Skip to main content
Top
Published in: Cardiovascular Diabetology 1/2015

Open Access 01-12-2015 | Original investigation

Low 25-hydroxyvitamin D2 and 25-hydroxyvitamin D3 levels are independently associated with macroalbuminuria, but not with retinopathy and macrovascular disease in type 1 diabetes: the EURODIAB prospective complications study

Authors: Lian Engelen, Casper G. Schalkwijk, Simone J. P. M. Eussen, Jean L. J. M. Scheijen, Sabita S. Soedamah-Muthu, Nish Chaturvedi, John H. Fuller, Coen D. A. Stehouwer

Published in: Cardiovascular Diabetology | Issue 1/2015

Login to get access

Abstract

Background

Low circulating levels of total vitamin D [25(OH)D] and 25(OH)D3 have been associated with vascular complications in few studies on individuals with type 1 diabetes. However, these measures are affected by UV light exposure. Circulating 25(OH)D2, however, solely represents dietary intake of vitamin D2, but its association with complications of diabetes is currently unknown. We investigated the associations between 25(OH)D2 and 25(OH)D3 and the prevalence of albuminuria, retinopathy and cardiovascular disease (CVD) in individuals with type 1 diabetes.

Methods

We measured circulating 25(OH)D2 and 25(OH)D3 in 532 individuals (40 ± 10 years old, 51 % men) with type 1 diabetes who participated in the EURODIAB Prospective Complications Study. Cross-sectional associations of 25(OH)D2 and 25(OH)D3 with albuminuria, retinopathy and CVD were assessed with multiple logistic regression analyses adjusted for age, sex, season, BMI, smoking, HbA1c, total-HDL-cholesterol-ratio, systolic blood pressure, antihypertensive medication, eGFR, physical activity, alcohol intake, albuminuria, retinopathy and CVD, as appropriate.

Results

Fully adjusted models revealed that 1 nmol/L higher 25(OH)D2 and 10 nmol/L higher 25(OH)D3 were associated with lower prevalence of macroalbuminuria with ORs (95 % CI) of 0.56 (0.43;0.74) and 0.82 (0.72;0.94), respectively. These vitamin D species were not independently associated with microalbuminuria, non-proliferative and proliferative retinopathy or CVD.

Conclusions

In individuals with type 1 diabetes, both higher 25(OH)D2 and 25(OH)D3 are associated with a lower prevalence of macroalbuminuria, but not of retinopathy and CVD. Prospective studies are needed to further examine the associations between 25(OH)D2 and 25(OH)D3 and the development of microvascular complications and CVD in type 1 diabetes.
Appendix
Available only for authorised users
Literature
2.
go back to reference Equils O, Naiki Y, Shapiro AM, Michelsen K, Lu D, Adams J, et al. 1,25-Dihydroxyvitamin D inhibits lipopolysaccharide-induced immune activation in human endothelial cells. Clin Exp Immunol. 2006;143(1):58–64.PubMedCentralPubMedCrossRef Equils O, Naiki Y, Shapiro AM, Michelsen K, Lu D, Adams J, et al. 1,25-Dihydroxyvitamin D inhibits lipopolysaccharide-induced immune activation in human endothelial cells. Clin Exp Immunol. 2006;143(1):58–64.PubMedCentralPubMedCrossRef
3.
go back to reference Schleithoff SS, Zittermann A, Tenderich G, Berthold HK, Stehle P, Koerfer R. Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr. 2006;83(4):754–9.PubMed Schleithoff SS, Zittermann A, Tenderich G, Berthold HK, Stehle P, Koerfer R. Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr. 2006;83(4):754–9.PubMed
4.
go back to reference Al-Daghri NM, Guerini FR, Al-Attas OS, Alokail MS, Alkharfy KM, Draz HM, et al. Vitamin D receptor gene polymorphisms are associated with obesity and inflammosome activity. PLoS One. 2014;9(7):e102141.PubMedCentralPubMedCrossRef Al-Daghri NM, Guerini FR, Al-Attas OS, Alokail MS, Alkharfy KM, Draz HM, et al. Vitamin D receptor gene polymorphisms are associated with obesity and inflammosome activity. PLoS One. 2014;9(7):e102141.PubMedCentralPubMedCrossRef
5.
go back to reference Molinari C, Uberti F, Grossini E, Vacca G, Carda S, Invernizzi M, et al. 1alpha,25-dihydroxycholecalciferol induces nitric oxide production in cultured endothelial cells. Cell Physiol Biochem. 2011;27(6):661–8.PubMedCrossRef Molinari C, Uberti F, Grossini E, Vacca G, Carda S, Invernizzi M, et al. 1alpha,25-dihydroxycholecalciferol induces nitric oxide production in cultured endothelial cells. Cell Physiol Biochem. 2011;27(6):661–8.PubMedCrossRef
6.
go back to reference Sugden JA, Davies JI, Witham MD, Morris AD, Struthers AD. Vitamin D improves endothelial function in patients with Type 2 diabetes mellitus and low vitamin D levels. Diabet Med. 2008;25(3):320–5.PubMedCrossRef Sugden JA, Davies JI, Witham MD, Morris AD, Struthers AD. Vitamin D improves endothelial function in patients with Type 2 diabetes mellitus and low vitamin D levels. Diabet Med. 2008;25(3):320–5.PubMedCrossRef
7.
go back to reference Li YC, Kong J, Wei M, Chen ZF, Liu SQ, Cao LP. 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest. 2002;110(2):229–38.PubMedCentralPubMedCrossRef Li YC, Kong J, Wei M, Chen ZF, Liu SQ, Cao LP. 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest. 2002;110(2):229–38.PubMedCentralPubMedCrossRef
8.
go back to reference Schram MT, Chaturvedi N, Schalkwijk CG, Fuller JH, Stehouwer CD. Markers of inflammation are cross-sectionally associated with microvascular complications and cardiovascular disease in type 1 diabetes–the EURODIAB Prospective Complications Study. Diabetologia. 2005;48(2):370–8.PubMedCrossRef Schram MT, Chaturvedi N, Schalkwijk CG, Fuller JH, Stehouwer CD. Markers of inflammation are cross-sectionally associated with microvascular complications and cardiovascular disease in type 1 diabetes–the EURODIAB Prospective Complications Study. Diabetologia. 2005;48(2):370–8.PubMedCrossRef
9.
go back to reference Astrup AS, Tarnow L, Pietraszek L, Schalkwijk CG, Stehouwer CD, Parving HH, et al. Markers of endothelial dysfunction and inflammation in type 1 diabetic patients with or without diabetic nephropathy followed for 10 years: association with mortality and decline of glomerular filtration rate. Diabetes Care. 2008;31(6):1170–6.PubMedCrossRef Astrup AS, Tarnow L, Pietraszek L, Schalkwijk CG, Stehouwer CD, Parving HH, et al. Markers of endothelial dysfunction and inflammation in type 1 diabetic patients with or without diabetic nephropathy followed for 10 years: association with mortality and decline of glomerular filtration rate. Diabetes Care. 2008;31(6):1170–6.PubMedCrossRef
10.
go back to reference Patel VB, Parajuli N, Oudit GY. Role of angiotensin-converting enzyme 2 (ACE2) in diabetic cardiovascular complications. Clin Sci (Lond). 2014;126(7):471–82.CrossRef Patel VB, Parajuli N, Oudit GY. Role of angiotensin-converting enzyme 2 (ACE2) in diabetic cardiovascular complications. Clin Sci (Lond). 2014;126(7):471–82.CrossRef
11.
go back to reference de Boer IH, Sachs MC, Cleary PA, Hoofnagle AN, Lachin JM, Molitch ME, et al. Circulating vitamin D metabolites and kidney disease in type 1 diabetes. J Clin Endocrinol Metab. 2012;97(12):4780–8.PubMedCentralPubMedCrossRef de Boer IH, Sachs MC, Cleary PA, Hoofnagle AN, Lachin JM, Molitch ME, et al. Circulating vitamin D metabolites and kidney disease in type 1 diabetes. J Clin Endocrinol Metab. 2012;97(12):4780–8.PubMedCentralPubMedCrossRef
12.
go back to reference Kaur H, Donaghue KC, Chan AK, Benitez-Aguirre P, Hing S, Lloyd M, et al. Vitamin D deficiency is associated with retinopathy in children and adolescents with type 1 diabetes. Diabetes Care. 2011;34(6):1400–2.PubMedCentralPubMedCrossRef Kaur H, Donaghue KC, Chan AK, Benitez-Aguirre P, Hing S, Lloyd M, et al. Vitamin D deficiency is associated with retinopathy in children and adolescents with type 1 diabetes. Diabetes Care. 2011;34(6):1400–2.PubMedCentralPubMedCrossRef
13.
go back to reference Joergensen C, Hovind P, Schmedes A, Parving HH, Rossing P. Vitamin D levels, microvascular complications, and mortality in type 1 diabetes. Diabetes Care. 2011;34(5):1081–5.PubMedCentralPubMedCrossRef Joergensen C, Hovind P, Schmedes A, Parving HH, Rossing P. Vitamin D levels, microvascular complications, and mortality in type 1 diabetes. Diabetes Care. 2011;34(5):1081–5.PubMedCentralPubMedCrossRef
14.
go back to reference Beveridge LA, Witham MD. Vitamin D and the cardiovascular system. Osteoporos Int. 2013;24(8):2167–80.PubMedCrossRef Beveridge LA, Witham MD. Vitamin D and the cardiovascular system. Osteoporos Int. 2013;24(8):2167–80.PubMedCrossRef
15.
go back to reference Cashman KD, Kinsella M, McNulty BA, Walton J, Gibney MJ, Flynn A, et al. Dietary vitamin D(2)–a potentially underestimated contributor to vitamin D nutritional status of adults? Br J Nutr. 2014;112(2):193–202.PubMedCrossRef Cashman KD, Kinsella M, McNulty BA, Walton J, Gibney MJ, Flynn A, et al. Dietary vitamin D(2)–a potentially underestimated contributor to vitamin D nutritional status of adults? Br J Nutr. 2014;112(2):193–202.PubMedCrossRef
16.
go back to reference Stephenson F, Fuller JH, on behalf of the EURODIAB IDDM Complications Study Group. Microvascular and acute complications in IDDM patients: the EURODIAB IDDM Complications Study. Diabetologia. 1994;37(3):278–85.CrossRef Stephenson F, Fuller JH, on behalf of the EURODIAB IDDM Complications Study Group. Microvascular and acute complications in IDDM patients: the EURODIAB IDDM Complications Study. Diabetologia. 1994;37(3):278–85.CrossRef
17.
go back to reference Koivisto VA, Stevens LK, Mattock M, Ebeling P, Muggeo M, Stephenson J, et al. Cardiovascular disease and its risk factors in IDDM in Europe. EURODIAB IDDM Complications Study Group. Diabetes Care. 1996;19(7):689–97.PubMedCrossRef Koivisto VA, Stevens LK, Mattock M, Ebeling P, Muggeo M, Stephenson J, et al. Cardiovascular disease and its risk factors in IDDM in Europe. EURODIAB IDDM Complications Study Group. Diabetes Care. 1996;19(7):689–97.PubMedCrossRef
18.
go back to reference Chaturvedi N, Schalkwijk CG, Abrahamian H, Fuller JH, Stehouwer CD. Circulating and urinary transforming growth factor beta1, Amadori albumin, and complications of type 1 diabetes: the EURODIAB prospective complications study. Diabetes Care. 2002;25(12):2320–7.PubMedCrossRef Chaturvedi N, Schalkwijk CG, Abrahamian H, Fuller JH, Stehouwer CD. Circulating and urinary transforming growth factor beta1, Amadori albumin, and complications of type 1 diabetes: the EURODIAB prospective complications study. Diabetes Care. 2002;25(12):2320–7.PubMedCrossRef
19.
go back to reference Chaturvedi N, Bandinelli S, Mangili R, Penno G, Rottiers RE, Fuller JH. Microalbuminuria in type 1 diabetes: rates, risk factors and glycemic threshold. Kidney Int. 2001;60(1):219–27.PubMedCrossRef Chaturvedi N, Bandinelli S, Mangili R, Penno G, Rottiers RE, Fuller JH. Microalbuminuria in type 1 diabetes: rates, risk factors and glycemic threshold. Kidney Int. 2001;60(1):219–27.PubMedCrossRef
20.
go back to reference Aldington SJ, Kohner EM, Meuer S, Klein R, Sjolie AK. Methodology for retinal photography and assessment of diabetic retinopathy: the EURODIAB IDDM complications study. Diabetologia. 1995;38(4):437–44.PubMedCrossRef Aldington SJ, Kohner EM, Meuer S, Klein R, Sjolie AK. Methodology for retinal photography and assessment of diabetic retinopathy: the EURODIAB IDDM complications study. Diabetologia. 1995;38(4):437–44.PubMedCrossRef
21.
go back to reference Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro 3rd AF, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604–12.PubMedCentralPubMedCrossRef Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro 3rd AF, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604–12.PubMedCentralPubMedCrossRef
22.
go back to reference Tielemans SM, Soedamah-Muthu SS, De Neve M, Toeller M, Chaturvedi N, Fuller JH, et al. Association of physical activity with all-cause mortality and incident and prevalent cardiovascular disease among patients with type 1 diabetes: the EURODIAB Prospective Complications Study. Diabetologia. 2013;56(1):82–91.PubMedCrossRef Tielemans SM, Soedamah-Muthu SS, De Neve M, Toeller M, Chaturvedi N, Fuller JH, et al. Association of physical activity with all-cause mortality and incident and prevalent cardiovascular disease among patients with type 1 diabetes: the EURODIAB Prospective Complications Study. Diabetologia. 2013;56(1):82–91.PubMedCrossRef
23.
go back to reference Beulens JW, Kruidhof JS, Grobbee DE, Chaturvedi N, Fuller JH, Soedamah-Muthu SS. Alcohol consumption and risk of microvascular complications in type 1 diabetes patients: the EURODIAB Prospective Complications Study. Diabetologia. 2008;51(9):1631–8.PubMedCrossRef Beulens JW, Kruidhof JS, Grobbee DE, Chaturvedi N, Fuller JH, Soedamah-Muthu SS. Alcohol consumption and risk of microvascular complications in type 1 diabetes patients: the EURODIAB Prospective Complications Study. Diabetologia. 2008;51(9):1631–8.PubMedCrossRef
24.
go back to reference Schram MT, Chaturvedi N, Schalkwijk C, Giorgino F, Ebeling P, Fuller JH, et al. Vascular risk factors and markers of endothelial function as determinants of inflammatory markers in type 1 diabetes: the EURODIAB Prospective Complications Study. Diabetes Care. 2003;26(7):2165–73.PubMedCrossRef Schram MT, Chaturvedi N, Schalkwijk C, Giorgino F, Ebeling P, Fuller JH, et al. Vascular risk factors and markers of endothelial function as determinants of inflammatory markers in type 1 diabetes: the EURODIAB Prospective Complications Study. Diabetes Care. 2003;26(7):2165–73.PubMedCrossRef
25.
go back to reference Sterne JA, White IR, Carlin JB, Spratt M, Royston P, Kenward MG, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. Bmj. 2009;338:b2393.PubMedCentralPubMedCrossRef Sterne JA, White IR, Carlin JB, Spratt M, Royston P, Kenward MG, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. Bmj. 2009;338:b2393.PubMedCentralPubMedCrossRef
26.
go back to reference Knol MJ, van der Tweel I, Grobbee DE, Numans ME, Geerlings MI. Estimating interaction on an additive scale between continuous determinants in a logistic regression model. Int J Epidemiol. 2007;36(5):1111–8.PubMedCrossRef Knol MJ, van der Tweel I, Grobbee DE, Numans ME, Geerlings MI. Estimating interaction on an additive scale between continuous determinants in a logistic regression model. Int J Epidemiol. 2007;36(5):1111–8.PubMedCrossRef
27.
go back to reference van Bussel BC, Soedamah-Muthu SS, Henry RM, Schalkwijk CG, Ferreira I, Chaturvedi N, et al. Unhealthy dietary patterns associated with inflammation and endothelial dysfunction in type 1 diabetes: the EURODIAB study. Nutr Metab Cardiovasc Dis. 2013;23(8):758–64.PubMedCrossRef van Bussel BC, Soedamah-Muthu SS, Henry RM, Schalkwijk CG, Ferreira I, Chaturvedi N, et al. Unhealthy dietary patterns associated with inflammation and endothelial dysfunction in type 1 diabetes: the EURODIAB study. Nutr Metab Cardiovasc Dis. 2013;23(8):758–64.PubMedCrossRef
28.
go back to reference Jones G. Extrarenal vitamin D activation and interactions between vitamin D(2), vitamin D(3), and vitamin D analogs. Annu Rev Nutr. 2013;33:23–44.PubMedCrossRef Jones G. Extrarenal vitamin D activation and interactions between vitamin D(2), vitamin D(3), and vitamin D analogs. Annu Rev Nutr. 2013;33:23–44.PubMedCrossRef
29.
go back to reference O’Seaghdha CM, Hwang SJ, Holden R, Booth SL, Fox CS. Phylloquinone and vitamin D status: associations with incident chronic kidney disease in the Framingham Offspring cohort. Am J Nephrol. 2012;36(1):68–77.PubMedCentralPubMedCrossRef O’Seaghdha CM, Hwang SJ, Holden R, Booth SL, Fox CS. Phylloquinone and vitamin D status: associations with incident chronic kidney disease in the Framingham Offspring cohort. Am J Nephrol. 2012;36(1):68–77.PubMedCentralPubMedCrossRef
30.
go back to reference Cai X, Hu Z, Chen L, Han X, Ji L. Analysis of the associations between vitamin D and albuminuria or beta-cell function in Chinese type 2 diabetes. Biomed Res Int. 2014;2014:640909.PubMedCentralPubMed Cai X, Hu Z, Chen L, Han X, Ji L. Analysis of the associations between vitamin D and albuminuria or beta-cell function in Chinese type 2 diabetes. Biomed Res Int. 2014;2014:640909.PubMedCentralPubMed
31.
go back to reference Ahmadieh H, Azar ST, Lakkis N, Arabi A. Hypovitaminosis d in patients with type 2 diabetes mellitus: a relation to disease control and complications. ISRN Endocrinol. 2013;2013:641098.PubMedCentralPubMed Ahmadieh H, Azar ST, Lakkis N, Arabi A. Hypovitaminosis d in patients with type 2 diabetes mellitus: a relation to disease control and complications. ISRN Endocrinol. 2013;2013:641098.PubMedCentralPubMed
32.
go back to reference Damasiewicz MJ, Magliano DJ, Daly RM, Gagnon C, Lu ZX, Ebeling PR, et al. 25-Hydroxyvitamin D levels and chronic kidney disease in the AusDiab (Australian Diabetes, Obesity and Lifestyle) study. BMC Nephrol. 2012;13:55.PubMedCentralPubMedCrossRef Damasiewicz MJ, Magliano DJ, Daly RM, Gagnon C, Lu ZX, Ebeling PR, et al. 25-Hydroxyvitamin D levels and chronic kidney disease in the AusDiab (Australian Diabetes, Obesity and Lifestyle) study. BMC Nephrol. 2012;13:55.PubMedCentralPubMedCrossRef
33.
go back to reference de Boer IH, Ioannou GN, Kestenbaum B, Brunzell JD, Weiss NS. 25-Hydroxyvitamin D levels and albuminuria in the Third National Health and Nutrition Examination Survey (NHANES III). Am J Kidney Dis. 2007;50(1):69–77.PubMedCrossRef de Boer IH, Ioannou GN, Kestenbaum B, Brunzell JD, Weiss NS. 25-Hydroxyvitamin D levels and albuminuria in the Third National Health and Nutrition Examination Survey (NHANES III). Am J Kidney Dis. 2007;50(1):69–77.PubMedCrossRef
34.
go back to reference Skaaby T, Husemoen LL, Pisinger C, Jorgensen T, Thuesen BH, Rasmussen K, et al. Vitamin D status and 5-year changes in urine albumin creatinine ratio and parathyroid hormone in a general population. Endocrine. 2013;44(2):473–80.PubMedCrossRef Skaaby T, Husemoen LL, Pisinger C, Jorgensen T, Thuesen BH, Rasmussen K, et al. Vitamin D status and 5-year changes in urine albumin creatinine ratio and parathyroid hormone in a general population. Endocrine. 2013;44(2):473–80.PubMedCrossRef
35.
go back to reference Patrick PA, Visintainer PF, Shi Q, Weiss IA, Brand DA. Vitamin D and retinopathy in adults with diabetes mellitus. Arch Ophthalmol. 2012;130(6):756–60.PubMedCrossRef Patrick PA, Visintainer PF, Shi Q, Weiss IA, Brand DA. Vitamin D and retinopathy in adults with diabetes mellitus. Arch Ophthalmol. 2012;130(6):756–60.PubMedCrossRef
36.
go back to reference Payne JF, Ray R, Watson DG, Delille C, Rimler E, Cleveland J, et al. Vitamin D insufficiency in diabetic retinopathy. Endocr Pract. 2012;18(2):185–93.PubMedCrossRef Payne JF, Ray R, Watson DG, Delille C, Rimler E, Cleveland J, et al. Vitamin D insufficiency in diabetic retinopathy. Endocr Pract. 2012;18(2):185–93.PubMedCrossRef
37.
go back to reference Theodoratou E, Tzoulaki I, Zgaga L, Ioannidis JP. Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials. BMJ. 2014;348:g2035.PubMedCentralPubMedCrossRef Theodoratou E, Tzoulaki I, Zgaga L, Ioannidis JP. Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials. BMJ. 2014;348:g2035.PubMedCentralPubMedCrossRef
38.
go back to reference Lavie CJ, Lee JH, Milani RV. Vitamin D and cardiovascular disease will it live up to its hype? J Am Coll Cardiol. 2011;58(15):1547–56.PubMedCrossRef Lavie CJ, Lee JH, Milani RV. Vitamin D and cardiovascular disease will it live up to its hype? J Am Coll Cardiol. 2011;58(15):1547–56.PubMedCrossRef
39.
40.
go back to reference Mursu J, Nurmi T, Voutilainen S, Tuomainen TP, Virtanen JK. The association between serum 25-hydroxyvitamin D3 concentration and risk of disease death in men: modification by magnesium intake. Eur J Epidemiol. 2015;30(4):343–7.PubMedCrossRef Mursu J, Nurmi T, Voutilainen S, Tuomainen TP, Virtanen JK. The association between serum 25-hydroxyvitamin D3 concentration and risk of disease death in men: modification by magnesium intake. Eur J Epidemiol. 2015;30(4):343–7.PubMedCrossRef
41.
go back to reference Mosekilde L. Vitamin D, requirement and setting recommendation levels: long-term perspectives. Nutr Rev. 2008;66(10 Suppl 2):S170–7.PubMedCrossRef Mosekilde L. Vitamin D, requirement and setting recommendation levels: long-term perspectives. Nutr Rev. 2008;66(10 Suppl 2):S170–7.PubMedCrossRef
Metadata
Title
Low 25-hydroxyvitamin D2 and 25-hydroxyvitamin D3 levels are independently associated with macroalbuminuria, but not with retinopathy and macrovascular disease in type 1 diabetes: the EURODIAB prospective complications study
Authors
Lian Engelen
Casper G. Schalkwijk
Simone J. P. M. Eussen
Jean L. J. M. Scheijen
Sabita S. Soedamah-Muthu
Nish Chaturvedi
John H. Fuller
Coen D. A. Stehouwer
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2015
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/s12933-015-0231-2

Other articles of this Issue 1/2015

Cardiovascular Diabetology 1/2015 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

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.