Effect of Anti-Obesity Drug on Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

BACKGROUND: Anti-obesity drugs are widely used to prevent the complications of obesity, however, the effects of anti-obesity drugs on cardiovascular risk factors are unclear at the present time. We carried out a comprehensively systematic review and meta-analysis to assess the effects of anti-obesity drugs on cardiovascular risk factors. METHODOLOGY AND PRINCIPAL FINDINGS: We systematically searched Medline, EmBase, the Cochrane Central Register of Controlled Trials, reference lists of articles and proceedings of major meetings for relevant literatures. We included randomized placebo-controlled trials that reported the effects of anti-obesity drugs on cardiovascular risk factors compared to placebo. Overall, orlistat produced a reduction of 2.39 kg (95%CI-3.34 to -1.45) for weight, a reduction of 0.27 mmol/L (95%CI: -0.36 to -0.17) for total cholesterol, a reduction of 0.21 mmol/L (95%CI: -0.30 to -0.12) for LDL, a reduction of 0.12 mmol/L (95%CI: -0.20 to -0.04) for fasting glucose, 1.85 mmHg reduction (95%CI: -3.30 to -0.40) for SBP, and a reduction of 1.49 mmHg (95%CI: -2.39 to -0.58) for DBP. Sibutramine only showed effects on weight loss and triglycerides reduction with statistical significances. Rimonabant was associated with statistically significant effects on weight loss, SBP reduction and DBP reduction. No other significantly different effects were identified between anti-obesity therapy and placebo. CONCLUSION/SIGNIFICANCE: We identified that anti-obesity therapy was associated with a decrease of weight regardless of the type of the drug. Orlistat and rimonabant could lead to an improvement on cardiovascular risk factors. However, Sibutramine may have a direct effect on cardiovascular risk factors

Co-occurrence of diabetes and hopelessness predicts adverse prognosis following percutaneous coronary intervention

We examined the impact of co-occurring diabetes and hopelessness on 3-year prognosis in percutaneous coronary intervention patients. Consecutive patients (n = 534) treated with the paclitaxel-eluting stent completed a set of questionnaires at baseline and were followed up for 3-year adverse clinical events. The incidence of 3-year death/non-fatal myocardial infarction was 3.5% in patients with no risk factors (neither hopelessness nor diabetes), 8.2% in patients with diabetes, 11.2% in patients with high hopelessness, and 15.9% in patients with both factors (p = 0.001). Patients with hopelessness (HR: 3.28; 95% CI: 1.49-7.23) and co-occurring diabetes and hopelessness (HR: 4.89; 95% CI: 1.86-12.85) were at increased risk of 3-year adverse clinical events compared to patients with no risk factors, whereas patients with diabetes were at a clinically relevant but not statistically significant risk (HR: 2.40; 95% CI: 0.82-7.01). These results remained, adjusting for baseline characteristics an

Veterans' views on military tobacco use and tobacco control policy.

National military and veteran service organizations (MVSOs) have the potential to be advocates for stronger military tobacco control. This study consisted of qualitative analysis of interviews with 5 MVSO leaders (or their designees) and 6 focus groups conducted with veterans, to explore the opinions of MVSO leaders and veterans about military tobacco use and tobacco control policy, and to assess their current knowledge, attitudes, and likelihood of engaging with civilian tobacco control. Themes discussed include the impact of tobacco use on the military mission and on veterans; the possibility of stronger military tobacco control policies; and the idea that such policies would affect the rights of military personnel. Participants considered whether tobacco use impacts the military mission in the most literal sense (e.g., giving away patrol locations), ignoring larger scale effects on long term health and costs. While familiar with tobacco's impacts on veterans' health, MVSO leaders did not endorse stronger policies, although some veterans did. Participants were largely unaware of the impact of tobacco use on military readiness. Establishment of better alliances among MVSOs and civilian public health groups for mutual education about tobacco's many negative effects on the military's mission may be necessary to achieve a tobacco-free military

DO SLEEP AND PHYSCIAL ACTIVITY PREDICT SOLDIERS’ UPPER/LOWER BODY STRENGTH AND ENDURANCE PERFORMANCE?

Elizabeth L. Rogers1, Cassandra M. Beattie1, Katie M. Heinrich1, FACSM, Chunki Fong2, Christopher K. Haddock3, Walker S. C. Poston3 1Kansas State University, Manhattan, Kansas; 2The City University of New York, New York, New York; 3NDRI-USA, Leawood, Kansas Peak performance depends on adequate sleep, yet only 37% of Army soldiers achieve the recommended 7-9 hours/night. Physical activity (PA) is associated with improved muscle strength and endurance; muscle strength correlates strongly with vigorous PA. Males are more likely to meet vigorous PA guidelines (31.6%), compared to females (26.0%). PURPOSE: This study aimed to identify if min/week of vigorous aerobic PA and strength training, sleep, and sex predicted soldiers’ fitness performance (i.e., 1-rep max deadlift, pull-up, horizontal jump, and dummy drag). We hypothesized that male sex and greater levels of sleep, vigorous PA, and strength training will predict better performance. METHODS: Data were from a 5-year cluster-randomized controlled trial. Participants (N = 119, 77.3% male) were active-duty military, National Guard, and Reserves personnel recruited to participate in 6-months of fitness training. At baseline, participants completed an online survey collecting moderate-vigorous aerobic PA min/week, strength training min/week, and accumulated hours of sleep/night. A 1-rep max deadlift, pull-ups, horizontal jump, and dummy drag test were also completed. Multiple linear regression analyses examined significant predictors for each fitness test. RESULTS: Vigorous PA and sleep were not significant predictors for any baseline measure. Over half the variance for deadlift weight (R2 = 0.544) was significantly predicted by strength training min/week (β = 0.276, p = 0.001) and sex (male; β = 0.640, p \u3c 0.001). Pull-ups (R2 = 0.435) were significantly predicted by strength training min/week (β = 0.201, p = 0.024) and sex (male; β = 0.514, p \u3c 0.001). Horizontal jump distance (R2 = 0.359) was significantly predicted by strength training min/week (β = 0.279, p = 0.003) and sex (male; β = 0.527, p \u3c 0.001). Dummy drag time (R2 = 0.478) was significantly predicted by sex (male; β = -0.651, p \u3c 0.001). CONCLUSION: Strength training and male sex were the best predictors for the fitness tests. Army policy surrounding physical fitness should consider prioritizing strength training more to improve performance in these fitness domains. Future research should examine changes in sleep and PA over time to determine how changes in each influence changes in fitness performance. ACKNOWLEDGEMENTS: This study was supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases awarded to Dr. Heinrich and Dr. Poston (R01DK099516)