- Email: [email protected]
We-P11:4 Normal glucose disposal and decreased insulin sensitivity in young normal weight men with non-treated hypertension
346
Wednesday, June 21, 2006" Poster Session Pll
OPTIMAL
ATHEROSCLEROSIS (lst PART)
MANAGEMENT
I
We-P11 1 IJ R E D U C I N G T H E C A R D I O V A S C U L A R RISK AT PATIENTS W I T H TYPE 2 D I A B E T E S BY C O N T R O L L I N G T H E RISK FACTORS C. Tudor, R.A. Jeberean, R. Buzas, A. Popescu, M. Ionita. Medical Cl#uc I -
Municipal Hospital, Timisoara, Romania Objective: Evaluation and reducing the global cardiovascular risk at patients with diabetes. Identification and appropriate treatment of the risk factors. The treatment of diabetes with insulin and statines. M e t h o d s : The study included 2 groups of patients: A formed by 230 persons with type 2 diabetes heaving the following risk factors: high blood pressure, obesity, dislipidemia, metabolic syndrome, albuminuria, smoking and absence of phisical activity and B that included 230 persons heaving the same risk factors excepting smoking and who were treated with insulin and were practicing phisical activity. Patients from both groups were treated simvastatin and there were quantificated: the plasma glucose levels, Hb A l c , albuminuria, total cholesterol, LDL and HDL cholesterol, triglycerides, fibrinogen, C reactive protein, at 3 month period. The caxdiovaculax risk was calculated at the beginning of the study and at 24 months. Results: In group B albuminuria was reduced, total cholesterol=5.12-4-0.18, LDL=2.79+0.38, H D L = l . 3 8 + 0 . 6 , T G = l . 4 8 + 0 . 6 m m o l / 1 compared with group A where the risk factors weren't under control, H D L = I . 0 2 + 0 . 5 (p<0.001) and the cardiovascular risk was higher. Conclusions: The correct treatment of the risk factors, insulin treatment and physical activity increase HDL cholesterol levels and lowers the frequency of cardiovascular events and the global risk is significant reduced compared with the group not treated in this manner. Funding: WORWAG P H A R M G M B H
IW e - P 1 1 : 3 1
I
P U L S E P R E S S U R E , A N I M P O R T A N T RISK F A C T O R F O R A T H E R O S C L E R O S I S , IS S I G N I F I C A N T L Y I N C R E A S E D IN D I A B E T E S T Y P E II
L. Salvanos 1,2.1Tzanio General Hospital, Greece." 2Health Center Vyronas,
Greece A i m of our study was to examine pulse pressure in type 2 diabetic patients in comparison to non diabetics, as well as the relationship of PP to history of myocardial infarction. M a t e r i a l a n d M e t h o d s : A total of 509 subjects (167 male and 342 female) were included in this survey, who were consecutive volunteers from the general population, aged above 17 years. All participants filled a questionnaire and underwent standardised body height, weight and waist circumference and blood pressure measurements. Blood samples were collected and total cholesterol and plasma glucose were examined by routine methods. Results: PP was found to be significantly higher (p=0.031) in subjects with a history of myocardial infaxction (56.3-4-16.6 mmHg, mean -4-SD)in comparison to subjects without MI (51.9-4-16.8 mmHg, mean: -4-SD). In multivariate analysis PP along with age, BMI and waist circumference was found to be a significant risk factor for myocardial infarction. PP was significantly increased (p<0.001) in type 2 diabetic patients (60.1+17.9mmHg, m e a n : + S D ) vs. non diabetic subjects (52.1-4-16.3mmHg, mean:-4-SD). PP was significantly correlated with age (r=0.358, p<0.001), male sex (r=0.12, p<0.001), body mass index (r=0.099, p=0.005), waist circumference (r=0.218, p<0.001) and fasting plasma glucose (r=0.139, p<0.001). In multiple linear regression analysis age, history of diabetes mellitus and waist circumference were found to be significant independent determinants of PE C o n d u s i o n s : Our study demonstrates that pulse pressure is a significant risk factor for myocardial infarction, which is significantly increased in type 2 diabetic patients.
GLUCOSE DISPOSAL AND DECREASED IWe-P11:41 NI NOSRUML IANL SENSITIVITY IN Y O U N G N O R M A L I i
WEIGHT MEN WITH NON-TREATED HYPERTENSION
I
W e - P 1 1 : 2 Ii P E R I P H E R A L A R T E R I A L D I S E A S E A N D P R E D I C T O R R E L A T E D FACTORS IN D I A B E T I C ELDERLY PATIENTS T. Kuswaxdhani 1, I.G.ES. Aryana 1 , EK. Wirajaya 2 , N. Astika 1 , K. Suastlka ~ . G e r t a t r t c Dtvtston, Denpasat; Bali, b~donesia." 2Department of
Intental Medicbte, Medical Facul~ Udayana Universi~JSanglah Hospital, Denpasat; Bali, Itulonesia Objective: Peripheral arterial disease (PAD) is one of chronic diabetic complication. Peripheral Arterial disease (PAD) is one of chronic diabetic complication caused by atherosclerotic occlusion of arteries to the leg, is important manifestation of systemic atherosclerosis. Prevalence of PAD will be increase in geriatric patients. This study aims to know the prevalence of PAD and predictor factors related to PAD in diabetic geriatric patients M e t h o d s : This study was cross sectional study. Samples were recruited with diagnosed elderly diabetic patient in out patient of Geriatric division, Sanglah hospital. PAD was assessed by ankle brachial index lowest through 0.90. Results: sixty one patients were recruited with 40 male and 21 female with mean age 67.23 -4- 5.79 years. All subjects have already diagnosed diabetes. Prevalence of PAD was 19.7%. Prevalence PAD in female 33.3% and in male 10% with ratio prevalence 4.5 (CI 1.10-17.8, p=0.024). The most patients have treatment with oral hypoglycemic agents 83.7% and 16.3% with insulin. Ninety one point eight % subjects got acetosal and 3,3% with statin. Significantly difference mean were found between non PAD and PAD in level of cholesterol total (192.46 vs 226, p=0.41), cholesterol LDL (128.22 vs 156.09, p=0.03), and diastolic blood pressure (88.92 vs 81.45, p=0.01). PAD have correlation with cholesterol total R=0.29, p=0.024. Conclusion: Prevalence of PAD in diabetic geriatric patients was 19.7%. Prevalence PAD was related with gender, hypertension and dyslipidemia.
L. Salvanos 1,2.1Tzanio General Hospital, Greece." 2Health Center Vyronas,
Greece B a c k g r o u n d a n d Aims: Hypertension is often associated with insulin resistance preferentially in overweight/obese and older subjects. Decreased insulin sensitivity has been observed also in young lean normotensive subjects with family history of hypertension. The aim of our study was to compare insulin and C-peptide responses to i.v. glucose load between young males with early diagnosed mild hypertension or high normal blood pressure (HT) and normotensive controls (NT). M a t e r i a l s a n d M e t h o d s : IVGTT (0.3 g glucose/kg body weight during 3 rain) was performed in 20 HT aged 22-4-1 (mean: ± S E M ) years with BMI 22.3-4-0.5 kg/m 2 and in 22 gender, age and BMI matched NT aged 25.2-4-1.7 years with BMI 22.6-4-0.7 kg/m 2. Insulin sensitivity indices (HOMA-IR, QUICKI, NISI) were calculated using plasma glucose, insulinin and C-peptide concentrations obtained during IVGTT. Results: Blood pressure was significantly higher in HT subjects compared to NT (132/69 vs. 114/58mmHg p < 0.001). Insulin resistance was significantly higher (HOMA-IR: 1.7-4-0.1 vs 1.0-4-0.1, p= 0.003) and insulin sensitivity was significantly lower (QUICKI: 0.31-4-0.01 vs. 0.34-4-0.01, p < 0.001, NISh 0.201-4-0.002 vs. 0.212-4-0.0010, p < 0.001) in HT subjects compared to NT subjects. Insulin (peak: 76.5-4-20.4 vs. 38.9-4-8.8 ItU/ml, p= 0.002, 2-way ANOVA) and C-peplide (peak: 2020-4-147 vs. 1284-4-112 pmol/L, p < 0.001, 2-way ANOVA) responses to i.i. glucose load were higher in HT subjects compared to NT subjects. C o n d u s i o n : Our results show that normal glucose homeostasis in young lean males with early hypertension was maintained by insulin hypersecretion. Thus, individuals with eaxly-onset hypertension or high normal blood pressure should be considered as subjects at high risk of insulin resistance and its detrimental consequences. Therefore, they represent another target group in which lifestyle management and periodical control of glucose tolerance and also insulin levels would be recommended.
XIV bztentational Symposium on Atherosclerosis, Rome, Italy, June 18-22, 2006
Wednesday, June 21, 2006" Poster Session Pll
OPTIMAL
ATHEROSCLEROSIS (lst PART)
MANAGEMENT
I
We-P11 1 IJ R E D U C I N G T H E C A R D I O V A S C U L A R RISK AT PATIENTS W I T H TYPE 2 D I A B E T E S BY C O N T R O L L I N G T H E RISK FACTORS C. Tudor, R.A. Jeberean, R. Buzas, A. Popescu, M. Ionita. Medical Cl#uc I -
Municipal Hospital, Timisoara, Romania Objective: Evaluation and reducing the global cardiovascular risk at patients with diabetes. Identification and appropriate treatment of the risk factors. The treatment of diabetes with insulin and statines. M e t h o d s : The study included 2 groups of patients: A formed by 230 persons with type 2 diabetes heaving the following risk factors: high blood pressure, obesity, dislipidemia, metabolic syndrome, albuminuria, smoking and absence of phisical activity and B that included 230 persons heaving the same risk factors excepting smoking and who were treated with insulin and were practicing phisical activity. Patients from both groups were treated simvastatin and there were quantificated: the plasma glucose levels, Hb A l c , albuminuria, total cholesterol, LDL and HDL cholesterol, triglycerides, fibrinogen, C reactive protein, at 3 month period. The caxdiovaculax risk was calculated at the beginning of the study and at 24 months. Results: In group B albuminuria was reduced, total cholesterol=5.12-4-0.18, LDL=2.79+0.38, H D L = l . 3 8 + 0 . 6 , T G = l . 4 8 + 0 . 6 m m o l / 1 compared with group A where the risk factors weren't under control, H D L = I . 0 2 + 0 . 5 (p<0.001) and the cardiovascular risk was higher. Conclusions: The correct treatment of the risk factors, insulin treatment and physical activity increase HDL cholesterol levels and lowers the frequency of cardiovascular events and the global risk is significant reduced compared with the group not treated in this manner. Funding: WORWAG P H A R M G M B H
IW e - P 1 1 : 3 1
I
P U L S E P R E S S U R E , A N I M P O R T A N T RISK F A C T O R F O R A T H E R O S C L E R O S I S , IS S I G N I F I C A N T L Y I N C R E A S E D IN D I A B E T E S T Y P E II
L. Salvanos 1,2.1Tzanio General Hospital, Greece." 2Health Center Vyronas,
Greece A i m of our study was to examine pulse pressure in type 2 diabetic patients in comparison to non diabetics, as well as the relationship of PP to history of myocardial infarction. M a t e r i a l a n d M e t h o d s : A total of 509 subjects (167 male and 342 female) were included in this survey, who were consecutive volunteers from the general population, aged above 17 years. All participants filled a questionnaire and underwent standardised body height, weight and waist circumference and blood pressure measurements. Blood samples were collected and total cholesterol and plasma glucose were examined by routine methods. Results: PP was found to be significantly higher (p=0.031) in subjects with a history of myocardial infaxction (56.3-4-16.6 mmHg, mean -4-SD)in comparison to subjects without MI (51.9-4-16.8 mmHg, mean: -4-SD). In multivariate analysis PP along with age, BMI and waist circumference was found to be a significant risk factor for myocardial infarction. PP was significantly increased (p<0.001) in type 2 diabetic patients (60.1+17.9mmHg, m e a n : + S D ) vs. non diabetic subjects (52.1-4-16.3mmHg, mean:-4-SD). PP was significantly correlated with age (r=0.358, p<0.001), male sex (r=0.12, p<0.001), body mass index (r=0.099, p=0.005), waist circumference (r=0.218, p<0.001) and fasting plasma glucose (r=0.139, p<0.001). In multiple linear regression analysis age, history of diabetes mellitus and waist circumference were found to be significant independent determinants of PE C o n d u s i o n s : Our study demonstrates that pulse pressure is a significant risk factor for myocardial infarction, which is significantly increased in type 2 diabetic patients.
GLUCOSE DISPOSAL AND DECREASED IWe-P11:41 NI NOSRUML IANL SENSITIVITY IN Y O U N G N O R M A L I i
WEIGHT MEN WITH NON-TREATED HYPERTENSION
I
W e - P 1 1 : 2 Ii P E R I P H E R A L A R T E R I A L D I S E A S E A N D P R E D I C T O R R E L A T E D FACTORS IN D I A B E T I C ELDERLY PATIENTS T. Kuswaxdhani 1, I.G.ES. Aryana 1 , EK. Wirajaya 2 , N. Astika 1 , K. Suastlka ~ . G e r t a t r t c Dtvtston, Denpasat; Bali, b~donesia." 2Department of
Intental Medicbte, Medical Facul~ Udayana Universi~JSanglah Hospital, Denpasat; Bali, Itulonesia Objective: Peripheral arterial disease (PAD) is one of chronic diabetic complication. Peripheral Arterial disease (PAD) is one of chronic diabetic complication caused by atherosclerotic occlusion of arteries to the leg, is important manifestation of systemic atherosclerosis. Prevalence of PAD will be increase in geriatric patients. This study aims to know the prevalence of PAD and predictor factors related to PAD in diabetic geriatric patients M e t h o d s : This study was cross sectional study. Samples were recruited with diagnosed elderly diabetic patient in out patient of Geriatric division, Sanglah hospital. PAD was assessed by ankle brachial index lowest through 0.90. Results: sixty one patients were recruited with 40 male and 21 female with mean age 67.23 -4- 5.79 years. All subjects have already diagnosed diabetes. Prevalence of PAD was 19.7%. Prevalence PAD in female 33.3% and in male 10% with ratio prevalence 4.5 (CI 1.10-17.8, p=0.024). The most patients have treatment with oral hypoglycemic agents 83.7% and 16.3% with insulin. Ninety one point eight % subjects got acetosal and 3,3% with statin. Significantly difference mean were found between non PAD and PAD in level of cholesterol total (192.46 vs 226, p=0.41), cholesterol LDL (128.22 vs 156.09, p=0.03), and diastolic blood pressure (88.92 vs 81.45, p=0.01). PAD have correlation with cholesterol total R=0.29, p=0.024. Conclusion: Prevalence of PAD in diabetic geriatric patients was 19.7%. Prevalence PAD was related with gender, hypertension and dyslipidemia.
L. Salvanos 1,2.1Tzanio General Hospital, Greece." 2Health Center Vyronas,
Greece B a c k g r o u n d a n d Aims: Hypertension is often associated with insulin resistance preferentially in overweight/obese and older subjects. Decreased insulin sensitivity has been observed also in young lean normotensive subjects with family history of hypertension. The aim of our study was to compare insulin and C-peptide responses to i.v. glucose load between young males with early diagnosed mild hypertension or high normal blood pressure (HT) and normotensive controls (NT). M a t e r i a l s a n d M e t h o d s : IVGTT (0.3 g glucose/kg body weight during 3 rain) was performed in 20 HT aged 22-4-1 (mean: ± S E M ) years with BMI 22.3-4-0.5 kg/m 2 and in 22 gender, age and BMI matched NT aged 25.2-4-1.7 years with BMI 22.6-4-0.7 kg/m 2. Insulin sensitivity indices (HOMA-IR, QUICKI, NISI) were calculated using plasma glucose, insulinin and C-peptide concentrations obtained during IVGTT. Results: Blood pressure was significantly higher in HT subjects compared to NT (132/69 vs. 114/58mmHg p < 0.001). Insulin resistance was significantly higher (HOMA-IR: 1.7-4-0.1 vs 1.0-4-0.1, p= 0.003) and insulin sensitivity was significantly lower (QUICKI: 0.31-4-0.01 vs. 0.34-4-0.01, p < 0.001, NISh 0.201-4-0.002 vs. 0.212-4-0.0010, p < 0.001) in HT subjects compared to NT subjects. Insulin (peak: 76.5-4-20.4 vs. 38.9-4-8.8 ItU/ml, p= 0.002, 2-way ANOVA) and C-peplide (peak: 2020-4-147 vs. 1284-4-112 pmol/L, p < 0.001, 2-way ANOVA) responses to i.i. glucose load were higher in HT subjects compared to NT subjects. C o n d u s i o n : Our results show that normal glucose homeostasis in young lean males with early hypertension was maintained by insulin hypersecretion. Thus, individuals with eaxly-onset hypertension or high normal blood pressure should be considered as subjects at high risk of insulin resistance and its detrimental consequences. Therefore, they represent another target group in which lifestyle management and periodical control of glucose tolerance and also insulin levels would be recommended.
XIV bztentational Symposium on Atherosclerosis, Rome, Italy, June 18-22, 2006