Prediabetic State – ABC CARDIOL

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Editorial

Can Intermittent Fasting Associated with a Low-Carb Diet Prevent Cardiovascular Disease in Pre-Diabetics?

Pre-diabetes is the term used to describe individuals who have altered glucose metabolism but do not meet the diagnostic criteria for diabetes. People with pre-diabetes have an increased risk of type 2 diabetes mellitus (DM2), cardiovascular disease (CVD), and all-cause mortality.^,

Lifestyle changes, including diet and regular physical activity, are effective in preventing diabetes and CVD. Some nutritional approaches have been used to promote weight loss and glycemic control. Intermittent fasting is a dietary practice restricting calorie consumption during a controlled period, followed by ad libitum caloric consumption. A carbohydrate-restricted diet, known as low-carb, is characterized by carbohydrate intake below the lower limit of an acceptable macronutrient distribution range for healthy adults (i.e., < 45% of energy intake).

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Original Article

The Value of Intermittent Fasting and Low Carbohydrate Diet in Prediabetic Patients for the Prevention of Cardiovascular Diseases

Mohamed Khalfallah et al. Basma Elnagar Shaimaa S. Soliman Ahmad Eissa Amany Allaithy

Abstract

Background:

Prediabetic patients are at increased risk for cardiovascular diseases and the development of microvascular and macrovascular complications. Intermittent fasting (IF) and low-carbohydrate diet (LCD) are promising dietary plans.

Objectives:

Our aims to analyze the benefits of IF combined with LCD on microvascular and macrovascular outcomes in prediabetic patients.

Methods:

The study included 485 prediabetic patients with no history of cardiovascular diseases divided into group I: (n = 240 patients) who underwent IF (16 h IF 3-4 days per week) combined with LCD (<130 g of carbohydrate per day), and group II: (n = 245 patients) with ad libitum calorie intake. The two groups were followed-up for two years for assessment of micro and macrovascular complications. A p-value < 0.05 was considered statistically significant.

Result:

There was a significant reduction in body weight, body mass index, waist circumference, body fat percentage and glycated hemoglobin in group I. The incidence of progression from prediabetes to diabetes was significantly lower in group I (2.1% vs. 6.9% in group II, p = 0.010). In addition, a significant increase in the incidence of microvascular and macrovascular complications was observed in group II, including retinopathy, neuropathy and unstable angina. Multivariate regression analysis revealed that increased body weight, fasting glucose, glycated hemoglobin and low-density lipoprotein were independent risk factors impacting microvascular and macrovascular outcomes.

Conclusions:

In prediabetic patients, IF, combined with LCD, was associated with lower progression to diabetes mellitus and lower incidence of microvascular and macrovascular complications.

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Editorial

Endothelial Biomarkers and Translational Medicine: Still a Challenge

Renato Jorge Alves

The article “Can the Serum Endocan Level Be Used as a Biomarker to Predict Subclinical Atherosclerosis in Patients with Prediabetes?” addressed a topic of the greatest relevance and originality, the diagnostic investigation of subclinical atherosclerosis in pre-diabetic patients. Therefore, the study evaluated the endothelial cell-specific molecule-1 (ESM-1) endocan concentration in pre-diabetic patients to verify the role of serum endocan levels in detecting subclinical atherosclerosis, aided by measuring the intima-media layer of the carotid arteries thickness (IMT).

Due to the global epidemic of obesity, there is an increasing number of patients diagnosed with type 2 diabetes. However, preceding this morbidity, an even greater contingent of individuals is hidden, those in the pre-diabetic or insulin resistance phase.

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Original Article

Can the Serum Endocan Level Be Used as a Biomarker to Predict Subclinical Atherosclerosis in Patients with Prediabetes?

Yucel Arman et al. Adem Atici Ozgur Altun Remzi Sarikaya … Sengül Aydin Yoldemir Murat Akarsu Orkide Kutlu Guzin Zeren Ozturk Pinar Demir Mustafa Ozcan Recep Yilmaz Bayraktarli Tufan Tukek

Abstract

Background

Patients with prediabetes have an increased risk of atherosclerotic cardiovascular disease; therefore, early detection is important.

Objective

The present study aimed to reveal the usability of serum endocan levels as a biomarker in the diagnosis of subclinical atherosclerosis in patients with prediabetes, based on CIMT measurements.

Methods

Participants were classified according to the presence (n=42) or absence (n=42) of prediabetes. Serum endocan, fasting blood sugar, fasting insulin, and glycated hemoglobin (HbA1c) values of patients were examined, and CIMT was measured. The level of significance for statistical analysis was 0.05.

Results

While serum endocan levels were found to be lower in patients with prediabetes, when compared to the control group (p=0.042), CIMT values were found to be higher (p=0.046). When evaluated by multivariate regression analysis, the serum endocan level was found to be associated with CIMT, regardless of other parameters (p=0.007). A negative correlation was found between plasma fasting insulin and endocan levels (r=-0.320, p=0.001).

Conclusions

Carotid intima media thickness was found to be high and the serum endocan level was low in patients with prediabetes. Decreased serum endocan levels in patients with prediabetes may be a contributing factor to atherosclerosis formation mechanisms.

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Can Intermittent Fasting Associated with a Low-Carb Diet Prevent Cardiovascular Disease in Pre-Diabetics?

The Value of Intermittent Fasting and Low Carbohydrate Diet in Prediabetic Patients for the Prevention of Cardiovascular Diseases

Abstract

Background:

Objectives:

Methods:

Result:

Conclusions:

Endothelial Biomarkers and Translational Medicine: Still a Challenge

Can the Serum Endocan Level Be Used as a Biomarker to Predict Subclinical Atherosclerosis in Patients with Prediabetes?

Abstract

Background

Objective

Methods

Results

Conclusions

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