Association between serum keptin concentrations and insulin resistance: A population-based study from China

BACKGROUND Insulin resistance contributes to the cardio-metabolic risk. The effect of leptin in obese and overweight population on insulin resistance was seldom reported. METHODS A total of 1234 subjects (572 men and 662 women) aged ≥18 y was sampled by the procedure. Adiposity measures included BMI, waist circumference, hip circumference, WHR, upper arm circumference, triceps skinfold and body fat percentage. Serum leptin concentrations were measured by an ELISA method. The homeostasis model (HOMA-IR) was applied to estimate insulin resistance. RESULTS In men, BMI was the variable which was most strongly correlated with leptin, whereas triceps skinfold was most sensitive for women. More importantly, serum leptin levels among insulin resistant subjects were almost double compared to the subjects who had normal insulin sensitivity at the same level of adiposity in both men and women, after controlling for potential confounders. In addition, HOMA-IR increased significantly across leptin quintiles after adjustment for age, BMI, total energy intake, physical activity and smoking status in both men and women (p for trend <0.0001). CONCLUSIONS There was a significant association between HOMA-IR and serum leptin concentrations in Chinese men and women, independently of adiposity levels. This may suggest that serum leptin concentration is an important predictor of insulin resistance and other metabolic risks irrespective of obesity levels. Furthermore, leptin levels may be used to identify the cardio-metabolic risk in obese and overweight population.Hui Zuo, Zumin Shi, Baojun Yuan, Yue Dai, Gaolin Wu, Akhtar Hussai

Acebutolol and left ventricular function: Assessment by radionuclide angiography

We assessed the effects of acebutolol, a cardioselective beta blocker, on global and regional left ventricular function in 26 patients with chronic angina pectoris. All patients underwent rest and maximal supine bicycle exercise radionuclide angiography while on placebo and oral acebutolol (400 mg three times a day). Resting ejection fraction on placebo was 51 ± 3% and on acebutolol was 54 ± 3% (p \u3c 0.05). No resting ejection fraction decreased ≥ 7%. Only one patient (resting ejection fraction 28% on placebo and 21% on acebutolol) developed signs of fluid retention. Exercise nuclear studies on placebo revealed responses consistent with coronary artery disease (abnormal ejection fraction response to exercise and regional wall motion abnormalities) in 24 of 26 patients. Peak exercise ejection fraction was of the same order on placebo and acebutolol (51 ± 3% and 54 ± 3%, P = NS). In four patients the ejection fraction response to exercise became normal and in five Patients all regional wall motion abnormalities became normal on acebutolol. Cardioselective beta blockade with acebutolol in effective antianginal doses is safe and mar improve resting and exercise ventricular function. © 1981

Effects of acebutolol on chronic stable angina pectoris. A placebo-controlled, double-blind, randomized crossover study

We evaluated the effects of acebutolol, a cardioselective β-adrenergic blocking agent, on the anginal pattern and exercise tolerance in 44 patients with chronic stable angina. There were 43 males and one female, with a mean age of 57 years (range 48-73 years). The study consisted of an initial 4-week, single-blind placebo control phase, followed by a 3-week, single-blind dose-titration phase using increasing doses of acebutolol and by two 5-week double-blind phases that included randomization to acebutolol or placebo and crossover. A 1-week withdrawal schedule followed each treatment phase. All patients kept a diary of anginal frequency and nitroglycerin consumption. Capsule counts of returned medication were made at each visit. Exercise treadmill tests were performed at entry into the study and on the final day of each of the four phases. Acebutolol produced a significant decrease in the frequency of angina attacks, consumption of nitroglycerin and exercise capacity. Resting and peak exercise values were significantly reduced. Heart rates were reduced by 16% and 18%, respectively (p \u3c 0.002) and rate-pressure products by 17% and 30%, respectively (p \u3c 0.002). At effective antianginal dosages, acebutolol had no significant adverse effects on pulmonary functions. No clinical side effects of acebutolol necessitated drug discontinuance. Acebutolol is a well-tolerated β-blocking drug that significantly reduces spontaneous anginal frequency, decreases consumption of nitroglycerin and increases exercise capacity in patients with chronic stable angina. It is a useful therapeutic addition to the group of β-adrenergic blocking agents. Further, its lack of deleterious effects on the bronchial smooth muscle suggest that acebutolol may be safely used in patients in whom angina is associated with obstructive pulmonary disease

Pulmonary effects of acebutolol, a \u27cardioselective\u27 beta adrenergic blocking agent

The effect of chronic oral therapy with acebutolol, a cardioselective beta adrenergic blocking agent, was evaluated on resting pulmonary functions in a group of patients who were free of overt obstructive airways disease and who had chronic stable angina pectoris. The study design involved a 20-week, placebo-controlled, double-blind, randomized cross-over trial, using acebutolol, an agent with partial agonist activity that has been shown to be effective in the treatment of hypertension, cardiac arrhythmias, and angina pectoris. Utilizing spirometry, flow volume loops, and arterial blood gas analyses, this study demonstrated that acebutolol had no significant deleterious effect on resting pulmonary function when used in clinically effective dosages

Cardiovascular disease prevention and management in the COVID-19 era and beyond: An international perspective.

Despite some indicators of a localized curtailing of cardiovascular disease (CVD) prevalence, CVD remains one of the largest contributors to global morbidity and mortality. While the magnitude and impact of the coronavirus disease 2019 (COVID-19) pandemic have yet to be realized in its entirety, an unquestionable impact on global health and well-being is already clear. At a time when the global state of CVD is perilous, we provide a continental overview of prevalence data and initiatives that have positively influenced CVD outcomes. What is clear is that despite attempts to address the global burden of CVD, there remains a lack of collective thinking and approaches. Moving forward, a coordinated global infrastructure that, if developed with appropriate and relevant key stakeholders, could provide significant and longstanding benefits to public health and yield prominent and consistent policy resulting in impactful change. To achieve global impact, research priorities that address multi-disciplinary social, environmental, and clinical perspectives must be underpinned by unified approaches that maximize public health