Association of obesity with glucose, blood pressure, and lipid goals attainment in patients with concomitant diabetes and hypertension

Li, Ping; Chen, Kang; Nie, Yi; Guo, Lingling; Wang, Haibin; Wang, Shuang-Shuang; Wang, Anping; Hu, Dayi; Mu, Yiming; Li, Jihu

doi:10.1185/03007995.2015.1058770

Cited by 12 publications

(18 citation statements)

References 32 publications

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“…In the present study, the overall 3B goal attainment rates were significantly lower in MetS (2.1%) compared with non-MetS (10.2%) type 2 diabetes patients, even with higher medical coverage rates in MetS patients. As 50.8% of the MetS patients in the present study were diagnosed with abdominal obesity, these data are partly in agreement with recent publications, in which obesity was a factor for poor 3B control in Chinese type 2 diabetes patients 32,33 . Furthermore, our additional findings illustrate that blood lipid attainment might influence blood glucose attainment; patients who achieved their lipid control targets were more likely to achieve their target glucose level.…”

Section: Discussionsupporting

confidence: 93%

Prevalence, treatment patterns and control rates of metabolic syndrome in a Chinese diabetic population: China Cardiometabolic Registries 3B study

Jing

Hong

et al. 2018

J of Diabetes Invest

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Aims/IntroductionTo investigate the prevalence and risk factors of metabolic syndrome (MetS) in Chinese type 2 diabetes mellitus patients, and assess the effect of MetS on the treatment patterns and blood glucose, blood pressure and blood lipids goal achievements.Materials and MethodsData from 25,454 type 2 diabetes mellitus patients including demographic data, anthropometric measurements, treatment patterns, and blood glucose and lipid profiles were retrospectively analyzed.ResultsUsing modified Adult Treatment Panel III MetS criteria, the prevalence of MetS was 57.4% in type 2 diabetes mellitus patients. Multivariable logistic regression analysis showed that type 2 diabetes mellitus patients, who also fulfilled the criteria for MetS, tended to be women, living in the northeast, with a diabetes duration ≥5 years and leading a sedentary lifestyle. Most MetS (53.4%) and non‐MetS (57%) diabetes patients received oral hypoglycemic drugs. Insulin or insulin combination therapies were more applied in MetS (37.5%) than in non‐MetS (33.1%) diabetes patients, and the percentages of MetS diabetes patients receiving antihypertensive and lipid‐modulating drugs were 52.9% and 28.2% vs 38.3% and 19.3% of the non‐MetS diabetes patients. Just 37.5%, 15.6% and 32.9% of the MetS diabetes patients vs 54.6%, 45.6% and 40.4% of the non‐MetS diabetes patients achieved the individual target goals for control of blood glucose (glycosylated hemoglobin <7%), blood pressure (systolic blood pressure <130 mmHg, diastolic blood pressure <80 mmHg) and blood lipids (total cholesterol <4.5 mmol/L), whereas just 2.1% achieved all three target goals.ConclusionsMetS with a high prevalence in Chinese type 2 diabetes mellitus patients is associated with poor blood glucose, blood pressure and blood lipids control rate.

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Section: Discussionsupporting

confidence: 93%

Prevalence, treatment patterns and control rates of metabolic syndrome in a Chinese diabetic population: China Cardiometabolic Registries 3B study

Jing

Hong

et al. 2018

J of Diabetes Invest

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“…This association was observed both across the trial population and after adjustment for potential confounding factors that are also related to obesity. These results are generally consistent with data from observational studies both in the general population and in high CV risk patients with T2DM [ 3 , 20 , 21 , 25 – 28 ]. Also, a significant association of reduced eGFR with BMI (but not WC) was observed, consistent with kidney dysfunction data from the BARI-2D trial [ 19 ].…”

Section: Discussionsupporting

confidence: 90%

“…Nevertheless, post hoc analyses of the SCOUT trial that recruited patients ≥55 years confirmed a relationship between weight loss and CV risk factors (such as total cholesterol) and outcomes (such as CV mortality) [ 40 , 41 ]. Furthermore, although including patients <50 years, studies have shown an association of obesity with suboptimal control of CV risk factors in diabetic patients across the mean age range of 62–65.7 years [ 2 , 19 , 21 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

LEADER 5: prevalence and cardiometabolic impact of obesity in cardiovascular high-risk patients with type 2 diabetes mellitus: baseline global data from the LEADER trial

Masmiquel

Leiter

Vidal

et al. 2016

Cardiovasc Diabetol

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BackgroundEpidemiological data on obesity are needed, particularly in patients with type 2 diabetes mellitus (T2DM) and high cardiovascular (CV) risk. We used the baseline data of liraglutide effect and action in diabetes: evaluation of CV outcome results—A long term Evaluation (LEADER) (a clinical trial to assess the CV safety of liraglutide) to investigate: (i) prevalence of overweight and obesity; (ii) relationship of the major cardiometabolic risk factors with anthropometric measures of adiposity [body mass index (BMI) and waist circumference (WC)]; and (iii) cardiometabolic treatment intensity in relation to BMI and WC.MethodsLEADER enrolled two distinct populations of high-risk patients with T2DM in 32 countries: (1) aged ≥50 years with prior CV disease; (2) aged ≥60 years with one or more CV risk factors. Associations of metabolic variables, demographic variables and treatment intensity with anthropometric measurements (BMI and WC) were explored using regression models (ClinicalTrials.gov identifier: NCT01179048).ResultsMean BMI was 32.5 ± 6.3 kg/m2 and only 9.1 % had BMI <25 kg/m2. The prevalence of healthy WC was also extremely low (6.4 % according to International Joint Interim Statement for the Harmonization of the Metabolic Syndrome criteria). Obesity was associated with being younger, female, previous smoker, Caucasian, American, with shorter diabetes duration, uncontrolled blood pressure (BP), antihypertensive agents, insulin plus oral antihyperglycaemic treatment, higher levels of triglycerides and lower levels of high-density lipoprotein cholesterol.ConclusionsOverweight and obesity are prevalent in high CV risk patients with T2DM. BMI and WC are related to the major cardiometabolic risk factors. Furthermore, treatment intensity, such as insulin, statins or oral antihypertensive drugs, is higher in those who are overweight or obese; while BP and lipid control in these patients are remarkably suboptimal. LEADER confers a unique opportunity to explore the longitudinal effect of weight on CV risk factors and hard endpoints.

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“…These are the expected lipid profiles in patients with obesity resulting from insulin resistance [34]. Overall, these metabolic disadvantages of Turkish patients with type 2 diabetes and obesity are similar to those populations from the different geographical regions of the world [10, 23, 35, 36]. Randomized controlled studies show that a significant proportion of patients with type 2 diabetes cannot reach prespecified targets for the major modifiable cardiovascular risk factors [37].…”

Section: Discussionmentioning

confidence: 99%

Impact of Obesity on the Metabolic Control of Type 2 Diabetes: Results of the Turkish Nationwide Survey of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Obesity Study)

et al. 2019

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Background: Obesity is the main obstacle for metabolic control in patients with type 2 diabetes. Turkey has the highest prevalence of obesity and type 2 diabetes in Europe. The effect of obesity on the metabolic control, and the macro- and microvascular complications of patients are not apparent. Objectives: This nationwide survey aimed to investigate the prevalence of overweight and obesity among patients with type 2 diabetes and to search for the impact of obesity on the metabolic control of these patients. We also investigated the independent associates of obesity in patients with type 2 diabetes. Methods: We consecutively enrolled patients who were under follow-up for at least 1 year in 69 tertiary healthcare units in 37 cities. The demographic, anthropometric, and clinical data including medications were recorded. Patients were excluded if they were pregnant, younger than 18 years, had decompensated liver disease, psychiatric disorders interfering with cognition or compliance, had bariatric surgery, or were undergoing renal replacement therapy. Results: Only 10% of patients with type 2 diabetes (n = 4,648) had normal body mass indexes (BMI), while the others were affected by overweight (31%) or obesity (59%). Women had a significantly higher prevalence of obesity (53.4 vs. 40%) and severe obesity (16.6 vs. 3.3%). Significant associations were present between high BMI levels and lower education levels, intake of insulin, antihypertensives and statins, poor metabolic control, or the presence of microvascular complications. Age, gender, level of education, smoking, and physical inactivity were the independent associates of obesity in patients with type 2 diabetes. Conclusion: The TEMD Obesity Study shows that obesity is a major determinant of the poor metabolic control in patients with type 2 diabetes. These results underline the importance of prevention and management of obesity to improve health care in patients with type 2 diabetes. Also, the results point out the independent sociodemographic and clinical associates of obesity, which should be the prior targets to overcome, in the national fight with obesity.

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Association of obesity with glucose, blood pressure, and lipid goals attainment in patients with concomitant diabetes and hypertension

Cited by 12 publications

References 32 publications

Prevalence, treatment patterns and control rates of metabolic syndrome in a Chinese diabetic population: China Cardiometabolic Registries 3B study

Prevalence, treatment patterns and control rates of metabolic syndrome in a Chinese diabetic population: China Cardiometabolic Registries 3B study

LEADER 5: prevalence and cardiometabolic impact of obesity in cardiovascular high-risk patients with type 2 diabetes mellitus: baseline global data from the LEADER trial

Impact of Obesity on the Metabolic Control of Type 2 Diabetes: Results of the Turkish Nationwide Survey of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Obesity Study)

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