Selected Organ and Endocrine Complications According to BMI and the Metabolic Category of Obesity: A Single Endocrine Center Study

Gau

et al. 2022

JCM

Background: Non-T2 asthma and hypothyroidism share several inflammatory mechanisms in common. However, large-scale, real-world studies evaluating the association between asthma and hypothyroidism are lacking. The objective of this study was to evaluate the risk for asthma patients of developing hypothyroidism. Methods: In the retrospective cohort study, people with asthma were recruited from the Longitudinal Health Insurance Database in Taiwan. After excluding ineligible patients with a previous history of hypothyroidism, 1:1 propensity matching was conducted to select a non-asthma control group. Based on the multivariate Cox regression model, the adjusted hazard ratio of asthma patients developing hypothyroidism was calculated. Results: In total, 95,321 asthma patients were selected as the asthma group and the same amount of people without asthma were selected as the control group. The incidence levels of new-onset hypothyroidism in asthma and non-asthma groups were 8.13 and 6.83 per 100,000 people per year, respectively. Compared with the non-asthma group, the adjusted hazard ratio of the asthma group developing hypothyroidism was 1.217 (95% confidence interval, 1.091–1.357). Conclusions: We found having asthma to be associated with an increased risk of hypothyroidism. Clinicians should be concerned regarding the endocrinological and inflammatory interaction between the two diseases while caring for people with asthma.

Section: Discussionmentioning

confidence: 99%

Increased Risk of Hypothyroidism in People with Asthma: Evidence from a Real-World Population-Based Study

Gau

et al. 2022

JCM

“…Usually raised triglycerides, total and LDL cholesterol, and reduced HDL cholesterol are observed ( 8 , 37 ). However, abnormal lipid panel might result from obesity alone ( 38 ). Previous studies in subjects with CS have shown a positive correlation between FABP4 and triglycerides, and BMI ( 13 , 19 ), as observed in our cohort, while correlations with cholesterol fractions were inconclusive.…”

Section: Discussionmentioning

confidence: 99%

Cushing’s syndrome is associated with altered adipokine profile

et al. 2022

Self Cite

IntroductionAdipokines are signaling molecules involved in the integration of metabolism. Changes in their concentrations were observed in obesity, metabolic syndrome, diabetes mellitus and cardiovascular diseases, as well as endocrine disorders. Cushing’s syndrome is associated with metabolic dysregulation, but the significance of adipokines in this entity and related complications is largely unknown. The aim of our study was to determine the concentrations of adipokines: fetuin A, fatty acid binding protein 4 (FABP4) and retinol binding protein 4 (RBP4) in Cushing’s syndrome and to assess their relation to established cardiovascular and diabetes risk markers.MethodsWe examined 21 subjects with Cushing’s syndrome and 24 healthy controls in a cross-sectional manner. Venous blood samples were analysed for adipokines, cortisol, adrenocorticotrophin, glucose, insulin, glycated haemoglobin (HbA1c), triglycerides, cholesterol fractions, thyrotropin and free thyroid hormones concentrations. Patients’ body mass index (BMI) was evaluated, homeostatic model assessment-insulin resistance and Systematic Coronary Risk Evaluation (SCORE) were calculated.ResultsWe found that the concentration of fetuin A was lower, while FABP4 and RBP4 concentrations were higher in Cushing’s syndrome compared to controls [156.4 ± 60.0 µg/ml vs 260.7 ± 49.6 µg/ml; 79.8 (35.2-156.1) ng/ml vs 27.9 (17.1-36.7) ng/ml and 34 (30-37.7) mg/l vs 25.8 (23.6-27.7) mg/l, respectively]. Fetuin A correlated inversely, while FABP4 and RBP4 positively, with the concentrations of urinary free cortisol and adrenocorticotrophin. Fetuin A was positively related to LDL-cholesterol, and negatively to SCORE and HbA1c. FABP4 was associated positively with BMI, HbA1c and triglycerides, while RBP4 correlated positively with triglycerides and systolic blood pressure.ConclusionsAdipokines’ concentrations change in hypercortisolism. Further research is needed to ascertain whether adipokines are involved in the development of metabolic complications accompanying Cushing’s syndrome or secondarily reflect metabolic dysregulation.

“…The link between increased cardiovascular risk and obesity can be explained by multiple mechanisms [ 166 ], such as increased incidence of hypertension [ 103 , 104 ], type II diabetes [ 109 ] and insulin resistance [ 167 ], hypercholesterolemia [ 103 ], systemic inflammation [ 168 ], endothelial dysfunction [ 169 ] and increased platelet aggregability [ 161 ].…”

Section: Cardiovascular Diseasesmentioning

confidence: 99%

ANMCO (Italian Association of Hospital Cardiologists) scientific statement: obesity in adults—an approach for cardiologists

Di Fusco,

Mocini,

Gulizia

et al. 2024

Eat Weight Disord

Obesity is a complex, chronic disease requiring a multidisciplinary approach to its management. In clinical practice, body mass index and waist-related measurements can be used for obesity screening. The estimated prevalence of obesity among adults worldwide is 12%. With the expected further increase in overall obesity prevalence, clinicians will increasingly be managing patients with obesity. Energy balance is regulated by a complex neurohumoral system that involves the central nervous system and circulating mediators, among which leptin is the most studied. The functioning of these systems is influenced by both genetic and environmental factors. Obesity generally occurs when a genetically predisposed individual lives in an obesogenic environment for a long period. Cardiologists are deeply involved in evaluating patients with obesity. Cardiovascular risk profile is one of the most important items to be quantified to understand the health risk due to obesity and the clinical benefit that a single patient can obtain with weight loss. At the individual level, appropriate patient involvement, the detection of potential obesity causes, and a multidisciplinary approach are tools that can improve clinical outcomes. In the near future, we will probably have new pharmacological tools at our disposal that will facilitate achieving and maintaining weight loss. However, pharmacological treatment alone cannot cure such a complex disease. The aim of this paper is to summarize some key points of this field, such as obesity definition and measurement tools, its epidemiology, the main mechanisms underlying energy homeostasis, health consequences of obesity with a focus on cardiovascular diseases and the obesity paradox.Level of evidence V: report of expert committees.