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Fiamingo M, Toler S, Lee K, Oshiro W, Krantz T, Evansky P, Davies D, Gilmour MI, Farraj A, Hazari MS. Depleted Housing Elicits Cardiopulmonary Dysfunction After a Single Flaming Eucalyptus Wildfire Smoke Exposure in a Sex-Specific Manner in ApoE Knockout Mice. Cardiovasc Toxicol 2024:10.1007/s12012-024-09897-8. [PMID: 39044058 DOI: 10.1007/s12012-024-09897-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 07/11/2024] [Indexed: 07/25/2024]
Abstract
Although it is well established that wildfire smoke exposure can increase cardiovascular morbidity and mortality, the combined effects of non-chemical stressors and wildfire smoke remains understudied. Housing is a non-chemical stressor that is a major determinant of cardiovascular health, however, disparities in neighborhood and social status have exacerbated the cardiovascular health gaps within the United States. Further, pre-existing cardiovascular morbidities, such as atherosclerosis, can worsen the response to wildfire smoke exposures. This represents a potentially hazardous interaction between inadequate housing and stress, cardiovascular morbidities, and worsened responses to wildfire smoke exposures. The purpose of this study was to examine the effects of enriched (EH) versus depleted (DH) housing on pulmonary and cardiovascular responses to a single flaming eucalyptus wildfire smoke (WS) exposure in male and female apolipoprotein E (ApoE) knockout mice, which develop an atherosclerosis-like phenotype. The results of this study show that cardiopulmonary responses to WS exposure occur in a sex-specific manner. EH blunts adverse WS-induced ventilatory responses, specifically an increase in tidal volume (TV), expiratory time (Te), and relaxation time (RT) after a WS exposure, but only in females. EH also blunted an increase in isovolumic relaxation time (IVRT) and the myocardial performance index (MPI) 1-week after exposures, also only in females. Our results suggest that housing alters the cardiovascular response to a single WS exposure, and that DH might cause increased susceptibility to environmental exposures that manifest in altered ventilation patterns and diastolic dysfunction in a sex-specific manner.
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Affiliation(s)
- Michelle Fiamingo
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina -Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Sydnie Toler
- Gillings School of Global Public Health and School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Kaleb Lee
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, 37830, USA
| | - Wendy Oshiro
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, 109 T.W. Alexander Dr., Research Triangle Park, NC, 27711, USA
| | - Todd Krantz
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, 109 T.W. Alexander Dr., Research Triangle Park, NC, 27711, USA
| | - Paul Evansky
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, 109 T.W. Alexander Dr., Research Triangle Park, NC, 27711, USA
| | - David Davies
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, 109 T.W. Alexander Dr., Research Triangle Park, NC, 27711, USA
| | - M Ian Gilmour
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, 109 T.W. Alexander Dr., Research Triangle Park, NC, 27711, USA
| | - Aimen Farraj
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, 109 T.W. Alexander Dr., Research Triangle Park, NC, 27711, USA
| | - Mehdi S Hazari
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, 109 T.W. Alexander Dr., Research Triangle Park, NC, 27711, USA.
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El-Sayed H, Abdelsalam A, Morad MY, Sonbol H, Ibrahim AM, Tawfik E. Phyto-synthesized silver nanoparticles from Sargassum subrepandum: anticancer, antimicrobial, and molluscicidal activities. FRONTIERS IN PLANT SCIENCE 2024; 15:1403753. [PMID: 38779072 PMCID: PMC11110841 DOI: 10.3389/fpls.2024.1403753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/18/2024] [Indexed: 05/25/2024]
Abstract
In the realm of nanotechnology, the use of algae to produce nanoparticles is an environmentally friendly, sustainable, and economically viable strategy. In the present study, the brown macroalgae Sargassum subrepandum was utilized to effectively produce silver nanoparticles (AgNPs). Through various characterization techniques, the AgNPs' structural integrity was confirmed. AgNPs exhibited significant antimicrobial activity against Pseudomonas aeruginosa and Fusarium equiseti. AgNPs showed cytotoxic effects on the MCF-7 breast adenocarcinoma cell line with an IC50 of 12.5 µg/ml. Treatment with AgNPs resulted in a marked reduction in cell viability, alongside evident apoptotic and necrotic morphological changes in the cancer cells. Through molecular docking studies, a deeper understanding of the interaction between AgNPs and crucial proteins related to cancer has been achieved, AgNPs showed a promising molluscicidal action on Biomphalaria alexandrina snails, a Schistosoma mansoni intermediate host. The half-lethal dose (LC50) of AgNPs was determined to be 0.84 mg/L. The potential consequences of its administration include potential disruptions to the glycolysis profile, as well as potential impacts on the steroidal hormone's estrogen and testosterone and certain kidney function tests. This study highlights the diverse uses of algae-synthesized AgNPs, ranging from healthcare to environmental management, demonstrating their importance in advancing nano-biotechnological solutions.
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Affiliation(s)
- Heba El-Sayed
- Botany and Microbiology Department, Faculty of Science, Helwan University, Helwan, Egypt
| | - Asmaa Abdelsalam
- Botany and Microbiology Department, Faculty of Science, Helwan University, Helwan, Egypt
| | - Mostafa Y. Morad
- Zoology and Entomology Department, Faculty of Science, Helwan University, Helwan, Egypt
| | - Hana Sonbol
- Department of Biology, College of Science, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Amina M. Ibrahim
- Medical Malacology Department, Theodor Bilharz Research Institute, Giza, Egypt
| | - Eman Tawfik
- Botany and Microbiology Department, Faculty of Science, Helwan University, Helwan, Egypt
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Fiamingo M, Toler S, Lee K, Oshiro W, Krantz T, Evansky P, Davies D, Gilmour MI, Farraj A, Hazari MS. Depleted housing elicits cardiopulmonary dysfunction after a single flaming eucalyptus wildfire smoke exposure in a sex-specific manner in ApoE knockout mice. RESEARCH SQUARE 2024:rs.3.rs-4237383. [PMID: 38659910 PMCID: PMC11042425 DOI: 10.21203/rs.3.rs-4237383/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Although it is well established that wildfire smoke exposure can increase cardiovascular morbidity and mortality, the combined effects of non-chemical stressors and wildfire smoke remains understudied. Housing is a non-chemical stressor that is a major determinant of cardiovascular health, however, disparities in neighborhood and social status have exacerbated the cardiovascular health gaps within the United States. Further, pre-existing cardiovascular morbidities, such as atherosclerosis, can worsen the response to wildfire smoke exposures. This represents a potentially hazardous interaction between inadequate housing and stress, cardiovascular morbidities, and worsened responses to wildfire smoke exposures. The purpose of this study was to examine the effects of enriched (EH) versus depleted (DH) housing on pulmonary and cardiovascular responses to a single flaming eucalyptus wildfire smoke (WS) exposure in male and female apolipoprotein E (ApoE) knockout mice, which develop an atherosclerosis-like phenotype. The results of this study show that cardiopulmonary responses to WS exposure occur in a sex-specific manner. EH blunts adverse WS-induced ventilatory responses, specifically an increase in tidal volume (TV), expiratory time (Te), and relaxation time (RT) after a WS exposure, but only in females. EH also blunted a WS-induced increase in isovolumic relaxation time (IVRT) and the myocardial performance index (MPI) 1-wk after exposures, also only in females. Our results suggest that housing alters the cardiovascular response to a single WS exposure, and that DH might cause increased susceptibility to environmental exposures that manifest in altered ventilation patterns and diastolic dysfunction in a sex-specific manner.
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Affiliation(s)
| | | | - Kaleb Lee
- Oak Ridge Institute for Science and Education
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Shan MA, Ishtiaq W, Kanwal S, Khan MU, Iftikhar A, Khan S. Cell-free DNA as a potential diagnostic biomarker in academic stress: A case-control study in young adults. Saudi J Biol Sci 2024; 31:103933. [PMID: 38304540 PMCID: PMC10831250 DOI: 10.1016/j.sjbs.2024.103933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 01/01/2024] [Accepted: 01/11/2024] [Indexed: 02/03/2024] Open
Abstract
Background Stress is a pervasive issue in modern life, affecting both physical and mental health. Identifying biomarkers like cell-free DNA (cfDNA) could provide insights into stress response and help detect individuals at risk for stress-related disorders. Objective The aim of this study is to investigate the potential use of cfDNA as a diagnostic biomarker in individuals experiencing stress. Methodology A case-control analysis was conducted using convenient sampling on university participants (N = 285 cases, N = 500 controls) aged 18-24. The study assessed haematological and lipid profile parameters using the Sysmex XP-300TM automated analyzer and an automated biochemistry analyzer, and cfDNA was extracted using a standardized in house developed Phenol-Chloroform protocol and estimated using Agarose Gel Electrophoresis and Nanodrop. Statistical analysis was performed using SPSS ver. 21.0. Results The results indicated a significant difference between stressed individuals and healthy controls in demographic, haematological and biochemical parameters. Specifically, stressed cases had significantly higher levels of cholesterol, LDL cholesterol, triglycerides, glucose, VLDL cholesterol, and lower levels of HDL compared to healthy controls. Stressed cases also showed significantly elevated levels of circulating cfDNA relative to healthy controls. Conclusion These findings suggest that cfDNA may have potential as a diagnostic biomarker for stress.
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Affiliation(s)
| | - Warda Ishtiaq
- Center for Molecular Biology, University of the Punjab, Lahore, Pakistan
| | - Shamsa Kanwal
- Muhammad Ali Jinnah University Karachi, Karachi, Pakistan
| | - Muhammad Umer Khan
- Institute of Molecular Biology and Biotechnology, The University of Lahore, Lahore, Pakistan
| | - Ayesha Iftikhar
- Lahore Business School, The University of Lahore, Lahore, Pakistan
| | - Samiullah Khan
- Institute of Molecular Biology and Biotechnology, The University of Lahore, Lahore, Pakistan
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Elkady EF, Ayoub HA, Ibrahim AM. Molluscicidal activity of calcium borate nanoparticles with kodom ball-flower structure on hematological, histological and biochemical parameters of Eobania vermiculata snails. PESTICIDE BIOCHEMISTRY AND PHYSIOLOGY 2024; 198:105716. [PMID: 38225073 DOI: 10.1016/j.pestbp.2023.105716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/16/2023] [Accepted: 11/27/2023] [Indexed: 01/17/2024]
Abstract
Land snails are the most harmful pests in agricultural fields. Eobania vermiculata is a widespread snail species that causes massive damage to all agricultural crops. Thus, the molluscicidal activity of calcium borate nanoparticles (CB-NPs) against Eobania vermiculata was evaluated and compared with metaldehyde (Gastrotox® E 5% G). The amorphous phase of CB-NPs was obtained after thermal treatment at a low temperature (500 °C) which conformed by X-ray diffraction (XRD) analysis. CB-NPs are composed of aggregated nano-sheets with an average thickness of 54 nm which enhanced their molluscicidal activity. These nano-sheets displayed meso-porous network architecture with pore diameters of 13.65 nm, and a 9.46 m2/g specific surface area. CB-NPs and metaldehyde (Gastrotox® E 5% G) exhibited molluscicidal effects on Eobania vermiculata snails with median lethal concentrations LC50 of 175.3 and 60.5 mg/l, respectively, after 72 h of exposure. The results also showed significant reductions of Eobania vermiculata snails hemocytes' mean total number, the levels of Testosterone (T) and Estrogen (E), alkaline phosphatase, acid phosphatase, albumin, and protein concentrations, succinate dehydrogenase, glucose, triglycerides and phospholipids levels, while significant increases in the phagocytic index and mortality index, both transaminases (ALT and AST) and glycogen phosphorylase concentration were observed after the exposure to LC50 of CB-NPs or metaldehyde (Gastrotox® E 5% G) compared to the control group. Therefore, CB-NPs could be used as an alternative molluscicide for controlling Eobania vermiculata, but further studies are needed to assess their effects on non-target organisms.
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Affiliation(s)
| | - Haytham A Ayoub
- Plant Protection Research Institute, Agricultural Research Center, Giza, Egypt
| | - Amina M Ibrahim
- Medical Malacology Department, Theodor Bilharz Research Institute, Giza, Egypt.
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Stone TW, Williams RO. Tryptophan metabolism as a 'reflex' feature of neuroimmune communication: Sensor and effector functions for the indoleamine-2, 3-dioxygenase kynurenine pathway. J Neurochem 2023. [PMID: 38102897 DOI: 10.1111/jnc.16015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/16/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023]
Abstract
Although the central nervous system (CNS) and immune system were regarded as independent entities, it is now clear that immune system cells can influence the CNS, and neuroglial activity influences the immune system. Despite the many clinical implications for this 'neuroimmune interface', its detailed operation at the molecular level remains unclear. This narrative review focuses on the metabolism of tryptophan along the kynurenine pathway, since its products have critical actions in both the nervous and immune systems, placing it in a unique position to influence neuroimmune communication. In particular, since the kynurenine pathway is activated by pro-inflammatory mediators, it is proposed that physical and psychological stressors are the stimuli of an organismal protective reflex, with kynurenine metabolites as the effector arm co-ordinating protective neural and immune system responses. After a brief review of the neuroimmune interface, the general perception of tryptophan metabolism along the kynurenine pathway is expanded to emphasize this environmentally driven perspective. The initial enzymes in the kynurenine pathway include indoleamine-2,3-dioxygenase (IDO1), which is induced by tissue damage, inflammatory mediators or microbial products, and tryptophan-2,3-dioxygenase (TDO), which is induced by stress-induced glucocorticoids. In the immune system, kynurenic acid modulates leucocyte differentiation, inflammatory balance and immune tolerance by activating aryl hydrocarbon receptors and modulates pain via the GPR35 protein. In the CNS, quinolinic acid activates N-methyl-D-aspartate (NMDA)-sensitive glutamate receptors, whereas kynurenic acid is an antagonist: the balance between glutamate, quinolinic acid and kynurenic acid is a significant regulator of CNS function and plasticity. The concept of kynurenine and its metabolites as mediators of a reflex coordinated protection against stress helps to understand the variety and breadth of their activity. It should also help to understand the pathological origin of some psychiatric and neurodegenerative diseases involving the immune system and CNS, facilitating the development of new pharmacological strategies for treatment.
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Affiliation(s)
- Trevor W Stone
- The Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford, UK
| | - Richard O Williams
- The Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford, UK
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Luo J, Beam CR, Gatz M. Is Stress an Overlooked Risk Factor for Dementia? A Systematic Review from a Lifespan Developmental Perspective. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:936-949. [PMID: 35622193 DOI: 10.1007/s11121-022-01385-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/26/2022]
Abstract
Stress exposure and stress reactivity may be potent factors associated with increased risk of dementia. The 2017 Lancet Commission on Dementia and its 2020 update reviewed modifiable risk factors associated with dementia, but stress was not addressed directly. The present study provides a focused review of the association between stress and dementia across the lifespan, with measures of stress including stress exposure, psychological stress, posttraumatic stress disorder (PTSD), and biological markers of stress. Published research articles were identified in the American Psychological Association PsycINFO database (1887-2021), Web of Science database, and Google Scholar. A total of 53 samples from 40 studies published from 1985 to 2020 met inclusion criteria. Results suggest that stressful life events that occur earlier in the lifespan, such as loss of a parent, psychological stress experienced in midlife, and extreme stress responses, i.e., PTSD, correlate with higher risk of dementia. Although results generally are mixed, a consistent theme is that stress experienced earlier in the lifespan and chronic stress portend the greatest risk of dementia. Reducing stress exposure and improving stress management when stress exposure cannot be changed are thus relevant strategies in dementia risk reduction.
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Affiliation(s)
- Jing Luo
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Avenue, Chicago, IL, 60611, USA.
| | - Christopher R Beam
- Department of Psychology, University of Southern California, Los Angeles, CA, 90089-1061, USA
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, 90089-0191, USA
| | - Margaret Gatz
- Department of Psychology, University of Southern California, Los Angeles, CA, 90089-1061, USA
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, 90089-3332, USA
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The association between allostatic load and brain: A systematic review. Psychoneuroendocrinology 2022; 145:105917. [PMID: 36113380 DOI: 10.1016/j.psyneuen.2022.105917] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 11/22/2022]
Abstract
Allostatic load (AL) refers to prolonged dysregulation related to chronic stress that affects brain regions such as the hippocampus, amygdala, and prefrontal cortex (PFC). Higher levels of AL have been associated with poor health outcomes, including psychiatric disorders, cognitive decline, and chronic somatic conditions. However, still little is known about the relationship between AL and the brain, and the mechanisms explaining the damaging effects of stress-related biological dysregulations. Therefore, we aimed to perform a systematic review of studies investigating the association of the AL index with brain structure and functioning in adult populations. PubMed/MEDLINE, CINAHL, Academic Search Complete and Web of Science were searched from their inception until August, 9th 2021. A total of 13 studies were included in the qualitative synthesis. There was a high between-study heterogeneity with respect to the methods used to calculate the AL index and brain parameters. All studies confirmed the associations between a higher AL index and alterations in various brain areas, especially: 1) the hippocampus, white matter volume, gray matter volume, and density in the older adults; 2) the cortex, fornix, hippocampus and choroid plexus in patients with schizophrenia spectrum disorders; and 3) whole-brain white matter tracts, cortical gray matter volume, and cortical thickness in overweight subjects. Overall, the findings of this systematic review imply that an elevated AL index might be associated with various neurostructural and neurofunctional alterations. Some of these associations may appear regardless of clinical or non-clinical populations being investigated (e.g., white matter tracts), whereas others may appear in specific populations (e.g., cortical thinning in overweight/obesity and schizophrenia spectrum disorders). However, additional studies utilizing a consistent approach to calculating the AL index are needed to extend these findings and indicate populations that are most vulnerable to the damaging effects of AL.
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Gupta SJ, Pradhan B, Bhanushali D, Nityapragya R. Physical and mental health at high altitude of individuals doing yogic practices. J Neurosci Rural Pract 2022; 13:647-651. [PMID: 36743761 PMCID: PMC9894322 DOI: 10.25259/jnrp-2022-3-25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/20/2022] [Indexed: 12/05/2022] Open
Abstract
Objectives There is an increase trend in the past few years, in the number of people traveling to high altitude for recreational activities such as pilgrims, mountaineering, and climbing and for occupational purposes such as defense and mining which have resulted in increasing in hypoxia conditions and anxiety-related medical problems at high altitude. As it is known that mental stress affects brain and heart functions, a recent research performed on Sudarshan Kriya Yoga (SKY) further validated the effectiveness of SKY on participants (practicing SKY) as compared to control after quantifying mental stress. To study the physiological effect of SKY advance breathing technique when immediately ascends to high altitude, we wanted to study the level of stress and mental well-being of lowlanders at high altitude. Materials and Methods It is an interventional study performed at high altitudes, with low landers as participants where their biochemical and psychological parameters are being assessed. Results The result for biochemical parameter cholesterol, triglycerides, low-density lipoproteins (LDLs), high-density lipoproteins (HDLs), very low-density lipoproteins, LDL-HDL ratio, and cholesterol-HDL ratio showed a significant decrease in the pre- and post-analyses values with P ≤ 0.001. Acute mountain sickness (AMS), Warwick-Edinburgh Mental Well-being Scale, and State and Trait Anxiety Inventory (STAI) also show a decreasing trend with significant result in AMS, mental well-being, and non-significant in STAI p value is P = 0.016, P = 0.055, and P = 0.125, respectively. Conclusion We observed positive outcome both in for biochemical and stress-related parameters with SKY advance program practitioners who have rapidly ascend to high altitude.
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Affiliation(s)
- Sheetal J. Gupta
- Division of Yoga and Humanities, Swami Vivekananda Yoga Anushandhan Samsthan University, Bengaluru, Karnataka, India
| | - Balaram Pradhan
- Deputy Registrar of Academics, Swami Vivekananda Yoga Anushandhan Samsthan University, Bengaluru, Karnataka, India
| | - Disha Bhanushali
- Sri Sri Institute of Advanced Research, Bengaluru, Karnataka, India
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Korošec D, Vrbnjak D, Štiglic G. Health Conditions and Long Working Hours in Europe: A Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12325. [PMID: 36231628 PMCID: PMC9566276 DOI: 10.3390/ijerph191912325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/17/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
Studies have shown that working conditions and employee health are related; therefore, this study aimed to determine the relationships between working long hours per week with health outcomes in different European countries. We analyzed data derived from the Survey of Health, Ageing, and Retirement in Europe. The sample included 12.099 participants aged ≥ 50 from 16 European countries. We analyzed self-reported working hours, health outcomes of blood cholesterol, heart attack, diabetes, and hypertension, as well as a longitudinal analysis of health outcomes among healthcare workers and workers in 13 other industries. Statistical analyses identified that men are working longer hours per week compared with women in all included countries, and different levels of increase in health conditions in different industries. We also observed a slower increase in the prevalence of health conditions for healthcare workers compared with workers in other industries, especially diabetes and hypertension. The largest increase in prevalence of observed health conditions was reported for cholesterol, which increased for 17.14% among healthcare workers and for 21.70% in other industries over the observed nine-year period. Although the data point to a potentially high level of awareness in the field of preventive health among healthcare workers, more preventive health activities should be included in workplaces to strengthen employees' health.
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Affiliation(s)
- Darja Korošec
- Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia
| | - Dominika Vrbnjak
- Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia
| | - Gregor Štiglic
- Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia
- Faculty of Electrical Engineering and Computer Science, University of Maribor, 2000 Maribor, Slovenia
- Usher Institute, University of Edinburgh, Edinburgh EH8 9YL, UK
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Johnson DA, Knutson K, Colangelo LA, Hale L, Redline S, Carnethon M, Kershaw KN. Associations of Chronic Burden, Sleep Characteristics, and Metabolic Syndrome in the Coronary Artery Risk Development in Young Adults Study. Psychosom Med 2022; 84:711-718. [PMID: 35420593 PMCID: PMC9271585 DOI: 10.1097/psy.0000000000001081] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Chronic exposure to stress is associated with metabolic syndrome (MetS), but the mechanism is unclear. We investigated the associations between chronic burden, sleep, and MetS in the Coronary Artery Risk Development in Young Adults Study. METHODS Chronic burden was self-reported (2000-2001) according to experiences with stressors for longer than 6 months. Wrist actigraphy-measured sleep duration and sleep efficiency were collected for 6 days; sleep duration, sleep quality, and daytime sleepiness were self-reported (2003-2004). MetS was measured during the clinic visit, from 2005 to 2006. Multivariable logistic and Cox proportional hazard models were fit to determine the associations of interest. Mediation by sleep was assessed using the product of coefficients approach. RESULTS Among participants ( n = 606), the average (standard deviation) age was 40 (3.6) years, 58% were female, and 43% were Black. The prevalences of chronic burden, short sleep (≤6 hours), and MetS were 35%, 43% and 20.5%, respectively. High versus low chronic burden was associated with shorter self-reported sleep duration and higher daytime sleepiness. Chronic burden was associated with 1.85 higher odds (95% confidence interval = 1.11-3.09) of MetS. Sleep characteristics were not associated with MetS. There was no evidence that sleep mediated the chronic burden-MetS relation. CONCLUSION Burden of chronic stress may be an emerging novel risk factor for both poor sleep and MetS.
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Affiliation(s)
- Dayna A Johnson
- From the Department of Epidemiology (Johnson), Emory University Rollins School of Public Health, Emory University, Atlanta, Georgia; Division of Sleep and Circadian Disorders (Johnson, Redline), Brigham and Women's Hospital, Boston, Massachusetts; Department of Preventive Medicine (Colangelo, Carnethon, Kershaw) and Department of Neurology (Knutson), Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Family (Hale), Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York; and Division of Sleep Medicine (Redline), Harvard Medical School, Boston, Massachusetts
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Bhuiyan N, Kang JH, Papalia Z, Bopp CM, Bopp M, Mama SK. Assessing the stress-buffering effects of social support for exercise on physical activity, sitting time, and blood lipid profiles. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1563-1569. [PMID: 33026309 PMCID: PMC8024406 DOI: 10.1080/07448481.2020.1810055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 04/26/2020] [Accepted: 05/05/2020] [Indexed: 06/01/2023]
Abstract
OBJECTIVE This study tested the hypothesized stress-buffering effects of social support on physical activity, sitting time, and blood lipid profiles. PARTICIPANTS 537 college students. METHODS College students volunteered to self-report stress, social support for exercise, physical activity and sitting time, and provided blood samples to assess lipid profiles in this cross-sectional study. RESULTS Lower stress was associated with higher vigorous physical activity (β = -0.1, t = -2.9, p = .004). Higher social support was associated with higher moderate (β = 0.2, t = 2.0, p = .042), vigorous (β = 0.5, t = 5.4, p < .001), and total (β = 0.1, t = 3.2, p = .001) physical activity, and lower sitting time on weekdays (β = -0.1, t = -3.3, p = .001) and weekends (β = -0.2, t = -3.6, p < .001). Social support moderated the association between stress and sitting time on weekdays. CONCLUSIONS Stress reduction and fostering social support may be important strategies for promoting physical activity and reducing sedentary behaviors in college students. Additional strategies are needed to buffer the deleterious effects of stress.
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Affiliation(s)
- Nishat Bhuiyan
- Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania
| | - Jamie H. Kang
- Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania
| | - Zack Papalia
- Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania
- Center for Fitness and Wellness, The Pennsylvania State University, University Park, Pennsylvania
| | - Christopher M. Bopp
- Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania
- Center for Fitness and Wellness, The Pennsylvania State University, University Park, Pennsylvania
| | - Melissa Bopp
- Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania
| | - Scherezade K. Mama
- Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania
- Penn State Cancer Institute, Hershey, Pennsylvania
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13
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Chang PY, Chiou ST, Lo WY, Huang N, Chien LY. Stressors and level of stress among different nursing positions and the associations with hyperlipidemia, hyperglycemia, and hypertension: a national questionnaire survey. BMC Nurs 2021; 20:250. [PMID: 34903232 PMCID: PMC8667416 DOI: 10.1186/s12912-021-00777-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/30/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Nurses are faced with varying job stressors depending on their positions and duties. Few previous studies have compared job stress and related chronic conditions among different nursing positions. The objectives were to compare job stressors among clinical registered nurses, nurse practitioners, and head nurses and explore the impact of job stressors and stress level on hyperlipidemia, hyperglycemia, and hypertension. METHODS Secondary data extracted from a survey of health-care workers conducted from May to July 2014 across 113 hospitals in Taiwan was used. This analysis included 17,152 clinical registered nurses, 1438 nurse practitioners, and 2406 head nurses. Socio-demographic characteristics, job stressors, stress levels, and hyperlipidemia, hyperglycemia, and hypertension variables were extracted. RESULTS Perceived stressors differed among clinical registered nurses, nurse practitioners, and head nurses, but overall stress level did not. Nurse practitioners and head nurses showed significantly higher prevalence of hyperlipidemia, hyperglycemia, and hypertension than clinical registered nurses. Higher stress levels, age, body mass index, work hours, and caring for family members were positively associated with hyperlipidemia, hyperglycemia, and hypertension. After adjustment for these variables, risk of hyperlipidemia, hyperglycemia, and hypertension did not differ across the nursing positions. CONCLUSIONS Although stressors vary by different nursing positions, overall stress level does not. Hyperlipidemia, hyperglycemia, and hypertension are related to stress level, age, body mass index, weekly working hours, and caring for family members. Hence, alleviating job stress and avoiding long working hours are likely to reduce the risk of hyperlipidemia, hyperglycemia, and hypertension in nurses.
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Affiliation(s)
- Po-Ya Chang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Shu-Ti Chiou
- Institute of Public Health, National Yang Ming Chaio Tung University, Yang-Ming Campus, Taipei, Taiwan.,Center for Healthcare Quality Management, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Wen-Yen Lo
- Department of Nursing, National Yang Ming Chiao Tung University, Yang-Ming Campus, Taipei, Taiwan
| | - Nicole Huang
- Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Yang-Ming Campus, Taipei, Taiwan
| | - Li-Yin Chien
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Yang-Ming Campus, 155 Li-Nong Street, Section 2, Bei-Tou, Taipei, 11221, Taiwan.
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14
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Meguro K, Svensson T, Chung UI, Svensson AK. Associations of work-related stress and total sleep time with cholesterol levels in an occupational cohort of Japanese office workers. J Occup Health 2021; 63:e12275. [PMID: 34679211 PMCID: PMC8535434 DOI: 10.1002/1348-9585.12275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 08/04/2021] [Accepted: 08/09/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE The aim of the study was to investigate the associations of total sleep time (TST) and occupational stress based on the Brief Job Stress Questionnaire (BJSQ) with cholesterol levels in an occupational cohort of Japanese office workers. METHODS The present study is a secondary analysis of a subset of participants from a randomized controlled trial. Participants were 179 employees from 5 companies in Tokyo who participated as the intervention group in a 3-month lifestyle intervention study among office workers with metabolic syndrome or at risk of metabolic syndrome. All intervention-group participants used a mobile app and a wearable device. The final population for analysis in the present study were 173 participants. Cholesterol measures were derived from participants' annual health check-up data in the fiscal year preceding their inclusion in the study. Multiple linear regression models were used to determine the association between exposures and outcome. RESULTS Overall, stress levels were significantly and inversely associated with LDL-C (-7.12 mg/dl; 95% CI: -11.78, -2.45) and LDL-C/HDL-C ratio (-0.16 mg/dl; 95% CI: -0.27, -0.04) per standard deviation increase. Compared to average TST 5.9-7.2 hours, average TST of 4.0-5.3 hours (-4.82 mg/dl; 95% CI: -9.22, -0.43) was inversely associated with HDL-C. CONCLUSION Incremental increases of stress were significantly and inversely associated with LDL-C and LDL-C/HDL-C ratio. The shortest average TST was inversely associated with HDL-C. The results should be interpreted with care given certain methodological limitations.
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Affiliation(s)
- Keiko Meguro
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Bunkyo, Japan.,School of Health Innovation, Kanagawa University of Human Services Graduate School, Kawasaki, Japan
| | - Thomas Svensson
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Bunkyo, Japan.,School of Health Innovation, Kanagawa University of Human Services Graduate School, Kawasaki, Japan.,Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ung-Il Chung
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Bunkyo, Japan.,School of Health Innovation, Kanagawa University of Human Services Graduate School, Kawasaki, Japan.,Clinical Biotechnology, Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan
| | - Akiko K Svensson
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Bunkyo, Japan.,Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.,Department of Diabetes and Metabolic Diseases, The University of Tokyo, Bunkyo, Japan
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15
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Jeon SY, Kim JL. Caregiving for a Spouse with Cognitive Impairment: Effects on Nutrition and Other Lifestyle Factors. J Alzheimers Dis 2021; 84:995-1003. [PMID: 34602480 DOI: 10.3233/jad-210694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Being a spousal caregiver (SCG) for a patient with cognitive impairment is well known to be associated with increased risk for dementia and cognitive decline. OBJECTIVE This study examined the impact of the care recipient's cognitive status on lifestyle factors influencing cognitive decline in SCGs, focusing on nutritional status and blood biomarkers. METHODS Fifty-one SCGs participated (mean age 73.5±7.0 years) in this study. All participants underwent clinical assessment including the Mini Nutritional Assessment (MNA), Geriatric Depression Scale, Pittsburgh Sleep Quality Index, and International Physical Activity Questionnaire to evaluate lifestyle factors, and the Mini-Mental State Examination to assess global cognition. Also, nutritional blood biomarkers were measured. RESULTS SCGs caring for a demented spouse showed significantly higher depression scores (t = -3.608, p = 0.001) and malnutrition risk (t = 2.894, p = 0.006). Decreased care recipients' cognition was significantly correlated with higher GDS (β= -0.593, t = -4.471, p < 0.001) and higher MNA scores (β= 0.315, t = 2.225, p = 0.031) and lower level of high-density lipoprotein (HDL) cholesterol (β= 0.383, t = 2.613, p = 0.012) in their SCGs. Gender had moderating effects on association of care recipients' cognition with sleep quality (B[SE] = 0.400[0.189], p = 0.041) and HDL cholesterol (B[SE] = -1.137[0.500], p = 0.028) among SCGs. Poorer care-recipient cognition was associated with worse sleep quality and low HDL cholesterol among wives but not husband caregivers. CONCLUSION This study provides substantial evidence that SCGs are at risk for depression and malnutrition, which can further affect cognitive decline. As such, these factors should be well assessed and monitored among SCGs for patient with cognitive impairment.
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Affiliation(s)
- So Yeon Jeon
- >Department of Psychiatry, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Jeong Lan Kim
- >Department of Psychiatry, Chungnam National University Hospital, Daejeon, Republic of Korea.,Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
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16
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Cao B, Zhao Y, Ren Z, McIntyre RS, Teopiz KM, Gao X, Ding L. Are Physical Activities Associated With Perceived Stress? The Evidence From the China Health and Nutrition Survey. Front Public Health 2021; 9:697484. [PMID: 34414158 PMCID: PMC8369204 DOI: 10.3389/fpubh.2021.697484] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/07/2021] [Indexed: 11/23/2022] Open
Abstract
Psychological stress is a negative affective state. The association between physical activity and psychological stress was commonly reported in previous researches. Few published studies with large sample sizes have explored such an association in Chinese population. The current research aims to assess the association between perceived stress and physical activity preferences, as well as the association between risk of high perceived stress and physical activity behaviors (e.g., sports-, transport-, occupational-related physical activity, sedentary activities and time in bed). The data were collected from the China Health and Nutrition Survey (CHNS) in 2015. Generalized linear models and logistic regression models were used to explore the association between perceived stress and physical activity. In total, 11,066 participants were included in the current analysis. For physical activity preferences, we found that “like” preference of all six mentioned domains of activities contributed to lower perceived stress (i.e., lower perceived stress scale −14 score, all β < 0 and p < 0.05). For physical activity behaviors, the results indicated that none/low intensity physical activity behaviors (e.g., sports-, occupational- related, sedentary) were associated with risk of high perceived stress, except that low intensity of transport-related activities seemed to be protective from high stress. However, the association between intensity of physical activity behaviors and perceived stress was not simply the higher the better. High intensity of all these physical activity behaviors was also associated with high perceived stress. Our findings suggest that positive preferences and moderate physical activity behaviors were associated with low perceived stress. The findings herein highlight the effect of regulating physical activity on perceived stress, as well as inform potential strategies to reduce psychological stress.
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Affiliation(s)
- Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China.,National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing, China
| | - Yuxiao Zhao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
| | - Zhongyu Ren
- College of Physical Education, Southwest University, Chongqing, China
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Kayla M Teopiz
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Xiao Gao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China.,National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing, China
| | - Ling Ding
- Pharmacy Department, The Central Hospital of Jiangjin, Chongqing, China
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17
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Anni NS, Jung SJ, Shim JS, Jeon YW, Lee GB, Kim HC. Stressful life events and serum triglyceride levels: the Cardiovascular and Metabolic Diseases Etiology Research Center cohort in Korea. Epidemiol Health 2021; 43:e2021042. [PMID: 34126706 PMCID: PMC8289470 DOI: 10.4178/epih.e2021042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 06/09/2021] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES Elevated serum triglyceride levels are a risk factor for developing cardiovascular disease. A number of studies have demonstrated a positive association between psychological stress and serum triglyceride levels. However, there is limited evidence regarding the impact of stressful life events (SLEs) on serum triglyceride levels in the healthy population. Therefore, we evaluated the independent association between SLEs and serum triglyceride levels in a middle-aged Korean population. METHODS We analyzed a sample of 2,963 people (aged 30-64 years; 36% men) using baseline data from the Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort study. The Korean version of the Life Experience Survey questionnaire was used to measure the presence and positive/negative impact of SLEs. Hypertriglyceridemia was defined as a fasting serum triglyceride level of ≥ 150 mg/dL. RESULTS Of the 2,963 participants, 33.1% reported at least 1 SLE over the past 6 months and 24.8% had hypertriglyceridemia. Even after adjusting for potential confounders, the serum triglyceride level was significantly associated with the total number of SLEs in men (3.333 mg/dL per event; p= 0.001), but not in women (0.451 mg/dL per event, p= 0.338). Hypertriglyceridemia was also associated with having 4 or more SLEs with positive effects (odds ratio [OR], 2.57; 95% CI, 1.02 to 6.46) and 4 or more SLEs with negative effects (OR, 1.99; 95% CI, 1.16 to 3.41) in men. CONCLUSIONS Our findings suggest that SLEs may increase the risk of hypertriglyceridemia in middle-aged men.
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Affiliation(s)
| | - Sun Jae Jung
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jee-Seon Shim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea.,Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Woo Jeon
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
| | - Ga Bin Lee
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
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18
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Al-Abbasi FA. Diazepam ameliorates altered proinflammatory and cardiac markers in stress exposed rats. Saudi J Biol Sci 2021; 28:566-571. [PMID: 33424340 PMCID: PMC7783838 DOI: 10.1016/j.sjbs.2020.10.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/09/2020] [Accepted: 10/20/2020] [Indexed: 11/01/2022] Open
Abstract
Regular exposure to stress causes alteration in biochemical parameter but till date no specific medicine prescribed for controlling it. Current study aimed to determine the effect of Diazepam on proinflammatory and cardiac markers in stress exposed rats. Male Wistar rats were divided into four groups with six animals in each group for 90 days study. Group-1 served as a Normal Control (NC), Groups-2, as a Disease Control (DC), Group-3 as a Diazepam Control (DMC) and Group-4 as a Disease + Diazepam Treatment (DT). DMC and DT animals exposed to regular stress by forced swimming exercise method for 90 days. DMC and DT received 5 mg/kg, p.o the daily dose of Diazepam. At the end of the protocol, animals were sacrificed. The level of serum proinflammatory marker interleukin-6 in DC increased significantly (p < 0.001) while restored significantly (p < 0.001) in DT. Level of interleukin-10 in DC decreased significantly (p < 0.001) while restored significantly (p < 0.001) in DT. Level of fibrinogen was also increased by stress, which was restored significantly (p < 0.05) by diazepam. Increased level of Creatine kinase-MB (CK-MB) by stress was restored significantly (p < 0.05) by diazepam. The level of cortisol was increased also significantly (p < 0.001) and restored to normal by diazepam. The level of C-reactive protein (CRP) and cholesterol was increased significantly (p < 0.01; p < 0.001) by stress while restored significantly (p < 0.01; p < 0.001) by diazepam. Findings from results suggest that diazepam ameliorates altered proinflammatory and cardiac markers in stress exposed rats.
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Affiliation(s)
- Fahad A. Al-Abbasi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
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19
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Xu Y, Li Y, Jadhav K, Pan X, Zhu Y, Hu S, Chen S, Chen L, Tang Y, Wang HH, Yang L, Wang DQH, Yin L, Zhang Y. Hepatocyte ATF3 protects against atherosclerosis by regulating HDL and bile acid metabolism. Nat Metab 2021; 3:59-74. [PMID: 33462514 PMCID: PMC7856821 DOI: 10.1038/s42255-020-00331-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 12/09/2020] [Indexed: 12/13/2022]
Abstract
Activating transcription factor (ATF)3 is known to have an anti-inflammatory function, yet the role of hepatic ATF3 in lipoprotein metabolism or atherosclerosis remains unknown. Here we show that overexpression of human ATF3 in hepatocytes reduces the development of atherosclerosis in Western-diet-fed Ldlr-/- or Apoe-/- mice, whereas hepatocyte-specific ablation of Atf3 has the opposite effect. We further show that hepatic ATF3 expression is inhibited by hydrocortisone. Mechanistically, hepatocyte ATF3 enhances high-density lipoprotein (HDL) uptake, inhibits intestinal fat and cholesterol absorption and promotes macrophage reverse cholesterol transport by inducing scavenger receptor group B type 1 (SR-BI) and repressing cholesterol 12α-hydroxylase (CYP8B1) in the liver through its interaction with p53 and hepatocyte nuclear factor 4α, respectively. Our data demonstrate that hepatocyte ATF3 is a key regulator of HDL and bile acid metabolism and atherosclerosis.
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Affiliation(s)
- Yanyong Xu
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Yuanyuan Li
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, Rootstown, OH, USA
- Zhongshan Institute for Drug Discovery, the Institutes of Drug Discovery and Development, Chinese Academy of Sciences, Zhongshan, China
- Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Kavita Jadhav
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Xiaoli Pan
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, Rootstown, OH, USA
- Divison of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yingdong Zhu
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Shuwei Hu
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Shaoru Chen
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Liuying Chen
- Divison of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Tang
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Helen H Wang
- Department of Medicine and Genetics, Marion Bessin Liver Research Center and Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ling Yang
- Divison of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - David Q-H Wang
- Department of Medicine and Genetics, Marion Bessin Liver Research Center and Albert Einstein College of Medicine, Bronx, NY, USA
| | - Liya Yin
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Yanqiao Zhang
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, Rootstown, OH, USA.
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20
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Campos-Ramírez C, Ramírez-Amaya V, Olalde-Mendoza L, Palacios-Delgado J, Anaya-Loyola MA. Soft Drink Consumption in Young Mexican Adults Is Associated with Higher Total Body Fat Percentage in Men but Not in Women. Foods 2020; 9:E1760. [PMID: 33260727 PMCID: PMC7761352 DOI: 10.3390/foods9121760] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/23/2020] [Accepted: 11/26/2020] [Indexed: 12/15/2022] Open
Abstract
A high consumption of soft drinks (SDs) has been linked with the development of anthropometric and metabolic alterations. We evaluate the association between SD consumption and some anthropometric and metabolic variables. This study is an observational study, using a sample of 394 university students, of which 158 were men (40.1%) and 238 women (59.9%), between 18 and 30 years. An SD intake questionnaire provided the consumption of different SDs. The participants' weight, height, and waist and hip circumferences were collected. Metabolic biomarkers were analyzed. The average intake of caloric SDs (CSDs) was 1193.6 ± 1534.8 mL/week and 84.5 ± 115.02 mL/week for non-caloric SDs (NCSDs). Sex differences were found in the amount of SD consumption and these statistical differences were driven by those men subjects with a high total body fat percentage (TBF%). In men, correlations were found between the intake of CSDs and the body mass index, waist and hip circumferences, TBF%, and visceral fat percentage. In woman, a correlation was found with glucose and triglycerides. The prediction model revealed that the intake of CSDs predicts TBF% and low-density lipoprotein only in men. A high amount of CSD consumption in men was associated with a high TBF%, and this may be predictive of future development of metabolic abnormalities.
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Affiliation(s)
- Cesar Campos-Ramírez
- Program of Biological Science, Department of Natural Sciences, Autonomous University of Queretaro, Av. de las Ciencias S/N, Juriquilla, Queretaro 76230, Mexico; (C.C.-R.); (L.O.-M.)
| | - Víctor Ramírez-Amaya
- Instituto de Investigación Médica Mercedes y Martín Ferreyra INIMEC-CONICET-UNC, Friuli 2434, Colinas de Vélez Sarsfield, Córdoba 5016, Argentina;
| | - Liliana Olalde-Mendoza
- Program of Biological Science, Department of Natural Sciences, Autonomous University of Queretaro, Av. de las Ciencias S/N, Juriquilla, Queretaro 76230, Mexico; (C.C.-R.); (L.O.-M.)
| | - Jorge Palacios-Delgado
- University of Mexican Valley-Campus Juriquilla, Blvd. Juriquilla 1000 Querétaro, Querétaro 76230, Mexico;
| | - Miriam Aracely Anaya-Loyola
- Department of Natural Sciences, Autonomous University of Queretaro, Av. de las Ciencias S/N, Juriquilla, Queretaro 76230, Mexico
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21
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Dany F, Dewi RM, Tjandrarini DH, Pradono J, Delima D, Sariadji K, Handayani S, Kusumawardani N. Urban-rural distinction of potential determinants for prediabetes in Indonesian population aged ≥15 years: a cross-sectional analysis of Indonesian Basic Health Research 2018 among normoglycemic and prediabetic individuals. BMC Public Health 2020; 20:1509. [PMID: 33023540 PMCID: PMC7539503 DOI: 10.1186/s12889-020-09592-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 09/22/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Based on Basic Health Research (RISKESDAS) conducted by Ministry of Health, Indonesia, prediabetes prevalence tends to increase from 2007 until 2018. The numbers are relatively higher in rural than those in urban area despite of small discrepancies between the two (~ 2-4%). The purpose of this study was to identify urban-rural differences in potential determinants for prediabetes in Indonesia. METHODS This analysis used secondary data collected from nationwide Health Survey in 2018. Respondents were aged ≥15 years who met inclusion criteria of analysis with no history of diabetes mellitus. Prediabetes criteria followed American Diabetes Association 2019. Multiple logistic regression was also employed to assess the transition probability of potential determinants for prediabetes in urban and rural Indonesia. RESULTS Up to 44.8% of rural respondents were prediabetics versus their urban counterparts at 34.9%, yet non-response bias was observed in the two. Young adults aged 30 years were already at risk of prediabetes. Urban-rural distinction for marital status and triglyceride level was observed while other determinants tended to overlap across residence. Several modifiable factors might contribute differently in both population with careful interpretation. CONCLUSIONS The minimum age limit for early prediabetes screening may start from 30 years old in Indonesia. Urban-rural distinction for marital status and triglyceride level was observed, yet non-response bias between the two groups could not be excluded. A proper model for early prediabetes screening need to be developed from a cohort study with adequate sample size.
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Affiliation(s)
- Frans Dany
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia.
| | - Rita Marleta Dewi
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Dwi Hapsari Tjandrarini
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Julianty Pradono
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Delima Delima
- Centre for Research and Development of Health Resources and Services, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Kambang Sariadji
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Sarwo Handayani
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Nunik Kusumawardani
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
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22
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Dany F, Dewi RM, Tjandrarini DH, Pradono J, Delima D, Sariadji K, Handayani S, Kusumawardani N. Urban-rural distinction of potential determinants for prediabetes in Indonesian population aged ≥15 years: a cross-sectional analysis of Indonesian Basic Health Research 2018 among normoglycemic and prediabetic individuals. BMC Public Health 2020. [PMID: 33023540 DOI: 10.1186/s12889-020-09592-7/peer-review] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Based on Basic Health Research (RISKESDAS) conducted by Ministry of Health, Indonesia, prediabetes prevalence tends to increase from 2007 until 2018. The numbers are relatively higher in rural than those in urban area despite of small discrepancies between the two (~ 2-4%). The purpose of this study was to identify urban-rural differences in potential determinants for prediabetes in Indonesia. METHODS This analysis used secondary data collected from nationwide Health Survey in 2018. Respondents were aged ≥15 years who met inclusion criteria of analysis with no history of diabetes mellitus. Prediabetes criteria followed American Diabetes Association 2019. Multiple logistic regression was also employed to assess the transition probability of potential determinants for prediabetes in urban and rural Indonesia. RESULTS Up to 44.8% of rural respondents were prediabetics versus their urban counterparts at 34.9%, yet non-response bias was observed in the two. Young adults aged 30 years were already at risk of prediabetes. Urban-rural distinction for marital status and triglyceride level was observed while other determinants tended to overlap across residence. Several modifiable factors might contribute differently in both population with careful interpretation. CONCLUSIONS The minimum age limit for early prediabetes screening may start from 30 years old in Indonesia. Urban-rural distinction for marital status and triglyceride level was observed, yet non-response bias between the two groups could not be excluded. A proper model for early prediabetes screening need to be developed from a cohort study with adequate sample size.
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Affiliation(s)
- Frans Dany
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia.
| | - Rita Marleta Dewi
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Dwi Hapsari Tjandrarini
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Julianty Pradono
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Delima Delima
- Centre for Research and Development of Health Resources and Services, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Kambang Sariadji
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Sarwo Handayani
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Nunik Kusumawardani
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
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23
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Naser AM, Rahman M, Unicomb L, Doza S, Selim S, Chaity M, Luby SP, Anand S, Staimez L, Clasen TF, Gujral UP, Gribble MO, Narayan KMV. Past Sodium Intake, Contemporary Sodium Intake, and Cardiometabolic Health in Southwest Coastal Bangladesh. J Am Heart Assoc 2020; 9:e014978. [PMID: 32875927 PMCID: PMC7727005 DOI: 10.1161/jaha.119.014978] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background We compared the relationship of past and contemporary sodium (Na) intake with cardiometabolic biomarkers. Methods and Results A total of 1191 participants' data from a randomized controlled trial in coastal Bangladesh were analyzed. Participants provided 24-hour urine Na (24UNa) data for 5 monthly visits. Their fasting blood glucose, total cholesterol, triglycerides, high-density lipoprotein, blood pressure, and 24-hour urine protein were measured at the fifth visit. Participants' mean 24UNa over the first 4 visits was the past Na, and 24UNa of the fifth visit was the contemporary Na intake. We estimated the prevalence ratios of elevated cardiometabolic biomarkers and metabolic syndrome across 24UNa tertiles by multilevel logistic regression using participant-, household-, and community-level random intercepts. Models were adjusted for age, sex, body mass index, smoking, physical activity, alcohol consumption, sleep hours, religion, and household wealth. Compared with participants in tertile 1 of past urine Na, those in tertile 3 had 1.46 (95% CI, 1.08-1.99) times higher prevalence of prediabetes or diabetes mellitus, 5.49 (95% CI, 2.73-11.01) times higher prevalence of large waist circumference, and 1.60 (95% CI, 1.04-2.46) times higher prevalence of metabolic syndrome. Compared with participants in tertile 1 of contemporary urine Na, those in tertile 3 had 1.93 (95% CI, 1.24-3.00) times higher prevalence of prediabetes or diabetes mellitus, 3.14 (95% CI, 1.45-6.83) times higher prevalence of proteinuria, and 2.23 (95% CI, 1.34-3.71) times higher prevalence of large waist circumference. Conclusions Both past and contemporary Na intakes were associated with higher cardiometabolic disease risk.
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Affiliation(s)
- Abu Mohd Naser
- Emory Global Diabetes Research Center Hubert Department of Global Health Rollins School of Public HealthEmory University Atlanta GA
| | - Mahbubur Rahman
- International Centre for Diarrhoeal Disease ResearchBangladesh (icddr,b) Dhaka Bangladesh
| | - Leanne Unicomb
- International Centre for Diarrhoeal Disease ResearchBangladesh (icddr,b) Dhaka Bangladesh
| | - Solaiman Doza
- International Centre for Diarrhoeal Disease ResearchBangladesh (icddr,b) Dhaka Bangladesh
| | - Shahjada Selim
- Department of Endocrinology Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh
| | | | - Stephen P Luby
- Division of Infectious Diseases and Geographic MedicineStanford University Stanford CA
| | - Shuchi Anand
- Division of Nephrology School of Medicine Stanford University Stanford CA
| | - Lisa Staimez
- Emory Global Diabetes Research Center Hubert Department of Global Health Rollins School of Public HealthEmory University Atlanta GA
| | - Thomas F Clasen
- Gangarosa Department of Environmental Health Sciences Rollins School of Public HealthEmory University Atlanta GA
| | - Unjali P Gujral
- Emory Global Diabetes Research Center Hubert Department of Global Health Rollins School of Public HealthEmory University Atlanta GA
| | - Matthew O Gribble
- Gangarosa Department of Environmental Health Sciences Rollins School of Public HealthEmory University Atlanta GA.,Department of Epidemiology Rollins School of Public HealthEmory University Atlanta GA
| | - K M Venkat Narayan
- Emory Global Diabetes Research Center Hubert Department of Global Health Rollins School of Public HealthEmory University Atlanta GA
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24
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Al-Duais MA, Al-Awthan YS. Prevalence of dyslipidemia among students of a Yemeni University. J Taibah Univ Med Sci 2019; 14:163-171. [PMID: 31435407 PMCID: PMC6694883 DOI: 10.1016/j.jtumed.2018.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/25/2018] [Accepted: 12/26/2018] [Indexed: 01/14/2023] Open
Abstract
Objectives To estimate the prevalence of dyslipidemia and patterns of lipid profile and associated factors among Yemeni university students. Methods This cross-sectional study included 240 Yemeni students (116 males and 124 females) at Ibb University. The students were randomly selected from various faculties of the university. Demographic and clinical data were obtained from all participants. Fasting blood specimens were collected from all students for measurement of serum levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). The criteria of the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) were used. Results The mean age of the studied cohort was 19.8 ± 1.8 years; 48.3% were men and 51.7% were women. About 56.7% of the participants were from rural areas. Qat chewers and cigarette smokers comprised 63.3% and 6.7% of the cohort, respectively. No obese students were found in this study; however, 11.7% were overweight. The overall prevalence of dyslipidemia, hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C among the participating students were 86.7%, 21.7%, 23.8%, 31.7%, and 81.7%, respectively. Mixed hyperlipidemia was present in 8.8% of the students. The prevalence of isolated hypercholesterolemia, hypertriglyceridemia, and low HDL-C was 12.9%, 15%, and 70%, respectively. Dyslipidemia was significantly associated with male sex, increasing age, urban residence, and medical and natural science faculties. In contrast, smoking, qat chewing, physical activity, and the consumption of fast food, fruits and vegetables, and fish were not significantly associated with dyslipidemia. Conclusion To our knowledge, this is the first human study conducted at Ibb University during wartime in Yemen. Dyslipidemia was highly prevalent among healthy Yemeni university students in Ibb city. Low HDL-C was the most prevalent type of dyslipidemia, followed by increased levels of LDL-C. Gender, age, residence, and type of faculty were also closely related to dyslipidemia. These results indicate the need for specialized programs to determine blood lipid levels and initiate intervention programs to reduce the prevalence and prevent the complications of dyslipidemia among Yemeni university students.
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Affiliation(s)
- Mohammed A Al-Duais
- Department of Biochemistry, Faculty of Science, University of Tabuk, Tabuk, KSA
| | - Yahya S Al-Awthan
- Department of Biology, Faculty of Science, Ibb University, Ibb, Yemen
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25
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Mussa BM, Schauman M, Kumar V, Skaria S, Abusnana S. Personalized intervention to improve stress and sleep patterns for glycemic control and weight management in obese Emirati patients with type 2 diabetes: a randomized controlled clinical trial. Diabetes Metab Syndr Obes 2019; 12:991-999. [PMID: 31388307 PMCID: PMC6607201 DOI: 10.2147/dmso.s201142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 04/24/2019] [Indexed: 12/27/2022] Open
Abstract
Background: There is growing evidence that stress and sleep deprivation are involved in development of type 2 diabetes (T2DM). The latter is one of the most challenging health problems in the UAE. Therefore, the present study aimed to investigate the effects of personalized intervention on glycemic and weight control in Emirati patients with T2DM. The intervention involved assessment and modification of stress levels and sleep patterns. Methods: This was a randomized controlled study conducted on 51 Emirati patients with T2DM (age 18-60 years, body-mass index (BMI) ≥25 kg/m2): those in the intervention group who completed the trial numbered 18 and those in the control group who completed the trial numbered 17. Heart-rate variability was used for real-life and long-term assessments of stress, sleep, and recovery. Body weight, BMI, HbA1c and lipid profile were included in the investigation. The National Clinical Trial identifier number is NCT03644134. Results: Percentage change in body weight was significantly greater (P<0.05) in the intervention group (-3.2±2.9) than the control group (-0.02). Percentage change in the BMI of the intervention group was -4.50±5.9, while the control group exhibited less change in BMI (-0.0003±3.3, P<0.05). In addition, a significant reduction in HbA1c was observed in the intervention group (-5.3±15.7) and an increase of 9.9±13.1 was observed in the control group (P<0.01). Conclusion: The findings of the present study show that personalized approaches that reduce stress levels, increase recovery levels, and promote healthy sleep habits play an important role in weight management and glycemic control in T2DM.
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Affiliation(s)
- Bashair M Mussa
- Basic Medical Science Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Correspondence: Bashair M MussaBasic Medical Science Department, College of Medicine, University of Sharjah, Sharjah, PO Box 27272, United Arab EmiratesTel +971 6 505 7220Fax +971 655 8579Email
| | - Mia Schauman
- Medical Research Department, Celolab, Dubai, United Arab Emirates
| | - Vijay Kumar
- Rashid Centre for Diabetes and Research, Ajman, United Arab Emirates
| | - Sijomol Skaria
- Rashid Centre for Diabetes and Research, Ajman, United Arab Emirates
| | - Salah Abusnana
- Clinical Science Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Diabetes and Endocrinology Department, University Hospital Sharjah, Sharjah, United Arab Emirates
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26
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Burkholder GA, Muntner P, Zhao H, Mugavero MJ, Overton ET, Kilgore M, Drozd DR, Crane HM, Moore RD, Mathews WC, Geng E, Boswell S, Floris-Moore M, Rosenson RS. Low-density lipoprotein cholesterol response after statin initiation among persons living with human immunodeficiency virus. J Clin Lipidol 2018; 12:988-998.e5. [PMID: 29853312 DOI: 10.1016/j.jacl.2018.03.082] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/25/2018] [Accepted: 03/16/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Meta-analyses of general population studies report mean low-density lipoprotein cholesterol (LDL-C) reductions of 30% to <50% with moderate-intensity and ≥50% with high-intensity statins. Persons living with human immunodeficiency virus (PLWH) are at high risk for atherosclerotic cardiovascular disease (ASCVD), yet many have elevated LDL-C. OBJECTIVE To evaluate LDL-C response after statin initiation among PLWH. METHODS We conducted a retrospective cohort study of PLWH initiating statins between 2009 and 2013 (N = 706). Patients were categorized into mutually exclusive groups in the following hierarchy: history of coronary heart disease (CHD), diabetes, prestatin LDL-C ≥190 mg/dL, 10-year predicted ASCVD risk ≥7.5%, and none of the above (ie, unknown statin indication). The primary outcome was a ≥30% reduction in LDL-C after statin initiation. RESULTS Among patients initiating statins, 5.8% had a history of CHD, 13.6% had diabetes, 6.2% had LDL-C ≥190 mg/dL, 35.4% had 10-year ASCVD risk ≥7.5%, and 39.0% had an unknown statin indication. Among patients with a history of CHD, 31.7% achieved a ≥30% LDL-C reduction compared with 25.0%, 59.1%, and 33.9% among those with diabetes, LDL-C ≥190 mg/dL, and 10-year ASCVD risk ≥7.5%, respectively. In multivariable adjusted analyses and compared to patients with an unknown statin indication, LDL-C ≥ 190 mg/dL was associated with a prevalence ratio for an LDL-C reduction ≥30% of 1.81 (95% confidence interval, 1.34-2.45), whereas no statistically significant association was present for history of CHD, diabetes, and 10-year ASCVD risk ≥7.5%. CONCLUSION A low percentage of PLWH achieved the expected reductions in LDL-C after statin initiation, highlighting an unmet need for ASCVD risk reduction.
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Affiliation(s)
- Greer A Burkholder
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Paul Muntner
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hong Zhao
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michael J Mugavero
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - E Turner Overton
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Meredith Kilgore
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Daniel R Drozd
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Heidi M Crane
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Richard D Moore
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - Elvin Geng
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Stephen Boswell
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Michelle Floris-Moore
- Department of Medicine, Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Robert S Rosenson
- Department of Medicine, Mount Sinai Icahn School of Medicine, New York, NY, USA
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