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Ruzhanskaya A, Ichihara K, Sukhacheva E, Skibo I, Vybornova N, Butlitski D, Vasiliev A, Agarkova G, Vilenskaya E, Emanuel V, Lugovskaya S. Derivation of Russian-specific reference intervals for complete blood count, iron markers and related vitamins. PLoS One 2024; 19:e0304020. [PMID: 39348390 PMCID: PMC11441669 DOI: 10.1371/journal.pone.0304020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 05/03/2024] [Indexed: 10/02/2024] Open
Abstract
OBJECTIVES This study aimed to establish reference intervals (RIs) for Russian adults for hematological parameters including related iron markers and vitamins. Sources of variation of reference values (RVs) and needs for secondary exclusion were explored for proper derivations of RIs. METHODS Following the harmonized protocol of the IFCC Committee on Reference Intervals and Decision Limits (C-RIDL), 506 healthy Russians (age 18-80; 46% male) were recruited. Complete blood counts (CBC) and leukocyte differentials, iron markers, vitamin B12, and folate were measured by Beckman Coulter's analyzers. Sources of variation were analyzed by multiple regression analysis, and ANOVAs, and the need for partitioning RVs was decided accordingly. Two schemes of excluding latent anemia were compared: (1) latent abnormal values exclusion method (LAVE) based on associations among CBC parameters, or (2) explicit exclusion of individuals with either ferritin or iron below the respective lower limit of the manufacturer. RIs were determined by the parametric method using two-parameter Box-Cox formula. RESULTS Gender-specific RIs were required for most analytes, while age-specific RIs were set only for ferritin in females. A BMI-related increase in RVs was prominently observed for reticulocyte parameters, hence we chose to exclude individuals with BMI>28 kg/m2 when establishing the RIs. The LAVE method was more effective in excluding individuals with latent anemia, than exclusion based on low ferritin and/or iron values. International comparison revealed that Russian RIs featured a lower side shift of platelet counts. Similar to African countries, Russian RIs for total leukocyte and neutrophil counts were lower compared to most of other countries. CONCLUSION RIs for the Russian population for 34 hematological and related parameters were established using up-to-date methods proposed by C-RIDL. Reducing the influences of latent anemia and obesity on RIs was crucial for erythrocyte parameters. Low levels of Russian RIs observed for platelet and neutrophil counts need further investigation.
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Affiliation(s)
| | - Kiyoshi Ichihara
- Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | | | | | | | | | | | | | | | - Vladimir Emanuel
- Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russia
| | - Svetlana Lugovskaya
- Russian Medical Academy of Continuing Professional Education of the Ministry of Health, Moscow, Russia
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Vats S, Sundquist K, Grundberg A, Sundquist J, Wang X, Zarrouk M, Gottsäter A, Memon AA. Hemoglobin homeostasis in abdominal aortic aneurysm: diagnostic and prognostic potential of hemoglobin/heme and scavenger molecules. BMC Cardiovasc Disord 2024; 24:452. [PMID: 39192217 DOI: 10.1186/s12872-024-04131-3] [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: 05/10/2024] [Accepted: 08/19/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND There is increasing evidence implicating hemoglobin/heme and their scavengers in oxidative stress-mediated pathologies, but information is limited in abdominal aortic aneurysm (AAA). METHODS AND RESULTS In this case-control study, we assessed heme/heme-related markers in 142 men with AAA and 279 men with a normal aortic diameter consecutively recruited from an ultrasound screening program in Sweden. Enzyme-linked immunosorbent assays (ELISAs) were used to measure heme oxygenase-1 (HO-1) and hemopexin (Hpx) plasma levels, colorimetric assays for cell-free heme and whole blood hemoglobin (Hb) levels, and droplet digital PCR (ddPCR) and real-time PCR to determine haptoglobin (Hp) (pheno)type and genotype, respectively. Hpx and heme plasma levels at baseline were elevated, while HO-1 levels were lower in men with AAA (p < 0.001) and were significantly associated with AAA prevalence independently of potential confounders. A combination of heme and HO-1 showed the best diagnostic potential based on the area under the curve (AUC): 0.76, sensitivity: 80%, specificity: 48%. Additionally, when previously described inflammatory biomarker interleukin-6 (IL-6), was added to our model it significantly improved the diagnostic value (AUC: 0.87, sensitivity: 80%, specificity: 79%) compared to IL-6 alone (AUC: 0.73, sensitivity: 80%, specificity: 49%). Finally, Hb (positively) and Hpx (negatively) levels at baseline were associated with AAA growth rate (mm/year), and their combination showed the best prognostic value for discriminating fast and slow-growing AAA (AUC: 0.76, sensitivity: 80%, specificity: 62%). CONCLUSIONS This study reports the distinct disruption of heme and related markers in both the development and progression of AAA, underscoring their potential in aiding risk stratification and therapeutic strategies.
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Affiliation(s)
- Sakshi Vats
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden.
- Center for Primary Health Care Research, Wallenberg Laboratory, 5th floor, Inga Marie Nilsson's gata 53, Malmö, 214 28, Sweden.
| | - Kristina Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
- University Clinic Primary Care Skåne, Region Skåne, Malmö, Sweden
- Department of Family and Community Medicine, McGovern Medical School, The University of Texas Health Science Center, Houston, Texas, USA
| | - Anton Grundberg
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
- University Clinic Primary Care Skåne, Region Skåne, Malmö, Sweden
- Department of Family and Community Medicine, McGovern Medical School, The University of Texas Health Science Center, Houston, Texas, USA
| | - Xiao Wang
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Moncef Zarrouk
- Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Lund University, Malmö, S-205 02, Sweden
| | - Anders Gottsäter
- Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Lund University, Malmö, S-205 02, Sweden
- Department of Medicine, Skåne University Hospital, Lund University, Malmö, S-205 02, Sweden
| | - Ashfaque A Memon
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
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Yao K, Chen Z, Zhou W, Liu Z, Cui W. Association between hemoglobin and non-alcoholic fatty liver disease (NAFLD) in United States adults: Results from NHANES 2017-2020. Prev Med Rep 2024; 44:102798. [PMID: 38983448 PMCID: PMC11231751 DOI: 10.1016/j.pmedr.2024.102798] [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: 02/28/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 07/11/2024] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD), a chronic liver condition of increasing prevalence, is closely related to various metabolic disorders. Hemoglobin, a protein that transports oxygen in red blood cells, is the focus of this study, which seeks to investigate its potential association with NAFLD. Methods We selected 6,516 eligible adult participants from the United States using the 2017-2020 National Health and Nutrition Examination Survey database for cross-sectional analyses. We analyzed the association of hemoglobin with NAFLD using weighted logistic regression models. Results The study performed a weighted logistic regression modeling analysis, which verified that hemoglobin levels were positively associated with NAFLD, especially in the higher hemoglobin quartile groups. Subgroup analyses revealed no significant interactions, demonstrating the robustness of the model. The analysis of mediation effects showed that Gamma-Glutamyl Transferase, Alanine Aminotransferase, and triglycerides were important mediating variables in the relationship between hemoglobin and NAFLD. Conclusion Increased hemoglobin levels were found to be significantly and independently associated with an increased NAFLD risk. This insight is crucial for the risk assessment and early detection of NAFLD, underscoring the need for heightened vigilance in individuals with higher hemoglobin levels.
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Affiliation(s)
- Kang Yao
- Department of General Surgery, Xuancheng People’s Hospital affiliated to Wannan Medical College, Xuancheng 242000, Anhui Province, China
| | - Zheng Chen
- Department of General Surgery, Xuancheng People’s Hospital affiliated to Wannan Medical College, Xuancheng 242000, Anhui Province, China
| | - Wei Zhou
- Department of General Surgery, Xuancheng People’s Hospital affiliated to Wannan Medical College, Xuancheng 242000, Anhui Province, China
| | - Zhihua Liu
- Department of General Surgery, Xuancheng People’s Hospital affiliated to Wannan Medical College, Xuancheng 242000, Anhui Province, China
| | - Wei Cui
- Department of General Surgery, Xuancheng People’s Hospital affiliated to Wannan Medical College, Xuancheng 242000, Anhui Province, China
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Dales R, Lukina A, Cakmak S. The association between the Canadian active living environments index and glucose metabolism in a Canadian national population study. ENVIRONMENTAL RESEARCH 2024; 258:119417. [PMID: 38880322 DOI: 10.1016/j.envres.2024.119417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 06/09/2024] [Accepted: 06/11/2024] [Indexed: 06/18/2024]
Abstract
Biomarkers of glucose metabolism may reflect insulin resistance, a risk factor for diabetes and cardiovascular disease (CVD). Neighborhoods conducive to a physically active lifestyle have the potential to improve these biomarkers. We examined cross-sectional associations between walkability and blood biomarkers of glucose metabolism in 29,649 Canadian Health Measures Survey (CHMS) participants. We used generalized linear mixed models with sampling weights adjusted for province, participants' age, sex, annual household income and educational attainment, cigarette smoking, environmental tobacco smoke, alcohol consumption, and exposure to ambient fine particulate air pollution (PM2.5). A higher value of the Canadian Active Living Environments Index, a measure of neighborhood walkability, equivalent to the magnitude of its interquartile range (IQR) of 2.4 was significantly associated with percentage differences of -0.48 (95% confidence interval (CI): 0.63, -0.32), -3.17 (95%CI: 5.27, -1.08), -3.88 (95%CI: 6.38, -1.38), and -3.36 (95%CI: 5.25, -1.47) in HbA1C, fasting insulin, HOMA-IR, and HOMA-β, respectively, for all CHMS participants. No significant effects were observed in those ≤16 years old. Canadians living in neighborhoods that facilitate active living have more favorable biomarkers of glucose metabolism, suggesting that the built environment has the potential to improve risk factors for diabetes and CVD in adults.
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Affiliation(s)
- Robert Dales
- Environmental Health Science & Research Bureau, Health Canada, Canada; University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Canada
| | - Anna Lukina
- Environmental Health Science & Research Bureau, Health Canada, Canada
| | - Sabit Cakmak
- Environmental Health Science & Research Bureau, Health Canada, Canada.
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Kwon SS, Yoon SY, Kim KH, Park BW, Lee MH, Kim H, Bang DW. Association of Higher Hemoglobin Level With Significant Carotid Artery Plaque in the General Population. J Lipid Atheroscler 2024; 13:184-193. [PMID: 38826178 PMCID: PMC11140247 DOI: 10.12997/jla.2024.13.2.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/11/2023] [Accepted: 12/27/2023] [Indexed: 06/04/2024] Open
Abstract
Objective Serum hemoglobin (Hb) level affects the viscosity of blood. Several studies have reported that Hb level is associated with adverse cardiovascular outcome. However, there is a paucity of evidence on the association between serum Hb level and the risk of subclinical atherosclerosis. Thus, the objective of this study was to investigate the relationship between Hb level and risk of carotid plaque in a health checkup cohort. Methods This retrospective study analyzed a total of 3,805 individuals without history of cardiovascular disease (CVD) who underwent carotid ultrasonography (USG) between January 2016 and June 2018. Participants were divided into 4 groups based on Hb quartiles in each of male and female. Carotid plaque score was calculated based on USG reports. Multivariable logistic regression analysis was performed for each index of quartile groups regarding the risk of carotid plaque. Results Of 3,805 individuals (mean age, 52.62±10.25 years; 2,674 [70.28%] males), mean Hb level was 15.11±0.75 g/dL in male and 13.35±0.74 g/dL in female. When the Q1 group was compared to the Q4, increasing quartile of Hb was associated with the presence of significant carotid plaque (plaque score ≥3) in male (adjusted odds ratio [OR], 1.538; 95% confidence interval [CI], 1.182-2.001; p=0.001) and female (adjusted OR, 1.749; 95% CI, 1.058-2.676; p=0.01). Conclusion A high Hb level is associated with an increased risk of carotid plaques in individuals without history of CVD. This finding may support the need for early screening of CVD in individuals with high Hb levels.
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Affiliation(s)
- Seong Soon Kwon
- Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Seug Yun Yoon
- Division of Hematology & Medical Oncology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Kyoung-Ha Kim
- Division of Hematology & Medical Oncology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Byoung-Won Park
- Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Min-Ho Lee
- Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Hyoungnae Kim
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Duk Won Bang
- Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
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O'Neill C, O'Connell C. Idiopathic erythrocytosis: A diagnostic and management challenge with emerging areas for exploration. Br J Haematol 2024; 204:774-783. [PMID: 38262687 DOI: 10.1111/bjh.19287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/18/2023] [Accepted: 12/22/2023] [Indexed: 01/25/2024]
Abstract
Despite published algorithms for approaching the work-up of erythrocytosis, a significant proportion of patients are left with uncertainty as to its aetiology and prognosis. The term 'idiopathic erythrocytosis' (IE) is applied when known primary and secondary aetiologies have been ruled out. However, the assignment of secondary aetiologies is not always straightforward or evidence based, which can lead to misdiagnosis and heterogeneity in cohort studies. Furthermore, new studies have identified germline or somatic mutations that may affect prognosis. Epidemiological and cohort data are inconsistent as to whether IE increases the risk for complications such as arterial and venous thromboembolism, clonal transformation or comorbid conditions. Randomized trials assessing the role of phlebotomy for long-term management of IE have not been performed, so treatment remains a vexing problem for clinicians. Standardization of terminology and testing strategies, including comprehensive genetic screening in clinical research, are key to refining our understanding of IE.
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Affiliation(s)
- Caitlin O'Neill
- Jane Anne Nohl Division of Hematology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Casey O'Connell
- Jane Anne Nohl Division of Hematology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Choudhary MK, Bouquin H, Hytönen J, Koskela JK, Niemelä O, Nevalainen PI, Mustonen J, Pörsti I. Blood Haemoglobin Concentration Is Directly and Independently Related with Pulse Wave Velocity, a Measure of Large Artery Stiffness. J Clin Med 2023; 12:7623. [PMID: 38137695 PMCID: PMC10743951 DOI: 10.3390/jcm12247623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/20/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
High haemoglobin level has been associated with metabolic syndrome, elevated blood pressure (BP), and increased mortality risk. In this cross-sectional study, we investigated the association of blood haemoglobin with haemodynamics in 743 subjects, using whole-body impedance cardiography and pulse wave analysis. The participants were allocated to sex-stratified haemoglobin tertiles with mean values 135, 144, and 154 g/L, respectively. The mean age was similar in all tertiles, while body mass index was higher in the highest versus the lowest haemoglobin tertile. The highest haemoglobin tertile had the highest erythrocyte and leukocyte counts, plasma C-reactive protein, uric acid, renin activity, and aldosterone. The lipid profile was less favourable and insulin sensitivity lower in the highest versus the lowest haemoglobin tertile. Aortic BP, cardiac output, and systemic vascular resistance were similar in all tertiles, while the pulse wave velocity (PWV) was higher in the highest versus the lowest haemoglobin tertile. In linear regression analysis, age (Beta 0.478), mean aortic BP (Beta 0.178), uric acid (Beta 0.150), heart rate (Beta 0.148), and aldosterone-to-renin ratio (Beta 0.123) had the strongest associations with PWV (p < 0.001 for all). Additionally, haemoglobin concentration was an explanatory factory for PWV (Beta 0.070, p = 0.028). To conclude, blood haemoglobin concentration had a small direct and independent association with a measure of large artery stiffness.
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Affiliation(s)
- Manoj Kumar Choudhary
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
| | - Heidi Bouquin
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
| | - Jere Hytönen
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
| | - Jenni K. Koskela
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland;
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital, 60220 Seinäjoki, Finland;
| | - Pasi I. Nevalainen
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland;
| | - Jukka Mustonen
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland;
| | - Ilkka Pörsti
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland;
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Ha LX, Du YD, Qu XX, Wang JJ. Correlation Between Hemoglobin Levels and Polycystic Ovary Syndrome Metabolic Disorder. Diabetes Metab Syndr Obes 2023; 16:3019-3027. [PMID: 37794898 PMCID: PMC10545805 DOI: 10.2147/dmso.s430120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/14/2023] [Indexed: 10/06/2023] Open
Abstract
Objective The purpose of this study was to explore the relationship between hemoglobin levels and metabolic disorders in patients with PCOS. Methods A total of 573 patients were selected, based on the hemoglobin level; 342 patients with PCOS were divided into two groups as follows: Group A (normal Hb group, n = 269) and Group B (high Hb group, n = 73); 231 non-PCOS patients were divided into two groups as follows: Group C (normal Hb group, n = 199), and Group D (high Hb group, n = 32). The general information, glucose and lipid metabolism indicators, and uric acid levels of all patients were compiled for data analysis. Results (1) Hb, HGB concentration in mean red blood cells and RDW in PCOS patients were higher than those in non-PCOS patients, and MCV was lower than that in non-PCOS patients (P < 0.05); (2) Compared with Group A, patients in Group B had higher BMI, Hb, 2-hPG, FINS, 2-hINS, HOMA-IR, LDL-C, and uric acid levels while the QUICKI was lower; in Group C, the age, FSH, HDL-C, and LDL-C were higher, and AMH, BMI, T, TG, and uric acid level were lower (P<0.05); compared with Group D, AMH, BMI, FINS, HOMA-IR, TG, uric acid level increased, while age, FSH, and QUICKI decreased in Group B; and Hb and T decreased in Group C (P<0.05); (3) Pearson's correlation analysis indicated that Hb in PCOS patients was positively correlated with BMI, FPG, 2-hPG, FINS, 2-hINS, and HOMA-IR, and negatively correlated with the QUICKI (P<0.05); (4) Multi-factor logistic regression analysis suggested that the high Hb level in PCOS patients was an independent risk factor of IR (P<0.05). Conclusion Hb level in patients with PCOS was associated with BMI and glucose metabolism indicators; a high Hb level may be an independent risk factor for IR.
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Affiliation(s)
- Ling-Xia Ha
- Reproductive Medicine Center, General Hospital of Ningxia Medical University, Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education, Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China
| | - Yu-Dong Du
- Ningxia Medical University, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China
- Department of Reproductive Medicine, Luoyang Maternal and Child Health Hospital, Luoyang, Henan, 471000, People’s Republic of China
| | - Xiao-Xiao Qu
- Ningxia Medical University, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China
| | - Jin-Juan Wang
- Ningxia Medical University, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China
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Ou H, Kawaguchi S, Sonomura K, Kawaguchi T, Kitada S, Yoshiji S, Brial F, Gauguier D, Xia J, Matsuda F. A phenome-wide association study (PheWAS) to identify the health impacts of 4-cresol sulfate in the Nagahama Study. Sci Rep 2023; 13:13926. [PMID: 37626071 PMCID: PMC10457396 DOI: 10.1038/s41598-023-40697-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Gut-microbiota derived metabolites are important regulators of host biology and metabolism. To understand the impacts of the microbial metabolite 4-cresol sulfate (4-CS) on four chronic diseases [type 2 diabetes mellitus, metabolic syndrome (MetS), non-alcoholic fatty liver disease, and chronic kidney disease (CKD)], we conducted association analyses of plasma 4-CS quantified by liquid chromatography coupled to mass spectrometry (LC-MS) in 3641 participants of the Nagahama study. Our results validated the elevation of 4-CS in CKD and identified a reducing trend in MetS. To delineate the holistic effects of 4-CS, we performed a phenome-wide association analysis (PheWAS) with 937 intermediate biological and behavioral traits. We detected associations between 4-CS and 39 phenotypes related to blood pressure regulation, hepatic and renal functions, hematology, sleep quality, intraocular pressure, ion regulation, ketone and fatty acid metabolisms, disease history and dietary habits. Among them, 19 PheWAS significant traits, including fatty acids and 14 blood pressure indices, were correlated with MetS, suggesting that 4-CS is a potential biomarker for MetS. Consistent associations of this gut microbial-derived metabolite on multiple endophenotypes underlying distinct etiopathogenesis support its role in the overall host health, with prospects of probiotic-based therapeutic solutions in chronic diseases.
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Affiliation(s)
- Huiting Ou
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
- Department of Human Genetics, McGill University, Montreal, QC, H3A 0C7, Canada
| | - Shuji Kawaguchi
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Kazuhiro Sonomura
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
- Life Science Research Center, Technology Research Laboratory, Shimadzu Corporation, Kyoto, 604-8511, Japan
| | - Takahisa Kawaguchi
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Seri Kitada
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Satoshi Yoshiji
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
- Department of Human Genetics, McGill University, Montreal, QC, H3A 0C7, Canada
| | - François Brial
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Dominique Gauguier
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
- Department of Human Genetics, McGill University, Montreal, QC, H3A 0C7, Canada
- University Paris Cité, INSERM UMR1124, 45 rue des Saints Peres, 75006, Paris, France
| | - Jianguo Xia
- Department of Human Genetics, McGill University, Montreal, QC, H3A 0C7, Canada
- Institute of Parasitology, McGill University, Montreal, QC, H9X 3V9, Canada
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan.
- Department of Human Genetics, McGill University, Montreal, QC, H3A 0C7, Canada.
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Wu N, Feng M, Zhao H, Tang N, Xiong Y, Shi X, Li D, Song H, You S, Wang J, Zhang L, Ji G, Liu B. A bidirectional link between metabolic syndrome and elevation in alanine aminotransferase in elderly female: a longitudinal community study. Front Cardiovasc Med 2023; 10:1156123. [PMID: 37408651 PMCID: PMC10318155 DOI: 10.3389/fcvm.2023.1156123] [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: 02/01/2023] [Accepted: 05/31/2023] [Indexed: 07/07/2023] Open
Abstract
Pre-obesity, as a significant risk factor for the progression of metabolic syndrome (MS), has become a prevalent public health threat globally. In this three-year longitudinal study of pre-obese women at baseline, the goal was to clarify the female-specific bidirectional relationship between the risk of MS and blood alanine aminotransferase. In this manuscript, the MS score was determined using the following equation: MS score = 2*waist/height + fasting glucose/5.6 + TG/1.7 + SBP/130-HDL/1.02 for men and 1.28 for women, which is highly related to the risk of MS. With 2,338 participants, a hierarchical nonlinear model with random effects was utilized to analyze the temporal trends of serum characteristics from 2017 to 2019. A bivariate cross-lagged panel model (CLPM) was employed to estimate the structural relations of frequently measured variables at three different time points to determine the directionality of the relationship between the risk of MS and serum characteristics. MassARRAY Analyzer 4 platforms were used to evaluate and genotype candidate SNPs. In this study, the MS score only rose with age in females; it was positively correlated with serum alanine aminotransferase (ALT) in females; the CLPM revealed that the MS score in 2017 predicted ALT in 2018 (β = 0.066, p < 0.001); and ALT in 2018 predicted an MS score in 2019 (β = 0.037, p < 0.050); both relationships were seen in females. Additionally, the MS score in elderly females with NAFLD was related to the rs295 in the lipoprotein lipase (LPL) gene (p = 0.042). Our work showed that there may be female-specific causal correlations between elevated ALT and risk of MS and that the polymorphism rs295 in LPL may serve as a marker for the prognosis of MS. The genetic roles of rs295 in the LPL gene in the onset of MS and the development of ALT in the elderly Chinese Han population are thus provided by this, offering one potential mechanism.
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Affiliation(s)
- Na Wu
- Shanghai Innovation Center of Traditional Chinese Medicine Health Service, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mofan Feng
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, Shanghai, China
| | - Hanhua Zhao
- Department of Sport Science, College of Education, Zhejiang University, Hangzhou, China
| | - Nan Tang
- Shanghai Innovation Center of Traditional Chinese Medicine Health Service, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yalan Xiong
- Shanghai Innovation Center of Traditional Chinese Medicine Health Service, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xinyu Shi
- Shanghai Innovation Center of Traditional Chinese Medicine Health Service, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Dong Li
- Zhangjiang Community Health Service Center of Pudong New District, Shanghai, China
| | - Hualing Song
- Shanghai Innovation Center of Traditional Chinese Medicine Health Service, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shengfu You
- Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jianying Wang
- Shanghai Innovation Center of Traditional Chinese Medicine Health Service, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lei Zhang
- Shanghai Innovation Center of Traditional Chinese Medicine Health Service, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guang Ji
- Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Baocheng Liu
- Shanghai Innovation Center of Traditional Chinese Medicine Health Service, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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11
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Lu LH, Tsai CC, Lin CY, Wang CW, Wu PY, Huang JC, Chen SC, Chang JM. Association and Interaction between Heavy Metals and Hyperuricemia in a Taiwanese Population. Diagnostics (Basel) 2023; 13:diagnostics13101741. [PMID: 37238228 DOI: 10.3390/diagnostics13101741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/05/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
The prevalence of hyperuricemia in Taiwan is high, and hyperuricemia has been associated with a risk of developing several diseases. Although the traditional risk factors for hyperuricemia are well known, the relationship between heavy metals and hyperuricemia is still undefined. Therefore, the aim of this study was to investigate the relationship between hyperuricemia and heavy metals. A total of 2447 participants (977 males and 1470 females) residing in southern Taiwan were enrolled, and levels of the following heavy metals were measured: lead in blood, and nickel, chromium, manganese, arsenic (As), copper, and cadmium in urine. Hyperuricemia was defined as a serum uric acid level greater than 7.0 mg/dL (416.5 μmol/L) in men and 6.0 mg/dL (357 μmol/L) in women. The participants were divided into two groups: those without hyperuricemia (n = 1821; 74.4%) and those with hyperuricemia (n = 626; 25.6%). Multivariate analysis showed that only high urine As (log per 1 μg/g creatinine; odds ratio, 1.965; 95% confidence interval, 1.449 to 2.664; p < 0.001), young age, male sex, high body mass index, high hemoglobin, high triglycerides, and low estimated glomerular filtration rate were significantly associated with hyperuricemia. In addition, the interactions between Pb × Cd (p = 0.010), Ni × Cu (p = 0.002), and Cr × Cd (p = 0.001) on hyperuricemia were statistically significant. Increasing levels of Pb and Cr yielded an increased prevalence of hyperuricemia, and the effect was progressively greater for increasing Cd. Moreover, increasing levels of Ni yielded an increased prevalence of hyperuricemia, and the effect was progressively greater for increasing Cu. In conclusion, our results show that high urine As is associated with hyperuricemia, and some interactions of heavy metals on hyperuricemia are noted. We also found that young age, male sex, high BMI, high hemoglobin, high triglycerides, and low eGFR were significantly associated with hyperuricemia.
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Affiliation(s)
- Lu-Heng Lu
- Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Chun-Chi Tsai
- Department of Occupational Safety and Health, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
| | - Chih-Yi Lin
- Department of Environmental and Occupational Medical Center, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
| | - Chih-Wen Wang
- Department of Environmental and Occupational Medical Center, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
- Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Pei-Yu Wu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Jiun-Chi Huang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Jer-Ming Chang
- Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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12
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Li N, Liu C, Luo Q, Zhang F, Sheng D, Liu Z. Correlation of White Blood Cell, Neutrophils, and Hemoglobin with Metabolic Syndrome and Its Components. Diabetes Metab Syndr Obes 2023; 16:1347-1355. [PMID: 37197062 PMCID: PMC10183630 DOI: 10.2147/dmso.s408081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/29/2023] [Indexed: 05/19/2023] Open
Abstract
Background Metabolic syndrome (MetS) is a global health problem. White blood cell (WBC), neutrophils and neutrophil-to-lymphocyte ratio (NLR) are valid indicators involved in acute and chronic inflammation. The aims of our study were to analyze the correlation and severity of these indicators with MetS and its components, and explore the diagnostic value of their combined tests for MetS. Methods A total of 7726 subjects were recruited, and laboratory biomarkers were collected. The differences of indicators between MetS group and non-MetS group were analyzed. The linear trend between each indicator and the increasing number of metabolic disorders was analyzed using trend variance test. The correlation between each indicator and MetS with its components was analyzed by logistic regression. Results The levels of WBC, neutrophil, and hemoglobin grew significantly in the MetS group compared to non-MetS group, and gradually increased with the increased number of MetS disorders. Logistic regression analysis indicated significant correlations between WBC, neutrophils, and hemoglobin with MetS and its components. ROC curve analysis showed WBC, neutrophils, and hemoglobin served as good predictors for MetS, especially in adults aged under 40. Conclusion Our study indicated that WBC, neutrophils, and hemoglobin are efficient indicators for predicting MetS and evaluate its severity.
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Affiliation(s)
- Nan Li
- Health Management Center, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Chenbing Liu
- Health Management Center, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Qian Luo
- Health Management Center, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Feng Zhang
- Health Management Center, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Di Sheng
- Health Management Center, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Zhong Liu
- Health Management Center, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Correspondence: Zhong Liu, The First Affiliated Hospital of Zhejiang University School of Medicine, No. 79 Qingchun Road, Shangcheng District, Hangzhou, Zhejiang, People’s Republic of China, Tel +8613957104885, Email
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13
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Zhang B, Wei Z, Gu C, Yao Y, Xue J, Zhu H, Kannan K, Sun H, Zhang T. First Evidence of Prenatal Exposure to Emerging Poly- and Perfluoroalkyl Substances Associated with E-Waste Dismantling: Chemical Structure-Based Placental Transfer and Health Risks. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:17108-17118. [PMID: 36399367 DOI: 10.1021/acs.est.2c05925] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Limited information is available about prenatal exposure to per- and polyfluoroalkyl substances (PFAS) in electronic waste (e-waste) recycling sites. In this study, we determined 21 emerging PFAS and 13 legacy PFAS in 94 paired maternal and cord serum samples collected from an e-waste dismantling site in Southern China. We found 6:2 fluorotelomer sulfonate (6:2 FTSA), 6:2 chlorinated polyfluorinated ether sulfonate (6:2 Cl-PFESA), and perfluorooctanephosphonate (PFOPA) as the major emerging PFAS, regardless of matrices, at median concentrations of 2.40, 1.78, and 0.69 ng/mL, respectively, in maternal serum samples, and 2.30, 0.73, and 0.72 ng/mL, respectively, in cord serum samples. Our results provide evidence that e-waste dismantling activities contribute to human exposure to 6:2 FTSA, 6:2 Cl-PFESA, and PFOPA. The trans-placental transfer efficiencies of emerging PFAS (0.42-0.94) were higher than that of perfluorooctanesulfonic acid (0.37) and were structure-dependent. The substitution of fluorine with chlorine or hydrogen and/or hydrophilic functional groups may alter trans-placental transfer efficiencies. Multiple linear regression analysis indicated significant associations between maternal serum concentrations of emerging PFAS and maternal clinical parameters, especially liver function and erythrocyte-related biomarkers. This study provides new insights into prenatal exposure to multiple PFAS in e-waste dismantling areas and the prevalence of emerging PFAS in people living near the sites.
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Affiliation(s)
- Bo Zhang
- School of Environmental Science and Engineering, Sun Yat-Sen University, Guangzhou 510275, China
| | - Ziyang Wei
- School of Environmental Science and Engineering, Sun Yat-Sen University, Guangzhou 510275, China
| | - Cheng Gu
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, Jiangsu, China
| | - Yiming Yao
- MOE Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China
| | - Jingchuan Xue
- Key Laboratory for City Cluster Environmental Safety and Green Development of the Ministry of Education, School of Ecology, Environment and Resources, Guangdong University of Technology, Guangzhou 510006, China
| | - Hongkai Zhu
- MOE Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China
| | - Kurunthachalam Kannan
- Department of Pediatrics, New York University School of Medicine, New York, New York 10016, United States
| | - Hongwen Sun
- MOE Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China
| | - Tao Zhang
- School of Environmental Science and Engineering, Sun Yat-Sen University, Guangzhou 510275, China
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14
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Association between metabolic syndrome and uric acid: a systematic review and meta-analysis. Sci Rep 2022; 12:18412. [PMID: 36319728 PMCID: PMC9626571 DOI: 10.1038/s41598-022-22025-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 10/07/2022] [Indexed: 01/01/2023] Open
Abstract
This systematic review and meta-analysis aim to provide the best evidence on the association between metabolic syndrome (MetS) and uric acid (UA) by determining the size of the effect of this biomarker on MetS. The review protocol is registered with PROSPERO (CRD42021231124). The search covered the PubMed and Scopus databases. Methodological quality was assessed with the STROBE tool, overall risk of bias with RevMan (Cochrane Collaboration) and quality of evidence with Grade Pro. Initially, 1582 articles were identified. Then, after excluding duplicates and reviewing titles and abstracts, 1529 articles were excluded from applying the eligibility criteria. We included 43 papers (56 groups) comparing UA concentrations between subjects 91,845 with MetS and 259,931 controls. Subjects with MetS had a higher mean UA of 0.57 mg/dl (95% CI 0.54-0.61) (p < 0.00001). Given the heterogeneity of the included studies, the researchers decided to perform subgroups analysis. Men with MetS have a higher UA concentration mg/dl 0.53 (95% CI 0.45-0.62, p < 0.00001) and women with MetS 0.57 (95% CI 0.48-0.66, p < 0.00001) compared to subjects without MetS. Assessment of UA concentration could provide a new avenue for early diagnosis of MetS, as a new biomarker and the possibility of new therapeutic targets.
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15
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Positive or U-Shaped Association of Elevated Hemoglobin Concentration Levels with Metabolic Syndrome and Metabolic Components: Findings from Taiwan Biobank and UK Biobank. Nutrients 2022; 14:nu14194007. [PMID: 36235661 PMCID: PMC9572591 DOI: 10.3390/nu14194007] [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: 08/10/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/17/2022] Open
Abstract
Iron overnutrition has been implicated with a higher risk of developing metabolic and cardiovascular diseases, including metabolic syndrome (MetS), whereas iron deficiency anemia exacerbates many underlying chronic conditions. Hemoglobin (Hb) concentration in the blood, which reflects a major functional iron (i.e., heme iron) in the body, may serve as a surrogate of the nutritional status of iron. We conducted sex-specific observational association studies in which we carefully titrated the association between Hb deciles and MetS and its components among the Taiwanese Han Chinese (HC) from the Taiwan Biobank and Europeans of White ancestry from the UK Biobank, representing two large ethnicities. Our data show that at higher-than-normal levels of Hb, increasing deciles of Hb concentration were significantly associated with MetS across all sex subgroups in both ethnicities, with the highest deciles resulting in up to three times greater risk than the reference group [Taiwanese HC: OR = 3.17 (95% CI, 2.75-3.67) for Hb ≥ 16.5 g/dL in men, OR = 3.11 (2.78-3.47) for Hb ≥ 14.5 g/dL in women; European Whites: OR = 1.89 (1.80-1.98) for Hb ≥ 16.24 g/dL in men, OR = 2.35 (2.24-2.47) for Hb ≥ 14.68 g/dL in women]. The association between stronger risks and increasing Hb deciles was similarly observed with all metabolic components except diabetes. Here we found that both the highest Hb decile groups and contrarily the lowest ones, with respect to the reference, were associated with higher odds of diabetes in both ethnic groups [e.g., Taiwanese HC men: OR = 1.64 (1.33-2.02) for Hb ≥ 16.5 g/dL, OR = 1.71 (1.39-2.10) for Hb ≤ 13.5 g/dL; European Whites women: OR = 1.39 (1.26-1.45) for Hb ≥ 14.68 g/dL, OR = 1.81 (1.63-2.01) for Hb ≤ 12.39 g/dL]. These findings confirm that elevated Hb concentrations, a potential indicator of iron overnutrition, may play a role in the pathophysiology of MetS and metabolic components.
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16
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Kim T, Choi H, Lee SM. Parametric and non-parametric estimation of reference intervals for routine laboratory tests: an analysis of health check-up data for 260 889 young men in the South Korean military. BMJ Open 2022; 12:e062617. [PMID: 35879016 PMCID: PMC9328105 DOI: 10.1136/bmjopen-2022-062617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/04/2022] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Determination of reference intervals (RIs) using big data faces several obstacles due to heterogeneity in analysers, period and ethnicity. The present study aimed to establish the RIs for routine common blood count (CBC) and biochemistry laboratory tests in homogeneous, healthy, male Korean soldiers in their 20s using a large health check-up data set, comparing parametric and non-parametric estimation. DESIGN A multicentre, cross-sectional study. SETTING Seven armed forces hospitals in South Korea. PARTICIPANTS A total of 609 649 men underwent health examination when promoted to corporal between January 2015 and September 2021. 260 889 eligible individuals aged 20-25 were included in the analysis. MAIN OUTCOMES AND MEASURES The RIs were established by parametric and non-parametric methods. In the parametric approach, maximum likelihood estimation was applied to measure the Box-Cox transformation parameter and the values at the 2.5th and 97.5th percentiles were recalculated. The non-parametric approach adopted the Tukey's exclusion test and the values at the 2.5th and 97.5th percentiles were obtained. Classification by body mass index was also performed. RESULTS The obtained RIs for haematology parameters were comparable between devices. If the values followed a Gaussian distribution, parametric and non-parametric methods were well matched for haematology and biochemical markers. When the values were right-skewed, the upper limits were higher with parametric than with non-parametric methods. Participants with obesity showed higher RIs for CBC, some liver function tests and some lipid profiles than participants without obesity. CONCLUSIONS Using data from healthy, male Korean soldiers in their 20s, we proposed the RIs for CBC and biochemical parameters, comparing parametric and non-parametric estimation. As such approaches based on large data sets become more prevalent, further studies are needed to discriminate eligible individuals and determine RIs in an extrapolated sample.
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Affiliation(s)
- Taeyun Kim
- Internal Medicine, The Armed Forces Goyang Hospital, Goyang, Republic of Korea
| | - Hyunji Choi
- Laboratory Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Gyeongnam, Republic of Korea
| | - Sun Min Lee
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Gyeongnam, Republic of Korea
- Laboratory Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
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17
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Cakmak S, Lukina A, Karthikeyan S, Atlas E, Dales R. The association between blood PFAS concentrations and clinical biochemical measures of organ function and metabolism in participants of the Canadian Health Measures Survey (CHMS). THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 827:153900. [PMID: 35218824 DOI: 10.1016/j.scitotenv.2022.153900] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 02/08/2022] [Accepted: 02/11/2022] [Indexed: 05/26/2023]
Abstract
Per- and poly-fluoroalkyl substances (PFAS) are ubiquitous and may persist in human tissue for several years. Only a small proportion of PFAS have been studied for human health effects. We tested the association between human blood levels of six PFAS and several clinical measures of organ and metabolic function in a nationally representative sample of 6768 participants aged 3-79 years old who participated in the Canadian Health Measures Survey. Cross-sectional associations were assessed by generalized linear mixed models incorporating survey-specific sampling weights. An increase in perfluorooctanoic acid (PFOA) equivalent to the magnitude of its geometric mean (GM) of 2.0 μg/L was associated with percentage (95% CI) increases in serum enzymes reflecting liver function: aspartate aminotransferase (AST) 3.7 (1.1, 6.4), gamma-glutamyl transferase (GGT) 11.8 (2.5, 21.8), alanine aminotransferase (ALT) 3.2 (0.5, 5.9), and bilirubin 3.6 (2.7, 4.5). A GM increase in perfluorodecanoic acid (PFDA) of 0.2 μg/L was positively associated with percentage increases in GGT, triglycerides, low-density lipoprotein (LDL) cholesterol, total cholesterol, and calcium with respective increases of 15.5 (2.2, 30.4), 7.0 (1.0, 13.2), 10.7 (5.5, 16.1), 2.8 (0.2, 5.3), and 0.8 (0.3, 1.3). PFOA, perfluorooctane sulfonate (PFOS), PFDA and perfluorononanoic acid (PFNA) were positively associated with GGT. All six congeners were positively associated with at least one biomarker of lipid metabolism, and 5 of 6, PFOA, PFOS, PFDA, perfluorohexane sulfonate (PFHxS) and PFNA were positively associated with serum calcium. Exposure to selected PFAS is associated with clinical blood tests reflecting metabolism and the function of several organ systems. These relatively small changes may possibly indicate early pathology that is clinically inapparent and may possibly be of significance in a general population or in individuals exposed to very high levels of PFAS.
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Affiliation(s)
- Sabit Cakmak
- Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Anna Lukina
- Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Subramanian Karthikeyan
- Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Ella Atlas
- Hazard Identification Division, Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Robert Dales
- Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada; University of Ottawa and Ottawa Hospital Research Institute, Canada.
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18
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Kimura LF, Sant'Anna MB, Andrade SA, Ebram MC, Lima CFG, Celano RMG, Viégas RFM, Picolo G. COVID-19 induces proatherogenic alterations in moderate to severe non-comorbid patients: A single-center observational study. Blood Cells Mol Dis 2021; 92:102604. [PMID: 34517295 PMCID: PMC8426321 DOI: 10.1016/j.bcmd.2021.102604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 12/23/2022]
Abstract
Patients with COVID-19 can be asymptomatic or present mild to severe symptoms, leading to respiratory and cardiovascular complications and death. Type 2 diabetes mellitus (T2DM) and obesity are considered risk factors for COVID-19 poor prognosis. In parallel, COVID-19 severe patients exhibit dyslipidemia and alterations in neutrophil to lymphocyte ratio (NLR) associated with disease severity and mortality. To investigate whether such alterations are caused by the infection or results from preexisting comorbidities, this work analyzed dyslipidemia and the hemogram profile of COVID-19 patients according to the severity and compared with patients without T2DM or obesity comorbidities. Dyslipidemia, with a marked decrease in HDL levels, and increased NLR accompanied the disease severity, even in non-T2DM and non-obese patients, indicating that COVID-19 causes the observed alterations. Because decreased hemoglobin is involved in COVID-19 severity, and hemoglobin concentration is associated with metabolic diseases, the erythrogram of patients was also evaluated. We verified a drop in hemoglobin and erythrocyte number in severe patients, independently of T2DM and obesity, which may explain in part the need for artificial ventilation in severe cases. Thus, the control of such parameters (especially HDL levels, NLR, and hemoglobin concentration) could be a good strategy to prevent COVID-19 complications and death.
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Affiliation(s)
- Louise F Kimura
- Laboratory of Pain and Signaling, Butantan Institute, Avenida Vital Brazil 1500, São Paulo, SP 05503-900, Brazil.
| | - Morena B Sant'Anna
- Laboratory of Pain and Signaling, Butantan Institute, Avenida Vital Brazil 1500, São Paulo, SP 05503-900, Brazil.
| | - Sonia A Andrade
- Laboratory of Pain and Signaling, Butantan Institute, Avenida Vital Brazil 1500, São Paulo, SP 05503-900, Brazil.
| | - Matteo C Ebram
- Laboratory of Pain and Signaling, Butantan Institute, Avenida Vital Brazil 1500, São Paulo, SP 05503-900, Brazil.
| | - Cristiane F G Lima
- Laboratory of Pain and Signaling, Butantan Institute, Avenida Vital Brazil 1500, São Paulo, SP 05503-900, Brazil.
| | - Rosa M G Celano
- University of Taubaté (UNITAU), Rua Quatro de Março, 432, Taubaté, SP 12020-270, Brazil.
| | - Ruy F M Viégas
- University of Taubaté (UNITAU), Rua Quatro de Março, 432, Taubaté, SP 12020-270, Brazil.
| | - Gisele Picolo
- Laboratory of Pain and Signaling, Butantan Institute, Avenida Vital Brazil 1500, São Paulo, SP 05503-900, Brazil.
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