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Stabley JN, Towler DA. Arterial Calcification in Diabetes Mellitus: Preclinical Models and Translational Implications. Arterioscler Thromb Vasc Biol 2017; 37:205-217. [PMID: 28062508 PMCID: PMC5480317 DOI: 10.1161/atvbaha.116.306258] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 12/12/2016] [Indexed: 02/07/2023]
Abstract
Diabetes mellitus increasingly afflicts our aging and dysmetabolic population. Type 2 diabetes mellitus and the antecedent metabolic syndrome represent the vast majority of the disease burden-increasingly prevalent in children and older adults. However, type 1 diabetes mellitus is also advancing in preadolescent children. As such, a crushing wave of cardiometabolic disease burden now faces our society. Arteriosclerotic calcification is increased in metabolic syndrome, type 2 diabetes mellitus, and type 1 diabetes mellitus-impairing conduit vessel compliance and function, thereby increasing the risk for dementia, stroke, heart attack, limb ischemia, renal insufficiency, and lower extremity amputation. Preclinical models of these dysmetabolic settings have provided insights into the pathobiology of arterial calcification. Osteochondrogenic morphogens in the BMP-Wnt signaling relay and transcriptional regulatory programs driven by Msx and Runx gene families are entrained to innate immune responses-responses activated by the dysmetabolic state-to direct arterial matrix deposition and mineralization. Recent studies implicate the endothelial-mesenchymal transition in contributing to the phenotypic drift of mineralizing vascular progenitors. In this brief overview, we discuss preclinical disease models that provide mechanistic insights-and point to challenges and opportunities to translate these insights into new therapeutic strategies for our patients afflicted with diabetes mellitus and its arteriosclerotic complications.
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MESH Headings
- Animals
- Animals, Genetically Modified
- Arteries/metabolism
- Arteries/pathology
- Atherosclerosis/etiology
- Atherosclerosis/metabolism
- Atherosclerosis/pathology
- Diabetes Mellitus, Experimental/complications
- Diabetes Mellitus, Experimental/genetics
- Diabetes Mellitus, Experimental/metabolism
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/genetics
- Diabetes Mellitus, Type 1/metabolism
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/genetics
- Diabetes Mellitus, Type 2/metabolism
- Diabetic Angiopathies/etiology
- Diabetic Angiopathies/metabolism
- Diabetic Angiopathies/pathology
- Diet, High-Fat
- Disease Models, Animal
- Female
- Genetic Predisposition to Disease
- Humans
- Hyperlipidemias/complications
- Hyperlipidemias/genetics
- Male
- Phenotype
- Plaque, Atherosclerotic
- Rats
- Signal Transduction
- Translational Research, Biomedical
- Vascular Calcification/etiology
- Vascular Calcification/metabolism
- Vascular Calcification/pathology
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Affiliation(s)
- John N Stabley
- From the Division of Endocrinology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX
| | - Dwight A Towler
- From the Division of Endocrinology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX.
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102
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DuBose LE, Voss MW, Weng TB, Kent JD, Dubishar KM, Lane-Cordova A, Sigurdsson G, Schmid P, Barlow PB, Pierce GL. Carotid β-stiffness index is associated with slower processing speed but not working memory or white matter integrity in healthy middle-aged/older adults. J Appl Physiol (1985) 2017; 122:868-876. [PMID: 28126907 DOI: 10.1152/japplphysiol.00769.2016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 01/05/2017] [Accepted: 01/17/2017] [Indexed: 01/09/2023] Open
Abstract
Aging is associated with increased carotid artery stiffness, a predictor of incident stroke, and reduced cognitive performance and brain white matter integrity (WMI) in humans. Therefore, we hypothesized that higher carotid stiffness/lower compliance would be independently associated with slower processing speed, higher working memory cost, and lower WMI in healthy middle-aged/older (MA/O) adults. Carotid β-stiffness (P < 0.001) was greater and compliance (P < 0.001) was lower in MA/O (n = 32; 64.4 ± 4.3 yr) vs. young (n = 19; 23.8 ± 2.9 yr) adults. MA/O adults demonstrated slower processing speed (27.4 ± 4.6 vs. 35.4 ± 5.0 U/60 s, P < 0.001) and higher working memory cost (-15.4 ± 0.14 vs. -2.2 ± 0.05%, P < 0.001) vs. young adults. Global WMI was lower in MA/O adults (P < 0.001) and regionally in the frontal lobe (P = 0.020) and genu (P = 0.009). In the entire cohort, multiple regression analysis that included education, sex, and body mass index, carotid β-stiffness index (B = -0.53 ± 0.15 U, P = 0.001) and age group (B = -4.61 ± 1.7, P = 0.012, adjusted R2 = 0.4) predicted processing speed but not working memory cost or WMI. Among MA/O adults, higher β-stiffness (B = -0.60 ± 0.18, P = 0.002) and lower compliance (B = 0.93 ± 0.26, P = 0.002) were associated with slower processing speed but not working memory cost or WMI. These data suggest that greater carotid artery stiffness is independently and selectively associated with slower processing speed but not working memory among MA/O adults. Carotid artery stiffening may modulate reductions in processing speed earlier than working memory with healthy aging in humans.NEW & NOTEWORTHY Previously, studies investigating the relation between large elastic artery stiffness, cognition, and brain structure have focused mainly on aortic stiffness in aged individuals with cardiovascular disease risk factors and other comorbidities. This study adds to the field by demonstrating that the age-related increases in carotid artery stiffness, but not aortic stiffness, is independently and selectively associated with slower processing speed but not working memory among middle-aged/older adults with low cardiovascular disease risk factor burden.
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Affiliation(s)
- Lyndsey E DuBose
- Department of Health and Human Physiology, University of Iowa, Iowa
| | - Michelle W Voss
- Department of Psychological and Brain Sciences, University of Iowa, Iowa.,Aging, Mind and Brain Initiative, University of Iowa, Iowa.,Interdisciplinary Neuroscience Program, University of Iowa, Iowa
| | - Timothy B Weng
- Department of Psychological and Brain Sciences, University of Iowa, Iowa
| | - James D Kent
- Interdisciplinary Neuroscience Program, University of Iowa, Iowa
| | | | | | | | - Phillip Schmid
- Department of Internal Medicine, University of Iowa, Iowa.,Abboud Cardiovascular Research Center, University of Iowa, Iowa City, Iowa
| | | | - Gary L Pierce
- Department of Health and Human Physiology, University of Iowa, Iowa; .,Center for Hypertension Research, University of Iowa, Iowa; and.,Abboud Cardiovascular Research Center, University of Iowa, Iowa City, Iowa
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103
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Kamchatnov PR, Chugunov AV, Tyazhelnikov AA, Pyshkina LI. Pathogenesis of chronic disorders of cerebral circulation. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:70-77. [DOI: 10.17116/jnevro201711712270-77] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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104
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Nieboer D, Douw L, van Dijk BW, Heymans MW, Stam CJ, Twisk JWR. Relation between carotid stiffness, cognitive performance and brain connectivity in a healthy middle-aged population: an observational neurophysiological cohort study with magnetoencephalography. BMJ Open 2016; 6:e013441. [PMID: 27979838 PMCID: PMC5168642 DOI: 10.1136/bmjopen-2016-013441] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE Impaired blood flow of the carotid artery can result in cognitive impairment, but how these vascular impairments lead to global cognitive disturbances is largely unknown. Problems in functional connectivity between brain areas may be responsible for these widespread effects. Therefore, the aim of this study was to examine the association between carotid stiffness, functional connectivity and cognitive performance in relatively young and healthy adults before clinical vascular pathology occurs. DESIGN The Amsterdam Growth and Health Longitudinal Study: an observational study. SETTING Participants were included by attending 1 of the 2 selected secondary schools in The Netherlands. PARTICIPANTS Men (n=110) and women (n=120) aged 41-44 years (42±0.7). PRIMARY AND SECONDARY OUTCOME MEASURES Data were obtained with regard to local carotid stiffness captured measured with the Young's elastic modulus (YEM). All participants underwent a commonly used Dutch intelligence test and resting-state eyes-closed magnetoencephalography (MEG). Five artefact-free epochs were analysed. The phase lag index (PLI) was used as a measure of functional connectivity between all sensors and was assessed in six frequency bands (δ-γ). RESULTS Carotid stiffness was significantly associated with increased functional connectivity in the α2 band in men (β: 0.287; p=0.008). The same results were found for women in the β band (β: 0.216; p=0.040). Furthermore, carotid stiffness was associated with superior cognitive function in men (β: 0.238; p=0.007). In addition, there was neither a significant association nor a consistent pattern between cognitive function and functional connectivity. CONCLUSIONS The increased connectivity might be a maladaptive phenomenon caused by disinhibition of neurons which may explain the direction of the results. This study suggests that detection of increased (local) carotid stiffness may be promising to identify a disturbance in the organisation of the functional brain network, even before clinical vascular pathology occurs.
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Affiliation(s)
- Dagmar Nieboer
- Department of Methodology and Applied Biostatistics, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Linda Douw
- Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | - Bob W van Dijk
- Department of Clinical Neurophysiology and MEG Center, VU University Medical Center, Amsterdam, The Netherlands
- Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands
| | - Martijn W Heymans
- Department of Methodology and Applied Biostatistics, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Cornelis J Stam
- Department of Clinical Neurophysiology and MEG Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
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105
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Cooper LL, Mitchell GF. Aortic Stiffness, Cerebrovascular Dysfunction, and Memory. Pulse (Basel) 2016; 4:69-77. [PMID: 27752478 DOI: 10.1159/000448176] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 07/05/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Aortic stiffness is associated with cardiovascular and cerebrovascular events and cognitive decline. This mini-review focuses on relations of aortic stiffness with microvascular dysfunction and discusses the contribution of abnormal pulsatile hemodynamics to cerebrovascular damage and cognitive decline. We also provide a rationale for considering aortic stiffness as a putative and important contributor to memory impairment in older individuals. SUMMARY Aging is associated with stiffening of the aorta but not the muscular arteries, which reduces wave reflection and increases the transmission of pulsatility into the periphery. Aortic stiffening thereby impairs a protective mechanism that shields the peripheral microcirculation from excessive pulsatility within downstream target organs. Beyond midlife, aortic stiffness increases rapidly and exposes the cerebral microcirculation to abnormal pulsatile mechanical forces that are associated with microvascular damage and remodeling in the brain. Aortic stiffening and high-flow pulsatility are associated with alterations in the microvasculature of the brain; however, a mechanistic link between aortic stiffness and memory has not been established. We showed that in a community-based sample of older individuals, cerebrovascular resistance and white matter hyperintensities - markers of cerebrovascular remodeling and damage - mediated the relation between higher aortic stiffness and lower performance on memory function tests. These data suggest that microvascular and white matter damage associated with excessive aortic stiffness contribute to impaired memory function with advancing age. KEY MESSAGES Increasing evidence suggests that vascular etiologies - including aortic stiffness and microvascular damage - contribute to memory impairment and the pathogenesis of dementia, including Alzheimer's disease. Interventions that reduce aortic stiffness may delay memory decline among older individuals.
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Affiliation(s)
- Leroy L Cooper
- Cardiovascular Engineering, Inc., Norwood, Mass, USA; Lifespan Cardiovascular Institute, W. Alpert Medical School of Brown University, Providence, R.I., USA
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106
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Lefferts WK, Heffernan KS, Barreira TV. Association between pulsatile blood pressure and cognitive performance among older adults: Insight from the National Health and Nutrition Examination Survey 1999-2002. Int J Cardiol 2016; 223:981-984. [PMID: 27591696 DOI: 10.1016/j.ijcard.2016.08.287] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 08/16/2016] [Accepted: 08/18/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND High blood pressure (BP) may be associated with impaired cognitive function. BP is comprised of a steady (mean arterial pressure; MAP) and pulsatile (pulse pressure; PP) component. The purpose of this study was to examine the relationship between steady and pulsatile BP and cognition among adults ≥60years old. METHODS 2058 adults age 60-85years from the 1999-2002 NHANES were used in this analysis. MAP and PP were calculated from brachial BP as 1/3 systolic +2/3 diastolic BP, and systolic - diastolic BP, respectively. Cognition was assessed using the digit-symbol substitution test (DSST). RESULTS Unadjusted multiple regression revealed although PP independently predicted DSST score (β=-0.21, p<0.05), MAP was only predictive when entered simultaneously with PP (β=0.06, p<0.05). Further adjustments for sociodemographics and medical history significantly improved prediction of DSST score (∆R2=0.37, p<0.05), and removed the association between MAP and DSST score, although PP remained a significant predictor (β=-0.07, p<0.05). CONCLUSIONS PP, but not MAP, was significantly and inversely related to cognitive function among a representative sample of adults aged ≥60years after controlling for sociodemographic information and medical history.
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107
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Nicholson CJ, Seta F, Lee S, Morgan KG. MicroRNA-203 mimics age-related aortic smooth muscle dysfunction of cytoskeletal pathways. J Cell Mol Med 2016; 21:81-95. [PMID: 27502584 PMCID: PMC5192880 DOI: 10.1111/jcmm.12940] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 06/23/2016] [Indexed: 12/20/2022] Open
Abstract
Increased aortic stiffness is a biomarker for subsequent adverse cardiovascular events. We have previously reported that vascular smooth muscle Src-dependent cytoskeletal remodelling, which contributes to aortic plasticity, is impaired with ageing. Here, we use a multi-scale approach to determine the molecular mechanisms behind defective Src-dependent signalling in an aged C57BL/6 male mouse model. Increased aortic stiffness, as measured in vivo by pulse wave velocity, was found to have a comparable time course to that in humans. Bioinformatic analyses predicted several miRs to regulate Src-dependent cytoskeletal remodelling. qRT-PCR was used to determine the relative levels of predicted miRs in aortas and, notably, the expression of miR-203 increased almost twofold in aged aorta. Increased miR-203 expression was associated with a decrease in both mRNA and protein expression of Src, caveolin-1 and paxillin in aged aorta. Probing with phospho-specific antibodies confirmed that overexpression of miR-203 significantly attenuated Src and extracellular signal regulated kinase (ERK) signalling, which we have previously found to regulate vascular smooth muscle stiffness. In addition, transfection of miR-203 into aortic tissue from young mice increased phenylephrine-induced aortic stiffness ex vivo, mimicking the aged phenotype. Upstream of miR-203, we found that DNA methyltransferases (DNMT) 1, 3a, and 3b are also significantly decreased in the aged mouse aorta and that DNMT inhibition significantly increases miR-203 expression. Thus, the age-induced increase in miR-203 may be caused by epigenetic promoter hypomethylation in the aorta. These findings indicate that miR-203 promotes a re-programming of Src/ERK signalling pathways in vascular smooth muscle, impairing the regulation of stiffness in aged aorta.
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Affiliation(s)
| | - Francesca Seta
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Sophie Lee
- Department of Health Sciences, Boston University, Boston, MA, USA
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108
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Pase MP, Beiser A, Himali JJ, Tsao C, Satizabal CL, Vasan RS, Seshadri S, Mitchell GF. Aortic Stiffness and the Risk of Incident Mild Cognitive Impairment and Dementia. Stroke 2016; 47:2256-61. [PMID: 27491735 DOI: 10.1161/strokeaha.116.013508] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 05/27/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE Aortic stiffening increases the transfers of high pressure and flow pulsatility to small cerebral vessels potentially causing the accumulation of vascular brain injury. Our aim was to investigate the prospective association of aortic stiffness with the risks of incident mild cognitive impairment and dementia. METHODS We studied 1101 dementia-free Framingham Offspring study participants (mean age, 69±6 years; 54% women). Aortic stiffness was measured as carotid-femoral pulse wave velocity using applanation tonometry and modeled as a linear variable and the top 2 quintiles (>11.4 m/s). Outcomes were the 10-year risk of incident mild cognitive impairment and dementia, including clinically characterized Alzheimer disease. We observed 106, 77, and 59 events of mild cognitive impairment, all-cause dementia, and clinical Alzheimer disease, respectively. RESULTS After adjustment for age and sex, higher continuous aortic stiffness predicted an increased risk of mild cognitive impairment (hazard ratio, 1.40 [95% confidence interval, 1.13-1.73]), all-cause dementia (hazard ratio, 1.45 [95% confidence interval, 1.13-1.87]), and Alzheimer disease (hazard ratio, 1.41 [95% confidence interval, 1.06-1.87]). In risk factor-adjusted statistical models, aortic stiffness remained a significant predictor of mild cognitive impairment but not incident dementia. In nondiabetic patients, the top 2 quintiles of aortic stiffness were associated with a higher risk of incident all-cause dementia across all statistical models. CONCLUSIONS Aortic stiffness was an independent predictor of incident mild cognitive impairment in the whole sample and with incident dementia in nondiabetic patients. Our findings suggest aortic stiffness as a potentially modifiable risk factor for clinical cognitive impairment and dementia.
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Affiliation(s)
- Matthew P Pase
- From the Department of Neurology, Boston University School of Medicine, MA (M.P.P., A.B., J.J.H., C.L.S., S.S.); Framingham Heart Study, MA (M.P.P., A.B., J.J.H., C.L.S., R.S.V., S.S., G.F.M.); Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Centre, Boston, MA (C.T.); and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.).
| | - Alexa Beiser
- From the Department of Neurology, Boston University School of Medicine, MA (M.P.P., A.B., J.J.H., C.L.S., S.S.); Framingham Heart Study, MA (M.P.P., A.B., J.J.H., C.L.S., R.S.V., S.S., G.F.M.); Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Centre, Boston, MA (C.T.); and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.)
| | - Jayandra J Himali
- From the Department of Neurology, Boston University School of Medicine, MA (M.P.P., A.B., J.J.H., C.L.S., S.S.); Framingham Heart Study, MA (M.P.P., A.B., J.J.H., C.L.S., R.S.V., S.S., G.F.M.); Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Centre, Boston, MA (C.T.); and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.)
| | - Connie Tsao
- From the Department of Neurology, Boston University School of Medicine, MA (M.P.P., A.B., J.J.H., C.L.S., S.S.); Framingham Heart Study, MA (M.P.P., A.B., J.J.H., C.L.S., R.S.V., S.S., G.F.M.); Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Centre, Boston, MA (C.T.); and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.)
| | - Claudia L Satizabal
- From the Department of Neurology, Boston University School of Medicine, MA (M.P.P., A.B., J.J.H., C.L.S., S.S.); Framingham Heart Study, MA (M.P.P., A.B., J.J.H., C.L.S., R.S.V., S.S., G.F.M.); Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Centre, Boston, MA (C.T.); and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.)
| | - Ramachandran S Vasan
- From the Department of Neurology, Boston University School of Medicine, MA (M.P.P., A.B., J.J.H., C.L.S., S.S.); Framingham Heart Study, MA (M.P.P., A.B., J.J.H., C.L.S., R.S.V., S.S., G.F.M.); Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Centre, Boston, MA (C.T.); and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.)
| | - Sudha Seshadri
- From the Department of Neurology, Boston University School of Medicine, MA (M.P.P., A.B., J.J.H., C.L.S., S.S.); Framingham Heart Study, MA (M.P.P., A.B., J.J.H., C.L.S., R.S.V., S.S., G.F.M.); Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Centre, Boston, MA (C.T.); and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.)
| | - Gary F Mitchell
- From the Department of Neurology, Boston University School of Medicine, MA (M.P.P., A.B., J.J.H., C.L.S., S.S.); Framingham Heart Study, MA (M.P.P., A.B., J.J.H., C.L.S., R.S.V., S.S., G.F.M.); Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Centre, Boston, MA (C.T.); and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.)
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109
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Carotid stiffness is associated with impairment of cognitive performance in individuals with and without type 2 diabetes. The Maastricht Study. Atherosclerosis 2016; 253:186-193. [PMID: 27503567 DOI: 10.1016/j.atherosclerosis.2016.07.912] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 07/17/2016] [Accepted: 07/20/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS There is increasing evidence linking arterial (mainly aortic) stiffness and type 2 diabetes, a risk factor for arterial stiffness, to cognitive impairment and dementia. However, data on carotid stiffness, which may be especially relevant for cognitive performance, are scarce, and few studies have addressed the interplay between arterial stiffness, type 2 diabetes, and cognitive performance. METHODS We studied individuals with (n = 197) and without (n = 528) type 2 diabetes, who completed a neuropsychological test battery and underwent applanation tonometry and vascular ultrasound to evaluate aortic (i.e. carotid-to-femoral pulse wave velocity) and carotid stiffness (i.e. distensibility, compliance and Young's elastic modulus). Linear regression analyses were performed and adjusted for demographics, vascular risk factors, and depression. RESULTS Overall, our results showed that carotid, but not aortic, stiffness was associated with worse cognitive performance, primarily in the domains of processing speed (standardized regression coefficient for distensibility -0.083, p = 0.040; compliance -0.077, p = 0.032) and executive function and attention (distensibility -0.133, p = 0.001; compliance -0.090, p = 0.015; Young's elastic modulus -0.081, p = 0.027). These associations did not differ by diabetes status. The differences in cognitive performance between individuals with and without type 2 diabetes (mean difference in domain scores relative to those without diabetes for free recall memory -0.23, processing speed -0.19, executive function and attention -0.23; all p ≤ 0.009 and adjusted for demographics, traditional vascular risk factors, and depression) were not substantially altered after additional adjustment for carotid stiffness. CONCLUSIONS Our findings suggest that carotid stiffness is associated with cognitive performance in both individuals with and without diabetes, but does not mediate the relationship between type 2 diabetes and cognitive dysfunction.
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110
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Fry JL, Al Sayah L, Weisbrod RM, Van Roy I, Weng X, Cohen RA, Bachschmid MM, Seta F. Vascular Smooth Muscle Sirtuin-1 Protects Against Diet-Induced Aortic Stiffness. Hypertension 2016; 68:775-84. [PMID: 27432859 DOI: 10.1161/hypertensionaha.116.07622] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/13/2016] [Indexed: 01/10/2023]
Abstract
Arterial stiffness, a major cardiovascular risk factor, develops within 2 months in mice fed a high-fat, high-sucrose (HFHS) diet, serving as a model of human metabolic syndrome, and it is associated with activation of proinflammatory and oxidant pathways in vascular smooth muscle (VSM) cells. Sirtuin-1 (SirT1) is an NAD(+)-dependent deacetylase regulated by the cellular metabolic status. Our goal was to study the effects of VSM SirT1 on arterial stiffness in the context of diet-induced metabolic syndrome. Overnight fasting acutely decreased arterial stiffness, measured in vivo by pulse wave velocity, in mice fed HFHS for 2 or 8 months, but not in mice lacking SirT1 in VSM (SMKO). Similarly, VSM-specific genetic SirT1 overexpression (SMTG) prevented pulse wave velocity increases induced by HFHS feeding, during 8 months. Administration of resveratrol or S17834, 2 polyphenolic compounds known to activate SirT1, prevented HFHS-induced arterial stiffness and were mimicked by global SirT1 overexpression (SirT1 bacterial artificial chromosome overexpressor), without evident metabolic improvements. In addition, HFHS-induced pulse wave velocity increases were reversed by 1-week treatment with a specific, small molecule SirT1 activator (SRT1720). These beneficial effects of pharmacological or genetic SirT1 activation, against HFHS-induced arterial stiffness, were associated with a decrease in nuclear factor kappa light chain enhancer of activated B cells (NFκB) activation and vascular cell adhesion molecule (VCAM-1) and p47phox protein expressions, in aorta and VSM cells. In conclusion, VSM SirT1 activation decreases arterial stiffness in the setting of obesity by stimulating anti-inflammatory and antioxidant pathways in the aorta. SirT1 activators may represent a novel therapeutic approach to prevent arterial stiffness and associated cardiovascular complications in overweight/obese individuals with metabolic syndrome.
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Affiliation(s)
- Jessica L Fry
- From the Vascular Biology Section, School of Medicine, Boston University Medical Campus, MA
| | - Leona Al Sayah
- From the Vascular Biology Section, School of Medicine, Boston University Medical Campus, MA
| | - Robert M Weisbrod
- From the Vascular Biology Section, School of Medicine, Boston University Medical Campus, MA
| | - Isabelle Van Roy
- From the Vascular Biology Section, School of Medicine, Boston University Medical Campus, MA
| | - Xiang Weng
- From the Vascular Biology Section, School of Medicine, Boston University Medical Campus, MA
| | - Richard A Cohen
- From the Vascular Biology Section, School of Medicine, Boston University Medical Campus, MA
| | - Markus M Bachschmid
- From the Vascular Biology Section, School of Medicine, Boston University Medical Campus, MA
| | - Francesca Seta
- From the Vascular Biology Section, School of Medicine, Boston University Medical Campus, MA.
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De Buyzere M. Young Adults With Stiff Arteries. Hypertension 2016; 67:490-2. [DOI: 10.1161/hypertensionaha.115.06716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Marc De Buyzere
- From the Department of Cardiology, University Hospital, Ghent, Belgium
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