1
|
Guariguata L, Hickey GM, Murphy MM, Guell C, Iese V, Morrissey K, Duvivier P, Herberg S, Kiran S, Unwin N. Understanding the links between human health, ecosystem health, and food systems in Small Island Developing States using stakeholder-informed causal loop diagrams. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001988. [PMID: 37725624 PMCID: PMC10508617 DOI: 10.1371/journal.pgph.0001988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/22/2023] [Indexed: 09/21/2023]
Abstract
Globalized food systems are a major driver of climate change, biodiversity loss, environmental degradation, and the increasing prevalence of overweight and obesity in society. Small Island Developing States (SIDS) are particularly sensitive to the negative effects of rapid environmental change, with many also exhibiting a heavy reliance on food imports and high burdens of nutrition-related disease, resulting in calls to (re)localize their food systems. Such a transition represents a complex challenge, with adaptation interventions in one part of the food system contingent on the success of interventions in other parts. To help address this challenge, we used group model-building techniques from the science of system dynamics to engage food system stakeholders in Caribbean and Pacific SIDS. Our aim was to understand the drivers of unhealthy and unsustainable food systems in SIDS, and the potential role that increased local food production could play in transformative adaptation. We present two causal loop diagrams (CLDs) considered helpful in designing resilience-enhancing interventions in local food systems. These CLDs represent 'dynamic hypotheses' and provide starting points that can be adapted to local contexts for identifying food system factors, understanding the interactions between them, and co-creating and implementing adaptation interventions, particularly in SIDS. The results can help guide understanding of complexity, assist in the co-creation of interventions, and reduce the risk of maladaptive consequences.
Collapse
Affiliation(s)
- Leonor Guariguata
- Department of Natural Resource Sciences, Faculty of Agricultural and Environmental Sciences, McGill University, Ste-Anne-de-Bellevue, QC, Canada
- George Alleyne Chronic Disease Research Centre, University of the West Indies, Bridgetown, Barbados
| | - Gordon M. Hickey
- Department of Natural Resource Sciences, Faculty of Agricultural and Environmental Sciences, McGill University, Ste-Anne-de-Bellevue, QC, Canada
| | - Madhuvanti M. Murphy
- George Alleyne Chronic Disease Research Centre, University of the West Indies, Bridgetown, Barbados
| | - Cornelia Guell
- European Centre for Environment and Human Health, University of Exeter, Exeter, United Kingdom
| | - Viliamu Iese
- Pacific Centre for Environment and Sustainable Development, University of the South Pacific, Suva, Fiji
| | - Karyn Morrissey
- Department of Technology, Management and Economics, Technical University of Denmark, Lyngby, Denmark
| | - Predner Duvivier
- Faculté d’Agronomie et de Médecine Vétérinaire, Université de d’État d’Haïti Port-au-Prince, Port-au-Prince, Haiti
| | - Stina Herberg
- Richmond Vale Academy, Richmond, St Vincent and The Grenadines
| | - Sashi Kiran
- Foundation for Rural Integrated Enterprises and Development (FRIEND), Lautoka, Fiji
| | - Nigel Unwin
- European Centre for Environment and Human Health, University of Exeter, Exeter, United Kingdom
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
2
|
Sotomayor CG, te Velde-Keyzer CA, Diepstra A, van Londen M, Pol RA, Post A, Gans RO, Nolte IM, Slart RH, de Borst MH, Berger SP, Rodrigo R, Navis GJ, de Boer RA, Bakker SJ. Galectin-3 and Risk of Late Graft Failure in Kidney Transplant Recipients: A 10-year Prospective Cohort Study. Transplantation 2021; 105:1106-1115. [PMID: 32639409 PMCID: PMC8078111 DOI: 10.1097/tp.0000000000003359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 05/04/2020] [Accepted: 06/01/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Galectin-3 may play a causal role in kidney inflammation and fibrosis, which may also be involved in the development of kidney graft failure. With novel galectin-3-targeted pharmacological therapies increasingly coming available, we aimed to investigate whether galectin-3 is associated with risk of late graft failure in kidney transplant recipients (KTR). METHODS We studied adult KTR who participated in TransplantLines Insulin Resistance and Inflammation Biobank and Cohort Study, recruited in a university setting (2001-2003). Follow-up was performed for a median of 9.5 (interquartile range, 6.2-10.2) years. Overall and stratified (Pinteraction < 0.05) multivariable-adjusted Cox proportional-hazards regression analyses were performed to study the association of galectin-3 with risk of graft failure (restart of dialysis or retransplantation). RESULTS Among 561 KTR (age 52 ± 12 y; 54% males), baseline median galectin-3 was 21.1 (interquartile range, 17.0-27.2) ng/mL. During follow-up, 72 KTR developed graft failure (13, 18, and 44 events over increasing tertiles of galectin-3). Independent of adjustment for donor, recipient, and transplant characteristics, galectin-3-associated with increased risk of graft failure (hazard ratios [HR] per 1 SD change, 2.12; 95% confidence interval [CI], 1.63-2.75; P < 0.001), particularly among KTR with systolic blood pressure ≥140 mmHg (HR, 2.29; 95% CI, 1.80-2.92; P < 0.001; Pinteraction = 0.01) or smoking history (HR, 2.56; 95% CI, 1.95-3.37; P < 0.001; Pinteraction = 0.03). Similarly, patients in the highest tertile of galectin-3 were consistently at increased risk of graft failure. CONCLUSIONS Serum galectin-3 levels are elevated in KTR, and independently associated with increased risk of late graft failure. Whether galectin-3-targeted therapies may represent novel opportunities to decrease the long-standing high burden of late graft failure in stable KTR warrants further studies.
Collapse
Affiliation(s)
- Camilo G. Sotomayor
- Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Radiology, Clinical Hospital of the University of Chile, University of Chile, Santiago, Chile
| | - Charlotte A. te Velde-Keyzer
- Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Arjan Diepstra
- Division of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marco van Londen
- Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Robert A. Pol
- Division of Transplantation Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Adrian Post
- Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rijk O.B. Gans
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ilja M. Nolte
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Riemer H.J.A. Slart
- Department of Nuclear and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Martin H. de Borst
- Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stefan P. Berger
- Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ramón Rodrigo
- Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Gerjan J. Navis
- Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rudolf A. de Boer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stephan J.L. Bakker
- Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
3
|
Stege NM, de Boer RA, van den Berg MP, Silljé HHW. The Time Has Come to Explore Plasma Biomarkers in Genetic Cardiomyopathies. Int J Mol Sci 2021; 22:2955. [PMID: 33799487 PMCID: PMC7998409 DOI: 10.3390/ijms22062955] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 12/17/2022] Open
Abstract
For patients with hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM) or arrhythmogenic cardiomyopathy (ACM), screening for pathogenic variants has become standard clinical practice. Genetic cascade screening also allows the identification of relatives that carry the same mutation as the proband, but disease onset and severity in mutation carriers often remains uncertain. Early detection of disease onset may allow timely treatment before irreversible changes are present. Although plasma biomarkers may aid in the prediction of disease onset, monitoring relies predominantly on identifying early clinical symptoms, on imaging techniques like echocardiography (Echo) and cardiac magnetic resonance imaging (CMR), and on (ambulatory) electrocardiography (electrocardiograms (ECGs)). In contrast to most other cardiac diseases, which are explained by a combination of risk factors and comorbidities, genetic cardiomyopathies have a clear primary genetically defined cardiac background. Cardiomyopathy cohorts could therefore have excellent value in biomarker studies and in distinguishing biomarkers related to the primary cardiac disease from those related to extracardiac, secondary organ dysfunction. Despite this advantage, biomarker investigations in cardiomyopathies are still limited, most likely due to the limited number of carriers in the past. Here, we discuss not only the potential use of established plasma biomarkers, including natriuretic peptides and troponins, but also the use of novel biomarkers, such as cardiac autoantibodies in genetic cardiomyopathy, and discuss how we can gauge biomarker studies in cardiomyopathy cohorts for heart failure at large.
Collapse
Affiliation(s)
| | | | | | - Herman H. W. Silljé
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, AB43, 9713 GZ Groningen, The Netherlands; (N.M.S.); (R.A.d.B.); (M.P.v.d.B.)
| |
Collapse
|
4
|
Aguilar D, Sun C, Hoogeveen RC, Nambi V, Selvin E, Matsushita K, Saeed A, McEvoy JW, Shah AM, Solomon SD, Boerwinkle E, Ballantyne CM. Levels and Change in Galectin-3 and Association With Cardiovascular Events: The ARIC Study. J Am Heart Assoc 2020; 9:e015405. [PMID: 32573308 PMCID: PMC7670497 DOI: 10.1161/jaha.119.015405] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Background Circulating galectin‐3 levels provide prognostic information in patients with established heart failure (HF), but the associations between galectin‐3 levels and other incident cardiovascular events in asymptomatic individuals at midlife and when remeasured ≈15 years later are largely uncharacterized. Methods and Results Using multivariable Cox proportional hazards models, we identified associations between plasma galectin‐3 levels (hazard ratio [HR] per 1 SD increase in natural log galectin‐3) and incident coronary heart disease, ischemic stroke, HF hospitalization, and total mortality in ARIC (Atherosclerosis Risk in Communities) participants free of cardiovascular disease at ARIC visit 4 (1996–1998; n=9247) and at ARIC visit 5 (2011–2013; n=4829). Higher galectin‐3 level at visit 4 (median age 62) was independently associated with incident coronary heart disease (adjusted HR, 1.30; 95% CI, 1.06–1.60), ischemic stroke (HR, 1.42; 95% CI, 1.01–2.00), HF (HR, 1.44; 95% CI, 1.17–1.76), and mortality (HR, 1.56; 95% CI, 1.35–1.80). At visit 5 (median age, 74), higher galectin‐3 level was associated with incident HF (HR, 1.93; 95% CI, 1.15–3.24) and total mortality (HR, 1.70; 95% CI, 1.15–2.52), but not coronary heart disease or stoke. Individuals with the greatest increase in galectin‐3 levels from visit 4 to visit 5 were also at increased risk of incident HF and total mortality. Conclusions In a large, biracial community‐based cohort, galectin‐3 measured at midlife and older age was associated with increased risk of cardiovascular events. An increase in galectin‐3 levels over this period was also associated with increased risk.
Collapse
Affiliation(s)
- David Aguilar
- Department of Epidemiology, Human Genetics, and Environmental Sciences School of Public Health University of Texas Health Science Center at Houston TX
| | | | - Ron C Hoogeveen
- Section of Cardiovascular Research Department of Medicine Baylor College of Medicine Houston TX.,Center for Cardiometabolic Disease Prevention Department of Medicine Baylor College of Medicine Houston TX
| | - Vijay Nambi
- Section of Cardiology Department of Medicine Baylor College of Medicine Houston TX.,Section of Cardiovascular Research Department of Medicine Baylor College of Medicine Houston TX.,Center for Cardiometabolic Disease Prevention Department of Medicine Baylor College of Medicine Houston TX.,Department of Medicine Michael E. DeBakey Veterans Affairs Medical Center Houston TX
| | - Elizabeth Selvin
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Kunihiro Matsushita
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Anum Saeed
- Section of Cardiovascular Research Department of Medicine Baylor College of Medicine Houston TX.,Heart and Vascular Institute University of Pittsburgh Medical Center Pittsburgh PA
| | - John W McEvoy
- Department of Medicine Ciccarone Center for the Prevention of Heart Disease Johns Hopkins School of Medicine Baltimore MD.,National University of Ireland and National Institute for Prevention and Cardiovascular Health Galway Ireland
| | - Amil M Shah
- Division of Cardiovascular Medicine Department of Medicine Brigham and Women's Hospital Boston MA
| | - Scott D Solomon
- Division of Cardiovascular Medicine Department of Medicine Brigham and Women's Hospital Boston MA
| | - Eric Boerwinkle
- Department of Epidemiology, Human Genetics, and Environmental Sciences School of Public Health University of Texas Health Science Center at Houston TX
| | - Christie M Ballantyne
- Section of Cardiology Department of Medicine Baylor College of Medicine Houston TX.,Section of Cardiovascular Research Department of Medicine Baylor College of Medicine Houston TX.,Center for Cardiometabolic Disease Prevention Department of Medicine Baylor College of Medicine Houston TX
| |
Collapse
|
5
|
Wang Z, Chen Z, Ma X, Yu H, Chen X. The predictive value of serum galectin 3 for abdominal aortic calcification in maintenance hemodialysis patients: A prospective cohort study. Hemodial Int 2020; 24:212-220. [PMID: 32048459 DOI: 10.1111/hdi.12825] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 01/21/2020] [Accepted: 01/26/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Heterotopic vascular calcification is a common complication of maintenance hemodialysis (MHD) patients. Galectin 3 (Gal-3) has been reported to be associated with cardiovascular calcification. The current study aims to explore the potential predictive value of serum Gal-3 for severe abdominal aortic calcification (AAC) and AAC progression in MHD patients. METHODS A prospective cohort who underwent hemodialysis during July 2014 at the Blood Purification Center of Ruijin Hospital were followed up for 3 years. Two AAC assessments were performed: one at baseline and one after the 3-year follow-up period. Serum Gal-3 was detected with quantitative ELISA kits. SPSS 23.0 and MedCalc 11.4.2.0 were used to analyze the data. FINDINGS One hundred and fifty-two patients were recruited. Approximately 59.9% were male, the median age was 60 (50-67) years. Logistic regression analysis indicated that serum Gal-3 was an independent risk factor for both follow-up severe AAC and AAC progression. Receiver operating characteristic (ROC) curve analysis revealed significant prognostic value of serum Gal-3 for predicting severe AAC and AAC progression within 3 years. DISCUSSION We found serum Gal-3 is correlated to vascular calcification in ESRD patients. Gal-3 may be a potential biomarker of vascular calcification for MHD patients.
Collapse
Affiliation(s)
- Zhiyu Wang
- Division of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zijin Chen
- Division of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaobo Ma
- Division of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haijin Yu
- Division of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaonong Chen
- Division of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
6
|
Patel DM, Thiessen-Philbrook H, Brown JR, McArthur E, Moledina DG, Mansour SG, Shlipak MG, Koyner JL, Kavsak P, Whitlock RP, Everett AD, Malenka DJ, Garg AX, Coca SG, Parikh CR. Association of plasma-soluble ST2 and galectin-3 with cardiovascular events and mortality following cardiac surgery. Am Heart J 2020; 220:253-263. [PMID: 31911262 PMCID: PMC7008086 DOI: 10.1016/j.ahj.2019.11.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 11/24/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Cardiac surgery induces hemodynamic stress on the myocardium, and this process can be associated with significant post-operative morbidity and mortality. Soluble suppression of tumorigenicity 2 (sST2) and galectin-3 (gal-3) are biomarkers of myocardial remodeling and fibrosis; however, their potential association with post-operative changes is unknown. METHODS We measured peri-operative plasma sST2 and gal-3 levels in two prospective cohorts (TRIBE-AKI and NNE) of over 1800 patients who underwent cardiac surgery. sST2 and gal-3 levels were evaluated for association with a composite primary outcome of cardiovascular event or mortality over median follow-up periods of 3.4 and 6.0 years, respectively, for the two cohorts. Meta-analysis of hazard ratio estimates from the cohorts was performed using random effects models. RESULTS Cohorts demonstrated event rates of 70.2 and 66.8 per 1000 person-years for the primary composite outcome. After adjustment for clinical covariates, higher post-operative sST2 and gal-3 levels were significantly associated with cardiovascular event or mortality [pooled estimate HRs: sST2 1.29 (95% CI 1.16, 1.44); gal-3 1.26 (95% CI 1.09, 1.46)]. These associations were not significantly modified by pre-operative congestive heart failure or AKI. CONCLUSIONS Higher post-operative sST2 and gal-3 values were associated with increased incidence of cardiovascular event or mortality. These two biomarkers should be further studied for potential clinical utility for patients undergoing cardiac surgery.
Collapse
Affiliation(s)
- Dipal M Patel
- Program of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, CT
| | | | - Jeremiah R Brown
- Dartmouth Institute for Health Policy and Clinical Practice, and the Departments of Biomedical Data Science and Epidemiology, Geisel School of Medicine, Lebanon, NH
| | | | - Dennis G Moledina
- Program of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, CT; Section of Nephrology, Yale University School of Medicine, New Haven, CT
| | - Sherry G Mansour
- Program of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, CT; Section of Nephrology, Yale University School of Medicine, New Haven, CT
| | - Michael G Shlipak
- Kidney Health Research Collaborative, University of California San Francisco, San Francisco, CA; Department of Medicine, San Francisco VA Medical Center and University of California, San Francisco, CA
| | - Jay L Koyner
- Section of Nephrology, Department of Medicine, University of Chicago, Pritzker School of Medicine, Chicago, IL
| | - Peter Kavsak
- Departments of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Richard P Whitlock
- Population Health Research Institute and Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Allen D Everett
- Division of Cardiology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
| | - David J Malenka
- Dartmouth Institute for Health Policy and Clinical Practice, and the Departments of Biomedical Data Science and Epidemiology, Geisel School of Medicine, Lebanon, NH
| | - Amit X Garg
- ICES, Toronto, ON, Canada; Division of Nephrology, Department of Medicine, Western University, London, ON, Canada
| | - Steven G Coca
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Chirag R Parikh
- Division of Nephrology, School of Medicine, Johns Hopkins University, Baltimore, MD.
| |
Collapse
|
7
|
Ghorbani A, Bhambhani V, Christenson RH, Meijers WC, de Boer RA, Levy D, Larson MG, Ho JE. Longitudinal Change in Galectin-3 and Incident Cardiovascular Outcomes. J Am Coll Cardiol 2018; 72:3246-3254. [PMID: 30573026 PMCID: PMC6516745 DOI: 10.1016/j.jacc.2018.09.076] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/12/2018] [Accepted: 09/22/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Galectin-3 (Gal-3) has been associated with heart failure (HF) and poor cardiovascular outcomes. However, the effect of longitudinal changes in Gal-3 on clinical outcomes remains unclear. OBJECTIVES The authors sought to study clinical determinants of change in Gal-3 among community-dwelling individuals. Further, they sought to examine the role of serial Gal-3 measurements in predicting risk of future HF, cardiovascular disease (CVD), and mortality. METHODS A total of 2,477 participants in the Framingham Heart Study Offspring cohort underwent measurement of plasma Gal-3 levels at 2 examinations (1995 to 1998 and 2005 to 2008). Linear regression models were used to examine clinical correlates of change in Gal-3. Proportional hazards models were used to relate future clinical outcomes with change in Gal-3. RESULTS The following clinical correlates were associated with greater longitudinal increases in Gal-3 levels: age, female sex, hypertension, diabetes, body mass index, interim development of chronic kidney disease, and HF (p < 0.0001 for all in multivariable model). Change in Gal-3 was associated with future HF (hazard ratio [HR]: 1.39 per 1-SD increase; 95% confidence interval [CI]: 1.13 to 1.71), CVD (HR: 1.29; 95% CI: 1.11 to 1.51), and all-cause mortality (HR: 1.30; 95% CI: 1.17 to 1.46). Change in Gal-3 was associated with both HF with preserved as well as reduced ejection fraction (p < 0.05 for both). CONCLUSIONS Longitudinal changes in Gal-3 are associated with traditional cardiovascular risk factors and renal disease. In turn, change in Gal-3 predicts future HF, CVD, and mortality in the community. Future studies are needed to determine whether serial Gal-3 measures may be useful in disease prevention.
Collapse
Affiliation(s)
- Anahita Ghorbani
- Calhoun Cardiology Center, University of Connecticut Health Center, Farmington, Connecticut
| | - Vijeta Bhambhani
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts; Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Robert H Christenson
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Wouter C Meijers
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Rudolf A de Boer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Daniel Levy
- National Heart, Lung, and Blood Institute, Boston University's Framingham Heart Study, Framingham, Massachusetts; Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Martin G Larson
- Framingham Heart Study, Framingham, Massachusetts; Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Jennifer E Ho
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts; Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts.
| |
Collapse
|
8
|
Melin EO, Dereke J, Thunander M, Hillman M. Depression in type 1 diabetes was associated with high levels of circulating galectin-3. Endocr Connect 2018; 7:819-828. [PMID: 29760188 PMCID: PMC6000756 DOI: 10.1530/ec-18-0108] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 05/14/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Neuroinflammatory responses are implicated in depression. The aim was to explore whether depression in patients with type 1 diabetes (T1D) was associated with high circulating galectin-3, controlling for metabolic variables, s-creatinine, life style factors, medication and cardiovascular complications. DESIGN Cross-sectional. METHODS Participants were T1D patients (n = 283, 56% men, age 18-59 years, diabetes duration ≥1 year). Depression was assessed by Hospital Anxiety and Depression Scale-depression subscale. Blood samples, anthropometrics and blood pressure were collected, and supplemented with data from medical records and the Swedish National Diabetes Registry. Galectin-3 ≥2.562 µg/l, corresponding to the 85th percentile, was defined as high galectin-3. RESULTS Median (quartile1, quartile3) galectin-3 (µg/l) was 1.3 (0.8, 2.9) for the 30 depressed patients, and 0.9 (0.5, 1.6) for the 253 non-depressed, P = 0.009. Depression was associated with high galectin-3 in all the 283 patients (adjusted odds ratio (AOR) 3.5), in the 161 men (AOR 3.4), and in the 122 women (AOR 3.9). HbA1c, s-lipids, s-creatinine, blood pressure, obesity, smoking, physical inactivity, cardiovascular complications and drugs (antihypertensive, lipid lowering, oral antidiabetic drugs and antidepressants) were not associated with high galectin-3. CONCLUSIONS This is the first study to show an association between depression and galectin-3. Depression was the only explored parameter associated with high circulating galectin-3 levels in 283 T1D patients. High galectin-3 levels might contribute to the increased risk for Alzheimer's disease, cardiovascular and all-cause mortality observed in persons with depression. Potentially, in the future, treatment targeting galactin-3 might improve the prognosis for patients with high galectin-3 levels.
Collapse
Affiliation(s)
- Eva Olga Melin
- Department of Clinical SciencesEndocrinology and Diabetes, Lund University, Faculty of Medicine, Lund, Sweden
- Department of Research and DevelopmentRegion Kronoberg, Växjö, Sweden
- Region KronobergPrimary Care, Växjö, Sweden
| | - Jonatan Dereke
- Department of Clinical Sciences LundLund University, Faculty of Medicine, Diabetes Research Laboratory, Lund, Sweden
| | - Maria Thunander
- Department of Clinical SciencesEndocrinology and Diabetes, Lund University, Faculty of Medicine, Lund, Sweden
- Department of Research and DevelopmentRegion Kronoberg, Växjö, Sweden
- Department of Internal MedicineEndocrinology and Diabetes, Central Hospital, Växjö, Sweden
| | - Magnus Hillman
- Department of Clinical Sciences LundLund University, Faculty of Medicine, Diabetes Research Laboratory, Lund, Sweden
| |
Collapse
|
9
|
Abstract
Galectin-3 plays a role in tissue inflammation, repair, and fibrosis. This article specifically focuses on heart failure (HF), in which galectin-3 has been shown to be a useful biomarker in prognosis and risk stratification, especially in HF with preserved ejection fraction. Experimental research has shown that galectin-3 directly induces pathologic remodeling of the heart, and is therefore considered a culprit protein in the development of cardiac fibrosis in HF, with potentially relevant clinical implications. In summary, galectin-3 is a biomarker and biotarget in cardiac remodeling and fibrosis and future research will target galectin-3-centered diseases.
Collapse
|