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Guaita A, Brunelli L, Davin A, Poloni TE, Vaccaro R, Gagliardi S, Pansarasa O, Cereda C. Homocysteine, Folic Acid, Cyanocobalamin, and Frailty in Older People: Findings From the “Invece. Ab” Study. Front Physiol 2021; 12:775803. [PMID: 34975530 PMCID: PMC8717775 DOI: 10.3389/fphys.2021.775803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/17/2021] [Indexed: 11/30/2022] Open
Abstract
Frailty is an important age-related syndrome associated with several adverse health outcomes. Its biological basis is undefined. Raised plasma homocysteine (HOcy) is an established risk factor for cardiovascular disease, dementia, cognitive impairment, and mortality, but little is known about the possible role of plasma HOcy, cyanocobalamin (B12), and folate (FO levels in the development of frailty. Our first aim was to explore the possible association between frailty and plasma concentrations of HOcy, FO, and B12 in a cohort of community-dwelling older people. The second was to assess the influence of these metabolic factors on six-year incidence of frailty in the 875 individuals eligible for inclusion in this study (those with a full follow-up dataset). This research is based on data from three waves – 2012 (herein taken as baseline), 2014, and 2018 – of a longitudinal study (InveCe.Ab) in which non-frail men and women born between 1935 and 1939 underwent multidimensional assessments. Frailty was estimated using a deficit accumulation-based frailty index (FI). HOcy concentration was significantly positively correlated with FI at all timepoints, while B12 and FO levels were not. Plasma concentration of HOcy emerged as a predictor of six-year cumulative incidence of frailty, independent of age, sex, and education, while B12 and FO levels showed no relationship with frailty incidence. Individuals with plasma HOcy in the top quintile showed five months less frailty-free survival (HR 1.487; 95% CI: 1.063–2.078), regardless of age, sex, and education. These results demonstrate that higher HOcy is a risk factor for frailty onset in older adults.
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Affiliation(s)
- Antonio Guaita
- Epidemiological and Neuropathological Laboratories, Golgi Cenci Foundation, Abbiategrasso, Italy
- *Correspondence: Antonio Guaita,
| | - Laura Brunelli
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Annalisa Davin
- Epidemiological and Neuropathological Laboratories, Golgi Cenci Foundation, Abbiategrasso, Italy
| | - Tino Emanuele Poloni
- Epidemiological and Neuropathological Laboratories, Golgi Cenci Foundation, Abbiategrasso, Italy
| | - Roberta Vaccaro
- Epidemiological and Neuropathological Laboratories, Golgi Cenci Foundation, Abbiategrasso, Italy
| | - Stella Gagliardi
- Genomic and Post-Genomic Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Orietta Pansarasa
- Genomic and Post-Genomic Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Cristina Cereda
- Epidemiological and Neuropathological Laboratories, Golgi Cenci Foundation, Abbiategrasso, Italy
- Department of Woman, Mother and Newborn, ASST Fatebenefratelli Sacco, “V. Buzzi” Children Hospital, Milan, Italy
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Wei J, Ji JS. Modification of vitamin B6 on the associations of blood lead levels and cardiovascular diseases in the US adults. BMJ Nutr Prev Health 2021; 3:180-187. [PMID: 33521527 PMCID: PMC7841818 DOI: 10.1136/bmjnph-2020-000088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/12/2020] [Accepted: 07/14/2020] [Indexed: 12/31/2022] Open
Abstract
Background Cardiovascular disease (CVD) is a leading cause of death in the US population. Lead exposure is an important risk factor of CVDs, as is associated with elevated homocysteine level and oxidative stress. We aim to examine whether vitamin B6, which has been shown to reduce homocysteine level, can modify the relationship between blood lead and the risk of CVDs. Methods Cross-sectional data on ever-report CVDs (congestive heart failure, coronary heart disease, angina pectoris, heart attack and stroke), blood lead level (BLL) and vitamin B6 in the form of plasma pyridoxal 5'-phosphate were obtained from US National Health and Nutrition Examination Survey 2005–2006 for adults≥20 years old. The association between CVDs and quartiles of BLL was estimated using multivariate logistic regression models adjusted for demographics factors, lifestyle variables, stress variables, comorbidities and CVD biomarkers (C reactive protein, homocysteine, cholesterol) and was stratified by vitamin B6 deficiency level (<20 nmol/L) and median value of vitamin B6 (42.5 nmol/L). Results Positive associations between BLL and CVDs only appeared in the vitamin B6 deficiency group, with quartile 2 to quartile 4 of BLL showing higher risk of CVDs (OR=3.1, 95% CI 0.9 to 10.6; OR=6.5, 95% CI 1.4 to 30.8; OR=5.5, 95% CI 1.4 to 21.7) compared with quartile 1. When stratified by median value of vitamin B6, a significant association between higher CVD risk with higher BLL was only observed in subjects with low vitamin B6 (p trend=0.004). Conclusions Vitamin B6 could modify the association between BLL and CVDs, which suggests a potential value of vitamin B6 in influencing the effects of lead exposure on the cardiovascular system.
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Affiliation(s)
- Jia Wei
- Environmental Research Center, Duke Kunshan University, Kunshan, China
| | - John S Ji
- Environmental Research Center, Duke Kunshan University, Kunshan, China.,Nicholas School of the Environment, Duke University, Durham, North Carolina, USA
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Badran M, Laher I. Waterpipe (shisha, hookah) smoking, oxidative stress and hidden disease potential. Redox Biol 2020; 34:101455. [PMID: 32086009 PMCID: PMC7327957 DOI: 10.1016/j.redox.2020.101455] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 01/27/2020] [Accepted: 02/06/2020] [Indexed: 02/08/2023] Open
Abstract
Due to the abundant research on the harmful effects of cigarette smoking and the strict regulations enacted by many health authorities, many smokers are seeking for safer and more acceptable tobacco forms. Waterpipe (also known as shisha or hookah) use has increased dramatically during the past decade, mostly due to its improved taste, lack of regulations and social acceptability as a safer option than cigarettes. However, recent clinical and experimental studies indicate that waterpipe use is as, or even more, harmful than cigarettes. Although they differ in the method of consumption, waterpipe tobacco has similar deleterious constituents found in cigarettes but are generated at greater amounts. These constituents are known to induce oxidative stress and inflammation, the major underlying mechanisms of a wide array of chronic pathological conditions. We review the relationship between waterpipe tobacco use and oxidative stress and the disease potential of waterpipe use. Waterpipe tobacco smoking is growing in popularity globally, since it is thought to be a safer alternative to cigarette smoking. The amount of harmful substances produced from one waterpipe smoking session are greater than found in a standard cigarette. Waterpipe smoking can cause oxidative stress and inflammation, which precede and exacerbate multiple pathological conditions.
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Affiliation(s)
- Mohammad Badran
- Department of Child Health and Child Health Research Institute, University of Missouri School of Medicine, Columbia, MO, USA
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada.
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Pathobiological mechanisms underlying metabolic syndrome (MetS) in chronic obstructive pulmonary disease (COPD): clinical significance and therapeutic strategies. Pharmacol Ther 2019; 198:160-188. [PMID: 30822464 PMCID: PMC7112632 DOI: 10.1016/j.pharmthera.2019.02.013] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a major incurable global health burden and is currently the 4th largest cause of death in the world. Importantly, much of the disease burden and health care utilisation in COPD is associated with the management of its comorbidities (e.g. skeletal muscle wasting, ischemic heart disease, cognitive dysfunction) and infective viral and bacterial acute exacerbations (AECOPD). Current pharmacological treatments for COPD are relatively ineffective and the development of effective therapies has been severely hampered by the lack of understanding of the mechanisms and mediators underlying COPD. Since comorbidities have a tremendous impact on the prognosis and severity of COPD, the 2015 American Thoracic Society/European Respiratory Society (ATS/ERS) Research Statement on COPD urgently called for studies to elucidate the pathobiological mechanisms linking COPD to its comorbidities. It is now emerging that up to 50% of COPD patients have metabolic syndrome (MetS) as a comorbidity. It is currently not clear whether metabolic syndrome is an independent co-existing condition or a direct consequence of the progressive lung pathology in COPD patients. As MetS has important clinical implications on COPD outcomes, identification of disease mechanisms linking COPD to MetS is the key to effective therapy. In this comprehensive review, we discuss the potential mechanisms linking MetS to COPD and hence plausible therapeutic strategies to treat this debilitating comorbidity of COPD.
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Ostrakhovitch EA, Tabibzadeh S. Homocysteine and age-associated disorders. Ageing Res Rev 2019; 49:144-164. [PMID: 30391754 DOI: 10.1016/j.arr.2018.10.010] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 09/30/2018] [Accepted: 10/25/2018] [Indexed: 12/26/2022]
Abstract
There are numerous theories of aging, a process which still seems inevitable. Aging leads to cancer and multi-systemic disorders as well as chronic diseases. Decline in age- associated cellular functions leads to neurodegeneration and cognitive decline that affect the quality of life. Accumulation of damage, mutations, metabolic changes, failure in cellular energy production and clearance of altered proteins over the lifetime, and hyperhomocysteinemia, ultimately result in tissue degeneration. The decline in renal functions, nutritional deficiencies, deregulation of methionine cycle and deficiencies of homocysteine remethylation and transsulfuration cofactors cause elevation of homocysteine with advancing age. Abnormal accumulation of homocysteine is a risk factor of cardiovascular, neurodegenerative and chronic kidney disease. Moreover, approximately 50% of people, aged 65 years and older develop hypertension and are at a high risk of developing cardiovascular insufficiency and incurable neurodegenerative disorders. Increasing evidence suggests inverse relation between cognitive impairment, cerebrovascular and cardiovascular events and renal function. Oxidative stress, inactivation of nitric oxide synthase pathway and mitochondria dysfunction associated with impaired homocysteine metabolism lead to aging tissue degeneration. In this review, we examine impact of high homocysteine levels on changes observed with aging that contribute to development and progression of age associated diseases.
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Affiliation(s)
- E A Ostrakhovitch
- Frontiers in Bioscience Research Institute in Aging and Cancer, Irvine, CA, USA.
| | - S Tabibzadeh
- Frontiers in Bioscience Research Institute in Aging and Cancer, Irvine, CA, USA.
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Whayne TF. Non-Traditional Cardiovascular Risk Markers in the Era of Established Major Risk Factors and Multiple Guidelines. Curr Vasc Pharmacol 2018; 17:270-277. [PMID: 29359673 DOI: 10.2174/1570161116666180123112956] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 01/11/2018] [Accepted: 01/11/2018] [Indexed: 12/13/2022]
Abstract
The non-traditional cardiovascular (CV) risk factors that appear to be of most clinical interest include: apolipoprotein A (ApoA), apolipoprotein B (ApoB), high-sensitivity C-Reactive protein (hsCRP), homocysteine, interleukin 1 (IL1), lipoprotein (a) [Lp(a)], the density of low-density lipoprotein (LDL) particles, the LDL particle number, tissue/tumor necrosis factor-α (TNF-α) and uric acid. These non-traditional risk factors may be of value in adding further confirmation and attention to suspected significant CV risk. They can also provide a better understanding of current concepts of atherogenesis (e.g. various potential mechanisms associated with inflammation) as an etiology and in guiding current plus future therapies. In the mid-20th century, atherosclerosis and CV disease were considered mechanistic occurrences with essentially no attention to possible metabolic and molecular etiologies. Therefore, the only treatments then centered around mainly surgical procedures to try to improve blood flow, first with peripheral arterial disease (PAD) and later coronary artery disease (CAD). Now, failure to treat CV risk factors, especially where there is good evidence-based medicine, as in the case of statins for high CV risk patients, is considered medical negligence. Nevertheless, many problems remain to be solved regarding atherosclerosis prevention and treatment.
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Affiliation(s)
- Thomas F Whayne
- Gill Heart and Vascular Institute, University of Kentucky, Lexington, KY 40536-0200, United States
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Liu G, Bin P, Wang T, Ren W, Zhong J, Liang J, Hu CAA, Zeng Z, Yin Y. DNA Methylation and the Potential Role of Methyl-Containing Nutrients in Cardiovascular Diseases. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:1670815. [PMID: 29348786 PMCID: PMC5733941 DOI: 10.1155/2017/1670815] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 10/31/2017] [Indexed: 02/08/2023]
Abstract
Patients suffering from cardiovascular diseases (CVDs) experience a low quality of life and increase pressure on healthcare systems both nationally and globally. DNA methylation, which refers to the pathway by which DNA methyltransferase facilitates the addition of a methyl group to DNA, is of critical importance in this respect primarily because the epigenetic modification is implicated in a range of serious conditions including atherosclerosis, CVDs, and cancer. Research findings indicate that the number of epigenetic alterations can be elicited (both in utero and in adults) through the administration of certain nutritional supplements, including folic acid and methionine; this is partly attributable to the effect employed by methyl-containing nutrients in DNA methylation. Thus, for the purpose of illuminating viable therapeutic measures and preventive strategies for CVDs, research should continue to explore the intricate associations that exist between epigenetic regulation and CVD pathogenesis. This review centers on an exposition of the mechanism by which DNA methylation takes place, the impact it has on a range of conditions, and the potential clinical value of nutrition, driven mainly by the observation that nutritional supplements such as folic acid can affect DNA methylation.
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Affiliation(s)
- Gang Liu
- Key Laboratory of Agro-Ecological Processes in Subtropical Region, Institute of Subtropical Agriculture, Chinese Academy of Sciences, National Engineering Laboratory for Pollution Control and Waste Utilization in Livestock and Poultry Production, Hunan Provincial Engineering Research Center of Healthy Livestock, Hunan Co-Innovation Center of Animal Production Safety, Hunan 410125, China
| | - Peng Bin
- Key Laboratory of Agro-Ecological Processes in Subtropical Region, Institute of Subtropical Agriculture, Chinese Academy of Sciences, National Engineering Laboratory for Pollution Control and Waste Utilization in Livestock and Poultry Production, Hunan Provincial Engineering Research Center of Healthy Livestock, Hunan Co-Innovation Center of Animal Production Safety, Hunan 410125, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Tianwei Wang
- University of Chinese Academy of Sciences, Beijing 100049, China
- State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China
| | - Wenkai Ren
- Key Laboratory of Agro-Ecological Processes in Subtropical Region, Institute of Subtropical Agriculture, Chinese Academy of Sciences, National Engineering Laboratory for Pollution Control and Waste Utilization in Livestock and Poultry Production, Hunan Provincial Engineering Research Center of Healthy Livestock, Hunan Co-Innovation Center of Animal Production Safety, Hunan 410125, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jin Zhong
- University of Chinese Academy of Sciences, Beijing 100049, China
- State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China
| | - Jun Liang
- College of Packaging and Printing Engineering, Tianjin University of Science and Technology, Tianjin 300222, China
| | - Chien-An Andy Hu
- Department of Biochemistry and Molecular Biology, University of New Mexico School of Medicine, MSC08 4670, Fitz 258, Albuquerque, NM 87131, USA
- Animal Nutrition and Human Health Laboratory, School of Life Sciences, Hunan Normal University, Changsha, Hunan 410081, China
| | - Zhaoying Zeng
- Key Laboratory of Agro-Ecological Processes in Subtropical Region, Institute of Subtropical Agriculture, Chinese Academy of Sciences, National Engineering Laboratory for Pollution Control and Waste Utilization in Livestock and Poultry Production, Hunan Provincial Engineering Research Center of Healthy Livestock, Hunan Co-Innovation Center of Animal Production Safety, Hunan 410125, China
| | - Yulong Yin
- Key Laboratory of Agro-Ecological Processes in Subtropical Region, Institute of Subtropical Agriculture, Chinese Academy of Sciences, National Engineering Laboratory for Pollution Control and Waste Utilization in Livestock and Poultry Production, Hunan Provincial Engineering Research Center of Healthy Livestock, Hunan Co-Innovation Center of Animal Production Safety, Hunan 410125, China
- Animal Nutrition and Human Health Laboratory, School of Life Sciences, Hunan Normal University, Changsha, Hunan 410081, China
- College of Animal Science, South China Agricultural University, Guangzhou 510642, China
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Stanhewicz AE, Kenney WL. Role of folic acid in nitric oxide bioavailability and vascular endothelial function. Nutr Rev 2017; 75:61-70. [PMID: 27974600 PMCID: PMC5155615 DOI: 10.1093/nutrit/nuw053] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Folic acid is a member of the B-vitamin family and is essential for amino acid metabolism. Adequate intake of folic acid is vital for metabolism, cellular homeostasis, and DNA synthesis. Since the initial discovery of folic acid in the 1940s, folate deficiency has been implicated in numerous disease states, primarily those associated with neural tube defects in utero and neurological degeneration later in life. However, in the past decade, epidemiological studies have identified an inverse relation between both folic acid intake and blood folate concentration and cardiovascular health. This association inspired a number of clinical studies that suggested that folic acid supplementation could reverse endothelial dysfunction in patients with cardiovascular disease (CVD). Recently, in vitro and in vivo studies have begun to elucidate the mechanism(s) through which folic acid improves vascular endothelial function. These studies, which are the focus of this review, suggest that folic acid and its active metabolite 5-methyl tetrahydrofolate improve nitric oxide (NO) bioavailability by increasing endothelial NO synthase coupling and NO production as well as by directly scavenging superoxide radicals. By improving NO bioavailability, folic acid may protect or improve endothelial function, thereby preventing or reversing the progression of CVD in those with overt disease or elevated CVD risk.
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Affiliation(s)
- Anna E Stanhewicz
- A.E. Stanhewicz and W.L. Kenney are with the Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, USA.
| | - W Larry Kenney
- A.E. Stanhewicz and W.L. Kenney are with the Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, USA
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Pisano G, Lombardi R, Fracanzani AL. Vascular Damage in Patients with Nonalcoholic Fatty Liver Disease: Possible Role of Iron and Ferritin. Int J Mol Sci 2016; 17:ijms17050675. [PMID: 27164079 PMCID: PMC4881501 DOI: 10.3390/ijms17050675] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 04/20/2016] [Accepted: 04/26/2016] [Indexed: 02/06/2023] Open
Abstract
Non Alcoholic Fatty Liver Disease (NAFLD) is the most common chronic liver disease in Western countries. Recent data indicated that NAFLD is a risk factor by itself contributing to the development of cardiovascular disease independently of classical known risk factors. Hyperferritinemia and mild increased iron stores are frequently observed in patients with NAFLD and several mechanisms have been proposed to explain the role of iron, through oxidative stress and interaction with insulin metabolism, in the development of vascular damage. Moreover, iron depletion has been shown to decrease atherogenesis in experimental models and in humans. This review presents the recent evidence on epidemiology, pathogenesis, and the possible explanation of the role of iron and ferritin in the development of cardiovascular damage in patients with NAFLD, and discusses the possible interplay between metabolic disorders associated with NAFLD and iron in the development of cardiovascular disease.
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Affiliation(s)
- Giuseppina Pisano
- Department of Pathophysiology and Transplantation, Ca' Granda IRCCS Foundation, Policlinico Hospital, University of Milan, Centre of the Study of Metabolic and Liver Diseases, Via Francesco Sforza 35, 20122 Milan, Italy.
| | - Rosa Lombardi
- Department of Pathophysiology and Transplantation, Ca' Granda IRCCS Foundation, Policlinico Hospital, University of Milan, Centre of the Study of Metabolic and Liver Diseases, Via Francesco Sforza 35, 20122 Milan, Italy.
| | - Anna Ludovica Fracanzani
- Department of Pathophysiology and Transplantation, Ca' Granda IRCCS Foundation, Policlinico Hospital, University of Milan, Centre of the Study of Metabolic and Liver Diseases, Via Francesco Sforza 35, 20122 Milan, Italy.
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Harris E, Rowsell R, Pipingas A, Macpherson H. No effect of multivitamin supplementation on central blood pressure in healthy older people: A randomized controlled trial. Atherosclerosis 2016; 246:236-42. [PMID: 26812001 DOI: 10.1016/j.atherosclerosis.2016.01.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 01/12/2016] [Accepted: 01/18/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS Central blood pressure rises with age, which increases cardiovascular risk. There is some evidence that nutritional supplements may be useful to reduce central blood pressures in older people, but no studies have investigated the effects of multivitamin supplements for this purpose. This randomized, double-blind, placebo-controlled study investigated the effects of 16-weeks supplementation with gender-specific multivitamin and herbal supplements. METHOD Participants were healthy individuals, free from heart disease, and included 160 females aged ≥ 50 and 79 males aged 50-65 years. Analyses of co-variance, correcting for baseline cardiovascular assessments, were used to determine the effects of supplementation on central cardiovascular measures including augmentation index, augmentation pressure and pulse pressure. Significance was set at p = 0.016. RESULTS No effects of multivitamin supplementation were observed in either males or females (respectively) for central augmentation index (p = 0.841; p = 0.296), central augmentation pressure (p = 0.794; p = 0.442), and central pulse pressure (p = 0.078; p = 0.304). Similarly, there was no treatment effect observed for brachial systolic, diastolic or pulse pressures. CONCLUSION Four months multivitamin supplementation does not appear to exert any benefit to measures of central blood pressure in healthy older people.
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Affiliation(s)
- Elizabeth Harris
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Vic, 3000, Australia; Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Vic, 3122, Australia.
| | - Renee Rowsell
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Vic, 3122, Australia.
| | - Andrew Pipingas
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Vic, 3122, Australia.
| | - Helen Macpherson
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Vic, 3122, Australia; Centre for Physical Activity and Nutrition Research, Deakin University, Burwood, Vic, 3125, Australia.
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Voelter-Mahlknecht S. Epigenetic associations in relation to cardiovascular prevention and therapeutics. Clin Epigenetics 2016; 8:4. [PMID: 26779291 PMCID: PMC4714496 DOI: 10.1186/s13148-016-0170-0] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 01/06/2016] [Indexed: 02/06/2023] Open
Abstract
Cardiovascular diseases (CVD) increasingly burden societies with vast financial and health care problems. Therefore, the importance of improving preventive and therapeutic measures against cardiovascular diseases is continually growing. To accomplish such improvements, research must focus particularly on understanding the underlying mechanisms of such diseases, as in the field of epigenetics, and pay more attention to strengthening primary prevention. To date, preliminary research has found a connection between DNA methylation, histone modifications, RNA-based mechanisms and the development of CVD like atherosclerosis, cardiac hypertrophy, myocardial infarction, and heart failure. Several therapeutic agents based on the findings of such research projects are currently being tested for use in clinical practice. Although these tests have produced promising data so far, no epigenetically active agents or drugs targeting histone acetylation and/or methylation have actually entered clinical trials for CVDs, nor have they been approved by the FDA. To ensure the most effective prevention and treatment possible, further studies are required to understand the complex relationship between epigenetic regulation and the development of CVD. Similarly, several classes of RNA therapeutics are currently under development. The use of miRNAs and their targets as diagnostic or prognostic markers for CVDs is promising, but has not yet been realized. Further studies are necessary to improve our understanding of the involvement of lncRNA in regulating gene expression changes underlying heart failure. Through the data obtained from such studies, specific therapeutic strategies to avoid heart failure based on interference with incRNA pathways could be developed. Together, research and testing findings raise hope for enhancing the therapeutic armamentarium. This review presents the currently available data concerning epigenetic mechanisms and compounds involved in cardiovascular diseases, as well as preventive and therapeutic approaches against them.
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Affiliation(s)
- Susanne Voelter-Mahlknecht
- University Hospital of Tuebingen, Institute of Occupational and Social Medicine and Health Services Research, Wilhelmstr. 27, 72074 Tuebingen, Germany
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Goszcz K, Deakin SJ, Duthie GG, Stewart D, Leslie SJ, Megson IL. Antioxidants in Cardiovascular Therapy: Panacea or False Hope? Front Cardiovasc Med 2015; 2:29. [PMID: 26664900 PMCID: PMC4671344 DOI: 10.3389/fcvm.2015.00029] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 06/10/2015] [Indexed: 12/31/2022] Open
Abstract
Oxidative stress is a key feature of the atherothrombotic process involved in the etiology of heart attacks, ischemic strokes, and peripheral arterial disease. It stands to reason that antioxidants represent a credible therapeutic option to prevent disease progression and thereby improve outcome, but despite positive findings from in vitro studies, clinical trials have failed to consistently show benefit. The aim of this review is to re-appraise the concept of antioxidants in the prevention and management of cardiovascular disease. In particular, the review will explore the reasons behind failed antioxidant strategies with vitamin supplements and will evaluate how flavonoids might improve cardiovascular function despite bioavailability that is not sufficiently high to directly influence antioxidant capacity. As well as reaching conclusions relating to those antioxidant strategies that might hold merit, the major myths, limitations, and pitfalls associated with this research field are explored.
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Affiliation(s)
- Katarzyna Goszcz
- Department of Diabetes and Cardiovascular Science, Centre for Health Science, University of the Highlands and Islands , Inverness , UK ; James Hutton Institute , Dundee , UK
| | - Sherine J Deakin
- Department of Diabetes and Cardiovascular Science, Centre for Health Science, University of the Highlands and Islands , Inverness , UK
| | - Garry G Duthie
- Rowett Institute of Health and Nutrition , Aberdeen , UK
| | - Derek Stewart
- James Hutton Institute , Dundee , UK ; School of Life Sciences, Heriot Watt University , Edinburgh , UK
| | - Stephen J Leslie
- Department of Diabetes and Cardiovascular Science, Centre for Health Science, University of the Highlands and Islands , Inverness , UK ; Cardiology Unit, Raigmore Hospital , Inverness , UK
| | - Ian L Megson
- Department of Diabetes and Cardiovascular Science, Centre for Health Science, University of the Highlands and Islands , Inverness , UK
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Bhardwaj S, Prabhuji MLV, Karthikeyan BV. Effect of non-surgical periodontal therapy on plasma homocysteine levels in Indian population with chronic periodontitis: a pilot study. J Clin Periodontol 2015; 42:221-7. [PMID: 25644517 DOI: 10.1111/jcpe.12374] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2015] [Indexed: 01/07/2023]
Abstract
AIM Homocysteine (Hcy) is implicated in the development of cardiovascular diseases (CVD). The effect of periodontal disease and periodontal therapy on plasma Hcy remains controversial. Hence, in this pilot study we assessed the effect of periodontal disease and non-surgical periodontal therapy (NSPT) on plasma Hcy in systemically healthy Indian subjects. MATERIALS AND METHODS Forty participants (30 to 39 years) were enrolled in the study and were divided into two groups based on gingival index, probing depth, and clinical attachment level (CAL): Healthy (control group; n = 20) and Chronic Periodontitis (test group; n = 20). Plasma samples were collected and quantified at baseline and 12 weeks after scaling and root planing (SRP) for Hcy using High Performance Liquid Chromatography with fluorescent detection (HPLC-fld). RESULTS Plasma Hcy levels of chronic periodontitis (17.87 ± 1.21 μmol/l) subjects was significantly higher than healthy subjects (9.09 ± 2.11 μmol/l). Post-therapy, the plasma Hcy concentration reduced significantly (11.34 ± 1.87 μmol/l) (p < 0.05). CONCLUSION The rise and descent of plasma Hcy levels with periodontal inflammation and therapy, respectively, indicate a direct relationship of Hcy with chronic periodontitis. NSPT may be employed as an adjunctive Hcy Lowering Therapy, contributing towards primary prevention against CVD's.
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Affiliation(s)
- Smiti Bhardwaj
- Department of Periodontics, Krishnadevaraya College of Dental Sciences and Hospital, Bangalore, India
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Lu YH, Cheng LM, Huang YH, Lo MY, Wu TJT, Lin HY, Hsu TR, Niu DM. Heterozygous carriers of classical homocystinuria tend to have higher fasting serum homocysteine concentrations than non-carriers in the presence of folate deficiency. Clin Nutr 2014; 34:1155-8. [PMID: 25516282 DOI: 10.1016/j.clnu.2014.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 10/27/2014] [Accepted: 11/27/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND & AIMS Many studies have reported that serum total homocysteine (tHcy) levels in cystathionine-beta-synthase (CBS) carriers are usually normal and only elevated after a methionine load. However, the amount of methionine required for a loading test is non-physiological and is never reached with regular feeding. Therefore, CBS carriers do not seem to be at an increased risk of cardiovascular diseases. However, the risk of cardiovascular diseases of CBS carriers with folate deficiency has not been studied. We recently found an extraordinarily high carrier rate (1/7.78) of a novel CBS mutation (p.D47E, c.T141A) in an Austronesian Taiwanese Tao tribe who live in a geographic area with folate deficiency. We evaluated if the CBS carriers tend to have higher fasting serum tHcy concentrations than non-carriers in presence of folate deficiency. METHODS The serum tHcy and folate levels before and after folate replacement were measured in 48 adult Tao carriers, 40 age-matched Tao non-carriers and 40 age-matched Han Taiwanese controls. RESULTS The serum tHcy level of the Tao CBS carriers (17.9 ± 3.8 μmol/l) was significantly higher than in Tao non-carriers (15.7 ± 3.5 μmol/l; p < 0.008) and Taiwanese controls (11.8 ± 2.9 μmol/l; p < 0.001). Furthermore, a high prevalence of folate deficiency in the Tao compared with the Taiwanese controls (4.9 ± 1.8 ng/ml vs. 10.6 ± 5.5 ng/ml; p < 0.001) was also noted. Of note, the difference in tHcy levels between the carriers and non-carriers was eliminated by folate supplementation. (carriers:13.65 ± 2.13 μmol/l; non-carriers:12.39 ± 3.25 μmol/l, p = 0.321). CONCLUSIONS CBS carriers tend to have a higher tHcy level in the presence of folate deficiency than non-carriers. Although many reports have indicated that CBS carriers are not associated with cardiovascular disease, the risk for CBS carriers with folate deficiency has not been well studied. Owing to a significantly elevated level of fasting tHcy without methionine loading, it is important to evaluate the risk of cardiovascular disease in CBS carriers with folate deficiency.
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Affiliation(s)
- Yung-Hsiu Lu
- Institute of Clinical Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC; Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Li-Mei Cheng
- Lanyu Township Health Office, Taitung, Taiwan, ROC
| | - Yu-Hsiu Huang
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ming-Yu Lo
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Tina Jui-Ting Wu
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Hsiang-Yu Lin
- Institute of Clinical Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC; Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, ROC
| | - Ting-Rong Hsu
- Institute of Clinical Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC; Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
| | - Dau-Ming Niu
- Institute of Clinical Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC; Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
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Debreceni B, Debreceni L. The role of homocysteine-lowering B-vitamins in the primary prevention of cardiovascular disease. Cardiovasc Ther 2014; 32:130-8. [PMID: 24571382 DOI: 10.1111/1755-5922.12064] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of mortality in the Western world. The effort of research should aim at the primary prevention of CVD. Alongside statin therapy, which is maintained to be an effective method of CVD prevention, there are alternative methods such as vitamin B substitution therapy with folic acid (FA), and vitamins B12 and B6 . B-vitamins may inhibit atherogenesis by decreasing the plasma level of homocysteine (Hcy)-a suspected etiological factor for atherosclerosis-and by other mechanisms, primarily through their antioxidant properties. Although Hcy-lowering vitamin trials have failed to demonstrate beneficial effects of B-vitamins in the prevention of CVD, a meta-analysis and stratification of a number of large vitamin trials have suggested their effectiveness in cardiovascular prevention (CVP) in some aspects. Furthermore, interpretation of the results from these large vitamin trials has been troubled by statin/aspirin therapy, which was applied along with the vitamin substitution, and FA fortification, both of which obscured the separate effects of vitamins in CVP. Recent research results have accentuated a new approach to vitamin therapy for CVP. Studies undertaken with the aim of primary prevention have shown that vitamin B substitution may be effective in the primary prevention of CVD and may also be an option in the secondary prevention of disease if statin therapy is accompanied by serious adverse effects. Further investigations are needed to determine the validity of vitamin substitution therapy before its introduction in the protocol of CVD prevention.
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Affiliation(s)
- Balazs Debreceni
- Department of Biochemistry and Medical Chemistry, Medical School, University of Pecs, Pecs, Hungary
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Molinari C, Risé P, Guerra C, Mauro N, Piani C, Bosi E, Galli C, Scavini M. Eight-week consumption of milk enriched with omega 3 fatty acids raises their blood concentrations yet does not affect lipids and cardiovascular disease risk factors in adult healthy volunteers. PHARMANUTRITION 2014. [DOI: 10.1016/j.phanu.2014.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Okura T, Miyoshi KI, Irita J, Enomoto D, Nagao T, Kukida M, Tanino A, Kudo K, Pei Z, Higaki J. Hyperhomocysteinemia is one of the risk factors associated with cerebrovascular stiffness in hypertensive patients, especially elderly males. Sci Rep 2014; 4:5663. [PMID: 25012721 PMCID: PMC4092328 DOI: 10.1038/srep05663] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 06/23/2014] [Indexed: 12/31/2022] Open
Abstract
Hyperhomocystemia has been reported to be associated with cardiovascular disease, especially stroke. The resistive index (RI) estimated by carotid ultrasound is an established variable for estimating the risk of cerebral infarction. The aim of this study was to evaluate the relationship between homocysteine concentration and carotid RI, a marker of cerebral vascular resistance in essential hypertensive patients. We measured serum total homocysteine and carotid RI in 261 patients. Multiple linear regression analysis was used to determine the association of homocysteine with carotid RI and intima media thickness (IMT). Age, sex, BMI, systolic blood pressure (SBP), homocysteine, total cholesterol, high density lipoprotein-cholesterol (HDL-C), uric acid, CRP, HbA1c, estimated glomerular filtration rate, and use of antihypertensive agents were included as independent variables. Age, sex, use of antihypertensive agents, HDL-C and homocysteine levels were shown to be significant predictors of carotid RI, but not IMT. Multiple regression analysis in men older than 65 years showed homocysteine and SBP were associated significantly with carotid RI. In elderly male patients, homocysteine was the strongest predictor of carotid RI (B = 0.0068, CI = 0.0017-0.0120, P = 0.011) in the multivariate model. In conclusion, hyperhomocysteinemia is associated with carotid RI, a surrogate marker of cerebral vascular resistance, especially in elderly men.
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Affiliation(s)
- Takafumi Okura
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon City, Ehime, 791-0295, Japan
| | - Ken-Ichi Miyoshi
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon City, Ehime, 791-0295, Japan
| | - Jun Irita
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon City, Ehime, 791-0295, Japan
| | - Daijiro Enomoto
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon City, Ehime, 791-0295, Japan
| | - Tomoaki Nagao
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon City, Ehime, 791-0295, Japan
| | - Masayoshi Kukida
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon City, Ehime, 791-0295, Japan
| | - Akiko Tanino
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon City, Ehime, 791-0295, Japan
| | - Kayo Kudo
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon City, Ehime, 791-0295, Japan
| | - Zouwei Pei
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon City, Ehime, 791-0295, Japan
| | - Jitsuo Higaki
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon City, Ehime, 791-0295, Japan
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Mangge H, Becker K, Fuchs D, Gostner JM. Antioxidants, inflammation and cardiovascular disease. World J Cardiol 2014; 6:462-477. [PMID: 24976919 PMCID: PMC4072837 DOI: 10.4330/wjc.v6.i6.462] [Citation(s) in RCA: 207] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 03/26/2014] [Accepted: 04/17/2014] [Indexed: 02/06/2023] Open
Abstract
Multiple factors are involved in the etiology of cardiovascular disease (CVD). Pathological changes occur in a variety of cell types long before symptoms become apparent and diagnosis is made. Dysregulation of physiological functions are associated with the activation of immune cells, leading to local and finally systemic inflammation that is characterized by production of high levels of reactive oxygen species (ROS). Patients suffering from inflammatory diseases often present with diminished levels of antioxidants either due to insufficient dietary intake or, and even more likely, due to increased demand in situations of overwhelming ROS production by activated immune effector cells like macrophages. Antioxidants are suggested to beneficially interfere with diseases-related oxidative stress, however the interplay of endogenous and exogenous antioxidants with the overall redox system is complex. Moreover, molecular mechanisms underlying oxidative stress in CVD are not fully elucidated. Metabolic dybalances are suggested to play a major role in disease onset and progression. Several central signaling pathways involved in the regulation of immunological, metabolic and endothelial function are regulated in a redox-sensitive manner. During cellular immune response, interferon γ-dependent pathways are activated such as tryptophan breakdown by the enzyme indoleamine 2,3-dioxygenase (IDO) in monocyte-derived macrophages, fibroblasts, endothelial and epithelial cells. Neopterin, a marker of oxidative stress and immune activation is produced by GTP-cyclohydrolase I in macrophages and dendritic cells. Nitric oxide synthase (NOS) is induced in several cell types to generate nitric oxide (NO). NO, despite its low reactivity, is a potent antioxidant involved in the regulation of the vasomotor tone and of immunomodulatory signaling pathways. NO inhibits the expression and function of IDO. Function of NOS requires the cofactor tetrahydrobiopterin (BH4), which is produced in humans primarily by fibroblasts and endothelial cells. Highly toxic peroxynitrite (ONOO-) is formed solely in the presence of superoxide anion (O2-). Neopterin and kynurenine to tryptophan ratio (Kyn/Trp), as an estimate of IDO enzyme activity, are robust markers of immune activation in vitro and in vivo. Both these diagnostic parameters are able to predict cardiovascular and overall mortality in patients at risk. Likewise, a significant association exists between increase of neopterin concentrations and Kyn/Trp ratio values and the lowering of plasma levels of vitamin-C, -E and -B. Vitamin-B deficiency is usually accompanied by increased plasma homoycsteine. Additional determination of NO metabolites, BH4 and plasma antioxidants in patients with CVD and related clinical settings can be helpful to improve the understanding of redox-regulation in health and disease and might provide a rationale for potential antioxidant therapies in CVD.
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Author response. Nutrition 2013; 29:1171-2. [DOI: 10.1016/j.nut.2013.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 06/01/2013] [Accepted: 06/06/2013] [Indexed: 11/22/2022]
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Hatzis CM, Papandreou C, Patelarou E, Vardavas CI, Kimioni E, Sifaki-Pistolla D, Vergetaki A, Kafatos AG. A 50-year follow-up of the Seven Countries Study: Prevalence of cardiovascular risk factors, food and nutrient intakes among Cretans. Hormones (Athens) 2013; 12:379-85. [PMID: 24121379 DOI: 10.1007/bf03401303] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To identify the cardiovascular disease (CVD) risk-factor status and dietary habits of the surviving elderly participants of the initial Seven Countries Study (SCS) cohort and newly recruited middle-aged men from the same villages. DESIGN Our total cohort of remaining survivors of the SCS consisted of 27 men aged 90 years old and over, while a younger cross-sectional study of 85 men between 53 and 73 years of age of the same catchment area were also examined. Biochemical, anthropometric, dietetic and lifestyle CVD risk factors information was obtained. RESULTS It was found that being overweight and having systolic blood pressure higher than the recommended were highly prevalent (>75%) among both age groups as well as abdominal obesity (about 50%). Hypercholesterolemia was highly prevalent in the younger population (68.8%), while smoking rates were relatively low among elderly. The daily meat consumption of SCS participants had doubled, from 35g in the 1960s to 76g among the SCS survivors in 2010 (p=0.002), while daily fruit and vegetable consumption had dropped from 656g to 266g (p<0.001). The younger participants also had increased dietary meat (130g/day) (p<0.001) and decreased fruits-vegetables intake (412g/day) (p<0.001) compared to 50 years ago. However, the younger population and elderly subjects showed higher fish intake (91g/day and 38g/day respectively, p<0.001) compared to 1960 and favorable olive oil consumption. In regard to nutrient intake, the majority of the subjects did not meet the recommendations for CVD prevention. CONCLUSIONS The study population is at increased risk for the development of CVD, while current dietary habits of the SCS survivors partially differed from those of 50 years ago.
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Affiliation(s)
- Christos M Hatzis
- Department of Social Medicine, Preventive Medicine and Nutrition Clinic, Medical School, University of Crete, Greece
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Söderström E, Eliasson M, Johnson O, Hallmans G, Weinehall L, Jansson JH, Hultdin J. Plasma folate, but not homocysteine, is associated with Apolipoprotein A1 levels in a non-fortified population. Lipids Health Dis 2013; 12:74. [PMID: 23697869 PMCID: PMC3679998 DOI: 10.1186/1476-511x-12-74] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 05/15/2013] [Indexed: 11/22/2022] Open
Abstract
Background Elevated total plasma homocysteine (tHcy) in humans is associated with cardiovascular disease but prevention trials have failed to confirm causality. Reported reasons for this association have been that homocysteine and its major genetic determinant methylenetetrahydrofolate reductase (MTHFR) may have an effect on HDL and Apolipoprotein (Apo) A1 levels. We wanted to study if tHcy and its major determinants were correlated with Apo A1 levels in a large population without folate fortification. Methods This study was a prospective incident nested case-referent study within the Northern Sweden Health and Disease Study Cohort (NSHDSC), including 545 cases with first myocardial infarction and 1054 matched referents, median age at inclusion was 59 years. Univariate and multiple regression analyzes was used to study the associations between apolipoproteins Apo A1 and B, tHcy, folate and vitamin B12 in plasma as well as MTHFR polymorphisms 677C>T and 1298A>C. Results Apo A1 and Apo B were strongly associated with the risk of a first myocardial infarction. tHcy was not associated with Apo A1 levels. Instead, folate had an independent positive association with Apo A1 levels in univariate and multiple regression models. The associations were seen in all men and women, among referents but not among cases. MTHFR polymorphisms had no clear effect on Apo A1 levels. Conclusions Analyzing over 1500 subjects we found an independent positive association between plasma folate (major dietary determinant of tHcy) and Apo A1 levels among those who later did not develop a first myocardial infarction. No association was seen between tHcy and Apo A1.
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Affiliation(s)
- Elisabet Söderström
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, 90185 Umeå, Sweden.
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Mangoni AA, Zinellu A, Carru C, Attia JR, McEvoy M. Serum thiols and cardiovascular risk scores: a combined assessment of transsulfuration pathway components and substrate/product ratios. J Transl Med 2013; 11:99. [PMID: 23587204 PMCID: PMC3637611 DOI: 10.1186/1479-5876-11-99] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Accepted: 04/09/2013] [Indexed: 12/22/2022] Open
Abstract
Background Serum thiols have shown associations with surrogate markers of cardiovascular disease. However, little information is available on their combined association with validated cardiovascular risk scores for primary prevention at population level. We sought to determine whether individual serum thiol concentrations and substrate/product ratios within the transsulfuration pathway are independently associated with such scores. Methods Data on clinical and demographic characteristics, serum thiols (homocysteine, cysteine, taurine, glutamylcysteine, total glutathione and cysteinylglycine) and high-sensitivity C-reactive protein (CRP) were collected from a sample of the Hunter Community Study without previous cardiovascular events [n=350, median age (IQR) = 62 (59–66) years]. Five-year absolute cardiovascular risk score for each subject was calculated using the Framingham Risk Equation. Results Median risk score was 7% (IQR 4–10). After adjusting for body mass index, estimated glomerular filtration rate and physical activity regression analysis showed independent associations between cardiovascular risk scores and a) higher serum homocysteine (B 0.066, 95% CI 0.040 to 0.091, P<0.001) and lower cysteine (B −0.003, 95% CI −0.005 to −0.001, P=0.003) and glutathione (B −0.029, 95% CI −0.056 to −0.003, P=0.03) concentrations; and b) higher homocysteine/cysteine (B 0.114, 95% CI 0.066 to 0.161, P<0.001) and lower glutathione/cysteinylglycine (B −1.145, 95% CI −2.030 to −0.260, P=0.011) ratios. No significant associations were observed between cardiovascular risk scores, taurine and CRP. Conclusions Serum homocysteine, cysteine and glutathione are independently associated with cardiovascular risk scores at population level. Enzymatic pathways involved in reduced bioconversion of homocysteine into cysteine and increased glutathione degradation might play an important role in such associations.
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Affiliation(s)
- Arduino A Mangoni
- Division of Applied Medicine, Section of Translational Medical Sciences, School of Medicine and Dentistry, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, UK.
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Ilkun O, Boudina S. Cardiac dysfunction and oxidative stress in the metabolic syndrome: an update on antioxidant therapies. Curr Pharm Des 2013; 19:4806-17. [PMID: 23323621 DOI: 10.2174/1381612811319270003] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 01/10/2013] [Indexed: 01/14/2023]
Abstract
The metabolic syndrome (MetS) is a cluster of risk factors including obesity, insulin resistance, dyslipidemia, elevated blood pressure and glucose intolerance. The MetS increases the risk for cardiovascular disease (CVD) and type 2 diabetes. Each component of the MetS causes cardiac dysfunction and their combination carries additional risk. The mechanisms underlying cardiac dysfunction in the MetS are complex and might include lipid accumulation, increased fibrosis and stiffness, altered calcium homeostasis, abnormal autophagy, altered substrate utilization, mitochondrial dysfunction and increased oxidative stress. Mitochondrial and extra-mitochondrial sources of reactive oxygen species (ROS) and reduced antioxidant defense mechanisms characterize the myocardium of humans and animals with the MetS. The mechanisms for increased cardiac oxidative stress in the MetS are not fully understood but include increased fatty acid oxidation, mitochondrial dysfunction and enhanced NADPH oxidase activity. Therapies aimed to reduce oxidative stress and enhance antioxidant defense have been employed to reduce cardiac dysfunction in the MetS in animals. In contrast, large scale clinical trials using antioxidants therapies for the treatment of CVD have been disappointing because of the lack of efficacy and undesired side effects. The focus of this review is to summarize the current knowledge about the mechanisms underlying cardiac dysfunction in the MetS with a special interest in the role of oxidative stress. Finally, we will update the reader on the results obtained with natural antioxidant and mitochondria-targeted antioxidant therapies for the treatment of CVD in the MetS.
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Affiliation(s)
- Olesya Ilkun
- Division of Endocrinology, Metabolism and Diabetes, Program in Human Molecular Biology & Genetics, University of Utah School of Medicine, Salt Lake City, Utah 84112, USA
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Garaiova I, Muchová J, Nagyová Z, Mišľanová C, Oravec S, Dukát A, Wang D, Plummer SF, Ďuračková Z. Effect of a plant sterol, fish oil and B vitamin combination on cardiovascular risk factors in hypercholesterolemic children and adolescents: a pilot study. Nutr J 2013; 12:7. [PMID: 23297818 PMCID: PMC3549748 DOI: 10.1186/1475-2891-12-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 12/20/2012] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Assessment of cardiovascular disease (CVD) risk factors can predict clinical manifestations of atherosclerosis in adulthood. In this pilot study with hypercholesterolemic children and adolescents, we investigated the effects of a combination of plant sterols, fish oil and B vitamins on the levels of four independent risk factors for CVD; LDL-cholesterol, triacylglycerols, C-reactive protein and homocysteine. METHODS Twenty five participants (mean age 16 y, BMI 23 kg/m2) received daily for a period of 16 weeks an emulsified preparation comprising plant sterols esters (1300 mg), fish oil (providing 1000 mg eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA)) and vitamins B12 (50 μg), B6 (2.5 mg), folic acid (800 μg) and coenzyme Q10 (3 mg). Atherogenic and inflammatory risk factors, plasma lipophilic vitamins, provitamins and fatty acids were measured at baseline, week 8 and 16. RESULTS The serum total cholesterol, LDL- cholesterol, VLDL-cholesterol, subfractions LDL-2, IDL-1, IDL-2 and plasma homocysteine levels were significantly reduced at the end of the intervention period (p<0.05). The triacylglycerols levels decreased by 17.6%, but did not reach significance. No significant changes in high sensitivity C-reactive protein, HDL-cholesterol and apolipoprotein A-1 were observed during the study period. After standardisation for LDL cholesterol, there were no significant changes in the levels of plasma γ-tocopherol, β-carotene and retinol, except for reduction in α-tocopherol levels. The plasma levels of n-3 fatty acids increased significantly with the dietary supplementation (p<0.05). CONCLUSIONS Daily intake of a combination of plant sterols, fish oil and B vitamins may modulate the lipid profile of hypercholesterolemic children and adolescents. TRIAL REGISTRATION Current Controlled Trials ISRCTN89549017.
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Affiliation(s)
- Iveta Garaiova
- Institute of Medical Chemistry, Biochemistry and Clinical Biochemistry, Faculty of Medicine, Comenius University, Bratislava, 813 72, Slovakia
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Wong YYE, Almeida OP, McCaul KA, Yeap BB, Hankey GJ, Flicker L. Homocysteine, Frailty, and All-Cause Mortality in Older Men: The Health in Men Study. J Gerontol A Biol Sci Med Sci 2012; 68:590-8. [DOI: 10.1093/gerona/gls211] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Buyukates M, Acikgoz S, Aktunc E, Kandemir O, Dogan SM, Aydin M. A preliminary study about the effects of warm priming solution on oxidative stress and postoperative atrial fibrillation in open heart surgery. Wien Klin Wochenschr 2012; 124:618-23. [PMID: 22878793 DOI: 10.1007/s00508-012-0222-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Accepted: 07/08/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND An important reason for production of ischemia and reperfusion injury and oxidative stress is the sudden and rapid changes in body temperature during the institution of cardiopulmonary bypass. The aim of this study was to investigate the effects of warm priming solution on oxidative stress and atrial fibrillation. METHODS This is a preliminary prospective study on a group of 40 patients who underwent elective coronary artery bypass grafting operation using cardiopulmonary bypass. Patients were randomized into two groups, each consisting of 20 patients; one group was primed with a solution at 20 °C and the other at 36 °C initially for cardiopulmonary bypass. Blood samples from both of the groups were drawn preoperatively and at the 15th and 60th min of aortic cross clamping and 24th h following the surgery. Serum malondialdehyde levels, protein carbonyl content and total antioxidant status were detected. Patients were followed for postoperative atrial fibrillation. RESULTS Malondialdehyde and protein carbonyl content were found to be significantly higher and total antioxidant status was concordantly lower in the cold priming group at the 15th and 60th min, recovering to the normal range postoperatively at the 24th h. Patients in the cold priming group had developed a significantly higher rate of atrial fibrillation when compared with the patients in the warm priming group during the postoperative period. CONCLUSION In conclusion, although this study has its limitation about the sample size it may provide an insight about the probable preventive effects of 36 °C warm priming solution in oxidative stress and postoperative atrial fibrillation.
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Affiliation(s)
- Mustafa Buyukates
- Department of Cardiovascular Surgery, School of Medicine, Zonguldak Karaelmas University, 67600, Kozlu-Zonguldak, Turkey.
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Rodrigo R. Prevention of postoperative atrial fibrillation: novel and safe strategy based on the modulation of the antioxidant system. Front Physiol 2012; 3:93. [PMID: 22518106 PMCID: PMC3325031 DOI: 10.3389/fphys.2012.00093] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Accepted: 03/26/2012] [Indexed: 01/15/2023] Open
Abstract
Postoperative atrial fibrillation (AF) is the most common arrhythmia following cardiac surgery with extracorporeal circulation. The pathogenesis of postoperative AF is multifactorial. Oxidative stress, caused by the unavoidable ischemia-reperfusion event occurring in this setting, is a major contributory factor. Reactive oxygen species (ROS)-derived effects could result in lipid peroxidation, protein carbonylation, or DNA oxidation of cardiac tissue, thus leading to functional and structural myocardial remodeling. The vulnerability of myocardial tissue to the oxidative challenge is also dependent on the activity of the antioxidant system. High ROS levels, overwhelming this system, should result in deleterious cellular effects, such as the induction of necrosis, apoptosis, or autophagy. Nevertheless, tissue exposure to low to moderate ROS levels could trigger a survival response with a trend to reinforce the antioxidant defense system. Administration of n-3 polyunsaturated fatty acids (PUFA), known to involve a moderate ROS production, is consistent with a diminished vulnerability to the development of postoperative AF. Accordingly, supplementation of n-3 PUFA successfully reduced the incidence of postoperative AF after coronary bypass grafting. This response is due to an up-regulation of antioxidant enzymes, as shown in experimental models. In turn, non-enzymatic antioxidant reinforcement through vitamin C administration prior to cardiac surgery has also reduced the postoperative AF incidence. Therefore, it should be expected that a mixed therapy result in an improvement of the cardioprotective effect by modulating both components of the antioxidant system. We present novel available evidence supporting the hypothesis of an effective prevention of postoperative AF including a two-step therapeutic strategy: n-3 PUFA followed by vitamin C supplementation to patients scheduled for cardiac surgery with extracorporeal circulation. The present study should encourage the design of clinical trials aimed to test the efficacy of this strategy to offer new therapeutic opportunities to patients challenged by ischemia-reperfusion events not solely in heart, but also in other organs such as kidney or liver in transplantation surgeries.
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Affiliation(s)
- Ramón Rodrigo
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of ChileSantiago, Chile
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