1.
Cardiovascular risk factors and cardiovascular disease in patients with type 1 diabetes and end-stage renal disease candidates for kidney-pancreas transplantation: Trends from 1999 to 2017.
Ruiz, S, Amor, AJ, Pané, A, Molina-Andujar, A, Montagud-Marrahi, E, Ventura-Aguiar, P, Ferrer-Fàbrega, J, Esmatjes, E
Diabetes research and clinical practice. 2020;:108135
Abstract
AIMS: To evaluate the changes in cardiovascular risk factors (CVRFs) and cardiovascular disease (CVD) in patients with type 1 diabetes (T1D) and end-stage renal disease (ESRD) who were candidates for kidney-pancreas transplantation (KPTx) from 1999 to 2017. METHODS Patients with T1D referred for KPTx evaluation were included. The cohort was divided into five groups according to the year of evaluation (1999-2002, 2003-2006, 2007-2010, 2011-2014 and 2015-2017). The control of CVRFs and the prevalence of prior CVD were evaluated. RESULTS We evaluated 360 patients (64.4% men, age 38.9 ± 7.1 years). LDL-cholesterol <100 mg/dl increased from 22.7% to 76.9% (1999-2002 vs. 2015-2017; p < 0.001), as did the use of statins (from 24.7% to 74.5%; p < 0.001). Systolic blood pressure decreased from 138.8 ± 27.6 to 125.1 ± 27.9 mmHg (p = 0.001) and current smokers from 48% to 25% (p = 0.018). Intensive insulin treatment increased from 34.4% to 93.6% (p < 0.001). Diabetes duration before the initiation of renal replacement therapy increased from 23 ± 5.5 to 26.9 ± 8.9 years (p = 0.001). Overall, 30.3% had previous CVD, without significant changes over time (p = 0.699), albeit patients were older and had longer diabetes duration. CONCLUSIONS Patients with T1D and ESRD referred for KPTx have better control of CVRFs over time, which might lead to a decrease in cardiovascular events.
2.
Treatment paradigm shifting implications of recent cardiovascular outcome trials: Core insights on the brink of the 2020ies.
Standl, E, Schnell, O
Diabetes research and clinical practice. 2020;:108054
Abstract
Based on cardiovascular (CV) outcome trials (CVOTs) being available on the brink of the 2020ies, CV safety assessed by major adverse CV event outcomes has been established for the classes of glucagon-like-peptide-1 receptor agonists (GLP1 RAs), sodium-glucose-co-transporter-2 inhibitors (SGLT2-is), and dipeptidyl-peptidase-4 inhibitors (DPP4is) in patients at very high CV risk. This should be relevant to the whole population with diabetes in general as well as the fact that no new serious and unexpected side effects have emerged within these trials. At the same time, treatment paradigm shifting CV benefit has been confirmed for two classes of diabetes medications (SGLT2is & GLP1 RAs), with important additional benefit of SGLT2is reducing heart failure and hard renal endpoints, both in patients with such diseases, but also in patients being in primary prevention. Moreover, the "soft" renal outcome of albuminurea progression seems to be attenuated by all three classes of drugs discussed in this overview. Still ongoing CVOTs are not expected to essentially change the current notions, with the potential of some differentiation regarding subgroups of primary heart failure populations in relation to treatment with SGLT2is.
3.
The Fifty Year Rehabilitation of the Egg.
McNamara, DJ
Nutrients. 2015;(10):8716-22
Abstract
The 1968 American Heart Association announced a dietary recommendation that all individuals consume less than 300 mg of dietary cholesterol per day and no more than three whole eggs per week. This recommendation has not only significantly impacted the dietary patterns of the population, but also resulted in the public limiting a highly nutritious and affordable source of high quality nutrients, including choline which was limited in the diets of most individuals. The egg industry addressed the egg issue with research documenting the minimal effect of egg intake on plasma lipoprotein levels, as well as research verifying the importance of egg nutrients in a variety of issues related to health promotion. In 2015 dietary cholesterol and egg restrictions have been dropped by most health promotion agencies worldwide and recommended to be dropped from the 2015 Dietary Guidelines for Americans.
4.
Pre-historic eating patterns in Latin America and protective effects of plant-based diets on cardiovascular risk factors.
Navarro, JC, Prado, SM, Cárdenas, PA, Santos, RD, Caramelli, B
Clinics (Sao Paulo, Brazil). 2010;(10):1049-54
Abstract
In this review, we present the contributions to nutrition science from Latin American native peoples and scientists, appreciated from a historic point of view since pre-historic times to the modern age. Additionally, we present epidemiological and clinical studies on the area of plant-based diets and their relation with the prevention and treatment of cardiovascular diseases conducted in recent decades, and we discuss challenges and perspectives regarding aspects of nutrition in the region.