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PO21-672 ADIPONECTIN AND INFLAMMATORY MARKERS IN OBESE NON-DIABETICS AND OBESE TYPE 2 DIABETICS
180 PO21-669
Poster Sessions PO21 Obesity/Metabolic syndrome STATINS ON RENAL FUNCTION AND SERUM-URIC ACID AND THEIR RELATION TO VASCULAR EVENTS IN CORONARY HEART DISEASE AND METABOLIC SYNDROME
V.G. Athyros 1 , D.P. Mikhailidis 2 , E.N. Liberopoulos 3 , A.I. Kakafika 1 , A. Karagiannis 1 , A.A. Papageorgiou 1 , K. Tziomalos 1 , E.S. Ganotakis 4 , M. Elisaf 3 . 1 Department of Internal Medicine, Aristotelian University, Thessaloniki, Greece; 2 Vascular Prevention Clinic, Royal Free University, London, UK; 3 Department of Internal Medicine, University of Ioannina, Ioannina, Greece; 4 Department of Internal Medicine, University of Crete, Heraklion, Greece Background: Metabolic syndrome (MetS) is associated with increased risk for both vascular and chronic kidney disease. Whether statins ameliorate these risks is not established. Methods: This post hoc analysis of the GREek-Atorvastatin-andCoronary heart disease (CHD)-Evaluation (GREACE) examines the effect of statins on estimated glomerular filtration rate (e-GFR) and serum uric acid (SUA) levels and their relation to vascular events in CHD patients with MetS. MetS patients were divided into 2 groups: Group A (n=365) received lifestyle advice, target-driven treatment with statins (mainly atorvastatin), and treatment for hypertension and elevated glucose. Group B (n=347) received the above except for statins. Patients without MetS were divided into those who received similar treatment with Group A and Group B [Groups C (n=504) and D (n=384), respectively]. All patients were followed for 3 years. Results: 12.1% of patients in Group A experienced a vascular event vs 28% in Group B; risk ratio (RR) 0.43, 95% confidence interval (CI) 0.20-0.64, p<0.0001, while in those without MetS (Group C vs D) the respective RR was 0.59, 95% CI 0.41-0.79, p<0.0001. In Group A, e-GFR increased by 13.7% and SUA levels fell by 8.9%, while in Group B e-GFR was reduced by 5.8% and SUA increased by 4.3% (p<0.005). Stepwise regression analysis showed that these changes were independently related to vascular events. Conclusion: Among CHD patients, those with MetS benefited more from statin treatment than those without MetS. This benefit could be partially attributed to favourable changes in e-GFR and SUA levels probably induced by statin treatment.
PO21-671
F.J. Guerrero-Igea, B. Escolano-Fernandez, J. Olivan-Martinez, A. Millan-Rodriguez, L. Orbea-Rios, R. Fernandez-Ojeda, M.C. Merino-Rumin, I. Marin-Montin, M. Sorinano-Perez, J.L. Serrano-Carrillo De Albornoz, A. Valiente-Mendez, A. Prados-Gallardo, V. Morales-Caballero De Leon, M. Rey-Rodriguez, J. Reveriego-Blanes, P. Retamar-Gentil, M.D. Aguayo-Canela. Internal Medicine A Service, University Hospital Virgen Macarena, Sevilla, Spain Background and Aims: This study makes comparative evaluations of the waist/height index and other anthropometric indices associated with basal insulinemia levels, analyzing its possible clinical utility as an anthropometric factor linked to insulin resistance. Methods: Observational, cross sectional study. Out-patient internal medicine clinics in our hospital. 220 premenopausal women who met the criteria for inclusion and made visits between January 2006 and September 2006. Age (A), body mass index (BMI, kg/m height), waist/hip index (W/H), waist measurement (W, cm), waist/height index (W/HT, height in meters), basal insulinemia(I, uU/ml), basal glucose level (Gl, mg/dl), average alcohol consumption (AAC) o cigarettes (ACC)were studied. Results: A sample of 220 women was studied: (A=31.1, CI 95% 30-32.1) (BMI=25.6, CI 95% 24.9-26.4) (W=78.9, CI95% 77.2-80.7)(WH=0.804, CI 95% 0.796-0.812) (W/HT=49.8, CI 95% 48.6-50.9) (I=8.3, CI 95% 7.6-8.9). In the simple correlation study, the BMI (r=0.57), W (r=0.58), W/H (r=0.39), W/HT(r=0.58), Gl (r=0.32) were associated with (p<0.05)levels of basal insulinemia; but not age, AAC or ACC. In the multiple regression analysis, only W/HT had an independent association with basal insulinemia (regression coeff.= 0.300, CI95% 0.245-0.355 p<0.001). In the logistic regression analysis, W/HT was associated independently with hyperinsulinemia (p<0.001). Conclusions: The waist/height index is associated with levels of basal insulinemia in premenopausal women. From this, we deduce the probable importance of this anthropometric factor in association with insulin resistance syndrome, and with the risk of non-insulin dependent diabetes mellitus. PO21-672
PO21-670
OBESITY AND METABOLIC SYNDROME IN PATIENTS WITH SEVERE HYPERTRIGLYCERIDEMIA
T.V. Chepetova, A.N. Meshkov, P.P. Malyshev, V.V. Kukharchuk. Institute of Clinical Cardiology, Russian Cardiology Research Center, Moscow, Russia Background: Cases of severe hypertriglyceridemia (triglyceride level >10 mmol/l) are common have genetic or mixed character, and occurs in about 1 in 1000 adults. Goal of this study was to determinant frequency of modifiable factors lead to increasing triglycerides. Methods: We analyzed clinical date of 76 patients who had level TG >10 mmol/l. 89% of these patients did not take triglyceride-lowering drugs before they were included in the study. Results: Mean age of study population was 49±11 years, 64% were male. Level of TG was 22,87±9,3 mmol/l, total cholesterol was 13,52±6,9 mmol/l, HDL-cholesterol was 0,88±0,38 mmol/l. The prevalence of overweight (BMI >25 and <30 kg/m2 ) was 34,5%, obesity (BMI >30 kg/m2 ) was 49,1%, diabetes was 42,6%, metabolic syndrome was 57,3%. Smoking habit frequency was 27,8%, more frequently in male. 45,2% of patients had coronary heart disease(CHD), 68% had hypertension(HT). Mean age of CHD development was 45,3±8,9 years. Mean age of HT development was 39,42±8,9 years. Conclusions: Obesity and metabolic syndrome are accompanied severe hypertriglyceridemia. Funding: RFBR grant #05-04-49762-a, RFBR grant #06-04-49691-a.
WAIST TO HEIGHT RATIO IS LINKED TO INSULIN RESISTANCE
ADIPONECTIN AND INFLAMMATORY MARKERS IN OBESE NON-DIABETICS AND OBESE TYPE 2 DIABETICS
J. Rioja 1 , A. Pozo 2 , M.J. Ariza 1 , M.T. Gonzalez-Alegre 1 , A. Hornos 1 , P. Valdivielso 1 , P. Gonzalez-Santos 1 . 1 CIMES, Department of Medicine, University of Malaga, Malaga, Spain; 2 Palma-Palmilla Health Centre, Malaga, Spain Objective: to evaluate adiponectin levels and inflammatory factors in obese non-diabetic (n = 60) and obese type 2 diabetic patients (n = 47) compared to non-obese healthy subjects (controls) (n = 25). Matherial and methods: Anthropometric and clinical parameters were assessed. C reactive protein (CRP), alpha-TNF, IL-6 and adiponectin levels were measured in fasting plasma using enzimatic immunoassays. HOMAIR index was also calculated. Lipoprotein and apolipoprotein profile was also determined. ANOVA test and correlation analysis were displayed to stablish statistical differences. Results: Obese non-diabetics and obese diabetics showed similar BMI and waist circunference but were significantly higher than controls (p < 0.05). Only obese diabetics showed higher glucose levels (162 ± 66 mg/dL; p < 0.05) compared to controls (83 ± 26 mg/dL) and obese non-diabectics (103 ± 18 mg/dL). HOMA-IR index was higher in obese (4.9 ± 12.7; p <0.05) but lower than obese diabetics (6.1 ±3.5; p < 0.05). Obese patients showed higher alphaTNF (p < 0.05) and CRP levels (p < 0.05) and lower adiponectin levels (p < 0.05) than controls. Compared to obese non-diabetics, obese diabetics showed higher alphaTNF (p < 0.05), similar CRP levels (p > 0.05) and lower adiponectin (p < 0.05). IL-6 was only higher in obese diabetics without antidiabetic treatment. Signifficantly, the correlations study showed a strong correlation of adiponectin with markers of atherogenic dislipidemia in obese diabetics (p < 0.05). Conclusions: both obese non-diabetics and obese diabetics show systemic inflammation and low adiponectin levels. Adiponectin is associated with the markers of the diabetic dislipidemia.
76th Congress of the European Atherosclerosis Society, June 10–13, 2007, Helsinki, Finland
Poster Sessions PO21 Obesity/Metabolic syndrome STATINS ON RENAL FUNCTION AND SERUM-URIC ACID AND THEIR RELATION TO VASCULAR EVENTS IN CORONARY HEART DISEASE AND METABOLIC SYNDROME
V.G. Athyros 1 , D.P. Mikhailidis 2 , E.N. Liberopoulos 3 , A.I. Kakafika 1 , A. Karagiannis 1 , A.A. Papageorgiou 1 , K. Tziomalos 1 , E.S. Ganotakis 4 , M. Elisaf 3 . 1 Department of Internal Medicine, Aristotelian University, Thessaloniki, Greece; 2 Vascular Prevention Clinic, Royal Free University, London, UK; 3 Department of Internal Medicine, University of Ioannina, Ioannina, Greece; 4 Department of Internal Medicine, University of Crete, Heraklion, Greece Background: Metabolic syndrome (MetS) is associated with increased risk for both vascular and chronic kidney disease. Whether statins ameliorate these risks is not established. Methods: This post hoc analysis of the GREek-Atorvastatin-andCoronary heart disease (CHD)-Evaluation (GREACE) examines the effect of statins on estimated glomerular filtration rate (e-GFR) and serum uric acid (SUA) levels and their relation to vascular events in CHD patients with MetS. MetS patients were divided into 2 groups: Group A (n=365) received lifestyle advice, target-driven treatment with statins (mainly atorvastatin), and treatment for hypertension and elevated glucose. Group B (n=347) received the above except for statins. Patients without MetS were divided into those who received similar treatment with Group A and Group B [Groups C (n=504) and D (n=384), respectively]. All patients were followed for 3 years. Results: 12.1% of patients in Group A experienced a vascular event vs 28% in Group B; risk ratio (RR) 0.43, 95% confidence interval (CI) 0.20-0.64, p<0.0001, while in those without MetS (Group C vs D) the respective RR was 0.59, 95% CI 0.41-0.79, p<0.0001. In Group A, e-GFR increased by 13.7% and SUA levels fell by 8.9%, while in Group B e-GFR was reduced by 5.8% and SUA increased by 4.3% (p<0.005). Stepwise regression analysis showed that these changes were independently related to vascular events. Conclusion: Among CHD patients, those with MetS benefited more from statin treatment than those without MetS. This benefit could be partially attributed to favourable changes in e-GFR and SUA levels probably induced by statin treatment.
PO21-671
F.J. Guerrero-Igea, B. Escolano-Fernandez, J. Olivan-Martinez, A. Millan-Rodriguez, L. Orbea-Rios, R. Fernandez-Ojeda, M.C. Merino-Rumin, I. Marin-Montin, M. Sorinano-Perez, J.L. Serrano-Carrillo De Albornoz, A. Valiente-Mendez, A. Prados-Gallardo, V. Morales-Caballero De Leon, M. Rey-Rodriguez, J. Reveriego-Blanes, P. Retamar-Gentil, M.D. Aguayo-Canela. Internal Medicine A Service, University Hospital Virgen Macarena, Sevilla, Spain Background and Aims: This study makes comparative evaluations of the waist/height index and other anthropometric indices associated with basal insulinemia levels, analyzing its possible clinical utility as an anthropometric factor linked to insulin resistance. Methods: Observational, cross sectional study. Out-patient internal medicine clinics in our hospital. 220 premenopausal women who met the criteria for inclusion and made visits between January 2006 and September 2006. Age (A), body mass index (BMI, kg/m height), waist/hip index (W/H), waist measurement (W, cm), waist/height index (W/HT, height in meters), basal insulinemia(I, uU/ml), basal glucose level (Gl, mg/dl), average alcohol consumption (AAC) o cigarettes (ACC)were studied. Results: A sample of 220 women was studied: (A=31.1, CI 95% 30-32.1) (BMI=25.6, CI 95% 24.9-26.4) (W=78.9, CI95% 77.2-80.7)(WH=0.804, CI 95% 0.796-0.812) (W/HT=49.8, CI 95% 48.6-50.9) (I=8.3, CI 95% 7.6-8.9). In the simple correlation study, the BMI (r=0.57), W (r=0.58), W/H (r=0.39), W/HT(r=0.58), Gl (r=0.32) were associated with (p<0.05)levels of basal insulinemia; but not age, AAC or ACC. In the multiple regression analysis, only W/HT had an independent association with basal insulinemia (regression coeff.= 0.300, CI95% 0.245-0.355 p<0.001). In the logistic regression analysis, W/HT was associated independently with hyperinsulinemia (p<0.001). Conclusions: The waist/height index is associated with levels of basal insulinemia in premenopausal women. From this, we deduce the probable importance of this anthropometric factor in association with insulin resistance syndrome, and with the risk of non-insulin dependent diabetes mellitus. PO21-672
PO21-670
OBESITY AND METABOLIC SYNDROME IN PATIENTS WITH SEVERE HYPERTRIGLYCERIDEMIA
T.V. Chepetova, A.N. Meshkov, P.P. Malyshev, V.V. Kukharchuk. Institute of Clinical Cardiology, Russian Cardiology Research Center, Moscow, Russia Background: Cases of severe hypertriglyceridemia (triglyceride level >10 mmol/l) are common have genetic or mixed character, and occurs in about 1 in 1000 adults. Goal of this study was to determinant frequency of modifiable factors lead to increasing triglycerides. Methods: We analyzed clinical date of 76 patients who had level TG >10 mmol/l. 89% of these patients did not take triglyceride-lowering drugs before they were included in the study. Results: Mean age of study population was 49±11 years, 64% were male. Level of TG was 22,87±9,3 mmol/l, total cholesterol was 13,52±6,9 mmol/l, HDL-cholesterol was 0,88±0,38 mmol/l. The prevalence of overweight (BMI >25 and <30 kg/m2 ) was 34,5%, obesity (BMI >30 kg/m2 ) was 49,1%, diabetes was 42,6%, metabolic syndrome was 57,3%. Smoking habit frequency was 27,8%, more frequently in male. 45,2% of patients had coronary heart disease(CHD), 68% had hypertension(HT). Mean age of CHD development was 45,3±8,9 years. Mean age of HT development was 39,42±8,9 years. Conclusions: Obesity and metabolic syndrome are accompanied severe hypertriglyceridemia. Funding: RFBR grant #05-04-49762-a, RFBR grant #06-04-49691-a.
WAIST TO HEIGHT RATIO IS LINKED TO INSULIN RESISTANCE
ADIPONECTIN AND INFLAMMATORY MARKERS IN OBESE NON-DIABETICS AND OBESE TYPE 2 DIABETICS
J. Rioja 1 , A. Pozo 2 , M.J. Ariza 1 , M.T. Gonzalez-Alegre 1 , A. Hornos 1 , P. Valdivielso 1 , P. Gonzalez-Santos 1 . 1 CIMES, Department of Medicine, University of Malaga, Malaga, Spain; 2 Palma-Palmilla Health Centre, Malaga, Spain Objective: to evaluate adiponectin levels and inflammatory factors in obese non-diabetic (n = 60) and obese type 2 diabetic patients (n = 47) compared to non-obese healthy subjects (controls) (n = 25). Matherial and methods: Anthropometric and clinical parameters were assessed. C reactive protein (CRP), alpha-TNF, IL-6 and adiponectin levels were measured in fasting plasma using enzimatic immunoassays. HOMAIR index was also calculated. Lipoprotein and apolipoprotein profile was also determined. ANOVA test and correlation analysis were displayed to stablish statistical differences. Results: Obese non-diabetics and obese diabetics showed similar BMI and waist circunference but were significantly higher than controls (p < 0.05). Only obese diabetics showed higher glucose levels (162 ± 66 mg/dL; p < 0.05) compared to controls (83 ± 26 mg/dL) and obese non-diabectics (103 ± 18 mg/dL). HOMA-IR index was higher in obese (4.9 ± 12.7; p <0.05) but lower than obese diabetics (6.1 ±3.5; p < 0.05). Obese patients showed higher alphaTNF (p < 0.05) and CRP levels (p < 0.05) and lower adiponectin levels (p < 0.05) than controls. Compared to obese non-diabetics, obese diabetics showed higher alphaTNF (p < 0.05), similar CRP levels (p > 0.05) and lower adiponectin (p < 0.05). IL-6 was only higher in obese diabetics without antidiabetic treatment. Signifficantly, the correlations study showed a strong correlation of adiponectin with markers of atherogenic dislipidemia in obese diabetics (p < 0.05). Conclusions: both obese non-diabetics and obese diabetics show systemic inflammation and low adiponectin levels. Adiponectin is associated with the markers of the diabetic dislipidemia.
76th Congress of the European Atherosclerosis Society, June 10–13, 2007, Helsinki, Finland