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Wu S, Zhao W, Yu Z. Novel Targets and Potential Mechanisms of Mizuhopecten yessoensis-Derived Tripeptide NCW as Antihypertensive Peptides. Mol Nutr Food Res 2024:e2300552. [PMID: 38366946 DOI: 10.1002/mnfr.202300552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/07/2023] [Indexed: 02/19/2024]
Abstract
SCOPE Mizuhopecten yessoensis-derived tripeptide Asn-Cys-Trp (NCW) exhibits a potent antihypertensive effect in vivo. However, a lack of knowledge of the antihypertensive mechanism of tripeptide NCW limits its application for functional foods industrialization. The purpose of this study is to elucidate the corresponding targets and mechanisms of tripeptide NCW in hypertension regulation. METHODS AND RESULTS Administration of tripeptide NCW for 3 weeks, the blood pressure of spontaneously hypertensive rats (SHRs) is significantly decreased. After sacrifice, the serum sample is analyzed using tandem mass tag (TMT)-based liquid chromatography with tandem mass spectrometry to identify differentially expressed proteins. The proteomic analysis indicates that tripeptide NCW administration alters serum protein profiles in SHR rats, significantly upregulating 106 proteins and downregulating 30 proteins. These proteins enhance the glycolysis, glucose, and TCA cycle, improve amino metabolism, trigger the cAMP/PKA, cGMP/PKG, PI3K/AKT, and AMPK signal pathways, and inhibit Ras-regulated JNK activation, TGF-β/MAPK, and TGF-β/ RhoA/ROCK pathways. CONCLUSION Tripeptide NCW supplementation is demonstrated to regulate signal pathways involved in the control of blood pressure and regulate the energy and amino acids metabolic processes in serum, providing important insights into the protective effects of tripeptide NCW on hypertension.
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Affiliation(s)
- Sijia Wu
- School of Food Science and Engineering, Hainan University, Haikou, 570228, P.R. China
- College of Food Science and Engineering, Jilin University, Changchun, 130062, P.R. China
| | - Wenzhu Zhao
- School of Food Science and Engineering, Hainan University, Haikou, 570228, P.R. China
| | - Zhipeng Yu
- School of Food Science and Engineering, Hainan University, Haikou, 570228, P.R. China
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2
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Li Y, Xie D, Li L, Jiang P. Comprehensive analysis of metabolic changes in spontaneously hypertensive rats. Clin Exp Hypertens 2023; 45:2190529. [PMID: 36922753 DOI: 10.1080/10641963.2023.2190529] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/02/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVES Hypertension is a chronic disease with multiple causative factors that involve metabolic disturbances and can cause various complications. However, the metabolic characteristics of hypertension at different stages are still unclear. This study aimed to explore the metabolic changes induced by hypertension at different ages. METHODS Spontaneously hypertensive rats (SHR) and Wistar Kyoto (WKY) rats were divided into four groups according to age: 5-week-old SHR (n = 6), 5-week-old WKY rats (n = 6), 32-week-old SHR (n = 6), and 32-week-old WKY rats (n = 6). Metabolites were analyzed in primary tissues (serum, heart, lung, kidney, brain, and brown adipose) using a non-targeted metabolomics approach. RESULTS Thirty-five metabolites and nine related metabolic pathways were identified in 5-week-old SHR, mainly related to the metabolism of amino acids. Fifty-one metabolites and seven related metabolic pathways were identified in the 32-week-old SHR, involving glycolysis, lipid, and amino acid metabolisms. CONCLUSION This experiment elucidates the metabolic profile of SHR at different ages and provides a basis for predicting and diagnosing hypertension. It also provides a reference for the pathogenesis of hypertension.
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Affiliation(s)
- Yanan Li
- Translational Pharmaceutical Laboratory, Jining First People's Hospital, Shandong First Medical University, Jining, China
| | - Dadi Xie
- Department of Endocrinology, Tengzhou Central People's Hospital, Tengzhou, China
| | - Luxi Li
- College of Marine Life Sciences, Ocean University of China, Qingdao, China
| | - Pei Jiang
- Translational Pharmaceutical Laboratory, Jining First People's Hospital, Shandong First Medical University, Jining, China
- Institute of Translational Pharmacy, Jining Medical Research Academy, Jining, China
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3
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Jeremic J, Govoruskina N, Bradic J, Milosavljevic I, Srejovic I, Zivkovic V, Jeremic N, Nikolic Turnic T, Tanaskovic I, Bolevich S, Jakovljevic V, Bolevich S, Zivanovic MN, Okwose N, Seklic D, Milivojevic N, Grujic J, Velicki L, MacGowan G, Jakovljevic DG, Filipovic N. Sacubitril/valsartan reverses cardiac structure and function in experimental model of hypertension-induced hypertrophic cardiomyopathy. Mol Cell Biochem 2023; 478:2645-2656. [PMID: 36997815 DOI: 10.1007/s11010-023-04690-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 02/24/2023] [Indexed: 04/01/2023]
Abstract
This study evaluated the effect of sacubtril/valsartan on cardiac remodeling, molecular and cellular adaptations in experimental (rat) model of hypertension-induced hypertrophic cardiomyopathy. Thirty Wistar Kyoto rats, 10 healthy (control) and 20 rats with confirmed hypertension-induced hypertrophic cardiomyopathy (HpCM), were used for this study. The HpCM group was further subdivided into untreated and sacubitril/valsartan-treated groups. Myocardial structure and function were assessed using echocardiography, Langendorff's isolated heart experiment, blood sampling and qualitative polymerase chain reaction. Echocardiographic examinations revealed protective effects of sacubitril/valsartan by improving left ventricular internal diameter in systole and diastole and fractional shortening. Additionally, sacubitril/valsartan treatment decreased systolic and diastolic blood pressures in comparison with untreated hypertensive rats. Moreover, sacubitril/valsartan treatment reduced oxidative stress and apoptosis (reduced expression of Bax and Cas9 genes) compared to untreated rats. There was a regular histomorphology of cardiomyocytes, interstitium, and blood vessels in treated rats compared to untreated HpCM rats which expressed hypertrophic cardiomyocytes, with polymorphic nuclei, prominent nucleoli and moderately dilated interstitium. In experimental model of hypertension-induced hypertrophic cardiomyopathy, sacubitril/valsartan treatment led to improved cardiac structure, haemodynamic performance, and reduced oxidative stress and apoptosis. Sacubitril/valsartan thus presents as a potential therapeutic strategy resulted in hypertension-induced hypertrophic cardiomyopathy.
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Affiliation(s)
- Jovana Jeremic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Center of Excellence for Redox Balance Research, Cardiovascular and Metabolic Disorders, Kragujevac, Serbia
| | - Natalia Govoruskina
- Federal Clinical Center for High Medical, Technologies Federal Health Biological Agency, Moscow, Russia
| | - Jovana Bradic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Center of Excellence for Redox Balance Research, Cardiovascular and Metabolic Disorders, Kragujevac, Serbia
| | - Isidora Milosavljevic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Center of Excellence for Redox Balance Research, Cardiovascular and Metabolic Disorders, Kragujevac, Serbia
| | - Ivan Srejovic
- Center of Excellence for Redox Balance Research, Cardiovascular and Metabolic Disorders, Kragujevac, Serbia
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, 34000, Kragujevac, Serbia
- Department of Pharmacology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Vladimir Zivkovic
- Center of Excellence for Redox Balance Research, Cardiovascular and Metabolic Disorders, Kragujevac, Serbia
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, 34000, Kragujevac, Serbia
- Department of Pharmacology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Nevena Jeremic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Center of Excellence for Redox Balance Research, Cardiovascular and Metabolic Disorders, Kragujevac, Serbia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Tamara Nikolic Turnic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Center of Excellence for Redox Balance Research, Cardiovascular and Metabolic Disorders, Kragujevac, Serbia
- F.F. Erismann Institute of Public Health, N.A. Semashko Public Health and Healthcare Department, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Irena Tanaskovic
- Department of Histology and Embryology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Stefani Bolevich
- Department of Pharmacology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Pathophysiology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Vladimir Jakovljevic
- Center of Excellence for Redox Balance Research, Cardiovascular and Metabolic Disorders, Kragujevac, Serbia.
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, 34000, Kragujevac, Serbia.
- Department of Human Pathology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
| | - Sergey Bolevich
- Department of Human Pathology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Marko N Zivanovic
- Institute for Information Technologies Kragujevac, University of Kragujevac, Kragujevac, Serbia
- BioIRC - Bioengineering Research and Development Center, University of Kragujevac, Kragujevac, Serbia
| | - Nduka Okwose
- Translational and Clinical Research Instutute, Faculty of Medical Sciences, Newcastle University and Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Dragana Seklic
- Institute for Information Technologies Kragujevac, University of Kragujevac, Kragujevac, Serbia
| | - Nevena Milivojevic
- Institute for Information Technologies Kragujevac, University of Kragujevac, Kragujevac, Serbia
| | - Jelena Grujic
- Institute for Information Technologies Kragujevac, University of Kragujevac, Kragujevac, Serbia
| | - Lazar Velicki
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - Guy MacGowan
- Translational and Clinical Research Instutute, Faculty of Medical Sciences, Newcastle University and Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Djordje G Jakovljevic
- Translational and Clinical Research Instutute, Faculty of Medical Sciences, Newcastle University and Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Faculty Research Centre (CSELS), Faculty of Health and Life Sciences, Institute for Health and Wellbeing (CSELS), Coventry University, London, UK
| | - Nenad Filipovic
- BioIRC - Bioengineering Research and Development Center, University of Kragujevac, Kragujevac, Serbia
- Faculty of Engineering, University of Kragujevac, Kragujevac, Serbia
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Links between Metabolic Syndrome and Hypertension: The Relationship with the Current Antidiabetic Drugs. Metabolites 2023; 13:metabo13010087. [PMID: 36677012 PMCID: PMC9863091 DOI: 10.3390/metabo13010087] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/23/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
Hypertension poses a significant burden in the general population, being responsible for increasing cardiovascular morbidity and mortality, leading to adverse outcomes. Moreover, the association of hypertension with dyslipidaemia, obesity, and insulin resistance, also known as metabolic syndrome, further increases the overall cardiovascular risk of an individual. The complex pathophysiological overlap between the components of the metabolic syndrome may in part explain how novel antidiabetic drugs express pleiotropic effects. Taking into consideration that a significant proportion of patients do not achieve target blood pressure values or glucose levels, more efforts need to be undertaken to increase awareness among patients and physicians. Novel drugs, such as incretin-based therapies and renal glucose reuptake inhibitors, show promising results in decreasing cardiovascular events in patients with metabolic syndrome. The effects of sodium-glucose co-transporter-2 inhibitors are expressed at different levels, including renoprotection through glucosuria, natriuresis and decreased intraglomerular pressure, metabolic effects such as enhanced insulin sensitivity, cardiac protection through decreased myocardial oxidative stress and, to a lesser extent, decreased blood pressure values. These pleiotropic effects are also observed after treatment with glucagon-like peptide-1 receptor agonists, positively influencing the cardiovascular outcomes of patients with metabolic syndrome. The initial combination of the two classes may be the best choice in patients with type 2 diabetes mellitus and multiple cardiovascular risk factors because of their complementary mechanisms of action. In addition, the novel mineralocorticoid receptor antagonists show significant cardio-renal benefits, as well as anti-inflammatory and anti-fibrotic effects. Overall, the key to better control of hypertension in patients with metabolic syndrome is to consider targeting multiple pathogenic mechanisms, using a combination of the different therapeutic agents, as well as drastic lifestyle changes. This article will briefly summarize the association of hypertension with metabolic syndrome, as well as take into account the influence of antidiabetic drugs on blood pressure control.
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Onuh JO, Qiu H. Metabolic Profiling and Metabolites Fingerprints in Human Hypertension: Discovery and Potential. Metabolites 2021; 11:687. [PMID: 34677402 PMCID: PMC8539280 DOI: 10.3390/metabo11100687] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/28/2021] [Accepted: 10/05/2021] [Indexed: 12/12/2022] Open
Abstract
Early detection of pathogenesis through biomarkers holds the key to controlling hypertension and preventing cardiovascular complications. Metabolomics profiling acts as a potent and high throughput tool offering new insights on disease pathogenesis and potential in the early diagnosis of clinical hypertension with a tremendous translational promise. This review summarizes the latest progress of metabolomics and metabolites fingerprints and mainly discusses the current trends in the application in clinical hypertension. We also discussed the associated mechanisms and pathways involved in hypertension's pathogenesis and explored related research challenges and future perspectives. The information will improve our understanding of the development of hypertension and inspire the clinical application of metabolomics in hypertension and its associated cardiovascular complications.
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Affiliation(s)
| | - Hongyu Qiu
- Center for Molecular and Translational Medicine, Institute of Biomedical Sciences, Georgia State University, Atlanta, GA 30303, USA;
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Logette E, Lorin C, Favreau C, Oshurko E, Coggan JS, Casalegno F, Sy MF, Monney C, Bertschy M, Delattre E, Fonta PA, Krepl J, Schmidt S, Keller D, Kerrien S, Scantamburlo E, Kaufmann AK, Markram H. A Machine-Generated View of the Role of Blood Glucose Levels in the Severity of COVID-19. Front Public Health 2021; 9:695139. [PMID: 34395368 PMCID: PMC8356061 DOI: 10.3389/fpubh.2021.695139] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/30/2021] [Indexed: 01/08/2023] Open
Abstract
SARS-CoV-2 started spreading toward the end of 2019 causing COVID-19, a disease that reached pandemic proportions among the human population within months. The reasons for the spectrum of differences in the severity of the disease across the population, and in particular why the disease affects more severely the aging population and those with specific preconditions are unclear. We developed machine learning models to mine 240,000 scientific articles openly accessible in the CORD-19 database, and constructed knowledge graphs to synthesize the extracted information and navigate the collective knowledge in an attempt to search for a potential common underlying reason for disease severity. The machine-driven framework we developed repeatedly pointed to elevated blood glucose as a key facilitator in the progression of COVID-19. Indeed, when we systematically retraced the steps of the SARS-CoV-2 infection, we found evidence linking elevated glucose to each major step of the life-cycle of the virus, progression of the disease, and presentation of symptoms. Specifically, elevations of glucose provide ideal conditions for the virus to evade and weaken the first level of the immune defense system in the lungs, gain access to deep alveolar cells, bind to the ACE2 receptor and enter the pulmonary cells, accelerate replication of the virus within cells increasing cell death and inducing an pulmonary inflammatory response, which overwhelms an already weakened innate immune system to trigger an avalanche of systemic infections, inflammation and cell damage, a cytokine storm and thrombotic events. We tested the feasibility of the hypothesis by manually reviewing the literature referenced by the machine-generated synthesis, reconstructing atomistically the virus at the surface of the pulmonary airways, and performing quantitative computational modeling of the effects of glucose levels on the infection process. We conclude that elevation in glucose levels can facilitate the progression of the disease through multiple mechanisms and can explain much of the differences in disease severity seen across the population. The study provides diagnostic considerations, new areas of research and potential treatments, and cautions on treatment strategies and critical care conditions that induce elevations in blood glucose levels.
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Affiliation(s)
- Emmanuelle Logette
- Blue Brain Project, École polytechnique fédérale de Lausanne (EPFL), Geneva, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Henry Markram
- Blue Brain Project, École polytechnique fédérale de Lausanne (EPFL), Geneva, Switzerland
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Yan WF, Gao Y, Zhang Y, Guo YK, Wang J, Jiang L, Li Y, Yang ZG. Impact of type 2 diabetes mellitus on left ventricular diastolic function in patients with essential hypertension: evaluation by volume-time curve of cardiac magnetic resonance. Cardiovasc Diabetol 2021; 20:73. [PMID: 33766020 PMCID: PMC7993470 DOI: 10.1186/s12933-021-01262-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 03/16/2021] [Indexed: 02/08/2023] Open
Abstract
Background Essential hypertension and type 2 diabetes mellitus (T2DM) are two common chronic diseases that often coexist, and both of these diseases can cause heart damage. However, the additive effects of essential hypertension complicated with T2DM on left ventricle (LV) diastolic function have not been fully illustrated. This study aims to investigate whether T2DM affects the diastolic function of the LV in patients with essential hypertension using the volume-time curve from cardiac magnetic resonance (CMR). Methods A total of 124 essential hypertension patients, including 48 with T2DM [HTN(T2DM +) group] and 76 without T2DM [HTN(T2DM-) group], and 52 normal controls who underwent CMR scans were included in this study. LV volume-time curve parameters, including the peak ejection rate (PER), time to peak ejection rate (PET), peak filling rate (PFR), time to peak filling rate from end-systole (PFT), PER normalized to end-diastolic volume (PER/EDV), and PFR normalized to EDV (PFR/EDV), were measured and compared among the three groups. Multivariate linear regression analyses were performed to determine the effects of T2DM on LV diastolic dysfunction in patients with hypertension. Pearson correlation was used to analyse the correlation between the volume-time curve and myocardial strain parameters. Results PFR and PFR/EDV decreased from the control group, through HTN(T2DM −), to HTN(T2DM +) group. PFT in the HTN(T2DM-) group and HTN(T2DM +) group was significantly longer than that in the control group. The LV remodelling index in the HTN(T2DM −) and HTN(T2DM +) groups was higher than that in the normal control group, but there was no significant difference between the HTN(T2DM −) and HTN(T2DM +) groups. Multiple regression analyses controlling for covariates of systolic blood pressure, age, sex, and heart rate demonstrated that T2DM was independently associated with PFR/EDV (β = 0.252, p < 0.05). The volume-time curve method has good repeatability, and there is a significant correlation between volume-time curve parameters (PER/EDV and PFR/EDV) and myocardial peak strain rate, especially circumferential peak strain rate, which exhibited the highest correlation (r = − 0.756 ~ 0.795). Conclusions T2DM exacerbates LV diastolic dysfunction in patients with essential hypertension. The LV filling model changes reflected by the CMR volume-time curve could provide more information for early clinical intervention.
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Affiliation(s)
- Wei-Feng Yan
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yue Gao
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yi Zhang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Ying-Kun Guo
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, 20# South Renmin Road, Chengdu, Sichuan, 610041, P.R. China
| | - Jin Wang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Li Jiang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yuan Li
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
| | - Zhi-Gang Yang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
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8
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Lee J, Park W, Sung E, Kim B, Kim N, Park S, Shin C, Park J. The effect of oral glucose tolerance testing on changes in arterial stiffness and blood pressure in elderly women with hypertension and relationships between the stage of diabetes and physical fitness levels. Phys Act Nutr 2021; 24:34-43. [PMID: 33539693 PMCID: PMC7934524 DOI: 10.20463/pan.2020.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 12/30/2020] [Indexed: 11/23/2022] Open
Abstract
[Purpose] The purpose of this study was to assess changes in blood glucose level, blood pressure, and arterial stiffness after a 75 g oral glucose tolerance test (OGTT) in elderly women aged over 65 years with hypertension and either normal glycemic control, impaired fasting glucose tolerance, or diabetes mellitus. We also wished to investigate the relationship between stages of diabetes and physical fitness. [Methods] A total of 24 elderly women with hypertension were assigned to a control group (CON; n=7), impaired fasting glucose group (IFG; n=9), and diabetes mellitus group (DM; n=8). In each group, blood glucose level, brachial ankle pulse wave velocity (PWV), and blood pressure were measured at baseline as well as 60 and 120 minutes after a 75 g OGTT. Physical fitness factors such as hand grip strength, balance test, 4 m gait speed test, chair stand test, short physical performance battery, and 6-minute walking test were subsequently assessed. [Results] In all three groups, blood glucose levels were significantly increased at 60 and 120 minutes after a 75 g OGTT. In the DM group, blood glucose levels were significantly higher before and after a 75 g OGTT than in the CON group. In the CON group, PWV was significantly increased at 60 minutes after a 75 g OGTT; however, there were no changes in other groups after glucose ingestion. In the CON group, systolic and diastolic blood pressures were significantly decreased at 60 and 120 minutes after a 75 g OGTT compared to baseline. However, there was no change in blood pressure after ingestion in the DM group. The IFG group had greater grip strength than the CON group; however, there were no differences in other variables between the groups. [Conclusion] After a 75 g OGTT, elderly women with hypertension and diabetes maintain higher blood glucose levels compared to those with hypertension alone. Unlike elderly women with hypertension alone, those with hypertension and diabetes did not show changes in arterial stiffness and blood pressure after a 75 g OGTT. Therefore, elderly women with hypertension and diabetes may not be able to control their blood vessels following a 75 g OGTT due to impaired vascular endothelial function. Moreover, there was no association between diabetes stage and physical fitness in elderly women with hypertension.
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Affiliation(s)
- Jaesong Lee
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Wonil Park
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Eunsook Sung
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Bokbeom Kim
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Nahyun Kim
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Saejong Park
- Department of Sports Science, Korea Institute of Sport Science, Seoul, Republic of Korea
| | - Chulho Shin
- Department of Health Care, Namseoul University, Cheonan, Republic of Korea
| | - Jonghoon Park
- Department of Physical Education, Korea University, Seoul, Republic of Korea
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9
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Zhao H, Zhang Y, Liu B, Zhang L, Bao M, Li L, Zhao N, Hussain M, Wang Y, Yi J, Chen P, Lu C. A pilot study to identify the longitudinal serum metabolite profiles to predict the development of hyperuricemia in essential hypertension. Clin Chim Acta 2020; 510:466-474. [DOI: 10.1016/j.cca.2020.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/04/2020] [Accepted: 08/04/2020] [Indexed: 12/20/2022]
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10
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Colás A, Vigil L, Vargas B, Cuesta–Frau D, Varela M. Detrended Fluctuation Analysis in the prediction of type 2 diabetes mellitus in patients at risk: Model optimization and comparison with other metrics. PLoS One 2019; 14:e0225817. [PMID: 31851681 PMCID: PMC6919578 DOI: 10.1371/journal.pone.0225817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 11/13/2019] [Indexed: 11/18/2022] Open
Abstract
Complexity analysis of glucose time series with Detrended Fluctuation Analysis (DFA) has been proved to be useful for the prediction of type 2 diabetes mellitus (T2DM) development. We propose a modified DFA algorithm, review some of its characteristics and compare it with other metrics derived from continuous glucose monitorization in this setting. Several issues of the DFA algorithm were evaluated: (1) Time windowing: the best predictive value was obtained including all time-windows from 15 minutes to 24 hours. (2) Influence of circadian rhythms: for 48-hour glucometries, DFA alpha scaling exponent was calculated on 24-hour sliding segments (1-hour gap, 23-hour overlap), with a median coefficient of variation of 3.2%, which suggests that analysing time series of at least 24-hour length avoids the influence of circadian rhythms. (3) Influence of pretreatment of the time series through integration: DFA without integration was more sensitive to the introduction of white noise and it showed significant predictive power to forecast the development of T2DM, while the pretreated time series did not. (4) Robustness of an interpolation algorithm for missing values: The modified DFA algorithm evaluates the percentage of missing values in a time series. Establishing a 2% error threshold, we estimated the number and length of missing segments that could be admitted to consider a time series as suitable for DFA analysis. For comparison with other metrics, a Principal Component Analysis was performed and the results neatly tease out four different components. The first vector carries information concerned with variability, the second represents mainly DFA alpha exponent, while the third and fourth vectors carry essentially information related to the two “pre-diabetic behaviours” (impaired fasting glucose and impaired glucose tolerance). The scaling exponent obtained with the modified DFA algorithm proposed has significant predictive power for the development of T2DM in a high-risk population compared with other variability metrics or with the standard DFA algorithm.
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Affiliation(s)
- Ana Colás
- Department of Internal Medicine, Hospital 12 de Octubre, Madrid, Spain
| | - Luis Vigil
- Department of Internal Medicine, Hospital Universitario de Móstoles, Móstoles, Madrid, Spain
| | - Borja Vargas
- Department of Internal Medicine, Hospital Universitario de Móstoles, Móstoles, Madrid, Spain
- * E-mail:
| | - David Cuesta–Frau
- Technological Institute of Informatics, Universitat Politècnica de València, Alcoi Campus, Alcoi, Spain
| | - Manuel Varela
- Department of Internal Medicine, Hospital Universitario de Móstoles, Móstoles, Madrid, Spain
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Christiansen D, Eibye KH, Hostrup M, Bangsbo J. Blood flow-restricted training enhances thigh glucose uptake during exercise and muscle antioxidant function in humans. Metabolism 2019; 98:1-15. [PMID: 31199953 DOI: 10.1016/j.metabol.2019.06.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/31/2019] [Accepted: 06/05/2019] [Indexed: 10/26/2022]
Abstract
This study examined the effects of blood-flow-restricted (BFR)-training on thigh glucose uptake at rest and during exercise in humans and the muscular mechanisms involved. Ten active men (~25 y; VO2max ~50 mL/kg/min) completed six weeks of training, where one leg trained with BFR (cuff pressure: ~180 mmHg) and the other leg without BFR. Before and after training, thigh glucose uptake was determined at rest and during exercise at 25% and 90% of leg incremental peak power output by sampling of femoral arterial and venous blood and measurement of femoral arterial blood flow. Furthermore, resting muscle samples were collected. After training, thigh glucose uptake during exercise was higher than before training only in the BFR-trained leg (p < 0.05) due to increased glucose extraction (p < 0.05). Further, BFR-training substantially improved time to exhaustion during exhaustive exercise (11 ± 5% vs. CON-leg; p = 0.001). After but not before training, NAC infusion attenuated (~50-100%) leg net glucose uptake and extraction during exercise only in the BFR-trained leg, which coincided with an increased muscle abundance of Cu/Zn-SOD (39%), GPX-1 (29%), GLUT4 (28%), and nNOS (18%) (p < 0.05). Training did not affect Mn-SOD, catalase, and VEGF abundance in either leg (p > 0.05), although Mn-SOD was higher in BFR-leg vs. CON-leg after training (p < 0.05). The ratios of p-AMPK-Thr172/AMPK and p-ACC-Ser79/ACC, and p-ACC-Ser79, remained unchanged in both legs (p > 0.05), despite a higher p-AMPK-Thr172 in BFR-leg after training (38%; p < 0.05). In conclusion, BFR-training enhances glucose uptake by exercising muscles in humans probably due to an increase in antioxidant function, GLUT4 abundance, and/or NO availability.
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Affiliation(s)
- Danny Christiansen
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, 2100 Copenhagen Ø, Denmark.
| | - Kasper H Eibye
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, 2100 Copenhagen Ø, Denmark
| | - Morten Hostrup
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, 2100 Copenhagen Ø, Denmark
| | - Jens Bangsbo
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, 2100 Copenhagen Ø, Denmark
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12
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Almeman AA, Beshir YA, Aldosary AH. Comparison of the Effects of Metoprolol and Bisoprolol on Lipid and Glucose Profiles in Cardiovascular Patients. Curr Drug Saf 2019; 14:27-30. [PMID: 30370856 DOI: 10.2174/1574886313666181029101247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 10/22/2018] [Accepted: 10/26/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cardioselective beta-blockers may affect glucose or lipid profiles. OBJECTIVE We sought to compare the effects of two beta-blockers, metoprolol and bisoprolol, as the most commonly used drugs in cardiology, on glucose and lipid profiles in patients with cardiovascular diseases. METHODS We conducted a retrospective cross-sectional matched study at Prince Sultan Cardiac Center in Burydah in August 2017. Patient records were screened, and adult patients with cardiovascular disorders who were treated with a stable dose of metoprolol or bisoprolol were included. Parameters related to glucose and lipid metabolism were compared using the Student's t-test between the two groups. RESULTS AND CONCLUSION The metoprolol and bisoprolol arms included 204 and 200 patients, respectively.
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Affiliation(s)
- Ahmad Abdulrahman Almeman
- Clinical Pharmacology and Therapeutics Department, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Yasir Ahmed Beshir
- Interventional Cardiology Department, Prince Sultan Cardiac Center, Buraydah, Qassim, Saudi Arabia
| | - Ahmad Hamad Aldosary
- Family and Community Medicine Department, Unaizah College of Medicine and Medical Sciences, Qassim University, Qassim, Saudi Arabia
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13
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Polak-Iwaniuk A, Harasim-Symbor E, Gołaszewska K, Chabowski A. How Hypertension Affects Heart Metabolism. Front Physiol 2019; 10:435. [PMID: 31040794 PMCID: PMC6476990 DOI: 10.3389/fphys.2019.00435] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 03/29/2019] [Indexed: 01/15/2023] Open
Abstract
Hypertension is one of the most frequently observed cardiovascular diseases, which precedes heart failure in 75% of its cases. It is well-established that hypertensive patients have whole body metabolic complications such as hyperlipidemia, hyperglycemia, decreased insulin sensitivity or diabetes mellitus. Since myocardial metabolism is strictly dependent on hormonal status as well as substrate milieu, the above mentioned disturbances may affect energy generation status in the heart. Interestingly, it was found that hypertension induces a shift in substrate preference toward increased glucose utilization in cardiac muscle, prior to structural changes development. The present work reports advances in the aspect of heart metabolism under high blood pressure conditions, including human and the most common animal models of hypertension.
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Affiliation(s)
| | - Ewa Harasim-Symbor
- Department of Physiology, Medical University of Białystok, Białystok, Poland
| | | | - Adrian Chabowski
- Department of Physiology, Medical University of Białystok, Białystok, Poland
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14
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Yang M, Yu Z, Chen X, Guo Z, Deng S, Chen L, Wu Q, Liang F. Active Acupoints Differ from Inactive Acupoints in Modulating Key Plasmatic Metabolites of Hypertension: A Targeted Metabolomics Study. Sci Rep 2018; 8:17824. [PMID: 30546033 PMCID: PMC6292875 DOI: 10.1038/s41598-018-36199-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 11/15/2018] [Indexed: 11/09/2022] Open
Abstract
The effect of active acupoints versus inactive acupoints in treating hypertension is not well documented. Metabolic phenotypes, depicted by metabolomics analysis, reflect the influence of external exposures, nutrition, and lifestyle on the integrated system of the human body. Therefore, we utilized high-performance liquid chromatography tandem mass spectrometry to compare the targeted metabolic phenotype changes induced by two different acupoint treatments. The clinical outcomes show that active acupoint treatment significantly lowers 24-hour systolic blood pressure but not diastolic blood pressure, as compared with inactive acupoint treatment. Furthermore, distinctive changes are observed between the metabolomics data of the two groups. Multivariate analysis shows that only in the active acupoint treatment group can the follow-up plasma be clearly separated from the baseline plasma. Moreover, the follow-up plasma of these two groups can be clearly separated, indicating two different post-treatment metabolic phenotypes. Three metabolites, sucrose, cellobiose, and hypoxanthine, are shown to be the most important features of active acupoint treatment. This study demonstrates that metabolomic analysis is a potential tool that can be used to efficiently differentiate the effect of active acupoints from inactive acupoints in treating hypertension. Possible mechanisms are the alternation of hypothalamic microinflammation and the restoration of host-gut microbiota interactions induced by acupuncture.
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Affiliation(s)
- Mingxiao Yang
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, 37 Shierqiao Road, Jinniu Street, Chengdu, 610075, Sichuan, China.,School of Chinese Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong SAR, China.,Department of Chinese Medicine, The University of Hong Kong-Shenzhen Hospital, 1 Haiyuan Road, Futian District, Shenzhen, 518053, Guangdong, China
| | - Zheng Yu
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, 37 Shierqiao Road, Jinniu Street, Chengdu, 610075, Sichuan, China
| | - Xiaomin Chen
- Metabolomics, Scientific Technology Department, BGI, Beishan Industrial Zone, Yantian District, Shenzhen, 518083, Guangdong, China
| | - Zhenyu Guo
- Metabolomics, Scientific Technology Department, BGI, Beishan Industrial Zone, Yantian District, Shenzhen, 518083, Guangdong, China
| | - Shufang Deng
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, 37 Shierqiao Road, Jinniu Street, Chengdu, 610075, Sichuan, China
| | - Lin Chen
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, 37 Shierqiao Road, Jinniu Street, Chengdu, 610075, Sichuan, China
| | - Qiaofeng Wu
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, 37 Shierqiao Road, Jinniu Street, Chengdu, 610075, Sichuan, China.
| | - Fanrong Liang
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, 37 Shierqiao Road, Jinniu Street, Chengdu, 610075, Sichuan, China.
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15
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Mosleh W, Sharma A, Sidhu MS, Page B, Sharma UC, Farkouh ME. The Role of SGLT-2 Inhibitors as Part of Optimal Medical Therapy in Improving Cardiovascular Outcomes in Patients with Diabetes and Coronary Artery Disease. Cardiovasc Drugs Ther 2018; 31:311-318. [PMID: 28536852 DOI: 10.1007/s10557-017-6729-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The optimal treatment approach to patients with coronary artery disease (CAD), including those with type 2 diabetes mellitus (T2DM), has been extensively evaluated. Several trials of stable ischemic heart disease including patients with T2DM have demonstrated that medical management is comparable to revascularization in terms of mortality and rates of major adverse cardiovascular events (MACE). There has been a growing appreciation for optimal medical therapy's (OMT) role in improving clinical outcomes. It is vital to target T2DM patients to prevent or delay MACE events through advanced OMT, ultimately delaying if not avoiding the need for revascularization. There has been significant evolution in the development of pharmacologic management of T2DM patients. Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a new pharmacologic therapy with tremendous potential to alter clinical practice and influence practice guidelines. SGLT2-inhibitors have great potential in reducing MACE in patients with T2DM and CAD. Empagliflozin should be considered as a part of OMT among these patients. If results similar to the EMPA-REG OUTCOMES trial are replicated in other trials, the use of these pharmacologic agents as a part of OMT may narrow the gap between revascularization and OMT alone in patients with T2DM and multi-vessel disease. Future studies on the role of SLGT-2 inhibitors with regard to heart failure outcomes are needed to elucidate the mechanisms and clinical effects in this vulnerable population.
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Affiliation(s)
- Wassim Mosleh
- University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Abhinav Sharma
- Duke Clinical Research Institute, Duke University, Durham, NC, USA
| | - Mandeep S Sidhu
- Department of Medicine, Albany Medical College, Albany Medical Center, Albany, NY, USA
| | - Brian Page
- University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Umesh C Sharma
- University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Michael E Farkouh
- Peter Munk Cardiac Centre, University Health Network, 585 University Avenue, 4N474, Toronto, ON, M5G 2N2, Canada. .,The Heart and Stroke Richard Lewar Centre of Excellence in Cardiovascular Research, University of Toronto, Toronto, ON, Canada.
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16
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Colas A, Vigil L, Rodríguez de Castro C, Vargas B, Varela M. New insights from continuous glucose monitoring into the route to diabetes. Diabetes Metab Res Rev 2018. [PMID: 29516622 DOI: 10.1002/dmrr.3002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
AIM Type 2 diabetes mellitus (T2DM) is preceded by a period of impaired glucoregulation. We investigated if continuous glucose monitoring system (CGMS) (1) could improve our capacity to predict the development of T2DM in subjects at risk. (2) Find out if impaired fasting glucose/impaired glucose tolerance differentiation through CGMS would also elucidate differences in clinical phenotypes. MATERIAL AND METHODS Observational study of 209 hypertensive patients, aged 18 to 85 years who wore at entry a CGMS. Two CGMS metrics, percent of time under the 100 mg/dL glycaemic threshold (TU100) (impaired fasting glucose surrogate phenotype) and area above the 140 mg/dL glycemic threshold (AO140) (impaired glucose tolerance surrogate phenotype) were measured. The median follow-up was 32 months (6-72 mo), and there were 17 new cases of T2DM. RESULTS In a multivariate Cox proportional hazard survival analysis including the conventional prediabetes-defining criteria and the 2 CGMS-derived variables, only TU100 and HbA1c were significant and independent variables in predicting T2DM development. An increase in 0.1 in TU100 resulted in a 0.69 (95% CI, 0.54-0.88; P < .01) odds ratio of developing T2DM. With cut-off points of 0.5 for TU100 and 5.7% for HbA1c , the test "TU < 0.5 and HbA1c > 5.7%" had a sensitivity of 0.81 (SD, 0.10), a specificity of 0.83 (SD, 0.03), and a likelihood ratio of 4.82 (SD, 1.03) for T2DM development. CONCLUSIONS Continuous glucose monitoring system allows for a better T2DM risk-development categorization than fasting glucose and HbA1c in a high-risk population. Continuous glucose monitoring system-derived phenotyping reveals clinical differences, not disclosed by conventional fasting plasma glucose/HbA1c categorization. These differences may correlate with distinct pathophysiological mechanisms.
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Affiliation(s)
- Ana Colas
- Internal Medicine, Hospital Universitario de Móstoles, Móstoles, Madrid, Spain
| | - Luis Vigil
- Internal Medicine, Hospital Universitario de Móstoles, Móstoles, Madrid, Spain
| | | | - Borja Vargas
- Internal Medicine, Hospital Universitario de Móstoles, Móstoles, Madrid, Spain
| | - Manuel Varela
- Internal Medicine, Hospital Universitario de Móstoles, Móstoles, Madrid, Spain
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Management of hypertension and diabetes mellitus by cardiovascular and endocrine physicians: a China registry. J Hypertens 2017; 34:1648-53. [PMID: 27270188 PMCID: PMC4933577 DOI: 10.1097/hjh.0000000000000994] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Objective: We investigated hypertension and diabetes mellitus in two management settings, namely cardiology and endocrinology, and their associations with albuminuria while accounting for the management of these two diseases. Methods: Our multicentre registry included patients (≥20 years) seen for hypertension in cardiology or for diabetes mellitus in endocrinology. We administered a questionnaire and measured blood pressure, glycosylated haemoglobin A1c and albuminuria. Results: Presence of both hypertension and diabetes was observed in 32.9% of hypertensive patients in cardiology (n = 1291) and 58.9% of diabetic patients in endocrinology (n = 1168). When both diseases were present, the use of combination antihypertensive therapy [odds ratio (OR) 0.31, P < 0.0001] and inhibitors of the renin–angiotensin system (OR 0.66, P = 0.0009) was less frequent in endocrinology than cardiology, and the use of combination antidiabetic therapy (OR 0.16, P < 0.0001) was less frequent in cardiology than endocrinology. The control of hypertension and diabetes, however, was not different between the two management settings (P ≥ 0.21), regardless of the therapeutic target (SBP/DBP < 140/90 or 130/80 mmHg and glycosylated haemoglobin A1c <7.0 or 6.5%). The prevalence of albuminuria was higher (P ≤ 0.02) in the presence of both diseases (23.3%) than those with either hypertension (12.6%) or diabetes alone (15.9%). Conclusion: Hypertension and diabetes mellitus were often jointly present, especially in the setting of endocrinology. The management was insufficient on the use of combination antihypertensive therapy and inhibitors of the renin–angiotensin system in endocrinology and for combination antidiabetic therapy in cardiology, indicating a need for more intensive management and better control of both clinical conditions.
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Huang XB, Tang WW, Liu Y, Hu R, Ouyang LY, Liu JX, Li XJ, Yi YJ, Wang TD, Zhao SP. Prevalence of diabetes and unrecognized diabetes in hypertensive patients aged 40 to 79 years in southwest China. PLoS One 2017; 12:e0170250. [PMID: 28192474 PMCID: PMC5305248 DOI: 10.1371/journal.pone.0170250] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 12/31/2016] [Indexed: 02/05/2023] Open
Abstract
This study aimed to assess the prevalence of diabetes and unrecognized diabetes in hypertensive patients aged 40 to 79 years in Southwest China. From September 2013 to March 2014, a cross-sectional survey was conducted in 4021 hypertensive patients aged 40 to 79 years living in Chengdu and Chongqing, China. Fasting plasma glucose (FPG) and 2h plasma glucose (2-hPG) in an oral glucose-tolerance test (OGTT) were used for assessments. Whether the patients previously had diabetes (DM) was determined by their own reports. The survey was carried out by the same questionnaire for all respondents. DM prevalence was 32.0% in hypertensive patients aged 40 to 79 years in Southwest China, with the rates of 29.6% and 33.5% in men and women, respectively (P<0.001). DM prevalence increased with age age and body-mass index. DM prevalence rates were 16.9%, 24.7%, 38.2% and 41.9% in hypertensive patients aged 40-49, 50-59, 60-69 and over 70, respectively. DM prevalence were 30.6%, 27.9%, 37.1%, and 37.4%, for BMI<18.5, 18.5-24.9, 25.0-29.9, and ≥30, respectively. Prevalence of unrecognized DM were 20.8% in hypertensive patients aged 40 to 79 years in Southwest China. Using only fasting blood glucose testing without OGTT would have resulted in 65.0% of missed DM diagnosis in these newly diagnosed patients. The prevalence of DM and unrecognized DM were high in hypertensive patients aged 40 to 79 years in Southwest China.These findings indicate that hypertensive patients aged 40 to 79 years should regularly submit to community-based OGTT screening for timely DM diagnosis.
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Affiliation(s)
- Xiao-bo Huang
- Department of Cardiology, Cent S Univ, Xiangya Hosp 2, Changsha, Hunan, China
- Department of Cardiology, the second people’s hospital of Chengdu, Chengdu, Sichuan Province, China
| | - Wei-wei Tang
- West China School of Public Health, Sichuan University, Chengdu, Sichuan Province, China
| | - Ya Liu
- Department of Cardiology, the second people’s hospital of Chengdu, Chengdu, Sichuan Province, China
| | - Rong Hu
- Division of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ling-yun Ouyang
- Department of Endocrinology and Metabolism, the second people’s hospital of Chengdu, Chengdu, Sichuan Province, China
| | - Jian-xiong Liu
- Department of Cardiology, the second people’s hospital of Chengdu, Chengdu, Sichuan Province, China
| | - Xiu-jun Li
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, People’s Republic of China
| | - Yan-jing Yi
- Department of Cardiology, the second people’s hospital of Chengdu, Chengdu, Sichuan Province, China
| | - Tzung-Dau Wang
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan
| | - Shui-ping Zhao
- Department of Cardiology, Cent S Univ, Xiangya Hosp 2, Changsha, Hunan, China
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Huang Z, Chen C, Li S, Kong F, Shan P, Huang W. Combined Treatment with Amlodipine and Atorvastatin Calcium Reduces Circulating Levels of Intercellular Adhesion Molecule-1 and Tumor Necrosis Factor-α in Hypertensive Patients with Prediabetes. Front Aging Neurosci 2016; 8:206. [PMID: 27610083 PMCID: PMC4996984 DOI: 10.3389/fnagi.2016.00206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 08/11/2016] [Indexed: 01/23/2023] Open
Abstract
Objective: To assess the effect of amlodipine and atorvastatin on intercellular adhesion molecule (ICAM)-1 and tumor necrosis factor (TNF)-α expression, as endothelial function and inflammation indicators, respectively, in hypertensive patients with and without prediabetes. Methods: Forty-five consecutive patients with hypertension, diagnosed according to JNC7, were divided into two groups based on the presence (HD group, n = 23) or absence (H group, n = 22) of prediabetes, diagnosed according to 2010 ADA criteria, including impaired glucose tolerance (IGT) and fasting glucose tests. All patients simultaneously underwent 12-week treatment with daily single-pill amlodipine besylate/atorvastatin calcium combination (5/10 mg; Hisun-Pfizer Pharmaceuticals Co. Ltd). Serum isolated before and after treatment from overnight fasting blood samples was analyzed by ELISA. Results: In the HD and H groups after vs. before 12-week amlodipine/atorvastatin treatment, there were significantly (all P < 0.01) lower levels of ICAM-1 (3.06 ± 0.34 vs. 4.07 ± 0.70 pg/ml; 3.26 ± 0.32 vs. 3.81 ± 0.60 pg/ml, respectively) and TNF-α (78.71 ± 9.19 vs. 110.94 ± 10.71 pg/ml; 80.95 ± 9.33 vs. 101.79 ± 11.72 pg/ml, respectively), with more pronounced reductions in HD vs. H group (ICAM-1Δ: 1.01 ± 0.80 vs. 0.55 ± 0.64 pg/ml, respectively, P = 0.037; TNF-αΔ: 32.23 ± 14.33 vs. 20.84 ± 14.89 pg/ml, respectively, P = 0.011), independent of the blood pressure (BP) and cholesterol level reduction. Conclusions: Amlodipine/atorvastatin improved endothelial function and inflammation, as reflected by lower circulating levels of ICAM-1 and TNF-α, more prominently in hypertensives with than without prediabetes. Starting statin treatment before overt diabetes in hypertensives might thus improve cardiovascular outcomes.
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Affiliation(s)
- Zhouqing Huang
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University WenZhou, ZheJiang, China
| | - Chen Chen
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University WenZhou, ZheJiang, China
| | - Sheng Li
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University WenZhou, ZheJiang, China
| | - Fanqi Kong
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University WenZhou, ZheJiang, China
| | - Peiren Shan
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University WenZhou, ZheJiang, China
| | - Weijian Huang
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University WenZhou, ZheJiang, China
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Zhan Y, Hu D, Yu J. Current status of glucose test prescription for hypertensive outpatients. Clin Exp Hypertens 2016; 38:550-4. [PMID: 27392259 DOI: 10.3109/10641963.2016.1174250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The prescription of glucose test for essential hypertensive patients is estimated to be very low in cardiology clinics, but it has not been well studied. The aim of the present study aimed to investigate glucose test prescription for the hypertensive outpatients. METHODS Five thousand two hundred and forty hypertensive outpatients without previous known diabetes were recruited consecutively by cardiologists from >90 hospitals. Blood glucose prescription records were collected by special investigators. RESULTS Of the 5240 hypertensive outpatients recruited, only 258 (4.92%) were prescribed glucose tests, and 12.17% and 42.61% of them were diagnosed with diabetes mellitus and impaired glucose tolerance, respectively. Patients' hypertension stage, cardiovascular disease history, diabetes family history, dyslipidemia, and hospital level were associated with higher odds of glucose tests prescription. CONCLUSION Glucose tests were poorly prescribed for hypertensive outpatients in China. It was highly recommended to raise cardiologists' awareness to prescribe glucose tests for hypertensive outpatients who were with high cardiovascular risk factors.
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Affiliation(s)
- Yiqiang Zhan
- a School of Public Health , Institute of Clinical Epidemiology, Fudan University , Shanghai , P. R. China
| | - Dayi Hu
- b Heart Center , Peking University People's Hospital , Beijing , P. R. China
| | - Jinming Yu
- a School of Public Health , Institute of Clinical Epidemiology, Fudan University , Shanghai , P. R. China
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21
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A Targeted Metabolomics MRM-MS Study on Identifying Potential Hypertension Biomarkers in Human Plasma and Evaluating Acupuncture Effects. Sci Rep 2016; 6:25871. [PMID: 27181907 PMCID: PMC4867614 DOI: 10.1038/srep25871] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 04/22/2016] [Indexed: 02/08/2023] Open
Abstract
The critical role of metabolic abnormality in hypertension is increasingly recognized, but its biomarkers are not clearly identified. In this study, 47 chemical compounds recorded by literature were employed as target metabolites of essential hypertension (EH). We detected their content in the plasma of EH patients and healthy subjects by using the Multiple Reaction Monitoring-Mass Spectrometry (MRM-MS). After screening the most altered compounds, acupuncture was used to treat patients for 3 months and these plasma metabolites were tested again. The results showed that oleic acid (OA) and myoinositol (MI) were the most important differential metabolites between the hypertensive plasma and the healthy plasma. They were also closely correlated with 24-hour blood pressure and nocturnal dipping. Moreover, plasma OA and MI could be restored to normal levels by acupuncture, accompanying with reduction of 24-hour systolic and diastolic blood pressure [from 145.10 ± 9.28 mm Hg to 140.70 ± 9.59 mm Hg (P < 0.0001), and 88.35 ± 7.92 mm Hg to 85.86 ± 7.95 mm Hg (P = 0.0024), respectively] and improvement of circadian blood pressure rhythm. This study demonstrated that plasma OA and MI were potential hypertension biomarkers and they could be used to preliminarily assess the treating effects such as acupuncture.
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22
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Huang Z, Chen C, Li S, Kong F, Shan P, Huang W. Serum Markers of Endothelial Dysfunction and Inflammation Increase in Hypertension with Prediabetes Mellitus. Genet Test Mol Biomarkers 2016; 20:322-7. [PMID: 27167462 DOI: 10.1089/gtmb.2015.0255] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
AIMS The aim of this study was to examine endothelial dysfunction and inflammation in hypertension and prediabetes by studying adhesion molecules and inflammatory factors. METHODS AND RESULTS This study included 133 outpatients. Participants were categorized into three groups based on the presence or absence of hypertension and prediabetes: control subjects without prediabetes and hypertension (N group, n = 39); patients with hypertension only (H group, n = 34); and patients with hypertension and prediabetes (HD group, n = 60). Hypertension was diagnosed according to JNC7 criteria. Prediabetes was defined according to 2010 American Diabetes Association criteria. Plasma was isolated from overnight fasting blood samples for enzyme-linked immunosorbent assay (ELISA) analysis of concentrations of intercellular adhesion molecule-1 (ICAM-1), tumor necrosis factor-α (TNF-α), P-selectin, and interleukin-6 (IL-6) as indicators of endothelial function and inflammation. We found that the H and HD groups showed significantly higher levels of all four biomarkers compared with the N group (all p < 0.01). The HD group also showed significantly higher levels of ICAM-1 (p = 0.042) and TNF-α (p < 0.01) compared with the H group; no significant differences in P-selectin (p = 0.59) and IL-6 (p = 0.70) levels were observed among these groups. CONCLUSIONS Prediabetes and hypertension induce endothelial dysfunction and inflammation by elevating levels of soluble adhesion molecules and inflammatory cytokines. The comorbidity of these diseases may exacerbate inflammation and endothelial dysfunction by enhancing the expression of ICAM-1 and TNF-α.
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Affiliation(s)
- Zhouqing Huang
- Department of Cardiology, The Key Lab of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Wenzhou, P.R. China
| | - Chen Chen
- Department of Cardiology, The Key Lab of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Wenzhou, P.R. China
| | - Sheng Li
- Department of Cardiology, The Key Lab of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Wenzhou, P.R. China
| | - Fanqi Kong
- Department of Cardiology, The Key Lab of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Wenzhou, P.R. China
| | - Peiren Shan
- Department of Cardiology, The Key Lab of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Wenzhou, P.R. China
| | - Weijian Huang
- Department of Cardiology, The Key Lab of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Wenzhou, P.R. China
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Au A, Cheng KK, Wei LK. Metabolomics, Lipidomics and Pharmacometabolomics of Human Hypertension. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 956:599-613. [PMID: 27722964 DOI: 10.1007/5584_2016_79] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Hypertension is a common but complex human disease, which can lead to a heart attack, stroke, kidney disease or other complications. Since the pathogenesis of hypertension is heterogeneous and multifactorial, it is crucial to establish a comprehensive metabolomic approach to elucidate the molecular mechanism of hypertension. Although there have been limited metabolomic, lipidomic and pharmacometabolomic studies investigating this disease to date, metabolomic studies on hypertension have provided greater insights into the identification of disease-specific biomarkers, predicting treatment outcome and monitor drug safety and efficacy. Therefore, we discuss recent updates on the applications of metabolomics technology in human hypertension with a focus on metabolic biomarker discovery.
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Affiliation(s)
- Anthony Au
- Institute of Bioproduct Development and Department of Bioprocess Engineering, Faculty of Chemical Engineering, Universiti Teknologi Malaysia, 81300, Johor, Malaysia.
| | - Kian-Kai Cheng
- Institute of Bioproduct Development and Department of Bioprocess Engineering, Faculty of Chemical Engineering, Universiti Teknologi Malaysia, 81300, Johor, Malaysia.,Innovation Centre in Agritechnology, Universiti Teknologi Malaysia, 81300, Johor, Malaysia
| | - Loo Keat Wei
- Centre for Biodiversity Research, Universiti Tunku Abdul Rahman, Bandar Barat, 31900, Kampar, Perak, Malaysia.,Department of Biological Science, Faculty of Science, Universiti Tunku Abdul Rahman, Bandar Barat, 31900, Kampar, Perak, Malaysia
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24
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Altered erythrocyte membrane protein composition mirrors pleiotropic effects of hypertension susceptibility genes and disease pathogenesis. J Hypertens 2015; 33:2265-77. [DOI: 10.1097/hjh.0000000000000699] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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25
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Dangas GD, Farkouh ME, Sleeper LA, Yang M, Schoos MM, Macaya C, Abizaid A, Buller CE, Devlin G, Rodriguez AE, Lansky AJ, Siami FS, Domanski M, Fuster V. Long-Term Outcome of PCI Versus CABG in Insulin and Non–Insulin-Treated Diabetic Patients. J Am Coll Cardiol 2014; 64:1189-97. [DOI: 10.1016/j.jacc.2014.06.1182] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 05/14/2014] [Accepted: 06/16/2014] [Indexed: 10/24/2022]
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26
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Vigil L, Condés E, Varela M, Rodriguez C, Colas A, Vargas B, Lopez M, Cirugeda E. Glucose series complexity in hypertensive patients. ACTA ACUST UNITED AC 2014; 8:630-6. [PMID: 25065679 DOI: 10.1016/j.jash.2014.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 05/13/2014] [Accepted: 05/14/2014] [Indexed: 10/25/2022]
Abstract
Nonlinear methods have been applied to the analysis of biological signals. Complexity analysis of glucose time series may be a useful tool for the study of the initial phases of glucoregulatory dysfunction. This observational, cross-sectional study was performed in patients with essential hypertension. Glucose complexity was measured with detrended fluctuation analysis (DFA), and glucose variability was measured by the mean amplitudes of glycemic excursion (MAGE). We included 91 patients with a mean age of 59 ± 10 years. We found significant correlations for the number of metabolic syndrome (MS)-defining criteria with DFA (r = 0.233, P = .026) and MAGE (r = 0.396, P < .0001). DFA differed significantly between patients who complied with MS and those who did not (1.44 vs. 1.39, P = .018). The MAGE (f = 5.3, P = .006), diastolic blood pressures (f = 4.1, P = .018), and homeostasis model assessment indices (f = 4.2, P = .018) differed between the DFA tertiles. Multivariate analysis revealed that the only independent determinants of the DFA values were MAGE (β coefficient = 0.002, 95% confidence interval: 0.001-0.004, P = .001) and abdominal circumference (β coefficient = 0.002, 95% confidence interval: 0.000015-0.004, P = .048). In our population, DFA was associated with MS and a number of MS criteria. Complexity analysis seemed to be capable of detecting differences in variables that are arguably related to the risk of the development of type 2 diabetes.
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Affiliation(s)
- Luis Vigil
- Department of Internal Medicine, University Hospital of Mostoles, Madrid, Spain.
| | - Emilia Condés
- Universidad Europea de Madrid (Campus Villaviciosa de Odón), Madrid, Spain
| | - Manuel Varela
- Department of Internal Medicine, University Hospital of Mostoles, Madrid, Spain
| | - Carmen Rodriguez
- Department of Internal Medicine, University Hospital of Mostoles, Madrid, Spain
| | - Ana Colas
- Department of Internal Medicine, University Hospital of Mostoles, Madrid, Spain
| | - Borja Vargas
- Department of Internal Medicine, University Hospital of Mostoles, Madrid, Spain
| | - Manuel Lopez
- Department of Internal Medicine, University Hospital of Mostoles, Madrid, Spain
| | - Eva Cirugeda
- Computer Science Department (DISCA), Polytechnic University of Valencia, Alcoi, Spain
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Liu J, Zhao D, Liu J, Qi Y, Sun J, Wang W. Prevalence of diabetes mellitus in outpatients with essential hypertension in China: a cross-sectional study. BMJ Open 2013; 3:e003798. [PMID: 24259390 PMCID: PMC3840347 DOI: 10.1136/bmjopen-2013-003798] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To investigate the prevalence of diabetes mellitus (DM) and new detection of DM using fasting plasma glucose (FPG) and 2 h plasma glucose (2-hPG) in hypertensive outpatients in China. DESIGN Multicenter cross-sectional study. SETTING 46 hospitals in China. PARTICIPANTS Study patients were consecutively recruited from June to December 2009 from hypertension outpatient clinics in 46 hospitals in 22 provinces, autonomous regions and municipalities in China. At least 100 consecutive patients were recruited in each hospital. FPG was measured for all patients and 2-hPG was measured in those without a history of DM. A total of 4942 hypertensive outpatients aged ≥20 years were included. RESULTS Prevalence of DM was 24.3% (which included both previously and newly diagnosed cases). Among the 1202 patients with DM, 417 (34.7%) were newly detected. In patients aged <45 years, 52.6% of cases of DM were newly detected. Of the 417 cases of newly detected diabetes, 54.9% were identified using FPG tests and the remaining 45.1% by 2-hPG tests; 27.1% of patients with newly detected DM had FPG <6.1 mmol/L and 16.5% had FPG <5.6 mmol/L. Among the elderly patients (≥65 years), 32.4% had normal FPG (<6.1 mmol/L) and 24.5% had optimal FPG (<5.6 mmol/L). CONCLUSIONS Our findings showed a high prevalence of DM and newly detected DM among Chinese hypertensive outpatients. Application of additional 2-hPG testing to FPG assay can improve the detection rate of DM, especially in elderly patients.
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Affiliation(s)
- Jun Liu
- Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
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Ndisang JF, Mishra M. The heme oxygenase system selectively suppresses the proinflammatory macrophage m1 phenotype and potentiates insulin signaling in spontaneously hypertensive rats. Am J Hypertens 2013; 26:1123-31. [PMID: 23757400 DOI: 10.1093/ajh/hpt082] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The mechanisms by which heme oxygenase (HO) improves glucose metabolism in essential hypertension are not completely understood. Because dysfunctional insulin signaling is associated with elevated inflammation and high cholesterol and triglycerides, we investigated the effects of HO on the proinflammatory macrophage M1 phenotype and the anti-inflammatory macrophage M2 phenotype in spontaneously hypertensive rats (SHRs). SHRs are a model of human essential hypertension with features of metabolic syndrome, including impaired glucose metabolism. METHODS Spectrophotometric analysis, enzyme immunoassay, enzyme-linked immunosorbent assay, and Western immunoblotting were used. HO was enhanced with hemin or inhibited with chromium-mesoporphyrin (CrMP). RESULTS Hemin suppressed inflammation by abating proinflammatory macro phage M1 phenotype (ED1) and chemokines such as macrophage chemoattractant protein 1 (MCP-1) and macrophage inflammatory protein 1 alpha (MIP-1α) while enhancing anti-inflammatory macrophage M2 phenotype by potentiating ED2, CD206, and CD14. Similarly, hemin improved insulin signaling by enhancing insulin receptor substrate 1 (IRS-1), IRS-2, phosphatidylinositol 3 kinase (PI3K), and glucose transporter 4 (GLUT4) but reduced total cholesterol and triglycerides. These effects were accompanied by increased HO-1, HO activity, and cyclic guanosine monophosphate (cGMP), whereas the HO inhibitor CrMP nullified the hemin effects. Importantly, the effects of the HO system on ED1, ED2, CD206, and CD14 in SHRs are novel. CONCLUSIONS Hemin abated inflammation in SHRs by selectively enhancing the anti-inflammatory macrophage M2 phenotype that dampens inflammation while suppressing the pronflammatory macrophage M1 phenotype and related chemokines such as MCP-1 and MIP-1α. Importantly, the reduction of inflammation, total cholesterol, and triglycerides was accompanied by the enhancement of important proteins implicated in insulin signaling, including IRS-1, IRS-2, PI3K, and GLUT4. Thus, the concomitant reduction of inflammation, total cholesterol and triglycerides and the corresponding potentiation of insulin signaling are among the multifaceted mechanisms by which the HO system improves glucose metabolism in essential hypertension.
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Affiliation(s)
- Joseph Fomusi Ndisang
- Department of Physiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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29
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Akande TO, Adeleye JO, Kadiri S. Insulin resistance in Nigerians with essential hypertension. Afr Health Sci 2013; 13:655-60. [PMID: 24250303 DOI: 10.4314/ahs.v13i3.19] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Reports on the association between hypertension and insulin resistance have been inconsistent even though most studies show a definite association. It is also not certain if the association between insulin resistance and hypertension applies to all populations. OBJECTIVE To determine the prevalence of insulin resistance in hypertensive Nigerians and to examine the association of insulin resistance with hypertension and some anthropometric indices. METHODS Thirty five adults with essential hypertension and thirty five normotensives were studied. Anthropometric parameters, blood pressure, fasting glucose and insulin were measured. Homeostasis model assessment (HOMA) was used to determine insulin resistance (IR). RESULTS The hypertensive subjects had significantly higher fasting insulin and HOMA-IR compared with normotensives (p = 0.02 and 0.04) respectively. There were significant correlations between HOMA-IR, BMI, waist and hip circumference in subjects with hypertension. At multiple linear regression, hypertension and body mass index were found to be the only significant predictors of insulin resistance. CONCLUSION The hypertensives we studied had a higher occurrence of insulin resistance compared to the normotensives. This makes it necessary for persons with hypertensive to have regular screening for diabetes and other categories of glucose intolerance as the increased insulin increases their risk of developing type 2 diabetes mellitus.
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Affiliation(s)
- T O Akande
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
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30
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Deedwania P, Shea J, Chen W, Brener L. Effects of Add-On Nebivolol on Blood Pressure and Glucose Parameters in Hypertensive Patients With Prediabetes. J Clin Hypertens (Greenwich) 2013; 15:270-8. [DOI: 10.1111/jch.12071] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 11/16/2012] [Accepted: 12/20/2012] [Indexed: 11/26/2022]
Affiliation(s)
- Prakash Deedwania
- Department of Medicine; UCSF School of Medicine; San Francisco CA
- Department of Cardiovascular; Cardiology section; UCSF Program; Fresno CA
| | - John Shea
- Forest Research Institute; Jersey City NJ
| | - Wei Chen
- Forest Research Institute; Jersey City NJ
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31
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Laffer CL, Elijovich F. Differential predictors of insulin resistance in nondiabetic salt-resistant and salt-sensitive subjects. Hypertension 2013; 61:707-15. [PMID: 23283360 DOI: 10.1161/hypertensionaha.111.00423] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We studied the characteristics of insulin resistance in 19 normotensive and 25 hypertensive subjects who underwent an acute protocol for determination of salt-sensitivity of blood pressure. Hypertensive subjects were older and more obese, with higher creatinine, lipids, and aldosterone than normotensive volunteers. They also had higher glucose and insulin levels with a marked decrease in insulin sensitivity (HOMA2-S index). Once all participants were classified into salt-sensitive (SS) and salt-resistant (SR) groups, most of these differences were no longer present. In contrast, SS had classical characteristics of this phenotype (higher percentage of blacks, suppressed plasma renin, increased aldosterone-to-renin ratio, and blunted renin and aldosterone responses to changes in salt balance). Despite similar insulin levels, HOMA2-S was significantly lower in SS than SR. Salt-loading did not change HOMA2-S in SS or SR. In contrast, salt-depletion, by significantly increasing glucose and insulin of SR, decreased their HOMA2-S to the levels observed in SS. Correlates of insulin resistance in SR included age, triglycerides, body mass index, mean arterial pressure, aldosterone, and epinephrine. However, only body mass index and aldosterone remained as significant predictors in multivariate analyses. Correlates of insulin resistance in SS were mean arterial pressure, epinephrine, and norepinephrine, all remaining as significant predictors in multivariate modeling. Our data confirm that salt-sensitivity of blood pressure is associated with insulin resistance, suggest that salt restriction may be beneficial in SS but perhaps detrimental in SR subjects, and uncover possible differences in mechanisms of insulin resistance between SS and SR, with implications for pharmacological therapy.
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Affiliation(s)
- Cheryl L Laffer
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-6602, USA.
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Predictive value of first fasting plasma glucose compared with admission plasma glucose for undiagnosed diabetes in a stable cardiology population. Clin Biochem 2012; 45:1057-63. [DOI: 10.1016/j.clinbiochem.2012.05.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 05/14/2012] [Accepted: 05/15/2012] [Indexed: 11/19/2022]
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Gu P, Jiang W, Cheng M, Lu B, Shao J, Du H, Jiang S. Glucose Metabolism in Outpatients with New-Onset Hypertension in Chinese Han Population. Clin Exp Hypertens 2012; 34:474-81. [DOI: 10.3109/10641963.2012.666601] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Qian Q, Li X, Feng B. Impact of hypertension, overall obesity and abdominal obesity on diabetes incidence in Shanghai residents with different glucose levels. Diabetes Res Clin Pract 2012; 96:e59-62. [PMID: 21906830 DOI: 10.1016/j.diabres.2011.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 07/31/2011] [Accepted: 08/16/2011] [Indexed: 12/01/2022]
Abstract
The impact of hypertension, overall obesity and abdominal obesity, individually or collectively, on diabetes incidence over a period of 5 years in residents with different glucose levels is diverse, with abdominal obesity having an impact in both non-diabetic hyperglycaemia and normal groups.
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Affiliation(s)
- Qiaohui Qian
- Department of Endocrinology, Tongji University, Shanghai, China
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35
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Qian Q, Li X, Huang X, Fu M, Meng Z, Chen M, Feng B. Glucose metabolism among residents in Shanghai: natural outcome of a 5-year follow-up study. J Endocrinol Invest 2012; 35:453-8. [PMID: 21738002 DOI: 10.3275/7854] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Previous studies have shown that Type 2 diabetes mellitus (T2DM) is usually preceded by a condition known as pre-diabetes. However, few studies evaluate the rate of each status of impaired glucose regulation progressed to T2DM and its related metabolic disorders impacting the development. AIM To investigate the natural outcome of glucose metabolism among Shanghai adult residents during a 5-yr period, and estimate the metabolic characteristics related with the conversion of glucose tolerance. SUBJECTS AND METHODS A cross-sectional survey with multiple- stage and random sampling was conducted among 1869 adult residents from Shanghai Pudong New District in 2002. In 2007, 1042 non-diabetic subjects were successfully followed up. All the participants completed a questionnaire and underwent anthropometric measurements and a 75-g oral glucose tolerance test. RESULTS The incidence of diabetes was higher in isolated impaired glucose tolerance (i- IGT), isolated impaired fasting glucose (i-IFG), and combined fasting and post-prandial hyperglycemia (IFG/IGT) group when compared to that in normal glucose tolerance group, as relative ratios with 95% confidence intervals of 9.2 (5.5- 15.2), 7.5 (3.6-15.7), and 13.2 (5.8-30.2), respectively. Subjects who had 2 or more metabolic disorders had a 2-3-fold higher incidence than those with less than 1 metabolic disorder (all p<0.001). CONCLUSIONS People with pre-diabetes are at increased risk of diabetes, suggesting the need for frequent screening in theloe people with several metabolic disorders.
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Affiliation(s)
- Q Qian
- Department of Endocrinology and Metabolism, Shanghai East Hospital, Tongji University, 150 Ji-mo Rd., Shanghai 200120, China
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Lee IT, Chiu YF, Hwu CM, He CT, Chiang FT, Lin YC, Assimes T, Curb JD, Sheu WHH. Central obesity is important but not essential component of the metabolic syndrome for predicting diabetes mellitus in a hypertensive family-based cohort. Results from the Stanford Asia-pacific program for hypertension and insulin resistance (SAPPHIRe) Taiwan follow-up study. Cardiovasc Diabetol 2012; 11:43. [PMID: 22537054 PMCID: PMC3476431 DOI: 10.1186/1475-2840-11-43] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 04/26/2012] [Indexed: 02/06/2023] Open
Abstract
Background Metabolic abnormalities have a cumulative effect on development of diabetes, but only central obesity has been defined as the essential criterion of metabolic syndrome (MetS) by the International Diabetes Federation. We hypothesized that central obesity contributes to a higher risk of new-onset diabetes than other metabolic abnormalities in the hypertensive families. Methods Non-diabetic Chinese were enrolled and MetS components were assessed to establish baseline data in a hypertensive family-based cohort study. Based on medical records and glucose tolerance test (OGTT), the cumulative incidence of diabetes was analyzed in this five-year study by Cox regression models. Contribution of central obesity to development of new-onset diabetes was assessed in subjects with the same number of positive MetS components. Results Among the total of 595 subjects who completed the assessment, 125 (21.0%) developed diabetes. Incidence of diabetes increased in direct proportion to the number of positive MetS components (P ≪ 0.001). Although subjects with central obesity had a higher incidence of diabetes than those without (55.7 vs. 30.0 events/1000 person-years, P ≪ 0.001), the difference became non-significant after adjusting of the number of positive MetS components (hazard ratio = 0.72, 95%CI: 0.45-1.13). Furthermore, in all participants with three positive MetS components, there was no difference in the incidence of diabetes between subjects with and without central obesity (hazard ratio = 1.04, 95%CI: 0.50-2.16). Conclusion In Chinese hypertensive families, the incidence of diabetes in subjects without central obesity was similar to that in subjects with central obesity when they also had the same number of positive MetS components. We suggest that central obesity is very important, but not the essential component of the metabolic syndrome for predicting of new-onset diabetes. (Trial registration: NCT00260910, ClinicalTrials.gov).
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Affiliation(s)
- I-Te Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, 407, Taiwan
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Liu YX. A new antihypertensive drug ameliorate insulin resistance. Acta Pharmacol Sin 2012; 33:429-30. [PMID: 22476059 DOI: 10.1038/aps.2012.31] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- Yan-xia Liu
- Department of Pharmacology, School of Basic Medical Sciences, Tianjin Medical University, China.
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Del Olmo MI, Merino-Torres JF, Argente M, Ramos A, Navas MS, Campos V, Cámara R, Pérez-Lázaro A. Detection of glucose abnormalities in patients with acute coronary heart disease: study of reliable tools in clinical practice. J Endocrinol Invest 2012; 35:71-6. [PMID: 21646857 DOI: 10.3275/7769] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
AIM To investigate the prevalence of glucose abnormalities in patients with acute coronary syndrome and to assess the reliability of certain clinical or analytical variables to predict a pathologic result of oral glucose tolerance test (OGTT) at 3 months from discharge. SUBJECTS AND METHODS Prospective study of 102 patients admitted to the coronary care units. Patients were classified according to the American Diabetes Association criteria. Three months after discharge, an OGTT was performed to non-diabetic patients. RESULTS Forty-six (45.1%) patients were identified as diabetic (5 previously undiagnosed) and 56 (54.9%) as non-diabetic. OGTT identified 22% of diabetes, 33% of impaired glucose tolerance, and 45% of normal glucose tolerance. Fasting glucose (r=0.55, p<0.001), glycated hemoglobin (HbA1c) (r=0.46, p<0.001), low HDL cholesterol (HDLc) levels (r=-0.34, p<0.02), waist-hip ratio (r=0.45, p<0.01), high systolic blood pressure (r=0.5, p<0.01), and presence of acute myocardial infarction (r=0.46, p<0.001) at admission resulted significant to predict a pathologic result of OGTT. CONCLUSIONS Glucose abnormalities are frequent in acute coronary syndrome patients. Certain clinical and analytical markers at admission such as fasting glucose, HbA1c, HDL-c<40 mg/dl, waist-hip ratio, and systolic blood pressure, are useful to recognize patients with a higher predisposition to present a pathologic result in OGTT at 3 months from discharge.
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Affiliation(s)
- M I Del Olmo
- Department of Endocrinology and Nutrition, University Hospital La Fe, Valencia, Spain.
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Abstract
South Asia is home to one of the largest population of people with metabolic syndrome (MetS). The prevalence of MetS in South Asians varies according to region, extent of urbanization, lifestyle patterns, and socioeconomic/cultural factors. Recent data show that about one-third of the urban population in large cities in India has the MetS. All classical risk factors comprising the MetS are prevalent in Asian Indians residing in India. The higher risk in this ethnic population necessitated a lowering of the cut-off values of the risk factors to identify and intervene for the MetS to prevent diabetes and cardiovascular disease. Some pharmacological and nonpharmacological interventions are underway in MetS to assess the efficacy in preventing the diabetes and cardiovascular disease in this ethnic population.
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Affiliation(s)
- Kaushik Pandit
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
| | - Soumik Goswami
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
| | - Sujoy Ghosh
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
| | - Pradip Mukhopadhyay
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
| | - Subhankar Chowdhury
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
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Cardiovascular risk stratification and antihypertensive therapy according to guidelines in the outpatient setting. Wien Med Wochenschr 2011; 161:557-64. [DOI: 10.1007/s10354-011-0032-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Accepted: 08/09/2011] [Indexed: 11/26/2022]
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Short-term metabolic changes achieved by weight loss in hypertensive patients. Int J Cardiol 2011; 153:286-90. [DOI: 10.1016/j.ijcard.2010.08.051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Revised: 07/13/2010] [Accepted: 08/17/2010] [Indexed: 10/19/2022]
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Additive beneficial effects of atorvastatin combined with amlodipine in patients with mild-to-moderate hypertension. Int J Cardiol 2011; 146:319-25. [DOI: 10.1016/j.ijcard.2009.07.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2009] [Revised: 07/07/2009] [Accepted: 07/08/2009] [Indexed: 11/21/2022]
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Manu P, Tsang J, Napolitano BA, Lesser ML, Correll CU. Predictors of insulin resistance in the obese with metabolic syndrome. Eur J Intern Med 2010; 21:409-13. [PMID: 20816595 DOI: 10.1016/j.ejim.2010.05.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 04/28/2010] [Accepted: 05/02/2010] [Indexed: 01/22/2023]
Abstract
BACKGROUND In the obese, the metabolic syndrome (MetS) is assumed to reflect insulin resistance. OBJECTIVE To determine the predictors of insulin resistance in obese subjects with MetS. DESIGN We used the 90th percentile of the homeostasis model assessment (HOMA) to define insulin resistance in 4958 nondiabetic adults evaluated in the National Health and Nutrition Examination Surveys, 1999-2004, and compared the 373 obese subjects who were insulin-resistant (HOMA 9.52+/-5.73) to a control group of 373 obese who had the highest sensitivity to insulin (HOMA 1.79+/-0.44). MEASUREMENTS MetS was present in 312 (83.6%) obese with insulin resistance and in 156 (41.8%) obese from the insulin-sensitive control group. Demographic, metabolic, and lifestyle variables were analyzed with logistic regression. RESULTS In a logistic model of insulin resistance given the presence of MetS, the significant predictors were triglycerides (P=0.0021), body mass index (P=0.0096), HDL-cholesterol (P=0.0098), age (P=0.0242) and smoking (P=0.0366). LIMITATIONS Cross-sectional design prevents elucidation of causality for the association between insulin resistance and MetS. CONCLUSIONS Insulin resistance is not an obligatory correlate of MetS in the obese. Its likelihood can be predicted by cigarette smoking and by the severity of obesity and dyslipidemia.
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Affiliation(s)
- Peter Manu
- The Zucker Hillside Hospital, 59-75 263rd Street, Glen Oaks, NY 11004, USA.
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Role of heme oxygenase in inflammation, insulin-signalling, diabetes and obesity. Mediators Inflamm 2010; 2010:359732. [PMID: 20508722 PMCID: PMC2872759 DOI: 10.1155/2010/359732] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2009] [Revised: 02/15/2010] [Accepted: 02/24/2010] [Indexed: 12/19/2022] Open
Abstract
Diabetes and obesity are chronic conditions associated with elevated oxidative/inflammatory activities with a continuum of tissue insults leading to more severe cardiometabolic and renal complications including myocardial infarction and end-stage-renal damage. A common denominator of these chronic conditions is the enhanced the levels of cytokines like tumour necrosis factor-alpha (TNF-α), interleukin (IL-6), IL-1β and resistin, which in turn activates the c-Jun-N-terminal kinase (JNK) and NF-κB pathways, creating a vicious cycle that exacerbates insulin resistance, type-2 diabetes and related complications. Emerging evidence indicates that heme oxygenase (HO) inducers are endowed with potent anti-diabetic and insulin sensitizing effects besides their ability to suppress immune/inflammatory response. Importantly, the HO system abates inflammation through several mechanisms including the suppression of macrophage-infiltration and abrogation of oxidative/inflammatory transcription factors like NF-κB, JNK and activating protein-1. This review highlights the mechanisms by which the HO system potentiates insulin signalling, with particular emphasis on HO-mediated suppression of oxidative and inflammatory insults. The HO system could be explored in the search for novel remedies against cardiometabolic diseases and their complications.
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Shimizu I, Minamino T, Toko H, Okada S, Ikeda H, Yasuda N, Tateno K, Moriya J, Yokoyama M, Nojima A, Koh GY, Akazawa H, Shiojima I, Kahn CR, Abel ED, Komuro I. Excessive cardiac insulin signaling exacerbates systolic dysfunction induced by pressure overload in rodents. J Clin Invest 2010; 120:1506-14. [PMID: 20407209 DOI: 10.1172/jci40096] [Citation(s) in RCA: 166] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2009] [Accepted: 02/10/2010] [Indexed: 01/15/2023] Open
Abstract
Although many animal studies indicate insulin has cardioprotective effects, clinical studies suggest a link between insulin resistance (hyperinsulinemia) and heart failure (HF). Here we have demonstrated that excessive cardiac insulin signaling exacerbates systolic dysfunction induced by pressure overload in rodents. Chronic pressure overload induced hepatic insulin resistance and plasma insulin level elevation. In contrast, cardiac insulin signaling was upregulated by chronic pressure overload because of mechanical stretch-induced activation of cardiomyocyte insulin receptors and upregulation of insulin receptor and Irs1 expression. Chronic pressure overload increased the mismatch between cardiomyocyte size and vascularity, thereby inducing myocardial hypoxia and cardiomyocyte death. Inhibition of hyperinsulinemia substantially improved pressure overload-induced cardiac dysfunction, improving myocardial hypoxia and decreasing cardiomyocyte death. Likewise, the cardiomyocyte-specific reduction of insulin receptor expression prevented cardiac ischemia and hypertrophy and attenuated systolic dysfunction due to pressure overload. Conversely, treatment of type 1 diabetic mice with insulin improved hyperglycemia during pressure overload, but increased myocardial ischemia and cardiomyocyte death, thereby inducing HF. Promoting angiogenesis restored the cardiac dysfunction induced by insulin treatment. We therefore suggest that the use of insulin to control hyperglycemia could be harmful in the setting of pressure overload and that modulation of insulin signaling is crucial for the treatment of HF.
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Affiliation(s)
- Ippei Shimizu
- Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
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Robles NR, Marcos G, Barroso S, Sánchez Muñoz-Torrero JF. Alteraciones del metabolismo glucídico en el estudio de control de factores de riesgo de Extremadura (estudio COFRE). ACTA ACUST UNITED AC 2010; 57:147-54. [DOI: 10.1016/j.endonu.2010.01.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2009] [Revised: 01/20/2010] [Accepted: 01/25/2010] [Indexed: 11/25/2022]
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Abstract
BACKGROUND Activation of the sympathetic nervous system (SNS) has been linked to hypertension. Beta-blockers, which decrease SNS activation via beta-adrenergic receptor antagonism, are effective in lowering blood pressure and reducing cardiovascular morbidity and mortality in several conditions, including post-myocardial infarction and heart failure. Despite these clinical benefits, many physicians are reluctant to prescribe beta-blockers because of perceived negative metabolic effects, including reduced glycemic control, masking of hypoglycemia, insulin resistance, and dyslipidemia. OBJECTIVE This article reviews the pathophysiology of hypertension and either insulin resistance or dyslipidemia as well as treatment effects from glucose- and lipid-lowering regimens on cardiovascular morbidity and mortality. Based on a PubMed literature search from January 1980 to December 2008, the effects of nonvasodilating (atenolol, metoprolol, and propranolol) and vasodilating beta-blockers (carvedilol, labetalol, and nebivolol) on parameters of glucose and lipid metabolism in hypertension are presented. Preference for clinical trial inclusion was given to randomized, controlled trials with at least 100 patients. Limitations of a drug class literature review may include trial inclusion bias with associated result skewing and underrepresentation of an individual agent, which may give different results. RESULTS Beta-blockers differ in terms of their mechanism of action and their effects on glucose and lipid metabolism. Nonvasodilating beta-blockers reduce blood pressure in association with a cardiac output reduction and may increase or have no appreciable effect on peripheral vascular resistance. As a result, nonvasodilating beta-blockers are associated with a worsening of glycemic and lipidic control. In contrast, vasodilating beta-blockers reduce peripheral vascular resistance but have little or no effect on cardiac output. Numerous studies have established that vasodilating beta-blockers are associated with more favorable effects on glucose and lipid profiles than nonvasodilating beta-blockers. CONCLUSIONS Improvements in glucose and lipid metabolism mediated by vasodilating beta-blockers may help reduce coronary artery disease risk among high-risk patients with hypertension.
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Ndisang JF, Lane N, Syed N, Jadhav A. Up-regulating the heme oxygenase system with hemin improves insulin sensitivity and glucose metabolism in adult spontaneously hypertensive rats. Endocrinology 2010; 151:549-60. [PMID: 20016031 DOI: 10.1210/en.2009-0471] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Accumulating clinical evidence indicates that impaired glucose tolerance is a common phenomenon in essential hypertension. Although recent evidence underscores the role of heme-oxygenase (HO) in diabetes, its effects on insulin sensitivity and glucose metabolism in spontaneously hypertensive rat (SHR), a model of essential hypertension with characteristics of metabolic syndrome including insulin resistance/impaired glucose metabolism remains largely unclear. Here we report the effects of the HO inducer, hemin, and the HO blocker, chromium-mesoporphyrin on insulin sensitivity and glucose metabolism in SHRs. Adult SHRs were severely hypertensive but normoglycemic. Hemin therapy lowered blood pressure, increased plasma insulin, decreased glycemia, and enhanced insulin sensitivity by improving glucose tolerance (ip glucose tolerance test) and insulin tolerance (ip insulin tolerance test) but reduced insulin resistance (homeostasis model assessment index). These effects were accompanied by increased gastrocnemius muscle HO-1, HO activity, cGMP, cAMP alongside antioxidants including bilirubin, ferritin, superoxide dismutase, catalase, and the total antioxidant capacity, whereas oxidative/inflammatory mediators like 8-isoprostane, nuclear-factor-kappaB, activating-protein-1, activating-protein-2, c-Jun-NH2-terminal-kinase, and heme were abated. Furthermore, hemin reduced proteinuria/albuminuria and enhanced the depressed levels of adiponectin, AMP-activated protein-kinase, and glucose transporter-4 in SHRs, suggesting that although SHRs are normoglycemic, insulin signaling and renal function may be impaired. Contrarily, the HO inhibitor chromium-mesoporphyrin exacerbated oxidative stress, aggravated insulin resistance, glucose tolerance, insulin tolerance and nephropathy. Hemin also enhanced HO signaling in Wistar Kyoto and Sprague Dawley rats and increased insulin sensitivity albeit less intensely than in SHRs, suggesting greater selectivity of HO in SHRs with dysfunctional insulin signaling. These results suggest that perturbations of insulin signaling may be a forerunner to hyperglycemia in essential hypertension. By concomitantly potentiating insulin-sensitizing agents, suppressing insulin/glucose intolerance, and abating oxidative stress, HO inducers may prevent metabolic and cardiovascular complications in essential hypertension.
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Affiliation(s)
- Joseph Fomusi Ndisang
- Department of Physiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, Saskatchewan, Canada.
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López-Jaramillo P. Tratamiento de la hipertensión arterial en el paciente con síndrome metabólico. REVISTA COLOMBIANA DE CARDIOLOGÍA 2010. [DOI: 10.1016/s0120-5633(10)70214-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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