Changes In Metabolic Risk Factors Research Articles

Efficacy and Safety of GLP-1 Agonists on Metabolic Parameters in Non-diabetic Patients with Inflammatory Bowel Disease.

Obesity in patients with IBD is increasing, accompanied by an increase in metabolic comorbidities. Although GLP-1 agonists have shown promise in weight reduction, their efficacy and safety in patients with IBD are underexplored. This study evaluated the impact of GLP-1-based therapies on weight loss and metabolic parameters in non-diabetic patients with IBD. We conducted a single-center observational cohort study that included adult patients with IBD who were started on GLP-1-based therapy (semaglutide or tirzepatide) for weight loss from January 2021 to April 2024. The primary outcomes were changes in BMI and total body weight. Secondary outcomes included tolerability, safety, and changes in metabolic risk factors. The study included 36 patients with IBD, predominantly female (64%), with a median age of 45.5 years (IQR 41-51.5 years). The majority (67%) had Crohn's disease (CD) and on advanced therapy (86%). BMI significantly decreased from 34.0 (IQR 31.0-38.2) to 31.0 (IQR 29.0-36.1) with GLP-1-based therapy (p < 0.0001). Total body weight (TBW) significantly decreased by a median of 8.15 kg (IQR 15.9-2.2 kg; p < 0.0001). Although a decrease in total cholesterol and glycated hemoglobin was seen, this was not statistically significant (p = 0.0634 for total cholesterol, p = 0.0536 for glycated hemoglobin). No significant changes were observed in ALT or CRP levels. The most common side effects were nausea (31%) and constipation (25%). Semaglutide and tirzepatide can effectively reduce BMI in non-diabetic patients with IBD with manageable side effects. However, further studies are required to explore the long-term safety of GLP-1 agonists in the IBD population.

GLP-1 Receptor Agonists Confer No Increased Rates of IBD Exacerbation Among Patients With IBD.

In patients with inflammatory bowel disease (IBD), multimorbidity with obesity and type 2 diabetes is common and increasing. Glucagon-like peptide 1 (GLP-1) receptor agonists are increasingly being prescribed for patients with IBD, yet their impact on patients with IBD is largely unknown. We aimed to assess the impact of GLP-1 receptor agonists on the course of IBD. We identified all IBD patients prescribed GLP-1 receptor agonists at a large academic healthcare network between 2009 and 2023. We analyzed demographics and IBD characteristics in the year pre- and post-GLP-1 receptor agonist prescription and matched them to non-IBD controls. Our primary outcome was IBD exacerbation in the year following GLP-1 receptor agonist initiation, measured as a composite of IBD-related hospitalization, corticosteroid prescription, medication escalation or changes, or IBD-related surgery. Secondary outcomes included change in metabolic risk factors. Overall, 224 patients met inclusion criteria. At GLP-1 receptor agonist initiation, the median age was 54 years, 63% were female, 77% were White, and median BMI was 33.2kg/m2. Compared to the 12-month period prior to GLP-1 receptor agonist initiation, in the 12 months post-GLP-1 receptor agonist initiation, there was no change in rates of IBD exacerbation, IBD-related hospitalization, steroids prescription, medication escalation or changes, or IBD-related surgery. There was a significant decrease in BMI in the year following GLP-1 receptor agonist initiation (median BMI 33.5 vs 31.6kg/m2, P < .01), with rates of decrease comparable to non-IBD matched controls. In patients with IBD, GLP-1 receptor agonists are effective for weight loss and associated with few episodes of disease exacerbation.

Associations of cholecystectomy with metabolic health changes and incident cardiovascular disease: a retrospective cohort study

Although some studies conducted about the risk of cholecystectomy and cardiovascular disease, there was a limit to explaining the relationship. We investigated the short-term and long-term relationship between cholecystectomy and cardiovascular disease, and evidence using the elements of the metabolic index as an intermediate step. It was a retrospective cohort study and we used the National Health Insurance Service database of South Korea between 2002 and 2015. Finally, 5,210 patients who underwent cholecystectomy and 49,457 at 1:10 age and gender-matched controls of subjects were collected. The main results was estimated by Multivariate Cox proportional hazard regression to calculate the hazard ratio (HR) with 95% confidence interval (CI) for risk of cardiovascular disease after cholecystectomy. Regarding short-term effects of cholecystectomy, increased risk of cardiovascular disease (aHR 1.35, 95% CI 1.15–1.58) and coronary heart disease (aHR 1.77, 95% CI 1.44–2.16) were similarly seen within 2 years of surgery. When analyzing the change in metabolic risk factors, cholecystectomy was associated with a change in systolic blood pressure (adjusted mean [aMean]: 1.51, 95% CI: [− 1.50 to − 4.51]), total cholesterol (aMean − 14.14, [− 20.33 to 7.95]) and body mass index (aMean − 0.13, [− 0.37 to 0.11]). Cholecystectomy patients had elevated risk of cardiovascular disease in the short-term, possibly due to the characteristics of the patient before surgery. The association of cholecystectomy and cardiovascular disease has decreased after 2 years in patients who underwent cholecystectomy, suggesting that because of improvement of metabolic health, cholecystectomy-associated elevation of cardiovascular disease risk may be ameliorated 2 years after cholecystectomy.

Associations of work-family conflict with changes in metabolic risk factors: a four-year longitudinal study.

Cardiovascular disease (CVD) is becoming prevalent among younger people who have dual roles at both work and home. A possible contributor to CVD is conflict between work and home life. Thus, this study investigated the impact of work-to-family conflict (WFC) and family-to-work conflict (FWC) on metabolic risk factors. We used longitudinal data with a 4-yr interval from the Midlife in Japan study. 152 participants who were employed at baseline without missing variables of interest were included. We assessed the associations of baseline WFC and FWC with changes in metabolic risk factors between baseline and follow-up using Generalized Estimating Equations. After adjusting for baseline sociodemographic, work and family-related, and lifestyle factors, the fully adjusted model showed WFC was significantly associated with changes in low-density lipoprotein cholesterol (LDL-C) and Total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) ratio. However, FWC was not significantly associated with changes in any metabolic risk factors. Our findings indicated a significant impact of WFC on LDL-C and TC/HDL-C ratio but no significant impact of FWC on metabolic health. Since these metabolic risk factors cause CVD, understanding the physiological responses to occupational psychosocial stress could help create primary prevention interventions and assess their effects on workers' metabolic health.

The COVID-19 pandemic and temporal change in metabolic risk factors for cardiovascular disease: A natural experiment within the HELIUS study

The coronavirus disease 2019 (COVID-19) pandemic, including the restrictive measures taken to reduce the spread of the virus, negatively affected people's health behavior. We explored whether the pandemic also had an effect on metabolic risk factors for cardiovascular disease (CVD) in women and men. We conducted a natural experiment, using data from 6962 participants without CVD at baseline (2011–2015) of six ethnic groups of the HELIUS study in Amsterdam, the Netherlands. We studied whether participants whose follow-up measurements were taken within the 11 months before the pandemic (control group) differed from those whose measurements were taken taken within 6 months after the first lockdown (exposed group). Using sex-stratified linear regressions with inverse probability weighting, we compared changes in baseline- and follow-up data between the control and exposed group in six metabolic risk factors: systolic and diastolic blood pressure (SBP, DBP), total cholesterol (TC), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), and estimated glomerular filtration rate (eGFR). Next, we explored the mediating effect of changes in body-mass index (BMI), alcohol, smoking, depressive symptoms and negative life events at follow-up. We observed less favorable changes in SBP (+1.12mmHg for women, +1.38mmHg for men), DBP (+0.85mmHg, +0.80mmHg) and FPG (only in women, +0.12 mmol/L) over time in the exposed group relative to the control group. Conversely, changes in HbA1c (−0.65 mmol/mol, −0.84 mmol/mol) and eGFR (+1.06 mL/min, +1.04 mL/min) were more favorable in the exposed compared to the control group, respectively. Changes in SBP, DBP, and FPG were partially mediated by changes in behavioral factors, in particular BMI and alcohol consumption. Concluding, the COVID-19 pandemic, in particular behavioral changes associated with restrictive lockdown measures, may have negatively affected several CVD risk factors, in both women and men.

Overview of systematic reviews of health interventions that aim to prevent and treat overweight and obesity among children

BackgroundChildhood overweight and obesity is a global public health issue. Although there is evidence of a reduced prevalence in some countries, there is still much controversy about the efficacy of health interventions that aim to prevent and treat obesity in this specific population. The objective of the present study is to develop an overview of systematic reviews (OSRs) that assesses the effects of school-based, family, and multi-component health interventions for the prevention and treatment of obesity, change in physical activity, dietary, and/or hydration behaviors, and change in metabolic risk factors in school-aged children.MethodsThis protocol was developed using the methodology proposed by Cochrane. It outlines a comprehensive search in 12 electronic databases to identify systematic reviews of health interventions, including studies that evaluate and how to prevent and/or treat overweight and/or obesity in children aged 6 to 12 years. The risk of bias of the included Systematic Reviews will be assessed with the ROBIS tool.DiscussionSince the OSRs methodology’s purpose is only to harmonize evidence from open access publications, ethical consent is not necessary for the present protocol. In terms of diffusion, a paper will be submitted for publication in a scientific journal to describe the main results obtained through the OSRs.Trial registrationThe present overview of the systematic review protocol has been registered in PROSPERO (ID number 218296).

Cardiovascular complications of Cushings syndrome: Impact on morbidity and mortality.

Cardiovascular complications of Cushings syndrome: Impact on morbidity and mortality.

비만인의 유산소 운동 강도가 대사성위험인자 및 마이오카인에 미치는 영향

Purpose: In this study is to examine changes in metabolic risk factors (TC, TG, LDL-C, HDL-C, BMI, fasting blood glucose, fasting insulin and HOMA-IR) and Myokines (Irisin and FGF-21) according to exercise intensity through long-term aerobic exercise for obese men.BR Method: Subjects of the study calculated individual VO2max by exercise load test, A: low-intensity aerobic exercise group, VO2R 40% (low-intensity exercise group; LIEG), B: medium-intensity aerobic exercise group, VO2 60% (middle-intensity exercise group; MIEG), C: high-intensity aerobic exercise group, VO2R 80% (high-intensity exercise group; HIEG), D: control group (CG). For aerobic exercise, the treadmill speed was adjusted to maintain about ±3 of the target heart rate until the time spent 300kcal at the corresponding exercise intensity with the individual target heart rate by wearing a wireless heart rate device. In consideration of exercise adaptability, exercise time and intensity were recalculated after 6 weeks and applied for 12 weeks, 3 times a week.BR Results: TG, LDL-C, HDL-C, BMI, Glucose, Insulin, and HOMA-IR showed significant decreases in LEDG and HIEG, excluding TC. In MIEG of exercise treatment, the duration of exercise treatment showed a greater reduction after 12 weeks than after 6 weeks. In addition, changes in Irisin and FGF-21 also showed the most effective increase in MIEG, and the improvement of myokine was higher after 12 weeks of aerobic exercise.BR Conclusion: Even with the same exercise in the exercise metabolism of obese people, 12 weeks of moderate-intensity aerobic exercise is considered the most effective exercise treatment for myokine expression and lipid relief by accelerating the change of metabolic risk factors and the browning of white fat.

Abstract MP32: Variation in NT-proBNP Levels After Bariatric Surgery and Its Association With Body Fat Percentage

Introduction: Natriuretic peptides are regulators of the cardiovascular system that are also related to adiposity and insulin resistance. NT-proBNP levels are inversely associated with adiposity and increase with weight loss, which may have hemodynamic implications in obesity. However, it is unclear if the changes in NT-proBNP with weight loss are independent of changes in insulin resistance and related metabolic risk factors. Hypothesis: NT-proBNP increases with surgical weight loss are partially independent of changes in other metabolic risk factors. Methods: We investigated 71 patients from the BARI-Heart Study, a prospective cohort with anthropometrics, metabolic risk factors and biomarkers before and after bariatric surgery. We compared data between pre- and post-surgical visits (1-2 weeks and 6 months, respectively) using t-tests, and performed regression analysis examining the association of changes adiposity measures with NT-proBNP before and after adjusting for metabolic risk factors. Results: After bariatric surgery, major reductions in weight, body-mass index (BMI) and body fat percentage (BFP) (mean change) were observed (Table 1), whereas NT-proBNP levels increased (mean change +61 pg/mL, SD 104). There were significant reductions post-surgery in HOMA-IR (from 9.9 to 2.6; p &lt;0.0001), as well as in triglycerides, total cholesterol, glucose, and blood pressure (all p&lt;0.05). A negative correlation between changes in ln-NT-proBNP and BFP was found ( r -0.27; p=0.03). In regression analysis, the inverse association remained statistically significant after adjustment for changes in the other metabolic risk factors (Table 2). Conclusions: Reductions in adiposity are linked to increases in NT-proBNP independent of changes in metabolic risk factors. The mechanisms and cardiovascular implications of this direct link between weight loss and NT-proBNP deserve further investigation.

Lipidomic profiling identifies signatures of metabolic risk.

BackgroundMetabolic syndrome (MetS), the clustering of metabolic risk factors, is associated with cardiovascular disease risk. We sought to determine if dysregulation of the lipidome may contribute to metabolic risk factors.MethodsWe measured 154 circulating lipid species in 658 participants from the Framingham Heart Study (FHS) using liquid chromatography-tandem mass spectrometry and tested for associations with obesity, dysglycemia, and dyslipidemia. Independent external validation was sought in three independent cohorts. Follow-up data from the FHS were used to test for lipid metabolites associated with longitudinal changes in metabolic risk factors.ResultsThirty-nine lipids were associated with obesity and eight with dysglycemia in the FHS. Of 32 lipids that were available for replication for obesity and six for dyslipidemia, 28 (88%) replicated for obesity and five (83%) for dysglycemia. Four lipids were associated with longitudinal changes in body mass index and four were associated with changes in fasting blood glucose in the FHS.ConclusionsWe identified and replicated several novel lipid biomarkers of key metabolic traits. The lipid moieties identified in this study are involved in biological pathways of metabolic risk and can be explored for prognostic and therapeutic utility.

Drops in Blood Pressure, BMI Common Prior to Dementia Diagnosis

Back to table of contents Previous article Next article Clinical and Research NewsFull AccessDrops in Blood Pressure, BMI Common Prior to Dementia DiagnosisNick ZagorskiNick ZagorskiSearch for more papers by this authorPublished Online:23 Oct 2018https://doi.org/10.1176/appi.pn.2018.9a16AbstractA study that tracked seniors over 14 years is one of the first to explore how temporal changes in metabolic risk factors affect dementia risk.Metabolic problems are a known risk factor for dementia, but studies examining the association between metabolic status at certain ages and dementia risk have found varied results. High blood pressure and low blood pressure at certain ages have both been linked with dementia risk, as have obesity and being underweight.iStock/Sasha_SuziIn a study published in JAMA Psychiatry, researchers at the University of Bordeaux in France described how rather than examining the relationship between metabolic status at a specific age and dementia risk, they tracked the trajectories of these risk factors. They found evidence to suggest that exaggerated drops in body mass index (BMI) and blood pressure could signify oncoming dementia. They also reaffirmed that high blood glucose in older age is a significant dementia risk factor.The findings were based on analysis of health data from nearly 4,000 individuals who were part of the Three-City (3C) study. The study followed adults aged 65 and older in three French cities (Bordeaux, Dijon, and Montpelier) for 14 years to ascertain connections between heart disease and dementia.The research team identified 841 people in the 3C cohort who developed dementia at some point during the study (the average length of time to diagnosis was about eight years). The researchers then tried to match each person with dementia with four control individuals with similar demographics at the time of diagnosis; they successfully matched 785 dementia cases with 3,140 controls for the final analysis.The researchers then plotted out all prior assessments of BMI; systolic and diastolic blood pressure; and high-density and low-density lipoprotein cholesterol (HDL-C and LDL-C), triglyceride, and blood glucose levels for these 3,925 people.The metabolic trajectories revealed that people who developed dementia showed much steeper declines in BMI in the years preceding their diagnosis, with the most rapid weight loss starting at about seven years before diagnosis. Over the 14-year period, the average BMI of dementia patients dropped from 26.1 to 24.8, whereas BMI in controls only dropped from 25.7 to 25.3. People who developed dementia also experienced a greater drop in blood pressure over time compared with controls. Although both groups of patients experienced rising blood glucose level with age, those with dementia had consistently higher glucose levels over the 14-year period. Lead study author Maude Wagner, M.P.H., of the University of Bordeaux said that the changes seen in dementia patients likely represent reverse causation—that is, subtle cognitive decline may be accelerating normal metabolic changes. In the case of BMI, early dementia may cause someone to eat less, which would increase age-related weight loss. Likewise, some research has suggested that early-stage dementia disrupts brain processes involved in blood pressure regulation.Because low blood pressure reduces the delivery of oxygen to the brain, Wagner and colleagues noted that it is also possible that lower blood pressure contributes to dementia.“This study reinforces that the relationship between metabolism and dementia is complex and highly dependent on timing,” Gary Small, M.D., director of geriatric psychiatry at the David Geffen School of Medicine at the University of California, Los Angeles, told Psychiatric News. Even so, he cautioned that it’s too soon for clinicians to make predictions using these measures.“We need more longitudinal studies to try to tease out this gray area of what changes are cause versus effect,” he said. The 3C is conducted under a partnership agreement between the Institut National de la Santé et de la Recherche Médicale (INSERM), the University of Bordeaux, and Sanofi. ■“Evaluation of the Concurrent Trajectories of Cardiometabolic Risk Factors in the 14 Years Before Dementia” can be acccessed here. ISSUES NewArchived

Short-term abstinence from alcohol and changes in cardiovascular risk factors, liver function tests and cancer-related growth factors: a prospective observational study

ObjectiveTo assess changes in metabolic risk factors and cancer-related growth factors associated with short-term abstinence from alcohol.DesignProspective, observational study.SettingSingle tertiary centre.ParticipantsHealthy subjects were recruited based on intention to: (1) abstain...

Predictive Nomogram of RAGE Genetic Polymorphisms and Metabolic Risk Factors for Myocardial Infarction Risk in a Han Chinese Population.

We investigated the association of 4 well-characterized polymorphisms in receptor for the advanced glycation end-product ( RAGE) gene with myocardial infarction (MI) risk and the changes in metabolic risk factors among 717/612 patients/controls, with the aim of constructing a predictive nomogram. The genotype/allele distributions differed significantly between the 2 groups for T-429C ( Pgenotype/allele = .004/.001) and G1704T ( P < .001/.001). T-429C was significantly associated with MI risk, especially under a recessive model (adjusted odds ratio: 2.24, 95% confidence interval: 1.33-3.79, P = .003). For G1704T, significance was detected under additive (1.37; 1.12-1.67; P = .002) and recessive (3.86; 2.27-6.57; P < .001) models. There were significant differences in blood pressure and low-density lipoprotein cholesterol (LDL-C) across T-429C genotypes and in total cholesterol and LDL-C across G1704T genotypes. The overall best multifactor dimensionality reduction model included dyslipidemia, G1704T, and T-429C. Further predictive nomogram on 2 significant polymorphisms, blood pressure and lipids, showed a better predictive capability (concordance index = 0.716, P < .001). Altogether, we identified 2 polymorphisms of RAGE, T-429C and G1704T, which interacted with metabolic risk factors associated with the occurrence of MI. We also constructed a genetic-metabolic nomogram that can better predict MI risk.

Smoking cessation improves cardiometabolic risk in overweight and obese subjects treated with varenicline and dietary counseling

Background and AimWeight gain after stopping smoking potentially counteracts improvements in cardiometabolic risks. We investigated changes in metabolic syndrome (MetS) components and homeostasis assessment model insulin resistance (HOMA-IR) in smokers given dietary counseling during their quit attempt. Methods and resultsSmokers (≥10 cigarettes/day) with BMI 25–40 kg/m2 were randomized to a low-carbohydrate or low-fat diet and treated with a standard course of varenicline for 12 weeks. Quitters were assessed according to the Russell standard (≤5 cigarettes after the quit date) validated with expired breath carbon monoxide (CO) < 10 ppm. Of 122 randomized participants, 108 (89%) completed clinical and laboratory assessments at 12 weeks. As changes in metabolic risk factors did not differ between dietary groups, we combined the groups to compare quitters to continuing smokers. We found similar weight change among 78 validated quitters as 30 continuing smokers (−0.1 ± 3.0 kg vs 0.3 ± 3.1 kg; p = 0.7) and change in waist circumference (−2.0 ± 3.8 cm vs −0.9 ± 3.9 cm; p = 0.2). Changes in triglyceride concentrations (−0.16 ± 0.52 mmol/l vs 0.21 ± 0.95 mmol/l; p = 0.015) and diastolic blood pressure (−0.9 ± 6 mmHg vs 1.9 ± 8 mmHg; p = 0.039) were more favorable in quitters. Changes in other cardiometabolic risks and HOMA-IR did not differ between quitters and continuous smokers, nor did energy intake or resting metabolic rate. ConclusionDyslipidemia and blood pressure improved and no early weight gain was seen in quitters, suggesting that dietary intervention can mitigate some of the effects of stopping smoking on cardiometabolic risk factors in overweight and obese smokers. Clinical trials registrationNCT01069458.

Changes in metabolic risk factors over 10 years and their associations with late-life cognitive performance: The Multi-Ethnic Study of Atherosclerosis

BackgroundWe examined whether changes in metabolic factors over 10 years were associated with cognitive performance. MethodsParticipants from the Multi-Ethnic Study of Atherosclerosis were followed since baseline (2000–2002) with five clinical examinations. At exam 5 (2010–2012), they received a short cognitive battery (Cognitive Abilities Screening Instrument [CASI], Digit Symbol Coding [DSC], and Digit Span [DS]). We examined associations between baseline metabolic factors and their changes over time before cognitive testing. ResultsAmong 4392 participants, baseline metabolic disorders (fasting glucose, systolic and diastolic blood pressures) were significantly associated with poorer CASI, DSC, and DS scores measured 10 years later. Increases in blood pressure were associated with lower cognitive performance. Results did not differ by race/ethnicity and were stronger among those without the APOE ε4 allele. ConclusionsCognitive performance was associated with antecedent abnormalities in glucose metabolism and blood pressure increases. Findings appeared stronger among APOE ε4-negative participants.

The effect of etanercept on traditional metabolic risk factors for cardiovascular disease in patients with rheumatoid arthritis

Patients with rheumatoid arthritis (RA) are at an increased risk of cardiovascular disease (CVD). Treatment with tumor necrosis factor inhibitors improves both joint symptoms associated with RA and also CVD risk. This exploratory analysis of a phase 4 study evaluated changes in metabolic risk factors in patients with RA treated with etanercept. Metabolic analytes were measured at baseline, week 12, and week 24 in patients enrolled in a randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of etanercept in moderately active RA. Patients received either placebo or etanercept 50 mg every week (QW) for 12 weeks, after which all patients received etanercept 50 mg QW through week 24. Levels of metabolic analytes were assessed in all patients, including patients with diabetes and hyperlipidemia, and described descriptively. A total of 210 patients were randomized, 104 to placebo and 106 to etanercept. There were no significant changes in metabolic risk factors from baseline to week 12 or 24 in all patients. Levels of metabolic analytes were similar in patients with diabetes and hyperlipidemia, with some exceptions; fasting glucose and fasting insulin decreased through week 12, and hemoglobin A1C decreased slightly through week 24 in patients with diabetes. Treatment with etanercept did not adversely affect levels of metabolic risk factors for CVD in patients with RA.

CHANGES IN METABOLIC RISK FACTORS OVER 10 YEARS AND THEIR ASSOCIATIONS WITH COGNITIVE PERFORMANCE: THE MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA)

CHANGES IN METABOLIC RISK FACTORS OVER 10 YEARS AND THEIR ASSOCIATIONS WITH COGNITIVE PERFORMANCE: THE MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA)

Cannabis use in people with severe mental illness: The association with physical and mental health--a cohort study. A Pharmacotherapy Monitoring and Outcome Survey study.

In the general population cannabis use is associated with better cardiometabolic outcomes. Patients with severe mental illness frequently use cannabis, but also present increased cardiometabolic risk factors. We explore the association between cannabis use and cardiometabolic risk factors in patients with severe mental illness. A total of 3169 patients with severe mental illness from a Dutch cohort were included in the study. The association of cannabis use with body mass index, waist circumference, blood pressure, cholesterol, triglycerides, glucose, glycated hemoglobin and Positive and Negative Syndrome Scale was examined with separate univariate AN(C)OVA. Changes in metabolic risk factors and Positive and Negative Syndrome Scale were examined after a follow-up interval of 9-24 months, for patients who continued, discontinued, started or were never using cannabis between the two assessments. Cannabis users at baseline had lower body mass index, smaller waist circumference, lower diastolic blood pressure, and more severe psychotic symptoms than non-users. Patients who discontinued their cannabis use after the first assessment had a greater increase in body mass index, waist circumference, diastolic blood pressure and triglyceride concentrations than other patients, and the severity of their psychotic symptoms had decreased more compared to continued users and non-users. Extra attention should be paid to the monitoring and treatment of metabolic parameters in patients who discontinue their cannabis use.

The Effect of a Community-Based Exercise Program on Inflammation, Metabolic Risk, and Fitness Levels Among Persons Living with HIV/AIDS.

The human immunodeficiency virus (HIV) pandemic remains a top national health priority. Chronic inflammation may be a critical component in the disease course of HIV as C-reactive protein (CRP) is elevated and associated with increased mortality. This study examined the effect of 3 months of combined aerobic and resistance exercise training among a diverse cohort of HIV-infected men and women. The fixed effect of time for CRP was found to be non-significant (F[1,57.3]=1.7, p=0.19). There was a significant fixed effect for time for upper body (F[1,51.6]=18.1, p<0.05) and lower body strength (F[1,48.0]=15.7, p<0.05) and significant declines in diastolic blood pressure (p=0.002) and waist circumference (p=0.027). Though levels of CRP were not impacted after 3 months training, participants demonstrated a significant increase in muscular strength as well as beneficial changes in metabolic risk factors. Future studies should focus on determining the optimal exercise intervention length and mode to reduce inflammation among individuals living with HIV.

Effect Of A Community-Based Exercise Program On Inflammation And Fitness Among Persons Living With HIV/AIDS

The Human Immunodeficiency Virus (HIV) pandemic remains a top national health priority. Chronic inflammation may be a critical component in the disease course of HIV as C-reactive protein (CRP) is elevated and associated with increased mortality. PURPOSE: To examine the effect of three months of combined aerobic and resistance exercise training on inflammation and metabolic risk among a diverse cohort of HIV-infected men and women. METHODS: Ninety male and female participants were enrolled in the Healthy Living for Better Days community-based exercise program for persons living with HIV/AIDS. All participants were encouraged to attend supervised exercise sessions held four times a week, but also given open access to the fitness center at the University of Miami. High sensitivity CRP, physical fitness, and metabolic risk factors were assessed for each participant at baseline and three months. Linear Mixed Modeling was used to assess the fixed effect of time on changes in the outcome variables from baseline to three months follow up. Paired t-tests were used to assess changes in metabolic risk factors. RESULTS: Fifty-five percent of total participants were non-compliant with the prescribed exercise, though nearly one-quarter of participants were meeting physical activity recommendations after three months. Mean levels of CRP were elevated at baseline (5.75 ± 0.82 mg/L). The fixed effect of time for CRP was found to be non-significant (F[1,57.3]=1.7, p=0.19). There was a significant fixed effect for time for upper body (F[1,51.6]=18.1, p<0.05) and lower body strength (F[1,48.0]=15.7, p<0.05) and significant declines in diastolic blood pressure (p=0.002) and waist circumference (p=0.027). CONCLUSION: Though levels of CRP were not impacted after three months training, participants demonstrated a significant increase in muscular strength as well as beneficial changes in metabolic risk factors. Low compliance to the prescribed exercise limited our ability to make definitive conclusions about the impact of exercise on systemic inflammation. Future studies should focus on effective ways of engaging and retaining HIV-infected minorities in structured exercise interventions and discerning the optimal dose and duration of exercise to reduce inflammation.