1
|
Zeng Y, Cao S, Yang H. Circulating sex hormone-binding globulin levels and ischemic stroke risk: a Mendelian randomization study. Postgrad Med J 2023; 99:1272-1279. [PMID: 37742091 DOI: 10.1093/postmj/qgad083] [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: 07/07/2023] [Revised: 08/07/2023] [Accepted: 09/01/2023] [Indexed: 09/25/2023]
Abstract
PURPOSE Previous studies have presented conflicting findings regarding the protective effects of circulating sex hormone-binding globulin (SHBG) on ischemic stroke (IS). This study aimed to assess the causal effect of SHBG on IS using Mendelian randomization (MR) analysis and to identify potential mediators. METHODS First, the causal effect of SHBG on any IS (AIS), cardioembolic stroke (CES), large artery stroke (LAS), and small vessel stroke (SVS) was assessed by inverse variance weighed (IVW) method. Two additional MR methods (weighted median and MR-Egger) were used to supplement the IVW results. Subsequently, a two-step MR was further performed to assess whether three glycemic profiles [fasting glucose, fasting insulin, and glycated hemoglobin (HbA1c)] and five lipid profiles (high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, non-HDL cholesterol, total cholesterol, and triglycerides) mediated the causal effect. Furthermore, Cochrane's Q test, MR-Egger intercept test, MR-PRESSO global test, and leave-one-out analysis were performed for sensitivity analyses. RESULTS The IVW results showed that SHBG significantly reduced SVS risk (odds ratio= 0.60, 95% confidence interval: 0.47-0.77, P = 4.60E-05). The weighted median and MR-Egger results were parallel to IVW. However, no significant associations were found between SHBG and AIS, CES, and LAS. Mediation analysis indicated that HbA1c may be involved in SHBG reducing SVS risk. Sensitivity tests demonstrated the reliability of causal estimates. CONCLUSIONS Circulating SHBG levels may decrease SVS risk by lowering HbA1c levels. Therefore, individuals with low circulating SHBG levels should focus on glycemic control to reduce future SVS risk.
Collapse
Affiliation(s)
- Youjie Zeng
- Department of Anesthesiology, Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China
| | - Si Cao
- Department of Anesthesiology, Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China
| | - Heng Yang
- Department of Neurology, Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China
| |
Collapse
|
2
|
Alshuweishi Y, Basudan AM, Alfaifi M, Daghistani H, Alfhili MA. Association of the HALP Score with Dyslipidemia: A Large, Nationwide Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2002. [PMID: 38004051 PMCID: PMC10673399 DOI: 10.3390/medicina59112002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Dyslipidemia is a major risk factor for cardiovascular disease (CVD). The identification of new biomarkers that may enhance the risk assessment of lipid abnormalities is a promising approach in improving risk prediction of CVD. There is no information on the association of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score with dyslipidemia. The aim of this study was to investigate the clinical utility of the HALP score in light of dyslipidemia. Materials and Methods: A retrospective analysis of 7192 subjects was initiated to assess the association between the HALP score and disturbed lipid markers. Medians were compared by Mann-Whitney U or Kruskal-Wallis tests and the diagnostic performance and risk assessment were calculated. Results: Median HALP score among all subjects was 53.3, with varying values between males and females. Notably, median HALP was significantly elevated in all forms of dyslipidemia and among males and females irrespective of age. The odds of having elevated HALP score values were significantly higher in all lipid abnormalities. Moreover, HALP score was significantly yet weakly correlated with lipid markers, while the highest diagnostic accuracy of the HALP score was observed with an elevated ratio of total cholesterol to high-density lipoprotein (TC/HDL) (area under the curve, AUC = 0.6411, p < 0.0001). The decision curve analysis (DCA) showed that the HALP score can reliably predict the presence of dyslipidemia. Conclusions: This study demonstrates that the HALP score is a novel, cost-effective index that is associated with a disturbed lipid profile. Further investigation of the nature of this association is needed.
Collapse
Affiliation(s)
- Yazeed Alshuweishi
- Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia; (Y.A.)
| | - Ahmed M. Basudan
- Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia; (Y.A.)
| | - Mohammed Alfaifi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Hussam Daghistani
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Department of Clinical Pathology, Al Borg Diagnostics, Jeddah 23437, Saudi Arabia
| | - Mohammad A. Alfhili
- Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia; (Y.A.)
| |
Collapse
|
3
|
Colineaux H, Neufcourt L, Delpierre C, Kelly-Irving M, Lepage B. Explaining biological differences between men and women by gendered mechanisms. Emerg Themes Epidemiol 2023; 20:2. [PMID: 36959612 PMCID: PMC10037796 DOI: 10.1186/s12982-023-00121-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/13/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND The principal aim of this study was to explore if biological differences between men and women can be explained by gendered mechanisms. METHODS We used data from the 1958 National Child Development Study, including all the living subjects of the cohort at the outcome collection wave (44-45 years). We explored several biomarkers as outcomes: systolic blood pressure, triglycerides, LDL cholesterol, HbA1c, CRP, and cortisol. Three conceptualizations of gender have been used to define methodological strategies: (a) Gender as an individual characteristic; (b) Gender as an effect of sex on socio-behavioural characteristics; (c) Gender as an interaction between sex and the social environment, here the early-life social environment. We estimated the total effect of sex and the proportion of total effect of sex at birth eliminated by gender, measured by 3 different ways according to these 3 concepts, using g-computation. RESULTS The average level of each biomarker was significantly different according to sex at birth, higher in men for cardiometabolic biomarkers and higher in women for inflammatory and neuroendocrine biomarkers. The sizes of the differences were always smaller than one standard deviation but were larger than differences due to early-life deprivation, except for CRP. We observed gender mechanisms underlying these differences between men and women, even if the mediation effects were rarely statistically significant. These mechanisms were of three kinds: (1) mediation by socio-behavioural characteristics; (2) attenuation by gendered mechanisms; (3) interaction with early social environment. Indeed, we observed that being born into a deprived rather than non-deprived family increased metabolic and inflammatory biomarkers levels more strongly in females than in males. CONCLUSIONS The biological differences between men and women seem to not be purely explained by biological mechanisms. The exploration of gender mechanisms opens new perspectives, in terms of methodology, understanding and potential applications.
Collapse
Affiliation(s)
- Hélène Colineaux
- EQUITY Team, CERPOP, INSERM, 37 Allees Jules Guesde, 31062, Toulouse, France.
| | - Lola Neufcourt
- EQUITY Team, CERPOP, INSERM, 37 Allees Jules Guesde, 31062, Toulouse, France
| | - Cyrille Delpierre
- EQUITY Team, CERPOP, INSERM, 37 Allees Jules Guesde, 31062, Toulouse, France
| | | | - Benoit Lepage
- EQUITY Team, CERPOP, INSERM, 37 Allees Jules Guesde, 31062, Toulouse, France
- Epidemiology Department, CHU Toulouse, 37 Allees Jules Guesde, 31062, Toulouse, France
- Biostatistic Department, Toulouse III University, 37 Allees Jules Guesde, 31062, Toulouse, France
| |
Collapse
|
4
|
Portes J, Bullón B, Gallardo I, Fernandez-Riejos P, Quiles JL, Giampieri F, Bullón P. Prevalence of undiagnosed diabetes and prediabetes related to periodontitis and its risk factors in elderly individuals. J Dent 2023; 132:104480. [PMID: 36948381 DOI: 10.1016/j.jdent.2023.104480] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 03/24/2023] Open
Abstract
OBJECTIVE The prevalence of undiagnosed diabetes was estimated to increase with age and can reach 3.5%. The purpose of the study was to evaluate the prevalence of undiagnosed diabetes and prediabetes in the elderly patients who attended a dental clinic and to find common risk factors. METHODS Male patients, older than 50 years, attended their first dental visit to the School of Dentistry for a period of two years, and it was proposed to evaluate undiagnosed type 2 diabetes mellitus. Periodontal, biochemical, microbiological examinations, nutritional profile, and physical activity were performed. RESULTS A total of 106 patients were examined, 6 (5.6%) had diabetes, and 37 (34.9%) had prediabetes without prior diagnosis. The severity of periodontitis was greater in patients with diabetes. Most of the patients were overweight and had increased systolic blood pressure. Patients with prediabetes and periodontitis had a low adherence to the Mediterranean diet. Tannerella forsythia was present in more patients with periodontitis, and the prevalence of Aggregatibacter actinomycetemcomitans is practically absent in groups with periodontitis, except for the group with diabetes. CONCLUSIONS In the population studied, the prevalence of patients without a diagnosis of diabetes and prediabetes was very high and underestimated. The increased severity of periodontitis in patients with diabetes and in conjunction with the high level of cortisol seen in patients with periodontitis, especially those with diabetes, emphasize the dysregulation of the immunoinflammatory system. CLINICAL SIGNIFICANCE It is essential to add all this data to our dental practice to cover patient health with a broader landscape.
Collapse
Affiliation(s)
- Juliana Portes
- Department of Periodontology, Dental School, University of Seville, C/Avicena, s/n, 41009 Seville, Spain; Dental School, Veiga de Almeida University, Rua Ibituruna, 108, 20271-020, Maracanã, Rio de Janeiro, Brazil
| | - Beatriz Bullón
- Department of Periodontology, Dental School, University of Seville, C/Avicena, s/n, 41009 Seville, Spain
| | - Isabel Gallardo
- Department of Periodontology, Dental School, University of Seville, C/Avicena, s/n, 41009 Seville, Spain
| | | | - Jose Luis Quiles
- Department of Physiology, Institute of Nutrition and Food Technology 'José Mataix', Center for Biomedical Research, Universidad de Granada, 18071 Armilla, Spain
| | - Francesca Giampieri
- Resarch Group on Food, Nutritional Biochemistry and Health. Univeridad Europea del Atlantico.39011 Santander, Spain
| | - Pedro Bullón
- Department of Periodontology, Dental School, University of Seville, C/Avicena, s/n, 41009 Seville, Spain.
| |
Collapse
|
5
|
Su F, Cao L, Ren X, Hu J, Tavengana G, Wu H, Zhou Y, Fu Y, Jiang M, Wen Y. Age and sex trend differences in hemoglobin levels in China: a cross-sectional study. BMC Endocr Disord 2023; 23:8. [PMID: 36624464 PMCID: PMC9827637 DOI: 10.1186/s12902-022-01218-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 11/15/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Both age and gender are the influence factors of hemoglobin concentration. However, the changing trend of hemoglobin levels between males and females with age remains unclear. This study aimed to explore their changing characteristics in different genders. METHODS A cross-sectional study was conducted in Physical Examination Center of the First Affiliated Hospital of Wannan Medical College in Wuhu, China from 2014 to 2016. The generalized linear model was applied to explore the relationship between age, gender and hemoglobin levels. RESULTS Among the 303,084 participants, the mean age for females and males was 46.9 ± 13.4(15-98) and 48.1 ± 13.7(14-98) years old, respectively. Generalized smoothing splines showed that hemoglobin levels increased up to age 25 and then decreased in men; in women the levels increased up until age 20, and then decreased, with slight increase again (β = 0.244, P < 0.01). After dividing all participants into hyperglycemia and normal groups, only the normal female group showed a significant upward trend (β = 0.257, P < 0.01) between ages 50-59. CONCLUSIONS Hemoglobin concentration changes with age and the curve is different in males and females. The slightly upward trend of female hemoglobin in the age range of 50-59 years old should be considered in developing the reference range of hemoglobin making.
Collapse
Affiliation(s)
- Fan Su
- School of Public Health, Wannan Medical College, Anhui Province, No.22, Wenchang Xi Road, Wuhu, 241002, China
| | - Lei Cao
- School of Public Health, Wannan Medical College, Anhui Province, No.22, Wenchang Xi Road, Wuhu, 241002, China
| | - Xia Ren
- School of Public Health, Wannan Medical College, Anhui Province, No.22, Wenchang Xi Road, Wuhu, 241002, China
| | - Jian Hu
- School of Public Health, Wannan Medical College, Anhui Province, No.22, Wenchang Xi Road, Wuhu, 241002, China
| | - Grace Tavengana
- School of Public Health, Wannan Medical College, Anhui Province, No.22, Wenchang Xi Road, Wuhu, 241002, China
| | - Huan Wu
- School of Laboratory Medicine, Wannan Medical College, Wuhu, Anhui Province, China
| | - Yumei Zhou
- School of Public Health, Wannan Medical College, Anhui Province, No.22, Wenchang Xi Road, Wuhu, 241002, China
| | - Yuhan Fu
- School of Public Health, Wannan Medical College, Anhui Province, No.22, Wenchang Xi Road, Wuhu, 241002, China
| | - Mingfei Jiang
- School of Clinical Medicine, Wannan Medical College, Wuhu, Anhui Province, China
| | - Yufeng Wen
- School of Public Health, Wannan Medical College, Anhui Province, No.22, Wenchang Xi Road, Wuhu, 241002, China.
| |
Collapse
|
6
|
Age-Related Sex Differences in Glucose Tolerance by 75 g Oral Glucose Tolerance Test in Japanese. Nutrients 2022; 14:nu14224868. [PMID: 36432554 PMCID: PMC9698682 DOI: 10.3390/nu14224868] [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: 10/13/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
To elucidate the age-related sex difference in glucose tolerance, we conducted 75 g oral glucose tolerance tests in 1156 participants. Participants were divided into four groups, namely, young (22−29) males, young females, middle-aged (>50) males, and middle-aged females. According to the Japanese Clinical Practice Guideline for Diabetes 2019, the prevalence of normal glucose tolerance (NGT) was significantly lower in middle-aged than in young participants. The prevalence of high-normal fasting plasma glucose (FPG) was higher, and NGT was lower in young males (high-normal FPG 15.2%, NGT 82.0%) than young females (high-FPG 3.9%, NGT 94.3%). Combined glucose intolerance (CGI) was higher and NGT was lower in middle-aged males (CGI 10.2%, NGT 25.2%) than in middle-aged females (CGI 3.3%, NGT 39.8%). FPG and body mass index (BMI) were the lowest and Homeostatic model assessment beta cell function (HOMA-β) was the highest in young females, followed by young males, middle-aged females, and middle-aged males. Multiple linear regression analysis revealed that BMI weakly correlated with HOMA-β and Matsuda index in all subjects except young females. The superior glucose tolerance in females was apparent in young, but attenuated in middle-aged females. The differences are due to the higher insulin secretion potential and lower BMI in young females.
Collapse
|
7
|
Chen F, Liu J, Hou D, Li T, Chen Y, Liao Z, Wu L. The Relationship between Fat Mass Percentage and Glucose Metabolism in Children and Adolescents: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14112272. [PMID: 35684072 PMCID: PMC9183098 DOI: 10.3390/nu14112272] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/26/2022] [Accepted: 05/26/2022] [Indexed: 12/04/2022] Open
Abstract
To assess the relationship between fat mass percentage (FMP) and glucose metabolism in children aged 0−18 years we performed a systematic review of the literature on Medline/PubMed, SinoMed, Embase and Cochrane Library using the PRISMA 2020 guidelines up to 12 October 2021 for observational studies that assessed the relationship of FMP and glucose metabolism. Twenty studies with 18,576 individuals were included in the meta-analysis. The results showed that FMP was significantly associated with fasting plasma glucose (FPG) (r = 0.08, 95% confidence interval (CI): 0.04−0.13, p < 0.001), fasting plasma insulin (INS) (r = 0.48, 95% CI: 0.37−0.57, p < 0.001), and homeostasis model assessment (HOMA)- insulin resistance (IR) (r = 0.44, 95% CI: 0.33−0.53, p < 0.001). The subgroup analysis according to country or overweight and obesity indicated that these associations remained significant between FMP and INS or HOMA-IR. Our results demonstrated that there is a positive relationship between FMP and FPG. Moreover, subgroup analysis according to country or overweight and obesity indicated that FMP is significantly associated with INS and HOMA-IR. This is the first known systematic review and meta-analysis to determine the associations of FMP with glucose metabolism in children and adolescents.
Collapse
Affiliation(s)
- Fangfang Chen
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China; (F.C.); (Y.C.)
| | - Junting Liu
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing 100020, China; (J.L.); (D.H.); (T.L.)
| | - Dongqing Hou
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing 100020, China; (J.L.); (D.H.); (T.L.)
| | - Tao Li
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing 100020, China; (J.L.); (D.H.); (T.L.)
| | - Yiren Chen
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China; (F.C.); (Y.C.)
| | - Zijun Liao
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing 100020, China;
| | - Lijun Wu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China; (F.C.); (Y.C.)
- Correspondence: ; Tel.: +86-10-85695537
| |
Collapse
|