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Katamine M, Minami Y, Asakura K, Nagata T, Katsura A, Muramatsu Y, Hashimoto T, Kinoshita D, Ako J. Body mass index and characteristics of coronary plaque in younger patients with type 2 diabetes. Nutr Metab Cardiovasc Dis 2024; 34:792-798. [PMID: 38218710 DOI: 10.1016/j.numecd.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/06/2023] [Accepted: 12/13/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND AND AIMS The association between the body mass index (BMI) and the characteristics of coronary plaque in younger type 2 diabetes (T2D) patients with coronary artery disease (CAD) remains to be elucidated. METHODS AND RESULTS A total of 138 consecutive younger (<65 years) T2D patients with CAD, who underwent optical coherence tomography imaging of the culprit lesion were included. The patients were classified into either the higher BMI group (n = 68) or the lower BMI group (n = 70) according to the median of BMI (25.9 kg/m2). The prevalence of thin-cap fibroatheroma (TCFA) (35.3 vs. 17.1 %, p = 0.015) was significantly higher in the higher BMI group than in the lower BMI group. The prevalence of TCFA was significantly higher in patients with higher BMI than in those with lower BMI among patients with hemoglobin A1c (HbA1c) ≥7.0 % (odds ratio [OR] 5.40, 95 % confidence interval [CI] 1.72-17.0, p = 0.003) although the significant difference was not observed among patients with HbA1c <7.0 % (OR 0.89, 95 % CI 0.25-3.13, p = 0.851). CONCLUSION Higher BMI was associated with a higher prevalence of TCFA in younger T2D patients with CAD, particularly in patients with HbA1c ≥ 7.0 %.
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Affiliation(s)
- Masahiro Katamine
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yoshiyasu Minami
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
| | - Kiyoshi Asakura
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Takako Nagata
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Aritomo Katsura
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yusuke Muramatsu
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Takuya Hashimoto
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Daisuke Kinoshita
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
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Alipoor E, Hosseinzadeh-Attar MJ, Vasheghani-Farahani A, Salmani M, Rezaei M, Namkhah Z, Ahmadpanahi M, Jenab Y, Alidoosti M, Yaseri M. The relationship of circulating neuregulin 4 and irisin, and traditional and novel cardiometabolic risk factors with the risk and severity of coronary artery disease. Cytokine 2023; 170:156314. [PMID: 37591135 DOI: 10.1016/j.cyto.2023.156314] [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: 10/27/2022] [Revised: 06/02/2023] [Accepted: 07/31/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND AND AIMS Neuregulin 4 (NRG4) and irisin are adipokines that have been suggested to be associated with cardiometabolic risk factors and coronary artery disease (CAD), but the data are inconclusive. This study aimed to investigate the relationship between circulating NRG4 and irisin and cardiometabolic risk factors with CAD risk and severity. METHODS AND RESULTS In this cross-sectional study, the presence of CAD and the severity of stenosis (gensini score) were documented based on coronary angiography in 166 adults. Circulating NRG4 and irisin, glucose homeostasis markers, hs-CRP, lipid profiles, blood pressure, and anthropometric measurements were assessed as well. Age (p = 0.005), sex (p = 0.008), SBP (p = 0.033), DBP (p = 0.04), MAP (p = 0.018), FBG (p = 0.012), insulin (p = 0.039) and HOMA-IR (p = 0.01) were significantly associated with odds of having CAD. The final logistic regression model showed that age, sex, HOMA-IR, and MAP were the most important determinants of having CAD. There were no significant associations between circulating irisin and NRG4 with odds of having CAD. The final general linear model showed that being men (β = 17.303, 95% CI: 7.086-27.52, P = 0.001), age (Aβ = 0.712, 95% CI: 0.21-1.214, P = 0.006), HOMA-IR (Aβ = 2.168, 95% CI: 0.256 to 4.079, P = 0.027), and NRG4 level (β = 1.836, 95% CI: 0.119-3.553, P = 0.036) were directly associated with higher gensini score. Participants with the three-vessel disease had a mean increase of about 5 units in circulating irisin compared to those with no clinical CAD (β = 5.221, 95% CI: 0.454-9.987, p = 0.032). CONCLUSIONS This study showed that the adipokines NRG4 and Irisin might be associated with the severity of coronary stenosis.
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Affiliation(s)
- Elham Alipoor
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Hosseinzadeh-Attar
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Clinical Cardiac Electrophysiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Salmani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Rezaei
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Namkhah
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Monireh Ahmadpanahi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Yaser Jenab
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Alidoosti
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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Laukkanen JA, Kunutsor SK, Hernesniemi J, Immonen J, Eskola M, Zaccardi F, Niemelä M, Mäkikallio T, Hagnäs M, Piuhola J, Juvonen J, Sia J, Rummukainen J, Kervinen K, Karvanen J, Nikus K. Underweight and obesity are related to higher mortality in patients undergoing coronary angiography: The KARDIO invasive cardiology register study. Catheter Cardiovasc Interv 2022; 100:1242-1251. [PMID: 36378689 PMCID: PMC10098486 DOI: 10.1002/ccd.30463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/10/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND In patients with some cardiovascular disease conditions, slightly elevated body mass index (BMI) is associated with a lower mortality risk (termed "obesity paradox"). It is uncertain, however, if this obesity paradox exists in patients who have had invasive cardiology procedures. We evaluated the association between BMI and mortality in patients who underwent coronary angiography. METHODS We utilised the KARDIO registry, which comprised data on demographics, prevalent diseases, risk factors, coronary angiographies, and interventions on 42,636 patients. BMI was categorised based on WHO cut-offs or transformed using P-splines. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated for all-cause mortality. RESULTS During a median follow-up of 4.9 years, 4688 all-cause deaths occurred. BMI was nonlinearly associated with mortality risk: compared to normal weight category (18.5-25 kg/m2 ), the age-adjusted HRs (95% CIs) for all-cause mortality were 1.90 (1.49, 2.43), 0.96 (0.92, 1.01), 1.04 (0.99, 1.09), 1.08 (0.96, 1.20), and 1.45 (1.22, 1.72) for underweight (<18.5 kg/m2 ), preobesity (25 to <30 kg/m2 ), obesity class I (30 to <35 kg/m2 ), obesity class II (35 to <40 kg/m2 ), and obesity class III (>40 kg/m2 ), respectively. The corresponding multivariable adjusted HRs (95% CIs) were 2.00 (1.55, 2.58), 0.92 (0.88, 0.97) 1.01 (0.95, 1.06), 1.10 (0.98, 1.23), and 1.49 (1.26, 1,78), respectively. CONCLUSIONS In patients undergoing coronary angiography, underweight and obesity class III are associated with increased mortality risk, and the lowest mortality was observed in the preobesity class. It appears the obesity paradox may be present in patients who undergo invasive coronary procedures.
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Affiliation(s)
- Jari A. Laukkanen
- School of MedicineInstitute of Clinical Medicine, University of Eastern FinlandKuopioFinland
- Central Finland Health Care District, Department of MedicineJyväskyläFinland
| | - Setor K. Kunutsor
- Central Finland Health Care District, Department of MedicineJyväskyläFinland
- Leicester Real World Evidence Unit, Diabetes Research CentreUniversity of Leicester, Leicester General HospitalLeicesterUK
- Translational Health Sciences, Bristol Medical SchoolUniversity of Bristol, Learning & Research Building (Level 1), Southmead HospitalBristolUK
| | - Jussi Hernesniemi
- Heart Center, Department of CardiologyTampere University HospitalTampereFinland
- Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
| | - Jaakko Immonen
- Central Finland Health Care District, Department of MedicineJyväskyläFinland
| | - Markku Eskola
- Heart Center, Department of CardiologyTampere University HospitalTampereFinland
| | - Francesco Zaccardi
- Central Finland Health Care District, Department of MedicineJyväskyläFinland
- Leicester Real World Evidence Unit, Diabetes Research CentreUniversity of Leicester, Leicester General HospitalLeicesterUK
| | - Matti Niemelä
- Division of Cardiology, Department of Internal MedicineOulu University HospitalOuluFinland
| | - Timo Mäkikallio
- Department of MedicineSouth‐Karelia Central HospitalLappeenrantaFinland
| | - Magnus Hagnäs
- Lapland Health Care District, Department of Internal MedicineRovaniemiFinland
| | - Jarkko Piuhola
- Division of Cardiology, Department of Internal MedicineOulu University HospitalOuluFinland
| | - Jukka Juvonen
- Department of Internal MedicineKainuu Central HospitalKajaaniFinland
| | - Jussi Sia
- Department of CardiologyKokkola Central HospitalKokkolaFinland
| | - Juha Rummukainen
- Department of Internal MedicineSatakunta Central HospitalPoriFinland
| | - Kari Kervinen
- Division of Cardiology, Department of Internal MedicineOulu University HospitalOuluFinland
| | - Juha Karvanen
- Department of Mathematics and StatisticsUniversity of JyvaskylaJyväskyläFinland
| | - Kjell Nikus
- Heart Center, Department of CardiologyTampere University HospitalTampereFinland
- Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
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Schwander B, Kaier K, Hiligsmann M, Evers S, Nuijten M. Does the Structure Matter? An External Validation and Health Economic Results Comparison of Event Simulation Approaches in Severe Obesity. PHARMACOECONOMICS 2022; 40:901-915. [PMID: 35771486 PMCID: PMC9363367 DOI: 10.1007/s40273-022-01162-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/29/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES As obesity-associated events impact long-term survival, health economic (HE) modelling is commonly applied, but modelling approaches are diverse. This research aimed to compare the events simulation and the HE outcomes produced by different obesity modelling approaches. METHODS An external validation, using the Swedish obesity subjects (SOS) study, of three main structural event modelling approaches was performed: (1) continuous body mass index (BMI) approach; (2) risk equation approach; and (3) categorical BMI-related approach. Outcomes evaluated were mortality, cardiovascular events, and type 2 diabetes (T2D) for both the surgery and the control arms. Concordance between modelling results and the SOS study were investigated by different state-of-the-art measurements, and categorized by the grade of deviation observed (grades 1-4 expressing mild, moderate, severe, and very severe deviations). Furthermore, the costs per quality-adjusted life-year (QALY) gained of surgery versus controls were compared. RESULTS Overall and by study arm, the risk equation approach presented the lowest average grade of deviation (overall grade 2.50; control arm 2.25; surgery arm 2.75), followed by the continuous BMI approach (overall 3.25; control 3.50; surgery 3.00) and by the categorial BMI approach (overall 3.63; control 3.50; surgery 3.75). Considering different confidence interval limits, the costs per QALY gained were fairly comparable between all structural approaches (ranging from £2,055 to £6,206 simulating a lifetime horizon). CONCLUSION None of the structural approaches provided perfect external event validation, although the risk equation approach showed the lowest overall deviations. The economic outcomes resulting from the three approaches were fairly comparable.
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Affiliation(s)
- Björn Schwander
- Department of Health Services Research, CAPHRI-Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- AHEAD GmbH-Agency for Health Economic Assessment and Dissemination, Wilhelm-Leibl-Str. 7, D-74321 Bietigheim-Bissingen, Germany
| | - Klaus Kaier
- Institute of Medical Biometry and Statistics (IMBI), University of Freiburg, Freiburg im Breisgau, Germany
| | - Mickaël Hiligsmann
- Department of Health Services Research, CAPHRI-Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Silvia Evers
- Department of Health Services Research, CAPHRI-Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Trimbos Institute-Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Mark Nuijten
- a2m-Ars Accessus Medica, Amsterdam, the Netherlands
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High-strength deep learning image reconstruction in coronary CT angiography at 70-kVp tube voltage significantly improves image quality and reduces both radiation and contrast doses. Eur Radiol 2022; 32:2912-2920. [DOI: 10.1007/s00330-021-08424-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 12/14/2022]
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Ribeiro IS, Pereira ÍS, Galantini MPL, Santos DP, Teles MF, Muniz IPR, Santos GS, Silva RAA. Regular physical activity reduces the effects of inflammaging in diabetic and hypertensive men. Exp Gerontol 2021; 155:111558. [PMID: 34547405 DOI: 10.1016/j.exger.2021.111558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 10/20/2022]
Abstract
The aim of this study was to assess the influence of physical activity in inflammatory, biochemical and endocrine parameters of middle-aged and elderly men with Systemic Arterial Hypertension (SAH) and Type 2 Diabetes Mellitus (T2DM). The assessment was comprised by 77 male volunteers aged between 45 and 59 years old (middle-aged men) or 60 to 86 years old (elderly men), diagnosed with SAH and T2DM, assisted by Family Health Units in Vitória da Conquista, Bahia, Brazil. According to age and lifestyle (sedentary or practicing physical activity), these men were classified as middle-aged sedentary men, middle-aged physically active men, elderly sedentary men, or elderly physically active men. It was noticed that active elderly people with SAH and T2DM had a better inflammatory balance than sedentary middle-aged men, through the evaluation of the relationship between the cytokines IL-10/TNF-α, IL-10/IL-17A and IL-10/IFN-γ. Moreover, in the extended correlation analysis, a greater global balance was observed among anthropometric, blood pressure, biochemical and cytokine parameters. Physical activity beneficially modulates aging-related disease risk factors even in elderly individuals.
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Affiliation(s)
- Israel S Ribeiro
- Multidisciplinary Institute of Health, Anísio Teixeira Campus - Federal University of Bahia, 58 Hormindo Barros Street - 17 Block - 58 Lot, Candeias, 45.029-094 Vitória da Conquista, Bahia, Brazil; Paulo Freire Campus - Federal University of Southern Bahia, 250 Joana Angélica Square, São José, 45.988-058 Teixeira de Freitas, Bahia, Brazil
| | - Ítalo S Pereira
- Multidisciplinary Institute of Health, Anísio Teixeira Campus - Federal University of Bahia, 58 Hormindo Barros Street - 17 Block - 58 Lot, Candeias, 45.029-094 Vitória da Conquista, Bahia, Brazil
| | - Maria P L Galantini
- Multidisciplinary Institute of Health, Anísio Teixeira Campus - Federal University of Bahia, 58 Hormindo Barros Street - 17 Block - 58 Lot, Candeias, 45.029-094 Vitória da Conquista, Bahia, Brazil
| | - Denisar P Santos
- Multidisciplinary Institute of Health, Anísio Teixeira Campus - Federal University of Bahia, 58 Hormindo Barros Street - 17 Block - 58 Lot, Candeias, 45.029-094 Vitória da Conquista, Bahia, Brazil; FG Universitary Center - UniFG, 459 Barão do Rio Branco Avenue, Zip code: 46430-000 Guanambi, Bahia, Brazil
| | - Mauro F Teles
- Multidisciplinary Institute of Health, Anísio Teixeira Campus - Federal University of Bahia, 58 Hormindo Barros Street - 17 Block - 58 Lot, Candeias, 45.029-094 Vitória da Conquista, Bahia, Brazil
| | - Igor P R Muniz
- Multidisciplinary Institute of Health, Anísio Teixeira Campus - Federal University of Bahia, 58 Hormindo Barros Street - 17 Block - 58 Lot, Candeias, 45.029-094 Vitória da Conquista, Bahia, Brazil
| | - Gilvanéia S Santos
- Multidisciplinary Institute of Health, Anísio Teixeira Campus - Federal University of Bahia, 58 Hormindo Barros Street - 17 Block - 58 Lot, Candeias, 45.029-094 Vitória da Conquista, Bahia, Brazil
| | - Robson A A Silva
- Multidisciplinary Institute of Health, Anísio Teixeira Campus - Federal University of Bahia, 58 Hormindo Barros Street - 17 Block - 58 Lot, Candeias, 45.029-094 Vitória da Conquista, Bahia, Brazil.
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Shui X, Wen Z, Chen Z, Xie X, Wu Y, Zheng B, Wu Z, Chen L. Elevated serum lipoprotein(a) is significantly associated with angiographic progression of coronary artery disease. Clin Cardiol 2021; 44:1551-1559. [PMID: 34432895 PMCID: PMC8571555 DOI: 10.1002/clc.23718] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/14/2021] [Accepted: 08/17/2021] [Indexed: 12/24/2022] Open
Abstract
Background Lipoprotein(a)[Lp(a)] has been considered as an independent risk factor for coronary artery disease (CAD). The present study aimed to evaluate the association between baseline serum Lp(a) and CAD progression determined by angiographic score. Methods A total of 814 patients who had undergone two or more coronary computed tomography angiography at least 6 months apart were consecutively enrolled and the coronary severity was determined by the Gensini score system. Patients were stratified into two groups according to Lp(a)>300 mg/L and Lp(a) ≤ 300 mg/L or classified as “progressors” and “non‐progressors” based on the Gensini score rate of change per year. The association of continuous Lp(a) and Lp(a)>300 mg/L with CAD progression were respectively assessed by logistic regression analysis. Moreover, further evaluation of those association was performed in subgroups of the study population. Results Patients in the “progressors” group had significant higher Lp(a) levels. Furthermore, the multivariate logistic regression analysis showed that elevated Lp(a) (odds ratio [OR]: 1.451, 95% confidence interval [CI]: 1.177–1.789, p<.001) and Lp(a)>300 mg/L (OR:1.642, 95% CI:1.018–2.649, p = .042) were positively associated with CAD progression after adjusting for confounding factors. In addition, those relation seemed to be more prominent in subjects with lower body mass index (OR: 1.880, 95% CI: 1.224–2.888, p for interaction = .060). Conclusions Elevated baseline serum Lp(a) is positively and independently associated with angiographic progression of CAD, particularly in participants with relatively low body mass index. Therefore, Lp(a) could be a potent risk factor for CAD progression, assisting in early risk stratification in cardiovascular patients.
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Affiliation(s)
- Xing Shui
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zheqi Wen
- Department of Cardiac Care Unit, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zefeng Chen
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xujing Xie
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yongxia Wu
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Binghan Zheng
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhen Wu
- Department of Cardiac Care Unit, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lin Chen
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Hudzik B, Nowak J, Szkodziński J, Zubelewicz-Szkodzińska B. Visceral Adiposity in Relation to Body Adiposity and Nutritional Status in Elderly Patients with Stable Coronary Artery Disease. Nutrients 2021; 13:nu13072351. [PMID: 34371863 PMCID: PMC8308712 DOI: 10.3390/nu13072351] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/19/2021] [Accepted: 07/08/2021] [Indexed: 01/04/2023] Open
Abstract
Introduction: The accumulation of visceral abdominal tissue (VAT) seems to be a hallmark feature of abdominal obesity and substantially contributes to metabolic abnormalities. There are numerous factors that make the body-mass index (BMI) a suboptimal measure of adiposity. The visceral adiposity index (VAI) may be considered a simple surrogate marker of visceral adipose tissue dysfunction. However, the evidence comparing general to visceral adiposity in CAD is scarce. Therefore, we have set out to investigate visceral adiposity in relation to general adiposity in patients with stable CAD. Material and methods: A total of 204 patients with stable CAD hospitalized in the Department of Medicine and the Department of Geriatrics entered the study. Based on the VAI-defined adipose tissue dysfunction (ATD) types, the study population (N = 204) was divided into four groups: (1) no ATD (N = 66), (2) mild ATD (N = 50), (3) moderate ATD (N = 48), and (4) severe ATD (N = 40). Nutritional status was assessed using the Controlling Nutritional Status (CONUT) score. Results: Patients with moderate and severe ATD were the youngest (median 67 years), yet their metabolic age was the oldest (median 80 and 84 years, respectively). CONUT scores were similar across all four study groups. The VAI had only a modest positive correlation with BMI (r = 0.59 p < 0.01) and body adiposity index (BAI) (r = 0.40 p < 0.01). There was no correlation between VAI and CONUT scores. There was high variability in the distribution of BMI-defined weight categories across all four types of ATD. A total of 75% of patients with normal nutritional status had some form of ATD, and one-third of patients with moderate or severe malnutrition did not have any ATD (p = 0.008). In contrast, 55-60% of patients with mild, moderate, or severe ATD had normal nutritional status (p = 0.008). ROC analysis demonstrated that BMI and BAI have poor predictive value in determining no ATD. Both BMI (AUC 0.78 p < 0.0001) and BAI (AUC 0.66 p = 0.003) had strong predictive value for determining severe ATD (the difference between AUC 0.12 being p = 0.0002). However, BMI predicted mild ATD and severe ATD better than BAI. Conclusions: ATD and malnutrition were common in patients with CAD. Notably, this study has shown a high rate of misclassification of visceral ATD via BMI and BAI. In addition, we demonstrated that the majority of patients with normal nutritional status had some form of ATD and as much as one-third of patients with moderate or severe malnutrition did not have any ATD. These findings have important clinical ramifications for everyday practice regarding the line between health and disease in the context of malnutrition in terms of body composition and visceral ATD, which are significant for developing an accurate definition of the standards for the intensity of clinical interventions.
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Affiliation(s)
- Bartosz Hudzik
- Department of Cardiovascular Disease Prevention, Department of Metabolic Disease Prevention, Faculty of Health Sciences, Medical University of Silesia, 41-902 Bytom, Poland;
- Third Department of Cardiology, Silesian Center for Heart Disease, Faculty of Medical Sciences, Medical University of Silesia, 41-800 Zabrze, Poland;
- Correspondence:
| | - Justyna Nowak
- Department of Cardiovascular Disease Prevention, Department of Metabolic Disease Prevention, Faculty of Health Sciences, Medical University of Silesia, 41-902 Bytom, Poland;
| | - Janusz Szkodziński
- Third Department of Cardiology, Silesian Center for Heart Disease, Faculty of Medical Sciences, Medical University of Silesia, 41-800 Zabrze, Poland;
| | - Barbara Zubelewicz-Szkodzińska
- Department of Nutrition-Related Disease Prevention, Department of Metabolic Disease Prevention, Faculty of Health Sciences, Medical University of Silesia, 41-902 Bytom, Poland;
- Department of Endocrinology, District Hospital, 41-940 Piekary Śląskie, Poland
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Dolbow DR, Credeur DP, Lemacks JL, Stokic DS, Pattanaik S, Corbin GN, Courtner AS. Electrically induced cycling and nutritional counseling for counteracting obesity after spinal cord injury: A pilot study. J Spinal Cord Med 2021; 44:533-540. [PMID: 31971487 PMCID: PMC8288120 DOI: 10.1080/10790268.2019.1710939] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Objective: The purpose of this pilot study was to determine the preliminary efficacy of interval functional electrical stimulation (FES) cycling combined with nutritional counseling in obese adults with SCI.Setting: Community-based individuals with chronic SCI.Participants: Ten participants with chronic SCI.Interventions: Participants were divided into 2 groups (1) FES cycling and nutritional counseling (FES & Nutri) and (2) nutritional counseling only (Nutri Only). The FES & Nutri group performed high intensity interval FES cycling for 30 min 3 times per week for 8 weeks and received nutritional counseling for 30 min once per week for 8 weeks. The Nutri Only group received the nutritional counseling only.Outcome Measures: Body composition (fat mass, lean mass, body fat percentage), blood glucose levels.Results: Participants in the FES & Nutri group had a statistically significant greater decrease in body fat percentage (M = -1.14) compared to those in the Nutri Only group (M = +0.28) and gained more lean mass in their legs (M = +0.66 kg) compared to the Nutri Only group (M = -1.05 kg).Discussion/Conclusion: The statistically significant decrease in body fat percentage for the FES & Nutri group provides evidence that further study is merited. Future studies should include larger numbers of participants and the possible introduction of a preliminary strengthening program before initiating interval FES cycling. In addition, an increase in exercise volume and a greater role for nutritional counseling should be considered in order to optimize the treatment for obesity.
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Affiliation(s)
- David R. Dolbow
- School of Physical Therapy, William Carey University, Hattiesburg, Mississippi, USA,Correspondence to: David R. Dolbow, Physical Therapy Program, William Carey University, 710 William Carey Parkway, Hattiesburg, MS39401, USA.
| | - Daniel P. Credeur
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Jennifer L. Lemacks
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Dobrivoje S. Stokic
- Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, Jackson, Mississippi, USA
| | - Sambit Pattanaik
- College of Osteopathic Medicine, William Carey University, Hattiesburg, Mississippi, USA
| | - Gevork N. Corbin
- College of Osteopathic Medicine, William Carey University, Hattiesburg, Mississippi, USA
| | - Andrew S. Courtner
- Educational Research and Higher Education Administration, Lincoln Memorial University, Knoxville, Tennessee, USA
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Powell-Wiley TM, Poirier P, Burke LE, Després JP, Gordon-Larsen P, Lavie CJ, Lear SA, Ndumele CE, Neeland IJ, Sanders P, St-Onge MP. Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation 2021; 143:e984-e1010. [PMID: 33882682 PMCID: PMC8493650 DOI: 10.1161/cir.0000000000000973] [Citation(s) in RCA: 890] [Impact Index Per Article: 296.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The global obesity epidemic is well established, with increases in obesity prevalence for most countries since the 1980s. Obesity contributes directly to incident cardiovascular risk factors, including dyslipidemia, type 2 diabetes, hypertension, and sleep disorders. Obesity also leads to the development of cardiovascular disease and cardiovascular disease mortality independently of other cardiovascular risk factors. More recent data highlight abdominal obesity, as determined by waist circumference, as a cardiovascular disease risk marker that is independent of body mass index. There have also been significant advances in imaging modalities for characterizing body composition, including visceral adiposity. Studies that quantify fat depots, including ectopic fat, support excess visceral adiposity as an independent indicator of poor cardiovascular outcomes. Lifestyle modification and subsequent weight loss improve both metabolic syndrome and associated systemic inflammation and endothelial dysfunction. However, clinical trials of medical weight loss have not demonstrated a reduction in coronary artery disease rates. In contrast, prospective studies comparing patients undergoing bariatric surgery with nonsurgical patients with obesity have shown reduced coronary artery disease risk with surgery. In this statement, we summarize the impact of obesity on the diagnosis, clinical management, and outcomes of atherosclerotic cardiovascular disease, heart failure, and arrhythmias, especially sudden cardiac death and atrial fibrillation. In particular, we examine the influence of obesity on noninvasive and invasive diagnostic procedures for coronary artery disease. Moreover, we review the impact of obesity on cardiac function and outcomes related to heart failure with reduced and preserved ejection fraction. Finally, we describe the effects of lifestyle and surgical weight loss interventions on outcomes related to coronary artery disease, heart failure, and atrial fibrillation.
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11
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Cademartiri F, Casolo G, Clemente A, Seitun S, Mantini C, Bossone E, Saba L, Sverzellati N, Nistri S, Punzo B, Cavaliere C, La Grutta L, Gentile G, Maffei E. Coronary CT angiography: a guide to examination, interpretation, and clinical indications. Expert Rev Cardiovasc Ther 2021; 19:413-425. [PMID: 33884942 DOI: 10.1080/14779072.2021.1915132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The introduction of Cardiac Computed Tomography (CCT) has changed the paradigm in the field of diagnostic cardiovascular medicine. CCT is the primary tool in the assessment of suspected Coronary Artery Disease (CAD) and should be followed by functional assessment when needed to stratify disease and to plan potential interventional or surgical therapy. AREAS COVERED We provided the current state of the knowledge on the main aspects of technique of examination, image interpretation and clinical indications. We have focused our attention on the basic routine applications and activities. EXPERT OPINION The primary role of CCT in suspected CAD will progressively become the standard approach. In general, any situation in which anatomy of the heart and thoracic vessels/structures is mandatory must be approached using CT first, whenever possible. The quantity and quality of information that can be provided by CCT is big and the operators should learn how to deal with this information. On the other hand, CCT is only apparently a straightforward and simple examination. It is actually the most complex diagnostic procedure that can be performed on CT and requires highly skilled operators and state-of-art-technology.
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Affiliation(s)
| | - Giancarlo Casolo
- Department of Cardiology, Ospedale Della Versilia, Viareggio, Italy
| | - Alberto Clemente
- Department of Radiology, Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - Sara Seitun
- Department of Radiology, Ospedale San Martino, Genova, Italy
| | - Cesare Mantini
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Eduardo Bossone
- Department of Cardiology, Ospedale Cardarelli, Naples, Italy
| | - Luca Saba
- Department of Radiology, University of Cagliari, Cagliari, Italy
| | | | | | - Bruna Punzo
- Department of Radiology, SDN IRCCS, Naples, Italy
| | | | | | | | - Erica Maffei
- Department of Radiology, Area Vasta 1, ASUR Marche, Urbino, Italy
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12
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Abstract
OBJECTIVE The aim of this study is to evaluate the association between Nutritional Risk Index (NRI), a simple tool to assess nutritional status, and coronary artery disease severity and complexity in patients undergoing coronary angiography. METHODS This study is a retrospective analysis of 822 patients undergoing coronary angiography. Patients with previous revascularization were excluded. Gensini and SYNTAX scores were calculated according to the angiographic images to determine atherosclerosis severity. NRI was calculated as follows: NRI = [15.19 × serum albumin (g/dl)] + [41.7 × (body weight/ideal body weight)]. In patients ≥65 years of age, Geriatric NRI (GNRI) was used instead of NRI. GNRI was calculated as follows: GNRI = [14.89 × serum albumin (g/dl)] + [41.7 × (body weight/ideal body weight)]. Patients were then divided into three groups as previously reported: NRI < 92, NRI 92-98 and NRI > 98. Gensini and SYNTAX scores were compared between three groups. RESULTS The mean age of study population was 61.9 ± 11.1 years. NRI < 92, 92-98, and >98 was measured in 212, 321 and 289 patients, respectively. There was no difference regarding to sex, BMI, smoking, hypertension and diabetes mellitus between three groups. Patients with NRI < 92 had the highest mean Gensini score than the patients with NRI 92-98 and NRI > 98 (38.0 ± 40.6 vs. 31.17 ± 42.4 vs. 25.8 ± 38.4, P = 0.005). Also patients with NRI < 92 had the highest mean SYNTAX score than the patients with NRI 92-98 and NRI > 98 (11.8 ± 12.9 vs. 9.3 ± 12.4 vs. 7.7 ± 11.8, P = 0.001). Also, Gensini score of ≥20 and high SYNTAX score of ≥33 were associated with lower NRI (P < 0.001 and P < 0.001, respectively). CONCLUSION In our study, nutritional status evaluated by the NRI was associated with more extensive and complex coronary atherosclerosis in patients undergoing coronary angiography.
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Maffei E, Punzo B, Cavaliere C, Bossone E, Saba L, Cademartiri F. Coronary atherosclerosis as the main endpoint of non-invasive imaging in cardiology: a narrative review. Cardiovasc Diagn Ther 2021; 10:1897-1905. [PMID: 33381433 DOI: 10.21037/cdt-20-525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The change of paradigm determined by the introduction of cardiac computed tomography (CCT) in the field of cardiovascular medicine has allowed new evidence to emerge. These evidences point towards a major role, probably the most important one in terms of prognostic impact, in the detection, characterization and quantification of atherosclerosis as the main driver and endpoint for the management of coronary artery disease (CAD). Extensive literature has been published in the last decade with large numbers and patients' populations, investigating several aspects and correlations between atherosclerotic plaque features and risk factors; also, the relationship between plaque features, both with qualitative and quantitative approaches, and cardiovascular events has been investigated. More recent studies have also pointed out the relationship between the knowledge and classification of sub-clinical atherosclerosis and the induced modification of medical therapy (both aggressiveness and compliance) that is most likely able to increase the effect of anti-atherosclerotic drugs, hence significantly improving prognosis. Non-invasive assessment of CAD by means of CCT is becoming the primary tool for management and also the most important parameter for the comprehension of natural history of CAD and how the therapies we adopt are affecting plaque burden as a whole. In this review we will address the modern concepts of CAD driven understanding and management of cardiovascular disease.
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Affiliation(s)
- Erica Maffei
- Department of Radiology, Area Vasta 1, ASUR Marche, Urbino (PU), Italy
| | - Bruna Punzo
- Department of Radiology, SDN IRCCS, Naples, Italy
| | | | - Eduardo Bossone
- Department of Cardiology, Ospedale Cardarelli, Naples, Italy
| | - Luca Saba
- Department of Radiology, University of Cagliari, Italy
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14
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Efe SÇ, Karagoz A, Dogan C, Bayram Z, Kalkan S, Altıntas MS, Yuksel Y, Karabag T, Ayca B, Ozdemir N. Relative Fat Mass Index can be solution for obesity paradox in coronary artery disease severity prediction calculated by SYNTAX Score. Postgrad Med J 2020; 97:434-441. [PMID: 33310896 DOI: 10.1136/postgradmedj-2020-138926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/20/2020] [Accepted: 10/29/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The relation between body mass index (BMI) and coronary artery disease (CAD) extension remains controversial. A new score was developed to estimate body fat percentage (BFP) known as Relative Fat Mass (RFM) Index. This study aimed to evaluate the value of RFM Index in predicting the severity of the CAD, compared with other anthropometric measurements. METHODS A total of 325 patients with chronic CAD were investigated. RFM, BFP, BMI and other anthropometric characteristics of patients were measured before angiography. CAD severity was determined by SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery trial (SYNTAX) Score. The association between SYNTAX Score and variables was evaluated using linear regression models. In order to compare the model performance, R-squared (R2), Akaike's information criterion, Bayesian information criterion and root mean square error were used. RESULTS Univariate linear regression outcome variable, SYNTAX was used to determine whether there was any relationship between variables. Independent variables were included in the multivariable linear logistic regression models. The analysis showed that in model 1, RFM (β coefficient: 2.31 (0.90 to 3.71), p=0.001)), diabetes mellitus (β coefficient: 3.72 (1.67 to 3.76), p=0.004)), haemoglobin (β coefficient: -2.12 (-3.70 to -0.53), p=0.03) and age (β coefficient: 1.83 (0.29 to 3.37), p=0.02)) were statistically significant. The adjusted R2 values in model 1 were higher than model 2 (BFP) and model 3 (BMI) (0.155, 0.137 and 0.130, respectively), and χ2 values of RFM were higher than BFP and BMI (10.5, 3.4 and 1.0, respectively). CONCLUSION RFM Index is a more reliable and compatible marker of obesity in showing the severity of CAD compared to BMI.
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Affiliation(s)
- Süleyman Çağan Efe
- Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Ali Karagoz
- Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Cem Dogan
- Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Zubeyde Bayram
- Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Sedat Kalkan
- Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | | | - Yasin Yuksel
- Cardiology, Istanbul Teaching and Research Hospital, Istanbul, Turkey
| | - Turgut Karabag
- Cardiology, Istanbul Teaching and Research Hospital, Istanbul, Turkey
| | - Burak Ayca
- Cardiology, Istanbul Teaching and Research Hospital, Istanbul, Turkey
| | - Nihal Ozdemir
- Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
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Chambergo-Michilot D, Runzer-Colmenares FM, Zamora Á, Santa-Cruz F, Zamora M. Body mass index and coronary revascularization in women with coronary artery disease: insight into obesity paradox. REVISTA COLOMBIANA DE CARDIOLOGÍA 2020. [DOI: 10.1016/j.rccar.2019.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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16
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Katta N, Loethen T, Lavie CJ, Alpert MA. Obesity and Coronary Heart Disease: Epidemiology, Pathology, and Coronary Artery Imaging. Curr Probl Cardiol 2020; 46:100655. [PMID: 32843206 DOI: 10.1016/j.cpcardiol.2020.100655] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/03/2020] [Indexed: 01/15/2023]
Abstract
Overweight and obesity contribute to the development of cardiovascular disease (CVD) in general and coronary heart disease (CHD) in particular in part by their association with traditional and nontraditional CVD risk factors. Obesity is also considered to be an independent risk factor for CVD. The metabolic syndrome, of which central obesity is an important component, is strongly associated with CVD including CHD. There is abundant epidemiologic evidence of an association between both overweight and obesity and CHD. Evidence from postmortem studies and studies involving coronary artery imaging is less persuasive. Recent studies suggest the presence of an obesity paradox with respect to mortality in persons with established CHD. Physical activity and preserved cardiorespiratory fitness attenuate the adverse effects of obesity on CVD events. Information concerning the effect of intentional weight loss on CVD outcomes in overweight and obese persons is limited.
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17
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Joseph MSc A, John PhD F, Thomas MSc JV, Sivadasan SDP, Maliakel PhD B, Mohan PhD R, I M K. Influence of a Novel Food-Grade Formulation of Red Chili Extract ( Capsicum annum) on Overweight Subjects: Randomized, Double-Blinded, Placebo-Controlled Study. J Diet Suppl 2020; 18:387-405. [PMID: 32578488 DOI: 10.1080/19390211.2020.1780363] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Capsaicinoids from pungent red chilies (Capsicum annum and Capsicum frutescens) have received significant attention as a natural supplement for the management of obesity. However, the consumption of chili extract at physiologically relevant dosage of capsaicinoids is a challenge owing to its pungency and gastrointestinal discomforts. The present study reports the systemic absorption, safety and influence of a novel, food-grade, and sustained-release formulation of capsaicinoids-rich red chili extract using fenugreek dietary fiber (Capsifen®). Twenty-four healthy overweight subjects were randomized into placebo (n = 12) and Capsifen (n = 12) groups and supplemented with 200 mg × 1/day of Capsifen (4 mg capsaicinoids/day) for 28 days. Influence of Capsifen on eating behavior and appetite was followed by Three-Factor Eating Questionnaire (TFEQ) and Council of Nutrition Appetite Questionnaire (CNAQ), respectively. Consumption of Capsifen did not reveal any adverse events or deviations in hematology and biochemical parameters related to safety. However, a significant decrease in body weight (2.1%), w/h ratio (4%) and body mass index (BMI) (2.2%) were observed among Capsifen group when compared to placebo. The TFEQ and appetite analysis revealed a significant improvement in uncontrolled eating and reduction in appetite among Capsifen subjects. The UPLC-ESI-MS/MS analysis confirmed the absorption of capsaicinoids from CAP supplementation. The study further demonstrated the safety and tolerability of Capsifen at the investigational dosage. Thus, the significant reduction in anthropometric parameters such as body weight, w/h ratio, and BMI along with the improvement in eating behaviour as well as appetite, indicated the potential body weight management effect of Capsifen.
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Affiliation(s)
| | - Febi John PhD
- Akay Natural Ingredients Pvt. Ltd., Cochin, Kerala, India
| | - Jestin V Thomas MSc
- Leads Clinical Research and Bio Services Pvt. Ltd., Bangalore, Karnataka, India
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18
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Romagnolli C, Bensenor IM, Santos IS, Lotufo PA, Bittencourt MS. Impact of metabolically healthy obesity on carotid intima-media thickness - The Brazilian Longitudinal Study of Adult Health. Nutr Metab Cardiovasc Dis 2020; 30:915-921. [PMID: 32402586 DOI: 10.1016/j.numecd.2020.02.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 01/11/2020] [Accepted: 02/17/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Obesity increases the risk of metabolic abnormalities, which contributes to elevated cardiovascular risk. However, the independent role of obesity in the development of cardiovascular disease is still debatable. There are individuals with an obesity phenotype without metabolic abnormalities: "metabolically healthy obesity" (MHO). This study evaluates the association between MHO and carotid intima-media thickness (CIMT), an early marker of subclinical atherosclerosis. METHODS AND RESULTS This is a cross-sectional analysis of the baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We used a strict definition to classify MHO: body mass index ≥30 kg/m2 and meeting none of the four metabolic syndrome criteria. Data from 10,335 participants were analyzed. The obesity prevalence in our population was 21.2% (n = 2191). The prevalence of MHO was 5.6% (n = 124). When individuals were stratified according to metabolic health, we found the metabolically healthy individuals were younger, more likely to be women and never smokers. The mean CIMT of the sample was 0.81 mm (±0.20). The mean CIMT of the metabolically healthy subsample was 0.70 mm (±0.13) in individuals without obesity and 0.76 mm (±0.13) in individuals with obesity (p < 0.001). The mean CIMT of the metabolically unhealthy subsample was 0.81 mm (±0.20) in individuals without obesity and 0.88 mm (±0.20) in individuals with obesity (p < 0.001). These findings remained essentially unchanged after multivariate adjustment for confounding factors. CONCLUSION The concept of MHO, even with the strict definition, seems inadequate, as even in this population, obesity is associated with higher CIMT levels.
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Affiliation(s)
- Carla Romagnolli
- Center for Clinical and Epidemiological Research, University Hospital, Universidade de São Paulo, São Paulo, Brazil.
| | - Isabela M Bensenor
- Center for Clinical and Epidemiological Research, University Hospital, Universidade de São Paulo, São Paulo, Brazil; Internal Medicine Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Itamar S Santos
- Center for Clinical and Epidemiological Research, University Hospital, Universidade de São Paulo, São Paulo, Brazil; Internal Medicine Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, Universidade de São Paulo, São Paulo, Brazil; Internal Medicine Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marcio S Bittencourt
- Center for Clinical and Epidemiological Research, University Hospital, Universidade de São Paulo, São Paulo, Brazil
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Gerdts E, Regitz-Zagrosek V. Sex differences in cardiometabolic disorders. Nat Med 2019; 25:1657-1666. [PMID: 31700185 DOI: 10.1038/s41591-019-0643-8] [Citation(s) in RCA: 222] [Impact Index Per Article: 44.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/02/2019] [Accepted: 10/04/2019] [Indexed: 02/06/2023]
Abstract
The prevalence of cardiometabolic disorders in both women and men has increased worldwide and is linked to a rise in obesity and obesity-associated associated clustering of other cardiometabolic risk factors such as hypertension, impaired glucose regulation and dyslipidemia. However, the predominance of common types of cardiometabolic disorders such as heart failure, atrial fibrillation and ischemic heart disease is sex specific, and our identification of these and the underlying mechanisms is only just emerging. New evidence suggests that sex hormones, sex-specific molecular mechanisms and gender influence glucose and lipid metabolisms, as well as cardiac energy metabolism, and function. Here we review sex differences in cardiometabolic risk factors, associated preclinical and clinical cardiac disorders and potential therapeutic avenues.
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Affiliation(s)
- Eva Gerdts
- Department of Clinical Science, University of Bergen, Bergen, Norway.
| | - Vera Regitz-Zagrosek
- Berlin Institute for Gender in Medicine, Charité Universitätsmedizin, Berlin, Germany.,DZHK, partner site Berlin, Berlin, Germany
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20
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Ribeiro IS, Pereira ÍS, Santos DP, Lopes DN, Prado AO, Calado SP, Gonçalves CV, Galantini MP, Muniz IP, Santos GS, Silva RA. Association between body composition and inflammation: A central role of IL-17 and IL-10 in diabetic and hypertensive elderly women. Exp Gerontol 2019; 127:110734. [DOI: 10.1016/j.exger.2019.110734] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 07/30/2019] [Accepted: 09/09/2019] [Indexed: 12/13/2022]
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Winzap P, Davies A, Klingenberg R, Obeid S, Roffi M, Mach F, Räber L, Windecker S, Templin C, Nietlispach F, Nanchen D, Gencer B, Muller O, Matter CM, von Eckardstein A, Lüscher TF. Diabetes and baseline glucose are associated with inflammation, left ventricular function and short- and long-term outcome in acute coronary syndromes: role of the novel biomarker Cyr 61. Cardiovasc Diabetol 2019; 18:142. [PMID: 31672144 PMCID: PMC6824030 DOI: 10.1186/s12933-019-0946-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 10/11/2019] [Indexed: 02/07/2023] Open
Abstract
Background Hyperglycemia in the setting of an acute coronary syndrome (ACS) impacts short term outcomes, but little is known about longer term effects. We therefore designed this study to firstly determine the association between hyperglycemia and short term and longer term outcomes in patients presenting with ACS and secondly evaluate the prognostic role of diabetes, body mass index (BMI) and the novel biomarker Cyr61 on outcomes. Methods The prospective Special Program University Medicine-Acute Coronary Syndrome (SPUM-ACS) cohort enrolled 2168 patients with ACS between December 2009 and October 2012, of which 2034 underwent PCI (93.8%). Patients were followed up for 12 months. Events were independently adjudicated by three experienced cardiologists. Participants were recruited from four tertiary hospitals in Switzerland: Zurich, Geneva, Lausanne and Bern. Participants presenting with acute coronary syndromes and who underwent coronary angiography were included in the analysis. Patients were grouped according to history of diabetes (or HbA1c greater than 6%), baseline blood sugar level (BSL; < 6, 6–11.1 and > 11.1 mmol/L) and body mass index (BMI). The primary outcome was major adverse cardiac events (MACE) which was a composite of myocardial infarction, stroke and all-cause death. Secondary outcomes included the individual components of the primary endpoint, revascularisations, bleeding events (BARC classification) and cerebrovascular events (ischaemic or haemorrhagic stroke or TIA). Results Patients with hyperglycemia, i.e. BSL ≥ 11.1 mmol/L, had higher levels of C-reactive protein (CRP), white blood cell count (WBC), creatinine kinase (CK), higher heart rates and lower left ventricular ejection fraction (LVEF) and increased N-terminal pro-brain natriuretic peptide. At 30 days and 12 months, those with BSL ≥ 11.1 mmol/L had more MACE and death compared to those with BSL < 6.0 mmol/L or 6.0–11.1 mmol/L (HR-ratio 4.78 and 6.6; p < 0.001). The novel biomarker Cyr61 strongly associated with high BSL and STEMI and was independently associated with 1 year outcomes (HR 2.22; 95% CI 1.33–3.72; Tertile 3 vs. Tertile 1). Conclusions and relevance In this large, prospective, independently adjudicated cohort of in all comers ACS patients undergoing PCI, both a history of diabetes and elevated entry glucose was associated with inflammation and increased risk of MACE both at short and long-term. The mediators might involve increased sympathetic activation, inflammation and ischemia as reflected by elevated Cyr61 levels leading to larger levels of troponin and lower LVEF. Trial registration Clinical Trial Registration Number: NCT01000701. Registered October 23, 2009
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Affiliation(s)
- Patric Winzap
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
| | - Allan Davies
- Royal Brompton and Harefield Hospitals and Imperial College, Sydney Street, London, SW3 6NP, UK
| | - Roland Klingenberg
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - Slayman Obeid
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Zurich, Switzerland
| | - Marco Roffi
- Department of Cardiology, Hopital Universitaire de Geneve, Geneva, Switzerland
| | - François Mach
- Department of Cardiology, Hopital Universitaire de Geneve, Geneva, Switzerland
| | - Lorenz Räber
- Department of Cardiology, Swiss Heart Centre, Inselspital, Bern, Switzerland
| | - Stephan Windecker
- Department of Cardiology, Swiss Heart Centre, Inselspital, Bern, Switzerland
| | - Christian Templin
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Zurich, Switzerland
| | - Fabian Nietlispach
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Zurich, Switzerland
| | - David Nanchen
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Baris Gencer
- Department of Cardiology, Hopital Universitaire de Geneve, Geneva, Switzerland
| | - Olivier Muller
- Service of Cardiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Christian M Matter
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland.,Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Zurich, Switzerland
| | | | - Thomas F Lüscher
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland. .,Royal Brompton and Harefield Hospitals and Imperial College, Sydney Street, London, SW3 6NP, UK.
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Formentini FS, Zaina Nagano FE, Lopes Neto FDN, Adam EL, Fortes FS, Silva LFD. Coronary artery disease and body mass index: What is the relationship? Clin Nutr ESPEN 2019; 34:87-93. [PMID: 31677718 DOI: 10.1016/j.clnesp.2019.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 08/10/2019] [Accepted: 08/17/2019] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Nowadays, obesity is considered an independent risk factor for the development of cardiovascular diseases (CVD), which has been presented as an important cause of worldwide morbidity and mortality, especially coronary artery disease (CAD). The objective of the study was to verify the association between body mass index (BMI) and severity of CAD, its risk factors and surgical and percutaneous treatment in patients hospitalized in cardiological units. METHODS An ambispective, cross-sectional study was performed with patients older than 18 years attended by nutrition in the cardiology units, who underwent coronary angiography. The severity of CAD was categorized into two distinct classifications (CAD Class I and II), considering the presence of CAD as lesions ≥50% and ≥70%. The nutritional status of the patient was established based on BMI according to the World Health Organization (WHO) for the total sample and group of adults, and according to the Pan American Health Organization (PAHO) for the elderly. Age, gender, presence of associated comorbidities, history of smoking, and performed procedures were collected in patients' records. For statistical analysis Kruskal Wallis and Chi-square tests were used, and Hodges-Lehmann estimate was used for the median. Comparisons and associations were considered significant when p < 0.05. RESULTS A total of 703 patients were included, of which 495 had arterial lesions ≥70% and 513 patients' lesions ≥50%. The average age was 61 years, women were older (63 vs 61; p = 0.008), had a higher BMI (28.16 kg/m2 vs 26.68 kg/m2, p = 0.001) and were more likely to have diabetes mellitus (DM) (p < 0.001), dyslipidemia (DSLP) (p < 0.001), and hypertension (HTN) (p = 0.001). The majority of the sample consisted of men, who more often underwent percutaneous coronary intervention (PCI) (53,9% vs 39%, p < 0.001), and were more likely to present more severe CAD (p < 0.001 and p = 0.003). In patients diagnosed with CAD the increase in BMI was positively associated with the presence of DM (p < 0.001), DSLP (p < 0.001) and HTN (p < 0.001), and negatively with age (p = 0.007). Patients with obesity III, were diagnosed with CAD, in average, 11 years earlier than patients with normal BMI (p = 0.05). Therefore, the higher the BMI, the lower the age at the moment of the examination in the total sample, and in the group of elderly, and this association was not found in adults. There was no significant association of BMI with the severity of CAD, or with PCI and coronary artery bypass grafting (CABG). The greater severity of CAD was positively associated with the presence of DM (p = 0.012 and p = 0.001), HTN (p = 0.033 and p = 0.003) and older age (p = 0.005 and p = 0.015). Patients who underwent CABG had a higher incidence of and HTN (p = 0.003), DM (p = 0.006), whereas patients who had PCI had a lower incidence of HTN (p = 0.021) and DM (p = 0.004). CONCLUSION Obesity was showed to be as an independent risk factor for the early incidence of CAD, which is strongly associated with the presence of comorbidities such as DM, HTN and DSLP. The greater severity of CAD and coronary interventions were associated with the presence of risk factors for CAD.
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Affiliation(s)
- Franciane Silvana Formentini
- Clinical Hospital Complex of the Federal University of Paraná (CHC-UFPR), Nutrition Unit, 181 General Carneiro Street, Curitiba, Paraná, 80060-900, Brazil.
| | - Francisca Eugênia Zaina Nagano
- Clinical Hospital Complex of the Federal University of Paraná (CHC-UFPR), Nutrition Unit, 181 General Carneiro Street, Curitiba, Paraná, 80060-900, Brazil.
| | - Francisco Diego Negrão Lopes Neto
- Clinical Hospital Complex of the Federal University of Paraná (CHC-UFPR), Nutrition Unit, 181 General Carneiro Street, Curitiba, Paraná, 80060-900, Brazil.
| | - Eduardo Leal Adam
- Clinical Hospital Complex of the Federal University of Paraná (CHC-UFPR), Nutrition Unit, 181 General Carneiro Street, Curitiba, Paraná, 80060-900, Brazil.
| | - Fernanda Santos Fortes
- Clinical Hospital Complex of the Federal University of Paraná (CHC-UFPR), Nutrition Unit, 181 General Carneiro Street, Curitiba, Paraná, 80060-900, Brazil.
| | - Lannay Ferreira da Silva
- Clinical Hospital Complex of the Federal University of Paraná (CHC-UFPR), Nutrition Unit, 181 General Carneiro Street, Curitiba, Paraná, 80060-900, Brazil.
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Badimon L, Bugiardini R, Cenko E, Cubedo J, Dorobantu M, Duncker DJ, Estruch R, Milicic D, Tousoulis D, Vasiljevic Z, Vilahur G, de Wit C, Koller A. Position paper of the European Society of Cardiology-working group of coronary pathophysiology and microcirculation: obesity and heart disease. Eur Heart J 2019; 38:1951-1958. [PMID: 28873951 DOI: 10.1093/eurheartj/ehx181] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 04/28/2017] [Indexed: 12/15/2022] Open
Affiliation(s)
- Lina Badimon
- Cardiovascular Research Center (CSIC-ICCC), CIBERCV, and Biomedical Research Institute Sant Pau (IIB-Sant Pau), c/Sant Antoni M Claret 167, 08025 Barcelona, Spain.,Cardiovascular Research Chair UAB, Barcelona, Spain
| | - Raffaele Bugiardini
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Giuseppe Massarenti 9, 40138 Bologna, Italy
| | - Edina Cenko
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Giuseppe Massarenti 9, 40138 Bologna, Italy
| | - Judit Cubedo
- Cardiovascular Research Center (CSIC-ICCC), CIBERCV, and Biomedical Research Institute Sant Pau (IIB-Sant Pau), c/Sant Antoni MaClaret 167, 08025 Barcelona, Spain
| | - Maria Dorobantu
- Cardiology Department, University of Medicine and Pharmacy "Carol Davila" of Bucharest, Emergency Clinical Hospital of Bucharest, 8, Calea Floreasca, Sector 1, 014461 Bucuresti, Romania
| | - Dirk J Duncker
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Cardiovascular Research Institute COEUR, Erasmus University Medical Center, PO Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - Ramón Estruch
- Department of Internal Medicine, Hospital Clinic, IDIBAPS, University of Barcelona, Villarroel, 170, 08036 Barcelona, Spain.,CIBER Obesity and Nutrition, Instituto de Salud Carlos III, Spain
| | - Davor Milicic
- Department for Cardiovascular Diseases, University Hospital Center Zagreb, University of Zagreb, Kispaticeva 12, HR-10000 Zagreb, Croatia
| | - Dimitris Tousoulis
- First Department of Cardiology, Hippokration Hospital, University of Athens Medical School, Vasilissis Sofias 114, TK 115 28 Athens, Greece
| | - Zorana Vasiljevic
- Clinical Center of Serbia, University of Belgrade, Pasterova 2, 11000 Belgrade, Serbia
| | - Gemma Vilahur
- Cardiovascular Research Center (CSIC-ICCC), CIBERCV, and Biomedical Research Institute Sant Pau (IIB-Sant Pau), c/Sant Antoni MaClaret 167, 08025 Barcelona, Spain
| | - Cor de Wit
- Institut für Physiologie, Universität zu Lübeck and Deutsches Zentrumfür Herz-Kreislauf-Forschung (DZHK) e.V., partner site: Hamburg/Kiel/Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Akos Koller
- Institute of Natural Sciences, University of Physical Education, Alkotas street, 44, 1123 Budapest, Hungary.,Department of Physiology, New York Medical College, Valhalla, NY 10595, USA
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24
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Michaels AD, Mehaffey JH, Hawkins RB, Kern JA, Schirmer BD, Hallowell PT. Bariatric surgery reduces long-term rates of cardiac events and need for coronary revascularization: a propensity-matched analysis. Surg Endosc 2019; 34:2638-2643. [DOI: 10.1007/s00464-019-07036-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/24/2019] [Indexed: 02/04/2023]
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25
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Li L, Hou X, Geng X, Xu Y. Body mass index predicts aldosterone production in hypertensive postmenopausal women. Clin Exp Hypertens 2019; 42:281-286. [PMID: 31362536 DOI: 10.1080/10641963.2019.1649683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Hypertension is a common clinical problem, and increased aldosterone is the most prevalent underlying characteristic. Related works have shown exciting results on the effects of various conditions on aldosterone content, but the correlation between aldosterone levels and body mass index (BMI) in premenopausal women has not yet been investigated. We herein report a cross-sectional analysis aimed to determine whether BMI is proportional to plasma aldosterone concentration in premenopausal and postmenopausal hypertensive women. The analysis of consecutive admitted female patients with hypertension revealed potential relationships among plasma aldosterone concentration, plasma renin activity, oestrogen, and BMI. It should be noted that plasma aldosterone concentration was significantly correlated with BMI (p < .05) in postmenopausal women, and both plasma aldosterone and oestrogen levels were decreased in premenopausal women. These findings suggest that BMI has a positive impact on aldosterone in postmenopausal hypertensive women but not in premenopausal women. Additionally, we predict that endogenous oestrogen may be an important indication of aldosterone changes in premenopausal hypertensive women of different body weights.
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Affiliation(s)
- Lijun Li
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Xiaoling Hou
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Xiaowen Geng
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Yong Xu
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
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26
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Won KB, Lee SE, Lee BK, Park HB, Heo R, Rizvi A, Hadamitzky M, Kim YJ, Sung JM, Conte E, Andreini D, Pontone G, Budoff MJ, Gottlieb I, Chun EJ, Cademartiri F, Maffei E, Marques H, Leipsic JA, Shin S, Choi JH, Virmani R, Samady H, Stone PH, Berman DS, Narula J, Shaw LJ, Bax JJ, Min JK, Chang HJ. Longitudinal quantitative assessment of coronary plaque progression related to body mass index using serial coronary computed tomography angiography. Eur Heart J Cardiovasc Imaging 2019; 20:591-599. [DOI: 10.1093/ehjci/jey192] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 11/26/2018] [Indexed: 12/12/2022] Open
Affiliation(s)
- Ki-Bum Won
- Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
| | - Sang-Eun Lee
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
- Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
| | - Byoung Kwon Lee
- Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, South Korea
| | - Hyung-Bok Park
- Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
- Division of Cardiology, Catholic Kwandong University International St. Mary's Hospital, Incheon, South Korea
| | - Ran Heo
- Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
- Division of Cardiology, Hanyang University Seoul Hospital, Hanyang University College of Medicine, Seoul, South Korea
| | - Asim Rizvi
- Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, New York, NY, USA
| | - Martin Hadamitzky
- Division of Radiology and Nuclear Medicine, German Heart Center, Munich, Germany
| | - Yong-Jin Kim
- Seoul National University Hospital, Seoul, South Korea
| | - Ji Min Sung
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
- Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
| | | | | | | | - Matthew J Budoff
- Department of Medicine, Harbor UCLA Medical Center, Los Angeles, CA, USA
| | - Ilan Gottlieb
- Department of Radiology, Casa de Saude São Jose, Rio de Janeiro, Brazil
| | - Eun Ju Chun
- Seoul National University, Bundang Hospital, Seoul, South Korea
| | | | - Erica Maffei
- Department of Radiology, Area Vasta 1/ASUR Marche, Urbino, Italy
| | | | - Jonathon A Leipsic
- Department of Radiology, St Paul’s Hospital, University of British Columbia, Vancouver, Canada
| | - Sanghoon Shin
- National Health Insurance Service Ilsan Hospital, Gyeonggi-do, South Korea
| | | | - Renu Virmani
- Department of Pathology, CVPath Institute, Gaithersburg, MD, USA
| | - Habib Samady
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Peter H Stone
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Daniel S Berman
- Department of Imaging, Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jagat Narula
- Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, Zena and Michael A. Wiener Cardiovascular Institute, Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, New York, NY, USA
| | - Leslee J Shaw
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - James K Min
- Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, New York, NY, USA
| | - Hyuk-Jae Chang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
- Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
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27
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Miao L, Yin RX, Pan SL, Yang S, Yang DZ, Lin WX. Circulating miR-3659 may be a potential biomarker of dyslipidemia in patients with obesity. J Transl Med 2019; 17:25. [PMID: 30642348 PMCID: PMC6332685 DOI: 10.1186/s12967-019-1776-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 01/05/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The present study attempted to identify potential key genes and miRNAs of dyslipidemia in obese, and to investigate the possible mechanisms associated with them. METHODS The microarray data of GSE66676 were downloaded, including 67 obese samples from the Gene Expression Omnibus (GEO) database. The weighted gene co-expression network (WGCNA) analysis was performed using WGCNA package and grey60 module was considered as the highest correlation. Gene Ontology annotation and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses for this module were performed by clusterProfiler and DOSE package. A protein-protein interaction (PPI) network was established using Cytoscape software, and significant modules were analyzed using molecular complex detection. RESULTS Collagen type I alpha 1 chain gene (COL1A1) had the best significant meaning. After bioinformatic analysis, we identified four miRNAs (hsa-miR-3659, hsa-miR-4658, hsa-miR151a-5p and hsa-miR-151b) which can bind SNPs in 3'UTR in COL1A1. After validation with RT-qPCR, only two miRNAs (hsa-miR-3659 and hsa-miR151a-5p) had statistical significance. CONCLUSIONS The area of 0.806 for miR-3659 and 0.769 for miR-151a-5p under the ROC curve (AUC) may have good diagnostic value for dyslipidemia. Circulating miR-3659 may be a potential biomarker of dyslipidemia in patients with obesity.
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Affiliation(s)
- Liu Miao
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical University, Nanning, 530021 Guangxi People’s Republic of China
| | - Rui-Xing Yin
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical University, Nanning, 530021 Guangxi People’s Republic of China
| | - Shang-Ling Pan
- Department of Pathophysiology, School of Premedical Science, Guangxi Medical University, Nanning, 530021 Guangxi People’s Republic of China
| | - Shuo Yang
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical University, Nanning, 530021 Guangxi People’s Republic of China
| | - De-Zhai Yang
- Department of Molecular Genetics, Medical Scientific Research Center, Guangxi Medical University, Nanning, 530021 Guangxi People’s Republic of China
| | - Wei-Xiong Lin
- Department of Molecular Genetics, Medical Scientific Research Center, Guangxi Medical University, Nanning, 530021 Guangxi People’s Republic of China
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JAKICIC JOHNM, ROGERS RENEEJ, DONNELLY JOSEPHE. The Health Risks of Obesity Have Not Been Exaggerated. Med Sci Sports Exerc 2019; 51:222-225. [DOI: 10.1249/mss.0000000000001747] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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29
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Phenome-wide association studies across large population cohorts support drug target validation. Nat Commun 2018; 9:4285. [PMID: 30327483 PMCID: PMC6191429 DOI: 10.1038/s41467-018-06540-3] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 09/05/2018] [Indexed: 12/12/2022] Open
Abstract
Phenome-wide association studies (PheWAS) have been proposed as a possible aid in drug development through elucidating mechanisms of action, identifying alternative indications, or predicting adverse drug events (ADEs). Here, we select 25 single nucleotide polymorphisms (SNPs) linked through genome-wide association studies (GWAS) to 19 candidate drug targets for common disease indications. We interrogate these SNPs by PheWAS in four large cohorts with extensive health information (23andMe, UK Biobank, FINRISK, CHOP) for association with 1683 binary endpoints in up to 697,815 individuals and conduct meta-analyses for 145 mapped disease endpoints. Our analyses replicate 75% of known GWAS associations (P < 0.05) and identify nine study-wide significant novel associations (of 71 with FDR < 0.1). We describe associations that may predict ADEs, e.g., acne, high cholesterol, gout, and gallstones with rs738409 (p.I148M) in PNPLA3 and asthma with rs1990760 (p.T946A) in IFIH1. Our results demonstrate PheWAS as a powerful addition to the toolkit for drug discovery. Testing the association between genetic variants and a range of phenotypes can assist drug development. Here, in a phenome-wide association study in up to 697,815 individuals, Diogo et al. identify genotype–phenotype associations predicting efficacy, alternative indications or adverse drug effects.
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30
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Rodriguez-Granillo GA, Reynoso E, Capunay C, Carpio J, Carrascosa P. Pericardial and visceral, but not total body fat, are related to global coronary and extra-coronary atherosclerotic plaque burden. Int J Cardiol 2018; 260:204-210. [DOI: 10.1016/j.ijcard.2018.01.106] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 01/08/2018] [Accepted: 01/22/2018] [Indexed: 01/12/2023]
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31
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Chang X, Dorajoo R, Sun Y, Han Y, Wang L, Khor CC, Sim X, Tai ES, Liu J, Yuan JM, Koh WP, van Dam RM, Friedlander Y, Heng CK. Gene-diet interaction effects on BMI levels in the Singapore Chinese population. Nutr J 2018; 17:31. [PMID: 29477148 PMCID: PMC6389173 DOI: 10.1186/s12937-018-0340-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 02/14/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Recent genome-wide association studies (GWAS) have identified 97 body-mass index (BMI) associated loci. We aimed to evaluate if dietary intake modifies BMI associations at these loci in the Singapore Chinese population. METHODS We utilized GWAS information from six data subsets from two adult Chinese population (N = 7817). Seventy-eight genotyped or imputed index BMI single nucleotide polymorphisms (SNPs) that passed quality control procedures were available in all datasets. Alternative Healthy Eating Index (AHEI)-2010 score and ten nutrient variables were evaluated. Linear regression analyses between z score transformed BMI (Z-BMI) and dietary factors were performed. Interaction analyses were performed by introducing the interaction term (diet x SNP) in the same regression model. Analysis was carried out in each cohort individually and subsequently meta-analyzed using the inverse-variance weighted method. Analyses were also evaluated with a weighted gene-risk score (wGRS) contructed by BMI index SNPs from recent large-scale GWAS studies. RESULTS Nominal associations between Z-BMI and AHEI-2010 and some dietary factors were identified (P = 0.047-0.010). The BMI wGRS was robustly associated with Z-BMI (P = 1.55 × 10- 15) but not with any dietary variables. Dietary variables did not significantly interact with the wGRS to modify BMI associations. When interaction analyses were repeated using individual SNPs, a significant association between cholesterol intake and rs4740619 (CCDC171) was identified (β = 0.077, adjPinteraction = 0.043). CONCLUSIONS The CCDC171 gene locus may interact with cholesterol intake to increase BMI in the Singaporean Chinese population, however most known obesity risk loci were not associated with dietary intake and did not interact with diet to modify BMI levels.
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Affiliation(s)
- Xuling Chang
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore; and Khoo Teck Puat - National University Children's Medical Institute, National University Health System, NUHS Tower Block, Level 12, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - Rajkumar Dorajoo
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| | - Ye Sun
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yi Han
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore; and Khoo Teck Puat - National University Children's Medical Institute, National University Health System, NUHS Tower Block, Level 12, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - Ling Wang
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| | - Chiea-Chuen Khor
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - E-Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jianjun Liu
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jian-Min Yuan
- Department of Epidemiology, Graduate School of Public Health; and University of Pittsburgh Cancer Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Woon-Puay Koh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Duke-NUS Medical School Singapore, Singapore, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yechiel Friedlander
- School of Public Health and Community Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. .,Unit of Epidemiology, Hebrew University-Hadassah Braun School of Public Health, POB 12272, 91120, Jerusalem, Israel.
| | - Chew-Kiat Heng
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore; and Khoo Teck Puat - National University Children's Medical Institute, National University Health System, NUHS Tower Block, Level 12, 1E Kent Ridge Road, Singapore, 119228, Singapore.
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Giannopoulos AA, Giannoglou GD, Chatzizisis YS. Predicting Coronary Atherosclerotic Plaque Burden From Clinical Parameters: Bringing Old Knowledge in the Game. Angiology 2017; 69:367-369. [PMID: 28877595 DOI: 10.1177/0003319717729290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Andreas A Giannopoulos
- 1 Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.,2 Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | | | - Yiannis S Chatzizisis
- 3 Cardiovascular Biology and Biomechanics Laboratory, Cardiovascular Division, University of Nebraska Medical Center, Omaha, NE, USA
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Liang Y, Kelemen A. Shared polymorphisms and modifiable behavior factors for myocardial infarction and high cholesterol in a retrospective population study. Medicine (Baltimore) 2017; 96:e7683. [PMID: 28906356 PMCID: PMC5604625 DOI: 10.1097/md.0000000000007683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Genetic and environmental (behavior, clinical, and demographic) factors are associated with increased risks of both myocardial infarction (MI) and high cholesterol (HC). It is known that HC is major risk factor that may cause MI. However, whether there are common single nucleotide polymorphism (SNPs) associated with both MI and HC is not firmly established, and whether there are modulate and modified effects (interactions of genetic and known environmental factors) on either HC or MI, and whether these joint effects improve the predictions of MI, is understudied.The purpose of this study is to identify novel shared SNPs and modifiable environmental factors on MI and HC. We assess whether SNPs from a metabolic pathway related to MI may relate to HC; whether there are moderate effects among SNPs, lifestyle (smoke and drinking), HC, and MI after controlling other factors [gender, body mass index (BMI), and hypertension (HTN)]; and evaluate prediction power of the joint and modulate genetic and environmental factors influencing the MI and HC.This is a retrospective study with residents of Erie and Niagara counties in New York with a history of MI or with no history of MI. The data set includes environmental variables (demographic, clinical, lifestyle). Thirty-one tagSNPs from a metabolic pathway related to MI are genotyped. Generalized linear models (GLMs) with imputation-based analysis are conducted for examining the common effects of tagSNPs and environmental exposures and their interactions on having a history of HC or MI.MI, BMI, and HTN are significant risk factors for HC. HC shows the strongest effect on risk of MI in addition to HTN; gender and smoking status while drinking status shows protective effect on MI. rs16944 (gene IL-1β) and rs17222772 (gene ALOX) increase the risks of HC, while rs17231896 (gene CETP) has protective effects on HC either with or without the clinical, behavioral, demographic factors with different effect sizes that may indicate the existence of moderate or modifiable effects. Further analysis with the inclusions of gene-gene and gene-environmental interactions shows interactions between rs17231896 (CETP) and rs17222772 (ALOX); rs17231896 (CETP) and gender. rs17237890 (CETP) and rs2070744 (NOS3) are found to be significantly associated with risks of MI adjusted by both SNPs and environmental factors. After multiple testing adjustments, these effects diminished as expected. In addition, an interaction between drinking and smoking status is significant. Overall, the prediction power in successfully classifying MI status is increased to 80% with inclusions of all significant tagSNPs and environmental factors and their interactions compared with environmental factors only (72%).Having a history of either HC or MI has significant effects on each other in both directions, in addition to HTN and gender. Genes/SNPs identified from this analysis that are associated with HC may be potentially linked to MI, which could be further examined and validated through haplotype-pairs analysis with appropriate population stratification corrections, and function/pathway regulation analysis to eliminate the limitations of the current analysis.
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Affiliation(s)
| | - Arpad Kelemen
- Department of Organizational Systems and Adult Health, University of Maryland, Baltimore, MD
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Alosco ML, Duskin J, Besser LM, Martin B, Chaisson CE, Gunstad J, Kowall NW, McKee AC, Stern RA, Tripodis Y. Modeling the Relationships Among Late-Life Body Mass Index, Cerebrovascular Disease, and Alzheimer's Disease Neuropathology in an Autopsy Sample of 1,421 Subjects from the National Alzheimer's Coordinating Center Data Set. J Alzheimers Dis 2017; 57:953-968. [PMID: 28304301 DOI: 10.3233/jad-161205] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The relationship between late-life body mass index (BMI) and Alzheimer's disease (AD) is poorly understood due to the lack of research in samples with autopsy-confirmed AD neuropathology (ADNP). The role of cerebrovascular disease (CVD) in the interplay between late-life BMI and ADNP is unclear. We conducted a retrospective longitudinal investigation and used joint modeling of linear mixed effects to investigate causal relationships among repeated antemortem BMI measurements, CVD (quantified neuropathologically), and ADNP in an autopsy sample of subjects across the AD clinical continuum. The sample included 1,421 subjects from the National Alzheimer's Coordinating Center's Uniform Data Set and Neuropathology Data Set with diagnoses of normal cognition (NC; n = 234), mild cognitive impairment (MCI; n = 201), or AD dementia (n = 986). ADNP was defined as moderate to frequent neuritic plaques and Braak stageIII-VI. Ischemic Injury Scale (IIS) operationalized CVD. Joint modeling examined relationships among BMI, IIS, and ADNP in the overall sample and stratified by initial visit Clinical Dementia Rating score. Subject-specific random intercept for BMI was the predictor for ADNP due to minimal BMI change (p = 0.3028). Analyses controlling for demographic variables and APOE ɛ4 showed lower late-life BMI predicted increased odds of ADNP in the overall sample (p < 0.001), and in subjects with CDR of 0 (p = 0.0021) and 0.5 (p = 0.0012), but not ≥1.0 (p = 0.2012). Although higher IIS predicted greater odds of ADNP (p < 0.0001), BMI did not predict IIS (p = 0.2814). The current findings confirm lower late-life BMI confers increased odds for ADNP. Lower late-life BMI may be a preclinical indicator of underlying ADNP.
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Affiliation(s)
- Michael L Alosco
- Boston University Alzheimer's Disease and CTE Center, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Jonathan Duskin
- Boston University Alzheimer's Disease and CTE Center, Boston University School of Medicine, Boston, MA, USA
| | - Lilah M Besser
- National Alzheimer's Coordinating Center, University of Washington, Seattle, WA, USA
| | - Brett Martin
- Boston University Alzheimer's Disease and CTE Center, Boston University School of Medicine, Boston, MA, USA.,Data Coordinating Center, Boston University School of Public Health, Boston, MA, USA
| | - Christine E Chaisson
- Boston University Alzheimer's Disease and CTE Center, Boston University School of Medicine, Boston, MA, USA.,Data Coordinating Center, Boston University School of Public Health, Boston, MA, USA
| | - John Gunstad
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Neil W Kowall
- Boston University Alzheimer's Disease and CTE Center, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston University School of Medicine, Boston, MA, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA.,Neurology Service, VA Boston Healthcare System, Boston, MA, USA
| | - Ann C McKee
- Boston University Alzheimer's Disease and CTE Center, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston University School of Medicine, Boston, MA, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA.,VA Boston Healthcare System, U.S. Department of Veteran Affairs, Boston, MA, USA.,Department of Veterans Affairs Medical Center, Bedford, MA, USA
| | - Robert A Stern
- Boston University Alzheimer's Disease and CTE Center, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston University School of Medicine, Boston, MA, USA.,Departments of Neurosurgery and Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Yorghos Tripodis
- Boston University Alzheimer's Disease and CTE Center, Boston University School of Medicine, Boston, MA, USA.,Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
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Vreman RA, Goodell AJ, Rodriguez LA, Porco TC, Lustig RH, Kahn JG. Health and economic benefits of reducing sugar intake in the USA, including effects via non-alcoholic fatty liver disease: a microsimulation model. BMJ Open 2017; 7:e013543. [PMID: 28775179 PMCID: PMC5577881 DOI: 10.1136/bmjopen-2016-013543] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 06/20/2017] [Accepted: 06/21/2017] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Excessive consumption of added sugars in the human diet has been associated with obesity, type 2 diabetes (T2D), coronary heart disease (CHD) and other elements of the metabolic syndrome. Recent studies have shown that non-alcoholic fatty liver disease (NAFLD) is a critical pathway to metabolic syndrome. This model assesses the health and economic benefits of interventions aimed at reducing intake of added sugars. METHODS Using data from US National Health Surveys and current literature, we simulated an open cohort, for the period 2015-2035. We constructed a microsimulation model with Markov chains for NAFLD (including steatosis, non-alcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma (HCC)), body mass index, T2D and CHD. We assessed reductions in population disease prevalence, disease-attributable disability-adjusted life years (DALYs) and costs, with interventions that reduce added sugars consumption by either 20% or 50%. FINDINGS The model estimated that a 20% reduction in added sugars intake will reduce prevalence of hepatic steatosis, NASH, cirrhosis, HCC, obesity, T2D and CHD. Incidence of T2D and CHD would be expected to decrease by 19.9 (95% CI 12.8 to 27.0) and 9.4 (95% CI 3.1 to 15.8) cases per 100 000 people after 20 years, respectively. A 20% reduction in consumption is also projected to annually avert 0.767 million (M) DALYs (95% CI 0.757M to 0.777M) and a total of US$10.3 billion (B) (95% CI 10.2B to 10.4B) in discounted direct medical costs by 2035. These effects increased proportionally when added sugars intake were reduced by 50%. CONCLUSIONS The decrease in incidence and prevalence of disease is similar to results in other models, but averted costs and DALYs were higher, mainly due to inclusion of NAFLD and CHD. The model suggests that efforts to reduce consumption of added sugars may result in significant public health and economic benefits.
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Affiliation(s)
- Rick A Vreman
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, California, USA
| | - Alex J Goodell
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, California, USA
| | - Luis A Rodriguez
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Travis C Porco
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
- FI Proctor Foundation for Research in Ophthalmology, University of California, San Francisco, California, USA
| | - Robert H Lustig
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, California, USA
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - James G Kahn
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, California, USA
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Classical determinants of coronary artery disease as predictors of complexity of coronary lesions, assessed with the SYNTAX score. Neth Heart J 2017; 25:490-497. [PMID: 28593492 PMCID: PMC5571593 DOI: 10.1007/s12471-017-1005-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background We need new biomarkers that can predict cardiovascular disease to improve both diagnosis and therapeutic strategies. The CIRCULATING CELLS study was designed to study the role of several cellular mediators of atherosclerosis as biomarkers of coronary artery disease (CAD). An objective and reproducible method for the quantification of CAD extension is required to establish relationships with these potential biomarkers. We sought to analyse the correlation of the SYNTAX score with known CAD risk factors to test it as a valid marker of CAD extension. Methods and results A subgroup of 279 patients (67.4% males) were included in our analysis. Main exclusion criteria were a history of previous percutaneous coronary intervention or surgical revascularisation that prevent an accurate assessment of the SS. Diabetes mellitus, smoking, renal insufficiency, body mass index and a history of CAD and myocardial infarction were all positively and strongly associated with a higher SYNTAX score after adjustment for the non-modifiable biological factors (age and sex). In the multivariate model, age and male sex, along with smoking and renal insufficiency, remain statistical significantly associated with the SYNTAX score. Conclusion In a selected cohort of revascularisation-naive patients with CAD undergoing coronary angiography, non-modifiable cardiovascular risk factors such as advanced age, male sex, as well as smoking and renal failure were independently associated with CAD complexity assessed by the SYNTAX score. The SYNTAX score may be a valid marker of CAD extension to establish relationships with potential novel biomarkers of coronary atherosclerosis.
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Hulten EA, Bittencourt MS, Preston R, Singh A, Romagnolli C, Ghoshhajra B, Shah R, Abbasi S, Abbara S, Nasir K, Blaha M, Hoffmann U, Di Carli MF, Blankstein R. Obesity, metabolic syndrome and cardiovascular prognosis: from the Partners coronary computed tomography angiography registry. Cardiovasc Diabetol 2017; 16:14. [PMID: 28122619 PMCID: PMC5264456 DOI: 10.1186/s12933-017-0496-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 01/12/2017] [Indexed: 12/14/2022] Open
Abstract
Objective To investigate the relationship among body mass index (BMI), cardiometabolic risk and coronary artery disease (CAD) among patients undergoing coronary computed tomography angiography (CTA). Methods Retrospective cohort study of 1118 patients, who underwent coronary CTA at two centers from September 2004 to October 2011. Coronary CTA were categorized as normal, nonobstructive CAD (<50%), or obstructive CAD (≥50%) in addition to segment involvement (SIS) and stenosis scores. Extensive CAD was defined as SIS > 4. Association of BMI with cardiovascular prognosis was evaluated using multivariable fractional polynomial models. Results Mean age of the cohort was 57 ± 13 years with median follow-up of 3.2 years. Increasing BMI was associated with MetS (OR 1.28 per 1 kg/m2, p < 0.001) and burden of CAD on a univariable basis, but not after multivariable adjustment. Prognosis demonstrated a J-shaped relationship with BMI. For BMI from 20–39.9 kg/m2, after adjustment for age, gender, and smoking, MetS (HR 2.23, p = 0.009) was more strongly associated with adverse events. Conclusions Compared to normal BMI, there was an increased burden of CAD for BMI > 25 kg/m2. Within each BMI category, metabolically unhealthy patients had greater extent of CAD, as measured by CCTA, compared to metabolically healthy patients.
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Affiliation(s)
- Edward A Hulten
- Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Cardiology Service, Division of Medicine, Walter Reed National Military Medical Center and Uniformed Services University of Health Sciences, Bethesda, MD, USA
| | - Marcio Sommer Bittencourt
- Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Ryan Preston
- Division of Medicine, Walter Reed National Military Medical Center and Uniformed Services University of Health Sciences, Bethesda, MD, USA
| | - Avinainder Singh
- Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Carla Romagnolli
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Brian Ghoshhajra
- Cardiac MR PET CT Program, Department of Radiology, Division of Cardiac Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ravi Shah
- Cardiology Division, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Siddique Abbasi
- Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Suhny Abbara
- Cardiothoracic Imaging Division, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9316, USA
| | - Khurram Nasir
- Center for Wellness and Prevention Research, Baptist Health South Florida, Miami, FL, USA
| | - Michael Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
| | - Udo Hoffmann
- Cardiac MR PET CT Program, Department of Radiology, Division of Cardiac Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Marcelo F Di Carli
- Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ron Blankstein
- Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. .,Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA.
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Mangili LC, Mangili OC, Bittencourt MS, Miname MH, Harada PH, Lima LM, Rochitte CE, Santos RD. Epicardial fat is associated with severity of subclinical coronary atherosclerosis in familial hypercholesterolemia. Atherosclerosis 2016; 254:73-77. [DOI: 10.1016/j.atherosclerosis.2016.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 09/08/2016] [Accepted: 09/09/2016] [Indexed: 12/22/2022]
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Atique SM, Shadbolt B, Marley P, Farshid A. Association Between Body Mass Index and Age of Presentation With Symptomatic Coronary Artery Disease. Clin Cardiol 2016; 39:653-657. [PMID: 27431761 DOI: 10.1002/clc.22576] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 06/11/2016] [Accepted: 06/21/2016] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Obesity is increasingly recognized as an important risk factor for coronary artery disease (CAD). HYPOTHESIS Patients with increased body mass index (BMI) present at a younger age with symptomatic CAD. METHODS We analyzed data on 2137 consecutive patients admitted for treatment of CAD proven on angiography from 2010 to 2013, excluding those with prior coronary intervention or bypass surgery. RESULTS Mean age was 64.1 ± 12.4 years; 75% were male; 43.6% were overweight (BMI 25-29.9 kg/m2 ) and 31.6% were obese (BMI ≥30 kg/m2 ). Patients with BMI ≥25 kg/m2 compared with <25 kg/m2 were more likely to have diabetes (24.5% vs 13.6%), hypertension (56.2% vs 45.5%), and hyperlipidemia (42.4% vs 31.6%; P < 0.0001 for all). On multivariate analysis adjusted for sex and cardiovascular risk factors, patients in higher BMI categories had lower mean age in a linear and stepwise fashion compared with those with normal BMI (P < 0.0001). For example, compared with patients with normal BMI, those with BMI of 35 to 39.9 kg/m2 were on average 9.2 years younger (P < 0.0001). Multivariate analysis examining the interaction between sex and BMI produced similar results for effect of BMI on age of presentation (P = 0.97 for interaction). CONCLUSIONS After multivariate adjustment, patients with increased BMI presented at an earlier age with symptomatic CAD compared with patients with normal BMI. Primary prevention efforts in those with increased BMI to reduce risk-factor burden, including evidence-based treatments for weight reduction, promise to reduce risk or delay onset of CAD.
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Affiliation(s)
- Syed M Atique
- Department of Cardiology, The Canberra Hospital, Canberra, Australia
| | - Bruce Shadbolt
- College of Medicine, Biology and Environment, Australian National University, Canberra, Australia
| | - Paul Marley
- Department of Cardiology, The Canberra Hospital, Canberra, Australia
| | - Ahmad Farshid
- Department of Cardiology, The Canberra Hospital, Canberra, Australia.,College of Medicine, Biology and Environment, Australian National University, Canberra, Australia
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Association of single nucleotide polymorphism rs2076185 in chromosome 6P24.1 with premature coronary artery diseases in Chinese Han population. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2016; 13:138-44. [PMID: 27168739 PMCID: PMC4854952 DOI: 10.11909/j.issn.1671-5411.2016.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To study the association of single nucleotide polymorphism (SNP) rs2076185 in chromosome 6p24.1 with the premature coronary artery diseases (PCAD) in Chinese Han population. METHODS A total of 1382 patients were divided into the PCAD group and the control group based on their coronary arteriography (CAG) results. Their SNP rs2076185 were analyzed by the mass-spectrometry. Their allele and genotype frequency in Hardy-Weinberg equilibrium were calculated for assessment. Logistic regression was employed to remove confounding factors and correlate SNP rs2076185 with PCAD. RESULTS The allele and genotype frequencies of the control group were in Hardy-Weinberg equilibrium (P > 0.05). The frequencies of allele G of rs2076185 were 54.2% in the PCAD group and 49.5% in the control group. The difference was significant (P = 0.042). The genotype distribution of rs2076185 of the two groups was also significantly different. The univariate analysis showed that the rs2076185 polymorphisms were associated with the PCAD only in the additive model (OR: 0.828, 95% CI: 0.711-0.964, P = 0.014), and in the dominant model (OR: 0.753, 95% CI: 0.591-0.958, P = 0.021). After removing the confounding variables, the rs2076185 polymorphisms was associated with PCAD in the additive model (OR: 0.775, 95% CI: 0.648-0.928, P = 0.005), in the dominant model (OR: 0.698, 95% CI: 0.527-0.925, P = 0.012), and in the recessive model (OR: 0.804, 95% CI: 0.538-0.983, P = 0.038). CONCLUSION Allele G of rs2076185 reduces the PCAD risks in Chinese Han population, therefore it could be a coronary artery diseases protective factor in Chinese Han population.
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Coronary computed tomography angiography investigation of the association between left main coronary artery bifurcation angle and risk factors of coronary artery disease. Int J Cardiovasc Imaging 2016; 32 Suppl 1:129-37. [DOI: 10.1007/s10554-016-0884-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 03/24/2016] [Indexed: 10/22/2022]
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Ren M, Sun K, Li F, Qi YQ, Lin DZ, Li N, Li Y, Yan L. Association between obesity measures and albuminuria: A population-based study. J Diabetes Complications 2016; 30:451-6. [PMID: 26831203 DOI: 10.1016/j.jdiacomp.2015.12.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 11/25/2015] [Accepted: 12/09/2015] [Indexed: 12/29/2022]
Abstract
AIMS The effects of obesity on the micro vascular diseases have drawn much attention. The aim of the study was to investigate the relationship between obesity measures and albuminuria in Chinese population. METHODS We conducted a population-based cross-sectional study in 8600 subjects aged 40 years or older from a community in Guangzhou. Urinary albumin excretion and creatinine were measured and urinary albumin-to-creatinine ratio (ACR) was calculated as urinary albumin divided by creatinine. Low-grade albuminuria was classified as the highest quartile of ACR in participants without increased urinary albumin excretion. Increased urinary albumin excretion was defined according to the ACR ranges greater or equal than 30 mg/g. RESULTS Pearson's correlation analysis and multivariate linear regression analysis revealed that body mass index (BMI), waist circumference and body fat content were significantly correlated with ACR (all P<0.01). Prevalence of low-grade albuminuria and increased urinary albumin excretion gradually increased across the BMI, waist circumference and body fat content quartiles (all P for trend<0.0001). Compared with participants in quartile 1 of BMI, waist circumference and body fat content, participants in quartile 4 had increased prevalence of low-grade albuminuria and increased urinary albumin excretion in logistic regression analysis after adjustment for age, sex, physical activity, fasting plasma glucose, triglycerides, low-density lipoprotein cholesterol and HbA1c (all P<0.05). CONCLUSION Obesity measures are associated with urinary albumin excretion in middle-aged and elderly Chinese.
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Affiliation(s)
- Meng Ren
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China
| | - Kan Sun
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China
| | - Feng Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China
| | - Yi Qin Qi
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China
| | - Diao Zhu Lin
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China
| | - Na Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China
| | - Yan Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China
| | - Li Yan
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China.
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Vijayakumar M, Vasudevan DM, Sundaram KR, Krishnan S, Vaidyanathan K, Nandakumar S, Chandrasekhar R, Mathew N. A randomized study of coconut oil versus sunflower oil on cardiovascular risk factors in patients with stable coronary heart disease. Indian Heart J 2016; 68:498-506. [PMID: 27543472 PMCID: PMC4990731 DOI: 10.1016/j.ihj.2015.10.384] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 10/28/2015] [Indexed: 01/08/2023] Open
Abstract
Background and rationale Coronary artery disease (CAD) and its pathological atherosclerotic process are closely related to lipids. Lipids levels are in turn influenced by dietary oils and fats. Saturated fatty acids increase the risk for atherosclerosis by increasing the cholesterol level. This study was conducted to investigate the impact of cooking oil media (coconut oil and sunflower oil) on lipid profile, antioxidant mechanism, and endothelial function in patients with established CAD. Design and methods In a single center randomized study in India, patients with stable CAD on standard medical care were assigned to receive coconut oil (Group I) or sunflower oil (Group II) as cooking media for 2 years. Anthropometric measurements, serum, lipids, Lipoprotein a, apo B/A-1 ratio, antioxidants, flow-mediated vasodilation, and cardiovascular events were assessed at 3 months, 6 months, 1 year, and 2 years. Results Hundred patients in each arm completed 2 years with 98% follow-up. There was no statistically significant difference in the anthropometric, biochemical, vascular function, and in cardiovascular events after 2 years. Conclusion Coconut oil even though rich in saturated fatty acids in comparison to sunflower oil when used as cooking oil media over a period of 2 years did not change the lipid-related cardiovascular risk factors and events in those receiving standard medical care.
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Affiliation(s)
- Maniyal Vijayakumar
- Professor of Cardiology, Amrita Institute of Medical Sciences and Research Centre (Amrita Vishwa Vidyapeetham University), AIMS Ponekkara P.O., Kochi, Kerala, India.
| | - D M Vasudevan
- Professor Biochemistry, Amrita Institute of Medical Sciences and Research Centre (Amrita Vishwa Vidyapeetham University), AIMS Ponekkara P.O., Kochi, Kerala, India
| | - K R Sundaram
- Professor Biostatistics, Amrita Institute of Medical Sciences and Research Centre (Amrita Vishwa Vidyapeetham University), AIMS Ponekkara P.O., Kochi, Kerala, India
| | - Sajitha Krishnan
- Professor Biochemistry, Amrita Institute of Medical Sciences and Research Centre (Amrita Vishwa Vidyapeetham University), AIMS Ponekkara P.O., Kochi, Kerala, India
| | - Kannan Vaidyanathan
- Associate Professor, Department of Biochemistry, Amrita Institute of Medical Sciences and Research Center (Amrita Vishwa Vidaypeetham University), India
| | - Sandya Nandakumar
- Research Fellow, Amrita Institute of Medical Sciences and Research Centre (Amrita Vishwa Vidyapeetham University), AIMS Ponekkara P.O., Kochi, Kerala, India
| | - Rajiv Chandrasekhar
- Professor of Cardiology, Amrita Institute of Medical Sciences and Research Centre (Amrita Vishwa Vidyapeetham University), AIMS Ponekkara P.O., Kochi, Kerala, India
| | - Navin Mathew
- Professor of Cardiology, Amrita Institute of Medical Sciences and Research Centre (Amrita Vishwa Vidyapeetham University), AIMS Ponekkara P.O., Kochi, Kerala, India
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Goh R, Darvall J, Wynne R, Tatoulis J. Obesity Prevalence and Associated Outcomes in Cardiothoracic Patients: A Single-Centre Experience. Anaesth Intensive Care 2016; 44:77-84. [DOI: 10.1177/0310057x1604400112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The objective of this study was to investigate the prevalence of obesity and its relationship with adverse outcomes in ICU cardiothoracic patients. We performed a retrospective analysis of cardiothoracic patients admitted to The Royal Melbourne Hospital ICU between 2002 and 2014. Eight thousand and sixty-four patients who underwent coronary artery bypass, valve replacement/repair, or both, were divided into six categories of body mass index using World Health Organization criteria. Prevalence of obesity over time in the ICU was measured and compared to prevalence of obesity in the adult Australian population. The association between obesity and adverse postoperative outcomes was then analysed. Obesity is currently 1.2 times more prevalent in the Royal Melbourne Hospital ICU cardiothoracic patients than in the adult Australian population, with 33.5% of patients having a body mass index ≥30 kg/m2. Over time, this was relatively constant, but an increasing proportion were morbidly obese. Obesity, but not morbid obesity, was associated with reduced 30-day mortality (odds ratio [OR] 0.41). Both obese and morbidly obese patients had reduced odds of return to theatre for bleeding (OR 0.49 and OR 0.19, respectively), but increased odds of new-onset renal failure (OR 1.62 and OR 3.17, respectively). Morbidly obese patients had double the odds of an ICU stay longer than 14 days (OR 2.05). In summary, a growing proportion of our obese ICU patients are morbidly obese, with a dramatically increased length of ICU stay. This has major implications for resource allocation in the ICU, and may inform modelling of future bed utilisation. Obesity, but not morbid obesity, conferred a mortality benefit.
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Affiliation(s)
- R. Goh
- Intensive Care Unit, Royal Melbourne Hospital, Parkville, Victoria
| | - J. Darvall
- Department of Anaesthesia and Pain Management and Intensive Care Unit, Royal Melbourne Hospital and Senior Lecturer in Medical Education – Critical Care, University of Melbourne, Melbourne, Victoria
| | - R. Wynne
- Department of Cardiothoracic Surgery, Royal Melbourne Hospital and Senior Lecturer, Department of Nursing, University of Melbourne, Parkville, Victoria
| | - J. Tatoulis
- Department of Cardiothoracic Surgery, Royal Melbourne Hospital and University of Melbourne, Parkville, Victoria
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Prevalent Long-Term Trends of Hypertension in Austria: The Impact of Obesity and Socio-Demography. PLoS One 2015; 10:e0140461. [PMID: 26469176 PMCID: PMC4607455 DOI: 10.1371/journal.pone.0140461] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 09/25/2015] [Indexed: 12/31/2022] Open
Abstract
Background Globally there are only less long-term-studies on hypertension available to provide reliable estimates and identify risk groups. This study aims to analyse the prevalence and long-term-trend of hypertension in Austria, recognize affected subpopulations and investigate social inequalities. Methods This representative population-based study is based on self-reported data of adults (mean age: 47.7 ± 17.5; n = 178,818) that were taken from five health surveys between 1973 and 2007. An adjustment of self-reported BMI was performed based on a preliminary validation study. Absolute changes (AC) and aetiologic fractions (AF) were calculated from logistic regressions in order to measure trends. To quantify the extent of social inequality, a relative index of inequality (RII) was computed. Results During the study period the age-standardized hypertension prevalence increased from 1.0% to 18.8%, with a considerable rise from 1991 onwards. There was a positive trend in all subpopulations, with the highest AC among obese women (+50.2%) and obese subjects aged 75 years and older (+54.4%), whereas the highest risk was observed among the youngest obese adults (AF: 99.4%). The RII for hypertension was higher for women than men, but in general unstable during the investigation period. Conclusions Obesity and older age are significant factors for increased morbidity of hypertension. The most undesirable trends occurred in obese women and obese subjects aged 75 years and older. These risk groups should be given special attention when planning hypertension prevention programs. The high increase in the prevalence of hypertension is due to different aspects, e.g. a demographic change and a change in the definition of hypertension. These findings help to understand why hypertension is becoming more common in the Austrian population.
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Comparison of 2-year mortality according to obesity in stabilized patients with type 2 diabetes mellitus after acute myocardial infarction: results from the DIAMOND prospective cohort registry. Cardiovasc Diabetol 2015; 14:141. [PMID: 26471283 PMCID: PMC4608118 DOI: 10.1186/s12933-015-0305-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 10/09/2015] [Indexed: 12/22/2022] Open
Abstract
Background After acute myocardial infarction (AMI), the replicated phenomenon of obesity paradox, i.e., obesity appearing to be associated with increased survival, has not been evaluated in stabilized (i.e., without clinical events within 1 month post AMI) Asian patients with diabetes mellitus (DM). Methods Among 1192 patients in the DIabetic Acute Myocardial InfarctiON Disease (DIAMOND) Korean multicenter registry between April 2010 and June 2012, 2-year cardiac and all-cause death were compared according to obesity (body mass index ≥25 kg/m2) in 1125 stabilized DM patients. Results Compared with non-obese DM patients (62 % of AMI patients), obese DM patients had: higher incidence of dyslipidemia (31 vs. 24 %, P < 0.01); lower incidence of chronic kidney disease (26 vs. 33 %) (P < 0.01); higher left ventricular ejection fraction after AMI (53 ± 11 vs. 50 ± 12 %, P < 0.001); and lower 2-year cardiac and all-cause death occurrence (0.7 vs. 3.6 % and 1.9 vs. 5.2 %, both P < 0.01) and cumulative incidence in Kaplan–Meier analysis (P < 0.005, respectively). Likewise, both univariate and multivariate Cox hazard regression analyses adjusted for the respective confounders showed that obesity was associated with decreased risk of both cardiac [HR, 0.18 (95 % CI 0.06–0.60), P = 0.005; and 0.24 (0.07–0.78), P = 0.018, respectively] and all-cause death [0.34 (0.16–0.73), P = 0.005; and 0.44 (0.20–0.95), P = 0.038]. Conclusions In a Korean population of stabilized DM patients after AMI, non-obese patients appear to have higher cardiac and all-cause mortality compared with obese patients after adjusting for confounding factors. Electronic supplementary material The online version of this article (doi:10.1186/s12933-015-0305-1) contains supplementary material, which is available to authorized users.
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Tanami Y, Jinzaki M, Kishi S, Matheson M, Vavere AL, Rochitte CE, Dewey M, Chen MY, Clouse ME, Cox C, Kuribayashi S, Lima JAC, Arbab-Zadeh A. Lack of association between epicardial fat volume and extent of coronary artery calcification, severity of coronary artery disease, or presence of myocardial perfusion abnormalities in a diverse, symptomatic patient population: results from the CORE320 multicenter study. Circ Cardiovasc Imaging 2015; 8:e002676. [PMID: 25752899 DOI: 10.1161/circimaging.114.002676] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Epicardial fat may play a role in the pathogenesis of coronary artery disease (CAD). We explored the relationship of epicardial fat volume (EFV) with the presence and severity of CAD or myocardial perfusion abnormalities in a diverse, symptomatic patient population. METHODS AND RESULTS Patients (n=380) with known or suspected CAD who underwent 320-detector row computed tomographic angiography, nuclear stress perfusion imaging, and clinically driven invasive coronary angiography for the CORE320 international study were included. EFV was defined as adipose tissue within the pericardial borders as assessed by computed tomography using semiautomatic software. We used linear and logistic regression models to assess the relationship of EFV with coronary calcium score, stenosis severity by quantitative coronary angiography, and myocardial perfusion abnormalities by single photon emission computed tomography (SPECT). Median EFV among patients (median age, 62.6 years) was 102 cm(3) (interquartile range: 53). A coronary calcium score of ≥1 was present in 83% of patients. Fifty-nine percent of patients had ≥1 coronary artery stenosis of ≥50% by quantitative coronary angiography, and 49% had abnormal myocardial perfusion results by SPECT. There were no significant associations between EFV and coronary artery calcium scanning, presence severity of ≥50% stenosis by quantitative coronary angiography, or abnormal myocardial perfusion by SPECT. CONCLUSIONS In a diverse population of symptomatic patients referred for invasive coronary angiography, we did not find associations of EFV with the presence and severity of CAD or with myocardial perfusion abnormalities. The clinical significance of quantifying EFV remains uncertain but may relate to the pathophysiology of acute coronary events rather than the presence of atherosclerotic disease.
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Affiliation(s)
- Yutaka Tanami
- From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.)
| | - Masahiro Jinzaki
- From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.)
| | - Satoru Kishi
- From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.)
| | - Matthew Matheson
- From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.)
| | - Andrea L Vavere
- From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.)
| | - Carlos E Rochitte
- From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.)
| | - Marc Dewey
- From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.)
| | - Marcus Y Chen
- From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.)
| | - Melvin E Clouse
- From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.)
| | - Christopher Cox
- From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.)
| | - Sachio Kuribayashi
- From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.)
| | - Joao A C Lima
- From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.)
| | - Armin Arbab-Zadeh
- From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.).
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Obesity and coronary artery calcification: Can it explain the obesity-paradox? Int J Cardiovasc Imaging 2015; 31:1063-70. [DOI: 10.1007/s10554-015-0643-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 03/13/2015] [Indexed: 10/23/2022]
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Chinetti-Gbaguidi G, Copin C, Derudas B, Vanhoutte J, Zawadzki C, Jude B, Haulon S, Pattou F, Marx N, Staels B. The coronary artery disease-associated gene C6ORF105 is expressed in human macrophages under the transcriptional control of PPARγ. FEBS Lett 2015; 589:461-6. [PMID: 25595457 DOI: 10.1016/j.febslet.2015.01.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 12/17/2014] [Accepted: 01/02/2015] [Indexed: 11/27/2022]
Abstract
Coronary artery disease (CAD) is a major cause of morbidity and mortality. Mutations in C6ORF105, associated with decreased gene expression, positively correlate with the risk of CAD in Chinese populations. Moreover, the C6ORF105-encoded protein may play a role in coagulation. Here, we report that C6ORF105 gene expression is lower in circulating mononuclear cells from obese diabetic than lean subjects. Moreover, C6ORF105 is expressed in human macrophages and atherosclerotic lesions, where its expression positively correlates with expression of the transcription factor Peroxisome Proliferator-Activated Receptor (PPAR)γ. Activation of PPARγ increases, in a PPARγ-dependent manner, the expression of C6ORF105 in human macrophages and atherosclerotic lesions.
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Affiliation(s)
- G Chinetti-Gbaguidi
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France
| | - C Copin
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France
| | - B Derudas
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France
| | - J Vanhoutte
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France
| | - C Zawadzki
- Université Lille 2, F-59000 Lille, France; Centre Hospitalier Régional Universitaire de Lille, France
| | - B Jude
- Université Lille 2, F-59000 Lille, France; Centre Hospitalier Régional Universitaire de Lille, France
| | - S Haulon
- Centre Hospitalier Régional Universitaire de Lille, France
| | - F Pattou
- Université Lille 2, F-59000 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France; Centre Hospitalier Régional Universitaire de Lille, France; Department of Endocrine Surgery, University Hospital, F-59000 Lille, France
| | - N Marx
- Department of Internal Medicine I, University Hospital Aachen, D-52074 Aachen, Germany
| | - B Staels
- Université Lille 2, F-59000 Lille, France; Inserm, U1011, F-59000 Lille, France; Institut Pasteur de Lille, F-59019 Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, F-59000 Lille, France.
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Positron Emission Tomography Myocardial Perfusion Imaging for Diagnosis and Risk Stratification in Obese Patients. CURRENT CARDIOVASCULAR IMAGING REPORTS 2014. [DOI: 10.1007/s12410-014-9304-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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