Diabesity in Elderly Cardiovascular Disease Patients: Mechanisms and Regulators

Abstract

Cardiovascular disease (CVD) is the leading cause of death in the world. In 2019, 550 million people were suffering from CVD and 18 million of them died as a result. Most of them had associated risk factors such as high fasting glucose, which caused 134 million deaths, and obesity, which accounted for 5.02 million deaths. Diabesity, a combination of type 2 diabetes and obesity, contributes to cardiac, metabolic, inflammation and neurohumoral changes that determine cardiac dysfunction (diabesity-related cardiomyopathy). Epicardial adipose tissue (EAT) is distributed around the myocardium, promoting myocardial inflammation and fibrosis, and is associated with an increased risk of heart failure, particularly with preserved systolic function, atrial fibrillation and coronary atherosclerosis. In fact, several hypoglycaemic drugs have demonstrated a volume reduction of EAT and effects on its metabolic and inflammation profile. However, it is necessary to improve knowledge of the diabesity pathophysiologic mechanisms involved in the development and progression of cardiovascular diseases for comprehensive patient management including drugs to optimize glucometabolic control. This review presents the mechanisms of diabesity associated with cardiovascular disease and their therapeutic implications.

Mediterranean diet and health in the elderly

“…Abdominal obesity accompanied by dyslipidemia, hypertension and insulin resistance result in metabolic syndrome (MetS) that has been increasing significantly in recent decades. The relationship between obesity and T2DM is so strong that the new term “diabesity” has been introduced [11] .…”

Insights into Exosome in the Intervertebral Disc: Emerging Role for Disc Homeostasis and Normal Function

“…A spectrum of pathogenic factors and intercellular effects participate in the IDD progression [33]. For instance: superfluous mechanical stress; excessive oxidative stress; adverse inflammatory cytokines [34][35][36][37][38][39][40]. Besides, diabesity and high body mass index which might change the microvasculature of CEP and adjacent vertebral body also influence the nutrient supply into IVD, thus accelerating the development of IDD [39][40][41].…”

Associations of diabesity with all‐cause and cardiovascular disease mortality: Findings from the Mexico City Prospective Study

“…4 Obesity and diabetes share risk factors, such as unhealthy diets and low leisure time physical activity, as well as conditions and diseases, including cardiovascular diseases (CVD), dyslipidemia, hypertension, metabolic-associated fatty liver disease and metabolic syndrome, among others. 4,5 The factor that probably stands out in both conditions is insulin resistance, a consequence of abdominal adiposity. 6 The term 'diabesity' describes a condition in which both diabetes and obesity coexist, referring to the close association in the pathophysiology of both conditions and how they exacerbate each other.…”

“…By 2017, a global prevalence of 6.3% was estimated, meaning about 462 million people had diabetes 4 . Obesity and diabetes share risk factors, such as unhealthy diets and low leisure time physical activity, as well as conditions and diseases, including cardiovascular diseases (CVD), dyslipidemia, hypertension, metabolic‐associated fatty liver disease and metabolic syndrome, among others 4,5 . The factor that probably stands out in both conditions is insulin resistance, a consequence of abdominal adiposity 6…”