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Luo L, Feng W, Mei M, Tian X, Zhao Y, Liu L, Zhao Z, Luo H, Guo X, Tao L, Liu X, Wang X, Luo Y. Greater variability in HDL-C was associated with an increased risk of cognitive decline in the middle- and elderly Chinese: A cohort study. Arch Gerontol Geriatr 2024; 125:105503. [PMID: 38852372 DOI: 10.1016/j.archger.2024.105503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/26/2024] [Accepted: 05/27/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Previous studies into relationship between high-density lipoprotein cholesterol (HDL-C) and cognitive decline were constrained to a single measurement, leaving the association between HDL-C variability and risk of cognitive decline unclear. METHODS We identified 5930 participants from the China Health and Retirement Longitudinal Study (CHARLS) who were devoid for stroke, dementia, and memory-related diseases at baseline and underwent a minimum of 2 sequential health examinations during 2011-2015. Variability in HDL-C was defined as (1) variability independent of the mean (VIM), (2) average real variability (ARV), and (3) standard deviation (SD) of HDL-C change from baseline and follow-up visits. Cognitive function was evaluated in 2018 by Mini-mental state examination (MMSE) in the Chinese version. Logistic regression was employed to explore the association between HDL-C variability and cognitive decline. Odd ratios (OR) and 95 % confidence intervals (CI) were reported. RESULTS The study included participants from CHARLS, mean age of 57.84±8.44 years and 44 % male. After adjustment for covariates, the highest quartile of VIM was associated with an increased risk of cognitive decline [OR:1.049, 95 %CI: 1.014-1.086] compared to the lowest quartile. For each SD increment of VIM, the OR was 1.015 (95 %CI:1.003-1.027). Strong dose-response relationships were identified (P for trend: 0.005). Consistent results were obtained for other measures of HDL-C variability (ARV and SD). Similar patterns were identified in different dimensions of cognition. CONCLUSIONS Elevated HDL-C variability was associated with increased cognitive decline risk. Strategies to reducing HDL-C variability may lower the risks of cognitive decline among the general population.
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Affiliation(s)
- Lili Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Wei Feng
- Neuroscience Department, Washington University in Saint Louis, MO 63110, USA
| | - Mei Mei
- Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, PR China
| | - Xue Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Yuhan Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Lulu Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Zemeng Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Hui Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Xiangtong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Xiaonan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China.
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China.
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Kim YH, Kim HJ, Park JW, Han KD, Park YG, Lee YB, Lee JH. Risk for Behçet's disease gauged via high-density lipoprotein cholesterol: a nationwide population-based study in Korea. Sci Rep 2022; 12:12735. [PMID: 35882901 PMCID: PMC9325767 DOI: 10.1038/s41598-022-17096-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/20/2022] [Indexed: 11/23/2022] Open
Abstract
Behçet’s disease (BD) is a chronic inflammatory disease. Low levels of plasma high-density lipoprotein cholesterol (HDL-C) are associated with Crohn’s disease, another chronic inflammatory disease. However, the effects of low HDL-C levels on BD are unclear. We investigated the effects of HDL-C levels, and variability therein, on the risk for BD. We used the Korean National Health Insurance System database to identify 5,587,754 adults without a history of BD who underwent ≥ 3 medical examinations between 2010 and 2013. Mean HDL-C levels at each visit were used to calculate variability independent of the mean (VIM) and the coefficient of variation (CV). There were 676 new cases of BD (0.012%). The risk for BD was increased in participants with highly variable and low mean HDL-C levels. In a multivariate-adjusted model, the hazard ratios (95% confidence intervals) for BD incidence were 1.335 (1.058–1.684) in a high mean/high VIM group, 1.527 (1.211–1.925) in a low mean/low VIM group, and 2.096 (1.67–2.63) in a low mean/high VIM group compared to a high mean/low VIM group. Low mean HDL-C levels, and high variability therein, are independent risk factors for BD.
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Affiliation(s)
- Yeong Ho Kim
- Department of Dermatology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Hyun Jee Kim
- Department of Dermatology, College of Medicine, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jin Woo Park
- Department of Dermatology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Kyung Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Yong Gyu Park
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young Bok Lee
- Department of Dermatology, College of Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, 271 Chunbo Street, 07345, Uijeongbu, Seoul, Republic of Korea.
| | - Ji Hyun Lee
- Department of Dermatology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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3
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Hukportie DN, Li F, Zhou R, Zheng J, Wu X, Zou M, Wu X. Lipid variability and risk of microvascular complications in Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial: A post hoc analysis. J Diabetes 2022; 14:365-376. [PMID: 35668633 PMCID: PMC9366577 DOI: 10.1111/1753-0407.13273] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/28/2022] [Accepted: 05/09/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Greater lipid variability may cause adverse health events among diabetic patients. We aimed to examine the effect of lipid variability on the risk of diabetic microvascular outcomes among type 2 diabetes mellitus patients. METHODS We assessed the association between visit-to-visit variability (measured by variability independent of mean) in high-density lipoprotein (HDL) cholesterol, low-density lipoprotein-cholesterol (LDL), triglyceride, and remnant cholesterol (RC) measurements among participants involved in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study and the risk of incident microvascular outcomes, including nephropathy, neuropathy, and retinopathy. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for potential confounders. RESULTS There were 2400, 2470, and 2468 cases of nephropathy, neuropathy, and retinopathy during a follow-up period of 22 600, 21 542, and 26 701 person-years, respectively. Higher levels of HDL, triglyceride, and RC variability were associated with an increased risk of incident nephropathy and neuropathy. Compared with the lowest quartile, the fully adjusted HRs (95% CI) for the highest quartile of HDL, triglyceride, and RC variability for nephropathy risk were 1.57 (1.22, 2.01), 1.50 (1.18, 1.92), and 1.40 (1.09, 1.80), respectively; and for neuropathy, the corresponding risks were 1.36 (1.05, 1.75), 1.47 (1.14, 1.91), and 1.35 (1.04, 1.74), respectively. Null association was observed between LDL variability and all microvascular complications. Additionally, all associations of variability in the other lipids with retinopathy risk were null. CONCLUSION Among individuals with type 2 diabetes mellitus, HDL, triglyceride, and RC variability were associated with increased risks of nephropathy and neuropathy but not retinopathy. TRIAL REGISTRATION ClinicalTrials.gov., no. NCT00000620.
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Affiliation(s)
- Daniel Nyarko Hukportie
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
| | - Fu‐Rong Li
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
- School of Public Health and Emergency ManagementSouthern University of Science and TechnologyShenzhenChina
| | - Rui Zhou
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
| | - Jia‐Zhen Zheng
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
| | - Xiao‐Xiang Wu
- Department of General Surgery157 Hospital, General Hospital of Guangzhou Military CommandGuangzhouChina
| | - Meng‐Chen Zou
- Department of Endocrinology and Metabolism, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Xian‐Bo Wu
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
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Kuang R, Liao Y, Xie X, Li B, Lin X, Liu Q, Liu X, Yu W. Dynamic physical examination indicators of cardiovascular health: A single-center study in Shanghai, China. PLoS One 2022; 17:e0268358. [PMID: 35550637 PMCID: PMC9098044 DOI: 10.1371/journal.pone.0268358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/27/2022] [Indexed: 11/19/2022] Open
Abstract
Dynamic physical examination data can provide both cross-sectional and time-series characteristics of cardiovascular health. However, most physical examination databases containing health and disease information have not been fully utilized in China. Hence, this study aimed to analyze dynamic physical examination indicators for cardiovascular health to provide evidence for precise prevention and control of cardiovascular diseases in the primary prevention domain among healthy population with different demographic characteristics in Shanghai. Three-year continuous data were collected from the physical examination center of a hospital in Shanghai from 2018 to 2020, which included a total of 14,044 participants with an average age of 46.51±15.57 years. The cardiovascular status of overall healthy individuals may have a decreasing trend, which is manifested as a significant year-on-year decrease in high-density lipoprotein cholesterol; a significant year-on-year increase in total cholesterol, low-density lipoprotein cholesterol, and blood glucose levels; and a possible increasing trend of diastolic blood pressure, body mass index, and triglycerides. Healthy population with different sex and age groups have various sensitives to cardiovascular physical examination indicators. To conduct more accurate cardiovascular health management and health promotion for key populations in primary prevention, focusing on the dynamic trends of blood pressure, blood lipids, blood glucose, and body mass index in men and changes in total cholesterol in women over time is especially important. The age group of 50–69 years is key for better prevention and control of cardiovascular health.
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Affiliation(s)
- Rongren Kuang
- Department of Cardiovascular Disease, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Yiling Liao
- Department of Cardiovascular Disease, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Xinhan Xie
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Biao Li
- Department of Cardiovascular Disease, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Xiaojuan Lin
- Department of Cardiovascular Disease, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Qiang Liu
- Department of Cardiovascular Disease, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
- * E-mail: (WY); (XL); (QL)
| | - Xiang Liu
- Department of Respiratory Disease, The 903rd Hospital of the People’s Liberation Army, Hangzhou, China
- * E-mail: (WY); (XL); (QL)
| | - Wenya Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- * E-mail: (WY); (XL); (QL)
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5
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Koh ES, Han KD, Kim MK, Kim ES, Lee MK, Nam GE, Kwon HS. Weight change and microvascular outcomes in patients with new-onset diabetes: a nationwide cohort study. Korean J Intern Med 2021; 36:932-941. [PMID: 32872746 PMCID: PMC8273818 DOI: 10.3904/kjim.2020.121] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/13/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND/AIMS Because weight control is important in treatment of type 2 diabetes, it is essential to understand the associations between weight change and the risk of microvascular complications among patients with type 2 diabetes. We examined whether weight changes early after new-onset diabetes have an impact on the clinical outcomes of diabetic nephropathy and retinopathy. METHODS Using the Korean National Health Insurance Service-National Health Screening Cohort database, 181,872 patients newly diagnosed with type 2 diabetes who were free of end-stage renal disease (ESRD) and proliferative diabetic retinopathy (PDR) during 2007 to 2012 were followed to the end of 2016. Weight change was defined as the difference in body weight from the time of diabetes diagnosis to 2 years later. RESULTS We identified 180 cases of ESRD and 780 cases of PDR followed up for a median of 5.5 years from the index year at 2 years after diagnosis. Those with 5% to 10% weight gain showed a significantly higher hazard ratio (HR) for ESRD, compared with those with ≤ 5% weight change after adjusting for several confounding factors, including the baseline estimated glomerular filtration rate (HR, 1.75; 95% confidence interval [CI], 1.14 to 2.70). Those with ≥ 10% weight loss showed the lowest HR for PDR (HR, 0.52; 95% CI, 0.33 to 0.83), whereas those with ≥ 10% weight gain showed the highest HR for PDR (HR, 3.20; 95% CI, 2.51 to 4.08). CONCLUSION Weight gain after new-onset diabetes was associated with increased risk of ESRD and PDR whereas weight loss with decreased risk of PDR, but not ESRD.
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Affiliation(s)
- Eun Sil Koh
- Division of Nephrology, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
- Cell Death Disease research Center, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Kyung Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul,
Korea
| | - Mee Kyoung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Eun Sook Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon,
Korea
| | - Min-Kyung Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang,
Korea
| | - Ga Eun Nam
- Department of Family Medicine, Korea University Anam Hospital, Seoul,
Korea
| | - Hyuk-Sang Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
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Park JH, Lee CW, Nam MJ, Kim H, Kwon DY, Yoo JW, Lee KN, Han K, Jung JH, Park YG, Kim DH. Association of High-Density Lipoprotein Cholesterol Variability and the Risk of Developing Parkinson Disease. Neurology 2021; 96:e1391-e1401. [PMID: 33536275 DOI: 10.1212/wnl.0000000000011553] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 11/09/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To investigate the longitudinal association among high-density lipoprotein cholesterol (HDL-C) level, HDL-C variability, and the risk of developing Parkinson disease (PD). METHODS We conducted a nationwide, population-based cohort study. We included 382,391 patients aged ≥65 years who underwent at least 3 health examinations provided by the Korean National Health Insurance System from 2008 to 2013 and followed up until 2017. Individuals with a history of PD and missing values were excluded (n = 1,987). We assessed HDL-C variability using 3 indices, including variability independent of the mean (VIM). A multivariate-adjusted Cox proportional hazards regression analysis was performed. RESULTS Among the 380,404 participants, 2,733 individuals were newly diagnosed with PD during a median follow-up period of 5 years. The lowest quartile (Q1) group of baseline HDL-C and mean HDL-C was associated with increased PD incidence as compared with the highest quartile (Q4) group (adjusted hazard ratio [aHR], 1.20; 95% confidence interval [CI], 1.08-1.34; and aHR, 1.16; 95% CI, 1.04-1.30, respectively). The Q4 group of HDL-C variability (VIM) was associated with increased PD incidence compared to the Q1 group (aHR, 1.19; 95% CI, 1.06-1.33). The group with the Q1 of baseline HDL-C and with the Q4 of HDL-C variability had the highest risk of PD incidence (aHR, 1.6; 95% CI, 1.31-1.96). CONCLUSION Lower HDL-C level and greater HDL-C variability were associated with a higher incidence of PD.
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Affiliation(s)
- Joo-Hyun Park
- From the Departments of Family Medicine (J.-H.P., C.-w.L., M.J.N., H.K., D.-H.K.) and Neurology (D.-Y.K.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea; Department of Internal Medicine (J.W.Y.), University of Nevada Las Vegas School of Medicine; Department of Statistics and Actuarial Science (K.N.L., K.H.), Soongsil University; and Department of Biostatistics (J.-H.J., Y.-G.P.), College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Chung-Woo Lee
- From the Departments of Family Medicine (J.-H.P., C.-w.L., M.J.N., H.K., D.-H.K.) and Neurology (D.-Y.K.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea; Department of Internal Medicine (J.W.Y.), University of Nevada Las Vegas School of Medicine; Department of Statistics and Actuarial Science (K.N.L., K.H.), Soongsil University; and Department of Biostatistics (J.-H.J., Y.-G.P.), College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Myung Ji Nam
- From the Departments of Family Medicine (J.-H.P., C.-w.L., M.J.N., H.K., D.-H.K.) and Neurology (D.-Y.K.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea; Department of Internal Medicine (J.W.Y.), University of Nevada Las Vegas School of Medicine; Department of Statistics and Actuarial Science (K.N.L., K.H.), Soongsil University; and Department of Biostatistics (J.-H.J., Y.-G.P.), College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyunjin Kim
- From the Departments of Family Medicine (J.-H.P., C.-w.L., M.J.N., H.K., D.-H.K.) and Neurology (D.-Y.K.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea; Department of Internal Medicine (J.W.Y.), University of Nevada Las Vegas School of Medicine; Department of Statistics and Actuarial Science (K.N.L., K.H.), Soongsil University; and Department of Biostatistics (J.-H.J., Y.-G.P.), College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Do-Young Kwon
- From the Departments of Family Medicine (J.-H.P., C.-w.L., M.J.N., H.K., D.-H.K.) and Neurology (D.-Y.K.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea; Department of Internal Medicine (J.W.Y.), University of Nevada Las Vegas School of Medicine; Department of Statistics and Actuarial Science (K.N.L., K.H.), Soongsil University; and Department of Biostatistics (J.-H.J., Y.-G.P.), College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ji Won Yoo
- From the Departments of Family Medicine (J.-H.P., C.-w.L., M.J.N., H.K., D.-H.K.) and Neurology (D.-Y.K.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea; Department of Internal Medicine (J.W.Y.), University of Nevada Las Vegas School of Medicine; Department of Statistics and Actuarial Science (K.N.L., K.H.), Soongsil University; and Department of Biostatistics (J.-H.J., Y.-G.P.), College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyu Na Lee
- From the Departments of Family Medicine (J.-H.P., C.-w.L., M.J.N., H.K., D.-H.K.) and Neurology (D.-Y.K.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea; Department of Internal Medicine (J.W.Y.), University of Nevada Las Vegas School of Medicine; Department of Statistics and Actuarial Science (K.N.L., K.H.), Soongsil University; and Department of Biostatistics (J.-H.J., Y.-G.P.), College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- From the Departments of Family Medicine (J.-H.P., C.-w.L., M.J.N., H.K., D.-H.K.) and Neurology (D.-Y.K.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea; Department of Internal Medicine (J.W.Y.), University of Nevada Las Vegas School of Medicine; Department of Statistics and Actuarial Science (K.N.L., K.H.), Soongsil University; and Department of Biostatistics (J.-H.J., Y.-G.P.), College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Jin-Hyung Jung
- From the Departments of Family Medicine (J.-H.P., C.-w.L., M.J.N., H.K., D.-H.K.) and Neurology (D.-Y.K.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea; Department of Internal Medicine (J.W.Y.), University of Nevada Las Vegas School of Medicine; Department of Statistics and Actuarial Science (K.N.L., K.H.), Soongsil University; and Department of Biostatistics (J.-H.J., Y.-G.P.), College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong-Gyu Park
- From the Departments of Family Medicine (J.-H.P., C.-w.L., M.J.N., H.K., D.-H.K.) and Neurology (D.-Y.K.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea; Department of Internal Medicine (J.W.Y.), University of Nevada Las Vegas School of Medicine; Department of Statistics and Actuarial Science (K.N.L., K.H.), Soongsil University; and Department of Biostatistics (J.-H.J., Y.-G.P.), College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Do-Hoon Kim
- From the Departments of Family Medicine (J.-H.P., C.-w.L., M.J.N., H.K., D.-H.K.) and Neurology (D.-Y.K.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea; Department of Internal Medicine (J.W.Y.), University of Nevada Las Vegas School of Medicine; Department of Statistics and Actuarial Science (K.N.L., K.H.), Soongsil University; and Department of Biostatistics (J.-H.J., Y.-G.P.), College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Changes in metabolic syndrome status affect the incidence of end-stage renal disease in the general population: a nationwide cohort study. Sci Rep 2021; 11:1957. [PMID: 33479302 PMCID: PMC7820283 DOI: 10.1038/s41598-021-81396-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 12/16/2020] [Indexed: 01/21/2023] Open
Abstract
Few studies have investigated the impact of a change in metabolic syndrome (MetS) components on clinical renal outcomes in the general population. Using nationally representative data from the Korean National Health Insurance System, 13,310,924 subjects who underwent two health examinations over 2 years and were free from end-stage renal disease (ESRD) from 2009 to 2012 were followed to the end of 2016. The subjects were divided into four groups according to the change in MetS components between the two visits over 2 years: no MetS (–/–), post-MetS (–/+), pre-MetS (+/–), and both MetS (+/+). After a median follow up of 5.11 years, 18,582 incident ESRD cases were identified. In the multivariate adjusted model, the hazard ratio (HR) and 95% confidence interval (CI) for the development of ESRD in the both-MetS (+/+) group compared with the no-MetS (–/–) group was 5.65 (95% CI, 5.42–5.89), which was independent of age, sex, and baseline estimated glomerular filtration rate. Additionally, the HR for the pre-MetS (+/–) group versus the no-MetS (–/–) group was 2.28 (2.15–2.42). In subgroup analysis according to renal function, the impact of a change in MetS on the incidence of ESRD was more pronounced in individuals with advanced renal dysfunction. Subjects with resolved MetS components had a decreased risk of ESRD, but not as low as those that never had MetS components. This provides evidence supporting the strategy of modulating MetS in the general population to prevent the development of ESRD.
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Lee SH, Kim MK, Rhee EJ. Effects of Cardiovascular Risk Factor Variability on Health Outcomes. Endocrinol Metab (Seoul) 2020; 35:217-226. [PMID: 32615706 PMCID: PMC7386100 DOI: 10.3803/enm.2020.35.2.217] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 06/10/2020] [Indexed: 02/06/2023] Open
Abstract
Innumerable studies have suggested "the lower, the better" for cardiovascular risk factors, such as body weight, lipid profile, blood pressure, and blood glucose, in terms of health outcomes. However, excessively low levels of these parameters cause health problems, as seen in cachexia, hypoglycemia, and hypotension. Body weight fluctuation is related to mortality, diabetes, obesity, cardiovascular disease, and cancer, although contradictory findings have been reported. High lipid variability is associated with increased mortality and elevated risks of cardiovascular disease, diabetes, end-stage renal disease, and dementia. High blood pressure variability is associated with increased mortality, myocardial infarction, hospitalization, and dementia, which may be caused by hypotension. Furthermore, high glucose variability, which can be measured by continuous glucose monitoring systems or self-monitoring of blood glucose levels, is associated with increased mortality, microvascular and macrovascular complications of diabetes, and hypoglycemic events, leading to hospitalization. Variability in metabolic parameters could be affected by medications, such as statins, antihypertensives, and hypoglycemic agents, and changes in lifestyle patterns. However, other mechanisms modify the relationships between biological variability and various health outcomes. In this study, we review recent evidence regarding the role of variability in metabolic parameters and discuss the clinical implications of these findings.
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Affiliation(s)
- Seung-Hwan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Mee Kyoung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Eun-Jung Rhee
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul,
Korea
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Binder CJ, Borén J, Catapano AL, Dallinga-Thie G, Kronenberg F, Mallat Z, Negrini S, Raggi P, von Eckardstein A. The year 2019 in Atherosclerosis. Atherosclerosis 2020; 299:67-75. [PMID: 32248950 DOI: 10.1016/j.atherosclerosis.2020.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Christoph J Binder
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Jan Borén
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Alberico L Catapano
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy; IRCCS Multimedica Hospital, Milan, Italy
| | - Geesje Dallinga-Thie
- Department of Vascular Medicine, Amsterdam University Medical Centers, AMC, Amsterdam, the Netherlands
| | - Florian Kronenberg
- Institute of Genetic Epidemiology, Department of Genetics and Pharmacology, Medical University of Innsbruck, Austria
| | - Ziad Mallat
- Department of Medicine, Division of Cardiovascular Medicine, University of Cambridge, Cambridge, United Kingdom; University of Paris, PARCC, INSERM, Paris, France
| | - Simona Negrini
- Institute of Clinical Chemistry, University of Zurich, University Hospital of Zurich, Zurich, Switzerland
| | - Paolo Raggi
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB, Canada; Department of Medicine, University of Alberta, Edmonton, AB, Canada; Division of Cardiology, University of Alberta, Edmonton, AB, Canada
| | - Arnold von Eckardstein
- Institute of Clinical Chemistry, University of Zurich, University Hospital of Zurich, Zurich, Switzerland.
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10
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Han BH, Han K, Yoon KH, Kim MK, Lee SH. Impact of Mean and Variability of High-Density Lipoprotein-Cholesterol on the Risk of Myocardial Infarction, Stroke, and Mortality in the General Population. J Am Heart Assoc 2020; 9:e015493. [PMID: 32248727 PMCID: PMC7428592 DOI: 10.1161/jaha.119.015493] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background A low level of high‐density lipoprotein‐cholesterol (HDL‐C) is a well‐known risk factor for cardiovascular events. Recent studies have also suggested that HDL‐C variability has a predictive role in patients with coronary artery disease. We investigated the combined effect of the mean and variability of HDL‐C on the risk of myocardial infarction (MI), stroke, and mortality in the general population. Methods and Results We selected 5 433 098 subjects in the Korean National Health Insurance System cohort who had no history of MI or stroke and who underwent ≥3 health examinations between 2009 and 2013. Visit‐to‐visit HDL‐C variability was calculated using the coefficient of variation, variability independent of the mean and average real variability. The low‐mean and high‐variability groups were defined as the lowest and highest quartiles of HDL‐C mean and variability, respectively. There were 27 605 cases of MI, 31 162 cases of stroke, and 50 959 deaths during the median follow‐up of 5.1±0.6 years. A lower mean or higher variability (coefficient of variation) of HDL‐C was associated with a higher risk of adverse outcomes, and the 2 measures had an additive effect. In the multivariable‐adjusted model, the hazard ratios (95% CIs) of the low‐mean/high‐variability group compared with the high‐mean/low‐variability group were 1.47 (1.41–1.54) for MI, 1.23 (1.18–1.28) for stroke, and 1.41 (1.36–1.45) for all‐cause mortality. Results were consistent when variability was modeled using variability independent of the mean or average real variability, and in various sensitivity and subgroup analyses. Conclusions Low mean and high variability of HDL‐C is associated with an increased risk of MI, stroke, and mortality.
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Affiliation(s)
- Byung-Hun Han
- College of Medicine The Catholic University of Korea Seoul Korea
| | - Kyungdo Han
- Department of Medical Statistics College of Medicine The Catholic University of Korea Seoul Korea
| | - Kun-Ho Yoon
- Division of Endocrinology and Metabolism Department of Internal Medicine Seoul St. Mary's Hospital College of Medicine The Catholic University of Korea Seoul Korea.,Department of Medical Informatics College of Medicine The Catholic University of Korea Seoul Korea
| | - Mee Kyoung Kim
- Division of Endocrinology and Metabolism Department of Internal Medicine Yeouido St. Mary's Hospital College of Medicine The Catholic University of Korea Seoul Korea
| | - Seung-Hwan Lee
- Division of Endocrinology and Metabolism Department of Internal Medicine Seoul St. Mary's Hospital College of Medicine The Catholic University of Korea Seoul Korea.,Department of Medical Informatics College of Medicine The Catholic University of Korea Seoul Korea
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