Body composition indices and cardiovascular risk in type 2 diabetes. CV biomarkers are not related to body composition

Markova, Aleksandra; Boyanov, Mihail; Bakalov, Dimitar; Tsakova, Adelina

doi:10.1515/med-2020-0043

Cited by 4 publications

(5 citation statements)

References 38 publications

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“…45 BMI is the obesity index that, more than others, is related to the estimated risks for coronary heart disease and stroke in the T2D population based on specific cardiovascular risk calculators, such as the Framingham Risk Score, the UKPDS version 2.0 and the ADVANCE risk engines. 46 Interestingly, we observed an improvement in BMI or a stabilization of the parameters when participants were engaged with web-based intervention, thus confirming the potential of this approach.…”

Section: Discussionsupporting

confidence: 73%

A nutritional web-based approach in obesity and diabetes before and during the COVID-19 lockdown

2020

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Introduction Obesity and type 2 diabetes (T2D) are two closely related pandemic conditions. Novel technologies represent promising tools for their management, the use of which has been greatly encouraged during the COVID-19 pandemic. The aim of the present study is to compare a web-based nutritional intervention versus a traditional one, before and during the Italian ‘lockdown’ period due to the COVID-19 outbreak, in overweight and obese subjects affected by T2D or impaired glucose regulation (IGR). Methods For the study, 36 subjects were randomly allocated into two arms: a traditional arm, providing face-to-face individual and group-based intervention; and a web arm, deploying the in-presence traditional approach with intervention provided through web technologies. The outcomes were the data resulting from the comparison between the subjects’ anthropometric and clinical parameters as well as PREDIMED scores at baseline with those at 3 months (T3), 6 months (T6) and at lockdown. Results In the web arm we detected a progressive reduction in weight and body mass index (BMI) from baseline to T6 and a minimal increase of both parameters during the lockdown. Improvement of these parameters compared with baseline was observed in controls during the lockdown. The PREDIMED score improved at T6 compared with baseline in both arms. Significant variations were observed considering weight ( p < 0.001), BMI ( p = 0.001) and PREDIMED scores ( p = 0.023) over time. Discussion The study showed the effectiveness and feasibility of a short-term nutritional web-based intervention in patients affected by T2D or IGR before and during the COVID 19 pandemic. Clinical Trial registration number: NCT04386200, ClinicalTrials.gov.

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Section: Discussionsupporting

confidence: 73%

A nutritional web-based approach in obesity and diabetes before and during the COVID-19 lockdown

2020

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“…[35] Few studies in the literature have attempted to correlate the use of biomarkers, especially those analyzed in the present study, and the CVR predicted by scores in the diabetic population. [36][37][38][39][40][41] One of these studies evaluated the association between a set of biomarkers that analyze different metabolic pathways, such as Asymmetric dimethylarginine (ADMA), Soluble endothelin-1 (ET-1), Placental growth factor-1 (PIGF-1) and NT-pro-BNP and the CVR predicted by the UKPDS and Action in Diabetes and Vascular disease (ADVANCE) scores in diabetic patients. This study showed that ADMA and PIGF-1 were not associated with CVR strati cation with any of the scores, while ET-1 was associated with the risk of stroke by the UKPDS and NT-proBNP was associated with CVR predicted by both tools.…”

Section: Discussionmentioning

confidence: 99%

VCAM-1 Is Associated With High Cardiovascular Risk Predicted by the Framingham Score: A Cross-Sectional Study With Diabetic Women

Neri

Júnior

Meneses

et al. 2021

Preprint

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Background The best strategy to establish cardiovascular risk (CVR) in women has yet to be defined, although risk scores are widely used. The inclusion of endothelial biomarkers, such as vascular cell adhesion molecule-1 (VCAM-1), to the risk scores could increase their discriminatory power and improve risk assessment. Objective To evaluate the association between endothelial biomarkers and CVR in women with type 2 DM (T2DM) and without previous cardiovascular disease (CVD). Methods Cross-sectional study, including women with T2DM from Fortaleza, Brazil, from January to October 2017. Women aged 30 to 74 years were included and those with CVD were excluded. Clinical and laboratory data were evaluated (age; time of T2DM diagnosis; hypertension presence and treatment; smoking; body mass index - BMI; systolic blood pressure - SBP and diastolic blood pressure - DBP; glycemic and lipid profiles and serum biomarkers VCAM-1, fibroblast growth factor-23, Syndecan-1 and Angiopoietin-2). The CVR was stratified using the Framingham Risk Score - FRS (version with laboratory tests - laboratory FRS and the one with the BMI - non-laboratory FRS) and the United Kingdom Prospective Diabetes Study (UKPDS) risk engine. Results In total, eighty-eight diabetic women were evaluated, with mean age 56 ± 10 years and T2DM time of 5 (3–9) years, most of them hypertensive (71.6%), overweight or obese (74%), with altered blood glucose levels (blood glucose 8.53 ± 3.65 mmol/L and hbA1c of 65 ± 1 mmol/mol) and lipids (LDL 27.06 ± 8.99 mmol/L), in addition to high risk according to laboratory (72.7%) and non-laboratory (81.8%) FRS and low risk for any UKPDS score outcome. Regarding the biomarkers, only VCAM-1 showed an association with CVR, mainly with a high-risk classification using laboratory FRS (p = 0.024), even in this population without CVD. Conclusion The assessed diabetic women without previous CVD had high CVR in traditional scores (FRS scores) and low CVR in specific score for diabetics (UKPDS score). VCAM-1 may be useful in detect subclinical endothelial dysfunction in women with T2DM and its incorporation into scores may improve the accuracy in risk stratification of women with T2DM.

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“…A total of 34 papers were found unsuitable after full-text review for the following reasons: 20 studies were in the general population, not in people with diabetes (population not as per protocol); in eight studies, subgroup analysis of people with diabetes was not available; three studies had an improper selection of intervention and control group as per protocol; and three studies assessed non-CV outcomes (outcomes not as per the protocol). Finally, 11 papers met the inclusion criteria and were included in the systematic review [12][13][14][15][16][17][18][19][20][21][22]. *Reasons for exclusion: 20 studies were in the general population, not in people with diabetes; in eight studies, subgroup analysis of people with diabetes was not available; three studies had an improper selection of intervention and control group as per protocol; and three studies assessed non-CV outcomes (outcomes not as per the protocol).…”

Section: Reviewmentioning

confidence: 99%

“…ADMA, endothelin 1 (ET-1), and NT-proBNP, as well as body composition parameters (BF%, FM, FFM, and TBW), were investigated in a study by Markova A et al [13] to see if they were associated with calculated CV risks. It was discovered that the strongest correlations between the calculated CV risk estimations were found with BMI, WHtR, and BF%.…”

Section: Interpretation Of Included Studiesmentioning

confidence: 99%

Comparative Evaluation of Waist-to-Height Ratio and BMI in Predicting Adverse Cardiovascular Outcome in People With Diabetes: A Systematic Review

Tewari¹,

Kumar²,

Maheshwari³

et al. 2023

Cureus

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Central obesity is strongly associated with cardiovascular risk in people with diabetes. BMI does not reflect a regional fat distribution. The other anthropometric indices, which are markers of central obesity, like waist circumference and waist-hip ratio, are subject to age, sex, and ethnic variations. An index like waist-toheight ratio (WHtR), which considers central obesity, outperforms BMI in predicting cardiometabolic risk. With a single cut-off of 0.5, irrespective of age, sex, and ethnic variations, WHtR has a wide application in screening obesity in population settings. Previous systematic analyses were conducted in the general population, assessing cardiometabolic risk. The current study is the first systematic analysis to compare the applicability of WHtR and BMI in predicting both cardiovascular risk and adverse cardiovascular outcomes in people with diabetes. It includes prospective cohort studies, cross-sectional studies, and randomized control trials to generate evidence. The summary scores indicate that WHtR is probably a better indicator than BMI to assess cardiovascular risk in people with diabetes. A future meta-analysis will pave the way for more robust evidence.

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Body composition indices and cardiovascular risk in type 2 diabetes. CV biomarkers are not related to body composition

Cited by 4 publications

References 38 publications

A nutritional web-based approach in obesity and diabetes before and during the COVID-19 lockdown

A nutritional web-based approach in obesity and diabetes before and during the COVID-19 lockdown

VCAM-1 Is Associated With High Cardiovascular Risk Predicted by the Framingham Score: A Cross-Sectional Study With Diabetic Women

Comparative Evaluation of Waist-to-Height Ratio and BMI in Predicting Adverse Cardiovascular Outcome in People With Diabetes: A Systematic Review

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