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Zhang T, Wang Q, Cui XM, Zhang YY, Guo FX, Wu QF, Dong MH, Luo XT. Mediating effect of cumulative lipid profile burden on the effect of diet and obesity on hypertension incidence: a cohort study of people aged 35-65 in rural China. Eur J Clin Nutr 2024; 78:54-63. [PMID: 37816846 DOI: 10.1038/s41430-023-01348-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Cumulative lipid profile burden is designed to dynamically measure lipid accumulation, and its effect on hypertension has been poorly studied. Our main purpose was to investigate the effect of cumulative lipid profile burden on the incidence of essential hypertension (EH) and to investigate whether cumulative lipid burden mediates the pathogenesis of the effects of diet and obesity on EH. SUBJECTS AND METHODS A total of 1295 participants were included in the study, which started in 2017. The average follow-up time was 2.98 years. A total of 240 EH patients occurred during the follow-up period. RESULTS The HR (95% CI) of the highest quartile in cumulative Total cholesterol (TC), triglyceride (TG) and high density lipoprotein (HDL) burden were 1.747 (1.145 - 2.664), 1.502 (1.038 - 2.173), 0.615 (0.413 - 0.917) for incidence of EH respectively, compared to the respective reference groups. Participants with EH consumed more red meat and refined grains, and red meat was positively associated with cumulative TC burden. BMI and Waist-To-Height Ratio (WHtR) increased the incidence of EH, and obesity was positively correlated with cumulative TG burden. Mediating analysis showed that cumulative TG had a partial mediating effect in the causal relationship between obesity and EH, and Mendelian randomization (MR) also proved this result. Diet was not found to influence EHn through cumulative lipid profile burden. CONCLUSIONS The cumulative TG burden partially mediates the effect of obesity on EH.
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Affiliation(s)
- Ting Zhang
- Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Qi Wang
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Xiao-Mei Cui
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Yu-Ying Zhang
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Fang-Xi Guo
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Qing-Feng Wu
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Ming-Hua Dong
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Xiao-Ting Luo
- Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China.
- College of General Medicine, Gannan Medical University, Ganzhou, China.
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Taeubert MJ, Wiertsema CJ, Vermeulen MJ, Quezada-Pinedo HG, Reiss IK, Muckenthaler MU, Gaillard R. Maternal Iron Status in Early Pregnancy and Blood Pressure Throughout Pregnancy, Placental Hemodynamics, and the Risk of Gestational Hypertensive Disorders. J Nutr 2021; 152:525-534. [PMID: 34647596 PMCID: PMC8826859 DOI: 10.1093/jn/nxab368] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/27/2021] [Accepted: 10/08/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND In nonpregnant populations, higher serum ferritin, which reflects high iron stores, is associated with an increased risk of hypertension. We hypothesized that a dysregulated maternal iron status in early pregnancy may lead to impaired gestational hemodynamic adaptations, leading to an increased risk of gestational hypertensive disorders. OBJECTIVES We examined the associations of maternal iron status with maternal blood pressure, placental hemodynamic parameters, and the risks of gestational hypertensive disorders. METHODS In a population-based prospective cohort study among 5983 pregnant women, we measured maternal serum ferritin, transferrin saturation, serum iron, and transferrin concentrations at a median of 13.2 weeks gestation (95% range, 9.6-17.6). Maternal blood pressure was measured in early pregnancy, mid pregnancy, and late pregnancy, and placental hemodynamic parameters in mid pregnancy and late pregnancy were measured by ultrasound. Information on gestational hypertensive disorders was collected from medical records. We examined the associations of maternal early pregnancy iron status with maternal systolic and diastolic blood pressure, placental hemodynamic parameters, and the risks of gestational hypertensive disorders using linear and logistic regression models. RESULTS Higher maternal early pregnancy serum ferritin concentrations were associated with higher systolic and diastolic blood pressure throughout pregnancy in the basic models (P values < 0.05). After adjustment for maternal inflammation, sociodemographic and lifestyle factors, higher maternal early pregnancy serum ferritin concentrations were only associated with a higher early pregnancy diastolic blood pressure [0.27 (95% CI, 0.03-0.51) mmHg per SD score increase in serum ferritin] and with a higher mid pregnancy umbilical artery pulsatility index (P < 0.05). No associations with the risk of gestational hypertensive disorders were present. CONCLUSIONS No consistent associations were present of maternal iron status in early pregnancy with gestational hemodynamic adaptations or the risks of gestational hypertensive disorders. Further studies are needed to examine the potential role of iron metabolism in the development of gestational hypertensive disorders within higher-risk populations.
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Affiliation(s)
- Minerva J Taeubert
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Pediatric Oncology, Hematology and Immunology, University Medical Center, Heidelberg, Germany
| | - Clarissa J Wiertsema
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Pediatrics, Sophia's Children's Hospital, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marijn J Vermeulen
- Department of Pediatrics, Sophia's Children's Hospital, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Hugo G Quezada-Pinedo
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Pediatrics, Sophia's Children's Hospital, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Irwin K Reiss
- Department of Pediatrics, Sophia's Children's Hospital, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Martina U Muckenthaler
- Department of Pediatric Oncology, Hematology and Immunology, University Medical Center, Heidelberg, Germany
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Henderson GC. Plasma Free Fatty Acid Concentration as a Modifiable Risk Factor for Metabolic Disease. Nutrients 2021; 13:nu13082590. [PMID: 34444750 PMCID: PMC8402049 DOI: 10.3390/nu13082590] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/18/2021] [Accepted: 07/27/2021] [Indexed: 02/07/2023] Open
Abstract
Plasma free fatty acid (FFA) concentration is elevated in obesity, insulin resistance (IR), non-alcoholic fatty liver disease (NAFLD), type 2 diabetes (T2D), and related comorbidities such as cardiovascular disease (CVD). Furthermore, experimentally manipulating plasma FFA in the laboratory setting modulates metabolic markers of these disease processes. In this article, evidence is presented indicating that plasma FFA is a disease risk factor. Elevations of plasma FFA can promote ectopic lipid deposition, IR, as well as vascular and cardiac dysfunction. Typically, elevated plasma FFA results from accelerated adipose tissue lipolysis, caused by a high adipose tissue mass, adrenal hormones, or other physiological stressors. Reducing an individual’s postabsorptive and postprandial plasma FFA concentration is expected to improve health. Lifestyle change could provide a significant opportunity for plasma FFA reduction. Various factors can impact plasma FFA concentration, such as chronic restriction of dietary energy intake and weight loss, as well as exercise, sleep quality and quantity, and cigarette smoking. In this review, consideration is given to multiple factors which lead to plasma FFA elevation and subsequent disruption of metabolic health. From considering a variety of medical conditions and lifestyle factors, it becomes clear that plasma FFA concentration is a modifiable risk factor for metabolic disease.
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Affiliation(s)
- Gregory C Henderson
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA
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Song Y, Qi Z, Zhang Y, Wei J, Liao X, Li R, Dong C, Zhu L, Yang Z, Cai Z. Effects of exposure to ambient fine particulate matter on the heart of diet-induced obesity mouse model. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 732:139304. [PMID: 32438171 DOI: 10.1016/j.scitotenv.2020.139304] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/06/2020] [Accepted: 05/07/2020] [Indexed: 06/11/2023]
Abstract
Exposure to fine particulate matter (PM2.5) is associated with decreased cardiac function, especially in high risk populations such as obese ones. In this study, impacts of PM2.5 exposure on cardiac function were investigated by using the diet-induced obesity mice model. Mice were fed with normal diet or high-fat diet (HFD) for four weeks and then exposed to phosphate-buffered solution or Taiyuan winter PM2.5 (0.25 mg/kg body/day) through intratracheal instillation for another four weeks. Among physiological indices recorded, heart rate and blood pressure were increased after PM2.5 exposure in the heart of the obese mice. Metabolomics and lipidomics were applied to explore molecular alterations in response to the co-treatment of PM2.5 and HFD. Our results demonstrated both direct impacts on cardiac function and indirect effects resulted from the injury of other organs. Inflammation of lung and hypothalamus may be responsible for the elevation of phenylalanine metabolism in serum and its downstream products: epinephrine and norepinephrine, the catecholamines involves in regulating cardiac system. In intracardiac system, the co-treatment led to imbalance of energy metabolism, in addition to oxidative stress and inflammation. In contrast to the upregulation of glucose and fatty acids uptake and CoA synthesis, levels of ATP, acetyl-CoA and the intermediates in glycolysis pathway decreased in the heart. The results indicated that energy metabolism disorder was possibly one of the important contributing factors to the more severe adverse effects of the combined treatment of HFD and PM2.5.
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Affiliation(s)
- Yuanyuan Song
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong, China
| | - Zenghua Qi
- School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou, China
| | - Yanhao Zhang
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong, China
| | - Juntong Wei
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong, China
| | - Xiaoliang Liao
- School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou, China
| | - Ruijin Li
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Chuan Dong
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Lin Zhu
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong, China
| | - Zhu Yang
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong, China
| | - Zongwei Cai
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong, China.
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5
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Wang H, Tian Y, Chen Y, Shen X, Pan L, Li G. Hyperinsulinemia rather than insulin resistance itself induces blood pressure elevation in high fat diet-fed rats. Clin Exp Hypertens 2020; 42:614-621. [PMID: 32349626 DOI: 10.1080/10641963.2020.1756316] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To investigate if insulin resistance per se or the accompanying hyperinsulinemia induced hypertension and its underlying mechanisms. METHODS Sprague-Dawley rats were randomized into normal diet-fed group (ND group) and high-fat diet-fed group (HFD group). Then, the HFD group was further randomly divided into the control group (HFD_C group), the PIO group (treated with pioglitazone), the STZ_DM group (to induce diabetes with streptozotocin) and the DM+Ins group (streptozotocin injection followed by insulin treatment). Insulin sensitivity, plasma insulin, endothelin-1, norepinephrine, aldosterone, angiotensinⅡ and 24-h urinary sodium excretion (USE) levels of the groups were measured and analyzed. A multiple stepwise regression analysis method was applied to exam our hypothesis. RESULTS Compared to HFD_C group, the groups with lower plasma insulin, the PIO group and STZ_DM group, showed higher USE and lower blood pressure. The groups with higher plasma insulin (but same level of insulin resistance), the HFD_C group and DM+Ins group, showed lower USE and higher blood pressure. The 24-h urinary sodium excretion was the most important contributor to the significant changes of blood pressure with an R2 of 25.2% in this animal experiment. CONCLUSIONS It is the compensatory hyperinsulinemia rather than insulin resistance per se that causes blood pressure elevation. The urinary sodium excretion is the key mediator among the multiple mechanisms. Therapies targeting hyperinsulinemia and restricting salt intake may favor a better control of hypertension associated with insulin resistance.
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Affiliation(s)
- Hui Wang
- Department of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing, China
| | - Yaqiang Tian
- Department of Endocrinology, Liaocheng People's Hospital , Liaocheng, Shandong Province, China
| | - Yanyan Chen
- Department of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing, China
| | - Xiaoxia Shen
- Department of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing, China
| | - Lin Pan
- Department of Endocrinology, China-Japan Friendship Hospital , Beijing, China
| | - Guangwei Li
- Department of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing, China.,Department of Endocrinology, China-Japan Friendship Hospital , Beijing, China
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Burtenshaw D, Kitching M, Redmond EM, Megson IL, Cahill PA. Reactive Oxygen Species (ROS), Intimal Thickening, and Subclinical Atherosclerotic Disease. Front Cardiovasc Med 2019; 6:89. [PMID: 31428618 PMCID: PMC6688526 DOI: 10.3389/fcvm.2019.00089] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/14/2019] [Indexed: 12/14/2022] Open
Abstract
Arteriosclerosis causes significant morbidity and mortality worldwide. Central to this process is the development of subclinical non-atherosclerotic intimal lesions before the appearance of pathologic intimal thickening and advanced atherosclerotic plaques. Intimal thickening is associated with several risk factors, including oxidative stress due to reactive oxygen species (ROS), inflammatory cytokines and lipid. The main ROS producing systems in-vivo are reduced nicotinamide dinucleotide phosphate (NADPH) oxidase (NOX). ROS effects are context specific. Exogenous ROS induces apoptosis and senescence, whereas intracellular ROS promotes stem cell differentiation, proliferation, and migration. Lineage tracing studies using murine models of subclinical atherosclerosis have revealed the contributory role of medial smooth muscle cells (SMCs), resident vascular stem cells, circulating bone-marrow progenitors and endothelial cells that undergo endothelial-mesenchymal-transition (EndMT). This review will address the putative physiological and patho-physiological roles of ROS in controlling vascular cell fate and ROS contribution to vascular regeneration and disease progression.
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Affiliation(s)
- Denise Burtenshaw
- Vascular Biology & Therapeutics, School of Biotechnology, Dublin City University, Dublin, Ireland
| | | | - Eileen M Redmond
- Department of Surgery, University of Rochester, Rochester, NY, United States
| | - Ian L Megson
- Centre for Health Science, UHI Institute of Health Research and Innovation, Inverness, United Kingdom
| | - Paul A Cahill
- Vascular Biology & Therapeutics, School of Biotechnology, Dublin City University, Dublin, Ireland
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Liu ZX, Hong Q, Peng DH, Yang Y, Yu WL, Shui H, Zhou X, Liu SM. Evaluation of serum free fatty acids in chronic renal failure: evidence from a rare case with undetectable serum free fatty acids and population data. Lipids Health Dis 2019; 18:151. [PMID: 31286991 PMCID: PMC6615299 DOI: 10.1186/s12944-019-1093-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 07/01/2019] [Indexed: 12/25/2022] Open
Abstract
Background Free fatty acid (FFA) accumulation in proximal tubules plays a fundamental role in the progress of kidney disease. Here, we reported a rare case with undetectable serum FFAs and further evaluated the changes of serum FFAs in patients with chronic renal failure (CRF). Methods We analyzed the clinical data of a rare case and 574 CRF patients. The mRNA expression of lipoprotein lipase (LPL), hepatic lipase (HL) and fatty acid synthase (FASN) were determined in the rare case and 30 age-matched healthy males with qPCR. Results This rare case had serious proteinuria, hyperglycemia, lipid disorders and bilateral renal glomerular filtration dysfunction. Compared with healthy males, this case showed a 1.49-fold increase of LPL expression (P < 0.01), a 3.38-fold reduction of HL expression (P < 0.001), and no significant change of FASN expression (P > 0.05). In total, 21.6% of CRF patients showed abnormal FFAs. Biochemical parameters such as blood urea nitrogen (BUN) and creatinine (CREA) significantly differed among groups with low-, normal- or high-level-FFAs. Moreover, serum FFAs was found to be associated with BUN. FFAs decreased in the group with higher BUN (> 17.4 mmol/L) and in the group with lower estimated glomerular filtration rate (eGFR) (< 15 mL/min/1.73m2). Conclusions The proteinuria, HL low expression and renal function failure may contribute to the FFA reduction, which might imply that the renal function is severely damaged. Electronic supplementary material The online version of this article (10.1186/s12944-019-1093-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zhen-Xian Liu
- Department of Clinical Laboratory, Center for Gene Diagnosis and Program of Clinical Laboratory, Zhongnan Hospital, Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Qian Hong
- Department of Nephrology, Renmin Hospital of Huangmei County, Huanggang, 435500, Hubei Province, China.,Department of Nephrology, Zhongnan Hospital, Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Ding-Hui Peng
- Department of Clinical Laboratory, Center for Gene Diagnosis and Program of Clinical Laboratory, Zhongnan Hospital, Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Ying Yang
- Department of Clinical Laboratory, Center for Gene Diagnosis and Program of Clinical Laboratory, Zhongnan Hospital, Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Wen-Li Yu
- Department of Nephrology, Zhongnan Hospital, Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Hua Shui
- Department of Nephrology, Zhongnan Hospital, Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Xin Zhou
- Department of Clinical Laboratory, Center for Gene Diagnosis and Program of Clinical Laboratory, Zhongnan Hospital, Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Song-Mei Liu
- Department of Clinical Laboratory, Center for Gene Diagnosis and Program of Clinical Laboratory, Zhongnan Hospital, Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei Province, China.
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Han L, Liu J, Zhu L, Tan F, Qin Y, Huang H, Yu Y. Free fatty acid can induce cardiac dysfunction and alter insulin signaling pathways in the heart. Lipids Health Dis 2018; 17:185. [PMID: 30089498 PMCID: PMC6083561 DOI: 10.1186/s12944-018-0834-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 07/26/2018] [Indexed: 02/05/2023] Open
Abstract
Background Insulin resistance has been independently related to heart failure. However, the specific mechanisms of high FFA levels in the pathophysiology of heart failure in insulin-resistant states are remain largely unclear. This study investigated whether elevated circulating free fatty acids (FFA) levels result in impaired cardiac structure and function in vivo via insulin-related signaling pathways in myocardium. Methods Male Wistar rats were randomly divided into the intralipid group (20% intralipid plus heparin infusion) and the control group (glycerol infusion). Blood samples were collected before and after 6-, 12-, and 24-h infusions. Cardiac structure and function were measured using echocardiography. Maximum velocity of myocardial contraction (+dP/dt max) and diastole (−dP/dt max) were measured using a physiological polygraph in vivo. Heart tissues were collected for western blotting. Results Compared with the control group, plasma FFA, plasma glucose, and serum insulin levels increased significantly in the intralipid group. With increasing infusion time, cardiac function in the intralipid group decreased gradually compared with the control group. After a 24-h infusion, early (E’, cm/s) diastolic peak velocities and (−dP/dt max) decreased significantly. Protein expression of phosphatidylinositol 3-kinase (PI3K), the serine/threonine kinase Akt, and phosphorylated Akt in myocardium increased after a 6-h infusion and decreased significantly after a 24-h infusion in the intralipid group. Protein expression of glucose transporter type 4 (GLUT4), Adenosine 5′-monophosphate -activated protein kinase (AMPK), phosphorylated AMPK(p-AMPK), and endothelial nitric oxide synthase (eNOS) in myocardium gradually decreased in the intralipid group. Conclusions Elevated FFA levels may impair cardiac function and cardiac dysfunction might result from myocardial insulin resistance with significant changes to PI3K-Akt-GLUT4 and AMPK-eNOS signaling pathways with increasing FFA levels.
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Affiliation(s)
- Lina Han
- Department of endocrinology and metabolism, West China Hospital, Sichuan University, Guoxue lane 37, Chengdu City, Sichuan Province, 610041, People's Republic of China
| | - Jiali Liu
- Department of endocrinology and metabolism, West China Hospital, Sichuan University, Guoxue lane 37, Chengdu City, Sichuan Province, 610041, People's Republic of China
| | - Leilei Zhu
- Department of endocrinology and metabolism, West China Hospital, Sichuan University, Guoxue lane 37, Chengdu City, Sichuan Province, 610041, People's Republic of China
| | - Fang Tan
- Department of endocrinology and metabolism, West China Hospital, Sichuan University, Guoxue lane 37, Chengdu City, Sichuan Province, 610041, People's Republic of China
| | - Yupei Qin
- Department of Cardiovascular, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, People's Republic of China
| | - He Huang
- Department of Cardiovascular, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, People's Republic of China
| | - Yerong Yu
- Department of endocrinology and metabolism, West China Hospital, Sichuan University, Guoxue lane 37, Chengdu City, Sichuan Province, 610041, People's Republic of China.
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Association between serum ferritin and hypertension according to the working type in Korean men: the fifth Korean National Health and nutrition examination survey 2010-2012. Ann Occup Environ Med 2018; 30:40. [PMID: 29942520 PMCID: PMC5996563 DOI: 10.1186/s40557-018-0251-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 05/28/2018] [Indexed: 11/17/2022] Open
Abstract
Background Several studies suggest that serum ferritin concentrations reflect systemic inflammation, and high ferritin levels can increase the risk of hypertension in adult men. Shift work is also known to increase the risk of hypertension; however, there has been no study about the relationship between serum ferritin levels and the prevalence of hypertension according to the working type. Methods This cross-sectional study included 4,442 male participants (3,651 daytime workers and 791 shift workers) who participated in the fifth Korean National Health and Nutrition Examination Survey. Hypertension was defined as a systolic blood pressure greater than or equal to 140 mmHg, a diastolic blood pressure greater than or equal to 90 mmHg or the current use of antihypertensive medications regardless of blood pressure values. For the statistical analyses, serum ferritin levels were reclassified into quartiles, and complex sample analyses were used to evaluate the relationship between serum ferritin levels and the prevalence of hypertension according to the working type in this study. Results Serum ferritin and shift work were positively associated with the prevalence of hypertension. The effect of interaction was above multiplicative. When compared to participants in the lowest serum ferritin quartile, the odds ratio for hypertension for participants in the highest serum ferritin quartile was 1.372 (1.027–1.833) in daytime workers and 2.009 (1.042–3.873) in shift workers after adjustment. Conclusions The prevalence of hypertension increased as ferritin levels increased in individuals, especially in shift workers.
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10
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Race/ethnicity determines the relationships between oxidative stress markers and blood pressure in individuals with high cardiovascular disease risk. J Hum Hypertens 2016; 31:70-75. [PMID: 27306086 PMCID: PMC5143227 DOI: 10.1038/jhh.2016.39] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 03/18/2016] [Accepted: 04/08/2016] [Indexed: 02/07/2023]
Abstract
Oxidative stress (OS) and cardiovascular (CV) reactivity are related to CV morbidity and mortality. However, little is known about the relationships between these CV risk factors and their confounders. We hypothesize that higher OS is linked to higher blood pressure (BP) reactivity to acute laboratory stressors and in the natural setting. We studied 137 subjects with a family history of hypertension and early myocardial infarction. There were 63 European Americans (EAs) (38 males) and 74 African Americans (AAs) (35 males), aged 19-36 (27.6±3.1). The protocol included a competitive video game, cold stressor and ambulatory BP recording. Blood samples were drawn six times for OS markers (8-hydroxydeoxyguanosine (8-OHdG) and 8-Isoprostane) assay. Repeated measures analyses of covariance were used to test for mean differences and Pearson correlations were used to test OS and BP associations. There were no significant race/ethnicity differences in BP reactivity to either stressor (both P's>0.48). 8-OHdG levels were significantly lower across all time points for AAs than for EAs (P<0.05), while levels of 8-isoprostane did not differ significantly (P>0.10). Averaged 8-OHdG levels significantly correlated with systolic blood pressure (SBP) reactivity (r=0.45, <0.01) and 24-h, daytime and nighttime SBP (r range=0.37-0.42, all P's<0.02) for EAs but not for AAs, whereas 8-isoprostane levels were significantly correlated with reactive SBP and nighttime diastolic blood pressure (DBP) (both r's=0.38, P<0.01) for AAs but not for EAs. These findings suggest a link between OS and BP changes in subjects at high risk for CV disease (CVD). Further, race/ethnicity determines which OS marker will impact BP variation implying race/ethnicity differences in OS-related mechanisms of CVD.
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Xu L, Guo ZN, Yang Y, Xu J, Burchell SR, Tang J, Zhang J, Xu J, Zhang JH. Angiopoietin-like 4: A double-edged sword in atherosclerosis and ischemic stroke? Exp Neurol 2015; 272:61-6. [PMID: 26033474 DOI: 10.1016/j.expneurol.2015.05.020] [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] [Received: 01/26/2015] [Revised: 05/21/2015] [Accepted: 05/27/2015] [Indexed: 12/27/2022]
Abstract
Ischemic stroke is one of the leading causes of death in the world, and thus is a major public health concern. Atherosclerosis, also known as atherogenesis, is a crucial risk factor for cerebral ischemia, yet how it develops remains largely unknown. It has been found, however, that angiopoietin-like protein 4 (ANGPTL4), a protein expressed in vascular endothelial cells, plays a role in the pathophysiology of atherosclerosis and may therefore be involved in ischemic stroke. ANGPTL4 activity is associated with endothelial cell integrity, inflammation, oxidative stress, and lipid metabolism. ANGPTL4 also serves as a potent inhibitor of the lipoprotein lipase, and may inhibit atherogenesis via regulating inflammatory signaling and lipid metabolism. In addition, ANGPTL4 plays a role in the regulation of oxidative stress. However, there currently exists a controversy on the role of ANGPTL4 in endothelial cells. Some studies indicate that ANGPTL4 can protect the integrity of endothelial cells, while others have shown that it can be destructive to the endothelium, thereby leading to the initiation of atherosclerosis. Thus, the effects of ANGPTL4 on development of atherosclerosis and thereby ischemic stroke, are undefined. Further research is needed to better understand ANGPTL4-mediated signaling pathways in endothelial function and to determine its potentials as therapeutic target for atherosclerosis and ischemic stroke.
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Affiliation(s)
- Liang Xu
- Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China; Department of Physiology and Pharmacology, Loma Linda University School of Medicine, CA, USA
| | - Zhen-Ni Guo
- Neuroscience Center, Department of Neurology, The First Norman Bethune Hospital of Jilin University, Changchun, People's Republic of China; Department of Physiology and Pharmacology, Loma Linda University School of Medicine, CA, USA
| | - Yi Yang
- Neuroscience Center, Department of Neurology, The First Norman Bethune Hospital of Jilin University, Changchun, People's Republic of China
| | - Jun Xu
- Department of General Surgery, Changhai Hospital, The First Affiliated Hospital of Second Military Medical University, Shanghai, People's Republic of China
| | - Sherrefa R Burchell
- Department of Physiology and Pharmacology, Loma Linda University School of Medicine, CA, USA
| | - Jiping Tang
- Department of Physiology and Pharmacology, Loma Linda University School of Medicine, CA, USA
| | - Jianmin Zhang
- Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China
| | - Jing Xu
- Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China
| | - John H Zhang
- Department of Physiology and Pharmacology, Loma Linda University School of Medicine, CA, USA.
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Pereira S, Shah A, George Fantus I, Joseph JW, Giacca A. Effect of N-acetyl-l-cysteine on insulin resistance caused by prolonged free fatty acid elevation. J Endocrinol 2015; 225:1-7. [PMID: 25609734 DOI: 10.1530/joe-14-0676] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Circulating free fatty acids (FFAs) are elevated in obesity and cause insulin resistance. The objective of the current study was to determine whether the antioxidant N-acetyl-l-cysteine (NAC) prevented hepatic and peripheral insulin resistance caused by prolonged elevation of plasma FFAs. Chronically cannulated Wistar rats received saline (SAL), Intralipid plus heparin (IH), IH plus NAC, or NAC i.v. infusion for 48 h. Insulin sensitivity was determined using the hyperinsulinemic-euglycemic clamp with tritiated glucose tracer. IH induced hepatic and peripheral insulin resistance (P<0.05). NAC co-infusion did not prevent insulin resistance in the liver, although it was able to prevent peripheral insulin resistance. Prolonged IH infusion did not appear to induce oxidative stress in the liver because hepatic content of protein carbonyl, malondialdehyde, and reduced to oxidized glutathione ratio did not differ across treatment groups. In alignment with our insulin sensitivity results, IH augmented skeletal muscle protein carbonyl content and this was prevented by NAC co-infusion. Taken together, our results indicate that oxidative stress mediates peripheral, but not hepatic, insulin resistance resulting from prolonged plasma FFA elevation. Thus, in states of chronic plasma FFA elevation, such as obesity, antioxidants may protect against peripheral but not hepatic insulin resistance.
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Affiliation(s)
- Sandra Pereira
- Department of PhysiologyUniversity of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario, Canada M5S 1A8Department of MedicineUniversity of Toronto, Toronto, Ontario, CanadaToronto General Research InstituteUniversity Health Network, Toronto, Ontario, CanadaBanting and Best Diabetes CentreUniversity of Toronto, Toronto, Ontario, CanadaInstitute of Medical ScienceUniversity of Toronto, Toronto, Ontario, CanadaSchool of PharmacyUniversity of Waterloo, Waterloo, Ontario, Canada
| | - Anu Shah
- Department of PhysiologyUniversity of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario, Canada M5S 1A8Department of MedicineUniversity of Toronto, Toronto, Ontario, CanadaToronto General Research InstituteUniversity Health Network, Toronto, Ontario, CanadaBanting and Best Diabetes CentreUniversity of Toronto, Toronto, Ontario, CanadaInstitute of Medical ScienceUniversity of Toronto, Toronto, Ontario, CanadaSchool of PharmacyUniversity of Waterloo, Waterloo, Ontario, Canada
| | - I George Fantus
- Department of PhysiologyUniversity of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario, Canada M5S 1A8Department of MedicineUniversity of Toronto, Toronto, Ontario, CanadaToronto General Research InstituteUniversity Health Network, Toronto, Ontario, CanadaBanting and Best Diabetes CentreUniversity of Toronto, Toronto, Ontario, CanadaInstitute of Medical ScienceUniversity of Toronto, Toronto, Ontario, CanadaSchool of PharmacyUniversity of Waterloo, Waterloo, Ontario, Canada Department of PhysiologyUniversity of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario, Canada M5S 1A8Department of MedicineUniversity of Toronto, Toronto, Ontario, CanadaToronto General Research InstituteUniversity Health Network, Toronto, Ontario, CanadaBanting and Best Diabetes CentreUniversity of Toronto, Toronto, Ontario, CanadaInstitute of Medical ScienceUniversity of Toronto, Toronto, Ontario, CanadaSchool of PharmacyUniversity of Waterloo, Waterloo, Ontario, Canada Department of PhysiologyUniversity of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario, Canada M5S 1A8Department of MedicineUniversity of Toronto, Toronto, Ontario, CanadaToronto General Research InstituteUniversity Health Network, Toronto, Ontario, CanadaBanting and Best Diabetes CentreUniversity of Toronto, Toronto, Ontario, CanadaInstitute of Medical ScienceUniversity of Toronto, Toronto, Ontario, CanadaSchool of PharmacyUniversity of Waterloo, Waterloo, Ontario, Canada Department of PhysiologyUniversity of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario, Canada M5S 1A8Department of MedicineUniversity of Toronto, Toronto, Ontario, CanadaToronto General Research InstituteUniversity Health Network, Toronto, Ontario, CanadaBanting and Best Diabetes CentreUniversity of Toronto, Toronto, Ontario, CanadaInstitute of Medical ScienceUniversity of Toronto, Toronto, Ontario, CanadaSchool of PharmacyUniversity of Waterloo
| | - Jamie W Joseph
- Department of PhysiologyUniversity of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario, Canada M5S 1A8Department of MedicineUniversity of Toronto, Toronto, Ontario, CanadaToronto General Research InstituteUniversity Health Network, Toronto, Ontario, CanadaBanting and Best Diabetes CentreUniversity of Toronto, Toronto, Ontario, CanadaInstitute of Medical ScienceUniversity of Toronto, Toronto, Ontario, CanadaSchool of PharmacyUniversity of Waterloo, Waterloo, Ontario, Canada
| | - Adria Giacca
- Department of PhysiologyUniversity of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario, Canada M5S 1A8Department of MedicineUniversity of Toronto, Toronto, Ontario, CanadaToronto General Research InstituteUniversity Health Network, Toronto, Ontario, CanadaBanting and Best Diabetes CentreUniversity of Toronto, Toronto, Ontario, CanadaInstitute of Medical ScienceUniversity of Toronto, Toronto, Ontario, CanadaSchool of PharmacyUniversity of Waterloo, Waterloo, Ontario, Canada Department of PhysiologyUniversity of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario, Canada M5S 1A8Department of MedicineUniversity of Toronto, Toronto, Ontario, CanadaToronto General Research InstituteUniversity Health Network, Toronto, Ontario, CanadaBanting and Best Diabetes CentreUniversity of Toronto, Toronto, Ontario, CanadaInstitute of Medical ScienceUniversity of Toronto, Toronto, Ontario, CanadaSchool of PharmacyUniversity of Waterloo, Waterloo, Ontario, Canada Department of PhysiologyUniversity of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario, Canada M5S 1A8Department of MedicineUniversity of Toronto, Toronto, Ontario, CanadaToronto General Research InstituteUniversity Health Network, Toronto, Ontario, CanadaBanting and Best Diabetes CentreUniversity of Toronto, Toronto, Ontario, CanadaInstitute of Medical ScienceUniversity of Toronto, Toronto, Ontario, CanadaSchool of PharmacyUniversity of Waterloo, Waterloo, Ontario, Canada Department of PhysiologyUniversity of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario, Canada M5S 1A8Department of MedicineUniversity of Toronto, Toronto, Ontario, CanadaToronto General Research InstituteUniversity Health Network, Toronto, Ontario, CanadaBanting and Best Diabetes CentreUniversity of Toronto, Toronto, Ontario, CanadaInstitute of Medical ScienceUniversity of Toronto, Toronto, Ontario, CanadaSchool of PharmacyUniversity of Waterloo
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Metastatic breast carcinoma induces vascular endothelial dysfunction in Balb-c mice: Role of the tumor necrosis factor-α and NADPH oxidase. Vascul Pharmacol 2013; 59:103-11. [DOI: 10.1016/j.vph.2013.07.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Revised: 06/18/2013] [Accepted: 07/30/2013] [Indexed: 12/18/2022]
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Kim MK, Baek KH, Song KH, Kang MI, Choi JH, Bae JC, Park CY, Lee WY, Oh KW. Increased serum ferritin predicts the development of hypertension among middle-aged men. Am J Hypertens 2012; 25:492-7. [PMID: 22278211 DOI: 10.1038/ajh.2011.241] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND We aimed to examine the relationship between iron status and hypertension as few studies have addressed this. METHODS We analyzed the association between ferritin/total iron-binding capacity (TIBC) and the subsequent development of hypertension. A total of 8,580 men who visited the Health Promotion Center for a medical checkup in 2005 were followed-up after 4 years. RESULTS Of the 8,580 men who were not hypertensive at baseline, 818 were found to be hypertensive at the 4-year follow-up. Compared with those who remained normotensive, these hypertensive subjects had higher levels of ferritin and TIBC at baseline, but had no significant difference in iron levels. After adjustment for age and body mass index (BMI), the odds ratios (OR) was substantially higher for new hypertension (OR 1.54, 95% confidence intervals (CIs) 1.26-1.88; P for trend <0.001) in subjects with the highest ferritin quartiles compared with those in the lowest quartiles. The association of serum ferritin levels with the incidence of hypertension was unchanged after adjustment for baseline blood pressure (BP). Adjustment for insulin resistance as measured by the homeostasis model assessment and the presence of a fatty liver reduced the magnitude of the OR for hypertension (first quartile reference, fourth quartiles OR 1.24, 95% CI 1.01-1.53, P for trend = 0.012), but did not affect their statistical significance. CONCLUSION Serum ferritin, but not iron level, was a significant predictor of hypertension in middle-aged Korean men. Fatty liver disease and insulin resistance may be mediators of this high ferritin-hypertension association.
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Zhang H, Dellsperger KC, Zhang C. The link between metabolic abnormalities and endothelial dysfunction in type 2 diabetes: an update. Basic Res Cardiol 2011; 107:237. [PMID: 22189563 DOI: 10.1007/s00395-011-0237-1] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 11/30/2011] [Accepted: 12/05/2011] [Indexed: 01/06/2023]
Abstract
Despite abundant clinical evidence linking metabolic abnormalities to diabetic vasculopathy, the molecular basis of individual susceptibility to diabetic vascular complications is still largely undetermined. Endothelial dysfunction in diabetes-associated vascular complications is considered an early stage of vasculopathy and has attracted considerable research interests. Type 2 diabetes is characterized by metabolic abnormalities, such as hyperglycemia, excess liberation of free fatty acids (FFA), insulin resistance and hyperinsulinemia. These abnormalities exert pathological impact on endothelial function by attenuating endothelium-mediated vasomotor function, enhancing endothelial apoptosis, stimulating endothelium activation/endothelium-monocyte adhesion, promoting an atherogenic response and suppressing barrier function. There are multiple signaling pathways contributing to the adverse effects of glucotoxicity on endothelial function. Insulin maintains the normal balance for release of several factors with vasoactive properties. Abnormal insulin signaling in the endothelium does not affect the whole-body glucose metabolism, but impairs endothelial response to insulin and accelerates atherosclerosis. Excessive level of FFA is implicated in the pathogenesis of insulin resistance. FFA induces endothelial oxidative stress, apoptosis and inflammatory response, and inhibits insulin signaling. Although hyperglycemia, insulin resistance, hyperinsulinemia and dyslipidemia independently contribute to endothelial dysfunction via various distinct mechanisms, the mutual interactions may synergistically accelerate their adverse effects. Oxidative stress and inflammation are predicted to be among the first alterations which may trigger other downstream mediators in diabetes associated with endothelial dysfunction. These mechanisms may provide insights into potential therapeutic targets that can delay or reverse diabetic vasculopathy.
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Affiliation(s)
- Hanrui Zhang
- Departments of Internal Medicine, Medical Pharmacology & Physiology and Nutritional Sciences, Dalton Cardiovascular Research Center, University of Missouri-Columbia, Columbia, MO 65211, USA.
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MacDonald SWS, DeCarlo CA, Dixon RA. Linking biological and cognitive aging: toward improving characterizations of developmental time. J Gerontol B Psychol Sci Soc Sci 2011; 66 Suppl 1:i59-70. [PMID: 21743053 DOI: 10.1093/geronb/gbr039] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES Chronological age is the most frequently employed predictor in life-span developmental research, despite repeated assertions that it is best conceived as a proxy for true mechanistic changes that influence cognition across time. The present investigation explores the potential that selected functional biomarkers may contribute to the more effective conceptual and operational definitions of developmental time. METHODS We used data from the Victoria Longitudinal Study to explore both static and dynamic biological or physiological markers that arguably influence process-specific mechanisms underlying cognitive changes in late life. Multilevel models were fit to test the dynamic coupling between change in theoretically relevant biomarkers (e.g., grip strength, pulmonary function) and change in select cognitive measures (e.g., executive function, episodic and semantic memory). RESULTS Results showed that, independent of the passage of developmental time (indexed as years in study), significant time-varying covariation was observed linking corresponding declines for select cognitive outcomes and biological markers. DISCUSSION Our findings support the interpretation that cognitive decline is not due to chronological aging per se but rather reflects multiple causal factors from a broad range of biological and physical health domains that operate along the age continuum.
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Jun JC, Drager LF, Najjar SS, Gottlieb SS, Brown CD, Smith PL, Schwartz AR, Polotsky VY. Effects of sleep apnea on nocturnal free fatty acids in subjects with heart failure. Sleep 2011; 34:1207-13. [PMID: 21886358 PMCID: PMC3157662 DOI: 10.5665/sleep.1240] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
STUDY OBJECTIVES Sleep apnea is common in patients with congestive heart failure, and may contribute to the progression of underlying heart disease. Cardiovascular and metabolic complications of sleep apnea have been attributed to intermittent hypoxia. Elevated free fatty acids (FFA) are also associated with the progression of metabolic, vascular, and cardiac dysfunction. The objective of this study was to determine the effect of intermittent hypoxia on FFA levels during sleep in patients with heart failure. DESIGN AND INTERVENTIONS During sleep, frequent blood samples were examined for FFA in patients with stable heart failure (ejection fraction < 40%). In patients with severe sleep apnea (apnea-hypopnea index = 65.5 ± 9.1 events/h; average low SpO₂ = 88.9%), FFA levels were compared to controls with milder sleep apnea (apnea-hypopnea index = 15.4 ± 3.7 events/h; average low SpO₂ = 93.6%). In patients with severe sleep apnea, supplemental oxygen at 2-4 liters/min was administered on a subsequent night to eliminate hypoxemia. MEASUREMENTS AND RESULTS Prior to sleep onset, controls and patients with severe apnea exhibited a similar FFA level. After sleep onset, patients with severe sleep apnea exhibited a marked and rapid increase in FFA relative to control subjects. This increase persisted throughout NREM and REM sleep exceeding serum FFA levels in control subjects by 0.134 mmol/L (P = 0.0038). Supplemental oxygen normalized the FFA profile without affecting sleep architecture or respiratory arousal frequency. CONCLUSION In patients with heart failure, severe sleep apnea causes surges in nocturnal FFA that may contribute to the accelerated progression of underlying heart disease. Supplemental oxygen prevents the FFA elevation.
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Affiliation(s)
- Jonathan C. Jun
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Luciano F. Drager
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
- Hypertension Unit, Heart Institute (InCor), University of Sao Paulo Medical School, Brazil
| | - Samer S. Najjar
- Heart Failure Service, Washington Hospital Center, Washington, DC
| | - Stephen S. Gottlieb
- Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Cynthia D. Brown
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Virginia, Charlottesville, VA
| | - Philip L. Smith
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Alan R. Schwartz
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Vsevolod Y. Polotsky
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
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