Skip to main content
Top
Published in: Journal of Endocrinological Investigation 3/2014

01-03-2014 | Original Article

Lipid and non-lipid cardiovascular risk factors in postmenopausal type 2 diabetic women with and without coronary heart disease

Authors: G. T. Russo, A. Giandalia, E. L. Romeo, M. Marotta, A. Alibrandi, C. De Francesco, K. V. Horvath, B. Asztalos, D. Cucinotta

Published in: Journal of Endocrinological Investigation | Issue 3/2014

Login to get access

Abstract

Background

Coronary heart disease (CHD) is the leading cause of death in diabetic women. In addition to hyperglycemia, other factors may contribute to the excessive cardiovascular risk.

Aim

In this study we evaluated common and emerging risk factors in a selected group of postmenopausal type 2 diabetic women with (n = 36) and without CHD (n = 59), not taking lipid-lowering medications.

Methods

Clinical and lifestyle data were collected, and metabolic and lipid profile, as well as fasting plasma levels of total homocysteine (tHcy), folate, vitamin B12, C-reactive protein (hsCRP), interleukin 6 (IL-6), and vascular cell adhesion molecule-1 (VCAM-1) were measured in all participants.

Results

Age, menopause and diabetes duration, family history for cardiovascular disease, prevalence of hypertension and current insulin use were greater in diabetic women with than without CHD (P < 0.05 for all comparisons). CHD women also showed higher levels of triglycerides, small dense LDL (sdLDL), remnant-like particle cholesterol, tHcy, and VCAM-1, and a lower creatinine clearance (P < 0.05 all). Conversely, the two groups were comparable for BMI, waist circumference, smoking habit, fasting plasma glucose, HbA1c, total cholesterol, low-density lipoprotein cholesterol (LDL-C), HDL cholesterol, folate, vitamin B12, hsCRP and IL-6 levels. At multivariate analysis, lower creatinine clearance (OR = 0.932, P = 0.017) and higher sdLDL serum concentration (OR = 1.224, P = 0.037) were the strongest risk factors associated with CHD in this population, whereas no significant association was noted with LDL-C.

Conclusions

Our data suggest that beyond LDL-C, a lower creatinine clearance and more subtle alterations of LDL particles, together with a constellation of several well known and emerging cardiovascular risk factors, are stronger contributors to the high CHD risk of diabetic women.
Literature
1.
go back to reference Raza JA, Reinhart RA, Movahed A (2004) Ischemic heart disease in women and the role of hormone therapy. Int J Cardiol 96:7–19CrossRefPubMed Raza JA, Reinhart RA, Movahed A (2004) Ischemic heart disease in women and the role of hormone therapy. Int J Cardiol 96:7–19CrossRefPubMed
2.
go back to reference Kannel WB, McGee DL (1979) Diabetes and glucose tolerance as risk factors for cardiovascular disease: the Framingham study. Diabetes Care 2:120–126CrossRefPubMed Kannel WB, McGee DL (1979) Diabetes and glucose tolerance as risk factors for cardiovascular disease: the Framingham study. Diabetes Care 2:120–126CrossRefPubMed
3.
go back to reference Yusuf S, Hawken S, Ounpuu S, On behalf of the INTERHEART study investigators et al (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case–control study. Lancet 364:937–952CrossRefPubMed Yusuf S, Hawken S, Ounpuu S, On behalf of the INTERHEART study investigators et al (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case–control study. Lancet 364:937–952CrossRefPubMed
4.
go back to reference Huxley R, Barzi F, Woodward M (2006) Excess risk of fatal coronary heart disease associated with diabetes in men and women: metaanalysis of 37 prospective cohort studies. BMJ 332:73–78CrossRefPubMedCentralPubMed Huxley R, Barzi F, Woodward M (2006) Excess risk of fatal coronary heart disease associated with diabetes in men and women: metaanalysis of 37 prospective cohort studies. BMJ 332:73–78CrossRefPubMedCentralPubMed
5.
go back to reference Rivellese AA, Riccardi G, Vaccaro O (2010) Cardiovascular risk in women with diabetes. Nutr Metab Cardiovasc Dis 20:474–480CrossRefPubMed Rivellese AA, Riccardi G, Vaccaro O (2010) Cardiovascular risk in women with diabetes. Nutr Metab Cardiovasc Dis 20:474–480CrossRefPubMed
6.
go back to reference UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352:837–853CrossRef UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352:837–853CrossRef
7.
go back to reference Grundy SM, Cleeman JI, Merz CN, For the Coordinating Committee of the National Cholesterol Education Program et al (2004) Implications of recent clinical trials for the national cholesterol education program adult treatment panel III guidelines. Circulation 110:227–239CrossRefPubMed Grundy SM, Cleeman JI, Merz CN, For the Coordinating Committee of the National Cholesterol Education Program et al (2004) Implications of recent clinical trials for the national cholesterol education program adult treatment panel III guidelines. Circulation 110:227–239CrossRefPubMed
8.
go back to reference Fruchart JC, Sacks F, Hermans MP et al (2008) The residual risk reduction initiative: a call to action to reduce residual vascular risk in patients with dyslipidemia. Am J Cardiol 102(10 Suppl):1K–34KCrossRefPubMed Fruchart JC, Sacks F, Hermans MP et al (2008) The residual risk reduction initiative: a call to action to reduce residual vascular risk in patients with dyslipidemia. Am J Cardiol 102(10 Suppl):1K–34KCrossRefPubMed
9.
go back to reference Taskinen MR (2003) Diabetic dyslipidemia: from basic research to clinical practice. Diabetologia 46:733–749CrossRefPubMed Taskinen MR (2003) Diabetic dyslipidemia: from basic research to clinical practice. Diabetologia 46:733–749CrossRefPubMed
10.
11.
go back to reference Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM (2001) C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA 286:327–334CrossRefPubMed Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM (2001) C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA 286:327–334CrossRefPubMed
12.
go back to reference Duncan BB, Schmidt MI, Pankow JS, Atherosclerosis Risk in Communities Study et al (2003) Low-grade systemic inflammation and the development of type 2 diabetes: the atherosclerosis risk in communities study. Diabetes 52:1799–1805CrossRefPubMed Duncan BB, Schmidt MI, Pankow JS, Atherosclerosis Risk in Communities Study et al (2003) Low-grade systemic inflammation and the development of type 2 diabetes: the atherosclerosis risk in communities study. Diabetes 52:1799–1805CrossRefPubMed
13.
go back to reference Ridker PM, Buring JE, Cook NR, Rifai N (2003) C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14,719 initially healthy American women. Circulation 107:391–397CrossRefPubMed Ridker PM, Buring JE, Cook NR, Rifai N (2003) C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14,719 initially healthy American women. Circulation 107:391–397CrossRefPubMed
14.
go back to reference Pfützner A, Forst T (2006) High-sensitivity C-reactive protein as cardiovascular risk marker in patients with diabetes mellitus. Diabetes Technol Ther 8:28–36CrossRefPubMed Pfützner A, Forst T (2006) High-sensitivity C-reactive protein as cardiovascular risk marker in patients with diabetes mellitus. Diabetes Technol Ther 8:28–36CrossRefPubMed
15.
go back to reference Jager A, van Hinsbergh VW, Kostense PJ et al (2000) Increased levels of Soluble Vascular Cell Adhesion Molecule 1 are associated with risk of cardiovascular mortality in type 2 diabetes. The Hoorn Study. Diabetes 49:485–491CrossRefPubMed Jager A, van Hinsbergh VW, Kostense PJ et al (2000) Increased levels of Soluble Vascular Cell Adhesion Molecule 1 are associated with risk of cardiovascular mortality in type 2 diabetes. The Hoorn Study. Diabetes 49:485–491CrossRefPubMed
16.
go back to reference Russo GT, Cucinotta D (2003) Hyperhomocysteinemia and cardiovascular risk in diabetes mellitus. Ann Ist Super Sanita 39:153–163PubMed Russo GT, Cucinotta D (2003) Hyperhomocysteinemia and cardiovascular risk in diabetes mellitus. Ann Ist Super Sanita 39:153–163PubMed
17.
go back to reference Russo GT, Di Benedetto A, Magazzù D et al (2001) Mild hyperhomocysteinemia, C677T polymorphism on methylenetetrahydrofolate reductase gene and the risk of macroangiopathy in type 2 diabetes: a prospective study. Acta Diabetol 48:95–101CrossRef Russo GT, Di Benedetto A, Magazzù D et al (2001) Mild hyperhomocysteinemia, C677T polymorphism on methylenetetrahydrofolate reductase gene and the risk of macroangiopathy in type 2 diabetes: a prospective study. Acta Diabetol 48:95–101CrossRef
18.
go back to reference Clarke R, Halsey J, Lewington S, B-Vitamin Treatment Trialists’ Collaboration et al (2010) Effects of lowering homocysteine levels with B vitamins on cardiovascular disease, cancer, and cause-specific mortality: meta-analysis of 8 randomized trials involving 37,485 individuals. Arch Intern Med 170:1622–1631CrossRefPubMed Clarke R, Halsey J, Lewington S, B-Vitamin Treatment Trialists’ Collaboration et al (2010) Effects of lowering homocysteine levels with B vitamins on cardiovascular disease, cancer, and cause-specific mortality: meta-analysis of 8 randomized trials involving 37,485 individuals. Arch Intern Med 170:1622–1631CrossRefPubMed
19.
go back to reference Rossi MC, Cristofaro MR, Gentile S, Lucisano G, Manicardi V, Mulas MF, Napoli A, Nicolucci A, Pellegrini F, Suraci C, Giorda C (2013) Sex disparities in the quality of diabetes care: biological and cultural factors may play a different role for different outcomes: a cross-sectional observational study from the AMD annals initiative. Diabetes Care 8 Jul [Epub ahead of print] PubMed PMID: 23835692 Rossi MC, Cristofaro MR, Gentile S, Lucisano G, Manicardi V, Mulas MF, Napoli A, Nicolucci A, Pellegrini F, Suraci C, Giorda C (2013) Sex disparities in the quality of diabetes care: biological and cultural factors may play a different role for different outcomes: a cross-sectional observational study from the AMD annals initiative. Diabetes Care 8 Jul [Epub ahead of print] PubMed PMID: 23835692
20.
go back to reference Franzini L, Ardigò D, Cavalot F, Miccoli R, Rivellese AA, Trovati M, Zavaroni I, Vaccaro O (2013) Women show worse control of type 2 diabetes and cardiovascular disease risk factors than men: results from the MIND. IT Study Group of the Italian Society of Diabetology. Nutr Metab Cardiovasc Dis 23(3):235–241CrossRefPubMed Franzini L, Ardigò D, Cavalot F, Miccoli R, Rivellese AA, Trovati M, Zavaroni I, Vaccaro O (2013) Women show worse control of type 2 diabetes and cardiovascular disease risk factors than men: results from the MIND. IT Study Group of the Italian Society of Diabetology. Nutr Metab Cardiovasc Dis 23(3):235–241CrossRefPubMed
21.
go back to reference Solini A, Penno G, Bonora E, Renal Insufficiency And Cardiovascular Events (RIACE) Study Group et al (2012) Diverging association of reduced glomerular filtration rate and albuminuria with coronary and noncoronary events in patients with type 2 diabetes: the renal insufficiency and cardiovascular events (RIACE) Italian multicenter study. Diabetes Care 35:143–149CrossRefPubMedCentralPubMed Solini A, Penno G, Bonora E, Renal Insufficiency And Cardiovascular Events (RIACE) Study Group et al (2012) Diverging association of reduced glomerular filtration rate and albuminuria with coronary and noncoronary events in patients with type 2 diabetes: the renal insufficiency and cardiovascular events (RIACE) Italian multicenter study. Diabetes Care 35:143–149CrossRefPubMedCentralPubMed
22.
go back to reference Russo GT, Di Benedetto A, Alessi E et al (2008) Menopause modulates homocysteine levels in diabetic and non-diabetic women. J Endocrinol Invest 31:546–551PubMed Russo GT, Di Benedetto A, Alessi E et al (2008) Menopause modulates homocysteine levels in diabetic and non-diabetic women. J Endocrinol Invest 31:546–551PubMed
23.
go back to reference American Diabetes Association (2012) Standards of medical care in diabetes–2012. Diabetes Care 35(Suppl 1):S11–S63. doi:10.2337/dc12-s011 American Diabetes Association (2012) Standards of medical care in diabetes–2012. Diabetes Care 35(Suppl 1):S11–S63. doi:10.​2337/​dc12-s011
24.
go back to reference Cockcroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16:31–41CrossRefPubMed Cockcroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16:31–41CrossRefPubMed
25.
go back to reference Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in men. Diabetologia 28:412–419CrossRefPubMed Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in men. Diabetologia 28:412–419CrossRefPubMed
26.
go back to reference Nakajima K, Saito T, Tamura A (1993) Cholesterol in remnant-like lipoproteins in human serum using monoclonal anti apo B-100 and anti apo A-I immunoaffinity mixed gels. Clin Chim Acta 223:53–71CrossRefPubMed Nakajima K, Saito T, Tamura A (1993) Cholesterol in remnant-like lipoproteins in human serum using monoclonal anti apo B-100 and anti apo A-I immunoaffinity mixed gels. Clin Chim Acta 223:53–71CrossRefPubMed
27.
go back to reference Hirano T, Ito Y, Saegusa H, Yoshino G (2003) A novel and simple method for quantitation of small dense low density lipoprotein. J Lipid Res 44:2193–2201CrossRefPubMed Hirano T, Ito Y, Saegusa H, Yoshino G (2003) A novel and simple method for quantitation of small dense low density lipoprotein. J Lipid Res 44:2193–2201CrossRefPubMed
28.
go back to reference Baggio G, Corsini A, Floreani A, Giannini S, Zagonel V (2013) Gender medicine: a task for the third millennium. Clin Chem Lab Med 51:713–727CrossRefPubMed Baggio G, Corsini A, Floreani A, Giannini S, Zagonel V (2013) Gender medicine: a task for the third millennium. Clin Chem Lab Med 51:713–727CrossRefPubMed
29.
go back to reference Avogaro A, Giorda C, Maggini M, Diabetes and Informatics Study Group, Association of Clinical Diabetologists, Istituto Superiore di Sanità et al (2007) Incidence of coronary heart disease in type 2 diabetic men and women: impact of microvascular complications, treatment, and geographic location. Diabetes Care 30:1241–1247CrossRefPubMed Avogaro A, Giorda C, Maggini M, Diabetes and Informatics Study Group, Association of Clinical Diabetologists, Istituto Superiore di Sanità et al (2007) Incidence of coronary heart disease in type 2 diabetic men and women: impact of microvascular complications, treatment, and geographic location. Diabetes Care 30:1241–1247CrossRefPubMed
30.
go back to reference Third Report of the National Cholesterol Education Program (NCEP) (2002) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). Circulation 106:3143–3421 Third Report of the National Cholesterol Education Program (NCEP) (2002) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). Circulation 106:3143–3421
31.
go back to reference Colhoun HM, Betteridge DJ, Durrington PN, CARDS investigators et al (2004) Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial. Lancet 364:685–696CrossRefPubMed Colhoun HM, Betteridge DJ, Durrington PN, CARDS investigators et al (2004) Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial. Lancet 364:685–696CrossRefPubMed
32.
go back to reference Heart Protection Study Collaborative Group (2003) MRC/BHF heart protection study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebo-controlled trial. Lancet 361:2005–2016CrossRef Heart Protection Study Collaborative Group (2003) MRC/BHF heart protection study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebo-controlled trial. Lancet 361:2005–2016CrossRef
33.
go back to reference Russo GT, Horvath KV, Di Benedetto A, Giandalia A, Cucinotta D, Asztalos B (2010) Influence of menopause and cholesteryl ester transfer protein (CETP) TaqIB polymorphism on lipid profile and HDL subpopulations distribution in women with and without type 2 diabetes. Atherosclerosis 210:294–301CrossRefPubMed Russo GT, Horvath KV, Di Benedetto A, Giandalia A, Cucinotta D, Asztalos B (2010) Influence of menopause and cholesteryl ester transfer protein (CETP) TaqIB polymorphism on lipid profile and HDL subpopulations distribution in women with and without type 2 diabetes. Atherosclerosis 210:294–301CrossRefPubMed
34.
go back to reference Gruppo Annali Associazione Medici Diabetologi. Annali AMD 2012—Analisi prospettica degli indicatori dell’Assistenza del diabete in Italia (2004–2011) ISBN 978-88-96489-08-06 Gruppo Annali Associazione Medici Diabetologi. Annali AMD 2012—Analisi prospettica degli indicatori dell’Assistenza del diabete in Italia (2004–2011) ISBN 978-88-96489-08-06
35.
go back to reference Hirayama S, Miida T (2012) Small dense LDL: an emerging risk factor for cardiovascular disease. Clin Chim Acta 414:215–224CrossRefPubMed Hirayama S, Miida T (2012) Small dense LDL: an emerging risk factor for cardiovascular disease. Clin Chim Acta 414:215–224CrossRefPubMed
36.
go back to reference Austin MA, Hokanson JE, Brunzell JD (1994) Characterization of low-density lipoprotein subclasses: methodologic approaches and clinical relevance. Curr Opin Lipidol 5:395–403CrossRefPubMed Austin MA, Hokanson JE, Brunzell JD (1994) Characterization of low-density lipoprotein subclasses: methodologic approaches and clinical relevance. Curr Opin Lipidol 5:395–403CrossRefPubMed
37.
go back to reference Lamarche B, Lemieux I, Despres JP (1999) The small, dense LDL phenotype and the risk of coronary heart disease: epidemiology, patho-physiology and therapeutic aspects. Diabetes Metab 25:199–211PubMed Lamarche B, Lemieux I, Despres JP (1999) The small, dense LDL phenotype and the risk of coronary heart disease: epidemiology, patho-physiology and therapeutic aspects. Diabetes Metab 25:199–211PubMed
38.
go back to reference Matthan N, Jalbert SM, Lamon-Fava S et al (2005) TRL, IDL, and LDL apolipoprotein B-100 and HDL apolipoprotein A-I kinetics as a function of age and menopausal status. Arterioscler Thromb Vasc Biol 25:1691–1696CrossRefPubMed Matthan N, Jalbert SM, Lamon-Fava S et al (2005) TRL, IDL, and LDL apolipoprotein B-100 and HDL apolipoprotein A-I kinetics as a function of age and menopausal status. Arterioscler Thromb Vasc Biol 25:1691–1696CrossRefPubMed
39.
go back to reference Ai M, Otokozawa S, Asztalos BF et al (2010) Small dense LDL cholesterol and coronary heart disease: results from the Framingham Offspring Study. Clin Chem 56:967–976CrossRefPubMedCentralPubMed Ai M, Otokozawa S, Asztalos BF et al (2010) Small dense LDL cholesterol and coronary heart disease: results from the Framingham Offspring Study. Clin Chem 56:967–976CrossRefPubMedCentralPubMed
40.
go back to reference Adler AI, Stevens RJ, Manley SE, Bilous RW, Cull CA, Holman RR, UKPDS GROUP (2003) Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int 63:225–232CrossRefPubMed Adler AI, Stevens RJ, Manley SE, Bilous RW, Cull CA, Holman RR, UKPDS GROUP (2003) Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int 63:225–232CrossRefPubMed
41.
go back to reference Muiesan ML, Ambrosioni E, Costa FV et al (2012) Sex differences in hypertension-related renal and cardiovascular diseases in Italy: the I-DEMAND study. J Hypertens 30:2378–2386CrossRefPubMed Muiesan ML, Ambrosioni E, Costa FV et al (2012) Sex differences in hypertension-related renal and cardiovascular diseases in Italy: the I-DEMAND study. J Hypertens 30:2378–2386CrossRefPubMed
42.
go back to reference Juutilainen A, Kortelainen S, Lehto S, Rönnemaa T, Pyörälä K, Laakso M (2004) Gender difference in the impact of type 2 diabetes on coronary heart disease risk. Diabetes Care 27:2898–2904CrossRefPubMed Juutilainen A, Kortelainen S, Lehto S, Rönnemaa T, Pyörälä K, Laakso M (2004) Gender difference in the impact of type 2 diabetes on coronary heart disease risk. Diabetes Care 27:2898–2904CrossRefPubMed
43.
go back to reference Turner RC, Millns H, Neil HAW, Stratton IM, Manley SE, Matthews DE (1998) Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS: 23). BMJ 316:823–828CrossRefPubMedCentralPubMed Turner RC, Millns H, Neil HAW, Stratton IM, Manley SE, Matthews DE (1998) Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS: 23). BMJ 316:823–828CrossRefPubMedCentralPubMed
44.
go back to reference Ruige JB, Assendelft WJ, Dekker JM, Kostense PJ, Heine RJ, Bouter LM (1998) Insulin and risk of cardiovascular disease: a metaanalysis. Circulation 97:996–1001CrossRefPubMed Ruige JB, Assendelft WJ, Dekker JM, Kostense PJ, Heine RJ, Bouter LM (1998) Insulin and risk of cardiovascular disease: a metaanalysis. Circulation 97:996–1001CrossRefPubMed
45.
go back to reference ORIGIN Trial Investigators, Gerstein HC, Bosch J, Dagenais GR, Díaz R, Jung H, Maggioni AP, Pogue J, Probstfield J, Ramachandran A, Riddle MC, Rydén LE, Yusuf S (2012) Basal insulin and cardiovascular and other outcomes in dysglycemia. N Engl J Med 367(4):319–328CrossRefPubMed ORIGIN Trial Investigators, Gerstein HC, Bosch J, Dagenais GR, Díaz R, Jung H, Maggioni AP, Pogue J, Probstfield J, Ramachandran A, Riddle MC, Rydén LE, Yusuf S (2012) Basal insulin and cardiovascular and other outcomes in dysglycemia. N Engl J Med 367(4):319–328CrossRefPubMed
46.
go back to reference Kones R (2010) Rosuvastatin, inflammation, C-reactive protein, JUPITER, and primary prevention of cardiovascular disease—a perspective. Drug Des Devel Ther 4:383–441CrossRefPubMedCentralPubMed Kones R (2010) Rosuvastatin, inflammation, C-reactive protein, JUPITER, and primary prevention of cardiovascular disease—a perspective. Drug Des Devel Ther 4:383–441CrossRefPubMedCentralPubMed
47.
go back to reference Kaptoge S, Di Angelantonio E, Lowe G et al (2010) C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet 375:132–140CrossRefPubMed Kaptoge S, Di Angelantonio E, Lowe G et al (2010) C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet 375:132–140CrossRefPubMed
Metadata
Title
Lipid and non-lipid cardiovascular risk factors in postmenopausal type 2 diabetic women with and without coronary heart disease
Authors
G. T. Russo
A. Giandalia
E. L. Romeo
M. Marotta
A. Alibrandi
C. De Francesco
K. V. Horvath
B. Asztalos
D. Cucinotta
Publication date
01-03-2014
Publisher
Springer International Publishing
Published in
Journal of Endocrinological Investigation / Issue 3/2014
Electronic ISSN: 1720-8386
DOI
https://doi.org/10.1007/s40618-013-0023-z

Other articles of this Issue 3/2014

Journal of Endocrinological Investigation 3/2014 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine