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Antoniak-Pietrynczak K, Zorena K, Jaskulak M, Hansdorfer-Korzon R, Koziński M. Effect of Manual Lymphatic Drainage on the Concentrations of Selected Adipokines, Cytokines, C-Reactive Protein and Parameters of Carbohydrate and Lipid Metabolism in Patients with Abnormal Body Mass Index: Focus on Markers of Obesity and Insulin Resistance. Int J Mol Sci 2023; 24:10338. [PMID: 37373485 DOI: 10.3390/ijms241210338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
The aim of the study was to assess the impact of manual lymphatic drainage (MLD) on the parameters of carbohydrate metabolism, lipid metabolism and the level of selected adipokines and cytokines in people with abnormal body mass index (BMI). In addition, an attempt was made to assess the optimal cut-off values of serum concentrations of the biochemical parameters studied in identifying the risk of obesity and insulin resistance (IR). The study included 60 subjects who underwent 10 and 30 min long MLD sessions three times a week. The study group included 15 patients with a normal body mass index (group I; n = 15), overweight patients (group II; n = 15) and obese patients (group III; n = 10). The control group was IV; n = 20 subjects not undergoing MLD. Biochemical tests were carried out on all subjects at stage 0' (before MLD therapy) and at stage 1' (one month after MLD therapy). In the control group, the time between the sample collection at stage 0' and stage 1' was the same as in the study group. Our results showed that 10 MLD sessions may have a positive effect on the selected biochemical parameters, including insulin, 2h-PG, leptin and HOMA-IR values in normal weight and overweight patients. In addition, in the study group, the highest AUCROC values in identifying the risk of obesity were found for leptin (AUCROC = 82.79%; cut-off = 17.7 ng/mL; p = 0.00004), insulin (AUCROC = 81.51%; cut-off = 9.5 µIU/mL; p = 0.00009) and C-peptide (AUCROC = 80.68%; cut-off = 2.3 ng/mL; p = 0.0001) concentrations as well as for HOMA-IR values (AUCROC = 79.97%; cut-off = 1.8; p = 0.0002). When considering the risk of IR, we observed the highest diagnostic value for insulin (AUCROC = 93.05%; cut-off = 1.8 ng/mL; p = 0.053), which was followed by C-peptide (AUCROC = 89.35%; cut-off = 17.7 ng/mL; p = 0.000001), leptin (AUCROC = 79.76%; cut-off = 17.6 ng/mL; p = 0.0002) and total cholesterol (AUCROC = 77.31%; cut-off = 198 mg/dL; p = 0.0008). Our results indicate that MLD may have a positive effect on selected biochemical parameters, including insulin, 2h-PG, leptin and HOMA-IR, in normal weight and overweight patients. In addition, we successfully established optimal cut-off values for leptin in the assessment of obesity and insulin in the assessment of insulin resistance in patients with abnormal body mass index. Based on our findings, we hypothesize that MLD, when combined with caloric restriction and physical activity, may serve as an effective preventive intervention against the development of obesity and insulin resistance.
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Affiliation(s)
- Klaudia Antoniak-Pietrynczak
- Department of Immunobiology and Environment Microbiology, Medical University of Gdansk, Dębinki 7, 80-211 Gdansk, Poland
| | - Katarzyna Zorena
- Department of Immunobiology and Environment Microbiology, Medical University of Gdansk, Dębinki 7, 80-211 Gdansk, Poland
| | - Marta Jaskulak
- Department of Immunobiology and Environment Microbiology, Medical University of Gdansk, Dębinki 7, 80-211 Gdansk, Poland
| | - Rita Hansdorfer-Korzon
- Department of Physiotherapy, Medical University of Gdansk, Dębinki 7, 80-211 Gdansk, Poland
| | - Marek Koziński
- Department of Cardiology and Internal Diseases, Institute of Maritime and Tropical Medicine, Faculty of Health Sciences, Medical University of Gdansk, Powstania Styczniowego 9b, 81-519 Gdynia, Poland
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Wang H, Li Y, Cao W, Zhang J, Cao M, Meng X, Liu D, Wang Y. Leveraging IgG N-glycosylation to infer the causality between T2D and hypertension. Diabetol Metab Syndr 2023; 15:80. [PMID: 37095539 PMCID: PMC10127371 DOI: 10.1186/s13098-023-01053-6] [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: 01/11/2023] [Accepted: 04/07/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Observational studies demonstrated a bidirectional association between type 2 diabetes (T2D) and hypertension, whereas Mendelian randomization (MR) analyses supported the causality from T2D to hypertension but not causal from hypertension to T2D. We previously found that IgG N-glycosylation is associated with both T2D and hypertension, and thus IgG N-glycosylation might link the causality between them. METHODS We carried out a genome-wide association study (GWAS) to identify IgG N-glycosylation-quantitative-trait loci (QTLs) integrating GWAS for T2D and hypertension and then performed bidirectional univariable and multivariable MR analyses to infer the causal association among them. The inverse-variance-weighted (IVW) analysis was performed as the primary analysis, followed by some sensitivity analyses to explore the stability of the results. RESULTS Six putatively causal IgG N-glycans for T2D and four for hypertension were identified in the IVW method. Genetically predicted T2D increased the risk of hypertension (odds ratio [OR] = 1.177, 95% confidence interval (95% CI) = 1.037-1.338, P = 0.012) and vice versa (OR = 1.391, 95% CI = 1.081-1.790, P = 0.010). Multivariable MR showed that T2D remained at risk effect with hypertension ([OR] = 1.229, 95% CI = 1.140-1.325, P = 7.817 × 10-8) after conditioning on T2D-related IgG-glycans. Conversely, hypertension was associated with higher T2D risk (OR = 1.287, 95% CI = 1.107-1.497, P = 0.001) after adjusting for related IgG-glycans. No evidence of horizontal pleiotropy was observed, as MR‒Egger regression provided P values for intercept > 0.05. CONCLUSION Our study validated the mutual causality between T2D and hypertension from the perspective of IgG N-glycosylation, further validating the "common soil" hypothesis underlying the pathogenesis of T2D and hypertension.
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Affiliation(s)
- Haotian Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 Xitoutiao, Beijing, 100069, China
| | - Yuan Li
- Lianyungang Maternal and Child Health Hospital, Lianyungang, 222062, Jiangsu, China
| | - Weijie Cao
- Centre for Precision Medicine, Edith Cowan University, Perth, 60127, Australia
| | - Jie Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 Xitoutiao, Beijing, 100069, China
| | - Mingyang Cao
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 Xitoutiao, Beijing, 100069, China
| | - Xiaoni Meng
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 Xitoutiao, Beijing, 100069, China
| | - Di Liu
- Centre for Biomedical Information Technology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, University Town, Nanshan District, Shenzhen, 518055, Guangdong, China.
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 Xitoutiao, Beijing, 100069, China.
- Centre for Precision Medicine, Edith Cowan University, Perth, 60127, Australia.
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Asgari S, Masrouri S, Khalili D, Azizi F, Hadaegh F. Differences in the impact of impaired glucose status on clinical outcomes in younger and older adults: Over a decade of follow-up in the Tehran lipid and glucose study. Front Cardiovasc Med 2022; 9:1018403. [PMID: 36386371 PMCID: PMC9662168 DOI: 10.3389/fcvm.2022.1018403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 09/28/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Studies found that the impact of dysglycemia on microvascular, macrovascular events and mortality outcomes were different between the younger vs. older population. We aimed to investigate the age-specific association of prediabetes with clinical outcomes including type 2 diabetes (T2DM), hypertension, chronic kidney disease (CKD), cardiovascular disease (CVD), and mortality. Materials and methods A total of 5,970 Iranians (3,829 women) aged ≥30 years, without T2DM, were included. The age-specific (<60 and ≥60 years; minimum p-value for interaction = 0.001) multivariable-adjusted Cox regression was done to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of the impaired glucose status including impaired fasting glucose (IFG) vs. normal fasting glucose (NFG), impaired glucose tolerance (IGT) vs. normal glucose tolerance (NGT), and IFG&IGT vs. NFG/NGT with each outcome. Results Among individuals aged ≥60 years, the prevalence of impaired glucose status (IFG, IGT, or both) was about 2 times higher compared to those aged <60. Age-specific association between prediabetes and incident hypertension was found for those aged <60 years; [HR (95% CI); IFG: 1.38 (1.16–1.65), IGT: 1.51 (1.26–1.81), and IFG&IGT: 1.62 (1.21–2.12)]. For CVD, in all impaired glycemic states, those aged <60 were at higher significant risk [IFG: 1.39 (1.09–1.77), IGT: 1.53 (1.19–1.97), and IFG&IGT: 1.60 (1.14–2.25)]. Stratified analyses showed similar associations for IFG and IGT with non-CV mortality 1.71 (1.04–2.80) and 2.12 (1.30–3.46), respectively, and for all-cause mortality among those aged <60 years [IFG: 1.63 (1.08–2.45) and IGT: 1.82 (1.20–2.76)]. In both age groups, all glycemic status groups were significantly associated with T2DM but not with CKD and CV mortality. Conclusions The high prevalence of prediabetes particularly among the elderly population, limited resources, and the observed significant age differences in the impact of prediabetes states on different clinical outcomes calls for multicomponent intervention strategies by policy health makers, including lifestyle and possible pharmacological therapy, with the priority for the young Iranian population.
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Affiliation(s)
- Samaneh Asgari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soroush Masrouri
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- *Correspondence: Farzad Hadaegh
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Louca P, Berry SE, Bermingham K, Franks PW, Wolf J, Spector TD, Valdes AM, Chowienczyk P, Menni C. Postprandial Responses to a Standardised Meal in Hypertension: The Mediatory Role of Visceral Fat Mass. Nutrients 2022; 14:nu14214499. [PMID: 36364763 PMCID: PMC9655022 DOI: 10.3390/nu14214499] [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: 09/18/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Postprandial insulinaemia, triglyceridaemia and measures of inflammation are thought to be more closely associated with cardiovascular risk than fasting measures. Although hypertension is associated with altered fasting metabolism, it is unknown as to what extent postprandial lipaemic and inflammatory metabolic responses differ between hypertensive and normotensive individuals. Linear models adjusting for age, sex, body mass index (BMI), visceral fat mass (VFM) and multiple testing (false discovery rate), were used to investigate whether hypertensive cases and normotensive controls had different fasting and postprandial (in response to two standardised test meal challenges) lipaemic, glycaemic, insulinaemic, and inflammatory (glycoprotein acetylation (GlycA)) responses in 989 participants from the ZOE PREDICT-1 nutritional intervention study. Compared to normotensive controls, hypertensive individuals had significantly higher fasting and postprandial insulin, triglycerides, and markers of inflammation after adjusting for age, sex, and BMI (effect size: Beta (Standard Error) ranging from 0.17 (0.08), p = 0.04 for peak insulin to 0.29 (0.08), p = 4.4 × 10-4 for peak GlycA). No difference was seen for postprandial glucose. When further adjusting for VFM effects were attenuated. Causal mediation analysis suggests that 36% of the variance in postprandial insulin response and 33.8% of variance in postprandial triglyceride response were mediated by VFM. Hypertensive individuals have different postprandial insulinaemic and lipaemic responses compared to normotensive controls and this is partially mediated by visceral fat mass. Consequently, reducing VFM should be a key focus of health interventions in hypertension. Trial registration: The ClinicalTrials.gov registration identifier is NCT03479866.
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Affiliation(s)
- Panayiotis Louca
- Department of Twin Research, King’s College London, St Thomas’ Hospital Campus, London SE1 7EH, UK
| | - Sarah E. Berry
- Department of Nutritional Sciences, King’s College London, Franklin Wilkins Building, London SE1 9NH, UK
| | - Kate Bermingham
- Department of Twin Research, King’s College London, St Thomas’ Hospital Campus, London SE1 7EH, UK
- Department of Nutritional Sciences, King’s College London, Franklin Wilkins Building, London SE1 9NH, UK
| | - Paul W. Franks
- Genetic & Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, SE-20502 Malmo, Sweden
| | | | - Tim D. Spector
- Department of Twin Research, King’s College London, St Thomas’ Hospital Campus, London SE1 7EH, UK
| | - Ana M. Valdes
- Nottingham NIHR Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
| | - Phil Chowienczyk
- Vascular Risk & Surgery, King’s College London, St Thomas’ Hospital Campus, London SE1 7EH, UK
| | - Cristina Menni
- Department of Nutritional Sciences, King’s College London, Franklin Wilkins Building, London SE1 9NH, UK
- Correspondence: ; Tel.: +44-(0)-207-188-7188 (ext. 52594)
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Liu L, Zhen D, Fu S, Sun W, Li H, Zhao N, Hou L, Tang X. Associations of the baseline level and change in glycosylated hemoglobin A1c with incident hypertension in non-diabetic individuals: a 3-year cohort study. Diabetol Metab Syndr 2022; 14:54. [PMID: 35436969 PMCID: PMC9014640 DOI: 10.1186/s13098-022-00827-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 04/05/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Diabetes mellitus increases the risk of developing hypertension. The relationship between glycosylated hemoglobin A1c (HbA1c) level and incident hypertension remains controversial. This study examined the associations of the baseline level and change in the HbA1c level over 3 years with incident hypertension in non-diabetic individuals. METHODS This community-based cohort study was conducted with 2591 individuals aged 40-75 years without hypertension or diabetes at baseline, who participated in a longitudinal (REACTION) study program. Questionnaires were administered during interviews, and anthropometric and laboratory measurements were performed at baseline (2011) and follow-up (2014-2015). Multivariate logistic regression models were applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of incident hypertension. RESULTS Over a median follow-up period of 3.08 years (interquartile range 3.00, 3.25), 384 (14.82%) subjects developed hypertension. In the fully adjusted linear regression models, change in HbA1c remained significantly associated with changes in systolic blood pressure and diastolic blood pressure [β-coefficient (95% CI), 4.421 (2.811-6.032), 1.681 (0.695-2.667)]. Logistic regression analyses showed that baseline HbA1c level was positively associated with incident hypertension in the unadjusted model; however, the association was no longer significant after further adjustment. Change in HbA1c was positively associated with the development of hypertension, both as a categorical variable stratified by tertiles [adjusted OR (95% CI) in the highest tertile was 1.690 (1.240-2.303) versus the lowest tertile)] and as a continuous variable [adjusted OR (95% CI), 1.242 (1.106-1.394)], independent of age, sex, body mass index, systolic blood pressure, fasting plasma glucose level, lipid profile, the HbA1c level at baseline and 3-year change in body mass index. CONCLUSIONS A higher baseline HbA1c level was not an independent risk factor for incident hypertension, whereas the change in HbA1c was independently associated with a greater longitudinal increase in blood pressure and an increased risk of incident hypertension in non-diabetic individuals.
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Affiliation(s)
- Lijuan Liu
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Donghu Zhen
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Songbo Fu
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Weiming Sun
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Hongli Li
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Nan Zhao
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Lijie Hou
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Xulei Tang
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
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Diagnostic and Predictive Values of LAP in Hypertension: A Cross-Sectional Study in Chinese Population Older Than 65 Years. Int J Hypertens 2021; 2021:3066007. [PMID: 34594579 PMCID: PMC8478592 DOI: 10.1155/2021/3066007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/22/2021] [Accepted: 08/28/2021] [Indexed: 11/18/2022] Open
Abstract
This study aimed to investigate the predictive value of lipid accumulation product (LAP) in hypertension in Chinese population older than 65 years. A total of 2092 adults from the communities in Pudong New Area of Shanghai were included in this cross-sectional study. The participants filled in questionnaire and received anthropometric and laboratory examinations. The receiver operating characteristics curve (ROC) was used to analyze the predictive value of different risk factors in hypertension. Results showed that LAP was closely related to hypertension (adjusted OR: 1.011, 95% CI: 1.007-1.015). In females, LAP, fasting blood glucose (FPG), and body mass index (BMI) were associated with hypertension; in males, triglycerides (TG) and waist circumference (WC) were related to hypertension. LAP (AUC = 0.655, 95% CI: 0.632-0.679) was better than neck circumference (NC) and BMI in predicting hypertension. When the cutoff value was 33.5, LAP had the best predictive performance. In males, LAP at 36.72 and 56.76 had the best predictive performance in males (AUC = 0.663, 95% CI: 0.629-0.697) and females (AUC = 0.650, 95% CI: 0.618-0.682), respectively. In conclusion, LAP is a risk factor of hypertension in the elderly. For hypertension, BMI, FPG, and LAP have favorable predictive performance in females, and WC and TG have better predictive performance in males.
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