The effect of intensive lifestyle intervention on renal function in patients with diabetes and obesity in real-world practice: A 5-years longitudinal study

Maradni, Ahmad Al; Tomah, Shaheen; Mottalib, Adham; Rosas, Sylvia E.; Alsibai, Khaled; Pober, David M.; Morsi, Amr; Hamdy, Osama

doi:10.1016/j.hnm.2021.200119

Cited by 2 publications

(7 citation statements)

References 31 publications

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“…We have previously published that participants in ILI sustained progressive improvement in serum creatinine and eGFR in the same cohort over 5 years irrespective of weight maintenance or weight regain. 22 The study also showed that the improvement in eGFR is independent of the improvement in systolic BP or the improvement in glycemic control. We postulated that the improvement in renal function is probably related to the improvement in inflammation consequent to weight reduction.…”

Section: Discussionmentioning

confidence: 87%

Long-term effect of intensive lifestyle intervention on cardiometabolic risk factors and microvascular complications in patients with diabetes in real-world clinical practice: a 10-year longitudinal study

Tomah

Zhang

Al‐Badri

et al. 2023

BMJ Open Diab Res Care

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IntroductionIntensive lifestyle intervention (ILI) has significantly reduced incidence of diabetes and improved many cardiovascular disease risk factors. We evaluated long-term effects of ILI on cardiometabolic risk factors, and microvascular and macrovascular complications among patients with diabetes in real-world clinical practice.Research design and methodsWe evaluated 129 patients with diabetes and obesity enrolled in a 12-week translational model of ILI. At 1 year, we divided participants into group A, who maintained <7% weight loss (n=61, 47.7%), and group B, who maintained ≥7% weight loss (n=67, 52.3%). We continued to follow them for 10 years.ResultsThe total cohort lost an average of 10.8±4.6 kg (−9.7%) at 12 weeks and maintained an average weight loss of 7.7±10 kg (−6.9%) at 10 years. Group A maintained 4.3±9.5 kg (−4.3%) and group B maintained 10.8±9.3 kg (−9.3%) of weight loss at 10 years (p<0.001 between groups). In group A, A1c decreased from 7.5±1.3% to 6.7±0.9% at 12 weeks but rebounded to 7.7±1.4% at 1 year and 8.0±1.9% at 10 years. In group B, A1c decreased from 7.4±1.2% to 6.4±0.9% at 12 weeks then increased to 6.8±1.2% at 1 year and 7.3±1.5% at 10 years (p<0.05 between groups). Maintenance of ≥7% weight loss at 1 year was associated with a 68% lower risk of developing nephropathy for up to 10 years compared with maintenance of <7% weight loss (adjusted HR for group B: 0.32, 95% CI 0.11, 0.9, p=0.007).ConclusionsWeight reduction in patients with diabetes can be maintained for up to 10 years in real-world clinical practice. Sustained weight loss is associated with significantly lower A1c at 10 years and improvement in lipid profile. Maintenance of ≥7% weight loss at 1 year is associated with decreased incidence of diabetic nephropathy at 10 years.

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Section: Discussionmentioning

confidence: 87%

Long-term effect of intensive lifestyle intervention on cardiometabolic risk factors and microvascular complications in patients with diabetes in real-world clinical practice: a 10-year longitudinal study

Tomah

Zhang

Al‐Badri

et al. 2023

BMJ Open Diab Res Care

Self Cite

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“…sdLDL-C was a subclass of type LDL-C. There are two types of LDL-C: pattern A [(large buoyant (lbLDL-C)] and pattern B [(small dense LDL-C (sdLDL-C)] [4]. sdLDL-C was considered an atherogenic subclass of LDL-C since its characteristic has a small size and more sustain in the artery wall [4] as the leading cause of vascular stiffening [5].…”

Section: Discussionmentioning

confidence: 99%

“…There are two types of LDL-C: pattern A [(large buoyant (lbLDL-C)] and pattern B [(small dense LDL-C (sdLDL-C)] [4]. sdLDL-C was considered an atherogenic subclass of LDL-C since its characteristic has a small size and more sustain in the artery wall [4] as the leading cause of vascular stiffening [5]. A crucial aspect led to cardiovascular diseases (CVD) is diabetic dyslipidemia or atherogenic dyslipidemia, which is signed by elevated sdLDL-C, elevated TG, and decreased HDL-C [6,7].…”

Section: Discussionmentioning

confidence: 99%

“…A new equation of cLDL-C seems more accurate and possibly be used in patients with low LDL-C levels and hypertriglyceridemia (TG levels, ≤800 mg/dL) than the previous equation [3]. The body mass index based on the Quetelet index (kg/m 2 ) was defined into three criteria [4]; normal (≥25.0), overweight (25.1-27.00), and obesity (≥27.1), and central obesity was defined as a waist circumference of ≥ 90 and ≥80 cm [5], for man and women respectively.…”

Section: Clinical Parametersmentioning

confidence: 99%

“…The numerous factors of DM are smoking, low physical activity, dietary pattern, age, gender, and dyslipidemia [4][5][6][7][8][9][10]. In addition, some studies considered the association of DM with education level, wealth [11], and place of living [12,13].…”

Section: Introductionmentioning

confidence: 99%

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Small Dense Low-Density Lipoprotein Cholesterol and Central Obesity Associated With Diabetes Mellitus Among Indonesian Adults

Rohmaeni,

Hardinsyah,

Hardinsyah

et al. 2023

JGI

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Background: Small dense low-density lipoprotein (sdLDL-C) is an atherogenic lipoprotein. Increased sdLDL-C concentration was hypothesized to be associated with obesity and diabetes mellitus (DM).Objectives: The study aimed to determine the association between sdLDL-C, central obesity, and DM among Indonesian adults, controlled by personal and clinical parameters.Materials and Methods: This study used secondary data from Basic Health Research 2013 of the Ministry of Health, which applied a cross-sectional study design. For this purpose, 30,548 subjects aged 19-79 were analyzed. The sdLDL-C was performed by using Sampson Formula derived from conventional lipid panels. As investigated by Sampson, the formula referred to cLDL-C (calculated LDL-C) and ElbLDL-C (estimated large buoyant LDL-C).Results: There was a positive association between sdLDL-C and central obesity (OR: 3.94; 95% CI: 3.13-3.89), as well as sdLDL-C and DM status (OR: 1.98; 95% CI; 1.43-2.75) after adjusting the personal and clinical parameters.Conclusion: This study demonstrated that the increment of sdLDL-C level and central obesity affected DM status in Indonesian adults. It implies that the sdLDL-C was a potential biomarker to assess the risk of DM.Keywords: Central obesity, Diabetes mellitus, Hypertension, Indonesian adult, sdLDL-C

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The effect of intensive lifestyle intervention on renal function in patients with diabetes and obesity in real-world practice: A 5-years longitudinal study

Cited by 2 publications

References 31 publications

Long-term effect of intensive lifestyle intervention on cardiometabolic risk factors and microvascular complications in patients with diabetes in real-world clinical practice: a 10-year longitudinal study

Long-term effect of intensive lifestyle intervention on cardiometabolic risk factors and microvascular complications in patients with diabetes in real-world clinical practice: a 10-year longitudinal study

Small Dense Low-Density Lipoprotein Cholesterol and Central Obesity Associated With Diabetes Mellitus Among Indonesian Adults

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