Impact of body mass index and metabolic phenotypes on coronary artery disease according to glucose tolerance status

Fujihara, Kazuya; Matsubayashi, Yasuhiro; Yamamoto, Masahiko; Osawa, Taeko; Ishizawa, Masahiro; Kaneko, Masanori; Matsunaga, Satoshi; Kato, Kiminori; Seida, Hiroyasu; Yamanaka, Nauta; Kodama, Satoru

doi:10.1016/j.diabet.2017.08.002

Cited by 26 publications

(20 citation statements)

References 15 publications

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“… 36 ) The impact of obesity and metabolically unhealthy phenotype on the development of CAD based on the glucose tolerance status showed that nonobese persons in a metabolically unhealthy state had an approximately two- to three-fold increased risk of CAD compared with those not in a metabolically unhealthy state across all glucose tolerance categories. 37 ) In contrast, the presence of obesity alone showed no increase in the risk of CAD in all glucose tolerance categories. Compared with nonobese individuals with normal glucose tolerance not in a metabolically unhealthy state, the risk of CAD in obese prediabetic individuals in a metabolically unhealthy state was four-fold, which was equal to that in nonobese individuals with diabetes not in a metabolically unhealthy state.…”

Section: Relationship Between Glucose Abnormality Metabolic Phenotypmentioning

confidence: 89%

“…Compared with nonobese individuals with normal glucose tolerance not in a metabolically unhealthy state, the risk of CAD in obese prediabetic individuals in a metabolically unhealthy state was four-fold, which was equal to that in nonobese individuals with diabetes not in a metabolically unhealthy state. 37 )…”

Section: Relationship Between Glucose Abnormality Metabolic Phenotypmentioning

confidence: 99%

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Cardiovascular Disease in Japanese Patients with Type 2 Diabetes Mellitus

Fujihara

Sone

2018

Annals of Vascular Diseases

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Individuals with diabetes have a two- to four-fold increased risk of coronary artery disease (CAD) and higher mortality rates than those without diabetes. Because not only microvascular but also macrovascular disease in patients with diabetes are known to predispose patients to a lower quality of life as well as lead to higher mortality rates, identifying and managing risk factors of CAD is of clinical relevance in diabetes care. A number of antihyperglycemic drugs are currently approved for the treatment of hyperglycemia in patients with type 2 diabetes mellitus (T2DM), with several new drugs having been developed during the last decade. Diabetes-related complications have been substantially reduced worldwide. However, in view of the current situation in which both the prevalence of obesity and glucose abnormality have increased worldwide, including Japan, diet and exercise remain the crucial means of treatment for patients with diabetes. Furthermore, predicting the development of CAD is essential. This review summarizes data from recent studies on cardiovascular disease in patients with T2DM, focusing on clinical trials and big data, including studies involving Japanese individuals.

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Section: Relationship Between Glucose Abnormality Metabolic Phenotypmentioning

confidence: 89%

Section: Relationship Between Glucose Abnormality Metabolic Phenotypmentioning

confidence: 99%

Cardiovascular Disease in Japanese Patients with Type 2 Diabetes Mellitus

Fujihara

Sone

2018

Annals of Vascular Diseases

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“…However, BMI alone may not accurately indicate MHO [21]; the combination of these obesity indices may be more suitable to investigate the incidence of MHO than each indicator alone. For example, one Japanese study classified CVD outcomes according to BMI and glucose tolerance status [22]. In one Korean study, subjects were enrolled from a health screening program in which 60% of the participants were employees with a mean age of 40.2 years.…”

Section: Discussionmentioning

confidence: 99%

The Association between Metabolically Healthy Obesity, Cardiovascular Disease, and All-Cause Mortality Risk in Asia: A Systematic Review and Meta-Analysis

Huang

Wang

Lin

et al. 2020

IJERPH

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We investigated the association among metabolically healthy obesity (MHO), cardiovascular disease (CVD)risk, and all-cause mortality in the Asian population. We searched databases from inception to 16 November, 2019 and pooled data using a random-effects model. Subgroup analysis was conducted according to the following comparison groups: MHNW (without overweight or underweight participants) and MHNO (non-obese, including overweight and underweight participants). Nineteen studies were included. The mean Newcastle–Ottawa Scale score was 7.8. Participants with MHO had a significantly higher CVD risk (odds ratio (OR) = 1.36, 95% confidence interval (CI) = 1.13–1.63) and significantly lower risk of all-cause mortality (OR = 0.88, 95% CI = 0.78–1.00) than the comparison group. Subgroup analyses revealed participants with MHO had a significantly higher CVD risk than MHNW participants (OR = 1.61; 95% CI = 1.24–2.08; I2 = 73%), but there was no significant difference compared with MHNO participants (OR, 1.04; 95% CI, 0.80–1.36; I2 = 68%). Participants with MHO had a significantly lower risk of all-cause mortality (OR = 0.83; 95% CI = 0.78–0.88; I2 = 9%) than MHNO participants, but a borderline significantly higher risk of all-cause mortality than MHNW participants (OR = 1.30; 95% CI = 0.99–1.72; I2 = 0%). The CVD risk and all-cause mortality of the MHO group changed depending on the control group. Thus, future studies should select control groups carefully.

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“…Weight gain is not a major concern with either SGLT2 or DPP‐4 inhibitors. However, obesity is associated with an increased risk of cardiovascular disease, 24 and we focused on the benefits of weight loss in the treatment of diabetes and established no weight gain as a composite primary endpoint in addition to a hypoglycaemic effect. The significance level of 0.025 (one‐sided) was compared using the chi‐squared test.…”

Section: Methodsmentioning

confidence: 99%

A 52‐week randomized controlled trial of ipragliflozin or sitagliptin in type 2 diabetes combined with metformin: The N‐ISM study

Kitazawa

Kubo²,

Suzuki

et al. 2021

Diabetes Obesity Metabolism

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Aim To compare the long‐term efficacy of sodium‐glucose co‐transporter‐2 inhibitors and dipeptidyl peptidase‐4 inhibitors as second‐line drugs after metformin for patients not at high risk of atherosclerotic cardiovascular disease (ASCVD). Materials and methods In a 52‐week randomized open‐label trial, we compared ipragliflozin and sitagliptin in Japanese patients diagnosed with type 2 diabetes, without prior ASCVD and treated with metformin. The primary endpoint was a glycated haemoglobin (HbA1c) reduction of ≥0.5% (5.5 mmol/mol) without weight gain at 52 weeks. Results Of a total of 111 patients (mean age 59.2 years, mean body mass index [BMI] 26.6 kg/m2, 61.3% men), 54 patients received ipragliflozin and 57 received sitagliptin. After 52 weeks, achievement of the primary endpoint was not significantly different (37.0% and 40.3%; P = 0.72). HbA1c reduction rate at 24 weeks was greater for sitagliptin (56.1%) than for ipragliflozin (31.5%; P = 0.01). From 24 to 52 weeks, the HbA1c reduction with sitagliptin was attenuated, with no significant difference in HbA1c reduction after 52 weeks between sitagliptin (54.4%) and ipragliflozin (38.9%; P = 0.10). Improvements in BMI, C‐peptide and high‐density lipoprotein cholesterol were greater with ipragliflozin than with sitagliptin. Adverse events occurred in 17 patients with ipragliflozin and in 10 patients with sitagliptin (P = 0.11). Conclusion The HbA1c‐lowering effect at 24 weeks was greater with sitagliptin than with ipragliflozin, but with no difference in efficacy related to HbA1c and body weight at 52 weeks. However, some ASCVD risk factors improved with ipragliflozin.

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Impact of body mass index and metabolic phenotypes on coronary artery disease according to glucose tolerance status

Cited by 26 publications

References 15 publications

Cardiovascular Disease in Japanese Patients with Type 2 Diabetes Mellitus

Cardiovascular Disease in Japanese Patients with Type 2 Diabetes Mellitus

The Association between Metabolically Healthy Obesity, Cardiovascular Disease, and All-Cause Mortality Risk in Asia: A Systematic Review and Meta-Analysis

A 52‐week randomized controlled trial of ipragliflozin or sitagliptin in type 2 diabetes combined with metformin: The N‐ISM study

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