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Li C, Wang T, Song J. A review regarding the article 'Electrocardiographic abnormalities in patients with metabolic dysfunction-associated Steatotic liver disease: A systematic review and meta-analysis.'. Curr Probl Cardiol 2024; 49:102626. [PMID: 38718937 DOI: 10.1016/j.cpcardiol.2024.102626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 05/05/2024] [Indexed: 05/12/2024]
Abstract
Metabolic-dysfunction-associated Steatotic liver disease (MASLD) is a high-risk condition for both liver fibrosis and cardiovascular disease (CVD). Therefore, therapeutic strategies to prevent both liver fibrosis and atherosclerotic CVD are required for the treatment of MASLD. Metabolic dysfunction-associated steatohepatitis (MASH) is the more severe form of MASLD, is defined histologically by the presence of lobular inflammation and hepatocyte ballooning and is associated with a greater risk of fibrosis progression. While CVD is the leading cause of mortality in patients with MASLD, those with more severe liver fibrosis are at increased risk of liver-related mortality, with the risk increasing exponentially with fibrosis stage. MASH has been found in 63% of patients with MASLD undergoing liver biopsy in an Asian multi-center cohort. Multiple complex pathways are involved in the association between MASLD and CVD. The visceral accumulation of fat around the liver and other organs, including the pericardium, leads to the release of fat-derived metabolites with the activation of several inflammatory pathways Cardiac rhythm abnormalities are prevalent in MASLD, such as prolongation of the QT interval, ventricular arrhythmias, and atrial fibrillation. Therapeutic interventions that improve cardiometabolic risk factors may be beneficial for an improvement in MASLD. The effects of such therapeutic interventions on lipid, lipoprotein and apoprotein accumulation in the liver and on hepatic steatosis and fibrosis still remain unelucidated. Which lipid factor is crucial for developing MASLD also remains largely unknown.
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Affiliation(s)
- Chao Li
- Department of Urology Surgery, Honghui Hospital, Xi'an Jiaotong University, Beilin District, Xi'an 710054, Shaanxi, China.
| | - Ting Wang
- Department of Urology Surgery, Honghui Hospital, Xi'an Jiaotong University, Beilin District, Xi'an 710054, Shaanxi, China
| | - Jinbo Song
- Department of Urology Surgery, Honghui Hospital, Xi'an Jiaotong University, Beilin District, Xi'an 710054, Shaanxi, China
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Xia B, Lu Y, Liang J, Li F, Peng J, Wang J, Wan C, Ding J, Le C, Dai J, Guo B, Shen Z. Association of GAL-8 promoter methylation levels with coronary plaque inflammation. Int J Cardiol 2024; 401:131782. [PMID: 38246423 DOI: 10.1016/j.ijcard.2024.131782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/12/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND AND AIMS Coronary heart disease (CHD) is a condition that carries a high risk of mortality and is associated with aging. CHD is characterized by the chronic inflammatory response of the coronary intima. Recent studies have shown that the methylation level of blood mononuclear cell DNA is closely associated with adverse events in CHD, but the roles and mechanisms of DNA methylation in CHD remain elusive. METHODS AND RESULTS In this study, the DNA methylation status within the epigenome of human coronary tissue in the sudden coronary death (SCD) group and control (CON) group of coronary heart disease was analyzed using the Illumina® Infinium Methylation EPIC BeadChip (850 K chip), resulting in the identification of a total of 2553 differentially methylated genes (DMGs). The differentially methylated genes were then subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis, and significant differential DNA methylation was found. Among the differentially hypomethylated genes were GAL-8, LTF, and RFPL3, while the highly methylated genes were TMEM9B, ANK3, and C6orF48. These genes were mainly enriched in 10 significantly enriched pathways, such as cell adhesion junctions, among which the differentially methylated gene GAL-8 was involved in inflammatory pathway signaling. For functional analysis of GAL-8, we first examined the differences in GAL-8 promoter methylation levels among different subgroups of human coronary tissue in the CON, CHD, and SCD groups using pyrophosphate sequencing. The results revealed reduced GAL-8 promoter methylation levels in the SCD group, while the difference between the CHD and CON groups was not statistically significant (P > 0.05). The reduced GAL-8 promoter methylation level was associated with upregulated GAL-8 expression, which led to increased expression of the inflammatory markers TNF-α, IL-1β, MCP-1, MIP-2, MMP-2, and MMP-9. This enhanced inflammatory response contributed to the accumulation of foam cells, thickening of the intima of human coronary arteries, and increased luminal stenosis, which promoted the occurrence of sudden coronary death. Next, we found that GAL-8 promoter methylation levels in PBMC were consistent with human coronary tissue. The unstable angina group (UAP) had significantly lower GAL-8 promoter methylation levels than stable angina (SAP) and healthy controls (CON) (P < 0.05), and there was a significant correlation between reduced GAL-8 promoter methylation levels and risk factors for coronary heart disease. These findings highlight the association between decreased GAL-8 promoter methylation and the presence of coronary heart disease risk factors. ROC curve analysis suggests that methylation of the GAL 8 promoter region is an independent risk factor for CHD. In conclusion, our study confirmed differential expression of GAL-8, LTF, MUC4D, TMEM9B, MYOM2, and ANK3 genes due to DNA methylation in the SCD group. We also established the consistency of GAL-8 promoter methylation alterations between human coronary tissue and patient peripheral blood monocytes. The decreased methylation level of the GAL-8 promoter may be related to the increased expression of GAL-8 and the coronary risk factors. CONCLUSIONS Accordingly, we hypothesized that reduced levels of GAL-8 promoter methylation may be an independent risk factor for adverse events in coronary heart disease.
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Affiliation(s)
- Bing Xia
- Department of Forensic Medicine, Guizhou Medical University, Guiyang 550000, China
| | - Yanlin Lu
- Department of Forensic Medicine, Guizhou Medical University, Guiyang 550000, China; School of Medicine and Science and Technology, Zunyi Medical University, Zunyi 563000, China
| | - Jingwei Liang
- Department of Forensic Medicine, Guizhou Medical University, Guiyang 550000, China
| | - Fangqin Li
- Department of Forensic Medicine, Guizhou Medical University, Guiyang 550000, China
| | - Jin Peng
- Department of Forensic Medicine, Guizhou Medical University, Guiyang 550000, China
| | - Jie Wang
- Department of Forensic Medicine, Guizhou Medical University, Guiyang 550000, China
| | - Changwu Wan
- Department of Forensic Medicine, Guizhou Medical University, Guiyang 550000, China
| | - Jiuyang Ding
- Department of Forensic Medicine, Guizhou Medical University, Guiyang 550000, China
| | - Cuiyun Le
- Department of Forensic Medicine, Guizhou Medical University, Guiyang 550000, China
| | - Jialin Dai
- Department of Forensic Medicine, Guizhou Medical University, Guiyang 550000, China
| | - Bing Guo
- Department of Forensic Medicine, Guizhou Medical University, Guiyang 550000, China; Affiliated Hospital of Guizhou Medical University, Guiyang 550000, China.
| | - Zheng Shen
- Department of Forensic Medicine, Guizhou Medical University, Guiyang 550000, China; Affiliated Hospital of Guizhou Medical University, Guiyang 550000, China.
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Pan J, Zhou Y, Pang N, Yang L. Dietary Niacin Intake and Mortality Among Individuals With Nonalcoholic Fatty Liver Disease. JAMA Netw Open 2024; 7:e2354277. [PMID: 38300619 PMCID: PMC10835509 DOI: 10.1001/jamanetworkopen.2023.54277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/11/2023] [Indexed: 02/02/2024] Open
Abstract
Importance Evidence regarding the effect of dietary niacin intake on the risk of mortality among patients with nonalcoholic fatty liver disease (NAFLD) is scarce. Objective To examine the association of dietary niacin intake with all-cause mortality and cardiovascular disease (CVD) mortality among individuals with NAFLD. Design, Setting, and Participants This cohort study used data from the National Health and Nutrition Examination Survey (2003-2018). In total, 4315 adults aged 20 years or older with NAFLD were included, with NAFLD defined using the United States Fatty Liver Index. Exposure Dietary niacin intake levels. Main Outcomes and Measures Weighted Cox proportional hazards models and restricted cubic splines were used to estimate hazard ratios and 95% CIs for all-cause and CVD mortality. Data were analyzed March 1 to September 1, 2023. Results This cohort study included data from 4315 participants in the analysis (mean [SD] age, 52.5 [16.2] years; 1670 participants ≥60 years [weighted, 30.9%]; 2351 men [weighted, 55.0%]). During a median (IQR) follow-up of 8.8 (4.6-11.8) years, 566 deaths were recorded, of which 197 were attributed to CVD. Compared with participants with a niacin intake of 18.4 mg or lower (the lowest tertile), the multivariable-adjusted hazard ratios for participants with a niacin intake of 26.7 mg or higher (the highest tertile) were 0.70 (95% CI, 0.50-0.96) for all-cause mortality (P = .03 for trend) and 0.65 (95% CI, 0.35-1.20) for CVD mortality (P = .16 for trend). Conclusions and Relevance Findings from this cohort study suggest that higher dietary niacin intake may be associated with lower risk of all-cause mortality among individuals with NAFLD. There was no evident inverse association between dietary niacin intake and the risk of CVD mortality.
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Affiliation(s)
- Jie Pan
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yujia Zhou
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Nengzhi Pang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lili Yang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Misan IA, Arisheva OS, Garmash IV, Cabello FR, Kobalava ZD. Prevalence and Prognostic Value of Non-Alcoholic Fatty Liver Disease in Patients Hospitalized With Decompensated Chronic Heart Failure. KARDIOLOGIIA 2023; 63:72-76. [PMID: 38156493 DOI: 10.18087/cardio.2023.12.n2360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/23/2022] [Indexed: 12/30/2023]
Abstract
Aim To study the incidence and effect of non-alcoholic fatty liver disease (NAFLD) on clinical outcomes in patients with decompensated chronic heart failure (DCHF).Material and methods The study included 338 patients with NYHA functional class III-IV DCHF (51.2% men, mean age 72.8±11.7 years), arterial hypertension (AH) in 90%, myocardial infarction in 37%, atrial fibrillation in 64%, chronic kidney disease (CKD) in 42%, type 2 diabetes mellitus (T2DM) in 35%, left ventricular ejection fraction (LVEF) <40% in 27%. NAFLD was diagnosed based on the 2021 Clinical Guidelines of the Russian Scientific Medical Society of Therapists and the Scientific Society of Gastroenterologists of Russia. The stage of liver steatosis was determined using transient elastometry with assessment of the controlled attenuation parameter (CAP) of ultrasound (S, dB/m) using a FibroScan device. Threshold CAP values <294 dB/m corresponded to the degree of steatosis: S0; S1, 295-309 dB/m; S2, 310-330 dB/m; S3, ≥331 dB/m.Results NAFLD was diagnosed in 28.9% of patients. The patients were divided into two groups: group 1 included patients with CHF and NAFLD (n=98 (28.9%), 50.0% men) and group 2 included patients with CHF without NAFLD (n=240 (71.0 %), 51.6% men). A multivariate regression analysis showed that independent predictors of NAFLD were systolic blood pressure ≥130 mm Hg (odds ratio (OR), 3.700; p <0.001), history of T2DM (OR, 2.807; p <0.005), and waist circumference >111 cm (OR, 2.530; p <0.012). Patients with CAP ≥331 dB/m (S3) had a worse prognosis during the 2-year follow-up for the composite adverse outcome (all-cause mortality + readmission) (Kaplan-Meier curves - Log-Rank p=0.035).Conclusions NAFLD was detected in almost one-third of patients hospitalized for DCHF. AH, T2DM, and abdominal obesity were associated with a high risk of NAFLD. However, only severe steatosis (S3) was an independent predictor of adverse clinical outcomes during a 2-year period after adjustment for known risk factors.
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Affiliation(s)
- I A Misan
- Patrice Lumumba Russian University of People's Friendship
| | - O S Arisheva
- Patrice Lumumba Russian University of People's Friendship; Vinogradov Municipal Hospital
| | - I V Garmash
- Patrice Lumumba Russian University of People's Friendship; Vinogradov Municipal Hospital
| | - F R Cabello
- Patrice Lumumba Russian University of People's Friendship
| | - Zh D Kobalava
- Patrice Lumumba Russian University of People's Friendship; Vinogradov Municipal Hospital
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Pan J, Hu Y, Pang N, Yang L. Association between Dietary Niacin Intake and Nonalcoholic Fatty Liver Disease: NHANES 2003-2018. Nutrients 2023; 15:4128. [PMID: 37836412 PMCID: PMC10574350 DOI: 10.3390/nu15194128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Evidence regarding the association between dietary niacin intake and nonalcoholic fatty liver disease (NAFLD) is limited. The objective of this study was to examine the association of dietary niacin intake with NAFLD. Subjects aged 20 years and older who participated in the National Health and Nutrition Examination Survey (NHANES) 2003-2018 were included in this study. Dietary niacin intake was assessed by two 24-h dietary recalls. NAFLD was defined using the United States fatty liver index (US-FLI). Weighted logistic regression models and restricted cubic splines were used to examine the association between dietary niacin and NAFLD. Of the 12,355 participants in this study, 4378 had NAFLD. There is no evident nonlinear relationship between dietary niacin intake and the presence of NAFLD in the restricted cubic spline regression (poverall < 0.001; pnon-linearity = 0.068). The multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for NAFLD were 0.84 (0.68-1.03), 0.80 (0.65-0.97), and 0.69 (0.55-0.85), respectively, when comparing the second, third, and fourth quartiles of niacin intake levels to the lowest quartile (ptrend = 0.001). Stratified analysis revealed that the effect of niacin intake on NAFLD varied in the group with or without hypertension (pinteraction = 0.033). In conclusion, our results indicate that higher dietary niacin intake may be associated with a lower likelihood of NAFLD.
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Affiliation(s)
- Jie Pan
- Department of Nutrition, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.P.)
| | - Yuhua Hu
- School of Public Health, Southeast University, Nanjing 210009, China
| | - Nengzhi Pang
- Department of Nutrition, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.P.)
| | - Lili Yang
- Department of Nutrition, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.P.)
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Chi Z, Teng Y, Liu Y, Gao L, Yang J, Zhang Z. Association between klotho and non-alcoholic fatty liver disease and liver fibrosis based on the NHANES 2007-2016. Ann Hepatol 2023; 28:101125. [PMID: 37286168 DOI: 10.1016/j.aohep.2023.101125] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/24/2023] [Accepted: 05/29/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION AND OBJECTIVES This study aims to explore the association between Klotho and Non-Alcoholic Fatty Liver Disease (NAFLD), a condition affecting millions worldwide. Klotho may have a protective effect against NAFLD mechanisms like inflammation, oxidative stress, and fibrosis. The study will use FLI and FIB-4 score to diagnose NAFLD in a large population for investigating the link between Klotho and NAFLD. MATERIALS AND METHODS The study aimed to explore the association between Klotho and NAFLD by measuring the α-Klotho protein levels in the participants' blood using ELISA. Patients with underlying chronic liver diseases were excluded. The severity of NAFLD was evaluated using FLI and FIB-4, and logistic regression models were used to analyze the data obtained from NHANES. Subgroup analyses were conducted to study Klotho's effect on hepatic steatosis and fibrosis in diverse subpopulations. RESULTS The study found that low levels of α-Klotho were associated with NAFLD, with ORs ranging from 0.72 to 0.83. However, high levels of α-Klotho were associated with NAFLD-related fibrosis. The Q4 group showed significant results in individuals aged 51 years or younger and in females. Non-Hispanic White ethnicity, education level of high school or above, non-smoking, non-hypertension, and non-diabetic groups showed negative correlations. CONCLUSIONS Our study suggests a potential correlation between α-Klotho levels in the blood and NAFLD in adult patients, especially among younger individuals, females and Non-Hispanic Whites. Elevated α-Klotho levels may have therapeutic benefits in treating NAFLD. Further research is required to validate these findings, but they provide new insights for managing this condition.
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Affiliation(s)
- Zhenfei Chi
- Liaoning University of Traditional Chinese Medicine, PR China
| | - Yun Teng
- Liaoning University of Traditional Chinese Medicine, PR China
| | - Yuting Liu
- Liaoning University of Traditional Chinese Medicine, PR China
| | - Lu Gao
- Liaoning University of Traditional Chinese Medicine, PR China
| | - Junhan Yang
- Liaoning University of Traditional Chinese Medicine, PR China
| | - Zhe Zhang
- Liaoning University of Traditional Chinese Medicine, PR China.
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Badmus OO, Hinds TD, Stec DE. Mechanisms Linking Metabolic-Associated Fatty Liver Disease (MAFLD) to Cardiovascular Disease. Curr Hypertens Rep 2023; 25:151-162. [PMID: 37191842 PMCID: PMC10839567 DOI: 10.1007/s11906-023-01242-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 05/17/2023]
Abstract
PURPOSE OF REVIEW Metabolic-associated fatty liver disease (MAFLD) is a condition of fat accumulation in the liver that occurs in the majority of patients in combination with metabolic dysfunction in the form of overweight or obesity. In this review, we highlight the cardiovascular complications in MAFLD patients as well as some potential mechanisms linking MAFLD to the development of cardiovascular disease and highlight potential therapeutic approaches to treating cardiovascular diseases in patients with MAFLD. RECENT FINDINGS MAFLD is associated with an increased risk of cardiovascular diseases (CVD), including hypertension, atherosclerosis, cardiomyopathies, and chronic kidney disease. While clinical data have demonstrated the link between MAFLD and the increased risk of CVD development, the mechanisms responsible for this increased risk remain unknown. MAFLD can contribute to CVD through several mechanisms including its association with obesity and diabetes, increased levels of inflammation, and oxidative stress, as well as alterations in hepatic metabolites and hepatokines. Therapies to potentially treat MAFLD-induced include statins and lipid-lowering drugs, glucose-lowering agents, antihypertensive drugs, and antioxidant therapy.
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Affiliation(s)
- Olufunto O Badmus
- Department of Physiology & Biophysics, Cardiorenal, and Metabolic Diseases Research Center, University of Mississippi Medical Center, Jackson, MS, 39216, USA
| | - Terry D Hinds
- Department of Pharmacology and Nutritional Sciences, Barnstable Brown Diabetes Center, Markey Cancer Center, University of Kentucky, Lexington, KY, 40508, USA
| | - David E Stec
- Department of Physiology & Biophysics, Cardiorenal, and Metabolic Diseases Research Center, University of Mississippi Medical Center, Jackson, MS, 39216, USA.
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Jeeyavudeen MS, Khan SKA, Fouda S, Pappachan JM. Management of metabolic-associated fatty liver disease: The diabetology perspective. World J Gastroenterol 2023; 29:126-143. [PMID: 36683717 PMCID: PMC9850951 DOI: 10.3748/wjg.v29.i1.126] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/26/2022] [Accepted: 12/14/2022] [Indexed: 01/04/2023] Open
Abstract
The metabolic syndrome as a consequence of the obesity pandemic resulted in a substantial increase in the prevalence of metabolic-associated fatty live disease (MAFLD) and type 2 diabetes mellitus (T2DM). Because of the similarity in pathobiology shared between T2DM and MAFLD, both disorders coexist in many patients and may potentiate the disease-related outcomes with rapid progression and increased complications of the individual diseases. In fact, awareness about this coexistence and the risk of complications are often overlooked by both hepatologists and diabetologists. Management of these individual disorders in a patient should be addressed wholistically using an appropriate multidisciplinary team approach involving both the specialists and, when necessary, liaising with dieticians and surgeons. This comprehensive review is to compile the current evidence from a diabetologist's perspective on MAFLD and T2DM and to suggest optimal management strategies.
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Affiliation(s)
- Mohammad Sadiq Jeeyavudeen
- Department of Endocrinology and Metabolism, University Hospitals of Edinburgh, Edinburgh EH4 2XU, United Kingdom
| | - Shahanas K A Khan
- Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Trust, Preston PR2 9HT, United Kingdom
| | - Sherouk Fouda
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC 3046, Australia
| | - Joseph M Pappachan
- Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Trust, Preston PR2 9HT, United Kingdom
- Faculty of Science, Manchester Metropolitan University, Manchester M15 6BH, United Kingdom
- Faculty of Biology, University of Manchester, Manchester M13 9PL, United Kingdom
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Minhas AMK, Jain V, Li M, Ariss RW, Fudim M, Michos ED, Virani SS, Sperling L, Mehta A. Family income and cardiovascular disease risk in American adults. Sci Rep 2023; 13:279. [PMID: 36609674 PMCID: PMC9822929 DOI: 10.1038/s41598-023-27474-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/03/2023] [Indexed: 01/07/2023] Open
Abstract
Socioeconomic status is an overlooked risk factor for cardiovascular disease (CVD). Low family income is a measure of socioeconomic status and may portend greater CVD risk. Therefore, we assessed the association of family income with cardiovascular risk factor and disease burden in American adults. This retrospective analysis included data from participants aged ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES) cycles between 2005 and 2018. Family income to poverty ratio (PIR) was calculated by dividing family (or individual) income by poverty guidelines specific to the survey year and used as a measure of socioeconomic status. The association of PIR with the presence of cardiovascular risk factors and CVD as well as cardiac mortality and all-cause mortality was examined. We included 35,932 unweighted participants corresponding to 207,073,472 weighted, nationally representative participants. Participants with lower PIR were often female and more likely to belong to race/ethnic minorities (non-Hispanic Black, Mexican American, other Hispanic). In addition, they were less likely to be married/living with a partner, to attain college graduation or higher, or to have health insurance. In adjusted analyses, the prevalence odds of diabetes mellitus, hypertension, coronary artery disease (CAD), congestive heart failure (CHF), and stroke largely decreased in a step-wise manner from highest (≥ 5) to lowest PIR (< 1). In adjusted analysis, we also noted a mostly dose-dependent association of PIR with the risk of all-cause and cardiac mortality during a mean 5.7 and 5.8 years of follow up, respectively. Our study demonstrates a largely dose-dependent association of PIR with hypertension, diabetes mellitus, CHF, CAD and stroke prevalence as well as incident all-cause mortality and cardiac mortality in a nationally representative sample of American adults. Public policy efforts should be directed to alleviate these disparities to help improve cardiovascular outcomes in vulnerable groups with low family income.
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Affiliation(s)
- Abdul Mannan Khan Minhas
- grid.414961.f0000 0004 0426 4740Department of Medicine, Forrest General Hospital, Hattiesburg, MS USA
| | - Vardhmaan Jain
- grid.189967.80000 0001 0941 6502Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA USA
| | - Monica Li
- grid.189967.80000 0001 0941 6502Department of Medicine, Emory University School of Medicine, Atlanta, GA USA
| | - Robert W. Ariss
- grid.62560.370000 0004 0378 8294Department of Medicine, Brigham and Women’s Hospital, Boston, MA USA
| | - Marat Fudim
- grid.189509.c0000000100241216Division of Cardiology, Duke University Medical Center, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Duke Clinical Research Institute, Durham, NC USA
| | - Erin D. Michos
- grid.21107.350000 0001 2171 9311Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Salim S. Virani
- grid.39382.330000 0001 2160 926XMichael E. DeBakey Veterans Affair Medical Center and Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX USA
| | - Laurence Sperling
- grid.189967.80000 0001 0941 6502Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA USA
| | - Anurag Mehta
- VCU Health Pauley Heart Center, Virginia Commonwealth University School of Medicine, 1200 East Broad Street, PO Box 980036, Richmond, VA, 23298, USA.
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Xing W, Gao W, Lv X, Zhao Z, Mao G, Dong X, Zhang Z. The effects of supplementation of probiotics, prebiotics, or synbiotics on patients with non-alcoholic fatty liver disease: A meta-analysis of randomized controlled trials. Front Nutr 2022; 9:1024678. [PMID: 36386939 PMCID: PMC9640999 DOI: 10.3389/fnut.2022.1024678] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/03/2022] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease. Research on the efficacy of probiotics, prebiotics, and synbiotics on NAFLD patients continues to be inconsistent. The purpose of this study is to evaluate the effectiveness of these microbial therapies on NAFLD. METHODS Eligible randomized-controlled trials reporting the effect of probiotics, prebiotics, or synbiotics in NAFLD were searched in PubMed, Web of Science, Embase, Google scholar, and CNKI databases from 2020 to Jul 2022. The changes in the outcomes were analyzed using standard mean difference (SMD) and 95% confidence intervals (CIs) with a random- or fixed-effects model to examine the effect of microbial therapies. Subgroup analysis, influence and publication bias analysis were also performed. The quality of the eligible studies was evaluated using the Cochrane Risk of Bias Tool. RESULTS Eleven studies met the inclusion criteria involving 741 individuals. Microbial therapies could improve liver steatosis, total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-c), alanine aminotransferase (ALT), alkaline phosphatase (ALP), glutamyl transpeptidase (GGT), and homeostasis model assessment-insulin resistance (HOMAI-R) (all P < 0.05). But microbial therapies could not ameliorate body mass index (BMI), energy, carbohydrate, fat intake, fasting blood sugar, HbA1c, insulin, high-sensitivity C-reactive protein (hs-CRP), and hepatic fibrosis of patients with NAFLD. CONCLUSION Probiotics, prebiotics, and synbiotics supplementation can potentially improve liver enzymes, lipid profiles, and liver steatosis in patients with NAFLD.
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Affiliation(s)
- Wenmin Xing
- Zhejiang Provincial Key Laboratory of Geriatrics, Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Wenyan Gao
- School of Pharmacy, Hangzhou Medical College, Hangzhou, China
| | - Xiaoling Lv
- Zhejiang Provincial Key Laboratory of Geriatrics, Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Zhenlei Zhao
- Zhejiang Provincial Key Laboratory of Geriatrics, Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Genxiang Mao
- Zhejiang Provincial Key Laboratory of Geriatrics, Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Xiaoyan Dong
- College of Pharmacy and Traditional Chinese Medicine, Jiangsu College of Nursing, Huaian, China
| | - Zuyong Zhang
- The Third People’s Hospital of Hangzhou, Hangzhou, China
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