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Tang Y, Xiao Y, Yang F, Gao X, Zhu X, Qiao G. Association between dietary vitamin A intake and risk of cardiometabolic multimorbidity. Sci Rep 2024; 14:16656. [PMID: 39030396 PMCID: PMC11271594 DOI: 10.1038/s41598-024-67723-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 07/15/2024] [Indexed: 07/21/2024] Open
Abstract
The association between vitamin A and single cardiometabolic diseases has been extensively studied, but the relationship between dietary vitamin A intake and the risk of cardiometabolic multimorbidity (CMM) has not been studied. Therefore, the present study was conducted to explore the association with CMM risk by analyzing different sources of vitamin A. This study utilized 13,603 subjects aged ≥ 18 years from 1997 to 2015 from the China Health and Nutrition Survey (CHNS). Dietary intake was calculated from 3 consecutive 24-h dietary recalls combined with a house hold food inventory. CMM is defined as the development of at least two cardiometabolic diseases. After a median follow-up of 9.0 years, there were 1050 new cases of CMM. The risk of CMM was significantly lower in those with higher vitamin A intake (Q1 vs Q5 HR 0.66, 95% CI 0.54-0.81). β-carotene (Q1 vs Q5 HR 0.82, 95% CI 0.66-1.02) and retinol (Q1 vs Q5 HR 0.59, 95% CI 0.48-0.73) intake had a similarly negative correlation. Using restricted cubic spline found an L-shaped relationship between retinol intake and CMM (p non-linear < 0.001). Negative associations were also found in specific CMD groups (hypertension, cardiovascular disease, stroke and diabetes). Dietary intake of vitamin A was negatively associated with CMM risk, and this protective effect was more pronounced in patients with cardiovascular disease. There was an L-shaped association between retinol intake and CMM risk.
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Affiliation(s)
- Yudi Tang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Yao Xiao
- Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430061, Hubei, China
- Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, 430061, Hubei, China
- Hubei Academy of Traditional Chinese Medicine, Wuhan, 430074, Hubei, China
| | - Fen Yang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xiaolian Gao
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xinhong Zhu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China.
| | - Guiyuan Qiao
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China.
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Farashi S, Shahidi S, Sarihi A, Zarei M. Association of vitamin A and its organic compounds with stroke - a systematic review and meta-analysis. Nutr Neurosci 2023; 26:960-974. [PMID: 36004815 DOI: 10.1080/1028415x.2022.2111746] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
PURPOSE The main purpose of this systematic review was to evaluate the association between the stroke (risk of stroke and the mortality due to stroke) and vitamin A, its organic compounds and its provitamins. METHOD Major databases including PubMed, Scopus, and Web of Science were searched. Studies with human samples were included for risk assessment. The association was assessed using odds ratio (log(OR)) and a random-effect model. I2 statistic, variance (tau2) and prediction interval were used for heterogeneity assessment. The funnel plot was used for publication bias. RESULTS Twenty-one studies including 5789 stroke patients were retrieved. Twenty studies had sufficient information for quantitative analyses. The pooled effect showed an inverse association between vitamin A and its organic compound with the risk of stroke (log(OR) = -0.46 95%CI (-0.81;-0.12)) and with the risk of mortality due to stroke (log(OR) = -0.39 95%CI (-0.74;-0.04)). However, according to subgroup analyses, the association was dependent on the compound in a way that retinol and beta-carotene were the most effective compounds. The effects of several confounding factors and the threshold levels for vitamin A and its organic compound on the effectiveness were discussed. CONCLUSION Insufficiency of retinol and beta-carotene significantly increased the risk of stroke; however, due to heterogeneity between studies more studies are needed for evaluating clinical significance of this outcome.
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Affiliation(s)
- Sajjad Farashi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Siamak Shahidi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Physiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abdolrahman Sarihi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Physiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Zarei
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Physiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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3
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Brecht P, Dring JC, Yanez F, Styczeń A, Mertowska P, Mertowski S, Grywalska E. How Do Minerals, Vitamins, and Intestinal Microbiota Affect the Development and Progression of Heart Disease in Adult and Pediatric Patients? Nutrients 2023; 15:3264. [PMID: 37513682 PMCID: PMC10384570 DOI: 10.3390/nu15143264] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/21/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death worldwide, far ahead of cancer. Epidemiological data emphasize the participation of many risk factors that increase the incidence of CVDs, including genetic factors, age, and sex, but also lifestyle, mainly nutritional irregularities and, connected with them, overweight and obesity, as well as metabolic diseases. Despite the importance of cardiovascular problems in the whole society, the principles of prevention of CVDs are not widely disseminated, especially among the youngest. As a result, nutritional neglect, growing from childhood and adolescence, translates into the occurrence of numerous disease entities, including CVDs, in adult life. This review aimed to draw attention to the role of selected minerals and vitamins in health and the development and progression of CVDs in adults and children. Particular attention was paid to the effects of deficiency and toxicity of the analyzed compounds in the context of the cardiovascular system and to the role of intestinal microorganisms, which by interacting with nutrients, may contribute to the development of cardiovascular disorders. We hope this article will draw the attention of society and the medical community to emphasize promoting healthy eating and proper eating habits in children and adults, translating into increased awareness and a reduced risk of CVD.
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Affiliation(s)
- Peet Brecht
- Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-093 Lublin, Poland
| | - James Curtis Dring
- Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-093 Lublin, Poland
| | - Felipe Yanez
- Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-093 Lublin, Poland
| | - Agnieszka Styczeń
- Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-093 Lublin, Poland
| | - Paulina Mertowska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Sebastian Mertowski
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Ewelina Grywalska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
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Kim H, Hwang S, Lee S, Kim Y. Classification and Prediction on Hypertension with Blood Pressure Determinants in a Deep Learning Algorithm. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15301. [PMID: 36430024 PMCID: PMC9690260 DOI: 10.3390/ijerph192215301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
Few studies classified and predicted hypertension using blood pressure (BP)-related determinants in a deep learning algorithm. The objective of this study is to develop a deep learning algorithm for the classification and prediction of hypertension with BP-related factors based on the Korean Genome and Epidemiology Study-Ansan and Ansung baseline survey. We also investigated whether energy intake adjustment is adequate for deep learning algorithms. We constructed a deep neural network (DNN) in which the number of hidden layers and the number of nodes in each hidden layer are experimentally selected, and we trained the DNN to diagnose hypertension using the dataset while varying the energy intake adjustment method in four ways. For comparison, we trained a decision tree in the same way. Experimental results showed that the DNN performs better than the decision tree in all aspects, such as having higher sensitivity, specificity, F1-score, and accuracy. In addition, we found that unlike general machine learning algorithms, including the decision tree, the DNNs perform best when energy intake is not adjusted. The result indicates that energy intake adjustment is not required when using a deep learning algorithm to classify and predict hypertension with BP-related factors.
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Affiliation(s)
- Hyerim Kim
- Department of Food and Nutrition, Gyeongsang National University, Jinju 52828, Republic of Korea
| | - Seunghyeon Hwang
- Department of Computer Science, Gyeongsang National University, Jinju 52828, Republic of Korea
| | - Suwon Lee
- Department of Computer Science, The Research Institute of Natural Science, Gyeongsang National University, Jinju 52828, Republic of Korea
| | - Yoona Kim
- Department of Food and Nutrition, Institute of Agriculture and Life Science, Gyeongsang National University, Jinju 52828, Republic of Korea
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Wang Z, Hu S, Song Y, Liu L, Huang Z, Zhou Z, Wei Y, Lin T, Huang M, Zhang H, Guo H, Sun Y, Wang B, Qin X, Xu X, Chi F, Ren B, Ren L. Association between plasma selenium and risk of ischemic stroke: A community-based, nested, and case-control study. Front Nutr 2022; 9:1001922. [DOI: 10.3389/fnut.2022.1001922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 10/19/2022] [Indexed: 11/19/2022] Open
Abstract
BackgroundThe prospective association between plasma Se and stroke risk remains inconclusive. The relationship between Se and ischemic stroke among a low circulating Se status population deserves more attention, especially for Chinese people who were a high-risk group for Se deficiency.ObjectiveThe relationship between plasma Se concentration and ischemic stroke risk in a large-scale Chinese community-based population and any potential effect modifiers were investigated.MethodsA nested, case-control study, using data from the “China H-type Hypertension Registry Study” were conducted. A total of 1,904 first ischemic stroke cases and 1,904 controls matched for age, sex, and village were included in this study. The association between plasma Se and first ischemic stroke was evaluated by conditional logistic regression analyses.ResultsThe median value of plasma Se was 65.8 μg/L among total participants. Overall, a significant inverse relationship between plasma Se and first ischemic stroke risk was found (per SD increment; adjusted OR: 0.87; 95% CI: 0.80 and 0.95). Accordingly, a significantly lower risk of first ischemic stroke was found in participants in quartile 3 (65.8−<77.8 μg/L) (adjusted OR: 0.78; 95% CI: 0.63 and 0.96) and quartile 4 (≥77.8 μg/L) (adjusted OR: 0.76; 95% CI: 0.59 and 0.96), compared with those in quartile 1 (<56.0 μg/L). Furthermore, a significantly lower ischemic stroke risk was found in those with lower low-density lipoprotein cholesterol (LDL-C) levels (<3.4 vs. ≥3.4 mmol/L; P for interaction = 0.015) or those with lower homocysteine levels (<12.1 (median) vs. ≥12.1 μmol/L; P for interaction = 0.027) at baseline.ConclusionPlasma Se was significantly inversely associated with the risk of first ischemic stroke among a large-scale Chinese community-based population (most adults with hypertension and elevated total homocysteine), especially among those with lower LDL-C and lower homocysteine levels.
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Schiborn C, Weber D, Grune T, Biemann R, Jäger S, Neu N, Müller von Blumencron M, Fritsche A, Weikert C, Schulze MB, Wittenbecher C. Retinol and Retinol Binding Protein 4 Levels and Cardiometabolic Disease Risk. Circ Res 2022; 131:637-649. [PMID: 36017698 PMCID: PMC9473720 DOI: 10.1161/circresaha.122.321295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Despite mechanistic studies linking retinol and RBP4 (retinol binding protein 4) to the pathogenesis of cardiovascular diseases (CVD) and type 2 diabetes (T2D), epidemiological evidence is still conflicting. We investigated whether conflicting results of previous studies may be explained by differences in the association of retinol and RBP4 with cardiometabolic risk across subgroups with distinct sex, hypertension state, liver, or kidney function. METHODS We used case-cohorts nested in the EPIC (European Prospective Investigation Into Cancer and Nutrition)-Potsdam cohort (N=27 548) comprising a random sample of participants (n=2500) and all physician-verified cases of incident CVD (n=508, median follow-up time 8.2 years) and T2D (n=820, median follow-up time 6.3 years). We estimated nonlinear and linear multivariable-adjusted associations between the biomarkers and cardiometabolic diseases by restricted cubic splines and Cox regression, respectively, testing potential interactions with hypertension, liver, and kidney function. Additionally, we performed 2-sample Mendelian Randomization analyses in publicly available data. RESULTS The association of retinol with cardiometabolic risk was modified by hypertension state (P interaction CVD<0.001; P interaction T2D<0.001). Retinol was associated with lower cardiometabolic risk in participants with treated hypertension (hazard ratioper SD [95% CI]: CVD, 0.71 [0.56-0.90]; T2D, 0.81 [0.70-0.94]) but with higher cardiometabolic risk in normotensive participants (CVD, 1.32 [1.06-1.64]; T2D, 1.15 [0.98-1.36]). Our analyses also indicated a significant interaction between RBP4 and hypertension on CVD risk (P interaction=0.04). Regarding T2D risk, we observed a u-shaped association with RBP4 in women (P nonlinearity=0.01, P effect=0.02) and no statistically significant association in men. The biomarkers' interactions with liver or kidney function were not statistically significant. Hypertension state-specific associations for retinol concentrations with cardiovascular mortality risk were replicated in National Health and Nutrition Examination Survey III. CONCLUSIONS Our findings suggest a hypertension-dependent relationship between plasma retinol and cardiometabolic risk and complex interactions of RBP4 with sex and hypertension on cardiometabolic risk.
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Affiliation(s)
- Catarina Schiborn
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (C.S., D.W., T.G., S.J., N.N., M.M.v.B., M.B.S., C. Wittenbecher).,German Center for Diabetes Research (DZD), Neuherberg, Germany (C.S., S.J., A.F., M.B.S., C. Wittenbecher)
| | - Daniela Weber
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (C.S., D.W., T.G., S.J., N.N., M.M.v.B., M.B.S., C. Wittenbecher)
| | - Tilman Grune
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (C.S., D.W., T.G., S.J., N.N., M.M.v.B., M.B.S., C. Wittenbecher).,German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Germany (T.G.)
| | - Ronald Biemann
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Germany (R.B.)
| | - Susanne Jäger
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (C.S., D.W., T.G., S.J., N.N., M.M.v.B., M.B.S., C. Wittenbecher).,German Center for Diabetes Research (DZD), Neuherberg, Germany (C.S., S.J., A.F., M.B.S., C. Wittenbecher)
| | - Natascha Neu
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (C.S., D.W., T.G., S.J., N.N., M.M.v.B., M.B.S., C. Wittenbecher)
| | - Marie Müller von Blumencron
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (C.S., D.W., T.G., S.J., N.N., M.M.v.B., M.B.S., C. Wittenbecher)
| | - Andreas Fritsche
- German Center for Diabetes Research (DZD), Neuherberg, Germany (C.S., S.J., A.F., M.B.S., C. Wittenbecher).,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany (A.F.).,Division of Endocrinology, Diabetology and Nephrology, Department of Internal Medicine, University of Tübingen, Germany (A.F.)
| | - Cornelia Weikert
- Department of Food Safety, German Federal Institute for Risk Assessment, Berlin, Germany (C. Weikert)
| | - Matthias B. Schulze
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (C.S., D.W., T.G., S.J., N.N., M.M.v.B., M.B.S., C. Wittenbecher).,German Center for Diabetes Research (DZD), Neuherberg, Germany (C.S., S.J., A.F., M.B.S., C. Wittenbecher).,Department of Food Safety, German Federal Institute for Risk Assessment, Berlin, Germany (C. Weikert)
| | - Clemens Wittenbecher
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (C.S., D.W., T.G., S.J., N.N., M.M.v.B., M.B.S., C. Wittenbecher).,German Center for Diabetes Research (DZD), Neuherberg, Germany (C.S., S.J., A.F., M.B.S., C. Wittenbecher).,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (C. Wittenbecher).,Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden (C. Wittenbecher)
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Holloway C, Zhong G, Kim YK, Ye H, Sampath H, Hammerling U, Isoherranen N, Quadro L. Retinoic acid regulates pyruvate dehydrogenase kinase 4 (Pdk4) to modulate fuel utilization in the adult heart: Insights from wild-type and β-carotene 9',10' oxygenase knockout mice. FASEB J 2022; 36:e22513. [PMID: 36004605 PMCID: PMC9544431 DOI: 10.1096/fj.202101910rr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 11/11/2022]
Abstract
Regulation of the pyruvate dehydrogenase (PDH) complex by the pyruvate dehydrogenase kinase PDK4 enables the heart to respond to fluctuations in energy demands and substrate availability. Retinoic acid, the transcriptionally active form of vitamin A, is known to be involved in the regulation of cardiac function and growth during embryogenesis as well as under pathological conditions. Whether retinoic acid also maintains cardiac health under physiological conditions is unknown. However, vitamin A status and intake of its carotenoid precursor β-carotene have been linked to the prevention of heart diseases. Here, we provide in vitro and in vivo evidence that retinoic acid regulates cardiac Pdk4 expression and thus PDH activity. Furthermore, we show that mice lacking β-carotene 9',10'-oxygenase (BCO2), the only enzyme of the adult heart that cleaves β-carotene to generate retinoids (vitamin A and its derivatives), displayed cardiac retinoic acid insufficiency and impaired metabolic flexibility linked to a compromised PDK4/PDH pathway. These findings provide novel insights into the functions of retinoic acid in regulating energy metabolism in adult tissues, especially the heart.
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Affiliation(s)
- Chelsee Holloway
- Graduate Program in Endocrinology and Animal Bioscience, Rutgers University, New Brunswick, New Jersey, USA.,Department of Food Science, Rutgers University, New Brunswick, New Jersey, USA.,Rutgers Center for Lipid Research and Institute of Food Nutrition and Health, Rutgers University, New Brunswick, New Jersey, USA
| | - Guo Zhong
- Department of Pharmaceutics Health Sciences, University of Washington, Seattle, Washington, USA
| | - Youn-Kyung Kim
- Department of Food Science, Rutgers University, New Brunswick, New Jersey, USA.,Rutgers Center for Lipid Research and Institute of Food Nutrition and Health, Rutgers University, New Brunswick, New Jersey, USA
| | - Hong Ye
- Department of Food Science, Rutgers University, New Brunswick, New Jersey, USA.,Rutgers Center for Lipid Research and Institute of Food Nutrition and Health, Rutgers University, New Brunswick, New Jersey, USA.,Department of Nutritional Sciences, Rutgers University, New Brunswick, New Jersey, USA
| | - Harini Sampath
- Rutgers Center for Lipid Research and Institute of Food Nutrition and Health, Rutgers University, New Brunswick, New Jersey, USA.,Department of Nutritional Sciences, Rutgers University, New Brunswick, New Jersey, USA
| | - Ulrich Hammerling
- Department of Food Science, Rutgers University, New Brunswick, New Jersey, USA.,Rutgers Center for Lipid Research and Institute of Food Nutrition and Health, Rutgers University, New Brunswick, New Jersey, USA
| | - Nina Isoherranen
- Department of Pharmaceutics Health Sciences, University of Washington, Seattle, Washington, USA
| | - Loredana Quadro
- Department of Food Science, Rutgers University, New Brunswick, New Jersey, USA.,Rutgers Center for Lipid Research and Institute of Food Nutrition and Health, Rutgers University, New Brunswick, New Jersey, USA
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Diet-Derived Circulating Antioxidants and Risk of Stroke: A Mendelian Randomization Study. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:6457318. [PMID: 35082970 PMCID: PMC8786473 DOI: 10.1155/2022/6457318] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/30/2021] [Accepted: 12/22/2021] [Indexed: 11/17/2022]
Abstract
Background Oxidative stress is crucial in stroke pathogenesis. Many cohort-based studies suggested that the intake of exogenous antioxidants originated from food may prevent stroke. However, the corresponding randomized controlled trials did not show diet-derived antioxidants have a protective effect on stroke. Objectives To examine the association of genetically proxied diet-derived antioxidants with stroke risk using Mendelian randomization. Methods We performed a two-sample Mendelian randomization (MR) analysis to evaluate the causal effect of diet-derived antioxidants on stroke risk. For exposure data, we extracted genetic variants as instrumental variables (IVs) that are strongly associated with frequently used diet-derived antioxidants, including vitamin C, vitamin E (α-tocopherol, γ-tocopherol), carotene, retinol, zinc, and selenium, from a large-scale genome-wide association study (GWAS). We obtained IVs' corresponding effect estimates on the risk of total stroke and ischemic stroke from a GWAS meta-analysis with 40,585 cases and 406,111 controls. Finally, we applied five types of Mendelian randomization analysis to obtain preliminary MR results and performed four three kinds of sensitivity analysis to verify them. Results According to the primary MR estimations and further sensitivity analyses, we established two robust associations after Bonferroni correction: genetically proxied circulating γ-tocopherol was causally associated with total stroke [odds ratio (OR) = 0.68, 95% confidence interval (CI) (0.52-0.88), p = 3.78E − 03] and ischemic stroke [OR = 0.66, 95% CI (0.51-0.86), p = 2.34E − 03]. There was no evidence to support the causal effect of other diet-derived antioxidants on the risk of total stroke and ischemic stroke. Conclusion Our study revealed a protective impact of genetic susceptibility to high circulating γ-tocopherol levels on stroke risk, providing new information on the potential therapeutic targets for primary stroke prevention.
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Wang Z, Ma H, Song Y, Lin T, Liu L, Zhou Z, Wei Y, Huang X, Chen P, Liu C, Li Y, Wang B, Li J, Zhang Y, Huo Y, Zhang H, Xu X, Qin X, Guo H. Plasma selenium and the risk of first stroke in adults with hypertension: a secondary analysis of the China Stroke Primary Prevention Trial. Am J Clin Nutr 2022; 115:222-231. [PMID: 34549258 DOI: 10.1093/ajcn/nqab320] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/17/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Previous studies have indicated that selenium (Se) may play an important role in cardio-cerebrovascular disease. However, the relation between circulating selenium and risk of first stroke remains inconclusive. OBJECTIVES We conducted a secondary analysis of the China Stroke Primary Prevention Trial (CSPPT), using a nested case-control design, and aimed to investigate the correlation between Se concentration and first stroke risk in adults with hypertension and examine the potential effect modifiers. METHODS In the CSPPT, a total of 20,702 adults with hypertension were randomly assigned to a double-blind daily treatment with either 10 mg enalapril and 0.8 mg folic acid or 10 mg enalapril alone. A total of 618 first stroke cases and 618 controls matched for age, sex, treatment group, and study site were included in this study. RESULTS During a median follow-up duration of 4.5 y (IQR: 4.2-4.6 y), there was a significant inverse association between plasma Se and the risk of first stroke (per SD increment; adjusted OR: 0.81; 95% CI: 0.68, 0.96) and ischemic stroke (per SD increment; adjusted OR: 0.76; 95% CI: 0.62, 0.93). Furthermore, a stronger inverse association between plasma Se and first stroke was observed in participants with higher folate concentrations at baseline [≥7.7 ng/mL (median), adjusted OR: 0.67; 95% CI: 0.54, 0.85, compared with <7.7 ng/mL, adjusted OR: 0.98; 95% CI: 0.80, 1.21; P-interaction = 0.008] and those with higher time-averaged systolic blood pressure (SBP) over the treatment period (≥140 mm Hg, adjusted OR: 0.71; 95% CI: 0.58, 0.86, compared with <140 mm Hg, adjusted OR: 0.96; 95% CI: 0.77, 1.20; P-interaction = 0.023). CONCLUSIONS There was a significant inverse association between plasma Se and risk of first stroke in Chinese adults with hypertension, especially among those with higher baseline folate concentrations and those with higher time-averaged SBP over the treatment period. This trial was registered at clinicaltrials.gov as NCT00794885.
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Affiliation(s)
- Zhuo Wang
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Hai Ma
- Rongcheng Center for Disease Control and Prevention, Rongcheng, China
| | - Yun Song
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China.,Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Tengfei Lin
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China.,College of Pharmacy, Jinan University, Guangzhou, China
| | - Lishun Liu
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Ziyi Zhou
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Yaping Wei
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xiao Huang
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ping Chen
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Chengzhang Liu
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Youbao Li
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health, Guangdong Laboratory, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Binyan Wang
- Institute of Biomedicine, Anhui Medical University, Hefei, China.,National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health, Guangdong Laboratory, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Hao Zhang
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xiping Xu
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China.,Institute of Biomedicine, Anhui Medical University, Hefei, China.,National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health, Guangdong Laboratory, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.,AUSA Research Institute, Shenzhen AUSA Pharmed Co Ltd, Shenzhen, China
| | - Xianhui Qin
- Institute of Biomedicine, Anhui Medical University, Hefei, China.,National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health, Guangdong Laboratory, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Huiyuan Guo
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
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10
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Guo L, Huang Y, Wan R, Shen Y, Hong K. Increased Blood Retinol Levels Are Associated With a Reduced Risk of TIA or Stroke in an Adult Population: Lifestyle Factors- and CVDs-Stratified Analysis. Front Cardiovasc Med 2021; 8:744611. [PMID: 34869649 PMCID: PMC8635055 DOI: 10.3389/fcvm.2021.744611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/15/2021] [Indexed: 01/09/2023] Open
Abstract
Background: Data on the existing evidence for the association between blood retinol and transient ischemic attack (TIA)/stroke risk are limited, and the results are inconclusive. This study aimed to further assess the associations between the blood retinol levels and the risk of TIA/stroke after controlling the lifestyle factors and age-related confounders. Methods: The cross-sectional data from 1,113 individuals (aged 34-84 years old) were obtained from the Midlife in the United States (MIDUS) study. The multivariable analyses were performed to investigate the association of blood retinol levels with ever and currently TIA/stroke. Results: There was an inverse association between the blood retinol levels and the risk of ever TIA or stroke (for per 1 μmol/L adjusted odds ration [OR]: 0.93; 95% CI: 0.89-0.97; for per 1-SD adjusted OR: 0.89; 95% CI: 0.83-0.96) and currently diagnosed TIA or stroke (for per 1 μmol/L adjusted OR: 0.91; 95% CI: 0.87-0.96; for per 1-SD adjusted OR: 0.84; 95% CI: 0.80-0.91) after controlling the lifestyle factors and age-related confounders. The significance of these associations was maintained after a sensitivity analysis and involving "ever chronic respiratory diseases" as a covariate. Moreover, the stratified analyses suggested that the inverse associations could be affected by overweight [body mass index (BMI) ≥ 28, kg/m2], hypertension, and diabetes. Conclusions: A significant inverse association between blood retinol and the risk of TIA or stroke was found. This inverse association did not change even after adjustment for many potential confounders. Moreover, the potential protective effect of retinol on TIA/stroke could be blunted by overweight [BMI ≥ 28, kg/m2], hypertension, and diabetes.
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Affiliation(s)
- Linjuan Guo
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ying Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Rong Wan
- Jiangxi Key Laboratory of Molecular Medicine, Nanchang, China
| | - Yang Shen
- Jiangxi Key Laboratory of Molecular Medicine, Nanchang, China
| | - Kui Hong
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China.,Jiangxi Key Laboratory of Molecular Medicine, Nanchang, China
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11
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Huang J, Weinstein SJ, Yu K, Männistö S, Albanes D. Association between serum retinol and overall and cause-specific mortality in a 30-year prospective cohort study. Nat Commun 2021; 12:6418. [PMID: 34741009 PMCID: PMC8571275 DOI: 10.1038/s41467-021-26639-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 09/30/2021] [Indexed: 12/11/2022] Open
Abstract
How retinol as a clinical indicator of vitamin A status is related to long-term mortality is unknown. Here we report the results of a prospective analysis examining associations between serum retinol and risk of overall and cause-specific mortality. During a 30-year cohort follow-up, 23,797 deaths were identified among 29,104 men. Participants with higher serum retinol experienced significantly lower overall, CVD, heart disease, and respiratory disease mortality compared to men with the lowest retinol concentrations, reflecting 17–32% lower mortality risk (Ptrend < 0.0001). The retinol-overall mortality association is similar across subgroups of smoking intensity, alcohol consumption, body mass index, trial supplementation, serum alpha-tocopherol and beta-carotene concentrations, and follow-up time. Mediation analysis indicated that <3% of the effects of smoking duration and diabetes mellitus on mortality were mediated through retinol concentration. These findings indicate higher serum retinol is associated with lower overall mortality, including death from cardiovascular, heart, and respiratory diseases. Vitamin A, of which retinol is the major form in the circulation, is a determinant of human health but whether vitamin A status is associated with mortality is not well understood. Here the authors report that in a prospective observational analysis of 29 104 men, higher serum retinol associates with lower risk of overall and cause-specific mortality.
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Affiliation(s)
- Jiaqi Huang
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China. .,Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, MD, USA.
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, MD, USA
| | - Kai Yu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, MD, USA
| | - Satu Männistö
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, MD, USA.
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12
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Association of CYP26C1 Promoter Hypomethylation with Small Vessel Occlusion in Korean Subjects. Genes (Basel) 2021; 12:genes12101622. [PMID: 34681016 PMCID: PMC8535232 DOI: 10.3390/genes12101622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/10/2021] [Accepted: 10/13/2021] [Indexed: 12/26/2022] Open
Abstract
The risk factors for stroke, a fatal disease, include type two diabetes, hypertension, and genetic influences. Small vessel occlusion (SVO) can be affected by epigenetic alterations, but an association between SVO and the methylation of cytochrome P450 family 26 subfamily C member 1 (CYP26C1) has not been identified. In this study, we measured the level of DNA methylation in the CYP26C1 promoter and the 5′ untranslated region of 115 normal subjects and 56 patients with SVO in Korea. The DNA methylation level of each subject was measured by bisulfite amplicon sequencing, and statistical analysis was performed using the general linear model or Pearson’s correlation. The average level of DNA methylation was markedly lower in patients with SVO than in normal subjects (20.4% vs. 17.5%). We found that the methylation of CYP26C1 has a significant positive correlation with blood parameters including white blood cells, hematocrit, lactate dehydrogenase, and Na+ in subjects with SVO. We predicted that binding of RXR-α and RAR-β might be affected by CYP26C1 methylation at CpG sites −246–237 and −294–285. These findings suggest that CYP26C1 methylation in the promoter region may be a predictor of SVO.
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13
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Peng X, Gao Q, Zhou J, Ma J, Zhao D, Hao L. Association between dietary antioxidant vitamins intake and homocysteine levels in middle-aged and older adults with hypertension: a cross-sectional study. BMJ Open 2021; 11:e045732. [PMID: 34642187 PMCID: PMC8513268 DOI: 10.1136/bmjopen-2020-045732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Plasma total homocysteine (tHcy) has been implicated in the development of cardiovascular disease. This study aimed to assess the relationship of dietary antioxidant vitamins intake with tHcy levels in middle-aged and older adults with hypertension. DESIGN A cross-sectional study. SETTING The survey was conducted in the Nanshan district of Shenzhen. PARTICIPANTS A total of 1465 middle-aged and older adults with hypertension were included between July and September of 2013. MEASUREMENTS Hyperhomocysteinaemia (HHcy) was defined as tHcy ≥15 µmol/L. Some dietary antioxidant vitamins (vitamin C (VC) and vitamin E (VE), carotenes, retinol, lutein) intake was estimated using the Food Frequency Questionnaire. Sociodemographic and potential covariates were evaluated through questionnaires, anthropometric measurements and blood tests. The association between dietary intakes of antioxidant vitamins and tHcy concentration were evaluated by multiple linear regression analyses after napierian logarithm transformed. Multiple logistic regression models were further used to determine ORs and 95% CIs. RESULTS The β (95% CIs) of VC intake and tHcy was -0.050 (-0.084 to -0.016). Compared with the lowest quartile in the fully adjusted model, the ORs (95% CIs) for HHcy levels across quartiles of dietary VC intake were 0.82 (0.57 to 1.16), 0.49 (0.33 to 0.74) and 0.40 (0.22 to 0.74) (p for trend=0.001). The β (95% CIs) of retinol intake and tHcy was -0.021 (-0.041 to -0.002) and the ORs (95% CIs) in the third quartile of retinol intake was 0.61 (0.42 to 0.86), while the effect for the highest quartile was not significant (p for trend=0.951). No significant association was observed between dietary VE, carotenes and lutein intake and HHcy. CONCLUSIONS A linear inverse association between dietary VC intake and HHcy prevalence, and an L-shaped association between dietary retinol intake and HHcy prevalence were found in Chinese middle-aged and older adults with hypertension.
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Affiliation(s)
- Xiaolin Peng
- Department of Tumor, Injury and Nutrition, Nanshan Centre for Chronic Disease Control, Shenzhen, Guangdong, People's Republic of China
| | - Qin Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
- Department of Public Health, Jining Medical College, Jining, Shandong, People's Republic of China
| | - Juan Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Jianping Ma
- Department of Tumor, Injury and Nutrition, Nanshan Centre for Chronic Disease Control, Shenzhen, Guangdong, People's Republic of China
| | - Dan Zhao
- Department of Tumor, Injury and Nutrition, Nanshan Centre for Chronic Disease Control, Shenzhen, Guangdong, People's Republic of China
| | - Liping Hao
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
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14
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Zhang Y, Liu M, Zhou C, Zhang Z, He P, Li Q, Liu C, Qin X. Inverse association between dietary vitamin A intake and new-onset hypertension. Clin Nutr 2021; 40:2868-2875. [PMID: 33940400 DOI: 10.1016/j.clnu.2021.04.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/22/2021] [Accepted: 04/07/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND & AIMS The prospective relation of dietary vitamin A intake with hypertension remains uncertain. We aimed to investigate the relationship of dietary vitamin A intake with new-onset hypertension and examine possible effect modifiers in general population. METHODS This prospective cohort study included 12,245 participants who were free of hypertension at baseline from China Health and Nutrition Survey (CHNS). Dietary intake was measured by 3 consecutive 24-h dietary recalls combined with a household food inventory. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg or diagnosed by physician or under antihypertensive treatment during the follow-up. RESULTS During a median follow-up duration of 6.1 years, a total of 4,304 (35.1%) participants developed new-onset hypertension. Overall, there was an L-shaped relation of total dietary vitamin A intake with new-onset hypertension (P for nonlinearity <0.001). Accordingly, compared with participants with lower vitamin A intake (quartile 1, <227.3 μg RE/day), those with higher vitamin A intake (quartile 2-4, ≥227.3 μg RE/day) had a significantly lower risk of new-onset hypertension (adjusted HR, 0.73; 95%CI: 0.63, 0.78). Similar results were found for plant-derived vitamin A intake (adjusted HR, 0.65; 95% CI, 0.61, 0.70) or animal-derived vitamin A intake (adjusted HR, 0.76; 95% CI, 0.70, 0.82). CONCLUSIONS There was a L-shaped relation of dietary vitamin A intake with new-onset hypertension in general Chinese adults. Our results emphasized the importance of maintaining relatively higher vitamin A intake levels for the prevention of hypertension.
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Affiliation(s)
- Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou, 510515, China; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou, 510515, China; Guangdong Provincial Institute of Nephrology, Guangzhou, 510515, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, 510515, China; Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou, 510515, China; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou, 510515, China; Guangdong Provincial Institute of Nephrology, Guangzhou, 510515, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, 510515, China; Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou, 510515, China; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou, 510515, China; Guangdong Provincial Institute of Nephrology, Guangzhou, 510515, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, 510515, China; Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Zhuxian Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou, 510515, China; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou, 510515, China; Guangdong Provincial Institute of Nephrology, Guangzhou, 510515, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, 510515, China; Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou, 510515, China; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou, 510515, China; Guangdong Provincial Institute of Nephrology, Guangzhou, 510515, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, 510515, China; Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Qinqin Li
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
| | - Chengzhang Liu
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou, 510515, China; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou, 510515, China; Guangdong Provincial Institute of Nephrology, Guangzhou, 510515, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, 510515, China; Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China.
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15
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Xie L, Zhao BX, Luo J, Li Y, Zhu F, Li GF, He M, Wang B, Zhang H, Cai Y, Huo Y, Wang X, Hou FF, Xu X, Qin X, Nie J. A U-shaped association between serum betaine and incident risk of first ischemic stroke in hypertensive patients. Clin Nutr 2020; 39:2517-2524. [DOI: 10.1016/j.clnu.2019.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 10/07/2019] [Accepted: 11/06/2019] [Indexed: 01/01/2023]
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16
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Olsen T, Blomhoff R. Retinol, Retinoic Acid, and Retinol-Binding Protein 4 are Differentially Associated with Cardiovascular Disease, Type 2 Diabetes, and Obesity: An Overview of Human Studies. Adv Nutr 2020; 11:644-666. [PMID: 31868199 PMCID: PMC7231588 DOI: 10.1093/advances/nmz131] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 11/12/2019] [Accepted: 11/26/2019] [Indexed: 12/12/2022] Open
Abstract
Vitamin A is a fat-soluble essential nutrient obtained from plant- and animal-based sources that has roles in growth, vision, and metabolism. Vitamin A circulates mainly as retinol bound to retinol-binding protein 4 (RBP4), and is delivered to tissues and converted to retinoic acid, which is a ligand for several nuclear receptors. In recent years, aspects of vitamin A metabolism have been under scrutiny with regards to the development of metabolic and lifestyle diseases including cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), and overweight and obesity in humans. Studies have mainly focused on RBP4 in this context, whereas the major circulating form, retinol, and the major bioactive form, retinoic acid, have been overlooked in this regard until recently. As one of the main roles of RBP4 is to deliver retinol to tissues for biological action, the associations of retinol and retinoic acid with these diseases must also be considered. In this review, we summarize and discuss recent and available evidence from human studies with focus on retinol, retinoic acid, and RBP4 and provide an overview of these crucial components of vitamin A metabolism in CVD, T2DM, and obesity. In summary, retinol was found to be both inversely and positively associated with CVD whereas the associations with T2DM and obesity were less clear. Although only a few studies have been published on retinoic acid, it was inversely associated with CVD. In contrast, serum RBP4 was mostly found to be positively associated with CVD, T2DM, and obesity. At present, it is difficult to ascertain why the reported associations differ depending on the compound under study, but there is a clear imbalance in the literature in disfavor of retinol and retinoic acid, which needs to be considered in future human studies.
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Affiliation(s)
- Thomas Olsen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway,Address correspondence to TO (e-mail: )
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway,Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
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17
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Association of plasma retinol levels with incident cancer risk in Chinese hypertensive adults: a nested case-control study. Br J Nutr 2019; 122:293-300. [PMID: 31352906 DOI: 10.1017/s000711451900120x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We aimed to investigate the association between plasma retinol and incident cancer among Chinese hypertensive adults. We conducted a nested case-control study, including 231 patients with incident cancer and 231 matched controls during a median 4·5-year follow-up of the China Stroke Primary Prevention Trial. There was a significant, inverse association between retinol levels and digestive system cancer (per 10 μg/dl increases: OR 0·79; 95 % CI 0·69, 0·91). When compared with participants in the first quartile of retinol (< 52·3 μg/dl), a significantly lower cancer risk was found in participants in quartile 2-4 ( ≥ 52·3 μg/dl: OR 0·31; 95 % CI 0·13, 0·71). However, there was a U-shaped association between retinol levels and non-digestive system cancers where the risk of cancers decreased (although not significantly) with each increment of plasma retinol (per 10 μg/dl increases: OR 0·89; 95 % CI 0·60, 1·31) in participants with retinol < 68·2 μg/dl, and then increased significantly with retinol (per 10 μg/dl increase: OR 1·65; 95 % CI 1·12, 2·44) in participants with retinol ≥ 68·2 μg/dl. In conclusion, there was a significant inverse dose-response association between plasma retinol and the risk of digestive system cancers. However, a U-shaped association was observed between plasma retinol and the risk of non-digestive cancers (with a turning point approximately 68·2 μg/dl).
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