Journal of the cardiometabolic syndrome最新文献

{"title":"The Diabetes Subgroup Baseline Characteristics of the Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension (ACCOMPLISH) Trial","authors":"George Bakris MD,&nbsp;Allen Hester PhD,&nbsp;Michael Weber MD,&nbsp;Bjorn Dahlof MD,&nbsp;Bert Pitt MD,&nbsp;Eric Velasquez MD,&nbsp;Linda Staikos-Byrne PhD,&nbsp;Victor Shi PhD,&nbsp; Ken Jamerson MD,&nbsp;on behalf of the ACCOMPLISH Investigators","doi":"10.1111/j.1559-4572.2008.00023.x","DOIUrl":"10.1111/j.1559-4572.2008.00023.x","url":null,"abstract":"<p>The Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension (ACCOMPLISH) trial is the first cardiovascular outcome trial designed to compare initial use of 2 different fixed-dose antihypertensive regimens, benazepril plus hydrochlorothiazide vs benazepril plus amlodipine, on cardiovascular end points in hypertensive patients at high cardiovascular risk secondary to previous major events or presence of diabetes mellitus (DM). Of the 11,464 patients, 60.4% had DM. Compared with non-DM patients, DM patients were less likely to have previous myocardial infarctions (15% vs 37%) or strokes (8% vs 21%). Those with DM were more likely to be female (43% vs 34%), black (15% vs 8%), overweight (body mass index, 32 vs 29 kg/m²). At baseline, DM patients were more likely to have the metabolic syndrome, manifested by higher levels of fasting glucose (145 vs 101 mg/dL) and triglycerides (178 vs 150 mg/dL) and slightly lower high-density lipoprotein cholesterol values (48 vs 51 mg/dL) compared to the non-DM cohort. Although estimated glomerular filtration rate (80 vs 76 mL/min/1.73 m²) was similar in the DM and non-DM groups, presence of both albuminuria (8.7% vs 3.5%) and microalbuminuria (29% vs 20%) were more prevalent in the DM group. After 6 months of treatment, blood pressure control rates (&lt;140/90 mm Hg) using blinded data (both therapeutic groups combined) for DM demonstrated that 42.8% of DM patients had blood pressure levels &lt;130/80 mm Hg. ACCOMPLISH will provide valuable guidance on optimizing treatment strategies in hypertensive patients at high cardiovascular risk with and without DM.</p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"3 4","pages":"229-233"},"PeriodicalIF":0.0,"publicationDate":"2008-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00023.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27865650","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":"Surgical Treatment of the Cardiometabolic Syndrome and Obesity","authors":"Khurshid Ahmad Khan MD,&nbsp;James R. Sowers MD","doi":"10.1111/j.1559-4572.2008.00021.x","DOIUrl":"10.1111/j.1559-4572.2008.00021.x","url":null,"abstract":"<p>Prevalence of overweight and obesity has reached a pandemic proportion worldwide and is increasingly contributing to premature morbidity and mortality. Lifestyle changes including behavioral modification, exercise, different dietary plans, and medications have very poor outcome on long-term weight loss. Bariatric surgery has shown to be very effective for morbidly obese patients. Surgery in these patients not only decreases their body weight but also may improve comorbid conditions associated with obesity. These patients on average lose 61% of excess body weight depending on the procedure performed. Diabetes, hyperlipidemia, and hypertension are normalized in these patients by 77%, 70%, and 62%, respectively. Patients need to be selected carefully for surgical treatment of obesity and have to be monitored closely over the long term for nutritional deficiencies and other complications.</p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"3 4","pages":"254-257"},"PeriodicalIF":0.0,"publicationDate":"2008-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00021.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27865653","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 Insulin Gradient Phenomenon: A Manifestation of the Effects of Body Weight on Blood Pressure and Insulin Resistance","authors":"Dagnovar Aristizabal MD,&nbsp;Jaime Gallo MD,&nbsp;Ricardo Fernández MD,&nbsp;Maria A. Restrepo MD,&nbsp;Nora Zapata RN,&nbsp;Monica Correa RN","doi":"10.1111/j.1559-4572.2008.00018.x","DOIUrl":"10.1111/j.1559-4572.2008.00018.x","url":null,"abstract":"<p>The relationship between hyperinsulinemia and hypertension is frequently observed in overweight patients; however, population studies have not confirmed an independent association. A population study was conducted to assess whether differences in body mass index and levels of insulinemia modify cardiovascular hemodynamics and arterial pressure. In all, 322 healthy adults underwent a medical evaluation including insulin sensitivity and cardiac performance assessment with echocardiography. A direct relationship between body mass index and blood pressure (r=0.36; P&lt;.01) was shown along with increments in fasting insulin levels. The underlying and progressive rise in insulin levels during blood pressure increase is named the insulin gradient. Left ventricular systolic indexes were significantly greater in the higher-insulin quartile. These findings suggest that body weight increases accompany a rise in systolic pressure and a drop in insulin sensitivity related to the insulin gradient. Increments in ejection fraction and cardiac output with normal total peripheral resistance are related to the blood pressure shift in these persons.</p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"3 4","pages":"218-223"},"PeriodicalIF":0.0,"publicationDate":"2008-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00018.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27865648","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":"Omega-3 Fatty Acids and the Cardiometabolic Syndrome","authors":"Vijaya Juturu PhD","doi":"10.1111/j.1559-4572.2008.00015.x","DOIUrl":"10.1111/j.1559-4572.2008.00015.x","url":null,"abstract":"<p>Benefits of fish consumption in patients with the cardiometabolic syndrome relate to the high biologic value of protein, omega-3 fatty acids, as well as certain minerals and vitamins in fish. Recently, the American Heart Association issued new guidelines for the intake of omega-3 oils for the prevention of coronary heart disease. The objective of this paper is to evaluate the potential health benefits of fish consumption and/or fish oil supplements in reducing cardiometabolic syndrome risk factors. The consumption of fish or fish oil containing omega-3 polyunsaturated fatty acids reduces the risk of coronary heart disease, decreases triglyceride, blood pressure, and inflammatory markers, improves endothelial function, prevents certain cardiac arrhythmias, reduces platelet aggregation (including reactivity and adhesion), reduces vasoconstriction, enhances fibrinolysis, reduces fibrin formation, and decreases the risk of microalbuminuria and sudden cardiac death. Thus, fish intake or fish oil supplement use is beneficial to reduce cardiometabolic risk factors.</p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"3 4","pages":"244-253"},"PeriodicalIF":0.0,"publicationDate":"2008-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00015.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27865651","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":"Attenuation of Endocrine-Exocrine Pancreatic Communication in Type 2 Diabetes: Pancreatic Extracellular Matrix Ultrastructural Abnormalities","authors":"Melvin R. Hayden MD,&nbsp;Kamlesh Patel MD,&nbsp;Javad Habibi PhD,&nbsp;Deepa Gupta MD,&nbsp;Seema S. Tekwani MD,&nbsp;Adam Whaley-Connell DO, MSPH,&nbsp;James R. Sowers MD","doi":"10.1111/j.1559-4572.2008.00024.x","DOIUrl":"10.1111/j.1559-4572.2008.00024.x","url":null,"abstract":"<p>Ultrastructural observations reveal a continuous interstitial matrix connection between the endocrine and exocrine pancreas, which is lost due to fibrosis in rodent models and humans with type 2 diabetes mellitus (T2DM). Widening of the islet-exocrine interface appears to result in loss of desmosomes and adherens junctions between islet and acinar cells and is associated with hypercellularity consisting of pericytes and inflammatory cells in T2DM pancreatic tissue. Organized fibrillar collagen was closely associated with pericytes, which are known to differentiate into myofibroblasts—pancreatic stellate cells. Of importance, some pericyte cellular processes traverse both the connecting islet-exocrine interface and the endoacinar interstitium of the exocrine pancreas. Loss of cellular paracrine communication and extracellular matrix remodeling fibrosis in young animal models and humans may result in a dysfunctional insulino-acinar-ductal–incretin gut hormone axis, resulting in pancreatic insufficiency and glucagon-like peptide deficiency, which are known to exist in prediabetes and overt T2DM in humans.</p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"3 4","pages":"234-243"},"PeriodicalIF":0.0,"publicationDate":"2008-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00024.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27865652","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":"Characterization of the Metabolic Syndrome by Apolipoproteins in the Oklahoma Cherokee","authors":"Petar Alaupovic PhD,&nbsp;Piers Blackett MB, ChB, FAAP,&nbsp;Wenyu Wang PhD,&nbsp; Elisa Lee PhD","doi":"10.1111/j.1559-4572.2008.00022.x","DOIUrl":"10.1111/j.1559-4572.2008.00022.x","url":null,"abstract":"<p>Native Americans are susceptible to type 2 diabetes and associated cardiovascular risk that precedes the diabetes. Nondiabetic Cherokee adolescents and young adults were studied for association of apolipoproteins A-I, B, and C-III with the metabolic syndrome, homeostasis model assessment–insulin resistance (HOMA-IR), and body mass index. Apolipoproteins, lipids, selected ratios, and HOMA-IR changed adversely according to the number of metabolic syndrome criteria present (<i>P</i>&lt;.001 for trend). Logistic regression showed heparin-precipitated apolipoprotein C-III, apolipoprotein C-III bound to apolipoprotein B–containing lipoproteins, to be a significant predictor of the metabolic syndrome in the adolescents and adults, and it appears to be more strongly associated than apolipoprotein B: apolipoprotein A-I. Regression modeling with components of the syndrome as the dependent variables showed that they were all significantly associated with heparin-precipitated apolipoprotein C-III except for fasting blood glucose. The Cherokee have a high prevalence of the metabolic syndrome, which is associated with atherosclerotic lipoprotein particles containing apolipoprotein C-III and B.</p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"3 4","pages":"193-199"},"PeriodicalIF":0.0,"publicationDate":"2008-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00022.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27865669","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 Effect of Pioglitazone on Nitric Oxide Synthase in Patients With Type 2 Diabetes Mellitus","authors":"Kazuaki Nishio MD, PhD,&nbsp;Meiei Shigemitsu MD,&nbsp;Yusuke Kodama MD,&nbsp;Seiji Itoh MD,&nbsp;Noburu Konno MD, PhD,&nbsp;Ryuji Satoh MD,&nbsp;Takashi Katagiri MD, PhD,&nbsp;Youichi Kobayashi MD, PhD","doi":"10.1111/j.1559-4572.2008.00019.x","DOIUrl":"10.1111/j.1559-4572.2008.00019.x","url":null,"abstract":"<p>The aim of this study was to evaluate the effect of pioglitazone on nitric oxide in patients with type 2 diabetes and coronary artery disease. Twenty-seven patients with coronary artery disease and diabetes mellitus who had received coronary stenting were eligible for the study. They were assigned to the no insulin resistance (NIR) group, the insulin resistance (IR) group, and the pioglitazone group (30 mg once a day). Endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS), tumor necrosis factor α (TNF-α), interleukin-6, leptin, and adiponectin were measured. In the pioglitazone group, eNOS, iNOS, and leptin were significantly lower and adiponectin was significantly higher than those in the IR group. Stepwise multiple regression analyses showed that eNOS correlated with TNF-α and iNOS correlated with leptin and TNF-α. Leptin was the strongest predictor of iNOS. Treatment with pioglitazone significantly reduced eNOS and iNOS by improving adipocytokine levels.</p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"3 4","pages":"200-204"},"PeriodicalIF":0.0,"publicationDate":"2008-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00019.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27865670","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":"Metabolic Syndrome Resolution in Children and Adolescents After 10 Weeks of Weight Loss","authors":"Ann Marie Coppen FNP, PhD,&nbsp;Joseph A. Risser MD, MPH,&nbsp;Peter D. Vash MD, MPH","doi":"10.1111/j.1559-4572.2008.00016.x","DOIUrl":"10.1111/j.1559-4572.2008.00016.x","url":null,"abstract":"<p>Without aggressive intervention, childhood obesity and the metabolic syndrome may result in lifelong physical consequences. Interventions that emphasize healthy eating and regular exercise are crucial to stop this epidemic and its ramifications. This paper discusses the incidence of the metabolic syndrome and cardiovascular risk factors before and after a weight loss program. A retrospective review was conducted in 135 children and adolescents (aged 6 to 19) who completed a 10-week medically supervised weight loss program. Outcome measures included mean change in each component of the metabolic syndrome, total cholesterol, low-density lipoprotein cholesterol, and hemoglobin A_1c. After 10 weeks of weight loss, a mean (SD) weight loss of 9.24 (19.5) kg was attained. Resolution of the metabolic syndrome was seen in 75.5% of children and adolescents. Weight loss can reverse metabolic syndrome and decrease cardiovascular risk in as little as 10 weeks.</p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"3 4","pages":"205-210"},"PeriodicalIF":0.0,"publicationDate":"2008-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00016.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27865671","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":"Chronic Low-Dose Lipid Infusion in Healthy Patients Induces Markers of Endothelial Activation Independent of Its Metabolic Effects","authors":"Sangeeta R. Kashyap MD,&nbsp;Renata Belfort MD,&nbsp;Eugenio Cersosimo MD,&nbsp;Shuko Lee PhD,&nbsp;Kenneth Cusi PhD","doi":"10.1111/j.1559-4572.2008.00013.x","DOIUrl":"https://doi.org/10.1111/j.1559-4572.2008.00013.x","url":null,"abstract":"<p> <i>Elevated plasma triglyceride/free fatty acid (FFA) levels and insulin resistance may promote atherosclerosis through endothelial activation (ie, increased expression of intercellular adhesion molecule 1 [ICAM-1]/vascular adhesion molecule 1 [VCAM-1], and endothelin-1 [ET-1]) in patients with the metabolic syndrome, but this has never been directly tested. The authors measured endothelial activation and insulin sensitivity (euglycemic insulin clamp with [3-</i>\u0000 ^{\u0000 <i>3</i>\u0000}\u0000 <i>H]-glucose) after a 4-day low-dose lipid infusion that elevated plasma FFA to levels observed in the metabolic syndrome in 20 lean, non-diabetic insulin-resistant subjects with a strong family history of type 2 diabetes mellitus (FH</i>\u0000 ^{\u0000 <i>+</i>\u0000}\u0000 <i>) and 10 insulin-sensitive volunteers without a family history of type 2 diabetes mellitus (FH</i>\u0000 ^{\u0000 <i>−</i>\u0000}\u0000 <i>). Low-dose lipid infusion reduced insulin sensitivity by approximately 25% in insulin-sensitive FH</i>\u0000 ^{\u0000 <i>−</i>\u0000}\u0000 <i>controls but did not worsen preexisting insulin resistance in FH</i>\u0000 ^{\u0000 <i>+</i>\u0000}\u0000 <i>. Low-dose lipid infusion elevated plasma ICAM and VCAM levels similarly in both groups (approximately 12%–18%;</i> P<i>&lt;.01 vs baseline), while plasma ET-1 levels increased more in FH</i>^<i>+</i><i>vs FH</i>^<i>−</i><i>(46% vs 10%;</i> P<i>=.005). Increased plasma FFA levels closely correlated with elevated ICAM (</i>r<i>=</i><i>0.60;</i> P<i>&lt;.01), VCAM, and ET-1 levels (</i>r<i>=</i><i>0.39 and</i> r<i>=</i><i>0.42, respectively;</i> P<i>&lt;.05). Low-dose lipid infusion induces endothelial activation in both lean insulin-resistant (FH</i>^<i>+</i><i>) and insulin-sensitive (FH</i>^<i>−</i><i>) healthy patients, regardless of changes in insulin sensitivity. These results prove that even a modest lipid oversupply may be sufficient to trigger a deleterious endothelial response.</i></p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"3 3","pages":"141-146"},"PeriodicalIF":0.0,"publicationDate":"2008-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00013.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72326795","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":"Impact of Obesity on the Risk of Heart Failure and Its Prognosis","authors":"Surya M. Artham MD,&nbsp;Carl J. Lavie MD,&nbsp;Hamang M. Patel MD,&nbsp;Hector O. Ventura MD","doi":"10.1111/j.1559-4572.2008.00001.x","DOIUrl":"https://doi.org/10.1111/j.1559-4572.2008.00001.x","url":null,"abstract":"<p> <i>Obesity is becoming a global epidemic in both children and adults, and it is associated with numerous comorbidities such as coronary heart disease, stroke/cerebrovascular disease, type 2 diabetes, hypertension, certain cancers, and sleep-disordered breathing. Over the past 2 decades, the incidence of and mortality from coronary heart disease and cardiovascular diseases has been continuously declining. In contrast, the incidence of and mortality from heart failure (HF) have been increasing, with HF diagnosed in approximately 5 million Americans and 550,000 new cases diagnosed each year and a death rate looming at 300,000 per year. Over the years, conventional risk factors including hypertension, type 2 diabetes, and dyslipidemia have been implicated for these unsavory statistics, and recently many studies have highlighted the important role of obesity as an independent risk factor for HF. Here, the authors review the available literature on the effects of overweight and obesity on a variety of cardiac structural adaptations and alterations, the effects on left ventricular systolic and diastolic function, and their role in the development and prognosis of HF. Numerous studies have demonstrated an “obesity paradox” regarding prognosis, however, in that obese patients with established HF tend to have a more favorable prognosis than do lean patients. Finally, the authors discuss the role of cardiopulmonary exercise testing in the risk stratification of obese patients with advanced HF.</i> </p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"3 3","pages":"155-161"},"PeriodicalIF":0.0,"publicationDate":"2008-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00001.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72327253","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}