New biomarkers of cardiometabolic risk: Hypothalamus-pituitary-adrenal axis and subclinical atherosclerosis. From type 1 diabetes to chronic kidney disease
[eng] INTRODUCTION: Type 1 diabetes (T1D) and chronic kidney disease (CKD) are populations with high cardiovascular risk and mortality despite recent improvements in healthcare. New strategies are needed to tackle cardiovascular risk and excess mortality in these complex populations. Imaging techniq...
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| Tipo de recurso: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 2024 |
| País: | España |
| Institución: | Universidad de Barcelona |
| Repositorio: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/219154 |
| Acceso en línea: | https://hdl.handle.net/2445/219154 http://hdl.handle.net/10803/693851 |
| Access Level: | acceso abierto |
| Palabra clave: | Malalties del ronyó Diabetis Hidrocortisona Neuropaties diabètiques Aterosclerosi Kidney diseases Diabetes Hydrocortisone Diabetic neuropathies Atherosclerosis |
| Sumario: | [eng] INTRODUCTION: Type 1 diabetes (T1D) and chronic kidney disease (CKD) are populations with high cardiovascular risk and mortality despite recent improvements in healthcare. New strategies are needed to tackle cardiovascular risk and excess mortality in these complex populations. Imaging techniques for the visualisation of preclinical atherosclerosis visualization, chronic diabetic complications markers and hypothalamus- pituitary-adrenal (HPA) axis hormones are emerging as biomarkers of cardiometabolic risk. HYPOTHESIS: The use of new image and biochemical biomarkers in high- risk populations, would enable the identification of those at a higher cardiovascular risk. In particular, identifying subclinical atherosclerosis by carotid ultrasonography in subjects with T1D and high cardiovascular risk and/or insidious diabetic kidney disease; the measurement of chronic exposure to cortisol through hair cortisol (HC) in subjects across different stages of CKD; and nocturnal cortisol and diabetic neuropathy in subjects with T1D and end-stage kidney disease (ESKD) undergoing pancreas- kidney transplantation, would make it possible to tailor cardiovascular risk reduction strategies in these populations and improve their prognosis. OBJECTIVES: To identify metabolic and cardiovascular risk biomarkers in high-risk populations: in both initial (carotid ultrasonography in T1D and high cardiovascular risk and/or early stages of diabetic kidney disease [DKD]) and more advanced stages (HPA axis variables across the CKD spectrum and finally, clinical and HPA axis variables in T1D with ESKD candidates to pancreas-kidney transplant). |
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