Cardiovascular endocrinology最新文献

Pheochromocytoma and paraganglioma are catecholamine-secreting tumours associated with major haemodynamic upheavals. The cardiovascular and other organ-related morbidity and even mortality has been ascribed to the major haemodynamic effects of these tumours. Many factors affect the nature and intensity of these haemodynamic changes. The rarity of these tumours as well as their extremely varied clinical presentation preclude conduct of randomized-controlled trials that may provide evidence in terms of these factors and the ways to predict and control them. Many retrospective studies and case reports, however, do provide some insight into their haemodynamic behaviour. Factors such as tumour pathology, associated genetic syndromes, anatomical attributes and perioperative drug therapy affect the haemodynamics of patients with these unique tumours. Knowledge of these factors and their presumed and known association with haemodynamic behaviour of the patients is important during the perioperative care of these patients. The review focuses on the tumour-related, patient-related and the perioperative care-related factors that affect the haemodynamic behaviour of these patients during the surgical removal of these tumours.

Introduction: Type 2 diabetes represents a major problem in many societies. Early detection and, even better, prevention could help to reduce the burden of the disease. Therefore, increased awareness of disorders of glucose metabolism is important. During the campaign 'Knowing what Matters in diabetes: Healthier below 7', in the last few years, more than 31 000 shopping mall visitors in Germany were voluntarily checked for their potential diabetes risk.

Methods: With a modified FINDRISK questionnaire, demographic, anthropometric and anamnestic data relevant for the estimation of the potential diabetes risk were collected. In addition, medical data such as plasma glucose, blood pressure (BP), BMI and waist circumference were obtained. Furthermore, lifestyle habits were documented. Hemoglobin (Hb)A_1c was assessed randomly in a subgroup of individuals (n=4133). In total, data from 26 522 valid questionnaires were collected and evaluated over 10 years (2005-2014) from 45 single locations throughout Germany. Results from participants with manifest diabetes have already been published in this journal. Here, we report on the results from participants without a previous history of diabetes mellitus.

Results: Among the 26 522 participants with a completed questionnaire, 21 055 (79.4%) participants did not have a previous history of diabetes. Characteristic risk factors for diabetes were common in this group. With about 17% being obese and 40% being overweight, more than half of these individuals were thus beyond the normal BMI range. In addition, waist circumference exceeded common thresholds in 44% of the participants. As expected, many of them followed an unhealthy lifestyle as 35% reported no regular physical activity and 20% reported an unhealthy diet. The mean BP was 141/85 mmHg. More than half (51%) half of the patients in the nondiabetic group had a systolic BP above 140 mmHg, but only one-third (35%) reported concomitant treatment with antihypertensives. In the questionnaire, 14% of the participants had a FINDRISK sum score of 15 points and above, indicating a moderate or high risk of potentially developing type 2 diabetes within 10 years. Surprisingly, in the subgroup with HbA_1c measurements (n=4133), 18.5% of the participants without a diagnosis or a history of diabetes were found to have an HbA_1c value of at least 6.5% indicating manifest, previously undetected type 2 diabetes.

Conclusion: The data collected in individuals without a known history of diabetes indicate a considerable prevalence of typical risk factors associated with diabetes. In addition, the data confirmed that screening of apparently healthy individuals consistently shows a significant proportion of individuals with previously undetected type 2 diabetes which, in the subgroup, was surprisingly high. As there is convincing evidence for the bene

As one of the leading causes of death in the USA, diabetes mellitus (DM) has become an epidemic over the past few decades. Despite the high prevalence of diagnosed DM, close to half of all people with DM are unaware of their disease. The risk of type 2 DM is determined by interplay of genetic and metabolic factors. Patients with type 2 DM have a higher risk of death from cardiovascular causes compared with their nondiabetic counterparts, and the mortality rate of DM associated cardiovascular disease is different among ethnicity groups and sex groups. Because of its adverse effect on people's health, DM also imposes an economic burden on individuals and households affected, as well as on the healthcare system. Current guidelines for cardiovascular disease prevention have focused on lifestyle management, blood pressure control, lipid control, blood glucose control, antiplatelet agent use, and tobacco use cessation.