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He J, Zhou H, Xiong J, Huang Y, Huang N, Jiang J. Association between elevated homocysteine levels and obstructive sleep apnea hypopnea syndrome: a systematic review and updated meta-analysis. Front Endocrinol (Lausanne) 2024; 15:1378293. [PMID: 38887264 PMCID: PMC11180825 DOI: 10.3389/fendo.2024.1378293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/14/2024] [Indexed: 06/20/2024] Open
Abstract
Objective This study aimed to distinguish between healthy controls and patients with OSAHS regarding homocysteine (HCY) levels and investigate how individuals with OSAHS respond to continuous positive airway pressure ventilation (CPAP) in terms of serum and plasma HCY levels. Methods To ascertain published articles about OSAHS, an exhaustive search was performed across medical databases, encompassing PubMed, Web of Science, EMBASE, CNKI, and Cochrane Library, until January 2, 2024. This study reviewed the literature regarding HCY levels in individuals with OSAHS and control groups, HCY levels under pre- and post-CPAP treatment, the Pearson/Spearman correlation coefficients between HCY levels and apnea-hypopnea index (AHI), and the hazard ratio (HR) of HCY levels concerning the occurrence of major adverse cerebrocardiovascular events (MACCEs) in patients with OSAHS. Meta-analyses were performed using weighted mean difference (WMD), correlation coefficients, and HR as effect variables. The statistical analysis was conducted using the R 4.1.2 and STATA 11.0 software packages. Results In total, 33 articles were selected for the final analysis. The OSAHS group exhibited significantly higher serum/plasma HCY levels than the control group (WMD = 4.25 μmol/L, 95% CI: 2.60-5.91, P< 0.001), particularly among individuals with moderate and severe OSAHS. Additionally, subgroup analysis using mean age, ethnicity, mean body mass index, and study design type unveiled significantly elevated levels of HCY in the serum/plasma of the OSAHS group compared to the control group. CPAP treatment can significantly decrease serum/plasma HCY levels in patients with OSAHS. Moreover, elevated HCY levels in individuals with OSAHS could be one of the risk factors for MACCEs (adjusted HR = 1.68, 95% CI = 1.10-2.58, P = 0.017). AHI scores show a positive correlation with serum/plasma HCY levels. Conclusion Patients with OSAHS had elevated serum/plasma HCY levels compared to healthy controls; however, CPAP therapy dramatically decreased HCY levels in patients with OSAHS. In patients with OSAHS, elevated HCY levels were linked with an increased risk of MACCEs, and HCY was positively connected with AHI values. HCY levels may serve as a useful clinical indicator for determining the severity and efficacy of OSAHS treatments. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42024498806.
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Affiliation(s)
- Jie He
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Haiying Zhou
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
- Department of Rehabilitation, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Juan Xiong
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
- Emergency department, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Yuanyuan Huang
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Na Huang
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Jiaqing Jiang
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
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Liu L, Zhang X, Geng HR, Qiao YN, Gui YH, Zhao JY. High paternal homocysteine causes ventricular septal defects in mouse offspring. iScience 2024; 27:109447. [PMID: 38523790 PMCID: PMC10960133 DOI: 10.1016/j.isci.2024.109447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 01/18/2024] [Accepted: 03/05/2024] [Indexed: 03/26/2024] Open
Abstract
Maternal hyperhomocysteinemia is widely considered as an independent risk of congenital heart disease (CHD). However, whether high paternal homocysteine causes CHD remains unknown. Here, we showed that increased homocysteine levels of male mice caused decreased sperm count, sperm motility defect and ventricular septal defect of the offspring. Moreover, high levels of paternal homocysteine decrease sperm DNMT3A/3B, accompanied with changes in DNA methylation levels in the promoter regions of CHD-related genes. Folic acid supplement could decrease the occurrence of VSD in high homocysteine male mice. This study reveals that increased paternal homocysteine level increases VSD risk in the offspring, indicating that decreasing paternal homocysteine may be an intervening target of CHD.
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Affiliation(s)
- Lian Liu
- Children’s Hospital of Fudan University and Shanghai Genitourinary Cancer Institute Fudan University, Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 201102, China
| | - Xuan Zhang
- Children’s Hospital of Fudan University and Shanghai Genitourinary Cancer Institute Fudan University, Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 201102, China
| | - Hao-Ran Geng
- School of Life Sciences, Fudan University, Shanghai 200438, China
- Institute for Developmental and Regenerative Cardiovascular Medicine, MOE-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Ya-Nan Qiao
- School of Life Sciences, Fudan University, Shanghai 200438, China
| | - Yong-Hao Gui
- Children’s Hospital of Fudan University and Shanghai Genitourinary Cancer Institute Fudan University, Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 201102, China
| | - Jian-Yuan Zhao
- Institute for Developmental and Regenerative Cardiovascular Medicine, MOE-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
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Zhang X, Guo B, Zhu H, Li D, Zhao Y, Liu Q, Hou J. H-type Hypertension Status and Influencing Factors of the Elderly People Over 80 Years Old Based on Random Forest Model. Int Heart J 2024; 65:263-270. [PMID: 38479846 DOI: 10.1536/ihj.23-488] [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] [Indexed: 04/02/2024]
Abstract
Hypertension is a common chronic disease in elderly people over 80 years old. Clinically, H-type hypertension occurs when hypertension coexists with hyperhomocysteinemia level of ≥ 10 umol/L. Effective identification of risk factors for H-type hypertension in the elderly can greatly improve patient prognosis.Consecutively, 494 patients with hypertension admitted to the Fourth Affiliated Hospital of Harbin Medical University from January 2019 to December 2021 were selected as the study population. They were divided into H-type hypertension (n = 197) and non-H-type hypertension groups (n = 297). Patient data were collected, including basic information, history, and clinical data. The random forest model and LASSO analysis were used to screen the influencing factors for H-type hypertension. Multiple stepwise regression analysis was used to analyze the selected variables.A total of 197 elderly people over 80 years old suffered from H-type hypertension, with an incidence rate of 39.88%. The random forest model and LASSO analysis results showed that the top 8 independent variables in importance ranking were ejection fraction (EF), fibrinogen, glycated hemoglobin (HbA1c), B-type natriuretic peptide, creatinine, fasting blood glucose, uric acid, and serum triiodothyronine levels. The results of multivariate analysis showed that EF was the protective factor, while fibrinogen, HbA1c, and creatinine were the risk factors for H-type hypertension in elderly people over 80 years old (P < 0.05).Healthcare professionals can indirectly assess the prevalence of H-type hypertension by focusing on EF, fibrinogen, creatinine, and HbA1c in elderly hypertensive patients. This provided proactive intervention and medical services to improve prognosis outcomes.
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Affiliation(s)
- Xiaobo Zhang
- Department of Cardiology Organization, The Second Affiliated Hospital, Harbin Medical University
- Department of Gerontology, The Fourth Affiliated Hospital, Harbin Medical University
| | - Botang Guo
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Health Science Center
| | - Hong Zhu
- Department of Health Policy, Health Management College, Harbin Medical University
- Department of Pharmacy Administration, Humanities and Social Science College, Harbin Medical University
| | - Dahe Li
- Department of Gerontology, The Fourth Affiliated Hospital, Harbin Medical University
| | - Yuanyuan Zhao
- Department of Gerontology, The Fourth Affiliated Hospital, Harbin Medical University
| | - Qi Liu
- Department of Cardiology Organization, The Second Affiliated Hospital, Harbin Medical University
- The Key Laboratory of Myocardial Ischemia Organization, Chinese Ministry of Education
| | - Jingbo Hou
- Department of Cardiology Organization, The Second Affiliated Hospital, Harbin Medical University
- The Key Laboratory of Myocardial Ischemia Organization, Chinese Ministry of Education
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4
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Zhang P, Xie X, Zhang Y. Associations between homocysteine, vitamin B12, and folate and the risk of all-cause mortality in American adults with stroke. Front Nutr 2023; 10:1279207. [PMID: 38035355 PMCID: PMC10682091 DOI: 10.3389/fnut.2023.1279207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
Objective Associations between plasma homocysteine (Hcy), vitamin B12, and folate and the risk of all-cause mortality are unclear. This study aimed to examine whether plasma Hcy, vitamin B12, and folate levels independently predict the risk of all-cause mortality in American adults with stroke. Methods Data from the United States National Health and Examination Survey (NHANES; 1999-2006) were used and linked with the latest (2019) National Death Index (NDI). Cox proportional hazards models and restricted cubic splines were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) of all-cause mortality for Hcy, folate, and B12 levels in adults with stroke. Sample weights were calculated to ensure the generalizability of the results. Results A total of 431 participants were included (average age: 64.8 years). During a median follow-up of 10.4 years, 316 deaths occurred. Hcy was positively associated with all-cause mortality in adults with stroke (HR, 1.053; 95% CI: 1.026-1.080). Stroke patients with plasma Hcy levels in the fourth quartile had a 1.631-fold higher risk of all-cause mortality (HR, 1.631; 95% CI: 1.160-2.291) than those in the first quartile. The association between plasma Hcy and all-cause mortality was strong significant in older patients (p for interaction = 0.020). Plasma folate and vitamin B12 concentrations were inversely correlated with Hcy concentrations [B-value (95% CI): -0.032 (-0.056- -0.008), -0.004 (-0.007- -0.002), respectively]. No significant associations were observed between folate, vitamin B12 levels, and all-cause mortality in adults with stroke. Conclusion Plasma Hcy levels were positively associated with all-cause mortality in older adults with stroke. Folate and vitamin B12 levels were inversely correlated with Hcy. Plasma Hcy may serve as a useful predictor in mortality risk assessment and targeted intervention in adults with stroke.
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Affiliation(s)
| | | | - Yurong Zhang
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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5
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Ding Z, Du S, Yang Y, Yu T, Hong X. Association between triglyceride glucose index and H-type hypertension in postmenopausal women. Front Cardiovasc Med 2023; 10:1224296. [PMID: 38028446 PMCID: PMC10646504 DOI: 10.3389/fcvm.2023.1224296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background Recent studies have reported better predictive performance of triglyceride glucose (TyG) index for cardiovascular events in women, however, whether this association persists in postmenopausal women is inconclusive. We investigated the association between TyG index and H-type hypertension (HHT) in postmenopausal women. Methods 1,301 eligible women with hypertension were included in this cross-sectional study. Concomitant homocysteine levels >10 μmol/L were defined as H-type hypertension. The TyG index was calculated as ln [triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. Multivariable logistic regression models and restricted cubic spline models were used to assess the association between TyG index and H-type hypertension in postmenopausal women, and subgroup analyses were performed for potential confounders. Results Of the 1,301 hypertensive patients, 634 (48.7%) participants had H-type hypertension. In each adjusted model, TyG index was significantly associated with the risk of H-type hypertension. each 1-unit increase in TyG index was associated with an increased risk of H-type hypertension in all participants (OR = 1.6; 95% CI, 1.3-2.0; P < 0.001), and there was a linear relationship between TyG index and H-type hypertension (P for linear trend < 0.001). Conclusion TyG index is positively associated with H-type hypertension in postmenopausal women, suggesting that TyG index may be a promising marker for H-type hypertension. By controlling lipid levels and blood glucose levels, it may help prevent H-type hypertension in postmenopausal women.
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Affiliation(s)
- Zihao Ding
- Clinical Epidemiology Research Office, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology, Hunan Normal University, Changsha, China
- Department of Epidemiology and Statistics, College of Medicine, Hunan Normal University, Changsha, China
| | - Shihong Du
- Clinical Epidemiology Research Office, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology, Hunan Normal University, Changsha, China
- Department of Epidemiology and Statistics, College of Medicine, Hunan Normal University, Changsha, China
| | - Yi Yang
- Clinical Epidemiology Research Office, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology, Hunan Normal University, Changsha, China
| | - Tong Yu
- Clinical Epidemiology Research Office, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology, Hunan Normal University, Changsha, China
- Department of Epidemiology and Statistics, College of Medicine, Hunan Normal University, Changsha, China
| | - Xiuqin Hong
- Clinical Epidemiology Research Office, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology, Hunan Normal University, Changsha, China
- Research Department, The First Affiliated Hospital of Hunan Norma University, Changsha, China
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Du S, Hong X, Yang Y, Ding Z, Yu T. Association between body fat percentage and H-type hypertension in postmenopausal women. Front Public Health 2022; 10:950805. [PMID: 35937205 PMCID: PMC9354540 DOI: 10.3389/fpubh.2022.950805] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 06/30/2022] [Indexed: 11/16/2022] Open
Abstract
Background Previous studies have explored the relationship between body fat percentage (BFP) and hypertension or homocysteine. However, evidence on the constancy of the association remains inconclusive in postmenopausal women. The aim of this study was to investigate the association between BFP and H-type hypertension in postmenopausal women. Methods This cross-sectional study included 1,597 eligible female patients with hypertension. Homocysteine levels ≥10 mmol/L were defined as H-type hypertension. BFP was calculated by measuring patients' physical parameters. Subjects were divided into 4 groups according to quartiles of BFP (Q1: 33.4% or lower, Q2: 33.4–36.1%, Q3: 36.1–39.1%, Q4: >39.1%). We used restricted cubic spline regression models and logistic regression analysis to assess the relationship between BFP and H-type hypertension. Additional subgroup analysis was performed for this study. Results Among 1,597 hypertensive patients, 955 (59.8%) participants had H-type hypertension. There were significant differences between the two groups in age, BMI, educational background, marital status, exercise status, drinking history, WC, TG, LDL, Scr, BUN, and eGFR (P < 0.05). The prevalence of H-type hypertension in the Q1 to Q4 groups was 24.9, 25.1, 24.9, and 25.1%, respectively. After adjusting for relevant factors, we found that the risk of H-type hypertension in the Q4 group had a significantly higher than the Q1 group (OR = 3.2, 95% CI: 1.3–7.5). Conclusion BFP was positively associated with the risk of H-type hypertension in postmenopausal women. Postmenopausal women should control body fat to prevent hypertension.
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Affiliation(s)
- Shihong Du
- Clinical Epidemiology Research Office, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology, Hunan Normal University, Changsha, China
- Department of Epidemiology and Statistics, College of Medicine, Hunan Normal University, Changsha, China
| | - Xiuqin Hong
- Clinical Epidemiology Research Office, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology, Hunan Normal University, Changsha, China
- Research Department, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- *Correspondence: Xiuqin Hong
| | - Yi Yang
- Clinical Epidemiology Research Office, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology, Hunan Normal University, Changsha, China
- Department of Epidemiology and Statistics, College of Medicine, Hunan Normal University, Changsha, China
| | - Zihao Ding
- Clinical Epidemiology Research Office, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology, Hunan Normal University, Changsha, China
- Department of Epidemiology and Statistics, College of Medicine, Hunan Normal University, Changsha, China
| | - Tong Yu
- Clinical Epidemiology Research Office, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- Key Laboratory of Molecular Epidemiology, Hunan Normal University, Changsha, China
- Department of Epidemiology and Statistics, College of Medicine, Hunan Normal University, Changsha, China
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Zhuo Y, Qu Y, Wu J, Huang X, Yuan W, Lee J, Yang Z, Zee B. Estimation of stroke severity with National Institutes of Health Stroke Scale grading and retinal features: A cross-sectional study. Medicine (Baltimore) 2021; 100:e26846. [PMID: 34397858 PMCID: PMC8341321 DOI: 10.1097/md.0000000000026846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 07/12/2021] [Indexed: 01/09/2023] Open
Abstract
To estimate National Institutes of Health Stroke Scale (NIHSS) grading of stroke patients with retinal characteristics.A cross-sectional study was conducted in Shenzhen Traditional Chinese Medicine Hospital. Baseline information and retinal photos were collected within 2 weeks of admission. An NIHSS score was measured for each patient by trained doctors. Patients were classified into 0 to 4 score group and 5 to 42 score group for analysis. Three multivariate logistic models, with traditional clinical characteristics alone, with retinal characteristics alone, and with both, were built.For clinical characteristics, hypertension duration is statistically significantly associated with higher NIHSS score (P = .014). Elevated total homocysteine levels had an OR of 0.456 (P = .029). For retinal characteristics, the fractal dimension of the arteriolar network had an OR of 0.245 (P < .001) for the left eyes, and an OR of 0.417 (P = .009) for right eyes. The bifurcation coefficient of the arteriole of the left eyes had an OR of 2.931 (95% CI 1.573-5.46, P = .001), the nipping of the right eyes had an OR of 0.092 (P = .003) showed statistical significance in the model.The area under receiver-operating characteristic curve increased from 0.673, based on the model with clinical characteristics alone, to 0.896 for the model with retinal characteristics alone and increased to 0.931 for the model with both clinical and retinal characteristics combined.Retinal characteristics provided more information than clinical characteristics in estimating NIHSS grading and can provide us with an objective method for stroke severity estimation.
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Affiliation(s)
- Yuanyuan Zhuo
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Yimin Qu
- Division of Biostatistics, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR
| | - Jiaman Wu
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Xingxian Huang
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Weiqu Yuan
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Jack Lee
- Division of Biostatistics, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR
- Centre for Clinical Trials and Biostatistics Lab, CUHK Shenzhen Research Institute, Shenzhen, China
| | - Zhuoxin Yang
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Benny Zee
- Division of Biostatistics, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR
- Centre for Clinical Trials and Biostatistics Lab, CUHK Shenzhen Research Institute, Shenzhen, China
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Chen ZN, Huang YR, Chen X, Liu K, Li SJ, Yang H, Chen W, Ren BQ, Luo ZH. Value of neutrophil-to-lymphocyte ratio as a marker of renal damage in patients with H-type hypertension. Biomark Med 2021; 15:637-646. [PMID: 34039027 DOI: 10.2217/bmm-2020-0638] [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: 11/21/2022] Open
Abstract
Aim: To explore the relationship between the neutrophil-to-lymphocyte ratio (NLR) and renal damage in patients with H-type hypertension. Materials & methods: A total of 618 patients between 2017 and 2019 were analyzed retrospectively. Results: NLR was significantly correlated with renal damage in hypertension patients. Appropriate cut-off value for NLR (2.247) was determined by receiver operating characteristic curve; linear regression analysis showed that NLR and estimated glomerular filtration rate, blood urea nitrogen/creatinine has a significant negative correlation in H-type hypertension group (p < 0.05); logistic regression analysis showed that the risk of renal damage increased by 10% for each 1 umol/l increase of homocysteine, and 51% for each 1.0 increase of NLR in H-type hypertension patients. Conclusion: NLR worth popularizing in prediction of renal damage in patients with H-type hypertension.
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Affiliation(s)
- Zhen-Ni Chen
- Department of Clinical Laboratory, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
| | - Yi-Ran Huang
- Hunan University of Traditional Chinese Medicine, Changsha, Hunan, China
| | - Xing Chen
- Hunan University of Traditional Chinese Medicine, Changsha, Hunan, China.,Department of Laboratory Medicine, Hunan Provincial Second People's Hospital, Changsha, Hunan, China
| | - Kun Liu
- Hunan University of Traditional Chinese Medicine, Changsha, Hunan, China.,Department of Medical Administration, Hunan Provincial Second People's Hospital, Changsha, Hunan, China
| | - Si-Jin Li
- Hunan University of Traditional Chinese Medicine, Changsha, Hunan, China.,Department of Laboratory Medicine, Hunan Provincial Second People's Hospital, Changsha, Hunan, China
| | - Huan Yang
- Hunan University of Traditional Chinese Medicine, Changsha, Hunan, China.,Department of Laboratory Medicine, Hunan Provincial Second People's Hospital, Changsha, Hunan, China
| | - Wei Chen
- Hunan University of Traditional Chinese Medicine, Changsha, Hunan, China.,Department of Laboratory Medicine, Hunan Provincial Second People's Hospital, Changsha, Hunan, China
| | - Bi-Qiong Ren
- Hunan University of Traditional Chinese Medicine, Changsha, Hunan, China.,Department of Laboratory Medicine, Hunan Provincial Second People's Hospital, Changsha, Hunan, China
| | - Zhi-Hong Luo
- Hunan University of Traditional Chinese Medicine, Changsha, Hunan, China.,Department of Medical Administration, Hunan Provincial Second People's Hospital, Changsha, Hunan, China
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Xiang T, Xiang H, Yan M, Yu S, Horwedel MJ, Li Y, Zeng Q. Systemic risk factors correlated with hyperhomocysteinemia for specific MTHFR C677T genotypes and sex in the Chinese population. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1455. [PMID: 33313200 PMCID: PMC7723589 DOI: 10.21037/atm-20-6587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background Methyltetrahydrofolate reductase (MTHFR) is a main regulatory enzyme in homocysteine (Hcy) metabolism. A common C677T mutation in the MTHFR gene results in decreased enzyme activity, which contributes to hyperhomocysteinemia (HHcy). Previous studies have shown that HHcy was correlated with various systemic diseases, such as cardiovascular disease, stroke, cancer, renal failure and so on. However, we hypothesized that HHcy in different genotype and sex groups may have different risk factors, which would lead to various pathologic states. Therefore, the aim of this study was to explore systemic information that are correlated with HHcy for specific MTHFR C677T genotypes and sex, which might be useful for predicting and preventing systemic diseases. Methods This cross-sectional study was performed through November 2017 to July 2019. A total of 4,534 adults aged 20–75 y were selected for this study. All the participants underwent a physical examination, blood tests and MTHFRC677T genotyping. Multivariable linear regression was performed to explore the risk factors for HHcy for each sex and genotype. Results The average of Hcy level is higher in the TT genotype than CC and CT genotypes (P=0.000). Multiple linear regression analysis identified the common protective factors (folate and Vit B12) and risk factor (Cr) for HHcy. Besides that, each group has its specific risk factors—female-CT (age, SBP, and Hb), female-TT (SBP and AST); male-CC (age, AST and Hb), male-CT (age and AST) and male-TT (SBP, AST, and Hb). Conclusions HHcy was associated with different risk factors for each specific sex and genotype. These risk factors might be useful for predicting and preventing systemic diseases.
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Affiliation(s)
- Tianyuan Xiang
- China Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.,Eli and Edythe Broad CIRM Center for Regenerative Medicine and Stem Cell Research at USC, Los Angeles, CA, USA
| | - Hang Xiang
- Eli and Edythe Broad CIRM Center for Regenerative Medicine and Stem Cell Research at USC, Los Angeles, CA, USA.,Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Muyang Yan
- Department of Hyperbaric-Oxygen, Chinese PLA General Hospital, Beijing, China
| | - Sheng Yu
- Department of Hepatobiliary Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Matthew John Horwedel
- Division of Engineering in Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, USA
| | - Yang Li
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Qiang Zeng
- China Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
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10
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H-Type Hypertension Is a Risk Factor for Cerebral Small-Vessel Disease. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6498903. [PMID: 32090105 PMCID: PMC7029257 DOI: 10.1155/2020/6498903] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 12/08/2019] [Accepted: 12/26/2019] [Indexed: 01/24/2023]
Abstract
Background The correlation between H-type hypertension and cerebral small-vessel diseases (CSVD) remains uncertain. Objective The present study was designed to explore the possible relationship between H-type hypertension and CSVD spectrum and total burden. Method We included 329 patients in the present study and divided them into four groups: the H-type hypertension group, isolated hypertension group, isolated hyperhomocysteinemia (HHcy) group, and control group. Clinical variables of interest and the MR examination sequences were obtained. We counted the presence of each CSVD feature and rated the total burden of CSVD on an ordinal scale from 0 to 4 according to a recent described score rule. Result The results showed that H-type hypertension was associated with the presence of cerebral microbleeds (CMBs), and the severity of white-matter hyperintensities (WMHs) and peripheral vascular space (PVS). CSVD total burden was significantly related to age (OR: 1.059, 95% CI: 1.037–1.082), systolic pressure (OR: 1.122, 95% CI: 1.007–1.136), triglycerides (OR: 1.386, 95% CI: 1.037–1.854), isolated HHcy (OR: 4.154, 95% CI 1.836–9.401), and H-type hypertension (OR: 5.028, 95% CI: 2.323–10.883). Also, we further observed hypertension and HHcy had a synergistic effect on CSVD total burden (OR: 2.776, 95% CI: 1.564–4.927). Conclusion H-type hypertension was associated with CSVD total burden and CSVD spectrum, which deserves further prevention measures. Furthermore, hypertension and HHcy had a synergistic effect on CSVD total burden.
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Chen YN, Wei P, Yu Bs J. Higher concentration of serum C-terminal cross-linking telopeptide of type I collagen is positively related with inflammatory factors in postmenopausal women with H-type hypertension and osteoporosis. Orthop Surg 2019; 11:1135-1141. [PMID: 31823500 PMCID: PMC6904650 DOI: 10.1111/os.12567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/22/2019] [Accepted: 10/08/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To investigate the changes of inflammatory factors and bone metabolism markers in postmenopausal women with H-type hypertension and to assess the relationship between them. METHODS Postmenopausal women who were diagnosed with osteoporosis were selected as observation objects. Participants were divided into three groups: only osteoporosis group (osteoporosis group), hypertension combined with osteoporosis group (hypertension group), and H-type hypertension combined with osteoporosis group (H-type hypertension group). The changes in bone mineral density and bone metabolic markers (osteocalcin [OC], procollagen type I N-terminal propeptide (PINP), and C-terminal cross-linking telopeptide of type I collagen [CTX]) and inflammatory factors (interleukin-6 [IL-6] and tumor necrosis factor-α [TNF-α]) were compared among three groups. RESULTS In the hypertension group and the H-type hypertension group, the bone mineral density of the lumbar spine (0.647 ± 0.038 vs 0.638 ± 0.034 vs 0.668 ± 0.047, P < 0.05) and the femoral neck (0.567 ± 0.047 vs 0.552 ± 0.053 vs 0.618 ± 0.059, P < 0.05) was significantly lower than that in the osteoporosis group. The concentrations of CTX (266.61 ± 64.65 vs 293.09 ± 72.34 vs 235.48 ± 62.85, P < 0.05), IL-6 (44.36 ± 6.45 vs 48.05 ± 8.04 vs 39.06 ± 7.95, P < 0.05) and TNF-α (30.53 ± 6.28 vs 34.52 ± 7.15 vs 28.66 ± 6.19, P < 0.01) in the hypertension group and in the H-type hypertension group were significantly higher than those in the osteoporosis group. The concentrations of OC (30.59 ± 6.43 vs 27.10 ± 6.51, P < 0.05) and PINP (36.36 ± 6.16 vs 33.16 ± 6.77, P < 0.05) in the H-type hypertension group were increased dramatically. The concentration of CTX was positively correlated with the concentration of IL-6 (r = 0.587, P < 0.01) and TNF-α (r = 0.474, P < 0.01) and negatively related with the concentration of OC (r = -0.591, P < 0.01) and PINP (r = -0.646, P < 0.01) and the bone mineral density of the lumbar spine (r = -0.470, P < 0.01) and the femoral neck (r = -0.509, P < 0.01). CONCLUSION Higher concentration of serum CTX is found in postmenopausal women with H-type hypertension, which is positively correlated with inflammatory factors. Besides, H-type hypertension could further enhance the activity of osteoclasts and increase the expressions of inflammatory factors, resulting in the aggravation of osteoporosis.
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Affiliation(s)
- Yu-Ning Chen
- Department of Geriatrics, Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Peng Wei
- Department of Cardiology, Xuzhou Hospital Affiliated to Southeast University, Xuzhou, China
| | - Jian Yu Bs
- Department of Geriatrics, Third Affiliated Hospital of Soochow University, Changzhou, China
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Qiao J, Zhou K, Huang C, Fu S, Xing Y, Zhang B. Comparison of serum Lp-PLA2 levels in ischemic stroke patients with H-type hypertension or non-H-type hypertension. J Clin Lab Anal 2019; 34:e23068. [PMID: 31630457 PMCID: PMC7031582 DOI: 10.1002/jcla.23068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 09/22/2019] [Accepted: 09/24/2019] [Indexed: 01/15/2023] Open
Abstract
Background Increased serum Lp‐PLA2 levels have been reported in patients who experienced an ischemic stroke; however, the relationship between Lp‐PLA2 and H‐type hypertension in patients with ischemic stroke remains unclear. Methods In the present study, we investigated the correlation between serum Lp‐PLA2 and H‐type hypertension in patients with ischemic stroke. A total of 135 patients who experienced acute ischemic stroke were enrolled in Tianjin Huanhu Hospital during October 2015 to May 2016. The demographic characteristics of the patients were collected, and biochemical parameters were detected. Results Among the 135 patients, 111 patients had essential hypertension, including 41 patients with H‐type hypertension and 70 with non‐H‐type hypertension. There were higher proportions of males and patients with diabetes mellitus in the H‐type hypertension group compared with the non‐H‐type hypertension group (P < .05). Lp‐PLA2, glucose, and LDL‐C levels were higher in the H‐type hypertension group than in the non‐H‐type hypertension group (P < .05). Multivariate logistic regression showed that Lp‐PLA2 levels >208.46 mg/L were independently associated with H‐type hypertension in patients with ischemic stroke (OR: 2.560, 95% CI: 1.085‐6.040, P = .032). The area under the ROC curve of Lp‐PAL2 levels in the H‐type hypertension group was 0.665 (95% CI: 0.561‐0.768, P = .004). Conclusion Synergetic effects of H‐type hypertension and Lp‐PLA2 levels were noted in the pathogenesis of ischemic stroke.
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Affiliation(s)
- Jie Qiao
- Tianjin Key Laboratory of Cerebral Vessels and Neural DegenerationTianjin Neurosurgical InstituteTianjin Huanhu HospitalTianjinChina
| | - KuiChen Zhou
- Department of Clinical LaboratoryThe First Affiliated Hospital of Jiamusi UniversityJiamusiChina
| | - Chao Huang
- Tianjin Key Laboratory of Cerebral Vessels and Neural DegenerationTianjin Neurosurgical InstituteTianjin Huanhu HospitalTianjinChina
| | - Siwen Fu
- Tianjin Key Laboratory of Cerebral Vessels and Neural DegenerationTianjin Neurosurgical InstituteTianjin Huanhu HospitalTianjinChina
| | - Yonghong Xing
- Tianjin Key Laboratory of Cerebral Vessels and Neural DegenerationTianjin Neurosurgical InstituteTianjin Huanhu HospitalTianjinChina
| | - Biao Zhang
- Tianjin Key Laboratory of Cerebral Vessels and Neural DegenerationTianjin Neurosurgical InstituteTianjin Huanhu HospitalTianjinChina
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Wu W, Liu J, Li A, Li J, Yang Y, Ye X, Zheng J. Effect of Intensive Blood Pressure Control on Carotid Morphology and Hemodynamics in Chinese Patients with Hyperhomocysteinemia-Type Hypertension and High Risk of Stroke. Med Sci Monit 2019; 25:5717-5726. [PMID: 31369520 PMCID: PMC6688516 DOI: 10.12659/msm.914482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 03/21/2019] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Different blood pressure targets should be formulated for different groups of people. This study aimed to assess the effectiveness of intensive blood control in improving the carotid morphology and hemodynamics in Chinese patients with hyperhomocysteinemia-type hypertension and high risk of stroke. MATERIAL AND METHODS Chinese hypertensive patients with high risk of stroke were randomized to intensive (n=187) and standard (n=192; controls) blood pressure management groups. Systolic blood pressure (SBP) targets were 100< SBP ≤120 and 120< SBP ≤140 mmHg, respectively. All patients received folic acid 0.8 mg/d and atorvastatin 20 mg/d. Calcium antagonist was first used. If blood pressure was still uncontrolled, angiotensin-converting enzyme inhibitor or angiotensin receptor antagonist, ß-receptor blocker, and diuretics were added successively. Follow-up was 12 months. Carotid features, hemodynamics, and adverse events were examined. RESULTS There were no differences in sex, age, body mass index, blood lipids, baseline carotid parameters, and histories of smoking, diabetes, statin use, and stroke between the 2 groups. Carotid plaques after 12 months of treatment were 19.4±2.1 and 23.6±3.1 cm² for the intensive and control groups, respectively (P=0.038). Plaque scores were lower in the intensive group (1.75±0.52 vs. 2.45±0.47, P=0.023). Compared with controls, intensive management resulted in relatively higher Vd and significantly lower Vs/Vd, PI, and RI (all P<0.05). Major adverse events such as hypotension (n=5 (2.7%) vs. 3 (1.6%), P=0.020) and dizziness (n=20 (10.7%) vs. 16 (8.3%), P=0.041) were more frequent in the intensive group. CONCLUSIONS Intensive blood pressure management could be beneficial for Chinese patients with hyperhomocysteinemia-type hypertension and high risk of stroke.
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Affiliation(s)
- Wenjing Wu
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, P.R. China
| | - Jian Liu
- Department of Ultrasound Diagnosis, China-Japan Friendship Hospital, Beijing, P.R. China
| | - Aili Li
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, P.R. China
| | - Jiahui Li
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, P.R. China
| | - Yiyun Yang
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, P.R. China
| | - Xiaojun Ye
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, P.R. China
| | - Jingang Zheng
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, P.R. China
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Huang HC, Chiang HP, Hsu NW, Huang CF, Chang SH, Lin KC. Differential risk group of developing stroke among older women with gouty arthritis: A latent transition analysis. Eur J Clin Invest 2019; 49:e13090. [PMID: 30912848 DOI: 10.1111/eci.13090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 09/24/2018] [Accepted: 10/26/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Gout-related comorbidities are intricate and its clinical features may demonstrate sex difference; however, few studies have evaluated the links between comorbidities and gout in a female population. The objectives of this study were to compare the aggregation and transitive trajectories of comorbidities of gout, and their consequences in female and male gout populations. METHODS A prospective cohort study was conducted using data from the Taiwan National Health Insurance Research Database. A female and male gout population were followed up from 2000 to 2009 to identify the comorbidities of cardiovascular disease, hyperlipidemia, hypertension, diabetes mellitus (DM) and chronic kidney disease. The cumulative incidence of stroke from 2000 to 2010 was examined. A latent trajectory analysis was used to determine the transitive trajectories of the comorbidities of gout. RESULTS Both female and male patients with gout had five risk cluster transition (CT) phenotypes of comorbidities within 10-year follow-up: CT1 and CT2, with various persistent comorbidities; CT3, with few persistent comorbidities; and CT4 and CT5, with transfer to cluster 1 from other clusters. The female participants in CT2 predominantly experienced DM and were associated with significantly increased risk of developing stroke. CONCLUSION Diabetes is a notable risk factor for the development of stroke in female patients with gout. Early assessment and management for the comorbidities of gout, particularly in DM, would effectively reduce future stroke risk in female gout population.
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Affiliation(s)
- Hui-Chuan Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hsueh-Ping Chiang
- Secretary Room, National Yang-Ming University Hospital, Yilan City, Taiwan
| | - Nai-Wei Hsu
- Division of Cardiology, Department of Internal Medicine, National Yang-Ming University Hospital, Yilan City, Taiwan
| | - Chien-Fang Huang
- Division of Quality Improvement, Joint Commission of Taiwan, New Taipei City, Taiwan
| | - Sheng Hsuan Chang
- Secretary Room, National Yang-Ming University Hospital, Yilan City, Taiwan
| | - Kuan-Chia Lin
- IInstitute of Hospital and Health Care Administration, Community Research Center, Preventive Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
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Association of H-Type Hypertension with Stroke Severity and Prognosis. BIOMED RESEARCH INTERNATIONAL 2018; 2018:8725908. [PMID: 30271787 PMCID: PMC6151242 DOI: 10.1155/2018/8725908] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/24/2018] [Accepted: 08/28/2018] [Indexed: 11/25/2022]
Abstract
Background. The correlation between H-type hypertension and acute ischemic stroke remains uncertain. Objective. The present study was designed to explore the possible relationship between H-type hypertension and severity and prognosis of acute ischemic stroke. Method. We included 372 patients with acute ischemic stroke and divided them into four groups: H-type hypertension group, simple hypertension group, simple hyperhomocysteinemia (HHcy) group, and the control group. NIHSS score was measured at both admission and two weeks later. mRS score, stroke recurrence, cardiovascular event, or all-cause mortality was recorded at 3-month and 1-year follow-up. Result. The results showed that the NIHSS score on admission in the H-type hypertension group (6.32 ± 5.91) was significantly higher than that in the control group (3.97 ± 3.59) (P < 0.05), while there was no obvious association between H-type hypertension and NIHSS score after 2-week treatment (P = 0.106). Endpoint events incidence in H-type hypertension group was the highest; however, in the cox regression model of multiple factor analysis, H-type hypertension was not an independent risk factor. Conclusion. H-type hypertension may result in early functional deterioration and higher incidence rate of endpoint events but not act as an independent risk factor.
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Djuric D, Jakovljevic V, Zivkovic V, Srejovic I. Homocysteine and homocysteine-related compounds: an overview of the roles in the pathology of the cardiovascular and nervous systems. Can J Physiol Pharmacol 2018; 96:991-1003. [PMID: 30130426 DOI: 10.1139/cjpp-2018-0112] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Homocysteine, an amino acid containing a sulfhydryl group, is an intermediate product during metabolism of the amino acids methionine and cysteine. Hyperhomocysteinemia is used as a predictive risk factor for cardiovascular disorders, the stroke progression, screening for inborn errors of methionine metabolism, and as a supplementary test for vitamin B12 deficiency. Two organic systems in which homocysteine has the most harmful effects are the cardiovascular and nervous system. The adverse effects of homocysteine are achieved by the action of several different mechanisms, such as overactivation of N-methyl-d-aspartate receptors, activation of Toll-like receptor 4, disturbance in Ca2+ handling, increased activity of nicotinamide adenine dinucleotide phosphate-oxidase and subsequent increase of production of reactive oxygen species, increased activity of nitric oxide synthase and nitric oxide synthase uncoupling and consequent impairment in nitric oxide and reactive oxygen species synthesis. Increased production of reactive species during hyperhomocysteinemia is related with increased expression of several proinflammatory cytokines, including IL-1β, IL-6, TNF-α, MCP-1, and intracellular adhesion molecule-1. All these mechanisms contribute to the emergence of diseases like atherosclerosis and related complications such as myocardial infarction, stroke, aortic aneurysm, as well as Alzheimer disease and epilepsy. This review provides evidence that supports the causal role for hyperhomocysteinemia in the development of cardiovascular disease and nervous system disorders.
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Affiliation(s)
- Dragan Djuric
- a Institute of Medical Physiology "Richard Burian" Faculty of Medicine, University of Belgrade, Visegradska 26, Belgrade 11000, Serbia
| | - Vladimir Jakovljevic
- b Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, Kragujevac 34000, Serbia.,c Department of Human Pathology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya st. 8, Moscow 119991, Russia
| | - Vladimir Zivkovic
- b Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, Kragujevac 34000, Serbia
| | - Ivan Srejovic
- b Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, Kragujevac 34000, Serbia
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Li S, Zhu J, Wu L, Peng L, Luo Y, Zhao Y, Dong R, Chen L, Tang X, Liu J. The association between plasma homocysteine and ambulatory blood pressure variability in patients with untreated hypertension. Clin Chim Acta 2017; 477:32-38. [PMID: 29203427 DOI: 10.1016/j.cca.2017.11.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 11/19/2017] [Accepted: 11/30/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Both homocysteine (Hcy) and blood pressure variability (BPV) are independent predictors of stroke, however, their relationship is rarely evaluated before. This study aimed to investigate the association Hcy and ambulatory BPV in subjects with untreated primary hypertension. METHODS A total of 252 eligible patients were recruited. Plasma Hcy was measured and 24-h ambulatory blood pressure monitoring was performed for each subject. The systolic and diastolic BPV values were calculated as the SD of individual blood pressure values during 24h, daytime and nighttime, and then stratified by the tertiles of Hcy concentration (T1 to T3). Univariate and multivariate linear regression models were used to assess the relationships between Hcy tertiles and BPV variables. RESULTS The mean values of Hcy from T1 to T3 were 7.51±1.21μmol/l, 11.09±1.07μmol/l and 19.14±6.26μmol/l, respectively. Systolic and diastolic mean blood pressures were similar among subjects with different Hcy tertiles. However, both systolic and diastolic BPV variables, no matter in 24-h, daytime or nighttime, were increasing significantly along with the rises in Hcy tertiles (all p<0.05 for linear trends analysis). Multivariate linear regression analysis indicated that Hcy tertiles were significantly associated with BPV variables, independently of mean blood pressures other confounding factors. In subgroup analysis, the associations between Hcy tertiles and BPV variables were enhanced by the increased risk stratification of hypertension. CONCLUSIONS Plasma Hcy was positively and independently associated with ambulatory BPV in patients with untreated hypertension.
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Affiliation(s)
- Suhua Li
- Department of Cardiology, the Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China
| | - Jieming Zhu
- Department of Cardiology, the Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China; Department of Electrocardiography, the Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China
| | - Lin Wu
- Department of Electrocardiography, the Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China
| | - Long Peng
- Department of Cardiology, the Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China
| | - Yanting Luo
- Department of Cardiology, the Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China
| | - Yunyue Zhao
- Department of Cardiology, the Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China
| | - Ruimin Dong
- Department of Cardiology, the Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China
| | - Lin Chen
- Department of Cardiology, the Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China
| | - Xixiang Tang
- Advanced Medical Center, the Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China.
| | - Jinlai Liu
- Department of Cardiology, the Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China.
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Wang H, Guo X, Chen Y, Li Z, Xu J, Sun Y. Relation of four nontraditional lipid profiles to diabetes in rural Chinese H-type hypertension population. Lipids Health Dis 2017; 16:199. [PMID: 29020963 PMCID: PMC5637264 DOI: 10.1186/s12944-017-0590-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/04/2017] [Indexed: 01/09/2023] Open
Abstract
Background Mounting evidence suggested that nontraditional lipid profiles have been recognized as a reliable indicator for unfavorable cardiovascular events. The purpose of this study was to explore the role of nontraditional lipid profiles as potential clinical indices for the assessment of prevalent diabetes in rural Chinese H-type hypertension population. Methods During 2012 to 2013, we conducted a large cross-sectional study of 2944 H-type hypertension participants (≥35 years of age) from rural areas in northeast China. Subjects underwent accurate assessment of lipid profiles, fasting plasma glucose (FPG), homocysteine (Hcy) according to standard protocols. Results The proportion of diabetes showed a graded and linear increase across the quartiles for all four nontraditional lipid parameters. Nontraditional lipid variables were independent determinants of FPG, and its correlation for TG/HDL-C was strongest, whether potential confounders were adjusted or not. Multivariable logistic regression analysis established that the highest triglycerides (TG)/ high-density lipoprotein cholesterol (HDL-C) quartile manifested the largest ORs of prevalent diabetes (OR: 3.275, 95%CI: 2.109–5.087) compared with the lowest quartile. The fully adjusted ORs (95%CI) were 2.753 (1.783–4.252), 2.178 (1.415–2.351), 1.648 (1.097–2.478) for the top quartile of total cholesterol (TC)/HDL-C, low-density lipoprotein cholesterol (LDL-C)/HDL-C, and non-high-density lipoprotein cholesterol (non-HDL-C), respectively. On the basis of the area under receiver-operating characteristic curve (AUC), TG/HDL-C showed the optimal discriminating power for diabetes (AUC: 0.684, 95% CI: 0.650–0.718). Conclusions Nontraditional lipid profiles (TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C) were all consistently and independently correlated with prevalent diabetes among the H-type hypertension population in rural China. TG/HDL-C was prone to be more profitable in assessing the risk of prevalent diabetes and should be encouraged as an effective clinical tool for monitoring and targeted intervention of diabetes in H-type hypertension adults.
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Affiliation(s)
- Haoyu Wang
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
| | - Yintao Chen
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
| | - Zhao Li
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
| | - Jiaqi Xu
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China.
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Finsterer J. Low risk of ischaemic stroke in hyperhomocysteinaemia. Lancet Neurol 2017; 16:682-683. [DOI: 10.1016/s1474-4422(17)30260-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 07/06/2017] [Indexed: 10/19/2022]
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Ma L, Li L, Tang Z. Epidemiological characteristics of hyperhomocysteinemia and H-type hypertension in the elderly in Beijing, China. Clin Exp Hypertens 2017. [PMID: 28640642 DOI: 10.1080/10641963.2017.1306540] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Lina Ma
- Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China
- Department of Epidemiology and Social Medicine, Xuan Wu Hospital, Capital Medical University, Key Laboratory for Neurodegenerative Disease of Ministry of Education, Center of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China
| | - Li Li
- Department of Epidemiology and Social Medicine, Xuan Wu Hospital, Capital Medical University, Key Laboratory for Neurodegenerative Disease of Ministry of Education, Center of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China
- Department of Geriatrics, Beijing Geriatric Hospital, Beijing, China
| | - Zhe Tang
- Department of Epidemiology and Social Medicine, Xuan Wu Hospital, Capital Medical University, Key Laboratory for Neurodegenerative Disease of Ministry of Education, Center of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China
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Liu K, Xuekelati S, Zhang Y, Yin Y, Li Y, Chai R, Li X, Peng Y, Wu J, Guo X. Expression levels of atherosclerosis-associated miR-143 and miR-145 in the plasma of patients with hyperhomocysteinaemia. BMC Cardiovasc Disord 2017. [PMID: 28633641 PMCID: PMC5477732 DOI: 10.1186/s12872-017-0596-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background An elevated level of homocysteine (Hcy) in the blood is designated hyperhomocysteinaemia (Hhcy) and is regarded as a strong risk factor for the development of atherosclerosis (ATH), although the association remains controversial. Considered to be essential gene expression regulators, micro-RNAs (miRNAs) modulate cardiovascular disease development and thus can be regarded as potential biomarkers and therapeutic targets in atherosclerosis. The aim of the current study is to investigate the expression levels of atherosclerosis-associated miR-143 and miR-145 in Hhcy patients and predict the progress of atherosclerosis in Hhcy patients. Methods A total of 100 participants were enrolled and included normal control subjects (NC = 20), hyperhomocysteinaemia alone subjects (Hhcy = 25), hyperhomocysteinaemia and carotid artery atherosclerosis combined subjects (Hhcy + ATH = 30) and patients with standalone carotid artery atherosclerosis (ATH = 25). Plasma Hcy, supplementary biochemical parameters and carotid artery ultrasonography (USG) were measured in all participants. MicroRNA expression levels in the peripheral blood were calculated by real-time reverse transcription-polymerase chain reaction (qRT-PCR). The correlations of miR-143 and miR-145 with Hcy, blood lipid parameters and carotid artery atherosclerotic plaques were evaluated using Pearson’s correlation coefficients. Receiver operating characteristic (ROC) curve analyses were performed to evaluate the capacities of miR-143 and miR-145 for the detection of Hhcy and atherosclerosis patients. Results MiR-143 and miR-145 exhibited trends towards significance with stepwise decreases from the NC to Hhcy groups and then to the Hhcy + ATH and ATH groups. Similar results were observed in the carotid artery plaque group (Hhcy + ATH and ATH grups) compared with the no-plaque group (NC and Hhcy groups). The miR-143 expression level exhibited significant negative correlations with Hcy, total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c). The miR-145 expression level exhibited significant negative correlations with Hcy, TC, triglyceride (TG) and LDL-c. MiR-143 and miR-145 exhibited the greatest area under the curves (AUCs) (0.775 and 0.681, respectively) for the detection of every Hhcy patient, including those in the Hhcy and Hhcy + ATH groups, from among all subjects. Conclusion The results indicated that the levels of atherosclerosis-associated circulating miR-143 and miR-145 are linked to Hhcy. MiR-143 may be used as a potential non-invasive biomarkers of Hhcy and thus may be helpful in predicting the progress of atherosclerosis in Hhcy patients. Electronic supplementary material The online version of this article (doi:10.1186/s12872-017-0596-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kejian Liu
- Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.,Department of Cardiology, the First Affiliated Hospital, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Saiyare Xuekelati
- The Key Laboratory of Xinjiang Endemic and Ethnic Diseases, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Yue Zhang
- The Key Laboratory of Xinjiang Endemic and Ethnic Diseases, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Yin Yin
- Department of Cardiology, the First Affiliated Hospital, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Yue Li
- Department of Cardiology, the First Affiliated Hospital, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Rui Chai
- Department of Cardiology, the First Affiliated Hospital, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Xinwei Li
- Department of Cardiology, the First Affiliated Hospital, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Yi Peng
- Department of Cardiology, the First Affiliated Hospital, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Jiangdong Wu
- The Key Laboratory of Xinjiang Endemic and Ethnic Diseases, Shihezi University, Shihezi, Xinjiang, 832000, China.
| | - Xiaomei Guo
- Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Roessler FC, Wolff S. Rapid healing of a patient with dramatic subacute combined degeneration of spinal cord: a case report. BMC Res Notes 2017; 10:18. [PMID: 28057043 PMCID: PMC5216536 DOI: 10.1186/s13104-016-2344-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 12/14/2016] [Indexed: 01/17/2023] Open
Abstract
Background Prevalence of cobalamin deficiency is high especially in older patients and an immediate therapy start is necessary to prevent irreversible neurological damages. Unfortunately, the diagnosis of cobalamin deficiency is difficult and at present, there is no consensus for diagnosis of this deficiency. Therefore, we aim to elucidate a meaningful diagnostic pathway by a case report with an initially misleading medical history. Case presentation A 57 year-old Caucasian man suffering from dramatic myelosis of the cervical posterior columns. Apart from associated neurological symptoms (tactile hypaesthesia, reduced vibration sensation, loss of stereognosis and of two-point-discrimination) there were no further complaints; especially no gastrointestinal, haematological or psychiatric disorders were provable. Cobalamin (vitamin B12) serum level was normal. The diagnosis of subacute combined degeneration of spinal cord was confirmed by an elevated methylmalonic acid, and hyperhomocysteinemia. Cobalamin deficiency was caused by asymptomatic chronic atrophic inflammation of the stomach with a lack of intrinsic factor producing gland cells. This was revealed by increased gastrin and parietal cell antibodies and finally confirmed by gastroscopy. Parenteral substitution of cobalamin rapidly initiated regeneration. Conclusions This case demonstrates that normal cobalamin serum levels do not rule out a cobalamin deficiency. In contrast, path-breaking results can be achieved by determining homocysteine, holotranscobalamin, and methylmalonic acid.
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Affiliation(s)
- Florian C Roessler
- Department of Neurology, Justus-Liebig-University Giessen, Klinikstraße 33, 35385, Gießen, Germany. .,Klinik und Poliklinik für Neurologie, Universitätsklinikum Standort Gießen, Klinikstraße 33, 35385, Gießen, Germany.
| | - Stephanie Wolff
- Department of Neurology, Justus-Liebig-University Giessen, Klinikstraße 33, 35385, Gießen, Germany
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Kirwan JP, Malin SK, Scelsi AR, Kullman EL, Navaneethan SD, Pagadala MR, Haus JM, Filion J, Godin JP, Kochhar S, Ross AB. A Whole-Grain Diet Reduces Cardiovascular Risk Factors in Overweight and Obese Adults: A Randomized Controlled Trial. J Nutr 2016; 146:2244-2251. [PMID: 27798329 PMCID: PMC5086786 DOI: 10.3945/jn.116.230508] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/03/2016] [Accepted: 08/29/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Increased dietary whole-grain intake may protect against cardiovascular disease (CVD). OBJECTIVE The objective was to evaluate the efficacy of whole grains compared with refined grains on body composition, hypertension, and related mediators of CVD in overweight and obese adults. METHODS We conducted a double-blind, randomized, controlled crossover trial in 40 overweight or obese men and women aged <50 y with no known history of CVD. Complete whole-grain and refined-grain diets were provided for two 8-wk periods, with a 10-wk washout between diets. Macronutrient composition was matched, except for the inclusion of either whole grains or refined grains (50 g/1000 kcal in each diet). Measurements included blood pressure, body composition, blood lipids and adiponectin, and markers of inflammation and glycemia. RESULTS Thirty-three participants (6 men and 27 women) completed the trial [mean ± SD age: 39 ± 7 y; mean ± SD body mass index (in kg/m2): 33.1 ± 4.3]. Decreases in diastolic blood pressure were -5.8 mm Hg (95% CI: -7.7, -4.0 mm Hg) after the whole-grain diet and -1.6 mm Hg (95% CI: -4.4, 1.3 mm Hg) after the control diet (between effect, P = 0.01). Decreases in plasma adiponectin were -0.1 (95% CI: -0.9, 0.7) after the whole-grain diet and -1.4 (95% CI: -2.6, -0.3) after the control diet (between effect, P = 0.05). Decreases in diastolic blood pressure correlated with the circulating adiponectin concentration (r = 0.35, P = 0.04). Substantial reductions in body weight, fat loss, systolic blood pressure, total cholesterol, and LDL cholesterol were observed during both diet periods, with no relevant difference between them. CONCLUSIONS The improvement in diastolic blood pressure was >3-fold greater in overweight and obese adults when they consumed a whole-grain compared with a refined-grain diet. Because diastolic blood pressure predicts mortality in adults aged <50 y, increased whole-grain intake may provide a functional approach to control hypertension. This may benefit patients at risk of vascular-related morbidity and mortality. This trial was registered at clinicaltrials.gov as NCT01411540.
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Affiliation(s)
- John P Kirwan
- Department of Pathobiology, Lerner Research Institute,
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH
| | | | | | | | - Sankar D Navaneethan
- Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, and
| | - Mangesh R Pagadala
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH
| | - Jacob M Haus
- Department of Pathobiology, Lerner Research Institute
| | | | - Jean-Philippe Godin
- Analytical Sciences Department, Nestlé Research Center, Lausanne, Switzerland; and
| | - Sunil Kochhar
- Analytical Sciences Department, Nestlé Research Center, Lausanne, Switzerland; and
| | - Alastair B Ross
- Analytical Sciences Department, Nestlé Research Center, Lausanne, Switzerland; and
- Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenberg, Sweden
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