Insulin resistance increases the occurrence of new cardiovascular events in patients with manifest arterial disease without known diabetes. The SMART study

Verhagen, Sandra N.; Wassink, Annemarie M J; Graaf, Yolanda van der; Gorter, Petra M.; Visseren, Frank L.J.

doi:10.1186/1475-2840-10-100

Cited by 30 publications

(23 citation statements)

References 43 publications

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“…[29,30], insulin resistance [7,31], diabetes mellitus [8,11], increased oxidative stress [32,33], inflammatory reactions [34,35] as well as mutations on genetic levels [36][37][38], of which the risks rise proportionally associated with MSC.…”

Section: Resultsmentioning

confidence: 99%

Utilizing the metabolic syndrome component count in workers’ health surveillance: An example of day-time vs. day-night rotating shift workers

Lin¹,

Hsieh²,

Chen³

2015

Int J Occup Med Environ Health

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Objectives: To establish a practical method for assessing the general metabolic health conditions among different employee groups, this study utilized the total count of metabolic syndrome (MetS) elements as a parameter, and performed a retrospective analysis comparing changes of MetS component count (MSC) of 5 years among day-time work (DW) and day-andnight rotating shift work (RSW) employees. Material and Methods: The data of personal histories, physical examinations, blood tests, abdominal sonographic examinations and occupational records were collected from a cohort of workers in an electronics manufacturing company. We first defined the arithmetic mean value of MSC as MSC density (MSCD) for the employee group; then we compared the changes of MSCD over 5 years between DW and RSW workers. Occupational, personal and health records were analyzed for the 1077 workers with an initial mean age of 32.4 years (standard deviation (SD): 6.2 years), including 565 RSW workers (52%). Results: The initial MSCDs were 1.26 and 1.12 (p = 0.06) for DW and RSW workers, respectively; after 5 years, the increments of MSCD for DW and RSW workers were 0.10 and 0.39, respectively (p < 0.01). By performing multivariate logistic regression analyses, and comparing with DW co-workers, final results indicated that the workers exposed to RSW have 1.7-fold increased risk of elevated MSCD (95% confidence interval (CI): 1.28-2.25, p < 0.01); and are 38% less likely (adjusted rate ratio (aRR) 0.62, 95% CI: 0.45-0.86, p < 0.01) to attain decreased MSCD. Conclusions: These observations demonstrate that changes of MSCD are significantly different between DW and RSW workers, and are increasingly associated with RSW exposure. In conclusion, MSCD can represent the general metabolic health conditions of a given employee group; MSC, MSCD and their transitional changes can be applied as simple and standardized tools for monitoring metabolic health risk profiles when managing employee health, at both the individual and company levels.

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Section: Resultsmentioning

confidence: 99%

Utilizing the metabolic syndrome component count in workers’ health surveillance: An example of day-time vs. day-night rotating shift workers

Lin¹,

Hsieh²,

Chen³

2015

Int J Occup Med Environ Health

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“…It has been reported that insulin resistance and metabolic syndrome increase the risk of new cardiovascular events also in patients without known diabetes but with manifest arterial disease [26]. In type 2 diabetes, metabolic syndrome is highly prevalent and often precedes hyperglycaemia onset [27,28].…”

Section: Discussionmentioning

confidence: 99%

Macrovascular complication phenotypes in type 2 diabetic patients

Papa

Degano

Iurato

et al. 2013

Cardiovasc Diabetol

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BackgroundMacrovascular diseases (MVD) in type 2 diabetes mellitus (T2DM) are often considered all together, without discriminating the areas involved. The aim of our study was to analyse MVD prevalence in a large population of T2DM patients by dividing the cases into subgroups according to MVD sites (NMVD, no MVD; NSCS, non-significant carotid stenosis; CBVD, cerebrovascular disease; CAD, coronary artery disease; PAD, peripheral artery disease; PVD, polyvascular disease) and studying the anthropometric, clinical and laboratory parameters in each group.MethodsA diabetic outpatient cohort (n = 1199) was retrospectively studied. Demographic, clinical and laboratory parameters were included in analyses. A thorough cardiovascular history as documented by previous medical records (including medical and hospital records) and vascular laboratory studies (including standardised electrocardiogram, echocardiogram, provocative tests for cardiac ischaemia, ankle/brachial index, duplex ultrasonography of the carotid and lower limbs and, in selected cases, computed tomography angiography, carotid and peripheral arteriography and evaluation of transcutaneous oxygen pressure), was collected for all of the patients. Standardised procedures were used to assess microvascular complications as well as metabolic syndrome (Mets).ResultsThe unadjusted MVD prevalence was 46.4% among the participants. The majority of patients with MVD were in the PVD group. In the multivariate analysis, age, male sex and diabetes duration were independent risk factors for PAD and PVD (P < 0.01). A low HDL-C value was an independent risk factor in the CAD and PVD groups (P = 0.03). Very high frequencies of MetS were observed in the PAD and PVD groups (94.9 and 95.7% respectively). The most MetS diagnostic criteria were recorded among members of the CAD group (all or all-1 criteria were present in 73% of patients). The average age in the CAD group (64.5 y) was comparable to that of the NMVD group. Microvascular complications were more frequent in the PAD and PVD patients.ConclusionPhenotypic heterogeneity is associated with different macrovascular complications in T2DM patients. These findings might have clinical implications for developing diagnostic and therapeutic strategies targeting type 2 diabetes.

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“…This high cardiovascular risk may be due to a combination of non-classical risk factors associated with insulin resistance, e.g. inflammation, hyperinsulinemia, oxidative stress, and hypercoagulability, together with the separate components of metabolic syndrome [28,29]. …”

Section: Discussionmentioning

confidence: 99%

Influence of fibrinogen and C-RP on progression of peripheral arterial disease in type 2 diabetes: a preliminary report

Bosevski

Bosevska

Stojanovska

2013

Cardiovasc Diabetol

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BackgroundLimited studies have suggested that inflammatory biomarkers play a role in the initiation and progression of atherosclerosis in diabetic patients. This study assesses the effect of inflammatory biomarkers: fibrinogen and C-reactive protein (C-RP) on the progression of peripheral arterial disease (PAD) in type 2 diabetic (T2D) patients.MethodsSixty two patients with T2D and PAD (mean age 60.28 ± 27 years and diabetes duration of 8.58 ± 6.17 years) were enrolled in a cohort prospective study of 36 months. Ankle-brachial index (ABI) was measured in all patients at baseline and after 36 months. Multiple linear regression analysis was used to determine the predictivity of variables for fibrinogen, C-RP, plasma lipid fractions, fasting plasma glucose, Body Mass Index (BMI), duration of diabetes status and the age on changes in ABI value.ResultsLinear regression analysis defined F as a predictor for endpoint value of ABI (β = 0.469, p = 0.007). Value of C-RP determinates change of minimal value of ABI (β = 0.449, p = 0.037) and change of mean ABI per year (β = 0.442, p = 0.025).ConclusionOur data indicate that plasma determination of fibrinogen and C-RP might have a clinical implication in defining the process of progression of PAD in T2D population.

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Insulin resistance increases the occurrence of new cardiovascular events in patients with manifest arterial disease without known diabetes. The SMART study

Cited by 30 publications

References 43 publications

Utilizing the metabolic syndrome component count in workers’ health surveillance: An example of day-time vs. day-night rotating shift workers

Utilizing the metabolic syndrome component count in workers’ health surveillance: An example of day-time vs. day-night rotating shift workers

Macrovascular complication phenotypes in type 2 diabetic patients

Influence of fibrinogen and C-RP on progression of peripheral arterial disease in type 2 diabetes: a preliminary report

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