Year: 2018
Type: article
Abstract: Notes from the world congress on insulin resistance, diabetes, and cardiovascular diseaseThe 16th annual World Congress on Insulin Resistance, Diabetes, and Cardiovascular disease (WCIRDC) was held in Los Angeles, California, on November 29-December 1, 2018.It is fascinating that this topic has remained so important to our understanding and of the development of cardiometabolic conditions and to new therapeutic approaches.The Congress addressed a wide spectrum of conditions related to insulin resistance and new understandings of obesity: fat cells, diabetes, circadian related pathology, cardiovascular (CV), renal, and hepatic disease.This year the Congress honored and celebrated the science and life of its co-founder, Professor Gerald Reaven from Stanford University, who recently passed away.Ronald Krauss, Oakland, CA reviewed new concepts of the relationship between diet and cardiovascular disease and dyslipidemia.He pointed out that population-based dietary studies are flawed by inaccuracies of recall, as well as by the challenge of incomplete ascertainment of confounders and covariates.Furthermore, simplistic attribution of changes in outcome to variations in one nutrient must take into account corresponding increases and decreases in others.Nevertheless, many studies now strongly suggest that dietary saturated fats (SFA) are not causally related to CVD. 1 However, SFA from meat is associated with higher and from dairy with lower CVD risk, 2,3 suggesting additional mediators such as trimethylamine N-oxide, a byproduct of the microbiome in response to red meat.4 High intake of simple carbohydrates (CHO) appeared to be most strongly associated with mortality, most strongly shown in the PURE study, in which 135 335 persons from 18 countries were compared.In this study, both SFA and unsaturated fat intake were associated with lower mortality.Furthermore, higher dietary CHO were associated with lower LDL and HDL cholesterol and apolipoproteins B and A1, with the apoB/apoA1 ratio appearing to be a somewhat better predictor, decreasing with higher dietary SFA. 5 A number of other studies suggest this ratio to be an important CVD risk marker, 6 one which is associated with higher levels of small, dense LDL particles, 7 which reflect lower insulin sensitivity.Insulin resistance is associated with higher levels of inflammatory mediators such as C-reactive protein (CRP).
Source: Journal of Diabetes
Authors: Zachary Bloomgarden, Yehuda Handelsman
Institution: Icahn School of Medicine at Mount Sinai
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2905550407