TY - JOUR A1 - Reichetzeder, Christoph A1 - Chen, Hong A1 - Foeller, Michael A1 - Slowinski, Torsten A1 - Li, Jian A1 - Chen, You-Peng A1 - Lang, Florian A1 - Hocher, Berthold T1 - Maternal vitamin D deficiency and fetal programming - lessons learned from humans and mice JF - Kidney & blood pressure research : official organ of the Gesellschaft für Nephrologie N2 - Background/Aims: Cardiovascular disease partially originates from poor environmental and nutritional conditions in early life. Lack of micronutrients like 25 hydroxy vitamin D-3 (25OHD) during pregnancy may be an important treatable causal factor. The present study explored the effect of maternal 25OHD deficiency on the offspring. Methods: We performed a prospective observational study analyzing the association of maternal 25OHD deficiency during pregnancy with birth outcomes considering confounding. To show that vitamin D deficiency may be causally involved in the observed associations, mice were set on either 25OHD sufficient or insufficient diets before and during pregnancy. Growth, glucose tolerance and mortality was analyzed in the F1 generation. Results: The clinical study showed that severe 25OHD deficiency was associated with low birth weight and low gestational age. ANCOVA models indicated that established confounding factors such as offspring sex, smoking during pregnancy and maternal BMI did not influence the impact of 25OHD on birth weight. However, there was a significant interaction between 25OHD and gestational age. Maternal 25OHD deficiency was also independently associated with low APGAR scores 5 minutes postpartum. The offspring of 25OHD deficient mice grew slower after birth, had an impaired glucose tolerance shortly after birth and an increased mortality during follow-up. Conclusions: Our study demonstrates an association between maternal 25OHD and offspring birth weight. The effect of 25OHD on birth weight seems to be mediated by vitamin D controlling gestational age. Results from an animal experiment suggest that gestational 25OHD insufficiency is causally linked to adverse pregnancy outcomes. Since birth weight and prematurity are associated with an adverse cardiovascular outcome in later life, this study emphasizes the need for novel monitoring and treatment guidelines of vitamin D deficiency during pregnancy. KW - Vitamin D KW - Birth weight KW - Preterm delivery KW - Fetal programming KW - Glucose tolerance KW - Cardiovascular diseases Y1 - 2014 U6 - https://doi.org/10.1159/000355809 SN - 1420-4096 SN - 1423-0143 VL - 39 IS - 4 SP - 315 EP - 329 PB - Karger CY - Basel ER - TY - JOUR A1 - Schulze, Matthias Bernd T1 - Metabolic health in normal-weight and obese individuals JF - Diabetologia : journal of the European Association for the Study of Diabetes (EASD) N2 - Cardiovascular complications are commonly associated with obesity. However, a subgroup of obese individuals may not be at an increased risk for cardiovascular complications; these individuals are said to have metabolically healthy obesity (MHO). In contrast, metabolically unhealthy individuals are at high risk of cardiovascular disease (CVD), irrespective of BMI; thus, this group can include individuals within the normal weight category (BMI 18.5-24.9kg/m(2)). This review provides a summary of prospective studies on MHO and metabolically unhealthy normal-weight (MUHNW) phenotypes. Notably, there is ongoing dispute surrounding the concept of MHO, including the lack of a uniform definition and the potentially transient nature of metabolic health status. This review highlights the relevance of alternative measures of body fatness, specifically measures of fat distribution, for determining MHO and MUHNW. It also highlights alternative approaches of risk stratification, which account for the continuum of risk in relation to CVD, which is observable for most risk factors. Moreover, studies evaluating the transition from metabolically healthy to unhealthy phenotypes and potential determinants for such conversions are discussed. Finally, the review proposes several strategies for the use of epidemiological research to further inform the current debate on metabolic health and its determination across different stages of body fatness. KW - Cardiovascular diseases KW - Cohort studies KW - Metabolically benign KW - Obesity KW - Review Y1 - 0208 U6 - https://doi.org/10.1007/s00125-018-4787-8 SN - 0012-186X SN - 1432-0428 VL - 62 IS - 4 SP - 558 EP - 566 PB - Springer CY - New York ER - TY - GEN A1 - Zoch-Lesniak, Beate A1 - Dobberke, Jeanette A1 - Schlitt, Axel A1 - Bongarth, Christa A1 - Glatz, Johannes A1 - Spörl-Dönch, Sieglinde A1 - Koran, Iryna A1 - Völler, Heinz A1 - Salzwedel, Annett T1 - Performance Measures for Short-Term Cardiac Rehabilitation in Patients of Working Age BT - Results of the Prospective Observational Multicenter Registry OutCaRe T2 - Postprints der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe N2 - Objective: To determine immediate performance measures for short-term, multicomponent cardiac rehabilitation (CR) in clinical routine in patients of working age, taking into account cardiovascular risk factors, physical performance, social medicine, and subjective health parameters and to explore the underlying dimensionality. Design: Prospective observational multicenter register study in 12 rehabilitation centers throughout Germany. Setting: Comprehensive 3-week CR. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 646 KW - Cardiac rehabilitation KW - Outcome measures KW - Cardiovascular diseases Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-473922 SN - 1866-8364 ER - TY - JOUR A1 - Zoch-Lesniak, Beate A1 - Dobberke, Jeanette A1 - Schlitt, Axel A1 - Bongarth, Christa A1 - Glatz, Johannes A1 - Spörl-Dönch, Sieglinde A1 - Koran, Iryna A1 - Völler, Heinz A1 - Salzwedel, Annett T1 - Performance Measures for Short-Term Cardiac Rehabilitation in Patients of Working Age BT - Results of the Prospective Observational Multicenter Registry OutCaRe JF - Archives of Rehabilitation Research and Clinical Translation N2 - Objective: To determine immediate performance measures for short-term, multicomponent cardiac rehabilitation (CR) in clinical routine in patients of working age, taking into account cardiovascular risk factors, physical performance, social medicine, and subjective health parameters and to explore the underlying dimensionality. Design: Prospective observational multicenter register study in 12 rehabilitation centers throughout Germany. Setting: Comprehensive 3-week CR. KW - Cardiac rehabilitation KW - Outcome measures KW - Cardiovascular diseases Y1 - 2019 U6 - https://doi.org/10.1016/j.arrct.2020.100043 SN - 2590-1095 VL - 2 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Schiborn, Catarina A1 - Schulze, Matthias Bernd T1 - Precision prognostics for the development of complications in diabetes JF - Diabetologia : journal of the European Association for the Study of Diabetes (EASD) N2 - Individuals with diabetes face higher risks for macro- and microvascular complications than their non-diabetic counterparts. The concept of precision medicine in diabetes aims to optimise treatment decisions for individual patients to reduce the risk of major diabetic complications, including cardiovascular outcomes, retinopathy, nephropathy, neuropathy and overall mortality. In this context, prognostic models can be used to estimate an individual's risk for relevant complications based on individual risk profiles. This review aims to place the concept of prediction modelling into the context of precision prognostics. As opposed to identification of diabetes subsets, the development of prediction models, including the selection of predictors based on their longitudinal association with the outcome of interest and their discriminatory ability, allows estimation of an individual's absolute risk of complications. As a consequence, such models provide information about potential patient subgroups and their treatment needs. This review provides insight into the methodological issues specifically related to the development and validation of prediction models for diabetes complications. We summarise existing prediction models for macro- and microvascular complications, commonly included predictors, and examples of available validation studies. The review also discusses the potential of non-classical risk markers and omics-based predictors. Finally, it gives insight into the requirements and challenges related to the clinical applications and implementation of developed predictions models to optimise medical decision making. KW - Cardiovascular diseases KW - Complications in diabetes KW - Macrovascular KW - complications KW - Microvascular complications KW - Personalised medicine KW - Precision medicine KW - Precision prognostics KW - Review KW - Risk prediction KW - Risk KW - scores Y1 - 2022 U6 - https://doi.org/10.1007/s00125-022-05731-4 SN - 0012-186X SN - 1432-0428 PB - Springer CY - New York ER - TY - JOUR A1 - Norman, Kristina A1 - Herder, Christian T1 - Sarkopene Adipositas und Inflammation T1 - Sarcopenic obesity and inflammation JF - Der Diabetologe N2 - Hintergrund: Die Kombination aus Übergewicht/Adipositas und reduzierter Skelettmuskelmasse (Sarkopenie) führt zu einem prognostisch ungünstigen Phänotyp, der als sarkopene Adipositas bezeichnet wird. Ziel der Arbeit: Ziel dieser Arbeit ist, eine Übersicht über Diagnosekriterien der sarkopenen Adipositas, ihre klinischen Implikationen, die pathophysiologischen Ursachen mit besonderem Fokus auf der subklinischen Inflammation und den verfügbaren therapeutischen Optionen zu geben. Ergebnisse: In aktuellen Studien werden verschiedene Diagnosekriterien der sarkopenen Adipositas verwendet, was einen Vergleich zwischen den Arbeiten erschwert und in Prävalenzschätzungen von 2–48 % in verschiedenen Studienpopulationen resultiert. Nichtsdestotrotz scheint die sarkopene Adipositas einen Risikofaktor für erhöhte Morbidität und Mortalität darzustellen, wobei kardiometabolische Erkrankungen und funktionelle Einschränkungen am besten erforscht sind. Neben Lebensstil- und genetischen Faktoren werden altersassoziierte endokrine und neuromuskuläre Parameter diskutiert. Sowohl hohes Lebensalter als auch Adipositas führen zu einer subklinischen Inflammation, die über einen fatalen Feedbackmechanismus zum Muskelabbau und zur Zunahme der Fettmasse beiträgt. Hinsichtlich Therapieoptionen stehen derzeit kombinierte Ernährungs- und Bewegungsinterventionen im Vordergrund. Schlussfolgerung: Die sarkopene Adipositas stellt einen klinisch relevanten Phänotyp dar, dessen Pathogenese aber nur z. T. verstanden ist, was Maßnahmen der Prävention und Therapie begrenzt. Neue Strategien zu Muskelaufbau und Fettreduktion sind daher dringend erforderlich, um gesundheitliche Beeinträchtigungen im höheren Lebensalter zu minimieren. N2 - Background: Sarcopenic obesity is defined as the presence of both obesity and reduced skeletal muscle mass and is aphenotype associated with poor outcome. Objective: This short review aims to give an overview on current diagnostic criteria for sarcopenic obesity, its clinical implications and therapeutic options as well as to provide insight into the pathogenesis of sarcopenic obesity with particular focus on subclinical inflammation. Results: Current studies use different criteria to define sarcopenic obesity which hampers comparison of results and leads to prevalence estimates ranging from 2 to 48% in different study populations. Despite this, sarcopenic obesity appears to be asignificant risk factor for increased morbidity and mortality with cardiometabolic disease and impaired physical capacity as the most commonly observed consequences. The causes are multifactorial and include genetic and age-associated factors (neuromuscular or endocrine changes) as well as lifestyle factors. Both advanced age and obesity lead to subclinical inflammation which via afatal feedback mechanism aggravates both muscle wasting and fat accumulation. At present, nutritional intervention with increased protein intake and resistance training are the most promising treatment options. Conclusion: Sarcopenic obesity is aclinically relevant phenotype, but its pathogenesis is still not perfectly understood which limits options for prevention and treatment. New strategies to enhance muscle anabolism and reduction of fat mass are urgently needed to minimize health impairment in older age. KW - Sarcopenia KW - Fat infiltration in muscle KW - Body weight KW - Cardiovascular diseases KW - Mortality KW - Sarkopenie KW - Fettinfiltration im Muskel KW - Gewicht KW - Kardiovaskuläre Erkrankungen KW - Mortalität Y1 - 2019 U6 - https://doi.org/10.1007/s11428-019-0456-x SN - 1860-9716 SN - 1860-9724 VL - 15 IS - 4 SP - 311 EP - 317 PB - Springer CY - Heidelberg ER -