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Titolo:
Distinct features of the atherosclerotic plaque of the insulino-resistant,type 2 diabetic patient: therapeutic implications
Autore:
Pascot, A; Poirier, P; Lemieux, I; Despres, JP;
Indirizzi:
Hop Laval, Ctr Rech, Inst Cardiol Quebec, St Foy, PQ G1V 4G5, Canada Hop Laval St Foy PQ Canada G1V 4G5 iol Quebec, St Foy, PQ G1V 4G5, Canada CHU Laval, CHUQ, Ctr Rech, Ctr Rech Malad Liqid, Quebec City, PQ G1V 4G2, Canada CHU Laval Quebec City PQ Canada G1V 4G2 , Quebec City, PQ G1V 4G2, Canada
Titolo Testata:
ANNALES D ENDOCRINOLOGIE
fascicolo: 4, volume: 62, anno: 2001,
pagine: 267 - 273
SICI:
0003-4266(200106)62:4<267:DFOTAP>2.0.ZU;2-N
Fonte:
ISI
Lingua:
FRE
Soggetto:
C-REACTIVE PROTEIN; CORONARY-ARTERY DISEASE; MYOCARDIAL-INFARCTION; HEART-DISEASE; CARDIOVASCULAR-DISEASE; RISK-FACTORS; ADIPOSE-TISSUE; FIBRINOLYTIC FACTORS; CLINICAL EVENTS; HDL-CHOLESTEROL;
Keywords:
type 2 diabetes; abdominal obesity; acute coronary syndrome; metabolic syndrome;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
56
Recensione:
Indirizzi per estratti:
Indirizzo: Despres, JP Hop Laval, Ctr Rech, Inst Cardiol Quebec, 2E Pavillon Mallet,2725 Chem St Foy, St Foy, PQ G1V 4G5, Canada Hop Laval 2E Pavillon Mallet,2725 Chem St Foy St Foy PQ Canada G1V 4G5
Citazione:
A. Pascot et al., "Distinct features of the atherosclerotic plaque of the insulino-resistant,type 2 diabetic patient: therapeutic implications", ANN ENDOCR, 62(4), 2001, pp. 267-273

Abstract

An accelerated atherosclerotic process is not only the factor leading to coronary artery disease in type 2 diabetic subjects with visceral obesity. This type of obesity is also associated with high levels of interleukin-6 (IL-6) and of plasminogen activator inhibitor-1 (PAI-1). Furthermore, recent data have shown that plasma concentrations of inflammatory markers, such asC-reactive protein (CRP), were closely related to the accumulation of abdominal fat. Thus, from the increased production of cytokines secreted by thehypertrophied visceral adipose tissue, type 2 diabetes could be associatedwith a state of chronic inflammation which could be deleterious for cardiovascular health as high levels of CRP have been associated with an increased risk of acute coronary events. Thus, type 2 diabetic patients with visceral obesity show an athero-thrombotic inflammatory profile. Furthermore, ischemic heart disease risk in these patients is not always related to the extent of coronary artery stenosis as the majority of coronary events could be attributed to occlusions at sites where the stenosis is less than 50 %, providing further support to the notion that we need to consider the atherothrombotic inflammatory profile ofthe patient. Thus, stabilization of the atherosclerotic plaque becomes a legitimate therapeutic objective for the prevention of coronary heart disease among viscerally obese patients with type 2 diabetes. In this regard, it is relevant to suggest that moderate weight loss (5-10 %) could substantially and rapidly decrease the risk of an acute coronary event, despite the possible lack of regression of coronary artery stenosis. Thus, the selective mobilization of visceral adipose tissue observed with weight reduction in obese patients with type 2 diabetes could lead to a reduced production of PAI-1, decreasing the risk of thrombosis. Such weight loss could also lead toa reduced secretion of IL-6 by adipose tissue, thereby reducing the production of CRP. Obviously, although these notions are plausible from a metabolic standpoint, we still do not have any randomized trials indicating that weight loss produced by diet or pharmacotherapy can reduce the incidence of ischemic heart disease risk in type 2 diabetic patients with visceral obesity.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/07/20 alle ore 10:31:10