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Trivedi MH, Jha MK, Elmore JS, Carmody T, Chin Fatt C, Sethuram S, Wang T, Mayes TL, Foster JA, Minhajuddin A. Clinical and sociodemographic features of the Texas resilience against depression (T-RAD) study: Findings from the initial cohort. J Affect Disord 2024; 364:146-156. [PMID: 39134154 DOI: 10.1016/j.jad.2024.08.006] [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: 02/12/2024] [Revised: 06/11/2024] [Accepted: 08/09/2024] [Indexed: 08/18/2024]
Abstract
OBJECTIVE The burden of major depressive disorder is compounded by a limited understanding of its risk factors, the limited efficacy of treatments, and the lack of precision approaches to guide treatment selection. The Texas Resilience Against Depression (T-RAD) study was designed to explore the etiology of depression by collecting comprehensive socio-demographic, clinical, behavioral, neurophysiological/neuroimaging, and biological data from depressed individuals (D2K) and youth at risk for depression (RAD). METHODS This report details the baseline sociodemographic, clinical, and functional features from the initial cohort (D2K N = 1040, RAD N = 365). RESULTS Of the total T-RAD sample, n = 1078 (76.73 %) attended ≥2 in-person visits, and n = 845 (60.14 %) attended ≥4 in-person visits. Most D2K (84.82 %) had a primary diagnosis of any depressive disorder, with a bipolar disorder diagnosis being prevalent (13.49 %). RAD participants (75.89 %) did not have a psychiatric diagnosis, but other non-depressive diagnoses were present. D2K participants had 9-item Patient Health Questionnaire scores at or near the moderate range (10.58 ± 6.42 > 24 yrs.; 9.73 ± 6.12 10-24 yrs). RAD participants were in the non-depressed range (2.19 ± 2.65). While the age ranges in D2K and RAD differ, the potential to conduct analyses that compare at-risk and depressed youth is a strength of the study. The opportunity to examine the trajectory of depressive symptoms in the D2K cohort over the lifespan is unique. LIMITATIONS As a longitudinal study, missing data were common. CONCLUSION T-RAD will allow data to be collected from multiple modalities on a clinically well-characterized sample. These data will drive important discoveries on diagnosis, treatment, and prevention of depression.
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Affiliation(s)
- Madhukar H Trivedi
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Manish K Jha
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Joshua S Elmore
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Thomas Carmody
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA; Peter O'Donnel Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Cherise Chin Fatt
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sangita Sethuram
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tianyi Wang
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Taryn L Mayes
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jane A Foster
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Abu Minhajuddin
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA; Peter O'Donnel Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Li T, Chen J, Zhao B, Garden GA, Giovanello KS, Wu G, Zhu H. The Interaction Effects of Sex, Age, APOE and Common Health Risk Factors on Human Brain Functions. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.05.24311482. [PMID: 39148839 PMCID: PMC11326347 DOI: 10.1101/2024.08.05.24311482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
IMPORTANCE Nonlinear changes in brain function during aging are shaped by a complex interplay of factors, including sex, age, genetics, and modifiable health risk factors. However, the combined effects and underlying mechanisms of these factors on brain functional connectivity remain poorly understood. OBJECTIVE To comprehensively investigate the combined associations of sex, age, APOE genotypes, and ten common modifiable health risk factors with brain functional connectivities during aging. DESIGN, SETTING, AND PARTICIPANTS This analysis used data from 36,630 UK Biobank participants, aged 44-81, who were assessed for sex, age, APOE genotypes, 10 health risk factors, and brain functional connectivities through resting-state functional magnetic resonance imaging. MAIN OUTCOMES AND MEASURES Brain functional connectivities were evaluated through within- and between-network functional connectivities and connectivity strength. Associations between risk factors and brain functional connectivities, including their interaction effects, were analyzed. RESULTS Hypertension, BMI, and education were the top three influential factors. Sex-specific effects were also observed in interactions involving APOE4 gene, smoking, alcohol consumption, diabetes, BMI, and education. Notably, a negative sex-excessive alcohol interaction showed a stronger negative effect on functional connectivities in males, particularly between the dorsal attention network and the language network, while moderate alcohol consumption appeared to have protective effects. A significant negative interaction between sex and APOE4 revealed a greater reduction in functional connectivity between the cingulo-opercular network and the posterior multimodal network in male APOE4 carriers. Additional findings included a negative age-BMI interaction between the visual and dorsal attention networks, and a positive age-hypertension interaction between the frontoparietal and default mode networks. CONCLUSIONS AND RELEVANCE The findings highlight significant sex disparities in the associations between age, the APOE4 gene, modifiable health risk factors, and brain functional connectivity, emphasizing the necessity of jointly considering these factors to gain a deeper understanding of the complex processes underlying brain aging.
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Lee HJ, Lee DC, Kim CO. The Association between Serum Lipid Levels and Tinnitus Prevalence and Severity in Korean Elderly: A Nationwide Population-Based Cross-Sectional Study. Yonsei Med J 2024; 65:156-162. [PMID: 38373835 PMCID: PMC10896670 DOI: 10.3349/ymj.2022.0626] [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: 02/08/2023] [Revised: 08/23/2023] [Accepted: 11/07/2023] [Indexed: 02/21/2024] Open
Abstract
PURPOSE We aimed to investigate the association between serum lipid level and tinnitus risk in Korean older adults. MATERIALS AND METHODS This study used data from the 2016-2018 Korea National Health and Nutrition Examination Survey. Overall, 6021 subjects aged ≥60 years were included. Hypertriglyceridemia was defined as a serum triglyceride level of ≥200 mg/dL. The high-risk threshold of the total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) ratio was defined as above 5.0. The presence of tinnitus was assessed via health interviews. Tinnitus severity was classified as "not annoying," "irritating," and "severely annoying and causing sleep problems." Multivariate logistic regression analysis was performed to examine the association between serum lipid level and tinnitus risk. RESULTS The odds ratio (OR) of tinnitus was 1.27-times higher in the group with hypertriglyceridemia than in the group without hypertriglyceridemia after adjusting for age, sex, hypertension, diabetes, dyslipidemia, anemia, current smoking, obesity, noise exposure, stress cognition, and depressive mood or anxiety [95% confidence interval (CI) 1.04-1.56, p=0.022]. The OR of tinnitus was 1.21-times higher in the group with a high TC/HDL-C ratio than in the group without a high TC/HDL-C ratio after adjusting for the same variables as above (95% CI 1.02-1.44, p=0.025). CONCLUSION This study revealed that hypertriglyceridemia and high TC/HDL-C ratio were significantly associated with an increased OR of tinnitus in Korean older adults.
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Affiliation(s)
- Hye Jun Lee
- Department of Family Medicine, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Duk Chul Lee
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea.
| | - Choon Ok Kim
- Department of Clinical Pharmacology, Severance Hospital, Yonsei University Health System, Seoul, Korea.
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Vasan RS, Rao S, van den Heuvel E. Race as a Component of Cardiovascular Disease Risk Prediction Algorithms. Curr Cardiol Rep 2023; 25:1131-1138. [PMID: 37581773 DOI: 10.1007/s11886-023-01938-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 08/16/2023]
Abstract
PURPOSE OF REVIEW Several prediction algorithms include race as a component to account for race-associated variations in disease frequencies. This practice has been questioned recently because of the risk of perpetuating race as a biological construct and diverting attention away from the social determinants of health (SDoH) for which race might be a proxy. We evaluated the appropriateness of including race in cardiovascular disease (CVD) prediction algorithms, notably the pooled cohort equations (PCE). RECENT FINDINGS In a recent investigation, we reported substantial and biologically implausible differences in absolute CVD risk estimates upon using PCE for predicting CVD risk in Black and White persons with identical risk factor profiles, which might result in differential treatment decisions based solely on their race. We recommend the development of raceless CVD risk prediction algorithms that obviate race-associated risk misestimation and racializing treatment practices, and instead incorporate measures of SDoH that mediate race-associated risk differences.
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Affiliation(s)
- Ramachandran S Vasan
- University of Texas School of Public Health and University of Texas Health Sciences Center, 8403 Floyd Curl Drive, Mail Code 7992, San Antonio, TX 78229, USA.
- Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
| | - Shreya Rao
- University of Texas School of Public Health and University of Texas Health Sciences Center, 8403 Floyd Curl Drive, Mail Code 7992, San Antonio, TX 78229, USA
| | - Edwin van den Heuvel
- Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, the Netherlands
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Feinstein MJ. Science and ART-Cardiovascular Disease Risk Assessment in HIV. JAMA Cardiol 2023; 8:107-108. [PMID: 36576806 DOI: 10.1001/jamacardio.2022.4880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Matthew J Feinstein
- Clinical and Translational Immunocardiology Program, Division of Cardiology, Department of Medicine, Department of Pathology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Choi H, Kim SH, Han K, Park TS, Park DW, Moon JY, Kim SH, Kim TH, Sohn JW, Yoon HJ, Lee H. Association between exercise and risk of cardiovascular diseases in patients with non-cystic fibrosis bronchiectasis. Respir Res 2022; 23:288. [PMID: 36258193 PMCID: PMC9580142 DOI: 10.1186/s12931-022-02202-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although cardiovascular comorbidities negatively impact survival in patients with bronchiectasis, there is limited evidence to recommend exercise in this population. We aimed to evaluate whether exercise habit changes are related to reduced cardiovascular disease risk and explore an optimal exercise amount. METHODS This study identified 165,842 patients with newly diagnosed bronchiectasis during 2010-2016 who underwent two health examinations and were followed up until December 2020. The exposure was the change in weekly habits of moderate- or vigorous-intensity physical activity between the two examinations, classified into non-exercisers and exercisers (further classified into new exercisers, exercise dropouts, and exercise maintainers). The amount of exercise was measured using metabolic equivalents of task (MET). The outcome was the incidence of myocardial infarction (MI) or stroke. RESULTS During a mean of 6.2 ± 2.1 follow-up years, 4,233 (2.6%) and 3,745 (2.3%) of patients with bronchiectasis had MI or stroke, respectively. Compared to non-exercisers, exercisers had a significantly lower risk of MI or stroke by 9-28% (p < 0.001 for both). Among exercisers, exercise maintainers showed the lowest risk of MI (adjusted hazard ratio [aHR], 0.72; 95% confidence interval [CI], 0.64-0.81) and stroke (aHR, 0.72; 95% CI, 0.64-0.82) compared to non-exercisers. Regarding exercise amount, a significant risk reduction was observed only in patients with bronchiectasis who exercised for ≥ 500 MET-min/wk. CONCLUSION Exercise was associated with a reduced risk of cardiovascular diseases in patients with bronchiectasis. In particular, the risk was lowest in exercise maintainers, and cardiovascular risk reduction was significant when exercising more than 500 MET-min/wk.
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Affiliation(s)
- Hayoung Choi
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.,Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Sang Hyuk Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Tai Sun Park
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Dong Won Park
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Ji-Yong Moon
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sang-Heon Kim
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Tae-Hyung Kim
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jang Won Sohn
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Ho Joo Yoon
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. .,Divsion of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, 04763, Seoul, Korea.
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Mori R, Miyata M, Kubozono T, Inadome N, Kawasoe S, Ojima S, Kawabata T, Salim AA, Miyahara H, Tokushige K, Ohishi M. Cutoff Values of Brachial-Ankle Pulse Wave Velocity for Atherosclerotic Risks by Age and Sex in the Japanese General Population. J Atheroscler Thromb 2022; 30:481-490. [PMID: 35989299 PMCID: PMC10164604 DOI: 10.5551/jat.63557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM In this study, we aim to analyze the correlation between brachial-ankle pulse wave velocity (baPWV) and Suita score or Framingham risk score and obtain the cutoff value of baPWV by sex and age for cardiovascular risk, as assessed by these scores in the large Japanese annual health checkup data. METHODS In total, 25,602 participants (14,539 men and 11,063 women), who had their annual health checkups, were included in this study. Cutoff values of baPWV for the moderate- and high-risk groups stratified by sex and age were obtained using a receiver operating characteristic (ROC) curve analysis. RESULTS As per our findings, the Suita score demonstrated better correlations with baPWV than the Framingham risk score in both sexes (men, Suita score R2=0.41 and Framingham risk score R2=0.37; women, Suita score R2 =0.54 and Framingham risk score R 2=0.33). The ROC curve analysis demonstrated the cutoff values of baPWV for moderate- and high-risk groups estimated using the Suita score, and they are as follows: in men, the baPWV cutoff values were 1,350 cm/s in the 40s, 1,430 cm/s in the 50s, 1,520 cm/s in the 60s, and 1,880 cm/s in the 70s. In women, the baPWV cutoff values were 1,350 cm/s in the 40s, 1,430 cm/s in the 50s, 1,570 cm/s in the 60s, and 1,800 cm/s in the 70s. CONCLUSIONS We demonstrated that baPWV significantly correlated with the Suita score or Framingham risk score in both men and women, with the former presenting a stronger correlation than the latter. We propose the cutoff values of baPWV for moderate- and high-risk groups estimated using the Suita score.
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Affiliation(s)
- Ryuko Mori
- International Center for Island Studies, Kagoshima University.,School of Health Sciences, Faculty of Medicine, Kagoshima University
| | - Masaaki Miyata
- School of Health Sciences, Faculty of Medicine, Kagoshima University
| | - Takuro Kubozono
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Naoko Inadome
- School of Health Sciences, Faculty of Medicine, Kagoshima University
| | - Shin Kawasoe
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Satoko Ojima
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Takeko Kawabata
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Anwar Ahmed Salim
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | | | | | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
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Haji Aghajani M, Madani Neishaboori A, Ahmadzadeh K, Toloui A, Yousefifard M. The association between apolipoprotein A-1 plasma level and premature coronary artery disease: A systematic review and meta-analysis. Int J Clin Pract 2021; 75:e14578. [PMID: 34181800 DOI: 10.1111/ijcp.14578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/25/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Apolipoprotein A-1 (Apo A-1) is a constituent of high-density lipoprotein (HDL) and emerging evidences put forward a potential association between Apo A-1 plasma levels and premature coronary artery disease (pCAD). The aim of the present study is to gather relative literature and perform a systematic review and meta-analysis regarding the association between serum ApoA-1 levels and pCAD. METHODS Medline (via PubMed), Scopus, Embase and Web of Science databases were searched from the inception of databases until December 7, 2020. All articles reporting the plasma levels of ApoA-1 in patients with pCAD and the control group were included. A meta-analysis with pooled standardised mean difference (SMD) and 95% confidence interval (95% CI) was reported. Subgroup analyses were done based on the observed heterogeneity in results. RESULTS Seventeen case-control studies were included. ApoA-1 plasma level was calculated to be lower in pCAD patients compared with the control group (SMD: -0.67; 95% CI: -0.48 to -0.86; P < .001). The subgroup analysis and meta-regression showed that the variation in gender distribution, the development level of the target population's country and quality score of included studies were the main sources of heterogeneity. It was observed that the relationship was only significant in the developed countries (P < .001). Also, the heterogeneity was reduced when the analysis was limited to males (I2 = 57.2%) and females only (I2 = 26.0%). CONCLUSION In conclusion, there seems to be a significant association between the serum levels of ApoA-1 and pCAD. However, all of the included studies had a case-control design and since there is no good quality and prospective cohort studies included, reliability of the current evidence is debatable. Therefore, further well-designed cohort studies are required to assess the impact of serum ApoA-1 reduction on pCAD onset.
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Affiliation(s)
- Mohammad Haji Aghajani
- Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Cardiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Koohyar Ahmadzadeh
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amirmohammad Toloui
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Yousefifard
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
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Liu G, Lin CJ, Yates CR, Prasad GL. Metabolomic Analysis Identified Reduced Levels of Xenobiotics, Oxidative Stress, and Improved Vitamin Metabolism in Smokers Switched to Vuse Electronic Nicotine Delivery System. Nicotine Tob Res 2021; 23:1133-1142. [PMID: 33165576 PMCID: PMC8274285 DOI: 10.1093/ntr/ntaa225] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 11/02/2020] [Indexed: 12/01/2022]
Abstract
Introduction Switching to noncombustible tobacco products presents an opportunity for
cigarette smokers to potentially reduce the health risks associated with
smoking. Electronic Nicotine Delivery Systems (ENDS) are one such product
because the vapor produced from ENDS contains far fewer toxicants than
cigarette smoke. To investigate the biochemical effects of switching from
smoking to an ENDS, we assessed global metabolomic profiles of smokers in a
7-day confinement clinical study. Methods In the first 2 days of this clinical study, the subjects used their usual
brand of cigarettes and then switched to exclusive ENDS ad libitum use for 5
days. Urine and plasma samples were collected at baseline and 5 days after
switching. The samples were analyzed using a mass spectrometry-based
metabolomic platform. Results Random forest analyses of urine and plasma metabolomic data revealed
excellent predictive accuracy (>97%) of a 30-metabolite signature that
can differentiate smokers from 5-day ENDS switchers. In these signatures,
most biomarkers are nicotine-derived metabolites or xenobiotics. They were
significantly reduced in urine and plasma, suggesting a decreased xenobiotic
load on subjects. Our results also show significantly decreased levels of
plasma glutathione metabolites after switching, which suggests reduced
levels of oxidative stress. In addition, increased urinary and plasma levels
of vitamins and antioxidants were identified, suggesting enhanced
bioavailability due to discontinuation of cigarette smoking and switching to
Vuse ENDS use. Conclusions Our results suggest reduced toxicant exposure, reduced oxidative stress, and
potential beneficial changes in vitamin metabolism within 5 days in smokers
switching to Vuse ENDS. Implications Switching from smoking to exclusive ENDS use in clinical confinement settings
results in significant reduction of nicotine metabolites and other
cigarette-related xenobiotics in urine and plasma of subjects. Significantly
decreased oxidative stress-related metabolites and increased urinary and
plasma levels of vitamin metabolites and antioxidants in 5-day short-term
ENDS switchers suggest less toxic physiological environment for consumers of
ENDS products and potential health benefits if such changes persist.
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Affiliation(s)
- Gang Liu
- RAI Services Company, Winston-Salem, NC
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Kharazmi-Khorassani J, Ghafarian Zirak R, Ghazizadeh H, Zare-Feyzabadi R, Kharazmi-Khorassani S, Naji-Reihani-Garmroudi S, Kazemi E, Esmaily H, Javan-Doust A, Banpour H, Mohammadi-Bajgiran M, Besharatlou MR, Ferns GA, Hashemi M, Ghayour-Mobarhan M. The role of serum monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs) in cardiovascular disease risk. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021049. [PMID: 33988177 PMCID: PMC8182619 DOI: 10.23750/abm.v92i2.9235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 03/27/2020] [Indexed: 11/23/2022]
Abstract
Free fatty acids (FFA) observed as independent risk factors of cardiovascular diseases (CVD). In this study we investigated FFA levels in patients with CVD, and its risk factors. In this case-control study, 214 patients experienced coronary angiography and 222 healthy subjects were enrolled. Participants were categorized into two groups: who had >50% and <30% stenosis were assigned to the angiogram positive (N=90) and negative (N=124) group, respectively. Several risk factors were assessed and the levels of FFAs were determined using gas chromatography. Serum FFA concentrations were compared between healthy and patients with positive and negative angiograms. The association of serum FFA levels with four major risk factors (hypertension, FBG level, high BMI and WHR) were also assessed. Our data showed that median of FFAs was higher in patients than healthy subjects (p<0.0001), such as SFA and n6-FFAs (in patients; 1.59 (1.27) and 1.22 (1.06) and in healthy subjects 0.33 (0.38) and 0.36 (0.35), respectively). According to anthropometric and biochemical data, there were not statistical differences between the groups, except FBG, SBP and hs-CRP that showed significantly higher levels in patients than controls (p<0.0001, p=0.001). Also, lower median levels of total cholesterol, LDL-C, HDL-C and DBP were observed in patients which can due to lipid-lowering medication use like Statins. High serum levels of FFAs are considered as an independent risk factor for CVDs, while various types of FFAs can have different influences on CVD risk factors. Therefore, longitudinal studies are needed to clarify the association between FFAs and CVD risk factors. (www.actabiomedica.it)
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Chung GE, Park HE, Lee H, Choi SY. Clinical significance of increased arterial stiffness associated with atrial fibrillation, according to Framingham risk score. Sci Rep 2021; 11:4955. [PMID: 33654162 PMCID: PMC7925576 DOI: 10.1038/s41598-021-84311-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 01/28/2021] [Indexed: 01/17/2023] Open
Abstract
Atrial fibrillation (AF) is the most common arrhythmia in the elderly. Arterial stiffness may predict the risk of AF, but this relationship has not been fully evaluated. We assessed the association between arterial stiffness and prevalent AF. All subjects who had electrocardiography performed and a cardio-ankle vascular index (CAVI) calculated during a screening examination between 2010 and 2019 were enrolled. To evaluate the association between increased arterial stiffness and AF, we divided the population according to their Framingham risk score (FRS) into low-, intermediate-, and high-risk groups. A total of 8048 subjects were evaluated. The multivariate analysis revealed that increased arterial stiffness was significantly associated with AF prevalence, even after adjusting cardiovascular risk factors [odds ratio (OR) 1.685, 95% confidence interval (CI) 1.908–2.588, p = 0.017]. When we subcategorized the subjects according to their FRS, increased arterial stiffness was significantly associated with AF in the intermediate- and high-risk groups (OR 3.062, 95% CI 1.39-6.740 and OR3.877, 95% CI 1.142-13.167, respectively, BMI adjusted. High arterial stiffness shows a significant association with AF in those with intermediate or high cardiovascular risk, and can be used for further risk stratification of patients.
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Affiliation(s)
- Goh Eun Chung
- Division of Gastroenterology, Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Hyo Eun Park
- Division of Cardiology, Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, 39FL. Gangnam Finance Center 737, Yeoksam-Dong, Gangnam-Gu, Seoul, 135-984, Korea.
| | - Heesun Lee
- Division of Cardiology, Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, 39FL. Gangnam Finance Center 737, Yeoksam-Dong, Gangnam-Gu, Seoul, 135-984, Korea
| | - Su-Yeon Choi
- Division of Cardiology, Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, 39FL. Gangnam Finance Center 737, Yeoksam-Dong, Gangnam-Gu, Seoul, 135-984, Korea
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Chang CC, Yang MH, Liu CT, Chu HL, Lin CY, Yen WJ, Chung CY, Ho SY, Tyan YC. Relationship between Semi-Quantitative Parameters of Thallium-201 Myocardial Perfusion Imaging and Coronary Artery Disease. Diagnostics (Basel) 2020; 10:diagnostics10100772. [PMID: 33007898 PMCID: PMC7600615 DOI: 10.3390/diagnostics10100772] [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: 08/10/2020] [Revised: 09/16/2020] [Accepted: 09/28/2020] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the diagnostic performance of semi-quantitative parameters of thallium-201 myocardial perfusion imaging (MPI) for coronary artery disease (CAD). From January to December 2017, patients were enrolled who had undergone Tl-201 MPI and received cardiac catheterization for coronary artery disease within three months of MPI. Receiver operating characteristics (ROC) analysis was used to determine the optimal cutoff values of semi-quantitative parameters. A comparison of the sensitivity and specificity of these parameters based on different subgroupings was further performed. A total of 130 patients were enrolled for further analysis. Among the collected parameters, the stress total perfusion deficit (sTPD) had the highest value of the area under curve (0.813) under the optimal cutoff value of 3.5%, with a sensitivity and specificity of 73.5% and 74.5%, respectively (p = 0.0000), for the diagnosis of CAD. With further subgrouping analysis based on history of diabetes or dyslipidemia, the sensitivity and specificity showed similar results. Based on the currently collected data and image acquisition conditions, the sTPD parameter has a clinical role for the diagnosis of CAD with a cutoff value of 3.5%.
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Affiliation(s)
- Chin-Chuan Chang
- Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-C.C.); (C.-T.L.); (H.-L.C.); (C.-Y.L.); (W.-J.Y.)
- Department of Electrical Engineering, I-Shou University, Kaohsiung 84001, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Ming-Hui Yang
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan;
| | - Chih-Ting Liu
- Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-C.C.); (C.-T.L.); (H.-L.C.); (C.-Y.L.); (W.-J.Y.)
| | - Hsiu-Lan Chu
- Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-C.C.); (C.-T.L.); (H.-L.C.); (C.-Y.L.); (W.-J.Y.)
| | - Chia-Yang Lin
- Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-C.C.); (C.-T.L.); (H.-L.C.); (C.-Y.L.); (W.-J.Y.)
| | - Wei-Jheng Yen
- Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-C.C.); (C.-T.L.); (H.-L.C.); (C.-Y.L.); (W.-J.Y.)
| | - Chao-Yu Chung
- Department of Chemistry, National Sun Yat-sen University, Kaohsiung 80424, Taiwan;
| | - Sheng-Yow Ho
- Department of Radiation Oncology, Chi Mei Medical Center, Tainan 71004, Taiwan;
- Graduate Institute of Medical Science, Chang Jung Christian University, Tainan 71101, Taiwan
| | - Yu-Chang Tyan
- Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Graduate Institute of Animal Vaccine Technology, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Correspondence:
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13
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Ghazizadeh H, Kathryn Bohn M, Ghaffarian Zirak R, Kamel Khodabandeh A, Zare-Feyzabadi R, Saberi-Karimian M, Timar A, Jaberi N, Mohammadi-Bajgiran M, Sharifan P, Tayefi M, Silakhori S, Emamian M, Oladi MR, Esmaily H, Ferns GA, Adeli K, Ghayour-Mobarhan M. Comprehensive laboratory reference intervals for routine biochemical markers and pro-oxidant-antioxidant balance (PAB) in male adults. J Clin Lab Anal 2020; 34:e23470. [PMID: 32986247 PMCID: PMC7676209 DOI: 10.1002/jcla.23470] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/09/2020] [Accepted: 06/17/2020] [Indexed: 01/05/2023] Open
Abstract
Background Reference values of biochemical markers are influenced by various parameters including age, sex, region, and lifestyle. Hence, we aimed to determine age‐ and BMI‐specific reference intervals (RIs) for important clinical biomarkers in a healthy adult male population from northeastern Iran. This is also the first study to investigate reference values for pro‐oxidant‐antioxidant balance (PAB). Methods Seven hundred and twenty (720) healthy men, aged 20‐60 years, were recruited from Sarakhs in the northeast region of Iran. Reference values for lipid profiles (total cholesterol, triglyceride, HDL‐C and LDL‐C), fasting blood glucose, inflammatory factors (hs‐CRP and PAB), minerals (zinc and copper), uric acid, and blood pressure were measured and statistically analyzed to establish accurate age‐ and BMI‐specific RIs in alignment with CLSI Ep28‐A3 guidelines. Results RIs for lipid profiles, inflammatory factors, minerals, and uric acid required no age partitioning with the exception of fasting blood glucose and blood pressure, which demonstrated significantly higher values in subjects aged 50 years and older. Among these biomarkers, only uric acid, blood pressure, and triglycerides demonstrated statistically significant increases in reference value concentrations with increasing BMI. Conclusion In this study, age‐ and BMI‐specific RIs for several biochemical markers were determined in healthy adult Iranian men. Partitioning by age and BMI was only required for a few analytes with most demonstrating no statistically significant changes with these covariates. These data can be useful to monitor various diseases in male adults with varying BMI in this region and others.
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Affiliation(s)
- Hamideh Ghazizadeh
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mary Kathryn Bohn
- Division of Clinical Biochemistry, Pediatric Laboratory Medicine, CALIPER Program, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada
| | | | - Atieh Kamel Khodabandeh
- Social Determinants of Health Research Center, Mashhad University of Medical sciences, Mashhad, Iran
| | - Reza Zare-Feyzabadi
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Saberi-Karimian
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ameneh Timar
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Naghmeh Jaberi
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Payam Sharifan
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Tayefi
- Norwegian Center for e-health Research, University hospital of North Norway, Tromsø, Norway
| | - Samaneh Silakhori
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Marzieh Emamian
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Reza Oladi
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Social Determinants of Health Research Center, Mashhad University of Medical sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, UK
| | - Khosrow Adeli
- Division of Clinical Biochemistry, Pediatric Laboratory Medicine, CALIPER Program, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
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14
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Fan R, Zhang N, Yang L, Ke J, Zhao D, Cui Q. AI-based prediction for the risk of coronary heart disease among patients with type 2 diabetes mellitus. Sci Rep 2020; 10:14457. [PMID: 32879331 PMCID: PMC7467935 DOI: 10.1038/s41598-020-71321-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 07/27/2020] [Indexed: 11/09/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is one common chronic disease caused by insulin secretion disorder that often leads to severe outcomes and even death due to complications, among which coronary heart disease (CHD) represents the most common and severe one. Given a huge number of T2DM patients, it is thus increasingly important to identify the ones with high risks of CHD complication but the quantitative method is still not available. Here, we first curated a dataset of 1,273 T2DM patients including 304 and 969 ones with or without CHD, respectively. We then trained an artificial intelligence (AI) model using randomly selected 4/5 of the dataset and use the rest data to validate the performance of the model. The result showed that the model achieved an AUC of 0.77 (fivefold cross-validation) on the training dataset and 0.80 on the testing dataset. To further confirm the performance of the presented model, we recruited 1,253 new T2DM patients as totally independent testing dataset including 200 and 1,053 ones with or without CHD. And the model achieved an AUC of 0.71. In addition, we implemented a model to quantitatively evaluate the risk contribution of each feature, which is thus able to present personalized guidance for specific individuals. Finally, an online web server for the model was built. This study presented an AI model to determine the risk of T2DM patients to develop to CHD, which has potential value in providing early warning personalized guidance of CHD risk for both T2DM patients and clinicians.
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Affiliation(s)
- Rui Fan
- Department of Biomedical Informatics, Department of Physiology and Pathophysiology, Center for Noncoding RNA Medicine, MOE Key Lab of Cardiovascular Sciences, School of Basic Medical Sciences, Peking University, 38 Xueyuan Rd, Beijing, 100191, China
| | - Ning Zhang
- Beijing Key Laboratory of Diabetes Research and Care, Center for Endocrine Metabolism and Immune Diseases, Lu He Hospital Capital Medical University, Beijing, 101149, China
| | - Longyan Yang
- Beijing Key Laboratory of Diabetes Research and Care, Center for Endocrine Metabolism and Immune Diseases, Lu He Hospital Capital Medical University, Beijing, 101149, China
| | - Jing Ke
- Beijing Key Laboratory of Diabetes Research and Care, Center for Endocrine Metabolism and Immune Diseases, Lu He Hospital Capital Medical University, Beijing, 101149, China
| | - Dong Zhao
- Beijing Key Laboratory of Diabetes Research and Care, Center for Endocrine Metabolism and Immune Diseases, Lu He Hospital Capital Medical University, Beijing, 101149, China.
| | - Qinghua Cui
- Department of Biomedical Informatics, Department of Physiology and Pathophysiology, Center for Noncoding RNA Medicine, MOE Key Lab of Cardiovascular Sciences, School of Basic Medical Sciences, Peking University, 38 Xueyuan Rd, Beijing, 100191, China.
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15
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de Weck O, Krob D, Lefei L, Lui PC, Rauzy A, Zhang X. Handling the COVID‐19 crisis: Toward an agile model‐based systems approach. SYSTEMS ENGINEERING 2020; 23:sys.21557. [PMCID: PMC7461451 DOI: 10.1002/sys.21557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/22/2020] [Accepted: 07/22/2020] [Indexed: 06/17/2023]
Abstract
The COVID‐19 pandemic has caught many nations by surprise and has already caused millions of infections and hundreds of thousands of deaths worldwide. It has also exposed a deep crisis in modeling and exposed a lack of systems thinking by focusing mainly on only the short term and thinking of this event as only a health crisis. In this paper, authors from several of the key countries involved in COVID‐19 propose a holistic systems model that views the problem from a perspective of human society including the natural environment, human population, health system, and economic system. We model the crisis theoretically as a feedback control problem with delay, and partial controllability and observability. Using a quantitative model of the human population allows us to test different assumptions such as detection threshold, delay to take action, fraction of the population infected, effectiveness and length of confinement strategies, and impact of earlier lifting of social distancing restrictions. Each conceptual scenario is subject to 1000+ Monte‐Carlo simulations and yields both expected and surprising results. For example, we demonstrate through computational experiments that maintaining strict confinement policies for longer than 60 days may indeed be able to suppress lethality below 1% and yield the best health outcomes, but cause economic damages due to lost work that could turn out to be counterproductive in the long term. We conclude by proposing a hierarchical Computerized, Command, Control, and Communications (C4) information system and enterprise architecture for COVID‐19 with real‐time measurements and control actions taken at each level.
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Affiliation(s)
- Olivier de Weck
- Institute for Data, Systems and SocietyMassachusetts Institute of TechnologyCambridgeMassachusetts
| | - Daniel Krob
- Center of Excellence on Systems Architecture Management Economy & Strategy (CESAMES)ParisFrance
| | | | | | - Antoine Rauzy
- Norwegian University of Science & TechnologyTrondheimNorway
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16
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Alqarni MS, Ghunaim AH, Abukhodair AW, Fernandez JA, Bennett SR. Renal Outcome in Patients Undergoing Cardiac Surgery Using Cardiopulmonary Bypass. Cureus 2020; 12:e9015. [PMID: 32775095 PMCID: PMC7406128 DOI: 10.7759/cureus.9015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 07/05/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction Renal dysfunction is a significant variable in determining the outcome of surgery, such as cardiopulmonary bypass graft and valvular replacement, used to treat cardiovascular diseases. In Saudi Arabia, the incidence of renal failure and diabetes is higher than in most western populations. Our aim is to determine the renal outcome of patients who underwent cardiac surgery at King Faisal Cardiac Center from 2014 to 2017. Methods This a retrospective cohort study using a non-probability consecutive sampling technique for selection of the study population to assess the renal outcome in cardiac surgery patients using cardiopulmonary bypass from May 2014 to June 2017 in King Faisal Cardiac Center, Jeddah. Patients older than 18 years of age undergoing cardiac surgery, with available data, were included. Categorical variables were summarized by percentages and frequencies, and continuous variables by means and standard deviations, or medians and interquartile ranges if their distributions were skewed. Logistic regression was done with post-op renal impairment as the dependent variable and pre-op renal dysfunction, age, gender, smoking status, diabetes, hypertension, dyslipidemia, and cardiopulmonary bypass time as independent variables. Results Our sample size included 244 patients who underwent cardiac surgery in this study period; their mean age was 60.5 (SD =7.5) with a mean body mass index (BMI) of 28.62 (SD=5.19). Among our population, 73% (n = 179) were males and 27% (n =66) were females. Two percent (2%) of patients (n = 5) died within 30 days, 4% of patients (n = 10) with temporary dialysis, 8% of patients (n = 19) with postoperative renal dysfunction, and no patients with permanent dialysis. The data showed a significant relationship between levels of creatinine preoperatively and postoperative renal dysfunction (p-value = 0.0001, OR=1.05, 95% CI of 1.031 to 1.064). Conclusion The main predictor of poor renal outcomes for cardiac surgery is preoperative creatinine. While other factors, such as age, gender, body mass index, cardiopulmonary bypass time, diabetes, hypertension, and dyslipidemia, did not show any risk to the postoperative renal outcome.
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Affiliation(s)
- Mohammed S Alqarni
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | | | | | | | - Sean R Bennett
- Anesthesiology, King Faisal Cardiac Center, King Abdullah Medical City, Jeddah, SAU
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17
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Comprehensive phenotyping of depression disease trajectory and risk: Rationale and design of Texas Resilience Against Depression study (T-RAD). J Psychiatr Res 2020; 122:22-32. [PMID: 31918350 DOI: 10.1016/j.jpsychires.2019.12.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/28/2019] [Accepted: 12/05/2019] [Indexed: 12/16/2022]
Abstract
Depression has a chronic and recurrent course often with early onset and is the leading cause of disability worldwide. In contrast to diagnoses for other conditions which rely on precise medical tests, the diagnosis of depression still focuses exclusively on symptom reports. As a result, heterogeneous patient groups are included under broad categories. Furthermore, in the absence of companion diagnostic tests, choosing specific treatments for patients remains imprecise with only one-third of patients entering remission with initial treatment, with others requiring multiple intervention steps to achieve remission. In addition to improving treatment outcomes, disease prevention is essential to reduce overall disease burden. Adolescence is a critical window where complex emotional, social, familial, and biological shifts may predispose to lifelong depression. Thus, personalized medicine, integrating individual variability in genes, brain function, and clinical phenotypes, can offer a comprehensive approach to provide precise diagnosis, novel drug development, optimal treatment assignment, and prevention of illness and its associated burden. Texas Resilience Against Depression study (T-RAD) encompasses two natural history, longitudinal (10 + years), prospective studies (D2K and RAD), each enrolling 2500 participants. The D2K study follows participants (ages 10 years and older) who have a current or past diagnosis of depression or bipolar disorder. The RAD study follows participants aged 10-24 years who are at risk for depression but not yet suffering from the disease. The T-RAD study will help to uncover the socio-demographic, lifestyle, clinical, psychological, and neurobiological factors that contribute to mood disorder onset, recurrence, progression, and differential treatment response.
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Urinary Leukotriene E4and 2,3-Dinor Thromboxane B2Are Biomarkers of Potential Harm in Short-Term Tobacco Switching Studies. Cancer Epidemiol Biomarkers Prev 2019; 28:2095-2105. [DOI: 10.1158/1055-9965.epi-19-0342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 08/22/2019] [Accepted: 09/19/2019] [Indexed: 11/16/2022] Open
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19
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Kruithof AC, Kumar R, Stevens J, de Kam ML, Gautam A, Alikunju S, Padhi BK, Kulkarni S, Raghuvanshi RS, Gandhi R, Burggraaf J, Kamerling IMC. Effect of Food on the Pharmacokinetics of 2 Formulations of DRL-17822, a Novel Selective Cholesteryl Ester Transfer Protein (CETP) Inhibitor, in Healthy Males. Clin Pharmacol Drug Dev 2019; 8:1042-1052. [PMID: 31183985 DOI: 10.1002/cpdd.707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 05/13/2018] [Accepted: 05/16/2019] [Indexed: 01/05/2023]
Abstract
DRL-17822 is a novel selective cholesteryl ester transfer protein inhibitor that showed an increased exposure, including an increase of >20-fold of maximum concentration and area under the plasma concentration-time curve from time zero to the time of the last quantifiable concentration, following a high-fat breakfast using a nanocrystal formulation. To reduce this effect of food, we generated an amorphous solid dispersion formulation. In this study, we compared the food effect of both formulations of DRL-17822 in a 2-part randomized, open-label, 4-way crossover study involving healthy adult males 18-45 years of age. In both parts of the study, 12 subjects received both formulations of DRL-17822 in both the fasted and fed states; a low-fat breakfast was provided in the first part and a high-fat breakfast in the second part. Compared to the nanocrystal formulation, the amorphous solid dispersion formulation substantially increased DRL-17822 exposure in the fasted state, including increased maximum concentration, area under the plasma concentration-time curve from time zero to the time of the last quantifiable concentration, and area under plasma concentration-time curve from time zero to infinity. Following a high-fat breakfast, DRL-17822 exposure was increased to a lesser extent in the amorphous solid dispersion formulation compared to the nanocrystal formulation (P < .001). Moreover, compared to the nanocrystal formulation the amorphous solid dispersion formulation caused a more pronounced increase in high-density lipoprotein in the fasted state. Consuming breakfast increased the effect of DRL-17822 on high-density lipoprotein. Taken together, our results indicate that by improving its formulation, DRL-17822 has a favorable exposure profile and therefore a more predictable food effect profile.
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20
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Niu Z, Tanenbaum H, Kiresich E, Cordola Hsu A, Lei X, Ma Y, Li Z, Xie B. Impact of childhood parent-child relationships on cardiovascular risks in adolescence. Prev Med 2018; 108:53-59. [PMID: 29277412 DOI: 10.1016/j.ypmed.2017.12.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 12/04/2017] [Accepted: 12/13/2017] [Indexed: 10/18/2022]
Abstract
This study aims to determine prospective effects of the childhood parent-child relationships on the development of cardiovascular risks in adolescence. Using available 917 parent-child dyads from the Study of Early Child Care and Youth Development (1991 to 2006), we analyzed the prospective effects of childhood parent-child relationships of Conflict and Closeness, as well as their categorized combinations (Harmonic, Dramatic, Hostile, and Indifferent) on the development of subscapular and triceps skinfold thickness (SST/TST), body mass index (BMI), systolic and diastolic blood pressure (SBP/DBP), and heart rate (HR) during adolescence. We found that higher levels of Conflict in the relationship with mothers (slope=0.05, P<0.001) and fathers (slope=0.04, P=0.03) increased the growth rate of TST among girls during adolescence, but not among boys. The maternal-girl dyadic with higher Conflict scores also increased girl's growth rate of BMI percentile (slope=0.10, P=0.02), though the paternal-boy dyadic with higher Conflict scores decreased boy's growth rate of BMI percentile (slope=-0.13, P=0.04). A Hostile maternal-son relationship lowered boy's growth rate of SBP (slope=-3.15, P<0.001) and DBP (slope=-4.42, P<0.001). A Dramatic maternal-son relationship increased boy's growth rate of SST (slope=0.89, P<0.001) and TST (slope=0.64, P=0.03). Hostile paternal-daughter relationships were positively associated with the growth rate of TST (slope=0.28, P=0.03). Overall, there was a significant influence of childhood parent-child relationships on the development of cardiovascular risks during adolescence, and the effect was further modified by both parents' and child's gender.
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Affiliation(s)
- Zhongzheng Niu
- School of Community and Global Health, Claremont Graduate University, Claremont, CA 91711, USA; Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY 14260, USA.
| | - Hilary Tanenbaum
- School of Community and Global Health, Claremont Graduate University, Claremont, CA 91711, USA
| | - Emily Kiresich
- School of Community and Global Health, Claremont Graduate University, Claremont, CA 91711, USA
| | - Amber Cordola Hsu
- School of Community and Global Health, Claremont Graduate University, Claremont, CA 91711, USA
| | - Xiaomeng Lei
- School of Community and Global Health, Claremont Graduate University, Claremont, CA 91711, USA
| | - Yunsheng Ma
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Zhaoping Li
- Center for Human Nutrition, David Geffen School of Medicine, Department of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, Claremont, CA 91711, USA.
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Rajanandh MG, Suresh S, Manobala K, Nandhakumar R, Jaswanthi G, Neha S. Prediction of cardiovascular risk in cancer patients of South India using WHO/ISH risk prediction charts and Framingham score - A prospective study. J Oncol Pharm Pract 2017; 24:354-358. [PMID: 28454502 DOI: 10.1177/1078155217707334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective Despite the fact that cancer and heart diseases are interconnected, there is lack of information about the prevalence of cardiovascular risk in cancer patients in the South Indian population. With this background, the present study sought to predict the cardiovascular disease in cancer patients. Methods A prospective, cross-sectional study was conducted in the Department of Medical Oncology, Sri Ramachandra University and Hospital, India. Patients' demographic details, medical information, height, weight, body mass index, blood pressure, total cholesterol and HDL-cholesterol were measured. Two risk prediction tools, namely World Health Organization/International Society of hypertension (WHO/ISH) risk prediction charts and Framingham score were used to assess the prevalence of cardiovascular risk over 10 years. Results A total of 70 patients were included for the study. Breast and stomach cancer were found to be most among the study patients. Cardiovascular disease was assessed using WHO/ISH and Framingham risk assessment tool. With respect to WHO/ISH risk, there is a significant difference in gender, type of cancer, smoking status and age between the risk groups. Males have a high risk compared to females, and smokers have a high risk compared to non-smokers. With respect to Framingham score, there is a significant difference in gender, smoking status and systolic blood pressure between the risk groups. Males have a high risk compared to females, and smokers have a high risk compared to non-smokers. A moderate degree of agreement exists between the two risk prediction tools. Conclusion The findings of the study revealed that there is a low risk of cardiovascular disease in cancer patients.
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Affiliation(s)
- M G Rajanandh
- 1 Department of Pharmacy Practice, Faculty of Pharmacy, Sri Ramachandra University, Chennai, India
| | - S Suresh
- 2 Department of Medical Oncology, Sri Ramachandra Medical College and Hospital, Sri Ramachandra University, Chennai, India
| | - K Manobala
- 1 Department of Pharmacy Practice, Faculty of Pharmacy, Sri Ramachandra University, Chennai, India
| | - R Nandhakumar
- 1 Department of Pharmacy Practice, Faculty of Pharmacy, Sri Ramachandra University, Chennai, India
| | - G Jaswanthi
- 1 Department of Pharmacy Practice, Faculty of Pharmacy, Sri Ramachandra University, Chennai, India
| | - S Neha
- 1 Department of Pharmacy Practice, Faculty of Pharmacy, Sri Ramachandra University, Chennai, India
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22
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Hoekstra M. MicroRNA-499-5p: a therapeutic target in the context of cardiovascular disease. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:539. [PMID: 28149900 DOI: 10.21037/atm.2016.11.61] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Menno Hoekstra
- Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Gorlaeus Laboratories, Einsteinweg 55, 2333CC Leiden, The Netherlands
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23
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Businelle MS, Ma P, Kendzor DE, Frank SG, Wetter DW, Vidrine DJ. Using Intensive Longitudinal Data Collected via Mobile Phone to Detect Imminent Lapse in Smokers Undergoing a Scheduled Quit Attempt. J Med Internet Res 2016; 18:e275. [PMID: 27751985 PMCID: PMC5088341 DOI: 10.2196/jmir.6307] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/23/2016] [Accepted: 09/24/2016] [Indexed: 11/14/2022] Open
Abstract
Background Mobile phone‒based real-time ecological momentary assessments (EMAs) have been used to record health risk behaviors, and antecedents to those behaviors, as they occur in near real time. Objective The objective of this study was to determine if intensive longitudinal data, collected via mobile phone, could be used to identify imminent risk for smoking lapse among socioeconomically disadvantaged smokers seeking smoking cessation treatment. Methods Participants were recruited into a randomized controlled smoking cessation trial at an urban safety-net hospital tobacco cessation clinic. All participants completed in-person EMAs on mobile phones provided by the study. The presence of six commonly cited lapse risk variables (ie, urge to smoke, stress, recent alcohol consumption, interaction with someone smoking, cessation motivation, and cigarette availability) collected during 2152 prompted or self-initiated postcessation EMAs was examined to determine whether the number of lapse risk factors was greater when lapse was imminent (ie, within 4 hours) than when lapse was not imminent. Various strategies were used to weight variables in efforts to improve the predictive utility of the lapse risk estimator. Results Participants (N=92) were mostly female (52/92, 57%), minority (65/92, 71%), 51.9 (SD 7.4) years old, and smoked 18.0 (SD 8.5) cigarettes per day. EMA data indicated significantly higher urges (P=.01), stress (P=.002), alcohol consumption (P<.001), interaction with someone smoking (P<.001), and lower cessation motivation (P=.03) within 4 hours of the first lapse compared with EMAs collected when lapse was not imminent. Further, the total number of lapse risk factors present within 4 hours of lapse (mean 2.43, SD 1.37) was significantly higher than the number of lapse risk factors present during periods when lapse was not imminent (mean 1.35, SD 1.04), P<.001. Overall, 62% (32/52) of all participants who lapsed completed at least one EMA wherein they reported ≥3 lapse risk factors within 4 hours of their first lapse. Differentially weighting lapse risk variables resulted in an improved risk estimator (weighted area=0.76 vs unweighted area=0.72, P<.004). Specifically, 80% (42/52) of all participants who lapsed had at least one EMA with a lapse risk score above the cut-off within 4 hours of their first lapse. Conclusions Real-time estimation of smoking lapse risk is feasible and may pave the way for development of mobile phone‒based smoking cessation treatments that automatically tailor treatment content in real time based on presence of specific lapse triggers. Interventions that identify risk for lapse and automatically deliver tailored messages or other treatment components in real time could offer effective, low cost, and highly disseminable treatments to individuals who do not have access to other more standard cessation treatments.
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Affiliation(s)
- Michael S Businelle
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.
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Saxena K, Liang Q, Muhammad-Kah R, Sarkar M. Evaluating the relationship between biomarkers of potential harm and biomarkers of tobacco exposure among current, past, and nonsmokers: data from the National Health and Nutrition Examination Survey 2007-2012. Biomarkers 2016; 22:403-412. [PMID: 27321022 DOI: 10.1080/1354750x.2016.1201536] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Potential long-term health effects from tobacco products can be estimated by measuring changes in biochemical indicators of disease mechanisms like inflammation. This study assesses the potential relationships between biomarkers of potential harm (BOPH) and biomarkers of cigarette smoke exposure (BOE) based on data from the NHANES (2007-2012, n = 17,293 respondents). Statistically significant relationships were observed between white blood cells (WBC) and high-density lipoprotein (HDL) and BOE; between WBC and high-sensitivity C-reactive protein and smoking status; and between WBC and HDL and smoking intensity. This analysis suggests that WBC and HDL are useful BOPH in studies assessing the health risks of cigarette smoking.
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Affiliation(s)
- Kunal Saxena
- a School of Pharmacy, Virginia Commonwealth University , Richmond , VA , USA
| | - Qiwei Liang
- b Altria Client Services LLC , Richmond , VA , USA
| | | | - Mohamadi Sarkar
- a School of Pharmacy, Virginia Commonwealth University , Richmond , VA , USA.,b Altria Client Services LLC , Richmond , VA , USA
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Yoshida A, Jinnouchi H, Sugiyama S, Hirose J, Segata T, Furuta K, Katahira K, Kajiwara K, Hieshima K, Jinnouchi T, Usuku K. Combined arteriosclerotic assessment of ankle-brachial index and maximum intima-media thickness via CCTA is useful for predicting coronary artery stenosis in patients with type 2 diabetes. Diabetes Res Clin Pract 2016; 117:91-9. [PMID: 27329027 DOI: 10.1016/j.diabres.2016.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 03/24/2016] [Accepted: 04/15/2016] [Indexed: 10/21/2022]
Abstract
AIMS Patients with diabetes mellitus (DM) are likely to develop asymptomatic myocardial infarction as a complication. However, coronary artery lesions are difficult to assess in internal medicine. This study aimed to develop a prediction formula for coronary artery stenosis, as determined by coronary computed tomographic angiography (CCTA), by analyzing risk factors in patients with type 2 DM. METHODS A prediction formula was developed based on a multivariate analysis of common factors in patients with ⩾50% coronary artery stenosis in a cohort of 327 patients with type 2 DM who underwent CCTA between 2007 and 2009, and cutoff values were calculated (derivation study). The validity of the optimal cutoff value was confirmed in a separate cohort of 317 patients with type 2 DM who underwent CCTA between 2010 and 2011 (validation study). RESULTS In the derivation study, five predictive factors (presence/absence of hypertension, estimated glomerular filtration rate, maximum intima-media thickness [max-IMT], ankle-brachial index [ABI], and use/nonuse of diabetic medication) were used to develop a prediction formula. In the validation study, positive predictive value (PPV) and negative predictive value (NPV) of the cutoff value derived from the prediction formula were 53% and 73%, respectively. CONCLUSIONS We developed a novel formula to predict coronary artery stenosis using five predictive factors. This formula is useful for determining whether computed tomography (CT) examination is necessary, even in clinical settings without CCTA equipment. Early detection of coronary artery stenosis in patients with DM may also lead to better health outcomes.
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Affiliation(s)
- Akira Yoshida
- Jinnouchi Clinic, 6-2-3 Kuhonji, Chuo-ku, Kumamoto 862-0976, Japan; Department of Medical Information Sciences and Administration Planning, Kumamoto University Hospital, 1-1-1 honjo, Chuo-ku, 860-8556 Kumamoto, Japan.
| | | | - Seigo Sugiyama
- Jinnouchi Clinic, 6-2-3 Kuhonji, Chuo-ku, Kumamoto 862-0976, Japan
| | - Jun Hirose
- Department of Medical Information Sciences and Administration Planning, Kumamoto University Hospital, 1-1-1 honjo, Chuo-ku, 860-8556 Kumamoto, Japan
| | - Tateki Segata
- Department of Medical Information Sciences and Administration Planning, Kumamoto University Hospital, 1-1-1 honjo, Chuo-ku, 860-8556 Kumamoto, Japan
| | - Kazue Furuta
- Jinnouchi Clinic, 6-2-3 Kuhonji, Chuo-ku, Kumamoto 862-0976, Japan
| | - Kazuhiro Katahira
- Department of Diagnostic Radiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Minami-ku, Kumamoto 862-0965, Japan
| | - Keizo Kajiwara
- Jinnouchi Clinic, 6-2-3 Kuhonji, Chuo-ku, Kumamoto 862-0976, Japan
| | - Kunio Hieshima
- Jinnouchi Clinic, 6-2-3 Kuhonji, Chuo-ku, Kumamoto 862-0976, Japan
| | - Tomio Jinnouchi
- Jinnouchi Clinic, 6-2-3 Kuhonji, Chuo-ku, Kumamoto 862-0976, Japan
| | - Koichiro Usuku
- Department of Medical Information Sciences and Administration Planning, Kumamoto University Hospital, 1-1-1 honjo, Chuo-ku, 860-8556 Kumamoto, Japan
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Tsai CH, Lin CL, Hsu HC, Chung WS. Increased risk of coronary heart disease in patients with hip fracture: a nationwide cohort study. Osteoporos Int 2015; 26:1849-55. [PMID: 25801182 DOI: 10.1007/s00198-015-3097-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 03/03/2015] [Indexed: 10/23/2022]
Abstract
UNLABELLED The study indicates that hip fracture is independently associated with increased risk of coronary heart disease. In addition, the highest risk of coronary heart disease following hip fracture appeared within the first year after hip fracture, indicating the need for multidisciplinary care for the patients. INTRODUCTION Bone and vasculature are modulated through numerous common pathways. However, data on the risk of coronary heart disease (CHD) after hip fracture are scarce. Therefore, we investigated whether hip fracture increased the risk of CHD by conducting a large nationwide cohort study. METHODS Using universal insurance claims data from 2000 to 2010, we identified a study cohort of 6013 participants newly diagnosed with hip fracture and a control cohort of 23,802 participants. Both cohorts were followed up to the end of 2011 to evaluate the risk of CHD. RESULTS The overall incidence of CHD was 1.69-fold higher in the hip fracture cohort than it was in the control cohort (29.2 vs. 17.1 per 1000 person-years) with an adjusted hazard ratio of 1.51 (95 % confidence interval [CI] = 1.39-1.65). Sex-, age-, and comorbidity-specific analyses showed a higher relative risk of CHD for both women and men, all age groups, those with and without comorbidities, and patients with hip fracture compared with the control cohort. The highest risk of CHD was within the first year after hip fracture (adjusted HR = 1.72, 95 % CI = 1.45-2.04), and the risk remained high in the following years. CONCLUSION Hip fracture was independently associated with a subsequent risk of CHD.
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Affiliation(s)
- C-H Tsai
- Graduate Institute of Clinical Medicine, China Medical University, Taichung, Taiwan
- Department of Orthopedics, China Medical University Hospital, Taichung, Taiwan
| | - C-L Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - H-C Hsu
- Graduate Institute of Clinical Medicine, China Medical University, Taichung, Taiwan
- Department of Orthopedics, China Medical University Hospital, Taichung, Taiwan
| | - W-S Chung
- Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, No. 199, Section 1, San-Min Road, Taichung City, 40343, Taiwan.
- Department of Health Services Administration, China Medical University, Taichung, Taiwan.
- Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.
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Lee YA, Kang SG, Song SW, Rho JS, Kim EK. Association between metabolic syndrome, smoking status and coronary artery calcification. PLoS One 2015; 10:e0122430. [PMID: 25816100 PMCID: PMC4376803 DOI: 10.1371/journal.pone.0122430] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 02/12/2015] [Indexed: 11/19/2022] Open
Abstract
Coronary artery calcification (CAC), an indicator of coronary artery stenosis, is an independent risk factor of ischemic heart disease. Smoking increases the risk of metabolic syndrome (MS) and cardiovascular disease. Almost no previous studies have evaluated the combined effect of MS and smoking status on CAC. Therefore, in this study we examined the relationships between CAC, MS, and smoking. This study included 775 adult males without histories of cardiovascular disease who visited the Health Promotion Center at the University Hospital in Gyeonggi-do, Republic of Korea from January 2, 2010 to December 31, 2012. All subjects were screened for CAC by multi-detector computed tomography (MDCT). CAC increased significantly with age and body mass index (BMI). Among MS components, abdominal obesity and elevated fasting blood glucose were correlated with CAC. After adjusting for age and BMI, MS was associated with a 1.46-fold increase in CAC (95% CI:1.02-2.09), abdominal obesity was associated with a 1.45-fold increase (95% CI:1.04-2.04), elevated fasting blood glucose was associated with a 2-fold increase (95% CI:1.36-2.94), and MS and smoking combined were associated with 2.44-fold increase in CAC. Thus, the combination of smoking and MS had a greater impact on CAC than any single factor alone. MS is correlated with an increased risk of CAC, and a combination of MS and smoking is associated with even greater risk. These findings can be used to prevent cardiovascular disease in adults.
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Affiliation(s)
- Yun-Ah Lee
- Department of Family Medicine, College of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Republic of Korea
| | - Sung-Goo Kang
- Department of Family Medicine, College of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Republic of Korea
- * E-mail:
| | - Sang-Wook Song
- Department of Family Medicine, College of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Republic of Korea
- Health Promotion Center, College of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Republic of Korea
| | - Jun-Seung Rho
- Department of Family Medicine, College of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Republic of Korea
| | - Eun-Kyung Kim
- Health Promotion Center, College of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Republic of Korea
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Kondo H, Ninomiya T, Hata J, Hirakawa Y, Yonemoto K, Arima H, Nagata M, Tsuruya K, Kitazono T, Kiyohara Y. Angiotensin I-Converting Enzyme Gene Polymorphism Enhances the Effect of Hypercholesterolemia on the Risk of Coronary Heart Disease in a General Japanese Population: The Hisayama Study. J Atheroscler Thromb 2015; 22:390-403. [DOI: 10.5551/jat.24166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Hideki Kondo
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Toshiharu Ninomiya
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
| | - Jun Hata
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
| | - Yoichiro Hirakawa
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University
- The George Institute for Global Health, University of Sydney
| | | | - Hisatomi Arima
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | - Masaharu Nagata
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Kazuhiko Tsuruya
- Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Yutaka Kiyohara
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University
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Budczies J, von Winterfeld M, Klauschen F, Kimmritz AC, Daniel JM, Warth A, Endris V, Denkert C, Pfeiffer H, Weichert W, Dietel M, Wittschieber D, Stenzinger A. Comprehensive analysis of clinico-pathological data reveals heterogeneous relations between atherosclerosis and cancer. J Clin Pathol 2014; 67:482-90. [PMID: 24519989 DOI: 10.1136/jclinpath-2013-202148] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
AIMS Atherosclerosis and cancer share common risk factors and involve similar molecular pathomechanisms. Most clinical and epidemiological studies show a positive correlation between atherosclerosis and smoking-related cancers and heterogeneous results for non-smoking-related cancers. However, up-to-date large-scale autopsy studies including a detailed analysis of cancer types are lacking. Therefore, we sought to investigate the relation between major cancer types and the grade of atherosclerosis in a recent well-powered autopsy cohort. METHODS In 2101 patients, both autopsy data and clinical data including demographics, disease groups, tumour type, cause of death and grade of atherosclerosis were reviewed and statistically analysed. RESULTS We found cancer in general is associated with less atherosclerosis (OR 0.60, p<0.0001). In particular, haematological neoplasm and sarcomas were associated with much less atherosclerosis (OR=0.45, p<0.0001 and OR=0.43, p=0.087), while carcinomas were associated with moderately less atherosclerosis (OR=0.72, p=0.002). Furthermore, non-smoking-related cancers were associated with much less atherosclerosis (OR=0.41, p<0.0001), while possibly smoking-related cancer and smoking-related cancer showed no significant association. In a comprehensive analysis of 21 cancer types, biliary tract cancer, lymphomas/lymphoid leukaemias and kidney cancer were associated with much less atherosclerosis (OR=0.19, p<0.0001; OR=0.41, p<0.0001; and OR=0.48, p=0.029). In an exploratory analysis of treatment strategies, we found that tumours with a recommendation of oxazaphosphorines and pyrimidine antagonist treatment were significantly associated with less atherosclerosis (OR=0.33, p=0.0068 and OR=0.58, p=0.012). CONCLUSIONS In conclusion, the study showed an inverse association between cancer and atherosclerosis postmortem that depends on the cancer type and suggests a possible impact of chemotherapy regimens.
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Affiliation(s)
- Jan Budczies
- Institute of Pathology, Charité University Hospital, Berlin, Germany
| | | | | | | | - Jan-Marcus Daniel
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Arne Warth
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Volker Endris
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Carsten Denkert
- Institute of Pathology, Charité University Hospital, Berlin, Germany
| | - Heidi Pfeiffer
- Institute of Legal Medicine, University Hospital Münster, Münster, Germany
| | - Wilko Weichert
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Manfred Dietel
- Institute of Pathology, Charité University Hospital, Berlin, Germany
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Okutsu M, Lira VA, Higashida K, Peake J, Higuchi M, Suzuki K. Corticosterone accelerates atherosclerosis in the apolipoprotein E-deficient mouse. Atherosclerosis 2014; 232:414-9. [DOI: 10.1016/j.atherosclerosis.2013.11.076] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 11/18/2013] [Accepted: 11/20/2013] [Indexed: 01/23/2023]
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Prentice RL, Zhao S, Johnson M, Aragaki A, Hsia J, Jackson RD, Rossouw JE, Manson JE, Hanash SM. Proteomic risk markers for coronary heart disease and stroke: validation and mediation of randomized trial hormone therapy effects on these diseases. Genome Med 2013; 5:112. [PMID: 24373343 PMCID: PMC3971342 DOI: 10.1186/gm517] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 12/17/2013] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND We previously reported mass spectrometry-based proteomic discovery research to identify novel plasma proteins related to the risk of coronary heart disease (CHD) and stroke, and to identify proteins with concentrations affected by the use of postmenopausal hormone therapy. Here we report CHD and stroke risk validation studies for highly ranked proteins, and consider the extent to which protein concentration changes relate to disease risk or provide an explanation for hormone therapy effects on these outcomes. METHODS Five proteins potentially associated with CHD (beta-2 microglobulin (B2M), alpha-1-acid glycoprotein 1 (ORM1), thrombospondin-1(THBS1), complement factor D pre-protein (CFD), and insulin-like growth factor binding protein 1 (IGFBP1)) and five potentially associated with stroke (B2M, IGFBP2, IGFBP4, IGFBP6, and hemopexin (HPX)) had high discovery phase significance level ranking and an available ELISA assay, and were included in case-control validation studies within the Women's Health Initiative (WHI) hormone therapy trials. Protein concentrations, at baseline and 1 year following randomization, were assessed for 358 CHD cases and 362 stroke cases, along with corresponding disease-free controls. Disease association, and mediation of estrogen-alone and estrogen plus progestin effects on CHD and stroke risk, were assessed using logistic regression. RESULTS B2M, THBS1, and CFD were confirmed (P <0.05) as novel CHD risk markers, and B2M, IGFBP2, and IGFBP4 were confirmed as novel stroke disease risk markers, while the assay for HPX proved to be unreliable. The change from baseline to 1 year in B2M was associated (P <0.05) with subsequent stroke risk, and trended similarly with subsequent CHD risk. Change from baseline to 1 year in IGFBP1 was also associated with CHD risk, and this change provided evidence of hormone therapy effect mediation. CONCLUSIONS Plasma B2M is confirmed to be an informative risk marker for both CHD and stroke. The B2M increase experienced by women during the first year of hormone therapy trial participation conveys cardiovascular disease risk. The increase in IGFBP1 similarly conveys CHD risk, and the magnitude of the IGFBP1 increase following hormone therapy may be a mediator of hormone therapy effects. Plasma THBS1 and CFD are confirmed as CHD risk markers, and plasma IGFBP4 and IGFBP2 are confirmed as stroke risk markers. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov identifier: NCT00000611.
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Affiliation(s)
- Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, P.O. Box 19024, Seattle, WA 98109, USA
| | - Shanshan Zhao
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, P.O. Box 19024, Seattle, WA 98109, USA
| | - Melissa Johnson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, P.O. Box 19024, Seattle, WA 98109, USA
| | - Aaron Aragaki
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, P.O. Box 19024, Seattle, WA 98109, USA
| | - Judith Hsia
- Research and Development, AstraZeneca LP, 1971 Rockland Road, Wilmington, DE 19803, USA
| | - Rebecca D Jackson
- Division of Endocrinology, The Ohio State University, 376 West Tenth Avenue, Suite 205, Columbus, OH 43210, USA
| | - Jacques E Rossouw
- WHI Project Office, National Heart, Lung, and Blood Institute, National Institutes of Health, 6701 Rockledge Drive, Bethesda, MD 20892, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, 900 Commonwealth Avenue, Boston, MA 02215, USA
| | - Samir M Hanash
- Department of Clinical Cancer Prevention, Red and Charline McCombs Institute for the Early Detection and Treatment of Cancer, The University of Texas MD Anderson Cancer Center, 6767 Bertner Street, Houston, TX 77030, USA
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Lautenbach DM, Christensen KD, Sparks JA, Green RC. Communicating genetic risk information for common disorders in the era of genomic medicine. Annu Rev Genomics Hum Genet 2013; 14:491-513. [PMID: 24003856 DOI: 10.1146/annurev-genom-092010-110722] [Citation(s) in RCA: 119] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Communicating genetic risk information in ways that maximize understanding and promote health is increasingly important given the rapidly expanding availability and capabilities of genomic technologies. A well-developed literature on risk communication in general provides guidance for best practices, including presentation of information in multiple formats, attention to framing effects, use of graphics, sensitivity to the way numbers are presented, parsimony of information, attentiveness to emotions, and interactivity as part of the communication process. Challenges to communicating genetic risk information include deciding how best to tailor it, streamlining the process, deciding what information to disclose, accepting that communications may have limited influence, and understanding the impact of context. Meeting these challenges has great potential for empowering individuals to adopt healthier lifestyles and improve public health, but will require multidisciplinary approaches and collaboration.
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Ahmed AA, Alsharief E, Alsharief A. Evaluation of risk factors for cardiovascular diseases among Saudi diabetic patients attending primary health care service. Diabetes Metab Syndr 2013; 7:133-137. [PMID: 23953177 DOI: 10.1016/j.dsx.2013.06.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cardiovascular disease is currently the primary cause of morbidity and mortality in patients with diabetes. For each risk factor present, the risk of cardiovascular death is about three times greater in people with diabetes than people without diabetes. OBJECTIVES To determine the risk factors for cardiovascular disease among patients with type 2 diabetes. To stratify the patients into risk categories to develop coronary arteries disease (CAD) based on the British Joint Societies risk chart. To assess the awareness and implementation of the risk assessment charts by primary care physicians SUBJECT AND METHODS Cross sectional study was designed. Sixty six (66 patients) diabetic patients were selected randomly by simple selection, from them 29 were males and 37 were females. Patients' medical records were reviewed. The following parameters were detected; blood pressure, lipid profile, weight, height, smoking and degree of glycemic control. A questionnaire was designed and distributed to randomly selected physicians working in primary health care assessed their awareness and implementation of risk assessment charts was done. RESULTS Uncontrolled diabetes was found to be the common risk factor followed by uncontrolled lipid profile, obesity, uncontrolled systolic blood pressure and smoking. Seven percent (7%) of male group felled in highest risk group in comparison with 1% in female group (P<0.05), while 31% in male group felled in mild risk group in comparison with 90% in female group (P<0.05). Sixty two percent (62%) in male group felled in high risk group in comparison with 9% in female group (P<0.05). Criteria for ranking in risk class differed between male and female group. Forty one physicians were contacted and received the questionnaire. Twenty nine (70.7%) physicians were responded to the questionnaire. Twenty two (22) informed that they were aware about risk assessment score systems. Fourteen (14) physicians informed that they were aware about the BJSs charts but only two informed that they had used it to assess their patients. CONCLUSION Clustering of multi risk factors is a serious event which may raise the risk category of diabetic patients. For each risk category the risk factors may differed between male and female patients. More studies are recommended to study distribution of risk factors between male and female diabetic patients. Attention should be directed toward raising the awareness about the risk assessment scoring system and encouraging physicians to use it.
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Yeh HL, Kuo LT, Sung FC, Chiang CW, Yeh CC. GSTM1, GSTT1, GSTP1, and GSTA1 genetic variants are not associated with coronary artery disease in Taiwan. Gene 2013; 523:64-9. [PMID: 23570881 DOI: 10.1016/j.gene.2013.02.052] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 01/18/2013] [Accepted: 02/13/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND OBJECTIVE The genetic variants of xenobiotic-metabolizing enzymes, such as those encoded by glutathione-S-transferase (GST) genes, may be associated with the risk of coronary artery disease (CAD). To investigate the genetic factors for CAD, we examined the GSTM1, GSTT1, GSTP1, and GSTA1 genotypes in a CAD cohort in Taiwan. METHODS Our study included 458 CAD participants and 209 control participants who received coronary angiography to assess CAD. The severity of CAD was defined as the number of coronary vessels with 50% or greater stenosis. Sequence variation of the GSTM1 and GSTT1 genes was determined using a polymerase chain reaction (PCR). The GSTP1 (Ile105Val), and GSTA1 (-69C>T) genetic variants were identified using a combination of PCR and restriction fragment length polymorphism analysis. Logistic regression analysis was used to calculate the odds ratios (ORs) and 95% confidence intervals. RESULTS Among the GST genetic variants examined, the GSTT1 null genotype was more prevalent in CAD participants with 3 stenosed vessels than in control participants (OR=1.64, P=.02). This association was no longer observed after adjusting for age, sex, smoking, alcohol use, diabetes mellitus, and serum levels of total cholesterol and high-density lipoprotein cholesterol (OR=1.28, P=.40). Both univariate and multivariate logistic regression analyses found no significant associations between CAD and the other genetic variants, either separately or in combination. In addition, no effects of interactions between the genotypes and environmental factors, such as cigarette smoking, were significantly associated with the risk of CAD. CONCLUSION The GST genetic variants examined were not associated with susceptibility to CAD in our Taiwanese cohort. This null association requires further confirmation with larger samples.
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Affiliation(s)
- Hseng-Long Yeh
- School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
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Bansal A, Pepe MS. Estimating improvement in prediction with matched case-control designs. LIFETIME DATA ANALYSIS 2013; 19:170-201. [PMID: 23358916 PMCID: PMC3664641 DOI: 10.1007/s10985-012-9237-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 11/26/2012] [Indexed: 06/01/2023]
Abstract
When an existing risk prediction model is not sufficiently predictive, additional variables are sought for inclusion in the model. This paper addresses study designs to evaluate the improvement in prediction performance that is gained by adding a new predictor to a risk prediction model. We consider studies that measure the new predictor in a case-control subset of the study cohort, a practice that is common in biomarker research. We ask if matching controls to cases in regards to baseline predictors improves efficiency. A variety of measures of prediction performance are studied. We find through simulation studies that matching improves the efficiency with which most measures are estimated, but can reduce efficiency for some. Efficiency gains are less when more controls per case are included in the study. A method that models the distribution of the new predictor in controls appears to improve estimation efficiency considerably.
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Affiliation(s)
- Aasthaa Bansal
- Department of Biostatistics, University of Washington, Seattle, WA 98195, USA
| | - Margaret Sullivan Pepe
- Department of Biostatistics, University of Washington, Seattle, WA 98195, USA. Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, M2-B500, Seattle, WA 98109, USA
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D'Agostino RB, Pencina MJ, Massaro JM, Coady S. Cardiovascular Disease Risk Assessment: Insights from Framingham. Glob Heart 2013; 8:11-23. [PMID: 23750335 PMCID: PMC3673738 DOI: 10.1016/j.gheart.2013.01.001] [Citation(s) in RCA: 173] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Cardiovascular disease (CVD) is among the leading causes of death and disability worldwide. Since its beginning, the Framingham study has been a leader in identifying CVD risk factors. Clinical trials have demonstrated that when the modifiable risk factors are treated and corrected, the chances of CVD occurring can be reduced. The Framingham study also recognized that CVD risk factors are multifactorial and interact over time to produce CVD. In response, Framingham investigators developed the Framingham Risk Functions (also called Framingham Risk Scores) to evaluate the chance or likelihood of developing CVD in individuals. These functions are multivariate functions (algorithms) that combine the information in CVD risk factors such as sex, age, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, smoking behavior, and diabetes status to produce an estimate (or risk) of developing CVD or a component of CVD (such as coronary heart disease, stroke, peripheral vascular disease, or heart failure) over a fixed time, for example, the next 10 years. These estimates of CVD risk are often major inputs in recommending drug treatments such as cholesterol-lowering drugs.
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Affiliation(s)
- Ralph B D'Agostino
- Mathematics and Statistics Department, Boston University, Boston, MA, USA ; Framingham Study, Framingham, MA, USA ; Biostatistics Department, Boston University, Boston, MA, USA
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W van Lammeren G, L Moll F, Borst GJD, de Kleijn DPV, P M de Vries JP, Pasterkamp G. Atherosclerotic plaque biomarkers: beyond the horizon of the vulnerable plaque. Curr Cardiol Rev 2012; 7:22-7. [PMID: 22294971 PMCID: PMC3131712 DOI: 10.2174/157340311795677680] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Revised: 10/16/2010] [Accepted: 01/07/2011] [Indexed: 01/28/2023] Open
Abstract
Cardiovascular disease (CVD) is the number one cause of death globally, and the majority of CVD is caused by atherosclerosis. Atherosclerosis is a systemic inflammatory disease that leads to myocardial infarction, stroke and lower limb ischemia. Pathological studies have given insight to development of atherosclerosis and the importance of local plaque vulnerability, leading to thrombus formation and cardiovascular events. Due to the burden of cardiovascular disease, identification of patients at risk for cardiovascular events and treatment stratification is needed. The predictive power of classical risk factors is limited, especially in patients with manifest atherosclerosis. Imaging modalities have focused on the characteristics of the vulnerable plaque. However, it has become evident that not all so-called vulnerable plaques lead to rupture and subsequent thrombosis. The latter obviously limits the positive predictive value for imaging assessment of plaques and patients at risk. Serum biomarkers have also been studied extensively, but have very limited application in a clinical setting for risk stratification. In line with the important relation between vulnerable plaques and cardiovascular events, plaque biomarker studies have been initiated. These longitudinal studies are based on the concept, that a vulnerable plaque contains predictive information for future cardiovascular events, also in other territories of the vascular tree. Results look promising and plaque markers can be used to develop imaging modalities to identify patients at risk, or to monitor treatment effect. Plaque biomarker studies do not challenge the definition of the vulnerable plaque, but use its concept in favor of prediction improvement for vascular patients.
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Affiliation(s)
- Guus W van Lammeren
- Experimental Cardiology Laboratory, University Medical Center Utrecht, The Netherlands
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Almeida-Pititto BD, Griffin SJ, Sharp SJ, Hirai AT, Gimeno SGA, Ferreira SRG. A behavioral intervention in a cohort of Japanese-Brazilians at high cardiometabolic risk. Rev Saude Publica 2012; 46:602-9. [PMID: 22735273 DOI: 10.1590/s0034-89102012005000045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To assess the effect of a health promotion program on cardiometabolic risk profile in Japanese-Brazilians. METHODS A total of 466 subjects from a study on diabetes prevalence conducted in the city of Bauru, southeastern Brazil, in 2000 completed a 1-year intervention program (2005-2006) based on healthy diet counseling and physical activity. Changes in blood pressure and metabolic parameters in the 2005-2006 period were compared with annual changes in these same variables in the 2000-2005 period. RESULTS During the intervention, there were greater annual reductions in mean (SD) waist circumference [-0.5(3.8) vs. 1.2(1.2) cm per year, p<0.001], systolic blood pressure [-4.6(17.9) vs. 1.8(4.3) mmHg per year, p<0.001], 2-hour plasma glucose [-1.2(2.1) vs. -0.2(0.6) mmol/L per year, p<0.001], LDL-cholesterol [-0.3(0.9) vs. -0.1(0.2) mmol/L per year, p<0.001] and Framingham coronary heart disease risk score [-0.25(3.03) vs. 0.11(0.66) per year, p=0.02] but not in triglycerides [0.2(1.6) vs. 0.1(0.42) mmol/L per year, p<0.001], and fasting insulin level [1.2(5.8) vs. -0.7(2.2) IU/mL per year, p<0.001] compared with the pre-intervention period. Significant reductions in the prevalence of impaired fasting glucose/impaired glucose tolerance and diabetes were seen during the intervention (from 58.4% to 35.4%, p<0.001; and from 30.1% to 21.7%, p= 0.004, respectively). CONCLUSIONS A one-year community-based health promotion program brings cardiometabolic benefits in a high-risk population of Japanese-Brazilians.
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Affiliation(s)
- Bianca de Almeida-Pititto
- Departamento de Nutrição em Saúde Pública, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil.
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Li Q, Wei XL, Yin RX. Association of ATP binding cassette transporter G8 rs4148217 SNP and serum lipid levels in Mulao and Han nationalities. Lipids Health Dis 2012; 11:46. [PMID: 22548731 PMCID: PMC3416707 DOI: 10.1186/1476-511x-11-46] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2012] [Accepted: 04/20/2012] [Indexed: 11/29/2022] Open
Abstract
Background The association of ATP binding cassette transporter G8 gene (ABCG8) rs4148217 single nucleotide polymorphism (SNP) and serum lipid profiles is still controversial in diverse racial/ethnic groups. Mulao nationality is an isolated minority in China. The aim of this study was to evaluate the association of ABCG8 rs4148217 SNP and several environmental factors with serum lipid levels in the Guangxi Mulao and Han populations. Methods A total of 634 subjects of Mulao nationality and 717 participants of Han nationality were randomly selected from our previous samples. Genotyping of the ABCG8 rs4148217 SNP was performed by polymerase chain reaction and restriction fragment length polymorphism combined with gel electrophoresis, and then confirmed by direct sequencing. Results The genotypic and allelic frequencies of ABCG8 rs4148217 SNP were different between the two nationalities (P < 0.01 for each), the frequency of A allele was higher in Mulao than in Han. The A allele carriers in Han had lower high-density lipoprotein cholesterol (HDL-C) and apolipoprotein (Apo) A1 levels than the A allele noncarriers (P < 0.05 for each), whereas the A allele carriers in Mulao had lower ApoA1 levels than the A allele noncarriers (P < 0.05). Subgroup analyses showed that the A allele carriers in Han had lower HDL-C and higher triglyceride (TG) levels in females but not in males than the A allele noncarriers (P < 0.05 for each), and the A allele carriers in Mulao had lower ApoA1 levels in females but not in males than the A allele noncarriers (P < 0.05). The levels of TG and HDL-C in Han, and ApoA1 in Mulao were associated with genotypes in females but not in males (P < 0.05-0.01). Serum lipid parameters were also correlated with several environmental factors (P < 0.05-0.001). Conclusions The ABCG8 rs4148217 SNP is associated with serum TG, HDL-C and ApoA1 levels in our study populations, but this association is different between the Mulao and Han populations. There is a sex (female)-specific association in both ethnic groups.
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Affiliation(s)
- Qing Li
- Department of Cardiology, Institute of Cardiovascular Diseases, the First Affiliated Hospital, Guangxi Medical University, 22 Shuangyong Road, Nanning 530021, Guangxi, People's Republic of China
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Pencina MJ, D'Agostino RB, Song L. Quantifying discrimination of Framingham risk functions with different survival C statistics. Stat Med 2012; 31:1543-53. [PMID: 22344892 DOI: 10.1002/sim.4508] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Accepted: 12/05/2011] [Indexed: 11/08/2022]
Abstract
Cardiovascular risk prediction functions offer an important diagnostic tool for clinicians and patients themselves. They are usually constructed with the use of parametric or semi-parametric survival regression models. It is essential to be able to evaluate the performance of these models, preferably with summaries that offer natural and intuitive interpretations. The concept of discrimination, popular in the logistic regression context, has been extended to survival analysis. However, the extension is not unique. In this paper, we define discrimination in survival analysis as the model's ability to separate those with longer event-free survival from those with shorter event-free survival within some time horizon of interest. This definition remains consistent with that used in logistic regression, in the sense that it assesses how well the model-based predictions match the observed data. Practical and conceptual examples and numerical simulations are employed to examine four C statistics proposed in the literature to evaluate the performance of survival models. We observe that they differ in the numerical values and aspects of discrimination that they capture. We conclude that the index proposed by Harrell is the most appropriate to capture discrimination described by the above definition. We suggest researchers report which C statistic they are using, provide a rationale for their selection, and be aware that comparing different indices across studies may not be meaningful.
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Abstract
The primary objective of this article is to analyze the role of tobacco smoke compounds able to damage the cardiovascular system and, in particular, to interfere with blood pressure. They are products of tobacco plant leaves, like nicotine, thiocyanate and aromatic amines, and a chemical derived from cigarette combustion, carbon monoxide. Of the other thousands of chemicals, there is no clear evidence of cardiovascular damage. Nicotine and its major metabolite, cotinine, usually increase blood pressure by a direct action and an action stimulating neuro-humoral metabolites of the body as well as sympathetic stimulation. An indirect mechanism of damage exerted by elevated carboxyhemoglobin concentrations is mediated by carbon monoxide, which, mainly induces arterial wall damage and, consequently, late rising in blood pressure by a toxic direct action on endothelial and blood cells. Thiocyanate, in turn, reinforces the hypoxic effects determined by carbon monoxide. Aromatic amines, depending on their chemical structure, may exert toxic effects on the cardiovascular system although they have little effect on blood pressure. A rise in blood pressure determined by smoking compounds is a consequence of both their direct toxicity and the characteristics of their chemical chains that are strongly reactive with a large number of molecules for their spatial shape. In addition, a rise in blood pressure has been documented in individuals smoking a cigarette, acutely and chronically, with irreversible artery wall alterations several years after beginning smoking. Since cigarette smoking has a worldwide diffusion, the evidence of this topic meets the interest of both the scientific community and those individuals aiming to control smoking.
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Liu J, Liang Q, Frost-Pineda K, Muhammad-Kah R, Rimmer L, Roethig H, Mendes P, Sarkar M. Relationship between biomarkers of cigarette smoke exposure and biomarkers of inflammation, oxidative stress, and platelet activation in adult cigarette smokers. Cancer Epidemiol Biomarkers Prev 2011; 20:1760-9. [PMID: 21708936 DOI: 10.1158/1055-9965.epi-10-0987] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cigarette smoking is a risk factor for several diseases, including cardiovascular disease, chronic obstructive pulmonary disease, and lung cancer, but the role of specific smoke constituents in these diseases has not been clearly established. METHODS The relationships between biomarkers of potential harm (BOPH), associated with inflammation [white blood cell (WBC), high sensitivity C-reactive protein (hs-CRP), fibrinogen, and von Willebrand factor (vWF)], oxidative stress [8-epi-prostaglandin F(2α) (8-epiPGF(2α))] and platelet activation [11-dehydro-thromboxin B(2) (11-dehTxB(2))], and machine-measured tar yields (grouped into four categories), biomarkers of exposure (BOE) to cigarette smoke: nicotine and its five metabolites (nicotine equivalents), 4-methylnitrosamino-1-(3-pyridyl)-1-butanol (total NNAL), carboxyhemoglobin, 1-hydroxypyrene, 3-hydroxypropylmercapturic acid, and monohydroxybutenyl-mercapturic acid, were investigated in 3,585 adult smokers and 1,077 nonsmokers. RESULTS Overall, adult smokers had higher levels of BOPHs than nonsmokers. Body mass index (BMI), smoking duration, tar category, and some of the BOEs were significant factors in the multiple regression models. Based on the F value, BMI was the highest ranking factor in the models for WBC, hs-CRP, fibrinogen, and 8-epiPGF(2α), respectively, and gender and smoking duration for 11-dehTxB(2) and vWF, respectively. CONCLUSIONS Although several demographic factors and some BOEs were statistically significant in the model, the R(2) values indicate that only up to 22% of the variability can be explained by these factors, reflecting the complexity and multifactorial nature of the disease mechanisms. IMPACT The relationships between the BOEs and BOPHs observed in this study may help with the identification of appropriate biomarkers and improve the design of clinical studies in smokers.
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Affiliation(s)
- Jianmin Liu
- Center for Research and Technology, Altria Client Services Inc., Richmond, VA 23219, USA.
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Leone A. Does Smoking Act as a Friend or Enemy of Blood Pressure? Let Release Pandora's Box. Cardiol Res Pract 2011; 2011:264894. [PMID: 21318159 PMCID: PMC3034987 DOI: 10.4061/2011/264894] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Accepted: 01/03/2011] [Indexed: 12/15/2022] Open
Abstract
In spite of the great number of observations which show the certainty of cardiovascular damage from smoking, the opinions on that are not yet unanimous. There is a discrepancy that could be attributed to the lack of reproducible data particularly in some epidemiological studies. On the contrary, experimental findings conducted on both animals and humans give evidence of exactly reproducible results of cardiovascular alterations and among these the course of Blood Pressure (BP). Findings identify an increase in BP of active smokers or non-smokers exposed to passive smoking, while a lot of others refer a lowering of BP due to smoking. This discrepancy could be explained as follows. Initially, a vasoconstriction mediated by nicotine causes acute but transient increase in systolic BP. This phase is followed by a decrease in BP as a consequence of depressant effects played chronically by nicotine itself. Simultaneously, carbon monoxide is acting directly on the arterial wall causing, in the long run, structurally irreversible alterations. At this time, there is a change in BP that increases again, and often constantly, its levels following chronic exposure. Changes in response to antihypertensive drugs have been observed in hypertensive smokers since smoking influences metabolic steps of the drugs.
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Affiliation(s)
- Aurelio Leone
- Department of Internal Medicine, City Hospital Massa, Via Provinciale 27, 19030 Castelnuovo Magra SP, Italy
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Fiscella K, Franks P. Assessing coronary risk assessment: what's next? J Gen Intern Med 2010; 25:1140-1. [PMID: 20697964 PMCID: PMC2947629 DOI: 10.1007/s11606-010-1469-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Kevin Fiscella
- Departments of Family Medicine and Community & Preventive Medicine, University of Rochester School of Medicine, Rochester, NY USA
- Department of Family Medicine, Research Division, 1381 South Ave, Rochester, NY 14620 USA
| | - Peter Franks
- Department of Family & Community Medicine, Center for Healthcare Policy and Research, University of California at Davis, Sacramento, CA USA
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Almeida-Pittito B, Hirai A, Sartorelli D, Gimeno S, Ferreira S. Impact of a 2-year intervention program on cardiometabolic profile according to the number of goals achieved. Braz J Med Biol Res 2010; 43:1088-94. [DOI: 10.1590/s0100-879x2010007500110] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Accepted: 10/01/2010] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - A.T. Hirai
- Universidade Federal de São Paulo, Brasil
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Hardy DS, Hoelscher DM, Aragaki C, Stevens J, Steffen LM, Pankow JS, Boerwinkle E. Association of glycemic index and glycemic load with risk of incident coronary heart disease among Whites and African Americans with and without type 2 diabetes: the Atherosclerosis Risk in Communities study. Ann Epidemiol 2010; 20:610-6. [PMID: 20609341 DOI: 10.1016/j.annepidem.2010.05.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Revised: 05/06/2010] [Accepted: 05/10/2010] [Indexed: 11/25/2022]
Abstract
PURPOSE In this study we examined whether high glycemic index (GI) and glycemic load (GL) diets are associated with increased risk of developing coronary heart disease (CHD) in Whites and African Americans with and without type 2 diabetes. METHODS Data on 13,051 patients ages 45 to 64 years from the Atherosclerosis Risk in Communities study were analyzed. The ARIC food frequency questionnaire baseline data provided GI and GL indices. A propensity score was created to estimate the effect of a patient's covariates on energy-adjusted GI or GL. During a maximum of 17 years of follow-up, 1683 cases of CHD (371 with diabetes and 1312 without diabetes) were recorded. RESULTS For every 5-units increase in GI, there was a 1.16-fold (95% confidence interval [95% CI], 1.01-1.33) increased risk of incident CHD in African Americans. For every 30-units increase in GL, there was a 1.11-fold (95% CI, 1.01-1.21) increased risk of incident CHD in Whites. High GL was an especially important CHD risk factor for Whites without diabetes (per 30-units increase; hazard ratio, 1.14; 95% CI, 1.02-1.26). However, these relationships were not seen in individuals with diabetes. CONCLUSIONS Nutritional advice to reduce the GI and GL in diets of African Americans and Whites subjects (without diabetes) may play a role in reducing CHD risk.
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Affiliation(s)
- Dale S Hardy
- Division of Epidemiology, University of Texas School of Public Health, Houston, TX 77225, USA
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Atsma F, Veldhuizen I, de Vegt F, Doggen C, de Kort W. Cardiovascular and demographic characteristics in whole blood and plasma donors: results from the Donor InSight study. Transfusion 2010; 51:412-20. [DOI: 10.1111/j.1537-2995.2010.02867.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Karaer A, Cavkaytar S, Mert I, Buyukkagnici U, Batioglu S. Cardiovascular risk factors in polycystic ovary syndrome. J OBSTET GYNAECOL 2010; 30:387-92. [PMID: 20455724 DOI: 10.3109/01443611003763408] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A total of 31 women with polycystic ovary syndrome (PCOS) and 31 healthy age/body mass index matched controls were compared for serum hormones, basal and oral-glucose stimulated glucose, insulin, homocysteine, high sensitive C-reactive protein (hsCRP) and lipid levels. The women with PCOS had significantly higher serum fasting insulin, homocysteine, total cholesterol and LDL cholesterol level than controls, whereas no differences were detected in serum fasting or OGTT 60th- and 120th-minute glucose concentrations, hsCRP, HDL cholesterol, VLDL cholesterol and triglyceride levels between PCOS and control women. Insulin resistance was found in 54.8% (17/31) of PCOS patients by glucose: insulin (G/I) ratio, whereas only 29.0% (9/31) of control women (p = 0.04). Multivariate linear regression analysis revealed that only waist/hip ratio was independent determinants of G/I ratio. PCOS is associated with some biochemical and clinical risk factors for cardiovascular disease. Therefore, patients with PCOS should undergo comprehensive evaluation for recognised cardiovascular risk factors.
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Affiliation(s)
- A Karaer
- Department of Obstetrics and Gynecology, Dr Zekai Tahir Burak Woman Health Education and Research Hospital, Ankara, Turkey.
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Kengne AP, Patel A, Colagiuri S, Heller S, Hamet P, Marre M, Pan CY, Zoungas S, Grobbee DE, Neal B, Chalmers J, Woodward M. The Framingham and UK Prospective Diabetes Study (UKPDS) risk equations do not reliably estimate the probability of cardiovascular events in a large ethnically diverse sample of patients with diabetes: the Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) Study. Diabetologia 2010; 53:821-31. [PMID: 20157695 DOI: 10.1007/s00125-010-1681-4] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2009] [Accepted: 01/14/2010] [Indexed: 02/04/2023]
Abstract
AIMS/HYPOTHESIS Available multivariable equations for cardiovascular risk assessment in people with diabetes have been derived either from the general population or from populations with diabetes. Their utility and comparative performance in a contemporary group of patients with type 2 diabetes are not well established. The aim of this study was to evaluate the performance of the Framingham and UK Prospective Diabetes Study (UKPDS) risk equations in participants who took part in the Action in Diabetes and Vascular disease: Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) trial. METHODS The 4-year risks of cardiovascular disease (CVD) and its constituents were estimated using two published Framingham and the UKPDS risk equations in 7,502 individuals with type 2 diabetes without prior known CVD at their enrolment in the trial. RESULTS The risk of major CVD was overestimated by 170% (95% CI 146-195%) and 202% (176-231%) using the two Framingham equations. The risk of major coronary heart disease was overestimated by 198% (162-238%) with the UKPDS, and by 146% (117-179%) and 289% (243-341%) with the two different Framingham equations, respectively. The risks of stroke events were also overestimated with the UKPDS and one of the Framingham equations. The ability of these equations to rank risk among ADVANCE participants was modest, with c-statistics ranging from 0.57 to 0.71. Results stratified by sex, treatment allocation and ethnicity were broadly similar. CONCLUSIONS/INTERPRETATION Application of the Framingham and UKPDS risk equations to a contemporary treated group of patients with established type 2 diabetes is likely to substantially overestimate cardiovascular risk.
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Affiliation(s)
- A P Kengne
- The George Institute for International Health, University of Sydney, PO Box M201, Level 10 KGV Building, RPAH, Missenden Road, Camperdown, Sydney, NSW 2050, Australia.
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