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Ceylan Hİ, Silva AF, Ramirez-Campillo R, Murawska-Ciałowicz E. Exploring the Effect of Acute and Regular Physical Exercise on Circulating Brain-Derived Neurotrophic Factor Levels in Individuals with Obesity: A Comprehensive Systematic Review and Meta-Analysis. BIOLOGY 2024; 13:323. [PMID: 38785805 PMCID: PMC11117522 DOI: 10.3390/biology13050323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/18/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024]
Abstract
Obesity is a major global health concern linked to cognitive impairment and neurological disorders. Circulating brain-derived neurotrophic factor (BDNF), a protein crucial for neuronal growth and survival, plays a vital role in brain function and plasticity. Notably, obese individuals tend to exhibit lower BDNF levels, potentially contributing to cognitive decline. Physical exercise offers health benefits, including improved circulating BDNF levels and cognitive function, but the specific impacts of acute versus regular exercise on circulating BDNF levels in obesity are unclear. Understanding this can guide interventions to enhance brain health and counter potential cognitive decline in obese individuals. Therefore, this study aimed to explore the impact of acute and regular physical exercise on circulating BDNF in individuals with obesity. The target population comprised individuals classified as overweight or obese, encompassing both acute and chronic protocols involving all training methods. A comprehensive search was conducted across computerized databases, including PubMed, Academic Search Complete, and Web of Science, in August 2022, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Initially, 98 studies were identified, from which 16 studies, comprising 23 trials, met the selection criteria. Substantial heterogeneity was observed for both acute (I2 = 80.4%) and long-term effects (I2 = 88.7%), but low risk of bias for the included studies. A single session of exercise increased circulating BDNF levels among obese patients compared to the control group (ES = 1.25, 95% CI = 0.19 to 2.30, p = 0.021). However, with extended periods of physical exercise, there was no significant increase in circulating BDNF levels when compared to the control group (ES = 0.49, 95% CI = -0.08 to 1.06, p = 0.089). These findings highlight the need to consider exercise duration and type when studying neurobiological responses in obesity and exercise research. The study's results have implications for exercise prescription in obesity management and highlight the need for tailored interventions to optimize neurotrophic responses. Future research should focus on elucidating the adaptive mechanisms and exploring novel strategies to enhance BDNF modulation through exercise in this population. However, further research is needed considering limitations such as the potential age-related confounding effects due to diverse participant ages, lack of sex-specific analyses, and insufficient exploration of how specific exercise parameters (e.g., duration, intensity, type) impact circulating BDNF.
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Affiliation(s)
- Halil İbrahim Ceylan
- Physical Education and Sports Teaching Department, Kazim Karabekir Faculty of Education, Ataturk University, 25240 Erzurum, Turkey
| | - Ana Filipa Silva
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, 4900-347 Viana do Castelo, Portugal
- Research Center in Sports Performance, Recreation, Innovation and Technology (SPRINT), 4960-320 Melgaço, Portugal
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago de Chile 7591538, Chile;
| | - Eugenia Murawska-Ciałowicz
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Wrocław University of Health and Sport Sciences, 51-612 Wrocław, Poland;
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Shimohata H, Usui J, Tawara-Iida T, Ebihara I, Ishizu T, Maeda Y, Kobayashi H, Numajiri D, Kaneshige A, Sega M, Yamashita M, Ohgi K, Maruyama H, Takayasu M, Hirayama K, Kobayashi M, Yamagata K. NT-pro BNP level at dialysis initiation is a useful biomarker for predicting hospitalization for ischemic heart disease. Clin Exp Nephrol 2024; 28:457-464. [PMID: 38238500 DOI: 10.1007/s10157-023-02442-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/28/2023] [Indexed: 04/23/2024]
Abstract
BACKGROUND Patients with end-stage kidney disease (ESKD) are at high risk of cardiovascular disease including stroke, heart failure, and ischemic heart disease (IHD). To prevent the occurrence and progression of CVD, a reliable prognostic cardiac biomarker is essential. We investigated the prognostic value of NT-proBNP for each incident type of CVD. METHODS Male patients from the Ibaraki Dialysis Initiation Cohort (iDIC) study with preserved serum samples from dialysis initiation day (n = 212) were analyzed. Patients were classified into four groups according to quartiles of baseline NT-pro BNP levels. The relationship between NT-proBNP levels at the initiation of dialysis and the subsequent incidence of hospitalization events due to IHD, heart failure, and stroke was analyzed. RESULTS The incidence rate for hospitalization due to IHD was significantly higher in the highest NT-proBNP category (Log rank p = 0.008); those of stroke and heart failure showed no significant differences among quartiles. Cox proportional hazards regression analysis revealed that serum NT-proBNT was the only prognostic factor for hospitalization for IHD after adjustment by major known IHD risk factors. (HR, 1.008; 95% confidence interval, 1.002-1.014; p = 0.01) The ROC curve analysis for the incidence of hospitalization due to IHD showed that NT-proBNP had an area under the curve (AUC) of 0.759 (95% CI 0.622-0.897; p = 0.004) at a cut-off value of 956.6 pg/mL. CONCLUSION NT-proBNP measurement at the initiation of dialysis therapy is useful to predict later hospitalization for IHD. TRIAL REGISTRATION UMIN000010806.
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Affiliation(s)
- Homare Shimohata
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan.
| | - Joichi Usui
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Ibaraki, Tsukuba, Japan
| | | | - Itaru Ebihara
- Department of Nephrology, Mito Saiseikai General Hospital, Ibaraki, Mito, Japan
| | - Takashi Ishizu
- Department of Nephrology, Ushiku Aiwa General Hospital, Ibaraki, Ushiku, Japan
| | - Yoshitaka Maeda
- Nephrology Division, Department of Internal Medicine, JA Toride Medical Center, Ibaraki, Toride, Japan
| | - Hiroaki Kobayashi
- Department of Nephrology, Ibaraki Prefectural Center Hospital, Ibaraki, Kasama, Japan
| | - Daichi Numajiri
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan
| | - Ayaka Kaneshige
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan
| | - Masatoshi Sega
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan
| | - Marina Yamashita
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan
| | - Kentaro Ohgi
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan
| | - Hiroshi Maruyama
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan
| | - Mamiko Takayasu
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan
| | - Kouichi Hirayama
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan
| | | | - Kunihiro Yamagata
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Ibaraki, Tsukuba, Japan
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Seo J, Payne JR, Novo Matos J, Fong WW, Connolly DJ, Luis Fuentes V. Biomarker changes with systolic anterior motion of the mitral valve in cats with hypertrophic cardiomyopathy. J Vet Intern Med 2020; 34:1718-1727. [PMID: 32822105 PMCID: PMC7517492 DOI: 10.1111/jvim.15807] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 05/02/2020] [Accepted: 05/06/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND N-terminal pro B-type natriuretic peptide (NT-proBNP) and cardiac troponin-I (cTnI) are biomarkers commonly evaluated in cats with suspected heart disease. Many cats with hypertrophic cardiomyopathy (HCM) have systolic anterior motion of the mitral valve (SAM), but its influence on circulating NT-proBNP or cTnI concentrations is currently unknown. HYPOTHESIS/OBJECTIVES Cats with HCM and SAM (HCMSAM+ ) have higher NT-proBNP and cTnI concentrations than do cats with HCM but without SAM (HCMSAM- ). ANIMALS One hundred forty cats with HCM: 70 with SAM and 70 without SAM. METHODS Retrospective case-to-case study. Cats were recruited if diagnosed with HCM by echocardiography and results were available for NT-proBNP or cTnI concentrations or both. Cats with SAM were matched to those without SAM for clinical presentation, left atrial (LA) size and left ventricular (LV) fractional shortening. RESULTS A total of 119 NT-proBNP and 123 cTnI results were available. The HCMSAM+ cats had higher median concentrations than did HCMSAM- cats for NT-proBNP (729 pmoL/L; interquartile range [IQR], 275-1467 versus 65 pmoL/L; IQR, 25-271; P < .001) and cTnI (0.27 ng/mL; IQR, 0.10-0.81 versus 0.07 ng/mL; IQR, 0.01-0.43; P = .002). In general linear models for both NT-proBNP and cTnI, the independent explanatory variables were SAM, congestive heart failure, maximal LV wall thickness, and LA size. CONCLUSIONS AND CLINICAL IMPORTANCE For cats with HCM and equivalent LA size and LV systolic function, those with SAM had higher NT-proBNP and cTnI concentrations than did those without SAM. Presence of SAM should be considered when interpreting biomarker concentrations in cats with HCM.
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Affiliation(s)
- Joonbum Seo
- Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
| | - Jessie Rosie Payne
- Langford Vets Small Animal Referral Hospital, University of Bristol, Bristol, United Kingdom
| | - Jose Novo Matos
- Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom.,Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Wesley Wynne Fong
- Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
| | - David J Connolly
- Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
| | - Virginia Luis Fuentes
- Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
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Abbas SS, Mahmoud HM, Schaalan MF, El-Abhar HS. Involvement of brain natriuretic peptide signaling pathway in the cardioprotective action of sitagliptin. Pharmacol Rep 2018; 70:720-729. [PMID: 29935398 DOI: 10.1016/j.pharep.2018.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 01/18/2018] [Accepted: 02/06/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND The current study is focusing on the role of brain natriuretic peptide (BNP), a substrate of dipeptidyl peptidase-4 (DPP-4) enzyme, and its signaling survival pathway in the cardioprotective mechanism of sitagliptin, a DPP-4 inhibitor. METHODS Male Wistar rats were randomized into 7 groups, sham, I/R, KT-5823 (selective protein kinase (PK) G inhibitor), 5-HD (selective mito-KATP channel blocker), sitagliptin (300mg/kg, po), sitagliptin+KT-5823, and sitagliptin+5-HD. Sitagliptin was administered for 3 days prior to induction of coronary I/R, while either KT-5823 or 5-HD was administered intravenously 5min before coronary ligation. RESULTS Pretreatment with sitagliptin provided significant protection against I/R injury as manifested by decreasing, percentage of infarct size, suppressing the elevated ST segment, reducing the increased cardiac enzymes, as well as DPP-4 activity and elevating both heart rate (HR) and left ventricular developed pressure (LVDP). However, the addition of either blocker to sitagliptin regimen reversed partly its cardioprotective effects. Although I/R increased BNP content, it unexpectedly decreased that of cGMP; nevertheless, sitagliptin elevated both parameters, an effect that was not affected by the use of the two blockers. On the molecular level, sitagliptin decreased caspase-3 activity and downregulated the mRNA levels of BNP, Bax, and Cyp D, while upregulated that of Bcl2. The use of either KT-5823 or 5-HD with sitagliptin hindered its effect on the molecular markers tested. CONCLUSIONS The results of the present study suggest that the cardioprotective effect of sitagliptin is mediated partly, but not solely, through the BNP/cGMP/PKG survival signaling pathway.
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Affiliation(s)
- Samah S Abbas
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Misr International University, Cairo, Egypt.
| | - Hesham M Mahmoud
- Department of Medical Pharmacology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mona F Schaalan
- Department of Biochemistry, Faculty of Pharmacy, Misr International University, Cairo, Egypt
| | - Hanan S El-Abhar
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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Breivik L, Jensen A, Guvåg S, Aarnes EK, Aspevik A, Helgeland E, Hovland S, Brattelid T, Jonassen AK. B-type natriuretic peptide expression and cardioprotection is regulated by Akt dependent signaling at early reperfusion. Peptides 2015; 66:43-50. [PMID: 25698234 DOI: 10.1016/j.peptides.2015.01.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 01/09/2015] [Accepted: 01/13/2015] [Indexed: 01/16/2023]
Abstract
Exogenously administered B-type natriuretic peptide (BNP) has been shown to offer cardioprotection through activation of particulate guanylyl cyclase (pGC), protein kinase G (PKG) and KATP channel opening. The current study explores if cardioprotection afforded by short intermittent BNP administration involves PI3K/Akt/p70s6k dependent signaling, and whether this signaling pathway may participate in regulation of BNP mRNA expression at early reperfusion. Isolated Langendorff perfused rat hearts were subjected to 30min of regional ischemia and 120min of reperfusion (IR). Applying intermittent 3×30s infusion of BNP peptide in a postconditioning like manner (BNPPost) reduced infarct size by >50% compared to controls (BNPPost 17±2% vs. control 42±4%, p<0.001). Co-treatment with inhibitors of the PI3K/Akt/p70s6k pathway (wortmannin, SH-6 and rapamycin) completely abolished the infarct-limiting effect of BNP postconditioning (BNPPost+Wi 36±5%, BNPPost+SH-6 41±4%, BNPPost+Rap 37±6% vs. BNPPost 17±2%, p<0.001). Inhibition of natriuretic peptide receptors (NPR) by isatin also abrogated BNPPost cardioprotection (BNPPost+isatin 46±2% vs. BNPPost 17±2%, p<0.001). BNPPost also significantly phosphorylated Akt and p70s6k at early reperfusion, and Akt phosphorylation was inhibited by SH-6 and isatin. Myocardial BNP mRNA levels in the area at risk (AA) were significantly elevated at early reperfusion as compared to the non-ischemic area (ANA) (Ctr(AA) 2.7±0.5 vs. Ctr(ANA) 1.2±0.2, p<0.05) and the ischemic control tissue (Ctr(AA) 2.7±0.5 vs. ischemia 1.0±0.1, p<0.05). Additional experiments also revealed a significant higher BNP mRNA level in ischemic postconditioned (IPost) hearts as compared to ischemic controls (IPost 6.7±1.3 vs. ischemia 1.0±0.2, p<0.05), but showed no difference from controls run in parallel (Ctr 5.4±0.8). Akt inhibition by SH-6 completely abrogated this elevation (IPost 6.7±1.3 vs. IPost+SH-6 1.8±0.7, p<0.05) (Ctr 5.4±0.8 vs. SH-6 1.5±0.9, p<0.05). In conclusion, Akt dependent signaling is involved in mediating the cardioprotection afforded by intermittent BNP infusion at early reperfusion, and may also participate in regulation of reperfusion induced BNP expression.
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Affiliation(s)
- L Breivik
- Department of Biomedicine, Faculty of Medicine and Dentistry, University of Bergen, Norway.
| | - A Jensen
- Department of Biomedicine, Faculty of Medicine and Dentistry, University of Bergen, Norway
| | - S Guvåg
- Department of Biomedicine, Faculty of Medicine and Dentistry, University of Bergen, Norway
| | - E K Aarnes
- Department of Biomedicine, Faculty of Medicine and Dentistry, University of Bergen, Norway
| | - A Aspevik
- Department of Biomedicine, Faculty of Medicine and Dentistry, University of Bergen, Norway
| | - E Helgeland
- Department of Biomedicine, Faculty of Medicine and Dentistry, University of Bergen, Norway
| | - S Hovland
- Department of Biomedicine, Faculty of Medicine and Dentistry, University of Bergen, Norway
| | - T Brattelid
- Department of Biomedicine, Faculty of Medicine and Dentistry, University of Bergen, Norway
| | - A K Jonassen
- Department of Biomedicine, Faculty of Medicine and Dentistry, University of Bergen, Norway
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Nyberg C, Karlsson T, Ronne-Engström E. Predictors of increased cumulative serum levels of the N-terminal prohormone of brain natriuretic peptide 4 days after acute spontaneous subarachnoid hemorrhage. J Neurosurg 2014; 120:599-604. [DOI: 10.3171/2013.8.jns13625] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
The rupture of an intracranial aneurysm is followed by increased intracranial pressure and decreased cerebral blood flow. A major systemic stress reaction follows, presumably to restore cerebral blood flow. However, this reaction can also cause adverse effects, including myocardial abnormalities, which are common and can be serious, and increased levels of natriuretic peptides, especially brain natriuretic peptide (BNP). The association of BNP with fluid and salt balance, vasospasm, brain ischemia, and cardiac injury has been studied but almost exclusively regarding events after admission. Brain natriuretic peptide has also been measured at various time points and analyzed in different ways statistically. The authors approached BNP measurement in a new way; they used the calculated area under the curve (AUC) for the first 4 days to quantitatively measure the BNP load during the first critical part of the disease state. Their rationale was a suspicion that early BNP load is a marker of the severity of the ictus and will influence the subsequent course of the disease by disturbing the fluid and salt balance.
Methods
The study included 156 patients with acute spontaneous subarachnoid hemorrhage (SAH). Mean patient age was 59.8 ± 11.2 years, and 105 (67%) of the patients were female. An aneurysm was found in 138 patients. A total of 82 aneurysms were treated by endovascular coiling, 50 were treated by surgery, and 6 were untreated. At the time of admission, serum samples were collected for troponin-I analysis and for the N-terminal prohormone of BNP (NT-proBNP); daily thereafter, samples were collected for the NT-proBNP analysis. The cumulative BNP load was calculated as the AUC for NT-proBNP during the first 4 days. The following variables were studied in terms of their influence on the AUC for NT-proBNP: sex, age, World Federation of Neurosurgical Societies grade of SAH, Fisher grade, angiographic result, treatment of aneurysm, clinical neurological deterioration, verified infections, vasospasm treatment, and 6-month outcome.
Results
The AUC for NT-proBNP was larger when variables indicated a more severe SAH. These variables were higher Fisher and World Federation of Neurosurgical Societies grades, high levels of troponin-I at admission, an aneurysm, neurological deficits, and infections. The AUC for NT-proBNP was also larger among women, older patients, and patients with poor outcomes. Linear regression showed that the best predicting model for large AUC for NT-proBNP was the combination of the following: female sex, high levels of troponin-I, an aneurysm, neurological deficits, and advanced age.
Conclusions
The cumulative BNP load during the first days after SAH can be predicted by variables describing the severity of the disease already known at the time of admission. This information can be used to identify patients at risk for an adverse course of the disease.
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Affiliation(s)
| | - Torbjörn Karlsson
- 2Department of Surgical Sciences, Section of Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
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Celik Guzel E, Bakkal E, Guzel S, Eroglu HE, Acar A, Kuçukyalcin V, Topcu B. Can low brain-derived neurotrophic factor levels be a marker of the presence of depression in obese women? Neuropsychiatr Dis Treat 2014; 10:2079-86. [PMID: 25395856 PMCID: PMC4226451 DOI: 10.2147/ndt.s72087] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE Depression is a common condition in obese women that can result in severe impairment of their physical and social functioning. A deficiency of brain-derived neurotrophic factor (BDNF) is involved in the mechanism of depression. The aim of this study is to investigate whether BDNF levels differ between obese female patients and healthy controls and whether BDNF levels alter with affective states in depressive obese women. METHODS The study group included 40 obese, 40 preobese, and 40 normal weight women. BDNF levels were measured with an enzyme-linked immunosorbent assay in patient and control groups. For identifying the depression and anxiety status, Beck Depression/Anxiety Inventories were used; and for the evaluation of cognitive functions, the mini-mental state examination was used. RESULTS BDNF levels were significantly lower in obese patients compared to the control group (P<0.01). BDNF levels were significantly lower in obese patients with depression compared to the obese patients without depression (P<0.05). The Beck Depression Inventory showed a negative correlation with BDNF (r=-0.044; P<0.01) and a positive correlation with the Beck Anxiety Inventory (r=0.643; P<0.001), vitamin B12 levels (r=0.023; P<0.001), and insulin levels (r=0.257; P<0.05) in obese patients. When receiver operating characteristic curve analysis was used to analyze the suitability of BDNF to identify depression in obese women, the area under the curve for BDNF, 0.756, was found to be significant (P=0.025). BDNF levels lower than 70.2 pg/mL were associated with a higher prevalence of depressive symptoms. CONCLUSION The results of our study suggest that the decrease in BDNF levels can be used as a marker for depression diagnosis in obese patients.
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Affiliation(s)
- Eda Celik Guzel
- Department of Family Physician, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey
| | - Esra Bakkal
- Department of Family Physician, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey
| | - Savas Guzel
- Department of Biochemistry, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey
| | | | - Ayse Acar
- Department of Biochemistry, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey
| | - Volkan Kuçukyalcin
- Department of Biochemistry, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey
| | - Birol Topcu
- Department of Biostatistics, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey
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Lurati Buse GAL, Schumacher P, Seeberger E, Studer W, Schuman RM, Fassl J, Kasper J, Filipovic M, Bolliger D, Seeberger MD. Randomized comparison of sevoflurane versus propofol to reduce perioperative myocardial ischemia in patients undergoing noncardiac surgery. Circulation 2012; 126:2696-704. [PMID: 23136158 DOI: 10.1161/circulationaha.112.126144] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Volatile anesthetics provide myocardial preconditioning in coronary surgery patients. We hypothesized that sevoflurane compared with propofol reduces the incidence of myocardial ischemia in patients undergoing major noncardiac surgery. METHODS AND RESULTS We enrolled 385 patients at cardiovascular risk in 3 centers. Patients were randomized to maintenance of anesthesia with sevoflurane or propofol. We recorded continuous ECG for 48 hours perioperatively, measured troponin T and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) on postoperative days 1 and 2, and evaluated postoperative delirium by the Confusion Assessment Method. At 6 and 12 months, we contacted patients by telephone to assess major adverse cardiac events. The primary end point was a composite of myocardial ischemia detected by continuous ECG and/or troponin elevation. Additional end points were postoperative NT-proBNP concentrations, major adverse cardiac events, and delirium. Patients and outcome assessors were blinded. We tested dichotomous end points by χ(2) test and NT-proBNP by Mann-Whitney test on an intention-to-treat basis. Myocardial ischemia occurred in 75 patients (40.8%) in the sevoflurane and 81 (40.3%) in the propofol group (relative risk, 1.01; 95% confidence interval, 0.78-1.30). NT-proBNP release did not differ across allocation on postoperative day 1 or 2. Within 12 months, 14 patients (7.6%) suffered a major adverse cardiac event after sevoflurane and 17 (8.5%) after propofol (relative risk, 0.90; 95% confidence interval, 0.44-1.83). The incidence of delirium did not differ (11.4% versus 14.4%; P=0.379). CONCLUSIONS Compared with propofol, sevoflurane did not reduce the incidence of myocardial ischemia in high-risk patients undergoing major noncardiac surgery. The sevoflurane and propofol groups did not differ in postoperative NT-proBNP release, major adverse cardiac events at 1 year, or delirium.
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Affiliation(s)
- Giovanna A L Lurati Buse
- Department of Anesthesia and Intensive Care Medicine, University Hospital Basel, Spitalstrasse 21, CH-4031 Basel, Switzerland.
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Jung S, Kittleson M. The Effect of Atenolol on NT-proBNP and Troponin in Asymptomatic Cats with Severe Left Ventricular Hypertrophy because of Hypertrophic Cardiomyopathy: A Pilot Study. J Vet Intern Med 2011; 25:1044-9. [DOI: 10.1111/j.1939-1676.2011.0754.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Infarct tissue characteristics of patients with versus without early revascularization for acute myocardial infarction: a contrast-enhancement cardiovascular magnetic resonance imaging study. Heart Vessels 2011; 27:250-7. [PMID: 21598029 DOI: 10.1007/s00380-011-0150-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Accepted: 04/15/2011] [Indexed: 10/18/2022]
Abstract
Histopathological studies have suggested that early revascularization for acute myocardial infarction (MI) limits the size, transmural extent, and homogeneity of myocardial necrosis. However, the long-term effect of early revascularization on infarct tissue characteristics is largely unknown. Cardiovascular magnetic resonance (CMR) imaging with contrast enhancement (CE) allows non-invasive examination of infarct tissue characteristics and left ventricular (LV) dimensions and function in one examination. A total of 69 patients, referred for cardiac evaluation for various clinical reasons, were examined with CE-CMR >1 month (median 6, range 1-213) post-acute MI. We compared patients with (n = 33) versus without (n = 36) successful early revascularization for acute MI. Cine-CMR measurements included the LV end-diastolic and end-systolic volumes (ESV), LV ejection fraction (LVEF, %), and wall motion score index (WMSI). CE images were analyzed for core, peri, and total infarct size (%), and for the number of transmural segments. In our population, patients with successful early revascularization had better LVEFs (46 ± 16 vs. 34 ± 14%; P < 0.01), superior WMSIs (0.53, range 0.00-2.29 vs. 1.42, range 0.00-2.59; P < 0.01), and smaller ESVs (121 ± 70 vs. 166 ± 82; P = 0.02). However, there was no difference in core (9 ± 6 vs. 11 ± 6%), peri (9 ± 4 vs. 10 ± 4%), and total infarct size (18 ± 9 vs. 21 ± 9%; P > 0.05 for all comparisons); only transmural extent (P = 0.07) and infarct age (P = 0.06) tended to be larger in patients without early revascularization. CMR wall motion abnormalities are significantly better after revascularization; these differences are particularly marked later after infarction. The difference in scar size is more subtle and does not reach significance in this study.
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Lurati Buse GA, Koller MT, Burkhart C, Seeberger MD, Filipovic M. The Predictive Value of Preoperative Natriuretic Peptide Concentrations in Adults Undergoing Surgery. Anesth Analg 2011; 112:1019-33. [DOI: 10.1213/ane.0b013e31820f286f] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Impact of obesity on plasma B-type natriuretic peptide levels in Japanese community-based subjects. Heart Vessels 2011; 27:287-94. [PMID: 21526421 DOI: 10.1007/s00380-011-0143-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2010] [Accepted: 04/01/2011] [Indexed: 01/08/2023]
Abstract
The plasma B-type natriuretic peptide (BNP) concentration was recently shown to be inversely correlated with body mass index (BMI). However, very few attempts have been made to associate abdominal obesity and BNP in the Japanese general population. Here, we conducted a cross-sectional study, and examined 339 male and 429 female residents without heart disease in a rural Japanese community who received an annual health checkup in 2006. BNP was inversely associated with both BMI and abdominal circumference (AC) in the age-adjusted regression analysis (p < 0.05). Following adjustment for traditional risk factors, multiple regression analysis revealed that BNP was negatively correlated with AC (p < 0.05), but not BMI. Although metabolic syndrome was not associated with BNP levels, AC had an influence on low BNP levels in the multiple regression analysis using both AC and BMI concurrently (p < 0.05 for AC and p > 0.60 for BMI). These effects were more prominent in men than in women. Collectively, plasma BNP levels are inversely related with obesity, as measured by AC, in Japanese community-based subjects.
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A slightly elevated level of N-terminal pro-brain natriuretic peptide can predict coronary artery disease in a population with normal left ventricular function. Heart Vessels 2010; 26:473-9. [DOI: 10.1007/s00380-010-0080-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Accepted: 07/30/2010] [Indexed: 11/25/2022]
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