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Differential effects of insulin sensitization and insulin provision treatment strategies on concentrations of circulating adipokines in patients with diabetes and coronary artery disease in the BARI 2D trial

Published on Jan 1, 2016in European Journal of Preventive Cardiology5.64
· DOI :10.1177/2047487314544046
Robert Wolk31
Estimated H-index: 31
(Pfizer),
Marnie Bertolet16
Estimated H-index: 16
(University of Pittsburgh)
+ 8 AuthorsVirend K. Somers93
Estimated H-index: 93
Abstract
AimsTo determine the effects of insulin sensitization (IS) and insulin provision (IP) treatment strategies on adipokines associated with cardiovascular disease in patients with type 2 diabetes mellitus and coronary artery disease in the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial (BARI 2D).Methods and resultsChanges in adipokine levels were compared in patients with type 2 diabetes mellitus and coronary artery disease randomized to IS (n = 1037) versus IP (n = 1019) treatment strategies in BARI 2D. Circulating concentrations of leptin, adiponectin, monocyte chemoattractant protein-1, tumor necrosis factor-alpha, interleukin 6 and C-reactive protein were evaluated at baseline and one year. IS and IP treatment strategies exerted significant (p < 0.0001) differential effects on: leptin (IS: 0.02% decrease, p = 0.01; IP: 13% increase, p < 0.0001); adiponectin (IS: 73% increase, p < 0.0001; IP: no change, p = 0.52); interleukin 6 (IS: 14% decrease, p < 0.0001; IP: no change, p = 0.68). ...
  • References (31)
  • Citations (7)
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References31
Newest
#1Silvio E. Inzucchi (Yale University)H-Index: 75
Last. David R. Matthews (NIHR: National Institute for Health Research)H-Index: 70
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Erratum to: DiabetologiaDOI 10.1007/s00125-012-2534-0In the text box ‘Properties of currently available glucose-lowering agents that may guide treatment choice in individualpatients with type 2 diabetes mellitus ’ vildagliptin was incor-rectly assigned footnote ‘a’ (Limited use in the USA/Europe)instead of footnote ‘b’ (Not licensed in the USA).
3,033 CitationsSource
#1Silvio E. Inzucchi (Yale University)H-Index: 75
Last. David R. Matthews (NIHR: National Institute for Health Research)H-Index: 70
view all 10 authors...
Glycemic management in type 2 diabetes mellitus has become increasingly complex and, to some extent, controversial, with a widening array of pharmacological agents now available (1–5), mounting concerns about their potential adverse effects and new uncertainties regarding the benefits of intensive glycemic control on macrovascular complications (6–9). Many clinicians are therefore perplexed as to the optimal strategies for their patients. As a consequence, the American Diabetes Association (ADA)...
2,254 CitationsSource
#1Andrea GiaccariH-Index: 30
#2Carlo GiordaH-Index: 21
Last. Simona FrontoniH-Index: 29
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2,049 CitationsSource
#1Burton E. Sobel (UVM: University of Vermont)H-Index: 102
#2Regina M. Hardison (UVM: University of Vermont)H-Index: 16
Last. Robert L. Frye (UVM: University of Vermont)H-Index: 72
view all 11 authors...
Background—Effects were compared in patients in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial of 2 mechanistically different strategies for treatment of hyperglycemia, insulin-sensitizing and insulin-providing strategies, on biomarker profiles reflecting the balance between fibrinolysis and thrombosis and the intensity of inflammation implicated in diabetic vasculopathy. Methods and Results—A total of 2368 patients with type 2 diabetes mellitus and clinically ...
49 CitationsSource
#1Sandra Galic (St. Vincent's Institute of Medical Research)H-Index: 22
#2Jon S. Oakhill (St. Vincent's Institute of Medical Research)H-Index: 1
Last. Gregory R. Steinberg (St. Vincent's Institute of Medical Research)H-Index: 58
view all 3 authors...
Obesity is characterized by increased storage of fatty acids in an expanded adipose tissue mass and is closely associated with the development of insulin resistance in peripheral tissues such as skeletal muscle and the liver. In addition to being the largest source of fuel in the body, adipose tissue and resident macrophages are also the source of a number of secreted proteins. Cloning of the obese gene and the identification of its product, leptin, was one of the first discoveries of an adipocy...
986 CitationsSource
#1Bernard R. Chaitman (SLU: Saint Louis University)H-Index: 68
#2Regina M. Hardison (SLU: Saint Louis University)H-Index: 16
Last. Robert L. Frye (SLU: Saint Louis University)H-Index: 72
view all 10 authors...
Background— The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial in 2368 patients with stable ischemic heart disease assigned before randomization to percutaneous coronary intervention or coronary artery bypass grafting strata reported similar 5-year all-cause mortality rates with insulin sensitization versus insulin provision therapy and with a strategy of prompt initial coronary revascularization and intensive medical therapy or intensive medical therapy alone with...
169 CitationsSource
#1L. Frye (Mayo Clinic)H-Index: 1
#2Phyllis August (New York Hospital Queens)H-Index: 31
Last. Bernard R. Chaitman (SLU: Saint Louis University)H-Index: 68
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At 5 years, rates of survival did not differ significantly between the revascularization group (88.3%) and the medical ­ therapy group (87.8%, P = 0.97) or between the in­ sulin ­ sensitization group (88.2%) and the insulin ­ provision group (87.9%, P = 0.89). The rates of freedom from major cardiovascular events also did not differ signifi­ cantly among the groups: 77.2% in the revascularization group and 75.9% in the medical ­ treatment group (P = 0.70) and 77.7% in the insulin ­ sensitization...
1,267 CitationsSource
IN BRIEF Type 2 diabetes is a progressive disease in which b[beta symbol]-cell function continually declines and eventually fails, ultimately requiring nearly all patients to be placed on insulin therapy. An increasing body of evidence suggests that early intensive glycemic control reduces long-term vascular outcomes and potentially may prolong b[beta symbol]-cell lifespan and function. Herein, evidence in favor of early insulin therapy on disease progression and long-term outcomes will be revie...
29 CitationsSource
#1Barbara Antuna-Puente (UPMC: Pierre-and-Marie-Curie University)H-Index: 9
#2Bruno Fève (University of Paris)H-Index: 30
Last. Jean-Philippe Bastard (UPMC: Pierre-and-Marie-Curie University)H-Index: 40
view all 4 authors...
Abstract White adipose tissue was believed to be just an energy-storage organ, but it is now recognized to be an active participant in energy homoeostasis and physiological functions such as immunity and inflammation. Macrophages are components of adipose tissue and actively participate in its activities. Adipose tissue is known to express and secrete a variety of products known as ‘adipokines', including leptin, adiponectin, resistin and visfatin, as well as cytokines and chemokines such as tum...
513 CitationsSource
#1Robert Wolk (Pfizer)H-Index: 31
#2Peter B. Berger (Duke University)H-Index: 88
Last. Virend K. Somers (Mayo Clinic)H-Index: 93
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Aims Obesity is a risk factor for an acute coronary syndrome (ACS). The association between elevated body mass index (BMI) and ACS is independent of most traditional risk factors, suggesting a possible contribution of other body fat-related mediators. This study evaluated the association between adiponectin and ACS. Methods and results Four hundred and ninety-nine patients undergoing coronary angiography were divided into a subgroup without ( n = 331) and with ACS ( n = 168). In multiple regress...
93 CitationsSource
Cited By7
Newest
#1Habib Yaribeygi (Shahid Beheshti University of Medical Sciences and Health Services)H-Index: 10
#2Luis E. Simental-Mendía (Mexican Social Security Institute)H-Index: 22
Last. Amirhossein Sahebkar (MUMS: Mashhad University of Medical Sciences)H-Index: 59
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#1Marian Sue Kirkman (UNC: University of North Carolina at Chapel Hill)H-Index: 2
#2Hussain Mahmud (University of Pittsburgh)H-Index: 1
Last. Mary T. Korytkowski (University of Pittsburgh)H-Index: 32
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#1Robert Wolk (Pfizer)H-Index: 31
#2Marnie Bertolet (University of Pittsburgh)H-Index: 16
Last. Virend K. Somers (Mayo Clinic)H-Index: 93
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Abstract Objective To evaluate the cardiovascular (CV) prognostic value of adipokines in a large prospective cohort of patients participating in the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial. Patients and Methods The effects of the adipokine levels at baseline and change from baseline on the composite outcome (CV death, myocardial infarction, and stroke) were analyzed using unadjusted and fully adjusted Cox models in 2330 patients with type 2 diabetes and coronary arter...
6 CitationsSource
#1Sanam Lathief (Yale University)H-Index: 2
#2Silvio E. Inzucchi (Yale University)H-Index: 75
Epidemiologic analyses have established a clear association between diabetes and macrovascular disease. Vascular dysfunction caused by metabolic abnormalities in patients with diabetes is associated with accelerated atherosclerosis and increased risk of myocardial infarction (MI), stroke, and peripheral arterial disease. Patients with diabetes are at two to four fold higher CV risk as compared to non-diabetic individuals, and CVD remains the leading cause of mortality in patients with this condi...
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#1André Scheen (University of Liège)H-Index: 73
#2Nathalie Esser (University of Liège)H-Index: 8
Last. Nicolas Paquot (University of Liège)H-Index: 12
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A growing body of evidence is emerging to show that abdominal obesity, the metabolic syndrome, type 2 diabetes, cardiovascular disease and microvascular diabetic complications are intimately related to chronic inflammation. These observations pave the way to the development of new pharmacological strategies that aim to reduce silent inflammation. However, besides specific anti-inflammatory agents, glucose-lowering medications may also exert anti-inflammatory effects that could contribute to impr...
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