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Büyükbayram G, Yüceer Ö, Oymak FS. The Relationship between Serum Uric Acid Levels and Early Mortality in Chronic Obstructive Pulmonary Disease Cases during Exacerbation. SARCOIDOSIS, VASCULITIS, AND DIFFUSE LUNG DISEASES : OFFICIAL JOURNAL OF WASOG 2022; 39:e2022014. [PMID: 36118541 PMCID: PMC9437757 DOI: 10.36141/svdld.v39i2.12127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 04/09/2022] [Indexed: 06/15/2023]
Abstract
AIM In this study, it was aimed to compare the levels of serum uric acid and uric acid/creatinine ratios in patients with COPD during an attack or in stable COPD, and to show whether serum uric acid and uric acid/creatinine ratios are associated with early mortality in COPD patients during an acute attack. MATERIALS AND METHODS In this study, COPD acute attack (n=155) and stable COPD (n=30) patients were evaluated. The data of these patients were obtained from patient files and computer records. COPD diagnosis and severity assessment were made according to the GOLD 2006 guideline. Participants' age, gender, body mass index, pulmonary function test, arterial blood gas, uric acid, creatinine values and comorbidity information were recorded in the previously prepared Case Data Form. In 2012, when we conducted this study, gold 2006 was taken as the guideline for spirometry measurement, but spirometric measurements determined with reference values determined according to age, height and gender, and FEV1/FVC measurement <70% as diagnostic criteria in acute attack after bronchodilator were the guidelines used later, gold 2017. It is also compatible with gold2020 and gold2021 spirometry criteria. RESULTS It was determined that the uric acid (p<0.001) and uric acid/creatinine (p<0.001) levels of the patients in the acute attack group were significantly higher than the levels of the patients in the stable group. The attack group was divided into two subgroups according to certain cut-off points for uric acid (>6 mg/dl for women and >7 mg/dl for men) and uric acid/creatinine ratio (median value 7.10). Since the upper limit of the uric acid value measured in the blood is 6 mg/dl in women and 7-8 mg/dl in men, the cut-off points for uric acid (>6 mg/dl for women and >7 mg/dl for men) were determined in our study. According to this categorization, it was determined that there was no statistically significant relationship between uric acid level (odds ratio 2.985 [95% confidence interval 0.61814,151]) and early mortality risk. CONCLUSION The results of this study showed that the uric acid and uric acid/creatinine levels in the attack group were higher than the levels in the stable group, but these parameters were not associated with early mortality.
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Affiliation(s)
| | - Ömer Yüceer
- Niğde Ömer Halis Demir Training and Research Hospital Emergency Service Niğde, Turkey
| | - Fatma Sema Oymak
- Erciyes University, Faculty of Medicine, Internal Medicine, Department of Chest Diseases
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Kwon S, Lee M, Crowley G, Schwartz T, Zeig-Owens R, Prezant DJ, Liu M, Nolan A. Dynamic Metabolic Risk Profiling of World Trade Center Lung Disease: A Longitudinal Cohort Study. Am J Respir Crit Care Med 2021; 204:1035-1047. [PMID: 34473012 DOI: 10.1164/rccm.202006-2617oc] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Rationale: Metabolic syndrome (MetSyn) increases the risk of World Trade Center (WTC) lung injury (LI). However, the temporal relationship of MetSyn, exposure intensity, and lung dysfunction is not well understood. Objective: To model the association of longitudinal MetSyn characteristics with WTC lung disease to define modifiable risk. Methods: Firefighters, for whom consent was obtained (N = 5,738), were active duty on September 11, 2001 (9/11). WTC-LI (n = 1,475; FEV1% predicted <lower limit of normal [LLN]) and non-WTC-LI (n = 4,263; FEV1% predicted ⩾LLN at all exams) was the primary outcome, and FVC% predicted <LLN and FEV1/FVC <0.70 were secondary outcomes. We assessed 1) the effect of concurrent MetSyn on longitudinal lung function by linear mixed models, 2) the temporal effect of MetSyn and exposure by Weibull proportional hazards, 3) the effects of MetSyn's rate of change by two-stage models, and 4) the nonlinear joint effect of longitudinal MetSyn components by a partially linear single-index model (PLSI). Measurements and Main Results: WTC-LI cases were more often ever-smokers, arrived in the morning (9/11), and had MetSyn. Body mass index ⩾30 kg/m2 and high-density lipoprotein <40 mg/dl were most contributory to concurrent loss of FEV1% predicted and FVC% predicted while conserving FEV1/FVC. Body mass index ⩾30 kg/m2 and dyslipidemia significantly predicted WTC-LI, FVC% predicted <LLN in a Weibull proportional hazards model. Dynamic risk assessment of WTC-LI on the basis of MetSyn and exposure showed how reduction of MetSyn factors further reduces WTC-LI likelihood in susceptible populations. PLSI demonstrates that MetSyn has a nonlinear relationship with WTC lung disease, and increases in cumulative MetSyn risk factors exponentially increase WTC-LI risk. An interactive metabolic-risk modeling application was developed to simplify PLSI interpretation. Conclusions: MetSyn and WTC exposure contribute to the development of lung disease. Dynamic risk assessment may be used to encourage treatment of MetSyn in susceptible populations. Future studies will focus on dietary intervention as a disease modifier.
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Affiliation(s)
- Sophia Kwon
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine
| | - Myeonggyun Lee
- Division of Biostatistics, Department of Population Health, and
| | - George Crowley
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine
| | - Theresa Schwartz
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York; and
| | - Rachel Zeig-Owens
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York; and.,Department of Epidemiology and Population Health and
| | - David J Prezant
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York; and.,Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Mengling Liu
- Division of Biostatistics, Department of Population Health, and.,Department of Environmental Medicine, New York University School of Medicine, New York, New York
| | - Anna Nolan
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine.,Department of Environmental Medicine, New York University School of Medicine, New York, New York.,Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York; and
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Wielscher M, Amaral AFS, van der Plaat D, Wain LV, Sebert S, Mosen-Ansorena D, Auvinen J, Herzig KH, Dehghan A, Jarvis DL, Jarvelin MR. Genetic correlation and causal relationships between cardio-metabolic traits and lung function impairment. Genome Med 2021; 13:104. [PMID: 34154662 PMCID: PMC8215837 DOI: 10.1186/s13073-021-00914-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Associations of low lung function with features of poor cardio-metabolic health have been reported. It is, however, unclear whether these co-morbidities reflect causal associations, shared genetic heritability or are confounded by environmental factors. METHODS We performed three analyses: (1) cardio-metabolic health to lung function association tests in Northern Finland Birth cohort 1966, (2) cross-trait linkage disequilibrium score regression (LDSC) to compare genetic backgrounds and (3) Mendelian randomisation (MR) analysis to assess the causal effect of cardio-metabolic traits and disease on lung function, and vice versa (bidirectional MR). Genetic associations were obtained from the UK Biobank data or published large-scale genome-wide association studies (N > 82,000). RESULTS We observed a negative genetic correlation between lung function and cardio-metabolic traits and diseases. In Mendelian Randomisation analysis (MR), we found associations between type 2 diabetes (T2D) instruments and forced vital capacity (FVC) as well as FEV1/FVC. Body mass index (BMI) instruments were associated to all lung function traits and C-reactive protein (CRP) instruments to FVC. These genetic associations provide evidence for a causal effect of cardio-metabolic traits on lung function. Multivariable MR suggested independence of these causal effects from other tested cardio-metabolic traits and diseases. Analysis of lung function specific SNPs revealed a potential causal effect of FEV1/FVC on blood pressure. CONCLUSIONS The present study overcomes many limitations of observational studies by using Mendelian Randomisation. We provide evidence for an independent causal effect of T2D, CRP and BMI on lung function with some of the T2D effect on lung function being attributed to inflammatory mechanisms. Furthermore, this analysis suggests a potential causal effect of FEV1/FVC on blood pressure. Our detailed analysis of the interplay between cardio-metabolic traits and impaired lung function provides the opportunity to improve the quality of existing intervention strategies.
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Affiliation(s)
- Matthias Wielscher
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Andre F S Amaral
- National Heart and Lung Institute (NHLI), Imperial College London, Emmanuel Kaye Building, London, SW3 6LR, UK
| | - Diana van der Plaat
- National Heart and Lung Institute (NHLI), Imperial College London, Emmanuel Kaye Building, London, SW3 6LR, UK
| | - Louise V Wain
- Genetic Epidemiology Group, Department of Health Sciences, George Davies Centre, University of Leicester, University Rd, Leicester, LE1 7RH, UK
- National Institute for Health Research, Leicester Respiratory Biomedical Research Centre, Glenfield Hospital, University Rd, Leicester, LE1 7RH, UK
| | - Sylvain Sebert
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O.Box 8000, FI-90014, Oulu, Finland
- Biocenter of Oulu, University of Oulu, Aapistie 5, FI-90014, Oulu, Finland
| | - David Mosen-Ansorena
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Juha Auvinen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O.Box 8000, FI-90014, Oulu, Finland
- Biocenter of Oulu, University of Oulu, Aapistie 5, FI-90014, Oulu, Finland
| | - Karl-Heinz Herzig
- Biocenter of Oulu, University of Oulu, Aapistie 5, FI-90014, Oulu, Finland
- Research Unit of Biomedicine, Medical Research Center (MRC), University of Oulu, University Hospital, P.O. Box 8000, Oulu, Finland
- Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, 41 Jackowskiego St, 60-512, Poznan, Poland
| | - Abbas Dehghan
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Debbie L Jarvis
- National Heart and Lung Institute (NHLI), Imperial College London, Emmanuel Kaye Building, London, SW3 6LR, UK.
| | - Marjo-Riitta Jarvelin
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK.
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O.Box 8000, FI-90014, Oulu, Finland.
- Biocenter of Oulu, University of Oulu, Aapistie 5, FI-90014, Oulu, Finland.
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Kingston Lane, London, UB8 3PH, UK.
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Carlin B, Ferguson GT, Ozol-Godfrey A, Goodin T, Sanjar S. The Effect of Metabolic Syndrome Status on Lung Function and Patient-reported Outcomes in Patients with COPD Receiving Nebulized Glycopyrrolate. CHRONIC OBSTRUCTIVE PULMONARY DISEASES-JOURNAL OF THE COPD FOUNDATION 2020; 7:315-326. [PMID: 32822528 DOI: 10.15326/jcopdf.7.4.2020.0145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background Concurrent chronic obstructive pulmonary disease (COPD) and metabolic syndrome (MetS) represent an important clinical phenotype with overlapping symptomology. The effect of MetS in COPD patients was assessed following treatment with nebulized glycopyrrolate (GLY; administered via eFlow® Closed System Nebulizer). Methods Posthoc analyses were performed on pooled lung function, patient-reported outcome (PRO) and safety data by MetS status from patients treated with placebo, GLY 25 and 50 mcg twice daily in two 12-week studies (GOLDEN 3 and 4; N=1293). Patients with MetS were characterized as having ≥ 3 of hypertension, hyperlipidemia, diabetes, body mass index (BMI) > 30 kg/m2 risk factors. The results are presented for the Food and Drug Administration-approved GLY 25 mcg dose. Results A total of25% of patients met MetS criteria.At baseline, the MetS subgroup had higher BMIs, more ex-smokers, greater incidences of cardiovascular risk factors, and MetS-specific risk factors were 2-14 times higher than non-MetS. At 12 weeks, GLY produced significant, clinically important improvements (MetS: 0.121 L; non-MetS: 0.083 L) in trough forced expiratory volume in 1 second. In the non-MetS group, significant improvements occurred in the St George's Respiratory Questionnaire (MetS: -2.28, p=0.157; non-MetS: -3.71) and Evaluating Respiratory Symptoms in COPD tool (MetS: 0.42, p=0.574; non-MetS: -1.61) total scores. Incidence of adverse events was similar with GLY versus placebo regardless of MetS status. Conclusion GLY was well-tolerated and significantly improved lung function regardless of MetS status, while significant PRO improvements occurred in non-MetS patients. These results highlight the importance of comorbidities on bronchodilator responses and patient symptoms in COPD patients.
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Affiliation(s)
- Brian Carlin
- Sleep Medicine and Lung Health Consultants, LLC, Pittsburgh, Pennsylvania
| | - Gary T Ferguson
- Pulmonary Research Institute of Southeast Michigan, Farmington Hills, Michigan
| | | | - Thomas Goodin
- Sunovion Pharmaceuticals, Inc., Marlborough, Massachusetts
| | - Shahin Sanjar
- Sunovion Pharmaceuticals, Inc., Marlborough, Massachusetts
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Gender Differences in the Pharmacological Actions of Pegylated Glucagon-Like Peptide-1 on Endothelial Progenitor Cells and Angiogenic Precursor Cells in a Combination of Metabolic Disorders and Lung Emphysema. Int J Mol Sci 2019; 20:ijms20215414. [PMID: 31671663 PMCID: PMC6862381 DOI: 10.3390/ijms20215414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/20/2019] [Accepted: 10/27/2019] [Indexed: 02/06/2023] Open
Abstract
In clinical practice, the metabolic syndrome (MetS) is often associated with chronic obstructive pulmonary disease (COPD). Although gender differences in MetS are well documented, little is known about sex-specific differences in the pathogenesis of COPD, especially when combined with MetS. Consequently, it is not clear whether the same treatment regime has comparable efficacy in men and women diagnosed with MetS and COPD. In the present study, using sodium glutamate, lipopolysaccharide, and cigarette smoke extract, we simulated lipid metabolism disorders, obesity, hyperglycemia, and pulmonary emphysema (comorbidity) in male and female C57BL/6 mice. We assessed the gender-specific impact of lipid metabolism disorders and pulmonary emphysema on angiogenic precursor cells (endothelial progenitor cells (EPC), pericytes, vascular smooth muscle cells, cells of the lumen of the nascent vessel), as well as the biological effects of pegylated glucagon-like peptide 1 (pegGLP-1) in this experimental paradigm. Simulation of MetS/COPD comorbidity caused an accumulation of EPC (CD45−CD31+CD34+), pericytes, and vascular smooth muscle cells in the lungs of female mice. In contrast, the number of cells involved in the angiogenesis decreased in the lungs of male animals. PegGLP-1 had a positive effect on lipids and area under the curve (AUC), obesity, and prevented the development of pulmonary emphysema. The severity of these effects was stronger in males than in females. Furthermore, PegGLP-1 stimulated regeneration of pulmonary endothelium. At the same time, PegGLP-1 administration caused a mobilization of EPC (CD45−CD31+CD34+) into the bloodstream in females and migration of precursors of angiogenesis and vascular smooth muscle cells to the lungs in male animals. Gender differences in stimulatory action of pegGLP-1 on CD31+ endothelial lung cells in vitro were not observed. Based on these findings, we postulated that the cellular mechanism of in vivo regeneration of lung epithelium was at least partly gender-specific. Thus, we concluded that a pegGLP-1-based treatment regime for metabolic disorder and COPD should be further developed primarily for male patients.
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He J, Zhang J, Dong L, Dang X, Wang L, Cheng L, Huang Y. Dihydromyricetin Attenuates Metabolic Syndrome And Improves Insulin Sensitivity By Upregulating Insulin Receptor Substrate-1 (Y612) Tyrosine Phosphorylation In db/db Mice. Diabetes Metab Syndr Obes 2019; 12:2237-2249. [PMID: 31802924 PMCID: PMC6830359 DOI: 10.2147/dmso.s218487] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 10/01/2019] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Dihydromyricetin (DHM), the main bioactive flavonoid in vine tea, exerts multiple health beneficial effects. This work aimed to identify whether a naturally derived flavonoid product, DHM, can significantly attenuate metabolic syndrome and improve insulin sensitivity. METHODS 10-week-old db/db mice were randomly assigned to receive the antidiabetic agent metformin (Met, 50 mg/kg BW), DHM (1.0 g and 0.5 g/kg BW) or placebo and were simultaneously fed a high-fat diet for 8 weeks. The general status of the animals was observed and recorded daily, body weight and blood glucose levels were measured weekly, during the experimental period. On day 55, the oral glucose tolerance test (OGTT) was performed. After OGTT, all animals were anesthetized and sacrificed by cervical decapitation. Blood samples were collected in tubes to detect plasma insulin and the biochemical parameters of lipid metabolism. Pancreas histological changes and islet fibrosis were demonstrated by H&E staining and Masson staining, respectively. Moreover, the expression of insulin receptor substrate-1 and phosphorylated insulin receptor substrate-1 in the insulin signaling pathway was detected by Western blot assay. RESULTS The oral administration of DHM (1.0 g and 0.5 g/kg BW) reduced the fasting blood glucose, serum insulin, and glycated hemoglobin levels and the insulin resistance (HOMA-IR) index. Furthermore, DHM intervention decreased body weight and the serum lipid profile. In addition, DHM treatment also markedly decreased the relative abdominal fat weight. Western blot analysis indicated that DHM upregulated the IRS-1 (Y612) tyrosine phosphorylation, improving insulin resistance. Treatment with dihydromyricetin attenuated the progression of insulin resistance and pancreatic fibrosis in fatty db/db mice. CONCLUSION In summary, we determined the antimetabolic syndrome effect of DHM in db/db obese mice. DHM upregulates the IRS-1 (Y612) tyrosine phosphorylation, improving insulin resistance. Therefore, DHM is a promising therapeutic candidate for the control of metabolic syndrome.
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Affiliation(s)
- Jidong He
- Department of Gastroenterology, Baoji People’s Hospital, Baoji, Shanxi721000, People’s Republic of China
| | - Junpeng Zhang
- Department of Gastroenterology, Baoji People’s Hospital, Baoji, Shanxi721000, People’s Republic of China
| | - Lijuan Dong
- Department of Gastroenterology, Baoji People’s Hospital, Baoji, Shanxi721000, People’s Republic of China
| | - Xuefeng Dang
- Department of Gastroenterology, Baoji People’s Hospital, Baoji, Shanxi721000, People’s Republic of China
| | - Li Wang
- Department of Diabetic Nephropathy, Baoji Central Hospital, Baoji, Shanxi721008, People’s Republic of China
- Correspondence: Li Wang Baoji Central Hospital, No. 8, Jiangtan Road, Baoji, Shanxi721008, People’s Republic of China Email
| | - Long Cheng
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing100193, People’s Republic of China
- Long Cheng Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences, Peking Union Medical College, No. 151, Malianwa North Road Haidian District, Beijing100094, People’s Republic of ChinaTel/Fax +86 10 57833013 Email
| | - Yunxiang Huang
- Department of R&D, Asparagus Engineering Research Center of Hebei Province, Qinhuangdao066008, People’s Republic of China
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