Impact of the dietary fatty acid intake on C-reactive protein levels in US adults

Inferring causal cell types of human diseases and risk variants from candidate regulatory elements

The heritability of human diseases is extremely enriched in candidate regulatory elements (cRE) from disease-relevant cell types. Critical next steps are to infer which and how many cell types are truly causal for a disease (after accounting for co-regulation across cell types), and to understand how individual variants impact disease risk through single or multiple causal cell types. Here, we propose CT-FM and CT-FM-SNP, two methods that leverage cell-type-specific cREs to fine-map causal cell types for a trait and for its candidate causal variants, respectively. We applied CT-FM to 63 GWAS summary statistics (average N = 417K) using nearly one thousand cRE annotations, primarily coming from ENCODE4. CT-FM inferred 81 causal cell types with corresponding SNP-annotations explaining a high fraction of trait SNP-heritability (~2/3 of the SNP-heritability explained by existing cREs), identified 16 traits with multiple causal cell types, highlighted cell-disease relationships consistent with known biology, and uncovered previously unexplored cellular mechanisms in psychiatric and immune-related diseases. Finally, we applied CT-FM-SNP to 39 UK Biobank traits and predicted high confidence causal cell types for 2,798 candidate causal non-coding SNPs. Our results suggest that most SNPs impact a phenotype through a single cell type, and that pleiotropic SNPs target different cell types depending on the phenotype context. Altogether, CT-FM and CT-FM-SNP shed light on how genetic variants act collectively and individually at the cellular level to impact disease risk.

The relationship between dietary inflammatory index and bone mineral density in CKD patients

INTRODUCTION

Chronic systemic inflammation was proposed as a critical factor in the development of osteoporosis. We aim to investigate the effect of the DII on bone mineral density (BMD) in CKD patients.

METHODS

2276 participants from NHANES were enrolled. The DII score was calculated based on a single 24-h dietary recall. Total BMD was measured using Dual-energy x-ray absorptiometry. A multiple-stepwise linear regression model was used to determine associations between BMD and DII in CKD patients.

RESULTS

When DII >0.35, a negative correlation was obtained between DII and BMD (all β = -0.008 and p < 0.05). In subgroup analysis, BMD levels decreased across increasing tertiles of the DII for patients with non-osteoporosis, postmenopause, and low eGFR (p for trend ≤0.01).

CONCLUSION

Higher consumption of pro-inflammatory diet correlates negatively with the BMD levels in CKD patients.

C-Reactive Protein: Pathophysiology, Diagnosis, False Test Results and a Novel Diagnostic Algorithm for Clinicians

The current literature provides a body of evidence on C-Reactive Protein (CRP) and its potential role in inflammation. However, most pieces of evidence are sparse and controversial. This critical state-of-the-art monography provides all the crucial data on the potential biochemical properties of the protein, along with further evidence on its potential pathobiology, both for its pentameric and monomeric forms, including information for its ligands as well as the possible function of autoantibodies against the protein. Furthermore, the current evidence on its potential utility as a biomarker of various diseases is presented, of all cardiovascular, respiratory, hepatobiliary, gastrointestinal, pancreatic, renal, gynecological, andrological, dental, oral, otorhinolaryngological, ophthalmological, dermatological, musculoskeletal, neurological, mental, splenic, thyroid conditions, as well as infections, autoimmune-supposed conditions and neoplasms, including other possible factors that have been linked with elevated concentrations of that protein. Moreover, data on molecular diagnostics on CRP are discussed, and possible etiologies of false test results are highlighted. Additionally, this review evaluates all current pieces of evidence on CRP and systemic inflammation, and highlights future goals. Finally, a novel diagnostic algorithm to carefully assess the CRP level for a precise diagnosis of a medical condition is illustrated.

Red Blood Cell Membrane Fatty Acid Composition, Dietary Fatty Acid Intake and Diet Quality as Predictors of Inflammation in a Group of Australian Adults

Evidence suggests that diet can play a role in modulating systemic inflammation. This study aims to examine the relationship between fatty acids (FAs) (self-reported dietary intake and red blood cell (RBC) membrane fatty acid concentrations), three diet quality scores, and the plasma concentrations of inflammatory markers (interleukin-6, IL-6; tumour necrosis factor alpha, TNF-α; and C-reactive protein, CRP) in a group of Australian adults (n = 92). Data were collected on their demographic characteristics, health status, supplement intake, dietary intake, RBC-FAs and plasma inflammatory markers over a nine-month period. Mixed-effects models were used to determine the relationship between RBC-FAs, dietary intake of FAs, diet quality scores and inflammatory markers to determine which variable most strongly predicted systemic inflammation. A significant association was identified between dietary saturated fat intake and TNF-α (β = 0.01, p < 0.05). An association was also identified between RBC membrane saturated fatty acids (SFA) and CRP (β = 0.55, p < 0.05). Inverse associations were identified between RBC membrane monounsaturated fatty acids (MUFAs) (β = -0.88, p < 0.01), dietary polyunsaturated fatty acids (PUFAs) (β = -0.21, p < 0.05) and CRP, and the Australian Eating Survey Modified Mediterranean Diet (AES-MED) score and IL-6 (β = -0.21, p < 0.05). In summary, using both objective and subjective measures of fat intake and diet quality, our study has confirmed a positive association between saturated fat and inflammation, while inverse associations were observed between MUFAs, PUFAs, the Mediterranean diet, and inflammation. Our results provide further evidence that manipulating diet quality, in particular fatty acid intake, may be useful for reducing chronic systemic inflammation.

Arterial stiffness nomogram identification by cluster analysis: A new approach of vascular phenotype modeling

Arterial stiffness, measured by arterial stiffness index (ASI), can be considered as a major denominator in cardiovascular diseases. Thus, it remains essential to highlight patient phenotyping profiles with high ASI values. A nomogram of arterial stiffness was evaluated by calculation of ASI nomogram. Theoretical ASI can be performed according to age, sex, mean blood pressure, and heart rate, allowing to form an individual ASI nomogram [(measured ASI - theoretical ASI)/theoretical ASI]. An ASI nomogram > 0 defined AS. This study investigates among UK Biobank participants without cardiovascular diseases, the hypothesis that K-means cluster analysis can be used to identify homogeneous phenotyping subgroups of participants according to ASI levels and then, the phenotype differences observed between these clusters. ASI nomogram was applied on 132 851 participants. K-means clustering was implemented with 10 clusters (optimal CCC value of 105.246). One cluster showed 100% rate of AS, corresponding to 25 393 participants (41.6% of the AS participants) with ASI nomogram = .26 (.22), ASI = 11.6 (2.3)m/s. A second cluster showed a 100% of non-AS, corresponding to 27 844 participants (38.8% of the participants with no arterial stiffness) with ASI nomogram = -.22 (.13), ASI = 7.1 (1.44)m/s. Threshold values of independent factors for differencing these two clusters were total cholesterol > 5.409 mmol/L (P < .001), triglycerides > 1.286 mmol/L (P < .001), smoking pack years > 11.8 pack/years, CRP > .99 (P < .001), daily alcohol consumption > 1.794 units/days and BMI > 26.641 kg/m² (P < .001). Cluster analysis allowed to highlight homogeneous participants profile with or without AS. Determine the markers differencing these clusters participates in the management of cardiovascular preventive strategies.

Avocado Consumption for 12 Weeks and Cardiometabolic Risk Factors: A Randomized Controlled Trial in Adults with Overweight or Obesity and Insulin Resistance

BACKGROUND

Diets emphasizing unsaturated fat and high fiber are associated with reducing cardiometabolic risk factors. Avocados are rich in MUFA and PUFA fats and fiber.

OBJECTIVES

Assess replacement of carbohydrate energy with avocado energy for 12 wk on glucose homeostasis and cardiometabolic risk factors in self-selecting free-living adults who are overweight or with obesity and have insulin resistance.

METHODS

In a single-center, randomized, 2-arm, controlled, 12-wk parallel trial, adults [n = 93; male/female: 39/54; mean ± SD age: 42 ± 12 y; BMI: 32.6 ± 3.9 (in kg/m2);  HOMA-IR: 2.7 ± 1.7] were counseled to exchange avocado (AV) or control food (C; low fat, low fiber, energy matched) for carbohydrate food in their usual diet for 12 wk. The primary outcome was the change in Matsuda Insulin Sensitivity Index (MISI) after 12-wk interventions. Secondary outcomes were changes in fasting and post-oral glucose tolerance test glycemic variables, fasting lipids, endothelial activation and inflammation markers. Automated Self-Administered 24-h Dietary Assessment Tool captured weekly dietary intake. Intervention effects were mainly determined by ANCOVA using PC-SAS version 9.4.

RESULTS

Dietary total, MUFA, and PUFA fat; fiber; and vegetable intake were higher in the AV group compared with the C group (P < 0.05), and no change in body weight or composition was observed (P > 0.05). Differences between the changes in MISI after AV compared with C were not different (Δ0-12 wk, P = 0.1092). Differences in fasting insulin (Δ0-12 wk, P = 0.0855) and improved glycated hemoglobin (Δ0-12 wk, P = 0.0632) after AV compared with C were suggested. C-reactive protein was significantly lower after AV compared with C at 12 wk (P = 0.0418). Select biomarkers of endothelial activation and lipoproteins by NMR were also influenced by AV compared with C food intake.

CONCLUSIONS

Avocado intake was associated with a healthier dietary pattern and trends favoring improved glucose control and reduced biomarkers of cardiometabolic risk when replacing avocado energy for carbohydrate energy in free-living adults who are overweight or with obesity and have insulin resistance. This trial was registered at clinicaltrials.gov as NCT02695433.

Strong association between the dietary inflammatory index(DII) and breast cancer: a systematic review and meta-analysis

The association between the Dietary Inflammatory Index (DII) and breast cancer risk has been widely reported in recent years, but there is still controversy about whether a pro-inflammatory diet is a risk factor for breast cancer. We conducted a meta-analysis to investigate the relationship between the DII and breast cancer risk in pre-menopausal and post-menopausal women. We comprehensively searched PubMed, Embase and the Cochrane Library in January 2021 to identify articles reporting an association between the DII and breast cancer risk. A pooled analysis was conducted with 14 studies covering 312,885 participants. Overall, women in the most pro-inflammatory diet category were at greater risk for breast cancer than those in the most anti-inflammatory category (relative risk [RR]=1.37, 95% confidence interval [CI] 1.17-1.60, P<0.001). This association was strong in both pre-menopausal women (RR=1.87, 95% CI 1.17-2.99, P=0.001) and post-menopausal women (RR=1.23, 95% CI 1.08-1.40, P<0.001). Thus, a strong and independent association was observed between a pro-inflammatory diet (assessed using the DII score) and breast cancer risk, irrespective of menopausal status. Further studies will be required to determine the relationship between a pro-inflammatory diet and different subtypes of breast cancer.

Adverse impact of egg consumption on fatty liver is partially explained by cardiometabolic risk factors: A population-based study

BACKGROUND AND AIMS

We evaluated the association of egg consumption with liver tests (LTs) and non-alcoholic fatty liver disease (NAFLD). This relationship is poorly documented.

METHODS

The National Health and Nutrition Examination Survey (NHANES, 2005-2010) database was used. Analysis of covariance, adjusted linear and logistic regression models were used.

RESULTS

Of the 14,369 participants, 46.8% were men and 45.2% had NAFLD. After correction for several variables including: age, gender, race, education, poverty to income ratio, alcohol intake, energy intake, smoking, and physical activity - fatty liver index (FLI), serum aspartate aminotransferase (AST) alanine aminotransferase (ALT) were 36.9, 25.8 (U/L) and 23.9 (U/L), respectively, in the first tertile (T1) reaching 68.7, 34.9 and 36.5, respectively, in the third tertile (T3) (p < 0.001 for all comparisons). In the model with same covariates, there was significant positive linear relationship between FLI (standard β coefficient (β): 0.196), AST (β: 0.099) and ALT (β: 0.112) with egg consumption and participants in the highest tertile (T3) of egg consumption had 11% higher chance of NAFLD compared with T1 (odds ratio: 1.11 and 95% confidence interval: 1.07-1.17). Of note, after more correction for triglycerides, hypertension and diabetes, the significant link between egg consumption and LTs and/or NAFLD attenuated and disappeared.

CONCLUSION

Our findings highlight the adverse role of egg consumption on LTs and likelihood of NAFLD. These associations seem to be attributable to cardio-metabolic risk factors. These findings require confirmation to improve our understanding of the role of egg consumption in the pathogenesis of NAFLD.

The Association between Inflammation and Pulse Wave Velocity in Dyslipidemia: An Evidence-Based Review

Dyslipidemia is associated with increased arterial stiffness (AS) which may lead to hypertension. Among the methods to assess AS are carotid-femoral and brachial-ankle pulse wave velocity. Dyslipidemia is also known to trigger inflammation. C-reactive protein (CRP) is one of the commonest inflammatory markers measured in the clinical setting. However, the association between inflammation and pulse wave velocity (PWV) in people with dyslipidemia is less studied. Therefore, this review investigated the association between inflammation (as measured by CRP) and PWV in dyslipidemia patients. The search of the literature was conducted via PubMed and Scopus database. The keywords used were "aortic stiffness" OR "arterial stiffness" OR "pulse wave velocity" OR "vascular stiffness" OR "carotid femoral pulse wave velocity" OR "pulse wave analysis" AND "inflammation" OR "c reactive protein" OR "c-reactive protein" OR "high sensitivity c reactive protein" AND "dyslipidemia" OR "hyperlipidemia" OR "hypercholesterolemia" OR "hyperlipoproteinemia" OR "hypertriglyceridemia". The following criteria were used: (1) only full-length original articles published in English language, (2) articles that reported the association between arterial stiffness measured as carotid-femoral PWV (cfPWV) or brachial-ankle PWV (baPWV) and CRP or high-sensitivity CRP, and (3) study involving human subjects. The search identified 957 articles published between 1980 and February 2020. Only eight articles fulfilled the inclusion criteria and were used for data extraction. Five of the studies were cross-sectional studies while another three studies were interventional studies. Seven out of eight papers found a significant positive association between AS and CRP, and the correlation ranged from mild to moderate association (Pearson r = 0.33 to r = 0.624). In conclusion, inflammation is associated with increased PWV in patients with dyslipidemia. This supports the involvement of inflammation in the development of AS in dyslipidemia.

A Greater Flavonoid Intake Is Associated with Lower Total and Cause-Specific Mortality: A Meta-Analysis of Cohort Studies

Introduction: The links between flavonoid intake and mortality were previously evaluated in epidemiological studies. The aim of the present study was to perform a systematic review and meta-analysis of cohort studies evaluating the link of flavonoid consumption with total and cause-specific mortality. Methods: Prospective cohort studies reporting flavonoid intake and mortality data published up to 30th April 2019 (without language restriction) were searched using PubMed, Scopus and EMBASE database. Generic inverse variance methods and random effects models were used to synthesize pooled and quantitative data. Sensitivity analysis was also performed by a leave-one-out method. Results: Overall, 16 articles met the inclusion criteria (nine studies were performed in Europe, five in the USA, one in Asia and one in Oceania); a total of 462,194 participants (all adults aged >19 years) with 23,473 mortality cases were included in the final analysis. The duration of follow-up ranged from 4.8 to 28 years. Most of the studies assessed flavonoid intake using food frequency questionnaires, whereas four studies used interviews and 1 study used 4-day food records. The meta-analysis showed that flavonoid consumption was inversely and significantly associated with total (relative risk (RR): 0.87, 95% confidence interval (CI) = 0.77–0.99) and cardiovascular disease mortality risk (RR: 0.85, 95%CI = 0.75–0.97), but not cancer (0.86, 95%CI = 0.65–1.14) mortality risk. These findings remained robust in sensitivity analyses. Conclusions: The present findings highlight the potential protective role of flavonoids against total and cause-specific mortality. These results support the recommendations for flavonoid-rich foods intake to prevent chronic diseases.

Effect of Dietary Insulinemia on All-Cause and Cause-Specific Mortality: Results From a Cohort Study

Background: Insulin response to diet might predict the risk of mortality; however, the evidence is limited. We prospectively evaluated the link between the dietary hyperinsulinemia index (DHI) and dietary insulin resistance index (DIRI) with all-cause and cause-specific (cardiovascular disease [CVD] and cancer) mortality.Methods: The National Health and Nutrition Examination Survey (1999-2010) database was used. Vital status through December 31, 2011, was ascertained. Stepwise linear regression models consisted of 39 macro/micronutrients applied, and fasting plasma C-peptide for the DHI and triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-C) for the DIRI were used. Adjusted Cox regression (followed by propensity score matching) was performed to determine the hazard ratios (HRs) and 95% confidence interval (95% CIs).Results: Overall, 22,246 participants were included (mean age = 47.8 years; 48.9% men). There was a significant increasing risk of mortality across the quartiles of DHI, i.e., participants with a highest score of DHI (Q4) had a greater risk of all-cause (HR: 1.21, 95% CI: 1.17-1.26), CVD (HR: 1.17, 95% CI: 1.07-1.29), and cancer (HR: 1.15, 95% CI: 1.08-1.23) mortality compared with the first quartile (Q1; p < 0.001 for all comparisons). Similarly, participants in the highest DIRI quartile (Q4) had 23% and 31% higher risk of all-cause and CVD mortality, respectively, compared with Q1, while the association between cancer mortality and DIRI was non-significant (HR: 0.88, 95% CI: 0.35-2.61).Conclusions: These findings highlight, for the first time, the detrimental role (association) of insulinemia and insulin resistance potential of diet on all-cause and cause-specific mortality. Our findings support the role of C-peptide and TG/HDL-C ratio as cost-effective and practical biomarkers in clinical settings. These results need to be confirmed to establish their implications.

Anti-Atherosclerotic and Anti-Inflammatory Effects of Curcumin on Hypercholesterolemic Male Rabbits

Curcumin has a potent antioxidant and anti-inflammatory properties that may suppress inflammatory component of atherosclerosis. It has been demonstrated that curcumin derivatives can reduce the formation of arterial fatty streaks in cholesterol-fed rabbits. Therefore in this study we evaluated the protective effects of Curcumin on the progression of atherosclerosis. 20 mature rabbits were included for this study; they were randomly divided into four groups each of 5. Group 1: (normal control) were fed corn pellets diet and tab water, group 2: (high cholesterol diet control) were kept on cholesterol rich diet (2% cholesterol) and tab water. Group 3: (cholesterol and rosuvastatin treated group) were kept on cholesterol rich diet (2% cholesterol) and 2.5 mg/kg/day Rosuvastatin dispersed in DW and given orally, group 4: (cholesterol and curcumin treated group) were kept on cholesterol rich diet (2% cholesterol) and 0.2% curcumin added with corn pellets. The study continued for 12 weeks then assessment of serum level of high sensitive C-reactive protein, ICAM1, VCAM1 and PCSK9 was carried out at the end of the study. Total antioxidant activity of curcumin was also determined. Histopathological examination of aortic tissues for atherosclerotic changes was also carried out. Atherogenic (cholesterol rich diet) induced an increment in serum level of TC, LDL, VLDL and TG with concomitant decrement in serum level of HDL and increased atherogenic index. Treatment with curcumin produced substantial reduction in serum TC, LDL, TG with no effect on HDL level thus decreased atherogenic index. Rabbits treated with curcumin showed a significant reduction in the serum level of high sensitive C-reactive protein, ICAM1, VCAM, PCSK9 serum expression and aortic total antioxidant capacity. Curcumin has a potent anti-inflammatory and anti- oxidant effects against atherosclerosis so exerts a protective role by decreasing lipid oxidation and inflammatory markers.

Adiposity May Moderate the Link Between Choline Intake and Non-alcoholic Fatty Liver Disease

Background: In animal models, histological and biochemical changes are observed in response to choline deficiency. It is unclear whether dietary choline is linked to non-alcoholic fatty liver disease (NAFLD). Objective: We examined the link among liver tests, fatty liver index (FLI), and choline consumption. Furthermore, we evaluated the impact of adiposity on this association. Method: The National Health and Nutrition Examination Survey (NHANES) was used to obtain data on choline intake and liver function biomarkers. Masked variance and weighting methodology were performed to account for the complex NHANES data. Results: Of the 20,643 participants, 46.8% were men and 45.6% had NAFLD (defined as United States FLI ≥30). In a fully adjusted model (for demographic, dietary, and clinical factors), a significant negative association was found between FLI and choline consumption (β = -0.206, p < 0.001). Participants in the highest quartile (Q4) of choline intake had a 14% lower risk of NAFLD compared with those in the first quartile (Q1). This link was stronger for postmenopausal women; women in Q4 had a 26% lower risk of NAFLD compared with those in Q1. Body mass index (BMI) strongly moderated the link between FLI and choline intake. For example, when choline consumption increased from low (272 mg/d) to high (356 mg/d), FLI decreased from 79.3 to 74.1 in the low BMI category (mean BMI = 22.1 kg/m²) and from 32.1 to 20.6 in the high BMI category (mean BMI =35.9 kg/m²). Conclusions: Our results suggest the presence of a reverse significant association between choline intake and risk of NAFLD. Furthermore, BMI was shown to mediate this relationship since changes in FLI, in relation to choline consumption, were more pronounced in participants with a higher BMI.

Dietary saturated fat and low-grade inflammation modified by accelerometer-measured physical activity in adolescence: results from the GINIplus and LISA birth cohorts

BACKGROUND

Saturated fatty acids (SFA) have been reported to promote inflammation. Nevertheless, evidence linking dietary SFA and low-grade inflammation in adolescents is scarce and inconsistent. The modulatory role of physical activity (PA) on fat metabolism and inflammation may provide a potential explanation. Thus, we assessed the association of dietary SFA with high-sensitivity C-reactive protein (hsCRP), a marker of low-grade inflammation, in 15-year-olds, and evaluated possible interactions between dietary SFA and different levels of PA.

METHODS

Children participating in the 15-year follow-ups of the GINIplus and LISA German birth cohort studies were included (N = 824). SFA intake was estimated by means of a food frequency questionnaire and PA recorded by accelerometers. Average daily minutes of PA were classified into "sedentary", "light" and "moderate-to-vigorous" (MVPA), using Freedson's cut-offs. HsCRP concentrations were measured in serum and categorized into 3 sex-specific levels (below detection limit (I), above 75th percentile (III), in between (II)). Sex-stratified cross-sectional associations between SFA and hsCRP were assessed using multinomial logistic regression, adjusting for potential confounders. Interaction terms were included between SFA and the different PA levels; and if significant interactions were observed, analyses stratified by tertiles of the relevant PA levels were performed. Relative risk ratios (RRR) and 95% confidence intervals (95%CI) were presented for a 1% increase in SFA.

RESULTS

An inverse association was observed between SFA intake and hsCRP (II vs. I) in males (RRR = 0.85 [95%CI = 0.76;0.96], p = 0.008), whereas no significant association was observed in females. A significant interaction was observed with "sedentary" and "light" PA but not with MVPA in both sexes (p < 0.05). Stratified analyses indicated a significant inverse association between SFA and medium hsCRP levels in males in the highest light PA tertile (hsCRP II vs. I: 0.67 [0.517;0.858], p = 0.002).

CONCLUSION

Our findings do not support a detrimental role of dietary SFA in low-grade inflammation among adolescents. In males, higher dietary SFA was associated with lower hsCRP, although this should be interpreted in the context of possibly correlated nutrients. Children spending the most time in light PA drove the observed inverse association, suggesting a synergistic effect of SFA and lifestyle PA in the resultant inflammatory response.

In-Situ imaging detection of cell membrane and intracellular cholesterol via cascade reactions

Herein, an effective membrane-to-intracellular cholesterol detection strategy was designed based on cascade reactions. A biochip array was firstly fabricated by consecutively immobilizing luminol modified gold nanoparticles (Au@luminol), soybean peroxidase (SBP) and cholesterol oxidase (ChoX) on the cellulose acetate (CA) membrane functionalized home-made micropore array. When cholesterol existed, it was oxidized by ChoX generating H₂O₂, which further triggered the CL reaction under the SBP catalysis, the CL signals were collected by a charge-coupled device (CCD). The proposed strategy exhibited a wide linear range from 0.12 μM to 1000 μM and relatively low detection limit (LOD) of 0.08 μM. Furthermore，it could be used to in-situ detect membrane cholesterol and intracelluar esterified cholesterol in HepG2 cells. After activated HepG2 cells were added to the modified biochip, membrane cholesterol was detected directly. Intracelluar esterified cholesterol was detected through the introduction of triton X-100 and cholesteryl esterase (ChoE). Additionally, the cholesterol content in cells was changed after stimulated by drugs, such as apolipoprotein A-I (ApoA-I), pitavastatin or probucol. The correlation of the CL signal with the amount of cholesterol confirmed that our strategy was feasible to simultaneously detect membrane and intracellular cholesterol at different cellular states. The proposed strategy exhibited excellent sensitivity, selectivity, stability, and reproducibility in a simple, cheap way, which opened a new door for studying clinic treatment of the cholesterol-related diseases.

Dietary inflammatory index is positively associated with serum high-sensitivity C-reactive protein in a Korean adult population

OBJECTIVE

To our knowledge, only a few studies have explored the relationship between the inflammatory potential of diet and serum inflammatory markers in Korean adults. The likely novel aim of this study was to examine the association between the dietary inflammatory index (DII) and serum high-sensitivity C-reactive protein (hs-CRP) in a Korean adult population.

METHODS

A cross-sectional study was conducted using the data set from the Korea National Health and Nutrition Examination Survey (KNHANES) 2015. Korean adults ≥19 y of age with hs-CRP values were included in this study. After excluding individuals with missing variables for covariates, the final analytic sample for the study was 3014 adults (1295 men and 1719 women). DII scores were calculated from a 1-d 24-h dietary recall, and hs-CRP was measured using the immunoturbidimetric method. Multivariable logistic regression analyses were performed to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) to test the effect of the DII score on serum hs-CRP as dichotomous (>2 versus ≤2 mg/L).

RESULTS

A significant association was observed between increasing DII scores and elevated hs-CRP. Korean adults in the highest quintile of the DII (indicating the most proinflammatory diet), compared with the lowest quintile of the DII (indicating the most anti-inflammatory diet), had increased odds of having elevated hs-CRP concentrations (>2 mg/L; AOR, 1.70; 95% CI, 1.07-2.69; P_trend < 0.0001) after controlling for age, sex, education, marital status, alcohol consumption, smoking status, body mass index, high-density lipoprotein cholesterol, and physical activity.

CONCLUSION

Higher DII scores were positively associated with elevated hs-CRP levels in Korean adults. Because inflammation affects the risk for cancer, cardiovascular disease, and other inflammation-related conditions, future studies are warranted to examine the effect of the DII on other inflammatory biomarkers and chronic disease outcomes among the Korean population.

Diet with greater inflammatory potential is associated with higher prevalence of fatty liver among US adults

The prevalence of non-alcoholic fatty liver disease (NAFLD) is rising-caused, at least in part, by unhealthy lifestyles including poor dietary choices. We examined the link between the inflammatory potential of diet as measured by the Dietary Inflammatory Index (DII^®) and liver function tests [summarised by the fatty liver index (FLI)]. Of 20,643 US NHANES participants, 48.7% were men and the mean age was 47.3 years. Significant associations were apparent between increasing DII score and prevalent fatty liver. Individuals in the fourth DII quartile had nearly a six-fold higher likelihood of fatty liver [odds ratio (OR) = 5.97, 95% confidence interval: 4.44-8.02] compared with those in the first quartile. Moderation analysis indicated a significant impact of adiposity on the link between FLI and DII score (p < 0.001). This study provides further evidence of an association between the inflammatory potential of diet and fatty liver.

A higher flavonoid intake is associated with less likelihood of nonalcoholic fatty liver disease: results from a multiethnic study

Limited information exists on the impact of flavonoid intake on nonalcoholic fatty liver disease (NAFLD). We evaluated the link between flavonoid intake, liver tests and risk of NAFLD in a randomly selected sample of US adults (from the National Health and Nutrition Examination Survey, NHANES, 2005-2010). Of the 17,685 participants, 46.9% were men and 45.4% had NAFLD. NAFLD patients had a significantly lower mean flavonoid intake than healthy individuals (111.3±3.6 vs. 201.3±2.3 mg/d, respectively; P<.001). Fatty liver index (FLI) and serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were significantly higher in the first tertile (T1) of flavonoid intake compared with the highest tertile (T3: with the highest flavonoid intake) (FLI: 67.1 vs. 36.2, AST: 31.2 VS 26.8 U/L and, ALT: 34.2 vs. 24.2 U/L, respectively; P<.001 for all comparisons). Adjusted linear regression displayed significant and negative associations between FLI, AST, ALT and flavonoid intake (P<.001 for all comparisons). Multivariable logistic regression showed that the risk for NAFLD significantly decreased as flavonoid intake tertiles increased in a stepwise manner (odds ratio: 0.81, 95% confidence interval: 0.78-0.86). Moderation analysis revealed that C-reactive protein (CRP) strongly modulated the impact of flavonoid intake on FLI; participants with higher CRP levels benefited less from flavonoid intake compared with those with lower CRP concentrations. In conclusions, our results suggest a reverse significant association between flavonoid consumption, liver tests and the risk for NAFLD. Furthermore, CRP was shown to essentially moderate this relationship. These findings support recommendations for consumption of flavonoid-rich foods to prevent cardiometabolic diseases.

Dietary inflammatory index and incidence of breast cancer in the SUN project

BACKGROUND & AIMS

Breast cancer (BC) is the most commonly diagnosed cancer, and diet is suspected to play a role in its development. Dietary factors may mediate this process through modulation of inflammation, though findings from previous studies have not been consistent. We aimed to longitudinally assess the association between the dietary inflammatory index (DII^®), a frequently used method to assess the inflammatory potential of the diet, and incident BC.

METHODS

We included 10,713 middle-aged, Spanish female university graduates from the SUN cohort. DII^® scores were derived from a validated 136-item food-frequency questionnaire, and it was based on scientific evidence on the relationship between diet and inflammatory biomarkers. Diagnosis of BC was reported by the participant or, if deceased, by the next of kin or identified from death certificates. Self-reports of BC were confirmed by revision of medical reports by an experienced oncologist. Cox proportional hazard models were used to estimate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for the association between quartiles of DII^® and incident BC.

RESULTS

After 10.3 years of median follow-up, we identified 100 confirmed and 168 probable incident BC cases. The multivariable-adjusted HR for participants in the 4th quartile to the 1st quartile was 1.44 (95% CI 0.76-2.72; p-trend: 0.339) when confirmed cases were analyzed, and 1.20 (95% CI 0.72-1.99; p-trend: 0.757) for the probable cases. We neither observed statistically significant differences in regard to menopausal status.

CONCLUSIONS

The apparent increase in risk between DII^® scores and BC in our cohort was not statistically significant, which could be partly explained by the small number of observed cases.

Association of ideal cardiovascular health metrics with serum uric acid, inflammation and atherogenic index of plasma: A population-based survey

BACKGROUND AND AIMS

We aimed to evaluate the link between inflammatory score [consisting of C-reactive protein (CRP) and white blood cells], serum uric acid (SUA) and atherogenic index of plasma (AIP) and the cardiovascular health (CVH) score.

METHODS

We used the cross-sectional National Health and Nutrition Examination Survey database. Statistical analyses accounted for the survey design and sample weights.

RESULTS

Overall, there were 23,004 participants (mean age = 47.2 years, 46.5% males). Participants with an ideal CVH level had the highest ratio of poverty to income (3.62%, p < 0.001), as well as lower levels of CRP, SUA and AIP (p < 0.001 for all comparisons). In adjusted linear regression, a significant negative association was observed between inflammatory score (β = -0.052, p < 0.001), SUA (β = -0.041, p < 0.001) and AIP (β = -0.039, p < 0.001) and CVH score, i.e. participants with a better (greater) CVH score had a lower inflammatory score. Results from adjusted logistic regression showed reduction in the likelihood of "high-risk atherosclerosis" (defined as AIP ≥0.21) [intermediate: odds ratio (OR) = 0.90, 95% confidence interval (CI):0.85-0.95, ideal: OR = 0.81, 95%CI: 0.74-0.88] and "high CVD risk" (defined as CRP ≥3 mg/l) [intermediate: OR = 0.86, 95%CI:0.73-0.98, ideal: OR = 0.82, 95%CI:0.69-0.95] across the categories of CVH.

CONCLUSIONS

Our findings highlight that CVH metrics were associated with inflammatory score, SUA and AIP. Furthermore, participants with a better CVH score had a lower CVD risk. These results reinforce the importance of implementing healthy behaviours as proposed by the American Heart Association. If confirmed in clinical trials, this knowledge may have implications for CVD prevention and management.

The impact of nuts consumption on glucose/insulin homeostasis and inflammation markers mediated by adiposity factors among American adults

BACKGROUND

Inconclusive results have been published regarding the impact of nut consumption on glucose/insulin homeostasis and inflammatory factors. Furthermore, it remains unanswered whether adiposity factors could mediate the association between nut consumption, glucose/insulin homeostasis and inflammatory markers; this is what the current study aims to investigate.

RESULTS

From a total of 16,784 individuals, 48.2% participants were men; overall mean age was 47.2 years. Age-, sex-, energy intake and race-adjusted mean of serum C-reactive protein (CRP)(0.49 to 0.26 mg/dl), apolipoprotein-β (apo- β) (95.6 to 90.8 mg/dl), glucose/insulin homeostasis parameters and triglyceride-glucose index (TyG) index (8.32 to 7.95) significantly decreased as the quartile of nut intake increased (all p < 0.001). We found that all evaluated potential mediators had significant and positive associations with markers of glucose/insulin homeostasis or inflammation (all p < 0.001). With regard to BMI, the mediated effects were significant for the associations between nut consumption and CRP, fasting blood glucose, insulin, hemoglobin A1c (HbA1c), triglyceride to high-density lipoprotein (TG:HDL) ratio and TyG index (all p < 0.001). As for WC, it had mediator impact on CRP, fasting blood glucose, HbA1c, TG:HDL ratio and TyG index (all p < 0.001). apVAT played no mediation role for any association (all p > 0.05).

CONCLUSIONS

This is the first study which quantify the role of nut consumption on inflammatory and glucose/insulin homeostasis markers. Nut intake was inversely associated with inflammatory and glucose/insulin homeostasis markers. Certain adiposity indexes (i.e. BMI and WC) mediated these associations. These findings convey an important message for the crucial role of weight management with dietary recommendations.

METHOD

We extracted data from the National Health and Nutrition Examination Survey (2005-2010) on nut consumption to evaluate the association between nut intake and markers of glucose/insulin homeostasis and inflammation. We assessed whether this link, if any, is mediated or affected by adiposity factors, including body mass index (BMI), waist circumference (WC, marker of central adiposity), anthropometrically predicted visceral adipose tissue (apVAT), visceral adiposity index (VAI, indicator of adipose distribution) and lipid accumulation product (LPA, novel index of central lipid accumulation). Analysis of co-variance and conceptus causal mediation analysis were conducted based on survey design and sample weights.

Food Patterns are Associated with Likelihood of CKD in US Adults

We investigated the association between dietary patterns and prevalent chronic kidney diseases (CKD), in participants of the 2005–2012 US National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2012, who had measured data on dietary intake and kidney function. Analyse of covariance (ANCOVA) and logistic regression models were employed to account for the survey design and sample weights. A total of 21,649 eligible participants (634 with and 20,015 without prevalent CKD) were included in the final analysis. Three food patterns together explained 50.8% of the variance of the dietary nutrients consumption. The first food pattern was representative of a diet containing high levels of saturated and mono-unsaturated fatty acids; the second food pattern comprised vitamins and trace elements; and the third food pattern was mainly representative of polyunsaturated fatty acids. The odd of prevalent CKD decreased across increasing quarters of vitamins and trace elements, so that the top quarter was associated with a 53% (95%CI: 42–62%) lower odds of CKD in age, sex and race adjusted logistic regression models. These results suggest that vitamins and trace elements intake are associated with lower risk of prevalent CKD.

Effects of conjugated linoleic acid supplementation on serum C-reactive protein: A systematic review and meta-analysis of randomized controlled trials

AIM

To undertake a systematic review and meta-analysis of prospective studies to determine the effect of conjugated linoleic acids (CLAs) supplementation on serum C-reactive protein (CRP).

METHOD

PubMed-Medline, Web of Science, Cochrane Database, and Google Scholar databases were searched (up until May 2016) to identify prospective studies evaluating the impact of CLAs supplementation on serum CRP. Random-effects models meta-analysis was used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. Heterogeneity was quantitatively assessed using the I² index. Systematic review registration: CRD42016038945.

RESULTS

From a total of 85 entries identified via searches, 14 studies were included in the final selection. The meta-analysis indicated a significant increase in serum CRP concentrations following supplementation with CLAs (weighted mean difference [WMD] 0.63 mg/dL, 95% confidence interval [95% CI] 0.13-1.13, N=21 arms, heterogeneity P=.026; I² =52.3%). These findings were robust in sensitivity analyses. Random-effects meta-regression revealed that changes in serum CRP levels were independent of the dosage of CLAs supplementation (slope: -0.02; 95% CI: -0.10, 0.12; P=.889) or duration of follow-up (slope: 0.271; 95% CI: -0.05, 0.59; P=.098).

CONCLUSIONS

This meta-analysis suggests that CLA supplementation is associated with an increase in plasma CRP concentrations and a reduction in serum adiponectin concentrations, which indicates that CLA supplements have a proinflammatory effect. Randomized control trials with larger sample size and a longer follow-up period may be required for future investigations to provide an unequivocal answer.

Association of dietary patterns of American adults with bone mineral density and fracture

OBJECTIVE

In a representative sample of US adults, we investigated the associations of nutrient patterns (NP) with bone mineral density (BMD) and fractures.

DESIGN

Cross-sectional.

SETTING

US community-based National Health and Nutrition Examination Survey (NHANES).

SUBJECTS

Participants with measured data on dietary intake and BMD from 2005 to 2010 were included. Principal components analysis was used to identify NP. BMD was measured using dual-energy X-ray absorptiometry. ANCOVA, adjusted logistic and linear regression models were employed, accounting for the complex survey design and sample weights.

RESULTS

We included a total of 18 318 participants, with 47·0 % (n 8607) being men. The mean age was 45·8 years with no sex difference. Three NP emerged, explaining 55·9 % of the variance in nutrient consumption. Multivariable-adjusted linear regressions revealed significant inverse associations between the 'high-energy' NP (rich in carbohydrates and sugar, total fat and saturated fat) and total femur, femoral neck, trochanter and intertrochanter BMD (β coefficient: -0·029, -0·025, -0·034 and -0·021, respectively, all P<0·001), while there were significant associations between the 'nutrient-dense' NP (rich in vitamins, minerals and fibre) and 'healthy fat' NP (high dietary PUFA and MUFA) and BMD at total femur, femoral neck, trochanter and intertrochanter (all P<0·001). In adjusted logistic regression models, the odds of hip, wrist or spine fractures did not vary significantly across NP quartiles.

CONCLUSIONS

Nutrient-dense and healthy fat NP are associated with higher BMD at various bone sites, while the high-energy NP is inversely associated with BMD measures.

Lipid accumulation product and triglycerides/glucose index are useful predictors of insulin resistance

OBJECTIVES

To investigate the association of triglycerides/glucose index (TyG index), anthropometrically predicted visceral adipose tissue (apVAT), lipid accumulation product (LAP), visceral adiposity index (VAI) and triglycerides (TG):high density lipoprotein-cholesterol (HDL-C) ratio with insulin resistance (IR) in adult Americans.

METHODS

This study was based on data from three NHANES cycles (2005 to 2010). The TyG index was calculated as ln [TG×fasting glucose/2]. VAI was calculated using gender-specific formulas: men [waist circumference (WC)/39.68+(1.88×body mass index (BMI)]×(TG/1.03)×(1.31/HDL-C); women: [WC/36.58+(1.89×BMI)]×(TG/0.81)×(1.52/HDL-C). LAP index was calculated as [WC-65]×[TG] in men, and [WC-58]×[TG] in women. Correlation and regression analyses accounted for the complex sampling of database.

RESULTS

A total of 18,318 subjects was included in this analysis [mean age 47.6Years]; 48.7% (n=8918) men]. The homeostatic model assessment of insulin resistance (HOMA-IR) had a significant positive correlation with the TyG index (r=0.502), LAP (r=0.551), apVAT (r=0.454), TG:HDL-C ratio (r=0.441) and VAI (r=451) (p<0.001 for all comparisons). Bland-Altman plots showed no systematic errors. The optimal cut-off to predict HOMA-diagnosed IR was 0.473 (sensitivity=74.5% and specificity=72.7%) for LAP, 0.478 (75.9%, 71.9%) for TyG, 0.391 (70.4%, 67.1%) for VAI, 0.392 (77.1% and 62.0%) for TG:HDL-C ratio and 0.381 (63.8%, 74.8%) for apVAT.

CONCLUSIONS

The LAP index is a simple, cheap and accurate although not perfect, surrogate marker of HOMA-diagnosed IR among adult Americans. Moreover, it has higher predictability than other screening tools which traditionally applied. Among the markers, apVAT had the highest specificity and the TG:HDL-C ratio had the highest sensitivity.

Effects of selected dietary constituents on high-sensitivity C-reactive protein levels in U.S. adults

BACKGROUND AND AIM

Growing evidence suggests that some of the effects of diet on cardiovascular disease (CVD) occur through mechanisms involving subclinical inflammation. We assessed the relationship between selected dietary constituents and serum high-sensitivity C-reactive protein (hsCRP) concentration in a population-based sample of United States adults.

METHODS

In this cross-sectional analysis, participants were selected from the US National Health and Nutrition Examination Survey (NHANES) and restricted to those with available data on dietary intake, biochemical and anthropometric measurements from 2001 to 2010. All statistical analyses accounted for the survey design and sample weights by using SPSS Complex Samples v22.0 (IBM Corp, Armonk, NY).

RESULTS

Of the 17,689 participants analysed, 8607 (48.3%) were men. The mean age was 45.8 years in the overall sample, 44.9 in men and 46.5 in women (p = .047). The age-, race-, sex-, energy intake- and body mass index-adjusted mean dietary intakes of total dietary fibre, polyunsaturated fatty-acids, vitamin E, vitamin A, vitamin B6, total folate, vitamin B family, vitamin C, vitamin K, magnesium, iron, copper and potassium monotonically decreased across increasing hsCRP quarters (p < .001 for all), whereas sugar intake increased (p < .001). In analysis of covariance adjusted for potential confounders (age-, race-, sex-, energy intake- and body weight-) hsCRP levels increased across increasing quarters of sugar intake (p < .001).

CONCLUSIONS

This study provides further evidence of an association between dietary sugar, polyunsaturated fatty-acids, fibre and antioxidant intake and hsCRP levels, a subclinical inflammation marker. hsCRP concentrations are likely modulated by dietary intake. KEY MESSAGES Serum high-sensitivity C-reactive protein (hsCRP) concentration is positively associated with sugar intake, and negatively with the consumption of minerals, vitamins and polyunsaturated fatty-acids (fruit and vegetables). hsCRP concentrations, and accordingly subclinical inflammation, are likely influenced by dietary intake.

Arachidonic acid supplementation modulates blood and skeletal muscle lipid profile with no effect on basal inflammation in resistance exercise trained men

Arachidonic acid (ARA), an omega-6 polyunsaturated fatty acid (PUFA), is the metabolic precursor to the eicosanoid family of lipid mediators. Eicosanoids have potent pro-inflammatory actions, but also act as important autocrine/paracrine signaling molecules in skeletal muscle growth and development. Whether dietary ARA is incorporated into skeletal muscle phospholipids and the resulting impact on intramuscular inflammatory and adaptive processes in-vivo is not known. In the current study, resistance trained men (≥1 year) received dietary supplementation with 1.5g/day ARA (n=9, 24 ± 1.5 years) or placebo (n=10, 26 ± 1.3 years) for 4-weeks while continuing their normal training regimen. Plasma and vastus lateralis muscle biopsies were collected in an overnight fasted state at baseline and week 4. ARA supplementation increased plasma content of ARA and gamma-linolenic acid, while decreasing relative abundance of linoleic acid, eicosapentaenoic acid, and dihomo-gamma-linolenic acid. In skeletal muscle, ARA and dihomo-gamma-linolenic acid content increased, whereas alpha-linolenic-acid was reduced. Compared to placebo, ARA supplementation reduced circulating platelet and monocyte number, and decreased the mRNA expression of the immune cell surface markers; neutrophil elastase/CD66b and interleukin 1-beta, in peripheral blood mononuclear cells. In muscle, ARA supplementation increased mRNA expression of the myogenic regulatory factors; MyoD and myogenin, but had no effect on a range of immune cell markers or inflammatory cytokines. These data show that dietary ARA supplementation can rapidly and safely modulate plasma and muscle fatty acid profile and promote myogenic gene expression in resistance trained men, without a risk of increasing basal systemic or intramuscular inflammation.

Dietary patterns, plasma vitamins and Trans fatty acids are associated with peripheral artery disease

BACKGROUND

To investigate the association between dietary patterns (DP), plasma vitamins and trans fatty acids (TFAs) with the likelihood of peripheral artery disease (PAD).

METHODS

National Health and Nutrition Examination Survey (NHANES) data for the years 1999-2002 were used. PAD was diagnosed by ankle brachial index assessment. Plasma concentrations of vitamins were measured using high performance liquid chromatography. Vitamin D levels were measured by radioimmunoassay. Analysis of covariance, principal components analysis (PCA) and adjusted logistic regression were applied, accounting for the survey design and sample weights.

RESULTS

Of the 4864 eligible participants, 2482 (51.0%) were men and 269 (5.5%) had prevalent PAD. PCA uncovered three DPs which accounted for 56.8% of the variance in dietary nutrients consumption including DP1 (fatty acids and cholesterol), DP2 (minerals, vitamins and fiber), and DP3 (polyunsaturated fatty acids [PUFA]). PAD patients had a significantly higher serum concentrations of trans 9-octadecenoic acid and trans 9, trans 12-octadienoic acid as well as lower plasma levels of vitamin D, retinol, retinyl stearate and retinyl palmitate (p < 0.001 for all comparisons). In models adjusted for age, race, diabetes, cholesterol, hypertension, smoking and energy intake, individuals in the highest quartile of the DP1 had higher odds for PAD compared with those in the lowest quartile [(odds ratio (OR): 6.43, 95% confidence interval (CI): 2.00-20.63 p < 0.001], while those in the highest quartile of DP2 and DP3 had lower odds of PAD relative to those in the lowest quartile (OR:0.28, OR:0.44, respectively; p < 0.001 for both comparisons).

CONCLUSION

We found that quality of diet, plasma vitamins and TFAs are associated with the likelihood of PAD. If confirmed in prospective studies, the possibility that dietary factors, plasma vitamins and TFAs might be valuable for preventing or delaying the clinical progression of PAD, should be investigated in intervention trials.

Association Between Plasma Trans-Fatty Acid Concentrations and Measures of Glucose Homeostasis and Cardiovascular Risk Factors in Adults in NHANES 1999-2000

There is limited evidence on the association between plasma trans-fatty acids (TFAs) and cardiometabolic risk factors. Therefore, we examined the association between plasma TFA concentrations and glucose homeostasis and cardiovascular (CV) risk factors in adult Americans from the 1999 to 2000 National Health and Nutrition Examination Survey participants. Derivatized TFAs were separated by capillary gas chromatography. Of the 1678 participants, 46.5% were men. The mean age was 50.5 years overall, with no significant difference between men and women ( P = .101). In age-, sex- and race-adjusted analyses, mean waist circumference, fat-free mass, fat mass, C-peptide, insulin, hemoglobin A_1c (HbA_1c), homeostatic model assessment of insulin resistance (HOMA-IR), serum triglycerides (TGs), and total cholesterol (TC) increased across increasing quarters of TFAs (for all P < .001), while mean serum high-density lipoprotein cholesterol decreased across increasing quarters of plasma TFAs ( P < .001). In multivariable adjusted linear regressions, there remained significant positive associations between all plasma TFAs and body mass index, waist circumference, fat-free mass, fat mass, C-peptide, insulin, fasting blood glucose, HOMA-IR, HbA_1c, TGs, low-density lipoprotein cholesterol, and TC ( P < .001). In conclusion, our findings support a possible association between plasma TFAs concentrations and measures of glucose homeostasis and several CV risk factors.

Fatty acid components in Asian female patients with irritable bowel syndrome

Abdominal pain is one of the key symptoms of irritable bowel syndrome (IBS). Studies have indicated an increase in the incidence of IBS in Asia. However, yet the pathophysiology of this disease remains unknown. Women are more likely to develop the condition than men, especially the constipation-predominant type. Essential fatty acid (EFA) malnutrition is one of several theories discussing the mechanism of IBS.The authors hypothesized that significant EFA deficiency may cause abdominal pain in patients with IBS. However, because patterns in the oral intake of EFAs differ between cultures, the authors narrowed this study to examine the nutritional status of Asian female patients with IBSThe authors investigated Asian female patients with IBS and compared them with a group of healthy controls. Thirty patients with IBS and 39 healthy individuals were included in this study. The participants' age, height, weight, and waist size were recorded. The 24-item Hamilton Depression Rating Scale was documented. Both erythrocyte and plasma fatty acid content were analyzed through gas-liquid chromatography.The authors found that patients with IBS exhibited significantly higher scores for depression, higher proportions of plasma saturated fatty acids and monounsaturated fatty acids, and lower proportions of docosahexaenoic acid and total omega-3 polyunsaturated fatty acids in plasma are associated with IBS in Asian female patients. Further study is indicated to confirm the causality of this association.

The effect of electro-acupuncture on pro-oxidant antioxidant balance values in overweight and obese subjects: a randomized controlled trial study

Objective To undertake a randomized controlled trial in 196 obese subjects to examine the effect of electro-acupuncture on serum pro-oxidant antioxidant balance (PAB) values. Methods Subjects received authentic acupuncture (cases) or sham acupuncture (controls) for 6 weeks in combination with a low-calorie diet. In the following 6 weeks, they received the low-calorie diet alone. Serum PAB was measured at baseline, and 6 and 12 weeks later. Results We found that serum PAB values decreased significantly in the group receiving the authentic acupuncture compared to the sham treatment (p<0.001) at week 6, and whilst serum PAB increased significantly (p<0.05) in the second phase of the study, a significant difference between two groups remained at 12 weeks (p<0.05). Conclusions Electro-acupuncture in combination with a low-calorie diet was more effective at reducing serum PAB values in obese subjects compared to diet alone. Further work is required to determine the mechanism by which electro-acupuncture has this effect.

The association between dietary inflammatory properties and bone mineral density and risk of fracture in US adults

BACKGROUND/OBJECTIVES

To examine the associations of dietary inflammatory index (DII) with bone mineral density (BMD) and fracture risk in adult Americans.Subjects/Method:The United States National Health and Nutrition Examination Survey participants during 2005-2010 were included if they had measured data on dietary intake and BMD. DII scores were calculated from estimated micro- and macronutrients from a single 24-h dietary recall. BMD was measured using dual-energy X-ray absorptiometry densitometers. Risk of fractures was obtained from participant self-report (ever) based on doctor information. Analyze of covariance and χ²-tests were employed, while accounting for the complex survey design.

RESULTS

A total of 18 318 participants were included, with 51.3% (9397) being men. Age, sex, race, physical activity, smoking, C-reactive protein and body mass index-adjusted mean BMD (g/cm²) in different bodily sites significantly decreased across increasing quarters of the DII (all P<0.001). After further adjustment for calcium intake, the trend in BMD across DII quarters remained significant for total femur, femoral neck, trochanter and intertrochanter BMD (all P<0.001). Across increasing quarters of the DII, the proportion of fractures ranged from 1.1 to 1.5% for hip fracture (P=0.02), from 7.9 to 10.5% for wrist fracture (P<0.001) and from 2.2 to 2.7% for spine fracture (P=0.002. Prevalent wrist fractures significantly differed across DII quarters (P<0.0001), driven by high prevalence in the top quarter, while hip and spine fractures' prevalence did not vary significantly.

CONCLUSIONS

The current study provides evidence suggesting a potential adverse effect of pro-inflammatory diet on bone health; which may have implications for dietary approaches for those with history of abnormal bone health complications.

Dietary food patterns and glucose/insulin homeostasis: a cross-sectional study involving 24,182 adult Americans

Aim

To investigate the association of major dietary patterns with glucose and insulin homeostasis parameters in a large American sample. The association between dietary patterns (DP) derived via principal components analysis (PCA), with glucose/insulin homeostasis parameters was assessed. The likelihood of insulin resistance (IR) across the DPs quarters was also explored.

Method

The United States National Health and Nutrition Examination Survey (NHANES) participants during 2005–2012 were included if they underwent measurement of dietary intake as well as glucose and insulin homeostasis parameters. Analysis of covariance (ANCOVA) and adjusted logistic and linear regression models were employed to account for the complex survey design and sample weights.

Results

A total of 24,182 participants were included; 48.9% (n = 11,815) were men. Applying PCA revealed three DP (56.8% of variance): the first was comprised mainly of saturated fat (SFA), total fat, mono-unsaturated fatty acids (MUFA) and carbohydrate (CHO); the second is highly enriched with vitamins, trace elements and dietary fiber; and the third was composed of polyunsaturated fatty acids (PUFA), cholesterol and protein. Among the total population, after adjustment for age, sex, race, C-reactive protein, smoking, and physical activity, glucose homeostasis factors, visceral adiposity index and lipid accumulation product improved across the quarters of the first and third DP; and a reverse pattern with the second DP. The same trend was observed for the non-diabetic subjects. Moreover, subjects with higher adherence to the first and third DP had higher likelihood for developing IR, whereas there was a lower likelihood for the second DP.

Conclusion

This study shows that the DP heavily loaded with CHO, SFA, PUFA, protein, total fat and MUFA as well as high-cholesterol-load foods is associated with impaired glucose tolerance; in contrast, the healthy pattern which is high in vitamins, minerals and fiber may have favourable effects on insulin sensitivity and glucose tolerance.

C-reactive Protein Is Associated With Prevalence of the Metabolic Syndrome, Hypertension, and Diabetes Mellitus in US Adults

The prevalence of metabolic syndrome (MetS) has increased globally and is associated with an increased risk of cardiovascular diseases that may be related to its association with inflammation. We have assessed whether the prevalence of the MetS correlates with a serum high-sensitivity C-reactive protein (hsCRP) concentration in a population-based sample of US men and women. Participants were selected from the US National Health and Nutrition Examination Survey from 2005 to 2010. Of the 17 689 participants analyzed, 8607 (48.3%) were men. The mean age was 45.8 years in the overall sample (between men and women P = .047). The prevalence of MetS, diabetes mellitus, and hypertension increased across quartiles for hsCRP (all P < .001). Moreover, we found that for the age-, race-, sex-, and smoking-adjusted logistic regression, with increasing hsCRP, the risk of having MetS increased with an odds ratio of 5.20 (95% confidence interval, 4.54-5.93, P < .001) when comparing the highest quartile of serum hsCRP with the lowest. This study provides further evidence for an association between MetS and subclinical inflammation.

Telomere attrition, kidney function, and prevalent chronic kidney disease in the United States

Background

Telomere length is an emerging novel biomarker of biologic age, cardiovascular risk and chronic medical conditions. Few studies have focused on the association between telomere length (TL) and kidney function.

Objective

We investigated the association between TL and kidney function/prevalent chronic kidney disease (CKD) in US adults.

Methods

The National Health and Nutrition Examination Survey (NHANES) participants with measured data on kidney function and TL from 1999 to 2002 were included. Estimated glomerular filtration rate (eGFR) was based on CKD Epidemiology Collaboration (CKD-EPI) equation. Urinary albumin excretion was assessed using urinary albumin-creatinine ratio (ACR). We used multivariable adjusted linear and logistic regression models, accounting for the survey design and sample weights.

Results

Of the 10568 eligible participants, 48.0% (n=5020) were men. Their mean age was 44.1 years. eGFR significantly decreased and ACR significantly increased across increasing quarters of TL (all p<0.001). The association between TL and kidney function remained robust even after adjusting for potential confounding factors, but the association between TL and ACR was only borderline significant (β-coefficient= -0.012, p=0.056).

Conclusion

The association of kidney function with a marker of cellular senescence suggests an underlying mechanism influencing the progression of nephropathy.

The relationship of plasma Trans fatty acids with dietary inflammatory index among US adults

Background

It has been suggested that trans fatty acids (TFAs) play an important role in cardiovascular diseases. We investigated the association between plasma TFAs and the dietary inflammatory index (DII) ™ in US adults.

Methods

National Health and Nutrition Examination Survey (NHANES) participants with data on plasma TFAs measured from 1999 to 2010 were included. Energy-adjusted-DII ™ (E-DII ™) expressed per 1000 kcal was calculated from 24-h dietary recalls. All statistical analyses accounted for the survey design and sample weights.

Results

Of the 5446 eligible participants, 46.8% (n = 2550) were men. The mean age of the population was 47.1 years overall, 47.8 years for men and 46.5 years for women (p = 0.09). After adjustment for C-reactive protein, body-mass-index, smoking, race, age, education, and marital status in linear regressions, trans 9-hexadecenoic acid [β coefficient 0.068 (95% CI: 0.032 to 0.188)], trans 11-octadecenoic acid [β coefficient 0.143 (95% CI: 0.155 to 0.310)], trans 9-octadecenoic acid [β coefficient 0.122 (95% CI: 0.120 to 0.277)], trans 9, and trans 12-octadienoic acid [β coefficient 0.103 (95% CI: 0.090 to 0.247)] were positively associated with the DII (all p < 0.001).

Conclusion

The association of plasma TFAs with a marker of dietary inflammation suggests an underlying mechanism in the initiation and progression of cardiovascular diseases.

Treatment with GLP1 receptor agonists reduce serum CRP concentrations in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials

AIM

To undertake a systematic review and meta-analysis of randomized controlled trials of the effect of glucagon-like peptide-1 receptor agonist (GLP-1 RAs) therapy on serum C-reactive protein (CRP) concentrations.

METHOD

PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases were searched for the period up until March 16, 2016. Prospective studies evaluating the impact of GLP-1 RAs on serum CRP were identified. A random effects model (using the DerSimonian-Laird method) and generic inverse variance methods were used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. Heterogeneity was quantitatively assessed using the I² index. Random effects meta-regression was performed using unrestricted maximum likelihood method to evaluate the impact of potential moderator. International Prospective Register for Systematic Reviews (PROSPERO) number CRD42016036868.

RESULTS

Meta-analysis of the data from 7 treatment arms revealed a significant reduction in serum CRP concentrations following treatment with GLP-1 RAs (WMD -2.14 (mg/dL), 95% CI -3.51, -0.78, P=0.002; I² 96.1%). Removal of one study in the meta-analysis did not change the result in the sensitivity analysis (WMD -2.14 (mg/dL), 95% CI -3.51, -0.78, P=0.002; I² 96.1%), indicating that our results could not be solely attributed to the effect of a single study. Random effects meta-regression was performed to evaluate the impact of potential moderator on the estimated effect size. Changes in serum CRP concentration were associated with the duration of treatment (slope -0.097, 95% CI -0.158, -0.042, P<0.001).

CONCLUSIONS

This meta-analysis suggests that GLP-1 RAs therapy causes a significant reduction in CRP.

Telomere Length Is Associated With Cardiometabolic Factors in US Adults

Telomere length (TL) has been associated with age-related health outcomes. We investigated the relationship of TL with cardiometabolic risk profile in adult Americans. We used the National Health and Nutrition Examination Surveys for 1999 to 2002, accounting for complex sampling and survey design. Of the 8892 eligible participants, 47.8% (n = 4123) were men. Mean serum high-density lipoprotein cholesterol concentrations significantly increased across increasing TL quarters ( P = .013), and mean fat mass, fat-free mass, hemoglobin A_1c (HbA_1c), and C-reactive protein significantly decreased across increasing TL quarters (all P < .001) in men. Only HbA_1c levels significantly decreased across increasing TL quarters ( P = .041) in women. Males in the upper quarter of TL had lower (38%) odds of prevalent metabolic syndrome compared with those in the lower quarter ( P < .001). These results support the hypotheses that cardiometabolic factors are related to TL, especially in men.

Association between telomere length and complete blood count in US adults

INTRODUCTION

Telomere length (TL) is related to age-related health outcomes, but little is known about the relationship between TL and complete blood count (CBC) parameters. We aimed to determine the relationship between TL and CBC in a sample of healthy US adults.

MATERIAL AND METHODS

Participants in the National Health and Nutrition Examination Survey (NHANES) recruited between 1999 and 2002 who had essential data on total CBC and TL were studied. We computed age- and race-adjusted mean values for total CBC using analysis of covariance (ANCOVA). All statistical analyses accounted for the survey design and sample weights by using SPSS Complex Samples v22.0 (IBM Corp, Armonk, NY).

RESULTS

Of the 8892 eligible participants, 47.8% (n = 4123) were men. The mean age was 41.8 years overall, 41.0 years in men and 42.6 in women (p = 0.238). The sex-stratified ANCOVA showed no significant difference in the total CBC across TL quartiles (all p > 0.05) in both sexes. In the adjusted model, there was a significant negative relationship with monocyte count (β = -0.051, 95% CI: -0.422; -0.142), mean cell hemoglobin (β = -0.051, 95% CI: -0.038; -0.011) and red cell distribution width (β = -0.031, 95% CI: -0.054; -0.003), while there was a significant positive relationship with basophil ratio (β = 0.046, 95% CI: 0.049-0.171).

CONCLUSIONS

These results support the possibility that telomere attrition may be a marker for reduced proliferative reserve in hematopoietic progenitor cells.