1
|
Scott DA, Ponir C, Shapiro MD, Chevli PA. Associations between insulin resistance indices and subclinical atherosclerosis: A contemporary review. Am J Prev Cardiol 2024; 18:100676. [PMID: 38828124 PMCID: PMC11143894 DOI: 10.1016/j.ajpc.2024.100676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 06/05/2024] Open
Abstract
Even in the absence of hyperglycemia or hyperlipidemia, it has been demonstrated that insulin resistance is an independent risk factor for atherosclerosis. Finding markers of insulin resistance that are associated with markers of atherosclerosis could help identify patients early in their disease course and allow for earlier initiation of preventative treatments. We reviewed available evidence regarding associations between known markers of insulin resistance and known markers of atherosclerosis. Serum triglycerides (TG), triglyceride-glucose index (TyG), and homeostasis model assessment (HOMA) were the insulin resistance markers reviewed. The coronary artery calcium score (CAC), carotid intimal medium thickness (cIMT), and pulse wave velocity (PWV) were reviewed as markers of atherosclerosis. TyG showed the most consistent association with CAC across broad demographic groups, though HOMA showed potential in obese individuals and those without diabetes. The data regarding cIMT and the reviewed insulin resistance markers did not yield any consistent associations, though very elevated TyG did appear to be associated with cIMT among normal weight individuals. Serum triglycerides showed a strong and consistent association with PWV across numerous studies and populations, though TyG index also demonstrated a strong association with PWV in a large systematic review. Of the insulin resistance markers reviewed, the TyG index appears to be most consistently associated with markers of atherosclerosis. TyG can be easily calculated with routine labwork and has the potential to inform decisions regarding early initiation of therapies in patients who would otherwise not be treated. Targeting insulin sensitivity prior to the development of T2DM has the potential to reduce development and progression of atherosclerosis, and patients without T2DM but who have elevated TyG index should be the topic of further research.
Collapse
Affiliation(s)
- Drake A. Scott
- Department of Internal Medicine, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA
| | - Cynthia Ponir
- Department of Internal Medicine, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA
| | - Michael D. Shapiro
- Department of Internal Medicine, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA
| | - Parag A. Chevli
- Department of Internal Medicine, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA
| |
Collapse
|
2
|
Lin J, Dong L, Huang Q, Xiao H, Li S, Tang J, Mao X, Huang P, Li X, Hong D. TG/HDL-c ratio as a predictor of progressive infarction in patients with anterior circulation single subcortical infarction. Brain Behav 2024; 14:e3453. [PMID: 38409927 PMCID: PMC10897359 DOI: 10.1002/brb3.3453] [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: 08/04/2023] [Revised: 11/24/2023] [Accepted: 02/06/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND The contributors predicting progressive infarction (PI) in patients with anterior circulation single subcortical infarction (ACSSI) and pontine single infarction (PSI) may be unidentical. The role of triglyceride to high-density lipoprotein cholesterol (TG/HDL-c) ratio on PI is unclear. The purpose of our study is to evaluate the correlation between TG/HDL-c ratio and PI in patients with ACSSI or PSI. METHODS Between January 2020 and October 2022, we retrospectively enrolled 738 patients including 638 ACSSI patients and 100 PSI patients to analyze. Demographic characteristics, clinical information, and laboratory data were collected within 24 h of admission. RESULTS PI occurred in 143 (19.4%) patients. In univariate analysis, patients with PI had higher initial National Institutes of Health Stroke Scale (NIHSS) scores, higher discharge NIHSS scores, higher levels of fasting glucose, total cholesterol, TG, low-density lipoprotein cholesterol, and TG/HDL-c ratio, but lower levels of creatinine compared to patients with non-PI (p < .05). Furthermore, the results of the subgroup analyses revealed the independent association between TG/HDL-c ratio and PI in ACSSI patients (OR 1.079, 95% CI 1.009-1.153, p = .026) rather than in PSI patients. Additionally, a receiver operating characteristic curve indicated that the optimal predictive cutoff value of the TG/HDL-c ratio was 3.985, and a TG/HDL-c ratio ≥3.985 was more likely to experience PI in ACSSI patients. CONCLUSION In conclusion, the TG/HDL-c ratio was independently associated with PI in patients with ACSSI.
Collapse
Affiliation(s)
- Jing Lin
- Department of NeurologyThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Liangbin Dong
- Department of NeurologyGaoxin Branch of The First Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Qin Huang
- Department of NeurologyThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Hui Xiao
- Department of NeurologyThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Shumeng Li
- Department of NeurologyThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Jincai Tang
- Department of NeurologyThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Xiaocheng Mao
- Department of NeurologyThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Pengcheng Huang
- Department of NeurologyThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Xiaobing Li
- Department of NeurologyThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Daojun Hong
- Department of NeurologyThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| |
Collapse
|
3
|
Iglesies-Grau J, Garcia-Alvarez A, Oliva B, Mendieta G, García-Lunar I, Fuster JJ, Devesa A, Pérez-Herreras C, Fernández-Ortiz A, Brugada R, Ibanez B, Fernandez-Jimenez R, Fuster V. Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis. Cardiovasc Diabetol 2023; 22:350. [PMID: 38115031 PMCID: PMC10731750 DOI: 10.1186/s12933-023-02090-1] [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: 10/27/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Elevated glycated hemoglobin (HbA1c) is associated with a higher burden of subclinical atherosclerosis (SA). However, the association with SA of earlier insulin resistance markers is poorly understood. The study assessed the association between the homeostatic model assessment of insulin resistance index (HOMA-IR) and SA in addition to the effect of cardiovascular risk factors (CVRFs) in individuals with normal HbA1c. METHODS A cohort of 3,741 middle-aged individuals from the Progression of Early Subclinical Atherosclerosis (PESA) study with basal HbA1c < 6.0% (< 42 mmol/mol) and no known CV disease underwent extensive imaging (multiterritorial vascular ultrasound and coronary artery calcium score, CACS) to assess the presence, burden, and extent of SA. RESULTS Individuals with higher HOMA-IR values had higher rates of CVRFs. HOMA-IR showed a direct association with the multiterritorial extent of SA and CACS (p < 0.001) and with global plaque volume measured by 3-dimensional vascular ultrasound (p < 0.001). After adjusting for key CVRFs and HbA1c, HOMA-IR values ≥ 3 were associated with both the multiterritorial extent of SA (odds ratio 1.41; 95%CI: 1.01 to 1.95, p = 0.041) and CACS > 0 (odds ratio 1.74; 95%CI: 1.20 to 2.54, p = 0.004), as compared with the HOMA-IR < 2 (the reference HOMA-IR category). In a stratified analysis, this association remained significant in individuals with a low-to-moderate SCORE2 risk estimate (75.6% of the cohort) but not in high-risk individuals. CONCLUSIONS The use of HOMA-IR identified low-risk individuals with a higher burden of SA, after adjusting for the effects of key traditional CVRFs and HbA1c. HOMA-IR is a simple measure that could facilitate earlier implementation of primary CV prevention strategies in clinical practice.
Collapse
Affiliation(s)
- Josep Iglesies-Grau
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Canada
- Universitat de Girona, Girona, Spain
| | - Ana Garcia-Alvarez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Calle Melchor Fernández Almagro, 3, Madrid, 28029, Spain
- Cardiology Departement, Institut Clinic Cardiovascular, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Belén Oliva
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Calle Melchor Fernández Almagro, 3, Madrid, 28029, Spain
| | - Guiomar Mendieta
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Calle Melchor Fernández Almagro, 3, Madrid, 28029, Spain
- Cardiology Departement, Institut Clinic Cardiovascular, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Inés García-Lunar
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Calle Melchor Fernández Almagro, 3, Madrid, 28029, Spain
- CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Cardiology Department, University Hospital La Moraleja, Madrid, Spain
| | - José J Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Calle Melchor Fernández Almagro, 3, Madrid, 28029, Spain
- CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Ana Devesa
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Calle Melchor Fernández Almagro, 3, Madrid, 28029, Spain
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai (ISMMS), New York, NY, USA
| | | | - Antonio Fernández-Ortiz
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Calle Melchor Fernández Almagro, 3, Madrid, 28029, Spain
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Ramon Brugada
- Universitat de Girona, Girona, Spain
- CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Department of Cardiology, Hospital Universitari Dr. Josep Trueta, Girona, Spain
- Institut d'Investigació Biomèdica de Girona (IDIBGI), Girona, Spain
| | - Borja Ibanez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Calle Melchor Fernández Almagro, 3, Madrid, 28029, Spain
- CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Rodrigo Fernandez-Jimenez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Calle Melchor Fernández Almagro, 3, Madrid, 28029, Spain.
- CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
- Hospital Universitario Clínico San Carlos, Madrid, Spain.
| | - Valentin Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Calle Melchor Fernández Almagro, 3, Madrid, 28029, Spain.
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai (ISMMS), New York, NY, USA.
| |
Collapse
|
4
|
You S, Gao JW, Zhang HF, Xiong ZC, Hao QY, Han JJ, Wang JF, Zhang SL, Liu PM. Predictors of long-term absence of coronary artery calcium in individuals with high blood pressure: results from the MESA study. Ann Med 2023; 55:2209334. [PMID: 37155413 PMCID: PMC10167869 DOI: 10.1080/07853890.2023.2209334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND & AIMS Individuals with high blood pressure (BP) have varying risks of cardiovascular events due to other coexisting factors. We aimed to identify the predictors of long-term absence of coronary artery calcium (CAC) in individuals with high BP, which is an indicator of healthy arterial aging and can guide preventive strategies. METHODS We analyzed data from participants with high BP (≥120/80 mm Hg) in the Multi-Ethnic Study of Atherosclerosis who had baseline CAC = 0 and underwent a second CAC scanning after 10 years. We used multivariable logistic regression to evaluate the association between various risk factors for atherosclerotic cardiovascular disease (ASCVD) and long-term CAC = 0. We also calculated the area under the receiver operating characteristic curve (AUC) to predict the phenotype of healthy arterial aging in this population. RESULTS We included 830 participants (37.6% male, mean ± SD age of 59.4 ± 8.7 years). During follow-up, 46.5% of participants (n = 386) had CAC = 0, and they were younger and had fewer metabolic syndrome components. Adding ASCVD risk factors to the demographic model (age, sex, and ethnicity) moderately increased the predictive value for long-term CAC = 0 (AUC: demographic model + ASCVD risk factors vs. demographic model alone, 0.653 vs. 0.597, p < .001; category net reclassification improvement = 0.104, p = .044; integrated discrimination improvement = 0.040, p < .001). CONCLUSION In individuals with high BP and initial CAC = 0, over 40% maintained CAC = 0 during a 10-year follow-up, which was associated with fewer ASCVD risk factors. These findings may have implications for preventive strategies in individuals with high BP.Clinical Trial registration number: The MESA was registered at clinical trials. gov as NCT00005487.KEY MESSAGESNearly half (46.5%) of individuals with high blood pressure (BP) maintained a long-term absence of coronary artery calcium (CAC) during a 10-year follow-up, and this was associated with a 66.6% lower risk of atherosclerotic cardiovascular disease (ASCVD) events compared to those who developed incident CAC.Individuals with high BP, who are usually assumed to have an increased risk of ASCVD, exhibit significant heterogeneity in their ASCVD risk; those who maintain CAC = 0 have a lower ASCVD risk.Adding overall ASCVD risk factors to demographic information resulted in a moderate improvement in predicting long-term CAC = 0.
Collapse
Affiliation(s)
- Si You
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jing-Wei Gao
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hai-Feng Zhang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhuo-Chao Xiong
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qing-Yun Hao
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jia-Jin Han
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jing-Feng Wang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shao-Ling Zhang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Pin-Ming Liu
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
5
|
Ding H, Zhu J, Tian Y, Xu L, Song L, Shi Y, Mu D, Chen R, Liu H, Liu B. Relationship between the triglyceride-glucose index and coronary artery calcification in asymptomatic, non-diabetic patients undergoing maintenance hemodialysis. Ren Fail 2023; 45:2200849. [PMID: 37133817 PMCID: PMC10158539 DOI: 10.1080/0886022x.2023.2200849] [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: 05/04/2023] Open
Abstract
OBJECTIVE Coronary artery calcification (CAC) is positively and independently associated with cardiovascular disease (CVD) in patients undergoing maintenance hemodialysis (MHD). Insulin resistance is independently associated with CAC and is an important risk factor for CVD. The triglyceride-glucose (TyG) index is a reliable biomarker of insulin resistance. This cross-sectional, observational study aimed to investigate the relationship between the TyG index and CAC in asymptomatic non-diabetic patients undergoing MHD. METHODS The quantitative coronary artery calcification score (CACS) was calculated and expressed using the Agatston score. The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Multiple Poisson regression analysis, Spearman correlation analysis, and receiver operating characteristic (ROC) curves were used to investigate the relationship between the TyG index and CAC. RESULTS The 151 patients were divided into three groups according to the tertiles of the TyG index. With an increase in the TyG index, the CACS significantly increased (Spearman's rho = 0.414, p < 0.001). Poisson regression analysis indicated that the TyG index was independently related to the presence of CAC (prevalence ratio, 1.281 [95% confidence interval, 1.121-1.465], p < 0.001). Furthermore, ROC curve analysis showed that the TyG index was of value in predicting the CAC in asymptomatic non-diabetic patients undergoing MHD, with an area under the curve of 0.667 (p = 0.010). CONCLUSION The TyG index is independently related to the presence of CAC in asymptomatic, non-diabetic patients undergoing MHD.
Collapse
Affiliation(s)
- Hong Ding
- Institute of Nephrology, People's Hospital of Yangzhong city, Zhenjiang, Jiangsu Province, China
| | - Jinhua Zhu
- Institute of Nephrology, People's Hospital of Yangzhong city, Zhenjiang, Jiangsu Province, China
| | - Ying Tian
- Institute of Nephrology, People's Hospital of Yangzhong city, Zhenjiang, Jiangsu Province, China
| | - Li Xu
- Institute of Nephrology, People's Hospital of Yangzhong city, Zhenjiang, Jiangsu Province, China
| | - Lei Song
- Institute of Nephrology, People's Hospital of Yangzhong city, Zhenjiang, Jiangsu Province, China
| | - Ying Shi
- Institute of Nephrology, People's Hospital of Yangzhong city, Zhenjiang, Jiangsu Province, China
| | - Dongxing Mu
- Institute of Nephrology, People's Hospital of Yangzhong city, Zhenjiang, Jiangsu Province, China
| | - Ruoxin Chen
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu Province, China
| | - Hong Liu
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu Province, China
| | - Bicheng Liu
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu Province, China
| |
Collapse
|
6
|
Li L, Zhong H, Shao Y, Hua Y, Zhou X, Luo D. Association between the homeostasis model assessment of insulin resistance and coronary artery calcification: a meta-analysis of observational studies. Front Endocrinol (Lausanne) 2023; 14:1271857. [PMID: 38089605 PMCID: PMC10711676 DOI: 10.3389/fendo.2023.1271857] [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: 08/03/2023] [Accepted: 11/06/2023] [Indexed: 12/18/2023] Open
Abstract
Background Insulin resistance (IR), a risk factor for cardiovascular diseases, has garnered significant attention in scientific research. Several studies have investigated the correlation between IR and coronary artery calcification (CAC), yielding varying results. In light of this, we conducted a systematic review to investigate the association between IR as evaluated by the homeostasis model assessment (HOMA-IR) and CAC. Methods A comprehensive search was conducted to identify relevant studies in PubMed, Embase, Scopus, and Web of Science databases. In addition, preprint servers such as Research Square, BioRxiv, and MedRxiv were manually searched. The collected data were analyzed using either fixed or random effects models, depending on the heterogeneity observed among the studies. The assessment of the body of evidence was performed using the GRADE approach to determine its quality. Results The current research incorporated 15 studies with 60,649 subjects. The analysis revealed that a higher category of HOMA-IR was associated with a greater prevalence of CAC in comparison to the lowest HOMA-IR category, with an OR of 1.13 (95% CI: 1.06-1.20, I2 = 29%, P < 0.001). A similar result was reached when HOMA-IR was analyzed as a continuous variable (OR: 1.27, 95% CI: 1.14-1.41, I2 = 54%, P < 0.001). In terms of CAC progression, a pooled analysis of two cohort studies disclosed a significant association between increased HOMA-IR levels and CAC progression, with an OR of 1.44 (95% CI: 1.04-2.01, I2 = 21%, P < 0.05). It is important to note that the strength of the evidence was rated as low for the prevalence of CAC and very low for the progression of CAC. Conclusion There is evidence to suggest that a relatively high HOMA-IR may be linked with an increased prevalence and progression of CAC.
Collapse
Affiliation(s)
- Longti Li
- Department of Nursing, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Huiqin Zhong
- Innovation Centre of Nursing Research, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Ya Shao
- Health Management Center, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Yu Hua
- Health Management Center, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Xu Zhou
- Health Management Center, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Desheng Luo
- Department of Nursing, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| |
Collapse
|
7
|
Yin D, Wang M, Liu X, Pan W, Ren Y, Liu J. Association of triglyceride glucose index levels with calcification patterns and vulnerability of plaques: an intravascular ultrasound study. Int J Cardiovasc Imaging 2023; 39:2285-2294. [PMID: 37773243 PMCID: PMC10673979 DOI: 10.1007/s10554-023-02932-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 08/08/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE High triglyceride glucose (TyG) index level is one of the risks for cardiovascular events. The purpose of this research was to examine the correlation of the triglyceride glucose (TyG) index levels with plaque characteristics and calcification types determined by intravascular ultrasound (IVUS) in acute coronary syndrome (ACS) patients. METHODS A total of 234 acute coronary syndromes (ACS) participants who completed intravascular ultrasound (IVUS) and coronary angiography (CAG) were finally enrolled. RESULTS Logistic regression analysis manifested that the TyG index was independently correlated with the occurrence of coronary calcification, minimum lumen area (MLA) ≤ 4.0 mm², plaque burden (PB) > 70%, and spotty calcification. Taking the lowest group as a reference, the risk of coronary calcification (OR, 2.57; 95%CI, 1.04-6.35; p = 0.040), MLA ≤ 4.0 mm² (OR, 7.32; 95%CI, 2.67-20.01; p < 0.001), PB > 70% (OR, 2.68; 95%CI, 1.04-6.91; p = 0.041), and spotty calcification (OR, 1.48; 95%CI, 0.59-3.71; p = 0.407) was higher in the highest TyG index group. TyG index was converted into a dichotomous variable or a continuous variable for analysis, and we found that a similar result was observed. In addition, optimal predictive models consisting of clinical variables and the TyG index distinctly improved the ability to predict the prevalence of coronary calcification and MLA ≤ 4.0 mm² (p < 0.05). CONCLUSION The TyG index may serve as a potential predictor for calcification patterns and plaque vulnerability.
Collapse
Affiliation(s)
- Da Yin
- Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Zhongshan District, Dalian, Liaoning Province, China.
| | - Minxian Wang
- Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Zhongshan District, Dalian, Liaoning Province, China
| | - Xuesong Liu
- Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Zhongshan District, Dalian, Liaoning Province, China
| | - Weili Pan
- Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Zhongshan District, Dalian, Liaoning Province, China
| | - Yongkui Ren
- Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Zhongshan District, Dalian, Liaoning Province, China
| | - Jinqiu Liu
- Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Zhongshan District, Dalian, Liaoning Province, China.
| |
Collapse
|
8
|
Hisamatsu T, Kinuta M. Coronary Artery Calcium in Assessment of Atherosclerotic Cardiovascular Disease Risk and its Role in Primary Prevention. J Atheroscler Thromb 2023; 30:1289-1302. [PMID: 37394660 PMCID: PMC10564647 DOI: 10.5551/jat.rv22009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 05/26/2023] [Indexed: 07/04/2023] Open
Abstract
Coronary artery calcium (CAC), which is detected using computed tomography scanning, is a well-established indicator of subclinical atherosclerosis. The CAC score is independently associated with atherosclerotic cardiovascular disease (ASCVD) outcomes and provides improved predictive values for estimating the risk of ASCVD beyond traditional risk factors. Thus, CAC is considered to have important implications for reclassification as a decision aid among individuals in the preclinical phase and as the primary prevention of ASCVD. This review is focused on epidemiological evidence on CAC in asymptomatic population-based samples from Western countries and Japan. We also discuss the usability of CAC as a tool for assessing ASCVD risk and its role in the primary prevention of ASCVD. A lack of evidence for the CAC score in ASCVD risk assessment beyond traditional risk factors in populations other than those in Western countries (including Japan) warrants further investigation. Clinical trials are also necessary to demonstrate the usefulness and safety of CAC screening in the primary prevention of ASCVD.
Collapse
Affiliation(s)
- Takashi Hisamatsu
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,
Okayama, Japan
- NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Minako Kinuta
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,
Okayama, Japan
| |
Collapse
|
9
|
Qian T, Sheng X, Shen P, Fang Y, Deng Y, Zou G. Mets-IR as a predictor of cardiovascular events in the middle-aged and elderly population and mediator role of blood lipids. Front Endocrinol (Lausanne) 2023; 14:1224967. [PMID: 37534205 PMCID: PMC10393118 DOI: 10.3389/fendo.2023.1224967] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/22/2023] [Indexed: 08/04/2023] Open
Abstract
Background Cardiovascular disease (CVD) is a global health concern, with a significant impact on morbidity and mortality rates. Using fasting glucose, fasting triglycerides, body mass index (BMI), and high-density lipoprotein cholesterol (HDL-C), the metabolic score of insulin resistance (Mets-IR), a novel index created by Mexican researchers to assess insulin sensitivity, is a more precise way to measure insulin sensitivity. This study aimes to explore the association between Mets-IR and CVD, as well as investigate the potential mediating role of of low-density lipoprotein cholesterol (LDL-C). Methods The study's data came from the 2011 and 2018 China Health and Retirement Longitudinal Studies (CHARLS). We used three logistic regression models to account for the potential effects of ten factors on cardiovascular disease/stroke/heart disease. Moreover, We performed mediation analyses to evaluate the role of LDL-C in the association between Mets-IR and incident CVD. Results This study comprised 4,540 participants, of whom 494 (10.88%) were found to develop disease (CVD). Each interquartile range (IQR) increased in Mets-IR raised the risk of developing CVD by 38% (OR=1.38; 95% CI, 1.21-1.56) and there was a linear dose-response relationship between Mets-IR and the risk of new-onset cardiovascular disease, stroke, and heart disease (P overall<0.05, P non-linear>0.05). Approximately 5% (indirect effect/total effect) of the significant association of Mets-IR with stroke was mediated by LDL-C, respectively. With the addition of Mets-IR to the base model, the continuous net reclassification improvement and integrated discrimination improvement for predicting cardiovascular disease increased by 0.175 (P <0.001) and 0.006 (P <0.001), respectively. Conclusion ets-IR is associated with an increased risk of cardiovascular disease/stroke/cardiac issues, with LDL-C mediating these relationships. Improving insulin sensitivity and lipid regulation may be essential and effective preventive measures for cardiovascular events.
Collapse
Affiliation(s)
- Taoming Qian
- Graduate School, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Xiaomeng Sheng
- Graduate School, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Pengyu Shen
- Department of Oncology, Second Ward, The First People’s Hospital of Bei’an City, Harbin, Heilongjiang, China
| | - Yuting Fang
- Graduate School, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Yao Deng
- Graduate School, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Guoliang Zou
- Cardiovascular Disease Branch One, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| |
Collapse
|
10
|
Brown RB. Salt-Sensitive Hypertension: Mediation by Salt-Induced Hypervolemia and Phosphate-Induced Vascular Calcification. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2023; 17:11795468231158206. [PMID: 37434790 PMCID: PMC10331233 DOI: 10.1177/11795468231158206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/01/2023] [Indexed: 07/13/2023]
Abstract
Preventing hypertension by restricting dietary salt intake, sodium chloride, is well established in public health policy, but a pathophysiological mechanism has yet to explain the controversial clinical finding that some individuals have a greater risk of hypertension from exposure to salt intake, termed salt-sensitive hypertension. The present perspective paper synthesizes interdisciplinary findings from the research literature and offers novel insights proposing that the pathogenesis of salt-sensitive hypertension is mediated by interaction of salt-induced hypervolemia and phosphate-induced vascular calcification. Arterial stiffness and blood pressure increase as calcification in the vascular media layer reduces arterial elasticity, preventing arteries from expanding to accommodate extracellular fluid overload in hypervolemia related to salt intake. Furthermore, phosphate has been found to be a direct inducer of vascular calcification. Reduction of dietary phosphate may help reduce salt-sensitive hypertension by lowering the prevalence and progression of vascular calcification. Further research should investigate the correlation of vascular calcification with salt-sensitive hypertension, and public health recommendations to prevent hypertension should encourage reductions of both sodium-induced hypervolemia and phosphate-induced vascular calcification.
Collapse
Affiliation(s)
- Ronald B Brown
- Ronald B Brown, School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada.
| |
Collapse
|
11
|
The Correlation between the Vascular Calcification Score of the Coronary Artery and the Abdominal Aorta in Patients with Psoriasis. Diagnostics (Basel) 2023; 13:diagnostics13020274. [PMID: 36673084 PMCID: PMC9858225 DOI: 10.3390/diagnostics13020274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/22/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
Psoriasis is known as an independent risk factor for cardiovascular disease due to its chronic inflammation. Studies have been conducted to evaluate the progress of atherosclerotic plaques in psoriasis. However, inadequate efforts have been made to clarify the relationship between atherosclerosis progress in coronary arteries and other important blood vessels. For that reason, we investigated the correlation and development of the coronary artery calcification score (CACS) and the abdominal aortic calcification score (AACS) during a follow-up examination. Eighty-three patients with psoriasis underwent coronary computed tomography angiography (CCTA) for total CACS and abdominal computed tomography (AbCT) for total AACS. PASI score, other clinical features, and blood samples were collected at the same time. The patients' medical histories were also retrieved for further analysis. Linear regression was used to analyze the CACS and AACS associations. There was a moderate correlation between CACS and AACS, while both calcification scores relatively reflected the coronary plaque number, coronary stenosis number, and stenosis severity observed with CCTA. Both calcification scores were independent of the PASI score. However, a significantly higher CACS was found in psoriatic arthritis, whereas no similar phenomenon was recorded for AACS. To conclude, both CACS and AACS might be potential alternative tests to predict the presence of coronary lesions as confirmed by CCTA.
Collapse
|
12
|
Maternal high-fat diet promotes calcified atherosclerotic plaque formation in adult offspring by enhancing transformation of VSMCs to osteochondrocytic-like phenotype. Heliyon 2022; 8:e10644. [PMID: 36158105 PMCID: PMC9489965 DOI: 10.1016/j.heliyon.2022.e10644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/17/2022] [Accepted: 09/08/2022] [Indexed: 11/22/2022] Open
Abstract
Aim Maternal high-fat diet (HFD) is associated with the development of cardiovascular disease (CVD) in adult offspring. Atherosclerotic vascular calcification is well documented in patients with CVD. We examined the effect of maternal HFD on calcified plaque formation. Methods and results Seven-week-old female apo-E−/− mice (C57BL6/J) were nourished either an HFD or a normal diet (ND) a week before mating, and during gestation and lactation. Offspring of both the groups were fed a high-cholesterol diet (HCD) from 8 weeks of age. Osteogenic activity of the thoracic aorta, assessed using an ex vivo imaging system, was significantly increased after 3 months of HCD in male offspring of HFD-fed dams (O-HFD) as compared with those of ND-fed dams (O-ND). Alizarin-red-positive area in the aortic root was significantly increased after 6 months of HCD in male O-HFD as compared to that of O-ND. Plaque size and Oil Red O-positive staining were comparable between the two groups. Primary cultured vascular smooth muscle cells (VSMCs) of the thoracic aorta were treated with phosphate and interleukinL-1β (IL-1β) to transform them into an osteochondrocytic-like phenotype. Intracellular calcium content and alkaline phosphatase activity were markedly higher in the VSMCs of O-HFD than in O-ND. IL-1β concentration in the supernatant of bone marrow-derived macrophages was markedly higher in O-HFD than in O-ND. Conclusion Our findings indicate that maternal HFD accelerates the expansion of atherogenic calcification independent of plaque progression. In vitro phosphate- and IL-1β-induced osteochondrocytic transformation of VSMCs was augmented in O-HFD. Inhibition of VSMCs, skewing toward osteochondrocytic-like cells, might be a potential therapeutic strategy for preventing maternal HFD-associated CVD development.
Collapse
|
13
|
Liu Y, Chang L, Wu M, Xu B, Kang L. Triglyceride Glucose Index Was Associated With the Risk of Peripheral Artery Disease. Angiology 2022; 73:655-659. [PMID: 35077252 DOI: 10.1177/00033197211070644] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This study aims to investigate the relationship between the triglyceride glucose (TyG) index and peripheral artery disease (PAD). A total of 3125 participants with completed TyG and ankle brachial pressure index (ABPI) records were enrolled from the National Health and Nutrition Examination Survey (NHANES) cycle of 1999-2004. The TyG index was calculated as ln [triglycerides (mg/dL) × glucose (mg/dL)/2], and the presence of PAD was defined as ABPI ≤.9. The participants were 59.9 ± 12.9 years old and 51.5% (1608) were male. The prevalence of PAD was 7.2% (225). Compared with the reference lowest quartile of TyG index, the highest quartile was associated with 1.27-fold increased (odds ratio [OR] 2.27, 95% confidence interval [CI] 1.53-3.41; P < .001) risk of PAD. After adjusting for sociodemographic, lifestyles, and cardiometabolic factors, the multivariate-adjusted OR and 95% CI were 1.74 (1.02-3.01; P = .044) in participants within the highest quartile. Subgroup analysis showed that the association between TyG index and the risk of PAD was still consistent across subgroups. In conclusion, higher TyG index was significantly associated with the higher risk of PAD, which could be a marker of PAD.
Collapse
Affiliation(s)
- Yihai Liu
- Department of Cardiology, Nanjing Drum Tower Hospital, 12461Clinical School of Nanjing Medical University, Nanjing, China
- Department of Cardiology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Lei Chang
- Department of Cardiology, Nanjing Drum Tower Hospital, 12461Clinical School of Nanjing Medical University, Nanjing, China
| | - Mingyue Wu
- Department of Cardiology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Biao Xu
- Department of Cardiology, Nanjing Drum Tower Hospital, 12461Clinical School of Nanjing Medical University, Nanjing, China
- Department of Cardiology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- State Key Laboratory of Pharmaceutical Biotechnology
| | - Lina Kang
- Department of Cardiology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| |
Collapse
|
14
|
Relation of Progression of Coronary Artery Calcium to Dementia (from the Multi-Ethnic Study of Atherosclerosis). Am J Cardiol 2022; 171:69-74. [PMID: 35287946 DOI: 10.1016/j.amjcard.2022.01.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/23/2022] [Accepted: 01/26/2022] [Indexed: 11/24/2022]
Abstract
Baseline coronary artery calcification has been shown to be associated with dementia. However, the value of coronary artery calcium (CAC) progression in the prediction of dementia remains unclear. In this study, we examined the association between CAC progression and dementia in the Multi-Ethnic Study of Atherosclerosis. The Multi-Ethnic Study of Atherosclerosis is a prospective study consisting of 6,814 participants 45 to 84 years of age, free of overt cardiovascular disease at baseline. A total of 5,570 subjects had baseline and follow-up CAC scans approximately 2.5 years apart and were included this analysis. A total of 4,173 of these participants completed cognitive testing with the Cognitive Abilities Screening Instrument (CASI) approximately 10 years after the baseline CAC scan. Dementia diagnoses were identified using International Classification of Diseases codes from hospitalizations, death certificates, and medications used to treat dementia. The absolute change between baseline and follow-up CAC was used to assess CAC progression. Cox proportional hazards and multivariable linear regression models were used to examine the association of CAC progression with incident dementia and with CASI score. Over a median follow-up of 13.2 (interquartile range: 11.2 to 15.3) years, 350 participants developed incident dementia. CAC progression showed no association with dementia risk after adjustment for age, gender, race/ethnicity, vascular risk factors, and baseline CAC score. There was no association of CAC progression with CASI score in any adjusted model. In conclusion, progression of CAC over approximately 2.5 years was not associated with increased risk of dementia after adjustment for demographic variables, vascular risk factors, and baseline CAC.
Collapse
|
15
|
Wang A, Li Y, Zhou L, Liu K, Li S, Song B, Gao Y, Li Y, Lu J, Tian C, Xu Y, Wang L. Triglyceride-Glucose Index Is Related to Carotid Plaque and Its Stability in Nondiabetic Adults: A Cross-Sectional Study. Front Neurol 2022; 13:823611. [PMID: 35401402 PMCID: PMC8987979 DOI: 10.3389/fneur.2022.823611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/04/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundCarotid plaque plays an important role in the development of stroke. The triglyceride-glucose (TyG) index is a reliable alternative marker of insulin resistance. However, there are limited data regarding the relationship between TyG index and carotid plaque and its stability in nondiabetic adults.MethodsThis study was carried out on 24,895 urban workers (10,978 men and 13,917 women) aged 20 years or older who participated in a comprehensive health screening between January 2016 and December 2017 at the First Affiliated Hospital of Zhengzhou University, China. Carotid plaque was assessed using ultrasonography. TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL) /2]. Logistic regression models and restricted cubic spline (RCS) models were used to estimate the association of the TyG index with carotid plaque and its stability by odds ratios (ORs) and 95% confidence intervals (CIs).ResultsCarotid plaque was detected in 5,668 (22.8%) respondents, with stable and unstable plaque accounting for 2,511 (10.1%) and 3,158 (12.7%), respectively. There was a significant positive association between the prevalence of carotid plaque and TyG index quartile levels, and the same associations were observed for the prevalence of stable and unstable carotid plaque (P for trend <0.0001). The multivariable-adjusted ORs (95% CIs) for the highest vs. lowest quartile of TyG index were 1.30 (1.15–1.47) for carotid plaque, 1.38 (1.17–1.63) for stable carotid plaque, and 1.24 (1.07–1.43) for unstable carotid plaque. The RCS analysis showed a linear association between TyG index and carotid plaque, and linear associations were also observed between TyG index and both stable carotid plaque and unstable carotid plaque (P for linearity<0.05).ConclusionOur findings suggested that the TyG index was significantly associated with carotid plaque and might be a useful indicator for the early identification of carotid plaque in nondiabetic subjects.
Collapse
Affiliation(s)
- Anran Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yapeng Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lue Zhou
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kai Liu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shaohua Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bo Song
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuan Gao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yusheng Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jie Lu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | | | - Yuming Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Yuming Xu
| | - Longde Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- The General Office of Stroke Prevention Project Committee, National Health Commission of the People's Republic of China, Beijing, China
- Longde Wang
| |
Collapse
|
16
|
Yun JS, Ko SH. Current trends in epidemiology of cardiovascular disease and cardiovascular risk management in type 2 diabetes. Metabolism 2021; 123:154838. [PMID: 34333002 DOI: 10.1016/j.metabol.2021.154838] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/07/2021] [Accepted: 07/07/2021] [Indexed: 02/06/2023]
Abstract
With the advances in diabetes care, the trend of incident cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM) has been decreasing over past decades. However, given that CVD is still a major cause of death in patients with diabetes and that the risk of CVD in patients with T2DM is more than twice that in those without DM, there are still considerable challenges to the prevention of CVD in diabetes. Accordingly, there have been several research efforts to decrease cardiovascular (CV) risk in T2DM. Large-scale genome-wide association studies (GWAS) and clinical cohort studies have investigated the effects of factors, such as genetic determinants, hypoglycaemia, and insulin resistance, on CVD and can account for the unexplained CV risk in T2DM. Lifestyle modification is a widely accepted cornerstone method to prevent CVD as the first-line strategy in T2DM. Recent reports from large CV outcome trials have proven the positive CV effects of sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1RAs) in patients with high CVD risk. Overall, current practice guidelines for the management of CVD in T2DM are moving from a glucocentric strategy to a more individualised patient-centred approach. This review will discuss the current epidemiologic trends of CVD in T2DM and the risk factors linking T2DM to CVD, including genetic contribution, hypoglycaemia, and insulin resistance, and proper care strategies, including lifestyle and therapeutic approaches.
Collapse
Affiliation(s)
- Jae-Seung Yun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
| |
Collapse
|
17
|
Wang A, Tian X, Zuo Y, Zhang X, Wu S, Zhao X. Association between the triglyceride-glucose index and carotid plaque stability in nondiabetic adults. Nutr Metab Cardiovasc Dis 2021; 31:2921-2928. [PMID: 34353702 DOI: 10.1016/j.numecd.2021.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 06/10/2021] [Accepted: 06/25/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS The rupture of an unstable atherosclerotic plaque is one of the major causes of thrombosis. However, there was limited evidence on the relationship of triglyceride-glucose (TyG) index, a simple surrogate marker of insulin resistance, with the carotid plaque stability. This study aimed to investigate the association between the TyG index and carotid plaque stability in nondiabetic adults. METHODS AND RESULTS The study included 4748 nondiabetic participants from the Asymptomatic Polyvascular Abnormalities Community study. Carotid plaque stability was assessed using ultrasonography. The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Logistic regression was used to evaluate the association of the TyG index with carotid plaque stability by calculating odds ratio (OR) and 95% confidence interval (CI). Of the 4748 participants, 1192 (25.11%) participants had stable carotid plaque, and 1247 (26.26%) had unstable carotid plaque. The prevalence of unstable carotid plaque substantially increased with increasing TyG index tertile (P for trend <0.0001). In the fully adjusted model, the OR comparing participants in the highest versus the lowest tertile of the TyG index was 1.31 (95% CI, 1.09-1.57). The optimal cutoff point for the TyG index in case of unstable carotid plaque was 8.56. However, we did not observe a statistically significant association between the TyG index and stable carotid plaque. CONCLUSIONS Elevated the TyG index was significantly associated with the prevalence of unstable carotid plaque in nondiabetic adults.
Collapse
Affiliation(s)
- Anxin Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xue Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yingting Zuo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xiaoli Zhang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, China.
| | - Xingquan Zhao
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| |
Collapse
|
18
|
Miyagawa N, Ohkubo T, Fujiyoshi A, Shiino A, Chen R, Ross GW, Willcox B, Miura K, Ueshima H, Masaki K. Factors Associated with Lower Cognitive Performance Scores Among Older Japanese Men in Hawaii and Japan. J Alzheimers Dis 2021; 81:403-412. [PMID: 33814425 DOI: 10.3233/jad-201084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Few studies have compared factors related to cognitive function among people with similar genetic backgrounds but different lifestyles. OBJECTIVE We aimed to identify factors related to lower cognitive scores among older Japanese men in two genetically similar cohorts exposed to different lifestyle factors. METHODS This cross-sectional study of community-dwelling Japanese men aged 71-81 years included 2,628 men enrolled in the Kuakini Honolulu-Asia Aging Study based in Hawaii and 349 men in the Shiga Epidemiological Study of Subclinical Atherosclerosis based in Japan. We compared participant performance through Cognitive Abilities Screening Instrument (CASI) assessment in Hawaii (1991-1993) and Japan (2009-2014). Factors related to low cognitive scores (history of cardiovascular disease, cardiometabolic factors, and lifestyle factors) were identified with questionnaires and measurements. Multivariable logistic regression analysis was used to calculate the adjusted odds ratios (ORs) of a low (< 82) CASI score based on different factors. RESULTS CASI scores were lower in Hawaii than in Japan [21.2%(n = 556) versus 12.3%(n = 43), p < 0.001], though this was not significant when adjusted for age and educational attainment (Hawaii 20.3%versus Japan 17.9%, p = 0.328). History of stroke (OR = 1.65, 95%confidence interval = 1.19-2.29) was positively associated with low cognitive scores in Hawaii. Body mass index ≥25 kg/m2 tended to be associated with low cognitive scores in Japan; there was a significant interaction between the cohorts. CONCLUSION Cognitive scores differences between cohorts were mostly explained by differences in educational attainment. Conversely, cardiovascular diseases and cardiometabolic factors differentially impacted cognitive scores among genetically similar older men exposed to different lifestyle factors.
Collapse
Affiliation(s)
- Naoko Miyagawa
- International Center for Nutrition and Information, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.,Department of Public Health, Shiga University of Medical Science, Otsu, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Akira Fujiyoshi
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.,Department of Hygiene, School of Medicine, Wakayama Medical University; Wakayama, Japan
| | - Akihiko Shiino
- Department of Neurosurgery, Shiga University of Medical Science, Otsu, Japan
| | - Randi Chen
- Kuakini Medical Center, Honolulu, HI, USA
| | - George Webster Ross
- Veterans Affairs Pacific Islands Health Care System, Honolulu, HI, USA.,Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Bradley Willcox
- Kuakini Medical Center, Honolulu, HI, USA.,Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Kamal Masaki
- Kuakini Medical Center, Honolulu, HI, USA.,Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| |
Collapse
|
19
|
Guerra JVS, Dias MMG, Brilhante AJVC, Terra MF, García-Arévalo M, Figueira ACM. Multifactorial Basis and Therapeutic Strategies in Metabolism-Related Diseases. Nutrients 2021; 13:nu13082830. [PMID: 34444990 PMCID: PMC8398524 DOI: 10.3390/nu13082830] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 12/11/2022] Open
Abstract
Throughout the 20th and 21st centuries, the incidence of non-communicable diseases (NCDs), also known as chronic diseases, has been increasing worldwide. Changes in dietary and physical activity patterns, along with genetic conditions, are the main factors that modulate the metabolism of individuals, leading to the development of NCDs. Obesity, diabetes, metabolic associated fatty liver disease (MAFLD), and cardiovascular diseases (CVDs) are classified in this group of chronic diseases. Therefore, understanding the underlying molecular mechanisms of these diseases leads us to develop more accurate and effective treatments to reduce or mitigate their prevalence in the population. Given the global relevance of NCDs and ongoing research progress, this article reviews the current understanding about NCDs and their related risk factors, with a focus on obesity, diabetes, MAFLD, and CVDs, summarizing the knowledge about their pathophysiology and highlighting the currently available and emerging therapeutic strategies, especially pharmacological interventions. All of these diseases play an important role in the contamination by the SARS-CoV-2 virus, as well as in the progression and severity of the symptoms of the coronavirus disease 2019 (COVID-19). Therefore, we briefly explore the relationship between NCDs and COVID-19.
Collapse
Affiliation(s)
- João V. S. Guerra
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biosciences National Laboratory (LNBio), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil; (J.V.S.G.); (M.M.G.D.); (M.F.T.)
- Graduate Program in Pharmaceutical Sciences, Faculty Pharmaceutical Sciences, University of Campinas, Campinas 13083-970, Brazil
| | - Marieli M. G. Dias
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biosciences National Laboratory (LNBio), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil; (J.V.S.G.); (M.M.G.D.); (M.F.T.)
- Graduate Program in Functional and Molecular Biology, Institute of Biology, State University of Campinas (Unicamp), Campinas 13083-970, Brazil;
| | - Anna J. V. C. Brilhante
- Graduate Program in Functional and Molecular Biology, Institute of Biology, State University of Campinas (Unicamp), Campinas 13083-970, Brazil;
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biorenewables National Laboratory (LNBR), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil
| | - Maiara F. Terra
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biosciences National Laboratory (LNBio), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil; (J.V.S.G.); (M.M.G.D.); (M.F.T.)
- Graduate Program in Functional and Molecular Biology, Institute of Biology, State University of Campinas (Unicamp), Campinas 13083-970, Brazil;
| | - Marta García-Arévalo
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biosciences National Laboratory (LNBio), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil; (J.V.S.G.); (M.M.G.D.); (M.F.T.)
- Correspondence: or (M.G.-A.); (A.C.M.F.)
| | - Ana Carolina M. Figueira
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biosciences National Laboratory (LNBio), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil; (J.V.S.G.); (M.M.G.D.); (M.F.T.)
- Correspondence: or (M.G.-A.); (A.C.M.F.)
| |
Collapse
|
20
|
Xin Y, Zhang J, Fan Y, Wang C. Serum free fatty acids are associated with severe coronary artery calcification, especially in diabetes: a retrospective study. BMC Cardiovasc Disord 2021; 21:343. [PMID: 34266394 PMCID: PMC8281587 DOI: 10.1186/s12872-021-02152-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 07/07/2021] [Indexed: 11/10/2022] Open
Abstract
Background Serum free fatty acid (FFA) concentrations are associated with coronary heart disease and diabetes mellitus (DM). Few studies focused on the relationship between serum FFA levels and coronary artery calcification (CAC). Methods This was a retrospective, single-centered study recruiting patients underwent FFA quantification, coronary angiography and intravascular ultrasound (IVUS). CAC severity was assessed with the maximum calcific angle (arc) of the calcified plaque scanned by IVUS. Patients with an arc ≥ 180° were classified into the severe CAC (SCAC) group, and those with an arc < 180° were classified into the non-SCAC group. Clinical characteristics, serum indices were compared between 2 groups. Logistic regression, receiver operating characteristic (ROC) curves and area under the curves (AUC) were performed. Results Totally, 426 patients with coronary artery disease were consecutively included. Serum FFA levels were significantly higher in the SCAC group than non-SCAC group (6.62 ± 2.17 vs. 5.13 ± 1.73 mmol/dl, p < 0.001). Logistic regression revealed that serum FFAs were independently associated with SCAC after adjusting for confounding factors in the whole cohort (OR 1.414, CI 1.237–1.617, p < 0.001), the non-DM group (OR 1.273, CI 1.087–1.492, p = 0.003) and the DM group (OR 1.939, CI 1.388–2.710, p < 0.001). ROC analysis revealed a serum FFA AUC of 0.695 (CI 0.641–0.750, p < 0.001) in the whole population. The diagnostic predictability was augmented (AUC = 0.775, CI 0.690–0.859, p < 0.001) in the DM group and decreased (AUC = 0.649, CI 0.580–0.718, p < 0.001) in the non-DM group. Conclusions Serum FFA levels were independently associated with SCAC, and could have some predictive capacity for SCAC. The association was strongest in the DM group. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-02152-w.
Collapse
Affiliation(s)
- Yangxun Xin
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junfeng Zhang
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuqi Fan
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Changqian Wang
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| |
Collapse
|
21
|
Influence of sex and menopausal status on the relationship between metabolic syndrome and coronary artery calcification: a Chinese community-based cross-sectional study. ACTA ACUST UNITED AC 2021; 28:546-553. [PMID: 33625107 DOI: 10.1097/gme.0000000000001750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To evaluate the association between metabolic syndrome and coronary artery calcification according to different sex and menopausal status. METHODS This cross-sectional study included 2,704 adults from the Jidong community (Tangshan, China) recruited from July 2013 to August 2014. Adults aged ≥40 years with no cardiovascular disease and with coronary artery calcification score data were included. Metabolic syndrome was defined according to the 2005 International Diabetes Federation standard. Coronary artery calcification score was determined using the Agatston method. The associations between metabolic syndrome and coronary artery calcification prevalence were evaluated using logistic regression. RESULTS In the multivariable regression analysis, metabolic syndrome was associated with coronary artery calcification (odds ratio: 1.34, 95% confidence interval: 1.04-1.71, P = 0.021). When stratified by sex, metabolic syndrome was positively associated with coronary artery calcification prevalence in female participants (odds ratio: 2.79, 95% confidence interval: 1.96-3.96, P < 0.001), whereas no association was observed in male participants. Furthermore, metabolic syndrome was associated with a higher prevalence of coronary artery calcification (P < 0.001) independent of adjustment for covariates in postmenopausal women than in premenopausal women, and coronary artery calcification prevalence increased with an increase in conditions related to metabolic syndrome. CONCLUSIONS Our findings indicate that metabolic syndrome in postmenopausal women is associated with a higher prevalence of coronary artery disease than in premenopausal women and men.
Collapse
|
22
|
Triglyceride Glucose-Waist Circumference Better Predicts Coronary Calcium Progression Compared with Other Indices of Insulin Resistance: A Longitudinal Observational Study. J Clin Med 2020; 10:jcm10010092. [PMID: 33383953 PMCID: PMC7795085 DOI: 10.3390/jcm10010092] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/21/2020] [Accepted: 12/25/2020] [Indexed: 12/16/2022] Open
Abstract
The triglyceride glucose (TyG) index, a product of triglyceride and fasting glucose, is a reliable marker for insulin resistance. We aimed to investigate the association between the TyG-related markers and coronary artery calcification (CAC) progression. We enrolled 1145 asymptomatic participants who underwent repeated CAC score measurements during routine health examinations. Homeostasis model assessment of insulin resistance (HOMA-IR), TyG index, TyG-BMI (body mass index), and TyG-WC (waist circumference) were calculated. Progression of CAC was defined as (1) incident CAC in a CAC-free population, or an (2) increase of ≥2.5 units between the baseline and final square root of the CAC scores in participants with detectable CAC. According to the quartiles of parameters, we stratified the subjects into four groups. The prevalence of progression increased with the TyG-WC quartile (15.0%, 24.1%, 31.0%, and 32.2% for each of the groups; p < 0.001). The multivariate-adjusted odds ratio (95% confidence interval) for CAC score progression was 1.66 (1.01–2.77) when the highest and lowest TyG-WC index quartiles were compared. Furthermore, the predictability of TyG-WC for CAC progression was better than the other indices in terms of the area under the curve. The TyG-WC index predicted CAC progression better than other indices and could be a potential marker of future coronary atherosclerosis.
Collapse
|
23
|
Wang Q, Zhao Y, Wang X, Ji X, Sang S, Shao S, Ma X, Wang G, Lv M, Xue F, Du Y, Sun Q. Association between asymptomatic intracranial arterial stenosis and insulin resistance or diabetes mellitus: a cross-sectional study in rural Shandong, China. BMJ Open Diabetes Res Care 2020; 8:8/2/e001788. [PMID: 33277341 PMCID: PMC7722366 DOI: 10.1136/bmjdrc-2020-001788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/13/2020] [Accepted: 11/15/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Recent studies have shown that insulin resistance (IR) is correlated to atherosclerosis development. However, few studies have investigated the association between IR and asymptomatic intracranial arterial stenosis (aICAS). RESEARCH DESIGN AND METHODS This cross-sectional study enrolled 2007 rural residents in China who were aged ≥40 years without a clinical history of stroke and transient ischaemic attack. We used transcranial Doppler ultrasonography in combination with magnetic resonance angiography to diagnose aICAS (stenosis ≥50%). IR was defined as a homeostasis model assessment of insulin resistance ≥3.0 based on the 75th percentile for all the participants. Multivariate logistic regression models were employed to assess the relationship of diabetic parameters with aICAS in all participants, as well as with aICAS in non-diabetic participants, and further stratified by sex. RESULTS After adjusting for age, gender, smoking habit, drinking habit, low-density lipoprotein cholesterol, raised blood pressure, triglycerides, high-density lipoprotein cholesterol and waist circumference, diabetes mellitus (DM) (OR=2.09, 95% CI 1.31 to 3.32), fasting plasma glucose (FPG) (OR=1.34, 95% CI 1.14 to 1.57), and IR (OR=1.75, 95% CI 1.11 to 2.75) were associated with aICAS in the total study population; however, these relationships remained significant only in men after the analyses were stratified by sex (DM: OR=3.40, 95% CI 1.62 to 7.13; FPG: OR=1.64, 95% CI 1.26 to 2.13; IR: OR=3.04, 95% CI 1.44 to 6.42). When further excluding the diabetic participants from the total study population, positive associations between IR and aICAS were similarly observed only in men (OR=4.65, 95% CI 1.69 to 12.82). CONCLUSIONS IR might predict the prevalence of aICAS independently of major cardiovascular risk factors and metabolic syndrome components among men living in rural China.
Collapse
Affiliation(s)
- Qiao Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yuanyuan Zhao
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xiang Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xiaokang Ji
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Shaowei Sang
- Department of Clinical Epidemiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Sai Shao
- Department of Radiology, Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiaotong Ma
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Guangbin Wang
- Department of Radiology, Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Ming Lv
- Department of Clinical Epidemiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Qinjian Sun
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| |
Collapse
|
24
|
Pham T, Fujiyoshi A, Hisamatsu T, Kadowaki S, Kadota A, Zaid M, Kunimura A, Torii S, Segawa H, Kondo K, Horie M, Miura K, Ueshima H. Smoking habits and progression of coronary and aortic artery calcification: A 5-year follow-up of community-dwelling Japanese men. Int J Cardiol 2020; 314:89-94. [PMID: 32430214 DOI: 10.1016/j.ijcard.2020.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 04/12/2020] [Accepted: 05/06/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND AIMS To examine whether smoking habits, including smoking amount and cessation duration at baseline, are associated with atherosclerosis progression. METHODS At baseline (2006-08, Japan), we obtained smoking status, amount of smoking and time since cessation for quitters in a community-based random sample of Japanese men initially aged 40-79 years and free of cardiovascular disease. Coronary artery calcification (CAC) and aortic artery calcification (AAC) as biomarker of atherosclerosis was quantified using Agatston's method at baseline and after 5 years of follow-up. We defined progression of CAC and AAC (yes/no) using modified criteria by Berry. RESULTS A total of 781 participants was analyzed. Multivariable adjusted odds ratios (ORs) of CAC and AAC progression for current smokers were 1.73 (95% CI, 1.09-2.73) and 2.47 (1.38-4.44), respectively, as compared to never smokers. In dose-response analyses, we observed a graded positive relationship of smoking amount and CAC progression in current smokers (multivariable adjusted ORs: 1.23, 1.72, and 2.42 from the lowest to the highest tertile of pack-years). Among the former smokers, earlier quitters (≥10.7 years) had similar ORs of the progression of CAC and AAC to that of participants who had never smoked. CONCLUSIONS Compared with never smokers, current smokers especially those with greater pack-years at baseline had higher risk of atherosclerosis progression in community-dwelling Japanese men. Importantly, the residual adverse effect appears to be present for at least ten years after smoking cessation. The findings highlight the importance of early avoidance or minimizing smoking exposure for the prevention of atherosclerotic disease.
Collapse
Affiliation(s)
- Tai Pham
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan; University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam
| | - Akira Fujiyoshi
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan; Department of Hygiene, School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takahashi Hisamatsu
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan; Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Sayaka Kadowaki
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Aya Kadota
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan; Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Maryam Zaid
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan; Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Ayako Kunimura
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Sayuki Torii
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Hiroyoshi Segawa
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Keiko Kondo
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Minoru Horie
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan; Department of Cardiovascular Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Katsuyuki Miura
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan; Department of Public Health, Shiga University of Medical Science, Shiga, Japan.
| | - Hirotsugu Ueshima
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan; Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | | |
Collapse
|
25
|
Fujiyoshi A, Miura K, Ohkubo T, Miyagawa N, Saito Y, Miyazawa I, Shiino A, Kadota A, Kadowaki S, Hisamatsu T, Torii S, Takashima N, Tooyama I, Ueshima H. Proteinuria and Reduced Estimated Glomerular Filtration Rate are Independently Associated With Lower Cognitive Abilities in Apparently Healthy Community-Dwelling Elderly Men in Japan: A Cross-sectional Study. J Epidemiol 2020; 30:244-252. [PMID: 31130560 PMCID: PMC7217691 DOI: 10.2188/jea.je20180258] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/01/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The association of proteinuria and reduced estimated glomerular filtration rate (eGFR) with cognition needs more clarification. We cross-sectionally examined whether proteinuria and reduced eGFR, even in moderate stages, were independently associated with lower cognition in a community-based sample of elderly men. METHODS Our cohort initially comprised 1,094 men aged 40-79 years from a random sample from Shiga, Japan in 2006-2008. Of 853 men who returned for the follow-up examination (2009-2014), we analyzed 561 who were ≥65 years, free of stroke, and completed the Cognitive Abilities Screening Instrument (CASI) at follow-up (higher CASI scores [range 0 to 100] indicate better cognition). Proteinuria was assessed via dipstick. eGFR was calculated according to the Chronic Kidney Disease Epidemiology Collaboration Equation. Participants were divided into three groups either by eGFR (≥60, 59-40, and <40 mL/min/1.73 m2) or by proteinuria (no, trace, and positive), considered normal, moderate, and advanced, respectively. Using linear regression, we computed mean CASI score, with simultaneous adjustment for proteinuria and eGFR in addition to other potential confounders. RESULTS Significant trends of lower cognition were observed across the groups of worse proteinuria and lower eGFR independently: multivariable-adjusted mean CASI scores were 90.1, 89.3, and 88.4 for proteinuria (Ptrend = 0.029), and 90.0, 88.5, and 88.5 for eGFR (Ptrend = 0.015) in mutual-adjustment model. CONCLUSIONS Proteinuria and reduced eGFR, even in their moderate stages, were independently associated with lower cognition in a community-based sample of elderly men. The results suggest the importance of proteinuria and low eGFR for early detection and prevention of cognitive decline.
Collapse
Affiliation(s)
- Akira Fujiyoshi
- Department of Hygiene, Wakayama Medical School, Wakayama, Japan
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Naoko Miyagawa
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Yoshino Saito
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Itsuko Miyazawa
- Department of Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Akihiko Shiino
- Molecular Neuroscience Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Sayaka Kadowaki
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Takashi Hisamatsu
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Department of Environmental Medicine and Public Health, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Sayuki Torii
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Naoyuki Takashima
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Ikuo Tooyama
- Molecular Neuroscience Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| |
Collapse
|
26
|
Mahajan H, Zaid M, Mackey R, Kadota A, Vishnu A, Fujiyoshi A, Vasudha A, Hisamatsu T, Evans R, Okamura T, Miura K, Kuller L, Ueshima H, Sekikawa A. Lipoprotein particles and coronary artery calcium in middle-aged US-White and Japanese men. Open Heart 2020; 6:e001119. [PMID: 31921430 PMCID: PMC6937418 DOI: 10.1136/openhrt-2019-001119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 11/03/2019] [Accepted: 11/26/2019] [Indexed: 11/22/2022] Open
Abstract
Objective This cross-sectional study examined whether contrasting distributions of nuclear magnetic resonance (NMR)-measured lipoproteins contribute to differences in the prevalence of subclinical atherosclerosis measured using coronary artery calcium (CAC) between the two groups of middle-aged males: the US-residing Caucasian (US-White) and Japan-residing Japanese (Japanese). Methods In a population-based study of 570 randomly selected asymptomatic men aged 40–49 years (270 US-White and 300 Japanese), we examined the relationship between race/ethnicity, NMR-measured lipoproteins and CAC (measured by Electron Beam CT and quantified using the Agatston method) using multivariable robust Poisson regression adjusting for traditional and novel risk factors for coronary heart disease (CHD). Results The US-White compared with the Japanese had significantly different NMR-measured lipoprotein particle distributions. The US-White had a significantly higher prevalence of CAC≥10 (CAC-prevalence) compared with the Japanese adjusting for CHD risk factors (prevalence ratio (PR)=2.10; 95% CI=1.24 to 3.48), and this difference was partially attenuated (~18%) with further adjustment for lipoprotein levels (PR=1.73; 95% CI=1.02 to 3.08). There was no reclassification improvement with further addition of lipoproteins particle concentrations/size to a model that already included traditionally measured lipids (low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides), cardiovascular risk factors, and inflammatory markers (net reclassification improvement index=−2% to 3%). Conclusions Variations in the distribution of NMR-measured lipoprotein particles partially accounted for the difference in the CAC-prevalence between middle-aged US-White and Japanese men.
Collapse
Affiliation(s)
- Hemant Mahajan
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Maryam Zaid
- Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Rachel Mackey
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Aya Kadota
- Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Abhishek Vishnu
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Ahuja Vasudha
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Takashi Hisamatsu
- Shimane University Faculty of Medicine Graduate School of Medicine, Izumo, Shimane, Japan
| | - Rhobert Evans
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | | | - Lewis Kuller
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Akira Sekikawa
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
27
|
Hisamatsu T, Liu K, Chan C, Krefman AE, Fujiyoshi A, Budoff MJ, Miura K, Lloyd-Jones DM, Ueshima H. Coronary Artery Calcium Progression Among the US and Japanese Men. Circ Cardiovasc Imaging 2019; 12:e008104. [PMID: 30755051 DOI: 10.1161/circimaging.118.008104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The risk of coronary heart disease remains low in Japan, although distributions of several coronary risk factors have become comparable with those in the United States. We prospectively compared coronary atherosclerosis burden, measured with coronary artery calcium (CAC) progression, between men in the 2 countries. Methods In 2 population-based samples of 1712 US White, Black, Hispanic, Chinese men (baseline, 2000-2002) and 697 Japanese men in Japan (2006-2008) aged 45-74 years without clinical cardiovascular disease, we quantified CAC progression by serial computed tomography with medians of 3.4 and 5.2 years between scans, respectively. Results Among White, Black, Hispanic, Chinese, and Japanese men free of baseline CAC, CAC incidence was observed in 35.2%, 26.9%, 29.2%, 18.9%, and 29.2%, respectively. After adjustment for times between scans, demographics, behaviors, coronary risk factors, and their changes between scans, White men had significantly higher CAC incidence than Japanese men (relative risk, 1.68; 95% CI, 1.13-2.50). Among those with detectable baseline CAC, after similar adjustments, all the US race/ethnic groups had significantly greater annual changes in CAC score (mean [95% CI]: 39.4 [35.2-43.6] for White, 26.9 [21.4-32.4] for Black, 30.6 [24.7-36.5] for Hispanic, and 30.2 [22.6-37.8] for Chinese men) than Japanese men (15.9 [10.1-21.8]). Conclusions We found a higher CAC incidence among US White men and greater increases in existing CAC among all the US race/ethnic groups than among Japanese men in Japan. These differences persisted despite adjustment for differences in coronary risk factors.
Collapse
Affiliation(s)
- Takashi Hisamatsu
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (T.H., K.L., C.C., A.E.K., D.M.L.-J.).,Department of Environmental Medicine and Public Health, Faculty of Medicine, Shimane University, Izumo, Japan (T.H.).,Department of Public Health, Shiga University of Medical Science, Otsu, Japan (T.H., A.F., K.M., H.U.)
| | - Kiang Liu
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (T.H., K.L., C.C., A.E.K., D.M.L.-J.)
| | - Cheeling Chan
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (T.H., K.L., C.C., A.E.K., D.M.L.-J.)
| | - Amy E Krefman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (T.H., K.L., C.C., A.E.K., D.M.L.-J.)
| | - Akira Fujiyoshi
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan (T.H., A.F., K.M., H.U.)
| | - Matthew J Budoff
- Division of Cardiology, Los Angeles Biomedical Research Center at Harbor-University of California Los Angeles, Torrance, CA (M.J.B.)
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan (T.H., A.F., K.M., H.U.)
| | - Donald M Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (T.H., K.L., C.C., A.E.K., D.M.L.-J.)
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan (T.H., A.F., K.M., H.U.)
| |
Collapse
|
28
|
Di Pino A, DeFronzo RA. Insulin Resistance and Atherosclerosis: Implications for Insulin-Sensitizing Agents. Endocr Rev 2019; 40:1447-1467. [PMID: 31050706 PMCID: PMC7445419 DOI: 10.1210/er.2018-00141] [Citation(s) in RCA: 180] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 10/18/2018] [Indexed: 12/12/2022]
Abstract
Patients with type 2 diabetes mellitus (T2DM) are at high risk for macrovascular complications, which represent the major cause of mortality. Despite effective treatment of established cardiovascular (CV) risk factors (dyslipidemia, hypertension, procoagulant state), there remains a significant amount of unexplained CV risk. Insulin resistance is associated with a cluster of cardiometabolic risk factors known collectively as the insulin resistance (metabolic) syndrome (IRS). Considerable evidence, reviewed herein, suggests that insulin resistance and the IRS contribute to this unexplained CV risk in patients with T2DM. Accordingly, CV outcome trials with pioglitazone have demonstrated that this insulin-sensitizing thiazolidinedione reduces CV events in high-risk patients with T2DM. In this review the roles of insulin resistance and the IRS in the development of atherosclerotic CV disease and the impact of the insulin-sensitizing agents and of other antihyperglycemic medications on CV outcomes are discussed.
Collapse
Affiliation(s)
- Antonino Di Pino
- Diabetes Division, University of Texas Health Science Center and Texas Diabetes Institute, San Antonio, Texas
| | - Ralph A DeFronzo
- Diabetes Division, University of Texas Health Science Center and Texas Diabetes Institute, San Antonio, Texas
| |
Collapse
|
29
|
Park K, Ahn CW, Lee SB, Kang S, Nam JS, Lee BK, Kim JH, Park JS. Elevated TyG Index Predicts Progression of Coronary Artery Calcification. Diabetes Care 2019; 42:1569-1573. [PMID: 31182490 DOI: 10.2337/dc18-1920] [Citation(s) in RCA: 182] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 05/17/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the triglyceride-glucose (TyG) index association with coronary artery calcification (CAC) progression in adult Koreans. RESEARCH DESIGN AND METHODS Various cardiovascular risk factors and anthropometric profiles were assessed in 1,175 subjects who previously had a CAC evaluation at least twice by multidetector computed tomography in a health care center. The TyG index was determined using ln(fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2). The CAC progression was defined as either incident CAC in a CAC-free population at baseline or an increase of ≥2.5 units between the square roots of the baseline and follow-up coronary artery calcium scores (CACSs) of subjects with detectable CAC at baseline. RESULTS CAC progression was seen in 312 subjects (27%) during 4.2 years follow-up. On the basis of the TyG index, subjects were stratified into three groups. Follow-up CACS and incidence of CAC progression were markedly elevated with rising TyG index tertile. Logistic regression analysis adjusted for various risk factors revealed an odds ratio for CAC progression of 1.82 (95% CI 1.20-2.77; P ≤ 0.01) when the highest and lowest TyG index tertiles were compared. CONCLUSIONS The TyG index is an independent predictor of CAC progression.
Collapse
Affiliation(s)
- Kahui Park
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Chul Woo Ahn
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Bae Lee
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Shinae Kang
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Sun Nam
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
| | - Byoung Kwon Lee
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Hye Kim
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Suk Park
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea .,Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
30
|
Yan Z, Yu D, Cai Y, Shang J, Qin R, Xiao J, Zhao B, Zhao Z, Simmons D. Triglyceride Glucose Index Predicting Cardiovascular Mortality in Chinese Initiating Peritoneal Dialysis: A Cohort Study. Kidney Blood Press Res 2019; 44:669-678. [PMID: 31315123 DOI: 10.1159/000500979] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 04/22/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Insulin resistance (IR) is increased among people with end-stage renal disease (ESRD). The Triglyceride glucose (TyG) index is a marker of IR and is also associated with the prognosis of cardiovascular disease among patients initiating peritoneal dialysis (PD). This study was aimed at examining the associations between TyG index and cardiovascular deaths in patients initiating PD. METHODS AND RESULTS Three thousand fifty-four patients initiating PD between 2007 and 2014 were included in a prospective cohort derived from Henan PD Registry, TyG index alongside other baseline characteristics were measured when ESRD patients initiated PD. Logistic regression adjusting for age, gender, and major cardiovascular risk factors estimated the association between TyG index and subsequent cardiovascular mortality within 2 years since the initiation of PD. RESULTS TyG index was positively associated with cardiovascular mortality: adjusted incidence rates ratio (95% CI) comparing the highest vs. lowest TyG index quartile was 2.32 (2.12-2.55) in all, 2.22 (2.01-2.46) in those with body mass index (BMI) <25 kg/m2, and 2.82 (2.24-3.54) in those with BMI ≥25 kg/m2, respectively. Linear dose-response relationships were revealed in all and by BMI. CONCLUSIONS TyG index might be a prognostic factor in predicting cardiovascular mortality among patients initiating PD.
Collapse
Affiliation(s)
- Zechen Yan
- Department of Urology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Dahai Yu
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.,Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, United Kingdom
| | - Yamei Cai
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Jin Shang
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Rui Qin
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Jing Xiao
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Bin Zhao
- The Second Division of Internal Medicine, Kejing Community Health Centre, Jiyuan, China
| | - Zhanzheng Zhao
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China,
| | - David Simmons
- Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.,Western Sydney University, Campbelltown, Sydney, New South Wales, Australia
| |
Collapse
|
31
|
Ye X, Kong W, Zafar MI, Chen LL. Serum triglycerides as a risk factor for cardiovascular diseases in type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies. Cardiovasc Diabetol 2019; 18:48. [PMID: 30987625 PMCID: PMC6466658 DOI: 10.1186/s12933-019-0851-z] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 03/27/2019] [Indexed: 12/18/2022] Open
Abstract
Objective The importance of triglycerides (TG) level as a risk factor for cardiovascular diseases (CVD) has been extensively investigated in the general population; however, their relationship in patients with type 2 diabetes mellitus (T2DM) is uncertain. We aimed to assess the association of TG with CVD in T2DM individuals. Research design and methods We searched bibliographic databases for studies published until June 2018, reporting on the relationship between TG and CVD in T2DM people. A random-effects model with inverse variance weighting was used to compute pooled estimates of the most fully adjusted risk ratios (RR) and corresponding 95% confidence intervals (CI) according to TG categories, unit TG, and logarithm (log) of TG for CVD. Results A total of 31 studies were included, involving 132,044 T2DM patients with 10,733 incident cardiovascular events. The pooled RR (95% CI) of CVD for an increase in baseline TG, log TG by 1-mmol/l and categorized in the highest vs. the lowest TG in T2DM were 1.06 (1.02, 1.09), 1.30 (1.18, 1.42) and 1.30 (1.16, 1.46), corresponding to a CVD risk increase of 6%, 30% and 30%, respectively. The pooled RR (95% CI) of CVD for per 1-mmol/L TG increment in eight studies and TG categories in three studies were 1.03 (0.98, 1.08) and 1.39 (0.92, 2.1) in T2DM patients adjusted for other lipids parameter, respectively. Conclusions In T2DM patients, an elevated triglyceride level cannot serve as an independent marker for an increased risk of cardiovascular events, but still, the higher serum TG levels tend to be associated with increased risks of CVD. Electronic supplementary material The online version of this article (10.1186/s12933-019-0851-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Xiaofeng Ye
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Wen Kong
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Mohammad Ishraq Zafar
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Lu-Lu Chen
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| |
Collapse
|
32
|
Affiliation(s)
- Ann Marie Schmidt
- From the Diabetes Research Program, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, New York University School of Medicine.
| |
Collapse
|
33
|
Thoracic aortic calcification across the clinical dysglycemic continuum in a large Asian population free of cardiovascular symptoms. PLoS One 2019; 14:e0207089. [PMID: 30608944 PMCID: PMC6319708 DOI: 10.1371/journal.pone.0207089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 10/24/2018] [Indexed: 01/01/2023] Open
Abstract
Thoracic aortic calcification (TAC) is tightly linked to pathological atherosclerosis and associated with certain cardiovascular diseases. While diabetes mellitus (DM) is known as a coronary heart disease equivalent, we examined the presence of TAC across the dysglycemic spectrum of diabetes mellitus (DM). We consecutively studied 3003 asymptomatic ethnic Asians underwent annual cardiovacular health survey, and further categorized them into: 1) 1760 normo-glycemic, 2) 968 pre-diabetic, and 3) 274 overt DM based on dysglycemic indices and medical histories. Several TAC parameters were assessed using non-contrast multi-detector computed tomography (MDCT), and related to dysglycemic indices or diabetes mellitus status. A remarkably graded increases of adjusted total TAC calcium burden, volume and density were seen across Non-diabetes, Pre-diabetes, and diabetes mellitus categories and positively correlated with all dysglycemic profiles (all p<0.001). Multi-variate logistic and linear regression models demonstrated independent associations between greater TAC density and all dysglycemic indices (Coef: 2.5, 1.4, 6.8 for fasting, postprandial sugar and HbA1c) and diabetes mellitus status (all p<0.05). Furthermore, Receiver-operating characteristic curves (ROC) showed fasting sugar and postprandial sugar set at 103mg/dL and 111mg/dL, separately, with HbA1c set at 5.8% all predict the presence of aortic calcification. Dysglycemic status, even without overt diabetes mellitus, were tighly linked to subclinical, pathological thoracic aortic calcification.
Collapse
|
34
|
Hisamatsu T, Miura K, Arima H, Fujiyoshi A, Kadota A, Kadowaki S, Zaid M, Miyagawa N, Satoh A, Kunimura A, Horie M, Ueshima H. Relationship of serum irisin levels to prevalence and progression of coronary artery calcification: A prospective, population-based study. Int J Cardiol 2018; 267:177-182. [PMID: 29859711 DOI: 10.1016/j.ijcard.2018.05.075] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/02/2018] [Accepted: 05/21/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND The mechanisms by which exercise reduces the risk of coronary heart disease remain poorly understood. Irisin, an exercise-induced polypeptide secreted from skeletal muscles, is proposed to potentially mediate beneficial effects of exercise, especially in metabolic regulation and development of atherosclerosis. We examined whether higher serum irisin levels are associated with lower prevalence and progression of coronary atherosclerosis. METHODS AND RESULTS We performed a prospective, population-based study of Japanese men aged 40-79 years without known coronary heart disease. We measured baseline serum irisin levels using an enzyme-linked immunosorbent assay and quantified coronary artery calcification (CAC) from serial computed tomography scans. Of 1038 participants (mean age, 63.9 years) at baseline, 670 (64.6%) had prevalent CAC. Of 810 participants at follow-up (median, 5.1 years), 407 (50.3%) experienced CAC progression. In Poisson regression with robust error variance adjusted for age and behavioral factors, serum irisin levels were inversely associated with CAC prevalence (relative risk [RR] of 4th versus 1st quartiles [95% confidence interval], 0.88 [0.78-0.99]; trend P = 0.016) and CAC progression (RR, 0.76 [0.63-0.91]; trend P = 0.002). After further adjustment for cardiometabolic risk factors, the inverse association with CAC prevalence disappeared (RR, 0.95 [0.84-1.08]; trend P = 0.319), but that with CAC progression persisted (RR, 0.77 [0.64-0.93]; trend P = 0.003). These associations were consistent when we applied ordinal logistic regression and across subgroups by cardiometabolic risk factor status. CONCLUSIONS Higher serum irisin levels were associated with less burden of coronary atherosclerosis. This association would be mediated through and beyond traditional cardiometabolic pathways.
Collapse
Affiliation(s)
- Takashi Hisamatsu
- Department of Environmental Medicine and Public Health, Faculty of Medicine, Shimane University, Izumo, Japan; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Public Health, Shiga University of Medical Science, Otsu, Japan.
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Akira Fujiyoshi
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Sayaka Kadowaki
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
| | - Maryam Zaid
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Naoko Miyagawa
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
| | - Atsushi Satoh
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Ayako Kunimura
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
| | - Minoru Horie
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| |
Collapse
|
35
|
Hisamatsu T, Miura K, Fujiyoshi A, Kadota A, Miyagawa N, Satoh A, Zaid M, Yamamoto T, Horie M, Ueshima H. Serum magnesium, phosphorus, and calcium levels and subclinical calcific aortic valve disease: A population-based study. Atherosclerosis 2018; 273:145-152. [PMID: 29655832 DOI: 10.1016/j.atherosclerosis.2018.03.035] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 02/22/2018] [Accepted: 03/21/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Calcific aortic valve disease (CAVD) is the most common valve disease. Although micronutrients are known to contribute to cardiovascular disease, the relationship with CAVD remains poorly evaluated. We examined the association of serum levels of magnesium, phosphorus, and calcium with prevalence, incidence, and progression of aortic valve calcification (AVC). METHODS We conducted a prospective study in a population-based sample of Japanese men aged 40-79 years without known cardiovascular disease and chronic kidney disease at baseline, and quantified AVC from serial computed tomographic images with the Agatston method. RESULTS Of 938 participants at baseline (mean age, 63.7 ± 9.9 years), AVC prevalence was observed in 173 (18.4%). Of 596 participants without baseline AVC at follow-up (median duration, 5.1 years), AVC incidence was observed in 138 (23.2%). After adjustment for demographics, behaviors and cardiovascular risk factors, relative risks (95% confidence intervals) in the highest versus lowest categories of serum magnesium, phosphorus, and calcium were 0.62 (0.44-0.86), 1.45 (1.02-2.04), and 1.43 (0.95-2.15), respectively, for AVC prevalence and 0.62 (0.42-0.92), 1.93 (1.28-2.91), and 1.09 (0.77-1.55), respectively, for AVC incidence. Their linear trends of serum magnesium and phosphorus were also all statistically significant. Of 131 participants with baseline AVC, there was no association of any serum micronutrients with AVC progression. CONCLUSIONS Serum magnesium was inversely associated, while serum phosphorus was positively associated with AVC prevalence and incidence, suggesting that these serum micronutrients may be potential candidates for risk prediction or prevention of CAVD, and warranting further studies.
Collapse
Affiliation(s)
- Takashi Hisamatsu
- Department of Environmental Medicine and Public Health, Faculty of Medicine, Shimane University, Izumo, Japan; Department of Public Health, Shiga University of Medical Science, Otsu, Japan; Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Akira Fujiyoshi
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Naoko Miyagawa
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
| | - Atsushi Satoh
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Maryam Zaid
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Takashi Yamamoto
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Minoru Horie
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | | |
Collapse
|
36
|
Zhu L, Zhu X, Sun G, Meng X, Wang M, Cui H, Wang J, Zhai Y, Yang K, Tang Y, Sun X, Liu X. Dai-Zong-Fang, A Traditional Chinese Herbal Formula, Ameliorates Insulin Resistance in db/db Mice. Front Physiol 2018; 9:224. [PMID: 29593575 PMCID: PMC5861217 DOI: 10.3389/fphys.2018.00224] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 02/28/2018] [Indexed: 12/16/2022] Open
Abstract
Intricate health problems, such as insulin resistance (IR) and its associated diseases, call for multi-targeted therapies with few side effects. Based on traditional Chinese medicine (TCM), Dai-Zong-Fang (DZF) is an herbal formula mainly composed of Rhizoma Coptidis (Huanglian) and Fructus Aurantii Immaturus (Zhishi), of which berberine and naringin are the main constituents. Though DZF has been clinically used for treatment of IR and metabolic syndrome for decades, its mechanism in vivo remains unknown. In the present study, we observed that both DZF and metformin, the first-line drug for type 2 diabetes, ameliorated insulin resistance with significant improvement of oral glucose tolerance test (OGTT) and homeostasis model assessment of IR (HOMA-IR) level in diabetic C57BL/Ksj-Lepr db−/− (db/db) mice. Low-density lipoprotein cholesterol (LDL-C) and fatty acids (FAs) also decreased in the blood. Higher dose of DZF (1 g·kg−1), but not metformin (0.25 g·kg−1), alleviated hepatic steatosis with reduced liver weight and hepatic lipid accumulation and provided protection from hepatic injury with lower alanine aminotransferase and aspartate aminotransferase and increased hepatic superoxide dismutase activity in db/db mice. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) showed a decrease in FA synthase gene (Fasn) and an increase in FA oxidation gene Ppara expression. Western blot demonstrated that both DZF and metformin activated 5′ AMP-activated protein kinase (AMPK) but inhibited Notch intracellular domain (NICD) and Hairy/enhancer-of-split 1 (Hes1) of Notch signaling pathway in the liver. DZF also dramatically improved the ultrastructure of skeletal muscles, AMPK phosphorylation, and GLUT4 translocation. DZF also promoted FA transport and oxidation with Cd36 and Cpt1b up-regulation in the skeletal muscle. In conclusion, DZF improves insulin sensitivity by reducing hepatic lipids through AMPK activation and Notch signal pathway inhibition and enhancing energy metabolism in the skeletal muscle via AMPK. This study provides insights into the treatment of complex conditions, such as IR, where TCM herbal formulas exert multipronged effects through correlating pathways.
Collapse
Affiliation(s)
- Lili Zhu
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaoyun Zhu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Guibo Sun
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiangbao Meng
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Min Wang
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hanming Cui
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jialong Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yadong Zhai
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ke Yang
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, China
| | - Yang Tang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaobo Sun
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ximing Liu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
37
|
Kim MK, Ahn CW, Kang S, Nam JS, Kim KR, Park JS. Relationship between the triglyceride glucose index and coronary artery calcification in Korean adults. Cardiovasc Diabetol 2017; 16:108. [PMID: 28830471 PMCID: PMC5568209 DOI: 10.1186/s12933-017-0589-4] [Citation(s) in RCA: 123] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 08/16/2017] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The triglyceride glucose (TyG) index has been considered a simple surrogate marker of insulin resistance. However, few studies have investigated the relationship between the TyG index and coronary artery calcification (CAC). Thus, we investigated the relationship between the TyG index and CAC in healthy Korean adults. METHODS In total, 4319 participants who underwent cardiac computed tomography (CT) in a health promotion center were enrolled. Anthropometric profiles and multiple cardiovascular risk factors were measured. The TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2], and the insulin resistance index of homeostasis model assessment (HOMA-IR) was estimated. The CAC was measured using multidetector CT, and CAC presence was defined as an Agatston score of >0. RESULTS All subjects were stratified into four groups based on their TyG indices. Significant differences were observed in cardiovascular parameters among the groups, and the prevalence of CAC significantly increased with increasing TyG index. In the logistic regression analysis after adjustment for multiple risk factors, the odds ratio for the prevalence of CAC, when comparing the highest and lowest quartiles of the TyG index was 1.95 (95% CI 1.23-3.11; P for trend = 0.01); the odds ratio for the prevalence of CAC, when comparing the highest and lowest quartiles of HOMA-IR was 1.64 (95% CI 1.12-2.40; P for trend = 0.04). In the receiver operating characteristics analysis, the TyG index was superior to HOMA-IR in predicting CAC. CONCLUSION The TyG index is more independently associated with the presence of coronary artery atherosclerosis than is HOMA-IR in healthy Korean adults.
Collapse
Affiliation(s)
- Min Kyung Kim
- Division of Endocrinology, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, 150, Seongan-ro, Gangdong-gu, Seoul, South Korea
| | - Chul Woo Ahn
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, South Korea.,Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, South Korea
| | - Shinae Kang
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, South Korea.,Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, South Korea
| | - Ji Sun Nam
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, South Korea.,Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, South Korea
| | - Kyung Rae Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, South Korea
| | - Jong Suk Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, South Korea. .,Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, South Korea.
| |
Collapse
|
38
|
Huang YQ, Huang C, Chen JY, Li J, Feng YQ. Plasma expression level of miRNA let-7 is positively correlated with carotid intima-media thickness in patients with essential hypertension. J Hum Hypertens 2017; 31:843-847. [PMID: 28816229 DOI: 10.1038/jhh.2017.52] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 05/17/2017] [Accepted: 06/06/2017] [Indexed: 12/22/2022]
Abstract
MicroRNAs (miRNA, miR) play vital part in the pathophysiology of arterial remodeling in hypertension patients, and are increasingly becoming novel biomarkers in cardiovascular disease. The study was designed to evaluate the correlation between let-7 expression level and subclinical atherosclerosis in untreated patients with newly diagnosed essential hypertension. We assessed 240 participants including 60 healthy volunteers with normal carotid intima-media thickness (nCIMT), 60 healthy volunteers with increased CIMT (iCIMT), 60 hypertension patients with nCIMT and 60 hypertension patients with iCIMT. All patients underwent measurements of CIMT and ambulatory blood pressure (BP) monitoring. The level of let-7 was quantified using real-time reverse transcription polymerase chain reaction. Correlations of let-7 expression with BP parameters and CIMT were assessed using multiple linear regression analysis. We observed the lowest miRNA let-7 expression (21.70±1.45 vs 29.33±2.58 vs 31.50±1.80 vs 35.49±2.33; P<0.001) in healthy controls with nCIMT, followed by healthy controls with iCIMT, then hypertension patients with nCIMT and highest expression in hypertension patients with iCIMT. Let-7 was independently correlated with CIMT(r=0.587, P<0.001), and multiple linear regression analysis showed that let-7 was independently correlated with CIMT (β=0.031, P<0.001). Our findings provide significant evidence that plasma let-7 could represent a non-invasive marker for atherosclerosis in hypertensive patients and herald the emergence of a potential indicator to monitor end-organ damage in hypertension.
Collapse
Affiliation(s)
- Y-Q Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - C Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - J-Y Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - J Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Y-Q Feng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| |
Collapse
|
39
|
Reaven GM, Knowles JW, Leonard D, Barlow CE, Willis BL, Haskell WL, Maron DJ. Relationship between simple markers of insulin resistance and coronary artery calcification. J Clin Lipidol 2017; 11:1007-1012. [PMID: 28652190 PMCID: PMC6686183 DOI: 10.1016/j.jacl.2017.05.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 05/26/2017] [Accepted: 05/27/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Insulin resistance in apparently healthy persons is associated with a cluster of metabolic abnormalities that promote coronary atherosclerosis. Identifying these individuals before manifest disease would provide useful clinical information. OBJECTIVE We hypothesized that combining 2 simple markers of insulin resistance, prediabetes (PreDM) and triglyceride (TG) concentration ≥150 mg/dL, would identify apparently healthy persons with adverse cardiometabolic risk profiles and increased coronary artery calcium (CAC) compared with those with neither or only 1 abnormality. METHODS A cross-sectional analysis was performed using data from 25,886 apparently healthy individuals (18,453 men and 7433 women) evaluated at the Cooper Clinic from 1998 to 2015. Participants were divided into those with a normal fasting glucose concentrations (<100 mg/dL = normal fasting glucose) or PreDM (fasting plasma glucose ≥100 and <126 mg/dL) and further subdivided into those with a plasma TG concentration <150 or ≥150 mg/dL. These 4 groups were compared on the basis of multiple coronary artery disease risk factors and the presence of CAC determined during their evaluation. RESULTS Participants with PreDM and a TG concentration ≥150 mg/dL had a significantly more adverse coronary artery disease risk profile than individuals with either abnormality or only 1 abnormality (PreDM or TG concentration ≥150 mg/dL). Furthermore, the odds of detectable CAC were higher in participants with PreDM and a TG ≥ 150 mg/dL than in participants with neither or only 1 abnormality. CONCLUSION The presence of 2 markers of insulin resistance, PreDM and TG concentration ≥150 mg/dL, is associated with increased cardiometabolic risk and detectable CAC within a population of apparently healthy individuals.
Collapse
Affiliation(s)
- Gerald M Reaven
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
| | - Joshua W Knowles
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | | | | | | | - William L Haskell
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - David J Maron
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|
40
|
Tune JD, Goodwill AG, Sassoon DJ, Mather KJ. Cardiovascular consequences of metabolic syndrome. Transl Res 2017; 183:57-70. [PMID: 28130064 PMCID: PMC5393930 DOI: 10.1016/j.trsl.2017.01.001] [Citation(s) in RCA: 269] [Impact Index Per Article: 38.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 12/22/2016] [Accepted: 01/03/2017] [Indexed: 01/18/2023]
Abstract
The metabolic syndrome (MetS) is defined as the concurrence of obesity-associated cardiovascular risk factors including abdominal obesity, impaired glucose tolerance, hypertriglyceridemia, decreased HDL cholesterol, and/or hypertension. Earlier conceptualizations of the MetS focused on insulin resistance as a core feature, and it is clearly coincident with the above list of features. Each component of the MetS is an independent risk factor for cardiovascular disease and the combination of these risk factors elevates rates and severity of cardiovascular disease, related to a spectrum of cardiovascular conditions including microvascular dysfunction, coronary atherosclerosis and calcification, cardiac dysfunction, myocardial infarction, and heart failure. While advances in understanding the etiology and consequences of this complex disorder have been made, the underlying pathophysiological mechanisms remain incompletely understood, and it is unclear how these concurrent risk factors conspire to produce the variety of obesity-associated adverse cardiovascular diseases. In this review, we highlight current knowledge regarding the pathophysiological consequences of obesity and the MetS on cardiovascular function and disease, including considerations of potential physiological and molecular mechanisms that may contribute to these adverse outcomes.
Collapse
Affiliation(s)
- Johnathan D Tune
- Department of Cellular & Integrative Physiology, Indiana University School of Medicine, Indianapolis, Ind.
| | - Adam G Goodwill
- Department of Cellular & Integrative Physiology, Indiana University School of Medicine, Indianapolis, Ind
| | - Daniel J Sassoon
- Department of Cellular & Integrative Physiology, Indiana University School of Medicine, Indianapolis, Ind
| | - Kieren J Mather
- Department of Cellular & Integrative Physiology, Indiana University School of Medicine, Indianapolis, Ind; Department of Medicine, Indiana University School of Medicine, Indianapolis, Ind
| |
Collapse
|