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He M, Ye J, Zheng W, Qiao P, Gu H, Qin W, He X. The impact of gender differences on the clinical characteristics of critically ill patients with venous thromboembolism: A retrospective, observational study. Medicine (Baltimore) 2024; 103:e38423. [PMID: 38875425 PMCID: PMC11175867 DOI: 10.1097/md.0000000000038423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2024] Open
Abstract
The aim of this study is to describe the general information, disease and treatment of venous thromboembolism (VTE) in critically ill patients, to explore the characteristics of severe patients with deep venous VTE and provide clinical reference data for the prevention and treatment of VTE in critically ill patients. This study carried out a retrospective study on the medical records of patients who were treated in the intensive care unit of Affiliated Hospital of Jining Medical College from 2020 to 2022. The general data, general conditions, drug use, past history, VTE prevention measures, post-VTE conditions, and Padua risk score of 297 patients with VTE during the period of hospitalization in intensive care unit (ICU) were classified and statistically analyzed. A total of 297 including 171 male and 126 male patient medical records were included in the analysis, we compared multiple clinical indicators between male and female patients. Compared to women, male patients have a higher acute physiology and chronic health evaluation II score(APACHE-II score) (P = .027), a higher state of consciousness (P = .003), a higher rate of smoking and drinking history (P < .001), a lower rate of heart failure (P = .003) and chronic depression (P = .013), and a higher rate of recommended operations for male patients after VTE (P = .031). The prothrombin time (PT) (P = .041) and activated partial thromboplastin time (APTT) (P = .040) of male patients were significantly higher than those of female patients, while triglyceride (P = .009) and total cholesterol (TC) (P = .001) were significantly lower than those of female patients. The difference in D-dimer (P = .739) was not significant. This study shows that male and female patients with VTE in the ICU have significant differences in general characteristics, general clinical conditions, history of past illness, thrombosis character, and examination items, this may be the reason for the different rates of VTE between male and female patients in the ICU.
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Affiliation(s)
- Meng He
- Department of Prehospital Emergency, Affiliated Hospital of Jining Medical University, Jining, Shandong, P. R. China
| | - Jiuhang Ye
- Department of Critical Care Medicine, Affiliated Hospital of Jining Medical University, Jining, Shandong, P. R. China
| | - Weiwei Zheng
- Department of Critical Care Medicine, Affiliated Hospital of Jining Medical University, Jining, Shandong, P. R. China
| | - Peng Qiao
- Department of Emergency Intensive Care Unit, Affiliated Hospital of Jining Medical University, Jining, Shandong, P. R. China
| | - Haiyan Gu
- Emergency Internal Medicine Ward, Affiliated Hospital of Jining Medical University, Jining, Shandong, P. R. China
| | - Wenwen Qin
- Emergency Internal Medicine Ward, Affiliated Hospital of Jining Medical University, Jining, Shandong, P. R. China
| | - Xuehong He
- Department of Nursing, Affiliated Hospital of Jining Medical University, Jining, Shandong, P. R. China
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Liu Q, Chang X, Lian R, Chen Q, Wang J, Fu S. Evaluation of bi-directional causal association between obstructive sleep apnoea syndrome and diabetic microangiopathy: a Mendelian randomization study. Front Cardiovasc Med 2024; 11:1340602. [PMID: 38784169 PMCID: PMC11112003 DOI: 10.3389/fcvm.2024.1340602] [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: 11/18/2023] [Accepted: 04/01/2024] [Indexed: 05/25/2024] Open
Abstract
Background The relationship between obstructive sleep apnea syndrome (OSAS) and diabetic microangiopathy remains controversial. Objective This study aimed to use bidirectional two-sample Mendelian Randomization (MR) to assess the causal relationship between OSAS and diabetic microangiopathy. Methods First, we used the Linkage Disequilibrium Score Regression(LDSC) analysis to assess the genetic correlation. Then, the bidirectional two-sample MR study was conducted in two stages: OSAS and lung function-related indicators (forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)) were investigated as exposures, with diabetic microangiopathy as the outcome in the first stage, and genetic tools were used as proxy variables for OSAS and lung function-related measures in the second step. Genome-wide association study data came from the open GWAS database. We used Inverse-Variance Weighted (IVW), MR-Egger regression, Weighted median, Simple mode, and Weighted mode for effect estimation and pleiotropy testing. We also performed sensitivity analyses to test the robustness of the results. Furthermore, we performed multivariate and mediation MR analyses. Results In the LDSC analysis, We found a genetic correlation between OSAS, FVC, FEV 1, and diabetic microangiopathy. In the MR analysis, based on IVW analysis, genetically predicted OSAS was positively correlated with the incidence of diabetic retinopathy (DR), diabetic kidney disease (DKD), and diabetic neuropathy (DN). In the subgroup analysis of DR, there was a significant causal relationship between OSAS and background diabetic retinopathy (BDR) and proliferative diabetic retinopathy (PDR). The reverse MR did not show a correlation between the incidence of diabetic microangiopathy and OSAS. Reduced FVC had a potential causal relationship with increased incidence of DR and PDR. Reduced FEV1 had a potential causal relationship with the increased incidence of BDR, PDR, and DKD. Multivariate MR analysis showed that the association between OSAS and diabetic microangiopathy remained significant after adjusting for confounding factors. However, we did not find the significant mediating factors. Conclusion Our results suggest that OSAS may be a cause of the development of diabetic microangiopathy, and OSAS may also be associated with a high risk of diabetic microangiopathy, providing a reference for a better understanding of the prevention of diabetic microangiopathy.
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Affiliation(s)
- Qianqian Liu
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Gansu Provincial Endocrine Disease Clinical MedicineResearch Center, Lanzhou, Gansu, China
| | - Xingyu Chang
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Rongna Lian
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qi Chen
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Gansu Provincial Endocrine Disease Clinical MedicineResearch Center, Lanzhou, Gansu, China
| | - Jialei Wang
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Gansu Provincial Endocrine Disease Clinical MedicineResearch Center, Lanzhou, Gansu, China
| | - Songbo Fu
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Gansu Provincial Endocrine Disease Clinical MedicineResearch Center, Lanzhou, Gansu, China
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Jiang W, Yang L, Dang Y, Jiang X, Wu L, Tong X, Guo J, Bao Y. Metabolomic profiling of deep vein thrombosis. Phlebology 2024; 39:154-168. [PMID: 37992130 PMCID: PMC10938490 DOI: 10.1177/02683555231215199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Deep vein thrombosis (DVT) of the lower extremities is one of the most common peripheral vascular diseases, with significant complications and sequelae. Metabolomics aims to identify small molecules in biological samples. It can serve as a promising method for screening compounds that can be used for early disease detection, diagnosis, treatment response prediction, and prognosis. In addition, high-throughput metabolomics screening can yield significant insights into the pathophysiological pathways of DVT. Currently, the metabolomic profiles of DVT have yielded inconsistent expression patterns. This article examines the recent advancements in metabolomic studies of DVT and analyzes the factors that may influence the results.
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Affiliation(s)
- Weiguang Jiang
- Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, China
- Department of Vascular Surgery, Chifeng Municipal Hospital, Chifeng, China
| | - Liu Yang
- Department of Vascular Surgery, Chifeng Municipal Hospital, Chifeng, China
| | - Yongkang Dang
- Department of Vascular Surgery, Chifeng Municipal Hospital, Chifeng, China
| | - Xuechao Jiang
- Department of Vascular Surgery, Chifeng Municipal Hospital, Chifeng, China
| | - Lan Wu
- Department of Vascular Surgery, Chifeng Municipal Hospital, Chifeng, China
| | - Xiangyang Tong
- Department of Vascular Surgery, Chifeng Municipal Hospital, Chifeng, China
| | - Jianquan Guo
- Department of Vascular Surgery, Chifeng Municipal Hospital, Chifeng, China
| | - Yongtao Bao
- Department of Vascular Surgery, Chifeng Municipal Hospital, Chifeng, China
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Cai Y, Wang J, Wang X, Yuan Q, Xu Y, Xu P. Causal relationship between dementia and delirium: Insights from a bidirectional two-sample Mendelian randomization analysis. J Affect Disord 2024; 349:69-76. [PMID: 38199390 DOI: 10.1016/j.jad.2024.01.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/22/2023] [Accepted: 01/04/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Our previous study found dementia as a significant risk factor for delirium development in elderly patients with hip fracture. However, the causal relationship between dementia and delirium remains unclear. METHODS To assess the causal relationship between delirium and dementia, we conducted a bidirectional Mendelian randomization (MR) analysis. Inversevariance weighted (IVW), weighted median, MR Egger, weighted mode, and simple mode were employed to conduct the MR analysis. Heterogeneity was assessed using the Cochran Q statistic in MR-Egger and IVW methods. Horizontal pleiotropy was examined via the MR pleiotropy residual sum and outliers (MR-PRESSO) and MR-Egger intercept tests. RESULTS The forward MR analysis revealed a significant association between unclassified dementia (1.604 (1.326-1.941), p = 1.12 × 10-6), Alzheimer's disease (1.259 (1.128-1.405), p = 4.10 × 10-5), and dementia with Lewy bodies (1.121 (1.026-1.225), p = 0.011) with an increased risk of delirium. In the reverse MR analysis, delirium was also suggested to increase the risk of unclassified dementia (1.133 (1.066-1.204), p = 6.31 × 10-5) and vascular dementia (1.246 (1.075-1.444), p = 0.003). These significant results were further validated in the multivariable MR analysis. No evidence of heterogeneity or horizontal pleiotropy was observed (p > 0.05). LIMITATIONS (1) Limited to European populations. (2) Sample population overlap between delirium and dementia. (3) Not all dementia subtypes were causally associated with delirium. CONCLUSIONS This study provides genetic evidence supporting a causal relationship between dementia and delirium, indicating that dementia may influence the risk of delirium while delirium may also increase the risk of dementia.
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Affiliation(s)
- Yongsong Cai
- Department of Joint Surgery, Xi'an Honghui Hospital, Xi'an Jiaotong University Health Science Center, Xi'an 710054, People's Republic of China
| | - Jiachen Wang
- Department of Joint Surgery, Xi'an Honghui Hospital, Xi'an Jiaotong University Health Science Center, Xi'an 710054, People's Republic of China
| | - Xinyi Wang
- Geriatric Cardiopulmonary Rehabilitation Department, Shaanxi Provincial Rehabilitation Hospital, Xi'an, 710065, People's Republic of China
| | - Qiling Yuan
- Department of Joint Surgery, Xi'an Honghui Hospital, Xi'an Jiaotong University Health Science Center, Xi'an 710054, People's Republic of China
| | - Yan Xu
- Department of Anesthesiology, Xi'an Central Hospital, Xi'an 710004, People's Republic of China
| | - Peng Xu
- Department of Joint Surgery, Xi'an Honghui Hospital, Xi'an Jiaotong University Health Science Center, Xi'an 710054, People's Republic of China.
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Desch K. LDL vs HDL: a sticky situation. Blood 2023; 142:1110-1111. [PMID: 37768693 DOI: 10.1182/blood.2023021854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
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Chung DW, Platten K, Ozawa K, Adili R, Pamir N, Nussdorfer F, St. John A, Ling M, Le J, Harris J, Rhoads N, Wang Y, Fu X, Chen J, Fazio S, Lindner JR, López JA. Low-density lipoprotein promotes microvascular thrombosis by enhancing von Willebrand factor self-association. Blood 2023; 142:1156-1166. [PMID: 37506337 PMCID: PMC10541996 DOI: 10.1182/blood.2023019749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/15/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
von Willebrand factor (VWF) mediates primary hemostasis and thrombosis in response to hydrodynamic forces. We previously showed that high shear promoted self-association of VWF into hyperadhesive strands, which can be attenuated by high-density lipoprotein (HDL) and apolipoprotein A-I. In this study, we show that low-density lipoprotein (LDL) binds VWF under shear and enhances self-association. Vortexing VWF in tubes resulted in its loss from the solution and deposition onto tube surfaces, which was prevented by HDL. At a stabilizing HDL concentration of 1.2 mg/mL, increasing concentrations of LDL progressively increased VWF loss, the effect correlating with the LDL-to-HDL ratio and not the absolute concentration of the lipoproteins. Similarly, HDL diminished deposition of VWF in a post-in-channel microfluidic device, whereas LDL increased both the rate and extent of strand deposition, with both purified VWF and plasma. Hypercholesterolemic human plasma also displayed accelerated VWF accumulation in the microfluidic device. The initial rate of accumulation correlated linearly with the LDL-to-HDL ratio. In Adamts13-/- and Adamts13-/-LDLR-/- mice, high LDL levels enhanced VWF and platelet adhesion to the myocardial microvasculature, reducing cardiac perfusion, impairing systolic function, and producing early signs of cardiomyopathy. In wild-type mice, high plasma LDL concentrations also increased the size and persistence of VWF-platelet thrombi in ionophore-treated mesenteric microvessels, exceeding the accumulation seen in similarly treated ADAMTS13-deficient mice that did not receive LDL infusion. We propose that targeting the interaction of VWF with itself and with LDL may improve the course of thrombotic microangiopathies, atherosclerosis, and other disorders with defective microvascular circulation.
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Affiliation(s)
- Dominic W. Chung
- Bloodworks Research Institute, Seattle, WA
- Department of Biochemistry, University of Washington, Seattle, WA
| | - Kimsey Platten
- Molecular Cell Biology Program, Washington University in St. Louis, St. Louis, MO
| | - Koya Ozawa
- Department of Medicine and Health, University of Sydney, Sydney, Australia
| | | | - Nathalie Pamir
- Cardiovascular Division, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR
| | | | | | | | - Jennie Le
- Bloodworks Research Institute, Seattle, WA
| | | | | | - Yi Wang
- Bloodworks Research Institute, Seattle, WA
| | - Xiaoyun Fu
- Bloodworks Research Institute, Seattle, WA
- Department of Medicine, University of Washington, Seattle, WA
| | | | - Sergio Fazio
- Cardiovascular Division, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR
- Department of Medicine, Stanford University, Stanford, CA
| | | | - José A. López
- Bloodworks Research Institute, Seattle, WA
- Department of Biochemistry, University of Washington, Seattle, WA
- Department of Medicine, University of Washington, Seattle, WA
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Lee J, Gilliland T, Koyama S, Nakao T, Dron J, Lannery K, Wong M, Peloso GM, Hornsby W, Natarajan P. Integrative metabolomics differentiate coronary artery disease, peripheral artery disease, and venous thromboembolism risks. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.06.21.23291103. [PMID: 37425786 PMCID: PMC10327201 DOI: 10.1101/2023.06.21.23291103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Rationale Arterial and venous cardiovascular conditions, such as coronary artery disease (CAD), peripheral artery disease (PAD), and venous thromboembolism (VTE), are genetically correlated. Interrogating distinct and overlapping mechanisms may shed new light on disease mechanisms. Objective In this study, we aimed to: identify and compare (1) epidemiologic and (2) causal, genetic relationships between metabolites and CAD, PAD, and VTE. Methods We used metabolomic data from 95,402 individuals in the UK Biobank, excluding individuals with prevalent cardiovascular disease. Logistic regression models adjusted for age, sex, genotyping array, first five principal components of ancestry, and statin use estimated the epidemiologic associations of 249 metabolites with incident CAD, PAD, or VTE. Bidirectional two-sample Mendelian randomization (MR) estimated the causal effects between metabolites and cardiovascular phenotypes using genome-wide association summary statistics for metabolites (N = 118,466 from UK Biobank), CAD (N = 184,305 from CARDIoGRAMplusC4D 2015), PAD (N = 243,060 from Million Veterans Project) and VTE (N = 650,119 from Million Veterans Project). Multivariable MR (MVMR) was performed in subsequent analyses. Results We found that 194, 111, and 69 metabolites were epidemiologically associated (P < 0.001) with CAD, PAD, and VTE, respectively. Metabolomic profiles exhibited variable similarity between disease pairs: CAD and PAD (N = 100 shared associations, R2 = 0.499), CAD and VTE (N = 68, R2 = 0.455), and PAD and VTE (N = 54, R2 = 0.752). MR revealed 28 metabolites that increased risk for both CAD and PAD and 2 metabolites that increased risk for CAD but decreased risk for VTE. Despite strong epidemiologic overlap, no metabolites had a shared genetic relationship between PAD and VTE. MVMR revealed several metabolites with shared causal effects on CAD and PAD related to cholesterol content within very-low-density lipoprotein particles. Conclusions While common arterial and venous conditions are associated with overlapping metabolomic profiles, MR prioritized the role of remnant cholesterol in arterial diseases but not venous thrombosis.
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Affiliation(s)
- Jiwoo Lee
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA
| | - Thomas Gilliland
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA
| | - Satoshi Koyama
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Tetsushi Nakao
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA
- Brigham and Women's Hospital, Boston, MA
- Dana-Farber Cancer Institute, Boston, MA
| | - Jacqueline Dron
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA
| | - Kim Lannery
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA
| | - Megan Wong
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA
| | - Gina M Peloso
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Whitney Hornsby
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA
| | - Pradeep Natarajan
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
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Luo P, Yuan Q, Wan X, Yang M, Xu P. A two-sample Mendelian randomization study of circulating lipids and deep venous thrombosis. Sci Rep 2023; 13:7432. [PMID: 37156934 PMCID: PMC10167313 DOI: 10.1038/s41598-023-34726-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 05/06/2023] [Indexed: 05/10/2023] Open
Abstract
In view of the current debate about the relationship between lipids and deep venous thrombosis (DVT) in clinical studies, a two-sample Mendelian randomization (MR) study was conducted to clarify the effects of five circulating lipids (apolipoprotein A1, apolipoprotein B, low-density lipoprotein, high-density lipoprotein and triglycerides) on DVT from the perspective of genetic inheritance. Five lipids (exposure) were analysed by MR with DVT (outcome) from two different data sources. For the analysis, we used inverse variance weighting and a weighted mode, weighted median, simple mode and MR-Egger regression to analyse the effect of circulating lipids on DVT. In addition, we used the MR-Egger intercept test, Cochran's Q test and "leave-one-out" sensitivity analysis to evaluate horizontal multiplicity, heterogeneity and stability, respectively, in the analysis. In the analysis, the two-sample Mendelian randomization analysis of five common circulating lipids and DVT showed that common circulating lipids had no causal effect on DVT, which is somewhat inconsistent with the findings of many published observational studies. Based on our results, our two-sample MR analysis failed to detect a statistically significant causal relationship between five common circulating lipids and DVT.
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Affiliation(s)
- Pan Luo
- Department of Joint Surgery, HongHui Hospital, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, China
| | - Qiling Yuan
- Department of Joint Surgery, HongHui Hospital, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, China
| | - Xianjie Wan
- Department of Joint Surgery, HongHui Hospital, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, China
| | - Mingyi Yang
- Department of Joint Surgery, HongHui Hospital, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, China
| | - Peng Xu
- Department of Joint Surgery, HongHui Hospital, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, China.
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