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Diagnosis and Management for Obesity, Diabetes and Cardiovascular Complications

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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (18 December 2022) | Viewed by 14997

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Special Issue Editor

Prof. Galina Chumakova

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1. Federal State Budgetary Institution "Research Institute for Complex Issues of Cardiovascular Diseases ", Kemerovo, Russia
2. Federal State Budgetary Educational Institution of Higher Education "Altai State Medical University" of the Ministry of Health of the Russian Federation, Barnaul, Russia
Interests: obesity; diabetes; visceral fat; epicardial fat; adipokines; lipotoxicity; lipotoxic cardiopathy

Special Issue Information

The World Health Organization has set the goal of reducing by 10% to 30% the prevalence of the main cardiovascular disease risk factors (hypodynamia, smoking, salt consumption, arterial hypertension) by 2025 аnd stop the steady increase in the prevalence of obesity and diabetes. Even with a deal on the prevalence of obesity and often accompanied with it type-2 diabetes, seemingly just a modest goal has been set: at least to stop the growth of their prevalence. These risk factors are the most uncontrollable in the world, and this is dangerous primarily because cardiovascular diseases are the main causes of death of patients with obesity and diabetes. It is not surprising that in recent years there has been an explosion of interest in studying the subtle pathogenesis mechanisms of cardiovascular complications (hypertension, atherosclerosis, cardiopathy) among patients with obesity and diabetes, as well as methods for the treatment of these diseases that can prevent cardiovascular risks.

Therefore, the recent research has led to an understanding of not only common but also visceral obesity with the dysregulation of adipokines, cytokines, proteins that control lipid metabolism, and many other factors that lead to the development of insulin resistance, leptin resistance, systemic inflammation, lipotoxicity, and other mechanisms of both cardiovascular and metabolic risks with the development of prediabetes, and then diabetes mellitus. The subtle mechanisms of the relationship between these factors and their control capabilities require close attention and detailed study.

We are inviting authors to submit their reviews of the literature and the results of their own research on Diagnosis and Management for Obesity, Diabetes and Cardiovascular Complications that will allow us to gain new knowledge on these topical issues.

Prof. Galina Chumakova
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Keywords

obesity
diabetes
adipokines
insulin resistance
systemic inflammation
lipotoxicity
hypertension
atherosclerosis
cardiopathy

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Published Papers (6 papers)

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Research

11 pages, 1762 KiB

Open AccessArticle

Diagnostic Performance of the Acute Kidney Injury Baseline Creatinine Equations in Children and Adolescents with Type 1 Diabetes Mellitus Onset

by Pier Luigi Palma, Stefano Guarino, Anna Di Sessa, Giulio Rivetti, Annalisa Barlabà, Federica Scaglione, Daniela Capalbo, Alfonso Papparella, Emanuele Miraglia del Giudice and Pierluigi Marzuillo

Diagnostics 2022, 12(10), 2268; https://doi.org/10.3390/diagnostics12102268 - 20 Sep 2022

Cited by 1 | Viewed by 1346

Abstract

Three new equations for calculating the estimated basal serum creatinine (ebSCr) in hospitalized children have been developed: the simplified acute kidney injury (AKI) baseline creatinine (ABC) equation which considered only age in the formula; the equation including age and minimum creatinine (Cr_min) within the initial 72 h from hospitalization (ABC-cr); and the equation including Cr_min and height, weight, and age as squared values (ABC-advanced). We aimed to test the diagnostic performance of the ABC, ABC-cr and ABC-advanced equations in diagnosing AKI in 163 prospectively enrolled children with type 1 diabetes mellitus (T1DM) onset. We considered measured basal serum creatinine (mbSCr), the creatinine measured 14 days after T1DM onset. AKI was defined by the highest/basal serum creatine (HC/BC) ratio > 1.5. On the basis of the mbSCr, the AKI was diagnosed in 66/163 (40.5%) patients. This prevalence was lower than the prevalence of AKI diagnosed on the basis of ABC ebSCr (122/163 patients; 74.8%) (p < 0.001) and similar to the prevalence of AKI diagnosed on the basis of ABC-cr ebSCr (72/163 patients; 44.2%) (p = 0.5) and to the prevalence of AKI diagnosed on the basis of ABC-advanced ebSCr (69/163; 42.3%) (p = 0.73). AKI determined using ABC ebSCr, ABC-cr ebSCr and ABC-advanced ebSCr showed, respectively, 63.5% (kappa = 0.35; p < 0.001), 87.7% (kappa = 0.75; p < 0.001), and 87.1% (kappa = 0.74; p < 0.001) agreement with AKI determined using mbSCr. Using the HC/BC ratio calculated on the basis of mbSCr as gold standard, for Bland–Altman plots the HC/BC ratio calculated on the basis of ABC formula presented higher bias and wider limits of agreement compared with the HC/BC ratio calculated on the basis of ABC-cr and ABC-advanced formulas. In the receiver–operating characteristics (ROC) curve analysis the HC/BC ratio calculated on the basis of ABC ebSCr presented lower area under the ROC curve (AUROC) (AUROC = 0.89; 95%CI: 0.85–0.95; p < 0.001) compared with HC/BC ratio calculated on the basis of ABC-cr (AUROC = 0.94; 95%CI: 0.91–0.98; p < 0.001) or ABC-advanced ebSCr (AUROC = 0.914; 95%CI: 0.91–0.97; p < 0.001). In both Bland–Altman plots and ROC curve analysis, the ABC-cr and ABC-advanced formulas performed similarly. In conclusion, the ABC-cr and ABC-advanced formulas present very good diagnostic performance toward AKI identification in a population of children with T1DM onset. Full article

(This article belongs to the Special Issue Diagnosis and Management for Obesity, Diabetes and Cardiovascular Complications)

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10 pages, 968 KiB

Open AccessArticle

Comparison of Innovative and Traditional Cardiometabolic Indices in Estimating Atherosclerotic Cardiovascular Disease Risk in Adults

by Ya-Chin Huang, Jiun-Chi Huang, Chia-I Lin, Hsu-Han Chien, Yu-Yin Lin, Chao-Ling Wang, Fu-Wen Liang, Chia-Yen Dai and Hung-Yi Chuang

Diagnostics 2021, 11(4), 603; https://doi.org/10.3390/diagnostics11040603 - 28 Mar 2021

Cited by 30 | Viewed by 3143

Abstract

This study aimed to investigate the performance of innovative and traditional cardiometabolic indices, including body mass index (BMI), waist circumference (WC), Chinese visceral adiposity index (CVAI), visceral adiposity index, lipid accumulation product, a body shape index (ABSI), body roundness index, conicity index (CI), triglyceride-glucose (TyG) index, TyG-BMI, and TyG-WC, in estimating atherosclerotic cardiovascular disease (ASCVD) risk in 3143 Taiwanese adults aged 20–79 years. Elevated 10-year ASCVD risk was defined as ≥7.5% using the Pooled Cohort Equations. The performance of different indices in estimating elevated ASCVD risk was assessed by receiver operating characteristic (ROC) curves. In multivariate-adjusted logistic regression analyses, all cardiometabolic indices (p-value < 0.001) were significantly associated with elevated ASCVD risk in both genders, except for ABSI and CI in women. In particular, CVAI had the largest area under the curve (AUC) in men (0.721) and women (0.883) in the ROC analyses. BMI had the lowest AUC in men (0.617), while ABSI had the lowest AUC in women (0.613). The optimal cut-off value for CVAI was 83.7 in men and 70.8 in women. CVAI performed best among various cardiometabolic indices in estimating elevated ASCVD risk. CVAI may be a reliable index for identifying people at increased risk of ASCVD. Full article

(This article belongs to the Special Issue Diagnosis and Management for Obesity, Diabetes and Cardiovascular Complications)

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16 pages, 981 KiB

Open AccessArticle

by Ioana Țaranu, Cecilia Lazea, Victoria Creț, Nicoleta Răcătăianu, Mihaela Iancu and Sorana D. Bolboacă

Diagnostics 2021, 11(3), 485; https://doi.org/10.3390/diagnostics11030485 - 9 Mar 2021

Cited by 8 | Viewed by 2650

Abstract

We aimed to investigate the effect of weight status on inflammation-related markers and thyroid function tests in overweight and obese pediatric patients. Children and adolescents diagnosed between January 2017 and January 2019 with overweight or obesity were included in the study. Neutrophil-to-lymphocyte ratio (NLR), platelet-to lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) were calculated for the groups defined according to Body Mass Index (BMI)-for-age z-score: overweight (≥1 BMI-for-age z-score), obese (≥2 BMI-for-age z-score) and severely obese (≥3 BMI-for-age z-score). Severely obese patients had significantly higher value of white blood cells (WBC) counts (median = 7.92) compared with overweight patients (7.37, p = 0.014). Absolute lymphocyte count was significantly associated with obesity degree in children (Spearman’s Rho coefficient ρ = 0.228. p = 0.035), whereas absolute polymorphonuclear neutrophils (PMNCs) count was significantly higher in severely obese adolescents than overweight adolescents (overweight: 4.04 vs. severely obese: 5.3 (p = 0.029)). In 8.19% of patients an elevated thyroid-stimulating hormone (TSH) level was found, and 3.36% of patients had a low level of free thyroxine with an elevated level of TSH. Total absolute WBC count may be a reliable inflammation-related marker in obese pediatric patients without metabolic syndrome, but needs to be validated in the context of all possible covariates. Subclinical and overt hypothyroidism may develop from an early age in overweight or obese patients. Full article

(This article belongs to the Special Issue Diagnosis and Management for Obesity, Diabetes and Cardiovascular Complications)

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11 pages, 296 KiB

Open AccessArticle

Evaluation of Chitotriosidase and Neopterin as Biomarkers of Microvascular Complications in Patients with Type 1 Diabetes Mellitus

by Ancuța Cutaș, Cristina Drugan, Gabriela Roman, Adriana Rusu, Cristina Sorina Cătană, Andrei Achimaș-Cadariu and Tudor Drugan

Diagnostics 2021, 11(2), 263; https://doi.org/10.3390/diagnostics11020263 - 8 Feb 2021

Cited by 12 | Viewed by 2252

Abstract

The chronic complications of diabetes mellitus (DM) are accompanied by inflammatory manifestations. Our study aimed to evaluate a possible association between the inflammatory status (reflected by serum chitotriosidase and neopterin) and the timely evolution and occurrence of chronic microvascular complications in patients with type 1 DM. This observational, cross-sectional study included 82 type 1 DM patients from the Centre for Diabetes, Nutrition and Metabolic Diseases, Cluj-Napoca, Romania. Our results demonstrated a link between the extent of inflammation, evaluated by the enzymatic activity of circulating chitotriosidase, and the onset of microvascular complications, especially diabetic neuropathy and retinopathy. Chitotriosidase enzymatic activity showed an ascending evolution over time. In non-smoking patients, the increase in chitotriosidase activity was correlated with the extent of microalbuminuria and the decline of glomerular filtration rate, while in smokers, only the presence of a positive correlation between chitotriosidase activity and disease progression was noticed. According to our results, the time span between the moment of diagnosis and the onset of microvascular complications was longer in non-smokers than in smokers. These results also imply that increased chitotriosidase activity may be a predictor of endothelial dysfunction in type 1 DM. Full article

(This article belongs to the Special Issue Diagnosis and Management for Obesity, Diabetes and Cardiovascular Complications)

10 pages, 717 KiB

Open AccessArticle

Effect of Exercise on Inflamed Psoas Muscle in Women with Obesity: A Pilot Prospective ¹⁸F-FDG PET/CT Study

by Kisoo Pahk, Eung Ju Kim, Chanmin Joung, Hyun Woo Kwon, Hong Seog Seo and Sungeun Kim

Diagnostics 2021, 11(2), 164; https://doi.org/10.3390/diagnostics11020164 - 24 Jan 2021

Cited by 1 | Viewed by 2308

Abstract

Obesity increases inflammation in skeletal muscle thereby promoting systemic inflammation which leads to increased risk of cardiometabolic disease. This prospective study aimed to evaluate whether the metabolic activity of psoas muscle (PM) was associated with systemic inflammation, and whether physical exercise could reduce the PM metabolic activity evaluated by ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in women with obesity. A total of 23 women with obesity who participated in a 3-month physical exercise program were enrolled. ¹⁸F-FDG PET/CT was performed before the start of the program (baseline) and after completion of the program. The maximum standardized uptake value of psoas muscle (PM SUVmax) was used for the PM metabolic activity. The SUVmax of spleen and bone marrow, and the high-sensitivity C-reactive protein were used to evaluate the systemic inflammation. At baseline, PM SUVmax was strongly correlated with the systemic inflammation. The exercise program significantly reduced the PM SUVmax, in addition to adiposity and systemic inflammation. Furthermore, we found that the association between PM SUVmax and the systemic inflammation disappeared after completion of the exercise program. In women with obesity, PM SUVmax, assessed by ¹⁸F-FDG PET/CT, was associated with obesity-induced systemic inflammation and exercise reduced the PM SUVmax and eliminated its association with systemic inflammation. Full article

(This article belongs to the Special Issue Diagnosis and Management for Obesity, Diabetes and Cardiovascular Complications)

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15 pages, 1257 KiB

Open AccessArticle

Role of Adiponectin and Tumor Necrosis Factor-Alpha in the Pathogenesis and Evolution of Type 1 Diabetes Mellitus in Children and Adolescents

by Csilla Enikő Szabo, Oana Iulia Man, Alexandru Istrate, Eva Kiss, Andreea Catana, Victoria Creț, Radu Sorin Șerban and Ioan Victor Pop

Diagnostics 2020, 10(11), 945; https://doi.org/10.3390/diagnostics10110945 - 13 Nov 2020

Cited by 11 | Viewed by 2486

Abstract

Type 1 diabetes mellitus (T1DM) is a complex condition caused by the destruction of pancreatic beta cells by autoimmune mechanisms. As a result, insulin deficiency and subsequent hyperglycemia occur. The aim of the present study is to investigate the role of adiponectin and tumor necrosis factor alpha (TNF-α) in the development of T1DM. The study is designed as an observational case-control study, involving 52 diabetic patients and 66 controls. Z scores for Body Mass Index (BMI), weight, height, and adiponectin and TNF-α serum levels were assessed in both groups. The T1DM group had significantly higher TNF-α levels and a significantly higher proportion of high-risk patients for inflammation based on TNF-α values as compared to the control group, while both groups had statistically similar adiponectin levels and a similar proportion of high/medium-risk patients based on adiponectin values. TNF-α plays a significant role in the pathogenesis and evolution of T1DM and it may represent an additional marker of disease progression, as well as a potential target of immunotherapeutic strategies. In the present study, no statistically significant differences were recorded in adiponectin levels neither in diabetic patients and controls, nor in high/medium severity risk diabetic patients. Full article

(This article belongs to the Special Issue Diagnosis and Management for Obesity, Diabetes and Cardiovascular Complications)

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