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Zhang F, de Bock GH, Denig P, Landman GW, Zhang Q, Sidorenkov G. Role of Serum Lipids, Blood Glucose and Blood Pressure in Breast Cancer Risk for Women with Type 2 Diabetes Mellitus. Clin Epidemiol 2023; 15:109-121. [PMID: 36718225 PMCID: PMC9884051 DOI: 10.2147/clep.s386471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/05/2022] [Indexed: 01/25/2023] Open
Abstract
PURPOSE Women with type 2 diabetes mellitus (T2DM) have an increased risk of breast cancer. We aimed to determine the contribution of lipids, glucose and blood pressure to this risk based on the multifactorial nature of T2DM. PATIENTS AND METHODS This population-based cohort study used data from a Dutch database (the Groningen Initiative to Analyse Type 2 Diabetes Treatment) for the period 2004-2013. The cohort included women diagnosed with T2DM, aged 30-80 years, with no history of breast cancer and with follow-up data for at least 1 year. We used Cox proportional hazards models to estimate the associations of exposures with breast cancer occurrence, reporting adjusted hazard ratios (aHR) with 95% confidence intervals (CI). Exposures of interest included total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, glycated hemoglobin A (HbA1c) and systolic blood pressure (SBP). RESULTS During a median of 4.45 years' follow-up, 183 of 10,183 included women received a breast cancer diagnosis. We observed U-shaped associations with breast cancer incidence for total cholesterol and HDL-C at baseline. Compared with moderate elevations, women had significantly higher breast cancer risks associated with high total cholesterol (aHR, 95% CI: 1.72, 1.15-2.55) and HDL-C (aHR, 95% CI: 1.74, 1.18-2.58) levels, while low total cholesterol (aHR, 95% CI: 1.43, 0.94-2.19) and HDL-C (aHR, 95% CI: 1.44, 0.95-2.17) levels produced marginal effects without significance. Women with high LDL-C levels more often received a breast cancer diagnosis than those with medium levels (aHR, 95% CI: 1.56, 1.03-2.35). CONCLUSION This real-world dataset highlights the importance of balancing lipid profiles, particularly total cholesterol and HDL-C. Dysregulation of the lipid profile, not the glucose or blood pressure profiles, may increase the risk of breast cancer in women with T2DM.
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Affiliation(s)
- Fan Zhang
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Department of Preventive Medicine, Shantou University Medical College, Shantou, People’s Republic of China
- Oncology Research Laboratory, Cancer Hospital of Shantou University Medical College, Shantou, People’s Republic of China
| | - Geertruida H de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Petra Denig
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Gijs W Landman
- Department of Internal Medicine, Gelre Hospital, Apeldoorn, the Netherlands
| | - Qingying Zhang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, People’s Republic of China
| | - Grigory Sidorenkov
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Correspondence: Grigory Sidorenkov, Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands, Email
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Garcia ML, Milanez MIO, Nishi EE, Sato AYS, Carvalho PM, Nogueira FN, Campos RR, Oyama LM, Bergamaschi CT. Retroperitoneal adipose tissue denervation improves cardiometabolic and autonomic dysfunction in a high fat diet model. Life Sci 2021; 283:119841. [PMID: 34298036 DOI: 10.1016/j.lfs.2021.119841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/29/2022]
Abstract
Sympathetic vasomotor overactivity is a major feature leading to the cardiovascular dysfunction related to obesity. Considering that the retroperitoneal white adipose tissue (rWAT) is an important fat visceral depot and receives intense sympathetic and afferent innervations, the present study aimed to evaluate the effects evoked by bilateral rWAT denervation in obese rats. Male Wistar rats were fed with HFD for 8 consecutive weeks and rWAT denervation was performed at the 6th week. Arterial pressure, splanchnic and renal sympathetic vasomotor nerve activities were assessed and inflammation and the components of the renin -angiotensin system were evaluated in different white adipose tissue depots. HFD animals presented higher serum levels of leptin and glucose, an increase in arterial pressure and splanchnic sympathetic nerve activity; rWAT denervation, normalized these parameters. Pro-inflammatory cytokines levels were significantly increased, as well as RAAS gene expression in WAT of HFD animals; rWAT denervation significantly attenuated these changes. In conclusion, HFD promotes vasomotor sympathetic overactivation and inflammation with repercussions on the cardiovascular system. In conclusion, the neural communication between WAT and the brain is fundamental to trigger sympathetic vasomotor activation and this pathway is a possible new therapeutic target to treat obesity-associated cardiovascular dysfunction.
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Affiliation(s)
- Michelle L Garcia
- Department of Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - Maycon I O Milanez
- Department of Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - Erika E Nishi
- Department of Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - Alex Y S Sato
- Department of Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - Polliane M Carvalho
- Department of Biomaterials and Oral Biology, Faculdade de Odontologia, Universidade de São Paulo, Brazil
| | - Fernando N Nogueira
- Department of Biomaterials and Oral Biology, Faculdade de Odontologia, Universidade de São Paulo, Brazil
| | - Ruy R Campos
- Department of Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - Lila M Oyama
- Department of Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - Cássia T Bergamaschi
- Department of Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil.
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Natural killer cells, gamma delta T cells and classical monocytes are associated with systolic blood pressure in the multi-ethnic study of atherosclerosis (MESA). BMC Cardiovasc Disord 2021; 21:45. [PMID: 33482725 PMCID: PMC7821496 DOI: 10.1186/s12872-021-01857-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/06/2021] [Indexed: 12/12/2022] Open
Abstract
Background Hypertension is a major source of cardiovascular morbidity and mortality. Recent evidence from mouse models, genetic, and cross-sectional human studies suggest increased proportions of selected immune cell subsets may be associated with levels of systolic blood pressure (SBP).
Methods We assayed immune cells from cryopreserved samples collected at the baseline examination (2000–2002) from 1195 participants from the multi-ethnic study of atherosclerosis (MESA). We used linear mixed models, with adjustment for age, sex, race/ethnicity, smoking, exercise, body mass index, education, diabetes, and cytomegalovirus titers, to estimate the associations between 30 immune cell subsets (4 of which were a priori hypotheses) and repeated measures of SBP (baseline and up to four follow-up measures) over 10 years. The analysis provides estimates of the association with blood pressure level. Results The mean age of the MESA participants at baseline was 64 ± 10 years and 53% were male. A one standard deviation (1-SD) increment in the proportion of γδ T cells was associated with 2.40 mmHg [95% confidence interval (CI) 1.34–3.42] higher average systolic blood pressure; and for natural killer cells, a 1-SD increment was associated with 1.88 mmHg (95% CI 0.82–2.94) higher average level of systolic blood pressure. A 1-SD increment in classical monocytes (CD14++CD16−) was associated with 2.01 mmHG (95% CI 0.79–3.24) lower average systolic blood pressure. There were no associations of CD4+ T helper cell subsets with average systolic blood pressure. Conclusion These findings suggest that the innate immune system plays a role in levels of SBP whereas there were no associations with adaptive immune cells.
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Abstract
Hypertension is an important risk factor for cardiovascular morbidity and mortality and for events such as myocardial infarction, stroke, heart failure and chronic kidney disease and is a major determinant of disability-adjusted life-years. Despite the importance of hypertension, the pathogenesis of essential hypertension, which involves the complex interaction of several mechanisms, is still poorly understood. Evidence suggests that interplay between bone marrow, microglia and immune mediators underlies the development of arterial hypertension, in particular through mechanisms involving cytokines and peptides, such as neuropeptide Y, substance P, angiotensin II and angiotensin-(1-7). Chronic psychological stress also seems to have a role in increasing the risk of hypertension, probably through the activation of neuroimmune pathways. In this Review, we summarize the available data on the possible role of neuroimmune crosstalk in the origin and maintenance of arterial hypertension and discuss the implications of this crosstalk for recovery and rehabilitation after cardiac and cerebral injuries.
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Wang Y, Wang BS, Hui X, Qiao J, Li WZ, Sun N. [Role of inducible costimulatory molecule-mediated Th17 cell polarization in renal fibrosis in spontaneously hypertensive rats]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2018; 38:534-540. [PMID: 29891448 PMCID: PMC6743898 DOI: 10.3969/j.issn.1673-4254.2018.05.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To explore the role of inducible costimulatory molecule (ICOS) signaling pathway-mediated Th17 cells polarization in renal damage in essential hypertension. METHODS Four-week-old spontaneously hypertensive rats (SHR) were randomly divided into control (SHR-C) group and intervention (SHR-I) group and subjected to intraperitoneal injections of PBS and ICOS monoclonal antibody for 2 weeks, respectively. Blood pressure of the rats was monitored using noninvasive tail artery blood pressure measuring instrument. The percentage of Th17 cells in the splenocytes was analyzed using flow cytometry, and the expression levels of IL-17A mRNA in the rat's kidneys were detected using RT-PCR. The levels of IL-17A and TGF-β1 in the plasma and kidneys were dynamically detected using ELISA and immunohistochemistry, respectively. Renal pathological changes in the rats were detected using Masson staining. RESULTS At the age of 10 and 30 weeks, the rats in SHR-C group had a significantly higher blood pressure than those in SHR-I group (P<0.05 or 0.01). In rats in SHR-C group, Th17 cells percentage in the splenocytes and IL-17A mRNA level in the kidney was significantly higher than those in SHR-I group from the age of 6 weeks (P<0.05). The expressions of IL-17A and TGF-β1 in the plasma and kidney were significantly higher in SHR-C group than that in SHR-I group at 6 weeks (P<0.05). Compared with those in SHR-C group, the rats in SHR-I group showed significant alleviation of renal fibrosis from the age of 30 weeks (P<0.05). CONCLUSION The ICOS signaling pathway-mediated Th17 cells polarization plays an important role in renal fibrosis in hypertensive rats.
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Affiliation(s)
- Yu Wang
- Department of Basic Medical Sciences, Medical College, Anhui University of Science & Technology, Huainan 232001, China.E-mail:
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De Ciuceis C, Agabiti-Rosei C, Rossini C, Airò P, Scarsi M, Tincani A, Tiberio GAM, Piantoni S, Porteri E, Solaini L, Duse S, Semeraro F, Petroboni B, Mori L, Castellano M, Gavazzi A, Agabiti-Rosei E, Rizzoni D. Relationship between different subpopulations of circulating CD4+ T lymphocytes and microvascular or systemic oxidative stress in humans. Blood Press 2017; 26:237-245. [PMID: 28276721 DOI: 10.1080/08037051.2017.1292395] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Different components of the immune system, including innate and adaptive immunity (T effector lymphocytes and T regulatory lymphocytes - TREGs) may be involved in the development of hypertension, vascular injury and inflammation. However, no data are presently available in humans about possible relationships between T-lymphocyte subtypes and microvascular oxidative stress. Our objective was to investigate possible relationships between T-lymphocyte subtypes and systemic and microvascular oxidative stress in a population of normotensive subjects and hypertensive patients. PATIENTS AND METHODS In the present study we enrolled 24 normotensive subjects and 12 hypertensive patients undergoing an elective surgical intervention. No sign of local or systemic inflammation was present. All patients underwent a biopsy of subcutaneous fat during surgery. A peripheral blood sample was obtained before surgery for assessment of T lymphocyte subpopulations by flow cytometry and circulating indices of oxidative stress. RESULTS A significant direct correlation was observed between Th1 lymphocytes and reactive oxygen species (ROS) production (mainly in microvessels). Additionally, significant inverse correlations were observed between ROS and total TREGs, or TREGs subtypes. Significant correlations were detected between circulating indices of oxidative stress/inflammation and indices of microvascular morphology/Th1 and Th17 lymphocytes. In addition, a significant inverse correlation was detected between TREGs in subcutaneous small vessels and C reactive protein. CONCLUSIONS Our data suggest that TREG lymphocytes may be protective against microvascular damage, probably because of their anti-oxidant properties, while Th1-Th17 lymphocytes seem to exert an opposite effect, confirming an involvement of adaptive immune system in microvascular damage.
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Affiliation(s)
- Carolina De Ciuceis
- a Department of Clinical and Experimental Sciences, Clinica Medica, University of Brescia , Brescia , Italy
| | - Claudia Agabiti-Rosei
- a Department of Clinical and Experimental Sciences, Clinica Medica, University of Brescia , Brescia , Italy
| | - Claudia Rossini
- a Department of Clinical and Experimental Sciences, Clinica Medica, University of Brescia , Brescia , Italy
| | - Paolo Airò
- b Chair of Rheumatology, Department of Clinical and Experimental Sciences , University of Brescia , Brescia , Italy
| | - Mirko Scarsi
- b Chair of Rheumatology, Department of Clinical and Experimental Sciences , University of Brescia , Brescia , Italy
| | - Angela Tincani
- b Chair of Rheumatology, Department of Clinical and Experimental Sciences , University of Brescia , Brescia , Italy
| | | | - Silvia Piantoni
- b Chair of Rheumatology, Department of Clinical and Experimental Sciences , University of Brescia , Brescia , Italy
| | - Enzo Porteri
- a Department of Clinical and Experimental Sciences, Clinica Medica, University of Brescia , Brescia , Italy
| | - Leonardo Solaini
- c Department of Clinical and Experimental Sciences, Clinica Chirurgica, University of Brescia , Brescia , Italy
| | - Sarah Duse
- d Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, Chair of Ophthalmology , University of Brescia , Brescia , Italy
| | - Francesco Semeraro
- d Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, Chair of Ophthalmology , University of Brescia , Brescia , Italy
| | - Beatrice Petroboni
- a Department of Clinical and Experimental Sciences, Clinica Medica, University of Brescia , Brescia , Italy
| | - Luigi Mori
- a Department of Clinical and Experimental Sciences, Clinica Medica, University of Brescia , Brescia , Italy
| | - Maurizio Castellano
- a Department of Clinical and Experimental Sciences, Clinica Medica, University of Brescia , Brescia , Italy
| | - Alice Gavazzi
- a Department of Clinical and Experimental Sciences, Clinica Medica, University of Brescia , Brescia , Italy
| | - Enrico Agabiti-Rosei
- a Department of Clinical and Experimental Sciences, Clinica Medica, University of Brescia , Brescia , Italy
| | - Damiano Rizzoni
- a Department of Clinical and Experimental Sciences, Clinica Medica, University of Brescia , Brescia , Italy.,e Division of Medicine , Istituto Clinico Città di Brescia , Brescia , Italy
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