scholarly journals The Systemic Redox Status Is Maintained in Non-Smoking Type 2 Diabetic Subjects Without Cardiovascular Disease: Association with Elevated Triglycerides and Large VLDL

2019 ◽  
Vol 9 (1) ◽  
pp. 49 ◽  
Author(s):  
Peter R. van Dijk ◽  
Amaal Eman Abdulle ◽  
Marian L.C. Bulthuis ◽  
Frank G. Perton ◽  
Margery A. Connelly ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Cardiovascular Disease ◽  
Linear Regression Analysis ◽  
Colorimetric Method ◽  
Positive Association ◽  
Lipid Lowering ◽  
Central Feature ◽  
Very Low Density Lipoproteins ◽  
Pltp Activity

Decreased circulating levels of free thiols (R-SH, sulfhydryl groups) reflect enhanced oxidative stress, which plays an important role in the pathogenesis of cardiometabolic diseases. Since hyperglycemia causes oxidative stress, we questioned whether plasma free thiols are altered in patients with type 2 diabetes mellitus (T2DM) without cardiovascular disease or renal function impairment. We also determined their relationship with elevated triglycerides and very low density lipoproteins (VLDL), a central feature of diabetic dyslipidemia. Fasting plasma free thiols (colorimetric method), lipoproteins, VLDL (nuclear magnetic resonance spectrometry), free fatty acids (FFA), phospholipid transfer protein (PLTP) activity and adiponectin were measured in 79 adult non-smoking T2DM subjects (HbA1c 51 ± 8 mmol/mol, no use of insulin or lipid lowering drugs), and in 89 non-smoking subjects without T2DM. Plasma free thiols were univariately correlated with glucose (r = 0.196, p < 0.05), but were not decreased in T2DM subjects versus non-diabetic subjects (p = 0.31). Free thiols were higher in subjects with (663 ± 84 µmol/L) versus subjects without elevated triglycerides (619 ± 91 µmol/L; p = 0.002). Age- and sex-adjusted multivariable linear regression analysis demonstrated that plasma triglycerides were positively and independently associated with free thiols (β = 0.215, p = 0.004), FFA (β = 0.168, p = 0.029) and PLTP activity (β = 0.228, p = 0.002), inversely with adiponectin (β = −0.308, p < 0.001) but not with glucose (β = 0.052, p = 0.51). Notably, the positive association of free thiols with (elevated) triglycerides appeared to be particularly evident in men. Additionally, large VLDL were independently associated with free thiols (β = 0.188, p = 0.029). In conclusion, circulating free thiols are not decreased in this cohort of non-smoking and generally well-controlled T2DM subjects. Paradoxically, higher triglycerides and more large VLDL particles are likely associated with higher plasma levels of thiols, reflecting lower systemic oxidative stress.

scholarly journals Therapies for the Treatment of Cardiovascular Disease Associated with Type 2 Diabetes and Dyslipidemia

2021 ◽  
Vol 22 (2) ◽  
pp. 660
Author(s):  
María Aguilar-Ballester ◽  
Gema Hurtado-Genovés ◽  
Alida Taberner-Cortés ◽  
Andrea Herrero-Cervera ◽  
Sergio Martínez-Hervás ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Molecular Mechanisms ◽  
Foam Cell ◽  
Leukocyte Adhesion ◽  
Experimental Studies ◽  
Lipid Lowering ◽  
Foam Cell Formation ◽  
Relevant Parameter

Cardiovascular disease (CVD) is the leading cause of death worldwide and is the clinical manifestation of the atherosclerosis. Elevated LDL-cholesterol levels are the first line of therapy but the increasing prevalence in type 2 diabetes mellitus (T2DM) has positioned the cardiometabolic risk as the most relevant parameter for treatment. Therefore, the control of this risk, characterized by dyslipidemia, hypertension, obesity, and insulin resistance, has become a major goal in many experimental and clinical studies in the context of CVD. In the present review, we summarized experimental studies and clinical trials of recent anti-diabetic and lipid-lowering therapies targeted to reduce CVD. Specifically, incretin-based therapies, sodium-glucose co-transporter 2 inhibitors, and proprotein convertase subtilisin kexin 9 inactivating therapies are described. Moreover, the novel molecular mechanisms explaining the CVD protection of the drugs reviewed here indicate major effects on vascular cells, inflammatory cells, and cardiomyocytes, beyond their expected anti-diabetic and lipid-lowering control. The revealed key mechanism is a prevention of acute cardiovascular events by restraining atherosclerosis at early stages, with decreased leukocyte adhesion, recruitment, and foam cell formation, and increased plaque stability and diminished necrotic core in advanced plaques. These emergent cardiometabolic therapies have a promising future to reduce CVD burden.

scholarly journals Association between refill adherence to lipid-lowering medications and the risk of cardiovascular disease and mortality in Swedish patients with type 2 diabetes mellitus: a nationwide cohort study

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020309 ◽  
Author(s):  
Sofia Axia Karlsson ◽  
Christel Hero ◽  
Ann-Marie Svensson ◽  
Stefan Franzén ◽  
Mervete Miftaraj ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Primary Prevention ◽  
Secondary Prevention ◽  
Exposure Period ◽  
Lipid Lowering ◽  
Refill Adherence

ObjectivesTo analyse the association between refill adherence to lipid-lowering medications, and the risk of cardiovascular disease (CVD) and mortality in patients with type 2 diabetes mellitus.DesignCohort study.SettingNational population-based cohort of Swedish patients with type 2 diabetes mellitus.Participants86 568 patients aged ≥18 years, registered with type 2 diabetes mellitus in the Swedish National Diabetes Register, who filled at least one prescription for lipid-lowering medication use during 2007–2010, 87% for primary prevention.Exposure and outcome measuresRefill adherence of implementation was assessed using the medication possession ratio (MPR), representing the proportion of days with medications on hand during an 18-month exposure period. MPR was categorised by five levels (≤20%, 21%–40%, 41%–60%, 61%–80% and >80%). Patients without medications on hand for ≥180 days were defined as non-persistent. Risk of CVD (myocardial infarction, ischaemic heart disease, stroke and unstable angina) and mortality by level of MPR and persistence was analysed after the exposure period using Cox proportional hazards regression and Kaplan-Meier, adjusted for demographics, socioeconomic status, concurrent medications and clinical characteristics.ResultsThe hazard ratios for CVD ranged 1.33–2.36 in primary prevention patients and 1.19–1.58 in secondary prevention patients, for those with MPR ≤80% (p<0.0001). The mortality risk was similar regardless of MPR level. The CVD risk was 74% higher in primary prevention patients and 33% higher in secondary prevention patients, for those who were non-persistent (p<0.0001). The mortality risk was 6% higher in primary prevention patients and 18% higher in secondary prevention patients, for non-persistent patients (p<0.0001).ConclusionsHigher refill adherence to lipid-lowering medications was associated with lower risk of CVD in primary and secondary prevention patients with type 2 diabetes mellitus.

scholarly journals Association of c-reactive protein and uric acid with Type 2 diabetes

1970 ◽  
Vol 20 (2) ◽  
pp. 191-199 ◽  
Author(s):  
Md Safiqul Islam ◽  
Md Saiful Islam ◽  
Yearul Kabir
Keyword(s):  
Type 2 Diabetes ◽  
Uric Acid ◽  
Colorimetric Method ◽  
Positive Association ◽  
C Reactive Protein ◽  
High Blood Glucose ◽  
Male And Female ◽  
Reactive Protein ◽  
Bangladeshi Population

Diabetes mellitus is a group of metabolic diseases characterized by high blood glucose levels that result from defects in insulin secretion or action or both. Some recent studies had shown that elevated level of C?reactive protein (CRP) and uric acid are involved in the pathogenesis of type 2 diabetes, regardless of other characteristics of subjects. Our aim was to investigate the association between CRP and uric acid levels with diabetes in Bangladeshi population. Two hundred type 2 diabetic subjects (male 110, female 90) and 60 non diabetic subjects (30 male, 30 female) were included in the study over six months. CRP and uric acid were measured by Latex Agglutination method and enzymatic colorimetric method, respectively. CRP was significantly higher (p < 0.01) in diabetic compared to non-diabetic subjects for both male and female subjects. The level of uric acid was also significantly higher in male and female diabetic subjects (p < 0.05 and p < 0.01) compared to non-diabetic subjects, respectively. In multiple regression analysis, CRP showed a positive association with uric acid and BMI in both diabetic and non-diabetic subjects. On the other hand, uric acid showed positive association with fasting blood sugar (FBS), diastolic blood pressure, HbA1c and CRP in case of diabetic subjects, but with age, BMI, CRP, HbA1c and creatinine in non-diabetic subject. Uric acid also shows a significantly (p < 0.001) positive Pearson correlation with CRP. These data strongly suggest that compared to non-diabetic subjects, diabetic subjects have significantly higher level of CRP and uric acid. Key words: C-reactive protein; Uric acid; Type 2 diabetes; Bangladeshi population DOI: http://dx.doi.org/10.3329/dujbs.v20i2.8980 DUJBS 2011; 20(2): 191-199

Relationship between Hyperlipidemia, Cardiovascular Disease and Stroke: a Systematic Review

2020 ◽  
Vol 16 ◽  
Author(s):  
Aladeen Alloubani ◽  
Refat Nimer ◽  
Rama Samara
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Prognostic Significance ◽  
Vascular Diseases ◽  
Positive Association ◽  
Cholesterol Concentration ◽  
Lipid Lowering ◽  
Mortality And Morbidity ◽  
The Impact

Background:: Globally, dyslipidemia has been shown to be an independent predictor of many cardiovascular and cerebrovascular events, which lead to recent advocacy towards dyslipidemia prevention and control as a key risk factor and its prognostic significance to reduce the burden of stroke and myocardial infarction. Aim:: This study aimed to evaluate hyperlipidemia as a risk factor connected with stroke and CVD. Moreover, having identified this risk factor, the study evaluates how hyperlipidemia has been examined earlier and what can be done in the future. Methods:: All prospective studies concerning hyperlipidemia as risk factors for stroke and CVD were identified by a search of PubMed/MEDLINE and EMBASE databases with keywords hyperlipidemia, risk factors, stroke, and cardiovascular disease. Results:: The constant positive association between the incidence of coronary heart disease and cholesterol concentration of LDL is apparent in observational studies in different populations. Thus, the reduction of LDL cholesterol in those populations, particularly with regard to initial cholesterol concentrations, can reduce the risk of vascular diseases. However, the impact of using lipid-lowering drugs, such as statins, has been demonstrated in several studies as an important factor in decreasing the mortality and morbidity in rates of patients with stroke and CVD. Conclusion:: After reviewing all the research mentioned in this review, it can be confirmed that hyperlipidemia is a risk factor for stroke and correlated in patients with CVD.

Lipids for Psychiatrists - an overview

2005 ◽  
Vol 19 (6_suppl) ◽  
pp. 66-75 ◽  
Author(s):  
Ian S. Young
Keyword(s):  
Cardiovascular Disease ◽  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Cardiovascular Risk Assessment ◽  
Important Place ◽  
Lifestyle Measures ◽  
Lipid Lowering Agents

Serum cholesterol is a major risk factor for cardiovascular disease. Total cholesterol, LDL cholesterol and triglycerides are positively related to cardiovascular disease, while HDL cholesterol has an inverse relationship. Measurement of lipids is essential in individuals with established cardiovascular disease or type 2 diabetes, and may also be carried out in healthy individuals as part of cardiovascular risk assessment. Lifestyle measures are important in cardiovascular disease prevention, but the mainstay of lipid lowering therapy is appropriate use of lipid lowering drugs. Total and LDL cholesterol are the primary targets for treatment, but consideration should also be given to raising HDL cholesterol and lowering triglycerides where appropriate. Statins are the most frequently used lipid lowering agents, but there is an important place for other drugs, including ezetimibe, fibrates and nicotinic acid.

scholarly journals Hydroxychloroquine: Looking into the Future

2017 ◽  
Vol 24 (4) ◽  
pp. 369-375 ◽  
Author(s):  
Saibal Chakravorty ◽  
Indranil Purkait ◽  
Anil Pareek ◽  
Avinash Talware
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Systemic Inflammation ◽  
Cardiovascular Effects ◽  
Lipid Lowering ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

AbstractHydroxychloroquine, an antimalarial agent has also been found to possess antidiabetic action. Onset of type-2 diabetes (T2DM) and cardiovascular disease is now considered to be the outcome of systemic inflammation. Many clinical trials are targeting systemic inflammation to reduce cardiovascular risk. Anti-inflammatory drugs with cardiovascular effects may be valuable therapeutic intervention to reduce massive cardiovascular risk in T2DM. In this review, antidiabetic action and potential cardioprotective role of hydroxychloroquine has been discussed. By virtue of its antidiabetic, lipid lowering, anti-platelet, anticoagulant and anti-inflammatory properties, hydroxychloroquine can be a key therapeutic alternative to manage patients with T2DM.

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