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Al-Zoubaidi DF, Johannsen TH, Jørgensen NR, Main KM. The effect of 30 min of supine rest on plasma renin concentrations in paediatric patients. Acta Paediatr 2024. [PMID: 39118328 DOI: 10.1111/apa.17360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 07/09/2024] [Accepted: 07/15/2024] [Indexed: 08/10/2024]
Abstract
AIM The aim of this study is to interpret plasma renin concentrations (PRCs) correctly in a clinical setting, it is essential to understand to what extent physical activity influences the concentration. Reference values for different postural positions exist for adults, but data for children are sparse. In this study, the effect of 30 min of rest on plasma renin concentrations in paediatric patients was examined. METHODS In total, 41 paediatric patients, undergoing either arginine or clonidine provocation tests for growth hormone deficiency, were included. For each stimulation test, two blood samples were drawn. One at time 0 min and one after 30 min of rest. In total, renin concentrations were determined in 86 serum samples. RESULTS Renin concentrations decreased from 0 to 30 min with a median value of -20.5% (inter-quartile range: -33.0% to -12.8%). This decrease was not dependent on sex, age, medication or comorbidity, and the variance of renin did not differ between 0 and 30 min. CONCLUSION Renin concentrations in children differ according to postural position, which is comparable to adults. Thus, the clinical interpretation of renin results needs to consider the preanalytical conditions applied in the local reference population.
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Affiliation(s)
- D F Al-Zoubaidi
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - T H Johannsen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - N R Jørgensen
- Department of Clinical Biochemistry, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- The Translational Research Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - K M Main
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Ramessur V, Hunma S, Joonas N, Ramessur BN, Schutz Y, Montani JP, Dulloo AG. Visceral-to-peripheral adiposity ratio: a critical determinant of sex and ethnic differences in cardiovascular risks among Asian Indians and African Creoles in Mauritius. Int J Obes (Lond) 2024; 48:1092-1102. [PMID: 38615158 PMCID: PMC11281908 DOI: 10.1038/s41366-024-01517-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND/AIMS Coronary heart disease morbidity and mortality are higher in people of South Asian origin than in those of African origin. We investigated whether as young adults without diabetes, people in Mauritius of South Asian descent (Indians) would show a more adverse cardiovascular risk profile that those of predominantly African descent (Creoles), and whether this could be explained by ethnic differences in visceral adiposity or other fat distribution patterns. METHODS The study was conducted in 189 young non-physically active adults, with the following measurements conducted after an overnight fast: anthropometry (weight, height, waist circumference), whole-body and regional body composition by dual-energy x-ray absorptiometry, blood pressure, and blood assays for glycemic (glucose and HbA1c) and lipid profile (triglycerides and cholesterols). RESULTS The results indicate higher serum triglycerides and lower HDL cholesterol in men than in women, and in Indians than in Creoles (p < 0.001). No significant differences due to sex or ethnicity are observed in body mass index and waist circumference, but indices of visceral adiposity (visceral/android, visceral/subcutaneous) and visceral-to-peripheral adiposity ratio (visceral/gynoid, visceral/limb) were significantly higher in men than in women, and in Indians than in Creoles. The significant effects of sex and ethnicity on blood lipid profile were either completely abolished or reduced to a greater extent after adjusting for the ratio of visceral-to-peripheral adiposity than for visceral adiposity per se. CONCLUSIONS In young adults in Mauritius, Indians show a more adverse pattern of body fat distribution and blood lipid risk profile than Creoles. Differences in their fat distribution patterns, however, only partially explain their differential atherogenic lipid risk profile, amid a greater impact of visceral-to-peripheral adiposity ratio than that of visceral adiposity per se on sex and ethnic differences in cardiovascular risks; the former possibly reflecting the ratio of hazardous (visceral) adiposity and protective (peripheral) superficial subcutaneous adiposity.
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Affiliation(s)
- Vinaysing Ramessur
- Obesity Research Unit, Biochemistry Dept., Central Health Laboratory, Victoria Hospital, Ministry of Health & Wellness, Plaines Wilhems, Mauritius
- Department of Endocrinology, Metabolism & Cardiovascular System, Faculty of Science & Medicine, University of Fribourg, Fribourg, Switzerland
| | - Sadhna Hunma
- Obesity Research Unit, Biochemistry Dept., Central Health Laboratory, Victoria Hospital, Ministry of Health & Wellness, Plaines Wilhems, Mauritius
| | - Noorjehan Joonas
- Obesity Research Unit, Biochemistry Dept., Central Health Laboratory, Victoria Hospital, Ministry of Health & Wellness, Plaines Wilhems, Mauritius
| | - Bibi Nasreen Ramessur
- Obesity Research Unit, Biochemistry Dept., Central Health Laboratory, Victoria Hospital, Ministry of Health & Wellness, Plaines Wilhems, Mauritius
| | - Yves Schutz
- Department of Endocrinology, Metabolism & Cardiovascular System, Faculty of Science & Medicine, University of Fribourg, Fribourg, Switzerland
| | - Jean-Pierre Montani
- Department of Endocrinology, Metabolism & Cardiovascular System, Faculty of Science & Medicine, University of Fribourg, Fribourg, Switzerland
| | - Abdul G Dulloo
- Department of Endocrinology, Metabolism & Cardiovascular System, Faculty of Science & Medicine, University of Fribourg, Fribourg, Switzerland.
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Cignarella A, Bolego C, Barton M. Sex and sex steroids as determinants of cardiovascular risk. Steroids 2024; 206:109423. [PMID: 38631602 DOI: 10.1016/j.steroids.2024.109423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/08/2024] [Accepted: 04/14/2024] [Indexed: 04/19/2024]
Abstract
There are considerable sex differences regarding the risk of cardiovascular disease (CVD), including arterial hypertension, coronary artery disease (CAD) and stroke, as well as chronic renal disease. Women are largely protected from these conditions prior to menopause, and the risk increases following cessation of endogenous estrogen production or after surgical menopause. Cardiovascular diseases in women generally begin to occur at a later age than in men (on average with a delay of 10 years). Cessation of estrogen production also impacts metabolism, increasing the risk of developing obesity and diabetes. In middle-aged individuals, hypertension develops earlier and faster in women than in men, and smoking increases cardiovascular risk to a greater degree in women than it does in men. It is not only estrogen that affects female cardiovascular health and plays a protective role until menopause: other sex hormones such as progesterone and androgen hormones generate a complex balance that differentiates heart and blood vessel function in women compared to men. Estrogens improve vasodilation of epicardial coronary arteries and the coronary microvasculature by augmenting the release of vasodilating factors such as nitric oxide and prostacyclin, which are mechanisms of coronary vasodilatation that are more pronounced in women compared to men. Estrogens are also powerful inhibitors of inflammation, which in part explains their protective effects on CVD and chronic renal disease. Emerging evidence suggests that sex chromosomes also play a significant role in shaping cardiovascular risk. The cardiovascular protection conferred by endogenous estrogens may be extended by hormone therapy, especially using bioidentical hormones and starting treatment early after menopause.
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Affiliation(s)
| | - Chiara Bolego
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Matthias Barton
- Molecular Internal Medicine, University of Zürich, Zürich, Switzerland; Andreas Grüntzig Foundation, Zürich, Switzerland.
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Betai D, Ahmed AS, Saxena P, Rashid H, Patel H, Shahzadi A, Mowo-Wale AG, Nazir Z. Gender Disparities in Cardiovascular Disease and Their Management: A Review. Cureus 2024; 16:e59663. [PMID: 38836150 PMCID: PMC11148660 DOI: 10.7759/cureus.59663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2024] [Indexed: 06/06/2024] Open
Abstract
Worldwide, cardiovascular diseases (CVDs) are still the primary cause of death, and there are notable differences between sexes when it comes to symptoms/course and treatment. Due to evolving healthcare technologies, significant progress has been made in understanding CVDs. Hence, it is evident that gender disparities exist in the clinical presentation, prevalence, management, outcomes, and risk factors, including biological, behavioral, and sociocultural factors. This narrative review is designed to provide a generalized idea of gender disparities in CVDs. It aims to provide insights to prove the role of hormonal influences, genetic predispositions, and the difference in physiological outcomes owing to different genders. This review explores subtle distinctions in CVD across genders, including changes in structure, biology, and hormones that affect how illness presents and progresses. Lifestyle variables also influence sociocultural factors and gender disparities in risk profiles. Traditional risk factors, diabetes mellitus (DM), cholesterol levels, and smoking may have different weights and relevance in men and women. Moreover, age and other conventional risk variables have distinct effects on gender. Treatment efficacy may be impacted by the expression of gender-specific factors, emphasizing the necessity for customized strategies. Development of CVDs can be delayed or prevented, and its consequences can be lessened with the early identification and effective management of gender-specific factors. More investigation is necessary to clarify complex interactions between structural, biochemical, and hormonal aspects across genders in order to maximize treatment results and reduce the burden of CVDs.
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Affiliation(s)
- Dhruva Betai
- General Practice, Pandit Deendayal Upadhyay Medical College, Rajkot, IND
| | - Aamina S Ahmed
- Internal Medicine, St. George's University School of Medicine, New York, USA
| | - Prerna Saxena
- Medicine and Surgery, K. S. Hegde Medical Academy, Mangalore, IND
| | - Hurria Rashid
- Basic Sciences, Fatima Jinnah Medical University, Lahore, PAK
| | - Happy Patel
- Internal Medicine, Angeles University Foundation, Angeles City, PHL
| | - Atika Shahzadi
- Medicine, Aziz Bhatti Shaheed Teaching Hospital, Gujrat, PAK
| | | | - Zahra Nazir
- Internal Medicine, Combined Military Hospital Quetta, Quetta, PAK
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Wang Y, Li J, Shi Y, Jiang T, Tu L, Xu J. Core characteristics of sublingual veins analysis and its relationship with hypertension. Technol Health Care 2024; 32:1641-1656. [PMID: 37955097 DOI: 10.3233/thc-230695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
BACKGROUND The sublingual vein (SV) is a specialized diagnostic method used in Traditional Chinese Medicine (TCM). Despite its ability to objectively reflect blood flow, SV is often overlooked in clinical practice. OBJECTIVE This study aims to analyze the core characteristics of SV and investigate the in-depth relationship between its digital characteristics and hypertension. The goal is to find a link between SV and hypertension and break out of the current situation. METHODS Modern digital analysis techniques were applied to the traditional SV diagnostic theory. In a controlled study with 204 participants, the digital characteristics of SV were documented using TFDA-1, and its color value was analyzed using TDAS. Morphological characteristics of SV, such as trunklength, width, and tortuosity, were examined by combining computer vision with expert interpretation. This involved the application of automatic ranging methods and a rectangular approximation algorithm, which are novel approaches in the field of TCM. The t-test and Mann-Whitney U test were used to analyze the digital characteristics of SV in hypertension. Binary logistic regression and neural network models were established using machine learning to explore the deep relationship between SV characteristics and hypertension. RESULTS There was a significant difference of the tortuosity of SV between the two groups (Z=-2.629, p= 0.009). The results revealed thick width of SV (OR = 2.64, 95% CI: 1.02-6.79) was the risk factor for hypertension. Addition of SV characteristics improved overall percent correct for hypertension prediction to 80%. CONCLUSION TCM method of diagnosis of SV has been greatly expanded in terms of technical means, and the close relationship between SV and hypertension has been found in clinical data.
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Affiliation(s)
- Yu Wang
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jun Li
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yulin Shi
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tao Jiang
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Liping Tu
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jiatuo Xu
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Allalou A, Peng J, Robinson GA, Marruganti C, D’Aiuto F, Butler G, Jury EC, Ciurtin C. Impact of puberty, sex determinants and chronic inflammation on cardiovascular risk in young people. Front Cardiovasc Med 2023; 10:1191119. [PMID: 37441710 PMCID: PMC10333528 DOI: 10.3389/fcvm.2023.1191119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/14/2023] [Indexed: 07/15/2023] Open
Abstract
Worrying trends of increased cardiovascular disease (CVD) risk in children, adolescents and young people in the Modern Era have channelled research and public health strategies to tackle this growing epidemic. However, there are still controversies related to the dynamic of the impact of sex, age and puberty on this risk and on cardiovascular health outcomes later in life. In this comprehensive review of current literature, we examine the relationship between puberty, sex determinants and various traditional CVD-risk factors, as well as subclinical atherosclerosis in young people in general population. In addition, we evaluate the role of chronic inflammation, sex hormone therapy and health-risk behaviours on augmenting traditional CVD-risk factors and health outcomes, ultimately aiming to determine whether tailored management strategies for this age group are justified.
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Affiliation(s)
- Amal Allalou
- University College London Medical School, University College London, London, United Kingdom
| | - Junjie Peng
- Centre for Adolescent Rheumatology Versus Arthritis, University College London, London, United Kingdom
- Centre for Rheumatology Research, Division of Medicine, University College London, London, United Kingdom
| | - George A. Robinson
- Centre for Adolescent Rheumatology Versus Arthritis, University College London, London, United Kingdom
- Centre for Rheumatology Research, Division of Medicine, University College London, London, United Kingdom
| | - Crystal Marruganti
- Eastman Dental Hospital, University College London Hospital, London, United Kingdom
| | - Francesco D’Aiuto
- Eastman Dental Hospital, University College London Hospital, London, United Kingdom
| | - Gary Butler
- Department of Paediatric Endocrinology, University College London Hospital, London, United Kingdom
- Institute of Child Health, University College London, London, United Kingdom
| | - Elizabeth C. Jury
- Centre for Rheumatology Research, Division of Medicine, University College London, London, United Kingdom
| | - Coziana Ciurtin
- Centre for Adolescent Rheumatology Versus Arthritis, University College London, London, United Kingdom
- Centre for Rheumatology Research, Division of Medicine, University College London, London, United Kingdom
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Li Y, Li B, Chen WD, Wang YD. Role of G-protein coupled receptors in cardiovascular diseases. Front Cardiovasc Med 2023; 10:1130312. [PMID: 37342437 PMCID: PMC10277692 DOI: 10.3389/fcvm.2023.1130312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/09/2023] [Indexed: 06/22/2023] Open
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death globally, with CVDs accounting for nearly 30% of deaths worldwide each year. G-protein-coupled receptors (GPCRs) are the most prominent family of receptors on the cell surface, and play an essential regulating cellular physiology and pathology. Some GPCR antagonists, such as β-blockers, are standard therapy for the treatment of CVDs. In addition, nearly one-third of the drugs used to treat CVDs target GPCRs. All the evidence demonstrates the crucial role of GPCRs in CVDs. Over the past decades, studies on the structure and function of GPCRs have identified many targets for the treatment of CVDs. In this review, we summarize and discuss the role of GPCRs in the function of the cardiovascular system from both vascular and heart perspectives, then analyze the complex ways in which multiple GPCRs exert regulatory functions in vascular and heart diseases. We hope to provide new ideas for the treatment of CVDs and the development of novel drugs.
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Affiliation(s)
- Yuanqiang Li
- State Key Laboratory of Chemical Resource Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Boyu Li
- Department of Gastroenterology and Hematology, The People's Hospital of Hebi, Henan, China
| | - Wei-Dong Chen
- Key Laboratory of Receptors-Mediated Gene Regulation and Drug Discovery, School of Basic Medical Science, Inner Mongolia Medical University, Hohhot, China
- Key Laboratory of Receptors-Mediated Gene Regulation, School of Medicine, The People’s Hospital of Hebi, Henan University, Kaifeng, China
| | - Yan-Dong Wang
- State Key Laboratory of Chemical Resource Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
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Cardiometabolic and endocrine comorbidities in women with bipolar disorder: A systematic review. J Affect Disord 2023; 323:841-859. [PMID: 36538952 DOI: 10.1016/j.jad.2022.12.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Bipolar Disorder (BD) is known to be equally distributed among males and females. The well-documented increased risk of medical comorbidities in patients with BD, in comparison to BD patients without medical comorbidities, shows a negative impact on the course of illness. There is some evidence suggesting that women with BD have higher psychiatric and medical comorbidities in comparison to men with BD, however there is no evidence in comparison to women without BD or other major psychiatric illness. These comorbidities, along with various psychosocial factors, are known to affect the course of BD. METHODS We aimed to systematically review the literature on cardiovascular, metabolic and endocrine comorbidities in women with BD in comparison to men with BD and control women. A comprehensive search of electronic databases including PubMed, PsycINFO, Embase, and SCOPUS was conducted, and a total of 61 identified studies were included in this review. RESULTS Women with BD had higher rates of cardiovascular risk factors/mortality, diabetes mellitus II and thyroid disorders compared to women in the general population. In comparison to men with BD, women with BD had comparable cardiovascular risk but higher prevalence of metabolic and thyroid disorders. LIMITATIONS Gender specific data was limited in multiple studies. CONCLUSIONS Results present a need for gender-specific screening and interventions for various medical comorbidities in patients with BD.
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Longpré-Poirier C, Dougoud J, Jacmin-Park S, Moussaoui F, Vilme J, Desjardins G, Cartier L, Cipriani E, Kerr P, Le Page C, Juster RP. Sex and Gender and Allostatic Mechanisms of Cardiovascular Risk and Disease. Can J Cardiol 2022; 38:1812-1827. [PMID: 36150584 DOI: 10.1016/j.cjca.2022.09.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/12/2022] [Accepted: 09/12/2022] [Indexed: 12/14/2022] Open
Abstract
Cardiovascular diseases are leading causes of mortality and morbidity in adults worldwide. Multiple studies suggest that there are clinically relevant sex differences in cardiovascular disease. Women and men differ substantially in terms of prevalence, presentation, management, and outcomes of cardiovascular disease. To date, however, little is known about why cardiovascular disease affects women and men differently. Because many studies do not differentiate the concept of sex and gender, it is sometimes difficult to discriminate sociocultural vs biological contributors that drive observed clinical differences. Female sex has some biological advantages in relation to cardiovascular disease, but many of these advantages seem to disappear as soon as women develop cardiovascular risk factors (eg, type 2 diabetes, hypertension, dyslipidemia). Furthermore, stress and allostatic load could play an important role in the relationship between sex/gender and cardiovascular diseases. In this narrative review, we argue that chronic stress and psychosocial factors might better encompass the patterns of allostatic load increases seen in women, while biological risk factors and unhealthy behaviours might be more important mechanisms that drive increased allostatic load in men. Indeed, men show allostatic load patterns that are more associated with impaired anthropometric, metabolic, and cardiovascular functioning and women have greater dysregulation in neuroendocrine and immune functioning. Thus gender-related factors might contribute to the pathogenesis of cardiovascular disease especially through stress mechanisms. It is important to continue to study the mechanisms by which gender influences chronic stress, because chronic stress could influence modifiable gendered factors to promote cardiovascular disease prevention.
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Affiliation(s)
- Christophe Longpré-Poirier
- Research Centre, University Institute of Mental Health at Montréal, University of Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addiction, University of Montréal, Montréal, Québec, Canada.
| | - Jade Dougoud
- Research Centre, University Institute of Mental Health at Montréal, University of Montréal, Montréal, Québec, Canada; Department of Psychology, University of Montréal, Montréal, Québec, Canada
| | - Silke Jacmin-Park
- Research Centre, University Institute of Mental Health at Montréal, University of Montréal, Montréal, Québec, Canada; Department of Psychology, University of Montréal, Montréal, Québec, Canada
| | - Fadila Moussaoui
- Research Centre, University Institute of Mental Health at Montréal, University of Montréal, Montréal, Québec, Canada
| | - Joanna Vilme
- Research Centre, University Institute of Mental Health at Montréal, University of Montréal, Montréal, Québec, Canada; Department of Psychology, University of Montréal, Montréal, Québec, Canada
| | - Gabriel Desjardins
- Research Centre, University Institute of Mental Health at Montréal, University of Montréal, Montréal, Québec, Canada; Department of Psychology, University of Montréal, Montréal, Québec, Canada
| | - Louis Cartier
- Research Centre, University Institute of Mental Health at Montréal, University of Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addiction, University of Montréal, Montréal, Québec, Canada
| | - Enzo Cipriani
- Research Centre, University Institute of Mental Health at Montréal, University of Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addiction, University of Montréal, Montréal, Québec, Canada
| | - Philippe Kerr
- Research Centre, University Institute of Mental Health at Montréal, University of Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addiction, University of Montréal, Montréal, Québec, Canada
| | - Cécile Le Page
- Research Centre, University Institute of Mental Health at Montréal, University of Montréal, Montréal, Québec, Canada
| | - Robert-Paul Juster
- Research Centre, University Institute of Mental Health at Montréal, University of Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addiction, University of Montréal, Montréal, Québec, Canada
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Assessment of health-related quality of life in patients with heart failure: a cross-sectional study in Saudi Arabia. Health Qual Life Outcomes 2022; 20:128. [PMID: 36042486 PMCID: PMC9425984 DOI: 10.1186/s12955-022-02040-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 08/22/2022] [Indexed: 11/27/2022] Open
Abstract
Background As a precarious clinical condition and a public health problem, heart failure (HF) is associated with a significant burden of morbidity, mortality, and health care costs. As almost all of the published research has been conducted in Western countries, there is a need for culturally relevant studies in Saudi Arabia. This is the first study to investigate health-related quality of life (HRQoL) and its associated factors among Saudi patients with HF in the Qassim region.
Methods A cross-sectional study was conducted at the only tertiary care hospital in the Qassim region of Saudi Arabia during the period from November 2020 to July 2021. The participants were interviewed face-to-face by trained interviewers using the standard validated 36-item Short-Form Health Survey (SF-36) questionnaire for HRQoL assessment. The data were analyzed using STATA version 16. Results The participants included 246 HF patients whose mean (SD) age was 56.7 (10.9) years. A majority of the respondents (80%, n = 197) were male, and 49% (n = 121) had an education level of less than secondary school. The median scores were high for the domains of social functioning (100 points) and bodily pain (75 points) and low for role-physical functioning (25 points). In general, the median scores for the physical and mental component summaries were 58.1 and 63.7, respectively. Patients with an education level less than secondary school were more likely to have a low physical component summary score (aOR 3.00, 95% CI 1.46–6.17), while female patients were more likely to have a low mental component summary score (aOR 2.67, 95% CI 1.38–5.16). Conclusions Health-related quality of life was found to be moderate among these HF patients. Periodic HRQoL assessment is recommended for HF patients to minimize their physical and psychological concerns, particularly for patients with low education levels and female patients.
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Renin-a in the Subfornical Organ Plays a Critical Role in the Maintenance of Salt-Sensitive Hypertension. Biomolecules 2022; 12:biom12091169. [PMID: 36139008 PMCID: PMC9496084 DOI: 10.3390/biom12091169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/20/2022] [Accepted: 08/22/2022] [Indexed: 11/17/2022] Open
Abstract
The brain renin-angiotensin system plays important roles in blood pressure and cardiovascular regulation. There are two isoforms of prorenin in the brain: the classic secreted form (prorenin/sREN) encoded by renin-a, and an intracellular form (icREN) encoded by renin-b. Emerging evidence indicates the importance of renin-b in cardiovascular and metabolic regulation. However, the role of endogenous brain prorenin in the development of salt-sensitive hypertension remains undefined. In this study, we test the hypothesis that renin-a produced locally in the brain contributes to the pathogenesis of hypertension. Using RNAscope, we report for the first time that renin mRNA is expressed in several regions of the brain, including the subfornical organ (SFO), the paraventricular nucleus of the hypothalamus (PVN), and the brainstem, where it is found in glutamatergic, GABAergic, cholinergic, and tyrosine hydroxylase-positive neurons. Notably, we found that renin mRNA was significantly elevated in the SFO and PVN in a mouse model of DOCA-salt–induced hypertension. To examine the functional importance of renin-a in the SFO, we selectively ablated renin-a in the SFO in renin-a–floxed mice using a Cre-lox strategy. Importantly, renin-a ablation in the SFO attenuated the maintenance of DOCA-salt–induced hypertension and improved autonomic function without affecting fluid or sodium intake. Molecularly, ablation of renin-a prevented the DOCA-salt–induced elevation in NADPH oxidase 2 (NOX2) in the SFO without affecting NOX4 or angiotensin II type 1 and 2 receptors. Collectively, our findings demonstrate that endogenous renin-a within the SFO is important for the pathogenesis of salt-sensitive hypertension.
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Belan M, Gélinas M, Carranza-Mamane B, Langlois MF, Morisset AS, Ruchat SM, Lavoie K, Adamo K, Poder T, Gallagher F, Pesant MH, Jean-Denis F, Baillargeon JP. Protocol of the Fit-For-Fertility study: a multicentre randomised controlled trial assessing a lifestyle programme targeting women with obesity and infertility. BMJ Open 2022; 12:e061554. [PMID: 35440463 PMCID: PMC9020282 DOI: 10.1136/bmjopen-2022-061554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/29/2022] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Women with obesity are at a higher risk of infertility as well as gestational and neonatal complications. Lifestyle changes are universally recommended for women with obesity seeking fertility treatments, but such intervention has only been assessed in very few robust studies. This study's objectives are therefore to assess the clinical outcomes and cost-effectiveness of an interdisciplinary lifestyle intervention (the Fit-For-Fertility Programme; FFFP) targeting women with obesity and subfertility in a diverse population. METHODS AND ANALYSIS This pragmatic multicentre randomised controlled trial (RCT) will include 616 women with obesity (body mass index ≥30 kg/m2 or ≥27 kg/m2 with polycystic ovary syndrome or at-risk ethnicities) who are evaluated at a Canadian fertility clinic for subfertility. Women will be randomised either to (1) the FFFP (experimental arm) alone for 6 months, and then in combination with usual care for infertility if not pregnant; or (2) directly to usual fertility care (control arm). Women in the intervention group benefit from the programme up to 18 months or, if pregnant, up to 24 months or the end of the pregnancy (whichever comes first). Women from both groups are evaluated every 6 months for a maximum of 18 months. The primary outcome is live birth rate at 24 months. Secondary outcomes include fertility, pregnancy and neonatal outcomes; lifestyle and anthropometric measures; and cost-effectiveness. Qualitative data collected from focus groups of participants and professionals will also be analysed. ETHICS AND DISSEMINATION This research study has been approved by the Research Ethics Board (REB) of Centre intégré universtaire de santé et des services sociaux de l'Estrie-CHUS (research coordinating centre) on 10 December 2018 and has been or will be approved successively by each participating centres' REB. This pragmatic RCT will inform decision-makers on improving care trajectories and policies regarding fertility treatments for women with obesity and subfertility. TRIAL REGISTRATION NUMBER NCT03908099. PROTOCOL VERSION 1.1, 13 April 2019.
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Affiliation(s)
- Matea Belan
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Myriam Gélinas
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Belina Carranza-Mamane
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Department of Obstetrics and Gynecology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Marie-France Langlois
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Anne-Sophie Morisset
- School of Nutrition, Faculty of Agricultural and Food Science, Laval University, Quebec city, Quebec, Canada
| | - Stephanie-May Ruchat
- Department of Human Kinetics, Université du Quebec à Trois-Rivières, Trois-Rivières, Quebec, Canada
| | - Kim Lavoie
- Research Center CIUSSS-NIM, Montreal Behavioural Medicine Centre, Montreal, Quebec, Canada
- Department of Psychology, Université du Québec a Montréal, Montréal, Quebec, Canada
| | - Kristi Adamo
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Thomas Poder
- School of Public Health, University of Montreal, Montreal, Quebec, Canada
- CIUSSS de l'Est de l'Île de Montréal, Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, Quebec, Canada
| | - Frances Gallagher
- School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Marie-Hélène Pesant
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Farrah Jean-Denis
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jean-Patrice Baillargeon
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
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ABDRAKHMANOVA S, TURGANBEKOVA A, ZHANGAZIEVA K, TURGAMBAYEVA A, TUYAKOVA N. Risk factors for chronic kidney disease of the Kazakh population. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.19.04225-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Johnston BC, Merdad R, Sherifali D, Kebbe M, Birken CS, Buchholz A, Ge L, Gehring ND, Hadjiyannakis S, Hamilton J, Hatanaka D, Henderson M, Lebel T, Moore SA, Morrison KM, Salas XR, Sebastianski M, Zenlea IS, Ball GDC. Updating the Canadian clinical practice guideline for managing pediatric obesity: a protocol. CMAJ Open 2022; 10:E155-E164. [PMID: 35232814 PMCID: PMC8896489 DOI: 10.9778/cmajo.20200289] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Since the first national guideline for managing obesity in adults and children in Canada was published in 2007, new evidence has emerged and guideline standards have evolved. Our purpose is to describe the protocol used to update the Canadian clinical practice guideline for managing pediatric obesity. METHODS This guideline will update the pediatric components of the 2007 Canadian clinical practice guideline for the management of obesity. In partnership with Obesity Canada, we began preliminary work in 2019; activities are scheduled for completion in 2022. The guideline will follow standards developed by the National Academy of Medicine and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) working group. Guideline development will be informed by 5 complementary literature reviews: a scoping review that focuses on clinical assessment in pediatric obesity management and 4 systematic reviews to synthesize evidence regarding families' values and preferences as well as the safety and effectiveness of interventions (psychological and behavioural; pharmacotherapeutic; and surgical). We will use standard systematic review methodology, including summarizing and assessing the certainty of evidence and determining the strength of recommendations. Competing interests will be managed proactively according to recommendations from the Guidelines International Network. Diverse stakeholders, including families and clinicians, will be engaged throughout guideline development. INTERPRETATION The guideline will support Canadian families and clinicians to make informed, value-sensitive and evidence-based clinical decisions related to managing pediatric obesity. The guideline and accompanying resources for end-users will be published in English and French, and we will partner with Obesity Canada to optimize dissemination using integrated and end-of-project knowledge translation.
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Affiliation(s)
- Bradley C Johnston
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Roah Merdad
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Diana Sherifali
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Maryam Kebbe
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Catherine S Birken
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Annick Buchholz
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Long Ge
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Nicole D Gehring
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Stasia Hadjiyannakis
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Jill Hamilton
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Dawn Hatanaka
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Mélanie Henderson
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Tracy Lebel
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Sarah A Moore
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Katherine M Morrison
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Ximena Ramos Salas
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Meghan Sebastianski
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Ian S Zenlea
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont
| | - Geoff D C Ball
- Departments of Nutrition and of Epidemiology and Biostatistics (Johnston), Texas A&M University, College Station, Tex.; Department of Community Health and Epidemiology (Johnston, Merdad), Dalhousie University, Halifax, NS; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Pennington Biomedical Research Center (Kebbe), Louisiana State University, Baton Rouge, La.; Department of Paediatrics (Birken, Hamilton), University of Toronto, Toronto, Ont.; Children's Hospital of Eastern Ontario Research Institute (Buchholz), Ottawa, Ont.; Department of Psychology (Buchholz), Carleton University, Ottawa, Ont.; Evidence-based Social Science Research Centre (Ge), School of Public Health, Lanzhou University, Lanzhou, China; School of Public Health (Gehring), University of Alberta, Edmonton, Alta.; Department of Pediatrics (Hadjiyannakis), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Obesity Canada (Hatanaka, Ramos Salas), Edmonton, Alta.; Department of Pediatrics (Henderson), Université de Montréal, Montréal, Que.; Centre de recherche du Centre hospitalier universitaire Sainte-Justine (Henderson), Montréal, Que.; Department of Social and Preventive Medicine (Henderson), School of Public Health, Université de Montréal, Montréal, Que.; patient and family partner (Lebel), Edmonton, Alta.; School of Health & Human Performance (Moore), Faculty of Health, Dalhousie University, Halifax, NS; Department of Pediatrics (Morrison), McMaster University, Hamilton, Ont.; Department of Pediatrics (Sebastianski, Ball), University of Alberta, Edmonton, Alta.; Institute for Better Health (Zenlea), Trillium Health Partners, Mississauga, Ont.
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15
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Kemp KA, Norris CM, Steele B, Fairie P, Santana MJ. Sex Differences in the Care Experiences of Patients Hospitalized Due to Ischemic Heart Disease in Alberta, Canada. CJC Open 2021; 3:S36-S43. [PMID: 34993432 PMCID: PMC8712602 DOI: 10.1016/j.cjco.2021.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/24/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Women with heart disease experience disparities in the diagnosis, treatment, and management of their condition. However, it is unknown whether these sex differences exist with respect to in-hospital patient experience. We examined the comprehensive experience of patients hospitalized due to ischemic heart disease (IHD) across Alberta, Canada, according to sex. METHODS Patients completed a modified version of the Canadian Patient Experiences Survey-Inpatient Care (CPES-IC) within 6 weeks of discharge. We examined 37 questions, including 33 regarding specific care processes and 4 global rating scales. Survey responses were reported as raw "top-box" percentages, that is, the most-positive answer choice to each question. Odds and corresponding 95% confidence intervals of women reporting a top-box response were then calculated for each question, while controlling for demographic and clinical factors. RESULTS From April 2014 to March 2020, a total of 5795 surveys (1612 women, 4183 men) were completed. Taking the survey margin of error into account, women had lower top-box percentages on 26 of 37 questions. Similar results were obtained for the adjusted odds of reporting a top-box response. Women did not have a higher percentage of top-box responses on any of the questions studied. CONCLUSIONS This study is a Canadian first, which stratified the experiences of hospitalized patients living with ischemic heart disease according to sex. Our results highlighted important sex differences. Future research to understand the mechanisms associated with these observed sex differences in patient-reported experiences is warranted.
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Affiliation(s)
- Kyle A. Kemp
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Patient Engagement Platform, Alberta Strategy for Patient-Oriented Research (SPOR), Calgary, Alberta, Canada
| | - Colleen M. Norris
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- Cardiovascular Health and Stroke Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada
| | - Brian Steele
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Paul Fairie
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Patient Engagement Platform, Alberta Strategy for Patient-Oriented Research (SPOR), Calgary, Alberta, Canada
| | - Maria J. Santana
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Patient Engagement Platform, Alberta Strategy for Patient-Oriented Research (SPOR), Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
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16
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Wu CY, Lin YH, Hsieh HH, Lin JJ, Peng SL. Sex Differences in the Effect of Diabetes on Cerebral Glucose Metabolism. Biomedicines 2021; 9:1661. [PMID: 34829890 PMCID: PMC8615590 DOI: 10.3390/biomedicines9111661] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 12/25/2022] Open
Abstract
The neuroimaging literature indicates that brain structure and function both deteriorate with diabetes, but information on sexual dimorphism in diabetes-related brain alterations is limited. This study aimed to ascertain whether brain metabolism is influenced by sex in an animal model of diabetes. Eleven rats (male, n = 5; female, n = 6) received a single intraperitoneal injection of 70 mg/kg streptozotocin (STZ) to develop diabetes. Another 11 rats (male, n = 5; female, n = 6) received the same amount of solvent through a single intraperitoneal injection. Longitudinal positron emission tomography scans were used to assess cerebral glucose metabolism before and 4 weeks after STZ or solvent administration. Before STZ or solvent injections, there was no evidence of sexual dimorphism in cerebral metabolism (p > 0.05). Compared with healthy control animals, rats with diabetes had significantly decreased brain metabolism in all brain regions (all p < 0.05). In addition, female diabetic rats exhibited further reduction in cerebral metabolism, relative to male diabetic rats (p < 0.05). The results of this study may provide some biological evidence, supporting the existence of a sexual dimorphism in diabetes-related complications.
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Affiliation(s)
- Chun-Yi Wu
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei Branch, Taipei 112304, Taiwan; (C.-Y.W.); (H.-H.H.)
| | - Yu-Hsin Lin
- Department of Pharmacy, National Yang Ming Chiao Tung University, Taipei Branch, Taipei 112304, Taiwan;
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 404333, Taiwan
| | - Hsin-Hua Hsieh
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei Branch, Taipei 112304, Taiwan; (C.-Y.W.); (H.-H.H.)
| | - Jia-Jia Lin
- Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan 404333, Taiwan;
| | - Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung 404332, Taiwan
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17
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Raeisi-Dehkordi H, Amiri M, Moghtaderi F, Zimorovat A, Rahmanian M, Mozaffari-Khosravi H, Salehi-Abargouei A. Effects of sesame, canola and sesame-canola oils on body weight and composition in adults with type 2 diabetes mellitus: a randomized, triple-blind, cross-over clinical trial. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2021; 101:6083-6092. [PMID: 33899246 DOI: 10.1002/jsfa.11265] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/23/2021] [Accepted: 04/25/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Recent investigations have proposed that sesame and canola oils might affect body fat distribution. The present study aimed to examine the effects of sesame, canola and sesame-canola (a blend of sesame and canola oils) oils on body weight and composition in adults with type 2 diabetes mellitus in the context of a randomized, triple-blind, three-way, cross-over clinical trial. RESULTS Eligible participants were randomized to replace their regular dietary oil with sesame oil (SO), canola oil (CO) and sesame-canola oil (SCO) (with 40% SO and 60% CO). Treatment periods lasted 9 weeks and were separated by 4-week wash-out periods. Body weight and composition were measured at the beginning, in the middle and at the end of each intervention phase. In total, 93 participants completed the study. After adjustment for confounders, within-period changes were observed following SO and CO intake for body weight (0.34 ± 0.16 kg and 0.33 ± 0.17 kg) and visceral fat (0.13 ± 0.06% and 0.13 ± 0.05%, P < 0.05), respectively. Body mass index was increased within SO intake (0.13 ± 0.05 kg m-2 , P = 0.031). All of the treatment oils resulted in reduced waist circumference and index of central obesity (P < 0.05). A significant difference in change values was observed for visceral fat between SCO (-0.14 ± 0.07%) and SO (0.12 ± 0.08%) treatment periods in females (P = 0.02). CONCLUSION Sesame and canola oils might lead to a modest favorable body fat redistribution by reducing central adiposity, particularly in females; however, the changes were of little clinical importance. © 2021 Society of Chemical Industry.
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Affiliation(s)
- Hamidreza Raeisi-Dehkordi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mojgan Amiri
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fatemeh Moghtaderi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Alireza Zimorovat
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Masoud Rahmanian
- Diabetes Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hassan Mozaffari-Khosravi
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Diabetes Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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18
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Zaghloul MS, Abdul-Malak OM, Cherfan P, Go C, Saadeddin Z, Al-Khoury GE, Chaer RA, Avgerinos ED. Female Gender is a Predictor of Lower Iliac Vein Stenting Patency Rates. Ann Vasc Surg 2021; 78:247-256. [PMID: 34464730 DOI: 10.1016/j.avsg.2021.06.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/29/2021] [Accepted: 06/06/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Iliac venous stenting (IVS) for thrombotic and nonthrombotic venous disease is increasingly used as evidence of the safety, efficacy and durability of these interventions increases. Female gender has been implicated as a predictor of failure in arterial endovascular interventions. We hypothesize that female gender could be predictive of patency rates of iliac vein stenting. METHODS Consecutive patients who underwent IVS for thrombotic or nonthrombotic venous disease at our institution from 2007 until 2019 were identified and divided into groups based on gender. Operative notes, venograms, and the electronic health record were then queried to obtain operative details, co-morbid conditions, postoperative outcomes and stent patency. Study outcome was long term patency rate. The data was analyzed using chi-square, logistic regression, and Kaplan-Meier analysis as appropriate. RESULTS A total of 200 consecutive patients (231 limbs) were identified in our retrospective analysis, with a mean age of 48.8 ± 17.3, and BMI of 31.6 ± 8.6. Of those, 119 (59.5%) patients, (131 [56.8%] limbs) were female. Comparisons between the gender groups revealed no difference in age, BMI, or preoperative comorbidities. There was no difference in type of venous disease between male (85% thrombotic, 15% nonthrombotic) and female (84% thrombotic, 16% nonthrombotic), P= 0.830. The male cohort was more likely to present with leg ulceration (17% vs. 4.6%, P = 0.002), and the female cohort was more likely to present with leg edema (98.5% vs. 93.0%, P= 0.03). The male cohort had a higher rate of caval (48% vs. 33.6%, P= 0.027) and infrainguinal stent extension. (11% vs. 6.9%, P= 0.02). Females had a higher rate of left sided stenting (80.9% vs. 66/0%, P= 0.010). There was no difference in the median stent diameter used between the cohorts. Primary patency at 5 years was significantly higher for the male cohort (94.1% vs. 74.4%, P= 0.01) On adjusted multivariable cox regression female gender was a predictor of loss of primary patency within 5 years (HR, 4.04; P= 0.007). CONCLUSIONS In this single center retrospective analysis of IVS, male patients were found to have better primary stent patency compared to female.
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Affiliation(s)
- Mohamed S Zaghloul
- Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Othman M Abdul-Malak
- Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Patrick Cherfan
- Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Catherine Go
- Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Zein Saadeddin
- Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Georges E Al-Khoury
- Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Rabih A Chaer
- Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Efthymios D Avgerinos
- Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
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19
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Huang J, Li W, Wei S, Zhou X, Nong Y, Sun J, Zhai Z, Lu W. Associations of Estimated Glomerular Filtration Rate with All-Cause Mortality and Cardiovascular Mortality in Patients with Diabetic Foot Osteomyelitis. Int J Gen Med 2021; 14:4499-4509. [PMID: 34429636 PMCID: PMC8374850 DOI: 10.2147/ijgm.s323015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/02/2021] [Indexed: 11/23/2022] Open
Abstract
Aim The purpose of this study was to explore the association between estimated glomerular filtration rate (eGFR) and clinical outcomes in patients with diabetic foot osteomyelitis (DFO). Methods This was a retrospective observational study. A total of 199 patients with DFO were recruited and divided into three groups by eGFR: normal kidney function group (eGFR ≥ 90), mildly decreased kidney function group (eGFR 60–89) and moderately to severely decreased kidney function group (eGFR < 60). The patients were followed-up for a median of 36 months, and the study outcomes were all-cause mortality and major cardiovascular adverse events (MACE). Cox proportional hazard models were used to assess the association between eGFR and the outcomes, and a stratified analysis by sex was conducted. Results During follow-up, all-cause mortality occurred in 51 (25.63%) patients among 199 participants, 54 (28.72%) had MACE in 188 participants and 26 (48.15%) of them died. After fully adjusting for potential confounders, compared to eGFR < 90 mL/min/1.73 m2, eGFR ≥ 90 mL/min/1.73 m2 had lower incidence of all-cause mortality (HR = 0.43, 95% CI: 0.22–0.85; P = 0.015) and MACE (HR = 0.51, 95% CI: 0.27–0.96; P = 0.038). Additionally, compared to eGFR < 90 mL/min/1.73 m2, eGFR ≥ 90 mL/min/1.73 m2 was independently associated with decreased risk of all-cause mortality (HR = 0.33; 95% CI 0.14–0.76, P = 0.010) and MACE (HR = 0.27; 95% CI 0.11–0.65, P = 0.004) in male, but not in female. Conclusion In conclusion, decreased eGFR is a risk factor for all-cause mortality and MACE in individuals with DFO. Additionally, male with decreased eGFR had a higher risk of all-cause mortality and MACE, but female did not.
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Affiliation(s)
- Jianhao Huang
- Department of Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People's Republic of China
| | - Weiwei Li
- The Office of Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People's Republic of China
| | - Suosu Wei
- Editorial Board of Chinese Journal of New Clinical Medicine, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People's Republic of China
| | - Xing Zhou
- Department of Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People's Republic of China
| | - Yuechou Nong
- Department of Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People's Republic of China
| | - Jingxia Sun
- Department of Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People's Republic of China
| | - Zhenwei Zhai
- Department of Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People's Republic of China
| | - Wensheng Lu
- Department of Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People's Republic of China
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20
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Blecha S, Zeman F, Specht S, Lydia Pfefferle A, Placek S, Karagiannidis C, Bein T. Invasiveness of Treatment Is Gender Dependent in Intensive Care: Results From a Retrospective Analysis of 26,711 Cases. Anesth Analg 2021; 132:1677-1683. [PMID: 32739963 DOI: 10.1213/ane.0000000000005082] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Health care and outcome of critically ill patients are marked by gender-related differences. Several studies have shown that male patients in intensive care units (ICU) more often receive mechanical ventilation, dialysis, pulmonary arterial catheterization (PAC), and central venous catheterization (CVC). We investigated gender-related differences in ICU treatment and mortality. METHODS This retrospective, single-center study analyzed adult ICU patients admitted to the University Medical Center Regensburg between January 2010 and December 2017. Illness severity was measured with the Simplified Acute Physiology Score II (SAPS II) at ICU admission. We evaluated the intensity of ICU treatment according to the implementation of tracheostomy and extracorporeal membrane oxygenation (ECMO). We then assessed gender-related differences in the duration of mechanical ventilation and other invasive monitoring (PAC) and treatment methods (CVC, endotracheal intubation rate, and dialysis). ICU treatment and mortality data were obtained from an electronic data capture system. After adjusting for age, reason for hospitalization, and SAPS II score, we assessed the influence of gender on the intensity of ICU treatment using multivariable logistic regression. Odds ratios (OR) for the logistic regression models and incidence rate ratios (IRR) for the negative binomial regression models were calculated as effect estimates together with the corresponding 95% confidence intervals (95% CI). A P value of <.05 was considered significant. RESULTS The study analyzed 26,711 ICU patients (64.8% men). The ICU mortality rate was 8.8%. Illness severity, ICU, and hospital mortality did not differ by gender. Women were older than men (62.6 vs 61.3 years; P < .001) at ICU admission. After multivariable adjustment, men were more likely to undergo tracheostomy (OR = 1.39 [1.26-1.54]), ECMO (OR = 1.37 [1.02-1.83]), dialysis (OR = 1.29 [1.18-1.41]), and PAC insertion (OR = 1.81 [1.40-2.33]) and had a longer duration of mechanical ventilation than women (IRR = 1.07 [1.02-1.12]). The frequency of endotracheal intubation (OR = 1.04 [0.98-1.11]) and placement of CVC (OR = 1.05 [0.98-1.11]) showed no gender-specific differences. Of ICU nonsurvivors, men were more likely to undergo tracheostomy (20.1% vs 15.3%; P = .004) and dialysis (54% vs 46.4%; P < .001) than women and had a longer duration of mechanical ventilation (6.3 vs 5.4 days; P = .015). CONCLUSIONS After adjustment for severity of disease and outcome, ICU treatment differs between men and women. Men were more likely than women to undergo tracheostomy and ECMO.
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Affiliation(s)
| | - Florian Zeman
- Center for Clinical Studies, University Medical Center Regensburg, Regensburg, Germany
| | | | | | | | - Christian Karagiannidis
- Department of Pneumology and Critical Care Medicine, Cologne-Merheim Hospital, ARDS and ECMO Center, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University Hospital, Cologne, Germany
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Raeisi-Dehkordi H, Amiri M, Zimorovat A, Moghtaderi F, Zarei S, Forbes SC, Salehi-Abargouei A. Canola oil compared with sesame and sesame-canola oil on glycaemic control and liver function in patients with type 2 diabetes: A three-way randomized triple-blind cross-over trial. Diabetes Metab Res Rev 2021; 37:e3399. [PMID: 32860716 DOI: 10.1002/dmrr.3399] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND This study aimed to compare the effects of sesame (SO), canola (CO), and sesame-canola (SCO: a blend) oils on glycaemic control markers and liver function enzymes in adults with type 2 diabetes. METHODS In this randomized, triple-blind, three-way, cross-over clinical trial, participants replaced their usual oil with the intervention oils for 9 weeks. Serum fasting blood sugar, fasting serum insulin (FSI), insulin resistance (HOMA2-IR), beta-cell function (HOMA2-%B), insulin sensitivity (HOMA2-%S), quantitative insulin sensitivity check index (QUICKI), as well as serum liver function enzymes were measured at baseline and end of intervention periods. RESULTS Ninety-two participants completed all treatment periods. After adjusting for confounders, all treatment oils resulted in significant improvements in FSI and HOMA2-%S (p < 0.05). SO and SCO led to favourable changes in HOMA2-IR and QUICKI (p < 0.05). Following CO and SCO, there was a significant decrease in HOMA2-%B (p < 0.05). The sex-stratified analysis revealed that FSI and HOMA2-IR were decreased after SO compared to CO in males (p = 0.024). Serum gamma-glutamyltransferase (GGT) was significantly lower following SO compared to CO in females (p = 0.02), however, the difference in change values was not significant (p = 0.058). CONCLUSIONS SO consumption appears to improve glycaemic control markers in males and serum GGT in females compared with CO in patients with type 2 diabetes (registration code: IRCT2016091312571N6).
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Affiliation(s)
- Hamidreza Raeisi-Dehkordi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mojgan Amiri
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Alireza Zimorovat
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fatemeh Moghtaderi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sadegh Zarei
- Department of Clinical Biochemistry, Faculty of medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Scott C Forbes
- Department of Physical Education, Faculty of Education, Brandon University, Brandon, Manitoba, Canada
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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22
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Karalija N, Papenberg G, Wåhlin A, Johansson J, Andersson M, Axelsson J, Riklund K, Lindenberger U, Nyberg L, Bäckman L. Sex differences in dopamine integrity and brain structure among healthy older adults: Relationships to episodic memory. Neurobiol Aging 2021; 105:272-279. [PMID: 34134056 DOI: 10.1016/j.neurobiolaging.2021.04.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 12/17/2022]
Abstract
Normal brain aging is a multidimensional process that includes deterioration in various brain structures and functions, with large heterogeneity in patterns and rates of decline. Sex differences have been reported for various cognitive and brain parameters, but little is known in relation to neuromodulatory aspects of brain aging. We examined sex differences in dopamine D2-receptor (D2DR) availability in relation to episodic memory, but also, grey-matter volumes, white-matter lesions, and cerebral perfusion in healthy older adults (n = 181, age: 64-68 years) from the Cognition, Brain, and Aging study. Women had higher D2DR availability in midbrain and left caudate and putamen, as well as superior episodic memory performance. Controlling for left caudate D2DR availability attenuated sex differences in memory performance. In men, lower left caudate D2DR levels were associated with lower cortical perfusion and higher burden of white-matter lesions, as well as with episodic memory performance. However, sex was not a significant moderator of the reported links to D2DR levels. Our findings suggest that sex differences in multiple associations among DA receptor availability, vascular factors, and structural connectivity contribute to sex differences in episodic memory. Future longitudinal studies need to corroborate these patterns by lead-lag associations. This manuscript is part of the Special Issue entitled 'Cognitive Neuroscience of Healthy and Pathological Aging' edited by Drs. M. N. Rajah, S. Belleville, and R. Cabeza. This article is part of the Virtual Special Issue titled COGNITIVE NEUROSCIENCE OF HEALTHY AND PATHOLOGICAL AGING. The full issue can be found on ScienceDirect at https://www.sciencedirect.com/journal/neurobiology-of-aging/special-issue/105379XPWJP.
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Affiliation(s)
- Nina Karalija
- Department of Radiation Sciences, Umeå University, Umeå, Sweden; Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden.
| | - Goran Papenberg
- Aging Research Center, Karolinska Institute & Stockholm University, Stockholm, Sweden
| | - Anders Wåhlin
- Department of Radiation Sciences, Umeå University, Umeå, Sweden; Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
| | - Jarkko Johansson
- Department of Radiation Sciences, Umeå University, Umeå, Sweden; Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
| | - Micael Andersson
- Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden; Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
| | - Jan Axelsson
- Department of Radiation Sciences, Umeå University, Umeå, Sweden; Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
| | - Katrine Riklund
- Department of Radiation Sciences, Umeå University, Umeå, Sweden; Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
| | - Ulman Lindenberger
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany; Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany, and London
| | - Lars Nyberg
- Department of Radiation Sciences, Umeå University, Umeå, Sweden; Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden; Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
| | - Lars Bäckman
- Aging Research Center, Karolinska Institute & Stockholm University, Stockholm, Sweden
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23
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Ambrož M, de Vries ST, Vart P, Dullaart RPF, Roeters van Lennep J, Denig P, Hoogenberg K. Sex Differences in Lipid Profile across the Life Span in Patients with Type 2 Diabetes: A Primary Care-Based Study. J Clin Med 2021; 10:jcm10081775. [PMID: 33921745 PMCID: PMC8072568 DOI: 10.3390/jcm10081775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/11/2021] [Accepted: 04/16/2021] [Indexed: 12/15/2022] Open
Abstract
We assessed sex differences across the life span in the lipid profile of type 2 diabetes (T2D) patients treated and not treated with statins. We used the Groningen Initiative to ANalyze Type 2 diabetes Treatment database, which includes T2D patients from the north of the Netherlands. Patients with a full lipid profile determined between 2010 and 2012 were included. We excluded patients treated with other lipid-lowering drugs than statins. Sex differences in low- and high-density lipoprotein cholesterol (LDL-c and HDL-c) and triglyceride (TG) levels across 11 age groups stratified by statin treatment were assessed using linear regression. We included 26,849 patients (51% women, 55% treated with statins). Without statins, women had significantly lower LDL-c levels than men before the age of 45 years, similar levels between 45 and 49 years, and higher levels thereafter. With statins, similar LDL-c levels were shown up to the age of 55, and higher levels in women thereafter. Women had significantly higher HDL-c levels than men, regardless of age or statin treatment. Men had significantly higher TG levels up to the age of 55 and 60, depending on whether they did not take or took statins, respectively, and similar levels thereafter. When managing cardiovascular risk in patients with T2D, attention is needed for the menopausal status of women and for TG levels in younger men.
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Affiliation(s)
- Martina Ambrož
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands; (S.T.d.V.); (P.V.); (P.D.)
- Correspondence:
| | - Sieta T. de Vries
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands; (S.T.d.V.); (P.V.); (P.D.)
| | - Priya Vart
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands; (S.T.d.V.); (P.V.); (P.D.)
| | - Robin P. F. Dullaart
- Department of Internal Medicine-Endocrinology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands;
| | - Jeanine Roeters van Lennep
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, 3015GD Rotterdam, The Netherlands;
| | - Petra Denig
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands; (S.T.d.V.); (P.V.); (P.D.)
| | - Klaas Hoogenberg
- Department of Internal Medicine, Martini Hospital, 9728NT Groningen, The Netherlands;
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24
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Azizi Z, Gisinger T, Bender U, Deischinger C, Raparelli V, Norris CM, Kublickiene K, Herrero MT, Emam KE, Kautzky-Willer A, Pilote L. Sex, Gender, and Cardiovascular Health in Canadian and Austrian Populations. Can J Cardiol 2021; 37:1240-1247. [PMID: 33785367 DOI: 10.1016/j.cjca.2021.03.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/09/2021] [Accepted: 03/07/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Evidence differentiating the effect of biological sex from psychosociocultural factors (gender) in different societies and its relation to cardiovascular diseases is scarce. We explored the association between sex, gender, and cardiovascular health (CVH) among Canadian (CAN) and Austrian (AT) populations. METHODS The Canadian Community Health Survey (CCHS) (n = 63,522; 55% female) and Austrian Health Interview Survey (AT-HIS) (n = 15,771; 56% female) were analyzed in a cross-sectional survey design. The CANHEART/ATHEART index, a measure of ideal CVH composed of 6 cardiometabolic risk factors (smoking, physical activity, fruit and vegetable consumption, overweight/obesity, diabetes, and hypertension; range 0-6; higher scores reflecting better CVH) was calculated for both databases. A composite measure of psychosociocultural gender was computed for each country (range 0-1, higher score identifying characteristics traditionally ascribed to women). RESULTS Median CANHEART 4 (interquartile range 3-5) and CAN gender scores 0.55 (0.49-0.60) were similar to median ATHEART 4 (3-5) and AT gender scores 0.55 (0.46-0.64). Although higher gender scores (CCHS: β = -1.33, 95% confidence interval [CI] -1.44 to -1.22; AT-HIS: β = -1.08, 95% CI -1.26 to -0.89)) were associated with worse CVH, female sex (CCHS: β = 0.35, 95% CI (0.33-0.37); AT-HIS: β = 0.60, 95% CI (0.55-0.64)) was associated with better CVH in both populations. In addition, higher gender scores were associated with increased prevalence of heart disease compared with female sex. The magnitude of this risk was higher in Austrians. CONCLUSIONS These results demonstrate that individuals with characteristics typically ascribed to women reported poorer cardiovascular health and higher risk of heart disease, independently from biological sex and baseline CV risk factors, in both countries. Female sex exhibited better CV health and a lower prevalence of heart disease than male in both populations. However, gender factors and magnitude of gender impact varied by country.
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Affiliation(s)
- Zahra Azizi
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montréal, Québec, Canada
| | - Teresa Gisinger
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Vienna, Austria
| | - Uri Bender
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montréal, Québec, Canada
| | - Carola Deischinger
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Vienna, Austria
| | - Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Colleen M Norris
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada; Heart and Stroke Strategic Clinical Networks, Alberta Health Services, Edmonton, Alberta, Canada
| | - Karolina Kublickiene
- Section for Renal Medicine, Department of Clinical Intervention, Science, and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | | | - Khaled El Emam
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Replica Analytics, Ottawa, Ontario, Canada
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Vienna, Austria
| | - Louise Pilote
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montréal, Québec, Canada; Divisions of Clinical Epidemiology and General Internal Medicine, McGill University Health Centre Research Institute, Montréal, Québec, Canada.
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25
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Ma Y, Sun M, Liang Q, Wang F, Lin L, Li T, Duan J, Sun Z. The relationship between long-term exposure to PM 2.5 and hypertension in women:A meta-analysis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 208:111492. [PMID: 33120275 DOI: 10.1016/j.ecoenv.2020.111492] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 10/04/2020] [Accepted: 10/10/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Gender difference and PM2.5 exposure all have effects on hypertension, change of estrogen level in different women's stage bring complex influence on blood pressure. Then we conduct this meta-analysis to investigate the association between long-term exposure (at least one year) to fine particulate matter (PM2.5) and hypertension in adult non-pregnant women. METHOD Four major databases: PubMed, Cochrane Library, Web of Science and Embase were searched with specific search terms, and 11 studies were finally selected. The meta-analysis module of software Stata 12.0 was used for data processing with the effect values hazard ratio (HR) and odds ratio (OR) respectively. RESULTS After sensitivity analysis, we removed a study with highly heterogeneity and finally included 10 studies. Meta-analysis results showed that exposure to PM2.5 (per 10 μg/m3 increase) was associated with hypertension in non-pregnancy adult women, HR = 1.23, 95%CI: 1.08-1.40; OR = 1.07, 95%CI: 1.00-1.14. And subgroup analysis showed that menopause, non-White and diabetes are the key risk factors of hypertension when exposed to PM2.5. CONCLUSION This is the first meta-analysis to explore the association between PM2.5 and non-pregnancy women, and calculate OR and HR respectively for the first time. Exposure to PM2.5 could increase the risk of hypertension in non-pregnancy women, and the combined 'HR' was much higher than 'OR'.
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Affiliation(s)
- Yuexiao Ma
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Mengqi Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Qingqing Liang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Fenghong Wang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Lisen Lin
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Tianyu Li
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Junchao Duan
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China.
| | - Zhiwei Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China.
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26
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Cismaru AC, Cismaru LG, Nabavi SF, Berindan-Neagoe I, Clementi E, Banach M, Nabavi SM. Game of "crowning" season 8: RAS and reproductive hormones in COVID-19 - can we end this viral series? Arch Med Sci 2021; 17:275-284. [PMID: 33747262 PMCID: PMC7959061 DOI: 10.5114/aoms.2020.96604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/27/2020] [Indexed: 01/08/2023] Open
Abstract
The outbreak of a newly identified coronavirus, the SARS-CoV-2 (alternative name 2019-nCoV), capable of jumping across species causing zoonosis with severe acute respiratory syndromes (SARS), has alerted authorities worldwide. Soon after the epidemic was first detected in the city of Wuhan in the Hubei Province of China, starting in late December 2019, the virus spread over multiple countries in different continents, being declared a pandemic by March 2020. The demographic characteristics of the infected patients suggest that age, sex, and comorbidities are predictive factors for the fatality of the infection. The mechanisms of viral entry into the human host cells seem to be in a close relationship with the mechanisms of regulating the renin-angiotensin system (RAS), which may explain the pathogenesis associated with the infection. This brings new insights into the possibilities of exploiting viral entry mechanisms to limit associated complications by means of enhancing the resistance of the infected patients using methods of regulating the RAS and strategies of modulating ACE2 expression. In this perspective article we exploit the mechanisms of COVID-19 pathogenesis based on the demographic characteristics of the infected patients reported in the recent literature and explore several approaches of limiting the initial steps of viral entry and pathogenesis based on viral interactions with ACE2 and RAS. We further discuss the implications of reproductive hormones in the regulation of the RAS and investigate the premise of using endocrine therapy against COVID-19.
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Affiliation(s)
- Andrei Cosmin Cismaru
- Research Centre for functional Genomics, Biomedicine, and Translational Medicine, The “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Department of Functional Sciences, Immunology, and Allergology, The “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - Laurentiu Gabriel Cismaru
- Department of Internal Medicine, Cardiology-Rehabilitation, The “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Seyed Fazel Nabavi
- Applied Biotechnology Research Centre, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Division of Translational Medicine, Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ioana Berindan-Neagoe
- Research Centre for functional Genomics, Biomedicine, and Translational Medicine, The “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- MEDFUTURE – Research Centre for Advanced Medicine – The “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- The Functional Genomics Department, The Oncology Institute “Prof. Dr. Ion Chiricuta”, Cluj-Napoca, Romania
| | - Emilio Clementi
- E. Medea Scientific Institute, Bosisio Parini, Italy
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, Luigi Sacco University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
| | - Seyed Mohammad Nabavi
- Applied Biotechnology Research Centre, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Division of Translational Medicine, Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, Tehran, Iran
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27
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Suskin NG, Huitema AA, Hartley T, McKelvie RS. Sex, Depression, and More in Cardiac Rehabilitation. Can J Cardiol 2020; 37:357-358. [PMID: 33290825 DOI: 10.1016/j.cjca.2020.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Neville G Suskin
- St Joseph's Health Care London, London, Ontario, Canada; Western University, London, Ontario, Canada.
| | - Ashlay A Huitema
- St Joseph's Health Care London, London, Ontario, Canada; Western University, London, Ontario, Canada
| | - Tim Hartley
- St Joseph's Health Care London, London, Ontario, Canada
| | - Robert S McKelvie
- St Joseph's Health Care London, London, Ontario, Canada; Western University, London, Ontario, Canada
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28
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Rodríguez-Sánchez E, Navarro-García JA, González-Lafuente L, Aceves-Ripoll J, Vázquez-Sánchez S, Poveda J, Mercado-García E, Corbacho-Alonso N, Calvo-Bonacho E, Fernández-Velasco M, Álvarez-Llamas G, Barderas MG, Ruilope LM, Ruiz-Hurtado G. Oxidized Low-Density Lipoprotein Associates with Ventricular Stress in Young Adults and Triggers Intracellular Ca 2+ Alterations in Adult Ventricular Cardiomyocytes. Antioxidants (Basel) 2020; 9:antiox9121213. [PMID: 33271910 PMCID: PMC7761043 DOI: 10.3390/antiox9121213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/20/2020] [Accepted: 11/26/2020] [Indexed: 12/13/2022] Open
Abstract
Oxidized low-density lipoprotein (oxLDL) is associated with cardiac damage and causes injury to multiple cell types. We aimed to investigate the role of oxLDL in ventricular stress. We first examined the association between circulating oxLDL and N-terminal pro-brain natriuretic peptide (NT-proBNP), a marker of myocardial stress, in young subjects (30-50 years) with or without stable coronary artery disease (SCAD). oxLDL and NT-proBNP were significantly higher in subjects at high cardiovascular risk (CVR) than in subjects at low CVR and were associated independently of traditional CVR factors and C-reactive protein. Furthermore, the levels of oxLDL and NT-proBNP were significantly lower in subjects with SCAD than in peers at high CVR. To determine the intracellular mechanisms involved in the cardiac effects of oxLDL, we analyzed the in vitro effect of oxLDL on intracellular Ca2+ handling in adult rat ventricular cardiomyocytes using confocal microscopy. Acute challenge of adult ventricular cardiomyocytes to oxLDL reduced systolic Ca2+ transients and sarcoplasmic reticulum Ca2+ load. Moreover, diastolic spontaneous Ca2+ leak increased significantly after acute exposure to oxLDL. Thus, we demonstrate that oxLDL associates with NT-proBNP in young subjects, and can directly induce Ca2+ mishandling in adult ventricular cardiomyoyctes, predisposing cardiomyocytes to cardiac dysfunction and arrhythmogenicity.
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Affiliation(s)
- Elena Rodríguez-Sánchez
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - José Alberto Navarro-García
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Laura González-Lafuente
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Jennifer Aceves-Ripoll
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Sara Vázquez-Sánchez
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Jonay Poveda
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Elisa Mercado-García
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Nerea Corbacho-Alonso
- Department of Vascular Physiopathology, Hospital Nacional de Parapléjicos, SESCAM, 45004 Toledo, Spain; (N.C.-A.); (M.G.B.)
| | | | - María Fernández-Velasco
- IdiPAZ Institute for Health Research/Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, CIBER-CV, 28029 Madrid, Spain;
| | | | - María G. Barderas
- Department of Vascular Physiopathology, Hospital Nacional de Parapléjicos, SESCAM, 45004 Toledo, Spain; (N.C.-A.); (M.G.B.)
| | - Luis M. Ruilope
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
- Hypertension Unit, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- CIBER-CV, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- European University of Madrid, Madrid, Spain
| | - Gema Ruiz-Hurtado
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
- Hypertension Unit, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- CIBER-CV, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- Correspondence: ; Tel.: +34-91-390-8001
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Mah SM, Sanmartin C, Riva M, Dasgupta K, Ross NA. Active living environments, physical activity and premature cardiometabolic mortality in Canada: a nationwide cohort study. BMJ Open 2020; 10:e035942. [PMID: 33444170 PMCID: PMC7682462 DOI: 10.1136/bmjopen-2019-035942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To evaluate sex-specific and age-specific associations of active living environments (ALEs) with premature cardiometabolic mortality. DESIGN Population-based retrospective cohort study. SETTING Residential neighbourhoods (1000-metre circular buffers from the centroids of dissemination areas) across Canada for which the Canadian ALE Measure was derived, based on intersection density, points of interest and dwelling density. PARTICIPANTS 249 420 survey respondents from an individual-level record linkage between the Canadian Community Health Survey (2000-2010) and the Canadian Mortality Database until 2011, comprised of older women (65-85 years), older men (65-81 years), middle-aged women (45-64 years) and middle-aged men (45-64 years). PRIMARY OUTCOME MEASURES Premature cardiometabolic mortality and average daily energy expenditure attributable to walking. Multivariable proportional hazards regression models were adjusted for age, educational attainment, dissemination area-level median income, smoking status, obesity, the presence of chronic conditions, season of survey response and survey cycle. RESULTS Survey respondents contributed a total of 1 451 913 person-years. Greater walking was observed in more favourable ALEs. Walking was associated with lower cardiometabolic death in all groups except for middle-aged men. Favourable ALEs conferred a 22% reduction in death from cardiometabolic causes (HR 0.78, 95% CI 0.63 to 0.97) for older women. CONCLUSIONS On average, people walk more in favourable ALEs, regardless of sex and age. With the exception of middle-aged men, walking is associated with lower premature cardiometabolic death. Older women living in neighbourhoods that favour active living live longer.
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Affiliation(s)
- Sarah M Mah
- Department of Geography, McGill University, Montreal, Quebec, Canada
| | | | - Mylène Riva
- Department of Geography, McGill University, Montreal, Quebec, Canada
- Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada
| | - Kaberi Dasgupta
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Nancy A Ross
- Department of Geography, McGill University, Montreal, Quebec, Canada
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Dong W, Wan EYF, Bedford LE, Wu T, Wong CKH, Tang EHM, Lam CLK. Prediction models for the risk of cardiovascular diseases in Chinese patients with type 2 diabetes mellitus: a systematic review. Public Health 2020; 186:144-156. [PMID: 32836004 DOI: 10.1016/j.puhe.2020.06.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 05/23/2020] [Accepted: 06/07/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Diabetes mellitus (DM) is a serious public health issue worldwide, and DM patients have higher risk of cardiovascular diseases (CVDs), which is the leading cause of DM-related deaths. China has the largest DM population, yet a robust model to predict CVDs in Chinese DM patients is still lacking. This systematic review is carried out to summarize existing models and identify potentially important predictors for CVDs in Chinese DM patients. STUDY DESIGN Systematic review. METHODS Medline and Embase were searched for data from April 1st, 2011 to May 31st, 2018. A study was eligible if it developed CVD (defined as total CVD or any major cardiovascular component) risk prediction models or explored potential predictors of CVD specifically for Chinese people with type 2 DM. Standardized forms were utilized to extract information, appraise applicability, risk of bias, and availabilities. RESULTS Five models and 29 studies focusing on potential predictors were identified. Models for a primary care setting, or to predict total CVD, are rare. A number of common predictors (e.g. age, sex, diabetes duration, smoking status, glycated hemoglobin (HbA1c), blood pressure, lipid profile, and treatment modalities) were observed in existing models, in which urine albumin:creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) are highly recommended for the Chinese population. Variability of blood pressure (BP) and HbA1c should be included in prediction model development as novel factors. Meanwhile, interactions between age, sex, and risk factors should also be considered. CONCLUSIONS A 10-year prediction model for CVD risk in Chinese type 2 DM patients is lacking and urgently needed. There is insufficient evidence to support the inclusion of other novel predictors in CVDs risk prediction functions for routine clinical use.
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Affiliation(s)
- W Dong
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong, China
| | - E Y F Wan
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong, China; Department of Pharmacology and Pharmacy, The University of Hong Kong, L02-56, 2/F, Laboratory Block, 21 Sassoon Road, Pokfulam, Hong Kong, China.
| | - L E Bedford
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong, China
| | - T Wu
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong, China
| | - C K H Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong, China
| | - E H M Tang
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong, China
| | - C L K Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong, China
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Abstract
Background: Although cardiovascular disease (CVD) is the leading cause of mortality in Latin American women, limited data exist on CVD perceptions in this population. This study aimed to assess CVD awareness and knowledge of women from Santiago, Chile. Methods: This was a cross-sectional study conducted in women 35 to 70 years old. A multistage probability sampling (stratified by age and socioeconomic level) was used for participant selection. Participants completed a home survey about knowledge of CVD, risk factors, and perceived risk (based on standardized questions from the American Heart Association awareness survey). Results: 723 women participated in the study (mean age: 51 ± 9 years; 17.6% with high education level). Only 9.3% of the respondents mentioned CVD as women’s primary health problem, whereas 22.7% and 16.1%, respectively, listed breast cancer and other cancers. When asked to identify the leading cause of women’s death, only 14.4% identified CVD compared to 69.1% who recorded cancer. Older women (≥ 55 years) more likely identified CVD as the main cause of death: (OR 2.9: 95% CI = 1.8–4.5) versus younger women (<55 years). CVD family history was also associated with higher awareness of CVD as the leading cause of death (OR 1.7: 95% IC; p = 1.1–2.6). Instead, women with middle education level were less likely to mention CVD as the main women’s killer. Conclusions: Chilean women from Santiago have a low awareness of CVD as the leading cause of death and do not recognize CVD as their prominent health problem. Efforts should focus on increasing awareness and knowledge about CVD especially in young women.
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Sex Differences in Association of Elevated Blood Pressure with Variables Characterizing Cardiometabolic Risk in Young Subjects with or Without Metabolic Abnormalities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103612. [PMID: 32455627 PMCID: PMC7277167 DOI: 10.3390/ijerph17103612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/15/2020] [Accepted: 05/17/2020] [Indexed: 02/08/2023]
Abstract
Males present higher blood pressure (BP) values, higher prevalence of elevated BP, and a different prevalence of cardiometabolic risk factors when compared with females. We assumed that the trends of risk markers across BP categories (normotension, high normal BP, and hypertension) differ in young males and females, and between subjects without metabolic abnormalities (without obesity, insulin resistance, atherogenic dyslipidemia, hyperuricemia, or microinflammation) and those presenting them. Data from 2543 subjects (48% males) aged from 16 to 23 years were analyzed. The findings showed that 15% of males and 4% of females presented high normal BP while 9% and 1%, respectively, had hypertension. In males, variables characterizing obesity status, insulin sensitivity, atherogenic dyslipidemia, uric acid, adiponectin, a soluble receptor for advanced glycation end-products, and leukocyte counts showed worsening trends across BP categories. Females presented significant trends only for obesity measures, LDL-cholesterol, and non-HDL-cholesterol. Across BP categories, trends of variables characterizing cardiometabolic risk differed among abnormalities-free and presenting males. The multivariate model selected measures of central obesity, atherogenic dyslipidemia, insulin resistance, and uric acid as significant predictors of BP in both genders, and C-reactive protein in females. Sex differences in measures of cardiovascular health in juveniles may remain undiscovered unless two sexes are analyzed separately. These differences may have implications for sex-specific disease risk in adulthood.
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Shehab A, AlHabib KF, Bhagavathula AS, Hersi A, Alfaleh H, Alshamiri MQ, Ullah A, Sulaiman K, Almahmeed W, Al Suwaidi J, Alsheikh-Ali AA, Amin H, Al Jarallah M, Salam AM. Clinical Presentation, Quality of Care, Risk Factors and Outcomes in Women with Acute ST-Elevation Myocardial Infarction (STEMI): An Observational Report from Six Middle Eastern Countries. Curr Vasc Pharmacol 2020. [PMID: 29542414 DOI: 10.2174/1570161116666180315104820] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Most of the available literature on ST-Elevated myocardial infarction (STEMI) in women was conducted in the developed world and data from Middle-East countries was limited. AIMS To examine the clinical presentation, patient management, quality of care, risk factors and inhospital outcomes of women with acute STEMI compared with men using data from a large STEMI registry from the Middle East. METHODS Data were derived from the third Gulf Registry of Acute Coronary Events (Gulf RACE-3Ps), a prospective, multinational study of adults with acute STEMI from 36 hospitals in 6 Middle-Eastern countries. The study included 2928 patients; 296 women (10.1%) and 2632 men (89.9%). Clinical presentations, management and in-hospital outcomes were compared between the 2 groups. RESULTS Women were 10 years older and more likely to have diabetes mellitus, hypertension, and hyperlipidemia compared with men who were more likely to be smokers (all p<0.001). Women had longer median symptom-onset to emergency department (ED) arrival times (230 vs. 170 min, p<0.001) and ED to diagnostic ECG (8 vs. 6 min., p<0.001). When primary percutaneous coronary intervention (PPCI) was performed, women had longer door-to-balloon time (DBT) (86 vs. 73 min., p=0.009). When thrombolytic therapy was not administered, women were less likely to receive PPCI (69.7 vs. 76.7%, p=0.036). The mean duration of hospital stay was longer in women (6.03 ± 22.51 vs. 3.41 ± 19.45 days, p=0.032) and the crude in-hospital mortality rate was higher in women (10.4 vs. 5.2%, p<0.001). However, after adjustments, multivariate analysis revealed a statistically non-significant trend of higher inhospital mortality among women than men (6.4 vs. 4.6%), (p=0.145). CONCLUSION Our study demonstrates that women in our region have almost double the mortality from STEMI compared with men. Although this can partially be explained by older age and higher risk profiles in women, however, correction of identified gaps in quality of care should be attempted to reduce the high morbidity and mortality of STEMI in our women.
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Affiliation(s)
- Abdulla Shehab
- Internal Medicine Department, College of Medicine and Health Sciences (CMHS), UAE University, Al Ain, United Arab Emirates
| | - Khalid F AlHabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Akshaya S Bhagavathula
- Department of Clinical Pharmacy, University of Gondar, College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Ahmad Hersi
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Hussam Alfaleh
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Mostafa Q Alshamiri
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Anhar Ullah
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | | | - Wael Almahmeed
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - Jassim Al Suwaidi
- Department of Cardiology, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Alwai A Alsheikh-Ali
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.,Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.,Tufts Clinical and Translational Science Institute, Tufts Medical Center, Boston, MA, United States
| | - Haitham Amin
- Mohammed Bin Khalifa Cardiac Center, Manama, Bahrain
| | | | - Amar M Salam
- Adult Cardiology, Hamad Medical Corporation, Doha, Qatar
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Feldman RD. Sex-Specific Determinants of Coronary Artery Disease and Atherosclerotic Risk Factors: Estrogen and Beyond. Can J Cardiol 2020; 36:706-711. [PMID: 32389343 DOI: 10.1016/j.cjca.2020.03.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 03/02/2020] [Accepted: 03/02/2020] [Indexed: 12/18/2022] Open
Abstract
The way we view coronary artery disease in women has changed dramatically over the past decades. From an initial perspective that coronary artery disease was a male disorder and that women were protected by estrogens, there has been the gradual appreciation that this is an equal opportunity disease. Postmenopausal women are more likely than men to be hypertensive, dyslipidemic, and have multiple risk factors. Beyond the appreciation of estrogen's global effects on cardiovascular and metabolic function, our further advances in the understanding of sex-specific risks and management will be based on a greater understanding of the diversity of estrogen-mediated receptor pathways, including appreciation of the sometimes divergent effects of estrogen when acting either via the classic estrogen receptor or the more recently appreciated G protein-coupled estrogen receptor. In addition, the importance of sex-specific regulation of cardiometabolic processes beyond the sex hormones, specifically via SRY regulation, is only beginning to be understood. Finally, the author summarizes his recent studies demonstrating sex-specific G protein-coupled estrogen receptor regulation of blood pressure and cholesterol metabolism that may serve as a paradigm for the elucidation of sex-specific determinants of cardiovascular risk and the basis for sex-specific management of those risks.
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Affiliation(s)
- Ross D Feldman
- Departments of Medicine, of Physiology & Pathophysiology, of Pharmacology & Therapeutics, University of Manitoba, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada.
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Langlois AW, Park AL, Lentz EJ, Ray JG. Preeclampsia Brings the Risk of Premature Cardiovascular Disease in Women Closer to That of Men. Can J Cardiol 2020; 36:60-68. [DOI: 10.1016/j.cjca.2019.06.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/28/2019] [Accepted: 06/18/2019] [Indexed: 01/06/2023] Open
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Altschul DM, Wraw C, Der G, Gale CR, Deary IJ. Hypertension Development by Midlife and the Roles of Premorbid Cognitive Function, Sex, and Their Interaction. Hypertension 2019; 73:812-819. [PMID: 30776973 PMCID: PMC6426348 DOI: 10.1161/hypertensionaha.118.12164] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Higher early-life cognitive function is associated with better later-life health outcomes, including hypertension. Associations between higher prior cognitive function and less hypertension persist even when accounting for socioeconomic status, but socioeconomic status-hypertension gradients are more pronounced in women. We predicted that differences in hypertension development between sexes might be associated with cognitive function and its interaction with sex, such that higher early-life cognitive function would be associated with lower hypertension risk more in women than in men. We used accelerated failure time modeling with the National Longitudinal Study of Youth 1979. Cognitive function was assessed in youth, when participants were aged between 14 and 21 years. Of 2572 men and 2679 women who completed all assessments, 977 men and 940 women reported hypertension diagnoses by 2015. Socioeconomic status in youth and adulthood were investigated as covariates, as were components of adult socioeconomic status: education, occupational status, and family income. An SD of higher cognitive function in youth was associated with reduced hypertension risk (acceleration factor: ĉ=0.97; 95% CI, 0.96-0.99; P=0.001). The overall effect was stronger in women (sex×cognitive function: ĉ=0.97; 95% CI, 0.94-0.99; P=0.010); especially, higher functioning women were less at risk than their male counterparts. This interaction was itself attenuated by a sex by family income interaction. People with better cognitive function in youth, especially women, are less likely to develop hypertension later in life. Income differences accounted for these associations. Possible causal explanations are discussed.
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Affiliation(s)
- Drew M Altschul
- From the Department of Psychology (D.M.A., C.W., I.J.D.), University of Edinburgh, United Kingdom.,Centre for Cognitive Ageing and Cognitive Epidemiology (D.M.A., C.W., C.R.G., I.J.D.), University of Edinburgh, United Kingdom
| | - Christina Wraw
- From the Department of Psychology (D.M.A., C.W., I.J.D.), University of Edinburgh, United Kingdom.,Centre for Cognitive Ageing and Cognitive Epidemiology (D.M.A., C.W., C.R.G., I.J.D.), University of Edinburgh, United Kingdom
| | - Geoff Der
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, United Kingdom (G.D.)
| | - Catharine R Gale
- Centre for Cognitive Ageing and Cognitive Epidemiology (D.M.A., C.W., C.R.G., I.J.D.), University of Edinburgh, United Kingdom.,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, United Kingdom (C.R.G.)
| | - Ian J Deary
- From the Department of Psychology (D.M.A., C.W., I.J.D.), University of Edinburgh, United Kingdom.,Centre for Cognitive Ageing and Cognitive Epidemiology (D.M.A., C.W., C.R.G., I.J.D.), University of Edinburgh, United Kingdom
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Rahman A, Jackson H, Hristov H, Isaacson RS, Saif N, Shetty T, Etingin O, Henchcliffe C, Brinton RD, Mosconi L. Sex and Gender Driven Modifiers of Alzheimer's: The Role for Estrogenic Control Across Age, Race, Medical, and Lifestyle Risks. Front Aging Neurosci 2019; 11:315. [PMID: 31803046 PMCID: PMC6872493 DOI: 10.3389/fnagi.2019.00315] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 10/31/2019] [Indexed: 12/22/2022] Open
Abstract
Research indicates that after advanced age, the major risk factor for late-onset Alzheimer’s disease (AD) is female sex. Out of every three AD patients, two are females with postmenopausal women contributing to over 60% of all those affected. Sex- and gender-related differences in AD have been widely researched and several emerging lines of evidence point to different vulnerabilities that contribute to dementia risk. Among those being considered, it is becoming widely accepted that gonadal steroids contribute to the gender disparity in AD, as evidenced by the “estrogen hypothesis.” This posits that sex hormones, 17β-estradiol in particular, exert a neuroprotective effect by shielding females’ brains from disease development. This theory is further supported by recent findings that the onset of menopause is associated with the emergence of AD-related brain changes in women in contrast to men of the same age. In this review, we discuss genetic, medical, societal, and lifestyle risk factors known to increase AD risk differently between the genders, with a focus on the role of hormonal changes, particularly declines in 17β-estradiol during the menopause transition (MT) as key underlying mechanisms.
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Affiliation(s)
- Aneela Rahman
- Department of Neurology, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Hande Jackson
- Department of Neurology, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Hollie Hristov
- Department of Neurology, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Richard S Isaacson
- Department of Neurology, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Nabeel Saif
- Department of Neurology, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Teena Shetty
- Concussion Clinic, Hospital for Special Surgery, New York, NY, United States
| | - Orli Etingin
- Department of Internal Medicine, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Claire Henchcliffe
- Department of Neurology, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Roberta Diaz Brinton
- Department of Pharmacology, College of Medicine, The University of Arizona, Tucson, AZ, United States.,Department of Neurology, College of Medicine, The University of Arizona, Tucson, AZ, United States
| | - Lisa Mosconi
- Department of Neurology, Weill Cornell Medicine, Cornell University, New York, NY, United States.,Department of Radiology, Weill Cornell Medicine, Cornell University, New York, NY, United States.,Department of Psychiatry, New York University School of Medicine, New York, NY, United States
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Depression, Anxiety, Perceived Stress, and Their Changes Predict Greater Decline in Physical Health Functioning over 12 Months Among Patients with Coronary Heart Disease. Int J Behav Med 2019; 26:352-364. [PMID: 31218559 DOI: 10.1007/s12529-019-09794-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although the deleterious impact of psychological distress on patients with coronary heart disease (CHD) is recognized, few studies have examined the influence of change in psychological distress on health outcomes over time. This study investigated whether three common manifestations of distress (depression, anxiety, and perceived stress) and their changes predicted the decline in physical functioning in CHD patients over 12 months. In addition, perceived social support was examined as a buffer of psychological distress or a direct predictor of physical functioning. METHODS Participants were 255 CHD patients with a mean age of 63 (SD = 8.65) years, including 208 men and 47 women. Psychological distress and physical functioning were assessed at baseline, 6 months and 12 months. Hierarchical regression analyses were conducted to examine the influences of psychological factors on physical functioning over 12 months. All models were adjusted for baseline physical functioning, age, gender, marital status, education, BMI, and length of participation at a wellness center. RESULTS For each psychological distress variable (depression, anxiety, or perceived stress), both the baseline (βs = - 0.19 to - 0.32, ps = 0.008 to < 0.001) and its respective change over time (βs = - 0.17 to - 0.38, ps = 0.020 to < 0.001) independently and significantly predicted greater decline in physical functioning at 6 and 12 months, after adjusting for covariates. Perceived social support predicted greater improvement in physical functioning at 12 months (β = 0.13, p = 0.050), but it did not buffer impact of psychological distress. CONCLUSIONS Findings underscore the importance of monitoring various forms of psychological distress continuously over time for CHD patients.
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Kanbay M, Ertuglu LA, Afsar B, Ozdogan E, Kucuksumer ZS, Ortiz A, Covic A, Kuwabara M, Cherney DZI, van Raalte DH, de Zeeuw D. Renal hyperfiltration defined by high estimated glomerular filtration rate: A risk factor for cardiovascular disease and mortality. Diabetes Obes Metab 2019; 21:2368-2383. [PMID: 31297976 DOI: 10.1111/dom.13831] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/30/2019] [Accepted: 07/08/2019] [Indexed: 12/22/2022]
Abstract
Renal hyperfiltration, defined as an increased glomerular filtration rate above normal values, is associated with early phases of kidney disease in the setting of various conditions such as obesity and diabetes. Although it is recognized that glomerular hyperfiltration, that is, increased filtration per nephron unit (usually studied at low glomerular filtration levels and often referred to as single nephron hyperfiltration), is a risk factor for the progression of chronic kidney disease, the implications of having renal hyperfiltration for cardiovascular disease and mortality risk are incompletely understood. Recent evidence from diverse populations, including healthy individuals and patients with diabetes or established cardiovascular disease, suggests that renal hyperfiltration is associated with a higher risk of cardiovascular disease and all-cause mortality. In this review, we critically summarize the existing studies, discuss possible mechanisms, and describe the remaining gaps in our knowledge regarding the association of renal hyperfiltration with cardiovascular disease and mortality risk.
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Affiliation(s)
- Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koç University School of Medicine, Istanbul, Turkey
| | - Lale A Ertuglu
- Department of Medicine, School of Medicine, Koç University, Istanbul, Turkey
| | - Baris Afsar
- Department of Medicine, Division of Nephrology, Suleyman Demirel University School of Medicine, Isparta, Turkey
| | - Elif Ozdogan
- Department of Medicine, School of Medicine, Koç University, Istanbul, Turkey
| | - Zeynep S Kucuksumer
- Department of Medicine, School of Medicine, Koç University, Istanbul, Turkey
| | - Alberto Ortiz
- Dialysis Unit, School of Medicine, IIS-Fundacion Jimenez Diaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Adrian Covic
- Nephrology Clinic, Dialysis and Renal Transplant Center, 'C.I. PARHON' University Hospital, and 'Grigore T. Popa' University of Medicine, Iasi, Romania
| | | | - David Z I Cherney
- Department of Medicine, Division of Nephrology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Daniel H van Raalte
- Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Dick de Zeeuw
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Juster RP, de Torre MB, Kerr P, Kheloui S, Rossi M, Bourdon O. Sex Differences and Gender Diversity in Stress Responses and Allostatic Load Among Workers and LGBT People. Curr Psychiatry Rep 2019; 21:110. [PMID: 31630247 DOI: 10.1007/s11920-019-1104-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Measuring biological sex differences and socio-cultural gender diversity provides insights into individual variation in stress physiology and the development of "sex-specific" diseases. PURPOSE OF REVIEW: In this selective review, we summarize recent findings that assess sex and gender in relation to the stress hormone cortisol and multi-systemic physiological dysregulation called allostatic load. The focus of this research centers on workers as well as sexual and gender minorities as these populations provide unique insights into sex and gender at various levels of analysis from the micro-level to the macro-level. RECENT FINDINGS: Male/female sex, sex hormones, gender identity, gender roles, and sexual orientation are all variables that are distinctly correlated with stress physiology. Beyond identifying patterns of vulnerability to stress-related diseases, pathways towards resilience are of high priority in emerging literature. Stress scientists must account for both sex and gender in biobehavioral research. Future directions should assess macro-level constructs like institutionalized gender, occupational sex composition, and structural stigma to better understand the social determinants of health.
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Affiliation(s)
- Robert-Paul Juster
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Canada.
- Research Center of the Montreal Mental Health University Institute, Montreal, Canada.
- Center on Sex*Gender, Allostasis, and Resilience (CESAR), Montreal, Canada.
- , Montréal, Canada.
| | - Margot Barbosa de Torre
- Research Center of the Montreal Mental Health University Institute, Montreal, Canada
- Center on Sex*Gender, Allostasis, and Resilience (CESAR), Montreal, Canada
- Department of Biomedical Sciences, University of Montreal, Montreal, Canada
| | - Philippe Kerr
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Canada
- Research Center of the Montreal Mental Health University Institute, Montreal, Canada
- Center on Sex*Gender, Allostasis, and Resilience (CESAR), Montreal, Canada
| | - Sarah Kheloui
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Canada
- Research Center of the Montreal Mental Health University Institute, Montreal, Canada
- Center on Sex*Gender, Allostasis, and Resilience (CESAR), Montreal, Canada
| | - Mathias Rossi
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Canada
- Research Center of the Montreal Mental Health University Institute, Montreal, Canada
- Center on Sex*Gender, Allostasis, and Resilience (CESAR), Montreal, Canada
| | - Olivier Bourdon
- Research Center of the Montreal Mental Health University Institute, Montreal, Canada
- Center on Sex*Gender, Allostasis, and Resilience (CESAR), Montreal, Canada
- Department of Psychology, University of Quebec in Montreal, Montreal, Canada
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Sex × Gender and Sexual Orientation in Relation to Stress Hormones and Allostatic Load. GENDER AND THE GENOME 2019. [DOI: 10.1177/2470289719862555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In this selective review, emerging literature linking biological sex, sociocultural gender, and sexual orientation to stress hormone functioning and multisystemic physiological dysregulations are summarized. Beyond sex as a binary biological variable, continuums of sex hormones, gender roles, gender identity, and sexual orientation each uniquely help delineate pathways and mechanisms linked to stress-related disease trajectories. This implicates glucocorticoid functioning and allostatic load, the “wear and tear” of chronic stress in synergy with unhealthy behaviors. Clinical considerations are also discussed for the field of gender medicine.
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Ali MT, Al Suwaidi J. Racial and ethnic differences in cardiovascular disease and outcome in type 1 diabetes patients. Expert Rev Endocrinol Metab 2019; 14:225-231. [PMID: 31081398 DOI: 10.1080/17446651.2019.1613887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/29/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Type 1 diabetes mellitus (T1DM) has increased dramatically over the last two decades with global variation greater than 350-fold difference reflecting the ethnic, racial, and geographical variation. Diabetic patients remain at a higher risk of cardiovascular mortality than those without diabetes. Therefore, it is vital for clinicians to have in-depth knowledge of T1DM statistics and their impact on people health and health resources. AREAS COVERED This review will cover the epidemiologic characteristics of T1DM and the influence of race, ethnicity, and geographical variation on the incidence and the outcome. The minority populations health disparities in the clinical presentation and outcomes among youth with T1DM, the long-term glycemic control patterns in racially and ethnically diverse youth, and the long-term influence of these factors on cardiovascular outcomes will be elucidated. The PubMed database was searched using the terms: T1DM ± incidence, Race, ethnicity, and Genetic. EXPERT OPINION Understanding the epidemiological characteristics of T1DM including race, ethnicity and the genetic predisposition will help to develop guidelines target these higher risk patients of an unfavorable outcome. Further research and interventional strategies to identify infants at genetic risk of T1DM may help to prevent, stop or retard the destructive autoimmune process leading to T1DM.
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Affiliation(s)
- Mohammed T Ali
- a Heart Hospital , Hamad Medical Corporation , Doha , Qatar
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Podzolkov VI, Bragina AE, Podzolkovа NM. Menopausal hormone therapy and heart disease prevention: desired or valid? КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2019. [DOI: 10.15829/1728-8800-2019-3-94-106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Cardiovascular diseases are the main cause of death for women in older age groups. For many decades, specialists have tried to prevent their development by the use of estrogen. The review of the literature presents current data on the effect of menopausal hormone therapy (MHT) on the risk of cardiovascular complications. The results of the main randomized clinical and observational studies in this area, conducted over several decades, are discussed. We described the concept of “window of opportunities”, in accordance with which an improvement in cardiovascular prognosis can be expected only at the onset of MHT in women under the age of 60 years in early postmenopause (menopause duration <10 years). There are experimental and clinical data explaining the different effects of estrogen on the cardiovascular prognosis in women of various age groups and different duration of postmenopause. The recommendations given in the review on the use of MHT are based on modern international guidelines.
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Affiliation(s)
| | - A. E. Bragina
- I. M. Sechenov First Moscow State Medical University
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Witt E, Lorenz M, Völker U, Stangl K, Hammer E, Stangl V. Sex-specific differences in the intracellular proteome of human endothelial cells from dizygotic twins. J Proteomics 2019; 201:48-56. [PMID: 30951907 DOI: 10.1016/j.jprot.2019.03.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/11/2019] [Accepted: 03/27/2019] [Indexed: 12/19/2022]
Abstract
Differences between men and women are being continuously identified in many human diseases. The underlying reasons are not yet fully understood. Beside the influence of endogenous hormones and life style, intrinsic sex-specific dimorphisms at the cellular level may also play a role. HUVECs from twin pairs of opposite sex provide an excellent tool to address the question of sex-specific differences at the molecular level. We compared for the first time protein levels of male and female HUVECs from dizygotic twins using a proteomic approach. To investigate differences under basal and stress conditions, cells were either left untreated or wounded and serum starved for different time points. Approximately 10% of all proteins monitored showed significant sexual dimorphisms in their level under the different conditions tested. The majority of the proteins displayed a higher abundance in female cells. The magnitude of the difference in protein levels between male and female cells was rather small. The most prominent differences throughout all conditions were observed for several X-chromosome encoded proteins with higher levels in female (UBA1, HDHD1) or in male cells (G6PD). Proteins involved in basic cellular processes, such as gene expression and translation (e.g. HMGN1, SRP54) displayed sex-specific levels in particular conditions only. SIGNIFICANCE: This study provides novel insights into sexual dimorphic protein levels in HUVECs from twin pairs of the opposite sex. The findings identify proteins with sex-specific differences in their levels under different cell culture conditions. The study also highlights the presence of X-chromosome encoded proteins escaping X-chromosomal inactivation. The results emphasize the need to consider the cellular sex of male and female HUVECs in in vitro experiments.
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Affiliation(s)
- Eric Witt
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Germany
| | - Mario Lorenz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Medizinische Klinik für Kardiologie und Angiologie, Campus Mitte, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Germany
| | - Karl Stangl
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Medizinische Klinik für Kardiologie und Angiologie, Campus Mitte, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany
| | - Elke Hammer
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Germany.
| | - Verena Stangl
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Medizinische Klinik für Kardiologie und Angiologie, Campus Mitte, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany
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Campbell-Scherer DL, Asselin J, Osunlana AM, Ogunleye AA, Fielding S, Anderson R, Cave A, Johnson JA, Sharma AM. Changing provider behaviour to increase nurse visits for obesity in family practice: the 5As Team randomized controlled trial. CMAJ Open 2019; 7:E371-E378. [PMID: 31147378 PMCID: PMC6544504 DOI: 10.9778/cmajo.20180165] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND There is increasing recognition that health care professionals often fail to provide meaningful obesity care in routine clinical practice. There is scant information on how to support practice change. The objective of the 5AsT trial was to assess whether a co-created educational intervention would increase the quantity of obesity visits conducted by family practice nurses. METHODS We conducted a randomized controlled trial with convergent mixed-methods evaluation in a primary care network in Alberta, Canada. The intervention, based on the Theoretical Domains Framework and 5As of Obesity Management, included 12 2-hour interactive educational sessions from November 2013 to April 2014. Twenty-four teams of nurses, mental health workers and dietitians were randomly assigned to receive the intervention or regular training. The primary outcome measure was the rate ratio of nurse visits for adult obesity care to total clinical visits. Qualitative thematic analysis was previously used to identify barriers and facilitators to intervention uptake. In this study, mixed-methods analysis assessed the impact of these factors on individual nurses' outcomes. RESULTS There was no significant increase in visits over the 6-month intervention (rate ratio 1.30, 95% confidence interval [CI] 0.83-2.03) nor the 9-month post-intervention period (rate ratio 1.38, 95% CI 0.87-2.19). However, provider confidence, views of obesity management, role identity and team and patient relationships were found to affect individual nurses' uptake of the intervention. INTERPRETATION Although the intervention did not demonstrate a significant increase in nurse visits for obesity care, this study provides insights into health care practitioners' challenges in changing their approach to obesity management. To improve provider capacity to change effectively within their teams, interventions need to foster not only provider knowledge but also confidence. Trial registration: ClinicalTrials.gov, no. NCT01967797.
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Affiliation(s)
- Denise L Campbell-Scherer
- Department of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta.
| | - Jodie Asselin
- Department of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta
| | - Adedayo M Osunlana
- Department of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta
| | - Ayodele A Ogunleye
- Department of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta
| | - Sheri Fielding
- Department of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta
| | - Robin Anderson
- Department of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta
| | - Andrew Cave
- Department of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta
| | - Jeffrey A Johnson
- Department of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta
| | - Arya M Sharma
- Department of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta
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Low HDL cholesterol as a predictor of chronic kidney disease progression: a cross-classification approach and matched cohort analysis. Heart Vessels 2019; 34:1440-1455. [PMID: 30874893 DOI: 10.1007/s00380-019-01375-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 03/08/2019] [Indexed: 02/08/2023]
Abstract
Emerging epidemiological evidence indicates that low serum high-density lipoprotein cholesterol (HDL-C) levels are associated with the risk of progression of chronic kidney disease (CKD). However, the differences in the influence of serum HDL-C levels on CKD progression in different subcohorts have rarely been examined in detail in previous studies. The aim of this study was to investigate the significance of low serum HDL-C levels as a predictor of disease progression in CKD patients according to sub-analyses using a cross-classified subcohort. We reviewed data obtained from 120 CKD patients. Prognostic factors for renal outcome were identified by the multivariate Cox proportional hazards method. Kaplan-Meier analysis was performed to assess disease progression, which was defined as a > 30% decline in the glomerular filtration rate (GFR), or end-stage renal disease. The mean age of the included participants was 58.3 ± 13.6 years. The subjects were divided into two groups (low HDL-C vs. high HDL-C). The median follow-up period was 112.8 months. The kidney survival rate in the low HDL-C group was significantly lower than that in the high HDL-C group (P < 0.0001). However, the age-stratified analysis showed no difference between the two groups in the cohort of patients ≥ 70 years old. Multivariate Cox regression analyses showed a significant association between low HDL-C [hazard ratio (HR) 4.80, P = 0.009] and a ≥ 30% eGFR decline or ESRD. This association was more evident in the cohort of patients < 70 years old (HR 4.96, P = 0.0165), especially the female subcohort (HR 13.86, P = 0.0033). Multivariate analysis showed a significant correlation between visceral fat area and serum HDL-C levels among both male (P = 0.0017) and female (P = 0.0449) patients. In a propensity score-matched cohort (patients < 70 years old), the kidney survival rate of CKD patients was significantly lower in the low HDL-C group than in the high HDL-C group (P = 0.0364). A low serum HDL-C level is a significant predictor of CKD progression, especially in female patients with CKD under 70 years of age. This finding is of importance to clinicians when determining the expected prognosis of CKD in patients.
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Incidence of metabolic syndrome in rural pre-menopausal women and associated risk factors. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-019-00718-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Langmia IM, Kräker K, Weiss SE, Haase N, Schütte T, Herse F, Dechend R. Cardiovascular Programming During and After Diabetic Pregnancy: Role of Placental Dysfunction and IUGR. Front Endocrinol (Lausanne) 2019; 10:215. [PMID: 31024453 PMCID: PMC6466995 DOI: 10.3389/fendo.2019.00215] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/18/2019] [Indexed: 12/31/2022] Open
Abstract
Intrauterine growth restriction (IUGR) is a condition whereby a fetus is unable to achieve its genetically determined potential size. IUGR is a global health challenge due to high mortality and morbidity amongst affected neonates. It is a multifactorial condition caused by maternal, fetal, placental, and genetic confounders. Babies born of diabetic pregnancies are usually large for gestational age but under certain conditions whereby prolonged uncontrolled hyperglycemia leads to placental dysfunction, the outcome of the pregnancy is an intrauterine growth restricted fetus with clinical features of malnutrition. Placental dysfunction leads to undernutrition and hypoxia, which triggers gene modification in the developing fetus due to fetal adaptation to adverse utero environmental conditions. Thus, in utero gene modification results in future cardiovascular programming in postnatal and adult life. Ongoing research aims to broaden our understanding of the molecular mechanisms and pathological pathways involved in fetal programming due to IUGR. There is a need for the development of effective preventive and therapeutic strategies for the management of growth-restricted infants. Information on the mechanisms involved with in utero epigenetic modification leading to development of cardiovascular disease in adult life will increase our understanding and allow the identification of susceptible individuals as well as the design of targeted prevention strategies. This article aims to systematically review the latest molecular mechanisms involved in the pathogenesis of IUGR in cardiovascular programming. Animal models of IUGR that used nutrient restriction and hypoxia to mimic the clinical conditions in humans of reduced flow of nutrients and oxygen to the fetus will be discussed in terms of cardiac remodeling and epigenetic programming of cardiovascular disease. Experimental evidence of long-term fetal programming due to IUGR will also be included.
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Affiliation(s)
- Immaculate M. Langmia
- Experimental and Clinical Research Center, A Joint Cooperation Between the Max-Delbrueck Center for Molecular Medicine and the Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- Alexander von Humboldt Foundation, Bonn, Germany
| | - Kristin Kräker
- Experimental and Clinical Research Center, A Joint Cooperation Between the Max-Delbrueck Center for Molecular Medicine and the Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
- Max-Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Sara E. Weiss
- Experimental and Clinical Research Center, A Joint Cooperation Between the Max-Delbrueck Center for Molecular Medicine and the Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Nadine Haase
- Experimental and Clinical Research Center, A Joint Cooperation Between the Max-Delbrueck Center for Molecular Medicine and the Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
- Max-Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Till Schütte
- Berlin Institute of Health (BIH), Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Center for Cardiovascular Research, Institute of Pharmacology, Charité -Universitätsmedizin Berlin, Berlin, Germany
| | - Florian Herse
- Experimental and Clinical Research Center, A Joint Cooperation Between the Max-Delbrueck Center for Molecular Medicine and the Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- Max-Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Ralf Dechend
- Experimental and Clinical Research Center, A Joint Cooperation Between the Max-Delbrueck Center for Molecular Medicine and the Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- HELIOS-Klinikum, Berlin, Germany
- *Correspondence: Ralf Dechend
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Biddle C, Fallavollita JA, Homish GG, Orom H. Gender bias in clinical decision making emerges when patients with coronary heart disease symptoms also have psychological symptoms. Heart Lung 2019; 48:331-338. [PMID: 30595342 DOI: 10.1016/j.hrtlng.2018.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 11/18/2018] [Accepted: 11/19/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Delayed treatment may contribute to women's relatively higher morbidity and mortality from coronary heart disease (CHD). We tested whether disparities in treatment may be due to bias in diagnosis and treatment recommendations for women with psychological symptoms. METHODS Fourth year medical students (N = 225) from 13 U.S. medical schools were randomly assigned to make clinical decisions (CHD risk judgments, diagnosis, treatment recommendations) about one of four experimental vignette patients (male or female; with symptoms of depression and anxiety or without). Vignettes were presented as text via an online survey platform. RESULTS The female patient with psychological symptoms was perceived to be at lowest risk for CHD. Perceptions of risk partly mediated lower likelihood of recommending the female patient with psychological symptoms be seen in an emergency department, take medication, or receive nutrition or exercise advice relative to the male patient with psychological symptoms. CONCLUSIONS There was a gender bias in CHD clinical decision-making when patients had concurrent psychological symptoms.
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Affiliation(s)
- Caitlin Biddle
- Department of Community Health and Health Behavior, University at Buffalo, State University of New York, 304 Kimball Tower, 3435 Main St., Buffalo, NY 14222, USA
| | - James A Fallavollita
- Department of Medicine, University at Buffalo, State University of New York, Buffalo, NY 14222, USA
| | - Gregory G Homish
- Department of Community Health and Health Behavior, University at Buffalo, State University of New York, 304 Kimball Tower, 3435 Main St., Buffalo, NY 14222, USA
| | - Heather Orom
- Department of Community Health and Health Behavior, University at Buffalo, State University of New York, 304 Kimball Tower, 3435 Main St., Buffalo, NY 14222, USA.
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50
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Zhang B, Miller VM, Miller JD. Influences of Sex and Estrogen in Arterial and Valvular Calcification. Front Endocrinol (Lausanne) 2019; 10:622. [PMID: 31620082 PMCID: PMC6763561 DOI: 10.3389/fendo.2019.00622] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 08/27/2019] [Indexed: 01/14/2023] Open
Abstract
Vascular and cardiac valvular calcification was once considered to be a degenerative and end stage product in aging cardiovascular tissues. Over the past two decades, however, a critical mass of data has shown that cardiovascular calcification can be an active and highly regulated process. While the incidence of calcification in the coronary arteries and cardiac valves is higher in men than in age-matched women, a high index of calcification associates with increased morbidity, and mortality in both sexes. Despite the ubiquitous portending of poor outcomes in both sexes, our understanding of mechanisms of calcification under the dramatically different biological contexts of sex and hormonal milieu remains rudimentary. Understanding how the critical context of these variables inform our understanding of mechanisms of calcification-as well as innovative strategies to target it therapeutically-is essential to advancing the fields of both cardiovascular disease and fundamental mechanisms of aging. This review will explore potential sex and sex-steroid differences in the basic biological pathways associated with vascular and cardiac valvular tissue calcification, and potential strategies of pharmacological therapy to reduce or slow these processes.
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Affiliation(s)
- Bin Zhang
- Department of Surgery, Mayo Clinic, Rochester, MN, United States
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States
| | - Virginia M. Miller
- Department of Surgery, Mayo Clinic, Rochester, MN, United States
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States
| | - Jordan D. Miller
- Department of Surgery, Mayo Clinic, Rochester, MN, United States
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, United States
- *Correspondence: Jordan D. Miller
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