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1.
Lower risk of death and cardiovascular events in patients with diabetes initiating glucagon-like peptide-1 receptor agonists or sodium-glucose cotransporter-2 inhibitors: A real-world study in two Italian cohorts.
Baviera, M, Genovese, S, Lepore, V, Colacioppo, P, Robusto, F, Tettamanti, M, D'Ettorre, A, Avanzini, F, Fortino, I, Nicolucci, A, et al
Diabetes, obesity & metabolism. 2021;(7):1484-1495
Abstract
AIM: To examine the efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 (SGLT2) inhibitors compared with other antihyperglycaemic agents (AHAs) in large and unselected populations of the Lombardy and Apulia regions in Italy. MATERIALS AND METHODS An observational cohort study of first-time users of GLP-1RAs, SGLT2 inhibitors or other AHAs was conducted from 2010 to 2018. Death and cardiovascular (CV) events were evaluated using conditional Cox models in propensity-score-matched populations. Adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated for each region and in a meta-analysis for pooled risks. RESULTS After propensity-score matching, the Lombardy cohort included 18 716 and 11 683 patients and the Apulia cohort 9772 and 6046 patients for the GLP-1RA and SGLT2 inhibitor groups, respectively. Use of GLP-1RAs was associated with lower rates of death (HR 0.61, CI 0.56-0.65, Lombardy; HR 0.63, CI 0.55-0.71, Apulia), cerebrovascular disease and ischaemic stroke (HR 0.70, CI 0.63-0.79; HR 0.72, CI 0.60-0.87, Lombardy), peripheral vascular disease (HR 0.72, CI 0.64-0.82, Lombardy; HR 0.80, CI 0.67-0.98, Apulia), and lower limb complications (HR 0.67, CI 0.56-0.81, Lombardy; HR 0.69, CI 0.51-0.93, Apulia). Compared with other AHAs, SGLT2 inhibitor use decreased the risk of death (HR 0.47, CI 0.40-0.54, Lombardy; HR 0.43, CI 0.32-0.57, Apulia), cerebrovascular disease (HR 0.75, CI 0.61-0.91, Lombardy; HR 0.72, CI 0.54-0.96, Apulia), and heart failure (HR 0.56, CI 0.46-0.70, Lombardy; HR 0.57, CI 0.42-0.77, Apulia). In the pooled cohorts, a reduction in heart failure was also observed with GLP-1RAs (HR 0.89, 95% CI 0.82-0.97). Serious adverse events were quite low in frequency. CONCLUSION Our findings from real-world practice confirm the favourable effect of GLP-1RAs and SGLT2 inhibitors on death and CV outcomes across both regions consistently. Thus, these drug classes should be preferentially considered in a broad type 2 diabetes population beyond those with CV disease.
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2.
Protein intake is not associated with functional biomarkers of physical frailty: A cross-sectional analysis of community-dwelling older adults with type 2 diabetes mellitus.
Villani, A, Barrett, M, McClure, R, Wright, H
Nutrition, metabolism, and cardiovascular diseases : NMCD. 2021;(3):827-833
Abstract
BACKGROUND AND AIM Frailty has emerged as a third category of complication in patients with type 2 diabetes mellitus (T2DM). It has been suggested that adequate protein intake is an important dietary strategy for counteracting frailty. Therefore, we explored the association between protein intake and functional biomarkers of frailty in older adults with T2DM. METHODS AND RESULTS Frailty was operationalized as the presence of three of the following: exhaustion, low muscle strength, low physical activity, slow gait speed, and weight loss. Functional biomarkers included handgrip strength (HGS), chair stands, the short physical performance battery and gait speed. Eighty-seven older adults (71.2 ± 8.2 years; 66.7% males) were included. A total of n = 6 (~7%) and n = 32 (~37%) participants were identified as frail and pre-frail respectively. No significant difference was observed for protein intake across staging of frailty (pre-frail/frail: 1.3 ± 0.4 g/kg BW; non-frail: 1.4 ± 0.4 g/kg BW; P = 0.320). A significant association was observed for total protein intake and HGS (β = 0.44; 95% CI: 0.23-1.8; P = 0.01). However, this was no longer significant after adjusting for age, gender, physical activity, energy intake and total appendicular lean muscle (β = 0.03; 95% CI: -0.45-0.60; P = 0.78). Nil other associations were observed between total protein intake and functional biomarkers of frailty. CONCLUSION Adequate protein intake was not associated with functional biomarkers in older adults with T2DM. Future research should focus on the efficacy of protein on attenuating functional decline in vulnerable older adults with low protein intake.
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3.
Determining the effect size of aerobic exercise training on the standard lipid profile in sedentary adults with three or more metabolic syndrome factors: a systematic review and meta-analysis of randomised controlled trials.
Wood, G, Taylor, E, Ng, V, Murrell, A, Patil, A, van der Touw, T, Sigal, R, Wolden, M, Smart, N
British journal of sports medicine. 2021
Abstract
OBJECTIVES To estimate the change in the standard lipid profile (SLP) of adults diagnosed with ≥3 metabolic syndrome (MetS) factors following aerobic exercise training (AET); and to investigate whether study/intervention covariates are associated with this change. DESIGN Systematic review with univariate meta-analysis and meta-regression. DATA SOURCES English language searches of online databases from inception until July 2020. ELIGIBILITY CRITERIA (1) Published randomised controlled human trials with study population ≥10 per group; (2) sedentary adults with ≥3 MetS factors but otherwise free of chronic disease, not pregnant/lactating; (3) AET-only intervention with duration ≥12 weeks; and (4) reporting pre-post intervention SLP outcomes. RESULTS Various univariate meta-analyses pooled 48 data sets of 2990 participants. Aerobic exercise training significantly (P<.001) improved all lipids (mmol/L mean difference ranges, 95% CIs): total cholesterol, -0.19 (-0.26 to -0.12) to -0.29 (-0.36 to -0.21); triglycerides, -0.17 (-0.19 to -0.14) to -0.18 (-0.24 to -0.13); high-density lipoprotein-cholesterol (HDL-C), 0.05 (0.03 to 0.07) to 0.10 (0.05 to 0.15); and low-density lipoprotein-cholesterol (LDL-C), -0.12 (-0.16 to -0.9) to -0.20 (-0.25 to -0.14). Meta-regression showed that intensity may explain change in triglycerides and volume may explain change in HDL-C and LDL-C. CONCLUSION Aerobic exercise training positively changes the SLP of sedentary and otherwise healthy adults with ≥3 MetS factors. Adjusting AET intervention training variables may increase the effects of AET on triglycerides and HDL-C. PROSPERO REGISTRATION NUMBER CRD42020151925.
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4.
Cardiac 1H MR spectroscopy: development of the past five decades and future perspectives.
Gupta, A, Houston, B
Heart failure reviews. 2021;(4):839-859
Abstract
Continued advances in laboratory medicine are required to realize the potential of individualized medicine to impact common cardiovascular diseases. Magnetic resonance imaging (MRI) and spectroscopy (MRS) techniques have advanced over recent years and offer unique, powerful insights into cardiac anatomic and metabolic changes, respectively, occurring in both nascent and advanced heart disease. Although numerous MRI-based in vivo diagnostics are already used in routine clinical practice and more are anticipated, MRS has been less incorporated into routine clinical practice. Given the ability of 1H MRS to identify and quantify specific molecules with high sensitivity and specificity, its potential utility should be successfully transition from "bench-to-bedside" is tantalizing. The present review will highlight the development of 1H MRS techniques for cardiac applications, observations in seminal studies with 1H MRS, and the prospects and challenges for widespread application in patients with cardiovascular disease.
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5.
Nutritional Composition, Antinutritional Factors, and Utilization Trends of Ethiopian Chickpea (Cicer arietinum L.).
Yegrem, L
International journal of food science. 2021;:5570753
Abstract
Chickpeas are a very important legume crop and have an abundant amount of proteins, carbohydrates, lipids, fibers, and mineral contents. Most of the time, breeders were focused on the yield and the disease resistance criteria parameters for releasing new varieties, but not that much attention is given to the nutritional quality and quantity aspect. So the objective of this review mainly focuses on giving some hints for breeders and nutritionists on nutritional profiles and effects of traditional processing of different Ethiopian chickpea varieties which may be used for variety selection for the new variety trial and new product development, respectively. Chickpeas have many bioactive compounds, important vitamins, and minerals. Besides having nutritional benefits, the consumption of chickpeas always requires some processing as they have many antinutritional factors. Various traditional processes such as soaking, cooking or boiling, germination, roasting, fermentation, and dehulling have their own effects on the availability of nutrients. Chickpeas are used to make many Ethiopian traditional chickpea-based food products such as nifro, kollo, shiro, dabo, mitad shiro, ashuk, boklet, kita, genfo, injera, and shimbra-asa by using different processing methods. Chickpeas have several potential health beneficial effects on some of the important human diseases like cardiovascular diseases, type 2 diabetes, digestive diseases, and cancers. This review summarized that different Ethiopian chickpea varieties have significant differences in the nutritional composition profiles between different varieties grown in Ethiopia and are an excellent source of micronutrients and macronutrients.
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6.
Which Diets Are Effective in Reducing Cardiovascular and Cancer Risk in Women with Obesity? An Integrative Review.
Silveira, EA, Noll, PRES, Mohammadifard, N, Rodrigues, APS, Sarrafzadegan, N, de Oliveira, C
Nutrients. 2021;(10)
Abstract
Women are more affected by obesity than men which increases their risk of cancer and cardiovascular disease (CVD). Therefore, it is important to understand the effectiveness of different types of diet in the context of women's health. This review aims to summarize the scientific evidence on the effects of different types of diet for women with obesity and their impact on CVD and cancer risk. This review included epidemiological and clinical studies on adult women and different types of diets, such as the Mediterranean (MED) diet, the Traditional Brazilian Diet, the Dietary Approach to Stop Hypertension (DASH), intermittent fasting (IF), calorie (energy) restriction, food re-education, low-carbohydrate diet (LCD) and a very low-carbohydrate diet (VLCD). Our main findings showed that although LCDs, VLCD and IF are difficult to adhere to over an extended period, they can be good options for achieving improvements in body weight and cardiometabolic parameters. MED, DASH and the Traditional Brazilian Diet are based on natural foods and reduced processed foods. These diets have been associated with better women's health outcomes, including lower risk of CVD and cancer and the prevention and treatment of obesity.
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7.
Traditional uses and pharmacological activities of the genus leea and its phytochemicals: A review.
Hossain, F, Mostofa, MG, Alam, AK
Heliyon. 2021;(2):e06222
Abstract
OBJECTIVES Plants have been used as traditional medicine (TM) since ancient times and TM remains an effective treatment option in the primary health care system in developing countries, including Bangladesh. There are several reasons to use plants as TM, which are cheaply and easily available and have a cultural heritage of their uses across generations. Leea, a genus of the Vitaceae family, possesses a large number of medicinal plants. In this review, the literature data on the traditional uses and pharmacological activities of Leea species and their phytochemicals are compiled. All the information was collected from the scientific databases. RESULTS Leea species are endemic that have opened a promising research field to identify new leads against different diseases. Leea contains approximately 70 species, which are widely distributed throughout the Northern and Eastern Australia, South and Southeast Asia and parts of Africa. The Leea plants are used traditionally in different ailments such as fever, diarrhea, dysentery, joint pain, rheumatism, diabetes, bone fracture, body ache, wound, sexual disorders, and so on. The majority of the Leea species are the medicinal plants, which have anticancer, cytotoxic, antimicrobial, antidiabetic, hepatoprotective, cardiovascular, and CNS activity. Moreover, phytochemicals such as flavonoids, glycosides, phenols, terpenoids, steroids, volatile oils, alkaloids, proteins, quinine derivatives, tannins, saponins, and many other organic compounds have been reported in the Leea species (Leea indica, Leea macrophylla, Leea asiatica, Leea aequata, Leea rubra and Leea guineensis). The presence of phytochemicals and the in vitro and in vivo biological activities reported of these plants support their use as TM. Though original research articles related to the Leea genus are available, supportive reviews on phytochemicals and pharmacological activities remain scarce. CONCLUSION Leea species are used as TM in different ailments and have a real interest in their diverse pharmacological properties. Also, Leea species contain a remarkable number of bioactive compounds. This review has provided a comprehensive report on the plants of Leea genus to identify its therapeutic potential and future prospects for betterment research. However, chemical and biological investigations of several species of Leea genus remain unexplored. Therefore, further studies on these species are necessary, especially regarding pharmacological properties, isolation of the compounds and mechanism of action for the development of new drugs.
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8.
Interplay between cognition and weight reduction in individuals following a Mediterranean Diet: Three-year follow-up of the PREDIMED-Plus trial.
Soldevila-Domenech, N, Forcano, L, Vintró-Alcaraz, C, Cuenca-Royo, A, Pintó, X, Jiménez-Murcia, S, García-Gavilán, JF, Nishi, SK, Babio, N, Gomis-González, M, et al
Clinical nutrition (Edinburgh, Scotland). 2021;(9):5221-5237
Abstract
BACKGROUND & AIMS Some cognitive profiles might facilitate successful weight loss and its maintenance. Also, weight reductions may result in cognitive benefits. However, little work to date has examined the interactions between cognition and weight changes in the context of interventions with the Mediterranean diet (MedDiet). We studied the within-subject longitudinal relationships between cognition, body mass index (BMI), physical activity (PA), and quality of life (QoL), in older adults following a MedDiet. METHODS The PREDIMED-Plus is a primary prevention trial testing the effect of a lifestyle intervention program with an energy-restricted MedDiet (er-MedDiet), weight-loss goals and PA promotion on cardiovascular disease. The PREDIMED-Plus-Cognition sub-study included 487 participants (50% women, mean age 65.2 ± 4.7 years), with overweight/obesity, metabolic syndrome and normal cognitive performance at baseline. A comprehensive neurocognitive test battery was administered at baseline and after 1 and 3 years. RESULTS Baseline higher performance in verbal memory (OR = 1.5; 95%CI 1.0, 2.1), visuoconstructive praxis and attention (OR = 1.5; 95%CI 0.9, 2.3), and inhibition (OR = 1.3; 95%CI 0.9, 1.9) were associated with a higher odd of achieving at least 8% weight loss after 3 years follow-up in participants randomized to the intervention group. There were moderate improvements in specific tests of memory and executive functions during follow-up. Higher adherence to the er-MedDiet was associated with greater improvements in memory. Women exhibited lower rates of change in global cognition, PA and QoL. Moreover, improvements in memory correlated with reductions in BMI after 1 year (βSTD = -0.14) and with improvements in PA after 3 years (βSTD = 0.13). Finally, participants who experienced greater improvements in executive functions and global cognition also experienced greater improvements in their QoL. CONCLUSIONS This study refines the understanding of the determinants and mutual interrelationships between longitudinally-assessed cognitive performance and weight loss, adding further evidence to the cognitive benefits associated with better adherence to a MedDiet. Our results also suggest that weight loss interventions tailored to the cognitive profile and gender of participants are promising avenues for future studies.
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9.
2021 Consensus Pathway of the Taiwan Society of Cardiology on Novel Therapy for Type 2 Diabetes.
Chiang, CE, Ueng, KC, Chao, TH, Lin, TH, Wu, YJ, Wang, KL, Sung, SH, Yeh, HI, Li, YH, Liu, PY, et al
JACC. Asia. 2021;(2):129-146
Abstract
Type 2 diabetes is a major threat to human health in the 21st century. More than half a billion people may suffer from this pandemic disease in 2030, leading to a huge burden of cardiovascular complications. Recently, 2 novel antidiabetic agents, glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter 2 inhibitors, reduced cardiovascular complications in a number of randomized control trials. To integrate new information and to achieve a streamlined process for better patient care, a working group was appointed by the Taiwan Society of Cardiology to formulate a stepwise consensus pathway for these therapies to reduce cardiovascular events in patients with type 2 diabetes. This consensus pathway is complementary to clinical guidelines, acting as a reference to improve patient care.
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10.
Revascularization versus medical therapy for the treatment of stable coronary artery disease: A meta-analysis of contemporary randomized controlled trials.
Laukkanen, JA, Kunutsor, SK
International journal of cardiology. 2021;:13-21
Abstract
BACKGROUND We conducted a systematic review and meta-analysis of contemporary randomized controlled trials (RCTs) to compare clinical outcomes among stable coronary artery disease (CAD) patients treated with revascularization [percutaneous coronary intervention (PCI), coronary-artery bypass grafting (CABG) or both] plus medical therapy (MT) versus MT alone. METHODS Prospective RCTs were sought from MEDLINE, Embase, The Cochrane Library, and Web of Science up to April 2020. Data was extracted on study characteristics, methods, and outcomes. Relative risks (RRs) with 95% confidence intervals (CIs) were pooled for the composite of all-cause mortality, myocardial infarction (MI), revascularizations, rehospitalizations, or stroke; its individual components and other cardiovascular endpoints. RESULTS Twelve unique RCTs comprising of 15,774 patients were included. There was no significant difference in all-cause mortality risk (0.95, 95% CI: 0.86-1.06); however, revascularization plus MT reduced the risk of the composite outcome of all-cause mortality, MI, revascularizations, rehospitalizations, or stroke (0.69, 95% CI: 0.55-0.87); unplanned revascularization (0.53, 95% CI: 0.40-0.71); and fatal MI (0.65, 95% CI: 0.49-0.84). Revascularization plus MT reduced the risk of stroke at 1 year (0.44, 95% CI: 0.30-0.65) and unplanned revascularization and the composite outcome of all-cause mortality, MI, revascularizations, rehospitalizations, or stroke at 2-5 years. CONCLUSIONS Revascularization plus MT does not confer survival advantage beyond that of MT among patients with stable CAD. However, revascularization plus MT may reduce the overall risk of the combined outcome of mortality, MI, revascularizations, rehospitalizations, or stroke, which could be driven by a decrease in the risk of unplanned revascularizations or fatal MI.
keywords:"Cardiovascular Diseases" OR (Cardiovascular AND Diseases) OR "Cardiovascular Diseases" OR (cardiovascular AND disease) OR "cardiovascular disease"