Association between serum γ-glutamyltranspeptidase and atherosclerosis: a population-based cross-sectional study

Association between the metabolic score for insulin resistance (METS-IR) and arterial stiffness among health check-up population in Japan: a retrospective cross-sectional study

Aim

This study examined the association between the metabolic score for insulin resistance (METS-IR), a novel surrogate indicator of insulin resistance, and brachial-ankle pulse wave velocity (baPWV) in Japanese health check participants.

Methods

A cross-sectional research was conducted involving individuals in a program of medical health screening at the Medical Health Check-up Center in Japan. The study assessed the connection between METS-IR and baPWV in 912 participants who joined the program between 3/1/2004 and 12/31/2012. Serum laboratory tests and lifestyle surveys were the covariates. Multivariate linear regression analysis and subgroup analyses were performed.

Results

912 participants were involved in this cross-sectional study. Adjusted for age, sex, BMI, AST, UA, HDL, eGFR, ankle-brachial index (ABI), alcohol consumption, and smoking status, multivariate linear regression analysis showed that METS-IR and baPWV showed a significant positive association (adjusted β=15.3, 95% confidence interval (CI): 6.61~23.98) with METS-IR as a continuous variable. When converting METS-IR to quartile categorical variables, higher quartile METS-IR indices had longer baPWV (Q3 vs Q1, β=86.14, 95% CI: 23.45~148.83; Q4 vs Q1, β=125.41, 95% CI: 39.99~210.84). In subgroup analysis, METS-IR was associated with baPWV in people with eGFR > 60 ml/min (adjusted β= 14.44, 95% CI: 5.61~23.26, P=0.001), none or light alcohol consumption (adjusted β=16.92, 95% CI: 6.85~27, P=0.001), non-smokers (adjusted β=15.48, 95% CI: 5.86~25.1, P=0.002), non-regular exercisers(adjusted β=17.34, 95% CI: 8.03~26.65, P<0.001), non-fatty liver (adjusted β=17.65, 95% CI: 5.92~29.39, P=0.003), and non-hypertensive (adjusted β=16.13, 95% CI:8.45~23.8, P<0.001).

Conclusion

METS-IR are remarkably associated with baPWV among health check-up participants in Gifu, Japan. As a simple, easily calculated predictor of arterial stiffness, METS-IR could be considered for primary care as a monitoring tool to identify people with high risk of cardiovascular disease in order to intervene early on risk factors. Future prospective, large-sample researches are still needed to confirm this.

The Role of Remnant Cholesterol Beyond Low-Density Lipoprotein Cholesterol in Arterial Stiffness: A Cross-Sectional Study

Background: Previous evidence has demonstrated that elevated low-density lipoprotein cholesterol (LDL-C) was associated with atherosclerosis. However, there is scarce population-based evidence for the role of remnant cholesterol (remnant-C) in arterial stiffness, an imaging marker for subclinical atherosclerosis. Herein, we aimed to evaluate the correlation of remnant-C with arterial stiffness beyond LDL-C in a check-up population. Methods: The study included consecutive subjects who visited the Murakami Memorial Hospital for health check-ups between 2004 and 2012. The calculation of remnant-C occurred as total cholesterol minus high-density lipoprotein cholesterol (HDL-C) minus LDL-C. The brachial-ankle pulse wave velocity (baPWV) >1400 cm/sec was defined as arterial stiffness or baPWV abnormality. The independent correlation of remnant-C level to arterial stiffness was evaluated using adjusted regression models. Results: A total of 909 participants were included (mean age 51.1 ± 9.6 years, male sex 64.9%). In multivariate linear regression analyses, remnant-C remained an independent predictor of the baPWV predictor [β: 94.76, 95% confidence interval (CI) 42.19-147.33, P < 0.001] after adjusting for confounders. After multivariable adjustment, including LDL-C, the highest remnant-C quartile odd ratio (OR) (95% CI) was 2.79 (1.27-6.09) for baPWV abnormality compared to the lowest quartile. Furthermore, each 10-mg/dL increase in remnant-C correlated with a 28% increased risk for baPWV abnormality (OR: 1.28, 95% CI: 1.04-1.57). Moreover, the correlation between remnant-C and baPWV abnormality was still significant in the participant subgroup with optimal levels of LDL-C. Conclusions: Our findings demonstrated that remnant-C levels correlated to arterial stiffness with the dependence of LDL-C and other cardiovascular risk factors in a check-up population.

Association between serum uric acid to high density lipoprotein-cholesterol ratio and arterial stiffness in a Japanese population

Uric acid (UA) and HDL-cholesterol (HDL-C) level are closely associated to the cardiovascular disease (CVD) morbidity. The UA/HDL-C ratio (UHR), a new parameter combination of serum UA and HDL-C, attracts attention for its association with metabolic and inflammatory conditions. There may exists the association between UHR and arterial stiffness. This study aims to explore the association between the UHR and brachial-ankle PWV (baPWV) and to determine whether or not UHR has effect on arterial stiffness. The present study included a total of 912 Japanese (592 men and 320 women), aged from 24 to 84, received a health medical checkup programme with an automatic waveform analyzer to measure baPWV and various standardized questionnaires in a medical center of Japan. Non-linear regression and threshold effect analysis were conducted to explore the association between UHR and baPWV. It was found that UHR was positively correlated with baPWV after adjusting for multiple confounders. A non-linear relationship (with a inflection point was 14.25) was found between UHR and baPWV. Subgroup analyses showed that the significant association between UHR and baPWV only existed in females group, no fatty liver group and normal BMI groups. This study revealed the nonlinear relationship between UHR and baPWV. A significant correlation between UHR and baPWV existed in females but not in males. Fatty liver status, BMI, and menopausal status may affect the above association.

Fully automatic carotid arterial stiffness assessment from ultrasound videos based on machine learning

Arterial stiffness (AS) refers to the loss of arterial compliance and alterations in vessel wall properties. The study of local carotid stiffness (CS) is particularly important since carotid artery stiffening raises the risk of stroke, cognitive impairment, and dementia. So, stiffness measurement as a screening tool approach is crucial because it can reduce mortality and facilitate therapy planning. This study aims to evaluate the stiffness of the CCA using machine learning (ML) through the features of diameter change (ΔD) and stiffness parameters. This study was conducted in seven stages: data collection, preprocessing, CCA segmentation, CCA lumen diameter (DCCA) computing during cardiac cycles, denoising signals of DCCA, computational of AS parameters, and stiffness assessment using ML. The 51 videos (with 25 s) of CCA B-mode ultrasound (US) were used and analyzed. Each US video yielded approximately 750 sequential frames spanning about 24 cardiac cycles. Firstly, US preset settings with time gain compensation with a U-pattern were employed to enhance CCA segmentations. The study showed that auto region-growing, employed three times, is appropriate for segmenting walls with a short running time (4.56 s/frame). The diameter computed for frames constructs a signal (diameter signal) with noisy parts in the shape of peak variance and an un-smooth side. Among the 12 employed smoothing methods, spline fitting with a mean peak difference per cycle (MPDCY) of 0.58 pixels was the most effective for the diameter signal. The authors propose the MPDCY as a new selection criterion for smoothing methods with highly preserved peaks. The ΔD (D_sys-D_dia) determined in this study was validated by statistical analysis as a viable replacement for manual ΔD measurement. Statistical analysis was carried out by Mann-Whitney t-test with a p-value of 0.81, regression line R² = 0.907, and there was no difference in means between the two groups for box plots. The stiffness parameters of the carotid arteries were calculated based on auto-ΔD and pulse pressure. Five ML models, including K-nearest neighbor (KNN), support vector machine (SVM), decision tree (DT), logistic regression (LR), and random forest (RF), fed by distension (ΔD) and five stiffness parameters, were used to distinguish between the stiffened and un-stiffened CCA. Except for SVM, all models performed excellently in terms of specificity, sensitivity, precision, and area under the curve (AUC). In addition, the scatterplot and statistical analysis of the fed features confirm these remarkable outcomes. The scatter plot demonstrates that a linear hyperline can easily distinguish between the two classes. The statistical analysis shows that the stiffness parameters computed from the database of this work were statistically (p < 0.05) distributed into the non-stiffness and stiffness groups. The presented models are validated by applying them to additional datasets. Applying models to other datasets reveals a model performance of 100%. The proposed ML models could be applied in clinical practice to detect CS early, which is essential for preventing stroke.

The correlation of atherosclerosis and triglyceride glucose index: a secondary analysis of a national cross-sectional study of Japanese

BACKGROUND

Few studies examined the relationship between triglyceride/glucose index (TyG index) and atherosclerosis in Japanese adults. Therefore, this study evaluated their relationship, as measured based on the brachial-ankle pulse wave velocity (baPWV) in Japanese adults.

METHODS

A total of 912 participants was selected from the NAGALA (NAFLD in Gifu Area, Longitudinal Analysis) study conducted from 2004 to 2012. The relationship between the TyG index and baPWV was estimated through a logistic model. Subgroup analyses by sex, age, body mass index (BMI), total cholesterol, low-density lipoprotein cholesterol, estimated glomerular filtration rate (eGFR), and fatty liver was performed. The formula for TyG index was ln (½fasting triglyceride level [mg/dL] × fasting plasma glucose level [mg/dL]).

RESULTS

A linear relationship between TyG and baPWV was discovered after adjusting for underlying confounders. An increased risk of baPWV was observed after adjusting for sex, age, BMI, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol, fatty liver, eGFR, and TyG as a continuous variable (adjusted odds ratio [adj OR], 1.57; 95% confidence interval [95% CI], 1.14-2.18). Compared with the TyG index in the first tertile, the probabilities of subjects in the third tertile that developed to baPWV were 1.78-fold higher (adj OR 1.78, 95% CI 1.08-2.95: P for trend 0.024). Moreover, stable associations were observed between the TyG index and baPWV in different variables through subgroup analyses.

CONCLUSIONS

The highest tertile (above 8.57) of the TyG index was positively and linearly related to subclinical atherosclerosis in Japanese adults and may be valuable as a predicted marker.

Prevalence and risk factors for vascular calcification based on the ankle-brachial index in the general population: a cross-sectional study

Background

To investigate the prevalence of vascular calcification based on the ankle‐brachial index (ABI) value and analyse the risk factors for vascular calcification in the general population.

Methods

A cross-sectional study was conducted to collect clinical, laboratory, and lifestyle data in individuals aged 30–70 recruited from the physical examination centre. The automatic arteriosclerosis detector was used to measure the ABI. Difference tests, correlation analyses, and multivariate logistic regression analyses were performed to identify risk factors for vascular calcification.

Results

The overall prevalence of vascular calcification was 24.39% in 1033 subjects. The prevalence of vascular calcification in males was much higher than that in females (27.80% vs. 17.49%, P < 0.001). The differences in age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), hypertension, and fatty liver disease were statistically significant in males (P < 0.05). The differences between serum uric acid (UA), total cholesterol (TC), TG, low-density lipoprotein cholesterol (LDL-C), estimated glomerular filtration rate (eGFR), alcohol consumption, exercise, and postmenopausal status were statistically significant in females (P < 0.05). Increased age (odds ratio (OR) = 1.028, 95% confidence interval (CI) 1.008–1.049, P = 0.007), increased BMI (OR = 1.238, 95% CI 1.147–1.337, P < 0.001) and elevated DBP (OR = 2.563, 95% CI 1.262–5.205, P = 0.009) were independent risk factors for vascular calcification in males after adjusting for confounding factors. Increased BMI (OR = 1.159, 95% CI 1.029–1.304, P = 0.015), elevated UA (OR = 1.545, 95% CI 1.077–2.216, P = 0.018), elevated LDL-C (OR = 1.044, 95% CI 1.060–1.027, P < 0.001), and a lack of exercise (OR = 2.402, 95% CI 1.073–5.373, P = 0.033) were independent risk factors for vascular calcification in females.

Conclusions

The prevalence of vascular calcification based on the ABI value is also high in the general population of our centre. Increased age, BMI, and elevated DBP are independent risk factors for vascular calcification in males. Increased BMI, UA, LDL-C, and a lack of exercise are independent risk factors for vascular calcification in females. Attention should be given to strengthening the prevention and control of vascular calcification in the general population.

Association between the metabolic score for insulin resistance (METS-IR) and estimated glomerular filtration rate (eGFR) among health check-up population in Japan: A retrospective cross-sectional study

AIM

This study aimed to investigate the relationship between a new metric-metabolic score for insulin resistance (METS-IR)-and estimated glomerular filtration rate (eGFR) among Japanese participants who underwent health check-ups.

METHODS

We conducted a cross-sectional study that involved participants in a medical health screening program, which was conducted at the Medical Health Check-up Center in Japan. This retrospective study examined the relationship between METS-IR and eGFR among 881 individuals that joined the program between March 1, 2004, and December 31, 2012. Covariates consisted of serum laboratory tests and lifestyle questionnaires. Multivariate linear regression analysis was used to explore the association between METS-IR and eGFR. In addition, subgroup and interaction analyses were done based on age, sex, body mass index (BMI), alcohol use, smoking status, and hyperuricemia.

RESULTS

A total of 881 individuals participated in this study. High METS-IR was highly linked with reduced eGFR (adjusted β = -5.04, 95% confidence interval (CI): -7.65 to -2.43), while METS-IR was utilized as a categorical variable inside the multiple regression analysis. A decrease in eGFR of 2.54 units was reported for every 10-unit rise in METS-IR (adjusted β = -2.54, 95% CI: -4.04 to -1.05, P-value = 0.001). Stratified analysis suggested no marked interaction between METS-IR and eGFR across age, sex, BMI, and alcohol consumption groups. However, there was an indication of interaction between METS-IR level, smoking status (P-value = 0.001), and uric level (P-value = 0.011) on eGFR decrease.

CONCLUSIONS

METS-IR is remarkably associated with eGFR among the participants who underwent health check-ups in Gifu, Japan. Although more studies are required to prove it, METS-IR could be applied as a monitoring index for early screening, primary prevention, and diagnostic and treatment management strategies for chronic kidney disease.

Association between remnant cholesterol and arterial stiffness: A secondary analysis based on a cross-sectional study

The relationship between conventional lipid parameters and arterial stiffness (AS) has been verified by previous studies. However, it remains unknown whether non‐conventional lipid parameters have certain predictive effect on AS represented by brachial‐ankle pulse wave velocity (baPWV). Therefore, the study was to explore the relationship between remnant cholesterol (RC) and other non‐conventional lipid parameters and AS in the general population free from cardiovascular disease. The study included 912 participants aged 24–84 years from a medical health checkup center of Murakami Memorial Hospital. Logistic regression analysis and receiver operating characteristic (ROC) curves were used to examine the association between non‐conventional lipid parameters and AS. The results showed that compared with non‐AS group, the AS group had higher RC, non‐high‐density lipoprotein cholesterol (Non‐HDL‐C), atherogenic index of plasma (AIP), lipoprotein combine index (LCI), atherosclerosis index (AI), triglycerides/HDL‐C (TG/HDL‐C), Castelli's risk index I (CRI‐I) and Castelli's risk index II (CRI‐II). Then, the authors divided participants into two groups by the optimal cutoff point of 23.6 of RC determined by Youden index. The baPWV was significantly higher in higher RC group compared with lower RC group, and RC was positively correlated with baPWV. Multivariate Logistic regression analysis showed that, regarding lower RC as reference, higher RC was independently associated with higher risk of AS, independent of other risk factors (OR = 1.794, 95% CI: 1.267‐2.539, p = .001). The area under the curve of AS predicted by RC was higher than that of other non‐conventional lipid parameters (almost all p < .05). The findings indicated that increased RC was a significant predictor of AS.

Association of Upper Lip Morphology Characteristics with Sagittal and Vertical Skeletal Patterns: A Cross Sectional Study

Background: Upper lip morphology is essential in diagnosis and treatment of orthodontics and orthognathic surgery. This study is aimed to evaluate the association between upper lip characteristics (ULCs) and skeletal patterns (SPs). Methods: 2079 patients were involved and grouped by sagittal and vertical. Class I, II, and III were identified by ANB angle, while normodivergent, hyperdivergent, and hypodivergent were identified by Facial Height Index and Sum of Angles. ULCs were evaluated by superior sulcus depth, nasolabial angle, upper lip length, basic upper lip thickness, and upper lip thickness. Confounders including demography, malocclusion, upper incisors, and upper lips were adjusted by multivariate linear regression to identify the association between ULCs and SPs. Group differences were evaluated with analysis of variance and Chi-square test. Results: The mean value of ULCs and prevalence of SPs were explored in the Western China population. ULCs were significantly different in various sagittal, vertical, and combined SPs. Superior sulcus depth was negatively related to Class II, and positively related to Class III and the hypodivergent pattern after adjusted by confounders. Conclusions: ULCs significantly varied among different SPs, while only superior sulcus depth was independently associated with SPs, indicating superior sulcus depth is the only ULC that might be significantly corrected by intervention of skeletal growth.

Development and Validation of a Prediction Model for Elevated Arterial Stiffness in Chinese Patients With Diabetes Using Machine Learning

Background

Arterial stiffness assessed by pulse wave velocity is a major risk factor for cardiovascular diseases. The incidence of cardiovascular events remains high in diabetics. However, a clinical prediction model for elevated arterial stiffness using machine learning to identify subjects consequently at higher risk remains to be developed.

Methods

Least absolute shrinkage and selection operator and support vector machine-recursive feature elimination were used for feature selection. Four machine learning algorithms were used to construct a prediction model, and their performance was compared based on the area under the receiver operating characteristic curve metric in a discovery dataset (n = 760). The model with the best performance was selected and validated in an independent dataset (n = 912) from the Dryad Digital Repository (https://doi.org/10.5061/dryad.m484p). To apply our model to clinical practice, we built a free and user-friendly web online tool.

Results

The predictive model includes the predictors: age, systolic blood pressure, diastolic blood pressure, and body mass index. In the discovery cohort, the gradient boosting-based model outperformed other methods in the elevated arterial stiffness prediction. In the validation cohort, the gradient boosting model showed a good discrimination capacity. A cutoff value of 0.46 for the elevated arterial stiffness risk score in the gradient boosting model resulted in a good specificity (0.813 in the discovery data and 0.761 in the validation data) and sensitivity (0.875 and 0.738, respectively) trade-off points.

Conclusion

The gradient boosting-based prediction system presents a good classification in elevated arterial stiffness prediction. The web online tool makes our gradient boosting-based model easily accessible for further clinical studies and utilization.

Development and Validation of a Prediction Model for Elevated Arterial Stiffness in Chinese Patients With Diabetes Using Machine Learning

Background

Arterial stiffness assessed by pulse wave velocity is a major risk factor for cardiovascular diseases. The incidence of cardiovascular events remains high in diabetics. However, a clinical prediction model for elevated arterial stiffness using machine learning to identify subjects consequently at higher risk remains to be developed.

Methods

Least absolute shrinkage and selection operator and support vector machine-recursive feature elimination were used for feature selection. Four machine learning algorithms were used to construct a prediction model, and their performance was compared based on the area under the receiver operating characteristic curve metric in a discovery dataset (n = 760). The model with the best performance was selected and validated in an independent dataset (n = 912) from the Dryad Digital Repository (https://doi.org/10.5061/dryad.m484p). To apply our model to clinical practice, we built a free and user-friendly web online tool.

Results

The predictive model includes the predictors: age, systolic blood pressure, diastolic blood pressure, and body mass index. In the discovery cohort, the gradient boosting-based model outperformed other methods in the elevated arterial stiffness prediction. In the validation cohort, the gradient boosting model showed a good discrimination capacity. A cutoff value of 0.46 for the elevated arterial stiffness risk score in the gradient boosting model resulted in a good specificity (0.813 in the discovery data and 0.761 in the validation data) and sensitivity (0.875 and 0.738, respectively) trade-off points.

Conclusion

The gradient boosting-based prediction system presents a good classification in elevated arterial stiffness prediction. The web online tool makes our gradient boosting-based model easily accessible for further clinical studies and utilization.

Association between lipid profiles and arterial stiffness: A secondary analysis based on a cross-sectional study

OBJECTIVES

The relationship between lipid levels and arterial stiffness remains controversial. Therefore, we aimed to determine the relationship between lipid profiles and brachial-ankle pulse wave velocity (baPWV) as an indicator of arterial stiffness.

METHODS

A total of 909 participants aged 24 to 84 years were stratified into four baPWV quartiles in our study. Serum lipids, baPWV, and other variables of the participants were measured. Univariable and multivariable linear regression analyses were used to examine the relationships between lipid parameters and baPWV.

RESULTS

The highest baPWV quartile group had higher aspartate transaminase, alanine aminotransferase, plasma glucose, total cholesterol, triglyceride (TG), and low-density lipoprotein cholesterol levels and maximum ankle-brachial index, and lower high-density lipoprotein cholesterol levels and estimated glomerular filtration rate. Univariate regression analysis showed that total cholesterol, TG, and low-density lipoprotein cholesterol levels were positively related and high-density lipoprotein cholesterol levels were negatively related to baPWV. After adjusting for age, body mass index, smoking status, aspartate transaminase, alanine aminotransferase, plasma glucose, and estimated glomerular filtration rate, only TG levels were correlated with baPWV (β = 0.075).

CONCLUSIONS

Four lipid variates are associated with arterial stiffness, and TG levels are positively related to arterial stiffness, independent of cardiovascular risks and liver function.

The Hepatoprotective mechanisms of 17β-estradiol after traumatic brain injury in male rats: Classical and non-classical estrogen receptors

Protective effects of estrogen (E2) on traumatic brain injury (TBI) have been determined. In this study, the hepatoprotective effects of E2 after TBI through its receptors and oxidative stress regulation have been evaluated. Diffuse TBI induced by the Marmarou method in male rats. G15, PHTPP, MPP, and ICI182-780 as selective antagonists of E2 were injected before TBI. The results indicated that TBI induces a significant increase in liver enzymes [Alkaline phosphatase (ALP), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Glutamyl transferase (GGT)], and oxidants levels [Malondialdehyde (MDA), Nitric oxide (NO)] and decreases in antioxidant biomarkers [Glutathione peroxidase (GPx) and Superoxide dismutase (SOD)] in the brain and liver, and plasma. We also found that E2 significantly preserved levels of these biomarkers and enzymatic activity. All antagonists inhibited the effects of E2 on increasing SOD and GPx. Also, the effects of E2 on brain MDA levels were inhibited by all antagonists, but in the liver, only ICI + G15 + E2 + TBI group was affected. The impacts of E2 on brain and liver and plasma NO levels were inhibited by all antagonists. The current findings demonstrated that E2 probably improved liver injury after TBI by modulating oxidative stress. Also, both classic (ERβ, ERα) and non-classic [G protein-coupled estrogen receptor (GPER)] receptors are affected in the protective effects of E2.

Mean arterial pressure and arterial stiffness in Japanese population: a secondary analysis based on a cross-sectional study

Previous researches demonstrate that mean arterial pressure (MAP) is associated with major cardiovascular events, but there are few research on the correlation between MAP and brachial-ankle pulse wave velocity (BaPWV). Thus, the present study is designated to examine the association between MAP and BaPWV. Our study is a cross-sectional study in Japanese. They participated in a medical check-up program which included BaPWV and standardized questionnaires. The main measurements include systolic blood pressure, diastolic blood pressure, BaPWV, ankle-brachial index (ABI), fatty liver diagnosed by ultrasonography, etc. It needs to be emphasized that Fukuda et al. finished the study and their data are used for secondary analysis. MAP is positively related with BaPWV [effect size = 10.4; 95% confidence interval (CI), 9.2-11.6] after adjusting age, sex, BMI, smoking status, alcohol consumption, exercise, glutamyltranspeptidase, alanine aminotransferase, aspartate transaminase, total cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein cholesterol (HDL), fatty liver, fasting-blood glucose, uric acid, estimated glomerular filtration rate, and ABI. The nonlinear association is identified between MAP and BaPWV whose inflection point is 94 mmHg. The effect size and 95% CI on the bilateral sides of the inflection point are 8.0 (4.4-11.6) and 14.8 (12.5-17.1), respectively. Subgroup analysis indicates that MAP has a more significantly positive association with BaPWV in ex-smokers, old people (age ≥60), and participants with lower HDL (<40 mg/dL). Consequently, it is practicable for us to roughly predict BaPWV with simple MAP measurement instead of the BaPWV examination.

Prevalence of fatty liver in metabolic syndrome

BACKGROUND

In Western world, non-alcohlic fatty liver disease (NAFLD) is considered to be the commonest liver problem, and it is being recognised as a major cause of liver-related morbidity and mortality. As the prevalence of overweight/obesity and metabolic syndrome increases, NASH may become one of the more common causes of end stage liver disease and hepatocellular carcinoma. But much information is not available in this association. So an attempt has been made to correlate both.

AIMS

The aims of this study are: 1. to study the prevalence of non-alcoholic fatty liver in metabolic syndrome; and 2. to study the correlation between the non-alcoholic fatty liver and metabolic syndrome along with its individual components.

MATERIALS AND METHODS

The study was an observational and analytical study of patients attending OPD and indoor patients of the Department of Medicine, G.G.S. Medical College and Hospital Faridkot. In total, 100 patients diagnosed as metabolic syndrome according to the NCEP ATP III criteria were subjected to ultrasonography; age and sex matched 100 controls were also taken; and the relationship between metabolic syndrome and NAFLD was studied.

RESULTS

In total, 73% cases of metabolic syndrome according to NCEP ATPIII were having fatty liver, while in controls 38% persons were having fatty liver which is statistically significant.

CONCLUSIONS

Fatty liver was found to be highly prevalent in metabolic syndrome, and the early detection of fatty liver can help in modifying the disease course and delaying more serious complications like cirrhosis of liver and hepatocellular carcinoma.

Association between uric acid and brachial-ankle pulse wave velocity: secondary analysis of data from a cross-sectional study

At present, the association between uric acid (UA) and brachial-ankle pulse wave velocity (baPWV) has not been well clarified. This study is the second analysis based on a cross-sectional study. 912 participants (average age is 51.5 ± 9.6 years) who underwent medical health examinations were included in this study, UA levels and baPWV were measured. Participants were divided into four groups according to UA levels (Quantile 1: 2.00-4.10 mg/dL; Quantile 2: 4.20-5.20 mg/dL; Quantile 3: 5.30-6.00 mg/dL and Quantile 4: 6.10-9.80 mg/dL), and the differences of baPWV between the four groups were compared. Univariate analysis showed a positive correlation between UA and baPWV [(Quantile 2 vs Quantile 1: 8.85 (-36.05, 53.75); Quantile 3 vs Quantile 1: 60.32 (13.22, 107.42) and Quantile 4 vs Quantile 1: 80.34 (36.19, 124.49)]. After adjusting for confounding factors, the positive correlation between UA and baPWV still exists [(Quantile 2 vs Quantile 1: -9.92 (-60.16, 40.32); Quantile 3 vs Quantile 1: 82.34 (4.00, 160.68) and Quantile 4 vs Quantile 1: 143.13 (0.75, 285.51)]. Furthermore, curve fitting showed that UA and baPWV had a non-linear positive correlation. In conclusion, elevated UA were associated with baPWV, suggesting that UA could be used as a predictor of atherosclerosis.

Sexual dimorphism in glutathione metabolism and glutathione-dependent responses

Glutathione is the most abundant intracellular low molecular weight thiol in cells and tissues, and plays an essential role in numerous cellular processes, including antioxidant defenses, the regulation of protein function, protein localization and stability, DNA synthesis, gene expression, cell proliferation, and cell signaling. Sexual dimorphisms in glutathione biology, metabolism and glutathione-dependent signaling have been reported for a broad range of biological processes, spanning the human lifespan from early development to aging. Sex-depended differences with regard to glutathione and its biology have also been reported for a number of human pathologies and diseases such as neurodegeneration, cardiovascular diseases and metabolic disorders. Here we review the latest literature in this field and discuss the potential impact of these sexual dimorphisms in glutathione biology on human health and diseases.

Estimated glomerular filtration rate and arterial stiffness in Japanese population: a secondary analysis based on a cross-sectional study

Background

Evidence regarding the relationship between estimated glomerular filtration rate (eGFR) and arterial stiffness is limited, and the data analysis is not sufficient to clarify the true relationship between the two. We aimed to investigate the relationship between eGFR and brachial-ankle pulse wave velocity (baPWV) in Japanese.

Methods

The present study was a cross-sectional study. Nine hundred twelve Japanese men and women, aging 24—84 years old, received a health medical check-up program including the results from baPWV inspection and various standardized questionnaires in a health examination center in Japan. The main outcome measures included eGFR, baPWV, fatty liver and postmenopausal status. Abdominal ultrasonography was used to diagnose fatty liver. Postmenopausal state was defined as beginning 1 year after the cessation of menses.

Results

The average age of the 912 selected participants was 51.5 ± 9.6 years old, and about 57.6% of them were male. The participants’ eGFR distribution was median 69.29 (min 39, max 122.28). The results of multivariate linear regression showed eGFR was not independently associated with baPWV after adjusting potential confounders (β = − 1.11, 95%CI -2.25 to 0.03), this is inconsistent with the result of eGFR (quartile) as a categorical variable (p for trend was 0.038). A non-linear relationship was detected between eGFR and baPWV, whose point was 77.05. The effect sizes and the confidence intervals of the left and right sides of inflection point were − 2.80 (− 4.41 to − 1.19) and 1.84 (− 0.50, 4.17), respectively. Subgroup analysis showed, the change in the elderly population is more pronounced (P for interaction = 0.018; − 2.83 with ≤60 year vs − 6.12 with > 60 year). The same trend was also seen in hypertensive people (P for interaction = 0.018; − 4.55 with hypertension vs − 0.82 with non-hypertension).

Conclusion

The relationship between eGFR and baPWV is non-linear. eGFR was negatively related to baPWV when eGFR is less than 77.05.

AST to ALT ratio and arterial stiffness in non-fatty liver Japanese population:a secondary analysis based on a cross-sectional study

Background

Previous studies have revealed that triglyceride to high-density lipoprotein cholesterol (HDL-C) ratio (henceforth TG/HDL-C) is one of the major risk factors for cardiovascular disease, insulin resistance and metabolism syndrome. However, there are fewer investigations of the correlations between the aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio and brachial ankle pulse wave velocity (baPWV). This study was undertaken to investigate the relationship between the AST to ALT ratio and brachial-ankle pulse wave velocity (baPWV) in a Japanese population.

Methods

The present study was a cross-sectional study. A total of 646 Japanese men and women without fatty liver, aged 24—84 years old, received a health medical check-up programme including the results from baPWV inspection and various standardized questionnaires in a health examination centre in Japan. Main outcome measures included AST/ALT ratio, baPWV, fatty liver and postmenopausal status. Abdominal ultrasonography was used to diagnose fatty liver. A postmenopausal state was defined as beginning 1 year following the cessation of menses.

Results

After adjusting for potential confounders (age, sex, BMI, SBP, DBP, AST, ALT, GGT, uric acid, fasting glucose, TC, LDL, eGFR, smoking and exercise statuses, fatty liver, alcohol consumption and ABI), a non-linear relationship was detected between AST/ALT and baPWV, which had an inflection point of 5.6. The effect sizes and the confidence intervals on the left and right sides of the inflection point were 12.7 (1.9 to 23.5) and − 16.7 (− 36.8 to 3.3), respectively. Subgroup analysis in participants with excessive alcohol consumption (more than 280 g/week) showed that AST/ALT had a negative correlation with baPWV (β = − 30.7, 95%CI (− 53.1, − 8.4)), and the P value for the interaction was less than 0.05.

Conclusion

The relationship between AST/ALT and baPWV is non-linear. AST/ALT was positively correlated with baPWV when AST/ALT was less than 5.6. In addition, the trend was the opposite in subjects who consumed excessive amounts of alcohol.

Gamma-Glutamyltransferase and Risk of Acute Coronary Syndrome in Young Chinese Patients: A Case-Control Study

Background

Serum gamma-glutamyltransferase (GGT) is a biomarker of hepatic disease. Recent studies have shown that GGT may also associate with the risk of coronary artery disease. However, the underlying mechanisms of this association are still unclear.

Methods

This study included 216 young patients with acute coronary syndrome (aged ≤55years) and 227 age-matched controls with normal findings by coronary angiography or coronary computed tomography angiography. We use standard colorimetric techniques and sandwich enzyme-linked immunosorbent assay to measure the levels of GGT and oxidized low-density lipoprotein (ox-LDL), respectively. Traditional risk factors of coronary artery disease, including smoking, diabetes mellitus, hypertension, dyslipidemia, and obesity/overweight, were evaluated according to the current guidelines.

Results

The levels of GGT were significantly correlated with body mass index and levels of triglyceride, fasting plasma glucose, aspartate aminotransferase, and ox-LDL (all P < 0.05). Multivariate logistic regression analysis showed that GGT was significantly associated with the risk of acute coronary syndrome in young Chinese patients (OR = 1.53, 95% CI = 1.09–2.15) after adjusting for traditional risk factors, including sex, age, quantity of smoking, hypertension, diabetes, body mass index, dyslipidemia, and high-sensitivity C-reactive protein. However, this association was significantly attenuated (OR = 1.20, 95% CI = 0.91–1.58) after further adjusting for the levels of ox-LDL.

Conclusions

GGT was associated with the risk of ACS in relatively young patients. The link between GGT and the risk of ACS may be dependent on ox-LDL levels, indicating that the prooxidant action is an important pathway for GGT in the development of cardiovascular disease.

Triglyceride to high-density lipoprotein cholesterol (HDL-C) ratio and arterial stiffness in Japanese population: a secondary analysis based on a cross-sectional study

Background

Previous studies have revealed that triglyceride to high-density lipoprotein cholesterol (HDL-C) ratio (henceforth TG/HDL-C) is one of major risk factors of cardiovascular diseases, insulin resistance and metabolism syndrome. However, there are fewer scientific dissertations about the correlation between TG/HDL-C and bapWV. This study was undertaken to investigate the relationship between Triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio and brachial-ankle pulse wave velocity (baPWV) in Japanese.

Methods

The present study was a cross-sectional study. 912 Japanese men and women, aging 24−84 years old, received a health medical a health check-up program including the results from baPWV inspection and various standardized questionnaire in a health examination Center in Japan. Main outcome measures included TG/HDL-C ratio, baPWV, fatty liver, postmenopausal status. Abdominal ultrasonography was used to diagnose fatty liver. Postmenopausal state was defined as beginning 1 year after the cessation of menses. It was noted that the entire study was completed by Fukuda et al., and uploaded the data to the DATADRYAD website. The author only used this data for secondary analysis.

Results

After adjusting potential confounders (age, sex, BMI, SBP, DBP, AST, ALT, GGT, uric acid, fasting glucose, TC, LDL, eGFR, smoking and exercise status, fatty liver, alcohol consumption and ABI), non-linear relationship was detected between TG/HDL-C and baPWV, whose point was 5.6. The effect sizes and the confidence intervals on the left and right sides of inflection point were 12.7 (1.9 to 23.5) and − 16.7 (− 36.8 to 3.3), respectively. Subgroup analysis showed, in participants with excessive alcohol consumption (more than 280 g/week), that TG/HDL-C had a negative correlation with BAPWV (β = − 30.7, 95%CI (− 53.1, − 8.4)), and the P for interaction was less than 0.05,

Conclusion

The relationship between TG/HDL-C and baPWV is non-linear. TG/HDL-C was positively related with baPWV when TG/HDL-C is less than 5.6. In addition, while the trend is opposite in excessive alcoholic subjects.