Browsing by Author "Mikhailidis, Dimitri P"

Now showing 1 - 6 of 6

Adoption of the ADA/EASD guidelines in 10 Eastern and Southern European countries: Physician survey and good clinical practice recommendations from an international expert panel
(2020) Mikhailidis, Dimitri P
Abstract: The aim of the present study was to assess the adoption of the ADA/EASD guidelines in a convenience sample of physicians from Eastern and Southern Europe, the barriers to the implementation of these guidelines and the measures needed to facilitate their implementation. Methods: Attendees at two international diabetes conferences could volunteer to respond to a fully anonymous survey. Responses were analysed descriptively and a panel of experts from around the region was consulted to interpret the survey results. Results: Responses (n = 96) from 10 countries were analysed. Most participants (63.4%) considered the ADA/EASD guidelines fundamental to their practice. All respondents saw the value of the CVOT-based ADA/EASD recommendations and 77–80% generally implemented them. Measures suggested to improve adherence to the ADA/EASD guidelines included aligning reimbursement policy with the guidelines (54.4%), publishing guidelines in a simple and concise form (42.4%) and translating guidelines into local languages (33.3%). Conclusions: Aligning reimbursement with recent evidence and providing short summaries of the ADA/EASD guidelines in local languages could facilitate physician adherence.
Effect of Intermittent Fasting on Lipid Profile, Anthropometric and Hepatic Markers in Non-Alcoholic Fatty Liver Disease (NAFLD): A Systematic Review
(2024-01) Mikhailidis, Dimitri P
Abstract: Background: The first-line treatment for non-alcoholic fatty liver disease (NAFLD) is lifestyle modification; this should accompany any pharmacological intervention. Intermittent fasting (IF) has shown benefits over metabolic and cardiovascular parameters. Non-religious IF includes Time-Restricted Feeding (TRF), Alternate-Day Fasting (ADF), and 5:2 IF interventions. Objective: To evaluate the effects of IF on anthropometric, liver damage, and lipid profile markers in subjects with NAFLD. Methods: A bibliographic search was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using PubMed and Scopus databases. Results: Five studies involving 470 patients with NAFLD were included. In relation to anthropometric markers, all the articles reported body weight reduction (2.48-7.63%), but only ADF and 5:2 IF reported a body weight reduction >5%; also, all the articles reported fat mass reduction. Concerning hepatic markers, all the articles reported a reduction in hepatic steatosis and alanine aminotransferase activity, but no changes in fat-free mass and high-density lipoprotein cholesterol levels. There were variable results on fibrosis, other liver enzymes, waist circumference and body mass index, as well as the levels of triglycerides, total cholesterol, and low-density lipoprotein cholesterol. Conclusion: Any form of IF could be potentially beneficial for NAFLD treatment and some associated cardiometabolic parameters. However, it is necessary to evaluate the effects and safety of IF in long-term studies involving a higher number of participants with different stages of NAFLD. The effect of IF on NAFLD-associated vascular risk also needs evaluation.
Endocrine Disease as a Cause of Cardiovascular Disease: Current Perspectives
(2020) Mikhailidis, Dimitri P
Abstract:‎ This special issue of “Current Pharmaceutical Design” is dedicated to endocrine diseases that are ‎associated with increased risk of cardiovascular (CV) disease (CVD).‎ In relation to Reproductive Endocrinology, Bosdou et al. [1] consider the association between female ‎infertility and CVD. In general, current data do not support a clear association, although common ‎pathways may lead to both entities, with a contributory role attributed to the ageing process [1]. The ‎inconsistency of evidence also extends to the association between female infertility and the prevalence ‎of CV risk factors, such as dyslipidaemia, arterial hypertension (AH) and type 2 diabetes mellitus (T2DM) ‎‎[1]. However, some causes of infertility, such as polycystic ovarian syndrome (PCOS) and ‎endometriosis, may be associated with increased CV risk [1]. Whether female infertility is an indicator of ‎early CVD needs to be confirmed in well-designed, large population-based studies [1]. In this context, ‎some indices of ovarian reserve, such as the anti-Müllerian hormone concentrations, which are negatively ‎associated with subclinical atherosclerosis markers (carotid intima-media thickness) [2], may serve this ‎purpose. The association of specific infertility states (such as PCOS) with increased risk of CVD events ‎and mortality also needs to be established in future studies. Of note, a recent meta-analysis showed an ‎increased risk of nonfatal cerebrovascular disease events [relative risk (RR) 1.41, 95% confidence ‎interval (CI) 1.02-1.94], but not coronary heart disease (CHD), in patients with PCOS compared with non-‎PCOS women [3]. (Continued…)‎
Glucagon-Like Peptide-1 Receptor Agonists and Dual Glucose-Dependent Insulinotropic Polypeptide/Glucagon-Like Peptide-1 Receptor Agonists in the Treatment of Obesity/Metabolic Syndrome, Prediabetes/Diabetes and Non-Alcoholic Fatty Liver Disease-Current Evidence
(2022-12) Mikhailidis, Dimitri P; Rizzo, Manfredi
Abstract: The obesity pandemic is accompanied by increased risk of developing metabolic syndrome (MetS) and related conditions: non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH), type 2 diabetes mellitus (T2DM) and cardiovascular (CV) disease (CVD). Lifestyle, as well as an imbalance of energy intake/expenditure, genetic predisposition, and epigenetics could lead to a dysmetabolic milieu, which is the cornerstone for the development of cardiometabolic complications. Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 RAs promote positive effects on most components of the "cardiometabolic continuum" and consequently help reduce the need for polypharmacy. In this review, we highlight the main pathophysiological mechanisms and risk factors (RFs), that could be controlled by GLP-1 and dual GIP/GLP-1 RAs independently or through synergism or differences in their mode of action. We also address the evidence on the use of GLP-1 and dual GIP/GLP-1 RAs in the treatment of obesity, MetS and its related conditions (prediabetes, T2DM and NAFLD/NASH). In conclusion, GLP-1 RAs have already been established for the treatment of T2DM, obesity and cardioprotection in T2DM patients, while dual GIP/GLP-1 RAs appear to have the potential to possibly surpass them for the same indications. However, their use in the prevention of T2DM and the treatment of complex cardiometabolic metabolic diseases, such as NAFLD/NASH or other metabolic disorders, would benefit from more evidence and a thorough clinical patient-centered approach. There is a need to identify those patients in whom the metabolic component predominates, and whether the benefits outweigh any potential harm.
Half a century and more of PhD theses by published papers Comment on: “Bringing the doctoral thesis by published papers to the Social Sciences and the Humanities: A quantitative easing? A small study of doctoral thesis submission rules and practice in two disciplines in the UK” by John Rigby and Barbara Jones in Scientometrics published online 15-May-2020
(2020) Mikhailidis, Dimitri P
Abstract: The recent article by Rigby and Jones in Scientometrics (15-May-2020) again draws attention to basing PhD-theses on published works, in their case introducing the system into the Social Sciences and Humanities. In this short communication we endeavour to provide additional information that is essential for this debate.
Obesity and nonalcoholic fatty liver disease in type 1 diabetes mellitus patients
(2022-11) Rizzo, Manfredi; Mikhailidis, Dimitri P
Introduction: Assessed the prevalence of nonalcoholic fatty liver disease (NAFLD) in children with type 1 diabetes mellitus (T1DM). They included 15 children with T1DM and obesity, 34 children with T1DM but no obesity and 28 obese children without T1DM. The authors1 found that age and body mass index (BMI)-matched obese children with or without T1DM share similar clinical, biochemical, and liver FibroScan features. Obesity was the main risk factor for NAFLD in pediatric T1DM. Tas et al.1 also provide cut-off values for BMI, high density lipoprotein cholesterol (HDL–C) and BMI:HDL-C ratio, that may help clinicians decide which children may benefit from further investigation to establish the presence or absence of NAFLD. The authors describe the limitations of their study (including imaging techniques) and of the previous literature.1 It may be premature to eliminate a role for T1DM in the etiology of childhood NAFLD because of the limitations of the present study.1 Nevertheless, we agree with the authors1 that their study makes a valuable contribution to the limited evidence that is currently available in this field.