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Alhusban IM, Hayajneh AA, Rababa M, Tawalbeh R, Al-Nusour EA, Al-Mugheed K, Alsenany SA, Abdelaliem SM, Alsatari ES. The variations in health cost based on the traditional obesity parameters among patients with coronary artery diseases undergoing cardiac catheterization. BMC Health Serv Res 2024; 24:1071. [PMID: 39285375 PMCID: PMC11403883 DOI: 10.1186/s12913-024-11486-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 08/23/2024] [Indexed: 09/20/2024] Open
Abstract
BACKGROUND In the literature, obesity has been correlated with coronary artery diseases (CADs) and high health costs. This study aimed to investigate the relationships between obesity parameters and the health costs among patients with CADs undergoing cardiac catheterization. METHOD A secondary data analysis was done for an original study. The original study was conducted among 220 hospitalized patients undergoing cardiac catheterization from two main hospitals located in the Middle and Northern regions of Jordan. Bivariate Pearson's correlation and forward linear regression analysis were calculated in this study. RESULTS The average health cost for the participants was 1,344 JOD (1,895.63 USD). A significant positive moderate correlation (r = 0.4) was found between hip circumference (HC) and health cost. There were significant positive weak correlations between low-density lipoprotein (LDL), triglycerides, high-sensitivity C-reactive protein (HS-CRP), hemoglobin A1c (HbA1c), and depression, and the health cost (correlation coefficient 0.17, 0.3, 0.29, 0.22 and 0.17, respectively. HC, waist circumference (WC), waist-height ratio (WHtR), waist-hip ratio (WHR), and body adiposity index (BAI) were significantly associated with health costs among male participants. In contrast, among females, none of the obesity parameters was significantly associated with health costs. The forward regression analysis illustrated that an increase of HC by 3.9 cm (β (0.292) * SD (13.4)) will increase the health cost by 1 JOD (0.71 USD). The same analysis revealed that HS-CRP increased by 0.4 mg/dl (β (0.258)*SD (1.43)), or triglycerides increased by 8.3 mg/dl (β (0.241)* SD (34.3)), or depression score increased by 0.32 score (β (0.137)* SD (2.3)), or total cholesterol increased by 4 mg/dl (β (0.163)* SD (24.7)), the health cost will increase by one JOD (0.71 USD). CONCLUSION Healthcare providers, including nurses, should significantly consider these factors to reduce the health costs for those at-risk patients by providing the appropriate healthcare on time.
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Affiliation(s)
- Islam M Alhusban
- Adult Health-Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, P.O. Box: 3030, Irbid, 22110, Jordan
| | - Audai A Hayajneh
- Adult Health-Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, P.O. Box: 3030, Irbid, 22110, Jordan.
| | - Mohammad Rababa
- Adult Health-Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, P.O. Box: 3030, Irbid, 22110, Jordan
| | - Raghad Tawalbeh
- Adult Health-Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, P.O. Box: 3030, Irbid, 22110, Jordan
| | - Esraa A Al-Nusour
- Prince Al Hussein Bin Abdullah II Academy for Civil Protection AlBalqa Applied University, P.O.Box 206, Salt, 19117, Jordan
| | - Khalid Al-Mugheed
- Adult Health Nursing Department, College of Nursing, Riyadh Elm University, Riyadh, 12734, Saudi Arabia
| | - Samira Ahmed Alsenany
- Public Health Department, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sally Mohammed Abdelaliem
- Department of Nursing Management and Education, College of Nursing, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia
| | - Eman S Alsatari
- School of Nursing, University of Louisville, Louisville, KY, 40202, USA
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Cai J, Zhao L, Li N, Xiao Z, Huang G. Mendelian randomization analysis separated the independent impact of childhood obesity and adult obesity on socioeconomic status, psychological status, and substance use. Heliyon 2024; 10:e36835. [PMID: 39263080 PMCID: PMC11388778 DOI: 10.1016/j.heliyon.2024.e36835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 08/06/2024] [Accepted: 08/22/2024] [Indexed: 09/13/2024] Open
Abstract
Background Obesity is linked to a variety of psychosocial and behavioral outcomes but the causalities remain unclear yet. Determining the causalities and distinguishing between the separate effects of childhood and adult obesity is critical to develop more targeted strategies to prevent adverse outcomes. Methods With single nucleotide polymorphisms (SNPs) used as genetic variables, we employed univariable Mendelian randomization (UVMR) to explore the causalities between childhood and adult body mass index (BMI) and socioeconomic status, psychological status, and substance use. Genetic data for childhood and adult BMI came respectively from 47,541 children aged 10 years and 339,224 adult participants. The outcome data were obtained from corresponding consortia. The direct impact of childhood BMI and adult BMI was then examined using a multivariable MR (MVMR). Results UVMR found that higher childhood BMI was linked causally to lower household income (β = -0.06, 95 % CI = -0.08 ∼ -0.03, P = 4.86 × 10-5), decreased subjective well-being (β = -0.07, 95 % CI = -0.12 ∼ -0.03, P = 1.74 × 10-3), and an increased tendency of smoking regularly (OR = 1.12, 95 % CI = 1.04-1.20, P = 1.52 × 10-3). Similar results were observed in adult BMI. MVMR further revealed that after adjusting with adult BMI, childhood BMI remained an isolated impact on household income. The impacts of adult BMI on the outcomes were diminished when adjusting with childhood BMI. Conclusion The findings indicate the impacts of childhood obesity on subjective well-being and smoking initiation are a result of higher BMI sustaining into adulthood, whereas the effect on household income is attributed to a lasting impact of obesity in early life. The results would help facilitate more targeted strategies for obesity management to prevent adverse outcomes.
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Affiliation(s)
- Jiahao Cai
- School of Pediatrics, Guangzhou Medical University, China
- Department of Neurology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Lei Zhao
- The Third Clinical Institute, Guangzhou Medical University, Guangzhou, China
| | - Nanfang Li
- Graduate School of Human Science, Osaka University, Osaka, Japan
| | - Zijin Xiao
- Guangzhou Medical University, Guangzhou, China
| | - Guiwu Huang
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA
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Krittayaphong R, Treesuwan W, Pramyothin P, Songsangjinda T, Kaolawanich Y, Srivanichakorn W, Jangtawee P, Yindeengam A, Tanapibunpon P, Vanavichit A. Impact of diet intervention on visceral adipose tissue and hepatic fat in patients with obesity or type 2 diabetes: a randomized trial. Sci Rep 2024; 14:21388. [PMID: 39271914 PMCID: PMC11399339 DOI: 10.1038/s41598-024-72246-w] [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] [Received: 02/02/2024] [Accepted: 09/05/2024] [Indexed: 09/15/2024] Open
Abstract
This study aimed to assess the effects of a diet intervention on visceral and hepatic fat in patients with obesity or type 2 diabetes (T2D). Participants with obesity or T2D were randomized to a diet intervention or their usual diet. The intervention comprised a "3G rice" regimen combined with a low-salt, high-fiber diet. The primary outcomes were changes in visceral adipose tissue (VAT) area and hepatic fat over 12 weeks assessed by magnetic resonance imaging. Eighty-six patients were randomized. Their mean age was 47.5 ± 11.0 years, and 82.3% were female. Eighty-one (94.2%) had obesity, and 16 (18.6%) had T2D. Baseline metrics were body weight 76.3 ± 16.1 kg, BMI 29.6 ± 4.6, VAT 12 629 ± 5819 mm2, and hepatic fat 7.9% ± 7.2%. At the 12-week follow-up, the diet group had greater VAT and hepatic fat reductions than controls (- 1468 ± 1468 vs. - 179 ± 1576 mm2, P = 0.001; and - 2.6% ± 3.4% vs. 0.4% ± 2.2%, P < 0.001). Adjusted differences remained significant for VAT (- 1093 mm2, P < 0.001) and hepatic fat (- 2.5%, P < 0.001). In conclusion, the 12-week diet intervention decreased VAT, hepatic fat, body weight, and BMI compared to a usual diet.
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Affiliation(s)
- Rungroj Krittayaphong
- Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand.
| | - Witcha Treesuwan
- Department of Nutrition and Health, Institute of Food Research and Product Development, Kasetsart University, Bangkok, Thailand
| | - Pornpoj Pramyothin
- Division of Nutrition, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Thammarak Songsangjinda
- Division of Internal Medicine, Faculty of Medicine, Cardiology Unit, Prince of Songkla University, Songkhla, Thailand
| | - Yodying Kaolawanich
- Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand
| | - Weerachai Srivanichakorn
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Preechaya Jangtawee
- Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand
| | - Ahthit Yindeengam
- Her Majesty Cardiac Center, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Prajak Tanapibunpon
- Her Majesty Cardiac Center, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Apichart Vanavichit
- Rice Science Center, Kasetsart University, Kamphangsaen, Nakhon Pathom, Thailand
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Wei G, Li B, Wang H, Chen L, Chen W, Chen K, Wang W, Wang S, Zeng H, Liu Y, Zeng Y, Rao H. Apolipoprotein E E3/E4 genotype is associated with an increased risk of coronary atherosclerosis in patients with hypertension. BMC Cardiovasc Disord 2024; 24:486. [PMID: 39261765 PMCID: PMC11391850 DOI: 10.1186/s12872-024-04169-3] [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] [Received: 05/21/2024] [Accepted: 09/05/2024] [Indexed: 09/13/2024] Open
Abstract
OBJECTIVE Apolipoprotein E (APOE) gene polymorphisms were associated with coronary atherosclerosis and hypertension. However, the relationship between APOE polymorphisms and coronary atherosclerosis susceptibility in hypertensive patients is unclear. The aim of this study was to assess the relationship. METHODS A total of 1713 patients with hypertension who were admitted to Meizhou People's Hospital from November 2019 to August 2023 were retrospectively analyzed, including 848 patients with coronary atherosclerosis and 865 patients without coronary atherosclerosis. The rs429358 and rs7412 polymorphisms of APOE were genotyped, and relationship between APOE polymorphisms and the risk of coronary atherosclerosis in hypertensive patients were analyzed. RESULTS There were 10 (0.6%), 193 (11.3%), 30 (1.8%), 1234 (72.0%), 233 (13.6%), and 13 (0.8%) individuals with APOE ɛ2/ɛ2, ɛ2/ɛ3, ɛ2/ɛ4, ɛ3/ɛ3, ɛ3/ɛ4, and ɛ4/ɛ4 genotype, respectively. The frequency of APOE ɛ3/ɛ4 was higher (16.4% vs. 10.9%, p = 0.001) in the patients with coronary atherosclerosis than controls. Logistic analysis showed that body mass index (BMI) ≥ 24.0 kg/m2 (24.0 kg/m2 vs. 18.5-23.9 kg/m2, odds ratio (OR): 1.361, 95% confidence interval (CI): 1.112-1.666, p = 0.003), advanced age (≥ 65/<65, OR:1.303, 95% CI: 1.060-1.602, p = 0.012), history of smoking (OR: 1.830, 95% CI: 1.379-2.428, p < 0.001), diabetes mellitus (OR: 1.380, 95% CI: 1.119-1.702, p = 0.003), hyperlipidemia (OR: 1.773, 95% CI: 1.392-2.258, p < 0.001), and APOE ɛ3/ɛ4 genotype (ɛ3/ɛ4 vs. ɛ3/ɛ3, OR: 1.514, 95% CI: 1.133-2.024, p = 0.005) were associated with coronary atherosclerosis in hypertensive patients. CONCLUSIONS Overweight (BMI ≥ 24.0 kg/m2), advanced age, history of smoking, diabetes mellitus, and APOE ɛ3/ɛ4 genotype were independent risk factors for coronary atherosclerosis in hypertensive patients.
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Affiliation(s)
- Guoliang Wei
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China.
| | - Bin Li
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
| | - Hao Wang
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
| | - Li Chen
- Data Center, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
| | - Wenhao Chen
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
| | - Kehui Chen
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
| | - Weihong Wang
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
| | - Shen Wang
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
| | - Hui Zeng
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
| | - Yuanliang Liu
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
| | - Yue Zeng
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
| | - Hui Rao
- Department of Laboratory Medicine, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China.
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Luo X, Cai B. Association between cardiometabolic index and congestive heart failure among US adults: a cross-sectional study. Front Cardiovasc Med 2024; 11:1433950. [PMID: 39318833 PMCID: PMC11419996 DOI: 10.3389/fcvm.2024.1433950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 08/26/2024] [Indexed: 09/26/2024] Open
Abstract
Background The risk of congestive heart failure (CHF) is significantly affected by obesity. However, data on the association between visceral obesity and the risk of CHF remain limited. We explored the relationship between CHF and cardiometabolic index (CMI). Methods Drawing from the National Health and Nutrition Examination Survey (NHANES) for 2011-2018, we enrolled 9,008 participants in a cross-sectional study. We calculated the CMI as triglyceride (TG)/high density lipid-cholesterol (HDL-C) × weight-to-height ratio (WHtR), and CMI-age as CMI × age. Then, we analyzed CMI and CMI-age as categorical and continuous variables to assess its correlation with CHF. To assess the relationships of CMI and CMI-age with CHF, we used multiple logistic regression models and performed subgroup analysis. To examine the predictive ability of CMI and CMI-age on patients with CHF, we used receiver operating characteristic (ROC) curves. Results The overall prevalence of CHF was 3.31%. The results revealed significant differences in demographic data, comorbidities, lifestyle variables, standing height, BMI, WC, WHtR, TG, and HDL-C among the four groups classified by CMI quartile and CMI-age quartile. When indicators were analyzed as continuous variables, CMI and CMI-age showed positive correlations with CHF in both the crude and adjusted models (all P < 0.05). When indicators were analyzed as categorical variables, it was found that in all four models, the ORs of group Q4 was significantly different compared to Q1 (all P < 0.05), suggesting the risk of CHF is significantly increased with higher CMI, and CMI-age. The associations of CMI and CMI-age with CHF were similar in all stratified populations (P for interaction > 0.05). The areas under the ROC curve (AUCs) of CMI and CMI-age in predicting CHF were 0.610 (95% CI, 0.578-0.642) and 0.697 (95% CI, 0.668-0.725) separately, suggesting that CMI-age was significantly better than the CMI in predicting CHF (P < 0.001). Conclusions Both CMI and CMI-age were independently correlated with the risk for CHF. These results suggested that the CMI-age, which provides new insights into the prevention and management of CHF. CMI-age could serve as effective tools to identify CHF during primary care examinations and in medically resource-limited areas.
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Affiliation(s)
- Xi Luo
- Department of Clinical Nutrition, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Bin Cai
- Department of Clinical Nutrition, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Clinical Nutrition, Shaoxing People’s Hospital, Shaoxing, China
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Zhang B, Hart JE, Laden F, Bozigar M, James P. Environmental mixtures and body mass index in two prospective US-based cohorts of female nurses. JOURNAL OF HAZARDOUS MATERIALS 2024; 480:135794. [PMID: 39265401 DOI: 10.1016/j.jhazmat.2024.135794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 08/23/2024] [Accepted: 09/08/2024] [Indexed: 09/14/2024]
Abstract
We estimated the joint effect of particulate matter ≤ 2.5 µm in diameter (PM2.5), nitrogen dioxide (NO2), seasonal temperature, noise, greenness, light at night, and neighborhood socioeconomic status (NSES) on body mass index (BMI) in a mixture context among 194,966 participants from the Nurses' Health Study (NHS) and Nurses' Health Study II (NHSII) over 30 years. BMI was calculated from self-reported weight and height. Single- and multi-exposure generalized estimating equations models were used to estimate the difference in BMI per interquartile range (IQR) increase of environmental factors, and quantile g-computation methods were used to estimate joint associations. In both cohorts, we consistently observed positive associations of BMI with PM2.5 and NO2 concentrations as well as negative associations with light at night and NSES regardless modeling approach. A positive association with noise was only observed in NHS. Negative associations with greenness and winter temperature were only observed in NHSII. Overall, the changes in BMI per quintile increase in all eight exposures were -0.11 (-0.13, -0.08) in NHS and -0.39 (-0.41, -0.37) in NHSII, which were largely driven by air pollution and nighttime noise (18-45 %) in the positive direction and NSES (>70 %) in the negative direction. Future intervention on environmental factors, especially reducing PM2.5, NO2 and noise or improving the NSES, might be helpful to lower BMI.
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Affiliation(s)
- Boya Zhang
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Jaime E Hart
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Francine Laden
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Matthew Bozigar
- School of Nutrition and Public Health, College of Health, Oregon State University, 160 SW 26th Street, Corvallis, OR 97331, USA
| | - Peter James
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
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Apaijai N, Pintana H, Saengmearnuparp T, Kongkaew A, Arunsak B, Chunchai T, Chattipakorn SC, Chattipakorn N. Inhibition of 5-alpha reductase attenuates cardiac oxidative damage in obese and aging male rats via the enhancement of antioxidants and the p53 protein suppression. Chem Biol Interact 2024; 403:111240. [PMID: 39265715 DOI: 10.1016/j.cbi.2024.111240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 08/31/2024] [Accepted: 09/09/2024] [Indexed: 09/14/2024]
Abstract
In aging and metabolic syndrome oxidative stress is a causative factor in the cardiovascular pathology. Upregulation of 5-⍺ reductase is associated with cardiac hypertrophy but how inhibition of 5-⍺ reductase affects cardiometabolic function during oxidative damage under those conditions is unclear. Our hypothesis was that Finasteride (Fin), a 5-⍺ reductase inhibitor, promotes an antioxidant response, leading to an improvement in cardiac function in obese and aging rats. Male rats were divided into 3 groups including normal diet (ND) fed rats, ND-fed rats treated with d-galactose (D-gal) to induce aging, and high-fat diet (HFD) fed rats to induce obesity. Rats received their assigned diet or D-gal for 18 weeks. At week 13, rats in each group were divided into 2 subgroups and received either a vehicle or Fin (5 mg/kg/day, oral gavage). Cardiometabolic and molecular parameters were subsequently investigated. Both D-gal and HFD successfully induced cardiometabolic dysfunction, oxidative stress, mitochondrial dysfunction, and DNA fragmentation. Fin treatment did not affect metabolic disturbances; however, it reduced cardiac sympathovagal imbalance, cardiac dysfunction through the inhibition of oxidative stress and promoted antioxidants, resulting in reduced p53 protein levels and DNA fragmentation. Surprisingly, Fin induced insulin resistance in ND-fed rats. Fin effectively improved cardiac function in both models by enhancing antioxidant levels, suppressing oxidative stress and DNA fragmentation. However, Fin treatment did not confer any beneficial effects on metabolic status. Fin administration effectively improved cardiac sympathovagal balance and cardiac function in rats with oxidative damage induced by either D-gal or HFD.
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Affiliation(s)
- Nattayaporn Apaijai
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Hiranya Pintana
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Thiraphat Saengmearnuparp
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand; Division of Urology, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Apisek Kongkaew
- Research Administration Section, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Busarin Arunsak
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Titikorn Chunchai
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Siriporn C Chattipakorn
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand; Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nipon Chattipakorn
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, 50200, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand; The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand.
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He F, Li Y, Xu X, Zhu S, Chen Y, Liu H, Zou X, Xie X, Chen YY. Exploring the mediating role of depression in the relationship between sarcopenia and cardiovascular health in the middle-aged and elderly: A cross-sectional study. J Affect Disord 2024; 368:127-135. [PMID: 39265866 DOI: 10.1016/j.jad.2024.09.051] [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: 05/16/2024] [Revised: 09/01/2024] [Accepted: 09/08/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND Cardiovascular health is influenced by various factors, including sarcopenia and depression. It has been demonstrated that sarcopenia has a negative impact on cardiovascular disease, with depression also being a contributing factor. However, the complex interplay between sarcopenia, depressive symptoms, and cardiovascular health in middle-aged and elderly populations is not fully explored. METHODS A total of 23,445 participants participated in China Health and Retirement Longitudinal Study and completed relevant measurements, including the Centre for Epidemiological Studies Depression Scale. The study also assessed sarcopenia and cardiovascular health score. The focus of the study was to test whether the association between sarcopenia and cardiovascular health scores was mediated by depression using PROCESS macros in R 4.3.2. Sensitivity analyses were conducted to affirm the robustness of our findings. RESULT The study revealed a partial mediation between sarcopenia and cardiovascular health score among the middle and elder adults, mediated by depression. Sarcopenia had a significant negative correlation with cardiovascular health score (B = -12.404, P < 0.05), and depression also showed a significant negative correlation (B = -1.515, P < 0.001). CONCLUSION The results support the notion that depression partially mediated the association between sarcopenia and cardiovascular health score. Therefore, interventions aimed at improving mood and addressing other cardiovascular risk factors may help alleviate the adverse effects of sarcopenia and potentially reduce the progression to cardiovascular disease.
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Affiliation(s)
- Feiying He
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yuqing Li
- School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Xiangchun Xu
- Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Sijing Zhu
- Department of Transfusion Medicine, Zhujiang Hospital of Southern Medical University, GuangZhou, China
| | - Yanwu Chen
- Research & Development Division, Perfect Life & Health Institute, Zhongshan, China; Research & Development Division, Perfect (Guangdong) Co., Ltd., Zhongshan, China
| | - Hualin Liu
- Research & Development Division, Perfect Life & Health Institute, Zhongshan, China; Research & Development Division, Perfect (Guangdong) Co., Ltd., Zhongshan, China
| | - Xiaoqing Zou
- Research & Development Division, Perfect Life & Health Institute, Zhongshan, China; Research & Development Division, Perfect (Guangdong) Co., Ltd., Zhongshan, China
| | - Xian Xie
- School of Nursing, Southern Medical University, GuangZhou, China.
| | - Yuan Yao Chen
- Research & Development Division, Perfect Life & Health Institute, Zhongshan, China; Research & Development Division, Perfect (Guangdong) Co., Ltd., Zhongshan, China.
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Wattanachayakul P, Yanpiset P, Wannaphut C, Suenghataiphorn T, Rujirachun P, Danpanichkul P, Polpichai N, Saowapa S, Kewcharoen J, Charoenngam N, Ungprasert P. Association between obesity paradox in the all-cause mortality among patients with cardiac resynchronization therapy device. Pacing Clin Electrophysiol 2024. [PMID: 39248344 DOI: 10.1111/pace.15069] [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: 04/26/2024] [Revised: 07/20/2024] [Accepted: 08/27/2024] [Indexed: 09/10/2024]
Abstract
BACKGROUND Recent studies have demonstrated an obesity paradox, where obese patients with cardiovascular disease have a better outcome compared to those with normal weight. However, the effect of obesity and body mass index (BMI) on the outcome of patients with cardiac resynchronization therapy (CRT) devices remains unclear. The current study aims to investigate this relationship using all available published data. METHODS We systematically reviewed studies from Medline and EMBASE databases from inception to January 2024. Eligible studies must investigate the association between BMI status and all-cause mortality in individuals with CRT devices. Relative risk (RR) or hazard ratio (HR) and 95% CIs were retrieved from each study and combined using the generic inverse variance method. RESULTS A total of 12 cohort studies were included in the meta-analysis. Pooled analysis showed that overweight and obesity patients had lower all-cause mortality compared to those with normal body weight with the pooled risk ratios (RR) for overweight of 0.77 (95% CI 0.69-0.87, I2 47%) and for obesity of 0.81 (95% CI 0.67-0.97, I2 59%). Conversely, the underweight exhibited higher all-cause mortality than the group with normal weight, with a pooled RR of 1.37 (95% CI 1.14-1.64, I2 0%). Additionally, higher BMI as continuous data was associated with decreased all-cause mortality, with a pooled HR of 0.94 (95% CI 0.89-0.98, I2 72%). CONCLUSIONS The pooled analyses observed an obesity paradox in patients with CRT, where overweight and obesity were associated with reduced all-cause mortality, while underweight individuals exhibited higher all-cause mortality. Further research is necessary to investigate the underlying mechanisms and their implications for clinical practice.
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Affiliation(s)
- Phuuwadith Wattanachayakul
- Department of Medicine, Jefferson Einstein Hospital, Philadelphia, Pennsylvania, USA
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Panat Yanpiset
- Department of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Chalothorn Wannaphut
- Department of Medicine, University of Hawaii John A. Burns School of Medicine, Honolulu, USA
| | | | | | - Pojsakorn Danpanichkul
- Department of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | | | - Sakditad Saowapa
- Department of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Jakrin Kewcharoen
- Division of Cardiology, University of California San Francisco, San Francisco, California, USA
| | - Nipith Charoenngam
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Patompong Ungprasert
- Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, Ohio, USA
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Feng X, Zhu J, Hua Z, Yao S, Tong H. Comparison of obesity indicators for predicting cardiovascular risk factors and multimorbidity among the Chinese population based on ROC analysis. Sci Rep 2024; 14:20942. [PMID: 39251694 PMCID: PMC11383956 DOI: 10.1038/s41598-024-71914-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 09/02/2024] [Indexed: 09/11/2024] Open
Abstract
To date, the best obesity-related indicators (ORIs) for predicting hypertension, dyslipidaemia, Type 2 diabetes mellitus (T2DM) and multimorbidity are still controversial. This study assessed the ability of 17 ORIs [body mass index (BMI), body fat percentage (BF%), c-index, Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), a body shape index (ABSI), body adiposity index (BAI), waist circumference (WC), waist-hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), abdominal volume index (AVI), triglyceride glucose index (TYG), lipid accumulation product (LAP), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), waist triglyceride index (WTI) and cardiometabolic index (CMI)] to predict hypertension, dyslipidemia, T2DM, and multimorbidity in populations aged 40-69 years. From November 2017 to December 2022, 10,432 compliant residents participated in this study. Receiver operating characteristic curves were used to assess the ability of ORIs to predict target diseases across the whole population and genders. The DeLong test was used to analyse the heterogeneity of area under curves (AUCs). Multivariable logistic regression was used to analyse the association of ORIs with hypertension, dyslipidaemia, T2DM, and multimorbidity. The prevalence of hypertension, dyslipidaemia, T2DM, and multimorbidity was 67.46%, 39.36%, 12.54% and 63.58%, respectively. After excluding ORIs associated with the target disease components, in the whole population, CVAI (AUC = 0.656), BMI (AUC = 0.655, not significantly different from WC and AVI), CVAI (AUC = 0.645, not significantly different from LAP, CMI, WHR, and WTI), and TYG (AUC = 0.740) were the best predictor of hypertension, dyslipidemia, T2DM, and multimorbidity, respectively (all P < 0.05). In the male population, BF% (AUC = 0.677), BMI (AUC = 0.698), CMI (AUC = 0.648, not significantly different from LAP and CVAI), and TYG (AUC = 0.741) were the best predictors (all P < 0.05). In the female population, CVAI (AUC = 0.677), CUN-BAE (AUC = 0.623, not significantly different from BF%, WC, WHR, WHtR, BRI and BMI), CVAI (AUC = 0.657, not significantly different from WHR), TYG (AUC = 0.740) were the best predictors (all P < 0.05). After adjusting for all covariates, all ORIs were significantly associated with hypertension, dyslipidaemia, T2DM, and multimorbidity (all P < 0.05), except for ABSI and hypertension and BAI and T2DM, which were insignificant. Ultimately, after considering the heterogeneity of prediction of ORIs among different populations, for hypertension, BF% was the best indicator for men and CVAI for the rest of the population. The best predictors of dyslipidaemia, T2DM, and multimorbidity were BMI, CVAI and TYG, respectively. Screening for common chronic diseases in combination with these factors may help to improve the effectiveness.
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Affiliation(s)
- Xiang Feng
- Institute of Tumour Prevention and Control, Yangzhong People's Hospital, Yangzhong, 212200, China.
| | - Jinhua Zhu
- Institute of Tumour Prevention and Control, Yangzhong People's Hospital, Yangzhong, 212200, China.
- Department of Gastroenterology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, 210000, China.
| | - Zhaolai Hua
- Institute of Tumour Prevention and Control, Yangzhong People's Hospital, Yangzhong, 212200, China
| | - Shenghua Yao
- Department of Gastroenterology, Yangzhong People's Hospital, Yangzhong, 212200, China
| | - Haiyuan Tong
- Department of Non-Communicable Disease Prevention and Control, Yangzhong Centre for Disease Control and Prevention, Yangzhong, 212200, China
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Huang X, Liang J, Zhang J, Fu J, Deng S, Xie W, Zheng F. Association of life's essential 8 with chronic cardiovascular-kidney disorder: a prospective cohort study. BMC Public Health 2024; 24:2448. [PMID: 39251953 PMCID: PMC11382523 DOI: 10.1186/s12889-024-19532-4] [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] [Received: 04/04/2024] [Accepted: 07/18/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND The coexistence of cardiovascular disease and chronic kidney disease, termed chronic cardiovascular-kidney disorder (CCV-KD), is increasingly prevalent. However, limited studies have assessed the association between cardiovascular health (CVH), assessed by the American Heart Association's Life's Essential 8 (LE8), and CCV-KD. METHODS We conducted a prospective cohort study using data from UK Biobank. Participants without cardiovascular disease and chronic kidney disease at baseline and having complete data on metrics of LE8 were included (N = 125,986). LE8 included eight metrics, and the aggregate score was categorized as low (< 50 points), intermediate (50 to < 80 points), and high (≥ 80 points), with a higher score indicating better CVH health. Adjusted Cox proportional hazard models were conducted to explore the association of CVH with the risk of CCV-KD. The adjusted proportion of population attributable risk (PAR%) was used to calculate the population-level risk caused by low or intermediate CVH. RESULTS During a median follow-up of 12.5 years, 1,054 participants (0.8%) had incident CCV-KD. Participants with intermediate and high CVH had 54% (HR = 0.46, 95% CI: 0.40-0.54, P < 0.001) and 75% (HR = 0.25, 95% CI: 0.18-0.34, P < 0.001) lower risks of incident CCV-KD compared with those in low CVH group. There was an approximately dose-response linear relationship between the overall LE8 score and incident CCV-KD. The risk of incident CCV-KD decreased by 30% (HR = 0.70, 95% CI: 0.67-0.74, P < 0.001) for a 10-point increment of LE8 score. The adjusted PAR% of lower overall CVH was 47.4% (95% CI: 31.6%-59.8%). CONCLUSIONS Better CVH, assessed by using LE8 score, was strongly associated with decreased risk of incident CCV-KD. These findings imply optimizing CVH may be a preventive strategy to reduce the burden of CCV-KD.
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Affiliation(s)
- Xinghe Huang
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Jie Liang
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Junyu Zhang
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Jiayi Fu
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Sicheng Deng
- West China School of Nursing, Sichuan University, Sichuan, 610044, China
| | - Wuxiang Xie
- Peking University Clinical Research Institute, Peking University First Hospital, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China.
| | - Fanfan Zheng
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, China.
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Yu B, Jia S, Sun T, Liu J, Jin J, Zhang S, Xiao Q, Dong H, Ou Y. Sarcopenic obesity is associated with cardiometabolic multimorbidity in Chinese middle-aged and older adults: a cross-sectional and longitudinal study. J Nutr Health Aging 2024; 28:100353. [PMID: 39244787 DOI: 10.1016/j.jnha.2024.100353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 08/28/2024] [Accepted: 08/29/2024] [Indexed: 09/10/2024]
Abstract
OBJECTIVES Sarcopenic obesity (SO) has been found to increase the risk of metabolic disorders, however, its relationship with cardiometabolic multimorbidity (CMM) remains unexplored. This study aims to investigate the potential association between SO and CMM in the middle-aged and older population. METHODS Our study subjects were from CHARLS. SO was defined as the combination of impaired grip strength (grip strength <28 kg for men and <18 kg for women) and increased body mass index (BMI ≥25 kg/m2). CMM was defined as having two or more cardiometabolic diseases, including diabetes mellitus, stroke, and heart disease. The participants were divided into four groups according to their sarcopenia and obesity status, and logistic regression analysis was used to examine the association between SO and CMM. RESULTS A total of 15,252 study subjects were included in the cross-sectional study, with an average age of 60.6 years and a male proportion of 47.4%. In the cross-sectional analysis conducted in 2015, the prevalence of CMM was highest in the SO group (9.1%), followed by the obesity (3.7%) and sarcopenia (3.5%) group. After adjustment for confounding factors, SO [OR (95%CI): 2.453 (1.742-3.455)], sarcopenia [OR (95% CI): 1.601 (1.157-2.217)], obesity [OR (95% CI): 1.446 (1.107-1.888)] were all observed to be associated with CMM, with the strongest association in the SO group. Furthermore, in the longitudinal analysis, only the SO group demonstrated a significant risk for developing CMM [OR (95% CI): 2.302 (1.239-4.228)]. CONCLUSIONS SO was independently and positively associated with CMM in middle-aged and older population.
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Affiliation(s)
- Bingyan Yu
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Shize Jia
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Tiantian Sun
- Department of Hematology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen 518107, China
| | - Jieliang Liu
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Junguo Jin
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Shanghong Zhang
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Qiyao Xiao
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Haojian Dong
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Nyingchi People's Hospital, Nyingchi 860000, Tibet, China.
| | - Yanqiu Ou
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
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Chen T, Liu YL, Li F, Qiu HN, Haghbin N, Li YS, Lin CY, Wu F, Xia LF, Li JB, Lin JN. Association of waist-to-hip ratio adjusted for body mass index with cognitive impairment in middle-aged and elderly patients with type 2 diabetes mellitus: a cross-sectional study. BMC Public Health 2024; 24:2424. [PMID: 39243030 PMCID: PMC11378611 DOI: 10.1186/s12889-024-19985-7] [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] [Received: 01/05/2024] [Accepted: 09/04/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND Numerous reports indicate that both obesity and type 2 diabetes mellitus (T2DM) are factors associated with cognitive impairment (CI). The objective was to assess the relationship between abdominal obesity as measured by waist-to-hip ratio adjusted for body mass index (WHRadjBMI) and CI in middle-aged and elderly patients with T2DM. METHODS A cross-sectional study was conducted, in which a total of 1154 patients with T2DM aged ≥ 40 years were included. WHRadjBMI was calculated based on anthropometric measurements and CI was assessed utilizing the Montreal Cognitive Assessment (MoCA). Participants were divided into CI group (n = 509) and normal cognition group (n = 645). Correlation analysis and binary logistic regression were used to explore the relationship between obesity-related indicators including WHRadjBMI, BMI as well as waist circumference (WC) and CI. Meanwhile, the predictive power of these indicators for CI was estimated by receiver operating characteristic (ROC) curves. RESULTS WHRadjBMI was positively correlated with MoCA scores, independent of sex. The Area Under the Curve (AUC) for WHRadjBMI, BMI and WC were 0.639, 0.521 and 0.533 respectively, and WHRadjBMI had the highest predictive power for CI. Whether or not covariates were adjusted, one-SD increase in WHRadjBMI was significantly related to an increased risk of CI with an adjusted OR of 1.451 (95% CI: 1.261-1.671). After multivariate adjustment, the risk of CI increased with rising WHRadjBMI quartiles (Q4 vs. Q1 OR: 2.980, 95%CI: 2.032-4.371, P for trend < 0.001). CONCLUSIONS Our study illustrated that higher WHRadjBMI is likely to be associated with an increased risk of CI among patients with T2DM. These findings support the detrimental effects of excess visceral fat accumulation on cognitive function in middle-aged and elderly T2DM patients.
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Affiliation(s)
- Tong Chen
- School of Medicine, Nankai University, Tianjin, China
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Yan-Lan Liu
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Fang Li
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Hui-Na Qiu
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Nahal Haghbin
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yao-Shuang Li
- Tianjin Union Medical Center, Tianjin Medical University, Tianjin, China
| | - Chen-Ying Lin
- Tianjin Union Medical Center, Tianjin Medical University, Tianjin, China
| | - Fan Wu
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Long-Fei Xia
- Tianjin Union Medical Center, Tianjin Medical University, Tianjin, China
| | - Jing-Bo Li
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 Jieyuan Road, Hongqiao District, Tianjin, 300121, China.
| | - Jing-Na Lin
- School of Medicine, Nankai University, Tianjin, China.
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, 190 Jieyuan Road, Hongqiao District, Tianjin, 300121, China.
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Zheng D, Cai J, Xu S, Jiang S, Li C, Wang B. The association of triglyceride-glucose index and combined obesity indicators with chest pain and risk of cardiovascular disease in American population with pre-diabetes or diabetes. Front Endocrinol (Lausanne) 2024; 15:1471535. [PMID: 39309107 PMCID: PMC11412814 DOI: 10.3389/fendo.2024.1471535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Accepted: 08/19/2024] [Indexed: 09/25/2024] Open
Abstract
Aim To investigate the correlation of the triglyceride-glucose (TyG) index and its combined obesity indicators with chest pain and cardiovascular disease (CVD) in the pre-diabetes and diabetes population. Methods This cross-sectional investigation encompassed 6488 participants with diabetes and pre-diabetes who participated in the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016. The association of the TyG and combined obesity index with chest pain and CVD was investigated using weighted logistic regression models and restricted cubic spline (RCS) analysis. The receiver operating characteristic (ROC) curve analysis was performed to compare different indicators. Results In multivariate logistic regression fully adjusted for confounding variables, our analyses revealed significant associations between TyG, TyG-BMI, TyG-WC, and TyG-WHtR and chest pain, with adjusted ORs (95% CI) of 1.21 (1.05, 1.39), 1.06 (1.01, 1.11), 1.08 (1.04, 1.14), and 1.27 (1.08, 1.48), respectively. For total-CVD, the adjusted ORs (95% CI) were 1.32 (1.08, 1.61), 1.10 (1.03, 1.17), 1.13 (1.06, 1.19), and 1.63 (1.35, 1.97), respectively, among which TyG, TyG-WC, and TyG-WHtR present curvilinear associations in RCS analysis (all P-nonlinear < 0.05). Furthermore, the ROC curve showed that TyG-WC had the most robust predictive efficacy for total-CVD, coronary heart disease (CHD), and myocardial infarction (MI), while TyG-WHtR had the best predictive ability for angina and heart failure. Conclusion There are significant associations of TyG and its related indicators with chest pain and total-CVD among the pathoglycemia population. TyG-WC and TyG-WHtR demonstrated superior predictive capability for the incidence of cardiovascular events.
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Affiliation(s)
- Dongze Zheng
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Human Phenome Institute, Shantou University Medical College, Shantou, Guangdong, China
| | - Jiamiao Cai
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Human Phenome Institute, Shantou University Medical College, Shantou, Guangdong, China
| | - Sifan Xu
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Human Phenome Institute, Shantou University Medical College, Shantou, Guangdong, China
| | - Shiyan Jiang
- Department of Nephrology, Jieyang People’s Hospital, Jieyang, Guangdong, China
| | - Chenlin Li
- Department of Cardiology, Jieyang People’s Hospital, Jieyang, Guangdong, China
| | - Bin Wang
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
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Khawaja T, Nied M, Wilgor A, Neeland IJ. Impact of Visceral and Hepatic Fat on Cardiometabolic Health. Curr Cardiol Rep 2024:10.1007/s11886-024-02127-1. [PMID: 39235730 DOI: 10.1007/s11886-024-02127-1] [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] [Accepted: 08/22/2024] [Indexed: 09/06/2024]
Abstract
PURPOSE OF REVIEW Body fat distribution plays a significant role in the cardiometabolic consequences of obesity. We review the impact of visceral and hepatic fat and highlight important interventions. RECENT FINDINGS Several epidemiologic studies have established a clear association between visceral fat and cardiovascular disease. The association between hepatic fat and cardiovascular disease is less clear with discordant results. Novel evidence demonstrates sodium glucose co-transporter-2 (SGLT2) inhibitors facilitate modest weight loss and reductions in ectopic fat depots in patient with type 2 diabetes. Glucagon-like peptide-1 (GLP-1) receptor agonists have been associated with decreased visceral/hepatic fat and reductions in MACE in populations with type 2 diabetes and with overweight/obesity. Clear associations between visceral fat and cardiometabolic outcomes have been established, whereas the impact of hepatic fat remains less clear. Lifestyle modification and pharmacologic interventions remain the initial therapies, while surgical intervention is associated with improved long-term outcomes. Emerging therapies have demonstrated a profound impact on body fat distribution and cardiometabolic risk.
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Affiliation(s)
- Tasveer Khawaja
- Harrington Heart and Vascular Institute, University Hospitals Cleveland and Case Western Reserve University, Cleveland, OH, USA
- Department of Medicine, University Hospitals Cleveland and Case Western Reserve University, 11100 Euclid Ave. Mailstop Lakeside, Cleveland, OH, USA
| | - Matthew Nied
- Department of Medicine, University Hospitals Cleveland and Case Western Reserve University, 11100 Euclid Ave. Mailstop Lakeside, Cleveland, OH, USA
| | - Abigail Wilgor
- Department of Medicine, University Hospitals Cleveland and Case Western Reserve University, 11100 Euclid Ave. Mailstop Lakeside, Cleveland, OH, USA
| | - Ian J Neeland
- Harrington Heart and Vascular Institute, University Hospitals Cleveland and Case Western Reserve University, Cleveland, OH, USA.
- Department of Medicine, University Hospitals Cleveland and Case Western Reserve University, 11100 Euclid Ave. Mailstop Lakeside, Cleveland, OH, USA.
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Koirala S, Sunnaa M, Bernier T, Oktay AA. The Role of Obesity as a Cardiac Disease Risk Factor in Patients with Type 2 Diabetes. Curr Cardiol Rep 2024:10.1007/s11886-024-02129-z. [PMID: 39235729 DOI: 10.1007/s11886-024-02129-z] [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] [Accepted: 08/23/2024] [Indexed: 09/06/2024]
Abstract
PURPOSE OF REVIEW Cardiovascular disease (CVD) is the leading cause of death globally and is closely associated with obesity and type 2 diabetes mellitus (T2DM). This review examines the interplay between obesity, T2DM, and CVD, highlighting the increasing prevalence and economic burden of these conditions. RECENT FINDINGS Pharmacologic therapies, particularly glucagon-like peptide-1 receptor agonists, show promise in substantial weight loss and subsequent reduction of adverse cardiovascular events in obese individuals with and without diabetes. Obesity significantly contributes to the development of insulin resistance and T2DM, further escalating CVD risk. The common co-occurrence of these three conditions may involve several other pathophysiological mechanisms, such as chronic inflammation, increased visceral adiposity, and endothelial dysfunction. Until recently, lifestyle modifications and bariatric surgery had been the primary methods for weight loss and mitigating obesity-associated cardiovascular risk. Newer pharmacological options have led to a paradigm shift in our approach to obesity management as they provide substantial benefits in weight loss, glycemic control, and cardiovascular risk reduction.
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Affiliation(s)
- Sushant Koirala
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Michael Sunnaa
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Thomas Bernier
- Division of Cardiology, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Ahmet Afsin Oktay
- Division of Cardiology, Rush University Medical Center, Chicago, IL, 60612, USA.
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Lima AFR, Rodrigues D, Machado MR, Oliveira-Neto JT, Bressan AFM, Pedersoli CA, Alves JV, Silva-Neto JA, Barros PR, Dias TB, Garcia LV, Bruder-Nascimento A, Bruder-Nascimento T, Carneiro FS, Leiria LOS, Tostes RC, Costa RM. Endothelin-1 down-regulates nuclear factor erythroid 2-related factor-2 and contributes to perivascular adipose tissue dysfunction in obesity. Clin Sci (Lond) 2024; 138:1071-1087. [PMID: 39136472 DOI: 10.1042/cs20240624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 08/08/2024] [Accepted: 08/09/2024] [Indexed: 09/01/2024]
Abstract
Perivascular adipose tissue (PVAT) negatively regulates vascular muscle contraction. However, in the context of obesity, the PVAT releases vasoconstrictor substances that detrimentally affect vascular function. A pivotal player in this scenario is the peptide endothelin-1 (ET-1), which induces oxidative stress and disrupts vascular function. The present study postulates that obesity augments ET-1 production in the PVAT, decreases the function of the nuclear factor erythroid 2-related factor-2 (Nrf2) transcription factor, further increasing reactive oxygen species (ROS) generation, culminating in PVAT dysfunction. Male C57BL/6 mice were fed either a standard or a high-fat diet for 16 weeks. Mice were also treated with saline or a daily dose of 100 mg·kg-1 of the ETA and ETB receptor antagonist Bosentan, for 7 days. Vascular function was evaluated in thoracic aortic rings, with and without PVAT. Mechanistic studies utilized PVAT from all groups and cultured WT-1 mouse brown adipocytes. PVAT from obese mice exhibited increased ET-1 production, increased ECE1 and ETA gene expression, loss of the anticontractile effect, as well as increased ROS production, decreased Nrf2 activity, and downregulated expression of Nrf2-targeted antioxidant genes. PVAT of obese mice also exhibited increased expression of Tyr216-phosphorylated-GSK3β and KEAP1, but not BACH1 - negative Nrf2 regulators. Bosentan treatment reversed all these effects. Similarly, ET-1 increased ROS generation and decreased Nrf2 activity in brown adipocytes, events mitigated by BQ123 (ETA receptor antagonist). These findings place ET-1 as a major contributor to PVAT dysfunction in obesity and highlight that pharmacological control of ET-1 effects restores PVAT's cardiovascular protective role.
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Affiliation(s)
- Anna Flavia R Lima
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Daniel Rodrigues
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Mirele R Machado
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - José Teles Oliveira-Neto
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Alecsander F M Bressan
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Carina A Pedersoli
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Juliano V Alves
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Júlio A Silva-Neto
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Paula R Barros
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Thiago B Dias
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Luis V Garcia
- Department of Biomechanics, Medicine and Locomotive Apparatus Rehabilitation, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | | | | | - Fernando S Carneiro
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Luiz Osório S Leiria
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Rita C Tostes
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Rafael M Costa
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
- Department of Physiology and Cell Biology, University of South Alabama, Mobile, AL, U.S.A
- Institute of Health Sciences, Federal University of Jatai, Jatai, GO, Brazil
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68
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Grunewald W, Sonnenblick R, Kinkel-Ram SS, Stanley TB, Clancy OM, Smith AR. Longitudinal relationships between anti-fat attitudes and muscle dysmorphia symptoms. Body Image 2024; 51:101786. [PMID: 39226792 DOI: 10.1016/j.bodyim.2024.101786] [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: 04/15/2024] [Revised: 08/22/2024] [Accepted: 08/26/2024] [Indexed: 09/05/2024]
Abstract
Weight stigma, and more specifically, anti-fat attitudes, is associated with disordered eating. Furthermore, these anti-fat attitudes influence various appearance ideals. Muscle dysmorphia (MD) is characterized by preoccupation with the muscular ideal and is a potential form of disordered eating commonly experienced by men. Despite theory suggesting that anti-fat attitudes may contribute to MD, research has yet to examine associations between anti-fat attitudes and MD symptoms. Therefore, the current study investigated longitudinal relationships between anti-fat attitudes and MD symptoms. Participants were 269 U.S. men recruited from Prolific who completed three self-report surveys each separated by one month. Primary analyses examined longitudinal relationships between specific anti-fat attitudes and MD symptoms using an adapted three-wave cross-lagged panel model. Results demonstrated that believing that fat people do not have willpower was longitudinally associated with desires to increase muscle size at multiple time points. Furthermore, MD-specific functional impairment predicted fears of becoming fat longitudinally. Practically, men may desire to increase their muscularity to demonstrate their own willpower and distance themselves from anti-fat stereotypes. Thus, clinicians may consider targeting weight stigmatizing attitudes to reduce MD symptom severity among their male clients.
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Affiliation(s)
- William Grunewald
- Auburn University Department of Psychological Sciences, 226 Thach Hall, Auburn, AL 36849, USA.
| | - Ross Sonnenblick
- Drexel University Center for Weight, Eating and Lifestyle Science, 3201 Chestnut St 2nd floor, Philadelphia, PA 19104, USA.
| | - Shruti S Kinkel-Ram
- Miami University Department of Clinical Psychology, 90 North Patterson Avenue, Oxford, OH 45056, USA.
| | - Taylor B Stanley
- Auburn University Department of Psychological Sciences, 226 Thach Hall, Auburn, AL 36849, USA.
| | - Olivia M Clancy
- Auburn University Department of Psychological Sciences, 226 Thach Hall, Auburn, AL 36849, USA.
| | - April R Smith
- Auburn University Department of Psychological Sciences, 226 Thach Hall, Auburn, AL 36849, USA.
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Pham MHX, Christensen DM, Kristensen AT, Middelfart C, Sindet-Pedersen C, Gislason G, Olsen NT. Association of overweight and obesity with coronary risk factors and the presence of multivessel disease in patients with obstructive coronary artery disease - A nationwide registry study. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2024; 22:200299. [PMID: 38983607 PMCID: PMC11231706 DOI: 10.1016/j.ijcrp.2024.200299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/22/2024] [Accepted: 06/13/2024] [Indexed: 07/11/2024]
Abstract
Background The growing prevalence of obesity is expected to increase the burden of coronary artery disease. This study examined the prevalence of overweight and obesity in patients with a first-time diagnosis of obstructive coronary artery disease in a contemporary population. The association of body-mass-index (BMI) with age, traditional risk factors, and the presence of multivessel disease were explored. Methods and results Using the Danish Nationwide registries, we identified 49,733 patients with a first-time diagnosis of obstructive coronary artery disease in the period 2012-2018. We investigated the association between BMI and coronary risk factors by multivariate logistic regression. Mean age was 65.8 ± 11.8 years, mean BMI was 27.5 kg/m2 ± 7.2, and 73.2 % were men. 66.3 % had a BMI ≥25 kg/m2 and 1.3 % were underweight. The prevalence of patients with BMI ≥25 kg/m2 decreased with increasing age and was 69 % in patients <50 year vs. 46.2 % in patients ≥80 years (p < 0.001). In all age groups, higher odds of BMI ≥25 kg/m2 were observed in males, former smokers, and patients with hypertension. In multivariate logistic regression, BMI ≥25 kg/m2 was not associated with presence of multivessel disease (p = 0.74). Conclusion In this large, nationwide study, 66.3 % of patients with first time diagnosis of obstructive coronary disease had BMI ≥25 kg/m2. Young patients had higher BMI and were more likely to be current smokers. Overweight or obesity was independently associated with the presence of diabetes and hypertension. BMI ≥25 kg/m2 was not independently associated with the presence of multivessel disease.
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Affiliation(s)
- Maria Hang Xuan Pham
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark
| | - Daniel Mølager Christensen
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark
- Department of Cardiology, Zealand University Hospital, Roskilde, Denmark
| | - Andreas Torp Kristensen
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark
| | - Charlotte Middelfart
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark
| | - Caroline Sindet-Pedersen
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark
- The Danish Heart Foundation, Copenhagen, Denmark
| | - Gunnar Gislason
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark
- The Danish Heart Foundation, Copenhagen, Denmark
| | - Niels Thue Olsen
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark
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70
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Belin MAF, Vieira TA, Grandini NA, Siqueira JS, Palacio TLN, Cruzeiro J, Sormani LE, Tanganini MD, Barbosa GS, Gregolin CS, de Campos DHS, Bazan SGZ, Minatel IO, Lima GPP, Correa CR. Cardiac biogenic amine profile and its relationship with parameters of cardiovascular disease in obesity. Vascul Pharmacol 2024; 156:107412. [PMID: 39033868 DOI: 10.1016/j.vph.2024.107412] [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] [Received: 04/25/2024] [Revised: 07/17/2024] [Accepted: 07/18/2024] [Indexed: 07/23/2024]
Abstract
AIMS To identify the cardiac biogenic amine profile of obese rats and associate these compounds with parameters of cardiovascular disease. MAIN METHODS Wistar rats (n = 20) were randomly distributed into two groups: control and obese. Obesity was induced by a high-sugar fat diet. Biochemical parameters were evaluated. Doppler Echocardiography and systolic blood pressure; interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α), protein carbonylation, ferric reducing antioxidant power (FRAP), and catalase activity were measured in cardiac tissue. HPLC evaluated the cardiac biogenic profile. Data were compared using the Student's T or Mann-Whitney tests and Spearman's correlation at 5% significance. The principal component analysis (PCA) was performed. KEY FINDINGS Obesity generated hypertension, cardiac remodeling and dysfunction, and imbalanced all biochemical, inflammatory, and oxidative markers (p < 0.001). Eight biogenic amines were found in cardiac tissue. Obesity increased serotonin and decreased agmatine, putrescine, cadaverine, and spermidine. Serotonin (r = 0.534 to 0.808) was strong and positively correlated with obesity, biochemical parameters, cardiac inflammation, oxidative stress, hypertension, cardiac remodeling, and dysfunction (p < 0.001). Spermidine (r = -0.560 to -0.680), putrescine (r = -0.532 to -0.805), cadaverine (r = -0.534 to -0.860), and agmatine (r = -0.579 to -0.884) were inversely correlated with the same parameters (p < 0.001). PCA allowed for distinguishing the control and obese groups. SIGNIFICANCE There are strong correlations between cardiac biogenic amine levels, cardiac remodeling, and dysfunction resulting from obesity. CONCLUSION There is an association between cardiac biogenic amines and cardiovascular disease in obesity. In addition, agmatine, putrescine, cadaverine, and, mainly, serotonin may be new biomarkers for cardiovascular health in obesity and help to improve the diagnosis and treatment of CVD resulting or not from obesity. However, more research is needed to support this conclusion.
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Affiliation(s)
| | - Taynara Aparecida Vieira
- Department of Pathology, Medical School, Sao Paulo State University (Unesp), Botucatu 18618-687, Brazil
| | - Núbia Alves Grandini
- Department of Pathology, Medical School, Sao Paulo State University (Unesp), Botucatu 18618-687, Brazil
| | - Juliana Silva Siqueira
- Department of Pathology, Medical School, Sao Paulo State University (Unesp), Botucatu 18618-687, Brazil
| | | | - Jordanna Cruzeiro
- Department of Pathology, Medical School, Sao Paulo State University (Unesp), Botucatu 18618-687, Brazil
| | - Luis Eduardo Sormani
- Department of Pathology, Medical School, Sao Paulo State University (Unesp), Botucatu 18618-687, Brazil
| | - Murilo Dalarme Tanganini
- Department of Pathology, Medical School, Sao Paulo State University (Unesp), Botucatu 18618-687, Brazil
| | - Gabriela Souza Barbosa
- Department of Pathology, Medical School, Sao Paulo State University (Unesp), Botucatu 18618-687, Brazil
| | - Cristina Schmitt Gregolin
- Department of Pathology, Medical School, Sao Paulo State University (Unesp), Botucatu 18618-687, Brazil
| | | | | | - Igor Otávio Minatel
- Department of Chemical and Biological Sciences, Institute of Bioscience, São Paulo State University (Unesp), Botucatu 18618-687, Brazil
| | - Giuseppina Pace Pereira Lima
- Department of Chemical and Biological Sciences, Institute of Bioscience, São Paulo State University (Unesp), Botucatu 18618-687, Brazil
| | - Camila Renata Correa
- Department of Pathology, Medical School, Sao Paulo State University (Unesp), Botucatu 18618-687, Brazil.
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71
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Vest AR, Schauer PR, Rodgers JE, Sanderson E, LaChute CL, Seltz J, Lavie CJ, Mandras SA, Tang WHW, daSilva-deAbreu A. Obesity and Weight Loss Strategies for Patients With Heart Failure. JACC. HEART FAILURE 2024; 12:1509-1527. [PMID: 39093256 DOI: 10.1016/j.jchf.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 05/29/2024] [Accepted: 06/04/2024] [Indexed: 08/04/2024]
Abstract
Obesity is a common comorbidity among patients with heart failure with reduced ejection fraction (HFrEF) or heart failure with preserved ejection fraction (HFpEF), with the strongest pathophysiologic link of obesity being seen for HFpEF. Lifestyle measures are the cornerstone of weight loss management, but sustainability is a challenge, and there are limited efficacy data in the heart failure (HF) population. Bariatric surgery has moderate efficacy and safety data for patients with preoperative HF or left ventricular dysfunction and has been associated with reductions in HF hospitalizations and medium-term mortality. Antiobesity medications historically carried concerns for cardiovascular adverse effects, but the safety and weight loss efficacy seen in general population trials of glucagon-like peptide 1 (GLP-1) and gastric inhibitory polypeptide/GLP-1 agonists are highly encouraging. Although there are safety concerns regarding GLP-1 agonists in advanced HFrEF, trials of the GLP-1 agonist semaglutide for treatment of obesity have confirmed safety and efficacy in patients with HFpEF.
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Affiliation(s)
- Amanda R Vest
- Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Kaufman Center for Heart Failure Treatment and Recovery, Cleveland Clinic, Cleveland, Ohio, USA.
| | - Philip R Schauer
- Metamor Metabolic Institute, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Jo E Rodgers
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Emily Sanderson
- Friedman School of Nutrition Science and Policy at Tufts University, Boston, Massachusetts, USA
| | - Courtney L LaChute
- Department of Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Jessica Seltz
- Frances Stern Nutrition Center, Tufts Medical Center, Boston, Massachusetts, USA
| | - Carl J Lavie
- Department of Cardiology, Ochsner Medical Center, New Orleans, Louisiana, USA; University of Queensland Ochsner Clinical School, University of Queensland, New Orleans, Louisiana, USA
| | - Stacy A Mandras
- Transplant Institute, AdventHealth Orlando, Orlando, Florida, USA
| | - W H Wilson Tang
- Doctoral School, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Adrian daSilva-deAbreu
- Doctoral School, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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72
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Putra IGNE, Daly M, Sutin A, Steptoe A, Scholes S, Robinson E. Obesity, psychological well-being related measures, and risk of seven non-communicable diseases: evidence from longitudinal studies of UK and US older adults. Int J Obes (Lond) 2024; 48:1283-1291. [PMID: 38824226 PMCID: PMC11347379 DOI: 10.1038/s41366-024-01551-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 05/14/2024] [Accepted: 05/21/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND We examined the role of psychological well-being related measures in explaining the associations between obesity and increased risk of non-communicable diseases (NCDs: hypertension, heart disease, stroke, diabetes, arthritis, cancer, and memory-related disease) in older adults. METHODS Data were from the English Longitudinal Study of Ageing (ELSA), UK (baseline: Wave 4-2008/2009; n = 8127) and the Health and Retirement Study (HRS), US (baseline: Waves 9 and 10-2008/2010; n = 12,477). Objective body mass index was used to define obesity. A range of psychological well-being related measures (e.g., depressive symptoms, life satisfaction) was available in ELSA (n = 7) and HRS (n = 15), and an index of overall psychological well-being was developed separately in each study. NCDs were from a self-reported doctor diagnosis and/or other assessments (e.g., biomarker data) in both studies; and in ELSA, NCDs from linked hospital admissions data were examined. Longitudinal associations between obesity status, psychological well-being measures, and NCDs were examined using Cox proportional hazard models (individual NCDs) and Poisson regression (a cumulative number of NCDs). Mediation by psychological well-being related measures was assessed using causal mediation analysis. RESULTS Obesity was consistently associated with an increased prospective risk of hypertension, heart disease, diabetes, arthritis, and a cumulative number of NCDs in both ELSA and HRS. Worse overall psychological well-being (index measure) and some individual psychological well-being related measures were associated with an increased prospective risk of heart disease, stroke, arthritis, memory-related disease, and a cumulative number of NCDs across studies. Findings from mediation analyses showed that neither the index of overall psychological well-being nor any individual psychological well-being related measures explained (mediated) why obesity increased the risk of developing NCDs in both studies. CONCLUSION Obesity and psychological well-being may independently and additively increase the risk of developing NCDs.
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Affiliation(s)
- I Gusti Ngurah Edi Putra
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK.
| | - Michael Daly
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Angelina Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Andrew Steptoe
- Department of Epidemiology and Health, Institute of Epidemiology and Health Care, Faculty of Population Health Sciences, University College London, London, UK
| | - Shaun Scholes
- Department of Epidemiology and Health, Institute of Epidemiology and Health Care, Faculty of Population Health Sciences, University College London, London, UK
| | - Eric Robinson
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
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73
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Wilcox NS, Amit U, Reibel JB, Berlin E, Howell K, Ky B. Cardiovascular disease and cancer: shared risk factors and mechanisms. Nat Rev Cardiol 2024; 21:617-631. [PMID: 38600368 PMCID: PMC11324377 DOI: 10.1038/s41569-024-01017-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 04/12/2024]
Abstract
Cardiovascular disease (CVD) and cancer are among the leading causes of morbidity and mortality globally, and these conditions are increasingly recognized to be fundamentally interconnected. In this Review, we present the current epidemiological data for each of the modifiable risk factors shared by the two diseases, including hypertension, hyperlipidaemia, diabetes mellitus, obesity, smoking, diet, physical activity and the social determinants of health. We then review the epidemiological data demonstrating the increased risk of CVD in patients with cancer, as well as the increased risk of cancer in patients with CVD. We also discuss the shared mechanisms implicated in the development of these conditions, highlighting their inherent bidirectional relationship. We conclude with a perspective on future research directions for the field of cardio-oncology to advance the care of patients with CVD and cancer.
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Affiliation(s)
- Nicholas S Wilcox
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Uri Amit
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jacob B Reibel
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Hematology Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Eva Berlin
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kendyl Howell
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Bonnie Ky
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Mirzai S, Carbone S, Batsis JA, Kritchevsky SB, Kitzman DW, Shapiro MD. Sarcopenic Obesity and Cardiovascular Disease: An Overlooked but High-Risk Syndrome. Curr Obes Rep 2024; 13:532-544. [PMID: 38753289 PMCID: PMC11306598 DOI: 10.1007/s13679-024-00571-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/03/2024] [Indexed: 08/09/2024]
Abstract
PURPOSE OF REVIEW Sarcopenic obesity (SO), defined as the coexistence of excess fat mass and reduced skeletal muscle mass and strength, has emerged as an important cardiovascular risk factor, particularly in older adults. This review summarizes recent findings on the diagnosis, prevalence, health impacts, and treatment of SO. RECENT FINDINGS Growing evidence suggests SO exacerbates cardiometabolic risk and adverse health outcomes beyond either condition alone; however, the heterogeneity in diagnostic criteria and the observational nature of most studies prohibit the evaluation of a causal relationship. This is concerning given that SO is increasing with the aging population, although that is also difficult to assess accurately given wide-ranging prevalence estimates. A recent consensus definition proposed by the European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity provides a framework of standardized criteria to diagnose SO. Adopting uniform diagnostic criteria for SO will enable more accurate characterization of prevalence and cardiometabolic risk moving forward. Although current management revolves around diet for weight loss coupled with resistance training to mitigate further muscle loss, emerging pharmacologic therapies have shown promising results. As the global population ages, diagnosing and managing SO will become imperative to alleviate the cardiovascular burden.
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Affiliation(s)
- Saeid Mirzai
- Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Salvatore Carbone
- Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Department of Kinesiology & Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, USA
| | - John A Batsis
- Division of Geriatric Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, The Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stephen B Kritchevsky
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Dalane W Kitzman
- Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Michael D Shapiro
- Center for Prevention of Cardiovascular Disease, Medical Center Blvd, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA.
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Bennett JP, Prado CM, Heymsfield SB, Shepherd JA. Evaluation of visceral adipose tissue thresholds for elevated metabolic syndrome risk across diverse populations: A systematic review. Obes Rev 2024; 25:e13767. [PMID: 38761009 DOI: 10.1111/obr.13767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/11/2024] [Accepted: 04/17/2024] [Indexed: 05/20/2024]
Abstract
Beyond obesity, excess levels of visceral adipose tissue (VAT) significantly contribute to the risk of developing metabolic syndrome (MetS), although thresholds for increased risk vary based on population, regions of interest, and units of measure employed. We sought to determine whether a common threshold exists that is indicative of heightened MetS risk across all populations, accounting for sex, age, BMI, and race/ethnicity. A systematic literature review was conducted in September 2023, presenting threshold values for elevated MetS risk. Standardization equations harmonized the results from DXA, CT, and MRI systems to facilitate a comparison of threshold variations across studies. A total of 52 papers were identified. No single threshold could accurately indicate elevated risk for both males and females across varying BMI, race/ethnicity, and age groups. Thresholds fluctuated from 70 to 165.9 cm2, with reported values consistently lower in females. Generally, premenopausal females and younger adults manifested elevated risks at lower VAT compared to their older counterparts. Notably, Asian populations exhibited elevated risks at lower VAT areas (70-136 cm2) compared to Caucasian populations (85.6-165.9 cm2). All considered studies reported associations of VAT without accommodating covariates. No single VAT area threshold for elevated MetS risk was discernible post-harmonization by technology, units of measure, and region of interest. This review summarizes available evidence for MetS risk assessment in clinical practice. Further exploration of demographic-specific interactions between VAT area and other risk factors is imperative to comprehensively delineate overarching MetS risk.
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Affiliation(s)
| | - Carla M Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
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76
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Diab R, Dimachkie L, Zein O, Dakroub A, Eid AH. Intermittent Fasting Regulates Metabolic Homeostasis and Improves Cardiovascular Health. Cell Biochem Biophys 2024; 82:1583-1597. [PMID: 38847940 PMCID: PMC11445340 DOI: 10.1007/s12013-024-01314-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 10/02/2024]
Abstract
Obesity is a leading cause of morbidity and mortality globally. While the prevalence of obesity has been increasing, the incidence of its related complications including dyslipidemia and cardiovascular disease (CVD) has also been rising. Recent research has focused on modalities aimed at reducing obesity. Several modalities have been suggested including behavioral and dietary changes, medications, and bariatric surgery. These modalities differ in their effectiveness and invasiveness, with dietary changes gaining more interest due to their minimal risks compared to other modalities. Specifically, intermittent fasting (IF) has been gaining interest in the past decade. IF is characterized by cycles of alternating fasting and eating windows, with several different forms practiced. IF has been shown to reduce weight and alleviate obesity-related complications. Our review of clinical and experimental studies explores the effects of IF on the lipid profile, white adipose tissue (WAT) dynamics, and the gut microbiome. Notably, IF corrects dyslipidemia, reduces WAT accumulation, and decreases inflammation, which reduces CVD and obesity. This comprehensive analysis details the protective metabolic role of IF, advocating for its integration into public health practices.
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Affiliation(s)
- Rawan Diab
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Lina Dimachkie
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Omar Zein
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali Dakroub
- St. Francis Hospital and Heart Center, Roslyn, NY, USA
| | - Ali H Eid
- Department of Basic Medical Sciences, College of Medicine, Qatar University, QU Health, Doha, Qatar.
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77
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You W. Ambient ultraviolet radiation as a cardioprotective factor: A global and regional analysis. Health Sci Rep 2024; 7:e70065. [PMID: 39286740 PMCID: PMC11403301 DOI: 10.1002/hsr2.70065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 08/23/2024] [Accepted: 08/28/2024] [Indexed: 09/19/2024] Open
Abstract
Background Ambient ultraviolet radiation (UVR) has been found to have a greater cardioprotective effect than previously believed. This study aimed to quantitatively measure the role of UVR in protecting against the progression of cardiovascular disease (CVD) in general on a global and regional scale. Methods Population-level data on UVR, CVD incidence, aging, economic affluence, CVD genetic background (indexed with the Biological State Index, Ibs), obesity prevalence, and urbanization were collected and analysed. The correlation between UVR and CVD was examined using bivariate correlations, partial correlation, and stepwise multiple linear regression. Countries were grouped to investigate regional correlations between UVR and CVD, and Fisher's r-to-z transformation was used to compare correlation coefficients. Results UVR showed a significant inverse correlation with CVD incidence rates in bivariate correlation analyses globally (r = - 0.775 and r = - 0.760, p < 0.001), as well as within high-income (r = -0.704, p < 0.001) and low- and middle-income countries (LMIC) (r = -0.851, p < 0.001). These correlations remained significant even after controlling for confounding variables (r = -0.689 to -0.812, p < 0.001). In stepwise regression models, UVR was found to be the most significant predictor of CVD incidence. The inverse correlation between UVR and CVD was stronger in LMICs compared to high-income countries (z = -1.96, p < 0.050). Conclusions Low ambient UVR may be a significant risk factor for the progression of CVD worldwide. The protective effect of UVR appears to be stronger in LMICs than in high-income countries, suggesting a greater impact of UVR on CVD prevention in these regions. These findings emphasize the need for further research into the mechanisms underlying the cardioprotective effects of UVR and the development of public health strategies to mitigate CVD risk associated with low UVR exposure.
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Affiliation(s)
- Wenpeng You
- Adelaide Medical School The University of Adelaide Adelaide South Australia Australia
- Heart and Lung, Royal Adelaide Hospital Adelaide South Australia Australia
- Adelaide Nursing School The University of Adelaide Adelaide South Australia Australia
- School of Nursing and Midwifery Western Sydney University Sydney New South Wales Australia
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78
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Katsoulis M, Leyrat C, Hingorani A, Gomes M. Bariatric Surgery and Cardiovascular Disease: The Target Trial Emulation Framework Provides Transparency in Articulating the Limits of Observational Studies. Epidemiology 2024; 35:730-733. [PMID: 39024012 PMCID: PMC11309341 DOI: 10.1097/ede.0000000000001766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 06/03/2024] [Indexed: 07/20/2024]
Affiliation(s)
- Michail Katsoulis
- From the Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Clemence Leyrat
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Aroon Hingorani
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Manuel Gomes
- Department of Primary Care and Population Health, University College London, London, United Kingdom
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79
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Medina Inojosa BJ, Somers VK, Lara-Breitinger K, Johnson LA, Medina-Inojosa JR, Lopez-Jimenez F. Prediction of presence and severity of metabolic syndrome using regional body volumes measured by a multisensor white-light 3D scanner and validation using a mobile technology. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2024; 5:582-590. [PMID: 39318693 PMCID: PMC11417481 DOI: 10.1093/ehjdh/ztae059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 05/17/2024] [Accepted: 06/25/2024] [Indexed: 09/26/2024]
Abstract
Aims To test whether an index based on the combination of demographics and body volumes obtained with a multisensor 3D body volume (3D-BV) scanner and biplane imaging using a mobile application (myBVI®) will reliably predict the severity and presence of metabolic syndrome (MS). Methods and results We enrolled 1280 consecutive subjects who completed study protocol measurements, including 3D-BV and myBVI®. Body volumes and demographics were screened using the least absolute shrinkage and selection operator to select features associated with an MS severity score and prevalence. We randomly selected 80% of the subjects to train the models, and performance was assessed in 20% of the remaining observations and externally validated on 133 volunteers who prospectively underwent myBVI® measurements. The mean ± SD age was 43.7 ± 12.2 years, 63.7% were women, body mass index (BMI) was 28.2 ± 6.2 kg/m2, and 30.2% had MS and an MS severity z-score of -0.2 ± 0.9. Features β coefficients equal to zero were removed from the model, and 14 were included in the final model and used to calculate the body volume index (BVI), demonstrating an area under the receiving operating curve (AUC) of 0.83 in the validation set. The myBVI® cohort had a mean age of 33 ± 10.3 years, 61% of whom were women, 10.5% MS, an average MS severity z-score of -0.8, and an AUC of 0.88. Conclusion The described BVI model was associated with an increased severity and prevalence of MS compared with BMI and waist-to-hip ratio. Validation of the BVI had excellent performance when using myBVI®. This model could serve as a powerful screening tool for identifying MS.
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Affiliation(s)
- Betsy J Medina Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Virend K Somers
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Kyla Lara-Breitinger
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
- Dan Abraham Healthy Living Center, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Lynne A Johnson
- Dan Abraham Healthy Living Center, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Jose R Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Francisco Lopez-Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
- Dan Abraham Healthy Living Center, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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80
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Adeyemi D, Arokoyo D, Hamed M, Dare A, Oyedokun P, Akhigbe R. Cardiometabolic Disorder and Erectile Dysfunction. Cell Biochem Biophys 2024; 82:1751-1762. [PMID: 38907942 DOI: 10.1007/s12013-024-01361-2] [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] [Received: 05/08/2024] [Accepted: 06/12/2024] [Indexed: 06/24/2024]
Abstract
Erectile dysfunction (ED), which is defined as the inability to attain and maintain a satisfactory penile erection to sufficiently permit sexual intercourse, is a consequence and also a cause of cardiometabolic disorders like diabetes mellitus, systemic hypertension, central obesity, and dyslipidemia. Although there are mounting and convincing pieces of evidence in the literature linking ED and cardiometabolic disorders, impairment of nitric oxide-dependent vasodilatation seems to be the primary signaling pathway. Studies have also implicated the suppression of circulating testosterone, increased endothelin-1, and hyperactivation of Ang II/ATIr in the pathogenesis of ED and cardiometabolic disorders. This study provides comprehensive details of the association between cardiometabolic disorders and ED and highlights the mechanisms involved. This would open areas to be explored as therapeutic targets in the management of ED and cardiometabolic disorders. It also provides sufficient evidence establishing the need for the management of cardiometabolic disorders as an adjunct therapy in the management of ED.
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Affiliation(s)
- Damilare Adeyemi
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, Osun State University, Osogbo, Osun State, Nigeria
| | - Dennis Arokoyo
- Department of Physiology, Federal University of Technology, Akure, Ondo State, Nigeria
| | - Moses Hamed
- Department of Medical Laboratory Sciences, Afe Babalola University, Ado Ekiti, Ekiti State, Nigeria
- The Brainwill Laboratories, Osogbo, Osun State, Nigeria
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria
| | - Ayobami Dare
- School of Medicine, University of Missouri, Columbia, MO, 65201, USA
| | - Precious Oyedokun
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - Roland Akhigbe
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria.
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria.
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Hoffman RK, Donze LF, Agurs-Collins T, Belay B, Berrigan D, Blanck HM, Brandau A, Chue A, Czajkowski S, Dillon G, Kompaniyets L, Kowtha B, Li R, Mujuru P, Mudd L, Nebeling L, Tomoyasu N, Young-Hyman D, Zheng X(T, Pratt C. Adult obesity treatment and prevention: A trans-agency commentary on the research landscape, gaps, and future opportunities. Obes Rev 2024; 25:e13769. [PMID: 38830619 PMCID: PMC11309895 DOI: 10.1111/obr.13769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 03/30/2024] [Accepted: 04/06/2024] [Indexed: 06/05/2024]
Abstract
Given the high and growing prevalence of obesity among adults in the United States, obesity treatment and prevention are important topics in biomedical and public health research. Although researchers recognize the significance of this problem, much remains unknown about safe and effective prevention and treatment of obesity in adults. In response to the worsening obesity epidemic and the many unknowns regarding the disease, a group of key scientific and program staff members of the National Institutes of Health (NIH) and other federal and non-government agencies gathered virtually in September 2021 to discuss the current state of obesity research, research gaps, and opportunities for future research in adult obesity prevention and treatment. The current article synthesizes presentations given by attendees and shares their organizations' current initiatives and identified gaps and opportunities. By integrating the information discussed in the meeting and current initiatives, we identify potential targets and overlapping priorities for future research, including health equity and disparities in obesity, the heterogeneity of obesity, and the use of technological and innovative approaches in interventions.
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Affiliation(s)
- Rebecca K. Hoffman
- Pacific Institute for Research and Evaluation, Beltsville, Maryland, USA
| | - Laurie Friedman Donze
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Tanya Agurs-Collins
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Brook Belay
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - David Berrigan
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Heidi M. Blanck
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- United States Public Health Service, Rockville, Maryland, USA
| | - Andrea Brandau
- Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | - Amanda Chue
- Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | - Susan Czajkowski
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Lyudmyla Kompaniyets
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Bramaramba Kowtha
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, USA
| | - Rui Li
- Maternal and Health Child Bureau, Health Resources and Services Administration, Rockville, Maryland, USA
| | - Priscah Mujuru
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | - Lanay Mudd
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Linda Nebeling
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Naomi Tomoyasu
- Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland, USA
| | - Deborah Young-Hyman
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland, USA
| | - Xincheng (Ted) Zheng
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Charlotte Pratt
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
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Quiroga D, Roman B, Salih M, Daccarett-Bojanini WN, Garbus H, Ebenebe OV, Dodd-O JM, O'Rourke B, Kohr M, Das S. Sex-dependent phosphorylation of Argonaute 2 reduces the mitochondrial translocation of miR-181c and induces cardioprotection in females. J Mol Cell Cardiol 2024; 194:59-69. [PMID: 38880194 PMCID: PMC11345856 DOI: 10.1016/j.yjmcc.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 06/18/2024]
Abstract
Obesity-induced cardiac dysfunction is growing at an alarming rate, showing a dramatic increase in global prevalence. Mitochondrial translocation of miR-181c in cardiomyocytes results in excessive reactive oxygen species (ROS) production during obesity. ROS causes Sp1, a transcription factor for MICU1, to be degraded via post-translational modification. The subsequent decrease in MICU1 expression causes mitochondrial Ca2+ accumulation, ultimately leading to a propensity for heart failure. Herein, we hypothesized that phosphorylation of Argonaute 2 (AGO2) at Ser 387 (in human) or Ser 388 (in mouse) inhibits the translocation of miR-181c into the mitochondria by increasing the cytoplasmic stability of the RNA-induced silencing complex (RISC). Initially, estrogen offers cardioprotection in pre-menopausal females against the consequences of mitochondrial miR-181c upregulation by driving the phosphorylation of AGO2. Neonatal mouse ventricular myocytes (NMVM) treated with insulin showed an increase in pAGO2 levels and a decrease in mitochondrial miR-181c expression by increasing the binding affinity of AGO2-GW182 in the RISC. Thus, insulin treatment prevented excessive ROS production and mitochondrial Ca2+ accumulation. In human cardiomyocytes, we overexpressed miR-181c to mimic pathological conditions, such as obesity/diabetes. Treatment with estradiol (E2) for 48 h significantly lowered miR-181c entry into the mitochondria through increased pAGO2 levels. E2 treatment also normalized Sp1 degradation and MICU1 transcription that normally occurs in response to miR-181c overexpression. We then investigated these findings using an in vivo model, with age-matched male, female and ovariectomized (OVX) female mice. Consistent with the E2 treatment, we show that female hearts express higher levels of pAGO2 and thus, exhibit higher association of AGO2-GW182 in cytoplasmic RISC. This results in lower expression of mitochondrial miR-181c in female hearts compared to male or OVX groups. Further, female hearts had fewer consequences of mitochondrial miR-181c expression, such as lower Sp1 degradation and significantly decreased MICU1 transcriptional regulation. Taken together, this study highlights a potential therapeutic target for conditions such as obesity and diabetes, where miR-181c is upregulated. NEW AND NOTEWORTHY: In this study, we show that the phosphorylation of Argonaute 2 (AGO2) stabilizes the RNA-induced silencing complex in the cytoplasm, preventing miR-181c entry into the mitochondria. Furthermore, we demonstrate that treatment with estradiol can inhibit the translocation of miR-181c into the mitochondria by phosphorylating AGO2. This ultimately eliminates the downstream consequences of miR-181c overexpression by mitigating excessive reactive oxygen species production and calcium entry into the mitochondria.
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Affiliation(s)
- Diego Quiroga
- Department of Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, United States of America
| | - Barbara Roman
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21205, United States of America
| | - Marwan Salih
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21205, United States of America
| | - William N Daccarett-Bojanini
- Department of Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, United States of America
| | - Haley Garbus
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States of America
| | - Obialunanma V Ebenebe
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States of America
| | - Jeffrey M Dodd-O
- Department of Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, United States of America
| | - Brian O'Rourke
- Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, United States of America
| | - Mark Kohr
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States of America
| | - Samarjit Das
- Department of Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, United States of America; Department of Pathology, Johns Hopkins University, Baltimore, MD 21205, United States of America.
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Pingili A, Vempati R, Vemula M, Lakkimsetti M, Madhavaram H, Nanjundappa A, Gummadi J, Singh S, Desai R, Sunkara P. Prevalence of cardiovascular events among transgender adults with obesity: A population-based analysis. OBESITY PILLARS 2024; 11:100125. [PMID: 39252793 PMCID: PMC11381998 DOI: 10.1016/j.obpill.2024.100125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 08/11/2024] [Accepted: 08/12/2024] [Indexed: 09/11/2024]
Abstract
Introduction Although obesity and its impact on cardiovascular (CV) events have been extensively studied in the cisgender population, little is known about its impact on CV events in transgender individuals. Our study aimed to establish the prevalence of obesity and CV events in transgender adults. Methods We conducted a retrospective cohort comparative study utilizing the U.S. National Inpatient Sample 2020 database. We identified admissions of transgender patients with administrative codes. Later, these patients were divided into obesity and non-obesity cohorts. Multivariable regression analysis was then performed for in-hospital all-cause mortality, acute myocardial infarction, acute ischemic stroke, cardiac arrest, pulmonary embolism and, major adverse cardiovascular and cerebrovascular events (MACCE). Results In 2020, 19,345 transgender patients were admitted; 16,390 (84.7 %) had no obesity, and 2,955 (15.3 %) had obesity. The median age was 31 years in the non-obesity cohort and 37 years in the obesity cohort. Transgender men comprised 54.5 % of the non-obesity cohort and 47.9 % of the obesity cohort. Common baseline conditions in the non-obesity and obesity cohorts, respectively, included hypertension (20.7 % vs. 43.5 %), diabetes (10.2 % vs. 32.5 %), chronic pulmonary disease (18.9 % vs. 27.7 %), and hyperlipidemia (11.5 % vs. 25 %). MACCE was observed in 2.3 % of the non-obesity cohort compared to 5.4 % in the obesity cohort, and cardiac arrest occurred in 0.2 % of the non-obesity cohort versus 1.2 % in the obesity cohort. A statistically significant association was found in MACCE [odds ratio (OR) 2.1, 95 % confidence interval (CI) 1.24-3.55, p = 0.006] and cardiac arrest [OR 3.92, 95 % CI 1.11-12.63, p = 0.022] among transgender patients with obesity. Conclusion We observed increased odds of MACCE and cardiac arrest in transgender patients with obesity, possibly due to obesity and CV risk factors like hypertension, diabetes, and hyperlipidemia. Further large-scale comparative studies are needed to better understand obesity's impact on CV outcomes in the transgender population.
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Affiliation(s)
- Adhvithi Pingili
- Department of Internal Medicine, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Roopeessh Vempati
- Department of Internal Medicine, Trinity Health Oakland Hospital, Pontiac, MI, USA
| | - Madhusha Vemula
- Department of General Medicine, Malla Reddy Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Mohit Lakkimsetti
- Department of General Medicine, Mamata Medical College, Khammam, Telangana, India
| | - Hasmitha Madhavaram
- Department of Internal Medicine, Morristown Medical Centre, Morristown, NJ, USA
| | | | - Jyotsna Gummadi
- Department of Medicine, MedStar Franklin Square Medical Centre, Baltimore, MD, USA
| | - Sandeep Singh
- University Hospitals of North Midlands MHS Trust, Stroke-on-Trent, UK
| | - Rupak Desai
- Independent Researcher, Outcomes Research, Atlanta, GA, USA
| | - Praveena Sunkara
- Department of Internal Medicine, Passion Health Primary Care, Denton, TX, USA
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Gacouin A, Guillot P, Delamaire F, Le Corre A, Quelven Q, Terzi N, Tadié JM, Maamar A. Impact of cardiovascular risk factors and cardiac diseases on mortality in patients with moderate to severe ARDS: A retrospective cohort study. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2024; 22:200318. [PMID: 39234517 PMCID: PMC11372786 DOI: 10.1016/j.ijcrp.2024.200318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 07/02/2024] [Accepted: 08/08/2024] [Indexed: 09/06/2024]
Abstract
Background History of coronary artery disease (CAD) and/or atrial fibrillation (AF) and/or valvular replacement (VR) are prevalent among patients admitted to intensive care units (ICUs). The impact of these conditions on outcomes in patients with acute respiratory distress syndrome (ARDS) remains insufficiently explored. Methods We performed a retrospective study on prospectively collected data from patients with ARDS and a PaO2/FiO2 ratio ≤150 mmHg. Patients were admitted between January 2006 and March 2022. We used multivariable logistic regression analysis. The primary outcome was 1-year mortality from admission to the ICU; secondary outcomes included mortality at 28 days and 90 days. Results Among 1.033 patients, 181 (17.5 %) had a history of CAD and/or AF and/or VR. History of CAD and/or AF and/or VR was independently associated with 1-year mortality (Odds-Ratio (OR) = 2.59, 95 % confidence interval (CI) 1.76-3.82, p < 0.001), with mortality at 90 days (OR = 1.87, 95 % CI 1.27-2.76, p = 0.001), but not with mortality at 28 days (OR = 1.40, 95 % CI 0.93-2.11, p = 0.10). In sensitivity analyses, history of CAD and/or AF and/or VR remained independently associated with 1-year mortality in ICU survivors (OR = 3.58, 95 % CI = 2.41-7.82, p < 0.001). Conclusions History of CAD and/or AF and/or VR was associated with mortality in ARDS. Prompt referral to cardiologists for comprehensive management post-ICU discharge may be warranted to optimize outcomes in this vulnerable population.
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Affiliation(s)
- Arnaud Gacouin
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France
- Université Rennes 1, Faculté de Médecine, Biosit, F-35043 Rennes, France
- Inserm-CIC-1414, Faculté de Médecine, Université Rennes 1, IFR 140, F-35033 Rennes, France
| | - Pauline Guillot
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France
- Université Rennes 1, Faculté de Médecine, Biosit, F-35043 Rennes, France
| | - Flora Delamaire
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France
- Université Rennes 1, Faculté de Médecine, Biosit, F-35043 Rennes, France
| | - Alexia Le Corre
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France
- Université Rennes 1, Faculté de Médecine, Biosit, F-35043 Rennes, France
| | - Quentin Quelven
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France
- Université Rennes 1, Faculté de Médecine, Biosit, F-35043 Rennes, France
| | - Nicolas Terzi
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France
- Université Rennes 1, Faculté de Médecine, Biosit, F-35043 Rennes, France
- Inserm-CIC-1414, Faculté de Médecine, Université Rennes 1, IFR 140, F-35033 Rennes, France
| | - Jean Marc Tadié
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France
- Université Rennes 1, Faculté de Médecine, Biosit, F-35043 Rennes, France
- Inserm-CIC-1414, Faculté de Médecine, Université Rennes 1, IFR 140, F-35033 Rennes, France
| | - Adel Maamar
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France
- Université Rennes 1, Faculté de Médecine, Biosit, F-35043 Rennes, France
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Ponce-España E, Cruz-Chamorro I, Santos-Sánchez G, Álvarez-López AI, Fernández-Santos JM, Pedroche J, Millán-Linares MC, Bejarano I, Lardone PJ, Carrillo-Vico A. Anti-obesogenic effect of lupin-derived protein hydrolysate through modulation of adiposopathy, insulin resistance and gut dysbiosis in a diet-induced obese mouse. Biomed Pharmacother 2024; 178:117198. [PMID: 39059351 DOI: 10.1016/j.biopha.2024.117198] [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] [Received: 04/02/2024] [Revised: 07/18/2024] [Accepted: 07/22/2024] [Indexed: 07/28/2024] Open
Abstract
The prevalence of obesity is increasingly widespread, resembling a global epidemic. Lifestyle changes, such as consumption of high-energy-dense diets and physical inactivity, are major contributors to obesity. Common features of this metabolic pathology involve an imbalance in lipid and glucose homeostasis including dyslipidemia, insulin resistance and adipose tissue dysfunction. Moreover, the importance of the gut microbiota in the development and susceptibility to obesity has recently been highlighted. In recent years, new strategies based on the use of functional foods, in particular bioactive peptides, have been proposed to counteract obesity outcomes. In this context, the present study examines the effects of a lupin protein hydrolysate (LPH) on obesity, dyslipidemia and gut dysbiosis in mice fed a high-fat diet (HFD). After 12 weeks of LPH treatment, mice gained less weight and showed decreased adipose dysfunction compared to the HFD-fed group. HFD-induced dyslipidemia (increased triglycerides, cholesterol and LDL concentration) and insulin resistance were both counteracted by LPH consumption. Discriminant analysis differentially distributed LPH-treated mice compared to non-treated mice. HFD reduced gut ecological parameters, promoted the blooming of deleterious taxa and reduced the abundance of commensal members. Some of these changes were corrected in the LPH group. Finally, correlation analysis suggested that changes in this microbial population could be responsible for the improvement in obesity outcomes. In conclusion, this is the first study to show the effect of LPH on improving weight gain, adiposopathy and gut dysbiosis in the context of diet-induced obesity, pointing to the therapeutic potential of bioactive peptides in metabolic diseases.
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Affiliation(s)
- Eduardo Ponce-España
- Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville 41013, Spain; Departamento de Bioquímica Médica y Biología Molecular e Inmunología, Facultad de Medicina, Universidad de Sevilla, Seville 41009, Spain
| | - Ivan Cruz-Chamorro
- Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville 41013, Spain; Departamento de Bioquímica Médica y Biología Molecular e Inmunología, Facultad de Medicina, Universidad de Sevilla, Seville 41009, Spain
| | - Guillermo Santos-Sánchez
- Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville 41013, Spain; Departamento de Bioquímica Médica y Biología Molecular e Inmunología, Facultad de Medicina, Universidad de Sevilla, Seville 41009, Spain
| | - Ana Isabel Álvarez-López
- Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville 41013, Spain; Departamento de Bioquímica Médica y Biología Molecular e Inmunología, Facultad de Medicina, Universidad de Sevilla, Seville 41009, Spain
| | - José María Fernández-Santos
- Departamento de Citología e Histología Normal y Patológica, Facultad de Medicina, Universidad de Sevilla, Seville 41009, Spain
| | - Justo Pedroche
- Department of Food & Health, Instituto de la Grasa, CSIC, Ctra Utrera Km 1, Seville 41013, Spain
| | | | - Ignacio Bejarano
- Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville 41013, Spain; Departamento de Bioquímica Médica y Biología Molecular e Inmunología, Facultad de Medicina, Universidad de Sevilla, Seville 41009, Spain
| | - Patricia Judith Lardone
- Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville 41013, Spain; Departamento de Bioquímica Médica y Biología Molecular e Inmunología, Facultad de Medicina, Universidad de Sevilla, Seville 41009, Spain
| | - Antonio Carrillo-Vico
- Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville 41013, Spain; Departamento de Bioquímica Médica y Biología Molecular e Inmunología, Facultad de Medicina, Universidad de Sevilla, Seville 41009, Spain.
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Zeitler EM, Glenn DA, Hu Y, Falk RJ, Hogan SL, Mottl AK. Association of Obesity With Kidney and Cardiac Outcomes Among Patients With Glomerular Disease: Findings From the Cure Glomerulonephropathy Network. Am J Kidney Dis 2024; 84:306-319.e1. [PMID: 38750877 PMCID: PMC11344669 DOI: 10.1053/j.ajkd.2024.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 02/18/2024] [Accepted: 03/09/2024] [Indexed: 07/10/2024]
Abstract
RATIONALE & OBJECTIVE The influence of obesity on cardiorenal outcomes in individuals with glomerular disease is incompletely known. This study examined the association between obesity and kidney and cardiovascular outcomes in children and adults with glomerular kidney disease. STUDY DESIGN Prospective, multicenter, observational study. SETTING & PARTICIPANTS Participants in the Cure Glomerulonephropathy Network (CureGN) who were≥5 years of age at enrollment. EXPOSURE Adult body mass index (BMI) groups: 20-24 (healthy) versus 25-34 (overweight/class 1 obesity) versus≥35 (class 2-3 obesity); and pediatric BMI percentiles: 5th-84th (healthy) versus 85th-94th (overweight) versus≥95th (obese). OUTCOME A composite kidney outcome (40% estimated glomerular filtration rate [eGFR] decline or kidney failure) and a composite cardiovascular outcome (myocardial infarction, stroke, heart failure, or death). ANALYTICAL APPROACH Time to composite primary outcomes by BMI strata were estimated using Kaplan-Meier analysis. The adjusted associations between BMI and outcomes were estimated using Cox proportional hazards analysis. RESULTS The study included 2,301 participants (1,548 adults and 753 children). The incidence of the primary kidney end point was 90.8 per 1,000 person-years in adults with class 2-3 obesity, compared with 58.0 in normal weight comparators. In the univariable analysis, class 2-3 obesity was associated with the primary kidney outcome only in adults (HR, 1.6 [95% CI, 1.1-2.2], P=0.006) compared with the healthy weight groups. In the multivariable adjusted analysis, class 2-3 obesity did not remain significant among adults when controlling for baseline eGFR and proteinuria. Adults with class 2-3 obesity had an incidence of 19.7 cardiovascular events per 1,000 person-years and greater cardiovascular risk (HR, 3.9 [95% CI, 1.4-10.7], P=0.009) in the fully adjusted model. LIMITATIONS BMI is an imperfect indicator of adiposity. Residual confounding may exist from socioeconomic factors. CONCLUSIONS Among adult patients in CureGN, class 2-3 obesity is associated with cardiovascular but not kidney outcomes when adjusted for potential confounding factors. PLAIN-LANGUAGE SUMMARY Obesity is a risk factor for adverse heart and kidney outcomes in patients with chronic kidney disease, but whether it is associated with these outcomes in patients with glomerulonephropathy is not known. This study used existing data from a large sample of adults and children with glomerular diseases to address this question. The findings suggest that obesity increases the risk of cardiovascular but not kidney disease events in adult patients with glomerular disease.
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Affiliation(s)
- Evan M Zeitler
- Division of Nephrology and Hypertension, Department of Medicine, UNC Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Dorey A Glenn
- Division of Nephrology and Hypertension, Department of Medicine, UNC Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Yichun Hu
- Division of Nephrology and Hypertension, Department of Medicine, UNC Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Ronald J Falk
- Division of Nephrology and Hypertension, Department of Medicine, UNC Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Susan L Hogan
- Division of Nephrology and Hypertension, Department of Medicine, UNC Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Amy K Mottl
- Division of Nephrology and Hypertension, Department of Medicine, UNC Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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87
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Bailin SS, Koethe JR. Weight Gain and Antiretroviral Therapy. Infect Dis Clin North Am 2024; 38:499-515. [PMID: 38871568 PMCID: PMC11305935 DOI: 10.1016/j.idc.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Antiretroviral therapy (ART) agents as a determinant of body weight in ART-naïve and ART-experienced persons with human immunodeficiency virus (HIV) (PWH) has become a major focus area in research and clinical settings. Recent studies demonstrating weight-suppressing properties of efavirenz and tenofovir disoproxil fumarate led to re-evaluation of weight gain studies, and a reassessment of whether other agents are weight promoting versus weight neutral. In this review, the authors synthesize recent literature on factors related to obesity, clinical measurements of adiposity, weight gain in ART-naïve and ART-experienced PWH, metabolic consequences of ART and weight gain, and the clinical management of weight gain in PWH.
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Affiliation(s)
- Samuel S Bailin
- Division of Infectious Diseases, Vanderbilt University Medical Center, 1161 21st Avenue South, A2200 Medical Center North, Nashville, TN 37232, USA.
| | - John R Koethe
- Division of Infectious Diseases, Vanderbilt University Medical Center, 1161 21st Avenue South, A2200 Medical Center North, Nashville, TN 37232, USA
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88
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Szczudlik E, Stępniewska A, Bik-Multanowski M, Brandt-Heunemann S, Flehmig B, Małecka-Tendera E, Mazur A, Petriczko E, Ranke MB, Wabitsch M, Zachurzok A, Wójcik M. The age of the obesity onset is a very important factor for the development of metabolic complications and cardiovascular risk in children and adolescents with severe obesity. Eur J Pediatr 2024; 183:3833-3841. [PMID: 38877324 PMCID: PMC11322218 DOI: 10.1007/s00431-024-05636-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/27/2024] [Accepted: 05/30/2024] [Indexed: 06/16/2024]
Abstract
Severe obesity defined as BMI value corresponding to an adult > 40 kg/m2 affects 1-5% of children and adolescents in Europe. The purpose of this study was to assess the occurrence of cardiovascular risk factors in children and adolescents with severe obesity. The analysis included 140 patients (75 female) at the mean age of 14 ± 2.1 SD (range 10-18) years (all recruited in 4 regional reference centers in Poland). Severe obesity was defined as BMI > 35 kg/m2 (children 6-14 years), and BMI > 40 kg/m2 (> 14 years). Fasting plasma samples have been obtained in all patients, and OGTT was performed in all patients. The metabolic risk factors were defined as high blood pressure (BP > 90 percentile for height, age, and sex), HDL cholesterol < 1.03 mmol/L, TG ≥ 1.7 mmol/L, and hyperglycemic state (fasting blood glucose > 5.6 mmol/L, or blood glucose 120' after oral glucose load > 7.8 mmol/L). Additionally, the MetS z-score was calculated using Metabolic Syndrome Severity Calculator. One hundred twenty-four (89%) participants presented with high BP, 117 (84%) with abnormal lipid profile, and 26 with the hyperglycemic. Only 12 (9%) were free of metabolic complications. More than 60% of patients had more than one cardiovascular risk factor. The high BP was significantly associated with the severity of obesity (F = 9.9, p = 0.002). Patients with at least one metabolic complication presented with significantly younger age of the onset of obesity (the mean age of the patients with no overt obesity complications was 10 years, while the mean age of those who presented at least one was 4.7 ± 3.5 SD years (p = 0.002)). A significant positive association between in the value of the Mets BMI z-score with age was observed (R = 0.2, p < 0.05). There were no differences between girls and boys regarding Mets BMI z-score (1.7 ± 0.8 vs 1.7 ± 0.7, p = 0.8).Conclusions: The most common metabolic risk factor in children and adolescents with severe obesity was high BP. The most important factor determining presence of obesity complications, and thus the total metabolic risk, seems to be younger (< 5 years) age of onset of obesity. What is Known? • It is estimated that 1-5% of children and adolescents in Europe suffer from severe obesity corresponding to an adult BMI > 40 kg/m2, and it is the fastest growing subcategory of childhood obesity. • Children with severe obesity face substantial health risk that may persist into adulthood, encompassing chronic conditions, psychological disorders and premature mortality. What is new: • The most common complication is high BP that is significantly associated with the severity of obesity (BMI z-score), contrary to dyslipidemia and hyperglycemic state, which do not depend on BMI z-score value. • The most important factor determining presence of obesity complications, and thus the total metabolic risk, seems to be younger (< 5 years) age of onset of obesity.
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Affiliation(s)
- Ewa Szczudlik
- Department of Pediatric and Adolescent Endocrinology, Pediatric Institute, Jagiellonian University Medical College, Cracow, Poland
| | - Anna Stępniewska
- Department of Pediatric and Adolescent Endocrinology, Pediatric Institute, Jagiellonian University Medical College, Cracow, Poland
| | - Mirosław Bik-Multanowski
- Department of Medical Genetics, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
- Institute of Human Genetics, University Hospital, LMU, Munich, Germany
| | - Stephanie Brandt-Heunemann
- Center for Rare Endocrine Diseases, Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm, Germany
| | | | - Ewa Małecka-Tendera
- Department of Pediatrics and Pediatric Endocrinology, Medical University of Silesia, School of Medicine in Katowice, Katowice, Poland
| | - Artur Mazur
- Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | - Elżbieta Petriczko
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Disorders and Cardiology of Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | - Michael B Ranke
- Children's Hospital, University of Tübingen, Tübingen, Germany
| | - Martin Wabitsch
- Center for Rare Endocrine Diseases, Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm, Germany
| | - Agnieszka Zachurzok
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Małgorzata Wójcik
- Department of Pediatric and Adolescent Endocrinology, Pediatric Institute, Jagiellonian University Medical College, Cracow, Poland.
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89
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Pan HM, Lee WJ, Ser KH, Soong TC, Lee MH, Lin CH, Hsu KF. Impact of metabolic bariatric surgery on outcomes and the 10-year risk of major adverse cardiovascular events during a 7-year period: a retrospective cohort study. Int J Surg 2024; 110:5563-5573. [PMID: 38770830 PMCID: PMC11392150 DOI: 10.1097/js9.0000000000001631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/07/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Metabolic bariatric surgery offers enduring weight reduction and alleviation of obesity-related comorbidities, including dyslipidemia, diabetes, hypertension, and major adverse cardiovascular events (MACE). Long-term data on one-anastomosis gastric bypass (OAGB) and single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy (SADJB-SG) is lacking, necessitating this investigation. MATERIALS AND METHODS In this multicenter prospectively-collected retrospective observational study, 830 adult Taiwanese patients (682 OAGB, 148 SADJB-SG) who underwent surgery from 1 January 2011 to 31 December 2017, were initially identified. Following protocol, 224 patients (177 OAGB, 47 SADJB-SG) with complete follow-up data at various intervals up to 3 years after surgery were included in the final analysis. The study's primary focus is to evaluate the long-term safety, efficacy, and durability of OAGB and SADJB-SG in promoting weight loss and diabetes remission. Additionally, changes in 10-year and lifetime risks of MACE before and 3-year after surgery are assessed using Taiwan MACE risk prediction model and the China-PAR project model. RESULTS SADJB-SG patients exhibit higher diabetes prevalence, lower BMI, and more severe diabetes compared to OAGB. Both groups demonstrate significant improvements in BMI, diabetes, hypertension, and dyslipidemia three years after surgery, with the most substantial improvements occurring in the second year. The Taiwan MACE risk model reveals a significant reduction in 10-year MACE and stroke risks for both groups. The China-PAR project model indicates a synchronized reduction in atherosclerotic cardiovascular disease 10-year and lifetime risk in both OAGB and SADJB-SG groups. CONCLUSIONS OAGB and SADJB-SG exhibit sustained improvements in weight reduction and obesity-related comorbidities over 3 years after surgery. Notably, both procedures contribute to a substantial reduction in 10-year MACE, stroke, and atherosclerotic cardiovascular disease risks. These findings underscore the efficacy of OAGB and SADJB-SG in the context of metabolic bariatric surgery.
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Affiliation(s)
- Hsin-Mei Pan
- Division of General Surgery, Department of Surgery/Bariatric and Metabolic Surgery and Weight Management Center, Tri‑Service General Hospital, National Defense Medical Center, Taipei
| | - Wei-Jei Lee
- Medical Weight Loss Center, China Medical University Hsinchu Hospital, Hsinchu
| | - Kong-Han Ser
- Bariatric and Metabolic Surgery Center, Ten-Chan General Hospital, Taoyuan
| | - Tien-Chou Soong
- Center for Weight Loss and Health Management, E-DA Dachang Hospital/College of Medicine, I-Shou University
| | - Ming-Hsien Lee
- Metabolic and Bariatric Surgical Department, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation/Department of Surgery, School of Medicine, Tzu Chi University, Hualien
| | - Chien-Hua Lin
- Division of General Surgery, Department of Surgery/Bariatric and Metabolic Surgery and Weight Management Center, Tri‑Service General Hospital, National Defense Medical Center, Taipei
- Department of Surgery, IRCAD Taiwan, Chang-Bing Show Chwan Memorial Hospital, Taiwan
| | - Kuo-Feng Hsu
- Division of General Surgery, Department of Surgery/Bariatric and Metabolic Surgery and Weight Management Center, Tri‑Service General Hospital, National Defense Medical Center, Taipei
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90
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Lobeek M, Peters A, van Veldhuisen SL, America YGCJ, Rienstra M, Hazebroek EJ, van Veldhuisen DJ, Gorter TM. Cardiac Abnormalities in Individuals Aged ≥ 50 Years with Severe Obesity Referred for Bariatric Surgery. Obes Surg 2024; 34:3513-3516. [PMID: 39088146 DOI: 10.1007/s11695-024-07422-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 07/17/2024] [Accepted: 07/19/2024] [Indexed: 08/02/2024]
Affiliation(s)
- Michelle Lobeek
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Aniek Peters
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Sophie L van Veldhuisen
- Department of Surgery, Amsterdam UMC, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands
- Department of Surgery/Vitalys Clinic, Rijnstate Hospital, PO Box 9555, 6800 TA, Arnhem, The Netherlands
| | - Yves G C J America
- Department of Cardiology, Rijnstate Hospital, PO Box 9555, 6800 TA, Arnhem, The Netherlands
| | - Michiel Rienstra
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Eric J Hazebroek
- Department of Surgery/Vitalys Clinic, Rijnstate Hospital, PO Box 9555, 6800 TA, Arnhem, The Netherlands
- Division of Human Nutrition and Health, Wageningen University & Research, PO Box 9101, 6700 HB, Wageningen, The Netherlands
| | - Dirk J van Veldhuisen
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Thomas M Gorter
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
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91
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Otani K, Uemura N, Funada H, Kodama T, Okada M, Yamawaki H. Alteration of reactivity in isolated mesenteric artery from Zucker fatty diabetes mellitus rats. J Pharmacol Sci 2024; 156:38-44. [PMID: 39068033 DOI: 10.1016/j.jphs.2024.06.006] [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] [Received: 04/14/2024] [Revised: 05/15/2024] [Accepted: 06/26/2024] [Indexed: 07/30/2024] Open
Abstract
Obesity and diabetes are major risk factors for cardiovascular diseases. Zucker fatty diabetes mellitus (ZFDM) rats are novel animal model of obesity and type 2 diabetes. We have recently reported that blood pressure in ZFDM-Leprfa/fa (Homo) rats was normal, while blood adrenaline level and heart rate were lower than those in control ZFDM-Leprfa/+ (Hetero) rats. Here, we compared the reactivity in isolated mesenteric artery between Hetero and Homo rats. Contraction induced by phenylephrine was increased, while relaxation induced by isoprenaline was decreased in Homo rats at 21-23 weeks old compared with those in Hetero rats. The mRNA expression for α1A but not β2 adrenoreceptor in Homo rats was increased. Nitric oxide (NO)-mediated relaxation induced by acetylcholine was decreased, while the mRNA expression for endothelial NO synthase (eNOS) was rather increased in mesenteric artery from Homo rats. These findings for the first time revealed that in Homo rats with reduced plasma adrenaline, blood pressure could be maintained by enhancing vascular contractility induced by adrenaline through the increased α1 adrenoceptor expression and the attenuated β2 adrenoceptor signaling. Additionally, NO-mediated endothelium-dependent relaxation is impaired perhaps due to eNOS dysfunction, which might also contribute to maintain the blood pressure in Homo rats.
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MESH Headings
- Animals
- Rats, Zucker
- Mesenteric Arteries/drug effects
- Mesenteric Arteries/physiopathology
- Male
- Receptors, Adrenergic, beta-2/genetics
- Receptors, Adrenergic, beta-2/metabolism
- Nitric Oxide Synthase Type III/metabolism
- Nitric Oxide Synthase Type III/genetics
- Nitric Oxide/metabolism
- Phenylephrine/pharmacology
- Disease Models, Animal
- Receptors, Adrenergic, alpha-1/genetics
- Receptors, Adrenergic, alpha-1/metabolism
- Isoproterenol/pharmacology
- Epinephrine/blood
- Epinephrine/pharmacology
- Diabetes Mellitus, Type 2/physiopathology
- Diabetes Mellitus, Type 2/metabolism
- Vasodilation/drug effects
- Acetylcholine/pharmacology
- Rats
- Obesity/metabolism
- Obesity/physiopathology
- Vasoconstriction/drug effects
- RNA, Messenger/metabolism
- RNA, Messenger/genetics
- Blood Pressure/drug effects
- In Vitro Techniques
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Affiliation(s)
- Kosuke Otani
- Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Kitasato University, Higashi 23-35-1, Towada, Aomori, 034-8628, Japan.
| | - Naofumi Uemura
- Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Kitasato University, Higashi 23-35-1, Towada, Aomori, 034-8628, Japan
| | - Hiroshi Funada
- Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Kitasato University, Higashi 23-35-1, Towada, Aomori, 034-8628, Japan
| | - Tomoko Kodama
- Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Kitasato University, Higashi 23-35-1, Towada, Aomori, 034-8628, Japan
| | - Muneyoshi Okada
- Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Kitasato University, Higashi 23-35-1, Towada, Aomori, 034-8628, Japan
| | - Hideyuki Yamawaki
- Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Kitasato University, Higashi 23-35-1, Towada, Aomori, 034-8628, Japan
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92
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Dong C, Kacmaz M, Schlettert C, Abumayyaleh M, Akin I, Hemetsberger R, Mügge A, Aweimer A, Hamdani N, El-Battrawy I. The Impact of Body Mass Index on the Mortality of Myocardial Infarction Patients With Nonobstructive Coronary Arteries. Clin Cardiol 2024; 47:e70013. [PMID: 39262111 PMCID: PMC11390790 DOI: 10.1002/clc.70013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 08/08/2024] [Accepted: 08/19/2024] [Indexed: 09/13/2024] Open
Abstract
OBJECTIVES Myocardial infarction without significant stenosis or occlusion of the coronary arteries carries a high risk of recurrent major adverse cardiovascular events and poor prognosis. This study aimed to investigate the association between body mass index and outcomes in patients with a suspected myocardial infarction with nonobstructive coronary artery disease (MINOCA). METHODS Patients were recruited at Bergmannsheil University Hospital from January 2010 to April 2021. The primary outcomes were in-hospital and long-term mortality. Secondary outcomes consisted of adverse events during hospitalization and during follow-up. RESULTS A total of 373 patients were included in the study, with a mean follow-up time of 6.2 years. The patients were divided into different BMI groups: < 25 kg/m² (n = 121), 25-30 kg/m² (n = 140), and > 30 kg/m² (n = 112). In-hospital mortality was 1.7% versus 2.1% versus 4.5% (p = 0.368). However, long-term mortality tended to be higher in the < 25 kg/m² group compared to the 25-30 and > 30 kg/m² groups (log-rank p = 0.067). Subgroup analysis using Kaplan-Meier analysis showed a higher rate of cardiac cause of death in the < 25 kg/m² group compared to the 25-30 and > 30 kg/m² groups: 5.7% versus 1.1% versus 0.0% (log-rank p = 0.042). No significant differences were observed in other adverse events between the different BMI groups during hospitalization and long-term follow-up. CONCLUSIONS Patients with a BMI < 25 kg/m² who experience a suspected myocardial infarction without significant coronary artery disease may have higher all-cause mortality and cardiovascular cause of death. However, further data are needed to confirm these findings.
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Affiliation(s)
- Chaohui Dong
- Department of Cellular and Translational Physiology, Institute of Physiology, Ruhr-University Bochum, Bochum, Germany
- Institut für Forschung und Lehre (IFL), Molecular and Experimental Cardiology, Ruhr-University Bochum, Bochum, Germany
- HCEMM-SU Cardiovascular Comorbidities Research Group, Center for Pharmacology and Drug Research & Development, Department of Pharmacology and Pharmacotherapy, Intézet címe Semmelweis University, Budapest, Hungary
| | - Mustafa Kacmaz
- Department of Cellular and Translational Physiology, Institute of Physiology, Ruhr-University Bochum, Bochum, Germany
- Institut für Forschung und Lehre (IFL), Molecular and Experimental Cardiology, Ruhr-University Bochum, Bochum, Germany
- HCEMM-SU Cardiovascular Comorbidities Research Group, Center for Pharmacology and Drug Research & Development, Department of Pharmacology and Pharmacotherapy, Intézet címe Semmelweis University, Budapest, Hungary
| | - Clara Schlettert
- Department of Cardiology and Angiology, Bergmannsheil University Hospital, Ruhr University of Bochum, Bochum, Germany
| | - Mohammad Abumayyaleh
- First Department of Medicine, University Medical Centre Mannheim (UMM), Mannheim, Germany
| | - Ibrahim Akin
- First Department of Medicine, University Medical Centre Mannheim (UMM), Mannheim, Germany
| | - Rayyan Hemetsberger
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Andreas Mügge
- Department of Cardiology and Angiology, Bergmannsheil University Hospital, Ruhr University of Bochum, Bochum, Germany
- Department of Cardiology and Rhythmology, University Hospital St. Josef Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Assem Aweimer
- Department of Cardiology and Angiology, Bergmannsheil University Hospital, Ruhr University of Bochum, Bochum, Germany
| | - Nazha Hamdani
- Department of Cellular and Translational Physiology, Institute of Physiology, Ruhr-University Bochum, Bochum, Germany
- Institut für Forschung und Lehre (IFL), Molecular and Experimental Cardiology, Ruhr-University Bochum, Bochum, Germany
- HCEMM-SU Cardiovascular Comorbidities Research Group, Center for Pharmacology and Drug Research & Development, Department of Pharmacology and Pharmacotherapy, Intézet címe Semmelweis University, Budapest, Hungary
- Department of Cardiology and Rhythmology, University Hospital St. Josef Hospital Bochum, Ruhr University Bochum, Bochum, Germany
- Departments of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Ibrahim El-Battrawy
- Department of Cellular and Translational Physiology, Institute of Physiology, Ruhr-University Bochum, Bochum, Germany
- Institut für Forschung und Lehre (IFL), Molecular and Experimental Cardiology, Ruhr-University Bochum, Bochum, Germany
- Department of Cardiology and Angiology, Bergmannsheil University Hospital, Ruhr University of Bochum, Bochum, Germany
- Department of Cardiology and Rhythmology, University Hospital St. Josef Hospital Bochum, Ruhr University Bochum, Bochum, Germany
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93
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Zhang Y, Xue J, Li S, Yang H, Kang C. Impact of bariatric surgery on carotid intima-media thickness and arterial stiffness in metabolically healthy obesity: a prospective study. Hormones (Athens) 2024; 23:467-475. [PMID: 38819742 DOI: 10.1007/s42000-024-00568-5] [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: 09/08/2023] [Accepted: 05/13/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE Cardiovascular disease is one of the leading causes of mortality in patients with obesity. Metabolically healthy obesity (MHO), in which people do not have metabolic disorders, is a transient state of obesity. However, over the long term, a proportion of individuals with MHO develop metabolic syndrome (MetS). We aimed to investigate the effect of substantial weight loss following bariatric surgery in MHO on carotid intima-media thickness (CIMT) and pulse-wave velocity (PWV), which are independent predictors of subclinical atherosclerosis. METHODS This prospective study included 38 patients (34 women, four men) undergoing bariatric surgery who had severe obesity but without comorbidities (hypertension, diabetes, and hyperlipidemia), and 28 control individuals who were matched for age and sex. CIMT and PWV of the left common carotid artery were measured. At 12-month follow-up after bariatric surgery, measurements were repeated in the 38 patients with obesity. RESULTS Mean baseline body mass index (BMI) in the MHO group was 40.55 ± 3.59 kg/m2, which decreased by 33.1% after bariatric surgery. Compared with controls, CIMT and PWV were increased in MHO (543.53 ± 55.29 vs. 407.82 ± 53.09 μm, 6.70 ± 1.22 vs. 5.45 ± 0.74 m/s, respectively; all P < 0.001). At 12 months post-bariatric surgery, CIMT in MHO was lower than baseline (466.79 ± 53.74 vs. 543.53 ± 55.29 μm, P = 0.009), but PWV was not significantly different from baseline (6.27 ± 0.86 vs. 6.70 ± 1.22 m/s, P = 0.132). Multivariate regression showed that BMI was an independent predictor of CIMT (β = 0.531, P < 0.001). CONCLUSION Carotid artery structure and function were impaired in MHO, and improved carotid artery structure was associated with weight loss in MHO after bariatric surgery.
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Affiliation(s)
- Yanxia Zhang
- Department of Ultrasonography, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, 99 Longcheng Street, Taiyuan City, Shanxi Province, 030032, China
| | - Jiping Xue
- Department of Ultrasonography, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, 99 Longcheng Street, Taiyuan City, Shanxi Province, 030032, China
| | - Shuai Li
- Department of Ultrasonography, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, 99 Longcheng Street, Taiyuan City, Shanxi Province, 030032, China
| | - Hongyu Yang
- Department of Ultrasonography, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, 99 Longcheng Street, Taiyuan City, Shanxi Province, 030032, China
| | - Chunsong Kang
- Department of Ultrasonography, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, 99 Longcheng Street, Taiyuan City, Shanxi Province, 030032, China.
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94
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Madenci AL, Kurgansky KE, Dickerman BA, Gerlovin H, Wanis KN, Smith AD, Trinquart L, Gagnon DR, Cho K, Gaziano JM, Casas JP, Robins JM, Hernán MA. Estimating the Effect of Bariatric Surgery on Cardiovascular Events Using Observational Data? Epidemiology 2024; 35:721-729. [PMID: 39024034 DOI: 10.1097/ede.0000000000001765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
BACKGROUND Observational studies have reported strongly protective effects of bariatric surgery on cardiovascular disease, but with oversimplified definitions of the intervention, eligibility criteria, and follow-up, which deviate from those in a randomized trial. We describe an attempt to estimate the effect of bariatric surgery on cardiovascular disease without introducing these sources of bias, which may not be entirely possible with existing observational data. METHODS We propose two target trials among persons with diabetes: (1) bariatric operation (vs. no operation) among individuals who have undergone preoperative preparation (lifestyle modifications and screening) and (2) preoperative preparation and a bariatric operation (vs. neither preoperative nor operative component). We emulated both target trials using observational data of US veterans. RESULTS Comparing bariatric surgery with no surgery (target trial #1; 8,087 individuals), the 7-year cardiovascular risk was 18.0% (95% CI = 6.9, 32.7) in the surgery group and 18.9% (95% CI = 17.7, 20.1) in the no-surgery group (risk difference -0.9, 95% CI = -12.0, 14.0). Comparing preoperative components plus surgery vs. neither (target trial #2; 10,065 individuals), the 7-year cardiovascular risk was 17.4% (95% CI = 13.6, 22.0) in the surgery group and 18.8% (95% CI = 17.8, 19.9) in the no-surgery group (risk difference -1.4, 95% CI = -5.1, 3.2). Body mass index and hemoglobin A1c were reduced with bariatric interventions in both emulations. CONCLUSIONS Within limitations of available observational data, our estimates do not provide evidence that bariatric surgery reduces cardiovascular disease and support equipoise for a randomized trial of bariatric surgery for cardiovascular disease prevention.
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Affiliation(s)
- Arin L Madenci
- From the CAUSALab, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Boston Children's Hospital and Harvard Medical School, Boston, MA
| | | | - Barbra A Dickerman
- From the CAUSALab, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | | | - Kerollos Nashat Wanis
- From the CAUSALab, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Surgery, Western University, London, ON
| | - Ann D Smith
- Veterans Affairs Boston Healthcare System, Boston, MA
| | - Ludovic Trinquart
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA
- Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA
| | - David R Gagnon
- Veterans Affairs Boston Healthcare System, Boston, MA
- Boston University School of Public Health, Boston, MA
| | - Kelly Cho
- Veterans Affairs Boston Healthcare System, Boston, MA
| | - J Michael Gaziano
- Veterans Affairs Boston Healthcare System, Boston, MA
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Juan P Casas
- Veterans Affairs Boston Healthcare System, Boston, MA
| | - James M Robins
- From the CAUSALab, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Miguel A Hernán
- From the CAUSALab, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
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95
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Khattab R. Weight Loss Programs: Why Do They Fail? A Multidimensional Approach for Obesity Management. Curr Nutr Rep 2024; 13:478-499. [PMID: 38861120 DOI: 10.1007/s13668-024-00551-x] [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] [Accepted: 06/04/2024] [Indexed: 06/12/2024]
Abstract
PURPOSE OF REVIEW Despite the prevalence of weight loss programs, their success rates remain discouraging, with around half of individuals regaining lost weight within two years. The primary objective of this review is to explore the factors contributing to the failure of weight loss programs and to provide insights into effective weight management strategies. RECENT FINDINGS Factors contributing to the failure of weight loss programs include the impracticality of restrictive diets, potential metabolic impacts, limited focus on lifestyle changes, genetic predispositions, psychological influences, socioeconomic status, and medical conditions. A holistic approach considering these factors is crucial for safe and sustainable weight loss. Key findings indicate the importance of holistic approaches to weight management, including lifestyle modifications, medical interventions, and behavioral and psychological strategies. Effective weight loss strategies emphasize low-calorie, nutrient-rich diets, regular physical activity, and interventions tailored to individual needs. Combining multiple approaches offers the best chance of successful weight management and improved health outcomes. This review provides insights into the complexities of obesity management and the factors contributing to the failure of weight loss programs. It highlights the necessity of adopting a holistic approach that addresses dietary habits, physical activity, genetic factors, psychological well-being, and socioeconomic influences. Recommendations include implementing lifestyle modifications, medical interventions when necessary, and integrating behavioral and psychological support to achieve sustainable weight loss and mitigate the global health challenge posed by obesity.
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Affiliation(s)
- Rabie Khattab
- Clinical Nutrition Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
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96
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Li SJ, Wei JQ, Kang YY, Wang RQ, Rong WW, Zhao JJ, Deng QW, Gao PJ, Li XD, Wang JG. Natriuretic peptide receptor-C perturbs mitochondrial respiration in white adipose tissue. J Lipid Res 2024; 65:100623. [PMID: 39154732 PMCID: PMC11418126 DOI: 10.1016/j.jlr.2024.100623] [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] [Received: 03/06/2024] [Revised: 07/15/2024] [Accepted: 08/11/2024] [Indexed: 08/20/2024] Open
Abstract
Natriuretic peptide receptor-C (NPR-C) is highly expressed in adipose tissues and regulates obesity-related diseases; however, the detailed mechanism remains unknown. In this research, we aimed to explore the potential role of NPR-C in cold exposure and high-fat/high-sugar (HF/HS) diet-induced metabolic changes, especially in regulating white adipose tissue (WAT) mitochondrial function. Our findings showed that NPR-C expression, especially in epididymal WAT (eWAT), was reduced after cold exposure. Global Npr3 (gene encoding NPR-C protein) deficiency led to reduced body weight, increased WAT browning, thermogenesis, and enhanced expression of genes related to mitochondrial biogenesis. RNA-sequencing of eWAT showed that Npr3 deficiency enhanced the expression of mitochondrial respiratory chain complex genes and promoted mitochondrial oxidative phosphorylation in response to cold exposure. In addition, Npr3 KO mice were able to resist obesity induced by HF/HS diet. Npr3 knockdown in stromal vascular fraction (SVF)-induced white adipocytes promoted the expression of proliferator-activated receptor gamma coactivator 1α (PGC1α), uncoupling protein one (UCP1), and mitochondrial respiratory chain complexes. Mechanistically, NPR-C inhibited cGMP and calcium signaling in an NPR-B-dependent manner but suppressed cAMP signaling in an NPR-B-independent manner. Moreover, Npr3 knockdown induced browning via AKT and p38 pathway activation, which were attenuated by Npr2 knockdown. Importantly, treatment with the NPR-C-specific antagonist, AP-811, decreased WAT mass and increased PGC-1α, UCP1, and mitochondrial complex expression. Our findings reveal that NPR-C deficiency enhances mitochondrial function and energy expenditure in white adipose tissue, contributing to improved metabolic health and resistance to obesity.
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Affiliation(s)
- Shi-Jin Li
- Department of Cardiovascular Medicine, Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; State Key Laboratory of Membrane Biology, Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing, China
| | - Jin-Qiu Wei
- Department of Cardiovascular Medicine, Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuan-Yuan Kang
- Department of Cardiovascular Medicine, Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rui-Qi Wang
- Department of Cardiovascular Medicine, Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Wu-Wei Rong
- Department of Cardiovascular Medicine, Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jia-Jia Zhao
- Department of Cardiovascular Medicine, Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian-Wan Deng
- Department of Cardiovascular Medicine, Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ping-Jin Gao
- Department of Cardiovascular Medicine, Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Dong Li
- Department of Cardiovascular Medicine, Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Ji-Guang Wang
- Department of Cardiovascular Medicine, Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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97
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Koskinas KC, Van Craenenbroeck EM, Antoniades C, Blüher M, Gorter TM, Hanssen H, Marx N, McDonagh TA, Mingrone G, Rosengren A, Prescott EB. Obesity and cardiovascular disease: an ESC clinical consensus statement. Eur J Prev Cardiol 2024:zwae279. [PMID: 39210708 DOI: 10.1093/eurjpc/zwae279] [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: 05/14/2024] [Revised: 07/08/2024] [Accepted: 07/26/2024] [Indexed: 09/04/2024]
Abstract
The global prevalence of obesity has more than doubled over the past four decades, currently affecting more than a billion individuals. Beyond its recognition as a high-risk condition that is causally linked to many chronic illnesses, obesity has been declared a disease per se that results in impaired quality of life and reduced life expectancy. Notably, two-thirds of obesity-related excess mortality is attributable to cardiovascular disease. Despite the increasingly appreciated link between obesity and a broad range of cardiovascular disease manifestations including atherosclerotic disease, heart failure, thromboembolic disease, arrhythmias, and sudden cardiac death, obesity has been underrecognized and sub-optimally addressed compared with other modifiable cardiovascular risk factors. In the view of major repercussions of the obesity epidemic on public health, attention has focused on population-based and personalized approaches to prevent excess weight gain and maintain a healthy body weight from early childhood and throughout adult life, as well as on comprehensive weight loss interventions for persons with established obesity. This clinical consensus statement by the European Society of Cardiology discusses current evidence on the epidemiology and aetiology of obesity; the interplay between obesity, cardiovascular risk factors and cardiac conditions; the clinical management of patients with cardiac disease and obesity; and weight loss strategies including lifestyle changes, interventional procedures, and anti-obesity medications with particular focus on their impact on cardiometabolic risk and cardiac outcomes. The document aims to raise awareness on obesity as a major risk factor and provide guidance for implementing evidence-based practices for its prevention and optimal management within the context of primary and secondary cardiovascular disease prevention.
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Affiliation(s)
- Konstantinos C Koskinas
- Department of Cardiology, Bern University Hospital-INSELSPITAL, University of Bern, Freiburgstrasse 18, Bern 3010, Switzerland
| | - Emeline M Van Craenenbroeck
- Department of Cardiology, Antwerp University Hospital, Drie Eikenstraat 655, Antwerp 2650, Belgium
- Research group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp, Belgium
| | - Charalambos Antoniades
- Acute Multidisciplinary Imaging and Interventional Centre Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Matthias Blüher
- Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
| | - Thomas M Gorter
- Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Henner Hanssen
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Nikolaus Marx
- Department of Internal Medicine I-Cardiology, RWTH Aachen University, Aachen, Germany
| | - Theresa A McDonagh
- Cardiology Department, King's College Hospital, London, UK
- King's College, London, UK
| | - Geltrude Mingrone
- Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, UK
- Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli & Catholic University, Rome, Italy
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital/Ostra, Västra Götaland Region, Gothenburg, Sweden
| | - Eva B Prescott
- Bispebjerg Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen 2400, Denmark
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98
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Koskinas KC, Van Craenenbroeck EM, Antoniades C, Blüher M, Gorter TM, Hanssen H, Marx N, McDonagh TA, Mingrone G, Rosengren A, Prescott EB. Obesity and cardiovascular disease: an ESC clinical consensus statement. Eur Heart J 2024:ehae508. [PMID: 39210706 DOI: 10.1093/eurheartj/ehae508] [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: 05/14/2024] [Revised: 07/08/2024] [Accepted: 07/26/2024] [Indexed: 09/04/2024] Open
Abstract
The global prevalence of obesity has more than doubled over the past four decades, currently affecting more than a billion individuals. Beyond its recognition as a high-risk condition that is causally linked to many chronic illnesses, obesity has been declared a disease per se that results in impaired quality of life and reduced life expectancy. Notably, two-thirds of obesity-related excess mortality is attributable to cardiovascular disease. Despite the increasingly appreciated link between obesity and a broad range of cardiovascular disease manifestations including atherosclerotic disease, heart failure, thromboembolic disease, arrhythmias, and sudden cardiac death, obesity has been underrecognized and sub-optimally addressed compared with other modifiable cardiovascular risk factors. In the view of major repercussions of the obesity epidemic on public health, attention has focused on population-based and personalized approaches to prevent excess weight gain and maintain a healthy body weight from early childhood and throughout adult life, as well as on comprehensive weight loss interventions for persons with established obesity. This clinical consensus statement by the European Society of Cardiology discusses current evidence on the epidemiology and aetiology of obesity; the interplay between obesity, cardiovascular risk factors and cardiac conditions; the clinical management of patients with cardiac disease and obesity; and weight loss strategies including lifestyle changes, interventional procedures, and anti-obesity medications with particular focus on their impact on cardiometabolic risk and cardiac outcomes. The document aims to raise awareness on obesity as a major risk factor and provide guidance for implementing evidence-based practices for its prevention and optimal management within the context of primary and secondary cardiovascular disease prevention.
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Affiliation(s)
- Konstantinos C Koskinas
- Department of Cardiology, Bern University Hospital-INSELSPITAL, University of Bern, Freiburgstrasse 18, Bern 3010, Switzerland
| | - Emeline M Van Craenenbroeck
- Department of Cardiology, Antwerp University Hospital, Drie Eikenstraat 655, Antwerp 2650, Belgium
- Research group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp, Belgium
| | - Charalambos Antoniades
- Acute Multidisciplinary Imaging and Interventional Centre Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Matthias Blüher
- Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
| | - Thomas M Gorter
- Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Henner Hanssen
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Nikolaus Marx
- Department of Internal Medicine I-Cardiology, RWTH Aachen University, Aachen, Germany
| | - Theresa A McDonagh
- Cardiology Department, King's College Hospital, London, UK
- King's College, London, UK
| | - Geltrude Mingrone
- Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, UK
- Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli & Catholic University, Rome, Italy
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital/Ostra, Västra Götaland Region, Gothenburg, Sweden
| | - Eva B Prescott
- Bispebjerg Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen 2400, Denmark
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99
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Fatriani R, Pratiwi FAK, Annisa A, Septaningsih DA, Aziz SA, Miladiyah I, Kusumastuti SA, Nasution MAF, Ramadhan D, Kusuma WA. Unveiling the anti-obesity potential of Kemuning (Murraya paniculata): A network pharmacology approach. PLoS One 2024; 19:e0305544. [PMID: 39208245 PMCID: PMC11361609 DOI: 10.1371/journal.pone.0305544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 05/30/2024] [Indexed: 09/04/2024] Open
Abstract
Obesity has become a global issue that affects the emergence of various chronic diseases such as diabetes mellitus, dysplasia, heart disorders, and cancer. In this study, an integration method was developed between the metabolite profile of the active compound of Murraya paniculata and the exploration of the targeting mechanism of adipose tissue using network pharmacology, molecular docking, molecular dynamics simulation, and in vitro tests. Network pharmacology results obtained with the skyline query technique using a block-nested loop (BNL) showed that histone acetyltransferase p300 (EP300), peroxisome proliferator-activated receptor gamma (PPARG), and peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PPARGC1A) are potential targets for treating obesity. Enrichment analysis of these three proteins revealed their association with obesity, thermogenesis, energy metabolism, adipocytokines, fat cell differentiation, and glucose homeostasis. Metabolite profiling of M. paniculata leaves revealed sixteen active compounds, ten of which were selected for molecular docking based on drug-likeness and ADME results. Molecular docking results between PPARG and EP300 with the ten active compounds showed a binding affinity value of ≤ -5.0 kcal/mol in all dockings, indicating strong binding. The stability of the protein-ligand complex resulting from docking was examined using molecular dynamics simulations, and we observed the best average root mean square deviation (RMSD) of 0.99 Å for PPARG with trans-3-indoleacrylic acid, which was lower than with the native ligand BRL (2.02 Å). Furthermore, the RMSD was 2.70 Å for EP300 and the native ligand 99E, and the lowest RMSD with the ligand (1R,9S)-5-[(E)-2-(4-Chlorophenyl)vinyl]-11-(5-pyrimidinylcarbonyl)-7,11-diazatricyclo[7.3.1.02,7]trideca-2,4-dien-6-one was 3.33 Å. The in vitro tests to validate the potential of M. paniculata in treating obesity showed that there was a significant decrease in PPARG and EP300 gene expressions in 3T3-L1 mature adipocytes treated with M. paniculata ethanolic extract starting at concentrations 62.5 μg/ml and 15.625 μg/ml, respectively. These results indicate that M. paniculata can potentially treat obesity by disrupting adipocyte maturation and influencing intracellular lipid metabolism.
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Affiliation(s)
- Rizka Fatriani
- Tropical Biopharmaca Research Center, IPB University, Bogor, Indonesia
| | | | - Annisa Annisa
- Department of Computer Science, Faculty of Mathematics and Natural Sciences, IPB University, Bogor, Indonesia
| | - Dewi Anggraini Septaningsih
- Department of Chemistry, Faculty of Military Mathematics and Natural Sciences, Republic of Indonesia Defense University, Bogor, Indonesia
| | - Sandra Arifin Aziz
- Department of Agronomy and Horticulture, Faculty of Agriculture, IPB University, Bogor, Indonesia
| | | | - Siska Andrina Kusumastuti
- Research Center for Pharmaceutical Ingredients and Traditional Medicine, National Research and Innovation Agency (BRIN), Bogor, Indonesia
| | | | - Donny Ramadhan
- Research Center for Pharmaceutical Ingredients and Traditional Medicine, National Research and Innovation Agency (BRIN), Bogor, Indonesia
| | - Wisnu Ananta Kusuma
- Tropical Biopharmaca Research Center, IPB University, Bogor, Indonesia
- Department of Computer Science, Faculty of Mathematics and Natural Sciences, IPB University, Bogor, Indonesia
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100
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Rusdiawan A, Mardikaningsih A, Sumitro NK, Kurniasari P, Pamungkas H, Padillah R. Sedentary parenting: a growing cause of childhood obesity in young families. J Public Health (Oxf) 2024:fdae224. [PMID: 39190897 DOI: 10.1093/pubmed/fdae224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 08/14/2024] [Indexed: 08/29/2024] Open
Affiliation(s)
- Afif Rusdiawan
- Sports Coaching Department, Universitas Negeri Surabaya, Surabaya 60231, Indonesia
| | - Agusti Mardikaningsih
- Physical Education Department, Universitas Insan Budi Utomo, Malang 65122, Indonesia
| | | | - Praharisti Kurniasari
- Physical Education Department, Universitas Insan Budi Utomo, Malang 65122, Indonesia
| | - Hari Pamungkas
- Physical Education Department, Universitas Insan Budi Utomo, Malang 65122, Indonesia
| | - Raup Padillah
- Guidance and Counselling, Universitas PGRI Banyuwangi, Banyuwangi 68416, Indonesia
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