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Nowell A, Torres SJ, Hall SJ, Keske MA, Torpy DJ, Parker L, Betik AC, Turner AI. Is high salt intake inducing obesity via production of cortisol? A novel working hypothesis and pilot study. Eur J Nutr 2024; 63:1315-1327. [PMID: 38409436 PMCID: PMC11139711 DOI: 10.1007/s00394-024-03354-6] [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: 05/14/2023] [Accepted: 02/13/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE Evidence is growing that high salt intake is an independent risk factor for obesity, but the mechanisms are unknown. Our novel working hypothesis is that high salt intake drives cortisol production, which in turn, drives obesity. The current study aimed to demonstrate an acute cortisol response following a single high salt meal. METHODS Eight participants (age 30.5 ± 9.8 years [mean ± SD], 50% female), consumed high salt (3.82 g; 1529 mg sodium) and low salt (0.02 g; 9 mg sodium) meals in a randomized cross-over design. RESULTS Urinary and salivary cortisol and plasma adrenocorticotropic hormone (ACTH) demonstrated order effects. When high salt was given second, there was a peak above baseline for urinary cortisol (26.3%), salivary cortisol (9.4%) and plasma ACTH (4.1%) followed by a significant decline in each hormone (treatment*time, F[9, 18] = 2.641, p = 0.038, partial η2 = 0.569; treatment*time, F[12, 24] = 2.668, p = 0.020, partial η2 = 0.572; treatment*time, F[12, 24] = 2.580, p = 0.023, partial η2 = 0.563, respectively), but not when high salt was given first (p > 0.05 for all). CONCLUSION These intriguing findings provide partial support for our hypothesis and support a need for further research to elucidate the role of high salt intake in cortisol production and, in turn, in the aetiology of obesity. TRIAL REGISTRATION NUMBER ACTRN12623000490673; date of registration 12/05/2023; retrospectively registered.
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Affiliation(s)
- Anthony Nowell
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Susan J Torres
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Sarah J Hall
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Michelle A Keske
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - David J Torpy
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Lewan Parker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Andrew C Betik
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Anne I Turner
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia.
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2
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Louçano B, Maletti S, Timóteo H, Figueiredo JP, Osório N, Barroca MJ, da Silva AM, Pereira T, Caseiro A. Assessing Sarcocornia as a Salt Substitute: Effects on Lipid Profile and Gelatinase Activity. Nutrients 2024; 16:929. [PMID: 38612961 PMCID: PMC11013238 DOI: 10.3390/nu16070929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
Sodium, although essential for life, is a key factor in changes in vascular function and cardiovascular disease when consumed in excess. Sarcocornia spp., a halophyte plant with many nutritional benefits, presents itself as a promising substitute for the consumption of purified salt. Matrix metalloproteinases (MMPs) 2 and 9 are widely studied due to their action in physiological processes and as biomarkers at the diagnostic level due to their increased expression in inflammatory processes. This study aimed to evaluate whether replacing salt with Sarcocornia perennis (S. perennis) powder in healthy young people leads to an improvement in biochemical profiles and the attenuation of MMP-2 and MMP-9 activity. In the present study, 30 participants were randomized into a control group that consumed salt and an intervention group that replaced salt with powdered S. perennis. The evaluation of the biochemical parameters was carried out by the spectrophotometry method, and the evaluation of MMP activity was carried out by zymography. A significant decrease was observed in the intervention group in total cholesterol, high-density lipoprotein cholesterol (HDL-c), and creatinine (p-value ≤ 0.05), along with lower but not significantly different mean values of triglycerides. Regarding MMP activity after the intervention, a lower mean value was observed for MMP-9 activity, with there being higher mean values for MMP-2 activity, both with p-values ≥ 0.05. The results confirmed that the consumption of S. perennis is a beneficial choice for health regarding the lipid profile. The evaluation of MMP activity indicated the potential of S. perennis in the regulation of MMP-9 activity in healthy individuals, along with the need for the further study of these proteases in individuals with pathologies.
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Affiliation(s)
- Beatriz Louçano
- Polytechnic Institute of Coimbra, Coimbra Health School, Biomedical Laboratory Sciences, Rua 5 de Outubro, S. Martinho do Bispo, 3046-854 Coimbra, Portugal; (B.L.); (H.T.); (N.O.); (A.C.)
| | - Sara Maletti
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, Faculty of Medicine and Surgery, University of Modena and Reggio Emilia, Policlinico, via del Pozzo, 7141124 Modena, Italy;
| | - Helena Timóteo
- Polytechnic Institute of Coimbra, Coimbra Health School, Biomedical Laboratory Sciences, Rua 5 de Outubro, S. Martinho do Bispo, 3046-854 Coimbra, Portugal; (B.L.); (H.T.); (N.O.); (A.C.)
| | - João Paulo Figueiredo
- Polytechnic Institute of Coimbra, Coimbra Health School, Medical Sciences, Socials and Humans, Rua 5 de Outubro, 3046-854 Coimbra, Portugal;
| | - Nádia Osório
- Polytechnic Institute of Coimbra, Coimbra Health School, Biomedical Laboratory Sciences, Rua 5 de Outubro, S. Martinho do Bispo, 3046-854 Coimbra, Portugal; (B.L.); (H.T.); (N.O.); (A.C.)
- LABINSAÚDE-Research Laboratory for Applied Health Sciences, Polytechnic Institute of Coimbra, Coimbra Health School, Rua 5 de Outubro, S. Martinho do Bispo, 3046-854 Coimbra, Portugal;
- Molecular Physical-Chemistry R&D Unit, Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal;
| | - Maria João Barroca
- Molecular Physical-Chemistry R&D Unit, Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal;
- Polytechnic Institute of Coimbra, Agriculture School of Coimbra, Bencanta, 3040-360 Coimbra, Portugal
| | - Aida Moreira da Silva
- Molecular Physical-Chemistry R&D Unit, Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal;
- Polytechnic Institute of Coimbra, Agriculture School of Coimbra, Bencanta, 3040-360 Coimbra, Portugal
| | - Telmo Pereira
- LABINSAÚDE-Research Laboratory for Applied Health Sciences, Polytechnic Institute of Coimbra, Coimbra Health School, Rua 5 de Outubro, S. Martinho do Bispo, 3046-854 Coimbra, Portugal;
- Polytechnic Institute of Coimbra, Coimbra Health School, Clinical Physiology, Rua 5 de Outubro, S. Martinho do Bispo, 3046-854 Coimbra, Portugal
- Faculty of Sport Science and Physical Education, University of Coimbra, CIDAF—Research Unit for Sport and Physical Activity, 3000-456 Coimbra, Portugal
| | - Armando Caseiro
- Polytechnic Institute of Coimbra, Coimbra Health School, Biomedical Laboratory Sciences, Rua 5 de Outubro, S. Martinho do Bispo, 3046-854 Coimbra, Portugal; (B.L.); (H.T.); (N.O.); (A.C.)
- LABINSAÚDE-Research Laboratory for Applied Health Sciences, Polytechnic Institute of Coimbra, Coimbra Health School, Rua 5 de Outubro, S. Martinho do Bispo, 3046-854 Coimbra, Portugal;
- Molecular Physical-Chemistry R&D Unit, Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal;
- Faculty of Sport Science and Physical Education, University of Coimbra, CIDAF—Research Unit for Sport and Physical Activity, 3000-456 Coimbra, Portugal
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3
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Yuan C, Jing P, Jian Z, Wei X. Association between urinary sodium and circulating lipid levels: a Mendelian randomization study. Front Endocrinol (Lausanne) 2023; 14:1189473. [PMID: 38093964 PMCID: PMC10716694 DOI: 10.3389/fendo.2023.1189473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
Background Urinary sodium was indicated to be associated with dyslipidemia, but inconsistent conclusions for this association exist across the present observational studies. Objectives This study aimed to evaluate the causal association between urinary sodium and circulating lipid levels [low-density lipoprotein cholesterol (LDL-C), triglycerides, and high-density lipoprotein cholesterol (HDL-C)] through Mendelian randomization. Methods Univariable Mendelian randomization (UVMR) and multivariable Mendelian randomization (MVMR) with pleiotropy-resistant methods were performed. Data for urinary sodium were obtained from the genome-wide association study (GWAS) from 446,237 European individuals. Data for lipid profiles were extracted from GWAS based on the UK Biobank (for the discovery analysis) and the Global Lipids Genetics Consortium (for the replication analysis). Results In the discovery analysis, UVMR provided evidence that per 1-unit log-transformed genetically increased urinary sodium was associated with a lower level of HDL-C level (beta = -0.32; 95% CI: -0.43, -0.20; p = 7.25E-08), but not with LDL-C and triglycerides. This effect was still significant in the further MVMR when considering the effect of BMI or the other two lipid contents. In contrast, higher genetically predicted triglycerides could increase urinary sodium in both UVMR (beta = 0.030; 95% CI: 0.020, -0.039; p = 2.12E-10) and MVMR analyses (beta = 0.029; 95% CI: 0.019, 0.037; p = 8.13E-10). Similar results between triglycerides and urinary sodium were found in the replication analysis. Conclusion Increased urinary sodium may have weak causal effects on decreased circulating HDL-C levels. Furthermore, genetically higher triglyceride levels may have independent causal effects on increased urinary sodium excretion.
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Affiliation(s)
- Chi Yuan
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Peijia Jing
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Zhongyu Jian
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
- West China Biomedical Big Data Center, Sichuan University, Chengdu, China
| | - Xin Wei
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
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Vecchiola A, García K, González-Gómez LM, Tapia-Castillo A, Artigas R, Baudrand R, Kalergis AM, Carvajal CA, Fardella CE. Plasminogen Activator Inhibitor-1 and Adiponectin Are Associated With Metabolic Syndrome Components. Am J Hypertens 2022; 35:311-318. [PMID: 34525175 DOI: 10.1093/ajh/hpab138] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 08/01/2021] [Accepted: 09/14/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND We aimed to study the associations of adipocytokines, endothelial damage markers, and high-sensitivity C-reactive protein (hs-CRP) with metabolic syndrome (MetS) components. METHODS This cross-sectional study included 202 subjects categorized into MetS and No-MetS according to Harmonizing Adult Treatment Panel III. RESULTS Subjects with MetS showed higher levels of proinflammatory molecules but significantly lower adiponectin levels than subjects with No-MetS. Among the studied adipocytokines, plasminogen activator inhibitor-1 (PAI-1) and adiponectin showed the strongest associations with most MetS components. PAI-1 was associated with MetS (odds ratio (OR) 1.107 (1.065-1.151), P < 0.0001), whereas adiponectin was inversely associated with MetS (OR 0.710 (0.610-0.825), P < 0.0001). Following adjustment by sex, age, body mass index, and 24-hour urinary sodium excretion in a multivariate analysis, the association of PAI-1 (OR 1.090 (1.044-1.137), P < 0.0001) and adiponectin (OR 0.634 (0.519-0.775), P < 0.0001) with MetS remained significant. Multivariate analyses supported a model in which systolic blood pressure (BP) could be predicted by PAI-1, hs-CRP, and matrix metalloproteinase 2 (R2 = 0.125; P = 0.04); diastolic BP (R2 = 0.218; P = 0.0001) and glucose (R2 = 0.074; P = 0.0001) could be predicted by PAI-1; waist circumference could be predicted by PAI-1 and hs-CRP (R2 = 0.28; P = 0.016). Receiver operating characteristic curve analysis showed that a PAI-1 concentration had the best sensitivity and specificity for discriminating subjects with MetS. CONCLUSION PAI-1 and adiponectin rendered the most robust associations with MetS components in a general population, indicating that unfavorable adipose tissue performance is a key contributor to these metabolic anomalies. Further prospective analyses should allow establishing whether these adipocytokines can anticipate the progress of MetS and cardiovascular risk.
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Affiliation(s)
- Andrea Vecchiola
- Departmento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millenium Institute on Immunology and Immunotherapy IMII, Santiago, Chile
- Translational Endocrinology (CETREN), Faculty of Medicine, Department of Endocrinology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Killén García
- Departmento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis M González-Gómez
- Departmento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millenium Institute on Immunology and Immunotherapy IMII, Santiago, Chile
| | - Alejandra Tapia-Castillo
- Departmento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millenium Institute on Immunology and Immunotherapy IMII, Santiago, Chile
- Translational Endocrinology (CETREN), Faculty of Medicine, Department of Endocrinology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rocío Artigas
- Advanced Center for Chronic Diseases (ACCDiS), Core Biodata, Santiago, Chile
| | - René Baudrand
- Departmento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Translational Endocrinology (CETREN), Faculty of Medicine, Department of Endocrinology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alexis M Kalergis
- Departmento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millenium Institute on Immunology and Immunotherapy IMII, Santiago, Chile
- Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cristian A Carvajal
- Departmento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millenium Institute on Immunology and Immunotherapy IMII, Santiago, Chile
- Translational Endocrinology (CETREN), Faculty of Medicine, Department of Endocrinology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carlos E Fardella
- Departmento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millenium Institute on Immunology and Immunotherapy IMII, Santiago, Chile
- Translational Endocrinology (CETREN), Faculty of Medicine, Department of Endocrinology, Pontificia Universidad Católica de Chile, Santiago, Chile
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5
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Saldanha Melo H, Monnerat JADS, Costa NDS, Bento Bernardes T, Magliano DC, Pereira AD, Almeida PP, Lima GF, Ferreira de Brito FC, Stockler Pinto MB, Kindlovits R, Nogueira AB, Sepúlveda-Fragoso V, Nóbrega ACLD, Motta NAVD, Medeiros RF. Impact of Brazil Nut ( Bertholletia excelsa, H.B.K.) Supplementation on Body Composition, Blood Pressure, and the Vascular Reactivity of Wistar Rats When Submitted to a Hypersodium Diet. J Am Coll Nutr 2021; 41:559-568. [PMID: 34156903 DOI: 10.1080/07315724.2021.1925995] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introdution: Endothelium integrity is a key that maintains vascular homeostasis but it can suffer irreversible damage by blood pressure changes, reflecting an imbalance in the maintenance of vascular homeostasis.Objective: The aim of this study was to investigate the impact of Brazil nut (Bertholletia excelsa, H.B.K.) (BN) supplementation (10% in chow, wt/wt) on the vascular reactivity of Wistar rats during chronic exposure to a sodium overload (1% in water).Methods: First, male Wistar rats were allocated into two groups: Control Group (CG) and the Hypersodic Group (HG) for 4 weeks. Afterward, the CG was divided into the Brazil Nut Group (BNG) and the HG Group into the Hypersodic Brazil Nut Group (HBNG) for a further 8 weeks, totaling 4 groups. Blood pressure was measured during the protocol. At the end of the protocol, the vascular reactivity procedure was performed. Glucose, lipid profile, lipid peroxidation, and platelet aggregation were analyzed in the serum. Body composition was determined by the carcass technique.Results: The groups that were supplemented with the BN chow presented less body mass gain and body fat mass, together with lower serum glucose levels. The HG Group presented an increase in blood pressure and a higher platelet aggregation, while the BN supplementation was able to blunt this effect. The HG Group also showed an increase in contractile response that was phenylephrine-induced and a decrease in maximum relaxation that was acetylcholine-induced when compared to the other groups.Conclusion: The BN supplementation was able to prevent an impaired vascular function in the early stages of arterial hypertension, while also improving body composition, serum glucose, and platelet aggregation.
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Affiliation(s)
- Henrique Saldanha Melo
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | | | - Nathalia da Silva Costa
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Thais Bento Bernardes
- Molecular Endocrinology Laboratory, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Niterói, Rio de Janeiro, Brazil
| | - D'Angelo Carlo Magliano
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Laboratory of Morphological and Metabolic Analyses, Department of Morphology, Biomedical Institute, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
| | - Aline D'Avila Pereira
- Laboratory of Experimental Nutrition, Department of Nutrition and Dietetics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Patricia Pereira Almeida
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Gabriel Ferreira Lima
- Laboratory of Experimental Pharmacology, Department of Physiology and Pharmacology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Fernanda Carla Ferreira de Brito
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Laboratory of Experimental Pharmacology, Department of Physiology and Pharmacology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Milena Barcza Stockler Pinto
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Department of Nutrition and Dietetics, College of Nutrition, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Nutrition Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Raquel Kindlovits
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Anna Beatriz Nogueira
- Laboratory of Exercise Sciences, Department of Physiology and Pharmacology, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
| | - Vinicius Sepúlveda-Fragoso
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Antonio Claudio Lucas da Nóbrega
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Laboratory of Exercise Sciences, Department of Physiology and Pharmacology, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
| | - Nadia Alice Vieira da Motta
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Laboratory of Experimental Pharmacology, Department of Physiology and Pharmacology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Renata Frauches Medeiros
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Department of Nutrition and Dietetics, College of Nutrition, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Nutrition Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Laboratory of Exercise Sciences, Department of Physiology and Pharmacology, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
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6
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NFAT5 directs hyperosmotic stress-induced fibrin deposition and macrophage infiltration via PAI-1 in endothelium. Aging (Albany NY) 2020; 13:3661-3679. [PMID: 33410782 PMCID: PMC7906158 DOI: 10.18632/aging.202330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 10/31/2020] [Indexed: 12/12/2022]
Abstract
Although stress can significantly promote atherosclerosis, the underlying mechanisms are still not completely understood. Here we successfully unveiled that high salt-induced nuclear factor of activated T cells 5 (NFAT5) control the endothelial-dependent fibrinolytic activity and the inflammatory adhesion-related molecules expression through regulation of plasminogen activator inhibitor-1 (PAI-1). We first observed that high salt diets instigated the expression of NFAT5 and PAI-1 in the endothelium which brought about the fibrin deposition and macrophage infiltration in the atherosclerotic arteries of ApoE-/- mice. Overexpression of NFAT5 increased PAI-1-mediated antifibrinolytic activity and activated inflammatory adhesion-related genes in endothelial cells. Knockdown of NFAT5 by siRNA inhibited the expression of PAI-1, antifibrinolytic and adhesive molecules. Moreover, chromatin immunoprecipitation assay demonstrated that high salt intake significantly promoted the binding of NFAT5 to PAI-1 promoter (TGGAATTATTT) in endothelial cells. Our study identified that NFAT5 has great potential to activate the PAI-1-mediated fibrinolytic dysfunction and inflammatory cell adhesion, thus promoting high salt-induced atherosclerosis disease.
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7
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Overwyk KJ, Quader ZS, Maalouf J, Bates M, Webster J, George MG, Merritt RK, Cogswell ME. Dietary Sodium Intake and Health Indicators: A Systematic Review of Published Literature between January 2015 and December 2019. Adv Nutr 2020; 11:1174-1200. [PMID: 32449929 PMCID: PMC7490163 DOI: 10.1093/advances/nmaa049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/26/2020] [Accepted: 04/01/2020] [Indexed: 12/29/2022] Open
Abstract
As the science surrounding population sodium reduction evolves, monitoring and evaluating new studies on intake and health can help increase our understanding of the associated benefits and risks. Here we describe a systematic review of recent studies on sodium intake and health, examine the risk of bias (ROB) of selected studies, and provide direction for future research. Seven online databases were searched monthly from January 2015 to December 2019. We selected human studies that met specified population, intervention, comparison, outcome, time, setting/study design (PICOTS) criteria and abstracted attributes related to the study population, design, intervention, exposure, and outcomes, and evaluated ROB for the subset of studies on sodium intake and cardiovascular disease risks or indicators. Of 41,601 abstracts reviewed, 231 studies were identified that met the PICOTS criteria and ROB was assessed for 54 studies. One hundred and fifty-seven (68%) studies were observational and 161 (70%) focused on the general population. Five types of sodium interventions and a variety of urinary and dietary measurement methods were used to establish and quantify sodium intake. Five observational studies used multiple 24-h urine collections to assess sodium intake. Evidence mainly focused on cardiovascular-related indicators (48%) but encompassed an assortment of outcomes. Studies varied in ROB domains and 87% of studies evaluated were missing information on ≥1 domains. Two or more studies on each of 12 outcomes (e.g., cognition) not previously included in systematic reviews and 9 new studies at low ROB suggest the need for ongoing or updated systematic reviews of evidence on sodium intake and health. Summarizing evidence from assessments on sodium and health outcomes was limited by the various methods used to measure sodium intake and outcomes, as well as lack of details related to study design and conduct. In line with research recommendations identified by the National Academies of Science, future research is needed to identify and standardize methods for measuring sodium intake.
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Affiliation(s)
- Katherine J Overwyk
- Division for Heart Disease and Stroke Prevention, CDC, Atlanta, GA, USA
- IHRC, Inc. Atlanta, GA, USA
| | - Zerleen S Quader
- Division for Heart Disease and Stroke Prevention, CDC, Atlanta, GA, USA
- IHRC, Inc. Atlanta, GA, USA
| | - Joyce Maalouf
- Division for Heart Disease and Stroke Prevention, CDC, Atlanta, GA, USA
| | - Marlana Bates
- Division for Heart Disease and Stroke Prevention, CDC, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Jacqui Webster
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Mary G George
- Division for Heart Disease and Stroke Prevention, CDC, Atlanta, GA, USA
| | - Robert K Merritt
- Division for Heart Disease and Stroke Prevention, CDC, Atlanta, GA, USA
| | - Mary E Cogswell
- Division for Heart Disease and Stroke Prevention, CDC, Atlanta, GA, USA
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8
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Nista F, Gatto F, Albertelli M, Musso N. Sodium Intake and Target Organ Damage in Hypertension-An Update about the Role of a Real Villain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2811. [PMID: 32325839 PMCID: PMC7215960 DOI: 10.3390/ijerph17082811] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/11/2020] [Accepted: 04/16/2020] [Indexed: 12/17/2022]
Abstract
Salt intake is too high for safety nowadays. The main active ion in salt is sodium. The vast majority of scientific evidence points out the importance of sodium restriction for decreasing cardiovascular risk. International Guidelines recommend a large reduction in sodium consumption to help reduce blood pressure, organ damage, and cardiovascular risk. Regulatory authorities across the globe suggest a general restriction of sodium intake to prevent cardiovascular diseases. In spite of this seemingly unanimous consensus, some researchers claim to have evidence of the unhealthy effects of a reduction of sodium intake, and have data to support their claims. Evidence is against dissenting scientists, because prospective, observational, and basic research studies indicate that sodium is the real villain: actual sodium consumption around the globe is far higher than the safe range. Sodium intake is directly related to increased blood pressure, and independently to the enlargement of cardiac mass, with a possible independent role in inducing left ventricular hypertrophy. This may represent the basis of myocardial ischemia, congestive heart failure, and cardiac mortality. Although debated, a high sodium intake may induce initial renal damage and progression in both hypertensive and normotensive subjects. Conversely, there is general agreement about the adverse role of sodium in cerebrovascular disease. These factors point to the possible main role of sodium intake in target organ damage and cardiovascular events including mortality. This review will endeavor to outline the existing evidence.
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Affiliation(s)
| | | | | | - Natale Musso
- Unit of Hypertension, Clinical Endocrinology, Department of Internal Medicine, Ospedale Policlinico San Martino Genova, University of Genoa Medical School, 6-16132 Genoa, Italy; (F.N.); (F.G.); (M.A.)
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Choi JW, Park JS, Lee CH. Interactive effect of high sodium intake with increased serum triglycerides on hypertension. PLoS One 2020; 15:e0231707. [PMID: 32298354 PMCID: PMC7162459 DOI: 10.1371/journal.pone.0231707] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/30/2020] [Indexed: 11/25/2022] Open
Abstract
Background A high salt diet is associated with the development of hypertension, one of the most important cardiovascular risk factors. A reduction in sodium intake seems to have an effect on increasing serum triglycerides (TGs). Elevated TGs are independently linked to cardiovascular risk. However, there is limited evidence of a possible interactive effect of sodium intake and serum TGs on high blood pressure (BP). Methods We conducted a nationwide, population-based interaction analysis using the Kawasaki method for estimating 24-h urinary sodium excretion (e24hUNaEKawasaki) as a candidate indicator of dietary sodium intake. All native Koreans aged 20 years or older without significant medical illness were eligible for inclusion. Results A total of 16936 participants were divided into quintiles according to their e24hUNaEKawasaki results. Participants in the highest quintile were more obese and hypertensive and had higher white blood cell count, lower hemoglobin, greater glycemic exposure, and poor lipid profiles compared to the same parameters of individuals in other quintiles. Linear regression revealed that e24UNaEKawasaki was related to systolic BP, diastolic BP, and TGs. Multiple logistic regression, adjusted for dietary sodium intake and various conventional risk factors for chronic vascular diseases, showed that both e24UNaEKawasaki and TGs were significant predictors of hypertension. Our interaction analysis demonstrated that increased sodium intake was associated with higher risk of hypertension in participants with elevated TGs than in those without (adjusted RERI = 0.022, 95% CI = 0.017–0.027; adjusted AP = 0.017, 95% CI = 0.006–0.028; adjusted SI = 1.010, 95% CI = 1.007–1.014). Conclusion Our findings suggest that the interaction between a high salt diet and elevated TGs may exert synergistic biological effects on the risk of hypertension.
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Affiliation(s)
- Jong Wook Choi
- Research Institute of Medical Science, Konkuk University School of Medicine, Chungju, Korea
| | - Joon-Sung Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
- * E-mail: (JSP); (CHL)
| | - Chang Hwa Lee
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
- * E-mail: (JSP); (CHL)
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Carvajal CA, Tapia-Castillo A, Vecchiola A, Baudrand R, Fardella CE. Classic and Nonclassic Apparent Mineralocorticoid Excess Syndrome. J Clin Endocrinol Metab 2020; 105:5691192. [PMID: 31909799 DOI: 10.1210/clinem/dgz315] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 12/28/2019] [Indexed: 02/13/2023]
Abstract
CONTEXT Arterial hypertension (AHT) is one of the most frequent pathologies in the general population. Subtypes of essential hypertension characterized by low renin levels allowed the identification of 2 different clinical entities: aldosterone-mediated mineralocorticoid receptor (MR) activation and cortisol-mediated MR activation. EVIDENCE ACQUISITION This review is based upon a search of Pubmed and Google Scholar databases, up to August 2019, for all publications relating to endocrine hypertension, apparent mineralocorticoid excess (AME) and cortisol (F) to cortisone (E) metabolism. EVIDENCE SYNTHESIS The spectrum of cortisol-mediated MR activation includes the classic AME syndrome to milder (nonclassic) forms of AME, the latter with a much higher prevalence (7.1%) than classic AME but different phenotype and genotype. Nonclassic AME (NC-AME) is mainly related to partial 11βHSD2 deficiency associated with genetic variations and epigenetic modifications (first hit) and potential additive actions of endogenous or exogenous inhibitors (ie, glycyrrhetinic acid-like factors [GALFS]) and other factors (ie, age, high sodium intake) (second hit). Subjects with NC-AME are characterized by a high F/E ratio, low E levels, normal to elevated blood pressure, low plasma renin and increased urinary potassium excretion. NC-AME condition should benefit from low-sodium and potassium diet recommendations and monotherapy with MR antagonists. CONCLUSION NC-AME has a higher prevalence and a milder phenotypical spectrum than AME. NC-AME etiology is associated to a first hit (gene and epigene level) and an additive second hit. NC-AME subjects are candidates to be treated with MR antagonists aimed to improve blood pressure, end-organ damage, and modulate the renin levels.
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Affiliation(s)
- Cristian A Carvajal
- Department of Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute on Immunology and Immunotherapy (IMII-ICM), Santiago, Chile
- Centro Traslacional de Endocrinología UC (CETREN), Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Alejandra Tapia-Castillo
- Department of Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute on Immunology and Immunotherapy (IMII-ICM), Santiago, Chile
- Centro Traslacional de Endocrinología UC (CETREN), Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Andrea Vecchiola
- Department of Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute on Immunology and Immunotherapy (IMII-ICM), Santiago, Chile
- Centro Traslacional de Endocrinología UC (CETREN), Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Rene Baudrand
- Department of Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centro Traslacional de Endocrinología UC (CETREN), Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Carlos E Fardella
- Department of Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute on Immunology and Immunotherapy (IMII-ICM), Santiago, Chile
- Centro Traslacional de Endocrinología UC (CETREN), Pontificia Universidad Catolica de Chile, Santiago, Chile
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