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Ma MY, Zhao YS. Modifiable factors mediating the effects of educational attainment on gestational diabetes mellitus: A two-step Mendelian randomization study. World J Clin Cases 2024; 12:5937-5945. [DOI: 10.12998/wjcc.v12.i26.5937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/01/2024] [Accepted: 07/10/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Although there is currently a wealth of evidence to indicate that maternal educational attainment is associated with gestational diabetes mellitus (GDM), the specific modifiable risk factors that mediate the causal relationship between these two variables have yet to be identified.
AIM To identify the specific modifiable risk factors that mediate the causal relationship between the level of maternal education and GDM.
METHODS Mendelian randomization (MR) was conducted using data from genome-wide association studies of European populations. We initially performed a two-sample MR analysis using data on genetic variants associated with the duration of education as instruments, and subsequently adopted a two-step MR approach using metabolic and lifestyle factors as mediators to examine the mechanisms underlying the relationship between the level of maternal education and risk of developing GDM. In addition, we calculated the proportions of total causal effects mediated by identified metabolic and lifestyle factors.
RESULTS A genetically predicted higher educational attainment was found to be associated with a lower risk of developing GDM (OR: 0.71, 95%CI: 0.60-0.84). Among the metabolic factors assessed, four emerged as potential mediators of the education-GDM association, which, ranked by mediated proportions, were as follows: Waist-to-hip-ratio (31.56%, 95%CI: 12.38%-50.70%), body mass index (19.20%, 95%CI: 12.03%-26.42%), high-density lipoprotein cholesterol (12.81%, 95%CI: 8.65%-17.05%), and apolipoprotein A-1 (7.70%, 95%CI: 4.32%-11.05%). These findings proved to be robust to sensitivity analyses.
CONCLUSION Our findings indicate a causal relationship between lower levels of maternal education and the risk of developing GDM can be partly explained by adverse metabolic profiles.
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Affiliation(s)
- Ming-Yue Ma
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Ya-Song Zhao
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
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Salih S. Association of Lipoprotein and Apolipoprotein Ratios With Glycemic Levels in Individuals With Prediabetes: A Case-Control Study. Cureus 2024; 16:e63500. [PMID: 39081429 PMCID: PMC11287781 DOI: 10.7759/cureus.63500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Prediabetes is defined as a hyperglycemic state between normal glucose metabolism and diabetes mellitus. It is also recognized as a predisposing factor for cardiovascular disease. Apolipoprotein is a constituent of lipoproteins, and its ratio levels (ApoB/ApoA1 ratio) are considered an independent risk factor for cardiovascular diseases. This study aimed to evaluate the apolipoprotein ratio (ApoB/ApoA1 ratio) and lipoprotein ratio (low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio) in prediabetes in relation to glycemic levels and establish the association between apolipoprotein and lipoprotein ratios in prediabetic individuals and their glycemic levels. METHODOLOGY A case-control study was conducted among 150 participants, 75 with prediabetes and 75 apparently healthy individuals (with no prediabetes or diabetes), from January 1, 2023 to December 30, 2023. The parameters involved are fasting serum glucose, insulin, blood HbA1c%, HDL-C, LDL-C, apolipoprotein A, apolipoprotein B, and lipoprotein(a) (Lp(a)), measured using different principles. RESULTS Prediabetes was more predominant in males (58.7%), particularly those aged over 40 years (74.7%). The mean Lp(a) (46.18±11.66 mg/dl), LDL-C/HDL-C ratio (1.74±0.96), and ApoB/ApoA ratio (1.10±0.62) were significantly higher among prediabetic individuals. Moreover, these ratios were insignificantly higher in prediabetic individuals with HbA1c level (5.8-6.4%) and fasting glucose level (100-125 mg/dl) than those with lower levels. CONCLUSIONS Prediabetic individuals exhibited a notably elevated average level of Lp(a), as well as increased mean ApoB/ApoA1 ratio and mean LDL-C/HDL-C ratio compared to individuals who were apparently healthy.
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Affiliation(s)
- Sherwan Salih
- Department of Medical Chemistry, College of Medicine, University of Duhok, Duhok, IRQ
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Antani M, Oza C, Khadilkar V, Gondhalekar K, Khadilkar A. Utility of apolipoprotein ratio in predicting metabolic risk and microvascular complications in Indian children and young adults with type 1 diabetes mellitus. J Pediatr Endocrinol Metab 2023:jpem-2022-0403. [PMID: 37141397 DOI: 10.1515/jpem-2022-0403] [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: 08/12/2022] [Accepted: 04/17/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVES To assess the relationship of apolipoproteins with glycemic control and insulin resistance (IR) in Indian children and youth with type-1 diabetes (T1D) and to assess its utility in predicting metabolic risk (MR) and microvascular complications in these subjects. METHODS This cross-sectional study included 152 participants aged 6-23 years with T1D. Demographic, anthropometric, clinical, biochemical and body composition data were obtained using standard protocols. IR was calculated using estimated glucose disposal rate (eGDR) and metabolic syndrome (MS) was diagnosed using the international diabetes federation consensus definition 2017. RESULTS Apolipoprotein ratio in subjects with T1D had negative and positive correlation with eGDR and HbA1c respectively. Positive correlation of Apolipoproten B and apolipoprotein ratio with urinary albumin creatinine ratio is noted. The ratio had area under curve of 0.766 and 0.737 to predict MR and microvascular complications respectively. The ratio cut-off of 0.536 yielded 77.1 % sensitivity and 61 % specificity to predict MR. On adding the apolipoprotein ratio as a predictor to the regression model developed to predict MR, the R2 and accuracy improved. CONCLUSIONS The apolipoprotein ratio had significant correlation with IR, microalbuminuria and glycaemic control. The ratio also predicts risk of development of microvascular complications and maybe used to predict MR in subjects with T1D.
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Affiliation(s)
- Misha Antani
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, India
| | - Chirantap Oza
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, India
| | - Vaman Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, India
- Senior Paediatric Endocrinologist, Jehangir Hospital, Pune and Bombay Hospital, Pune, India
- Department of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India
| | | | - Anuradha Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, India
- Department of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India
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Effectiveness of Non-Contact Dietary Coaching in Adults with Diabetes or Prediabetes Using a Continuous Glucose Monitoring Device: A Randomized Controlled Trial. Healthcare (Basel) 2023; 11:healthcare11020252. [PMID: 36673620 PMCID: PMC9859545 DOI: 10.3390/healthcare11020252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
We aimed to evaluate the effectiveness of dietary coaching and continuous glucose monitoring (CGM) in patients with diabetes or prediabetes to improve their behavioral skills and health outcomes. A randomized controlled study with pre- and post-testing was conducted. Data were collected between November 2020 and April 2021. Forty-five patients with diabetes or prediabetes who used a CGM device were enrolled and analyzed. Dietary education, individual coaching and group coaching were provided to participants in the experimental group for 4 weeks. After the intervention, the thigh circumference in men significantly differed between the two groups (z = -2.02, p = 0.044). For women, participants in the experimental group showed greater improvement in eating self-efficacy compared with those in the control group (z = -2.66, p = 0.008). Insomnia was negatively related to the change in eating self-efficacy (r = -0.35, p = 0.018) and increase in thigh circumference (r = -0.35, p = 0.017). Even if used within a short intervention period, non-contact dietary coaching programs can help enhance behavioral skills, such as eating self-efficacy and health outcomes, such as thigh circumference. Moreover, the changed variables can indirectly improve other health outcomes in patients with diabetes or prediabetes.
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Liu Y, Ma X, Ma L, Su Z, Li D, Chen X. Elevated ApoB/ApoA-I ratio is associated with acute anti-N-Methyl-D-aspartate receptor encephalitis, but not disease outcomes. Front Neurol 2022; 13:896656. [PMID: 36119695 PMCID: PMC9475113 DOI: 10.3389/fneur.2022.896656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/08/2022] [Indexed: 12/03/2022] Open
Abstract
Objective The purpose of the present study is to clarify the relationship between the apolipoprotein B100/apolipoprotein A-I (ApoB/ApoA-I) ratio and anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. Methods A total of 71 patients with anti-NMDAR encephalitis were included in this study, and their ApoB/ApoA-I ratios in baseline and follow-up were retrospectively analyzed. Results The ApoB/ApoA-I ratio was closely correlated with the baseline-modified Rankin scale (mRS) score of >3 in patients with anti-NMDAR encephalitis. A subgroup analysis showed obvious differences between the high and low ApoB/ApoA-I ratio groups. The ApoB/ApoA-I ratio was positively correlated with intensive care unit (ICU) treatment, length of hospital stay, baseline mRS score, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). The ratios of the high and low ApoB/ApoA-I groups both improved in the follow-up. Conclusion The increased ApoB/ApoA-I ratio is associated with acute anti-NMDAR encephalitis, but not disease outcomes. Serum ApoB/ApoA-I ratio was related to inflammation and immunity in peripheral blood. The findings might provide a new idea for further exploration of the pathogenesis and treatment of anti-NMDAR encephalitis.
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Association between apolipoprotein B/A1 and the risk of metabolic dysfunction associated fatty liver disease according to different lipid profiles in a Chinese population: A cross-sectional study. Clin Chim Acta 2022; 534:138-145. [PMID: 35905837 DOI: 10.1016/j.cca.2022.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIM Metabolic dysfunction associated fatty liver disease (MAFLD) is the most common liver disease and dyslipidemia is commonly considered a prominent risk factor for MAFLD. This study was to investigate the association between the apolipoprotein B/A1 (apo B/A1) ratio and the risk of MAFLD based on new diagnostic criteria. METHODS We conducted a cross-sectional study on 3341 participants. Restricted cubic spline (RCS) analyses, logistic regression, Synergistic effects analyses and stratified analyses were used to evaluate the association between the apo B/A1 ratio and the risk of MAFLD. RESULTS The apo B/A1 ratio was nonlinearly related to the increased risk of MAFLD and the OR and 95% CI for the apo B/A1 95th percentile was 1.700 (1.004-2.879) compared with the 50th percentile. Each 1 SD increase in apo B/A1 ratio would increase the 1.313-fold risk of the risk of MAFLD in all participants and 1.46-fold risk in normolipidemic participants. Synergistic effects indicated elevated Apo B/A1 ratio and dyslipidemia collectively contributed to an increased risk of MAFLD [OR (95 %CI): 2.496(1.869-3.334)]. CONCLUSIONS The apo B/A 1 ratio was a risk factor of the presence of MAFLD. Dyslipidemia and elevated the Apo B/A1 ratio can synergistically contributed to the risk of MAFLD.
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Yang T, Zhao B, Pei D. Relationship between the ApoB/ApoA-I ratio trajectory and risk of type 2 diabetes in China: a retrospective cohort study. Endocrine 2022; 76:36-43. [PMID: 35032012 DOI: 10.1007/s12020-021-02961-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/08/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Little research has investigated the correlation of changes in long-term apolipoprotein B/apolipoprotein A-I (ApoB/ApoA-I) ratio with risk of new-onset type 2 diabetes (T2D) among ordinary people. Therefore, the research took long-term ApoB/ApoA-I ratio trajectories as independent variables for exploring their association with the risk of newly diagnosed T2D. METHODS Altogether 5362 non-diabetic participants with a median age of 49 were enrolled in the cohort study. Their ApoB/ApoA-I ratio trajectories from 2016 to 2019 were analyzed and grouped using group-based trajectory modeling. The Kaplan-Meier approach was employed for calculating the newly diagnosed T2D-related incidence with different ApoB/ApoA-I ratio trajectories. A log-rank test was conducted for testing the presence of statistical difference in new-onset T2D incidence among the different ApoB/ApoA-I ratio trajectory groups. A multivariate Cox proportional hazards regression model was adopted for analyzing how ApoB/ApoA-I ratio trajectory changes affected new-onset T2D. RESULTS From 2016 to 2019, 199 patients developed T2D (3% in 3 years). The incidence of T2D was 2.0%, 3.28%, 5.86%, and 6.92% for low, middle, upper, and high ApoB/ApoA-I ratio trajectories, respectively. Following adjustment of underlying confounding factors, in contrast to low ApoB/ApoA-I ratio trajectory, new-onset T2D risk ratios and hazard ratio (HR) (95% confidence intervals [CI]) for the middle lower ApoB/ApoA-I ratio trajectory, and upper middle and high ApoB/ApoA-I ratio trajectories were [HR (95% CI)] 1.35(0.88-2.08), 1.98(1.27-3.09) and 2.42(1.35-4.34), respectively, indicating high and statistically significant risks of T2D. CONCLUSION Variations of the ApoB/ApoA-I ratio trajectory exerted independent effects on the 3-year incidence of T2D. Long-term monitoring on the ApoB/ApoA-I ratio locus may help improve the identification on patients with T2D.
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Affiliation(s)
- Tengfei Yang
- Department of Health Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bo Zhao
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Dongmei Pei
- Department of Health Management, Shengjing Hospital of China Medical University, Shenyang, China.
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Yu J, Xia X, Huang NY, Qiu YG, Yang X, Mao HP, Chen W, Huang FX. Association of Ratio of Apolipoprotein B to Apolipoprotein A1 With Survival in Peritoneal Dialysis. Front Nutr 2022; 9:801979. [PMID: 35399692 PMCID: PMC8993134 DOI: 10.3389/fnut.2022.801979] [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: 10/26/2021] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundAlthough the ratio of apolipoprotein B (apo B) to apolipoprotein A1 (apo A1) (apo B/apo A1) seems to be associated with mortality in hemodialysis (HD) patients, the association of apo B/apo A1 ratio with death remains not clear in peritoneal dialysis (PD) patients.AimsThe study targets to examine the relationship of apo B/apo A1 ratio with survival in patients receiving PD treatment.MethodsIn this single-center prospective observational cohort study, we enrolled 1,616 patients receiving PD treatment with a median follow-up time of 47.6 months. We used a multivariable Cox proportional hazards model to examine the relationship between apo B/apo A1 ratio and cardiovascular (CV) and all-cause mortality. The association of apo B/apo A1 ratio with atherosclerotic and non-atherosclerotic CV mortality was further evaluated by competing risk regression models.ResultsDuring the follow-up, 508 (31.4%) patients died, 249 (49.0%) died from CV events, of which 149 (59.8%) were atherosclerotic CV mortality. In multivariable models, for 1-SD increase in apo B/apo A1 ratio level, the adjusted hazard ratios for CV and all-cause mortality were 1.26 [95% confidence interval (CI), 1.07–1.47; P = 0.005] and 1.20 (95% CI, 1.07–1.35; P = 0.003), respectively. The adjusted subdistribution hazard ratios for atherosclerotic and non-atherosclerotic CV mortality were 1.43 (95% CI, 1.19–1.73; P < 0.001) and 0.85 (95% CI, 0.64–1.13; P = 0.256), respectively. For quartile analysis, patients in quartile 4 had higher CV, all-cause, and atherosclerotic CV mortality compared with those in quartile 1. Moreover, apo B/apo A1 ratio had a diabetes-related difference in CV, all-cause, and atherosclerotic CV mortality.ConclusionElevated apo B/apo A1 ratio level was significantly associated with CV, all-cause, and atherosclerotic CV mortality in patients undergoing PD. Moreover, the association was especially statistically significant in patients with diabetes.
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Affiliation(s)
- Jing Yu
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Nephrology, National Health Commission and Guangdong Province, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xi Xia
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Nephrology, National Health Commission and Guangdong Province, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Na-Ya Huang
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Nephrology, National Health Commission and Guangdong Province, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ya-Gui Qiu
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Nephrology, National Health Commission and Guangdong Province, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiao Yang
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Nephrology, National Health Commission and Guangdong Province, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hai-Ping Mao
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Nephrology, National Health Commission and Guangdong Province, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wei Chen
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Nephrology, National Health Commission and Guangdong Province, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Wei Chen,
| | - Feng-Xian Huang
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Nephrology, National Health Commission and Guangdong Province, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Feng-Xian Huang,
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Nitschke P, Lodge S, Hall D, Schaefer H, Spraul M, Embade N, Millet O, Holmes E, Wist J, Nicholson JK. Direct low field J-edited diffusional proton NMR spectroscopic measurement of COVID-19 inflammatory biomarkers in human serum. Analyst 2022; 147:4213-4221. [DOI: 10.1039/d2an01097f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A JEDI NMR pulse experiment incorporating relaxation, diffusion and J-modulation peak editing was implemented at a low field (80 MHz) spectrometer system to quantify two recently discovered plasma markers of SARS-CoV-2 infection and general inflammation.
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Affiliation(s)
- Philipp Nitschke
- Australian National Phenome Centre and Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA6150, Australia
| | - Samantha Lodge
- Australian National Phenome Centre and Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA6150, Australia
| | - Drew Hall
- Australian National Phenome Centre and Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA6150, Australia
| | - Hartmut Schaefer
- Bruker Biospin GmbH, Rudolf-Plank Strasse 23, 76275 Ettlingen, Germany
| | - Manfred Spraul
- Bruker Biospin GmbH, Rudolf-Plank Strasse 23, 76275 Ettlingen, Germany
| | - Nieves Embade
- Precision Medicine and Metabolism Laboratory, CIC bioGUNE, Parque Tecnológico de Bizkaia, Bld. 800, 48160, Derio, Spain
| | - Oscar Millet
- Precision Medicine and Metabolism Laboratory, CIC bioGUNE, Parque Tecnológico de Bizkaia, Bld. 800, 48160, Derio, Spain
| | - Elaine Holmes
- Australian National Phenome Centre and Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA6150, Australia
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, Sir Alexander Fleming Building, South Kensington, London SW7 2AZ, UK
| | - Julien Wist
- Australian National Phenome Centre and Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA6150, Australia
- Chemistry Department, Universidad del Valle, Cali 76001, Colombia
| | - Jeremy K. Nicholson
- Australian National Phenome Centre and Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA6150, Australia
- Institute of Global Health Innovation, Faculty of Medicine, Imperial College London, Level 1, Faculty Building, South Kensington Campus, London, SW7 2NA, UK
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Ma W, Ren X, Zhang L, Dong H, Lu X, Feng W. Apolipoprotein E Gene Polymorphism and Coronary Artery Disease Risk Among Patients in Northwest China. Pharmgenomics Pers Med 2021; 14:1591-1599. [PMID: 34908864 PMCID: PMC8665779 DOI: 10.2147/pgpm.s338285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/23/2021] [Indexed: 12/25/2022] Open
Abstract
PURPOSE The association between apolipoprotein E (ApoE) gene polymorphisms and the risk of coronary artery disease (CAD) among different populations has been assessed in numerous previous studies, but the results remain inconclusive. The present study aimed to determine the role of ApoE genotypes in CAD risk and the interrelationships between lipid profiles and ApoE alleles and genotypes among the population of northwest China. PATIENTS AND METHODS This study was performed on 308 patients with CAD and 308 control participants. ApoE gene polymorphism was analysed using the polymerase chain reaction and hybridization. RESULTS The findings indicated that the frequencies of ε3/ε4 genotype and ε4 allele frequency were significantly higher in patients with CAD than in the control participants. ε2 carriers had significantly lower total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) levels than did ε3 or ε4 carriers among the control participants. However, our study found no significant differences in plasma lipoprotein levels between ɛ2, ɛ3 and ɛ4 carriers in patients with CAD. Moreover, ε4 carriers had significantly higher ApoB, ApoB/ApoA-I levels and significantly lower ApoE levels in both patients with CAD and control participants. ε4 allele presence was associated with a nearly two-fold higher CAD risk. After adjusting for other established risk factors, ε4 allele was an independent risk factor for CAD. After stratified by age (≤ 60 years and >60 years), ε4 allele was indicated to increase the CAD risk 3.3-fold in elderly patients with CAD, but not in young patients with CAD. After stratified by sex, ε4 allele was not a risk factor in females and males patients with CAD. CONCLUSION This study provides evidence that the ε4 allele, drinking, smoking, hypertension, and TG and ApoE levels are independent risk factor for CAD among patients in northwest China.
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Affiliation(s)
- Wenbing Ma
- Department of Pharmacology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, 710061, People’s Republic of China
- Department of Biological Science and Bioengineering, Key Laboratory of Biomedical Information Engineering of the Ministry of Education, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, Shaanxi, 710049, People’s Republic of China
| | - Xiaodong Ren
- Department of Pharmacology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, 710061, People’s Republic of China
| | - Liting Zhang
- Department of Pharmacology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, 710061, People’s Republic of China
| | - Haiyan Dong
- Department of Pharmacology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, 710061, People’s Republic of China
| | - Xiaoyun Lu
- Department of Biological Science and Bioengineering, Key Laboratory of Biomedical Information Engineering of the Ministry of Education, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, Shaanxi, 710049, People’s Republic of China
| | - Weiyi Feng
- Department of Pharmacology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, 710061, People’s Republic of China
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Holmes E, Wist J, Masuda R, Lodge S, Nitschke P, Kimhofer T, Loo RL, Begum S, Boughton B, Yang R, Morillon AC, Chin ST, Hall D, Ryan M, Bong SH, Gay M, Edgar DW, Lindon JC, Richards T, Yeap BB, Pettersson S, Spraul M, Schaefer H, Lawler NG, Gray N, Whiley L, Nicholson JK. Incomplete Systemic Recovery and Metabolic Phenoreversion in Post-Acute-Phase Nonhospitalized COVID-19 Patients: Implications for Assessment of Post-Acute COVID-19 Syndrome. J Proteome Res 2021; 20:3315-3329. [PMID: 34009992 PMCID: PMC8147448 DOI: 10.1021/acs.jproteome.1c00224] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Indexed: 12/15/2022]
Abstract
We present a multivariate metabotyping approach to assess the functional recovery of nonhospitalized COVID-19 patients and the possible biochemical sequelae of "Post-Acute COVID-19 Syndrome", colloquially known as long-COVID. Blood samples were taken from patients ca. 3 months after acute COVID-19 infection with further assessment of symptoms at 6 months. Some 57% of the patients had one or more persistent symptoms including respiratory-related symptoms like cough, dyspnea, and rhinorrhea or other nonrespiratory symptoms including chronic fatigue, anosmia, myalgia, or joint pain. Plasma samples were quantitatively analyzed for lipoproteins, glycoproteins, amino acids, biogenic amines, and tryptophan pathway intermediates using Nuclear Magnetic Resonance (NMR) spectroscopy and mass spectrometry. Metabolic data for the follow-up patients (n = 27) were compared with controls (n = 41) and hospitalized severe acute respiratory syndrome SARS-CoV-2 positive patients (n = 18, with multiple time-points). Univariate and multivariate statistics revealed variable patterns of functional recovery with many patients exhibiting residual COVID-19 biomarker signatures. Several parameters were persistently perturbed, e.g., elevated taurine (p = 3.6 × 10-3 versus controls) and reduced glutamine/glutamate ratio (p = 6.95 × 10-8 versus controls), indicative of possible liver and muscle damage and a high energy demand linked to more generalized tissue repair or immune function. Some parameters showed near-complete normalization, e.g., the plasma apolipoprotein B100/A1 ratio was similar to that of healthy controls but significantly lower (p = 4.2 × 10-3) than post-acute COVID-19 patients, reflecting partial reversion of the metabolic phenotype (phenoreversion) toward the healthy metabolic state. Plasma neopterin was normalized in all follow-up patients, indicative of a reduction in the adaptive immune activity that has been previously detected in active SARS-CoV-2 infection. Other systemic inflammatory biomarkers such as GlycA and the kynurenine/tryptophan ratio remained elevated in some, but not all, patients. Correlation analysis, principal component analysis (PCA), and orthogonal-partial least-squares discriminant analysis (O-PLS-DA) showed that the follow-up patients were, as a group, metabolically distinct from controls and partially comapped with the acute-phase patients. Significant systematic metabolic differences between asymptomatic and symptomatic follow-up patients were also observed for multiple metabolites. The overall metabolic variance of the symptomatic patients was significantly greater than that of nonsymptomatic patients for multiple parameters (χ2p = 0.014). Thus, asymptomatic follow-up patients including those with post-acute COVID-19 Syndrome displayed a spectrum of multiple persistent biochemical pathophysiology, suggesting that the metabolic phenotyping approach may be deployed for multisystem functional assessment of individual post-acute COVID-19 patients.
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Affiliation(s)
- Elaine Holmes
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
- Department of Metabolism, Digestion, and Reproduction,
Faculty of Medicine, Imperial College London, Sir Alexander
Fleming Building, South Kensington, London SW7 2AZ, U.K.
| | - Julien Wist
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
- Chemistry Department, Universidad del
Valle, 76001 Cali, Colombia
| | - Reika Masuda
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
| | - Samantha Lodge
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
| | - Philipp Nitschke
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
| | - Torben Kimhofer
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
| | - Ruey Leng Loo
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
| | - Sofina Begum
- Department of Metabolism, Digestion, and Reproduction,
Faculty of Medicine, Imperial College London, Sir Alexander
Fleming Building, South Kensington, London SW7 2AZ, U.K.
| | - Berin Boughton
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
| | - Rongchang Yang
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
| | - Aude-Claire Morillon
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
| | - Sung-Tong Chin
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
| | - Drew Hall
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
| | - Monique Ryan
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
| | - Sze-How Bong
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
| | - Melvin Gay
- Bruker Pty. Ltd., Preston,
VIC 3072, Australia
| | - Dale W. Edgar
- State Adult Burn Unit, Fiona Stanley
Hospital, Murdoch, WA 6150, Australia
- Burn Injury Research Node, The University
of Notre Dame, Fremantle, WA 6160, Australia
| | - John C. Lindon
- Department of Surgery and Cancer, Faculty of
Medicine, Imperial College London, London SW7 2AZ,
U.K.
| | - Toby Richards
- Department of Surgery, Fiona Stanley Hospital, Medical
School, University of Western Australia,Harry Perkins Building,
Murdoch, Perth, WA 6150, Australia
| | - Bu B. Yeap
- Department of Endocrinology and Diabetes, Fiona
Stanley Hospital, Medical School, University of Western
Australia, Harry Perkins Building, Murdoch, Perth, WA 6150,
Australia
| | - Sven Pettersson
- Singapore National NeuroScience
Centre, Mandalay Road, Singapore 308232,
Singapore
- Lee Kong Chian School of Medicine.
Nanyang Technological University, Mandalay Road, Singapore
308232, Singapore
- Department of Life Science Centre,
Sunway University, Kuala Lumpur 47500,
Malaysia
| | | | | | - Nathan G. Lawler
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
| | - Nicola Gray
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
| | - Luke Whiley
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Perron Institute for Neurological and
Translational Science, Nedlands, WA 6009,
Australia
| | - Jeremy K. Nicholson
- Australian National Phenome Centre, Health Futures
Institute, Murdoch University, Harry Perkins Building, 5 Robin
Warren Drive, Perth, WA 6150, Australia
- Center for Computational and Systems Medicine, Health
Futures Institute, Murdoch University, 5 Robin Warren Drive,
Perth, WA 6150, Australia
- Institute of Global Health Innovation,
Imperial College London, Level 1, Faculty Building, South
Kensington Campus, London SW7 2AZ, U.K.
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12
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Gao L, Zhang Y, Wang X, Dong H. Association of apolipoproteins A1 and B with type 2 diabetes and fasting blood glucose: a cross-sectional study. BMC Endocr Disord 2021; 21:59. [PMID: 33794863 PMCID: PMC8017773 DOI: 10.1186/s12902-021-00726-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 03/25/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Apolipoprotein (Apo) may be associated with type 2 diabetes (T2D), however, little is known whether or not serum apolipoproteins are correlated with fasting blood glucose (FBG) and the prevalence of T2D in Chinese populations. In this study, we examined the association of serum ApoA1, ApoB, and the ratio of ApoB/ApoA1 (ApoB/A1 ratio) with T2D and FBG level, and compared apolipoprotein indicators in predicting T2D in Chinese adults. METHODS A total of 1027 subjects were enrolled in this cross-sectional study. The association of ApoA1, ApoB, and ApoB/A1 ratio with T2D prevalence was determined using logistic regression models. Multivariate-analysis of covariance (ANCOVA) was performed for comparisons of the mean difference in FBG level. RESULTS We found that ApoB and ApoB/A1 ratio were positively associated with T2D prevalence and FBG, while inverse association was noted between ApoA1 and T2D prevalence as well as FBG. Stratified analyses for sex, age, body mass index (BMI), smoking, and alcohol consumption showed no significant difference for the association of ApoA1, ApoB, and ApoB/A1 ratio with the prevalence of T2D among subgroups (all p-interactions> 0.05). Nonetheless, ApoA1 poorly performed in predicting T2D as it provided an AUC value of 0.310 that was significantly lower than those observed for ApoB (AUC value: 0.631) and ApoB/A1 ratio (AUC value: 0.685). Finally, path analyses indicated that the association between ApoB and T2D was mediated by BMI. CONCLUSIONS This study reveals the association of serum ApoA1, ApoB, and ApoB/A1 ratio with T2D and FBG in Chinese adults, suggesting that ApoB and ApoB/A1 ratio may be early indicators for predicting T2D. Prospective investigation in large cohort is needed.
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Affiliation(s)
- Liang Gao
- Department of Clinical Laboratory, Affiliated Maternity & Child Health Care Hospital of Nantong University, Nantong, 226018, Jiangsu Province, China
| | - Yaju Zhang
- Finance Section, Affiliated Traditional Chinese Medicine Hospital of Nantong University, Nantong, 226018, Jiangsu Province, China
| | - Xingmin Wang
- Nantong Institute of Genetics and Reproductive Medicine, Affiliated Maternity & Child Health Care Hospital of Nantong University, Nantong, 226018, Jiangsu Province, China.
| | - Hongli Dong
- Scientific Education Section, Affiliated Maternity & Child Health Care Hospital of Nantong University, Nantong, 226018, Jiangsu Province, China.
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13
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Zhou B, Ren H, Zhou X, Yuan G. Associations of iron status with apolipoproteins and lipid ratios: a cross-sectional study from the China Health and Nutrition Survey. Lipids Health Dis 2020; 19:140. [PMID: 32546165 PMCID: PMC7298938 DOI: 10.1186/s12944-020-01312-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 06/04/2020] [Indexed: 12/23/2022] Open
Abstract
Background Iron overload has been found to be related with various cardiometabolic disorders, like dyslipidemia, metabolic syndrome, and diabetes. The disturbance of the iron status and lipid metabolism can contribute to organ damage such as atherosclerotic plaque growth and instability. An assessment on the associations of iron status with apolipoproteins and lipid ratios would be informative for maintenance of metabolic homeostasis and hinderance of disease progression. Hence, this study aims to establish the relationships of iron status with apolipoproteins and lipid ratios. Methods A cross-sectional study of 7540 adult participants from the China Health and Nutrition Survey 2009 was conducted. Logistic regression analyses were used to investigate the relationships between indicators of iron status and the prevalence of unfavorable apolipoprotein profiles. Multivariate linear regression models were constructed to assess the dose-response correlations between serum ferritin and lipid parameters. Results After adjustment for confounding factors, in both sexes, the subjects in the top quartile of ferritin had the highest prevalence of an elevated apolipoprotein B (men: odds ratio (OR) 1.97, 95% confidence interval (CI) 1.50–2.62; women: OR 2.13, 95% CI 1.53–2.97) and an elevated apolipoprotein B/apolipoprotein A1 ratio (men: OR 2.00, 95% CI 1.50–2.66; women: OR 1.41, 95% CI 1.04–1.92) when compared with individuals in the lowest quartile. Hemoglobin were also independently associated with unfavorable apolipoprotein B and apolipoprotein B/apolipoprotein A1 ratio both in men and women. However, transferrin (men: OR 0.74, 95% CI 0.56–0.99; women: OR 0.73, 95% CI 0.56–0.95) and soluble transferrin receptor (men: OR 0.75, 95% CI 0.57–0.99; women: OR 0.71, 95% CI 0.55–0.91) were found to be negatively associated with a decreased apolipoprotein A1. Moreover, after controlling for potential confounders, the ferritin concentrations were significantly associated with the levels of lipid ratios including TG/HDL-C, non-HDL-C/HDL-C, TC/HDL-C, apoB/apoA1, and LDL-C/HDL-C ratio in men (β coefficient = 0.147, 0.061, 0.043, 0.038, 0.032, respectively, all P values < 0.001) and in women (β coefficient = 0.074, 0.034, 0.025, 0.020, 0.018, respectively, all P values < 0.05). Conclusions The indicators of iron status are significantly associated with unfavorable apolipoprotein profiles. Serum ferritin concentrations are positively correlated with the levels of lipid ratios. The management on the modifiable iron status and lipid metabolism has a clinical significance. The atherosclerotic lipid profiles of the patients with iron overload deserve special clinical concerns.
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Affiliation(s)
- Bowen Zhou
- Department of Endocrinology and Metabolism, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Huihui Ren
- Department of Endocrinology and Metabolism, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Xinrong Zhou
- Department of Endocrinology and Metabolism, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Gang Yuan
- Department of Endocrinology and Metabolism, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
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14
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Wang X, Wang Z, Li B, Yang P. Prognosis evaluation of universal acute coronary syndrome: the interplay between SYNTAX score and ApoB/ApoA1. BMC Cardiovasc Disord 2020; 20:293. [PMID: 32539722 PMCID: PMC7294645 DOI: 10.1186/s12872-020-01562-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 06/01/2020] [Indexed: 02/08/2023] Open
Abstract
Background Acute coronary syndrome (ACS) is a group of clinical syndromes associated with substantial morbidity and mortality rate. SYNTAX and SYNTAX II score used to be a reference for surgical selection of coronary revascularization and prognosis evaluation in patients with 3-vessel or left main artery disease. In addition, apoB/apoA1 is an important predictor of ACS risk. This study aims to assess the prognosis value of different kinds of SYNTAX score together with apoB/apoA1 in universal ACS patients (Regardless of ACS type, lesion location and vessel numbers). Method Three hundred ninety-six patients with ACS undergoing percutaneous coronary intervention(PCI)and coronary stenting from 2013 to 2014 were chosen and recorded the major adverse cardiovascular and cerebrovascular events (MACCE) and quality of life during the next 5 years. According to SYNTAX and SYNTAX II score, the patients were divided into low-risk, medium-risk and high-risk groups, and the clinical features, MACCE incidence and EQ-5D score at each time points were compared. And the predictive factors of MACCE incidence were analyzed. Results ① Compared with SYNTAX low-risk group, MACCE incidence in 1 year significantly increased in medium/high risk group (p = 0.011). Compared with SYNTAX II low-risk group, MACCE incidence in 5 years significantly increased in medium and high-risk group (p = 0.032). ② Compared with SYNTAX II low-risk group, cardiovascular mortality in 3 and 5 years significantly elevated in high-risk group (p = 0.001, p<0.001 respectively). ③ Compared with SYNTAX II low and medium-risk group, EQ-5D score in 5 years significantly decreased in high-risk group (p = 0.019, p = 0.023 respectively). ④ ApoB/ApoA1 was more likely to be classified as high risk in SYNTAX/SYNTAX II medium and high-risk group (p = 0.023, p = 0.044 respectively). ⑤ Logistic regression analysis showed that apoB/apoA1 was an independent predictor of MACCE events in hospital and 5 years (p = 0.038, p = 0.016 respectively), SYNTAX score was an independent predictor of MACCE events in 1 year (medium-risk group: p = 0.02; high-risk group: p = 0.015) SYNTAX II score was an independent predictor of MACCE events in 5 yeasrs (p = 0.003). Conclusions ① SYNTAX score has a high predictive value for short-term prognosis while SYNTAX II score is more predictive of long-term prognosis. ② SYNTAX II score is superior to SYNTAX score in predicting cardiovascular death. ③ The combination of apoB/apoA1 high-risk and SYNTAX II medium and high-risk group is the focus of clinical treatment and long-term follow-up observation.
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Affiliation(s)
- Xiaotong Wang
- Department of Cardiology, China-Japan Union hospital of Jilin university, 126 Xiantai Street, Changchun, 130031, China
| | - Zhongyu Wang
- Department of Cardiology, China-Japan Union hospital of Jilin university, 126 Xiantai Street, Changchun, 130031, China
| | - Bing Li
- Department of Cardiology, China-Japan Union hospital of Jilin university, 126 Xiantai Street, Changchun, 130031, China.
| | - Ping Yang
- Department of Cardiology, China-Japan Union hospital of Jilin university, 126 Xiantai Street, Changchun, 130031, China
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15
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Liu Y, Jia SD, Yuan DS, Xu N, Jiang L, Gao Z, Chen J, Yang YJ, Gao RL, Xu B, Yuan JQ. Apolipoprotein B/A-I Ratio Predicts Lesion Severity and Clinical Outcomes in Diabetic Patients With Acute Coronary Syndrome. Circ J 2020; 84:1132-1139. [PMID: 32418956 DOI: 10.1253/circj.cj-19-1097] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Dyslipidemia plays a crucial role in acute coronary syndrome (ACS). Paucity of data is available concerning the effect of apolipoprotein (apo) B/A-I ratio on the severity and outcomes in diabetic patients with ACS. This study investigated these associations in a Chinese cohort undergoing percutaneous coronary intervention.Methods and Results:In 2013, a total of 2,563 diabetic patients concomitant with ACS were included. Patients were divided into 2 groups based on the apoB/apoA-I ratio on admission: <0.63 (n=1,279, 49.9%) and ≥0.63 (n=1,284, 50.1%). Angiographic complexity and severity were determined by SYNTAX score (SS). A higher apo ratio was significantly associated with higher proportions of acute myocardial infarction (MI) and intermediate-high SS. Multivariable logistic regression analysis showed that the apo ratio was an independent factor of complicated lesions (OR 1.341, 95% confidence interval 1.039-1.730, P=0.024). Moreover, consistent results were found in the subgroups of normal concentrations of conventional lipid parameters. During a median follow-up period of 878 days, significant differences were found in periprocedural MI (1.0% vs. 2.2%, P=0.019) and total events of MI (2.0% vs. 3.3%, P=0.028). After adjusting for confounders, a high apo ratio remained independently predictive of MI, the risk of which was doubled during the periprocedural period and in the long term. CONCLUSIONS The ApoB/apoA-I ratio is an independent predictor for complicated lesions and future MI in patients with diabetes and ACS.
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Affiliation(s)
- Yue Liu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College
| | - Si-da Jia
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College
| | - De-Shan Yuan
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College
| | - Na Xu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College
| | - Lin Jiang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College
| | - Zhan Gao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College
| | - Jue Chen
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College
| | - Yue-Jin Yang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College
| | - Run-Lin Gao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College
| | - Bo Xu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College
| | - Jin-Qing Yuan
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College
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16
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Li X, Wang F, Xu H, Qian Y, Zou J, Yang M, Zhu H, Yi H, Guan J, Yin S. Interrelationships among common predictors of cardiovascular diseases in patients of OSA: A large-scale observational study. Nutr Metab Cardiovasc Dis 2020; 30:23-32. [PMID: 31753787 DOI: 10.1016/j.numecd.2019.07.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/19/2019] [Accepted: 07/19/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS The apolipoprotein B/apolipoprotein A-I (ApoB/ApoA-I) and insulin resistance has been recognized as common cardiovascular diseases (CVD) risk factors. However, whether they were biomarkers for 10-year CVD risk in obstructive sleep apnea (OSA) had been rarely studied. Besides, interrelationships between the ApoB/ApoA-I, insulin resistance and OSA remain unclear. METHODS AND RESULTS A total of 4010 subjects were finally included. Anthropometric, fasting biochemical, and polysomnographic parameters were collected. 10-year Framingham CVD risk score (FRS) was calculated for each subjects. The relationships between insulin resistance, OSA risk and the ApoB/ApoA-I was evaluated through logistic regressions analysis, restricted cubic spline (RCS) analysis and mediation analysis. ApoB/ApoA-I, HOMA-IR and AHI were all risk factors for high10-year CVD risk as assessed by FRS (odds ratios (OR) = 5.365, 1.094, 1.010, respectively, all P < 0.001)). The fully adjusted OR (95% confidence intervals) for both OSA [1 (reference), 1.308 (1.027-1.665), 1.517 (1.178-1.953), and 1.803 (1.371-2.372)] and insulin resistance [1 (reference), 1.457 (1.173-1.711), 1.701 (1.369-2.113), 2.051(1.645-2.558)] increased from the first to the fourth quartiles of the ApoB/ApoA-I. The RCS mapped a nonlinear dose-effect relationship between the ApoB/ApoA-I and risk of insulin resistance and OSA. Mediation analyses showed HOMA-IR explain 9.7%, 4.7% and 10.8% of the association between apnea-hypopnea index, oxygen desaturation index, micro-arousal index and ApoB/ApoA-I, respectively. CONCLUSIONS Our study revealed that ApoB/ApoA-I, insulin resistance and OSA were risk factors for CVD. Insulin resistance may serve as a potential mediator in OSA-related lipoprotein disorders and further increase CVD risk.
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Affiliation(s)
- Xinyi Li
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, 200233 Shanghai, China; Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, 200233 Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, China.
| | - Fan Wang
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, 200233 Shanghai, China; Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, 200233 Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, China.
| | - Huajun Xu
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, 200233 Shanghai, China; Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, 200233 Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, China.
| | - Yingjun Qian
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, 200233 Shanghai, China; Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, 200233 Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, China.
| | - Jianyin Zou
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, 200233 Shanghai, China; Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, 200233 Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, China.
| | - Mingpo Yang
- Institute of Neuroscience, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Yueyang Road 320, 200031 Shanghai, China.
| | - Huaming Zhu
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, 200233 Shanghai, China; Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, 200233 Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, China.
| | - Hongliang Yi
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, 200233 Shanghai, China; Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, 200233 Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, China.
| | - Jian Guan
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, 200233 Shanghai, China; Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, 200233 Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, China.
| | - Shankai Yin
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, 200233 Shanghai, China; Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, 200233 Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, China.
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Yücel Ç, Omma A, Sertoğlu E, Sezer S, Turhan T, Özgürtaş T. Evaluation of atherogenic laboratory markers in Behçet's disease patients with vascular involvement. Arch Med Sci 2020; 16:531-537. [PMID: 32399099 PMCID: PMC7212210 DOI: 10.5114/aoms.2018.79139] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 08/21/2018] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Behçet's disease is a chronic inflammatory vasculitis presenting with immunological and endothelial changes. The aim of the present study is to evaluate blood levels of diagnostic markers which can be used in Behçet's patients with vascular involvement. MATERIAL AND METHODS Fifty Behçet's patients (22 with vascular involvement) and 30 healthy controls were included in the study. High-sensitivity C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR), tumor necrosis factor-α (TNF-α), apolipoprotein A1 (apoA1), apolipoprotein B (apoB), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride, total cholesterol, Lp-plA-2, homocysteine and ischemia modified albumin (IMA) levels were analyzed. Statistical analysis was performed with the SPSS program version 11.0. p < 0.05 was accepted as statistically significant. RESULTS hsCRP, TNF-α, homocysteine, IMA, apoA1, apoB, HDL, Lp-pla2 and ESR levels in patient and control groups were significantly different (p < 0.001, p = 0.001, p < 0.001, p < 0.001, p = 0.005, p < 0.001, p < 0.001, p < 0.001 and p = 0.003 respectively). In Behçet's patients with vascular involvement, homocysteine, TNF-α and Lp-pla2 levels were significantly higher than in Behçet's patients without vascular involvement (p = 0.035, p = 0.010 and p < 0.001 respectively). CONCLUSIONS Increased levels of inflammatory and atherogenic markers in Behçet's patients are an expected outcome due to the inflammatory nature of the disease. Especially, elevated levels of homocysteine, TNF-α and Lp-pla2 make them candidate diagnostic tools to be helpful in clinical evaluation of Behçet's disease patients with vascular involvement.
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Affiliation(s)
- Çiğdem Yücel
- Department of Clinical Biochemistry, Ankara Numune Training and Research Hospital, Altındağ, Ankara, Turkey
| | - Ahmet Omma
- Department of Rheumatology Ankara Numune Training and Research Hospital, Altındağ, Ankara, Turkey
| | - Erdim Sertoğlu
- Department of Clinical Biochemistry, Ankara Gülhane Training and Research Hospital, Etlik, Ankara, Turkey
| | - Sevilay Sezer
- Department of Clinical Biochemistry, Ankara Numune Training and Research Hospital, Altındağ, Ankara, Turkey
| | - Turan Turhan
- Department of Clinical Biochemistry, Ankara Numune Training and Research Hospital, Altındağ, Ankara, Turkey
| | - Taner Özgürtaş
- Department of Clinical Biochemistry, Ankara Gülhane Training and Research Hospital, Etlik, Ankara, Turkey
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Suastika K, Semadi IMS, Dwipayana IMP, Saraswati MR, Gotera W, Budhiarta AAG, Matsumoto K, Kajiwara N, Taniguchi H. Dyslipidemia in diabetes: a population-based study in Bali. Int J Gen Med 2019; 12:313-321. [PMID: 31564954 PMCID: PMC6730602 DOI: 10.2147/ijgm.s215548] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 08/15/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose To establish the lipid pattern in subjects with diabetes mellitus (DM) and factors that are correlated with insulin resistance and lipid disorders in a population of Bali. Methods A cross-sectional population-based study which enrolled 1840 subjects (age 13–100 years) from 7 villages was carried out. Several clinical parameters were measured including age, gender, body mass index, waist circumference (WC), fasting blood glucose, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein (apo) A (apoA), apoB, non-HDL-C, T/HDL-C ratio, LDL-C/apoB ratio, apoB/A ratio, plasma insulin, and homeostasis of model assessment-insulin resistance (HOMA-IR). Results TC, TG, and non-HDL-C levels were higher in DM subjects than in normal glucose tolerance (NGT) subjects in both genders; total/HDL-C ratio was higher in subjects with DM than in NGT subjects only in men; LDL-C levels, apoB levels, and apoB/A ratios were higher and LDL/apoB was lower in subjects with DM than in NGT in women. In subjects with DM, the target for LDL-C (79%), non-HDL-C (85.2%), apoB (80%), HDL-C (34.9%), TG (46.7%), and small-dense low density lipoprotein (42.2%) was not achieved. Conclusion FBG was correlated with TC, TG, LDL-C, apoB, non-HDL-C levels, LDL/apoB, and apoB/apoA ratios. Subjects with DM had higher levels of TC, TG, and non-HDL-C levels in both genders; T/HDL-C ratio only in men; LDL-C, apoB/apoA ratio and lower LDL/apoB ratio only in women. Obesity was correlated with lipid levels. WC was correlated with LDL/apoB ratio, insulin level, HOMA-IR, and TG; highest absolute strength of correlation was with LDL/apoB ratio. Insulin resistance was correlated with lipid levels or ratios, especially in women. In women, HOMA-IR had a positive correlation with total/HDL-C ratio, non-HDL-C, apoB, and a negative correlation with HDL-C levels.
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Affiliation(s)
- Ketut Suastika
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia
| | - I Made Siswadi Semadi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia
| | - I Made Pande Dwipayana
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia
| | - Made Ratna Saraswati
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia
| | - Wira Gotera
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia
| | - Anak Agung Gde Budhiarta
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia
| | - Kinuyo Matsumoto
- Graduate School of Life Science, Kobe Women's University, Kobe, Japan
| | - Naemi Kajiwara
- Graduate School of Life Science, Kobe Women's University, Kobe, Japan
| | - Hiroshi Taniguchi
- Department of Diabetology, Graduate School of Health Sciences, Kobe University, Kobe, Japan
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Ren H, Liu Z, Zhou X, Yuan G. Association of sleep duration with apolipoproteins and the apolipoprotein B/A1 ratio: the China health and nutrition survey. Nutr Metab (Lond) 2018; 15:1. [PMID: 29312456 PMCID: PMC5755033 DOI: 10.1186/s12986-017-0237-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 12/25/2017] [Indexed: 02/01/2023] Open
Abstract
Background Short sleep duration has been related to established cardiovascular risk factors, likely obesity, diabetes, hypertension and dyslipidaemia. However, to the best of our knowledge, the associations between sleep duration and apolipoprotein concentrations and their ratios have not been investigated to date. This study aimed to explore the independent relationship of sleep duration with apolipoprotein (apo) A1, apoB and the apoB/apoA1 ratio in a Chinese adult population. Methods Data from 7381 participants, aged 18 to 75 years, from the National Health and Nutrition Survey 2009 were analysed in this cross-sectional study. Participants were divided into 3 categories according to sleep duration: ≤6, 7-8, and ≥9 h. Logistic regression analysis with odds ratios was employed to assess the association between sleep duration and apo profile. Results Using 7-8 h of sleep as a reference, short sleep duration was associated with significantly increased odds of elevated apoB (OR =1.75, 95% CI 1.12-2.72), whereas long sleep duration was correlated with a decreased (but not statistically significant) risk for elevated apoB (OR =0.86, 95% CI 0.54-1.38) among females after controlling for covariates. Among males, long sleep duration was only marginally related to decreased odds ratios for elevated apoB/apoA1 ratio after adjustment for covariates (OR =0.78, 95% CI 0.6-0.99). Conclusions These results indicate that short sleep duration is strongly associated with an increased risk of elevated apoB levels in women and that long sleep duration is correlated with decreased apoB/apoA1 levels in men. Sleep hygiene management could serve to treat and prevent cardiovascular diseases by altering unfavourable apo profile.
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Affiliation(s)
- Huihui Ren
- Department of Internal Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei 430030 People's Republic of China
| | - Zhelong Liu
- Department of Internal Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei 430030 People's Republic of China
| | - Xinrong Zhou
- Department of Internal Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei 430030 People's Republic of China
| | - Gang Yuan
- Department of Internal Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei 430030 People's Republic of China
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