Evidence mapPaperPMID 23978693Full record

ArticleJournal of the American College of Cardiology2013

Insulin status and vascular responses to weight loss in obesity.

Sherman J Bigornia, Melissa G Farb, Stephanie Tiwari, Shakun Karki, Naomi M Hamburg, Joseph A Vita, Donald T Hess, Michael P Lavalley, Caroline M Apovian, Noyan Gokce

Open access · greenAbstract read
In one paragraph

Article in Journal of the American College of Cardiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 1 pooled it
4.2field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.

  1. Pooled it
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  6. Article
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  8. Acute effects of singing on cardiovascular biomarkers.Frontiers in cardiovascular medicine · 2022
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  11. Fasting Plasma Glucose and Coronary Heart Disease in a Rural Population of North Henan, China.Evidence-based complementary and alternative medicine : eCAM · 2020
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  14. WNT5A regulates adipose tissue angiogenesis via antiangiogenic VEGF-AAmerican journal of physiology. Heart and circulatory physiology · 2017
    Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Forkhead box O-1 modulation improves endothelial insulin resistance in human obesity.Arteriosclerosis, thrombosis, and vascular biology · 2015
    Article
  20. Visceral adiposopathy: a vascular perspective.Hormone molecular biology and clinical investigation · 2015
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Sherman J BigorniaEvans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts.
Melissa G FarbEvans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts.
Stephanie TiwariEvans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts.
Shakun KarkiEvans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts.
Naomi M HamburgEvans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts.
Joseph A VitaEvans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts.
Donald T HessDepartment of General Surgery, Boston University School of Medicine, Boston, Massachusetts.
Michael P LavalleyDepartment of Biostatistics, Boston University School of Public Health, Boston, Massachusetts.
Caroline M ApovianDepartment of Medicine, Section of Endocrinology, Diabetes and Nutrition, Boston University School of Medicine, Boston, Massachusetts.
Noyan GokceEvans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts. Electronic address: noyan.gokce@bmc.org.
Boston University · US

Funding

Transgenic CoreP30DK046200 · NIDDK · TUFTS MEDICAL CENTER · PI GREENBERG, ANDREW S, PERISSI, VALENTINA · 1992 to 2021
$25.0M
Redox regulation in Endothelial Progenitor CellsP01HL081587 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI HAMBURG, NAOMI MIRIAM · 2005 to 2015
$21.5M
Multidisciplinary Training in Cardiovascular ResearchT32HL007224 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI HAMBURG, NAOMI MIRIAM, WAINFORD, RICHARD DAVID · 1985 to 2020
$12.3M
Vascular Consequences of Insulin Resistance and ObesityP50HL083801 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI KEANEY, JOHN FRANCIS · 2006 to 2010
$11.2M
Clinical Utility of Endothelial Function in PADR01HL075795 · NHLBI · BOSTON MEDICAL CENTER · PI VITA, JOSEPH A. · 2003 to 2007
$4.9M
Boston University Medical Center Leadership Program in Vascular MedicineK12HL083781 · NHLBI · BOSTON MEDICAL CENTER · PI EBERHARDT, ROBERT THOMAS · 2007 to 2013
$3.4M
Inflammation and Vascular Dysfunction in ObesityR01HL084213 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI GOKCE, NOYAN · 2007 to 2011
$2.3M
Adipose inflammation, mitochondrial function & endothelial phenotypes in obesityR01HL114675 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI GOKCE, NOYAN · 2012 to 2016
$2.3M
Endothelial Insulin Resistance, Inflammation and Vascular Function in DiabetesR01HL102299 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI HAMBURG, NAOMI MIRIAM · 2010 to 2014
$2.0M
Determinants of Shear Stress-Mediated Arterial RemodelingR01HL083269 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI VITA, JOSEPH A. · 2006 to 2009
$1.9M
MicroRNA Profile in Peripheral Artery DiseaseR21HL109790 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI HAMBURG, NAOMI MIRIAM · 2012 to 2013
$455k
NHLBI NIH HHS HL081587NHLBI NIH HHS HL083269NHLBI NIH HHS HL083801NHLBI NIH HHS HL084213NHLBI NIH HHS HL102299NHLBI NIH HHS HL109790NHLBI NIH HHS HL1145675NHLBI NIH HHS HL75795NHLBI NIH HHS K12 HL083781NHLBI NIH HHS P01 HL081587NHLBI NIH HHS P50 HL083801NHLBI NIH HHS R01 HL075795NHLBI NIH HHS R01 HL083269NHLBI NIH HHS R01 HL084213NHLBI NIH HHS R01 HL102299NHLBI NIH HHS R01 HL114675NHLBI NIH HHS R21 HL109790NHLBI NIH HHS T32 HL007224NIDDK NIH HHS P30 DK046200NIDDK NIH HHS P30DK046200
6 · The paper itself

Abstract

objectivesThe aim of this study was to determine whether the effects of weight loss on arterial function are differentially modified by insulin status.

backgroundClinical studies suggest that plasma insulin levels may predict the extent of cardiovascular benefit achieved with weight loss in obese individuals, but mechanisms are currently unknown.

methodsWe prospectively followed 208 overweight or obese patients (body mass index [BMI] ≥25 kg/m(2)) receiving medical/dietary (48%) or bariatric surgical (52%) weight-loss treatment during a median period of 11.7 months (interquartile range: 4.6 to 13 months). We measured plasma metabolic parameters and vascular endothelial function using ultrasound at baseline and following weight-loss intervention and stratified analyses by median plasma insulin levels.

resultsPatients age 45 ± 1 years, with BMI 45 ± 9 kg/m(2), experienced 14 ± 14% weight loss during the study period. In individuals with higher baseline plasma insulin levels (above median >12 μIU/ml; n = 99), ≥10% weight loss (compared with <10%) significantly improved brachial artery macrovascular flow-mediated vasodilation and microvascular reactive hyperemia (p < 0.05 for all). By contrast, vascular function did not change significantly in the lower insulin group (≤12 μIU/ml; n = 109) despite a similar degree of weight loss. In analyses using a 5% weight loss cut point, only microvascular responses improved in the higher insulin group (p = 0.02).

conclusionsInsulin status is an important determinant of the positive effect of weight reduction on vascular function with hyperinsulinemic patients deriving the greatest benefit. Integrated improvement in both microvascular and macrovascular function was associated with ≥10% weight loss. Reversal of insulin resistance and endothelial dysfunction may represent key therapeutic targets for cardiovascular risk reduction in obesity.

Indexed as

Weight LossBlood Flow VelocityBody Mass IndexBrachial ArteryCholesterolFemaleFollow-Up StudiesGlycated HemoglobinHomeostasisHumansHyperemiaInsulinMaleMicrocirculationMiddle AgedObesityCholesterolGlycated Hemoglobinhemoglobin A1c protein, humanInsulinTriglyceridesbariatric surgeryBMIbody mass indexflow-mediated dilationFMDglycosylated hemoglobinHbA(1c)HDLhigh-density lipoproteinHOMAhomeostasis model assessmenthyperinsulinemiaLDLlow-density lipoproteinobesityvasculatureweight loss

Identifiers

PMID23978693
PMCPMC3873767
OpenAlexW2033877965

What Socratic holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.