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Dearing C, Sanford E, Olmstead N, Morano R, Wulsin L, Myers B. Sex-specific cardiac remodeling in aged rats after adolescent chronic stress: associations with endocrine and metabolic factors. Biol Sex Differ 2024; 15:65. [PMID: 39180122 PMCID: PMC11342553 DOI: 10.1186/s13293-024-00639-7] [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: 04/12/2024] [Accepted: 08/07/2024] [Indexed: 08/26/2024] Open
Abstract
BACKGROUND Cardiovascular disease is a leading cause of death worldwide. Rates of cardiovascular disease vary both across the lifespan and between sexes. While multiple factors, including adverse life experiences, impact the development and progression of cardiovascular disease, the potential interactions of biological sex and stress history on the aged heart are unknown. To this end, we examined sex- and stress-specific impacts on left ventricular hypertrophy (VH) after aging. We hypothesized that early-life chronic stress exposure impacts behavioral and physiologic responses that predict cardiac remodeling in a sex-specific manner. METHODS Histological analysis was conducted on hearts of male and female rats previously exposed to chronic variable stress during the late adolescent period (postnatal days 43-62). These animals were challenged with a forced swim test and a glucose tolerance test before aging to 15 months and again being challenged. Predictive analyses were then used to isolate factors that relate to cardiac remodeling among these groups. RESULTS Early-life chronic stress impacted cardiac remodeling in a sex-specific manner. Among rats with a history of chronic stress, females had increased concentric VH. However, there were few associations within the female groups among individual behavioral and physiologic parameters and cardiac remodeling. While males as a group did not have VH after chronic stress, they exhibited multiple individual associations with cardiac susceptibility. Passive coping in young males and active coping in aged males related to VH in a stress history-dependent manner. Moreover, baseline corticosterone positively correlated with VH in unstressed males, while chronically-stressed males had positive correlations between VH and visceral adiposity. CONCLUSIONS These results indicate that females as a group are uniquely susceptible to the effects of early-life stress on cardiac remodeling later in life. Conversely, males have more individual differences in vulnerability, where susceptibility to cardiac remodeling relates to endocrine, metabolic, and behavioral measures depending on stress history. These results ultimately support a framework for assessing cardiovascular risk based on biological sex and prior adverse experiences.
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Affiliation(s)
- Carley Dearing
- Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Ella Sanford
- Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | | | - Rachel Morano
- Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Lawson Wulsin
- Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Brent Myers
- Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
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Srinivasan N, Gullapalli N, Shah KS. Highlighting the South Asian Heart Failure Epidemic. Card Fail Rev 2024; 10:e07. [PMID: 39144581 PMCID: PMC11322948 DOI: 10.15420/cfr.2023.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 04/18/2024] [Indexed: 08/16/2024] Open
Abstract
Heart failure (HF) remains a progressive syndrome with high morbidity and mortality, and accounts for many hospitalisations globally with a downstream impact of increasing healthcare costs. South Asian individuals account for most of the global burden of non-communicable diseases. In this systematic review, a literature search was performed for all studies focusing on South Asians and HF using PubMed as the primary research tool and citations were included from relevant MEDLINE-indexed journals. Upon identification of relevant studies, pertinent data points were extracted systematically from each eligible study. South Asians have an earlier age of onset of many non-communicable diseases compared to other ethnic groups worldwide, including cardiovascular disease (CVD). Given the large number of South Asians impacted by CVD and both traditional and non-traditional risk factors for CVD, HF has the potential to become an epidemic among South Asians across the world. Individuals of South Asian origin are at elevated risk for CVD compared to many other populations and should be followed closely for the potential development of HF. This review describes what is unique to South Asian individuals at risk for and with established HF, as well as management and prognostic considerations. Future directions and potential policy changes are highlighted that can reduce the HF burden among South Asians globally.
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Affiliation(s)
| | - Nagesh Gullapalli
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Utah Salt Lake City, UT, US
| | - Kevin S Shah
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Utah Salt Lake City, UT, US
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Dearing C, Sanford E, Olmstead N, Morano R, Wulsin L, Myers B. Sex-Specific Cardiac Remodeling in Aged Rats after Early-Life Chronic Stress: Associations with Endocrine and Metabolic Factors. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.03.587944. [PMID: 38617312 PMCID: PMC11014584 DOI: 10.1101/2024.04.03.587944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Background Cardiovascular disease is a leading cause of death worldwide. Rates of cardiovascular disease vary both across the lifespan and between sexes. While multiple factors, including adverse life experiences, impact the development and progression of cardiovascular disease, the potential interactions of biological sex and stress history on the aged heart are unknown. To this end, we examined sex- and stress-specific impacts on left ventricular hypertrophy (VH) after aging. We hypothesized that early life chronic stress exposure impacts behavioral and physiologic responses that predict cardiac remodeling in a sex-specific manner. Methods Histological analysis was conducted on hearts of male and female rats previously exposed to chronic variable stress during the late adolescent period (postnatal days 43-62). These animals were challenged with a forced swim test and a glucose tolerance test before aging to 15 months and again being challenged. Predictive analyses were then used to isolate factors that relate to cardiac remodeling among these groups. Results Early-life chronic stress impacted cardiac remodeling in a sex-specific manner. Among rats with a history of chronic stress, females had increased inward VH. However, there were few associations within the female groups among individual behavioral and physiologic parameters and cardiac remodeling. While males as a group did not have VH after chronic stress, they exhibited multiple individual associations with cardiac susceptibility. Passive coping in young males and active coping in aged males related to VH in a stress history-dependent manner. Moreover, baseline corticosterone positively correlated with VH in unstressed males, while chronically-stressed males had positive correlations between VH and visceral adiposity. Conclusions These results indicate that females as a group are uniquely susceptible to the effects of early-life stress on cardiac remodeling later in life. Conversely, males have more individual differences in vulnerability, where susceptibility to cardiac remodeling relates to endocrine, metabolic, and behavioral measures depending on stress history. These results ultimately support a framework for accessing cardiovascular risk based on biological sex and prior adverse experiences.
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Affiliation(s)
- Carley Dearing
- Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Ella Sanford
- Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | | | - Rachel Morano
- Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Lawson Wulsin
- Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Brent Myers
- Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
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4
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Zhao X, Lu C, Song B, Chen D, Teng D, Shan Z, Teng W. The prevalence and clustering of metabolic syndrome risk components in Chinese population: a cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1290855. [PMID: 38152127 PMCID: PMC10751355 DOI: 10.3389/fendo.2023.1290855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/30/2023] [Indexed: 12/29/2023] Open
Abstract
Objective The metabolic syndrome (MetS) is diagnosed upon the manifestation of ≥ 3 out of 5 specific components. The present study evaluated the epidemiological characteristics of the MetS components and their clustering condition among Chinese adults. Methods 68383 participants aged 18-80 years from TIDE were scored on a six-point (0-5) MetS severity score (MSSS), which quantified their cumulative amount of MetS risk components. We evaluated the epidemiological characteristics of these components and their clustering conditions. Additionally, we examined the relation of age with the prevalence of different MSSSs or specific MetS components using restricted cubic splines. Results Among 68383 participants, 26113 men and 24582 women had abnormal MetS components. There were significant differences in most epidemiological characteristics between the 6 MSSS groups. The top three prevalence of abnormal metabolic components were high systolic blood pressure (SBP) (9.41%, n=6568), high waist circumference (WC) (8.13%, n=6120), and the cooccurrence of high SBP and high WC (6.33%, n=4622). Participants were more likely to have all five MetS components when HDL-C was low. Restricted cubic splines showed that when the MSSS ≥3, the MetS prevalence of male peaked and that of the female population increased most rapidly at 40-60 age group. Conclusion The 40-60 age group can be regarded as the high-risk period of MetS, and elderly women have a higher risk of multiple metabolic disorders than men. The top three clustering of abnormal metabolic components were high SBP, high WC, and their combination. Multiple components aggregation was more likely to occur when HDL-C decreased.
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Affiliation(s)
| | | | | | | | - Di Teng
- The Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, China
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Okura GC, Bharadwaj AG, Waisman DM. Recent Advances in Molecular and Cellular Functions of S100A10. Biomolecules 2023; 13:1450. [PMID: 37892132 PMCID: PMC10604489 DOI: 10.3390/biom13101450] [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: 08/17/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
S100A10 (p11, annexin II light chain, calpactin light chain) is a multifunctional protein with a wide range of physiological activity. S100A10 is unique among the S100 family members of proteins since it does not bind to Ca2+, despite its sequence and structural similarity. This review focuses on studies highlighting the structure, regulation, and binding partners of S100A10. The binding partners of S100A10 were collated and summarized.
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Affiliation(s)
- Gillian C. Okura
- Department of Pathology, Dalhousie University, Halifax, NS B3H 1X5, Canada; (G.C.O.); (A.G.B.)
| | - Alamelu G. Bharadwaj
- Department of Pathology, Dalhousie University, Halifax, NS B3H 1X5, Canada; (G.C.O.); (A.G.B.)
- Departments of Biochemistry and Molecular Biology, Dalhousie University, Halifax, NS B3H 1X5, Canada
| | - David M. Waisman
- Department of Pathology, Dalhousie University, Halifax, NS B3H 1X5, Canada; (G.C.O.); (A.G.B.)
- Departments of Biochemistry and Molecular Biology, Dalhousie University, Halifax, NS B3H 1X5, Canada
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Shao Q, Li J, Wu Y, Liu X, Wang N, Jiang Y, Zhao Q, Zhao G. Enhanced Predictive Value of Lipid Accumulation Product for Identifying Metabolic Syndrome in the General Population of China. Nutrients 2023; 15:3168. [PMID: 37513586 PMCID: PMC10383986 DOI: 10.3390/nu15143168] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/15/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023] Open
Abstract
The purpose of this research was to evaluate the lipid accumulation product (LAP)'s accuracy and predictive value for identifying metabolic syndrome (MS) in the general Chinese population compared with other obesity indicators. Baseline survey information from a population-based cohort study carried out in Shanghai's Songjiang District was used in this research. Odds ratios (OR) and a 95% confidence interval (CI) were obtained by logistic regression. The ability of each variable to detect MS was assessed using the receiver operating characteristic curve (ROC). The optimum cut-off point for each indicator was selected using Youden's index. The survey involved 35,446 participants in total. In both genders, the prevalence of MS rose as the LAP increased (p < 0.001). The LAP's AUC was 0.901 (95%CI: 0.895-0.906) in males and 0.898 (95%CI: 0.893-0.902) in females, making it substantially more predictive of MS than other variables (BMI, WC, WHR, WHtR). The optimal cutoff point of the LAP for men and women was 36.04 (Se: 81.91%, Sp: 81.06%) and 34.95 (Se: 80.93%, Sp: 83.04%). The Youden index of the LAP was 0.64 for both sexes. Our findings imply that the LAP, compared to other obesity markers in China, is a more accurate predictor of MS.
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Affiliation(s)
- Qi Shao
- Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China; (Q.S.); (X.L.); (N.W.); (G.Z.)
| | - Jing Li
- Zhongshan Community Health Center, Shanghai 201613, China;
| | - Yiling Wu
- Songjiang District Center for Disease Control and Prevention, Shanghai 201600, China; (Y.W.); (Y.J.)
| | - Xing Liu
- Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China; (Q.S.); (X.L.); (N.W.); (G.Z.)
| | - Na Wang
- Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China; (Q.S.); (X.L.); (N.W.); (G.Z.)
| | - Yonggen Jiang
- Songjiang District Center for Disease Control and Prevention, Shanghai 201600, China; (Y.W.); (Y.J.)
| | - Qi Zhao
- NHC Key Laboratory of Health Technology Assessment, Department of Social Medicine, School of Public Health, Fudan University, Shanghai 200032, China
| | - Genming Zhao
- Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China; (Q.S.); (X.L.); (N.W.); (G.Z.)
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Koh HP, Md Redzuan A, Mohd Saffian S, Hassan H, R Nagarajah J, Ross NT. Mortality outcomes and predictors of failed thrombolysis following STEMI thrombolysis in a non-PCI capable tertiary hospital: a 5-year analysis. Intern Emerg Med 2023; 18:1169-1180. [PMID: 36648707 PMCID: PMC9843664 DOI: 10.1007/s11739-023-03202-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/09/2023] [Indexed: 01/18/2023]
Abstract
Pharmacological reperfusion remains the primary strategy for ST-elevation myocardial infarction (STEMI) in low- and medium-income countries. Literature has reported inconsistent incidences and outcomes of failed thrombolysis (FT). This study aimed to identify the incidence, mortality outcomes and predictors of FT in STEMI pharmacological reperfusion. This single-centre retrospective cohort study analyzed data on consecutive STEMI patients who received thrombolytic therapy from 2016 to 2020 in a public tertiary hospital. Total population sampling was used in this study. Logistic regression analyses were used to assess independent predictors of the mortality outcomes and FT. We analyzed 941 patients with a mean age of 53.0 ± 12.2 years who were predominantly male (n = 846, 89.9%). The in-hospital mortality was 10.3% (n = 97). FT occurred in 86 (9.1%) patients and was one of the predictors of mortality (aOR 3.847, p < 0.001). Overall, tenecteplase use (aOR 1.749, p = 0.021), pre-existing hypertension (aOR 1.730, p = 0.024), history of stroke (aOR 4.176, p = 0.004), and heart rate ≥ 100 bpm at presentation (aOR 2.333, p < 0.001) were the general predictors of FT. The predictors of FT with streptokinase were Killip class ≥ II (aOR 3.197, p = 0.004) and heart rate ≥ 100 bpm at presentation (aOR 3.536, p = 0.001). History of stroke (aOR 6.144, p = 0.004) and heart rate ≥ 100 bpm at presentation (aOR 2.216, p = 0.015) were the predictors of FT in STEMI patients who received tenecteplase. Mortality following STEMI thrombolysis remained high in our population and was attributed to FT. Identified predictors of FT enable early risk stratification to evaluate the patients' prognosis to manage them better.
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Affiliation(s)
- Hock Peng Koh
- Pharmacy Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Jalan Pahang, 50586, Kuala Lumpur, Malaysia.
| | - Adyani Md Redzuan
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Hasnita Hassan
- Emergency and Trauma Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Jivanraj R Nagarajah
- Pharmacy Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Jalan Pahang, 50586, Kuala Lumpur, Malaysia
| | - Noel Thomas Ross
- Medical Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
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8
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Armandi A, Bugianesi E. Extrahepatic Outcomes of Nonalcoholic Fatty Liver Disease: Cardiovascular Diseases. Clin Liver Dis 2023; 27:239-250. [PMID: 37024205 DOI: 10.1016/j.cld.2023.01.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Patients with nonalcoholic fatty liver disease (NAFLD) are at high risk of cardiovascular disease, including carotid atherosclerosis, coronary artery disease, heart failure, and arrhythmias. The risk is partially due to shared risk factors, but it may vary according to liver injury. A fatty liver may induce an atherogenic profile, the local necro-inflammatory changes of nonalcoholic steatohepatitis may enhance systemic metabolic inflammation, and fibrogenesis can run parallel in the liver and in the myocardium and precedes heart failure. The detrimental impact of a Western diet combines with polymorphisms in genes associated with atherogenic dyslipidemia. Shared clinical/diagnostic algorithms are needed to manage the cardiovascular risk in NAFLD.
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Affiliation(s)
- Angelo Armandi
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, Torino 10126, Italy
| | - Elisabetta Bugianesi
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, Torino 10126, Italy.
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Morrow GB, Mutch NJ. Past, Present, and Future Perspectives of Plasminogen Activator Inhibitor 1 (PAI-1). Semin Thromb Hemost 2023; 49:305-313. [PMID: 36522166 DOI: 10.1055/s-0042-1758791] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Plasminogen activator inhibitor 1 (PAI-1), a SERPIN inhibitor, is primarily known for its regulation of fibrinolysis. However, it is now known that this inhibitor functions and contributes to many (patho)physiological processes including inflammation, wound healing, cell adhesion, and tumor progression.This review discusses the past, present, and future roles of PAI-1, with a particular focus on the discovery of this inhibitor in the 1970s and subsequent characterization in health and disease. Throughout the past few decades diverse functions of this serpin have unraveled and it is now considered an important player in many disease processes. PAI-1 is expressed by numerous cell types, including megakaryocytes and platelets, adipocytes, endothelial cells, hepatocytes, and smooth muscle cells. In the circulation PAI-1 exists in two pools, within plasma itself and in platelet α-granules. Platelet PAI-1 is secreted following activation with retention of the inhibitor on the activated platelet membrane. Furthermore, these anucleate cells contain PAI-1 messenger ribonucleic acid to allow de novo synthesis.Outside of the traditional role of PAI-1 in fibrinolysis, this serpin has also been identified to play important roles in metabolic syndrome, obesity, diabetes, and most recently, acute respiratory distress syndrome, including coronavirus disease 2019 disease. This review highlights the complexity of PAI-1 and the requirement to ascertain a better understanding on how this complex serpin functions in (patho)physiological processes.
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Affiliation(s)
- Gael B Morrow
- Aberdeen Cardiovascular and Diabetes Centre, Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
- Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Nicola J Mutch
- Aberdeen Cardiovascular and Diabetes Centre, Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
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Mahadevan M, Bose M, Gawron KM, Blumberg R. Metabolic Syndrome and Chronic Disease Risk in South Asian Immigrants: A Review of Prevalence, Factors, and Interventions. Healthcare (Basel) 2023; 11:healthcare11050720. [PMID: 36900725 PMCID: PMC10000781 DOI: 10.3390/healthcare11050720] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/21/2023] [Accepted: 02/26/2023] [Indexed: 03/05/2023] Open
Abstract
South Asians (SAs) are among the fastest-growing ethnic groups in the U.S. Metabolic syndrome (MetS) is a condition that is characterized by multiple health factors that increase the risk for chronic diseases, such as cardiovascular disease (CVD) and diabetes. MetS prevalence among SA immigrants ranges from 27-47% in multiple cross-sectional studies using different diagnostic criteria, which is generally higher compared to other populations in the receiving country. Both genetic and environmental factors are attributed to this increased prevalence. Limited intervention studies have shown effective management of MetS conditions within the SA population. This review reports MetS prevalence in SAs residing in non-native countries, identifies contributing factors, and discusses ways to develop effective community-based strategies for health promotion targeting MetS among SA immigrants. There is a need for more consistently evaluated longitudinal studies to facilitate the development of directed public health policy and education to address chronic diseases in the SA immigrant community.
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Affiliation(s)
- Meena Mahadevan
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA
- Correspondence: ; Tel.: +1-973-655-7574
| | - Mousumi Bose
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA
| | | | - Renata Blumberg
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA
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Roy I, Jover E, Matilla L, Alvarez V, Fernández-Celis A, Beunza M, Escribano E, Gainza A, Sádaba R, López-Andrés N. Soluble ST2 as a New Oxidative Stress and Inflammation Marker in Metabolic Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032579. [PMID: 36767947 PMCID: PMC9915842 DOI: 10.3390/ijerph20032579] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/23/2023] [Accepted: 01/30/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Metabolic syndrome (MS) is a complex and prevalent disorder. Oxidative stress and inflammation might contribute to the progression of MS. Soluble ST2 (sST2) is an attractive and druggable molecule that sits at the interface between inflammation, oxidative stress and fibrosis. This study aims to analyze the relationship among sST2, oxidative stress, inflammation and echocardiographic parameters in MS patients. METHODS Fifty-eight patients with MS were recruited and underwent physical, laboratory and transthoracic echocardiography examinations. Commercial ELISA and appropriate colorimetric assays were used to quantify serum levels of oxidative stress and inflammation markers and sST2. RESULTS Circulating sST2 was increased in MS patients and was significantly correlated with the oxidative stress markers nitrotyrosine and 8-hydroxy-2'-deoxyguanosine as well as with peroxide levels. The inflammatory parameters interleukin-6, intercellular adhesion molecule-1 and myeloperoxidase were positively correlated with sST2. Noteworthy, sST2 was positively correlated with left ventricular mass, filling pressures and pulmonary arterial pressures. CONCLUSION Circulating levels of sST2 are associated with oxidative stress and inflammation burden and may underlie the pathological remodeling and dysfunction of the heart in MS patients. Our results suggest that sST2 elevation precedes diastolic dysfunction, emerging as an attractive biotarget in MS.
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The Correlation between the Triglyceride-Glucose Index and Coagulation Markers in Patients with Recent Acute Myocardial Infarction. DISEASE MARKERS 2022; 2022:6206802. [PMID: 36312588 PMCID: PMC9613396 DOI: 10.1155/2022/6206802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 11/17/2022]
Abstract
Background Metabolic abnormalities and hypercoagulability seem to have an important predictive role in patients with coronary artery disease (CAD). The triglyceride-glucose (TyG) index has emerged as a good marker for metabolic syndrome with predictive value for cardiovascular events. Overall haemostatic potential (OHP) is a reliable global haemostatic essay to identify hypercoagulability in CAD patients. The aim of our study was therefore to evaluate a possible correlation between the TyG index and haemostatic derangements in patients with CAD. Methods Consecutive patients referred for the first follow-up visit after acute myocardial infarction between December 1, 2018, and March 31, 2020, and did not meet exclusion criteria were included. We determined OHP, overall coagulation potential (OCP), overall fibrinolytic potential (OFP), fibrinogen, D-dimer, and von Willebrand factor from peripheral blood samples. The TyG index was calculated with the previously described and validated formula. Linear regression models were constructed for the multivariate analysis. Results A total of 117 patients (mean age 56 ± 10 years, 20% women) were included. A correlation was found between TyG index and OCP (r = 0.229, p = 0.026), TyG index and OHP (r = 0.202, p = 0.050), and TyG index and fibrinogen (r = 0.271, p = 0.005). In the multivariate model which accounted for sex, age, and BMI, the correlation between TyG index and OCP (R2 0.108; ANOVA for regression p = 0.035; beta 2.08 [0.79-4.01], p = 0.042) and between TyG index and fibrinogen (R2 0.11; ANOVA for regression p = 0.015; beta 0.35 [0.08-0.62], p = 0.012) emerged as statistically significant. Conclusion The TyG index, a marker of metabolic syndrome, has a strong correlation with a hypercoagulability state in CAD, as determined by the OCP and higher fibrinogen levels. Our findings suggest that metabolic syndrome may be an important driver of atherothrombotic risk in patients with CAD.
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Lu C, Ahmed R, Lamri A, Anand SS. Use of race, ethnicity, and ancestry data in health research. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001060. [PMID: 36962630 PMCID: PMC10022242 DOI: 10.1371/journal.pgph.0001060] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Race, ethnicity, and ancestry are common classification variables used in health research. However, there has been no formal agreement on the definitions of these terms, resulting in misuse, confusion, and a lack of clarity surrounding these concepts for researchers and their readers. This article examines past and current understandings of race, ethnicity, and ancestry in research, identifies the distinctions between these terms, examines the reliability of these terms, and provides researchers with guidance on how to use these terms. Although race, ethnicity, and ancestry are often treated synonymously, they should be considered as distinct terms in the context of health research. Researchers should carefully consider which term is most appropriate for their study, define and use the terms consistently, and consider how their classification may be used in future research by others. The classification should be self-reported rather than assigned by an observer wherever possible.
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Affiliation(s)
- Clara Lu
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Rabeeyah Ahmed
- Arts and Science Program, McMaster University, Hamilton, Ontario, Canada
| | - Amel Lamri
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sonia S. Anand
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
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Dearing C, Handa RJ, Myers B. Sex differences in autonomic responses to stress: implications for cardiometabolic physiology. Am J Physiol Endocrinol Metab 2022; 323:E281-E289. [PMID: 35793480 PMCID: PMC9448273 DOI: 10.1152/ajpendo.00058.2022] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/21/2022] [Accepted: 07/01/2022] [Indexed: 11/22/2022]
Abstract
Chronic stress is a significant risk factor for negative health outcomes. Furthermore, imbalance of autonomic nervous system control leads to dysregulation of physiological responses to stress and contributes to the pathogenesis of cardiometabolic and psychiatric disorders. However, research on autonomic stress responses has historically focused on males, despite evidence that females are disproportionality affected by stress-related disorders. Accordingly, this mini-review focuses on the influence of biological sex on autonomic responses to stress in humans and rodent models. The reviewed literature points to sex differences in the consequences of chronic stress, including cardiovascular and metabolic disease. We also explore basic rodent studies of sex-specific autonomic responses to stress with a focus on sex hormones and hypothalamic-pituitary-adrenal axis regulation of cardiovascular and metabolic physiology. Ultimately, emerging evidence of sex differences in autonomic-endocrine integration highlights the importance of sex-specific studies to understand and treat cardiometabolic dysfunction.
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Affiliation(s)
- Carley Dearing
- Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Robert J Handa
- Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Brent Myers
- Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado
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15
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Izadi N, Najafi A, Saraei M. Metabolic syndrome and its determinants among professional drivers: a systematic review and meta-analysis. J Diabetes Metab Disord 2021; 20:2015-2023. [PMID: 34900837 DOI: 10.1007/s40200-021-00928-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 10/23/2021] [Indexed: 11/29/2022]
Abstract
Background Drivers are one of the trade unions that are most exposed to various health-related risks, especially metabolic diseases. The present study aimed to systematically assess the overall prevalence of metabolic syndrome and its determinants among drivers in the world. Methods All retrospective, cross-sectional, or prospective studies evaluating the prevalence and risk for metabolic syndrome and its main components among male professional drivers were eligible for the initial assessment. PRISMA guideline was used. Two blinded reviewers independently screened the titles and abstracts of the manuscripts followed by a deep assessment of the full texts for determining the inclusion appropriateness. Results In the final, 12 articles were eligible for the final analysis. Overall, 19,350 professional male drivers with a total average age of 43.06 years (ranged from 35.5 to 51.1 years) were included in the study. The prevalence of metabolic syndrome was estimated to be 32.8% (95%CI: 32.1% to 33.5%), and the major determinants of appearing this syndrome among professional drivers were advanced age, years of driving experience, higher body mass index, smoking, high cholesterol dietary regimen, high Framingham risk score, low regular exercising, history of diabetes mellitus, history of gout, and shift work pattern. Conclusion According to the 32.8% prevalence rate of metabolic syndrome among drivers, managerial measures are needed to prevent and control metabolic disturbances among professional drivers are recommended.
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Affiliation(s)
- Nazanin Izadi
- Occupational Sleep Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Saraei
- Occupational Sleep Research Center, Tehran University of Medical Sciences, Tehran, Iran
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16
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Azab SM, de Souza RJ, Lamri A, Shanmuganathan M, Kroezen Z, Schulze KM, Desai D, Williams NC, Morrison KM, Atkinson SA, Teo KK, Britz-McKibbin P, Anand SS. Metabolite profiles and the risk of metabolic syndrome in early childhood: a case-control study. BMC Med 2021; 19:292. [PMID: 34823524 PMCID: PMC8616718 DOI: 10.1186/s12916-021-02162-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/18/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Defining the metabolic syndrome (MetS) in children remains challenging. Furthermore, a dichotomous MetS diagnosis can limit the power to study associations. We sought to characterize the serum metabolite signature of the MetS in early childhood using high-throughput metabolomic technologies that allow comprehensive profiling of metabolic status from a biospecimen. METHODS In the Family Atherosclerosis Monitoring In earLY life (FAMILY) prospective birth cohort study, we selected 228 cases of MetS and 228 matched controls among children age 5 years. In addition, a continuous MetS risk score was calculated for all 456 participants. Comprehensive metabolite profiling was performed on fasting serum samples using multisegment injection-capillary electrophoresis-mass spectrometry. Multivariable regression models were applied to test metabolite associations with MetS adjusting for covariates of screen time, diet quality, physical activity, night sleep, socioeconomic status, age, and sex. RESULTS Compared to controls, thirteen serum metabolites were identified in MetS cases when using multivariable regression models, and using the quantitative MetS score, an additional eight metabolites were identified. These included metabolites associated with gluconeogenesis (glucose (odds ratio (OR) 1.55 [95% CI 1.25-1.93]) and glutamine/glutamate ratio (OR 0.82 [95% CI 0.67-1.00])) and the alanine-glucose cycle (alanine (OR 1.41 [95% CI 1.16-1.73])), amino acids metabolism (tyrosine (OR 1.33 [95% CI 1.10-1.63]), threonine (OR 1.24 [95% CI 1.02-1.51]), monomethylarginine (OR 1.33 [95% CI 1.09-1.64]) and lysine (OR 1.23 [95% CI 1.01-1.50])), tryptophan metabolism (tryptophan (OR 0.78 [95% CI 0.64-0.95])), and fatty acids metabolism (carnitine (OR 1.24 [95% CI 1.02-1.51])). The quantitative MetS risk score was more powerful than the dichotomous outcome in consistently detecting this metabolite signature. CONCLUSIONS A distinct metabolite signature of pediatric MetS is detectable in children as young as 5 years old and may improve risk assessment at early stages of development.
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Affiliation(s)
- Sandi M Azab
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Russell J de Souza
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
| | - Amel Lamri
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
| | - Meera Shanmuganathan
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, ON, Canada
| | - Zachary Kroezen
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, ON, Canada
| | | | - Dipika Desai
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
| | | | - Katherine M Morrison
- Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | | | - Koon K Teo
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
| | - Philip Britz-McKibbin
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, ON, Canada
| | - Sonia S Anand
- Department of Medicine, McMaster University, Hamilton, ON, Canada.
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
- Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, ON, Canada.
- Population Health Research Institute, Hamilton, ON, Canada.
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17
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Uhanova J, O'Brien M, Minuk G, Tate R. Chronic Liver Disease and Metabolic Comorbidities in Healthy Young Males Followed for 65 Years: The Manitoba Follow-up Study. Clin Gastroenterol Hepatol 2021; 19:2417-2424.e2. [PMID: 33080354 DOI: 10.1016/j.cgh.2020.10.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 10/11/2020] [Accepted: 10/13/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS The prevalence of chronic liver disease (CLD) is largely derived from cross-sectional epidemiologic surveys. The goal of this long-term, prospective study was to document the lifetime risk of developing chronic liver disease and determine the impact of common metabolic conditions associated with metabolic syndrome (MetS) on the development and outcomes of CLD. METHODS 3,983 air force men were enrolled in the Manitoba Follow-up Study in 1948. The comprehensive database on results of routine physicals and health encounters was examined for evidence of CLD and MetS. The joint relationship between CLD and components of MetS on mortality was examined using Cox proportional hazard model. RESULTS In 65 follow-up years, 5.2% of men developed CLD and 6.4% MetS. Hypertension was the strongest predictor of CLD (HR 2.958, 95% CI - 2.065 to 4.236, p < .0001), followed by insulin resistance /diabetes mellitus (IR/DM) (2.008, 95% CI - 1.332 to 3.027, p = .0009) and obesity (1.958, 95% CI - 1.419 to 2.703, p < .0001). Relative to men without MetS comorbidities, an increasing gradient of risk for CLD was apparent with increasing numbers of MetS components; the HR of 3.67, 5.97 and 14.3 for IR/DM, IR/DM + one component, and IR/DM + two or more components respectively. The relative risk of mortality in men with vs. without CLD was 3.33 (95% CI - 2.83 to 3.91, p < .0001) and 1.505 (95% CI - 1.31 to 1.73, p < .0001) in men with vs. without MetS. CONCLUSIONS CLD and MetS independently increase the relative risk of mortality; the magnitude of the effect is greater in CLD.
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Affiliation(s)
| | | | | | - Robert Tate
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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18
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Dearing C, Morano R, Ptaskiewicz E, Mahbod P, Scheimann JR, Franco-Villanueva A, Wulsin L, Myers B. Glucoregulation and coping behavior after chronic stress in rats: Sex differences across the lifespan. Horm Behav 2021; 136:105060. [PMID: 34537487 PMCID: PMC8629951 DOI: 10.1016/j.yhbeh.2021.105060] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/27/2021] [Accepted: 08/24/2021] [Indexed: 01/01/2023]
Abstract
The purpose of the current study was to determine how biological sex shapes behavioral coping and metabolic health across the lifespan after chronic stress. We hypothesized that examining chronic stress-induced behavioral and endocrine outcomes would reveal sex differences in the biological basis of susceptibility. During late adolescence, male and female Sprague-Dawley rats experienced chronic variable stress (CVS). Following completion of CVS, all rats experienced a forced swim test (FST) followed 3 days later by a fasted glucose tolerance test (GTT). The FST was used to determine coping in response to a stressor. Endocrine metabolic function was evaluated in the GTT by measuring glucose and corticosterone, the primary rodent glucocorticoid. Rats then aged to 15 months when the FST and GTT were repeated. In young rats, chronically stressed females exhibited more passive coping and corticosterone release in the FST. Additionally, chronically stressed females had elevated corticosterone and impaired glucose clearance in the GTT. Aging affected all measurements as behavioral and endocrine outcomes were sex specific. Furthermore, regression analysis between hormonal and behavioral responses identified associations depending on sex and stress. Collectively, these data indicate increased female susceptibility to the effects of chronic stress during adolescence. Further, translational investigation of coping style and glucose homeostasis may identify biomarkers for stress-related disorders.
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Affiliation(s)
- Carley Dearing
- Biomedical Sciences, Colorado State University, Fort Collins, CO, United States of America
| | - Rachel Morano
- Pharmacology and Systems Physiology, University of Cincinnati, Cincinnati, OH, United States of America
| | - Elaine Ptaskiewicz
- Biomedical Sciences, Colorado State University, Fort Collins, CO, United States of America
| | - Parinaz Mahbod
- Pharmacology and Systems Physiology, University of Cincinnati, Cincinnati, OH, United States of America
| | - Jessie R Scheimann
- Pharmacology and Systems Physiology, University of Cincinnati, Cincinnati, OH, United States of America
| | - Ana Franco-Villanueva
- Pharmacology and Systems Physiology, University of Cincinnati, Cincinnati, OH, United States of America
| | - Lawson Wulsin
- Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States of America
| | - Brent Myers
- Biomedical Sciences, Colorado State University, Fort Collins, CO, United States of America.
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19
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Park HY, Jung WS, Kim SW, Lim K. Relationship Between Sarcopenia, Obesity, Osteoporosis, and Cardiometabolic Health Conditions and Physical Activity Levels in Korean Older Adults. Front Physiol 2021; 12:706259. [PMID: 34290624 PMCID: PMC8287569 DOI: 10.3389/fphys.2021.706259] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/15/2021] [Indexed: 01/14/2023] Open
Abstract
This study aimed to analyze the status of sarcopenia, obesity, osteoporosis, and cardiometabolic disease according to the level of physical activity (PA) among elderly people in Korea. Among the data obtained from the National Health and Nutrition Survey (2008–2011), we analyzed the data of a total of 3,573 Korean elderly people over 65 years of age who were surveyed for dual X-ray absorptiometry (DXA) and PA. Higher levels of PA were associated with a lower prevalence of cardiometabolic disease (χ2 = 33.865, p < 0.001), osteoporosis (χ2 = 94.198, p < 0.001), sarcopenia, obesity, and sarcopenic obesity (χ2 = 71.828, p < 0.001). Above moderate-active PA was associated with lower body weight (p < 0.001), body fat mass (p < 0.001), and percent body fat (p < 0.001), and higher free-fat mass (p < 0.001) and appendicular skeletal muscle mass (ASM) (p < 0.001) than in low-active PA. In addition, when high-active is the risk factors of cardiometabolic were lower in waist circumference (p = 0.001), total cholesterol (TC) (p = 0.015), and triglyceride (TG) (p < 0.001) than low- and moderate-active PA, and higher in high-density lipoprotein cholesterol (HDL-C) (p < 0.001). The prevalence of cardiometabolic diseases was significantly decreased in high-active PA (odds ratio (OR) 0.60, 95% confidence interval (CI) 0.50–0.71); waist circumference (OR 0.85, 95% CI, 0.73–0.99; OR 0.59, 95% CI, 0.50–0.70) and HDL-C (OR 0.76, 95% CI, 0.65–0.88; OR 0.56, 95% CI, 0.47–0.67) significantly improved in moderate- and high-active PA, respectively, and TG (0.67 95% CI, 0.55–0.80) significantly improved in high-active PA. Osteoporosis (OR 0.62, 95% CI, 0.53–0.74; OR 0.46, 95% CI, 0.38–0.55) and sarcopenia (OR 0.77, 95% CI, 0.60–0.98; OR 0.73, 95% CI, 0.57–0.93) were significantly improved in moderate- and high-active PA, respectively. The incidence of obesity (OR 0.47, 95% CI, 0.39–0.57) and sarcopenic obesity (OR 0.47, 95% CI, 0.30–0.75) were significantly decreased in high-active PA. Therefore, we verified a lower prevalence of sarcopenia, osteoporosis, obesity, and cardiac metabolic disease in Korean elderly with more active PA. This suggests that more active PA maybe reduce the prevalence of sarcopenia, osteoporosis, obesity, and cardiometabolic diseases in older adults.
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Affiliation(s)
- Hun-Young Park
- Physical Activity and Performance Institute, Konkuk University, Seoul, South Korea.,Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, South Korea
| | - Won-Sang Jung
- Physical Activity and Performance Institute, Konkuk University, Seoul, South Korea
| | - Sung-Woo Kim
- Physical Activity and Performance Institute, Konkuk University, Seoul, South Korea
| | - Kiwon Lim
- Physical Activity and Performance Institute, Konkuk University, Seoul, South Korea.,Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, South Korea.,Department of Physical Education, Konkuk University, Seoul, South Korea
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20
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Morrow GB, Whyte CS, Mutch NJ. A Serpin With a Finger in Many PAIs: PAI-1's Central Function in Thromboinflammation and Cardiovascular Disease. Front Cardiovasc Med 2021; 8:653655. [PMID: 33937363 PMCID: PMC8085275 DOI: 10.3389/fcvm.2021.653655] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/23/2021] [Indexed: 12/27/2022] Open
Abstract
Plasminogen activator inhibitor 1 (PAI-1) is a member of the serine protease inhibitor (serpin) superfamily. PAI-1 is the principal inhibitor of the plasminogen activators, tissue plasminogen activator (tPA), and urokinase-type plasminogen activator (uPA). Turbulence in the levels of PAI-1 tilts the balance of the hemostatic system resulting in bleeding or thrombotic complications. Not surprisingly, there is strong evidence that documents the role of PAI-1 in cardiovascular disease. The more recent uncovering of the coalition between the hemostatic and inflammatory pathways has exposed a distinct role for PAI-1. The storm of proinflammatory cytokines liberated during inflammation, including IL-6 and TNF-α, directly influence PAI-1 synthesis and increase circulating levels of this serpin. Consequently, elevated levels of PAI-1 are commonplace during infection and are frequently associated with a hypofibrinolytic state and thrombotic complications. Elevated PAI-1 levels are also a feature of metabolic syndrome, which is defined by a cluster of abnormalities including obesity, type 2 diabetes, hypertension, and elevated triglyceride. Metabolic syndrome is in itself defined as a proinflammatory state associated with elevated levels of cytokines. In addition, insulin has a direct impact on PAI-1 synthesis bridging these pathways. This review describes the key physiological functions of PAI-1 and how these become perturbed during disease processes. We focus on the direct relationship between PAI-1 and inflammation and the repercussion in terms of an ensuing hypofibrinolytic state and thromboembolic complications. Collectively, these observations strengthen the utility of PAI-1 as a viable drug target for the treatment of various diseases.
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Affiliation(s)
- Gael B Morrow
- Aberdeen Cardiovascular and Diabetes Centre, Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom.,Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Claire S Whyte
- Aberdeen Cardiovascular and Diabetes Centre, Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - Nicola J Mutch
- Aberdeen Cardiovascular and Diabetes Centre, Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
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21
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Manaf MRA, Nawi AM, Tauhid NM, Othman H, Rahman MRA, Yusoff HM, Safian N, Ng PY, Manaf ZA, Kadir NBA, Yanasegaran K, Basir SMA, Ramakrishnappa S, Ganasegeran K. Prevalence of metabolic syndrome and its associated risk factors among staffs in a Malaysian public university. Sci Rep 2021; 11:8132. [PMID: 33854087 PMCID: PMC8047014 DOI: 10.1038/s41598-021-87248-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/18/2021] [Indexed: 02/02/2023] Open
Abstract
Public health systems are concerned with the commensurate rise of metabolic syndrome (MetS) incidence across populations worldwide, due to its tendency to amplify greater risk of diabetes and cardiovascular diseases within communities. This study aimed to determine the prevalence of MetS and its associated risk factors among staffs in a Malaysian public university. A cross-sectional study was conducted among 538 staffs from the Universiti Kebangsaan Malaysia (UKM) between April and June 2019. MetS was defined according to JIS "Harmonized" criteria. A questionnaire that consisted of items on socio-demographics, lifestyle risk behaviors and personal medical history information was administered to participants. Subsequently, a series of physical examination and biochemical assessment was conducted at the hall or foyer of selected faculties in the university. Descriptive and inferential statistics were conducted using SPSS version 22.0. Multivariate models were yielded to determine the risk factors associated with MetS. Statistical significance was set at P < 0.05. The overall prevalence of MetS was 20.6%, with men having greater prevalence than women (24.9% vs. 18.3%). Prevalence of MetS increased with age. Factors contributed to MetS in the overall sample were BMI, hypertension, diabetes and physical activity of moderate intensity. Diabetes and hypertension were significantly associated with MetS in men, whereas BMI, diabetes and hyperlipidemia were significantly associated with MetS in women. Lifestyle behaviors and cardio-metabolic risk factors were associated with MetS for the overall sample, and across genders.
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Affiliation(s)
- Mohd Rizal Abdul Manaf
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Azmawati Mohammed Nawi
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Noorlaili Mohd Tauhid
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hanita Othman
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Rizam Abdul Rahman
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hanizah Mohd Yusoff
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nazaruddin Safian
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Pei Yuen Ng
- Drug and Herbal Research Centre, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zahara Abdul Manaf
- Dietetic Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Ba'yah Abdul Kadir
- Psychology Program, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Kevina Yanasegaran
- Drug and Herbal Research Centre, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Siti Munirah Abdul Basir
- Dietetic Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sowmya Ramakrishnappa
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Kurubaran Ganasegeran
- Clinical Research Center, Seberang Jaya Hospital, Ministry of Health Malaysia, Penang, Malaysia
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22
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Goyal S, Sanghera DK. Genetic and Non-genetic Determinants of Cardiovascular Disease in South Asians. Curr Diabetes Rev 2021; 17:e011721190373. [PMID: 33461471 PMCID: PMC10370262 DOI: 10.2174/1573399817666210118103022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/18/2020] [Accepted: 11/20/2020] [Indexed: 01/09/2023]
Abstract
South Asians (SAs), people from the Indian subcontinent (e.g., India, Pakistan, Bangladesh, Sri Lanka, and Nepal) have a higher prevalence of cardiovascular disease (CVD) and suffer from a greater risk of CVD-associated mortality compared to other global populations. These problems are compounded by the alterations in lifestyles due to urbanization and changing cultural, social, economic, and political environments. Current methods of CV risk prediction are based on white populations that under-estimate the CVD risk in SAs. Prospective studies are required to obtain actual CVD morbidity/mortality rates so that comparisons between predicted CVD risk can be made with actual events. Overwhelming data support a strong influence of genetic factors. Genome-Wide Association Studies (GWAS) serve as a starting point for future genetic and functional studies since the mechanisms of action by which these associated loci influence CVD is still unclear. It is difficult to predict the potential implication of these findings in clinical settings. This review provides a systematic assessment of the risk factors, genetics, and environmental causes of CV health disparity in SAs, and highlights progress made in clinical and genomics discoveries in the rapidly evolving field, which has the potential to show clinical relevance in the near future.
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Affiliation(s)
- Shiwali Goyal
- Department of Pediatrics, Section of Genetics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Dharambir K Sanghera
- Department of Pediatrics, Section of Genetics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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23
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Translational insight into prothrombotic state and hypercoagulation in nonalcoholic fatty liver disease. Thromb Res 2020; 198:139-150. [PMID: 33340925 DOI: 10.1016/j.thromres.2020.12.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/17/2020] [Accepted: 12/07/2020] [Indexed: 02/08/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is an emerging and threatening pathological condition, ranging from fatty liver (FL) to chronic steatohepatitis (NASH), liver cirrhosis, and eventually to hepatocellular carcinoma (HCC). Recent findings suggest that patients with NAFLD have a higher risk of cardiovascular events and thromboembolism and that this risk is independent of metabolic diseases that are frequently associated with NAFLD, such as diabetes, hyperlipidaemia, and obesity. The vascular involvement of NAFLD might be considered its systemic burden, conditioning higher mortality in patients affected by the disease. These clinical findings suggested the existence of a prothrombotic state in NAFLD, which is partially unexplored and whose underlying mechanisms are to date not completely understood. Here, we review the mechanisms involved in the pathogenesis of the prothrombotic state in NAFLD across the progression from the healthy liver through the different stages of the disease. We focused on the possible role of several metabolic features of NAFLD possibly leading to hypercoagulation other than endothelial and platelet activation, such as insulin-resistance, nitric oxide production regulation, and gut microbiota homeostasis. Also, we analysed the involvement of plasminogen activator inhibitor-1 (PAI-1) and thromboinflammation taking place in NAFLD. Finally, we described factors striking a prothrombotic imbalance in NASH cirrhosis, with a particular focus on the pathogenesis of portal vein thrombosis.
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24
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Kasper P, Martin A, Lang S, Kütting F, Goeser T, Demir M, Steffen HM. NAFLD and cardiovascular diseases: a clinical review. Clin Res Cardiol 2020; 110:921-937. [PMID: 32696080 PMCID: PMC8238775 DOI: 10.1007/s00392-020-01709-7] [Citation(s) in RCA: 291] [Impact Index Per Article: 72.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/07/2020] [Indexed: 02/06/2023]
Abstract
Non-alcoholic fatty liver DISEASE (NAFLD) is the most common chronic liver disease in Western countries and affects approximately 25% of the adult population. Since NAFLD is frequently associated with further metabolic comorbidities such as obesity, type 2 diabetes mellitus, or dyslipidemia, it is generally considered as the hepatic manifestation of the metabolic syndrome. In addition to its potential to cause liver-related morbidity and mortality, NAFLD is also associated with subclinical and clinical cardiovascular disease (CVD). Growing evidence indicates that patients with NAFLD are at substantial risk for the development of hypertension, coronary heart disease, cardiomyopathy, and cardiac arrhythmias, which clinically result in increased cardiovascular morbidity and mortality. The natural history of NAFLD is variable and the vast majority of patients will not progress from simple steatosis to fibrosis and end stage liver disease. However, patients with progressive forms of NAFLD, including non-alcoholic steatohepatitis (NASH) and/or advanced fibrosis, as well as NAFLD patients with concomitant types 2 diabetes are at highest risk for CVD. This review describes the underlying pathophysiological mechanisms linking NAFLD and CVD, discusses the role of NAFLD as a metabolic dysfunction associated cardiovascular risk factor, and focuses on common cardiovascular manifestations in NAFLD patients.
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Affiliation(s)
- Philipp Kasper
- Department of Gastroenterology and Hepatology, Faculty of Medicine, and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Anna Martin
- Department of Gastroenterology and Hepatology, Faculty of Medicine, and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Sonja Lang
- Department of Medicine, University of California, La Jolla, San Diego, USA
| | - Fabian Kütting
- Department of Gastroenterology and Hepatology, Faculty of Medicine, and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Tobias Goeser
- Department of Gastroenterology and Hepatology, Faculty of Medicine, and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Münevver Demir
- Department of Hepatology and Gastroenterology, Charité University Medicine, Campus Virchow Clinic, Berlin, Germany
| | - Hans-Michael Steffen
- Department of Gastroenterology and Hepatology, Faculty of Medicine, and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. .,Hypertension Center, Faculty of Medicine, and University Hospital Cologne, University of Cologne, Cologne, Germany.
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Lechner K, McKenzie AL, Kränkel N, Von Schacky C, Worm N, Nixdorff U, Lechner B, Scherr J, Weingärtner O, Krauss RM. High-Risk Atherosclerosis and Metabolic Phenotype: The Roles of Ectopic Adiposity, Atherogenic Dyslipidemia, and Inflammation. Metab Syndr Relat Disord 2020; 18:176-185. [PMID: 32119801 PMCID: PMC7196362 DOI: 10.1089/met.2019.0115] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Current algorithms for assessing risk of atherosclerotic cardiovascular disease (ASCVD) and, in particular, the reliance on low-density lipoprotein (LDL) cholesterol in conditions where this measurement is discordant with apoB and LDL-particle concentrations fail to identify a sizeable part of the population at high risk for adverse cardiovascular events. This results in missed opportunities for ASCVD prevention, most notably in those with metabolic syndrome, prediabetes, and diabetes. There is substantial evidence that accumulation of ectopic fat and associated metabolic traits are markers for and pathogenic components of high-risk atherosclerosis. Conceptually, the subset of advanced lesions in high-risk atherosclerosis that triggers vascular complications is closely related to a set of coordinated high-risk traits clustering around a distinct metabolic phenotype. A key feature of this phenotype is accumulation of ectopic fat, which, coupled with age-related muscle loss, creates a milieu conducive for the development of ASCVD: atherogenic dyslipidemia, nonresolving inflammation, endothelial dysfunction, hyperinsulinemia, and impaired fibrinolysis. Sustained vascular inflammation, a hallmark of high-risk atherosclerosis, impairs plaque stabilization in this phenotype. This review describes how metabolic and inflammatory processes that are promoted in large measure by ectopic adiposity, as opposed to subcutaneous adipose tissue, relate to the pathogenesis of high-risk atherosclerosis. Clinical biomarkers indicative of these processes provide incremental information to standard risk factor algorithms and advanced lipid testing identifies atherogenic lipoprotein patterns that are below the discrimination level of standard lipid testing. This has the potential to enable improved identification of high-risk patients who are candidates for therapeutic interventions aimed at prevention of ASCVD.
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Affiliation(s)
- Katharina Lechner
- Department of Prevention, Rehabilitation and Sports Medicine, School of Medicine, Technical University of Munich, Munich, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | | | - Nicolle Kränkel
- Klinik Für Kardiologie, Campus Benjamin Steglitz, Charité—Universitätsmedizin Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Clemens Von Schacky
- Preventive Cardiology, Ludwig-Maximilians University, Munich, Germany
- Omegametrix, Martinsried, Germany
| | - Nicolai Worm
- German University for Prevention and Health Care Management, Saarbrücken, Germany
| | | | - Benjamin Lechner
- Department of Internal Medicine IV, Ludwig-Maximilians University, Munich, Germany
| | - Johannes Scherr
- Department of Prevention, Rehabilitation and Sports Medicine, School of Medicine, Technical University of Munich, Munich, Germany
- University Center for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | | | - Ronald M. Krauss
- University of California, San Francisco, San Francisco, California, USA
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26
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Campbell PT, VanWagner LB, Colangelo LA, Lewis CE, Henkel A, Ajmera VH, Lloyd-Jones DM, Vaughan DE, Khan SS. Association between plasminogen activator inhibitor-1 in young adulthood and nonalcoholic fatty liver disease in midlife: CARDIA. Liver Int 2020; 40:1111-1120. [PMID: 32090434 PMCID: PMC7823725 DOI: 10.1111/liv.14417] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 01/26/2020] [Accepted: 02/20/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Prior studies have demonstrated a cross-sectional association between elevated plasminogen activator inhibitor-1 (PAI-1) levels and nonalcoholic fatty liver disease (NAFLD). However, there are no prospective longitudinal assessments of the association between PAI-1 and NAFLD. We aimed to describe the association between PAI-1 levels in early adulthood with NAFLD in midlife. METHODS Among the 5115 participants in the coronary artery risk development in young adults (CARDIA) study, participants were randomly selected from a subset that was free of obesity, diabetes and hypertension at the 1992-1993 exam and attended the 2005-2006 exam (n = 996). A subset of participants (n = 896) also had CT liver fat measured (2010-2011). Participants with secondary causes of steatosis were excluded (n = 87). NAFLD was defined as liver attenuation ≤51 Hounsfield units. Logistic regression models assessed the association between PAI-1 and NAFLD. RESULTS Of 809 participants, 53% were female, 37% black with a mean age of 32 years. Median PAI-1 level at 1st assessment (1992-1993) was 23.4 ng/mL among participants with NAFLD vs 11.9 ng/mL among those without NAFLD (P < .0001). Median PAI-1 level at 2nd assessment (2005-2006) was 55.6 ng/mL among participants with NAFLD vs 19.5 ng/mL among those without NAFLD (P < .0001). Higher PAI-1 levels were independently associated with NAFLD (1st assessment adjusted OR [AOR] 2.16 per 1 standard deviation higher log(PAI-1) level (95% confidence interval [CI] 1.63-2.85); 2nd assessment AOR 2.71 (95% CI 2.03-3.61)). CONCLUSIONS Plasma PAI-1 levels in young adulthood were independently associated with NAFLD in midlife. Further studies may indicate whether PAI-1 plays a role in NAFLD pathophysiology.
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Affiliation(s)
| | - Lisa B. VanWagner
- Division of GI & Hepatology, Northwestern University, Chicago, IL, United States.,Department of Preventive Medicine, Northwestern Universtiy, Chicago, IL, United States
| | - Laura A. Colangelo
- Department of Preventive Medicine, Northwestern Universtiy, Chicago, IL, United States
| | - Cora E. Lewis
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Anne Henkel
- Division of GI & Hepatology, Northwestern University, Chicago, IL, United States
| | - Veeral H. Ajmera
- Division of GI & Hepatology, University of California San Diego, San Diego, CA, United States
| | - Donald M. Lloyd-Jones
- Department of Medicine, Northwestern University, Chicago, IL, United States.,Department of Preventive Medicine, Northwestern Universtiy, Chicago, IL, United States
| | - Douglas E. Vaughan
- Department of Medicine, Northwestern University, Chicago, IL, United States.,Department of Preventive Medicine, Northwestern Universtiy, Chicago, IL, United States
| | - Sadiya S Khan
- Department of Preventive Medicine, Northwestern Universtiy, Chicago, IL, United States
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Iqbal SP, Ramadas A, Fatt QK, Shin HL, Onn WY, Kadir KA. Relationship of sociodemographic and lifestyle factors and diet habits with metabolic syndrome (MetS) among three ethnic groups of the Malaysian population. PLoS One 2020; 15:e0224054. [PMID: 32191727 PMCID: PMC7082049 DOI: 10.1371/journal.pone.0224054] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 02/21/2020] [Indexed: 12/28/2022] Open
Abstract
Objectives Literature shows a high prevalence of MetS among Malaysians, varying across the major ethnicities. Since sociodemographic characteristics, lifestyle factors and diet habits of such communities have been reported to be diverse, the objective of this study was to investigate the association of various sociodemographic characteristics, lifestyle factors and diet habits with MetS overall, as well as with the three major ethnic communities in Malaysia, specifically. Materials and methods We conducted a cross-sectional study among 481 Malaysians of ages 18 years and above living in the state of Johor, Malaysia. Information on demographics, lifestyle and diet habits were collected using a structured questionnaire. Harmonized criteria were used to assess the status of MetS. Multiple logistic regression was employed to determine any associations between sociodemographic and lifestyle factors and dietary behaviours with MetS. Results MetS was found among 32.2% of the respondents and was more prevalent among the Indians (51.9%), followed by the Malays (36.7%) and the Chinese (20.2%). Overall, increasing age (AOR = 2.44[95%CI = 1.27–4.70] at 40–49 years vs. AOR = 4.14[95%CI = 1.97–8.69] at 60 years and above) and Indian ethnicity (AOR = 1.95[95%CI = 1.12–3.38)] increased the odds of MetS, while higher education (AOR = 0.44[95%CI = 0.20–0.94] decreased the odds of MetS in this population. Quick finishing of meals (AOR = 2.17[95%CI = 1.02–4.60]) and low physical activity (AOR = 4.76[95%CI = 1.49–15.26]) were associated with increased odds of MetS among the Malays and the Chinese, respectively. Conclusion The population of Johor depicts a diverse lifestyle and diet behaviour, and some of these factors are associated with MetS in certain ethnic groups. In the light of such differences, ethnic specific measures would be needed to reduce the prevalence of MetS among those in this population.
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Affiliation(s)
- Saleem Perwaiz Iqbal
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
- * E-mail:
| | - Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
| | - Quek Kia Fatt
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
| | - Ho Loon Shin
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
| | - Wong Yin Onn
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
| | - Khalid Abdul Kadir
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
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Su Y, Lu Y, Li W, Xue M, Chen C, Haireti M, Li Y, Liu Z, Liu Y, Wang S, Yao H. Prevalence and Correlation of Metabolic Syndrome: A Cross-Sectional Study of Nearly 10 Million Multi-Ethnic Chinese Adults. Diabetes Metab Syndr Obes 2020; 13:4869-4883. [PMID: 33335411 PMCID: PMC7737555 DOI: 10.2147/dmso.s278346] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/05/2020] [Indexed: 12/26/2022] Open
Abstract
PURPOSE This study aimed to examine the prevalence and correlates of metabolic syndrome (MetS) in multi-ethnic populations of Northwest China based on Large-scale provincial health checking data. PATIENTS AND METHODS A total of 9,745,640 Chinese aged ≥18 years in Xinjiang, the largest autonomous region of multi-ethnic in China, were enrolled from Feb. to Sep. 2019. MetS was defined by modified Adult Treatment Panel (ATP III) criteria. RESULTS The overall prevalence of MetS was 20.85% [Sex: 20.06% female, 21.56% male; Age: 39.22% 60-years and above, 26.32% 40- to 59-years and 9.56% 18- to 39-years; Ethnicity: 28.19% Hui followed by Han (26.39%), Uyghur (18.56%), Other (18.61%), Kazak (17.98%), Mongolian (17.87%), Kyrgyz (14.44%)]. People living in cities and towns (23.03%) or North (24.78%) had higher prevalence of MetS than rural (19.94%) and South (17.66%). Although the prevalence of hypertension, smoking, drinking and lack of physical activity were higher in Kyrgyz, Mongolian and Kazak than those of other ethnic groups, the risk of MetS was lower. CONCLUSION The results indicated that a high prevalence of MetS in Hui and Han groups and people living in cities and towns. Living in North Xinjiang and elder population tend to have higher prevalence of MetS. The prevention and management of MetS in these populations should be prioritized.
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Affiliation(s)
- Yinxia Su
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- Health Management Institute, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Yaoqin Lu
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- Center of Disease Control and Prevention, Urumqi, Xinjiang, People’s Republic of China
| | - Wenli Li
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Mingyue Xue
- Health Management Institute, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- The Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Chen Chen
- School of Biomedical Sciences, University of Queensland, Brisbane4072, Australia
| | - Muyaseer Haireti
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Yuanyuan Li
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Zhenhui Liu
- Department of Microrepair and Reconstruction, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Yanshi Liu
- Department of Microrepair and Reconstruction, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Shuxia Wang
- Health Management Institute, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Hua Yao
- Health Management Institute, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- Correspondence: Hua Yao; Shuxia Wang Email ;
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29
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Lear SA, Gasevic D. Ethnicity and Metabolic Syndrome: Implications for Assessment, Management and Prevention. Nutrients 2019; 12:nu12010015. [PMID: 31861719 PMCID: PMC7019432 DOI: 10.3390/nu12010015] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/12/2019] [Accepted: 12/17/2019] [Indexed: 02/06/2023] Open
Abstract
The metabolic syndrome (MetS) is a constellation of cardiometabolic risk factors that identifies people at increased risk for type 2 diabetes and cardiovascular disease. While the global prevalence is 20%–25% of the adult population, the prevalence varies across different racial/ethnic populations. In this narrative review, evidence is reviewed regarding the assessment, management and prevention of MetS among people of different racial/ethnic groups. The most popular definition of MetS considers race/ethnicity for assessing waist circumference given differences in visceral adipose tissue and cardiometabolic risk. However, defining race/ethnicity may pose challenges in the clinical setting. Despite 80% of the world’s population being of non-European descent, the majority of research on management and prevention has focused on European-derived populations. In these studies, lifestyle management has proven an effective therapy for reversal of MetS, and randomised studies are underway in specific racial/ethnic groups. Given the large number of people at risk for MetS, prevention efforts need to focus at community and population levels. Community-based interventions have begun to show promise, and efforts to improve lifestyle behaviours through alterations in the built environment may be another avenue. However, careful consideration needs to be given to take into account the unique cultural context of the target race/ethnic group.
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Affiliation(s)
- Scott A. Lear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
- Division of Cardiology, Providence Health Care, Vancouver, BC V6Z 1Y6, Canada
- Correspondence: ; Tel.: +1-604-682-2344 (ext. 62778)
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia;
- Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK
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30
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Anand SS, Abonyi S, Arbour L, Balasubramanian K, Brook J, Castleden H, Chrisjohn V, Cornelius I, Davis AD, Desai D, de Souza RJ, Friedrich MG, Harris S, Irvine J, L'Hommecourt J, Littlechild R, Mayotte L, McIntosh S, Morrison J, Oster RT, Picard M, Poirier P, Schulze KM, Toth EL. Explaining the variability in cardiovascular risk factors among First Nations communities in Canada: a population-based study. Lancet Planet Health 2019; 3:e511-e520. [PMID: 31868600 DOI: 10.1016/s2542-5196(19)30237-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/15/2019] [Accepted: 11/19/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Historical, colonial, and racist policies continue to influence the health of Indigenous people, and they continue to have higher rates of chronic diseases and reduced life expectancy compared with non-Indigenous people. We determined factors accounting for variations in cardiovascular risk factors among First Nations communities in Canada. METHODS Men and women (n=1302) aged 18 years or older from eight First Nations communities participated in a population-based study. Questionnaires, physical measures, blood samples, MRI of preclinical vascular disease, and community audits were collected. In this cross-sectional analysis, the main outcome was the INTERHEART risk score, a measure of cardiovascular risk factor burden. A multivariable model was developed to explain the variations in INTERHEART risk score among communities. The secondary outcome was MRI-detected carotid wall volume, a measure of subclinical atherosclerosis. FINDINGS The mean INTERHEART risk score of all communities was 17·2 (SE 0·2), and more than 85% of individuals had a risk score in the moderate to high risk range. Subclinical atherosclerosis increased significantly across risk score categories (p<0·0001). Socioeconomic advantage (-1·4 score, 95% CI -2·5 to -0·3; p=0·01), trust between neighbours (-0·7, -1·2 to -0·3; p=0·003), higher education level (-1·9, -2·9 to -0·8, p<0·001), and higher social support (-1·1, -2·0 to -0·2; p=0·02) were independently associated with a lower INTERHEART risk score; difficulty accessing routine health care (2·2, 0·3 to 4·1, p=0·02), taking prescription medication (3·5, 2·8 to 4·3; p<0·001), and inability to afford prescription medications (1·5, 0·5 to 2·6; p=0·003) were associated with a higher INTERHEART risk score. Collectively, these factors explained 28% variation in the cardiac risk score among communities. Communities with higher socioeconomic advantage and greater trust, and individuals with higher education and social support, had a lower INTERHEART risk score. Communities with difficulty accessing health care, and individuals taking or unable to afford prescription medications, had a higher INTERHEART risk score. INTERPRETATION Cardiac risk factors are lower in communities with high socioeconomic advantage, greater trust, social support and educational opportunities, and higher where it is difficult to access health care or afford prescription medications. Strategies to optimise the protective factors and reduce barriers to health care in First Nations communities might contribute to improved health and wellbeing. FUNDING Heart and Stroke Foundation of Canada, Canadian Partnership Against Cancer, Canadian Institutes for Health Research.
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Affiliation(s)
- Sonia S Anand
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; Department of Health Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; Population Health Research Institute, Hamiliton Health Sciences, Hamilton, ON, Canada.
| | - Sylvia Abonyi
- Faculty of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Laura Arbour
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada; Division of Biomedical Sciences, University of Victoria, Victoria, BC, Canada
| | - Kumar Balasubramanian
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; Population Health Research Institute, Hamiliton Health Sciences, Hamilton, ON, Canada
| | - Jeffrey Brook
- Dalla Lana School of Public Health and Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, ON, Canada
| | - Heather Castleden
- Department of Geogrophy and Planning, Queens University, Kingston, ON, Canada
| | - Vicky Chrisjohn
- Oneida Health Centre, Oneida Nation of the Thames, Southwold, ON, Canada
| | - Ida Cornelius
- Oneida Health Centre, Oneida Nation of the Thames, Southwold, ON, Canada
| | | | - Dipika Desai
- Population Health Research Institute, Hamiliton Health Sciences, Hamilton, ON, Canada
| | - Russell J de Souza
- Department of Health Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; Population Health Research Institute, Hamiliton Health Sciences, Hamilton, ON, Canada
| | - Matthias G Friedrich
- Department of Medicine and Diagnostic Radiology, McGill University, Montréal, QC, Canada
| | - Stewart Harris
- Department of Family Medicine, Western University, London, ON, Canada
| | - James Irvine
- Department of Family Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Randy Littlechild
- Maskwacis Health Services, Maskwacis First Nation, Maskwacis, AB, Canada
| | - Lisa Mayotte
- Health Services, Lac La Ronge Indian Band, La Ronge, SK, Canada
| | - Sarah McIntosh
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | | | - Richard T Oster
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Manon Picard
- Health Services, Wendake Reserve, Wendake, QC, Canada
| | - Paul Poirier
- Institut universitaire de cardiologie et de pneumologie de Quebec, Université Laval, QC, Canada
| | - Karleen M Schulze
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; Population Health Research Institute, Hamiliton Health Sciences, Hamilton, ON, Canada
| | - Ellen L Toth
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Bhosale VV, Singh S, Srivastava M, Pathak P, Prakash S, Sonkar S, Misra AK, Misra R, Ghatak A. A case control study of clinical and biochemical parameters of metabolic syndrome with special attention among young and middle aged population. Diabetes Metab Syndr 2019; 13:2653-2659. [PMID: 31405690 DOI: 10.1016/j.dsx.2019.07.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 07/10/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Metabolic syndrome (MS) increases the risk of heart disease, stroke, and other complications. AIM The aim of this study was to assess the clinical and biochemical parameters of MS and its complications (cerebrovascular accidents, cardiovascular accidents, DN or chronic kidney disease (CKD) compared with healthy controls especially among the younger population in Northern India. MATERIAL AND METHODS A total of 245 (healthy, MS and it's complicated) aged 18-70 years participated in the Open-Label, Single Centered; hospital-based random selection case-control comparative study. All anthropometric and biochemical assessment was done after proper consent. The metabolic syndrome was determined by IDF criteria. RESULTS The key risk parameters in three groups i.e. Control, Metabolic syndrome, and Complicated was TG (96.5 ± 46.9, 194.1 ± 87.8, 148.0 ± 102.2). LDL (91.2 ± 27.2, 114.0 ± 31.8, 69.1 ± 42.5, BP (120.1 ± 9.9, 139.3 ± 13.3, 132.1 ± 15.0) and high fasting glucose (81.1 ± 13.7, 164.5 ± 84.3, 138.0 ± 74.5). The hs-CRP is also significantly increased in the complicated group. The subanalysis of data also indicates that younger middle age (36-55 years) group both male and female is obese, hypertensive, diabetic with lipid abnormality according to IDF criteria. CONCLUSION The risk factors like high TG, low HDL, high BP, and high fasting glucose were found higher particularly in younger population which may lead to diagnosis & complications of diabetes, hypertension and lipid abnormality. Due to changing physiology in young and middle age population these individuals are moving towards metabolic syndrome easily and needs frequent monitoring, preventive checkups, and lifestyle changes to prevent complications.
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Affiliation(s)
- Vivek V Bhosale
- Department of Toxicology and Experimental Medicine, CSIR-Central Drug Research Institute, Sector 10, Jankipuram Vistar, Lucknow, 226031, India.
| | - Shail Singh
- Department of Toxicology and Experimental Medicine, CSIR-Central Drug Research Institute, Sector 10, Jankipuram Vistar, Lucknow, 226031, India
| | - Mukesh Srivastava
- Department of Toxicology and Experimental Medicine, CSIR-Central Drug Research Institute, Sector 10, Jankipuram Vistar, Lucknow, 226031, India
| | - Priyanka Pathak
- Department of Toxicology and Experimental Medicine, CSIR-Central Drug Research Institute, Sector 10, Jankipuram Vistar, Lucknow, 226031, India
| | - Shakti Prakash
- Department of Toxicology and Experimental Medicine, CSIR-Central Drug Research Institute, Sector 10, Jankipuram Vistar, Lucknow, 226031, India
| | - Satyendra Sonkar
- Department of Medicine, King George Medical University, Chowk, Lucknow, 226003, India.
| | - Arvind K Misra
- Department of Medicine, King George Medical University, Chowk, Lucknow, 226003, India
| | - Ravi Misra
- Department of Medicine, King George Medical University, Chowk, Lucknow, 226003, India
| | - Ashim Ghatak
- Division of Clinical and Experimental Medicine, CSIR-Central Drug Research Institute, Sector 10, Jankipuram Vistar, Lucknow, 226031, India
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32
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Kelly L, Matsumoto CL, Schreiber Y, Gordon J, Willms H, Olivier C, Madden S, Hopko J, Tobe SW. Prevalence of chronic kidney disease and cardiovascular comorbidities in adults in First Nations communities in northwest Ontario: a retrospective observational study. CMAJ Open 2019; 7:E568-E572. [PMID: 31501170 PMCID: PMC6768774 DOI: 10.9778/cmajo.20190040] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The prevalence of adult chronic kidney disease and cardiovascular comorbidities in Canadian Indigenous communities is largely unknown. We conducted a study to document the prevalence of chronic kidney disease and concurrent diabetes mellitus, hypertension and dyslipidemia in a First Nations population in northwest Ontario. METHODS In this observational study, we used retrospective data collected from regional electronic medical records of 16 170 adults (age ≥ 18 yr) from 26 First Nations communities in northwest Ontario from May 2014 to May 2017. Demographic and laboratory data included age, gender, prescribed medications, estimated glomerular filtration rate, urine albumin:creatinine ratio, low-density lipoprotein cholesterol (LDL-C) level and glycated hemoglobin (HbA1c) concentration. We identified patients with diabetes by an HbA1c concentration of 6.5% or higher, or the use of a diabetic medication, those with dyslipidemia by an elevated LDL-C level (≥ 2.0 mmol/L) or use of lipid-lowering medication, and those with hypertension by use of antihypertensive medication. RESULTS Of the 16 170 adults residing in the communities, 5224 unique patients (32.3%) had renal testing (albumin:creatinine ratio and/or estimated glomerular filtration rate). The age-adjusted prevalence of chronic kidney disease was 14.5%, and the prevalence of stage 3-5 chronic kidney disease (estimated glomerular filtration rate < 60 mL/min) was 7.0%. Most patients with chronic kidney disease (1487 [80.0%]) had at least 1 cardiovascular comorbidity. A total of 1332 patients (71.6%) had diabetes, 1313 (70.6%) had dyslipidemia, and 1098 (59.1%) had hypertension; all 3 comorbidities were present in 716 patients (38.5%). INTERPRETATION We document a high prevalence of advanced chronic kidney disease in this First Nations population, 7.0%, double the rate in the general population. High rates of cardiovascular comorbidities were also common in these patients with chronic kidney disease, which places them at increased risk for cardiovascular disease.
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Affiliation(s)
- Len Kelly
- Anishinaabe Bimaadiziwin Research Program (Kelly, Schreiber, Willms), Sioux Lookout Meno Ya Win Health Centre; Approaches to Community Wellbeing (Matsumoto) and Health Services (Gordon, Hopko), Sioux Lookout First Nations Health Authority, Sioux Lookout, Ont.; Division of Infectious Diseases (Schreiber), The Ottawa Hospital, University of Ottawa; The Ottawa Hospital Research Institute (Schreiber); School of Epidemiology and Public Health (Schreiber), University of Ottawa, Ottawa, Ont.; University of Saskatchewan (Olivier), Saskatoon, Sask.; Division of Clinical Sciences (Madden), Northern Ontario School of Medicine, Sioux Lookout, Ont.; Department of Medicine (Tobe), Sunnybrook Health Sciences Centre, Toronto, Ont.
| | - Cai-Lei Matsumoto
- Anishinaabe Bimaadiziwin Research Program (Kelly, Schreiber, Willms), Sioux Lookout Meno Ya Win Health Centre; Approaches to Community Wellbeing (Matsumoto) and Health Services (Gordon, Hopko), Sioux Lookout First Nations Health Authority, Sioux Lookout, Ont.; Division of Infectious Diseases (Schreiber), The Ottawa Hospital, University of Ottawa; The Ottawa Hospital Research Institute (Schreiber); School of Epidemiology and Public Health (Schreiber), University of Ottawa, Ottawa, Ont.; University of Saskatchewan (Olivier), Saskatoon, Sask.; Division of Clinical Sciences (Madden), Northern Ontario School of Medicine, Sioux Lookout, Ont.; Department of Medicine (Tobe), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Yoko Schreiber
- Anishinaabe Bimaadiziwin Research Program (Kelly, Schreiber, Willms), Sioux Lookout Meno Ya Win Health Centre; Approaches to Community Wellbeing (Matsumoto) and Health Services (Gordon, Hopko), Sioux Lookout First Nations Health Authority, Sioux Lookout, Ont.; Division of Infectious Diseases (Schreiber), The Ottawa Hospital, University of Ottawa; The Ottawa Hospital Research Institute (Schreiber); School of Epidemiology and Public Health (Schreiber), University of Ottawa, Ottawa, Ont.; University of Saskatchewan (Olivier), Saskatoon, Sask.; Division of Clinical Sciences (Madden), Northern Ontario School of Medicine, Sioux Lookout, Ont.; Department of Medicine (Tobe), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Janet Gordon
- Anishinaabe Bimaadiziwin Research Program (Kelly, Schreiber, Willms), Sioux Lookout Meno Ya Win Health Centre; Approaches to Community Wellbeing (Matsumoto) and Health Services (Gordon, Hopko), Sioux Lookout First Nations Health Authority, Sioux Lookout, Ont.; Division of Infectious Diseases (Schreiber), The Ottawa Hospital, University of Ottawa; The Ottawa Hospital Research Institute (Schreiber); School of Epidemiology and Public Health (Schreiber), University of Ottawa, Ottawa, Ont.; University of Saskatchewan (Olivier), Saskatoon, Sask.; Division of Clinical Sciences (Madden), Northern Ontario School of Medicine, Sioux Lookout, Ont.; Department of Medicine (Tobe), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Hannah Willms
- Anishinaabe Bimaadiziwin Research Program (Kelly, Schreiber, Willms), Sioux Lookout Meno Ya Win Health Centre; Approaches to Community Wellbeing (Matsumoto) and Health Services (Gordon, Hopko), Sioux Lookout First Nations Health Authority, Sioux Lookout, Ont.; Division of Infectious Diseases (Schreiber), The Ottawa Hospital, University of Ottawa; The Ottawa Hospital Research Institute (Schreiber); School of Epidemiology and Public Health (Schreiber), University of Ottawa, Ottawa, Ont.; University of Saskatchewan (Olivier), Saskatoon, Sask.; Division of Clinical Sciences (Madden), Northern Ontario School of Medicine, Sioux Lookout, Ont.; Department of Medicine (Tobe), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Christopher Olivier
- Anishinaabe Bimaadiziwin Research Program (Kelly, Schreiber, Willms), Sioux Lookout Meno Ya Win Health Centre; Approaches to Community Wellbeing (Matsumoto) and Health Services (Gordon, Hopko), Sioux Lookout First Nations Health Authority, Sioux Lookout, Ont.; Division of Infectious Diseases (Schreiber), The Ottawa Hospital, University of Ottawa; The Ottawa Hospital Research Institute (Schreiber); School of Epidemiology and Public Health (Schreiber), University of Ottawa, Ottawa, Ont.; University of Saskatchewan (Olivier), Saskatoon, Sask.; Division of Clinical Sciences (Madden), Northern Ontario School of Medicine, Sioux Lookout, Ont.; Department of Medicine (Tobe), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Sharen Madden
- Anishinaabe Bimaadiziwin Research Program (Kelly, Schreiber, Willms), Sioux Lookout Meno Ya Win Health Centre; Approaches to Community Wellbeing (Matsumoto) and Health Services (Gordon, Hopko), Sioux Lookout First Nations Health Authority, Sioux Lookout, Ont.; Division of Infectious Diseases (Schreiber), The Ottawa Hospital, University of Ottawa; The Ottawa Hospital Research Institute (Schreiber); School of Epidemiology and Public Health (Schreiber), University of Ottawa, Ottawa, Ont.; University of Saskatchewan (Olivier), Saskatoon, Sask.; Division of Clinical Sciences (Madden), Northern Ontario School of Medicine, Sioux Lookout, Ont.; Department of Medicine (Tobe), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Josh Hopko
- Anishinaabe Bimaadiziwin Research Program (Kelly, Schreiber, Willms), Sioux Lookout Meno Ya Win Health Centre; Approaches to Community Wellbeing (Matsumoto) and Health Services (Gordon, Hopko), Sioux Lookout First Nations Health Authority, Sioux Lookout, Ont.; Division of Infectious Diseases (Schreiber), The Ottawa Hospital, University of Ottawa; The Ottawa Hospital Research Institute (Schreiber); School of Epidemiology and Public Health (Schreiber), University of Ottawa, Ottawa, Ont.; University of Saskatchewan (Olivier), Saskatoon, Sask.; Division of Clinical Sciences (Madden), Northern Ontario School of Medicine, Sioux Lookout, Ont.; Department of Medicine (Tobe), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Sheldon W Tobe
- Anishinaabe Bimaadiziwin Research Program (Kelly, Schreiber, Willms), Sioux Lookout Meno Ya Win Health Centre; Approaches to Community Wellbeing (Matsumoto) and Health Services (Gordon, Hopko), Sioux Lookout First Nations Health Authority, Sioux Lookout, Ont.; Division of Infectious Diseases (Schreiber), The Ottawa Hospital, University of Ottawa; The Ottawa Hospital Research Institute (Schreiber); School of Epidemiology and Public Health (Schreiber), University of Ottawa, Ottawa, Ont.; University of Saskatchewan (Olivier), Saskatoon, Sask.; Division of Clinical Sciences (Madden), Northern Ontario School of Medicine, Sioux Lookout, Ont.; Department of Medicine (Tobe), Sunnybrook Health Sciences Centre, Toronto, Ont
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Rezazadeh L, Gargari BP, Jafarabadi MA, Alipour B. Effects of probiotic yogurt on glycemic indexes and endothelial dysfunction markers in patients with metabolic syndrome. Nutrition 2019; 62:162-168. [DOI: 10.1016/j.nut.2018.12.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 11/06/2018] [Accepted: 12/29/2018] [Indexed: 12/13/2022]
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Zahran AM, Sayed SK, Abd El Hafeez HA, Khalifa WA, Mohamed NA, Hetta HF. Circulating microparticle subpopulation in metabolic syndrome: relation to oxidative stress and coagulation markers. Diabetes Metab Syndr Obes 2019; 12:485-493. [PMID: 31043798 PMCID: PMC6469468 DOI: 10.2147/dmso.s191750] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Circulating microparticles (MPs) contribute to the pathogenesis of atherothrombotic disorders and are raised in cardiovascular diseases. Herein, we aimed to investigate the effect of moderate metabolic abnormalities in an early stage of metabolic syndrome (MetS) on the level of MP subpopulations and to study relationships between MP subpopulations and both oxidative stress and coagulation markers. METHODS Flow cytometry used to evaluate circulating MPs subpopulations in 40 patients with an early stage MetS and 30 healthy controls. ELISA was used to quantify plasminogen activator inhibitor type 1/tissue plasminogen activator (PAI-1/TPA) while plasma glutathione peroxidase (GPx) activity was measured spectrophotometrically. RESULTS Total MPs were significantly elevated in MetS (P<0.001). Glutathione peroxidase and PAI1/TPA activity was significantly increased in subjects with MetS (P<0.001). Waist circumference, diastolic blood pressure, and total cholesterol positively influenced levels of total MPs, platelet-derived microparticles, and endothelium-derived microparticles. Fasting blood glucose, cholesterol, triglycerides, and low-density lipoprotein positively influenced the coagulation factors (TPA, PAI1). However, high-density lipoprotein negatively influenced platelet-derived MPs and factors associated with fibrinolysis (TPA, PAI1). CONCLUSION Elevated circulating MPs are associated with MetS abnormalities, oxidative stress and coagulation factors and may act as early predictor of metabolic syndrome with risk of cardiovascular disease.
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Affiliation(s)
- Asmaa M Zahran
- Department of Clinical Pathology, South Egypt Cancer Institute, Assiut, Egypt
| | - Sohair K Sayed
- Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Heba A Abd El Hafeez
- Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Walaa A Khalifa
- Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Nahed A Mohamed
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Helal F Hetta
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt,
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA,
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Yoldemir T, Garibova N, Atasayan K. The association between sexual dysfunction and metabolic syndrome among Turkish postmenopausal women. Climacteric 2019; 22:472-477. [PMID: 30889983 DOI: 10.1080/13697137.2019.1580256] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Objective: The aim of this study is to determine the association between sexual dysfunction and metabolic syndrome (MS) among Turkish postmenopausal women Methods: In total, 290 postmenopausal women between the ages of 50 and 70 years and 265 premenopausal women between the ages of 30 and 49 years who applied to Menopause and Gynecology Clinics at Marmara University-affiliated Pendik Education and Research Hospital, Istanbul, Turkey were included in this prospective survey. Sexual function was assessed using the Female Sexual Function Index (FSFI). A FSFI total score of <26.5 was suggestive of sexual dysfunction. MS was assessed by the National Cholesterol Education Program Adult Treatment Panel III criteria. Results: Sexual dysfunction prevalence among postmenopausal women was 64.6% in relation to 42.1% in premenopausal women (p = 0.001). MS prevalence was 13.5% among premenopausal women and 15.5% among postmenopausal women (p = 0.57). The total FSFI score and each score in the desire, arousal, lubrication, orgasm, satisfaction, and dyspareunia domains of the FSFI did not differ between premenopausal and postmenopausal women, regarding the MS status. In the premenopausal group, 45.7% of women without MS and 37% of women with MS had lower sexual dysfunction (p = 0.40); whereas in the postmenopausal group, 62.2% of women without MS and 77.4% of women with MS had lower sexual function (p = 0.22). Conclusion: In our study population, the rate of sexual dysfunction increased in postmenopausal women in contrast to premenopausal women. The MS status did not make a difference in terms of sexual dysfunction either in premenopausal or postmenopausal women. Since our survey was conducted in a tertiary medical center which gave medical care service to women from middle and low socioeconomic classes, our results should be confirmed by a large multicenter survey enrolling women from all different socioeconomic classes.
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Affiliation(s)
- T Yoldemir
- Department of Obstetrics and Gynaecology, Marmara University Hospital , Istanbul , Turkey
| | - N Garibova
- Obstetrics and Gynaecology Clinic, Baku Medical Center , Baku , Azerbaijan
| | - K Atasayan
- Department of Obstetrics and Gynaecology, Maltepe University Hospital , Istanbul , Turkey
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Mosimah CI, Murray PJ, Simpkins JW. Not all clots are created equal: a review of deficient thrombolysis with tissue plasminogen activator (tPA) in patients with metabolic syndrome. Int J Neurosci 2018; 129:612-618. [PMID: 30465701 DOI: 10.1080/00207454.2018.1550400] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Metabolic syndrome is a cluster of cardiovascular risk factors associated with a prothrombotic, proinflammatory and hypofibrinolysis state. Although resistance to tissue plasminogen activator (tPA) in metabolic syndrome patients has been associated with a defective fibrinolytic system, the factors and mechanisms underlining such resistance is unclear. While there is a great debate on proposed mechanisms, fundamental questions regarding resistance to tPA in metabolic syndrome patients with ischemic stroke remain unanswered. This article reviews articles and documents published between 2001 and 2017, and provides an overview of metabolic syndrome, factors associated with tPA resistance in metabolic syndrome, conflicting evidence of insufficient dosing of tPA in overweight/obese patients and future directions for research.
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Affiliation(s)
- Charles I Mosimah
- a Department of Clinical and Translational Sciences , West Virginia University , Morgantown , WV , USA
| | - Pamela J Murray
- b Department of Pediatrics , West Virginia University , Morgantown , WV , USA
| | - James W Simpkins
- c Department of Physiology Pharmacology & Neuroscience , West Virginia University , Morgantown , WV , USA
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Maistry T, Gordon M, Sartorius B, Naidoo DP. Candidate gene polymorphisms related to lipid metabolism in Asian Indians living in Durban, South Africa. Indian J Med Res 2018; 148:169-179. [PMID: 30381540 PMCID: PMC6206769 DOI: 10.4103/ijmr.ijmr_1150_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND & OBJECTIVES Asian Indians have been shown to have a high prevalence of metabolic syndrome (MetS), related to insulin resistance and possibly genetic factors. The aim of this study was to determine the genetic patterns associated with MetS in Asian Indians living in Durban, South Africa. METHODS Nine hundred and ninety nine participants from the Phoenix Lifestyle Project underwent clinical, biochemical and genetic assessment. MetS was diagnosed according to the harmonized definition. The apolipoprotein A5 Q139X, lipoprotein lipase (LPL) Hinf I, human paraoxonase 1 (PON1) 192Arg/Gln, cholesteryl ester transfer protein (CETP) Taq1B, adiponectin 45T>G and leptin (LEP) 25CAG were genotyped by real-time polymerase chain reaction in participants with and without MetS. Univariate-unadjusted and multivariate-adjusted relations were conducted for all analyses. RESULTS The prevalence of MetS was high (49.0%). More females had MetS than males (51.0 vs 42.8%). There was no significant difference in the distribution of genotypes between participants with MetS and those without. Males with the MetS who had the adiponectin TG genotype and human paraoxonase 1 AA genotype were more likely to have reduced high-density lipoprotein cholesterol (HDL-C) (P=0.001) and higher systolic blood pressure (P=0.018), respectively. INTERPRETATION & CONCLUSIONS About half of the Asian Indians living in Phoenix had MetS. No association between the polymorphisms studied and the risk for MetS was observed. The adiponectin TG genotype may be associated with reduced HDL-C and the human paraoxonase 1 AA genotype with hypertension in males. This suggested that lifestyle factors were the major determinant for MetS in this ethnic group and the genetic risk might be related to its component risk factors than to MetS as an entity.
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Affiliation(s)
- Tanya Maistry
- Department of Cardiology, Nelson R Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa
| | - Michelle Gordon
- Department of Molecular Biology, Nelson R Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa
| | - Benn Sartorius
- Department of Public Health Medicine, Nelson R Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa
| | - Datshana P. Naidoo
- Department of Cardiology, Nelson R Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa
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Chengji W, Xianjin F. Treadmill exercise alleviates diabetic cardiomyopathy by suppressing plasminogen activator inhibitor expression and enhancing eNOS in streptozotocin-induced male diabetic rats. Endocr Connect 2018; 7:553-559. [PMID: 29555653 PMCID: PMC5887130 DOI: 10.1530/ec-18-0060] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 03/19/2018] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate the biological mechanism of the effect of different intensity exercises on diabetic cardiomyopathy. METHODS 87 raise specific pathogen SPF healthy 6-week-old male Sprague-Dawley rats, fed 6 weeks with high-fat diet for rats were used, and a diabetic model was established by intraperitoneal injection of streptozotocin - randomly selected 43 rats were divided into Diabetic control group (DCG, n = 10), Diabetic exercise group 1 (DEG1, n = 11), Diabetic exercise group 2 (DEG2, n = 11) and Diabetic exercise group 3 (DEG3, n = 11). The rats in DEG1 were forced to run on a motorized treadmill, the exercise load consisted of running at a speed of 10 m/min, the exercise load of the rats in DEG2 were running at a speed of 15 m/min, the exercise load of the rats in DEG3 were running at a speed of 20 m/min, for one hour once a day for 6 weeks. After 6 weeks of exercise intervention, glucose metabolism-related indexes in rats such as blood glucose (FBG), glycosylated serum protein (GSP) and insulin (FINS); cardiac fibrinolytic system parameters such as PAI-1 (plasminogen activator inhibitor 1), Von Willebrand factor (vWF), protein kinase C (PKC) and diacylglycerol (DAG); and serum level of NO, eNOS and T-NOS were measured. RESULT Compared with DCG, fasting blood glucose and GSP were decreased, while insulin sensitivity index and insulin level were increased in all rats of the three exercise groups. FBG decrease was statistically significant (P < 0.01), only GSP decrease was statistically significant (P < 0.05) in DEG1 and DEG2, PAI-1 in three exercise groups were significantly reduced (P < 0.05), plasma vWF levels in the three exercise groups were significantly lower than those in the DCG group (P < 0.01); PKC levels decreased dramatically in the three exercise groups and DAG levels decrease slightly (P < 0.05), but with no significant difference. Compared with DCG, the serum level of NO was significantly higher (P < 0.05), and eNOS level was significantly elevated (P < 0.05). T-NOS elevation was statistically significant in DEG1 (P < 0.05). CONCLUSIONS Low- and moderate-intensity exercise can better control blood glucose level in diabetic rats; myocardial PAI-1 in DEG1, DEG2 and DEG3 rats decreased significantly (P < 0.05), serum NO increased (P < 0.05) and eNOS increased (P < 0.05) significantly. Therefore, it is inferred that exercise improves the biological mechanism of diabetic cardiomyopathy by affecting the levels of PAI-1 and eNOS, and there is a dependence on intensity.
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Affiliation(s)
- Wang Chengji
- College of Physical EducationChaohu University, Anhui Province, China
| | - Fan Xianjin
- College of Physical EducationChaohu University, Anhui Province, China
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Kandasamy S, Anand SS. Cardiovascular Disease Among Women From Vulnerable Populations: A Review. Can J Cardiol 2018; 34:450-457. [PMID: 29571426 DOI: 10.1016/j.cjca.2018.01.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 01/11/2018] [Accepted: 01/16/2018] [Indexed: 12/14/2022] Open
Abstract
On a global scale, cardiovascular disease (CVD) is the leading cause of mortality. It is also the number 1 cause of death among women, resulting in 8.6 million deaths annually and constituting one third of all deaths in women worldwide. The burden of CVD and related risk factors has taken priority in the policy development for noncommunicable diseases. However, vulnerable populations, defined here as women who are socially or economically disadvantaged (eg, low income), nonwhite (specifically South Asian and indigenous women), and those who are elderly have often been overlooked in these discussions. These additional vulnerabilities, which may exist independently or in combination, place such women at higher risk for CVD. Specifically, these vulnerabilities include low socioeconomic status, a low sense of control, high stress, South Asian or indigenous ancestry, and increased age. Thus it is vital that we initiate a multipronged approach to CVD prevention that includes rigorous monitoring of CVD risk factors in high-risk populations and the implementation of timely, accurate, and contextually tailored prevention programs, services, and treatments. Well-trained nonphysician health care workers can support the accurate monitoring and management of CVD and CVD risk factors so that groups of women who may otherwise be overlooked can receive adequate attention.
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Affiliation(s)
- Sujane Kandasamy
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sonia S Anand
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
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Pedro-Botet J, Ascaso JF, Barrios V, De la Sierra A, Escalada J, Millán J, Mostaza JM, Pérez-Martínez P, Pintó X, Salas-Salvadó J, Valdivielso P. COSMIC project: consensus on the objectives of the metabolic syndrome in clinic. Diabetes Metab Syndr Obes 2018; 11:683-697. [PMID: 30464566 PMCID: PMC6217133 DOI: 10.2147/dmso.s165740] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Metabolic syndrome (MetS), a disorder with a high and growing prevalence, is a recognized risk factor for cardiovascular disease (CVD) and type 2 diabetes. It is a constellation of clinical and metabolic risk factors that include abdominal obesity, dyslipidemia, glucose intolerance, and hypertension. Unfortunately, MetS is typically underrecognized, and there is great heterogeneity in its management, which can hamper clinical decision-making and be a barrier to achieving the therapeutic goals of CVD and diabetes prevention. Although no single treatment for MetS as a whole currently exists, management should be targeted at treating the conditions contributing to it and possibly reversing the risk factors. All this justifies the need to develop recommendations that adapt existing knowledge to clinical practice in our healthcare system. In this regard, professionals from different scientific societies who are involved in the management of the different MetS components reviewed the available scientific evidence focused basically on therapeutic aspects of MetS and developed a consensus document to establish recommendations on therapeutic goals that facilitate their homogenization in clinical decision-making.
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Affiliation(s)
- Juan Pedro-Botet
- Lipids and Vascular Risk Unit, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain,
| | - Juan F Ascaso
- Endocrinology and Nutrition Service, Hospital Clínico, Universitat de Valencia, Valencia, Spain
- INCLIVA Research Institute, Diabetes and Metabolic Diseases Ciber (Networked Biomedical Research Centres - CIBERDEM), Carlos III, Valencia, Spain
| | - Vivencio Barrios
- Cardiology Service, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain
- Department of Medicine, Universidad Católica de Murcia (UCAM), Murcia, Spain
| | - Alejandro De la Sierra
- Internal Medicine Service, Hospital Mutua de Terrassa, Department of Medicine, Universidad de Barcelona, Spain
| | - Javier Escalada
- Department of Endocrinology and Nutrition, Clínica Universitaria de Navarra, IdiSNA
- CIBEROBN "Physiopathology of Obesity and Nutrition", Carlos III Health Institute, Spain
| | - Jesús Millán
- Lipid Unit, Department of Internal Medicine, Hospital Universitario General Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - Jose M Mostaza
- Lipid and Arteriosclerosis Unit, Internal Medicine Service, Hospital Carlos III, Madrid, Spain
| | - Pablo Pérez-Martínez
- CIBEROBN "Physiopathology of Obesity and Nutrition", Carlos III Health Institute, Spain
- Lipid and Arteriosclerosis Unit, Hospital Universitario Reina Sofía, IMIBIC/University of Cordoba, Cordoba, Spain
| | - Xavier Pintó
- CIBEROBN "Physiopathology of Obesity and Nutrition", Carlos III Health Institute, Spain
- Lipids Unit, Department of Internal Medicine Hospital Universitario de Bellvitge, Universidad de Barcelona, Barcelona, Spain
| | - Jordi Salas-Salvadó
- CIBEROBN "Physiopathology of Obesity and Nutrition", Carlos III Health Institute, Spain
- Nutrition Unit, Hospital Universitari Sant Joan de Reus, Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili
| | - Pedro Valdivielso
- Internal Medicine Service, Department of Medicine and Dermatology, Hospital Universitario Virgen de la Victoria, Málaga Biomedicine Institute (IBIMA), Universidad de Málaga, Málaga, Spain
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Most J, Tosti V, Redman LM, Fontana L. Calorie restriction in humans: An update. Ageing Res Rev 2017; 39:36-45. [PMID: 27544442 PMCID: PMC5315691 DOI: 10.1016/j.arr.2016.08.005] [Citation(s) in RCA: 306] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 08/11/2016] [Accepted: 08/11/2016] [Indexed: 12/11/2022]
Abstract
Calorie restriction (CR), a nutritional intervention of reduced energy intake but with adequate nutrition, has been shown to extend healthspan and lifespan in rodent and primate models. Accumulating data from observational and randomized clinical trials indicate that CR in humans results in some of the same metabolic and molecular adaptations that have been shown to improve health and retard the accumulation of molecular damage in animal models of longevity. In particular, moderate CR in humans ameliorates multiple metabolic and hormonal factors that are implicated in the pathogenesis of type 2 diabetes, cardiovascular diseases, and cancer, the leading causes of morbidity, disability and mortality. In this paper, we will discuss the effects of CR in non-obese humans on these physiological parameters. Special emphasis is committed to recent clinical intervention trials that have investigated the feasibility and effects of CR in young and middle-aged men and women on parameters of energy metabolism and metabolic risk factors of age-associated disease in great detail. Additionally, data from individuals who are either naturally exposed to CR or those who are self-practicing this dietary intervention allows us to speculate on longer-term effects of more severe CR in humans.
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Affiliation(s)
- Jasper Most
- Reproductive Endocrinology and Women's Health, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
| | - Valeria Tosti
- Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Leanne M Redman
- Reproductive Endocrinology and Women's Health, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA.
| | - Luigi Fontana
- Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Clinical and Experimental Sciences, Brescia University Medical School, Brescia, Italy; CEINGE Biotecnologie Avanzate, Napoli, Italy.
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Rahamon SK, Fabian UA, Charles-Davies MA, Olaniyi JA, Fasanmade AA, Akinlade KS, Oyewole OE, Owolabi MO, Adebusuyi JR, Hassan OO, Ajobo BM, Ebesunun MO, Adigun K, Popoola OO, Omiyale W, Arinola OG, Agbedana EO. Changes in mediators of inflammation and pro-thrombosis after 12 months of dietary modification in adults with metabolic syndrome. Afr Health Sci 2017; 17:453-462. [PMID: 29062341 DOI: 10.4314/ahs.v17i2.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE This study evaluated the effects of a 12-month dietary modification on indices of inflammation and pro-thrombosis in adults with metabolic syndrome (MS). MATERIALS AND METHODS This longitudinal study involved 252 adults with MS recruited from the Bodija market, Ibadan and its environs. Participants were placed on 20%, 30% and 50% calories obtained from protein, total fat and carbohydrate respectively and were followed up monthly for 12 months. Anthropometry and blood pressure were measured using standard methods. Fasting plasma glucose (FPG), total cholesterol (TC), triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), fibrinogen, plasminogen activator inhibitor-1 (PAI-1)], interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured using spectrophotometric methods and ELISA as appropriate. Data was analysed using ANCOVA, Student's t-test, Mann-Whitney U and Wilcoxon signed-rank tests. P-values less than 0.05 were considered significant. RESULTS After 6 months of dietary modification, there was a significant reduction in waist circumference (WC), while the levels of HDL-C, fibrinogen and PAI-1 were significantly increased when compared with the corresponding baseline values. However, WC and fibrinogen reduced significantly, while HDL-C and IL-10 significantly increased after 12 months of dietary modification as compared with the respective baseline values. CONCLUSION Long-term regular dietary modification may be beneficial in ameliorating inflammation and pro-thrombosis in metabolic syndrome.
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Affiliation(s)
- S K Rahamon
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - U A Fabian
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - M A Charles-Davies
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - J A Olaniyi
- Department of Haematology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - A A Fasanmade
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - K S Akinlade
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - O E Oyewole
- Department of Health Promotion and Education, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - M O Owolabi
- Department of Haematology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - J R Adebusuyi
- Department of Medical Social Services, University College Hospital, Ibadan, Nigeria
| | - O O Hassan
- Department of Medical Social Services, University College Hospital, Ibadan, Nigeria
| | - B M Ajobo
- Dietetics Department, University College Hospital, Ibadan, Nigeria
| | - M O Ebesunun
- Department of Chemical Pathology, College of Health Sciences, Olabisi Onabanjo University, Ago-Iwoye, Nigeria
| | - K Adigun
- Department of Family Medicine, University College Hospital, Ibadan, Nigeria
| | - O O Popoola
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - W Omiyale
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - O G Arinola
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - E O Agbedana
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Kaler SN, Ralph-Campbell K, Pohar S, King M, Laboucan CR, Toth EL. High rates of the metabolic syndrome in a First Nations Community in western Canada: prevalence and determinants in adults and children. Int J Circumpolar Health 2016; 65:389-402. [PMID: 17319084 DOI: 10.3402/ijch.v65i5.18139] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES Increasing type 2 diabetes in Aboriginal communities across North America raises concerns about metabolic syndrome in these populations. Some prevalence information for American Indians exists, but little has been available for Canada's First Nations. STUDY DESIGN We screened 60% of the eligible population of a single First Nation in Alberta for diabetes, pre-diabetes, cardiovascular risk, and metabolic syndrome. METHODS NCEP/ATP III and IDF criteria were used to identify metabolic syndrome in participants aged > or = 18; modified NCEP/ATP III criteria were used for participants aged < 18. Logistic regression identified factors associated with the metabolic syndrome. RESULTS 297 individuals were screened (176 adults, 84 children/adolescents, with complete data). 52.3% of adults had metabolic syndrome using NCEP/ATP III criteria, and 50% using IDF criteria. 40.5% of individuals aged < 18 had the condition. Waist circumference was the most prevalent correlate. Bivariate analysis suggested that age, BMI, weight, Alc, LDL-C, ADA risk score and activity pattern were associated with metabolic syndrome. CONCLUSIONS Our data represent the first available for Western Cree and are consistent with prevalence reported for Aboriginal populations in Ontario and Manitoba. High rates of obesity, pre-diabetes and metabolic syndrome for participants aged < 18 raise concerns about future prevalence of diabetes and cardiovascular disease.
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Affiliation(s)
- Sharndeep Norry Kaler
- Heritage Research Medical Center, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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Brede S, Serfling G, Klement J, Schmid SM, Lehnert H. Clinical Scenario of the Metabolic Syndrome. Visc Med 2016; 32:336-341. [PMID: 27921045 DOI: 10.1159/000449028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The term metabolic syndrome (MeS) refers to a cluster of associated symptoms composed of impaired fasting glucose, abdominal obesity, hypertension, and dyslipidemia. MeS is associated with an increased risk of cardiovascular and diabetes-associated morbidity and mortality. The increased amount of visceral fat together with a chronic inflammatory state predisposes to the development of arteriosclerosis. Furthermore, insulin resistance (IR) and dyslipidemia are associated with fatty liver disease. In addition, MeS is linked to non-cardiovascular diseases such as cancer as well as psychiatric or endocrine disorders. Here, we discuss the clinical impact of MeS in cardiovascular and non-cardiovascular diseases to highlight the importance of prevention, early diagnosis, and multifactorial treatment of high-risk individuals.
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Affiliation(s)
- Swantje Brede
- Department of Medicine I, University of Lübeck, Lübeck, Germany
| | - Georg Serfling
- Department of Medicine I, University of Lübeck, Lübeck, Germany
| | - Johanna Klement
- Department of Medicine I, University of Lübeck, Lübeck, Germany
| | | | - Hendrik Lehnert
- Department of Medicine I, University of Lübeck, Lübeck, Germany
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Abstract
The common clustering of glucose intolerance, insulin resistance, abdominal adiposity, elevated blood pressure, and low HDL cholesterol is referred to as metabolic syndrome. Individuals with this syndrome have an increased risk of developing cardiovascular disease (CVD). The World Health Organisation and the National Cholesterol Education Programme’s Adult Treatment Panel III (NCEP-ATP III) have outlined specific diagnostic criteria for the diagnosis of the metabolic syndrome to help in the Identification of this syndrome in clinical practice. While the WHO criteria were specifically developed for use in research, the NCEP criteria are useful in clinical diagnosis of the metabolic syndrome. The metabolic syndrome is amenable to lifestyle modifications such as increased physical activity, weight loss, and possibly intake of low-glycemic foods. Drug therapy may be used to treat individual components of the syndrome such as elevated blood pressure and dyslipidemia. To control elevated glucose levels (when there is failure of lifestyle modification), medications such as metformin, thiazolidinedione derivatives and alpha glucosidase inhibitors may be used.
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Affiliation(s)
- Dorairaj Prabhakaran
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada
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Lytvyn Y, Bjornstad P, Pun N, Cherney DZI. New and old agents in the management of diabetic nephropathy. Curr Opin Nephrol Hypertens 2016; 25:232-9. [PMID: 26890303 PMCID: PMC5841607 DOI: 10.1097/mnh.0000000000000214] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Diabetic nephropathy is a long-standing complication of diabetes mellitus and is responsible for more than 40% of end-stage renal disease cases in developed countries. Unfortunately, conventional renin-angiotensin-aldosterone system (RAAS) inhibitor medications only partially protect against the development and progression of diabetic nephropathy. Moreover, RAAS inhibitors have failed as primary prevention therapy in type 1 diabetes. Thus, agents targeting alternative pathogenic mechanisms leading to diabetic nephropathy have been intensively investigated, which is the topic of this review. RECENT FINDINGS Promising emerging agents have targeted neurohormonal activation (alternative components of the RAAS and neprilysin inhibition), tubuloglomerular feedback mechanisms (sodium glucose cotransporter 2 inhibition and incretin-based therapy) and renal inflammation/fibrosis. SUMMARY Evidence demonstrating the potential of these agents to protect and prevent progression of diabetic nephropathy is summarized in this review. There are dedicated clinical trials ongoing with these therapies, which have the potential to change the clinical practice.
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Affiliation(s)
- Yuliya Lytvyn
- aDivision of Nephrology, Department of Medicine, University Health Network bDepartment of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada cDepartment of Pediatric Endocrinology, University of Colorado School of Medicine dBarbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA *Drs Lytvyn, Bjornstad and Pun are the co-first authors of the article
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Mellendijk L, Wiesmann M, Kiliaan AJ. Impact of Nutrition on Cerebral Circulation and Cognition in the Metabolic Syndrome. Nutrients 2015; 7:9416-39. [PMID: 26580647 PMCID: PMC4663605 DOI: 10.3390/nu7115477] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 10/12/2015] [Accepted: 11/03/2015] [Indexed: 12/12/2022] Open
Abstract
The increasing prevalence of Metabolic Syndrome (MetS), defined as the clustering of abdominal obesity, dyslipidemia, hypertension, and hyperglycemia, appears to be driving the global epidemics cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Nutrition has a major impact on MetS and plays an important role in the prevention, development, and treatment of its features. Structural and functional alterations in the vasculature, associated with MetS, might form the link between MetS and the increased risk of developing CVD and T2DM. Not only does the peripheral vasculature seem to be affected, but the syndrome has a profound impact on the cerebral circulation and thence brain structure as well. Furthermore, strong associations are shown with stroke, cognitive impairment, and dementia. In this review the impact of nutrition on the individual components of MetS, the effects of MetS on peripheral and cerebral vasculature, and its consequences for brain structure and function will be discussed.
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Affiliation(s)
- Laura Mellendijk
- Department of Anatomy, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen 6500 HB, The Netherlands.
| | - Maximilian Wiesmann
- Department of Anatomy & Geriatric Medicine, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen 6500 HB, The Netherlands.
| | - Amanda J Kiliaan
- Department of Anatomy, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen 6500 HB, The Netherlands.
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Metabolic syndrome, atrial fibrillation, and stroke: Tackling an emerging epidemic. Heart Rhythm 2015; 12:2332-43. [DOI: 10.1016/j.hrthm.2015.06.038] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Indexed: 12/11/2022]
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Arpaci D, Saglam F, Ozdemir D, Ersoy R, Cakir B. Does glycemic regulation affect hypercoagulable states in diabetic patients? Int J Diabetes Dev Ctries 2015. [DOI: 10.1007/s13410-015-0311-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Intravenous Thrombolysis with Recombinant Tissue-type Plasminogen Activator for Acute Ischemic Stroke in Patients with Metabolic Syndrome. J Stroke Cerebrovasc Dis 2015; 24:1787-92. [DOI: 10.1016/j.jstrokecerebrovasdis.2015.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Revised: 03/30/2015] [Accepted: 04/01/2015] [Indexed: 11/21/2022] Open
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