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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EIt is now well established that cardiovascular disease is the most common cause of death among diabetics, and that diabetes is an independent risk factor for cardiovascular events. The effect of diabetes on the heart however, is not limited to the vasculature and can extend to the myocardium as well as in the form of diabetic cardiomyopathy. The associations between diabetes and damage to the heart and vascular system are not fully understood.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Ediabetes mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Einflammatory disease\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EIt is now well established that cardiovascular disease is the most common cause of death among diabetics, and that diabetes is an independent risk factor for cardiovascular events. The effect of diabetes on the heart however, is not limited to the vasculature and can extend to the myocardium as well as in the form of diabetic cardiomyopathy. The associations between diabetes and damage to the heart and vascular system are not fully understood.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-2\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003EDiabetic Cardiomyopathy\u003C\/h2\u003E\n         \u003Cp id=\u0022p-3\u0022\u003E\u201cDoes \u2018diabetic cardiomyopathy\u2019 really exist?\u201d asked Paul Poirier, MD, Hospital Laval, Quebec. Based on clinical and experimental lines of evidence, the answer is \u201cyes.\u201d Sustained diabetes leads to deterioration of cardiac function independent of macro-and microvascular disease. \u201cBecause heart disease is the major cause of mortality in patients with diabetes, early detection of altered cardiac function is important to improve medical interventions and outcomes,\u201d he emphasized.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EIdiopathic cardiomyopathy is 9 times more frequent among diabetics than among non-diabetic subjects, according to a case control study of 500,000 hospitalized patients [Bertoni AG et al. \u003Cem\u003EDiabetes Care\u003C\/em\u003E 2003]. It occurs in both type 1 and type 2 diabetes, and appears to be related to glycosylated hemoglobin. One study found that for each 1% increase in HbA1c levels, there was an 8% increase in the incidence of heart failure [Iribarren C et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2001] (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). Independent risk factors for heart failure included increased age, longer duration of diabetes, use of insulin, and increased body weight.\u003C\/p\u003E\n         \u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/6\/13\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Diabetes and Heart Failure.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1747040681\u0022 data-figure-caption=\u0022Diabetes and Heart Failure.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/6\/13\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/6\/13\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/6\/13\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11274\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-5\u0022 class=\u0022first-child\u0022\u003EDiabetes and Heart Failure.\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-6\u0022\u003E\u201cBut diabetic cardiomyopathy is an ill-defined entity,\u201d Prof. Poirier continued. Clinically, diabetic cardiomyopathy cannot be distinguished from other forms of heart failure in diabetic patients. The scenario of diabetic cardiomyopathy includes early impairment of diastolic function (possibly the earliest clinical sign), subclinical abnormal cardiac metabolism, and cardiac autonomic neuropathy. \u201cEarly on, the preclinical manifestations may not seem significant in daily life,\u201d he said. With further injury to the abnormal myocardium, systolic dysfunction occurs years later (\u003Ca id=\u0022xref-fig-2-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F2\u0022\u003EFigure 2\u003C\/a\u003E).\u003C\/p\u003E\n         \u003Cdiv id=\u0022F2\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/6\/13\/F2.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Diabetic Cardiomyopathy.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1747040681\u0022 data-figure-caption=\u0022Diabetic Cardiomyopathy.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 2.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/6\/13\/F2.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/6\/13\/F2.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 2.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/6\/13\/F2.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/10823\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 2.\u003C\/span\u003E \n               \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003EDiabetic Cardiomyopathy.\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EThe worse the diastolic dysfunction, the lower the energy efficiency of the heart. Patients with diabetic cardiomyopathy have elevated heart rates and reduced exercise capacity These characteristics can be utilized in screening and diagnosis, he said. In addition, Dr. Poirier also performs ECG, chest radiography and echocardiography, and measures brain natriuretic peptide and microalbuminuria, which are markers of worse prognosis.\u003C\/p\u003E\n         \u003Cp id=\u0022p-9\u0022\u003EFor treatment, he aims for strong control of blood pressure, dyslipdemia, and glycemia. Neurohumoral inhibition with ACE inhibitors, beta-blockers, and aldosterone blockers is desirable. He has found that exercise may help normalize diastolic dysfunction, \u201cbut the ideal treatment is prevention,\u201d he concluded.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-3\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003EExperiments Explore the Link Between Diabetes and Cardiomyopathy\u003C\/h2\u003E\n         \u003Cp id=\u0022p-10\u0022\u003EThe causes of diabetic cardiomyopathy are being explored through animal models and, according to Jun Ren, PhD, University of Wyoming, Laramie, Wyoming, United States, oxidative stress may be particularly important. Oxidative stress results from an imbalance between the production and the breakdown of reactive oxygen species. It may occur as a result of hyperglycemia, inflammatory responses, or dyslipidemia. In animal models, Dr. Ren has shown that antioxidants can reverse both morphological and functional abnormalities in diabetic hearts, although antioxidant supplementation in humans has not shown a consistent benefit.\u003C\/p\u003E\n         \u003Cp id=\u0022p-11\u0022\u003EGlycogen synthase kinase 3 (GSK3) may also be important in the pathogenesis of cardiomyopathy. GSK3 is a highly conserved and ubiquitously expressed serine\/threonine kinase that has been linked to the regulation of glycogen metabolism and cardiac growth. GSK3\u03b2 (the most abundant GSK3 in the heart) is overactive in diabetes and insulin-resistant states. Chronic GSK3\u03b2 overactivity may be detrimental as it may aggravate insulin resistance, induce apoptosis, impair SERA2a\/cardiac calcium handling, and interfere with prohypertrophic pathways, said Professor Ronald Vlasboom, VU University Medical Center, Amsterdam, the Netherlands.\u003C\/p\u003E\n         \u003Cp id=\u0022p-12\u0022\u003EThe plethora of substrates and signaling cascades impacted by GSK3\u03b2 renders this kinase a potential therapeutic target (\u003Ca id=\u0022xref-fig-3-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F3\u0022\u003EFigure 3\u003C\/a\u003E). Selective inhibition of GSK3\u03b2 in animal studies with experimental compounds improved both metabolic and cardiac function, he noted.\u003C\/p\u003E\n         \u003Cdiv id=\u0022F3\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/6\/13\/F3.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Cardiac Hypertrophy: Therapeutic Interventions for antihypertrophic strategies.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1747040681\u0022 data-figure-caption=\u0022Cardiac Hypertrophy: Therapeutic Interventions for antihypertrophic strategies.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 3.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/6\/13\/F3.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/6\/13\/F3.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 3.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/6\/13\/F3.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/10824\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 3.\u003C\/span\u003E \n               \u003Cp id=\u0022p-13\u0022 class=\u0022first-child\u0022\u003ECardiac Hypertrophy: Therapeutic Interventions for antihypertrophic strategies.\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-14\u0022\u003EAbnormalities in cardiac energy metabolism\u2014in particular, excessive fatty acid metabolism, diminished carbohydrate utilization, and lipotoxicity\u2014may also be part of the pathogenesis, according to Brian Finck, PhD, Washington University School of Medicine, St. Louis, Missouri, United States. His work has focused on a particular nuclear receptor, the peroxisome proliferator-activated receptor (PPAR\u03b1). PPAR\u03b1, together with PGC-1\u03b1, activates the expression of many genes involved in the uptake, esterification and oxidation of cellular fatty acids and is increased in several mouse models of diabetes.\u003C\/p\u003E\n         \u003Cp id=\u0022p-15\u0022\u003EIn a transgenic mouse model of the cardiometabolic phenotype (it has cardiac-specific overexpression of PPAR\u03b1), Dr. Fink has observed numerous metabolic derangements involving fatty acids and glucose, and an increase in mitochondrial production. These alterations are accompanied by cardiac hypertrophy and ultimately systolic ventricular dysfunction, and they can be exacerbated by a high-fat diet. These findings suggest that abnormalities mediated by PPAR\u03b1 in cardiac energy homeostasis (cardiac fatty acid overload) can be linked to the development of cardiac dysfunction in the diabetic heart.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-4\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003ETrials Explore Clinical Issues of Diabetes-Related Heart Disease\u003C\/h2\u003E\n         \u003Cp id=\u0022p-16\u0022\u003ESome oral antidiabetic drugs are believed to be associated with an increased risk of cardiovascular events, but a large retrospective \u201creal world\u201d registry analysis suggests that they may actually possess protective qualities.\u003C\/p\u003E\n         \u003Cp id=\u0022p-17\u0022\u003EResults from the French Registry on Acute ST-Elevation and Non-ST-Elevation Myocardial Infarction (FAST-MI) showed that combined use of metformin plus a sulfonylurea was associated with improved early and 6-month survival after acute myocardial infarction (AMI). The population included 1,316 diabetic patients admitted for an AMI to 223 French intensive care units over a 2-month period. Diabetic patients were categorized according to their use of oral antidiabetic medications prior to admission.\u003C\/p\u003E\n         \u003Cp id=\u0022p-18\u0022\u003EAfter multivariate adjustments, the best 6-month survival after AMI was found in patients who were admitted while taking both sulfonylureas and metformin. Survival was 95% in this group, compared with 80% in patients who received neither oral agent, for a reduction in risk of 73% (p\u0026lt;0.001). For patients receiving just one agent, survival ranged from 90\u201395% with the sulfonylurea group faring better than those on metformin alone. Five-day mortality was also significantly improved in the combined treatment group: 0.5% versus 6.1% for users of neither drug (p\u0026lt;0.001), reported Marianne Zeller, MD, Centre Hospitalier Universitaire Dijon, France.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-5\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003EImpact of Hypoglycemia During Hospitalization\u003C\/h2\u003E\n         \u003Cp id=\u0022p-19\u0022\u003EHypoglycemia has been associated with adverse outcomes after AMI, but a study based on the Diabetes Mellitus Insulin-Glucose Infusion in Acute Myocardial Infarction2 (DIGAMI 2) database found no association between treatment-induced hypoglycemia and long-term prognosis.\u003C\/p\u003E\n         \u003Cp id=\u0022p-20\u0022\u003EThe DIGAMI 2 population included 1,253 type 2 diabetics from 48 European centers hospitalized for suspected MI. Patients were randomly assigned to treatment with insulin-glucose infusion followed by multi-dose subcutaneous insulin, to insulin-glucose followed by conventional treatment, or to conventional treatment only. After 2 years of follow-up, when researchers adjusted for numerous variables, the occurrence of hypoglycemia during hospitalization (blood glucose \u0026lt;3 mmol\/L) had no significant effect on total mortality, cardiovascular mortality, or the composite of death\/stroke\/reinfarction, reported Linda Melbin, MD, Karolinska Institute, Stockholm, Sweden.\u003C\/p\u003E\n         \u003Cp id=\u0022p-21\u0022\u003EProf. Melbin maintained that the prospective nature and large size of the cohort support the data\u0027s reliability. Her main message was that clinicians should not be afraid to attempt to lower blood glucose during hospitalization.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-6\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003EAdiponectin and Diabetic Complications\u003C\/h2\u003E\n         \u003Cp id=\u0022p-22\u0022\u003ERecent studies have reported a relationship between low adiponectin levels and cardiovascular disease. However, an international study showed that low adiponectin levels do not provide additional predictive value beyond established cardiovascular risk factors.\u003C\/p\u003E\n         \u003Cp id=\u0022p-23\u0022\u003EInvestigators from the Quebec Heart Institute reported the results of a prospective case-control analysis nested in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk cohort. The study population included 1,034 adults who were healthy at baseline but developed coronary artery disease over time matched with 1,919 controls who remained disease-free. Baseline non-fasting plasma adiponectin concentrations were found to be significantly lower in cases than in matched controls (p=0.005) and to increase the risk for future events (p\u0026lt;0.001). However, after adjustment for body mass index, waist circumference and established cardiovascular disease risk factors, these relationships were no longer significant (\u003Ca id=\u0022xref-fig-4-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F4\u0022\u003EFigure 5\u003C\/a\u003E).\u003C\/p\u003E\n         \u003Cdiv id=\u0022F4\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/6\/13\/F4.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Odds Ratio for Future Coronary Artery Disease (Men and Women).\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1747040681\u0022 data-figure-caption=\u0022Odds Ratio for Future Coronary Artery Disease (Men and Women).\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 5.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/6\/13\/F4.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/6\/13\/F4.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 5.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/6\/13\/F4.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/10826\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 5.\u003C\/span\u003E \n               \u003Cp id=\u0022p-24\u0022 class=\u0022first-child\u0022\u003EOdds Ratio for Future Coronary Artery Disease (Men and Women).\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-25\u0022\u003EThe risk of developing coronary artery disease was more closely related to the presence of a high waist circumference and low HDL levels than to low adiponectin levels, reported M\u00e9lanie C\u00f4t\u00e9, MD, Hospital Laval, Quebec, Canada.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-7\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003EImproving Risk Calculations Through Genotyping\u003C\/h2\u003E\n         \u003Cp id=\u0022p-26\u0022\u003ETraditional calculations of cardiovascular risk, such as the Framingham Risk Score, only accurately predict events only in a minority of subjects. Investigators from the United Kingdom evaluated whether a set of common variants in genes previously found related to coronary heart disease risk might enhance the utility of such algorithms. In a multivariate analysis, they found that several genes significantly (p\u0026lt;0.001) improved the predictive utility of such algorithms, including those related to uncoupling protein 2, apolipoprotein E, lipoprotein lipase, and apolipoprotein A4, as well as several genes showing interaction with smoking, interleukin-6 and platelet\/endothelial cell adhesion molecule genotypes. In the future, risk estimates may include not only conventional risk factors but also a panel of selected genotypes concluded Philippa Talmud, PhD, University College London, United Kingdom.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-8\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003ESevere Mental Illness and Type 2 Diabetes\u003C\/h2\u003E\n         \u003Cp id=\u0022p-27\u0022\u003EThe prevalence of diabetes among patients with severe mental illness is 2\u20133 times higher than that for the general population. While this disproportionate risk has largely been attributed to treatment with atypical antipsychotic agents, Stephen Gough, MD, University of Birmingham, UK, said, \u201cI think the link goes well beyond this.\u201d\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2007 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/7\/6\/13.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzm821\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzm821\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}