Cardiovascular Endocrinology & Metabolism最新文献

{"title":"Comprehensive evaluation of cardiovascular efficacy and safety outcomes of SGLT2 inhibitors in high risk patients of cardiovascular disease: systematic review and meta-analysis.","authors":"Mukul Bhattarai, Mohsin Salih, Manjari Regmi, Mohammad Al-Akchar, Cameron Koester, Abdisamad Ibrahim, Priyanka Parajuli, Odalys Lara Garcia, Bishal Bhandari, Anis Rehman, Momin Siddique","doi":"10.1097/XCE.0000000000000229","DOIUrl":"10.1097/XCE.0000000000000229","url":null,"abstract":"<p><strong>Objectives: </strong>To demonstrate a magnitude of the cardiovascular benefits, concomitantly analyzing the safety outcomes of sodium-glucose cotransporter 2 inhibitor (SGLT2-I) comprehensively, as a class effect in a larger sample size combined from recent randomized control trials.</p><p><strong>Methods: </strong>We searched electronic databases using specific terms and evaluated 6 efficacy and 10 safety outcomes. Odds ratios (ORs) and 95% confidence interval (CI) were used to compare two interventions.</p><p><strong>Results: </strong>Five studies (<i>n</i> = 41 267) were included, among which 23 539 received SGLT2-I. The SGLT2-I group favored reduction in major adverse cardiovascular events (OR, 0.78; 95% CI, 0.62-0.98; <i>P</i> = 0.03), cardiovascular death (CVD) or heart failure hospitalization (OR, 0.60; 95% CI, 0.46-0.80; <i>P</i> = 0.0004), rate of hospitalization for heart failure (OR, 0.56; 95% CI, 0.44-0.72; <i>P</i> < 0.00001), CVD (OR, 0.68; 95% CI, 0.50-0.93; <i>P</i> = 0.01), all-cause mortality (OR, 0.67; 95% CI, 0.48-0.93; <i>P</i> = 0.02) and myocardial infarction (OR, 0.79; 95% CI, 0.64-0.99; <i>P</i> = 0.04) when compared to the placebo group. Safety analysis showed higher diabetic ketoacidosis (DKA) rate in SGLT2-I group (OR, 2.33; 95% CI, 1.40-3.90; <i>P</i> = 0.001); in contrast, major hypoglycemic events were significantly lower (OR, 0.79; 95% CI, 0.73-0.87; <i>P</i> < 0.00001). AKI was significantly higher in the placebo group (OR, 0.76; 95% CI, 0.65-0.88; <i>P</i> = 0.0004). There were no statistically significant effects on other outcomes.</p><p><strong>Conclusion: </strong>In selected high-risk patients of cardiovascular disease, the SGLT2-I is a potential effective class of drugs for improving cardiovascular outcomes and all-cause mortality without an increased risk of all other major complications except DKA on this meta-analysis.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 2","pages":"89-98"},"PeriodicalIF":2.3,"publicationDate":"2020-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8186520/pdf/xce-10-089.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39100975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Androgen receptor-reduced sensitivity is associated with increased mortality and poorer glycaemia in men with type 2 diabetes mellitus: a prospective cohort study.","authors":"Adrian H Heald,&nbsp;Ghasem Yadegar Far,&nbsp;Mark Livingston,&nbsp;Helene Fachim,&nbsp;Mark Lunt,&nbsp;Ram Prakash Narayanan,&nbsp;Kirk Siddals,&nbsp;Gabriela Moreno,&nbsp;Richard Jones,&nbsp;Nagaraj Malipatil,&nbsp;Martin Rutter,&nbsp;Martin Gibson,&nbsp;Rachelle Donn,&nbsp;Geoff Hackett,&nbsp;Hugh Jones","doi":"10.1097/XCE.0000000000000230","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000230","url":null,"abstract":"<p><strong>Introduction: </strong>Hypogonadism is associated with poorer glycaemic outcomes/increased all-cause and cardiovascular morbidity/mortality in type 2 diabetes mellitus (T2DM). Increasing CAG repeat number within exon-1 of the androgen receptor (AR) gene is associated with increased AR resistance/insulin resistance.</p><p><strong>Methods: </strong>We determined in a long-term 14-year follow-up cohort of 423 T2DM Caucasian men, the association between baseline androgen status/CAG repeat number (by PCR then Sequenom sequencing) and metabolic/cardiovascular outcomes.</p><p><strong>Results: </strong><i>Metabolic outcomes</i>: Lower total testosterone was associated with higher BMI (kg/m²) at 14-year-follow-up: regression coefficient -0.30 (95% confidence interval -0.445 to -0.157), <i>P</i> = 0.0001. The range of CAG repeat number was 9-29 repeats. Higher CAG repeat number in exon-1 of the AR gene was associated with higher follow-up HbA1c2016 - each unit increase in CAG repeat-associated with an increment of 0.1% in HbA1C2016 (<i>P</i> = 0.04), independent of baseline testosterone. <i>Cardiovascular outcomes and mortality</i>: At an average of 14-year-follow-up, 55.8% of hypogonadal men had died vs 36.1% of eugonadal men (<i>P</i> = 0.001). There was a 'u' shaped relation between number of CAG repeats and mortality. Twenty-one CAG repeats were associated with an up to nearly 50% lower mortality rate than <21 CAG repeats and >21 CAG repeats - independent of baseline testosterone level.</p><p><strong>Conclusion: </strong>A higher number of CAG repeats at the AR gene associates with higher future HbA1c. There was a 'u' shaped relation between CAG repeat number and mortality rate. Determination of CAG repeat number may become part of assessment of androgen status/its consequences for men with T2DM.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":" ","pages":"37-44"},"PeriodicalIF":2.3,"publicationDate":"2020-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7901820/pdf/xce-10-37.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25414023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of serum leptin with angiographically proven cardiovascular disease and with components of the metabolic syndrome: a cross-sectional study in East Azerbaijan.","authors":"Nafiseh Khanbabaei,&nbsp;Hossein Mozafar Saadati,&nbsp;Shahnam Valizadeh Shahbazloo,&nbsp;Reyhaneh Hoseinpoor,&nbsp;Seyed Hossein Naderi,&nbsp;Roya Taghvamanesh,&nbsp;Sakhavat Abolhasani","doi":"10.1097/XCE.0000000000000227","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000227","url":null,"abstract":"<p><strong>Background: </strong>Role of leptin is well documented in cardiometabolic diseases. The objective of this study was to investigate if the serum levels of leptin associates with the serum levels of markers related to cardiac and metabolic disorders in adults.</p><p><strong>Materials and methods: </strong>One hundred eighty subjects [120 cardiovascular disease (CVD) and 60 healthy controls] were enrolled in the study, to determine the association of the serum leptin (in quartiles) and cardiometabolic diseases [metabolic syndrome (MetS) and CVD] adjusted for other biological and physical examination. MetS was according to the WHO Clinical Criteria for MetS definition and CVD by angiography outcomes. The serum levels of leptin and OX-LDL were measured by ELISA.</p><p><strong>Results: </strong>Leptin levels were significantly higher in patients with MetS and those with positive angiography compared with controls. After controlling for potential confounders, a significant association of the leptin levels with cardiometabolic diseases was proven, albeit there was a higher rate of significance between CVD and leptin in comparison with MetS. Additionally, receiver operating characteristic analysis revealed that the serum levels of leptin were a valuable biomarker of the cardiometabolic diseases.</p><p><strong>Conclusion: </strong>Our findings demonstrate that serum leptin levels are associated with components of the MetS and with CVD. Serum leptin may be a useful biomarker for CVD.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":" ","pages":"45-50"},"PeriodicalIF":2.3,"publicationDate":"2020-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7901824/pdf/xce-10-45.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25414024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction: cardiometabolic considerations in COVID-19.","authors":"Andrew J Krentz","doi":"10.1097/XCE.0000000000000225","DOIUrl":"10.1097/XCE.0000000000000225","url":null,"abstract":"","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"9 3","pages":"101"},"PeriodicalIF":2.3,"publicationDate":"2020-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38271994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visceral fat reduction and increase of intracellular fluid in weight loss participants on antihypertension medication.","authors":"Gerald C Dembrowski,&nbsp;Jessica W Barnes","doi":"10.1097/XCE.0000000000000222","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000222","url":null,"abstract":"<p><strong>Objectives: </strong>Complex physiological interactions between hypertension and obesity contribute to and perpetuate a heightened morbidity and mortality. With the prevalence of both hypertension and obesity reaching epidemic proportions, we asked whether antihypertensive medications affect the ability of participants to achieve the same level of body composition improvements as other participants in a comprehensive weight loss program focused on reduction of visceral adipose tissue.</p><p><strong>Methods: </strong>Data was analyzed from 2200 subjects completing a commercially available, expert supervised weight loss program including ~6 weeks of a proprietary, nutritionally complete, very low-calorie diet (VLCD) followed by a ~3-week structured transition back to a normal dietary intake. Overall, 33% of the subjects reported taking at least one prescription antihypertensive medication.</p><p><strong>Results: </strong>Our data show participants in both groups (± antihypertensive drugs) achieved clinically relevant and statistically significant improvements in standard measures of weight loss and endpoints directly related to inflammation and hypertension.</p><p><strong>Conclusion: </strong>A nonpharmacologic, nonsurgical VLCD-based weight loss and metabolic health program is capable of producing clinically meaningful improvements in body composition and physiological endpoints, including those linked to hypertension, cardiovascular disease and inflammation, and is as equally effective for adults taking prescription antihypertensives as it is for those participants who are not.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":" ","pages":"31-36"},"PeriodicalIF":2.3,"publicationDate":"2020-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7901822/pdf/xce-10-31.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25414022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The future of cardiovascular and metabolic medical practice: evidence-based winds of change.","authors":"Andrew J Krentz, Stephan Jacob","doi":"10.1097/XCE.0000000000000226","DOIUrl":"10.1097/XCE.0000000000000226","url":null,"abstract":"","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"9 3","pages":"64-65"},"PeriodicalIF":2.3,"publicationDate":"2020-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7410033/pdf/xce-9-064.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38279790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiometabolic medicine - the US perspective on a new subspecialty.","authors":"Cara Reiter-Brennan, Miguel Cainzos-Achirica, Garshasb Soroosh, David R Saxon, Michael J Blaha, Robert H Eckel","doi":"10.1097/XCE.0000000000000224","DOIUrl":"10.1097/XCE.0000000000000224","url":null,"abstract":"<p><p>The high prevalence of cardiovascular disease and worldwide diabetes epidemic has created an ever-increasing burden on the healthcare system. This calls for the creation of a new medicine subspecialty: cardiometabolic medicine. Using information from review articles listed on PubMed and professional society guidelines, the authors advocate for a cardiometabolic medicine specialization training program. The curriculum would integrate relevant knowledge and skills of cardiology and endocrinology as well as content of other disciplines essential to the optimal care of cardiometabolic patients, such as epidemiology, biostatistics, behavioral science and psychology. Cardiometabolic medicine should be seen as an opportunity for life-long learning, with core concepts introduced in medical school and continuing through CME courses for practicing physicians. To improve care for complex patients with multiple co-morbidities, a paradigm shift must occur, transforming siloed education, and treatment and training to interdisciplinary and collaborative work.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"9 3","pages":"70-80"},"PeriodicalIF":2.3,"publicationDate":"2020-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7410029/pdf/xce-9-070.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38279793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Black esophagus and diabetes: a close relationship.","authors":"Laura Rodriguez Fernandez,&nbsp;María Concepción García Sánchez,&nbsp;José María Prieto de Paula,&nbsp;José Pablo Miramontes González","doi":"10.1097/XCE.0000000000000221","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000221","url":null,"abstract":"<p><p>The black esophagus is a rare clinical entity, down to 0.2% in autopsy series and 0.001-0.2% in series of endoscopies. Although it is an entity that has already been reported in the literature, its etiopathogenesis is not completely known. Different theories have been proposed to clarify their cause. One of these theories makes a hypothesis of a viral infection as the underlying cause; this theory can be seen in the literature extensively, but only two cases were reported. The first case is a case with histopathological confirmation of Herpes virus infection. The second is a case in which vascular deterioration has been the main cause of esophageal necrosis. In both cases, diabetes is the factor that determines a bad evolution of the disease.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":" ","pages":"59-61"},"PeriodicalIF":2.3,"publicationDate":"2020-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7901817/pdf/xce-10-59.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25406754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid progression of aortic stenosis after initiation of teriparatide treatment: a case report.","authors":"Arie Solomon,&nbsp;Shlomo Birkenfeld","doi":"10.1097/XCE.0000000000000220","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000220","url":null,"abstract":"<p><strong>Introduction: </strong>Teriparatide, a recombinant formulation of endogenous PTH, is indicated for the treatment of osteoporosis in patients at high risk for fracture including postmenopausal women, men with primary or hypogonadal osteoporosis and patients with glucocorticoid-induced osteoporosis.</p><p><strong>Case report: </strong>A 64-year-old Jewish osteoporotic woman initiated use of Teriparatide (FORTEOTM, 250 µg per 1 ml subcutaneously per day) in April 2018. Prior to therapy initiation, the patient has undergone eight echocardiograms with an aortic valve pressure gradient ranging between 29 and 39 mmHg, defined as mild aortic stenosis (AS), with no clear trend of progression. In two subsequent echo tests conducted 4 and 7 months after treatment initiation, there was a rapid progression of AS with gradient pressures of 55 and 58 mmHg, respectively.</p><p><strong>Conclusion: </strong>Intermittent exposure to PTH analogues may be one of the causes of rapid progression of AS. Studies with sizeable populations are required to assess causal relationship between PTH analogues use and progression of AS.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":" ","pages":"56-58"},"PeriodicalIF":2.3,"publicationDate":"2020-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7901823/pdf/xce-10-56.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25406753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type 2 diabetes prevalence in Pakistan: what is driving this? Clues from subgroup analysis of normal weight individuals in diabetes prevalence survey of Pakistan.","authors":"Azizul Hasan Aamir, Zia Ul-Haq, Sheraz Fazid, Basharat Hussain Shah, Abbas Raza, Ali Jawa, Saeed A Mahar, Ibrar Ahmad, Faisal Masood Qureshi, Adrian H Heald","doi":"10.1097/XCE.0000000000000212","DOIUrl":"10.1097/XCE.0000000000000212","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is a global health tissue. We determined factors relating to the likelihood of developing T2DM in normal BMI individuals.</p><p><strong>Methodology: </strong>This was a cross-sectional community-based representative survey, of people aged ≥20 years in Pakistan, using HBA1c as the screening tool. The prevalence of T2DM/prediabetes in people having normal BMI together with associated risk factors was estimated.</p><p><strong>Results: </strong>Of 6824 normal BMI individuals, there was still a high prevalence of T2DM 14.92% and in underweight at 10.14% (overall prevalence 16.96%). Corresponding rates for prediabetes for the normal BMI category: 9.79% and underweight 8.99%. Multivariate logistic regression modeling for normal BMI individuals, showed a significantly increased risk of T2DM with increasing age (odds ratio [OR] 2.1, 3.3, 4.5 and 4.8, <i>P</i> < 0.001 for 31-40, 41-50, 51-60 and 61 years and above respectively, compared to age decade 20-30 years). Similarly, there was a significantly high risk of T2DM with lower education level [OR for no vs graduate 2.4, 95% confidence interval (CI) 1.5-3.8]. There was a significantly increased risk of T2DM in individuals having a positive family history [OR 4.3 (95% CI 7.0-11.5)]. Overall the influence of overweight/obese on T2DM occurrence (20% increased risk) was much less than in other regions of the world.</p><p><strong>Conclusion: </strong>There are higher than expected rates of T2DM/prediabetes in Pakistani ethnicity normal BMI individuals. Targeted screening of older individuals with historical lack of educational opportunity, with a family history of T2DM even if of normal BMI may result in a significant benefit in the Pakistan population.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"9 4","pages":"159-164"},"PeriodicalIF":2.3,"publicationDate":"2020-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7673776/pdf/xce-9-159.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38641604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}