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Toyama M, Satoh M, Nakayama S, Hashimoto H, Muroya T, Murakami T, Hirose T, Obara T, Nakaya N, Mori T, Ohkubo T, Imai Y, Hozawa A, Metoki H. Combined effects of blood pressure and glucose status on the risk of chronic kidney disease. Hypertens Res 2024; 47:1831-1841. [PMID: 38671217 PMCID: PMC11224015 DOI: 10.1038/s41440-024-01683-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: 09/07/2023] [Revised: 03/24/2024] [Accepted: 03/31/2024] [Indexed: 04/28/2024]
Abstract
This study aimed to assess the combined effects of blood pressure (BP) and glucose status on chronic kidney disease (CKD) incidence in young and middle-aged adults. We examined data from 1,297,341 Japanese individuals aged <60 years (60.1% men; mean age 41.4 ± 9.3 years) with no history of CKD at baseline. The interval-censored Cox proportional hazards model with covariates was used. During a median follow-up period of 2.1 years, new onset CKD (estimated glomerular filtration rate <60 ml/min/1.73 m2 and/or proteinuria) occurred in 80,187 participants. In participants without antihypertensive treatment (AHT), the adjusted hazard ratios (95% confidence interval) per 1-standard deviation, that is, 15 mmHg increase in systolic BP for CKD incidence, were 1.08 (1.07-1.09), 1.12 (1.10-1.13), and 1.15 (1.12-1.18) in normoglycemia, borderline glycemia, and diabetes groups, respectively. These ratios were significantly higher in the borderline glycemia and diabetes groups compared with those in the normoglycemia group (interaction p < 0.0001). The interaction between BP and borderline glycemia was evident when the outcome definition was restricted to proteinuria. In participants under AHT, systolic BP was most strongly associated with CKD risk in the diabetes group, although no significant interaction was observed. High BP and high glucose status may synergistically increase the incidence of CKD. Strict BP management may play an important role in the early prevention of CKD in individuals with worse glucose status within the young and middle-aged population. This large-scale longitudinal cohort study showed high BP and diabetes synergistically increased the risk of CKD in individuals without AHT. Strict BP management may play an important role in the early prevention of CKD in individuals with worse glucose status within the young and middle-aged population.
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Affiliation(s)
- Maya Toyama
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Department of Nephrology, Self-Defense Forces Sendai Hospital, Sendai, Japan
| | - Michihiro Satoh
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
- Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Japan.
| | - Shingo Nakayama
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Division of Nephrology and Endocrinology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Hideaki Hashimoto
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Division of Nephrology and Endocrinology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Tomoko Muroya
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Division of Internal Medicine, Izumi Hospital, Sendai, Japan
| | - Takahisa Murakami
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takuo Hirose
- Division of Nephrology and Endocrinology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Department of Endocrinology and Applied Medical Science, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Obara
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Naoki Nakaya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Takefumi Mori
- Division of Nephrology and Endocrinology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Yutaka Imai
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
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Michielsen M, Böhmer MN, Vermeulen RCH, Vlaanderen JJ, Beekman ATF, Kooij JJS. ADHD, sleep, chronotype and health in a large cohort of Dutch nurses. J Psychiatr Res 2024; 174:159-164. [PMID: 38636152 DOI: 10.1016/j.jpsychires.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/05/2024] [Accepted: 04/02/2024] [Indexed: 04/20/2024]
Affiliation(s)
- M Michielsen
- PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR, The Hague, the Netherlands.
| | - M N Böhmer
- PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR, The Hague, the Netherlands
| | - R C H Vermeulen
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Jenalaan 18d, 3584 CK, Utrecht, Utrecht, the Netherlands
| | - J J Vlaanderen
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Jenalaan 18d, 3584 CK, Utrecht, Utrecht, the Netherlands
| | - A T F Beekman
- Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam University Medical Center/VUmc, Oldenaller 1, 1081 HL, Amsterdam, the Netherlands
| | - J J S Kooij
- PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR, The Hague, the Netherlands; Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam University Medical Center/VUmc, Oldenaller 1, 1081 HL, Amsterdam, the Netherlands
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Wang L, Du H, Sheng C, Dai H, Chen K. Association between metabolic syndrome and kidney cancer risk: a prospective cohort study. Lipids Health Dis 2024; 23:142. [PMID: 38760801 PMCID: PMC11100063 DOI: 10.1186/s12944-024-02138-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/08/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Kidney cancer has become known as a metabolic disease. However, there is limited evidence linking metabolic syndrome (MetS) with kidney cancer risk. This study aimed to investigate the association between MetS and its components and the risk of kidney cancer. METHODS UK Biobank data was used in this study. MetS was defined as having three or more metabolic abnormalities, while pre-MetS was defined as the presence of one or two metabolic abnormalities. Hazard ratios (HRs) and 95% confidence intervals (CIs) for kidney cancer risk by MetS category were calculated using multivariable Cox proportional hazards models. Subgroup analyses were conducted for age, sex, BMI, smoking status and drinking status. The joint effects of MetS and genetic factors on kidney cancer risk were also analyzed. RESULTS This study included 355,678 participants without cancer at recruitment. During a median follow-up of 11 years, 1203 participants developed kidney cancer. Compared to the metabolically healthy group, participants with pre-MetS (HR= 1.36, 95% CI: 1.06-1.74) or MetS (HR= 1. 70, 95% CI: 1.30-2.23) had a significantly greater risk of kidney cancer. This risk increased with the increasing number of MetS components (P for trend < 0.001). The combination of hypertension, dyslipidemia and central obesity contributed to the highest risk of kidney cancer (HR= 3.03, 95% CI: 1.91-4.80). Compared with participants with non-MetS and low genetic risk, those with MetS and high genetic risk had the highest risk of kidney cancer (HR= 1. 74, 95% CI: 1.41-2.14). CONCLUSIONS Both pre-MetS and MetS status were positively associated with kidney cancer risk. The risk associated with kidney cancer varied by combinations of MetS components. These findings may offer novel perspectives on the aetiology of kidney cancer and assist in designing primary prevention strategies.
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Affiliation(s)
- Lin Wang
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, 300060, China
| | - Han Du
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, 300060, China
| | - Chao Sheng
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, 300060, China
| | - Hongji Dai
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, 300060, China.
| | - Kexin Chen
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, 300060, China.
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Jarrett MS, Anderson T, Wideman L, Davis PG. Direct and indirect effects of adiposity on markers of autonomic nervous system activity in older adults. PLoS One 2024; 19:e0303117. [PMID: 38753844 PMCID: PMC11098483 DOI: 10.1371/journal.pone.0303117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 04/12/2024] [Indexed: 05/18/2024] Open
Abstract
Several cardiovascular disease (CVD) risk factors (e.g., hypertension, poor glycemic control) can affect and be affected by autonomic nervous system (ANS) activity. Since excess adiposity can influence CVD development through its effect on hypertension and diabetes mellitus, it is important to determine how adiposity and altered ANS activity are related. The present study employed structural equation modeling to investigate the relation between adiposity and ANS activity both directly and indirectly through biological variables typically associated with glycemic impairment and cardiac stress in older adults. Utilizing the Atherosclerosis Risk in Communities (ARIC) dataset, 1,145 non-smoking adults (74±4.8 yrs, 62.8% female) free from known CVD, hypertension, and diabetes and not currently taking beta-blockers were evaluated for fasting blood glucose (FBG), insulin, and HbA1c concentrations, waist circumference (WC), blood pressure (BP), and markers of ANS activity. WC was recorded just above the iliac crest and was used to reflect central adiposity. Resting 2-minute electrocardiograph recordings, pulse wave velocity, and ankle-brachial index data were used to assess the root mean square of successive differences in RR intervals (RMSSD) and the pre-ejection period (PEP), markers of parasympathetic and sympathetic activity, respectively. FBG, insulin, and HbA1c inferred a latent variable termed glycemic impairment (GI), whereas heart rate and diastolic BP inferred a latent variable termed cardiac stress (CS). The structural equation model fit was acceptable [root mean square error of approximation = 0.050 (90% CI = .036, .066), comparative fit index = .970, Tucker Lewis Index = 0.929], with adiposity having both significant direct (β = 0.208, p = 0.018) and indirect (β = -.217, p = .041) effects on PEP through GI. Adiposity displayed no significant direct effect on RMSSD. CS displayed a significant pathway (β = -0.524, p = 0.035) on RMSSD, but the indirect effect of WC on RMSSD through CS did not reach statistical significance (β = -0.094, p = 0.137). These results suggest that adiposity's relation to ANS activity is multifaceted, as increased central adiposity had opposing direct and indirect effects on markers of sympathetic activity in this population of older adults.
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Affiliation(s)
- Michael S. Jarrett
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, United States of America
- Department of Exercise Physiology, Winston Salem State University, Winston Salem, North Carolina, United States of America
| | - Travis Anderson
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, United States of America
- United States Olympic and Paralympic Committee, Colorado Springs, Colorado, United States of America
| | - Laurie Wideman
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, United States of America
| | - Paul G. Davis
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, United States of America
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Scime NV, Turner S, Miliku K, Simons E, Moraes TJ, Field CJ, Turvey SE, Subbarao P, Mandhane PJ, Azad MB. Association of Human Milk Fatty Acid Composition with Maternal Cardiometabolic Diseases: An Exploratory Prospective Cohort Study. Breastfeed Med 2024; 19:357-367. [PMID: 38501380 PMCID: PMC11250837 DOI: 10.1089/bfm.2024.0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Background: Human milk fatty acids derive from maternal diet, body stores, and mammary synthesis and may reflect women's underlying cardiometabolic health. We explored whether human milk fatty acid composition was associated with maternal cardiometabolic disease (CMD) during pregnancy and up to 5 years postpartum. Materials and Methods: We analyzed data from the prospective CHILD Cohort Study on 1,018 women with no preexisting CMD who provided breast milk samples at 3-4 months postpartum. Milk fatty acid composition was measured using gas-liquid chromatography. Maternal CMD (diabetes or hypertension) was classified using questionnaires and birth records as no CMD (reference outcome group; 81.1%), perinatal CMD (developed and resolved during the perinatal period; 14.9%), persistent CMD (developed during, and persisted beyond, the perinatal period; 2.9%), and incident CMD (developed after the perinatal period; 1.1%). Multinomial logistic regression was used to model associations between milk fatty acid composition (individual, summary, ratios, and patterns identified using principal component analysis) and maternal CMD, adjusting for pre-pregnancy anthropometry and race/ethnicity. Results: Medium-chain saturated fatty acids (MC-SFA), lauric (C12:0; odds ratio [OR] = 0.73, 95% confidence interval [CI] = 0.60-0.89) and myristic acid (C14:0; OR = 0.80, 95% CI = 0.66-0.97), and the high MC-SFA principal component pattern (OR = 0.86, 95% CI = 0.76-0.96) were inversely associated with perinatal CMD. Long-chain polyunsaturated fatty acids adrenic acid (C22:4n-6) was positively associated with perinatal (OR = 1.21, 95% CI = 1.01-1.44) and persistent CMD (OR = 1.56, 95% CI = 1.08-2.25). The arachidonic (C20:4n-6)-to-docosahexaenoic acid (C22:6n-3) ratio was inversely associated with incident CMD (OR = 0.52, 95% CI = 0.28-0.96). Conclusions: These exploratory findings highlight a potential novel utility of breast milk for understanding women's cardiometabolic health.
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Affiliation(s)
- Natalie V. Scime
- Department of Health & Society, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Sarah Turner
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kozeta Miliku
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Elinor Simons
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Theo J. Moraes
- Division of Respiratory Medicine, Department of Pediatrics, SickKids Research Institute, Toronto, Ontario, Canada
| | - Catherine J. Field
- Department of Agricultural Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Stuart E. Turvey
- BC Children’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada
- Division of Allergy and Immunology, Department of Pediatrics, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Padmaja Subbarao
- Division of Respiratory Medicine, Department of Pediatrics, SickKids Research Institute, Toronto, Ontario, Canada
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Piushkumar J. Mandhane
- Department of Pediatrics, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
| | - Meghan B. Azad
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
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Varalakshmi D, Rekha K, Mohammed R. Type 2 Diabetes Mellitus Prevalence and Associated Risk Factors in Postmenopausal Women. Cureus 2024; 16:e60247. [PMID: 38872669 PMCID: PMC11170058 DOI: 10.7759/cureus.60247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 06/15/2024] Open
Abstract
Introduction Type 2 diabetes mellitus (T2DM) is the most common problem in postmenopausal women. This study aimed to find out the prevalence of T2DM and its risk factors in postmenopausal women. Methods The study is a population-based cross-sectional study. Anthropometric measurements, blood pressure, and biochemical measurements of 2295 postmenopausal women up to the age of 55 years were taken following face-to-face interviews. Odds ratio was used to find out the role of risk factors associated with T2DM. Results Prevalence of T2DM was reported to be 15.51%. Significant contribution of waist circumference (WC) followed by body mass index (BMI), total cholesterol (TC), and triglycerides (p<0.05) was noted in increasing the risk of T2DM. No association was found between T2DM and hypertension (p>0.05). Conclusion A high prevalence of T2DM was reported in postmenopausal women. Higher levels of BMI, WC, TC, and triglycerides were found to be the major risk factors for T2DM.
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Affiliation(s)
- D Varalakshmi
- Physiotherapy, Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
- Physiotherapy, Apollo College of Physiotherapy, Hyderabad, IND
| | - K Rekha
- Physiotherapy, Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Rafi Mohammed
- Physiotherapy, School of Allied and Health Care Sciences, Malla Reddy University, Hyderabad, IND
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Sharma JR, Fokkens H, Laubscher R, Apalata TR, Nomatshila SC, Alomatu SY, Strijdom H, Johnson R. No Association Between AGT Gene Polymorphisms with Hypertension in a South African Population. Diabetes Metab Syndr Obes 2024; 17:1853-1865. [PMID: 38706806 PMCID: PMC11069114 DOI: 10.2147/dmso.s452272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/16/2024] [Indexed: 05/07/2024] Open
Abstract
Purpose Hypertension is a leading cause of cardiovascular-related morbidity and mortality worldwide, with a prevalence increasing at an alarming rate in both middle- and low-income countries. Various environmental and genetic factors have been attributed to play a significant role in the increasing prevalence of hypertension. Single nucleotide polymorphisms (SNPs) in the angiotensinogen (AGT) gene are reported to have a significant association with hypertension; however, there are limited studies done on South African populations. Therefore, this case-control study aimed to investigate the association between AGT SNPs (rs2004776, rs3789678, rs5051 and rs7079) with hypertension in a study population of isiXhosa-speaking participants from the Eastern Cape Province in South Africa. Materials and Methods The SNPs were genotyped in 250 hypertensive cases and 237 normotensive controls, using TaqMan genotyping assays. Results For the SNP rs2004776, the frequency of CC genotype (18.4%) and C allele (44%) in hypertensive cases showed no significant differences (p = 0.52, χ2 = 1.32), when compared to the normotensive control group (CC: 19.8% and C allele: 43%). Similar results were obtained for the genotypic and allelic frequencies between hypertensive cases and normotensive controls for rs3789678 (p = 0.88, χ2=0.26) and rs5051 (p = 0.57, χ2=1.12), and rs7079 (p = 0.33, χ2=2.23). These findings demonstrate that there were no significant associations between the SNPs rs2004776, rs3789678, rs7079, rs5051 with hypertension in our study population. Conclusion These findings suggest that AGT gene polymorphisms are not associated with the development of hypertension in the studied population. The present study represents the first genetic report to investigate the AGT gene polymorphisms with hypertension in an isiXhosa-speaking South African population.
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Affiliation(s)
- Jyoti Rajan Sharma
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town, South Africa
| | - Hannah Fokkens
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town, South Africa
- Centre for Cardiometabolic Research in Africa, Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Ria Laubscher
- Biostatistics Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Teke Ruffin Apalata
- Department of Laboratory-Medicine and Pathology, Faculty of Health Sciences, Walter Sisulu University and National Health Laboratory Services, Mthatha, South Africa
| | - Sibusiso Cyprian Nomatshila
- Department of Public Health, Faculty of Medicine and Health Sciences, Walter Sisulu University, Mthatha, South Africa
| | - Samuel Yao Alomatu
- Department of Internal Medicine, Nelson Mandela Central Hospital and Walter Sisulu University, Mthatha, South Africa
| | - Hans Strijdom
- Centre for Cardiometabolic Research in Africa, Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rabia Johnson
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town, South Africa
- Centre for Cardiometabolic Research in Africa, Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Ahmed W. Additive interaction of family medical history of diabetes with hypertension on the diagnosis of diabetes among older adults in India: longitudinal ageing study in India. BMC Public Health 2024; 24:999. [PMID: 38600575 PMCID: PMC11005278 DOI: 10.1186/s12889-024-18146-0] [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: 09/29/2023] [Accepted: 02/18/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND The present study aimed to estimate the additive interaction of family history of diabetes and hypertension on the diagnosis of diabetes among individuals aged 45 years and above in India. The coexistence of these two exposures may act synergistically on the risk of diabetes, leading to adverse health outcomes. METHODS The study utilized the data from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017-2018). The total sample size for the current study was 58,612 individuals aged 45 years and above. Multivariable logistic regression models were employed to determine the individual and joint effect of a family history of diabetes with hypertension on diabetes. An additive model was applied to assess the interaction effect of the family medical history of diabetes with hypertension on the diagnosis of diabetes by calculating three different measures of additive interaction such as the relative excess risk ratio (RERI), attribution proportion due to interaction (AP), and synergy index (S). RESULTS The prevalence of diabetes was three times higher among individuals with family history of diabetes (27.8% vs. 9.2%) than those without family history. Individuals with family history of diabetes (AOR: 2.47, CI: 2.11 2.89) had 2.47 times higher odds of having diabetes than those without family history. The prevalence of diabetes was significantly higher among individuals with hypertension and family history of diabetes (46.6%, 95% CI: 39.7-53.6) than those without the coexistence of family history of diabetes and hypertension (9.9%, 95% CI: 9.5-10.4), individuals with hypertension and without a family history of diabetes (22.7%, 95% CI: 21.2-24.2), and individuals with family history of diabetes and without hypertension (16.5%, 95% CI: 14.5-18.7). Moreover, the adjusted odds ratio (AOR) of the joint effect between family medical history of diabetes and hypertension on diabetes was 9.28 (95% CI: 7.51-11.46). In the adjusted model, the RERI, AP, and S for diabetes were 3.5 (95% CI: 1.52-5.47), 37% (0.37; 95% CI: 0.22-0.51), and 1.69 (95% CI: 1.31-2.18) respectively, which indicates that there is a significant positive interaction between family history of diabetes and hypertension on the diagnosis of diabetes. The study findings on interaction effects further demonstrate consistent results for two models of hypertension (self-reported hypertension and hypertensive individuals receiving medication) even after adjustment with potential confounding factors on diabetes (self-reported diabetes and individuals with diabetes receiving medication). CONCLUSIONS The study findings strongly suggest that the interaction of family history of diabetes with hypertension has a positive and significant effect on the risk of diabetes even after adjustment with potential confounding factors. Furthermore, the findings indicate a synergistic effect, emphasizing the importance of considering both family medical history of diabetes and hypertension when assessing diabetes risk and designing preventive strategies or interventions.
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Affiliation(s)
- Waquar Ahmed
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India.
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Aziz F, Khan MF, Moiz A. Gestational diabetes mellitus, hypertension, and dyslipidemia as the risk factors of preeclampsia. Sci Rep 2024; 14:6182. [PMID: 38486097 PMCID: PMC10940289 DOI: 10.1038/s41598-024-56790-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 03/11/2024] [Indexed: 03/18/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is a known risk factor for gestational hypertension which further progress toward conditions like proteinuria, dyslipidemia, thrombocytopenia, pulmonary edema leading to Preeclampsia (PE). Pregnancy can be a challenging time for many women, especially those diagnosed with GDM and PE. Thus, the current prospective study investigates the association of OGTT glucose levels with systolic and diastolic blood pressure and lipid profile parameters in pregnant women diagnosed with GDM and PE. A total of 140 pregnant women were stratified into GDM (n = 50), PE (n = 40) and controls (n = 50). Two hour 75 g oral glucose tolerance test (OGTT) was performed for screening GDM. Biochemical parameters analysis of OGTT, total cholesterol (TC), triglyceride (Tg), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), urinary albumin and creatinine were tested to find urinary albumin creatinine ratio (uACR). Statistical analysis was performed using ANOVA followed by post hoc test and regression analysis. Among the studied groups, GDM and PE groups showed no significant difference in age and increased BMI. Increased 2 h OGTT & TC in GDM group; elevated uACR, systolic/diastolic blood pressure, Tg, HDL-C, LDL-C in PE group was observed and differ significantly (p < 0.0001) with other groups. A significant positive effect of 2 h OGTT was observed on blood pressure (R2: GDM = 0.85, PE = 0.71) and lipid profile determinants (R2: GDM = 0.85, PE = 0.33) at p < 0.0001. The current study concludes that glucose intolerance during the later weeks of pregnancy is associated with gestational hypertension and hyperlipidemia as a risk factor for PE. Further research is needed for a detailed assessment of maternal glucose metabolism at various pregnancy stages, including the use of more sensitive markers such as C-peptide and their relation to pregnancy-related hypertensive disorders.
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Affiliation(s)
- Farah Aziz
- Department of Basic Medical Science, College of Applied Medical Science, King Khalid University, Abha, Saudi Arabia.
| | - Mohammad Fareed Khan
- Department of Infection Prevention and Control, The Specialist Hospital, Abha, Saudi Arabia
| | - Amna Moiz
- Medical City, King Khalid University, Abha, Saudi Arabia
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Xiong T, Jia Y, Tan F, Long X, Yuan X, She Q, Du J. Integrated analysis reveals ceRNA network of cardiac remodeling by SGLT2 inhibitor in middle-aged hypertensive rats. Biochem Biophys Res Commun 2024; 696:149434. [PMID: 38198921 DOI: 10.1016/j.bbrc.2023.149434] [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: 10/23/2023] [Revised: 12/18/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024]
Abstract
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) represent an innovative class of antidiabetic agents that have demonstrated promise in mitigating cardiac remodeling. However, the transcriptional regulatory mechanisms underpinning their impact on blood pressure and the reversal of hypertension-induced cardiac remodeling remain largely unexplored. Given this context, our study concentrated on comparing the cardiac expression profiles of lncRNAs and mRNAs between Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHR). To validate our results, we performed blood pressure measurements, tissue staining, and qRT-PCR. The treatment led to a significant reduction in systolic blood pressure and improved cardiac remodeling by reducing myocardial fibrosis and regulating the inflammatory response. Our examination disclosed that ventricular tissue mRNA, regulated by hypertension, was primarily concentrated in the complement and coagulation cascades and cytokine-cytokine receptor interactions. Compared with SHR, the SGLT2i treatment group was associated with myocardial contraction. Investigation into the lncRNA-mRNA regulatory network and competing endogenous RNA (ceRNA) network suggested that the potential roles of these differentially expressed (DE) lncRNAs and mRNAs were tied to processes such as collagen fibril organization, inflammatory response, and extracellular matrix (ECM) modifications. We found that the expression of Col3a1, C1qa, and lncRNA NONRATT007139.2 were altered in the SHR group and that SGLT2i treatment reversed these changes. Our results suggest that dapagliflozin effectively reverses hypertension-induced myocardial remodeling through a lncRNA-mRNA transcriptional regulatory network, with immune cell-mediated ECM deposition as a potential regulatory target. This underlines the potentiality of SGLT2i and genes related to immunity as promising targets for the treatment of hypertension.
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Affiliation(s)
- Tianhua Xiong
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuewang Jia
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fangyan Tan
- Department of Nephrology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xianglin Long
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xin Yuan
- Department of Nephrology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiang She
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jianlin Du
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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11
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Pankova O, Korzh O. Plasma catestatin levels are related to metabolic parameters in patients with essential hypertension and type 2 diabetes mellitus. Heart Vessels 2024; 39:144-159. [PMID: 37758851 DOI: 10.1007/s00380-023-02318-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
Catestatin (CST) is a pleiotropic peptide with cardioprotective and metabolic effects. CST is involved in the pathogenesis of both arterial hypertension (AH) and type 2 diabetes mellitus (T2DM), which are the risk factors of cardiovascular diseases. In this study, we aimed to investigate the plasma CST levels in hypertensive patients, especially with T2DM, as well as compare those with healthy volunteers, and explore the relationship between CST levels and clinical, anthropometric and laboratory parameters. 106 Hypertensive patients, 55 of which had comorbidity T2DM, and 30 healthy volunteers were enrolled in the study. All subjects underwent clinical examination, including vital signs and anthropometric data assessment, medical history interview, and blood sample collection. Plasma CST levels were measured by an enzyme-linked immunosorbent assay (ELISA), using a commercial diagnostic kit. The plasma CST levels were significantly lower in hypertensive patients (N = 106) compared with healthy subjects (N = 30) (5.02 ± 1.09 vs. 6.64 ± 0.72; p < 0.001). Furthermore, hypertensive patients with T2DM (N = 55) have significantly reduced CST levels in comparison with those without T2DM (N = 51) (4.47 ± 1.16 vs. 5.61 ± 0.61; p < 0.001). CST significantly correlated with anthropometric characteristics, in particular, weight (r = - 0.344; p < 0.001), BMI (r = - 0.42; p < 0.001), neck (r = - 0.358; p < 0.001), waist (r = - 0.487; p < 0.001), hip (r = - 0.312; p < 0.001), wrist circumferences (r = - 0.264; p = 0.002), and waist-to-hip ratio (r = - 0.395; p < 0.001). Due to its antihypertensive effect, CST has significant associations with systolic BP (r = - 0.475; p < 0.001) and duration of AH (r = - 0.26; p = 0.007). CST also has an inverse relationship with insulin (r = - 0.382; p < 0.001), glucose (r = - 0.45; p < 0.001), index HOMA-IR (r = - 0.481; p < 0.001) and HbA1c (r = - 0.525; p < 0.001), that indicate its involvement in T2DM development. Besides, CST has significant correlations with uric acid levels (r = - 0.412; p < 0.001) as well as lipid parameters, especially HDL-C (r = 0.480; p < 0.001), VLDL-C (r = - 0.238; p = 0.005), TG (r = - 0.4; p < 0.001), non-HDL-C/HDL-C (r = - 0.499; p < 0.001). Multiple linear regression analysis indicated BMI (β = - 0.22; p = 0.007), AH duration (β = - 0.25; p = 0.008), HbA1c (β = - 0.43; p = 0.019) and HDL-C levels (β = 0.27; p = 0.001) as independent predictors of CST levels. The hypertensive patients have significantly decreased CST levels that are even more reduced in the presence of comorbid T2DM. The established correlations with anthropometric and laboratory parameters indicate not only antihypertensive but also metabolic effects of CST. Our results suggest the probable role of CST in the pathophysiology of cardiometabolic diseases and the development of cardiovascular complications.
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Affiliation(s)
- Olena Pankova
- Department of General Practice-Family Medicine, Kharkiv National Medical University, Heroiv Kharkova Ave., 275, Kharkiv, 61106, Ukraine.
| | - Oleksii Korzh
- Department of General Practice-Family Medicine, Kharkiv National Medical University, Heroiv Kharkova Ave., 275, Kharkiv, 61106, Ukraine
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Goyal A, Jain H, Verma A, Jain J, Shamim U, Kanagala SG, Motwani J, Dey RC, Chunawala Z, Sohail AH, Belur AD. The role of renal denervation in cardiology and beyond: An updated comprehensive review and future directives. Curr Probl Cardiol 2024; 49:102196. [PMID: 37952794 DOI: 10.1016/j.cpcardiol.2023.102196] [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: 11/05/2023] [Accepted: 11/09/2023] [Indexed: 11/14/2023]
Abstract
Renal denervation (RDN) is a minimally invasive intervention performed by denervation of the nervous fibers in the renal plexus, which decreases sympathetic activity. These sympathetic nerves influence various physiological functions that regulate blood pressure (BP), including intravascular volume, electrolyte composition, and vascular tone. Although proven effective in some trials, controversial trials, such as the Controlled Trial of Renal Denervation for Resistant Hypertension (SYMPLICITY-HTN3), have demonstrated contradictory results for the effectiveness of RDN in resistant hypertension (HTN). In the treatment of HTN, individuals with primary HTN are expected to experience greater benefits compared to those with secondary HTN due to the diverse underlying causes of secondary HTN. Beyond its application for HTN, RDN has also found utility in addressing cardiac arrhythmias, such as atrial fibrillation, and managing cases of heart failure. Non-cardiogenic applications of RDN include reducing the intensity of obstructive sleep apnea (OSA), overcoming insulin resistance, and in chronic kidney disease (CKD) patients. This article aims to provide a comprehensive review of RDN and its uses in cardiology and beyond, along with providing future directions and perspectives.
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Affiliation(s)
- Aman Goyal
- Department of Internal Medicine, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - Hritvik Jain
- Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Amogh Verma
- Department of Medicine and Surgery, Rama Medical College Hospital and Research Centre, Hapur, India
| | - Jyoti Jain
- Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Urooj Shamim
- Department of Internal Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Sai Gautham Kanagala
- Department of Internal Medicine, Metropolitan Hospital Center, NY, New York, United States
| | - Jatin Motwani
- Department of Internal Medicine, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Rohit Chandra Dey
- Department of Internal Medicine, Altai State Medical University, Barnaul, Altai Krai, Russia
| | - Zainali Chunawala
- Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas, United States
| | - Amir H Sohail
- Department of Surgery, University of New Mexico Health Sciences, Albuquerque, NM, United States
| | - Agastya D Belur
- Department of Cardiovascular Medicine, University of Louisville, Louisville, KY, United States.
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Su W, Wang J, Chen K, Yan W, Gao Z, Tang X, Wan Q, Luo Z, Ning G, Mu Y. A higher TyG index level is more likely to have enhanced incidence of T2DM and HTN comorbidity in elderly Chinese people: a prospective observational study from the reaction study. Diabetol Metab Syndr 2024; 16:29. [PMID: 38287450 PMCID: PMC10826216 DOI: 10.1186/s13098-024-01258-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/03/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Triglyceride glucose index (TyG index) was related with both type 2 diabetes (T2DM) and hypertension (HTN). Prospective studies linking the TyG index to the incidence of T2DM and HTN comorbidity remain unclear. This study aimed to to explore the longitudinal association between TyG and new-onset T2DM with HTN. METHODS 4,434 subjects (1249 males and 3185 females) without initial T2DM and HTN were followed up for 7 years. This study was conducted from November 2011 to August 2018 in the Gucheng, Laoshan and Jinding communities of Beijing. The incidence of T2DM with HTN during the 7-year follow-up was identified as the endpoint. The TyG index was divided into four quartiles: the < 25% level, the 25-50% level, the 50-75% level and the ≥ 75% level. The relationships between the TyG index and T2DM with HTN were evaluated by Cox proportional hazards regression models. RESULTS During 7 years, the augmented trend of T2DM with HTN was observed in the participants. After adjusting for all confounding factors, compared with those in the lowest quartile of TyG index, the population in the highest quartile of TyG index had a higher risk of T2DM with HTN (hazard ratio (HR), 2.878; 95% confidence intervals (95% CI), 1.230-6.731, P = 0.015), however, the association remained significant only in the female population (HR 2.753, 95% CI, 1.061-7.139, p = 0.037). The TyG had superior predictive ability of increased risk of T2DM with HTN for the populations of older age (≥ 65 years) (HR 2.694, 95% CI 1.212-5.989, p = 0.015), higher eGFR (≥ 90 mL/(min·1.73 m2)) (HR 2.603, 95% CI 1.164-5.818, p = 0.020) or obesity (BMI ≥ 28 kg/m2) (HR 2.547, 95% CI 1.001-6.478, p = 0.020). CONCLUSION A population with a higher TyG index level was more likely to have an enhanced incidence of T2DM and HTN comorbidity. TyG index could have the significance of clinical in early protection against T2DM with HTN.
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Affiliation(s)
- Wanlu Su
- Department of Endocrinology, The First Clinical Medical Center of Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
- School of Medicine, Nankai University, No. 94 Weijin Road, Tianjin, 300071, China
| | - Jie Wang
- Department of Endocrinology, Affiliated Beijing Chaoyang Hospital of Capital Medical University, No. 8 Workers Stadium South Road, Chaoyang District, Beijing, 100853, China
| | - Kang Chen
- Department of Endocrinology, The First Clinical Medical Center of Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Wenhua Yan
- Department of Endocrinology, The First Clinical Medical Center of Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Zhengnan Gao
- Department of Endocrinology, Dalian Municipal Central Hospital, No. 826 Southwest Shahekou District Road, Dalian, 116033, China
| | - Xulei Tang
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Department of Endocrinology, Center Hospital of Dalian, Dalian, Liaoning, China
| | - Qin Wan
- Department of Endocrinology, Affiliated Hospital of Luzhou Medical College, No. 25 Taiping Road, Luzhou, 646000, China
| | - Zuojie Luo
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Guang Ning
- State Key Laboratory of Medical Genomics, Department of Endocrinology, Shanghai National Research Center for Endocrine and Metabolic Disease, Shanghai Institute for Endocrine and Metabolic Disease, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yiming Mu
- Department of Endocrinology, The First Clinical Medical Center of Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, China.
- School of Medicine, Nankai University, No. 94 Weijin Road, Tianjin, 300071, China.
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Zeng Q, Li G, Chen W. Ultrasound-activatable and skin-associated minimally invasive microdevices for smart drug delivery and diagnosis. Adv Drug Deliv Rev 2023; 203:115133. [PMID: 37925075 DOI: 10.1016/j.addr.2023.115133] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023]
Abstract
Ultrasound-activatable and skin-associated minimally invasive microdevices (USMIMs) have garnered significant attention in the domains of smart drug delivery and biomedical diagnosis for on-demand healthcare, owing to their outstanding wearability, flexibility, and comfort. In this review, we present a comprehensive overview of the noteworthy advancements in USMIMs, with a specific focus on device design, potential applications, challenges, and future prospects. The classification of such microdevices primarily encompasses biointerfacing microsystems, including skin-perforable US-assisted microneedles (MNs), skin-attachable sonophoresis and their combination with microbubbles, as well as non-biointerfacing microsystems for drug delivery. Additionally, US-mediated and skin-attached microtransducers utilized in biomedical diagnosis are classified into imaging-related microtransducers, diagramming detection devices, and their combinative systems with applications on diverse signal detection. Besides, the review also highlights the challenges associated with USMIMs, focusing on aspects such as safety, environmental tolerance, wearability/comfortability, and personalization. Furthermore, it offers insights into future perspectives that address these challenges and discuss potential advancements in the field. It is firmly believed that the proposed USMIMs possess immense potential to significantly improve human lives in the near future.
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Affiliation(s)
- Qi Zeng
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Key Laboratory for Drug Target Researches and Pharmacodynamic Evaluation, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Guanyue Li
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Key Laboratory for Drug Target Researches and Pharmacodynamic Evaluation, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Wei Chen
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Key Laboratory for Drug Target Researches and Pharmacodynamic Evaluation, Huazhong University of Science and Technology, Wuhan 430022, China.
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15
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Mussa J, Rahme E, Dahhou M, Nakhla M, Dasgupta K. Considering gestational diabetes and gestational hypertension history across two pregnancies in relationship to cardiovascular disease development: A retrospective cohort study. Diabetes Res Clin Pract 2023; 206:110998. [PMID: 37951478 DOI: 10.1016/j.diabres.2023.110998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/17/2023] [Accepted: 11/08/2023] [Indexed: 11/14/2023]
Abstract
AIMS Gestational diabetes (GDM) and hypertension (GHTN) occurrences signal elevated cardiovascular disease (CVD) risk. There is little study of occurrence and recurrence of these conditions in relationship to CVD. Among women with two singleton pregnancies, we aimed to quantify CVD risk in relationship to the number of GDM/GHTN occurrences. METHODS In this Quebec-based retrospective cohort study (n = 431,980), we ascertained the number of GDM/GHTN occurrences over two pregnancies and assessed for CVD over a median of 16.4 years (cohort inception 1990-2012, outcomes 1990-2019). We defined CVD as a composite of myocardial infarction, stroke, and angina, requiring hospitalization and/or causing death. We adjusted Cox proportional hazards models for offspring size, preterm/term birth status, maternal age group, time between deliveries, ethnicity, deprivation level, and co-morbid conditions. RESULTS Compared to absence of GDM/GHTN in either pregnancy, one GDM/GHTN occurrence increased CVD hazards by 47% (hazard ratio [HR] = 1.47, 95% confidence interval [CI] 1.35-1.61), two occurrences nearly doubled hazards (HR = 1.91, 95% CI 1.68-2.17), and three or more approximately tripled CVD hazards (HR = 2.93, 95% CI 2.20-3.90). Individual components of the composite demonstrated similar findings. CONCLUSIONS Health care providers and mothers should consider a complete history of GDM/GHTN occurrences to ascertain the importance and urgency of preventive action.
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Affiliation(s)
- Joseph Mussa
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Quebec, Canada
| | - Elham Rahme
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Quebec, Canada
| | - Mourad Dahhou
- Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Quebec, Canada
| | - Meranda Nakhla
- Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Quebec, Canada; Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Kaberi Dasgupta
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Quebec, Canada.
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16
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Begum S, Parvej H, Dalui R, Paul S, Maity S, Sepay N, Afzal M, Chandra Halder U. Structural modulation of insulin by hydrophobic and hydrophilic molecules. RSC Adv 2023; 13:34097-34106. [PMID: 38019994 PMCID: PMC10662218 DOI: 10.1039/d3ra06647a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/13/2023] [Indexed: 12/01/2023] Open
Abstract
In the bloodstream, insulin interacts with various kinds of molecules, which can alter its structure and modulate its function. In this work, we have synthesized two molecules having extremely hydrophilic and hydrophobic side chains. The effects of hydrophilic and hydrophobic molecules on the binding with insulin have been investigated through a multi-spectroscopic approach. We found that hydrophilic molecules have a slightly higher binding affinity towards insulin. Insulin can bind with the hydrophilic molecules as it binds glucose. The high insulin binding affinity of a hydrophobic molecule indicates its dual nature. The hydrophobic molecule binds at the hydrophobic pocket of the insulin surface, where hydrophilic molecules interact at the polar surface of the insulin. Such binding with the hydrophobic molecule perturbs strongly the secondary structure of the insulin much more in comparison to hydrophilic molecules. Therefore, the stability of insulin decreases in the presence of hydrophobic molecules.
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Affiliation(s)
- Shahnaz Begum
- Department of Chemistry, Jadavpur University Kolkata-700032 India
| | - Hasan Parvej
- Department of Chemistry, Jadavpur University Kolkata-700032 India
| | - Ramkrishna Dalui
- Department of Chemistry, Jadavpur University Kolkata-700032 India
| | - Swarnali Paul
- Department of Chemistry, Jadavpur University Kolkata-700032 India
| | - Sanhita Maity
- Department of Chemistry, Jadavpur University Kolkata-700032 India
| | - Nayim Sepay
- Department of Chemistry, Lady Brabourne College Kolkata-700017 India
| | - Mohd Afzal
- Department of Chemistry, College of Science, King Saud University Riyadh 11451 Saudi Arabia
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Gumede N, Khathi A. The role of fibrinolysis in the development of prediabetes-associated coronary heart disease: a focus on the plasminogen activator inhibitor -1 and its potential use as a predictive marker in diet-induced prediabetes. Front Nutr 2023; 10:1256427. [PMID: 38024366 PMCID: PMC10652797 DOI: 10.3389/fnut.2023.1256427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cardiovascular diseases (CVD). However, the onset of T2DM is preceded by prediabetes, which is associated with sedentary lifestyles and consumption of high-calorie diets. Studies have shown that impaired glucose homeostasis creates an environment for developing T2DM-related complications. Using a high-fat-high-carbohydrate diet-induced prediabetes animal model, this study sought to assess the risk factors of coronary heart disease (CHD) in diet-induced prediabetes and identify biomarkers that can be used for early detection of prediabetes-associated CHD. Methods Male Sprague Dawley rats were randomly grouped into two groups and were kept on different diets for 20 weeks (n = 6 in each group). One group was fed standard rat chow to serve as a non-prediabetes (NPD) control, while the other group consumed a high-fat-high-carbohydrate diet to induce prediabetes (PD). Post induction, the homeostasis model assessment- insulin resistance (HOMA-IR) and glycated haemoglobin (HbA1c) was used to test for insulin resistance. Body weight, mean arterial pressure (MAP), resting heart rate (HR), inflammatory cytokines (C-reactive protein (CRP), tumor necrosis factor (TNF-α), interleukin-6 (IL-6)), lipids (total cholesterol (TC), triglyceride (TG), lipoproteins (HDL, LDL, VLDL)), endothelial function (endothelial nitric oxide (eNOS), endothelin -1 (ET-1)), fibrinolysis (plasminogen activator inhibitor-1 (PAI-1)) were all measured to assess the risk of CHD. All data were expressed as means ± S.E.M. Statistical comparisons were performed with Graph Pad. Instat Software using Student's two-sided t-test. The Pearson correlation coefficient and linear regression were calculated to assess the association. The value of p < 0.05 was considered statistically significant. Results There was significant insulin resistance accompanied by significantly increased HbA1c and body weight in PD compared to NPD. Simultaneously, there was a significant increase in inflammatory cytokines in PD compared to NPD. This was accompanied by significantly increased TG and VLDL and endothelial dysfunction in PD. The association between HOMA-IR and PAI-1 was insignificantly positive in NPD, whereas a significantly strong positive association was observed in PD. Conclusion There is a positive correlation between insulin resistance and PAI-1 during prediabetes; therefore, suggesting that prediabetes increases the risk of developing vascular thrombosis. The current therefore study warrants further investigation on PAI-1 and other markers of fibrinolysis for the early detection of thrombosis and risk of CHD in prediabetes.
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Affiliation(s)
- Nompumelelo Gumede
- Department of Human Physiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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18
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Arabshomali A, Bazzazzadehgan S, Mahdi F, Shariat-Madar Z. Potential Benefits of Antioxidant Phytochemicals in Type 2 Diabetes. Molecules 2023; 28:7209. [PMID: 37894687 PMCID: PMC10609456 DOI: 10.3390/molecules28207209] [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: 09/22/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
The clinical relationship between diabetes and inflammation is well established. Evidence clearly indicates that disrupting oxidant-antioxidant equilibrium and elevated lipid peroxidation could be a potential mechanism for chronic kidney disease associated with type 2 diabetes mellitus (T2DM). Under diabetic conditions, hyperglycemia, especially inflammation, and increased reactive oxygen species generation are bidirectionally associated. Inflammation, oxidative stress, and tissue damage are believed to play a role in the development of diabetes. Although the exact mechanism underlying oxidative stress and its impact on diabetes progression remains uncertain, the hyperglycemia-inflammation-oxidative stress interaction clearly plays a significant role in the onset and progression of vascular disease, kidney disease, hepatic injury, and pancreas damage and, therefore, holds promise as a therapeutic target. Evidence strongly indicates that the use of multiple antidiabetic medications fails to achieve the normal range for glycated hemoglobin targets, signifying treatment-resistant diabetes. Antioxidants with polyphenols are considered useful as adjuvant therapy for their potential anti-inflammatory effect and antioxidant activity. We aimed to analyze the current major points reported in preclinical, in vivo, and clinical studies of antioxidants in the prevention or treatment of inflammation in T2DM. Then, we will share our speculative vision for future diabetes clinical trials.
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Affiliation(s)
- Arman Arabshomali
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS 38677, USA; (A.A.); (S.B.)
| | - Shadi Bazzazzadehgan
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS 38677, USA; (A.A.); (S.B.)
| | - Fakhri Mahdi
- Department of BioMolecular Sciences, Division of Pharmacology, School of Pharmacy, University of Mississippi, University, MS 38677, USA;
| | - Zia Shariat-Madar
- Department of BioMolecular Sciences, Division of Pharmacology, School of Pharmacy, University of Mississippi, University, MS 38677, USA;
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19
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da Silva AM, do Carmo AS, Alves VP, de Carvalho LSF. Prevalence of non-communicable chronic diseases: arterial hypertension, diabetes mellitus, and associated risk factors in long-lived elderly people. Rev Bras Enferm 2023; 76:e20220592. [PMID: 37820146 PMCID: PMC10561953 DOI: 10.1590/0034-7167-2022-0592] [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: 08/11/2022] [Accepted: 03/27/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE To identify the prevalence of non-communicable chronic diseases: arterial hypertension, diabetes mellitus, and associated risk factors in long-lived elderly people from three Brazilian regions. METHODS This is a multicenter, cross-sectional, and comparative study conducted with elderly people aged 80 years or older. RESULTS Higher prevalence of arterial hypertension were observed among those who use polypharmacy (75.7%), among elderly people aged between 80 and 84 years (33.9%), as well as in elderly people who are overweight (78.2%). The prevalence of diabetes was 24% (RP: 0.76; 95% CI: 0.59-0.98) lower among women compared to men and 2.15 times higher among those who use five or more medications (RP: 2.15; 95% CI: 1.63-2.85). CONCLUSIONS In our sample, polypharmacy, body weight, and gender determine the prevalence of non-communicable chronic diseases: arterial hypertension and diabetes mellitus in long-lived elderly people.
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Touray TA, Woodall J, Warwick-Booth L. Lived experience of diet-related health education in type 2 diabetes and hypertension comorbidity in The Gambia. Health Promot Int 2023; 38:daad125. [PMID: 37791594 PMCID: PMC10548409 DOI: 10.1093/heapro/daad125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
The incidence and prevalence of type 2 diabetes mellitus (T2DM) and hypertension (and their comorbidity) have been increasing in sub-Saharan Africa, including The Gambia. Diet is a critical driver of these public health problems, and diet-related health education is a major strategy employed for their prevention and management. The aim of this paper is to explore the lived experiences of diet-related health education among individuals with comorbid type 2 diabetes and hypertension in Serrekunda, The Gambia, a subject hitherto unexplored in the country. The study employed a qualitative (interpretivist) methodology. Thirty-two interviews were conducted with 18 participants, with most participating in two interviews at separate time-points between November 2018 and July 2019. In addition to participant validation, the two points in time interviews elicited more depth and provided rich data. The data were analysed using Braun and Clarke's six-phased approach to Thematic Analysis. Four main themes were generated in relation to the experiences: (i) one-off blanket dietary advice (ii) education in a vacuum (iii) diabetes-hypertension diet dichotomy and (iv) imbalanced power relationship. The study underscores the need for a reconfiguration of diet-related health education in The Gambia to include lived experiences as critical components of health promotion in tackling T2DM and hypertension. This requires an ecological approach, critical health education, regulations on unhealthy foods, and active participation of individuals as equal partners in health education.
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Affiliation(s)
- Tahir Ahmad Touray
- Cardiff School of Sports and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - James Woodall
- Centre for Health Promotion Research, Leeds Beckett University, Leeds, UK
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Gu J, Wang Q, Wu X, Zhang H, Wu C, Qiu W. Causal Paradigm Between Common Comorbidities of Cardiovascular and Metabolism-Related Diseases in Elderly: Evidence from Cross-Sectional and Mendelian Randomization Studies. Diabetes Metab Syndr Obes 2023; 16:2953-2966. [PMID: 37771468 PMCID: PMC10522458 DOI: 10.2147/dmso.s427103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/19/2023] [Indexed: 09/30/2023] Open
Abstract
Background Comorbidity is a common problem among elderly people, significantly damaging individuals' health and healthcare systems. However, observational studies may be susceptible to residual confounding factors and bias. The present study aimed to assess the causal effect of common chronic disease comorbidity using the Mendelian randomization (MR) approach. Methods Data for the present study were obtained from a community survey conducted between 2018 and 2020 in four counties in Ganzhou City, southern China. A cross-sectional survey was conducted using a multi-stage stratified random sampling method. A total of 1756 valid questionnaires were collected to analyze common chronic disease comorbidities. Genetic variants associated with hypertension, diabetes, stroke, and hyperlipidemia-related factors were selected as instrumental variables for univariate and multivariate MR analyses. Results The self-reported prevalence of chronic disease in the older adult population in Southern China was 68.1%, with hypertension (46.1%), diabetes (10.5%), and hyperlipidemia (8.5%) being the three most common conditions. The prevalence of chronic disease comorbidity was 20.7% among the 12 chronic diseases studied. Hypertension was identified as a predictor of diabetes (OR [95% CI]: 1.114 [1.049, 1.184], p < 0.001), and diabetes mellitus was equally identified as a risk factor for hypertension (OR [95% CI]: 1.118 [1.069, 1.187], p < 0.001). Furthermore, high triglyceride levels were identified as a risk factor for hypertension (OR [95% CI]: 1.262 [1.129, 1.411], p < 0.001). In contrast to intracranial hemorrhages, hypertension had a significant impact on ischemic stroke (OR [95% CI]: 1.299 [1.161, 1.454], p < 0.001). Conclusion The causal association between multiple cardiovascular and metabolism-related diseases is mediated by hypertension, with a bidirectional cause-and-effect relationship between hypertension and diabetes. Hypertension is a risk factor for ischemic stroke, and the hyperlipidemia-related factor triglycerides (TG) influence hypertension. Therefore, prioritizing hypertension prevention and control in the elderly is critical for effective chronic disease management.
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Affiliation(s)
- Junwang Gu
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi Province, 341000, People’s Republic of China
| | - Qi Wang
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi Province, 341000, People’s Republic of China
| | - Xuanhui Wu
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi Province, 341000, People’s Republic of China
| | - Han Zhang
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi Province, 341000, People’s Republic of China
| | - Chunmei Wu
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi Province, 341000, People’s Republic of China
| | - Wei Qiu
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi Province, 341000, People’s Republic of China
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Gao YX, Man Q, Zhang J. The association of prediabetes with dietary patterns, life behavior and cardiovascular risk factors among adult population without previously diagnosed non-communicable diseases. Nutr Metab Cardiovasc Dis 2023; 33:1693-1701. [PMID: 37414658 DOI: 10.1016/j.numecd.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/02/2023] [Accepted: 03/07/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND AND AIMS Prediabetes and its risk factors are difficult to recognize because there may be no clear symptoms in that stage of diabetes mellitus (DM) progression. This cross-sectional study aims to examine associations between prediabetes and potential risk factors among adult population without previously diagnosed non-communicable diseases. METHODS AND RESULTS Study participants (n = 30823) were selected all over China. Their dietary, life behavior and laboratory data were obtained through questionnaires, physical examination or biochemical measurement. Factor analysis was applied to identify dietary patterns. Non-proportional odds model was applied to analyze associations between those data and stages of DM progression. The prevalence of prediabetes and DM was 20.6% and 4.5%, respectively. Two dietary patterns were identified: the first pattern was characterized by high consumption of diverse plant- and animal-based food items, and the second pattern was characterized by high consumption of starchy food items. The risk of prediabetes was inversely associated with sufficient sleep duration (OR: 0.939, 95% CI: 0.888-0.993) and the second pattern (OR: 0.882, 95% CI: 0.850-0.914), but not significantly associated with the first pattern (OR: 1.030, 95% CI: 0.995-1.067). High density lipoprotein cholesterol was inversely associated with DM risk (OR: 0.811, 95% CI: 0.667-0.986) but not prediabetes (OR: 1.035, 95% CI: 0.942-1.137). CONCLUSIONS The prevalence of undetected prediabetes was high among adult population, and some factors may exert different effects on different stages of DM progression. Dietary diversity, which was reflected by the first pattern to a certain extent, may be not significantly associated with risk of prediabetes.
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Affiliation(s)
- Yi-Xiong Gao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 100050, Peking, China.
| | - Qingqing Man
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 100050, Peking, China
| | - Jian Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 100050, Peking, China
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Akash MSH, Shahid M, Suhail S, Rehman K, Nadeem A, Mir TM. Tetra-ARMS PCR analysis of angiotensinogen AGT T174M (rs4762) genetic polymorphism in diabetic patients: a comprehensive study. Front Endocrinol (Lausanne) 2023; 14:1240291. [PMID: 37693342 PMCID: PMC10485609 DOI: 10.3389/fendo.2023.1240291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/02/2023] [Indexed: 09/12/2023] Open
Abstract
Background and purpose Hypertension (HTN) is a multifactorial chronic disease that poses a significant global health burden and is associated with increased mortality rates. It often coexists with other conditions, such as cardiovascular, liver, and renal diseases, and has a strong association with diabetes mellitus. Insulin resistance and endothelial dysfunction commonly occur in individuals with both HTN and type 2 diabetes mellitus (T2DM). Genetic factors, along with environmental and pathological factors, play a role in the development of HTN. Recent studies have revealed the influence of single nucleotide polymorphisms (SNPs) in various genes on HTN. In this study, we aimed to investigate the genetic polymorphism of angiotensinogen (AGT) T174M (rs4762) and its association with HTN in diabetic patients. Methods A total of 300 participants were enrolled in this study and divided into three groups: control, hypertensive, and hypertensive diabetic. Blood samples were collected, and predetermined biochemical parameters were assessed. Genotyping of the AGT T174M (rs4762) gene was conducted using Tetra ARMS PCR with specific primers. Results The study findings revealed a significant association between AGT T174M (rs4762) genotype and HTN in diabetic patients within the Pakistani population. The C/T genotype of AGT T174M (rs4762) was found to be significant in both the hypertensive and hypertensive diabetic participants compared to the control group. This genotype was identified as a risk factor for developing HTN in both the hypertensive and hypertensive diabetic participants. Conclusion This study demonstrates a significant association between AGT T174M (rs4762) genetic polymorphism and HTN in diabetic patients. The C/T genotype of AGT T174M (rs4762) may serve as a potential marker for identifying individuals at risk of developing HTN, specifically in the hypertensive and hypertensive diabetic populations. Further research is warranted to elucidate the underlying mechanisms and validate these findings in larger cohorts.
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Affiliation(s)
| | - Momina Shahid
- Department of Pharmacy, The University of Faisalabad, Faisalabad, Pakistan
| | - Shaleem Suhail
- Department of Pharmacy, University of Chenab, Gujrat, Pakistan
| | - Kanwal Rehman
- Department of Pharmacy, The Women University, Multan, Pakistan
| | - Ahmed Nadeem
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Tahir Maqbool Mir
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, Oxford, MS, United States
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Qi S, Xu Y, Zeng K, Li Y, Ma J. Incidence and Factors Associated with Hyperglycemia in Patients with First Hospitalization for Major Depression Disorder: A Large Cross-Sectional Sample. Neuropsychiatr Dis Treat 2023; 19:1809-1818. [PMID: 37637977 PMCID: PMC10455853 DOI: 10.2147/ndt.s421984] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/10/2023] [Indexed: 08/29/2023] Open
Abstract
Purpose Major depressive disorder (MDD) is a mood disorder characterized by persistent spontaneous depression and has a high rate of disability and mortality. There is a complex relationship between MDD and disorders of glucose metabolism, and our study aimed to investigate the prevalence and risk factors for hyperglycemia in patients with MDD who were hospitalized for the first times. Patients and Methods A total of 981 first-time inpatients with MDD were recruited, socio-demographic information, anthropometric data, and biochemical parameters were collected for each participant. The 17-item Hamilton Assessment Scale for Depression (HAMD-17), the 14-item Hamilton Anxiety Scale (HAMA-14), the Positive Syndrome Scale (PSS), and Clinical General Impressions Inventory-Severity of Illness (CGI-SI) scores were used to assess patients' clinical symptoms. Results The prevalence of hyperglycemia was 9.28% among patients with MDD who were hospitalized for the first time. Compared to the non-hyperglycemic subgroup, patients in the hyperglycemic subgroup were found to have more extensive and significant demographic and clinical characteristics, higher levels of metabolism-related parameters, and more severe psychological and psycho-pathological symptoms. Age, thyroid stimulating hormone (TSH), triglycerides (TG) were risk factors for hyperglycemia in MDD patients, while course of disease was a protective factor. Conclusion The study findings suggest that the prevalence of hyperglycemia is not high in patients with MDD who are hospitalized for the first time. The risk variables for predicting hyperglycemia include age, TSH and TG. The above three factors and course of disease have good combined diagnostic ability for hyperglycemia.
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Affiliation(s)
- Shuangyu Qi
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- Wuhan Hospital for Psychotherapy, Wuhan, People’s Republic of China
| | - Yang Xu
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- Wuhan Hospital for Psychotherapy, Wuhan, People’s Republic of China
| | - Kuan Zeng
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- Wuhan Hospital for Psychotherapy, Wuhan, People’s Republic of China
| | - Yi Li
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- Wuhan Hospital for Psychotherapy, Wuhan, People’s Republic of China
| | - Jun Ma
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- Wuhan Hospital for Psychotherapy, Wuhan, People’s Republic of China
- Department of Psychiatry, Renmin Hospital, Wuhan University, Wuhan, People’s Republic of China
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Farhadi A, Javadian H, Vahedparast H, Marzban M, Nemati R, Larijani B, Nabipour I. Association between depression and blood pressure in community-dwelling older adults: focus on Bushehr elderly health (BEH) program. BMC Public Health 2023; 23:1565. [PMID: 37592235 PMCID: PMC10436588 DOI: 10.1186/s12889-023-16288-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/11/2023] [Indexed: 08/19/2023] Open
Abstract
INTRODUCTION Depression and increased blood pressure are significant burdens in elderly care. This study was conducted to discover the association between hypertension (HTN) and depression based on data obtained from the Bushehr Elderly Health (BEH) program in a large population of Iranian elderly in Bushehr, southern Iran. METHODS This study was carried out based on data obtained from the Bushehr Elderly Health (BEH) program in a large population of Iranian elderly in Bushehr, a southern city in Iran. 2419 old adults were included in the study through multi-stage random sampling. Depression was assessed using Patient Health Questionnaire-9 (PHQ-9), and blood pressure was measured using a standard mercury sphygmomanometer. Statistical analysis was conducted via chai-square, analysis of variance (ANOVA), and univariate and multivariate linear regression tests. RESULTS The mean age of participants was 69.95 ± 6.95 years. The prevalence of depression was 23.8%. Diastolic blood pressure (DBP) decreased with increasing PHQ score (B=-0.001; 95%CI: -0.00 to -0.00, P-value = 0.011). In the final model adjusted for confounding variables, no significant association was found between depression score and DBP (B=-0.00; 95%CI: -0.00 to 0.00, P = 0.13). Conversely, in the final model, which included the confounding variable, SBP was significantly associated with depression. It was deduced that a variable acted as a negative confounder in this association; in a way that with increased depression score, SBP significantly decreased (B=-0.00; 95% CI: -0.00 to -0.00, P = 0.04). CONCLUSION Depression and its related medications could be significantly associated with controlled SBP. Health practitioners in primary health care centers must monitor the elderly inflicted with HTN for early symptoms of depression to help maintain blood pressure levels using medicinal and non-medicinal interventions.
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Affiliation(s)
- Akram Farhadi
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Hamed Javadian
- Student Research Committee, Bushehr University of Medical Sciences, Bushehr, Iran.
- Department of Nursing, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Hakimeh Vahedparast
- Department of Nursing, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Maryam Marzban
- Clinical Research Development Center, The Persian Gulf Martyrs Hospital, Bushehr University of Medical Sciences, Bushehr, Iran.
- Department of Human Genetics, McGill University, Montreal, QC, Canada.
| | - Reza Nemati
- Clinical Research Development Center, The Persian Gulf Martyrs Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
- Department of Medical Emergencies, School of Allied Medical Sciences, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
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Kannan N, Koshy T, Raavi V, Bhaskar E, Moorthy S, Pulivadula Mohanarangam VS, Srinivas Kondaveeti S, Visweswaran S, Perumal V. Candidate Gene Expression in Regional Population and Its Relevance for Radiation Triage. Cytogenet Genome Res 2023; 163:210-222. [PMID: 37253332 DOI: 10.1159/000531258] [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: 12/21/2022] [Accepted: 05/24/2023] [Indexed: 06/01/2023] Open
Abstract
Quantification of gene expression signatures has been substantiated as a potential and rapid marker for radiation triage and biodosimetry during nuclear emergencies. Similar to the established biodosimetry assays, the gene expression assay has drawbacks such as being highly dynamic and transient, not specific to ionizing radiation, and also influenced by confounding factors such as gender, health status, lifestyle, and inflammation. In view of that, prior knowledge of baseline expression of certain candidate genes in a population could complement the discrimination of the unexposed from the exposed individuals without the need for individual pre-exposure controls. We intended to establish a baseline expression of reported radiation-responsive genes such as CDKN1A, DDB2, FDXR, and PCNA in the blood samples of healthy human participants and then compare it with diabetic/hypertension participants (as a chronic inflammatory condition) drawn from south Indian population. Further, we have examined the appropriateness of the assay for radiation triage-like situations; i.e., the expression profiles of those genes were examined in the participants who underwent X-ray-based medical imaging. Acute inflammation induced by lipopolysaccharide exposure in the blood significantly increased the fold expression of those genes (p < 0.0001) compared to the control. Whereas the basal expression level of those genes among the participants with the inflammatory condition is marginally higher than those observed in the healthy participants; despite the excess, the fold increase in those genes between the groups did not differ significantly. Consistent with the inflammatory participants, the basal expression level of those genes in the blood sample of participants who received X-radiation during neuro-interventional and computed tomography imaging is marginally higher than those observed in the pre-exposure of respective groups. Nevertheless, the fold increase in those genes did not differ significantly as the fold change fell within the two folds. Thus, overall results suggest that the utility of CDKN1A, DDB2, FDXR, and PCNA gene expression for radiation triage specific after very low-dose radiation exposure needs to be interpreted with caution for a much more reliable triage.
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Affiliation(s)
- Nandhini Kannan
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), Chennai, India
| | - Teena Koshy
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), Chennai, India
| | - Venkateswarlu Raavi
- Department of Cell Biology and Molecular Genetics, Sri Devaraj Urs Academy of Higher Education and Research (Deemed to Be University), Kolar, India
| | - Emmanuel Bhaskar
- Department of General Medicine, SRMC&RI, Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), Chennai, India
| | - Swathy Moorthy
- Department of General Medicine, SRMC&RI, Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), Chennai, India
| | - Venkata Sai Pulivadula Mohanarangam
- Department of Radiology and Imaging Sciences, SRMC&RI, Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), Chennai, India
| | - Satish Srinivas Kondaveeti
- Department of Radiation Oncology, SRMC&RI, Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), Chennai, India
| | - Shangamithra Visweswaran
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), Chennai, India
| | - Venkatachalam Perumal
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), Chennai, India
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Ambaw Kassie G, Alemu A, Yosef Gebrekidan A, Asmare Adella G, Eshetu K, Wolie Asres A, Sisay Asgedom Y. Undiagnosed hypertension and associated factors among adults in ethiopia: a systematic review and meta-analysis. BMC Cardiovasc Disord 2023; 23:278. [PMID: 37244992 PMCID: PMC10225092 DOI: 10.1186/s12872-023-03300-0] [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: 03/17/2023] [Accepted: 05/13/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Hypertension is a major public health problem, resulting in 10 million deaths annually. Undiagnosed hypertension affects more people than ever before. It is more likely to be linked to severe hypertension, which can lead to stroke, cardiovascular disease, and ischemic heart disease. Thus, this systematic review and meta-analysis aimed to synthesize the prevalence of undiagnosed hypertension and its associated factors in Ethiopia. METHODS Databases, such as Medline/PubMed, Google Scholar, Science Direct, AJOL, and the Cochrane Library, were systematically searched to find potential studies published until December 2022. A Microsoft Excel spreadsheet was used to enter the extracted data. The pooled prevalence of undiagnosed hypertension and its associated factors was estimated using a random effect model. I2 statistics and the Cochrane Q-test were used to assess statistical heterogeneity across the studies. Begg's and Egger's tests were performed to identify possible publication bias. RESULTS A total of ten articles with 5,782 study participants were included in this meta-analysis. In the random effects model, the pooled prevalence of undiagnosed hypertension was 18.26% (95% CI = 14.94-21.58). Being older (OR = 3.8, 95% CI = 2.56, 5.66), having a body mass index > 25 kg/m2 (OR = 2.71, 95% CI = 2.1, 3.53), having a family history of hypertension (OR = 2.22, 95% CI = 1.47, 3.36), and having DM comorbidity (OR = 2.44, 95% CI = 1.38, 4.32) were significantly associated with undiagnosed hypertension. CONCLUSION In this meta-analysis, the pooled prevalence of undiagnosed hypertension was found to be high in Ethiopia. Being older, having a BMI > 25 kg/m2, having a family history of hypertension, and having DM comorbidity were found to be risk factors for undiagnosed hypertension.
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Affiliation(s)
- Gizachew Ambaw Kassie
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
| | - Afework Alemu
- School of Medicine, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amanuel Yosef Gebrekidan
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Getachew Asmare Adella
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kirubel Eshetu
- School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Abiyot Wolie Asres
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Yordanos Sisay Asgedom
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Manica D, Sandri G, da Silva GB, Manica A, da Silva Rosa Bonadiman B, Dos Santos D, Flores ÉMM, Bolzan RC, Barcelos RCS, Tomazoni F, Suthovski G, Bagatini MD, Benvegnú DM. Evaluation of the effects of metformin on antioxidant biomarkers and mineral levels in patients with type II diabetes mellitus: A cross-sectional study. J Diabetes Complications 2023; 37:108497. [PMID: 37209504 DOI: 10.1016/j.jdiacomp.2023.108497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/03/2023] [Accepted: 05/10/2023] [Indexed: 05/22/2023]
Abstract
Diabetes mellitus (DM) and arterial hypertension are considered serious public health problems. Several studies have shown that oxidative stress is usually related to the onset of DM and hypertension, as well their associated complications. Moreover, the levels of some minerals are closely related to the pathophysiology of these diseases. Thus, in this study we aimed to evaluate the effect of metformin on the redox profile and mineral levels in the serum of patients with DM type 2 and hypertension. We also tested the effect of metformin on the viability and redox profile of peripheral blood mononuclear cells (PBMCs) for 24 h. As expected, we found that patients with type 2 DM and hypertension + type 2 DM had higher fasting glucose and triglyceride levels. As groundbreaking research, we found that both patients DM type 2 and Hypertension + DM type 2 had reduced myeloperoxidase (MPO) activity. On the other hand, the levels of total thiols (PSH) and vitamin C were increased. There was no statistical significance for the alterations in mineral levels. In addition, metformin treatment had no cytotoxic effect on PBMCs. Similarly, in patients of both groups, MPO activity was reduced and PSH levels were increased in PBMCs. We have shown that metformin is a drug with a protective effect in patients with DM type 2 against oxidative stress by reducing MPO activity and improving the levels of PSH and antioxidant defenders such as vitamin C. The results of in vitro assays support the antioxidant effect of metformin. Furthermore, we suggest studies to assess the biochemical mechanisms of metformin and how it can be used in a pharmacological therapeutic perspective against oxidative damage.
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Affiliation(s)
- Daiane Manica
- Post-graduate Program in Biochemistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Gabriela Sandri
- Post Graduate Program of Health, Welfare and Sustainable Animal Production on Fronteira Sul, Federal University of Fronteira Sul, Realeza, PR, Brazil
| | - Gilnei Bruno da Silva
- Multicentric Postgraduate Program in Biochemistry and Molecular Biology, State University of Santa Catarina, Lages, SC, Brazil
| | - Aline Manica
- Post Graduate Program in Health Sciences of the Community University of Chapecó Region - Unochapecó, Chapecó, SC, Brazil
| | - Beatriz da Silva Rosa Bonadiman
- School of Health, Area of Biological and Health Sciences, Community University of Chapecó Region - Unochapecó, Chapecó, SC, Brazil
| | - Daniel Dos Santos
- Graduate Program in Chemical Engineering, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | | | | | - Fernanda Tomazoni
- Graduate Program in Dental Science, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Gabriela Suthovski
- Post Graduate Program of Health, Welfare and Sustainable Animal Production on Fronteira Sul, Federal University of Fronteira Sul, Realeza, PR, Brazil
| | - Margarete Dulce Bagatini
- Post Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil.
| | - Dalila Moter Benvegnú
- Post Graduate Program of Health, Welfare and Sustainable Animal Production on Fronteira Sul, Federal University of Fronteira Sul, Realeza, PR, Brazil
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Alkhatieb MT, Aljehani KM, Alkhalifah HA, Alghamdi NS, Almaghrabi AS, Alqarni BB, Alzahrani AY. The Impact of Frequent Glucose Monitoring on the Prevalence of Complications Among Patients With Diabetes in Saudi Arabia. Cureus 2023; 15:e39796. [PMID: 37398779 PMCID: PMC10313341 DOI: 10.7759/cureus.39796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM), including type 1 diabetes (T1D) and type 2 diabetes (T2D), affects the absorption of glucose from the blood. DM has serious complications that can be prevented by adequate knowledge of the disease and its complications, a healthy lifestyle, a modified diet, and regular glucose monitoring. Hence, this study aimed to assess the effects of frequent glucose monitoring on the occurrence of DM complications. METHODS This cross-sectional study was performed at King Abdulaziz University Hospital between June and December 2022 and included patients with T1D or T2D. After consent, participants who agreed to join filled out an online questionnaire that was used to acquire information, such as demographic data, type of diabetes, blood glucose monitoring, and diabetic complications. RESULTS A total of 206 diabetic patients participated in this study, with a mean age of 41.2±19.37, with 53.4% having T1D. Most participants monitored their glucose levels (85.4%), and the majority (65.3%) monitored them once or more daily. Patients who monitored their glucose levels more frequently had significantly fewer complications (p = 0.002). Continuous glucose monitoring (CGM) was the best monitoring method, as it demonstrated the lowest rate of complications compared to other methods (p = 0.002). CONCLUSIONS Frequent glucose monitoring and the use of CGM devices were associated with a decreased number of DM complications. Thus, we recommend that physicians encourage patients to perform CGM as it helps increase the frequency of monitoring.
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Affiliation(s)
- Maram T Alkhatieb
- Department of Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
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Sakboonyarat B, Poovieng J, Srisawat P, Hatthachote P, Mungthin M, Rangsin R, Jongcherdchootrakul K. Prevalence, awareness, and control of hypertension and associated factors among Royal Thai Army personnel in Thailand from 2017 to 2021. Sci Rep 2023; 13:6946. [PMID: 37117457 PMCID: PMC10141845 DOI: 10.1038/s41598-023-34023-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/22/2023] [Indexed: 04/30/2023] Open
Abstract
Hypertension (HTN) is a potential risk factor for cardiovascular diseases. We aimed to determine the prevalence, awareness, and control of HTN among RTA personnel in Thailand. We conducted a series of cross-sectional studies from 2017 to 2021. HTN was defined by systolic blood pressure (BP) ≥ 140 mmHg or a diastolic BP ≥ 90 mmHg from a physical health examination, a history of HTN diagnosed by medical personnel, or taking antihypertensive medication. A total of 504,484 participants were included in the present study. The overall HTN prevalence was 29.4%. The prevalence of HTN among males was 30.5%, while it was 17.1% among females. Of the RTA personnel with HTN, 35.9% were aware of their condition. The overall control of HTN among RTA personnel with HTN was 15.8% in 2017 and 17.6% in 2021. Behavioral factors associated with HTN were current smoking, alcohol consumption, and sedentary behavior. A higher BMI was associated with higher HTN prevalence and HTN awareness but less likely to have controllable HTN. Male participants, younger individuals, current alcohol use, and sedentary behavior were associated with a lower prevalence of HTN awareness and controlled HTN. Current tobacco use was also associated with a lower prevalence of HTN awareness.
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Affiliation(s)
- Boonsub Sakboonyarat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Jaturon Poovieng
- Department of Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Phutsapong Srisawat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Panadda Hatthachote
- Department of Physiology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Mathirut Mungthin
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Kanlaya Jongcherdchootrakul
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand.
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Kwok J, Speyer LG, Soursou G, Murray AL, Fanti KA, Auyeung B. Maternal metabolic syndrome in pregnancy and child development at age 5: exploring mediating mechanisms using cord blood markers. BMC Med 2023; 21:124. [PMID: 37013575 PMCID: PMC10071709 DOI: 10.1186/s12916-023-02835-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 03/15/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND There is limited evidence on how the classification of maternal metabolic syndrome during pregnancy affects children's developmental outcomes and the possible mediators of this association. This study uses a cohort sample of 12,644 to 13,832 mother-child pairs from the UK Born in Bradford Study to examine the associations between maternal metabolic syndrome classification (MetS) and child development outcomes at age 5, using cord blood markers as candidate mediators. METHODS Maternal cardiometabolic markers included diabetes, obesity, triglycerides, high-density lipoprotein cholesterol, blood pressure, hypertension, and fasting glucose during pregnancy. Cord blood markers of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, leptin, and adiponectin were used as child mediators. Child outcomes included two starting school variables: British Picture Vocabulary Scale (BPVS) and the Letter Identification Assessment (LID), and five developmental milestone domains from a national UK framework: (1) communication and language (COM); (2) personal, social, and emotional (PSE); (3) physical development (PHY); (4) literacy (LIT); and (5) mathematics (MAT). Mediation models were used to examine the associations between the classification of maternal metabolic syndrome and child developmental milestones. Models were adjusted for potential maternal, socioeconomic, and child confounders such as maternal education, deprivation, and gestational age. RESULTS In mediation models, significant total effects were found for MetS associations with children's development in the LIT domain at age 5. MetS predicted individual cord blood mediators of lower HDL and increased leptin levels in both adjusted and unadjusted models. Total indirect effects (effects of all mediators combined) for MetS on a child's COM and PSE domain were significant, through all child cord blood mediators of LDL, HDL, triglycerides, adiponectin, and leptin for adjusted models. CONCLUSIONS The results support the hypothesis that maternal metabolic syndrome classification during pregnancy is associated with some child developmental outcomes at age 5. After adjusting for maternal, child, and environmental covariates, maternal metabolic syndrome classification during pregnancy was associated with children's LIT domain through direct effects of maternal metabolic health and indirect effects of cord blood markers (total effects), and COM and PSE domains via changes only in a child's cord blood markers (total indirect effects).
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Affiliation(s)
- Janell Kwok
- School of Philosophy, Psychology and Language Sciences, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK.
| | - Lydia Gabriela Speyer
- School of Philosophy, Psychology and Language Sciences, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Georgia Soursou
- Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Aja Louise Murray
- School of Philosophy, Psychology and Language Sciences, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Kostas A Fanti
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Bonnie Auyeung
- School of Philosophy, Psychology and Language Sciences, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
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Kálcza Jánosi K, Lukács A. Independent and interactive effect of type 2 diabetes and hypertension on memory functions in middle aged adults. BMC Endocr Disord 2023; 23:59. [PMID: 36894922 PMCID: PMC9999571 DOI: 10.1186/s12902-023-01308-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 02/21/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND The study distinguishes the effect of type 2 diabetes and hypertension on cognitive functions when the two diseases are alone or when they occur together, compared to healthy individuals. METHODS A total of 143 middle-aged adults were screened using the Wechsler Memory Scale - Revised psychometric test (verbal memory, visual memory, attention/concentration and delayed memory). Participants were divided into four groups based on their diseases: patients with type 2 diabetes (36), patients with hypertension (30), patients having both diseases (33), and healthy controls (44). RESULTS This study found no differences among investigated groups in verbal and visual memory, however, hypertension and both-disease group performed unfavorably compared to patients with diabetes and to healthy individuals in attention/concentration and delayed memory. CONCLUSIONS The findings of this study suggest that there is a relationship between hypertension and cognitive dysfunction, whereas type 2 diabetes without consequences was not proved to have an association with cognitive decline in middle-aged people.
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Affiliation(s)
- Kinga Kálcza Jánosi
- Faculty of Psychology and Educational Sciences, Babes-Bolyai University, 7, Sindicatelor Street, 400604 Cluj-Napoca-Napoca, Romania
| | - Andrea Lukács
- Faculty of Health Sciences, University of Miskolc, 3515 Miskolc-Egyetemváros, Hungary
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Abolbaghaei A, Turner M, Thibodeau JF, Holterman CE, Kennedy CRJ, Burger D. The Proteome of Circulating Large Extracellular Vesicles in Diabetes and Hypertension. Int J Mol Sci 2023; 24:ijms24054930. [PMID: 36902363 PMCID: PMC10003702 DOI: 10.3390/ijms24054930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/14/2023] [Accepted: 02/23/2023] [Indexed: 03/08/2023] Open
Abstract
Hypertension and diabetes induce vascular injury through processes that are not fully understood. Changes in extracellular vesicle (EV) composition could provide novel insights. Here, we examined the protein composition of circulating EVs from hypertensive, diabetic and healthy mice. EVs were isolated from transgenic mice overexpressing human renin in the liver (TtRhRen, hypertensive), OVE26 type 1 diabetic mice and wild-type (WT) mice. Protein content was analyzed using liquid chromatography-mass spectrometry. We identified 544 independent proteins, of which 408 were found in all groups, 34 were exclusive to WT, 16 were exclusive to OVE26 and 5 were exclusive to TTRhRen mice. Amongst the differentially expressed proteins, haptoglobin (HPT) was upregulated and ankyrin-1 (ANK1) was downregulated in OVE26 and TtRhRen mice compared with WT controls. Conversely, TSP4 and Co3A1 were upregulated and SAA4 was downregulated exclusively in diabetic mice; and PPN was upregulated and SPTB1 and SPTA1 were downregulated in hypertensive mice, compared to WT mice. Ingenuity pathway analysis identified enrichment in proteins associated with SNARE signaling, the complement system and NAD homeostasis in EVs from diabetic mice. Conversely, in EVs from hypertensive mice, there was enrichment in semaphroin and Rho signaling. Further analysis of these changes may improve understanding of vascular injury in hypertension and diabetes.
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Affiliation(s)
- Akram Abolbaghaei
- Chronic Disease Program, Kidney Research Centre, Ottawa Hospital Research Institute, Ottawa, ON K1H 8M5, Canada
| | - Maddison Turner
- Chronic Disease Program, Kidney Research Centre, Ottawa Hospital Research Institute, Ottawa, ON K1H 8M5, Canada
| | - Jean-François Thibodeau
- Chronic Disease Program, Kidney Research Centre, Ottawa Hospital Research Institute, Ottawa, ON K1H 8M5, Canada
| | - Chet E. Holterman
- Chronic Disease Program, Kidney Research Centre, Ottawa Hospital Research Institute, Ottawa, ON K1H 8M5, Canada
| | - Christopher R. J. Kennedy
- Chronic Disease Program, Kidney Research Centre, Ottawa Hospital Research Institute, Ottawa, ON K1H 8M5, Canada
- Departments of Medicine and Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Dylan Burger
- Chronic Disease Program, Kidney Research Centre, Ottawa Hospital Research Institute, Ottawa, ON K1H 8M5, Canada
- Departments of Medicine and Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada
- School of Pharmaceutical Sciences, University of Ottawa, Ottawa, ON K1H 8M5, Canada
- Correspondence: ; Tel.: +1-613-562-5800 (ext. 8241)
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Lotfi M, Nouri M, Turki Jalil A, Rezaianzadeh A, Babajafari S, Ghoddusi Johari M, Faghih S. Plant-based diets could ameliorate the risk factors of cardiovascular diseases in adults with chronic diseases. Food Sci Nutr 2023; 11:1297-1308. [PMID: 36911818 PMCID: PMC10002912 DOI: 10.1002/fsn3.3164] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/15/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022] Open
Abstract
Adherence to plant-based diets is recommended to prevent and control chronic diseases. However, not all plant-based foods are healthy for this purpose. This study investigated the relationship between plant-based diets and risk factors for cardiovascular diseases (CVDs) in adults with chronic diseases. This cross-sectional study was performed on 3678 males and females (age range: 40-70 years) with chronic diseases who participated in the Kharameh cohort study. A validated semiquantitative food-frequency questionnaire was used to calculate the plant-based diet index (PDI), healthy plant-based diet index (hPDI), and unhealthy plant-based diet index (uPDI). Lipid profile, fasting blood sugar (FBS), blood pressure, and anthropometric indices were measured. Multivariable-adjusted logistic regression analysis was performed to determine the association between plant-based diets and CVDs risk factors. Higher adherence to the PDI was inversely associated with the level of FBS (odds ratio [OR] = 0.42; 95% confidence interval [CI]: 0.33-0.53; p < .001). A significant decrease was observed for total cholesterol in those with higher adherence to hPDI (OR = 0.80; 95% CI: 0.65-0.98; p = .035). Additionally, the score of uPDI was positively related to FBS (OR = 1.23; 95% CI: 1.00-1.53; p = .01), total cholesterol (OR = 1.23; 95% CI: 1.01-1.49; p = .061), and low-density lipoprotein (OR = 1.39; 95% CI: 1.13-1.71; p = .009). It was concluded that adherence to PDI and hPDI was related to a lower level of FBS and total cholesterol, respectively. Moreover, the findings suggested that regular intake of the uPDI was correlated with some risk factors for CVDs in adults with chronic diseases.
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Affiliation(s)
- Mostafa Lotfi
- Department of Community Nutrition, School of Nutrition and Food ScienceShiraz University of Medical SciencesShirazIran
| | - Mehran Nouri
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
- Students' Research CommitteeShiraz University of Medical SciencesShirazIran
| | | | - Abbas Rezaianzadeh
- Department of Epidemiology, School of Health and NutritionShiraz University of Medical SciencesShirazIran
| | - Siavash Babajafari
- Nutrition research center, Department of Clinical NutritionSchool of Nutrition and Food Science, Shiraz University of Medical SciencesShirazIran
| | | | - Shiva Faghih
- Department of Community Nutrition, School of Nutrition and Food ScienceShiraz University of Medical SciencesShirazIran
- Nutrition Research CenterShiraz University of Medical SciencesShirazIran
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Shitomi-Jones LM, Akam L, Hunter D, Singh P, Mastana S. Genetic Risk Scores for the Determination of Type 2 Diabetes Mellitus (T2DM) in North India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3729. [PMID: 36834424 PMCID: PMC9959290 DOI: 10.3390/ijerph20043729] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Globally, type 2 diabetes mellitus (T2DM) is one of the fastest-growing noncommunicable multifactorial and polygenic diseases, which leads to many health complications and significant morbidity and mortality. South Asians have a high genetic predisposition to T2DM, with India being home to one in six diabetics. This study investigates the association of selected genetic polymorphisms with T2DM risk and develops a polygenic risk score (PRS). METHODS A case-control study recruited fully consented participants from a population of Jat Sikhs in north India. DNA samples were genotyped for a range of polymorphisms and odds ratios were calculated under several genetic association models. Receiver operating characteristic (ROC) curves were produced for combinations of the PRS and clinical parameters. RESULTS The GSTT1(rs17856199), GSTM1(rs366631), GSTP1(rs1695), KCNQ1(rs2237892), ACE(rs4646994), and TCF7L2(rs12255372; rs7903146; rs7901695) polymorphisms were associated with increased T2DM risk (p ≤ 0.05). No association was observed with IGF2BP2(rs4402960) or PPARG2(rs1801282). The weighted PRS was found to be significantly higher in patients (mean = 15.4, SD = 3.24) than controls (mean = 11.9, SD = 3.06), and t(454) = -12.2 (p < 0.001). The ROC curve analysis found the weighted PRS in combination with clinical variables to be the most effective predictor of T2DM (area under the curve = 0.844, 95%CI = 0.0.808-0.879). CONCLUSIONS Several polymorphisms were associated with T2DM risk. PRS based on even a limited number of loci improves the prediction of the disease. This may provide a useful method for determining T2DM susceptibility for clinical and public health applications.
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Affiliation(s)
- Lisa Mitsuko Shitomi-Jones
- School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Leicestershire, Loughborough LE11 3TU, UK
| | - Liz Akam
- School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Leicestershire, Loughborough LE11 3TU, UK
| | - David Hunter
- School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Leicestershire, Loughborough LE11 3TU, UK
| | - Puneetpal Singh
- Department of Human Genetics, Punjabi University, Patiala 147002, India
| | - Sarabjit Mastana
- School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Leicestershire, Loughborough LE11 3TU, UK
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Saito N, Toyoda M, Kondo M, Abe M, Sanechika N, Kimura M, Sawada K, Fukagawa M. Regulation of Renin Expression by Β1-Integrin in As4.1 Juxtaglomerular Line Cells. Biomedicines 2023; 11:biomedicines11020501. [PMID: 36831037 PMCID: PMC9953579 DOI: 10.3390/biomedicines11020501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023] Open
Abstract
(1) Background: Renal dysfunction and hypertension are mutually aggravating factors; however, the details of their interaction remain unclear. In a study using renal tissue from diabetic rats, we found that β1-integrin, a cell-substrate adhesion molecule, is specifically phosphorylated in juxtaglomerular cells that secrete renin, a blood pressure regulator. (2) Methods: A mouse juxtaglomerular cell line (As4.1 cells) was used for the following experiments: drug-induced promotion of β1-integrin phosphorylation/dephosphorylation; knockdown of β1-integrin and the cell adhesion molecule connexin-40 (a candidate for the main body of baroreceptor); and pressurization to atmospheric pressure + 100 mmHg. culture in hypotonic liquid medium. The expression of renin under these conditions was measured by qRT-PCR. (3) Results: Phosphorylation of β1-integrin suppressed the expression of renin, while dephosphorylation conversely promoted it. β1-integrin and connexin-40 knockdown both promoted the expression of renin. Pneumatic pressurization and hypotonic medium culture both decreased the expression of renin, which was restored by the knockdown of β1-integrin. (4) Conclusions: β1-integrin plays an inhibitory role in the regulation of the expression of renin, which may be controlled by phosphorylation and dephosphorylation. It is hypothesized that β1-integrin and other adhesion factors regulate the expression of renin by altering the sensitivity of baroreceptors on the plasma membrane.
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Affiliation(s)
| | - Masao Toyoda
- Correspondence: ; Tel.: +81-463-93-1121 (ext. 2490)
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Della Guardia L, Carnevale Pellino V, Filipas L, Bonato M, Gallo G, Lovecchio N, Vandoni M, Codella R. Nordic Walking Improves Cardiometabolic Parameters, Fitness Performance, and Quality of Life in Older Adults With Type 2 Diabetes. Endocr Pract 2023; 29:135-140. [PMID: 36400400 DOI: 10.1016/j.eprac.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/05/2022] [Accepted: 11/10/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the effect of Nordic walking (NW) on cardiometabolic health, physical performance, and well-being in sedentary older adults with type 2 diabetes (T2D). METHODS Fifteen subjects with T2D (female, 5; male, 10; age, 65 ± 6.2 years [mean ± standard deviation]; body mass index, 27.3 ± 4.9 kg/m2 [mean ± standard deviation]) were enrolled in a 6-month NW training program. The fasting glucose and glycosylated hemoglobin levels, lipid profile (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides), systolic blood pressure (SBP), and diastolic blood pressures were measured before and after the intervention. Participants' quality of life (Short-Form Health Survey) and physical fitness (6-minute walking test) were also evaluated. RESULTS Compared with baseline, NW significantly improved the fasting glucose level (103.5 ± 18.5 vs 168.7 ± 37.7 mg/dL, P = .01), SBP (121.8 ± 12.2 vs 133 ± 14.4 mm Hg, P = .02), physical fitness (759.88 ± 69 vs 615.5 ± 62.6 m, P < .001), and both mental health (54.5 ± 4.4 vs 45.7 ± 5.6, P < .01) and physical health (49.8 ± 4.7 vs 40.3 ± 5.9, P < .01). The levels of glycosylated hemoglobin (6.15% ± 0.8% vs 6.4% ± 1%, P = .46), total cholesterol (162.2 ± 31.2 vs 175.5 ± 28.8 mg/dL, P = .13), low-density lipoprotein cholesterol (95.2 ± 24.2 vs 106.3 ± 32.3 mg/dL, P = .43), and triglycerides (135.5 ± 60.8 vs 127.6 ± 57.4 mg/dL, P = 0.26) improved without reaching significance. CONCLUSION NW training improved the glycemic levels, SBP, physical fitness, and perception of quality of life in older adults with T2D. NW represents a suitable complementary strategy to improve the global health status in this population.
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Affiliation(s)
- Lucio Della Guardia
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, Pavia, Italy
| | - Luca Filipas
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy; Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milano, Italy
| | - Matteo Bonato
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Gabriele Gallo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Nicola Lovecchio
- Department of Human and Social Science, University of Bergamo, Bergamo, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, Pavia, Italy
| | - Roberto Codella
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy; Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milano, Italy.
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Pradhan T, Gupta O, Kumar V, Sristi, Chawla G. A comprehensive review on the antidiabetic attributes of thiazolidine-4-ones: Synthetic strategies and structure-activity relationships. Arch Pharm (Weinheim) 2023; 356:e2200452. [PMID: 36378997 DOI: 10.1002/ardp.202200452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022]
Abstract
The thiazolidine-4-one scaffold has recently emerged as a potential pharmacophore having clinical significance for medicinal chemists. This heterocyclic ring has been reported to possess a plethora of biological activities, including antidiabetic activity that has inspired researchers to integrate this core with different pharmacophoric fragments to design novel and effective antidiabetic leads. The antidiabetic activity has been observed due to the ability of the thiazolidine-4-one nucleus to interact with different biological targets, including peroxisome proliferator-activated receptor γ, protein tyrosine phosphatase 1B, aldose reductase, α-glucosidase, and α-amylase. The present review discusses the mode of action of thiazolidine-4-ones through these antidiabetic drug targets. This review attempts to summarize and analyze the recent developments with regard to the antidiabetic potential of thiazolidine-4-ones covering different synthetic strategies, structure-activity relationships, and docking studies reported in the literature. The significance of various structural modifications at C-2, N-3, and C-5 of the thiazolidine-4-one ring has also been discussed in this manuscript. This comprehensive compilation will provide an inevitable scope for the design and development of potential antidiabetic drug candidates having a thiazolidine-4-one core.
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Affiliation(s)
- Tathagata Pradhan
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Education and Research, Jamia Hamdard University, New Delhi, India
| | - Ojasvi Gupta
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Education and Research, Jamia Hamdard University, New Delhi, India
| | - Vivek Kumar
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Education and Research, Jamia Hamdard University, New Delhi, India
| | - Sristi
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Education and Research, Jamia Hamdard University, New Delhi, India
| | - Gita Chawla
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Education and Research, Jamia Hamdard University, New Delhi, India
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Quah Y, Tong SR, Bojarska J, Giller K, Tan SA, Ziora ZM, Esatbeyoglu T, Chai TT. Bioactive Peptide Discovery from Edible Insects for Potential Applications in Human Health and Agriculture. Molecules 2023; 28:molecules28031233. [PMID: 36770900 PMCID: PMC9921607 DOI: 10.3390/molecules28031233] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/31/2023] Open
Abstract
In the past decade, there has been fast-growing interest among researchers to discover bioactive peptides from edible insects and to evaluate their potential applications in the management of human, livestock, and plant health. This review summarizes current knowledge of insect-derived peptides and their potential role in tackling human health issues and solving agriculture problems by protecting crops and livestock against their pathogens. Numerous bioactive peptides have been identified from edible insect species, including peptides that were enzymatically liberated from insect proteins and endogenous peptides that occur naturally in insects. The peptides exhibited diverse bioactivities, encompassing antioxidant, anti-angiotensin-converting enzyme, anti-dipeptidyl peptidase-IV, anti-glucosidase, anti-lipase, anti-lipoxygenase, anti-cyclooxygenase, anti-obesity, and hepatoprotective activities. Such findings point to their potential contribution to solving human health problems related to inflammation, free radical damage, diabetes, hypertension, and liver damage, among others. Although most of the experiments were performed in vitro, evidence for the in vivo efficacy of some peptides is emerging. Evidence of the protective effects of insect-derived endogenous antimicrobial peptides in combating farm animal and plant pathogens is available. The ability of insect-derived endogenous neuropeptides to protect plants against herbivorous insects has been demonstrated as well. Nevertheless, the potency of peptides identified from insect protein hydrolysates in modulating livestock and plant health remains a knowledge gap to be filled.
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Affiliation(s)
- Yixian Quah
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon 34114, Republic of Korea
| | - Shi-Ruo Tong
- Department of Physical Science, Faculty of Applied Sciences, Tunku Abdul Rahman University of Management and Technology, Setapak, Kuala Lumpur 53300, Malaysia
| | - Joanna Bojarska
- Department of Chemistry, Technical University of Lodz, Zeromskiego 116, 90-924 Lodz, Poland
| | - Katrin Giller
- Institute of Agricultural Sciences, ETH Zurich, Universitätstrasse 2, 8092 Zurich, Switzerland
| | - Sheri-Ann Tan
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University of Management and Technology, Setapak, Kuala Lumpur 53300, Malaysia
| | - Zyta Maria Ziora
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Tuba Esatbeyoglu
- Department of Food Development and Food Quality, Institute of Food Science and Human Nutrition, Gottfried Wilhelm Leibniz University Hannover, Am Kleinen Felde 30, 30167 Hannover, Germany
| | - Tsun-Thai Chai
- Department of Chemical Science, Faculty of Science, Universiti Tunku Abdul Rahman, Jalan Universiti, Bandar Barat, Kampar 31900, Malaysia
- Center for Agriculture and Food Research, Universiti Tunku Abdul Rahman, Jalan Universiti, Bandar Barat, Kampar 31900, Malaysia
- Correspondence:
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Huang X, Qin C, Guo X, Cao F, Tang C. Association of hemoglobin A1c with the incidence of hypertension: A large prospective study. Front Endocrinol (Lausanne) 2023; 13:1098012. [PMID: 36726461 PMCID: PMC9884972 DOI: 10.3389/fendo.2022.1098012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/22/2022] [Indexed: 01/19/2023] Open
Abstract
Background Although hemoglobin A1c (HbA1c) is closely related to diabetes, its relationship with the incidence of hypertension is still unknown, so we aimed to evaluate the relationship between HbA1c and the incidence of hypertension in the general population. Method In this large prospective cohort study with a median follow-up of 2 years, we included 4,074 participants from the China Health and Nutrition Survey (CHNS). Multivariate COX regression, subgroup analysis, receiver operator characteristic (ROC) curve and restricted cubic spline (RCS) were used to evaluate the relationship between HbA1c and incidental hypertension. Results Compared with participants without incident hypertension, participants with incident hypertension had higher levels of HbA1c (P < 0.05). In univariate COX regression analysis, HbA1c was associated with the risk of hypertension (HR: 1.161, 95% CI: 1.105-1.221, P < 0.001). In multivariate COX regression analysis adjusted for confounding variables, HbA1c was still closely related to the risk of hypertension (HR: 1.102, 95% CI: 1.006-1.206, P = 0.037). And subgroup analysis showed that the relationship between HbA1c and hypertension remained significant in female, lower than high school and non-obese subgroups (P < 0.05). ROC curve also showed that HbA1c could predict the risk of hypertension (AUC = 0.583, 95% CI: 0.568-0.598, P < 0.001). Further RCS analysis showed that HbA1c was positively correlated with the risk of hypertension (P for nonlinearity = 0.642). Conclusion HbA1c was linearly and positively associated with the incidence of hypertension.
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Affiliation(s)
- Xu Huang
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Cheng Qin
- Department of Geriatric Cardiology, National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xiaoxu Guo
- Department of Digestive Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Feng Cao
- Department of Geriatric Cardiology, National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Chengchun Tang
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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Roomaney RA, van Wyk B, Cois A, Pillay van-Wyk V. Multimorbidity patterns in South Africa: A latent class analysis. Front Public Health 2023; 10:1082587. [PMID: 36711391 PMCID: PMC9875075 DOI: 10.3389/fpubh.2022.1082587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction South Africa has the largest burden of HIV worldwide and has a growing burden of non-communicable diseases; the combination of which may lead to diseases clustering in ways that are not seen in other regions. This study sought to identify common disease classes and sociodemographic and lifestyle factors associated with each disease class. Methods Data were analyzed from the South African Demographic and Health Survey 2016. A latent class analysis (LCA) was conducted using nine disease conditions. Sociodemographic and behavioral factors associated with each disease cluster were explored. All analysis was conducted in Stata 15 and the LCA Stata plugin was used to conduct the latent class and regression analysis. Results Multimorbid participants were included (n = 2 368). Four disease classes were identified: (1) HIV, Hypertension and Anemia (comprising 39.4% of the multimorbid population), (2) Anemia and Hypertension (23.7%), (3) Cardiovascular-related (19.9%) and (4) Diabetes and Hypertension (17.0%). Age, sex, and lifestyle risk factors were associated with class membership. In terms of age, with older adults were less likely to belong to the first class (HIV, Hypertension and Anemia). Males were more likely to belong to Class 2 (Anemia and Hypertension) and Class 4 (Diabetes and Hypertension). In terms of alcohol consumption, those that consumed alcohol were less likely to belong to Class 4 (Diabetes and Hypertension). Current smokers were more likely to belong to Class 3 (Cardiovascular-related). People with a higher body mass index tended to belong to Class 3 (Cardiovascular-related) or the Class 4 (Diabetes and Hypertension). Conclusion This study affirmed that integrated care is urgently needed, evidenced by the largest disease class being an overlap of chronic infectious diseases and non-communicable diseases. This study also highlighted the need for hypertension to be addressed. Tackling the risk factors associated with hypertension could avert an epidemic of multimorbidity.
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Affiliation(s)
- Rifqah Abeeda Roomaney
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa,School of Public Health, University of the Western Cape, Cape Town, South Africa,*Correspondence: Rifqah Abeeda Roomaney ✉
| | - Brian van Wyk
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Annibale Cois
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa,Division of Health Systems and Public Health, Department of Global Health, University of Stellenbosch, Stellenbosch, South Africa
| | - Victoria Pillay van-Wyk
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
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Lee JJN, Abdul Aziz A, Chan S, Raja Abdul Sahrizan RSFB, Ooi AYY, Teh Y, Iqbal U, Ismail NA, Yang A, Yang J, Teh DBL, Lim L. Effects of mobile health interventions on health-related outcomes in older adults with type 2 diabetes: A systematic review and meta-analysis. J Diabetes 2023; 15:47-57. [PMID: 36649940 PMCID: PMC9870745 DOI: 10.1111/1753-0407.13346] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 09/29/2022] [Accepted: 12/02/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition that is associated with multiple comorbidities. Apart from pharmacological approaches, patient self-management remains the gold standard of care for diabetes. Improving patients' self-management among the elderly with mobile health (mHealth) interventions is critical, especially in times of the COVID-19 pandemic. However, the extent of mHealth efficacy in managing T2DM in the older population remains unknown. Hence, the present review examined the effectiveness of mHealth interventions on cardiometabolic outcomes in older adults with T2DM. METHODS A systematic search from the inception till May 31, 2021, in the MEDLINE, Embase, and PubMed databases was conducted, and 16 randomized controlled trials were included in the analysis. RESULTS The results showed significant benefits on glycosylated hemoglobin (HbA1c) (mean difference -0.24%; 95% confidence interval [CI]: -0.44, -0.05; p = 0.01), postprandial blood glucose (-2.91 mmol/L; 95% CI: -4.78, -1.03; p = 0.002), and triglycerides (-0.09 mmol/L; 95% CI: -0.17, -0.02; p = 0.010), but not on low-density lipoprotein cholesterol (-0.06 mmol/L; 95% CI: -0.14, 0.02; p = 0.170), high-density lipoprotein cholesterol (0.05 mmol/L; 95% CI: -0.03, 0.13; p = 0.220), and blood pressure (systolic blood pressure -0.82 mm Hg; 95% CI: -4.65, 3.00; p = 0.670; diastolic blood pressure -1.71 mmHg; 95% CI: -3.71, 0.29; p = 0.090). CONCLUSIONS Among older adults with T2DM, mHealth interventions were associated with improved cardiometabolic outcomes versus usual care. Its efficacy can be improved in the future as the current stage of mHealth development is at its infancy. Addressing barriers such as technological frustrations may help strategize approaches to further increase the uptake and efficacy of mHealth interventions among older adults with T2DM.
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Affiliation(s)
- Jovin Jie Ning Lee
- Bia‐Echo Asia Center for Reproductive Longevity & Equality (ACRLE), Yong Loo Lin School of MedicineNational University of SingaporeSingapore
| | - Alia Abdul Aziz
- Department of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Sok‐Teng Chan
- Department of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | | | | | - Yi‐Ting Teh
- Department of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Usman Iqbal
- Global Health & Health Security Department, College of Public HealthTaipei Medical UniversityTaipeiTaiwan
- Health ICT, Department of HealthCanberraTasmaniaAustralia
| | - Noor Azina Ismail
- Department of Economics and Applied Statistics, Faculty of Business and EconomicsUniversity of MalayaKuala LumpurMalaysia
| | - Aimin Yang
- Department of Medicine and TherapeuticsThe Chinese University of Hong KongHong KongChina
| | - Jingli Yang
- College of Earth and Environmental SciencesLanzhou UniversityLanzhouChina
- School of Public Health and Social WorkQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Daniel Boon Loong Teh
- Bia‐Echo Asia Center for Reproductive Longevity & Equality (ACRLE), Yong Loo Lin School of MedicineNational University of SingaporeSingapore
- Department of Ophthalmology, Yong Loo Lin School of MedicineNational University of SingaporeSingapore
- Department of Anatomy, Yong Loo Lin School of MedicineNational University of SingaporeSingapore
- Neurobiology Programme, Life Science InstituteNational University of SingaporeSingapore
| | - Lee‐Ling Lim
- Department of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
- Department of Medicine and TherapeuticsThe Chinese University of Hong KongHong KongChina
- Asia Diabetes FoundationHong KongChina
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Alvarez MR, Alarcon JM, Roman CA, Lazaro D, Bobrowski-Khoury N, Baena-Caldas GP, Esber GR. Can a basic solution activate the inflammatory reflex? A review of potential mechanisms, opportunities, and challenges. Pharmacol Res 2023; 187:106525. [PMID: 36441036 DOI: 10.1016/j.phrs.2022.106525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/09/2022] [Accepted: 10/25/2022] [Indexed: 11/24/2022]
Abstract
Stimulation of the inflammatory reflex (IR) is a promising strategy to treat systemic inflammatory disorders. However, this strategy is hindered by the cost and side effects of traditional IR activators. Recently, oral intake of sodium bicarbonate (NaHCO3) has been suggested to activate the IR, providing a safe and inexpensive alternative. Critically, the mechanisms whereby NaHCO3 might achieve this effect and more broadly the pathways underlying the IR remain poorly understood. Here, we argue that the recognition of NaHCO3 as a potential IR activator presents exciting clinical and research opportunities. To aid this quest, we provide an integrative review of our current knowledge of the neural and cellular pathways mediating the IR and discuss the status of physiological models of IR activation. From this vantage point, we derive testable hypotheses on potential mechanisms whereby NaHCO3 might stimulate the IR and compare NaHCO3 with classic IR activators. Elucidation of these mechanisms will help determine the therapeutic value of NaHCO3 as an IR activator and provide new insights into the IR circuitry.
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Affiliation(s)
- Milena Rodriguez Alvarez
- Department of Internal Medicine, Division of Rheumatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.
| | - Juan Marcos Alarcon
- Department of Pathology, The Robert F. Furchgott Center for Neural and Behavioral Science, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Christopher A Roman
- Department of Cell Biology, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY 11203, USA
| | - Deana Lazaro
- Division of Rheumatology, Department of Internal Medicine, Veterans Affairs New York Harbor Healthcare System, Brooklyn, NY, USA
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Dong J, Liu YH, Lu YK, Hu LK, Chen N, Ma LL, Chu X, Yan YX. Association between surrogate indicators of insulin resistance and risk of type 2 diabetes combined with hypertension among Chinese adults: two independent cohort studies. Nutr Metab (Lond) 2022; 19:85. [PMID: 36581855 PMCID: PMC9798583 DOI: 10.1186/s12986-022-00720-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 12/20/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Type 2 diabetes (T2D) combined with hypertension has a higher risk of developing cardiovascular diseases. This study aimed to investigate the relationships between the surrogate indicators of insulin resistance (TyG, TG/HDL, and Mets-IR) with the risk of T2D combined with hypertension. METHODS This study is based on a functional community cohort from Beijing and the China Health and Retirement Longitudinal Study, comprising 4234 and 4658 participants respectively. Cox proportional hazards models and restricted cubic spline regression were performed to assess the link between TyG, TG/HDL, and Mets-IR with T2D combined with hypertension. The cross-lagged panel analysis and the mediation analysis were used to examine the temporal relationship between insulin resistance and obesity and their temporal relationship with follow-up T2D combined with hypertension. RESULTS In multivariable-adjusted models, higher TyG was associated with a higher risk of developing T2D combined with hypertension, the hazard ratios (95% confidence interval) were 3.46 (2.43-4.93) and 2.02 (1.67-2.44), in two cohorts respectively. A similar positive association was shown for Mets-IR, the hazard ratios (95% confidence interval) were 1.04 (1.03-1.06) and 1.05 (1.03-1.07), in two cohorts respectively. However, the association between TG/HDL with T2D combined with hypertension was different in two cohorts. The restricted cubic spline regression showed a linear association between TyG and T2D combined with hypertension (P-nonlinear > 0.05). The cross-lagged path coefficient from baseline BMI to follow-up TyG index was significantly greater than the path coefficient from baseline TyG to follow-up BMI. TyG partially mediated the effect of BMI on the risk of T2D combined with hypertension and the percentage of mediated association was estimated at 41.58% and 48.41% in two cohorts, respectively. CONCLUSION These findings indicated positive associations between TyG and Mets-IR with the risk of T2D combined with hypertension in two cohorts. In addition, BMI change may precede TyG index change, and the TyG index plays a mediating role in BMI induced T2D combined with hypertension.
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Affiliation(s)
- Jing Dong
- grid.24696.3f0000 0004 0369 153XHealth Management Center, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, People’s Republic of China
| | - Yu-Hong Liu
- grid.24696.3f0000 0004 0369 153XDepartment of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You’anmenWai, Fengtai District, 100069 Beijing, People’s Republic of China
| | - Ya-Ke Lu
- grid.24696.3f0000 0004 0369 153XDepartment of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You’anmenWai, Fengtai District, 100069 Beijing, People’s Republic of China
| | - Li-Kun Hu
- grid.24696.3f0000 0004 0369 153XDepartment of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You’anmenWai, Fengtai District, 100069 Beijing, People’s Republic of China
| | - Ning Chen
- grid.24696.3f0000 0004 0369 153XDepartment of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You’anmenWai, Fengtai District, 100069 Beijing, People’s Republic of China
| | - Lin-Lin Ma
- grid.24696.3f0000 0004 0369 153XDepartment of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You’anmenWai, Fengtai District, 100069 Beijing, People’s Republic of China
| | - Xi Chu
- grid.24696.3f0000 0004 0369 153XHealth Management Center, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, People’s Republic of China
| | - Yu-Xiang Yan
- grid.24696.3f0000 0004 0369 153XDepartment of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You’anmenWai, Fengtai District, 100069 Beijing, People’s Republic of China ,grid.24696.3f0000 0004 0369 153XMunicipal Key Laboratory of Clinical Epidemiology, Beijing, People’s Republic of China
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Hao X, Li W, Shi R, Wang Q. Investigating the causal mediating effect of type 2 diabetes on the relationship between traits and systolic blood pressure: A two-step Mendelian randomization study. Front Endocrinol (Lausanne) 2022; 13:1090867. [PMID: 36589843 PMCID: PMC9800519 DOI: 10.3389/fendo.2022.1090867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) and hypertension commonly coexist, and we presumed that T2DM might mediate the relationship between some shared risk factors and systolic blood pressure (SBP). Methods The causal association between T2DM and SBP was first confirmed using Mendelian randomization (MR) analyses, and a two-step MR design was then used to test the causal mediating effect of T2DM on the relationship between 107 traits and SBP using summary statistics from genome-wide association studies. Results T2DM was causally associated with SBP. The univariable MR of the two-step causal mediation analyses suggested that 44 and 45 of the 107 traits had causal associations with T2DM and SBP, respectively. Five of the 27 traits that were significantly associated with both T2DM and SBP could not be reversely altered by T2DM and were included in the second step of the causal mediation analyses. The results indicated that most of the investigated traits causally altered SBP independent of T2DM, but the partial causal mediating effect of T2DM on the association between fasting insulin and SBP was successfully identified with a mediation proportion of 33.6%. Conclusions Our study provides novel insights into the role of risk factors in the comorbidity of T2DM and high blood pressure, which is important for long-term disease prevention and management.
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Affiliation(s)
- Xuezeng Hao
- Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Weixin Li
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ruiqing Shi
- Respiratory Endocrine Department, Beijing Fengtai You′anmen Hospital, Beijing, China
| | - Qiuhong Wang
- Department of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Kamalumpundi V, Shams E, Tucker C, Cheng L, Peterson J, Thangavel S, Ofori O, Correia M. Mechanisms and pharmacotherapy of hypertension associated with type 2 diabetes. Biochem Pharmacol 2022; 206:115304. [DOI: 10.1016/j.bcp.2022.115304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/09/2022] [Accepted: 10/11/2022] [Indexed: 11/28/2022]
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Lee S, Han M, Moon S, Kim K, An WJ, Ryu H, Oh KH, Park SK. Identifying Genetic Variants and Metabolites Associated with Rapid Estimated Glomerular Filtration Rate Decline in Korea Based on Genome-Metabolomic Integrative Analysis. Metabolites 2022; 12:metabo12111139. [PMID: 36422279 PMCID: PMC9695695 DOI: 10.3390/metabo12111139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/09/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
Identifying the predisposing factors to chronic or end-stage kidney disease is essential to preventing or slowing kidney function decline. Therefore, here, we investigated the genetic variants related to a rapid decline in the estimated glomerular filtration rate (eGFR) (i.e., a loss of >5 mL/min/1.73 m2 per year) and verified the relationships between variant-related diseases and metabolic pathway signaling in patients with chronic kidney disease. We conducted a genome-wide association study that included participants with diabetes, hypertension, and rapid eGFR decline from two Korean data sources (N = 115 and 69 for the discovery and the validation cohorts, respectively). We identified a novel susceptibility locus: 4q32.3 (rs10009742 in the MARCHF1 gene, beta = −3.540, P = 4.11 × 10−8). Fine-mapping revealed 19 credible, causal single-nucleotide polymorphisms, including rs10009742. The pimelylcarnitine and octadecenoyl carnitine serum concentrations were associated with rs10009742 (beta = 0.030, P = 7.10 × 10−5, false discovery rate (FDR) = 0.01; beta = 0.167, P = 8.11 × 10−4, FDR = 0.08). Our results suggest that MARCHF1 is associated with a rapid eGFR decline in patients with hypertension and diabetes. Furthermore, MARCHF1 affects the pimelylcarnitine metabolite concentration, which may mediate chronic kidney disease progression by inducing oxidative stress in the endoplasmic reticulum.
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Affiliation(s)
- Sangjun Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Republic of Korea
| | - Miyeun Han
- Department of Internal Medicine, National Medical Center, Seoul 04564, Republic of Korea
| | - Sungji Moon
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
- Interdisciplinary Program in Cancer Biology, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea
| | - Kyungsik Kim
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Republic of Korea
| | - Woo Ju An
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Hyunjin Ryu
- Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
- Correspondence: (K.-H.O.); (S.K.P.); Tel.: +82-2-2072-0776 (K.-H.O.); +82-2-740-8338 (S.K.P.)
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
- Correspondence: (K.-H.O.); (S.K.P.); Tel.: +82-2-2072-0776 (K.-H.O.); +82-2-740-8338 (S.K.P.)
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Ntenda PAM, El-Meidany WMR, Tiruneh FN, Motsa MPS, Nyirongo J, Chirwa GC, Kapachika A, Nkoka O. Determinants of self-reported hypertension among women in South Africa: evidence from the population-based survey. Clin Hypertens 2022; 28:39. [PMCID: PMC9664601 DOI: 10.1186/s40885-022-00222-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Hypertension (HTN), characterized by an elevation of blood pressure, is a serious public health chronic condition that significantly raises the risks of heart, brain, kidney, and other diseases. In South Africa, the prevalence of HTN (measured objectively) was reported at 46.0% in females, nonetheless little is known regarding the prevalence and risks factors of self-reported HTN among the same population. Therefore, the aim of this study was to examine determinants of self-reported HTN among women in South Africa.
Methods
The study used data obtained from the 2016 South African Demographic and Health Survey. In total, 6,027 women aged ≥ 20 years were analyzed in this study. Self-reported HTN was defined as a case in which an individual has not been clinically diagnosed with this chronic condition by a medical doctor, nurse, or health worker. Multiple logistic regression models were employed to examine the independent factors of self-reported HTN while considering the complex survey design.
Results
Overall, self-reported HTN was reported in 23.6% (95% confidence interval [CI], 23.1–24.1) of South African women. Being younger (adjusted odds ratio [aOR], 0.04; 95% CI, 0.03–0.06), never married (aOR, 0.69; 95% CI, 0.56–0.85), and not covered by health insurance (aOR, 0.74; 95% CI, 0.58–0.95) reduced the odds of self-reported HTN. On the other hand, being black/African (aOR, 1.73; 95% CI, 1.17–2.54), perception of being overweight (aOR, 1.72; 95% CI, 1.40–2.11), and perception of having poor health status (aOR, 3.53; 95% CI, 2.53–5.21) and the presence of other comorbidities (aOR, 7.92; 95% CI, 3.63–17.29) increased the odds of self-reported HTN.
Conclusions
Self-reported HTN was largely associated with multiple sociodemographic, health, and lifestyle factors and the presence of other chronic conditions. Health promotion and services aiming at reducing the burden of HTN in South Africa should consider the associated factors reported in this study to ensure healthy aging and quality of life among women.
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Medication non-adherence and therapeutic inertia independently contribute to poor disease control for cardiometabolic diseases. Sci Rep 2022; 12:18936. [PMID: 36344613 PMCID: PMC9640683 DOI: 10.1038/s41598-022-21916-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/05/2022] [Indexed: 11/09/2022] Open
Abstract
Poorly controlled cardiometabolic biometric health gap measures [e.g.,uncontrolled blood pressure (BP), HbA1c, and low-density lipoprotein cholesterol (LDL-C)] are mediated by medication adherence and clinician-level therapeutic inertia (TI). The study of comparing relative contribution of these two factors to disease control is lacking. We conducted a retrospective cohort study using 7 years of longitudinal electronic health records (EHR) from primary care cardiometabolic patients who were 35 years or older. Cox-regression modeling was applied to estimate how baseline proportion of days covered (PDC) and TI were associated with cardiometabolic related health gap closure. 92,766 patients were included in the analysis, among which 89.9%, 85.8%, and 73.3% closed a BP, HbA1c, or LDL-C gap, respectively, with median days to gap closure ranging from 223 to 408 days. Patients who did not retrieve a medication were the least likely to achieve biometric control, particularly for LDL-C (HR = 0.58, 95% CI: 0.55-0.60). TI or uncertainty of TI was associated with a high risk of health gap persistence, particularly for LDL-C (HR ranges 0.46-0.48). Both poor medication adherence and TI are independently associated with persistent health gaps, and TI has a much higher impact on disease control compared to medication adherence, implying disease management strategies should prioritize reducing TI.
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Kumar V, Agarwal S, Saboo B, Makkar B. RSSDI Guidelines for the management of hypertension in patients with diabetes mellitus. Int J Diabetes Dev Ctries 2022; 42:576-605. [PMID: 36536953 PMCID: PMC9750845 DOI: 10.1007/s13410-022-01143-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 11/01/2022] [Indexed: 12/23/2022] Open
Abstract
Hypertension and diabetes mellitus (DM) are two of the leading lifestyle diseases in the Indian and South Asian populations that often co-exist due to overlapping pathophysiological factors. Obesity, insulin resistance, inflammation, and oxidative stress are thought to be some common pathways. Up to 50% of hypertensive cases in India are diagnosed with type 2 diabetes mellitus (T2DM), which defines the need for a comprehensive guideline for managing hypertension in diabetic patients. These RSSDI guidelines have been formulated based on consultation with expert endocrinologists in India and Southeast Asia, acknowledging the needs of the Indian population. Ambulatory blood pressure monitoring and office and home-based blood pressure (BP) monitoring are recommended for the early analysis of risks. Cardiovascular risks, end-organ damage, and renal disorders are the primary complications associated with diabetic hypertension that needs to be managed with the help of non-pharmacological and pharmacological interventions. The non-pharmacological interventions include the nutrition education of the patient to reduce the intake of salt, sodium, and trans fats and increase the consumption of nuts, fresh fruits, vegetables, and potassium-rich foods. It is also recommended to initiate 50 to 60 min of exercise three to four times a week since physical activity has shown to be more beneficial for hypertension control in Indian patients than dietary modulation. For the pharmacological management of hypertension in patients with T2DM, angiotensin II receptor blockers (ARBs) are recommended as the first line of therapy, demonstrating their superiority over other antihypertensive agents such as ACEi. However, most of the global hypertension guidelines recommend initiation with combination therapy to achieve better BP control in most patients and to reduce the risk of adverse events. For combination therapy, calcium channel blockers (CCBs) are recommended to be administered along with ARBs instead of beta-blockers or diuretics to avoid the risk of cardiovascular events and hyperglycaemia. Among the CCBs, novel molecules (e.g. cilnidipine) are recommended in combination with ARBs for better cardiovascular and reno-protection in diabetic hypertensive patients.
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Affiliation(s)
- Vasanth Kumar
- Apollo Hospitals, Hyderabad, India
- President. RSSDI, Prune, India
| | - Sanjay Agarwal
- Aegle Clinic-Diabetes Care, Pune, India
- Department of Medicine and Diabetes, Ruby Hall Clinic, Pune, India
- Secretary-General, RSSDI, Pune, India
| | - Banshi Saboo
- Immediate Past-President, RSSDI, Pune, India
- Dia-Care Hormone Clinic, Ahmedabad, India
| | - Brij Makkar
- President-Elect, RSSDI, Prune, India
- Dr Makkar’s Diabetes & Obesity Centre, A-5B/122, Paschim Vihar, New Delhi, 110063 India
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