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Chen Z, Wei D, Zhao M, Shi J, Ma C, Zhang C, Lin H, Huo W, Wang C, Fan C, Mao Z. Associations of serum glucocorticoid levels on hypertension and blood pressure-related indicators: a nested case-control study in rural China. J Hypertens 2024; 42:1555-1565. [PMID: 38747439 DOI: 10.1097/hjh.0000000000003758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
BACKGROUND The relationship between glucocorticoids and hypertension has shown inconsistent findings in previous studies. To address this, our study employed a nested case-control design in rural areas to further investigate the association between serum glucocorticoid levels and hypertension, and blood pressure-related indicators. METHODS This study employed a nested case-control design, involving 560 pairs of hypertensive cases and matched controls. The concentrations of serum cortisol (F), cortisone (E) and 11-deoxycortisol (S) were determined using liquid chromatography-tandem mass spectrometry. We employed various methods, including generalized linear model (GLM), conditional logistic regression model, restricted cubic spline regression, subgroup analysis, interaction, and joint effects, with adjustments for multiple covariates to analyze the relationships between glucocorticoids, hypertension, and blood pressure-related indicators. RESULTS After multivariable adjustments, ln-F, ln-F/E, and ln-S were positively associated with SBP, DBP, pulse pressure (PP), and mean arterial pressure (MAP), while ln-E was negatively associated with DBP and MAP ( P < 0.05). Interestingly, ln-S showed no statistically significant association with hypertension prevalence ( P > 0.05), whereas ln-F and ln-F/E were positively associated with it ( P < 0.05). The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were 1.153 (1.011-1.315) for ln-F and 2.072 (1.622-2.645) for ln-F/E, respectively. In contrast, ln-E exhibited a negative association with hypertension prevalence (adjusted OR = 0.837, 95% CI 0.714-0.982). Moreover, a significant association was observed between the combined use of high-dose F/E and high-dose S with hypertension prevalence (adjusted OR = 3.273, 95% CI 2.013-5.321). Blood pressure indicators and hypertension prevalence significantly increased with elevated serum F and F/E concentrations ( P < 0.05). Interaction analysis further revealed that among women, the positive association between F/E and hypertension prevalence was more pronounced than in men ( P < 0.05), and S exhibited a more significant positive association with hypertension prevalence in the overweight population ( P < 0.05). CONCLUSION Serum F/E and S levels demonstrated positive associations with hypertension and blood pressure-related indicators, and their combined influence exhibited a synergistic effect on hypertension. Notably, F, F/E, and S were associated with heightened hypertension risk, warranting particular attention in women and overweight populations.
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Affiliation(s)
- Zhiwei Chen
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan
| | - Dandan Wei
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan
| | - Mengzhen Zhao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan
| | - Jiayu Shi
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan
| | - Cuicui Ma
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan
| | - Caiyun Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat Sen University, Guangzhou
| | - Wenqian Huo
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan
| | - Caini Fan
- Department of Hypertension, Henan Provincial People's Hospital, Zhengzhou
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan
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Ozcagli E, Kubickova B, Jacobs MN. Addressing chemically-induced obesogenic metabolic disruption: selection of chemicals for in vitro human PPARα, PPARγ transactivation, and adipogenesis test methods. Front Endocrinol (Lausanne) 2024; 15:1401120. [PMID: 39040675 PMCID: PMC11260640 DOI: 10.3389/fendo.2024.1401120] [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: 03/14/2024] [Accepted: 06/10/2024] [Indexed: 07/24/2024] Open
Abstract
Whilst western diet and sedentary lifestyles heavily contribute to the global obesity epidemic, it is likely that chemical exposure may also contribute. A substantial body of literature implicates a variety of suspected environmental chemicals in metabolic disruption and obesogenic mechanisms. Chemically induced obesogenic metabolic disruption is not yet considered in regulatory testing paradigms or regulations, but this is an internationally recognised human health regulatory development need. An early step in the development of relevant regulatory test methods is to derive appropriate minimum chemical selection lists for the target endpoint and its key mechanisms, such that the test method can be suitably optimised and validated. Independently collated and reviewed reference and proficiency chemicals relevant for the regulatory chemical universe that they are intended to serve, assist regulatory test method development and validation, particularly in relation to the OECD Test Guidelines Programme. To address obesogenic mechanisms and modes of action for chemical hazard assessment, key initiating mechanisms include molecular-level Peroxisome Proliferator-Activated Receptor (PPAR) α and γ agonism and the tissue/organ-level key event of perturbation of the adipogenesis process that may lead to excess white adipose tissue. Here we present a critical literature review, analysis and evaluation of chemicals suitable for the development, optimisation and validation of human PPARα and PPARγ agonism and human white adipose tissue adipogenesis test methods. The chemical lists have been derived with consideration of essential criteria needed for understanding the strengths and limitations of the test methods. With a weight of evidence approach, this has been combined with practical and applied aspects required for the integration and combination of relevant candidate test methods into test batteries, as part of an Integrated Approach to Testing and Assessment for metabolic disruption. The proposed proficiency and reference chemical list includes a long list of negatives and positives (20 chemicals for PPARα, 21 for PPARγ, and 11 for adipogenesis) from which a (pre-)validation proficiency chemicals list has been derived.
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Bowman-Busato J, Schreurs L, Halford JCG, Yumuk V, O'Malley G, Woodward E, De Cock D, Baker JL. Providing a common language for obesity: the European Association for the Study of Obesity obesity taxonomy. Int J Obes (Lond) 2024:10.1038/s41366-024-01565-9. [PMID: 38902385 DOI: 10.1038/s41366-024-01565-9] [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: 01/30/2024] [Revised: 05/30/2024] [Accepted: 06/10/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND The basis for a high-performing and resilient healthcare system is having a common, precise, and scientifically accurate language used across all stakeholder groups. However, such a common language is lacking for obesity. Therefore, the European Association for the Study of Obesity undertook a taxonomy initiative to provide standardised language for obesity as commonly used from policy to practice for other major policy-prioritised non-communicable diseases (NCDs). METHODS An online Delphi consensus study was conducted, involving a panel of experts representing stakeholder groups of policymakers, healthcare professionals, people with lived experience, and researchers. Based on the understanding of obesity as an adiposity-based chronic disease, 54 statements demarcated into definition, scope and contextual usage were developed across six themes: Definition of obesity, Causes, onset and progression, Obesity prevention, Screening and early diagnosis, Treatment and management, Obesity consequences. RESULTS Of the 194 invited experts, 70 (36%), 63 (33%), and 58 (30%) experts participated in rounds one, two, and three, respectively. Consensus was achieved on 70% of the proposed definitions, scope, and contextual usage after round one, 94% after round two and 100% after round three. The Definition of Obesity theme included distinctions between population-level indicators and individual-level signs of obesity, and how pre-obesity was defined. The Causes, Onset and Progression theme characterised the timing of obesity development. The Obesity Prevention theme explicitly differentiated between health promotion and primary prevention. Both the Screening and Early Diagnosis, and the Treatment and Management themes defined concepts supporting a continuum of care model. The Consequences of Obesity theme encompassed health and socio-economic outcomes. CONCLUSION The taxonomy provides a contemporary evidence-based language about obesity that aligns with language used for policy-prioritised NCDs. The taxonomy is useful for education, advocacy, and communication and can be used by policymakers, healthcare professionals, people living with obesity, researchers, and health system users.
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Affiliation(s)
| | - Lucas Schreurs
- Biostatistics and Medical Informatics Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), 1090, Brussels, Belgium.
| | - Jason C G Halford
- European Association for the Study of Obesity, Teddington, United Kingdom
- Department of Psychology, University of Liverpool, Liverpool, UK
- School of Psychology, University of Leeds, Leeds, UK
| | - Volkan Yumuk
- European Association for the Study of Obesity, Teddington, United Kingdom
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Grace O'Malley
- European Association for the Study of Obesity, Teddington, United Kingdom
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Euan Woodward
- European Association for the Study of Obesity, Teddington, United Kingdom
| | - Diederik De Cock
- Biostatistics and Medical Informatics Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), 1090, Brussels, Belgium
| | - Jennifer L Baker
- European Association for the Study of Obesity, Teddington, United Kingdom
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Frederiksberg, Denmark
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Zhang Y, Li Y, Peila R, Wang T, Xue X, Kaplan RC, Dannenberg AJ, Qi Q, Rohan TE. Associations of Lifestyle and Genetic Risks with Obesity and Related Chronic Diseases in the UK Biobank: A Prospective Cohort Study. Am J Clin Nutr 2024; 119:1514-1522. [PMID: 38677521 PMCID: PMC11251215 DOI: 10.1016/j.ajcnut.2024.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/01/2024] [Accepted: 04/24/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Interplay between lifestyle risk scores (LRSs) and genetic risk scores (GRSs) on obesity and related chronic diseases are underinvestigated and necessary for understanding obesity causes and developing prevention strategies. OBJECTIVES This study aimed to investigate independent and joint associations and interactions of LRS and GRS with obesity prevalence and risks of diabetes, cardiovascular disease (CVD), and obesity-related cancer. METHODS In this cohort study of 444,957 UK Biobank participants [age: 56.5 ± 8.1 y; BMI (in kg/m2): 27.4 ± 4.7], LRS included physical activity, dietary score, sedentary behavior, sleep duration, and smoking (range: 0-20, each factor had 5 levels). GRS was calculated based on 941 genetic variants related to BMI. Both scores were categorized into quintiles. Obesity (n = 106,301) was defined as baseline BMI ≥30. Incident diabetes (n = 16,311), CVD (n = 18,076), and obesity-related cancer (n = 17,325) were ascertained through linkage to registries over a median of 12-y follow-up. RESULTS The LRS and GRS were independently positively associated with all outcomes. Additive interactions of LRS and GRS were observed for all outcomes (P < 0.021). Comparing the top with bottom LRS quintile, prevalence differences (95% CIs) for obesity were 17.8% (15.9%, 19.7%) in the top GRS quintile and 10.7% (8.3%, 13.1%) in the bottom GRS quintile; for diabetes, CVD, and obesity-related cancer, incidence rate differences associated with per SD increase in LRS were greater in the top than that in the bottom GRS quintile. Participants from top quintiles of both LRS and GRS had 6.16-fold, 3.81-fold, 1.56-fold, and 1.44-fold higher odds/risks of obesity, diabetes, CVD, and obesity-related cancer, respectively, than those from bottom quintiles of both scores. CONCLUSIONS Higher LRS was associated with higher obesity prevalence and risks of related chronic diseases regardless of GRS, highlighting the broad benefits of healthy lifestyles. Additive gene-lifestyle interactions emphasize the public health importance of lifestyle interventions among people with high genetic risks.
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Affiliation(s)
- Yanbo Zhang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Yang Li
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Rita Peila
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Tao Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | | | - Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States.
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States.
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Geldsetzer P, Tisdale RL, Stehr L, Michalik F, Lemp J, Aryal KK, Damasceno A, Houehanou C, Jørgensen JMA, Lunet N, Mayige M, Saeedi Moghaddam S, Mwangi KJ, Bommer C, Marcus ME, Theilmann M, Ebert C, Atun R, Davies JI, Flood D, Manne-Goehler J, Seiglie J, Bärnighausen T, Vollmer S. The prevalence of cardiovascular disease risk factors among adults living in extreme poverty. Nat Hum Behav 2024; 8:903-916. [PMID: 38480824 DOI: 10.1038/s41562-024-01840-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/24/2024] [Indexed: 04/10/2024]
Abstract
Evidence on cardiovascular disease (CVD) risk factor prevalence among adults living below the World Bank's international line for extreme poverty (those with income <$1.90 per day) globally is sparse. Here we pooled individual-level data from 105 nationally representative household surveys across 78 countries, representing 85% of people living in extreme poverty globally, and sorted individuals by country-specific measures of household income or wealth to identify those in extreme poverty. CVD risk factors (hypertension, diabetes, smoking, obesity and dyslipidaemia) were present among 17.5% (95% confidence interval (CI) 16.7-18.3%), 4.0% (95% CI 3.6-4.5%), 10.6% (95% CI 9.0-12.3%), 3.1% (95% CI 2.8-3.3%) and 1.4% (95% CI 0.9-1.9%) of adults in extreme poverty, respectively. Most were not treated for CVD-related conditions (for example, among those with hypertension earning <$1.90 per day, 15.2% (95% CI 13.3-17.1%) reported taking blood pressure-lowering medication). The main limitation of the study is likely measurement error of poverty level and CVD risk factors that could have led to an overestimation of CVD risk factor prevalence among adults in extreme poverty. Nonetheless, our results could inform equity discussions for resource allocation and design of effective interventions.
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Affiliation(s)
- Pascal Geldsetzer
- Department of Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA.
- Chan Zuckerberg Biohub - San Francisco, San Francisco, CA, USA.
| | - Rebecca L Tisdale
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Lisa Stehr
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Felix Michalik
- Department of Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Julia Lemp
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Krishna K Aryal
- Department for International Development/Nepal Health Sector Programme 3/Monitoring Evaluation and Operational Research, Abt Associates, Kathmandu, Nepal
| | - Albertino Damasceno
- Department of Public and Forensic Health Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Corine Houehanou
- Laboratory of Epidemiology of Chronic and Neurological Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - Jutta Mari Adelin Jørgensen
- Institute of Global Health, Dept of Public Health and Epidemiology, Copenhagen University, Copenhagen, Denmark
| | - Nuno Lunet
- Department of Public and Forensic Health Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Mary Mayige
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Christian Bommer
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany
| | - Maja-Emilia Marcus
- Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany
- Department of Economics, University of Goettingen, Göttingen, Germany
| | - Michaela Theilmann
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Cara Ebert
- RWI-Leibniz Institute for Economic Research, Essen (Berlin Office), Berlin, Germany
| | - Rifat Atun
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, USA
| | - Justine Ina Davies
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - David Flood
- Division of Hospital Medicine, Department of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Jennifer Manne-Goehler
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
- Medical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jacqueline Seiglie
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Harvard Center for Population and Development Studies, Cambridge, MA, USA
| | - Sebastian Vollmer
- Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany
- Department of Economics, University of Goettingen, Göttingen, Germany
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Wu J, Feng Y, Zhao Y, Guo Z, Liu R, Zeng X, Yang F, Liu B, Gu J, Tarimo CS, Shao W, Guo X, Li Q, Zhao L, Ma M, Shen Z, Zhao Q, Miao Y. Lifestyle behaviors and risk of cardiovascular disease and prognosis among individuals with cardiovascular disease: a systematic review and meta-analysis of 71 prospective cohort studies. Int J Behav Nutr Phys Act 2024; 21:42. [PMID: 38650004 PMCID: PMC11036700 DOI: 10.1186/s12966-024-01586-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/20/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Healthy lifestyle behaviors (LBs) have been widely recommended for the prevention and management of cardiovascular disease (CVD). Despite a large number of studies exploring the association between combined LBs and CVD, a notable gap exists in integration of relevant literatures. We conducted a systematic review and meta-analysis of prospective cohort studies to analyze the correlation between combined LBs and the occurrence of CVD, as well as to estimate the risk of various health complications in individuals already diagnosed with CVD. METHODS Articles published up to February 10, 2023 were sourced through PubMed, EMBASE and Web of Science. Eligible prospective cohort studies that reported the relations of combined LBs with pre-determined outcomes were included. Summary relative risks (RRs) and 95% confidence intervals (CIs) were estimated using either a fixed or random-effects model. Subgroup analysis, meta-regression, publication bias, and sensitivity analysis were as well performed. RESULTS In the general population, individuals with the healthiest combination of LBs exhibited a significant risk reduction of 58% for CVD and 55% for CVD mortality. For individuals diagnosed with CVD, adherence to the healthiest combination of LBs corresponded to a significant risk reduction of 62% for CVD recurrence and 67% for all-cause mortality, when compared to those with the least-healthy combination of LBs. In the analysis of dose-response relationship, for each increment of 1 healthy LB, there was a corresponding decrease in risk of 17% for CVD and 19% for CVD mortality within the general population. Similarly, among individuals diagnosed with CVD, each additional healthy LB was associated with a risk reduction of 27% for CVD recurrence and 27% for all-cause mortality. CONCLUSIONS Adopting healthy LBs is associated with substantial risk reduction in CVD, CVD mortality, and adverse outcomes among individuals diagnosed with CVD. Rather than focusing solely on individual healthy LB, it is advisable to advocate for the adoption of multiple LBs for the prevention and management of CVD. TRIAL REGISTRATION PROSPERO: CRD42023431731.
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Affiliation(s)
- Jian Wu
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yifei Feng
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yuanyuan Zhao
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Zhiping Guo
- Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Rongmei Liu
- Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xin Zeng
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Fan Yang
- School of Public Health, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, People's Republic of China
| | - Bei Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Jianqing Gu
- Healthy Lifestyle Medicine Research Center, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, People's Republic of China
| | - Clifford Silver Tarimo
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- Department of Science and Laboratory Technology, Dar es Salaam Institute of Technology, P.O. Box 2958, Dar es Salaam, Tanzania
| | - Weihao Shao
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xinghong Guo
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Quanman Li
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Lipei Zhao
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Mingze Ma
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Zhanlei Shen
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Qiuping Zhao
- Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| | - Yudong Miao
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
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7
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Poursalehi D, Bahrami G, Mirzaei S, Asadi A, Akhlaghi M, Saneei P. Association between alternative healthy eating index (AHEI) with metabolic health status in adolescents with overweight and obesity. BMC Public Health 2024; 24:42. [PMID: 38166997 PMCID: PMC10763351 DOI: 10.1186/s12889-023-17558-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND There has been lack of evidence on the association between healthy dietary patterns and metabolic health status of adolescents. The present study aimed to evaluate the association between alternative healthy eating index (AHEI) and metabolic health status among a relatively representative sample of Iranian adolescents with overweight/obesity. METHODS Adolescents with extra body weight (n = 203, aged 12-18 y), were selected for this cross-sectional study by a multistage cluster random-sampling method. Habitual dietary intakes and diet quality of individuals were assessed using validated food frequency questionnaire and AHEI-2010, respectively. Data on other covariates were also gathered by pre-tested questionnaires. To determine fasting glucose, insulin and lipid profiles, fasting blood samples were collected. Participants were categorized as having metabolically healthy overweight/obesity (MHO) or metabolically unhealthy overweight/obesity (MUO) phenotypes, based on two approaches (International Diabetes Federation (IDF) and combination of IDF with Homeostasis Model Assessment Insulin Resistance (HOMA-IR)). RESULTS The overall prevalence of MUO was 38.9% (based on IDF criteria) and 33.0% (based on IDF/HOMA-IR criteria). After considering all potential confounders, participants in highest tertiles of AHEI-2010 had lower odds of MUO profile according to both IDF (OR = 0.05; 95% CI: 0.01-0.15) and IDF/HOMA-IR (OR = 0.05; 95% CI: 0.02-0.19) definitions. This association was stronger in adolescents with overweight compared with obese ones and also among girls than boys. Moreover, each unit increase in AHEI-2010 score was associated with lower risk of MUO based on both criteria. CONCLUSIONS Higher adherence to AHEI-2010 was inversely associated with odds of MUO in Iranian adolescents with overweight/obesity.
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Affiliation(s)
- Donya Poursalehi
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
| | - Ghazaleh Bahrami
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
| | - Saeideh Mirzaei
- Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Asadi
- Department of Exercise Physiology, School of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran.
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8
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Tremblett M, Poon AYX, Aveyard P, Albury C. What advice do general practitioners give to people living with obesity to lose weight? A qualitative content analysis of recorded interactions. Fam Pract 2023; 40:789-795. [PMID: 36510443 PMCID: PMC10745272 DOI: 10.1093/fampra/cmac137] [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] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Guidelines recommend general practitioners (GPs) take every opportunity to talk to people living with obesity about their weight, and evidence shows even very brief advice is associated with weight loss. However, little is known about what GPs say when giving brief behavioural advice, and if it reflects evidence-based recommendations for people living with obesity. To understand what behavioural advice GPs give, we categorized the content and delivery of GPs' advice during brief interventions. METHODS Qualitative content analysis was applied to 159 audio recordings of consultations from the Brief Interventions for Weight Loss (BWeL) trial, where GPs gave brief weight-loss advice to patients with a body mass index ≥30 kg/m2 (or ≥25 kg/m2 if Asian) in 137 UK surgeries. Similar content was grouped into descriptive clusters. RESULTS The results comprised 4 clusters, illuminating different aspects of the advice given: (i) Content of diet and physical activity advice, showing this was highly varied; (ii) Content of "implementation tips" given to support changes, e.g. using smaller plates; (iii) Content of signposting support, either towards further clinician support, or other resources, e.g. information booklets; (iv) Style of advice delivery, showing GPs rarely gave personalized advice, or reasons for their advice. CONCLUSIONS AND IMPLICATIONS Weight-loss advice from GPs to patients with obesity rarely included effective methods, mostly communicating a general "eat less, do more" approach. Advice was mostly generic, and rarely tailored to patients' existing knowledge and behaviours. Effectiveness of brief weight-loss advice could be improved if GPs were given clearer guidance on evidence-based recommendations.
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Affiliation(s)
- Madeleine Tremblett
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Annabel Y X Poon
- Medical Sciences, Faculty of Biology, University of Cambridge, Cambridge, United Kingdom
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Charlotte Albury
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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Wang M, Au Yeung SL, Luo S, Jang H, Ho HS, Sharp SJ, Wijndaele K, Brage S, Wareham NJ, Kim Y. Adherence to a healthy lifestyle, genetic susceptibility to abdominal obesity, cardiometabolic risk markers, and risk of coronary heart disease. Am J Clin Nutr 2023; 118:911-920. [PMID: 37923500 DOI: 10.1016/j.ajcnut.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/20/2023] [Accepted: 08/01/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Little is known about whether the association between genetic susceptibility to high waist-to-hip ratio (WHR), a measure of abdominal obesity, and incident coronary heart disease (CHD) is modified by adherence to a healthy lifestyle. OBJECTIVES To explore the interplay of genetic susceptibility to high WHR and adherence to a healthy lifestyle on incident CHD. METHODS This study included 282,316 white British individuals from the UK Biobank study. Genetic risk for high WHR was estimated in the form of weighted polygenic risk scores (PRSs), calculated based on 156 single-nucleotide polymorphisms. Lifestyle scores were calculated based on 5 healthy lifestyle factors: regular physical activity, no current smoking, a healthy diet, <3 times/wk of alcohol consumption and 7-9 h/d of sleep. Incident CHD (n = 11,635) was accrued over a median 13.8 y of follow-up, and 12 individual cardiovascular disease risk markers assessed at baseline. RESULTS Adhering to a favorable lifestyle (4-5 healthy factors) was associated with a 25% (hazard ratio: 0.75, 95% confidence interval: 0.70, 0.81) lower hazard of CHD compared with an unfavorable lifestyle (0-1 factor), independent of PRS for high WHR. Estimated 12-y absolute risk of CHD was lower for a favorable lifestyle at high genetic risk (1.73%) and medium genetic risk (1.67%) than for an unfavorable lifestyle at low genetic risk (2.08%). Adhering to a favorable lifestyle was associated with healthier levels of cardiovascular disease risk markers (except random glucose and high-density lipoprotein), independent of PRS for high WHR. CONCLUSIONS Individuals who have high or medium genetic risk of abdominal obesity but adhere to a healthy lifestyle may have a lower risk of developing CHD, compared with those who have low genetic risk and an unhealthy lifestyle. Future clinical trials of lifestyle modification could be implemented for individuals at high genetic risk of abdominal obesity for the primary prevention of CHD events.
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Affiliation(s)
- Mengyao Wang
- School of Public Health, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong SAR, China
| | - Shiu Lun Au Yeung
- School of Public Health, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong SAR, China
| | - Shan Luo
- School of Public Health, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong SAR, China
| | - Haeyoon Jang
- School of Public Health, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong SAR, China
| | - Hin Sheung Ho
- School of Public Health, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong SAR, China
| | - Stephen J Sharp
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, Cambridgeshire, United Kingdom
| | - Katrien Wijndaele
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, Cambridgeshire, United Kingdom
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, Cambridgeshire, United Kingdom
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, Cambridgeshire, United Kingdom
| | - Youngwon Kim
- School of Public Health, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong SAR, China; MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, Cambridgeshire, United Kingdom.
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Valenzuela PL, Santos-Lozano A, Saco-Ledo G, Castillo-García A, Lucia A. Obesity, cardiovascular risk, and lifestyle: cross-sectional and prospective analyses in a nationwide Spanish cohort. Eur J Prev Cardiol 2023; 30:1493-1501. [PMID: 37317985 DOI: 10.1093/eurjpc/zwad204] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 06/06/2023] [Accepted: 06/12/2023] [Indexed: 06/16/2023]
Abstract
AIMS To assess whether overweight and obesity are independently associated with cardiometabolic health [as categorized based on the presence/absence of cardiovascular disease (CVD) risk factors (diabetes, hypercholesterolaemia, or hypertension)], and the role of lifestyle on this association. METHODS AND RESULTS A nationwide cohort of Spanish adults (18-64 years) was studied using a cross-sectional design and prospective observational design. Lifestyle-related factors (physical activity, sleeping characteristics, alcohol drinking, and smoking) were registered, and participants were classified as having an 'unhealthy' or 'healthy' cardiometabolic status attending to the presence or absence, respectively, of ≥1 CVD risk factor. A number of 596 111 participants (44 ± 9 years, 67% male) were studied at baseline, with prospective analyses in a subcohort [n = 302 061; median follow-up, 2 years (range, 2 to 5)]. Compared to normal weight, overweight and obesity were associated with a higher prevalence [odds ratio, 1.67 (95% confidence interval, 1.61-1.67) and 2.70 (2.69-2.78), respectively] and incidence [1.62 (1.59-1.67) and 2.70 (2.63-2.78)] of an unhealthy cardiometabolic status. Meeting physical activity guidelines reduced the odds of an unhealthy cardiometabolic status at baseline [0.87 (0.85-0.88)] among individuals with overweight/obesity, as well as of transitioning from a healthy status to an unhealthy status during the follow-up [0.87 (0.84-0.94)]. No significant associations were found for the remainder of lifestyle factors. CONCLUSION Overweight and obesity are independently associated with an unhealthy cardiometabolic status. Regular physical activity attenuates not only the prevalence but also the incidence of CVD risk factors.
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Affiliation(s)
- Pedro L Valenzuela
- Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital 12 de Octubre ('imas12'), 7ª Planta, Bloque D., Av. de Córdoba s/n, 28041 Madrid, Spain
- Department of Systems Biology, University of Alcalá, C/ 19, Av. de Madrid, Km 33,600, Alcalá de Henares, 28871 Madrid, Spain
| | - Alejandro Santos-Lozano
- i+HeALTH, European University Miguel de Cervantes, C/ del Padre Julio Chevalier, 2, 47012 Valladolid, Spain
| | - Gonzalo Saco-Ledo
- Faculty of Sport Sciences, Universidad Europea de Madrid, C. Tajo, s/n, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Adrián Castillo-García
- Department of Systems Biology, University of Alcalá, C/ 19, Av. de Madrid, Km 33,600, Alcalá de Henares, 28871 Madrid, Spain
| | - Alejandro Lucia
- Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital 12 de Octubre ('imas12'), 7ª Planta, Bloque D., Av. de Córdoba s/n, 28041 Madrid, Spain
- Faculty of Sport Sciences, Universidad Europea de Madrid, C. Tajo, s/n, Villaviciosa de Odón, 28670 Madrid, Spain
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Zhang Y, Zhang T, Liu Y, Bai S, Jiang J, Zhou H, Luan J, Cao L, Lv Y, Zhang Q, Liu L, Sun S, Wang X, Zhou M, Jia Q, Song K, Zhang H, Chang Q, Fan X, Ding Y, Chen L, Zhao Y, Niu K, Xia Y. Adherence to healthy lifestyle was associated with an attenuation of the risk of chronic kidney disease from metabolic dysfunction-associated fatty liver disease: Results from two prospective cohorts. Diabetes Metab Syndr 2023; 17:102873. [PMID: 37804689 DOI: 10.1016/j.dsx.2023.102873] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/09/2023]
Abstract
AIMS Non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) are important risk factors of chronic kidney disease (CKD). Whether adherence to a healthy lifestyle can modify these effects remain unknown. This study aimed to evaluate the modification effects of healthy lifestyle on the associations among NAFLD, MAFLD, and the risk of CKD, with taking into the effect of genetic risk. METHODS The Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study (TCLSIH), the UK Biobank Study (UKB). The outcome was incident CKD. The exposures including NAFLD, MAFLD, healthy lifestyle, and a genetic risk score (GRS) for CKD. RESULTS After 1,135,334 person-year follow-up, we documented 2975 incident CKD cases in the two cohorts. MAFLD and NAFLD were associated with a higher risk of CKD, particularly in patients with MAFLD. In the TCLSIH and UKB, the hazard ratios (95% confidence intervals) of incident CKD for MAFLD were 1.47 (1.30, 1.66) and 1.73 (1.57, 1.91), respectively. Adherence to a healthier lifestyle decreased the risk of CKD from MAFLD with significant interaction effects (TCLSIH: Pinteraction = 0.02; UKB: Pinteraction = 0.04). Participants with a lower CKD-GRS experienced a higher risk of CKD from MAFLD, but achieved two healthy lifestyles can significantly decreased the risk of CKD in patients with MAFLD. CONCLUSIONS MAFLD and NAFLD are associated with a higher CKD risk, particularly MAFLD. Adherence to a healthier lifestyle was associated with a lower risk of CKD from MAFLD. These results highlight the important role of following a healthy lifestyle to prevent CKD.
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Affiliation(s)
- Yixiao Zhang
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China; Department of Urology Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tingjing Zhang
- School of Public Health, Wannan Medical College, Wuhu, China
| | - Yashu Liu
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Song Bai
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China; Department of Urology Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jinguo Jiang
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China; Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Hua Zhou
- Department of Nephrology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Junjun Luan
- Department of Nephrology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Limin Cao
- The Third Central Hospital of Tianjin, Tianjin, China
| | - Yanling Lv
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qing Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Shaomei Sun
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Xing Wang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Zhou
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiyu Jia
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Kun Song
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Hehua Zhang
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China
| | - Qing Chang
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China
| | - Xiude Fan
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yang Ding
- Department of Infectious Diseases, Shengjing Hospital of China Medical University, Shenyang, China; Diagnosis and Treatment Centre for Liver Diseases of Liaoning Province, China
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuhong Zhao
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China; Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Kaijun Niu
- School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China; Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.
| | - Yang Xia
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China; Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
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12
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Behavioral and Metabolic Risk Factors for Noncommunicable Diseases among Population in the Republic of Srpska (Bosnia and Herzegovina). Healthcare (Basel) 2023; 11:healthcare11040483. [PMID: 36833017 PMCID: PMC9957477 DOI: 10.3390/healthcare11040483] [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: 12/04/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023] Open
Abstract
Noncommunicable diseases (NCDs) are the major cause of death worldwide, and they are attributable to genetic and physiological determinants, behavioral risk factors and environmental impacts. The aim of this study is to assess behavioral risk factors for metabolic disease using demographic and social-economic aspects of the population characterized by risk factors, and to investigate relations among lifestyle risk factors (alcohol consumption, tobacco use, physical inactivity, intake of vitamins, fruits and vegetables) that are responsible for the majority of NCD deaths in the Republic of Srpska's (RS's) population. This is a cross-sectional study based on the analysis of a survey conducted among 2311 adult (≥18 years) persons (54.0% women, and 46.0% men). The statistical analysis was carried out by using Cramer's V values, clustering, logistic regression (binomial, multinomial and ordinal), a chi-square test and odds ratios. In the case of logistic regression, we provide the prediction accuracy in percentages. A significant statistical correlation between demographic characteristics (gender and age) and risk factors was observed. The highest difference according to gender was observed in alcohol consumption (odds ratio (OR) = 2.705, confidence interval (95% CI) = 2.206-3.317), particularly in frequent consumption (OR = 3.164, 95% CI = 2.664-3.758). The highest prevalence of high blood pressure was registered in the elderly (66.5%); the same holds for hypertension (44.3%). Additionally, physical inactivity was one of the most common risk factors (33.4% physically inactive respondents). A significant presence of risk factors was confirmed among the RS population, with higher involvement of metabolic risk factors among the older population, while the prevalence of behavioral factors was related to younger age groups, particularly in the case of alcohol consumption and smoking. A low level of preventive awareness was observed among the younger population. Therefore, prevention is one of the most important instruments related to decreasing NCD risk factors in the RS population.
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Hao X, Li Y, Huang G, Zeng Y. Role of the N6-methyladenosine regulatory factor in reducing the risk of cardiovascular disease: subtype diagnosis following aerobic exercise-assisted weight loss. Am J Transl Res 2022; 14:5363-5378. [PMID: 36105062 PMCID: PMC9452351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This study aimed to construct a model based on different N6-methyladenosine (m6A) regulatory factors involved in reducing the risk of the development of cardiovascular diseases under conditions of aerobic exercise. METHODS We screened for significantly different expressions of m6A regulators from the GSE66175 dataset. Five candidate m6A regulators were identified using the random forest model to predict aerobic exercise-mediated fat loss and reduction of the risk of cardiovascular disease. A nomogram model was established for analysis, and the consensus clustering method was used to distinguish between the two m6A clusters (clusters A and B). The single-sample gene set-enrichment analysis method was used to assess the abundance of immune cells in the samples related to cardiovascular anomalies. We determined the relationship between the functions of 29 immune cells and m6A clusters. RESULTS Twelve significantly and differentially expressed m6A regulators in the control and aerobic exercise groups were screened out, and it was observed that METTL13 correlated positively with the expression levels of the YTH domain containing 1 (YTHDC1), YTH N (6)-methyl adenosine RNA binding protein 1, and leucine-rich pentatricopeptide repeat-containing. The fat mass and obesity-associated gene negatively correlated with YTHDC1 and the fragile X mental retardation 1 protein. The random forest and support vector machine models were used to screen the ELAV-like RNA binding protein 1 (ELAVL1), RNA binding motif protein 15B (RBM15B), insulin-like growth factor binding protein 1 (IGFBP1), Wilms tumor 1-associated protein (WTAP), and zinc finger CCCH-type containing 13 (ZC3H13) genes. Analysis of the line graph model and the results obtained using decision curve analysis revealed the efficiency of the model. Gene ontology enrichment analysis was used to analyze the m6A regulatory gene model, and the results suggested that it was associated with RNA splicing. The results obtained using the Kyoto Encyclopedia of Genes and Genomes enrichment analysis method suggests that the genes were associated with Alzheimer's disease and neurodegeneration pathways associated with multiple diseases. The m6A regulatory gene model was associated with most of the immune cells infiltrating tumors and was also closely related to genes associated with lipid metabolism. CONCLUSIONS The m6A regulatory factor plays an important role in reducing the risk of cardiovascular disease under conditions of aerobic exercise-assisted weight loss. It is also associated with the metabolic pathways of low-density lipoprotein, high-density lipoprotein, and triglyceride.
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Affiliation(s)
- Xiaoya Hao
- College of Physical Education, University of South ChinaHengyang, Hunan, China
| | - Yukun Li
- Hunan Province Key Laboratory of Cancer Cellular and Molecular Pathology, Cancer Research Institute, Hengyang Medical School, University of South ChinaHengyang, Hunan, China
| | - Guo Huang
- Hunan Province Key Laboratory of Cancer Cellular and Molecular Pathology, Cancer Research Institute, Hengyang Medical School, University of South ChinaHengyang, Hunan, China
| | - Ying Zeng
- Hunan Province Key Laboratory of Cancer Cellular and Molecular Pathology, Cancer Research Institute, Hengyang Medical School, University of South ChinaHengyang, Hunan, China
- School of Nursing, Hengyang Medical School, University of South ChinaHengyang, Hunan, China
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Wu E, Ni JT, Zhu ZH, Xu HQ, Tao L, Xie T. Association of a Healthy Lifestyle with All-Cause, Cause-Specific Mortality and Incident Cancer among Individuals with Metabolic Syndrome: A Prospective Cohort Study in UK Biobank. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19169936. [PMID: 36011568 PMCID: PMC9408492 DOI: 10.3390/ijerph19169936] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/07/2022] [Accepted: 08/10/2022] [Indexed: 05/10/2023]
Abstract
This study investigated the association between a healthy lifestyle with all-cause, cause-specific mortality, and cancer incidence among individuals with metabolic syndrome (MetS). Healthy lifestyle scores were created based on MetS management guidelines, including never/quitting smoking, moderate drinking, good sleep, healthy diet, sufficient exercise, social support, and less sedentary behaviour. Weighted healthy lifestyle scores were further constructed and classified into three groups: unfavourable (lowest quintile), intermediate (quintiles 2−4), and favourable (highest quintile) lifestyles. We included 87,342 MetS participants from the UK Biobank. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using multivariate-adjusted Cox proportional hazards regression. During a median follow-up of 12.54 years, 6739 deaths were reported; during a median follow-up of 10.69 years, 10,802 new cancer cases were documented. We found a favourable lifestyle was inversely associated with all-cause mortality (HR: 0.57; 95%CI: 0.53−0.62), cause-specific mortality from respiratory disease, cancer, digestive disease, cardiovascular disease (HR < 1; p-trend < 0.001), and overall cancer incidence (HR: 0.84; 95% CI: 0.79−0.90). Our results indicate that adherence to healthy lifestyles is associated with lower overall cancer incidence and all-cause mortality risk among MetS individuals. However, causality cannot be made due to the nature of observational studies.
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Affiliation(s)
- E Wu
- School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou 311121, China
| | - Jun-Tao Ni
- Women’s Hospital School of Medicine Zhejiang University, Hangzhou 310006, China
| | - Zhao-Hui Zhu
- School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
| | - Hong-Quan Xu
- School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou 311121, China
| | - Lin Tao
- School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou 311121, China
| | - Tian Xie
- School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou 311121, China
- Correspondence: ; Tel.: +86-571-28860237
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Ranjan R, Adhikary D, Das D, Adhikary AB. Prevalence and Risk Factors Analysis of Carotid Stenosis Among Ischaemic Heart Diseases Patient in Bangladesh: A Cross-Sectional Study. Int J Gen Med 2022; 15:3325-3331. [PMID: 35355796 PMCID: PMC8959875 DOI: 10.2147/ijgm.s349846] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/18/2022] [Indexed: 12/05/2022] Open
Abstract
Purpose This study aimed to evaluate the prevalence of carotid stenosis among ischaemic heart disease (IHD) patients undergoing coronary artery bypass graft (CABG) surgery and identify risk factors associated with carotid stenosis at a tertiary-level hospital in Bangladesh. Patients and Methods This cross-sectional study examined 200 IHD patients scheduled for isolated and elective CABG surgery, and multivariate regression analysis was used to determine the impact of independent variables on carotid stenosis with coronary artery disease. A vascular surgeon and sonographer assessed carotid stenosis, and the severity of stenosis was classified according to the current Grayscale and Doppler US diagnosis models. Results We observed that the prevalence of carotid artery stenosis was 13.5%, and the male was significantly higher (85.2%) in the carotid stenosis group. A multivariate regression analysis observed that age (OR 1.79), dyslipidaemia (OR 2.19), uncontrolled hypertension (OR 2.38), uncontrolled DM (OR 2.51), multivessel coronary artery disease (OR 3.79), and multiple comorbidities (OR 4.46) are potential predictors of having significant carotid stenosis in a patient undergoing CABG surgery. Conclusion In Bangladesh, multivessel coronary artery disease, especially in elderly patients with multiple comorbidities, are 4 (four) times higher risk to have significant carotid artery stenosis. Preoperative carotid duplex screening should be performed to curtail the risk of postoperative adverse cerebrovascular events, particularly those who have carotid stenosis associated potential risk factors.
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Affiliation(s)
- Redoy Ranjan
- Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
- Department of Medicine & Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
- Correspondence: Redoy Ranjan, Department of cardiac Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, 1000, Bangladesh, Tel +8801717556046, Email
| | - Dipannita Adhikary
- Department of Medicine & Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
| | - Debasish Das
- Department of Thoracic Surgery, Dhaka Medical College & Hospital, Dhaka, Bangladesh
| | - Asit Baran Adhikary
- Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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