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BETEL NUT CHEWING IS ASSOCIATED WITH HYPERTENSION IN TAIWANESE PATIENTS WITH TYPE 2 DIABETES MELLITUS
Poster Sessions PO20 Diabetes
74
Methods: We analyzed patients’ record files of the period 1991-1995 at the Diabetes Outpatient Clinic of Modena. Inclusion criteria were age 35-65, T2D and no past medical history of CV; patients global CV risk was estimated according to Framingham, RISCARD, Progetto Cuore and UKPDS algorithms and compared with the rate of CV events over the following 10 years. Results: 4575 patients were screened but only 1532 (33.5%) were elegible for defined criteria and completeness of data. In this population 14.6% had a CV event. When comparing the estimated risk rate according to the different functions we observed a high degree of variability; UKPDS algorithm was more consistent with the observed data. Subjects with a CV event differed significantly (p<0.05) from those with no events in HbA1C and diabetes duration, variables included also in UKPDS algorithm. Conclusions: CV risk estimation depends enormously on the used and on the baseline risk of the studied population. The overall performance of such algorithms is however low. The algorithm derived from the present study will be utilized for prospective evaluation of CV risk in our local cohort.
(Cornell voltage criteria for ECG/LVH) were performed in 118 T2D patients with NAFLD and in 118 T2D patients without NAFLD and no clinical evidence of heart disease. NAFLD was diagnosed by abdominal ultrasonography. NAFLD patients had no history of alcohol abuse and negative tests for hepatitis B and C virus. Groups were individually matched for age, sex, smoking status, hypertension level, body mass index and diabetes duration. Results: LVMI mass (151±6 g/m2 vs 133±5 g/m2 , p = 0.01) and LVH prevalence, using the two definitions, were greater in patients with NAFLD (61 vs. 31%, p = 0.02). Systolic and diastolic functions were similar in both groups. Conclusions: LVH is more common and severe in patients with T2D who developed NAFLD. Its presence may constitute independent risk factor for fatal and non-fatal cardiac events and strengthens the case for echocardiography screening to identify high risk patients who might benefit from aggressive cardiovascular risk factor intervention. PO20-234
PO20-232
TRYGLYCERIDES AND GLYCEMIC CONTROL HAVE INFLUCENCE ON SMALL ARTERY ELASTICITY IN DIABETIC PATIENTS
J. Saban-Ruiz 1 , R. Fabregate 1 , M. Fabregate 1 , S. Redondo 2 , E. Marin 2 , V. Garcia-Prieto 2 , N. De La Torre 1 . 1 Endothelial Pathology Unit. Ramon Y Cajal Hospital, Madrid, Spain; 2 Vascular Surgery Service. Ramon Y Cajal Hospital, Madrid, Spain Introduction: The HDI/PulseWave CR-2000 obtains upper-arm blood pressure values and waveform data by non-invasive methods. Aims: To determine the prevalence of abnormal elasticity index in a DM2 and its correlation with hemodynamic evaluation and glycemic control. Methods: N=106, 22-81yrs; Group A: N=50 (non-diabetic); group B: N=56 (diabetic); HDI/PulseWave. Results: 1. Prevalence of abnormal large artery elasticity (C1) was 37.7% in A+B; 28% in A and 46,4 in B (p<0,05). Abnormal subjects were older (p=0,001) and had higher values of, DBP (p=0,004), SBP and MBP (p<0,001), PP (p<0,001) than those with normal elasticity. 2. In relation to C1, significant differences in SVR (p<0,001), TVI (p<0,001), CO (p<0,001), CO Index (p=0,003), SV (p<0,001) and SVI (p=0,001). 3. The prevalence of abnormal small artery elasticity (C2) was 43,4% in A+B; 40,0% in A and 46,4% in B. Abnormal subjects were older (p<0,001), and had higher SBP (p=0,02), DBP (p=0,014), MBP (p<0,001), and PP (p=0,010). 5. In relation to C2, significant differences in the determination of SVResistance (p<0,001), TVImpedance (p=0,007), C Output (p=0,001), CO (p<0,001), Stroke V (p=0,004) and SVIndex (p=0,002). 6. Correlation between small artery elasticity and triglyceride (p=0,007). 7. An age-independent linear correlation between C2 and metabolic control in the diabetic population p=0,013. Conclusions: 1-The prevalence of stiff large and small arteries: 38,3% and 43,4.2-Age is more important than the diabetic status in vascular elasticity. 3-Both phenomena present with changes in other cardiovascular parameters. 4-The stiffness of small arteries is related to levels of triglycerides in all subjects and to glycemic control in diabetic patients. PO20-233
PREVALENCE AND PROGNOSTIC ROLE OF LEFT VENTRICULAR HYPERTROPHY IN TYPE 2 DIABETIC PATIENTS WITH AND WITHOUT NON-ALCOHOLIC FATTY LIVER DISEASE
C. Pop 1 , L. Pop 2 , D. Delia 2 , D. Dicu 2 , R. Hojda 2 , M. Puschita 3 . 1 County Hospital Baia Mare, Faculty of Medicine, Arad, Romania; 2 County Hospital Baia Mare, Romania; 3 Faculty of Medicine Arad, Romania Background: The left ventricle hypertrophy (LVH) and the non-alcoholic fatty liver disease (NAFLD) coexist frequently in patients with obesity, dyslipidemia and type 2 diabetes (T2D). The correlation between insulin resistance and the increased incidence of LVH and NAFLD was proven in recent studies. Objectives: To compare presence of LVH and ventricular function in T2D patients with and without NAFLD and to evaluate the mechanism of increased cardiac morbidity and mortality in T2D patients with NAFLD. Methods: Echocardiography (Left ventricular mass index-LVMI mass > 131 g/m2 in men and >100 g/m2 in women) and electrocardiography
BETEL NUT CHEWING IS ASSOCIATED WITH HYPERTENSION IN TAIWANESE PATIENTS WITH TYPE 2 DIABETES MELLITUS
C.H. Tseng 1,2,3 . 1 Dept. of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; 2 Dept. of Medical Research and Development, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan; 3 Division of Endocrinology and Metabolism, Dept. of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan Background and aims: Betel nut chewing is associated with oral cancers and diabetes. This study investigated whether betel nut chewing could be associated with hypertension in Taiwanese patients with type 2 diabetes mellitus. Methods: The data of a total of 81,226 (37,226 men and 44,000 women) patients with type 2 diabetes mellitus obtained from a cross-sectional telephone survey in a national sample of diabetic patients in Taiwan were analyzed. Hypertension was defined by a positive history or reported ordinary systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. Analyses were performed in separate sexes with the consideration of the potential confounding effects of age, diabetic duration, body mass index and smoking. Results: Prevalence of betel nut chewing in men and women was 20.4% and 1.1%, respectively. Betel nut chewing was more common in the younger age groups of the male sex. The multivariate-adjusted odds ratios for hypertension in chewers vs. non-chewers were 1.067 (1.007-1.131) and 1.897 (1.534-2.346) for men and women, respectively. In multiple linear regression, although the use of anti-hypertensive agents were not adjusted, betel nut chewing was also significantly associated with blood pressure, with regression coefficients of 0.958 (SE: 0.163) for systolic and 0.441 (0.108) for diastolic blood pressure in men; and the respective values for women were 1.805 (0.618) and 1.198 (0.393). Conclusions: Betel nut chewing is significantly associated with hypertension in Taiwanese patients with type 2 diabetes mellitus and the association was stronger in women. PO20-235
SOLUBLE RECEPTOR OF ADVANCED GLYCATION END PRODUCTS IS INVERSELY RELATED TO CORONARY ATHEROMATOSIS IN DIABETICS
A. Xanthis 1 , A. Hatzitolios 1 , C. Befani 2 , G. Koliakos 2 . 1 1st Propedeutic Medical Dept, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece; 2 Biological Chemistry Dept, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece Background and aims: Advanced glycation end products (AGEs) accumulation in diabetes mellitus (DM) leads to accelerated atheromatosis via their linkage to a macrophage receptor (RAGE). A soluble form of this receptor (sRAGE) is considered to be a decoy binding AGEs. On the grounds that atheromatosis is a diffuse process, we compared sRAGE and number of coronary vessels having stenosis >50% to define the relationship between sRAGE and coronary artery disease. Methods: Our study included 58 diabetic men (aged 65.7± 7.7 years) who underwent coronary angiography without any history of percutaneous coronary interventions or by-pass surgery. Basic cardiovascular risk factors were recorded, as well as plasma sRAGE (measured by ELISA) and AGEs (measured by fluoroscence). Univariate analysis investigated possible correlation between AGEs, sRAGE and coronary atheromatosis.
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey
74
Methods: We analyzed patients’ record files of the period 1991-1995 at the Diabetes Outpatient Clinic of Modena. Inclusion criteria were age 35-65, T2D and no past medical history of CV; patients global CV risk was estimated according to Framingham, RISCARD, Progetto Cuore and UKPDS algorithms and compared with the rate of CV events over the following 10 years. Results: 4575 patients were screened but only 1532 (33.5%) were elegible for defined criteria and completeness of data. In this population 14.6% had a CV event. When comparing the estimated risk rate according to the different functions we observed a high degree of variability; UKPDS algorithm was more consistent with the observed data. Subjects with a CV event differed significantly (p<0.05) from those with no events in HbA1C and diabetes duration, variables included also in UKPDS algorithm. Conclusions: CV risk estimation depends enormously on the used and on the baseline risk of the studied population. The overall performance of such algorithms is however low. The algorithm derived from the present study will be utilized for prospective evaluation of CV risk in our local cohort.
(Cornell voltage criteria for ECG/LVH) were performed in 118 T2D patients with NAFLD and in 118 T2D patients without NAFLD and no clinical evidence of heart disease. NAFLD was diagnosed by abdominal ultrasonography. NAFLD patients had no history of alcohol abuse and negative tests for hepatitis B and C virus. Groups were individually matched for age, sex, smoking status, hypertension level, body mass index and diabetes duration. Results: LVMI mass (151±6 g/m2 vs 133±5 g/m2 , p = 0.01) and LVH prevalence, using the two definitions, were greater in patients with NAFLD (61 vs. 31%, p = 0.02). Systolic and diastolic functions were similar in both groups. Conclusions: LVH is more common and severe in patients with T2D who developed NAFLD. Its presence may constitute independent risk factor for fatal and non-fatal cardiac events and strengthens the case for echocardiography screening to identify high risk patients who might benefit from aggressive cardiovascular risk factor intervention. PO20-234
PO20-232
TRYGLYCERIDES AND GLYCEMIC CONTROL HAVE INFLUCENCE ON SMALL ARTERY ELASTICITY IN DIABETIC PATIENTS
J. Saban-Ruiz 1 , R. Fabregate 1 , M. Fabregate 1 , S. Redondo 2 , E. Marin 2 , V. Garcia-Prieto 2 , N. De La Torre 1 . 1 Endothelial Pathology Unit. Ramon Y Cajal Hospital, Madrid, Spain; 2 Vascular Surgery Service. Ramon Y Cajal Hospital, Madrid, Spain Introduction: The HDI/PulseWave CR-2000 obtains upper-arm blood pressure values and waveform data by non-invasive methods. Aims: To determine the prevalence of abnormal elasticity index in a DM2 and its correlation with hemodynamic evaluation and glycemic control. Methods: N=106, 22-81yrs; Group A: N=50 (non-diabetic); group B: N=56 (diabetic); HDI/PulseWave. Results: 1. Prevalence of abnormal large artery elasticity (C1) was 37.7% in A+B; 28% in A and 46,4 in B (p<0,05). Abnormal subjects were older (p=0,001) and had higher values of, DBP (p=0,004), SBP and MBP (p<0,001), PP (p<0,001) than those with normal elasticity. 2. In relation to C1, significant differences in SVR (p<0,001), TVI (p<0,001), CO (p<0,001), CO Index (p=0,003), SV (p<0,001) and SVI (p=0,001). 3. The prevalence of abnormal small artery elasticity (C2) was 43,4% in A+B; 40,0% in A and 46,4% in B. Abnormal subjects were older (p<0,001), and had higher SBP (p=0,02), DBP (p=0,014), MBP (p<0,001), and PP (p=0,010). 5. In relation to C2, significant differences in the determination of SVResistance (p<0,001), TVImpedance (p=0,007), C Output (p=0,001), CO (p<0,001), Stroke V (p=0,004) and SVIndex (p=0,002). 6. Correlation between small artery elasticity and triglyceride (p=0,007). 7. An age-independent linear correlation between C2 and metabolic control in the diabetic population p=0,013. Conclusions: 1-The prevalence of stiff large and small arteries: 38,3% and 43,4.2-Age is more important than the diabetic status in vascular elasticity. 3-Both phenomena present with changes in other cardiovascular parameters. 4-The stiffness of small arteries is related to levels of triglycerides in all subjects and to glycemic control in diabetic patients. PO20-233
PREVALENCE AND PROGNOSTIC ROLE OF LEFT VENTRICULAR HYPERTROPHY IN TYPE 2 DIABETIC PATIENTS WITH AND WITHOUT NON-ALCOHOLIC FATTY LIVER DISEASE
C. Pop 1 , L. Pop 2 , D. Delia 2 , D. Dicu 2 , R. Hojda 2 , M. Puschita 3 . 1 County Hospital Baia Mare, Faculty of Medicine, Arad, Romania; 2 County Hospital Baia Mare, Romania; 3 Faculty of Medicine Arad, Romania Background: The left ventricle hypertrophy (LVH) and the non-alcoholic fatty liver disease (NAFLD) coexist frequently in patients with obesity, dyslipidemia and type 2 diabetes (T2D). The correlation between insulin resistance and the increased incidence of LVH and NAFLD was proven in recent studies. Objectives: To compare presence of LVH and ventricular function in T2D patients with and without NAFLD and to evaluate the mechanism of increased cardiac morbidity and mortality in T2D patients with NAFLD. Methods: Echocardiography (Left ventricular mass index-LVMI mass > 131 g/m2 in men and >100 g/m2 in women) and electrocardiography
BETEL NUT CHEWING IS ASSOCIATED WITH HYPERTENSION IN TAIWANESE PATIENTS WITH TYPE 2 DIABETES MELLITUS
C.H. Tseng 1,2,3 . 1 Dept. of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; 2 Dept. of Medical Research and Development, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan; 3 Division of Endocrinology and Metabolism, Dept. of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan Background and aims: Betel nut chewing is associated with oral cancers and diabetes. This study investigated whether betel nut chewing could be associated with hypertension in Taiwanese patients with type 2 diabetes mellitus. Methods: The data of a total of 81,226 (37,226 men and 44,000 women) patients with type 2 diabetes mellitus obtained from a cross-sectional telephone survey in a national sample of diabetic patients in Taiwan were analyzed. Hypertension was defined by a positive history or reported ordinary systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. Analyses were performed in separate sexes with the consideration of the potential confounding effects of age, diabetic duration, body mass index and smoking. Results: Prevalence of betel nut chewing in men and women was 20.4% and 1.1%, respectively. Betel nut chewing was more common in the younger age groups of the male sex. The multivariate-adjusted odds ratios for hypertension in chewers vs. non-chewers were 1.067 (1.007-1.131) and 1.897 (1.534-2.346) for men and women, respectively. In multiple linear regression, although the use of anti-hypertensive agents were not adjusted, betel nut chewing was also significantly associated with blood pressure, with regression coefficients of 0.958 (SE: 0.163) for systolic and 0.441 (0.108) for diastolic blood pressure in men; and the respective values for women were 1.805 (0.618) and 1.198 (0.393). Conclusions: Betel nut chewing is significantly associated with hypertension in Taiwanese patients with type 2 diabetes mellitus and the association was stronger in women. PO20-235
SOLUBLE RECEPTOR OF ADVANCED GLYCATION END PRODUCTS IS INVERSELY RELATED TO CORONARY ATHEROMATOSIS IN DIABETICS
A. Xanthis 1 , A. Hatzitolios 1 , C. Befani 2 , G. Koliakos 2 . 1 1st Propedeutic Medical Dept, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece; 2 Biological Chemistry Dept, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece Background and aims: Advanced glycation end products (AGEs) accumulation in diabetes mellitus (DM) leads to accelerated atheromatosis via their linkage to a macrophage receptor (RAGE). A soluble form of this receptor (sRAGE) is considered to be a decoy binding AGEs. On the grounds that atheromatosis is a diffuse process, we compared sRAGE and number of coronary vessels having stenosis >50% to define the relationship between sRAGE and coronary artery disease. Methods: Our study included 58 diabetic men (aged 65.7± 7.7 years) who underwent coronary angiography without any history of percutaneous coronary interventions or by-pass surgery. Basic cardiovascular risk factors were recorded, as well as plasma sRAGE (measured by ELISA) and AGEs (measured by fluoroscence). Univariate analysis investigated possible correlation between AGEs, sRAGE and coronary atheromatosis.
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey