LEADER 5: prevalence and cardiometabolic impact of obesity in cardiovascular high-risk patients with type 2 diabetes mellitus: baseline global data from the LEADER trial

Background: Epidemiological data on obesity are needed, particularly in patients with type 2 diabetes mellitus (T2DM) and high cardiovascular (CV) risk. We used the baseline data of liraglutide effect and action in diabetes: evaluation of CV outcome results-A long term Evaluation (LEADER) (a clinica...

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Bibliographic Details
Authors: Masmiquel, Lluís, Leiter, L. A., Vidal, Josep, Bain, S., Petrie, J., Franek, Edward, Raz, I., Comlekci, A., Jacob, S., Van Gaal, L., Baeres, F. M. M., Marso, S. P., Eriksson, M., LEADER Investigators
Format: article
Publication Date:2016
Country:España
Institution:Conselleria de Salut i Consum del Govern de les Illes Balears
Repository:Docusalut
Language:English
OAI Identifier:oai:docusalut.com:20.500.13003/10473
Online Access:https://hdl.handle.net/20.500.13003/10473
Access Level:Open access
Keyword:Female
Male
Waist Circumference
Prevalence
Liraglutide
Body Mass Index
Treatment Outcome
Risk Factors
Cardiovascular Diseases
Diabetes Mellitus, Type 2
Metabolic Syndrome
Aged, 80 and over
Aged
Risk Assessment
Humans
Middle Aged
Double-Blind Method
Obesity
Hypoglycemic Agents
Time Factors
Índice de Masa Corporal
Síndrome Metabólico
Prevalencia
Resultado del Tratamiento
Anciano
Diabetes Mellitus Tipo 2
Anciano de 80 o más Años
Medición de Riesgo
Enfermedades Cardiovasculares
Método Doble Ciego
Circunferencia de la Cintura
Factores de Riesgo
Hipoglucemiantes
Humanos
Persona de Mediana Edad
Obesidad
Liraglutida
Femenino
Masculino
Factores de Tiempo
Cardiovascular
Type 2 diabetes
LEADER
Cardiometabolic
Overweight
Description
Summary:Background: Epidemiological data on obesity are needed, particularly in patients with type 2 diabetes mellitus (T2DM) and high cardiovascular (CV) risk. We used the baseline data of liraglutide effect and action in diabetes: evaluation of CV outcome results-A long term Evaluation (LEADER) (a clinical trial to assess the CV safety of liraglutide) to investigate: (i) prevalence of overweight and obesity; (ii) relationship of the major cardiometabolic risk factors with anthropometric measures of adiposity [body mass index (BMI) and waist circumference (WC)]; and (iii) cardiometabolic treatment intensity in relation to BMI and WC. Methods: LEADER enrolled two distinct populations of high-risk patients with T2DM in 32 countries: (1) aged >= 50 years with prior CV disease; (2) aged >= 60 years with one or more CV risk factors. Associations of metabolic variables, demographic variables and treatment intensity with anthropometric measurements (BMI and WC) were explored using regression models (ClinicalTrials. gov identifier: NCT01179048). Results: Mean BMI was 32.5 +/- 6.3 kg/m(2) and only 9.1 % had BMI <25 kg/m(2). The prevalence of healthy WC was also extremely low (6.4 % according to International Joint Interim Statement for the Harmonization of the Metabolic Syndrome criteria). Obesity was associated with being younger, female, previous smoker, Caucasian, American, with shorter diabetes duration, uncontrolled blood pressure (BP), antihypertensive agents, insulin plus oral antihyperglycaemic treatment, higher levels of triglycerides and lower levels of high-density lipoprotein cholesterol. Conclusions: Overweight and obesity are prevalent in high CV risk patients with T2DM. BMI and WC are related to the major cardiometabolic risk factors. Furthermore, treatment intensity, such as insulin, statins or oral antihypertensive drugs, is higher in those who are overweight or obese; while BP and lipid control in these patients are remarkably suboptimal. LEADER confers a unique opportunity to explore the longitudinal effect of weight on CV risk factors and hard endpoints.

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