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Mahadevan A, Adivi S, Akella SA, Doshi P, Salian RB, Kohli M, Radhareddy AR, Krishnakumar M, Pinnamaneni M, Desai R. Acute Ischemic Stroke in Young Adults: Comparative Analysis of Outcomes and Mortality in Metabolically Healthy Obese or Overweight Vs. Non-Obese or Overweight Hospitalizations, 2016-2019 Cohort. J Stroke Cerebrovasc Dis 2024:107847. [PMID: 38977229 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 06/21/2024] [Accepted: 07/01/2024] [Indexed: 07/10/2024] Open
Abstract
INTRODUCTION Rising obesity rates and the increasing prevalence of stroke in the metabolically healthy obese and overweight (MHOO) necessitate examining its association in younger (18-44 year) populations and analyzing acute ischemic stroke (AIS) trends and outcomes in MHOO vs. metabolically healthy non-obese or overweight (MHnOO). METHODS Data from the United States National Inpatient Sample (2016-2019) was analyzed to identify young MHOO and MHnOO AIS patients using ICD-10-CM codes. Metabolically healthy status was defined by excluding hospitalization records with diagnostic codes for hypertension, diabetes, and dyslipidemia. Demographics, trends, and outcomes were compared using appropriate statistical approaches. RESULTS Of 26,949,310 young metabolically healthy hospitalizations between 2016 and 2019, 47,795 had AIS, of which 4,985 were MHOO and 42,810 were MHnOO. The median age of AIS hospitalization was 35 years, and primarily female and white. From 2016 to 2019, AIS incidence rose slightly, which was significant only for the MHnOO cohort. The in-hospital mortality rate was significantly lower in the MHOO cohort (6.0% vs. 8.6%, p < 0.001). Hospitalization length and cost did not differ substantially between groups. Adjusted multivariable analysis revealed no significant difference in AIS hospitalization risk between MHOO and MHnOO (aOR: 1.02, p=0.701), with subgroup analysis in males (aOR: 0.88, p=0.161) or females (aOR: 1.06, p=0.363). However, all-cause in-hospital mortality (ACIHM) in AIS had lower odds in the MHOO vs. MHnOO cohorts (aOR: 0.60, p=0.021). CONCLUSION Our study finds a rising trend of AIS hospitalizations in young metabolically healthy adults, with obesity or overweight status not being associated with AIS hospitalization. We identify an "obesity paradox" of lower odds for ACIHM for AIS hospitalizations in the MHOO cohort.
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Affiliation(s)
- Arankesh Mahadevan
- Department of Neurology, University of Utah Health, Salt Lake City, Utah, USA.
| | - Santoshini Adivi
- Department of Medicine, NRI Medical College & Hospital, Mangalagiri, India
| | - Sai Anusha Akella
- Department of Internal Medicine, Kakatiya Medical College, Warangal, India
| | - Preet Doshi
- Department of Internal Medicine, SUNY Upstate University, Syracuse, NY, USA
| | | | - Muskan Kohli
- Department of Medicine, Anna Medical College, Mauritius
| | | | - Manaswini Krishnakumar
- Department of Internal Medicine, SRM Medical College Hospital and Research Centre, Kattankulathur, India
| | - Monitha Pinnamaneni
- Department of Internal Medicine, SRM Medical College Hospital and Research Centre, Kattankulathur, India
| | - Rupak Desai
- Independent Outcome Researcher, Atlanta, GA, USA
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Chen Y, Yu W, Lv J, Sun D, Pei P, Du H, Yang L, Chen Y, Zhang H, Chen J, Chen Z, Li L, Yu C. Early adulthood BMI and cardiovascular disease: a prospective cohort study from the China Kadoorie Biobank. Lancet Public Health 2024:S2468-2667(24)00043-4. [PMID: 38885669 DOI: 10.1016/s2468-2667(24)00043-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND The associations of early adulthood BMI with cardiovascular diseases have yet to be completely delineated. There is little reliable evidence about these associations among east Asian populations, that differ in fat distribution, disease patterns, and lifestyle factors from other populations. We aimed to study the associations between early adulthood BMI and cardiovascular diseases in a Chinese population, and the effect of midlife lifestyle factors on outcomes. METHODS In this prospective analysis, we used data from the China Kadoorie Biobank, a large and long-term cohort from five urban areas and five rural areas, using participants aged 35-70 years. The primary outcome was the incidence of cardiovascular diseases as a group, ischaemic heart disease, haemorrhagic stroke, and ischaemic stroke, which were obtained mainly through linkage to disease registries and the national database for health insurance claims. Early adulthood BMI was assessed through self-report at baseline survey. We used Cox proportional hazards regression models to examine the prospective associations. We also undertook multiplicative and additive interaction analyses to investigate the potential modification effect of midlife healthy lifestyle factors (a combined score covering smoking, drinking, physical activity, and diet). FINDINGS Participants were recruited for baseline survey between June, 2004, and July, 2008. During a median follow-up of 12·0 years (IQR 11·3-13·1), we documented 57 203 (15·9%) of incident cardiovascular diseases in 360 855 participants. After adjustment for potential confounders, monotonic dose-response associations were observed between higher early adulthood BMI and increased risks of incident cardiovascular diseases. Compared with an early adulthood BMI of 20·5-22·4 kg/m2 (the reference group), the hazard ratios for a BMI of less than 18·5 kg/m2 was 0·97 (95% CI 0·94-1·00), 18·5-20·4 kg/m2 was 0·97 (0·95-0·99), 22·5-23·9 kg/m2 was 1·04 (1·02-1·07), 24·0-25·9 kg/m2 was 1·12 (1·09-1·15), 26·0-27·9 kg/m2 was 1·19 (1·14-1·24), 28·0-29·9 kg/m2 was 1·34 (1·25-1·44), and ≥30·0 kg/m2 was 1·58 (1·42-1·75). Except for haemorrhagic stroke, lower early adulthood BMI (<20·5 kg/m2) was associated with decreased incident cardiovascular disease risks. No significant interaction was found between midlife healthy lifestyle factors and early adulthood BMI on cardiovascular disease risks. INTERPRETATION Increased risks of cardiovascular disease incidence were found among participants with high early adulthood adiposity, including ischaemic heart disease, haemorrhagic stroke, and ischaemic stroke. Our findings suggest early adulthood as an important time to focus on weight management and obesity prevention for cardiovascular health later in life. FUNDING National Natural Science Foundation of China, National Key Research and Development Program of China, Chinese Ministry of Science and Technology, Kadoorie Charitable Foundation, and the Wellcome Trust.
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Affiliation(s)
- Yuanyuan Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Wei Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Bejing, China
| | - Dianjianyi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China
| | - Pei Pei
- Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China
| | - Huaidong Du
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ling Yang
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yiping Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Huanxu Zhang
- Tongxiang Center for Disease Control and Prevention, Zhejiang, China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Bejing, China.
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Dutta S, Singhal AK, Suryan V, Chandra NC. Obesity: An Impact with Cardiovascular and Cerebrovascular Diseases. Indian J Clin Biochem 2024; 39:168-178. [PMID: 38577137 PMCID: PMC10987439 DOI: 10.1007/s12291-023-01157-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/23/2023] [Indexed: 04/06/2024]
Abstract
The authors sought to correlate the complex sequel of obesity with various parameters known to develop metabolic syndrome viz. insulin resistance, dyslipidemia, hypertension etc., as these anomalies are linked to vascular atherosclerosis and outbreak of cardiovascular and cerebrovascular diseases. A comprehensive online survey using MEDLINE, Scopus, PubMed and Google Scholar was conducted for relevant journals from 1970 till present time (2023) with key search terms like: 'obesity', 'leptin', type-2 diabetes', 'atherosclerosis', 'cardiovascular and cerebrovascular diseases'. The findings of the reports were compared and correlated. The information was then collated for developing this review. Reports showed that in human obesity, hyper-leptinemia could induce hyperglycemia, which in turn templates hypercholesterolemia. Persisting hypercholesterolemia over a period of time may en-route atherosclerosis in blood vessels. Thus obesity has been considered as a template for originating hyperglycemia, hypercholesterolemia and outbreak of vascular atherogenesis or in other words, obesity in long run can trigger atherosclerosis and its related disorders e.g. heart attack and stroke. Literature survey shows that primarily, co-morbidities of human obesity start with leptin and insulin resistance and then multiplies with metabolic irregularities to an extreme that results in pathogenesis of heart attack and stroke. Atherosclerosis associated cardiovascular and cerebrovascular events are independent risks of obese subjects and particularly in the cases of persisting obesity.
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Affiliation(s)
- Savi Dutta
- Department of Biochemistry, Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana 122505 India
| | - A. K. Singhal
- Department of Biochemistry, Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana 122505 India
- Present Address: Department of Biochemistry, Al Falah School of Medical Sciences & Research Centre, Faridabad, Haryana India
| | - Varsha Suryan
- Department of Biochemistry, Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana 122505 India
- Present Address: Department of Paramedical Science, Faculty of Allied Health Sciences, Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana 122505 India
| | - Nimai Chand Chandra
- Department of Biochemistry, Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana 122505 India
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Lu J, Gong S, Zhu J, Fang Q. Relationships between obesity and functional outcome after ischemic stroke: a Mendelian randomization study. Neurol Sci 2024:10.1007/s10072-024-07415-w. [PMID: 38466476 DOI: 10.1007/s10072-024-07415-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/17/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND AND OBJECTIVES Most previous studies suggested obesity deteriorates the functional outcome after ischemic stroke. But there are researches claiming that obesity is associated with lower mortality, recurrence, and readmission rates, which is known as the obesity paradox. Our current research aimed to investigate the correlation between genetically obesity and the post-stroke outcome with the Mendelian randomization (MR) method. METHODS The UK Biobank and the GIANT consortium provided instrumental variables for body mass index (BMI, 806,834 individuals) and waist-to-hip ratio (WHR, 697,734 individuals). Data of functional outcome after ischemic stroke were obtained from the Genetics of Ischemic Stroke Functional Outcome network (6012 individuals). Inverse-variance weighted approach was utilized as the primary analyses. Sensitivity analyses involved the utilization of different MR methods. The heterogeneity among genetic variants was assessed by I2 and Q value statistics. RESULTS In univariable analysis, there was a significant connection between genetic susceptibility to WHR and worse functional outcome (modified Rankin Scale 3) after ischemic stroke (OR [95%CI] = 1.47 [1.07, 2.02], P = 0.016). Genetic liability to BMI and was not associated with post-stroke functional outcome (all P > 0.05). The overall patterns between genetic liability to WHR and functional outcome post-ischemic outcome no longer existed in the multivariable MR analysis after adjusting for BMI (OR [95%CI] = 1.26[0.76,1.67], P = 0.56). CONCLUSION The current MR study provided evidence that WHR was correlated to unfavorable outcome post-ischemic stroke. Exploring interventions against obesity may potentially improve recovery after ischemic stroke.
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Affiliation(s)
- Jieyi Lu
- Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China
- Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Siqi Gong
- Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China
- Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Juehua Zhu
- Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China.
| | - Qi Fang
- Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China.
- Department of Neurology, Dushu Lake Hospital Affiliated to Soochow University, 9 Chongwen Road, Suzhou, 215125, China.
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Han F. N6-methyladenosine modification in ischemic stroke: Functions, regulation, and therapeutic potential. Heliyon 2024; 10:e25192. [PMID: 38317953 PMCID: PMC10840115 DOI: 10.1016/j.heliyon.2024.e25192] [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: 06/29/2023] [Revised: 12/09/2023] [Accepted: 01/22/2024] [Indexed: 02/07/2024] Open
Abstract
N6-methyladenosine (m6A) modification is the most frequently occurring internal modification in eukaryotic RNAs. By modulating various aspects of the RNA life cycle, it has been implicated in a wide range of pathological and physiological processes associated with human diseases. Ischemic stroke is a major cause of death and disability worldwide with few treatment options and a narrow therapeutic window, and accumulating evidence has indicated the involvement of m6A modifications in the development and progression of this type of stroke. In this review, which provides insights for the prevention and clinical treatment of stroke, we present an overview of the roles played by m6A modification in ischemic stroke from three main perspectives: (1) the association of m6A modification with established risk factors for stroke, including hypertension, diabetes mellitus, hyperlipidemia, obesity, and heart disease; (2) the roles of m6A modification regulators and their functional regulation in the pathophysiological injury mechanisms of stroke, namely oxidative stress, mitochondrial dysfunction, endothelial dysfunction, neuroinflammation, and cell death processes; and (3) the diagnostic and therapeutic potential of m6A regulators in the treatment of stroke.
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Affiliation(s)
- Fei Han
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
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Ozcan S, Donmez E, Coban E, Korkut E, Ziyrek M, Sahin I, Okuyan E. Role of Cardiac Risk Scores in Clinical Use to Predict Outcomes of Acute Ischemic Stroke. Neurol India 2023; 71:1197-1204. [PMID: 38174458 DOI: 10.4103/0028-3886.391383] [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] [Indexed: 01/05/2024]
Abstract
Introduction Acute coronary syndromes and ischemic stroke have similar risk factors. Risk scores help to identify disease severity in both diseases. We aimed to evaluate if HEART (History, ECG, Age, Risk factors, and Troponin) score could predict re-hospitalization, recurrent cardiac/cerebrovascular events risk, and mortality within 1-year follow-up in patients presenting with acute ischemic stroke. Methods Patients hospitalized with a diagnosis of acute ischemic stroke in our tertiary center between 2019 and 2021 were included in this retrospective study. CHA2DS2-VASc and HEART scores on admission were calculated. In-hospital, 1-month, and 1-year mortalities, as well as re-hospitalization due to recurrent ischemic (cardiac/cerebral), were defined as major adverse cardiac and cerebrovascular events (MACCE), and occurrence of MACCE was accepted as the primary endpoint of the study. Comparative statistical and regression analyses were obtained. Results A total of 297 patients were included. The mortality rate for 30 days was 7.4% and 1 year was 20.5%. HEART and CHA2DS2-VASc scores were found independent risk factors associated with the occurrence of MACCE. Patients who experienced MACCE had higher HEART and CHA2DS2-VASc scores. Meanwhile, HEART score had better prognostic accuracy than CHA2DS2-VASc score when a cutoff value of 3.5 was set, which is associated with 84.7% sensitivity and 75.2% specificity in the prediction of MACCE. Conclusion HEART score is effective in determining re-hospitalization and recurrent cerebral ischemic event risk as well as mortality within 30 days and 1 year in patients presenting with acute ischemic stroke. Thus, concomitant use of HEART and CHA2DS2-VASc scores may provide better characterization of worse prognosis in ischemic stroke patients with high sensitivity and specificity.
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Affiliation(s)
- Sevgi Ozcan
- Department of Cardiology, Bağcılar Training and Research Hospital, Bağcılar - İstanbul, Turkey
| | - Esra Donmez
- Department of Cardiology, Bağcılar Training and Research Hospital, Bağcılar - İstanbul, Turkey
| | - Eda Coban
- Department of Neurology, Bağcılar Training and Research Hospital, Bağcılar - İstanbul, Turkey
| | - Elif Korkut
- Department of Neurology, Bağcılar Training and Research Hospital, Bağcılar - İstanbul, Turkey
| | - Murat Ziyrek
- Department of Cardiology, Bağcılar Training and Research Hospital, Bağcılar - İstanbul, Turkey
| | - Irfan Sahin
- Department of Cardiology, Bağcılar Training and Research Hospital, Bağcılar - İstanbul, Turkey
| | - Ertuğrul Okuyan
- Department of Cardiology, Bağcılar Training and Research Hospital, Bağcılar - İstanbul, Turkey
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Knapik JJ, Farina EK, Steelman RA, Trone DW, Lieberman HR. The Medical Burden of Obesity and Overweight in the US Military: Association of BMI with Clinically Diagnosed Medical Conditions in United States Military Service Members. J Nutr 2023; 153:2951-2967. [PMID: 37619919 DOI: 10.1016/j.tjnut.2023.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/13/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND A high BMI is associated with various medical conditions, notably type 2 diabetes, cardiovascular disease, and mental health disorders. In the US military, BMI increased linearly between 1975 and 2015. OBJECTIVE This cross-sectional study investigated the associations between BMI and a comprehensive range of clinically diagnosed medical conditions (CDMCs) in US military service members (SMs). METHODS A stratified random sample of SMs (n=26,177) completed an online questionnaire reporting their height, weight, and demographic/lifestyle characteristics. Medical conditions for 6 mo before questionnaire completion were obtained from a comprehensive military electronic medical surveillance system and grouped into 39 CDMCs covering both broad (largely systemic) and specific medical conditions. BMI was calculated as weight/height2 (kg/m2). The prevalence of CDMCs was compared among normal weight (<25.0 kg/m2), overweight (25.0-29.9 kg/m2), and obese (≥30 kg/m2) SMs. RESULTS After multivariable adjustment for demographic/lifestyle characteristics, higher BMI was associated with higher odds of a diagnosed medical condition in 30 of 39 CDMCs, with all 30 displaying dose-response relationships. The 5 major CDMCs with the largest odds ratios comparing obese to normal weight were endocrine/nutritional/metabolic diseases (OR=2.67, 95%CI=2.24-3.15), nervous system diseases (odds ratio [OR]=2.59, 95%CI=2.32-2.90), circulatory system diseases (OR=2.56, 95%CI=2.15-3.06), musculoskeletal system diseases (OR=1.92, 95%CI=1.76-2.09), and mental/behavioral disorders (OR=1.69, 95%CI=1.51-1.90). Compared with normal weight SMs, overweight or obese SMs had a higher number of CDMCs (1.8±1.9 vs. 2.0±2.0 and 2.5±2.3, mean ± standard deviation, respectively, P<0.01). CONCLUSIONS In a young, physically active population, higher BMI was associated with a host of medical conditions, even after adjustment for demographic/lifestyle characteristics. The US Department of Defense should improve nutrition education and modify other factors that contribute to overweight and obesity. This study demonstrates that the medical burden of obesity is substantial in overweight and obese SMs.
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Affiliation(s)
- Joseph J Knapik
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, MA, United States.
| | - Emily K Farina
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, MA, United States
| | - Ryan A Steelman
- Clinical Public Health and Epidemiology, Defense Centers for Public Health-Aberdeen, MD, United States
| | - Daniel W Trone
- Deployment Health, Naval Health Research Center, CA, United States
| | - Harris R Lieberman
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, MA, United States
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Asiah ASS, Norhayati MN, Muhammad J, Muhamad R. Effect of yoga on anthropometry, quality of life, and lipid profile in patients with obesity and central obesity: A systematic review and meta-analysis. Complement Ther Med 2023; 76:102959. [PMID: 37356673 DOI: 10.1016/j.ctim.2023.102959] [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: 06/30/2022] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 06/27/2023] Open
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to determine the effectiveness of yoga on anthropometry, quality of life, and lipid profiles in patients with obesity and central obesity. METHODOLOGY The Cochrane Central Register of Controlled Trials (CENTRAL) and PubMed (1985-January 2022) and trial registries for relevant randomised clinical trials were used. Relevant and published randomised clinical trials were reviewed and evaluated. The primary outcomes were anthropometry measurements, which were weight, waist circumference, body mass index (BMI), and body fat percentages. The secondary outcomes were changes in quality of life, psychological impact, lipid profile measurement, presence of adverse events, and changes in blood pressure and blood glucose. We assessed the data for risk of bias, heterogeneity, sensitivity, reporting bias, and quality of evidence. RESULTS 15 studies are included, involving 1161 participants. The analysis performed is based on three comparisons. For the first comparison between yoga and control, yoga reduces the waist circumference (MD -0.84, 95% CI [-5.12 to 3.44]), while there is no difference in body weight, BMI, or body fat percentages. In the second comparison between yoga and calorie restriction, yoga reduces body weight (MD -3.47, 95% CI [-6.20 to -0.74]), while there is no difference in waist circumference, BMI, or body fat percentage. In the third comparison between yoga and exercise, yoga reduces the body weight (MD -7.58, 95% CI [-11.51 to -3.65]), while there is no difference in waist circumference or BMI. For the secondary outcomes, yoga intervention reduces total cholesterol (MD -17.12, 95% CI [-32.24 to -2.00]) and triglycerides (MD -21.75, 95% CI [-38.77 to -4.73]) compared to the control group, but there is no difference compared to the calorie restriction and exercise group. There is no difference in the rest of the outcomes, which are LDL, HDL, quality of life, psychological impact, adverse events, blood pressure, and blood glucose. However, findings are not robust due to a high risk of bias and low-quality evidence. CONCLUSION From our review, there were methodological drawbacks and very low to moderate quality of evidence across all comparisons, and hence, it is inconclusive to say that yoga can significantly improve anthropometric parameters. More well-designed trials are needed to confirm and support the beneficial effects of yoga.
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Affiliation(s)
- Ahmad Sabri Siti Asiah
- Department of Family Medicine, Universiti Sains Malaysia, School of Medical Sciences, 16150 Kubang, Kerian, Malaysia
| | - Mohd Noor Norhayati
- Department of Family Medicine, Universiti Sains Malaysia, School of Medical Sciences, 16150 Kubang, Kerian, Malaysia
| | - Juliawati Muhammad
- Department of Family Medicine, Universiti Sains Malaysia, School of Medical Sciences, 16150 Kubang, Kerian, Malaysia.
| | - Rosediani Muhamad
- Department of Family Medicine, Universiti Sains Malaysia, School of Medical Sciences, 16150 Kubang, Kerian, Malaysia
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Janes F, Sozio E, Gigli GL, Ripoli A, Sbrana F, Kuris F, Nesi L, Semenzin T, Bertolino G, Deana C, Bagatto D, Ciardi C, Fabris M, Merlino G, Bax F, Nilo A, Pez S, Valente M, Tascini C. Ischemic strokes in COVID-19: risk factors, obesity paradox, and distinction between trigger and causal association. Front Neurol 2023; 14:1222009. [PMID: 37592943 PMCID: PMC10428626 DOI: 10.3389/fneur.2023.1222009] [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: 05/13/2023] [Accepted: 07/17/2023] [Indexed: 08/19/2023] Open
Abstract
Background and purpose Stroke has been described as a COVID-19 complication. However, its occurrence rate, risk factors, and causal relationships are still not well established. Methods We describe the characteristics of confirmed COVID-19-related strokes among all cases of COVID-19 hospitalized in our health network, from November 1, 2020 to April 30, 2021. Risk factor analysis has been conducted for ischemic stroke (IS), which represents 92% of all confirmed cases of Covid-19-related strokes, and a "causal attribution to infection" classification is provided. Results In all, 62/4105 hospitalized COVID-19 patients had an acute stroke (1.51%). Severe COVID-19 (OR 2.27-CI 1.06-4.77; p = 0.032), atrial fibrillation (OR 3.65-CI 1.63-7.98; p = 0.001), and ischemic heart disease (OR 4.590-CI 1.714-12.137; p = 0.002) proved to be independent risk factors for IS, while obesity was a protective factor (OR 0.90-CI 0.82-0.97; p = 0.012). COVID-19 had a causal role in 32.1% of IS cases, was a relevant cofactor in 28.6% of cases of IS, and was a possible trigger in 39.3% of events. Conclusion Our stroke occurrence rate is consistent with other population-based reports (range 0.34-2.7%). Prespecified peculiar clinical and radiological features allow the distinction between "IS caused by COVID-19" and "IS triggered by COVID-19." Clinical history of vascular diseases and risk factors is crucial in determining the risk of IS in patients with COVID-19. However, the protective effect of a BMI > 30 kg/m2 seems to suggest an obesity paradox.
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Affiliation(s)
- Francesco Janes
- Clinic of Neurology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
- Department of Medical Area (DAME), University of Udine (UNIUD), Udine, Italy
| | - Emanuela Sozio
- Clinic of Infectious Diseases, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Gian Luigi Gigli
- Department of Medical Area (DAME), University of Udine (UNIUD), Udine, Italy
| | - Andrea Ripoli
- Cardiology OU, Cardiothoracic Department, G. Monasterio Foundation, Pisa, Italy
| | - Francesco Sbrana
- Cardiology OU, Cardiothoracic Department, G. Monasterio Foundation, Pisa, Italy
| | - Fedra Kuris
- Clinic of Neurology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
- Department of Medical Area (DAME), University of Udine (UNIUD), Udine, Italy
| | - Lorenzo Nesi
- Clinic of Neurology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
- Department of Medical Area (DAME), University of Udine (UNIUD), Udine, Italy
| | - Tosca Semenzin
- Clinic of Infectious Diseases, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Giacomo Bertolino
- Clinic of Infectious Diseases, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Cristian Deana
- Department of Anesthesia and Intensive Care, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Daniele Bagatto
- Institute of Neuroradiology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Chiara Ciardi
- Institute of Neuroradiology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Martina Fabris
- Institute of Clinical Pathology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Giovanni Merlino
- Clinic of Neurology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Francesco Bax
- Clinic of Neurology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Annacarmen Nilo
- Clinic of Neurology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Sara Pez
- Clinic of Neurology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
- Department of Medical Area (DAME), University of Udine (UNIUD), Udine, Italy
| | - Mariarosaria Valente
- Clinic of Neurology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
- Department of Medical Area (DAME), University of Udine (UNIUD), Udine, Italy
| | - Carlo Tascini
- Department of Medical Area (DAME), University of Udine (UNIUD), Udine, Italy
- Clinic of Infectious Diseases, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
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10
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Chen M, Zhao J, Ding X, Qin Y, Wu X, Li X, Wang L, Jiang G. Ketogenic diet and calorie-restricted diet attenuate ischemic brain injury via UBR4 and downstream CamkⅡ/TAK1/JNK signaling. J Funct Foods 2023. [DOI: 10.1016/j.jff.2022.105368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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11
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Xiao X, Tang C, Zhai X, Li S, Ma W, Liu K, Kokoro S, Sheerah HA, Zhu H, Cao J. Early-Adulthood Weight Change and Later Physical Activity in Relation to Cardiovascular and All-Cause Mortality: NHANES 1999-2014. Nutrients 2022; 14:nu14234974. [PMID: 36501003 PMCID: PMC9736862 DOI: 10.3390/nu14234974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/12/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022] Open
Abstract
Limited evidence investigated the combined influence of early-adulthood weight change and later physical activity on the risk of cardiovascular (CVD) and all-cause mortality. The aim of this study is to explore the associations of early-adulthood weight change and later physical activity with CVD and all-cause mortality. This is a cohort study of 23,193 US adults aged 40 to 85 years from the National Health and Nutrition Examination Survey (NHANES) 1999 to 2014. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) of CVD and all-cause mortality associated with early-adulthood weight change and later physical activity. During a median follow-up of 9.2 years, there were 533 and 2734 cases of CVD and all-cause deaths. Compared with being physically inactive, the HRs of the CVD mortality of being physically active were 0.44 (0.26 to 0.73), 0.58 (0.19 to 1.82), 0.38 (0.17 to 0.86) and 0.46 (0.21 to 1.02) among individuals with stable normal, stable obese, non-obese to obese and maximum overweight early-adulthood weight change patterns. Using stable normal patterns that were physically active later as the reference, other early-adulthood weight change patterns did not show a significantly higher risk of CVD mortality when participants were physically active in later life; later physically inactive participants had a significantly increased risk of CVD mortality, with HRs of 2.17 (1.30 to 3.63), 5.32 (2.51 to 11.28), 2.59 (1.29 to 5.18) and 2.63 (1.32 to 5.26) in the stable normal, stable obese, non-obese to obese and maximum overweight groups, respectively. Similar results can be seen in the analyses for all-cause mortality. Our findings suggest that inadequate physical activity worsens the negative impact of unhealthy early-adulthood weight change patterns, which is worthy of being noted in the improvement of public health.
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Affiliation(s)
- Xinyu Xiao
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Chengyao Tang
- Biomedical Statistics, Department of Integrated Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi 565-0871, Osaka, Japan
| | - Xiaobing Zhai
- Center for Artificial Intelligence Driven Drug Discovery, Faculty of Applied Sciences, Macao Polytechnic University, Macau SAR, China
| | - Shiyang Li
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Wenzhi Ma
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Keyang Liu
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi 565-0871, Osaka, Japan
| | - Shirai Kokoro
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi 565-0871, Osaka, Japan
| | | | - Huiping Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China
- Correspondence: (J.C.); (H.Z.); Tel./Fax: +86-27-68759299 (J.C.)
| | - Jinhong Cao
- School of Public Health, Wuhan University, Wuhan 430071, China
- Correspondence: (J.C.); (H.Z.); Tel./Fax: +86-27-68759299 (J.C.)
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12
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Du Z, Zhu W, Zhao Y, Liu S, Chu H, Sun Z, Chu M. The epidemic of stroke mortality attributed to high body mass index in mainland China: Current trends and future prediction. Front Public Health 2022; 10:1021646. [PMID: 36353279 PMCID: PMC9639780 DOI: 10.3389/fpubh.2022.1021646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/04/2022] [Indexed: 01/28/2023] Open
Abstract
Background High body mass index (BMI) is an important risk factor for stroke. The aim of this study was to assess the long-term trend of high BMI-attributed stroke mortality and make projections through 2030. Methods Data were extracted from the Global Burden of Disease Study 2019 and World Population Prospects 2019. An age-period-cohort framework was used in the analysis. Results From 1990 to 2019, the age-standardized mortality rate (ASMR) of high BMI-attributed stroke among females decreased by 15.2%, while among males, it increased by 31.1%. All of the age groups studied showed an increasing pattern over the last 30 years in males, and in female, the age groups encompassing participants who were 25-69 years old showed a decreasing pattern. In the same birth cohort, high BMI-attributable stroke mortality rates increased exponentially with age in both sexes. For females, the period rate ratios (RR) showed a downward trend after 2000-2004, and the cohort RR also showed a downward trend after the birth cohort 1930-1934. For males, the period RR showed an upward trend, but this increase was halted in the most recent period, and the cohort RRs showed a monotonic increasing pattern. It was projected that the ASMR of high BMI-attributed stroke would decrease among females and increase among males in the near future and that the proportion of elderly individuals with death due to high BMI-attributed stroke was projected to increase. Conclusions Over the last three decades, the high BMI-attributed stroke mortality rate decreased among females and increased among males, and these trends are projected to continue in the future. In addition, the proportion of elderly individuals with high BMI-attributed stroke mortality was projected to increase gradually in both men and women. More health-promoting efforts are needed, especially for elderly individuals and males.
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Affiliation(s)
- Zhaoqing Du
- Department of Hepatobiliary Surgery, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Wenxuan Zhu
- Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yuqi Zhao
- Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Shenghang Liu
- Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Hao Chu
- School of Urban Planning and Municipal Engineering, Xi'an Polytechnic University, Xi'an, China
| | - Zhonghe Sun
- Nanjing First Hospital, Nanjing Medical University, Nanjing, China,*Correspondence: Zhonghe Sun
| | - Meng Chu
- Department of Hepatobiliary Surgery, Shaanxi Provincial People's Hospital, Xi'an, China,The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China,Meng Chu
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13
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Tully L, Arthurs N, Wyse C, Browne S, Case L, McCrea L, O’Connell JM, O’Gorman CS, Smith SM, Walsh A, Ward F, O’Malley G. Guidelines for treating child and adolescent obesity: A systematic review. Front Nutr 2022; 9:902865. [PMID: 36313105 PMCID: PMC9597370 DOI: 10.3389/fnut.2022.902865] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
Obesity is a chronic disease that compromises the physical and mental health of an increasing proportion of children globally. In high-income countries, prevalence of paediatric obesity is increasing faster in those from marginalised populations such as low-income households, suggesting the disease as one that is largely systemic. Appropriate treatment should be prioritised in these settings to prevent the development of complications and co-morbidities and manage those that already exist. An array of clinical practice guidelines are available for managing overweight and obesity in children and adolescents, but no systematic review has yet compared their quality or synthesised their recommendations. We aimed to narratively review clinical practice guidelines published in English for treating child and adolescent obesity, to identify the highest quality guidelines, and assess similarities, conflicts, and gaps in recommendations. We systematically searched academic databases and grey literature for guidelines published. We used the AGREE II tool to assess the quality, and identified nine high quality guidelines for inclusion in a narrative review of recommendations. Guidelines predominantly recommended the delivery of multi-component behaviour-change interventions aimed at improving nutrition and physical activity. Treatment outcomes were generally focussed on weight, with less emphasis on managing complications or improving quality-of-life. There was no evidence-based consensus on the best mode of delivery, setting, or treatment format. The guidelines rarely included recommendations for addressing the practical or social barriers to behaviour change, such as cooking skills or supervised physical activity. There is insufficient evidence to evaluate pharmaceutical and surgical interventions in children, and these were generally not recommended. It should be noted that this review addressed documents published in English only, and therefore the included guidelines were applicable predominantly to high-resource settings.
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Affiliation(s)
- Louise Tully
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Niamh Arthurs
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland,W82GO Child and Adolescent Obesity Service, Children’s Health Ireland at Temple Street, Dublin, Ireland
| | - Cathy Wyse
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Sarah Browne
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Lucinda Case
- W82GO Child and Adolescent Obesity Service, Children’s Health Ireland at Temple Street, Dublin, Ireland
| | - Lois McCrea
- W82GO Child and Adolescent Obesity Service, Children’s Health Ireland at Temple Street, Dublin, Ireland
| | - Jean M. O’Connell
- St. Columcille’s Hospital Weight Management Service, St.Vincent’s University Hospital, Dublin, Ireland
| | - Clodagh S. O’Gorman
- School of Medicine, University of Limerick, Limerick, Ireland,Department of Paediatrics, University Hospital Limerick, Limerick, Ireland
| | - Susan M. Smith
- Discipline of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
| | - Aisling Walsh
- Department of Epidemiology, Division of Population Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Fiona Ward
- Department of Clinical Nutrition and Dietetics, Children’s Health Ireland at Crumlin, Dublin, Ireland
| | - Grace O’Malley
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland,W82GO Child and Adolescent Obesity Service, Children’s Health Ireland at Temple Street, Dublin, Ireland,*Correspondence: Grace O’Malley,
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14
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Wang X, Huang Y, Chen Y, Yang T, Su W, Chen X, Yan F, Han L, Ma Y. The relationship between body mass index and stroke: a systemic review and meta-analysis. J Neurol 2022; 269:6279-6289. [PMID: 35971008 DOI: 10.1007/s00415-022-11318-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Stroke is an acute cerebrovascular event closely related to brain tissue damage, and is one of the major causes of death and disability in worldwide. Various studies have reported the effects of body mass index (BMI) on the risk of stroke, but the results remain varied and these results have not been synthesized. Therefore, a meta-analysis was performed to evaluate the relationship between BMI and the risk of stroke. OBJECTIVES This systematic review was conducted to explore the relationship between BMI and the risk of stroke. METHODS PubMed, EMBASE, Web of Science and Cochrane Library, China Knowledge Resource Integrated Database (CNKI), WanFang Database, Chinese Biomedical Database (CBM), and CQVIP were comprehensively searched for studies exploring the relationship between BMI and stroke from inception to December 1, 2021. RESULTS This review included 24 studies involving 5,798,826 subjects. The results of meta-analysis showed that the pooled RR of stroke risk was 0.93 (95% confidence interval [CI] 0.82-1.06, I2 = 88.8%, P = 0.29) for the underweight group. Higher BMI (overweight or obese group) was associated with an increased overall risk of stroke, with pooled RR values of 1.25 (95% CI 1.16-1.34, I2 = 84.8%, P = 0.00) and 1.47 (95% CI: 1.02-2.11, I2 = 99.4%, P = 0.04). CONCLUSION The risk of stroke was positively correlated with BMI, and the association was stronger in male and ischemic stroke. Lowering BMI can be used as a way to prevent stroke, and for people who are overweight or obese, lowering body weight can reduce the risk of stroke.
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Affiliation(s)
- Xinyu Wang
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China
| | - Yanan Huang
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China
| | - Yanru Chen
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China
| | - Tingting Yang
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China
| | - Wenli Su
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China
| | - Xiaoli Chen
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China
- Department of Nursing, Gansu Provincial Hospital, Lanzhou, Gansu Province, China
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China
| | - Fanghong Yan
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China
| | - Lin Han
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China.
- Department of Nursing, Gansu Provincial Hospital, Lanzhou, Gansu Province, China.
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China.
| | - Yuxia Ma
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China.
- Department of Nursing, Gansu Provincial Hospital, Lanzhou, Gansu Province, China.
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China.
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15
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Pharmacological Management of Obesity: A Century of Expert Opinions in Cecil Textbook of Medicine. Am J Ther 2022; 29:e410-e424. [PMID: 35687055 DOI: 10.1097/mjt.0000000000001524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Innovations in drug therapy for obesity have had a limited impact on the body mass index, prevalence of medical complications, quality of life, and work potential of a substantial majority of affected persons. STUDY QUESTION What are the milestones of the changes in the expert approach to the pharmacological management of obesity in the past century? STUDY DESIGN To determine the changes in the experts' approach to the management of obesity, as presented in a widely used textbook in the United States. DATA SOURCES The primary sources were chapters describing the management of obesity in the 26 editions of Cecil Textbook of Medicine published from 1927 through 2020. Secondary sources were publications retrieved from Medline that clarified technical issues related to the development, regulatory approval, and use of the drugs mentioned in the Cecil Textbook of Medicine. RESULTS Pharmacological interventions aimed at increasing caloric expenditures through thermogenesis were recommended from 1927 through 1943. Thyroid extracts were prescribed even in the absence of demonstrated hypothyroidism or decreased basal metabolic rate throughout this period. Dinitrophenol was mentioned in 1937, but was banned soon thereafter. Appetite suppression with amphetamine was considered useful from 1943 through 1988, after which the drug was replaced with other centrally acting molecules, such as fenfluramine in 1988, sibutramine in 2000, and rimonabant in 2008, which were in turn withdrawn because of major adverse effects. In the past decade, obesity has been treated with the appetite suppressants phentermine-topiramate, bupropion-naltrexone, lorcaserin, and liraglutide, and with orlistat, a drug promoting fat malabsorption. The change in weight produced by these drugs is generally modest and transient. CONCLUSIONS The pharmacological management of obesity has remained frustratingly inefficient. The reasons for the relative lack of success may reside in the ever-growing access to dense, palatable, and relatively inexpensive food, coupled with the decrease in energy expenditure created by a sedentary lifestyle.
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16
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Huang Q, Cai G, Liu T, Liu Z. Relationships Among Gut Microbiota, Ischemic Stroke and Its Risk Factors: Based on Research Evidence. Int J Gen Med 2022; 15:2003-2023. [PMID: 35795301 PMCID: PMC9252587 DOI: 10.2147/ijgm.s353276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/08/2022] [Indexed: 11/27/2022] Open
Abstract
Stroke is a highly lethal disease and disabling illness while ischemic stroke accounts for the majority of stroke. It has been found that inflammation plays a key role in the initiation and progression of stroke, and atherosclerotic plaque rupture is considered to be the leading cause of ischemic stroke. Furthermore, chronic inflammatory diseases, such as obesity, type 2 diabetes mellitus (T2DM) and hypertension, are also considered as the high-risk factors for stroke. Recently, the topic on how gut microbiota affects human health has aroused great concern. The initiation and progression of ischemic stroke has been found to have close relation with gut microbiota dysbiosis. Hence, this manuscript briefly summarizes the roles of gut microbiota in ischemic stroke and its related risk factors, and the practicability of preventing and alleviating ischemic stroke by reconstructing gut microbiota.
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Affiliation(s)
- Qinhong Huang
- First Clinical School, Guangzhou Medical University, Guangzhou, 511436, People’s Republic of China
| | - Guannan Cai
- First Clinical School, Guangzhou Medical University, Guangzhou, 511436, People’s Republic of China
| | - Ting Liu
- Guangzhou Key Laboratory of Enhanced Recovery after Abdominal Surgery, Innovation Center for Advanced Interdisciplinary Medicine, the Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, People’s Republic of China
- Correspondence: Ting Liu; Zhihua Liu, Email ;
| | - Zhihua Liu
- Department of Anorectal Surgery, the Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, People’s Republic of China
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17
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Fung TT, Li Y, Bromage S, Bhupathiraju SN, Batis C, Fawzi W, Holmes MD, Stampfer M, Hu FB, Deitchler M, Willett WC. Higher Global Diet Quality Score Is Associated with Less 4-Year Weight Gain in US Women. J Nutr 2021; 151:162S-167S. [PMID: 34689192 PMCID: PMC8542092 DOI: 10.1093/jn/nxab170] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/21/2021] [Accepted: 05/05/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND We have developed a simple and globally applicable tool, the Global Diet Quality Score (GDQS), to measure diet quality. OBJECTIVES To test the utility of the GDQS, we examined the associations of the GDQS with weight change and risk of obesity in US women. METHODS Health, lifestyle, and diet information were collected from women (n = 68,336) in the Nurses' Health Study II (aged 27-44 y in 1991) through repeated questionnaires (1991-2015). The GDQS has 25 food groups (maximum = 49 points) and scoring higher points reflects a healthier diet. The association between GDQS change in 4-y intervals and concurrent weight change was computed with linear models adjusted for confounders. RESULTS Mean ± SD weight gain across 4-y periods was 1.68 ± 6.26 kg. A >5-point improvement in GDQS was associated with -1.13 kg (95% CI: -1.19, -0.77 kg) weight gain compared with a score change of <±2 points. For each 5-point increase, weight gain was 0.83 kg less for age <50 y compared with 0.71 kg less for age ≥50 y (P-interaction < 0.05). A >5-point score decrease was associated with 1.13 kg (95% CI: 1.04, 1.22 kg) more weight gain in women aged <50 y and 0.81 kg more (95% CI: 0.63, 0.98 kg) in women aged ≥50 y. Compared with little change in score, obesity RR was 0.77 (95% CI: 0.74, 0.81) for a >5-point increase and 1.32 (95% CI: 1.26, 1.37) for a >5-point decrease. Risk of obesity did not differ by age. Compared with other diet quality scores, the Alternate Healthy Eating Index-2010 had somewhat stronger associations than the GDQS (P < 0.05) but the GDQS had stronger associations than the Minimum Dietary Diversity for Women score (P < 0.05). CONCLUSIONS Improvement of diet quality as measured by the GDQS was associated with less weight gain and risk of obesity in US women. The association was stronger for women aged <50 y. Associations similar in direction and magnitude were observed between the GDQS and obesity across age groups.
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Affiliation(s)
- Teresa T Fung
- Department of Nutrition, Simmons University, Boston, MA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Yanping Li
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Sabri Bromage
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Shilpa N Bhupathiraju
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Carolina Batis
- CONACYT—Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Wafaie Fawzi
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Michelle D Holmes
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Meir Stampfer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Megan Deitchler
- Intake—Center for Dietary Assessment, FHI Solutions, Washington, DC, USA
| | - Walter C Willett
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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18
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Santaularia NJ, Baker MR, Erickson D, Frazier P, Laska MN, Lust K, Mason SM. Classes of lifetime adversity in emerging adult women and men and their associations with weight status. Prev Med 2021; 146:106455. [PMID: 33636192 PMCID: PMC8149137 DOI: 10.1016/j.ypmed.2021.106455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 02/04/2021] [Accepted: 02/06/2021] [Indexed: 11/17/2022]
Abstract
The aim of this paper was to better understand how child and adult adversities cluster together into classes, and how these classes relate to body weight and obesity. Analyses included 2015 and 2018 data from emerging adults (18-25 years old) who participated in a state surveillance system of 2- and 4-year college students in Minnesota (N = 7475 in 2015 and N = 6683 in 2018). Latent Class Analyses (LCA) of 12 child and adult adversities were run stratified by gender and replicated between 2015 and 2018. The distal outcome procedure and three-step Bolck-Croon-Hagenaars approach were used to estimate predicted BMI means and predicted probabilities of obesity for each class, adjusted for covariates. The LCA identified seven classes in women and 5 in men. In women, BMI ranged from 23.9 kg/m2 in the lowest-BMI class ("Adult Adversities and Childhood Household Dysfunction"; 95% CI: 22.6-25.1) to 27.3 kg/m2 in the highest-BMI class ("High Lifetime Adversities"; 95% CI: 25.9-28.7), a statistically significant difference of 3.4 kg/m2. In men, the adjusted BMIs ranged from 24.6 kg/m2 ("Low Adversities"; 95% CI: 24.3-25.0) to 26.0 kg/m2 ("Childhood Household Mental Illness"; 95% CI: 25.1-26.9), a statistically significant difference of 1.4 kg/m2. The pattern was similar for obesity. These results indicate that specific classes of child and adult adversities are strongly associated with BMI and obesity, particularly in women. A key contribution of LCA appeared to be identification of small classes at high risk for excess weight.
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Affiliation(s)
- N Jeanie Santaularia
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St Unit 300, Minneapolis, MN 55454, United States of America; Minnesota Population Center, University of Minnesota, 225 19th Ave S #50th, Minneapolis, MN 55455, United States of America.
| | - Majel R Baker
- Department of Psychology, University of Minnesota, 75 E River Rd, Minneapolis, MN 55455, United States of America
| | - Darin Erickson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St Unit 300, Minneapolis, MN 55454, United States of America
| | - Patricia Frazier
- Department of Psychology, University of Minnesota, 75 E River Rd, Minneapolis, MN 55455, United States of America
| | - Melissa N Laska
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St Unit 300, Minneapolis, MN 55454, United States of America
| | - Katherine Lust
- Boynton Health, University of Minnesota, 410 Church St SE, Minneapolis, MN 55455, United States of America
| | - Susan M Mason
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St Unit 300, Minneapolis, MN 55454, United States of America
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Quiñones-Ossa GA, Lobo C, Garcia-Ballestas E, Florez WA, Moscote-Salazar LR, Agrawal A. Obesity and Stroke: Does the Paradox Apply for Stroke? Neurointervention 2021; 16:9-19. [PMID: 33389919 PMCID: PMC7946563 DOI: 10.5469/neuroint.2020.00108] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 11/04/2020] [Accepted: 11/11/2020] [Indexed: 12/14/2022] Open
Abstract
Historically, obesity has been identified as one of the most important risk factors for developing cardiovascular diseases including stroke; however, a theory called "The Obesity Paradox" has been recently considered. The paradoxical theory is that obese or overweight patients (according to body mass index score) can have better outcomes compared to leaner or malnourished patients. The paradox was initially discovered in patients with heart failure. The purpose of this manuscript was to investigate whether this paradox also applies to stroke patients, according to information available in the current literature.
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Affiliation(s)
- Gabriel A Quiñones-Ossa
- Faculty of Medicine, University El Bosque, Bogota, Colombia
- Centro de Investigaciones Biomedicas (CIB), Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | - Carolina Lobo
- Faculty of Medicine, University El Bosque, Bogota, Colombia
| | - Ezequiel Garcia-Ballestas
- Consejo Latinoamericano de Neurointensivismo (CLaNi), Cartagena, Colombia
- Centro de Investigaciones Biomedicas (CIB), Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | - William A Florez
- Centro de Investigaciones Biomedicas (CIB), Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | - Luis Rafael Moscote-Salazar
- Consejo Latinoamericano de Neurointensivismo (CLaNi), Cartagena, Colombia
- Centro de Investigaciones Biomedicas (CIB), Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | - Amit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Madhya Pradesh, India
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20
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Feng L, Han Y, Wang Y, Li G, Wang G. Remote medulla ablongata ventral acute subarachnoid hemorrhage following cervical spinal surgery: A case report. Int J Surg Case Rep 2021; 80:105675. [PMID: 33639502 PMCID: PMC7921496 DOI: 10.1016/j.ijscr.2021.105675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/11/2021] [Accepted: 02/13/2021] [Indexed: 11/30/2022] Open
Abstract
Remote intracranial hemorrhage (RICH) in patients during spinal surgery is rare. Our case was a man with subarachnoid hemorrhage due to cervical spinal surgery. The pathomechanism leading to RICH is probably due to rapid leak of CSF. Treatment for RICH depends on the size of hematoma and symptoms.
Introduction The incidence of remote intracranial hemorrhage (RICH) in patients during spinal surgery is rare and the detailed mechanism remains unclear. Presentation of case A 55-year-old man had undergone cervical discectomy and fusion at C5–6 and C6–7 due to herniated disc and secondary spinal canal stenosis. He had severe headache 20 h postoperatively and his drain output increased from 100 to 350 mL in the second 10 h after surgery. Computed tomography (CT) and magnetic resonance imaging (MRI) were performed and he was diagnosed with acute subarachnoid hemorrhage in the ventral medulla oblongata. The drainage tube was quickly removed. Infusion of hypertonic saline was used to reduce intracranial pressure and nimodipine prevented vasospasm around the brainstem. The patient made a gradual, satisfactory recovery with conservative treatment. Discussion The most likely pathomechanism leading to RICH is venous bleeding due to rapid leak of a large amount of cerebral spinal fluid (CSF) after spinal surgery. If the patient has a headache or neurological complaints after spinal surgery, immediate imaging is recommended to confirm the diagnosis. Treatment depends on the amount and location of intracranial hemorrhage. Conclusion RICH is a serious but rare complication of spinal surgery and cerebellar hemorrhage is the most common. The most important pathomechanism leading to RICH after spinal surgery is venous bleeding due to rapid leak of a large amount of CSF. Timely CT is necessary to exclude RICH. Treatment of RICH depends on the size of the intracranial hematoma and the patient’s symptoms.
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Affiliation(s)
- Lu Feng
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin, 130021, PR China
| | - Yanwu Han
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin, 130021, PR China
| | - Yanjuan Wang
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin, 130021, PR China
| | - Guanglin Li
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin, 130021, PR China
| | - Guangming Wang
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin, 130021, PR China.
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21
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Morais Filho ABD, Rego TLDH, Mendonça LDL, Almeida SSD, Nóbrega MLD, Palmieri TDO, Giustina GZD, Melo JP, Pinheiro FI, Guzen FP. The physiopathology of spontaneous hemorrhagic stroke: a systematic review. Rev Neurosci 2021; 32:631-658. [PMID: 33594841 DOI: 10.1515/revneuro-2020-0131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/22/2021] [Indexed: 12/29/2022]
Abstract
Hemorrhagic stroke (HS) is a major cause of death and disability worldwide, despite being less common, it presents more aggressively and leads to more severe sequelae than ischemic stroke. There are two types of HS: Intracerebral Hemorrhage (ICH) and Subarachnoid Hemorrhage (SAH), differing not only in the site of bleeding, but also in the mechanisms responsible for acute and subacute symptoms. This is a systematic review of databases in search of works of the last five years relating to the comprehension of both kinds of HS. Sixty two articles composed the direct findings of the recent literature and were further characterized to construct the pathophysiology in the order of events. The road to the understanding of the spontaneous HS pathophysiology is far from complete. Our findings show specific and individual results relating to the natural history of the disease of ICH and SAH, presenting common and different risk factors, distinct and similar clinical manifestations at onset or later days to weeks, and possible complications for both.
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22
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Zou X, Wang L, Xiao L, Xu Z, Yao T, Shen M, Zeng Y, Zhang L. Deciphering the Irregular Risk of Stroke Increased by Obesity Classes: A Stratified Mendelian Randomization Study. Front Endocrinol (Lausanne) 2021; 12:750999. [PMID: 34925231 PMCID: PMC8671740 DOI: 10.3389/fendo.2021.750999] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To investigate the relationship between different classes of obesity and stroke, we conducted a stratified Mendelian randomization (MR) study. METHODS The body mass index (BMI) data of 263,407 Europeans with three classes of obesity (obesity class I, 30 kg/m2 ≤ BMI < 35 kg/m2; obesity class II, 35 kg/m2 ≤ BMI < 40 kg/m2; obesity class III, 40 kg/m2 ≤ BMI) were extracted from the Genetic Investigation of ANthropometric Traits (GIANT) consortium. Summary-level data of stroke and its subtypes [ischemic stroke (IS) and intracerebral hemorrhage (ICH)] were obtained from the genome-wide association study (GWAS) meta-analysis, which was performed by the MEGASTROKE consortium. MR methods were used to identify the causal relationships. RESULTS The MR analysis revealed that both obesity class I [odds ratio (OR) = 1.08, 95% CI: 1.05-1.12, p = 1.0 × 10-5] and obesity class II (OR = 1.06, 95% CI: 1.03-1.09, p = 1 × 10-4) were significantly positively related to IS, while obesity class III was not (OR = 1.01, 95% CI: 0.96-1.06, p = 0.65). In contrast to IS, there was no class of obesity associated with ICH risk. Further examination of the relationship between obesity classification and IS subtypes revealed that certain degrees of obesity were related to large artery stroke (LAS) (OR = 1.14, 95% CI: 1.04-1.24, p = 2.8 × 10-3 for class I; OR = 1.08, 95% CI: 1.01-1.16, p = 0.002 for class II) and cardioembolic stroke (CES) (OR = 1.11, 95% CI: 1.02-1.20, p = 0.02 for class I; OR = 1.08, 95% CI: 1.02-1.15, p = 0.007 for class II). CONCLUSIONS A higher risk of IS, but not ICH, could be linked to obesity classes I and II. A strong association between LAS and CES and obesity was observed among all IS subtypes in the obese population.
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Affiliation(s)
- Xuelun Zou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Leiyun Wang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, China
| | - Linxiao Xiao
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Zihao Xu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Tianxing Yao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Minxue Shen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yi Zeng
- Department of Geriatrics, Second Xiangya Hospital, Central South University, Changsha, China
| | - Le Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
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Prestgaard E, Mariampillai J, Engeseth K, Erikssen J, Bodegård J, Liestøl K, Kjeldsen S, Grundvold I, Berge E. Change in Body Weight and Long-Term Risk of Stroke and Death in Healthy Men. Stroke 2020; 51:1435-1441. [DOI: 10.1161/strokeaha.119.027233] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background and Purpose—
The importance of weight change for the risk of stroke is not well known. We examined the associations between early- and mid-life weight change and risks of stroke and death during long-term follow-up of healthy men.
Methods—
We recruited healthy men aged between 40 and 59 years and performed a cardiovascular examination at baseline and again at 7 years. We collected data on weight change since the age of 25 (early-life weight change) and measured weight change from baseline to the visit at 7 years (mid-life weight change). For both weight change periods, participants were divided into the following categories: weight loss, weight gain 0 to 4.9 kg, weight gain 5 to 9.9 kg, and weight gain ≥10 kg. Data on stroke and death were collected up to 35 years, from study visits, hospital records, and the National Cause of Death Registry. We used Cox regression to analyze the associations between weight change during early-life and mid-life and risks of stroke and death.
Results—
Of the 2014 participants, 2014 (100%) had data on early-life weight change and were followed for a median of 30.1 years, while 1403 had data on mid-life weight change and were followed for a median of 24.6 years. During early-life, compared with those who had weight gain 0 to 4.9 kg, hazard ratio for stroke was 1.46 (95% CI, 1.09–1.95) among those with weight gain 5 to 9.9 kg, 1.39 (95% CI, 1.03–1.87) for those with weight gain ≥10 kg, and 1.46 (95% CI, 0.99–2.11) among those with weight loss. For all-cause death, the hazard ratios were 1.08 (95% CI, 0.92–1.23), 1.14 (95% CI, 0.98–1.33), and 1.29 (95% CI, 1.06–1.56), respectively. During mid-life, there were no significant differences in risk of stroke or death between the groups.
Conclusions—
Weight increase during early-life, but not mid-life, seems to be associated with increased long-term risk of stroke in healthy men. If these findings can be confirmed, efforts to prevent weight increase should target the younger population.
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Affiliation(s)
- Erik Prestgaard
- From the Institute of Clinical Medicine (E.P., J.E., S.K.), University of Oslo, Norway
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway (E.P., J.M., K.E., J.B., S.K., I.G., E.B.)
| | - Julian Mariampillai
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway (E.P., J.M., K.E., J.B., S.K., I.G., E.B.)
| | - Kristian Engeseth
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway (E.P., J.M., K.E., J.B., S.K., I.G., E.B.)
| | - Jan Erikssen
- From the Institute of Clinical Medicine (E.P., J.E., S.K.), University of Oslo, Norway
| | - Johan Bodegård
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway (E.P., J.M., K.E., J.B., S.K., I.G., E.B.)
| | - Knut Liestøl
- Department of Informatics (K.L.), University of Oslo, Norway
| | - Sverre Kjeldsen
- From the Institute of Clinical Medicine (E.P., J.E., S.K.), University of Oslo, Norway
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway (E.P., J.M., K.E., J.B., S.K., I.G., E.B.)
| | - Irene Grundvold
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway (E.P., J.M., K.E., J.B., S.K., I.G., E.B.)
| | - Eivind Berge
- Department of Cardiology, Oslo University Hospital, Ullevål, Norway (E.P., J.M., K.E., J.B., S.K., I.G., E.B.)
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Blueberry and cardiovascular disease risk factors: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2020; 53:102389. [PMID: 33066847 DOI: 10.1016/j.ctim.2020.102389] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND AIMS Cardiovascular disease (CVD) remains an important cause of mortality and morbidity that can be prevented by the consumption of healthy foods. These include blueberry, a dark coloured berry containing extremely high amounts of functional ingredients. We therefore examined the extent to which supplementation with blueberry effects on CVD risk indices. METHODS We searched the ISI Web of Science, Scopus, PubMed and Cochrane Library on March 2020 and checked reference lists from primary studies and review articles for any additional studies. No language restrictions were applied. All randomized and controlled clinical trials (RCTs) using blueberry supplements to modify CVD risk factors were included in our analysis. RESULTS Mean Difference (MD) was pooled using a random effects model and 11 studies were included in the final analysis. Pooled effect size showed that supplementation with blueberry had a small insignificant effect in reducing plasma triglycerides (MD = -0.27 mmol/l; 95 % CI: -0.57, 0.17, p = 0.06). Although current study found no differences between blueberry and control groups for any other outcomes, subgroup analysis suggested a favourable impact of blueberry on reducing body weight. Significant weight loss was indicated from studies longer with a follow up of more than 6 weeks or with blueberry powder or freeze-dried blueberry. CONCLUSION Current evidence is insufficient to show a benefit of blueberry supplements in modifying CVD risk factors across a variety of adult populations. Robust data and larger studies are required to assess potential effects.
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Marini S, Merino J, Montgomery BE, Malik R, Sudlow CL, Dichgans M, Florez JC, Rosand J, Gill D, Anderson CD. Mendelian Randomization Study of Obesity and Cerebrovascular Disease. Ann Neurol 2020; 87:516-524. [PMID: 31975536 PMCID: PMC7392199 DOI: 10.1002/ana.25686] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/19/2020] [Accepted: 01/20/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To systematically investigate causal relationships between obesity and cerebrovascular disease and the extent to which hypertension and hyperglycemia mediate the effect of obesity on cerebrovascular disease. METHODS We used summary statistics from genome-wide association studies for body mass index (BMI), waist-to-hip ratio (WHR), and multiple cerebrovascular disease phenotypes. We explored causal associations with 2-sample Mendelian randomization (MR) accounting for genetic covariation between BMI and WHR, and we assessed what proportion of the association between obesity and cerebrovascular disease was mediated by systolic blood pressure (SBP) and blood glucose levels, respectively. RESULTS Genetic predisposition to higher BMI did not increase the risk of cerebrovascular disease. In contrast, for each 10% increase in WHR there was a 75% increase (95% confidence interval [CI] = 44-113%) in risk for large artery ischemic stroke, a 57% (95% CI = 29-91%) increase in risk for small vessel ischemic stroke, a 197% increase (95% CI = 59-457%) in risk of intracerebral hemorrhage, and an increase in white matter hyperintensity volume (β = 0.11, 95% CI = 0.01-0.21). These WHR associations persisted after adjusting for genetic determinants of BMI. Approximately one-tenth of the observed effect of WHR was mediated by SBP for ischemic stroke (proportion mediated: 12%, 95% CI = 4-20%), but no evidence of mediation was found for average blood glucose. INTERPRETATION Abdominal adiposity may trigger causal pathological processes, partially independent from blood pressure and totally independent from glucose levels, that lead to cerebrovascular disease. Potential targets of these pathological processes could represent novel therapeutic opportunities for stroke. ANN NEUROL 2020;87:516-524.
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Affiliation(s)
- Sandro Marini
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Boston University Medical Center, Boston, MA, USA
| | - Jordi Merino
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Vascular Medicine and Metabolism Unit, Research Unit on Lipids and Atherosclerosis, Sant Joan University Hospital, Universitat Rovira i Virgili, IISPV, CIBERDEM, Reus, Spain
| | | | - Rainer Malik
- Institute for Stroke and Dementia Research (ISD), University Hospital of Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Catherine L. Sudlow
- Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital of Ludwig-Maximilians-University (LMU), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Centre for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Jose C. Florez
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Programs in Metabolism and Medical & Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Jonathan Rosand
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Programs in Metabolism and Medical & Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Christopher D. Anderson
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Programs in Metabolism and Medical & Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
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26
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Bertomeu-Gonzalez V, Moreno-Arribas J, Esteve-Pastor MA, Roldán-Rabadán I, Muñiz J, Raña-Míguez P, Ruiz-Ortiz M, Cequier Á, Bertomeu-Martínez V, Badimón L, Anguita M, Lip GYH, Marín F. Association of Body Mass Index With Clinical Outcomes in Patients With Atrial Fibrillation: A Report From the FANTASIIA Registry. J Am Heart Assoc 2019; 9:e013789. [PMID: 31870235 PMCID: PMC6988150 DOI: 10.1161/jaha.119.013789] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Obesity and atrial fibrillation (AF) frequently coexist and independently increase mortality. We sought to assess the association between obesity and adverse events in patients receiving oral anticoagulants for AF. Methods and Results Consecutive AF outpatients receiving anticoagulant agents (both vitamin K antagonists and direct oral anticoagulants) were recruited into the FANTASIIA (Atrial fibrillation: influence of the level and type of anticoagulation on the incidence of ischemic and hemorrhagic stroke) registry. This observational, multicenter, and prospective registry of AF patients analyzes the quality of anticoagulation, incidence of events, and differences between oral anticoagulant therapies. We analyzed baseline patient characteristics according to body mass index, normal: <25 kg/m2, overweight: 25–30 kg/m2, and obese: ≥30 kg/m2), assessing all‐cause mortality, stroke, major bleeding and major adverse cardiovascular events (a composite of ischemic stroke, myocardial infarction, and total mortality) at 3 years’ follow‐up. In this secondary prespecified substudy, the association of weight on prognosis was evaluated. We recruited 1956 patients (56% men, mean age 73.8±9.4 years): 358 (18.3%) had normal body mass index, 871 (44.5%) were overweight, and 727 (37.2%) were obese. Obese patients were younger (P<0.01) and had more comorbidities. Mean time in the therapeutic range was similar across body mass index categories (P=0.42). After a median follow‐up of 1070 days, 255 patients died (13%), 45 had a stroke (2.3%), 146 a major bleeding episode (7.5%) and 168 a major adverse cardiovascular event (8.6%). Event rates were similar between groups for total mortality (P=0.29), stroke (P=0.90), major bleeding (P=0.31), and major adverse cardiovascular events (P=0.24). On multivariate Cox analysis, body mass index was not independently associated with all‐cause mortality, cardiovascular mortality, stroke, major bleeding, or major adverse cardiovascular events. Conclusions In this prospective cohort of patients anticoagulated for AF, obesity was highly prevalent and was associated with more comorbidities, but not with poor prognosis.
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Affiliation(s)
- Vicente Bertomeu-Gonzalez
- Department of Cardiology Hospital Universitario de San Juan de Alicante Universidad Miguel Hernández Alicante Spain.,Centro de Investigación Biomédica en Red-Enfermedades Cardiovasculares: CIBER-CV Madrid Spain
| | - José Moreno-Arribas
- Department of Cardiology Hospital Universitario de San Juan de Alicante Universidad Miguel Hernández Alicante Spain.,Centro de Investigación Biomédica en Red-Enfermedades Cardiovasculares: CIBER-CV Madrid Spain
| | - María Asunción Esteve-Pastor
- Department of Cardiology Hospital Clínico Universitario Virgen de la Arrixaca Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca) Murcia Spain.,Centro de Investigación Biomédica en Red-Enfermedades Cardiovasculares: CIBER-CV Madrid Spain
| | - Inmaculada Roldán-Rabadán
- Department of Cardiology Hospital La Paz Madrid Spain.,Centro de Investigación Biomédica en Red-Enfermedades Cardiovasculares: CIBER-CV Madrid Spain
| | - Javier Muñiz
- Instituto Universitario de Ciencias de la Salud Instituto de Investigación Biomédica de A Coruña (INIBIC) Universidade da Coruña La Coruña Spain.,Centro de Investigación Biomédica en Red-Enfermedades Cardiovasculares: CIBER-CV Madrid Spain
| | | | - Martín Ruiz-Ortiz
- Department of Cardiology Hospital Universitario Reina Sofía Córdoba Spain
| | - Ángel Cequier
- Department of Cardiology Hospital de Bellvitge Barcelona Spain.,Centro de Investigación Biomédica en Red-Enfermedades Cardiovasculares: CIBER-CV Madrid Spain
| | - Vicente Bertomeu-Martínez
- Department of Cardiology Hospital Universitario de San Juan de Alicante Universidad Miguel Hernández Alicante Spain.,Centro de Investigación Biomédica en Red-Enfermedades Cardiovasculares: CIBER-CV Madrid Spain
| | - Lina Badimón
- Cardiovascular Research Center (CSIC-ICCC) Hospital de la Santa Creu i Sant Pau Barcelona Spain.,Centro de Investigación Biomédica en Red-Enfermedades Cardiovasculares: CIBER-CV Madrid Spain
| | - Manuel Anguita
- Department of Cardiology Hospital Universitario Reina Sofía Córdoba Spain
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science University of Liverpool and Liverpool Heart & Chest Hospital Liverpool United Kingdom.,Aalborg Thrombosis Research Unit Department of Clinical Medicine Aalborg University Aalborg Denmark
| | - Francisco Marín
- Department of Cardiology Hospital Clínico Universitario Virgen de la Arrixaca Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca) Murcia Spain.,Centro de Investigación Biomédica en Red-Enfermedades Cardiovasculares: CIBER-CV Madrid Spain
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Haghighatdoost F, Amini M, Aminorroaya A, Abyar M, Feizi A. Different metabolic/obesity phenotypes are differentially associated with development of prediabetes in adults: Results from a 14-year cohort study. World J Diabetes 2019; 10:350-361. [PMID: 31231458 PMCID: PMC6571483 DOI: 10.4239/wjd.v10.i6.350] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 05/10/2019] [Accepted: 05/14/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The risk of developing prediabetes based on the metabolic/obesity phenotypes has been poorly investigated.
AIM To examine the association of baseline metabolic/obesity phenotypes and their changes over time with the risk of prediabetes development.
METHODS In a population-based cohort study, 1741 adults (aged > 19 years) with normal blood glucose were followed for 14 years. Anthropometric and biochemical measures were evaluated regularly during the follow-up period. According to body mass index and metabolic health status, participants were categorized into four groups: Metabolically healthy normal weight (MHNW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUNW) and metabolically unhealthy obese (MUO). Multivariable Cox regression analysis was used to measure the risk of prediabetes according to the baseline metabolic/obesity phenotype and their changes during the follow-up.
RESULTS In the whole population with a mean (95CCI for mean) follow up duration of 12.7 years (12.6-12.9), all three MUNW, MHO, MUO groups were at higher risk for developing prediabetes compared to the MHNW group (P = 0.022). The MUNW group had the highest risk for developing prediabetes (hazard ratio (HR): 3.84, 95%CI: 1.20, 12.27). In stratified analysis by sex, no significant association was found in men, while women in the MUNW group were at the greatest risk for prediabetes (HR: 6.74, 95%CI: 1.53, 29.66). Transforming from each phenotype to MHNW or MHO was not related to the risk of prediabetes development, whereas transforming from each phenotype to MUO was associated with an increased risk of prediabetes (HR > 1; P < 0.05).
CONCLUSION Our findings indicate that MHO is not a high risk, unless it transforms into MUO over time. However, people in the MUNW group have the greatest risk for developing prediabetes, and therefore, they should be screened and treated.
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Affiliation(s)
- Fahimeh Haghighatdoost
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Masoud Amini
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Majid Abyar
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Awat Feizi
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
- Biostatistics and Epidemiology Department, School of Health, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
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Yue X, Lixia L, Yan H, Zhang P, Gui Y, Song J. Association between PDE4D polymorphism and ischemic stroke in young population. Saudi J Biol Sci 2019; 26:1023-1026. [PMID: 31303835 PMCID: PMC6600768 DOI: 10.1016/j.sjbs.2019.04.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 01/25/2023] Open
Abstract
Objective To explore the association between the polymorphisms of the phosphodiesterase (PDE) 4D gene (SNP83 and SNP87) and the risk of ischemic stroke (IS) in Chinese young population. Methods This study included 393 patients who were divided into IS group and non-IS group. Semiconductor high-throughput sequencing technology and multivariate logistic regression analysis were performed. Results In the case group, the frequency of CC genotype and C allele of the SNP83 gene was significantly higher than that in the control group. There was no significant difference in genotype frequency distribution of SNP87 between the two groups. Conclusion We found an association between SNP83 and the risk of IS in Chinese young population from northern Henan province. There was not a significant association between SNP87 and IS in Chinese young population.
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Affiliation(s)
- Xuejing Yue
- School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang 453000, China
| | - Liu Lixia
- School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang 453000, China
| | - Haiqing Yan
- The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China
| | - Ping Zhang
- The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China
| | - Yongkun Gui
- The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China
| | - Jinggui Song
- The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China
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Darke S, Duflou J, Kaye S, Farrell M, Lappin J. Body mass index and fatal stroke in young adults: A national study. J Forensic Leg Med 2019; 63:1-6. [PMID: 30822741 DOI: 10.1016/j.jflm.2019.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 01/22/2019] [Accepted: 02/04/2019] [Indexed: 01/09/2023]
Abstract
Rates of stroke and obesity have increased in recent years. This study aimed to determine the body mass index (BMI) of fatal stroke cases amongst young adults, their clinical characteristics and the association with BMI with risk factors. All cases aged 15-44 years where death was attributed to stroke for whom BMI was available were retrieved from the National Coronial Information System (1/1/2009-31/12/2016). 179 cases were identified: haemorrhagic (165), ischaemic (5), thrombotic (6), mycotic (3), embolic (0). Proportions in each BMI category were: underweight (5.6%), normal weight (37.4%), overweight (27.4%), obese (29.6%). There was a significant linear trend in the proportion of subarachnoid haemorrhages as BMI increased (p < 0.05), and between higher BMI and hypertension (p < 0.001). There were no group differences in cardiomegaly or left ventricular hypertrophy where known causes were other than hypertension, cardiomyopathy, severe coronary artery atherosclerosis, endocarditis or cerebral arteries atherosclerosis. A history of alcoholism (p < 0.01) was less likely with higher BMI. There was no association between BMI and previous stroke, diabetes, vasculitis, gravid/post-partum, tobacco use, psychostimulant use or injecting drug use. Overweight and obese cases were prominent among young fatalities of stroke. Reducing rates of obesity, and associated hypertension, would be expected to reduce the escalating stoke rates among young adults.
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Affiliation(s)
- Shane Darke
- National Drug & Alcohol Research Centre, University of New South Wales, NSW, 2052, Australia.
| | - Johan Duflou
- National Drug & Alcohol Research Centre, University of New South Wales, NSW, 2052, Australia; Sydney Medical School, University of Sydney, NSW, 2006, Australia
| | - Sharlene Kaye
- National Drug & Alcohol Research Centre, University of New South Wales, NSW, 2052, Australia
| | - Michael Farrell
- National Drug & Alcohol Research Centre, University of New South Wales, NSW, 2052, Australia
| | - Julia Lappin
- National Drug & Alcohol Research Centre, University of New South Wales, NSW, 2052, Australia; School of Psychiatry, University of New South Wales, NSW, 2052, Australia
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30
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Polivka J, Polivka J, Pesta M, Rohan V, Celedova L, Mahajani S, Topolcan O, Golubnitschaja O. Risks associated with the stroke predisposition at young age: facts and hypotheses in light of individualized predictive and preventive approach. EPMA J 2019; 10:81-99. [PMID: 30984317 DOI: 10.1007/s13167-019-00162-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 02/06/2019] [Indexed: 12/25/2022]
Abstract
Stroke is one of the most devastating pathologies of the early twenty-first century demonstrating 1-month case-fatality rates ranging from 13 to 35% worldwide. Though the majority of cases do occur in individuals at an advanced age, a persistently increasing portion of the patient cohorts is affected early in life. Current studies provide alarming statistics for the incidence of "young" strokes including adolescents. Young stroke is a multifactorial disease involving genetic predisposition but also a number of modifiable factors, the synergic combination of which potentiates the risks. The article analyzes the prevalence and impacts of "traditional" risk factors such as sedentary lifestyle, smoking, abnormal alcohol consumption, drug abuse, overweight, hypertension, abnormal sleep patterns, and usage of hormonal contraceptives, among others. Further, less explored risks such as primary vascular dysregulation and associated symptoms characteristic for Flammer syndrome (FS) are considered, and the relevance of the FS phenotype for the stroke predisposition at young age is hypothesized. Considering the high prevalence of known genetic and modifiable risk factors in the overall predisposition to the young stroke, the risk mitigating measures are recommended including innovative screening programs by application of specialized questionnaires and biomarker panels as well as educational programs adapted to the target audiences such as children, adolescents, and young adults.
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Affiliation(s)
- Jiri Polivka
- 1Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
- 2Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
- 3Department of Neurology, University Hospital Pilsen, and Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
| | - Jiri Polivka
- 3Department of Neurology, University Hospital Pilsen, and Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
| | - Martin Pesta
- 2Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
- 4Department of Biology, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
| | - Vladimir Rohan
- 3Department of Neurology, University Hospital Pilsen, and Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
| | - Libuse Celedova
- 5Department of Social and Assessment Medicine, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
| | | | - Ondrej Topolcan
- 7Department of Immunochemistry, University Hospital Pilsen, Pilsen, Czech Republic
| | - Olga Golubnitschaja
- 8Radiological Clinic, UKB, Rheinische Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
- 9Breast Cancer Research Centre, UKB, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
- 10Centre for Integrated Oncology, Cologne-Bonn, UKB, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
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31
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Bilirubin and Ischemic Stroke: Rendering the Current Paradigm to Better Understand the Protective Effects of Bilirubin. Mol Neurobiol 2019; 56:5483-5496. [PMID: 30612336 DOI: 10.1007/s12035-018-1440-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 11/21/2018] [Indexed: 01/14/2023]
Abstract
Novel and innovative methods are critical in fostering new treatments and improving clinical outcomes in patients who suffer from ischemic stroke. Bilirubin has long been considered metabolic waste that can be harmful to the body; however, it is now becoming recognized as one of the body's most potent antioxidant, anti-inflammatory, and neuroprotective molecules. These properties facilitate bilirubin's anti-atherogenic effects to impede and prevent the formation of thrombi in ischemic stroke. These functions allow for protection from neuronal injury during an ischemic state and suggest that elevated bilirubin levels may be linked to a lower rate of morbidity and mortality. Therefore, here we discuss the pathophysiology of stroke and the molecular properties of bilirubin to better understand their beneficial relationship. We outline clinical studies looking at the relationship between serum bilirubin levels and ischemic stroke prevalence. At this time, few studies have rigorously looked at the relationship between bilirubin and ischemic stroke, whether it is positive or negative. Thus, rigorous research is needed to provide evidence supporting the current studies, expand on these studies, and facilitate their translation to bedside therapy for patients who suffer from ischemic stroke.
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32
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Hadi A, Askarpour M, Miraghajani M, Symonds ME, Sheikhi A, Ghaedi E. Effects of strawberry supplementation on cardiovascular risk factors: a comprehensive systematic review and meta-analysis of randomized controlled trials. Food Funct 2019; 10:6987-6998. [DOI: 10.1039/c9fo01684h] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Based on our findings, strawberry supplements that contained 10–454 g day−1 freeze-dried/fresh strawberries and taken for 3–12 weeks can improve DBP, CRP, MDA and LDL.
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Affiliation(s)
- Amir Hadi
- Halal Research Center of IRI
- FDA
- Tehran
- Iran
- Department of Clinical Nutrition
| | - Moein Askarpour
- Department of Community Nutrition
- School of Nutritional Sciences and Dietetics
- Tehran University of Medical Sciences
- Tehran
- Iran
| | - Maryam Miraghajani
- Cancer Research Center
- Shahid Beheshti University of Medical Sciences
- Tehran
- Iran
- The Early Life Research Unit
| | - Michael E. Symonds
- The Early Life Research Unit
- Academic Division of Child Health
- Obstetrics and Gynaecology
- and Nottingham Digestive Disease Centre and Biomedical Research Centre
- The School of Medicine
| | - Ali Sheikhi
- Department of Community Nutrition
- School of Nutritional Sciences and Dietetics
- Tehran University of Medical Sciences
- Tehran
- Iran
| | - Ehsan Ghaedi
- Students’ Scientific Research Center (SSRC)
- Tehran University of Medical Sciences (TUMS)
- Tehran
- Iran
- Department of Cellular and Molecular Nutrition
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Xiong L, Liu W, Gao L, Mu Q, Liu X, Feng Y, Tang Z, Tang H, Liu H. The ANRIL Genetic Variants and Their Interactions with Environmental Risk Factors on Atherothrombotic Stroke in a Han Chinese Population. J Stroke Cerebrovasc Dis 2018; 27:2336-2347. [PMID: 29773352 DOI: 10.1016/j.jstrokecerebrovasdis.2018.04.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 04/01/2018] [Accepted: 04/15/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Ischemic stroke (IS) is considered to be a heterogeneous, multifactorial disease with a strong genetic background. This study aims to determine whether variants in the antisense noncoding RNA in the INK4 locus (ANRIL) gene are associated with IS in Han Chinese, as well as whether there is evidence of a gene-environment interactions. MATERIALS AND METHODS A case-controlled association study was conducted in which only patients with atherothrombotic stroke (ATS) were enrolled. Multifactor dimensionality reduction model was employed to screen the best interaction combinations among gene and environmental risk factors; RESULTS: A total of 405 subjects (200 cases and 205 controls) and 16 single nucleotide polymorphisms (SNPs) in ANRIL gene were included in this study. The 4 SNPs (rs1537378, rs2184061, rs7044859, and rs7865618) were found to be significantly related to ATS in Chinese Han nationality. In overall people or subjects aged 45 years or older, the GG genotype and G allele of rs1537378, the AA genotype and A allele of rs2184061 and rs7865618, and the AA genotype of rs7044859 increased the risk of ATS. In males, the GG genotype and G allele of rs1537378, the AA genotype and A allele of rs7865618, and the A allele of rs2184061 conferred a susceptibility to ATS. Additionally, the AAAGAGCAAAAAATAG haplotype exhibited an elevated risk of ATS, and a significant interaction was found in ATS susceptibility between ANRIL gene and dyslipidemia; CONCLUSIONS: The ANRIL gene was related to ATS susceptibility in a Han Chinese. Future studies should be performed with larger samples and among different ethnic populations.
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Affiliation(s)
- Li Xiong
- Department of Neurology, Nanchong Central Hospital & the Second Clinical Medical College, North Sichuan Medical College, Nanchong, China
| | - Wei Liu
- Department of Neurology, Nanbu County People's Hospital, Nanbu, China
| | - Li Gao
- Department of Neurology, The Third People's Hospital of Chengdu & the Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Qiwen Mu
- Department of Neurology, Nanchong Central Hospital & the Second Clinical Medical College, North Sichuan Medical College, Nanchong, China
| | - Xindong Liu
- Department of Neurology, Nuclear Industry 416 Hospital & the Second Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Yuhuan Feng
- Department of Neurology, Yanting County People's Hospital, Yanting, China
| | - Zhi Tang
- Department of Neurology, Yanting County People's Hospital, Yanting, China
| | - Huanyu Tang
- Department of Neurology, Yanting County People's Hospital, Yanting, China
| | - Hua Liu
- Department of Neurology, Nanchong Central Hospital & the Second Clinical Medical College, North Sichuan Medical College, Nanchong, China; Department of Neurology, The Third People's Hospital of Chengdu & the Affiliated Hospital of Southwest Jiaotong University, Chengdu, China; Department of Neurology, Yanting County People's Hospital, Yanting, China.
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34
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Zhernakova YV, Zheleznova EA, Chazova IE, Oshchepkova EV, Dolgusheva YA, Yarovaya EB, Blinova NV, Orlovsky AA, Konosova ID, Shalnova SA, Rotar’ OP, Konradi AO, Shlyakhto EV, Boytsov SA. The prevalence of abdominal obesity and the association with socioeconomic status in Regions of the Russian Federation, the results of the epidemiological study - ESSE-RF. TERAPEVT ARKH 2018. [DOI: 10.26442/terarkh201890104-22] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Abdominal obesity (AO) is a predictor of cardiovascular disease and diabetes mellitus type 2. The assessment of the disease prevalence and the study of socioeconomic status of people with this phenotype of obesity are necessary to develop effective mechanisms to combat this risk factor in the population. The aim of the study is to determine the prevalence of AO in the population and to assess the association with socioeconomic factors according to the data of the ESSE-RF study (Epidemiology of Cardiovascular diseases in the Regions of the Russian Federation). Materials and methods. The object of the study is a random population sample of men and women aged 25-64 years from 13 regions of the Russian Federation (n=21 817). Abdominal obesity in men was defined as waist circumference (WC) >94 cm, and in women - WC >80 cm. Body mass index (BMI) >30.0 kg/m2 was adopted as the criterion of common obesity. Results and discussion. The prevalence of AO in Russia was 55% (61.8% in women and 44% in men), while the percent of people with obesity, defined by BMI was significantly lower (33.4%). The number of examined patients with AO increased with age among both men and women (p
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35
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Dardiotis E, Siokas V, Sokratous M, Tsouris Z, Aloizou AM, Florou D, Dastamani M, Mentis AFA, Brotis AG. Body mass index and survival from amyotrophic lateral sclerosis: A meta-analysis. Neurol Clin Pract 2018; 8:437-444. [PMID: 30564498 DOI: 10.1212/cpj.0000000000000521] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 06/25/2018] [Indexed: 12/12/2022]
Abstract
Background Several studies have examined the relationship between body mass index (BMI) and survival from amyotrophic lateral sclerosis (ALS). Many indicate that low BMI at diagnosis or during follow-up may be associated with accelerated progression and shortened survival. This study systematically evaluated the relationship between BMI and survival in patients with ALS. Methods The PubMed database was searched to identify all available studies reporting time-to-event data. Eight studies with 6,098 patients fulfilled the eligibility criteria. BMI was considered a continuous and ordered variable. Interstudy heterogeneity was assessed by the Cochran Q test and quantified by the I2 metric. Fixed- or random-effects odds ratios summarized pooled effects after taking interstudy variability into account. Significance was set at p < 0.05. Results The ALS survival hazard ratio (HR) decreased approximately by 3% (95% confidence interval [CI]: 2%-5%) for each additional BMI unit when BMI was considered a continuous variable. When BMI was considered a categorical variable, the HRs for "normal" BMI vs "overweight" BMI and "obese" BMI were estimated to be as high as 0.91 (95% CI: 0.79-1.04) and 0.78 (95% CI: 0.60-1.01), respectively. The HR for the comparison of the "normal" BMI vs "underweight" BMI was estimated to be as high as 1.94 (95% CI: 1.42-2.65). Conclusions BMI is significantly and inversely associated with ALS survival.
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Affiliation(s)
- Efthimios Dardiotis
- Department of Neurology (ED, VS, MS, ZT, A-MA, DF, MD), Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Greece; Department of Microbiology (A-FAM), University of Thessaly, University Hospital of Larissa, Larissa, Greece; Public Health Laboratories (A-FAM), Hellenic Pasteur Institute, Athens, Greece; and Department of Neurosurgery (AGB), University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Vasileios Siokas
- Department of Neurology (ED, VS, MS, ZT, A-MA, DF, MD), Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Greece; Department of Microbiology (A-FAM), University of Thessaly, University Hospital of Larissa, Larissa, Greece; Public Health Laboratories (A-FAM), Hellenic Pasteur Institute, Athens, Greece; and Department of Neurosurgery (AGB), University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Maria Sokratous
- Department of Neurology (ED, VS, MS, ZT, A-MA, DF, MD), Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Greece; Department of Microbiology (A-FAM), University of Thessaly, University Hospital of Larissa, Larissa, Greece; Public Health Laboratories (A-FAM), Hellenic Pasteur Institute, Athens, Greece; and Department of Neurosurgery (AGB), University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Zisis Tsouris
- Department of Neurology (ED, VS, MS, ZT, A-MA, DF, MD), Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Greece; Department of Microbiology (A-FAM), University of Thessaly, University Hospital of Larissa, Larissa, Greece; Public Health Laboratories (A-FAM), Hellenic Pasteur Institute, Athens, Greece; and Department of Neurosurgery (AGB), University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Athina-Maria Aloizou
- Department of Neurology (ED, VS, MS, ZT, A-MA, DF, MD), Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Greece; Department of Microbiology (A-FAM), University of Thessaly, University Hospital of Larissa, Larissa, Greece; Public Health Laboratories (A-FAM), Hellenic Pasteur Institute, Athens, Greece; and Department of Neurosurgery (AGB), University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Desponia Florou
- Department of Neurology (ED, VS, MS, ZT, A-MA, DF, MD), Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Greece; Department of Microbiology (A-FAM), University of Thessaly, University Hospital of Larissa, Larissa, Greece; Public Health Laboratories (A-FAM), Hellenic Pasteur Institute, Athens, Greece; and Department of Neurosurgery (AGB), University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Metaxia Dastamani
- Department of Neurology (ED, VS, MS, ZT, A-MA, DF, MD), Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Greece; Department of Microbiology (A-FAM), University of Thessaly, University Hospital of Larissa, Larissa, Greece; Public Health Laboratories (A-FAM), Hellenic Pasteur Institute, Athens, Greece; and Department of Neurosurgery (AGB), University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Alexios-Fotios A Mentis
- Department of Neurology (ED, VS, MS, ZT, A-MA, DF, MD), Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Greece; Department of Microbiology (A-FAM), University of Thessaly, University Hospital of Larissa, Larissa, Greece; Public Health Laboratories (A-FAM), Hellenic Pasteur Institute, Athens, Greece; and Department of Neurosurgery (AGB), University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Alexandros G Brotis
- Department of Neurology (ED, VS, MS, ZT, A-MA, DF, MD), Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Greece; Department of Microbiology (A-FAM), University of Thessaly, University Hospital of Larissa, Larissa, Greece; Public Health Laboratories (A-FAM), Hellenic Pasteur Institute, Athens, Greece; and Department of Neurosurgery (AGB), University of Thessaly, University Hospital of Larissa, Larissa, Greece
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Miri A, Nasiri M, Zonoori S, Yarahmad F, Dabbagh-Moghadam A, Askari G, Sadeghi O, Asadi M. The association between obesity and migraine in a population of Iranian adults: a case-control study. Diabetes Metab Syndr 2018; 12:733-736. [PMID: 29706311 DOI: 10.1016/j.dsx.2018.04.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 04/09/2018] [Indexed: 12/21/2022]
Abstract
AIM To assess the association between obesity and risk of migraine with aura and features of migraine attacks among a population of Iranian adults. METHODS In this case-control study, 102 confirmed cases of migraine with aura were matched based on age and gender with 102 healthy subjects. Data on demographic characteristics and anthropometric measurements were collected from all cases and controls by the same methods. Overweight and obesity were considered as body mass index ≥25-30 kg/m2 and ≥ 30 kg/m2, respectively. Features of migraine attacks including frequency, duration and headache daily result were determined for patients based on international headache society criteria. RESULTS Mean age of subjects was 34.5 ± 7.4 years and 77.9% of them were female. Compared with subjects with normal body mass index, those with obesity had greater odds for having migraine with aura (OR: 3.06, 95% CI: 1.11-8.43). Such finding was also seen even after adjusting for confounding variables; in a way that subjects with obesity were 2.92 times more likely for having migraine with aura compared with those with normal weight (OR: 2.92, 95% CI: 1.03-8.33). Among migraine with aura patients, we found that those with obesity had higher headache daily result compared with subjects with normal weight. However, obesity was not associated with frequency and duration of migraine attacks. CONCLUSIONS We found that obesity was positively associated with risk of migraine with aura. In addition, subjects with obesity had higher headache daily result compared with those with normal weight.
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Affiliation(s)
- Ali Miri
- Department of Nutrition, School of Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Morteza Nasiri
- Department of Operation Room Technology, School of Paramedicine, Qom University of Medical Sciences, Qom, Iran
| | - Sahar Zonoori
- Department of Nursing, Brojerd School of Nursing, Lorestan University of Medical Sciences, Lorestan, Iran
| | - Fatemeh Yarahmad
- Department of Nursing, Brojerd School of Nursing, Lorestan University of Medical Sciences, Lorestan, Iran
| | - Arasb Dabbagh-Moghadam
- Department of Health, School of Health, AJA University of Medical Sciences, Tehran, Iran
| | - Gholamreza Askari
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omid Sadeghi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| | - Masoumeh Asadi
- Department of Nursing and Midwifery, Abadan School of Medical Sciences, Abadan, Iran
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37
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Chen G, Thakkar M, Robinson C, Doré S. Limb Remote Ischemic Conditioning: Mechanisms, Anesthetics, and the Potential for Expanding Therapeutic Options. Front Neurol 2018; 9:40. [PMID: 29467715 PMCID: PMC5808199 DOI: 10.3389/fneur.2018.00040] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 01/17/2018] [Indexed: 12/23/2022] Open
Abstract
Novel and innovative approaches are essential in developing new treatments and improving clinical outcomes in patients with ischemic stroke. Remote ischemic conditioning (RIC) is a series of mechanical interruptions in blood flow of a distal organ, following end organ reperfusion, shown to significantly reduce infarct size through inhibition of oxidation and inflammation. Ischemia/reperfusion (I/R) is what ultimately leads to the irreversible brain damage and clinical picture seen in stroke patients. There have been several reports and reviews about the potential of RIC in acute ischemic stroke; however, the focus here is a comprehensive look at the differences in the three types of RIC (remote pre-, per-, and postconditioning). There are some limited uses of preconditioning in acute ischemic stroke due to the unpredictability of the ischemic event; however, it does provide the identification of biomarkers for clinical studies. Remote limb per- and postconditioning offer a more promising treatment during patient care as they can be harnessed during or after the initial ischemic insult. Though further research is needed, it is imperative to discuss the importance of preclinical data in understanding the methods and mechanisms involved in RIC. This understanding will facilitate translation to a clinically feasible paradigm for use in the hospital setting.
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Affiliation(s)
- Gangling Chen
- Department of Anesthesiology, Center for Translational Research in Neurodegenerative Disease, University of Florida, Gainesville, FL, United States.,Department of Pharmacology of Chinese Materia Medica, China Pharmaceutical University, Nanjing, China
| | - Mrugesh Thakkar
- Department of Anesthesiology, Center for Translational Research in Neurodegenerative Disease, University of Florida, Gainesville, FL, United States
| | - Christopher Robinson
- McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Sylvain Doré
- Department of Anesthesiology, Center for Translational Research in Neurodegenerative Disease, University of Florida, Gainesville, FL, United States.,McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Neurology, University of Florida, Gainesville, FL, United States.,Department of Psychiatry, University of Florida, Gainesville, FL, United States.,Department of Pharmaceutics, University of Florida, Gainesville, FL, United States.,Department of Psychology, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States
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Niba LL, Atanga MB, Navti LK. A cross sectional analysis of eating habits and weight status of university students in urban Cameroon. BMC Nutr 2017; 3:55. [PMID: 32153835 PMCID: PMC7050815 DOI: 10.1186/s40795-017-0178-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 07/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The changeover from high school to university is characterized by the inability to make informed food choices and unhealthy eating habits. This study sets out to determine the prevalence of overweight/obesity, examine variations in dietary habits and assess the relationships between some dietary factors and overweight/obesity in university students. METHODS University students (N = 906, mean age 21.4 ± 2.1 years) that included 434 males and 472 females were recruited using a simple random sampling technique from six departments in two universities in a cross sectional study in the North West Region of Cameroon. Weight and height were measured and body mass index calculated. Eating habits and weekly consumption of selected food items were self-reported by the students using a pre-tested questionnaire. RESULTS The prevalence of overweight and obesity were 24.6% and 2.2% respectively. A majority (60.7%) of the students had less than three meals a day. Also, 53.4% ate fried foods, 46.0% had sweets/chocolates and 39.5% had sugar sweetened beverages twice or more times in a week. Skipping/rarely having breakfast (OR 1.8, 95% CI 1.2-2.9) and having snacks in-between meals three or more times a day (OR 2.2, 95% CI 1.4-5.5) were associated with overweight/obesity after controlling for confounding variables. In addition, skipping/rarely having breakfast (OR 2.2, 95% CI 1.3-3.5) independently predicted overweight/obesity in a model that included confounding variables and selected dietary behaviors. CONCLUSION The unhealthy eating habits exhibited by students in this study is worrying. Qualitative studies need to be carried out in the future to identify determinants (of Cameroon ethnicity) of poor eating habits in university students.
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Affiliation(s)
- Loveline L. Niba
- Department of Biochemistry, Catholic University of Cameroon (CATUC), Bamenda, P.O. Box 782, Cameroon
- Nutrition and Health Research Group (NHRG), Bamenda, Cameroon
| | - Mary B. Atanga
- Department of Nursing and Midwifery, University of Bamenda, P.O. Box 39, Bambili, Bamenda, Cameroon
| | - Lifoter K. Navti
- Department of Biochemistry, Catholic University of Cameroon (CATUC), Bamenda, P.O. Box 782, Cameroon
- Nutrition and Health Research Group (NHRG), Bamenda, Cameroon
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Yang GT, Zhao HY, Kong Y, Sun NN, Dong AQ. Study of the effects of nesfatin-1 on gastric function in obese rats. World J Gastroenterol 2017; 23:2940-2947. [PMID: 28522911 PMCID: PMC5413788 DOI: 10.3748/wjg.v23.i16.2940] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/15/2017] [Accepted: 03/02/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the effects of nesfatin-1 on gastric function in obese rats.
METHODS The obese rat model was induced by a high-fat diet. The gastric emptying rate and gastric acid secretory capacity of the rats were determined after treatment with different drug concentrations of nesfatin-1 and administration routes. Based on this, the expression of H+/K+-ATPase was measured using RT-PCR and western blot to preliminarily explore the mechanism of gastric acid secretion changes.
RESULTS Body weight, body length, and Lee’s index of the rats significantly increased in the high-fat diet-induced obese rat model. Two hours after lateral intracerebroventricular injection of nesfatin-1, the gastric emptying rate and gastric acid secretory capacity of rats decreased. Four hours after injection, both were restored to normal levels. In addition, the expression of H+/K+-ATPase decreased and moved in line with changes in gastric acid secretory capacity. This in vivo experiment revealed that intracerebroventricular injection of nesfatin-1, rather than intravenous injection, could suppress gastric function in obese rats. Moreover, its effect on the gastric emptying and gastric acid secretory capacity of rats is dose-dependent within a certain period of time.
CONCLUSION Through this research, we provide a theoretical basis for further studies on nesfatin-1, a potential anti-obesity drug.
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The proportion of cancer-related entries in PubMed has increased considerably; is cancer truly "The Emperor of All Maladies"? PLoS One 2017; 12:e0173671. [PMID: 28282418 PMCID: PMC5345838 DOI: 10.1371/journal.pone.0173671] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 02/26/2017] [Indexed: 02/07/2023] Open
Abstract
In this work, the public database of biomedical literature PubMed was mined using queries with combinations of keywords and year restrictions. It was found that the proportion of Cancer-related entries per year in PubMed has risen from around 6% in 1950 to more than 16% in 2016. This increase is not shared by other conditions such as AIDS, Malaria, Tuberculosis, Diabetes, Cardiovascular, Stroke and Infection some of which have, on the contrary, decreased as a proportion of the total entries per year. Organ-related queries were performed to analyse the variation of some specific cancers. A series of queries related to incidence, funding, and relationship with DNA, Computing and Mathematics, were performed to test correlation between the keywords, with the hope of elucidating the cause behind the rise of Cancer in PubMed. Interestingly, the proportion of Cancer-related entries that contain “DNA”, “Computational” or “Mathematical” have increased, which suggests that the impact of these scientific advances on Cancer has been stronger than in other conditions. It is important to highlight that the results obtained with the data mining approach here presented are limited to the presence or absence of the keywords on a single, yet extensive, database. Therefore, results should be observed with caution. All the data used for this work is publicly available through PubMed and the UK’s Office for National Statistics. All queries and figures were generated with the software platform Matlab and the files are available as supplementary material.
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Characteristics of Hemorrhagic Stroke following Spine and Joint Surgeries. BIOMED RESEARCH INTERNATIONAL 2017; 2017:5390839. [PMID: 28164124 PMCID: PMC5259668 DOI: 10.1155/2017/5390839] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 11/29/2016] [Accepted: 12/14/2016] [Indexed: 11/17/2022]
Abstract
Hemorrhagic stroke can occur after spine and joint surgeries such as laminectomy, lumbar spinal fusion, tumor resection, and total joint arthroplasty. Although this kind of stroke rarely happens, it may cause severe consequences and high mortality rates. Typical clinical symptoms of hemorrhagic stroke after spine and joint surgeries include headache, vomiting, consciousness disturbance, and mental disorders. It can happen several hours after surgeries. Most bleeding sites are located in cerebellar hemisphere and temporal lobe. A cerebrospinal fluid (CSF) leakage caused by surgeries may be the key to intracranial hemorrhages happening. Early diagnosis and treatments are very important for patients to prevent the further progression of intracranial hemorrhages. Several patients need a hematoma evacuation and their prognosis is not optimistic.
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