Results For example, the Da Qing study proved the efficacy of lifestyle modification with respect to manifestation of diabetes, but failed to show clear benefits regarding cardiovascular mortality. Several studies raised doubt, whether the concept of optimally reducing glucose is the LY3039478 chemical structure optimal treatment for improving cardiovascular endpoints. Moreover other studies, such as Steno-2, showed an impressive effect of a multimodal therapy on hard endpoints.
Conclusions In the future, the focus on new strategies for individualized therapies will increase. Additionally,
approaches targeting novel molecular pathways are on the horizon, since plasma levels of posttranslationally modified proteins such as HbA1c are strong cardiovascular risk predictors despite normal glucose levels. For the clinician, it now becomes obvious that epidemiologically proven associations
do not necessarily BTSA1 supplier reflect causality. Studies addressing defined clinical endpoints, such as micro-and macrovascular morbidity and mortality are needed, as well as basic research, investigating other pathophysiological mechanisms, e. g., reactive metabolites and the digestive tract. The unexplained reduction in diabetes and its complications by bariatric surgery will give further insight not only into new therapeutic approaches, but also into mechanisms yet to be discovered.”
“The objective of this study was to assess the impact of bariatric surgery performed in extremely obese non-diabetic subjects on the following parameters: endothelial function, inflammatory processes (assessed by high-sensitivity C-reactive protein [hs-CRP]), carotid artery intima-media thickness (CIMT), and glucose
and lipid profiles.
Forty-seven obese individuals with body mass index > 40 kg/m(2) underwent bariatric surgery and returned for post-procedure assessment between 6 and 19 months after surgery. Ninety-three percent of patients were female. Their age ranged from 18 to 65 (mean 41) years old at baseline. Baseline was CRT0066101 in vivo defined as the maximum of 30 days before surgery. Before and after surgery, all patients were subjected to a brachial artery ultrasound examination to evaluate endothelial-dependent dilation, CIMT by ultrasound, and laboratory analyses including glucose, lipid and inflammatory profiles were performed.
Subjects lost an average of 33 % of their original weight (p < 0.001). Flow-mediated dilation showed significant improvement after surgery from 7.4 % to 18.9 % (p < 0.001) on average. There was regression of CIMT, with the median being reduced from 0.8 to 0.5 mm (p < 0.001). The median Hs-CRP reduced from 0.83 to 0.18 mg/dl (p < 0.001), while glucose and lipid profiles were also improved after surgery.