George Lyman Duff Memorial Lecture. Atherogenesis in diabetes.

Bierman, Edwin L.

doi:10.1161/01.atv.12.6.647

Cited by 360 publications

(78 citation statements)

References 77 publications

(38 reference statements)

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“…11 Multiple risk factors are associated with cardiovascular disease in subjects with diabetes, including hypertension, hyperlipidemia and obesity. 12 The present study, for the first time, reports the level of control of CVD risk factors in patients of T2DM with regard to gender in the southern region of Saudi Arabia. It reveals that hyperglycaemia, hypertension, and dyslipidaemia have been poorly controlled in such patients, despite widespread coverage of medical care.…”

Section: Discussionmentioning

confidence: 84%

Prevalence and control of cardiovascular risk factors among type 2 diabetes mellitus patients in southern region of Saudi Arabia

Alavudeen¹,

Dhanapal²,

Khan³

et al. 2013

Journal of Young Pharmacists

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a b s t r a c tBackground/Aim: Dyslipidemia is a significant predictor of cardiovascular events and mortality in diabetes patients. The aim of this study is to estimate the prevalence rates, characteristics of dyslipidemia and their control in outpatient population in a Diabetic Centre. Methods: A cross sectional prospective study design was used to collect data from 255 patients which included patient characteristics, past medical history of CVD, medications and parameters related to DM and cardiovascular risk factor control. Blood pressure and laboratory measurements for glycosylated hemoglobin and lipoprotein panel were recorded. Results: Body mass index (BMI) of the dyslipidemic diabetic patients was significantly higher for females. In terms of age, duration of diabetes, family history, diabetes treatment offered did not differed significantly among genders. Clinical characteristics of HDL values were significantly higher for female in comparison to men (P ¼ 0.02) whereas glycosylated hemoglobin and blood pressure appeared not to differ significantly. Among the three factors studied BMI, duration of diabetes mellitus and drug therapy on lipoprotein levels of diabetes patients, except for the influence of drug therapy which influenced significantly the total cholesterol level (P ¼ 0.02). Number of females with normolipid were more than males (P ¼ 0.009) and number of males with abnormal cholesterol and triglyceride patients were significantly more than females (0.0002). Conclusion: Dyslipidemia among males were higher than females which could be a significant risk factor for causing low glycemic control culminating in cardiovascular events. Control of hyperglycaemia and other CVD risk factor appears to be suboptimal in Saudi Arabia. Addressing health system components such as providing medical staff training, incentive to health professionals and better patient education may improve quality of DM care.

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Section: Discussionmentioning

confidence: 84%

Prevalence and control of cardiovascular risk factors among type 2 diabetes mellitus patients in southern region of Saudi Arabia

Alavudeen¹,

Dhanapal²,

Khan³

et al. 2013

Journal of Young Pharmacists

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“…This possibility is supported by the fact that glycation of plasma LP is elevated in diabetic subjects, which relates to several lipid and LP disturbances in this disease [1,32,48,49].…”

Section: Discussionmentioning

confidence: 90%

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confidence: 99%

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Plasma lipoproteins from patients with poorly controlled diabetes mellitus and "in vitro" glycation of lipoproteins enhance the transfer rate of cholesteryl ester from HDL to apo-B-containing lipoproteins

et al. 1997

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Several factors may be responsible for the high prevalence of premature atherosclerosis in diabetes mellitus [1], including possible alterations in the reverse cholesterol transport system [2][3][4][5][6][7].Plasma lipoproteins (LP) are continually modified intravascularly and in the interstitium due to enzymatic action and interchanges of lipid fractions and apolipoproteins [2,8,9]. The role of cholesteryl ester transfer protein (CETP) in intravascular cholesteryl ester (CE) transport has been fully reviewed [2,[10][11][12]. In addition to promoting a bidirectional flux of cholesteryl ester between LP, CETP also mediates the heteromolecular exchange whereby triglyceride (TG)-rich LP gains CE and loses TG [13]. The direction of this flow is partially determined by the lipid composition of the LP involved [14,15]. Diabetologia (1997Diabetologia ( ) 40: 1085Diabetologia ( -1093 Plasma lipoproteins from patients with poorly controlled diabetes mellitus and "in vitro" glycation of lipoproteins enhance the transfer rate of cholesteryl ester from HDL to apo-B-containing lipoproteins Summary Alterations in the reverse cholesterol transport system have been described in diabetic mellitus patients in several but not all studies. Furthermore, recently published investigations suggest that a faster "in vitro" transfer rate of cholesteryl ester from high density lipoproteins to apoB-containing lipoproteins could be solely ascribed to variation of the plasma lipoprotein composition and concentration in the diabetic state. The present study analysed the influence of lipoprotein glycation on the cholesteryl ester transfer protein-mediated transfer of esterified cholesterol from high density lipoprotein and its subfractions to lighter density lipoproteins. For this purpose two sets of "in vitro" experiments were carried out utilizing:1) plasma lipoproteins drawn from diabetic and from normal subjects and; 2) normal lipoproteins or partially purified cholesteryl ester transfer protein submitted to "in vitro" glycation. The transfer rate of 14 C-cholesteryl ester labelled HDL subfractions to low or very low density lipoproteins was measured in all experiments. After incubations with plasma d > 1.21 g/ml or with purified cholesteryl ester transfer protein, apoB-containing lipoproteins were precipitated with a dextran sulfate/MgCl 2 solution. The "in vitro" glycation of the partially purified cholesteryl ester transfer protein markedly impaired its activity. However, greater transfer rates were observed when lipoproteins from diabetic individuals or the "in vitro" glycated lipoproteins were utilized. This effect was attributed to glycation of the protein component of HDL. In conclusion, lipoprotein glycation elicits an enrichment of the apoB-containing lipoproteins with cholesteryl ester that is likely related to the premature atherosclerosis in patients with poorly controlled diabetes. [Diabetologia (1997[Diabetologia ( ) 40: 1085[Diabetologia ( -1093

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“…The purpose of conducting this study in diabetic families was with definite aim to examine the prevalence of metabolic syndrome, insulin resistance and oxidative stress in those with and without genetic predisposition. Diabetic subjects have greater probability of developing CVD and there are reports that in adult patients with diabetes, the risk of CAD is 3 to 5 folds greater than in non-diabetics despite controlling for other known risk factors (10,18). Metabolic syndrome, which is considered as CHD equivalent in ATP III guidelines has almost 20% chances of developing CHD in 10 years and various components of metabolic syndrome-obesity, HT, hyperglycemia and dyslipidemia are found to be associated with insulin resistance.…”

Section: Resultsmentioning

confidence: 99%

Oxidative stress in metabolic syndrome

Sharma

Mishra

Ajmera

et al. 2005

Indian J Clin Biochem

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As antioxidants play a protective role in the pathophysiology of diabetes and cardiovascular diseases, understanding the physiological status of antioxidant concentration among people at high risk for developing these conditions, such as Metabolic Syndrome, is of interest. In present study out of 187 first degree non-diabetic relatives and 192 non-diabetic spouses, 33.1% and 19.7 % were found to have metabolic syndrome respectively. Subjects with metabolic syndrome (> 3 risk factors) had poor antioxidants status as reflected by significantly low levels of vitamin A, C & E and significantly increased (p < 0.01) oxidative stress as compared to those without metabolic syndrome. At the same time serum insulin levels and insulin resistance were found to be significantly high (p < 0.001) in metabolic syndrome. A strong positive correlation (r=0.946; p<0.001) between oxidative stress and insulin resistance was observed in metabolic syndrome. Low levels of antioxidants and increased oxidative stress with insulin resistance in metabolic syndrome suggests that besides therapeutic life style changes (TLC) as suggested in ATP III guidelines inclusion of antioxidant vitamins, fruits and vegetable could be beneficial to ward off the consequences of metabolic syndrome.

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George Lyman Duff Memorial Lecture. Atherogenesis in diabetes.

Cited by 360 publications

References 77 publications

Prevalence and control of cardiovascular risk factors among type 2 diabetes mellitus patients in southern region of Saudi Arabia

Prevalence and control of cardiovascular risk factors among type 2 diabetes mellitus patients in southern region of Saudi Arabia

Plasma lipoproteins from patients with poorly controlled diabetes mellitus and "in vitro" glycation of lipoproteins enhance the transfer rate of cholesteryl ester from HDL to apo-B-containing lipoproteins

Oxidative stress in metabolic syndrome

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