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Grymyr LMD, Nadirpour S, Gerdts E, Nedrebø BG, Hjertaas JJ, Matre K, Cramariuc D. One-year impact of bariatric surgery on left ventricular mechanics: results from the prospective FatWest study. EUROPEAN HEART JOURNAL OPEN 2021; 1:oeab024. [PMID: 35919265 PMCID: PMC9241572 DOI: 10.1093/ehjopen/oeab024] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/22/2021] [Accepted: 08/18/2021] [Indexed: 12/14/2022]
Abstract
Aims Patients with severe obesity are predisposed to left ventricular (LV) hypertrophy, increased myocardial oxygen demand, and impaired myocardial mechanics. Bariatric surgery leads to rapid weight loss and improves cardiovascular risk profile. The present prospective study assesses whether LV wall mechanics improve 1 year after bariatric surgery. Methods and results Ninety-four severely obese patients [43 ± 10 years, 71% women, body mass index (BMI) 41.8 ± 4.9 kg/m2, 57% with hypertension] underwent echocardiography before, 6 months and 1 year after gastric bypass surgery in the FatWest (Bariatric Surgery on the West Coast of Norway) study. We assessed LV mechanics by midwall shortening (MWS) and global longitudinal strain (GLS), LV power/mass as 0.222 × cardiac output × mean blood pressure (BP)/LV mass, and myocardial oxygen demand as the LV mass-wall stress-heart rate product. Surgery induced a significant reduction in BMI, heart rate, and BP (P < 0.001). Prevalence of LV hypertrophy fell from 35% to 19% 1 year after surgery (P < 0.001). The absolute value of GLS improved by—4.6% (i.e. 29% increase in GLS) while LV ejection fraction, MWS, and LV power/mass remained unchanged. In multivariate regression analyses, 1 year improvement in GLS was predicted by lower preoperative GLS, larger mean BP, and BMI reduction (all P < 0.05). Low 1-year MWS was associated with female sex, preoperative hypertension, and higher 1-year LV relative wall thickness and myocardial oxygen demand (all P < 0.001). Conclusion In severely obese patients, LV longitudinal function is largely recovered one year after bariatric surgery due to reduced afterload. LV midwall mechanics does not improve, particularly in women and patients with persistent LV geometric abnormalities. ClinicalTrials.gov identifier NCT01533142, 15 February 2012.
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Affiliation(s)
- Lisa M D Grymyr
- Haukeland University Hospital, Jonas Liesvei 65, 5021 Bergen, Norway
| | | | - Eva Gerdts
- Department of Clinical Science, Center for Research on Cardiac Disease in Women, Jonas Liesvei 65, 5021 Bergen, Norway
| | | | | | - Knut Matre
- Haukeland University Hospital, Jonas Liesvei 65, 5021 Bergen, Norway
| | - Dana Cramariuc
- Haukeland University Hospital, Jonas Liesvei 65, 5021 Bergen, Norway
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252
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Dabbah MA, Reed AB, Booth ATC, Yassaee A, Despotovic A, Klasmer B, Binning E, Aral M, Plans D, Morelli D, Labrique AB, Mohan D. Machine learning approach to dynamic risk modeling of mortality in COVID-19: a UK Biobank study. Sci Rep 2021; 11:16936. [PMID: 34413324 PMCID: PMC8376891 DOI: 10.1038/s41598-021-95136-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/19/2021] [Indexed: 12/13/2022] Open
Abstract
The COVID-19 pandemic has created an urgent need for robust, scalable monitoring tools supporting stratification of high-risk patients. This research aims to develop and validate prediction models, using the UK Biobank, to estimate COVID-19 mortality risk in confirmed cases. From the 11,245 participants testing positive for COVID-19, we develop a data-driven random forest classification model with excellent performance (AUC: 0.91), using baseline characteristics, pre-existing conditions, symptoms, and vital signs, such that the score could dynamically assess mortality risk with disease deterioration. We also identify several significant novel predictors of COVID-19 mortality with equivalent or greater predictive value than established high-risk comorbidities, such as detailed anthropometrics and prior acute kidney failure, urinary tract infection, and pneumonias. The model design and feature selection enables utility in outpatient settings. Possible applications include supporting individual-level risk profiling and monitoring disease progression across patients with COVID-19 at-scale, especially in hospital-at-home settings.
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Affiliation(s)
| | | | | | - Arrash Yassaee
- Huma Therapeutics Limited, London, UK
- Centre for Paediatrics and Child Health, Faculty of Medicine, Imperial College London, London, UK
| | - Aleksa Despotovic
- Huma Therapeutics Limited, London, UK
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | | | - Mert Aral
- Huma Therapeutics Limited, London, UK
| | - David Plans
- Huma Therapeutics Limited, London, UK.
- University of Exeter, SITE, Exeter, UK.
| | - Davide Morelli
- Huma Therapeutics Limited, London, UK
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | - Alain B Labrique
- Johns Hopkins Bloomberg School Public Health, Baltimore, MD, USA
| | - Diwakar Mohan
- Johns Hopkins Bloomberg School Public Health, Baltimore, MD, USA
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253
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Abstract
While much has been written about the syndrome of diabetic cardiomyopathy, clinicians and research scientists are now beginning to realize that an entirely unique syndrome exists, albeit with several commonalities to the diabetic syndrome, that being obesity cardiomyopathy. This syndrome develops independent of such comorbidities as hypertension, myocardial infarction and coronary artery disease; and it is characterized by specific alterations in adipose tissue function, inflammation and metabolism. Recent insights into the etiology of the syndrome and its consequences have focused on the roles played by altered intracellular calcium homeostasis, reactive oxygen species, and mitochondrial dysfunction. A timely and comprehensive review by Ren, Wu, Wang, Sowers and Zhang (1) identifies unique mechanisms underlying this syndrome, its relationship to heart failure and the recently identified incidence of COVID-19-related cardiovascular mortality. Importantly, the review concludes by advancing recommendations for novel approaches to the clinical management of this dangerous form of cardiomyopathy.
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Affiliation(s)
- Willis K Samson
- Department of Pharmacology and Physiology, Saint Louis University, St. Louis, MO, United States
| | - Gina L C Yosten
- Department of Pharmacology and Physiology, Saint Louis University, St. Louis, MO, United States
| | - Carol Ann Remme
- Experimental Cardiology, Academic Medical Center, Amsterdam, Netherlands
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254
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Posai V, Suksatan W, Choompunuch B, Koontalay A, Ounprasertsuk J, Sadang JM. Assessment of the Health-Promoting Behaviors of Hospitalized Patients with Non-Communicable Diseases During the Second Wave of COVID-19. J Multidiscip Healthc 2021; 14:2185-2194. [PMID: 34413651 PMCID: PMC8370493 DOI: 10.2147/jmdh.s329344] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/02/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has affected the health-related behaviors of patients with non-communicable diseases (NCDs). Thus, the factors predicting the health-promoting behaviors (HPBs) of hospitalized patients with NCDs during the second wave of COVID-19 should be examined. OBJECTIVE The aims of this study were to determine the relationships among the patients' characteristics, perceived self-efficacy, social support, perception of the benefits of and barriers, and HPBs, and to determine the predictive factors of HPBs among hospitalized patients with NCDs during the second wave of COVID-19. PATIENTS AND METHODS The study had a cross-sectional predictive correlational design and included 250 patients with NCDs 18 years of age or older hospitalized in a tertiary hospital in Thailand. Descriptive statistics, the chi-square test, the Pearson's correlation coefficient, and stepwise multiple linear regression were used for data analysis. RESULTS Most of the participants had a cardiovascular disease (34.0%). Followed by diabetes (28.8%), cancer (11.2%), hypertension (10.0%), heart disease (9.6%), or chronic obstructive pulmonary disease (6.4%) and had a moderate level of overall HPBs (M = 106.09; SD = 4.66). Among the six components of the HPBs, the participants achieved the moderate levels in nutrition, interpersonal relations, spiritual growth, and stress management, and low levels in physical-activity and health responsibility. The patients' perception of the benefits and barriers to the adoption of HPBs and perceived self-efficacy and social support were able to predict their HPBs, accounting for approximately 38.0% of the variance of such behaviors. CONCLUSION On the basis of our study's results, we suggest that researchers, multidisciplinary teams, the government, and policymakers establish effective interventions, guidelines, and policies for the development of HPBs to prevent and control the spread of COVID-19 particularly among patients with NCDs, and to improve their capacity for high-quality and continuing self-care.
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Affiliation(s)
- Vachira Posai
- Nursing Department, Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand
| | - Wanich Suksatan
- Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | | | | | - Jatuporn Ounprasertsuk
- College of Allied Health Sciences, Suan Sunandha Rajabhat University, Bangkok, Samut Songkram Province, Thailand
| | - Jonaid M Sadang
- College of Health Sciences, Mindanao State University- Marawi, Marawi, Philippines
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255
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da Silva CA, Mendes RML, de Moraes Santana N, Dos Santos NF, Pinho CPS. Dynapenic abdominal obesity in hospitalized elderly patients with acute myocardial infarction. Exp Gerontol 2021; 154:111512. [PMID: 34384888 DOI: 10.1016/j.exger.2021.111512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 07/11/2021] [Accepted: 08/04/2021] [Indexed: 10/20/2022]
Abstract
Obesity and dynapenia are cardiovascular risk factors. When present together, it is called dynapenic abdominal obesity and can potentiate adverse outcomes. This study aims to estimate the prevalence of dynapenic abdominal obesity and its relationship with prognostic markers in patients with acute myocardial infarction (AMI). This is a hybrid study with a longitudinal component plus a cross-sectional component at baseline involving elderly patients admitted to a reference hospital in cardiology due to AMI in the Brazilian Northeast from May to October 2015. We analyzed patients' admission data and evaluated some prognostic markers up to two years after admission. We established abdominal obesity by measuring waist circumference (>102 cm for men and >88 cm for women) and dynapenia by handgrip strength (<27 kg/F for men and <16 kg/F for women). We considered the prognostic markers troponin and creatinine kinase - MB (CKMB), AMI classification according to ST segment elevation, TIMI score, need for coronary angioplasty or coronary artery bypass surgery, complications during hospitalization and within two years after admission, and re-admission to the same service. We evaluated 92 patients with a mean age of 71.4 ± 7.5 years. The prevalence of abdominal obesity and dynapenia was 56.5% and 44.6%, respectively. The coexistence of the two conditions occurred in 25.0% of the patients, being higher among women (p < 0.001). When comparing the dynapenic abdominal obese groups with the group of patients who had one of the two isolated conditions we observed that, for a same mean age and clinical characteristics, patients with only one of the conditions had a higher CKMB (p = 0.046) and troponin median (p = 0.032). The presence of dynapenia in the groups of abdominal obese and non-abdominal obese individuals is not associated with risk marker parameters (p > 0.05). High prevalence of abdominal obesity and dynapenia occurred among patients with AMI and in a quarter of these both conditions coexisted. Dynapenic abdominal obesitydoes not increase the risk of adverse outcomes and isolated dynapenia is not a marker of a poor prognosis.
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Affiliation(s)
- Clécia Alves da Silva
- Hospital das Clínicas - UFPE, Av. Moraes Rego, 1235 - Cidade Universitária, Recife, PE, 50670-901, Brazil.
| | - Roberta Maria Lins Mendes
- Cardiology Emergency Department of Pernambuco, Rua dos Palmares, s / n - Santo Amaro, Recife CEP: 50.100-060, PE, Brazil
| | - Natália de Moraes Santana
- Cardiology Emergency Department of Pernambuco, Rua dos Palmares, s / n - Santo Amaro, Recife CEP: 50.100-060, PE, Brazil
| | - Natalia Fernandes Dos Santos
- Cardiology Emergency Department of Pernambuco, Rua dos Palmares, s / n - Santo Amaro, Recife CEP: 50.100-060, PE, Brazil
| | - Cláudia Porto Sabino Pinho
- Clinical Nutrition Residency Program, Hospital das Clínicas - UFPE, Av. Moraes Rego, 1235 - Cidade Universitária, Recife, - PE, 50670-901, Brazil
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256
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Logette E, Lorin C, Favreau C, Oshurko E, Coggan JS, Casalegno F, Sy MF, Monney C, Bertschy M, Delattre E, Fonta PA, Krepl J, Schmidt S, Keller D, Kerrien S, Scantamburlo E, Kaufmann AK, Markram H. A Machine-Generated View of the Role of Blood Glucose Levels in the Severity of COVID-19. Front Public Health 2021; 9:695139. [PMID: 34395368 PMCID: PMC8356061 DOI: 10.3389/fpubh.2021.695139] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/30/2021] [Indexed: 01/08/2023] Open
Abstract
SARS-CoV-2 started spreading toward the end of 2019 causing COVID-19, a disease that reached pandemic proportions among the human population within months. The reasons for the spectrum of differences in the severity of the disease across the population, and in particular why the disease affects more severely the aging population and those with specific preconditions are unclear. We developed machine learning models to mine 240,000 scientific articles openly accessible in the CORD-19 database, and constructed knowledge graphs to synthesize the extracted information and navigate the collective knowledge in an attempt to search for a potential common underlying reason for disease severity. The machine-driven framework we developed repeatedly pointed to elevated blood glucose as a key facilitator in the progression of COVID-19. Indeed, when we systematically retraced the steps of the SARS-CoV-2 infection, we found evidence linking elevated glucose to each major step of the life-cycle of the virus, progression of the disease, and presentation of symptoms. Specifically, elevations of glucose provide ideal conditions for the virus to evade and weaken the first level of the immune defense system in the lungs, gain access to deep alveolar cells, bind to the ACE2 receptor and enter the pulmonary cells, accelerate replication of the virus within cells increasing cell death and inducing an pulmonary inflammatory response, which overwhelms an already weakened innate immune system to trigger an avalanche of systemic infections, inflammation and cell damage, a cytokine storm and thrombotic events. We tested the feasibility of the hypothesis by manually reviewing the literature referenced by the machine-generated synthesis, reconstructing atomistically the virus at the surface of the pulmonary airways, and performing quantitative computational modeling of the effects of glucose levels on the infection process. We conclude that elevation in glucose levels can facilitate the progression of the disease through multiple mechanisms and can explain much of the differences in disease severity seen across the population. The study provides diagnostic considerations, new areas of research and potential treatments, and cautions on treatment strategies and critical care conditions that induce elevations in blood glucose levels.
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Affiliation(s)
- Emmanuelle Logette
- Blue Brain Project, École polytechnique fédérale de Lausanne (EPFL), Geneva, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Henry Markram
- Blue Brain Project, École polytechnique fédérale de Lausanne (EPFL), Geneva, Switzerland
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257
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Gusev E, Sarapultsev A, Hu D, Chereshnev V. Problems of Pathogenesis and Pathogenetic Therapy of COVID-19 from the Perspective of the General Theory of Pathological Systems (General Pathological Processes). Int J Mol Sci 2021; 22:7582. [PMID: 34299201 PMCID: PMC8304657 DOI: 10.3390/ijms22147582] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/30/2021] [Accepted: 07/12/2021] [Indexed: 01/18/2023] Open
Abstract
The COVID-19 pandemic examines not only the state of actual health care but also the state of fundamental medicine in various countries. Pro-inflammatory processes extend far beyond the classical concepts of inflammation. They manifest themselves in a variety of ways, beginning with extreme physiology, then allostasis at low-grade inflammation, and finally the shockogenic phenomenon of "inflammatory systemic microcirculation". The pathogenetic core of critical situations, including COVID-19, is this phenomenon. Microcirculatory abnormalities, on the other hand, lie at the heart of a specific type of general pathological process known as systemic inflammation (SI). Systemic inflammatory response, cytokine release, cytokine storm, and thrombo-inflammatory syndrome are all terms that refer to different aspects of SI. As a result, the metabolic syndrome model does not adequately reflect the pathophysiology of persistent low-grade systemic inflammation (ChSLGI). Diseases associated with ChSLGI, on the other hand, are risk factors for a severe COVID-19 course. The review examines the role of hypoxia, metabolic dysfunction, scavenger receptors, and pattern-recognition receptors, as well as the processes of the hemophagocytic syndrome, in the systemic alteration and development of SI in COVID-19.
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Affiliation(s)
- Evgenii Gusev
- Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Science, 620049 Ekaterinburg, Russia; (E.G.); (V.C.)
| | - Alexey Sarapultsev
- Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Science, 620049 Ekaterinburg, Russia; (E.G.); (V.C.)
- School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia
| | - Desheng Hu
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 200092, China;
| | - Valeriy Chereshnev
- Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Science, 620049 Ekaterinburg, Russia; (E.G.); (V.C.)
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258
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Yan T, Xiao R, Wang N, Shang R, Lin G. Obesity and severe coronavirus disease 2019: molecular mechanisms, paths forward, and therapeutic opportunities. Theranostics 2021; 11:8234-8253. [PMID: 34373739 PMCID: PMC8343994 DOI: 10.7150/thno.59293] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 06/20/2021] [Indexed: 01/08/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appears to have higher pathogenicity among patients with obesity. Obesity, termed as body mass index greater than 30 kg/m2, has now been demonstrated to be important comorbidity for disease severity during coronavirus disease 2019 (COVID-19) pandemic and associated with adverse events. Unraveling mechanisms behind this phenomenon can assist scientists, clinicians, and policymakers in responding appropriately to the COVID-19 pandemic. In this review, we systemically delineated the potential mechanistic links between obesity and worsening COVID-19 from altered physiology, underlying diseases, metabolism, immunity, cytokine storm, and thrombosis. Problematic ventilation caused by obesity and preexisting medical disorders exacerbate organ dysfunction for patients with obesity. Chronic metabolic disorders, including dyslipidemia, hyperglycemia, vitamin D deficiency, and polymorphisms of metabolism-related genes in obesity, probably aid SARS-CoV-2 intrusion and impair antiviral responses. Obesity-induced inadequate antiviral immunity (interferon, natural killer cells, invariant natural killer T cell, dendritic cell, T cells, B cell) at the early stage of SARS-CoV-2 infection leads to delayed viral elimination, increased viral load, and expedited viral mutation. Cytokine storm, with the defective antiviral immunity, probably contributes to tissue damage and pathological progression, resulting in severe symptoms and poor prognosis. The prothrombotic state, driven in large part by endothelial dysfunction, platelet hyperactivation, hypercoagulability, and impaired fibrinolysis in obesity, also increases the risk of severe COVID-19. These mechanisms in the susceptibility to severe condition also open the possibility for host-directed therapies in population with obesity. By bridging work done in these fields, researchers can gain a holistic view of the paths forward and therapeutic opportunities to break the vicious cycle of obesity and its devastating complications in the next emerging pandemic.
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Affiliation(s)
- Tiantian Yan
- Military Burn Center, the 990th Hospital of People's Liberation Army Joint Logistics Support Force, Zhumadian, Henan, China
| | - Rong Xiao
- Military Burn Center, the 990th Hospital of People's Liberation Army Joint Logistics Support Force, Zhumadian, Henan, China
| | - Nannan Wang
- Military Burn Center, the 990th Hospital of People's Liberation Army Joint Logistics Support Force, Zhumadian, Henan, China
| | - Ruoyu Shang
- State Key Laboratory of Trauma, Burns, and Combined Injury, Institute of Burn Research, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing Key Laboratory for Disease Proteomics, Chongqing, China
| | - Guoan Lin
- Military Burn Center, the 990th Hospital of People's Liberation Army Joint Logistics Support Force, Zhumadian, Henan, China
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259
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Aizuddin AN, Chan CM, Anwar AR, Ong YX, Chin KY. Performance of Body Mass Index in Identifying Obesity Defined by Body Fat Percentage and Hypertension Among Malaysian Population: A Retrospective Study. Int J Gen Med 2021; 14:3251-3257. [PMID: 34267543 PMCID: PMC8276827 DOI: 10.2147/ijgm.s316360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/28/2021] [Indexed: 01/08/2023] Open
Abstract
Purpose Body mass index (BMI) is used universally to define obesity. Many studies have indicated that the current BMI cutoff value for obesity may be inaccurate in identifying individuals with excess body fat (BF) and at risk for cardiovascular diseases (CVD). This study aims to assess the performance of BMI in diagnosing obesity defined by BF percentage (BF%). Patients and Methods A total of 136 participants who attended an annual health screening programme were recruited. The subjects completed the health examinations, including BMI, BF% and blood pressure measurement. A receiver operating curve (ROC) analysis was conducted to determine the optimal cutoff value of BMI in classifying obesity based on BF% (>25%). Results The ROC analysis revealed that the optimal BMI cutoff value in classifying subjects with obesity based on BF% was 24.8 kg/m2. The agreement between the classification scheme based on the new BMI cutoff (>24.8 kg/m2) and BF% was higher (κ=0.722) compared to the standard BMI cutoff (>27.5 kg/m2) (κ=0.532). BMI 24.8 kg/m2 also had higher sensitivity (80.0%) than 27.5 kg/m2 (56.0%) in detecting subjects with high adiposity. The new BMI cutoff also showed a sensitivity of 63.9% in identifying subjects with hypertension compared to the standard cutoff (36.1%). Conclusion The current definition of obesity based on BMI value needs to be reassessed by taking BF% into account. A new BMI cutoff point, 24.8 kg/m2 for obesity, can identify a higher percentage of Malaysian at risk for CVD.
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Affiliation(s)
- Azimatun Noor Aizuddin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Chee Mun Chan
- Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - A Rahman Anwar
- Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Yee Xien Ong
- Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
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260
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Pavlovska I, Polcrova A, Mechanick JI, Brož J, Infante-Garcia MM, Nieto-Martínez R, Maranhao Neto GA, Kunzova S, Skladana M, Novotny JS, Pikhart H, Urbanová J, Stokin GB, Medina-Inojosa JR, Vysoky R, González-Rivas JP. Dysglycemia and Abnormal Adiposity Drivers of Cardiometabolic-Based Chronic Disease in the Czech Population: Biological, Behavioral, and Cultural/Social Determinants of Health. Nutrients 2021; 13:nu13072338. [PMID: 34371848 PMCID: PMC8308692 DOI: 10.3390/nu13072338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 06/28/2021] [Accepted: 07/05/2021] [Indexed: 12/12/2022] Open
Abstract
In contrast to the decreasing burden related to cardiovascular disease (CVD), the burden related to dysglycemia and adiposity complications is increasing in Czechia, and local drivers must be identified. A comprehensive literature review was performed to evaluate biological, behavioral, and environmental drivers of dysglycemia and abnormal adiposity in Czechia. Additionally, the structure of the Czech healthcare system was described. The prevalence of obesity in men and diabetes in both sexes has been increasing over the past 30 years. Possible reasons include the Eastern European eating pattern, high prevalence of physical inactivity and health illiteracy, education, and income-related health inequalities. Despite the advanced healthcare system based on the compulsory insurance model with free-for-service healthcare and a wide range of health-promoting initiatives, more effective strategies to tackle the adiposity/dysglycemia are needed. In conclusion, the disease burden related to dysglycemia and adiposity in Czechia remains high but is not translated into greater CVD. This discordant relationship likely depends more on other factors, such as improvements in dyslipidemia and hypertension control. A reconceptualization of abnormal adiposity and dysglycemia into a more actionable cardiometabolic-based chronic disease model is needed to improve the approach to these conditions. This review can serve as a platform to investigate causal mechanisms and secure effective management of cardiometabolic-based chronic disease.
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Affiliation(s)
- Iuliia Pavlovska
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic;
- Correspondence: ; Tel.: +4-207-770-90433
| | - Anna Polcrova
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, 62500 Brno, Czech Republic;
| | - Jeffrey I. Mechanick
- The Marie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jan Brož
- Department of Internal Medicine, Charles University Second Faculty of Medicine, 10506 Prague, Czech Republic;
| | - Maria M. Infante-Garcia
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Barquisimeto 3001, Lara, Venezuela;
| | - Ramfis Nieto-Martínez
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Barquisimeto 3001, Lara, Venezuela;
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02115, USA
- LifeDoc Health, Memphis, TN 38119, USA
| | - Geraldo A. Maranhao Neto
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
| | - Sarka Kunzova
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
| | - Maria Skladana
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Second Department of Internal Medicine, St. Anne’s University Hospital in Brno and Faculty of Medicine, Masaryk University, 65691 Brno, Czech Republic
| | - Jan S. Novotny
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
| | - Hynek Pikhart
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, 62500 Brno, Czech Republic;
- Department of Epidemiology and Public Health, University College London, London WC1E6BT, UK
| | - Jana Urbanová
- Center for Research in Diabetes, Metabolism and Nutrition, Second Department of Internal Medicine, Third Faculty of Medicine, University Hospital Královské Vinohrady, 10000 Prague, Czech Republic;
| | - Gorazd B. Stokin
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
| | - Jose R. Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA;
- Marriott Heart Disease Research Program, Mayo Clinic, Rochester, MN 55905, USA
| | - Robert Vysoky
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic;
- Department of Health Support, Faculty of Sport Studies, Masaryk University, 62500 Brno, Czech Republic
| | - Juan P. González-Rivas
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Barquisimeto 3001, Lara, Venezuela;
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02115, USA
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261
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Barrantes FJ. The unfolding palette of COVID-19 multisystemic syndrome and its neurological manifestations. Brain Behav Immun Health 2021; 14:100251. [PMID: 33842898 PMCID: PMC8019247 DOI: 10.1016/j.bbih.2021.100251] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/23/2021] [Accepted: 03/28/2021] [Indexed: 02/07/2023] Open
Abstract
Although our current knowledge of the pathophysiology of COVID-19 is still fragmentary, the information so far accrued on the tropism and life cycle of its etiological agent SARS-CoV-2, together with the emerging clinical data, suffice to indicate that the severe acute pulmonary syndrome is the main, but not the only manifestation of COVID-19. Necropsy studies are increasingly revealing underlying endothelial vasculopathies in the form of micro-haemorrhages and micro-thrombi. Intertwined with defective antiviral responses, dysregulated coagulation mechanisms, abnormal hyper-inflammatory reactions and responses, COVID-19 is disclosing a wide pathophysiological palette. An additional property in categorising the disease is the combination of tissue (e.g. neuro- and vasculo-tropism) with organ tropism, whereby the virus preferentially attacks certain organs with highly developed capillary beds, such as the lungs, gastrointestinal tract, kidney and brain. These multiple clinical presentations confirm that the acute respiratory syndrome as described initially is increasingly unfolding as a more complex nosological entity, a multiorgan syndrome of systemic breadth. The neurological manifestations of COVID-19, the focus of this review, reflect this manifold nature of the disease.
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Affiliation(s)
- Francisco J. Barrantes
- Institute of Biomedical Research (BIOMED), UCA-CONICET, Av. Alicia Moreau de Justo 1600, C1107AFF, Buenos Aires, Argentina
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262
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Candel FJ, Barreiro P, San Román J, Carretero MM, Sanz JC, Perez-Abeledo M, Ramos B, Viñuela-Prieto JM, Canora J, Martínez-Peromingo FJ, Barba R, Zapatero A. The demography and characteristics of SARS-CoV-2 seropositive residents and staff of nursing homes for older adults in the Community of Madrid: the SeroSOS study. Age Ageing 2021; 50:1038-1047. [PMID: 33945607 PMCID: PMC8135991 DOI: 10.1093/ageing/afab096] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Nursing homes for older adults have concentrated large numbers of severe cases and deaths for COVID-19. Methods: Point seroprevalence study of nursing homes to describe the demography and characteristic of SARS-CoV-2 IgG-positive residents and staff. Results: Clinical information and blood samples were available for 9,332 residents (mean age 86.7 ± 8.1 years, 76.4% women) and 10,614 staff (mean age 45.6 ± 11.5, 86.2% women). Up to 84.4% of residents had frailty, 84.9% co-morbidity and 69.3% cognitive impairment; 65.2% of workers were health-aides. COVID-19 seroprevalence was 55.4% (95% CI, 54.4–56.4) for older adults and 31.5% (30.6–32.4) for staff. In multivariable analysis frailty of residents was related with seropositivity (OR: 1.19, p = 0.02). In the case of staff, age > 50 years (2.10, p < 0.001), obesity (1.19, p = 0.01), being a health-aide (1.94, p < 0.001), working in a center with high seroprevalence in residents (3.49, p < 0.001), and contact with external cases of COVID-19 (1.52, p < 0.001) were factors associated with seropositivity. Past symptoms of COVID-19 were good predictors of seropositivity for residents (5.41, p < 0.001) and staff (2.52, p < 0.001). Conclusions: Level of dependency influences risk of COVID-19 among residents. Individual and work factors, and contacts outside the nursing home are associated with COVID-19 exposure in staff members. It is key to strengthen control measures to prevent the introduction of COVID-19 into care facilities from the community.
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Affiliation(s)
- F J Candel
- Clinical Microbiology and Infectious Diseases, IdISSC and IML Health Institutes, Hospital Universitario San Carlos, Madrid
- Regional Public Health Laboratory, Community of Madrid
| | - P Barreiro
- Address correspondence to: Pablo Barreiro, MD PhD, Infectious Diseases. Internal Medicine. Hospital General Universitario La Paz. Madrid. Spain, E-mail:
| | - J San Román
- Department of Medical Specialties and Public Health, Rey Juan Carlos University, Madrid
- Regional Public Health Laboratory, Community of Madrid
| | - M M Carretero
- Regional Public Health Laboratory, Community of Madrid
| | - J C Sanz
- Regional Public Health Laboratory, Community of Madrid
| | | | - B Ramos
- Regional Public Health Laboratory, Community of Madrid
| | - J M Viñuela-Prieto
- Department of Neurosurgery, Hospital General Universitario La Paz, Madrid
| | - J Canora
- Assistant to the Vice-counselor of Public Health, Community of Madrid
| | | | - R Barba
- Medical Manager, Hospital Universitario Rey Juan Carlos, Madrid
| | - A Zapatero
- Vice-counselor of Public Health, Community of Madrid
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263
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Natalucci V, Marini CF, Flori M, Pietropaolo F, Lucertini F, Annibalini G, Vallorani L, Sisti D, Saltarelli R, Villarini A, Monaldi S, Barocci S, Catalano V, Rocchi MBL, Benelli P, Stocchi V, Barbieri E, Emili R. Effects of a Home-Based Lifestyle Intervention Program on Cardiometabolic Health in Breast Cancer Survivors during the COVID-19 Lockdown. J Clin Med 2021; 10:2678. [PMID: 34204528 PMCID: PMC8235209 DOI: 10.3390/jcm10122678] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 12/16/2022] Open
Abstract
This study aimed to evaluate the cardiometabolic effects of a home-based lifestyle intervention (LI) in breast cancer survivors (BCSs) during the COVID-19 lockdown. In total, 30 BCSs (women; stages 0-II; non-metastatic; aged 53.5 ± 7.6 years; non-physically active; normal left ventricular systolic function) with a risk factor for recurrence underwent a 3-month LI based on nutrition and exercise. Anthropometrics, Mediterranean diet adherence, physical activity level (PAL), cardiorespiratory fitness (VO2max), echocardiographic parameters, heart rate variability (average standard deviation of NN intervals (ASDNN/5 min) and 24 h very- (24 hVLF) and low-frequency (24 hLF)), and metabolic, endocrine, and inflammatory serum biomarkers (glycemia, insulin resistance, progesterone, testosterone, and high-sensitivity C-reactive protein (hs-CRP)) were evaluated before (T0) and after (T1) the LI. After the LI, there were improvements in: body mass index (kg/m2: T0 = 26.0 ± 5.0, T1 = 25.5 ± 4.7; p = 0.035); diet (Mediet score: T0 = 6.9 ± 2.3, T1 = 8.8 ± 2.2; p < 0.001); PAL (MET-min/week: T0 = 647 ± 547, T1 = 1043 ± 564; p < 0.001); VO2max (mL·min-1·kg-1: T0 = 30.5 ± 5.8, T1 = 33.4 ± 6.8; p < 0.001); signs of diastolic dysfunction (participants: T0 = 15, T1 = 10; p = 0.007); AS-DNN/5 min (ms: T0 = 50.6 ± 14.4, T1 = 55.3 ± 16.7; p = 0.032); 24 hLF (ms2: T0 = 589 ± 391, T1 = 732 ± 542; p = 0.014); glycemia (mg/dL: T0 = 100.8 ± 11.4, T1 = 91.7 ± 11.0; p < 0.001); insulin resistance (HOMA-IR score: T0 = 2.07 ± 1.54, T1 = 1.53 ± 1.11; p = 0.005); testosterone (ng/mL: T0 = 0.34 ± 0.27, T1 = 0.24 ± 0.20; p = 0.003); hs-CRP (mg/L: T0 = 2.18 ± 2.14, T1 = 1.75 ± 1.74; p = 0.027). The other parameters did not change. Despite the home-confinement, LI based on exercise and nutrition improved cardiometabolic health in BCSs.
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Affiliation(s)
- Valentina Natalucci
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Carlo Ferri Marini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Marco Flori
- U.O.C. Cardiologia/UTIC, Ospedale Santa Maria della Misericordia, Area Vasta n.1, 61029 Urbino, Italy; (M.F.); (F.P.)
| | - Francesca Pietropaolo
- U.O.C. Cardiologia/UTIC, Ospedale Santa Maria della Misericordia, Area Vasta n.1, 61029 Urbino, Italy; (M.F.); (F.P.)
| | - Francesco Lucertini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Luciana Vallorani
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Davide Sisti
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Roberta Saltarelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Anna Villarini
- Epidemiology Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milano, Italy;
| | - Silvia Monaldi
- U.O.C. Oncologia Medica, ASUR Area Vasta 1, Ospedale Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy; (S.M.); (V.C.); (R.E.)
| | - Simone Barocci
- U.O.C. Patologia Clinica, Ospedale Santa Maria della Misericordia, Area Vasta n. 1, 61029 Urbino, Italy;
| | - Vincenzo Catalano
- U.O.C. Oncologia Medica, ASUR Area Vasta 1, Ospedale Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy; (S.M.); (V.C.); (R.E.)
| | - Marco Bruno Luigi Rocchi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Piero Benelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Vilberto Stocchi
- Department of Human Sciences for the Promotion of Quality of Life, University San Raffaele, 20132 Roma, Italy;
| | - Elena Barbieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Rita Emili
- U.O.C. Oncologia Medica, ASUR Area Vasta 1, Ospedale Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy; (S.M.); (V.C.); (R.E.)
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Russo FP, Piano S, Bruno R, Burra P, Puoti M, Masarone M, Montagnese S, Ponziani FR, Petta S, Aghemo A. Italian association for the study of the liver position statement on SARS-CoV2 vaccination. Dig Liver Dis 2021; 53:677-681. [PMID: 33941488 PMCID: PMC8086184 DOI: 10.1016/j.dld.2021.03.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/01/2021] [Accepted: 03/09/2021] [Indexed: 02/06/2023]
Abstract
The vaccination campaign against Sars-CoV-2 commenced in Italy at the end of December 2020. The first ones to receive the immunization against the virus were the health workers and the residents of nursing homes, following which the vaccine would be available for the entire population, beginning with the most vulnerable individuals. SARS-CoV2 vaccines have been demonstrated to be safe for the general population, although no data for patients with liver diseases or those having undergone liver transplantation are available so far. The present position statement AISF is an attempt to suggest, based on the published data on the impact of Sars-Cov-2 infection in patients with chronic liver disease, a possible priority for vaccination for this category of patients.
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Affiliation(s)
- Francesco Paolo Russo
- Department of Surgery, University Hospital Padua, Oncology and Gastroenterology, Italy.
| | | | - Raffaele Bruno
- Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Italy
| | - Patrizia Burra
- Department of Surgery, University Hospital Padua, Oncology and Gastroenterology, Italy
| | - Massimo Puoti
- Infectious Diseases Unit, ASST Grande Ospedale Metropolitano Niguarda, Italy
| | - Mario Masarone
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Italy
| | | | - Francesca Romana Ponziani
- Internal Medicine, Gastroenterology and Hepatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Salvatore Petta
- Dipartimento Biomedico di Medicina Interna e Specialistica Di.Bi.M.I.S, University of Palermo, Italy
| | - Alessio Aghemo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Humanitas Research Hospital IRCCS, Rozzano, Italy
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265
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Kommentar. DIABETOL STOFFWECHS 2021. [DOI: 10.1055/a-1464-9859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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266
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Hörber S, Lehmann R, Stefan N, Machann J, Birkenfeld AL, Wagner R, Heni M, Häring HU, Fritsche A, Peter A. Hemostatic alterations linked to body fat distribution, fatty liver, and insulin resistance. Mol Metab 2021; 53:101262. [PMID: 34082137 PMCID: PMC8165974 DOI: 10.1016/j.molmet.2021.101262] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/17/2021] [Accepted: 05/25/2021] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE Obesity, in particular visceral obesity, and insulin resistance emerged as major risk factors for severe coronavirus disease 2019 (COVID-19), which is strongly associated with hemostatic alterations. Because obesity and insulin resistance predispose to thrombotic diseases, we investigated the relationship between hemostatic alterations and body fat distribution in participants at risk for type 2 diabetes. SUBJECTS Body fat distribution (visceral and subcutaneous abdominal adipose tissue) and liver fat content of 150 participants - with impaired glucose tolerance and/or impaired fasting glucose - were determined using magnetic resonance imaging and spectroscopy. Participants underwent precise metabolic characterization and major hemostasis parameters were analyzed. RESULTS Procoagulant factors (FII, FVII, FVIII, and FIX) and anticoagulant proteins (antithrombin, protein C, and protein S) were significantly associated with body fat distribution. In patients with fatty liver, fibrinogen (298 mg/dl vs. 264 mg/dl, p = 0.0182), FVII (99% vs. 90%, p = 0.0049), FVIII (114% vs. 90%, p = 0.0098), protein C (124% vs. 111%, p = 0.0006), and protein S (109% vs. 89%, p < 0.0001) were higher than in controls. In contrast, antithrombin (97% vs. 102%, p = 0.0025) was higher in control patients. In multivariate analyses controlling for insulin sensitivity, body fat compartments, and genotype variants (PNPLA3I148MM/MI/TM6SF2E167kK/kE), only protein C and protein S remained significantly increased in fatty liver. CONCLUSIONS Body fat distribution is significantly associated with alterations of procoagulant and anticoagulant parameters. Liver fat plays a key role in the regulation of protein C and protein S, suggesting a potential counteracting mechanism to the prothrombotic state in subjects with prediabetes and fatty liver.
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Affiliation(s)
- Sebastian Hörber
- Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine, University Hospital Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany.
| | - Rainer Lehmann
- Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine, University Hospital Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Norbert Stefan
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Germany
| | - Jürgen Machann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; Section on Experimental Radiology, Department of Radiology, University Hospital Tübingen, Germany
| | - Andreas L Birkenfeld
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Germany
| | - Robert Wagner
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Germany
| | - Martin Heni
- Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine, University Hospital Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Germany
| | - Hans-Ulrich Häring
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Andreas Fritsche
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Germany
| | - Andreas Peter
- Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine, University Hospital Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
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267
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Pinhel MAS, Watanabe LM, Noronha NY, Junior WS, Nonino CB. The intersection between COVID-19 and obesity in the context of an emerging country. Clin Nutr ESPEN 2021; 44:472-474. [PMID: 34330509 PMCID: PMC8142025 DOI: 10.1016/j.clnesp.2021.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND & AIMS The worldwide outbreak of the coronavirus disease 2019 (COVID-19) has already caused a substantial public health burden. Increasing number of studies linked obesity to more severe COVID-19 consequence and mortality, challenging health systems worldwide, especially in emerging countries like Brazil. Herein, we aimed to search the literature and present the current intersection between obesity and COVID-19 in the Brazilian population. METHODS One hundred twenty-five articles were initially searched after duplicate removal, and nine were finally included in our analysis. RESULTS Our findings emphasized the magnitude of COVID-19 infection in Brazil and the impact of obesity as a risk factor that aggravates the prognosis of outpatients or hospitalized patients. We also demonstrated social aspects of COVID-19 that could act enhancing the obesity condition in Latin American countries. CONCLUSIONS A more careful look at the available data could help to understand better the dynamic between obesity and COVID-19, focusing on the Brazilian population and could eventually guide management strategies and therapies for COVID-19 in the future.
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Affiliation(s)
- Marcela A S Pinhel
- Department of Health Science, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil; Department of Molecular Biology, São Jose Do Rio Preto Medical School, São Jose Do Rio Preto, SP, Brazil
| | - Ligia M Watanabe
- Department of Health Science, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Natalia Y Noronha
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Wilson S Junior
- Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Carla B Nonino
- Department of Health Science, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
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268
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Wang S, Sun J, Wang J, Ping Z, Liu L. Does obesity based on body mass index affect semen quality?-A meta-analysis and systematic review from the general population rather than the infertile population. Andrologia 2021; 53:e14099. [PMID: 34028074 DOI: 10.1111/and.14099] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 04/08/2021] [Accepted: 04/11/2021] [Indexed: 02/06/2023] Open
Abstract
Whether obesity affects the quality of semen has become the focus of research. However, there are some deficiencies in the past research, because the vast majority of known infertile patients were included in the study samples. Taking infertile men as the research object to analyse the impact of obesity on semen quality, which cannot accurately prove that the impact on semen quality is caused by obesity, because the impact on semen quality may also be caused by other factors. Therefore, we selected ordinary obese men rather than infertile patients to conduct a systematic review and meta-analysis of the effects of obesity on semen parameters. The results showed that obesity had no effect on sperm concentration (SMD: -0.15, 95% CI: -0.32 ~ 0.02, p = .088) and percentage of normal sperm morphology (SMD: -0.17, 95% CI: -0.66 ~ 0.32, p = .487), but decreased semen volume (SMD: -0.32, 95% CI: -0.52 ~ -0.12, p = .002), total sperm number (SMD: -0.77, 95% CI: -1.31 ~ -0.23, p = .005), percentage of forward progression (SMD: -0.95, 95% CI: -1.7 ~ -0.19, p = .014) and percentage of viability (SMD: -0.812, 95% CI: -1.532 ~ -0.093, p = .027). Therefore, obesity affects semen quality to a certain extent, and maintaining normal weight may be one of the effective ways to improve male fertility.
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Affiliation(s)
- SuiYan Wang
- School of basic medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Jun Sun
- School of basic medical Sciences, Zhengzhou University, Zhengzhou, China
| | - JunYi Wang
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - ZhiGuang Ping
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Li Liu
- School of basic medical Sciences, Zhengzhou University, Zhengzhou, China
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269
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Mohan M, Perry BI, Saravanan P, Singh SP. COVID-19 in People With Schizophrenia: Potential Mechanisms Linking Schizophrenia to Poor Prognosis. Front Psychiatry 2021; 12:666067. [PMID: 34079487 PMCID: PMC8166317 DOI: 10.3389/fpsyt.2021.666067] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/15/2021] [Indexed: 01/08/2023] Open
Abstract
As the global burden of mortality from COVID-19 continues to rise, an understanding of who is most at risk of adverse outcomes is of paramount importance. Pre-existing cardiometabolic, renal and respiratory diseases as well as old age are well-established risk factors associated with disease severity and mortality among patients with COVID-19. However, mounting evidence also indicates an increased susceptibility to, and risk of adverse outcomes from COVID-19 in people with schizophrenia, independent of age and comorbidity. Therefore, elucidating the underlying pathophysiological mechanisms which may increase the risk of poor outcomes in people with schizophrenia is of crucial importance. Here, we provide a narrative on the current understanding of COVID-19 in patients with schizophrenia and propose potential mechanisms which may link schizophrenia with an increased susceptibility to, and greater risk of adverse outcomes from COVID-19. Given the existing knowledge gaps, robust clinical and biological studies are required to further our understanding of some of these underlying mechanisms, so that effective prevention and treatment strategies for COVID-19 in patients with schizophrenia can be developed.
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Affiliation(s)
- Mohapradeep Mohan
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Benjamin Ian Perry
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Ponnusamy Saravanan
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Academic Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital, Nuneaton, United Kingdom
| | - Swaran Preet Singh
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Coventry and Warwickshire Partnership Trust, Coventry, United Kingdom
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270
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Claro AE, Palanza C, Tartaglione L, Mazza M, Janiri L, Pitocco D. COVID-19 and the role of chronic inflammation in patients with type 2 diabetes and depression. Minerva Endocrinol (Torino) 2021; 47:128-129. [PMID: 33979072 DOI: 10.23736/s2724-6507.21.03492-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Angelo E Claro
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy -
| | | | - Linda Tartaglione
- Diabetes Care Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marianna Mazza
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luigi Janiri
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Dario Pitocco
- Diabetes Care Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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271
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Zemer Tov B, Walfisch A, Schwartz N, Meir H, Kleitman V. Cytomegalovirus seroconversion in pregnant army personnel of the Israel Defense Forces: Trends and risk factors. Int J Gynaecol Obstet 2021; 154:285-290. [PMID: 33730394 DOI: 10.1002/ijgo.13679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Cytomegalovirus (CMV) seroconversion in pregnancy is a major health issue with potentially devastating fetal consequences. We opted to determine rates and trends of CMV seroconversion in pregnant army personnel and to isolate risk factors. METHODS In this retrospective cohort study, all pregnancies of army personnel between 2009 and 2019 were evaluated (n = 10 409) and all pregnancies with CMV laboratory records were included. Seroconversion rate was calculated overall and per year. Demographic and obstetrical characteristics were compared between exposed and unexposed women. Independent predictors of seroconversion were further investigated using logistic regression models. RESULTS Cytomegalovirus serology status was available in 7665 pregnancies. Seroconversion was evident in 66 women (4.15%) among the seronegative pregnancies. Women in the seroconversion group were significantly more likely to belong to a higher social class. In the regression models, adjusted for age, place of residence, and education, higher parity (adjusted odds ratio [aOR] 2, P < 0.001) and residing in a central district (aOR 2.67, P = 0.002) were significantly associated with seroconversion. CONCLUSION Higher social class appears to be a significant risk factor for CMV seroconversion during pregnancy. Residing in a central district and higher parity appear to be independently associated with an increased risk for seroconversion during pregnancy among army personnel.
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Affiliation(s)
- Bar Zemer Tov
- Tzameret Military Medical Track, Hebrew University-Hadassah School of Medicine, Jerusalem, Israel
| | - Asnat Walfisch
- Department of Obstetrics and Gynecology, Hadassah University Medical Center, Mount Scopus, The Hebrew University, Jerusalem, Israel
| | - Naama Schwartz
- School of Public Health, University of Haifa, Haifa, Israel
| | | | - Vered Kleitman
- Department of Obstetrics and Gynecology, Israel Defense Forces, Israel
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272
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Tamarind (Tamarindus indica L.) Seed a Candidate Protein Source with Potential for Combating SARS-CoV-2 Infection in Obesity. Drug Target Insights 2021; 15:5-12. [PMID: 33840996 PMCID: PMC8025844 DOI: 10.33393/dti.2021.2192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 03/11/2021] [Indexed: 12/17/2022] Open
Abstract
Introduction: Obesity and coronavirus disease (COVID)-19 are overlapping pandemics, and one might worsen the other. Methods: This narrative review discusses one of the primary mechanisms to initiate acute respiratory distress syndrome, uncontrolled systemic inflammation in COVID-19, and presents a potential candidate for adjuvant treatment. Blocking the S protein binding to angiotensin-converting enzyme 2 (ACE-2) and the 3C-like protease (3CL pro) is an effective strategy against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Results: Host proteases such as FURIN, trypsin, and transmembrane serine protease 2 (TMPRSS) act in S protein activation. Tamarind trypsin inhibitor (TTI) shows several beneficial effects on the reduction of inflammatory markers (tumor necrosis factor α [TNF-α], leptin) and biochemical parameters (fasting glycemia, triglycerides, and very low-density lipoprotein [VLDL]), in addition to improving pancreatic function and mucosal integrity in an obesity model. TTI may inhibit the action of proteases that collaborate with SARS-CoV-2 infection and the neutrophil activity characteristic of lung injury promoted by the virus. Conclusion: Thus, TTI may contribute to combating two severe overlapping problems with high cost and social complex implications, obesity and COVID-19.
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273
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The Inflammatory Profile of Obesity and the Role on Pulmonary Bacterial and Viral Infections. Int J Mol Sci 2021; 22:ijms22073456. [PMID: 33810619 PMCID: PMC8037155 DOI: 10.3390/ijms22073456] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 12/16/2022] Open
Abstract
Obesity is a globally increasing health problem, entailing diverse comorbidities such as infectious diseases. An obese weight status has marked effects on lung function that can be attributed to mechanical dysfunctions. Moreover, the alterations of adipocyte-derived signal mediators strongly influence the regulation of inflammation, resulting in chronic low-grade inflammation. Our review summarizes the known effects regarding pulmonary bacterial and viral infections. For this, we discuss model systems that allow mechanistic investigation of the interplay between obesity and lung infections. Overall, obesity gives rise to a higher susceptibility to infectious pathogens, but the pathogenetic process is not clearly defined. Whereas, viral infections often show a more severe course in obese patients, the same patients seem to have a survival benefit during bacterial infections. In particular, we summarize the main mechanical impairments in the pulmonary tract caused by obesity. Moreover, we outline the main secretory changes within the expanded adipose tissue mass, resulting in chronic low-grade inflammation. Finally, we connect these altered host factors to the influence of obesity on the development of lung infection by summarizing observations from clinical and experimental data.
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274
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Vazirani AA. COVID-19, an Incentive to Tackle Sugar in Hospitals and at Home. J Endocr Soc 2021; 5:bvab037. [PMID: 33977196 PMCID: PMC7989335 DOI: 10.1210/jendso/bvab037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Indexed: 11/19/2022] Open
Abstract
Obesity and metabolic disease are thwarting our efforts to recover from COVID-19. Chronic inflammation is a key feature of both COVID-19 and the metabolic syndrome. Sugar consumption in particular has been shown to affect COVID-19 mortality by contributing to the chronic inflammatory state. Restriction of free sugar intake has a measurable effect on disease-predicting physiological parameters in as little as 9 days. The rapid reduction in inflammation following fructose restriction is key in the context of the COVID-19 pandemic, as COVID-19 exacerbates the same inflammatory pathways as those driven by the metabolic syndrome. Healthcare providers have a duty to implement international recommendations of reduced free sugar intake. By doing so, they could reduce the chronic inflammatory burden contributing to COVID-19 patients’ demise. Further, it would set a precedent for reducing the risk of severe disease in the uninfected, by maximizing their potential metabolic health in the context of an infection predicated on its disruption.
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275
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Bhutani S, Coppin G, Veldhuizen MG, Parma V, Joseph PV. COVID-19 Related Chemosensory Changes in Individuals with Self-Reported Obesity. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.02.28.21252536. [PMID: 33688677 PMCID: PMC7941654 DOI: 10.1101/2021.02.28.21252536] [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] [Indexed: 11/24/2022]
Abstract
BACKGROUND/OBJECTIVES Individuals with obesity show alterations in smell and taste abilities. Smell and taste loss are also the most prominent neurological symptoms of COVID-19, yet how chemosensory ability present in individuals with obesity with a positive COVID-19 diagnosis is unknown. SUBJECTS/METHODS In this secondary analysis of a cross-sectional global dataset, we compared self-reported chemosensory ability in participants with a respiratory illness reporting a positive (C19+; n = 5156) or a negative (C19-; n = 659) COVID-19 laboratory test outcome, who also self-reported to be obese (C19+; n = 433, C19-; n = 86) or non-obese. RESULTS Compared to the C19- group, C19+ exhibited a greater decline in smell, taste, and chemesthesis during illness, though these symptoms did not differ between participants with obesity and without obesity. In 68% of participants who reported recovery from respiratory illness symptoms (n=3431 C19+ and n= 539 C19-), post-recovery chemosensory perception did not differ in C19+ and C19- diagnosis, and by self-reported obesity. Finally, we found that all chemosensory and other symptoms combined predicted the C19+ diagnosis in participants with obesity with a moderately good estimate (63% accuracy). However, in C19+ participants with obesity, we observed a greater relative prevalence of non-chemosensory symptoms, including respiratory as respiratory and GI symptoms. CONCLUSIONS We conclude that despite a presumed lower sensitivity to chemosensory stimuli, COVID-19 respondents with obesity experience a similar self-reported chemosensory loss as those without obesity, and in both groups self-reported chemosensory symptoms are similarly predictive of COVID-19.
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Affiliation(s)
- S Bhutani
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA
| | - G Coppin
- Department of Psychology, Formation Universitaire à Distance (UniDistance), Brig, Switzerland; Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - M G Veldhuizen
- Department of Anatomy, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - V Parma
- Department of Psychology, Temple University; Monell Chemical Senses Center
| | - P V Joseph
- National Institutes of Alcohol Abuse and Alcoholism and National Institute of Nursing Research
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276
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Al-Rabia MW, Alhakamy NA, Ahmed OAA, Eljaaly K, Alaofi AL, Mostafa A, Asfour HZ, Aldarmahi AA, Darwish KM, Ibrahim TS, Fahmy UA. Repurposing of Sitagliptin- Melittin Optimized Nanoformula against SARS-CoV-2: Antiviral Screening and Molecular Docking Studies. Pharmaceutics 2021; 13:307. [PMID: 33652894 PMCID: PMC8025909 DOI: 10.3390/pharmaceutics13030307] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 12/19/2022] Open
Abstract
The outbreak of the COVID-19 pandemic in China has become an urgent health and economic challenge. The objective of the current work was to evaluate the efficacy of the combined complex of Sitagliptin (SIT) with melittin (MEL) against SARS-CoV-2 virus. SIT-MEL nano-conjugates were optimized by a full three-factor bi-level (23) factorial design. In addition, SIT concentration (mM, X1), MEL concentration (mM, X2), and pH (X3) were selected as the critical factors. Particle size (nm, Y1) and zeta potential (mV, Y2) were assessed as responses. Characterization of the optimized formula for Fourier-transformed infrared (FTIR) was carried out. The optimized formula showed particle size and zeta potential values of 77.42 nm and 27.67 mV, respectively. When compared with SIT and MEL, the combination of SIT-MEL complex has shown anti-viral potential against isolate of SARS-CoV-2 with IC50 values of 8.439 μM with significant improvement (p < 0.001). In addition, the complex showed IC50 in vitro 3CL-protease inhibition with IC50 7.216 µM. Molecular docking has revealed that formula components have good predicted pocket accommodation of the SARS-CoV-2 3-CL protease. An optimized formulation of SIT-MEL could guarantee both enhanced delivery to the target cells and the enhanced cellular uptake with promising activities against SARS-CoV-2.
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Affiliation(s)
- Mohammed W. Al-Rabia
- Department of Medical microbiology and parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (M.W.A.-R.); (H.Z.A.)
| | - Nabil A. Alhakamy
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (N.A.A.); (O.A.A.A.)
- Center of Excellence for Drug Research and Pharmaceutical Industries, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Mohamed Saeed Tamer Chair for Pharmaceutical Industries, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Osama A. A. Ahmed
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (N.A.A.); (O.A.A.A.)
- Center of Excellence for Drug Research and Pharmaceutical Industries, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Mohamed Saeed Tamer Chair for Pharmaceutical Industries, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Khalid Eljaaly
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Pharmacy Practice and Science Department, College of Pharmacy, University of Arizona, Tucson, AZ 85704, USA
| | - Ahmed L. Alaofi
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 12372, Saudi Arabia;
| | - Ahmed Mostafa
- Center of Scientific Excellence for Influenza Viruses, National Research Centre, Giza 12622, Egypt;
| | - Hani Z. Asfour
- Department of Medical microbiology and parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (M.W.A.-R.); (H.Z.A.)
| | - Ahmed A. Aldarmahi
- College of Sciences and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Jeddah 21582, Saudi Arabia;
| | - Khaled M. Darwish
- Medicinal Chemistry Department, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt;
| | - Tarek S. Ibrahim
- Department of Pharmaceutical chemistry, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Usama A. Fahmy
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (N.A.A.); (O.A.A.A.)
- Center of Excellence for Drug Research and Pharmaceutical Industries, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Mohamed Saeed Tamer Chair for Pharmaceutical Industries, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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277
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Bobik TV, Kostin NN, Skryabin GA, Tsabai PN, Simonova MA, Knorre VD, Stratienko ON, Aleshenko NL, Vorobiev II, Khurs EN, Mokrushina YA, Smirnov IV, Alekhin AI, Nikitin AE, Gabibov AG. COVID-19 in Russia: Clinical and Immunological Features of the First-Wave Patients. Acta Naturae 2021; 13:102-115. [PMID: 33959390 PMCID: PMC8084292 DOI: 10.32607/actanaturae.11374] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/16/2021] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease outbreak in 2019 (COVID-19) has now achieved the level of a global pandemic and affected more than 100 million people on all five continents and caused over 2 million deaths. Russia is, needless to say, among the countries affected by SARS-CoV-2, and its health authorities have mobilized significant efforts and resources to fight the disease. The paper presents the result of a functional analysis of 155 patients in the Moscow Region who were examined at the Central Clinical Hospital of the Russian Academy of Sciences during the first wave of the pandemic (February-July, 2020). The inclusion criteria were a positive PCR test and typical, computed tomographic findings of viral pneumonia in the form of ground-glass opacities. A clinical correlation analysis was performed in four groups of patients: (1) those who were not on mechanical ventilation, (2) those who were on mechanical ventilation, and (3) those who subsequently recovered or (4) died. The correlation analysis also considered confounding comorbidities (diabetes, metabolic syndrome, hypertension, etc.). The immunological status of the patients was examined (levels of immunoglobulins of the M, A, G classes and their subclasses, as well as the total immunoglobulin level) using an original SARS-CoV-2 antibody ELISA kit. The ELISA kit was developed using linear S-protein RBD-SD1 and NTD fragments, as well as the N-protein, as antigens. These antigens were produced in the prokaryotic E. coli system. Recombinant RBD produced in the eukaryotic CHO system (RBD CHO) was used as an antigen representing conformational RBD epitopes. The immunoglobulin A level was found to be the earliest serological criterion for the development of a SARS-CoV-2 infection and it yielded the best sensitivity and diagnostic significance of ELISA compared to that of class M immunoglobulin. We demonstrated that the seroconversion rate of "early" N-protein-specific IgM and IgA antibodies is comparable to that of antibodies specific to RBD conformational epitopes. At the same time, seroconversion of SARS-CoV-2 N-protein-specific class G immunoglobulins was significantly faster compared to that of other specific antibodies. Our findings suggest that the strong immunogenicity of the RBD fragment is for the most part associated with its conformational epitopes, while the linear RBD and NTD epitopes have the least immunogenicity. An analysis of the occurrence rate of SARS-CoV-2-specific immunoglobulins of different classes revealed that RBD- and N-specific antibodies should be evaluated in parallel to improve the sensitivity of ELISA. An analysis of the immunoglobulin subclass distribution in sera of seropositive patients revealed uniform induction of N-protein-specific IgG subclasses G1-G4 and IgA subclasses A1-A2 in groups of patients with varying severity of COVID-19. In the case of the S-protein, G1, G3, and A1 were the main subclasses of antibodies involved in the immune response.
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Affiliation(s)
- T. V. Bobik
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - N. N. Kostin
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - G. A. Skryabin
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - P. N. Tsabai
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - M. A. Simonova
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - V. D. Knorre
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - O. N. Stratienko
- Central Clinical Hospital of the Russian Academy of Sciences, Moscow, 117593 Russia
| | - N. L. Aleshenko
- Central Clinical Hospital of the Russian Academy of Sciences, Moscow, 117593 Russia
| | - I. I. Vorobiev
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - E. N. Khurs
- Engelhardt Institute of Molecular Biology, RAS, Moscow, 119991 Russia
| | - Yu. A. Mokrushina
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - I. V. Smirnov
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - A. I. Alekhin
- Central Clinical Hospital of the Russian Academy of Sciences, Moscow, 117593 Russia
| | - A. E. Nikitin
- Central Clinical Hospital of the Russian Academy of Sciences, Moscow, 117593 Russia
| | - A. G. Gabibov
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
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