Annals of medicine
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Review
Systemic inflammatory biomarkers and co-morbidities of chronic obstructive pulmonary disease.
Chronic obstructive pulmonary disease (COPD) can no longer be considered as a disease affecting only the lungs. Increasing evidence supports the presence of a systemic inflammatory component which is thought to provide the link between COPD and the co-morbidities commonly associated with this disease. These include cardiovascular disorders, skeletal muscle dysfunction, diabetes, and osteoporosis. ⋯ This review describes systemic biomarkers in COPD and their relationship with both the local lung and systemic manifestations of the disease. A summary is provided of the most promising biomarkers that have been investigated in COPD and its co-morbidities. Such biomarkers may be used to assess and manage the systemic effects of COPD, and may guide future development of novel therapeutic interventions to provide a more holistic approach to treating this multi-faceted disease.
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The correlation between total testosterone levels, exercise capacity, and metabolic and echocardiographic parameters was studied in 1097 male subjects with coronary artery disease (CAD) and different stages of glucose tolerance. ⋯ A negative correlation between low testosterone and dysmetabolic features was observed. Independent of metabolic status, low plasma testosterone seems to be an indicator of impaired maximal exercise capacity and cardiac hypertrophy among CAD patients with type II diabetes.
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Randomized Controlled Trial Multicenter Study
Nordic walking decreased circulating chemerin and leptin concentrations in middle-aged men with impaired glucose regulation.
Dysfunction of adipose tissue is one of the major factors leading to insulin resistance. Altered adipokine concentration is an early sign of adipose tissue dysfunction. The aim of this study was to assess the impact of exercise intervention on adipokine profile, glycemic control, and risk factors of the metabolic syndrome (MeS) in men with impaired glucose regulation (IGR). ⋯ Nordic walking intervention seems to decrease chemerin and leptin levels, and subjects in this intervention group achieved the most beneficial effects on components of MeS.
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There is a paucity of detailed information about the role of childhood food patterns or on the impact of individual nutrients on adulthood cardiovascular disease (CVD). We review here the reports that have investigated these questions in the Young Finns Study with its 3596 subjects at baseline, aged 3 to 18 years. All the participants filled in a food habit questionnaire, and half of them provided a 48-hour dietary recall interview. ⋯ These patterns remain relatively stable over the life-course and associate with cardiovascular risk factors and vascular markers of subclinical atherosclerosis. For example, a traditional dietary pattern characterized by low intakes of fruits and vegetables was associated with elevated increased adulthood IMT especially in men, whereas a diet with a high intake of vegetables was independently associated with increased arterial elasticity in both genders. Our findings and the current literature suggest that childhood nutrition has a significant role in the progression of CVD.
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Review
The relationship between bipolar disorder and type 2 diabetes: more than just co-morbid disorders.
Type 2 diabetes mellitus (T2DM) rates are three times higher in patients with bipolar disorder (BD), compared to the general population. This is a major contributing factor to the elevated risk of cardiovascular mortality, the leading cause of death in bipolar patients. There may be shared pathophysiology linking the two disorders, including hypothalamic-pituitary-adrenal and mitochondrial dysfunction, common genetic links, and epigenetic interactions. ⋯ Glucose abnormalities in bipolar patients need to be screened for and treated. Metformin appears to have the best benefit/risk ratio, and the dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists and analogues also appear promising, although these agents have not been specifically studied in populations with mood disorders. Physicians need to be aware of the increased risk for T2DM and cardiovascular disease in bipolar patients, and appropriate prevention, screening, case finding, and treatment is recommended.