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Liu H, Zhou Y, Jin M, Hao H, Yuan Y, Jia H. The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and prevalence of urinary stones in US adults: a cross-sectional NHANES study. Int Urol Nephrol 2024:10.1007/s11255-024-04140-3. [PMID: 39008223 DOI: 10.1007/s11255-024-04140-3] [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: 03/28/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND This study examines the association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and urinary stones in American adults. METHODS We conducted a cross-sectional study utilizing the 2007-2018 National Health and Nutrition Examination Survey (NHANES) data set. The prevalence of urinary stones was determined based on patient-reported experiences of renal colic. We converted NHHR to natural logarithm (ln-NHHR) to align it better with our statistical analyses. Our analysis methods included weighted multivariate logistic regression, generalized additive model (GAM), and application of smoothed curves to better elucidate the association between ln-NHHR and the prevalence of urinary stones. In addition, we conducted subgroup analyses and employed multiple imputation for sensitivity analyses. RESULTS This study involved a total of 30,903 participants, with a 9.97% prevalence of urinary stones and reported colic experience. Elevated ln-NHHR levels were linked with a higher likelihood of urinary stones (OR = 1.20, 95% CI 1.07-1.35). Smooth curve fitting revealed an inverted U-shaped relationship, pinpointing a significant increase in urinary stone risk at ln-NHHR levels below 1.43 (OR = 1.40, 95% CI 1.19-1.64, p < 0.001). Notably, this correlation was stronger among Non-Hispanic Whites and those married or living with a partner. Multiple imputation analyses strengthened the confidence in our results. CONCLUSIONS Our findings suggest a reverse U-shaped association between urinary stone occurrence and NHHR level, with a positive association at ln-NHHR < 1.43. This correlation was more pronounced in the Non-Hispanic White population and among those married or living with a partner.
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Affiliation(s)
- Heng Liu
- Department of Urology, Renmin Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, People's Republic of China
| | - Yu Zhou
- Department of Urology, Renmin Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, People's Republic of China
| | - Mingchu Jin
- Department of Urology, Renmin Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, People's Republic of China
| | - Haidong Hao
- Department of Urology, Renmin Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, People's Republic of China
| | - Yutang Yuan
- Department of Urology, Renmin Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, People's Republic of China
| | - Hongtao Jia
- Department of Urology, Renmin Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, People's Republic of China.
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Qian S, Shi Y, Senfeld J, Peng Q, Shen J. The P2Y 2 receptor mediates terminal adipocyte differentiation and insulin resistance: Evidence for a dual G-protein coupling mode. J Biol Chem 2024; 300:105589. [PMID: 38141758 PMCID: PMC10828443 DOI: 10.1016/j.jbc.2023.105589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 11/29/2023] [Accepted: 12/12/2023] [Indexed: 12/25/2023] Open
Abstract
Several P2Y nucleotide receptors have been shown to be involved in the early stage of adipocyte differentiation in vitro and insulin resistance in obese mice; however, the exact receptor subtype(s) and its underlying molecular mechanism in relevant human cells are unclear. Here, using human primary visceral preadipocytes as a model, we found that during preadipocyte-to-mature adipocyte differentiation, the P2Y2 nucleotide receptor (P2Y2R) was the most upregulated subtype among the eight known P2Y receptors and the only one further dramatically upregulated after inflammatory TNFα treatment. Functional studies indicated that the P2Y2R induced intracellular Ca2+, ERK1/2, and JNK signaling but not the p38 pathway. In addition, stimulation of the P2Y2R suppressed basal and insulin-induced phosphorylation of AKT, accompanied by decreased GLUT4 membrane translocation and glucose uptake in mature adipocytes, suggesting a role of P2Y2R in insulin resistance. Mechanistically, we found that activation of P2Y2R did not increase lipolysis but suppressed PIP3 generation. Interestingly, activation of P2Y2R triggered Gi-protein coupling, and pertussis toxin pretreatment largely inhibited P2Y2R-mediated ERK1/2 signaling and cAMP suppression. Further, treatment of the cells with AR-C 118925XX, a selective P2Y2R antagonist, significantly inhibited adipogenesis, and P2Y2R knockout decreased mouse body weight gain with smaller eWAT mass infiltrated with fewer macrophages as compared to WT mice in response to a Western diet. Thus, we revealed that terminal adipocyte differentiation and inflammation selectively upregulate P2Y2R expression and that P2Y2R mediates insulin resistance by suppressing the AKT signaling pathway, highlighting P2Y2R as a potential new drug target to combat obesity and type-2 diabetes.
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Affiliation(s)
- Shenqi Qian
- Department of Drug Discovery and Development, Harrison College of Pharmacy, Auburn University, Auburn, Alabama, USA; Department of Pharmacy, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yi Shi
- Department of Drug Discovery and Development, Harrison College of Pharmacy, Auburn University, Auburn, Alabama, USA
| | - Jared Senfeld
- Department of Drug Discovery and Development, Harrison College of Pharmacy, Auburn University, Auburn, Alabama, USA
| | - Qianman Peng
- Department of Drug Discovery and Development, Harrison College of Pharmacy, Auburn University, Auburn, Alabama, USA
| | - Jianzhong Shen
- Department of Drug Discovery and Development, Harrison College of Pharmacy, Auburn University, Auburn, Alabama, USA.
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Ahmad SS, Chun HJ, Ahmad K, Choi I. Therapeutic applications of ginseng for skeletal muscle-related disorder management. J Ginseng Res 2024; 48:12-19. [PMID: 38223826 PMCID: PMC10785254 DOI: 10.1016/j.jgr.2023.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/01/2023] [Accepted: 06/09/2023] [Indexed: 01/14/2024] Open
Abstract
Skeletal muscle (SM) is the largest organ of the body and is largely responsible for the metabolism required to maintain body functions. Furthermore, the maintenance of SM is dependent on the activation of muscle satellite (stem) cells (MSCs) and the subsequent proliferation and fusion of differentiating myoblasts into mature myofibers (myogenesis). Natural compounds are being used as therapeutic options to promote SM regeneration during aging, muscle atrophy, sarcopenia, cachexia, or obesity. In particular, ginseng-derived compounds have been utilized in these contexts, though ginsenoside Rg1 is mostly used for SM mass management. These compounds primarily function by activating the Akt/mTOR signaling pathway, upregulating myogenin and MyoD to induce muscle hypertrophy, downregulating atrophic factors (atrogin1, muscle ring-finger protein-1, myostatin, and mitochondrial reactive oxygen species production), and suppressing the expressions of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in cachexia. Ginsenoside compounds are also used for obesity management, and their anti-obesity effects are attributed to peroxisome proliferator activated receptor gamma (PPARγ) inhibition, AMPK activation, glucose transporter type 4 (GLUT4) translocation, and increased phosphorylations of insulin resistance (IR), insulin receptor substrate-1 (IRS-1), and Akt. This review was undertaken to provide an overview of the use of ginseng-related compounds for the management of SM-related disorders.
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Affiliation(s)
- Syed Sayeed Ahmad
- Department of Medical Biotechnology, Yeungnam University, Gyeongsan, Republic of Korea
- Research Institute of Cell Culture, Yeungnam University, Gyeongsan, Republic of Korea
| | - Hee Jin Chun
- Department of Medical Biotechnology, Yeungnam University, Gyeongsan, Republic of Korea
| | - Khurshid Ahmad
- Department of Medical Biotechnology, Yeungnam University, Gyeongsan, Republic of Korea
- Research Institute of Cell Culture, Yeungnam University, Gyeongsan, Republic of Korea
| | - Inho Choi
- Department of Medical Biotechnology, Yeungnam University, Gyeongsan, Republic of Korea
- Research Institute of Cell Culture, Yeungnam University, Gyeongsan, Republic of Korea
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Liu H, Ma Y, Shi L. Higher weight-adjusted waist index is associated with increased likelihood of kidney stones. Front Endocrinol (Lausanne) 2023; 14:1234440. [PMID: 37800142 PMCID: PMC10548222 DOI: 10.3389/fendo.2023.1234440] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/29/2023] [Indexed: 10/07/2023] Open
Abstract
Objectives The objective of this study was to evaluate the association between weight-adjusted waist index (WWI) and the prevalence of kidney stones among adults in the United States. Methods The cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2007-2018. A total of 31,344 participants were categorized into two groups: those with kidney stones and those without. WWI was determined by dividing waist circumference (cm) by the square root of body weight (kg). To examine the relationship between kidney stones and WWI, multivariate logistic regression models, smoothed curve fitting, and weighted generalized additive model (GAM) regression were employed. Subgroup analysis and interaction tests were conducted to explore the stability of this association across different groups. Results The final analysis comprised a total of 31,344 participants, including 2,928 individuals who had a history of kidney stones. In the fully adjusted model, an increase in WWI exhibited a positive correlation with the prevalence of kidney stones (OR=1.34, 95% CI: 1.18-1.51). When WWI was converted into quartiles (Q1-Q4), participants in the highest quartile (Q4) had a 69% greater risk of developing kidney stones compared to those in the lowest quartile (Q1) (OR=1.69, 95% CI: 1.28-2.25). This positive association was particularly notable among non-diabetic patients. Conclusion Our study demonstrates a significant positive association between weight-adjusted waist index levels and an elevated prevalence of kidney stones among US adults. Furthermore, this research highlights the potential utility of weight-adjusted waist index in the prevention of kidney stones in the overall population. This relationship is limited and further research is needed to test this hypothesis.
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Affiliation(s)
- Hangyu Liu
- Department of Plastic Surgery and Burn Center, the Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Yang Ma
- Department of Plastic Surgery, Meizhou Clinical Institute of Shantou University Medical College, Meizhou, Guangdong, China
| | - Lungang Shi
- Department of Plastic Surgery, Meizhou Clinical Institute of Shantou University Medical College, Meizhou, Guangdong, China
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Seidu S, Abdool M, Almaqhawi A, Wilkinson TJ, Kunutsor SK, Khunti K, Yates T. Physical activity and risk of chronic kidney disease: systematic review and meta-analysis of 12 cohort studies involving 1,281,727 participants. Eur J Epidemiol 2023; 38:267-280. [PMID: 36626101 PMCID: PMC10033580 DOI: 10.1007/s10654-022-00961-7] [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: 08/12/2022] [Accepted: 12/26/2022] [Indexed: 01/11/2023]
Abstract
The role of regular physical activity in preventing vascular and non-vascular disease is well established. Chronic kidney disease (CKD) is a major cause of global morbidity and mortality and largely preventable, but it is uncertain if regular physical activity can reduce the risk of CKD. Using a systematic review and meta-analysis of published observational cohort studies in the general population, we sought to assess the association between physical activity and CKD risk. Relevant studies with at least one-year of follow-up were sought from inception until 02 May 2022 in MEDLINE, Embase, Web of Science, and manual search of relevant articles. Relative risks (RRs) with 95% confidence intervals (CIs) for the maximum versus the minimal amount of physical activity groups were pooled using random effects meta-analysis. The quality of the evidence was evaluated using the GRADE tool. A total of 12 observational cohort studies comprising 1,281,727 participants and 66,217 CKD events were eligible for the analysis. The pooled multivariable-adjusted RR (95% CI) of CKD comparing the most versus the least physically active groups was 0.91 (0.85-0.97). The association was consistent across several study level subgroups. Exclusion of any single study at a time from the meta-analysis did not change the direction or significance of the association. There was no evidence of small study effects among contributing studies. The GRADE quality of the evidence was low. In the general population, individuals who are most physically active have a lowered risk of CKD compared to those who are not or least physically active. CRD42022327640.
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Affiliation(s)
- Samuel Seidu
- Diabetes Research Centre, University of Leicester, Leicester, UK.
- Hockley Farm Medical Practice, Leicester, UK.
- Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4WP, UK.
| | | | - Abdullah Almaqhawi
- Department of Family and Community Medicine, College of Medicine, King Faisal University, Dammam, Saudi Arabia
| | | | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Learning and Research Building (Level 1), Southmead Hospital, University of Bristol, Bristol, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Hockley Farm Medical Practice, Leicester, UK
| | - Tom Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK
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Kunutsor SK, Isiozor NM, Myers J, Seidu S, Khunti K, Laukkanen JA. Baseline and usual cardiorespiratory fitness and the risk of chronic kidney disease: A prospective study and meta-analysis of published observational cohort studies. GeroScience 2023:10.1007/s11357-023-00727-3. [PMID: 36646903 PMCID: PMC10400499 DOI: 10.1007/s11357-023-00727-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 01/04/2023] [Indexed: 01/18/2023] Open
Abstract
Chronic kidney disease (CKD) is a global public health burden but is largely preventable. Few studies have reported an association between high levels of cardiorespiratory fitness (CRF) and decreased risk of CKD. However, some relevant aspects of the association, such as the dose-response relationship and the long-term relevance of CRF levels to CKD, have yet to be addressed. We, therefore, aimed to quantify the nature and magnitude of the association between CRF and CKD in a cohort of 2099 men aged 42-61 years with normal kidney function at baseline. CRF was directly measured using a respiratory gas exchange analyzer during cardiopulmonary exercise testing. Hazard ratios (HRs) (95% CIs) were estimated for the incidence of CKD. Correction for within-person variability was made using data from repeat measurements of CRF taken 11 years after baseline. A total of 197 CKD events were recorded during a median follow-up of 25.8 years. The age-adjusted regression dilution ratio for CRF was 0.59 (95% CI: 0.53-0.65). The risk of CKD decreased in a graded fashion with increasing CRF. Comparing extreme tertiles of CRF, the HR (95% CI) for CKD was 0.67 (0.46-0.97) following adjustment for several established and emerging risk factors. The corresponding adjusted HR (95% CI) was 0.51 (0.27-0.96) following correction for within-person variability. In a meta-analysis of five population-based cohort studies (including the current study) comprising 32,447 participants and 4,043 CKD cases, the fully-adjusted risk ratios (95% CIs) for CKD comparing extreme tertiles of baseline and long-term CRF values were 0.58 (0.46-0.73) and 0.40 (0.27-0.59), respectively. Findings from a new prospective study and pooled analysis of previous studies plus the new study indicate that high CRF levels are strongly and independently associated with a reduced risk of CKD and consistent with a linear dose-response relationship. Using single baseline measurements of CRF to investigate the association between CRF and CKD risk could considerably underestimate the true association.
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Affiliation(s)
- Setor K Kunutsor
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4WP, UK.
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK.
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, BS10 5NB, UK.
| | - Nzechukwu M Isiozor
- Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jonathan Myers
- Cardiology Division, Veterans Affairs Palo Alto Healthcare System and Stanford University, Palo Alto, CA, USA
| | - Samuel Seidu
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, BS10 5NB, UK
| | - Kamlesh Khunti
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, BS10 5NB, UK
| | - Jari A Laukkanen
- Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland
- Central Finland Health Care District Hospital District, Department of Medicine,Jyväskylä, Finland District, Jyväskylä, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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Yang D, Chen J, Zhang T, Lin Y, Yao X, Meng L, Guo F, Chen K, Dai H, Tang M. Influencing factors of wide pulse pressure in an elderly Chinese population: A cross-sectional study. J Clin Hypertens (Greenwich) 2022; 24:1482-1490. [PMID: 36259250 DOI: 10.1111/jch.14582] [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: 07/15/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/30/2022]
Abstract
Blood pressure and pulse pressure (PP) had their own characteristics in the elderly population. This cross-sectional study including 5030 elderly participants was conducted to describe the distribution of blood pressure and wide PP in the elderly population and find influencing factors of wide PP. Wide PP was defined as PP equal to or more than 65 mmHg, and was classified three types as low systolic blood pressure (SBP) and low diastolic blood pressure (DBP) (LSLD), high SBP and low DBP (HSLD), and high SBP and high DBP (HSHD). Using multivariate logistic regression models to analyze the associations of demographic factors, health-related factors and lifestyle factors with different wide PP types. The associations of lifestyles with wide PP by gender were estimated by subgroup analyses. Among 5030 elderly participants, 2727 (54.2%) participants had wide PP. Logistic regression models showed older age (OR = 2.48, 95%CI: 2.14-2.88), female (OR = 1.31, 95%CI: 1.07-1.60), not married (OR = 1.26, 95%CI: 1.07-1.49), having chronic diseases (OR = 1.28, 95%CI: 1.09-1.50), current alcohol drinker (OR = 1.29, 95%CI: 1.11-1.50) were positively associated, and higher body height (OR = .78, 95%CI: .62-.99), higher education level (OR = .60, 95%CI: .43-.82), current smoker (OR = .79, 95%CI: .64-.97) were negatively associated with wide PP. Among three different types of wide PP including LSLD, HSLD, HSHD, these factors had different effects. Subgroup analyses found that only among male, current smoker was negatively associated and current alcohol drinker was positively associated with wide PP.
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Affiliation(s)
- Dandan Yang
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jie Chen
- Fourth Affiliated Hospital, Zhejiang University School of Medicine, Jinhua, China
| | - Tingting Zhang
- Fourth Affiliated Hospital, Zhejiang University School of Medicine, Jinhua, China
| | - Yaoyao Lin
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xuecheng Yao
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lin Meng
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Fanjia Guo
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kun Chen
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Honglei Dai
- Fourth Affiliated Hospital, Zhejiang University School of Medicine, Jinhua, China
| | - Mengling Tang
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Teshome DF, Balcha SA, Ayele TA, Atnafu A, Sisay M, Asfaw MG, Mitike G, Gelaye KA. Perceived barriers and enablers influencing health extension workers toward home-based hypertension screening in rural northwest Ethiopia: interpretive descriptive study. BMC Health Serv Res 2022; 22:1156. [PMID: 36100900 PMCID: PMC9472423 DOI: 10.1186/s12913-022-08523-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 09/01/2022] [Indexed: 11/19/2022] Open
Abstract
Background Hypertension, a major but modifiable risk factor for cardiovascular diseases, is a global health problem including Ethiopia. In a limited infrastructure task sharing of hypertension screening for community health workers is a feasible strategy to improve hypertension management. Recent finding have shown that trained health extension workers (HEWs) can identify high blood pressure, which was effective and feasible. Identifying barriers and enablers for home-based hypertension screening by HEWs is crucial for its implementation. This study aimed to explore barriers and enablers that influence health extension workers’ home-based hypertension screening in the community. Methods The interpretive descriptive design was implemented. In-depth interviews were conducted during October, 2020. A total of 26 participants including HEWs, supervisors, and heads of district health office were purposively selected. They were asked to describe their perception toward home-based hypertension screening by the HEWs. The interviews were audio-recorded, transcribed verbatim into Amharic, and translated into English. The transcripts were coded and themes were identified. Thematic approach was used for data analysis. Results The participants identified key perceived barriers and enablers of HEWs home-based hypertension screening. The most common barriers were a lack of hypertension training, blood pressure measuring devices, blood pressure guidelines and manuals, skilled HEWs, financial incentives, and poor community awareness of the disease. The most common enablers were support from community leaders, presence of functional development army and community trust for HEWs, presence of routine campaign on vaccination and community based health insurance, and an integrated health system. Conclusions Our findings have implications for the HEWs' ongoing implementation of home-based hypertension screening. Successful implementation of this strategy requires scaling up of hypertension training programs for health extension workers and their supervisors, provision of standardized protocols, provision of adequate blood pressure measuring equipment, and regular supportive supervision.
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de Lima TR, González-Chica DA, D' Orsi E, Moreno YMF, Sui X, Silva DAS. Muscle Strength Assessed by Handgrip Strength Moderates the Relationship Between Overweight and Obesity With Cardiometabolic Risk Markers Among Adults and Older Adults. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022:1-9. [PMID: 35404780 DOI: 10.1080/02701367.2021.2002246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 10/26/2021] [Indexed: 06/14/2023]
Abstract
Background and aims: Few population-based studies have studied whether muscle strength (MS) levels influence the relationship between cardiometabolic markers with excess body weight. We investigate the possible moderator role of MS in the relationship between overweight and obesity with cardiometabolic markers. Methods: Cross-sectional analysis using data from two studies in Florianópolis, Brazil (EpiFloripa Adult Cohort Study, n = 862, 39.3 ± 11.4 years; EpiFloripa Aging Cohort Study, n = 1,197, 69.7 ± 7.1 years). MS was assessed by handgrip strength. Body mass index (BMI) was classified as overweight or obesity (BMI 25.0-29.9 or ≥30.0 kg/m2, respectively). Cardiometabolic markers included systolic (SBP) and diastolic blood pressure (DBP), C-reactive protein (CRP), lipids, glucose markers, and carotid intima-media thickness (CIMT). Linear regression models stratified by age groups (adults: <60 years; older adults: ≥60 years) and adjusted for confounders were used. Results: Compared to those with a normal BMI, overweight and obesity were related to higher SBP, DBP, lnCRP, ln triglycerides, fasting glucose (FG), and glicated hemoglobin (HbA1c), and inversely associated with HDL-C among adults and older adults (p value < .05 for all). Additionally, BMI was positively associated with LDL-C and CIMT only among adults (p value < .05). Among adults and older adults, elevated MS attenuated the adverse relationship between excess body weight with FG and HbA1c. Conclusion: Higher MS might help adults and older adults with overweight or obesity reduce their cardiovascular risk by keeping their FG and HbA1c at the same levels of those with a normal BMI.
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Gao H, Jin Z, Tang K, Ji Y, Suarez J, Suarez JA, Cunha e Rocha K, Zhang D, Dillmann WH, Mahata SK, Ying W. Microbial DNA Enrichment Promotes Adrenomedullary Inflammation, Catecholamine Secretion, and Hypertension in Obese Mice. J Am Heart Assoc 2022; 11:e024561. [PMID: 35112881 PMCID: PMC9245808 DOI: 10.1161/jaha.121.024561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Obesity is an established risk factor for hypertension. Although obesity‐induced gut barrier breach leads to the leakage of various microbiota‐derived products into host circulation and distal organs, the roles of microbiota in mediating the development of obesity‐associated adrenomedullary disorders and hypertension have not been elucidated. We seek to explore the impacts of microbial DNA enrichment on inducing obesity‐related adrenomedullary abnormalities and hypertension. Methods and Results Obesity was accompanied by remarkable bacterial DNA accumulation and elevated inflammation in the adrenal glands. Gut microbial DNA containing extracellular vesicles (mEVs) were readily leaked into the bloodstream and infiltrated into the adrenal glands in obese mice, causing microbial DNA enrichment. In lean wild‐type mice, adrenal macrophages expressed CRIg (complement receptor of the immunoglobulin superfamily) that efficiently blocks the infiltration of gut mEVs. In contrast, the adrenal CRIg+ cell population was greatly decreased in obese mice. In lean CRIg−/− or C3−/− (complement component 3) mice intravenously injected with gut mEVs, adrenal microbial DNA accumulation elevated adrenal inflammation and norepinephrine secretion, concomitant with hypertension. In addition, microbial DNA promoted inflammatory responses and norepinephrine production in rat pheochromocytoma PC12 cells treated with gut mEVs. Depletion of microbial DNA cargo markedly blunted the effects of gut mEVs. We also validated that activation of cGAS (cyclic GMP‐AMP synthase)/STING (cyclic GMP–AMP receptor stimulator of interferon genes) signaling is required for the ability of microbial DNA to trigger adrenomedullary dysfunctions in both in vivo and in vitro experiments. Restoring CRIg+ cells in obese mice decreased microbial DNA abundance, inflammation, and hypertension. Conclusions The leakage of gut mEVs leads to adrenal enrichment of microbial DNA that are pathogenic to induce obesity‐associated adrenomedullary abnormalities and hypertension. Recovering the CRIg+ macrophage population attenuates obesity‐induced adrenomedullary disorders.
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Affiliation(s)
- Hong Gao
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
| | - Zhongmou Jin
- Division of Biological SciencesUniversity of California, San DiegoLa JollaCA
| | | | - Yudong Ji
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
- Department of AnesthesiologyInstitute of Anesthesiology and Critical CareUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Jorge Suarez
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
| | - Jorge A. Suarez
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
| | - Karina Cunha e Rocha
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
| | - Dinghong Zhang
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
| | - Wolfgang H. Dillmann
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
| | - Sushil K. Mahata
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
- VA San Diego Healthcare SystemSan DiegoCA
| | - Wei Ying
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
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Li G, Liang H, Hao Y, Huang Q, Shen X, Chen Y, Chen M, Xi J, Hao Z. Association between body fat distribution and kidney stones: Evidence from a US population. Front Endocrinol (Lausanne) 2022; 13:1032323. [PMID: 36277687 PMCID: PMC9585195 DOI: 10.3389/fendo.2022.1032323] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/26/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES We aimed to evaluate the relationship between the proportion of Android to Gynoid ratio and the incidence of kidney stones among US adults. METHODS Participants aged 20-59 years from the 2011-2018 National Health and Nutrition Examination Survey (NHANES) database were selected to assess the association between Android to Gynoid ratio and kidney stone prevalence using logistic regression analysis, subgroup analysis and calculation of dose-response curves. RESULTS This study ultimately included 10858 participants, of whom 859 self-reported a history of kidney stones. And after adjusting for all confounders, an increased Android to Gynoid ratio was associated with an increased prevalence of kidney stones (OR=2.75, 95% CI:1.62-4.88). And subgroup analysis showed an increased prevalence of kidney stones in women (OR=3.55, 95% CI: 1.54-8.22), non-diabetic (OR=2.59, 95% CI: 1.45-4.60), 60 > age ≥ 40 years (OR=3.51, 95% CI: 1.83-6.71), Mexican-American (OR=4.35, 95% CI: 1.40- 13.53) and white (OR=3.86, 95% CI: 1.82-8.18) groups, there was a significant positive association between A/G ratio and kidney stones. In contrast, in the hypertensive subgroup, the A/G ratio was associated with kidney stones in all groups. CONCLUSIONS Higher Android to Gynoid ratio is associated with a high prevalence of kidney stone disease.
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Affiliation(s)
- Guoxiang Li
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Urology, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Hu Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Urology, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Yunwu Hao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Urology, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Qingfeng Huang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Urology, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Xudong Shen
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Urology, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Yang Chen
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Urology, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Mingwei Chen
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- *Correspondence: Mingwei Chen, ; Junhua Xi, ; Zongyao Hao,
| | - Junhua Xi
- Department of Urology, The Second people’s Hospital of Hefei (Hefei Hospital Affiliated to Anhui Medical University), Hefei, China
- *Correspondence: Mingwei Chen, ; Junhua Xi, ; Zongyao Hao,
| | - Zongyao Hao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Institute of Urology, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
- *Correspondence: Mingwei Chen, ; Junhua Xi, ; Zongyao Hao,
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Climent E, Oliveras A, Pedro-Botet J, Goday A, Benaiges D. Bariatric Surgery and Hypertension. J Clin Med 2021; 10:jcm10184049. [PMID: 34575161 PMCID: PMC8467380 DOI: 10.3390/jcm10184049] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/25/2021] [Accepted: 09/07/2021] [Indexed: 12/14/2022] Open
Abstract
A clear pathogenetic association exists between obesity and arterial hypertension, becoming even more evident in subjects with severe obesity. Bariatric surgery has proved to be the most effective treatment for severe obesity, with its benefits going beyond weight loss. The present review aimed to determine the effects of bariatric surgery on arterial hypertension evident in short- and long-term follow-ups. Moreover, the differences between surgical techniques regarding hypertension remission are described as well as the possible pathophysiologic mechanisms involved. In addition, the effects of bariatric surgery beyond blood pressure normalization are also analyzed, including those on target organs and cardiovascular morbidity and mortality.
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Affiliation(s)
- Elisenda Climent
- Endocrinology Department, Hospital Universitari del Mar, 08003 Barcelona, Spain; (E.C.); (J.P.-B.); (A.G.)
- IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain;
- Department of Medicine, Universitat Autònoma de Barcelona, 08139 Barcelona, Spain
| | - Anna Oliveras
- IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain;
- Nephrology Department, Hospital Universitari del Mar, 08003 Barcelona, Spain
- Department of Experimental and Health Sciences, Area of Medicine, Universitat Pompeu Fabra, 08002 Barcelona, Spain
- Red de Investigación Renal (REDINREN), Instituto Carlos III-FEDER, 28029 Madrid, Spain
| | - Juan Pedro-Botet
- Endocrinology Department, Hospital Universitari del Mar, 08003 Barcelona, Spain; (E.C.); (J.P.-B.); (A.G.)
- IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain;
- Department of Medicine, Universitat Autònoma de Barcelona, 08139 Barcelona, Spain
| | - Albert Goday
- Endocrinology Department, Hospital Universitari del Mar, 08003 Barcelona, Spain; (E.C.); (J.P.-B.); (A.G.)
- IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain;
- Department of Medicine, Universitat Autònoma de Barcelona, 08139 Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Obesidad y Nutrición, CIBERobn, 28029 Madrid, Spain
| | - David Benaiges
- Endocrinology Department, Hospital Universitari del Mar, 08003 Barcelona, Spain; (E.C.); (J.P.-B.); (A.G.)
- IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain;
- Department of Medicine, Universitat Autònoma de Barcelona, 08139 Barcelona, Spain
- Consorci Sanitari de l’Alt Penedès i Garraf, 08720 Vilafranca del Penedès, Spain
- Correspondence: ; Tel.: +34-93-248-3902; Fax: +34-93-248-3254
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13
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Leisure-time, occupational, and commuting physical activity and the risk of chronic kidney disease in a working population. Sci Rep 2021; 11:12308. [PMID: 34112832 PMCID: PMC8192894 DOI: 10.1038/s41598-021-91525-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 05/28/2021] [Indexed: 11/09/2022] Open
Abstract
Physical activity has been linked to a lower risk of chronic kidney disease (CKD); however, evidence on the relationship between domain-specific physical activity and CKD is scarce. This study aimed to examine the risk of CKD in relation to leisure-time, occupational, and commuting physical activities in a large occupational cohort in Japan. Participants were 17,331 workers (20-65 years old) without CKD and were followed-up for a maximum period of 13 years. Incident CKD was defined as an estimated glomerular filtration rate of < 60 mL/min/1.73 m2 and/or proteinuria determined using the dipstick test. The Cox proportional hazards models were used to examine the associations. During 147,752 person-years of follow-up, 4013 participants developed CKD. Workers who were standing or walking at work and those who were fairly active at work had adjusted hazard ratios of 0.88 (95% confidence interval 0.86-0.96) and 0.89 (95% confidence interval 0.78-1.02), respectively, for developing CKD than sedentary workers. Leisure-time physical activity and walking for commute were not associated with CKD risk. Our findings suggest that occupational, but not leisure-time and commuting physical activities, is associated with a lower CKD risk.
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14
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Saxton SN, Toms LK, Aldous RG, Withers SB, Ohanian J, Heagerty AM. Restoring Perivascular Adipose Tissue Function in Obesity Using Exercise. Cardiovasc Drugs Ther 2021; 35:1291-1304. [PMID: 33687595 PMCID: PMC8578065 DOI: 10.1007/s10557-020-07136-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 12/24/2022]
Abstract
Purpose Perivascular adipose tissue (PVAT) exerts an anti-contractile effect which is vital in regulating vascular tone. This effect is mediated via sympathetic nervous stimulation of PVAT by a mechanism which involves noradrenaline uptake through organic cation transporter 3 (OCT3) and β3-adrenoceptor-mediated adiponectin release. In obesity, autonomic dysfunction occurs, which may result in a loss of PVAT function and subsequent vascular disease. Accordingly, we have investigated abnormalities in obese PVAT, and the potential for exercise in restoring function. Methods Vascular contractility to electrical field stimulation (EFS) was assessed ex vivo in the presence of pharmacological tools in ±PVAT vessels from obese and exercised obese mice. Immunohistochemistry was used to detect changes in expression of β3-adrenoceptors, OCT3 and tumour necrosis factor-α (TNFα) in PVAT. Results High fat feeding induced hypertension, hyperglycaemia, and hyperinsulinaemia, which was reversed using exercise, independent of weight loss. Obesity induced a loss of the PVAT anti-contractile effect, which could not be restored via β3-adrenoceptor activation. Moreover, adiponectin no longer exerts vasodilation. Additionally, exercise reversed PVAT dysfunction in obesity by reducing inflammation of PVAT and increasing β3-adrenoceptor and OCT3 expression, which were downregulated in obesity. Furthermore, the vasodilator effects of adiponectin were restored. Conclusion Loss of neutrally mediated PVAT anti-contractile function in obesity will contribute to the development of hypertension and type II diabetes. Exercise training will restore function and treat the vascular complications of obesity. Supplementary Information The online version contains supplementary material available at 10.1007/s10557-020-07136-0.
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Affiliation(s)
- Sophie N Saxton
- Division of Cardiovascular Sciences, University of Manchester, Manchester, UK
- The Lydia Becker Institute of Immunology & Inflammation, University of Manchester, Manchester, UK
| | - Lauren K Toms
- Division of Cardiovascular Sciences, University of Manchester, Manchester, UK
| | | | - Sarah B Withers
- Division of Cardiovascular Sciences, University of Manchester, Manchester, UK
- The Lydia Becker Institute of Immunology & Inflammation, University of Manchester, Manchester, UK
- School of Science, Engineering and Environment, University of Salford, Salford, UK
| | - Jacqueline Ohanian
- Division of Cardiovascular Sciences, University of Manchester, Manchester, UK
| | - Anthony M Heagerty
- Division of Cardiovascular Sciences, University of Manchester, Manchester, UK.
- The Lydia Becker Institute of Immunology & Inflammation, University of Manchester, Manchester, UK.
- Division of Cardiovascular Sciences, Manchester Academic Health Science Centre, Core Technology Facility (3rd floor), 46 Grafton Street, Manchester, M13 9NT, UK.
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15
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HIV-positive demonstrate more salt sensitivity and nocturnal non-dipping blood pressure than HIV-negative individuals. Clin Hypertens 2021; 27:2. [PMID: 33446278 PMCID: PMC7809779 DOI: 10.1186/s40885-020-00160-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 12/14/2020] [Indexed: 12/24/2022] Open
Abstract
Background High dietary salt and a lack of reduced blood pressure (BP) at night (non-dipping) are risk factors for the development of hypertension which may result in end-organ damage and death. The effect of high dietary salt on BP in black people of sub-Saharan Africa living with HIV is not well established. The goal of this study was to explore the associations between salt sensitivity and nocturnal blood pressure dipping according to HIV and hypertension status in a cohort of adult Zambian population. Methods We conducted an interventional study among 43 HIV-positive and 42 HIV-negative adults matched for age and sex. Study participants were instructed to consume a low (4 g) dietary salt intake for a week followed by high (9 g) dietary salt intake for a week. Salt resistance and salt sensitivity were defined by a mean arterial pressure difference of ≤5 mmHg and ≥ 8 mmHg, respectively, between the last day of low and high dietary salt intervention. Nocturnal dipping was defined as a 10–15% decrease in night-time blood pressure measured with an ambulatory blood pressure monitor. Results The median age was 40 years for both the HIV-positive and the HIV-negative group with 1:1 male to female ratio. HIV positive individuals with hypertension exhibited a higher BP sensitivity to salt (95%) and non-dipping BP (86%) prevalence compared with the HIV negative hypertensive (71 and 67%), HIV positive (10 and 24%) and HIV-negative normotensive (29 and 52%) groups, respectively (p < 0.05). Salt sensitivity was associated with non-dipping BP and hypertension in both the HIV-positive and HIV-negative groups even after adjustment in multivariate logistic regression (< 0.001). Conclusions The results of the present study suggest that high dietary salt intake raises blood pressure and worsens nocturnal BP dipping to a greater extent in hypertensive than normotensive individuals and that hypertensive individuals have higher dietary salt intake than their normotensive counterparts. Regarding HIV status, BP of HIV-positive hypertensive patients may be more sensitive to salt intake and demonstrate more non-dipping pattern compared to HIV-negative hypertensive group. However, further studies with a larger sample size are required to validate this. Supplementary Information The online version contains supplementary material available at 10.1186/s40885-020-00160-0.
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Zhu Y, Bu Y, Zhang G, Ding S, Zhai D, Wan Z, Yu Z. Association of physical activity with chronic kidney disease: a systematic review and dose-response meta-analysis. Aging (Albany NY) 2020; 12:19221-19232. [PMID: 33027768 PMCID: PMC7732321 DOI: 10.18632/aging.103747] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/07/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND The relationship between physical activity (PA) and chronic kidney disease (CKD) risk was inconsistent. We therefore conducted a systematic review and dose-response meta-analysis to comprehensively evaluate the association of PA and CKD. RESULTS A total of 14 studies from 13 articles with 353,975 participants were included. By comparing the highest vs. the lowest level of PA, we found that PA was inversely associated with CKD risk (odds ratio [OR] = 0.94, 95% confidence interval [CI] = 0.91-0.98). Seven studies from 6 articles were included in dose-response analysis. Restricted cubic splines showed no evidence of a nonlinear dose-response relationship of PA and CKD risk (Pnonlinearity = 0.135). The risk of CKD was reduced by 2% (OR = 0.98, 95% CI = 0.96-1.00) with each 10 metabolic equivalent h/week increment of PA. CONCLUSIONS The findings demonstrated that the higher level of PA might have a protective effect against the risk of CKD. METHODS Electronic databases PubMed and Embase were searched up to March 11, 2020. Observational studies investigated the relationship between PA and CKD risk with estimated effects (relative risk, hazard ratio, or OR) with 95 % CI among adults were included.
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Affiliation(s)
- Yongjian Zhu
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China
| | - Yongjun Bu
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China
| | - Guofu Zhang
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China
| | - Shibin Ding
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China
| | - Desheng Zhai
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China
| | - Zhongxiao Wan
- School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Zengli Yu
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China,School of Public Health, Zhengzhou University, Zhengzhou 450001, China
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Shen FC, Cheng BC, Chen JF. Peri-renal fat thickness is positively associated with the urine albumin excretion rate in patients with type 2 diabetes. Obes Res Clin Pract 2020; 14:345-349. [PMID: 32653293 DOI: 10.1016/j.orcp.2020.06.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/15/2020] [Accepted: 06/23/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUNDS Albuminuria, the earliest clinical manifestation of diabetic kidney disease (DKD), is a major prognostic indicator of renal progression. Obesity itself is associated with the development of DKD and accelerates its progression. Accumulation of peri-renal fat on the kidneys can damage kidney function. Measuring the perirenal fat thickness (PFT) by ultrasound is a non-invasive method to measure ectopic fat deposition on the kidney. In this study, we aim to obtain the association between albuminuria and PFT. METHODS Eighty-nine subjects with type 2 diabetes mellitus (T2DM) were enrolled. Albuminuria was defined as a urine albumin-to-creatinine ratio (UACR) ≧30 mg/g. Measurement of the PFT was performed by B-mode ultrasound (Toshiba SSA-680A) and determined from the surface of the abdominal musculature to the surface of kidney. Pearson correlation coefficients were determined to test the significant independent relationship between the PFT and demographic, anthropometric and laboratory parameters. RESULTS Patients were divided into those with (n = 66) and without (n = 23) albuminuria. PFT (odds ratio [OR], 19.3; 95% CI, 2.25-165.00; p = 0.01) was significantly correlated with albuminuria based on multiple logistic regression analysis. Additionally, linear regression confirmed that degree of albuminuria has a positive association with the PFT (r = 0.233; p = 0.03). CONCLUSIONS Our study showed that an increased PFT is positively associated with the albuminuria among patients with T2DM. Our findings suggest that measurement of the PFT may represent a helpful tool to assess the risk of developing albuminuria in patients with T2DM.
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Affiliation(s)
- Feng-Chih Shen
- Division of Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Center for Mitochondrial Research and Medicine, Departments of Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ben-Chung Cheng
- Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan; Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Jung-Fu Chen
- Division of Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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Perrone MA, Babu Dasari J, Intorcia A, Gualtieri P, Marche M, Di Luozzo M, Merra G, Bernardini S, Romeo F, Sergi D. Phenotypic classification and biochemical profile of obesity for cardiovascular prevention. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2020. [DOI: 10.23736/s0393-3660.20.04259-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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19
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Associations between ideal blood pressure based on different BMI categories and stroke incidence. J Hypertens 2020; 38:1271-1277. [PMID: 32195818 DOI: 10.1097/hjh.0000000000002404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES The 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline for high blood pressure (BP) in adults redefined hypertension as SBP at least 130 mmHg or DBP at least 80 mmHg. However, the optimal BP for different BMI population to reduce stroke incidence is uncertain. METHODS A prospective cohort study was designed by four examinations: baseline (2004-2006), 2008, 2010 and 2017 follow-up. The study group composed of 36 352 individuals, to determine the ideal BP range to reduce stroke incidence of two BMI level, adjusted Cox proportional hazards models were utilized to establish the associations between SBP/DBP and the risk of stroke incident. Then, the restricted cubic spline regression was applied to find the ideal range of SBP/DBP values for two kinds of BMI categories definitions. RESULTS During a median follow-up period of 12.5 years, 2548 (7.0%) nonstroke individuals at baseline developed incident stroke. After fully adjusting confounding factors, SBP (per 20 mmHg increase) and DBP (per 10 mmHg increase) are independently associated with the risk of stroke incidence [SBP, hazard ratio = 1.277, 95% confidence interval (95% CI), 1.217-1.340, P < 0.001; DBP, hazard ratio = 1.138, 95% CI, 1.090-1.189, P < 0.001]. CONCLUSION Our study revealed that the ideal BP for a population with BMI less than 24 kg/m was less than 130/80 mmHg, whereas the ideal BP for BMI at least 24 kg/m was less than 120/80 mmHg. The sensitivity analyses between BMI less than 25 kg/m and BMI at least 25 kg/m showed similar findings. This finding provides more accurate primary prevention strategies based on various BMI populations.
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Guo C, Tam T, Bo Y, Chang LY, Lao XQ, Thomas GN. Habitual physical activity, renal function and chronic kidney disease: a cohort study of nearly 200 000 adults. Br J Sports Med 2020; 54:1225-1230. [PMID: 31969348 DOI: 10.1136/bjsports-2019-100989] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND There is limited information on the association between habitual physical activity (PA) and renal function. OBJECTIVE To report the longitudinal association between self-reported habitual PA and measures of renal function in a large cohort in Taiwan. METHODS A total of 199 421 participants (aged ≥20 years) were selected from a Taiwan cohort between 1996 and 2014. All participants underwent at least two standardised medical examinations between 1996 and 2014. Self-administrated questionnaires were used to collect information on habitual PA. We used a generalised linear mixed model to investigate the associations between habitual PA and yearly change in estimated glomerular filtration rate (eGFR). The Cox proportional hazard regression model was used to investigate the associations between habitual PA and incident chronic kidney disease (CKD). RESULTS Participants had a median follow-up duration of 4.2 years (0.2-18.9). The yearly mean (±SD) decrease in eGFR in participants with baseline very low-PA, low-PA, moderate-PA and high-PA was 0.46±1.01, 0.36±0.97, 0.30±0.94 and 0.27±0.91 mL/min/1.73 m2, respectively. Relative to the participants with very low-PA, the coefficients of yearly eGFR change were -43.93 (95% CI -79.18 to -8.68), 35.20 (95% CI -2.56 to 72.96) and 53.56 (95% CI 10.42 to 96.70) µL/min/1.73 m2, respectively, for the participants with low-PA, moderate-PA and high-PA, after controlling for a wide range of covariates. Relative to the very low-PA participants, those who had low-PA, moderate-PA and high-habitual PA had HRs of 0.93 (95% CI 0.88 to 0.98), 0.94 (95% CI 0.89 to 0.99) and 0.91 (95% CI 0.85 to 0.96) to develop CKD, respectively, after controlling for the covariates. CONCLUSIONS A higher level of habitual PA is associated with a smaller decrease in the level of eGFR and a lower risk of developing CKD.
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Affiliation(s)
- Cui Guo
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Tony Tam
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Yacong Bo
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.,School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Ly-Yun Chang
- Institute of Sociology, Academia Sinica, Taipei, Taiwan.,MJ Health Research Foundation, MJ Group, Taipei, Taiwan
| | - Xiang Qian Lao
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong .,Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - G Neil Thomas
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
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Lino ADDS, Aquino Júnior AED, Leite RD, Speretta GFF, Moraes FDD, Fabrizzi F, Moraes G, Selistre-de-Araújo HS, Duarte ACGDO. Resistance training improves the lipid profile, combat oxidative stress and inhibit MMP-2 activity in the left ventricle diet-induced obese rats. MOTRIZ: REVISTA DE EDUCACAO FISICA 2020. [DOI: 10.1590/s1980-6574202000030199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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22
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Sun CQ. Aqueous charge injection: solvation bonding dynamics, molecular nonbond interactions, and extraordinary solute capabilities. INT REV PHYS CHEM 2018. [DOI: 10.1080/0144235x.2018.1544446] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Chang Q. Sun
- EBEAM, Yangtze Normal University, Chongqing, People's Republic of China
- NOVITAS, EEE, Nanyang Technological University, Singapore, Singapore
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Ni C, Sun C, Zhou Z, Huang Y, Liu X. Surface tension mediation by Na-based ionic polarization and acidic fragmentation: Inference of hypertension. J Mol Liq 2018. [DOI: 10.1016/j.molliq.2018.02.113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Arena R, Daugherty J, Bond S, Lavie CJ, Phillips S, Borghi-Silva A. The combination of obesity and hypertension: a highly unfavorable phenotype requiring attention. Curr Opin Cardiol 2018; 31:394-401. [PMID: 27070650 DOI: 10.1097/hco.0000000000000294] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Body habitus is a key lifestyle characteristic whose current status and future projections are disconcerting. The percentage of the global population who are either overweight or obese has substantially increased, with no indication that any country has a solution to this issue. Hypertension is a key unfavorable health metric that, like obesity, has disastrous health implications if left uncontrolled. Poor lifestyle characteristics and health metrics often cluster together to create complex and difficult to treat phenotypes. Excess body mass is such an example, creating an obesity-hypertension phenotype, which is the focus of this review. RECENT FINDINGS An increased risk for hypertension is clearly linked to obesity, indicating that the two conditions are intimately linked. The cascade of obesity-induced pathophysiologic adaptations creates a clear path to hypertension. Adopting a healthy lifestyle is a primary intervention for the prevention as well as treatment of the obesity-hypertension phenotype. SUMMARY The obesity-hypertension phenotype is highly prevalent and has disastrous health implications. A primordial prevention strategy, focused on lifelong healthy lifestyle patterns, is the optimal approach for this condition. For those individuals already afflicted by the obesity-hypertension phenotype, interventions must aggressively focus on weight loss and blood pressure control.
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Affiliation(s)
- Ross Arena
- aDepartment of Physical Therapy and the Integrative Physiology Laboratory, College of Applied Health Sciences bDepartment of Biomedical and Health Information Sciences, College of Applied Science, University of Illinois, Chicago, Illinois cDepartment of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine; New Orleans, Louisiana, USA dCardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, São Paulo, Brazil
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Makhija P, Wilson C, Garimella S. Utility of Doppler sonography for renal artery stenosis screening in obese children with hypertension. J Clin Hypertens (Greenwich) 2018; 20:807-813. [PMID: 29575497 DOI: 10.1111/jch.13241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 01/02/2018] [Accepted: 01/12/2018] [Indexed: 11/28/2022]
Abstract
Pediatric hypertension guidelines recommend Doppler renal ultrasonography as a screening study for the evaluation of possible renal artery stenosis (RAS) in normal-weight children ≥ 8 years of age who are suspected of having RAS and who will cooperate with the procedure. Obese children are excluded because of technical and vascular concerns. There are no data on RI in obese children. This is a retrospective review of children aged 1.5-18 who received Doppler imaging studies over a 10-year period. A total of 174 patients were studied. There was no significant difference between the RI values based on BMI. Of the 174 individuals in the study 22 obtained follow-up CT/MRA after abnormal Doppler ultrasounds. On advanced imaging 3 were confirmed to have RAS. Obesity does not seem to influence RI.RI alone should not be used as a screening tool for RAS. An approach toward diagnosis is suggested based on BMI, renin levels, and ultrasound.
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Affiliation(s)
- Pooja Makhija
- Department of Pediatrics, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Christopher Wilson
- Department of Mathematical Sciences, Clemson University College of Engineering and Sciences, Clemson, SC, USA
| | - Sudha Garimella
- University of South Carolina School of Medicine, Greenville Health System, Greenville, SC, USA
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The relationship between obesity and hypertension: an updated comprehensive overview on vicious twins. Hypertens Res 2017; 40:947-963. [DOI: 10.1038/hr.2017.75] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/07/2017] [Accepted: 04/14/2017] [Indexed: 02/07/2023]
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Le Jemtel TH, Samson R, Jaiswal A, Lewine EB, Oparil S. Regression of Left Ventricular Mass After Bariatric Surgery. Curr Hypertens Rep 2017; 19:68. [DOI: 10.1007/s11906-017-0767-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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De Jong KA, Czeczor JK, Sithara S, McEwen K, Lopaschuk GD, Appelbe A, Cukier K, Kotowicz M, McGee SL. Obesity and type 2 diabetes have additive effects on left ventricular remodelling in normotensive patients-a cross sectional study. Cardiovasc Diabetol 2017; 16:21. [PMID: 28178970 PMCID: PMC5299776 DOI: 10.1186/s12933-017-0504-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 02/03/2017] [Indexed: 01/19/2023] Open
Abstract
Background It is unclear whether obesity and type 2 diabetes (T2D), either alone or in combination, induce left ventricular hypertrophy (LVH) independent of hypertension. In the current study, we provide clarity on this issue by rigorously analysing patient left ventricular (LV) structure via clinical indices and via LV geometric patterns (more commonly used in research settings). Importantly, our sample consisted of hypertensive patients that are routinely screened for LVH via echocardiography and normotensive patients that would normally be deemed low risk with no further action required. Methods This cross sectional study comprised a total of 353 Caucasian patients, grouped based on diagnosis of obesity, T2D and hypertension, with normotensive obese patients further separated based on metabolic health. Basic metabolic parameters were collected and LV structure and function were assessed via transthoracic echocardiography. Multivariable logistic and linear regression analyses were used to identify predictors of LVH and diastolic dysfunction. Results Metabolically healthy normotensive obese patients exhibited relatively low risk of LVH. However, normotensive metabolically non-healthy obese, T2D and obese/T2D patients all presented with reduced normal LV geometry that coincided with increased LV concentric remodelling. Furthermore, normotensive patients presenting with both obesity and T2D had a higher incidence of concentric hypertrophy and grade 3 diastolic dysfunction than normotensive patients with either condition alone, indicating an additive effect of obesity and T2D. Alarmingly these alterations were at a comparable prevalence to that observed in hypertensive patients. Interestingly, assessment of LVPWd, a traditional index of LVH, underestimated the presence of LV concentric remodelling. The implications for which were demonstrated by concentric remodelling and concentric hypertrophy strongly associating with grade 1 and 3 diastolic dysfunction respectively, independent of sex, age and BMI. Finally, pulse pressure was identified as a strong predictor of LV remodelling within normotensive patients. Conclusions These findings show that metabolically non-healthy obese, T2D and obese/T2D patients can develop LVH independent of hypertension. Furthermore, that LVPWd may underestimate LV remodelling in these patient groups and that pulse pressure can be used as convenient predictor of hypertrophy status. Electronic supplementary material The online version of this article (doi:10.1186/s12933-017-0504-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kirstie A De Jong
- Metabolic Research Unit, Metabolic Reprogramming Laboratory, School of Medicine, Deakin University, Waurn Ponds, VIC, Australia.
| | - Juliane K Czeczor
- Metabolic Research Unit, Metabolic Reprogramming Laboratory, School of Medicine, Deakin University, Waurn Ponds, VIC, Australia.,Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich-Heine University, c/o Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.,German Center of Diabetes Research, Ingolstädter Landstraße 1, 85764, München-Neuherberg, Germany
| | - Smithamol Sithara
- Metabolic Research Unit, Metabolic Reprogramming Laboratory, School of Medicine, Deakin University, Waurn Ponds, VIC, Australia
| | - Kevin McEwen
- Metabolic Research Unit, Metabolic Reprogramming Laboratory, School of Medicine, Deakin University, Waurn Ponds, VIC, Australia
| | - Gary D Lopaschuk
- Department of Pediatrics, University of Alberta, Edmonton, AB, T6G 2H7, Canada.,Department of Pharmacology, University of Alberta, Edmonton, AB, T6G 2H7, Canada
| | - Alan Appelbe
- Cardiology Department, Barwon Health, University Hospital Geelong, Victoria, Australia
| | - Kimberly Cukier
- Geelong Endocrinology and Diabetes Centre, Geelong, VIC, Australia
| | - Mark Kotowicz
- Endocrinology Department, Barwon Health, University Hospital, Geelong, VIC, Australia.,School of Medicine, Deakin University, Waurn Ponds, VIC, Australia.,Melbourne Medical School-Western Precinct, The University of Melbourne, Victoria, Australia
| | - Sean L McGee
- Metabolic Research Unit, Metabolic Reprogramming Laboratory, School of Medicine, Deakin University, Waurn Ponds, VIC, Australia
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Skurdal AC, Nordrum IS. A retrospective study of postmortem heart weight in an adult Norwegian population. Cardiovasc Pathol 2016; 25:461-467. [DOI: 10.1016/j.carpath.2016.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 07/04/2016] [Accepted: 07/16/2016] [Indexed: 12/19/2022] Open
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Bar-Lev Y, Moshitch-Moshkovitz S, Tsarfaty G, Kaufman D, Horev J, Resau JH, Tsarfaty I. Mimp/Mtch2, an Obesity Susceptibility Gene, Induces Alteration of Fatty Acid Metabolism in Transgenic Mice. PLoS One 2016; 11:e0157850. [PMID: 27359329 PMCID: PMC4928869 DOI: 10.1371/journal.pone.0157850] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 06/06/2016] [Indexed: 12/26/2022] Open
Abstract
Objective Metabolic dysfunctions, such as fatty liver, obesity and insulin resistance, are among the most common contemporary diseases worldwide, and their prevalence is continuously rising. Mimp/Mtch2 is a mitochondrial carrier protein homologue, which localizes to the mitochondria and induces mitochondrial depolarization. Mimp/Mtch2 single-nucleotide polymorphism is associated with obesity in humans and its loss in mice muscle protects from obesity. Our aim was to study the effects of Mimp/Mtch2 overexpression in vivo. Methods Transgenic mice overexpressing Mimp/Mtch2-GFP were characterized and monitored for lipid accumulation, weight and blood glucose levels. Transgenic mice liver and kidneys were used for gene expression analysis. Results Mimp/Mtch2-GFP transgenic mice express high levels of fatty acid synthase and of β-oxidation genes and develop fatty livers and kidneys. Moreover, high-fat diet–fed Mimp/Mtch2 mice exhibit high blood glucose levels. Our results also show that Mimp/Mtch2 is involved in lipid accumulation and uptake in cells and perhaps in human obesity. Conclusions Mimp/Mtch2 alters lipid metabolism and may play a role in the onset of obesity and development of insulin resistance.
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Affiliation(s)
- Yamit Bar-Lev
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Galia Tsarfaty
- Department of Diagnostic Imaging, Sheba Medical Center, Ramat-Gan, Israel
| | - Dafna Kaufman
- Van Andel Research Institute, Grand Rapids, Michigan, 49503, United States of America
| | - Judith Horev
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - James H. Resau
- Van Andel Research Institute, Grand Rapids, Michigan, 49503, United States of America
| | - Ilan Tsarfaty
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- * E-mail:
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Hanew K, Tanaka T, Horikawa R, Hasegawa T, Fujita K, Yokoya S. Women with Turner syndrome are at high risk of lifestyle-related disease -From questionnaire surveys by the Foundation for Growth Science in Japan. Endocr J 2016; 63:449-56. [PMID: 26877182 DOI: 10.1507/endocrj.ej15-0288] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In this study, the prevalence of obesity and complications of lifestyle-related diseases, such as diabetes mellitus, hypertension, dyslipidemia and liver dysfunction, as well as the relationship with karyotypes, were investigated in 492 patients with Turner syndrome (TS) aged 17 years or older. Data were obtained through questionnaire surveys administered by attending physicians throughout Japan. Collected data were compared with data from the National Health and Nutrition Survey. Patient ages ranged from 17.1 to 42.5 years (mean ± standard error, 26.6±0.2). The prevalence of lifestyle-related diseases at age 20 or over was 6.3% for diabetes, 8.7% for hypertension, 20.2% for dyslipidemia and 12.4% for liver dysfunction. These four diseases were clearly associated with severity of obesity. Obesity (BMI ≥25 kg/m(2)) was observed in 106 out of 426 patients with TS aged 15 to 39 years (24.7%) and the prevalence was significantly higher than that of the general female population (9.4%). The mean BMI in age subgroups without any complications ranged from 21.2 to 22.7, which although was within normal ranges was significantly higher than that in the general female population (20.3-21.3). In this study population, patients with TS had more complications related to lifestyle-related diseases that were highly related to obesity. Few associations between complications and karyotypes were found. In the follow-up of patients with TS, the presence of lifestyle-related disease should be considered in the evaluation and treatment of the disease.
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Affiliation(s)
- Kunihiko Hanew
- Growth Hormone Treatment Study Group, Foundation for Growth Science, Tokyo, Japan
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Yao Y, Shen D, Chen R, Ying C, Wang C, Guo J, Zhang G. Galectin-3 Predicts Left Ventricular Remodeling of Hypertension. J Clin Hypertens (Greenwich) 2015; 18:506-11. [PMID: 26693954 DOI: 10.1111/jch.12757] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/05/2015] [Accepted: 10/11/2015] [Indexed: 12/19/2022]
Affiliation(s)
- Yongwei Yao
- Division of Cardiology; Department of Medicine; The Affiliated People's Hospital of Jiangsu University; ZhenJiang City Jiangsu Province China
| | - Dongli Shen
- Division of Cardiology; Department of Medicine; The Affiliated People's Hospital of Jiangsu University; ZhenJiang City Jiangsu Province China
| | - Rong Chen
- Division of Cardiology; Department of Medicine; The Affiliated People's Hospital of Jiangsu University; ZhenJiang City Jiangsu Province China
| | - Chunyang Ying
- Division of Cardiology; Department of Medicine; The Affiliated People's Hospital of Jiangsu University; ZhenJiang City Jiangsu Province China
| | - Chenghua Wang
- Division of Cardiology; Department of Medicine; The Affiliated People's Hospital of Jiangsu University; ZhenJiang City Jiangsu Province China
| | - Junfang Guo
- Division of Cardiology; Department of Medicine; The Affiliated People's Hospital of Jiangsu University; ZhenJiang City Jiangsu Province China
| | - Guohui Zhang
- Division of Cardiology; Department of Medicine; The Affiliated People's Hospital of Jiangsu University; ZhenJiang City Jiangsu Province China
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Overweight, adipocytokines and hypertension: a prospective population-based study. J Hypertens 2015; 32:1488-94; discussion 1494. [PMID: 24805956 DOI: 10.1097/hjh.0000000000000207] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The adipocytokines, leptin, adiponectin, and interleukin-6, which stimulate liver C-reactive protein (CRP) production, are regarded as potential candidate intermediates between adipose tissue and overweight-induced hypertension. METHODS We examined the associations between leptin, adiponectin, and CRP levels with both prevalent and 5-year incident hypertension (IHT) in a general population of Danish adults (n = 5,868, 51.3% women, mean age 45.8 ± 7.9 years). RESULTS We recorded 2195 prevalent and 379 incident cases of hypertension. In models including leptin, CRP, adiponectin, sex, age, lifestyle risk factors, lipids, insulin, hemoglobin A1c, and in the incident model also baseline heart rate and blood pressure, only leptin of the three candidate intermediates was significantly associated with both prevalent and IHT [odds ratio (OR) = 1.18, 95% confidence interval (CI) 1.06-1.32, P = 0.002, and OR = 1.24, 95% CI 1.01-1.54, P = 0.044] for one standard deviation increase in log-transformed leptin levels, respectively. Log-transformed CRP was associated with prevalent (OR = 1.16, 95% CI 1.07-1.26, P < 0.001) but not IHT (OR = 0.98, 95% CI 0.84-1.14, P = 0.76). Log-transformed adiponectin was neither associated with prevalent nor IHT (OR = 0.94, 95% CI 0.87-1.02, P = 0.11 and OR = 0.93, 95% CI 0.80-1.08, P = 0.33). Comparing the lowest with the highest quintile of sex-specific BMI levels, there was an almost two-fold increase in IHT (OR = 1.89, 95% CI 1.10-3.25, P = 0.023) in the fully adjusted model. The population attributable risk estimate of IHT owing to overweight was 31%. CONCLUSION Leptin, but not adiponectin or CRP, may play a mediating role in overweight-induced hypertension. However, as BMI was a strong independent predictor of hypertension, other factors than leptin must be involved in the pathogenesis of overweight-related hypertension.
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Owen JG, Reisin E. Anti-hypertensive Drug Treatment of Patients with and the Metabolic Syndrome and Obesity: a Review of Evidence, Meta-Analysis, Post hoc and Guidelines Publications. Curr Hypertens Rep 2015; 17:558. [DOI: 10.1007/s11906-015-0558-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Nikonorov AA, Skalnaya MG, Tinkov AA, Skalny AV. Mutual interaction between iron homeostasis and obesity pathogenesis. J Trace Elem Med Biol 2015; 30:207-14. [PMID: 24916791 DOI: 10.1016/j.jtemb.2014.05.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Revised: 04/15/2014] [Accepted: 05/14/2014] [Indexed: 02/08/2023]
Abstract
Obesity is identified as an important medical problem. One of the pathologic conditions observed in obesity is systemic iron deficiency and hypoferremia. Along with a large number of studies indicating disturbed iron homeostasis in obesity, recent data indicate a cause-effect relationship between iron status and obesity-related pathologies. The primary objective of the article is to consider two aspects of the iron-obesity interplay: (1) the mechanisms leading to impaired iron balance, and (2) the pathways of iron participation in obesity-related pathogenesis. While considering disturbance of iron homeostasis in obesity, a number of potential mechanisms of hypoferremia are proposed. At the same time, the inflammation of obesity and obesity-related hepcidin and lipocalin 2 hyperproduction seem to be the most probable reasons of obesity-related hypoferremia. Oversecretion of these proteins leads to iron sequestration in reticuloendothelial system cells. The latter also leads to increased adipose tissue iron content, thus producing preconditions for adverse effects of local iron overload. Being a redox-active metal, iron is capable of inducing oxidative stress as well as endoplasmic reticulum stress, inflammation and adipose tissue endocrine dysfunction. Iron-mediated mechanisms of toxicity may influence aspects of obesity pathogenesis possibly even leading to obesity aggravation. Thus, a mutual interaction between disturbance in iron homeostasis and obesity pathogenesis is proposed. All sides of this interaction should be considered to design new therapeutic approaches to the treatment of disturbed iron homeostasis in obesity.
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Affiliation(s)
- Alexandr A Nikonorov
- Department of Biochemistry, Orenburg State Medical Academy, Sovetskaya Street 6, Orenburg 460000, Russia.
| | - Margarita G Skalnaya
- Russian Society of Trace Elements in Medicine, Zemlyanoy Val Street 46, Moscow 105064, Russia
| | - Alexey A Tinkov
- Department of Biochemistry, Orenburg State Medical Academy, Sovetskaya Street 6, Orenburg 460000, Russia
| | - Anatoly V Skalny
- Russian Society of Trace Elements in Medicine, Zemlyanoy Val Street 46, Moscow 105064, Russia; Institute of Bioelementology (Russian Satellite Centre of Trace Element - Institute for UNESCO), Orenburg State University, Pobedy Avenue 13, Orenburg 460352, Russia
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Sharma AM, Weir MR. The Role of Angiotensin Receptor Blockers in Diabetic Nephropathy. Postgrad Med 2015; 123:109-21. [DOI: 10.3810/pgm.2011.05.2289] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Zhang K, Huang F, Chen J, Cai Q, Wang T, Zou R, Zuo Z, Wang J, Huang H. Independent influence of overweight and obesity on the regression of left ventricular hypertrophy in hypertensive patients: a meta-analysis. Medicine (Baltimore) 2014; 93:e130. [PMID: 25437025 PMCID: PMC4616382 DOI: 10.1097/md.0000000000000130] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Overweight and obesity are associated with adverse cardiovascular outcomes. However, the role of overweight and obesity in left ventricular hypertrophy (LVH) of hypertensive patients is controversial. The aim of the current meta-analysis was to evaluate the influence of overweight and obesity on LVH regression in the hypertensive population.Twenty-eight randomized controlled trials comprising 2403 hypertensive patients (mean age range: 43.8-66.7 years) were identified. Three groups were divided according to body mass index: normal weight, overweight, and obesity groups.Compared with the normal-weight group, LVH regression in the overweight and obesity groups was more obvious with less reduction of systolic blood pressure after antihypertensive therapies (P < 0.001). The renin-angiotensin system inhibitor was the most effective in regressing LVH in overweight and obese hypertensive patients (19.27 g/m, 95% confidence interval [15.25, 23.29], P < 0.001), followed by β-blockers, calcium channel blockers, and diuretics. In the stratified analysis based on blood pressure measurement methods and age, more significant LVH regression was found in 24-h ambulatory blood pressure monitoring (ABPM) group and in relatively young patients (40-60 years' old) group (P < 0.01).Overweight and obesity are independent risk factors for LVH in hypertensive patients. Intervention at an early age and monitoring by ABPM may facilitate therapy-induced LVH regression in overweight and obese hypertensive patients.
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Affiliation(s)
- Kun Zhang
- From the Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University (KZ, FH, JW, HH); Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology (KZ, FH, JC, TW, RZ, JW, HH); Department of Radiation Oncology, Sun Yat-sen Memorial Hospital (JC); Department of Internal Medicine, Cancer Center, Sun Yat-sen University, Guangzhou, China (QC); and Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA, USA (ZZ)
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Nadruz W. Myocardial remodeling in hypertension. J Hum Hypertens 2014; 29:1-6. [PMID: 24804791 DOI: 10.1038/jhh.2014.36] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 03/25/2014] [Accepted: 04/02/2014] [Indexed: 02/07/2023]
Abstract
Left ventricular (LV) hypertrophy and remodeling are frequently seen in hypertensive subjects and result from a complex interaction of several hemodynamic and non-hemodynamic variables. Although increased blood pressure is considered the major determinant of LV structural alterations, ethnicity, gender, environmental factors, such as salt intake, obesity and diabetes mellitus, as well as neurohumoral and genetic factors might influence LV mass and geometry. The conventional concept of hypertensive LV remodeling has been that hypertension leads to concentric hypertrophy, as an adaptive response to normalize wall stress, which is then followed by chamber dilation and heart failure. However, several lines of evidence have challenged this dogma. Concentric hypertrophy is not the most frequent geometric pattern and is less usually seen than eccentric hypertrophy in hypertensive subjects. In addition, data from recent studies suggested that transition from LV concentric hypertrophy to dilation and systolic dysfunction is not a common finding, especially in the absence of coronary heart disease. LV hypertrophy is also consistently associated with increased cardiovascular morbidity and mortality, raising doubts whether this phenotype is an adaptive response. Experimental evidence exists that a blunting of load-induced cardiomyocyte hypertrophy does not necessarily result in LV dysfunction or failure. Furthermore, the hypertrophic myocardium shows fibrosis, alterations in the coronary circulation and cardiomyocyte apoptosis, which may result in heart failure, myocardial ischemia and arrhythmias. Overall, this body of evidence suggests that LV hypertrophy is a complex phenotype that predicts adverse cardiovascular outcomes and may not be necessarily considered as an adaptive response to systemic hypertension.
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Affiliation(s)
- W Nadruz
- Department of Internal Medicine, School of Medical Sciences, University of Campinas, Campinas, Brazil
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Abstract
It is well known that people with high levels of body fat are at higher risk for developing diabetes mellitus, kidney disease, and cardiovascular disorders. Since individuals who are slightly overweight, or even individuals of normal weight, can vary in body fat distribution, their metabolic profiles and the degree of association of these profiles with cardiometabolic risk factors may differ. Fat distribution might be more of a predictive factor for cardiorenometabolic risk than obesity itself, which has led researchers to investigate whether ectopic fat accumulation may partially account for the development of cardiorenometabolic disorders. In addition to visceral obesity, fat can accumulate in the liver and muscle, and these intrahepatic and intramuscular lipid stores are associated with insulin resistance and adverse metabolic phenotypes. More recently, pericardial fat, perivascular fat, and perirenal fat were found to be associated with coronary atherosclerosis, cardiovascular diseases, and kidney damage, respectively. Thus, regional fat distribution may play a key role in understanding the development of cardiorenometabolic diseases in nonobese people.
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Affiliation(s)
- Soo Lim
- Department of Internal Medicine, Seoul National University Bundang
Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Abstract
Although obesity is a well-known risk factor for hypertension, the mechanisms by which hypertension develops in obese patients are not entirely clear. Animal models of obesity and their different susceptibilities to develop hypertension have revealed some of the mechanisms linking obesity and hypertension. Adipose tissue is an endocrine organ secreting hormones that impact blood pressure, such as elements of the renin-angiotensin system whose role in hypertension have been established. In addition, the appetite-suppressing adipokine leptin activates the sympathetic nervous system via the melanocortin system, and this activation, especially in the kidney, increases blood pressure. Leptin secretion from adipocytes is increased in most models of obesity due to leptin resistance, although the resistance is often selective to the anorexigenic effect, while the susceptibility to the hypertensive effect remains intact. Understanding the pathways by which obesity contributes to increased blood pressure will hopefully pave the way to and better define the appropriate treatment for obesity-induced hypertension.
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Badshah H, Ullah I, Kim SE, Kim TH, Lee HY, Kim MO. Anthocyanins attenuate body weight gain via modulating neuropeptide Y and GABAB1 receptor in rats hypothalamus. Neuropeptides 2013; 47:347-53. [PMID: 23830691 DOI: 10.1016/j.npep.2013.06.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Revised: 05/10/2013] [Accepted: 06/03/2013] [Indexed: 02/05/2023]
Abstract
Anthocyanins in a variety of plant species have been identified and are known for its hypolipidemic and anti-obesity effects. The effect of anthocyanins extracted from black soybean on body weight and daily food intake in adult rats raised on normal diet were studied. Male Sprague-Dawley rats were daily intra-gastric administered water or anthocyanins 6 mg/kg and 24 mg/kg for 40 days. During this period daily food intake and body weight were measured prior to anthocyanins treatment. These findings showed that anthocyanins treatment resulted in significantly lowered body weight and food intake compared with water treated rats. In addition, anthocyanins dose dependently reduced the adipose tissue size compared with control group. Western blot analysis showed that high dose of anthocyanins treatment significantly reduced the expression of neuropeptide Y (NPY) and increased γ-amino butyric acid receptor (GABAB1R) in hypothalamus. Furthermore, these events were followed by a decreased in expression of GABAB1R downstream signaling molecules protein kinase A-α (PKA) and phosphorylated cAMP-response element binding protein (p-CREB) in hypothalamus. These data support the concept that anthocyanins even in normal circumstances have the capability to reduce body weight and food intake through its modulatory effect on NPY and GABAB1R in hypothalamus. These results suggest that anthocyanins from black soybean seed coat might have a novel role in preventing obesity in rats on normal diet.
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Affiliation(s)
- Haroon Badshah
- Department of Biology, College of Natural Sciences (RINS), Gyeongsang National University, Jinju 660-701, Republic of Korea
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Lim S, Meigs JB. Ectopic fat and cardiometabolic and vascular risk. Int J Cardiol 2013; 169:166-76. [PMID: 24063931 DOI: 10.1016/j.ijcard.2013.08.077] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 06/16/2013] [Accepted: 08/28/2013] [Indexed: 12/16/2022]
Abstract
Given that the variation in how regional adipose tissue handles and stores excess dietary energy has substantial cardiometabolic implications, ectopic fat distribution might be an important predictor of cardiometabolic and vascular risk, in addition to overall obesity itself. Conceptually, ectopic fat depots may be divided into systemically acting fat depots and locally acting fat depots. Systemically acting fat depots include visceral fat, fat in the liver, muscle, or neck, and subcutaneous fat. Accumulation in the abdominal visceral area, compared with overall obesity, has an equally or more important role in the development of cardiometabolic risk. Fat depots in liver/muscle tissue cause adverse cardiometabolic effects by affecting energy metabolism. Fat depots in lower-body subcutaneous areas may be protective regarding cardiometabolic risk, by trapping remnant energy. Fat accumulation in the neck is a unique type of fat depot that may increase cardiovascular risk by increasing insulin resistance. Locally acting fat depots include pericardial fat, perivascular fat, and renal sinus fat. These fat depots have effects primarily on adjacent anatomic organs, directly via lipotoxicity and indirectly via cytokine secretion. Pericardial fat is associated with coronary atherosclerosis. Perivascular fat may play an independent role in adverse vascular biology, including arterial stiffness. Renal sinus fat is a unique fat depot that may confer additional cardiometabolic risk. Thus, ectopic fat depots may contribute to the understanding of the link between body composition and cardiometabolic risk. In this review, we focus on the role and clinical implications of ectopic fat depots in cardiometabolic and vascular risk.
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Affiliation(s)
- Soo Lim
- General Medicine Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, South Korea.
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Gupta A, Braunwald E, McNulty S, Felker GM, Gilbert EM, Alharethi R, Lee KL, Anstrom KJ, Redfield MM, Goldsmith SR, O'Connor CM, Bull DA, Stehlik J, Litwin SE. Obesity and the response to intensified diuretic treatment in decompensated heart failure: a DOSE trial substudy. J Card Fail 2013; 18:837-44. [PMID: 23141856 DOI: 10.1016/j.cardfail.2012.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 08/08/2012] [Accepted: 09/21/2012] [Indexed: 01/21/2023]
Abstract
BACKGROUND Obesity could attenuate diuretic effectiveness in treatment of acute decompensated heart failure (HF). METHODS AND RESULTS The DOSE trial randomized 308 subjects with acute HF to low- versus high-intensification intravenous diuretic therapy. We tested for statistical interactions between obesity and dosing strategy across clinical end points. After 72 hours of treatment, obese subjects (body mass index >30 kg/m(2); n = 173) had greater volume loss than nonobese subjects (n = 119) but similar improvements in dyspnea and freedom from congestion. Both groups had greater fluid loss with high-intensification treatment. Obese subjects had a higher incidence of worsening renal function (WRF) at 72 hours with low-intensification treatment, compared with nonobese subjects. In contrast, nonobese and obese subjects had similar incidence of WRF with high-intensification treatment. There were no differences between obese and nonobese subjects in time to discharge and 60-day freedom from death, emergency department visit, or rehospitalization. CONCLUSIONS The incidence of WRF was greater in obese than in nonobese subjects with low-intensification treatment. However, the frequency of WRF was equivalent in obese and nonobese subjects with high-intensification treatment. Additional studies are needed to assess whether obese patients with acute HF benefit from an initial high-intensification treatment strategy.
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Affiliation(s)
- Achal Gupta
- Division of Cardiology, University of Utah, Salt Lake City, Utah, USA
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Kibar AE, Pac FA, Ballı S, Oflaz MB, Ece I, Bas VN, Aycan Z. Early subclinical left-ventricular dysfunction in obese nonhypertensive children: a tissue Doppler imaging study. Pediatr Cardiol 2013; 34:1482-90. [PMID: 23503947 DOI: 10.1007/s00246-013-0674-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 02/13/2013] [Indexed: 11/24/2022]
Abstract
A direct effect of obesity on myocardial function has not been not well established. Our aim was to investigate the effect of body mass index (BMI) and homeostatic model assessment of insulin resistance (HOMA-IR) on left-ventricular (LV) myocardial function in normotensive overweight and obese children by tissue Doppler imaging (TDI). We calculated the mitral annular displacement index (DI) and myocardial performance index (MPI) using TDI indices of systolic and diastolic LV function. In this hospital-based, prospective cross-sectional study, we studied 60 obese (mean age 13.2 ± 2.0 years) and 50 normal children. Subjects were divided into three groups: group 1 (BMI < 25, n = 50, control), group 2 (BMI 25-29.9 kg/m(2), n = 30, overweight), and group 3 (BMI ≥ 30 kg/m(2), n = 30, morbidly obese). Standard echocardiography showed increased LV diameters and LV mass/index and preserved ejection fraction in obese children. By TDI, LV systolic and diastolic function showed that peak late myocardial velocity (Em = 15.4 ± 2 cm/s), peak early myocardial velocity (Am = 8.7 ± 1.3 cm/s), Em/Am ratio (1.8 ± 0.3), isovolumetric relaxation time (IVRT = 59.2 ± 8.2 ms), MPI (0.39 ± 0.03), and DI (25.5 ± 3.2 %) of the lateral mitral annulus in the obese subgroups were significantly different from those of control subjects (18.2 ± 1.2 cm/sn, 6.9 ± 0.6 cm/sn, 2.6 ± 0.2, 51.2 ± 9.6 ms, 0.34 ± 0.03, and 33.13 ± 5.0 %, respectively; p < 0.001). These structural and functional abnormalities were significantly related to BMI. There were positive correlations between HOMA-IR, septal MPI, and LV mass. DI and MPI data indicated impaired subclinical LV function in all grades of isolated obesity at a preclinical stage. Insulin resistance and BMI correlated significantly with indices of LV function.
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Affiliation(s)
- Ayse Esin Kibar
- Department of Pediatric Cardiology, Mersin Women's and Children's Hospital, Güneykent, Mersin, Turkey.
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45
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Abstract
Obesity is an increasing epidemic in the United States, with approximately 70% of Americans falling into either the overweight or obese categories. There also has been a global increase in the number of obese individuals worldwide, and an estimated one in ten of the world's adult population are overweight or obese. The number of overweight and obese children also has greatly increased, which likely will predispose them to earlier onset of obesity-related morbidity and mortality and further contribute to the burden obesity places on society. Obesity is a preventable and treatable cause of many systemic diseases affecting the heart, liver, lungs, endocrine, and musculoskeletal systems. Though it affects almost all organ systems, this state of over-nutrition induces abnormalities that culminate in changes in hemodynamics, heart structure, cardiac myocyte metabolism, and coronary artery disease that often lead to consequences such as systemic and pulmonary hypertension, obesity cardiomyopathy, heart failure, atrial fibrillation, and/or sudden cardiac death. Despite the prevalence of obesity in our current society, the exact effects on health are still being elucidated and, interestingly, there are some data to suggest certain populations of obese individuals may have less cardiovascular morbidity than their non-obese counterparts. Forensic pathologists should be aware of the effects of obesity, particularly on the cardiovascular system, as the number of these decedents seen at forensic autopsy increases. This review describes the non-atherosclerotic effects of obesity on the cardiovascular system.
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Affiliation(s)
- Katherine F. Maloney
- New York City Office of Chief Medical Examiner, New York, NY
- Department of Forensic Medicine at New York University School of Medicine, New York, NY
| | - Candace H. Schoppe
- City Medical Examiner at the New York City Office of Chief Medical Examiner
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Xi B, Zhang M, Wang C, Shen Y, Zhao X, Wang X, Mi J. The common SNP (rs9939609) in the FTO gene modifies the association between obesity and high blood pressure in Chinese children. Mol Biol Rep 2012; 40:773-8. [PMID: 23111453 DOI: 10.1007/s11033-012-2113-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 10/03/2012] [Indexed: 02/02/2023]
Abstract
Previous studies have suggested that common variants in fat mass- and obesity-associated (FTO) gene are associated with body mass index (BMI) and the risk of obesity. Since obesity plays an important role in the etiology of high blood pressure (HBP), we aim to investigate the association between obesity and HBP in a population with different variants of the FTO gene. A total of 3,494 children (1,775 boys, 50.8 %) aged 6-18 years were recruited for measuring pubertal status, BMI and systolic and diastolic blood pressure. The single nucleotide polymorphism rs9939609 of the FTO gene was genotyped. The blood pressure levels increased by 1.4, 1.5 and 1.8 mmHg for systolic blood pressure and 0.8, 0.9 and 1.2 mmHg for diastolic blood pressure per 1-unit BMI increase in subjects carrying TT, TA and AA genotypes, respectively. After stratifying for FTO rs9939609 genotypes (TT, TA and AA), the odds ratios (95 % confidence intervals) of HBP in obese versus non-obese children were 4.26 (3.18-5.71), 5.13 (2.96-8.90) and 10.37 (1.59-67.43), respectively, with adjustment for age, gender and pubertal status. The FTO rs9939609 SNP modifies the effect of obesity on HBP in Chinese children, with obese ones carrying the AA homozygous genotype of the FTO rs9939609 having the highest risk of developing HBP.
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Affiliation(s)
- Bo Xi
- Department of Maternal and Child Health Care, School of Public Health, Shandong University, Jinan, 250012, China
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Yiannikouris F, Gupte M, Putnam K, Thatcher S, Charnigo R, Rateri DL, Daugherty A, Cassis LA. Adipocyte deficiency of angiotensinogen prevents obesity-induced hypertension in male mice. Hypertension 2012; 60:1524-30. [PMID: 23108647 DOI: 10.1161/hypertensionaha.112.192690] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Previous studies demonstrated that diet-induced obesity increased plasma angiotensin II concentrations and elevated systolic blood pressures in male mice. Adipocytes express angiotensinogen and secrete angiotensin peptides. We hypothesize that adipocyte-derived angiotensin II mediates obesity-induced increases in systolic blood pressure in male high fat-fed C57BL/6 mice. Systolic blood pressure was measured by radiotelemetry during week 16 of low-fat or high-fat feeding in Agt(fl/fl) and adipocyte angiotensinogen-deficient mice (Agt(aP2)). Adipocyte angiotensinogen deficiency had no effect on diet-induced obesity. Basal 24-hour systolic blood pressure was not different in low fat-fed Agt(fl/fl) compared with Agt(aP2) mice (124 ± 3 versus 128 ± 3 mm Hg, respectively). In Agt(fl/fl) mice, high-fat feeding significantly increased systolic blood pressure (24 hours; 134 ± 2 mm Hg; P<0.05). In contrast, high fat-fed Agt(aP2) mice did not exhibit an increase in systolic blood pressure (126 ± 2 mm Hg). Plasma angiotensin II concentrations were increased by high-fat feeding in Agt(fl/fl) mice (low fat, 32 ± 14; high fat, 219 ± 58 pg/mL; P<0.05). In contrast, high fat-fed Agt(aP2) mice did not exhibit elevated plasma angiotensin II concentrations (high fat, 18 ± 7 pg/mL). Similarly, adipose tissue concentrations of angiotensin II were significantly decreased in low fat- and high fat-fed Agt(aP2) mice compared with controls. In conclusion, adipocyte angiotensinogen deficiency prevented high fat-induced elevations in plasma angiotensin II concentrations and systolic blood pressure. These results suggest that adipose tissue serves as a major source of angiotensin II in the development of obesity hypertension.
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Affiliation(s)
- Frederique Yiannikouris
- Graduate Center for Nutritional Sciences, University of Kentucky, Lexington, KY 40536-0200, USA
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The complex interaction between overweight, hypertension, and sympathetic overactivity. ACTA ACUST UNITED AC 2012; 3:353-65. [PMID: 20409978 DOI: 10.1016/j.jash.2009.10.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Revised: 09/29/2009] [Accepted: 10/01/2009] [Indexed: 11/22/2022]
Abstract
There is ample evidence in the epidemiological and clinical literature that hypertension and overweight are closely and causally interrelated. Sympathetic nervous system (SNS) overactivity has been well documented in both hypertension and overweight, but it is not clear whether this is a coincidental finding or whether the association reflects a mechanistic role of SNS in these two interrelated clinical conditions. Whereas in this review we focus on the evidence for a primary role of SNS in the development of hypertension and overweight, it is clear that the process can be initiated from other starting points such as primary overeating or sleep apnea. After overweight evolves, hormones secreted by fat cells further accelerate SNS overactivity, weight gain, and blood pressure increase. The main thesis of this article is that regardless of where the process started, the same clinical picture of hypertension, overweight, and SNS overactivity will emerge. There is good evidence that in genetically prone individuals, prolonged SNS stimulation elicits a down regulation of beta-adrenergic receptors. This in turn decreases the ability to dissipate calories and diminishes the beta-adrenoceptor-mediated vasodilatation. We hypothesize that beta-adrenoceptor downregulation is the linchpin in the association of SNS with overweight and hypertension.
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Juhola J, Oikonen M, Magnussen CG, Mikkilä V, Siitonen N, Jokinen E, Laitinen T, Würtz P, Gidding SS, Taittonen L, Seppälä I, Jula A, Kähönen M, Hutri-Kähönen N, Lehtimäki T, Viikari JS, Juonala M, Raitakari OT. Childhood Physical, Environmental, and Genetic Predictors of Adult Hypertension. Circulation 2012; 126:402-9. [DOI: 10.1161/circulationaha.111.085977] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background—
Hypertension is a major modifiable cardiovascular risk factor. The present longitudinal study aimed to examine the best combination of childhood physical and environmental factors to predict adult hypertension and furthermore whether newly identified genetic variants for blood pressure increase the prediction of adult hypertension.
Methods and Results—
The study cohort included 2625 individuals from the Cardiovascular Risk in Young Finns Study who were followed up for 21 to 27 years since baseline (1980; age, 3–18 years). In addition to dietary factors and biomarkers related to blood pressure, we examined whether a genetic risk score based on 29 newly identified single-nucleotide polymorphisms enhances the prediction of adult hypertension. Hypertension in adulthood was defined as systolic blood pressure ≥130 mm Hg and/or diastolic blood pressure ≥85 mm Hg or medication for the condition. Independent childhood risk factors for adult hypertension included the individual's own blood pressure (
P
<0.0001), parental hypertension (
P
<0.0001), childhood overweight/obesity (
P
=0.005), low parental occupational status (
P
=0.003), and high genetic risk score (
P
<0.0001). Risk assessment based on childhood overweight/obesity status, parental hypertension, and parental occupational status was superior in predicting hypertension compared with the approach using only data on childhood blood pressure levels (C statistics, 0.718 versus 0.733;
P
=0.0007). Inclusion of both parental hypertension history and data on novel genetic variants for hypertension further improved the C statistics (0.742;
P
=0.015).
Conclusions—
Prediction of adult hypertension was enhanced by taking into account known physical and environmental childhood risk factors, family history of hypertension, and novel genetic variants. A multifactorial approach may be useful in identifying children at high risk for adult hypertension.
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Affiliation(s)
- Jonna Juhola
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
| | - Mervi Oikonen
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
| | - Costan G. Magnussen
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
| | - Vera Mikkilä
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
| | - Niina Siitonen
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
| | - Eero Jokinen
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
| | - Tomi Laitinen
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
| | - Peter Würtz
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
| | - Samuel S. Gidding
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
| | - Leena Taittonen
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
| | - Ilkka Seppälä
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
| | - Antti Jula
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
| | - Mika Kähönen
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
| | - Nina Hutri-Kähönen
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
| | - Terho Lehtimäki
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
| | - Jorma S.A. Viikari
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
| | - Markus Juonala
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
| | - Olli T. Raitakari
- From the Research Center of Applied and Preventive Cardiovascular Medicine (J.J., M.O., C.G.M., N.S., M.J., O.T.R.), Department of Clinical Physiology (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland (V.M.); Children's Hospital,
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