Cardiovascular, renal and liver protection with novel antidiabetic agents beyond blood glucose lowering in type 2 diabetes: consensus article from the European Society of Hypertension Working Group on Obesity, Diabetes and the High-risk Patient

Kotsis, Vasilios; Jordan, Jens; Stabouli, Stella; Antza, Christina; Micić, Dragan; Jelaković, Bojan; Schlaich, Markus P.; Nilsson, Peter M.; Kreutz, Reinhold; Mancia, Giuseppe; Tsioufis, Kostas

doi:10.1097/hjh.0000000000002279

Cited by 32 publications

(37 citation statements)

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“…1 Obesity is associated with most cardiovascular risk factors, including metabolic syndrome (MetS), hypertension, type 2 diabetes, and dyslipidemia. 2 However, large interindividual heterogeneity in the development of obesity-related complications has been suggested. 3 Despite increased body fat, a subset of people with obesity do not have obesity-related cardiometabolic abnormalities; this is referred to as metabolically healthy obesity (MHO).…”

Section: Introductionmentioning

confidence: 99%

Trends in the Prevalence of Metabolically Healthy Obesity Among US Adults, 1999-2018

Wang

Xia

et al. 2023

JAMA Netw Open

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ImportanceImproved understanding of trends in the proportion of individuals with metabolically healthy obesity (MHO) may facilitate stratification and management of obesity and inform policy efforts.ObjectivesTo characterize trends in the prevalence of MHO among US adults with obesity, overall and by sociodemographic subgroups.Design, Setting, and ParticipantsThis survey study included 20 430 adult participants from 10 National Health and Nutrition Examination Survey (NHANES) cycles between 1999-2000 and 2017-2018. The NHANES is a series of cross-sectional and nationally representative surveys of the US population conducted continuously in 2-year cycles. Data were analyzed from November 2021 to August 2022.ExposuresNational Health and Nutrition Examination Survey cycles from 1999-2000 to 2017-2018.Main Outcomes and MeasuresMetabolically healthy obesity was defined as a body mass index of 30.0 (calculated as weight in kilograms divided by height in meters squared) without any metabolic disorders in blood pressure, fasting plasma glucose (FPG), high-density lipoprotein cholesterol (HDL-C), or triglycerides based on established cutoffs. Trends in the age-standardized prevalence of MHO were estimated using logistic regression analysis.ResultsThis study included 20 430 participants. Their weighted mean (SE) age was 47.1 (0.2) years; 50.8% were women, and 68.8% self-reported their race and ethnicity as non-Hispanic White. The age-standardized prevalence (95% CI) of MHO increased from 3.2% (2.6%-3.8%) in the 1999-2002 cycles to 6.6% (5.3%-7.9%) in the 2015-2018 cycles (P &lt; .001 for trend). There were 7386 adults with obesity. Their weighted mean (SE) age was 48.0 (0.3) years, and 53.5% were women. The age-standardized proportion (95% CI) of MHO among these 7386 adults increased from 10.6% (8.8%-12.5%) in the 1999-2002 cycles to 15.0% (12.4%-17.6%) in the 2015-2018 cycles (P = .02 for trend). Substantial increases in the proportion of MHO were observed for adults aged 60 years or older, men, non-Hispanic White individuals, and those with higher income, private insurance, or class I obesity. In addition, there were significant decreases in the age-standardized prevalence (95% CI) of elevated triglycerides (from 44.9% [40.9%-48.9%] to 29.0% [25.7%-32.4%]; P &lt; .001 for trend) and reduced HDL-C (from 51.1% [47.6%-54.6%] to 39.6% [36.3%-43.0%]; P = .006 for trend). There was also a significant increase in elevated FPG (from 49.7% [95% CI, 46.3%-53.0%] to 58.0% [54.8%-61.3%]; P &lt; .001 for trend) but no significant change in elevated blood pressure (from 57.3% [53.9%-60.7%] to 54.0% [50.9%-57.1%]; P = .28 for trend).Conclusions and RelevanceThe findings of this cross-sectional study suggest that the age-standardized proportion of MHO increased among US adults from 1999 to 2018, but differences in trends existed across sociodemographic subgroups. Effective strategies are needed to improve metabolic health status and prevent obesity-related complications in adults with obesity.

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Section: Introductionmentioning

confidence: 99%

Trends in the Prevalence of Metabolically Healthy Obesity Among US Adults, 1999-2018

Wang

Xia

et al. 2023

JAMA Netw Open

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“…Second, SGLT2 inhibitors may contribute to better prognosis of HCC via improved liver function and preventing the development of hepatocarcinogenesis from NAFLD. SGLT2 inhibitors have been reported to ameliorate hepatic steatosis in patients with diabetes and non-alcohol fatty liver disease [19,42]. Recent studies have suggested that the stage of fibrosis is the most important predictor of liver outcomes, including HCC [43][44][45].…”

Section: Plos Onementioning

confidence: 99%

“…Besides their benefits in treatment of diabetes, SGLT2 inhibitors are considered to have additional renal and cardiovascular risk reduction benefits [16][17][18]. Because of these benefits, SGLT-2 inhibitors are recently being used one of the firstline drugs for glucose lowering, particularly in patients with type 2 diabetes at increased cardiovascular risk [19].…”

Section: Introductionmentioning

confidence: 99%

“…Accumulating animal studies and human clinical trial studies have reported that SGLT2 inhibitors may be effective for improvement of NAFLD [19,20]. Several laboratory studies have also indicated that SGLT2-inhibitors have anti-proliferative activity by attenuating the uptake of glucose in several tumor cell lines, including HCC cells [21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

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Sodium-glucose cotransporter 2 (SGLT2) inhibitor initiation and hepatocellular carcinoma prognosis

et al. 2022

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Introduction Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a relatively new class of antidiabetic drugs. Emerging findings from laboratory studies indicate that SGLT2 inhibitors can improve liver function and suppress the proliferation of hepatocellular carcinoma (HCC) cells. The aim of this study was to test the hypothesis that initiation of SGLT2 inhibitors improves HCC prognosis in a human population. Methods We used National Surveillance, Epidemiology and End Results (SEER)—Medicare linked data in the United States to evaluate the role of SGLT2 inhibitor initiation on the survival of HCC patients. 3,185 HCC patients newly diagnosed between 2014 and 2017 aged 66 years or older with pre-existing type 2 diabetes were included and followed to the end of 2019. Information on SGLT2 inhibitor initiation was extracted from the Medicare Part D file. Results SGLT2 inhibitor initiation was associated with significantly lower mortality risk after adjusting for potential confounders (HR = 0.68, 95% CI = 0.54–0.86) with stronger association for longer duration of use (HR = 0.60, 95% CI = 0.41–0.88). Further, we found that SGLT2 inhibitor initiation was associated with a lower risk mortality risk ranging from 14% to 60% regardless of patient demographic variables, tumor characteristics, and cancer treatments. Conclusion Our large SEER-Medicare linked data study indicates that SGLT2 inhibitor initiation was associated with improved overall survival of HCC patients with pre-existing type 2 diabetes compared with no SGLT2 inhibitor use. Further studies are needed to confirm our findings and elucidate the possible mechanisms behind the association.

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“…O DM2 tem uma forte propensão genética que se manifesta quando um paciente é exposto a um estilo de vida ocidental típico, ganha peso e se torna obeso (Kotsis et al, 2019).…”

Section: Introdução E Revisão Da Literaturaunclassified

Efeito do probiótico Lactobacillus acidophilus LA5 em modelo de periodontite induzida em camundongos diabéticos

Cardoso¹

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Agradeço primeiramente a Deus por ter me concedido a honra de realizar este trabalho e de tÊ-lo comigo em todos os momentos, sendo a minha fortaleza.Agradeço ao meu esposo Augusto Cesar Santos SIlva, meu melhor amigo, meu parceiro, meu presente de Deus, que me deu forças, incentivo, motivação e que acima de tudo orou por mim todos os dias para que eu pudesse chegar ao final com êxito e alegria.Agradeço aos meus pais e ao meu irmão, pela base e pela estrutura familiar que sempre me deram, pelo amparo, pelo amor incondicional e também por suas orações me fazendo sempre acreditar que os sonhos se realizam e que as promessas de Deus se cumprem na vida daqueles que O amam. Agradeço aos meus sogros, pelas orações, pelas palavras amigas e por me fazerem sempre lembrar que somos servos de Deus e Ele nunca nos desampara. Agradeço a Universidade de São Paulo, ao Instituto de Ciências Biomédicas e ao departamento de Microbiologia, sempre com admiração e respeito. Agradeço a minha orientadora Profa. Dra. Marcia Pinto Alves Mayer, pelo empenho e dedicação em me orientar, pela paciência e pelo amparo em todas as fases do projeto e também da vida nesses anos compartilhados, pelo auxílio, pela amizade e por ter acreditado em mim. Um exemplo de professora, de ser humano, de excelência em tudo que se propõe a fazer. Foi uma honra ser sua orientada. Agradeço a Dra. Pamela Pontes Amado, pela grande amizade que construímos e por ter sido meu primeiro exemplo dentro do laboratório, me inspirando e me ensinando com amor a dar os meus primeiros passos dentro do laboratório. Meu amor, meu respeito e minha admiração. Agradeço a todos os professores e colegas do departamento de Microbiologia. O presente trabalho foi realizado com apoio da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior -Brasil (CAPES) -Código de Financiamento 001. regulada positivamente quando D+PPPB foi comparado ao controle D+PP (ANOVA, p<0.05)., L.acidophilus LA5 induziu a regulação positiva da transcrição de ocln, tanto na presença como na ausência de periodontite, embora não tenha sido observada diferença significante na expressão deste gene entre os grupos D+PP e D+PPPB. A periodontite e/ou a diabetes não interferiram na expressão relativa de muc1, no entanto, a administração do probiótico levou a regulação positiva de muc1 (não significante) quando comparados os grupos D+SHAM e D+PB, e esta regulação positiva pelo probiótico foi estatisticamente significante entre os grupos D+SHAM e D+PP e D+PPPB. Apesar das limitações dos modelos animais, o presente estudo sugere que L. acidophilus LA5 apresenta potencial para ser utilizado como adjuvante ao tratamento da diabetes tipo 2 e da periodontite. No entanto, outros estudos experimentais elucidando seu mecanismo de ação devem ser realizados antes de seu uso clínico. Palavras chaves: Periodontite. Diabetes. Lactobacillus acidophilus. Probiótico.

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Cardiovascular, renal and liver protection with novel antidiabetic agents beyond blood glucose lowering in type 2 diabetes: consensus article from the European Society of Hypertension Working Group on Obesity, Diabetes and the High-risk Patient

Cited by 32 publications

References 98 publications

Trends in the Prevalence of Metabolically Healthy Obesity Among US Adults, 1999-2018

Trends in the Prevalence of Metabolically Healthy Obesity Among US Adults, 1999-2018

Sodium-glucose cotransporter 2 (SGLT2) inhibitor initiation and hepatocellular carcinoma prognosis

Efeito do probiótico Lactobacillus acidophilus LA5 em modelo de periodontite induzida em camundongos diabéticos

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