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Ilich JZ, Pokimica B, Ristić-Medić D, Petrović S, Arsić A, Vasiljević N, Vučić V, Kelly OJ. Osteosarcopenic adiposity (OSA) phenotype and its connection with cardiometabolic disorders: Is there a cause-and-effect? Ageing Res Rev 2024; 98:102326. [PMID: 38734146 DOI: 10.1016/j.arr.2024.102326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/23/2024] [Accepted: 05/05/2024] [Indexed: 05/13/2024]
Abstract
The objectives were to examine if there is a causal relationship between osteosarcopenic adiposity (OSA) syndrome (coexistence of osteopenia/osteoporosis, sarcopenia, and excess adiposity) and cardiometabolic disorders or if these disorders initiate the development of OSA and its worsening. The search was conducted in PubMed, Scopus, and Web of Science to include articles up to the end of 2023. Of n=539 articles retrieved, n=15 met the eligibility criteria. Only studies conducted in adults and with all three body composition compartments (bone, muscle/lean, adipose) measured were considered. The results revealed that several cardiometabolic disorders, namely, hypertension, dyslipidemia (elevated total and LDL-cholesterol, lower HDL-cholesterol), insulin resistance, hyperglycemia, lower serum vitamin D, and some inflammatory markers were accompanied by OSA. In most cases, the OSA phenotype was associated with worse outcomes than cases with healthy or less impaired body composition. Our initial questions about the reciprocal cause-and-effect relationships could be surmised with more certainty for the OSA and some cardiovascular risks (hypertension, dyslipidemia) and some metabolic abnormalities (several inflammatory markers). The results of this review underscore the importance of body composition in health and from a clinical perspective, all three body composition compartments should be measured by standardized technologies using regulated diagnostic criteria to identify OSA. Randomized trials and prospective studies in diverse groups of older and younger individuals are necessary to determine if the relationships between OSA and clinical endpoints are causal and reversible through intervention and to uncover the mechanisms.
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Affiliation(s)
- Jasminka Z Ilich
- Institute for Successful Longevity, Florida State University, Tallahassee, Florida 32306, United States.
| | - Biljana Pokimica
- Group for Nutritional Biochemistry and Dietology, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia; Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia
| | - Danijela Ristić-Medić
- Group for Nutritional Biochemistry and Dietology, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia; Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia
| | - Snjezana Petrović
- Group for Nutritional Biochemistry and Dietology, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia; Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia
| | - Aleksandra Arsić
- Group for Nutritional Biochemistry and Dietology, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia; Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia
| | - Nadja Vasiljević
- Institute of Hygiene and Medical Ecology, Medical Faculty University of Belgrade, Belgrade 11000, Serbia
| | - Vesna Vučić
- Group for Nutritional Biochemistry and Dietology, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia; Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia
| | - Owen J Kelly
- Department of Molecular and Cellular Biology, College of Osteopathic Medicine, Sam Houston State University, 925 City Central Avenue, Conroe, Texas 77304, USA
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Alsharairi NA, Li L. Social marketing targeting healthy eating and physical activity in young adult university students: A scoping review. Heliyon 2024; 10:e31930. [PMID: 38845968 PMCID: PMC11153240 DOI: 10.1016/j.heliyon.2024.e31930] [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: 10/23/2023] [Revised: 05/19/2024] [Accepted: 05/24/2024] [Indexed: 06/09/2024] Open
Abstract
Adult obesity has remained a key health concern globally. Theory-based social marketing interventions are considered effective for improving dietary and physical activity (PA) behaviours. However, their application in universities is not yet established. This review aimed to identify social marketing strategies targeting healthy eating and/or PA behaviours of young adult university students and outline the intervention effectiveness. Literature search, screening, and data extraction followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. PubMed/Medline and Scopus databases were searched for intervention and exploratory studies published between January 1, 2000, and September 20, 2023. Twelve articles were selected based on the eligibility criteria. Although different in study design, all studies reported improved healthy eating-related outcomes, while three showed improved PA-related outcomes. One study incorporated all six of the social marketing benchmarks, but the majority identified two. Most studies focused on behavioural objective, formative research, and marketing mix in their intervention design. Four studies incorporated behaviour change theories in development of the social marketing campaigns. Social marketing using social media could be a significant approach for improving healthy eating and PA in young adult university students when behavioural change theories and all social marketing benchmarks are adopted. More generalizable longer-term investigation into the effectiveness of this approach in university young adults is needed to tackle adult obesity related health issues.
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Affiliation(s)
- Naser A. Alsharairi
- Heart, Mind and Body Research Group, Griffith University, Gold Coast, QLD, 4222, Australia
| | - Li Li
- School of Science, Western Sydney University, Richmond, NSW, 2753, Australia
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Relationship between blood pressure and BMI in young adult population: a national-level assessment in Bangladesh. Br J Nutr 2022; 128:2075-2082. [PMID: 34963504 DOI: 10.1017/s0007114521005134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Young adulthood is a crucial period for major physiological transitions. Environmental changes associated with these transitions can influence health behaviour and health (e.g. poor diet, high body weight and elevated blood pressure (EBP)). Excess body weight can lead to EBP; however, little is known about this relationship among young adults in developing countries. Focusing on Bangladesh, this study assessed the association between BMI and blood pressure (BP) metrics (systolic BP (SBP), diastolic BP (DBP) and BP class (optimal, normal/high normal and elevated)). Sex-specific analyses of these relationships were performed to assess any difference across sexes. Furthermore, associations of overweight/obesity with BP metrics were investigated. Young adults aged 18-24 years (n 2181) were included from nationally representative cross-sectional Bangladesh Demographic and Health Survey 2017-2018. Multivariable linear and multinomial logistic regression models examined the relationships between BMI, overweight/obesity and BP metrics. Findings reveal that higher BMI was associated with higher SBP (0·83; 95 % CI 0·67, 0·99), DBP (0·66; 95 % CI 0·54, 0·74) and higher odds of having EBP (adjusted OR 1·24; 95 % CI 1·17, 1·31). These relationships were stronger among males than females. Moreover, overweight/obese individuals had higher SBP, DBP and higher odds of having EBP than individuals with normal BMI. Strategies to reduce body weight and to improve healthy lifestyle, and awareness and monitoring of BP may help to address these serious health problems, particularly at an early age.
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Grant R, Pawlak R, Vos P, Bilgin AA, Berg J, Pearce R, Morris M. Cardiovascular Disease Risk Factors Profile Among Australian Vegetarian and Nonvegetarian Teenagers. Am J Lifestyle Med 2021; 15:313-321. [PMID: 34025324 PMCID: PMC8120605 DOI: 10.1177/1559827619829000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Atherosclerosis develops over a long period of time and often begins in childhood. The goal of this study was to make a cross-sectional assessment of the pattern of cardiovascular disease risk factors among Australian vegetarian (n = 49) and nonvegetarian (n = 639) 14- to 17-year-old participants from New South Wales, Australia. Vegetarians had statistically significant lower mean total (4.05 vs 4.4 mmol/L;P < .001) and low-density lipoprotein (LDL) cholesterol (2.18 vs 2.55 mmol/L; P < .001) and lower incidence of abnormal total and LDL cholesterol (31.1% vs 46.2%, P = .036, having total cholesterol ≥4.4 mmol/L and 13.3% vs 29.6%, P = .021, having LDL cholesterol ≥2.84 mmol/L). Vegetarians had a higher diastolic BP (72.0 vs 69.7 mm Hg; P = .038). No statistically significant difference was found in other risk factors including high-density lipoprotein cholesterol (P = .83), triglycerides (P = .601), systolic blood pressure (P = .727), body mass index (P = .159), plasma glucose (P = .09), C-reactive protein (P = .527), or homocysteine (P = .45). The prevalence rate with 3 or more risk factors was 12.2% among vegetarians and 13.9% among nonvegetarians (P = .156). The high percentage of abnormal total cholesterol in both diet groups and, in addition, LDL cholesterol in nonvegetarians is a cause of concern and underlines the need for lifestyle change.
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Affiliation(s)
- Ross Grant
- School of Medical Sciences, UNSW, Sydney, New South Wales, Australia (RG)
- East Carolina University, Greenville, North Carolina (R Pawlak, PV)
- Department of Mathematics and Statistics, Faculty of Science and Engineering, Macquarie University, North Ryde, New South Wales, Australia (AAB)
- Australasian Research Institute, Sydney Adventist Hospital, Sydney, New South Wales, Australia (JB)
- Lifestyle Research Centre, Avondale College of Higher Education, New South Wales, Australia (R Pearce)
- School of Medical Sciences, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia (MM)
| | - Roman Pawlak
- Roman Pawlak, PhD, RDN, East Carolina University, AHS 3437, Greenville, NC; e-mail:
| | - Paul Vos
- School of Medical Sciences, UNSW, Sydney, New South Wales, Australia (RG)
- East Carolina University, Greenville, North Carolina (R Pawlak, PV)
- Department of Mathematics and Statistics, Faculty of Science and Engineering, Macquarie University, North Ryde, New South Wales, Australia (AAB)
- Australasian Research Institute, Sydney Adventist Hospital, Sydney, New South Wales, Australia (JB)
- Lifestyle Research Centre, Avondale College of Higher Education, New South Wales, Australia (R Pearce)
- School of Medical Sciences, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia (MM)
| | - Ayse A. Bilgin
- School of Medical Sciences, UNSW, Sydney, New South Wales, Australia (RG)
- East Carolina University, Greenville, North Carolina (R Pawlak, PV)
- Department of Mathematics and Statistics, Faculty of Science and Engineering, Macquarie University, North Ryde, New South Wales, Australia (AAB)
- Australasian Research Institute, Sydney Adventist Hospital, Sydney, New South Wales, Australia (JB)
- Lifestyle Research Centre, Avondale College of Higher Education, New South Wales, Australia (R Pearce)
- School of Medical Sciences, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia (MM)
| | - Jade Berg
- School of Medical Sciences, UNSW, Sydney, New South Wales, Australia (RG)
- East Carolina University, Greenville, North Carolina (R Pawlak, PV)
- Department of Mathematics and Statistics, Faculty of Science and Engineering, Macquarie University, North Ryde, New South Wales, Australia (AAB)
- Australasian Research Institute, Sydney Adventist Hospital, Sydney, New South Wales, Australia (JB)
- Lifestyle Research Centre, Avondale College of Higher Education, New South Wales, Australia (R Pearce)
- School of Medical Sciences, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia (MM)
| | - Robyn Pearce
- School of Medical Sciences, UNSW, Sydney, New South Wales, Australia (RG)
- East Carolina University, Greenville, North Carolina (R Pawlak, PV)
- Department of Mathematics and Statistics, Faculty of Science and Engineering, Macquarie University, North Ryde, New South Wales, Australia (AAB)
- Australasian Research Institute, Sydney Adventist Hospital, Sydney, New South Wales, Australia (JB)
- Lifestyle Research Centre, Avondale College of Higher Education, New South Wales, Australia (R Pearce)
- School of Medical Sciences, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia (MM)
| | - Margaret Morris
- School of Medical Sciences, UNSW, Sydney, New South Wales, Australia (RG)
- East Carolina University, Greenville, North Carolina (R Pawlak, PV)
- Department of Mathematics and Statistics, Faculty of Science and Engineering, Macquarie University, North Ryde, New South Wales, Australia (AAB)
- Australasian Research Institute, Sydney Adventist Hospital, Sydney, New South Wales, Australia (JB)
- Lifestyle Research Centre, Avondale College of Higher Education, New South Wales, Australia (R Pearce)
- School of Medical Sciences, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia (MM)
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Chen X, Kong C, Yu H, Gong J, Lan L, Zhou L, Gong J, Liu P, Xu L, Deng Q. Association between osteosarcopenic obesity and hypertension among four minority populations in China: a cross-sectional study. BMJ Open 2019; 9:e026818. [PMID: 31324680 PMCID: PMC6661579 DOI: 10.1136/bmjopen-2018-026818] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Osteosarcopenic obesity (OSO) may be associated with an increased prevalence of hypertension. The aim of this study was to examine the difference in the prevalence of OSO and hypertension among four minority populations in China and explore the relationship between OSO and hypertension by sex. DESIGN This study adopted a cross-sectional design. PARTICIPANTS In total, 1939 participants aged ≥50 years, including 459 Jing, 514 Maonan, 535 Hmong and 431 Yao participants from Guangxi Province, China, were included using stratified cluster random sampling. MAIN OUTCOME MEASURES The body composition, bone mineral density and blood pressure were measured by an MC-180 body composition analyser, Achilles Express ultrasound bone densitometer and OMRON HEM-1000 electronic sphygmomanometer, respectively. RESULTS The results showed that 65.77% of Hmong men, 58.79% of Hmong women, 54.82% of Maonan men, 50.00% of Maonan women, 41.92% of Jing men, 45.21% of Jing women, 53.66% of Yao men and 42.32% of Yao women suffered from hypertension. Compared with those among the normal group, the adjusted OR and 95% CI of age among the women with OSO was 3.15 (1.13 to 8.78). After adjusting for age, ethnicity, smoking status, alcohol consumption, physical activity and menopausal status, the women with OSO also had a higher OR (OR=3.18, 95% CI 1.14 to 8.88) for hypertension than those in the normal group. However, the ORs (95% CI) for hypertension in men with one or more components were not significant after adjusting for age and ethnicity. CONCLUSION These results suggest that OSO is a risk factor for hypertension, especially in women. Furthermore, the prevalence of OSO and hypertension in the present study displayed sex-specific and ethnic-specific differences among the four minority populations.
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Affiliation(s)
- Xingcai Chen
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
| | - Cunqing Kong
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
| | - Hongrong Yu
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
| | - Jiangu Gong
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
| | - Ling Lan
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
| | - Lining Zhou
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
| | - Jichun Gong
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
| | - Peng Liu
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
| | - Lin Xu
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
- Guangxi Colleges and Universities Key Laboratory of Human Development and Disease Research, Guangxi Medical University, Nanning, China
| | - Qiongying Deng
- Department of Human Anatomy, Guangxi Medical University, Nanning, China
- Guangxi Colleges and Universities Key Laboratory of Human Development and Disease Research, Guangxi Medical University, Nanning, China
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Yuan E, Duan X, Xiang L, Ren J, Lai X, Li Q, Sun L, Sun S. Aged Oolong Tea Reduces High-Fat Diet-Induced Fat Accumulation and Dyslipidemia by Regulating the AMPK/ACC Signaling Pathway. Nutrients 2018; 10:nu10020187. [PMID: 29419789 PMCID: PMC5852763 DOI: 10.3390/nu10020187] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/01/2018] [Accepted: 02/06/2018] [Indexed: 11/16/2022] Open
Abstract
While oolong tea (OT) has been shown to induce weight loss and reduce fat accumulation, the mechanisms remain poorly defined, especially for aged OT. In this study, five groups of mice (n = 9/group) were used including a normal diet with vehicle treatment, and a high-fat diet (HFD) with vehicle or the water extracts from aged OTs (EAOTs, three different storage years) by oral gavage at 1000 mg/kg·BW for 6 weeks. Body weight, fat accumulation, and serum biochemical parameters were used to evaluate obesity. The morphology of hepatocytes and adipocytes was analyzed by being stained with hematoxylin and eosin. The levels of p-AMPK, p-ACC (and non-phosphorylated versions), CPT-1 and FAS were determined by Western blotting and immunohistochemistry. EAOTs decreased HFD-induced body weight, fat accumulation, serum levels of triglyceride, total cholesterol, and low-density lipoprotein cholesterol, while enhancing the serum high-density lipoprotein cholesterol level. At the same time, EAOTs clearly alleviated fatty liver and reduced the size of adipocytes in the epididymal fat, especially in the 2006 group. Most importantly, EAOTs increased the phosphorylation of AMPK and ACC, and up-regulated the expression of CPT-1 but down-regulated the expression of fatty acid synthase, TNF-α and iNOS. Thus, EAOTs may inhibit obesity by up-regulating energy expenditure and fatty acid oxidation while inhibiting fatty acid synthesis and inflammation.
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Affiliation(s)
- Erdong Yuan
- School of Food Science and Engineering, South China University of Technology, Guangzhou 510641, China.
| | - Xuefei Duan
- School of Food Science and Engineering, South China University of Technology, Guangzhou 510641, China.
| | - Limin Xiang
- Tea Research Institute, Guangdong Academy of Agricultural Sciences, Guangdong Provincial Key Laboratory of Tea Plant Resources Innovation & Utilization, Guangzhou 510640, China.
| | - Jiaoyan Ren
- School of Food Science and Engineering, South China University of Technology, Guangzhou 510641, China.
- Sino-Singapore International Joint Research Institution, Guangzhou Knowledge City, Guangzhou 510000, China.
| | - Xingfei Lai
- Tea Research Institute, Guangdong Academy of Agricultural Sciences, Guangdong Provincial Key Laboratory of Tea Plant Resources Innovation & Utilization, Guangzhou 510640, China.
| | - Qiuhua Li
- Tea Research Institute, Guangdong Academy of Agricultural Sciences, Guangdong Provincial Key Laboratory of Tea Plant Resources Innovation & Utilization, Guangzhou 510640, China.
| | - Lingli Sun
- Tea Research Institute, Guangdong Academy of Agricultural Sciences, Guangdong Provincial Key Laboratory of Tea Plant Resources Innovation & Utilization, Guangzhou 510640, China.
| | - Shili Sun
- Tea Research Institute, Guangdong Academy of Agricultural Sciences, Guangdong Provincial Key Laboratory of Tea Plant Resources Innovation & Utilization, Guangzhou 510640, China.
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Kheirandish-Gozal L, Philby MF, Qiao Z, Khalyfa A, Gozal D. Endothelial Dysfunction in Children With Obstructive Sleep Apnea Is Associated With Elevated Lipoprotein-Associated Phospholipase A2 Plasma Activity Levels. J Am Heart Assoc 2017; 6:e004923. [PMID: 28183716 PMCID: PMC5523777 DOI: 10.1161/jaha.116.004923] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 12/15/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is a highly prevalent condition, especially in obese children, and has been associated with increased risk for endothelial dysfunction and dislipidemia, which are precursors of atherosclerosis. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is recognized as an independent risk factor for cardiovascular risk and atheromatous plaque activity. We hypothesized that Lp-PLA2 levels would be elevated in children with OSA, particularly among obese children who also manifest evidence of endothelial dysfunction. METHODS AND RESULTS One hundred sixty children (mean age 7.1±2.3 years), either nonobese with (n=40) and without OSA (n=40) or obese with (n=40) and without OSA (n=40) underwent overnight polysomnographic and postocclusive reperfusion evaluation and a fasting blood draw the morning after the sleep study. In addition to lipid profile, Lp-PLA2 plasma activity was assessed using a commercial kit. Obese children and OSA children had significantly elevated plasma Lp-PLA2 activity levels compared to controls. Furthermore, when both obesity and OSA were concurrently present or when endothelial function was present, Lp-PLA2 activity was higher. Treatment of OSA by adenotonsillectomy resulted in reductions of Lp-PLA2 activity (n=37; P<0.001). CONCLUSIONS Lp-PLA2 plasma activity is increased in pediatric OSA and obesity, particularly when endothelial dysfunction is present, and exhibits decreases on OSA treatment. The short-term and long-term significance of these findings in relation to cardiovascular risk remain undefined.
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Affiliation(s)
- Leila Kheirandish-Gozal
- Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, IL
| | - Mona F Philby
- Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, IL
| | - Zhuanghong Qiao
- Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, IL
| | - Abdelnaby Khalyfa
- Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, IL
| | - David Gozal
- Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, IL
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Cheon JH, Kim N, Lee DH, Kim JM, Kim JS, Jung HC, Song IS. Long-term outcomes after Helicobacter pylori eradication with second-line, bismuth-containing quadruple therapy in Korea. Eur J Gastroenterol Hepatol 2006; 18:515-9. [PMID: 16607147 DOI: 10.1097/00042737-200605000-00010] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To determine the long-term outcomes in terms of Helicobacter pylori and ulcer recurrence after second-line eradication with bismuth-containing quadruple regimens in Korea. METHODS Sixty-seven patients with peptic ulcer disease after successful eradication using second-line quadruple therapies were prospectively followed up 1 month after treatment and then every 6 months or when dyspeptic symptoms reappeared to ascertain H. pylori and ulcer status. RESULTS Three patients were lost during follow-up. The median duration of follow-up of the remaining 64 patients was 26.8 months. H. pylori recurrence occurred in 11 of these 64 patients (17.2%), giving a calculated reinfection rate of 6.0% per patient-year. Only one of the 11 patients was reinfected by 12 months after treatment completion. Four of 11 patients (36.4%) who became reinfected experienced peptic ulcer recurrence, but none of 53 patients who were not reinfected experienced recurrence. No evidence was obtained to indicate that the reinfection rate depended on the age, sex, ulcer location, or eradication regimens. The relapse of dyspeptic symptoms was the only factor predictive of H. pylori recurrence. CONCLUSION This study suggests that the recurrence rate of H. pylori at 1 year after second-line, bismuth-containing quadruple therapy is low, but the annual reinfection rate is as high as 6%. Surveillance for H. pylori reinfection facilitating peptic ulcer recurrence may be warranted even after a second eradication, especially when dyspeptic symptoms reappear in Korea.
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Affiliation(s)
- Jae Hee Cheon
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea
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