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Masud R, Anjum A, Anwar M, Khan W, Shahzad M, Jawwad G. The risk stratification of coronary vascular disease as linked to homocysteine, its modulating genes, genetic polymorphisms, conventional predictors, and with antihypertensive medicaments. CHINESE J PHYSIOL 2021; 64:298-305. [DOI: 10.4103/cjp.cjp_71_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Patel SS, Guzman LA, Lin FP, Pence T, Reichman T, John B, Celi FS, Liptrap E, Bhati C, Siddiqui MS. Utilization of aspirin and statin in management of coronary artery disease in patients with cirrhosis undergoing liver transplant evaluation. Liver Transpl 2018; 24:872-880. [PMID: 29624871 DOI: 10.1002/lt.25067] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 03/12/2018] [Accepted: 03/22/2018] [Indexed: 12/12/2022]
Abstract
Coronary artery disease (CAD) assessment is a vital part of liver transplantation (LT) evaluation, as it allows for identification and medical optimization prior to transplantation. Although aspirin and statins are standard of care for CAD, they are not universally used in cirrhosis due to concerns about adverse events. Per protocol, coronary angiography was performed as part of the LT evaluation in all patients over the age of 50 years or with CAD risk factors, even if they were younger than 50. Optimal CAD medical management was defined as the use of both statin and aspirin, unless a contraindication was documented. Impact of these medications on hepatic decompensation, renal function, gastrointestinal bleeding, and need for transfusion was evaluated. CAD was detected in 84/228 (36.8%) patients. Lipid profile was similar in patients with and without CAD. In patients with CAD, statins were started in 19 (23%), while aspirin was used in 30 (36%) patients. In patients with obstructive or multivessel CAD, statin therapy was used only in 41% and 65%, respectively. Statins were more likely to be prescribed in patients with diabetes (32% versus 15%, P = 0.05) and history of dyslipidemia (38% versus 15%, P = 0.02). Use of statin therapy was not linked to hepatic decompensation, hospitalization, or rise in Model for End-Stage Liver Disease (MELD). Similarly, use of aspirin therapy was not associated with increased risk acute variceal hemorrhage, gastrointestinal bleeding, or worsening anemia. In conclusion, in decompensated cirrhosis, lipid profile alone is unable to risk stratify patients with CAD. Statin and aspirin appear to be safe. However, they are significantly underutilized for the management of CAD in this patient population. Liver Transplantation 24 872-880 2018 AASLD.
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Affiliation(s)
- Samarth S Patel
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA
| | - Luis A Guzman
- Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA
| | - Fei-Pi Lin
- School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Taylor Pence
- School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Trevor Reichman
- Division of Transplant Surgery, Department of Surgery, Virginia Commonwealth University, Richmond, VA
| | - Binu John
- Division of Gastroenterology and Hepatology, Hunter-Holmes McGuire Veterans Affairs Medical Center, Virginia Commonwealth University, Richmond, VA
| | - Francesco S Celi
- Division of Endocrinology, Diabetes and Metabolism, Virginia Commonwealth University, Richmond, VA
| | - Erika Liptrap
- Division of Transplant Surgery, Department of Surgery, Virginia Commonwealth University, Richmond, VA
| | - Chandra Bhati
- Division of Transplant Surgery, Department of Surgery, Virginia Commonwealth University, Richmond, VA
| | - Mohammad S Siddiqui
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA
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Li MN, Wang HJ, Zhang NR, Xuan L, Shi XJ, Zhou T, Chen B, Zhang J, Li H. MTHFR C677T gene polymorphism and the severity of coronary lesions in acute coronary syndrome. Medicine (Baltimore) 2017; 96:e9044. [PMID: 29245302 PMCID: PMC5728917 DOI: 10.1097/md.0000000000009044] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The association between methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism, circulating levels of homocysteine (Hcy), and the severity of coronary lesion in patients with acute coronary syndrome (ACS) remains unknown.Consecutive ACS patients were included. MTHFR C677T polymorphisms were determined via amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). Gensini scores were used to evaluate the severity of coronary lesions.Three hundred ten ACS patients were included, and grouped according to the MTHFR C677T polymorphism variant: CC (n = 78, 25.2%), CT (n = 137, 44.2%), and TT (n = 95, 30.6%) groups. No significant differences were detected with respect to baseline characteristics. Patients in TT group had significantly higher Hcy, and significantly lower folic acid (FA) levels as compared with those in the other 2 groups (P < .05 for both). More importantly, patients with TT had more severe coronary lesions as compared with those from the other 2 groups, as evidenced by higher Gensini scores (P < .05 for both); however, no significant differences were observed with respect to the numbers of affected coronary arteries, or the number, length, and diameter of stents implanted in each group (P > .05 for all). On multivariate logistic regression analysis, presence of a T allele in MTHFR C677T was found to be independently associated with higher circulating Hcy (odds ratio [OR] = 1.06, 95% confidence interval [CI]: 1.01-1.12, P = .024), and higher Gensini scores (OR: 1.01, 95% CI: 1.00-1.02, P = .046).MTHFR C677T TT polymorphism was associated with higher Hcy levels and more severe coronary lesions in patients with ACS.
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Gu Y, Feng L, Xu Y, Zhao Y. Co-prevalence of carotid stenosis and coronary artery disease in Chinese patients with paroxysmal atrial fibrillation. J Int Med Res 2014; 42:1294-300. [PMID: 25231437 DOI: 10.1177/0300060514543034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To investigate the co-prevalence of coronary artery disease (CAD) and carotid stenosis and to determine predictors related to CAD in Chinese patients with paroxysmal atrial fibrillation (PAF), presenting without previously diagnosed or excluded CAD. METHODS Consecutive patients with PAF were recruited. CAD was evaluated using multislice computed tomography. Intima-media thickness (IMT) of the carotid artery was evaluated via ultrasonography. RESULTS A total of 62/192 (32.3%) patients had CAD. Carotid stenosis was observed in 26/192 (13.5%) patients. The co-prevalence of carotid stenosis and CAD was 7.8% (15/192). The prevalence of carotid stenosis was 8.5%, 16.7%, 25.0%, and 41.7% in patients with zero-, one-, two-, and three-vessel CAD, respectively. Diabetes mellitus, maximal IMT and hyperhomocysteinaemia were independently related to the presence of CAD. CONCLUSIONS The prevalence of CAD was 32.3% in Chinese patients with PAF. Carotid stenosis and CAD co-occurred in 7.8% of patients, and the prevalence of carotid stenosis correlated with the severity of CAD. Screening of carotid stenosis is recommended, especially in patients with PAF and multivessel CAD.
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Affiliation(s)
- Yuanyuan Gu
- Department of Neurology, Zhengzhou People's Hospital, Zhengzhou, Henan, China
| | - Laihui Feng
- Department of Neurology, Zhengzhou People's Hospital, Zhengzhou, Henan, China
| | - Yu Xu
- Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Yonghui Zhao
- Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, Henan, China
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Mahalle N, Garg MK, Naik SS, Kulkarni MV. Association of metabolic syndrome with severity of coronary artery disease. Indian J Endocrinol Metab 2014; 18:708-714. [PMID: 25285291 PMCID: PMC4171897 DOI: 10.4103/2230-8210.139238] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND South Asians are more prone to develop metabolic syndrome (MetS). The additive predictive value of components of MetS for cardiovascular diseases is still debated. We undertook this study to evaluate the association of MetS and its components with severity of coronary artery disease (CAD). MATERIALS AND METHODS Three hundred patients with known coronary disease above the age of 25 years were included in this study. Blood samples were collected for biochemical markers. Patients were stratified into subjects with and without MetS (International Diabetes Federation, IDF, criteria) and severity of CAD (number of vessel involved). RESULTS Mean age of the patient in the study was 60.9 ± 12.4 years (male, M: 72%; female, F: 28%). MetS was present in 64% patients. Patients with MetS had more severe CAD compared to those without MetS. Triple vessel disease (TVD) was present in 62.5% of patients with MetS compared to 34.3% among without MetS (P < 0.0001). The percent number of patients with TVD showed increasing trend with increasing number of components of MetS (0-0%; 1-20%; 2-27.5%; 3-47.8%; 4-72.6%; 5-78.3%; Chi square for trend < 0.0001). Inflammatory markers [interleukin (IL) 6: 77.67 ± 79.48 vs. 41.21 ± 60.72 pg/ml, P < 0.0001; tumor nuclear factor (TNF)-α: 28.0 ± 47.49 vs 20.43 ± 24.5 pg/ml, P < 0.0001; high sensitive C-reactive protein (hsCRP): 14.30 ± 9.91 vs. 7.02 ± 7.18 mg/L, P < 0.0001], insulin resistance [homeostatic model analysis insulin resistance (HOMA-IR): 22.33 ± 23.37 vs. 10.86 ± 13.90, P < 0.0001] were higher and insulin sensitivity [quantitative insulin check index (QUICKI): 0.26 ± 0.03 vs. 0.30 ± 0.04, P < 0.0001] was significantly lower in subjects with MetS compared to subjects without MetS. Among lipids, total cholesterol were comparable but triglyceride (175 ± 42 vs. 179 ± 48 vs. 180 ± 47 mg/dl, P < 0.0001) was high and high-density lipoprotein (HDL; 44.72 ± 7.63 vs. 39.96 ± 8.70 vs. 36.05 ± 8.84, P < 0.0001) was low in subjects with TVD compared to others. Similarly, percentage of patients with diabetes (7.5% vs. 26.3% vs. 63.7%, P < 0.0001) and hypertension (34.3% vs. 56.6% vs. 77.7%, P < 0.0001) were higher in subjects with TVD compared to others. CONCLUSIONS There is a strong correlation of MetS and its components with severity of CAD.
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Affiliation(s)
- Namita Mahalle
- Department of Pathology, Biochemistry Section, Deenanath Mangeshkar Hospital and Research Center, Pune, Maharashtra, India
| | - M. K. Garg
- Commandant and Consultant, Medicine and Endocrinology, Military Hospital, Shillong, Meghalaya, India
| | - Sadanand S. Naik
- Department of Pathology, Biochemistry Section, Deenanath Mangeshkar Hospital and Research Center, Pune, Maharashtra, India
| | - Mohan V. Kulkarni
- Department of Chemistry, Division of Biochemistry, University of Pune, Pune, Maharashtra, India
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He LY, Zhao JF, Han JL, Shen SS, Chen XJ. Correlation between serum free fatty acids levels and Gensini score in elderly patients with coronary heart disease. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2014; 11:57-62. [PMID: 24748883 PMCID: PMC3981985 DOI: 10.3969/j.issn.1671-5411.2014.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 12/10/2013] [Accepted: 12/17/2013] [Indexed: 01/14/2023]
Abstract
Objectives To investigate the relationship between serum free fatty acids (FFAs) levels and the severity of coronary artery lesions in elderly patients with coronary heart disease (CAD). Methods A total of 172 elderly patients who underwent coronary angiography were divided into CAD group (n = 128) and non-CAD group (n = 44) according to the results of coronary angiography. Serum FFAs and lipid levels were measured and the Gensini score were calculated. Results No matter the differences between age, gender and the usage of statins or not, there was no statistical significance in FFAs levels (P > 0.05). In terms of the Gensini score, it was higher in patients aged 70–79 years than in patients 60–69 years old [15.00 (5.00, 34.00) vs. 10.00 (2.00, 24.00), P < 0.05], higher in men than women [14.00 (4.00, 34.00) vs. 7.00 (2.50, 19.75), P < 0.05], and higher in patients on statins [13.50 (4.25, 33.50) vs. 6.50 (2.00, 18.00), P < 0.05]. The serum FFAs levels [449.50 (299.00, 624.75) mEq/L vs. 388.00 (258.50, 495.25) mEq/L, P < 0.05] and Gensini score [17.50 (8.00, 41.75) vs. 1.00 (0, 5.00), P < 0.05] were higher in the CAD group than in the non-CAD group. In the CAD group, there was no statistical significance in FFAs levels among patients with different numbers of diseased coronary vessels (P > 0.05). Furthermore, the FFAs levels were positively correlated with the Gensini score (r = 0.394, P = 0.005). Regression analysis showed that the FFAs levels were related to the Gensini score independently after adjusting for the other risk factors. Conclusions The serum FFAs levels were associated with the Gensini score in elderly patients with CAD. It might indicate FFAs as a biomarker predicting the severity of coronary artery lesions.
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Affiliation(s)
- Li-Yun He
- Department of Cardiology, Peking University Third Hospital and Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health, Beijing 100191, China
| | - Jun-Feng Zhao
- Department of Emergency, the Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, Zhejiang Province, China
| | - Jiang-Li Han
- Department of Cardiology, Peking University Third Hospital and Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health, Beijing 100191, China
| | - Shan-Shan Shen
- Department of Geriatrics, Zhejiang Hospital, Hangzhou 310013, Zhejiang Province, China
| | - Xu-Jiao Chen
- Department of Geriatrics, Zhejiang Hospital, Hangzhou 310013, Zhejiang Province, China
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Huang KL, Chang YJ, Chang CH, Chang TY, Liu CH, Hsieh IC, Wong HF, Wai YY, Chen YW, Yip BS, Lee TH. Impact of coexisting coronary artery disease on the occurrence of cerebral ischemic lesions after carotid stenting. PLoS One 2014; 9:e94280. [PMID: 24732408 PMCID: PMC3986076 DOI: 10.1371/journal.pone.0094280] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 03/14/2014] [Indexed: 11/19/2022] Open
Abstract
Background Coronary artery disease (CAD) may coexist with extracranial carotid artery stenosis (ECAS), but the influence of CAD on procedure-related complications after carotid artery stenting (CAS) has not been well investigated. The study aimed to determine the impact of CAD on the occurrence of peri-CAS cerebral ischemic lesions on diffusion-weighted imaging (DWI) scanning. Methods Coronary angiography was performed within six months before CAS. DWI scanning was repetitively done within 1 week before and after CAS. Clinical outcome measures were stroke, angina, myocardial infarction and death within 30 days. Results Among 126 patients (69.5±9.0 years) recruited for unilateral protected CAS, 33 (26%) patients had peri-CAS DWI-positive lesions. CAD was noted in 79% (26 in 33) and 48% (45 in 93) of patients with and without peri-CAS DWI-positive lesions (OR, 4.0; 95% CI, 1.6–10.0; P = .0018), and the number of concomitant CAD on coronary angiography was positively correlated with the risk for peri-CAS DWI-positive lesions (P = .0032). In patients with no CAD (n = 55), asymptomatic CAD (n = 41) and symptomatic CAD (n = 30), the occurrence rates of peri-CAS DWI-positive lesions were 13%, 41% and 30% (P = .0048), and the peri-CAS stroke rates were 2%, 7% and 0% (P = .2120). Conclusions The severity of morphological CAD and the presence of either symptomatic or asymptomatic CAD are associated with the occurrence of peri-CAS cerebral ischemic lesions.
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Affiliation(s)
- Kuo-Lun Huang
- Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yeu-Jhy Chang
- Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Hung Chang
- Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Electrical Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Ting-Yu Chang
- Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Hung Liu
- Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - I-Chang Hsieh
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Internal Medicine, Section of Cardiology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ho-Fai Wong
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yau-Yau Wai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yu-Wei Chen
- Department of Neurology, Landseed Hospital, Taoyuan, Taiwan
- Department of Neurology, National Taiwan University Hospital, Taipei City, Taiwan
- Department of Computer Science and Information Engineering, National Central University, Zhongli City, Taiwan
| | - Bak-Sau Yip
- Department of Neurology, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
| | - Tsong-Hai Lee
- Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- * E-mail:
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Siddiqui MS, Sterling RK, Luketic VA, Puri P, Stravitz RT, Bouneva I, Boyett S, Fuchs M, Sargeant C, Warnick GR, Grami S, Sanyal AJ. Association between high-normal levels of alanine aminotransferase and risk factors for atherogenesis. Gastroenterology 2013; 145:1271-9.e1-3. [PMID: 23973920 PMCID: PMC3840068 DOI: 10.1053/j.gastro.2013.08.036] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 08/08/2013] [Accepted: 08/09/2013] [Indexed: 12/26/2022]
Abstract
BACKGROUND & AIMS Liver disease has been associated with cardiovascular disorders, but little is known about the relationship between serum levels of alanine aminotransferase (ALT) and markers of atherogenesis. We investigated the relationship between low-normal and high-normal levels of ALT and an extended panel of cardiovascular risk factors among individuals with no known diseases in a primary care setting. METHODS We performed a retrospective analysis of data collected from 6442 asymptomatic patients at wellness visits to a primary care setting in central Virginia from 2010 through 2011. Serum levels of ALT were compared with levels of lipids and lipoproteins, as well as metabolic, inflammatory, and coagulation-related factors associated with risk for cardiovascular disease. RESULTS Serum levels of ALT were higher than 40 IU/L in 12% of subjects, and in the high-normal range (19-40 IU/L in women and 31-40 IU/L in men) in 25% of subjects. ALT level was associated with the apolipoprotein B level, concentration and particle size of very-low-density lipoproteins, concentration of low-density lipoprotein (LDL) particles (LDL-P), and percentages of small dense LDL (sdLDL) and sdLDL-cholesterol (sdLDL-C) (P < .0001 for all). A high-normal level of ALT was associated with higher levels of LDL-C, LDL-P, sdLDL-C, and sdLDL particles (P < .001 for all). These effects were independent of age, body mass index, and hyperinsulinemia. Increasing levels of ALT and fasting hyperinsulinemia (>12 μU/mL) synergized with increasing levels of triglycerides, very-low-density lipoprotein particles, LDL-P, sdLDL-C, and percentage of sdLDL-C. Levels of APOA1, high-density lipoprotein-cholesterol, and high-density lipoprotein-class 2 were associated inversely with serum level of ALT (P < .0001 for all). CONCLUSIONS In an analysis of asymptomatic individuals, increased serum levels of ALT (even high-normal levels) are associated with markers of cardiovascular disease.
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Affiliation(s)
- M. Shadab Siddiqui
- Division of Gastroenterology & Hepatology, Virginia Commonwealth University, Richmond, VA
| | - Richard K. Sterling
- Division of Gastroenterology & Hepatology, Virginia Commonwealth University, Richmond, VA
| | - Velimir A. Luketic
- Division of Gastroenterology & Hepatology, Virginia Commonwealth University, Richmond, VA
| | - Puneet Puri
- Division of Gastroenterology & Hepatology, Virginia Commonwealth University, Richmond, VA
| | - Richard T. Stravitz
- Division of Gastroenterology & Hepatology, Virginia Commonwealth University, Richmond, VA
| | - Iliana Bouneva
- Division of Gastroenterology & Hepatology, Virginia Commonwealth University, Richmond, VA
| | - Sherry Boyett
- Division of Gastroenterology & Hepatology, Virginia Commonwealth University, Richmond, VA
| | - Michael Fuchs
- Division of Gastroenterology & Hepatology, McGuire Veteran’s Administration Medical Center, Richmond, VA
| | - Carol Sargeant
- Division of Gastroenterology & Hepatology, Virginia Commonwealth University, Richmond, VA
| | | | | | - Arun J. Sanyal
- Division of Gastroenterology & Hepatology, Virginia Commonwealth University, Richmond, VA
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Xie F, Song Q. Association of the G1359A Polymorphism in the CNR1Gene with the Presence of Coronary Artery Disease in Patients with Metabolic Syndrome. Lab Med 2013. [DOI: 10.1309/lmwjisddz1ol8u7f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Zhou SS, Zhou YM, Li D, Lun YZ. Dietary methyl-consuming compounds and metabolic syndrome. Hypertens Res 2011; 34:1239-45. [PMID: 21814217 DOI: 10.1038/hr.2011.133] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The metabolic syndrome, a major risk factor for type 2 diabetes and cardiovascular disease, is a cluster of metabolic abnormalities including obesity, insulin resistance, hypertension and dyslipidemia. Although systemic oxidative stress and aberrant methylation status are known to have important roles in the development of metabolic syndrome, how they occur remains unclear. The metabolism of methyl-consuming compounds generates reactive oxygen species and consumes labile methyl groups; therefore, a chronic increase in the levels of methyl-consuming compounds in the body can induce not only oxidative stress and subsequent tissue injury, but also methyl-group pool depletion and subsequent aberrant methylation status. In the past few decades, the intake amount of methyl-consuming compounds has substantially increased primarily due to pollution, food additives, niacin fortification and high meat consumption. Thus, increased methyl consumers might have a causal role in the development and prevalence of metabolic syndrome and its related diseases. Moreover, factors that decrease the elimination/metabolism of methyl-consuming compounds and other xenobiotics (for example, sweat gland inactivity and decreased liver function) or increase the generation of endogenous methyl-consuming compounds (for example, mental stress-induced increase in catecholamine release) may accelerate the progression of metabolic syndrome. Based on current nutrition knowledge and the available evidence from epidemiological, ecological, clinical and laboratory studies on metabolic syndrome and its related diseases, this review outlines the relationship between methyl supply-consumption imbalance and metabolic syndrome, and proposes a novel mechanism for the pathogenesis and prevalence of metabolic syndrome and its related diseases.
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Affiliation(s)
- Shi-Sheng Zhou
- Department of Physiology, Medical College, Dalian University, Dalian, China.
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Polyzos SA, Kountouras J, Zavos C, Deretzi G. The association between Helicobacter pylori infection and insulin resistance: a systematic review. Helicobacter 2011; 16:79-88. [PMID: 21435084 DOI: 10.1111/j.1523-5378.2011.00822.x] [Citation(s) in RCA: 151] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Helicobacter pylori infection has been associated with diverse extradigestive morbidity, including insulin resistance (IR) syndrome. The aim of this systematic review was to summarize the epidemiologic evidence concerning the association between H. pylori infection and IR quantitative indexes. MATERIALS AND METHODS A computerized literature search in PubMed electronic databases and Cochrane Central Register of Controlled Trials was performed. RESULTS Nine studies reporting data on 2120 participants were finally eligible for this systematic review. Seven of them were cross-sectional studies and two were nonrandomized, open-label, controlled trials investigating the effect of H. pylori eradication on IR. Homeostatic model of assessment insulin resistance (HOMA-IR) was used in all studies to quantify IR. There seems to be a trend toward a positive association between H. pylori infection and HOMA-IR, strengthened by regression analysis in one study. However, there was significant heterogeneity between studies regarding the method(s) of H. pylori infection diagnosis based on and the study populations. The studies for the effect of H. pylori eradication on HOMA-IR revealed conflicting results. CONCLUSIONS Although data seem to indicate a potential association between H. pylori infection and IR, further studies are needed to strengthen this association and to clarify whether there is a causative link between them. If a causal link is confirmed in the future, this may have a major impact on the pathophysiology and management of IR syndrome, including type 2 diabetes mellitus and nonalcoholic fatty liver disease.
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Affiliation(s)
- Stergios A Polyzos
- Second Medical Clinic, Medical School, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Macedonia, Greece
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