Plasma triglycerides predict incident albuminuria and progression of coronary artery calcification in adults with type 1 diabetes: The Coronary Artery Calcification in Type 1 Diabetes Study

Bjornstad, Petter; Maahs, David M.; Wadwa, R. Paul; Pyle, Laura; Rewers, Marian; Eckel, Robert H.; Snell‐Bergeon, Janet K.

doi:10.1016/j.jacl.2014.08.008

Cited by 30 publications

(22 citation statements)

References 35 publications

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“…In addition, other study has shown no difference between diabetic CAD and non-CAD group. 18 The high LDL and low HDL areconsidered to be major key player in the development of coronary atherosclerosis though, 19,20,21 the present study revealed no association between dyslipidemia and coronary stenosis (p = 0.6). This discrepancy may be due to the limited size of the study population and is mono-centered.…”

Section: Discussionmentioning

confidence: 50%

Association of Cardiovascular Risk Factors and Coronary Artery Lesion Among Coronary Artery Disease Patients

Koju

Humagain

Khanal

2015

Kathmandu Univ. Med. J.

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Background Coronary artery disease (CAD) is associated with the numbers of risk factors causing coronary atherosclerosis. Coronary artery stenosis is mostly caused by coronary atherosclerosis.Objective This study aims to analyze the association between coronary artery stenosis and cardiovascular risk factors.Methods An observational study was conducted among CAD patients. The diagnostic coronary angiogram was performed from femoral approach using standard catheters and techniques to find out any abnormalities.Result A total 73 patients (44 male and 29 female) with coronary artery disease undergoing diagnostic coronary angiography was included with the documented cardiovascular risk factors. The coronary stenosis was found in 40 patients on the basis of stenosis grading. Among the established cardiovascular risk factors, sex, diabetes mellitus and smokers show are significantly associated with coronary stenosis among CAD patients. The present study shows the significant association of coronary stenosis among male CAD patients (OR 2.47; CI 0.94 – 6.48, p <0.05) and similar association has been observed in diabetes mellitus (OR 3.32; CI 1.12 – 9.84, p <0.05) and smoking (OR 4.10; CI 1.45 – 11.61, p <0.01).Conclusion The prevalence of CAD is increased with numbers of presence of cardiovascular risk factors. Male gender, diabetes mellitus and smoking are significantly associated with coronary stenosis among CAD patients. However, hypertension and dyslipidemia are comparable between coronary stenosis and no significant stenosis group.Kathmandu University Medical Journal Vol.12(2) 2014: 137-140

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Section: Discussionmentioning

confidence: 50%

Association of Cardiovascular Risk Factors and Coronary Artery Lesion Among Coronary Artery Disease Patients

Koju

Humagain

Khanal

2015

Kathmandu Univ. Med. J.

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“…The inverse association between HDL-C and triglycerides complicates analysis designed to evaluate the independent contribution of elevated triglycerides levels to mortality. Although the majority of studies found a substantial direct association between triglycerides and adverse outcomes, [3][4][5][6][7][8][9][10][11]28,29 triglycerides have received less attention as a causal risk factor, as adjustment for HDL-C and other potential cofounders, tend to attenuate or nullify the association between triglycerides concentration and cardiovascular risk. [12][13][14][15]30,31 In a recent longitudinal observational study in out-patients with type 2 diabetes mellitus, mean triglycerides levels were significantly associated with all-cause mortality after adjustment for several confounding factors including mean values of HDL-C. 32 In our report, triglycerides levels are significantly associated with excessive risk for 22-year mortality, even after adjustment for HDL-C and for other potential confounders.…”

Section: Pendulum Moves From Hdl-c To Triglyceridesmentioning

confidence: 99%

Elevated Triglyceride Level Is Independently Associated With Increased All-Cause Mortality in Patients With Established Coronary Heart Disease

Klempfner

Erez

Ben‐Zekry

et al. 2016

Circ: Cardiovascular Quality and Outcomes

159

107

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Background-The independent association between elevated triglycerides and all-cause mortality among patients with established coronary heart disease is controversial. The aim of this study was to investigate this association in a large cohort of patients with proven coronary heart disease. Methods and Results-The study cohort comprised 15 355 patients who were screened for the Bezafibrate Infarction Prevention (BIP) trial. Twenty-two-year mortality data were obtained from the national registry. Patients were divided into 5 groups according to strata of fasting serum triglycerides: (1) low-normal triglycerides (<100 mg/dL); (2) highnormal triglycerides (100-149 mg/dL); (3) borderline hypertriglyceridemia triglycerides (150-199 mg/dL); (4) moderate hypertriglyceridemia triglycerides (200-499 mg/dL); (5) severe hypertriglyceridemia triglycerides (≥500 mg/dL). Ageand sex-adjusted survival was 41% in the low-normal triglycerides group than 37%, 36%, 35%, and 25% in groups with progressively higher triglycerides (P<0.001). In an adjusted Cox-regression for various covariates including high-density lipoprotein cholesterol, each 1 unit of natural logarithm (Ln) triglycerides elevation was associated with a corresponding 6% (P=0.016) increased risk of 22-year all-cause mortality. The 22-year mortality risk for patients with severe hypertriglyceridemia was increased by 68% when compared with patients with low-normal triglycerides (P<0.001). Conclusions-In patients with established coronary heart disease, higher triglycerides levels are independently associated with increased 22-year mortality. Even in patients with triglycerides of 100 to 149 mg/dL, the elevated risk for death could be detected than in patients with lower triglycerides levels, whereas severe hypertriglyceridemia denotes a population with particularly increased mortality risk. (Circ Cardiovasc Qual Outcomes. 2016;9:100-108.

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“…Plasma triglyceride levels predict incident albuminuria in T1D subjects and rodents (36,55). Diabetic albuminuria involves several pathogenic mechanisms, including disruption of the glomerular barrier as well as proximal tubular injury.…”

Section: Mia-602 Improves Vascular Function In T1dmentioning

confidence: 99%

Role of growth hormone-releasing hormone in dyslipidemia associated with experimental type 1 diabetes

Romero

Lucas

Dou

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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Dyslipidemia associated with triglyceride-rich lipoproteins (TRLs) represents an important residual risk factor for cardiovascular and chronic kidney disease in patients with type 1 diabetes (T1D). Levels of growth hormone (GH) are elevated in T1D, which aggravates both hyperglycemia and dyslipidemia. The hypothalamic growth hormone-releasing hormone (GHRH) regulates the release of GH by the pituitary but also exerts separate actions on peripheral GHRH receptors, the functional role of which remains elusive in T1D. In a rat model of streptozotocin (STZ)-induced T1D, GHRH receptor expression was found to be up-regulated in the distal small intestine, a tissue involved in chylomicron synthesis. Treatment of T1D rats with a GHRH antagonist, MIA-602, at a dose that did not affect plasma GH levels, significantly reduced TRL, as well as markers of renal injury, and improved endothelial-dependent vasorelaxation. Glucagon-like peptide 1 (GLP-1) reduces hyperglucagonemia and postprandial TRL, the latter in part through a decreased synthesis of apolipoprotein B-48 (ApoB-48) by intestinal cells. Although plasma GLP-1 levels were elevated in diabetic animals, this was accompanied by increased rather than reduced glucagon levels, suggesting impaired GLP-1 signaling. Treatment with MIA-602 normalized GLP-1 and glucagon to control levels in T1D rats. MIA-602 also decreased secretion of ApoB-48 from rat intestinal epithelial cells in response to oleic acid stimulation in vitro, in part through a GLP-1-dependent mechanism. Our findings support the hypothesis that antagonizing the signaling of GHRH in T1D may improve GLP-1 function in the small intestine, which, in turn, diminishes TRL and reduces renal and vascular complications.yslipidemia frequently accompanies type 1 diabetes (T1D) and represents an important component of the disease, imposing cardiovascular risk and correlating with renal dysfunction (1, 2). Current clinical approaches directed toward diabetic dyslipidemia, including changes in lifestyle, stringent glycemic control, lipid lowering therapy, or combinations thereof, offer limited benefit, thus emphasizing the need for the development of novel therapies.Therapy with statins reduces major cardiovascular events largely through reduction of low-density lipoprotein (LDL) cholesterol (3). Still, an important residual cardiovascular risk, which is independent of LDL cholesterol levels, remains (4-8). Chylomicrons (CMs), chylomicron remnants (CMRs), and very low-density lipoproteins (VLDLs), cumulatively known as triglyceride-rich lipoproteins (TRLs), contribute significantly to postprandial lipemia (9). Increased TRL levels represent an important additional risk factor for atherosclerosis (10), particularly in subjects with diabetes or the metabolic syndrome (11).Glucagon-like peptide 1 (GLP-1), an incretin hormone secreted in the small intestine, promotes postprandial insulin release, thereby reducing blood glucose levels (12). Endogenous GLP-1 also reduces postprandial glucagon secretion through direct actions on p...

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Plasma triglycerides predict incident albuminuria and progression of coronary artery calcification in adults with type 1 diabetes: The Coronary Artery Calcification in Type 1 Diabetes Study

Cited by 30 publications

References 35 publications

Association of Cardiovascular Risk Factors and Coronary Artery Lesion Among Coronary Artery Disease Patients

Association of Cardiovascular Risk Factors and Coronary Artery Lesion Among Coronary Artery Disease Patients

Elevated Triglyceride Level Is Independently Associated With Increased All-Cause Mortality in Patients With Established Coronary Heart Disease

Role of growth hormone-releasing hormone in dyslipidemia associated with experimental type 1 diabetes

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