Metabolic Cardiovascular Risk Factors Research Articles

정상 체중 비만 성인의 체지방 감량을 위한 한약 처방의 활용: 후향적 차트 리뷰

Objectives Normal weight obesity (NWO) is defined as a normal body weight according to Body Mass Index (BMI) but with a high body fat percentage. NWO is associated with metabolic abnormalities and cardiovascular risk factors, thereby emphasizing the importance of body fat loss. The objective of this study is to evaluate changes in weight and body fat with NWO who were prescribed Korean herbal medicine. Methods A retrospective chart review was conducted for subjects with NWO, within the normal weight range but with over 30% body fat percentage. These subjects were prescribed herbal medicine for a 12-week between March 2021 and May 2023. Weight (kg), body fat mass (kg), body fat percentage (%) and % Fat Free Mass (FFM) loss/weight loss (%FFML) were assessed before and after the period. Reported adverse events were evaluated for severity, causality, and system-organ classes. Results A total of 42 subjects were included (mean±SD, weight 57.38±3.45 kg, body fat percentage 33.65±2.12%). The average weight loss rate was 6.99±3.22% with a reduction of 4.08±1.95 kg, while the body fat loss rate averaged 18.00± 0.08% with a decrease of 3.54±1.73 kg. The average of %FFML was 21.89±0.16%. Most adverse events reported were mild (90.9%) in severity, and the likelihood of events being 'Unlikely' increased from 48.8% to 64.3% as the program progressed. Conclusions The administration of Korean herbal medicine can be considered an appropriate method to alleviate normal weight obesity, without causing serious adverse reactions. Further well-designed controlled trials and clinical studies with the analysis of hematological indicators are needed to validate its efficacy.

Unraveling the Complexities of Polycystic Ovarian Syndrome: A Comprehensive Review

Polycystic Ovarian Syndrome (PCOS) is a complex endocrine disorder affecting reproductive-age women, characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. This comprehensive review delves into the multifaceted nature of PCOS, exploring its etiology, pathophysiology, clinical manifestations, diagnostic criteria, and management strategies. Key topics include the role of insulin resistance and hyperinsulinemia in PCOS pathogenesis, the impact of hormonal imbalances on menstrual irregularities and fertility, and the association of PCOS with metabolic syndrome and cardiovascular risk factors. Furthermore, the review discusses current diagnostic criteria and controversies surrounding PCOS diagnosis, as well as evidence-based approaches to treatment, encompassing lifestyle modifications, pharmacological interventions, and assisted reproductive technologies. By synthesizing current knowledge and emerging research findings, this review aims to provide a comprehensive overview of PCOS for clinicians, researchers, and individuals affected by this prevalent endocrine disorder.

Premature coronary heart disease complicated with hypertension in hospitalized patients: Incidence, risk factors, cardiovascular-related comorbidities and prognosis, 2008–2018

BackgroundThe clinical characteristics and risk factors of all-cause mortality in young hospitalized patients with comorbid coronary heart disease and hypertension (CAD + HT) are not well-characterized. MethodA total of 2288 hospitalized CAD patients (age<45 years) with or without hypertension in the Chinese PLA General Hospital from August 5, 2008 to June 22, 2018 were conducted. The risk factors of all-cause mortality were estimated in young CAD + HT patients by COX models. ResultsThe overall prevalence of hypertension in young CAD patients was 50.83% (n = 1163). CAD + HT patients had older age, higher heart rate, BMI, uric acid, triglyceride and lower level of eGFR and HDL-C than CAD patients (P < 0.05). The proportion of cardiovascular-related comorbidities (including obesity, diabetes mellitus, hyperuricemia and chronic kidney disease [CKD]) in the CAD + HT group was significantly higher than that in CAD group (P < 0.0001). The risk of all-cause mortality was higher in CAD + HT patients, although after adjusting for all covariates, there was no significant difference between the two groups. Furthermore, CKD (HR, 3.662; 95% CI, 1.545–8.682) and heart failure (HF) (HR, 3.136; 95%CI, 1.276–7.703) were associated with an increased risk of all-cause mortality and RAASi (HR, 0.378; 95%CI, 0.174–0.819) had a beneficial impact in CAD + HT patients. ConclusionsHypertension was highly prevalent in young CAD patients. Young CAD + HT patients had more cardiovascular metabolic risk factors, more cardiovascular-related comorbidities and higher risk of all-cause mortality. CKD and HF were the risk factors, while RAASi was a protective factor, of all-cause mortality in CAD + HT patients.

Current Status of Metabolic Compliance and Risk of Cardiovascular Disease in Patients with Type 2 Diabetes in the Zhuang Population in China.

This study aimed to investigate the blood glucose, blood pressure, and blood lipid status in Zhuang patients with T2DM and to analyze the correlation between compliance with metabolic monitoring and cardiovascular risk factors. A total of 1975 Zhuang patients with T2DM were evaluated in four Class III Grade A hospitals in three prefecture-level cities in the Guangxi Zhuang Autonomous Region between January and August 2022. Laboratory indicators, lifestyle, and demographic characteristics were collected. The compliance rates for blood glucose, blood pressure, and blood lipids were 26.08%, 45.77%, and 30.58%, respectively, and only 5.06% of the patients reached the standard in all three indices. The compliance rates for blood glucose, blood pressure, and blood lipids in the CVD group were 32.92%, 21.74%, and 9.94%, respectively. In the CVD group, the usage rates of hypoglycemic, antihypertensive, and lipid-lowering drugs were 77.54%, 3.17%, and 4.11%, respectively. Binary logistic regression analysis showed that older age (OR = 1.033, 95% CI [1.016, 1.050]), female (OR = 0.402, 95% CI [0.260, 0.621]), smoke (OR = 1.994, 95% CI [1.361, 2.922]), blood pressure noncompliance + use of antihypertensive drugs (OR = 0.348, 95% CI [0.230, 0.527]), and blood lipid noncompliance + use of lipid-lowering drugs (OR = 0.244, 95% CI [0.142, 0.417]) were risk factors for CVDs, and moderate-intensity exercise (OR = 0.439, 95% CI [0.300,0.640]) was protective against CVD. Older age, female, smoke, blood lipid levels, and blood pressure noncompliance were risk factors for CVD while moderate-intensity exercise was observed to be protective.

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.

Bariatric surgery and blood pressure control in patients with hypertension: a systematic review and meta-analysis

Abstract Background Bariatric surgery remains the most effective method for sustained weight loss in patients with class II or III obesity. However, the effects of bariatric surgery on BP control in obese patients with hypertension are not consistent across studies. Purpose The purpose of this study was to compare the effects of bariatric surgery versus nonsurgical treatment on blood pressure control in patients with hypertension. Methods Randomized controlled trials evaluating the effects of bariatric surgery versus nonsurgical treatment on blood pressure reduction were searched in PubMed, Embase, Cochrane Database and Cochrane Clinical Trials Registry, and nineteen randomized controlled trials (in 1,375 obese patients) were finally included. The primary outcome was the rate of hypertension remission, and the follow-up periods ranged from 12 to 60 months. Results The results showed that bariatric surgery was associated with a higher hypertension remission rate (RR: 4.61, 95% CI: 2.27–9.35, P &amp;lt; 0.0001) and a greater decrease in diastolic blood pressure (WMD: -3 mmHg, 95% CI: -4.28 to -1.72, p&amp;lt;0.00001). However, no significant difference was observed in systolic blood pressure (WMD: -2.4 mmHg, 95% CI: -5.8 to 1, p=0.17). Furthermore, the following metabolic conditions and cardiovascular risk factors were also improved by bariatric surgery in patients with hypertension. Conclusion In conclusion, our study confirmed that bariatric surgery was associated with a higher rate of short-to-medium-term hypertension remission and a greater decrease in diastolic blood pressure for patients with hypertension. Bariatric surgery should be considered in these patients.

71 NIH-AARP: Association of caregiving with lifestyle cardiovascular disease risk factors

Abstract Background Adult caregiving has been associated with adverse effects on cardiovascular risk factors and health outcomes, with most research focused on caregivers of individuals with dementia and single risk factors. We sought to explore the association of adult and child caregiving, across a spectrum of intensity, with multiple lifestyle risk factors. Methods We evaluated the association of caregiving with behavioural and metabolic cardiovascular risk factors, using unconditional logistic regression analyses in the NIH-AARP Diet and Health Study. Results While the overall association of self-reported caregiving with cardiovascular risk factors suggested a mostly positive relationship with healthy lifestyle traits (other than sleep duration), our findings also revealed that higher duration caregiving of adults (≥7 hours per week) was associated with an increased frequency of unhealthy behaviours, including diet, and smoking. Conclusion Our findings suggest that the association of caregiving and behavioural cardiovascular risk factors differ by type and intensity of caregiving.

Intermittent Fasting and Its Effects on Weight, Glycemia, Lipids, and Blood Pressure: A Narrative Review.

Metabolic syndrome (MetS) has become a significant public health concern globally. Weight managementis crucial in controlling MetS risk factors, making energy balance and weight loss strategies important in nutrition recommendations. Intermittent fasting (IF) has gained traction as a dietary approach for weight management and cardiovascular risk reduction. However, the effects of IF on cardiovascular risk factors have been inconsistent in previous studies. This review aims to summarize the effects of various types of IF on body mass index (BMI), glycemia, lipid profile, and blood pressure, while providing insights into their clinical implications. A comprehensive search of interventional studies and meta-analyses was conducted, and the results were analyzed. The findings indicate that different types of IF lead to mixed effects. Time-restricted eating (TRE) and alternate-day fasting (ADF) consistently showed decreases in BMI, while the outcomes of intermittent energy restriction (IER) were more uncertain. The effects of IF on glycemia and lipid profile were also variable, with TRE and ADF generally showing positive results. However, the impact of IER remained inconsistent. More research is needed to understand the long-term effects and optimal implementation of IF for managing metabolic syndrome and cardiovascular risk factors.

Dietary pro-oxidant score (POS) and cardio-metabolic panel among obese individuals: a cross-sectional study

BackgroundOxidative stress is a disturbance in the natural balance between oxidative and anti-oxidative processes, which is the major effective factor in cardiovascular disorders and metabolic syndrome (MetS), due to the role of pro-oxidants in inducing oxidative stress, and as a result, the occurrence and exacerbation of components of metabolic syndrome and cardiovascular risk factors, this cross-sectional study was conducted with the aim of investigating the relationship between the status of dietary pro-oxidants score (POS) and metabolic parameters including serum lipids, glycemic markers and blood pressure among obese adults.Methods338 individuals with obesity (BMI ≥ 30 kg/m 2), aged between 20 and 50 years were recruited in the present cross-sectional study. A validated food frequency questionnaire (FFQ) was used to determine the dietary pro-oxidant score (POS). Analysis of variance (ANOVA) with Tukey’s post-hoc comparisons after adjustment for confounders and multivariable logistic regression analysis were performed to determine the association of cardiometabolic risk factors among the tertiles of POS.ResultsParticipants with higher POS had lower levels of body mass index (BMI), weight and waist circumference (WC). There were no significant associations between metabolic parameters including glycemic markers and lipid profile in one-way ANOVA and multivariate multinomial logistic regression models.ConclusionsThe findings of this study revealed that greater dietary pro-oxidant intake might be associated with lower BMI, body weight, and WC in Iranian obese individuals. Further studies with interventional or longitudinal approaches will help to better elucidate the causality of the observed associations.

368-OR: Life Expectancy and Causes of Death after Bariatric Surgery or Usual Care in Patients Stratified by Baseline Type 2 Diabetes in the Swedish Obese Subjects Study

Introduction: Patients with and without type 2 diabetes (T2D) differ in terms of metabolic disturbances and cardiovascular risk factors. Thus, it is possible that the increased survival after surgical obesity treatment is due to reduction of different causes of death. Here, we determined mortality and causes of death after bariatric surgery in relation to baseline T2D status in the prospective controlled Swedish Obese Subjects (SOS) study. Methods: Deaths after bariatric surgery or usual care were determined in subgroups defined by baseline T2D (n=697) or non-T2D (n=3335) during a median follow-up of 26 years. The Swedish Cause of Death Register, case sheets and autopsy reports were assessed to determine the direct cause of death. Analyses were adjusted for preselected risk factors (age, sex, BMI and smoking at baseline, and year of inclusion in the study). Results In T2D and non-T2D subgroups, bariatric surgery was associated with increased life expectancy (2.1, 95% confidence interval (95% CI) 0.2-4.0 and 1.6, 0.5-2.7 years, respectively) and lower overall mortality (adjusted hazard ratio (adjHR)=0.77, 95% CI 0.61-0.97; and 0.82, 0.72-0.94, respectively), and the treatment benefit was similar (p for interaction 0.615). Bariatric surgery was associated with reduced cardiovascular mortality in both subgroups (adjHR=0.65, 95% CI 0.46-0.91; and 0.70, 0.55-0.88, respectively (p for interaction 0.516)). Conclusions: Bariatric surgery is associated with similar reduction of overall and cardiovascular mortality and increased life expectancy regardless of baseline diabetes status. Disclosure K.Sjöholm: None. J.C.Andersson assarsson: None. M.Taube: None. L.Carlsson ekander: None. Funding Swedish Research Council; Swedish State; Swedish Heart and Lung Foundation; Swedish Diabetes Foundation; Adlerbert Research Foundation

#3829 ARTERIAL STIFFNESS AND METABOLIC SYNDROME INDICES IN RENAL TRANSPLANTATION PATIENTS

Abstract Background and Aims Although renal transplantation improves survival, cardiovascular morbidity and mortality still remain as a significant problem compared with nonrenal populations. In end stage renal disease metabolic cardiovascular risk factors such as hypertension, hyperuricemia, obesity and diabetes mellitus have been confirmed to be positively correlated with arterial stiffness. Arterial stiffness is an important characteristic of the arterial wall and can be assessed noninvasively by the measurement of carotid-femoral pulse wave velocity (PWv). The aim of this study is to evaluate the risk factors for arterial stiffness in kidney transplant recipients. Method One hundred and forty nine kidney transplant recipients from our renal transplant outpatient clinic were enrolled into the study. All patients were evaluated for their standard clinical (age, gender, duration of hemodialysis, post-transplant time), biochemical parameters. Anthropometric and body composition analyses were performed for all patients. Body compositions were analyzed by using the Body Composition Analyzer (Tanita BC- 420MA). PWv was determined from pressure tracing over carotid and femoral arteries using the SphygmoCor system. Results Patients were divided into two groups according to PWv levels. The frequency of patients with PWv ≥ 7 m/s was higher in patients with new onset diabetes (55.9%), hyperuricemia (uric acid level type="Periodical" type="Periodical" type="Periodical" type="Periodical" type="Periodical" type="Periodical" type="Periodical" type="Periodical"&amp;gt; 7 mg/dl) (p:0.029, 0.05). Higher carotid-femoral PWv was significantly related with systolic (p:0.003) and diastolic blood pressure (p:0.002), uric acid (p:0.0001) and fasting glucose (p: 0.02) levels. According to body composition analyses, muscle mass, visceral fat ratio and body weight were significantly higher in patients with PWv ≥ 7 m/s (p &amp;lt; 0.005). In patients with high PWv, sagittal abdominal diameters and waist circumferences were significantly higher than patients with PWv &amp;lt; 7 m/s. When criteria for metabolic syndrome were assessed there were a significant increase in pulse wave velocity in patients with 0-1; 2-3; and 4-5criteria (p &amp;lt; 0.01). Conclusion In post transplantation period, metabolic syndrome indices as high blood pressure, hyperuricemia, hyperglycemia and increased waist and hip circumferences are closely related with arterial stiffness. For cardiovascular risk reduction after renal transplantation; blood pressure, serum glucose and uric acid levels should be under strict control.

Treatment of comorbid anxiety symptoms and insomnia in patients with schizophrenia: A review of Pros and Cons.

IntroductionRecent studies report a prevalence of comorbid anxiety disorder of 38% and 80% of sleep disorders in schizophrenia. Insomnia has been associated with worsening of psychopathological symptoms and increased hospitalization rates.ObjectivesThe aim of our work was to review mechanisms of action and the use of benzodiazepines, GABAergic drugs and melatonin for the treatment of anxiety and insomnia in schizophrenia.MethodsWe carried out a narrative review of studies focusing on the treatment of anxiety disorders and insomnia in schizophrenia through PubMed and Google Scholar (2002-September 2022). The use of benzodiazepines, GABAergic drugs and melatonin in schizophrenia are discussed, illustrating them with case reports.ResultsA total of 32 studies were included. (A)Benzodiazepines (BZD) work facilitating the inhibitory actions of gamma-aminobutyric acid (GABA) by binding GABA type A receptors. The beneficial effect of combined use of antipsychotics and BZD is controversial (cognitive complications, sedation, overdosing, substance use, etc). (B)GABAergic drugs: gabapentin (GP) and pregabalin (PG) (structurally related molecules), have no direct GABAergic action and act inhibiting voltage-gated calcium channels. The efficacy of GP and PG in the treatment of anxiety symptoms in schizophrenia is understudied. Positive effects of GP in schizophrenia suffering from restless legs syndrome receiving clozapine. (C )Melatonin, an hormone produced in the pineal gland has been used to treat insomnia. Positive effects on metabolic syndrome and cardiovascular risk factors have been reported. Several works considered it an alternative in schizophrenia.ConclusionsFew evidence is available on the use of BZD, GP, and PG in schizophrenia. Melatonin is a promising compound to treat insomnia.Disclosure of InterestNone Declared

Spousal Similarities in Cardiovascular Risk Factors in Northern China: A Community-Based Cross-Sectional Study.

Objectives: The aim of this study was to explore spousal similarities in cardiovascular risk factors in northern China. Methods: We conducted a cross-sectional study of married couples from Beijing, Hebei, Gansu, and Qinghai provinces between 2015 and 2019. A total of 2,020 couples were included in the final analyses. The spousal similarities for metabolic indicators and cardiovascular risk factors (including lifestyle factors and cardiometabolic diseases) were evaluated using Spearman's correlation and logistic regression analyses, respectively. Results: All metabolic indicators showed positive spousal correlations (p < 0.001), with the strongest for fasting blood glucose (r = 0.30) and the lowest for high-density lipoprotein cholesterol (r = 0.08). Significant husband-wife associations were observed for several cardiovascular risk factors except for hypertension in multivariable models, with the strongest association for physical inactivity (odds ratios with 95% confidence intervals of 3.59 [2.85, 4.52] and 3.54 [2.82, 4.46] for husbands and wives, respectively). In addition, the interaction of age with spousal overweight/obesity status was statistically significant, and the association was stronger in people ≥50years. Conclusion: There were spousal similarities in cardiovascular risk factors. The finding may have public health implications that targeted screening and interventions for spouses of people with cardiovascular risk factors.

Association between daily eating frequency and mortality in people with diabetes: Findings from NHANES 1999-2014.

Previous studies have shown that increasing the frequency of eating is beneficial in terms of cardiovascular metabolic risk factors; however, limited evidence is available for the association between daily eating frequency and mortality, especially in people with diabetes. Therefore, we aimed to explore the association between eating frequency and long-term mortality in populations with diabetes. We selected 4,924 individuals suffering from diabetes (mean age: 57.77 years; 51.3% men) from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2014. Daily eating frequency was used as the exposure factor in this study. We extracted the mortality data from the National Death Index records and matched them with the population of NHANES. All participants were followed up from the date of getting enrolled in NHANES to 31 December 2015. Multivariate Cox proportional hazards regression, Kaplan-Meier survival curves, and restricted cubic spline were used to assess the associations between eating frequency and all-cause and cause-specific mortality among people with diabetes. During 34,950 person-years of follow-up, 1,121 deaths were documented, including 272 cardiovascular disease (CVD)-related deaths and 156 cancer-related deaths. After adjusting for confounding factors, the daily eating frequency was linearly inversely associated with all-cause and CVD-related mortality, and the HR (95% CIs) for per one-time increment of eating frequency was 0.88 (0.80-0.98) and 0.77 (0.63-0.93), respectively. Sensitivity analyses showed that the main results and statistical significance were still stable. Higher eating frequency was independently related to lower all-cause and CVD-related mortality in people with diabetes, which can be used as a potential strategy for daily-diet management among populations suffering from diabetes.

Factor V Leiden but not the factor II 20210G>A mutation is a risk factor for premature coronary artery disease: a case-control study in Iran

BackgroundFactor V Leiden (FVL) and factor II c.∗97G>A (rs1799963) are genetic risk factors for venous thromboembolism. Their contribution to coronary artery disease (CAD) is less clear. ObjectivesThis study aimed to investigate the association between FVL, rs1799963, and premature CAD in Iranians. MethodsWe performed a genetic case-control study of 944 cases and 1081 controls from the premature CAD Milano-Iran study, including patients aged 18-55 (female) and 18-45 years (male) who underwent coronary angiography at the Tehran Heart Centre (Iran) in 2004-2011. Cases had luminal stenosis ≥50% in at least 1 main coronary artery or branch. Controls were age- and sex-matched with no CAD history. FVL and rs1799963 were genotyped using TaqMan SNP genotyping assays. Association was tested by logistic regression adjusted for matching factors and ethnicity. Effect modification by sex and cardiovascular risk factors (metabolic [obesity, hypertension, hyperlipidemia, and diabetes], and smoking) was assessed. ResultsThe risk of premature CAD was increased by 50% in FVL carriers (adjusted odds ratio [adjOR] 1.54 [95% CI, 0.95-2.48]) and slightly reduced in rs1799963 carriers (adjOR 0.71 [95% CI, 0.40-1.27]). These effects were more pronounced in women than men (FVL, adjOR 1.66 vs 1.25; rs1799963, adjOR 0.60 vs 1.07). The risk of premature CAD was substantially increased in carriers of FVL with at least 1 metabolic risk factor compared with noncarriers without metabolic risk factors (adjOR 25.14 [95% CI, 12.51-50.52]). ConclusionFVL but not FII rs1799963 was associated with an increased risk of CAD in young Iranians. This risk increased considerably when combined with metabolic cardiovascular risk factors.

Comparison of novel markers of metabolic complications and cardiovascular risk factors between obese non-diabetic and obese type 1 diabetic children and young adults.

For the past years, the prevalence of obesity is growing in the general population of children, as well as among diabetic patients, resulting in increased risk of cardiovascular complications. Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases in children and young adults, leading to decreased life quality and lifespan, with obesity being recognized recently as a major contributing factor to these health problems. The objective of this study was to analyze and compare the selected novel markers for metabolic complications of obesity and vascular risk factors between obese non-diabetic and obese T1DM children and young adults. One hundred four subjects, aged between 10 and 24 years (31 with T1DM and excessive body weight, 41 with obesity without diabetes, and 32 with T1DM and normal weight), and 32 matched lean controls were included in the study. Clinical characteristics, blood pressure measurements, daily requirement for insulin, HbA1c%, plasma lipids, fetuin-A, E-selectin, and osteoprotegerin levels were compared with respect to body mass index (BMI), body mass index standard deviation score (BMI-SDS), and carotid intima-media thickness (cIMT) of common carotid arteries. Patients with T1DM and excessive body weight compared to non-diabetic obese subjects had similar values of systolic blood pressure (125.6 ± 8.2 vs. 127.3 ± 12.9 mmHg, p = 0.515), diastolic blood pressure (78.19 ± 7.03 vs. 78.02 ± 8.01 mmHg, p = 0.918), cholesterol (175.26 ± 34.1 vs. 163.51 ± 26.08 mg/dl, p = 0.102), LDL (108.03 ± 32.55 vs. 112.22 ± 26.36 mg/dl, p = 0.548), and triglyceride levels (118.19 ± 71.20 vs. 117 ± 55.80 mg/dl, p = 0.937); all values were found to be higher compared to non-obese T1DM and healthy controls. HbA1c level and insulin resistance indices were significantly worse in T1DM obese vs. T1DM non-obese patients. Fetuin-A levels were higher among obese non-diabetic patients (p = 0.01), and E-selectin and osteoprotegerin levels were similar in both groups with obesity, but higher than in the reference group. There were no statistical differences in cIMT with T1DM with normal weight, excessive weight, and non-diabetic obese children; however, the cIMT value was higher compared to the reference group. Novel markers of metabolic complications of obesity are similar between obese T1DM and non-diabetic subjects. Obesity in patients with T1DM results in worse metabolic control, insulin resistance, and increased risk for vascular complications.

Evaluation of epicardial fat tissue and echocardiographic parameters in patients with silent enemy subclinical hypothyroidism.

To evaluate epicardial adipose tissue (EAT) which is known to be closely associated with metabolic syndrome and cardiovascular risk factors (hypertension, diabetes mellitus, obesity, age, smoking) and which is a more specific marker of visceral adiposity than waist circumference using echocardiographic examination in subclinical hypothyroidism which is one of the most common endocrine system diseases in the community but is mostly missed due to its asymptomatic nature. The study included 60 individuals aged 18-65 years, comprising 30 patients with newly diagnosed subclinical hypothyroidism and 30 age- and gender-matched control subjects that had a normal thyroid hormone profile. 2D transthoracic echocardiography was utilized for measuring EAT thickness and other basic echocardiographic parameters. No significant difference was found between the two groups with regard to gender, age, body mass index (BMI), and other diameters and measurements obtained by 2D transthoracic echocardiography. EAT thickness was significantly higher in the patient group compared to the control group (p &lt;.001). Epicardial adipose tissue (EAT) is increased in patients with subclinical hypothyroidism.

The Effect of miR-505-5p on Inhibition of Serum Uromodulin Ameliorates Myocardial Inflammation and Apoptosis Induced by Ischemia-Reperfusion.

Background It has been found that miR-505-5p is closely related to cardiovascular metabolic risk factors. Nonetheless, there is little research analyzing miR-505-5p for its role as well as molecular mechanism in myocardial injury caused by ischemia-reperfusion (I/R). Methods This work utilized quantitative reverse transcriptase PCR (qRT-PCR) for detecting miR-505-5p and serum uromodulin (sUmod) levels. sUmod, interleukin-1beta (IL-1β), IL-6, IL-10, caspase7, caspase9, tumor necrosis factor-alpha (TNF-α), Bax, and Bcl-xL expression was detected by western blot. Bioinformatics database was used for target prediction and miR-505-5's target was determined by luciferase reporter gene assay. Results Relative to sham group, sUmod was highly expressed within myocardial I/R injury (MIRI), whereas sUmod silencing significantly decreased the heart weight/body weight ratio, reduced serum myocardial enzymes expression, ameliorated I/R-mediated myocardial apoptosis, and inflammation. TargetScan bioinformatics database and luciferase reporter genes confirmed that sUmod was miR-505-5p's direct target gene, besides, miR-505-5p overexpression significantly improved the myocardial injury score, increased IL-10, decreased TNF-α, IL-1β, IL-6 expression, decreased caspase7, caspase9, Bax expression, and increased Bcl-xL expression. More importantly, overexpression of sUmod abolished miR-505-5p overexpression's role in I/R-mediated myocardial apoptosis and inflammation. Conclusion miR-505-5p can improve I/R-mediated myocardial apoptosis and inflammation by targeting sUmod. In this study, miR-505-5p is related to MIRI pathogenesis, which provides the new possible targeted therapy in patients with MIRI.

A Significant Effect of Oral Semaglutide on Cardiovascular Risk Factors in Patients With Type 2 Diabetes.

The once-daily glucagon-like peptide 1 (GLP-1) analogue, liraglutide has been shown to reduce major adverse cardiovascular events (MACE) and progression of chronic kidney disease (CKD). The once-weekly GLP-1 analogue, semaglutide also reduced MACE and renal events. Based on the evidence for GLP-1 analogues on MACE and renal events, the guideline recommended to treat high-risk diabetic individuals with GLP-1 analogues to reduce MACE and CKD progression. Recently, a once-daily oral semaglutide was developed and shown to reduce MACE. However, its effects on renal outcome and cardiovascular metabolic risk factors remain unknown. We retrospectively picked up patients who had taken oral semaglutide from March 2021 to June 2022 and compared metabolic parameters at baseline with the data at 3, 6 months after the start of oral semaglutide. We found 47 patients who had taken oral semaglutide. Body weight significantly decreased at 3 and 6 months after the start of oral semaglutide, and systolic blood pressure significantly decreased after 6 months. Hemoglobin A1c (HbA1c) tended to decrease after 3 months and significantly deceased after 6 months. Serum low-density lipoprotein cholesterol (LDL-C) levels significantly decreased after 6 months and non-high-density lipoprotein-cholesterol (non-HDL-C) levels tended to decrease after 6 months. Urinary albumin to creatinine ratio (UACR) tended to decrease after 3 and 6 months. Such favorable metabolic changes by oral semaglutide were observed more prominently in patients who had not ever used GLP-1 analogues than in patients who switched from subcutaneous GLP-1 analogues. Our study showed that oral semaglutide improved body weight, blood pressure, HbA1c, LDL-C, non-HDL-C and UACR, in type 2 diabetic obese patients, especially, in patients who had not ever used GLP-1 analogues.

The association between the hypertriglyceridaemia waist phenotype, cardiovascular risk factors and the metabolic syndrome in South African Asian-Indians

Background and aimsThe combination of high triglycerides and increased waist circumference (HTGW) has not been examined as a predictor of cardiometabolic abnormalities or the metabolic syndrome (MetS) in high-risk Asian populations. This study examines the so-called hypertriglyceridemia waist (HTGW) phenotype, (high serum triglycerides [Tg]) and increased waist circumference (WC) as a predictor of cardiometabolic abnormalities in a high-risk Asian population. MethodsData from the Phoenix Lifestyle Project, a cross-sectional study of 1349 South Asian Indians (15–65 years; 379 men; 970 women) in Durban, KwaZulu-Natal, were reclassified into different waist and Tg phenotypes using the demographic, anthropometric, and biochemical parameters. The HTGW phenotype was defined as WC ≥ 90 cm for men; ≥80 cm for women & TG ≥ 1.7 mmol/L. The MetS was determined using the harmonised criteria. Stepwise logistic regression was used to determine the strength of each phenotype as a predictor of the MetS. ResultsThe HTGW phenotype was recorded in 35.4% of participants, predominantly women (36.1%) and 8.2% smokers. Metabolic derangements and cardiovascular risk factors increased significantly in those with HTGW phenotype. After adjustment, multivariate logistic regression showed that the association between elevated total serum cholesterol, LDL, lowered HDL, diabetes and hypertension with HTGW persisted. The odds for participants with the HTGW phenotype developing the MetS was 19.7 (95% CI 13.9; 27.9). The degree of concordance between the HTGW was highest with the IDF and harmonised criteria for MetS. ConclusionThe HTGW phenotype was associated with a significantly higher risk of developing additional lipid derangements, hypertension, diabetes and the MetS.