51
|
Lee YJ, Choi Y, Yoo HW, Lee YA, Shin CH, Choi HS, Kim HS, Kim JH, Moon JE, Ko CW, Ahn MB, Suh BK, Choi JH. Metabolic Impacts of Discontinuation and Resumption of Recombinant Human Growth Hormone Treatment during the Transition Period in Patients with Childhood-Onset Growth Hormone Deficiency. Endocrinol Metab (Seoul) 2022; 37:359-368. [PMID: 35504604 PMCID: PMC9081298 DOI: 10.3803/enm.2021.1384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/12/2022] [Accepted: 02/25/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Discontinuing growth hormone (GH) treatment during the transition to adulthood has been associated with adverse health outcomes in patients with childhood-onset growth hormone deficiency (CO-GHD). This study investigated the metabolic changes associated with interrupting GH treatment in adolescents with CO-GHD during the transition period. METHODS This study included 187 patients with CO-GHD who were confirmed to have adult GHD and were treated at six academic centers in Korea. Data on clinical parameters, including anthropometric measurements, metabolic profiles, and bone mineral density (BMD) at the end of childhood GH treatment, were collected at the time of re-evaluation for GHD and 1 year after treatment resumption. RESULTS Most patients (n=182, 97.3%) had organic GHD. The median age at treatment discontinuation and re-evaluation was 15.6 and 18.7 years, respectively. The median duration of treatment interruption was 2.8 years. During treatment discontinuation, body mass index Z-scores and total cholesterol, low-density lipoprotein, and non-high-density lipoprotein (HDL) cholesterol levels increased, whereas fasting glucose levels decreased. One year after GH treatment resumption, fasting glucose levels, HDL cholesterol levels, and femoral neck BMD increased significantly. Longer GH interruption (>2 years, 60.4%) resulted in worse lipid profiles at re-evaluation. The duration of interruption was positively correlated with fasting glucose and non-HDL cholesterol levels after adjusting for covariates. CONCLUSION GH treatment interruption during the transition period resulted in worse metabolic parameters, and a longer interruption period was correlated with poorer outcomes. GH treatment should be resumed early in patients with CO-GHD during the transition period.
Collapse
Affiliation(s)
- Yun Jeong Lee
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yunha Choi
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Han-Wook Yoo
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Ah Lee
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Choong Ho Shin
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Han Saem Choi
- Departmend of Pediatrics, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ho-Seong Kim
- Departmend of Pediatrics, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Hyun Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jung Eun Moon
- Department of Pediatrics, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Cheol Woo Ko
- Department of Pediatrics, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Moon Bae Ahn
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung-Kyu Suh
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin-Ho Choi
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
52
|
Ha J, Park SH, Park SS, Han S. Metabolic Disease Incidence After Allogeneic Stem Cell Transplantation: A Nationwide Korean Case-Control Study. J Clin Endocrinol Metab 2022; 107:943-952. [PMID: 34905058 DOI: 10.1210/clinem/dgab900] [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: 08/11/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT There have been no large-scale reports elucidating the relative risks of developing metabolic diseases in adult allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients compared to the general population. OBJECTIVE This work aimed to investigate the relative risk of developing metabolic diseases and cerebrovascular or cardiovascular disease (CVA) in allo-HSCT recipients compared to the general population in a real-world setting, using a large Korean cohort under long-term observation. METHODS We conducted a population-based case-control study and analyzed data of 8230 adult allo-HSCT recipients and 32 920 healthy individuals matched for age, sex, and index date in a 1:4 ratio, using a nationwide database of the Korean National Health Insurance Service. Thereafter, we established 4 substudies to investigate the relative risks of metabolic disease development following allo-HSCT: hypertension (cohort A study), diabetes (cohort B study), dyslipidemia (cohort C study), and CVA (cohort D study). RESULTS The 10-year cumulative incidence of metabolic disease in each experimental cohort was statistically significantly higher than that in the control cohort (overall P value < .001 for all): cohort A study, 17.6% vs 11.8%; cohort B study, 23.5% vs 14.4%; cohort C study for dyslipidemia, 44.5% vs 32.1%; and cohort D study for CVA, 4.2% vs 3.2%. In comparison to the incidence of metabolic diseases in the general population, allo-HSCT recipients presented adjusted hazard ratios of 1.58 for hypertension, 2.06 for diabetes, 1.62 for dyslipidemia, and 1.45 for CVA. CONCLUSION Recipients of allo-HSCT need to be rigorously monitored for the development of metabolic diseases, including hypertension, diabetes, dyslipidemia, and CVA, based on an enhanced lifelong health care policy including a robust screening program compared to the general population.
Collapse
Affiliation(s)
- Jeonghoon Ha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - See Hyun Park
- Department of Pharmacology, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Sung-Soo Park
- Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Leukemia Research Institute, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Seunghoon Han
- Department of Pharmacology, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| |
Collapse
|
53
|
Santos L. The impact of nutrition and lifestyle modification on health. Eur J Intern Med 2022; 97:18-25. [PMID: 34670680 DOI: 10.1016/j.ejim.2021.09.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/12/2021] [Accepted: 09/27/2021] [Indexed: 12/30/2022]
Abstract
The main recommendations from public health entities include healthy diets and physical activity as the main lifestyle factors impacting the development of chronic diseases such as cardiovascular and metabolic diseases, cancer, and even neurological diseases. Randomized clinical trials have been designed to demonstrate those lifestyle modifications can change the pattern of chronic diseases development and progression. Among these, nutrition is one of the most impacting factors. Therefore, nutrition and diets were also included in different randomized clinical trials, and most of them showed a favorable impact of nutrition modification on the participant's health. Nevertheless, study designs were considerably different, and future studies are needed to support nutrition modifications further. The choice of a healthy considered diet, like the Mediterranean diet, was shown to impact chronic diseases, cardiovascular risk, and adult life expectancy mainly due to its anti-inflammatory and antioxidant properties. Furthermore, a high intake of fibers, fruits, and vegetables together with a low intake of fat and energy-dense, processed foods contribute to an inflammation reduction and a more robust immune system leading. Besides these well-known properties, all lifestyle modifications must be personalized according to the availability of foods, geographic localizations, and the healthy status of the patient.
Collapse
Affiliation(s)
- Lèlita Santos
- Internal Medicine Service, Coimbra Hospital and University Centre, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Portugal; CIMAGO Research Centre, Faculty of Medicine, University of Coimbra, Portugal.
| |
Collapse
|
54
|
Relationship between continuity of care and clinical outcomes in patients with dyslipidemia in Korea: a real world claims database study. Sci Rep 2022; 12:3062. [PMID: 35197513 PMCID: PMC8866465 DOI: 10.1038/s41598-022-06973-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 02/08/2022] [Indexed: 12/04/2022] Open
Abstract
Dyslipidemia is a risk factor for atherosclerotic cardiovascular disease and requires proactive management. This study aimed to investigate the association between care continuity and the outcomes of patients with dyslipidemia. We conducted a retrospective cohort study on patients with dyslipidemia by employing the Korea National Health Insurance claims database during the period 2007–2018. The Continuity of Care Index (COCI) was used to measure continuity of care. We considered incidence of atherosclerotic cardiovascular disease as a primary outcome. A Cox's proportional hazards regression model was used to quantify risks of primary outcome. There were 236,486 patients newly diagnosed with dyslipidemia in 2008 who were categorized into the high and low COC groups depending on their COCI. The adjusted hazard ratio for the primary outcome was 1.09 times higher (95% confidence interval: 1.06–1.12) in the low COC group than in the high COC group. The study shows that improved continuity of care for newly-diagnosed dyslipidemic patients might reduce the risk of atherosclerotic cardiovascular disease.
Collapse
|
55
|
Markovič R, Grubelnik V, Vošner HB, Kokol P, Završnik M, Janša K, Zupet M, Završnik J, Marhl M. Age-Related Changes in Lipid and Glucose Levels Associated with Drug Use and Mortality: An Observational Study. J Pers Med 2022; 12:jpm12020280. [PMID: 35207767 PMCID: PMC8876997 DOI: 10.3390/jpm12020280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/09/2022] [Accepted: 02/11/2022] [Indexed: 02/01/2023] Open
Abstract
Background: The pathogenesis of type 2 diabetes mellitus is complex and still unclear in some details. The main feature of diabetes mellitus is high serum glucose, and the question arises of whether there are other statistically observable dysregulations in laboratory measurements before the state of hyperglycemia becomes severe. In the present study, we aim to examine glucose and lipid profiles in the context of age, sex, medication use, and mortality. Methods: We conducted an observational study by analyzing laboratory data from 506,083 anonymized laboratory tests from 63,606 different patients performed by a regional laboratory in Slovenia between 2008 and 2019. Laboratory data-based results were evaluated in the context of medication use and mortality. The medication use database contains anonymized records of 1,632,441 patients from 2013 to 2018, and mortality data were obtained for the entire Slovenian population. Results: We show that the highest percentage of the population with elevated glucose levels occurs approximately 20 years later than the highest percentage with lipid dysregulation. Remarkably, two distinct inflection points were observed in these laboratory results. The first inflection point occurs at ages 55 to 59 years, corresponding to the greatest increase in medication use, and the second coincides with the sharp increase in mortality at ages 75 to 79 years. Conclusions: Our results suggest that medications and mortality are important factors affecting population statistics and must be considered when studying metabolic disorders such as dyslipidemia and hyperglycemia using laboratory data.
Collapse
Affiliation(s)
- Rene Markovič
- Faculty of Natural Sciences and Mathematics, University of Maribor, 2000 Maribor, Slovenia;
- Faculty of Electrical Engineering and Computer Science, University of Maribor, 2000 Maribor, Slovenia; (V.G.); (P.K.)
| | - Vladimir Grubelnik
- Faculty of Electrical Engineering and Computer Science, University of Maribor, 2000 Maribor, Slovenia; (V.G.); (P.K.)
| | - Helena Blažun Vošner
- Community Healthcare Center Dr. Adolf Drolc Maribor, 2000 Maribor, Slovenia;
- Faculty of Health and Social Sciences, 2380 Slovenj Gradec, Slovenia
- Alma Mater Europaea—ECM, 2000 Maribor, Slovenia
| | - Peter Kokol
- Faculty of Electrical Engineering and Computer Science, University of Maribor, 2000 Maribor, Slovenia; (V.G.); (P.K.)
| | - Matej Završnik
- Department of Endocrinology and Diabetology, University Medical Center Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia;
| | - Karmen Janša
- The Health Insurance Institute of Slovenia, Miklošičeva cesta 24, 1507 Ljubljana, Slovenia; (K.J.); (M.Z.)
| | - Marjeta Zupet
- The Health Insurance Institute of Slovenia, Miklošičeva cesta 24, 1507 Ljubljana, Slovenia; (K.J.); (M.Z.)
| | - Jernej Završnik
- Faculty of Natural Sciences and Mathematics, University of Maribor, 2000 Maribor, Slovenia;
- Community Healthcare Center Dr. Adolf Drolc Maribor, 2000 Maribor, Slovenia;
- Alma Mater Europaea—ECM, 2000 Maribor, Slovenia
- Science and Research Center Koper, 6000 Koper, Slovenia
- Correspondence: (J.Z.); (M.M.)
| | - Marko Marhl
- Faculty of Natural Sciences and Mathematics, University of Maribor, 2000 Maribor, Slovenia;
- Faculty of Education, University of Maribor, 2000 Maribor, Slovenia
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia
- Correspondence: (J.Z.); (M.M.)
| |
Collapse
|
56
|
Kim JE, Choi YJ, Oh SW, Kim MG, Jo SK, Cho WY, Ahn SY, Kwon YJ, Ko GJ. The Effect of Statins on Mortality of Patients With Chronic Kidney Disease Based on Data of the Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM) and Korea National Health Insurance Claims Database. FRONTIERS IN NEPHROLOGY 2022; 1:821585. [PMID: 37674813 PMCID: PMC10479676 DOI: 10.3389/fneph.2021.821585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 12/29/2021] [Indexed: 09/08/2023]
Abstract
The role of statins in chronic kidney disease (CKD) has been extensively evaluated, but it remains controversial in specific population such as dialysis-dependent CKD. This study examined the effect of statins on mortality in CKD patients using two large databases. In data from the Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM) from two hospitals, CKD was defined as an estimated glomerular filtration rate < 60 mL/min/m2; we compared survival between patients with or without statin treatment. As a sensitivity analysis, the results were validated with the Korea National Health Insurance (KNHI) claims database. In the analysis of CDM datasets, statin users showed significantly lower risks of all-cause and cardiovascular mortality in both hospitals, compared to non-users. Similar results were observed in CKD patients from the KNHI claims database. Lower mortality in the statin group was consistently evident in all subgroup analyses, including patients on dialysis and low-risk young patients. In conclusion, we found that statins were associated with lower mortality in CKD patients, regardless of dialysis status or other risk factors.
Collapse
Affiliation(s)
- Ji Eun Kim
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea
- Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Yun Jin Choi
- Biomedical Research Institute, Korea University Guro Hospital, Seoul, South Korea
| | - Se Won Oh
- Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - Myung Gyu Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - Sang Kyung Jo
- Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - Won Yong Cho
- Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - Shin Young Ahn
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea
- Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Young Joo Kwon
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea
- Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Gang-Jee Ko
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea
- Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| |
Collapse
|
57
|
Hong J. A new perspective on cholesterol in pediatric health: association of vitamin D metabolism, respiratory diseases, and mental health problems. Clin Exp Pediatr 2022; 65:65-72. [PMID: 34886593 PMCID: PMC8841974 DOI: 10.3345/cep.2020.00934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/13/2021] [Indexed: 11/27/2022] Open
Abstract
Cholesterol, the main structural molecule of cell membranes, is involved in essential functions of the human body. Dyslipidemia is an established risk factor for cardiovascular diseases (CVDs) that is observed even in childhood. To reduce the risk of CVDs in children, several clinical guidelines have been published for the management of pediatric dyslipidemia. However, pediatric dyslipidemia is also associated with several health problems other than CVDs. This article reviews the current data on dyslipidemia-related pediatric health issues. There is strong evidence that low serum vitamin D levels, asthma, and mental health problems may be associated with dyslipidemia in the pediatric population regardless of body mass index. This review also highlights the need for further large-scale population-based studies in the Korean pediatric population to establish effective strategies for promoting children's health.
Collapse
Affiliation(s)
- Jeana Hong
- Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea
| |
Collapse
|
58
|
Cardiometabolic factors and risk of non-arteritic anterior ischemic optic neuropathy: a systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol 2022; 260:1445-1456. [DOI: 10.1007/s00417-021-05522-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 12/02/2021] [Accepted: 12/14/2021] [Indexed: 11/04/2022] Open
|
59
|
Jo SY, Kwon YJ, Cho AR. Serum Low-Density Lipoprotein Cholesterol Levels and Depressive Mood in Korean Adults: A Nationwide Population-Based Study. Korean J Fam Med 2022; 43:63-68. [PMID: 35130641 PMCID: PMC8820962 DOI: 10.4082/kjfm.21.0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 08/30/2021] [Indexed: 11/29/2022] Open
Abstract
Background The association between serum cholesterol levels and depression has been studied extensively; however, results are inconsistent. This study aimed to investigate the association between low-density lipoprotein cholesterol (LDL-C) levels and depressive symptoms among Korean adults. Methods This cross-sectional study used data obtained from the 2007–2015 Korea National Health and Nutrition Examination Survey. In total, 40,904 adults were included in the final analysis. Participants were categorized into five groups according to their LDL-C levels, using the Korean guidelines for dyslipidemia. Symptoms of depression were evaluated using a self-reported questionnaire. Weighted logistic regression was used to examine the relationship between LDL-C levels and self-reported depressive symptoms. Results Compared with the intermediate category, the lowest (<70 mg/dL) and highest (≥160 mg/dL) LDL-C categories were associated with depressive symptoms, after adjusting for potential confounding factors (odds ratio [OR], 1.191; 95% confidence interval [CI], 1.008–1.409; OR, 1.241; 95% CI, 1.073–1.435, respectively). The highest LDL-C category was positively associated with depressive symptoms in those who were middle-aged, female, had a low body mass index, and taking or not taking dyslipidemia medications. Conclusion A U-shaped association was identified between LDL-C categories and self-reported depressive symptoms. Our findings suggest that LDL-C levels that are too low or too high are associated with self-reported depressive symptoms. Further prospective studies are needed to determine the causal relationship of this association.
Collapse
Affiliation(s)
- Seog-Young Jo
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Yu-Jin Kwon
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - A-Ra Cho
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
- *Corresponding Author: A-Ra Cho Tel: +82-31-5189-8777, Fax: +82-3462-8209, E-mail:
| |
Collapse
|
60
|
Min HK, Moon J, Lee SY, Lee AR, Lee CR, Lee J, Kwok SK, Cho ML, Park SH. Expanded IL-22 + Group 3 Innate Lymphoid Cells and Role of Oxidized LDL-C in the Pathogenesis of Axial Spondyloarthritis with Dyslipidaemia. Immune Netw 2022; 21:e43. [PMID: 35036030 PMCID: PMC8733192 DOI: 10.4110/in.2021.21.e43] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/28/2021] [Accepted: 11/07/2021] [Indexed: 12/29/2022] Open
Abstract
Group 3 innate lymphoid cells (ILC3), which express IL-22 and IL-17A, has been introduced as one of pathologic cells in axial spondyloarthritis (axSpA). Dyslipidaemia should be managed in axSpA patients to reduce cardiovascular disease, and dyslipidaemia promotes inflammation. This study aimed to reveal the role of circulating ILC3 in axSpA and the impact of dyslipidaemia on axSpA pathogenesis. AxSpA patients with or without dyslipidaemia and healthy control were recruited. Peripheral blood samples were collected, and flow cytometry analysis of circulating ILC3 and CD4+ T cells was performed. The correlation between Ankylosing Spondylitis Disease Activity Score (ASDAS)-C-reactive protein (CRP) and circulating immune cells was evaluated. The effect of oxidized low-density lipoprotein cholesterol (oxLDL-C) on immune cell differentiation was confirmed. AxSpA human monocytes were cultured with with oxLDL-C, IL-22, or oxLDL-C plus IL-22 to evaluate osteoclastogenesis using tartrate-resistant acid phosphatase (TRAP) staining and real-time quantitative PCR of osteoclast-related gene expression. Total of 34 axSpA patients (13 with dyslipidaemia and 21 without) were included in the analysis. Circulating IL-22+ ILC3 and Th17 were significantly elevated in axSpA patients with dyslipidaemia (p=0.001 and p=0.034, respectively), and circulating IL-22+ ILC3 significantly correlated with ASDAS-CRP (Rho=0.4198 and p=0.0367). Stimulation with oxLDL-C significantly increased IL-22+ ILC3, NKp44- ILC3, and Th17 cells, and these were reversed by CD36 blocking agent. IL-22 and oxLDL-C increased TRAP+ cells and osteoclast-related gene expression. This study suggested potential role of circulating IL-22+ ILC3 as biomarker in axSpA. Furthermore, dyslipidaemia augmented IL-22+ ILC3 differentiation, and oxLDL-C and IL-22 markedly increased osteoclastogenesis of axSpA.
Collapse
Affiliation(s)
- Hong Ki Min
- Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul 05030, Korea
| | - Jeonghyeon Moon
- The Rheumatism Research Center, Catholic Research Institute of Medical Science, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Seon-Yeong Lee
- The Rheumatism Research Center, Catholic Research Institute of Medical Science, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - A Ram Lee
- The Rheumatism Research Center, Catholic Research Institute of Medical Science, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.,Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Chae Rim Lee
- The Rheumatism Research Center, Catholic Research Institute of Medical Science, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.,Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Jennifer Lee
- Devision of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Seung-Ki Kwok
- Devision of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Mi-La Cho
- The Rheumatism Research Center, Catholic Research Institute of Medical Science, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.,Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.,Impact Biotech, Seoul 06591, Korea
| | - Sung-Hwan Park
- Devision of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| |
Collapse
|
61
|
Susekov AV. Topical issues concerning modern lipid-lowering therapy. CONSILIUM MEDICUM 2022. [DOI: 10.26442/20751753.2022.1.201484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Hypercholesterolemia (high levels of atherogenic lipoproteins) is the main modifiable cardiovascular risk factor in most of the populations, including the Russian population. 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) have been used in clinical practice for more than 40 years and have a substantial evidence-based proof of efficacy and safety. Unfortunately, the most of the patients with high cardiovascular risk, including the Russian Federation, still receive initial statin doses and only in 10% of the cases we can reach the recommended target level of low-density lipoprotein cholesterol. This article deals with the current principles of statin therapy according to the latest guidelines and shows updated information concerning the optimization of statin therapy in the elderly and in patients with chronic kidney disease. This article, as well, shows the safety of applying HMG-CoA reductase inhibitors (impact on muscles, liver and cognitive impairments). In addition, the review presents the algorithms for the combination therapy of statins and ezetimibe.
Collapse
|
62
|
Lee J, Hoang T, Lee S, Kim J. Association Between Dietary Patterns and Dyslipidemia in Korean Women. Front Nutr 2022; 8:756257. [PMID: 35096924 PMCID: PMC8797145 DOI: 10.3389/fnut.2021.756257] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/20/2021] [Indexed: 12/24/2022] Open
Abstract
Background: The prevalence of dyslipidemia among Korean women differs significantly according to menopausal status. This study aimed to identify major dietary patterns among Korean women and examine their associations with the prevalence of dyslipidemia and its components. Methods: This study recruited 6,166 women from the Cancer Screenee Cohort 2007–2019 from the National Cancer Center of Korea. Dietary patterns were identified using factor analysis. Multivariable logistic regression was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between dietary patterns and the prevalence of dyslipidemia and its components, including hypercholesterolemia, hypertriglyceridemia, hypo-high-density lipoprotein (HDL) cholesterol, and hyper-low-density lipoprotein (LDL) cholesterol. Stratification analyses were performed for the premenopausal and postmenopausal subgroups. Results: The factor analysis identified three main dietary patterns, including traditional, western, and prudent dietary patterns. Compared with those with the lowest pattern scores, those with the highest pattern scores of the traditional (OR = 1.32, 95% CI = 1.05–1.67) and western (OR = 1.40, 95% CI = 1.11–1.78) diets had a higher prevalence of hyper-LDL cholesterol. When accounting for menopausal status in the analysis, traditional (OR = 1.44, 95% CI = 1.10–1.89) and western (OR = 1.43, 95% CI = 1.09–1.88) diets were still associated with hyper-LDL cholesterol in postmenopausal women. Additionally, consumption of a traditional diet was associated with a decreased prevalence of hypertriglyceridemia (OR = 0.73, 95% CI = 0.54–0.99), and consumption of a western diet was associated with an increased prevalence of hypercholesterolemia (OR = 1.41, 95% CI = 1.11–1.79) but a reduced prevalence of hypo-HDL cholesterol (OR = 0.60, 95% CI = 0.36–0.99). However, the prudent dietary pattern was not significantly associated with dyslipidemia and its components in the group of all women or the subgroups according to menopausal status. Conclusion: There were significant associations between the traditional and western dietary patterns and hyper-LDL cholesterol in the entire group and postmenopausal subgroup of women. In the perspective of energy restriction, our findings recommend women not to eat either traditional or western diets excessively or too frequently. Menopause may induce the effect of both the traditional diet on triglyceride reduction and the western diet on increasing total cholesterol.
Collapse
|
63
|
Lee J, Kim T, Yang H, Bae SH. Prevalence trends of non-alcoholic fatty liver disease among young men in Korea: A Korean military population-based cross-sectional study. Clin Mol Hepatol 2022; 28:196-206. [PMID: 35021598 PMCID: PMC9013620 DOI: 10.3350/cmh.2021.0371] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 01/07/2022] [Indexed: 11/23/2022] Open
Abstract
Background/Aims Non-alcoholic fatty liver disease (NAFLD) has become a major concern in Korea since its emergence as a dominant cause of chronic liver disease. However, no study has explored its prevalence in adults under 30 years of age. Therefore, we performed a cross-sectional study to investigate the prevalence of NAFLD in Korean men in their early 20s. Methods We collected data of 596,359 Korean soldiers who participated in a health examination between January 2015 and July 2021. A total of 571,872 individuals were analyzed after excluding those with missing data and hepatitis B antigen positivity. Hepatic steatosis was determined using the hepatic steatosis index (HSI). Participants with HSI >36 were considered to have NAFLD. Results All participants were men, and the mean age was 20.9±1.3 years. Of the 571,872 participants screened, 77,020 (13.47%) were classified as having NAFLD. The prevalence of NAFLD consistently increased from 2015 to 2021 (10.66% vs. 16.44%, P<0.001). Increases from 2015 to 2021 were also noted in the prevalence of hypercholesterolemia, hyperglycemia, and hypertension (P<0.001 for all). The mean body mass index also increased from 23.3±3.0 kg/m2 to 23.9±3.1 kg/m2 between 2015 and 2021 (P<0.001). Conclusions The prevalence of NAFLD and of other metabolic dysfunctions in Korean men in their early 20s increased from 2015 to 2021.
Collapse
Affiliation(s)
- Jaejun Lee
- Department of Internal Medicine, Armed Forces Goyang Hospital, Goyang 10267, Republic of Korea.,The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Taeyun Kim
- Department of Internal Medicine, Armed Forces Goyang Hospital, Goyang 10267, Republic of Korea
| | - Hyun Yang
- The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Si Hyun Bae
- The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
64
|
Bae J, Kim SH, Won YJ, Kim YM. Age- and Sex-Specific Differences in Distribution of Cardiometabolic Diseases and Associations of Hand-Grip Strength Indices with Type 2 Diabetes in Korean Adults. Metab Syndr Relat Disord 2022; 20:199-209. [PMID: 35020479 DOI: 10.1089/met.2021.0105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: To evaluate age- and sex-specific differences in the distribution of cardiometabolic diseases and associations of hand-grip strength (HGS) indices with type 2 diabetes (T2D). Methods: This cross-sectional observational study enrolled participants from the Korea National Health and Nutrition Examination Survey (n = 16,126, age ≥19 years). Information on cardiometabolic diseases was obtained through surveys or proper criteria applied for undiagnosed participants. Absolute and body size-adjusted HGS indices were evaluated. Clinical manifestations were compared, and associations of HGS indices with T2D were estimated by using odd ratio (OR). Results: Prevalence of T2D in all, younger, and older groups were 13.1%, 4.2%, and 21.4%, respectively. Proportions of cardiometabolic diseases were all higher in those with than without T2D in sex-stratified age groups, whereas obesity (OB) and nonalcoholic fatty liver disease (NAFLD) were higher in younger T2D, and hypertension (HTN) was higher in older T2D in both sexes. Adjusted HGS significantly correlated with cardiometabolic parameters, and thus, high ORs for T2D in low tertiles of adjusted HGS were shown in all groups, whereas high ORs for T2D in low tertiles of absolute HGS were observed only in older men. Conclusions: Among highly prevalent cardiometabolic diseases associated with T2D, OB and NAFLD were more prevalent in younger T2D, but HTN was more prevalent in older T2D in both sexes. Low adjusted HGS was associated with higher T2D risk in all groups, whereas low absolute HGS was associated with higher T2D risk in older men. Thus, adjusted HGS might be useful in screening especially younger or obese T2D.
Collapse
Affiliation(s)
- Jaehyun Bae
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea
| | - Se Hwa Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea
| | - Young Jun Won
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea
| | - Yoo Mee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea
| |
Collapse
|
65
|
Song S, Shim JE. Food behaviors accounting for the recent trends in dietary fatty acid profiles among Korean adults. Nutr Res Pract 2022; 16:405-417. [PMID: 35663438 PMCID: PMC9149317 DOI: 10.4162/nrp.2022.16.3.405] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/07/2021] [Accepted: 10/21/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/OBJECTIVES This study examined the changes in food behaviors of dietary fatty acids over 2007–2018 among Korean adults. SUBJECTS/METHODS This study used data from the 4th (2007–2009), 5th (2010–2012), 6th (2013–2015), and 7th (2016–2018) Korea National Health and Nutrition Examination Surveys. A total of 46,307 adults aged 19–64 yrs were selected and dietary data were obtained from a single 24-h recall. In the 4th and 7th data, the major food sources for each fatty acid based on the contributing percentage of the food item were compared. The consumption trends in the major food sources were presented as grams per day over 2007–2018 and compared across the survey periods using the multiple regression model. RESULTS From 2007 to 2018, for total fat, saturated fatty acid (SFA), and monounsaturated fatty acid, the contribution of animal food sources, including beef, chicken, and eggs increased but plant food sources (e.g., tofu, soybean, and plant oil) decreased. As polyunsaturated fatty acid sources, mayonnaise, eggs, and bread showed higher contributions, whereas soybean and tofu showed lower contributions in the 7th data compared to the 4th data. For n-3 fatty acids, the contribution of fish decreased between the 4th and 7th data. Over 12 yrs, the significant increases in the absolute amount of consumption from animal sources were observed. In contrast, decreases in the consumption from plant sources and fish were seen across the survey periods. CONCLUSIONS In Korean adults, increases in the intake of dietary fatty acids along with changes in the food behaviors during 2007–2018 have evoked great concern for SFA intake, which is a cardiovascular disease risk factor. Healthy food sources of dietary fatty acids should be emphasized in this population.
Collapse
Affiliation(s)
- SuJin Song
- Department of Food and Nutrition, Hannam University, Daejeon 34054, Korea
| | - Jae Eun Shim
- Department of Food and Nutrition, Daejeon University, Daejeon 34520, Korea
| |
Collapse
|
66
|
Oh GC, Ko T, Kim JH, Lee MH, Choi SW, Bae YS, Kim KH, Lee HY. Estimation of low-density lipoprotein cholesterol levels using machine learning. Int J Cardiol 2022; 352:144-149. [DOI: 10.1016/j.ijcard.2022.01.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/31/2021] [Accepted: 01/14/2022] [Indexed: 12/21/2022]
|
67
|
Kim HL, Chung J, Kim KJ, Kim HJ, Seo WW, Jeon KH, Cho I, Park JJ, Lee MH, Suh J, Lim SY, Choi S, Kim SH. Lifestyle Modification in the Management of Metabolic Syndrome: Statement From Korean Society of CardioMetabolic Syndrome (KSCMS). Korean Circ J 2022; 52:93-109. [PMID: 35128848 PMCID: PMC8819565 DOI: 10.4070/kcj.2021.0328] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/08/2021] [Accepted: 12/01/2021] [Indexed: 11/11/2022] Open
Abstract
Metabolic syndrome (MetS) is highly prevalent and is associated with worse cardiovascular outcome. Lifestyle modification is the most effective way to reduce the incidence of cardiovascular complications caused by MetS. Here, we would like to review the effects and specific methods of the 6 lifestyle modifications (weight control, smoking cessation, alcohol drinking in moderation, diet control, exercise and physical activity, and cognitive behavioral therapy) and control of blood pressure, dyslipidemia, and blood sugar based on evidence in the management of MetS. With the recent rapid increase in obesity worldwide, metabolic syndrome (MetS) has gained significant importance. MetS is a cluster of obesity-related cardiovascular risk factors including abdominal obesity, atherogenic dyslipidemia, high blood pressure and impaired glucose tolerance. MetS is highly prevalent and strongly associated with an increased risk of developing diabetes and cardiovascular disease, putting a great burden on human society. Therefore, it is very important to reduce MetS risk, which can improve patients’ cardiovascular prognosis. The primary and most effective strategy to control each component of MetS is lifestyle change such as losing body weight, keeping regular exercise, adopting a healthy diet, quitting smoking and alcohol drinking in moderation. Many studies have shown that lifestyle modification has improved all components of MetS, and reduces the incidence of diabetes and cardiovascular disease. Here, the Korean Society of CardioMetabolic Syndrome has summarized specific and practical methods of lifestyle modification in the management of MetS in the healthcare field.
Collapse
Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jaehoon Chung
- Division of Cardiology, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Kyung-Jin Kim
- Division of Cardiology, Department of Internal Medicine, Ewha Womans University Medical Center, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyun-Jin Kim
- Department of Cardiology in Internal Medicine, Hanyang University Guri Hospital, Guri, Korea
| | - Won-Woo Seo
- Division of Cardiology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Ki-Hyun Jeon
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Iksung Cho
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Joo Park
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min-Ho Lee
- Division of Cardiology, Department of Internal Medicine, Soon Chun Hyang University Seoul Hospital, Seoul, Korea
| | - Jon Suh
- Division of Cardiology, Department of Internal Medicine, Soon Chun Hyang Bucheon Hospital, Soon Chun Hyang University College of Medicine, Bucheon, Korea
| | - Sang-Yup Lim
- Departments of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Seonghoon Choi
- Division of Cardiology, Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
68
|
Kwon YJ, Hyun DS, Koh SB, Lee JW. Differential relationship between dietary fat and cholesterol on total mortality in Korean population cohorts. J Intern Med 2021; 290:866-877. [PMID: 34114281 DOI: 10.1111/joim.13328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 04/26/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Associations among dietary fat, cholesterol intake and total mortality remain controversial, and most available data cover Western populations. The aim of this study was to assess associations for dietary fat and cholesterol in relation to total mortality in Koreans. METHODS This study used data from three prospective Korean Genome and Epidemiology studies (conducted between June 2001 and December 2013). A total of 194,295 middle-aged and older Korean adults were included. Dietary fat intake was classified into quintiles. Dietary cholesterol intake was categorized into three groups based on cholesterol intake as follows: <200 mg, 200-299 mg and ≥300 mg. A multivariable Cox frailty model with random effects was applied to calculate hazard ratios (HR) and 95% confidence intervals (CIs) after adjusting for confounders. RESULTS We documented 3866 deaths across a mean (min-max) follow-up period of 8.15 years (3-13 years). Higher fat intake was associated with lower total mortality (Q5 vs. Q1, HR 0.82 [95% CI 0.69, 0.98]; p trend < 0.01) after adjusting for age, sex, body mass index, alcohol, smoking, exercise and total calorie and protein (%) intake. Higher dietary cholesterol intake (≥300 mg/day) was associated with a higher risk of total mortality (HR 1.19 [95% CI 1.04, 1.37]) than lower cholesterol intake (<200 mg/day) in the multivariate model. CONCLUSIONS In Koreans, high dietary fat intake is associated with a lower risk of total mortality, while dietary cholesterol intake above 300 mg/day is associated with a higher risk of total mortality.
Collapse
Affiliation(s)
- Yu-Jin Kwon
- From the, Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Dae Sung Hyun
- Health Insurance Research Institute, National Health Insurance Service, Wonju, Korea
| | - Sang-Baek Koh
- Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, Wonju, Korea.,Department of Preventive Medicine and Institute of Occupational and Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Ji-Won Lee
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
69
|
Lee H, Lee YH, Kim SU, Kim HC. Metabolic Dysfunction-Associated Fatty Liver Disease and Incident Cardiovascular Disease Risk: A Nationwide Cohort Study. Clin Gastroenterol Hepatol 2021; 19:2138-2147.e10. [PMID: 33348045 DOI: 10.1016/j.cgh.2020.12.022] [Citation(s) in RCA: 236] [Impact Index Per Article: 78.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/04/2020] [Accepted: 12/15/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS An international expert panel proposed a new definition for metabolic dysfunction-associated fatty liver disease (MAFLD) as a name change from nonalcoholic fatty liver disease (NAFLD). The clinical impact of this change on the assessment of cardiovascular disease (CVD) risk is yet unknown. We evaluated the prevalence of fatty liver disease (FLD) and the associated CVD risk using each of these definitions. METHODS From a nationwide health screening database, we included 9,584,399 participants (48.5% male) aged 40-64 years between 2009 and 2010. Participants were categorized by presence of NAFLD and MAFLD, separately, and by the combination of the 2 definitions-Neither-FLD, NAFLD-only, MAFLD-only, or Both-FLD. The primary outcome was a composite CVD event, including myocardial infarction, ischemic stroke, heart failure, or CVD-related death. RESULTS The prevalence of NAFLD and MAFLD was 28.0% and 37.3%, respectively. After excluding those with prior CVD, 8,962,813 participants were followed for a median of 10.1 years. NAFLD and MAFLD were each associated with significantly higher risk for CVD events. When the Neither-FLD group was the reference, multivariable-adjusted hazard ratios (95% confidence interval) for CVD events were 1.09 (1.03-1.15) in the NAFLD-only group, 1.43 (1.41-1.45) in the MAFLD-only group, and 1.56 (1.54-1.58) in the Both-FLD group. CONCLUSIONS A considerable proportion of middle-aged Korean adults have MAFLD without satisfying the former definition of NAFLD. The change from NAFLD to MAFLD criteria may identify a greater number of individuals with metabolically complicated fatty liver and increased risk for CVD.
Collapse
Affiliation(s)
- Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Yong-Ho Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea.
| | - Seung Up Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; Yonsei Liver Center, Severance Hospital, Seoul, Korea.
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
| |
Collapse
|
70
|
Yang Y, Li Y, Pei J, Cheng M, Xu W, Shi Y. Dynamic changes in metabolic health status in Chinese adults: Multiple population-based surveys in Shanghai, China. J Diabetes Investig 2021; 12:1784-1796. [PMID: 33787069 PMCID: PMC8504919 DOI: 10.1111/jdi.13556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 03/17/2021] [Accepted: 03/27/2021] [Indexed: 12/29/2022] Open
Abstract
AIMS/INTRODUCTION Metabolic syndrome (MS) has been increasing worldwide. The secular change in MS components, however, remains unclear. This study aimed to examine the dynamic change in metabolic health status in Chinese adults. MATERIALS AND METHODS Three population-based surveys using multistage stratified sampling were performed in Chinese aged 35-74 years in Shanghai in 2002-2003 (n = 12,302), 2009 (n = 7,400), and 2017 (n = 19,023). MS was defined according to the Adult Treatment Panel III criteria for Asian-Americans. Generalized Estimating Equations and Cochran-Armitage Trend Test was used to assess the prevalence trend over the years. RESULTS The prevalence of MS doubled in Chinese adults over the period (P for trend < 0.001). The largest increase occurred in younger men. Among MS components, the prevalence of high waist-circumference (HWC), high blood glucose (HBG) and high blood pressure (HBP) increased in all subjects, whereas the prevalence of high triglycerides (HTG) and low high-density lipoprotein cholesterol (LHC) increased in men but decreased in women. The increase in HBP contributed most to elevated MS, followed by HBG and HWC, resulting in the HBP-HBG-HWC the most common cluster of MS components. Metabolically unhealthy overweight also grew over the period. CONCLUSIONS Metabolic health status has been exacerbating in Chinese adults and may increase burden of non-communicable diseases.
Collapse
Affiliation(s)
- Yihui Yang
- Department of EpidemiologySchool of Public HealthFudan UniversityShanghaiChina
| | - Yanyun Li
- Department of NCDs Prevention and ControlShanghai Municipal Center for Disease Control and PreventionShanghaiChina
| | - Jianfeng Pei
- Department of EpidemiologySchool of Public HealthFudan UniversityShanghaiChina
| | - Minna Cheng
- Department of NCDs Prevention and ControlShanghai Municipal Center for Disease Control and PreventionShanghaiChina
| | - Wanghong Xu
- Department of EpidemiologySchool of Public HealthFudan UniversityShanghaiChina
| | - Yan Shi
- Department of NCDs Prevention and ControlShanghai Municipal Center for Disease Control and PreventionShanghaiChina
| |
Collapse
|
71
|
Ferrari F, Santos RD. Physical Activity and HDL-C: Are There Gender Differences in the Dose-response Effect? Arq Bras Cardiol 2021; 117:501-502. [PMID: 34550235 PMCID: PMC8462943 DOI: 10.36660/abc.20210551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Filipe Ferrari
- Programa de Pós-graduação em Cardiologia e Ciências Cardiovasculares - Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS - Brasil.,Grupo de Pesquisa em Cardiologia do Exercício (CardioEx) - UFRGS, HCPA, Porto Alegre, RS - Brasil
| | - Raul D Santos
- Unidade Clínica de Lípides do Instituto do Coração (InCor) - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP - Brasil.,Hospital Israelita Albert Einstein, São Paulo, SP - Brasil
| |
Collapse
|
72
|
Park MS, Youn JC, Kim EJ, Han KH, Lee SH, Kim SH, Kim BJ, Kwon SU, Ryu KH. Efficacy and Safety of Fenofibrate-Statin Combination Therapy in Patients With Inadequately Controlled Triglyceride Levels Despite Previous Statin Monotherapy: A Multicenter, Randomized, Double-blind, Phase IV Study. Clin Ther 2021; 43:1735-1747. [PMID: 34518033 DOI: 10.1016/j.clinthera.2021.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/21/2021] [Accepted: 08/10/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE Residual cardiovascular risk reduction by fenofibrate in patients with high serum triglyceride (TG) levels despite previous statin monotherapy is not well characterized. The purpose of this study was to evaluate the efficacy and safety of a combination of choline fenofibrate and statin in patients with inadequately controlled TG levels despite previous statin monotherapy. METHODS This prospective, multicenter, randomized, double-blind study was conducted in Korea. A total of 133 patients with controlled LDL-C but elevated TG levels, already receiving statin monotherapy, were enrolled in the study, which was conducted from July 2018 to December 2019. Patients were randomly assigned to receive combination therapy with choline fenofibrate and statin or statin monotherapy in a 1:1 ratio. After 8 weeks of treatment, the lipid profiles and safety parameters of the patients in the 2 groups were compared. FINDINGS The study included 127 patients (64 in the combination group and 63 in the control group) older than 19 years. After 8 weeks of therapy, mean serum TG levels significantly decreased from 269.8 to 145.5 mg/dL (P < 0.0001) in the combination therapy group, whereas no significant changes occurred in the statin monotherapy group (from 271.1 to 280.5 mg/dL). Contrarily, the mean serum HDLC levels significantly increased from 45.0 to 50.4 mg/dL (P = 0.0004) in the combination therapy group, whereas there were no significant changes in the monotherapy group (from 44.3 to 44.7 mg/dL). There were no additional serious adverse events in the combination therapy group compared with the statin monotherapy group. IMPLICATIONS The combination therapy using choline fenofibrate and statin was found to be effective in serum TG control and likely tolerable in patients with high TG levels despite statin monotherapy. A larger study, conducted for a longer duration, is needed to evaluate the effectiveness of this combination in reducing cardiovascular risk. ClinicalTrials.gov identifier: NCT03874260.
Collapse
Affiliation(s)
- Myung Soo Park
- Department of Cardiology, Hallym University, Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Jong-Chan Youn
- Division of Cardiology, Department of Internal Medicine, Seoul St Mary's Hospital, Cardiovascular Research Institute for Intractable Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eung Ju Kim
- Department of Cardiology, Korea University, Guro Hospital, Seoul, Korea
| | - Ki Hoon Han
- Department of Internal Medicine, Ulsan University, Asan Medical Center, Seoul, Korea
| | - Sang Hak Lee
- Department of Cardiology and Cardiovascular Research Institute, Yonsei University, Severance Hospital, Seoul, Korea
| | - Sung Hea Kim
- Department of Cardiology, Konkuk University Medical Center, Seoul, Korea
| | - Byung Jin Kim
- Department of Internal Medicine, Sungkyunkwan University, Kangbuk Samsung Hospital, Seoul, Korea
| | - Sung Uk Kwon
- Department of Cardiology, Inje University, Ilsan Paik Hospital, Goyang, Korea
| | - Kyu-Hyung Ryu
- Department of Cardiology, Hallym University, Dongtan Sacred Heart Hospital, Hwaseong, Korea.
| |
Collapse
|
73
|
Kaesler N, Baid-Agrawal S, Grams S, Nadal J, Schmid M, Schneider MP, Eckardt KU, Floege J, Bergmann MM, Schlieper G, Saritas T. Low adherence to CKD-specific dietary recommendations associates with impaired kidney function, dyslipidemia, and inflammation. Eur J Clin Nutr 2021; 75:1389-1397. [PMID: 33531632 PMCID: PMC8416654 DOI: 10.1038/s41430-020-00849-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND/OBJECTIVES A diet following chronic kidney disease (CKD)-specific recommendations is considered essential for optimal management of patients with CKD. However, data on the adherence to these recommendations and its implications for health-relevant biomarkers are lacking. The objectives were to estimate adherence to CKD-specific dietary recommendations, to identify characteristics and lifestyle variables associated with poor adherence, and to investigate the relationship of adherence with biomarkers. METHODS In this cross-sectional analysis, average dietary intake was estimated in 3193 participants with moderately severe CKD enrolled into the observational multicenter German CKD study using a food frequency questionnaire. A CKD diet score was developed to assess adherence to CKD-specific dietary recommendations based on intake of sodium, potassium, fiber, protein, sugar, and cholesterol. The associations of dietary adherence with characteristics, lifestyle variables, and biomarker levels were determined. RESULTS Logistic regression analysis revealed younger age, higher body mass index, male gender, lower educational attainment, various lifestyle variables (cigarette smoking, infrequent alcohol consumption, low physical activity), and lower estimated glomerular filtrate rate associated with lower adherence to dietary recommendations. Low adherence to dietary recommendations was further associated with dyslipidemia, higher uric acid, and C-reactive protein levels. Associations between low dietary adherence and biomarkers were mostly driven by low intake of fiber and potassium, and high intake of sugar and cholesterol. CONCLUSIONS This study revealed differential characteristics and biomarkers associated with lower adherence to CKD-specific dietary recommendations. Promotion of CKD-specific dietary recommendations may help to mitigate the adverse prognosis in CKD patients.
Collapse
Affiliation(s)
- Nadine Kaesler
- Division of Nephrology and Clinical Immunology, University Hospital RWTH Aachen, Aachen, Germany
| | - Seema Baid-Agrawal
- Department of Nephrology and Transplant Center, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Sabine Grams
- German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - Jennifer Nadal
- Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Matthias Schmid
- Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Markus P Schneider
- Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Department of Nephrology and Hypertension, Klinikum Nürnberg, Paracelsus Private Medical University, Nürnberg, Germany
| | - Kai-Uwe Eckardt
- Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Department of Nephrology and Medical Intensive Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jürgen Floege
- Division of Nephrology and Clinical Immunology, University Hospital RWTH Aachen, Aachen, Germany
| | - Manuela M Bergmann
- German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - Georg Schlieper
- Division of Nephrology and Clinical Immunology, University Hospital RWTH Aachen, Aachen, Germany
- Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany
| | - Turgay Saritas
- Division of Nephrology and Clinical Immunology, University Hospital RWTH Aachen, Aachen, Germany.
| |
Collapse
|
74
|
Fat-to-Muscle Ratios and the Non-Achievement of LDL Cholesterol Targets: Analysis of the Korean Genome and Epidemiology Study. J Cardiovasc Dev Dis 2021; 8:jcdd8080096. [PMID: 34436238 PMCID: PMC8396939 DOI: 10.3390/jcdd8080096] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 12/18/2022] Open
Abstract
Maintaining optimal low-density lipoprotein (LDL) cholesterol levels is necessary to prevent cardiovascular disease (CVD). Excessive fat mass and decreased muscle mass are both associated with increased risks of developing dyslipidemia. Thus, we investigated the longitudinal relationship between the fat-to-muscle ratio (FMR) and the non-achievement of LDL cholesterol targets. We analyzed a total of 4386 participants aged 40–69 years from the Korean Genome and Epidemiology Study. FMR was defined as the ratio of total fat mass to total muscle mass, measured by bioelectrical impedance. The non-achievement of an LDL cholesterol target was defined as an LDL cholesterol level higher than the established target level according to individual CVD risk. The adjusted hazard ratios and 95% confidence interval for the incidence of non-achievement of LDL cholesterol targets for the sex-specific middle and highest tertiles vs. the referent lowest tertile of FMR were 1.56 (1.29–1.90) and 1.86 (1.47–2.31) in men and 1.40 (1.18–1.66) and 1.31 (1.06–1.62) in women after adjusting confounders. Our findings suggest that FMR, a novel indicator of the combined effects of fat and muscle mass, is useful for predicting non-achievement of LDL cholesterol targets.
Collapse
|
75
|
Association between chronic kidney disease and new-onset dyslipidemia: The Japan Specific Health Checkups (J-SHC) study. Atherosclerosis 2021; 332:24-32. [PMID: 34375910 DOI: 10.1016/j.atherosclerosis.2021.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/02/2021] [Accepted: 08/03/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS Dyslipidemias are common among patients with chronic kidney disease (CKD) and are a major risk factor for cardiovascular disease. This study aimed to investigate the association between early-stage CKD and new-onset dyslipidemia for each lipid profile. METHODS This nationwide longitudinal study included data from the Japan Specific Health Checkups (J-SHC) Study. New-onset dyslipidemia was indicated by hypertriglyceridemia (High-TG; ≥150 mg/dL), hyper-LDL cholesterolemia (High-LDL-C; ≥140 mg/dL), or hypo-HDL chelesterolemia (Low-HDL-C; <40 mg/dL) levels according to the guideline of Japan Atherosclerosis Society, or High-TG/HDL-C ratio (≥3.5) which was a good predictor of atherosclerosis. The incidence of new-onset dyslipidemia was compared between participants with and without CKD. Survival curves were used to analyze the incidence of each dyslipidemia. RESULTS Of 289,462 participants with a median follow-up period of 3 years, the incidence of High-TG, High-LDL-C, Low-HDL-C, and High-TG/HDL-C ratios were 64.4/1000 person-years, 83.1/1000 person-years, 14.5/1000 person-years, and 39.6/1000 person-years, respectively. The adjusted hazard ratios (95% confidence intervals) for High-TG, High-LDL-C, Low-HDL-C, and High-TG/HDL-C ratio were 1.09 (1.05-1.13), 0.99 (0.95-1.04), 1.12 (1.05-1.18), and 1.14 (1.09-1.18), respectively, in CKD participants as compared to non-CKD participants. Decreased eGFR and presence of proteinuria were independently associated with higher risks for new-onset of High-TG, Low-HDL-C, and High-TG/HDL-C ratios. CONCLUSIONS CKD was associated with a higher risk of new-onset High-TG, Low-HDL-C, and High-TG/HDL-C ratios, but not High-LDL-C, in the general population. These CKD-specific lipid abnormalities may explain the residual risk for CKD-related cardiovascular disease.
Collapse
|
76
|
Radiologists' Increasing Role in Population Health Management: AJR Expert Panel Narrative Review. AJR Am J Roentgenol 2021; 218:7-18. [PMID: 34286592 DOI: 10.2214/ajr.21.26030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Population health management (PHM) is the holistic process of improving health outcomes of groups of individuals through the support of appropriate financial and care models. Radiologists' presence at the intersection of many aspects of healthcare, including screening, diagnostic imaging, and image-guided therapies, provides significant opportunity for increased radiologist engagement in PHM. Further, innovations in artificial intelligence and imaging informatics will serve as critical tools to improve value in healthcare through evidence-based and equitable approaches. Given radiologists' limited engagement in PHM to date, it is imperative to define the specialty's PHM priorities so that the radiologists' full value in improving population health is realized. In this expert review, we explore programs and future directions for radiology in PHM.
Collapse
|
77
|
Kim HC. Epidemiology of cardiovascular disease and its risk factors in Korea. Glob Health Med 2021; 3:134-141. [PMID: 34250288 DOI: 10.35772/ghm.2021.01008] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/27/2021] [Accepted: 04/02/2021] [Indexed: 01/04/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of death and a major contributor to disability worldwide. Currently, Korea is among countries with the lowest CVD mortality rates, and the age-adjusted CVD mortality rate is still decreasing. However, depending on the CVD type, the mortality and incidence trends vary. Without age-standardization, cerebrovascular disease mortality peaked in 1994 (82.1 per 100K) and continued to decline until 2018 (44.7 per 100K), while heart disease mortality recorded the lowest level in 2001 (44.9 per 100K) then increased again until 2018 (74.5 per 100K). Age-standardized mortality rates showed different trends: both cerebrovascular disease and heart disease mortality rates have declined over the past few decades, although the rate of decline varies. Based on the National Health Insurance claim database, the numbers of hospitalization for cerebrovascular disease and ischemic heart disease are increasing, but the age-standardized hospitalization rates are decreasing. Unlike other types of CVDs, heart failure is rapidly increasing in both mortality and hospitalization rates regardless of age-standardization. Seventy percent of Korean adults have at least one risk factor, 41% have ≥ 2 risk factors, and 19% have ≥ 3 risk factors including hypertension, diabetes, hypercholesterolemia, obesity, and smoking. Exposure to multiple risk factors increases with age, with 65% of senior citizens over 70 having ≥ 2 risk factors and 34% having ≥ 3 risk factors. As the elderly population, especially those with multiple risk factors and chronic disorders, is increasing, the management of this high-risk group will be an important challenge to prevent CVD in Korea.
Collapse
Affiliation(s)
- Hyeon Chang Kim
- Department of Preventive Medicine, Integrative Research Center for Cerebrovascular and Cardiovascular Diseases, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
78
|
Song Y, Lee HS, Baik SJ, Jeon S, Han D, Choi SY, Chun EJ, Han HW, Park SH, Sung J, Jung HO, Lee JW, Chang HJ. Comparison of the effectiveness of Martin's equation, Friedewald's equation, and a Novel equation in low-density lipoprotein cholesterol estimation. Sci Rep 2021; 11:13545. [PMID: 34188076 PMCID: PMC8241859 DOI: 10.1038/s41598-021-92625-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 06/14/2021] [Indexed: 01/29/2023] Open
Abstract
Low-density-lipoprotein cholesterol (LDL-C) is the main target in atherosclerotic cardiovascular disease (ASCVD). We aimed to validate and compare a new LDL-C estimation equation with other well-known equations. 177,111 samples were analysed from two contemporary population-based cohorts comprising asymptomatic Korean adults who underwent medical examinations. Performances of the Friedewald (FLDL), Martin (MLDL), and Sampson (SLDL) equations in estimating direct LDL-C by homogenous assay were assessed by measures of concordance (R2, RMSE, and mean absolute difference). Analyses were performed according to various triglyceride (TG) and/or LDL-C strata. Secondary analyses were conducted within dyslipidaemia populations of each database. MLDL was superior or at least similar to other equations regardless of TG/LDL-C, in both the general and dyslipidaemia populations (RMSE = 11.45/9.20 mg/dL; R2 = 0.88/0.91; vs FLDL: RMSE = 13.66/10.42 mg/dL; R2 = 0.82/0.89; vs SLDL: RMSE = 12.36/9.39 mg/dL; R2 = 0.85/0.91, per Gangnam Severance Hospital Check-up/Korea Initiatives on Coronary Artery Calcification data). MLDL had a slight advantage over SLDL with the lowest MADs across the full spectrum of TG levels, whether divided into severe hyper/non-hyper to moderate hypertriglyceridaemia samples or stratified by 100-mg/dL TG intervals, even up to TG values of 500-600 mg/dL. MLDL may be a readily adoptable and cost-effective alternative to direct LDL-C measurement, irrespective of dyslipidaemia status. In populations with relatively high prevalence of mild-to-moderate hypertriglyceridaemia, Martin's equation may be optimal for LDL-C and ASCVD risk estimation.
Collapse
Affiliation(s)
- Youhyun Song
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Korea
| | - Su Jung Baik
- Healthcare Research Team, Health Promotion Center, Gangnam Severance Hospital, 211 Eunju-ro, Gangnam-gu, Seoul, 06273, Korea
| | - Soyoung Jeon
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Korea
| | - Donghee Han
- Department of Imaging and Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Su-Yeon Choi
- Division of Cardiology, Seoul National University Healthcare System Gangnam Center, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Ju Chun
- Department of Radiology, Seoul National University Bundang Hospital, Seoul, Korea
| | - Hae-Won Han
- Department of Internal Medicine, Gangnam Heartscan Clinic, Seoul, Korea
| | - Sung Hak Park
- Department of Radiology, Gangnam Heartscan Clinic, Seoul, Korea
| | - Jidong Sung
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Heart Stroke & Vascular Institute, Samsung Medical Center, Seoul, Korea
| | - Hae Ok Jung
- Division of Cardiology, Cardiovascular Center, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Ji Won Lee
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Korea.
| | - Hyuk-Jae Chang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
| |
Collapse
|
79
|
Simental-Mendía LE, Simental-Mendía M, Sánchez-García A, Linden-Torres E. Effect of hydroxychloroquine on lipid levels: A systematic review and meta-analysis. Curr Pharm Des 2021; 27:4133-4139. [PMID: 34176459 DOI: 10.2174/1381612827666210625162612] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/27/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND It has been suggested that hydroxychloroquine may have positive effects on LDL-C, HDL-C, and triglyceride levels; however, the hypolipidemic activities of this drug are still uncertain. OBJECTIVE The aim of this meta-analysis of randomized controlled trials was to explore the effect of hydroxychloroquine on circulating lipid concentrations. METHOD Randomized controlled trials examining the impact of hydroxychloroquine on lipid parameters were searched in PubMed, Web of Science, Scopus, and Google Scholar databases. Meta-analysis was performed using a random-effects model and sensitivity analysis through the leave one-out method. RESULTS Meta-analysis showed that patients receiving hydroxychloroquine therapy significantly decreased total cholesterol (WMD: 0.18 mmol/L, 95% CI: -0.28, -0.08, I2 = 6%, p = 0.0004), LDL-C (WMD: -0.21 mmol/L, 95% CI: -0.36, -0.06, I2 = 75%, p = 0.006), triglycerides (WMD: -0.09 mmol/L, 95% CI: -0.15, -0.04, I2 = 22%, p = 0.001), and non-HDL-C (WMD: -0.28 mmol/L, 95% CI: -0.45, -0.12, I2 = 0%, p = 0.0009), and increased HDL-C concentrations (WMD: 0.03 mmol/L, 95% CI: 0.00, 0.06, I2 = 0%, p = 0.03). CONCLUSION Our results suggest that hydroxychloroquine improves lipid parameters by reducing total cholesterol, LDL-C, triglycerides, non-HDL-C, and increasing HDL-C levels.
Collapse
Affiliation(s)
- Luis E Simental-Mendía
- Unidad de Investigación Biomédica, Delegación Durango, Instituto Mexicano del Seguro Social, Mexico
| | - Mario Simental-Mendía
- Department of Orthopedics and Traumatology, Hospital Universitario "Dr. José E. González", Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico
| | - Adriana Sánchez-García
- Endocrinology Division, Hospital Universitario "Dr. José E. González", Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico
| | - Enrique Linden-Torres
- Unidad de Investigación Biomédica, Delegación Durango, Instituto Mexicano del Seguro Social, Mexico
| |
Collapse
|
80
|
Lee EJ, Shin CM, Lee DH, Han K, Park SH, Kim YJ, Yoon H, Park YS, Kim N. The Association Between Cholecystectomy and the Risk for Fracture: A Nationwide Population-Based Cohort Study in Korea. Front Endocrinol (Lausanne) 2021; 12:657488. [PMID: 34122336 PMCID: PMC8190474 DOI: 10.3389/fendo.2021.657488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 04/28/2021] [Indexed: 01/29/2023] Open
Abstract
Objectives To evaluate the risk of fracture in individuals with a history of cholecystectomy in Korean population. Methods Individuals (n = 143,667) aged ≥ 40 y who underwent cholecystectomy between 2010 and 2015 and the controls (n = 255,522), matched by age and sex, were identified from the database of the Korean National Health Insurance Services. The adjusted hazard ratio (aHR) and 95% confidence interval (CI) of fracture were estimated following cholecystectomy, and a Cox regression analysis was performed. Results The incidence rates of all fractures, vertebral, and hip fractures were 14.689, 6.483 and 1.228 cases per 1000 person-years respectively in the cholecystectomy group, whereas they were 13.862, 5.976, and 1.019 cases per 1000 person-years respectively in the control group. After adjustment for age, sex, income, place of residence, diabetes mellitus, hypertension, dyslipidemia, smoking, alcohol drinking, exercise, and body mass index, patients who underwent cholecystectomy showed an increased risk of all fractures, vertebral fractures, and hip fractures (aHR [95% CI]: 1.095 [1.059-1.132], 1.134 [1.078-1.193], and 1.283 [1.139-1.444] for all fractures, vertebral fractures, and hip fractures, respectively). The risk of vertebral fractures following cholecystectomy was more prominent in the young age group (40 to 49 y) than in the old age group (≥ 65 y) (1.366 [1.082-1.724] vs. 1.132 [1.063-1.206], respectively). However, the incidence of hip fractures following cholecystectomy was not affected by age. Conclusion Individuals who underwent cholecystectomy have an increased risk of fracture. In the younger population, the risk of vertebral fractures may be further increased following cholecystectomy.
Collapse
Affiliation(s)
- Eun Ji Lee
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Cheol Min Shin
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dong Ho Lee
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - Sang Hyun Park
- Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Yoo Jin Kim
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Hyuk Yoon
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Young Soo Park
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Nayoung Kim
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea
| |
Collapse
|
81
|
Classification and Prediction on the Effects of Nutritional Intake on Overweight/Obesity, Dyslipidemia, Hypertension and Type 2 Diabetes Mellitus Using Deep Learning Model: 4-7th Korea National Health and Nutrition Examination Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115597. [PMID: 34073854 PMCID: PMC8197245 DOI: 10.3390/ijerph18115597] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/17/2021] [Accepted: 05/21/2021] [Indexed: 11/17/2022]
Abstract
Few studies have been conducted to classify and predict the influence of nutritional intake on overweight/obesity, dyslipidemia, hypertension and type 2 diabetes mellitus (T2DM) based on deep learning such as deep neural network (DNN). The present study aims to classify and predict associations between nutritional intake and risk of overweight/obesity, dyslipidemia, hypertension and T2DM by developing a DNN model, and to compare a DNN model with the most popular machine learning models such as logistic regression and decision tree. Subjects aged from 40 to 69 years in the 4-7th (from 2007 through 2018) Korea National Health and Nutrition Examination Survey (KNHANES) were included. Diagnostic criteria of dyslipidemia (n = 10,731), hypertension (n = 10,991), T2DM (n = 3889) and overweight/obesity (n = 10,980) were set as dependent variables. Nutritional intakes were set as independent variables. A DNN model comprising one input layer with 7 nodes, three hidden layers with 30 nodes, 12 nodes, 8 nodes in each layer and one output layer with one node were implemented in Python programming language using Keras with tensorflow backend. In DNN, binary cross-entropy loss function for binary classification was used with Adam optimizer. For avoiding overfitting, dropout was applied to each hidden layer. Structural equation modelling (SEM) was also performed to simultaneously estimate multivariate causal association between nutritional intake and overweight/obesity, dyslipidemia, hypertension and T2DM. The DNN model showed the higher prediction accuracy with 0.58654 for dyslipidemia, 0.79958 for hypertension, 0.80896 for T2DM and 0.62496 for overweight/obesity compared with two other machine leaning models with five-folds cross-validation. Prediction accuracy for dyslipidemia, hypertension, T2DM and overweight/obesity were 0.58448, 0.79929, 0.80818 and 0.62486, respectively, when analyzed by a logistic regression, also were 0.52148, 0.66773, 0.71587 and 0.54026, respectively, when analyzed by a decision tree. This study observed a DNN model with three hidden layers with 30 nodes, 12 nodes, 8 nodes in each layer had better prediction accuracy than two conventional machine learning models of a logistic regression and decision tree.
Collapse
|
82
|
Karantas ID, Okur ME, Okur NÜ, Siafaka PI. Dyslipidemia Management in 2020: An Update on Diagnosis and Therapeutic Perspectives. Endocr Metab Immune Disord Drug Targets 2021; 21:815-834. [PMID: 32778041 DOI: 10.2174/1871530320666200810144004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/10/2020] [Accepted: 06/19/2020] [Indexed: 11/22/2022]
Abstract
Cardiovascular diseases are the leading cause of death in the modern world and dyslipidemia is one of the major risk factors. The current therapeutic strategies for cardiovascular diseases involve the management of risk factors, especially dyslipidemia and hypertension. Recently, the updated guidelines of dyslipidemia management were presented, and the newest data were included in terms of diagnosis, imaging, and treatment. In this targeted literature review, the researchers presented the most recent evidence on dyslipidemia management by including the current therapeutic goals for it. In addition, the novel diagnostic tools based on theranostics are shown. Finally, the future perspectives on treatment based on novel drug delivery systems and their potential to be used in clinical trials were also analyzed. It should be noted that dyslipidemia management can be achieved by the strict lifestyle change, i.e., by adopting a healthy life, and choosing the most suitable medication. This review can help medical professionals as well as specialists of other sciences to update their knowledge on dyslipidemia management, which can lead to better therapeutic outcomes and newer drug developments.
Collapse
Affiliation(s)
| | - Mehmet E Okur
- University of Health Sciences, Faculty of Pharmacy, Department of Pharmacology, Istanbul, Turkey
| | - Neslihan Ü Okur
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Health Sciences, Istanbul, Turkey
| | - Panoraia I Siafaka
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Health Sciences, Istanbul, Turkey
| |
Collapse
|
83
|
Kalra S, Chen Z, Deerochanawong C, Shyu KG, Tan RS, Tomlinson B, Yeh HI. Familial Hypercholesterolemia in Asia Pacific: A Review of Epidemiology, Diagnosis, and Management in the Region. J Atheroscler Thromb 2021; 28:417-434. [PMID: 33746137 PMCID: PMC8193778 DOI: 10.5551/jat.56762] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 12/22/2020] [Indexed: 01/26/2023] Open
Abstract
Familial hypercholesterolemia (FH) is a common genetic disease that is estimated to affect at least 15 million people in the Asia Pacific region. Affected individuals are at significantly increased risk of premature atherosclerotic cardiovascular disease. A literature review was undertaken to provide an overview of the epidemiology, diagnosis, and management of FH across the region.Currently, epidemiological data relating to FH are lacking across the Asia Pacific. Of the 15 countries and regions considered, locally conducted studies to determine FH prevalence were only identified for Australia, China, India, and Japan. Although practically all national clinical guidelines for dyslipidemia include some commentary on FH, specific guidelines on the management of FH are available for only one third of the countries and regions evaluated. Estimates of current FH diagnosis rates suggest that most affected individuals remain undiagnosed and untreated. Although innovative medications such as proprotein convertase subtilisin/kexin type 9 inhibitors have been approved and are available in most countries and regions considered, they are currently reimbursed in only one quarter.Despite these shortcomings, there is cause for optimism. Early experience with cascade screening in Hong Kong, India, and Vietnam has proven an effective means of identifying family members of probands, as has a reverse screening of family members of children with FH in China. FH registries are gaining momentum across the region, with registries now established in almost half of the countries and regions evaluated. This review concludes with a Call to Action on FH for Asia Pacific to engage healthcare professionals, improve public awareness, and form national FH alliances, comprising all relevant healthcare professional organizations, as a platform to expedite national quality improvement programs in the management of FH.
Collapse
Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, India
| | - Zhenyue Chen
- Cardiology Department, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | | | - Kou-Gi Shyu
- Division of Cardiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Ru San Tan
- National Heart Centre Singapore, Duke-NUS Medical Singapore
| | - Brian Tomlinson
- Faculty of Medicine, Macau University of Science & Technology, Avenida Wai Long, Taipa, Macau, China
| | - Hung-I Yeh
- Departments of Internal Medicine and Medical Research, Mackay Memorial Hospital, Mackay Medical College, New Taipei City, Taiwan
| |
Collapse
|
84
|
Zhao XN, Sun Q, Cao YQ, Ran X, Cao Y. Association between apolipoprotein gene polymorphisms and hyperlipidemia: a meta-analysis. BMC Genom Data 2021; 22:14. [PMID: 33836655 PMCID: PMC8034140 DOI: 10.1186/s12863-021-00968-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 03/25/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Hyperlipidemia plays an important role in the etiology of cardio-cerebrovascular disease. Over recent years, a number of studies have explored the impact of apolipoprotein genetic polymorphisms in hyperlipidemia, but considerable differences and uncertainty have been found in their association with different populations from different regions. RESULTS A total of 59 articles were included, containing in total 13,843 hyperlipidemia patients in the case group and 15,398 healthy controls in the control group. Meta-analysis of the data indicated that APOA5-1131 T > C, APOA1 -75 bp, APOB XbaI, and APOE gene polymorphisms were significantly associated with hyperlipidemia, with OR values of 1.996, 1.228, 1.444, and 1.710, respectively. All P-values were less than 0.05. CONCLUSIONS Meta-analysis of the data indicated that the C allele of APOA5 1131 T > C, the A allele at APOA1-75 bp, the APOB XbaI T allele, and the ε2 and ε4 allele of APOE were each a risk factor for susceptibility for hyperlipidemia.
Collapse
Affiliation(s)
- Xiao-Ning Zhao
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Quan Sun
- School of Public Health, Hebei Medical University, Shijiazhuang, 050017, China
| | - You-Qin Cao
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Xiao Ran
- School of Health, Guizhou Medical University, 550025, Guiyang, China
| | - Yu Cao
- School of Health, Guizhou Medical University, 550025, Guiyang, China.
| |
Collapse
|
85
|
Cho SMJ, Lee H, Lee HH, Baek J, Heo JE, Joo HJ, Hong SJ, Kim HC. Dyslipidemia Fact Sheets in Korea 2020: an Analysis of Nationwide Population-based Data. J Lipid Atheroscler 2021; 10:202-209. [PMID: 34095012 PMCID: PMC8159761 DOI: 10.12997/jla.2021.10.2.202] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/17/2021] [Accepted: 03/16/2021] [Indexed: 12/29/2022] Open
Abstract
Objective The Korean Society of Lipid and Atherosclerosis (KSoLA) has published the Dyslipidemia Fact Sheets in Korea 2020 to provide an overview of magnitude and management status of dyslipidemia and their recent trends therein. Methods The Fact Sheets were based on the analyses of Korean adults aged 20 years or older of the 2007-2018 Korea National Health and Nutrition Examination Survey (KNHANES) and the 2002-2018 National Health Insurance Big Data (NHI-BD). Results Between 2007 and 2018, the crude prevalence of hypercholesterolemia increased from 9.0% to 20.7%. During the same period, its management rate also improved yet remained unsatisfactory. In 2018, the prevalence of dyslipidemia was 45.6% in men and 31.3% in women, which increased with older age and presence of metabolic abnormalities. Indeed, the number of people diagnosed with dyslipidemia has increased nearly 8-fold from 1.5 million in 2002 to 11.6 million in 2018; alongside, the number of people receiving pharmacological treatment for dyslipidemia has also risen. Of the 7.7 million people treated for dyslipidemia in 2018, statin accounted for the majority (91.8%) of lipid-lowering drug prescriptions, followed by ezetimibe (14.6%), fibrate (8.5%), and omega-3 acid (5.9%). The most frequently used combination therapy was statin plus ezetimibe, accounting for 72% of dual therapy prescriptions. Conclusion Dyslipidemia continues to impose a substantial disease burden in Korea. Both healthcare practitioners and patients need to actively adopt guideline-recommended lifestyle modification and pharmacological treatment for comprehensive, timely, and sustained management.
Collapse
Affiliation(s)
- So Mi Jemma Cho
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeok-Hee Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jongmin Baek
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Eun Heo
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyung Joon Joo
- Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Soon Jun Hong
- Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | | |
Collapse
|
86
|
Tomlinson B, Patil NG, Fok M, Lam CWK. Role of PCSK9 Inhibitors in Patients with Familial Hypercholesterolemia. Endocrinol Metab (Seoul) 2021; 36:279-295. [PMID: 33866776 PMCID: PMC8090480 DOI: 10.3803/enm.2021.964] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/15/2021] [Indexed: 12/12/2022] Open
Abstract
Patients with familial hypercholesterolemia (FH) are at high or very high risk for cardiovascular disease. Those with heterozygous FH (HeFH) often do not reach low-density lipoprotein cholesterol (LDL-C) targets with statin and ezetimibe therapy, and those with homozygous FH (HoFH) usually require additional lipid-modifying therapies. Drugs that inhibit proprotein convertase subtilisin/kexin type 9 (PCSK9) offer a novel approach to reduce LDL-C. The monoclonal antibodies, alirocumab and evolocumab, given by subcutaneous injection every 2 or 4 weeks produce reductions in LDL-C of 50% to 60% in patients with HeFH, allowing many of them to achieve their LDL-C goals. Patients with HoFH show a reduced and more variable LDL-C response, which appears to depend on residual LDL receptor activity, and those with receptor-negative mutations may show no response. Inclisiran is a long-acting small interfering RNA therapeutic agent that inhibits the synthesis of PCSK9. Subcutaneous doses of 300 mg can reduce LDL-C by more than 50% for at least 6 months and the responses in HeFH and HoFH patients are similar to those achieved with monoclonal antibodies. These PCSK9 inhibitors are generally well tolerated and they provide a new opportunity for effective treatment for the majority of patients with FH.
Collapse
Affiliation(s)
- Brian Tomlinson
- Faculty of Medicine, Macau University of Science and Technology, Macau, China
| | | | - Manson Fok
- Faculty of Medicine, Macau University of Science and Technology, Macau, China
| | | |
Collapse
|
87
|
Lee JH, Lee HS, Cho AR, Lee YJ, Kwon YJ. Non-Alcoholic Fatty Liver Disease Is an Independent Risk Factor for LDL Cholesterol Target Level. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073442. [PMID: 33810315 PMCID: PMC8037151 DOI: 10.3390/ijerph18073442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 12/11/2022]
Abstract
Although patients with non-alcoholic fatty liver disease (NAFLD) face a higher risk of cardiovascular disease (CVD), it is not known whether people with NAFLD are less likely to achieve optimal management of low-density lipoprotein (LDL) cholesterol than those without NAFLD. We aimed to investigate the longitudinal effect of NAFLD on the management of LDL cholesterol in 5610 adults from the Korean Genome and Epidemiology Study. Participants were classified into NAFLD and normal groups. Non-achievement of the target LDL cholesterol level was set according to one's cardiovascular disease (CVD) risk level. The estimated proportion of individuals who did not achieve their LDL cholesterol targets was higher in the NAFLD group than in the normal group during the follow-up period of 12 years in a generalized estimation equation model. Multivariable Cox regression analysis revealed a hazard ratio and 95% confidence interval for incident non-achievement of one's LDL cholesterol target of 1.196 (1.057-1.353) in the NAFLD group (p = 0.005). We found that NAFLD was significantly related to non-achievement of LDL cholesterol targets in this prospective cohort study. Prevention and proper management of NAFLD have important health implications for the prevention of CVD.
Collapse
Affiliation(s)
- Jun-Hyuk Lee
- Department of Family Medicine, Nowon Eulji Medical Center, Eulji University, Seoul 01830, Korea;
- School of Medicine, Eulji University, Daejeon 34824, Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul 06273, Korea;
| | - A-Ra Cho
- Department of Family Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 06273, Korea; (A.-R.C.); (Y.-J.L.)
| | - Yong-Jae Lee
- Department of Family Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 06273, Korea; (A.-R.C.); (Y.-J.L.)
| | - Yu-Jin Kwon
- Department of Family Medicine, Yonsei University College of Medicine, Yongin Severance Hospital, Yongin-si 16995, Korea
- Correspondence: ; Tel.: +82-31-5189-8777
| |
Collapse
|
88
|
Turana Y, Tengkawan J, Chia YC, Nathaniel M, Wang J, Sukonthasarn A, Chen C, Minh HV, Buranakitjaroen P, Shin J, Siddique S, Nailes JM, Park S, Teo BW, Sison J, Ann Soenarta A, Hoshide S, Tay JC, Prasad Sogunuru G, Zhang Y, Verma N, Wang T, Kario K. Hypertension and stroke in Asia: A comprehensive review from HOPE Asia. J Clin Hypertens (Greenwich) 2021; 23:513-521. [PMID: 33190399 PMCID: PMC8029540 DOI: 10.1111/jch.14099] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/16/2020] [Accepted: 10/20/2020] [Indexed: 02/06/2023]
Abstract
Stroke is the primary cause of disability and vascular death worldwide, including Asia. Asian characteristics that differ from the West lead to higher stroke incidence. Stroke epidemiology studies in Asia have shown varying levels of mortality, incidence, prevalence, and burden of disease. Hypertension is the most prevalent risk factor found in Asia. Besides ethnicity that is associated with stroke incidence, both systolic blood pressure, diastolic blood pressure, and blood pressure variability are positively correlated with stroke incidence. Post-stroke cognitive impairment is one of the sequelae that affect one-third of stroke survivors and has become a significant public health concern that is often neglected despite its increasing prevalence. Therefore, it is very important to prevent recurrence by treating stroke optimally and effectively. Increasing awareness and treatment adherence to hypertension, the leading risk factor for stroke, became the main goal in several countries in Asia.
Collapse
Affiliation(s)
- Yuda Turana
- School of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Jeslyn Tengkawan
- School of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Yook Chin Chia
- Department of Medical SciencesSchool of Healthcare and Medical SciencesSunway UniversityBandar SunwayMalaysia
- Department of Primary Care MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Michael Nathaniel
- School of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Ji‐Guang Wang
- Department of HypertensionCentre for Epidemiological Studies and Clinical TrialsThe Shanghai Institute of HypertensionShanghai Key Laboratory of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Apichard Sukonthasarn
- Cardiology DivisionDepartment of Internal MedicineFaculty of MedicineChiang Mai UniversityChiang MaiThailand
| | - Chen‐Huan Chen
- Department of MedicineFaculty of MedicineNational Yang‐Ming UniversityTaipeiTaiwan
| | - Huynh Van Minh
- Department of CardiologyHue University HospitalHue UniversityHue CityVietnam
| | - Peera Buranakitjaroen
- Division of HypertensionDepartment of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Jinho Shin
- Faculty of Cardiology ServiceHanyang University Medical CenterSeoulKorea
| | | | - Jennifer M. Nailes
- University of the East Ramon Magsaysay Memorial Medical Center Inc.Quezon CityPhilippines
| | - Sungha Park
- Division of CardiologyCardiovascular HospitalYonsei Health SystemSeoulKorea
| | - Boon Wee Teo
- Division of NephrologyDepartment of MedicineYong Loo Lin School of MedicineNational University of SingaporeSingapore CitySingapore
- Division of NephrologyDepartment of MedicineNational University Health SystemSingapore CitySingapore
| | - Jorge Sison
- Section of CardiologyDepartment of MedicineMedical Center ManilaManilaPhilippines
| | - Arieska Ann Soenarta
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversity of Indonesia‐National Cardiovascular CenterHarapan KitaJakartaIndonesia
| | - Satoshi Hoshide
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingaporeSingapore
| | - Guru Prasad Sogunuru
- MIOT International HospitalChennaiIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | - Yuqing Zhang
- Divisions of Hypertension and Heart FailureFu Wai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Narsingh Verma
- Department of PhysiologyKing George's Medical UniversityLucknowIndia
| | - Tzung‐Dau Wang
- Cardiovascular Center and Division of CardiologyDepartment of Internal MedicineNational Taiwan University Hospital and National Taiwan University College of MedicineTaipei CityTaiwan
| | - Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | | |
Collapse
|
89
|
Choi SY, Ko SH. Severe hypoglycemia as a preventable risk factor for cardiovascular disease in patients with type 2 diabetes mellitus. Korean J Intern Med 2021; 36:263-270. [PMID: 32872725 PMCID: PMC7969056 DOI: 10.3904/kjim.2020.327] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/05/2020] [Indexed: 12/11/2022] Open
Abstract
Glucose-lowering medication and lifestyle modification are essential for optimal glycemic control in patients with type 2 diabetes mellitus (T2DM). However, glucose-lowering agents, particularly insulin and insulin secretagogues, may cause hypoglycemia, which has multiple negative effects on the cardiovascular (CV) system and may cause death. Previous studies using institutional data from the Korean Nationwide Health Insurance database have consistently found a causal relationship between severe hypoglycemia and CV outcomes and mortality. Screening for high-risk patients, appropriate management, and intensive individualized education are the most effective measures and essential for the prevention of harmful hypoglycemic events. Based on identified risk factors that predict severe hypoglycemia, we developed an 1-year risk prediction model for severe hypoglycemia that can be used in clinical settings. In this review, we describe the current understanding of severe hypoglycemia and the clinical implications in patients with T2DM. Furthermore, we highlight the importance of intensive individualized education for high-risk patients and the risk prediction model to reduce severe hypoglycemia.
Collapse
Affiliation(s)
- Soo-Yeon Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| |
Collapse
|
90
|
Assessment of Dietary Habits Using the Diet Quality Index-International in Cerebrovascular and Cardiovascular Disease Patients. Nutrients 2021; 13:nu13020542. [PMID: 33562317 PMCID: PMC7914702 DOI: 10.3390/nu13020542] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 11/17/2022] Open
Abstract
Improvement of dietary habits is recommended for the management of cerebrovascular and cardiovascular diseases (CCVD). This study aimed to evaluate the dietary habits of CCVD patients and compare them with the general population by using the Diet Quality Index—International (DQI-I). Data from the Korean National Health and Nutrition Examination Surveys (2013–2016) were used. Cardiovascular diseases included myocardial infarction, angina pectoris, and heart failure; and cerebrovascular diseases included stroke, cerebral infarction, and hemorrhage. In total, 12,683 subjects over 20 years old were included, comprising 718 CCVD patients and 11,965 non-CCVD subjects. Survey-weighted multiple linear regression analyses with adjustment for covariates were used to compare DQI-I scores. The mean total DQI-I scores for the CCVD and non-CCVD groups were 66.7 ± 9.2 and 67.8 ± 9.2, respectively. After adjusting for covariates, the CCVD group had DQI-I scores significantly lower than the non-CCVD group (coefficient −1.13, p-value = 0.011). In the analysis of each DQI-I component, the CCVD group had lower scores for variety (coefficient −0.54, p-value = 0.004) and adequacy (coefficient −0.86, p-value = 0.001). In this study, using nationally representative data, dietary habits of CCVD patients were shown to be lower in quality than non-CCVD subjects. Therefore, evaluation and education of adequate dietary habits are needed in the management of CCVD patients.
Collapse
|
91
|
Salman AA, Salman MA, Shawkat M, Hassan SA, Saad EH, Hussein AM, Refaie ORM, Tourky MS, Shaaban HED, Abd Allah N, El Domiaty HF, Elkassar H. Effect of laparoscopic sleeve gastrectomy on vasoactive mediators in obese hypertensive patients: A prospective study. Clin Endocrinol (Oxf) 2021; 94:193-203. [PMID: 33064869 DOI: 10.1111/cen.14352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 10/01/2020] [Accepted: 10/05/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The causal relationship between obesity and high blood pressure is established; however, the detailed pathways for such association are still under research. This work aims to assess the changes in neprilysin, vasoconstrictor and vasodilatory molecules in obese hypertensive patients undergoing laparoscopic sleeve gastrectomy (LSG). PATIENTS The present prospective study was done on 59 hypertensive obese patients in whom LGS was performed. Blood pressure, as well as blood samples for neprilysin, angiotensinogen, angiotensin II, renin, endothelin-1 "ET-1", aldosterone, atrial natriuretic peptide "ANP" and B-type natriuretic peptide "BNP", were assessed before and 15 months after surgery. Patients were divided into two groups according to the remission of hypertension (HTN). RESULTS After 15 months, remission of hypertension was seen in 42 patients (71%). The declines in the following measurements were significantly higher in patients with remission than those with persistent HTN: aldosterone (p = .029567), angiotensin II (p < .000001), angiotensinogen (p = .000021), neprilysin (p = .000601), renin (p = .000454) and endothelin-1(p = .000030). There was a significantly higher increment in ANP (p = .000002) and a non-significant increment in BNP (p = .081740). Angiotensin II 15 months after LSG and Δ ANP % were significant independent predictors of persistent HTN. CONCLUSION In the setting of LSG, aldosterone, angiotensinogen, angiotensin II, renin and neprilysin were significantly lower in patients with remission of HTN after 15 months than those with persistent HTN, and natriuretic peptides were significantly higher. A lower postoperative level of angiotensin II and a larger percentage increment of ANP are independently associated with hypertension remission after LSG.
Collapse
Affiliation(s)
| | | | - Mohamed Shawkat
- Internal Medicine Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Shady A Hassan
- Internal Medicine Department, Faculty of medicine, Cairo University, Cairo, Egypt
| | - Eman H Saad
- Internal Medicine Department, Faculty of medicine, Cairo University, Cairo, Egypt
| | | | - Osama R M Refaie
- General Surgery Department, Faculty of medicine, Cairo University, Cairo, Egypt
| | | | - Hossam El-Din Shaaban
- Gastroenterology & Hepatology Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Nesrin Abd Allah
- Anatomy and Embryology Department, Faculty of Medicine, Menoufia University, Al Minufiyah, Egypt
| | - Heba Fathy El Domiaty
- Clinical Physiology Department, Faculty of Medicine, Menoufia University, Al Minufiyah, Egypt
| | - Hesham Elkassar
- Internal Medicine Department, Faculty of medicine, Cairo University, Cairo, Egypt
| |
Collapse
|
92
|
Relationship between muscle mass index and LDL cholesterol target levels: Analysis of two studies of the Korean population. Atherosclerosis 2021; 325:1-7. [PMID: 33857762 DOI: 10.1016/j.atherosclerosis.2021.01.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 01/08/2021] [Accepted: 01/13/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Decreased skeletal muscle mass is an important change in body composition with aging. Maintaining the optimal low-density lipoprotein (LDL) cholesterol level is crucial for the prevention of cardiovascular diseases (CVD). We investigated whether muscle mass was associated with dyslipidemia. METHODS We analyzed the data of 17,546 adults from the 2008-2011 Korean National Health and Nutrition Examination Survey (KNHANES) and 5126 adults from the Korean Genome and Epidemiology Study (KoGES). Participants were classified into the lower skeletal muscle mass index (LSMI) group and normal group. LSMI was defined as body mass index (BMI)-adjusted appendicular skeletal muscle mass <0.789 (men) and <0.512 (women) in the KNHANES, and as sex-specific lowest quintile of the BMI-adjusted total skeletal muscle mass in the KoGES. Participants were defined as having dyslipidemia when the serum LDL cholesterol levels were higher than their LDL cholesterol management targets based on their CVD risk level. RESULTS The odds ratio with 95% confidence interval (CI) for dyslipidemia of the LSMI group was 1.230 (1.016-1.488, p = 0.034) after adjusting for confounding variables compared to the normal group in the 2008-2011 KNHANES. In the KoGES, the hazard ratio with 95% CI for incident dyslipidemia of the LSMI group compared to the normal group was 1.225 (1.101-1.364, p < 0.001). Regardless of abdominal obesity, LSMI was significantly associated with a higher risk of incident dyslipidemia. CONCLUSIONS LSMI was associated with dyslipidemia regardless of abdominal obesity. Prevention of muscle mass loss may be an important strategy for LDL cholesterol management.
Collapse
|
93
|
Park S, Hong M, Lee H, Cho NJ, Lee EY, Lee WY, Rhee EJ, Gil HW. New Model for Predicting the Presence of Coronary Artery Calcification. J Clin Med 2021; 10:457. [PMID: 33503990 PMCID: PMC7865676 DOI: 10.3390/jcm10030457] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 12/23/2022] Open
Abstract
Coronary artery calcification (CAC) is a feature of coronary atherosclerosis and a well-known risk factor for cardiovascular disease (CVD). As the absence of CAC is associated with a lower incidence rate of CVD, measurement of a CAC score is helpful for risk stratification when the risk decision is uncertain. This was a retrospective study with an aim to build a model to predict the presence of CAC (i.e., CAC score = 0 or not) and evaluate the discrimination and calibration power of the model. Our data set was divided into two set (80% for training set and 20% for test set). Ten-fold cross-validation was applied with ten times of interaction in each fold. We built prediction models using logistic regression (LRM), classification and regression tree (CART), conditional inference tree (CIT), and random forest (RF). A total of 3,302 patients from two cohorts (Soonchunhyang University Cheonan Hospital and Kangbuk Samsung Health Study) were enrolled. These patients' ages were between 40 and 75 years. All models showed acceptable accuracies (LRM, 70.71%; CART, 71.32%; CIT, 71.32%; and RF, 71.02%). The decision tree model using CART and CIT showed a reasonable accuracy without complexity. It could be implemented in real-world practice.
Collapse
Affiliation(s)
- Samel Park
- Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan 31151, Korea; (S.P.); (N.-j.C.); (E.-Y.L.)
| | - Min Hong
- Department of Software Convergence, Soonchunhyang University, Asan 31538, Korea; (M.H.); (H.L.)
| | - HwaMin Lee
- Department of Software Convergence, Soonchunhyang University, Asan 31538, Korea; (M.H.); (H.L.)
| | - Nam-jun Cho
- Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan 31151, Korea; (S.P.); (N.-j.C.); (E.-Y.L.)
| | - Eun-Young Lee
- Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan 31151, Korea; (S.P.); (N.-j.C.); (E.-Y.L.)
- Institute of Tissue Regeneration, College of Medicine, Soonchunhyang University, Cheonan 31151, Korea
- BK21 FOUR Project, College of Medicine, Soonchunhyang University, Cheonan 31151, Korea
| | - Won-Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul 03181, Korea;
| | - Eun-Jung Rhee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul 03181, Korea;
| | - Hyo-Wook Gil
- Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan 31151, Korea; (S.P.); (N.-j.C.); (E.-Y.L.)
| |
Collapse
|
94
|
Association between Dyslipidemia and Mercury Exposure in Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020775. [PMID: 33477628 PMCID: PMC7831478 DOI: 10.3390/ijerph18020775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 01/13/2021] [Accepted: 01/15/2021] [Indexed: 12/26/2022]
Abstract
Background-Dyslipidemia is one of the prominent risk factors for cardiovascular disease, which is the leading cause of death worldwide. Dyslipidemia has various causes, including metabolic capacity, genetic problems, physical inactivity, and dietary habits. This study aimed to determine the association between dyslipidemia and exposure to heavy metals in adults. Methods-Using data from the seventh Korean National Health and Nutrition Examination Survey (2016-2017), 5345 participants aged ≥20 years who were tested for heavy metal levels were analyzed in this study. Multiple logistic regression was conducted to assess the factors affecting the prevalence of dyslipidemia. Results-The risks of dyslipidemia among all and male participants with mercury (Hg) levels of ≥2.75 μg/L (corresponding to the Korean average level) were 1.273 and 1.699 times higher than in those with levels of <2.75 μg/L, respectively. The factors that significantly affected the dyslipidemia risk were age, household income, body mass index, and subjective health status in both males and females. Conclusions-In adult males, exposure to Hg at higher-than-average levels was positively associated with dyslipidemia. These results provide a basis for targeted prevention strategies for dyslipidemia using lifestyle guidelines for reducing Hg exposure and healthy behavioral interventions.
Collapse
|
95
|
Mood and Metabolic Health Status of Elderly Osteoporotic Patients in Korea: A Cross-Sectional Study of a Nationally Representative Sample. Healthcare (Basel) 2021; 9:healthcare9010077. [PMID: 33466908 PMCID: PMC7830950 DOI: 10.3390/healthcare9010077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/01/2021] [Accepted: 01/11/2021] [Indexed: 11/26/2022] Open
Abstract
This study aimed to investigate the association between osteoporosis and comorbidity, which are very common in Korea, and develop a treatment strategy to improve bone health based on the findings of the Korean National Health and Nutritional Examination Surveys (KNHANES). This study was based on data obtained from 4060 subjects (1755 males, 2305 females) aged above 60 years in the KNHANES (2016–2017). Well-trained medical staff performed the standard procedures and measured several variables including height, weight, and waist circumference. Interviews and laboratory tests were based on the diagnosis of hyperuricemia, dyslipidemia, type 2 diabetes mellitus (T2DM), osteoporosis, and depression. Comorbidities were defined as a self-reported physician diagnosis. The association of osteoporosis with depression and metabolic disease was assessed statistically using the complex sample analysis method of SPSS. The presence of osteoporosis, dyslipidemia, T2DM, hyperuricemia, obesity, abdominal obesity, and depression was 6.1 ± 0.5%, 15.2 ± 0.7%, 6.5 ± 0.4%, 13.4 ± 0.7%, 30.8 ± 0.8%, 19.4 ± 0.9%, 4.0 ± 0.2%, respectively. After adjusted by age, osteoporotic subjects were significance in the presence of abdominal obesity (p = 0.024, OR 0.80), hyperuricemia (p = 0.013, OR 0.68), dyslipidemia (p < 0.001, OR 1.84), and depression (p < 0.001, OR 2.56), respectively. Subgroup analyses showed dyslipidemia (female subjects, p < 0.001, OR 1.04; male subjects, p = 0.94, OR 1.09) and depression (female subjects, p < 0.001, OR 1.76; male subjects, p = 0.51, OR 0.62) were associated with osteoporotic female subjects but not in male subjects. The comorbidity of dyslipidemia and depression in female subjects was associated with osteoporosis and an odds ratio was 13.33 (95% CI: 8.58–20.71) (p < 0.001). The comorbidity of abdominal obesity (female subjects, p = 0.75, OR 0.97; male subjects, p = 0.94, OR 1.02) and hyperuricemia (female subjects, p = 0.27, OR 0.81; male subjects p = 0.07, OR 0.35) was not associated with osteoporosis in both Subgroup. The result of this study shows a strong dependency of comorbidity with dyslipidemia and depression in elderly women with osteoporosis. Therefore, efforts to improve dyslipidemia and depression might prevent compromised bone health.
Collapse
|
96
|
Lee K, Kim H, Rebholz CM, Kim J. Association between Different Types of Plant-Based Diets and Risk of Dyslipidemia: A Prospective Cohort Study. Nutrients 2021; 13:nu13010220. [PMID: 33466664 PMCID: PMC7828805 DOI: 10.3390/nu13010220] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 12/11/2022] Open
Abstract
We evaluated the associations among different types of plant-based diet indices, risk of dyslipidemia, and individual lipid disorders in Asian populations with different dietary patterns from Western populations. Participants included 4507 Korean adults aged ≥40 years without dyslipidemia and related chronic diseases at baseline (2001–2002). Dietary intakes were assessed using an average of validated food frequency questionnaires measured twice. We calculated three plant-based diet indices: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). During a follow-up of 14 years, 2995 incident dyslipidemia cases occurred. Comparing the highest with lowest quintiles, the multivariable-adjusted hazard ratios (HRs) for incident dyslipidemia were 0.78 (95% CI, 0.69–0.88) for PDI, 0.63 (95% CI, 0.56–0.70) for hPDI, and 1.48 (95% CI, 1.30–1.69) for uPDI (P-trend < 0.0001 for all). Associations between PDI and individual lipid disorders differed by sex. The PDI was inversely associated with risk of developing hypertriglyceridemia in men and with risk of developing low high-density lipoprotein cholesterol in women. The hPDI was inversely associated with risk of all lipid disorders, whereas the uPDI was positively associated with individual lipid disorders. The quality of plant foods is important for prevention of dyslipidemia in a population that consumes diets high in plant foods.
Collapse
Affiliation(s)
- Kyueun Lee
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea;
| | - Hyunju Kim
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (H.K.); (C.M.R.)
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Casey M. Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (H.K.); (C.M.R.)
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Jihye Kim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea;
- Correspondence: ; Tel.: +82-31-201-3497
| |
Collapse
|
97
|
The association between olfactory dysfunction and cardiovascular disease and its risk factors in middle-aged and older adults. Sci Rep 2021; 11:1248. [PMID: 33441955 PMCID: PMC7806612 DOI: 10.1038/s41598-020-80943-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 12/30/2020] [Indexed: 12/31/2022] Open
Abstract
While previous studies have reported olfactory dysfunction (OD) in relation to cardiovascular disease (CVD), few population-based studies have investigated whether such associations differ by sex. The purpose of this study was to identify the association between CVD and its risk factors with OD, and the sex-associated differences within the general population. We examined 20,016 adults aged 40 and older from the Korean National Health and Nutrition Examination Survey. All subjects reported on their history of OD. CVD and its risk factors included coronary artery disease (CAD), stroke, hypertension, diabetes, obesity, abdominal obesity, and hypertriglyceridemia; logistic regression was used to analyse their associations with OD, and additive interaction was used to analyse the interaction between risk factors and sex. In males, CAD was more likely to be associated with OD (odds ratio [OR] 1.81, 95% confidence interval [CI] 1.05–3.14), whereas abdominal obesity was associated with OD in females (OR 1.39, 95% CI 1.06–1.84).Additive interaction were observed between abdominal obesity and female sex with a relative excess risk of interaction of 0.45 (95% CI 0.26–0.63). Our findings suggest the relationship between OD and CVD and its risk factors and sex-associated differences among middle-aged and older adults.
Collapse
|
98
|
Lee HY, Lim S, Park S. Role of Inflammation in Arterial Calcification. Korean Circ J 2021; 51:114-125. [PMID: 33525066 PMCID: PMC7853899 DOI: 10.4070/kcj.2020.0517] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 12/24/2020] [Indexed: 01/11/2023] Open
Abstract
Arterial calcification, characterized by calcium phosphate deposition in the arteries, can be divided into intimal calcification and medial calcification. The former is the predominant form of calcification in coronary artery plaques; the latter mostly affects peripheral arteries and aortas. Both forms of arterial calcification have strong correlations with adverse cardiovascular events. Intimal microcalcification is associated with increased risk of plaque disruption while the degree of burden of coronary calcification, measured by coronary calcium score, is a marker of overall plaque burden. Continuous research on vascular calcification has been performed during the past few decades, and several cellular and molecular mechanisms and therapeutic targets were identified. However, despite clinical trials to evaluate the efficacy of drug therapies to treat vascular calcification, none have been shown to have efficacy until the present. Therefore, more extensive research is necessary to develop appropriate therapeutic strategies based on a thorough understanding of vascular calcification. In this review, we mainly focus on intimal calcification, namely the pathobiology of arterial calcification, and its clinical implications.
Collapse
Affiliation(s)
- Hae Young Lee
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Soyeon Lim
- Institute for Bio-Medical Convergence, College of Medicine, Catholic Kwandong University, Gangneung, Korea
| | - Sungha Park
- Division of Cardiology, Severance Cardiovascular Hospital and Integrative Research Center for Cerebrovascular and Cardiovascular Diseases, Yonsei University College of Medicine, Seoul, Korea.
| |
Collapse
|
99
|
Yousefzadeh G, Najafipour H, Baneshi M, Ahmadi Gohari M, Shahouzehi B, Farokhi M, Mirzazadeh A. Prevalence and 5-year incidence rate of dyslipidemia and its association with other coronary artery disease risk factors in Iran: Results of the Kerman coronary artery disease risk factors study (Phase 2). JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2021; 26:99. [PMID: 34899937 PMCID: PMC8607185 DOI: 10.4103/jrms.jrms_748_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 01/04/2021] [Accepted: 05/31/2021] [Indexed: 11/04/2022]
|
100
|
Rhee EJ. Recent dyslipidemia guidelines for patients with diabetes mellitus. PRECISION AND FUTURE MEDICINE 2020. [DOI: 10.23838/pfm.2020.00100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|