Certain risk factors have been shown to cluster with clinical conditions like obesity, type 2 diabetes and cardiovascular problems. Such clustering of risk factors have led investigators to propose a new condition called cardiometabolic risk syndrome. Cardiometabolic risk has gained much attention recently and has been linked directly with visceral adiposity. Few investigations have implicated a direct link between centrally obese men and low levels of testosterone. Association of Testosterone with insulin resistance, obesity, diabetes and atheroschlerosis has been presented earlier but has not received much attention. Higher incidence of metabolic syndrome has also been hypothesized to be associated with decline in testosterone levels. There is evidence that testosterone replacement therapy results in reduced insulin resistance and central obesity in type 2 diabetic men. In this study, we have investigated relationship between testosterone and markers of cardiometabolic risk.
A cohort of male patient samples from ZRT database was selected for the study and categorized in tertiles based on testosterone levels with low (<300),>800). The relationship between testosterone levels and cardiometabolic risk was evaluated using bloodspot testing of insulin, hemoglobin A1c, triglycerides and high sensitivity c-reactive protein. All bloodspot assays were developed in house and showed good correlations with serum/plasma levels of risk markers tested.
A total of 124 male patient samples (41 with testosterone levels <>800 ng/dL) were tested for cardiometabolic risk markers. Mean age (+/- SD) was 50.8 (+/- 12.8). Insulin (4.7 µIU/mL) and high sensitivity c-reactive protein (1.83 mg/L) were found to be significantly lower in the highest tertile with testosterone levels greater than 800 ng/dL when compared with insulin (6.3 µIU/mL) and hs-CRP (3.46 mg/L) concentrations in the lowest tertile with testosterone levels less than 300 ng/dL. There was no significant difference observed in HbA1c and triglyceride levels in different groups.
Our data suggest that a higher testosterone level in men is associated with lower CRP and insulin concentrations. These patients may have a lower risk of developing metabolic syndrome and/or atheroschlerotic cardiovascular events.
Showing posts with label Cardiometabolic risk. Show all posts
Showing posts with label Cardiometabolic risk. Show all posts
Thursday, April 30, 2009
Wednesday, March 4, 2009
What is CardioMetabolic Risk? Is it different from Metabolic Syndrome?
Cardiometabolic Risk is clustering of various risk factors, which put an individual at high risk of developing type 2 diabetes and cardiovascular disease. It also includes the abdominal obesity (the visceral obesity) and several other markers that have not been considered traditionally while defining overall risk of cardiovascular disease.
Cardiometabolic risk is not something different from Metabolic Syndrome; neither it has been coined to replace Metabolic Syndrome. We have known that metabolic syndrome involves insulin resistance, obesity in terms of large waist, high triglycerides, high blood pressure, low HDL cholesterol. Cardiometabolic Risk includes, in addition to all these risk factors, high LDL cholesterol, Inflammation (high C-reactive protein), smoking, physical inactivity, unhealthy eating, some psychosocial issues like stress and depression and high blood glucose, in addition to race, gender, age and family history.
All of these together and also each one of these independently increase the risk of disease and other related complications. So, cardiometabolic risk is a global risk condition involving all these markers that increase an individual’s overall risk of developing type 2 diabetes and cardiovascular disease.
Therefore, it is very important to detect, treat and control for these factors well in time, before it is too late. Lifestyle modifications like weight reduction, regular exercise/ physical activity, healthy diet, quitting smoking, all have benefits in terms of reducing the risk. We must understand that improvement in any one of these health markers results in improvement in other markers because our body does not work in isolation. Similarly, when there is any one of these risk factors present in a person, there could be other related conditions also that have not been diagnosed. So, clinicians should screen patients during their regular visits for any or all of these risk factors for cardiovascular disease and diabetes.
How will the screening help?
This will help them:
1. Understand the comprehensive picture of their patient’s overall health and alert them about any possible future health condition.
2. Facilitate better communication with their patient to make better clinical decisions, one they have identified different markers.
3. Intervene at an early stage, as we know that conditions like insulin resistance and hyperglycemia occur long before the clinical diagnosis of diabetes.
Routine screening and early assessment may help both the physician and their patient work together to address important lifestyle changes like healthy eating, qutting smoking if they smoke, include 30 minutes or more of exercise or physical activity of any kind 5 days a week, to avoid risk of developing type 2 diabetes and cardiovascular disease.
Such assessments provide great tools to clinicians and their patients for a comprehensive and broader management of different health conditions, especially for cardiovascular disease and diabetes risk.
Cardiometabolic risk is not something different from Metabolic Syndrome; neither it has been coined to replace Metabolic Syndrome. We have known that metabolic syndrome involves insulin resistance, obesity in terms of large waist, high triglycerides, high blood pressure, low HDL cholesterol. Cardiometabolic Risk includes, in addition to all these risk factors, high LDL cholesterol, Inflammation (high C-reactive protein), smoking, physical inactivity, unhealthy eating, some psychosocial issues like stress and depression and high blood glucose, in addition to race, gender, age and family history.
All of these together and also each one of these independently increase the risk of disease and other related complications. So, cardiometabolic risk is a global risk condition involving all these markers that increase an individual’s overall risk of developing type 2 diabetes and cardiovascular disease.
Therefore, it is very important to detect, treat and control for these factors well in time, before it is too late. Lifestyle modifications like weight reduction, regular exercise/ physical activity, healthy diet, quitting smoking, all have benefits in terms of reducing the risk. We must understand that improvement in any one of these health markers results in improvement in other markers because our body does not work in isolation. Similarly, when there is any one of these risk factors present in a person, there could be other related conditions also that have not been diagnosed. So, clinicians should screen patients during their regular visits for any or all of these risk factors for cardiovascular disease and diabetes.
How will the screening help?
This will help them:
1. Understand the comprehensive picture of their patient’s overall health and alert them about any possible future health condition.
2. Facilitate better communication with their patient to make better clinical decisions, one they have identified different markers.
3. Intervene at an early stage, as we know that conditions like insulin resistance and hyperglycemia occur long before the clinical diagnosis of diabetes.
Routine screening and early assessment may help both the physician and their patient work together to address important lifestyle changes like healthy eating, qutting smoking if they smoke, include 30 minutes or more of exercise or physical activity of any kind 5 days a week, to avoid risk of developing type 2 diabetes and cardiovascular disease.
Such assessments provide great tools to clinicians and their patients for a comprehensive and broader management of different health conditions, especially for cardiovascular disease and diabetes risk.
Friday, February 27, 2009
Dried Blood Spot Screening for Cardiometabolic Risk Markers shows Benefits of Exercise
The prevalence of diabetes and cardiovascular disease is increasing at an alarming rate. Several clinical and observational studies have demonstrated reduced risk of diabetes when physical activity increases. Simple screening tools are needed to monitor effects of treatment interventions in individuals at high risk.
At ZRT Laboratory in Beaverton, Oregon we assessed the application of dried blood spot technology to measure important cardiometabolic risk markers. Dried blood spot collection has advantages compared to conventional blood draws, such as minimal invasiveness, low sample volume, convenience of repeated measurements and ease of sample storage and transport.
Fifteen participants (28- 63 years of age) enrolled in a fitness study that included 30 minute exercise/ brisk walking five days a week for four months. Levels of insulin, hemoglobin A1c, C-reactive protein and triglycerides were measured in blood spot samples obtained by a simple and easy finger stick before and after the program. Dried blood spot samples were stored at -20C until used for analysis using modified methods developed in house from commercially available assays.
Insulin levels decreased significantly ; triglycerides dropped by 18% and C-reactive protein levels also showed significant improvement. The HbA1c levels remained unchanged during the program.
In conclusion, exercise/ brisk walking for 30 minutes five days a week for four months improved cardiometabolic risk factors independently as confirmed by dried bloodspot testing. This simple screening method has important implications for monitoring overall cardiometabolic health of high risk individuals.
At ZRT Laboratory in Beaverton, Oregon we assessed the application of dried blood spot technology to measure important cardiometabolic risk markers. Dried blood spot collection has advantages compared to conventional blood draws, such as minimal invasiveness, low sample volume, convenience of repeated measurements and ease of sample storage and transport.
Fifteen participants (28- 63 years of age) enrolled in a fitness study that included 30 minute exercise/ brisk walking five days a week for four months. Levels of insulin, hemoglobin A1c, C-reactive protein and triglycerides were measured in blood spot samples obtained by a simple and easy finger stick before and after the program. Dried blood spot samples were stored at -20C until used for analysis using modified methods developed in house from commercially available assays.
Insulin levels decreased significantly ; triglycerides dropped by 18% and C-reactive protein levels also showed significant improvement. The HbA1c levels remained unchanged during the program.
In conclusion, exercise/ brisk walking for 30 minutes five days a week for four months improved cardiometabolic risk factors independently as confirmed by dried bloodspot testing. This simple screening method has important implications for monitoring overall cardiometabolic health of high risk individuals.
Subscribe to:
Posts (Atom)