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Elmelid A, Vandikas MS, Gillstedt M, Alsterholm M, Osmancevic A. The Effect of Phototherapy on Systemic Inflammation Measured with Serum Vitamin D-Binding Protein and hsCRP in Patients with Inflammatory Skin Disease. Int J Mol Sci 2024; 25:8632. [PMID: 39201319 PMCID: PMC11354249 DOI: 10.3390/ijms25168632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/31/2024] [Accepted: 08/02/2024] [Indexed: 09/02/2024] Open
Abstract
Vitamin D plays a role in inflammatory skin disease, but the exact mechanisms and the clinical significance remain unclear. According to the free hormone hypothesis, it is the free concentration of 25-hydroxy vitamin D (25(OH)D) that is biologically active. Vitamin D-binding protein (DBP) acts as the major transporter of vitamin D in the circulation, and DBP concentration defines the free 25(OH)D levels. DBP levels are elevated in various inflammatory conditions, including psoriasis. Narrowband-ultraviolet B (NB-UVB) is the most widely used phototherapy and is an established first-line treatment for psoriasis and atopic dermatitis (AD), often used before proceeding to systemic treatment. The aim of this study was to investigate the influence of NB-UVB phototherapy on DBP and high-sensitivity C-reactive protein (hsCRP) levels, as markers of systemic inflammation, in inflammatory skin disease. Thirty adults (psoriasis (n = 20) and AD (n = 10)) were treated with NB-UVB. Serum DBP, hsCRP, total and free 25(OH)D, and 1,25-dihydroxy vitamin D (1,25(OH)2D) were measured before and after NB-UVB. Disease severity was assessed with Psoriasis Area and Severity Index (PASI), SCORing Atopic Dermatitis (SCORAD), and Visual Analogue Scale (VAS). DBP decreased in psoriasis patients and varied with no clear trend in AD patients. HsCRP decreased in both groups, but this did not reach statistical significance. PASI, SCORAD, and VAS improved, and vitamin D levels increased after NB-UVB. Sub-analysis indicated a better response to NB-UVB for patients with vitamin D deficiency and insufficiency compared to vitamin D-sufficient patients. The decrease in DBP after NB-UVB in psoriasis patients suggests a potential systemic anti-inflammatory effect of phototherapy. Measurement of vitamin D levels may potentially serve as a tool to identify patients who would derive the greatest benefit from NB-UVB phototherapy.
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Affiliation(s)
- Andrea Elmelid
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden; (M.S.V.); (M.G.); (M.A.)
- Center for Clinical Research Dalarna, Uppsala University, 791 82 Falun, Sweden
| | - Maria Siekkeri Vandikas
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden; (M.S.V.); (M.G.); (M.A.)
- Dermatology and Venereology Unit, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Martin Gillstedt
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden; (M.S.V.); (M.G.); (M.A.)
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, 413 45 Gothenburg, Sweden
| | - Mikael Alsterholm
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden; (M.S.V.); (M.G.); (M.A.)
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, 413 45 Gothenburg, Sweden
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Amra Osmancevic
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden; (M.S.V.); (M.G.); (M.A.)
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, 413 45 Gothenburg, Sweden
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Landrier JF, Breniere T, Sani L, Desmarchelier C, Mounien L, Borel P. Effect of tomato, tomato-derived products and lycopene on metabolic inflammation: from epidemiological data to molecular mechanisms. Nutr Res Rev 2023:1-17. [PMID: 38105560 DOI: 10.1017/s095442242300029x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
The goal of this narrative review is to summarise the current knowledge and limitations related to the anti-inflammatory effects of tomato, tomato-derived products and lycopene in the context of metabolic inflammation associated to cardiometabolic diseases. The potential of tomato and tomato-derived product supplementation is supported by animal and in vitro studies. In addition, intervention studies provide arguments in favour of a limitation of metabolic inflammation. This is also the case for observational studies depicting inverse association between plasma lycopene levels and inflammation. Nevertheless, current data of intervention studies are mixed concerning the anti-inflammatory effect of tomato and tomato-derived products and are not in favour of an anti-inflammatory effect of pure lycopene in humans. From epidemiological to mechanistic studies, this review aims to identify limitations of the current knowledge and gaps that remain to be filled to improve our comprehension in contrasted anti-inflammatory effects of tomato, tomato-derived products and pure lycopene.
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Affiliation(s)
| | - Thomas Breniere
- Aix-Marseille Université, C2VN, INRAE, INSERM, Marseille, France
- INRAE-Centre d'Avignon UR1115 Plantes et Systèmes de Culture Horticoles, Avignon, France
- Laboratoire de Physiologie Expérimentale Cardiovasculaire (LAPEC), UPR-4278, Université d'Avignon, 84029 Avignon, France
| | - Léa Sani
- Aix-Marseille Université, C2VN, INRAE, INSERM, Marseille, France
| | | | - Lourdes Mounien
- Aix-Marseille Université, C2VN, INRAE, INSERM, Marseille, France
| | - Patrick Borel
- Aix-Marseille Université, C2VN, INRAE, INSERM, Marseille, France
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Mustafa AI, Hamed AM, Kadah AS, Fawzy EM, El Shimi OS. A Notorious Trio! Inflammation, Metabolic Syndrome and Vitiligo. Indian Dermatol Online J 2023; 14:493-499. [PMID: 37521222 PMCID: PMC10373801 DOI: 10.4103/idoj.idoj_674_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/10/2023] [Accepted: 03/11/2023] [Indexed: 08/01/2023] Open
Abstract
Background There is evidence to support that vitiligo is linked to metabolic syndrome (MS), confirming its systemic nature. However, the underlying pathogenic mechanisms remain unknown. Objectives To reveal the possible association of MS with vitiligo. We also attempted to study the connection between some inflammatory markers and MS in vitiligo patients to evaluate their utility in predicting MS risk. Materials and Methods The study included 100 vitiligo patients with an age range between 18 to 60 years and 100 controls with matched age, gender, and body mass index. All subjects were tested for MS components. Serum visceral adipose tissue-derived serine protease inhibitor (vaspin), fatty acid binding protein 4 (FABP4), vascular adhesion protein 1 (VAP-1), chitinase-3-like protein 1 (YKL-40), and high-sensitivity C-reactive protein (hs-CRP) were also measured. Results Regarding MS, it was observed in 22.0% of vitiligo patients and 2.0% of control subjects (P < 0.001). Serum FABP4, VAP-1, YKL-40, and hs-CRP concentrations were higher in patients than in the control group (P < 0.05 each), and their levels showed high sensitivity and specificity to differentiate MS when using the receiver operating characteristic (ROC). Levels of these markers, except serum vaspin, were significantly positively correlated with lipid profile markers (except high-density lipoprotein cholesterol) and fasting blood glucose levels (P < 0.05 each). Conclusion MS was more common in vitiligo patients. The levels of the biomarkers studied were significantly higher in vitiligo patients. Furthermore, their levels accurately predicted MS in vitiligo patients. According to current research, these markers may be useful in assessing MS risk in vitiligo patients. Extensive research, however, is required.
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Affiliation(s)
- Amany I. Mustafa
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Benha University, Cairo, Egypt
| | - Ahmed M. Hamed
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Benha University, Cairo, Egypt
| | - Ahmed S. Kadah
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Eman M. Fawzy
- Department of Laboratory Medicine, Mansoura Fever Hospital, Mansoura, Egypt
| | - Ola S. El Shimi
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Benha University, Cairo, Egypt
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Liu H, Huan C, Nie L, Gu H, Sun J, Suo X, Liu D, Liu J, Wang M, Song Y, Mao Z, Wang C, Huo W. The association of cortisol/testosterone ratio and sleep quality with coronary heart disease: A case-control study in Chinese rural population. Steroids 2023; 193:109197. [PMID: 36773705 DOI: 10.1016/j.steroids.2023.109197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 01/10/2023] [Accepted: 02/03/2023] [Indexed: 02/12/2023]
Abstract
PURPOSE There were limited studies that have probed into the combined effect of the cortisol/testosterone (C/T) ratio as a biomarker of stress and Pittsburgh Sleep Quality Index (PSQI) on coronary heart disease (CHD). This research aimed to explore the association of C/T ratio and PSQI with the risk of CHD in a rural Chinese population, as well as the interaction and combined effect between C/T ratio and PSQI on CHD. METHODS A case-control study was performed including 307 individuals without CHD and 307 patients drawn from Henan Rural Cohort. Logistic regression was utilized to survey the independent and joint effects of the C/T ratio and PSQI on CHD. To estimate the interaction impact of the C/T ratio and sleep quality (PSQI) on CHD, a cross-product term was introduced in the generalized linear model. RESULTS Higher C/T ratio and PSQI index scores are related to increased odds ratio for CHD (Odds ratios (ORs) and 95 % confidence interval (CI) were 1.17 (1.07, 1.29), p-trend < 0.001; 1.16 (1.09, 1.22), respectively). The odds ratio of C/T ratio for CHD increased with increasing PSQI in women (pinteraction = 0.018) and total population (pinteraction = 0.033). The combined group of high C/T ratio and high PSQI had the highest risk of CHD (Total: OR = 7.53, 95 % CI: 4.12-13.76). CONCLUSIONS The risk of CHD was associated with low testosterone levels, high C/T ratios, and high PSQI scores. Additionally, poor sleep quality aggravated the effect of high C/T ratio on coronary heart disease.
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Affiliation(s)
- Huan Liu
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Changsheng Huan
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Luting Nie
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Huiwen Gu
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jiaqi Sun
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiangying Suo
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Daohan Liu
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jingru Liu
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Mian Wang
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yu Song
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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Zhong M, Huang J, Wu Z, Chan KG, Wang L, Li J, Lee LH, Law JWF. Potential Roles of Selectins in Periodontal Diseases and Associated Systemic Diseases: Could They Be Targets for Immunotherapy? Int J Mol Sci 2022; 23:14280. [PMID: 36430760 PMCID: PMC9698067 DOI: 10.3390/ijms232214280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/14/2022] [Accepted: 10/31/2022] [Indexed: 11/19/2022] Open
Abstract
Periodontal diseases are predisposing factors to the development of many systemic disorders, which is often initiated via leukocyte infiltration and vascular inflammation. These diseases could significantly affect human health and quality of life. Hence, it is vital to explore effective therapies to prevent disease progression. Periodontitis, which is characterized by gingival bleeding, disruption of the gingival capillary's integrity, and irreversible destruction of the periodontal supporting bone, appears to be caused by overexpression of selectins in periodontal tissues. Selectins (P-, L-, and E-selectins) are vital members of adhesion molecules regulating inflammatory and immune responses. They are mainly located in platelets, leukocytes, and endothelial cells. Furthermore, selectins are involved in the immunopathogenesis of vascular inflammatory diseases, such as cardiovascular disease, diabetes, cancers, and so on, by mediating leukocyte recruitment, platelet activation, and alteration of endothelial barrier permeability. Therefore, selectins could be new immunotherapeutic targets for periodontal disorders and their associated systemic diseases since they play a crucial role in immune regulation and endothelium dysfunction. However, the research on selectins and their association with periodontal and systemic diseases remains limited. This review aims to discuss the critical roles of selectins in periodontitis and associated systemic disorders and highlights the potential of selectins as therapeutic targets.
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Affiliation(s)
- Mei Zhong
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbiome and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor Darul Ehsan, Malaysia
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
| | - Jiangyong Huang
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
| | - Zhe Wu
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
| | - Kok-Gan Chan
- Division of Genetics and Molecular Biology, Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur 50603, Malaysia
- International Genome Centre, Jiangsu University, Zhenjiang 212013, China
| | - Lijing Wang
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbiome and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor Darul Ehsan, Malaysia
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
- Vascular Biology Research Institute, School of Life Sciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Jiang Li
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbiome and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor Darul Ehsan, Malaysia
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
| | - Learn-Han Lee
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbiome and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor Darul Ehsan, Malaysia
| | - Jodi Woan-Fei Law
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbiome and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor Darul Ehsan, Malaysia
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6
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Andersen LAC, Palstrøm NB, Diederichsen A, Lindholt JS, Rasmussen LM, Beck HC. Determining Plasma Protein Variation Parameters as a Prerequisite for Biomarker Studies-A TMT-Based LC-MSMS Proteome Investigation. Proteomes 2021; 9:proteomes9040047. [PMID: 34941812 PMCID: PMC8707687 DOI: 10.3390/proteomes9040047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/24/2021] [Accepted: 11/26/2021] [Indexed: 12/03/2022] Open
Abstract
Specific plasma proteins serve as valuable markers for various diseases and are in many cases routinely measured in clinical laboratories by fully automated systems. For safe diagnostics and monitoring using these markers, it is important to ensure an analytical quality in line with clinical needs. For this purpose, information on the analytical and the biological variation of the measured plasma protein, also in the context of the discovery and validation of novel, disease protein biomarkers, is important, particularly in relation to for sample size calculations in clinical studies. Nevertheless, information on the biological variation of the majority of medium-to-high abundant plasma proteins is largely absent. In this study, we hypothesized that it is possible to generate data on inter-individual biological variation in combination with analytical variation of several hundred abundant plasma proteins, by applying LC-MS/MS in combination with relative quantification using isobaric tagging (10-plex TMT-labeling) to plasma samples. Using this analytical proteomic approach, we analyzed 42 plasma samples prepared in doublets, and estimated the technical, inter-individual biological, and total variation of 265 of the most abundant proteins present in human plasma thereby creating the prerequisites for power analysis and sample size determination in future clinical proteomics studies. Our results demonstrated that only five samples per group may provide sufficient statistical power for most of the analyzed proteins if relative changes in abundances >1.5-fold are expected. Seventeen of the measured proteins are present in the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Biological Variation Database, and demonstrated remarkably similar biological CV’s to the corresponding CV’s listed in the EFLM database suggesting that the generated proteomic determined variation knowledge is useful for large-scale determination of plasma protein variations.
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Affiliation(s)
| | - Nicolai Bjødstrup Palstrøm
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, DK-5000 Odense, Denmark; (N.B.P.); (L.M.R.)
- Center for Clinical Proteomics (CCP), Odense University Hospital, DK-5000 Odense, Denmark
| | - Axel Diederichsen
- Center for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, DK-5000 Odense, Denmark; (A.D.); (J.S.L.)
- Department of Cardiology, Odense University Hospital, DK-5000 Odense, Denmark
| | - Jes Sanddal Lindholt
- Center for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, DK-5000 Odense, Denmark; (A.D.); (J.S.L.)
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, DK-5000 Odense, Denmark
| | - Lars Melholt Rasmussen
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, DK-5000 Odense, Denmark; (N.B.P.); (L.M.R.)
- Center for Clinical Proteomics (CCP), Odense University Hospital, DK-5000 Odense, Denmark
- Center for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, DK-5000 Odense, Denmark; (A.D.); (J.S.L.)
| | - Hans Christian Beck
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, DK-5000 Odense, Denmark; (N.B.P.); (L.M.R.)
- Center for Clinical Proteomics (CCP), Odense University Hospital, DK-5000 Odense, Denmark
- Center for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, DK-5000 Odense, Denmark; (A.D.); (J.S.L.)
- Correspondence: ; Tel.: +45-29-647-470
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Blackburn CMR, Schilke RM, Vozenilek AE, Chandran S, Bamgbose TT, Finck BN, Woolard MD. Myeloid-associated lipin-1 transcriptional co-regulatory activity is atheroprotective. Atherosclerosis 2021; 330:76-84. [PMID: 34256308 DOI: 10.1016/j.atherosclerosis.2021.06.927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 05/27/2021] [Accepted: 06/30/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS Atherosclerosis is the most prominent underlying cause of cardiovascular disease (CVD). It is initiated by cholesterol deposition in the arterial intima, which causes macrophage recruitment and proinflammatory responses that promote plaque growth, necrotic core formation, and plaque rupture. Lipin-1 is a phosphatidic acid phosphohydrolase for glycerolipid synthesis. We have shown that lipin-1 phosphatase activity promotes macrophage pro-inflammatory responses when stimulated with modified low-density lipoprotein (modLDL) and accelerates atherosclerosis. Lipin-1 also independently acts as a transcriptional co-regulator where it enhances the expression of genes involved in β-oxidation. In hepatocytes and adipocytes, lipin-1 augments the activity of transcription factors such as peroxisome proliferator-activated receptor (PPARs). PPARs control the expression of anti-inflammatory genes in macrophages and slow or reduce atherosclerotic progression. Therefore, we hypothesize myeloid-derived lipin-1 transcriptional co-regulatory activity reduces atherosclerosis. METHODS We used myeloid-derived lipin-1 knockout (lipin-1mKO) and littermate control mice and AAV8-PCSK9 along with high-fat diet to elicit atherosclerosis. RESULTS Lipin-1mKO mice had larger aortic root plaques than littermate control mice after 8 and 12 weeks of a high-fat diet. Lipin-1mKO mice also had increased serum proinflammatory cytokine concentrations, reduced apoptosis in plaques, and larger necrotic cores in the plaques compared to control mice. CONCLUSIONS Combined, the data suggest lipin-1 transcriptional co-regulatory activity in myeloid cells is atheroprotective.
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Affiliation(s)
- Cassidy M R Blackburn
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center, Shreveport, LA, United States
| | - Robert M Schilke
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center, Shreveport, LA, United States
| | - Aimee E Vozenilek
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center, Shreveport, LA, United States
| | - Sunitha Chandran
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center, Shreveport, LA, United States
| | - Temitayo T Bamgbose
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center, Shreveport, LA, United States
| | - Brian N Finck
- Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO, United States
| | - Matthew D Woolard
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center, Shreveport, LA, United States.
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8
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Czick M, Shapter C, Shapter R. COVID's Razor: RAS Imbalance, the Common Denominator Across Disparate, Unexpected Aspects of COVID-19. Diabetes Metab Syndr Obes 2020; 13:3169-3192. [PMID: 32982349 PMCID: PMC7495349 DOI: 10.2147/dmso.s265518] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/04/2020] [Indexed: 12/25/2022] Open
Abstract
A modern iteration of Occam's Razor posits that "the simplest explanation is usually correct." Coronavirus Disease 2019 involves widespread organ damage and uneven mortality demographics, deemed unexpected from what was originally thought to be "a straightforward respiratory virus." The simplest explanation is that both the expected and unexpected aspects of COVID-19 share a common mechanism. Silent hypoxia, atypical acute respiratory distress syndrome (ARDS), stroke, olfactory loss, myocarditis, and increased mortality rates in the elderly, in men, in African-Americans, and in patients with obesity, diabetes, and cancer-all bear the fingerprints of the renin-angiotensin system (RAS) imbalance, suggesting that RAS is the common culprit. This article examines what RAS is and how it works, then from that baseline, the article presents the evidence suggesting RAS involvement in the disparate manifestations of COVID-19. Understanding the deeper workings of RAS helps one make sense of severe COVID-19. In addition, recognizing the role of RAS imbalance suggests potential routes to mitigate COVID-19 severity.
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Affiliation(s)
- Maureen Czick
- University of Connecticut, Department of Anesthesia, Farmington, CT, USA
| | | | - Robert Shapter
- Independent Consultant ( Medical Research, Medical Communications, and Medical Education), Hartford, CT, USA
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9
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Kamer AR, Craig RG, Niederman R, Fortea J, de Leon MJ. Periodontal disease as a possible cause for Alzheimer's disease. Periodontol 2000 2020; 83:242-271. [PMID: 32385876 DOI: 10.1111/prd.12327] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 06/23/2019] [Indexed: 12/13/2022]
Abstract
Approximately 47 million people worldwide have been diagnosed with dementia, 60%-80% of whom have dementia of the Alzheimer's disease type. Unfortunately, there is no cure in sight. Defining modifiable risk factors for Alzheimer's disease may have a significant impact on its prevalence. An increasing body of evidence suggests that chronic inflammation and microbial dysbiosis are risk factors for Alzheimer's disease. Periodontal disease is a chronic inflammatory disease that develops in response to response to microbial dysbiosis. Many studies have shown an association between periodontal disease and Alzheimer's disease. The intent of this paper was to review the existing literature and determine, using the Bradford Hill criteria, whether periodontal disease is causally related to Alzheimer's disease.
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Affiliation(s)
- Angela R Kamer
- Department of Periodontology and Implant Dentistry, New York University, College of Dentistry, New York, New York, USA
| | - Ronald G Craig
- Department of Periodontology and Implant Dentistry, New York University, College of Dentistry, New York, New York, USA.,Department of Basic Sciences and Craniofacial Biology, New York University, College of Dentistry, New York, New York, USA
| | - Richard Niederman
- Department of Epidemiology and Health Promotion, New York University, College of Dentistry, New York, New York, USA
| | - Juan Fortea
- Alzheimer Down Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau- Biomedical Research Institute Sant Pau- Universitat Autònoma de Barcelona and Barcelona Down Medical Center, Fundació Catalana Síndrome de Down, Barcelona, Spain.,Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | - Mony J de Leon
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, New York, USA
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Li X, Tu P, Umar M, Liu Q, Luo W, Yang X, Zhu J, Kong D, Li M. A study on molecular mechanisms of adiposis induced by long-term treatment of high-fat and high-sucrose in C57BL/6J mice. Physiol Res 2019; 68:75-87. [PMID: 30433796 DOI: 10.33549/physiolres.933830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Adiposis is reputed as a twin disease of type 2 diabetes and greatly harmful to human health. In order to understand the molecular mechanisms of adiposis, the changes of physiological, pathological, epigenetic and correlative gene expression were investigated during the adiposis development of C57BL/6J mice induced by long time (9 months) high-fat and high-sucrose diet (HFSD) sustainably. The results showed that mRNA transcription level of the Leptin, Glut4 and Glut2 genes have been obviously changed, which exhibit a negative correlation with methylation on their promoter DNA. The results also revealed that HFSD induced higher level of DNA methyltransferase 1 (DNMT1) in fat tissue might play important role in regulating the changes of methylation pattern on Glut4 and Leptin genes, and which might be one of the molecular mechanisms for the adiposis development.
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Affiliation(s)
- X Li
- Life Science College, Nankai University, Nankai District, Tianjin, China.
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11
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Gonzalez LL, Garrie K, Turner MD. Type 2 diabetes - An autoinflammatory disease driven by metabolic stress. Biochim Biophys Acta Mol Basis Dis 2018; 1864:3805-3823. [PMID: 30251697 DOI: 10.1016/j.bbadis.2018.08.034] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 08/27/2018] [Indexed: 02/06/2023]
Abstract
Type 2 diabetes has traditionally been viewed as a metabolic disorder characterised by chronic high glucose levels, insulin resistance, and declining insulin secretion from the pancreas. Modern lifestyle, with abundant nutrient supply and reduced physical activity, has resulted in dramatic increases in the rates of obesity-associated disease conditions, including diabetes. The associated excess of nutrients induces a state of systemic low-grade chronic inflammation that results from production and secretion of inflammatory mediators from the expanded pool of activated adipocytes. Here, we review the mechanisms by which obesity induces adipose tissue dysregulation, detailing the roles of adipose tissue secreted factors and their action upon other cells and tissues central to glucose homeostasis and type 2 diabetes. Furthermore, given the emerging importance of adipokines, cytokines and chemokines in disease progression, we suggest that type 2 diabetes should now be viewed as an autoinflammatory disease, albeit one that is driven by metabolic dysregulation.
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Affiliation(s)
- Laura L Gonzalez
- Interdisciplinary Biomedical Research Centre, School of Science and Technology, Nottingham Trent University, Clifton, Nottingham NG11 8NS, United Kingdom
| | - Karin Garrie
- Interdisciplinary Biomedical Research Centre, School of Science and Technology, Nottingham Trent University, Clifton, Nottingham NG11 8NS, United Kingdom
| | - Mark D Turner
- Interdisciplinary Biomedical Research Centre, School of Science and Technology, Nottingham Trent University, Clifton, Nottingham NG11 8NS, United Kingdom.
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12
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Milajerdi A, Saneei P, Larijani B, Esmaillzadeh A. The effect of dietary glycemic index and glycemic load on inflammatory biomarkers: a systematic review and meta-analysis of randomized clinical trials. Am J Clin Nutr 2018; 107:593-606. [PMID: 29635487 DOI: 10.1093/ajcn/nqx042] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 11/21/2017] [Indexed: 12/29/2022] Open
Abstract
Background To our knowledge, there is no study available that summarizes earlier findings on the effect of dietary glycemic index (GI) and glycemic load (GL) on inflammatory biomarkers. Objective This systematic review and meta-analysis was conducted to systematically review the available clinical trials that examined the effects of low-GI (LGI) and low-GL (LGL) diets on several inflammatory biomarkers in adults. Design We searched for relevant articles published up to June 2017 through PubMed, Medline, SCOPUS, EMBASE, and Google Scholar with the use of relevant keywords. Clinical trials that examined the effect of dietary GI and GL on inflammation in adults were included. Results Overall, 28 randomized controlled trials (RCTs) including 2961 participants (59% women, 41% men) were included in this meta-analysis. By combining findings from 14 studies on high-sensitivity C-reactive protein (hs-CRP) concentrations, we found no significant effect of LGI or LGL diets on serum hs-CRP concentrations compared with the control diet [weighted mean difference (WMD) for dietary GI: -0.05 mg/L (95% CI: -0.21, 0.10 mg/L); and WMD for dietary GL: 0.08 mg/L (95% CI: -0.26, 0.42 mg/L), respectively]. After combining effect sizes from 5 studies, we did not find significant changes in serum tumor necrosis factor α (TNF-α) concentrations comparing control diets with LGI (WMD: -0.18 mg/L; 95% CI: -0.43, 0.06 mg/L) or LGL (WMD: -0.20 mg/L; 95% CI: -0.33, 0.07 mg/L) diets. Significant changes were also not seen in leptin and interleukin 6 (IL-6) concentrations after the consumption of LGI or LGL diets. Conclusions We did not find any significant effect of dietary GI or GL on serum concentrations of inflammatory cytokines, including hs-CRP, leptin, IL-6, and TNF-α in adults. Additional RCTs-in particular, feeding trials-are required to shed light on this issue.
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Affiliation(s)
- Alireza Milajerdi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics
| | | | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics.,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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13
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Chae BS. Pretreatment of Low-Dose and Super-Low-Dose LPS on the Production of In Vitro LPS-Induced Inflammatory Mediators. Toxicol Res 2018; 34:65-73. [PMID: 29372003 PMCID: PMC5776914 DOI: 10.5487/tr.2018.34.1.065] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 12/17/2017] [Accepted: 12/20/2017] [Indexed: 12/13/2022] Open
Abstract
Pretreatment of low-dose lipopolysaccharide (LPS) induces a hyporesponsive state to subsequent secondary challenge with high-dose LPS in innate immune cells, whereas super-low-dose LPS results in augmented expression of pro-inflammatory cytokines. However, little is known about the difference between super-low-dose and low-dose LPS pretreatments on immune cell-mediated inflammatory and hepatic acute-phase responses to secondary LPS. In the present study, RAW 264.7 cells, EL4 cells, and Hepa-1c1c7 cells were pretreated with super-low-dose LPS (SL-LPS: 50 pg/mL) or low-dose LPS (L-LPS: 50 ng/mL) in fresh complete medium once a day for 2~3 days and then cultured in fresh complete medium for 24 hr or 48 hr in the presence or absence of LPS (1~10 μg/mL) or concanavalin A (Con A). SL-LPS pretreatment strongly enhanced the LPS-induced production of tumor necrosis factor (TNF)-α, interleukin (IL)-6, TNF-α/IL-10, prostaglandin E2 (PGE2), and nitric oxide (NO) by RAW 264.7 cells compared to the control, whereas L-LPS increased IL-6 and NO production only. SL-LPS strongly augmented the Con A-induced ratios of interferon (IFN)-γ/IL-10 in EL4 cells but decreased the LPS-induced ratios of IFN-γ/IL-10 compared to the control, while L-LPS decreased the Con A- and LPS-induced ratios of IFN-γ/IL-10. SL-LPS enhanced the LPS-induced production of IL-6 by Hepa1c1c-7 cells compared to the control, while L-LPS increased IL-6 but decreased IL-1β and C reactive protein (CRP) levels. SL-LPS pretreatment strongly enhanced the LPS-induced production of TNF-α, IL-6, IL-10, PGE2, and NO in RAW 264.7 cells, and the IL-6, IL-1β, and CRP levels in Hepa1c1c-7 cells, as well as the ratios of IFN-γ/IL-10 in LPS- and Con A-stimulated EL4 cells compared to L-LPS. These findings suggest that pre-conditioning of SL-LPS may contribute to the mortality to secondary infection in sepsis rather than pre-conditioning of L-LPS.
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14
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Morena M, Bosc JY, Jaussent I, Dupuy AM, Terrier N, Leray-Moragues H, Flavier JL, Maurice F, Delcourt C, Cristol JP, Canaud B. The role of mineral metabolism and inflammation on dialysis vascular access failure. J Vasc Access 2018; 7:77-82. [PMID: 16868901 DOI: 10.1177/112972980600700207] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Thrombosis of arteriovenous fistula (AVF) is the leading cause of vascular access (VA) loss usually due to silent stenosis. Therefore, assessment of relevant risk factors of VA monitoring may provide insight into potential therapeutic targets for stenosis and thrombosis. The aim of this study was to evaluate the influence of cardiovascular risk factors (including inflammation and mineral metabolism dysfunctions) on the failure of internal AVF in HD patients. 128 HD patients with internal AVF were included in the study and followed up for two years. At baseline, VA morphology and function were followed by Doppler ultrasonography and serum albumin, prealbumine, C-reactive protein, orosomucoid, calcium, phosphorus, parathyroid hormone, bone-type alkaline phosphatase, osteoprotegerin and receptor activator of nuclear factor κB ligand were measured. At baseline, 50 stenoses were detected but none of them required any intervention. Age and biological parameters did not significantly differ between patients with or without VA stenosis. Over the two year- follow up, VA thrombosis occurred in 19 patients. Preexisting stenosis of VA was present in 9/19 patients (47.3% of cases) (chi-square = 3.708, p = 0.0538). Despite the low rate of events, phosphorus [1.75 (0.95–2.77) vs 1.42 (0.47–3.22) mmol/L, p = 0.0416], Calcium x Phosphorus product [4.00 (2.00–5.90) vs 3.40 (1.10–6.80) mmol2/L2, p = 0.0676] and parathyroid hormone [165.00 (1.00–944.00) vs 79.50 (1.00–846.60) ng/L, p = 0.0814) levels were higher in the 19 thrombotic patients whereas all other biological parameters did not significantly differ. These results, which confirm that VA thrombosis occurs more frequently upon preexisting stenosis, also demonstrate that mineral metabolism disorders, compared to inflammation, may contribute to VA dysfunction leading to thrombosis.
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Affiliation(s)
- M Morena
- Biochemistry Laboratory, Lapeyronie University Hospital, Montpellier, France
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15
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Dutheil F, Gordon BA, Naughton G, Crendal E, Courteix D, Chaplais E, Thivel D, Lac G, Benson AC. Cardiovascular risk of adipokines: a review. J Int Med Res 2017; 46:2082-2095. [PMID: 28974138 PMCID: PMC6023062 DOI: 10.1177/0300060517706578] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Over the last two decades, the understanding of adipose tissue has undergone radical change. The perception has evolved from an inert energy storage tissue to that of an active endocrine organ. Adipose tissue releases a cluster of active molecules named adipokines. The severity of obesity-related diseases does not necessarily correlate with the extent of body fat accumulation but is closely related to body fat distribution, particularly to visceral localization. There is a distinction between the metabolic function of central obesity (visceral abdominal) and peripheral obesity (subcutaneous) in the production of adipokines. Visceral fat accumulation, linked with levels of some adipokines, induces chronic inflammation and metabolic disorders, including glucose intolerance, hyperlipidaemia, and arterial hypertension. Together, these conditions contribute to a diagnosis of metabolic syndrome, directly associated with the onset of cardiovascular disease. If it is well known that adipokines contribute to the inflammatory profile and appetite regulation, this review is novel in synthesising the current state of knowledge of the role of visceral adipose tissue and its secretion of adipokines in cardiovascular risk.
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Affiliation(s)
- Frédéric Dutheil
- 1 University Hospital of Clermont-Ferrand (CHU), Preventive and Occupational Medicine, Clermont-Ferrand, France.,2 Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, Clermont-Ferrand, France.,3 Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia.,4 WittyFit, Paris, France
| | - Brett Ashley Gordon
- 5 La Trobe University, La Trobe Rural Health School, Exercise Physiology, Bendigo, Victoria, Australia
| | - Geraldine Naughton
- 3 Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia
| | - Edward Crendal
- 3 Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia
| | - Daniel Courteix
- 3 Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia.,6 Université Clermont Auvergne, Laboratoire des Adaptations Métaboliques à l'Exercice en conditions Physiologiques et Pathologiques (AME2P), Clermont-Ferrand, France
| | - Elodie Chaplais
- 3 Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia.,6 Université Clermont Auvergne, Laboratoire des Adaptations Métaboliques à l'Exercice en conditions Physiologiques et Pathologiques (AME2P), Clermont-Ferrand, France
| | - David Thivel
- 6 Université Clermont Auvergne, Laboratoire des Adaptations Métaboliques à l'Exercice en conditions Physiologiques et Pathologiques (AME2P), Clermont-Ferrand, France
| | - Gérard Lac
- 6 Université Clermont Auvergne, Laboratoire des Adaptations Métaboliques à l'Exercice en conditions Physiologiques et Pathologiques (AME2P), Clermont-Ferrand, France
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16
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Pérez CM, Muñoz F, Andriankaja OM, Ritchie CS, Martínez S, Vergara J, Vivaldi J, López L, Campos M, Joshipura KJ. Cross-sectional associations of impaired glucose metabolism measures with bleeding on probing and periodontitis. J Clin Periodontol 2017; 44:142-149. [PMID: 27978601 DOI: 10.1111/jcpe.12662] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2016] [Indexed: 12/17/2022]
Abstract
AIM This study assessed the associations of pre-diabetes and insulin resistance with bleeding on probing (BOP) and periodontitis among adults. MATERIALS AND METHODS We included 1191 Hispanic adults aged 40-65 years, free of diabetes, enrolled in San Juan Overweight Adults Longitudinal Study. Pre-diabetes was defined as impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or impaired glycated haemoglobin. Impaired one-hour plasma glucose (1hPG) was defined as levels >155 mg/dl. Insulin resistance was defined using the study population-specific 75th percentile (HOMA-IR ≥ 3.13). High BOP was defined as percentage of teeth with bleeding ≥30%. Periodontitis was defined according to the CDC/AAP definition. RESULTS After multivariable adjustment for age, gender, education, smoking status, alcohol consumption, physical activity, obesity, HDL-C, and plaque index, pre-diabetes with and without 1hPG, IFG, impaired 1hPG, IGT, and HOMA-IR were significantly associated with high BOP; pre-diabetes, IFG, and impaired 1hPG were significantly associated with severe periodontitis. Most of these associations remained significant when the analyses were restricted to non-smokers. CONCLUSIONS This study suggests associations between pre-diabetes and insulin resistance with BOP and periodontitis. Given the high prevalence of impaired glucose metabolism and periodontitis, the assessment of the temporal sequence of these associations is of utmost importance.
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Affiliation(s)
- Cynthia M Pérez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Francisco Muñoz
- Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Oelisoa M Andriankaja
- Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Christine S Ritchie
- San Francisco Veterans Affairs Medical Center, Center for Research on Aging at the Jewish Home of San Francisco, San Francisco, CA, USA
| | - Sasha Martínez
- Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - José Vergara
- Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - José Vivaldi
- School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Lydia López
- School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Maribel Campos
- Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Kaumudi J Joshipura
- Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA
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17
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László A, Tabák Á, Kőrösi B, Eörsi D, Torzsa P, Cseprekál O, Tislér A, Reusz G, Nemcsik-Bencze Z, Gonda X, Rihmer Z, Nemcsik J. Association of affective temperaments with blood pressure and arterial stiffness in hypertensive patients: a cross-sectional study. BMC Cardiovasc Disord 2016; 16:158. [PMID: 27503108 PMCID: PMC4977892 DOI: 10.1186/s12872-016-0337-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 07/29/2016] [Indexed: 01/31/2023] Open
Abstract
Background Affective temperaments (anxious, depressive, cyclothymic, irritable and hyperthymic) measure subclinical manifestations of major mood disorders. Furthermore, cumulating evidence suggests their involvement in somatic disorders as well. We aimed to assess associations between affective temperament scores and blood pressure and arterial stiffness parameters in hypertensive patients. Methods In this cross-sectional study, 173 patients with well-controlled or grade 1 chronic hypertension, with no history of depression, completed the TEMPS-A, Beck Depression Inventory (BDI) and Hamilton Anxiety Scale (HAM-A) questionnaires in three GP practices. Arterial stiffness was measured with tonometry (PulsePen). Results According to multiple linear regression analysis, cyclothymic temperament score was positively associated with brachial systolic blood pressure independently of age, sex, total cholesterol, brachial diastolic blood pressure, BDI, HAM-A and the use of alprazolam (β = 0.529, p = 0.042), while hyperthymic temperament score was negatively related to augmentation index independent of age, sex, smoking, heart rate, BDI, HAM-A and the use of alprazolam (β = -0.612, p = 0.013). A significant interaction was found between cyclothymic temperament score and sex in predicting brachial systolic blood pressure (p = 0.025), between irritable and anxious temperament scores and sex in predicting pulse wave velocity (p = 0.021, p = 0.023, respectively) and an interaction with borderline significance between hyperthymic temperament score and sex in predicting augmentation index (p = 0.052). Conclusions The present findings highlight elevated blood pressure among subjects with high cyclothymic temperament as well as an increased level of arterial stiffening in subjects with low hyperthymic scores suggesting that affective temperaments may play a role in the development of hypertension and arterial stiffening and may thus represent markers of cardiovascular risk. Sex differences were also present in these associations.
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Affiliation(s)
- Andrea László
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Ádám Tabák
- 1st Department of Medicine, Semmelweis University, Budapest, Hungary.,Department of Epidemiology and Public Health, University College, London, UK
| | - Beáta Kőrösi
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Dániel Eörsi
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Torzsa
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Orsolya Cseprekál
- 1st Department of Medicine, Semmelweis University, Budapest, Hungary
| | - András Tislér
- 1st Department of Medicine, Semmelweis University, Budapest, Hungary
| | - György Reusz
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Zsófia Nemcsik-Bencze
- Magnetic Resonance Imaging Research Center, Semmelweis University, Budapest, Hungary
| | - Xénia Gonda
- Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary. .,Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary. .,MTA-SE Neurochemistry Research Group, Budapest, Hungary.
| | - Zoltán Rihmer
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - János Nemcsik
- Department of Family Medicine, Semmelweis University, Budapest, Hungary.,Health Service of Zugló (ZESZ), Budapest, Hungary
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18
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Nash MS, Tractenberg RE, Mendez AJ, David M, Ljungberg IH, Tinsley EA, Burns-Drecq PA, Betancourt LF, Groah SL. Cardiometabolic Syndrome in People With Spinal Cord Injury/Disease: Guideline-Derived and Nonguideline Risk Components in a Pooled Sample. Arch Phys Med Rehabil 2016; 97:1696-705. [PMID: 27465752 DOI: 10.1016/j.apmr.2016.07.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 07/14/2016] [Accepted: 07/16/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To assess cardiometabolic syndrome (CMS) risk definitions in spinal cord injury/disease (SCI/D). DESIGN Cross-sectional analysis of a pooled sample. SETTING Two SCI/D academic medical and rehabilitation centers. PARTICIPANTS Baseline data from subjects in 7 clinical studies were pooled; not all variables were collected in all studies; therefore, participant numbers varied from 119 to 389. The pooled sample included men (79%) and women (21%) with SCI/D >1 year at spinal cord levels spanning C3-T2 (American Spinal Injury Association Impairment Scale [AIS] grades A-D). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES We computed the prevalence of CMS using the American Heart Association/National Heart, Lung, and Blood Institute guideline (CMS diagnosis as sum of risks ≥3 method) for the following risk components: overweight/obesity, insulin resistance, hypertension, and dyslipidemia. We compared this prevalence with the risk calculated from 2 routinely used nonguideline CMS risk assessments: (1) key cut scores identifying insulin resistance derived from the homeostatic model 2 (HOMA2) method or quantitative insulin sensitivity check index (QUICKI), and (2) a cardioendocrine risk ratio based on an inflammation (C-reactive protein [CRP])-adjusted total cholesterol/high-density lipoprotein cholesterol ratio. RESULTS After adjustment for multiple comparisons, injury level and AIS grade were unrelated to CMS or risk factors. Of the participants, 13% and 32.1% had CMS when using the sum of risks or HOMA2/QUICKI model, respectively. Overweight/obesity and (pre)hypertension were highly prevalent (83% and 62.1%, respectively), with risk for overweight/obesity being significantly associated with CMS diagnosis (sum of risks, χ(2)=10.105; adjusted P=.008). Insulin resistance was significantly associated with CMS when using the HOMA2/QUICKI model (χ(2)2=21.23, adjusted P<.001). Of the subjects, 76.4% were at moderate to high risk from elevated CRP, which was significantly associated with CMS determination (both methods; sum of risks, χ(2)2=10.198; adjusted P=.048 and HOMA2/QUICKI, χ(2)2=10.532; adjusted P=.04). CONCLUSIONS As expected, guideline-derived CMS risk factors were prevalent in individuals with SCI/D. Overweight/obesity, hypertension, and elevated CRP were common in SCI/D and, because they may compound risks associated with CMS, should be considered population-specific risk determinants. Heightened surveillance for risk, and adoption of healthy living recommendations specifically directed toward weight reduction, hypertension management, and inflammation control, should be incorporated as a priority for disease prevention and management.
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Affiliation(s)
- Mark S Nash
- Department of Neurological Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL; Department of Physical Medicine and Rehabilitation, and Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL; The Miami Project to Cure Paralysis, Leonard M. Miller School of Medicine, University of Miami, Miami, FL.
| | - Rochelle E Tractenberg
- Collaborative for Research on Outcomes and Metrics, Georgetown University Medical Center, Washington, DC; Department of Neurology, Georgetown University Medical Center, Washington, DC; Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University Medical Center, Washington, DC; Department of Rehabilitation Medicine, Georgetown University Medical Center, Washington, DC
| | - Armando J Mendez
- Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL; Diabetes Research Institute, Leonard M. Miller School of Medicine, University of Miami, Miami, FL
| | - Maya David
- The Miami Project to Cure Paralysis, Leonard M. Miller School of Medicine, University of Miami, Miami, FL
| | | | | | - Patricia A Burns-Drecq
- The Miami Project to Cure Paralysis, Leonard M. Miller School of Medicine, University of Miami, Miami, FL
| | - Luisa F Betancourt
- The Miami Project to Cure Paralysis, Leonard M. Miller School of Medicine, University of Miami, Miami, FL
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19
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Whalen KA, McCullough ML, Flanders WD, Hartman TJ, Judd S, Bostick RM. Paleolithic and Mediterranean Diet Pattern Scores Are Inversely Associated with Biomarkers of Inflammation and Oxidative Balance in Adults. J Nutr 2016; 146:1217-26. [PMID: 27099230 PMCID: PMC4877627 DOI: 10.3945/jn.115.224048] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 10/23/2015] [Accepted: 03/15/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Chronic inflammation and oxidative balance are associated with poor diet quality and risk of cancer and other chronic diseases. A diet-inflammation/oxidative balance association may relate to evolutionary discordance. OBJECTIVE We investigated associations between 2 diet pattern scores, the Paleolithic and the Mediterranean, and circulating concentrations of 2 related biomarkers, high-sensitivity C-reactive protein (hsCRP), an acute inflammatory protein, and F2-isoprostane, a reliable marker of in vivo lipid peroxidation. METHODS In a pooled cross-sectional study of 30- to 74-y-old men and women in an elective outpatient colonoscopy population (n = 646), we created diet scores from responses on Willett food-frequency questionnaires and measured plasma hsCRP and F2-isoprostane concentrations by ELISA and gas chromatography-mass spectrometry, respectively. Both diet scores were calculated and categorized into quintiles, and their associations with biomarker concentrations were estimated with the use of general linear models to calculate and compare adjusted geometric means, and via unconditional ordinal logistic regression. RESULTS There were statistically significant trends for decreasing geometric mean plasma hsCRP and F2-isoprostane concentrations with increasing quintiles of the Paleolithic and Mediterranean diet scores. The multivariable-adjusted ORs comparing those in the highest with those in the lowest quintiles of the Paleolithic and Mediterranean diet scores were 0.61 (95% CI: 0.36, 1.05; P-trend = 0.06) and 0.71 (95% CI: 0.42, 1.20; P-trend = 0.01), respectively, for a higher hsCRP concentration, and 0.51 (95% CI: 0.27, 0.95; P-trend 0.01) and 0.39 (95% CI: 0.21, 0.73; P-trend = 0.01), respectively, for a higher F2-isoprostane concentration. CONCLUSION These findings suggest that diets that are more Paleolithic- or Mediterranean-like may be associated with lower levels of systemic inflammation and oxidative stress in humans.
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Affiliation(s)
| | | | - W Dana Flanders
- Department of Epidemiology and Department of Biostatistics and Bioinformatics, Rollins School of Public Health, and Winship Cancer Institute, Emory University, Atlanta, GA
| | - Terryl J Hartman
- Department of Epidemiology and Winship Cancer Institute, Emory University, Atlanta, GA
| | - Suzanne Judd
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL
| | - Roberd M Bostick
- Department of Epidemiology and Winship Cancer Institute, Emory University, Atlanta, GA;
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Ye X, Peng L, Kan H, Wang W, Geng F, Mu Z, Zhou J, Yang D. Acute Effects of Particulate Air Pollution on the Incidence of Coronary Heart Disease in Shanghai, China. PLoS One 2016; 11:e0151119. [PMID: 26942767 PMCID: PMC4778855 DOI: 10.1371/journal.pone.0151119] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 02/22/2016] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Evidence based on ecological studies in China suggests that short-term exposure to particulate matter (PM) is associated with cardiovascular mortality. However, there is less evidence of PM-related morbidity for coronary heart disease (CHD) in China. This study aims to investigate the relationship between acute PM exposure and CHD incidence in people aged above 40 in Shanghai. METHODS Daily CHD events during 2005-2012 were identified from outpatient and emergency department visits. Daily average concentrations for particulate matter with aerodynamic diameter less than 10 microns (PM10) were collected over the 8-year period. Particulate matter with aerodynamic diameter less than 2.5 microns (PM2.5) were measured from 2009 to 2012. Analyses were performed using quasi-poisson regression models adjusting for confounders, including long-term trend, seasonality, day of the week, public holiday and meteorological factors. The effects were also examined by gender and age group (41-65 years, and >65 years). RESULTS There were 619928 CHD outpatient and emergency department visits. The average concentrations of PM10 and PM2.5 were 81.7 μg/m3 and 38.6 μg/m3, respectively. Elevated exposure to PM10 and PM2.5 was related with increased risk of CHD outpatients and emergency department visits in a short time course. A 10 μg/m3 increase in the 2-day PM10 and PM2.5 was associated with increase of 0.23% (95% CI: 0.12%, 0.34%) and 0.74% (95% CI: 0.44%, 1.04%) in CHD morbidity, respectively. The associations appeared to be more evident in the male and the elderly. CONCLUSION Short-term exposure to high levels of PM10 and PM2.5 was associated with increased risk of CHD outpatient and emergency department visits. Season, gender and age were effect modifiers of their association.
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Affiliation(s)
- Xiaofang Ye
- Department of Environment Health, School of Public Health, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Li Peng
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Haidong Kan
- School of Public Health and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
| | - Weibing Wang
- School of Public Health and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
- Fudan Tyndall Centre, Shanghai, China
| | - Fuhai Geng
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Zhe Mu
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Ji Zhou
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Dandan Yang
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
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Choi JR, Jang Y, Kim Yoon S, Park JK, Sorn SR, Park MY, Lee M. The Impact of CDH13 Polymorphism and Statin Administration on TG/HDL Ratio in Cardiovascular Patients. Yonsei Med J 2015; 56:1604-12. [PMID: 26446643 PMCID: PMC4630049 DOI: 10.3349/ymj.2015.56.6.1604] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 07/21/2015] [Accepted: 07/21/2015] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Adiponectin is expressed in adipose tissue, and is affected by smoking, obesity, and genetic factors, such as CDH13 polymorphism, contributing to the development of coronary vascular diseases (CVDs). MATERIALS AND METHODS We investigated the effect of genetic variations of CDH13 (rs3865188) on blood chemistry and adiponectin levels in 345 CVD patients undergoing statin-free or statin treatment. RESULTS Genetic variation in CDH13 was significantly correlated with several clinical factors, including adiponectin, diastolic blood pressure, triglyceride (TG), and insulin levels. Subjects with the T allele (mutant form) had significantly lower adiponectin levels than those with the A allele. Total cholesterol (TC), low-density lipoprotein cholesterol (LDLc), TG/high-density lipoprotein cholesterol (HDLc) ratio, and HDL3b subtype were markedly decreased in statin treated subjects regardless of having the A or T allele. TG and TG/HDL in the statin-free group with TT genotype of the rs3865188 was higher than in the others but they were not different in the statin-treated subjects. We observed a significant difference in adiponectin levels between patients with the A and T alleles in the statin-free group; meanwhile, no difference in adiponectin levels was noted in the statin group. Plasma levels of other cytokines, leptin, visfatin, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α), were not different among the CDH13 genotypes according to statin administration. Body mass index (BMI), TG, insulin, HDL3b, and TG/HDL ratio showed negative correlations with adiponectin levels. CONCLUSION Plasma adiponectin levels and TG/HDL ratio were significantly different according to variants of CDH13 and statin administration in Korean patients with CVD.
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Affiliation(s)
- Jung Ran Choi
- Department of Food and Nutrition, and Research Institute of Obesity Sciences, Sungshin Women's University, Seoul, Korea
| | - Yangsoo Jang
- Cardiovascular Genome Center, Cardiology Division, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
| | - Sungjoo Kim Yoon
- Research Institute of Molecular Genetics, The Catholic University of Korea, Seoul, Korea
| | - Jong Keun Park
- Research Institute of Molecular Genetics, The Catholic University of Korea, Seoul, Korea
| | | | - Mi-Young Park
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Myoungsook Lee
- Department of Food and Nutrition, and Research Institute of Obesity Sciences, Sungshin Women's University, Seoul, Korea.
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László A, Babos L, Kis-Igari Z, Pálfy A, Torzsa P, Eőry A, Kalabay L, Gonda X, Rihmer Z, Cseprekál O, Tislér A, Hodrea J, Lénárt L, Fekete A, Nemcsik J. Identification of hypertensive patients with dominant affective temperaments might improve the psychopathological and cardiovascular risk stratification: a pilot, case-control study. Ann Gen Psychiatry 2015; 14:33. [PMID: 26512294 PMCID: PMC4623904 DOI: 10.1186/s12991-015-0072-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 10/14/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Although mood disorders and cardiovascular diseases have widely studied psychosomatic connections, data concerning the influence of the psychopathologically important affective temperaments in hypertension are scarce. To define a possibly higher cardiovascular risk subpopulation we investigated in well-treated hypertensive patients with dominant affective temperaments (DOM) and in well-treated hypertensive patients without dominant temperaments the level of depression and anxiety, arterial stiffness and serum Brain-derived Neurotrophic Factor (seBDNF). METHODS 175 hypertensive patients, free of the history of psychiatric diseases, completed the TEMPS-A, Beck Depression Inventory and Hamilton Anxiety Scale questionnaires in two primary care practices. Of those 175 patients, 24 DOM patients and 24 hypertensive controls (matched in age, sex and the presence of diabetes) were selected for measurements of arterial stiffness and seBDNF level. RESULTS Beck and Hamilton scores in DOM patients were higher compared with controls. Pulse wave velocity and augmentation index did not differ between the groups while in the DOM patients decreased brachial systolic and diastolic and central diastolic blood pressures were found compared with controls. SeBDNF was lower in the DOM group than in the controls (22.4 ± 7.2 vs. 27.3 ± 7.8 ng/mL, p < 0.05). CONCLUSIONS Although similar arterial stiffness parameters were found in DOM patients, their increased depression and anxiety scores, the decreased brachial and central diastolic blood pressures as well as the decreased seBDNF might refer to their higher vulnerability regarding the development not only of major mood disorders, but also of cardiovascular complications. These data suggest that the evaluation of affective temperaments should get more attention both with regard to psychopathology and cardiovascular health management.
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Affiliation(s)
- Andrea László
- Department of Family Medicine, Semmelweis University Budapest, Budapest, Hungary
| | - Levente Babos
- Department of Family Medicine, Semmelweis University Budapest, Budapest, Hungary
| | - Zsóka Kis-Igari
- Department of Family Medicine, Semmelweis University Budapest, Budapest, Hungary
| | - Adrienn Pálfy
- Department of Family Medicine, Semmelweis University Budapest, Budapest, Hungary
| | - Péter Torzsa
- Department of Family Medicine, Semmelweis University Budapest, Budapest, Hungary
| | - Ajándék Eőry
- Department of Family Medicine, Semmelweis University Budapest, Budapest, Hungary
| | - László Kalabay
- Department of Family Medicine, Semmelweis University Budapest, Budapest, Hungary
| | - Xenia Gonda
- Department of Pharmacodynamics, Semmelweis University Budapest, Budapest, Hungary ; Department of Clinical and Theoretical Mental Health, Semmelweis University Budapest, Budapest, Hungary ; MTA-SE Neurochemistry Research Group, Budapest, Hungary
| | - Zoltán Rihmer
- Department of Clinical and Theoretical Mental Health, Semmelweis University Budapest, Budapest, Hungary
| | | | - András Tislér
- Ist Department of Internal Medicine, Budapest, Hungary
| | - Judit Hodrea
- MTA-SE "Lendület" Diabetes Research Group Budapest, Budapest, Hungary
| | - Lilla Lénárt
- MTA-SE "Lendület" Diabetes Research Group Budapest, Budapest, Hungary
| | - Andrea Fekete
- MTA-SE "Lendület" Diabetes Research Group Budapest, Budapest, Hungary
| | - János Nemcsik
- Department of Family Medicine, Semmelweis University Budapest, Budapest, Hungary ; Health Service of Zugló (ZESZ), Budapest, Hungary
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Orsatti CL, Nahas EAP, Nahas-Neto J, Orsatti FL, Giorgi VI, Witkin SS. Evaluation of Toll-Like receptor 2 and 4 RNA expression and the cytokine profile in postmenopausal women with metabolic syndrome. PLoS One 2014; 9:e109259. [PMID: 25329057 PMCID: PMC4201477 DOI: 10.1371/journal.pone.0109259] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 09/04/2014] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To evaluate the gene expression of Toll-Like (TLR-2 and TLR-4) receptors and cytokine profile in postmenopausal women with or without metabolic syndrome (MetS). METHODS In this cross-sectional study, 311 Brazilian women (age≥45 years and amenorrhea≥12 months) were included. Women showing three or more of the following diagnostic criteria were diagnosed as positive for MetS: waist circumference>88 cm, triglycerides≥150 mg/dL, HDL cholesterol<50 mg/dL, blood pressure≥130/85 mmHg, and fasting glucose≥100 mg/dL. The expression of TLR-2 and TLR-4 in peripheral blood was evaluated by RNA extraction and subsequent real time PCR analysis. The cytokine profile, tumor necrosis factor alpha (TNF-α) and interleukins 1β, 6, and 10, were measured by ELISA. RESULTS The expression of TLR-2 RNA was demonstrated in 32.5% and TLR-4 in 20.6% of the subjects. There was no association between the expression of TLR-2 and TLR-4 and the presence or absence of MetS (P>0.05). A greater production of IL-6 was associated with TLR-2 and TLR-4 expressions and greater production of TNF-α was associated only with TLR-2 expression (P>0.05). Only the lower quartile of IL-10 was associated with the presence of the MetS (P>0.05). CONCLUSIONS TLR-2 and TLR-4 expressions were associated with increased pro-inflammatory cytokines, IL-6 and TNF-α, with no association with biomarkers of MetS. The low concentrations of IL-10 may suggest an anti-inflammatory modulation in postmenopausal women with MetS.
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Affiliation(s)
- Claudio Lera Orsatti
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University-UNESP, Botucatu, São Paulo, Brazil
| | - Eliana Aguiar Petri Nahas
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University-UNESP, Botucatu, São Paulo, Brazil
| | - Jorge Nahas-Neto
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University-UNESP, Botucatu, São Paulo, Brazil
| | - Fabio Lera Orsatti
- Department of Sports Science Institute of Health Sciences-UFTM, Uberaba, Minas Gerais, Brazil
| | - Vanessa Innocenti Giorgi
- Department of Microbiology and Immunology, Institute of Biosciences, Sao Paulo State University- UNESP, Botucatu, Sao Paulo, Brazil
| | - Steven S. Witkin
- Department of Obstetrics and Gynecology, Division of Immunology and Infectious Diseases, Weill Cornell Medical College, New York, New York, United States of America
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Isoda K, Akita K, Isobe S, Niida T, Adachi T, Iwakura Y, Daida H. Interleukin-1 receptor antagonist originating from bone marrowderived cells and non-bone marrow-derived cells helps to suppress arterial inflammation and reduce neointimal formation after injury. J Atheroscler Thromb 2014; 21:1208-18. [PMID: 25223697 DOI: 10.5551/jat.25668] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Interleukin-1 receptor antagonist (IL-1Ra) negatively regulates IL-1 signaling by blocking the functional receptor. We previously demonstrated that IL-1Ra-deficient (IL-1Ra-/-) mice exhibit marked neointimal formation after injury. IL-1Ra is expressed on bone marrow (BM)-derived cells as well as non-BM intrinsic arterial cells. However, the importance of various cell types as sources of IL-1Ra remains unknown. The aim of this study was to test the hypothesis that IL-1Ra originating from BM-derived cells and non-BM intrinsic cells helps to suppress both inflammation and neointimal formation after vascular injury using a model of BM cell transplantation (BMT). METHODS In order to determine the contribution of IL-1Ra-deficient (Ra-/-) and wild-type (WT) BM cells to neointimal formation, we developed four types of BM chimeric mice (BMT(WT→WT) (n=12), BMT(Ra-/-→WT) (n=12), BMT(WT→Ra-/-) (n=12) and BMT(Ra-/-→Ra-/-) (n=12)). At four weeks after BMT, we induced vascular injury by placing a non-occlusive cuff around the femoral artery. Histological analyses were subsequently performed two weeks after injury. RESULTS Neointimal formation was decreased in the BMT(WT→Ra-/-) mice compared with that observed in the BMT(Ra-/-→Ra-/-) mice (p<0.001), but significantly more so in the BMT(Ra-/-→WT) (p<0.01) and BMT(WT→WT) (p<0.01) mice. In contrast, the neointimal formation in the BMT(Ra-/-→WT) mice was significantly increased compared with that noted in the BMT(WT→WT) mice (p<0.05). In addition, immunostaining revealed that Mac3-positive areas were significantly increased in the BMT(Ra-/-→Ra-/-) mice compared with those seen in the other three groups (p<0.001), with a significantly decreased percentage of alpha-SMA-positive areas in the neointima in the BMT(Ra-/-→Ra-/-) mice compared with that found in the remaining groups (p<0.001). Furthermore, IL-1Ra staining demonstrated the IL-1Ra expression in several inflammatory cells in the adventitia in the BMT(WT→WT) and BMT(WT→Ra-/-) mice, compared to the neointima in the BMT(WT→WT) and BMT(Ra-/-→WT) mice. CONCLUSIONS The IL-1Ra present in BM-derived cells and non-BM cells helps to suppress arterial inflammation, resulting in decreased neointimal formation after injury. These findings shed new light on the mechanisms underlying the development of atherosclerosis and restenosis after angioplasty.
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Miller WM, Nori Janosz KE, Yanez J, McCullough PA. Effects of weight loss and pharmacotherapy on inflammatory markers of cardiovascular disease. Expert Rev Cardiovasc Ther 2014; 3:743-59. [PMID: 16076283 DOI: 10.1586/14779072.3.4.743] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Obesity is currently an epidemic, and the prevalence of cardiovascular risk factors is increasing dramatically as a result. Visceral adiposity is correlated with a proinflammatory and prothrombotic state that is believed to promote atherosclerosis and acute coronary syndromes. This article will review clinical trials on the effects of weight loss and pharmacotherapy on obesity associated inflammatory and thrombotic markers linked with cardiovascular disease.
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Affiliation(s)
- Wendy M Miller
- Beaumont Health Center, Weight Control Center, Division of Nutrition and Preventive Medicine, William Beaumont Hospital, Royal Oak, 4949 Coolidge Highway, Royal Oak, MI 48078, USA.
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DiRienzo DB. Effect of probiotics on biomarkers of cardiovascular disease: implications for heart-healthy diets. Nutr Rev 2013; 72:18-29. [DOI: 10.1111/nure.12084] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Schwingshackl L, Hoffmann G. Long-term effects of low glycemic index/load vs. high glycemic index/load diets on parameters of obesity and obesity-associated risks: a systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2013; 23:699-706. [PMID: 23786819 DOI: 10.1016/j.numecd.2013.04.008] [Citation(s) in RCA: 168] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 02/18/2013] [Accepted: 04/21/2013] [Indexed: 01/26/2023]
Abstract
AIM The aim of the present meta-analysis was to investigate the long-term effects of glycemic index-related diets in the management of obesity with a special emphasis on the potential benefits of low glycemic index/load (GI/GL) in the prevention of obesity-associated risks. DATA SYNTHESIS Electronic searches for randomized controlled trials (RCTs) comparing low glycemic index/load versus high glycemic index/load diets were performed in MEDLINE, EMBASE and the Cochrane Library. Outcome of interest markers included anthropometric data as well as biomarkers of CVD and glycemic control. Study specific weighted mean differences were pooled using a random effect model. 14 studies were included in the primary meta-analysis. Weighted mean differences in change of C-reactive protein [WMD: -0.43 mg/dl, (95% CI -0.78 to -0.09), p = 0.01], and fasting insulin [WMD: -5.16 pmol/L, (95% CI -8.45 to -1.88), p = 0.002] were significantly more pronounced in benefit of low GI/GL diets. However decrease in fat free mass [WMD: -1.04 kg (95% CI -1.73 to -0.35), p = 0.003] was significantly more pronounced following low GI/GL diets as well. No significant changes were observed for blood lipids, anthropometric measures, HbA1c and fasting glucose. Sensitivity analysis was performed for RCTs excluding subjects with type 2 diabetes. Decreases in C-reactive protein and fasting insulin remained statistically significant in the low GI/GL subgroups. CONCLUSIONS The present systematic review provides evidence for beneficial effects of long-term interventions administering a low glycemic index/load diet with respect to fasting insulin and pro-inflammatory markers such as C-reactive protein which might prove to be helpful in the primary prevention of obesity-associated diseases.
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Affiliation(s)
- L Schwingshackl
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Althanstreet 14, UZAII, A-1090 Vienna, Austria.
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Abstract
African Americans have an endothelial dysfunction that likely contributes to their high prevalence of hypertension. Endothelial cell (EC) responses to stimuli could play a role in the development of endothelial dysfunction and hypertension. High physiological levels of vascular laminar shear stress can alter EC phenotype profoundly. It is not known whether there are race-dependent EC responses to laminar shear stress.
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Stegger JG, Schmidt EB, Berentzen TL, Tjønneland A, Vogel U, Rimm E, Sørensen TIA, Overvad K, Jensen MK. Interaction between obesity and the NFKB1 - 94ins/delATTG promoter polymorphism in relation to incident acute coronary syndrome: a follow up study in three independent cohorts. PLoS One 2013; 8:e63004. [PMID: 23671649 PMCID: PMC3650017 DOI: 10.1371/journal.pone.0063004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Accepted: 03/27/2013] [Indexed: 01/24/2023] Open
Abstract
Introduction The NF-κB transcription factor family regulates several genes encoding pro-inflammatory and anti-inflammatory proteins in adipose tissues and in atherosclerotic plaques. The deletion variant allele of the NFKB1 - 94ins/delATTG promoter polymorphism leads to lower transcript levels of the p50 subunit, and the variant allele has been associated with the risk of several inflammatory diseases as well as coronary heart disease where inflammation is important in the pathogenesis. The objective of this study was to explore the potential interaction between the NFKB1-94ins/delATTG promoter polymorphism and general, abdominal, and gluteofemoral obesity in relation to the risk of incident acute coronary syndrome (ACS) in three large independent cohorts. Methods and Results The analyses were conducted in the Danish prospective study Diet, Cancer and Health and the two US based cohorts; Nurses’ Health Study and Health Professionals Follow-up Study. We conducted sex stratified analyses that included 1202 male and 708 female cases of incident ACS. We observed a positive association for general and abdominal obesity with risk of incident ACS, independent of genotype in both genders. Gluteofemoral obesity was negatively associated with ACS risk in women independent of genotype, whereas there was no clear association for men. We calculated the relative excess risk due to interaction (RERI) and observed a statistically significant excess risk among men jointly exposed to general or abdominal obesity and the variant allele of the NFKB1-94ATTG polymorphism, whereas there was a tendency towards sub-additivity for gluteofemoral obesity. The excess risks in all analyses were, however, small and could not clearly be demonstrated in women. Conclusion The variant allele of the NFKB1-94ins/delATTG promoter polymorphism did not substantially modify the association between obesity and incident ACS.
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Affiliation(s)
- Jakob Gerhard Stegger
- Department of Cardiology, Center for Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark.
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Saleh MH, Bertolami MC, Assef JE, Taha MI, de Freitas W, Petisco ACG, Barretto RBM, Le Bihan DC, Barbosa JEM, de Jesus CA, Sousa AGMR. Improvement of atherosclerotic markers in non-diabetic patients after bariatric surgery. Obes Surg 2013; 22:1701-7. [PMID: 22777211 DOI: 10.1007/s11695-012-0706-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND The objective of this study was to assess the impact of bariatric surgery performed in extremely obese non-diabetic subjects on the following parameters: endothelial function, inflammatory processes (assessed by high-sensitivity C-reactive protein [hs-CRP]), carotid artery intima-media thickness (CIMT), and glucose and lipid profiles. METHODS Forty-seven obese individuals with body mass index >40 kg/m(2) underwent bariatric surgery and returned for post-procedure assessment between 6 and 19 months after surgery. Ninety-three percent of patients were female. Their age ranged from 18 to 65 (mean 41) years old at baseline. Baseline was defined as the maximum of 30 days before surgery. Before and after surgery, all patients were subjected to a brachial artery ultrasound examination to evaluate endothelial-dependent dilation, CIMT by ultrasound, and laboratory analyses including glucose, lipid and inflammatory profiles were performed. RESULTS Subjects lost an average of 33 % of their original weight (p < 0.001). Flow-mediated dilation showed significant improvement after surgery from 7.4 % to 18.9 % (p < 0.001) on average. There was regression of CIMT, with the median being reduced from 0.8 to 0.5 mm (p < 0.001). The median Hs-CRP reduced from 0.83 to 0.18 mg/dl (p < 0.001), while glucose and lipid profiles were also improved after surgery. CONCLUSIONS This study shows that severely obese, non-diabetic patients who had pronounced weight loss after bariatric surgery had an overall improvement in brachial flow-mediated dilation, CIMT, high-sensitivity CRP, and glucose and lipid metabolism. The best responses of the brachial flow-mediated dilation after surgery were observed in non-smokers and in younger subjects.
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Affiliation(s)
- Mohamed Hassan Saleh
- Instituto Dante Pazzanese de Cardiologia, State of Sao Paulo - Health Secretary, Sao Paulo, Brazil.
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Casula M, Tragni E, Zambon A, Filippi A, Brignoli O, Cricelli C, Poli A, Catapano AL. C-reactive protein distribution and correlation with traditional cardiovascular risk factors in the Italian population. Eur J Intern Med 2013; 24:161-6. [PMID: 23040261 DOI: 10.1016/j.ejim.2012.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 09/04/2012] [Accepted: 09/13/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND C-reactive protein (CRP) increases during an inflammatory response; its plasma levels are believed to be an independent predictor of future atherosclerotic disease. We report the distribution of plasma levels of CRP and its possible relationship with other cardiovascular risk factors in an Italian cohort. METHODS CRP was assessed in frozen plasma samples of 1949 participants in the CHECK study (2001-2005), which collected clinical and biochemical data from randomly selected subjects (40-79 years) in the setting of Italian general practice. RESULTS Median CRP (interquartile range) was higher in women (1.42 [0.58-2.86] vs 1.28 [0.58-2.50]; p=.163), in people aged ≥ 65 years (1.74 [0.89-3.34] vs 1.11 [0.52-2.45]; p<.001), in patients with obesity (2.37 [1.27-4.15] vs 1.16 [0.52-2.41]; p<.001), metabolic syndrome (2.12 [1.16-3.72] vs 1.10 [0.50-2.38]; p<.001), or higher cardiovascular risk (2.03 [1.01-3.42] vs 1.19 [0.53-2.50]; p<.001). Stepwise regression analysis showed significant associations (R(2)=.264) of circulating log(e)CRP with body mass index, fibrinogen, apoB, age, gender, smoking habits, physical inactivity, creatinine levels, and systolic blood pressure. CONCLUSION This study provides epidemiological data of CRP in the Italian population and reinforces the existing evidences about the close correlation between CRP and markers of inflammation and adiposity.
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Affiliation(s)
- Manuela Casula
- Epidemiology and Preventive Pharmacology Centre (SEFAP), Department of Pharmacological Sciences, University of Milan, Via Balzaretti 9, 20133 Milano, Italy
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Zhao J, Gao Z, Tian Z, Xie Y, Xin F, Jiang R, Kan H, Song W. The biological effects of individual-level PM(2.5) exposure on systemic immunity and inflammatory response in traffic policemen. Occup Environ Med 2013; 70:426-31. [PMID: 23322918 DOI: 10.1136/oemed-2012-100864] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Ambient fine-particle particulate matter (PM2.5) exposure is associated with the decline in pulmonary function, prevalence of coronary heart disease and incidence of myocardial infarction. The study is to observe the effects of ambient PM2.5 on the cardiovascular system and to explore the potential inflammatory and immune mechanisms. METHODS The subjects included 110 traffic policemen in Shanghai, China, who were aged 25-55 years. Two-times continuous 24 h individual-level PM2.5 measurements were performed in winter and summer, respectively. The inflammatory marker (high-sensitivity C-reactive protein, hs-CRP), immune parameters (IgA, IgG, IgM and IgE) and lymphocyte profiles (CD4 T cells, CD8 T cells, CD4/CD8 T cells) were measured in blood. The associations between individual-level PM2.5 and inflammatory marker and immune parameters were analysed by multiple linear regression. RESULTS The average concentration of 24 h personal PM2.5 for participants was 116.98 μg/m(3) and 86.48 μg/m(3) in winter and summer, respectively. In the main analysis, PM2.5 exposure is associated with the increases in hs-CRP of 1.1%, IgG of 6.7%, IgM of 11.2% and IgE of 3.3% in participants, and decreases in IgA of 4.7% and CD8 of 0.7%, whereas we found no statistical association in CD4 T cells and CD4/CD8 T cells. In the adjusted model, the results showed that the increase of PM2.5 was associated with the changes of inflammatory markers and immune markers both in winter and summer. CONCLUSIONS Traffic policeman have been a high-risk group suffering inflammatory response or immune injury because of the high exposure to PM2.5. These findings provided new insight into the mechanisms linking ambient PM2.5 and inflammatory and immune response.
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Affiliation(s)
- Jinzhuo Zhao
- Department of Environment Health, School of Public Health, the Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai 200032, China
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Bellingrath S, Rohleder N, Kudielka BM. Effort-reward-imbalance in healthy teachers is associated with higher LPS-stimulated production and lower glucocorticoid sensitivity of interleukin-6 in vitro. Biol Psychol 2012; 92:403-9. [PMID: 23246534 DOI: 10.1016/j.biopsycho.2012.12.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 11/30/2012] [Accepted: 12/05/2012] [Indexed: 12/14/2022]
Abstract
BACKGROUND According to the effort-reward-imbalance (ERI) model, a lack of reciprocity between costs and gains at work increases the risk for adverse health outcomes. Inflammation has been shown to play a crucial role in a variety of stress-related diseases and alterations in immune system glucocorticoid sensitivity may help to explain the increased risk for cardiovascular disease (CVD) and depression related to chronic work stress. METHODS Changes in lipopolysaccharide (LPS)-induced interleukin (IL)-6 production and inhibition of IL-6 production by dexamethasone in reaction to the Trier Social Stress Test (TSST) were assessed in forty-six healthy school teachers to test whether chronic work stress is accompanied by alterations in inflammatory activity and glucocorticoid sensitivity of the innate immune system. RESULTS High ERI was associated with an increase in pro-inflammatory potential, reflected in elevated IL-6 production before and after stress and with a lower capacity of dexamethasone to suppress IL-6 production in vitro over all measurement time points. ERI was not associated with stress-related changes in GC sensitivity. CONCLUSION The present findings suggest a less effective anti-inflammatory regulation by glucocorticoids in teachers suffering from chronic work stress.
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Affiliation(s)
- Silja Bellingrath
- Institute of Psychology, University of Duisburg-Essen, Berliner Platz 6-8, 45127 Essen, Germany.
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O'Donovan A, Slavich GM, Epel ES, Neylan TC. Exaggerated neurobiological sensitivity to threat as a mechanism linking anxiety with increased risk for diseases of aging. Neurosci Biobehav Rev 2012; 37:96-108. [PMID: 23127296 DOI: 10.1016/j.neubiorev.2012.10.013] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 10/19/2012] [Accepted: 10/28/2012] [Indexed: 12/11/2022]
Abstract
Anxiety disorders increase risk for the early development of several diseases of aging. Elevated inflammation, a common risk factor across diseases of aging, may play a key role in the relationship between anxiety and physical disease. However, the neurobiological mechanisms linking anxiety with elevated inflammation remain unclear. In this review, we present a neurobiological model of the mechanisms by which anxiety promotes inflammation. Specifically we propose that exaggerated neurobiological sensitivity to threat in anxious individuals may lead to sustained threat perception, which is accompanied by prolonged activation of threat-related neural circuitry and threat-responsive biological systems including the hypothalamic-pituitary-adrenal (HPA) axis, autonomic nervous system (ANS), and inflammatory response. Over time, this pattern of responding can promote chronic inflammation through structural and functional brain changes, altered sensitivity of immune cell receptors, dysregulation of the HPA axis and ANS, and accelerated cellular aging. Chronic inflammation, in turn, increases risk for diseases of aging. Exaggerated neurobiological sensitivity to threat may thus be a treatment target for reducing disease risk in anxious individuals.
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Affiliation(s)
- Aoife O'Donovan
- Department of Psychiatry, University of California, San Francisco, CA, USA.
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Wick PA, Mombelli A, Pagano S, Moren X, Giannopoulou C, Mach F, Roux-Lombard P, Vuilleumier N. Anti-apolipoprotein A-1 autoantibodies as biomarker for atherosclerosis burden in patients with periodontitis. J Periodontal Res 2012; 48:350-6. [PMID: 23050768 DOI: 10.1111/jre.12014] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2012] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVE Anti-apolipoprotein A-1 (anti-apoA-1) IgG is a potential marker of atherosclerotic plaque vulnerability and cardiovascular complications. In patients with periodontitis the presence of anti-apoA-1 IgGs in serum and their association with atherosclerosis is unknown. MATERIAL AND METHODS One-hundred and thirty subjects with periodontal disease and 46 healthy subjects, matched for age and gender, participated in this study. Anti-apoA-1 IgG, high-sensitivity C-reactive protein (hsCRP) and matrix metalloproteinase (MMP) -2, -3, -8 and -9 were measured in serum samples. An ankle-brachial index (ABI) value below 1.11 served as a surrogate marker of atherosclerosis. Predictive accuracies of biomarkers for abnormal ABI were determined using receiver-operating characteristics curves and logistic regression analyses. RESULTS Compared with healthy controls, periodontitis patients showed lower median ABI values (1.10 vs. 1.15; p < 0.0001), a higher prevalence of anti-apoA-1 IgG positivity (23.8% vs. 6.5%; p = 0.009) and higher concentrations of hsCRP (1.62 mg/L vs. 0.85 mg/L; p = 0.02) and MMP-9 (435 μg/mL vs. 283 μg/mL; p < 0.0001). In patients younger than 50 years of age (n = 66), anti-apoA-1 IgG was found to be the best predictor for an abnormal ABI (area under the curve = 0.63; p = 0.03). Anti-apoA-1 IgG positivity increased the risk of having an abnormal ABI (odds ratio = 4.20; p = 0.04), independently of diabetes, smoking and body mass index. CONCLUSIONS Anti-apoA-1 IgG positivity and atherosclerosis, as reflected by abnormal ABI, were more prevalent in periodontitis patients than in age- and gender-matched controls. In younger periodontitis patients, anti-apoA-1 IgG was found to be the best predictor of atherosclerosis burden.
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Affiliation(s)
- P A Wick
- Department of Periodontology, School of Dental Medicine, University of Geneva, Geneva, Switzerland
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Rastogi P, Singhal R, Sethi A, Agarwal A, Singh VK, Sethi R. Assessment of the effect of periodontal treatment in patients with coronary artery disease : A pilot survey. J Cardiovasc Dis Res 2012; 3:124-7. [PMID: 22629030 PMCID: PMC3354455 DOI: 10.4103/0975-3583.95366] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Periodontitis is a chronic inflammatory condition believed to cause a low but long lasting systemic inflammatory reaction which in turn contributes to the development of atherosclerosis. Recent data suggests that around 40% cases of coronary artery disease remain unaccounted despite the identification of the classical risk factors. OBJECTIVES To evaluate the efficacy of non surgical periodontal therapy on the levels of serum inflammatory markers in subjects with chronic periodontitis and known coronary artery disease. MATERIALS AND METHODS Twenty subjects with known coronary artery disease (CAD) were recruited from the Department of Cardiology, CSM Medical University, Lucknow, India, for this study. Periodontal disease was measured through the clinical parameters bleeding on probing (BOP) and probing depth (PD). All subjects received non surgical periodontal therapy that included oral hygiene instructions and meticulous scaling and root planing. Systemic levels of inflammatory markers such as high-sensitivity C reactive proteins (hsCRP), tumor necrosis factor-α (TNF-α), and white blood cell (WBC) counts were measured prior to and 1 month after periodontal therapy. RESULTS Subjects experienced significant reductions in bleeding on probing (BOP) and probing depth (PD), indicating improvement in overall periodontal health. In all subjects, high-sensitivity C reactive proteins (hsCRP), and WBC counts were reduced significantly,; however, tumor necrosis factor-α (TNF-α) levels showed no statistically significant reduction. CONCLUSION In this study, periodontal treatment resulted in a significant decrease in bleeding on probing (BOP) and probing depth (PD), and this treatment lowered the serum inflammatory markers (hsCRP and WBC counts) in patients with coronary artery disease. This may result in a decreased risk for coronary artery disease in the periodontally treated patients.
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Affiliation(s)
- Pavitra Rastogi
- Department of Periodontics, Faculty of Dental Sciences, C.S.M. Medical University (Erstwhile K. G. Medical College Lucknow), Lucknow, Uttar Pradesh, India
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Stegger JG, Schmidt EB, Tjønneland A, Kopp TI, Sørensen TIA, Vogel U, Overvad K. Single nucleotide polymorphisms in IL1B and the risk of acute coronary syndrome: a Danish case-cohort study. PLoS One 2012; 7:e36829. [PMID: 22768033 PMCID: PMC3387186 DOI: 10.1371/journal.pone.0036829] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 04/07/2012] [Indexed: 12/12/2022] Open
Abstract
Background Interleukin-1B (IL-1B) is a key pro-inflammatory cytokine that has been associated with the development of atherosclerosis and myocardial infarction. However, the prospective associations between functional single nucleotide polymorphisms (SNPs) in IL1B and incident acute coronary syndrome (ACS) have not been thoroughly investigated. The aims of this study were to examine the associations between individual SNPs in and SNP haplotypes of the promoter region of IL1B and incident ACS in a prospective study. Furthermore, we wanted to explore potential interactions with other risk factors for ACS on an additive scale. Methodology/Principal Findings The present study was based on the Danish prospective study Diet, Cancer and Health comprising more than 57 000 participants aged 50–64 at baseline. During a median follow-up of 7.2 years we identified 989 cases of incident ACS (755 men and 234 women). All cases were validated by review of medical records, and information on covariates was collected by study technicians. The study was conducted according to a case-cohort study design including ACS cases and a sex-stratified sub cohort of 1663 participants drawn randomly from the entire cohort. Weighted Cox proportional hazard models with age as time axis were used in the statistical analyses. Individual IL1B SNPs, SNP haplotypes, or haplotype combinations were not significantly associated with incident ACS, and, likewise, we found no evidence of interaction on an additive scale between IL1B haplotypes and risk factors, respectively. Conclusions/Significance Genetic variation in the promoter region of IL1B may not be associated with incident ACS in men or women above the age of 50 years.
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Affiliation(s)
- Jakob Gerhard Stegger
- Department of Cardiology, Center for Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark.
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C-reactive protein is associated with aortic stiffness in a cohort of African American and white women transitioning through menopause. Menopause 2012; 18:1291-7. [PMID: 21892111 DOI: 10.1097/gme.0b013e31821f81c2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Arterial stiffness is a marker of cardiovascular health. Arterial stiffness and C-reactive protein (CRP) are linked to cardiovascular outcomes. Increases in both inflammation and arterial stiffness are known to occur with menopause. The association between CRP and arterial stiffness is well accepted; however, no study has determined whether there are differences in this association by menopause status and race, independent of age. METHODS The cross-sectional association between CRP and aortic pulse wave velocity (PWV), a validated measure of central arterial stiffening, was evaluated in 307 African American and white women enrolled in an ancillary study to the Study of Women's Health Across the Nation. Women were categorized into premenopausal or early perimenopausal (n = 185) and late perimenopausal or postmenopausal (n = 122). RESULTS Natural log-transformed CRP was not associated with PWV in a linear regression model adjusted for age and cardiovascular risk factors (β = 15.9, P = 0.11). Moreover, models stratified by menopause status showed a linear relationship between CRP and PWV among late perimenopausal or postmenopausal women (β = 36.2, P = 0.049) but not for premenopausal or early perimenopausal women (β = 5.9, P = 0.61). The menopause status × log-transformed CRP and menopause status × race interactions were significant in their respective models adjusted for age and risk factors (P = 0.03 for both); however, when combined into one model, the two interactions were slightly attenuated (P = 0.063 and 0.052, respectively). CONCLUSIONS Menopause is strengthening the association between CRP and PWV, independent of age, and this effect seems to be stronger among African American women. This study provides a potential mechanism for the increased risk of cardiovascular disease among postmenopausal women.
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Bifidobacterium longum with fructo-oligosaccharides in patients with non alcoholic steatohepatitis. Dig Dis Sci 2012; 57:545-53. [PMID: 21901256 DOI: 10.1007/s10620-011-1887-4] [Citation(s) in RCA: 306] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 08/16/2011] [Indexed: 12/12/2022]
Abstract
BACKGROUND Increased exposure to intestinal bacterial products may contribute to the pathogenesis of non alcoholic steatohepatitis (NASH). Bifidobacteria are predominant bacterial species in the human gut microbiota and have been considered to exert a beneficial effect on human health by maintaining the equilibrium of the resident microbiota. AIMS To evaluate the effects of Bifidobacterium longum with fructo-oligosaccharides (Fos) in the treatment of NASH. METHODS A total of 66 patients were randomly and equally divided into two groups receiving Bifidobacterium longum with Fos and lifestyle modification (i.e., diet and exercise) versus lifestyle modification alone. The following variables were assessed at -4 (beginning of the dietary lead-in period), 0 (randomization), 6, 12, 18, and 24 weeks: aspartate transaminase (AST), alanine transaminase (ALT), bilirubin, albumin, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, fasting plasma glucose, insulin, C-peptide, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, homeostasis model assessment of insulin resistance (HOMA-IR), and serum endotoxins. Liver biopsies were performed at entry and repeated after 24 weeks of treatment. RESULTS At the end of study period, we observed that the Bifidobacterium longum with Fos and lifestyle modification group versus the lifestyle modification alone group showed significant differences in the AST -69.6 versus -45.9 IU/mL (P < 0.05), LDL cholesterol -0.84 versus -0.18 mmol/L (P < 0.001), CRP -2.9 versus -0.7 mg/L (P < 0.05), TNF-α -0.45 versus -0.12 ng/mL (P < 0.001), HOMA-IR -1.1 versus -0.6 (P < 0.001), serum endotoxin -45.2 versus -30.6 pg/mL (P < 0.001), steatosis (P < 0.05), and the NASH activity index (P < 0.05). CONCLUSIONS Bifidobacterium longum with Fos and lifestyle modification, when compared to lifestyle modification alone, significantly reduces TNF-α, CRP, serum AST levels, HOMA-IR, serum endotoxin, steatosis, and the NASH activity index.
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Dietary inflammation factor rating system and risk of Alzheimer disease in elders. Alzheimer Dis Assoc Disord 2011; 25:149-54. [PMID: 21606905 DOI: 10.1097/wad.0b013e3181ff3c6a] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
It has been suggested that inflammation is involved in Alzheimer disease (AD) pathogenesis. The aim of this study is to evaluate the association between inflammatory aspects of diet and incident AD risk. About 2258 nondemented elderly (age ≥ 65) in New York who provided dietary information at baseline were followed-up prospectively for AD development. We examined the composite total Inflammation Factor Rating (tIFR), as a measure of inflammatory impact of foods, in relation with (i) serum level of high-sensitivity C-reactive protein (hsCRP) and (ii) risk of incident AD using Cox proportional hazard model. The tIFR was not associated with serum hsCRP level. After an average of 4.0 years of follow-up, 262 participants developed incident AD. The tIFR was not associated with AD risk: compared with the lowest tertile of tIFR (most proinflammatory), hazard ratios (95% confidence interval) for the highest tertile (most anti-inflammatory) was 0.97 (0.69-1.35) (P-for-trend=0.71), in the adjusted model. We conclude that tIFR might not be a biologically relevant measure of the inflammatory impact of the diet. In addition, although it remains possible that tIFR might be related with some other aspects of inflammation not captured by hsCRP, lack of association with AD risk suggests its limited clinical utility.
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Albus C, Beutel ME, Deter HC, Fritzsche K, Hellmich M, Jordan J, Juenger J, Krauth C, Ladwig KH, Michal M, Mueck-Weymann M, Petrowski K, Pieske B, Ronel J, Soellner W, Waller C, Weber C, Herrmann-Lingen C. A stepwise psychotherapy intervention for reducing risk in coronary artery disease (SPIRR-CAD) - rationale and design of a multicenter, randomized trial in depressed patients with CAD. J Psychosom Res 2011; 71:215-22. [PMID: 21911098 DOI: 10.1016/j.jpsychores.2011.02.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Revised: 02/17/2011] [Accepted: 02/24/2011] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Depressive symptoms are highly relevant for the quality of life, health behavior, and prognosis in patients with coronary artery disease (CAD). However, previous psychotherapy trials in depressed CAD patients produced small to moderate effects on depression, and null effects on cardiac events. In this multicentre psychotherapy trial, symptoms of depression are treated together with the Type D pattern (negative affectivity and social inhibition) in a stepwise approach. METHODS Men and women (N=569, age 18-75 years) with any manifestation of CAD and depression scores ≥ 8 on the Hospital Anxiety and Depression Scale (HADS), will be randomized (allocation ratio 1:1) into the intervention or control group. Patients with severe heart failure, acutely life-threatening conditions, chronic inflammatory disease, severe depressive episodes or other severe mental illness are excluded. Both groups receive usual medical care. Patients in the intervention group receive three initial sessions of supportive individual psychotherapy. After re-evaluation of depression (weeks 4-8), patients with persisting symptoms receive an additional 25 sessions of combined psychodynamic and cognitive-behavioral group therapy. The control group receives one psychosocial counseling session. Primary efficacy variable is the change of depressive symptoms (HADS) from baseline to 18 months. Secondary endpoints include cardiac events, remission of depressive disorder (SCID) and Type D pattern, health-related quality of life, cardiovascular risk profile, neuroendocrine and immunological activation, heart rate variability, and health care utilization, up to 24 months of follow-up (ISRCTN: 76240576; NCT00705965). Funded by the German Research Foundation.
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Affiliation(s)
- Christian Albus
- Dept. of Psychosomatics and Psychotherapy, University of Cologne, Germany.
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Infliximab induces increase in triglyceride levels in psoriatic arthritis patients. Clin Dev Immunol 2011; 2011:352686. [PMID: 21804855 PMCID: PMC3143445 DOI: 10.1155/2011/352686] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 04/19/2011] [Accepted: 05/27/2011] [Indexed: 02/08/2023]
Abstract
Objectives. To evaluate lipid profile changes after anti-TNF therapy in patients with psoriatic arthritis (PsA). Methods. Fifteen PsA patients (eight polyarticular, four oligoarticular, two axial, and one mutilating) under infliximab were included. None had dyslipoproteinemia or previous statin use. Total cholesterol (TC) and its fractions, inflammatory markers, and prednisone use were evaluated. Results. The comparisons of lipid levels between baseline and after three months (3M) of anti-TNF therapy showed that there was a significant increase in mean triglycerides (117.8 ± 49.7 versus 140.1 ± 64.1 mg/dL, P = 0.028) and VLDL-c (23.6 ± 10.5 versus 28.4 ± 13.7 mg/dL, P = 0.019) levels. In contrast, there were no differences in the mean TC (P = 0.28), LDL-c (P = 0.42), and HDL-c (P = 0.26) levels. Analysis of the frequencies of each lipid alteration at baseline and at 3M were alike (P > 0.05). Positive correlations were found between VLDL-c and CRP (r = 0.647, P = 0.009) and between triglycerides and CRP (r = 0.604, P = 0.017) levels at 3M. ESR reduction was observed after 3M (P = 0.04). Mean prednisone dose remained stable at beginning and at 3M (P = 0.37). Conclusion. This study demonstrated that anti-TNF may increase TG and VLDL-c levels in PsA patients after three months.
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van Kuilenburg J, Lappegård KT, Sexton J, Plesiewicz I, Lap P, Bouwels L, Sprong T, Mollnes TE, Verheugt F, van Heerde WL, Pop GA. Persisting thrombin activity in elderly patients with atrial fibrillation on oral anticoagulation is decreased by anti-inflammatory therapy with intensive cholesterol-lowering treatment. J Clin Lipidol 2011; 5:273-80. [DOI: 10.1016/j.jacl.2011.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Revised: 05/07/2011] [Accepted: 05/10/2011] [Indexed: 11/15/2022]
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Abstract
Glucocorticoids remain a valuable and necessary component of therapy for many diseases. Nonetheless, sustained glucocorticoid treatment increases potential for future cardiovascular disease through multiple pathways, resulting in a tradeoff between benefit and harm. This article explores the potential mechanisms of glucocorticoid-induced hyperglycemia and dyslipidemia. Interactions between glucocorticoids and other potential cardiovascular risk factors are also reviewed. Safe, alternate strategies for minimizing the need for glucocorticoids are urgently needed.
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Affiliation(s)
- Erika A Strohmayer
- Division of Endocrinology and Diabetes and Bone Disease, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA.
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Abstract
Obesity is a pathological condition aggregating a substantial number of proatherogenic factors, such as insulin resistance, type 2 diabetes mellitus, dyslipidaemia and hypertension. In addition to these classic cardiometabolic risk factors, atherosclerosis may be aggravated by other non-classic factors, which are characterized as conditional, including homocysteine, fibrinogen, lipoprotein(a), LDL particle size and high-sensitivity CRP. Some of these biomarkers are disturbed in obesity because of a combination of dietary factors, hypertrophic adipose tissue, low-grade inflammation, insulin resistance and other parameters under investigation. For the reduction of these risk factors, weight loss exceeding 10-20% of the initial body weight is probably necessary, achieved through either conventional lifestyle measures or more drastic interventions such as bariatric surgery. It has been shown that certain well-balanced diets, such as the Mediterranean diet, constitute a means of improving in a concerted manner the levels of CRP, fibrinogen, homocysteine and small dense LDL particles, regardless of weight loss. The significance of considering these factors in weight management intervention is an issue that needs further investigation.
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Affiliation(s)
- T Tzotzas
- Department of Endocrinology, Diabetes andMetabolism, Panagia General Hospital,Thessaloniki, Greece.
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Gu Y, Luchsinger JA, Stern Y, Scarmeas N. Mediterranean diet, inflammatory and metabolic biomarkers, and risk of Alzheimer's disease. J Alzheimers Dis 2011; 22:483-92. [PMID: 20847399 DOI: 10.3233/jad-2010-100897] [Citation(s) in RCA: 145] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We aimed to investigate the association between adherence to the Mediterranean diet (MeDi) and Alzheimer's disease (AD) risk in a prospective study. Specifically, we analyzed reduced inflammation and improved metabolic profile as a potential medium through which the MeDi reduced the risk of AD. During a 4-year follow-up, 118 incident AD cases were identified among the 1219 non-demented elderly (age ≥ 65) subjects who provided dietary information and blood samples at baseline. We used high-sensitivity C-reactive protein (hsCRP) as an index of systemic inflammation, and fasting insulin and adiponectin as indexes of metabolic profile. We investigated whether there was a change in the association between MeDi and incident AD risk when the biomarkers were introduced into multivariable adjusted COX models. Better adherence to MeDi was associated with lower level of hsCRP (p =0.003), but not fasting insulin or adiponectin. Better adherence to MeDi was significantly associated with lower risk for AD: compared to those in the lowest tertile of MeDi, subjects in the highest tertile had a 34% less risk of developing AD (p-for-trend =0.04). Introduction of the hsCRP, fasting insulin, adiponectin, or combinations of them into the COX model did not change the magnitude of the association between MeDi and incident AD. Ultimately, the favorable association between better adherence to MeDi and lower risk of AD did not seem to be mediated by hsCRP, fasting insulin, or adiponectin. Other aspects of inflammatory and metabolic pathways not captured by these biomarkers, or non-inflammatory or non-metabolic pathways, may be relevant to the MeDi-AD association.
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Affiliation(s)
- Yian Gu
- Taub Institute for Research of Alzheimer's Disease and Aging Brain, Columbia University, New York, NY, USA
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Guo S, Meng S, Chen B, Liu J, Gao L, Wu Y. C-Reactive Protein Can Influence the Proliferation, Apoptosis, and Monocyte Chemotactic Protein-1 Production of Human Umbilical Vein Endothelial Cells. DNA Cell Biol 2011; 30:157-62. [PMID: 20979529 DOI: 10.1089/dna.2010.1093] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Shujuan Guo
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Shu Meng
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Bin Chen
- Department of Periodontology, Institute and Hospital of Stomatology, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Juan Liu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Li Gao
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yafei Wu
- Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Gupta AK, Bray GA, Greenway FL, Martin CK, Johnson WD, Smith SR. Pioglitazone, but not metformin, reduces liver fat in Type-2 diabetes mellitus independent of weight changes. J Diabetes Complications 2010; 24:289-96. [PMID: 19577936 PMCID: PMC2891296 DOI: 10.1016/j.jdiacomp.2009.05.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2008] [Revised: 05/04/2009] [Accepted: 05/20/2009] [Indexed: 12/23/2022]
Abstract
BACKGROUND Pioglitazone (Pio) treatment induces weight gain in Type 2 diabetes mellitus (T2DM), which could worsen hepatic lipid accumulation, and alter adiponectin and high-sensitivity C-reactive protein (hs-CRP). OBJECTIVE To compare changes in hepatic lipid, serum adiponectin and hs-CRP in diabetics treated with Pio (with and without weight gain) against metformin (Met) treatment, which produces weight loss. DESIGN Fifty-one men and women with T2DM, naive to thiazolidinediones, entered a 16-week, open-label, parallel arm study, where participants were randomized to one of three groups: (1) Pio plus the American Diabetes Association diet (Pio+ADA); (2) Pio plus a portion control weight loss diet (Pio+PC), or (3) metformin plus ADA diet (Met+ADA). METHODS Hepatic lipid was assessed with abdominal computed tomography (CT) and the serum adiponectin and hs-CRP by enzyme-linked immunosorbent assay at baseline and study end. RESULTS Forty-eight subjects completed the study. The Pio+ADA group gained (mean+/-S.E.M.) 2.15+/-1.09 kg, while Pio+PC and Met+ADA group lost -2.59+/-1.25 and -3.21+/-0.7 kg, respectively. Pio-treated groups (Pio+ADA and Pio+PC) significantly decreased hepatic fat as indicated by increased liver density on CT scan [10.1+/-2.4: 11.4+/-1.0 Hounsfield units (HU)], compared with Met+ADA group (-2.4+/-3.1 HU). The Pio groups demonstrated significantly increased serum adiponectin, (8.6+/-1.5; 7.4+/-1.6 microg/ml) independent of weight change, compared to Met+ADA (-0.14+/-0.6 microgm/ml) group which lost weight. Serum hs-CRP decreased in groups showing weight loss (Pio+PC, -3.1+/-1.7 mg/l; Met+ADA, -1.5+/-1.2 mg/l) compared to Pio+ADA (1.8+/-3.0 mg/l) group that gained weight. CONCLUSIONS Pio treatment in T2DM significantly reduced hepatic lipid and increased adiponectin independent of weight change, while decreasing hs-CRP with weight loss.
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Affiliation(s)
- Alok K Gupta
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808, USA.
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Abdelmalak B, Maheshwari A, Mascha E, Srivastava S, Marks T, Tang WW, Kurz A, Sessler DI. Design and Organization of the Dexamethasone, Light Anesthesia and Tight Glucose Control (DeLiT) Trial: a factorial trial evaluating the effects of corticosteroids, glucose control, and depth-of-anesthesia on perioperative inflammation and morbidity from major non-cardiac surgery. BMC Anesthesiol 2010; 10:11. [PMID: 20591163 PMCID: PMC2910009 DOI: 10.1186/1471-2253-10-11] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Accepted: 06/30/2010] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The perioperative period is characterized by an intense inflammatory response. Perioperative inflammation promotes postoperative morbidity and increases mortality. Blunting the inflammatory response to surgical trauma might thus improve perioperative outcomes. We are studying three interventions that potentially modulate perioperative inflammation: corticosteroids, tight glucose control, and light anesthesia. METHODS/DESIGN The DeLiT Trial is a factorial randomized single-center trial of dexamethasone vs placebo, intraoperative tight vs. conventional glucose control, and light vs deep anesthesia in patients undergoing major non-cardiac surgery. Anesthetic depth will be estimated with Bispectral Index (BIS) monitoring (Aspect medical, Newton, MA). The primary outcome is a composite of major postoperative morbidity including myocardial infarction, stroke, sepsis, and 30-day mortality. C-reactive protein, a measure of the inflammatory response, will be evaluated as a secondary outcome. One-year all-cause mortality as well as post-operative delirium will be additional secondary outcomes. We will enroll up to 970 patients which will provide 90% power to detect a 40% reduction in the primary outcome, including interim analyses for efficacy and futility at 25%, 50% and 75% enrollment. DISCUSSION The DeLiT trial started in February 2007. We expect to reach our second interim analysis point in 2010. This large randomized controlled trial will provide a reliable assessment of the effects of corticosteroids, glucose control, and depth-of-anesthesia on perioperative inflammation and morbidity from major non-cardiac surgery. The factorial design will enable us to simultaneously study the effects of the three interventions in the same population, both individually and in different combinations. Such a design is an economically efficient way to study the three interventions in one clinical trial vs three. TRIAL REGISTRATION This trial is registered at Clinicaltrials.gov #: NTC00433251.
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Affiliation(s)
- Basem Abdelmalak
- Department of OUTCOMES RESEARCH, Cleveland Clinic, Cleveland, Ohio, USA.
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Affiliation(s)
- Vinod Chandran
- Division of Rheumatology, Department of Medicine, University of Toronto, Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, 399 Bathurst Street, 1E-410B, Toronto, Ontario M5T 2S8, Canada
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