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Zhan F, Lin G, Duan K, Huang B, Chen L, Ni J. Higher oxidative balance score decreases risk of stroke in US adults: evidence from a cross-sectional study. Front Cardiovasc Med 2023; 10:1264923. [PMID: 38034387 PMCID: PMC10682657 DOI: 10.3389/fcvm.2023.1264923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/23/2023] [Indexed: 12/02/2023] Open
Abstract
Background The oxidative balance score (OBS) can be used to represent the overall burden of oxidative stress in an individual. This study aimed to explore the association between the risk of stroke and OBS. Methods and materials The National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018 was used to extract a series of variables for participants who took the stroke questionnaire. The construction of OBS relied on diet and lifestyle components, which included 16 nutrients and 4 lifestyle factors. Weighted multivariable-adjusted logistic regression was performed to investigate the association between stroke risk and OBS. A stratified analysis was also conducted. The dose-response relationship between stroke risk and OBS was elucidated by performing a restricted cubic spline function. Results A total of 20,680 participants were included for analysis, 768 of whom suffered from stroke. Based on weighted multivariable logistic regression analysis, we discovered that the stroke prevalence decreased by 2% for each OBS unit added [OR: 0.98 (0.97-1.00), P < 0.01]. For the OBS subgroup, we also discovered that higher OBS was related to a reduction in the risk of stroke [Q4 vs. Q1: OR:0.65 (0.46-0.90), P < 0.01]. The prevalence of stroke declined by 3% with every OBS unit added to the diet component [OR: 0.97 (0.96-0.99), P < 0.01]. For the dietary OBS subgroup, higher OBS in diet components was associated with a decrease in the prevalence of stroke [Q4 vs. Q1: OR: 0.65, (0.47-0.91), P < 0.05]. Further stratified analysis showed that every OBS unit raised was associated with a decline in stroke prevalence, which was statistically significant in participants in subgroups of ≥60 years, female, no-diabetes mellitus and no-hypertension. OBS and stroke prevalence were correlated in a linear manner. Conclusion The study found that a higher OBS was associated with a decrease in stroke prevalence, which could be a significant indicator for evaluating stroke risk.
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Affiliation(s)
- Fangfang Zhan
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Rehabilitation Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Gaoteng Lin
- Department of Urology, The 900th Hospital of Joint Logistic Support Force, Fuzhou, China
| | - Kefei Duan
- Department of Geriatric Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Bixia Huang
- Department of Neurology, The Affiliated Hospital of Putian University, Putian, China
| | - Longfei Chen
- Department of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Neurology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Jun Ni
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Rehabilitation Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
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2
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Wu M, Li S, Lv Y, Liu K, Wang Y, Cui Z, Wang X, Meng H. Associations between the inflammatory potential of diets with adherence to plant-based dietary patterns and the risk of new-onset cardiometabolic diseases in Chinese adults: findings from a nation-wide prospective cohort study. Food Funct 2023; 14:9018-9034. [PMID: 37740363 DOI: 10.1039/d3fo02579a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
Aims: convincing evidence is still limited for the validation of associations between the inflammatory potential of diets, based on the dietary inflammatory index (DII), and cardiometabolic outcomes. We aimed to investigate the associations between the DII with adherence to plant-based dietary patterns and the risk of new-onset cardiometabolic diseases (CMDs), including stroke, type 2 diabetes mellitus (T2DM) and myocardial infarction (MI). Methods: adults (N = 14 652) from the China Health and Nutrition Survey (1997-2015) were included in the current analysis. Dietary intake data were collected using a combination of 3 day consecutive 24 h dietary recalls and the food weighing method. The DII was calculated with established and validated methods. CMDs were identified using validated self-reported questionnaires. The Cox proportional hazard regression model was used for statistical analysis. Results: during a mean follow-up of 10 years, a total of 404 new-onset stroke, 1051 new-onset T2DM and 280 new-onset MI cases were identified. Lower PDI, hPDI, ERD, WISH and PHDI scores and higher uPDI scores were associated with higher DII scores (all P-trend < 0. 0001). A pro-inflammatory diet, as reflected by relatively higher DII scores, was positively associated with an increased risk of stroke (Q5 vs. Q1: HR = 1.90; 95% CI: 1.26-2.88; P-trend = 0.0006), T2DM (Q5 vs. Q1: HR = 2.08; 95% CI: 1.61-2.69; P-trend < 0.0001) and MI (Q5 vs. Q1: HR = 1.70; 95% CI: 1.04-2.76; P-trend = 0.0114) in the entire cohort. Sex and BMI significantly modified the association between the DII and the risk of T2DM, and sex significantly modified the association between the DII and the risk of MI. Conclusions: lower adherence to healthy and sustainable plant-based dietary patterns and higher adherence to unhealthy plant-based dietary patterns were associated with higher DII scores. With the use of the DII, we reported long-term positive associations between a pro-inflammatory diet and an increased risk of new-onset stroke, T2DM and MI in Chinese adults who were free from CMDs and cancer at the baseline. These findings provided evidence for the validation of associations between the DII and cardiometabolic health, and contributed to the current literature suggesting careful evaluations of whether the DII should be incorporated into dietary guidelines and utilized as an effective tool for improving the diet quality and CMD prevention in the Chinese population.
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Affiliation(s)
- Man Wu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Shun Li
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Yiqian Lv
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Ke Liu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Yin Wang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Zhixin Cui
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Xiaoling Wang
- The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong 518033, China
| | - Huicui Meng
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, Guangdong 510080, China
- Guangdong Province Engineering Laboratory for Nutrition Translation, Guangzhou, Guangdong 510080, China
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3
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Ghose M, Das M, Das R, Barua AR, Deka P, Barman A, Lahan V, Choudhury DJ, Sharma JP, Mathur M, Borah NC, Choudhury N, Barman A. Homocysteine, Vitamins B6, B12, and Folate and the Risk of Ischemic and Hemorrhagic Stroke: A Case-control Study from Northeast India. Ann Neurosci 2022. [DOI: 10.1177/09727531221124425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Stroke is a major leading global health complication. Identification and management of risk factors associated with stroke can help in prior detection, prevention, and improvement in patient care. Purpose To investigate the prevalence of hyperhomocysteinemia (HHcy) and Vitamins B6, B12, and folate deficiency in stroke patients and also to assess other risk factors associated with ischemic and hemorrhagic stroke. Methods Detail history of all the subjects in the study including history of hypertension, anemia, fasting glucose, carotid artery thickness, smoking, alcohol, and dietary intake was recorded. Standard assays for homocysteine (Hcy), Vitamins B6, B12, and folate estimation were done. Lipid and renal profile tests were also performed. The prevalence and odds of having HHcy, Vitamins B6, B12, and folate deficiency, and other risk factors in ischemic and hemorrhagic stroke patients were evaluated. Student’s t-tests and chi-square tests were done for statistical validation of the data. Results Prevalence of HHcy and Vitamins B6, B12, and folate deficiency was not observed in ischemic cases. HHcy and folate deficiency was found to be prevalent in hemorrhagic stroke patients. The odds that a person with HHcy and folate deficiency has hemorrhagic stroke was found to be significantly high. Conclusion In our study, high Hcy and low folate levels emerged as risk factors for hemorrhagic stroke.
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Affiliation(s)
- Manash Ghose
- Department of Neurology, GNRC Hospitals, Dispur, Guwahati, Assam, India
| | - Madhumita Das
- Department of Biochemistry, GNRC Medical, North Guwahati, Assam, India
| | - Rupjyoti Das
- Department of Neurology, GNRC Hospitals, Dispur, Guwahati, Assam, India
| | | | - Prasenjit Deka
- Department of Neurology, GNRC Hospitals, Six Mile, Guwahati, Assam, India
| | - Aparajita Barman
- Department of Neurology, GNRC Hospitals, Dispur, Guwahati, Assam, India
| | - Vivekananda Lahan
- Department of Neurology, GNRC Hospitals, Six Mile, Guwahati, Assam, India
| | | | | | - Manik Mathur
- Department of Neurology, GNRC Hospitals, Dispur, Guwahati, Assam, India
| | | | - Nupur Choudhury
- Department of Research and Analytics, GNRC Hospitals, Dispur, Assam, India
| | - Ananya Barman
- Department of Research and Analytics, GNRC Hospitals, Dispur, Assam, India
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4
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Shi Y, Wu Z, Wu J, Chen Z, Li P. Serum Homocysteine Level Is Positively Correlated With Serum Uric Acid Level in U.S. Adolescents: A Cross Sectional Study. Front Nutr 2022; 9:818836. [PMID: 35425802 PMCID: PMC9001925 DOI: 10.3389/fnut.2022.818836] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 02/15/2022] [Indexed: 11/29/2022] Open
Abstract
Background Physiologically, the levels of homocysteine (Hcy) and serum uric acid (SUA) are closely related; however, clinical studies on the relationship between Hcy and SUA have drawn different conclusions and have not analyzed this association among adolescents. This study therefore aimed to evaluate the relationship between Hcy and SUA levels among adolescents. Methods In this study, we performed a cross-sectional analysis of data from the National Health and Nutrition Examination Survey for the period 1999–2006, which included 5,404 adolescents aged 12–19 years. An elevated SUA level was defined as ≥5.5 mg/dL. Multivariate logistic regression and multivariate linear regression models were also applied in this study. Results The mean concentrations of Hcy and SUA were 6.0 μmol/L and 5.0 mg/dL, respectively, and 33.6% of the participants had SUA levels of ≥5.5 mg/dL. There was a dose–response relationship between Hcy and SUA, and Hcy was linearly positively correlated with SUA. The β value [95% confidence interval (CI)] for SUA in the fully adjusted model was1.43 (95% CI: 1.18, 1.68). The multivariate logistic regression model showed that per 1 increment in log-transformed Hcy, the risk of elevated SUA levels increased by 8.80 times (odds ratio, 8.80, 95% CI: 4.25, 18.20). Subgroup analyses showed that the relationship between Hcy and SUA was significantly different according to sex, age, body mass index (BMI), and estimated glomerular filtration rate (eGFR) stratification (P for interaction <0.05). Conclusion Hcy levels were positively correlated with SUA levels and elevated SUA levels among U.S. teenagers, and this effect was more significant among boys aged ≥17 years and among people with lower BMI and eGFR.
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5
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Martens LG, Luo J, Willems van Dijk K, Jukema JW, Noordam R, van Heemst D. Diet-Derived Antioxidants Do Not Decrease Risk of Ischemic Stroke: A Mendelian Randomization Study in 1 Million People. J Am Heart Assoc 2021; 10:e022567. [PMID: 34796734 PMCID: PMC9075393 DOI: 10.1161/jaha.121.022567] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Dietary intake and blood concentrations of vitamins E and C, lycopene, and carotenoids have been associated with a lower risk of incident (ischemic) stroke. However, causality cannot be inferred from these associations. Here, we investigated causality by analyzing the associations between genetically influenced antioxidant levels in blood and ischemic stroke using Mendelian randomization. Methods and Results For each circulating antioxidant (vitamins E and C, lycopene, β‐carotene, and retinol), which were assessed as either absolute blood levels and/or high‐throughput metabolite levels, independent genetic instrumental variables were selected from earlier genome‐wide association studies (P<5×10−8). We used summary statistics for single‐nucleotide polymorphisms–stroke associations from 3 European‐ancestry cohorts (cases/controls): MEGASTROKE (60 341/454 450), UK Biobank (2404/368 771), and the FinnGen study (8046/164 286). Mendelian randomization analyses were performed on each exposure per outcome cohort using inverse variance–weighted analyses and subsequently meta‐analyzed. In a combined sample of 1 058 298 individuals (70 791 cases), none of the genetically influenced absolute antioxidants or antioxidant metabolite concentrations were causally associated with a lower risk of ischemic stroke. For absolute antioxidants levels, the odds ratios (ORs) ranged between 0.94 (95% CI, 0.85–1.05) for vitamin C and 1.04 (95% CI, 0.99–1.08) for lycopene. For metabolites, ORs ranged between 1.01 (95% CI, 0.98–1.03) for retinol and 1.12 (95% CI, 0.88–1.42) for vitamin E. Conclusions This study did not provide evidence for a causal association between dietary‐derived antioxidant levels and ischemic stroke. Therefore, antioxidant supplements to increase circulating levels are unlikely to be of clinical benefit to prevent ischemic stroke.
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Affiliation(s)
- Leon G Martens
- Department of Internal Medicine Section of Gerontology and Geriatrics Leiden University Medical Center Leiden The Netherlands
| | - Jiao Luo
- Department of Internal Medicine Section of Gerontology and Geriatrics Leiden University Medical Center Leiden The Netherlands.,Department of Clinical Epidemiology Leiden University Medical Center Leiden The Netherlands
| | - Ko Willems van Dijk
- Department of Human Genetics Leiden University Medical Center Leiden The Netherlands.,Department of Internal Medicine Division of Endocrinology Leiden University Medical Center Leiden The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine Leiden University Medical Center Leiden The Netherlands
| | - J Wouter Jukema
- Department of Cardiology Leiden University Medical Center Leiden The Netherlands.,Netherlands Heart Institute Utrecht The Netherlands
| | - Raymond Noordam
- Department of Internal Medicine Section of Gerontology and Geriatrics Leiden University Medical Center Leiden The Netherlands
| | - Diana van Heemst
- Department of Internal Medicine Section of Gerontology and Geriatrics Leiden University Medical Center Leiden The Netherlands
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6
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Wei L, Sui H, Zhang J, Guo Z. Synthesis and antioxidant activity of the inulin derivative bearing 1,2,3-triazole and diphenyl phosphate. Int J Biol Macromol 2021; 186:47-53. [PMID: 34186123 DOI: 10.1016/j.ijbiomac.2021.06.148] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/01/2021] [Accepted: 06/22/2021] [Indexed: 10/21/2022]
Abstract
In this paper, the inulin derivative (3) bearing 1,2,3-triazole and diphenyl phosphate was successfully synthesized by CuAAC Click chemistry. Detailed structural characterization was determined using FTIR spectroscopy, 1H NMR spectroscopy, 13C NMR spectroscopy, and elemental analysis. The antioxidant activities against hydroxyl radicals, superoxide radicals, and DPPH radicals were estimated in vitro respectively. The results showed that the antioxidant activity of the inulin derivative (3) was significantly enhanced compared with inulin. The inulin derivative (3) exhibited stronger radical scavenging abilities, especially against hydroxyl radicals and superoxide radicals. The scavenging values of the inulin derivative (3) were 98.2% and 95.4% at 1.6 mg/mL against hydroxyl radicals and superoxide radicals respectively. Besides, the scavenging value of the inulin derivative (3) increased by about 40% to scavenge DPPH radicals at 1.6 mg/mL than inulin. The results showed that the inulin derivative (3) bearing 1,2,3-triazole and diphenyl phosphate exhibited tremendously enhanced antioxidant activity compared with inulin. The synthetic strategy might provide an effective way to prepare novel inulin antioxidant biomaterials.
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Affiliation(s)
- Lijie Wei
- Weifang Inspection and Testing Center, Weifang Administration for Market Regulation, Weifang, Shandong 261000, China; Key Laboratory of Coastal Biology and Bioresource Utilization, Yantai Institute of Coastal Zone Research, Chinese Academy of Sciences, Yantai 264003, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Haishan Sui
- Weifang Inspection and Testing Center, Weifang Administration for Market Regulation, Weifang, Shandong 261000, China
| | - Jingjing Zhang
- Key Laboratory of Coastal Biology and Bioresource Utilization, Yantai Institute of Coastal Zone Research, Chinese Academy of Sciences, Yantai 264003, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhanyong Guo
- Key Laboratory of Coastal Biology and Bioresource Utilization, Yantai Institute of Coastal Zone Research, Chinese Academy of Sciences, Yantai 264003, China; University of Chinese Academy of Sciences, Beijing 100049, China; Center for Ocean Mega-Science, Chinese Academy of Sciences, 7 Nanhai Road, Qingdao 266071, China.
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Bjørklund G, Peana M, Dadar M, Lozynska I, Chirumbolo S, Lysiuk R, Lenchyk L, Upyr T, Severin B. The role of B vitamins in stroke prevention. Crit Rev Food Sci Nutr 2021; 62:5462-5475. [PMID: 33724098 DOI: 10.1080/10408398.2021.1885341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Elevated plasma levels of homocysteine (Hcy) are a recognized risk factor for stroke. This relationship represents one aspect of the debated `Hcy hypothesis'. Elevated Hcy may be an independent and treatable cause of atherosclerosis and thrombotic vascular diseases. Further observations indicate that proper dietary supplementation with B-vitamins decreases total plasma Hcy concentrations and may be an effective intervention for stroke prevention. Metabolic vitamin B12 deficiency is a nutritional determinant of total Hcy and stroke risk. Genetic factors may link B vitamins with stroke severity due to the impact on Hcy metabolism of polymorphism in the genes coding for methylenetetrahydrofolate reductase, methionine-synthase, methionine synthase reductase, and cystathionine β-synthase. Several meta-analyses of large randomized controlled trials exist. However, they are not completely in agreement about B vitamins' role, particularly folic acid levels, vitamin B12, and B6, in lowering the homocysteine concentrations in people at high stroke risk. A very complex relationship exists between Hcy and B vitamins, and several factors appear to modify the preventive effects of B vitamins in stroke. This review highlights the regulating factors of the active role of B vitamins active in stroke prevention. Also, inputs for further large, well-designed studies, for specific, particularly sensitive subgroups are given.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Mo i Rana, Norway
| | | | - Maryam Dadar
- Education and Extension Organization (AREEO), Razi Vaccine and Serum Research Institute, Agricultural Research, Karaj, Iran
| | - Iryna Lozynska
- Department of Biochemistry, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.,CONEM Ukraine Life Science Research Group, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,CONEM Scientific Secretary, Verona, Italy
| | - Roman Lysiuk
- CONEM Ukraine Life Science Research Group, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.,Department of Pharmacognosy and Botany, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Larysa Lenchyk
- Department of Quality, Standardization and Certification of Medicines of IATPS, National University of Pharmacy, Kharkiv, Ukraine.,CONEM Ukraine Pharmacognosy and Natural Product Chemistry Research Group National University of Pharmacy, Kharkiv, Ukraine
| | - Taras Upyr
- CONEM Ukraine Pharmacognosy and Natural Product Chemistry Research Group National University of Pharmacy, Kharkiv, Ukraine.,Department of Pharmacognosy, National University of Pharmacy, Kharkiv, Ukraine
| | - Beatrice Severin
- Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
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8
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Rawashdeh SI, Al-Mistarehi AH, Yassin A, Rabab'ah W, Skaff H, Ibdah R. A Concurrent Ischemic Stroke, Myocardial Infarction, and Aortic Thrombi in a Young Patient with Hyperhomocysteinemia: A Case Report. Int Med Case Rep J 2020; 13:581-590. [PMID: 33192104 PMCID: PMC7653271 DOI: 10.2147/imcrj.s279603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/21/2020] [Indexed: 12/31/2022] Open
Abstract
We are presenting a case report of a previously healthy 39-year-old man who was found to have acute inferior ST-elevation myocardial infarction (STEMI) and acute large right middle cerebral artery (MCA) ischemic stroke with hemorrhagic transformation. Transesophageal echocardiogram and chest CT angiogram revealed two thrombi; one attached to the wall of the ascending aorta just above the right coronary artery sinus, and one at the origin of the brachiocephalic trunk. The occlusion of the coronary artery and right MCA most likely could be because of embolization from these thrombi. Extensive workup looking for underlying etiology and risk factors for these concurrent vascular events in this young man revealed hyperhomocysteinemia along with unfavorable lipid profile, and family history of premature coronary artery disease which increased the suspicion of familial hypercholesterolemia. Besides, the presence of vitamin B12 and folate deficiencies. The elevated serum homocysteine is likely a major risk factor for thromboembolism in this patient. The patient received antithrombotics and vitamin supplementations and gradually improved without any worsening of the stroke's hemorrhagic transformation. We suggest that hyperhomocysteinemia needs to be considered in the differential etiology of vascular events in young people or those with no significant history of major vascular risk factors. Besides, vitamin supplementation could be a cost-effective, safe, and efficient way to decrease elevated serum homocysteine levels and prevent vascular complications. As well as this case report demonstrates that antithrombotics can safely be used after stroke's hemorrhagic transformation without neurological deterioration or aggravation of hemorrhagic transformation.
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Affiliation(s)
- Sukaina I Rawashdeh
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdel-Hameed Al-Mistarehi
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ahmed Yassin
- Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Walaa Rabab'ah
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Hussam Skaff
- Department of Diagnostic Radiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Rasheed Ibdah
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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9
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Malnutrition Rate in Stroke Patients on Admission. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2020; 53:272-275. [PMID: 32377095 PMCID: PMC7192266 DOI: 10.14744/semb.2018.81994] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/05/2018] [Indexed: 01/04/2023]
Abstract
Objectives Malnutrition is frequently observed in patients with acute stroke and its prevalence after stroke varies widely among published reports. Differences in the timing of assessment, stroke type, comorbid medical conditions, and stroke complications may have contributed to this large variability. This study is conducted to investigate the prevalence of malnutrition, and its associated risk factors in stroke patients admitted to our stroke clinic. Methods A prospective design was used to measure the nutritional status and nutritional risk of stroke patients during hospitalisation between June 2016 and February 2017. Nutritional status was measured at admission. Demographic data and information on clinical variables were collected, which included the patient's age, gender, type of stroke and other comorbid disorders. Blood samples, including concentrations of high-sensitivity C-reactive protein (CRP), serum albumin, serum creatinine, lipid profile and serum lymphocyte count, were measured by routine methods. Nutritional status was measured using the Mini Nutritional Assessment (MNA); for elderly stroke patients (age older than 65). For stroke patients younger than 65 age, Nutrition Screening 2002 (NRS 2002) was used. Results 318 patients with acute stroke were assessed for their nutritional status at admission. There were 145 (45%) female and 173 (55%) male patients. Their mean age was 66.16±14.32. 66.1% of the patients elder than 65 years were malnourished. 12.2% of the patients younger than 65 years were found to be malnourished. We found no relationship between comorbidities and malnutrition, except hyperlipidemia. Nourished stroke patients older than 65 years had higher serum lipid levels than the malnourished patients. We also found no relationship between malnutrition biomarkers and being malnourished. Conclusion Malnutrition is frequently observed in patients with stroke. Early recognition of malnutrition is crucial, but the absence of valid markers hampers to find out the presence of malnutrition. Thus, further research is needed in targeting the modifiable nutrition risk factors and give attention to nutrition in stroke patients.
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10
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Sharma V, Sharma V, Khan A, Wassmer DJ, Schoenholtz MD, Hontecillas R, Bassaganya-Riera J, Zand R, Abedi V. Malnutrition, Health and the Role of Machine Learning in Clinical Setting. Front Nutr 2020; 7:44. [PMID: 32351968 PMCID: PMC7174626 DOI: 10.3389/fnut.2020.00044] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 03/23/2020] [Indexed: 12/16/2022] Open
Abstract
Nutrition plays a vital role in health and the recovery process. Deficiencies in macronutrients and micronutrients can impact the development and progression of various disorders. However, malnutrition screening tools and their utility in the clinical setting remain largely understudied. In this study, we summarize the importance of nutritional adequacy and its association with neurological, cardiovascular, and immune-related disorders. We also examine general and specific malnutrition assessment tools utilized in healthcare settings. Since the implementation of the screening process in 2016, malnutrition data from hospitalized patients in the Geisinger Health System is presented and discussed as a case study. Clinical data from five Geisinger hospitals shows that ~10% of all admitted patients are acknowledged for having some form of nutritional deficiency, from which about 60-80% of the patients are targeted for a more comprehensive assessment. Finally, we conclude that with a reflection on how technological advances, specifically machine learning-based algorithms, can be integrated into electronic health records to provide decision support system to care providers in the identification and management of patients at higher risk of malnutrition.
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Affiliation(s)
- Vaibhav Sharma
- Geisinger Commonwealth School of Medicine, Scranton, PA, United States
| | - Vishakha Sharma
- Geisinger Commonwealth School of Medicine, Scranton, PA, United States
| | - Ayesha Khan
- Neuroscience Institute, Geisinger Health System, Danville, PA, United States
| | - David J. Wassmer
- Neuroscience Institute, Geisinger Health System, Danville, PA, United States
| | | | | | | | - Ramin Zand
- Neuroscience Institute, Geisinger Health System, Danville, PA, United States
| | - Vida Abedi
- Department of Molecular and Functional Genomics, Geisinger Health System, Danville, PA, United States
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Zhang T, Jiang Y, Zhang S, Tie T, Cheng Y, Su X, Man Z, Hou J, Sun L, Tian M, Zhang Y, Li J, Ma Y. The association between homocysteine and ischemic stroke subtypes in Chinese: A meta-analysis. Medicine (Baltimore) 2020; 99:e19467. [PMID: 32195946 PMCID: PMC7220264 DOI: 10.1097/md.0000000000019467] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The findings on the association between elevated plasma homocysteine levels and the risk of the trial of org 10172 in acute stroke treatment (TOAST) of ischemic stroke have been inconsistent in Chinese. So far, there is no meta-analysis about the association between Hcy and the TOAST subtypes of ischemic stroke in Chinese. This study; therefore, aimed to evaluate whether elevated homocysteine levels are associated with the TOAST subtypes of ischemic stroke using a meta-analysis. MATERIALS AND METHODS A systematic search of electronic databases were conducted for studies reporting homocysteine levels in ischemic stroke and the TOAST of ischemic stroke to April 18, 2018. The data were extracted after the application of inclusion and exclusion criteria. All the data were analyzed using Stata software version 9.0 (Stata Corp LP, College Station, TX). The standardized mean difference (SMD) and 95% confidence interval (CI) were used to compare continuous variables. RESULTS Thirteen studies comprising 3114 participants (2243 patients and 871controls) met the eligibility criteria and were included in the meta-analysis. The meta-analysis revealed that the ischemic stroke group had significantly higher levels of homocysteine than controls (SMD = 1.15, 95% CI = 0.85-1.45, P < .05). The subgroup analyses suggested that the groups of patients with large-artery atherosclerosis, small-vessel occlusion, cardioembolism, stroke of other determined etiology and stroke of undetermined etiology had significantly higher levels of homocysteine compared to those in the control group (large-artery atherosclerosis: SMD = 2.12, 95% CI = 1.40-2.84, P < .05; small-vessel occlusion: SMD = 1.10, 95% CI = 0.72-1.48, P < .05; CE: SMD = 1.17, 95% CI = 0.64-1.71, P < .05; stroke of other determined etiology: SMD = 0.88, 95% CI = 0.53-1.24, P < .05; stroke of undetermined etiology: SMD = 1.50, 95% CI = 0.66-2.33, P < .05, respectively). CONCLUSION This meta-analysis found that ischemic stroke patients and the TOAST of ischemic stroke patients in Chinese had significantly higher homocysteine levels than the controls, suggesting that serum homocysteine levels may be a risk factor for ischemic stroke and the TOAST subtypes of ischemic stroke in Chinese.
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Affiliation(s)
- Tao Zhang
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Yuan Jiang
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Shuhua Zhang
- Tengzhou Central People's Hospital, Zaozhuang, Shandong province, China
| | - Tingting Tie
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Yan Cheng
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Xiaoming Su
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Zhu Man
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Jing Hou
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Li Sun
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Meiyuan Tian
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Yaogang Zhang
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Jianhua Li
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Yanyan Ma
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
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Sabbouh T, Torbey MT. Malnutrition in Stroke Patients: Risk Factors, Assessment, and Management. Neurocrit Care 2019; 29:374-384. [PMID: 28799021 DOI: 10.1007/s12028-017-0436-1] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Toni Sabbouh
- Cerebrovascular and Neurocritical Care Division, Department of Neurology, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Michel T Torbey
- Cerebrovascular and Neurocritical Care Division, Department of Neurology, Wexner Medical Center, The Ohio State University, Columbus, OH, USA. .,Department of Neurosurgery, The Ohio State University Wexner Medical Center, 410 W. 10th Avenue, Columbus, OH, 43210, USA.
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Niazi F, Aslam A, Khattak S, Waheed S. Frequency of Homocysteinemia in Young Ischemic Stroke Patients and Its Relationship with the Early Outcome of a Stroke. Cureus 2019; 11:e5625. [PMID: 31700728 PMCID: PMC6822887 DOI: 10.7759/cureus.5625] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 09/11/2019] [Indexed: 11/11/2022] Open
Abstract
Objective To find out the frequency of hyperhomocysteinemia in young ischaemic stroke patients and its relationship with early morbidity and mortality. Methods This prospective study was conducted on young ischemic stroke patients in Pakistan Atomic Energy Commission General Hospital, Islamabad. Ischaemic stroke patients of age < 45 years were selected from both the outpatient and inpatient departments. A fasting venous blood sample was sent for analysis. Data was collected through a structured proforma and were analyzed using SPSS 24.0 (IBM Corp, Armonk, NY, US). The outcome was measured at discharge using the modified Rankin scale. Results The mean age of the 71 patients in the study was 35.8 years. Overall, 36 (50.7%) cases had hyper-homocysteinemia. The frequency was significantly higher in males and in the age group 36-45 years (63.4%). Levels of homocysteine did not significantly affect the outcome at discharge. Conclusion Hyperhomocysteinaemia, a modifiable risk factor for ischaemic stroke, was seen in about half of young stroke patients. The levels of homocysteine did not correlate with early stroke outcome.
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Affiliation(s)
- Farheen Niazi
- Neurology, Pakistan Atomic Energy Commission Hospital, Islamabad, PAK
| | | | - Sadaf Khattak
- Neurology, Pakistan Atomic Energy Commission Hospital, Islamabad, PAK
| | - Satia Waheed
- Internal Medicine, Services Hospital, Lahore, PAK
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Korakas E, Dimitriadis G, Raptis A, Lambadiari V. Dietary Composition and Cardiovascular Risk: A Mediator or a Bystander? Nutrients 2018; 10:E1912. [PMID: 30518065 PMCID: PMC6316552 DOI: 10.3390/nu10121912] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 02/07/2023] Open
Abstract
The role of nutrition in the pathogenesis of cardiovascular disease has long been debated. The established notion of the deleterious effects of fat is recently under question, with numerous studies demonstrating the benefits of low-carbohydrate, high-fat diets in terms of obesity, diabetes, dyslipidemia, and metabolic derangement. Monounsaturated and polyunsaturated fatty acids, especially n-3 PUFAs (polyunsaturated fatty acids), are the types of fat that favor metabolic markers and are key components of the Mediterranean Diet, which is considered an ideal dietary pattern with great cardioprotective effects. Except for macronutrients, however, micronutrients like polyphenols, carotenoids, and vitamins act on molecular pathways that affect oxidative stress, endothelial function, and lipid and glucose homeostasis. In relation to these metabolic markers, the human gut microbiome is constantly revealed, with its composition being altered by even small dietary changes and different microbial populations being associated with adverse cardiovascular outcomes, thus becoming the target for potential new treatment interventions. This review aims to present the most recent data concerning different dietary patterns at both the macro- and micronutrient level and their association with atherosclerosis, obesity, and other risk factors for cardiovascular disease.
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Affiliation(s)
- Emmanouil Korakas
- Second Department of Internal Medicine and Research Institute, University General Hospital Attikon, 124 62 Haidari, Greece.
| | - George Dimitriadis
- Second Department of Internal Medicine and Research Institute, University General Hospital Attikon, 124 62 Haidari, Greece.
| | - Athanasios Raptis
- Second Department of Internal Medicine and Research Institute, University General Hospital Attikon, 124 62 Haidari, Greece.
| | - Vaia Lambadiari
- Second Department of Internal Medicine and Research Institute, University General Hospital Attikon, 124 62 Haidari, Greece.
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Anraku M, Gebicki JM, Iohara D, Tomida H, Uekama K, Maruyama T, Hirayama F, Otagiri M. Antioxidant activities of chitosans and its derivatives in in vitro and in vivo studies. Carbohydr Polym 2018; 199:141-149. [DOI: 10.1016/j.carbpol.2018.07.016] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 06/26/2018] [Accepted: 07/06/2018] [Indexed: 02/07/2023]
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16
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Gungor L, Polat M, Ozberk MB, Avci B, Abur U. Which Ischemic Stroke Subtype Is Associated with Hyperhomocysteinemia? J Stroke Cerebrovasc Dis 2018; 27:1921-1929. [DOI: 10.1016/j.jstrokecerebrovasdis.2018.02.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 02/05/2018] [Accepted: 02/17/2018] [Indexed: 10/17/2022] Open
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17
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Ng GYQ, Yun-An L, Sobey CG, Dheen T, Fann DYW, Arumugam TV. Epigenetic regulation of inflammation in stroke. Ther Adv Neurol Disord 2018; 11:1756286418771815. [PMID: 29774056 PMCID: PMC5949939 DOI: 10.1177/1756286418771815] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 03/29/2018] [Indexed: 12/30/2022] Open
Abstract
Despite extensive research, treatments for clinical stroke are still limited only to the administration of tissue plasminogen activator and the recent introduction of mechanical thrombectomy, which can be used in only a limited proportion of patients due to time constraints. A plethora of inflammatory events occur during stroke, arising in part due to the body's immune response to brain injury. Neuroinflammation contributes significantly to neuronal cell death and the development of functional impairment and death in stroke patients. Therefore, elucidating the molecular and cellular mechanisms underlying inflammatory damage following stroke injury will be essential for the development of useful therapies. Research findings increasingly point to the likelihood that epigenetic mechanisms play a role in the pathophysiology of stroke. Epigenetics involves the differential regulation of gene expression, including those involved in brain inflammation and remodelling after stroke. Hence, it is conceivable that epigenetic mechanisms may contribute to differential interindividual vulnerability and injury responses to cerebral ischaemia. In this review, we summarize recent findings on the emerging role of epigenetics in the regulation of neuroinflammation in stroke. We also discuss potential epigenetic targets that may be assessed for the development of stroke therapies.
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Affiliation(s)
- Gavin Yong-Quan Ng
- Department of Physiology, Yong Loo Lin School Medicine, National University of Singapore, Singapore
| | - Lim Yun-An
- Department of Physiology, Yong Loo Lin School Medicine, National University of Singapore, Singapore
| | - Christopher G. Sobey
- Department of Physiology, Anatomy and Microbiology, School of Life Sciences, La Trobe University, Bundoora, Australia
| | - Thameem Dheen
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - David Yang-Wei Fann
- Department of Physiology, Yong Loo Lin School Medicine, National University of Singapore, Singapore
| | - Thiruma V. Arumugam
- Department of Physiology, Yong Loo Lin School Medicine, National University of Singapore, Medical Drive, MD9, Singapore School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea Neurobiology/Ageing Programme, Life Sciences Institute, National University of Singapore, Singapore
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18
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Tripathi M, Zhang CW, Singh BK, Sinha RA, Moe KT, DeSilva DA, Yen PM. Hyperhomocysteinemia causes ER stress and impaired autophagy that is reversed by Vitamin B supplementation. Cell Death Dis 2016; 7:e2513. [PMID: 27929536 PMCID: PMC5260994 DOI: 10.1038/cddis.2016.374] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 10/11/2016] [Accepted: 10/11/2016] [Indexed: 12/19/2022]
Abstract
Hyperhomocysteinemia (HHcy) is a well-known risk factor for stroke; however, its underlying molecular mechanism remains unclear. Using both mouse and cell culture models, we have provided evidence that impairment of autophagy has a central role in HHcy-induced cellular injury in the mouse brain. We observed accumulation of LC3B-II and p62 that was associated with increased MTOR signaling in human and mouse primary astrocyte cell cultures as well as a diet-induced mouse model of HHcy, HHcy decreased lysosomal membrane protein LAMP2, vacuolar ATPase (ATP6V0A2), and protease cathepsin D, suggesting that lysosomal dysfunction also contributed to the autophagic defect. Moreover, HHcy increased unfolded protein response. Interestingly, Vitamin B supplementation restored autophagic flux, alleviated ER stress, and reversed lysosomal dysfunction due to HHCy. Furthermore, the autophagy inducer, rapamycin was able to relieve ER stress and reverse lysosomal dysfunction caused by HHcy in vitro. Inhibition of autophagy by HHcy exacerbated cellular injury during oxygen and glucose deprivation and reperfusion (OGD/R), and oxidative stress. These effects were prevented by Vitamin B co-treatment, suggesting that it may be helpful in relieving detrimental effects of HHcy in ischemia/reperfusion or oxidative stress. Collectively, these findings show that Vitamin B therapy can reverse defects in cellular autophagy and ER stress due to HHcy; and thus may be a potential treatment to reduce ischemic damage caused by stroke in patients with HHcy.
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Affiliation(s)
- Madhulika Tripathi
- Laboratory of Hormonal Regulation, Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore 169857, Singapore.,Stroke Trial Unit, Department of Neurology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.,National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
| | - Cheng Wu Zhang
- National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
| | - Brijesh Kumar Singh
- Laboratory of Hormonal Regulation, Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Rohit Anthony Sinha
- Laboratory of Hormonal Regulation, Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Kyaw Thu Moe
- Newcastle University Medicine Malaysia (NUMed, Malaysia) No. 1 Jalan Sarjana, Iskandar Puteri (formerly Nusajaya), Johor 179200, Malaysia
| | - Deidre Anne DeSilva
- Stroke Trial Unit, Department of Neurology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.,National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
| | - Paul Michael Yen
- Laboratory of Hormonal Regulation, Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore 169857, Singapore
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Choe H, Hwang JY, Yun JA, Kim JM, Song TJ, Chang N, Kim YJ, Kim Y. Intake of antioxidants and B vitamins is inversely associated with ischemic stroke and cerebral atherosclerosis. Nutr Res Pract 2016; 10:516-523. [PMID: 27698959 PMCID: PMC5037069 DOI: 10.4162/nrp.2016.10.5.516] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 12/11/2015] [Accepted: 05/17/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND/OBJECTIVES This study was conducted to examine relationships between dietary habits and intakes of antioxidants and B vitamins and the risk of ischemic stroke, and to compare dietary factors according to the presence of cerebral artery atherosclerosis and stroke subtypes. SUBJECTS/METHODS A total of 147 patients and 144 control subjects were recruited consecutively in the metropolitan area of Seoul, Korea. Sixty participants each in the case and control groups were included in analyses after 1:1 frequency matching. In addition, 117 acute ischemic stroke patients were classified into subtypes according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) guidelines. Dietary intake was measured using a semi-quantitative food frequency questionnaire composed of 111 food items and plasma lipid and homocysteine levels were analyzed. RESULTS When compared with control subjects, stroke patients had unfavorable dietary behaviors and lower intakes of fruits (73.1 ± 83.2 g vs. 230.9 ± 202.1 g, P < 0.001), vegetables (221.1 ± 209.0 g vs. 561.7 ± 306.6 g, P < 0.001), and antioxidants, including vitamins C, E, B6, β-carotene, and folate. The intakes of fruits, vegetables, vitamin C, and folate were inversely associated with the risk of ischemic stroke after adjusting for confounding factors. Intakes of vegetables, vitamins C, B6, B12, and folate per 1,000 kcal were lower in ischemic stroke with cerebral atherosclerosis than in those without. Overall vitamin B12 intake per 1,000 kcal differed according to the TOAST classification (P = 0.004), but no differences among groups existed based on the post-hoc test. CONCLUSIONS When compared with control subjects, ischemic stroke patients, particularly those with cerebral atherosclerosis, had unfavorable dietary intake, which may have contributed to the development of ischemic stroke. These results indicate that proper dietary recommendations are important for the prevention of ischemic stroke.
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Affiliation(s)
- Hansaem Choe
- Department of Nutritional Science and Food Management, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
| | - Ji-Yun Hwang
- Department of Foodservice Management and Nutrition, Sangmyung University, Seoul 03016, Korea
| | - Jin A Yun
- Department of Nutritional Science and Food Management, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
| | - Ji-Myung Kim
- Food and Nutrition Major, Division of Food Science and Culinary Arts, Shinhan University, Gyeonggi 11644, Korea
| | - Tae-Jin Song
- Department of Neurology, Ewha Womans University, School of Medicine, Seoul 03760, Korea
| | - Namsoo Chang
- Department of Nutritional Science and Food Management, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
| | - Yong-Jae Kim
- Department of Neurology, Ewha Womans University, School of Medicine, Seoul 03760, Korea
| | - Yuri Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
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20
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Bhardwaj RL, Nandal U. Nutritional and therapeutic potential of bael (Aegle marmelos Corr.) fruit juice: a review. ACTA ACUST UNITED AC 2015. [DOI: 10.1108/nfs-05-2015-0058] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The purpose of this paper is to summarize the scientific information of various qualities of bael fruit juice used in traditional system of medicine for variety of purposes. Utilization of bael fruit juice in day-to-day life has great nutritional, therapeutic, and commercial importance. Bael fruit contains nutrients like vitamins (riboflavin), minerals, trace elements, energy and phytochemicals, including flavonoids, polyphenols and antioxidants, that have been shown to have varied health benefits. In past few decades, bael has been extensively studied for its medicinal properties by advanced scientific techniques, and a variety of bioactive compounds like marmelosin, tannins, alkaloids, coumarins, steroids, rutacine, y-sitosterol, psoralin, xanthotoxin, scopolotein, aegelemine, aegeline, marmeline, fragrine, dictamine, cinnamide and different derivatives of cinnamide have been isolated from its fruit juice.
Design/methodology/approach
– The medicinal value of bael fruit is very high when the harvests just begin to ripen. As a result, it has a high demand as alternative medicine for curing the diseases like diabetes, high cholesterol, peptic ulcer, inflammation, diarrhea and dysentery, constipation, respiratory infection. Furthermore, the bael fruit juice has anticancer, cardio protective, antibacterial, antifungal, radio protective, antipyretic, analgesic, antioxidant, antiviral, anthelmintic and anti-inflammatory, hepatoprotective, wound healing properties. The ripe fruit juice is aromatic, has cooling and laxative effects, and arrests secretion or bleeding.
Findings
– The unripe or half-ripe fruit juice is good for digestion, useful in preventing or curing scurvy, and it strengthens the stomach action. It helps in the healing of ulcerated intestinal surfaces and has appreciable activity against intestinal pathogenic organisms. The present review summarizes the scientific information of various qualities of bael fruit juice used in traditional system of medicine for a variety of purposes.
Originality/value
– It is quite evident from this review that bael is an important medicinal herb and extensively used in Ayurveda, Siddha and other medicinal systems. Bael fruit juice is an excellent source of water and natural sugar and is important principally for containing vitamins, minerals, phytochemicals, antioxidants, pigments, energy, organic acids, dietary fiber and other food components, which are the key factors in the medicinal value of this plant. Moreover, mechanisms of action of a few bioactive compounds have been identified so far.
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Wang C, Han L, Wu Q, Zhuo R, Liu K, Zhao J, Zhang L, Hao Y, Fan R, Liu Y, Li R, Chen Z, Zhang T, Chen S, Ma J, Liu S, Peng X, Duan S. Association between homocysteine and incidence of ischemic stroke in subjects with essential hypertension: a matched case-control study. Clin Exp Hypertens 2015; 37:557-62. [PMID: 25992490 DOI: 10.3109/10641963.2015.1026039] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND To assess the association between total plasma homocysteine (tHcy) and ischemic stroke (IS) in hypertensive subjects in a matched case-control study. METHODS This is a 1:2 matched and population-based case-control study, all of the participants were recruited from the 60 communities in Shenzhen, China. Demographic and socioeconomic characteristics, medical records, lifestyle risk factors and other clinical characteristics were obtained from all of the subjects. The association between tHcy and incidence of IS was analyzed by using conditional logistic regression models. RESULTS The median values of plasma tHcy were significantly higher in IS subjects than in non-IS subjects, especially in women. After adjusted for the confounding factors in Model 2, compared with the lowest quartile of tHcy, the odds ratios (ORs) and 95% CIs of the highest quartile of tHcy for IS were 0.83 (0.36-1.90) in men, 4.51 (1.29-15.7) in women and 1.31 (0.70-2.47) in the total subjects; the ORs and 95% CIs for IS per 5 μmol/L increase in homocysteine were 1.11 (0.99-1.22), 1.25 (1.03-1.58) and 1.15 (1.01-1.28) in men, women and total subjects, respectively. We observed significant associations in crude model, Model 1 and Model 2 in women for the comparison of tHcy ≥ 15 μmol/L versus < 15 μmol/L. Interaction analysis showed that the association of tHcy with IS was significant in women (p-interaction = 0.04). CONCLUSION This matched case-control study indicates that tHcy may increase the susceptibility to IS in essential hypertension subjects, especially in women. Further large prospective cohort studies are needed to confirm our findings.
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Affiliation(s)
- Changyi Wang
- a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China
| | - Liyuan Han
- b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China
| | - Qunhong Wu
- c Department of Social Medicine , School of Public Health, Harbin Medical University , Harbin , Heilongjiang Province , People's Republic of China , and
| | - Renjie Zhuo
- b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China
| | - Kui Liu
- d Department of Science Research and Information Management , Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou , China
| | - Jinshun Zhao
- b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China
| | - Lina Zhang
- b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China
| | - Yanhua Hao
- c Department of Social Medicine , School of Public Health, Harbin Medical University , Harbin , Heilongjiang Province , People's Republic of China , and
| | - Rui Fan
- b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China
| | - Yanfen Liu
- b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China
| | - Runhua Li
- b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China
| | - Zhongwei Chen
- a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China
| | - Tao Zhang
- a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China
| | - Sihan Chen
- a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China
| | - Jianping Ma
- a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China
| | - Shengyuan Liu
- a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China
| | - Xiaolin Peng
- a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China
| | - Shiwei Duan
- b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China
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Allahtavakoli M, Amin F, Esmaeeli-Nadimi A, Shamsizadeh A, Kazemi-Arababadi M, Kennedy D. Ascorbic Acid Reduces the Adverse Effects of Delayed Administration of Tissue Plasminogen Activator in a Rat Stroke Model. Basic Clin Pharmacol Toxicol 2015; 117:335-9. [PMID: 25899606 DOI: 10.1111/bcpt.12413] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 03/24/2015] [Indexed: 12/13/2022]
Abstract
Delayed treatment of stroke with recombinant tissue plasminogen activator (r-tPA) induces overexpression of matrix metalloproteinase 9 (MMP-9) which leads to breakdown of the blood-brain barrier (BBB) and causes more injuries to the brain parenchyma. In this study, the effect of ascorbic acid (AA), an antioxidant agent, on the delayed administration of r-tPA in a rat model of permanent middle cerebral artery occlusion (MCAO) was investigated. Forty male rats were randomly divided into four groups: untreated control rats (ischaemic animals), AA-treated (500 mg/kg; 5 hr after stroke) rats, r-tPA-treated (5 hr after stroke 1 mg/kg) rats and rats treated with the combination of AA and r-tPA. Middle cerebral artery occlusion was induced by occluding the right middle cerebral artery (MCA). Infarct size, BBB, brain oedema and the levels of MMP-9 were measured at the end of study. Neurological deficits were evaluated at 24 and 48 hr after stroke. Compared to the control or r-tPA-treated animals, AA alone (p < 0.001) or in combination with r-tPA (p < 0.05) significantly decreased infarct volume. Ascorbic acid alone or r-tPA + AA significantly reduced BBB permeability (p < 0.05), levels of MMP-9 (p < 0.05 versus control; p < 0.01 versus r-tPA) and brain oedema (p < 0.001) when compared to either the control or the r-tPA-treated animals. Latency to the removal of sticky labels from the forepaw was also significantly decreased after the administration of AA + r-tPA (p < 0.05) at 24 or 48 hr after stroke. Based on our data, acute treatment with AA may be considered as a useful candidate to reduce the side effects of delayed application of r-tPA in stroke therapy.
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Affiliation(s)
- Mohammad Allahtavakoli
- Physiology-Pharmacology Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Fatemeh Amin
- Physiology-Pharmacology Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ali Esmaeeli-Nadimi
- Department of Cardiology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ali Shamsizadeh
- Physiology-Pharmacology Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mohammad Kazemi-Arababadi
- Immunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Derek Kennedy
- School of Natural Sciences, Eskitis Institute for Drug Discovery, Griffith University Nathan, Nathan, Qld, Australia
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Prins A. The nutritional management of a central venous incident. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2015. [DOI: 10.1080/16070658.2015.11734544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Vanzin CS, Manfredini V, Marinho AE, Biancini GB, Ribas GS, Deon M, Wyse ATDS, Wajner M, Vargas CR. Homocysteine contribution to DNA damage in cystathionine β-synthase-deficient patients. Gene 2014; 539:270-4. [DOI: 10.1016/j.gene.2014.02.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Revised: 01/07/2014] [Accepted: 02/07/2014] [Indexed: 11/28/2022]
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Alfieri A, Srivastava S, Siow RCM, Cash D, Modo M, Duchen MR, Fraser PA, Williams SCR, Mann GE. Sulforaphane preconditioning of the Nrf2/HO-1 defense pathway protects the cerebral vasculature against blood-brain barrier disruption and neurological deficits in stroke. Free Radic Biol Med 2013; 65:1012-1022. [PMID: 24017972 DOI: 10.1016/j.freeradbiomed.2013.08.190] [Citation(s) in RCA: 165] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 08/23/2013] [Accepted: 08/29/2013] [Indexed: 12/30/2022]
Abstract
Disruption of the blood-brain barrier (BBB) and cerebral edema are the major pathogenic mechanisms leading to neurological dysfunction and death after ischemic stroke. The brain protects itself against infarction via activation of endogenous antioxidant defense mechanisms, and we here report the first evidence that sulforaphane-mediated preactivation of nuclear factor erythroid 2-related factor 2 (Nrf2) and its downstream target heme oxygenase-1 (HO-1) in the cerebral vasculature protects the brain against stroke. To induce ischemic stroke, Sprague-Dawley rats were subjected to 70 min middle cerebral artery occlusion (MCAo) followed by 4, 24, or 72 h reperfusion. Nrf2 and HO-1 protein expression was upregulated in cerebral microvessels of peri-infarct regions after 4-72 h, with HO-1 preferentially associated with perivascular astrocytes rather than the cerebrovascular endothelium. In naïve rats, treatment with sulforaphane increased Nrf2 expression in cerebral microvessels after 24h. Upregulation of Nrf2 by sulforaphane treatment prior to transient MCAo (1h) was associated with increased HO-1 expression in perivascular astrocytes in peri-infarct regions and cerebral endothelium in the infarct core. BBB disruption, lesion progression, as analyzed by MRI, and neurological deficits were reduced by sulforaphane pretreatment. As sulforaphane pretreatment led to a moderate increase in peroxynitrite generation, we suggest that hormetic preconditioning underlies sulforaphane-mediated protection against stroke. In conclusion, we propose that pharmacological or dietary interventions aimed to precondition the brain via activation of the Nrf2 defense pathway in the cerebral microvasculature provide a novel therapeutic approach for preventing BBB breakdown and neurological dysfunction in stroke.
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Affiliation(s)
- Alessio Alfieri
- Cardiovascular Division, British Heart Foundation Centre of Research Excellence, School of Medicine, King's College London, London SE1 9NH, UK
| | - Salil Srivastava
- Cardiovascular Division, British Heart Foundation Centre of Research Excellence, School of Medicine, King's College London, London SE1 9NH, UK
| | - Richard C M Siow
- Cardiovascular Division, British Heart Foundation Centre of Research Excellence, School of Medicine, King's College London, London SE1 9NH, UK
| | - Diana Cash
- Centre for Neuroimaging Sciences, Institute of Psychiatry, King's College London, London SE5 8AF, UK
| | - Michel Modo
- Centre for the Cellular Basis of Behaviour, Institute of Psychiatry, King's College London, London SE5 9NU, UK
| | - Michael R Duchen
- Department of Cell and Developmental Biology, University College London, London WC1E 6BT, UK
| | - Paul A Fraser
- Cardiovascular Division, British Heart Foundation Centre of Research Excellence, School of Medicine, King's College London, London SE1 9NH, UK
| | - Steven C R Williams
- Centre for Neuroimaging Sciences, Institute of Psychiatry, King's College London, London SE5 8AF, UK
| | - Giovanni E Mann
- Cardiovascular Division, British Heart Foundation Centre of Research Excellence, School of Medicine, King's College London, London SE1 9NH, UK.
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Sharma S, Sheehy T, Kolonel LN. Ethnic differences in grains consumption and their contribution to intake of B-vitamins: results of the Multiethnic Cohort Study. Nutr J 2013; 12:65. [PMID: 23688109 PMCID: PMC3665444 DOI: 10.1186/1475-2891-12-65] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 05/03/2013] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Research indicates that a diet rich in whole grains may reduce the risk of prevalent chronic diseases, including cardiovascular disease, diabetes, and some cancers, and that risk for these diseases varies by ethnicity. The objective of the current study was to identify major dietary sources of grains and describe their contribution to B vitamins in five ethnic groups. METHODS A cross-sectional mail survey was used to collect data from participants in the Multiethnic Cohort Study in Hawaii and Los Angeles County, United States, from 1993 to 1996. Dietary intake data collected using a quantitative food frequency questionnaire was available for 186,916 participants representing five ethnic groups (African American, Latino, Japanese American, Native Hawaiian and Caucasian) aged 45-75 years. The top sources of grain foods were determined, and their contribution to thiamin, riboflavin, niacin, vitamin B6, and folic acid intakes were analyzed. RESULTS The top source of whole grains was whole wheat/rye bread for all ethnic-sex groups, followed by popcorn and cooked cereals, except for Native Hawaiian men and Japanese Americans, for whom brown/wild rice was the second top source; major contributors of refined grains were white rice and white bread, except for Latinos. Refined grain foods contributed more to grain consumption (27.1-55.6%) than whole grain foods (7.4-30.8%) among all ethnic-sex groups, except African American women. Grain foods made an important contribution to the intakes of thiamin (30.2-45.9%), riboflavin (23.1-29.2%), niacin (27.1-35.8%), vitamin B6 (22.9-27.5%), and folic acid (23.3-27.7%). CONCLUSIONS This is the first study to document consumption of different grain sources and their contribution to B vitamins in five ethnic groups in the U.S. Findings can be used to assess unhealthful food choices, to guide dietary recommendations, and to help reduce risk of chronic diseases in these populations.
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Affiliation(s)
- Sangita Sharma
- Department of Medicine, Aboriginal and Global Health Research Group, University of Alberta, 5-10 University Terrace, 8303 112 Street, Edmonton, Alberta T6G 2T4, Canada.
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Wei M, Wu Y, Chen D, Gu Y. Changes of free radicals and digestive enzymes in saliva in cases with deficiency in spleen-yin syndrome. J Biomed Res 2013; 24:250-5. [PMID: 23554637 PMCID: PMC3596561 DOI: 10.1016/s1674-8301(10)60035-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2009] [Indexed: 11/19/2022] Open
Abstract
Objective To explore the nature of deficiency in spleen-yin syndrome, which could provide scientific theoretical support and practical guidance for clinical Traditional Chinese Medicine (TCM) syndrome differentiation based on biology, and had a strong clinical significance. Methods Serum Cu and Zn were detected by atomic absorption spectrophotometer, serum vitamin E by high performance liquid chromatography, serum vitamin C by 2,4-Dinitrophenylhydrazine Colorimetry, total superoxide dismutase (SOD) and Cu and Zn-SOD by the xanthine oxidase method, and malondialdehyde (MDA) by the 2-thiobarbituric acid method (TBA). Total antioxidant capacity was detected by a colorimetry kit. Amylase Activity was detected by an automatic biochemical analyzer. Lysozyme was detected by lysozyme detection plate, the diameter of bacteriolysis circle was measured and the corresponding content of lysozyme was obtained from a table of standard curve values. Results No significant difference in total SOD and Cu, Zn-SOD was found between deficiency in spleen-yin group and normal group. However, such factors in deficiency in kidney-yin group were significantly lower than the other groups (P < 0.05). The MDA content in both deficiency in spleen-yin group and deficiency in kidney-yin group were significantly higher than that of normal group (P < 0.05), while the total antioxidant capacity was significantly lower than normal group (P < 0.05). The vitamin E content in deficiency in kidney-yin group was significantly lower than that in the other two groups (P < 0.05). No significant difference in the contents of vitamin C, Cu and Zn were observed in these groups. The Zn/Cu level in deficiency in kidney-yin group and the vitamin E level in deficiency in spleen-yin group decreased, but with no significant difference. Amylase activity in unit time in cases with deficiency in spleen-yin was lower than and had significant differences with that in normal cases, and higher than that in cases with deficiency in kidney-yin. The sectional velocity of saliva and the ratio of lysozyme in normal case group were significantly higher than other two groups, while deficiency in the spleen-yin group was significantly higher than the deficiency in kidney-yin group. Conclusion All the results indicated that the objective pathological mechanism between the deficiency in spleen-yin and deficiency in kidney-yin was different.
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Affiliation(s)
- Muxin Wei
- *Corresponding author E-mail address:
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Sorce S, Krause KH, Jaquet V. Targeting NOX enzymes in the central nervous system: therapeutic opportunities. Cell Mol Life Sci 2012; 69:2387-407. [PMID: 22643836 PMCID: PMC11114708 DOI: 10.1007/s00018-012-1014-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 04/18/2012] [Accepted: 04/20/2012] [Indexed: 12/14/2022]
Abstract
Among the pathogenic mechanisms underlying central nervous system (CNS) diseases, oxidative stress is almost invariably described. For this reason, numerous attempts have been made to decrease reactive oxygen species (ROS) with the administration of antioxidants as potential therapies for CNS disorders. However, such treatments have always failed in clinical trials. Targeting specific sources of reactive oxygen species in the CNS (e.g. NOX enzymes) represents an alternative promising option. Indeed, NOX enzymes are major generators of ROS, which regulate progression of CNS disorders as diverse as amyotrophic lateral sclerosis, schizophrenia, Alzheimer disease, Parkinson disease, and stroke. On the other hand, in autoimmune demyelinating diseases, ROS generated by NOX enzymes are protective, presumably by dampening the specific immune response. In this review, we discuss the possibility of developing therapeutics targeting NADPH oxidase (NOX) enzymes for the treatment of different CNS pathologies. Specific compounds able to modulate the activation of NOX enzymes, and the consequent production of ROS, could fill the need for disease-modifying drugs for many incurable CNS pathologies.
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Affiliation(s)
- Silvia Sorce
- Department of Pathology and Immunology, Geneva Medical Faculty, Geneva University Hospitals Centre Medical Universitaire 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
- Department of Genetic and Laboratory Medicine, Geneva University Hospitals Centre Medical Universitaire 1, Geneva 4, Switzerland
| | - Karl-Heinz Krause
- Department of Pathology and Immunology, Geneva Medical Faculty, Geneva University Hospitals Centre Medical Universitaire 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
- Department of Genetic and Laboratory Medicine, Geneva University Hospitals Centre Medical Universitaire 1, Geneva 4, Switzerland
| | - Vincent Jaquet
- Department of Pathology and Immunology, Geneva Medical Faculty, Geneva University Hospitals Centre Medical Universitaire 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
- Department of Genetic and Laboratory Medicine, Geneva University Hospitals Centre Medical Universitaire 1, Geneva 4, Switzerland
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Kuklina EV, Tong X, George MG, Bansil P. Epidemiology and prevention of stroke: a worldwide perspective. Expert Rev Neurother 2012; 12:199-208. [PMID: 22288675 DOI: 10.1586/ern.11.99] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This paper reviews how epidemiological studies during the last 5 years have advanced our knowledge in addressing the global stroke epidemic. The specific objectives were to review the current evidence supporting management of ten major modifiable risk factors for prevention of stroke: hypertension, current smoking, diabetes, obesity, poor diet, physical inactivity, atrial fibrillation, excessive alcohol consumption, abnormal lipid profile and psychosocial stress/depression.
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Affiliation(s)
- Elena V Kuklina
- Division of Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Malnutrition in patients with acute stroke. J Nutr Metab 2011; 2011:167898. [PMID: 22254136 PMCID: PMC3255318 DOI: 10.1155/2011/167898] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 11/03/2011] [Indexed: 02/06/2023] Open
Abstract
Stroke is a devastating event that carries a potential for long-term disability. Malnutrition is frequently observed in patients with stroke, and dysphagia contributes to malnutrition risk. During both the acute phase of stroke and rehabilitation, specific nutritional interventions in the context of a multidisciplinary team effort can enhance the recovery of neurocognitive function. Early identification and management of malnutrition with dietary modifications or specific therapeutic strategies to ensure adequate nutritional intake should receive more attention, since poor nutritional status appears to exacerbate brain damage and to contribute to adverse outcome. The main purpose of nutritional intervention should be the prevention or treatment of complications resulting from energy-protein deficit. This paper reviews the evaluation and management of malnutrition and the use of specialized nutrition support in patients with stroke. Emphasis is given to enteral tube and oral feeding and to strategies to wean from tube feeding.
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Abstract
There is good agreement concerning average requirements and reference intakes for vitamin B6 but less agreement over safe upper levels from supplements. High-dose supplements cause sensory nerve damage. Supplements of vitamin B6 have been advocated for treatment of the premenstrual syndrome, with little evidence of efficacy. There are plausible mechanisms for an antidepressant action and protection against steroid hormone—dependent cancers but no evidence from clinical trials. Pyridoxamine reduces the glycation of proteins and so could be beneficial in preventing the adverse effects of poor glycemic control in diabetes. There are plausible mechanisms for an antihypertensive action but only suggestive evidence from small intervention trials. There is no evidence that supplements of vitamin B6 have any beneficial effect in hyperhomocysteinemia. There is neither a plausible mechanism nor any evidence from controlled trials for any effect of supplements of vitamin B6 in preventing a decline in cognitive function with aging, amelioration of dementia or autism, or improvement of the carpal tunnel syndrome.
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Is nitrous oxide use appropriate in neurosurgical and neurologically at-risk patients? Curr Opin Anaesthesiol 2010; 23:544-50. [PMID: 20689409 DOI: 10.1097/aco.0b013e32833e1520] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW To address controversial issues surrounding the use of nitrous oxide as a component of anesthesia in neurosurgical and neurologically at-risk patients. RECENT FINDINGS Nitrous oxide has been used as a component of general anesthesia for over 160 years and has contributed to countless apparently uneventful anesthetics in neurologically at-risk patients. Avoidance of nitrous oxide in specific circumstances, such as pre-existing pneumocephalus, during acute venous air embolism, and in patients with disorders of folate metabolism, is warranted. However, various controversies exist regarding the use of this drug in the general neurosurgical population. Specifically, some suggest a possible association between nitrous oxide and the postoperative development of tension pneumocephalus despite lack of data to support this notion. Additionally, data describing alterations of cerebral hemodynamics and metabolism and exacerbation of ischemic neurologic injury by nitrous oxide are inconsistent. Recent data derived from humans having cerebral aneurysm clipping failed to show any long-term adverse effect from the use of nitrous oxide on gross neurologic or cognitive function. SUMMARY Except in a few specific circumstances, there exists no conclusive evidence to support the dogmatic avoidance of nitrous oxide in neurosurgical patients.
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Failure of vitamin supplementation to lower the risk of recurrent stroke. Curr Neurol Neurosci Rep 2010; 11:1-5. [PMID: 20963642 DOI: 10.1007/s11910-010-0152-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Current world literature. Neuroanaesthesia. Pain medicine. Regional anaesthesia. Curr Opin Anaesthesiol 2010; 23:671-8. [PMID: 20811177 DOI: 10.1097/aco.0b013e32833f3f68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Influence of vitamin C on markers of oxidative stress in the earliest period of ischemic stroke. Pharmacol Rep 2010; 62:751-6. [DOI: 10.1016/s1734-1140(10)70334-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2009] [Revised: 01/19/2010] [Indexed: 11/20/2022]
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Northstone K, Emmett PM. Dietary patterns of men in ALSPAC: associations with socio-demographic and lifestyle characteristics, nutrient intake and comparison with women's dietary patterns. Eur J Clin Nutr 2010; 64:978-86. [PMID: 20571501 DOI: 10.1038/ejcn.2010.102] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The aim of this study is to obtain distinct dietary patterns using principal components analysis (PCA) in men taking part in the Avon Longitudinal Study of Parents and Children and to determine the associations with (a) the patterns derived in the study women (the men's partners), (b) socio-demographic and lifestyle factors and (c) estimated nutrient intakes. DESIGN AND METHODS A total of 4681 men taking part in a population-based cohort study recorded their current frequency of food consumption through questionnaire. Dietary patterns were identified using PCA, and scores were calculated for each pattern. A wide variety of social and demographic characteristics and lifestyle factors were also collected through self-completion questionnaire. RESULTS Four dietary patterns were established: 'health conscious', 'traditional', 'processed/confectionery' and 'semi-vegetarian'. There were relatively strong correlations and levels of agreement between the 'health conscious' and 'vegetarian' style patterns in men and women (P<0.001). Strong associations were evident between several socio-demographic variables and the dietary patterns, similar to those earlier reported in women. Finally, nutrient intakes were plausibly associated with dietary pattern scores. CONCLUSIONS Distinct dietary patterns in men have been identified using PCA that are similar, but not identical to those obtained in their partners at the same time point. Researchers should always consider stratifying by gender when examining dietary patterns. This study will form the basis for further work investigating the associations between parental and child dietary patterns.
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Affiliation(s)
- K Northstone
- Department of Social Medicine, University of Bristol, Bristol, UK.
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Lai CQ, Parnell LD, Troen AM, Shen J, Caouette H, Warodomwichit D, Lee YC, Crott JW, Qiu WQ, Rosenberg IH, Tucker KL, Ordovás JM. MAT1A variants are associated with hypertension, stroke, and markers of DNA damage and are modulated by plasma vitamin B-6 and folate. Am J Clin Nutr 2010; 91:1377-86. [PMID: 20335551 PMCID: PMC2854908 DOI: 10.3945/ajcn.2009.28923] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The S-adenosylmethionine synthetase type 1 (MAT1A) gene encodes a key enzyme in one-carbon nutrient metabolism. OBJECTIVE This study aimed to determine the association of MAT1A variants with homocysteine, DNA damage, and cardiovascular disease (CVD). DESIGN Eight variants of MAT1A were examined for associations with hypertension, stroke, CVD, homocysteine, and DNA damage in 1006 participants of the Boston Puerto Rican Health Study. Two variants were replicated in 1147 participants of the Nutrition, Aging, and Memory in Elders Study. RESULTS Two variants and haplotypes were strongly associated with hypertension and stroke, independent of methylenetetrahydrofolate reductase (MTHFR) variants. Homozygotes of the MAT1A d18777A (rs3851059) allele had a significantly greater likelihood of stroke (odds ratio: 4.30; 95% CI: 1.34, 12.19; P = 0.006), whereas 3U1510A (rs7087728) homozygotes had a lower likelihood of hypertension (odds ratio: 0.67; 95% CI: 0.48, 0.95; P = 0.022) and stroke (odds ratio: 0.35; 95% CI: 0.15, 0.82; P = 0.015). A similar trend of association was observed in a second elderly population. Furthermore, strong interactions between MAT1A genotypes and vitamin B-6 status were found. Carriers of the nonrisk allele 3U1510A had a lower 8-hydroxydeoxyguanosine concentration--a biomarker of oxidative DNA damage--when plasma vitamin B-6 was high, whereas homozygotes for the risk-allele 3U1510G had higher 8-hydroxydeoxyguanosine concentrations, regardless of vitamin B-6 status. CONCLUSIONS MAT1A variants were strongly associated with hypertension and stroke. Improving folate and vitamin B-6 status might decrease the CVD risk of only a subset of the population, depending on genotype. These findings suggest that impairments in methylation activity, independent of homocysteine, have an effect on CVD risk.
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Affiliation(s)
- Chao-Qiang Lai
- Nutrition and Genomics Laboratory, Jean Mayer-US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA.
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Editorial. Finding suitable reviewers. Nutr Res Rev 2009; 22:1-2. [PMID: 19555516 DOI: 10.1017/s0954422409990059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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