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Vihinen M. How to Define Pathogenicity, Health, and Disease? Hum Mutat 2016; 38:129-136. [PMID: 27862583 DOI: 10.1002/humu.23144] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 10/13/2016] [Accepted: 11/03/2016] [Indexed: 11/07/2022]
Abstract
Scientific and clinical communities produce ever increasing amounts of data and details about health and disease. Our ability to understand and utilize this information is limited because of imprecise language and lack of well-defined concepts. This problem involves also the principal concepts of health, disease, and pathogenicity. Here, a systematic model is presented for pathogenicity, as well as for health and disease. It has three components: extent, modulation, and severity, which jointly define the continuum of pathogenicity. The model is population based, and once implemented, it can be used for numerous purposes such as diagnosis, patient stratification, prognosis, finding phenotype-genotype correlations, or explaining adverse drug reactions. The new model has several benefits including health economy by allowing evidence-based personalized/precision medicine.
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Affiliation(s)
- Mauno Vihinen
- Department of Experimental Medical Science, Lund University, BMC B13, Lund, SE-22184, Sweden
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Ding Z, Pi F, Zhang S, Dong W, Wen Y, Wu J, Zhang Q. Establishment and application of a new diagnostic definition of metabolic syndrome in the Shantou region of southern China. Sci Rep 2016; 6:22210. [PMID: 26902456 PMCID: PMC4763302 DOI: 10.1038/srep22210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 02/09/2016] [Indexed: 02/05/2023] Open
Abstract
The existing definitions of metabolic syndrome (MetS) may not be fully appropriate for the Shantou population because of ethnic and regional differences. We sought to establish a 95% multivariate medical reference range (MMRR) model for diagnosing MetS in Shantou adults and to evaluate the prevalence of MetS by the MMRR, JCDCG (the Chinese Guidelines), and International Diabetes Federation (IDF) criteria. A total of 4,580 participants were recruited in Shantou, southern China. We developed a MMRR model based on the combinatorial indicatrixes method for three categorized indicatrixes. According to the developed MMRR criteria, men (women) in Shantou have MetS by meeting 3 or more of the following: waist circumference ≥89 (81) cm; triglycerides level ≥1.73 (1.64) mmol/L; high-density lipoprotein cholesterol level ≤1.07 (1.05) mmol/L; blood pressure ≥138/89 (136/85) mmHg; and fasting plasma glucose ≥5.8 (5.7) mmol/L. The agreement of the MMRR with JCDCG and IDF criteria was "substantial" (both κ > 0.68), but the recommended reference values and proportion of individual components of MetS defined by the 3 criteria differed. The population-based MMRR criteria may be appropriate for diagnosing MetS in Shantou population and the model might be useful for generalization to other geographic regions.
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Affiliation(s)
- Zan Ding
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China
| | - Fuhua Pi
- Department of Sports, Shantou University Medical College, Shantou, Guangdong 515041, China
| | - Shengchao Zhang
- Shenzhen Baoan District Central Hospital, Shenzhen, Guangdong 518102, China
| | - Wenya Dong
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China
| | - Ye Wen
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China
| | - Jiang Wu
- Shenzhen Baoan District Central Hospital, Shenzhen, Guangdong 518102, China
| | - Qingying Zhang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China
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Varounis C, Rallidis LS, Franco OH, Kotakos C, Lekakis J. Depressive symptomatology in patients with metabolic syndrome: A cross-sectional study of stable coronary artery disease patients. Eur J Intern Med 2015; 26:e54-5. [PMID: 26277354 DOI: 10.1016/j.ejim.2015.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 07/28/2015] [Accepted: 07/30/2015] [Indexed: 11/20/2022]
Affiliation(s)
- Christos Varounis
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; 2nd Department of Cardiology, Attikon University Hospital, Athens, Greece.
| | | | - Oscar H Franco
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Christos Kotakos
- 2nd Department of Cardiology, Attikon University Hospital, Athens, Greece
| | - John Lekakis
- 2nd Department of Cardiology, Attikon University Hospital, Athens, Greece
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Wang Q, Chair SY, Wong EML, Li X, Liu M, Zhang Y. Comparing the Predictive Abilities of Different Metabolic Syndrome Definitions for Acute Coronary Syndrome: A Case–Control Study in Chinese Adults. Metab Syndr Relat Disord 2014; 12:390-6. [DOI: 10.1089/met.2014.0010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Qun Wang
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sek Ying Chair
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eliza Mi Ling Wong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiaomei Li
- Faculty of Nursing, College of Medicine, Xian Jiaotong University, Xian, China
| | - Meili Liu
- Department of Cardiac Medicine, The First Affiliated Hospital of Medical College of Xian Jiaotong University, Xian, China
| | - Yulian Zhang
- Department of Nursing, The Third Affiliated Hospital of Medicine College of Xian Jiaotong University, Xian, China
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Tadic M, Cuspidi C, Sljivic A, Andric A, Ivanovic B, Scepanovic R, Ilic I, Jozika L, Marjanovic T, Celic V. Effects of the metabolic syndrome on right heart mechanics and function. Can J Cardiol 2013; 30:325-31. [PMID: 24484912 DOI: 10.1016/j.cjca.2013.12.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 12/08/2013] [Accepted: 12/08/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND We sought to investigate right ventricular (RV) and right atrial (RA) deformation obtained using 3-dimensional echocardiography (3DE) and 2-dimensional (2DE) strain in subjects with the metabolic syndrome (MS). METHODS This cross-sectional study included 108 untreated subjects with the MS and 75 control subjects similar according to sex and age. The MS was defined by the presence ≥ 3 American Heart Association/National Heart, Lung, and Blood Institute criteria. All the subjects underwent adequate laboratory analyses and complete 2DE and 3DE examination. RESULTS 2DE global longitudinal strain of the RV was significantly decreased in the MS group compared with the control subjects (-24 ± 5 vs -27 ± 5%; P < 0.001). Similar results were obtained for the RA longitudinal strain (40 ± 5 vs 44 ± 7%; P < 0.001). Systolic and early diastolic RV and RA strain rates were decreased, whereas late diastolic strain rates were increased among the MS participants compared with the control subjects. 3DE RV ejection fraction was significantly decreased in the MS subjects (55 ± 4 vs 58 ± 4%; P < 0.001). The multivariate analysis of MS criteria showed that systolic blood pressure, waist circumference, and fasting glucose were independently associated with RV and/or RA myocardial function and deformation. CONCLUSIONS RV mechanics and RA mechanics, assessed using 3DE and 2DE strain, were significantly deteriorated in the MS subjects. Among all MS risk factors, systolic blood pressure, abdominal circumference, and fasting glucose were the most responsible for the right heart remodelling.
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Affiliation(s)
- Marijana Tadic
- University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia.
| | - Cesare Cuspidi
- University of Milan-Bicocca and Istituto Auxologico Italiano, Clinical Research Unit, Meda, Italy
| | - Aleksandra Sljivic
- University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia
| | - Anita Andric
- University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia
| | - Branislava Ivanovic
- Clinical Centre of Serbia, Clinic of Cardiology, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Radisav Scepanovic
- University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Irena Ilic
- University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia
| | - Ljilja Jozika
- University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia
| | - Tamara Marjanovic
- University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia
| | - Vera Celic
- University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
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Foulds HJ, Shubair MM, Warburton DE. A Review of the Cardiometabolic Risk Experience Among Canadian Métis Populations. Can J Cardiol 2013; 29:1006-13. [DOI: 10.1016/j.cjca.2012.11.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 11/23/2012] [Accepted: 11/23/2012] [Indexed: 12/31/2022] Open
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Ma X, Zhu S. Metabolic syndrome in the prevention of cardiovascular diseases and diabetes--still a matter of debate? Eur J Clin Nutr 2013; 67:518-21. [PMID: 23403882 DOI: 10.1038/ejcn.2013.24] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
After metabolic syndrome was first introduced to identify persons at greater cardiovascular disease (CVD) risk, it has been associated with an increased risk of CVD and type 2 diabetes (T2D). Obesity has been considered as the fundamental factor in metabolic syndrome and it is thought to be mediated, at least in part by the role of the adipocyte in controlling circulating free fatty acids and the development of insulin resistance. However, the obese population is not perfectly overlapped with the population with metabolic syndrome. Is metabolic syndrome a better predictor than obesity to prevent CVD and T2D? Has metabolic syndrome been considered as a cluster of risk factors or an additional independent risk factor to assess CVD and T2D risk? The debate on the necessity of metabolic syndrome diagnosis seems not to be ended. Various definitions of metabolic syndrome were advocated by different organizations with emphasis on different components, and these definitions have different abilities to predict CVD and T2D among different populations because of fundamental philosophical differences. In the definitions of metabolic syndrome, only the cutoffs of each component were presented but rather continuous values or the degree of the severity of the syndrome with multiple cutoffs. Moreover, metabolic syndrome did not incorporate all the risk factors as known for CVD and T2D, such as physical activity. Future prospective studies with the measurement of sophisticated metabolic markers and of abdominal visceral and subcutaneous adiposity are needed to examine if the metabolic syndrome is a good CVD and T2D risk predictor over obesity and other risk factors. In practice, prevention action should be taken at the stage of obesity and providers need to pay attention to any components in the definition of metabolic syndrome even if the number of positive components has not achieved three or more.
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Affiliation(s)
- X Ma
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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