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Cao W, Xu Y, Shen Y, Hu T, Wang Y, Ma X, Bao Y. Neck circumference predicts development of carotid intima-media thickness and carotid plaque: A community-based longitudinal study. Nutr Metab Cardiovasc Dis 2022; 32:1627-1634. [PMID: 35599091 DOI: 10.1016/j.numecd.2022.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/14/2022] [Accepted: 03/28/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND AIMS Carotid intima-media thickness (C-IMT) is an important index for evaluating subclinical atherosclerosis. Neck circumference (NC), a new anthropometric index of the upper body fat, is closely related to cardiovascular disease (CVD) and CVD risk factors. This study investigated the relationship between NC, C-IMT, and carotid plaque in a community-based cohort. METHODS AND RESULTS Participants recruited from Shanghai communities were followed up for 1.1-2.9 years. All participants underwent anthropometric and biochemical measurements. Elevated NC was defined as NC ≥ 38.5 cm and NC ≥ 34.5 cm in men and women, respectively. Elevated C-IMT, determined by ultrasound, was defined as a level higher than the 75th percentile in the study population (>0.75 mm). In total, 1189 participants without carotid plaque at baseline were included, with an average age of 59.6 ± 7.3 years. After a mean follow-up of 2.1 ± 0.2 years, 203 participants developed carotid plaques. After adjusting for various atherosclerosis risk factors, the logistic regression showed that the higher NC group had a significantly greater risk of developing carotid plaque than the lower NC group (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.12-2.14; P = 0.008). Of those without carotid plaque at follow-up, 495 participants developed elevated C-IMT. Compared to the lower NC group, the higher NC group had a significantly increased risk of elevated C-IMT (OR, 1.49; 95% CI, 1.14-1.95; P = 0.003). CONCLUSION Higher NC was significantly positively correlated with the risk of carotid plaque and elevated C-IMT.
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Affiliation(s)
- Weijie Cao
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yiting Xu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yun Shen
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Tingting Hu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yufei Wang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China.
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China.
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Di Bella S, Cesareo R, De Cristofaro P, Palermo A, Sanson G, Roman‐Pognuz E, Zerbato V, Manfrini S, Giacomazzi D, Dal Bo E, Sambataro G, Macchini E, Quintavalle F, Campagna G, Masala R, Ottaviani L, Del Borgo C, Ridola L, Leonetti F, Berlot G, Luzzati R. Neck circumference as reliable predictor of mechanical ventilation support in adult inpatients with COVID-19: A multicentric prospective evaluation. Diabetes Metab Res Rev 2021; 37:e3354. [PMID: 32484298 PMCID: PMC7300447 DOI: 10.1002/dmrr.3354] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 05/13/2020] [Indexed: 12/14/2022]
Abstract
AIMS COVID-19 is especially severe for elderly subjects with cardiometabolic and respiratory comorbidities. Neck circumference (NC) has been shown to be strongly related to cardiometabolic and respiratory illnesses even after adjustment for body mass index (BMI). We performed a prospective study to investigate the potential of NC to predict the need for invasive mechanical ventilation (IMV) in adult COVID-19 inpatients. MATERIALS AND METHODS We prospectively and consecutively enrolled COVID-19 adult patients admitted to dedicated medical wards of two Italian hospitals from 25 March to 7 April 2020. On admission, clinical, biochemical and anthropometric data, including BMI and NC were collected. As primary outcome measure, the maximum respiratory support received was evaluated. Follow-up time was 30 days from hospital admission. RESULTS We enrolled 132 subjects (55.0-75.8 years, 32% female). During the study period, 26 (19.7%) patients underwent IMV. In multivariable logistic regression analyses, after adjusting for age, sex, diabetes, hypertension and COPD, NC resulted independently and significantly associated with IMV risk (adjusted OR 1.260-per 1 cm increase 95% CI:1.120-1.417; P < .001), with a stronger association in the subgroup with BMI ≤30 Kg/m2 (adjusted OR 1.526; 95% CI:1.243-1.874; P < .001). NC showed a good discrimination power in predicting patients requiring IMV (AUC 0.783; 95% CI:0.684-0.882; P < .001). In particular, NC > 40.5 cm (>37.5 for females and >42.5 for males) showed a higher and earlier IMV risk compared to subjects with lower NC (Log-rank test: P < .001). CONCLUSIONS NC is an easy to measure parameter able to predict the need for IMV in adult COVID-19 inpatients.
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Affiliation(s)
- Stefano Di Bella
- Department of Medical, Surgical and Health SciencesUniversity of TriesteTriesteItaly
| | - Roberto Cesareo
- UOS Malattie MetabolicheSanta Maria Goretti HospitalLatinaItaly
| | | | - Andrea Palermo
- Unit of Endocrinology and DiabetesUniversity Campus Bio‐MedicoRomeItaly
| | - Gianfranco Sanson
- Clinical Department of Medical, Surgical and Health SciencesUniversity of TriesteTriesteItaly
| | - Erik Roman‐Pognuz
- Department of Perioperative Medicine, Intensive Care and EmergencyUniversity HospitalTriesteItaly
| | - Verena Zerbato
- Infectious Diseases DepartmentUniversity of UdineUdineItaly
| | - Silvia Manfrini
- Unit of Endocrinology and DiabetesUniversity Campus Bio‐MedicoRomeItaly
| | | | - Eugenia Dal Bo
- Azienda Sanitaria Universitaria Giuliano IsontinaTriesteItaly
| | - Gianluca Sambataro
- Regional Referral Centre for Rare Lung DiseaseAOU “Policlinico‐Vittorio Emanuele”, Department of Clinical and Experimental MedicineCataniaItaly
| | - Elisabetta Macchini
- Department of Perioperative Medicine, Intensive Care and EmergencyUniversity HospitalTriesteItaly
| | - Francesco Quintavalle
- Department of Perioperative Medicine, Intensive Care and EmergencyUniversity HospitalTriesteItaly
| | - Giuseppe Campagna
- Department of Internal MedicineSanta Maria Goretti HospitalLatinaItaly
| | - Renato Masala
- Department of Internal MedicineSanta Maria Goretti HospitalLatinaItaly
| | - Luigi Ottaviani
- Department of Internal MedicineSanta Maria Goretti HospitalLatinaItaly
| | - Cosmo Del Borgo
- Infectious Diseases UnitSanta Maria Goretti HospitalLatinaItaly
| | - Lorenzo Ridola
- Department of Translational and Precision Medicine“Sapienza” University of RomeRomeItaly
| | - Frida Leonetti
- Diabetes Unit, Department of Medical‐Surgical Sciences and BiotechnologiesSanta Maria Goretti Hospital, Sapienza University of RomeLatinaItaly
| | - Giorgio Berlot
- Department of Perioperative Medicine, Intensive Care and EmergencyUniversity HospitalTriesteItaly
| | - Roberto Luzzati
- Department of Medical, Surgical and Health SciencesUniversity of TriesteTriesteItaly
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Neck-to-height ratio and arterial stiffness in Chinese adults: cross-sectional associations in a community-based cohort. J Hypertens 2020; 39:1195-1202. [PMID: 33323908 DOI: 10.1097/hjh.0000000000002751] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the association between neck-to-height ratio (NHR) and arterial stiffness in adults from a community-based Chinese cohort in a cross-sectional study. METHODS We conducted cross-sectional analysis using data from the Kailuan study, a population-based cohort research. Altogether, 18 972 individuals were included in the analysis. Brachial ankle pulse wave velocity (baPWV), anthropometric indexes and cardiovascular risk factors were recorded. Data were analyzed by multiple lineal regression model. RESULTS NHR was positively associated with baPWV after adjusted for age, sex, blood pressure, heart rate, BMI, waist-hip ratio, current smoking, fasting blood glucose, serum cholesterol, uric acid, high-sensitivity C reactive protein and creatinine clearance (β = 5.76, P < 0.001), while the association of neck circumference and baPWV was NS after adjusting the variables mentioned above. In subgroups analysis, the association between NHR and baPWV did not reach statistical significance in female, while in males, the association was significant. Interaction effects were observed among BMI stratifications and the individuals with metabolic syndrome and history of cardiovascular events (P for intereaction = 0.002, 0.038 and 0.003, respectively). CONCLUSION The current study demonstrated for the first time that NHR was positively associated with baPWV in community-based population, NHR might be a promising independent predictor for cardiovascular disease.
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Association between Neck Circumference and the Risk of Decreased Estimated Glomerular Filtration Rate in the General Population of China: A Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2020; 2020:3496328. [PMID: 33299866 PMCID: PMC7707937 DOI: 10.1155/2020/3496328] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 09/05/2020] [Accepted: 11/07/2020] [Indexed: 12/16/2022]
Abstract
Background The burden of chronic kidney disease is increasing substantially worldwide. Neck circumference (NC), an anthropometric index for upper-body adiposity, has been recognized as an indicator of cardiometabolic diseases. However, the association between NC and renal dysfunction has not been fully disclosed. Objectives The aim of this study was to investigate the association between NC and estimated glomerular filtration rate (eGFR) in the general population in China. Methods A total of 8805 participants (3322 men and 5483 women) were enrolled in this study. Logistic regression analysis was conducted to examine the association between NC and eGFR. The male and female subjects were divided into four groups according to the NC quartiles. The primary outcome was defined as an eGFR ≤ 90 mL/min/1.73 m2. Results Logistic regression analysis revealed that in both sexes, higher NC was significantly associated with a higher risk of decreased eGFR even after fully adjusting for age, other anthropometric indexes, traditional risk factors for chronic kidney diseases, and sociologic risk factors (quartile 1 as a reference; the odds ratios [95% confidence intervals] were as follows: quartile 2, 1.26 [0.99-1.59]; quartile 3, 1.40 [1.07-1.83]; and quartile 4, 1.71 [1.22-2.38], in men; quartile 2, 1.14 [0.95-1.37]; quartile 3, 1.31 [1.03-1.66]; and quartile 4, 1.32 [1.04-1.68], in women). Stratified analyses suggested that the association was significant among subjects with prediabetes or normal serum uric acid levels and those without cardiovascular diseases (CVD). Among subjects with CVD, the association persisted only in males. When the subjects were stratified according to blood pressure or BMI, the association persisted among male subjects with abnormal blood pressure and was strengthened among male subjects who were overweight/obese, while the association disappeared among female subjects. Conclusions NC is independently associated with the risk of decreased eGFR in the general population in China, indicating that NC could contribute to renal dysfunction risk assessment.
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Moura BAB, Santos IS, Goulart AC, Schmidt MI, Lotufo PA, Bensenor IM, Baena CP. Neck and waist circumference values according to sex, age, and body-mass index: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). ACTA ACUST UNITED AC 2020; 53:e9815. [PMID: 32813851 PMCID: PMC7433850 DOI: 10.1590/1414-431x20209815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 06/10/2020] [Indexed: 11/22/2022]
Abstract
Body fat distribution predicts cardiovascular events better than body-mass index (BMI). Waist circumference (WC) and neck circumference (NC) are inexpensive anthropometric measurements. We aimed to present the conditional distribution of WC and NC values according to BMI, stratified by age and sex, from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline data. We analyzed 15,085 ELSA-Brasil participants with complete data. We used spline quantile regression models, stratified by sex and age, to estimate the NC and WC quantiles according to BMI. To test a putative association between age and median NC or WC values, we built sex-specific median regression models using both BMI and age as explanatory variables. We present estimated 25th, 50th, 75th, and 90th percentiles for NC and WC values, according to BMI, age, and sex. Predicted interquartile intervals for NC values varied from 1.6 to 3.8 cm and, for WC values, from 5.1 to 10.3 cm. Median NC was not associated with age in men (P=0.11) nor in women (P=0.79). However, median WC increased with advancing age in both sexes (P<0.001 for both). There was significant dispersion in WC and NC values for a given BMI and age strata for both men and women. WC, but not NC values, were associated with increasing age. The smaller influence of advancing age on the relationship between BMI and NC (compared to WC) values may be useful in longitudinal studies.
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Affiliation(s)
- B A B Moura
- Escola de Medicina, Programa de Pós Graduação em Ciências da Saúde, Pontifícia Universidade Católica Paraná, Curitiba, PR, Brasil
| | - I S Santos
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil
| | - A C Goulart
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil
| | - M I Schmidt
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - P A Lotufo
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil
| | - I M Bensenor
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil
| | - C P Baena
- Escola de Medicina, Programa de Pós Graduação em Ciências da Saúde, Pontifícia Universidade Católica Paraná, Curitiba, PR, Brasil
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Hsiao PJ, Chiu CC, Lin KH, Hu FK, Tsai PJ, Wu CT, Pang YK, Lin Y, Kuo MH, Chen KH, Wu YS, Wu HY, Chang YT, Chang YT, Cheng CS, Chuu CP, Lin FH, Chang CW, Li YK, Chan JS, Chu CM. Usability of Wearable Devices With a Novel Cardiac Force Index for Estimating the Dynamic Cardiac Function: Observational Study. JMIR Mhealth Uhealth 2020; 8:e15331. [PMID: 32706725 PMCID: PMC7404011 DOI: 10.2196/15331] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 12/18/2019] [Accepted: 03/22/2020] [Indexed: 12/14/2022] Open
Abstract
Background Long-distance running can be a form of stress to the heart. Technological improvements combined with the public’s gradual turn toward mobile health (mHealth), self-health, and exercise effectiveness have resulted in the widespread use of wearable exercise products. The monitoring of dynamic cardiac function changes during running and running performance should be further studied. Objective We investigated the relationship between dynamic cardiac function changes and finish time for 3000-meter runs. Using a wearable device based on a novel cardiac force index (CFI), we explored potential correlations among 3000-meter runners with stronger and weaker cardiac functions during running. Methods This study used the American product BioHarness 3.0 (Zephyr Technology Corporation), which can measure basic physiological parameters including heart rate, respiratory rate, temperature, maximum oxygen consumption, and activity. We investigated the correlations among new physiological parameters, including CFI = weight * activity / heart rate, cardiac force ratio (CFR) = CFI of running / CFI of walking, and finish times for 3000-meter runs. Results The results showed that waist circumference, smoking, and CFI were the significant factors for qualifying in the 3000-meter run. The prediction model was as follows: ln (3000 meters running performance pass probability / fail results probability) = –2.702 – 0.096 × [waist circumference] – 1.827 × [smoke] + 0.020 × [ACi7]. If smoking and the ACi7 were controlled, contestants with a larger waist circumference tended to fail the qualification based on the formula above. If waist circumference and ACi7 were controlled, smokers tended to fail more often than nonsmokers. Finally, we investigated a new calculation method for monitoring cardiac status during exercise that uses the CFI of walking for the runner as a reference to obtain the ratio between the cardiac force of exercise and that of walking (CFR) to provide a standard for determining if the heart is capable of exercise. A relationship is documented between the CFR and the performance of 3000-meter runs in a healthy 22-year-old person. During the running period, data are obtained while participant slowly runs 3000 meters, and the relationship between the CFR and time is plotted. The runner’s CFR varies with changes in activity. Since the runner’s acceleration increases, the CFR quickly increases to an explosive peak, indicating the runner’s explosive power. At this period, the CFI revealed a 3-fold increase (CFR=3) in a strong heart. After a time lapse, the CFR is approximately 2.5 during an endurance period until finishing the 3000-meter run. Similar correlation is found in a runner with a weak heart, with the CFR at the beginning period being 4 and approximately 2.5 thereafter. Conclusions In conclusion, the study results suggested that measuring the real-time CFR changes could be used in a prediction model for 3000-meter running performance.
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Affiliation(s)
- Po-Jen Hsiao
- Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan.,Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Life Sciences, National Central University, Taoyuan, Taiwan.,Big Data Research Center, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Chih-Chien Chiu
- Big Data Research Center, Fu-Jen Catholic University, New Taipei, Taiwan.,Division of Infectious Disease and Tropical Medicine, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
| | - Ke-Hsin Lin
- Division of Biostatistics and Medical Informatics, Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Fu-Kang Hu
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Pei-Jan Tsai
- Division of Biostatistics and Medical Informatics, Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chun-Ting Wu
- Division of Biostatistics and Medical Informatics, Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Yuan-Kai Pang
- Division of Biostatistics and Medical Informatics, Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Yu Lin
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.,Department of Nursing, University of Kang Ning, Tainan, Taiwan
| | - Ming-Hao Kuo
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Kang-Hua Chen
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Syuan Wu
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Hao-Yi Wu
- Division of Biostatistics and Medical Informatics, Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Ya-Ting Chang
- Division of Biostatistics and Medical Informatics, Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Tien Chang
- Division of Biostatistics and Medical Informatics, Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Shiang Cheng
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Pin Chuu
- Institute of Cellular and System Medicine, National Health Research Institutes, Miaoli, Taiwan
| | - Fu-Huang Lin
- Division of Biostatistics and Medical Informatics, Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Wen Chang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Division of Pediatric Endocrinology & Genetics, Department of Pediatrics, Chang-Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yuan-Kuei Li
- Division of Colorectal Surgery, Department of Surgery, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan.,Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan
| | - Jenq-Shyong Chan
- Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan.,Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Ming Chu
- Big Data Research Center, Fu-Jen Catholic University, New Taipei, Taiwan.,Division of Biostatistics and Medical Informatics, Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.,Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Public Health, School of Public Health, China Medical University, Taichung, Taiwan
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Qiu Q, Meng X, Li Y, Liu X, Teng F, Wang Y, Zang X, Wang Y, Liang J. Evaluation of the associations of body height with blood pressure and early-stage atherosclerosis in Chinese adults. J Clin Hypertens (Greenwich) 2020; 22:1018-1024. [PMID: 32442361 DOI: 10.1111/jch.13870] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 01/12/2023]
Abstract
Body height has been recently related to the risk of coronary heart disease and metabolic risk factors. However, data are scarce regarding the relationship between body height and early-stage atherosclerotic changes, especially in Chinese individuals. In this study, we aimed to comprehensively examine the associations of body height with early-stage atherosclerosis and blood pressure in Chinese adults. Carotid-femoral pulse wave velocity (cfPWV), carotid-radial pulse wave velocity (crPWV), carotid artery-dorsalis pedis pulse wave velocity (cdPWV), and body height were measured in 5098 men and women. All samples were obtained from a community-based health examination survey in central China. After adjusting for sex, age, weight, fasting glucose level, lipid level, creatinine, and heart rate, low body heights were significantly associated with higher cfPWV, crPWV, and blood pressure (all P for trend <.01), whereas no significant association was found between body height and cdPWV. In addition, we found a significant interaction between prehypertension status and body height in relation to cfPWV, after adjusting for covariates (P for interaction = .0024). The associations were stronger in participants with prehypertension than in those with normal blood pressure. Compared to the group with the tallest stature and normal blood pressure, individuals in the group with the shortest stature and prehypertension had nearly a 2.5 m/s higher cfPWV. These results indicate that short body height was associated with an increased risk of early-stage atherosclerosis in Chinese adults, independent of traditional cardiometabolic risk factors. Prehypertension might modify the association between body height and cfPWV.
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Affiliation(s)
- Qinqin Qiu
- Department of Endocrinology and Central Laboratory, Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Xuzhou, China.,The Clinical School of Xuzhou Medical University, The Affiliated Xuzhou Central Hospital of Nanjing University of Chinese Medicine, The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, China
| | | | - Yanjun Li
- Department of Orthopedic, Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Xuzhou, China
| | - Xuekui Liu
- Department of Endocrinology and Central Laboratory, Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Xuzhou, China.,The Clinical School of Xuzhou Medical University, The Affiliated Xuzhou Central Hospital of Nanjing University of Chinese Medicine, The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, China
| | - Fei Teng
- Department of Endocrinology and Central Laboratory, Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Xuzhou, China.,The Clinical School of Xuzhou Medical University, The Affiliated Xuzhou Central Hospital of Nanjing University of Chinese Medicine, The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, China
| | - Yu Wang
- Department of Endocrinology and Central Laboratory, Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Xuzhou, China.,The Clinical School of Xuzhou Medical University, The Affiliated Xuzhou Central Hospital of Nanjing University of Chinese Medicine, The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, China
| | - Xiu Zang
- Department of Endocrinology and Central Laboratory, Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Xuzhou, China.,The Clinical School of Xuzhou Medical University, The Affiliated Xuzhou Central Hospital of Nanjing University of Chinese Medicine, The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, China
| | - Yun Wang
- Xuzhou Medical University, Xuzhou, China
| | - Jun Liang
- Department of Endocrinology and Central Laboratory, Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Xuzhou, China.,The Clinical School of Xuzhou Medical University, The Affiliated Xuzhou Central Hospital of Nanjing University of Chinese Medicine, The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, China
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Association between Neck Circumference and the Occurrence of Cardiovascular Events in Type 2 Diabetes: Beijing Community Diabetes Study 20 (BCDS-20). BIOMED RESEARCH INTERNATIONAL 2019; 2019:4242304. [PMID: 31886212 PMCID: PMC6925677 DOI: 10.1155/2019/4242304] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 08/22/2019] [Accepted: 10/21/2019] [Indexed: 11/25/2022]
Abstract
Background Neck circumference (NC) was found to be related to the risk factors of cardiovascular disease. However, the effects of NC on cardiovascular disease are still controversial. A prospective study of Chinese patients with type 2 diabetes was performed to evaluate the relationship between NC and cardiovascular disease. Methods A multicenter prospective study with eight-year follow-up was conducted in Beijing communities. Cardiovascular events were defined as myocardial infarction, unstable angina pectoris, hospitalization for heart failure, coronary revascularization, cardiac death, stroke, transient ischemic attack, and cerebral hemorrhage. Results A total of 3,009 diabetic patients were recruited. Following an eight-year follow-up, 211 patients with cardiovascular events (105 in men and 106 in women) were identified. All patients were categorized into two groups according to the upper quartile of NC (43 cm in men and 39 cm in women). The prevalence of cardiovascular events in men with an NC >43 cm (16.48%) was higher than that in the group with an NC <43 cm (8.16%, p=0.007). The prevalence of cardiovascular events in women with the NC >39 cm (10.67%) was higher compared to the group with NC <39 cm (5.31%, p=0.004). The longitudinal prevalence of cardiovascular events in groups with different NC increased with the increasing duration of follow-up (p < 0.001). Cox regression analysis showed that higher NC was associated with the occurrence of cardiovascular events after adjusting for confounding variables (adjusted HR = 2.305 (1.535–3.460)). Conclusions NC was associated with the occurrence of cardiovascular events in type 2 diabetes in Chinese communities, and greater NC may increase the risk of cardiovascular events by about 2.3-fold.
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He H, Pan L, Liu F, Ma J, Wang L, Hu Z, Li Y, Shan G. Neck circumference as an indicator of elevated blood pressure independent from body composition: implications from the China nation health survey (CNHS). BMC Cardiovasc Disord 2019; 19:244. [PMID: 31694566 PMCID: PMC6833177 DOI: 10.1186/s12872-019-1227-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 10/18/2019] [Indexed: 11/10/2022] Open
Abstract
Background The independent association of neck circumference (NC) on elevated blood pressure is still uncertain in adults of China. The aim of this study is to explore such association and investigate the predictive value of NC on hypertension. Methods A total of 4279 adults aged 20–80 years participated in the cross-sectional study in 2014. Anthropometric information, NC, body composition indexes such as waist circumference, hip circumference and body fat percentage, and blood pressure were measured. General linear regression model was used to explore the association between NC and blood pressure; Logistic regression models were fitted to calculate the multi-variable adjusted prevalence, and the association of NC with hypertension. Results The overall prevalence of hypertension and pre-hypertension were 11.05 and 23.63%, respectively. NC was positively associated with both SBP and DBP (p < 0.001). The adjusted prevalence of hypertension increased with elevated NC quartiles in both sexes (p for trend < 0.001), from 17.81 to 42.93% in male and 9.72 to 21.31% in female. For male, NC was only associated with hypertension (OR: 1.15, 95% CI: 1.05–1.25) but not with pre-hypertension (OR: 0.97, 95% CI: 0.88–1.06). However, in female, NC was associated with both pre-hypertension and hypertension, the BMI adjusted ORs were 1.15 (1.03–1.28) and 1.24 (1.14–1.34). The sex-specific AUCs for NC predicting hypertension were 0.633 in male and 0.663 in female, similar with AUCs of other body fat indexes. Conclusions NC was associated with both pre-HTN and HTN independent from other body composition indexes. NC is a simple and useful anthropometric index to identify elevated blood pressure in Chinese adults.
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Affiliation(s)
- Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical, Beijing, 100005, China.,Department of Epidemiology and Statistics, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical, Beijing, 100005, China.,Department of Epidemiology and Statistics, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China
| | - Feng Liu
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, 710054, China
| | - Jingang Ma
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, 710054, China
| | - Li Wang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical, Beijing, 100005, China.,Department of Epidemiology and Statistics, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China
| | - Zhiping Hu
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, 710054, China
| | - Yajun Li
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, 710054, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical, Beijing, 100005, China. .,Department of Epidemiology and Statistics, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China.
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10
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Yang GR, Dye TD, Zand MS, Fogg TT, Yuan SY, Yang JK, Li D. Association Between Neck Circumference and Coronary Heart Disease: A Meta-analysis. Asian Pac Isl Nurs J 2019; 4:34-46. [PMID: 31037271 PMCID: PMC6484201 DOI: 10.31372/20190401.1031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aims: Neck circumference (NC) was found to be related to the risk factors for coronary heart disease (CHD). However, the effects of NC on CHD are still controversial. To evaluate the relationship between NC and CHD, a meta-analysis of observational studies was performed. Method: Eligible studies on the association between NC and CHD were searched in Medline, Embase, Ovid, and Web of Science databases published in English from January 1980 to December 2016. Moreover, studies published in Chinese in Wanfang and China Hospital Knowledge databases were also searched. Random effects models in the metafor package in statistical analysis software R 3.3.3 were used for the meta-analysis. Heterogeneity was analyzed with Q statistics. Results: Eight studies were selected for the meta-analysis. A larger NC was associated with a higher prevalence of CHD (OR = 1.18, 95% CI 1.04–1.34, p = 0.0108). The eight studies were further divided into three subgroups according to the criteria for diagnosing CHD. In the subgroup of coronary angiography, NC was also found to be associated with the prevalence of CHD with low heterogeneity (OR = 1.17, 95% CI 1.07–1.28, p = 0.0007, I2 = 17.02%). However, in the subgroup of computed tomography or past history, no association between NC and CHD was found. In addition, subgroup analyses were also conducted according to the regions of the study. No association between NC and CHD was identified in either Chinese studies or Brazil studies (OR = 1.20, 95% CI 0.96–1.49; OR = 1.31, 95% CI 0.82–2.09, respectively). Conclusion: Larger NC is associated with increased risk of CHD, especially when coronary angiography was taken to diagnose CHD.
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Affiliation(s)
- Guang-Ran Yang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Timothy D Dye
- Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Martin S Zand
- Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Thomas T Fogg
- Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Shen-Yuan Yuan
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jin-Kui Yang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Dongmei Li
- Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
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11
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Cozma A, Sitar-Taut A, Orăşan O, Leucuta D, Alexescu T, Stan A, Negrean V, Sampelean D, Pop D, Zdrenghea D, Vulturar R, Fodor A. Determining Factors of Arterial Stiffness in Subjects with Metabolic Syndrome. Metab Syndr Relat Disord 2018; 16:490-496. [PMID: 30183523 DOI: 10.1089/met.2018.0057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MS) is a clustering entity characterized by obesity, hypertension, hyperglycemia, dyslipidemia, and insulin resistance. Early detection of atherosclerosis is important in patients with MS because cardiovascular diseases are the main cause of mortality in these patients. METHODS We aimed to investigate the factors influencing arterial stiffness, pulse wave velocity, and the augmentation index, respectively, in 150 subjects with MS (94 women and 56 men; mean age 60.56 ± 9.8 years). Arterial stiffness was measured using the TensioMed™ Arteriograph. We tested the relationship between arterial parameters and insulin resistance measured by the determination of insulinemia (the ELISA method) and the homeostasis model assessment index (HOMA). RESULTS In multivariate analysis we identified the independent factors that influence arterial stiffness: systolic blood pressure (coefficient of determination 3.586; P < 0.0001), serum triglycerides (coefficient of determination 3.579; P < 0.0001), and age (coefficient of determination 3.510; P = 0.001) are independent predictive factors for pulse wave velocity. The independent predictive factors of the augmentation index were the body mass index (coefficient of determination 0.55; P = 0.009), the presence of diabetes mellitus (coefficient of determination 4.7; P = 0.03), mean arterial pressure (coefficient of determination 0.44; P < 0.0001), gender (coefficient of determination 9.2; P < 0.0001), age (coefficient of determination 0.3; P < 0.0001), and heart rate (coefficient of determination 0.66; P < 0.0001). Insulin resistance (HOMA index) was a predictor of the brachial augmentation index (β coefficient 3.4; P < 0.001) and was not a predictor of pulse wave velocity (β = -0.3; P = 0.6) in our study. CONCLUSIONS Given the known predictive value of pulse wave velocity for cardiovascular events, identifying the factors responsible for the increase in arterial stiffness is extremely important.
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Affiliation(s)
- Angela Cozma
- 1 Department of Internal Medicine, 4th Medical Clinic, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Adela Sitar-Taut
- 1 Department of Internal Medicine, 4th Medical Clinic, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Olga Orăşan
- 1 Department of Internal Medicine, 4th Medical Clinic, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Daniel Leucuta
- 2 Med Informat & Biostat Department, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Teodora Alexescu
- 1 Department of Internal Medicine, 4th Medical Clinic, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Adina Stan
- 3 Department of Neurology and Clinical Rehabilitation Hospital, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Vasile Negrean
- 1 Department of Internal Medicine, 4th Medical Clinic, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Dorel Sampelean
- 1 Department of Internal Medicine, 4th Medical Clinic, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Dana Pop
- 4 Department of Cardiology, Clinical Rehabilitation Hospital, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Dumitru Zdrenghea
- 4 Department of Cardiology, Clinical Rehabilitation Hospital, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Romana Vulturar
- 5 Department of Cell Biology, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
| | - Adriana Fodor
- 6 Clinical Center of Diabetes, Nutrition, Metabolic Diseases, "Iuliu Haţieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania
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12
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Wang M, Liu M, Ni T, Liu Q. miR‑214 mediates vascular inflammation and apoptosis via PTEN expression. Mol Med Rep 2018; 18:2229-2236. [PMID: 29916551 DOI: 10.3892/mmr.2018.9185] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 09/01/2017] [Indexed: 11/05/2022] Open
Abstract
The present study aimed to investigate the role of miR‑214 on inflammation and apoptosis in the vascular system and to examine its potential mechanisms. Anti‑miR‑214 mimics were used to downregulate miR‑214 expression in HUVECs. Cell viability and the apoptosis rate were measured using MTT assay and flow cytometry. Tumor necrosis factor (TNF)‑α, interleukin (IL)‑1β, IL‑6 and IL‑18 levels were measured using ELISA kits. Following this, caspase‑3/9, Bax, phosphatase and tensin homolog (PTEN), nuclear factor (NF)‑κB and phosphorylated‑(p)‑protein kinase B (Akt) protein expression were analyzed using western blotting. The results demonstrated that anti‑miR‑214 mimics inhibited cell proliferation, increased apoptosis and inflammatory factors (TNF‑α, IL‑1β, IL‑6 and IL‑18 levels), inhibited cell proliferation, and induced Bax protein expression in TNF‑α‑induced vascular endothelial cells through induction of PTEN and NF‑κB protein expression and inhibition of Akt protein expression. The PTEN inhibitor inhibited the function of anti‑miR‑214 on apoptosis and inflammation in TNF‑α‑induced inflammation vascular endothelial cells through the PTEN/Akt signaling pathway. These results suggest that miR‑214 mediates vascular inflammation and apoptosis via PTEN expression.
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Affiliation(s)
- Mingliang Wang
- Department of Cardiology, Shanghai Putuo District People's Hospital, Shanghai 200060, P.R. China
| | - Min Liu
- Department of Cardiology, Shanghai Putuo District People's Hospital, Shanghai 200060, P.R. China
| | - Ting Ni
- Department of Cardiology, Shanghai Putuo District People's Hospital, Shanghai 200060, P.R. China
| | - Qiliang Liu
- Department of Cardiology, Shanghai Putuo District People's Hospital, Shanghai 200060, P.R. China
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13
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Hsiao PJ, Lin HC, Chang ST, Hsu JT, Lin WS, Chung CM, Chang JJ, Hung KC, Shih YW, Chen FC, Hu FK, Wu YS, Chang CW, Su SL, Chu CM. Albuminuria and neck circumference are determinate factors of successful accurate estimation of glomerular filtration rate in high cardiovascular risk patients. PLoS One 2018; 13:e0185693. [PMID: 29394255 PMCID: PMC5796684 DOI: 10.1371/journal.pone.0185693] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 09/18/2017] [Indexed: 01/22/2023] Open
Abstract
Background Estimated glomerular filtration rate (eGFR) is used for diagnosis of chronic kidney disease (CKD). The eGFR models based on serum creatinine or cystatin C are used more in clinical practice. Albuminuria and neck circumference are associated with CKD and may have correlations with eGFR. Aim We explored the correlations and modelling formulates among various indicators such as serum creatinine, cystatin C, albuminuria, and neck circumference for eGFR. Design Cross-sectional study. Methods We reviewed the records of patients with high cardiovascular risk from 2010 to 2011 in Taiwan. 24-hour urine creatinine clearance was used as the standard. We utilized a decision tree to select for variables and adopted a stepwise regression method to generate five models. Model 1 was based on only serum creatinine and was adjusted for age and gender. Model 2 added serum cystatin C, models 3 and 4 added albuminuria and neck circumference, respectively. Model 5 simultaneously added both albuminuria and neck circumference. Results Total 177 patients were recruited in this study. In model 1, the bias was 2.01 and its precision was 14.04. In model 2, the bias was reduced to 1.86 with a precision of 13.48. The bias of model 3 was 1.49 with a precision of 12.89, and the bias for model 4 was 1.74 with a precision of 12.97. In model 5, the bias could be lower to 1.40 with a precision of 12.53. Conclusions In this study, the predicting ability of eGFR was improved after the addition of serum cystatin C compared to serum creatinine alone. The bias was more significantly reduced by the calculation of albuminuria. Furthermore, the model generated by combined albuminuria and neck circumference could provide the best eGFR predictions among these five eGFR models. Neck circumference can be investigated potentially in the further studies.
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Affiliation(s)
- Po-Jen Hsiao
- Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
- Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taiwan, R.O.C
- Big Data Research Center, Fu-Jen Catholic University, Taiwan, R.O.C
| | - Hung-Che Lin
- Department of Otolaryngology–Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Shih-Tai Chang
- Division of Cardiology, Chang Gung Memorial Hospital-Linkou, Chang GungUniversity College of Medicine, Tao-Yuan, Taiwan, R.O.C
| | - Jen-Te Hsu
- Division of Cardiology, Chang Gung Memorial Hospital-Linkou, Chang GungUniversity College of Medicine, Tao-Yuan, Taiwan, R.O.C
| | - Wei-Shiang Lin
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Chang-Min Chung
- Division of Cardiology, Chang Gung Memorial Hospital-Linkou, Chang GungUniversity College of Medicine, Tao-Yuan, Taiwan, R.O.C
| | - Jung-Jung Chang
- Division of Cardiology, Chang Gung Memorial Hospital-Linkou, Chang GungUniversity College of Medicine, Tao-Yuan, Taiwan, R.O.C
| | - Kuo-Chun Hung
- Division of Cardiology, Chang Gung Memorial Hospital-Linkou, Chang GungUniversity College of Medicine, Tao-Yuan, Taiwan, R.O.C
| | - Yun-Wen Shih
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Fu-Chi Chen
- Department of Biomedical Engineering, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Fu-Kang Hu
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Yi-Syuan Wu
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Chi-Wen Chang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan, R.O.C
- Division of Endocrinology, Department of Pediatrics, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C
| | - Sui-Lung Su
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, R.O.C
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Chi-Ming Chu
- Big Data Research Center, Fu-Jen Catholic University, Taiwan, R.O.C
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, R.O.C
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, R.O.C
- Department of Public Health, China Medical University, Taichung City, Taiwan, R.O.C
- * E-mail:
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14
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Kelishadi R, Heidari-Beni M, Qorbani M, Motamed-Gorji N, Motlagh ME, Ziaodini H, Taheri M, Ahadi Z, Aminaee T, Heshmat R. Association between neck and wrist circumferences and cardiometabolic risk in children and adolescents: The CASPIAN-V study. Nutrition 2017; 43-44:32-38. [PMID: 28935142 DOI: 10.1016/j.nut.2017.06.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 06/07/2017] [Accepted: 06/25/2017] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The predictive potentials of neck and wrist circumferences for cardiometabolic risks in children and adolescents remain to be determined. The aim of this study was to evaluate the association of neck and wrist circumferences with some cardiometabolic risk factors in children and adolescents. METHODS This multicenter study was conducted during the 2014 to 2015 school year with 4200 children and adolescents ages 7 to 18 y. The children were selected by multistage cluster sampling from 30 provinces of Iran. Anthropometric indices (neck, wrist and waist circumference, and body mass index), biochemical and clinical parameters were measured. Metabolic syndrome was defined based on the Adult Treatment Panel III criteria modified for the pediatric age group. High total cholesterol, high low-density lipoprotein cholesterol, and obesity were included as other cardiometabolic risk factors. RESULTS The participation rate for blood sampling was 91.5% (n = 3843). The mean (standard deviation) age of participants was 12.3 y (3.2 y). In a multivariate model, neck and wrist circumferences had significant association with elevated blood pressure, low high-density lipoprotein cholesterol, increased body mass index (overweight, excess weight, and generalized obesity), abdominal obesity, and metabolic syndrome. Additionally, obesity had the strongest associations with neck (odds ratio, 1.48; 95% confidence interval, 1.45-1.51) and wrist circumference (odds ratio, 2.25; 95% confidence interval, 2.15-2.36). CONCLUSION Neck and wrist circumferences are associated with some cardiometabolic risk factors. They could be used as alternative clinical tools and easy-to-use indicators of cardiometabolic risk in children and adolescents.
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Affiliation(s)
- Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Motahar Heidari-Beni
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran; Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nazgol Motamed-Gorji
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hasan Ziaodini
- Office of Health and Fitness, Ministry of Education, Tehran, Iran
| | - Majzoubeh Taheri
- Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Zeinab Ahadi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Aminaee
- Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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15
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Qiu Q, Gong Y, Liu X, Dou L, Wang Y, Wang B, Liang J. Serum Uric Acid and Impaired Glucose Tolerance: The Cardiometabolic Risk in Chinese (CRC) Study. Cell Biochem Biophys 2017; 73:155-62. [PMID: 25707501 DOI: 10.1007/s12013-015-0597-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Serum uric acid (SUA) elevation has been previously related to impaired fasting glucose and type 2 diabetes. The present study was comprehensive to examine the associations between SUA and impaired glucose tolerance (IGT) in Chinese adults. For this purpose, data were collected from a community-based health examination survey conducted in Central China; 2-h glucose (OGTT) and SUA were measured in 1956 men and women. In multivariate models, SUA levels were significantly associated with an increasing trend of 2-h glucose (OGTT) (P for trend < 0.0001). The odds ratios (OR; 95 % CI) of IGT across increasing quartiles of SUA were 1.0, 1.354 (0.948-2.087), 1.337 (0.959-2.251), and 2.192 (1.407-3.416), after adjusting for age, sex, body mass index, waist circumference, fasting insulin, blood pressure, serum lipids, serum creatinine, and estimated glomerular filtration rate. (P for trend = 0.001). In addition, we found an additive pattern between SUA and triglyceride (TG; P = 0.038) or between SUA and low-density lipoprotein cholesterol (LDL-C; P = 0.041) in relation to IGT. SUA was related to IGT in the Chinese adults, independent of other conventional metabolic risk factors. TG and LDL-C might modify the associations.
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Affiliation(s)
- Qinqin Qiu
- Xuzhou Medical College, Xuzhou, 221009, Jiangsu, China
| | - Ying Gong
- Department of Endocrinology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical College, Affiliated Hospital of Southeast University, 199# South Jiefang Road, Xuzhou, 221009, Jiangsu, China.,Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Xuzhou, 221009, Jiangsu, China
| | - Xuekui Liu
- Department of Endocrinology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical College, Affiliated Hospital of Southeast University, 199# South Jiefang Road, Xuzhou, 221009, Jiangsu, China.,Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Xuzhou, 221009, Jiangsu, China
| | - Lianjun Dou
- Department of Endocrinology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical College, Affiliated Hospital of Southeast University, 199# South Jiefang Road, Xuzhou, 221009, Jiangsu, China.,Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Xuzhou, 221009, Jiangsu, China
| | - Yu Wang
- Xuzhou Medical College, Xuzhou, 221009, Jiangsu, China.,Department of Endocrinology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical College, Affiliated Hospital of Southeast University, 199# South Jiefang Road, Xuzhou, 221009, Jiangsu, China.,Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Xuzhou, 221009, Jiangsu, China
| | - Ben Wang
- Department of Endocrinology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical College, Affiliated Hospital of Southeast University, 199# South Jiefang Road, Xuzhou, 221009, Jiangsu, China.,Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Xuzhou, 221009, Jiangsu, China
| | - Jun Liang
- Department of Endocrinology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical College, Affiliated Hospital of Southeast University, 199# South Jiefang Road, Xuzhou, 221009, Jiangsu, China. .,Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Xuzhou, 221009, Jiangsu, China.
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16
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Liang J, Sun Y, Liu X, Zhu Y, Pei Y, Wang Y, Qiu Q, Yang M, Qi L. Genetic predisposition to obesity is associated with insulin secretion in Chinese adults: The Cardiometabolic Risk in Chinese (CRC) study. J Diabetes Complications 2016; 30:1229-33. [PMID: 27324702 DOI: 10.1016/j.jdiacomp.2016.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 05/03/2016] [Accepted: 06/06/2016] [Indexed: 11/28/2022]
Abstract
AIMS The etiological role of obesity in determining diabetes risk among Asians may be different from that among Caucasians. The current study aimed to investigate the association between genetic predisposition to obesity and measures of insulin secretion and resistance in a large Chinese cohort. METHODS Study samples were from a community-based health examination survey in central China. A total of 2058 subjects with available biomarkers levels were included in the present study. A genetic risk score (GRS) of obesity was derived on the basis of thirteen Asian-specific body mass index (BMI)-associated variants. RESULTS High obesity GRS was significantly associated with increased homeostasis model assessment (HOMA)-B score (β=7.309; P=0.001) but not related to measures of insulin resistance. Adjustment for age, sex, BMI, and levels of lipids did not appreciably change the results. In addition, we found significant interactions between the obesity GRS and measures of body fat distribution including waist circumference (WC; P for interaction=0.004) and neck circumference (NC; P for interaction=0.014) on HOMA-B score. CONCLUSIONS Our results suggest that genetic predisposition to obesity may affect beta cell function in Chinese; and body fat distribution may modify the genetic effects.
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Affiliation(s)
- Jun Liang
- Department of Endocrinology of Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Jiangsu 221009, China; Xuzhou Clinical School of Xuzhou Medical College, Xuzhou Central Hospital Affiliated to Nanjing University of Chinese Medicine, Affiliated Hospital of Southeast University, Xuzhou, Jiangsu 221009, China.
| | - Yuting Sun
- Xuzhou Medical College, Jiangsu 221000, China
| | - Xuekui Liu
- Department of Endocrinology of Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Jiangsu 221009, China; Xuzhou Clinical School of Xuzhou Medical College, Xuzhou Central Hospital Affiliated to Nanjing University of Chinese Medicine, Affiliated Hospital of Southeast University, Xuzhou, Jiangsu 221009, China
| | - Yan Zhu
- Xuzhou Medical College, Jiangsu 221000, China
| | - Ying Pei
- School of Medicine, Southeast University, Jiangsu 210009, China
| | - Yu Wang
- Department of Endocrinology of Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Jiangsu 221009, China; Xuzhou Clinical School of Xuzhou Medical College, Xuzhou Central Hospital Affiliated to Nanjing University of Chinese Medicine, Affiliated Hospital of Southeast University, Xuzhou, Jiangsu 221009, China
| | - Qinqin Qiu
- Xuzhou Medical College, Jiangsu 221000, China
| | - Manqing Yang
- Department of Endocrinology of Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Jiangsu 221009, China; Xuzhou Clinical School of Xuzhou Medical College, Xuzhou Central Hospital Affiliated to Nanjing University of Chinese Medicine, Affiliated Hospital of Southeast University, Xuzhou, Jiangsu 221009, China
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70118, United States; Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, United States.
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Wakabayashi H, Matsushima M. Neck Circumference Is Not Associated with Dysphagia but with Undernutrition in Elderly Individuals Requiring Long-term Care. J Nutr Health Aging 2016; 20:355-60. [PMID: 26892586 DOI: 10.1007/s12603-015-0587-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The purpose was to assess the association between neck circumference, dysphagia, and undernutrition in elderly individuals requiring long-term care. DESIGN Cross-sectional study. SETTING Geriatric health services facilities, acute hospitals, and the community. PARTICIPANTS Elderly individuals ≥65 years of age with dysphagia or possible dysphagia (N=385). MEASUREMENTS Neck circumference, the Dysphagia Severity Scale (DSS) and the Mini Nutritional Assessment Short Form (MNA-SF). RESULTS Participants included 130 males and 255 females with a mean age (± standard deviation) of 83 ± 8.0 years. Sixty-six were in acute hospitals, 195 were in geriatric health services facilities, and 124 were community-dwelling. The mean neck circumference in males and females was 37.1 ± 3.0 cm and 33.3 ± 3.3 cm, respectively. Based on the DSS, 81 participants were within normal limits, 137 had dysphagia without aspiration, and 167 had dysphagia with aspiration. The MNA-SF revealed that 173 were malnourished, 172 were at risk of malnutrition, and 40 had a normal nutritional status. Neck circumference was not significantly correlated with the DSS (r=-0.080) but was significantly correlated with the MNA-SF (r=0.183) in the Spearman rank correlation analysis. In the logistic regression, neck circumference was not independently associated with the DSS after adjusting for the MNA-SF, the Barthel Index, age, sex, setting, and cerebrovascular disorders. However, the multiple regression analysis showed that neck circumference had an independent effect on the MNA-SF after adjusting for the Barthel Index, age, sex, setting and cerebrovascular disorders. CONCLUSIONS Neck circumference is not associated with dysphagia but with undernutrition in elderly individuals requiring long-term care.
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Affiliation(s)
- H Wakabayashi
- Hidetaka Wakabayashi, Department of Rehabilitation Medicine, Yokohama City University Medical Center, 4-57 Urafune-chou, Minami ward, Yokohama City, Japan 232-0024, E-mail: , Tel: +81-45-261-5656; Fax: +81-45-253-9955
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Aoi S, Miyake T, Iida T, Ikeda H, Ishizaki F, Chikamura C, Tamura N, Nitta Y, Harada T, Miyaguchi H. Association of Changes in Neck Circumference with Cardiometabolic Risk in Postmenopausal Healthy Women. J Atheroscler Thromb 2016; 23:728-36. [PMID: 26797264 DOI: 10.5551/jat.31963] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Although neck circumference (NC) is thought to predict obesity-related metabolic abnormality, its causal role in cardiometabolic risk is unclear. The aim of this study was to clarify the impact of changes in NC on cardiometabolic risk in healthy postmenopausal women through a community-based longitudinal study. METHODS From a local community in Japan, 63 generally healthy postmenopausal women were recruited. All participants received an assessment of obesity-related anthropometric markers, biochemical parameters, and hemodynamic measures and were followed on average for 3 years. RESULTS At baseline analysis, larger NC was positively associated with atherosclerosis-related markers, brachial-ankle pulse wave velocity (baPWV) and blood pressure, as well as some lipid parameters. After the follow-up period, change in NC was associated with changes in body mass index (BMI), body fat percentage, and waist circumference (WC). Interestingly, significant correlations of change in NC with changes in baPWV and blood pressure were observed, whereas changes in WC and BMI were only associated with changes in low-density lipoprotein cholesterol and/or total cholesterol. In multivariate linear regression analysis, change in NC was significantly associated with changes in baPWV and systolic blood pressure, independent of changes in BMI, WC, and biochemical parameters. In addition, an increase in NC was associated with a 2.69-fold increased odds ratio of accelerated baPWV. CONCLUSIONS Change in NC was independently associated with changes in atherosclerosis-related markers. These observations suggest that NC is an important predictor of the risk of developing obesity-related atherosclerosis in healthy postmenopausal women.
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Affiliation(s)
- Satomi Aoi
- Faculty of Health and Welfare, Prefectural University of Hiroshima
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Abstract
Fungal microbiota (mycobiota) is potentially involved in the intestinal illness. The characterization of the mycobiota in patients with adenomas is essential for understanding the etiology of the pre-cancerous lesion since the mycobiota is potentially associated with the presents of adenomas. The recovery of the mycobiome may also help to identify the potential biomarkers which may closely relate to different stages of adenoma.
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Affiliation(s)
- Chunguang Luan
- China National Research Institute of Food & Fermentation Industries; Beijing China
| | - Huifang Miao
- Chinese National Human Genome Center; Beijing, China,SinoGenoMax Co. Ltd.; Beijing, China
| | - Baoli Zhu
- CAS key Laboratory of Pathogenic Microbiology and Immunology; Institute of Microbiology; Chinese Academy of Sciences; Beijing, China,Correspondence to: Baoli Zhu;
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Zhao D, Bi G, Feng J, Huang R, Chen X. Association of Serum Chemerin Levels with Acute Ischemic Stroke and Carotid Artery Atherosclerosis in a Chinese Population. Med Sci Monit 2015; 21:3121-8. [PMID: 26471865 PMCID: PMC4612685 DOI: 10.12659/msm.895866] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 09/28/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aim of this study was to examine the association between serum level of chemerin with AIS and carotid artery atherosclerosis, and to investigate the level of chemerin as a potential novel cerebrovascular risk factor. MATERIAL AND METHODS We compared the serum chemerin levels and cerebrovascular parameters between 70 AIS patients and 70 non-AIS subjects in a Chinese population. Enzyme-linked immunosorbent assay (ELISA) was used to measure the levels of serum chemerin. The state of carotid artery plaques in the AIS group was detected by color Doppler ultrasound. We used SPSS software for statistical analysis. RESULTS Compared with the non-AIS group, serum level of chemerin in the AIS group increased significantly (p<0.01). Multivariable logistic regression suggested that serum chemerin level, neutrophil count, and BMI were independent risk factors for AIS (p<0.05). Compared with the non-unstable plaque group, there were significant differences from the unstable plaque group in serum chemerin level (p<0.01). Multivariable logistic regression analysis revealed that the LDL-C, FIB, and serum chemerin levels were independent risk factors for carotid artery plaque instability (P<0.05). The levels of serum chemerin in the subjects with no carotid artery plaque were significantly lower than in those with carotid artery plaques of 2 and ≥3 (P=0.013; P=0.01). CONCLUSIONS The results of this study suggest that the serum chemerin level may be an independent risk factor for AIS and carotid artery plaque instability in Chinese populations.
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Affiliation(s)
| | - Guorong Bi
- Corresponding Author: Guorong Bi, e-mail:
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Serum fibroblast growth factor 21 levels are related to subclinical atherosclerosis in patients with type 2 diabetes. Cardiovasc Diabetol 2015; 14:72. [PMID: 26047614 PMCID: PMC4475300 DOI: 10.1186/s12933-015-0229-9] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/23/2015] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Fibroblast growth factor 21 (FGF21), a glucose and lipid metabolic regulator, has recently been demonstrated to be associated with cardiovascular diseases (CVD) such as carotid atherosclerosis, coronary heart disease and carotid artery plaques. However, the relationship between circulating FGF21 and subclinical atherosclerosis or atherosclerosis of other arteries such as the femoral and iliac artery remains unclear. In this study, we evaluated the association of serum FGF21 with intima-media thickness (IMT) and subclinical atherosclerosis in type 2 diabetic patients. METHODS Serum FGF21 levels were detected by enzyme-linked immunosorbent assay in 212 newly diagnosed type 2 diabetic patients without clinical symptoms of atherosclerosis or cardiovascular diseases. IMT of the carotid, femoral, and iliac arteries were measured by high-resolution B-mode ultrasound to determine the presence of subclinical atherosclerosis, which was defined as having an IMT > 1.0 mm and/or plaque on one or more of the three arteries without any clinical manifestations. The relationship between serum FGF21 levels and subclinical atherosclerosis was analyzed. RESULTS Serum FGF21 levels were significantly higher in patients with subclinical atherosclerosis compared to those without [261.3 (135.1-396.4) versus 144.9 (95.9-223.0) ng/L, P < 0.001]. These differences were also observed in both men and women with subclinical atherosclerosis compared to their respective groups without [men: 243.2 (107.6-337.0) versus 136.8 (83.6-212.8) ng/L, P = 0.048; women: 292.4 (174.2-419.9) versus 160.4 (115.3-258.5) ng/L, P = 0.001]. Moreover, serum FGF21 levels showed a significantly positive correlation with carotid IMT in women (r = 0.23, P = 0.018) and with iliac IMT in both genders (women: r = 0.27, P = 0.005; men: r = 0.22, P = 0.024). Multiple logistic regression analysis further showed that serum FGF21 was an independent impact factor for subclinical atherosclerosis in patients with type 2 diabetes. CONCLUSIONS Serum FGF21 is elevated in newly diagnosed type 2 diabetes, and positively correlates with carotid and iliac lesions in patients with subclinical atherosclerosis, especially in women. High levels of FGF21 may be a compensatory reaction to offset atherosclerosis.
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Gómez-Marcos MÁ, Recio-Rodríguez JI, Patino-Alonso MC, Agudo-Conde C, Gómez-Sánchez L, Gomez-Sanchez M, Rodríguez-Sanchez E, Maderuelo-Fernandez JA, García-Ortiz L. Cardio-ankle vascular index is associated with cardiovascular target organ damage and vascular structure and function in patients with diabetes or metabolic syndrome, LOD-DIABETES study: a case series report. Cardiovasc Diabetol 2015; 14:7. [PMID: 25853841 PMCID: PMC4299688 DOI: 10.1186/s12933-014-0167-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Accepted: 12/28/2014] [Indexed: 12/21/2022] Open
Abstract
Background The cardio ankle vascular index (CAVI) is a new index of the overall stiffness of the artery from the origin of the aorta to the ankle. This index can estimate the risk of atherosclerosis. We aimed to find the relationship between CAVI and target organ damage (TOD), vascular structure and function, and cardiovascular risk factors in Caucasian patients with type 2 diabetes mellitus or metabolic syndrome. Methods We included 110 subjects from the LOD-Diabetes study, whose mean age was 61 ± 11 years, and 37.3% were women. Measurements of CAVI, brachial ankle pulse wave velocity (ba-PWV), and ankle brachial index (ABI) were taken using the VaSera device. Cardiovascular risk factors, renal function by creatinine, glomerular filtration rate, and albumin creatinine index were also obtained, as well as cardiac TOD with ECG and vascular TOD and carotid intima media thickness (IMT), carotid femoral PWV (cf-PWV), and the central and peripheral augmentation index (CAIx and PAIx). The Framingham-D’Agostino scale was used to measure cardiovascular risk. Results Mean CAVI was 8.7 ± 1.3. More than half (54%) of the participants showed one or more TOD (10% cardiac, 13% renal; 48% vascular), and 13% had ba-PWV ≥ 17.5 m/s. Patients with any TOD had the highest CAVI values: 1.15 (CI 95% 0.70 to 1.61, p < 0.001) and 1.14 (CI 95% 0.68 to 1.60, p < 0.001) when vascular TOD was presented, and 1.30 (CI 95% 0.51 to 2.10, p = 0.002) for the cardiac TOD. The CAVI values had a positive correlation with HbA1c and systolic and diastolic blood pressure, and a negative correlation with waist circumference and body mass index. The positive correlations of CAVI with IMT (β = 0.29; p < 0.01), cf-PWV (β = 0.83; p < 0.01), ba-PWV (β = 2.12; p < 0.01), CAIx (β = 3.42; p < 0.01), and PAIx (β = 5.05; p = 0.04) remained after adjustment for cardiovascular risk, body mass index, and antihypertensive, lipid-lowering, and antidiabetic drugs. Conclusions The results of this study suggest that the CAVI is positively associated with IMT, cf-PWV, ba-PWV, CAIx, and PAIx, regardless of cardiovascular risk and the drug treatment used. Patients with cardiovascular TOD have higher values of CAVI. Trial registration Clinical Trials.gov Identifier: NCT01065155
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Lukich A, Gavish D, Shargorodsky M. Normal weight diabetic patients versus obese diabetics: relation of overall and abdominal adiposity to vascular health. Cardiovasc Diabetol 2014; 13:141. [PMID: 25331525 PMCID: PMC4226853 DOI: 10.1186/s12933-014-0141-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 10/05/2014] [Indexed: 12/18/2022] Open
Abstract
Objective The present study investigated the impact of overall obesity defined by BMI and abdominal obesity defined by WC on vascular atherosclerotic changes in obese and normal weight diabetic subjects. Design and methods 285 subjects were divided according to presence diabetes mellitus (DM) and obesity: Group 1 included 144 nonobese subjects without DM; Group 2 consisted of 141 type 2 diabetic patients. Then diabetic patients were divided into two groups according to presence of overall obesity, defined by BMI and furthermore, abdominal obesity, defined by waist circumference (WC). Pulse wave velocity (PWV) and augmentation index (AI) were performed using SphygmoCor (version 7.1, AtCor Medical, Sydney, Australia). Results Between Group Comparisons by BMI: Diabetic subjects with and without overall obesity did not differ from one another in terms of AI and PWV. Between Group Comparisons by WC: AI as well as PWV increased consistently from Group 1 to Group 3, AI and PWV were significantly higher in abdominally obese diabetic subjects than in the diabetics without abdominal obesity (p = 0.008 and p = 0.013, respectively). Significant by-group differences in PWV and AI persisted after adjustment for age, sex, blood pressure, fasting glucose and BMI. Conclusions Abdominal obesity defined by WC was associated with significantly higher AI and PWV in in both diabetic men and women; whereas overall obesity defined by BMI did not predict adverse vascular changes in this study population. Abdominal obesity was associated with an adverse effect on blood vessels, independently of age, sex, blood pressure, fasting glucose and BMI.
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