Cardiovascular endocrinology最新文献

{"title":"Pioglitazone and cardiovascular risk reduction: time for a second look?","authors":"A. Perdigoto, L. Young, S. Inzucchi","doi":"10.1097/XCE.0000000000000110","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000110","url":null,"abstract":"Insulin resistance, a fundamental pathophysiological abnormality in patients with type 2 diabetes, is associated with increased cardiovascular (CV) disease risk. In diabetes management, the macrovascular impact of antihyperglycemic agents that do not improve insulin sensitivity has generally been disappointing. In contrast, glucose-lowering drugs that work as insulin sensitizing agents have been postulated to reduce CV complications. The data to support this hypothesis have, however, been inconsistent. The impact of thiazolidinediones on macrovascular events is of particular interest. In this review, we discuss the results of trials reporting CV outcomes in patients treated with thiazolidinediones. We focus on the findings of the recent Insulin Resistance Intervention after Stroke trial that demonstrated a beneficial effect of pioglitazone on CV outcomes in stroke patients with insulin resistance. We discuss the Insulin Resistance Intervention after Stroke results and its implications for clinical practice. We discuss the selective use of pioglitazone as secondary prevention to reduce CV risk in insulin resistant patients.","PeriodicalId":72529,"journal":{"name":"Cardiovascular endocrinology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89058557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of vitamin D status on lipid profile in premenopausal women: a cross-sectional study","authors":"G. Tamer, O. Telci Caklili, K. Gungor, I. Kartal, H. G. Sagun, S. Arik, İrem Bozkurt Çakır, H. Mutlu","doi":"10.1097/XCE.0000000000000124","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000124","url":null,"abstract":"Objective High lipid levels play important roles in the pathogenesis of atherosclerosis and some authors suggest vitamin D deficiency as a risk factor for atherosclerosis. The aim of this study was to evaluate the effect of vitamin D status on lipid profile in premenopausal women. Patients and methods A total of 315 nonsmoking premenopausal female volunteers without diabetes mellitus were included in the study. Patients were divided into four subgroups. The groups were as follows: patients with less than or equal to 12 ng/ml (group 1, n=126) vitamin D levels, between 20 and 12 ng/ml (group 2, n=48), between 30 and 20 ng/ml (group 3, n=21), and at least 30 ng/ml (group 4, n=120) vitamin D levels. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and non-HDL-C levels of the four groups were compared. Results HDL-C levels of group 4 were the highest (P=0.03), and TG and non-HDL-C levels of group 1 were the highest (P=0.04, 0.016, respectively) in all groups. There was no significant difference between serum parathormone, calcium, and phosphorus levels of the four groups (P=0.778, 0.121, 0.184, respectively). In unadjusted analysis, 25-hydroxy vitamin D levels were found to be correlated negatively with BMI (P=0.0005), LDL-C (P=0.01), and non-HDL-C (P=0.003) and correlated positively with HDL-C levels (P=0.006). After adjustments for age, sex, BMI, and log parathormone levels were made, no correlation was found between 25-hydroxy vitamin D and lipid (TC, LDL-C, HDL-C, and TG) levels (P=0.91, 0.06, 0.95, 0.79, respectively). Conclusion There may be an association between vitamin D insufficiency and dyslipidemia. However, this association may depend on obesity.","PeriodicalId":72529,"journal":{"name":"Cardiovascular endocrinology","volume":"109 2 1","pages":"86–91"},"PeriodicalIF":0.0,"publicationDate":"2017-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89730611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting the haemodynamic behaviour of patients undergoing pheochromocytoma and paraganglioma removal: A review.","authors":"Rashmi Ramachandran, Vimi Rewari","doi":"10.1097/XCE.0000000000000090","DOIUrl":"10.1097/XCE.0000000000000090","url":null,"abstract":"<p><p>Pheochromocytoma and paraganglioma are catecholamine-secreting tumours associated with major haemodynamic upheavals. The cardiovascular and other organ-related morbidity and even mortality has been ascribed to the major haemodynamic effects of these tumours. Many factors affect the nature and intensity of these haemodynamic changes. The rarity of these tumours as well as their extremely varied clinical presentation preclude conduct of randomized-controlled trials that may provide evidence in terms of these factors and the ways to predict and control them. Many retrospective studies and case reports, however, do provide some insight into their haemodynamic behaviour. Factors such as tumour pathology, associated genetic syndromes, anatomical attributes and perioperative drug therapy affect the haemodynamics of patients with these unique tumours. Knowledge of these factors and their presumed and known association with haemodynamic behaviour of the patients is important during the perioperative care of these patients. The review focuses on the tumour-related, patient-related and the perioperative care-related factors that affect the haemodynamic behaviour of these patients during the surgical removal of these tumours.</p>","PeriodicalId":72529,"journal":{"name":"Cardiovascular endocrinology","volume":"6 2","pages":"73-80"},"PeriodicalIF":0.0,"publicationDate":"2017-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6768518/pdf/ce-6-73.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41221777","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":"'Knowing what Matters in diabetes: Healthier below 7': results of the campaign's first 10 years (part 2), participants without known diabetes history.","authors":"Stephan Jacob,&nbsp;Andrea Klimke-Huebner,&nbsp;Franz W Dippel,&nbsp;Werner Hopfenmueller","doi":"10.1097/XCE.0000000000000109","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000109","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 diabetes represents a major problem in many societies. Early detection and, even better, prevention could help to reduce the burden of the disease. Therefore, increased awareness of disorders of glucose metabolism is important. During the campaign 'Knowing what Matters in diabetes: Healthier below 7', in the last few years, more than 31 000 shopping mall visitors in Germany were voluntarily checked for their potential diabetes risk.</p><p><strong>Methods: </strong>With a modified FINDRISK questionnaire, demographic, anthropometric and anamnestic data relevant for the estimation of the potential diabetes risk were collected. In addition, medical data such as plasma glucose, blood pressure (BP), BMI and waist circumference were obtained. Furthermore, lifestyle habits were documented. Hemoglobin (Hb)A_1c was assessed randomly in a subgroup of individuals (<i>n</i>=4133). In total, data from 26 522 valid questionnaires were collected and evaluated over 10 years (2005-2014) from 45 single locations throughout Germany. Results from participants with manifest diabetes have already been published in this journal. Here, we report on the results from participants without a previous history of diabetes mellitus.</p><p><strong>Results: </strong>Among the 26 522 participants with a completed questionnaire, 21 055 (79.4%) participants did not have a previous history of diabetes. Characteristic risk factors for diabetes were common in this group. With about 17% being obese and 40% being overweight, more than half of these individuals were thus beyond the normal BMI range. In addition, waist circumference exceeded common thresholds in 44% of the participants. As expected, many of them followed an unhealthy lifestyle as 35% reported no regular physical activity and 20% reported an unhealthy diet. The mean BP was 141/85 mmHg. More than half (51%) half of the patients in the nondiabetic group had a systolic BP above 140 mmHg, but only one-third (35%) reported concomitant treatment with antihypertensives. In the questionnaire, 14% of the participants had a FINDRISK sum score of 15 points and above, indicating a moderate or high risk of potentially developing type 2 diabetes within 10 years. Surprisingly, in the subgroup with HbA_1c measurements (<i>n</i>=4133), 18.5% of the participants without a diagnosis or a history of diabetes were found to have an HbA_1c value of at least 6.5% indicating manifest, previously undetected type 2 diabetes.</p><p><strong>Conclusion: </strong>The data collected in individuals without a known history of diabetes indicate a considerable prevalence of typical risk factors associated with diabetes. In addition, the data confirmed that screening of apparently healthy individuals consistently shows a significant proportion of individuals with previously undetected type 2 diabetes which, in the subgroup, was surprisingly high. As there is convincing evidence for the bene","PeriodicalId":72529,"journal":{"name":"Cardiovascular endocrinology","volume":"6 1","pages":"48-54"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/XCE.0000000000000109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34898419","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":"Epidemiology in diabetes mellitus and cardiovascular disease.","authors":"Wenjun Fan","doi":"10.1097/XCE.0000000000000116","DOIUrl":"10.1097/XCE.0000000000000116","url":null,"abstract":"<p><p>As one of the leading causes of death in the USA, diabetes mellitus (DM) has become an epidemic over the past few decades. Despite the high prevalence of diagnosed DM, close to half of all people with DM are unaware of their disease. The risk of type 2 DM is determined by interplay of genetic and metabolic factors. Patients with type 2 DM have a higher risk of death from cardiovascular causes compared with their nondiabetic counterparts, and the mortality rate of DM associated cardiovascular disease is different among ethnicity groups and sex groups. Because of its adverse effect on people's health, DM also imposes an economic burden on individuals and households affected, as well as on the healthcare system. Current guidelines for cardiovascular disease prevention have focused on lifestyle management, blood pressure control, lipid control, blood glucose control, antiplatelet agent use, and tobacco use cessation.</p>","PeriodicalId":72529,"journal":{"name":"Cardiovascular endocrinology","volume":"6 1","pages":"8-16"},"PeriodicalIF":0.0,"publicationDate":"2017-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6768526/pdf/ce-6-08.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41221776","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 prevention in Romania: a midsummer night's dream?","authors":"D. Gaita, S. Moșteoru","doi":"10.1097/XCE.0000000000000111","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000111","url":null,"abstract":"Cardiovascular mortality has decreased by 25% in Romania in the last 10 years, but it is still high despite renewed efforts between the Romanian Cardiac Societies and the government to increase life expectancy and decrease death rates through coronary heart disease or stroke. Ranking fifth among the European countries in terms of high cardiovascular risk, according to an ESC statistic, Romania has been struggling with hypertension as the leading risk factor (39.1%) together with hypercholesterolemia (39.1%), followed by smoking (26.7%) and obesity (21.3%) [1]. Another alarming fact is that the prevalence of insufficient physical activity in adults over 18 years of age is 25.3% (2010). Moreover, the prevalence of diabetes is estimated to be 11.6% in the population between 20 and 79 years of age (between 535 413 and 1 967 200 individuals). Newly reported cases represent 20.69% [2].","PeriodicalId":72529,"journal":{"name":"Cardiovascular endocrinology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77532936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolically healthy versus unhealthy obesity and risk for diabetes mellitus and cardiovascular diseases","authors":"D. Gaita, S. Moșteoru","doi":"10.1097/XCE.0000000000000119","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000119","url":null,"abstract":"Obesity presents one of the biggest issues of modern-day life for a wide variety of medical specialties, starting with the cardiologist and ending with the diabetologist or the bariatric surgeon. However, in the last few years a new entity has emerged, the metabolically healthy obese (MHO) individual. This category encompasses obese individuals without the presence of metabolic diseases such as type 2 diabetes mellitus, dyslipidemia, or hypertension. Several studies have thus been undertaken to determine the risk of these MHO individuals for diabetes mellitus or cardiovascular diseases compared with the ‘unhealthy’ obese. Data are still controversial on this matter, but one trend seems to be emerging: MHO is but a transient phase in the path toward insulin resistance and metabolic syndrome.","PeriodicalId":72529,"journal":{"name":"Cardiovascular endocrinology","volume":"17 1","pages":"23–26"},"PeriodicalIF":0.0,"publicationDate":"2017-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87921778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of the evidence for alternative and complementary medical approaches in the prevention of atherosclerotic cardiovascular disease and diabetes","authors":"Jonathan Nieves, S. Baum","doi":"10.1097/XCE.0000000000000118","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000118","url":null,"abstract":"The use of complementary and alternative medicine approaches has increased in the recent years. It has been utilized in both the treatment and prevention of many chronic diseases, especially in the management of hypertension, diabetes, and hyperlipidemia. Lifestyle modifications play a fundamental role in alternative and complementary medicine. Regular exercise, maintenance of optimal weight, and a healthful diet play vital roles in maintaining ideal health. Specifically, the Dietary Approaches to Stop Hypertension and Mediterranean diets have been established as having beneficial effects on blood pressure and cholesterol and even cardiovascular outcomes. Still, additional supplements including fish oil, CoQ10, and red yeast rice (among others) have shown promising beneficial effects. Unfortunately, many of the beneficial claims of natural products are not scientifically proven, lack reproducibility, and/or yield conflicting results. Until more concrete evidence can be produced, it is important for physicians and patients alike to familiarize themselves with these natural products and increase their awareness of any potential adverse effects.","PeriodicalId":72529,"journal":{"name":"Cardiovascular endocrinology","volume":"1 1","pages":"39–43"},"PeriodicalIF":0.0,"publicationDate":"2017-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86942722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiodiabetology: The convergence of diabetes and cardiovascular disease.","authors":"N. Wong","doi":"10.1097/XCE.0000000000000113","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000113","url":null,"abstract":"With the predominant causes of morbidity and mortality in persons with type 2 diabetes mellitus being atherosclerotic cardiovascular disease (ASCVD) and its complications [1], including myocardial infarction, stroke, and heart failure, and the combination of both diabetes and cardiovascular disease being associated with a substantial additional risk for mortality from cardiovascular disease and all causes compared with either alone [2], a close understanding of the epidemiology and management of cardiovascular risk factors beyond glycemic control in persons with diabetes is needed. The long-term followup of the Steno-2 study [3] as well as observational follow-up of three major US cohort studies [4] shows the powerful long-term benefits of multifactorial risk factor control. Unfortunately, many patients in the USA with diabetes are not at target for composite risk factors [5], warranting a need for better coordinated care for the management of ASCVD risk factors in those with type 2 diabetes mellitus. Importantly a close collaboration between the fields of cardiology and endocrinology as well as primary care fields managing most of the patients with diabetes is needed if we are to address the expanding epidemic of diabetes and cardiovascular disease globally.","PeriodicalId":72529,"journal":{"name":"Cardiovascular endocrinology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77303650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The emergence of cardiodiabetology","authors":"P. Rosenblit, N. Lepor, N. Wong","doi":"10.1097/XCE.0000000000000117","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000117","url":null,"abstract":"Atherosclerotic cardiovascular disease (ASCVD) and its complications [i.e. heart attacks, strokes, peripheral arterial disease, chronic kidney disease (CKD), and heart failure (HF)] are the key causes of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM) 1. Cardiodiabetology focuses on both the science and the clinical management strategies aimed to reduce the associated risks and treat the cardiovascular consequences in patients with diabetes. Cardiodiabetology emphasizes a close collaboration between not only the clinical endocrinologist-diabetologist and cardiologist, but encompasses multidisciplinary diabetes treatment experts, including nephrologists, exercise physiologists, nutrition experts, podiatrists, cardio-thoracic and other vascular surgeons, primary care physicians, as well as the scientists involved in studying the connection between diabetes and ASCVD. In this very brief commentary, it is suggested that an interactive cardiodiabetology collaboration, focusing on both scientific discoveries and clinical management strategies, can ultimately reduce risks, in the primary prevention, or delay, of chronic complications, or optimally treat the ASCVD consequences, to, ultimately, improve patient outcomes, quality of life, and longevity in persons with diabetes.","PeriodicalId":72529,"journal":{"name":"Cardiovascular endocrinology","volume":"118 1","pages":"3–7"},"PeriodicalIF":0.0,"publicationDate":"2017-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73653496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}