Diabetes and Glucose Tolerance as Risk Factors for Cardiovascular Disease: The Framingham Study

Kannel, W. B.; McGee, Dan

doi:10.2337/diacare.2.2.120

Cited by 1,088 publications

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“…14 Furthermore, elevated systemic SAA levels are a hallmark of individuals who suffer from obesity and diabetes, 32,33 and these inflammatory diseases are linked to an increased risk of developing atherosclerosis and heart disease. 34,35 Moreover, in an animal experiment with apolipoprotein E-deficient mice, the overexpression of SAA directly accelerated the progression of atherosclerosis independent of all other risk factors. 15 Strikingly, mice receiving only a single injection of SAA also had increased atherosclerosis compared with controls.…”

Section: Discussionmentioning

confidence: 98%

Systemic serum amyloid A as a biomarker for exposure to zinc and/or copper-containing metal fumes

Baumann

Gube

Markert

et al. 2017

J Expo Sci Environ Epidemiol

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Zinc-and copper-containing welding fumes increase systemic C-reactive protein (CRP). The aim of this study was to investigate the performance of the biomarkers serum amyloid A (SAA) and soluble vascular cell adhesion molecule-1 (VCAM-1) in this regard. Fifteen male subjects were exposed under controlled conditions to welding fumes containing either zinc, or copper, or copper and zinc for 6 h. Plasma samples were collected before, 6 and 24 h after start of exposure and biomarkers therein were measured by electrochemiluminescent assay. For each exposure, systemic concentrations of systemic SAA, but not VCAM-1, increased significantly at 24 h after exposure start compared with baseline ("copper only": P = 0.0005, "zinc only": P = 0.027, "copper and zinc": P = 0.001). SAA showed a wider range of concentrations than did CRP and its levels increased up to 19-fold after welding fume exposure. The recognition of copper as a potential harmful component in welding fumes, also independent from zinc, deserves further consideration. SAA might represent a new sensitive biomarker for potential subclinical sterile inflammation after inhalation of copper-and/or zinc-containing welding fumes. As elevations of CRP and SAA protein have both been linked to a higher risk for cardiovascular disease, these findings might particularly be important for long-term welders. Journal of Exposure Science and Environmental Epidemiology INTRODUCTIONA large number of workers are exposed to welding fumes containing various types of gases and metal particles in occupational settings. Depending on the constitution of the welding fumes and the respective exposure conditions, epidemiological studies have shown that welding fume exposure is associated with the risk of health impairment through respiratory illness, inflammation and cardiovascular disease. [1][2][3][4] Zinc and copper play an increasing role in modern joining technology, especially in the automotive industry, and hence exposures from workers become more frequent. In a recent study, a distinct increase of systemic C-reactive protein (CRP) has been shown after inhalation of welding fume from a metal inert gas brazing process of zinc-coated steel using a copper-containing welding wire at an average fume concentration of 2.5 mg/m 3 . 5 A further study tested the effect of elevated systemic CRP levels after exposure with three different doses of this welding fume and found increases of CRP after exposure with 2.0 and 2.5 mg/m 3 average fume concentration, but not at 1.4 mg/m 3 . Hence, it was concluded that the no-observed-effect level for systemic inflammation after such exposures was 1.4 mg/m 3 and the lowest observed effect level was 2.0 mg/m 3 . 6 This corresponds to zinc concentrations of 0.84 mg/m 3 and 1.2 mg/m 3 , respectively, and copper concentrations of 0.24 mg/m 3 and 0.34 mg/m 3 , respectively. 6 A subsequent third study showed that the observed effects were due to the zinc as well as copper present in the welding fume, as the welding fumes which contained either zinc and no cop...

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Section: Discussionmentioning

confidence: 98%

Systemic serum amyloid A as a biomarker for exposure to zinc and/or copper-containing metal fumes

Baumann

Gube

Markert

et al. 2017

J Expo Sci Environ Epidemiol

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“…The first observed abnormality in plasma glucose with insulin resistance is IGT, and many prospective studies have shown that IGT is a risk factor for CVD. 6,7 Therefore, in this study, a slight increase in FPG may have strongly affected the occurrence of warning ischemic ECG changes and portended the occurrence of IHD in the future. We emphasize that the increase in FPG may be more important than the change of BMI and cholesterol profile in the short term for the prediction of the onset of IHD.…”

Section: Discussionmentioning

confidence: 74%

“…Diabetes mellitus (DM) and glucose intolerance are also known as major risk factors for CHD and have been studied extensively. 6 The control of glucose tolerance and the interval for developing DM and impaired glucose tolerance (IGT) both affect the incidence of CHD. 6 The subjects in this study were normal adults who were not diagnosed as having DM or IGT at the study entry.…”

Section: Discussionmentioning

confidence: 99%

“…6 The control of glucose tolerance and the interval for developing DM and impaired glucose tolerance (IGT) both affect the incidence of CHD. 6 The subjects in this study were normal adults who were not diagnosed as having DM or IGT at the study entry. Eight subjects (16%) in Group I were diagnosed with DM during the study and commenced treatment within the 2-year period.…”

Section: Discussionmentioning

confidence: 99%

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A slight increase of fasting plasma glucose after 2 years was associated with electrocardiogram changes suggestive of coronary heart disease in normal subjects

et al. 2005

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SummaryBackground: Much attention has been focused on the primary prevention of ischemic heart disease (IHD), but the prevalence and prognostic indicators of IHD remain unclear in healthy Japanese subjects.Hypothesis: The purpose of this study was to determine the predictors for the transition of IHD in healthy adult subjects using data from annual medical examinations.Methods: We analyzed clinical data on 2,710 healthy subjects (1,836 men and 874 women aged 26-76 years in 2000) who underwent medical examinations in both 2000 and 2002. Ischemic changes in the electrocardiogram (ECG) suggestive of IHD were defined as the existence of abnormal Q-wave and/or ST-T abnormalities without left ventricular high voltage. We assigned the subjects to two groups: the ischemic heart group (Group I), including subjects with normal ECG findings in 2000, followed by suspicious ischemic changes in the ECGs in 2002; and the normal group (Group N), including subjects with normal ECGs in both 2000 and 2002.Results: Fifty-nine subjects (2%, 20 women) were assigned to Group I and 2,538 subjects (96%, 810 women) were assigned to Group N. There were significant differences between the two groups in baseline age (Group I vs. Group N: 53 vs. 47 years, p < 0.001), body mass index (24 vs. 23 kg/m 2 , p = 0.036), systolic blood pressure (132 vs. 122 mmHg, p < 0.001), diastolic blood pressure (83 vs. 76 mmHg, p < 0.001), and fasting

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“…9 The negative impact of diabetes on CV prognosis is well established. 10,11 Particularly, diabetes is associated with coronary artery disease and with LV diastolic dysfunction. 12,13 A recent paper by our group 1 confirmed that the prevalence of LVH is very high in hypertensive patients with CKD, and is increasingly greater along with declining renal function.…”

Section: Introductionmentioning

confidence: 99%

Impact of type 2 diabetes on left ventricular geometry and diastolic function in hypertensive patients with chronic kidney disease

et al. 2010

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Left ventricular hypertrophy (LVH) and diastolic dysfunction are very common in patients with chronic kidney disease (CKD). Aim of this study was to evaluate the impact of type 2 diabetes on LV geometry and diastolic function in hypertensive patients with CKD. We enrolled 288 Caucasian subjects with hypertension and CKD; of them, 112 had diabetes. Patients with cardiovascular (CV) diseases, glomerular filtration rate (GFR) 460 ml min À1 per 1.73 m 2 , dialysis treatment and other major non-CV diseases were excluded. All patients underwent routine biochemical analyses and echocardiographic examination with tissue Doppler imaging (TDI). Patients with diabetes had significantly higher LV wall thicknesses (P ¼ 0.0001), relative wall thickness (RWT) (P ¼ 0.0001) and left atrium volume index (P ¼ 0.03), when compared with patients without diabetes. Further, diabetic patients had very high prevalence of concentric LVH. Em, evaluated by TDI, was significantly lower in patients with diabetes (P ¼ 0.005). However, the difference lost statistical significance after correction by analysis of covariance for RWT. Multiple stepwise linear regression analysis showed that the variables independently associated with Em were: age (b 0.364; P ¼ 0.0001), GFR (beta 0.101; P ¼ 0.019), and the presence of diabetes (b 0.166; P ¼ 0.002). Our study showed that in hypertensive patients with CKD the presence of diabetes is associated with increased LV-wall thicknesses and concentric geometry; further, diabetes together with renal function (GFR) is associated with worse diastolic function, independently of potential confounders, such as age, gender, body mass index and blood pressure.

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Diabetes and Glucose Tolerance as Risk Factors for Cardiovascular Disease: The Framingham Study

Cited by 1,088 publications

References 0 publications

Systemic serum amyloid A as a biomarker for exposure to zinc and/or copper-containing metal fumes

Systemic serum amyloid A as a biomarker for exposure to zinc and/or copper-containing metal fumes

A slight increase of fasting plasma glucose after 2 years was associated with electrocardiogram changes suggestive of coronary heart disease in normal subjects

Impact of type 2 diabetes on left ventricular geometry and diastolic function in hypertensive patients with chronic kidney disease

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