study, considering the baseline data of the Ravansar Non-Communicable Disease (RaNCD) cohort, patients with T2DM (n = 785) and non-T2DM cases (n = 8254) were included. The dietary inflammatory index (DII) was calculated using a food frequency questionnaire (FFQ) and was classified into four groups (quartiles) with lowest to highest scores. Logistic regression analysis was conducted to determine the association between DII and cardiometabolic risk factors in both groups.ResultsThe participants were 9,039 (4140 men and 4889 women) with a mean age of 47.4 ± 8.2 years; the mean body mass index (BMI) and DII were 27.49 ± 4.63 kg/m2 and − 2.49 ± 1.59, respectively. After adjustment for confounding factors, we found that DII can increase the risk of T2DM by 61% (95% CI 1.27 to 2.05, P < 0.001). A comparison of two groups revealed that the association of DII, obesity/overweight and dyslipidemia were also significant in both diabetic (P < 0.05) and non-diabetic cases (P < 0.05). However, no significant association was found between DII, MetS, and hypertension in either of the groups. The association between DII and cardiovascular diseases (CVDs) was only significant in diabetic patients (1.65; 95%CI: 1.02 to 2.65, P = 0.04) and T2DM showed an interaction with the association between DII and CVDs.ConclusionInflammatory potential of diet may increase the risk of T2DM. Although it can increase the risk of some cardiometabolic risk factors in both diabetic and non-diabetic cases, its effects were greater among patients with T2DM. However, further prospective studies are required to confirm these associations.

The correlation between obesity and other cardiovascular disease risk factors among adult patients attending a specialist clinic in Kumasi. Ghana

&lt;abstract&gt;&lt;sec&gt; &lt;title&gt;Background&lt;/title&gt; &lt;p&gt;Obesity is a complex and multifactorial disease marker, which has become a major threat to cardiovascular health. We sought to assess the correlation of obesity and other cardio-metabolic risk factors in patients seen at the outpatient specialist clinic in Ghana.&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Methods&lt;/title&gt; &lt;p&gt;A prospective cross-sectional study was conducted on 395 patients at Precise Specialist Clinic in Kumasi, Ghana. A standardized questionnaire was used to obtain demographic, anthropometric and clinical data of patients. Fisher's exact test for statistical significance at a 95% confidence interval was used to evaluate associations between categorical variables. The associations between obesity indices and cardiovascular disease risk factors were analyzed by Pearson's correlation.&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Results&lt;/title&gt; &lt;p&gt;Of the 395 participants, 187 were males and 208 were females. The mean (± standard deviation) age of study participants was 59.29 (± 13.93); more than half of the participants were between 50 and 69 years. The mean BMI of male participants was significantly lower than the mean BMI of female participants (28.18 kg/m&lt;sup&gt;2&lt;/sup&gt; vs 31.16 kg/m&lt;sup&gt;2&lt;/sup&gt;, &lt;italic&gt;P-value&lt;/italic&gt; &amp;lt; 0.0001). Gender was significantly associated with the weight categories (&lt;italic&gt;P&lt;/italic&gt; = 0.0144). Obesity was seen more in females (49.0%) than in males (35.8%). The Pearson correlation analysis also showed a significant positive correlation between obesity, increasing systolic blood pressure (&lt;italic&gt;r&lt;/italic&gt; = 0.1568, &lt;italic&gt;P-value&lt;/italic&gt; = 0.0018) and increasing diastolic blood pressure (&lt;italic&gt;r&lt;/italic&gt; = 0.2570, &lt;italic&gt;P-value&lt;/italic&gt; &amp;lt; 0.0001).&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Conclusions&lt;/title&gt; &lt;p&gt;Obesity was found to be significantly associated with female gender, increasing age, increasing systolic blood pressure, and increasing diastolic blood pressure. Efforts to step-up preventive measures to reduce the increasing prevalence of obesity in Ghana are highly recommended.&lt;/p&gt; &lt;/sec&gt;&lt;/abstract&gt;

Target Metabolome Profiling-Based Machine Learning as a Diagnostic Approach for Cardiovascular Diseases in Adults.

Metabolomics is a promising technology for the application of translational medicine to cardiovascular risk. Here, we applied a liquid chromatography/tandem mass spectrometry approach to explore the associations between plasma concentrations of amino acids, methylarginines, acylcarnitines, and tryptophan catabolism metabolites and cardiometabolic risk factors in patients diagnosed with arterial hypertension (HTA) (n = 61), coronary artery disease (CAD) (n = 48), and non-cardiovascular disease (CVD) individuals (n = 27). In total, almost all significantly different acylcarnitines, amino acids, methylarginines, and intermediates of the kynurenic and indolic tryptophan conversion pathways presented increased (p &lt; 0.05) in concentration levels during the progression of CVD, indicating an association of inflammation, mitochondrial imbalance, and oxidative stress with early stages of CVD. Additionally, the random forest algorithm was found to have the highest prediction power in multiclass and binary classification patients with CAD, HTA, and non-CVD individuals and globally between CVD and non-CVD individuals (accuracy equal to 0.80 and 0.91, respectively). Thus, the present study provided a complex approach for the risk stratification of patients with CAD, patients with HTA, and non-CVD individuals using targeted metabolomics profiling.

Implications of Elevated Postprandial Glucose and Nutritional Approaches for Postprandial Glucose Management with a Focus on Whey Proteins

This symposium took place at the 58th Annual Meeting of the European Association for the Study of Diabetes (EASD) in Stockholm, Sweden. The first speaker was John L. Sievenpiper, who discussed the pathophysiology of postprandial hyperglycaemia and how it may impact the risk of cardiovascular disease (CVD), peripheral vascular disease, insulin resistance, and other comorbidities in patients with Type 2 diabetes (T2D). Sievenpiper then reviewed various pharmacological interventions that target postprandial glucose (PPG) and insulin levels, including incretin therapies and α-glucosidase inhibitors, such as acarbose. Data presented showed that a low glycaemic index (GI) diet can improve glycaemic control and reduce cardiometabolic risk factors in patients with Type 1 diabetes (T1D) and T2D. Sievenpiper then presented data on novel non-pharmacological approaches that target PPG, including mulberry leaf (Morus alba L) extract (MLE), which has α-glucosidase inhibitor activity, reducing PPG and insulin responses to sucrose. The second speaker, Bo Ahrén, presented data on the effects of whey protein (WP) and branched-chain amino acids (BCAA) on PPG management and as a potential intervention for postprandial hyperglycaemia. They also discussed the mechanisms underlying the effects of WP, and highlighted data presented at the 2022 58th Annual EASD meeting by Johansen and colleagues on a novel micelle microgel technology. WP microgels (WPM) deliver highly concentrated and lower calorie doses of WP, with the potential to be developed clinically as therapeutics for T2D. The symposium concluded with a question and answer session between panel members and the audience. Ian J. Neeland was the meeting moderator.

Implications of Elevated Postprandial Glucose and Nutritional Approaches for Postprandial Glucose Management with a Focus on Whey Proteins

This symposium took place at the 58th Annual Meeting of the European Association for the Study of Diabetes (EASD) in Stockholm, Sweden. The first speaker was John L. Sievenpiper, who discussed the pathophysiology of postprandial hyperglycaemia and how it may impact the risk of cardiovascular disease (CVD), peripheral vascular disease, insulin resistance, and other comorbidities in patients with Type 2 diabetes (T2D). Sievenpiper then reviewed various pharmacological interventions that target postprandial glucose (PPG) and insulin levels, including incretin therapies and α-glucosidase inhibitors, such as acarbose. Data presented showed that a low glycaemic index (GI) diet can improve glycaemic control and reduce cardiometabolic risk factors in patients with Type 1 diabetes (T1D) and T2D. Sievenpiper then presented data on novel non-pharmacological approaches that target PPG, including mulberry leaf (Morus alba L) extract (MLE), which has α-glucosidase inhibitor activity, reducing PPG and insulin responses to sucrose. The second speaker, Bo Ahrén, presented data on the effects of whey protein (WP) and branched-chain amino acids (BCAA) on PPG management and as a potential intervention for postprandial hyperglycaemia. They also discussed the mechanisms underlying the effects of WP, and highlighted data presented at the 2022 58th Annual EASD meeting by Johansen and colleagues on a novel micelle microgel technology. WP microgels (WPM) deliver highly concentrated and lower calorie doses of WP, with the potential to be developed clinically as therapeutics for T2D. The symposium concluded with a question and answer session between panel members and the audience. Ian J. Neeland was the meeting moderator.

The impact of bariatric surgery procedures on the modulation of cardiometabolic risk factors in patients with severe obesity: a 12-month follow-up

To evaluate the effects of one anastomosis gastric bypass (OAGB), Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy (SG) on cardiometabolic risk factors (CMRFs) in patients with severe obesity. This retrospective cohort study included patients with severe obesity who had undergone OAGB, RYGB, or SG between 2015 and 2017 and follow-up assessments over 12-months. Among 485 included patients, anthropometric measurements, body composition, fasting blood glucose (FBG), lipid profile, and comorbidities were significantly improved for all three procedures throughout the follow-up period. Weight, % total weight loss (%TWL), body mass index, fat mass and fat mass to fat-free mass ratio improvements were higher with RYGB and OAGB than SG. There were no significant differences between procedures in all other variables. A significant trend toward remission rate of dyslipidemia and type 2 diabetes mellitus was observed with all three procedures, with no significant difference between the three groups. %TWL statistically correlated with fat mass, FBG, and triglycerides. OAGB, RYGB, and SG had a beneficial impact on CMRFs and comorbidities during 12 months of follow-up. Of note, RYGB and OAGB may result in better outcomes, particularly anthropometric and body composition indices. Further large-sample, long-term follow-up studies are required to expand on the present findings.

Efficacy and safety of oral alpha-lipoic acid supplementation for type 2 diabetes management: a systematic review and dose-response meta-analysis of randomized trials.

ObjectiveTo examine the dose-dependent influence of oral alpha-lipoic acid (ALA) supplementation on cardiometabolic risk factors in patients with type 2 diabetes (T2D).DesignWe followed the instructions outlined in the Cochrane Handbook for Systematic Reviews of Interventions and the Grading of Recommendations, Assessment, Development, and Evaluation Handbook to conduct our systematic review. The protocol of the study was registered in PROSPERO (CRD42021260587).MethodWe searched PubMed, Scopus, and Web of Science to May 2021 for trials of oral ALA supplementation in adults with T2D. The primary outcomes were HbA1c, weight loss, and LDL cholesterol (LDL-C). Secondary outcomes included fasting plasma glucose (FPG), triglyceride (TG), C-reactive protein (CRP), and blood pressure. We conducted a random-effects dose–response meta-analysis to calculate the mean difference (MD) and 95% CI for each 500 mg/day oral ALA supplementation. We performed a nonlinear dose–response meta-analysis using a restricted cubic spline.ResultsWe included 16 trials with 1035 patients. Each 500 mg/day increase in oral ALA supplementation significantly reduced HbA1c, body weight, CRP, FPG, and TG. Dose–response meta-analyses indicated a linear decrement in body weight at ALA supplementation of more than 600 mg/day (MD600 mg/day: −0.30 kg, 95% CI: −0.04, −0.57). A relatively J-shaped effect was seen for HbA1c (MD: −0.32%, 95% CI: −0.45, −0.18). Levels of FPG and LDL-C decreased up to 600 mg/day ALA intake. The point estimates were below minimal clinically important difference thresholds for all outcomes.ConclusionDespite significant improvements, the effects of oral ALA supplementation on cardiometabolic risk factors in patients with T2D were not clinically important.

Relationship between Cardiometabolic Factors and the Response of Blood Pressure to a One-Year Primary Care Lifestyle Intervention in Metabolic Syndrome Patients.

Systemic hypertension has been recognized as a modifiable traditional cardiovascular risk factor and influenced by many factors such as eating habits, physical activity, diabetes, and obesity. The objective of this cross-sectional study was to identify factors that predict changes in blood pressure induced by a one-year lifestyle intervention in primary care settings involving a collaboration between family physicians, dietitians, and exercise specialists. Patients with metabolic syndrome diagnosis were recruited by family physicians participating in primary care lifestyle intervention among several family care clinics across Canada. Participants for whom all cardiometabolic data at the beginning (T0) and the end (T12) of the one-year intervention were available were included in the present analysis (n = 101). Patients visited the dietitian and the exercise specialist weekly for the first three months and monthly for the last nine months. Diet quality, exercise capacity, anthropometric indicators, and cardiometabolic variables were evaluated at T0 and at T12. The intervention induced a statistically significant decrease in waist circumference (WC), systolic (SBP) and diastolic (DBP) blood pressure, and plasma triglycerides, and an increase in cardiorespiratory fitness (estimated VO2max). Body weight (p < 0.001), body mass index (BMI) (p < 0.001), and fasting blood glucose (p = 0.006) reduction, and VO2max increase (p = 0.048) were all related to changes in SBP. WC was the only variable for which changes were significantly correlated with those in both SBP (p < 0.0001) and DBP (p = 0.0004). Variations in DBP were not associated with changes in other cardiometabolic variables to a statistically significant extent. Twelve participants were identified as adverse responders (AR) in both SBP and DBP and displayed less favorable changes in WC. The beneficial effects of the primary care lifestyle intervention on blood pressure were significantly associated with cardiometabolic variables, especially WC. These findings suggest that a structured lifestyle intervention in primary care can help improve cardiometabolic risk factors in patients with metabolic syndrome and that WC should be systematically measured to better stratify the patient’s hypertension risk.

Efficacy of time-restricted eating and behavioural economic interventions in reducing fasting plasma glucose, HbA1c and cardiometabolic risk factors compared with time-restricted eating alone or usual care in patients with impaired fasting glucose: protocol for an open-label randomised controlled trial

IntroductionImpaired fasting glucose (IFG) is a significant risk factor for diabetes mellitus. Time-restricted eating (TRE) is one type of diet showing positive effects on metabolic signal pathways. However, effects of...

Dietary insulin index and load in relation to cardiometabolic risk factors in patients with type 2 diabetes mellitus: A cross-sectional study on the RaNCD cohort study

ObjectivesThe aim of the present study was to evaluate the link between the dietary insulin index (DII) and dietary insulin load (DIL) and cardiometabolic risk factors in patients with type 2 diabetes mellitus (T2DM). MethodIn this cross-sectional population-based study, 827 participants with diabetes were included based on the RaNCD (Ravansar Non-Communicable Disease) cohort study baseline data. DII and DIL were calculated based on standard formulas using food insulin index values published earlier. Logistic regression analysis was used to determine the association of DII and DIL with cardiovascular risk factors. ResultsA significantly direct association was shown between DII and metabolic syndrome (MetS; odds ratio [OR], 1.32; 95% confidence interval [CI], 1.05–2.50). The odds of developing abdominal obesity in patients with the highest DII were almost twice as high as those with the lowest DII (OR, 2.06; 95% CI, 1.02–4.99). Patients in the top quintile of DIL had twice the odds of being obese than those in the bottom quintile. Furthermore, positive associations were found between DIL and both MetS (OR, 1.98; 95% CI, 1.10–4.21) and waist circumference (OR, 2.90; 95% CI, 1.10–7.20). ConclusionHigher DII and DIL were positively related to greater risks for both MetS and abdominal obesity among patients with T2DM. Additionally, higher DIL was associated with a higher risk for obesity in the Ravansar population. However, further prospective investigations are needed to clarify the cause-and-effect link between DII, DIL, and cardiovascular risk factors in patients with T2DM.

Aquatic Aerobic and Combined Training in Management of Type 2 Diabetes: The Diabetes and Aquatic Training Study (DATS): A Randomized Clinical Trial.

To compare the effects of aquatic aerobic and combined (aerobic more resistance) training on glycemic control and other cardiometabolic outcomes in patients with type 2 diabetes. Patients were randomized to an aquatic aerobic training (AERO, n = 19; 57.5 [7.4]y; 9 [47%] women), or an aquatic combined training (COMBI, n = 19; 60.9 [7.4]y; 10 [53%] women), or an aquatic active procedure control (n = 19; 58.6 [9.7]y; 10 [53%] women) in 3 weekly sessions (50min each), during 15weeks. Glycated hemoglobin was the primary outcome, whereas insulin resistance markers, lipid profile, systemic inflammation, renin concentration, blood pressure, physical activity levels, and sitting time were secondary outcomes. Glycated hemoglobin was reduced in all groups (P = .021), although changes were more marked in AERO (-0.36%) and COMBI (-0.44%) than in active control (-0.26%) group. Lipid profile was similarly modified in all groups. Diastolic blood pressure and renin concentration were also reduced in all groups; however, renin showed more marked reductions in AERO (-17.7uIU/mL) and COMBI (-15.1uIU/mL) than in active control (0.2uIU/mL) group. Fasting insulin, triglycerides, C-reactive protein, systolic blood pressure, walking time, and sitting time on weekends were not modified. AERO and COMBI presented similar effect to improve glycemic control and some cardiometabolic risk factors in patients with type 2 diabetes.

Insomnia, sleep disordered breathing and cardiometabolic risk factors in patients complaining of pain in the orofacial region

Insomnia, sleep disordered breathing and cardiometabolic risk factors in patients complaining of pain in the orofacial region

Dose-dependent effect of carbohydrate restriction for type 2 diabetes management: a systematic review and dose-response meta-analysis of randomized controlled trials

Carbohydrate restriction is effective for type 2 diabetes management. We aimed to evaluate the dose-dependent effect of carbohydrate restriction in patients with type 2 diabetes. We systematically searched PubMed, Scopus, and Web of Science to May 2021 for randomized controlled trials evaluating the effect of a carbohydrate-restricted diet (≤45% total calories) in patients with type 2 diabetes. The primary outcome was glycated hemoglobin (HbA1c). Secondary outcomes included fasting plasma glucose (FPG); body weight; serum total, LDL, and HDL cholesterol; triglyceride (TG); and systolic blood pressure (SBP). We performed random-effects dose-response meta-analyses to estimate mean differences (MDs) for a 10% decrease in carbohydrate intake. Fifty trials with 4291 patients were identified. At 6 months, compared with a carbohydrate intake between 55%-65% and through a maximum reduction down to 10%, each 10% reduction in carbohydrate intake reduced HbA1c (MD, -0.20%; 95% CI, -0.27% to -0.13%), FPG (MD, -0.34mmol/L; 95% CI, -0.56 to -0.12 mmol/L), and body weight (MD, -1.44kg; 95% CI, -1.82 to -1.06 kg). There were also reductions in total cholesterol, LDL cholesterol, TG, and SBP. Levels of HbA1c, FPG, body weight, TG, and SBP decreased linearly with the decrease in carbohydrate intake from 65% to 10%. A U-shaped effect was seen for total cholesterol and LDL cholesterol, with the greatest reduction at 40%. At 12 months, a linear reduction was seen for HbA1c and TG. A U-shaped effect was seen for body weight, with the greatest reduction at 35%. Carbohydrate restriction can exert a significant and important reduction on levels of cardiometabolic risk factors in patients with type 2 diabetes. Levels of most cardiometabolic outcomes decreased linearly with the decrease in carbohydrate intake. U-shaped effects were seen for total cholesterol and LDL cholesterol at 6 months and for body weight at 12 months.