Hemodynamics assessed via approximate entropy analysis of impedance cardiography time series: effect of metabolic syndrome

Therapeutic potential of cPLA2 inhibitor to counteract dilated-cardiomyopathy in cholesterol-treated H9C2 cardiomyocyte and MUNO rat

BACKGROUND AND PURPOSE

The pathogenesis of cardiomyopathy in metabolically unhealthy obesity (MUO) has been well studied. However, the pathogenesis of cardiomyopathy typically associated with high cholesterol levels in metabolically unhealthy nonobesity (MUNO) remains unclear. We investigated whether cholesterol-generated LysoPCs contribute to cardiomyopathy and the role of cytosolic phospholipase A2 (cPLA2) inhibitor in cholesterol-induced MUNO.

EXPERIMENTAL APPROACH

Cholesterol diet was performed in Sprague-Dawley rats that were fed either regular chow (C), or high cholesterol chow (HC), or HC diet with 10 % fructose in drinking water (HCF) for 12 weeks. LysoPCs levels were subsequently measured in rats and in MUNO human patients. The effects of cholesterol-mediated LysoPCs on cardiac injury, and the action of cPLA2 inhibitor, AACOCF3, were further assessed in H9C2 cardiomyocytes.

KEY RESULTS

HC and HCF rats fed cholesterol diets demonstrated a MUNO-phenotype and cholesterol-induced dilated cardiomyopathy (DCM). Upregulated levels of LysoPCs were found in rat myocardium and the plasma in MUNO human patients. Further testing in H9C2 cardiomyocytes revealed that cholesterol-induced atrophy and death of cardiomyocytes was due to mitochondrial dysfunction and conditions favoring DCM (i.e. reduced mRNA expression of ANF, BNP, DSP, and atrogin-1), and that AACOCF3 counteracted the cholesterol-induced DCM phenotype.

CONCLUSION AND IMPLICATIONS

Cholesterol-induced MUNO-DCM phenotype was counteracted by cPLA2 inhibitor, which is potentially useful for the treatment of LysoPCs-associated DCM in MUNO.

Hemodynamic differences among hypertensive patients with and without heart failure using impedance cardiography

Background:

Impedance cardiography is a reliable, well-tolerated, and non-invasive method used to obtain hemodynamic measurements and could potentially be useful in heart failure (HF) diagnosis, hemodynamic monitoring of critically ill patients, and help in the choice of antihypertensive therapy. The objective of this study was to determine the differences between hemodynamic parameters in a study population of hypertensive patients with and without HF, using impedance cardiography.

Methods:

A case-control study was designed and named the TARGET study. Participants were enrolled in two study groups: control group C, hypertensive patients without HF and the HF group, hypertensive patients with HF. A descriptive analysis was carried out to characterize the sample and differences in continuous variables were tested for statistical significance by independent sample t test.

Results:

The study included 102 hypertensive outpatients. The control group consisted of 77 individuals (58.4% males; mean age 63.9 ± 12.5 years old) and the HF group consisted of 25 individuals (44.0% males; mean age 74.2 ± 8.7 years old). The mean Cardiac Index (CI) was 2.70 ± 1.02 L.min.m⁻² (2.89 ± 1.04 versus 2.12 ± 0.70; p < 0.001), mean Stroke Index (SI) was 35.5 ± 14.7 mL.m⁻² (37.7 ± 15.2 versus 28.5 ± 10.8; p = 0.006), mean Ejection Phase Contractility Index (EPCI) was 33.7 ± 12.7 1000 s⁻² (35.8 ± 13.1 versus 27.2 ± 9.2; p = 0.003), mean Inotropic State Index (ISI) was 74.3 ± 28.2 100 s⁻² (78.8 ± 28.9 versus 60.6 ± 20.7; p = 0.005), and mean Left Stroke Work Index (LSWI) was 51.3 ± 23.1 g.min.m⁻² (55.4 ± 23.5 versus 38.9 ± 16.6; p = 0.002).

Conclusions:

In this study, hypertensive patients with HF had significantly lower values of blood flow parameters, contractility, and left work indices compared with hypertensive patients without HF. These differences reflected the incorrect hemodynamic pattern (mostly hypodynamic) of these patients. Impedance cardiography (ICG) seems to be an adequate method to reflect these differences.

Metabolic syndrome is a risk factor for cancer mortality in the general Japanese population: the Jichi Medical School Cohort Study

BACKGROUND

Metabolic syndrome (MetS) and cancer are major public health problems worldwide. The relationship between MetS and cancer death is of great interest. We examined the predictive value of MetS for cancer mortality in Japan.

METHODS

Study participants included 4495 men and 7028 women aged 18-90 years who were registered between 1992 and 1995 as part of the Jichi Medical School Cohort Study. We used a definition of MetS modified for the Japanese population. The primary outcome was cancer mortality. Additionally, the relationship between MetS and cancer-type specific mortality was examined. Analyses were conducted with Cox's regression models adjusted for age, smoking status, alcohol drinking status, marital status, educational attainment, physical activity, occupational category, and menopausal status (only in women).

RESULTS

During a mean follow-up of 18.5 years, 473 men and 297 women died from cancer. MetS was positively associated with cancer mortality in women (hazard ratio [HR], 1.69; 95% confidence interval [CI] 1.21-2.36), but not in men (HR, 1.21; 95% CI 0.90-1.62). Additionally, MetS was associated with a high risk of colorectal (HR, 3.48; 95% CI 1.68-7.22) and breast (HR, 11.90; 95% CI 2.25-62.84) cancer deaths in women.

CONCLUSION

MetS was a significant predictor of cancer mortality in women.

Adipocytokine correlations with thyroid function and autoimmunity in euthyroid sardinians

OBJECTIVE

Cytokines release by adipocytes could interact with TSH secretion. We evaluated the relationship between adipocytokines and TSH. We further tested for association of cytokines and thyroid autoimmunity.

METHODS

We conducted a cross-sectional study in a community-based sample including 5385 individuals (2964 female) with TSH within the reference range. Subjects who reported taking thyroid medications or drugs that alter thyroid function were excluded. TSH, FT4, adiponectin, leptin, antibody against thyroperoxidase and against thyroglobulin were measured. Linear and logistic regression models were used to test for association.

RESULTS

Females had higher adiponectin and leptin level and increased frequency of thyroid antibodies. In multiple regression analysis TSH was directly associated with leptin (β = 0.003, p = 0.001) and the presence of circulating antibody against thyroperoxidase (β = 0.315, p < 0.001), but negatively associated with age (β = -0.012, p < 0.001) and FT4 (β = -0.359, p < 0.001). Adiponectin, the presence of antibody against thyroglobulin and smoking habit were not associated with TSH levels (p = 0.223, p = 0.174 and p = 0.788, respectively). Logistic regression analysis revealed that higher adiponectin levels were associated with thyroid autoimmunity.

CONCLUSIONS

Leptin is positively associated with TSH levels in euthyroid individuals, suggesting an effect of the adipokine on TSH secretion. Our results support the hypothesis that the leptin and pituitary-thyroid axis might interact in the context of energy homeostasis. The effect of adiponectin on thyroid autoimmunity will require more studies.

Role of dysfunctional adipocytes in cholesterol-induced nonobese metabolic syndrome

Many studies have reported the causes of obese metabolic syndrome (MS); however, the causes of nonobese MS (NMS) remain unknown. In this study, we demonstrated that inflamed dysfunctional adipose tissue plays a crucial role in cholesterol-induced NMS. Control (C), high cholesterol (HC) and HC with 10% fructose in drinking water (HCF) diets were fed to Sprague-Dawley rats for 12 weeks. After 12 weeks, the body weights of the C- and HC-fed rats were comparable, but the weights of the HCF-fed rats were relatively low. Cholesterol caused metabolic problems such as high blood pressure, hypercholesterolemia and hypoinsulinemia. The HCF-fed rats exhibited whole-body insulin resistance with low circulating high-density lipoprotein levels. Increases in the tumor necrosis factor α level in the plasma, the number of CD68+ macrophages and the free nuclear factor-κB level in gonadal white adipose tissue (gWAT) resulted in local inflammation, which appeared as inflamed dysfunctional gWAT. Reduced superoxide dismutases (SODs) deteriorate natural antioxidant defense systems and induce reactive oxygen species in gWAT. Dysregulation of plasma levels of catecholamine, adipokines (leptin and adiponectin), hormone-sensitive lipase and perilipin in cholesterol-induced inflamed adipose tissue contributed to increased lipolysis and increased circulating nonesterified fatty acids. Cholesterol activated inflammation, lipolysis and cell death in 3T3-L1 adipocytes. Moreover, Chol-3T3-CM reduced the population of M2-type Raw264.7 macrophages, indicating that the macrophage polarization is mediated by cholesterol. Together, our findings indicate that inflamed dysfunctional adipocytes are critical in NMS, supporting the development of anti-inflammatory agents as potential therapeutic drugs for treating NMS.

Hypoglycemia-related electroencephalogram changes assessed by multiscale entropy

BACKGROUND

Several clinical studies have shown that low blood glucose (BG) levels affect electroencephalogram (EEG) rhythms through the quantification of traditional indicators based on linear spectral analysis. Nonlinear measures used in the last decades to characterize the EEG in several physiopathological conditions have never been assessed in hypoglycemia. The present study investigates if properties of the EEG signal measured by nonlinear entropy-based algorithms are altered in a significant manner when a state of hypoglycemia is entered.

SUBJECTS AND METHODS

EEG was acquired from 19 patients with type 1 diabetes during a hyperinsulinemic-euglycemic-hypoglycemic clamp experiment. In parallel, BG was frequently monitored by the standard YSI glucose and lactate analyzer and used to identify two 1-h intervals corresponding to euglycemia and hypoglycemia, respectively. In each subject, the P3-C3 EEG derivation in the two glycemic intervals was assessed using the multiscale entropy (MSE) approach, obtaining measures of sample entropy (SampEn) at various temporal scales. The comparison of how signal irregularity measured by SampEn varies as the temporal scale increases in the two glycemic states provides information on how EEG complexity is affected by hypoglycemia.

RESULTS

For both glycemic states, the MSE analysis showed that SampEn increases at small time scales and then monotonically decreases as the time scale becomes larger. Comparing the two conditions, SampEn was higher in hypoglycemia only at medium time scales.

CONCLUSIONS

A decrease in the complexity of EEG occurs when a state of hypoglycemia is entered, because of a degradation of the EEG long-range temporal correlations. Thanks to its ability to assess nonlinear dynamics of the EEG signal, the MSE approach seems to be a useful tool to complement information brought by standard linear indicators and provide new insights on how hypoglycemia affects brain functioning.

Cardiovascular autonomic function analysis using approximate entropy from 24-h heart rate variability and its frequency components in patients with type 2 diabetes

Aims/Introduction

The principal aim of the present study was to investigate the cardiovascular autonomic system status of diabetes patients using approximate entropy (ApEn) extracted from 24-h heart rate variability (HRV) and its frequency components.

Materials and Methods

A total of 29 healthy controls and 63 type 2 diabetes patients were included. Participants’ 24-h HRV signals were recorded, and decomposed and reconstructed into four frequency components: high, low, very low and ultra low. The total 24-h HRV and its four components were divided into 24 1-h segments. ApEn values were extracted and statistically analyzed. Four traditional HRV indices, namely standard deviation of the RR intervals, root mean square of successive differences, coefficient of variance of RR intervals and ratio of low to high power of HRV, were also calculated.

Results

The low-frequency component contained the most abundant non-linear information, so was potentially most suitable for studying the cardiovascular system status with non-linear methods. ApEn values extracted from low- and high-frequency components of healthy controls were higher than those of diabetes patients. Except for root mean square of successive differences, standard deviation of the RR intervals, low to high power of HRV and coefficient of variance of RR intervals of healthy controls were all higher than those of diabetes patients.

Conclusions

The results showed that ApEn contained information on disorders of autonomic system function of diabetes patients as traditional HRV indices in time and frequency domains. ApEn and three traditional indices showed accordance to some degree. Non-linear information in subcomponents of HRV was shown, which is potentially more effective for distinguishing healthy individuals and diabetes patients than that extracted from the total HRV. Compared with diabetes patients, the cardiovascular system of healthy controls showed information of higher complexity, and better regulation function in response to changes of environment.

Overexpression of Jazf1 reduces body weight gain and regulates lipid metabolism in high fat diet

Jazf1 is a 27 kDa nuclear protein containing three putative zinc finger motifs that is associated with diabetes mellitus and prostate cancer; however, little is known about the role that this gene plays in regulation of metabolism. Recent evidence indicates that Jazf1 transcription factors bind to the nuclear orphan receptor TR4. This receptor regulates PEPCK, the key enzyme involved in gluconeogenesis. To elucidate Jazf1's role in metabolism, we fed a 60% fat diet for up to 15 weeks. In Jazf1 overexpression mice, weight gain was found to be significantly decreased. The expression of Jazf1 in the liver also suppressed lipid accumulation and decreased droplet size. These results suggest that Jazf1 plays a critical role in the regulation of lipid homeostasis. Finally, Jazf1 may provide a new therapeutic target in the management of obesity and diabetes.