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Manosroi W, Phudphong P, Atthakomol P, Phimphilai M. The differences of serum lipid profiles between primary aldosteronism and essential hypertension: a meta-analysis and systematic review. BMC Endocr Disord 2022; 22:217. [PMID: 36045354 PMCID: PMC9429522 DOI: 10.1186/s12902-022-01135-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/22/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The data on lipid profile differences between primary aldosteronism (PA) and essential hypertension (EH) patients are inconsistent and inconclusive. Most studies reported lower levels of lipid profiles in PA than in EH. This meta-analysis aimed to explore differences in serum lipid profiles including triglyceride (TG), total cholesterol (TC), LDL and HDL levels in PA patients and EH patients. METHODS A search of published studies was performed using PubMed, Embase and Scopus databases from their inception through August 2022. Thirty studies involving 11,175 patients were identified. Inclusion criteria included 1) observational studies which contained data on any of the lipid profiles of interest (TG, TC, LDL and HDL) which could be acquired from baseline data or the outcomes, 2) data which should be compared between adult PA and EH patients and 3) the use of appropriate methods to diagnose PA. Standardized mean difference (SMD) with a 95% confidence interval (95% CI) was calculated to assess effect size by using STATA program version 15.0. Risk of bias was assessed by Joanna Briggs Institute (JBI) Critical Appraisal Tools for cross-sectional, cohort and case-control studies. RESULTS Levels of the lipid parameters TG (SMD - 0.16 mmol/L; 95%CI (- 0.25, - 0.07)), TC (SMD - 0.30 mmol/L; 95%CI (- 0.41, - 0.19)) and LDL (SMD - 0.17 mmol/L; 95%CI (- 0.27, - 0.08)) were significantly lower in PA than in EH patients. There was no statistically significant difference in HDL between PA and EH patients (SMD - 0.08 mmol/L; 96%CI (- 0.23,0.07)). High levels of heterogeneity for TG, TC, HDL and LDL were observed in all studies. Risk of bias among the studies was low to moderate. CONCLUSION Lower levels of TG, TC and LDL were observed in PA than in EH patients. Further study should be conducted to address the underlying mechanisms of lipid alteration in PA.
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Affiliation(s)
- Worapaka Manosroi
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, 110 Intrawarorot Road Soi 2, Si Phum, Amphoe Mueang Chiang Mai, Chiang Mai, 50200, Thailand.
| | - Pitchaporn Phudphong
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, 110 Intrawarorot Road Soi 2, Si Phum, Amphoe Mueang Chiang Mai, Chiang Mai, 50200, Thailand
| | - Pichitchai Atthakomol
- Orthopaedics Department, Faculty of Medicine, Chiang Mai University, Muang Chiang Mai, Chiang Mai, Thailand
- Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Mattabhorn Phimphilai
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, 110 Intrawarorot Road Soi 2, Si Phum, Amphoe Mueang Chiang Mai, Chiang Mai, 50200, Thailand
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Collins KA, Ross LM, Slentz CA, Huffman KM, Kraus WE. Differential Effects of Amount, Intensity, and Mode of Exercise Training on Insulin Sensitivity and Glucose Homeostasis: A Narrative Review. SPORTS MEDICINE - OPEN 2022; 8:90. [PMID: 35834023 PMCID: PMC9283590 DOI: 10.1186/s40798-022-00480-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 06/18/2022] [Indexed: 11/29/2022]
Abstract
As type 2 diabetes remains a leading cause of morbidity and mortality, identifying the most appropriate preventive treatment early in the development of disease is an important public health matter. In general, lifestyle interventions incorporating exercise and weight loss via caloric restriction improve cardiometabolic risk by impacting several key markers of insulin sensitivity and glucose homeostasis. However, variations in the effects of specific types of exercise interventions on these markers have led to conflicting results surrounding the optimal amount, intensity, and mode of exercise for optimal effects. Moreover, the addition of weight loss via caloric restriction to exercise interventions appears to differentially impact changes in body composition, metabolism, and insulin sensitivity compared to exercise alone. Determining the optimal amount, intensity, and mode of exercise having the most beneficial impact on glycemic status is both: (1) clinically important to provide guidelines for appropriate exercise prescription; and (2) physiologically important to understand the pathways by which exercise-with and without weight loss-impacts glycemic status to enhance precision lifestyle medicine. Thus, the purposes of this narrative review are to: (1) summarize findings from the three Studies of a Targeted Risk Reduction Intervention through Defined Exercise (STRRIDE) randomized trials regarding the differential effects of exercise amount, intensity, and mode on insulin action and glucose homeostasis markers; and (2) compare the STRRIDE findings to other published dose-response exercise trials in order to piece together the various physiologic pathways by which specific exercise interventions-with or without weight loss-impact glycemic status.
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Affiliation(s)
- Katherine A Collins
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Leanna M Ross
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA.
| | - Cris A Slentz
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Kim M Huffman
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - William E Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
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Wang MH, Li NF, Luo Q, Wang GL, Heizhati M, Wang L, Wang L, Zhang WW. Development and validation of a novel diagnostic nomogram model to predict primary aldosteronism in patients with hypertension. Endocrine 2021; 73:682-692. [PMID: 34028647 DOI: 10.1007/s12020-021-02745-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 04/27/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Primary aldosteronism (PA) remains, to a large extent, an under-diagnosed disease. We aimed to develop and validate a novel clinical nomogram to predict PA based on routine biochemical variables including new ones, calcium-phosphorus product. METHODS Records from 806 patients with hypertension were randomly divided into 70% (n = 564) as the training set and the remaining 30% (n = 242) as the validation set. Predictors for PA were extracted to construct a nomogram model based on regression analysis of the training set. An internal validation was performed to assess the nomogram model's discrimination and consistency using the area under the curve for receiver operating characteristic curves and calibration plots. The diagnostic accuracy was compared between nomogram and other known prediction models, using receiver operating characteristics (ROC) and decision curve analyses (DCA). RESULTS Female gender, serum potassium, serum calcium-phosphorus product, and urine pH were adopted as predictors in the nomogram. The nomogram resulted in an area under the curve of 0.73 (95% confidence interval: 0.68-0.78) in the training set and an area under the curve of 0.68 (0.59-0.75) in the validation set. Predicted probability and actual probability matched well in the nomogram (p > 0.05). Based on ROC and DCA, 21-70% threshold to predict PA in the nomogram model was clinically useful. CONCLUSIONS We have developed a novel nomogram to predict PA in hypertensive individuals based on routine biochemical variables. External validation is needed to further demonstrate its predictive ability in primary care settings.
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Affiliation(s)
- Meng-Hui Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91 Tianchi Road Urumqi, 830001, Xinjiang, China
| | - Nan-Fang Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91 Tianchi Road Urumqi, 830001, Xinjiang, China.
| | - Qin Luo
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91 Tianchi Road Urumqi, 830001, Xinjiang, China
| | - Guo-Liang Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91 Tianchi Road Urumqi, 830001, Xinjiang, China
| | - Mulalibieke Heizhati
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91 Tianchi Road Urumqi, 830001, Xinjiang, China
| | - Ling Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91 Tianchi Road Urumqi, 830001, Xinjiang, China
| | - Lei Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91 Tianchi Road Urumqi, 830001, Xinjiang, China
| | - Wei-Wei Zhang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91 Tianchi Road Urumqi, 830001, Xinjiang, China
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Moon SJ, Jang HN, Kim JH, Moon MK. Lipid Profiles in Primary Aldosteronism Compared with Essential Hypertension: Propensity-Score Matching Study. Endocrinol Metab (Seoul) 2021; 36:885-894. [PMID: 34372626 PMCID: PMC8419600 DOI: 10.3803/enm.2021.1012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/07/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There has been controversy regarding the association between primary aldosteronism (PA) and dyslipidemia and few studies considered the effects of diabetes and renal function on lipid metabolism. We analyzed lipid profiles of PA patients and compared them to propensity-score (PS)-matched essential hypertension (EH) patients adjusting for glycemic status and renal function. METHODS Patients who were diagnosed with PA using a saline-infusion test at Seoul National University Hospital from 2000 to 2018 were retrospectively analyzed. EH patients who had aldosterone-renin ratio (ARR) results were selected as controls. Covariates, including diabetes, were PS-matched for patients with PA, lateralized PA, non-lateralized PA, and high ARR to EH patients, respectively. RESULTS Among a total of 80 PA and 80 EH patients, total cholesterol (TC) and triglyceride (TG) levels were significantly lower in the PA patients than in the EH patients (least-squares mean±standard error: 185.5±4.4 mg/dL vs. 196.2±4.4 mg/dL, P=0.047, for TC; and 132.3±11.5 mg/dL vs. 157.4±11.4 mg/dL, P=0.035, for TG) in fully adjusted model (adjusting for multiple covariates, including diabetes status, glycosylated hemoglobin level, and estimated glomerular filtration rate). There were no significant differences in high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol levels between the two groups. According to increments in aldosterone levels, an increasing tendency of HDL-C and decreasing tendencies of TG and non-HDL-C were observed. CONCLUSION PA patients had lower TC and TG levels than EH patients, independent of glycemic status and renal function.
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Affiliation(s)
- Sun Joon Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul,
Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Han Na Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul,
Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
| | - Jung Hee Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul,
Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
| | - Min Kyong Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul,
Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul,
Korea
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Wang W, Li Y, Li Q, Zhang T, Wang W, Mo D, Tian H, Chen T, Ren Y. Developing a research database of primary aldosteronism: rationale and baseline characteristics. BMC Endocr Disord 2021; 21:137. [PMID: 34187449 PMCID: PMC8244177 DOI: 10.1186/s12902-021-00794-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/19/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Management of primary aldosteronism (PA) has become a research hotspot in the field of endocrinology. To obtain reliable research evidence, it is necessary to establish a high-quality PA research database. METHODS The establishment of PA research database involved two steps. Firstly, patients with confirmation of PA diagnosis between 1 Jan 2009 to 31 Aug 2019 at West China Hospital were identified and data were extracted. Secondly, patients with confirmatory testing for PA will be enrolled into a prospective cohort. Data will be prospectively collected based on the case report forms since 1 Sep 2019. We evaluated the quality of research database through assessment of quality of key variables. RESULTS Totally, 862 patients diagnosed as PA were identified, of which 507 patients who had positive confirmatory testing for PA were included into the retrospective database. Among 862 patients diagnosed as PA, the mean systolic blood pressure (SBP) was 156.1 (21.7) mmHg, mean diastolic blood pressure (DBP) was 97.2 (14.5) mmHg. Among included patients, the mean serum potassium level was 2.85 (IQR, (2.47-3.36) mmol/L, and the mean plasma aldosterone concentration (PAC) was 28.1 (IQR, 20.0-40.4) ng/dL. The characteristics of patients with positive confirmatory testing for PA were similar. Validation of data extracting and linking showed the accuracy were 100%. Evaluation of missing data showed that the completeness of BMI (95.9%), SBP (99.4%) and DBP (99.4%) were high. CONCLUSION Through integrating retrospective and prospective cohort of PA, a research database of PA with high quality and comprehensive data can be established. We anticipate that the research database will provide a high level of feasibility for management of PA in China.
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Affiliation(s)
- Wen Wang
- Chinese Evidence-based Medicine Center and CREAT Group, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yuanmei Li
- Department of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Qianrui Li
- Chinese Evidence-based Medicine Center and CREAT Group, West China Hospital, Sichuan University, Chengdu, 610041, China
- Department of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Tingting Zhang
- Health Management Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Wei Wang
- Department of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Dan Mo
- Department of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Haoming Tian
- Department of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Tao Chen
- Department of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Yan Ren
- Department of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Sokooti S, Flores-Guerrero JL, Kieneker LM, Heerspink HJL, Connelly MA, Bakker SJL, Dullaart RPF. HDL Particle Subspecies and Their Association With Incident Type 2 Diabetes: The PREVEND Study. J Clin Endocrinol Metab 2021; 106:1761-1772. [PMID: 33567068 PMCID: PMC8118359 DOI: 10.1210/clinem/dgab075] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Indexed: 12/29/2022]
Abstract
CONTEXT High-density lipoproteins (HDL) may be protective against type 2 diabetes (T2D) development, but HDL particles vary in size and function, which could lead to differential associations with incident T2D. A newly developed nuclear magnetic resonance (NMR)-derived algorithm provides concentrations for 7 HDL subspecies. OBJECTIVE We aimed to investigate the association of HDL particle subspecies with incident T2D in the general population. METHODS Among 4828 subjects of the Prevention of Renal and Vascular End-Stage Disease (PREVEND) study without T2D at baseline, HDL subspecies with increasing size from H1P to H7P were measured by NMR (LP4 algorithm of the Vantera NMR platform). RESULTS A total of 265 individuals developed T2D (median follow-up of 7.3 years). In Cox regression models, HDL size and H4P (hazard ratio [HR] per 1 SD increase 0.83 [95% CI, 0.69-0.99] and 0.85 [95% CI, 0.75-0.95], respectively) were inversely associated with incident T2D, after adjustment for relevant covariates. In contrast, levels of H2P were positively associated with incident T2D (HR 1.15 [95% CI, 1.01-1.32]). In secondary analyses, associations with large HDL particles and H6P were modified by body mass index (BMI) in such a way that they were particularly associated with a lower risk of incident T2D, in subjects with BMI < 30 kg/m2. CONCLUSION Greater HDL size and lower levels of H4P were associated with a lower risk, whereas higher levels of H2P were associated with a higher risk of developing T2D. In addition, large HDL particles and H6P were inversely associated with T2D in nonobese subjects.
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Affiliation(s)
- Sara Sokooti
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, the Netherlands
- Correspondence: Sara Sokooti Oskooei, MD, Department of Internal Medicine, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, 9713 GZ Groningen, Netherlands.
| | - Jose L Flores-Guerrero
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, the Netherlands
| | - Lyanne M Kieneker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, the Netherlands
| | - Hiddo J L Heerspink
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, the Netherlands
| | - Margery A Connelly
- Laboratory Corporation of America® Holdings (LabCorp), Morrisville, NC, USA
| | - Stephan J L Bakker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, the Netherlands
| | - Robin P F Dullaart
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, the Netherlands
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Ross LM, Slentz CA, Zidek AM, Huffman KM, Shalaurova I, Otvos JD, Connelly MA, Kraus VB, Bales CW, Houmard JA, Kraus WE. Effects of Amount, Intensity, and Mode of Exercise Training on Insulin Resistance and Type 2 Diabetes Risk in the STRRIDE Randomized Trials. Front Physiol 2021; 12:626142. [PMID: 33613319 PMCID: PMC7892901 DOI: 10.3389/fphys.2021.626142] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/14/2021] [Indexed: 12/19/2022] Open
Abstract
Background Lipoprotein Insulin Resistance Index (LP-IR) and Diabetes Risk Index are novel spectroscopic multimarkers of insulin resistance and type 2 diabetes risk. As the Studies of a Targeted Risk Reduction Intervention through Defined Exercise (STRRIDE) randomized trials have previously demonstrated the ability of exercise training to improve traditional markers of insulin action, the aim of this study was to examine the effects of exercise amount, intensity, and mode on LP-IR and the Diabetes Risk Index. Methods A total of 503 adults with dyslipidemia [STRRIDE I (n = 194), STRRIDE AT/RT (n = 139)] or prediabetes [STRRIDE-PD (n = 170)] were randomized to control or one of 10 exercise interventions, ranging from doses of 8–23 kcal/kg/week; intensities of 50–75% V̇O2peak; and durations of 6–8 months. Two groups included resistance training and one included dietary intervention (7% weight loss goal). Fasting plasma samples were obtained at baseline and 16–24 h after the final exercise bout. LP-IR, the Diabetes Risk Index, and concentrations of the branched chain amino acids valine and leucine were determined using nuclear magnetic resonance spectroscopy. LP-IR and the Diabetes Risk Index scores range from 0–100 and 1–100, respectively (greater scores indicate greater risk). Paired t-tests determined significance within groups (p < 0.05). Results After training, six exercise groups significantly improved LP-IR (ranging from −4.4 ± 8.2 to −12.4 ± 14.1), and four exercise groups significantly improved the Diabetes Risk Index (ranging from −2.8 ± 8.2 to −8.3 ± 10.4). The most beneficial interventions for both LP-IR and the Diabetes Risk Index were low amount/moderate intensity aerobic, aerobic plus resistance, and aerobic plus diet. Summary Multiple exercise interventions improved LP-IR and the Diabetes Risk Index. In those with dyslipidemia, adding resistance to aerobic training elicited a synergistic effect on insulin resistance and type 2 diabetes risk. In individuals with prediabetes, combining a dietary intervention and weight loss with aerobic training resulted in the most robust type 2 diabetes risk improvement.
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Affiliation(s)
- Leanna M Ross
- Department of Medicine, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, United States
| | - Cris A Slentz
- Department of Medicine, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, United States
| | - Alyssa M Zidek
- Department of Medicine, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, United States
| | - Kim M Huffman
- Department of Medicine, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, United States
| | - Irina Shalaurova
- Laboratory Corporation of America Holdings (LabCorp), Morrisville, NC, United States
| | - James D Otvos
- Laboratory Corporation of America Holdings (LabCorp), Morrisville, NC, United States
| | - Margery A Connelly
- Laboratory Corporation of America Holdings (LabCorp), Morrisville, NC, United States
| | - Virginia B Kraus
- Department of Medicine, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, United States
| | - Connie W Bales
- Center for the Study of Aging, Department of Medicine, Duke University School of Medicine, Durham, NC, United States.,Geriatric Research, Education, and Clinical Center, Durham VA Medical Center, Durham, NC, United States
| | - Joseph A Houmard
- Department of Kinesiology, East Carolina University, Greenville, NC, United States
| | - William E Kraus
- Department of Medicine, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, United States
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van der Boom T, Jia C, Lefrandt JD, Connelly MA, Links TP, Tietge UJF, Dullaart RPF. HDL Cholesterol Efflux Capacity is Impaired in Severe Short-Term Hypothyroidism Despite Increased HDL Cholesterol. J Clin Endocrinol Metab 2020; 105:5881625. [PMID: 32761088 PMCID: PMC7947992 DOI: 10.1210/clinem/dgaa411] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/28/2020] [Indexed: 01/01/2023]
Abstract
CONTEXT Severe hypothyroidism has profound effects on lipoprotein metabolism including high-density lipoprotein (HDL) cholesterol elevations but effects on HDL function metrics are unknown. OBJECTIVE To determine the impact of severe short-term hypothyroidism on HDL particle characteristics, HDL cholesterol efflux capacity (CEC), and HDL antioxidative capacity. DESIGN Observational study with variables measured during severe short-term hypothyroidism (median TSH 81 mU/L) and after 20 weeks of thyroid hormone supplementation (median TSH 0.03 mU/L) (Netherlands Trial Registry ID 7228). SETTING University hospital setting in The Netherlands. PATIENTS Seventeen patients who had undergone a total thyroidectomy for differentiated thyroid carcinoma. MAIN OUTCOME MEASURES HDL particle characteristics (nuclear magnetic resonance spectrometry), CEC (human THP-1-derived macrophage foam cells and apolipoprotein B-depleted plasma), and HDL anti-oxidative capacity (inhibition of low-density lipoprotein oxidation). RESULTS During hypothyroidism plasma total cholesterol, HDL cholesterol and apolipoprotein A-I were increased (P ≤ 0.001). HDL particle concentration was unchanged, but there was a shift in HDL subclasses toward larger HDL particles (P < 0.001). CEC was decreased (P = 0.035), also when corrected for HDL cholesterol (P < 0.001) or HDL particle concentration (P = 0.011). HDL antioxidative capacity did not change. CONCLUSION During severe short-term hypothyroidism CEC, an important antiatherogenic metric of HDL function, is impaired. HDL cholesterol and larger HDL particles are increased but HDL particle concentration is unchanged. Combined, these findings suggest that HDL quality and quantity are not improved, reflecting dysfunctional HDL in hypothyroidism.
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Affiliation(s)
- Trynke van der Boom
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, RB Groningen, The Netherlands
- Department of Vascular Medicine, University of Groningen, University Medical Center Groningen, RB Groningen, The Netherlands
| | - Congzhuo Jia
- Department of Pediatrics, University Medical Center Groningen, University of Groningen, RB Groningen, The Netherlands
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Joop D Lefrandt
- Department of Vascular Medicine, University of Groningen, University Medical Center Groningen, RB Groningen, The Netherlands
| | - Margery A Connelly
- Laboratory Corporation of America Holdings (LabCorp), Morrisville, North Carolina
| | - Thera P Links
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, RB Groningen, The Netherlands
- Correspondence and Reprint Requests: T.P. Links, MD, PhD, University Medical Center Groningen, Department of Endocrinology, PO Box 30.001, 9700 RB Groningen, The Netherlands. E-mail:
| | - Uwe J F Tietge
- Department of Pediatrics, University Medical Center Groningen, University of Groningen, RB Groningen, The Netherlands
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden
| | - Robin P F Dullaart
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, RB Groningen, The Netherlands
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Adolf C, Berends AMA, Connelly MA, Reincke M, Dullaart RPF. Lipoprotein insulin resistance score and branched-chain amino acids increase after adrenalectomy for unilateral aldosterone-producing adenoma: a preliminary study. Endocrine 2020; 68:420-426. [PMID: 32133607 PMCID: PMC7266834 DOI: 10.1007/s12020-020-02235-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 02/18/2020] [Indexed: 12/02/2022]
Abstract
BACKGROUND AND AIMS Primary aldosteronism (PA) due to unilateral aldosterone-producing adenoma (APA) is preferentially treated by unilateral adrenalectomy (ADX), but little is known about the changes in lipid and glucose metabolism that may occur after ADX. METHODS We studied 19 non-diabetic patients who did not use lipid-lowering drugs with PA due to APA before and 6 months after unilateral ADX. Fasting plasma lipids, lipoprotein subfractions, branched-chain amino acids (BCAA), and GlycA, a pro-inflammatory glycoprotein biomarker, were measured by nuclear magnetic resonance (NMR) spectroscopy. The Lipoprotein Insulin Resistance (LP-IR) score, which is based on six lipoprotein variables, was calculated. RESULTS In all patients, hyperaldosteronism was resolved after ADX. Body mass index and fasting plasma glucose were unchanged, but HbA1c increased (p = 0.002). Plasma triglycerides, large triglyceride-rich lipoprotein (TRL) cholesterol, and large TRL particles were increased (p < 0.01), resulting in an increase in TRL size (p = 0.027). High-density lipoprotein size was decreased (p = 0.015). LP-IR scores (p = 0.001) and total BCAA (p = 0.017) were increased, but GlycA remained unaltered. CONCLUSIONS Based on increases in LP-IR scores and BCAA, which each have been shown to predict new onset type 2 diabetes mellitus independent of conventional risk factors in the general population, this preliminary study suggests that diabetes risk is not improved but may even be increased after ADX for APA despite remission of PA.
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Affiliation(s)
- Christian Adolf
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, 80336, Munich, Germany
| | - Annika M A Berends
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Margery A Connelly
- Laboratory Corporation of America Holdings (LabCorp), Morrisville, NC, USA
| | - Martin Reincke
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, 80336, Munich, Germany
| | - Robin P F Dullaart
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Sokooti S, Szili-Torok T, Flores-Guerrero JL, Osté MCJ, Gomes-Neto AW, Kootstra-Ros JE, Heerspink HJ, Connelly MA, Bakker SJL, Dullaart RPF. High-Density Lipoprotein Particles and Their Relationship to Posttransplantation Diabetes Mellitus in Renal Transplant Recipients. Biomolecules 2020; 10:E481. [PMID: 32245262 PMCID: PMC7175217 DOI: 10.3390/biom10030481] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/11/2020] [Accepted: 03/19/2020] [Indexed: 12/12/2022] Open
Abstract
High concentrations of high-density lipoprotein (HDL) cholesterol are likely associated with a lower risk of posttransplantation diabetes mellitus (PTDM). However, HDL particles vary in size and density with yet unestablished associations with PTDM risk. The aim of our study was to determine the association between different HDL particles and development of PTDM in renal transplant recipients (RTRs). We included 351 stable outpatient adult RTRs without diabetes at baseline evaluation. HDL particle characteristics and size were measured by nuclear magnetic resonance (NMR) spectroscopy. During 5.2 (IQR, 4.1‒5.8) years of follow-up, 39 (11%) RTRs developed PTDM. In multivariable Cox regression analysis, levels of HDL cholesterol (hazard ratio [HR] 0.61, 95% confidence interval [CI] 0.40-0.94 per 1SD increase; p = 0.024) and of large HDL particles (HR 0.68, 95% CI 0.50-0.93 per log 1SD increase; p = 0.017), as well as larger HDL size (HR 0.58, 95% CI 0.36-0.93 per 1SD increase; p = 0.025) were inversely associated with PTDM development, independently of relevant covariates including, age, sex, body mass index, medication use, transplantation-specific parameters, blood pressure, triglycerides, and glucose. In conclusion, higher concentrations of HDL cholesterol and of large HDL particles and greater HDL size were associated with a lower risk of PTDM development in RTRs, independently of established risk factors for PTDM development.
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Affiliation(s)
- Sara Sokooti
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (T.S.-T.); (J.L.F.-G.); (M.C.J.O.); (A.W.G.-N.); (S.J.L.B.); (R.P.F.D.)
| | - Tamas Szili-Torok
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (T.S.-T.); (J.L.F.-G.); (M.C.J.O.); (A.W.G.-N.); (S.J.L.B.); (R.P.F.D.)
| | - Jose L. Flores-Guerrero
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (T.S.-T.); (J.L.F.-G.); (M.C.J.O.); (A.W.G.-N.); (S.J.L.B.); (R.P.F.D.)
| | - Maryse C. J. Osté
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (T.S.-T.); (J.L.F.-G.); (M.C.J.O.); (A.W.G.-N.); (S.J.L.B.); (R.P.F.D.)
| | - António W. Gomes-Neto
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (T.S.-T.); (J.L.F.-G.); (M.C.J.O.); (A.W.G.-N.); (S.J.L.B.); (R.P.F.D.)
| | - Jenny E. Kootstra-Ros
- Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands;
| | - Hiddo J.L. Heerspink
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands;
| | - Margery A. Connelly
- Laboratory Corporation of America® Holdings (LabCorp), Morrisville, NC 27560, USA;
| | - Stephan J. L. Bakker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (T.S.-T.); (J.L.F.-G.); (M.C.J.O.); (A.W.G.-N.); (S.J.L.B.); (R.P.F.D.)
| | - Robin P. F. Dullaart
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (T.S.-T.); (J.L.F.-G.); (M.C.J.O.); (A.W.G.-N.); (S.J.L.B.); (R.P.F.D.)
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11
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Fuertes-Martín R, Correig X, Vallvé JC, Amigó N. Title: Human Serum/Plasma Glycoprotein Analysis by 1H-NMR, an Emerging Method of Inflammatory Assessment. J Clin Med 2020; 9:E354. [PMID: 32012794 PMCID: PMC7073769 DOI: 10.3390/jcm9020354] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/13/2020] [Accepted: 01/17/2020] [Indexed: 12/17/2022] Open
Abstract
Several studies suggest that variations in the concentration of plasma glycoproteins can influence cellular changes in a large number of diseases. In recent years, proton nuclear magnetic resonance (1H-NMR) has played a major role as an analytical tool for serum and plasma samples. In recent years, there is an increasing interest in the characterization of glycoproteins through 1H-NMR in order to search for reliable and robust biomarkers of disease. The objective of this review was to examine the existing studies in the literature related to the study of glycoproteins from an analytical and clinical point of view. There are currently several techniques to characterize circulating glycoproteins in serum or plasma, but in this review, we focus on 1H-NMR due to its great robustness and recent interest in its translation to the clinical setting. In fact, there is already a marker in H-NMR representing the acetyl groups of the glycoproteins, GlycA, which has been increasingly studied in clinical studies. A broad search of the literature was performed showing a general consensus that GlycA is a robust marker of systemic inflammation. The results also suggested that GlycA better captures systemic inflammation even more than C-reactive protein (CRP), a widely used classical inflammatory marker. The applications reviewed here demonstrated that GlycA was potentially a key biomarker in a wide range of diseases such as cancer, metabolic diseases, cardiovascular risk, and chronic inflammatory diseases among others. The profiling of glycoproteins through 1H-NMR launches an encouraging new paradigm for its future incorporation in clinical diagnosis.
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Affiliation(s)
- Rocío Fuertes-Martín
- Biosfer Teslab SL, 43201 Reus, Spain; (R.F.-M.); (N.A.)
- Metabolomic s platform, IISPV, CIBERDEM, Rovira i Virgili University, 43007 Tarragona, Spain
| | - Xavier Correig
- Metabolomic s platform, IISPV, CIBERDEM, Rovira i Virgili University, 43007 Tarragona, Spain
| | - Joan-Carles Vallvé
- Metabolomic s platform, IISPV, CIBERDEM, Rovira i Virgili University, 43007 Tarragona, Spain
- Lipids and Arteriosclerosis Research Unit, Sant Joan de Reus University Hospital, 43201 Reus, Spain
| | - Núria Amigó
- Biosfer Teslab SL, 43201 Reus, Spain; (R.F.-M.); (N.A.)
- Metabolomic s platform, IISPV, CIBERDEM, Rovira i Virgili University, 43007 Tarragona, Spain
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12
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BiLiGe W, Wang C, Bao J, Yu D, Min A, Hong Z, Chen X, Wang M, Wang D. Predicting factors related with uncured hypertension after retroperitoneal laparoscopic adrenalectomy for unilateral primary aldosteronism. Medicine (Baltimore) 2019; 98:e16611. [PMID: 31348309 PMCID: PMC6708826 DOI: 10.1097/md.0000000000016611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Although unilateral primary aldosteronism (PA) is the most common surgically correctable cause of hypertension, the cure rate varies widely. The predicting factors related to uncured hypertension are not completely established. This study was designed to determine predicting factors associated with resolution of hypertension after adrenalectomy for PA.The records of unilateral PA patients who had undergone retroperitoneal laparoscopic adrenalectomy were retrospectively reviewed from January 2010 to December 2017 in a single center. Patient demographics and preoperative factors were analyzed, including age, sex, smoking history, family history of hypertension, the presence of diabetes, body mass index (BMI), systolic blood pressure, diastolic blood pressure, biochemical results and tumor characteristics. Univariate and multivariate Logistic regression analysis were used for statistical assessment.126 patients with unilateral PA were enrolled, and the mean age at the time of surgery was 54.2 years. Of these patients, 74 (58.7%) were women, and the mean BMI and duration of hypertension were 26 kg/m and 61 months, respectively. Hypertension was cured in 46% patients, of the patients with uncured hypertension, 91% had improved control of hypertension. In univariate analysis, age (P = .03), BMI (P = .01), duration of hypertension >5 years (P = .03), preoperative antihypertensive agents>2 (P = .02), contralateral abnormalities (P = .03) were the main factors related to uncured hypertension after adrenalectomy. In multivariate regression analysis, uncured hypertension was independently associated with obesity (25.00-29.99: odds ratio [OR], 2.97, P < .02; ≥30: OR, 6.42, P < .01), duration of hypertension >5 years (OR, 6.25, P < .01), preoperative antihypertensive agents >2 (OR, 5.30, P < .001), and contralateral adrenal abnormalities (OR, 8.38, P < .01).The hypertension cure rate of unilateral adrenalectomy in PA is not high. Obesity, duration of hypertension >5 years, preoperative antihypertensive agents >2 and contralateral adrenal abnormalities were independently associated with uncured hypertension.
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Affiliation(s)
- WuYun BiLiGe
- Department of Urology, Affiliated Hospital of Inner Mongolia University for the Nationlities
| | - Chaoqi Wang
- Department of Urology, Affiliated Hospital of Inner Mongolia University for the Nationlities
| | - JiRiGaLa Bao
- Department of Urology, Affiliated Hospital of Inner Mongolia University for the Nationlities
| | - Dahai Yu
- Department of Urology, Affiliated Hospital of Inner Mongolia University for the Nationlities
| | - A Min
- Department of Urology, Affiliated Hospital of Inner Mongolia University for the Nationlities
| | - Zhi Hong
- Department of Urology, Affiliated Hospital of Inner Mongolia University for the Nationlities
| | - Xiangbao Chen
- Department of Urology, Affiliated Hospital of Inner Mongolia University for the Nationlities
| | - Min Wang
- Department of Urology, Affiliated Hospital of Inner Mongolia University for the Nationlities
| | - Dongmei Wang
- Medical College of Inner Mongolia University for the Nationlities, Tongliao, P.R. China
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