Search Results

You are looking at 31 - 40 of 202 items for

  • Abstract: Arteries x
  • Abstract: Atherosclerosis x
  • Abstract: Carotid x
  • Abstract: Circulation x
  • Abstract: Ghrelin x
  • Abstract: Stroke x
  • Abstract: Veins x
  • Abstract: Heart x
  • Abstract: Cardio* x
Clear All Modify Search
Shuang Wan Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
Department of Endocrinology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China

Search for other papers by Shuang Wan in
Google Scholar
PubMed
Close
,
Chengcheng Zheng Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China

Search for other papers by Chengcheng Zheng in
Google Scholar
PubMed
Close
,
Tao Chen Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China

Search for other papers by Tao Chen in
Google Scholar
PubMed
Close
,
Lu Tan Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China

Search for other papers by Lu Tan in
Google Scholar
PubMed
Close
,
Jia Tang Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China

Search for other papers by Jia Tang in
Google Scholar
PubMed
Close
,
Haoming Tian Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China

Search for other papers by Haoming Tian in
Google Scholar
PubMed
Close
, and
Yan Ren Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China

Search for other papers by Yan Ren in
Google Scholar
PubMed
Close

We applied 24-h Holter monitoring to analyze the characteristics of arrhythmias and heart rate variability in Chinese patients with primary aldosteronism (PA) and compared them with age-, sex-, and blood pressure-matched primary hypertension (PH) patients. A total of 216 PA patients and 261 PH patients were enrolled. The nonstudy data were balanced using propensity score matching (PSM), and the risk variables for developing arrhythmias were then analyzed using logistic regression analysis. Before PSM, the proportion of PA patients with combined atrial premature beats and prolonged QT interval was higher than the corresponding proportion in the PH group. After PSM, the PA group had a larger percentage of transient atrial tachycardia and frequent atrial premature beats, and it had higher heart rate variability metrics. The proportion of unilateral PA combined with multiple ventricular premature beats was higher than that of bilateral PA. Older age, grade 3 hypertension, and hypokalemia were independent risk factors for the emergence of arrhythmias in PA patients. PA patients suffer from a greater prevalence of arrhythmias than well-matched PH patients.

Open access
Leyre Lorente-Poch Endocrine Surgery Unit, Hospital del Mar, Barcelona, Spain
Departament de Cirurgia, Universitat Autònoma de Barcelona, Barcelona, Spain

Search for other papers by Leyre Lorente-Poch in
Google Scholar
PubMed
Close
,
Sílvia Rifà-Terricabras Departament de Cirurgia, Universitat Autònoma de Barcelona, Barcelona, Spain

Search for other papers by Sílvia Rifà-Terricabras in
Google Scholar
PubMed
Close
,
Juan José Sancho Endocrine Surgery Unit, Hospital del Mar, Barcelona, Spain
Departament de Cirurgia, Universitat Autònoma de Barcelona, Barcelona, Spain

Search for other papers by Juan José Sancho in
Google Scholar
PubMed
Close
,
Danilo Torselli-Valladares Endocrine Surgery Unit, Hospital del Mar, Barcelona, Spain

Search for other papers by Danilo Torselli-Valladares in
Google Scholar
PubMed
Close
,
Sofia González-Ortiz Department of Radiology, Hospital del Mar, Barcelona, Spain

Search for other papers by Sofia González-Ortiz in
Google Scholar
PubMed
Close
, and
Antonio Sitges-Serra Endocrine Surgery Unit, Hospital del Mar, Barcelona, Spain
Departament de Cirurgia, Universitat Autònoma de Barcelona, Barcelona, Spain

Search for other papers by Antonio Sitges-Serra in
Google Scholar
PubMed
Close

Objective:

Permanent hypoparathyroidism is an uncommon disease resulting most frequently from neck surgery. It has been associated with visceral calcifications but few studies have specifically this in patients with post-surgical hypoparathyroidism. The aim of the present study was to assess the prevalence of basal ganglia and carotid artery calcifications in patients with long-term post-thyroidectomy hypoparathyroidism compared with a control population.

Design:

Case–control study.

Methods:

A cross-sectional review comparing 29 consecutive patients with permanent postoperative hypoparathyroidism followed-up in a tertiary reference unit for Endocrine Surgery with a contemporary control group of 501 patients who had an emergency brain CT scan. Clinical variables and prevalence of basal ganglia and carotid artery calcifications were recorded.

Results:

From a cohort of 46 patients diagnosed with permanent hypoparathyroidism, 29 were included in the study. The mean duration of disease was 9.2 ± 7 years. Age, diabetes, hypertension, smoking and dyslipidemia were similarly distributed in case and control groups. The prevalence of carotid artery and basal ganglia calcifications was 4 and 20 times more frequent in patients with permanent hypoparathyroidism, respectively. After propensity score matching of the 28 the female patients, 68 controls were matched for age and presence of cardiovascular factors. Cases showed a four-fold prevalence of basal ganglia calcifications, whereas that of carotid calcifications was similar between cases and controls.

Conclusion:

A high prevalence of basal ganglia calcifications was observed in patients with post-surgical permanent hypoparathyroidism. It remains unclear whether carotid artery calcification may also be increased.

Open access
Mette Faurholdt Gude Medical/Steno Aarhus Research Laboratory, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark

Search for other papers by Mette Faurholdt Gude in
Google Scholar
PubMed
Close
,
Rikke Hjortebjerg Department of Molecular Endocrinology, University of Southern Denmark, Odense, Denmark
Steno Diabetes Centre Odense, Odense University Hospital, Odense, Denmark

Search for other papers by Rikke Hjortebjerg in
Google Scholar
PubMed
Close
,
Mette Bjerre Medical/Steno Aarhus Research Laboratory, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark

Search for other papers by Mette Bjerre in
Google Scholar
PubMed
Close
,
Morten Haaning Charles Department of Public Health, Aarhus University, Aarhus, Denmark
Steno Diabetes Centre Aarhus, Aarhus University Hospital, Aarhus, Denmark

Search for other papers by Morten Haaning Charles in
Google Scholar
PubMed
Close
,
Daniel R Witte Department of Public Health, Aarhus University, Aarhus, Denmark
Steno Diabetes Centre Aarhus, Aarhus University Hospital, Aarhus, Denmark

Search for other papers by Daniel R Witte in
Google Scholar
PubMed
Close
,
Annelli Sandbæk Department of Public Health, Aarhus University, Aarhus, Denmark
Steno Diabetes Centre Aarhus, Aarhus University Hospital, Aarhus, Denmark

Search for other papers by Annelli Sandbæk in
Google Scholar
PubMed
Close
, and
Jan Frystyk Endocrine Research Unit, Department of Endocrinology, Odense University Hospital & Department of Clinical Research, Faculty of Health, University of Southern Denmark, Odense, Denmark

Search for other papers by Jan Frystyk in
Google Scholar
PubMed
Close

Objective

Physiologically, pregnancy-associated plasma protein-A (PAPP-A) serves to liberate bound IGF1 by enzymatic cleavage of IGF-binding proteins (IGFBPs), IGFBP4 in particular. Clinically, PAPP-A has been linked to cardiovascular disease (CVD). Stanniocalcin-2 (STC2) is a natural inhibitor of PAPP-A enzymatic activity, but its association with CVD is unsettled. Therefore, we examined associations between the STC2–PAPP-A–IGFBP4–IGF1 axis and all-cause mortality and CVD in patients with type 2 diabetes (T2D).

Design

We followed 1284 participants with T2D from the ADDITION trial for 5 years.

Methods

Circulating concentrations of STC2, PAPP-A, total and intact IGFBP4 and IGF1 and -2 were measured at inclusion. End-points were all-cause mortality and a composite CVD event: death from CVD, myocardial infarction, stroke, revascularisation or amputation. Survival analysis was performed by Cox proportional hazards model.

Results

During follow-up, 179 subjects presented with an event. After multivariable adjustment, higher levels of STC2, PAPP-A, as well as intact and total IGFBP4, were associated with all-cause mortality; STC2: hazard ratio (HR) = 1.84 (1.09–3.12) (95% CI); P = 0.023, PAPP-A: HR = 2.81 (1.98–3.98); P < 0.001, intact IGFBP4: HR = 1.43 (1.11–1.85); P = 0.006 and total IGFBP4: HR = 3.06 (1.91–4.91); P < 0.001. Higher PAPP-A levels were also associated with CVD events: HR = 1.74 (1.16–2.62); P = 0.008, whereas lower IGF1 levels were associated with all-cause mortality: HR = 0.51 (0.34–0.76); P = 0.001.

Conclusions

This study supports that PAPP-A promotes CVD and increases mortality. However, STC2 is also associated with mortality. Given that STC2 inhibits the enzymatic effects of PAPP-A, we speculate that STC2 either serves to counteract harmful PAPP-A actions or possesses effects independently of the PAPP-A–IGF1 axis.

Significance statement

PAPP-A has pro-atherosclerotic effects and exerts these most likely through IGF1. IGF1 is regulated by the STC2–PAPP-A–IGFBP4–IGF1 axis, where STC2, an irreversible inhibitor of PAPP-A, has been shown to reduce the development of atherosclerotic lesions in mice. We examined the association of this axis to mortality and CVD in T2D. We demonstrated an association between PAPP-A and CVD. All components of the STC2–PAPP-A–IGFBP4–IGF1 axis were associated with mortality and it is novel that STC2 was associated with mortality in T2D. Our study supports that inhibition of PAPP-A may be a new approach to reducing mortality and CVD. Whether modification of STC2 could serve as potential intervention warrants further investigation.

Open access
Shenghe Luo College of Pharmacy, Yanbian University, Yanji, China

Search for other papers by Shenghe Luo in
Google Scholar
PubMed
Close
,
Yunhui Zuo Department of Physiology and Pathophysiology, College of Medicine, Yanbian University, Yanji, China
Department of Cardiology, Yanbian University Hospital, Yanji, China

Search for other papers by Yunhui Zuo in
Google Scholar
PubMed
Close
,
Xiaotian Cui Department of Physiology and Pathophysiology, College of Medicine, Yanbian University, Yanji, China

Search for other papers by Xiaotian Cui in
Google Scholar
PubMed
Close
,
Meiping Zhang Department of Cardiology, Yanbian University Hospital, Yanji, China

Search for other papers by Meiping Zhang in
Google Scholar
PubMed
Close
,
Honghua Jin Department of Pharmacy, Yanbian University Hospital, Yanji, China

Search for other papers by Honghua Jin in
Google Scholar
PubMed
Close
, and
Lan Hong Department of Physiology and Pathophysiology, College of Medicine, Yanbian University, Yanji, China

Search for other papers by Lan Hong in
Google Scholar
PubMed
Close

To observe the effects of liraglutide (analog of glucagon-like peptide 1 (GLP-1)) on atrial natriuretic peptide (ANP) secretion and atrial dynamics, an ex vivo isolated rat atrial perfusion model was used to determine atrial ANP secretion and pulse pressure. DPP-4−/− mice were also established in vivo. ANP levels were determined by radioimmunoassay; GLP-1 content was determined by Elisa. The expression levels of GLP-1 receptor (GLP-1R), PI3K/AKT/mTOR, piezo 1, and cathepsin K were analyzed by Western blot. In the clinical study, patients with acute coronary syndrome (ACS) had low levels of plasma GLP-1 but relatively high levels of plasma ANP. In ex vivo (3.2 nmol/L) and in vivo (30 μg/kg) models, liraglutide significantly decreased ANP levels and atrial pulse pressure. Exendin9–39 alone (GLP-1R antagonist) reversibly significantly increased ANP secretion, and the reduction effect of liraglutide on the secretion of ANP was significantly alleviated by Exendin9–39. Exendin9–39 demonstrated slightly decreased atrial pulse pressure; however, combined liraglutide and Exendin9–39 significantly decreased atrial pulse pressure. Ly294002 (PI3K/AKT inhibitor) inhibited the increase of ANP secretion by liraglutide for a short time, while Ly294002 didn't counteract the decrease in pulse pressure by liraglutide in atrial dynamics studies. Liraglutide increased the expression of GLP-1R and PI3K/AKT/mTOR in isolated rat atria and the hearts of mice in vivo, whereas Exendin9–39 reversibly reduced the expression of GLP-1R and PI3K/AKT/mTOR. Piezo 1 was significantly decreased in wild type and DPP-4−/− mouse heart or isolated rat atria after being treated with liraglutide. Cathepsin K expression was only decreased in in vivo model hearts. Liraglutide can inhibit ANP secretion while decreasing atrial pulse pressure mediated by GLP-1R. Liraglutide probably plays a role in the reduction of ANP secretion via the PI3K/AKT/mTOR signaling pathway. Piezo 1 and cathepsin K may be involved in the liraglutide mechanism of reduction.

Open access
Willem de Ronde Department of Internal Medicine, Spaarne Gasthuis, Haarlem, the Netherlands

Search for other papers by Willem de Ronde in
Google Scholar
PubMed
Close
and
Diederik L Smit Department of Internal Medicine, Spaarne Gasthuis, Haarlem, the Netherlands

Search for other papers by Diederik L Smit in
Google Scholar
PubMed
Close

This review summarizes 10 years experience with male abusers of anabolic androgenic steroids (AAS). The typical user of AAS is male, aged between 20 and 40 and lifting weights. Illegal AAS are cheap and easily obtained via internet or local suppliers. AAS are mostly used in cycles with a duration between 6 and 18 weeks. Most AAS cycles contain multiple agents, used simultaneously in a dose vastly exceeding a substitution dose. A variety of other performance and image-enhancing drugs are commonly used, including human growth hormone, thyroid hormone, tamoxifen, clomiphene citrate and human chorionic gonadotrophin. Short-term clinical and biochemical side effects are well established. Long-term side effects are uncertain, but may include heart failure, mood-and anxiety disorders, hypogonadism and subfertility. We share our views on the management of common health problems associated with AAS abuse.

Open access
Yueyuan Yang Department of Endocrinology, Renmin Hospital of Wuhan University, Wuhan, China

Search for other papers by Yueyuan Yang in
Google Scholar
PubMed
Close
,
Tingting Yu Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, China

Search for other papers by Tingting Yu in
Google Scholar
PubMed
Close
,
Zhili Niu Department of Clinical Laboratory, Institute of translational medicine, Renmin Hospital of Wuhan University, Wuhan, China

Search for other papers by Zhili Niu in
Google Scholar
PubMed
Close
, and
Ling Gao Department of Endocrinology, Renmin Hospital of Wuhan University, Wuhan, China

Search for other papers by Ling Gao in
Google Scholar
PubMed
Close

Objective

Uridine might be a common link between pathological pathways in diabetes and cardiovascular diseases. This study aimed to investigate the predictive value of plasma uridine for type 2 diabetes (T2D) and T2D with atherosclerosis.

Methods

Individuals with T2D and healthy controls (n = 218) were randomly enrolled in a cross-sectional study. Patients with T2D were divided into two groups based on carotid ultrasound: patients with carotid atherosclerosis (CA) (group DCA) and patients without CA (group D). Plasma uridine was determined using HPLC-MS/MS. Correlation and logistic regression analyses were used to analyze the results.

Results

Fasting and postprandial uridine were significantly increased in patients with T2D compared with healthy individuals. Logistic regression suggested that fasting and postprandial uridine were independent risk factors for T2D. The receiver operating characteristic (ROC) curve showed that fasting uridine had a predictive value on T2D (95% CI, 0.686–0.863, sensitivity 74.3%, specificity 71.8%). Fasting uridine was positively correlated with LDL-c, FBG, and PBG and negatively correlated with fasting C-peptide (CP-0h) and HOMA-IS. The change in postprandial uridine from fasting baseline (Δuridine) was smaller in T2D patients with CA compared with those without (0.80 (0.04–2.46) vs 2.01 (0.49–3.15), P = 0.010). Δuridine was also associated with T2D with CA and negatively correlated with BMI, CP-0h, and HOMA-IR.

Conclusion

Fasting uridine has potential as a predictor of diabetes. Δuridine is closely associated with carotid atherosclerosis in patients with T2D.

Open access
Karoline Winckler Department of Cardiology, Department of Research, Institute of Clinical Studies, Clinical Research Unit, Department of Paediatrics, Department of Medicine, Department of Physiology and Nuclear Medicine, Institute of Clinical Medicine, Nephrology and Endocrinology

Search for other papers by Karoline Winckler in
Google Scholar
PubMed
Close
,
Lise Tarnow Department of Cardiology, Department of Research, Institute of Clinical Studies, Clinical Research Unit, Department of Paediatrics, Department of Medicine, Department of Physiology and Nuclear Medicine, Institute of Clinical Medicine, Nephrology and Endocrinology
Department of Cardiology, Department of Research, Institute of Clinical Studies, Clinical Research Unit, Department of Paediatrics, Department of Medicine, Department of Physiology and Nuclear Medicine, Institute of Clinical Medicine, Nephrology and Endocrinology
Department of Cardiology, Department of Research, Institute of Clinical Studies, Clinical Research Unit, Department of Paediatrics, Department of Medicine, Department of Physiology and Nuclear Medicine, Institute of Clinical Medicine, Nephrology and Endocrinology

Search for other papers by Lise Tarnow in
Google Scholar
PubMed
Close
,
Louise Lundby-Christensen Department of Cardiology, Department of Research, Institute of Clinical Studies, Clinical Research Unit, Department of Paediatrics, Department of Medicine, Department of Physiology and Nuclear Medicine, Institute of Clinical Medicine, Nephrology and Endocrinology
Department of Cardiology, Department of Research, Institute of Clinical Studies, Clinical Research Unit, Department of Paediatrics, Department of Medicine, Department of Physiology and Nuclear Medicine, Institute of Clinical Medicine, Nephrology and Endocrinology

Search for other papers by Louise Lundby-Christensen in
Google Scholar
PubMed
Close
,
Thomas P Almdal Department of Cardiology, Department of Research, Institute of Clinical Studies, Clinical Research Unit, Department of Paediatrics, Department of Medicine, Department of Physiology and Nuclear Medicine, Institute of Clinical Medicine, Nephrology and Endocrinology
Department of Cardiology, Department of Research, Institute of Clinical Studies, Clinical Research Unit, Department of Paediatrics, Department of Medicine, Department of Physiology and Nuclear Medicine, Institute of Clinical Medicine, Nephrology and Endocrinology

Search for other papers by Thomas P Almdal in
Google Scholar
PubMed
Close
,
Niels Wiinberg Department of Cardiology, Department of Research, Institute of Clinical Studies, Clinical Research Unit, Department of Paediatrics, Department of Medicine, Department of Physiology and Nuclear Medicine, Institute of Clinical Medicine, Nephrology and Endocrinology

Search for other papers by Niels Wiinberg in
Google Scholar
PubMed
Close
,
Pia Eiken Department of Cardiology, Department of Research, Institute of Clinical Studies, Clinical Research Unit, Department of Paediatrics, Department of Medicine, Department of Physiology and Nuclear Medicine, Institute of Clinical Medicine, Nephrology and Endocrinology
Department of Cardiology, Department of Research, Institute of Clinical Studies, Clinical Research Unit, Department of Paediatrics, Department of Medicine, Department of Physiology and Nuclear Medicine, Institute of Clinical Medicine, Nephrology and Endocrinology

Search for other papers by Pia Eiken in
Google Scholar
PubMed
Close
,
Trine W Boesgaard Department of Cardiology, Department of Research, Institute of Clinical Studies, Clinical Research Unit, Department of Paediatrics, Department of Medicine, Department of Physiology and Nuclear Medicine, Institute of Clinical Medicine, Nephrology and Endocrinology

Search for other papers by Trine W Boesgaard in
Google Scholar
PubMed
Close
, and
the CIMT trial group
Search for other papers by the CIMT trial group in
Google Scholar
PubMed
Close

Despite aggressive treatment of cardiovascular disease (CVD) risk factors individuals with type 2 diabetes (T2D) still have increased risk of cardiovascular morbidity and mortality. The primary aim of this study was to examine the cross-sectional association between total (25-hydroxy vitamin D (25(OH)D)) and risk of CVD in patients with T2D. Secondary objective was to examine the association between 25(OH)D and bone health. A Danish cohort of patients with T2D participating in a randomised clinical trial were analysed. In total 415 patients (68% men, age 60±9 years (mean±s.d.), duration of diabetes 12±6 years), including 294 patients (71%) treated with insulin. Carotid intima–media thickness (IMT) and arterial stiffness (carotid artery distensibility coefficient (DC) and Young's elastic modulus (YEM)) were measured by ultrasound scan as indicators of CVD. Bone health was assessed by bone mineral density and trabecular bone score measured by dual energy X-ray absorptiometry. In this cohort, 214 patients (52%) were vitamin D deficient (25(OH)D <50 nmol/l). Carotid IMT was 0.793±0.137 mm, DC was 0.0030±0.001 mmHg, YEM was 2354±1038 mmHg and 13 (3%) of the patients were diagnosed with osteoporosis. A 25(OH)D level was not associated with carotid IMT or arterial stiffness (P>0.3) or bone health (P>0.6) after adjustment for CVD risk factors. In conclusion, 25(OH)D status was not associated with carotid IMT, arterial stiffness or bone health in this cohort of patients with T2D. To explore these associations and the association with other biomarkers further, multicentre studies with large numbers of patients are required.

Open access
Dandan Hu D Hu, Department of Endocrinology, Suzhou Municipal Hospital, Suzhou, China

Search for other papers by Dandan Hu in
Google Scholar
PubMed
Close
,
Xiangguo Cong X Cong, Department of Endocrinology, The Affiliated Suzhou Hospital of Nanjing Medical University, suzhou, China

Search for other papers by Xiangguo Cong in
Google Scholar
PubMed
Close
,
Beibei Gao B Gao, Department of Endocrinology, Suzhou Municipal Hospital, Suzhou, China

Search for other papers by Beibei Gao in
Google Scholar
PubMed
Close
,
Ying Wu Y Wu, Department of Endocrinology, Suzhou Municipal Hospital, Suzhou, China

Search for other papers by Ying Wu in
Google Scholar
PubMed
Close
,
Qiong Shen Q Shen, Department of Endocrinology, Suzhou Municipal Hospital, Suzhou, China

Search for other papers by Qiong Shen in
Google Scholar
PubMed
Close
, and
Lei Chen L Chen, The Affiliated Suzhou Hospital of Nanjing Medical University, 苏州, 2100000, China

Search for other papers by Lei Chen in
Google Scholar
PubMed
Close

Background:

Evidence has demonstrated that visceral fat area (VFA) and subcutaneous fat area (SFA) had different influences on cardiovascular disease (CVD) risk in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the relationship between the visceral fat area (VFA) to subcutaneous fat area (SFA) ratio (V/S) and carotid atherosclerosis (CAS) in patients with T2DM.

Methods:

From January 2018 to May 2023, 1,838 patients with T2DM admitted to the National Metabolic Management Centre in our hospital were assigned to two groups based on comorbid CAS. Dual bioelectrical impedance analysis was used to measure the VAF and SFA, and the V/S was calculated. Patient characteristics and serum biochemical indices were compared between groups. Factors influencing comorbid CAS were determined, and correlations between V/S and other clinical indices were analyzed.

Results:

The group with comorbid CAS included 858 individuals and 980 without comorbid CAS. Those with comorbid CAS were older and had a longer disease duration, more significant systolic blood pressure, and greater V/S. The proportions of patients with comorbid hypertension increased significantly with the V/S ratio. The V/S ratio positively correlated with triglyceride (TG), low-density lipoprotein cholesterol levels, and waist circumference. According to binary logistic regression analysis, V/S was an independent risk factor for CAS.

Conclusion:

Elevated V/S is an independent risk factor for CAS in patients with T2DM.

Open access
Sahar Hossam El Hini Diabetes and Endocrinology Unit, Department of Internal Medicine, Faculty of Medicine, Minia University, Minia, Egypt

Search for other papers by Sahar Hossam El Hini in
Google Scholar
PubMed
Close
,
Yehia Zakaria Mahmoud Department of Internal Medicine, Faculty of Medicine, Minia University, Minia, Egypt

Search for other papers by Yehia Zakaria Mahmoud in
Google Scholar
PubMed
Close
,
Ahmed Abdelfadel Saedii Department of Clinical Pathology, Faculty of Medicine, Minia University, Minia, Egypt

Search for other papers by Ahmed Abdelfadel Saedii in
Google Scholar
PubMed
Close
,
Sayed Shehata Mahmoud Department of Cardiology, Faculty of Medicine, Minia University, Minia, Egypt

Search for other papers by Sayed Shehata Mahmoud in
Google Scholar
PubMed
Close
,
Mohamed Ahmed Amin Department of Radiology, Faculty of Medicine, Minia University, Minia, Egypt

Search for other papers by Mohamed Ahmed Amin in
Google Scholar
PubMed
Close
,
Shereen Riad Mahmoud Diabetes and Endocrinology Unit, Department of Internal Medicine, Faculty of Medicine, Minia University, Minia, Egypt

Search for other papers by Shereen Riad Mahmoud in
Google Scholar
PubMed
Close
, and
Ragaa Abdelshaheed Matta Diabetes and Endocrinology Unit, Department of Internal Medicine, Faculty of Medicine, Minia University, Minia, Egypt

Search for other papers by Ragaa Abdelshaheed Matta in
Google Scholar
PubMed
Close

Objective

Angiopoietin-like proteins (ANGPTL) 3, 4 and 8 are upcoming cardiovascular biomarkers. Experimental studies showed that thyroid hormones altered their levels. We assessed ANGPTL3, 4 and 8 as predictors of cardiovascular functions among naïve subclinical and naïve overt hypothyroidism (SCH and OH) and altered ANGPTL levels with levothyroxine replacement (LT4) and their association with improved cardiovascular risk factors and cardiovascular function.

Design and methods

The study was a prospective follow-up study that assessed ANGPTL3, 4 and 8 levels, vascular status (flow-mediated dilation% of brachial artery (FMD%), carotid intima-media thickness (CIMT), aortic stiffness index (ASI)), left ventricle (LV) parameters (ejection fraction (EF), myocardial performance index (MPI), and LV mass), well-known cardiovascular risk factors and homeostatic model for the assessment of insulin resistance, at two time points, that is, among naïve SCH, naïve OH, and healthy subjects groups; and at 6 months after achieving the euthyroid state with LT4 by calculating their increased or decreased delta changes (∆↑ or ∆↓) in longitudinal arm among LT4-hypothyroid groups.

Results

Significantly elevated levels of ANGPTL3, 4 and 8 among hypothyroid groups than the healthy subjects were reduced with LT4. Multivariate analysis revealed ANGPTLs as independent predictors of cardiovascular functions and the contributors for ANGPTL level included ANGPTL3 and 4 for impaired FMD%, and ANGPTL8 for LV mass among naïve SCH; ANGPTL3 for EF% and ANGPTL8 for CIMT in naïve OH; ∆↓ANGPTL3 for ∆↓ASI meanwhile ∆↑freeT4 for ∆↓ANGPTL3, ∆↓fasting glucose, ∆↓triglyceride, and ∆↓thyroid peroxidase antibody for ∆↓ANGPTL4 among LT4-SCH. ∆↓ANGPTL4 for ∆↓MPI and ∆↓LV mass, meanwhile ∆↓TSH and ∆↓triglyceride for ∆↓ANGPTL3, ∆↑free T3 and ∆↓HOMA-IR for ∆↓ANGPTL4, and systolic blood pressure and waist circumference for ∆↓ANGPTL8 among LT4-OH.

Conclusion

Elevated ANGPTL3, 4 and 8 levels are differentially independent predictors of endothelial and cardiac function and are reduced with LT4 in SCH and OH.

Open access
Myrtille Fouché Department of Anaesthesiology and Critical Care Medicine, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France

Search for other papers by Myrtille Fouché in
Google Scholar
PubMed
Close
,
Yves Bouffard Department of Anaesthesiology and Critical Care Medicine, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France

Search for other papers by Yves Bouffard in
Google Scholar
PubMed
Close
,
Mary-Charlotte Le Goff Department of Anaesthesiology and Critical Care Medicine, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France

Search for other papers by Mary-Charlotte Le Goff in
Google Scholar
PubMed
Close
,
Johanne Prothet Department of Anaesthesiology and Critical Care Medicine, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France

Search for other papers by Johanne Prothet in
Google Scholar
PubMed
Close
,
François Malavieille Department of Anaesthesiology and Critical Care Medicine, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France

Search for other papers by François Malavieille in
Google Scholar
PubMed
Close
,
Pierre Sagnard Department of Anaesthesiology and Critical Care Medicine, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France

Search for other papers by Pierre Sagnard in
Google Scholar
PubMed
Close
,
Françoise Christin Department of Anaesthesiology and Critical Care Medicine, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France

Search for other papers by Françoise Christin in
Google Scholar
PubMed
Close
,
Davy Hayi-Slayman Department of Anaesthesiology and Critical Care Medicine, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France

Search for other papers by Davy Hayi-Slayman in
Google Scholar
PubMed
Close
,
Arnaud Pasquer Department of Visceral Surgery, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France

Search for other papers by Arnaud Pasquer in
Google Scholar
PubMed
Close
,
Gilles Poncet Department of Visceral Surgery, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France

Search for other papers by Gilles Poncet in
Google Scholar
PubMed
Close
,
Thomas Walter Department of Hepatogastroenterology and Oncology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France

Search for other papers by Thomas Walter in
Google Scholar
PubMed
Close
, and
Thomas Rimmelé Department of Anaesthesiology and Critical Care Medicine, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
EA 7426 Hospices Civils de Lyon-University Claude Bernard Lyon 1-Biomérieux ‘Pathophysiology of Injury-Induced Immunosuppression’ Pi3, Lyon, France

Search for other papers by Thomas Rimmelé in
Google Scholar
PubMed
Close

Only few descriptions of intraoperative carcinoid syndrome (ioCS) have been reported. The primary objective of this study was to describe ioCS. A second aim was to identify risk factors of ioCS. We retrospectively analysed patients operated for small-bowel neuroendocrine tumour in our institution between 2007 and 2015, and receiving our preventive local regimen of octreotide continuous administration. ioCS was defined as highly probable in case of rapid (<5 min) arterial blood pressure changes ≥40%, not explained by surgical/anaesthetic management and regressive ≥20% after octreotide bolus injection. Probable cases were ioCS which did not meet all criteria of highly-probable ioCS. Suspected ioCS were detected on the anaesthesia record by an injection of octreotide due to a manifestation which did not meet the criteria for highly-probable or probable ioCS. A total of 81 patients (liver metastases: 59, prior carcinoid syndrome: 49, carcinoid heart disease: 7) were included; 139 ioCS occurred in 45 patients: 45 highly probable, 67 probable and 27 suspected. ioCs was hypertensive (91%) and/or hypotensive (29%). There was no factor, including the use of vasopressors, significantly associated with the occurrence of an ioCS. All surgeries were completed and one patient died from cardiac failure 4 days after surgery. After preoperative octreotide continuous infusion, ioCS were mainly hypertensive. No ioCS risk factors, including vasopressor use, were identified. No intraoperative carcinoid crisis occurred, suggesting the clinical relevance of a standardized octreotide prophylaxis protocol.

Open access