Serum homocysteine and cysteine levels and changes in the lipid profile of children and adolescents over a 12-month follow-up period

Effect of nano-curcumin supplementation on angina status, and traditional and novel cardiovascular risk factors in overweight or obese patients with coronary slow flow phenomenon: a randomized double-blind placebo-controlled clinical trial

BACKGROUND

Cardiovascular events and poor quality of life are frequently observed in patients with coronary slow flow phenomenon (CSFP). This trial evaluated the effect of nano-curcumin supplement containing curcuminoids, as multifunctional nutraceuticals, on angina status, and some traditional and novel cardiovascular risk factors in overweight or obese patients with CSFP.

METHODS

In this double-blind, randomized, placebo-controlled clinical trial, 42 overweight or obese patients with CSFP received either 80 mg/day of nano-curcumin or placebo for 12 weeks. Seattle angina questionnaire (SAQ) as a clinical measure of angina status, circulating endocan, adropin, homocysteine, lipid profile, and the novel scores of visceral adiposity index (VAI) and waist-triglyceride index (WTI) were assessed before and after the intervention. The independent samples t-test, Mann-Whitney test, analysis of covariance, Chi-square, and Fisher's exact tests were used where appropriate.

RESULTS

All domains of SAQ including physical limitation, angina stability, angina frequency-severity, treatment satisfaction, and disease perception and quality of life improved significantly in the nano-curcumin compared with the placebo group. No significant changes were observed in serum endocan, adropin, and homocysteine following the intervention. Triglycerides, triglyceride/high-density lipoprotein cholesterol ratio, WTI and VAI values improved significantly only within the nano-curcumin group.

CONCLUSIONS

Supplementation with 80 mg/day nano-curcumin (containing curcuminoids) for 12 weeks significantly improved clinically important disease-specific aspects of health in patients with CSFP. Some traditional and novel cardiovascular risk factors improved significantly only compared with the baseline values, which need further investigation.

TRIAL REGISTRATION

This study was approved by the Ethics Committee of Tehran University of Medical Sciences (IR.TUMS.VCR.REC.1398.794). The study protocol was registered at Iranian Registry of Clinical Trials by IRCT20131125015536N8 registration ID at 19.06.2019.

Magnetic field therapy enhances muscle mitochondrial bioenergetics and attenuates systemic ceramide levels following ACL reconstruction: Southeast Asian randomized-controlled pilot trial

Background

Metabolic disruption commonly follows Anterior Cruciate Ligament Reconstruction (ACLR) surgery. Brief exposure to low amplitude and frequency pulsed electromagnetic fields (PEMFs) has been shown to promote in vitro and in vivo murine myogeneses via the activation of a calcium–mitochondrial axis conferring systemic metabolic adaptations. This randomized-controlled pilot trial sought to detect local changes in muscle structure and function using MRI, and systemic changes in metabolism using plasma biomarker analyses resulting from ACLR, with or without accompanying PEMF therapy.

Methods

20 patients requiring ACLR were randomized into two groups either undergoing PEMF or sham exposure for 16 weeks following surgery. The operated thighs of 10 patients were exposed weekly to PEMFs (1 ​mT for 10 ​min) for 4 months following surgery. Another 10 patients were subjected to sham exposure and served as controls to allow assessment of the metabolic repercussions of ACLR and PEMF therapy. Blood samples were collected prior to surgery and at 16 weeks for plasma analyses. Magnetic resonance data were acquired at 1 and 16 weeks post-surgery using a Siemens 3T Tim Trio system. Phosphorus (³¹P) Magnetic Resonance Spectroscopy (MRS) was utilized to monitor changes in high-energy phosphate metabolism (inorganic phosphate (P_i), adenosine triphosphate (ATP) and phosphocreatine (PCr)) as well as markers of membrane synthesis and breakdown (phosphomonoesters (PME) and phosphodiester (PDE)). Quantitative Magnetization Transfer (qMT) imaging was used to elucidate changes in the underlying tissue structure, with T1-weighted and 2-point Dixon imaging used to calculate muscle volumes and muscle fat content.

Results

Improvements in markers of high-energy phosphate metabolism including reductions in ΔP_i/ATP, P_i/PCr and (P_i ​+ ​PCr)/ATP, and membrane kinetics, including reductions in PDE/ATP were detected in the PEMF-treated cohort relative to the control cohort at study termination. These were associated with reductions in the plasma levels of certain ceramides and lysophosphatidylcholine species. The plasma levels of biomarkers predictive of muscle regeneration and degeneration, including osteopontin and TNNT1, respectively, were improved, whilst changes in follistatin failed to achieve statistical significance. Liquid chromatography with tandem mass spectrometry revealed reductions in small molecule biomarkers of metabolic disruption, including cysteine, homocysteine, and methionine in the PEMF-treated cohort relative to the control cohort at study termination. Differences in measurements of force, muscle and fat volumes did not achieve statistical significance between the cohorts after 16 weeks post-ACLR.

Conclusion

The detected changes suggest improvements in systemic metabolism in the post-surgical PEMF-treated cohort that accords with previous preclinical murine studies. PEMF-based therapies may potentially serve as a manner to ameliorate post-surgery metabolic disruptions and warrant future examination in more adequately powered clinical trials.

The Translational Potential of this Article

Some degree of physical immobilisation must inevitably follow orthopaedic surgical intervention. The clinical paradox of such a scenario is that the regenerative potential of the muscle mitochondrial pool is silenced. The unmet need was hence a manner to maintain mitochondrial activation when movement is restricted and without producing potentially damaging mechanical stress. PEMF-based therapies may satisfy the requirement of non-invasively activating the requisite mitochondrial respiration when mobility is restricted for improved metabolic and regenerative recovery.

Homocysteine levels and cardiovascular risk factors in children and adolescents: systematic review and meta-analysis

CONTEXT

Studies have indicated that homocysteine levels are nontraditional markers for cardiovascular disease. The onset of atherosclerotic disease begins in childhood and adolescence; thus, prevention of its risk factors should occur early.

OBJECTIVE

This systematic review and meta-analysis was conducted to summarize the association between high homocysteine levels and traditional cardiovascular risk factors in children and adolescents.

DATA SOURCES

This systematic review and meta-analysis were developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the protocol was submitted to PROSPERO. Only observational studies in children and adolescents with homocysteine levels as an exposure variable and cardiovascular risk factors as outcome variables were included and searched in the following electronic bibliographic databases: PubMed/MEDLINE, Web of Science, Embase, Latin American and Caribbean Literature in Health Sciences, Ovid and Scopus.

DATA EXTRACTION

Two authors independently extracted data from eligible studies. The methodological quality of the studies was assessed using the Newcastle-Ottawa scale.

DATA ANALYSIS

Seven studies were included in the systematic review; they were published from 1999 to 2017, predominantly were of a cross-sectional design, and mainly evaluated adolescents. In the meta-analysis (n = 6), cross-sectional studies (n = 3) identified that high homocysteine levels were positive and weakly correlated with overweight in children and adolescents (odds ratio, 1.08; 95%CI, 1.04-1.11).

CONCLUSION

High homocysteine levels were weakly associated with overweight in children and adolescents in the reviewed cross-sectional studies. However, for the other traditional cardiovascular risk factors, the findings, although important, were inconclusive. Additional robust longitudinal studies are recommended to be conducted to better identify these associations.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42018086252.

Homocysteine: Its Possible Emerging Role in At-Risk Population Groups

Increased plasma homocysteine is a risk factor for several pathological disorders. The present review focused on the role of homocysteine (Hcy) in different population groups, especially in risk conditions (pregnancy, infancy, old age), and on its relevance as a marker or etiological factor of the diseases in these age groups, focusing on the nutritional treatment of elevated Hcy levels. In pregnancy, Hcy levels were investigated in relation to the increased risk of adverse pregnancy outcomes such as small size for gestational age at birth, preeclampsia, recurrent abortions, low birth weight, or intrauterine growth restriction. In pediatric populations, Hcy levels are important not only for cardiovascular disease, obesity, and renal disease, but the most interesting evidence concerns study of elevated levels of Hcy in autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Finally, a focus on the principal pathologies of the elderly (cardiovascular and neurodegenerative disease, osteoporosis and physical function) is presented. The metabolism of Hcy is influenced by B vitamins, and Hcy-lowering vitamin treatments have been proposed. However, clinical trials have not reached a consensus about the effectiveness of vitamin supplementation on the reduction of Hcy levels and improvement of pathological condition, especially in elderly patients with overt pathologies, suggesting that other dietary and non-dietary factors are involved in high Hcy levels. The importance of novel experimental designs focusing on intra-individual variability as a complement to the typical case-control experimental designs and the study of interactions between different factors it should be emphasized.

Anthropometric status and lipid profile among children and adolescents: Changes after 18-month follow-up

BACKGROUND & AIMS

Overweight children and adolescents are more likely to evolve with high cholesterol, be obese adults and develop cardiovascular disease. The objective of this study was to identify the influence of anthropometric status on the changes in the lipid profile of children and adolescents during an 18-month follow-up period.

METHODS

A cohort study involving 540 boys and girls from 7 to 15 years of age was conducted over 18 months' follow-up. The outcome variables were the lipid indicators and the principal exposure variable was anthropometric status, measured by different indicators. A generalized estimating equation (GEE) approach was used to identify the associations of interest.

RESULTS

Irrespective of age, sex, socio-economic status, physical activity and diet, for each gain of 1 cm in the waist circumference (WC) mean in the adjusted model, triglyceride levels increased by a mean of 0.5 mg/dl (p < 0.000) and there was an increase of 0.21 mg/dL in the total cholesterol after the 18-month period. The increase of 0.1 in the mean body mass index (BMI) Z-score promoted a gain of 2.7 mg/dL in the triglycerides mean levels (p < 0.000) and an increase of 1.5 mg/dL in the total cholesterol mean levels (p = 0.014) after the follow-up period. Regarding the waist-to-height ratio (WHtR) and conicity index (CI), an increment of 40.6 mg/dL (p = 0.02) and of 30.1 mg/dL (p = 0.01) was observed in the triglycerides' mean when the participants increased 0.1 in the WHtR mean and CI mean, and the same was observed in the total cholesterol mean, with an increase of 45.4,g/dL (p = 0.02) and 19.3 mg/dL (p = 0.03), for each indicator, respectively. Changes of the traditional anthropometric indicators (WC and BMI) did not promote variations in the mean levels of LDL-cholesterol. HDL-cholesterol was not influenced by the changes in the anthropometric indicators.

CONCLUSIONS

At the baseline, a higher triglyceride mean and lower levels of HDL-c were observed in children and adolescents with altered anthropometric status for all measures. Mean triglyceride and total cholesterol levels are influenced by changes in the anthropometric status, regardless of the measure, after 18 months of follow-up. However, for LDL-cholesterol, it was observed that changes in the traditional anthropometric indicators (WC and BMI) did not promote variations in the mean levels of this biochemical variable, while HDL-c was not influenced by changes in any of the anthropometric indicators.