1
|
Gómez-Sánchez M, Gómez-Sánchez L, Llamas-Ramos R, Rodríguez-Sánchez E, García-Ortiz L, Martí-Lluch R, Rodríguez MC, Llamas-Ramos I, Gómez-Marcos MA. Relationship between the Mediterranean Diet and Vascular Function in Subjects with and without Increased Insulin Resistance. Nutrients 2024; 16:3106. [PMID: 39339706 PMCID: PMC11435013 DOI: 10.3390/nu16183106] [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: 08/28/2024] [Revised: 09/09/2024] [Accepted: 09/10/2024] [Indexed: 09/30/2024] Open
Abstract
(1) The main aim of this study was to analyze the relationship of the Mediterranean diet (MD) with vascular function in participants with and without increased insulin resistance (IR) in the Spanish population. A secondary aim was to study differences by gender. (2) Methods: Data were analyzed from 3401 subjects in the EVA, MARK, and EVIDENT studies (mean age = 60 years and 57% men). IR was evaluated with the triglyceride and glucose index (TyG index). TyG index = Ln [(fasting triglyceride mg/dL × fasting glucose mg/dL)/2]. The MD was measured against the MEDAS questionnaire, with the 14 items used in the PREDIMED study. Vascular stiffness was estimated with the brachial-ankle pulse wave velocity (baPWV) and the cardio ankle vascular index (CAVI) using the Vasera VS-1500®. (3) Results: The mean MEDAS value was 5.82 ± 2.03; (men: 5.66 ± 2.06; women: 6.04 ± 1.99; p < 0.001). MD adherence was 36.8% (men: 34.2%; women: 40.3%; p < 0.001). The mean baPWV value was 14.39 ± 2.78; (men: 14.50 ± 2.65; women: 14.25 ± 2.93; p = 0.005). A baPWV value ≥ 14.5 m/s was found in 43.4% (men: 43.6%; women: 40.0%; p = 0.727). The mean CAVI value was 8.59 ± 1.28; (men: 8.75 ± 1.28; women: 8.37 ± 1.26; p < 0.001). CAVI values ≥ 9 were present in 39.0% (men: 44.4%; women: 31.7%; p < 0.001). The mean value of the TGC/G index was 10.93 ± 1.39; (men: 11.08 ± 1.33; women: 10.73 ± 1.43; p < 0.001). IR was found in 49.9%. The average value of the MD score value was negatively associated with baPWV and CAVI in all groups analyzed (<0.05), except in the group of women with insulin resistance. (4) Conclusions: The results suggest that MD adherence is negatively associated with the vascular stiffness parameters analyzed in all the groups studied except the group of women with insulin resistance.
Collapse
Affiliation(s)
- Marta Gómez-Sánchez
- Home Hospitalization Service, Marqués of Valdecilla University Hospital, s/n, 39008 Santander, Spain;
- Primary Care Research Unit of Salamanca (APISAL), Health Centre of San Juan, Avenida Portugal 83, 2° P, 37005 Salamanca, Spain; (L.G.-S.); (R.L.-R.); (E.R.-S.); (L.G.-O.); (I.L.-R.)
| | - Leticia Gómez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Health Centre of San Juan, Avenida Portugal 83, 2° P, 37005 Salamanca, Spain; (L.G.-S.); (R.L.-R.); (E.R.-S.); (L.G.-O.); (I.L.-R.)
- Emergency Service, University Hospital of La Paz, Walk. of Castellana, 261, 28046 Madrid, Spain
| | - Rocío Llamas-Ramos
- Primary Care Research Unit of Salamanca (APISAL), Health Centre of San Juan, Avenida Portugal 83, 2° P, 37005 Salamanca, Spain; (L.G.-S.); (R.L.-R.); (E.R.-S.); (L.G.-O.); (I.L.-R.)
- Institute of Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Walk of San Vicente, 182, 37007 Salamanca, Spain
- Faculty of Nursing and Physiotherapy, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Health Centre of San Juan, Avenida Portugal 83, 2° P, 37005 Salamanca, Spain; (L.G.-S.); (R.L.-R.); (E.R.-S.); (L.G.-O.); (I.L.-R.)
- Institute of Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Walk of San Vicente, 182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 37005 Salamanca, Spain;
- Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), 37007 Salamanca, Spain
- Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Luis García-Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Health Centre of San Juan, Avenida Portugal 83, 2° P, 37005 Salamanca, Spain; (L.G.-S.); (R.L.-R.); (E.R.-S.); (L.G.-O.); (I.L.-R.)
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 37005 Salamanca, Spain;
- Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), 37007 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37007 Salamanca, Spain
| | - Ruth Martí-Lluch
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 37005 Salamanca, Spain;
- Vascular Health Research Group, Instituto Universitario para la Investigación en Atención Primaria de Salud Jordi Gol i Gurina (IDIAPJGol), 08007 Girona, Spain
- Girona Biomedical Research Institute (IDIBGI), Doctor Trueta University Hospital, 17190 Girona, Spain
- Department of Medical Science, Faculty of Medicine, University of Girona (UdG), 17003 Girona, Spain
| | - María Cortés Rodríguez
- Institute of Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Walk of San Vicente, 182, 37007 Salamanca, Spain
- Department of Statistics, University of Salamanca, 37008 Salamanca, Spain
- Department of Hematology, University Hospital of Salamanca, 37008 Salamanca, Spain
| | - Inés Llamas-Ramos
- Primary Care Research Unit of Salamanca (APISAL), Health Centre of San Juan, Avenida Portugal 83, 2° P, 37005 Salamanca, Spain; (L.G.-S.); (R.L.-R.); (E.R.-S.); (L.G.-O.); (I.L.-R.)
- Institute of Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Walk of San Vicente, 182, 37007 Salamanca, Spain
- Faculty of Nursing and Physiotherapy, Universidad de Salamanca, 37007 Salamanca, Spain
- Girona Biomedical Research Institute (IDIBGI), Doctor Trueta University Hospital, 17190 Girona, Spain
| | - Manuel A. Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Health Centre of San Juan, Avenida Portugal 83, 2° P, 37005 Salamanca, Spain; (L.G.-S.); (R.L.-R.); (E.R.-S.); (L.G.-O.); (I.L.-R.)
- Institute of Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Walk of San Vicente, 182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 37005 Salamanca, Spain;
- Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), 37007 Salamanca, Spain
- Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
| |
Collapse
|
2
|
Salvado R, Santos-Minguez S, Lugones-Sánchez C, Gonzalez-Sánchez S, Tamayo-Morales O, Quesada-Rico JA, Benito R, Rodríguez-Sánchez E, Gómez-Marcos MA, Casado-Vicente V, Guimarães-Cunha P, Hernandez-Rivas JM, Mira A, García-Ortiz L. Gut microbiota and its relationship with early vascular ageing in a Spanish population (MIVAS study). Eur J Clin Invest 2024; 54:e14228. [PMID: 38655910 DOI: 10.1111/eci.14228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/01/2024] [Accepted: 04/06/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Gut microbiota and its by-products are increasingly recognized as having a decisive role in cardiovascular diseases. The aim is to study the relationship between gut microbiota and early vascular ageing (EVA). METHODS A cross-sectional study was developed in Salamanca (Spain) in which 180 subjects aged 45-74 years were recruited. EVA was defined by the presence of at least one of the following: carotid-femoral pulse wave velocity (cf-PWV), cardio-ankle vascular index (CAVI) or brachial-ankle pulse wave velocity (ba-PWV) above the 90th percentile of the reference population. All other cases were considered normal vascular ageing (NVA). MEASUREMENTS cf-PWV was measured by SphygmoCor® System; CAVI and ba-PWV were determined by Vasera 2000® device. Gut microbiome composition in faecal samples was determined by 16S rRNA Illumina sequencing. RESULTS Mean age was 64.4 ± 6.9 in EVA group and 60.4 ± 7.6 years in NVA (p < .01). Women in EVA group were 41% and 53% in NVA. There were no differences in the overall composition of gut microbiota between the two groups when evaluating Firmicutes/Bacteriodetes ratio, alfa diversity (Shannon Index) and beta diversity (Bray-Curtis). Bilophila, Faecalibacterium sp.UBA1819 and Phocea, are increased in EVA group. While Cedecea, Lactococcus, Pseudomonas, Succiniclasticum and Dielma exist in lower abundance. In logistic regression analysis, Bilophila (OR: 1.71, 95% CI: 1.12-2.6, p = .013) remained significant. CONCLUSIONS In the studied Spanish population, early vascular ageing is positively associated with gut microbiota abundance of the genus Bilophila. No relationship was found between phyla abundance and measures of diversity.
Collapse
Affiliation(s)
- Rita Salvado
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Sandra Santos-Minguez
- Instituto de Investigación del Cáncer, Instituto de Biología Molecular y Celular del Cáncer, Universidad de Salamanca-CSIC, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
| | - Susana Gonzalez-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
| | - Olaya Tamayo-Morales
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
| | - José A Quesada-Rico
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
- Facultad de Medicina, Universidad Miguel Hernández de Elche, Sant Joan, D'Alacant, Spain
| | - Rocío Benito
- Instituto de Investigación del Cáncer, Instituto de Biología Molecular y Celular del Cáncer, Universidad de Salamanca-CSIC, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
- Departamento de Medicina, Universidad de Salamanca, Salamanca, Spain
| | - Manuel A Gómez-Marcos
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
- Departamento de Medicina, Universidad de Salamanca, Salamanca, Spain
| | - Verónica Casado-Vicente
- Centro de Salud Parquesol. Gerencia de Salud Valladolid Oeste, Gerencia Regional de Salud de Castilla y Leon (SACyL), Valladolid, Spain
- Departamento de Medicina, Dermatología and Toxicología, Universidad de Valladolid, Valladolid, Spain
| | - Pedro Guimarães-Cunha
- Life and Health Sciences Research Institute (IICVS) and School of Medicine, Universidade do Minho, Braga, Portugal
- Center for the Research and Treatment of arterial Hypertension and cardiovascular Risk, Hospital Senhora da Oliveira, Guimarães, Portugal
| | - Jesús M Hernandez-Rivas
- Instituto de Investigación del Cáncer, Instituto de Biología Molecular y Celular del Cáncer, Universidad de Salamanca-CSIC, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, Salamanca, Spain
- Departamento de Hematología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Alex Mira
- Departamento de Salud y Genómica, Fundación FISABIO, Valencia, Spain
- CIBER Centro de Epidemiología y Salud Pública, Madrid, Spain
| | - Luis García-Ortiz
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
- Departamento de Ciencias Biomédicas y del Diagnóstico, Universidad de Salamanca, Salamanca, Spain
| |
Collapse
|
3
|
Gómez-Sánchez L, González-Falcon D, Llamas-Ramos R, Rodríguez MC, Rodríguez-Sánchez E, García-Ortiz L, Llamas-Ramos I, Gómez-Sánchez M, Gómez-Marcos MA. The Relationship between Healthy Vascular Aging with the Mediterranean Diet and Other Lifestyles in the Spanish Population: The EVA Study. Nutrients 2024; 16:2565. [PMID: 39125444 PMCID: PMC11314054 DOI: 10.3390/nu16152565] [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: 07/13/2024] [Revised: 07/28/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024] Open
Abstract
The aim of this study was to analyze the relationship between healthy vascular aging (HVA) and the Mediterranean diet alongside other lifestyles in a Spanish population aged 35 to 75 years without previous cardiovascular diseases. METHODS In this cross-sectional descriptive study, 501 individuals aged 35 to 75 years were recruited from five health centers by random sampling stratified by age and sex (55.90 ± 14.24 years, 49.70% men). HVA was determined in two steps. Step 1: Subjects with vascular damage to the carotid arteries or peripheral arterial disease were classified as non-HVA. Step 2: The study population was classified by age and sex using the percentiles of the vascular aging index (VAI), with VAI ≤p25 considered HVA and >p25 considered non-HVA. The VAI was estimated using the following formula (VAI = (log (1.09) × 10 cIMT + log (1.14) cfPWV) × 39.1 + 4.76. Carotid-femoral pulse wave velocity (cfPWV) was measured with the SphygmoCor® device, and carotid intima-media thickness using Sonosite Micromax® ultrasound. Mediterranean diet (MD) adherence, alcohol and tobacco use were recorded through validated questionnaires. Physical activity was assessed with the ActiGraph-GT3X® accelerometer. RESULTS The mean VAI value was 61.23 ± 12.86 (men-63.47 ± 13.75 and women-59.04 ± 11.54; p < 0.001). HVA was found in 18.9% (men-19.9% and women-17.8%). In the multiple regression analysis after adjusting for possible confounding factors, the mean VAI value showed a positive association with alcohol use (β = 0.020) and sedentary hours per week (β = 0.109) and a negative association with hours of activity per week (β = -0.102) and with the number of healthy lifestyles (β = -0.640). In the logistic regression analysis, after adjusting for possible confounding factors and compared to those classified as non-HVA, subjects classified as HVA were more likely to show MD adherence (OR = 0.571), do more than 26 h per week of physical activity (OR = 1.735), spend under 142 h per week being sedentary (OR = 1.696), and have more than two healthy lifestyles (OR = 1.877). CONCLUSION The results of this study suggest that the more time spent doing physical activity and the less time spent in a sedentary state, the lower the vascular aging index and the greater the likelihood of being classified in the group of subjects with HVA.
Collapse
Affiliation(s)
- Leticia Gómez-Sánchez
- Emergency Service, University Hospital of La Paz P. of Castellana, 261, 28046 Madrid, Spain;
- Primary Care Research Unit of Salamanca (APISAL), Health Centre of San Juan, Av. Portugal 83, 37005 Salamanca, Spain; (D.G.-F.); (R.L.-R.); (E.R.-S.); (L.G.-O.); (M.G.-S.)
| | - David González-Falcon
- Primary Care Research Unit of Salamanca (APISAL), Health Centre of San Juan, Av. Portugal 83, 37005 Salamanca, Spain; (D.G.-F.); (R.L.-R.); (E.R.-S.); (L.G.-O.); (M.G.-S.)
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain;
| | - Rocío Llamas-Ramos
- Primary Care Research Unit of Salamanca (APISAL), Health Centre of San Juan, Av. Portugal 83, 37005 Salamanca, Spain; (D.G.-F.); (R.L.-R.); (E.R.-S.); (L.G.-O.); (M.G.-S.)
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain;
- Faculty of Nursing and Physiotherapy, Universidad de Salamanca, 37007 Salamanca, Spain
| | - María Cortés Rodríguez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain;
- Department of Statistics, University of Salamanca, 37008 Salamanca, Spain
- Department of Hematology, University Hospital of Salamanca, 37008 Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Health Centre of San Juan, Av. Portugal 83, 37005 Salamanca, Spain; (D.G.-F.); (R.L.-R.); (E.R.-S.); (L.G.-O.); (M.G.-S.)
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain;
- Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), 37007 Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
- Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Luis García-Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Health Centre of San Juan, Av. Portugal 83, 37005 Salamanca, Spain; (D.G.-F.); (R.L.-R.); (E.R.-S.); (L.G.-O.); (M.G.-S.)
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain;
- Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), 37007 Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37007 Salamanca, Spain
| | - Inés Llamas-Ramos
- Primary Care Research Unit of Salamanca (APISAL), Health Centre of San Juan, Av. Portugal 83, 37005 Salamanca, Spain; (D.G.-F.); (R.L.-R.); (E.R.-S.); (L.G.-O.); (M.G.-S.)
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain;
- Faculty of Nursing and Physiotherapy, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Marta Gómez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Health Centre of San Juan, Av. Portugal 83, 37005 Salamanca, Spain; (D.G.-F.); (R.L.-R.); (E.R.-S.); (L.G.-O.); (M.G.-S.)
- Home Hospitalization Service, Marqués of Valdecilla University Hospital, 39008 Santander, Spain
| | - Manuel A. Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Health Centre of San Juan, Av. Portugal 83, 37005 Salamanca, Spain; (D.G.-F.); (R.L.-R.); (E.R.-S.); (L.G.-O.); (M.G.-S.)
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain;
- Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), 37007 Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
- Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
| |
Collapse
|
4
|
Gómez-Sánchez L, Gómez-Sánchez M, Tamayo-Morales O, Lugones-Sánchez C, González-Sánchez S, Martí-Lluch R, Rodríguez-Sánchez E, García-Ortiz L, Gómez-Marcos MA. Relationship between the Mediterranean Diet and Metabolic Syndrome and Each of the Components That Form It in Caucasian Subjects: A Cross-Sectional Trial. Nutrients 2024; 16:1948. [PMID: 38931300 PMCID: PMC11207079 DOI: 10.3390/nu16121948] [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: 05/21/2024] [Revised: 06/07/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024] Open
Abstract
The main objective of this work is to investigate the relationship between the Mediterranean diet (MD) and metabolic syndrome (MetS) and its components in Caucasian subjects between 35 and 74 years. The secondary objective is to analyze sex differences. METHODS A cross-sectional trial. This study utilized data from the EVA, MARK, and EVIDENT studies, and a total of 3417 subjects with a mean age ± SD of 60.14 ± 9.14 years (57% men) were included. We followed the five criteria established in the National Cholesterol Education Program III to define MetS. The MD was assessed with the 14-item Mediterranean diet adherence screener (MEDAS) used in the PREDIMED study. Good adherence was considered when the MD value was higher than the median value. RESULTS The mean ± SD value of the MEDAS questionnaire was 5.83 ± 2.04 (men 5.66 ± 2.06 and women 6.04 ± 1.99; p < 0.001). Adherence to the MD was observed by 38.6% (34.3% men and 40.3% women; p < 0.001). MetS was observed in 41.6% (39.0% men and 45.2% women; p < 0.001). In the multiple regression analysis, after adjusting for possible confounders, the mean MD value showed a negative association with the number of MetS components per subject (β = -0.336), and with the different components of MetS: systolic blood pressure (β = -0.011), diastolic blood pressure (β = -0.029), glycemia (β = -0.009), triglycerides (β = -0.004), and waist circumference (β = -0.026), except with the HDL-cholesterol value which showed a positive association (β = 0.021); p < 0.001 in all cases. In the logistic regression analysis performed, we found that an increase in MD adherence was associated with a decrease in the probability of MetS (OR = 0.56) and its components: blood pressure levels ≥ 130/85 mmHg (OR = 0.63), fasting plasma glucose ≥ 100 mg/dL (OR = 0.62), triglyceride levels ≥ 150 mg/dL (OR = 0.65), waist circumference levels ≥ 88 cm in women and ≥102 cm in men (OR = 0.74), and increased high-density lipoprotein cholesterol < 40 mg/dL in men and <50 mg/dL in women (OR = 1.70); p < 0.001 in all cases. The results by sex were similar, both in multiple regression and logistic regression. CONCLUSIONS The results found in our work indicate that the greater the adherence to the MD, the lower the probability of presenting MetS. This result is repeated in the study by sex. More studies are needed to clarify that these results can be extended to the rest of the Mediterranean countries, and to other countries outside the Mediterranean basin.
Collapse
Affiliation(s)
- Leticia Gómez-Sánchez
- Emergency Service, University Hospital of La Paz P. of Castellana, 261, 28046 Madrid, Spain
| | - Marta Gómez-Sánchez
- Home Hospitalization Service, Marqués of Valdecilla University Hospital, s/n, 39008 Santander, Spain;
| | - Olaya Tamayo-Morales
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 37005 Salamanca, Spain;
| | - Cristina Lugones-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 37005 Salamanca, Spain;
| | - Susana González-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 37005 Salamanca, Spain;
| | - Ruth Martí-Lluch
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 37005 Salamanca, Spain;
- Vascular Health Research Group, Instituto Universitario para la Investigación en Atención Primaria de Salud Jordi Gol i Gurina (IDIAPJGol), 08007 Girona, Spain
- Girona Biomedical Research Institute (IDIBGI), Doctor Trueta University Hospital, 17190 Girona, Spain
- Department of Medical Science, Faculty of Medicine, University of Girona (UdG), 17003 Girona, Spain
| | - Emiliano Rodríguez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 37005 Salamanca, Spain;
- Department of Medicine, University of Salamanca, 28046 Salamanca, Spain
| | - Luis García-Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 37005 Salamanca, Spain;
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37007 Salamanca, Spain
| | - Manuel A. Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 37005 Salamanca, Spain;
- Department of Medicine, University of Salamanca, 28046 Salamanca, Spain
| |
Collapse
|
5
|
Vicente-Gabriel S, Lugones-Sánchez C, Tamayo-Morales O, Vicente Prieto A, González-Sánchez S, Conde Martín S, Gómez-Sánchez M, Rodríguez-Sánchez E, García-Ortiz L, Gómez-Sánchez L, Gómez-Marcos MA. Relationship between addictions and obesity, physical activity and vascular aging in young adults (EVA-Adic study): a research protocol of a cross-sectional study. Front Public Health 2024; 12:1322437. [PMID: 38344236 PMCID: PMC10853417 DOI: 10.3389/fpubh.2024.1322437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/08/2024] [Indexed: 02/15/2024] Open
Abstract
Background Behavioral and substance addictions are prevalent health problems that, alongside obesity, are linked to reduced physical activity and increased sedentary time. Similarly, arterial stiffness and vascular aging are processes that begin gradually at an early age and are closely associated with morbidity and mortality from cardiovascular diseases. The main objective of this study is to analyze how addictions are related to obesity and body fat distribution, physical activity, sedentary time, arterial stiffness and vascular aging, as well as sleep quality, cognitive function and gender differences in young adults aged between 18 and 34 years. Methods This cross-sectional descriptive observational study will analyze data from 500 subjects (250 men and 250 women) aged 18-34 without cardiovascular disease, selected by simple random sampling with replacement from the urban population of the city center of Salamanca (34,044 people aged 18-34, with 18,450 women and 15,594 men). Behavioral and substance addictions, as well as sleep quality and cognitive impairment will be assessed using questionnaires. The Pittisburg Sleep Quality Index (PSQI) will be used to measure sleep quality and the Ford questionnaire will be used to measure insomnia in response to stress. For obesity, weight, height, waist and hip circumference, body composition will be measured with the Inbody 230® impedance meter. For physical activity and sedentary time, we will use the Actigraph® accelerometer alongside the international physical activity questionnaire (IPAQ) and the Marshall questionnaire. The Sphygmocor System® will be used for pulse wave analysis and carotid-femoral pulse wave velocity (cfPWV), while the Vasera VS-2000® will measure cardio ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV). Vascular aging will be calculated with the 10th and 90th percentiles of cfPWV or baPWV. Demographic, analytical variables will be collected, as will data to assess vascular, cardiac, renal, and brain injury. Discussion Addictions are on the rise in today's society, affecting the mental health and well-being of those who suffer from them, generating important social problems such as job loss, family dysfunction, debt and social isolation. Together with obesity, they are prevalent health problems in young adults and are associated with lower physical activity and higher sedentary time. Meanwhile, arterial stiffness and vascular aging are processes that begin gradually at an early age and determine morbidity and mortality caused by cardiovascular diseases. The results of this project will allow us to understand the situation regarding behavioral and substance addictions in young adults. Better understanding of these addictions will in turn facilitate the development of more effective prevention strategies and intervention programs, which can then reduce the negative impact at both the individual and societal levels. Clinical trial registration [ClinicalTrials.gov], identifier [NCT05819840].
Collapse
Affiliation(s)
- Sara Vicente-Gabriel
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Intensive Care Unit, Salamanca University Hospital, Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
| | - Olaya Tamayo-Morales
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | - Alberto Vicente Prieto
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
| | - Susana González-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | - Sandra Conde Martín
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
| | - Marta Gómez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Home Hospitalization Unit, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Emiliano Rodríguez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Luis García-Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Leticia Gómez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Emergency Department, La Paz University Hospital, Madrid, Spain
| | - Manuel A. Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | | |
Collapse
|
6
|
Navarro Cáceres A, Navarro-Matías E, Gómez-Sánchez M, Tamayo-Morales O, Lugones-Sánchez C, González-Sánchez S, Rodríguez-Sánchez E, García-Ortiz L, Gómez-Sánchez L, Gómez-Marcos MA. Increase in Vascular Function Parameters According to Lifestyles in a Spanish Population without Previous Cardiovascular Disease-EVA Follow-Up Study. Nutrients 2023; 15:4614. [PMID: 37960267 PMCID: PMC10648779 DOI: 10.3390/nu15214614] [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: 10/03/2023] [Revised: 10/25/2023] [Accepted: 10/29/2023] [Indexed: 11/15/2023] Open
Abstract
The aim of this longitudinal descriptive observational study was to analyze the influence of different lifestyles on arterial stiffness (AS) throughout five years of follow-up and to describe the differences by sex in a Spanish adult population without cardiovascular disease at the start of the study. A random stratified sampling by age and sex was used to obtain 501 subjects included in the initial assessment. No cardiovascular disease was allowed in the subjects. The average age was 55.9 years, and 50.3% were women. A total of 480 subjects were analyzed again five years later. Alcohol and tobacco consumption were collected with standardized questionnaires. Adherence to the Mediterranean diet was assessed with the Mediterranean diet adherence screener (MEDAS) questionnaire. Physical activity was assessed with the short version of the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and sedentary time was assessed with the Marshall Sitting Questionnaire (MSQ). AS was assessed by measuring carotid-femoral pulse wave velocity (cfPWV) and central augmentation index (CAIx) with SphygmoCor System®, and ankle pulse wave velocity (baPWV) and cardio ankle vascular index (CAVI) with Vasera VS-1500®. Increases in vascular function measures per year of follow-up were: cfPWV = 0.228 ± 0.360 m/s, baPWV = 0.186 ± 0.308 m/s, CAVI = 0.041 ± 0.181 m/s, and CAIx = 0.387 ± 2.664 m/s. In multiple regression analysis, positive association was shown between an increase in baPWV and tobacco index (β = 0.007) and alcohol consumption (β = 0.005). Negative association was shown between CAVI and Mediterranean diet score (β = -0.051). In multinomial logistic regression analysis, the OR of tobacco index of subjects with a cfPWV increase >P75 was OR = 1.025 and of subjects classified between P25 and P75 was OR = 1.026 regarding subjects classified with an increase P75 was OR = 1.006 regarding subjects classified with an increase P75, and an OR = 0.841 was found of subjects classified between P25-75 regarding subjects classified with an increase
Collapse
Affiliation(s)
- Alicia Navarro Cáceres
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
| | - Elena Navarro-Matías
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
| | - Marta Gómez-Sánchez
- Home Hospitalization Service, Marqués de Valdecilla University Hospital, 39008 Santander, Spain;
| | - Olaya Tamayo-Morales
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
| | - Susana González-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
- Department of Medicine, University of Salamanca, 28046 Salamanca, Spain
| | - Luis García-Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37007 Salamanca, Spain
| | - Leticia Gómez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Emergency Service, University Hospital of La Paz, 37007 Madrid, Spain
| | - Manuel A. Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
- Department of Medicine, University of Salamanca, 28046 Salamanca, Spain
| | | |
Collapse
|
7
|
Lugones-Sánchez C, Santos-Mínguez S, Salvado R, González-Sánchez S, Tamayo-Morales O, Hoya-González A, Ramírez-Manent JI, Magallón-Botaya R, Quesada-Rico JA, Garcia-Cubillas MD, Rodríguez-Sánchez E, Gómez-Marcos MA, Benito-Sanchez R, Mira A, Hernandez-Rivas JM, Garcia-Ortiz L. Lifestyles, arterial aging, and its relationship with the intestinal and oral microbiota (MIVAS III study): a research protocol for a cross-sectional multicenter study. Front Public Health 2023; 11:1164453. [PMID: 37457284 PMCID: PMC10344706 DOI: 10.3389/fpubh.2023.1164453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/30/2023] [Indexed: 07/18/2023] Open
Abstract
Background The microbiota is increasingly recognized as a significant factor in the pathophysiology of many diseases, including cardiometabolic diseases, with lifestyles probably exerting the greatest influence on the composition of the human microbiome. The main objectives of the study are to analyze the association of lifestyles (diet, physical activity, tobacco, and alcohol) with the gut and oral microbiota, arterial aging, and cognitive function in subjects without cardiovascular disease in the Iberian Peninsula. In addition, the study will examine the mediating role of the microbiome in mediating the association between lifestyles and arterial aging as well as cognitive function. Methods and analysis MIVAS III is a multicenter cross-sectional study that will take place in the Iberian Peninsula. One thousand subjects aged between 45 and 74 years without cardiovascular disease will be selected. The main variables are demographic information, anthropometric measurements, and habits (tobacco and alcohol). Dietary patterns will be assessed using a frequency consumption questionnaire (FFQ) and the Mediterranean diet adherence questionnaire. Physical activity levels will be evaluated using the International Physical Activity Questionnaire (IPAQ), Marshall Questionnaire, and an Accelerometer (Actigraph). Body composition will be measured using the Inbody 230 impedance meter. Arterial aging will be assessed through various means, including measuring medium intimate carotid thickness using the Sonosite Micromax, conducting analysis with pulse wave velocity (PWA), and measuring pulse wave velocity (cf-PWV) using the Sphygmocor System. Additional cardiovascular indicators such as Cardio Ankle Vascular Index (CAVI), ba-PWV, and ankle-brachial index (Vasera VS-2000®) will also be examined. The study will analyze the intestinal microbiota using the OMNIgene GUT kit (OMR-200) and profile the microbiome through massive sequencing of the 16S rRNA gene. Linear discriminant analysis (LDA), effect size (LEfSe), and compositional analysis, such as ANCOM-BC, will be used to identify differentially abundant taxa between groups. After rarefying the samples, further analyses will be conducted using MicrobiomeAnalyst and R v.4.2.1 software. These analyses will include various aspects, such as assessing α and β diversity, conducting abundance profiling, and performing clustering analysis. Discussion Lifestyle acts as a modifier of microbiota composition. However, there are no conclusive results demonstrating the mediating effect of the microbiota in the relationship between lifestyles and cardiovascular diseases. Understanding this relationship may facilitate the implementation of strategies for improving population health by modifying the gut and oral microbiota. Trial registration clinicaltrials.gov/ct2/show/NCT04924907, ClinicalTrials.gov, identifier: NCT04924907. Registered on 21 April 2021.
Collapse
Affiliation(s)
- Cristina Lugones-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
| | - Sandra Santos-Mínguez
- Cancer Research Centre, Institute of Biomedical Research of Salamanca (IBSAL), Institute of Molecular and Cellular Biology of Cancer (IBMCC), University of Salamanca-CSIC, Salamanca, Spain
| | - Rita Salvado
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Susana González-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
| | - Olaya Tamayo-Morales
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
| | - Amaya Hoya-González
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - José I. Ramírez-Manent
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
- Calvià Primary Care Center, Balearic Islands Health Research Institute (IDIBSA), Health Service of Balearic Islands, Calvià, Spain
- Department of Medicine, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Rosa Magallón-Botaya
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
| | - José A. Quesada-Rico
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
- Department of Clinical Medicine, Miguel Hernandez University of Elche, Sant Joan d'Alacant, Spain
| | - Miriam D. Garcia-Cubillas
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Manuel A. Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Rocío Benito-Sanchez
- Cancer Research Centre, Institute of Biomedical Research of Salamanca (IBSAL), Institute of Molecular and Cellular Biology of Cancer (IBMCC), University of Salamanca-CSIC, Salamanca, Spain
| | - Alex Mira
- Department of Health and Genomics, FISABIO Foundation, Valencia, Spain
- CIBER Center for Epidemiology and Public Health, Madrid, Spain
| | - Jesus M. Hernandez-Rivas
- Department of Medicine, University of Salamanca, Salamanca, Spain
- Haematology Department, Institute of Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Salamanca, Spain
| | - Luis Garcia-Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Healthcare Management, Castilla y León Regional Health Authority (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | | |
Collapse
|
8
|
Hong L, Xu H, Ge C, Tao H, Shen X, Song X, Guan D, Zhang C. Prediction of low cardiac output syndrome in patients following cardiac surgery using machine learning. Front Med (Lausanne) 2022; 9:973147. [PMID: 36091676 PMCID: PMC9448978 DOI: 10.3389/fmed.2022.973147] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThis study aimed to develop machine learning models to predict Low Cardiac Output Syndrome (LCOS) in patients following cardiac surgery using machine learning algorithms.MethodsThe clinical data of cardiac surgery patients in Nanjing First Hospital between June 2019 and November 2020 were retrospectively extracted from the electronic medical records. Six conventional machine learning algorithms, including logistic regression, support vector machine, decision tree, random forest, extreme gradient boosting and light gradient boosting machine, were employed to construct the LCOS predictive models with all predictive features (full models) and selected predictive features (reduced models). The discrimination of these models was evaluated by the area under the receiver operating characteristic curve (AUC) and the calibration of the models was assessed by the calibration curve. Shapley Additive explanation (SHAP) and Local Interpretable Model-Agnostic Explanations (LIME) were used to interpret the predictive models.ResultsData from 1,585 patients [982 (62.0%) were male, aged 18 to 88, 212 (13.4%) with LCOS] were employed to train and validate the LCOS models. Among the full models, the RF model (AUC: 0.909, 95% CI: 0.875–0.943; Sensitivity: 0.849, 95% CI: 0.724–0.933; Specificity: 0.835, 95% CI: 0.796–0.869) and the XGB model (AUC: 0.897, 95% CI: 0.859–0.935; Sensitivity: 0.830, 95% CI: 0.702–0.919; Specificity: 0.809, 95% CI: 0.768–0.845) exhibited well predictive power for LCOS. Eleven predictive features including left ventricular ejection fraction (LVEF), first post-operative blood lactate (Lac), left ventricular diastolic diameter (LVDd), cumulative time of mean artery blood pressure (MABP) lower than 65 mmHg (MABP < 65 time), hypertension history, platelets level (PLT), age, blood creatinine (Cr), total area under curve above threshold central venous pressure (CVP) 12 mmHg and 16 mmHg, and blood loss during operation were used to build the reduced models. Among the reduced models, RF model (AUC: 0.895, 95% CI: 0.857–0.933; Sensitivity: 0.830, 95% CI: 0.702–0.919; Specificity: 0.806, 95% CI: 0.765–0.843) revealed the best performance. SHAP and LIME plot showed that LVEF, Lac, LVDd and MABP < 65 time significantly contributed to the prediction model.ConclusionIn this study, we successfully developed several machine learning models to predict LCOS after surgery, which may avail to risk stratification, early detection and management of LCOS after cardiac surgery.
Collapse
Affiliation(s)
- Liang Hong
- Cardiovascular Intensive Care Unit, Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Huan Xu
- Cardiovascular Intensive Care Unit, Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Chonglin Ge
- College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Hong Tao
- Cardiovascular Intensive Care Unit, Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xiao Shen
- Cardiovascular Intensive Care Unit, Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xiaochun Song
- Cardiovascular Intensive Care Unit, Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Donghai Guan
- College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
- Donghai Guan,
| | - Cui Zhang
- Cardiovascular Intensive Care Unit, Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
- *Correspondence: Cui Zhang,
| |
Collapse
|
9
|
Hernandez L, Laucyte-Cibulskiene A, Ward LJ, Kautzky-Willer A, Herrero MT, Norris CM, Raparelli V, Pilote L, Stenvinkel P, Kublickiene K. Gender dimension in cardio-pulmonary continuum. Front Cardiovasc Med 2022; 9:916194. [PMID: 36003909 PMCID: PMC9393639 DOI: 10.3389/fcvm.2022.916194] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022] Open
Abstract
Cardio-pulmonary diseases, which were once regarded as a man's illness, have been one of the leading causes of morbidity and mortality for both men and women in many countries in recent years. Both gender and sex influence the functional and structural changes in the human body and therefore play an important role in disease clinical manifestation, treatment choice, and/or response to treatment and prognosis of health outcomes. The gender dimension integrates sex and gender analysis in health sciences and medical research, however, it is still relatively overlooked suggesting the need for empowerment in the medical research community. Latest advances in the field of cardiovascular research have provided supportive evidence that the application of biological variables of sex has led to the understanding that heart disease in females may have different pathophysiology compared to males, particularly in younger adults. It has also resulted in new diagnostic techniques and a better understanding of symptomatology, while gender analysis has informed more appropriate risk stratification and prevention strategies. The existing knowledge in the pulmonary field shows the higher prevalence of pulmonary disorders among females, however, the role of gender as a socio-cultural construct has yet to be explored for the implementation of targeted interventions. The purpose of this review is to introduce the concept of gender dimension and its importance for the cardiopulmonary continuum with a focus on shared pathophysiology and disease presentation in addition to interrelation with chronic kidney disease. The review presents basic knowledge of what gender dimension means, and the application of sex and gender aspects in cardiovascular medicine with a specific focus on early pulmonary development, pulmonary hypertension, and chronic obstructive pulmonary disease (COPD). Early vascular aging and inflammation have been presented as a potential pathophysiological link, with further interactions between the cardiopulmonary continuum and chronic kidney disease. Finally, implications for potential future research have been provided to increase the impact of gender dimension on research excellence that would add value to everybody, foster toward precision medicine and ultimately improve human health.
Collapse
Affiliation(s)
- Leah Hernandez
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Agne Laucyte-Cibulskiene
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Nephrology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Liam J. Ward
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden
| | - Alexandra Kautzky-Willer
- Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Maria-Trinidad Herrero
- Clinical and Experimental Neuroscience, Institutes for Aging Research and Bio-Health Research of Murcia, School of Medicine, University of Murcia, Murcia, Spain
| | - Colleen M. Norris
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
- Cardiovascular and Stroke Strategic Clinical Network, Alberta Health Services, Edmonton, AB, Canada
| | - Valeria Raparelli
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Louise Pilote
- Division of Clinical Epidemiology, Research Institute of McGill University Health Centre, McGill University, Montreal, QC, Canada
| | - Peter Stenvinkel
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Karolina Kublickiene
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | | |
Collapse
|
10
|
Gómez-Sánchez L, Gómez-Sánchez M, Rodríguez-Sánchez E, Patino-Alonso C, Alonso-Dominguez R, Sanchez-Aguadero N, Lugones-Sánchez C, Llamas-Ramos I, García-Ortiz L, Gómez-Marcos MA. Relationship of Different Anthropometric Indices with Vascular Ageing in an Adult Population without Cardiovascular Disease-EVA Study. J Clin Med 2022; 11:jcm11092671. [PMID: 35566797 PMCID: PMC9105296 DOI: 10.3390/jcm11092671] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/04/2022] [Accepted: 05/06/2022] [Indexed: 02/01/2023] Open
Abstract
The objectives of this study were to analyse the capacity of different anthropometric indices to predict vascular ageing and this association in Spanish adult population without cardiovascular disease. A total of 501 individuals without cardiovascular disease residing in the capital of Salamanca (Spain) were selected (mean age: 55.9 years, 50.3% women), through stratified random sampling by age and sex. Starting from anthropometric measurements such as weight, height, and waist circumference, hip circumference, or biochemical parameters, we could estimate different indices that reflected general obesity, abdominal obesity, and body fat distribution. Arterial stiffness was evaluated by measuring carotid-femoral pulse wave velocity (cf-PWV) using a SphygmoCor® device. Vascular ageing was defined in three steps: Step 1: the participants with vascular injury were classified as early vascular ageing (EVA); Step 2: classification of the participants using the 10 and 90 percentiles of cf-PWV in the study population by age and sex in EVA, healthy vascular ageing (HVA) and normal vascular ageing (NVA); Step 3: re-classification of participants with arterial hypertension or type 2 diabetes mellitus included in HVA as NVA. The total prevalence of HVA and EVA was 8.4% and 21.4%, respectively. All the analysed anthropometric indices, except waist/hip ratio (WHpR), were associated with vascular ageing. Thus, as the values of the different anthropometric indices increase, the probability of being classified with NVA and as EVA increases. The capacity of the anthropometric indices to identify people with HVA showed values of area under the curve (AUC) ≥ 0.60. The capacity to identify people with EVA, in total, showed values of AUC between 0.55 and 0.60. In conclusion, as the values of the anthropometric indices increased, the probability that the subjects presented EVA increased. However, the relationship of the new anthropometric indices with vascular ageing was not stronger than that of traditional parameters. Therefore, BMI and WC can be considered to be the most useful indices in clinical practice to identify people with vascular ageing in the general population.
Collapse
Affiliation(s)
- Leticia Gómez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Marta Gómez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Department of Medicine, University of Salamanca, 37008 Salamanca, Spain
| | - Carmen Patino-Alonso
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Statistics Department, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Rosario Alonso-Dominguez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, 37008 Salamanca, Spain
| | - Natalia Sanchez-Aguadero
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, 37008 Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Ines Llamas-Ramos
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, 37008 Salamanca, Spain
| | - Luis García-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37008 Salamanca, Spain
| | - Manuel A. Gómez-Marcos
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Department of Medicine, University of Salamanca, 37008 Salamanca, Spain
- Correspondence: ; Tel.: +34-923-124465
| | | |
Collapse
|
11
|
Shen X, Dong N, Xu Y, Han L, Yang R, Liao J, Zhang X, Xie T, Wang Y, Chen C, Liu M, Jiang Y, Yu L, Fang Q. Analyzing Corin–BNP–NEP Protein Pathway Revealing Differential Mechanisms in AF-Related Ischemic Stroke and No AF-Related Ischemic Stroke. Front Aging Neurosci 2022; 14:863489. [PMID: 35615592 PMCID: PMC9125077 DOI: 10.3389/fnagi.2022.863489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background The incidence of atrial fibrillation (AF)-related stroke increases with aging. Natriuretic peptides (NPs) family, including Corin-B type natriuretic peptide (BNP)-neprilysin (NEP) protein levels increased with age and are risk markers of cardiovascular and cerebrovascular diseases, such as AF and cardioembolic stroke. Aging is also linked to epigenetics, specifically DNA methylation. However, only a few studies have investigated the effect of DNA methylation on the NP system. Thus, the present study aimed to investigate whether the Corin-BNP-NEP protein pathway is involved in the pathogenesis of AF-stroke and CpG methylation in the promoter region of the Corin protein gene has an effect on AF-related ischemic stroke. Methods A total of 82 patients hospitalized with acute ischemic strokes were enrolled in this study. The differences in clinical information were compared between the AF-stroke (n = 37) and no AF-stroke groups (n = 45). Plasma-soluble Corin and NEP were detected using an ELISA kit. CpG methylation in the promoter region of the gene was assessed by a next-generation sequencing-based bisulfite sequencing polymerase chain reaction (BSP). Results (1) Patients in AF-stroke were older, had higher initial NIHSS score, 90-day mRs, higher D2-dimer, INR, and APTT, and low TG, TC, and HbA1c (all p < 0.05). (2) Serum levels of Corin and BNP in the AF-stroke group were significantly higher than that in the no AF-stroke group (p < 0.05). No significant difference was detected in the serum levels of NEP between the two groups. (3) The levels of CpG methylation in the promoter region of the Corin protein gene in the AF-stroke group was significantly lower than that in the no AF-stroke group (p < 0.05). The CpG sites with maximal methylation differences between the two groups were CORIN:678, CORIN:682, CORIN:694, and CORIN:700. Conclusion The current findings raise the possibility that the Corin–BNP–NEP protein pathway may be involved in the pathogenesis of AF-related ischemic stroke. Deficient CpG methylation in the promoter region of the Corin protein gene is associated with AF-related ischemic stroke.
Collapse
Affiliation(s)
- Xiaozhu Shen
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Department of Geriatrics, Lianyungang Second People’s Hospital, Lianyungang, China
| | - Nan Dong
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Department of Neurology, Suzhou Industrial Park Xinghai Hospital, Suzhou, China
| | - Yiwen Xu
- Department of General Medicine, Lianyungang Hospital, Affiliated to Jiangsu University (Lianyungang Second People’s Hospital), Lianyungang, China
- *Correspondence: Yiwen Xu,
| | - Lin Han
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Rui Yang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Juan Liao
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xianxian Zhang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Tao Xie
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yugang Wang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Chen Chen
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Mengqian Liu
- Department of General Medicine, Lianyungang Hospital, Affiliated to Jiangsu University (Lianyungang Second People’s Hospital), Lianyungang, China
| | - Yi Jiang
- Bengbu Medical College, Bengbu, China
| | - Liqiang Yu
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qi Fang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Qi Fang,
| |
Collapse
|
12
|
Llamas-Ramos I, Llamas-Ramos R, Alonso-Domínguez R, Gómez-Sánchez L, Tamayo-Morales O, Lugones-Sánchez C, Rodríguez-Sánchez E, García-Ortiz L, Gómez-Marcos MA. Sedentary Behaviour and Its Relationship with Early Vascular Ageing in the General Spanish Population: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095450. [PMID: 35564843 PMCID: PMC9101612 DOI: 10.3390/ijerph19095450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 12/04/2022]
Abstract
Sedentary behaviour is associated with a greater predisposition to developing cardiovascular diseases. The aim of the study was to analyse the relationship between sedentary time and early vascular ageing. A total of 501 participants (49.70% men) were recruited through random sampling stratified by age group and sex. Vascular ageing was evaluated considering three criteria: (1) the vascular ageing index (VAI); (2) the carotid−femoral pulse wave velocity (cfPWV) 10th and 90th percentiles of the reference values in the European population by age; and (3) the Framingham’s heart age. The carotid intima−media thickness was measured using a Sonosite Micromaxx ultrasound, the presence of peripheral artery disease was assessed by calculating the ankle−brachial index using a VaSera VS-1500, and the cfPWV was measured with a SphygmoCor® device. Weekly sedentary hours were evaluated through a sitting time questionnaire. The average age of the population was 55.90 ± 14.24 years. The men spent more hours sitting per week (47.6 ± 16.6 vs. 36.8 ± 17.3 h/W), at work (16.7 ± 16.2 vs. 9.73 ± 14.9 h/W), and watching TV (21.6 ± 12.5 vs. 18.7 ± 11.9 h/W). In the logistic regression analysis, the individuals with early vascular aging (EVA), with respect to those with healthy vascular aging (HVA), spent more hours sitting per week (OR = 1.03 vs. OR = 1.02; p < 0.05) and watching TV (OR = 1.03 vs. OR = 1.03; p < 0.05), using the criteria of the European guideline and VAI, and more hours sitting when commuting (OR = 1.04; p < 0.05), using Framingham’s heart age to define EVA. The results of this study indicate that sedentary time is associated with early vascular ageing. Therefore, reducing sedentary time would improve vascular health.
Collapse
Affiliation(s)
- Inés Llamas-Ramos
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Department of Nursing and Physiotherapy, Universidad de Salamanca, 37007 Salamanca, Spain
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- University Hospital of Salamanca, 37007 Salamanca, Spain
- Correspondence: ; Tel.: +34-663005052
| | - Rocío Llamas-Ramos
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Department of Nursing and Physiotherapy, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Rosario Alonso-Domínguez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Department of Nursing and Physiotherapy, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Leticia Gómez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
| | - Olaya Tamayo-Morales
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
| | - Cristina Lugones-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
| | - Emiliano Rodríguez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- Department of Medicine, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Luis García-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Manuel A. Gómez-Marcos
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- Department of Medicine, Universidad de Salamanca, 37007 Salamanca, Spain
| |
Collapse
|
13
|
Hong L, Shen X, Shi Q, Song X, Chen L, Chen W, Chen S, Xue Y, Zhang C, Zhou J. Association Between Hypernatremia and Delirium After Cardiac Surgery: A Nested Case-Control Study. Front Cardiovasc Med 2022; 9:828015. [PMID: 35355967 PMCID: PMC8959150 DOI: 10.3389/fcvm.2022.828015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
Background The association between hypernatremia and delirium after cardiac surgery has rarely been investigated. This study aimed to determine whether hypernatremia increases the risk of delirium after exposure. Materials and Methods From April 2016 to June 2021, 7,831 consecutive patients receiving cardiac surgery were screened for potential enrollment. The primary outcome was postoperative delirium (POD). For the respective case of delirium, 10 controls were matched according to the index date within the nested case-control design. Hypernatremia exposure was defined as serum sodium > 145 mmol/L within 7 days before the index date. A generalized estimation equation was performed to assess excess risks for POD associated with hypernatremia, adjusted for demographics and clinical variables. Results About 7,277 patients were included in the final analyses. About 669 (9.2%) patients with POD were assigned to the case group, and 6,690 controls were identified from the whole population. About 66.5% of the cases and 36.3% of the controls had hypernatremia exposure. After being adjusted to certain well-recognized confounding factors, hypernatremia showed a significant correlation with increased risk of delirium after cardiac surgery (adjusted OR, 1.73; 95% CI, 1.41~2.12). An e-value analysis suggested the robustness to unmeasured confounding. Conclusions Hypernatremia was associated with an increased risk of delirium after cardiac surgery. This finding could have implications for risk stratification, early detection, and management of delirium in patients receiving cardiac surgery.
Collapse
Affiliation(s)
- Liang Hong
- Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xiao Shen
- Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Qiankun Shi
- Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xiaochun Song
- Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Lihai Chen
- Department of Anesthesia, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Wenxiu Chen
- Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Shangyu Chen
- Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yingyin Xue
- Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Cui Zhang
- Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
- *Correspondence: Cui Zhang
| | - Jifang Zhou
- School of International Business, China Pharmaceutical University, Nanjing, China
- Jifang Zhou
| |
Collapse
|
14
|
Vecsey-Nagy M, Szilveszter B, Kolossváry M, Boussoussou M, Vattay B, Merkely B, Maurovich-Horvat P, Radovits T, Nemcsik J. Correlation between Coronary Artery Calcium- and Different Cardiovascular Risk Score-Based Methods for the Estimation of Vascular Age in Caucasian Patients. J Clin Med 2022; 11:jcm11041111. [PMID: 35207388 PMCID: PMC8877766 DOI: 10.3390/jcm11041111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 02/04/2023] Open
Abstract
Vascular age can be derived from cardiovascular (CV) risk scores such as the Framingham Risk Score (FRS) and the Systematic Coronary Risk Evaluation (SCORE). Recently, coronary artery calcium score (CACS) was proposed as a means of assessing arterial age. We aimed to compare these approaches for the assessment of vascular age. FRS-, SCORE-, and CACS-based vascular ages of 241 consecutive Caucasian patients undergoing coronary CT angiography were defined according to previously published methods. Vascular ages based on FRS, SCORE, and CACS were 68.0 (IQR: 55.0–82.0), 63.0 (IQR: 53.0–75.0), and 47.1 (IQR: 39.1–72.3) years, respectively, (p < 0.001). FRS- and SCORE-based biological age showed strong correlation [ICC: 0.91 (95%CI: 0.88–0.93)], while CACS-based vascular age moderately correlated with FRS- and SCORE-based vascular age [ICC: 0.66 (95%CI: 0.56–0.73) and ICC: 0.65 (95%CI: 0.56–0.73), respectively, both p < 0.001)]. Based on FRS, SCORE, and CACS, 83.4%, 93.8%, and 42.3% of the subjects had higher vascular age than their documented chronological age (FRS+, SCORE+, CACS+), and 53.2% of the FRS+ (107/201) and 57.1% of the SCORE+ (129/226) groups were classified as CACS-. Traditional risk equations demonstrate a tendency of overestimating vascular age in low- to intermediate-risk patients compared to CACS. Prospective studies are warranted to further evaluate the contribution of different vascular age calculations to CV preventive strategies.
Collapse
Affiliation(s)
- Milán Vecsey-Nagy
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (B.S.); (M.K.); (M.B.); (B.V.); (P.M.-H.)
- Correspondence:
| | - Bálint Szilveszter
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (B.S.); (M.K.); (M.B.); (B.V.); (P.M.-H.)
| | - Márton Kolossváry
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (B.S.); (M.K.); (M.B.); (B.V.); (P.M.-H.)
| | - Melinda Boussoussou
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (B.S.); (M.K.); (M.B.); (B.V.); (P.M.-H.)
| | - Borbála Vattay
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (B.S.); (M.K.); (M.B.); (B.V.); (P.M.-H.)
| | - Béla Merkely
- Cardiology Department, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (B.M.); (T.R.)
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (B.S.); (M.K.); (M.B.); (B.V.); (P.M.-H.)
- Medical Imaging Centre, Semmelweis University, 1082 Budapest, Hungary
| | - Tamás Radovits
- Cardiology Department, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (B.M.); (T.R.)
| | - János Nemcsik
- Department of Family Medicine, Semmelweis University, 1085 Budapest, Hungary;
- Health Service of Zugló (ZESZ), 1148 Budapest, Hungary
| |
Collapse
|
15
|
Predictive Ability of Machine-Learning Methods for Vitamin D Deficiency Prediction by Anthropometric Parameters. MATHEMATICS 2022. [DOI: 10.3390/math10040616] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Background: Vitamin D deficiency affects the general population and is very common among elderly Europeans. This study compared different supervised learning algorithms in a cohort of Spanish individuals aged 35–75 years to predict which anthropometric parameter was most strongly associated with vitamin D deficiency. Methods: A total of 501 participants were recruited by simple random sampling with replacement (reference population: 43,946). The analyzed anthropometric parameters were waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), body roundness index (BRI), visceral adiposity index (VAI), and the Clinical University of Navarra body adiposity estimator (CUN-BAE) for body fat percentage. Results: All the anthropometric indices were associated, in males, with vitamin D deficiency (p < 0.01 for the entire sample) after controlling for possible confounding factors, except for CUN-BAE, which was the only parameter that showed a correlation in females. Conclusions: The capacity of anthropometric parameters to predict vitamin D deficiency differed according to sex; thus, WC, BMI, WHtR, VAI, and BRI were most useful for prediction in males, while CUN-BAE was more useful in females. The naïve Bayes approach for machine learning showed the best area under the curve with WC, BMI, WHtR, and BRI, while the logistic regression model did so in VAI and CUN-BAE.
Collapse
|
16
|
Gómez-Sánchez L, Gómez-Sánchez M, Patino-Alonso C, Recio-Rodríguez JI, González-Sánchez J, Agudo-Conde C, Maderuelo-Fernández JA, Rodríguez-Sánchez E, García-Ortiz L, Gómez-Marcos MA. Retinal blood vessel calibre and vascular ageing in a general Spanish population: A EVA study. Eur J Clin Invest 2022; 52:e13684. [PMID: 34582566 DOI: 10.1111/eci.13684] [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: 07/03/2021] [Revised: 08/10/2021] [Accepted: 09/21/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of this work was to analyse the association of the retinal arteriolar calibre and the arteriole/venule index (AV index) with vascular ageing in a general population without previous cardiovascular disease. MATERIALS AND METHODS Descriptive cross-sectional study. A total of 482 individuals without cardiovascular disease (mean age: 55.6 ± 14.2 years) were selected by random sampling, stratified by age and sex. The retinal arteriolar calibre was measured using digital fundus images of the back of the eye captured with a validated, semiautomatized and computer-assisted software (Index calculator). Vascular ageing was defined using three criteria based on the values of: (1) Carotid-femoral Pulse Wave Velocity (cfPWV), (2) Brachial-ankle Pulse Wave Velocity (baPWV) and (3) Carotid Intima-Media Thickness. RESULTS The AV index and arteriolar calibre show a negative correlation with age, arterial pressure, cardiovascular risk and parameters of vascular structure and function (p < 0.001 in all cases). We found lower mean values of the AV index and arteriolar calibre in the individuals with early vascular ageing compared to those with healthy vascular ageing. AV index was negatively correlated with cfPWV ((β=-2.9; 95% CI (-4.7; -1.1)), baPWV ((β=-3.2; 95% CI (-5.4; -0.9)) and vascular ageing index ((β=-1.7; 95% CI (-2.7; -0.7)). Arteriolar calibre showed a negative correlation with baPWV (β=-0.1; 95% CI (-0.2; -0.1)). In the logistic regression analysis, lower values of AV index ((OR=0.01; 95% CI (0.01-0.10), OR=0.03; 95% CI (0.01-0.11) and OR=0.09; 95% CI (0.01-0.67)) were associated with EVA defined with cfPWV, baPWV and vascular ageing index respectively, and lower values of arteriolar calibre ((OR=0.71; 95% CI (0.55-0.91)) were associated with EVA defined with vascular ageing index. CONCLUSIONS Lower values of AV index and retinal arteriolar calibre were associated with vascular ageing in a general Spanish population without previous cardiovascular disease.
Collapse
Affiliation(s)
- Leticia Gómez-Sánchez
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de investigación Biomédica de Salamanca (IBSAL), Salamanca, España
| | - Marta Gómez-Sánchez
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de investigación Biomédica de Salamanca (IBSAL), Salamanca, España
| | - Carmen Patino-Alonso
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de investigación Biomédica de Salamanca (IBSAL), Salamanca, España.,Departamento de Estadística, Universidad de Salamanca, Calle Alfonso X el Sabio s/n, Salamanca, España
| | - Jose I Recio-Rodríguez
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de investigación Biomédica de Salamanca (IBSAL), Salamanca, España.,Departamento de Enfermería y Fisioterapia, Universidad de Salamanca, Calle Donantes de Sangre, s/n, Salamanca, España
| | - Jesús González-Sánchez
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de investigación Biomédica de Salamanca (IBSAL), Salamanca, España.,Departamento de Enfermería y Fisioterapia, Universidad de Salamanca, Calle Donantes de Sangre, s/n, Salamanca, España
| | - Cristina Agudo-Conde
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de investigación Biomédica de Salamanca (IBSAL), Salamanca, España.,GERENCIA de Atención Primaria de Salamanca, Gerencia Regional de salud de Castilla y León (SACyL), Salamanca, España
| | - José A Maderuelo-Fernández
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de investigación Biomédica de Salamanca (IBSAL), Salamanca, España.,GERENCIA de Atención Primaria de Salamanca, Gerencia Regional de salud de Castilla y León (SACyL), Salamanca, España
| | - Emiliano Rodríguez-Sánchez
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de investigación Biomédica de Salamanca (IBSAL), Salamanca, España.,GERENCIA de Atención Primaria de Salamanca, Gerencia Regional de salud de Castilla y León (SACyL), Salamanca, España.,Departamento de Medicina, Universidad de Salamanca, Calle Alfonso X el Sabio s/n, Salamanca, España
| | - Luis García-Ortiz
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de investigación Biomédica de Salamanca (IBSAL), Salamanca, España.,GERENCIA de Atención Primaria de Salamanca, Gerencia Regional de salud de Castilla y León (SACyL), Salamanca, España.,Departamento de Ciencias Biomédicas y del Diagnóstico, Universidad de Salamanca, Calle Alfonso X el Sabio s/n, Salamanca, España
| | - Manuel A Gómez-Marcos
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de investigación Biomédica de Salamanca (IBSAL), Salamanca, España.,GERENCIA de Atención Primaria de Salamanca, Gerencia Regional de salud de Castilla y León (SACyL), Salamanca, España.,Departamento de Medicina, Universidad de Salamanca, Calle Alfonso X el Sabio s/n, Salamanca, España
| | | |
Collapse
|
17
|
Gómez-Sánchez L, Gómez-Sánchez M, Lugones-Sánchez C, Tamayo-Morales O, González-Sánchez S, Rodríguez-Sánchez E, García-Ortiz L, Gómez-Marcos MA. Association of Insulin Resistance with Vascular Ageing in a General Caucasian Population: An EVA Study. J Clin Med 2021; 10:jcm10245748. [PMID: 34945044 PMCID: PMC8707603 DOI: 10.3390/jcm10245748] [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: 11/22/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022] Open
Abstract
The data on the relationship between insulin resistance and vascular ageing are limited. The aim of this study was to explore the association of different indices of insulin resistance with vascular ageing in an adult Caucasian population without cardiovascular disease. We selected 501 individuals without cardiovascular disease (mean age: 55.9 years, 50.3% women) through random sampling stratified by sex and age. Arterial stiffness was evaluated by measuring the carotid-to-femoral pulse wave velocity (cfPWV) and brachial-to-ankle pulse wave velocity (baPWV). The participants were classified into three groups according to the degree of vascular ageing: early vascular ageing (EVA), normal vascular ageing (NVA) and healthy vascular ageing (HVA). Insulin resistance was evaluated with the homeostatic model assessment of insulin resistance (HOMA-IR) and another five indices. The prevalence of HVA and EVA was 8.4% and 21.4%, respectively, when using cfPWV, and 7.4% and 19.2%, respectively, when using baPWV. The deterioration of vascular ageing, with both measurements, presented as an increase in all the analysed indices of insulin resistance. In the multiple regression analysis and logistic regression analysis, the indices of insulin resistance showed a positive association with cfPWV and baPWV and with EVA.
Collapse
Affiliation(s)
- Leticia Gómez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (C.L.-S.); (O.T.-M.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Marta Gómez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (C.L.-S.); (O.T.-M.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (C.L.-S.); (O.T.-M.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Olaya Tamayo-Morales
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (C.L.-S.); (O.T.-M.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Susana González-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (C.L.-S.); (O.T.-M.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (C.L.-S.); (O.T.-M.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Luis García-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (C.L.-S.); (O.T.-M.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Manuel A. Gómez-Marcos
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (C.L.-S.); (O.T.-M.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain
- Correspondence: ; Tel.: +34-923-124465
| | | |
Collapse
|
18
|
Alonso-Domínguez R, Sánchez-Aguadero N, Patino-Alonso MC, Agudo-Conde C, de Cabo-Laso Á, Gómez-Sánchez M, Gómez-Sánchez L, Rodríguez-Sánchez E, García-Ortiz L, Gómez-Marcos MA. Association between measurements of arterial stiffness and target organ damage in a general Spanish population. Ann Med 2021; 53:345-356. [PMID: 33533280 PMCID: PMC7877984 DOI: 10.1080/07853890.2021.1881812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 01/21/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Little is known about the relationship between arterial stiffness and cardiovascular target organ damage (TOD) in the general population. The aim was to analyse the relationship between different measurements of arterial stiffness and TOD, in a general Spanish population without a history of cardiovascular event. MATERIALS AND METHODS Transversal descriptive study. Through stratified random sampling, a total of 501 individuals were included. Carotid-femoral pulse wave velocity (cf-PWV) was measured using a SphygmoCor System®, the cardio-ankle vascular index (CAVI) was determined with aVasera VS-1500® and brachial-ankle pulse wave velocity (ba-PWV)was calculated through a validated equation. RESULTS The average age was 55.84 ± 14.26.The percentage of vascular TOD, left ventricular hypertrophy (LVH) and renal TOD was higher in men (p < .001). A positive correlation was obtained between carotid intima-media thickness (c-IMT) and the measurements of vascular function. In the model 1 of the logistic regression analysis, cf-PWV was associated with vascular TOD (OR = 1.15, p = .040), ba-PWV was associated with vascular TOD (OR = 1.20, p = .010) and LVH (OR = 1.12, p = .047). CONCLUSIONS The different measurements of arterial stiffness are highly associated with each other. Moreover, cf-PWV and ba-PWV were associated with vascular TOD, and ba-PWV with LVH, although they disappear when adjusting for cardiovascular risk factors. Key Messages There is a strong correlation between the different measurements of vascular structure and function. Carotid-femoral and brachial-ankle pulse wave velocity were positively associated with vascular target organ damage, the latter was also positively associated with left ventricular hypertrophy. This associations disappear when adjusting for cardiovascular risk factors.
Collapse
Affiliation(s)
- Rosario Alonso-Domínguez
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - Natalia Sánchez-Aguadero
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - María C. Patino-Alonso
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Department of Statistics, University of Salamanca, Salamanca, Spain
| | - Cristina Agudo-Conde
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
| | - Ángela de Cabo-Laso
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
| | - Marta Gómez-Sánchez
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
| | - Leticia Gómez-Sánchez
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Portugal and Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Luis García-Ortiz
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Portugal and Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Manuel A. Gómez-Marcos
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Portugal and Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | | |
Collapse
|
19
|
Gómez-Sánchez M, Gómez-Sánchez L, Patino-Alonso C, Recio-Rodríguez JI, Alonso-Domínguez R, Sánchez-Aguadero N, Sánchez CL, Sánchez ER, García-Ortiz L, Gomez-Marcos MA. Reference values of central blood pressure and central haemodynamic parameters and their relationship with cardiovascular risk factors in a Spanish population: early vascular ageing study. J Hypertens 2021; 39:2147-2156. [PMID: 34343142 DOI: 10.1097/hjh.0000000000002916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Central blood pressure (BP) predicts mortality independent of office brachial BP. The aim was to describe reference values for central blood pressure and pulsatile hemodynamic parameters, and their relationship with cardiovascular risk factors in an adult Spanish population without cardiovascular disease. METHODS Cross-sectional study. We included 501 participants stratified by age and sex by random sampling, with a mean age of 56 years (50.3% women). The SphygmoCor System device's pulse wave analysis software was used to perform the measurements. RESULTS The following values were obtained: central blood pressure median (109/76 mmHg), central pulse pressure (33 mmHg), pulse pressure amplification (8.5 mmHg), ejection duration (130 ms) and subendocardial viability ratio (163%). All parameters were greater in men, except heart rate and ejection duration. In the logistic regression analysis, controlled for age, sex and taking antihypertensive drugs, being hypertensive was associated with cSBP (OR = 1.265), cDBP (OR = 1.307), cPP (OR = 1.067), pulse wave amplification (OR = 1.034) and SEVR (OR = 0.982); being diabetic was associated with SEVR (OR = 0.982); being obese was associated with cSBP (OR = 1.028) and cDBP (OR = 1.058) and being a smoker was associated with ejection duration (OR = 0.980) and SEVR (OR = 0.984). CONCLUSION This study provides reference values for central blood pressure and parameters derived from the pulse wave analysis in a random sample of the Spanish population. The only risk factor that is not associated with any of the parameters analysed is dyslipidaemia. TRIAL REGISTRATION NUMBER https://clinicaltrials.gov/ct2/show/NCT02623894.
Collapse
Affiliation(s)
- Marta Gómez-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
| | - Leticia Gómez-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
| | - Carmen Patino-Alonso
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
- Departamento de estadística
| | - Jose I Recio-Rodríguez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
- Departamento de enfermería y fisioterapia, Universidad de Salamanca (USAL)
| | - Rosario Alonso-Domínguez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
- Departamento de enfermería y fisioterapia, Universidad de Salamanca (USAL)
| | - Natalia Sánchez-Aguadero
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
- Departamento de enfermería y fisioterapia, Universidad de Salamanca (USAL)
| | - Cristina Lugones Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
| | - Emiliano Rodríguez Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
- Servicio de Salud de Castilla y León (SACyL)
- Departamento de Medicina
| | - Luis García-Ortiz
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
- Servicio de Salud de Castilla y León (SACyL)
- Departamento de biomedicina y diagnóstico de la ciencia, Universidad de Salamanca, Salamanca, Spain
| | - Manuel A Gomez-Marcos
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
- Servicio de Salud de Castilla y León (SACyL)
- Departamento de Medicina
| |
Collapse
|
20
|
Relación del envejecimiento vascular saludable con los estilos de vida y el síndrome metabólico en población general española. Estudio EVA. Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.06.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
21
|
Gómez-Sánchez M, Gómez-Sánchez L, Patino-Alonso MC, Alonso-Domínguez R, Sánchez-Aguadero N, Recio-Rodríguez JI, González-Sánchez J, García-Ortiz L, Gómez-Marcos MA. Relationship of healthy vascular aging with lifestyle and metabolic syndrome in the general Spanish population. The EVA study. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2021; 74:854-861. [PMID: 33132098 DOI: 10.1016/j.rec.2020.06.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 06/29/2020] [Indexed: 12/30/2022]
Abstract
INTRODUCTION AND OBJECTIVES Our objective was to study the relationship of healthy vascular aging (HVA) with lifestyle and the components of metabolic syndrome. We also analyzed the differences between chronological age and heart age (HA) and vascular age (VA) in the Spanish adult population without cardiovascular disease. METHODS This descriptive cross-sectional study selected 501 individuals without cardiovascular disease (mean age, 55.9 years; 50.3% women) via random sampling stratified by age and sex. HA was estimated with the Framingham equation, whereas VA was estimated with the VaSera VS-1500 device. HVA was defined as a <5-year difference between the chronological age and the HA or VA and the absence of a vascular lesion, hypertension, and diabetes mellitus. RESULTS Compared with the chronological age, the mean HA and VA were 2.98±10.13 and 3.08±10.15 years lower, respectively. Smoking (OR, 0.23), blood pressure ≥ 130/85mmHg (OR, 0.11), altered baseline blood glucose (OR, 0.45), abdominal obesity (OR, 0.58), triglycerides ≥ 150mg/dL (OR, 0.17), and metabolic syndrome (OR, 0.13) decreased the probability of HVA estimated by HA; an active lifestyle (OR, 1.84) and elevated high-density lipoprotein-cholesterol (OR, 3.26) increased the probability of HVA estimated by HA. Smoking (OR, 0.45), blood pressure ≥ 130/85mmHg (OR, 0.26), altered baseline blood glucose (OR, 0.42), and metabolic syndrome (OR, 0.40) decreased the probability of HVA estimated by VA; abdominal obesity (OR, 1.81) had the opposite effect. CONCLUSIONS HA and VA were 3 years lower than the chronological age. HA was associated with tobacco consumption, physical activity, and the components of metabolic syndrome. Meanwhile, VA was associated with tobacco consumption, blood pressure, waist circumference, and altered baseline glycemia. CLINICAL TRIAL REGISTRATION http://www.clinicaltrials.gov. Identifier: NCT02623894.
Collapse
Affiliation(s)
- Marta Gómez-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Leticia Gómez-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - M Carmen Patino-Alonso
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Departamento de Estadística, Universidad de Salamanca (USAL), Salamanca, Spain
| | - Rosario Alonso-Domínguez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Natalia Sánchez-Aguadero
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Departamento de Enfermería y Fisioterapia, Universidad de Salamanca (USAL), Salamanca, Spain
| | - José I Recio-Rodríguez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Departamento de Enfermería y Fisioterapia, Universidad de Salamanca (USAL), Salamanca, Spain
| | - Jesús González-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Departamento de Enfermería y Fisioterapia, Universidad de Salamanca (USAL), Salamanca, Spain
| | - Luis García-Ortiz
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Departamento de Ciencias Biomédicas y del Diagnóstico, Universidad de Salamanca, Salamanca, Spain; Servicio de Salud de Castilla y León (SACyL), Salamanca, Spain
| | - Manuel A Gómez-Marcos
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Servicio de Salud de Castilla y León (SACyL), Salamanca, Spain; Departamento de Medicina, Universidad de Salamanca, Salamanca, Spain.
| | | |
Collapse
|
22
|
The association between accelerated vascular aging and cyclothymic affective temperament in women. J Psychosom Res 2021; 145:110423. [PMID: 33773765 DOI: 10.1016/j.jpsychores.2021.110423] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/25/2021] [Accepted: 03/13/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Affective temperaments (depressive, anxious, irritable, hyperthymic, cyclothymic) are regarded as the biologically stable core of personality. Accumulating data suggest their relationship with cardiovascular diseases. However, there are currently limited data on the association of affective temperaments and accelerated vascular aging. The aim of our study was to evaluate the relationship between affective temperaments and vascular age, as assessed by coronary artery calcium scoring (CACS). METHODS In our cross-sectional study, 209 consecutive patients referred to coronary computed tomography angiography (CCTA) due to suspected coronary artery disease (CAD) were included. All patients completed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) and the Beck Depression Inventory (BDI). Vascular age was estimated using CACS and its difference from chronological age for each patient was calculated. Linear regression analysis was used to identify predictors of accelerated vascular aging in the entire cohort and in male and female sub-populations. RESULTS Besides traditional risk factors, cyclothymic temperament score proved to be an independent predictor of accelerated vascular aging in women (β = 0.89 [95%CI: 0.04-1.75]), while this association was absent in men. CONCLUSIONS Our results suggest that cyclothymic affective temperament is associated with accelerated vascular aging in women. Assessment of affective temperaments may potentiate more precise cardiovascular risk stratification of patients.
Collapse
|
23
|
Vascular aging and its relationship with lifestyles and other risk factors in the general Spanish population: Early Vascular Ageing Study. J Hypertens 2021; 38:1110-1122. [PMID: 32371801 DOI: 10.1097/hjh.0000000000002373] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To describe the prevalence of healthy vascular aging (HVA), normal vascular aging and early vascular aging (EVA) in a sample of Spanish population without cardiovascular disease. The relationship of vascular aging with lifestyle, cardiovascular risk factors, psychological and inflammatory risk factors is also analyzed. METHODS A total of 501 participants were recruited (49.70% men, aged 55.90 ± 14.24 years) by random sampling. Vascular aging was defined in three steps: Step 1: participants with vascular damage in carotid arteries or peripheral artery disease were classified as EVA. Step 2: with the percentiles of carotid-to-femoral pulse wave velocity (cfPWV) we used three criteria, first, the 10th and 90th cfPWV percentiles of the population studied by age and sex; second, the 10th and 90th percentiles of the European population reference values and third, the 25th and 75th cfPWV percentiles of the population studied by age and sex. Step 3: participants with hypertension or type 2 diabetes mellitus included in HVA were reclassified as normal vascular aging. Arterial stiffness was assessed with cfPWV using a Sphygmocor device. Physical activity was measured with an accelerometer. Psychological factors, lifestyle and other clinical information were obtained by standard questionnaire. RESULTS The global prevalence of HVA was 8 and 14% (men 8 and 10%, women 9 and 18%), and 22 and 18% (men 26 and 23%, women 17 and 12%) for EVA, using criteria a and b, respectively. In the logistic regression analysis, vascular aging maintains positive associations with more sedentary time [odds ratio (OR) = 2.37 and 4.51], having triglycerides above 150 mg/dl (OR = 6.55 and 4.06), abdominal obesity (OR = 2.73 and 2.90), increased uric acid (OR = 4.63 and 2.98) and insulin resistance index homeostatic model assessment (OR = 4.05 and 6.78), and a negative association with less physical activity (OR = 0.29 and 0.28) using criteria a and b, respectively. CONCLUSION One in 10 has HVA and one in five EVA. The prevalence of EVA is higher in men. Study results suggest that preventive strategies aimed at increasing physical activity, reducing sedentary time and decreasing obesity and insulin resistance improve vascular aging.
Collapse
|
24
|
Salvado R, Santos-Minguez S, Agudo-Conde C, Lugones-Sanchez C, Cabo-Laso A, Mª Hernandez-Sanchez J, Benito R, Rodriguez-Sanchez E, Gomez-Marcos MA, Hernandez-Rivas JM, Guimarães Cunha P, Garcia-Ortiz L, Investigators M. Gut microbiota composition and arterial stiffness measured by pulse wave velocity: case-control study protocol (MIVAS study). BMJ Open 2021; 11:e038933. [PMID: 33574140 PMCID: PMC7880115 DOI: 10.1136/bmjopen-2020-038933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Intestinal microbiota is arising as a new element in the physiopathology of cardiovascular diseases. A healthy microbiota includes a balanced representation of bacteria with health promotion functions (symbiotes). The aim of this study is to analyse the relationship between intestinal microbiota composition and arterial stiffness. METHODS AND ANALYSIS An observational case-control study will be developed. Cases will be defined by the presence of at least one of the following: carotid-femoral pulse wave velocity (cf-PWV), Cardio-Ankle Vascular Index (CAVI), brachial ankle pulse wave velocity (ba or ba-PWV) above the 90th percentile, for age and sex, of the reference population. Controls will be selected from the same population as cases. The study will be developed in Primary Healthcare Centres. We will select 500 subjects (250 cases and 250 controls), between 45 and 74 years of age. Cases will be selected from a database that combines data from EVA study (Spain) and Guimarães/Vizela study (Portugal). MEASUREMENTS cf-PWV will be measured using the SphygmoCor system, CAVI, ba-PWV and Ankle-Brachial Index will be determined using VaSera device. Gut microbiome composition in faecal samples will be determined by 16S ribosomal RNA sequencing. Lifestyle will be assessed by food frequency questionnaire, adherence to the Mediterranean diet and IPAQ (International Physical Activity Questionnaire). Body composition will be evaluated by bioimpedance. ETHICS AND DISSEMINATION The study has been approved by 'Committee of ethics of research with medicines of the health area of Salamanca' on 14 December 2018 (cod. 2018-11-136) and the 'Ethics committee for health of Guimaraes' (Portugal) on 15 October 2019 (ref: 67/2019). All study participants will sign an informed consent form agreeing to participate in the study, in compliance with the Declaration of Helsinki and the WHO standards for observational studies. The results of this study will allow a better description of gut microbiota in patients with arterial stiffness. TRIAL REGISTRATION DETAILS ClinicalTrials.gov, identifier NCT03900338.
Collapse
Affiliation(s)
- Rita Salvado
- Primary Health Care Research Unit of Salamanca (APISAL), Health Service of Castilla y León (SACyL), Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Castilla y León, Spain
| | - Sandra Santos-Minguez
- Institute of Molecular and Cellular Biology of Cancer (IBMCC), Cancer Research Institute (USAL-CSIC), Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Castilla y León, Spain
| | - Cristina Agudo-Conde
- Primary Health Care Research Unit of Salamanca (APISAL), Health Service of Castilla y León (SACyL), Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Castilla y León, Spain
| | - Cristina Lugones-Sanchez
- Primary Health Care Research Unit of Salamanca (APISAL), Health Service of Castilla y León (SACyL), Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Castilla y León, Spain
| | - Angela Cabo-Laso
- Primary Health Care Research Unit of Salamanca (APISAL), Health Service of Castilla y León (SACyL), Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Castilla y León, Spain
| | - Jesus Mª Hernandez-Sanchez
- Institute of Molecular and Cellular Biology of Cancer (IBMCC), Cancer Research Institute (USAL-CSIC), Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Castilla y León, Spain
| | - Rocio Benito
- Institute of Molecular and Cellular Biology of Cancer (IBMCC), Cancer Research Institute (USAL-CSIC), Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Castilla y León, Spain
| | - Emiliano Rodriguez-Sanchez
- Primary Health Care Research Unit of Salamanca (APISAL), Health Service of Castilla y León (SACyL), Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Castilla y León, Spain
- Departmente of Medicine, University of Salamanca, Salamanca, Castilla y León, Spain
| | - Manuel A Gomez-Marcos
- Primary Health Care Research Unit of Salamanca (APISAL), Health Service of Castilla y León (SACyL), Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Castilla y León, Spain
- Departmente of Medicine, University of Salamanca, Salamanca, Castilla y León, Spain
| | - Jesus M Hernandez-Rivas
- Institute of Molecular and Cellular Biology of Cancer (IBMCC), Cancer Research Institute (USAL-CSIC), Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Castilla y León, Spain
- Department of Medicine, Hematology, University Hospital of Salamanca, University of Salamanca, Salamanca, Castilla y León, Spain
| | - Pedro Guimarães Cunha
- Life and Health Sciences Research Institute (IICVS). School of Medicine, University of Minho, Braga, Braga, Portugal
| | - Luis Garcia-Ortiz
- Primary Health Care Research Unit of Salamanca (APISAL), Health Service of Castilla y León (SACyL), Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Castilla y León, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Castilla y León, Spain
| | - Mivas Investigators
- Iberian Network on Arterial Structure, School of Medicine, University of Minho, Braga, Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Portugal
| |
Collapse
|
25
|
García-Ortiz L, Barreiro-Perez M, Merchan-Gómez S, Ignacio Recio-Rodriguez J, Sánchez-Aguadero N, Alonso-Dominguez R, Lugones-Sanchez C, Rodríguez-Sanchez E, Sanchez PL, Gómez-Marcos MA. Prevalence of coronary atherosclerosis and reclassification of cardiovascular risk in Spanish population by coronary computed tomography angiography: EVA study. Eur J Clin Invest 2020; 50:e13272. [PMID: 32406060 DOI: 10.1111/eci.13272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/26/2020] [Accepted: 05/09/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND A more complete assessment of coronary artery disease (CAD) can be performed by coronary computed tomography angiography (CCTA). The aim was to assess the prevalence, distribution and characteristics of coronary artery disease (CAD) and the reclassification of cardiovascular risk by CCTA in an asymptomatic Spanish population. DESIGN We included, in a cross-sectional study, 501 random subjects from asymptomatic population, aged 35 and 75. Risk factors, target organ damage and cardiovascular risk were assessed. CCTA was offered to measure the coronary artery calcium score(CACS), segment involvement score(SIS) and segment stenosis score(SSS). The offer was accepted by 220 subjects (44%), with a mean age of 58 ± 14 years, 56% of them male. RESULTS The mean CACS was 119.6 ± 381.7 (median (IQR) (0 (0-61.55))), with higher scores in males (191.9 ± 493.1) than females (26.1 ± 73.3; P < .01). CCTA revealed coronary atherosclerosis in 89 cases, 40% (CI95%:34%-46%) in global, 51% in male and 25% in female, of which 13 had obstructive lesions (5.9%). Mean SIS was 1.5 ± 2.5 and SSS 1.2 ± 3.1. When the CACS was included in the CAD risk scale, there was a reclassification of 24%, and when using the SIS percentile, it was 38%, with a 9% increase in risk in both cases. CONCLUSIONS The prevalence of CAD in asymptomatic Spanish population was 40%, with greater proportion among males. The incorporation of CACS and SIS in the assessment of cardiovascular risk allows reclassifying subjects who are at low or moderate risk and thus identify those with high cardiovascular risk and also the other way.
Collapse
Affiliation(s)
- Luis García-Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Institute of Biomedical Research of Salamanca (IBSAL), Health Service of Castilla y León (SACyL), Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences, University of Salamanca (USAL), Salamanca, Spain
| | - Manuel Barreiro-Perez
- Cardiology Department, Institute of Biomedical Research of Salamanca (IBSAL), Hospital Universitario, Health Service of Castilla y León (SACyL), Salamanca, Spain
| | - Soraya Merchan-Gómez
- Cardiology Department, Institute of Biomedical Research of Salamanca (IBSAL), Hospital Universitario, Health Service of Castilla y León (SACyL), Salamanca, Spain
| | - José Ignacio Recio-Rodriguez
- Primary Care Research Unit of Salamanca (APISAL), Institute of Biomedical Research of Salamanca (IBSAL), Health Service of Castilla y León (SACyL), Salamanca, Spain.,Department of Nurse and Physiotherapy, University of Salamanca (USAL), Salamanca, Spain
| | - Natalia Sánchez-Aguadero
- Primary Care Research Unit of Salamanca (APISAL), Institute of Biomedical Research of Salamanca (IBSAL), Health Service of Castilla y León (SACyL), Salamanca, Spain.,Department of Nurse and Physiotherapy, University of Salamanca (USAL), Salamanca, Spain
| | - Rosario Alonso-Dominguez
- Primary Care Research Unit of Salamanca (APISAL), Institute of Biomedical Research of Salamanca (IBSAL), Health Service of Castilla y León (SACyL), Salamanca, Spain
| | - Cristina Lugones-Sanchez
- Primary Care Research Unit of Salamanca (APISAL), Institute of Biomedical Research of Salamanca (IBSAL), Health Service of Castilla y León (SACyL), Salamanca, Spain
| | - Emiliano Rodríguez-Sanchez
- Primary Care Research Unit of Salamanca (APISAL), Institute of Biomedical Research of Salamanca (IBSAL), Health Service of Castilla y León (SACyL), Salamanca, Spain.,Department of Medicine, University of Salamanca (USAL), Salamanca, Spain
| | - Pedro L Sanchez
- Cardiology Department, Institute of Biomedical Research of Salamanca (IBSAL), Hospital Universitario, Health Service of Castilla y León (SACyL), Salamanca, Spain.,Department of Medicine, University of Salamanca (USAL), Salamanca, Spain
| | - Manuel A Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Institute of Biomedical Research of Salamanca (IBSAL), Health Service of Castilla y León (SACyL), Salamanca, Spain.,Department of Medicine, University of Salamanca (USAL), Salamanca, Spain
| | | |
Collapse
|
26
|
Gonzalez-Sanchez J, Garcia-Ortiz L, Rodriguez-Sanchez E, Maderuelo-Fernandez JA, Tamayo-Morales O, Lugones-Sanchez C, Recio-Rodriguez JI, Gomez-Marcos MA. The Relationship Between Alcohol Consumption With Vascular Structure and Arterial Stiffness in the Spanish Population: EVA Study. Alcohol Clin Exp Res 2020; 44:1816-1824. [PMID: 32623750 DOI: 10.1111/acer.14411] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Controversy exists regarding the way alcohol use is associated with vascular structure and arterial stiffness parameters. The purpose of this study is to evaluate the association between alcohol consumption with vascular structure and arterial stiffness in an adult population. METHODS We conducted a cross-sectional study. Five hundred and one participants were recruited by random sampling from an urban population of 43,946 individuals aged 35 to 75 years, assigned from 5 healthcare centers located in Salamanca, Spain. This was a subanalysis of the EVA study. Arterial stiffness was assessed by measuring cardio-ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (ba-PWV) with the VaSera VS-1500® device, and carotid-femoral pulse wave velocity (cf-PWV) with the Sphygmocor® . Vascular structure was evaluated by measuring the carotid intima-media thickness (c-IMT) with a Sonosite Micromax® ultrasound. Alcohol consumption was calculated using a standardized questionnaire and quantified in g/wk. RESULTS In the multiple regression analysis adjusted for sex, age, smoking status, and systolic blood pressure, the c-IMT and cf-PWV values of individuals drinking > 70 g/wk were higher than those of the reference group (nondrinkers) by 0.02 mm (p = 0.030) and 0.42 m/s (p = 0.021), respectively. The association between alcohol consumption with vascular structure and arterial stiffness only attains statistical significance for cf-PWV (p = 0.039) and c-IMT (p = 0.019), showing an association which suggests a J-shaped association. This association was not statistically significant for ba-PWV and CAVI (p = 0.446 and p = 0.141, respectively), although a similar trend was observed with ba-PWV. CONCLUSIONS The results of this study suggest that heavy alcohol consumption (>70 g/wk) is associated with increased c-IMT and cf-PWV. Moreover, we found a J-shaped association between alcohol consumption and c-IMT and cf-PWV values as markers of vascular structure and arterial stiffness, with no association with ba-PWV and CAVI being observed.
Collapse
Affiliation(s)
- Jesus Gonzalez-Sanchez
- From the, Primary Care Research Unit of Salamanca (APISAL), (JG, LG, ER, JAM, OT, CL, JIR, MAG), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Department of Nursing and Physiotherapy (JG, JIR), University of Salamanca, Salamanca, Spain
| | - Luis Garcia-Ortiz
- From the, Primary Care Research Unit of Salamanca (APISAL), (JG, LG, ER, JAM, OT, CL, JIR, MAG), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences (LG), University of Salamanca, Salamanca, Spain.,Iberian Network on Arterial Structure (LG, ER, MAG), Central Hemodynamics and Neurocognition, Salamanca, Spain
| | - Emiliano Rodriguez-Sanchez
- From the, Primary Care Research Unit of Salamanca (APISAL), (JG, LG, ER, JAM, OT, CL, JIR, MAG), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Iberian Network on Arterial Structure (LG, ER, MAG), Central Hemodynamics and Neurocognition, Salamanca, Spain.,Department of Medicine (ER, MAG), University of Salamanca, Salamanca, Spain
| | - Jose A Maderuelo-Fernandez
- From the, Primary Care Research Unit of Salamanca (APISAL), (JG, LG, ER, JAM, OT, CL, JIR, MAG), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Olaya Tamayo-Morales
- From the, Primary Care Research Unit of Salamanca (APISAL), (JG, LG, ER, JAM, OT, CL, JIR, MAG), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Cristina Lugones-Sanchez
- From the, Primary Care Research Unit of Salamanca (APISAL), (JG, LG, ER, JAM, OT, CL, JIR, MAG), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Jose I Recio-Rodriguez
- From the, Primary Care Research Unit of Salamanca (APISAL), (JG, LG, ER, JAM, OT, CL, JIR, MAG), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Department of Nursing and Physiotherapy (JG, JIR), University of Salamanca, Salamanca, Spain
| | - Manuel A Gomez-Marcos
- From the, Primary Care Research Unit of Salamanca (APISAL), (JG, LG, ER, JAM, OT, CL, JIR, MAG), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Iberian Network on Arterial Structure (LG, ER, MAG), Central Hemodynamics and Neurocognition, Salamanca, Spain.,Department of Medicine (ER, MAG), University of Salamanca, Salamanca, Spain
| | | |
Collapse
|
27
|
Association of Alk1 and Endoglin Polymorphisms with Cardiovascular Damage. Sci Rep 2020; 10:9383. [PMID: 32523017 PMCID: PMC7287057 DOI: 10.1038/s41598-020-66238-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 05/14/2020] [Indexed: 01/02/2023] Open
Abstract
Cardiovascular diseases are associated to risk factors as obesity, hypertension and diabetes. The transforming growth factor-β1 receptors ALK1 and endoglin regulate blood pressure and vascular homeostasis. However, no studies relate the association of ALK1 and endoglin polymorphisms with cardiovascular risk factors. We analysed the predictive value of the ALK1 and endoglin polymorphisms on cardiovascular target organ damage in hypertensive and diabetic patients in 379 subjects with or without hypertension and diabetes in a Primary Care setting. The ALK1 rs2071219 polymorphism (AA genotype) is associated with a lower presence of diabetic retinopathy and with the absence of altered basal glycaemia. Being carrier of the ALK1 rs3847859 polymorphism (G allele) is associated with lower basal heart rate and with higher LDL-cholesterol levels. The endoglin rs3739817 polymorphism (AA genotype) is associated with higher levels of LDL-cholesterol, and being carrier of the endoglin rs10987759 polymorphism (C allele) is associated with higher haemoglobin levels and with an increased heart rate. Summarizing, several ALK1 and endoglin gene polymorphisms increase the risk of cardiovascular events. The analysis of these polymorphisms in populations at risk, in combination with the determination of other parameters and biomarkers, could implement the diagnosis and prognosis of susceptibility to cardiovascular damage.
Collapse
|
28
|
Gómez Sánchez M, Gómez Sánchez L, Patino-Alonso MC, Alonso-Domínguez R, Sánchez-Aguadero N, Lugones-Sánchez C, Rodríguez Sánchez E, García Ortiz L, Gómez-Marcos MA. Adherence to the Mediterranean Diet in Spanish Population and Its Relationship with Early Vascular Aging according to Sex and Age: EVA Study. Nutrients 2020; 12:nu12041025. [PMID: 32276498 PMCID: PMC7231158 DOI: 10.3390/nu12041025] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/02/2020] [Accepted: 04/07/2020] [Indexed: 12/18/2022] Open
Abstract
The objective of this study is to analyze the influence of adherence to the Mediterranean diet (MDA) and its components on early vascular aging (EVA) in a Spanish population sample free of cardiovascular disease and to analyze the differences by sex. METHODS We recruited 501 individuals aged 35-75 without cardiovascular disease by random sampling (55.90 ± 14.24 years, 49.70% men). EVA was defined in two steps: Step 1: subjects with vascular damage in carotid arteries or peripheral artery disease were classified as EVA. Step 2: subjects at the percentile of the combined Vascular Aging Index (VAI) were classified; ≥ p90 was considered EVA and < p90 was considered normal vascular aging (NVA), estimated using the following formula (VAI = (log (1.09) × 10 cIMT + log (1.14) cfPWV) × 39.1 + 4.76 by age and sex. Carotid-femoral pulse wave velocity (cfPWV) was measured by SphigmoCor System® and carotid intima-media thickness by Sonosite Micromax® ultrasound and classified thus: values ≥ Percentile 90 were considered EVA and those < Percentile 90 as NVA, with population percentiles analyzed. The principal result variable was assessed using the 14-item MEDAS questionnaire, developed and validated by the PREDIMED group, comprising 12 questions about the frequency of food consumption and two questions regarding the Spanish population's typical eating habits. RESULTS MDA was observed by 25% (17% men and 34% women). EVA was present in 17% (29% men and 4% women). The adjusted logistic regression models showed that an increase in MDA decreases the probability of EVA in the global analysis (OR = 0.36; 95% CI: 0.16-0.82). In the analysis by sex, this association was only seen in men (OR = 0.33; 95% CI: 0.12-0.86), but not in women (OR = 0.31; 95% CI: 0.04-2.50). CONCLUSION The results of this study suggest that a greater adherence to the Mediterranean diet decreases the probability of presenting EVA. In the analysis by sex, this association applies only to men.
Collapse
Affiliation(s)
- Marta Gómez Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
| | - Leticia Gómez Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
| | - Maria C Patino-Alonso
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
- Department of Statistics, University of Salamanca (USAL), IGA Research Group, 37007 Salamanca, Spain
| | - Rosario Alonso-Domínguez
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
| | - Natalia Sánchez-Aguadero
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
| | - Emiliano Rodríguez Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- Spanish Network for Preventive Activities and Health Promotion (redIAPP), Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, 37007 Salamanca, Spain
- Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Luis García Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- Spanish Network for Preventive Activities and Health Promotion (redIAPP), Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, 37007 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37005 Salamanca, Spain
| | - Manuel A Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
- Spanish Network for Preventive Activities and Health Promotion (redIAPP), Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, 37007 Salamanca, Spain
- Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
- Correspondence: ; Tel.: +34-923-291-100
| |
Collapse
|
29
|
Prieto M, Vicente-Vicente L, Casanova AG, Hernández-Sánchez MT, Gomez-Marcos MA, Garcia-Ortiz L, Morales AI. Designing new diagnostic systems for the early detection of tobacco-associated chronic renal damage in patients of a primary care centre in Salamanca, Spain: an observational, prospective study protocol. BMJ Open 2020; 10:e032918. [PMID: 32152160 PMCID: PMC7064146 DOI: 10.1136/bmjopen-2019-032918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Tobacco causes kidney damage that can progress to chronic kidney disease. However, the diagnostic parameters used in clinics are not effective in identifying smokers at risk. Our first objective is to more effectively detect subclinical renal damage in smokers. In addition, we hypothesise that tobacco consumption can predispose smokers to renal damage on exposure to other potentially nephrotoxic events (drugs, diagnostic procedures and so on). We will test this hypothesis in our second objective by investigating whether certain predisposition markers (GM2 ganglioside activator protein (GM2AP), transferrin and t-gelsolin) are able to detect smokers who are predisposed to kidney damage. Finally, in our third objective, we will study whether smoking cessation reduces subclinical and/or predisposition to renal damage. METHODS AND ANALYSIS For our first objective, a prospective cross-sectional study will be carried out with patients from a primary healthcare centre. The influence of tobacco on renal damage, in patients both with and without additional risk factors, will be studied using a panel of early biomarkers (albuminuria, N-acetyl-beta-D-glucosaminidase, kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin). For our second objective, a prospective longitudinal study will be carried out with patients recruited for our first objective. We will study whether certain predisposition biomarkers (GM2AP, transferrin and t-gelsolin) are able to detect smokers predisposed to renal damage. For our third objective, a prospective longitudinal study will be carried out with patients from a smoking cessation unit. We will study the evolution of the markers described above following smoking cessation. ETHICS AND DISSEMINATION The study has been approved by the Clinical Research Ethics Committee of the Healthcare Area of Salamanca. All study participants will sign an informed consent form in compliance with the Declaration of Helsinki and the WHO standards for observational studies. Results will be presented at conferences and submitted to peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03850756.
Collapse
Affiliation(s)
- Marta Prieto
- Toxicology Unit, University of Salamanca, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Group of Translational Research on Renal and Cardiovascular Diseases (TRECARD), University of Salamanca, Salamanca, Spain
| | - Laura Vicente-Vicente
- Toxicology Unit, University of Salamanca, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Group of Translational Research on Renal and Cardiovascular Diseases (TRECARD), University of Salamanca, Salamanca, Spain
| | - Alfredo G Casanova
- Toxicology Unit, University of Salamanca, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Group of Translational Research on Renal and Cardiovascular Diseases (TRECARD), University of Salamanca, Salamanca, Spain
| | - Maria Teresa Hernández-Sánchez
- Toxicology Unit, University of Salamanca, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Group of Translational Research on Renal and Cardiovascular Diseases (TRECARD), University of Salamanca, Salamanca, Spain
| | - Manuel A Gomez-Marcos
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Salamanca, Spain
| | - Luis Garcia-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Salamanca, Spain
| | - Ana Isabel Morales
- Toxicology Unit, University of Salamanca, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Group of Translational Research on Renal and Cardiovascular Diseases (TRECARD), University of Salamanca, Salamanca, Spain
| |
Collapse
|
30
|
Patino-Alonso MC, Gómez Sánchez M, Gómez Sánchez L, Alonso-Domínguez R, Sánchez-Aguadero N, Sánchez Salgado B, Rodríguez Sánchez E, García Ortiz L, Gómez-Marcos MA. Multivariate Analysis of Influence of Vitamin Intake on Vascular Function Parameters by Sex in the General Spanish Population: EVA Study. Nutrients 2020; 12:E643. [PMID: 32121178 PMCID: PMC7146244 DOI: 10.3390/nu12030643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 02/21/2020] [Accepted: 02/25/2020] [Indexed: 12/18/2022] Open
Abstract
The influence of vitamin intake on vascular function parameters in the Spanish general population has not been studied. The main objective of this study is to analyze the influence of vitamin intake on vascular function and as a secondary objective the adequacy of vitamin intake in a sample of the Spanish population without previous cardiovascular disease and analyze the differences according to sex. Methods: We included 501 individuals obtained by simple random sampling with replacement (reference population 43,946). The average age was 55.90 ± 14.24 years, 49.70% men. Participants recorded the intake of vitamins using the EVIDENT app, previously validated, during a period of 3 days. Vascular function was assessed by measuring carotid-femoral pulse wave velocity (cfPWV) with the SphygmoCor device, cardio-ankle vascular index (CAVI) with the VaSera device and brachial-ankle pulse wave velocity (baPWV) by using a validated equation. Results: The vitamins with the least adequate intake was vitamin D, less than 5%, and vitamin B9, less than 35%. Vitamins with an adequate intake percentage, close to 100%, were B12 and B6. The multiple regression analysis showed a negative association between cfPWV and vitamin B2 in both sexes, and a positive one with retinol in men and B3 in women. baPWV was negatively associated with vitamins B1 and B12 in women and B9 in men, while being positively linked with B6 in men. CAVI presented a negative association with vitamin D in women. The results were similar in the canonical correspondence analysis. In conclusion, the results of this study suggest that the influence of vitamins on vascular function is not homogeneous and varies according to the parameter analyzed. Thus, in men, vitamins B2 and retinol were associated with cfPWV and vitamins B6 and B9 with baPWV. In women, vitamins B2 and B3 were related cfPWV, vitamins B1 and B12 with cfPWV and vitamin D with CAVI.
Collapse
Affiliation(s)
- Maria C Patino-Alonso
- Department of Statistics, University of Salamanca (USAL), IGA Research Group, 37007 Salamanca, Spain
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (R.A.-D.); (N.S.-A.); (B.S.S.); (E.R.S.); (L.G.O.); (M.A.G.-M.)
| | - Marta Gómez Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (R.A.-D.); (N.S.-A.); (B.S.S.); (E.R.S.); (L.G.O.); (M.A.G.-M.)
| | - Leticia Gómez Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (R.A.-D.); (N.S.-A.); (B.S.S.); (E.R.S.); (L.G.O.); (M.A.G.-M.)
| | - Rosario Alonso-Domínguez
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (R.A.-D.); (N.S.-A.); (B.S.S.); (E.R.S.); (L.G.O.); (M.A.G.-M.)
- Department of Nursing and Physiotherapy, University of Salamanca. 37007 Salamanca, Spain
| | - Natalia Sánchez-Aguadero
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (R.A.-D.); (N.S.-A.); (B.S.S.); (E.R.S.); (L.G.O.); (M.A.G.-M.)
- Department of Nursing and Physiotherapy, University of Salamanca. 37007 Salamanca, Spain
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
| | - Benigna Sánchez Salgado
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (R.A.-D.); (N.S.-A.); (B.S.S.); (E.R.S.); (L.G.O.); (M.A.G.-M.)
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
| | - Emiliano Rodríguez Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (R.A.-D.); (N.S.-A.); (B.S.S.); (E.R.S.); (L.G.O.); (M.A.G.-M.)
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- Iberian network on arterial structure, central hemodynamics and neurocognition, 4800-263 Guimaraes, Portugal, 37005 Salamanca, Spain
- Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Luis García Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (R.A.-D.); (N.S.-A.); (B.S.S.); (E.R.S.); (L.G.O.); (M.A.G.-M.)
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- Iberian network on arterial structure, central hemodynamics and neurocognition, 4800-263 Guimaraes, Portugal, 37005 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37007 Salamanca, Spain
| | - Manuel A Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (R.A.-D.); (N.S.-A.); (B.S.S.); (E.R.S.); (L.G.O.); (M.A.G.-M.)
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- Iberian network on arterial structure, central hemodynamics and neurocognition, 4800-263 Guimaraes, Portugal, 37005 Salamanca, Spain
- Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
| |
Collapse
|
31
|
Gómez-Sánchez M, Patino-Alonso MC, Gómez-Sánchez L, Recio-Rodríguez JI, Rodríguez-Sánchez E, Maderuelo-Fernández JA, García-Ortiz L, Gómez-Marcos MA, Gómez-Marcos MA, García-Ortiz L, Recio-Rodríguez JI, Martínez-Salgado C, Hernández-Rivas JM, González-Sarmiento R, Sánchez-Fernández PL, Rodríguez-Sánchez E, Patino-Alonso MC, Maderuelo-Fernández JA, Gómez-Sánchez L, González-Sánchez J, Alonso-Domínguez R, Rodríguez-Martín C, Gómez-Sánchez M, de Cabo-Laso Á, Sánchez-Salgado B, Aguadero NS, Mora-Simón S, González-Porras JR, Bastida-Bermejo JM, Fuentes-Calvo I. Valores de referencia de parámetros de rigidez arterial y su relación con los factores de riesgo cardiovascular en población española. Estudio EVA. Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2019.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
32
|
Gómez-Sánchez M, Patino-Alonso MC, Gómez-Sánchez L, Recio-Rodríguez JI, Rodríguez-Sánchez E, Maderuelo-Fernández JA, García-Ortiz L, Gómez-Marcos MA. Reference values of arterial stiffness parameters and their association with cardiovascular risk factors in the Spanish population. The EVA Study. ACTA ACUST UNITED AC 2019; 73:43-52. [PMID: 31521574 DOI: 10.1016/j.rec.2019.04.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 04/10/2019] [Indexed: 12/18/2022]
Abstract
INTRODUCTION AND OBJECTIVES To describe, for the first time, reference values for the cardio-ankle vascular index (CAVI), brachial-ankle pulse wave velocity (BA-PWV), carotid-femoral pulse wave velocity (CF-PWV), and the central augmentation index and to establish their association with cardiovascular risk factors in the Spanish adult population aged 35 to 75 years without cardiovascular disease. METHODS We conducted a cross-sectional study. Through random sampling stratified by age and sex, we included 501 participants without cardiovascular disease. The mean age was 55.9 years and 50.3% were women. The measurements were taken using the SphigmoCor and Vasera VS-1500 devices. RESULTS Values for all measures, except those for the central augmentation index, were higher in men and increased with age and blood pressure. The mean values were as follows: CAVI, 8.01±1.44; BA-PWV, 12.93±2.68m/s; CF-PWV, 6.53±2.03 m/s, and central augmentation index, 26.84±12.79. On multiple regression analysis, mean blood pressure was associated with the 4 measures, glycated hemoglobin was associated with all measures except the central augmentation index, and body mass index showed an inverse association with CAVI. The explanatory capacity of age, sex, and mean blood pressure was 62% for BA-PWV, 49% for CF-PWV 49%, 54% for the CAVI, and 38% for the central augmentation index. On logistic regression, hypertension was associated with the CAVI (OR=3.45), VOP-BT (OR=3.44), VOP-CF (OR=3.38) and with the central augmentation index (OR=3.73). CONCLUSIONS All arterial stiffness measures increased with age. The CAVI and CF-PWV were higher in men and the central augmentation index was higher in women, with no differences in BA-PWV. This study is registered at ClinicalTrials.gov. Identifier NCT02623894.
Collapse
Affiliation(s)
- Marta Gómez-Sánchez
- Unidad de Investigación en Atención Primaria, Centro de Salud La Alamedilla, Salamanca, Spain
| | - M Carmen Patino-Alonso
- Unidad de Investigación en Atención Primaria, Centro de Salud La Alamedilla, Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Departamento de Estadística, Universidad de Salamanca, Salamanca, Spain
| | - Leticia Gómez-Sánchez
- Unidad de Investigación en Atención Primaria, Centro de Salud La Alamedilla, Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - José I Recio-Rodríguez
- Unidad de Investigación en Atención Primaria, Centro de Salud La Alamedilla, Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Facultad de Ciencias de la Salud, Universidad de Burgos, Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Unidad de Investigación en Atención Primaria, Centro de Salud La Alamedilla, Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Servicio de Salud de Castilla y León (SACyL), Salamanca, Spain; Departamento de Medicina, Universidad de Salamanca, Salamanca, Spain
| | - José A Maderuelo-Fernández
- Unidad de Investigación en Atención Primaria, Centro de Salud La Alamedilla, Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Servicio de Salud de Castilla y León (SACyL), Salamanca, Spain
| | - Luis García-Ortiz
- Unidad de Investigación en Atención Primaria, Centro de Salud La Alamedilla, Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Servicio de Salud de Castilla y León (SACyL), Salamanca, Spain; Departamento de Ciencias Biomédicas y del Diagnóstico, Universidad de Salamanca, Salamanca, Spain
| | - Manuel A Gómez-Marcos
- Unidad de Investigación en Atención Primaria, Centro de Salud La Alamedilla, Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Servicio de Salud de Castilla y León (SACyL), Salamanca, Spain; Departamento de Medicina, Universidad de Salamanca, Salamanca, Spain.
| | | |
Collapse
|
33
|
Noninvasive validation of central and peripheral augmentation index estimated by a novel wrist-worn tonometer. J Hypertens 2019; 36:2204-2214. [PMID: 29846328 DOI: 10.1097/hjh.0000000000001806] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The validation of new blood pressure devices with easier use and more rapid data collection may facilitate the incorporation of these measures into clinical practice. We analyze the reliability and validity of Pulse Wave Analysis as reported by a novel wrist-worn device, easy and quick to use, comparing central and peripheral augmentation index (AIx) with the same measures from the SphygmoCor. Additionally, we analyzed clinical relevance through the association of the Pulse Wave Analysis, as reported by a novel wrist-worn device, with other cardiovascular parameters. METHODS Cross-sectional study including 254 participants. Mean age was 51.9 ± 13.4 years and 53% were women. MEASUREMENTS peripheral AIx (PAIx) and central AIx (CAIx) by the wrist-worn device and SphygmoCor (MM3); carotid-femoral (cf) pulse wave velocity (PWV) by SphygmoCor (MM3); cardioankle-vascular index (CAVI), ankle-brachial index (ABI) and brachial-ankle (ba) PWV by the Vasera device and carotid-intima media thickness (IMT) by ultrasonography. RESULTS Intra-observer intra-class correlation coefficient (ICC) for PAIx was 0.886 (95% CI 0.803-0.934) and for CAIx 0.943 (95% CI 0.901-0.968) with Bland Altman limits of agreement -0.75 (-23.8 to 21.8) and 0.08 (-15.7 to 15.9), respectively. Inter-observer ICC for PAIx was 0.952 (95% CI 0.915-0.972) and CAIx 0.893 (95% CI 0.811-0.939) with limits of agreement -0.45 (-13.7 to 12.8) and 0.43 (-17.7 to 18.5), respectively. Comparing the wrist-worn device with SphygmoCor, the ICC was 0.849 (95% CI 0.798-0.887) for PAIx, and 0.783 (95% CI 0.711-0.838) for CAIx. In Bland-Altman, limits of agreement for PAIx 1.03 (-20.67 to 22.73), and for CAIx -2.14 (-24.79 to 20.50). PAIx and CAIx, from the wrist-worn device, correlated with age, CAVI, ABI, baPWV, cfPWV, IMT, glomerular filtration and cardiovascular risk. CONCLUSION AIx measurements by wrist-worn device shows a good intra-observer and inter-observer reliability, inter-device noninvasive reliability and validity when compared with SphygmoCor, and clinical relevance by association with measures of vascular structure and function, end-organ damage and cardiovascular risk. TRIAL REGISTRATION Clinicaltrials.gov NCT02623894; https://clinicaltrials.gov/ct2/show/NCT02623894.
Collapse
|
34
|
Melero-Alegria JI, Cascon M, Romero A, Vara PP, Barreiro-Perez M, Vicente-Palacios V, Perez-Escanilla F, Hernandez-Hernandez J, Garde B, Cascon S, Martin-Garcia A, Diaz-Pelaez E, de Dios JM, Uribarri A, Jimenez-Candil J, Cruz-Gonzalez I, Blazquez B, Hernandez JM, Sanchez-Pablo C, Santolino I, Ledesma MC, Muriel P, Dorado-Diaz PI, Sanchez PL. SALMANTICOR study. Rationale and design of a population-based study to identify structural heart disease abnormalities: a spatial and machine learning analysis. BMJ Open 2019; 9:e024605. [PMID: 30765403 PMCID: PMC6398793 DOI: 10.1136/bmjopen-2018-024605] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 10/06/2018] [Accepted: 12/18/2018] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION This study aims to obtain data on the prevalence and incidence of structural heart disease in a population setting and, to analyse and present those data on the application of spatial and machine learning methods that, although known to geography and statistics, need to become used for healthcare research and for political commitment to obtain resources and support effective public health programme implementation. METHODS AND ANALYSIS We will perform a cross-sectional survey of randomly selected residents of Salamanca (Spain). 2400 individuals stratified by age and sex and by place of residence (rural and urban) will be studied. The variables to analyse will be obtained from the clinical history, different surveys including social status, Mediterranean diet, functional capacity, ECG, echocardiogram, VASERA and biochemical as well as genetic analysis. ETHICS AND DISSEMINATION The study has been approved by the ethical committee of the healthcare community. All study participants will sign an informed consent for participation in the study. The results of this study will allow the understanding of the relationship between the different influencing factors and their relative importance weights in the development of structural heart disease. For the first time, a detailed cardiovascular map showing the spatial distribution and a predictive machine learning system of different structural heart diseases and associated risk factors will be created and will be used as a regional policy to establish effective public health programmes to fight heart disease. At least 10 publications in the first-quartile scientific journals are planned. TRIAL REGISTRATION NUMBER NCT03429452.
Collapse
Affiliation(s)
- Jose Ignacio Melero-Alegria
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Manuel Cascon
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | | | - Pedro Pablo Vara
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Manuel Barreiro-Perez
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Victor Vicente-Palacios
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | | | - Jesus Hernandez-Hernandez
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Beatriz Garde
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Sara Cascon
- Robleda Primary Care Center, Salamanca, Spain
| | - Ana Martin-Garcia
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Elena Diaz-Pelaez
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | | | - Aitor Uribarri
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Javier Jimenez-Candil
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Ignacio Cruz-Gonzalez
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | | | | | - Clara Sanchez-Pablo
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | | | | | - Paz Muriel
- Miguel Armijo Primary Care Centre, Salamanca, Spain
| | - P Ignacio Dorado-Diaz
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Pedro L Sanchez
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| |
Collapse
|
35
|
Combined use of a healthy lifestyle smartphone application and usual primary care counseling to improve arterial stiffness, blood pressure and wave reflections: a Randomized Controlled Trial (EVIDENT II Study). Hypertens Res 2018; 42:852-862. [DOI: 10.1038/s41440-018-0182-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 09/21/2018] [Accepted: 11/05/2018] [Indexed: 12/17/2022]
|
36
|
Kim S, Lee SJ, Kim YH, Kim JS, Lim SY, Kim SH, Ahn JC, Song WH, Jee SH, Park CG. Irreversible effects of long-term chronic smoking on arterial stiffness: An analysis focusing on ex-smokers among otherwise healthy middle-aged men. Clin Exp Hypertens 2018; 41:766-773. [PMID: 30582369 DOI: 10.1080/10641963.2018.1557677] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective: Smoking is a modifiable cardiovascular risk factor closely related to arterial stiffness (AS). However, data are lacking regarding the chronic effects of smoking on AS, especially in ex-smoker (ES) who faces remnant cardiovascular risk when compared to never-smokers (NS).Methods: Among 1722 health screening participants, we retrospectively evaluated 652 healthy men with different smoking history [240 current smoker (CS) vs. 228 ES vs. 184 NS]. To assess AS, augmentation index (AIx), pulse pressure amplification (PPamp), and carotid-femoral pulse wave velocity (cfPWV) were measured and compared.Results: Baseline characteristics were similar except age and triglyceride level. AIx was lowest in NS, followed by ES, and was highest in CS. PPamp was highest in NS, lowest in CS, and ES was of intermediate level. The differences were more robust after adjustment for baseline covariates (AIx, p = 0.005; PPamp: p = 0.001). On the other hand, no significant intergroup difference was observed for cfPWV in our middle-aged population. With the regression analyses revealing an independent association between smoking duration and AS in ES, subgroup analysis demonstrated that long-term ES (smoking duration ≥20 years) had significantly higher AS than short-term ES (<20 years) and NS, approaching levels comparable to CS (AIx and PPamp: p < 0.0001).Conclusions: Our study demonstrated impaired arterial elastic properties in long-term ES, suggesting that AS caused by chronic smoking might be irreversible even after smoking cessation. Further longitudinal studies are warranted to determine the impacts of past smoking on AS and its clinical relevance.
Collapse
Affiliation(s)
- Sunwon Kim
- Department of Cardiology, Korea University Ansan Hospital, Ansan-si, Republic of Korea
| | - Sun Ju Lee
- Institute for Health Promotion, Department of Epidemiology and Health Promotion, Yonsei University Graduate School of Public Health, Seoul, Republic of Korea
| | - Yong-Hyun Kim
- Department of Cardiology, Korea University Ansan Hospital, Ansan-si, Republic of Korea
| | - Jin-Seok Kim
- Department of Cardiology, Korea University Ansan Hospital, Ansan-si, Republic of Korea
| | - Sang-Yup Lim
- Department of Cardiology, Korea University Ansan Hospital, Ansan-si, Republic of Korea
| | - Seong Hwan Kim
- Department of Cardiology, Korea University Ansan Hospital, Ansan-si, Republic of Korea
| | - Jeong-Cheon Ahn
- Department of Cardiology, Korea University Ansan Hospital, Ansan-si, Republic of Korea
| | - Woo-Hyuk Song
- Department of Cardiology, Korea University Ansan Hospital, Ansan-si, Republic of Korea
| | - Sun Ha Jee
- Institute for Health Promotion, Department of Epidemiology and Health Promotion, Yonsei University Graduate School of Public Health, Seoul, Republic of Korea.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Chang Gyu Park
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea
| |
Collapse
|
37
|
Della-Morte D, Gardener H, Dong C, Markert M, Cabral D, Elkind MSV, Sacco RL, Rundek T. Association Between Carotid Artery Function and Structure in the Northern Manhattan Study. Front Neurol 2018; 9:246. [PMID: 29713306 PMCID: PMC5911635 DOI: 10.3389/fneur.2018.00246] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 03/28/2018] [Indexed: 11/13/2022] Open
Abstract
Background and purpose Carotid plaque (CP), carotid intima media thickness (cIMT), and stiffness (STIFF) are pre-clinical markers of atherosclerosis and predictors of cerebrovascular disease (CVD). We sought to investigate whether STIFF is a significant determinant of cIMT and CP, which may provide an insight into the mechanism by which STIFF adds to the risk of CVD. Methods We analyzed 876 stroke-free subjects from the Northern Manhattan Study with available ultrasound measures. To obtain the associations with STIFF, we performed multivariable-adjusted regression, negative binomial regression (for CP number), and multinomial logistic regression (for plaque area). Results The mean age was 64 ± 9 years; 63% women and 65% Caribbean Hispanics. The mean cIMT was 0.93 ± 0.9 mm, the mean diastolic diameter 6.24 ± 0.94 mm, and STIFF 8.6 ± 6.2 ln mmHg. Prevalence of CP was 57%, and the mean total plaque area was 22.6 ± 23.0 mm2. STIFF was positively associated with cIMT but not with CP. There was an association between diastolic diameter and thick plaque. For each millimeter increase in diastolic diameter, there was about a 20% increased risk of having thick plaque (vs. no plaque). In longitudinal analyses, each millimeter increase in diastolic diameter was associated with a 37% increased risk of incident plaque. Conclusion Increased STIFF was associated with increased cIMT and carotid artery dilatation with greater plaque burden. Increased cIMT and plaque burden represent vascular remodeling likely resulting from the two different age-related mechanisms, one that includes diffuse wall thickening (cIMT) with STIFF and another that incorporates focal atherosclerosis (plaque) with luminal dilatation.
Collapse
Affiliation(s)
- David Della-Morte
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, United States.,Department of Systems Medicine, School of Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University, Rome, Italy
| | - Hannah Gardener
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Chuanhui Dong
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Matthew Markert
- Department of Neurology, Kansas University Medical Center, Kansas City, MO, United States
| | - Digna Cabral
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Mitchell S V Elkind
- Division of Stroke, Department of Neurology, Columbia University, New York, NY, United States
| | - Ralph L Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, United States
| |
Collapse
|
38
|
Fu S, Lin Y, Luo L, Ye P. Relationship between Central Arterial Stiffness and Insulin Resistance in Chinese Community-Dwelling Population without Diabetes Mellitus. Int J Endocrinol 2017; 2017:1073919. [PMID: 28588615 PMCID: PMC5446882 DOI: 10.1155/2017/1073919] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 04/16/2017] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Insulin resistance (IR) is a pathological condition present not only in patients with type 2 diabetes mellitus (DM), but also in community-dwelling population without DM. Both central arterial stiffness and IR are closely correlated with cardiovascular morbidity and mortality. The relationship between central arterial stiffness and IR has not been described in Chinese community-dwelling population without DM. The current analysis was designed to investigate the relationship between central arterial stiffness and IR in Chinese community-dwelling population without DM. METHODS There were 1150 participants fully assessed for not only homeostasis model assessment of insulin resistance (HOMA-IR) but also carotid-femoral pulse wave velocity (cfPWV). RESULTS Median age was 39 (18-80) years, and 69.7% were men. Bivariate correlation analysis showed that cfPWV was significantly related to HOMA-IR (P < 0.05). Logistic regression analysis indicated that cfPWV was independently associated with HOMA-IR (P < 0.05). CONCLUSIONS This community-based analysis testified that the relationship between central arterial stiffness and IR was evident as early as during nondiabetic stage. Early interventions in Chinese community-dwelling population without DM to improve the IR are also important in the prevention of cardiovascular diseases.
Collapse
Affiliation(s)
- Shihui Fu
- Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China
- Department of Cardiology and Hainan Branch, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Ying Lin
- Department of Cardiology and Hainan Branch, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Leiming Luo
- Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China
- *Leiming Luo: and
| | - Ping Ye
- Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China
- *Ping Ye:
| |
Collapse
|