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Yu X, Cao Y, Li X, Liang Q, Dong X, Liang B. Association between arterial stiffness index and age-related diseases: A Mendelian randomization study. Rejuvenation Res 2024. [PMID: 39291781 DOI: 10.1089/rej.2024.0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2024] Open
Abstract
Arterial stiffness is an emerging indicator of cardiovascular risk, but its causal relationship with a variety of age-related diseases is unclear. Objective is to assess the causal relationship between arterial stiffness index (ASI) and age-related diseases by Mendelian randomization (MR) analysis. We obtained instrumental variables associated with age-related diseases from genome-wide association studies (GWAS) of 484,598 European individuals, and data for ASI were obtained from the UK Biobank GWAS of 127,127 participants. We used the inverse variance-weighted (IVW) as the primary analysis method. In addition, several sensitivity analyses including MR-Egger, weighted-median (WM), MR-PRESSO and Cochran's Q test were performed to test the robustness of the results. Reverse MR analysis were also performed to assess reverse Causal relationships between age-related diseases and ASI. We verified causal relationship between eight age-related diseases and ASI, of which cardiovascular disease, gallbladder disease, Liver, biliary or pancreas problem, hypertension, joint disorder and esophageal disorder elevated ASI. In contrast, hyperthyroidism or thyrotoxicosis and bowel problem may reduce ASI. This MR analysis reveals causal relationships between ASI and several age-related diseases. ASI is expected to be a potential indicator of health conditions for older populations.
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Affiliation(s)
- Xiaojie Yu
- Jinan University, Department of Anesthesiology, Guangzhou Red Cross Hospital, Guangzhou, Guangdong, China;
| | - Yang Cao
- Jinan University, Department of Anesthesiology, Guangzhou Red Cross Hospital, Guangzhou, Guangdong, China;
| | - Xinyi Li
- Jinan University, Department of Anesthesiology, Guangzhou Red Cross Hospital, Guangzhou, Guangdong, China;
| | - Qingchun Liang
- The Third Affiliated Hospital of Southern Medical University, Department of Anesthesiology, Guangzhou, Guangdong, China;
| | - Xiaodan Dong
- Guangzhou Red Cross Hospital, Department of Anesthesiology, Guangzhou, Guangdong, China;
| | - Bing Liang
- Guangzhou Red Cross Hospital, Anesthesiology, 396 Tongfu Middle Road, Guangzhou, China, 510220;
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Yu L, Pan G, Li Z, Li L, Gao S, Liu F, He Y, Liu Y, Liu Y, Zhao J, Yang R, Yu C. Impaired sensitivity to thyroid hormones is associated with different grades of hypertension: A multicenter cross-sectional study. Nutr Metab Cardiovasc Dis 2024; 34:1581-1589. [PMID: 38744581 DOI: 10.1016/j.numecd.2023.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/27/2023] [Accepted: 12/20/2023] [Indexed: 05/16/2024]
Abstract
BACKGROUND AND AIM Accumulating evidence suggests a potential link between thyroid function with hypertension. However, the research results are limited, and there is no research to explore the relationship between central and peripheral thyroid hormones (THs) sensitivity and different grades of hypertension in patients with coronary heart disease (CHD). This study aims to prove the complex interaction between thyroid system and blood pressure, and provides new ideas for the assessment of hypertension in patients with CHD. METHODS AND RESULTS Calculate parameters representing central and peripheral sensitivity to THs. Logistic regression analysis was used to analyze the relationship between central and peripheral THs sensitivity of CHD patients and different grades of hypertension, especially in different ages, sexes, blood glucose levels, smoking, and drinking statuses. Among the 34,310 participants, 19,610 (57.16 %) were diagnosed with hypertension. The risk of hypertension and TSHI (OR: 0.88; 95 % CI: 0.87-0.90; P < 0.001), TT4RI (OR: 0.998; 95 % CI: 0.998-0.999; P < 0.001), TFQI (OR: 0.63; 95 % CI: 0.60-0.67; P < 0.001), PTFQI (OR: 0.63; 95 % CI: 0.59-0.67; P < 0.001) was negatively associated. The risk of hypertension was positively associated with FT3/FT4 (OR: 1.20; 95 % CI: 1.17-1.22; P < 0.001). After stratified analysis, these associations remained significant at different ages, sexes, blood glucose levels, grades of hypertension, smoking, and drinking statuses (P < 0.001). CONCLUSIONS This study shows that the decrease in central THs sensitivity index and the increase in peripheral THs sensitivity index are associated with a higher risk of hypertension in CHD patients.
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Affiliation(s)
- Lu Yu
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
| | - Guangwei Pan
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
| | - Zhu Li
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Binjiang District, Hangzhou, China
| | - Lin Li
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
| | - Shan Gao
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
| | - Fanfan Liu
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
| | - Yuanyuan He
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
| | - Yijia Liu
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
| | - Yutong Liu
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
| | - Jia Zhao
- Tianjin Chest Hospital, Tianjin, 300222, China.
| | - Rongrong Yang
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China.
| | - Chunquan Yu
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China.
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Mengesha S, Tadesse A, Worku BM, Alamrew K, Yesuf T, Gedamu Y. Control rate of hyperthyroidism and its associated factors after prolonged use of anti-thyroid drugs in a hospital setting, Northwest Ethiopia. Medicine (Baltimore) 2024; 103:e38201. [PMID: 38847659 PMCID: PMC11155532 DOI: 10.1097/md.0000000000038201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 04/19/2024] [Indexed: 06/10/2024] Open
Abstract
Hyperthyroidism is increased synthesis and secretion of thyroid hormones by the thyroid gland resulting in thyrotoxicosis. The modality of therapy for hyperthyroidism includes anti-thyroid drugs, radioiodine and surgery. Anti-thyroid drugs are the only available therapy for hyperthyroid patients in developing world as radioiodine is inaccessible and surgical set up does not exist as required. The aim of this study was to determine the magnitude and predictors of uncontrolled hyperthyroidism among hyperthyroid patients after prolonged anti-thyroid drug use. An institutional-based cross sectional study was conducted at the University of Gondar hospital, Northwest Ethiopia, between April 1, 2022 and October 31, 2022. A consecutive sampling method was used to recruit 317 study subjects. Data were collected through a pre-designed questionnaire. Patients were interviewed to obtain socio-demographic data and relevant medical information. Laboratory analyses were done based on the follow up protocol. Data were entered into EPI Info version 4.6.0.0 (EPI Info, Atlanta) and analyzed in STATA version 14 (Stata Corp LP, Texas, USA). Binary logistic regression model was used to identify variables associated with uncontrolled hyperthyroidism among hyperthyroid patients. P value < .05 was used to declare significant association. A total of 317 patients with hyperthyroidism were included in the study. The median age of the study subjects was 45 years (IQR 36-55 years). Most (95%) of the study participants were females. Toxic multi-nodular goiter was the most common cause of hyperthyroidism (92%), followed by toxic adenoma (5%) and Graves' disease (2%). On multivariate binary logistic regression, large goiter size (AOR: 3.163, 95% CI [1.333-7.506]), severe disease (AOR: 2.275, 95% CI [1.060-4.880]), infrequent iodinated salt intake (AOR: 3.668, 95% CI [1.245-10.802]), and poor adherence to anti-thyroid drug (AOR:15.724, 95% CI [5.542-44.610]) were statistically significant with uncontrolled hyperthyroidism at 12 months of anti-thyroid drug intake. A quarter of patients with hyperthyroidism didn't achieve euthyroid state after 12 months of anti-thyroid drug use. The identified predictors for non-euthyroid state were large goiter size, severe disease, infrequent iodinated salt intake, and poor adherence to anti-thyroid drug.
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Affiliation(s)
- Seyoum Mengesha
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abilo Tadesse
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Biruk Mulat Worku
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kifle Alamrew
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfaye Yesuf
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yonas Gedamu
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Gonzalez-Almazan JA, Cortes-Contreras AP, Flores-Rabasa R, Mendez-Garcia LA, Escobedo G, Navarro Olvera JL, Carrillo-Ruiz JD. Metabolic Syndrome Components in Patients with Pituitary Adenoma. Horm Metab Res 2024; 56:118-127. [PMID: 38081188 DOI: 10.1055/a-2209-0538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
Pituitary adenomas are benign tumors of the anterior portion of the pituitary gland (adenohypophysis), representing the 25% of all the tumor alterations. Pituitary adenomas are classified by the type of hormone secreted, cellularity, size, and structural alterations by the hormonal segregation. The diagnosis consists on the histopathological identification of cell types and the image-guided by magnetic resonance or tomography; the treatment can be both pharmacological and surgical. Metabolic Syndrome is the set of clinical conditions that increase the risk of cardiovascular diseases with an estimated prevalence of 25% worldwide. The alterations of metabolic syndrome are obesity, hypertension, dyslipidemia, insulin resistance, and diabetes mellitus type II. Pituitary adenomas and metabolic syndrome have an important relationship, hormone-secreting by pituitary adenomas affects a myriad of signaling pathways, which allows a favorable environment for the appearance of the metabolic syndrome. Moreover, patients with pituitary adenomas are shown to have an improvement in metabolic parameters after the medical/surgical treatment. The objective of this review is to explore the possible mechanisms through which PAs contributes to MetSx.
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Affiliation(s)
- Jorge A Gonzalez-Almazan
- Research Division, General Hospital of Mexico, Ciudad de Mexico, Mexico
- Functional & Stereotactic Neurosurgery Unit, General Hospital of Mexico, Ciudad de Mexico, Mexico
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autonoma de Mexico Facultad de Estudios Superiores Iztacala, Tlalnepantla, Mexico
| | - Ana Paula Cortes-Contreras
- Research Division, General Hospital of Mexico, Ciudad de Mexico, Mexico
- Functional & Stereotactic Neurosurgery Unit, General Hospital of Mexico, Ciudad de Mexico, Mexico
- Faculty of Medicine, National Autonomous University of Mexico, Ciudad de Mexico, Mexico
| | - Regina Flores-Rabasa
- Research Division, General Hospital of Mexico, Ciudad de Mexico, Mexico
- Faculty of Health Sciences, Anahuac University Mexico - Southern Campus, Ciudad de Mexico, Mexico
| | | | - Galileo Escobedo
- Research Division, General Hospital of Mexico, Ciudad de Mexico, Mexico
| | - José L Navarro Olvera
- Functional & Stereotactic Neurosurgery Unit, General Hospital of Mexico, Ciudad de Mexico, Mexico
| | - José D Carrillo-Ruiz
- Research Division, General Hospital of Mexico, Ciudad de Mexico, Mexico
- Functional & Stereotactic Neurosurgery Unit, General Hospital of Mexico, Ciudad de Mexico, Mexico
- Coordination of Neuroscience, Faculty of Psychology, University Anahuac Mexico, Huixquilucan, Mexico
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Kulkarni S, Wilkinson IB. Adrenoceptors and Hypertension. Handb Exp Pharmacol 2024; 285:297-332. [PMID: 38890192 DOI: 10.1007/164_2024_719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
Hypertension is a very prevalent condition associated with high mortality and morbidity, secondary to changes resulting in blood vessels and resultant end-organ damage. Haemodynamic changes, including an initial rise in cardiac output followed by an increase in total peripheral resistance, denote the early changes associated with borderline or stage 1 hypertension, especially in young men. Increased sodium reabsorption leading to kidney damage is another mechanism proposed as one of the initial triggers for essential hypertension. The underlying pathophysiological mechanisms include catecholamine-induced α1- and ß1-adrenoceptor stimulation, and renin-angiotensin-aldosterone system activation leading to endothelial dysfunction which is believed to lead to persistent blood pressure elevation.α1 blockers, α2 agonists, and ß blockers were among the first oral anti-hypertensives. They are no longer first-line therapy after outcome trials did not demonstrate any benefits over and above other agents, despite similar blood pressure reductions. Angiotensin-converting enzyme inhibitors (or angiotensin receptor blockers), calcium channel blockers, and thiazide-like diuretics are now considered the first line of therapy, although adrenoceptor agents still have a role as second- or third-line therapy. The chapter also highlights hypertension in specific medical conditions such as pregnancy, phaeochromocytoma, hyperthyroidism, portal hypertension, pulmonary arterial hypertension, and ocular hypertension, to provide an overview for clinicians and researchers interested in the role of adrenoceptors in the pathophysiology and management of hypertension.
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Affiliation(s)
- Spoorthy Kulkarni
- Department of Experimental Medicine and Immunotherapeutics, Vascular Research Clinic, ACCI Level 3, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Ian B Wilkinson
- Department of Experimental Medicine and Immunotherapeutics, Vascular Research Clinic, ACCI Level 3, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.
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Prakash K, Hamid P. Thyroid Hormone Resistance Syndrome: From Molecular Mechanisms to Its Potential Contribution to Hypertension. Cureus 2023; 15:e49913. [PMID: 38174182 PMCID: PMC10762495 DOI: 10.7759/cureus.49913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
Thyroid hormone resistance (THR) is a rare inherited disorder that affects approximately one in every 40,000 live births. This condition arises from a mutation in the thyroid hormone receptor β, leading to reduced responsiveness of target tissues. It can result in a combination of hypothyroidism and hyperthyroidism symptoms in different tissues. The thyroid hormone is crucial for controlling blood pressure, and even small changes in its levels can have an effect on vascular resistance, cardiac performance, and heart rhythm. Both hypo- and hyperthyroidism have been associated with elevated blood pressure, underscoring the significant link between thyroid hormone sensitivity and vascular function. Considering thyroid hormone sensitivity is essential in clinical practice, particularly when managing patients with hypertension, to ensure personalized and effective treatment approaches. Monitoring thyroid function is essential during the diagnosis of hypertension, as thyroid dysfunction can often be corrected to normalize blood pressure. It's crucial to distinguish between essential hypertension and hypertension associated with a thyroid abnormality in THR. The mechanisms behind the development of hypertension in THR include reduced nitric oxide production, dysregulation of the renin-angiotensin-aldosterone system, impaired endothelial function, and mutations in the deiodinases. Physicians should understand the underlying mechanisms of THR and identify new therapeutic targets for hypertension in THR.
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Affiliation(s)
- Keerthana Prakash
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Pousette Hamid
- Neurology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
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Lu L, Mi J, Jin B, Zhang L, Luo Q, Li X, Yan Y, Cao Y. Inhibitory effects of the anthocyanins from Lycium ruthenicum Murray on angiotensin-I-converting enzyme: in vitro and molecular docking studies. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2023; 103:7164-7175. [PMID: 37347844 DOI: 10.1002/jsfa.12803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 06/11/2023] [Accepted: 06/22/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Lycium ruthenicum Murray (LRM), a perennial shrub plant belonging to the Solanaceae family, is rich in anthocyanins, which have anti-inflammatory, antioxidant, lipid-lowering, intestinal flora regulating, and other pharmacological qualities. This study was primarily aimed to investigate the inhibitory effect of different anthocyanin purities from LRM on angiotensin-I-converting enzyme (ACE) activity in vitro. Moreover, the inhibitory mechanism was further analyzed by molecular docking technology. RESULTS Two main anthocyanin isomers were identified by ultra-performance liquid chromatography-tandem mass spectrometry and proton/carbon-13 nuclear magnetic resonance, namely petunidin-3-O-[rhamnopyranosyl-(trans-p-coumaroyl)]-5-O-(β-d-glucopyranoside) (trans-Pt3R5G) and petunidin-3-O-[rhamnopyranosyl-(cis-p-coumaroyl)]-5-O-(β-d-glucopyranoside) (cis-Pt3R5G), with a molar ratio of 9:1. Three purification grades of Pt3R5G all showed excellent inhibitory effects on ACE, with the half maximal inhibitory concentration (IC50 ) values being 0.562, 0.421, and 0.106 mg·mL-1 . Increasing the purity may reduce the IC50 within a certain concentration range. An enzymatic kinetic experiment showed that the inhibitory effect of Pt3R5G on ACE was reversible and non-competitive: Pt3R5G and substrate were not in competition for the active sites of ACE. Molecular docking technology further revealed the possible mechanism was that Pt3R5G and ACE amino acid residues were interacting by hydrogen bonds to exert the inhibitory effect. CONCLUSION The results indicated that Pt3R5G from LRM was highly effective at inhibiting ACE activity in vitro, with the hydrogen bonds of Pt3R5G and ACE amino acid residues exerting the inhibition. As a potential plant-based ACE inhibitor, Pt3R5G can be used as a functional ingredient for antihypertensive effects. © 2023 Society of Chemical Industry.
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Affiliation(s)
- Lu Lu
- National Wolfberry Engineering Technology Research Center, Institute of Wolfberry Science, Ningxia Academy of Agricultural and Forestry Sciences, Yinchuan, China
| | - Jia Mi
- National Wolfberry Engineering Technology Research Center, Institute of Wolfberry Science, Ningxia Academy of Agricultural and Forestry Sciences, Yinchuan, China
| | - Bo Jin
- National Wolfberry Engineering Technology Research Center, Institute of Wolfberry Science, Ningxia Academy of Agricultural and Forestry Sciences, Yinchuan, China
| | - Lutao Zhang
- National Wolfberry Engineering Technology Research Center, Institute of Wolfberry Science, Ningxia Academy of Agricultural and Forestry Sciences, Yinchuan, China
| | - Qing Luo
- National Wolfberry Engineering Technology Research Center, Institute of Wolfberry Science, Ningxia Academy of Agricultural and Forestry Sciences, Yinchuan, China
| | - Xiaoying Li
- National Wolfberry Engineering Technology Research Center, Institute of Wolfberry Science, Ningxia Academy of Agricultural and Forestry Sciences, Yinchuan, China
| | - Yamei Yan
- National Wolfberry Engineering Technology Research Center, Institute of Wolfberry Science, Ningxia Academy of Agricultural and Forestry Sciences, Yinchuan, China
| | - Youlong Cao
- National Wolfberry Engineering Technology Research Center, Institute of Wolfberry Science, Ningxia Academy of Agricultural and Forestry Sciences, Yinchuan, China
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Allam MM, El-Zawawy HT, El-Zawawy TH. Renal function changes in patients with subclinical hyperthyroidism: a novel postulated mechanism. Endocrine 2023; 82:78-86. [PMID: 37490265 PMCID: PMC10462537 DOI: 10.1007/s12020-023-03361-3] [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: 01/09/2023] [Accepted: 03/29/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Subclinical hyperthyroidism (SCH) is found to be associated with renal dysfunction. Hyperthyroidism is a well-known cause of secondary systolic hypertension. However, the effect of SCH on the kidney and its vasculature is still unknown. AIM To assess the presence of renal function changes and renal vasodysfunction in SCH patients and their relation to hypertension. METHODS The study included 321 patients with SCH and 80 healthy matched controls. Laboratory investigations included thyroid function tests, anti-TSH receptor antibody (TRAb), creatinine, estimated glomerular filtration rate (eGFR), serum osmolarity (S. Osmol), urine osmolarity (U. Osmol), Fractional Excretion of Sodium (FeNa), Fractional Excretion of Potassium (FeK), copeptin (CPP), and aldosterone/renin ratio (ARR). Ultrasound for the thyroid gland, echocardiography, total peripheral resistance (TPR), flow-mediated dilatation (FMD), and Renal Arterial distensibility (RAD) was also done. RESULTS Serum creatinine was significantly lower while eGFR was significantly higher in SCH patients compared to euthyroid subjects (mean 0.59 ± 0.11 mg/dl Vs mean 0.8 ± 0.1 mg/dl, p = 0.001 and mean 128.28 ± 14.69 ml/min/1.73m2 Vs mean 100.49 ± 14.9 ml/min/1.73m2, p = 0.013, respectively). The TPR and FMD showed a significant decrease in SCH group compared to controls (mean 975.85 ± 159.33 mmHg.min/L Vs mean 1120.24 ± 135.15 mmHg.min/L, p = 0.045 and mean 7.03 ± 4.02% Vs mean 13.48 ± 4.57%, p = 0.003, respectively). RAD was significantly higher in hypertensive SCH patients compared to normotensive SCH patients (mean 17.82 ± 2.46 mmHg Vs mean 11.98 ± 3.21 mmHg, p = 0.001). CONCLUSION SCH patients showed vascular resistance reduction. Alterations in thyroid hormones and blood pressure could be the driving mechanisms for the change in renal functions in patients with SCH.
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Affiliation(s)
- Magdy Mohamed Allam
- Internal Medicine Department, Endocrinology division, Alexandria University Student Hospital, Alexandria, Egypt.
| | - Hanaa Tarek El-Zawawy
- Internal Medicine Department, Endocrinology division, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Tarek Hussein El-Zawawy
- Cardiology and Angiology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Chen Z, Liang W, Liang J, Dou J, Guo F, Zhang D, Xu Z, Wang T. Probiotics: functional food ingredients with the potential to reduce hypertension. Front Cell Infect Microbiol 2023; 13:1220877. [PMID: 37465757 PMCID: PMC10351019 DOI: 10.3389/fcimb.2023.1220877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/15/2023] [Indexed: 07/20/2023] Open
Abstract
Hypertension is an increasingly pressing public health concern across the globe. It can be triggered by a variety of factors such as age and diet, as well as the stress of modern life. The traditional treatment of hypertension includes calcium ion blockers, angiotensin II receptor inhibitors and β-receptor blockers, but these drugs have at least some side effects. Recent studies have revealed that intestinal flora plays a vital role in maintaining and promoting human health. This is due to the type and amount of probiotics present in the flora. Probiotics can reduce hypertension symptoms through four mechanisms: regulating vascular oxidative stress, producing short-chain fatty acids, restoring endothelial cell function, and reducing inflammation. It has been reported that certain functional foods, using probiotics as their raw material, can modify the composition of intestinal flora, thus regulating hypertension symptoms. Consequently, utilizing the probiotic function of probiotics in conjunction with the properties of functional foods to treat hypertension is a novel, side-effect-free treatment method. This study seeks to summarize the various factors that contribute to hypertension, the mechanism of probiotics in mitigating hypertension, and the fermented functional foods with probiotic strains, in order to provide a basis for the development of functional foods which utilize probiotics as their raw material and may have the potential to reduce hypertension.
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Affiliation(s)
- Zouquan Chen
- State Key Laboratory of Biobased Material and Green Papermaking, Qilu University of Technology, Shandong Academy of Science, Jinan, China
- School of Bioengineering, Qilu University of Technology, Shandong Academy of Science, Jinan, China
| | - Wanjie Liang
- Research and Development Department(R&D), Shandong Ande Healthcare Apparatus Co., Ltd., Zibo, China
| | - Jie Liang
- State Key Laboratory of Biobased Material and Green Papermaking, Qilu University of Technology, Shandong Academy of Science, Jinan, China
- School of Bioengineering, Qilu University of Technology, Shandong Academy of Science, Jinan, China
| | - Jiaxin Dou
- State Key Laboratory of Biobased Material and Green Papermaking, Qilu University of Technology, Shandong Academy of Science, Jinan, China
- School of Bioengineering, Qilu University of Technology, Shandong Academy of Science, Jinan, China
| | - Fangyu Guo
- State Key Laboratory of Biobased Material and Green Papermaking, Qilu University of Technology, Shandong Academy of Science, Jinan, China
- School of Bioengineering, Qilu University of Technology, Shandong Academy of Science, Jinan, China
| | - Daolei Zhang
- School of Bioengineering, Shandong Polytechnic, Jinan, China
- Henan Province Key Laboratory of Water Pollution Control and Rehabilitation Technology, Henan University of Urban Construction, Pingdingshan, China
| | - Zhenshang Xu
- State Key Laboratory of Biobased Material and Green Papermaking, Qilu University of Technology, Shandong Academy of Science, Jinan, China
- School of Bioengineering, Qilu University of Technology, Shandong Academy of Science, Jinan, China
| | - Ting Wang
- State Key Laboratory of Biobased Material and Green Papermaking, Qilu University of Technology, Shandong Academy of Science, Jinan, China
- School of Bioengineering, Qilu University of Technology, Shandong Academy of Science, Jinan, China
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10
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Wu L, Huang L, Li M, Xiong Z, Liu D, Liu Y, Liang S, Liang H, Liu Z, Qian X, Ren J, Chen Y. Differential diagnosis of secondary hypertension based on deep learning. Artif Intell Med 2023; 141:102554. [PMID: 37295898 DOI: 10.1016/j.artmed.2023.102554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 02/06/2023] [Accepted: 04/11/2023] [Indexed: 06/12/2023]
Abstract
Secondary hypertension is associated with higher risks of target organ damage and cardiovascular and cerebrovascular disease events. Early aetiology identification can eliminate aetiologies and control blood pressure. However, inexperienced doctors often fail to diagnose secondary hypertension, and comprehensively screening for all causes of high blood pressure increases health care costs. To date, deep learning has rarely been involved in the differential diagnosis of secondary hypertension. Relevant machine learning methods cannot combine textual information such as chief complaints with numerical information such as the laboratory examination results in electronic health records (EHRs), and the use of all features increases health care costs. To reduce redundant examinations and accurately identify secondary hypertension, we propose a two-stage framework that follows clinical procedures. The framework carries out an initial diagnosis process in the first stage, on which basis patients are recommended for disease-related examinations, followed by differential diagnoses of different diseases based on the different characteristics observed in the second stage. We convert the numerical examination results into descriptive sentences, thus blending textual and numerical characteristics. Medical guidelines are introduced through label embedding and attention mechanisms to obtain interactive features. Our model was trained and evaluated using a cross-sectional dataset containing 11,961 patients with hypertension from January 2013 to December 2019. The F1 scores of our model were 0.912, 0.921, 0.869 and 0.894 for primary aldosteronism, thyroid disease, nephritis and nephrotic syndrome and chronic kidney disease, respectively, which are four kinds of secondary hypertension with high incidence rates. The experimental results show that our model can powerfully use the textual and numerical data contained in EHRs to provide effective decision support for the differential diagnosis of secondary hypertension.
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Affiliation(s)
- Lin Wu
- Department of Endocrinology and Metabolism, Medical Center for Comprehensive Weight Control, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong, China; Guangdong Provincial Key Laboratory of Diabetology and Guangzhou Municipal Key Laboratory of Mechanistic and Translational Obesity Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong, China; Department of Cardiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong, China
| | - Liying Huang
- School of Computer Science And Engineering, Sun Yat-sen University, Guangzhou, 510275, Guangdong, China
| | - Mei Li
- VIP Medical Service Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong, China
| | - Zhaojun Xiong
- Department of Cardiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong, China
| | - Dinghui Liu
- Department of Cardiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong, China
| | - Yong Liu
- Department of Cardiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong, China
| | - Suzhen Liang
- Department of Cardiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong, China
| | - Hua Liang
- Department of Endocrinology and Metabolism, Medical Center for Comprehensive Weight Control, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong, China; Guangdong Provincial Key Laboratory of Diabetology and Guangzhou Municipal Key Laboratory of Mechanistic and Translational Obesity Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong, China
| | - Zifeng Liu
- Clinical data center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong, China
| | - Xiaoxian Qian
- Department of Cardiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong, China.
| | - Jiangtao Ren
- School of Computer Science And Engineering, Sun Yat-sen University, Guangzhou, 510275, Guangdong, China.
| | - Yanming Chen
- Department of Endocrinology and Metabolism, Medical Center for Comprehensive Weight Control, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong, China; Guangdong Provincial Key Laboratory of Diabetology and Guangzhou Municipal Key Laboratory of Mechanistic and Translational Obesity Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong, China.
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11
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Prevalence and risk factors of thyroid dysfunction in outpatients with overweight or obese first-episode and drug-naïve major depressive disorder. J Affect Disord 2023; 328:135-140. [PMID: 36806659 DOI: 10.1016/j.jad.2023.02.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 02/06/2023] [Accepted: 02/15/2023] [Indexed: 02/21/2023]
Abstract
BACKGROUND Thyroid dysfunction is common in patients with major depressive disorder (MDD). However, few studies have examined risk factors for thyroid dysfunction in overweight or obese first-episode and drug-naïve (FEDN) MDD patients. This study aimed to investigate the prevalence and risk factors of thyroid dysfunction in FEDN MDD patients with comorbid high body mass index (BMI). METHODS A total of 1718 FEDN MDD patients were included. Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) positive subscale were used to assess the clinical symptoms of the patients. In addition, metabolic parameters and thyroid hormone levels were measured. RESULTS The prevalence of thyroid dysfunction was approximately 1.75 times higher in MDD patients with comorbid overweight or obesity (72.3 %) than in patients without high BMI (58.8 %). The HAMD score, HAMA score, systolic blood pressure (BP), fasting blood glucose (FBG), thyroid peroxidase antibody (TPOAb), total cholesterol (TC), high-density lipoprotein (HDL-C), and low-density lipoprotein (LDL-C), were risk factors for thyroid dysfunction in MDD patients with high BMI. The combination of HAMD, FBG, TC, LDL-C, and systolic BP had a high AUC value of 0.76 differentiating patients with and without thyroid dysfunction. LIMITATION Causality cannot be drawn due to cross-sectional design. CONCLUSIONS This study demonstrated a high prevalence of thyroid dysfunction in FEDN MDD patients with high BMI. Severity of depression and anxiety, levels of systolic BP, FBG, TPOAb, TC, HDL-C and LDL-C appear to be associated with thyroid dysfunction in FEDN MDD patients with high BMI.
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Jo U, Park K. Phytochemical index and hypertension in Korean adults using data from the Korea National Health and Nutrition Examination Survey in 2008-2019. Eur J Clin Nutr 2022; 76:1594-1599. [PMID: 35701525 DOI: 10.1038/s41430-022-01155-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 04/24/2022] [Accepted: 04/26/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/OBJECTIVES Although previous in vivo and in vitro studies have reported the beneficial effects of phytochemical-rich food on cardiovascular health, limited information is available regarding its' health effect on the community-dwelling population. This is especially true in Korea. Here, we examined the cross-sectional association between phytochemical levels and hypertension in Korean adults. SUBJECTS/METHODS We analyzed data from 38,198 Koreans aged ≥30 years who participated in the Korea National Health and Nutrition Examination Survey (2008-2019) and met the study's inclusion criteria. The Korean version of the Phytochemical Index (PI) was computed based on 24 h recall data. Hypertension was defined based on the American College of Cardiology/American Heart Association definition in 2017. Multivariate logistic regression analysis was used to examine the association between PI and hypertension. RESULTS In the multivariable adjusted model, participants in the highest PI quintile had a significantly low prevalence of hypertension (Odd ratio, 0.86; 95% confidence interval, 0.79-0.95). A dose-response analysis confirmed the inverse linearity between PI and hypertension (p for nonlinearity = 0.2634). CONCLUSIONS Consumption of phytochemical-rich foods may lower the prevalence of hypertension. A large-scale, prospective cohort study is required to validate these findings.
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Affiliation(s)
- Unhui Jo
- Department of Food and Nutrition, Yeungnam University, 280 Daehak-ro, Gyeongsan, Gueongbuk, 38541, Republic of Korea
| | - Kyong Park
- Department of Food and Nutrition, Yeungnam University, 280 Daehak-ro, Gyeongsan, Gueongbuk, 38541, Republic of Korea.
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13
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Pappan N, Din MTU, Venkat D, Wedgeworth P, Fu S. Screening for Thyroid Disorders Among Resistant Hypertension Patients: Are We Doing Enough? Clin Med Res 2022; 20:70-73. [PMID: 34996821 PMCID: PMC9242733 DOI: 10.3121/cmr.2021.1676] [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: 03/15/2021] [Revised: 07/17/2021] [Accepted: 09/20/2021] [Indexed: 11/18/2022]
Abstract
Objective: To perform a quality assurance study assessing if hypo- and hyperthyroidism are appropriately screened for in patients with resistant hypertension.Design: Data was collected from patients diagnosed with resistant hypertension, defined as being on four or more different classes of anti-hypertensive medications. These patients were filtered to determine if thyroid stimulating hormone (TSH) measurement occurred within 90 days of the addition of a fourth medication class.Setting: Two internal medicine residency clinics in Pittsburgh, PA.Participants: Patients were selected who had a diagnosis of hypertension and were seen in clinic between January 1, 2018 and December 23, 2020.Methods: A single center retrospective review was performed.Results: A total of 1,125 patients were identified as having resistant hypertension. Of these, only 74 patients were found to have a TSH measurement taken within 90 days of having a fourth medication class prescribed. Seven TSH values were found to be abnormal with one patient being diagnosed with hyperthyroidism, demonstrating a screening rate of 6.6%. There were statistically significant differences in age, body mass index, and diastolic blood pressure in those screened versus not.Conclusions: Thyroid disease is under-screened as an etiology for resistant hypertension, particularly given the ease of diagnosis and reversibility of these conditions.
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Affiliation(s)
- Nikos Pappan
- Medicine Institute, Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA, USA
| | - Mian Tanveer Ud Din
- Medicine Institute, Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA, USA
| | - Divya Venkat
- Medicine Institute, Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA, USA
| | - Patrick Wedgeworth
- Medicine Institute, Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA, USA
| | - Sheng Fu
- Cardiovascular Institute, Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA USA
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Wang Q, Zeng Z, Nan J, Zheng Y, Liu H. Cause of Death Among Patients With Thyroid Cancer: A Population-Based Study. Front Oncol 2022; 12:852347. [PMID: 35359353 PMCID: PMC8964038 DOI: 10.3389/fonc.2022.852347] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/17/2022] [Indexed: 12/13/2022] Open
Abstract
Background Over the last decades, the number of patients diagnosed with thyroid carcinoma has been increasing, highlighting the importance of comprehensively evaluating causes of death among these patients. This study aimed to comprehensively characterize the risk of death and causes of death in patients with thyroid carcinoma. Methods A total of 183,641 patients diagnosed with an index thyroid tumor were identified from the Surveillance, Epidemiology, and End Result database (1975-2016). Standardized mortality rates (SMRs) for non-cancer deaths were calculated to evaluate mortality risk and to compare mortality risks with the cancer-free US population. Cumulative mortality rates were calculated to explore the factors associated with higher risk of deaths. Results There were 22,386 deaths recorded during follow-up, of which only 31.0% were due to thyroid cancer and 46.4% due to non-cancer causes. Non-cancer mortality risk among patients with thyroid cancer was nearly 1.6-fold (SMR=1.59) that of the general population. Cardiovascular diseases were the leading cause of non-cancer deaths, accounting for 21.3% of all deaths in thyroid cancer patients. Non-cancer causes were the dominant cause of death in thyroid cancer survivors as of the third year post-diagnosis. We found that males with thyroid cancer had a higher risk of all-cause mortality compared with females. The risk of suicide was highest in the first post-diagnostic year (<1 year: SMR=1.51). The long-term risk of Alzheimer's disease was notably increased in thyroid cancer patients (>5 years: SMR=8.27). Conclusion Non-cancer comorbidities have become the major risks of death in patients with thyroid tumor in the US, as opposed to death from the tumor itself. Clinicians and researchers should be aware of these risk trends in order to conduct timely intervention strategies.
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Affiliation(s)
- Qian Wang
- Department of General Practice, The First Affiliated Hospital of Nanchang University, Nanchang, China
- Department of Geriatric Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zhen Zeng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junjie Nan
- Zhejiang Provincial Key Laboratory of Laparoscopic Technology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yongqiang Zheng
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Huanbing Liu
- Department of General Practice, The First Affiliated Hospital of Nanchang University, Nanchang, China
- Department of Geriatric Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
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Giontella A, Lotta LA, Overton JD, Baras A, Sartorio A, Minuz P, Gill D, Melander O, Fava C. Association of Thyroid Function with Blood Pressure and Cardiovascular Disease: A Mendelian Randomization. J Pers Med 2021; 11:1306. [PMID: 34945778 PMCID: PMC8704995 DOI: 10.3390/jpm11121306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/24/2021] [Accepted: 12/01/2021] [Indexed: 12/14/2022] Open
Abstract
Thyroid function has a widespread effect on the cardiometabolic system. However, the causal association between either subclinical hyper- or hypothyroidism and the thyroid hormones with blood pressure (BP) and cardiovascular diseases (CVD) is not clear. We aim to investigate this in a two-sample Mendelian randomization (MR) study. Single nucleotide polymorphisms (SNPs) associated with thyroid-stimulating hormone (TSH), free tetraiodothyronine (FT4), hyper- and hypothyroidism, and anti-thyroid peroxidase antibodies (TPOAb), from genome-wide association studies (GWAS), were selected as MR instrumental variables. SNPs-outcome (BP, CVD) associations were evaluated in a large-scale cohort, the Malmö Diet and Cancer Study (n = 29,298). Causal estimates were computed by inverse-variance weighted (IVW), weighted median, and MR-Egger approaches. Genetically increased levels of TSH were associated with decreased systolic BP and with a lower risk of atrial fibrillation. Hyperthyroidism and TPOAb were associated with a lower risk of atrial fibrillation. Our data support a causal association between genetically decreased levels of TSH and both atrial fibrillation and systolic BP. The lack of significance after Bonferroni correction and the sensitivity analyses suggesting pleiotropy, should prompt us to be cautious in their interpretation. Nevertheless, these findings offer mechanistic insight into the etiology of CVD. Further work into the genes involved in thyroid functions and their relation to cardiovascular outcomes may highlight pathways for targeted intervention.
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Affiliation(s)
- Alice Giontella
- Department of Medicine, University of Verona, 37134 Verona, Italy; (A.G.); (A.S.); (P.M.)
- Clinical Research Center, Department of Clinical Sciences, Lund University, 214 28 Malmö, Sweden;
| | - Luca A. Lotta
- Regeneron Genetics Center, Tarrytown, NY 10591, USA; (L.A.L.); (J.D.O.); (A.B.)
| | - John D. Overton
- Regeneron Genetics Center, Tarrytown, NY 10591, USA; (L.A.L.); (J.D.O.); (A.B.)
| | - Aris Baras
- Regeneron Genetics Center, Tarrytown, NY 10591, USA; (L.A.L.); (J.D.O.); (A.B.)
| | | | - Andrea Sartorio
- Department of Medicine, University of Verona, 37134 Verona, Italy; (A.G.); (A.S.); (P.M.)
| | - Pietro Minuz
- Department of Medicine, University of Verona, 37134 Verona, Italy; (A.G.); (A.S.); (P.M.)
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, Imperial College London, London SW7 2AZ, UK;
- Novo Nordisk Research Centre Oxford, Old Road Campus, Oxford OX3 7FZ, UK
- Clinical Pharmacology Group, Pharmacy and Medicines Directorate, St. George’s University Hospitals NHS Foundation Trust, London SW17 0QT, UK
- Clinical Pharmacology and Therapeutics Section, Institute for Infection and Immunity, St George’s, University of London, London SW17 0RE, UK
| | - Olle Melander
- Clinical Research Center, Department of Clinical Sciences, Lund University, 214 28 Malmö, Sweden;
- Department of Emergency and Internal Medicine, Skåne University Hospital, 214 28 Malmö, Sweden
| | - Cristiano Fava
- Department of Medicine, University of Verona, 37134 Verona, Italy; (A.G.); (A.S.); (P.M.)
- Clinical Research Center, Department of Clinical Sciences, Lund University, 214 28 Malmö, Sweden;
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