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Zheng Z, Pan J, Liu M, Chen Z, Zhang L, Gao J, Gao P, Zhang X. Anemia and testosterone deficiency risk: insights from NHANES data analysis and a Mendelian randomization analysis. Aging Male 2024; 27:2346312. [PMID: 38685728 DOI: 10.1080/13685538.2024.2346312] [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: 11/27/2023] [Accepted: 04/17/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Previous research has shown that testosterone deficiency (TD) increases the risk of anemia, but it is unclear whether anemia affects testosterone levels. This study investigated the influence of anemia on testosterone levels. METHODS Utilizing data from six NHANES cycles, including demographic, testosterone levels, and hemoglobin concentrations, we employed multivariable-adjusted logistic regression to investigate the relationship between anemia and testosterone levels. Moreover, a two-sample Mendelian randomization (MR) study employing genome-wide association study (GWAS) data examined the causal relationship. Kaplan-Meier survival estimation was used to compared the overall survival (OS) of anemic and nonanemic patients with low testosterone and normal testosterone levels. RESULTS The inclusion of 21,786 participants (2318 with anemia and19,468 without anemia) revealed that nonanemic patients exhibited higher testosterone levels than did anemic patients (β = 22.616, 95% CI: 3.873-41.359, p = 0.01807). MR analysis confirmed anemia as a cause of TD (OR = 1.045, 95% CI: 1.020-1.071, p < 0.001). Anemic males with low testosterone had reduced OS compared to those with normal levels (p < 0.001). CONCLUSIONS Anemia emerged as a potential risk factor for TD, highlighting a bidirectional relationship between these conditions. Additional prospective investigations are essential for the validation and reinforcement of our findings.
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Affiliation(s)
- Zhenming Zheng
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, PR China
- Institute of Urology, Anhui Medical University, Hefei, PR China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, PR China
| | - Jiashan Pan
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, PR China
- Institute of Urology, Anhui Medical University, Hefei, PR China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, PR China
| | - Ming Liu
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, PR China
- Institute of Urology, Anhui Medical University, Hefei, PR China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, PR China
| | - Zhimin Chen
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, PR China
- Institute of Urology, Anhui Medical University, Hefei, PR China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, PR China
| | - Lvwen Zhang
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, PR China
- Institute of Urology, Anhui Medical University, Hefei, PR China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, PR China
| | - Jingjing Gao
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, PR China
- Institute of Urology, Anhui Medical University, Hefei, PR China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, PR China
| | - Pan Gao
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, PR China
- Institute of Urology, Anhui Medical University, Hefei, PR China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, PR China
| | - Xiansheng Zhang
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, PR China
- Institute of Urology, Anhui Medical University, Hefei, PR China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, PR China
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Piperi A, Warnier G, VAN Doorslaer DE Ten Ryen S, Benoit N, Antoine N, Copine S, Francaux M, Deldicque L. Repeated Sprint Training in Hypoxia Improves Repeated Sprint Ability to Exhaustion Similarly in Active Males and Females. Med Sci Sports Exerc 2024; 56:1988-1999. [PMID: 38767990 DOI: 10.1249/mss.0000000000003485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
PURPOSE The aim of this study was to compare the physiological adaptations of males and females to repeated sprint training in hypoxia (RSH). METHODS Active males and females completed 7 wk of repeated sprint training in normoxia (RSN; F i O 2 = 0.209, males: n = 11, females: n = 8) or RSH (F i O 2 = 0.146, males: n = 12, females: n = 10). Before (Pre-) and after (Post-) training, a repeated sprint ability (RSA) test was performed (10-s cycle sprints with 20-s recovery between sprints, until exhaustion), and aerobic and anaerobic qualities were evaluated in normoxia. RESULTS The number of sprints during RSA increased after training in HYP from 11 to 21 in males and from 8 to 14 in females ( P < 0.001, 95% confidence interval = 5-11), without significant changes after RSN (10 vs 14 and 8 vs 10 in males and females, respectively). No improvements in mean or peak power output were found in either group. Total work during RSA improved after training in all groups (+9 ± 2 kJ, P < 0.001). Tissue saturation index during the repeated sprints was higher in females than males (+10% ± 2%, P < 0.001). The difference in tissue saturation index between the recovery and sprint phases remained unchanged after training. O 2 peak during an incremental exercise test increased in all groups (+3 ± 1 mL·kg -1 ·min -1 , P = 0.039). Mean power output during a Wingate test also increased in both males and females in RSN and RSH (+0.38 ± 0.18 W·kg -1 , P = 0.036). No changes were observed in hematological parameters after training. CONCLUSIONS Seven weeks of RSH further increased the number of repeated sprints performed to exhaustion compared with RSN in females, in the same order of magnitude as in males.
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Affiliation(s)
- Anna Piperi
- Institute of Neuroscience, UCLouvain, Louvain-la-Neuve, BELGIUM
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Li Q, Xu Z, Gong Q, Shen X. Clinical characteristics and a diagnostic model for high-altitude pulmonary edema in habitual low altitude dwellers. PeerJ 2024; 12:e18084. [PMID: 39346082 PMCID: PMC11439376 DOI: 10.7717/peerj.18084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 08/21/2024] [Indexed: 10/01/2024] Open
Abstract
Background The fatal risk of high-altitude pulmonary edema (HAPE) is attributed to the inaccurate diagnosis and delayed treatment. This study aimed to identify the clinical characteristics and to establish an effective diagnostic nomogram for HAPE in habitual low altitude dwellers. Methods A total of 1,255 individuals of Han Chinese were included in the study on the Qinghai-Tibet Plateau at altitudes exceeding 3,000 m. LASSO algorithms were utilized to identify significant predictors based on Akaike's information criterion (AIC), and a diagnostic nomogram was developed through multivariable logistic regression analysis. Internal validation was conducted through bootstrap resampling. Model performance was evaluated using ROC curves and the Hosmer-Lemeshow test. Results The nomogram included eleven predictive factors and demonstrated high discrimination with an AUC of 0.787 (95% CI [0.757-0.817]) and 0.833 (95% CI [0.793-0.874]) in the training and validation cohorts, respectively. Calibration curves were assessed in both the training (P = 0.793) and validation datasets (P = 0.629). Confusion matrices revealed accuracies of 70.95% and 74.17% for the training and validation groups. Furthermore, decision curve analysis supported the use of the nomogram for patients with HAPE. Conclusion We propose clinical features and column charts based on hematological parameters and demographic variables, which can be conveniently used for the diagnosis of HAPE. In high-altitude areas with limited emergency environments, a diagnostic model can provide fast and reliable diagnostic support for medical staff, helping them make better treatment decisions.
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Affiliation(s)
- Qiong Li
- School of Public Health, Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
- School of Public Health, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Zhichao Xu
- School of Public Health, Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
- School of Public Health, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Qianhui Gong
- School of Public Health, Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
- School of Public Health, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Xiaobing Shen
- School of Public Health, Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
- School of Public Health, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
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Šarić Jadrijev A, Bego A, Lojpur B, Poljak D, Žaja M, Matas J, Pivalica B, Stojanović Stipić S, Čapkun V, Vukojević K, Glavina Durdov M, Bratanić A. Admission Hemoglobin Associated with Increased Mortality in Hip Fracture Surgical Patients: An Observational Study. Biomedicines 2024; 12:2041. [PMID: 39335554 PMCID: PMC11428683 DOI: 10.3390/biomedicines12092041] [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: 07/26/2024] [Revised: 09/05/2024] [Accepted: 09/06/2024] [Indexed: 09/30/2024] Open
Abstract
In hip fracture patients, who are mostly elderly, preexisting anemia can be worsened when combined with trauma and surgery. To this date, there is no unequivocal approach about transfusion thresholds. We analyzed hemoglobin (Hb) and hematocrit (Hct) levels at three time points in surgical patients with proximal femoral fractures (PFF) to see which levels were triggers for transfusions and whether transfusions were related to mortality after hospital discharge. A total of 956 patients were operated on from 1 January 2021 to 31 December 2022 at the University Hospital of Split and included in the study. There were more women (74%); 47% patients had admission Hb < 120 g/L. Transfusion was given preoperatively to 88, intraoperatively to 74 and postoperatively to 309 patients. Transfusion thresholds were as follows: Hb 84 g/L preoperatively, 99 intraoperatively and 83 postoperatively. After hospital discharge, 10.79% of patients died within the 1st month and 23% within 6 months. In the group of non-survivors, 60% of patients had admission Hb ≤ 117 g/L and the proportion of patients transfused preoperatively was two times higher. Preoperative transfusion thresholds could be set to higher levels for patients with surgically treated PFF. However, that could increase mortality even more. Further investigation is necessary.
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Affiliation(s)
- Ana Šarić Jadrijev
- Department of Anaesthesiology and Intensive Care, University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
| | - Ana Bego
- Department of Anaesthesiology and Intensive Care, University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
| | - Borna Lojpur
- Institute of Emergency Medicine in Split-Dalmatia County, Spinčićeva 1, 21000 Split, Croatia
| | - Dino Poljak
- Department of Surgery, University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
| | - Marija Žaja
- Department of Anaesthesiology and Intensive Care, University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
| | - Jakov Matas
- Priska Med Polyclinic, Kroz Smrdečac 45, 21000 Split, Croatia
| | - Božen Pivalica
- Department of Surgery, University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
| | - Sanda Stojanović Stipić
- Department of Anaesthesiology and Intensive Care, University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
| | - Vesna Čapkun
- Department of Anatomy, Histology and Embryology, School of Medicine, University of Split, Šoltanska 2A, 21000 Split, Croatia
| | - Katarina Vukojević
- Department of Anatomy, Histology and Embryology, School of Medicine, University of Split, Šoltanska 2A, 21000 Split, Croatia
| | - Merica Glavina Durdov
- Department of Pathology, Legal Medicine and Cytology, University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
| | - Andre Bratanić
- Department of Internal Medicine, University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
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Zhang YT, Zeeshan M, Fan YY, Tan WH, Zhao K, Liang LX, Huang JW, Zhou JX, Guo LH, Lin LZ, Liu RQ, Zeng XW, Dong GH, Chu C. Isomer of per- and polyfluoroalkyl substances and red blood cell indices in adults: The Isomers of C8 Health Project in China. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2024; 79:153-165. [PMID: 39219509 DOI: 10.1080/19338244.2024.2396927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 08/12/2024] [Indexed: 09/04/2024]
Abstract
This study aimed to explore the isomer-specific, sex-specific, and joint associations of PFAS and red blood cell indices. We used data of 1,238 adults from the Isomers of C8 Health Project in China. Associations of PFAS isomers and red blood cell indices were explored using multiple linear regression models, Bayesian Kernel Machine Regression models and subgroup analysis across sex. We found that serum concentration of linear (n-) and branched (Br-) isomers of perfluorooctane sulfonate (PFOS) and perfluorohexanesulfonic acid (PFHxS) were significantly associated with red blood cell indices in single-pollutant models, with stronger associations observed for n-PFHxS than Br-PFHxS, in women than in men. For instance, the estimated percentage change in hemoglobin concentration for n-PFHxS (3.65%; 95% CI: 2.95%, 4.34%) was larger than that for Br-PFHxS (0.96%; 95% CI: 0.52%, 1.40%). The estimated percentage change in red blood cell count for n-PFHxS in women (2.55%; 95% CI: 1.81%, 3.28%) was significantly higher than that in men (0.12%; 95% CI: -1.04%, 1.29%) (Pinter < 0.001). Similarly, sex-specific positive association of PFAS mixture and outcomes was observed. Therefore, the structure, susceptive population, and joint effect of PFAS isomers should be taken into consideration when evaluating the health risk of chemicals.
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Affiliation(s)
- Yun-Ting Zhang
- Department of Reproductive Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Mohammed Zeeshan
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou, China
| | - Yuan-Yuan Fan
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou, China
| | - Wei-Hong Tan
- Department of Reproductive Medicine and Genetics Center, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Kun Zhao
- Department of Reproductive Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Li-Xia Liang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou, China
| | - Jing-Wen Huang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou, China
| | - Jia-Xin Zhou
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou, China
| | - Li-Hao Guo
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou, China
| | - Li-Zi Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou, China
| | - Ru-Qing Liu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou, China
| | - Xiao-Wen Zeng
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou, China
| | - Guang-Hui Dong
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou, China
| | - Chu Chu
- Department of Reproductive Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Ramasamy I. Gender Reassignment and the Role of the Laboratory in Monitoring Gender-Affirming Hormone Therapy. J Clin Med 2024; 13:5134. [PMID: 39274346 PMCID: PMC11396367 DOI: 10.3390/jcm13175134] [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: 07/15/2024] [Revised: 08/18/2024] [Accepted: 08/26/2024] [Indexed: 09/16/2024] Open
Abstract
Transgender people experience distress due to gender incongruence (i.e., a discrepancy between their gender identity and sex assigned at birth). Gender-affirming hormone treatment (GAHT) is a part of gender reassignment treatment. The therapeutic goals of the treatment are to develop the physical characteristics of the affirmed gender as far as possible. Guidelines have been developed for GAHT, which recommend dosage as well as different formulations of oestrogen and testosterone for treatment. Questions arise about the metabolic side effects of hormone treatment. Establishing reference ranges for common analytes in transgender individuals remains a task for laboratory medicine. It has been suggested once GAHT is commenced, the reference ranges for affirmed gender are reported for red blood cells, haemoglobin and haematocrit. For transgender assigned-female-at-birth (AFAB) people, testosterone concentrations are recommended to be within the reference interval established for cisgender men and for transgender assigned-male-at-birth (AMAB) people, estradiol concentrations are within the reference range for cisgender women. Sex-specific reference ranges are available for certain laboratory tests, and these may be organ (e.g., heart)-specific. Transgender-specific reference ranges may be a requirement for such tests. Laboratories may need to make decisions on how to report other tests in the transgender population, e.g., eGFR. Interpretation of further tests (e.g., reproductive hormones) can be individualized depending on clinical information. Electronic medical record systems require fields for gender identity/biological sex at birth so that laboratory results can be flagged appropriately. In this review, we aim to summarise the current position of the role of the laboratory in the clinical care of the transgender individual. Prior to the review, we will summarise the genetics of sex determination, the aetiology of gender incongruence, and the recommendations for GAHT and monitoring for the transgender population.
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He L, Yang J, Lin S, Shi K, Fang Y. Frailty detection with routine blood tests using data from the english longitudinal study of ageing (ELSA). Eur Geriatr Med 2024:10.1007/s41999-024-01038-2. [PMID: 39190227 DOI: 10.1007/s41999-024-01038-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 08/06/2024] [Indexed: 08/28/2024]
Abstract
PURPOSE Frailty is a rising global health issue in ageing society. Easily accessible and sensitive tools are needed for frailty monitoring while routine blood factors can be potential candidates. METHODS Data from 1907 participants (aged 60 years or above) were collected from the 4th to 9th wave of the English longitudinal study of ageing. 14 blood factors obtained from blood tests were included in the analysis. A 52-item frailty index (FI) was calculated for frailty evaluation. Logistic regression and Cox proportional hazards analysis were used to explore the relationships between baseline blood factors and the incidence of frailty over time respectively. All analyses were controlled for age and sex. RESULTS The mean age of participants was 67.3 years and 47.2% of them were male. Our study identified that 8 blood factors (mean corpuscular haemoglobin, HDL, triglyceride, ferritin, hsCRP, dehydroepiandrosterone, haemoglobin, and WBC) involved in inflammatory, nutritional and metabolic processes were associated with frailty. The combined model with these 8 blood factors had an AUC of 0.758 at cross-sectional level. In the Cox proportional hazards analysis, higher triglyceride (HR: 1.30, 95%CI: 1.07 ~ 1.59), WBC (HR: 1.16, 95%CI: 1.05 ~ 1.28), and lower HDL (HR: 0.58, 95%CI: 0.38 ~ 0.90) at baseline were linked to greater risk of developing frailty within 10 years. Compared to adults without abnormal blood factors at baseline, the hazard ratios of participants with two or more abnormal blood factors were almost twofold higher in developing frailty over time. CONCLUSIONS Routine blood factors, particularly triglyceride, HDL and WBC, could be used for frailty screening in clinical practice and estimate the development of frailty over time.
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Affiliation(s)
- Lingxiao He
- Center for Ageing and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Jinzhu Yang
- Center for Ageing and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Shujing Lin
- Center for Ageing and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Kanglin Shi
- Center for Ageing and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Ya Fang
- Center for Ageing and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China.
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Küchenhoff S, Bayrak Ş, Zsido RG, Saberi A, Bernhardt BC, Weis S, Schaare HL, Sacher J, Eickhoff S, Valk SL. Relating sex-bias in human cortical and hippocampal microstructure to sex hormones. Nat Commun 2024; 15:7279. [PMID: 39179555 PMCID: PMC11344136 DOI: 10.1038/s41467-024-51459-7] [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: 11/02/2023] [Accepted: 07/25/2024] [Indexed: 08/26/2024] Open
Abstract
Determining sex-bias in brain structure is of great societal interest to improve diagnostics and treatment of brain-related disorders. So far, studies on sex-bias in brain structure predominantly focus on macro-scale measures, and often ignore factors determining this bias. Here we study sex-bias in cortical and hippocampal microstructure in relation to sex hormones. Investigating quantitative intracortical profiling in-vivo using the T1w/T2w ratio in 1093 healthy females and males of the cross-sectional Human Connectome Project young adult sample, we find that regional cortical and hippocampal microstructure differs between males and females and that the effect size of this sex-bias varies depending on self-reported hormonal status in females. Microstructural sex-bias and expression of sex hormone genes, based on an independent post-mortem sample, are spatially coupled. Lastly, sex-bias is most pronounced in paralimbic areas, with low laminar complexity, which are predicted to be most plastic based on their cytoarchitectural properties. Albeit correlative, our study underscores the importance of incorporating sex hormone variables into the investigation of brain structure and plasticity.
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Affiliation(s)
- Svenja Küchenhoff
- Institute of Neuroscience and Medicine (INM-7: Brain and Behavior), Research Centre Jülich, Jülich, Germany.
- Otto Hahn Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK.
| | - Şeyma Bayrak
- Institute of Neuroscience and Medicine (INM-7: Brain and Behavior), Research Centre Jülich, Jülich, Germany
- Otto Hahn Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Rachel G Zsido
- Cognitive Neuroendocrinology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Amin Saberi
- Institute of Neuroscience and Medicine (INM-7: Brain and Behavior), Research Centre Jülich, Jülich, Germany
- Otto Hahn Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | | | - Susanne Weis
- Institute of Neuroscience and Medicine (INM-7: Brain and Behavior), Research Centre Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - H Lina Schaare
- Institute of Neuroscience and Medicine (INM-7: Brain and Behavior), Research Centre Jülich, Jülich, Germany
- Otto Hahn Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Julia Sacher
- Centre for Integrative Women's Health and Gender Medicine, Medical Faculty & University Hospital Leipzig, Leipzig, Germany
| | - Simon Eickhoff
- Institute of Neuroscience and Medicine (INM-7: Brain and Behavior), Research Centre Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Sofie L Valk
- Institute of Neuroscience and Medicine (INM-7: Brain and Behavior), Research Centre Jülich, Jülich, Germany.
- Otto Hahn Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
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Saldarriaga C, Rivera-Toquica A, Echeverry-Navarrete EJ, Lugo-Peña JR, Cerón JA, Rincón-Peña OS, Silva-Diazgranados LE, Osorio-Carmona HE, Posada-Bastidas A, García JC, Ochoa-Morón AD, Rolong B, Manzur-Jatin F, Echeverría LE, Gómez-Mesa JE. Impact of sex on clinical and laboratory parameters in patients with heart failure: insights from the Colombian Heart Failure Registry (RECOLFACA). Acta Cardiol 2024:1-8. [PMID: 39145526 DOI: 10.1080/00015385.2024.2391133] [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: 11/16/2023] [Revised: 03/06/2024] [Accepted: 08/06/2024] [Indexed: 08/16/2024]
Abstract
INTRODUCTION Heart failure (HF) is one of the leading causes of morbidity and mortality worldwide. This study aimed to assess the impact of sex on sociodemographic, clinical, and laboratory parameters in patients with HF who were included in the Colombian Heart Failure Registry (RECOLFACA). METHODS This was a cross-sectional analytical research. All 2528 patients included in RECOLFACA were analysed. The Mann-Whitney U test was used to compare median values as well as first and third quartiles (Q1-Q3). The age-related trend of NT-proBNP levels for both men and women groups was statistically evaluated. RESULTS The study included 2528 patients with HF (1072 women and 1456 men). The echocardiographic evidence showed that men presented reduced left ventricular ejection fraction (LVEF) (79.63 vs. 69.75%, respectively; p < 0.001) more often than women, which had a significantly higher proportion of preserved LVEF (20.46 vs.11.24%, respectively; p < 0.001). Women displayed a higher value of systolic blood pressure (p < 0.001) and heart rate (p = 0.014) compared to men. Haemoglobin, creatinine, and sodium levels were significantly higher in men. Men had a considerably lower glomerular filtration rate value, with the median reaching a G3a value for chronic renal failure. According to age, the levels of NT-proBNP in each sex increased equivalently with age. CONCLUSION Sex differences presented in this study are comparable to those discovered in other nations. However, certain variations show that these sex differences may differ by geographical area, which should encourage further investigations to describe them.
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Affiliation(s)
| | - Alex Rivera-Toquica
- Department of Cardiology, Centro Médico para el Corazón, Pereira, Colombia
- Department of Cardiology, Clínica los Rosales, Pereira, Colombia
- Department of Cardiology, Universidad Tecnológica de Pereira, Pereira, Colombia
| | | | | | - Juan Alberto Cerón
- Department of Cardiology, Hospital Universitario Departamental de Nariño, Pasto, Colombia
| | | | | | | | | | | | | | - Balkis Rolong
- Department of Cardiology, Cardiología Integral, Barranquilla, Colombia
| | | | | | - Juan Esteban Gómez-Mesa
- Department of Cardiology, Fundación Valle del Lili, Cali, Colombia
- Department of Health Sciences, Universidad Icesi, Cali, Colombia
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10
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Mallikarjun DN, Jain S, Malo PK, Kahali B, Sundarakumar JS, Diwakar L, Ravindranath V. Distribution of biochemical and haematological parameters in an aging population from southern India: A cross-sectional analysis. Ann Clin Biochem 2024:45632241267905. [PMID: 39054723 DOI: 10.1177/00045632241267905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
BACKGROUND Examining the distribution of biochemical and haematological tests in different age groups of rural population is necessary to ensure that health care facilities are equipped to address the prevalent health conditions and manage age-related illness effectively. Hence, this study is aimed at seeing the distributions of blood biochemical and haematological parameters in rural population. METHODS This cross-sectional study investigated the distribution of 26 different haematological and biochemical parameters in longitudinal cohort study (Srinivaspura Aging, NeuoSenescence and COGnition - SANSCOG), from the villages of Srinivaspura, Kolar district, India. A total of 2592 participants (1240 males and 1352 females), aged ≥45 years who are cognitively healthy were included for the analysis. Mean, 2.5th, 5th, 25th, 50th, 75th, 95th and 97.5th percentiles were calculated for the entire sample. Additionally, median and percentiles were determined for both gender and age categories (45-54, 55-64, 65-74, and ≥75 years). RESULTS We observed the distinct distributions of various haematological and biochemical parameters, with elevated levels of glycaemic, lipid, liver, and thyroid parameters. CONCLUSION Findings revealed the notable variations from the established reference ranges, indicating the potential undiagnosed cases and highlighting the gaps in health awareness and health seeking behaviour.
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Affiliation(s)
| | - Shubham Jain
- Bhanix Finanace and Investment Limited, Mumbai, India
| | - Palash Kumar Malo
- Centre for Brain Research, Indian Institute of Science, Bangalore, India
| | - Bratati Kahali
- Centre for Brain Research, Indian Institute of Science, Bangalore, India
| | | | - Latha Diwakar
- Centre for Brain Research, Indian Institute of Science, Bangalore, India
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11
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Esposito CM, De Cagna F, Caldiroli A, Capuzzi E, Ceresa A, Di Paolo M, Auxilia AM, Capellazzi M, Tagliabue I, Cirella L, Clerici M, Brondino N, Barkin JL, Politi P, Buoli M. Gender differences in clinical and biochemical parameters among patients hospitalized for schizophrenia: towards precision medicine. Eur Arch Psychiatry Clin Neurosci 2024; 274:1093-1103. [PMID: 37436457 PMCID: PMC11229447 DOI: 10.1007/s00406-023-01644-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/25/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND The scientific literature shows some gender differences in the clinical course of schizophrenia. The aim of this study is to identify gender differences in clinical and biochemical parameters in subjects affected by schizophrenia. This would allow for the implementation of individualized treatment strategies. METHODS We examined a large set of clinical and biochemical parameters. Data were obtained from clinical charts and blood analyses from a sample of 555 schizophrenia patients consecutively admitted for exacerbation of symptoms to the inpatient clinic of Fondazione IRCCS Policlinico (Milan) or ASST Monza in Italy from 2008 to 2021. Univariate analyses, binary logistic regression, and a final logistic regression model were performed with gender as dependent variable. RESULTS The final logistic regression models showed that male patients (compared to females) were more prone to lifetime substance use disorders (p = 0.010). However, they also had higher GAF (global functioning) mean scores (p < 0.001) at the time of hospitalization. Univariate analyses showed that male patients (with respect to females) had an earlier age at onset (p < 0.001), a more frequent family history of multiple psychiatric disorders (p = 0.045), were more often smokers (p < 0.001), had a more frequent comorbidity with at least one psychiatric disorder (p = 0.001), and less often suffered from hypothyroidism (p = 0.011). In addition, men had higher levels of albumin (p < 0.001) and bilirubin (t = 2.139, p = 0.033), but lower levels of total cholesterol (t = 3.755, p < 0.001). CONCLUSIONS Our analyses indicate a less severe clinical profile in female patients. This is evident especially in the early years of the disorder, as suggested by less comorbidity with psychiatric disorders or later age at onset; this is consistent with the related literature. In contrast, female patients seem to be more vulnerable to metabolic alterations as demonstrated by more frequent hypercholesterolemia and thyroid dysfunction. Further studies are needed to confirm these results in the framework of precision medicine.
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Affiliation(s)
- Cecilia Maria Esposito
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy.
| | | | - Alice Caldiroli
- Psychiatric Department, Azienda Socio-Sanitaria Territoriale Monza, Monza, Italy
| | - Enrico Capuzzi
- Psychiatric Department, Azienda Socio-Sanitaria Territoriale Monza, Monza, Italy
| | - Alessandro Ceresa
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy
| | - Martina Di Paolo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy
| | - Anna Maria Auxilia
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Martina Capellazzi
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Ilaria Tagliabue
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Luisa Cirella
- Healthcare Professionals Department, Foundation IRCCS Ca Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio-Sanitaria Territoriale Monza, Monza, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Natascia Brondino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- ASST Pavia, Pavia, Italy
| | | | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- ASST Pavia, Pavia, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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12
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Cai L, Jin D, Lai J, Li L, Luo Y, Shi J, Lai X, Liu L, Zhao Y, Yu J, Qiu Y, Song K, Yu F, Guo Q, Jin A, Huang H, Ding S, Ye Y. Psychological and physical side effects during G-CSF mobilization in related donors of allo-HCT. Ann Hematol 2024; 103:3199-3206. [PMID: 38637333 DOI: 10.1007/s00277-024-05753-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 04/08/2024] [Indexed: 04/20/2024]
Abstract
The psychological side effects of granulocyte colony-stimulating factor mobilization in related donors of allogeneic hematopoietic cell transplantation (allo-HCT) and impacts of psychological/physical side effects on harvest outcomes remain largely unknown. We prospectively analyzed 349 consecutive related peripheral blood stem cell (PBSC) donors for allo-HCT at the First Affiliated Hospital, Zhejiang University, School of Medicine from March 2021 to August 2023. Higher baseline peripheral blood white blood cell counts (p = 0.046), monocyte counts (p < 0.001), platelet counts (p = 0.001), and hemoglobin (p < 0.001) had a positive correlation to CD34+ cell counts in the first leukapheresis, while female donors (male vs. female, p < 0.001) and older age (> 40 vs. < = 40, p = 0.003) were negatively related to CD34+ cell counts. Bone pain was the most observed physical side effect and was more frequent in female donors (p = 0.032). The incidence of fatigue was higher in female donors and older donors (female vs. male, p = 0.016; > 40 vs. < = 40, p = 0.015). Donor depression (pre vs. during mobilization, p < 0.001), anxiety (pre vs. during mobilization, p = 0.043) and insomnia (pre vs. during mobilization, p = 0.011) scores increased during the mobilization period. Donors with higher depression, anxiety and stress scores at admission were more likely to experience nausea. At 1 month after the last leukapheresis, the counts of white blood cell, neutrophil, monocyte and hemoglobin were significant lower than baseline counts, while the platelet counts recovered to baseline. The mobilization and harvest process can increase the depression, anxiety and insomnia scores. Poor psychological status of the donor can aggravate the occurrence of physical side effects.
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Affiliation(s)
- Lingxia Cai
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Diange Jin
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianbo Lai
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lin Li
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, China
| | - Yi Luo
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, China
| | - Jimin Shi
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoyu Lai
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, China
| | - Lizhen Liu
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, China
| | - Yanmin Zhao
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, China
| | - Jian Yu
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, China
| | - Yunfei Qiu
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kaixia Song
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Fangquan Yu
- Department of Hematology, Jinhua People's Hospital, Jinhua, China
| | - Qinna Guo
- Department of Hematology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Aiyun Jin
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - He Huang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
- Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, China.
| | - Shuyi Ding
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Yishan Ye
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
- Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, China.
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13
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Callum J, Putowski Z, Alhazzani W, Belley-Cote E, Møller MH, Curry N, Al Duhailib Z, Fung M, Giocobbo L, Granholm A, Louw V, Maybohm P, Muller M, Nielsen N, Oleschuk C, Raza S, Scruth E, Siegal D, Stanworth SJ, Vlaar APJ, White M, Oczkowski S. Small-volume blood sample collection tubes in adult intensive care units: A rapid practice guideline. Acta Anaesthesiol Scand 2024. [PMID: 39034625 DOI: 10.1111/aas.14497] [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: 06/11/2024] [Accepted: 06/27/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND This Intensive Care Medicine Rapid Practice Guideline (ICM-RPG) provides an evidence-based recommendation to address the question: in adult patients in intensive care units (ICUs), should we use small-volume or conventional blood collection tubes? METHODS We included 23 panelists in 8 countries and assessed and managed financial and intellectual conflicts of interest. Methodological support was provided by the Guidelines in Intensive Care, Development, and Evaluation (GUIDE) group. We conducted a systematic review, including evidence from observational and randomized studies. Using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach, we evaluated the certainty of evidence and developed recommendations using the Evidence-to-Decision framework. RESULTS We identified 8 studies (1 cluster and 2 patient-level randomized trials; 5 observational studies) comparing small-volume to conventional tubes. We had high certainty evidence that small-volume tubes reduce daily and cumulative blood sampling volume; and moderate certainty evidence that they reduce the risk of transfusion and mean number of red blood cell units transfused, but these estimates were limited by imprecision. We had high certainty that small-volume tubes have a similar rate of specimens with insufficient quantity. The panel considered that the desirable effects of small-volume tubes outweigh the undesirable effects, are less wasteful of resources, and are feasible, as demonstrated by successful implementation across multiple countries, although there are upfront implementation costs to validate small-volume tubes on laboratory instrumentation. CONCLUSION This ICM-RPG panel made a strong recommendation for the use of small-volume sample collection tubes in adult ICUs based on overall moderate certainty evidence.
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Affiliation(s)
- Jeannie Callum
- Pathology and Molecular Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - Zbignew Putowski
- Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Waleed Alhazzani
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Critical Care, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Research Institute of St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- GUIDE Group, Hamilton, Ontario, Canada
| | - Emilie Belley-Cote
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- GUIDE Group, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton, Ontario, Canada
| | - Morten Hylander Møller
- GUIDE Group, Hamilton, Ontario, Canada
- Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Nicola Curry
- Department of Clinical Haematology, Haemophilia & Thrombosis Centre, Oxford University Hospitals National Health Service Foundation Trust, Oxford, UK
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Zainab Al Duhailib
- Critical Care Medicine Department, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
- Department of Medicine, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Mark Fung
- University of Vermont Medical Center, Burlington, Vermont, USA
| | - Louise Giocobbo
- Halton Healthcare, Oakville Trafalgar Memorial Hospital, Oakville, Ontario, Canada
| | - Anders Granholm
- GUIDE Group, Hamilton, Ontario, Canada
- Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Vernon Louw
- Division Clinical Haematology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Patrick Maybohm
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Marcella Muller
- Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Nathan Nielsen
- Division of Pulmonary, Critical Care and Sleep Medicine, and Section of Transfusion Medicine and Therapeutic Pathology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Curtis Oleschuk
- Pathology and Molecular Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - Sheharyar Raza
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth Scruth
- NCAL Quality, Safety, Risk Department, Kaiser Permanente, Oakland, California, USA
| | - Deborah Siegal
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Resarch Institute, Ottawa, Ontario, Canada
| | - Simon J Stanworth
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
- Systematic Review Initiative, NHS Blood and Transplant, Oxford, UK
| | - Alexander P J Vlaar
- Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, the Netherlands
- Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam University Medical Centers - Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Micheline White
- College of the Humanities and the Department of English, Carleton University, Ottawa, Ontario, Canada
| | - Simon Oczkowski
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Research Institute of St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- GUIDE Group, Hamilton, Ontario, Canada
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14
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Alves S, Silva F, Esteves F, Costa S, Slezakova K, Alves M, Pereira M, Teixeira J, Morais S, Fernandes A, Queiroga F, Vaz J. The Impact of Sleep on Haematological Parameters in Firefighters. Clocks Sleep 2024; 6:291-311. [PMID: 39051311 PMCID: PMC11270419 DOI: 10.3390/clockssleep6030021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 06/18/2024] [Accepted: 06/20/2024] [Indexed: 07/27/2024] Open
Abstract
Sleep is a vital process that impacts biological functions such as cell renewal, bone regeneration, and immune system support. Disrupted sleep can interrupt erythropoiesis, leading to fewer red blood cells, reduced haemoglobin concentration, and decreased haematocrit levels, potentially contributing to haematological disorders. This is particularly concerning for shift workers for example firefighters. While previous studies have explored sleep's adverse effects on various professions, research specific to firefighters is limited. This study investigates the relationship between sleep quality and haematological parameters among firefighters in Northeast Portugal. From a sample of 201 firefighters, variations in red blood cells, haemoglobin, and haematocrit values were linked to sleep quality. The study utilised non-parametric tests (Wilcoxon-Mann-Whitney, Spearman's correlation) to explore the connection between sleep quality and haematological profile. The impact of covariates on haematological parameters was assessed using non-parametric ANCOVA (Quade's). A multiple regression analysis was employed to further understand how sleep quality and various confounding variables impact haematological levels. Findings suggest a negative link between sleep quality and haematological levels, meaning that as sleep quality deteriorates, there is a tendency for haematological levels to decrease, as indicated by Spearman's correlation (rRBC = -0.157, pRBC = 0.026; rHb = -0.158, pHb = 0.025; rHCT = -0.175, pHCT = 0.013). As observed in scientific literature, the correlation found suggests a possible inhibition of erythropoiesis, the process responsible for red blood cell production. Despite firefighters presenting a haematological profile within the reference range (RBC: 5.1 × 106/mm3 (SD ± 0.4), Hb: 15.6 g/dL (SD ± 1.3), 47% (SD ± 1.0), there is already an observable trend towards lower levels. The analysis of co-variables did not reveal a significant impact of sleep quality on haematological levels. In conclusion, this study underscores the importance of sleep quality in determining haematological parameters among firefighters. Future research should investigate the underlying mechanisms and long-term implications of poor sleep quality on firefighter health. Exploring interventions to enhance sleep quality is vital for evidence-based strategies promoting firefighter well-being.
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Affiliation(s)
- Sara Alves
- Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Francisca Silva
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal (F.Q.)
| | - Filipa Esteves
- Environmental Health Department, National Institute of Health, Rua das Taipas 135, 4050-600 Porto, Portugal; (F.E.); (S.C.); (J.T.)
- EPIUnit, National Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Solange Costa
- Environmental Health Department, National Institute of Health, Rua das Taipas 135, 4050-600 Porto, Portugal; (F.E.); (S.C.); (J.T.)
- EPIUnit, National Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Klara Slezakova
- REQUIMTE/LAQV, ISEP, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 4249-015 Porto, Portugal; (K.S.); (S.M.)
| | - Maria Alves
- AquaValor-Centro de Valorização e Transferência de Tecnologia da Água-Associação, Rua Dr. Júlio Martins n.º 1, 5400-342 Chaves, Portugal;
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal;
| | - Maria Pereira
- LEPABE-ALiCE, Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - João Teixeira
- Environmental Health Department, National Institute of Health, Rua das Taipas 135, 4050-600 Porto, Portugal; (F.E.); (S.C.); (J.T.)
- EPIUnit, National Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Simone Morais
- REQUIMTE/LAQV, ISEP, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 4249-015 Porto, Portugal; (K.S.); (S.M.)
| | - Adília Fernandes
- Research Centre for Active Living and Wellbeing (LiveWell), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Felisbina Queiroga
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal (F.Q.)
| | - Josiana Vaz
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal;
- Research Centre for Active Living and Wellbeing (LiveWell), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
- Laboratório Associado para a Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
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15
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Islam Z, Adnan M, Noor H, Chaudhary R, Farhan M, Sherani FS, Rizvi A. Physiotypic variations lead to variations within the normal range for red blood cells and haemoglobin levels in a healthy human population: An evaluation using generalised additive modelling and hierarchical structure analysis. Int J Lab Hematol 2024. [PMID: 38924350 DOI: 10.1111/ijlh.14333] [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: 03/19/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES Haematological parameters have been used for a long time for clinical evaluations, however the dynamics of these parameters has not been studied at length, in healthy populations. We aim to understand the dependence of haematological parameters on human physiotypes. DESIGN AND METHODS Using an age and gender restricted healthy human (male) population (n = 100), we attempt to analyse the dynamics of haemoglobin and red blood cells, with reference to age, height and weight of individuals. Using advanced generalised additive modelling and classical hierarchical structural analysis we aim to establish relationships between these parameters and human physiotypes. RESULTS We demonstrate that definitive relationships can be established for number of red blood cells, haemoglobin levels, RDW-CV, RDW-SD and weight, height and age of individuals. CONCLUSION This study provides a proof of principle, that haematological parameters are dependent on physiotypic variation, within the normal ranges in a healthy population. It may also be noted that there is a definitive influence of height, weight and age on normal ranges and stratification by these factors might therefore make reference intervals narrower, in turn, possibly allowing more precise clinical decisions based on the complete blood count (CBC).
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Affiliation(s)
- Zainul Islam
- Department of Kulliyat, Faculty of Unani Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Mohd Adnan
- Department of Kulliyat, Faculty of Unani Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Huma Noor
- Department of Kulliyat, Faculty of Unani Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Rohit Chaudhary
- Department of Wildlife Sciences, College of Forestry, Navsari Agricultural University, Navsari, Gujrat, India
| | - Mohd Farhan
- Department of Basic Sciences, Preparatory Year, King Faisal University, Al-Ahsa, Saudi Arabia
- Department of Chemistry, College of Science, King Faisal University, Al-Ahsa, Saudi Arabia
| | - F S Sherani
- Department of Kulliyat, Faculty of Unani Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Asim Rizvi
- Department of Kulliyat, Faculty of Unani Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
- Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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16
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Haider MA, Ward SA, Rajahraman V, Rozell JC, Macaulay W, Schwarzkopf R, Hepinstall M. Blood Transfusion in the Age of Tranexamic Acid: Who Needs a Type and Screen Before Total Hip Arthroplasty? J Arthroplasty 2024:S0883-5403(24)00648-X. [PMID: 38914146 DOI: 10.1016/j.arth.2024.06.053] [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: 01/23/2024] [Revised: 06/17/2024] [Accepted: 06/19/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Modern surgical protocols, particularly the use of tranexamic acid (TXA), have reduced, but not eliminated, blood transfusions surrounding total hip arthroplasty (THA). Identifying patients at risk for transfusion remains important for risk reduction and to determine type and screen testing. METHODS We reviewed 6,405 patients who underwent primary, unilateral THA between January 2014 and January 2023 at a single academic institution, received TXA, and had preoperative hemoglobin (Hgb) values. We compared demographics, baseline Hgb levels, and surgical details between patients who were and were not transfused. Data were analyzed utilizing multivariate regression and receiver operating characteristic curve analysis. RESULTS The overall perioperative and intraoperative transfusion rates were 3.4 and 1.0%, respectively. Patients who were older, women, and American Society of Anesthesiologists class >II demonstrated an increased risk of transfusion. Risk of transfusion demonstrated an inverse correlation with preoperative Hgb levels, a bimodal association with body mass index, and a direct correlation with age, surgical time, and estimated blood loss on multivariate analysis. The receiver operating characteristic analysis demonstrated a preoperative Hgb cutoff of 12 g/dL for predicting any transfusion. Above the threshold of 12 g/dL, total and intraoperative transfusions were rare, with rates of 1.7 and 0.3%, respectively. Total and intraoperative transfusion rates with Hgb between 11 and 12 g/dL were 14.3 and 4.6%, respectively. Below 11 g/dL, total and intraoperative transfusion rates were 27.5 and 10.1%, respectively. CONCLUSIONS In the age of TXA, blood transfusion is rare in THA when preoperative Hgb is >12 g/dL, challenging the need for universal type and screening. Conversely, patients who have Hgb < 11.0 g/dL, remain at substantial risk for transfusion. Between Hgb 11 and 12 g/dL, patient age, sex, body mass index, American Society of Anesthesiologists classification, anticipated estimated blood loss, and surgical time may help predict transfusion risk and the need for a perioperative type and screen. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Muhammad A Haider
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Spencer A Ward
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Vinaya Rajahraman
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Joshua C Rozell
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - William Macaulay
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Ran Schwarzkopf
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Matthew Hepinstall
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
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17
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Howarth TP, Sillanmäki S, Karhu T, Rissanen M, Islind AS, Hrubos-Strøm H, de Chazal P, Huovila J, Kainulainen S, Leppänen T. Nocturnal oxygen resaturation parameters are associated with cardiorespiratory comorbidities. Sleep Med 2024; 118:101-112. [PMID: 38657349 DOI: 10.1016/j.sleep.2024.03.047] [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: 12/05/2023] [Revised: 03/12/2024] [Accepted: 03/30/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND There are strong associations between oxygen desaturations and cardiovascular outcomes. Additionally, oxygen resaturation rates are linked to excessive daytime sleepiness independent of oxygen desaturation severity. No studies have yet looked at the independent effects of comorbidities or medications on resaturation parameters. METHODS The Sleep Heart Health Study data was utilised to derive oxygen saturation parameters from 5804 participants. Participants with a history of comorbidities or medication usage were compared against healthy participants with no comorbidity/medication history. RESULTS 4293 participants (50.4% female, median age 64 years) were included in the analysis. Females recorded significantly faster resaturation rates (mean 0.61%/s) than males (mean 0.57%/s, p < 0.001), regardless of comorbidities. After adjusting for demographics, sleep parameters, and desaturation parameters, resaturation rate was reduced with hypertension (-0.09 (95% CI -0.16, -0.03)), myocardial infarction (-0.13 (95% CI -0.21, -0.04)) and heart failure (-0.19 (95% CI -0.33, -0.05)), or when using anti-hypertensives (-0.10 (95% CI -0.17, -0.03)), mental health medications (-0.18 (95% CI -0.27, -0.08)) or anticoagulants (-0.41 (95% CI -0.56, -0.26)). Desaturation to Resaturation ratio for duration was decreased with mental health (-0.21 (95% CI -0.34, -0.08)) or diabetic medications (-0.24 (95% CI -0.41, -0.07)), and desaturation to resaturation ratio for area decreased with heart failure (-0.25 (95% CI -0.42, -0.08)). CONCLUSIONS Comorbidities and medications significantly affect nocturnal resaturation parameters, independent of desaturation parameters. However, the causal relationship remains unclear. Further research can enhance our knowledge and develop more precise and safer interventions for individuals affected by certain comorbidities.
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Affiliation(s)
- Timothy P Howarth
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; Darwin Respiratory and Sleep Health, Darwin Private Hospital, Darwin, Australia; College of Health and Human Sciences, Charles Darwin University, Darwin, Australia; Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.
| | - Saara Sillanmäki
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland; Faculty of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Tuomas Karhu
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Marika Rissanen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; Department of Clinical Neurophysiology, Seinäjoki Central Hospital, Seinäjoki, Finland
| | | | - Harald Hrubos-Strøm
- Department of Otorhinolaryngology, Akershus University Hospital, Lørenskog, Norway; Clinic for Surgical Research, Campus Ahus, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Philip de Chazal
- School of Biomedical Engineering, The University of Sydney, Sydney, Australia
| | - Juuso Huovila
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Samu Kainulainen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Timo Leppänen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland; School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Australia
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18
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Pérez-Pacheco A, Ramírez-Chavarría RG, Colín-García MP, Cortés-Ortegón FDC, Quispe-Siccha RM, Martínez‑Tovar A, Olarte‑Carrillo I, Polo-Parada L, Gutiérrez-Juárez G. Study of erythrocyte sedimentation in human blood through the photoacoustic signals analysis. PHOTOACOUSTICS 2024; 37:100599. [PMID: 38495950 PMCID: PMC10940783 DOI: 10.1016/j.pacs.2024.100599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/22/2023] [Accepted: 02/26/2024] [Indexed: 03/19/2024]
Abstract
Introduction In this study, we utilized the pulsed photoacoustic (PA) technique to analyze globular sedimentation in whole human blood, with a focus on distinguishing between healthy individuals and those with hemolytic anemia. Methods Blood samples were collected from both healthy individuals (women and men) and those with hemolytic anemia, and temporal and spectral parameters of PA signals were employed for analysis. Results Significant differences (p < 0.05) were observed in PA metrics between the two groups. The proposed spectral analysis allowed significant differentiation within a 25-minute measurement window. Anemic blood samples exhibited higher erythrocyte sedimentation rate (ESR) values, indicating increased erythrocyte aggregation. Discussion This study underscores the potential of PA signal analysis in ESR assessment as an efficient method for distinguishing between healthy and anemic blood, surpassing traditional approaches. It represents a promising contribution to the development of precise and sensitive techniques for analyzing human blood samples in clinical settings.
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Affiliation(s)
- Argelia Pérez-Pacheco
- Unidad de Investigación y Desarrollo Tecnológico (UIDT), Hospital General de México, Dr. Eduardo Liceaga, Ciudad de México 06726, Mexico
| | | | - Marco Polo Colín-García
- Instituto de Ciencias Aplicadas y Tecnología (ICAT), Universidad Nacional Autónoma de México, Apartado Postal 70‑186, Ciudad de México 04510, Mexico
| | - Flor del Carmen Cortés-Ortegón
- Instituto de Ciencias Aplicadas y Tecnología (ICAT), Universidad Nacional Autónoma de México, Apartado Postal 70‑186, Ciudad de México 04510, Mexico
| | - Rosa María Quispe-Siccha
- Unidad de Investigación y Desarrollo Tecnológico (UIDT), Hospital General de México, Dr. Eduardo Liceaga, Ciudad de México 06726, Mexico
| | - Adolfo Martínez‑Tovar
- Laboratorio de Biología Molecular, Servicio de Hematología, Hospital General de México, Dr. Eduardo Liceaga, Ciudad de México 06726, Mexico
| | - Irma Olarte‑Carrillo
- Laboratorio de Biología Molecular, Servicio de Hematología, Hospital General de México, Dr. Eduardo Liceaga, Ciudad de México 06726, Mexico
| | - Luis Polo-Parada
- Department of Medical Pharmacology and Physiology and Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA
| | - Gerardo Gutiérrez-Juárez
- Departamento de Ingeniería Física, División de Ciencias e Ingenierías, Universidad de Guanajuato-Campus León, León, Guanajuato C.P. 37150, Mexico
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19
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Coe LN, Astorino TA. No Sex Differences in Perceptual Responses to High-Intensity Interval Training or Sprint Interval Training. J Strength Cond Res 2024; 38:1025-1032. [PMID: 38781466 DOI: 10.1519/jsc.0000000000004738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
ABSTRACT Coe, LN and Astorino, TA. No sex differences in perceptual responses to high-intensity interval training or sprint interval training. J Strength Cond Res 36(6): 1025-1032, 2024-High-intensity interval training (HIIT) elicits similar and, in some cases, superior benefits vs. moderate-intensity continuous training (MICT). However, HIIT is typically more aversive than MICT because of the higher intensity and in turn, greater blood lactate accumulation (BLa). This study explored potential sex differences in perceptual responses to acute HIIT and sprint interval training. Fifteen men (age and V̇O2max = 29 ± 8 years and 39 ± 3 ml·kg-1·min-1) and 13 women (age and V̇O2max = 22 ± 2 years and 38 ± 5 ml·kg-1·min-1) who are healthy and recreationally active initially underwent testing of maximal oxygen uptake (V̇O2max) on a cycle ergometer. In randomized order on 3 separate occasions, they performed the 10 × 1-minute protocol at 85% of peak power output, 4 × 4-minute protocol at 85-95% maximal heart rate (%HRmax), or reduced exertion high intensity interval training consisting of 2 "all-out" 20-second sprints at a load equal to 5% body mass. Before and throughout each protocol, rating of perceived exertion (rating of perceived exertion [RPE] 6-20 scale), affective valence (+5 to -5 of the Feeling Scale), and BLa were assessed. Five minutes postexercise, enjoyment was measured using the Physical Activity Enjoyment scale survey. Results showed no difference in RPE (p = 0.17), affective valence (0.27), or enjoyment (p = 0.52) between men and women. Blood lactate accumulation increased in response to all protocols (p < 0.001), and men showed higher BLa than women (p = 0.03). Previous research suggests that interval exercise protocols are not interchangeable between men and women, yet our data reveal that men and women having similar V̇O2max exhibit no differences in perceptual responses to interval exercise.
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Affiliation(s)
- Leah N Coe
- Department of Kinesiology, CSU-San Marcos, San Marcos, California
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20
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Mian SA, Ariza‐McNaughton L, Anjos‐Afonso F, Guring R, Jackson S, Kizilors A, Gribben J, Bonnet D. Influence of donor-recipient sex on engraftment of normal and leukemia stem cells in xenotransplantation. Hemasphere 2024; 8:e80. [PMID: 38774656 PMCID: PMC11107397 DOI: 10.1002/hem3.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/12/2024] [Accepted: 04/09/2024] [Indexed: 05/24/2024] Open
Abstract
Immunodeficient mouse models are widely used for the assessment of human normal and leukemic stem cells. Despite the advancements over the years, reproducibility, as well as the differences in the engraftment of human cells in recipient mice remains to be fully resolved. Here, we used various immunodeficient mouse models to characterize the effect of donor-recipient sex on the engraftment of the human leukemic and healthy cells. Donor human cells and recipient immunodeficient mice demonstrate sex-specific engraftment levels with significant differences observed in the lineage output of normal CD34+ hematopoietic stem and progenitor cells upon xenotransplantation. Intriguingly, human female donor cells display heightened sensitivity to the recipient mice's gender, influencing their proliferation and resulting in significantly increased engraftment in female recipient mice. Our study underscores the intricate interplay taking place between donor and recipient characteristics, shedding light on important considerations for future studies, particularly in the context of pre-clinical research.
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Affiliation(s)
- Syed A. Mian
- Haematopoietic Stem Cell LabThe Francis Crick InstituteLondonUK
| | | | | | - Remisha Guring
- Haematopoietic Stem Cell LabThe Francis Crick InstituteLondonUK
| | - Sophie Jackson
- Laboratory for Molecular Haemato‐OncologyKing's College Hospital LondonLondonUK
| | - Aytug Kizilors
- Laboratory for Molecular Haemato‐OncologyKing's College Hospital LondonLondonUK
| | - John Gribben
- Department of Haemato‐Oncology, Barts Cancer InstituteQueen Mary University of LondonLondonUK
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21
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Mykhailova O, Brandon-Coatham M, Phan C, Yazdanbakhsh M, Olafson C, Yi QL, Kanias T, Acker JP. Red cell concentrates from teen male donors contain poor-quality biologically older cells. Vox Sang 2024; 119:417-427. [PMID: 38418415 DOI: 10.1111/vox.13602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/27/2024] [Accepted: 01/31/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND AND OBJECTIVES Donor factors influence the quality characteristics of red cell concentrates (RCCs) and the lesions that develop in these heterogeneous blood products during hypothermic storage. Teen male donors' RCCs contain elevated levels of biologically old red blood cells (RBCs). The aim of this study was to interrogate the quality of units of different donor ages and sexes to unravel the complex interplay between donor characteristics, long-term cold storage and, for the first time, RBC biological age. MATERIALS AND METHODS RCCs from teen males, teen females, senior males and senior females were density-separated into less-dense/young (Y-RBCs) and dense/old RBCs (O-RBCs) throughout hypothermic storage for testing. The unseparated and density-separated cells were tested for haematological parameters, stress (oxidative and osmotic) haemolysis and oxygen affinity (p50). RESULTS The O-RBCs obtained from teen donor samples, particularly males, had smaller mean corpuscular volumes and higher mean corpuscular haemoglobin concentrations. While biological age did not significantly affect oxygen affinity, biologically aged O-RBCs from stored RCCs exhibited increased oxidative haemolysis and decreased osmotic fragility, with teenage male RCCs exhibiting the highest propensity to haemolyse. CONCLUSION Previously, donor age and sex were shown to have an impact on the biological age distribution of RBCs within RCCs. Herein, we demonstrated that RBC biological age, particularly O-RBCs, which are found more prevalently in male teens, to be a driving factor of several aspects of poor blood product quality. This study emphasizes that donor factors should continue to be considered for their potential impacts on transfusion outcomes.
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Affiliation(s)
- Olga Mykhailova
- Innovation and Portfolio Management, Canadian Blood Services, Edmonton, Alberta, Canada
| | | | - Celina Phan
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Mahsa Yazdanbakhsh
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Carly Olafson
- Innovation and Portfolio Management, Canadian Blood Services, Edmonton, Alberta, Canada
| | - Qi-Long Yi
- Canadian Blood Services, Ottawa, Ontario, Canada
| | - Tamir Kanias
- Vitalant Research Institute, Denver, Colorado, USA
| | - Jason P Acker
- Innovation and Portfolio Management, Canadian Blood Services, Edmonton, Alberta, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
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22
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Traylor MK, Batman GB, Sears KN, Ransom KV, Hammer SM, Keller JL. Sex-specific microvascular and hemodynamic responses to passive limb heating in young adults. Microcirculation 2024; 31:e12848. [PMID: 38281244 DOI: 10.1111/micc.12848] [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: 10/04/2023] [Revised: 12/20/2023] [Accepted: 01/17/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVE We examined sex-specific microvascular reactivity and hemodynamic responses under conditions of augmented resting blood flow induced by passive heating compared to normal blood flow. METHODS Thirty-eight adults (19 females) completed a vascular occlusion test (VOT) on two occasions preceded by rest with or without passive heating in a randomized, counterbalanced order. Skeletal muscle tissue oxygenation (StO2, %) was assessed with near-infrared spectroscopy (NIRS), and the rate of desaturation and resaturation as well as maximal StO2 (StO2max) and prolonged hypersaturation (area under the curve, StO2AUC) were quantified. Before the VOT, brachial artery blood flow (BABF), vascular conductance, and relative BABF (BABF normalized to forearm lean mass) were determined. Sex × condition ANOVAs were used. A p-value ≤.05 was considered statistically significant. RESULTS Twenty minutes of heating increased BABF compared to the control (102.9 ± 28.3 vs. 36.0 ± 20.9 mL min-1; p < .01). Males demonstrated greater BABF than females (91.9 ± 34.0 vs. 47.0 ± 19.1 mL min-1; p < .01). There was no sex difference in normalized BABF. There were no significant interactions for NIRS-VOT outcomes, but heat did increase the rate of desaturation (-0.140 ± 0.02 vs. -0.119 ± 0.03% s-1; p < .01), whereas regardless of condition, males exhibited greater rates of resaturation and StO2max than females. CONCLUSIONS These results suggest that blood flow is not the primary factor causing sex differences in NIRS-VOT outcomes.
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Affiliation(s)
- Miranda K Traylor
- Integrative Laboratory of Exercise and Applied Physiology (iLEAP), Department of Health, Kinesiology, and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, Alabama, USA
| | - Genevieve B Batman
- Integrative Laboratory of Exercise and Applied Physiology (iLEAP), Department of Health, Kinesiology, and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, Alabama, USA
| | - Kylie N Sears
- School of Kinesiology, Applied Health and Recreation, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Kyndall V Ransom
- Integrative Laboratory of Exercise and Applied Physiology (iLEAP), Department of Health, Kinesiology, and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, Alabama, USA
- Chemistry Department, College of Arts and Science, University of South Alabama, Mobile, Alabama, USA
| | - Shane M Hammer
- School of Kinesiology, Applied Health and Recreation, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Joshua L Keller
- Integrative Laboratory of Exercise and Applied Physiology (iLEAP), Department of Health, Kinesiology, and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, Alabama, USA
- Department of Physiology & Cell Biology, College of Medicine, University of South Alabama, Mobile, Alabama, USA
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23
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Demkova L, Bugajev V, Adamcova MK, Kuchar L, Grusanovic S, Alberich-Jorda M, Draber P, Halova I. Simultaneous deletion of ORMDL1 and ORMDL3 proteins disrupts immune cell homeostasis. Front Immunol 2024; 15:1376629. [PMID: 38715613 PMCID: PMC11074395 DOI: 10.3389/fimmu.2024.1376629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/08/2024] [Indexed: 06/04/2024] Open
Abstract
ORMDL3 is a prominent member of a family of highly conserved endoplasmic reticulum resident proteins, ORMs (ORM1 and ORM2) in yeast, dORMDL in Drosophila and ORMDLs (ORMDL1, ORMDL2, and ORMDL3) in mammals. ORMDL3 mediates feedback inhibition of de novo sphingolipid synthesis. Expression levels of ORMDL3 are associated with the development of inflammatory and autoimmune diseases including asthma, systemic lupus erythematosus, type 1 diabetes mellitus and others. It has been shown that simultaneous deletions of other ORMDL family members could potentiate ORMDL3-induced phenotypes. To understand the complex function of ORMDL proteins in immunity in vivo, we analyzed mice with single or double deletions of Ormdl genes. In contrast to other single and double knockouts, simultaneous deletion of ORMDL1 and ORMDL3 proteins disrupted blood homeostasis and reduced immune cell content in peripheral blood and spleens of mice. The reduced number of splenocytes was not caused by aberrant immune cell homing. A competitive bone marrow transplantation assay showed that the development of Ormdl1-/-/Ormdl3-/- B cells was dependent on lymphocyte intrinsic factors. Highly increased sphingolipid production was observed in the spleens and bone marrow of Ormdl1-/-/Ormdl3-/- mice. Slight, yet significant, increase in some sphingolipid species was also observed in the spleens of Ormdl3-/- mice and in the bone marrow of both, Ormdl1-/- and Ormdl3-/- single knockout mice. Taken together, our results demonstrate that the physiological expression of ORMDL proteins is critical for the proper development and circulation of lymphocytes. We also show cell-type specific roles of individual ORMDL family members in the production of different sphingolipid species.
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Affiliation(s)
- Livia Demkova
- Laboratory of Signal Transduction, Institute of Molecular Genetics of the Czech Academy of Sciences, Prague, Czechia
| | - Viktor Bugajev
- Laboratory of Signal Transduction, Institute of Molecular Genetics of the Czech Academy of Sciences, Prague, Czechia
| | - Miroslava K. Adamcova
- Laboratory of Hemato-Oncology, Institute of Molecular Genetics of the Czech Academy of Sciences, Prague, Czechia
| | - Ladislav Kuchar
- Research Unit for Rare Diseases, Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Srdjan Grusanovic
- Laboratory of Hemato-Oncology, Institute of Molecular Genetics of the Czech Academy of Sciences, Prague, Czechia
| | - Meritxell Alberich-Jorda
- Laboratory of Hemato-Oncology, Institute of Molecular Genetics of the Czech Academy of Sciences, Prague, Czechia
| | - Petr Draber
- Laboratory of Signal Transduction, Institute of Molecular Genetics of the Czech Academy of Sciences, Prague, Czechia
| | - Ivana Halova
- Laboratory of Signal Transduction, Institute of Molecular Genetics of the Czech Academy of Sciences, Prague, Czechia
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24
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Vishnyakova O, Song X, Rockwood K, Elliott LT, Brooks-Wilson A. Physiological phenotypes have optimal values relevant to healthy aging: sweet spots deduced from the Canadian Longitudinal Study on Aging. GeroScience 2024; 46:1589-1605. [PMID: 37688655 PMCID: PMC10828371 DOI: 10.1007/s11357-023-00895-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 07/27/2023] [Indexed: 09/11/2023] Open
Abstract
Previous observations on a group of exceptionally healthy "Super-Seniors" showed a lower variance of multiple physiological measures relevant for health than did a less healthy group of the same age. The finding was interpreted as the healthier individuals having physiological measurement values closer to an optimal level, or "sweet spot." Here, we tested the generalizability of the sweet-spot hypothesis in a larger community sample, comparing differences in the variance between healthier and less healthy groups. We apply this method to the Canadian Longitudinal Study on Aging (CLSA) comprehensive cohort of 30,097 participants aged 45 to 85 years with deep phenotype data. Data from both sexes and four age ranges were analyzed. Five instruments were used to represent different aspects of health, physical, and cognitive functioning. We tested 231 phenotypic measures for lower variance in the most healthy vs. least healthy quartile of each sex and age group, as classified by the five instruments. Segmented regression was used to determine sex-specific optimal values. One hundred forty-two physiological measures (61%) showed lower variance in the healthiest than in the least healthy group, in at least one sex and age group. The difference in variance was most significant for hemoglobin A1c and was also significant for many body composition measurements, but not for bone mineral density. Ninety-four phenotypes showed a nonmonotonic relationship with health, consistent with the idea of a sweet spot; for these, we determined optimal values and 95% confidence intervals that were generally narrower than the ranges of current clinical reference intervals. These findings for sweet spot discovery validate the proposed approach for identifying traits important for healthy aging.
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Affiliation(s)
- Olga Vishnyakova
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC, Canada
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
- Department of Statistics & Actuarial Science, Simon Fraser University, Room SC K10545, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Xiaowei Song
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
- Surrey Memorial Hospital, Fraser Health Authority, Surrey, BC, Canada
| | - Kenneth Rockwood
- Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
| | - Lloyd T Elliott
- Department of Statistics & Actuarial Science, Simon Fraser University, Room SC K10545, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
| | - Angela Brooks-Wilson
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC, Canada.
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.
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25
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Ciekot-Sołtysiak M, Kusy K, Podgórski T, Pospieszna B, Zieliński J. Changes in red blood cell parameters during incremental exercise in highly trained athletes of different sport specializations. PeerJ 2024; 12:e17040. [PMID: 38560450 PMCID: PMC10981411 DOI: 10.7717/peerj.17040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/12/2024] [Indexed: 04/04/2024] Open
Abstract
Background During physical exercise, the level of hematological parameters change depending on the intensity and duration of exercise and the individual's physical fitness. Research results, based on samples taken before and after exercise, suggest that hematological parameters increase during incremental exercise. However, there is no data confirming this beyond any doubt. This study examined how red blood cell (RBC) parameters change during the same standard physical exertion in athletes representing different physiological training profiles determined by sport discipline. Methods The study included 39 highly trained male members of national teams: 13 futsal players, 12 sprinters, and 14 triathletes. We used multiple blood sampling to determine RBC, hemoglobin (Hb), hematocrit value (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red blood cell distribution width (RDW) before, during (every 3 min), and after (5, 10, 15, 20, and 30 min) an incremental treadmill exercise test until exhaustion. Results There were no significant exercise-induced differences in RBC parameters between athletic groups. No significant changes were recorded in RBC parameters during the low-intensity phase of exercise. RBC, Hb, and Hct increased significantly during incremental physical exercise, and rapidly returned to resting values upon test termination. Conclusions The general pattern of exercise-induced changes in RBC parameters is universal regardless of the athlete's physiological profile. The changes in RBC parameters are proportional to the intensity of exercise during the progressive test. The increase in hemoglobin concentration associated with the intensity of exercise is most likely an adaptation to the greater demand of tissues, mainly skeletal muscles, for oxygen.
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Affiliation(s)
- Monika Ciekot-Sołtysiak
- Department of Athletics Strength and Conditioning, Poznan University of Physical Education, Poznan, Poland
| | - Krzysztof Kusy
- Department of Athletics Strength and Conditioning, Poznan University of Physical Education, Poznan, Poland
| | - Tomasz Podgórski
- Department of Physiology and Biochemistry, Poznan University of Physical Education, Poznan, Poland
| | - Barbara Pospieszna
- Department of Athletics Strength and Conditioning, Poznan University of Physical Education, Poznan, Poland
| | - Jacek Zieliński
- Department of Athletics Strength and Conditioning, Poznan University of Physical Education, Poznan, Poland
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Richter S, Bechmann N. Patient Sex and Origin Influence Distribution of Driver Genes and Clinical Presentation of Paraganglioma. J Endocr Soc 2024; 8:bvae038. [PMID: 38481600 PMCID: PMC10928507 DOI: 10.1210/jendso/bvae038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Indexed: 04/07/2024] Open
Abstract
Context Sexual and ancestral differences in driver gene prevalence have been described in many cancers but have not yet been investigated in pheochromocytoma and paraganglioma (PPGL). Objective This study aims to assess whether sex and ancestry influence prevalence of PPGL driver genes and clinical presentation. Methods We conducted a retrospective analysis of patients with PPGL considering studies from 2010 onwards that included minimal data of type of disease, sex, mutated gene, and country of origin. Additional features were recorded when available (age, tumor location, bilateral or multifocal, somatic or germline, and metastatic disease). Results We included 2162 patients: 877 in Europe and 757 in Asia. Males presented more often with germline pathogenic variants (PVs) in genes activating hypoxia pathways (P = .0006) and had more often sympathetic paragangliomas (P = .0005) and metastasis (P = .0039). On the other hand, females with PPGLs due to MAX PVs were diagnosed later than males (P = .0378) and more often developed metastasis (P = .0497). European but not Asian females presented more often with PPGLs due to PVs in genes related to kinase signaling (P = .0052), particularly RET and TMEM127. Contrary to experiences from Europe, Asian patients with PPGL due to PVs in kinase signaling genes NF1, HRAS, and FGFR1 showed a high proportion of sympathetic tumors, while European patients almost exclusively had adrenal tumors (P < .005). Conclusion Personalized management of patients with PPGL might benefit from considering sexual and ancestral differences. Further studies with better clinically aligned cohorts from various origins are required to better dissect ancestral influences on PPGL development.
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Affiliation(s)
- Susan Richter
- Institute for Clinical Chemistry and Laboratory Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Nicole Bechmann
- Institute for Clinical Chemistry and Laboratory Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
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Harik L, Habib RH, Dimagli A, Rahouma M, Perezgrovas-Olaria R, Jr Soletti G, Alzghari T, An KR, Rong LQ, Sandner S, Bairey-Merz CN, Redfors B, Girardi L, Gaudino M. Intraoperative Anemia Mediates Sex Disparity in Operative Mortality After Coronary Artery Bypass Grafting. J Am Coll Cardiol 2024; 83:918-928. [PMID: 38418006 DOI: 10.1016/j.jacc.2023.12.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 03/01/2024]
Abstract
BACKGROUND Women undergoing coronary artery bypass grafting (CABG) have higher operative mortality than men. OBJECTIVES The purpose of this study was to evaluate the relationship between intraoperative anemia (nadir intraoperative hematocrit), CABG operative mortality, and sex. METHODS This was a cohort study of 1,434,225 isolated primary CABG patients (344,357 women) from the Society of Thoracic Surgeons Adult Cardiac Surgery Database (2011-2022). The primary outcome was operative mortality. The attributable risk (AR) (the risk-adjusted strength of the association of female sex with CABG outcomes) for the primary outcome was calculated. Causal mediation analysis derived the total effect of female sex on operative mortality risk and the proportion of that effect mediated by intraoperative anemia. RESULTS Women had lower median nadir intraoperative hematocrit (22.0% [Q1-Q3: 20.0%-25.0%] vs 27.0% [Q1-Q3: 24.0%-30.0%], standardized mean difference 97.0%) than men. Women had higher operative mortality than men (2.8% vs 1.7%; P < 0.001; adjusted OR: 1.36; 95% CI: 1.30-1.41). The AR of female sex for operative mortality was 1.21 (95% CI: 1.17-1.24). After adjusting for nadir intraoperative hematocrit, AR was reduced by 43% (1.12; 95% CI: 1.09-1.16). Intraoperative anemia mediated 38.5% of the increased mortality risk associated with female sex (95% CI: 32.3%-44.7%). Spline regression showed a stronger association between operative mortality and nadir intraoperative hematocrit at hematocrit values <22.0% (P < 0.001). CONCLUSIONS The association of female sex with increased CABG operative mortality is mediated to a large extent by intraoperative anemia. Avoiding nadir intraoperative hematocrit values below 22.0% may reduce sex differences in CABG operative mortality.
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Affiliation(s)
- Lamia Harik
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Robert H Habib
- The Society of Thoracic Surgeons Research and Analytic Center, Chicago, Illinois, USA
| | - Arnaldo Dimagli
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Mohamed Rahouma
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA
| | | | - Giovanni Jr Soletti
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Talal Alzghari
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Kevin R An
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Lisa Q Rong
- Department of Anesthesiology, Weill Cornell Medicine, New York, New York, USA
| | - Sigrid Sandner
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - C Noel Bairey-Merz
- Barbara Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Bjorn Redfors
- Department of Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Leonard Girardi
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Mario Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA.
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Gómez CA, Brochard L, Goligher EC, Rozenberg D, Reid WD, Roblyer D. Combined frequency domain near-infrared spectroscopy and diffuse correlation spectroscopy system for comprehensive metabolic monitoring of inspiratory muscles during loading. JOURNAL OF BIOMEDICAL OPTICS 2024; 29:035002. [PMID: 38532926 PMCID: PMC10965138 DOI: 10.1117/1.jbo.29.3.035002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 03/28/2024]
Abstract
Significance Mechanical ventilation (MV) is a cornerstone technology in the intensive care unit as it assists with the delivery of oxygen in critically ill patients. The process of weaning patients from MV can be long and arduous and can lead to serious complications for many patients. Despite the known importance of inspiratory muscle function in the success of weaning, current clinical standards do not include direct monitoring of these muscles. Aim The goal of this project was to develop and validate a combined frequency domain near-infrared spectroscopy (FD-NIRS) and diffuse correlation spectroscopy (DCS) system for the noninvasive characterization of inspiratory muscle response to a load. Approach The system was fabricated by combining a custom digital FD-NIRS and DCS system. It was validated via liquid phantom titrations and a healthy volunteer study. The sternocleidomastoid (SCM), an accessory muscle of inspiration, was monitored during a short loading period in fourteen young, healthy volunteers. Volunteers performed two different respiratory exercises, a moderate load and a high load, which consisted of a one-minute baseline, a one-minute load, and a six-minute recovery period. Results The system has low crosstalk between absorption, reduced scattering, and flow when tested in a set of liquid titrations. Faster dynamics were observed for changes in blood flow index (BF i ), and metabolic rate of oxygen (MRO 2 ) compared with hemoglobin + myoglobin (Hb+Mb) based parameters after the onset of loads in males. Additionally, larger percent changes in BF i , and MRO 2 were observed compared with Hb+Mb parameters in both males and females. There were also sex differences in baseline values of oxygenated Hb+Mb, total Hb+Mb, and tissue saturation. Conclusions The dynamic characteristics of Hb+Mb concentration and blood flow were distinct during loading of the SCM, suggesting that the combination of FD-NIRS and DCS may provide a more complete picture of inspiratory muscle dynamics.
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Affiliation(s)
- Carlos A. Gómez
- Boston University, Department of Biomedical Engineering, Boston, Massachusetts, United States
| | - Laurent Brochard
- St. Michael’s Hospital, Unity Health Toronto, Li Ka Shing Knowledge Institute, Keenan Research Centre, Toronto, Ontario, Canada
- St. Michael’s Hospital, Department of Critical Care, Toronto, Ontario, Canada
- University of Toronto, Interdepartmental Division of Critical Care Medicine, Toronto, Ontario, Canada
| | - Ewan C. Goligher
- University of Toronto, Interdepartmental Division of Critical Care Medicine, Toronto, Ontario, Canada
- University Health Network, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
- University of Toronto, Department of Physiology, Toronto, Ontario, Canada
| | - Dmitry Rozenberg
- University Health Network, Toronto General Hospital Research Institute, Ajmera Transplant Center, Toronto, Ontario, Canada
- University of Toronto, Division of Respirology, Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - W. Darlene Reid
- University of Toronto, Department of Physical Therapy, Toronto, Ontario, Canada
- University of Toronto, Interdepartmental Division of Critical Care Medicine, Toronto, Ontario, Canada
- University Health Network, KITE – Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Darren Roblyer
- Boston University, Department of Biomedical Engineering, Boston, Massachusetts, United States
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Dragčević D, Pandžić Jakšić V, Jakšić O. Athlete biological passport: longitudinal biomarkers and statistics in the fight against doping. Arh Hig Rada Toksikol 2024; 75:24-31. [PMID: 38548376 PMCID: PMC10978099 DOI: 10.2478/aiht-2024-75-3793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 10/01/2023] [Accepted: 02/01/2024] [Indexed: 04/01/2024] Open
Abstract
As novel substances, short time windows, and limits of detection increasingly challenge direct methods of doping detection in sports, indirect tools inevitably take a greater role in the fight against it. One such tool is the athlete biological passport (ABP) - a longitudinal profiling of the measured haematological and biochemical biomarkers, combined with calculated scores, against the background of epidemiological data crucial for doping detection. In both of its modules, haematological and steroidal, ABP parameters are analysed with the Bayesian adaptive model, which individualises reference and cut-off values to improve its sensitivity. It takes into account the confounding factors with proven and potential influence on the biomarkers, such as race and altitude exposure. The ABP has already changed the fight against doping, but its importance will further grow with the new modules (e.g., endocrinological), parameters (e.g., plasma volume-independent parameters), and complementing indirect methods (e.g., transcriptomic).
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Affiliation(s)
- Dora Dragčević
- University Hospital Merkur, Department of Haematology, Zagreb, Croatia
| | - Vlatka Pandžić Jakšić
- University Hospital Dubrava, Department of Endocrinology, Zagreb, Croatia
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Ozren Jakšić
- University of Zagreb School of Medicine, Zagreb, Croatia
- University Hospital Dubrava, Department of Haematology, Zagreb, Croatia
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Tang GH, Sholzberg M. Iron deficiency anemia among women: An issue of health equity. Blood Rev 2024; 64:101159. [PMID: 38042684 DOI: 10.1016/j.blre.2023.101159] [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: 10/17/2023] [Revised: 11/16/2023] [Accepted: 11/23/2023] [Indexed: 12/04/2023]
Abstract
Iron deficiency is the most common and widespread nutritional deficiency in the world. For women, the risk of iron deficiency and iron deficiency anemia increases due to iron demands during pregnancy and regular iron losses due to menstruation during reproductive years. These interrelated conditions are of public health concern as they are highly prevalent, and the negative consequences such as chronic fatigue, cognitive impairment and poor quality of life are broad and multifaceted. People of low socioeconomic status are at higher risk of iron deficiency due to low intake of expensive iron-rich foods, and decreased access to healthcare. In this review, we applied a health equity lens to describe the current state of care for women with iron deficiency with or without anemia. We have highlighted several structural challenges that span from the laboratory diagnosis, inconsistent screening guidelines, and stigma associated with heavy menstrual bleeding, to treatment barriers.
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Affiliation(s)
- Grace H Tang
- Hematology-Oncology Clinical Research Group, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Michelle Sholzberg
- Department of Medicine, and Department of Laboratory Medicine and Pathobiology, St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada.
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31
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Solleiro Pons M, Bernert L, Hume E, Hughes L, Williams ZJ, Burnley M, Ansdell P. No sex differences in oxygen uptake or extraction kinetics in the moderate or heavy exercise intensity domains. J Appl Physiol (1985) 2024; 136:472-481. [PMID: 38205552 PMCID: PMC11213575 DOI: 10.1152/japplphysiol.00429.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/12/2024] Open
Abstract
The integrative response to exercise differs between sexes, with oxidative energy contribution purported as a potential mechanism. The present study investigated whether this difference was evident in the kinetics of oxygen uptake (V̇o2) and extraction (HHb + Mb) during exercise. Sixteen adults (8 males, 8 females, age: 27 ± 5 yr) completed three experimental visits. Incremental exercise testing was performed to obtain lactate threshold and V̇o2peak. Subsequent visits involved three 6-min cycling bouts at 80% of lactate threshold and one 30-min bout at a work rate of 30% between the lactate threshold and power at V̇o2peak. Pulmonary gas exchange and near-infrared spectroscopy of the vastus lateralis were used to continuously sample V̇o2 and HHb + Mb, respectively. The phase II V̇o2 kinetics were quantified using monoexponential curves during moderate and heavy exercise. Slow component amplitudes were also quantified for the heavy-intensity domain. Relative V̇o2peak values were not different between sexes (P = 0.111). Males achieved ∼30% greater power outputs (P = 0.002). In the moderate- and heavy-intensity domains, the relative amplitude of the phase II transition was not different between sexes for V̇o2 (∼24 and ∼40% V̇o2peak, P ≥ 0.179) and HHb + Mb (∼20 and ∼32% ischemia, P ≥ 0.193). Similarly, there were no sex differences in the time constants for V̇o2 (∼28 s, P ≥ 0.385) or HHb + Mb (∼10 s, P ≥ 0.274). In the heavy-intensity domain, neither V̇o2 (P ≥ 0.686) or HHb + Mb (P ≥ 0.432) slow component amplitudes were different between sexes. The oxidative response to moderate- and heavy-intensity exercises did not differ between males and females, suggesting similar dynamic responses of oxidative metabolism during intensity-matched exercise.NEW & NOTEWORTHY This study demonstrated no sex differences in the oxidative response to moderate- and heavy-intensity cycling exercise. The change in oxygen uptake and deoxyhemoglobin were modeled with monoexponential curve fitting, which revealed no differences in the rate of oxidative energy provision between sexes. This provides insight into previously reported sex differences in the integrative response to exercise.
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Affiliation(s)
- Maria Solleiro Pons
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Lina Bernert
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
- Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | - Emily Hume
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Luke Hughes
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Zander J Williams
- Department of Respiratory Medicine, Royal Brompton Hospital, London, United Kingdom
| | - Mark Burnley
- School of Sport, Health and Exercise Sciences, Loughborough University, Loughborough, United Kingdom
| | - Paul Ansdell
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
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Lawrence ES, Gu W, Bohlender RJ, Anza-Ramirez C, Cole AM, Yu JJ, Hu H, Heinrich EC, O’Brien KA, Vasquez CA, Cowan QT, Bruck PT, Mercader K, Alotaibi M, Long T, Hall JE, Moya EA, Bauk MA, Reeves JJ, Kong MC, Salem RM, Vizcardo-Galindo G, Macarlupu JL, Figueroa-Mujíca R, Bermudez D, Corante N, Gaio E, Fox KP, Salomaa V, Havulinna AS, Murray AJ, Malhotra A, Powel FL, Jain M, Komor AC, Cavalleri GL, Huff CD, Villafuerte FC, Simonson TS. Functional EPAS1/ HIF2A missense variant is associated with hematocrit in Andean highlanders. SCIENCE ADVANCES 2024; 10:eadj5661. [PMID: 38335297 PMCID: PMC10857371 DOI: 10.1126/sciadv.adj5661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/10/2024] [Indexed: 02/12/2024]
Abstract
Hypoxia-inducible factor pathway genes are linked to adaptation in both human and nonhuman highland species. EPAS1, a notable target of hypoxia adaptation, is associated with relatively lower hemoglobin concentration in Tibetans. We provide evidence for an association between an adaptive EPAS1 variant (rs570553380) and the same phenotype of relatively low hematocrit in Andean highlanders. This Andean-specific missense variant is present at a modest frequency in Andeans and absent in other human populations and vertebrate species except the coelacanth. CRISPR-base-edited human cells with this variant exhibit shifts in hypoxia-regulated gene expression, while metabolomic analyses reveal both genotype and phenotype associations and validation in a lowland population. Although this genocopy of relatively lower hematocrit in Andean highlanders parallels well-replicated findings in Tibetans, it likely involves distinct pathway responses based on a protein-coding versus noncoding variants, respectively. These findings illuminate how unique variants at EPAS1 contribute to the same phenotype in Tibetans and a subset of Andean highlanders despite distinct evolutionary trajectories.
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Affiliation(s)
- Elijah S. Lawrence
- Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Wanjun Gu
- Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Ryan J. Bohlender
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Cecilia Anza-Ramirez
- Laboratorio de Fisiología Comparada/Fisiología de del Transporte de Oxígeno-LID, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Amy M. Cole
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - James J. Yu
- Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Hao Hu
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Erica C. Heinrich
- Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, USA
| | - Katie A. O’Brien
- Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge CB2 3EG, UK
| | - Carlos A. Vasquez
- Department of Chemistry and Biochemistry, University of California, San Diego, La Jolla, CA, USA
| | - Quinn T. Cowan
- Department of Chemistry and Biochemistry, University of California, San Diego, La Jolla, CA, USA
| | - Patrick T. Bruck
- Department of Anthropology and Global Health, University of California, San Diego, La Jolla, CA, USA
| | - Kysha Mercader
- Department of Medicine and Pharmacology, University of California, San Diego, La Jolla, CA, USA
| | - Mona Alotaibi
- Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
- Department of Medicine and Pharmacology, University of California, San Diego, La Jolla, CA, USA
| | - Tao Long
- Department of Medicine and Pharmacology, University of California, San Diego, La Jolla, CA, USA
- Sapient Bioanalytics, LLC, San Diego, CA, USA
| | - James E. Hall
- Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Esteban A. Moya
- Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Marco A. Bauk
- Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Jennifer J. Reeves
- Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Mitchell C. Kong
- Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
- Department of Bioengineering, University of California, San Diego, La Jolla, CA, USA
| | - Rany M. Salem
- Herbert Wertheim School of Public Health and Longevity Sciences, University of California, San Diego, La Jolla, CA, USA
| | - Gustavo Vizcardo-Galindo
- Laboratorio de Fisiología Comparada/Fisiología de del Transporte de Oxígeno-LID, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Jose-Luis Macarlupu
- Laboratorio de Fisiología Comparada/Fisiología de del Transporte de Oxígeno-LID, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Rómulo Figueroa-Mujíca
- Laboratorio de Fisiología Comparada/Fisiología de del Transporte de Oxígeno-LID, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Daniela Bermudez
- Laboratorio de Fisiología Comparada/Fisiología de del Transporte de Oxígeno-LID, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Noemi Corante
- Laboratorio de Fisiología Comparada/Fisiología de del Transporte de Oxígeno-LID, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Eduardo Gaio
- Laboratório de Fisiologia Respiratória, Faculdade de Medicina, Universidade de Brasília, Brasília, Brazil
| | - Keolu P. Fox
- Department of Anthropology and Global Health, University of California, San Diego, La Jolla, CA, USA
| | - Veikko Salomaa
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Aki S. Havulinna
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM-HiLIFE), Helsinki, Finland
| | - Andrew J. Murray
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge CB2 3EG, UK
| | - Atul Malhotra
- Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Frank L. Powel
- Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Mohit Jain
- Department of Medicine and Pharmacology, University of California, San Diego, La Jolla, CA, USA
- Sapient Bioanalytics, LLC, San Diego, CA, USA
| | - Alexis C. Komor
- Department of Chemistry and Biochemistry, University of California, San Diego, La Jolla, CA, USA
| | - Gianpiero L. Cavalleri
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Chad D. Huff
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Francisco C. Villafuerte
- Laboratorio de Fisiología Comparada/Fisiología de del Transporte de Oxígeno-LID, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Tatum S. Simonson
- Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
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Pérez-Pacheco A, Ramírez-Chavarría RG, Quispe-Siccha RM, Colín-García MP. Dynamic modeling of photoacoustic sensor data to classify human blood samples. Med Biol Eng Comput 2024; 62:389-403. [PMID: 37880558 PMCID: PMC10794472 DOI: 10.1007/s11517-023-02939-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/14/2023] [Indexed: 10/27/2023]
Abstract
The photoacoustic effect is an attractive tool for diagnosis in several biomedical applications. Analyzing photoacoustic signals, however, is challenging to provide qualitative results in an automated way. In this work, we introduce a dynamic modeling scheme of photoacoustic sensor data to classify blood samples according to their physiological status. Thirty-five whole human blood samples were studied with a state-space model estimated by a subspace method. Furthermore, the samples are classified using the model parameters and the linear discriminant analysis algorithm. The classification performance is compared with time- and frequency-domain features and an autoregressive-moving-average model. As a result, the proposed analysis can predict five blood classes: healthy women and men, microcytic and macrocytic anemia, and leukemia. Our findings indicate that the proposed method outperforms conventional signal processing techniques to analyze photoacoustic data for medical diagnosis. Hence, the method is a promising tool in point-of-care devices to detect hematological diseases in clinical scenarios.
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Affiliation(s)
- Argelia Pérez-Pacheco
- Unidad de Investigación y Desarrollo Tecnológico (UIDT), Hospital General de México "Dr. Eduardo Liceaga", Dr. Balmis 148, 06720, Cuauhtémoc, Doctores, Ciudad de México, México.
| | - Roberto G Ramírez-Chavarría
- Instituto de Ingeniería, Universidad Nacional Autónoma de México, Av. Universidad 3000, 04510, Ciudad Universitaria, Coyoacán, Ciudad de México, México.
| | - Rosa M Quispe-Siccha
- Unidad de Investigación y Desarrollo Tecnológico (UIDT), Hospital General de México "Dr. Eduardo Liceaga", Dr. Balmis 148, 06720, Cuauhtémoc, Doctores, Ciudad de México, México
| | - Marco P Colín-García
- Programa de Maestría y Doctorado en Ingeniería, Universidad Nacional Autónoma de México, Av. Universidad 3000, 04510, Ciudad Universitaria, Coyoacán, Ciudad de México, México
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Raberin A, Burtscher J, Citherlet T, Manferdelli G, Krumm B, Bourdillon N, Antero J, Rasica L, Malatesta D, Brocherie F, Burtscher M, Millet GP. Women at Altitude: Sex-Related Physiological Responses to Exercise in Hypoxia. Sports Med 2024; 54:271-287. [PMID: 37902936 PMCID: PMC10933174 DOI: 10.1007/s40279-023-01954-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 11/01/2023]
Abstract
Sex differences in physiological responses to various stressors, including exercise, have been well documented. However, the specific impact of these differences on exposure to hypoxia, both at rest and during exercise, has remained underexplored. Many studies on the physiological responses to hypoxia have either excluded women or included only a limited number without analyzing sex-related differences. To address this gap, this comprehensive review conducted an extensive literature search to examine changes in physiological functions related to oxygen transport and consumption in hypoxic conditions. The review encompasses various aspects, including ventilatory responses, cardiovascular adjustments, hematological alterations, muscle metabolism shifts, and autonomic function modifications. Furthermore, it delves into the influence of sex hormones, which evolve throughout life, encompassing considerations related to the menstrual cycle and menopause. Among these physiological functions, the ventilatory response to exercise emerges as one of the most sex-sensitive factors that may modify reactions to hypoxia. While no significant sex-based differences were observed in cardiac hemodynamic changes during hypoxia, there is evidence of greater vascular reactivity in women, particularly at rest or when combined with exercise. Consequently, a diffusive mechanism appears to be implicated in sex-related variations in responses to hypoxia. Despite well-established sex disparities in hematological parameters, both acute and chronic hematological responses to hypoxia do not seem to differ significantly between sexes. However, it is important to note that these responses are sensitive to fluctuations in sex hormones, and further investigation is needed to elucidate the impact of the menstrual cycle and menopause on physiological responses to hypoxia.
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Affiliation(s)
- Antoine Raberin
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Johannes Burtscher
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Tom Citherlet
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Giorgio Manferdelli
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Bastien Krumm
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Nicolas Bourdillon
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Juliana Antero
- Institut de Recherche Bio-Médicale Et d'Épidémiologie du Sport (EA 7329), French Institute of Sport, Paris, France
| | - Letizia Rasica
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Davide Malatesta
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Franck Brocherie
- Laboratory Sport, Expertise and Performance (EA 7370), French Institute of Sport, Paris, France
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Grégoire P Millet
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
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Banyeh M, Mayeem BN, Woli MK, Kolekang AS, Dagungong CB, Bure D, Wemegah RK, Azindow MI, Yakubu S, Seidu M, Baba MM, Essoun E, Owireduwaa N. Exploring Hematological and Biochemical Disparities in Same-Sex and Opposite-Sex Females: A Cross-Sectional Twin Study in a Ghanaian Population. Twin Res Hum Genet 2024; 27:50-55. [PMID: 38444332 DOI: 10.1017/thg.2024.7] [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: 03/07/2024]
Abstract
There are sex-dependent differences in hematological and biochemical variables in adulthood attributed to the predominant effects of testosterone in males and estrogen in females. The Twin Testosterone Transfer (TTT) hypothesis proposes that opposite-sex females may develop male-typical traits due to exposure to relatively higher levels of prenatal testosterone than same-sex females. Additionally, prenatal testosterone exposure has been suggested as a correlate of current circulating testosterone levels. Consequently, opposite-sex females might exhibit male-typical patterns in their hematological and biochemical variables. Despite this hypothesis, routine laboratory investigations assign the same reference range to all females. Our cross-sectional study, conducted in Tamale from January to September 2022, included 40 twins, comprising 10 opposite-sex (OS) males (25%), 10 OS females (25%), and 20 same-sex (SS) females (50%), all aged between 18 and 27 years. Fasting venous blood samples were collected and analyzed using automated hematology and biochemistry laboratory analyzers. Results indicated that levels of hemoglobin, serum creatinine, gamma-glutamyl transferase, total protein, globulins, and total testosterone were significantly higher in OS males than OS females. Conversely, total cholesterol and low-density lipoprotein cholesterol were significantly higher in OS females than OS males. Unexpectedly, levels of low-density lipoprotein cholesterol and total testosterone were significantly higher in SS females than OS females. Contrary to expectations, opposite-sex females did not exhibit male-typical patterns in their hematological and biochemical variables. This suggests that the TTT effect may not occur or may not be strong enough to markedly affect hematological and biochemical variables in OS females.
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Affiliation(s)
- Moses Banyeh
- Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
| | - Benjamin N Mayeem
- Department of Medical Laboratory, Living Waters Hospital, Ejisu-krapa, Kumasi, Ghana
| | - Moses Kofi Woli
- Department of Medical Diagnostics, College of Health and Well-Being, Kintampo, Ghana
| | - Augusta S Kolekang
- Department of Epidemiology, Biostatistics and Disease Control, University for Development Studies, Tamale, Ghana
| | | | - David Bure
- Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
| | - Romarick Kofi Wemegah
- Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
| | - Mikail Ihsan Azindow
- Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
| | - Suleman Yakubu
- Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
| | - Musah Seidu
- Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
| | - Mohammed Madde Baba
- Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
| | - Elisha Essoun
- Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
| | - Nancy Owireduwaa
- Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
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Šebeková K, Gurecká R, Podracká Ľ. Association of Leukocyte, Erythrocyte, and Platelet Counts with Metabolic Syndrome and Its Components in Young Individuals without Overt Signs of Inflammation: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:66. [PMID: 38255379 PMCID: PMC10814977 DOI: 10.3390/children11010066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/30/2023] [Accepted: 01/02/2024] [Indexed: 01/24/2024]
Abstract
The presence of metabolic syndrome (MetS) increases the risk of developing type 2 diabetes, cardiovascular diseases, and mortality. MetS is associated with increased leukocyte or erythrocyte counts. In 16- to 20-year-old males (n = 1188) and females (n = 1231) without signs of overt inflammation, we studied whether the presence of MetS and its components results in elevated blood cell counts. The leukocyte, erythrocyte, and thrombocyte counts significantly but weakly correlated with the continuous MetS score, MetS components, uric acid, and C-reactive protein levels both in males (r = -0.09 to 0.2; p < 0.01) and females (r = -0.08 to 0.2; p < 0.05). Subjects with MetS had higher leukocyte (males: 6.2 ± 1.3 vs. 6.9 ± 1.2 × 109/L; females 6.6 ± 1.5 vs. 7.5 ± 1.6 × 109/L; p < 0.001), erythrocyte (males: 5.1 ± 0.3 vs. 5.3 ± 0.3 × 1012/L; females: 4.5 ± 0.3 vs. 4.8 ± 0.3 × 1012/L; p < 0.001), and platelet counts (males: 245 ± 48 vs. 261 ± 47 × 109/L; females: 274 ± 56 vs. 288 ± 74 × 109/L; p < 0.05) than those without MetS. With the exception of platelet counts in females, the blood counts increased with the number of manifested MetS components. Phenotypes with the highest average leukocyte, erythrocyte, or platelet counts differed between sexes, and their prevalence was low (males: 0.3% to 3.9%; females: 1.2% to 2.7%). Whether functional changes in blood elements accompany MetS and whether the increase in blood counts within the reference ranges represents a risk for future manifestation of cardiometabolic diseases remain unanswered.
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Affiliation(s)
- Katarína Šebeková
- Institute of Molecular BioMedicine, Faculty of Medicine, Comenius University, 81108 Bratislava, Slovakia;
| | - Radana Gurecká
- Institute of Molecular BioMedicine, Faculty of Medicine, Comenius University, 81108 Bratislava, Slovakia;
- Institute of Medical Physics, Biophysics, Informatics and Telemedicine, Faculty of Medicine, Comenius University, 81372 Bratislava, Slovakia
| | - Ľudmila Podracká
- Department of Pediatrics, Faculty of Medicine, National Institute for Children Health, Comenius University, 83340 Bratislava, Slovakia;
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Min Y, Dalal AR, Pedroza AJ, Pham TD, Panigrahi AK, Goldstone AB, MacArthur JW, Woo YJ, Baiocchi M, Fischbein MP. Blood transfusion in cardiac surgeries - Toward a personalized protocol. Am J Surg 2024; 227:237-238. [PMID: 37558518 DOI: 10.1016/j.amjsurg.2023.07.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/11/2023]
Affiliation(s)
- Yan Min
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford CA, USA
| | - Alex R Dalal
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford CA, USA
| | - Albert J Pedroza
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford CA, USA
| | - Tho D Pham
- Department of Pathology, Stanford University School of Medicine, Stanford CA, USA
| | - Anil K Panigrahi
- Department of Pathology, Stanford University School of Medicine, Stanford CA, USA; Department of Anesthesiology, Stanford University School of Medicine, Stanford CA, USA
| | - Andrew B Goldstone
- Division of Cardiac, Thoracic, and Vascular Surgery, Columbia University Irving Medical Center, New York, NY, USA
| | - John W MacArthur
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford CA, USA
| | - Y Joseph Woo
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford CA, USA
| | - Michael Baiocchi
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford CA, USA
| | - Michael P Fischbein
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford CA, USA.
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38
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Coe LN, Astorino TA. Sex differences in hemodynamic response to high-intensity interval exercise. Scand J Med Sci Sports 2024; 34:e14495. [PMID: 37724816 DOI: 10.1111/sms.14495] [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: 05/21/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/21/2023]
Abstract
Sex differences in the cardiorespiratory and hemodynamic response to exercise exist due to differences in heart size, blood volume, and hemoglobin mass, eliciting higher maximal oxygen uptake (VO2max ) in men versus women. Data are equivocal whether sex differences in training responsiveness occur. This study investigated potential sex differences in the hemodynamic response (stroke volume (SV) and cardiac output (CO)) to high-intensity interval exercise (HIIE). Habitually active men (n = 15) and women (n = 13) underwent VO2max testing, followed by three HIIE sessions consisting of the 4 × 4, 10 × 1, and reduced exertion high-intensity training (REHIT), whose order was randomized. During exercise, oxygen uptake (VO2 ) and hemodynamic responses were determined. Results showed no sex difference in peak relative VO2 (p = 0.263), CO (p = 0.277), or SV (p = 0.116), although absolute values were higher in men (p < 0.05). Peak absolute (127.3 ± 20.6 vs. 115.2 ± 16.6 mL/beat, p = 0.004, d = 0.66) and relative SV (111.0 ± 15.5 vs. 100.7 ± 11.1% max, p = 0.005, d = 0.78) were higher with REHIT versus 4 × 4. No sex differences in mean relative VO2 , CO, or SV occurred (p > 0.05). Data showed lower mean VO2 during REHIT versus 4 × 4 (59.3 ± 6.8 vs. 65.8 ± 5.8 %VO2max , p < 0.001, d = 1.05) and 10 × 1 (59.3 ± 6.8 vs. 69.1 ± 7.4 %VO2max , p < 0.001, d = 1.4). Mean CO was lower in REHIT than 10 × 1 (79.8 ± 8.6 vs. 84.0 ± 7.4% max, p = 0.012, d = 0.53). Previously reported differences in VO2max response to HIIE may not be due to unique hemodynamic responses.
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Affiliation(s)
- Leah Noël Coe
- Department of Kinesiology, California State University, San Marcos, California, USA
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Cortese L, Fernández Esteberena P, Zanoletti M, Lo Presti G, Aranda Velazquez G, Ruiz Janer S, Buttafava M, Renna M, Di Sieno L, Tosi A, Dalla Mora A, Wojtkiewicz S, Dehghani H, de Fraguier S, Nguyen-Dinh A, Rosinski B, Weigel UM, Mesquida J, Squarcia M, Hanzu FA, Contini D, Mora Porta M, Durduran T. In vivocharacterization of the optical and hemodynamic properties of the human sternocleidomastoid muscle through ultrasound-guided hybrid near-infrared spectroscopies. Physiol Meas 2023; 44:125010. [PMID: 38061053 DOI: 10.1088/1361-6579/ad133a] [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: 06/13/2023] [Accepted: 12/07/2023] [Indexed: 12/28/2023]
Abstract
Objective.In this paper, we present a detailedin vivocharacterization of the optical and hemodynamic properties of the human sternocleidomastoid muscle (SCM), obtained through ultrasound-guided near-infrared time-domain and diffuse correlation spectroscopies.Approach.A total of sixty-five subjects (forty-nine females, sixteen males) among healthy volunteers and thyroid nodule patients have been recruited for the study. Their SCM hemodynamic (oxy-, deoxy- and total hemoglobin concentrations, blood flow, blood oxygen saturation and metabolic rate of oxygen extraction) and optical properties (wavelength dependent absorption and reduced scattering coefficients) have been measured by the use of a novel hybrid device combining in a single unit time-domain near-infrared spectroscopy, diffuse correlation spectroscopy and simultaneous ultrasound imaging.Main results.We provide detailed tables of the results related to SCM baseline (i.e. muscle at rest) properties, and reveal significant differences on the measured parameters due to variables such as side of the neck, sex, age, body mass index, depth and thickness of the muscle, allowing future clinical studies to take into account such dependencies.Significance.The non-invasive monitoring of the hemodynamics and metabolism of the sternocleidomastoid muscle during respiration became a topic of increased interest partially due to the increased use of mechanical ventilation during the COVID-19 pandemic. Near-infrared diffuse optical spectroscopies were proposed as potential practical monitors of increased recruitment of SCM during respiratory distress. They can provide clinically relevant information on the degree of the patient's respiratory effort that is needed to maintain an optimal minute ventilation, with potential clinical application ranging from evaluating chronic pulmonary diseases to more acute settings, such as acute respiratory failure, or to determine the readiness to wean from invasive mechanical ventilation.
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Affiliation(s)
- Lorenzo Cortese
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
| | - Pablo Fernández Esteberena
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
| | - Marta Zanoletti
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
- Politecnico di Milano, Dipartimento di Fisica, I-20133 Milano, Italy
| | - Giuseppe Lo Presti
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
| | | | - Sabina Ruiz Janer
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, E-08036 Barcelona, Spain
| | - Mauro Buttafava
- Politecnico di Milano, Dipartimento di Elettronica Informazione e Bioingegneria, I-20133 Milano, Italy
- Now at PIONIRS s.r.l., I-20124 Milano, Italy
| | - Marco Renna
- Politecnico di Milano, Dipartimento di Elettronica Informazione e Bioingegneria, I-20133 Milano, Italy
- Now at Athinoula A. Martinos Center for Biomedical Imaging, MGH, Harvard Medical School, Charlestown, MA 02129, United States of America
| | - Laura Di Sieno
- Politecnico di Milano, Dipartimento di Fisica, I-20133 Milano, Italy
| | - Alberto Tosi
- Politecnico di Milano, Dipartimento di Elettronica Informazione e Bioingegneria, I-20133 Milano, Italy
| | | | - Stanislaw Wojtkiewicz
- University of Birmingham, School of Computer Science, Edgbaston, Birmingham, B15 2TT, United Kingdom
- Now at Nalecz Institute of Biocybernetics and Biomedical Engineering, 02-109 Warsaw, Poland
| | - Hamid Dehghani
- University of Birmingham, School of Computer Science, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | | | | | | | - Udo M Weigel
- HemoPhotonics S.L., E-08860 Castelldefels (Barcelona), Spain
| | - Jaume Mesquida
- Área de Crítics, Parc Taulí Hospital Universitari, E-08208 Sabadell, Spain
| | - Mattia Squarcia
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, E-08036 Barcelona, Spain
- Neuroradiology Department, Hospital Clínic of Barcelona, E-08036 Barcelona, Spain
| | - Felicia A Hanzu
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, E-08036 Barcelona, Spain
- Endocrinology and Nutrition Department, Hospital Clínic of Barcelona, E-08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), E-28029 Madrid, Spain
| | - Davide Contini
- Politecnico di Milano, Dipartimento di Fisica, I-20133 Milano, Italy
| | - Mireia Mora Porta
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, E-08036 Barcelona, Spain
- Endocrinology and Nutrition Department, Hospital Clínic of Barcelona, E-08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), E-28029 Madrid, Spain
| | - Turgut Durduran
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), E-08010 Barcelona, Spain
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Jung C, Erkens R, Wischmann P, Piayda K, Kelm M, Kuhnle G. Haemoglobin levels as a predictor for the occurrence of future cardiovascular events in adults-Sex-dependent results from the EPIC trial. Eur J Intern Med 2023; 118:118-124. [PMID: 37563040 DOI: 10.1016/j.ejim.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/23/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND The impact of hemoglobin levels on the occurrence of future health events remains equivocal. Due to its integral role in human hemostasis, both, high and low hemoglobin levels may play a significant role in the development of future cardiovascular (CV) events in otherwise healthy adults. METHODS Data from the European Prospective Investigation into Cancer (EPIC)-InterAct cohort was analyzed. In 13.648 individuals, physical activity, body mass index, family history of cardiovascular events, kidney function, smoking status, blood pressure and LDL levels were modelled to concomitant hemoglobin levels and correlated to the occurrence of clinically-overt cardiovascular events and death over a 21-year period. (Sex specific) cox regression analysis were used to develop hazard ratios (HRs) for CV events and all-cause mortality. RESULTS Anemia (hemoglobin (HGB) levels < 13.0 g/dl in men and < 12.0 g/dl in non-pregnant women) were associated with an increased all-cause mortality in men but not in women (HR anemia in men 1.4 (1.2; 1.6)) p=<0.0001).This was particularly visible with increasing age. Various sex specific Cox regression models, accounting for several CV risk factors confirmed these results. The incidence of future CV events and myocardial infarction was significantly influenced by underlying HGB levels in men with increasing age but not in women. CONCLUSION The influence of HGB levels on future cardiovascular events is sex-dependent. In men, presenting with anemia at baseline, the overall survival probability was impaired with increasing age. After adjusting for several CV risk factors, abnormal hemoglobin levels could be identified as a risk factor for the development of clinically-apparent future CV events in men. None of these effects were observed in women.
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Affiliation(s)
- Christian Jung
- Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, Düsseldorf 40225, Germany; Cardiovascular Research Institute Düsseldorf (CARID), Heinrich Heine University, Düsseldorf, Germany
| | - Ralf Erkens
- Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, Düsseldorf 40225, Germany.
| | - Patricia Wischmann
- Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, Düsseldorf 40225, Germany
| | - Kerstin Piayda
- Department of Cardiology and Angiology, Universitätsklinikum Gießen und Marburg, Gießen 35391, Germany
| | - Malte Kelm
- Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, Düsseldorf 40225, Germany; Cardiovascular Research Institute Düsseldorf (CARID), Heinrich Heine University, Düsseldorf, Germany
| | - Gunter Kuhnle
- Department of Food and Nutritional Sciences, University of Reading, Reading, United Kingdom
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Gómez CA, Brochard L, Goligher EC, Rozenberg D, Reid WD, Roblyer D. A combined frequency domain near infrared spectroscopy and diffuse correlation spectroscopy system for comprehensive metabolic monitoring of inspiratory muscles during loading. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.30.569133. [PMID: 38076980 PMCID: PMC10705398 DOI: 10.1101/2023.11.30.569133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Significance Mechanical ventilation (MV) is a cornerstone technology in the intensive care unit as it assists with the delivery of oxygen in critical ill patients. The process of weaning patients from MV can be long, and arduous and can lead to serious complications for many patients. Despite the known importance of inspiratory muscle function in the success of weaning, current clinical standards do not include direct monitoring of these muscles. Aim The goal of this project was to develop and validate a combined frequency domain near infrared spectroscopy (FD-NIRS) and diffuse correlation spectroscopy (DCS) system for the noninvasive characterization of inspiratory muscle response to a load. Approach The system was fabricated by combining a custom digital FD-NIRS and DCS system. It was validated via liquid phantom titrations and a healthy volunteer study. The sternocleidomastoid (SCM), an accessory muscle of inspiration, was monitored during a short loading period in fourteen young healthy volunteer. Volunteers performed two different respiratory exercises, a moderate and high load, which consisted of a one-minute baseline, a one-minute load, and a six-minute recovery period. Results The system has low crosstalk between absorption, reduced scattering, and flow when tested in a set of liquid titrations. Faster dynamics were observed for changes in blood flow index (BFi), and metabolic rate of oxygen (MRO2) compared to hemoglobin + myoglobin (Hb+Mb) based parameters after the onset of loads in males. Additionally, larger percent changes in BFi, and MRO2 were observed compared to Hb+Mb parameters in both males and females. There were also sex differences in baseline values of oxygenated Hb+Mb, total Hb+Mb, and tissue saturation. Conclusion The dynamic characteristics of Hb+Mb concentration and blood flow were distinct during loading of the SCM, suggesting that the combination of FD-NIRS and DCS may provide a more complete picture of inspiratory muscle dynamics.
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Affiliation(s)
- Carlos A Gómez
- Department of Biomedical Engineering, Boston University, Boston, MA 02125, USA
| | - Laurent Brochard
- Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Critical Care, St. Michael's Hospital, Toronto, ON, Canada
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Ewan C Goligher
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
- Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Dmitry Rozenberg
- Division of Respirology, Temerty Faculty of Medicine, University of Toronto, ON, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - W Darlene Reid
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Darren Roblyer
- Department of Biomedical Engineering, Boston University, Boston, MA 02125, USA
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Fiseha T, Alemayehu E, Mohammed O, Gedefie A, Adamu A, Tamir Z, Gebreweld A. Reference Intervals of Haematological Parameters for Apparently Healthy Adults in Northeast Ethiopia. Int J Gen Med 2023; 16:5309-5321. [PMID: 38021065 PMCID: PMC10660733 DOI: 10.2147/ijgm.s430751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 11/10/2023] [Indexed: 12/01/2023] Open
Abstract
Background Clinical laboratory reference intervals play a vital role in evaluating overall well-being, tracking the progression of diseases, and detecting potential harmful effects and complications. Despite evidence revealing disparities, many African nations currently rely on reference intervals for blood analysis obtained mainly from Western populations. This practice increases the risk of misidentifying and misdiagnosing healthy individuals. The aim of this study was to establish common hematological parameters reference intervals for healthy adults in Northeast Ethiopia. Methods This community-based cross-sectional study consisted of 328 individuals who were presumed to be in good health. To assess their blood-related characteristics, blood samples were collected and analyzed using the advanced Dirui BF-6500 analyzer, along with serological testing. In accordance with guidelines provided by the Clinical and Laboratory Standards Institute, the study employed a non-parametric approach to calculate the medians and 95% confidence intervals. To explore potential variations between males and females, a statistical test known as the Mann-Whitney U-test was used to compare the reference intervals. Results The established reference intervals were: white blood cells 3.5-11.3×109/L; red blood cells 4.0-6.1×1012/L; hemoglobin 11.2-17.5g/dL; hematocrit 35.4-52.0%; MCV 77.9-93.8fl; MCH 24.7-32.0pg; MCHC 306-349g/L; RDW-CV 12.1-13.8% and platelet 131-391×109/L. The reference values of monocytes, eosinophils, red blood cells, hemoglobin, hematocrit and RDW-CV in males were higher than females, while females had significantly higher platelet counts compared to males. The reference intervals discovered differed from the reference intervals now in use, those mentioned in earlier research in Ethiopia or other African nations, as well as those conducted on Western populations. Conclusion In the adult demographic of Northeast Ethiopia, specific reference intervals for commonly observed hematological parameters were established, tailored to the local community. Consequently, these reference intervals hold the potential to enhance informed decision-making within this population, by providing valuable guidance when interpreting laboratory test outcomes.
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Affiliation(s)
- Temesgen Fiseha
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ermiyas Alemayehu
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ousman Mohammed
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Alemu Gedefie
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Aderaw Adamu
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Zemenu Tamir
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Angesom Gebreweld
- Department of Medical Laboratory Science, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Alshuweishi Y, Basudan AM, Alfaifi M, Daghistani H, Alfhili MA. Association of the HALP Score with Dyslipidemia: A Large, Nationwide Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2002. [PMID: 38004051 PMCID: PMC10673399 DOI: 10.3390/medicina59112002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Dyslipidemia is a major risk factor for cardiovascular disease (CVD). The identification of new biomarkers that may enhance the risk assessment of lipid abnormalities is a promising approach in improving risk prediction of CVD. There is no information on the association of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score with dyslipidemia. The aim of this study was to investigate the clinical utility of the HALP score in light of dyslipidemia. Materials and Methods: A retrospective analysis of 7192 subjects was initiated to assess the association between the HALP score and disturbed lipid markers. Medians were compared by Mann-Whitney U or Kruskal-Wallis tests and the diagnostic performance and risk assessment were calculated. Results: Median HALP score among all subjects was 53.3, with varying values between males and females. Notably, median HALP was significantly elevated in all forms of dyslipidemia and among males and females irrespective of age. The odds of having elevated HALP score values were significantly higher in all lipid abnormalities. Moreover, HALP score was significantly yet weakly correlated with lipid markers, while the highest diagnostic accuracy of the HALP score was observed with an elevated ratio of total cholesterol to high-density lipoprotein (TC/HDL) (area under the curve, AUC = 0.6411, p < 0.0001). The decision curve analysis (DCA) showed that the HALP score can reliably predict the presence of dyslipidemia. Conclusions: This study demonstrates that the HALP score is a novel, cost-effective index that is associated with a disturbed lipid profile. Further investigation of the nature of this association is needed.
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Affiliation(s)
- Yazeed Alshuweishi
- Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia; (Y.A.)
| | - Ahmed M. Basudan
- Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia; (Y.A.)
| | - Mohammed Alfaifi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Hussam Daghistani
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Department of Clinical Pathology, Al Borg Diagnostics, Jeddah 23437, Saudi Arabia
| | - Mohammad A. Alfhili
- Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia; (Y.A.)
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Lonardo MS, Cacciapuoti N, Chiurazzi M, Di Lauro M, Guida B, Damiano S, Cataldi M. Combined use of handgrip strength and hemoglobin as markers of undernutrition in patients with stage 3-5 chronic kidney disease. Nutr Metab Cardiovasc Dis 2023; 33:2169-2178. [PMID: 37544868 DOI: 10.1016/j.numecd.2023.06.015] [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: 11/24/2022] [Revised: 05/31/2023] [Accepted: 06/19/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND AND AIMS The early identification of undernourished patients with CKD could help instating appropriate nutritional intervention before the full development of the threatening condition known as Protein Energy Wasting (PEW). Handgrip strength (HGS) and blood hemoglobin (Hb) concentration are two parameters considered representative of nutritional status but not included among the criteria for PEW diagnosis. In the present work we investigated whether they could help identifying CKD patients at risk of undernutrition. METHODS AND RESULTS We performed a two-step cluster analysis to classify a cohort of 71 stage 3-5 CKD patients, none of which with PEW, according to their Hb concentration and dominant-hand HGS. Two clusters were finely separated using this method. When we compared the two groups for main body composition and nutritional variables by using t-test statistics or Mann-Whitney test, as appropriate, we found significant differences in PhA, ECW/TBW, ASMI, serum iron. Then we stratified our population by gender and performed cluster analysis as well. PhA, ECW/TBW were still significantly different in the two clusters both in M and in F, while serum iron concentration only in males and ASMI only in females. CONCLUSION These results suggest that either in male than in female Hb concentration and HGS may distinguish two subgroups of CKD patients with different nutritional status and disease severity. Patient belonging to either of these cluster can be easily identified by using the HGS/Hb ratio which represents the HGS normalized per gr Hb.
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Affiliation(s)
- Maria Serena Lonardo
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy.
| | - Nunzia Cacciapuoti
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy
| | - Martina Chiurazzi
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy
| | - Mariastella Di Lauro
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy
| | - Bruna Guida
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy
| | - Simona Damiano
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy
| | - Mauro Cataldi
- Department of Neuroscience, Reproductive Sciences and Dentistry, Division of Pharmacology, Federico II University of Naples, Italy
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Ortiz de Zevallos J, Hogwood AC, Kruse K, De Guzman J, Buckley M, Weltman AL, Allen JD. Sex differences in the effects of inorganic nitrate supplementation on exercise economy and endurance capacity in healthy young adults. J Appl Physiol (1985) 2023; 135:1157-1166. [PMID: 37823208 DOI: 10.1152/japplphysiol.00220.2023] [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: 04/06/2023] [Revised: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 10/13/2023] Open
Abstract
Dietary nitrate (NO3-) is a widely used supplement purported to provide beneficial effects during exercise. Most studies to date include predominantly males. Therefore, the present study aimed to investigate if there is a sex-dependent effect of NO3- supplementation on exercise outcomes. We hypothesized that both sexes would exhibit improvements in exercise economy and exercise capacity following NO3- supplementation, but males would benefit to a greater extent. In a double-blind, randomized, crossover study, twelve females (24 ± 4 yr) and fourteen males (23 ± 4 yr) completed two 4-min moderate-intensity (MOD) exercise bouts followed by a time-to-exhaustion (TTE) task after following 3 days of NO3- supplementation (beetroot juice or BRJ) or NO3--depleted placebo (PL). Females were tested during the early follicular phase of the menstrual cycle. During MOD exercise, BRJ reduced the steady-state V̇o2 by ∼5% in males (M: Δ -87 ± 115 mL·min-1; P < 0.05) but not in females (F: Δ 6 ± 195 mL·min-1). Similarly, BRJ extended TTE by ∼15% in males (P < 0.05) but not in females. Dietary NO3- supplementation improved exercise economy during moderate-intensity exercise and exercise capacity during severe-intensity TTE in males but not in females. These differences could be related to estrogen levels, antioxidant capacity, nitrate-reducing bacteria, or a variety of known physiologic differences such as skeletal muscle calcium handling, and/or fiber type. Overall, our data suggests the ergogenic benefits of oral NO3- supplementation found in studies predominantly on male subjects may not be applicable to females.NEW & NOTEWORTHY While inorganic nitrate (NO3-) supplementation has increased in popularity as an ergogenic aid to improve exercise performance, the role of sex in NO3- supplementation on exercise outcomes is lacking despite known physiological differences during exercise between sex. This study revealed that males, but not females, improved exercise economy during submaximal exercise and exercise capacity during exercise within the severe-intensity domain following NO3- supplementation.
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Affiliation(s)
- Joaquin Ortiz de Zevallos
- Department of Kinesiology, School of Education and Human Development, University of Virginia, Charlottesville, Virginia, United States
| | - Austin C Hogwood
- Department of Kinesiology, School of Education and Human Development, University of Virginia, Charlottesville, Virginia, United States
| | - Ka'eo Kruse
- Department of Kinesiology, School of Education and Human Development, University of Virginia, Charlottesville, Virginia, United States
| | - Jeison De Guzman
- Department of Kinesiology, School of Education and Human Development, University of Virginia, Charlottesville, Virginia, United States
| | - Meredith Buckley
- Department of Kinesiology, School of Education and Human Development, University of Virginia, Charlottesville, Virginia, United States
| | - Arthur L Weltman
- Department of Kinesiology, School of Education and Human Development, University of Virginia, Charlottesville, Virginia, United States
- Division of Cardiovascular Medicine, School of Medicine, University of Virginia, Charlottesville, Virginia, United States
| | - Jason D Allen
- Department of Kinesiology, School of Education and Human Development, University of Virginia, Charlottesville, Virginia, United States
- Division of Cardiovascular Medicine, School of Medicine, University of Virginia, Charlottesville, Virginia, United States
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Overmars LM, van Solinge WW, Ruijter HMD, van der Worp HB, Van Es B, Hulsbergen-Veelken CAR, Biessels GJ, Exalto LG, Haitjema S. Sexual dimorphism in peripheral blood cell characteristics linked to recanalization success of endovascular thrombectomy in acute ischemic stroke. J Thromb Thrombolysis 2023; 56:614-625. [PMID: 37596427 PMCID: PMC10550865 DOI: 10.1007/s11239-023-02881-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 08/20/2023]
Abstract
Endovascular thrombectomy (EVT) success to treat acute ischemic stroke varies with factors like stroke etiology and clot composition, which can differ between sexes. We studied if sex-specific blood cell characteristics (BCCs) are related to recanalization success. We analyzed electronic health records of 333 EVT patients from a single intervention center, and extracted 71 BCCs from the Sapphire flow cytometry analyzer. Through Sparse Partial Least Squares Discriminant Analysis, incorporating cross-validation and stability selection, we identified BCCs associated with successful recanalization (TICI 3) in both sexes. Stroke etiology was considered, while controlling for cardiovascular risk factors. Of the patients, successful recanalization was achieved in 51% of women and 49% of men. 21 of the 71 BCCs showed significant differences between sexes (pFDR-corrected < 0.05). The female-focused recanalization model had lower error rates than both combined [t(192.4) = 5.9, p < 0.001] and male-only models [t(182.6) = - 15.6, p < 0.001]. In women, successful recanalization and cardioembolism were associated with a higher number of reticulocytes, while unsuccessful recanalization and large artery atherosclerosis (LAA) as cause of stroke were associated with a higher mean corpuscular hemoglobin concentration. In men, unsuccessful recanalization and LAA as cause of stroke were associated with a higher coefficient of variance of lymphocyte complexity of the intracellular structure. Sex-specific BCCs related to recanalization success varied and were linked to stroke etiology. This enhanced understanding may facilitate personalized treatment for acute ischemic stroke.
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Affiliation(s)
- L Malin Overmars
- Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center, Utrecht University, Utrecht, The Netherlands.
| | - Wouter W van Solinge
- Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Hester M den Ruijter
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - H Bart van der Worp
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center, Utrecht University, Utrecht, The Netherlands
| | - Bram Van Es
- Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center, Utrecht University, Utrecht, The Netherlands
| | - Lieza G Exalto
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center, Utrecht University, Utrecht, The Netherlands
| | - Saskia Haitjema
- Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Tao H, Dar HY, Tian C, Banerjee S, Glazer ES, Srinivasan S, Zhu L, Pacifici R, He P. Differences in hepatocellular iron metabolism underlie sexual dimorphism in hepatocyte ferroptosis. Redox Biol 2023; 67:102892. [PMID: 37741044 PMCID: PMC10519854 DOI: 10.1016/j.redox.2023.102892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 09/15/2023] [Indexed: 09/25/2023] Open
Abstract
Males show higher incidence and severity than females in hepatic injury and many liver diseases, but the mechanisms are not well understood. Ferroptosis, an iron-mediated lipid peroxidation-dependent death, plays an important role in the pathogenesis of liver diseases. We determined whether hepatocyte ferroptosis displays gender difference, accounting for sexual dimorphism in liver diseases. Compared to female hepatocytes, male hepatocytes were much more vulnerable to ferroptosis by iron and pharmacological inducers including RSL3 and iFSP1. Male but not female hepatocytes exhibited significant increases in mitochondrial Fe2+ and mitochondrial ROS (mtROS) contents. Female hepatocytes showed a lower expression of iron importer transferrin receptor 1 (TfR1) and mitochondrial iron importer mitoferrin 1 (Mfrn1), but a higher expression of iron storage protein ferritin heavy chain 1 (FTH1). It is well known that TfR1 expression is positively correlated with ferroptosis. Herein, we showed that silencing FTH1 enhanced while knockdown of Mfrn1 decreased ferroptosis in HepG2 cells. Removing female hormones by ovariectomy (OVX) did not dampen but rather enhanced hepatocyte resistance to ferroptosis. Mechanistically, OVX potentiated the decrease in TfR1 and increase in FTH1 expression. OVX also increased FSP1 expression in ERK-dependent manner. Elevation in FSP1 suppressed mitochondrial Fe2+ accumulation and mtROS production, constituting a novel mechanism of FSP1-mediated inhibition of ferroptosis. In conclusion, differences in hepatocellular iron handling between male and female account, at least in part, for sexual dimorphism in induced ferroptosis of the hepatocytes.
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Affiliation(s)
- Hui Tao
- Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Hamid Y Dar
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Cheng Tian
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Somesh Banerjee
- Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Evan S Glazer
- Departments of Surgery and Cancer Center, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Shanthi Srinivasan
- Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA; Atlanta Veterans Administration Medical Center, Decatur, GA, USA
| | - Liqin Zhu
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Roberto Pacifici
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Peijian He
- Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, 615 Michael Street, Atlanta, GA, 30322, USA.
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Oberlin DJ. Sex differences and athletic performance. Where do trans individuals fit into sports and athletics based on current research? Front Sports Act Living 2023; 5:1224476. [PMID: 37964771 PMCID: PMC10641525 DOI: 10.3389/fspor.2023.1224476] [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: 05/17/2023] [Accepted: 10/10/2023] [Indexed: 11/16/2023] Open
Abstract
There are well known sex differences in parameters of physical fitness/performance due to changes occurring during sexual development. Thus, many sport and athletic events have regulations separating male and female participants. However, the inclusion or exclusion of transgender individuals in athletics has recently received outsized attention despite relatively few cases of transgender athletes. When determining which athletic gender category trans individuals should be permitted to compete in, it is important to understand the level of physical fitness/performance these individuals possess relative to their cisgender counterparts. Unfortunately, there are few studies investigating this topic, and several complications that confound this research. The current review seeks to discuss sex and gender as concepts, review sex differences in fitness/performance and how they develop, and then, consider how current evidence suggests that trans individuals compare to cis individuals. Finally, this review seeks to offer considerations for whether trans individuals should be excluded from sports and athletics, and how future research should proceed to better understand this marginalized population.
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Affiliation(s)
- D. J. Oberlin
- Department of Exercise Sciences and Recreation, City University of New York, Lehman College, Bronx, NY, United States
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Bielitzki R, Behrendt T, Nguyen T, Behrens M, Malczewski V, Franz A, Schega L. Influence of cuff stiffness on hemodynamics and perceived cuff pressure in the upper extremities in males and females: implications for practical blood flow restriction training. BMC Sports Sci Med Rehabil 2023; 15:134. [PMID: 37858237 PMCID: PMC10585869 DOI: 10.1186/s13102-023-00745-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 10/03/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Practical blood flow restriction (pBFR) during exercise is a cost-saving alternative to traditional blood flow restriction using pneumatic cuffs, particularly when exercising in a group setting. Depending on the pBFR technique, several factors (e.g., cuff width, limb circumference) have already been shown to be of importance when applying the pBFR pressure. Given that elastic cuffs are often used for pBFR, the cuff stiffness might be an additional influencing factor. Therefore, the present study compared the acute effects of three elastic cuffs with identical width but different stiffness (high stiffness (HS), medium stiffness (MS), and low stiffness (LS)) on hemodynamic measures and perceived cuff pressure at rest. METHODS In a randomized, counter-balanced cross-over study, 36 young and normotensive participants completed three experimental trials. After a 10-min rest period in supine position, the cuff was loosely and proximally applied to the right upper arm. Following baseline data recording, the cuff was successively tightened in 10%-increments with respect to the limb circumference (%overlap) until arterial blood flow was occluded. At baseline and during each %overlap, systolic peak blood flow velocity of the brachial artery, rating of perceived cuff pressure, as well as muscle oxygen saturation and total hemoglobin concentration of the biceps brachii muscle were recorded. RESULTS The %overlap required to occlude arterial blood flow was different between the three cuffs (HS: 30.9 ± 3.8%, MS: 43.9 ± 6.1%, LS: 54.5 ± 8.3%). Furthermore, at 30% overlap, systolic peak blood flow velocity was lower when applying the HS (9.0 ± 10.9 cm∙s- 1) compared to MS (48.9 ± 21.9 cm∙s- 1) and LS cuff (62.9 ± 19.1 cm∙s- 1). Rating of perceived cuff pressure at 30% overlap was higher when using the HS (6.5 ± 1.5 arbitrary unit (a.u.)) compared to MS (5.1 ± 1.4 a.u.) and LS cuff (4.9 ± 1.5 a.u.) with no difference between the MS and LS cuff. However, muscle oxygen saturation and total hemoglobin concentration were not different between the three cuffs. CONCLUSIONS The present study revealed that the cuff stiffness influenced blood flow velocity and arterial occlusion pressure. Therefore, cuff stiffness seems an important factor for the application of pBFR.
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Affiliation(s)
- Robert Bielitzki
- Department of Sport Science, Institute III, Otto-von-Guericke University Magdeburg, 39104 Magdeburg, Germany
| | - Tom Behrendt
- Department of Sport Science, Institute III, Otto-von-Guericke University Magdeburg, 39104 Magdeburg, Germany
| | - Toan Nguyen
- Department of Sport Science, Institute III, Otto-von-Guericke University Magdeburg, 39104 Magdeburg, Germany
| | - Martin Behrens
- University of Applied Sciences for Sport and Management Potsdam, Olympischer Weg 7, 14471 Potsdam, Germany
| | - Victoria Malczewski
- Department of Sport Science, Institute III, Otto-von-Guericke University Magdeburg, 39104 Magdeburg, Germany
| | - Alexander Franz
- Department of Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany
| | - Lutz Schega
- Department of Sport Science, Institute III, Otto-von-Guericke University Magdeburg, 39104 Magdeburg, Germany
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50
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Webb KL, Gorman EK, Morkeberg OH, Klassen SA, Regimbal RJ, Wiggins CC, Joyner MJ, Hammer SM, Senefeld JW. The relationship between hemoglobin and [Formula: see text]: A systematic review and meta-analysis. PLoS One 2023; 18:e0292835. [PMID: 37824583 PMCID: PMC10569622 DOI: 10.1371/journal.pone.0292835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 09/29/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVE There is widespread agreement about the key role of hemoglobin for oxygen transport. Both observational and interventional studies have examined the relationship between hemoglobin levels and maximal oxygen uptake ([Formula: see text]) in humans. However, there exists considerable variability in the scientific literature regarding the potential relationship between hemoglobin and [Formula: see text]. Thus, we aimed to provide a comprehensive analysis of the diverse literature and examine the relationship between hemoglobin levels (hemoglobin concentration and mass) and [Formula: see text] (absolute and relative [Formula: see text]) among both observational and interventional studies. METHODS A systematic search was performed on December 6th, 2021. The study procedures and reporting of findings followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Article selection and data abstraction were performed in duplicate by two independent reviewers. Primary outcomes were hemoglobin levels and [Formula: see text] values (absolute and relative). For observational studies, meta-regression models were performed to examine the relationship between hemoglobin levels and [Formula: see text] values. For interventional studies, meta-analysis models were performed to determine the change in [Formula: see text] values (standard paired difference) associated with interventions designed to modify hemoglobin levels or [Formula: see text]. Meta-regression models were then performed to determine the relationship between a change in hemoglobin levels and the change in [Formula: see text] values. RESULTS Data from 384 studies (226 observational studies and 158 interventional studies) were examined. For observational data, there was a positive association between absolute [Formula: see text] and hemoglobin levels (hemoglobin concentration, hemoglobin mass, and hematocrit (P<0.001 for all)). Prespecified subgroup analyses demonstrated no apparent sex-related differences among these relationships. For interventional data, there was a positive association between the change of absolute [Formula: see text] (standard paired difference) and the change in hemoglobin levels (hemoglobin concentration (P<0.0001) and hemoglobin mass (P = 0.006)). CONCLUSION These findings suggest that [Formula: see text] values are closely associated with hemoglobin levels among both observational and interventional studies. Although our findings suggest a lack of sex differences in these relationships, there were limited studies incorporating females or stratifying results by biological sex.
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Affiliation(s)
- Kevin L. Webb
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Ellen K. Gorman
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Olaf H. Morkeberg
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Stephen A. Klassen
- Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
| | - Riley J. Regimbal
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Chad C. Wiggins
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Michael J. Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Shane M. Hammer
- Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, Oklahoma, United States of America
| | - Jonathon W. Senefeld
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois
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