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Omega-3 Fatty Acids and Their Interaction with the Gut Microbiome in the Prevention and Amelioration of Type-2 Diabetes. Nutrients 2022; 14:nu14091723. [PMID: 35565691 PMCID: PMC9104474 DOI: 10.3390/nu14091723] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/16/2022] [Accepted: 04/18/2022] [Indexed: 01/27/2023] Open
Abstract
Type-2 diabetes mellitus (T2DM) is often linked with hyperglycemia, disturbed lipid profiles, inflammation, and gut dysbiosis. Omega-3 fatty acid supplementation has a vital role in the management of T2DM. As a result, a better understanding of the potential role of omega-3 fatty acids in the development and progression of T2DM by influencing the intestinal microflora will help to improve the therapeutic intervention for T2DM and related complications. Focusing on the molecular mechanisms and signaling pathways induced by omega-3 fatty acids, this paper attempts to comprehensively review and discuss the putative associations between omega-3 fatty acids, gut dysbiosis, and the pathophysiology of T2DM and its related comorbidities. In addition, we contemplate the importance of gut microbiota in T2DM prevention and treatment and ponder the role of omega-3 fatty acids in T2DM by positively modulating gut microbiota, which may lead to discovery of novel targets and therapeutic strategies thereby paving way for further comprehensive, mechanistic, and clinical studies.
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Ackerman-Banks CM, Grechukhina O, Spatz E, Lundsberg L, Chou J, Smith G, Greenberg VR, Reddy UM, Xu X, O'Bryan J, Smith S, Perley L, Lipkind HS. Seizing the Window of Opportunity Within 1 Year Postpartum: Early Cardiovascular Screening. J Am Heart Assoc 2022; 11:e024443. [PMID: 35411781 PMCID: PMC9238464 DOI: 10.1161/jaha.121.024443] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background Our objective was to assess new chronic hypertension 6 to 12 months postpartum for those with hypertensive disorder of pregnancy (HDP) compared with normotensive participants. Methods and Results We performed a prospective cohort study of participants with singleton gestations and no known preexisting medical conditions who were diagnosed with HDP compared with normotensive women with no pregnancy complications (non-HDP). Participants underwent cardiovascular risk assessment 6 to 12 months after delivery. Primary outcome was onset of new chronic hypertension at 6 to 12 months postpartum. We also examined lipid values, metabolic syndrome, prediabetes, diabetes, and 30-year cardiovascular disease (CVD) risk. Multivariable logistic regression was performed to assess the association between HDP and odds of a postpartum diagnosis of chronic hypertension while adjusting for parity, body mass index, insurance, and family history of CVD. There were 58 participants in the HDP group and 51 participants in the non-HDP group. Baseline characteristics between groups were not statistically different. Participants in the HDP group had 4-fold adjusted odds of developing a new diagnosis of chronic hypertension 6 to 12 months after delivery, compared with those in the non-HDP group (adjusted odds ratio, 4.60 [95% CI, 1.65-12.81]), when adjusting for body mass index, parity, family history of CVD, and insurance. Of the HDP group, 58.6% (n=34) developed new chronic hypertension. Participants in the HDP group had increased estimated 30-year CVD risk and were more likely to have metabolic syndrome, a higher fasting blood glucose, and higher low-density lipoprotein cholesterol. Conclusions Participants without known underlying medical conditions who develop HDP have 4-fold increased odds of new diagnosis of chronic hypertension by 6 to 12 months postpartum as well as increased 30-year CVD risk scores. Implementation of multidisciplinary care models focused on CVD screening, patient education, and lifestyle interventions during the first year postpartum may serve as an effective primary prevention strategy for the development of CVD.
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Affiliation(s)
| | - Olga Grechukhina
- Department of Obstetrics, Gynecology, & Reproductive Science Yale University New Haven CT
| | - Erica Spatz
- Section of Cardiovascular Medicine Yale University New Haven CT
| | - Lisbet Lundsberg
- Department of Obstetrics, Gynecology, & Reproductive Science Yale University New Haven CT
| | - Josephine Chou
- Section of Cardiovascular Medicine Yale University New Haven CT
| | - Graeme Smith
- Kingston General Hospital Kingston Ontario Canada
| | - Victoria R Greenberg
- Department of Obstetrics and Gynecology Medstar Georgetown University Hospital Washington DC
| | - Uma M Reddy
- Department of Obstetrics and Gynecology Columbia University New York NY
| | - Xiao Xu
- Department of Obstetrics, Gynecology, & Reproductive Science Yale University New Haven CT
| | - Jane O'Bryan
- Department of Obstetrics, Gynecology, & Reproductive Science Yale University New Haven CT
| | - Shelby Smith
- University of Connecticut School of Medicine Hartford CT
| | - Lauren Perley
- Department of Obstetrics, Gynecology, & Reproductive Science Yale University New Haven CT
| | - Heather S Lipkind
- Department of Obstetrics, Gynecology, & Reproductive Science Yale University New Haven CT
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103
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Ferraro RA, Leucker T, Martin SS, Banach M, Jones SR, Toth PP. Contemporary Management of Dyslipidemia. Drugs 2022; 82:559-576. [PMID: 35303294 PMCID: PMC8931779 DOI: 10.1007/s40265-022-01691-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2022] [Indexed: 12/30/2022]
Abstract
The treatment of dyslipidemia continues to be a dynamic and controversial topic. Even the most appropriate therapeutic range for lipid levels-including that of triglycerides and low-density lipoprotein cholesterol-remain actively debated. Furthermore, with ever-increasing options and available treatment modalities, the management of dyslipidemia has progressed in both depth and complexity. An understanding of appropriate lipid-lowering therapy remains an essential topic of review for practitioners across medical specialties. The goal of this review is to provide an overview of recent research developments and recommendations for patients with dyslipidemia as a means of better informing the clinical practice of lipid management. By utilizing a guideline-directed approach, we provide a reference point on optimal lipid-lowering therapies across the spectrum of dyslipidemia. Special attention is paid to long-term adherence to lipid-lowering therapies, and the benefits derived from instituting appropriate medications in a structured manner alongside monitoring. Novel therapies and their impact on lipid lowering are discussed in detail, as well as potential avenues for research going forward. The prevention of cardiovascular disease remains paramount, and this review provides a roadmap for instituting appropriate therapies in cardiovascular disease prevention.
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Affiliation(s)
- Richard A Ferraro
- From the Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thorsten Leucker
- From the Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Seth S Martin
- From the Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz, Lodz, Poland
| | - Steven R Jones
- From the Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter P Toth
- From the Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- CGH Medical Center, 101 East Miller Road, Sterling, IL, 61081, USA.
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Parhofer KG, Birkenfeld AL, Krone W, Lehrke M, Marx N, Merkel M, Schütt KS, Zirlik A, Müller-Wieland D. Position Paper on Lipid Therapy in Patients with Diabetes Mellitus. Exp Clin Endocrinol Diabetes 2022; 130:S117-S122. [PMID: 35359011 DOI: 10.1055/a-1624-3572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Klaus G Parhofer
- Department of Medicine IV, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Andreas L Birkenfeld
- Department of Internal Medicine IV, University Hospital, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases (IDM) of Helmholtz Zentrum München at the University of Tübingen, German Centre for Diabetes Research, Germany
| | - Wilhelm Krone
- Center for Endocrinology, Diabetology and Preventive Medicine, University Hospital Cologne, Cologne, Germany
| | - Michael Lehrke
- Department of Internal Medicine I - Cardiology, Angiology and Internal Intensive Care Medicine, University Hospital Aachen, Aachen, Germany
| | - Nikolaus Marx
- Department of Internal Medicine I - Cardiology, Angiology and Internal Intensive Care Medicine, University Hospital Aachen, Aachen, Germany
| | | | - Katharina S Schütt
- Department of Internal Medicine I - Cardiology, Angiology and Internal Intensive Care Medicine, University Hospital Aachen, Aachen, Germany
| | - Andreas Zirlik
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Austria
| | - Dirk Müller-Wieland
- Department of Internal Medicine I - Cardiology, Angiology and Internal Intensive Care Medicine, University Hospital Aachen, Aachen, Germany
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105
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Wu QL, Zheng T, Li SZ, Chen JA, Xie ZC, Lai JM, Zeng JY, Lin JT, Huang JS, Lin MH. Effects of dapagliflozin in the progression of atherosclerosis in patients with type 2 diabetes: a meta-analysis of randomized controlled trials. Diabetol Metab Syndr 2022; 14:41. [PMID: 35272683 PMCID: PMC8908556 DOI: 10.1186/s13098-022-00810-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/23/2022] [Indexed: 02/07/2023] Open
Abstract
AIMS At present, an increasing number of studies are trying to determine whether dapagliflozin has a significant effect on the occurrence and development of atherosclerosis in patients with type 2 diabetes mellitus (T2DM), but there is no consensus. In addition, the former meta-analyses, relying on only a few previous studies and a minimal number of research indicators, have not been able to draw sufficient conclusions simultaneously. Consequently, we conducted a meta-analysis to evaluate the effectiveness of dapagliflozin in the occurrence and development of atherosclerosis in patients with T2DM. METHODS We searched electronic databases (PubMed, Embase, Cochrane, and Scopus) and reference lists in relevant papers for articles published in 2011-2021. We selected studies that evaluated the effects of dapagliflozin on the risk factors related to the occurrence or development of atherosclerosis in patients with T2DM. A fixed or random-effect model calculated the weighted average difference of dapagliflozin on efficacy, and the factors affecting heterogeneity were determined by Meta-regression analysis. RESULTS Twelve randomized controlled trials (18,758 patients) were incorporated in our meta-analysis. In contrast with placebo, dapagliflozin was associated with a significantly increase in high density lipoprotein-cholesterol (HDL-C) [MD = 1.39; 95% CI (0.77, 2.01); P < 0.0001], Δflow-mediated vasodilatation (ΔFMD) [MD = 1.22; 95% CI (0.38, 2.06); P = 0.005] and estimated Glomerular Filtration Rate(eGFR) [MD = 1.94; 95% CI (1.38, 2.51); P < 0.00001]. Furthermore, dapagliflozin had a tremendous advantage in controlling triglycerides (TG) in subgroups whose baseline eGFR < 83 ml/min/1.73m2 [MD = - 10.38; 95% CI (- 13.15, - 7.60); P < 0.00001], systolic blood pressure (SBP) [MD = - 2.82; 95% CI (- 3.22, - 2.42); P < 0.00001], HbA1c, BMI, body weight and waist circumference. However, dapagliflozin has an adverse effect on increasing total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C). Besides, there were no significant changes in other indicators, including adiponectin and C-peptide immunoreactivity. CONCLUSIONS Our pooled analysis suggested that dapagliflozin has a terrifically better influence over HDL-C, ΔFMD, and eGFR, and it concurrently had a tremendous advantage in controlling TG, SBP, DBP, HbA1c, BMI, body weight, and waist circumference, but it also harms increasing TC and LDL-C. Furthermore, this study found that the effect of dapagliflozin that decreases plasma levels of TG is only apparent in subgroups of baseline eGFR < 83 ml/min/1.73m2, while the subgroup of baseline eGFR ≥ 83 ml/min/1.73m2 does not. Finally, the above results summarize that dapagliflozin could be a therapeutic option for the progression of atherosclerosis in patients with T2DM. Systematic review registration PROSPERO CRD42021278939.
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Affiliation(s)
- Qian-Long Wu
- Guangzhou Medical University, Guangzhou, 511436, China
| | - Ting Zheng
- Department of Rehabilitation Medicine, Hospital for the Aged Guangzhou, Guangzhou, 510550, China.
| | - Sheng-Zhen Li
- Guangzhou Medical University, Guangzhou, 511436, China
| | - Jin-An Chen
- Guangzhou Medical University, Guangzhou, 511436, China
| | - Zi-Chun Xie
- Guangzhou Medical University, Guangzhou, 511436, China
| | - Jian-Mei Lai
- Guangzhou Medical University, Guangzhou, 511436, China
| | - Ji-Yuan Zeng
- Guangzhou Medical University, Guangzhou, 511436, China
| | - Jin-Ting Lin
- Guangzhou Medical University, Guangzhou, 511436, China
| | | | - Min-Hua Lin
- Guangzhou Medical University, Guangzhou, 511436, China
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106
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Puri R, Mehta V, Duell P, Iyengar S, Yusuf J, Dalal J, Narasingan S, Kalra D, Kapoor A, Pradhan A, Mukhopadhyay S, Vijayaraghavan K, Aggarwal R, Muruganathan A, Prabhakar D, Misra S, Shetty S, Kasliwal RR, Bansal M, Khanna NN, Khan A, Melinkeri RP, Kumar S, Chakraborty RN, Bardoloi N, Sahoo P, Vinayagam P, Modi R, Nanda R, Wong ND. Evidence for Intensive LDL-C Lowering for Acute Coronary Syndrome: Recommendations from the Lipid Association of India. J Clin Lipidol 2022; 16:261-271. [PMID: 35508456 DOI: 10.1016/j.jacl.2022.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/28/2022] [Accepted: 03/20/2022] [Indexed: 02/08/2023]
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107
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Atherosclerosis in HIV Patients: What Do We Know so Far? Int J Mol Sci 2022; 23:ijms23052504. [PMID: 35269645 PMCID: PMC8910073 DOI: 10.3390/ijms23052504] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/20/2022] [Accepted: 02/21/2022] [Indexed: 12/21/2022] Open
Abstract
For the past several decades, humanity has been dealing with HIV. This disease is one of the biggest global health problems. Fortunately, modern antiretroviral therapy allows patients to manage the disease, improving their quality of life and their life expectancy. In addition, the use of these drugs makes it possible to reduce the risk of transmission of the virus to almost zero. Atherosclerosis is another serious pathology that leads to severe health problems, including disability and, often, the death of the patient. An effective treatment for atherosclerosis has not yet been developed. Both types of immune response, innate and adaptive, are important components of the pathogenesis of this disease. In this regard, the peculiarities of the development of atherosclerosis in HIV carriers are of particular scientific interest. In this review, we have tried to summarize the data on atherosclerosis and its development in HIV carriers. We also looked at the classic therapeutic methods and their features concerning the concomitant diagnosis.
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108
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Yu J, Liu X, Chen S, Liu Y, Liu H, Zheng H, Yang N, Wu S, Li Y. Effects of low-density lipoprotein cholesterol on cardiovascular disease and all-cause mortality in elderly patients (≥75 years old). Endocrine 2022; 75:418-426. [PMID: 34618323 DOI: 10.1007/s12020-021-02870-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/04/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Although increased low-density lipoprotein cholesterol (LDL-C) is one of the major risk factors for the cardiovascular disease (CVD), the associations of LDL-C with CVD and all-cause mortality are unclear in elderly (≥75 years) individuals. METHODS A total of 3674 individuals aged 75 or older underwent medical examinations at the Kailuan Group from 2006 to 2007, including 3478 males (94.67%) and 196 females (5.33%). Participants were divided into three groups based on the LDL-C level: the ideal level (LDL-C < 100 mg/dl), appropriate level (100 mg/dl ≤ LDL-C < 130 mg/dl) and elevated level (LDL-C ≥ 130 mg/dl) groups. CVD and all-cause mortality events were recorded during the follow-up period. The Cox proportional hazards regression model was applied to evaluate the effects of LDL-C on CVD and all-cause mortality events. RESULTS The average follow-up time was 9.87 ± 3.60 years. After adjustment for confounding factors, the multivariate Cox proportional hazards regression model showed that the CVD risk in the elevated level group was 1.45 (95% CI, 1.08-1.95), acute myocardial infarction risk was 1.96 (95% CI, 1.19-3.24) and all-cause mortality risk was 1.18 (95% CI, 1.02-1.37) compared with those in the ideal level group. For every standard deviation increase in LDL-C levels, the CVD risk increased by 10%, acute myocardial infarction risk increased by 21% and all-cause mortality event risk increased by 4%. No association was observed between elevated LDL-C levels and the risk of stroke. CONCLUSIONS In the sample of older Chinese individuals investigated in the present study, elevated LDL-C levels (≥130 mg/dl) are a risk factor for CVD and all-cause mortality.
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Affiliation(s)
- Jiaxin Yu
- Department of Graduate School, Tianjin Medical University, 300051, Tianjin, P.R. China
- Department of Cardiology, Tangshan Worker's Hospital, 063000, Tangshan, P.R. China
| | - Xiaokun Liu
- Department of Cardiology, Tangshan Worker's Hospital, 063000, Tangshan, P.R. China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, 063000, Tangshan, P.R. China
| | - Yan Liu
- Department of Cardiology, Kailuan General Hospital, 063000, Tangshan, P.R. China
| | - HongMin Liu
- Department of Cardiology, Kailuan General Hospital, 063000, Tangshan, P.R. China
| | - Hongwei Zheng
- Department of Cardiology, Tangshan Worker's Hospital, 063000, Tangshan, P.R. China
| | - Ning Yang
- Department of Cardiology, TEDA International Cardiovascular Hospital, 300457, Tianjin, P.R. China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, 063000, Tangshan, P.R. China.
| | - Yuming Li
- Department of Cardiology, TEDA International Cardiovascular Hospital, 300457, Tianjin, P.R. China.
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109
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Lumsden RH, Pagidipati N. Management of cardiovascular risk factors during pregnancy. Heart 2022; 108:1438-1444. [DOI: 10.1136/heartjnl-2021-319606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/02/2021] [Indexed: 11/04/2022] Open
Abstract
Cardiovascular (CV) risk factors are rising among women of reproductive age. Obesity, hyperlipidaemia, diabetes, and hypertension are associated with adverse pregnancy outcomes and increased CV disease (CVD) risk following pregnancy. Pre-conception counselling and longitudinal postpartum follow-up with ongoing CV risk factor screening are critical for early CVD prevention, though significant racial/ethnic disparities in access to care result in significant gaps. This review summarises the recommended management of CV risk factors during and after pregnancy. For obesity, prevention of excessive weight gain is critical. Except in rare cases, lipid-lowering therapies for women with hyperlipidaemia should be stopped before pregnancy. Women with diabetes in pregnancy should maintain tight glucose control, with hemolgobin A1c (HbA1c) <6.5% to prevent congenital abnormalities. Hypertensive disorders of pregnancy are associated with high maternal and neonatal morbidity and require long-term follow-up to prevent future CVD. Finally, this review highlights the lack of clinical trials informing optimal treatment strategies of CV risk factors during and after pregnancy. Further research is needed to better understand how to improve long-term CV health among this high-risk population.
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110
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Shan Y, Wang Q, Zhang Y, Tong X, Pu S, Xu Y, Gao X. High remnant cholesterol level is relevant to diabetic retinopathy in type 2 diabetes mellitus. Lipids Health Dis 2022; 21:12. [PMID: 35057797 PMCID: PMC8772129 DOI: 10.1186/s12944-021-01621-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/29/2021] [Indexed: 02/06/2023] Open
Abstract
Background Diabetic retinopathy (DR) is the primary oculopathy causing blindness in diabetic patients. Currently, there is increasing interest in the role of lipids in the development of diabetic retinopathy, but it remains controversial. Remnant cholesterol (RC) is an inexpensive and easily measurable lipid parameter; however, the relationship between RC and DR in type 2 diabetes mellitus (T2DM) has not been elucidated. This research investigates the relevance between RC levels and DR severity while building a risk prediction model about DR. Methods In this single-centre retrospective cross-sectional study. Each hospitalised T2DM patient had no oral lipid-lowering drugs in the past three months, and coronary angiography showed epicardial coronary artery stenosis of less than 50% and completed seven-field stereo photographs, fluorescein fundus angiography, and optical coherence tomography detection. The RC value is calculated according to the internationally recognised formula. Binary logistic regression was used to correct confounding factors, and the receiver operating characteristic (ROC) analysis was used to identify risk factors and assess the nomogram’s diagnostic efficiency. Results A total of 456 T2DM patients were included in the study. The RC levels in the DR team was higher [0.74 (0.60–1.12) mmo/l vs 0.54 (0.31–0.83) mmol/l P < 0.001] in the non-DR team. After adjusting for confounding elements, RC levels are still associated with DR risk (OR = 5.623 95%CI: 2.996–10.556 P < 0.001). The ratio of DR in every stage (except mild non-proliferative diabetic retinopathy) and DME in the high RC level team were further increased compared to the low-level team (all P < 0.001). After ROC analysis, the overall risk of DR was predicted by a nomogram constructed for RC, diabetes duration, and the neutrophil-lymphocyte ratio as 0.758 (95%CI 0.714–0.802 P < 0.001). Conclusions High RC levels may be a potential risk factor for diabetic retinopathy, and the nomogram does better predict DR. Despite these essential findings, the limitation of this study is that it is single-centred and small sample size analysis. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-021-01621-7.
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111
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Vallée A. Association Between Lipids and Arterial Stiffness for Primary Cardiovascular Prevention in a General Middle-Aged European Population. Front Cardiovasc Med 2022; 9:899841. [PMID: 35711343 PMCID: PMC9197205 DOI: 10.3389/fcvm.2022.899841] [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: 03/19/2022] [Accepted: 05/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background Dyslipidemia contributes to the progression of arterial stiffness (AS). The purpose of this study was to investigate the association of the different lipid parameters with arterial stiffness index (ASI) in a middle-aged population free of cardiovascular (CV) disease. Methods Among 71,326 volunteers from the UK Biobank population, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), lipoprotein (a) [Lp(a)], apolipoproteins A and B (Apo A and Apo B), and ASI were measured. Values for non-HDL, TC/HDL, TG/HDL, and LDL/HDL were calculated. AS was defined as an ASI > 10 m/s. Associations between lipid parameters and ASI were performed using multiple linear logistic regressions. The results reported from univariate models were the squared partial correlation coefficient, r 2, and from multivariate models, the adjusted coefficient of determination, R 2, to describe the contribution of ASI variability for each lipid parameter. Results We found that TG/HDL was mainly associated with ASI [β = 0.53 (0.01), r 2 = 3.66%, p < 0.001 and adjusted β = 0.21 (0.01), R 2 = 13.58%, p < 0.001] and AS [odds ratio (OR) = 1.86 (1.80-1.92), r 2 = 1.65%, p < 0.001 and adjusted OR = 1.15 (1.13-1.17), R 2 = 8.54%, p < 0.001] rather than the others. TG/HDL remained the only lipid parameter that showed added value in linear multivariate models. TG/HDL remained less associated with AS than age (r 2 = 5.55%, p < 0.001), mean blood pressure (BP; r 2 = 5.31%, p < 0.001), and gender (r 2 = 4.44%, p < 0.001), but more highly associated than body mass index (BMI; r 2 = 1.95%, p < 0.001), heart rate (HR; r 2 = 0.81%, p < 0.001), fasting glucose (r 2 = 0.18%, p < 0.001), tobacco (r 2 = 0.05%, p < 0.001), and glomerular filtration rate (GFR; r 2 = 0.01%, p < 0.001). Conclusions In primary CV prevention, lipids, especially through the TG/HDL ratio, could be more instructive in preventing the increase in AS than other modifiable factors.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation (DRCI), Foch Hospital, Suresnes, France
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112
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Pharmacokinetics and pharmacodynamics of inclisiran, a small interfering RNA therapy, in patients with hepatic impairment. J Clin Lipidol 2022; 16:208-219. [DOI: 10.1016/j.jacl.2022.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/17/2021] [Accepted: 01/03/2022] [Indexed: 11/23/2022]
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113
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Zhu X, Yang Z, He Z, Hu J, Yin T, Bai H, Li R, Cai L, Guo H, Li M, Yan T, Li Y, Shen C, Sun K, Liu Y, Sun Z, Wang B. Factors correlated with targeted prevention for prediabetes classified by impaired fasting glucose, impaired glucose tolerance, and elevated HbA1c: A population-based longitudinal study. Front Endocrinol (Lausanne) 2022; 13:965890. [PMID: 36072930 PMCID: PMC9441664 DOI: 10.3389/fendo.2022.965890] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is still controversy surrounding the precise characterization of prediabetic population. We aim to identify and examine factors of demographic, behavioral, clinical, and biochemical characteristics, and obesity indicators (anthropometric characteristics and anthropometric prediction equation) for prediabetes according to different definition criteria of the American Diabetes Association (ADA) in the Chinese population. METHODS A longitudinal study consisted of baseline survey and two follow-ups was conducted, and a pooled data were analyzed. Prediabetes was defined as either impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or elevated glycosylated hemoglobin (HbA1c) according to the ADA criteria. Robust generalized estimating equation models were used. RESULTS A total of 5,713 (58.42%) observations were prediabetes (IGT, 38.07%; IGT, 26.51%; elevated HbA1c, 23.45%); 9.66% prediabetes fulfilled all the three ADA criteria. Among demographic characteristics, higher age was more evident in elevated HbA1c [adjusted OR (aOR)=2.85]. Female individuals were less likely to have IFG (aOR=0.70) and more likely to suffer from IGT than male individuals (aOR=1.41). Several inconsistency correlations of biochemical characteristics and obesity indicators were detected by prediabetes criteria. Body adiposity estimator exhibited strong association with prediabetes (D10: aOR=4.05). For IFG and elevated HbA1c, the odds of predicted lean body mass exceed other indicators (D10: aOR=3.34; aOR=3.64). For IGT, predicted percent fat presented the highest odds (D10: aOR=6.58). CONCLUSION Some correlated factors of prediabetes under different criteria differed, and obesity indicators were easily measured for target identification. Our findings could be used for targeted intervention to optimize preventions to mitigate the obviously increased prevalence of diabetes.
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Affiliation(s)
- Xiaoyue Zhu
- Key Laboratory of Environment Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Zhipeng Yang
- School of Software, Fudan University, Shanghai, China
| | - Zhiliang He
- Key Laboratory of Environment Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Jingyao Hu
- Key Laboratory of Environment Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Tianxiu Yin
- Key Laboratory of Environment Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Hexiang Bai
- Key Laboratory of Environment Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Ruoyu Li
- Key Laboratory of Environment Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Le Cai
- Key Laboratory of Environment Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Haijian Guo
- Integrated Business Management Office, Jiangsu Province Centre Disease Control and Prevention, Nanjing, China
| | - Mingma Li
- Key Laboratory of Environment Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Tao Yan
- Key Laboratory of Environment Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - You Li
- Key Laboratory of Environment Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Chenye Shen
- Key Laboratory of Environment Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Kaicheng Sun
- Yandu Centre for Disease Control and Prevention, Yancheng, China
| | - Yu Liu
- Jurong Centre for Disease Control and Prevention, Jurong, China
| | - Zilin Sun
- Department of Endocrinology, Institute of Diabetes, Medical School, Southeast University, Nanjing, China
| | - Bei Wang
- Key Laboratory of Environment Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- *Correspondence: Bei Wang,
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Kim KS, Hong S, Han K, Park CY. Assessing the Validity of the Criteria for the Extreme Risk Category of Atherosclerotic Cardiovascular Disease: A Nationwide Population-Based Study. J Lipid Atheroscler 2022; 11:73-83. [PMID: 35118023 PMCID: PMC8792820 DOI: 10.12997/jla.2022.11.1.73] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/17/2021] [Accepted: 07/21/2021] [Indexed: 12/03/2022] Open
Abstract
Objective To validate the criteria for the extreme risk category for atherosclerotic cardiovascular disease (ASCVD). Methods An observational cohort study of 35,464 individuals with established ASCVD was performed using the National Health Information Database. Incident myocardial infarction (MI), ischemic stroke, and death in patients with established ASCVD was investigated to validate the criteria for the extreme risk category of ASCVD defined as the presence of diabetes mellitus (DM), chronic kidney disease (CKD), and history of premature ASCVD. Results Among 35,464 patients, 77.97% of them were classified into the extreme risk group of ASCVD. A total of 28.10%, 39.61%, and 32.12% had DM, CKD, and a history of premature ASCVD, respectively. During a mean follow-up of 8.39 years, MI, ischemic stroke, and all-cause death were found in 3.87%, 8.51%, and 23.98% of participants, respectively. In multivariate analysis, patients with DM had higher risk for MI (hazard ratio [HR], 1.62; 95% confidence interval [CI], 1.45–1.81), ischemic stroke (HR, 1.39; 95% CI, 1.29–1.50), and all-cause death (HR, 1.52; 95% CI, 1.45–1.59) than those without DM. Patients with CKD had 1.56 times higher risk for MI, 1.12 times higher risk for ischemic stroke, and 1.34 times higher risk for death than those without CKD. However, the risk for MI, ischemic stroke, and all-cause death was not different between patients with and without a history of premature ASCVD. Conclusion DM and CKD, but not a history of premature ASCVD, could be considered as reasonable criteria of an extreme risk for ASCVD.
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Affiliation(s)
- Kyung-Soo Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Sangmo Hong
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Cheol-Young Park
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Vuković-Dejanović V, Spasojević-Kalimanovska V, Kalimanovska-Oštrić D, Bogavac-Stanojević N. Does Pentraxin-3 contribute to the reduction of low-density lipoprotein levels by statin therapy? ARHIV ZA FARMACIJU 2022. [DOI: 10.5937/arhfarm72-36122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Statins have been shown to decrease inflammatory markers, especially high sensitivity C reactive protein (hsCRP), in a dose-dependent manner. Pentraxin-3 (PTX3) is another important inflammatory biomarker from the pentraxin family that provides useful prognostic information and facilitates diagnostics of cardiovascular diseases. This study investigated the effect of statin therapy on PTX3 and hsCRP concentrations and whether statins acted synergistically with PTX3 and hsCRP concentrations in lowering LDL-C. The study group consisted of 90 patients undergoing coronary angiography. The results showed that statins reduced PTX3 concentrations (p=0.031). PTX3 and hsCRP levels were significantly different between subclinical and severe stenosis groups (p=0.011 and p=0.009, respectively). Statin therapy was significantly associated with lower PTX3 and LDL-C levels in multiple logistic analyses. The probability that statin therapy would achieve target LDL-C values was highest in patients with low PTX3 values (OR=3.683, p=0.040), while multiplicative interaction was 23.3. The effect of statins on PTX3 reduction was higher than on hsCRP. It can be suggested that statin therapy was more successful in patients with low PTX3 values.
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Wang J, Yin J, Qiu J, Jiang J, Hu Y, Zhu K, Zheng H, Luo T, Zhong X. Comparison of dyslipidemia incidence in Chinese early-stage breast cancer patients following different endocrine therapies: A population-based cohort study. Front Endocrinol (Lausanne) 2022; 13:815960. [PMID: 36147563 PMCID: PMC9486544 DOI: 10.3389/fendo.2022.815960] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is lack of large-scale real-world research evidence showing the impact of endocrine therapy on blood lipids in Chinese breast cancer patients, especially those with premenopausal breast cancer. Based on a large breast cancer cohort at West China Hospital, we aimed to compare the risk of dyslipidemia between premenopausal and postmenopausal women based on the endocrine therapy used. METHODS A total of 1,883 early-stage breast cancer (EBC) patients who received endocrine monotherapy [selective estrogen receptor modulator (SERM) and aromatase inhibitor (AI), with or without ovarian function suppression] with normal blood lipid levels at baseline were retrospectively included between October 2008 and April 2017. Dyslipidemia was defined as an abnormality in cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein, and total cholesterol (TC) levels. The risk accumulation function was used to calculate the incidence of dyslipidemia in order to assess the absolute risk, while the multivariate Cox regression model was used to calculate the relative risk of dyslipidemia between the groups. RESULTS Patients with EBC were followed up for 60 months to monitor their blood lipid levels. The accumulated 5-year incidence of dyslipidemia in postmenopausal patients was higher than that in premenopausal patients (adjusted HR [95% confidence interval], 1.25 [1.01-1.56], 41.7% vs. 31.2%, p = 0.045). In premenopausal patients, the risk of abnormal TC was significantly higher in the OFS+AI group compared with that in the SERM group (adjusted HR [95% CI], 6.24 [3.19-12.20], p < 0.001, 5-year abnormal rates: 21.5% vs. 2.4%), and that of abnormal LDL-C level also increased (adjusted HR [95% CI], 10.54 [3.86-28.77], p < 0.001, 5-year abnormal rates: 11.1% vs. 0.9%). In postmenopausal patients, the risk of abnormal TC or LDL-C levels showed a similar trend in the AI and SERM groups. CONCLUSIONS In addition to postmenopausal patients, dyslipidemia is also common in premenopausal Chinese patients with EBC who received endocrine therapy. Irrespective of menopausal status, AI treatment increases the risk of TC/LDL-C dyslipidemia than SERM treatment.
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Affiliation(s)
- Junren Wang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Jin Yin
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
- School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiajun Qiu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Jingwen Jiang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yao Hu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Kunrui Zhu
- Cancer Center, Breast Disease Center, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Molecular Diagnosis of Cancer, Clinical Research Center for Breast, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Zheng
- Cancer Center, Breast Disease Center, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Molecular Diagnosis of Cancer, Clinical Research Center for Breast, West China Hospital, Sichuan University, Chengdu, China
| | - Ting Luo
- Cancer Center, Breast Disease Center, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Molecular Diagnosis of Cancer, Clinical Research Center for Breast, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaorong Zhong
- Cancer Center, Breast Disease Center, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Molecular Diagnosis of Cancer, Clinical Research Center for Breast, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Xiaorong Zhong,
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Guan P, Su Y, Wang M, Ye X, Hang Y, Li D, Zhang P, Hu W. A wide range of triglyceride levels is sufficient for fetal growth at gestational weeks 12-16, but higher triglyceride levels are associated with gestational hypertension. Pregnancy Hypertens 2021; 27:74-80. [PMID: 34973596 DOI: 10.1016/j.preghy.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/14/2021] [Accepted: 12/22/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To learn whether and how lipid levels are associated with gestational hypertension and fetal growth in normal pregnancy. STUDY DESIGN In a case-control study course, 464 patients with gestational hypertension were pooled into a case group; a total of 1077 women with full-term pregnancies and no pregnancy complications were selected as controls. In a cross-sectional study, whether maternal lipid levels were associated with fetal growth were evaluated in 1077 healthy controls. MAIN OUTCOME MEASURES Maternal lipids and glucose levels and fetal measurements. RESULTS Maternal levels of triglyceride (TG) were significantly higher in the case group than in controls at gestational weeks 12-16. Levels of TG, total cholesterol (TC) and low-densitylipoprotein (LDL-C) in control mothers increased gradually and significantly with increasing gestational week, however, these lipid concentrations lost these steady elevating trends with gestational week increases in the cases. Binary logistic regression showed that TG is a risk factor associated with hypertension at gestational weeks 12-16 and independent to maternal blood levels of LDL-C and glucose. Of the healthy mothers at gestational weeks 12-16, quantile regression showed that TG levels were not associated with real-time fetal growth measurements or final birthweight. The reference standards for maternal TG levels were estimated via the 10th, 25th, 50th, 75th, and 90th percentiles by gestational week. CONCLUSIONS Maternal TG levels are associated with gestational hypertension, and a wide range of TG levels is sufficient for fetal growth within a given gestational week.
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Affiliation(s)
- Ping Guan
- Department of Cardiology, Minhang Hospital, Fudan University, 170 Xinsong Road, Minhang District, Shanghai 201199, PR China
| | - Yanling Su
- Department of Cardiology, Minhang Hospital, Fudan University, 170 Xinsong Road, Minhang District, Shanghai 201199, PR China
| | - Man Wang
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, 170 Xinsong Road, Minhang District, Shanghai 201199, PR China
| | - Xiaomiao Ye
- Department of Cardiology, Minhang Hospital, Fudan University, 170 Xinsong Road, Minhang District, Shanghai 201199, PR China
| | - Yanwen Hang
- Department of Cardiology, Minhang Hospital, Fudan University, 170 Xinsong Road, Minhang District, Shanghai 201199, PR China
| | - Dandan Li
- Department of Cardiology, Minhang Hospital, Fudan University, 170 Xinsong Road, Minhang District, Shanghai 201199, PR China
| | - Peng Zhang
- Department of Cardiology, Minhang Hospital, Fudan University, 170 Xinsong Road, Minhang District, Shanghai 201199, PR China
| | - Wei Hu
- Department of Cardiology, Minhang Hospital, Fudan University, 170 Xinsong Road, Minhang District, Shanghai 201199, PR China.
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Abstract
Low-quality dietary patterns impair cardiometabolic health by increasing the risk of obesity-related disorders. Cardiometabolic risk relative to dairy-food consumption continues to be a controversial topic, due to recommendations that endorse low-fat and nonfat dairy foods over full-fat varieties despite accumulated evidence that does not strongly support these recommendations. Controlled human studies and mechanistic preclinical investigations support that full-fat dairy foods decrease cardiometabolic risk by promoting gut health, reducing inflammation, and managing dyslipidemia. These gut- and systemic-level cardiometabolic benefits are attributed, at least in part, to milk polar lipids (MPLs) derived from the phospholipid- and sphingolipid-rich milk fat globule membrane that is of higher abundance in full-fat dairy milk. The controversy surrounding full-fat dairy food consumption is discussed in this review relative to cardiometabolic health and MPL bioactivities that alleviate dyslipidemia, shift gut microbiota composition, and reduce inflammation. This summary, therefore, is expected to advance the understanding of full-fat dairy foods through their MPLs and the need for translational research to establish evidence-based dietary recommendations.
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Affiliation(s)
- Richard S Bruno
- Human Nutrition Program, The Ohio State University, Columbus, Ohio, USA
| | - Avinash Pokala
- Human Nutrition Program, The Ohio State University, Columbus, Ohio, USA
| | | | - Christopher N Blesso
- Department of Nutritional Sciences, University of Connecticut, Storrs, Connecticut, USA
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Odhaib KJ, Al-Hajjar QN, Alallawee MHA. Incorporation of Herbal Plants in the Diet of Ruminants: Effect on Meat Quality. THE IRAQI JOURNAL OF VETERINARY MEDICINE 2021. [DOI: 10.30539/ijvm.v45i1.1036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The use of herbal plants as food additives in animal nutrition to enhance meat processing efficiency and meat quality has been reviewed. Today, the consumer demand is safety, nutritive value, taste, uniformity, meat variety, and good appearance of meat products. Thus, to meet the consumers' demand, development of product and research should be improved. Studies have been shown that the use of herbs, spices, and their extracts are of the major interventions, which were adopted in the industry of the meat for improving its quality traits. In the present paper, the most recent literature about use of bioactive compounds in herbal plants for evaluating a number of parameters related to meat quality, including fat content and distribution, water content, water holding capacity, collagen content, pH, tenderness color, lipid oxidation and flavor were reviewed.
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Influence of Gegenqinlian Decoction on Pharmacokinetics and Pharmacodynamics of Atorvastatin Calcium in Hyperlipidemic Rats. Eur J Drug Metab Pharmacokinet 2021; 47:117-126. [PMID: 34855161 DOI: 10.1007/s13318-021-00738-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Gegenqinlian decoction (GQD), a classic traditional Chinese medicine (TCM), was described in Shanghan Lun. GQD is often combined with antihyperlipidemic drugs (mainly atrovastatin calcium) in TCM clinics. However, the herb-drug interaction between GQD and atrovastatin calcium (AC) is still unknown. To determine whether the combination is safe, we evaluated the effects of GQD on the activities of cytochrome P450 (CYP) 3A2 enzyme and investigated the impact of GQD on the pharmacokinetics and pharmacodynamics of AC in rats. METHODS The pharmacokinetics of AC (10 mg/kg) with or without pretreatment with GQD (freeze-dried powder, 1.35 g/kg) were investigated using HPLC. The influence of GQD on pharmacodynamics of AC were determined by detecting the levels of serum total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Moreover, the probe drug method was used to explore the effect of GQD on CYP3A2 activity. RESULTS The pharmacokinetic parameters of AC combined with GQD were significantly affected (P < 0.05) in hyperlipidemic rats. The serum TC, TG and LDL-C levels of the combination were significantly reduced (P < 0.05), and the serum HDL-C level was significantly increased (P < 0.05) compared with AC/GQD alone. AST and ALT activities treated with both GQD and AC+GQD group were significantly reduced (P < 0.05) compared with AC group. There was a significant difference in the pharmacokinetic parameters of midazolam between control and GQD groups (P < 0.05). Maximum concentration (Cmax), area under the concentration-time curve (AUC) from time 0 to the last quantifiable concentration (AUC0-t) and AUC from time 0 to infinity (AUC0-∞) increased significantly in GQD group. CONCLUSIONS The result suggested that GQD combined with AC can improve the lipid-lowering effect of AC and reduce the damage of AC to the liver simultaneously. However, GQD can inhibit the activity of CYP3A2 in hyperlipidemic rats and increase the blood concentration of AC. Therefore, the clinical dose of AC should be adjusted when they are combined. Since the study was conducted in rats, further research should be carried out to assess the uniformity of the pharmacokinetics and pharmacodynamics between rats and humans.
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Al Sayed N, Almahmeed W, Alnouri F, Al Waili K, Sabbour H, Sulaiman K, Zubaid M, Ray KK, Al-Rasadi K. Consensus clinical recommendations for the management of plasma lipid disorders in the Middle East – 2021 update. Atherosclerosis 2021; 343:28-50. [DOI: 10.1016/j.atherosclerosis.2021.11.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/20/2021] [Accepted: 11/23/2021] [Indexed: 12/14/2022]
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Santoleri F, Romagnoli A, Costantini A. Adherence and persistence in the use of statins and ezetimibe over 8 years in a real-life study. Curr Med Res Opin 2021; 37:2061-2066. [PMID: 34515600 DOI: 10.1080/03007995.2021.1980777] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Adherence and persistence to treatment are crucial in statin therapy as they are synonymous with efficacy and quality of care. The aim of this study was the real-life assessment of adherence and persistence over eight years in treatment-naive patients receiving atorvastatin, lovastatin, simvastatin, pravastatin, ezetimibe. METHODS Adherence to treatment was calculated using the 'proportion of days covered' method and persistence as the difference between the start and end of the therapy under study. RESULTS Treatment adherence was consistently above 85% for all drugs under study in each year. Treatment persistence was shown to half halved already from the first year. CONCLUSION Adherent patients had a higher persistence than non-adherent patients.
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A new phenotypic classification system for dyslipidemias based on the standard lipid panel. Lipids Health Dis 2021; 20:170. [PMID: 34838008 PMCID: PMC8627634 DOI: 10.1186/s12944-021-01585-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 10/22/2021] [Indexed: 02/07/2023] Open
Abstract
Background Dyslipoproteinemias can be classified by their distinct lipoprotein patterns, which helps determine atherosclerotic cardiovascular disease (ASCVD) risk and directs lipid management but this has required advanced laboratory testing. Objective To develop a new algorithm for classifying lipoprotein disorders that only relies on the standard lipid panel. Methods Lipid thresholds for defining the different lipoprotein phenotypes were derived for Non-High-Density Lipoprotein-Cholesterol (NonHDL-C) and Triglycerides (TG) to be concordant when possible with the current US Multi-Society guidelines for blood cholesterol management. Results The new classification method categorizes patients into all the classical Fredrickson-like phenotypes except for Type III dysbetalipoproteinemia. In addition, a new hypolipidemic phenotype (Type VI) due to genetic mutations in apoB-metabolism is described. The validity of the new algorithm was confirmed by lipid analysis by NMR (N = 11,365) and by concordance with classification by agarose gel electrophoresis/beta-quantification (N = 5504). Furthermore, based on the Atherosclerosis Risk in Communities (ARIC) cohort (N = 14,742), the lipoprotein phenotypes differ in their association with ASCVD (TypeV>IIb > IVb > IIa > IVa > normolipidemic) and can be used prognostically as risk enhancer conditions in the management of patients. Conclusions We describe a clinically useful lipoprotein phenotyping system that is only dependent upon the standard lipid panel. It, therefore, can be easily implemented for increasing compliance with current guidelines and for improving the care of patients at risk for ASCVD. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-021-01585-8. A new algorithm is described for categorizing dyslipidemic patients into Fredrickson-like lipoprotein phenotypes except for Type III. The new lipoprotein phenotypes were validated by NMR-lipoprotein analysis and by agarose gel electrophoresis/beta-quantification in a large number of subjects. The new lipoprotein phenotyping system identifies high-risk cardiovascular patients and helps direct clinical management. A major advance is that the new lipoprotein phenotypes are based on just the standard lipid panel, and thus can be automatically calculated by the clinical laboratory and widely implemented.
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Ng AKY, Ng PY, Ip A, Siu CW. High-Intensity Statin vs. Low-Density Lipoprotein Cholesterol Target for Patients Undergoing Percutaneous Coronary Intervention: Insights From a Territory-Wide Cohort Study in Hong Kong. Front Cardiovasc Med 2021; 8:760926. [PMID: 34778412 PMCID: PMC8581611 DOI: 10.3389/fcvm.2021.760926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/27/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Different guidelines recommend different approaches to lipid management in patients with atherosclerotic cardiovascular disease. We aim to determine the best strategy for lipid management in Asian patients undergoing percutaneous coronary intervention (PCI). Method: This was a retrospective cohort study conducted in patients who underwent first-ever PCI from 14 hospitals in Hong Kong. All participants either achieved low-density lipoprotein cholesterol (LDL-C) target of <55 mg/dl with ≥50% reduction from baseline (group 1), or received high-intensity statin (group 2), or both (group 3) within 1 yr after PCI. The primary endpoint was a composite outcome of all-cause mortality, myocardial infarction, stroke, and any unplanned coronary revascularization between 1 and 5 yr after PCI. Results: A total of 8,650 patients were analyzed with a median follow-up period of 4.2 yr. After the adjustment of baseline characteristics, complexity of PCI and medications prescribed and the risks of the primary outcome were significantly lower in group 2 (hazard ratio [HR], 0.82; 95% confidence interval [CI], 0.74–0.93, P = 0.003) and group 3 (HR, 0.75; 95% CI, 0.62–0.90; P = 0.002). The primary outcome occurred at similar rates between group 2 and group 3. Conclusions: Use of high intensity statin, with or without the attainment of guidelines recommended LDL-C target, was associated with a lower adjusted risk of MACE at 5 yr, compared with patients who attained LDL-C target without high intensity statin.
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Affiliation(s)
- Andrew Kei-Yan Ng
- Cardiac Medical Unit, Grantham Hospital, Wong Chuk Hang, Hong Kong, SAR China
| | - Pauline Yeung Ng
- Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong, SAR China.,Division of Respiratory and Critical Care Medicine, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR China
| | - April Ip
- Division of Respiratory and Critical Care Medicine, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR China
| | - Chung-Wah Siu
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, SAR China
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Luo D, Luo Y, Zou Y, Xu Y, Fu B, Yang D, Yang J, Xu C, Ling S, Li S, Qi A. Non-high-density lipoprotein cholesterol may predict the cardio-cerebrovascular risk in patients on maintenance hemodialysis. Lipids Health Dis 2021; 20:159. [PMID: 34774042 PMCID: PMC8590291 DOI: 10.1186/s12944-021-01546-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 09/06/2021] [Indexed: 11/29/2022] Open
Abstract
Background Non-high-density lipoprotein cholesterol (non-HDL-C) may be an independent risk factor for cardio-cerebrovascular disease (CVD); however, the cutoff level in patients on maintenance hemodialysis (MHD) is unknown. Methods This was a retrospective multicenter study of MHD patients treated at 10 dialysis centers in Guangdong Province from July 1, 2016, to April 1, 2017. Laboratory test data were collected and CVD complications and outcomes recorded. Results In total, 1288 eligible patients were included in this study; the non-HDL-C interquartile range was 2.76 (2.24–3.45) mmol/L. Over a median follow-up time of 24 months, 141 patients developed CVD. The non-HDL-C level was a principal risk factor for such events (P < 0.05; 95% confidence interval 0.800–0.842). The maximum Youden index was 0.549 and the best cutoff > 3.39 mmol/L. Conclusion Higher baseline non-HDL-C levels may increase the CVD risk in MHD patients. Thus, non-HDL-C effectively predicts CVD.
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Affiliation(s)
- Denggui Luo
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Yueming Luo
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Yanhong Zou
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Yuanzhao Xu
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Bo Fu
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Dong Yang
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Jun Yang
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Cai Xu
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Shuyi Ling
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Shunmin Li
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.
| | - Airong Qi
- The Fourth Affiliated Hospital of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.
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Wang A, Tian X, Zuo Y, Wu J, Tang H, Wang Y, Zhao X. Association of remnant cholesterol with intra- and extra-cranial atherosclerosis in Chinese community population. ATHEROSCLEROSIS PLUS 2021; 46:20-26. [PMID: 36643726 PMCID: PMC9833241 DOI: 10.1016/j.athplu.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/27/2021] [Accepted: 10/22/2021] [Indexed: 01/18/2023]
Abstract
Background Multifocal atherosclerosis has dramatically increased annual risk of adverse cardiovascular events than single artery affected. Triglyceride-rich lipoprotein (TRL) has been implicated in the early development of atherosclerosis.However, evidence on the effect of remnant cholesterol, a major atherogenic component of TRL, on multifocal atherosclerosis in Chinese health asymptomatic subjects is insufficient. This study aimed to investigate the association of remnant cholesterol with intra- and extra-cranial atherosclerosis in Chinese population. Methods This study enrolled 3665 participants (median age 52.31 years) from the Asymptomatic Polyvascular Abnormalities Community study. Parameters of intra- and extra-cranial atherosclerosis includes intracranial artery stenosis (ICAS), carotid plaque, carotid artery stenosis (CAS), and carotid hypertrophy (intima-media thickness >0.9 mm). Logistic regression was used to assess these associations. Results The prevalence of vascular atherosclerosis significantly increased with increasing remnant cholesterol quartiles (P for trend <0.0001). In the multivariable-adjusted model, the odds ratio with 95% confidence interval comparing participants in Q4 versus Q1 of remnant cholesterol was 1.73 (1.29-2.31) for ICAS, 1.54 (1.22-1.94) for carotid plaque, 1.47 (1.17-1.84) for CAS, and 1.93 (1.48-2.52) for carotid hypertrophy, respectively. Furthermore, multivariable-adjusted spline regression showed S-shaped associations between remnant cholesterol and these outcomes. Conclusion Individuals with a high level of remnant cholesterol had a higher risk of intra- and extra-cranial atherosclerosis in Chinese population. Interventions aimed at reducing remnant cholesterol to prevent atherosclerotic diseases warrant further investigations.
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Affiliation(s)
- Anxin Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xue Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yingting Zuo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jianwei Wu
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hefei Tang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yongjun Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Corresponding author. China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
| | - Xingquan Zhao
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
- Corresponding author. China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 100070, China.
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Zhang Y, Wang C, Liu D, Zhou Z, Gu S, Zuo H. Association of total pre-existing comorbidities with stroke risk: a large-scale community-based cohort study from China. BMC Public Health 2021; 21:1910. [PMID: 34674693 PMCID: PMC8529731 DOI: 10.1186/s12889-021-12002-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 10/11/2021] [Indexed: 01/01/2023] Open
Abstract
Background Comorbidities, any other coexisting diseases in patients with a particular index disease, are known to increase the mortality of a stroke. However, the association of pre-existing comorbidities with stroke risk has not been fully studied. Methods This study included 16,246 adults from a prospective community-based cohort with a baseline survey conducted in 2013 in China. Participants were followed up with hospitalization records and the Cause of Death Registry. The association of eight pre-existing comorbidities (coronary heart disease, hyperlipidemia, hypertension, diabetes, previous stroke, chronic obstructive pulmonary disease, nephropathy, and cancer) with stroke risk was analyzed using the Cox proportional hazard model in 2020. Results At a median follow-up of 5.5 years, a total of 449 participants (206 men and 243 women) developed a stroke. Four pre-existing comorbidities (hypertension, congenital heart disease, previous stroke, and diabetes) were independently and positively associated with the risk for all types of stroke. The adjusted hazard ratios for participants with only 1 and ≥ 2 pre-existing comorbidities compared with those without pre-existing conditions were 1.96 (95% CI: 1.44, 2.67; P < 0.001) and 2.87 (95% CI; 2.09, 3.94; P < 0.001) for total stroke, respectively. Moreover, male and female participants with a combination of increased age and a higher number of pre-existing comorbidities experienced the greatest risk of stroke. Conclusions The number of pre-existing comorbidities was independently associated with an increased risk of stroke. There was a synergic effect between increased age and a higher number of pre-existing comorbidities on stroke occurrence. Our novel findings emphasize the importance and potential application of pre-existing comorbidities as a risk indicator in stroke prevention. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12002-1.
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Affiliation(s)
- Ya Zhang
- School of Public Health, Medical College of Soochow University, 199 Ren'ai Rd., Suzhou, 215123, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Ren'ai Rd., Suzhou, 215123, China
| | - Cuicui Wang
- School of Public Health, Medical College of Soochow University, 199 Ren'ai Rd., Suzhou, 215123, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Ren'ai Rd., Suzhou, 215123, China
| | - Dong Liu
- School of Public Health, Medical College of Soochow University, 199 Ren'ai Rd., Suzhou, 215123, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Ren'ai Rd., Suzhou, 215123, China
| | - Zhengyuan Zhou
- Changshu Center for Disease Control and Prevention, 6 Fuyang Rd., Suzhou, 215500, China
| | - Shujun Gu
- Changshu Center for Disease Control and Prevention, 6 Fuyang Rd., Suzhou, 215500, China.
| | - Hui Zuo
- School of Public Health, Medical College of Soochow University, 199 Ren'ai Rd., Suzhou, 215123, China. .,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Ren'ai Rd., Suzhou, 215123, China.
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128
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Banerjee Y, Pantea Stoian A, Cicero AFG, Fogacci F, Nikolic D, Sachinidis A, Rizvi AA, Janez A, Rizzo M. Inclisiran: a small interfering RNA strategy targeting PCSK9 to treat hypercholesterolemia. Expert Opin Drug Saf 2021; 21:9-20. [PMID: 34596005 DOI: 10.1080/14740338.2022.1988568] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Inclisiran is a novel posttranscriptional gene silencing therapy that inhibits proprotein convertase subtilisin/kexin type 9 (PCSK9) synthesis by RNA interference and has a potent, dose-dependent, durable effect in lowering LDL-C, and therefore is an effective drug to treat dyslipidemia, reducing the risk for acute cardiovascular (CV) events. It is safe and well-tolerated. AREAS COVERED This paper aims to review the mechanism of action of inclisiran while evaluating its efficacy and safety in the treatment of dyslipidemia from data of the clinical trials in the ORION program. EXPERT OPINION Data from the clinical trials in the ORION program demonstrated efficacy and safety of inclisiran in patients with dyslipidemia. Adverse events were similar in the inclisiran and placebo groups in the clinical trials, although injection-site reactions were more frequent with inclisiran than with placebo. Although the combination of efficacy and safety makes inclisiran a good option for the treatment of dyslipidemia compared to other PCSK9 targeting therapeutic strategies, however, further studies should exclude the possibility that inclisiran, through lower-affinity interactions, may influence other mRNAs in the physiological milieu.
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Affiliation(s)
- Yajnavalka Banerjee
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates and Centre of Medical Education, University of Dundee, UK
| | - Anca Pantea Stoian
- Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Arrigo Francesco Giuseppe Cicero
- Hypertension and Cardiovascular Risk Factors Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Italy
| | - Federica Fogacci
- Hypertension and Cardiovascular Risk Factors Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Italy
| | - Dragana Nikolic
- Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (Promise), University of Palermo, Italy
| | - Alexandros Sachinidis
- Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (Promise), University of Palermo, Italy
| | - Ali A Rizvi
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of South Carolina, Columbia, SC, USA.,Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Andrej Janez
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center Ljubljana, Slovenia
| | - Manfredi Rizzo
- Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (Promise), University of Palermo, Italy.,Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of South Carolina, Columbia, SC, USA
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129
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Radkhah N, Shabbidar S, Zarezadeh M, Safaeiyan A, Barzegar A. Effects of vitamin D supplementation on apolipoprotein A1 and B100 levels in adults: Systematic review and meta-analysis of controlled clinical trials. J Cardiovasc Thorac Res 2021; 13:190-197. [PMID: 34630965 PMCID: PMC8493225 DOI: 10.34172/jcvtr.2021.21] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 02/10/2021] [Indexed: 11/09/2022] Open
Abstract
Cardiovascular disease (CVD) is a leading cause of death around the world. According to the studies, apolipoproteins A1 and B100 play crucial role in CVD development and progression. Also, findings have indicated the positive role of vitamin D on these factors. Thus, we conducted the present meta-analysis of randomized controlled trials (RCTs) to demonstrate the impact of vitamin D supplementation on apolipoproteins A1 and B100 levels in adults. PubMed and Scopus databases and Google Scholar were searched up to 21 December 2020. Relevant articles were screened, extracted, and assessed for quality based on the Cochrane collaboration's risk of bias tool. Data analysis conducted by random-effect model and expressed by standardized mean difference (SMD). The heterogeneity between studies was assessed by I-squared (I2) test. Subgroups and sensitivity Analyses were also conducted. Seven RCTs were identified investigating the impact of vitamin D on Apo A1 levels and six on Apo B100 levels. The findings showed the insignificant effect of vitamin D supplementation on Apo A1 (SMD=0.26 mg/dL; 95% confidence interval (CI), -0.10, 0.61; P = 0.155) and Apo B100 (standardized mean difference (SMD)=-0.06 mg/dL; 95% CI, -0.24, 0.12; P = 0.530) in adults. There was a significant between-study heterogeneity in Apo A1 (I2=89.3%, P < 0.001) and Apo B100 (I2 = 57.1%, P = 0.030). However, significant increase in Apo A1 in daily dosage of vitamin D (SMD=0.56 mg/dL; 95% CI, 0.02, 1.11; P = 0.044) and ≤12 weeks of supplementation duration (SMD=0.71 mg/dL; 95% CI, 0.08, 1.34; P = 0.028) was observed. No significant effects of vitamin D on Apo A1 and Apo B100 levels after subgroup analysis by mean age, gender, study population, dosage and duration of study. Overall, daily vitamin D supplementation and ≤12 weeks of supplementation might have beneficial effects in increasing Apo A1 levels, however, future high-quality trials considering these a primary outcome are required.
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Affiliation(s)
- Nima Radkhah
- Department of Community Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sakineh Shabbidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Meysam Zarezadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.,Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abdolrasoul Safaeiyan
- Department of Vital Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Barzegar
- Department of Community Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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130
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Dietary Approaches to Stop Hypertension (DASH) diet, Mediterranean diet and blood lipid profiles in less-developed ethnic minority regions. Br J Nutr 2021; 128:1137-1146. [PMID: 34605387 DOI: 10.1017/s0007114521004013] [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] [Indexed: 02/05/2023]
Abstract
Different from developed countries, there is a paucity of research examining how the Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets relate to lipids in less-developed ethnic minority regions (LEMR). A total of 83 081 participants from seven ethnic groups were retrieved from the baseline data of the China Multi-Ethnic Cohort study, which was conducted in less-developed Southwest China between May 2018 and September 2019. Multivariable linear regression models were then used to examine the associations of the DASH and alternative Mediterranean diet (AMED) scores, assessed by modified DASH score and AMED, as well as their components with total cholesterol (TC), LDL-cholesterol, HDL-cholesterol, TAG and TC/HDL-cholesterol. The DASH scores were negatively associated with TC, HDL-cholesterol and TAG. Comparing the highest quintiles with the lowest DASH scores, TC decreased 0·0708 (95 % CI -0·0923, -0·0493) mmol/l, HDL-cholesterol decreased 0·0380 (95 % CI -0·0462, -0·0299) mmol/l and TAG decreased 0·0668 (95 % CI -0·0994, -0·0341) mmol/l. The AMED scores were negatively associated with TC, LDL-cholesterol and HDL-cholesterol. Comparing the highest quintiles with the lowest AMED scores, TC decreased 0·0816 (95 % CI -0·1035, -0·0597) mmol/l, LDL-cholesterol decreased 0·0297 (95 % CI -0·0477, -0·0118) mmol/l and HDL-cholesterol decreased 0·0275 (95 % CI -0·0358, -0·0192) mmol/l. Although both the DASH diet and the Mediterranean diet were negatively associated with blood lipids, those associations showed different patterns in LEMR, particularly for TAG and HDL-cholesterol.
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131
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Wang N, Pan D, Guo Z, Xiang X, Wang S, Zhu J, Sun G. Effects of guar gum on blood lipid levels: A systematic review and meta-analysis on randomized clinical trials. J Funct Foods 2021. [DOI: 10.1016/j.jff.2021.104605] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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132
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Parhofer KG, Birkenfeld AL, Krone W, Lehrke M, Marx N, Merkel M, Schütt KS, Zirlik A, Müller-Wieland D. Lipidtherapie bei Patienten mit Diabetes mellitus – Eine gemeinsame Stellungnahme der Kommission Fettstoffwechsel sowie der AG Herz und Diabetes der Deutschen Diabetes Gesellschaft (DDG), der Sektion Diabetes, Adipositas und Stoffwechsel der Deutschen Gesellschaft für Endokrinologie (DGE), der AG Herz und Diabetes der Deutschen Gesellschaft für Kardiologie (DGK) und der gemeinsamen AG Herz – Hormone – Diabetes der DGK, DGE und DDG. DIABETOL STOFFWECHS 2021. [DOI: 10.1055/a-1515-9059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Klaus G. Parhofer
- Medizinische Klinik IV – Großhadern, Klinikum der Universität München, München
| | - Andreas L. Birkenfeld
- Medizinische Klinik IV, Universitätsklinikum Tübingen
- Institut für Diabetesforschung und Metabolische Erkrankungen (IDM) des Helmholtz Zentrums München an der Universität Tübingen, Deutsches Zentrum für Diabetesforschung (DZD e. V.)
| | - Wilhelm Krone
- Poliklinik für Endokrinologie, Diabetologie und Präventivmedizin, Uniklinik Köln, Köln
| | - Michael Lehrke
- Medizinische Klinik I – Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum RWTH Aachen, Aachen
| | - Nikolaus Marx
- Medizinische Klinik I – Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum RWTH Aachen, Aachen
| | | | - Katharina S. Schütt
- Medizinische Klinik I – Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum RWTH Aachen, Aachen
| | - Andreas Zirlik
- Klinik für Innere Medizin – Abteilung für Kardiologie, LKH-Universitätsklinikum Graz, Medizinische Universität Graz
| | - Dirk Müller-Wieland
- Medizinische Klinik I – Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum RWTH Aachen, Aachen
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133
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Li J, Chen R, Chen Y, Zhu D, Wu Z, Chen F, Huang X, Ali Khan B, Al Hennawi HE, Albazee E, Prabahar K, Hou K. The effect of guar gum consumption on the lipid profile in type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr 2021; 63:2886-2895. [PMID: 34558350 DOI: 10.1080/10408398.2021.1981228] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Dyslipidemia is a common encounter in type 2 diabetes mellitus (T2DM) and the current strategies to manage it are still suboptimal. Subsequently, identifying newer molecules with lipid-lowering effects is necessary. A great deal of attention has been given in recent years to fiber supplements, e.g., guar gum. Thus, we screened and evaluated the quality of the evidence regarding the benefits of guar gum supplementation in T2DM and conducted a meta-analysis to assess the effects of this compound on serum lipids in T2DM. We conducted a comprehensive search in PubMed/Medline, Web of Science, Scopus, Google Scholar and Embase, from the inception of these databases until January 2021. In total, 11 papers were included based on the eligible criteria in our meta-analysis. The meta-analysis of the eligible trials demonstrated a significant reduction of total cholesterol (TC) (WMD: -20.32 mg/dL, 95% CI: -27.02, -13.62, P < 0.001) and low-density lipoprotein cholesterol (LDL-C) (WMD: -14.52 mg/dL, 95% CI: -20.69, -8.35, P < 0.001) following guar gum supplementation in T2DM patients. The subgroup analysis based on the dosage (g/day) of this compound revealed that ≥20 g/day of guar gum led to a notable decrease in triglyceride (TG) levels (WMD: -12.55 mg/dL, 95% CI: -23.72, -1.37, P = 0.02) versus < 20 g/day (WMD: -1.84 mg/dL, 95% CI: -32.18, 28.49, P = 0.90). Guar gum supplementation had no effects on high-density lipoprotein cholesterol (HDL-C) (WMD: 0.66 mg/dL, 95% CI: -0.95, 2.28, P = 0.42). Guar gum consumption has lipid-lowering effects when administered to patients with type 2 diabetes mellitus and it is particularly able to reduce TC, LDL-C and TG levels. Further research is however needed to confirm our findings.
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Affiliation(s)
- Jilin Li
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou City, Guangdong Province, China
| | - Rongping Chen
- Hospital of Southern Medical University, Guangzhou City, Guangdong Province, China
| | - Yongru Chen
- Department of Emergency Intensive Care Unit, The First affiliated Hospital of Shantou University Medical College, Shantou City, Guangdong Province, China
| | - Dan Zhu
- Department of Endocrine and Metabolic Diseases, Longhu Hospital, The First Affiliated Hospital of Shantou University Medical College,Shantou City, Guangdong Province
| | - Zezhen Wu
- Department of Endocrine and Metabolic Diseases, Longhu Hospital, The First Affiliated Hospital of Shantou University Medical College,Shantou City, Guangdong Province
| | - Fengwu Chen
- Department of Endocrine and Metabolic Diseases, Longhu Hospital, The First Affiliated Hospital of Shantou University Medical College,Shantou City, Guangdong Province
| | - Xiaojun Huang
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou City, Guangdong Province, China
| | | | | | | | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk,Tabuk, Kingdom of Saudi Arabia
| | - Kaijian Hou
- Department of Endocrine and Metabolic Diseases, Longhu Hospital, The First Affiliated Hospital of Shantou University Medical College,Shantou City, Guangdong Province
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134
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Gu HQ, Yang KX, Yang X, Wang CJ, Lyu TJ, Zhao XQ, Wang YL, Liu LP, Liu C, Li H, Jiang Y, Wang YJ, Li ZX. Guideline-directed low-density lipoprotein management in high-risk ischemic stroke or transient ischemic attack admissions in China from 2015 to 2019. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1224. [PMID: 34532361 PMCID: PMC8421930 DOI: 10.21037/atm-21-1467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/28/2021] [Indexed: 11/13/2022]
Abstract
Background Lowering low-density lipoprotein cholesterol (LDL-C) is crucial for secondary stroke prevention in stroke patients with preexisting cardiovascular diseases (CVD) or cerebrovascular diseases (CeVD). However, data on attainment of guideline-recommended LDL-C levels are lacking. Methods We analyzed data from the Chinese Stroke Center Alliance (CSCA) program for patients with ischemic stroke and transient ischemic attack (TIA) hospitalized between August 2015 and July 2019. Participants were classified into different disease groups according to preexisting CeVD (stroke/TIA) or CVD [coronary heart disease (CHD) or myocardial infarction (MI)]. Results Of 858,509 patients presenting with an acute stroke/TIA, 251,176 (29.3%) had a preexisting CeVD, 44,158 (5.1%) had preexisting CVD, 33,070 (3.9%) had concomitant preexisting CeVD and CVD, and 530,105 (61.7%) had no documented history of CeVD/CVD. Overall, only 397,596 (46.3%) met the target for LDL-C <2.6 mmol/L, 128,177 (14.9%) for LDL-C <1.8 mmol/L and 55,275 (6.4%) for LDL-C <1.4 mmol/L, and patients with concomitant CeVD and CVD had higher attainment rates than other disease groups (P<0.001). Despite improvements over time in the proportion of patients who attain LDL-C targets (P for trend <0.05), it remains suboptimal. Younger age, women, having a history of hypertension or dyslipidemia, current smoking or drinking, and being admitted to hospitals located in eastern China were associated with lower odds of meeting the LDL-C goals. Conclusions Overall attainment of guideline LDL-C targets in a population of stroke/TIA patients is low and indicates the need for better management of dyslipidemia, particularly for high-risk stroke patients with pre-existing CeVD or CVD.
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Affiliation(s)
- Hong-Qiu Gu
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Kai-Xuan Yang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xin Yang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chun-Juan Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tian-Jie Lyu
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xing-Quan Zhao
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yi-Long Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Li-Ping Liu
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Neuro-intensive Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chelsea Liu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Hao Li
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yong Jiang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yong-Jun Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zi-Xiao Li
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Chinese Institute for Brain Research, Beijing, China.,Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
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135
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Drapkina OM, Karamnova NS, Kontsevaya AV, Gorny BE, Dadaeva VA, Drozdova LY, Yeganyan RA, Eliashevich SO, Izmailova OV, Lavrenova EA, Lischenko OV, Skripnikova IA, Shvabskaya OB, Shishkova VN. Russian Society for the Prevention of Noncommunicable Diseases (ROPNIZ). Alimentary-dependent risk factors for chronic non-communicable diseases and eating habits: dietary correction within the framework of preventive counseling. Methodological Guidelines. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2021. [DOI: 10.15829/1728-8800-2021-2952] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The methodological guidelines are developed as a practical document for medical specialists working in the field of preventive medicine, in order to expand and improve the provision of this type of medical service to the adult population. The methodological guidelines include an informational and informative part for medical specialists and a practical part for patients, presented in the format of memos, contain the main sections-healthy nutrition, correction of eating habits, issues of modifying the diet for the main alimentary-dependent risk factors for chronic non-communicable diseases, such as arterial hypertension, obesity, disorders of lipid, carbohydrate and purine metabolism, a decrease in bone mineral density. They are intended for medical specialists working in the field of prevention, for doctors and secondary medical personnel of offices and departments of medical prevention, public health and medical prevention centers, healthy lifestyle specialists, teachers of medical educational institutions, for specialists who develop and implement educational programs for patients, as well as for medical specialists of a therapeutic profile.
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Affiliation(s)
- O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
| | - N. S. Karamnova
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. V. Kontsevaya
- National Medical Research Center for Therapy and Preventive Medicine
| | - B. E. Gorny
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. A. Dadaeva
- National Medical Research Center for Therapy and Preventive Medicine
| | - L. Yu. Drozdova
- National Medical Research Center for Therapy and Preventive Medicine
| | - R. A. Yeganyan
- National Medical Research Center for Therapy and Preventive Medicine
| | - S. O. Eliashevich
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. V. Izmailova
- National Medical Research Center for Therapy and Preventive Medicine
| | - E. A. Lavrenova
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. V. Lischenko
- National Medical Research Center for Therapy and Preventive Medicine
| | - I. A. Skripnikova
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. B. Shvabskaya
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. N. Shishkova
- National Medical Research Center for Therapy and Preventive Medicine
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Dong Y, Ding M, Cui M, Fang M, Gong L, Xu Z, Zhang Y, Wang X, Xu X, Liu X, Li G, Zhao Y, Dong Q. Development and validation of a clinical model (DREAM-LDL) for post-stroke cognitive impairment at 6 months. Aging (Albany NY) 2021; 13:21628-21641. [PMID: 34506303 PMCID: PMC8457606 DOI: 10.18632/aging.203507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/17/2021] [Indexed: 01/31/2023]
Abstract
Introduction: This multicenter, retrospective study assessed the prevalence of post-stroke cognitive impairment (PSCI) 6 months after acute ischemic stroke (AIS) and its risk factors to build a bedside early predictive model for PSCI using the Montreal Cognitive Assessment (MoCA). Methods: Records of consecutive patients with AIS treated at 4 stroke centers in Shanghai had MoCA assessments within 2 weeks after AIS onset and 6 months later were reviewed. Prevalence of PSCI (MoCA<22) was calculated and risk factors were identified by multivariate logistic regression analysis. The modeling and validation and identified risk factors were included in a predictive model using multivariate regression. Results: There were 383 patients included and prevalence of PSCI 6 months after AIS was 34.2%, significantly lower than prevalence of patients with acute cognitive impairment (49.6%). Aging, less education, higher glucose level and severe stroke were PSCI risk factors, while level of low-density lipoprotein cholesterol (LDL-C) had a paradox effect on the risk of PSCI. 40.0% of the patients with cognitive impairment at acute phase reverted to normal, and patients with LDL-C 1.8-2.5 mmol/L were more likely to revert. The predictive model we built, DREAM-LDL (Diabetes [fasting blood glucose level], Rating [NIHSS], level of Education, Age, baseline MoCA and LDL-C level), had an AUROC of 0.93 for predicting PSCI at 6 months. Conclusion: PSCI was common among AIS patients 6 months after AIS. We provided a practical tool to predict PSCI based on MoCA and risk factors present during acute phase of AIS.
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Affiliation(s)
- Yi Dong
- Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Mengyuan Ding
- Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Mei Cui
- Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Min Fang
- Department of Neurology, The Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Li Gong
- Department of Neurology, The Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Zhuojun Xu
- Department of Neurology, The East Hospital Affiliated to Tongji University, Shanghai, China
| | - Yue Zhang
- Department of Neurology, The East Hospital Affiliated to Tongji University, Shanghai, China
| | - Xiuzhe Wang
- Department of Neurology, The Six People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Xiaofeng Xu
- Department of Neurology, The Six People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Xueyuan Liu
- Department of Neurology, The Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Gang Li
- Department of Neurology, The East Hospital Affiliated to Tongji University, Shanghai, China
| | - Yuwu Zhao
- Department of Neurology, The Six People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Qiang Dong
- Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
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Plazas Guerrero CG, Acosta Cota SDJ, Castro Sánchez FH, Vergara Jiménez MDJ, Ríos Burgueño ER, Sarmiento Sánchez JI, Picos Corrales LA, Osuna Martínez U. Evaluation of sucrose-enriched diet consumption in the development of risk factors associated to type 2 diabetes, atherosclerosis and non-alcoholic fatty liver disease in a murine model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2021; 31:651-669. [PMID: 31668088 DOI: 10.1080/09603123.2019.1680817] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/09/2019] [Indexed: 06/10/2023]
Abstract
Overconsumption of sucrose, the main contributor of the total added sugar intake in the world, has been associated with negative metabolic effects related to non-communicable diseases. However, this relationship continues to be a controversial topic and further studies are needed. The aim of this study was to evaluate the sucrose-enriched diet consumption in the development of risk factors associated with type 2 diabetes, atherosclerosis and non-alcoholic fatty liver disease in a murine model. Sucrose-enriched diet-fed rats showed a decrease in food, lipids and protein intake as well as in serum total cholesterol levels, an increase in carbohydrates intake, glucose, insulin, triglycerides, VLDL-c and HDL-c levels and a greater degree of insulin resistance, steatosis and non-alcoholic steatohepatitis. Our results show that sucrose-enriched diet consumption during 25 weeks contribute to the development of risk factors associated with type 2 diabetes, atherosclerosis and non-alcoholic fatty liver disease in male Wistar rats.
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Affiliation(s)
| | | | | | | | - Efrén Rafael Ríos Burgueño
- Centro de Investigación y Docencia en Ciencias de la Salud, Universidad Autónoma de Sinaloa, Culiacán de Rosales, Mexico
| | | | | | - Ulises Osuna Martínez
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Sinaloa, Culiacán de Rosales, Mexico
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Li S, Li Y, Kong M, Zhang C, Geng Y, Sun M, He L, Li S, Liu H. Factors Associated with Age-Related Changes in Non-Smoking Urban Men and Women in China Determined by Low-Dose Computed Tomography Imaging. Med Sci Monit 2021; 27:e931006. [PMID: 34437515 PMCID: PMC8406892 DOI: 10.12659/msm.931006] [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] [Indexed: 11/25/2022] Open
Abstract
Background Respiratory function usually worsens in the elderly with aging. This study aimed to retrospectively investigate tracheal changes caused by “normal aging” through use of low-dose CT (LDCT) in non-smoking asymptomatic urban residents and the related factors influencing tracheal changes. Material/Methods A total of 733 Chinese subjects who underwent LDCT were recruited. The trachea shape, width, and calcification degree of the tracheal wall were measured and compared between males and females and among different age groups. The effects of age, sex, trachea morphology, BMI, BP, GLU, TC, TG, HDL, and LDL on the width and calcification of tracheal wall were analyzed by multiple linear regression. Results Significant sex differences in trachea shape were found, as type II and type I were found mainly in the males and females, respectively. The values of anterior-posterior inner diameter (AP), left-right inner diameter (LR), width, and calcification score of tracheae in the males were higher than that in the females. In both males and females, trachea AP, wall width, and calcification scores increased with age, but this trend was not observed in tracheal LR. Age, sex, and trachea shape had significant effects on the width and calcification scores of tracheal walls, and trachea calcification was one of the factors influencing tracheal wall width. Conclusions Tracheal aging can be evaluated by measuring trachea shape, thickness, and the degree of calcification of the tracheal wall by LDCT, while sex and age should be taken into consideration comprehensively for judging normal trachea aging. In addition, obesity may aggravate trachea aging.
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Affiliation(s)
- Shujing Li
- Department of Radiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Yaguang Li
- Department of Radiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Meibao Kong
- Department of Radiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Chenguang Zhang
- Department of Radiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Yulan Geng
- Department of Laboratory, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Mengyue Sun
- Department of Radiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Li He
- Department of Radiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Shengnan Li
- Department of Radiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Huaijun Liu
- Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
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Kim JE, Park S, Kim MS, Kang SJ, Lee JW, Kim KS, Kim YC, Kim DK, Joo KW, Kim YS, Park M, Lee H. Statin initiation and all-cause mortality in incident statin-naïve dialysis patients. Atherosclerosis 2021; 337:59-65. [PMID: 34429195 DOI: 10.1016/j.atherosclerosis.2021.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 07/21/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS Cardiovascular disease is the main cause of death in end-stage kidney disease (ESKD) patients. We aimed to explore the association between statin initiation after starting dialysis and all-cause mortality in statin-naïve ESKD patients. METHODS We analyzed nationwide claims data of incident dialysis patients from 2010 to 2017 in South Korea. Patients who had previous cardiovascular events or were administered statins before dialysis were excluded. The study group included dialysis patients receiving statins within 1 year after dialysis initiation. The control group was organized after propensity-score matching with age, sex, time of dialysis initiation, and underlying diabetes mellitus and hypertension. The main outcomes were all-cause mortality and major cardiovascular events. RESULTS We included 1596 patients who started statin treatment and 1:1 matched statin-nonusers. During the 9438 person-year follow-up, 468 deaths and 264 major adverse cardiovascular events (MACEs) occurred. Statin initiation was associated with a reduced risk of all-cause mortality (adjusted hazard ratio (aHR) 0.72, 95% confidence interval (CI) 0.60-0.87, p = 0.001), but not with MACE incidence (aHR 1.06, 95% CI 0.83-1.36, p = 0.62). In particular, patients prescribed the recommended dosage of statins according to the Kidney Disease Improving Global Outcomes guidelines showed the lowest mortality risk (aHR 0.55, 95% CI 0.40-0.75, p < 0.001). CONCLUSIONS Statin initiation was associated with lower risk of all-cause mortality in statin-naïve ESKD patients. As indication bias may be present in observational study setting, further prospective studies are warranted to validate the association of statin initiation with mortality in incident dialysis cases.
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Affiliation(s)
- Ji Eun Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - Sehoon Park
- Department of Internal Medicine, Armed Forces Capital Hospital, Gyeonggi-do, South Korea
| | - Myeong-Seok Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Sung Jin Kang
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Jang Wook Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Kwang Soo Kim
- Transdisciplinary Department of Medicine & Advanced Technology, Seoul National University Hospital, Seoul, South Korea
| | - Yong Chul Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Dong Ki Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Kidney Research Institute, Seoul National University, Seoul, South Korea
| | - Kwon Wook Joo
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Kidney Research Institute, Seoul National University, Seoul, South Korea
| | - Yon Su Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Kidney Research Institute, Seoul National University, Seoul, South Korea
| | - Minsu Park
- Department of Informations and Statistics, Chungnam National University, Daejeon, South Korea.
| | - Hajeong Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
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Thobani A, Hassen L, Mehta LS, Agarwala A. Management of Hypercholesterolemia in Pregnant Women with Atherosclerotic Cardiovascular Disease. Curr Atheroscler Rep 2021; 23:58. [PMID: 34345940 DOI: 10.1007/s11883-021-00957-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW In this review, we discuss strategies for managing dyslipidemia in pregnant women with ASCVD. RECENT FINDINGS Cardiovascular disease (CVD) is the leading cause of mortality in women as well as the leading cause of pregnancy-related mortality in the USA. It is paramount to screen, identify, counsel, and treat women of childbearing age who have existing atherosclerotic disease to mitigate the risks of complications and mortality. Dyslipidemias, including hypercholesterolemia and hyperlipidemia, can further enhance the risk for future CVD events. Treating hypercholesterolemia during pregnancy is crucial, and this is an opportune time for cross-collaboration of subspecialties in cardiology, obstetrics, and gynecology.
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Affiliation(s)
- Aneesha Thobani
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Lauren Hassen
- Department of Medicine, Division of Cardiology, The Ohio State University, Columbus, OH, USA
| | - Laxmi S Mehta
- Department of Medicine, Division of Cardiology, The Ohio State University, Columbus, OH, USA
| | - Anandita Agarwala
- Department of Medicine, Division of Cardiology, Baylor Scott and White, The Health Heart Hospital Baylor Plano, 1100 Allied Dr., Plano, TX, 75093, USA.
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Abstract
Cardiovascular (CV) disease (CVD) is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD) and with end-stage renal disease. CKD has a strong association with dyslipidemia. Dyslipidemias can affect kidney function and increase the risk for CVD development, so it is an important risk factor. Statin therapy can decrease CV events in patients with pre-end-stage CKD and in renal transplant patients, but not in those already on dialysis. This article focuses on epidemiology of CKD, how dyslipidemias confer a higher risk for CVD, the approach to management and treatment of dyslipidemias, and recent guidelines.
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Affiliation(s)
- Aneesha Thobani
- Department of Cardiovascular Disease, Emory University School of Medicine, Cardiovascular Disease Fellowship Training Program, 101 Woodruff Circle, WMB 2125, Atlanta, GA 30322, USA
| | - Terry A Jacobson
- Department of Medicine, Lipid Clinic and Cardiovascular Disease Prevention Program, Emory University School of Medicine, Faculty Office Building, 49 Jesse Hill Jr Dr SE, Atlanta, GA 30303, USA.
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Wang S, Wang N, Pan D, Zhang H, Sun G. Effects of Copper Supplementation on Blood Lipid Level: a Systematic Review and a Meta-Analysis on Randomized Clinical Trials. Biol Trace Elem Res 2021; 199:2851-2857. [PMID: 33030656 DOI: 10.1007/s12011-020-02423-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
Studies have evaluated the effect of copper (Cu) supplementation on blood lipid level. We therefore investigated whether the supplement of Cu on blood lipid level will have an impact in a meta-analysis on randomized controlled trials (RCTs). Literature search was conducted in Scopus, PubMed, Web of Science, and Cochrane Library (from database to January 2020). Randomized controlled trials of Cu supplementation on blood lipid level were retrieved according to the requirements of systematic review, and the quality of the included research was evaluated. Then the meta-analysis was performed. Data from 5 trials representing 176 participants were examined. Pooled mean net change in total cholesterol (TC) (standard mean difference(SMD) [95% CI] = - 0.05 [- 0.52, 0.43]), low density lipoprotein cholesterol (LDL-C) (SMD [95% CI] = 0.22 [- 0.46, 0.89]), and high density lipoprotein cholesterol (HDL-C) (SMD [95% CI] = 0.18 [- 0.14, 0.49]) for those treated with Cu supplementation had no significant difference when compared with control. Cu supplementation has not affected blood lipids in the result of meta-analysis. More research is needed to determine if this pattern will apply broadly.
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Affiliation(s)
- Shaokang Wang
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 87 Ding Jia Qiao Road, Nanjing, 210009, Jiangsu, People's Republic of China.
| | - Niannian Wang
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 87 Ding Jia Qiao Road, Nanjing, 210009, Jiangsu, People's Republic of China
| | - Da Pan
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 87 Ding Jia Qiao Road, Nanjing, 210009, Jiangsu, People's Republic of China
| | - Hong Zhang
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 87 Ding Jia Qiao Road, Nanjing, 210009, Jiangsu, People's Republic of China
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 87 Ding Jia Qiao Road, Nanjing, 210009, Jiangsu, People's Republic of China
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Groth SW, Fernandez ID, Block RC, Thurston SW, Wong E, Brunner J, Mayo N, Kapula N, Yu Y, Meng Y, Yeh KL, Kinkade CW, Thornburg LL, O’Connor TG, Barrett ES. Biological changes in the pregnancy-postpartum period and subsequent cardiometabolic risk-UPSIDE MOMS: A research protocol. Res Nurs Health 2021; 44:608-619. [PMID: 33993510 PMCID: PMC8378197 DOI: 10.1002/nur.22141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/05/2021] [Accepted: 05/02/2021] [Indexed: 01/21/2023]
Abstract
Multiple physiological changes occur in pregnancy as a woman's body adapts to support the growing fetus. These pregnancy-induced changes are essential for fetal growth, but the extent to which they reverse after pregnancy remains in question. For some women, physiological changes persist after pregnancy and may increase long-term cardiometabolic disease risk. The National Institutes of Health-funded study described in this protocol addresses a scientific gap by characterizing weight and biological changes during pregnancy and an extended postpartum period in relation to cardiometabolic risk. We use a longitudinal repeated measures design to prospectively examine maternal health from early pregnancy until 3 years postpartum. The aims are: (1) identify maternal weight profiles in the pregnancy-postpartum period that predict adverse cardiometabolic risk profiles three years postpartum; (2) describe immune, endocrine, and metabolic biomarker profiles in the pregnancy-postpartum period, and determine their associations with cardiometabolic risk; and (3) determine how modifiable postpartum health behaviors (diet, physical activity, breastfeeding, sleep, stress) (a) predict weight and cardiometabolic risk in the postpartum period; and (b) moderate associations between postpartum weight retention and downstream cardiometabolic risk. The proposed sample is 250 women. This study of mothers is conducted in conjunction with the Understanding Pregnancy Signals and Infant Development study, which examines child health outcomes. Biological and behavioral data are collected in each trimester and at 6, 12, 24, and 36 months postpartum. Findings will inform targeted health strategies that promote health and reduce cardiometabolic risk in childbearing women.
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Affiliation(s)
- Susan W Groth
- University of Rochester, School of Nursing, Rochester NY
| | - I Diana Fernandez
- University of Rochester School of Medicine and Dentistry, Department of Public Health Sciences
| | - Robert C Block
- University of Rochester, Departments of Public Health Sciences, Cardiology, and Medicine
| | - Sally W Thurston
- University of Rochester, Department of Biostatistics and Computational Biology
| | - Eunyoung Wong
- University of Rochester, School of Nursing, Rochester NY
| | - Jessica Brunner
- University of Rochester Medical Center, Department of Obstetrics and Gynecology
| | - Nicole Mayo
- University of Rochester School of Medicine and Dentistry, Department of Public Health Sciences
| | - Ntemena Kapula
- University of Rochester Medical Center, Department of Obstetrics and Gynecology
| | - Yang Yu
- University of Rochester, School of Nursing, Rochester NY
| | - Ying Meng
- University of Rochester, School of Nursing, Rochester NY
| | - Kuan-Lin Yeh
- University of Rochester, School of Nursing, Rochester NY
| | - Carolyn W Kinkade
- Rutgers University, Exposure Science and Epidemiology, Environmental and Occupational Health Sciences Institute
| | - Loralei L Thornburg
- University of Rochester Medical Center, Department of Obstetrics and Gynecology
| | - Thomas G O’Connor
- University of Rochester, Departments of Psychiatry, Psychology, Neuroscience, Obstetrics and Gynecology, and Wynne Center for Family Research
| | - Emily S Barrett
- University of Rochester Medical Center, Department of Obstetrics and Gynecology
- Rutgers University, Exposure Science and Epidemiology, Environmental and Occupational Health Sciences Institute
- Rutgers School of Public Health, Biostatistics and Epidemiology
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Virani SS, Morris PB, Agarwala A, Ballantyne CM, Birtcher KK, Kris-Etherton PM, Ladden-Stirling AB, Miller M, Orringer CE, Stone NJ. 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol 2021; 78:960-993. [PMID: 34332805 DOI: 10.1016/j.jacc.2021.06.011] [Citation(s) in RCA: 130] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Abstract
Introduction: Familial hypercholesterolemia (FH) is characterized by lifelong elevation of low-density lipoprotein cholesterol (LDL-C), early onset coronary atherosclerosis, and premature death. FH is underdiagnosed and undertreated, but requires aggressive LDL-C-lowering to prevent complications. Current treatment strategies such as lifestyle modification and numerous LDL-C-lowering medications are often insufficient to achieve lipid goals in FH.Areas covered: Angiopoietin-like 3 protein (ANGPTL3) is intricately involved in lipid metabolism. Loss-of-function mutations in ANGPTL3 are associated with panhypolipidemia and reduced coronary atherosclerosis. Evinacumab, a fully human monoclonal antibody, inhibits ANGPTL3 and reduces multiple lipoprotein fractions ~50%, including LDL-C. The use of evinacumab within the FH population is described as well as its regulatory journey to an approved therapeutic.Expert opinion: Evinacumab, with its capacity to lower multiple lipoprotein fractions, particularly LDL-C, independently of LDLR function has potential to revolutionize treatment for FH patients. Current FDA-approval is only for homozygous FH (HoFH), arguably the most impactful indication, but use in other lipid disorders is under investigation. The short-term tolerability of evinacumab is very good, with infrequent, mild, and transient adverse events; however, long-term safety data are needed. The high cost and requirement for intravenous administration may limit adoption of evinacumab, but dramatic LDL-C-lowering and need for new therapeutic options for HoFH will drive interest.
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Affiliation(s)
- Bruce A Warden
- Center for Preventive Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, USA
| | - P Barton Duell
- Center for Preventive Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, USA.,Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health & Science University, Portland, USA
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146
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Elevated Interarm Systolic Blood Pressure Difference Is Positively Associated with Increased Likelihood of Coronary Artery Disease. Int J Hypertens 2021; 2021:5577957. [PMID: 34336266 DOI: 10.1155/2021/5577957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/29/2021] [Indexed: 11/17/2022] Open
Abstract
Background Systolic interarm differences in blood pressure have been associated with all-cause mortality and cardiovascular disease. We investigated the relationship between interarm systolic blood pressure difference and coronary artery disease. Methods We retrospectively analyzed data for patients undergoing coronary angiography and brachial-ankle pulse wave velocity examination during hospitalization from 2013 to 2018. Patients underwent simultaneous upper arm blood pressure measurement. Interarm systolic blood pressure difference (IASBPD) was defined as the absolute value of the difference between the right and left upper limb systolic blood pressure. Patients with IASBPD ≥10 mmHg constituted the high group, and those with IASBPD <10 mmHg constituted the normal group. We also recorded data for cardiovascular risk factors. Coronary artery disease was defined as ≥50% vessel stenosis or having undergone interventional therapy according to coronary angiography results. Results Compared with the normal group, the number of patients with coronary artery disease was higher in the high group (86.1% vs. 74.6%, P=0.029). Multiple logistic regression showed that IASBPD ≥10 mmHg were positively correlated with coronary artery disease (odds ratio, 2.313; 95% confidence interval, 1.086-4.509; P=0.029), and as the IASBPD value increased, the correlation also gradually increased. Conclusions IASBPD ≥10 mmHg was positively related to coronary artery disease and increased IASBPD values were correlated with coronary artery disease severity.
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147
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McGraw-Senat CM, Dillard N, Guelda T, Samuel E, Ling H. Bempedoic Acid: A First-in-Class Agent for Lowering Cholesterol Levels. Sr Care Pharm 2021; 36:331-336. [PMID: 34144722 DOI: 10.4140/tcp.n.2021.331] [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]
Abstract
Despite statin therapy being the cornerstone for the treatment of hypercholesterolemia, a significant number of patients do not tolerate statin therapy because of muscle-related adverse effects or cannot achieve their individual low-density lipoproteincholesterol (LDL-C) goals with statin therapy alone. Several nonstatin agents have been evaluated for the management of LDL-C levels and reduction of cardiovascular (CV) risk in these patients, but there are some limitations with their use. Bempedoic acid is a novel nonstatin agent for the management of lipid disorders, via the inhibition of adenosine triphosphate citrate lyase (ACL). It was recently approved by the US Food and Drug Administration based on several phase III trials which showed promising results regarding safety and efficacy. Though CV outcome data are not available yet, bempedoic acid may be a useful adjunct therapy for select patients. The purpose of this review is to evaluate the major findings in these clinical trials and discuss the potential role of bempedoic acid in clinical practice and its use in older people.
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Affiliation(s)
| | - Nakoasha Dillard
- 1Philadelphia College of Osteopathic Medicine, School of Pharmacy, Suwanee, Georgia
| | - Taylor Guelda
- 1Philadelphia College of Osteopathic Medicine, School of Pharmacy, Suwanee, Georgia
| | - Essie Samuel
- 1Philadelphia College of Osteopathic Medicine, School of Pharmacy, Suwanee, Georgia
| | - Hua Ling
- 1Philadelphia College of Osteopathic Medicine, School of Pharmacy, Suwanee, Georgia
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148
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Microalgal feedstock for the production of omega-3 fatty acid ethyl esters and ɛ-polylysine. ACTA ACUST UNITED AC 2021; 31:e00656. [PMID: 34277365 PMCID: PMC8267437 DOI: 10.1016/j.btre.2021.e00656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 12/04/2022]
Abstract
Microalgal omega-3 fatty acids can be an alternative for fish based omega-3 fatty acids. Potassium carbonate is the efficient catalyst for the ethyl ester production. ɛ-polylysine can be produced from the spent biomass after transesterification. Co-production of two products could be the promising bio-refinery approach.
Microalgal omega-3 fatty acids are considered as an efficient alternative for fish-based omega-3 fatty acids. Ethyl esters derived from omega-3 fatty acids are being considered as the drug for hypertriglyceridemia. In this study, omega-3 fatty acids rich Chlorella sp. was utilized for the transesterification for the ethyl ester production using a potassium carbonate alkaline catalyst. At the optimized conditions of transesterification, 86.2% ethyl ester yield was achieved with solvent to algae ratio (20 mL/g), water addition (45 %), catalyst (4 %), temperature (75°C), and reaction time (60 min). Additionally, the acid-hydrolysed spent biomass was used for the production of ɛ-polylysine by fermentation using Streptomyces sp. as fermentative organism. The maximum yield of 1.78 g/L was achieved after 90 h fermentation. This study established a biorefinery approach where two highly valuable compounds could be produced from the Chlorella sp. by transesterification followed by fermentation.
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149
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Watts GF, Sullivan DR, Hare DL, Kostner KM, Horton AE, Bell DA, Brett T, Trent RJ, Poplawski NK, Martin AC, Srinivasan S, Justo RN, Chow CK, Pang J. Essentials of a new clinical practice guidance on familial hypercholesterolaemia for physicians. Intern Med J 2021; 51:769-779. [PMID: 34047032 DOI: 10.1111/imj.15327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/05/2021] [Accepted: 03/16/2021] [Indexed: 11/28/2022]
Abstract
Familial hypercholesterolaemia (FH) is a common, heritable and preventable cause of premature coronary artery disease. New clinical practice recommendations are presented to assist practitioners in enhancing the care of all patients with FH. Core recommendations are made on the detection, diagnosis, assessment and management of adults, children and adolescents with FH. Management is under-pinned by the precepts of risk stratification, adherence to healthy lifestyles, treatment of non-cholesterol risk factors and appropriate use of low-density lipoprotein (LDL)-cholesterol-lowering therapies including statins, ezetimibe and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. The recommendations need to be utilised using judicious clinical judgement and shared decision-making with patients and families. New government-funded schemes for genetic testing and use of PCSK9 inhibitors, as well as the National Health Genomics Policy Framework, will enable adoption of the recommendations. However, a comprehensive implementation science and practice strategy is required to ensure that the guidance translates into benefit for all families with FH.
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Affiliation(s)
- Gerald F Watts
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia.,Lipid Disorders Clinic, Cardiometabolic Service, Departments of Cardiology and Internal Medicine, Royal Perth Hospital, Perth, Western Australia, Australia
| | - David R Sullivan
- Department of Chemical Pathology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - David L Hare
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Department of Cardiology, Austin Health, Melbourne, Victoria, Australia
| | - Karam M Kostner
- Department of Cardiology, Mater Hospital, University of Queensland, Brisbane, Queensland, Australia
| | - Ari E Horton
- Monash Heart and Monash Children's Hospital, Monash Health, Melbourne, Victoria, Australia.,Monash Cardiovascular Research Centre, Melbourne, Victoria, Australia.,Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Damon A Bell
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia.,Lipid Disorders Clinic, Cardiometabolic Service, Departments of Cardiology and Internal Medicine, Royal Perth Hospital, Perth, Western Australia, Australia.,Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Royal Perth Hospital and Fiona Stanley Hospital Network, Perth, Western Australia, Australia.,Department of Clinical Biochemistry, Clinipath Pathology, Perth, Western Australia, Australia.,Sonic Genetics, Sonic Pathology, Sydney, New South Wales, Australia
| | - Tom Brett
- General Practice and Primary Health Care Research, School of Medicine, University of Notre Dame Australia, Perth, Western Australia, Australia
| | - Ronald J Trent
- Department of Medical Genomics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Nicola K Poplawski
- Adult Genetics Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Andrew C Martin
- Department General Paediatrics, Perth Children's Hospital, Perth, Western Australia, Australia.,Division of Paediatrics, University of Western Australia, Perth, Western Australia, Australia
| | - Shubha Srinivasan
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Discipline of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Robert N Justo
- Department of Paediatric Cardiology, Queensland Children's Hospital, Brisbane, Queensland, Australia.,School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Clara K Chow
- Westmead Applied Research Centre, The University of Sydney, Sydney, New South Wales, Australia.,Department of Cardiology, Westmead Hospital, Sydney, New South Wales, Australia.,George Institute for Global Health, Sydney, New South Wales, Australia
| | - Jing Pang
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
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150
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Derosa G, Colletti A, Maffioli P, D'Angelo A, Lupi A, Zito GB, Mureddu GF, Raddino R, Fedele F, Cicero AFG. Lipid-lowering nutraceuticals update on scientific evidence. J Cardiovasc Med (Hagerstown) 2021; 21:845-859. [PMID: 32639326 DOI: 10.2459/jcm.0000000000000970] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
: Cardiovascular diseases (CVDs) are the main cause of mortality worldwide. Risk factors of CVD can be classified into modifiable (smoking, hypertension, diabetes, hypercholesterolemia) through lifestyle changes or taking drug therapy and not modifiable (age, ethnicity, sex and family history). Elevated total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) levels have a lead role in the development of coronary heart disease (CHD), while high levels of high-density lipoprotein-cholesterol (HDL-C) seem to have a protective role.The current treatment for dyslipidemia consists of lifestyle modification or drug therapy even if not pharmacological treatment should be always considered in addition to lipid-lowering medications.The use of lipid-lowering nutraceuticals alone or in association with drug therapy may be considered when the atherogenic cholesterol goal was not achieved.These substances can be classified according to their mechanisms of action into natural inhibitors of intestinal cholesterol absorption, inhibitors of hepatic cholesterol synthesis and enhancers of the excretion of LDL-C. Nevertheless, many of them are characterized by mixed or unclear mechanisms of action.The use of these nutraceuticals is suggested in individuals with borderline lipid profile levels or with drug intolerance, but cannot replace standard lipid-lowering treatment in patients at high, or very high CVD risk.Nutraceuticals can also have vascular effects, including improvement in endothelial dysfunction and arterial stiffness, as well as antioxidative properties. Moreover, epidemiological and clinical studies reported that in patients intolerant of statins, many nutraceuticals with demonstrated hypolipidemic effect are well tolerated.
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Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, PAVIA; SINut (Italian Society of Nutraceuticals)
| | - Alessandro Colletti
- Department of Medical and Surgical Sciences, University of Bologna, BOLOGNA; SINut (Italian Society of Nutraceuticals)
| | - Pamela Maffioli
- Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, PAVIA; SINut (Italian Society of Nutraceuticals)
| | - Angela D'Angelo
- Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, PAVIA; SINut (Italian Society of Nutraceuticals)
| | - Alessandro Lupi
- Cardiology Unit, Ospedali Riuniti di Domodossola e Verbania, OMEGNA; CFC (Federative College of Cardiology)
| | - Giovanni B Zito
- ASL Naples 3 SOUTH, NAPLES; ARCA (Regional Association of Ambulatorial Cardiologists)
| | - Gian Francesco Mureddu
- Cardiology Unit - San Giovanni Addolorata Hospital, ROME; AICPR (Italian Association of Clinical, Preventive and Rehabilitative Cardiology)
| | - Riccardo Raddino
- Cardiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University, Cardiothoracic Department, Spedali Civili of Brescia, BRESCIA; SIRC (Italian Society of Cardiovascular Research)
| | - Francesco Fedele
- Department of Cardiovascular, Respiratory, Anesthesiology, Nephrology and Geriatric Sciences, Sapienza University of Rome, ROME; INCRC (Cardiovascular Research Consortium)
| | - Arrigo F G Cicero
- Department of Medical and Surgical Sciences, University of Bologna, BOLOGNA; SINut (Italian Society of Nutraceuticals)
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