Among the other Markers of Atherosclerosis > 자유게시판

The present study provides preliminary evidence in favor of the GLP-1 based therapies in providing beneficial effects against atherosclerosis as indicated by the significant reductions in atherosclerosis markers including BNP, PAI-1 and hsCRP, besides statistically non-significant reductions in several other markers including IMT, FMD, IL-6 and TNF-α were also noted. Moreover, GLP-1-based therapies were also associated with significant reductions in total cholesterol, LDL-cholesterol and triglycerides. The present study finds a significant acute effect of GLP-1-based therapies in increasing % FMD but in the long term this increase was not statistically significant. Previously, it has been found that the GLP-1 infusion in healthy subjects increases baseline and acetylcholine-induced vasodilatation45. Upon infusion, GLP-1 exerts potent vasodilatory effects on conduit artery and arterioles in healthy humans leading to increased blood flow for enhanced microvascular recruitment and muscular perfusion46. This shows that GLP-1-based therapies, besides providing glycemic control, also plays a significant role in the maintenance of endothelial function and vascular health. However, for long-term effects of the GLP-1-based therapies, more trials’ data will be required.

Intima media thickness is a well-recognized marker of sub-clinical atherosclerosis36. Increment in carotid IMT of more than 0.34 mm/year can lead to a cardiovascular event with first myocardial infarction and stroke can happen with a carotid IMT above 0.882 mm and 0.75 mm, respectively47. Whereas, some longitudinal studies have noticed a significant decrease in the IMT following a GLP-1-based therapy14,36, the present meta-analysis reveals a non-significant decrease in IMT, but this may be because of the less availability of data and paradigmatic and treatment spell deviations, thus necessitates the conduct of more trials with better designs. Blood levels of CRP above 3 mg/L are suggested to be predictive of adverse cardiovascular outcome one year later48. It is thought that CRP has a causative role in endothelial cell activation and dysfunction, neo-intimal formation, monocyte and macrophage activity and matrix metalloproteinase function49. The present study finds that GLP-1-based therapies significantly reduce CRP while statistically non-significantly reducing TNF-α and IL-6 levels. This is suggestive of the effects of GLP-1-based therapies on attenuating inflammatory processes that may cause atherosclerosis development.

The present study finds a significant reduction in PAI-1 with GLP-1 based therapies in diabetic patients. A critical feature of atherosclerosis is the increased production of adhesion molecules from the endothelium. Deposition of cholesterol in the intima of arteries induces endothelium to produce VCAM-150 which appears to be cytokine dependent as the presence of TNF-α in the smooth muscle cells is associated with an increase expression of VCAM-151. In human cell culture studies, increased expressions of PAI-1 and VCAM-1 have been reported to be associated with hyperglycemia-related endothelial cell dysfunction, a process that predisposes vasculature to accelerated atherogenesis52. Among the other markers of atherosclerosis, BNP, which is secreted mainly by the ventricular myocardium53,54,55, has been found to decrease significantly by the GLP-1-based therapies but MCP-1, which is secreted by the peripheral blood mononuclear cells56, has been found un-affected by the GLP-1-based therapies, MedicGLP in the present study. However, the present study remains inconclusive with regards to the effects on TNF-α, VCAM-1 and MCP-1, because of the unavailability of adequate data. Taken together, results of this meta-analysis are able to provide preliminary evidence in favor of GLP-1-based therapies in overcoming atherosclerosis development/progression which is also substantiated by the significant decreases in the total cholesterol, LDL-cholesterol and triglycerides observed in the studies which fulfilled inclusion criteria of this study. Of the limitations of the present study, owing to the availability of fewer studies in some comparisons of individual parameters, it remains under-powered to generate conclusive evidence. Methodologically, among the included longitudinal studies, only 9 were double blind RCTs, 11 were open-label RCTs and 4 were non-randomized observational studies. This may also affects the level of evidence and thus the outcomes of this analytical review should be assigned as preliminary evidence only. Funnel plots also reflected a considerable publication bias (Fig. S2). In some comparisons, statistical heterogeneity was high; although, sensitivity analyses revealed only one comparison with truly higher I2.

Science continues to prove that the old adage "you are what you eat" is profoundly true. This is because you have trillions of microorganisms living in your gut, which are directly responsible for MedicGLP nearly every aspect of your health. These microbes make up what’s called your "gut microbiota." They are especially influential in determining your likelihood of gaining excessive weight, becoming obese, and developing obesity-related diseases like diabetes, heart disease, and premature death. The gut microbiome (the expressed genes of your gut microbiota) plays a major role in your metabolism through energy production, storage, and expenditure. So, it’s no surprise that science has found a strong connection between gut microbiome imbalance and metabolic syndrome. Yikes! If you have the wrong mix of microbes, it could be making it tough for you to get your health on track! Did you know: Scientists can actually look at your gut microbiome composition and tell with 90% accuracy if you are obese or lean. That’s pretty impressive, isn’t it?

1. Unable to lose weight and keep it off? 2. Struggling to fight cravings? 3. Sick of starving yourself for dietary weight support weight loss? 4. Baffled as to why no diet seems to really work for you? Depending on the composition of your gut microbiome, your microbes can either boost your health or weigh you down (figuratively and literally). The good news is this: You have control over these little guys with every bite you eat. Diet has the power to change the landscape of your gut microbiome. So, if you’ve tried multiple diets and can’t seem to get the results you want, it’s time to look into your gut microbiome.Will You Lose Weight Naturally on an Individualized Diet? If you’ve been struggling to lose weight and keep it off - it could be your gut microbiome. While Viome doesn’t guarantee weight loss, it has been an exciting result many of our customers have reported. "Fiona’s update day 37!