Waist circumference reduction is more strongly correlated with the improvement in endothelial function after acute coronary syndrome than body mass index reduction

Miyazaki, Shôzo; Hiasa, Yoshikazu; Takahashi, Takefumi; Tobetto, Yohei; Chen, Hirotoshi; Mahara, Keitaro; Ogura, Riyo; Miyajima, Hitoshi; Yuba, Kenichiro; Hosokawa, Shinobu; Kishi, Koichi; Ohtani, Ryuji

doi:10.1016/j.jjcc.2009.11.006

Cited by 12 publications

(9 citation statements)

References 32 publications

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“…First, waist circumference, and mid arm circumference or triceps skinfold were not measured as indicators of body fat. These data would have provided more definitive support for our results [18,19]. Second, the distribution of body mass index in this study was lower than that reported in studies from western countries [20,21].…”

Section: Study Limitationssupporting

confidence: 75%

The prognostic importance of objective nutritional indexes in patients with chronic heart failure

Narumi

Arimoto

Funayama

et al. 2013

Journal of Cardiology

216

187

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Section: Study Limitationssupporting

confidence: 75%

The prognostic importance of objective nutritional indexes in patients with chronic heart failure

Narumi

Arimoto

Funayama

et al. 2013

Journal of Cardiology

216

187

View full text Add to dashboard Cite

show abstract

“…The insulin dose was also decreased significantly in both the groups, and this may have resulted in the increase in body weight. The improvements in ΔHbA1c, body weight, HDL-C, and TG and the reduction in HbA1c in the empagliflozin group did not affect the FMD, although the correlation between the change in the levels of a decrease in visceral adipose tissue mass, waist circumference, and ΔFMD has been shown in previous studies [8,16]. These findings suggest that empagliflozin had no effect in improving FMD although empagliflozin is effective in improving HbA1c.…”

Section: Discussionsupporting

confidence: 51%

Comparison of the effects of empagliflozin and glimepiride on endothelial function in patients with type 2 diabetes: A randomized controlled study

Tamura

Kondo

Ito

et al. 2020

Preprint

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Background : Among patients with type 2 diabetes and established cardiovascular disease, those receiving empagliflozin have a lower rate of primary composite cardiovascular outcome and death from any cause. While treatment with sulfonylurea reduces microvascular complications in diabetes, it increases cardiovascular hospitalization or mortality in combination with metformin. In the present study, we assessed the effects of empagliflozin and glimepiride, a commonly prescribed sulfonylurea, on endothelial function using flow–mediated dilation (FMD) to estimate arteriosclerosis and cardiovascular events in patients with type 2 diabetes. Methods : In this prospective, open-label, randomized, parallel-group study, 58 patients with type 2 diabetes received metformin and glargine before bedtime for 12 weeks. This was followed by additional treatment with either 10 mg empagliflozin or 0.5 mg glimepiride for 12 weeks. The primary outcome was the change in the FMD measurement (DFMDs), measured prior to and after 12 weeks of additional treatment. Secondary outcomes comprised changes in metabolic markers and body composition. Results : Analysis of the empagliflozin group ( n = 30) and glimepiride group ( n = 28) showed no significant differences in DFMDs (empagliflozin, −0.19 ± 2.34%; glimepiride, −0.37 ± 2.77%; P = 0.79). Similarly, changes in glycated hemoglobin (HbA1c) were similar between the two groups. However, significant difference in body weight changes were observed between the two groups (empagliflozin, –0.59 ± 2.5 kg; glimepiride, 1.2 ± 3.0 kg; P = 0.02). In addition, an analysis of the body composition revealed that body fluid volume significantly decreased after empagliflozin treatment (baseline, 35.8 ± 6.8 L; after 12 weeks, –0.33 ± 0.72 L; P = 0.03). Conclusions : Empagliflozin did not improve endothelial function when compared to glimepiride in patients with type 2 diabetes but decreased their body fluid volume. This suggested that the coronary protective effect of empagliflozin is not derived by protection of the endothelial function but rather from reduction in the risk of heart failure. Trial Registration : This trial was registered on September 13, 2016; UMIN000024001 . Keywords: Empagliflozin, Endothelial function, Glimepiride, Diabetes, Flow–mediated dilation

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“…The insulin dose was also decreased signi cantly in both groups, and this might have resulted in the decrease in body weight. The improvements in ΔHbA1c, body weight, HDL-C, and TG and the reduction in HbA1c in the empagli ozin group did not affect the FMD, although the correlation among the change in the decrease in visceral adipose tissue mass, waist circumference, and ΔFMD has been shown in previous studies [8,17]. These ndings suggest that empagli ozin had no effect on improving FMD although it is effective in improving HbA1c.…”

Section: Discussionsupporting

confidence: 47%

Comparison of the effects of empagliflozin and glimepiride on endothelial function in patients with type 2 diabetes: A randomized controlled study

Tamura

Kondo

Ito

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Among patients with type 2 diabetes and established cardiovascular disease, those receiving empagliflozin have a lower rate of primary composite cardiovascular outcomes and death from any cause. While treatment with sulfonylurea reduces microvascular complications in diabetes, it increases cardiovascular hospitalization or mortality when combined with metformin. In the present study, we assessed the effects of empagliflozin and glimepiride, a commonly prescribed sulfonylurea, on endothelial function using flow-mediated dilation (FMD) to estimate arteriosclerosis and cardiovascular events in patients with type 2 diabetes.Methods: In this prospective, open-label, randomized, parallel-group study, 58 patients with type 2 diabetes received metformin and glargine before bedtime for 12 weeks. This was followed by additional treatment with either 10 mg empagliflozin or 0.5 mg glimepiride for 12 weeks. The primary outcome was the change in the FMD measurement (DFMDs), measured prior to and after 12 weeks of additional treatment. Secondary outcomes comprised changes in metabolic markers and body composition.Results: An analysis of the empagliflozin group (n = 30) and glimepiride group (n = 28) showed no significant differences in DFMDs (empagliflozin, −0.19 ± 2.34%; glimepiride, −0.37 ± 2.77%; P = 0.79). Similarly, changes in glycated hemoglobin were similar between the two groups. However, a significant difference in body weight changes was observed between the two groups (empagliflozin, −0.59 ± 2.5 kg; glimepiride, 1.2 ± 3.0 kg; P = 0.02). In addition, an analysis of the body composition revealed that body fluid volume significantly decreased after empagliflozin treatment (baseline, 35.8 ± 6.8 L; after 12 weeks, −0.33 ± 0.72 L; P = 0.03).Conclusions: Empagliflozin did not improve endothelial function when compared to that with glimepiride for patients with type 2 diabetes but decreased body fluid volumes. This suggested that the coronary-protective effect of empagliflozin is not derived from protection of the endothelial function but rather from a reduction in the risk of heart failure.Trial Registration: This trial was registered on September 13, 2016; UMIN000024001.

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Waist circumference reduction is more strongly correlated with the improvement in endothelial function after acute coronary syndrome than body mass index reduction

Abstract: WC reduction is more strongly correlated with the improvement of endothelial function after ACS than BMI reduction.

Cited by 12 publications

References 32 publications

The prognostic importance of objective nutritional indexes in patients with chronic heart failure

The prognostic importance of objective nutritional indexes in patients with chronic heart failure

Comparison of the effects of empagliflozin and glimepiride on endothelial function in patients with type 2 diabetes: A randomized controlled study

Comparison of the effects of empagliflozin and glimepiride on endothelial function in patients with type 2 diabetes: A randomized controlled study

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