Imaging Atherosclerosis in Diabetes: Current State

Rahmani, Sina; Nakanishi, Rine; Budoff, Matthew J.

doi:10.1007/s11892-016-0799-2

Cited by 16 publications

(11 citation statements)

References 61 publications

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“…Long-term increased hyperglycemia damages the vascular endothelial cells, promotes the migration and proliferation of vascular smooth muscle cells ( 11 ), and activates plasminogen activator inhibitor-1 in the body ( 12 ), thus increasing the levels of procoagulant factors as well as antithrombotic factors ( 13 ) accelerating the formation of thrombosis and the incidence of cardiovascular events in patients with T2DM complicated with CHD ( 14 ). In addition, in patients with T2DM complicated with CHD ( 15 ), the body's inflammatory cytokines and their effector cells will lead to cytotoxicity inducing pancreatic β-cell apoptosis, thereby increasing insulin resistance ( 16 ). This will, in turn, induce the adipose tissue cells to secrete more inflammatory factors ( 17 ), further aggravating the body's inflammatory response.…”

Section: Discussionmentioning

confidence: 99%

Insulin resistance, blood glucose and inflammatory cytokine levels are risk factors for cardiovascular events in diabetic patients complicated with coronary heart disease

Wang

Guo

et al. 2017

Exp Ther Med

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This study was designed to investigate the relation of insulin resistance, blood glucose and inflammatory cytokines with cardiovascular events in diabetic patients complicated with coronary heart disease (CHD). A total of 120 patients with diabetes mellitus type 2 (T2DM) complicated with CHD admitted to Jinan Central Hospital from January 2015 to March 2016 were enrolled in this study. There were 60 cases complicated with cardiovascular events and 60 had no history of cardiovascular events; there were 40 cases with abnormal blood glucose, 40 with insulin resistance and 40 with elevated inflammatory cytokines. Changes in the levels of blood glucose, fasting serum insulin and inflammatory cytokines as well as changes in the homeostasis model assessment of insulin resistance indexes (HOMA-IR) were recorded and compared among groups of patients. Besides, changes in the Global Registry of Acute Coronary Events (GRACE) risk score and the incidence rate of cardiovascular events were also detected and multivariate logistic regression analysis was conducted so as to identify relevant risk factors. Our results showed the fasting blood glucose and the 2 h postprandial blood glucose levels in the non-cardiovascular event group were lower than those in the cardiovascular event group (P<0.05). However, levels of fasting serum insulin and HOMA-IR in the non-cardiovascular event group were significantly higher than those in the cardiovascular event group (P<0.05). Additionally, levels of tumor necrosis factor-α (TNF-α), interleukin-6 and C-reactive protein in the non-cardiovascular event group were significantly lower than those in the cardiovascular event group (P<0.05). Moreover, GRACE risk scores in patients with elevated inflammatory cytokines were higher than those in patients with insulin resistance and those in patients with blood glucose abnormalities (P<0.05). The incidence rate of cardiovascular events in patients with blood glucose abnormalities was lower than that in patients with insulin resistance and that in patients with elevated inflammatory cytokines. There was a positive correlation between TNF-α and HOMA-IR (P<0.05), and between HOMA-IR and the GRACE risk score (P<0.05). Blood glucose abnormalities, insulin resistance and inflammatory cytokines were all independent risk factors for cardiovascular events. Based on our findings, stronger inflammatory responses in patients with T2DM complicated with CHD lead to higher incidence rates of cardiovascular events. Besides that, elevated blood glucose and insulin resistance levels are also independent risk factors for cardiovascular events.

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Section: Discussionmentioning

confidence: 99%

Insulin resistance, blood glucose and inflammatory cytokine levels are risk factors for cardiovascular events in diabetic patients complicated with coronary heart disease

Wang

Guo

et al. 2017

Exp Ther Med

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“…The MESA [23] and Heinz Nixdorf [24] studies demonstrated that CAC is a predictor of coronary events and is useful for stratification of cardiovascular risk among patients in primary prevention. This is also true for patients with diabetes: the higher the CAC score, the higher the risk of cardiovascular events in subjects with diabetes [25]. …”

Section: Module 2: Screening Of Subclinical Atherosclerosismentioning

confidence: 99%

Brazilian guidelines on prevention of cardiovascular disease in patients with diabetes: a position statement from the Brazilian Diabetes Society (SBD), the Brazilian Cardiology Society (SBC) and the Brazilian Endocrinology and Metabolism Society (SBEM)

Bertoluci

Moreira

Faludi

et al. 2017

Diabetol Metab Syndr

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BackgroundSince the first position statement on diabetes and cardiovascular prevention published in 2014 by the Brazilian Diabetes Society, the current view on primary and secondary prevention in diabetes has evolved as a result of new approaches on cardiovascular risk stratification, new cholesterol lowering drugs, and new anti-hyperglycemic drugs. Importantly, a pattern of risk heterogeneity has emerged, showing that not all diabetic patients are at high or very high risk. In fact, most younger patients who have no overt cardiovascular risk factors may be more adequately classified as being at intermediate or even low cardiovascular risk. Thus, there is a need for cardiovascular risk stratification in patients with diabetes. The present panel reviews the best current evidence and proposes a practical risk-based approach on treatment for patients with diabetes.Main bodyThe Brazilian Diabetes Society, the Brazilian Society of Cardiology, and the Brazilian Endocrinology and Metabolism Society gathered to form an expert panel including 28 cardiologists and endocrinologists to review the best available evidence and to draft up-to-date an evidence-based guideline with practical recommendations for risk stratification and prevention of cardiovascular disease in diabetes. The guideline includes 59 recommendations covering: (1) the impact of new anti-hyperglycemic drugs and new lipid lowering drugs on cardiovascular risk; (2) a guide to statin use, including new definitions of LDL-cholesterol and in non-HDL-cholesterol targets; (3) evaluation of silent myocardial ischemia and subclinical atherosclerosis in patients with diabetes; (4) hypertension treatment; and (5) the use of antiplatelet therapy.ConclusionsDiabetes is a heterogeneous disease. Although cardiovascular risk is increased in most patients, those without risk factors or evidence of sub-clinical atherosclerosis are at a lower risk. Optimal management must rely on an approach that will cover both cardiovascular disease prevention in individuals in the highest risk as well as protection from overtreatment in those at lower risk. Thus, cardiovascular prevention strategies should be individualized according to cardiovascular risk while intensification of treatment should focus on those at higher risk.

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“…In recent years, the prevalence of diabetes mellitus showed a continuous increase in the trend worldwide [1]. Simultaneously, diabetes mellitus remains a significant independent cardiovascular risk factor.…”

Section: Introductionmentioning

confidence: 99%

Sphingolipids Profiling of Plasma in Patients with Diabetes Mellitus Associated with Atherosclerosis by a Novel Normal-Phase UPLC-QToF MS Method

Yang

Huang

et al. 2017

J. Anal. Test.

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A novel normal-phase UPLC-QToF MS method was developed for sphingolipids analysis, which was then applied to separate and identify seven classes of sphingolipids in plasma. The time-consuming of this novel method was much shorter than previous 2D LC-MS method, while the sensitivity, repeatability and resolution for sphingolipids analysis were better or comparable. Besides, the differences of lipids in human plasma among diabetes mellitus patients, diabetes mellitus associated with atherosclerosis patients and control subjects were also compared. Finally, 12 sphingolipids species were identified as the amounts of which in diabetes mellitus associated with atherosclerosis patients were significantly higher than them in diabetes mellitus patients (VIP [1.0, p value \0.05, fold change [1.5). As the isomers of GalCs and GluCs were successfully separated, it was found that five GluCs, rather than GalCs, were included in these 12 potential biomarkers. These results suggest the need to separate GalCs from GluCs, and also indicated that there may be some extra activation pathways of diabetes mellitus associated with atherosclerosis, different from the atherosclerosis pathway and the diabetes mellitus pathway, causing cardiovascular disease.

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Imaging Atherosclerosis in Diabetes: Current State

Cited by 16 publications

References 61 publications

Insulin resistance, blood glucose and inflammatory cytokine levels are risk factors for cardiovascular events in diabetic patients complicated with coronary heart disease

Insulin resistance, blood glucose and inflammatory cytokine levels are risk factors for cardiovascular events in diabetic patients complicated with coronary heart disease

Brazilian guidelines on prevention of cardiovascular disease in patients with diabetes: a position statement from the Brazilian Diabetes Society (SBD), the Brazilian Cardiology Society (SBC) and the Brazilian Endocrinology and Metabolism Society (SBEM)

Sphingolipids Profiling of Plasma in Patients with Diabetes Mellitus Associated with Atherosclerosis by a Novel Normal-Phase UPLC-QToF MS Method

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