Metabolic Cardiovascular Risk Research Articles

Metabolic profiling links cardiovascular risk and vascular end organ damage

Background and aimsAn untargeted metabolomics approach allows for a better understanding and identification of new candidate metabolites involved in the etiology of vascular disease. We aimed to investigate the associations of cardiovascular (CV) risk factors with the metabolic fingerprint and macro- and microvascular health in an untargeted metabolomic approach in predefined CV risk groups of aged individuals. MethodsThe metabolic fingerprint and the macro- and microvascular health from 155 well-characterized aged (50–80 years) individuals, based on the EXAMIN AGE study, were analysed. Nuclear magnetic resonance spectroscopy was used to analyse the metabolic fingerprint. Carotid-femoral pulse wave velocity and retinal vessel diameters were assessed to quantify macro- and microvascular health. ResultsThe metabolic fingerprint became more heterogeneous with an increasing number of risk factors. There was strong evidence for higher levels of glutamine [estimate (95% CI): −14.54 (−17.81 to −11.27), p < 0.001], glycine [−5.84 (−7.88 to −3.79), p < 0.001], histidine [−0.73 (−0.96 to −0.50), p < 0.001], and acetate [−1.68 (−2.91 to −0.46), p = 0.007] to be associated with a lower CV risk profile. Tryptophan, however, was positively associated with higher CV risk [0.31 (0.06–0.56), p = 0.015]. The combination of a priori defined CV risk factors explained up to 45.4% of the metabolic variation. The metabolic fingerprint explained 20% of macro- and 23% of microvascular variation. ConclusionsMetabolic profiling has the potential to improve CV risk stratification by identifying new underlying metabolic pathways associated with atherosclerotic disease development, from cardiovascular risk to metabolites, to vascular end organ damage.

Vegetarian Diets and Cardiovascular Risk in Women

Introduction: Vegetarian diets have favorable effects on cardiovascular risk, provided that they do not contain ultra-processed foods (UPF). Objective: To compare the metabolic profile, cardiovascular risk, body composition, and food consumption in vegan (VEG), lacto-ovo vegetarian (LOV), and omnivorous (OMNI) women. To verify the association between UPF consumption and cardiovascular risk. Methods: Cross-sectional study with 119 VEG (n = 43), LOV (n = 38), and OMNI (n = 38) women. Anthropometric and biochemical parameters and the Framingham risk score [...]

EFFECTS OF EXERCISE ON GLUCOSE AND LIPID METABOLISM IN ELDERLY PATIENTS

ABSTRACT Introduction: Metabolic syndrome is a condition in which multiple cardiovascular metabolic risk factors gather in the body. Objective: To explore the effects of exercise prescription on glucose and lipid metabolism in elderly patients with metabolic syndrome. Methods: A total of 85 elderly people were selected from a pension community. The influencing factors of physical activity were analyzed by the Pearson correlation analysis method, Mann-Whitneyu test and Kruskal-Wallish test. Finally, we quantitatively analyzed the influence and path of each factor on the physical activity of the elderly. Results: Among the 85 elderly people in nursing homes, 2 cases (1.1%) had a high level of physical activity, 70 cases (38.9%) had a medium level of physical activity, and 51 cases (60.0%) had a low level of physical activity. Conclusions: The improvement of glucose and lipid metabolism and healthy body fitness with the prescription of exercises of high oxygen + low resistance and that of exercises of high resistance + low oxygen is better than that with the prescription of exercises of full oxygen and full resistance. The improvement of sleep quality with the prescription of exercise with high oxygen and low resistance was better than that of exercise with complete oxygen, complete resistance and high resistance and low oxygen. Level of evidence II; Therapeutic studies - investigation of treatment results.

Metabolic Syndrome Prevalence and Cardiovascular Risk Assessment in HIV-Positive Men with and without Antiretroviral Therapy.

Treatment of HIV infection is a lifelong process and associated with chronic diseases. We evaluated the prevalence and predictors of metabolic syndrome (MetS) and cardiovascular diseases (CVDs) with individual antiretroviral drugs exposure among HIV-infected men in Taiwan. A total of 200 patients’ data were collected with a mean age of 32.9. Among them, those who had CD4 positive cell number less than 350/mL were eligible to have highly active antiretroviral therapy (HAART). Patients were divided into group-1 that contains 45 treatment-naïve participants, and group-2 that includes 155 HAART treatment-experienced participants. MetS prevalence between group-1 and group-2 was 18% and 31%, respectively. The Framingham Risk Score (FRS) for the naïve and experienced groups were 4.7 ± 4.2 and 3.87 ± 5.92, respectively. High triglyceride (TG > 150 mg/dL) in group-1 and group-2 were 15.6% and 36.6% (p < 0.05), whereas, lower high-density lipoprotein (HDL < 39 mg/dL) in group-1 and group-2 presented as 76.7% versus 51% (p < 0.05), respectively. In group-2, treatment with protease inhibitors (PIs) resulted in higher TG levels when compared with non-nucleotide reverse transcriptase inhibitors (NNRTIs) and integrase inhibitors (InSTIs). The prevalence of MetS in the treatment-naïve group was lower than that of the treatment-experienced group; high TG level resulted in higher MetS prevalence in the treatment-experienced group. In contrast, the cardiovascular risk of FRS in the treatment-naïve group was higher than that of the treatment-experienced group, which may result from the low HDL level. Although group-1 participants have a higher risk of developing CVDs, in group-2, an increasing TG level in PIs user indicated higher CVDs risk. TG and HDL are two significant biofactors that required regular evaluation in HIV-positive individuals.

Impact of dental health intervention on cardiovascular metabolic risk: a pilot study of Japanese adults.

This study aimed to determine whether a dental health education program would reduce cardiometabolic risk (obesity, hypertension, dyslipidemia, and hyperglycemia) in people with periodontitis. We used annual check-up data provided by the Japanese company's health insurance union. Of 182 male employees with cardiometabolic risk and periodontal pockets at baseline, 21 participants of the dental health education program and 21 non-participants matched for age, the presence of obesity, and periodontal pocket at baseline were allocated to the intervention (mean age, 53.3 ± 7.0) and the non-intervention groups (mean age, 52.9 ± 7.0), respectively. The program focused on self-removal of dental plaque with a toothbrush and interdental brush and comprised five sessions over 12 months. In the intervention group, waist circumference (cm) and diastolic blood pressure (mmHg) decreased from 88.4 ± 6.3 to 86.8 ± 6.3 and from 85.7 ± 8.2 to 82.6 ± 8.3, respectively (P < 0.05). Intergroup comparison showed significant improvement of systolic blood pressure (mmHg) in the intervention group (-3.7 ± 12.5) compared with the non-intervention group (4.0 ± 15.9) (P < 0.05) with no significant differences in the other parameters. The intervention group had a decrease in plaque accumulation and periodontitis symptoms, such as the depth of periodontal pocket and the presence of periodontal pocket and bleeding on probing, but an increase in the frequency of interdental brushing and duration of tooth brushing. Our findings show that dental self-care may improve blood pressure in people with cardiometabolic risk factors and periodontitis.

Association between the Use of Health Services, Cardiovascular Risk Factors and Metabolic Syndrome in Mexican Adults.

Background: The use of health services is a complex behavioral phenomenon affected by multiple factors (availability, distance, cost, quality, attitudes, cultural beliefs, socioeconomic characteristics, and individuals’ self-perception of health). Mexico has a segmented health system, and the access to it depends on the labor insertion and the population’s ability to pay. Objective: To assess association between use of health services and cardiovascular and metabolic syndrome risk factors among Mexican adults. Methods: Analytical cross-sectional nationally representative study carried out on Mexican adults (≥20-year-old adults of both sexes; n = 4595). Socioeconomic factors, geographic area, health care coverage, information about the use of health services, previous medical diagnoses of diabetes and hypertension, and smoking were assessed. Anthropometrics, triglyceride, total cholesterol, HDL-cholesterol, and glucose plasma levels were measured. Metabolic syndrome (MetS) and cardiovascular risk factors were assessed. Prevalences were expressed in terms of percentages, and significant differences were calculated using χ2 test. Univariate and multivariate analysis was performed to evaluate the association between the use of health services and cardiovascular risk factors and sociodemographic variables. Results: The probability of using health services is higher and more significant in subjects with obesity, diabetes (OR (95% CI): 1.73 (1.49–2.00; p < 0.001), hypertension (OR (95% CI): 1.29 (1.14–1.45; p < 0.001), hypertriglyceridemia (OR (95% CI): 1.30 (1.15–1.46; p < 0.001), and in those with hypercholesterolemia (OR (95% CI): 1.23 (1.03–1.39; p = 0.001). Conclusions: Among health service users, there is a positive significant association between the use of health services and the presence of metabolic syndrome, obesity, diabetes, hypertension, hypertriglyceridemia, and hypercholesterolemia.

Metabolic profile and cardiovascular risk assessment in subclinical cushing’s syndrome

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

Usefulness of different adiposity indexes for identification of metabolic disturbances in patients with obesity

Context Despite the role of BMI as a classical obesity index, other indexes reflecting mainly abdominal obesity, usually outperform BMI in terms of metabolic complications prediction. Objective The aim of the present study is to compare the usefulness of different adiposity indexes for the identification of metabolic disturbances in patients with obesity. Methods In the study, we included 461 patients – group 1 with obesity (n = 182), group 2 with prediabetes (n = 193), and group 3 with newly diagnosed type 2 diabetes (n = 86). Different anthropometric and adiposity indexes were calculated – WHR, WSR, VAI, ABSI, BRI, Hip index, WWI, LAP. Results VAI and LAP had the highest predictive value for the presence of carbohydrate disturbances. VAI also showed the strongest correlation with Framingham and SCORE compared to other adiposity indexes. Conclusions VAI and LAP are most useful for the identification of metabolic disturbances and cardiovascular risk in patients with obesity.

Association of Cardiovascular Risk Factors and Metabolic Syndrome with non-alcoholic and alcoholic fatty liver disease: a retrospective analysis

BackgroundAlthough many studies on non-alcoholic fatty liver disease (NAFLD) are underway worldwide, and several existing studies have investigated the association between NAFLD and cardiovascular risk factors, studies comparing NAFLD and alcoholic fatty liver disease (AFLD) are scarce. This study aimed to evaluate differences between the incidence of cardiovascular risk factors and metabolic syndrome in NAFLD and AFLD.MethodsA retrospective analysis of 913 patients who underwent abdominal computed tomography (CT) was performed to compare the incidence of cardiovascular risk factors and metabolic syndrome between NAFLD and AFLD. Subjects were divided into three groups based on criteria: healthy (n = 572), NAFLD (n = 295), and AFLD (n = 46). The healthy group had no liver disease. NAFLD was defined as fatty liver diagnosed on CT and drinking less than 140 g/week for men or 70 g/week for women. AFLD was defined as fatty liver diagnosed on CT and drinking more than 140 g/week for men or 70 g/week for women. We compared the incidence of cardiovascular risk factors and metabolic syndrome between the three groups. The relationship between each group and the metabolic syndrome risk was analyzed through multivariate logistic regression analysis.ResultsNo significant differences in several cardiovascular risk factors were observed between the NAFLD and AFLD groups. Upon analyzing the metabolic syndrome status in each group after making appropriate adjustments, the odds ratios (ORs) in the NAFLD (OR = 2.397, P = 0.002) and AFLD groups (OR = 4.445, P = 0.001) were found to be significantly higher than that in the healthy group; the incidence rate of metabolic syndrome was similar in the NAFLD and AFLD groups.ConclusionsBoth the NAFLD and AFLD groups had more cardiovascular risk factors and higher metabolic syndrome risk than the healthy group. Thus, the prevention of fatty liver disease, regardless of the specific type, should involve the identification of cardiovascular and metabolic syndrome risk factors. If abdominal CT reveals a fatty liver, whether NAFLD or AFLD, the risk of cardiovascular disease and metabolic syndrome should be assessed.

Associated Factors with Dietary Adherence among People with Cardiovascular Metabolic Risk Factors based on PRECEDE Framework: a Mixed-Method Study

Associated Factors with Dietary Adherence among People with Cardiovascular Metabolic Risk Factors based on PRECEDE Framework: a Mixed-Method Study

Prevalence of cardiovascular metabolic risk factors among 12-18 years old adolescents in Yinchuan City from 2017 to 2019

To understand the prevalence of cardiovascular metabolic risk factors among 12-18 years old children and adolescents in Yinchuan City. A survey was conducted among 12-18 years old middle school students in Yinchuan from September 2017 to September 2019. A total of 1956 subjects were collected by using convenient sampling method, with an average age of(14. 4±1. 4) years. Boys and girls accounted for 52. 1% and 47. 9%, respectively, The Han and Hui nationalities accounted for 77. 7% and 16. 4%, respectively. Basic data such as age and gender were collected through questionnaire survey, and physical examination was used to measure height, weight, waist circumference and blood pressure. Fasting blood glucose, triglyceride(TG), total cholesterol(TC), high density lipoprotein cholesterol(HDL-C) and low density lipoprotein cholesterol(LDL-C) were measured by laboratory blood pressure biochemistry. The detection rates of obesity, abdominal obesity, hypertension, hyperglycemia, high TG, high LDL-C, low HDL-C, high LDL-C and dyslipidemia among 12-and 18-year-olds in Yinchuan City were 8. 3%, 17. 9%, 12. 4%, 1. 9%, 13. 2%, 2. 4%, 18. 6%, 1. 9% and 30. 1%, respectively. The detection rates of obesity, hyperglycemia, low HDL-C, high TG and dyslipidemia in boys were significantly higher than those in girls. Obesity, abdominal obesity and hypertension in 12-15-year-old group were higher than those in 16-18-year-old group, and the detection rates of high TC, low HDL-C, high LDL-C and dyslipidemia were lower than those in 16-18-year-old group(P& lt; 0. 05). The prevalence of cardiovascular risk factors in different age groups of boys and girls were compared. The detection rates of obesity, abdominal obesity and hypertension in the 12-15 age group were higher than those in the 16-18 age group, while the rates of high TG, low HDL-C, high LDL-C and dyslipidemia were higher in the 12-15 age group, but these differences were only significant in boys. Among girls, the detection rate of high TC and high LDL-C was higher in the age group of 12 to 15 years old(P& lt; 0. 05). The detection rate of metabolic syndrome in 12-18-year-old adolescents was 7. 9%. The detection rate of metabolic syndrome in boys(10. 1%) was higher than that in girls(5. 5%). The detection rates of metabolic syndrome in 12-15 years old and 16-18 years old were 9. 1% and 4. 9% respectively, and the differences were statistically significant(P& lt; 0. 05). The prevalence of cardiovascular metabolic risk factors in 12-18 years old adolescents in Yinchuan City is at a high level, boys are higher than girls, and the prevalence of obesity, abdominal obesity and hypertension are higher in 12-15 years old group. Dyslipidemia varies greatly in different gender and age groups.

Insulin resistance in type 1 diabetes managed with metformin (INTIMET): Study protocol of a double-blind placebo-controlled, randomised trial.

Insulin resistance is an under-recognised metabolic defect and cardiovascular risk factor in Type 1 diabetes. Whether metformin improves hepatic, muscle or adipose tissue insulin sensitivity has not been studied in adults with Type 1 diabetes. We initiated the INTIMET study (INsulin resistance in Type 1 diabetes managed with METformin), a double-blind randomised, placebo-controlled trial to measure the effect of metformin on tissue-specific insulin resistance in adults with Type 1 diabetes. We will study 40 adults aged 20-55years with Type 1 diabetes (HbA1c 80mmol/mol [9.5%], fasting C-peptide <0.3nmol/L) and 20 age-, gender- and body mass index (BMI)-matched controls. Insulin sensitivity will be determined by the two-step hyperinsulinaemic-euglycaemic clamp method with deuterated glucose to document liver, muscle and adipose insulin sensitivity. Subjects with Type 1 diabetes will be randomised to metformin extended-release 1500mg daily or matched placebo for 26weeks. The primary outcome is change in hepatic insulin sensitivity, assessed by change in basal rate of appearance (Ra) of glucose and suppression of endogenous glucose production (EGP) during the low-dose stage of the clamp. The INTIMET study is the first clinical trial to quantify the impact of metformin on liver, muscle and adipose insulin resistance in adults with Type 1 diabetes. This study may identify factors that predict an individual's response to metformin in Type 1 diabetes. ACTRN12619001440112.

Galanin and glypican-4 levels depending on metabolic and cardiovascular risk factors in patients with polycystic ovary syndrome.

Galanin is a neuropeptide which has effects not only on metabolic syndrome but also on reproduction. Glypican-4 is an adipokine associated with insulin sensitivity by interacting directly with the insulin receptor. This study evaluated serum concentrations of galanin and glypican-4 in relation with the hormonal profile as well as metabolic and cardiovascular risk factors in patients with and without polycystic ovary syndrome (PCOS). A total of 44 women with PCOS and 44 age-matched controls were eligible. Hirsutism scores, hormonal profile, metabolic and cardiovascular risk factors as well as galanin and glypican-4 levels were evaluated in each subject. Women with PCOS exhibited lower levels of galanin (20.2 pg/mL versus 26.4 pg/mL, p = 0.002) and higher concentrations of glypican-4 (3.1 ng/mL versus 2.6 ng/mL, p < 0.001) than controls. Both adipokines were correlated positively with body mass index (BMI), insulin, triglyceride and Homeostasis Model Assessment (HOMA) index; glypican-4 also showed positive correlations with fasting blood glucose, free testosterone, modified Ferriman-Gallwey scores (p < 0.05). Multiple Linear Regression analyses showed that PCOS and BMI were the best predictors affecting galanin levels with a decreasing and increasing effect respectively; however BMI was the best predictor affecting glypican-4 levels with an increasing effect (p < 0.001). Galanin levels were lower and glypican-4 levels were higher in women with PCOS than controls. Further studies are needed to determine whether these adipokines could be used as additional markers for insulin sensitivity and lipid profile and whether they might play a role in the pathogenesis of PCOS, in which metabolic cardiovascular risks are increased.

Effects of Orlistat/Phentermine versus Phentermine on Vascular Endothelial Cell Function in Obese and Overweight Adults: A Randomized, Double-Blinded, Placebo-Controlled Trial.

BackgroundIn clinical practice, concomitant treatment of orlistat with phentermine is commonly used off-label. However, clinical trials have not been performed to evaluate whether their combination improves metabolic parameters and cardiovascular risk factors other than weight loss. Therefore, we aimed to compare the efficacy of concomitant administration of orlistat and phentermine versus phentermine alone on the endothelial cell function in overweight and obese adults with back pain.MethodsWe conducted a 12-week, double-blinded, placebo-controlled clinical trial involving 114 patients with a body mass index of ≥30 (obese) or ≥27 (overweight) with weight-related comorbidities. We randomly assigned patients in a 1:1 ratio to receive orlistat (120mg) three times daily and phentermine (37.5mg) once daily, or a placebo three times daily and phentermine (37.5mg) once daily. Primary endpoint was changes in endothelium-dependent vasodilatation measured using ultrasound assessment of flow-mediated dilatation (FMD). Differences within groups after intervention were compared using the paired t-test or Wilcoxon signed-rank test. Differences in changes between the groups were calculated using an analysis of covariance after adjusting for each baseline value.ResultsMean weight loss during the 12-week study period was 6.1kg in the orlistat/phentermine group and in the placebo/phentermine group. Adjusted mean changes in total and non-high-density lipoprotein cholesterol were significantly greater in the orlistat/phentermine group than in the placebo/phentermine group. Adjusted mean changes in endothelium-dependent FMD were significantly greater in the orlistat/phentermine group than in the placebo/phentermine group (4.97±0.98% vs 2.05±0.99%, respectively; p=0.038). Changes in endothelium-independent nitroglycerin-mediated dilatation were not significantly different between the groups.ConclusionOrlistat/phentermine significantly improved the vascular endothelial cell function compared with phentermine alone. Orlistat might have beneficial effects on the decrease of the risk of cardiovascular disease, especially in overweight and obese patients with comorbidities.Trial RegistrationClinicalTrails.gov number, NCT03675191.

Evaluation of Serum Ischemia Modified Albumin Level in Male Patients with Androgenetic Alopecia

Male pattern androgenetic alopecia (AGA) is associated with oxidative stress. Ischemia modified albumin (IMA) is albumin due to albumin modification caused by reactive oxygen species which occur during ischemia.to evaluate IMA levels in AGA patients and compare their levels in healthy control. The four study groups were group (A) included thirty obese patients with AGA, (B) included thirty non-obese patients with AGA, group (C) included ten obese normal volunteer and group (D) ten non obese normal volunteer. The AGA severity was calculated according to the modified Norwood Hamilton classification and serum IMA was measured by ELISA in all participants.The patients and control groups showed a non-significant difference as regards age, smoking and BMI. There was a significant difference between patients and control groups as regards the IMA levels (P= <0.0001). The IMA level showed a significant difference between obese patients and obese control (P= <0.0001), between non-obese patients and non-obese control (P <0.0001), between obese patients and non-obese patients (P < 0.0001), while it showed a non-significant difference between obese and non-obese control (P= 0.7776).The current study suggested that IMA levels were increased by the effect of obesity, but the AGA has an adding effect. The IMA levels showed a positive correlation with AGA duration and AGA severity. The IMA approved as diagnostic indicator of myocardial ischemia and elevated IMA were reported in metabolic syndrome, cardiovascular risk and obesity, and IMA might confirm the link between AGA and these metabolic disorders.

EVALUATION OF HORMONAL AND METABOLIC PARAMETERS, ALONG WITH CARDIOVASCULAR RISK FACTORS IN WOMEN WITH NON-ALCOHOLIC FATTY LIVER DISEASE COMBINED WITH SUBCLINICAL HYPOTHYROIDISM DEPENDING ON AGE

Patients with NAFLD (non-alcoholic fatty liver disease) and subclinical hypothyroidism are at risk of cardiovascular complications that cause cardiometabolic changes, thus enabling to broaden our understanding of the cardiovascular events risk in a comorbid patient.&#x0D; The aim: The study of hormonal and metabolic indicators and cardiovascular risk factors in women from NAFLD combined with SH (subclinical hypothyroidism) depending on the age.&#x0D; Materials and methods: 128 patients with NAFLD were studied, which were divided into 2 groups: І group – patients with NAFLD and level of thyroid-stimulating hormone (TSH) – 4 to 10 mIU/mL (n=45), ІІ group - patients with NAFLD and level of TSH &gt;10 mIU/mL (n=49). The control group consisted of 34 NAFLD patients without SH. Depending on the level of TSH and age, degree of cardiovascular risk, indicators of carbohydrate and lipid metabolism, as well as the indicators that reflect ED were evaluated.&#x0D; Results: Comparison of metabolic parameters in two groups showed a significant difference (p&lt;0.01 between indicators depending on the TSH level, where patients were below 50 years of age: HbA1c, LDL cholesterol, HDL cholesterol, gamma-glutamyltranspeptidase (GGTP). The levels of CDEC (circulating desquamated endothelial cells), VEGF (vascular endothelial growth factor), CRP (C-reactive protein) and TNF-α (tumor necrosis factor-α) were dependent not only on TSH, but also on age. Significant differences (p=0.001) were obtained in patients aged ≤ 50 years: CDEC; VEGF, CRP; TNF-α.&#x0D; Conclusions: Patients from NAFLD combined with SH have hormonal-metabolic disorders, and their degree depends on the TSH level. Early cardiometabolic changes in women are formed already at the age under 50 years, which indicates the formation of early atherosclerotic vascular changes

Complete Androgen Insensitivity Syndrome: From Bench to Bed.

Complete androgen insensitivity syndrome (CAIS) is due to complete resistance to the action of androgens, determining a female phenotype in persons with a 46,XY karyotype and functioning testes. CAIS is caused by inactivating mutations in the androgen receptor gene (AR). It is organized in eight exons located on the X chromosome. Hundreds of genetic variants in the AR gene have been reported in CAIS. They are distributed throughout the gene with a preponderance located in the ligand-binding domain. CAIS mainly presents as primary amenorrhea in an adolescent female or as a bilateral inguinal/labial hernia containing testes in prepubertal children. Some issues regarding the management of females with CAIS remain poorly standardized (such as the follow-up of intact testes, the timing of gonadal removal and optimal hormone replacement therapy). Basic research will lead to the consideration of new issues to improve long-term well-being (such as bone health, immune and metabolic aspects and cardiovascular risk). An expert multidisciplinary approach is mandatory to increase the long-term quality of life of women with CAIS.

Increased epicardial adipose tissue thickness associated with increased metabolic risk and the presence of heart failure in patients with Chronic Chagas disease.

It has been described that Trypanosoma cruzi is capable of promoting metabolic disturbances currently considered as cardiovascular risk factors. Moreover, it has been observed that the protozoa can remain in adipose tissue and alter its immune endocrine functions. The aim of this study was to characterize the thickness of epicardial adipose tissue (EAT) in patients with chronic Chagas disease (CCD) concerning their cardiovascular metabolic risk profile compared with those without CCD. A cross-sectional study was performed including T. cruzi seropositive individuals categorized according to a standard CCD classification and a matched seronegative control group. Complete clinical examination, metabolic laboratory tests and transthoracic echocardiography to assess cardiac function and to quantify EAT were performed. Fifty-five individuals aged 46.7±11.9 y, 34 with CCD and 21 in the control group, were included. The CCD group presented higher EAT thickness in relation to controls (4.54±1.28 vs 3.22±0.99 mm; p=0.001), which was significantly associated with the presence of insulin resistance (OR=3, 95% CI 1.58 to 5.73; p<0.001). This group presented lower levels of plasmatic adiponectin than controls, especially in those patients with EAT ≥4.5 mm (p=0.005) who also presented with heart failure more frequently (p=0.01). In patients with CCD, a higher EAT thickness is observed and is associated with an increased metabolic risk profile indicated mainly by insulin resistance.

Efficacy and safety of glucagon-like peptide-1/glucagon receptor co-agonist JNJ-64565111 in individuals with type 2 diabetes mellitus and obesity: A randomized dose-ranging study.

Weight loss has been shown to improve metabolic parameters and cardiovascular risk in people with type 2 diabetes mellitus (T2DM). This phase 2 study evaluated the safety and efficacy of JNJ-64565111, a dual agonist of GLP-1 and glucagon receptors, in individuals with T2DM and class II/III obesity. In this randomized, double-blind study, participants with T2DM (HbA1c 6.5%-9.5%), body mass index of 35 to 50 kg/m2 and stable weight were randomly assigned (1:1:1:1) to placebo or JNJ-64565111 (5.0 mg, 7.4 mg or 10.0 mg). The primary endpoint was percent change from baseline in body weight at week 12. Of 195 dosed participants, 144 (73.8%) completed treatment. At week 12, placebo-subtracted body weight changes were -4.6%, -5.9% and -7.2% with JNJ-64565111 5.0 mg, 7.4 mg and 10.0 mg, respectively. All JNJ-64565111 doses were associated with no change in HbA1c and slight numerical elevation of fasting insulin. Numerical increases in fasting plasma glucose were observed with JNJ-64565111 5.0 mg and 7.4 mg. Incidence of treatment-emergent adverse events, especially nausea and vomiting, was higher with JNJ-64565111 vs placebo. Overall, JNJ-64565111 significantly reduced body weight in a dose-dependent manner vs placebo but was associated with greater incidence of treatment-emergent adverse events, no HbA1c reductions, and increased fasting plasma glucose and fasting insulin.

Gallbladder polyps: modern approaches to diagnostics and treatment

Gallbladder polyps are an elevation of the mucous membrane that protrudes into the lumen of the gallbladder cavity. Their prevalence in the general population varies from 0.3 to 13.8%. According to the modern classification, polyps of the gallbladder are divided into benign non-tumor, benign tumor and malignant tumor polyps. A review of modern literature presents cohort and randomized controlled trials, including those summarized in meta-analyzes and systematic reviews, suggesting that the dominant form of polypoid formations of the gallbladder are cholesterol pseudo-polyps with no malignant potential associated with impaired cholesterol metabolism, often combined with gallbladder cholesterosis, metabolic syndrome and cardiovascular morbidity. Evidence is building up on the effectiveness of ursodeoxycholic acid for controlling components of the metabolic syndrome and cardiovascular risks. Ursodeoxycholic acid preparations may become promising for the management of cholesterol polyps.