Cardiovascular risk in diabetes can be reduced using hormones, claims study

e363d334-2094-4d09-a3e6-3fd2b440b877articleimage.jpg

04 Dec 2017 --- Scientists at Joslin Diabetes Center in the US have taken another step toward solving a long-standing puzzle about heart health in Type 2 diabetes, with a finding that eventually may point towards more personalized patient care. Genetic analysis has linked the hormone known as glucagon-like peptide 1 (GLP-1) with cardiovascular mortality risks.

People with Type 2 diabetes, who are at least twice as likely to develop cardiovascular disease (CVD) as people without the condition, can generally reduce their risks by carefully controlling their glycemic (blood glucose) levels.

However, back in 2008, the ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial made a paradoxical finding, says Alessandro Doria, M.D., Ph.D., M.P.H., a senior investigator in Joslin's Section on Genetics and Epidemiology. Among people with diabetes and high risk of CVD, it found that those who achieved extremely tight glycemic control showed higher risks of fatal heart attacks than those who did not, he says.

Last year, Doria and his colleagues made progress toward explaining this surprising discovery by identifying two genetic variants associated with a threefold increase in CVD specifically among patients in ACCORD who underwent intensive glycemic control.

GLP-1 holds key to genetic markers
Now in a paper published in Diabetes Care, the Joslin team has linked one of these genetic markers with levels of the hormone GLP-1, says Doria, senior author on the paper and an Associate Professor of Medicine at Harvard Medical School.

ACCORD participants who carried the variant associated with increased cardiovascular mortality showed a significant drop in fasting levels of GLP-1 during 12 months of intensive glycemic control, he says. GLP-1 levels were instead stable or increased among patients who did not carry that variant.

The Joslin team began its analysis by measuring 65 biomarker molecules in the blood among 351 people in ACCORD. The researchers then looked for an association between these biomarkers and the previously discovered genetic variants for CVD in the two arms of the study – one arm with intense glycemic control and the other arm with standard glycemic control. 

The most common measurement for glycemic control is a “hemoglobin A1C” or HbA1C test, which reflects average blood glucose levels over several months. Those in the trial's intensive-control group sought to reduce their HbA1C levels below 6 percent, while those following standard guidelines aimed for HbA1C levels below 8 percent.

While the link between higher risks of fatal heart attacks and lower GLP-1 levels after 12 months of intensive glycemic control was unexpected, it fitted in with what is known about the hormone.

“GLP-1 is produced by intestinal cells, and its main action is to stimulate insulin secretion from beta cells, but the hormone also has a beneficial effect on the heart and blood vessels that is independent from its action on insulin secretion,” says Doria.

The US Food & Drug Administration has approved several GLP-1 “agonist” drugs (injectable GLP-1-like molecules) for people with Type 2 diabetes, Doria says. In addition to lowering blood glucose, these drugs have been shown to improve cardiovascular health of diabetic patients. An earlier class of drugs known as DPP4 inhibitors, given orally, aims to provide similar effects by preserving the hormone in the bloodstream.

If the latest Joslin study is confirmed by other research, it will suggest that people with diabetes eventually might be tested for the genetic risk marker associated with lower GLP-1 levels. This testing could be done relatively inexpensively, Doria says, and patients who carry this marker might be particularly good candidates for using GLP-1 drugs to improve their glycemic control.

Doria and his co-workers will follow up on their work with experiments in cells that help them understand how the genetic variant affects GLP-1 production.

Additionally, the scientists will analyze other ACCORD data to pursue other methods that might help to personalize heart health in Type 2 diabetes. “The trial itself was concluded in 2009, but researchers continue to mine its data, which shows the deep benefits of carefully collected data sets and samples,” Doria says.

To contact our editorial team please email us at editorial@cnsmedia.com

Related Articles

Nutrition & Health News

Weekly Digest: Valensa's Saw Palmetto gains sustainable logo

18 May 2018 --- The past week saw Valensa International gain sustainable recognition with the Fresh from Florida logo for their Saw Palmetto product, as well as USP’s (United States Pharmacopeia) Dietary Supplement Verification Program nabbing the top spot for reliability as determined by pharmacists in a survey conducted by the Pharmacy Times. Furthermore, in clinical news, omega 3 and omega 6 were found to aid the regulation of blood glucose levels in rats. The findings open up the potential for the use of supplements in type 2 diabetes regulation.

Nutrition & Health News

Glanbia targets modern lifestyle demands with new performance nutrition ingredients 

17 May 2018 --- Glanbia Nutritionals has launched two new performance nutrition ingredients for formulation in functional beverages in Europe, the Middle East and Africa. Ignitor and WheyXR were developed to enhance amino acid release, allowing manufacturers to maximize the health benefits of protein supplementation. Both ingredients target the ever-expanding market for sports nutrition options and were included in its range of prototypes at this year’s Vitafoods Europe 2018, which showcased Glanbia’s portfolio and applications expertise.

Nutrition & Health News

Calories from sugar-sweetened drinks deemed most harmful, review finds

16 May 2018 --- A group of scientists have agreed that sugar-sweetened beverages play a unique role in chronic health problems, elevating their calorie status to more harmful than calories from other foods and drinks. The conclusions come from a position paper, published in Obesity Review, compiled by a group of researchers. Also highlighted in the paper was the overall difficulty in conducting and interpreting nutritional research. 

Nutrition & Health News

Major players support WHO call for global elimination of trans fats by 2023

15 May 2018 --- The International Food and Beverage Alliance (IFBA), which brings together 12 leading food and beverage companies, has agreed to help contribute to the WHO goal of eliminating industrially produced trans fats from the global food supply by 2023. The move comes just one month before the June 18th total US ban on trans fats in products. It is encased within a six-step guide called Replace and calls for strong public-private cooperation and product reformulation with the public health in mind.

Nutrition & Health News

Coffee consumption while pregnant linked to increase in overweight children

14 May 2018 --- Even moderate coffee consumption during pregnancy, one to two cups per day, is related to a risk of overweight or obesity in school-age children, according to a study published in the BMJ Open journal. It has not been clearly shown if caffeine is the direct cause of the overweight, but the relationship, alone, has caused researchers to encourage increased caution.

More Articles
URL : http://www.nutritioninsight.com:80/news/cardiovascular-risk-in-diabetes-can-be-reduced-using-hormones-claims-study.html