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      Body Composition Indices and Cardiovascular Risk in Type 2 Diabetes. CV Biomarkers are not Related to Body Composition

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          Abstract

          Background

          This study aims to explore the correlations of body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR) and body composition with levels of asymmetric dimethylarginine (ADMA), endothelin 1(ET-1), N-terminal brain natriuretic pro-peptide (NT-proBNP) and calculated cardiovascular risks.

          Methods

          102 women and 67 men with type 2 diabetes participated. Serum levels of NT-proBNP were measured by electro-hemi-luminescence while ELISA were used for ADMA and ET-1. Cardiovascular risks were calculated using the Framingham Risk Score (FRS), the UKPDS 2.0 and the ADVANCE risk engines. Statistical analysis was performed on an IBM SPSS 19.0.

          Results

          The BMI outperformed all other indices of obesity (WC, WHtR, WHR), as well as body composition parameters (body fat%, fat mass, fat free mass and total body water) in relation to the estimated risks for coronary heart disease and stroke, based on different calculators. The correlations of the obesity indices with the serum cardiovascular biomarkers were not significant except for BMI and fat mass versus ET-1, and for fat free mass and total body water versus ADMA.

          Conclusions

          The WC, WHR, WHtR, BF%, FM and FFM apparently do not add significant information related to the levels of cardiovascular biomarkers or the calculated CV-risks.

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          Most cited references34

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          European Practical and Patient-Centred Guidelines for Adult Obesity Management in Primary Care

          Dominique Durrer Schutz, Luca Busetto, Dror Dicker … (2019)
          The first contact for patients with obesity for any medical treatment or other issues is generally with General Practitioners (GPs). Therefore, given the complexity of the disease, continuing GPs’ education on obesity management is essential. This article aims to provide obesity management guidelines specifically tailored to GPs, favouring a practical patient-centred approach. The focus is on GP communication and motivational interviewing as well as on therapeutic patient education. The new guidelines highlight the importance of avoiding stigmatization, something frequently seen in different health care settings. In addition, managing the psychological aspects of the disease, such as improving self-esteem, body image and quality of life must not be neglected. Finally, the report considers that achieving maximum weight loss in the shortest possible time is not the key to successful treatment. It suggests that 5–10% weight loss is sufficient to obtain substantial health benefits from decreasing comorbidities. Reducing waist circumference should be considered even more important than weight loss per se , as it is linked to a decrease in visceral fat and associated cardiometabolic risks. Finally, preventing weight regain is the cornerstone of lifelong treatment, for any weight loss techniques used (behavioural or pharmaceutical treatments or bariatric surgery).
          Article 0 comments Cited 109 times – based on 0 reviews     Review now
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            Current body composition measurement techniques.

            Thaisa Lemos, Dympna Gallagher (2017)
            The current article reviews the most innovative and precise, available methods for quantification of in-vivo human body composition.
            Article 0 comments Cited 79 times – based on 0 reviews     Review now
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              Overweight and obese humans demonstrate increased vascular endothelial NAD(P)H oxidase-p47(phox) expression and evidence of endothelial oxidative stress.

              Demetra Christou, K Moreau, Iratxe Eskurza … (2007)
              Obesity may alter vascular endothelial cell protein expression (VECPE) of molecules that influence susceptibility to atherosclerosis. Quantitative immunofluorescence was performed on vascular endothelial cells collected from 108 men and women free of clinical disease who varied widely in adiposity (body mass index 18.4 to 36.7 kg/m2; total body fat 5.8 to 55.0 kg; waist circumference: 63.0 to 122.9 cm). All 3 expressions of adiposity were positively associated with VECPE of the oxidant enzyme subunit NAD(P)H oxidase-p47(phox) (part correlation coefficient [r(part)] 0.22 to 0.24, all P or = 25 kg/m2) had 35% to 130% higher VECPE of NAD(P)H oxidase-p47(phox), nitrotyrosine, catalase, and the cytosolic antioxidant CuZn superoxide dismutase (all P < 0.05), as well as a 56% greater VECPE of the potent local vasoconstrictor endothelin-1 (P = 0.05) than normal-weight subjects (body mass index < 25 kg/m2). Nuclear factor-kappaB protein expression was approximately 60% to 100% greater in the most obese adults than in the leanest adults (P < or = 0.01). These relations were independent of sex but were selectively reduced after accounting for the influence of plasma C-reactive protein, fasting glucose-insulin metabolism, or serum triglycerides. Compared with their normal-weight peers, overweight and obese adults demonstrate increased vascular endothelial expression of NAD(P)H oxidase-p47(phox) and evidence of endothelial oxidative stress, with selective compensatory upregulation of antioxidant enzymes and Ser1177-phosphorylated endothelial nitric oxide synthase. Endothelin-1 and nuclear factor-kappaB protein expression also appear to be elevated in obese compared with lean adults. These findings may provide novel insight into the molecular mechanisms linking obesity to increased risk of clinical atherosclerotic diseases in humans.
              Article 0 comments Cited 48 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Open Med (Wars)
                Journal ID (iso-abbrev): Open Med (Wars)
                Journal ID (publisher-id): med
                Journal ID (pmc): med
                Title: Open Medicine
                Publisher: De Gruyter
                ISSN (Electronic): 2391-5463
                Publication date (Electronic): 17 April 2020
                Publication date Collection: 2020
                Volume: 15
                Pages: 309-316
                Affiliations
                [1 ]Clinic of Endocrinology and Metabolism, University Hospital Alexandrovska , 1 Sv. Georgi Sofiyski str., Sofia 1431, Sofia Bulgaria
                [2 ]Department Internal Medicine, Medical University Sofia , Sofia, Bulgaria
                [3 ]Central Clinical Laboratory, University Hospital Alexandrovska , Sofia, Bulgaria
                [4 ]Department Clinical Laboratory and Clinical Immunology, Medical University Sofia , Sofia, Bulgaria
                Author notes
                Article
                Publisher ID: med-2020-0043
                DOI: 10.1515/med-2020-0043
                PMC ID: 7175638
                PubMed ID: 32337369
                SO-VID: cdd48566-3d04-454c-a827-f2e1dc229063
                Copyright © © 2020 Aleksandra Markova et al., published by De Gruyter
                License:

                This work is licensed under the Creative Commons Attribution 4.0 Public License.

                History
                Date received : 19 November 2019
                Date accepted : 01 February 2020
                Page count
                Pages: 8
                Categories
                Subject: Research Article

                Keywords: anthropometric indices,nt-probnp,asymmetric dimethylarginine,endothelin-1,body composition analysis
                Data availability:
                Keywords: anthropometric indices, nt-probnp, asymmetric dimethylarginine, endothelin-1, body composition analysis

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