17 results on '"Neeland, Ian J."'
Search Results
2. Adipose Tissue Inflammation and Cardiovascular Disease: An Update
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Rana, Mariam N. and Neeland, Ian J.
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- 2022
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3. Changes in lean body mass with glucagon‐like peptide‐1‐based therapies and mitigation strategies.
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Neeland, Ian J., Linge, Jennifer, and Birkenfeld, Andreas L.
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MUSCLE mass , *WEIGHT loss , *LEAN body mass , *TYPE 2 diabetes , *INSULIN sensitivity - Abstract
Weight loss induced by glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) and dual glucagon‐like peptide‐1 receptor (GLP‐1R)/glucose‐dependent insulinotropic polypeptide receptor agonists is coming closer to the magnitudes achieved with surgery. However, with greater weight loss there is concern about potential side effects on muscle quantity (mass), health and function. There is heterogeneity in the reported effects of GLP‐1‐based therapies on lean mass changes in clinical trials: in some studies, reductions in lean mass range between 40% and 60% as a proportion of total weight lost, while other studies show lean mass reductions of approximately 15% or less of total weight lost. There are several potential reasons underlying this heterogeneity, including population, drug‐specific/molecular, and comorbidity effects. Furthermore, changes in lean mass may not always reflect changes in muscle mass as the former measure includes not only muscle but also organs, bone, fluids, and water in fat tissue. Based on contemporary evidence with the addition of magnetic resonance imaging‐based studies, skeletal muscle changes with GLP‐1RA treatments appear to be adaptive: reductions in muscle volume seem to be commensurate with what is expected given ageing, disease status, and weight loss achieved, and the improvement in insulin sensitivity and muscle fat infiltration likely contributes to an adaptive process with improved muscle quality, lowering the probability for loss in strength and function. Nevertheless, factors such as older age and severity of disease may influence the selection of appropriate candidates for these therapies due to risk of sarcopenia. To further improve muscle health during weight loss, several pharmacological treatments to maintain or improve muscle mass designed in combination with GLP‐1‐based therapies are under development. Future research on GLP‐1‐based and other therapies designed for weight loss should focus on more accurate and meaningful assessments of muscle mass, composition, as well as function, mobility or strength, to better define their impact on muscle health for the substantial number of patients who will likely be taking these medications well into the future. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Continuous glucose monitoring for glycaemic control and cardiovascular risk reduction in patients with type 2 diabetes not on insulin therapy: A clinical trial.
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Reed, Joseph, Dong, Tony, Eaton, Elke, Friswold, Janice, Porges, Jodie, Al‐Kindi, Sadeer G., Rajagopalan, Sanjay, and Neeland, Ian J.
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CONTINUOUS glucose monitoring ,GLYCEMIC control ,TYPE 2 diabetes ,CARDIOVASCULAR diseases risk factors ,INSULIN ,INSULIN therapy ,GLYCOSYLATED hemoglobin ,INSULIN aspart ,HYPERGLYCEMIA - Abstract
Aim: To evaluate the impact of the Dexcom G6 continuous glucose monitoring (CGM) device on glycaemic control and cardiometabolic risk in patients with type 2 diabetes mellitus (T2DM) at high cardiovascular risk who are not on insulin therapy. Materials and Methods: Adults with T2DM with glycated haemoglobin (HbA1c) >7% and body mass index (BMI) ≥30 kg/m2 not using insulin were enrolled in a two‐phase cross‐over study. In phase 1, CGM data were blinded, and participants performed standard glucose self‐monitoring. In phase 2, the CGM data were unblinded, and CGM, demographic and cardiovascular risk factor data were collected through 90 days of follow‐up and compared using paired tests. Results: Forty‐seven participants were included (44% women; 34% Black; mean age 63 years; BMI 37 kg/m2; HbA1c 8.4%; 10‐year predicted atherosclerotic cardiovascular disease risk 24.0%). CGM use was associated with a reduction in average glucose (184.0 to 147.2 mg/dl, p <.001), an increase in time in range (57.8 to 82.8%, p <.001) and a trend towards lower glucose variability (26.2 to 23.8%). There were significant reductions in HbA1c, BMI, triglycerides, blood pressure, total cholesterol, diabetes distress and 10‐year predicted risk for atherosclerotic cardiovascular disease (p <.05 for all) and an increase in prescriptions for sodium‐glucose cotransporter 2 inhibitors (36.2 to 83.0%) and glucagon‐like peptide‐1 receptor agonists (42.5 to 87.2%, p <.001 for both). Conclusions: Dexcom G6 CGM was associated with improved glycaemic control and cardiometabolic risk in patients with T2DM who were not on insulin. CGM can be a safe and effective tool to improve diabetes management in patients at high risk for adverse cardiovascular outcomes. [ABSTRACT FROM AUTHOR]
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- 2024
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5. The transiency of metabolically healthy obesity: Metabolic decline and atherosclerotic risk.
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Mirzai, Saeid, Neeland, Ian J., and Lavie, Carl J.
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OBESITY ,CAROTID intima-media thickness ,ATHEROSCLEROTIC plaque ,WEIGHT loss ,CARDIOVASCULAR diseases - Abstract
A study published in the journal Diabetes/Metabolism Research & Reviews examines the concept of metabolically healthy obesity (MHO) and its association with cardiovascular disease (CVD) risk. The study analyzed data from over 50,000 middle-aged and elderly Chinese adults and found that individuals with MHO had a higher risk of carotid atherosclerosis compared to metabolically healthy normal weight individuals. Additionally, a significant number of participants with initially metabolically healthy overweight or obesity developed metabolic abnormalities within a 2-year follow-up period. The study suggests that while metabolic health is more important than obesity for atherosclerosis, excess weight still increases the risk. The findings also indicate that MHO is often a transient state rather than a long-term phenotype. The study highlights the need for further research to identify predictors of metabolic health decline and interventions to stabilize the MHO phenotype. The authors suggest that assessing cardiorespiratory fitness and its impact on CVD outcomes should be a priority in future studies on MHO. Overall, the study emphasizes the importance of weight loss for population health gains, even among individuals currently without metabolic abnormalities. [Extracted from the article]
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- 2024
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6. Associations of liver fat content with cardiometabolic phenotypes and outcomes in a multi‐ethnic population: Results from the Dallas Heart Study.
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Le, Minh‐da, Wu, Yiling, Berry, Jarett D., Browning, Jeffrey D., de Lemos, James A., Neeland, Ian J., and Lingvay, Ildiko
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C-reactive protein ,ABDOMINAL adipose tissue ,NUCLEAR magnetic resonance spectroscopy ,CORONARY artery calcification ,FAT ,LIVER ,ADIPOSE tissues - Abstract
Aims: To evaluate the associations between liver fat content and cardiometabolic parameters to explore potential threshold values that define metabolically healthy liver fat content, and to examine the association of liver fat content with cardiovascular events as well as its longitudinal progression. Methods: Participants in the Dallas Heart Study underwent clinical evaluation, including laboratory testing, and liver fat quantification by magnetic resonance spectroscopy (MRS) at baseline (N = 2287) and at follow‐up (N = 343) after a mean of 7.3 years. Cardiovascular events were adjudicated (>12 years). Results: The mean age at study entry was 44 years, 47% of participants were men, and 48% were African American. The following cardiometabolic biomarkers worsened across liver fat quintiles (P < 0.0001): body mass index (BMI); waist circumference; prevalence of hypertension; prevalence of diabetes; cholesterol, triglyceride, high‐sensitivity C‐reactive protein (CRP), leptin and fasting glucose levels; homeostatic model assessment of insulin resistance index (HOMA‐IR); coronary artery calcium score; visceral adipose tissue; abdominal subcutaneous adipose tissue; and lower body subcutaneous adipose tissue. Cardiovascular events were comparable across groups defined by tertile of baseline liver fat content. Change in BMI (R = 0.40), waist circumference (R = 0.35), CRP (R = 0.31), alanine aminotransferase (R = 0.27), HOMA‐IR (R = 0.26), aspartate transaminase (R = 0.15) and triglycerides (R = 0.12) significantly correlated with change in liver fat content (P < 0.01 for all). Conclusion: Clinically relevant metabolic abnormalities were higher across quintiles of liver fat, with increases noted well within normal liver fat ranges, but cardiovascular events were not associated with liver fat content. Longitudinal changes in metabolic parameters, especially adiposity‐related parameters, were correlated with change in liver fat content. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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7. Is Metabolically Healthy Obesity Really Healthy for the Heart?
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Lavie, Carl J. and Neeland, Ian J.
- Abstract
[Display omitted] [ABSTRACT FROM AUTHOR]
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- 2023
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8. 21st Century Advances in Multimodality Imaging of Obesity for Care of the Cardiovascular Patient.
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Neeland, Ian J., Yokoo, Takeshi, Leinhard, Olof Dahlqvist, and Lavie, Carl J.
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Although obesity is typically defined by body mass index criteria, this does not differentiate true body fatness, as this includes both body fat and muscle. Therefore, other fat depots may better define cardiometabolic and cardiovascular disease (CVD) risk imposed by obesity. Data from translational, epidemiological, and clinical studies over the past 3 decades have clearly demonstrated that accumulation of adiposity in the abdominal viscera and within tissue depots lacking physiological adipose tissue storage capacity (termed "ectopic fat") is strongly associated with the development of a clinical syndrome characterized by atherogenic dyslipidemia, hyperinsulinemia/glucose intolerance/type 2 diabetes mellitus, hypertension, atherosclerosis, and abnormal cardiac remodeling and heart failure. This state-of-the-art paper discusses the impact of various body fat depots on cardiometabolic parameters and CVD risk. Specifically, it reviews novel and emerging imaging techniques to evaluate adiposity and the risk of cardiometabolic diseases and CVD. • Anthropometric and laboratory markers of obesity have limited utility for personalized treatment. Direct imaging measures of obesity may improve diagnosis, guide decision-making for appropriate interventions, and monitor responses to treatment. • Multimodality imaging is used to assess visceral and ectopic fat depots (such as within the heart, liver, skeletal muscle, pancreas, and kidney) to improve evaluation of metabolic disease and CVD risk. • Future studies will combine body fat assessment with physical activity/cardiorespiratory fitness to further improve efforts to prevent and treat obesity and its progression to CVD. [ABSTRACT FROM AUTHOR]
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- 2021
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9. Hemodynamic and Mechanical Properties of the Proximal Aorta in Young and Middle-Aged Adults With Isolated Systolic Hypertension: The Dallas Heart Study.
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Yuichiro Yano, Neeland, Ian J., Ayers, Colby, Peshock, Ronald, Berry, Jarett D., Lloyd-Jones, Donald M., Greenland, Philip, Mitchell, Gary F., Vongpatanasin, Wanpen, and Yano, Yuichiro
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The aim of this study was to assess characteristic impedance (Zc) of the proximal aorta in young and middle-aged individuals with isolated systolic hypertension (ISH). Zc is an index of aortic stiffness relative to aortic size. In the Dallas Heart Study, 2001 untreated participants 18 to 64 years of age (mean age: 42.3 years; 44% black race) were divided into the following groups based on office blood pressure (BP) measurements: (1) optimal BP (systolic BP [SBP] <120 mm Hg and diastolic BP [DBP] <80 mm Hg; n=837); (2) prehypertension (SBP 120-139 mm Hg and DBP 80-89 mm Hg; n=821); (3) ISH (SBP ≥140 mm Hg and DBP <90 mm Hg; n=121); (4) isolated diastolic hypertension (SBP <140 mm Hg and DBP ≥90 mm Hg; n=44); and (5) systolic-diastolic hypertension (SBP ≥140 mm Hg and DBP ≥90 mm Hg; n=178). Zc, aortic arch pulse wave velocity, and minimum ascending aortic size were quantified using cardiovascular magnetic resonance. In multivariable-adjusted linear models, Zc was highest in the ISH group compared with the optimal BP, isolated diastolic hypertension, or systolic-diastolic hypertension groups (103.2±4.0 versus 68.3±2.1, 75.4±6.0, and 88.9±4.8 dyne*seconds/cm5, respectively; all P<0.05). The Zc-ISH association did not differ by race. Aortic pulse wave velocity was highest in the ISH group compared with the optimal BP, isolated diastolic hypertension, or systolic-diastolic hypertension groups (6.3±0.3 versus 4.3±0.1, 4.4±0.4 and 5.5±0.3 m/s, respectively; all P<0.05), whereas aortic size was similar across groups (all P>0.2). Results were similar in a subgroup of 1551 participants 18 to 49 years of age. In a multiracial population-based sample, we found evidence of a mismatch between proximal aortic stiffness and diameter in young and middle-aged adults with ISH. [ABSTRACT FROM AUTHOR]
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- 2017
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10. Effect of treatment with rosiglitazone on high-sensitivity cardiac troponin levels among patients with type 2 diabetes mellitus.
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Salahuddin, Usman I., Pandey, Ambarish, Ayers, Colby R., See, Raphael, Neeland, Ian J., Gore, M. Odette, Grinsfelder, D. Bennett, Abdullah, Shuaib M., Khera, Amit, de Lemos, James A., and McGuire, Darren K.
- Abstract
Objective: To assess the impact of intermediate-term treatment with rosiglitazone on high-sensitivity cardiac troponin T levels among patients with type 2 diabetes mellitus with or at high risk of coronary artery disease. Methods: High-sensitivity cardiac troponin T level was measured at baseline and after 6 months of study treatment in a randomized trial comparing rosiglitazone versus placebo in patients with type 2 diabetes and prevalent cardiovascular disease or multiple cardiovascular disease risk factors. Univariable and multivariable linear regression analyses were performed to assess the effect of rosiglitazone versus placebo on high-sensitivity cardiac troponin T levels. Results: The study included 150 randomized participants, of whom 106 had paired baseline and end-of-study blood samples for analysis (mean age: 56 ± 8 years, 42% women; 8.8 years average type 2 diabetes duration; mean haemoglobin A1c of 7.5). Almost all study participants (93%) had detectable high-sensitivity cardiac troponin T (⩾3 ng/L) at baseline, including 23% with high-sensitivity cardiac troponin T levels exceeding the threshold commonly used to diagnose myocardial infarction (⩾14 ng/L). Change in high-sensitivity cardiac troponin T levels from baseline to follow-up was not significantly different between rosiglitazone and placebo groups (p = 0.316). Conclusion: Rosiglitazone did not impact high-sensitivity cardiac troponin T levels, adding to the growing body of literature suggesting that the incremental heart failure risk associated with rosiglitazone is not mediated by direct myocardial injury. [ABSTRACT FROM AUTHOR]
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- 2016
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11. Taking the Obesity Paradox to New Heights in Cerebral Atherosclerosis.
- Author
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Lavie, Carl J., Carbone, Salvatore, and Neeland, Ian J.
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- 2022
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12. Time to Retire the BMI?: Evaluating Abdominal Adipose Tissue Imaging as Novel Cardiovascular Risk Biomarker.
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Neeland, Ian J. and de Lemos, James A.
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CARDIOVASCULAR diseases risk factors , *BODY mass index , *TYPE 2 diabetes risk factors , *ABDOMINAL adipose tissue , *COMPUTED tomography , *DUAL-energy X-ray absorptiometry - Published
- 2016
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13. The Pros and Cons of Mendelian Randomization Studies to Evaluate Emerging Cardiovascular Risk Factors.
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Savla, Jainy and Neeland, Ian J.
- Abstract
Purpose of Review: Mendelian randomization (MR) is a technique that uses natural genetic variation to assess the potential causal role of a modifiable risk factor on cardiovascular disease. Advances have led to the identification of single nucleotide polymorphisms linked with risk factors that act as naturally randomized instruments to investigate the risk factor-disease relationship.Recent Findings: There are several pros and cons when using MR. It can address many limitations of observational study design including confounding, reverse causation, and demonstration of causality when a randomized controlled trial is not practical or feasible. However, several limitations do exist and include pleiotropy (multiple downstream effects of a single genetic variant), linkage disequilibrium (non-random association of genetic variation), and imprecise estimates of causal effects.Summary: MR is an important tool in cardiovascular research and has been applied to assess cardiovascular risk factors including obesity and atrial fibrillation. While these studies provide insight into disease causation, understanding the strengths and limitations of the technique is important for appropriate interpretation of results. [ABSTRACT FROM AUTHOR]
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- 2018
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14. Contemporary utilization of GLP1 receptor agonists and SGLT2 inhibitors in patients with diagnosed type 2 diabetes and cardiovascular disease in the United States.
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Al-Kindi, Sadeer G., Janus, Scott E., Neeland, Ian J., and Rajagopalan, Sanjay
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- 2022
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15. The CardioMetabolic Health Alliance: Working Toward a New Care Model for the Metabolic Syndrome.
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Sperling, Laurence S., Mechanick, Jeffrey I., Neeland, Ian J., Herrick, Cynthia J., Després, Jean-Pierre, Ndumele, Chiadi E., Vijayaraghavan, Krishnaswami, Handelsman, Yehuda, Puckrein, Gary A., Araneta, Maria Rosario G., Blum, Quie K., Collins, Karen K., Cook, Stephen, Dhurandhar, Nikhil V., Dixon, Dave L., Egan, Brent M., Ferdinand, Daphne P., Herman, Lawrence M., Hessen, Scott E., and Jacobson, Terry A.
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METABOLIC syndrome treatment , *HEART metabolism , *MEDICAL care , *PATHOLOGICAL physiology , *COMORBIDITY , *CARDIOVASCULAR diseases - Abstract
The Cardiometabolic Think Tank was convened on June 20, 2014, in Washington, DC, as a “call to action” activity focused on defining new patient care models and approaches to address contemporary issues of cardiometabolic risk and disease. Individual experts representing >20 professional organizations participated in this roundtable discussion. The Think Tank consensus was that the metabolic syndrome (MetS) is a complex pathophysiological state comprised of a cluster of clinically measured and typically unmeasured risk factors, is progressive in its course, and is associated with serious and extensive comorbidity, but tends to be clinically under-recognized. The ideal patient care model for MetS must accurately identify those at risk before MetS develops and must recognize subtypes and stages of MetS to more effectively direct prevention and therapies. This new MetS care model introduces both affirmed and emerging concepts that will require consensus development, validation, and optimization in the future. [ABSTRACT FROM AUTHOR]
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- 2015
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16. Management of Obesity in Cardiovascular Practice: JACC Focus Seminar.
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Després, Jean-Pierre, Carpentier, André C., Tchernof, André, Neeland, Ian J., and Poirier, Paul
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ADIPOSE tissues , *MEDICAL personnel , *CARDIOVASCULAR diseases , *WEIGHT loss , *BODY mass index - Abstract
Obesity contributes to reduced life expectancy because of its link with type 2 diabetes and cardiovascular disease. Yet, targeting this poorly diagnosed, ill-defined, and underaddressed modifiable risk factor remains a challenge. In this review, we emphasize that the tendency among health care professionals to amalgam all forms of obesity altogether as a single entity may contribute to such difficulties and discrepancies. Obesity is a heterogeneous condition both in terms of causes and health consequences. Attention should be given to 2 prevalent subgroups of individuals: 1) patients who are overweight or moderately obese with excess visceral adipose tissue; and 2) patients with severe obesity, the latter group having distinct additional health issues related to their large body fat mass. The challenge of tackling high-cardiovascular-risk forms of obesity through a combination of personalized clinical approaches and population-based solutions is compounded by the current obesogenic environment and economy. [ABSTRACT FROM AUTHOR]
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- 2021
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17. Abstract 15986: GlycA: A Novel Marker of Inflammation and Potential Link Between Obesity and Cardiovascular Disease.
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Riggs, Kayla A, Rocha, Natalia A, Patel, Kershaw V, Khera, Amit, Ayers, Colby R, Neeland, Ian J, and Rohatgi, Anand
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OBESITY , *CARDIOVASCULAR diseases , *ACUTE phase proteins , *PROPORTIONAL hazards models , *BODY mass index , *WAIST circumference , *C-reactive protein - Abstract
Background: GlycA, an integrated glycosylation protein of five acute phase reactants, is a novel inflammatory biomarker associated with both obesity and cardiovascular disease (CVD). We assessed the hypothesis that visceral adipose tissue (VAT) associates with GlycA and this association may partially explain the pathophysiological link between VAT and CVD. Methods: Baseline measurements of risk factors, body mass index (BMI), waist circumference (WC), and VAT were obtained from 2352 adults in the Dallas Heart Study, a multi-ethnic population-based cohort. GlycA was derived from NMR spectral features. Linear regression was used to assess associations between adiposity variables and GlycA. Cox proportional hazards models were used to assess the associations of VAT and GlycA with first or subsequent CVD event over a median of 11.4 years among those with obesity (BMI >=30). Results: Median age was 43, 56% women and 47% blacks. VAT, BMI and WC were each associated with GlycA in separate models adjusted for traditional risk factors (standardized beta estimates of 0.26, 0.27, and 0.27, respectively; all p < 0.0001). VAT remained directly associated with GlycA when additionally adjusting for BMI or WC. In adjusted models for first and recurrent CV events, the significant direct association between VAT and CV events (HR 1.22, 95% CI 1.04 to 1.44; p=0.01) was partially attenuated when adjusted for GlycA (HR 1.19, 95% CI 1.00 to 1.40; p=0.05). In contrast, VAT remained associated with CV events when adjusted for high sensitivity C-reactive protein. GlycA remained strongly associated with CV events despite adjustment for VAT (HR 1.30, 95% CI 1.13 to 1.49; p=0.0002; Table). Conclusions: Direct imaging assessment of VAT is associated with GlycA, a novel marker of inflammation. The link between VAT and CVD may be partly explained by inflammation reflected by GlycA. These findings suggest that GlycA may be a potentially useful surrogate marker for the adverse CVD risk associated with VAT. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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