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Ghosh S, Nguyen MT, Choi HE, Stahl M, Kühn AL, Van der Auwera S, Grabe HJ, Völzke H, Homuth G, Myers SA, Hogaboam CM, Noth I, Martinez FJ, Petsko GA, Glimcher LH. RIOK2 transcriptionally regulates TRiC and dyskerin complexes to prevent telomere shortening. Nat Commun 2024; 15:7138. [PMID: 39164231 DOI: 10.1038/s41467-024-51336-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 08/02/2024] [Indexed: 08/22/2024] Open
Abstract
Telomere shortening is a prominent hallmark of aging and is emerging as a characteristic feature of Myelodysplastic Syndromes (MDS) and Idiopathic Pulmonary Fibrosis (IPF). Optimal telomerase activity prevents progressive shortening of telomeres that triggers DNA damage responses. However, the upstream regulation of telomerase holoenzyme components remains poorly defined. Here, we identify RIOK2, a master regulator of human blood cell development, as a critical transcription factor for telomere maintenance. Mechanistically, loss of RIOK2 or its DNA-binding/transactivation properties downregulates mRNA expression of both TRiC and dyskerin complex subunits that impairs telomerase activity, thereby causing telomere shortening. We further show that RIOK2 expression is diminished in aged individuals and IPF patients, and it strongly correlates with shortened telomeres in MDS patient-derived bone marrow cells. Importantly, ectopic expression of RIOK2 alleviates telomere shortening in IPF patient-derived primary lung fibroblasts. Hence, increasing RIOK2 levels prevents telomere shortening, thus offering therapeutic strategies for telomere biology disorders.
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Affiliation(s)
- Shrestha Ghosh
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
- Department of Immunology, Harvard Medical School, Boston, MA, USA.
| | - Mileena T Nguyen
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Yale University, New Haven, CT, USA
| | - Ha Eun Choi
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Maximilian Stahl
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Annemarie Luise Kühn
- Department for Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Sandra Van der Auwera
- Department for Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Department for Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | | | - Cory M Hogaboam
- Women's Guild Lung Institute, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Imre Noth
- Division of Pulmonary and Critical Care Medicine, University of Virginia, Charlottesville, VA, USA
| | - Fernando J Martinez
- Division of Pulmonary and Critical Care Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Gregory A Petsko
- Department of Neurology, Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Laurie H Glimcher
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
- Department of Immunology, Harvard Medical School, Boston, MA, USA.
- Department of Medicine, Harvard Medical School, Boston, MA, USA.
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Maura G, Blotière PO, Wastesson JW, Johnell K. Spousal bereavement and four-year trajectories of medication use: A nationwide register-based study in Swedish older adults. J Am Geriatr Soc 2024; 72:2048-2059. [PMID: 38720614 DOI: 10.1111/jgs.18950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 03/14/2024] [Accepted: 04/14/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Medication use around widowhood has been poorly described for most medication classes. Medication use patterns can reflect health consequences of spousal loss, as previously shown for psychotropic drugs. METHODS We used data from nationwide health registers (2008-2020) to describe the patterns of use of dispensed medications in all widowed Swedes aged ≥65 years followed between 2 years before and 2 years after spousal death. All prescription drugs used by at least 5% of the cohort were considered according to their therapeutic subgroups (Anatomical Therapeutic Chemical [ATC] classification system 2nd level). We used group-based trajectory models to cluster widowed individuals into up to 4 distinct longitudinal patterns of monthly medication use. We ranked the therapeutic subgroups with similar patterns according to their plausibility to reflect potential health effects of spousal loss, compared to those of psycholeptics (mainly anxiolytics, hypnotics) and psychoanaleptics (mainly antidepressants) as the references. RESULTS From 212,111 widowed adults included (68% female and 70% aged ≥75 years), we observed a significant increasing trend in medication use, especially after spousal death, for 21 out of the 39 different therapeutic subgroups that were used by at least 5% (most represented pharmacological groups: cardiovascular system, nervous system, and alimentary tract and metabolism). This increasing trend often concerned only a small proportion of individuals, with varying magnitude and speed of change in medication use across therapeutic subgroups. The patterns of use of antiepileptics, laxatives, skin emollients/protectives, analgesics, and drugs for anemia, constipation, or peptic ulcers, were the closest to those of references, displaying the largest changes in use, and were therefore ranked as the most likely to reflect health effects of spousal loss. CONCLUSION Our results confirmed the increase in psychotropic medications' use in widowed older adults and identified several potential physical health effects of spousal loss that warrant further research.
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Affiliation(s)
- Géric Maura
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Pierre-Olivier Blotière
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jonas W Wastesson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Stockholm, Sweden
| | - Kristina Johnell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Lee JSW, Auyeung TW. When haemoglobin drops in the older hospitalized patient. Maturitas 2024:108002. [PMID: 38653624 DOI: 10.1016/j.maturitas.2024.108002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024]
Affiliation(s)
- Jenny Shun Wah Lee
- Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong.
| | - Tung Wai Auyeung
- Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong
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Hwang J, Kim HJ. Association of ambient air pollution with hemoglobin levels and anemia in the general population of Korean adults. BMC Public Health 2024; 24:988. [PMID: 38594672 PMCID: PMC11003135 DOI: 10.1186/s12889-024-18492-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/31/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Emerging evidence has suggested significant associations between ambient air pollution and changes in hemoglobin levels or anemia in specific vulnerable groups, but few studies have assessed this relationship in the general population. This study aimed to evaluate the association between long-term exposure to air pollution and hemoglobin concentrations or anemia in general adults in South Korea. METHODS A total of 69,830 Korean adults from a large-scale nationwide survey were selected for our final analysis. Air pollutants included particulate matter with an aerodynamic diameter less than or equal to 10 micrometers (PM10), particulate matter with an aerodynamic diameter less than or equal to 2.5 micrometers, nitrogen dioxide, sulfur dioxide (SO2), and carbon monoxide (CO). We measured the serum hemoglobin concentration to assess anemia for each participant. RESULTS In the fully adjusted model, exposure levels to PM10, SO2, and CO for one and two years were significantly associated with decreased hemoglobin concentrations (all p < 0.05), with effects ranging from 0.15 to 0.62% per increase in interquartile range (IQR) for each air pollutant. We also showed a significant association of annual exposure to PM10 with anemia (p = 0.0426); the odds ratio (OR) [95% confidence interval (CI)] for anemia per each increase in IQR in PM10 was estimated to be 1.039 (1.001-1.079). This association was also found in the 2-year duration of exposure (OR = 1.046; 95% CI = 1.009-1.083; adjusted Model 2). In addition, CO exposure during two years was closely related to anemia (OR = 1.046; 95% CI = 1.004-1.091; adjusted Model 2). CONCLUSIONS This study provides the first evidence that long-term exposure to air pollution, especially PM10, is significantly associated with reduced hemoglobin levels and anemia in the general adult population.
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Affiliation(s)
- Juyeon Hwang
- Cancer Big Data Center, National Cancer Control Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, 10408, Goyang-si Gyeonggi-do, South Korea
| | - Hyun-Jin Kim
- Cancer Big Data Center, National Cancer Control Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, 10408, Goyang-si Gyeonggi-do, South Korea.
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Oyedeji CI, Artz AS, Cohen HJ. How I treat anemia in older adults. Blood 2024; 143:205-213. [PMID: 36827619 PMCID: PMC10808247 DOI: 10.1182/blood.2022017626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/31/2023] [Accepted: 02/18/2023] [Indexed: 02/26/2023] Open
Abstract
ABSTRACT With the global growing older adult population, clinicians face the common, yet complex challenge of how to evaluate and manage anemia in this population. Older age predisposes to common causes of anemia such as nutritional deficiencies, inflammatory disorders, chronic kidney disease, and hematologic malignancies. Failure to diagnose and appropriately manage anemia may result in decreased quality of life, impaired cognition, impaired mobility, and increased mortality. Anemia diagnosis in older adults presents a diagnostic conundrum because anemia may have a single cause, may be multifactorial, or may have no apparent cause even after an extensive evaluation. We believe a systematic approach to diagnosis ensures appropriate testing and avoids the pitfall of undertreatment and overtreatment. In this article we present our recommended approach through common scenarios for the management of anemia in the older adult.
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Affiliation(s)
- Charity I. Oyedeji
- Division of Hematology, Department of Medicine, Duke University School of Medicine, Durham, NC
- Duke Claude D. Pepper Older Americans Independence Center, Durham, NC
| | | | - Harvey Jay Cohen
- Duke Claude D. Pepper Older Americans Independence Center, Durham, NC
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC
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Nguyen Hoai B, Hoang L, Nguyen Cao T, Pham Minh Q, A Jannini E. Testosterone and aging male, a perspective from a developing country. Aging Male 2023; 26:2223712. [PMID: 37335039 DOI: 10.1080/13685538.2023.2223712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/19/2023] [Accepted: 06/06/2023] [Indexed: 06/21/2023] Open
Abstract
PURPOSE Hypogonadism is associated with a wide range of physical and psychological symptoms that can affect the overall health of men. However, in a developing country, there are several imposing challenges in the diagnosis and treatment of hypogonadism, including a lack of awareness and understanding of the condition among healthcare providers and patients, limited resources and the high cost of treatment. This review aimed to examine the potential benefits and risks of testosterone replacement therapy (TRT) and provides a perspective of a developing country on the topic. MATERIALS AND METHODS A comprehensive literature review was conducted to gather relevant information on the impact of testosterone deficiency on ageing males and the effectiveness of TRT for treating hypogonadism. Published peer-reviewed articles were analyzed to evaluate the benefits and risks of TRT. Additionally, the unique challenges faced in the diagnosis and treatment of hypogonadism in a developing country were considered. RESULTS Testosterone replacement therapy has been shown to be an effective treatment for hypogonadism, particularly in symptomatic men with low testosterone levels. It offers potential benefits such as improvements in symptoms and overall quality of life. However, there are associated risks and side effects that need to be considered. In a developing country, challenges such as limited awareness and understanding of hypogonadism, resource constraints, and high treatment costs pose additional barriers to accessing TRT and comprehensive care. CONCLUSION In conclusion, TRT holds promise as a treatment for hypogonadism, but its implementation and accessibility face significant challenges in a developing country. Addressing these challenges, including raising awareness, allocating resources, and finding cost-effective solutions, is crucial for ensuring that men with hypogonadism in such settings receive appropriate diagnosis and treatment. Further research and efforts are needed to improve the management of hypogonadism in developing countries and optimize the potential benefits of TRT for affected individuals.
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Affiliation(s)
- Bac Nguyen Hoai
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Long Hoang
- Department of Urology, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Thang Nguyen Cao
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Quan Pham Minh
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Emmanuele A Jannini
- Chair of Endocrinology and Sexual Medicine (ENDOSEX), University of Rome Tor Vergata, Rome, Italy
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Loveikyte R, van den Berg Y, van der Meulen-de Jong AE, Vlasveld LT. The Role of Hepcidin and an Oral Iron Absorption Test in Identifying the Root Cause of Iron-Restricted Anemia (Enter-Iron). Acta Haematol 2023; 147:402-412. [PMID: 37972576 PMCID: PMC11296559 DOI: 10.1159/000535275] [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: 07/07/2023] [Accepted: 11/13/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Traditional iron parameters often fail to distinguish the cause of iron-restricted anemia in patients without an obvious underlying cause. We evaluated whether an oral iron absorption test (OIAT) and hepcidin measurement could be useful diagnostic tests in these patients. METHODS We retrospectively analyzed data extracted from medical records of all patients who underwent an OIAT and hepcidin measurement, noting subsequent clinical diagnosis. Δ Iron >15 µmol/L during the OIAT and a hepcidin level below the median (or suppressed ≤0.5 nm) were considered appropriate. RESULTS Thirty-nine adult patients were included in the study. Sixteen patients with adequate OIAT had suppressed hepcidin levels indicative of classical iron-deficiency anemia (IDA); 59% of patients had abnormal OIAT. In this group, most patients with low hepcidin levels had anemia associated with abnormalities in the gastrointestinal tract, whereas 83.3% patients with high hepcidin levels had iron-refractory iron-deficiency anemia (IRIDA), confirmed by genetic testing. Finally, transferrin/log ferritin ratio accurately identified patients with suppressed hepcidin: AUC 0.98 [95% CI: 0.95-1.02], p < 0.001. CONCLUSION OIAT differentiates between classical IDA and other types of anemia caused by abnormalities in iron absorption or systemic iron availability. Additionally, elevated hepcidin in patients with oral iron malabsorption could indicate IRIDA.
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Affiliation(s)
- Roberta Loveikyte
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands
| | - Yascha van den Berg
- Department of Internal Medicine, Haaglanden Medical Center, The Hague, The Netherlands
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Donat-Vargas C, Mico V, San-Cristobal R, Martínez-González MÁ, Salas-Salvadó J, Corella D, Fitó M, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, López-Miranda J, Estruch R, Damas-Fuentes M, Lapetra J, Serra-Majem L, Bueno-Cavanillas A, Tur JA, Cinza-Sanjurjo S, Pintó X, Delgado-Rodríguez M, Matía-Martín P, Vidal J, Causso C, Ros E, Toledo E, Manzanares JM, Ortega-Azorín C, Castañer O, Peña-Orihuela PJ, Zazo JM, Muñoz Bravo C, Martinez-Urbistondo D, Chaplin A, Casas R, Cano Ibáñez N, Tojal-Sierra L, Gómez-Perez AM, Pascual Roquet-Jalmar E, Mestre C, Barragán R, Schröder H, Garcia-Rios A, Candela García I, Ruiz-Canela M, Babio N, Malcampo M, Daimiel L, Martínez A. Dietary Iron, Anemia Markers, Cognition, and Quality of Life in Older Community-Dwelling Subjects at High Cardiovascular Risk. Nutrients 2023; 15:4440. [PMID: 37892515 PMCID: PMC10610130 DOI: 10.3390/nu15204440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Anemia causes hypo-oxygenation in the brain, which could lead to cognitive disorders. We examined dietary iron intake as well as anemia markers (i.e., hemoglobin, hematocrit, mean corpuscular volume) and diabetes coexistence in relation to neuropsychological function and quality of life. In this study, 6117 community-dwelling adults aged 55-75 years (men) and 60-75 years (women) with overweight/obesity and metabolic syndrome were involved. We performed the Mini-Mental State Examination (MMSE), the Trail Making Test parts A and B (TMT-A/B), Semantic Verbal Fluency of animals (VFT-a), Phonological Verbal Fluency of letter P (VFT-p), Digit Span Test (DST), the Clock Drawing Test (CDT), and the Short Form-36 Health Survey (SF36-HRQL test). Dietary iron intake did not influence neuropsychological function or quality of life. However, anemia and lower levels of anemia markers were associated with worse scores in all neurophysiological and SF36-HRQL tests overall, but were especially clear in the MMSE, TMT-B (cognitive flexibility), and the physical component of the SF36-HRQL test. The relationships between anemia and diminished performance in the TMT-A/B and VFT tasks were notably pronounced and statistically significant solely among participants with diabetes. In brief, anemia and reduced levels of anemia markers were linked to inferior cognitive function, worse scores in different domains of executive function, as well as a poorer physical, but not mental, component of quality of life. It was also suggested that the coexistence of diabetes in anemic patients may exacerbate this negative impact on cognition. Nevertheless, dietary iron intake showed no correlation with any of the outcomes. To make conclusive recommendations for clinical practice, our findings need to be thoroughly tested through methodologically rigorous studies that minimize the risk of reverse causality.
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Affiliation(s)
- Carolina Donat-Vargas
- ISGlobal, Campus Mar, 08036 Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (A.B.-C.); (N.C.I.); (H.S.)
| | - Víctor Mico
- Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain; (V.M.); (R.S.-C.); (M.D.-R.)
| | - Rodrigo San-Cristobal
- Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain; (V.M.); (R.S.-C.); (M.D.-R.)
| | - Miguel Ángel Martínez-González
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, 31008 Pamplona, Spain
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jordi Salas-Salvadó
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain; (J.S.-S.); (J.M.M.)
- Food, Nutrition, Development and Mental Health Research Group, Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - Dolores Corella
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - Montserrat Fitó
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), 08003 Barcelona, Spain; (O.C.); (M.M.)
| | - Ángel Maria Alonso-Gómez
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- EpiPHAAN Research Group, Department of Nursing, School of Health Sciences, University of Málaga-IBIMA (Instituto de Investigación Biomédica de Málaga), 29071 Málaga, Spain
| | - Jesús Vioque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (A.B.-C.); (N.C.I.); (H.S.)
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010 Alicante, Spain
| | - Dora Romaguera
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - José López-Miranda
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Córdoba, Spain
| | - Ramon Estruch
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Internal Medicine, Institut d’Investigació Biomèdica August Pi I Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
| | - Miguel Damas-Fuentes
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria Hospital, University of Málaga, 29016 Málaga, Spain
| | - José Lapetra
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, 41013 Sevilla, Spain
| | - Luís Serra-Majem
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, 35016 Las Palmas, Spain
| | - Aurora Bueno-Cavanillas
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (A.B.-C.); (N.C.I.); (H.S.)
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain
| | - Josep Antoni Tur
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, 07122 Palma de Mallorca, Spain
| | - Sergio Cinza-Sanjurjo
- CS Milladoiro, Área Sanitaria de Santiago de Compostela, 15706 Santiago de Compostela, Spain;
- Instituto de Investigación de Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Departamento de Medicina, Universidad de Santiago de Compostela, 15701 Santiago de Compostela, Spain
| | - Xavier Pintó
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Miguel Delgado-Rodríguez
- Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain; (V.M.); (R.S.-C.); (M.D.-R.)
- Division of Preventive Medicine, Faculty of Medicine, University of Jaén, 23071 Jaén, Spain
| | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain;
| | - Josep Vidal
- Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain;
- Biomedical Research Centre for Diabetes and Metabolic Diseases Network (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Claudia Causso
- Servicio de Endocrinologia Hospital General de Villalba, 28400 Madrid, Spain;
| | - Emilio Ros
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, 08036 Barcelona, Spain
| | - Estefanía Toledo
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, 31008 Pamplona, Spain
| | - Josep Maria Manzanares
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain; (J.S.-S.); (J.M.M.)
| | - Carolina Ortega-Azorín
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - Olga Castañer
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), 08003 Barcelona, Spain; (O.C.); (M.M.)
| | - Patricia Judith Peña-Orihuela
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Córdoba, Spain
| | - Juan Manuel Zazo
- Department of Preventive Medicine and Public Health, School of Medicine, Instituto de Investigación Biomédica de Málaga, University of Málaga, 29590 Málaga, Spain;
| | - Carlos Muñoz Bravo
- Department of Public Health and Psychiatry, University of Malaga-IBIMA (Instituto de Investigación Biomédica de Málaga), 29071 Málaga, Spain
| | | | - Alice Chaplin
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Rosa Casas
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Internal Medicine, Institut d’Investigació Biomèdica August Pi I Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
| | - Naomi Cano Ibáñez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (A.B.-C.); (N.C.I.); (H.S.)
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, 18012 Granada, Spain
| | - Lucas Tojal-Sierra
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain
| | - Ana María Gómez-Perez
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria Hospital, University of Málaga, 29016 Málaga, Spain
| | | | - Cristina Mestre
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain; (J.S.-S.); (J.M.M.)
- Food, Nutrition, Development and Mental Health Research Group, Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain
| | - Rocío Barragán
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - Helmut Schröder
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (A.B.-C.); (N.C.I.); (H.S.)
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), 08003 Barcelona, Spain; (O.C.); (M.M.)
| | - Antonio Garcia-Rios
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Córdoba, Spain
| | | | - Miguel Ruiz-Canela
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, 31008 Pamplona, Spain
| | - Nancy Babio
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain; (J.S.-S.); (J.M.M.)
- Food, Nutrition, Development and Mental Health Research Group, Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain
| | - Mireia Malcampo
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), 08003 Barcelona, Spain; (O.C.); (M.M.)
| | - Lidia Daimiel
- Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain;
| | - Alfredo Martínez
- Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain; (V.M.); (R.S.-C.); (M.D.-R.)
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, 31008 Pamplona, Spain
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Roberts M, Jimson S, Srinivasan M. Are Adults Over 18 Years of Age with Anaemia More Likely to Develop Chronic Periodontitis Than Adults Without Anaemia? - A Systematic Review and Meta-Analysis. J Int Soc Prev Community Dent 2023; 13:287-298. [PMID: 37876584 PMCID: PMC10593371 DOI: 10.4103/jispcd.jispcd_37_23] [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: 03/14/2023] [Revised: 07/10/2023] [Accepted: 07/13/2023] [Indexed: 10/26/2023] Open
Abstract
Aims and Objectives Periodontitis is a chronic disease affecting the supporting tissues of the teeth and exhibits bidirectional relation with systemic diseases. This study aims to determine the association between chronic periodontitis and erythrocyte functional measures: total red blood cells (RBCs), hemoglobin (Hb) concentration, mean corpuscular volume (MCV), and mean corpuscular hemoglobin concentration (MCHC) by systematic review and meta-analysis. Materials and Methods A systematic search of the electronic databases PUBMED, OVID, Embase, Web on Science, and Google Scholar was undertaken from inception to July 2022. English language studies that evaluated the erythrocyte functional measures in periodontitis and health were selected. Other review reports, letters/opinion articles, studies without a definition of periodontitis, and the concomitant presence of systemic conditions (diabetes, kidney disease, cancer) were excluded. Two reviewers determined full-text eligibility in a blinded process. Meta-Essentials software was used to generate forest plots and to determine heterogeneity and publication bias. Results Twenty-six studies involving 1082 patients with chronic periodontitis and 980 healthy controls were analyzed. Pooled results showed lower Hb concentration (Hedges' g = -1.16; 95% confidence intervals [CI], -1.7 to -0.62), RBC counts (Hedges' g = -0.85; 95% CI, -1.31 to -0.38) and packed cell volume (-0.56; 95% CI, -1.02 to -0.11) in patients with chronic periodontitis. Conclusion This meta-analysis showed a decreasing trend in the hematological parameters, including hemoglobin concentration, number of erythrocytes, and hematocrit in patients with chronic periodontitis compared to healthy controls.
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Affiliation(s)
- Madison Roberts
- Department of Periodontics & Allied Dental Health, Indianapolis, Indiana, USA
- Department of Oral Pathology, Medicine and Radiology, Indianapolis, Indiana, USA
| | - Sudha Jimson
- Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Mythily Srinivasan
- Department of Oral Pathology, Medicine and Radiology, Indianapolis, Indiana, USA
- Department of Oral Pathology, Medicine & Radiology, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu, India
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Balducci L, Falandry C, List A. A Proactive Approach to Prevent Hematopoietic Exhaustion During Cancer Chemotherapy in Older Patients: Temporary Cell-Cycle Arrest. Drugs Aging 2023; 40:263-272. [PMID: 36715830 DOI: 10.1007/s40266-022-01005-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2022] [Indexed: 01/31/2023]
Abstract
Age is associated with the decline of multiple organ systems. In older patients, hematological toxicities associated with chemotherapy are often dose limiting, impairing dose intensity and treatment efficacy. Contrary to the classical path using growth factors to activate tissue regeneration, a novel strategy is emerging to prevent chemotherapy toxicity that involves temporary cell-cycle arrest of normal cells, such as hematopoietic or epithelial precursors. This proactive approach may allow the sparing of the stem cell reserve of these tissues. Two molecules are included in this new category, trilaciclib and ALRN-6924, which induce cell-cycle arrest by two different pathways. Previous approaches, such as the use of myelopoietic growth factors, were reactive and they might even have accelerated the depletion of stem cells by enhancing the commitment of these elements. Trilaciclib causes cell-cycle arrest by CDK 4/6 inhibition and ALRN-6924 by p53 activation. In a pooled analysis of three randomized phase II studies of patients with small cell lung cancer, trilaciclib prevented neutropenia, thrombocytopenia, and anemia. Similar chemoprotective results were observed with ALRN-6924 in an open-label phase Ib study of patients with p53-mutated small cell lung cancer. Trilaciclib is now approved as a myelopreservation agent in patients with extensive-stage small cell lung cancer. ALRN-6924 is currently in phase Ib clinical development in patients with p53-mutated cancer. In addition to preserving the normal hemopoietic pool, these drugs promise to preserve the stem cell reserve of other normal tissues with high turnover, preventing potentially other dose-limiting toxicities, such as mucositis and diarrhea. An "ex vivo" study provided early evidence that ALRN-6924 may prevent chemotherapy-induced alopecia. By affording protection from multiple toxicities with a single drug, trilaciclib and ALRN-6924 have the potential to transform the current standards of supportive care for oncology patients and may prevent the depletion of tissue stem cells already compromised with age.
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Affiliation(s)
- Lodovico Balducci
- Emeritus Moffitt Cancer Center, 12902 Usf Magnolia Dr, Tampa, FL, 33612, USA.
| | - Claire Falandry
- Service de Gériatrie, Centre Hospitaliser Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- Laboratoire CarMeN, Inserm U1060, INRA U1397, Université Claude Bernard Lyon, Lyon, France
| | - Alan List
- Precision Bioscience, Durham, NC, USA
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Hadley JB, Kelher MR, D’Alessandro A, Gamboni F, Hansen K, Coleman J, Jones K, Cohen M, Moore EE, Banerjee A, Silliman CC. A pilot study of the metabolic profiles of apheresis platelets modified by donor age and sex and in vitro short-term incubation with sex hormones. Transfusion 2022; 62:2596-2608. [PMID: 36309927 PMCID: PMC9837799 DOI: 10.1111/trf.17165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/16/2022] [Accepted: 09/18/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Platelets are part of innate immunity and comprise the cellular portion of hemostasis. Platelets express sex hormone receptors on their plasma membrane and sex hormones can alter their function in vitro. Little is known about how age and sex may affect platelet biology; thus, we hypothesized that platelets from males and females have different metabolomic profiles, which may be altered by age and in vitro treatment with sex hormones. METHODS Day 1 apheresis platelets were drawn from five 18-53-year-old, premenopausal younger females (YF), five ≥54-year-old, postmenopausal, older females (OF), five 18-44-year-old younger males (YM), and four ≥45-year-old older males (OM). Platelets were normalized to a standard concentration and metabolomics analyses were completed. Unsupervised statistical analyses and hierarchical clustering with principal component analyses were completed. RESULTS Platelets from OM had (1) elevated mono-, di- and tri-carboxylates, (2) increased levels of free fatty acids, acyl-carnitines, and free amino acids, and (3) increased purine breakdown and deamination products. In vitro incubation with sex hormones only affected platelets from OM donors with trends towards increased ATP and other high-energy purines and decreases in L-proline and other amino acids. CONCLUSION Platelets from OM's versus YF, OF, and YM have a different metabolome implying increased energy metabolism, more free fatty acids, acylcarnitines, and amino acids, and increased breakdown of purines and deamination products. However, only platelets from OM were affected by sex hormones in vitro. Platelets from OM are metabolically distinct, which may impart functional differences when transfused.
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Affiliation(s)
- Jamie B. Hadley
- The Department of Surgery, University of Colorado Denver, Aurora, Colorado, USA
| | - Marguerite R. Kelher
- The Department of Surgery, University of Colorado Denver, Aurora, Colorado, USA,Vitalant Research Institute, Denver, Colorado, USA
| | - Angelo D’Alessandro
- The Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Aurora, Colorado, USA
| | - Fabia Gamboni
- The Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Aurora, Colorado, USA
| | - Kirk Hansen
- The Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Aurora, Colorado, USA
| | - Julia Coleman
- The Department of Surgery, University of Colorado Denver, Aurora, Colorado, USA
| | - Kenneth Jones
- Department of Biostatistics, University of Oklahoma School of Medicine, Oklahoma City, Oklahoma, USA
| | - Mitchell Cohen
- The Department of Surgery, University of Colorado Denver, Aurora, Colorado, USA
| | - Ernest E. Moore
- The Department of Surgery, University of Colorado Denver, Aurora, Colorado, USA
| | - Anirban Banerjee
- The Department of Surgery, University of Colorado Denver, Aurora, Colorado, USA
| | - Christopher C. Silliman
- The Department of Surgery, University of Colorado Denver, Aurora, Colorado, USA,Vitalant Research Institute, Denver, Colorado, USA,The Department of Pediatrics, School of Medicine, University of Colorado Denver, Aurora, Colorado, USA
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Wu YC, Lin YH, Lin YT, Wang WC, Chen KH, Pan CC, Wang JS, Lee CH. Pre-operative anemia was associated with all-cause mortality in patients with vertebral fracture who underwent percutaneous vertebroplasty. Front Med (Lausanne) 2022; 9:1058636. [PMID: 36479098 PMCID: PMC9719986 DOI: 10.3389/fmed.2022.1058636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/07/2022] [Indexed: 08/30/2023] Open
Abstract
PURPOSE We investigated the association between pre-operative anemia and long-term all-cause mortality in patients with vertebral fracture who underwent a vertebroplasty. MATERIALS AND METHODS We retrospectively selected patients who were admitted for vertebroplasty for vertebral compression fracture between 2013 and 2020. Patients who had pathologic fractures or had no assessment of bone mineral density were excluded. Relevant information was collected from electronic medical records. Patients' survival status was confirmed at the end of March 2021. Cox-proportional hazard models were conducted to examine the effects of anemia (<12 g/dL vs. ≥12 g/dL) and pre-operative hemoglobin levels (as a continuous variable) on all-cause mortality with multivariate adjustments. RESULTS A total of 167 patients were analyzed (mean age 75.8 ± 9.3 years, male 25.7%). After a median follow-up duration of 2.1 years, pre-operative anemia (hemoglobin <12 g/dL vs. ≥12 g/dL) was independently associated with a higher risk of all-cause mortality (hazard ratio 2.762, 95% CI 1.184 to 6.442, p = 0.019). An increase in pre-operative hemoglobin was associated with a lower risk of all-cause mortality after multivariate adjustment (hazard ratio 0.775, 95% CI 0.606 to 0.991, p = 0.042). CONCLUSION Pre-operative anemia (<12 g/dL) was independently associated with survival outcome among patients with vertebral compression fractures who underwent vertebroplasty. Our findings highlight anemia as a risk factor of long-term mortality in this elderly surgical population.
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Affiliation(s)
- Yun-Che Wu
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yu-Hsien Lin
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yu-Tsung Lin
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Wen-Chien Wang
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Kun-Hui Chen
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Computer Science and Information Engineering, Providence University, Taichung, Taiwan
| | - Chien-Chou Pan
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Rehabilitation Science, Jenteh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan
| | - Jun-Sing Wang
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Cheng-Hung Lee
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Food Science and Technology, Hung Kuang University, Taichung, Taiwan
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13
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On-Admission Anemia and Survival Rate in COVID-19 Patients. IRANIAN BIOMEDICAL JOURNAL 2022; 26:389-97. [PMID: 36369775 PMCID: PMC9763880 DOI: 10.52547/ibj.3703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Anemia often worsens the severity of respiratory illnesses, and few studies have so far elucidated the impact of anemia on COVID-19 infection. This study aimed to evaluate the effect of anemia at admission on the overall survival of COVID-19 patients using accelerated failure time (AFT) models. This registry-based, single-center retrospective cohort study was conducted in a university hospital in Ilam, the southwest of Iran, between March 2020 and September 2021. AFT models were applied to set the data of 2,441 COVID-19 patients. Performance of AFT models was assessed using Akaike’s information criterion (AIC) and Cox-Snell residual. On-admission anemia was defined as hemoglobin (Hb) concentration <120 g/l in men, <110 g/l in women, and <100 g/l in pregnant women. The median in-hospital survival times for anemic and non-anemic patients were 27 and 31 days, respectively. Based on the AIC and Cox-Snell residual graph, the Weibull model had the lowest AIC and it was the best fitted model to the data set among AFT models. In the adjusted model, the results of the Weibull model suggested that the anemia (adjusted time ratio: 1.04; 95% CI: 1.00-1.08; p = 0.03) was the accelerated factor for progression to death in COVID-19 patients. Each unit of increase in hemoglobin in COVID-19 patients enhanced the survival rate by 4%. Anemia is an independent risk factor associated with the risk of mortality from COVID-19 infection. Therefore, healthcare professionals should be more sensitive to the Hb level of COVID-19 patients upon admission.
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14
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Maslov PZ, Sabharwal B, Ahmadi A, Baliga R, Narula J. Religious Fasting and the Vascular Health. Indian Heart J 2022; 74:270-274. [PMID: 35917971 PMCID: PMC9453020 DOI: 10.1016/j.ihj.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Kristjansdottir HL, Mellström D, Johansson P, Karlsson M, Vandenput L, Lorentzon M, Herlitz H, Ohlsson C, Lerner UH, Lewerin C. Anemia is associated with increased risk of non-vertebral osteoporotic fractures in elderly men: the MrOS Sweden cohort. Arch Osteoporos 2022; 17:85. [PMID: 35739404 PMCID: PMC9226079 DOI: 10.1007/s11657-022-01130-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 06/15/2022] [Indexed: 02/03/2023]
Abstract
This study includes 1005 men from the Gothenburg part of the Osteoporotic Fracture in Men Study (MrOS). Included are 66 men with anemia (hemoglobin < 130 g/L). The follow-up time was up to 16 years, and the main results are that anemia is associated with all fractures and non-vertebral osteoporotic fractures. INTRODUCTION Anemia and osteoporotic fractures are conditions that are associated with increased morbidity and mortality. Clinical studies have suggested that anemia can be used as a predictor of future osteoporotic fractures. METHOD Men from the Osteoporotic Fractures in Men Study (MrOS) Sweden, Gothenburg, with available hemoglobin (Hb) values (n = 1005, median age 75.3 years (SD 3.2)), were included in the current analyses. Of these, 66 suffered from anemia, defined as Hb < 130 g/L. Median follow-up time for fracture was 10.1 years and the longest follow-up time was 16.1 years. RESULTS Men with anemia had, at baseline, experienced more falls and had a higher prevalence of diabetes, cancer, prostate cancer, hypertension, and stroke. Anemia was not statistically significantly associated with bone mineral density (BMD). Men with anemia had higher serum levels of fibroblast growth factor 23 (iFGF23) (p < 0.001) and phosphate (p = 0.001) and lower serum levels of testosterone (p < 0.001) and estradiol (p < 0.001). Moreover, men with anemia had an increased risk of any fracture (hazard ratio (HR) 1.97, 95% CI 1.28-3.02) and non-vertebral osteoporotic fracture (HR 2.15, 95% CI 1.18-3.93), after adjustment for age and total hip BMD, in 10 years. The risk for any fracture was increased in 10 and 16 years independently of falls, comorbidities, inflammation, and sex hormones. The age-adjusted risk of hip fracture was increased in men with anemia (HR 2.32, 95% CI 1.06-5.12), in 10 years, although this was no longer statistically significant after further adjustment for total hip BMD. CONCLUSIONS Anemia is associated with an increased risk for any fracture and non-vertebral osteoporotic fracture in elderly men with a long follow-up time. The cause is probably multifactorial and our results support that anemia can be used as a predictor for future fracture.
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Affiliation(s)
- Hallgerdur Lind Kristjansdottir
- Section of Hematology and Coagulation at the Sahlgrenska University Hospital and Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
| | - Dan Mellström
- Center for Bone and Arthritis Research (CBAR) at the Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Department of Geriatric Medicine, Internal Medicine, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Peter Johansson
- Section of Hematology and Coagulation at the Sahlgrenska University Hospital and Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Magnus Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics, Skåne University Hospital (SUS), Lund University, Malmö, Sweden
| | - Liesbeth Vandenput
- Center for Bone and Arthritis Research (CBAR) at the Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Mary MacKillop, Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Mattias Lorentzon
- Center for Bone and Arthritis Research (CBAR) at the Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Department of Geriatric Medicine, Internal Medicine, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Mary MacKillop, Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Hans Herlitz
- Department of Molecular and Clinical Medicine/Nephrology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Claes Ohlsson
- Center for Bone and Arthritis Research (CBAR) at the Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Department of Drug Treatment, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Ulf H Lerner
- Center for Bone and Arthritis Research (CBAR) at the Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Catharina Lewerin
- Section of Hematology and Coagulation at the Sahlgrenska University Hospital and Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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