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436 results on '"Ferrannini, Eleuterio"'

292. Residual macrovascular risk in 2013: what have we learned?

Author

Fruchart, Jc, Davignon, J, Hermans, Mp, Al Rubeaan, K, Amarenco, P, Assmann, G, Barter, P, Betteridge, J, Bruckert, E, Cuevas, A, Farnier, M, Ferrannini, Eleuterio, Fioretto, P, Genest, J, Ginsberg, Hn, Gotto AM Jr, Hu, D, Kadowaki, T, Kodama, T, Krempf, M, Matsuzawa, Y, Núñez Cortés JM, Monfil, Cc, Ogawa, H, Plutzky, J, Rader, Dj, Sadikot, S, Santos, Rd, Shlyakhto, E, Sritara, P, Sy, R, Tall, A, Tan, Ce, Tokgözoğlu, L, Toth, Pp, Valensi, P, Wanner, C, Zambon, A, Zhu, J, Zimmet, P, Residual Risk Reduction Initiative, UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - (SLuc) Service d'endocrinologie et de nutrition, Residual Risk Reduction Initiative (R3i), and Kardiyoloji

Subjects
Cardiovascular system--Diseases, medicine.medical_specialty, Statin, Epidemiology, medicine.drug_class, Endocrinology, Diabetes and Metabolism, Type 2 diabetes, Disease, Review, Ezetimibe, Risk Factors, Internal medicine, Diabetes mellitus, medicine, Non-insulin-dependent diabetes, Animals, Humans, Learning, ddc:610, Intensive care medicine, Atherogenic dyslipidaemia, Dyslipidemias, business.industry, medicine.disease, Residual risk, Endocrinology, Diabetes Mellitus, Type 2, Cardiovascular Diseases, Residual cardiovascular risk, Therapeutic options, Medicine, lipids (amino acids, peptides, and proteins), Metabolic syndrome, business, Cardiology and Cardiovascular Medicine, Niacin, medicine.drug
Abstract

Cardiovascular disease poses a major challenge for the 21st century, exacerbated by the pandemics of obesity, metabolic syndrome and type 2 diabetes. While best standards of care, including high-dose statins, can ameliorate the risk of vascular complications, patients remain at high risk of cardiovascular events. The Residual Risk Reduction Initiative (R(3)i) has previously highlighted atherogenic dyslipidaemia, defined as the imbalance between proatherogenic triglyceride-rich apolipoprotein B-containing-lipoproteins and antiatherogenic apolipoprotein A-I-lipoproteins (as in high-density lipoprotein, HDL), as an important modifiable contributor to lipid-related residual cardiovascular risk, especially in insulin-resistant conditions. As part of its mission to improve awareness and clinical management of atherogenic dyslipidaemia, the R(3)i has identified three key priorities for action: i) to improve recognition of atherogenic dyslipidaemia in patients at high cardiometabolic risk with or without diabetes; ii) to improve implementation and adherence to guideline-based therapies; and iii) to improve therapeutic strategies for managing atherogenic dyslipidaemia. The R(3)i believes that monitoring of non-HDL cholesterol provides a simple, practical tool for treatment decisions regarding the management of lipid-related residual cardiovascular risk. Addition of a fibrate, niacin (North and South America), omega-3 fatty acids or ezetimibe are all options for combination with a statin to further reduce non-HDL cholesterol, although lacking in hard evidence for cardiovascular outcome benefits. Several emerging treatments may offer promise. These include the next generation peroxisome proliferator-activated receptor alpha agonists, cholesteryl ester transfer protein inhibitors and monoclonal antibody therapy targeting proprotein convertase subtilisin/kexin type 9. However, long-term outcomes and safety data are clearly needed. In conclusion, the R(3)i believes that ongoing trials with these novel treatments may help to define the optimal management of atherogenic dyslipidaemia to reduce the clinical and socioeconomic burden of residual cardiovascular risk.

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293. Soluble CD40 Ligand and C-Reactive Protein Concentrations Are Affected by Glucose and Insulin Levels in Subjects with Essential Hypertension.

Author

Penno, Giuseppe, Miccoli, Roberto, Pedrinelli, Roberto, Pucci, Laura, Santini, Eleonora, Dell'omo, Giulia, Lucchesi, Daniela, Ferrannini, Eleuterio, del Prato, Stefano, and Solini, Anna

Subjects
LIGANDS (Biochemistry), C-reactive protein, GLUCOSE, INSULIN, PATIENTS, HYPERTENSION, BLOOD platelets, CARDIOVASCULAR diseases
Abstract

Subclinical inflammation and platelets activation are involved in the patho-physiology of cardiovascular disease (CVD). Recently both sCD40L (released by activated platelets) and hs-CRP (an inflammatory marker) have been reported higher among hypertensive patients, but factors affecting both parameters are poorly understood. We aimed to measure hs-CRP and sCD40L in 89 CVD event-free men with essential hypertension and normal renal function, and to explore CVD risk factors affecting circulating levels of hs-CRP and sCD40L with emphasis to Metabolic Syndrome (MS) components. We studied 89 patients (age 49±11 yrs, range of BMI: 18.4-34.5 kg/m2, creatinine below 1.2 mg/dl and cystatin-C ranging from 0.53 to 1.18 mg/1). All subjects underwent a 24 hour ABPM and an OGTT. Specific immnnoassay were used for sCD40L and hs-CRP. Among these subjects, 18% had IFG, 8% IGT, 5% both conditions. MS (NCEP/ATPIII criteria) was present in 30 out of 89 subjects (34%). Mean levels of hs-CRP were 2.4±2.3 (range 0.4 to 8.5) ng/ml; mean levels of sCD40L 8.8±5:0 (range 0.8 to 18.5) ng/ml. No correlation was observed between hs-CRP and sCD40L (p=0.97) and no differences in both parameters emerged in subjects with and without MS. Neither hs-CRP and sCD40L did correlate with age, BMI, systolic and diastolic 24h ABPM parameters, renal function indexes or urinary albumin excretion. Within lipid parameters, a weak positive regression was observed between total cholesterol and sCD40L (p=0.047). hs-CRP correlated with fibrinogen levels (p<0.0001). sCD40L positively correlated with fasting glucose (r=0.23, p=0.029), basal insulin levels (r=0.34, p=0.002), and HOMA-IR (r=0.37, p=0.001), while hs-CRP weakly correlated with the insulinogenic index (r=0.25, p=0.05) and the area under the OGTT curve for insulin (r=0.32, p=0.027). In a multiple regression model, HOMA-IR emerged as the main determinant of the variability of sCD40L levels, while AUC insulin was the main determinant of the variability of hs-CRP concentrations. In conclusion, minor changes in glucose and insulin metabolism might account at least in part for the inflammatory disorders related to essential hypertension. [ABSTRACT FROM AUTHOR]

Published
2007

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