Cardiometabolic Chronicle

The Spectrum of Cardiovascular Prevention: Obesity Paradox, Physical Activity, Sedentary Behaviors and Emerging Therapeutics in Type 2 Diabetes Mellitus

August 3, 2021
Tags: Clinical Conversations

A conversation with Salvatore Carbone, PhD, Assistant Professor at the Department of Kinesiology & Health Sciences, College of Humanities & Sciences at the Virginia Commonwealth University in Richmond, VA.

CARDIOMETABOLIC CHRONICLE: An interesting concept that has been proposed is the “obesity paradox,” a view that obesity confers some sort of protection for adverse CV events. Can you comment on what is the basis for this and whether it is a real phenomenon?

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REFERENCES:

1. Ortega, Francisco B., Carl J. Lavie, and Steven N. Blair. “Obesity and cardiovascular disease.” Circulation Research 118.11 (2016): 1752-1770.
2. Carbone, Salvatore, et al. “Obesity paradox in cardiovascular disease: where do we stand?.” Vascular Health and Risk Management 15 (2019): 89 - 100.
3. Carbone, Salvatore, Carl J. Lavie, and Ross Arena. “Obesity and heart failure: focus on the obesity paradox.” Mayo Clinic Proceedings 92.2 (2017): 266 – 279.
4. Horwich, Tamara B., et al. “The relationship between obesity and mortality in patients with heart failure.” Journal of the American College of Cardiology 38.3 (2001): 789-795.
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7. Lavie, Carl J., et al. “Healthy weight and obesity prevention: JACC Health Promotion Series.” Journal of the American College of Cardiology 72.13 (2018): 1506 - 1531.
8. Carbone, Salvatore, et al. “Obesity, body composition and cardiorespiratory fitness in heart failure with preserved ejection fraction.” Future Cardiology 13.5 (2017): 451-463.
9. Carbone, Salvatore, et al. “Lean mass abnormalities in heart failure: the role of sarcopenia, sarcopenic obesity and cachexia.” Current Problems in Cardiology (2019).
10. Ortega, Francisco B., et al. “Body mass index, the most widely used but also widely criticized index: would a criterion standard measure of total body fat be a better predictor of cardiovascular disease mortality?.” Mayo Clinic Proceedings. 91.4 (2016): 443 - 455.
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14. Lavie, Carl J., et al. “Sedentary behavior, exercise, and cardiovascular health.” Circulation Research 124.5 (2019): 799-815.
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17. UK Prospective Diabetes Study (UKPDS) Group. “Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33).” The Lancet 352.9131 (1998): 837-853.
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21. Perkovic, Vlado, et al. “Canagliflozin and renal outcomes in type 2 diabetes and nephropathy.” New England Journal of Medicine 380.24 (2019): 2295-2306.
22. Marso, Steven P., et al. “Liraglutide and cardiovascular outcomes in type 2 diabetes.” New England Journal of Medicine 375.4 (2016): 311-322.
23. Marso, Steven P., et al. “Semaglutide and cardiovascular outcomes in patients with type 2 diabetes.” New England Journal of Medicine 375.19 (2016): 1834-1844.
24. Hernandez, Adrian F., et al. “Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial.” The Lancet 392.10157 (2018): 1519-1529.
25. American Diabetes Association. “9. Pharmacologic approaches to glycemic treatment: standards of medical care in diabetes—2019.” Diabetes Care 42.Supplement 1 (2019): S90-S102.
26. Carbone, Salvatore, et al. “Glucose-lowering therapies for cardiovascular risk reduction in type 2 diabetes mellitus: State-of-the-Art Review.” Mayo Clinic Proceedings 93.18 (2018): 1629 – 1647.