Editorial: Rising stars in cardiovascular endocrinology 2022

COPYRIGHT © 2023 Lorenzo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. TYPE Editorial PUBLISHED 13 March 2023 DOI 10.3389/fendo.2023.1175403

unique studies identified, 20 studies met the inclusion criteria. After risk ratio adjustment, associations between diabetes and all-cause mortality in both males and females were attenuated but still significantly elevated for short-term, mid-term, and long-term mortality. Thus, diabetes has substantial and sustained effects on post-AMI all-cause mortality regardless of sex. These results demonstrate the need to tailor in-hospital and post-discharge care plans for patients with AMI based on their diabetes status, discharge duration, and sex. Identifying individuals with undiagnosed diabetes and preventing its development will impact AMI prognosis. On the other hand, an interesting strategy to attenuate CVD in diabetic and obese patients may include the glucagon-like protein (GLP-1) receptor agonists (GLP-1RA) (6). However, the impact of GLP-1RA on patients with heart failure has not been fully described. In an observational study, Peŕez-Belmonte et al. enrolled 136 outpatients with type 2 diabetes, obesity, and heart failure, who started once weekly semaglutide and were followed up for 3-12 months. From the baseline to 12 months, there was a significant improvement on the Kansas City Cardiomyopathy Questionnaire total symptom score and a reduction in the proportion of patients with New York Heart Association functional class III, and in N-terminal pro-brain natriuretic peptide levels. Moreover, emergency department visits, hospitalizations due to heart failure, and all-cause hospitalizations declined together with glycated hemoglobin and body weight. This manuscript proposes a proof of concept for new randomized clinical trials with GLP-1RA to provide more evidence on the efficacy and safety of these drugs in patients with HF. In line with this, endurance of physical exercise can be also suggested to attenuate CVD in diabetes (7). Interestingly, the effects of exercise on glucose and blood lipid levels at different times of the day may differ. Kim et al. investigated the effects of short-term endurance exercise intervention (60-min walking on a treadmill at approximately 60% of maximal oxygen uptake) in the morning (09:00-11:00) or in the late afternoon (16:00-18:00) on 24-h blood glucose and lipid levels. Significantly lower values of glucose, triglycerides (TG), and TG/high-density lipoprotein cholesterol (HDL-C) were found for the late-afternoon exercise versus that in the morning session, before or after corresponding meals. Therefore, late-afternoon endurance exercise is more effective than morning exercise at improving 24-h plasma glucose and triglyceride levels. This approach could help pharmacological strategies (i.e., GLP1RA) for CVD in diabetes.
Cardiorespiratory fitness is associated with a cardioprotective metabolite profile. In adults, cardiorespiratory fitness has been directly associated with circulating and muscle lipidome composition and inversely associated with cardiovascular risk (8). In this sense, Haapala et al. investigated the cross-sectional association of cardiorespiratory fitness with serum nuclear magnetic resonance-derived metabolic biomarkers (PANIC study) in 450 children. Cardiorespiratory fitness was directly associated with HDL-C, the average HDL particle diameter, and the concentrations of extra-large HDL particles, large HDL particles, and medium HDL particles after adjustment for age and sex. Higher cardiorespiratory fitness was also associated with higher concentrations of ApoA1, glutamine, and phenylalanine. After further adjustment for body fat, they still found direct associations of HDL-C concentrations, medium HDL particles, ApoA1, glutamine, and phenylalanine with cardiorespiratory fitness. Thus, higher cardiorespiratory fitness was associated with a HDL-C profile in children, mostly in an adiposity-independent manner. It will be of great interest to explore whether HDL-C particles could mediate the cardioprotective effects of cardiorespiratory fitness against CVD since childhood.

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