Clinical cornerstone最新文献_第9页

Cardiometabolic risk and risk management 心脏代谢风险和风险管理

Clinical cornerstone Pub Date : 2007-01-01 Epub Date: 2008-04-29 DOI: 10.1016/S1098-3597(07)80023-8

引用次数: 0

CME Test Answer Sheet and Evaluation Form for Advances in cardiometabolic health CME测试答题卡和心脏代谢健康进展评估表

Clinical cornerstone Pub Date : 2007-01-01 Epub Date: 2007-12-22 DOI: 10.1016/S1098-3597(07)80014-7

引用次数: 0

CME Test Answers management and prevention of glucose dysregulation CME测试回答管理和预防血糖失调

Clinical cornerstone Pub Date : 2007-01-01 Epub Date: 2007-12-23 DOI: 10.1016/S1098-3597(07)80022-6

引用次数: 0

The blockade of the endocannabinoid CB1 receptors and its influence on cardiometabolic risk: Lesson from rimonabant in obesity (RIO) trials 内源性大麻素CB1受体的阻断及其对心脏代谢风险的影响:利莫那班在肥胖(里约热内卢)试验中的教训

Clinical cornerstone Pub Date : 2007-01-01 Epub Date: 2008-04-29 DOI: 10.1016/S1098-3597(07)80031-7

Richard A. Johnson MD, Roberto Vettor, Marco Rossato, Francesco Fallo, Claudio Pagano

引用次数: 4

High-density lipoprotein cholesterol and residual cardiometabolic risk in metabolic syndrome 代谢综合征中高密度脂蛋白胆固醇和残余心脏代谢风险

Clinical cornerstone Pub Date : 2007-01-01 Epub Date: 2007-12-22 DOI: 10.1016/S1098-3597(07)80011-1

Christopher P. Cannon MD

{"title":"High-density lipoprotein cholesterol and residual cardiometabolic risk in metabolic syndrome","authors":"Christopher P. Cannon MD","doi":"10.1016/S1098-3597(07)80011-1","DOIUrl":"10.1016/S1098-3597(07)80011-1","url":null,"abstract":"<div><p>It has long been recognized that elevated levels of low-density lipoprotein cholesterol (LDL-C) increase the risk of cardiovascular disease (CVD) and that pharmacologic therapy to decrease LDL-C significantly reduces cardiovascular events. Despite the effectiveness of statins for CVD risk reduction, even optimal LDL-lowering therapy alone fails to avert ∼60% to 70% of CVD cases, and the incidence of CVD mortality continues to grow. A low plasma concentration of high-density lipoprotein cholesterol (HDL-C) is also associated with increased risk of CVD and is 1 component of metabolic syndrome, a cluster of interrelated CVD risk factors. HDL stimulates reverse cholesterol transport from the peripheral tissues to the liver for removal from the body, prevents deleterious effects of LDL on endothelial function, acts as an antioxidant, and also possesses anti-inflammatory, antithrombotic, and antiapoptotic effects. Some of the treatments that increase HDL-C concentrations have been shown to reduce atheroma volume and may prevent the formation of new atherosclerotic lesions, thereby reducing the risk of CVD. For these reasons, increasing HDL-C concentrations has become a potentially attractive therapeutic target for individuals who are at increased risk of CVD, including those with metabolic syndrome. Traditional strategies to increase HDL-C include the use of niacin, statins, and fibric acid derivatives. Pharmacotherapies that have recently been developed and are currently being evaluated include inhibition of the enzyme <em>cholesteryl ester transfer protein</em> (CETP) and antagonism of the endocannabinoid CB<sub>1</sub> receptor. Initial studies of CETP inhibitors suggest that these agents may markedly increase HDL-C concentrations. Clinical trials with rimonabant, a CB<sub>1</sub> receptor antagonist, have demonstrated significant weight loss as well as increased HDL-C levels and reduced triglyceride levels.</p></div>","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 ","pages":"Pages S14-S23"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(07)80011-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27058356","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}

引用次数: 23

Role of the endocannabinoid system in regulating cardiovascular and metabolic risk factors 内源性大麻素系统在调节心血管和代谢危险因素中的作用。

Clinical cornerstone Pub Date : 2007-01-01 Epub Date: 2008-04-29 DOI: 10.1016/S1098-3597(07)80030-5

Richard A. Johnson MD, Stephen C. Woods PhD

引用次数: 20

Early identification and treatment of insulin resistance: Impact on subsequent prediabetes and type 2 diabetes 胰岛素抵抗的早期识别和治疗:对后续糖尿病前期和2型糖尿病的影响

Clinical cornerstone Pub Date : 2007-01-01 Epub Date: 2007-12-23 DOI: 10.1016/S1098-3597(07)80017-2

Vivian A. Fonseca MD

{"title":"Early identification and treatment of insulin resistance: Impact on subsequent prediabetes and type 2 diabetes","authors":"Vivian A. Fonseca MD","doi":"10.1016/S1098-3597(07)80017-2","DOIUrl":"10.1016/S1098-3597(07)80017-2","url":null,"abstract":"<div><p>Insulin resistance (IR) is characterized by decreasing sensitivity of target tissues to the action of insulin, elevated blood glucose concentration, and increased hepatic production of atherogenic lipids. IR is associated with declining insulin production by the pancreas, the emergence of type 2 diabetes, and increasing risk of cardiovascular disease (CVD). Clinical markers of IR include elevated plasma glucose concentration under fasting conditions or following ingestion of an oral glucose challenge. IR and hyperinsulinemia produce a number of effects that promote CVD, including adverse effects on blood pressure, endothelial cell function, lipid profile, platelet function, and blood coagulation. Glucose dysregulation often occurs in combination with other cardiovascular risk factors, including hypertension, obesity, and dyslipidemia. Clinical trials have shown that lifestyle changes to promote weight loss and medical therapy with insulin-sensitizing agents can reduce the likelihood of progression from early stages of IR to type 2 diabetes. However, it is important to recognize that obesity is a chronic condition that needs strategies beyond a diet plan to maintain sufficient weight loss over time. Pharmacologic therapies that are currently in development may help not only to promote weight loss but also to improve the symptoms of cardiometabolic risk in patients with and without diabetes. (<em>Clinical Cornerstone</em>. 2007;8[Suppl 7]:S7-S18)</p></div>","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 ","pages":"Pages S7-S18"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(07)80017-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192439","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}

引用次数: 44

The relation of adipose tissue to cardiometabolic risk 脂肪组织与心脏代谢风险的关系

Clinical cornerstone Pub Date : 2006-01-01 Epub Date: 2007-01-05 DOI: 10.1016/S1098-3597(06)80040-2

MD F. Xavier Pi-Sunyer (Professor)

{"title":"The relation of adipose tissue to cardiometabolic risk","authors":"MD F. Xavier Pi-Sunyer (Professor)","doi":"10.1016/S1098-3597(06)80040-2","DOIUrl":"10.1016/S1098-3597(06)80040-2","url":null,"abstract":"<div><p>Adipose tissue is an active and complex endocrine organ that secretes numerous bioactive substances, including hormones, growth factors, and cytokines. Central obesity, one of the components of metabolic syndrome, is a cardiometabolic risk factor associated with a state of chronic inflammation and coagulation, one in which the expression of certain adipocytokines, including tumor necrosis factor-alpha (TNF-(α), interleukin (IL)-6, and plasminogen activator inhibitor-1 (PAI-1) is more abundantly increased, while adiponectin expression is decreased. TNF-α initiates and organizes inflammatory changes in vascular tissue. IL-6, an inflammatory cytokine directly implicated in atherogenesis, exerts pleiotropic effects on a variety of tissues. An increased concentration of PAI-1, an important regulator of the endogenous fibrinolytic system, promotes continued clotting. Adiponectin, on the other hand, has potent vasculoprotective, angiogenic, anti-inflammatory, and antiatherogenic properties. Adiponectin levels are low in obese individuals and increase when weight is lost, thereby serving as a marker for cardioprotection. Weight loss has long been promoted as a means to reduce the risk of type 2 diabetes and cardiovascular disease; for example, exercise and a hypocaloric diet have been shown to decrease PAI-1 levels. Weight loss drugs, such as orlistat, a lipase inhibitor, and sibutramine, a serotonin and norepinephrine reuptake inhibitor, have both been shown to produce a decrease in C-reactive protein levels and an increase in serum adiponectin. Rimonabant, a selective cannabinoid 1 receptor antagonist in Phase III studies, also has been shown to increase adiponectin levels. These agents may play a role in the regulation of adipocytokines, which may directly affect the risk for cardiometabolic disease.</p></div>","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 ","pages":"Pages S14-S23"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(06)80040-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26476680","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}

引用次数: 44

The endocannabinoid system: Body weight and metabolic regulation 内源性大麻素系统:体重和代谢调节

Clinical cornerstone Pub Date : 2006-01-01 Epub Date: 2007-01-05 DOI: 10.1016/S1098-3597(06)80041-4

MD Stefan Engeli, MD Jens Jordan

{"title":"The endocannabinoid system: Body weight and metabolic regulation","authors":"MD Stefan Engeli, MD Jens Jordan","doi":"10.1016/S1098-3597(06)80041-4","DOIUrl":"10.1016/S1098-3597(06)80041-4","url":null,"abstract":"<div><p>The endocannabinoid system elicits multiple physiologic functions that are not fully understood. Antagonism of cannabinoid type 1 (CB<sub>1</sub>) receptors has been the only successful new pharmacologic treatment approach in Phase III studies in obesity in the last 8 years. Whereas antagonism of (CB<sub>1</sub>) receptors acutely reduces food intake, the long-term effects on weight reduction and metabolic regulation appear to be mediated by stimulation of energy expenditure and by peripheral effects related to liver, skeletal muscle, adipose tissue, and pancreas physiology. For example, in the liver, lipogenic enzymes and fatty acid synthesis are upregulated by endocannabinoids, and in adipose tissue, antagonism of (CB<sub>1</sub>) receptors increases secretion of adiponectin. Some studies suggest that endocannabinoid formation is increased in obesity, perhaps because endocannabinoid degradation is decreased. Although many questions remain unanswered at present, the emerging concept of endocannabinoids as metabolic regulators helps to explain the success of rimonabant (SR141716), an antagonist of (CB<sub>1</sub>) receptors, currently in Phase III studies.</p></div>","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 ","pages":"Pages S24-S35"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(06)80041-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26476681","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}

引用次数: 31

Successful control of dyslipidemia in patients with metabolic syndrome: focus on lifestyle changes 代谢综合征患者血脂异常的成功控制:关注生活方式的改变

Clinical cornerstone Pub Date : 2006-01-01 Epub Date: 2006-08-28 DOI: 10.1016/S1098-3597(06)80004-9

MD Neil J. Stone (Professor)

{"title":"Successful control of dyslipidemia in patients with metabolic syndrome: focus on lifestyle changes","authors":"MD Neil J. Stone (Professor)","doi":"10.1016/S1098-3597(06)80004-9","DOIUrl":"10.1016/S1098-3597(06)80004-9","url":null,"abstract":"<div><p>Approaches to controlling dyslipidemia in patients with metabolic syndrome must take into consideration a patient's individual characteristics and underlying lipid disorder: Some patients will require pharmacologic therapy, whereas others can be controlled with lifestyle changes alone. The National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) guidelines recommend that patients with at least 3 of the following clinical variables be designated as having metabolic syndrome: abdominal obesity as reflected in increased waist circumference; a low high-density lipoprotein cholesterol (HDL-C) level; an elevated triglyceride level; elevated blood pressure or treatment with antihypertensive medications; and/or elevated fasting plasma glucose or treatment with antidiabetic medications. Unless patients with metabolic syndrome change their lifestyle, existing cardiovascular and metabolic risk factors will worsen or new risk factors will develop. This helps explain why these patients are at increased risk for developing type 2 diabetes mellitus (DM) and coronary heart disease (CHD). The lifestyle changes recommended by NCEP ATP III for controlling dyslipidemia (ie, elevated levels of triglycerides and decreased levels of HDL-C) in patients with metabolic syndrome or type 2DM include (1) reduced intake of saturated fats and dietary cholesterol, (2) intake of dietary options to enhance lowering of low-density lipoprotein cholesterol, (3) weight control, and (4) increased physical activity. If lifestyle changes are not successful for individuals at high risk of developing CHD, or for those who currently have CHD, a CHD risk equivalent, or persistent atherogenic dyslipidemia, then pharmacotherapy may be necessary as defined by NCEP ATP III guidelines.</p></div>","PeriodicalId":80265,"journal":{"name":"Clinical cornerstone","volume":"8 ","pages":"Pages S15-S20"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1098-3597(06)80004-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26192478","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}

引用次数: 17