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Bjelica B, Wohnrade C, Osmanovic A, Schreiber-Katz O, Schuppner R, Greten S, Petri S. Metabolic syndrome is common in adults with 5q-spinal muscular atrophy and impacts quality of life and fatigue. Muscle Nerve 2024; 70:257-264. [PMID: 38872508 DOI: 10.1002/mus.28183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 05/27/2024] [Accepted: 06/01/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION/AIMS Spinal muscular atrophy (SMA) is a multisystem disorder. We assessed metabolic syndrome (MetS) prevalence in adults with SMA and its association with motor function, quality of life (QoL), fatigue, and depression. METHODS MetS was diagnosed using 2009 consensus criteria. Hammersmith Functional Motor Scale Expanded (HFMSE), Revised Upper Limb Module (RULM), Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), and 36-Item Short Form Health Survey (SF-36) were recorded and correlations between muscle function, depression, fatigue, QoL, and MetS were analyzed. RESULTS We included 36 individuals (18 males; mean age: 38.7 ± 14.6 years). MetS was present in 25.0%. The most common component of MetS was central obesity (69.7%). Nearly half of the SMA individuals exhibited at least one abnormal lipid level result. Individuals with MetS more frequently were SMA type 3 (77.8% vs. 37.0%, p = .02) and had higher levels of fatigue (48.4 ± 6.7 vs. 39.5 ± 11.6, p = .03) than those without MetS. No associations of the presence of MetS with ambulatory status or HFMSE/RULM scores were observed. SMA individuals with MetS scored significantly lower in mental and social domains of QoL and total SF-36 score (p = .04). We observed weak to moderate correlations between the presence of MetS and SMA type, presence of comorbidities, QoL, and fatigue. DISCUSSION The frequency of MetS was modestly higher among adults with SMA than in the general population, particularly in SMA type 3. MetS was associated with reduced QoL and increased fatigue. Larger studies are needed to fully understand the significance of MetS in adults with SMA.
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Affiliation(s)
- Bogdan Bjelica
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Camilla Wohnrade
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Alma Osmanovic
- Department of Neurology, Hannover Medical School, Hannover, Germany
- Essen Center for Rare Diseases (EZSE), University Hospital Essen, Essen, Germany
| | | | - Ramona Schuppner
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Stephan Greten
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Susanne Petri
- Department of Neurology, Hannover Medical School, Hannover, Germany
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Eissa T, Leonardo C, Kepesidis KV, Fleischmann F, Linkohr B, Meyer D, Zoka V, Huber M, Voronina L, Richter L, Peters A, Žigman M. Plasma infrared fingerprinting with machine learning enables single-measurement multi-phenotype health screening. Cell Rep Med 2024; 5:101625. [PMID: 38944038 PMCID: PMC11293328 DOI: 10.1016/j.xcrm.2024.101625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 04/19/2024] [Accepted: 06/07/2024] [Indexed: 07/01/2024]
Abstract
Infrared spectroscopy is a powerful technique for probing the molecular profiles of complex biofluids, offering a promising avenue for high-throughput in vitro diagnostics. While several studies showcased its potential in detecting health conditions, a large-scale analysis of a naturally heterogeneous potential patient population has not been attempted. Using a population-based cohort, here we analyze 5,184 blood plasma samples from 3,169 individuals using Fourier transform infrared (FTIR) spectroscopy. Applying a multi-task classification to distinguish between dyslipidemia, hypertension, prediabetes, type 2 diabetes, and healthy states, we find that the approach can accurately single out healthy individuals and characterize chronic multimorbid states. We further identify the capacity to forecast the development of metabolic syndrome years in advance of onset. Dataset-independent testing confirms the robustness of infrared signatures against variations in sample handling, storage time, and measurement regimes. This study provides the framework that establishes infrared molecular fingerprinting as an efficient modality for populational health diagnostics.
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Affiliation(s)
- Tarek Eissa
- Department of Laser Physics, Ludwig Maximilian University of Munich (LMU), Garching, Germany; Laboratory for Attosecond Physics, Max Planck Institute of Quantum Optics (MPQ), Garching, Germany; School of Computation, Information and Technology, Technical University of Munich (TUM), Garching, Germany.
| | - Cristina Leonardo
- Department of Laser Physics, Ludwig Maximilian University of Munich (LMU), Garching, Germany
| | - Kosmas V Kepesidis
- Department of Laser Physics, Ludwig Maximilian University of Munich (LMU), Garching, Germany; Laboratory for Attosecond Physics, Max Planck Institute of Quantum Optics (MPQ), Garching, Germany; Center for Molecular Fingerprinting (CMF), Budapest, Hungary
| | - Frank Fleischmann
- Department of Laser Physics, Ludwig Maximilian University of Munich (LMU), Garching, Germany; Laboratory for Attosecond Physics, Max Planck Institute of Quantum Optics (MPQ), Garching, Germany
| | - Birgit Linkohr
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Daniel Meyer
- Laboratory for Attosecond Physics, Max Planck Institute of Quantum Optics (MPQ), Garching, Germany; Center for Molecular Fingerprinting (CMF), Budapest, Hungary
| | - Viola Zoka
- Department of Laser Physics, Ludwig Maximilian University of Munich (LMU), Garching, Germany; Center for Molecular Fingerprinting (CMF), Budapest, Hungary
| | - Marinus Huber
- Department of Laser Physics, Ludwig Maximilian University of Munich (LMU), Garching, Germany; Laboratory for Attosecond Physics, Max Planck Institute of Quantum Optics (MPQ), Garching, Germany
| | - Liudmila Voronina
- Department of Laser Physics, Ludwig Maximilian University of Munich (LMU), Garching, Germany
| | - Lothar Richter
- School of Computation, Information and Technology, Technical University of Munich (TUM), Garching, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; School of Public Health, Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer, Ludwig Maximilian University of Munich (LMU), Munich, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Munich, Munich, Germany
| | - Mihaela Žigman
- Department of Laser Physics, Ludwig Maximilian University of Munich (LMU), Garching, Germany; Laboratory for Attosecond Physics, Max Planck Institute of Quantum Optics (MPQ), Garching, Germany.
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Zhang L, Muscat JE, Chinchilli VM, Kris-Etherton PM, Al-Shaar L, Richie JP. Berry Consumption in Relation to Allostatic Load in US Adults: The National Health and Nutrition Examination Survey, 2003-2010. Nutrients 2024; 16:403. [PMID: 38337686 PMCID: PMC10857206 DOI: 10.3390/nu16030403] [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: 11/13/2023] [Revised: 01/11/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Berries are a rich source of antioxidant polyphenols and other nutrients that are associated with good health. Allostatic load (AL) is an aggregate measure of chronic stress-induced physiological dysregulations across cardiovascular, metabolic, autonomic, and immune systems; the extent of these dysregulations, collectively or in each system, can be characterized by a composite score or a domain score assessed by integrated biomarkers. It was hypothesized that the anti-inflammatory and other effects of berries lower AL. The association was determined between berry consumption and AL composite and domain scores in the 2003-2010 National Health and Nutrition Examination Survey (NHANES). METHODS Berry intake was measured using two 24 h dietary recalls collected from US adults in the 2003-2010 NHANES (n = 7684). The association with AL and its specific domains was examined using population weight-adjusted multivariable linear regression. RESULTS The mean AL composite scores for consumers of any berries (11.9), strawberries (11.6), and blueberries (11.6), respectively, were significantly lower than nonconsumers (12.3), after fully adjusting for sociodemographic, lifestyle, and dietary confounders. A significant dose-response relationship was determined between greater consumption of total berries, strawberries, and blueberries and lower mean AL composite scores (p-trend < 0.05, for all). Consistently, mean cardiovascular and metabolic domain scores remained significantly lower in the consumers of total berries (mean cardiovascular domain score: 4.73 versus 4.97 for nonconsumers; mean metabolic domain score: 2.97 versus 3.1), strawberries (4.73 versus 4.95; 2.99 versus 3.1), and blueberries (4.6 versus 4.95; 2.92 versus 3.11). Berry consumers also had significantly lower mean AL immune scores (1.52 versus 1.56) and lower mean AL autonomic scores (2.49 versus 2.57) than nonconsumers (initial sample: n = 15,620). CONCLUSIONS The current study indicates that consumption of berries lowers the AL composite scores and potentially reduces stress-related disease risks in the US adult population.
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Affiliation(s)
- Li Zhang
- Department of Public Health Sciences, Penn State Cancer Institute, Penn State College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA; (V.M.C.); (L.A.-S.); (J.P.R.)
| | - Joshua E. Muscat
- Department of Public Health Sciences, Penn State Cancer Institute, Penn State College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA; (V.M.C.); (L.A.-S.); (J.P.R.)
| | - Vernon M. Chinchilli
- Department of Public Health Sciences, Penn State Cancer Institute, Penn State College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA; (V.M.C.); (L.A.-S.); (J.P.R.)
| | - Penny M. Kris-Etherton
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA 16802, USA;
| | - Laila Al-Shaar
- Department of Public Health Sciences, Penn State Cancer Institute, Penn State College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA; (V.M.C.); (L.A.-S.); (J.P.R.)
| | - John P. Richie
- Department of Public Health Sciences, Penn State Cancer Institute, Penn State College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA; (V.M.C.); (L.A.-S.); (J.P.R.)
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Latief K, Nurrika D, Tsai MK, Gao W. Body Mass Index Asian populations category and stroke and heart disease in the adult population: a longitudinal study of the Indonesia Family Life Survey (IFLS) 2007 and 2014. BMC Public Health 2023; 23:2221. [PMID: 37950166 PMCID: PMC10636903 DOI: 10.1186/s12889-023-17126-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND A substantially elevated Body Mass Index (BMI) is one of the largest global modifiable risk factors for stroke and heart diseases. Most studies classify BMI according to the WHO BMI cut-off point in stroke and heart disease studies. However, there is a limited understanding of the association between the BMI cut-off point in the Asian population category and stroke and heart disease. This study aimed to investigate the incidence rate ratio of stroke and heart disease by BMI categories for the Asian population. METHODS A 7-year prospective longitudinal study (2007-2014) was conducted on 6,688 adult Indonesian individuals (≥ 35 years) residing across 13 different provinces in Indonesia during the survey periods. Data on BMI were collected in 2007. Information on stroke and heart disease was obtained in both 2007 and in 2014. A multivariate-adjusted Poisson regression model was used to estimate the incidence rate ratio (IRR) and 95% confidence intervals (CIs) of either stroke or heart disease or both stroke and heart disease by BMI. RESULTS Among the 6,688 eligible participants, 334 (5%) were judged as stroke and heart disease in 2014. The IRR (95% CI) of stroke and heart disease for participants with obesity was 2.57 (1.64-4.04) compared with those within normal weight. This incidence rate ratio was more pronounced among middle-aged adults (< 55 years) rather than the older adults (≥55 years).The IRR of stroke and heart disease among obese middle-aged adults was 4.18 (95% CI 2.10-8.31). CONCLUSIONS An association was observed between obesity and the risk of stroke and heart disease, especially in middle-aged adults. These findings suggest that lowering BMI through the adoption of healthy dietary habits and increasing physical activity, particularly among middle-aged adults with high education, occupational employment, and residence in either urban or rural areas, may be beneficial for preventing stroke and heart disease.
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Affiliation(s)
- Kamaluddin Latief
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, 250 Wuxing Street, 110, Taipei, Taiwan
- Center for Family Welfare, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Dieta Nurrika
- Public Health Study Program, Banten School of Health Science, South Tangerang, 15318, Indonesia
- The Ministry of Education, Culture, Research, and Technology, Higher Education Service Institutions (LL-DIKTI) Region IV, Bandung, 40124, Indonesia
| | - Min-Kuang Tsai
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, 250 Wuxing Street, 110, Taipei, Taiwan
| | - Wayne Gao
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, 250 Wuxing Street, 110, Taipei, Taiwan.
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McCallum RK, Kramer AI, Marchand M, Akioyamen LE, Genest J, Brunham LR. Estimating the Prevalence of Hypercholesterolemia in Indigenous Populations: A Systematic Review and Meta-Analysis. JACC. ADVANCES 2023; 2:100315. [PMID: 38939583 PMCID: PMC11198456 DOI: 10.1016/j.jacadv.2023.100315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/09/2023] [Accepted: 02/19/2023] [Indexed: 06/29/2024]
Abstract
Background Hypercholesterolemia is a common condition characterized by elevated levels of low-density lipoprotein cholesterol (LDL-C) and increased risk of atherosclerotic cardiovascular disease (ASCVD). Indigenous populations experience disproportionate rates of ASCVD, however, the extent to which hypercholesterolemia contributes to this burden is unknown. Objectives This study aimed to estimate the prevalence of hypercholesterolemia, severe hypercholesterolemia, and familial hypercholesterolemia (FH) in Indigenous populations in Canada, the United States, Australia, and New Zealand. Methods We searched MEDLINE, EMBASE, Web of Science, Native Health Database, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews for peer-reviewed studies reporting on hypercholesterolemia and elevated LDL-C in Indigenous populations. All diagnostic criteria used to classify hypercholesterolemia were included. Pooled prevalence and 95% CIs were calculated using a random-effects model. Results There were no studies reporting the prevalence of FH and one study reporting the prevalence of severe hypercholesterolemia in Indigenous populations. The pooled prevalence of hypercholesterolemia was 28.9% or ∼1 in 3 to 1 in 4 individuals (95% CI: 22.4%-36.4%) and 12.6% (95% CI: 7.7%-19.9%) using an LDL-C cutoff of ≥3.5 mmol/L (135 mg/dL). The pooled prevalence in Indigenous populations in North America was 24.3% (95% CI: 17.1%-33.3%) compared with 40.0% (95% CI: 31.3%-49.3%) in Australia. Meta-regression showed diabetes had a significant effect on prevalence (P = 0.022). Conclusions Hypercholesterolemia is prevalent in Indigenous communities and may contribute to the high burden of ASCVD these populations face. There is insufficient research on FH and severe hypercholesterolemia in Indigenous populations worldwide.
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Affiliation(s)
- Rylan K. McCallum
- Centre for Heart and Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada
- Manitoba Métis Federation, Manitoba, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Adam I. Kramer
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Miles Marchand
- Centre for Heart and Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada
- Syilx Okanagan First Nation, British Columbia, Canada
| | - Leo E. Akioyamen
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jacques Genest
- Department of Medicine, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Liam R. Brunham
- Centre for Heart and Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
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Gomez Cardoso A, Rahin Ahmed S, Keshavarz-Motamed Z, Srinivasan S, Reza Rajabzadeh A. Recent advancements of nanomodified electrodes - Towards point-of-care detection of cardiac biomarkers. Bioelectrochemistry 2023; 152:108440. [PMID: 37060706 DOI: 10.1016/j.bioelechem.2023.108440] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 04/17/2023]
Abstract
The increasing number of deaths from cardiovascular diseases has become a substantial concern in both developed and underdeveloped countries. Rapid and on-site monitoring of this disease is urgently important to control, prevent and make awareness of public health. Recently, a lot of focus has been placed on nanomaterials and modify these nanomaterials have been explored to detect cardiac biomarkers. By implementing biosensors that are modified with novel recognition elements and more stable nanomaterials, the use of electrochemistry for point-of-care devices is more realistic every day. This review focuses on the current state of nanomaterials conjugated biorecognition elements (enzyme integrated with nanomaterials, antibody conjugated nanomaterials and aptamer conjugated nanomaterials) for electrochemical cardiovascular disease detection. Specifically, a lot of attention has been given to the trends toward more stable biosensors that have increased the potential to be used as point-of-care devices for the detection of cardiac biomarkers due to their high stability and specificity. Moreover, the recent progress on biomolecule-free electrochemical nanosensors for cardiovascular disease detection has been considered. At last, the possibility and drawbacks of some of these techniques for point-of-care cardiac device development in the future have been discussed.
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Affiliation(s)
- Ana Gomez Cardoso
- Department of Mechanical Engineering, McMaster University, 1280 Main Street, West Hamilton, Ontario L8S 4L7, Canada
| | - Syed Rahin Ahmed
- W Booth School of Engineering Practice and Technology, McMaster University, 1280 Main Street, West Hamilton, Ontario L8S 4L7, Canada
| | - Zahra Keshavarz-Motamed
- Department of Mechanical Engineering, McMaster University, 1280 Main Street, West Hamilton, Ontario L8S 4L7, Canada
| | - Seshasai Srinivasan
- Department of Mechanical Engineering, McMaster University, 1280 Main Street, West Hamilton, Ontario L8S 4L7, Canada; W Booth School of Engineering Practice and Technology, McMaster University, 1280 Main Street, West Hamilton, Ontario L8S 4L7, Canada.
| | - Amin Reza Rajabzadeh
- Department of Mechanical Engineering, McMaster University, 1280 Main Street, West Hamilton, Ontario L8S 4L7, Canada; W Booth School of Engineering Practice and Technology, McMaster University, 1280 Main Street, West Hamilton, Ontario L8S 4L7, Canada.
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White Z, Sun Z, Sauge E, Cox D, Donen G, Pechkovsky D, Straub V, Francis GA, Bernatchez P. Limb-girdle muscular dystrophy type 2B causes HDL-C abnormalities in patients and statin-resistant muscle wasting in dysferlin-deficient mice. Skelet Muscle 2022; 12:25. [PMID: 36447272 PMCID: PMC9706908 DOI: 10.1186/s13395-022-00308-6] [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: 07/07/2022] [Accepted: 11/11/2022] [Indexed: 12/03/2022] Open
Abstract
Limb-girdle muscular dystrophy (MD) type 2B (LGMD2B) and Duchenne MD (DMD) are caused by mutations to the Dysferlin and Dystrophin genes, respectively. We have recently demonstrated in typically mild dysferlin- and dystrophin-deficient mouse models that increased plasma cholesterol levels severely exacerbate muscle wasting, and that DMD patients display primary dyslipidemia characterized by elevated plasma cholesterol and triglycerides. Herein, we investigate lipoprotein abnormalities in LGMD2B and if statin therapy protects dysferlin-deficient mice (Dysf) from muscle damage. Herein, lipoproteins and liver enzymes from LGMD2B patients and dysferlin-null (Dysf) mice were analyzed. Simvastatin, which exhibits anti-muscle wasting effects in mouse models of DMD and corrects aberrant expression of key markers of lipid metabolism and endogenous cholesterol synthesis, was tested in Dysf mice. Muscle damage and fibrosis were assessed by immunohistochemistry and cholesterol signalling pathways via Western blot. LGMD2B patients show reduced serum high-density lipoprotein cholesterol (HDL-C) levels compared to healthy controls and exhibit a greater prevalence of abnormal total cholesterol (CHOL)/HDL-C ratios despite an absence of liver dysfunction. While Dysf mice presented with reduced CHOL and associated HDL-C and LDL-C-associated fractions, simvastatin treatment did not prevent muscle wasting in quadriceps and triceps muscle groups or correct aberrant low-density lipoprotein receptor (LDLR) and 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) protein expression. LGMD2B patients present with reduced serum concentrations of HDL-C, a major metabolic comorbidity, and as a result, statin therapy is unlikely to prevent muscle wasting in this population. We propose that like DMD, LGMD2B should be considered as a new type of genetic dyslipidemia.
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Affiliation(s)
- Zoe White
- grid.17091.3e0000 0001 2288 9830Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia (UBC), 217-2176 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,grid.416553.00000 0000 8589 2327UBC Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, Canada
| | - Zeren Sun
- grid.17091.3e0000 0001 2288 9830Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia (UBC), 217-2176 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,grid.416553.00000 0000 8589 2327UBC Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, Canada
| | - Elodie Sauge
- grid.17091.3e0000 0001 2288 9830Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia (UBC), 217-2176 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,grid.416553.00000 0000 8589 2327UBC Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, Canada
| | - Dan Cox
- grid.1006.70000 0001 0462 7212Newcastle University Translational and Clinical Research Institute, Newcastle upon Tyne, UK
| | - Graham Donen
- grid.17091.3e0000 0001 2288 9830Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia (UBC), 217-2176 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,grid.416553.00000 0000 8589 2327UBC Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, Canada
| | - Dmitri Pechkovsky
- grid.17091.3e0000 0001 2288 9830Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia (UBC), 217-2176 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,grid.416553.00000 0000 8589 2327UBC Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, Canada
| | - Volker Straub
- grid.1006.70000 0001 0462 7212Newcastle University Translational and Clinical Research Institute, Newcastle upon Tyne, UK
| | - Gordon A. Francis
- grid.416553.00000 0000 8589 2327UBC Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, Canada ,grid.17091.3e0000 0001 2288 9830Department of Medicine, UBC, Vancouver, Canada
| | - Pascal Bernatchez
- grid.17091.3e0000 0001 2288 9830Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia (UBC), 217-2176 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,grid.416553.00000 0000 8589 2327UBC Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, Canada
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Buawangpong N, Aramrat C, Pinyopornpanish K, Phrommintikul A, Soontornpun A, Jiraporncharoen W, Pliannuom S, Angkurawaranon C. Risk Prediction Performance of the Thai Cardiovascular Risk Score for Mild Cognitive Impairment in Adults with Metabolic Risk Factors in Thailand. Healthcare (Basel) 2022; 10:healthcare10101959. [PMID: 36292406 PMCID: PMC9602158 DOI: 10.3390/healthcare10101959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 11/04/2022] Open
Abstract
Individuals with metabolic risks are at high risk of cognitive impairment. We aimed to investigate whether the Thai Cardiovascular Risk (TCVR) score can be used to predict mild cognitive impairment (MCI) in Thai adults with metabolic risks. The study was conducted using secondary data of patients with metabolic risks from Maharaj Nakorn Chiang Mai Hospital. MCI was indicated by an MoCA score of less than 25. Six different TCVR models were used with various combinations of ten different variables for predicting the risk of MCI. The area under the receiver operator characteristic curve (AuROC) and Hosmer–Lemeshow goodness of fit tests were used for determining discriminative performance and model calibration. The sensitivity of the discriminative performance was further evaluated by stratifying by age and gender. From a total of 421 participants, 348 participants had MCI. All six TCVR models showed a similar AuROC, varying between 0.58 and 0.61. The anthropometric-based model showed the best risk prediction performance in the older age group (AuROC 0.69). The laboratory-based model provided the highest discriminative performance for the younger age group (AuROC 0.60). There is potential for the development of an MCI risk model based on values from routine cardiovascular risk assessments among patients with metabolic risks.
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Affiliation(s)
- Nida Buawangpong
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Chanchanok Aramrat
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Kanokporn Pinyopornpanish
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai 50200, Thailand
- Correspondence: ; Tel.: +66-53935462
| | - Arintaya Phrommintikul
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Atiwat Soontornpun
- Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Wichuda Jiraporncharoen
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Suphawita Pliannuom
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai 50200, Thailand
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Zhang JX, Li W, Tao XJ, Chen C, Wang QA, Liu WL, Yang C, Wang KR, Qiu JW, Zhao Y, Zhang YH. Fat-to-muscle ratio as a predictor for dyslipidaemia in transitional-age youth. Lipids Health Dis 2022; 21:88. [PMID: 36123675 PMCID: PMC9487042 DOI: 10.1186/s12944-022-01697-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/06/2022] [Indexed: 11/11/2022] Open
Abstract
Background Although dyslipidaemia may have a crucial impact on cardiovascular health in adults, there is a lack of specific data in transitional-age youth. Therefore, this study attempted to evaluate the association of dyslipidaemia with fat-to-muscle ratio (FMR), and establish FMR thresholds for diagnosing dyslipidaemia in transitional-age youth. Methods One thousand six hundred sixty individuals aged 16 to 24 years from the baseline of a subcohort in the Northwest China Natural Population Cohort: Ningxia Project were analysed. Anthropometric characteristics were gauged by a bioelectrical impedance analyser, and dyslipidaemia components were measured using a Beckman AU480 chemistry analyser. Additionally, this study used logistic regression to estimate the risk of dyslipidaemia based on FMR quintiles, and calculate the gender-specific ideal cut-off values of dyslipidaemia and its components by the receiver operating characteristic (ROC) curve. Results Of the 1660 participants, aged 19.06 ± 1.14 years, 558 males and 1102 females. The prevalence of dyslipidaemia was 13.4% and was significantly associated with FMR quintiles among all participants (P < 0.05). The ideal values of FMR in diagnosing dyslipidaemia were 0.2224 for males and 0.4809 for females, while males had a higher AUC than females (0.7118 vs. 0.6656). Meanwhile, high FMR values were significantly associated with adverse outcomes of dyslipidaemia, hypercholesterolemia and hypertriglyceridaemia (P < 0.05). Conclusions The FMR was positively correlated with the prevalence of dyslipidaemia. The FMR can be used as an effective body composition index for diagnosing dyslipidaemia, especially in males, and preventive strategies should be initiated in transitional-age youth to decrease obesity-related dyslipidaemia.
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Affiliation(s)
- Jia-Xing Zhang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China
| | - Wen Li
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China
| | - Xiu-Juan Tao
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China
| | - Chen Chen
- Department of Hospital Infection Management, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, People's Republic of China
| | - Qing-An Wang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China
| | - Wan-Lu Liu
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China
| | - Chan Yang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China
| | - Kai-Rong Wang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China
| | - Jiang-Wei Qiu
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China
| | - Yi Zhao
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China. .,Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China.
| | - Yu-Hong Zhang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China. .,Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China.
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10
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Pallangyo P, Komba M, Mkojera ZS, Kisenge PR, Bhalia S, Mayala H, Kifai E, Richard MK, Khanbhai K, Wibonela S, Millinga J, Yeyeye R, Njau NF, Odemary TK, Janabi M. Medication Adherence and Blood Pressure Control Among Hypertensive Outpatients Attending a Tertiary Cardiovascular Hospital in Tanzania: A Cross-Sectional Study. Integr Blood Press Control 2022; 15:97-112. [PMID: 35991354 PMCID: PMC9390787 DOI: 10.2147/ibpc.s374674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/08/2022] [Indexed: 11/23/2022] Open
Abstract
Background Notwithstanding the availability of effective treatments, asymptomatic nature and the interminable treatment length, adherence to medication remains a substantial challenge among patients with hypertension. Suboptimal adherence to BP-lowering agents is a growing global concern that is associated with the substantial worsening of disease, increased service utilization and health-care cost escalation. This study aimed to explore medication adherence and its associated factors among hypertension outpatients attending a tertiary-level cardiovascular hospital in Tanzania. Methods The pill count adherence ratio (PCAR) was used to compute adherence rate. In descriptive analyses, adherence was dichotomized and consumption of less than 80% of the prescribed medications was used to denote poor adherence. Logistic regression analyses was used to determine factors associated with adherence. Results A total of 849 outpatients taking antihypertensive drugs for ≥1 month prior to recruitment were randomly enrolled in this study. The mean age was 59.9 years and about two-thirds were females. Overall, a total of 653 (76.9%) participants had good adherence and 367 (43.2%) had their blood pressure controlled. Multivariate logistic regression analysis showed; lack of a health insurance (OR 0.5, 95% CI 0.3–0.7, p<0.01), last BP measurement >1 week (OR 0.6, 95% CI 0.4–0.8, p<0.01), last clinic attendance >1 month (OR 0.4, 95% CI 0.3–0.6, p<0.001), frequent unavailability of drugs (OR 0.6, 95% CI 0.3–0.9, p = 0.03), running out of medication before the next appointment (OR 0.6, 95% CI 0.4–0.9, p = 0.01) and stopping medications when asymptomatic (OR 0.6, 95% CI 0.4–0.8, p<0.001) to be independent associated factors for poor adherence. Conclusion A substantial proportion of hypertensive outpatients in this tertiary-level setting had good medication adherence. Nonetheless, observed suboptimal blood pressure control regardless of a fairly satisfactory adherence rate suggests that lifestyle modification plays a central role in hypertension management.
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Affiliation(s)
- Pedro Pallangyo
- Unit of Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania.,Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Makrina Komba
- Unit of Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Zabella S Mkojera
- Unit of Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Peter R Kisenge
- Unit of Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania.,Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Smita Bhalia
- Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Henry Mayala
- Directorate of Clinical Support Services, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Engerasiya Kifai
- Directorate of Clinical Support Services, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Mwinyipembe K Richard
- Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Khuzeima Khanbhai
- Unit of Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania.,Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Salma Wibonela
- Directorate of Nursing, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Jalack Millinga
- Directorate of Nursing, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Robert Yeyeye
- Directorate of Nursing, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Nelson F Njau
- Directorate of Clinical Support Services, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Thadei K Odemary
- Directorate of Clinical Support Services, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Mohamed Janabi
- Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
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11
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Tomasiuk R. Evaluation of Applicability of Novel Markers of Metabolic Syndrome in Adult Men. Am J Mens Health 2022; 16:15579883221108895. [PMID: 35962582 PMCID: PMC9380215 DOI: 10.1177/15579883221108895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
There is a continuous worldwide increase in incidences of metabolic
syndrome (MetS) reaching about a quarter of the world’s population.
Thus, studies that allow for a robust diagnosis of MetS are of
paramount importance from an economic and medical point of view. This
study was carried out in a group of men diagnosed with MetS using
consensus definition criteria that included the definitions of the
International Diabetes Foundation and Diabetes Federation and the
American Heart Association/National Heart, Lung, and Blood Institute.
The control group consisted of men for whom the parameters that define
the MetS were in the norm. This study analyzed statistical differences
between MetS and healthy men and the correlations between the set of
14 potential markers of MetS, that is, between body mass index, total
cholesterol, high-density lipoprotein cholesterol, low-density
lipoprotein, triglycerides, cortisol, adiponectin, monocyte
chemotactic protein-1 (MCP-1), C-reactive protein (CRP), adipsin,
leptin, resistin, and plasminogen activator inhibitor-1 (PAI)-1. This
report revealed a significant difference between MetS and healthy men
in most of the parameters studied. Furthermore, a strong positive
correlation between cortisol levels and body mass index was
demonstrated. Furthermore, MCP-1 levels in men with MetS were
significantly higher than their levels in healthy men. Finally, a
strong positive correlation was also observed between adiponectin and
adipsin in Mets men. Thus, this study reveals the potential usefulness
of adiponectin, MCP-1, adipsin, leptin, resistin, and PAI-1 as markers
of MetS in adult men.
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Affiliation(s)
- Ryszard Tomasiuk
- Faculty of Medical Sciences and Health Sciences, Kazimierz Pulaski University of Technology and Humanities in Radom, Radom, Poland
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12
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Rowland DL, Althof SE, McMahon CG. The Unfinished Business of Defining Premature Ejaculation: The Need for Targeted Research. Sex Med Rev 2022; 10:323-340. [PMID: 34996746 DOI: 10.1016/j.sxmr.2021.11.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Fifteen years have passed since the International Society of Sexual Medicine first established the 3-pronged criteria for premature ejaculation (PE): a short ejaculation latency, lack of ejaculatory control, and bother/distress. Although the process of establishing valid criteria for any condition or disorder is an ongoing one, a dearth of targeted research on these criteria has hindered professional societies from updating and revising them. OBJECTIVES To review and critique existing criteria used in the diagnosis of PE, to identify specific problems with them, and to recommend studies that will address shortcomings. METHODS Each of the PE criteria was evaluated and compared against standard procedures for establishing validated measures. Following each analysis, targeted research to address the gaps has been recommended. RESULTS Each PE criterion has shortcomings and each can be improved by using standard validation procedures, as noted by the targeted research outcomes. Professional societies can play an important role by encouraging broad participation in research that generates new and relevant data supporting, validating, or challenging the existing criteria. CONCLUSION The concepts underlying the diagnostic criteria for PE have both broad consensus and functional utility. Nevertheless, much of the research investigating PE has uncritically adopted these criteria without concomitantly recognizing their limitations. These limitations prevent determining accurate prevalence rates, interpreting research findings with confidence, and establishing efficacious treatment outcomes. Rowland DL, Althof SE, McMahon CG. The Unfinished Business of Defining Premature Ejaculation: The Need for Targeted Research. Sex Med Rev 2021;XX:XXX-XXX.
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Affiliation(s)
- David L Rowland
- Department of Psychology, Valparaiso University, Valparaiso, IN, USA.
| | - Stanley E Althof
- Center for Marital and Sexual Health of South Florida, Greenacres, FL, USA and Case Western Reserve School of Medicine, Cleveland, OH, USA
| | - Chris G McMahon
- Australian Centre for Sexual Health, St Leonards, New South Wales, Australia
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13
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Pallangyo P, Mkojera ZS, Komba M, Mgopa LR, Bhalia S, Mayala H, Wibonela S, Misidai N, Swai HJ, Millinga J, Chavala E, Kisenge PR, Janabi M. Burden and correlates of cognitive impairment among hypertensive patients in Tanzania: a cross-sectional study. BMC Neurol 2021; 21:433. [PMID: 34749692 PMCID: PMC8573988 DOI: 10.1186/s12883-021-02467-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/25/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The evolution of cognitive impairment of vascular origin is increasingly becoming a prominent health threat particularly in this era where hypertension is the leading contributor of global disease burden and overall health loss. Hypertension is associated with the alteration of the cerebral microcirculation coupled by unfavorable vascular remodeling with consequential slowing of mental processing speed, reduced abstract reasoning, loss of linguistic abilities, and attention and memory deficits. Owing to the rapidly rising burden of hypertension in Tanzania, we sought to assess the prevalence and correlates of cognitive impairment among hypertensive patients attending a tertiary cardiovascular hospital in Tanzania. METHODOLOGY A hospital-based cross-sectional study was conducted at Jakaya Kikwete Cardiac Institute, a tertiary care public teaching hospital in Dar es Salaam, Tanzania between March 2020 and February 2021. A consecutive sampling method was utilized to recruit consented hypertensive outpatients during their scheduled clinic visit. General Practitioner Assessment of Cognition (GPCOG) Score was utilized in the assessment of cognitive functions. All statistical analyses utilized STATA v11.0 software. Pearson Chi square and Student's T-test were used to compare categorical and continuous variables respectively. Logistic regression analyses were used to assess for factors associated with cognitive impairment. Odd ratios with 95% confidence intervals and p-values are reported. All tests were 2-sided and p < 0.05 was used to denote a statistical significance. RESULTS A total of 1201 hypertensive patients were enrolled in this study. The mean age was 58.1 years and females constituted nearly two-thirds of the study population. About three quarters had excess body weight, 16.6% had diabetes, 7.7% had history of stroke, 5.7% had heart failure, 16.7% had renal dysfunction, 53.7% had anemia, 27.7% had hypertriglyceridemia, 38.5% had elevated LDL, and 2.4% were HIV-infected. Nearly two-thirds of participants had uncontrolled blood pressure and 8.7% had orthostatic hypotension. Overall, 524 (43.6%) of participants had cognitive impairment. During bivariate analysis in a logistic regression model of 16 characteristics, 14 parameters showed association with cognitive functions. However, after controlling for confounders, multivariate analysis revealed ≤primary education (OR 3.5, 95%CI 2.4-5.2, p < 0.001), unemployed state (OR 1.7, 95%CI 1.2-2.6, p < 0.01), rural habitation (OR 1.8, 95%CI 1.1-2.9, p = 0.01) and renal dysfunction (OR 1.7, 95%CI 1.0-2.7, p = 0.04) to have independent association with cognitive impairment. CONCLUSION This present study underscore that cognitive decline is considerably prevalent among individuals with systemic hypertension. In view of this, it is pivotal to incorporate cognitive assessment in routine evaluation of hypertensive patients.
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Affiliation(s)
- Pedro Pallangyo
- PédPäl Research Initiative, P.O Box 65066, Dar es Salaam, Tanzania
- Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | | | - Makrina Komba
- PédPäl Research Initiative, P.O Box 65066, Dar es Salaam, Tanzania
| | - Lucy R. Mgopa
- PédPäl Research Initiative, P.O Box 65066, Dar es Salaam, Tanzania
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, P.O Box 65001, Dar es Salaam, Tanzania
| | - Smita Bhalia
- Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | - Henry Mayala
- Directorate of Clinical Support Services, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | - Salma Wibonela
- Directorate of Nursing, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | - Nsajigwa Misidai
- PédPäl Research Initiative, P.O Box 65066, Dar es Salaam, Tanzania
| | | | - Jalack Millinga
- PédPäl Research Initiative, P.O Box 65066, Dar es Salaam, Tanzania
- Directorate of Nursing, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | - Ester Chavala
- PédPäl Research Initiative, P.O Box 65066, Dar es Salaam, Tanzania
- Directorate of Nursing, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | - Peter R. Kisenge
- Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | - Mohamed Janabi
- Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
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14
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Huang G, Lu H, Li M, Lv Q, Chen Q. Association of total cholesterol and atherosclerotic cardiovascular disease in patients with follicular thyroid cancer: A real-world study from Chinese populations. Medicine (Baltimore) 2021; 100:e27310. [PMID: 34596129 PMCID: PMC8483838 DOI: 10.1097/md.0000000000027310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 08/18/2021] [Accepted: 09/06/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT The association between serum total cholesterol (TC) level and incident atherosclerotic cardiovascular disease (ASCVD) in patients with follicular thyroid cancer postthyroidectomy is unknown.This was a retrospective study and patients (n = 384) were divided into low and high TC groups according to the median TC level. Incidence of composite ASCVD (myocardial infarction, ischemic stroke, and cardiovascular death) was compared between these 2 groups and factors contributing to the association of TC and ASCVD were evaluated.Patients in the high TC group were older and more likely to have diabetes and have higher C-reactive protein level. After thyroidectomy, serum levels of free triiodothyronine and free thyroxine were lower while thyroid-stimulating hormone level was higher in the high TC group. 31.6% and 39.7% of patients developed hypothyroidism in the low and high TC groups (P < .05) postthyroidectomy. The incidence rate of composite ASCVD was higher in the high TC versus low TC groups, with incidence rate ratio of 1.69 (95% confidence interval [CI]: 1.07-2.69), which was mainly driven by a higher incidence rate of myocardial infarction in the high TC group (incidence rate ratio: 2.11 and 95% CI: 1.10-4.20). In unadjusted model, higher TC was associated with 73% higher risk of composite ASCVD. After adjustment for hypothyroidism, the association of higher TC and composite ASCVD was attenuated into insignificance, with hazard ratio of 0.92 and 95% CI: 0.81 to 1.34.Increased TC level was associated with composite ASCVD, which might be attributed to hypothyroidism postthyroidectomy. The use of levothyroxine might help to prevent hypercholestemia and reduce the incidence of ASCVD.
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15
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Wirth MD, Zhao L, Turner-McGrievy GM, Ortaglia A. Associations between Fasting Duration, Timing of First and Last Meal, and Cardiometabolic Endpoints in the National Health and Nutrition Examination Survey. Nutrients 2021; 13:nu13082686. [PMID: 34444846 PMCID: PMC8397975 DOI: 10.3390/nu13082686] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/30/2021] [Accepted: 07/31/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Research indicates potential cardiometabolic benefits of energy consumption earlier in the day. This study examined the association between fasting duration, timing of first and last meals, and cardiometabolic endpoints using data from the National Health and Nutrition Examination Survey (NHANES). Methods: Cross-sectional data from NHANES (2005–2016) were utilized. Diet was obtained from one to two 24-h dietary recalls to characterize nighttime fasting duration and timing of first and last meal. Blood samples were obtained for characterization of C-reactive protein (CRP); glycosylated hemoglobin (HbA1c %); insulin; glucose; and high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol. Survey design procedures for adjusted linear and logistic regression were performed. Results: Every one-hour increase in nighttime fasting duration was associated with a significantly higher insulin and CRP, and lower HDL. Every one-hour increase in timing of the last meal of the day was statistically significantly associated with higher HbA1c and lower LDL. Every one-hour increase in first mealtime was associated with higher CRP (β = 0.044, p = 0.0106), insulin (β = 0.429, p < 0.01), and glucose (β = 0.662, p < 0.01), and lower HDL (β = −0.377, p < 0.01). Conclusion: In this large public health dataset, evidence for the beneficial effect of starting energy consumption earlier in the day on cardiometabolic endpoints was observed.
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Affiliation(s)
- Michael D. Wirth
- College of Nursing, University of South Carolina, 1601 Greene Street, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA; (L.Z.); (A.O.)
- Correspondence: ; Tel.: +1-(803)-576-6736
| | - Longgang Zhao
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA; (L.Z.); (A.O.)
| | - Gabrielle M. Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29209, USA;
| | - Andrew Ortaglia
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA; (L.Z.); (A.O.)
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16
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Clinical outcomes of a community clinic-based lifestyle change program for prevention and management of metabolic syndrome: Results of the 'Vida Sana/Healthy Life' program. PLoS One 2021; 16:e0248473. [PMID: 33793595 PMCID: PMC8016241 DOI: 10.1371/journal.pone.0248473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 02/28/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction As US Hispanic populations are at higher risk than non-Hispanics for cardiovascular disease and Type 2 diabetes targeted interventions are clearly needed. This paper presents the four years results of the Vida Sana Program (VSP), which was developed and is implemented by a small clinic serving mostly Spanish-speaking, limited literacy population. Methods The eight-week course of interactive two-hour sessions taught by Navegantes, bilingual/cultural community health workers, was delivered to participants with hypertension, or high lipids, BMI, waist circumference, glucose or hemoglobin A1C (A1C). Measures, collected by Navegantes and clinic nurses, included blood chemistries, blood pressure, anthropometry, and an assessment of healthy food knowledge. Results Most participants (67%) were female, Hispanic (95%), and all were 18 to 70 years of age. At baseline, close to half of participants were obese (48%), had high waist circumference (53%), or elevated A1C (52%), or fasting blood glucose (57%). About one third had high blood pressure (29%) or serum cholesterol (35%), and 22% scored low on the knowledge assessment. After the intervention, participants decreased in weight (-1.0 lb), BMI (-0.2 kg/m2), WC (-0.4 inches), and cholesterol (-3.5 mg/dl, all p<0.001). Systolic blood pressure decreased (-1.7 mm Hg, p<0.001), and the knowledge score increased (6.8 percent, p<0.001). Discussion VSP shows promising improvements in metabolic outcomes, similar to other programs with longer duration or higher intensity interventions. VSP demonstrates an important model for successful community-connected interventions.
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17
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Sukkriang N, Chanprasertpinyo W, Wattanapisit A, Punsawad C, Thamrongrat N, Sangpoom S. Correlation of body visceral fat rating with serum lipid profile and fasting blood sugar in obese adults using a noninvasive machine. Heliyon 2021; 7:e06264. [PMID: 33644479 PMCID: PMC7893433 DOI: 10.1016/j.heliyon.2021.e06264] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/08/2020] [Accepted: 02/09/2021] [Indexed: 02/07/2023] Open
Abstract
Increased visceral fat is associated with an increased mortality rate. Bioelectrical impedance analysis (BIA) is a noninvasive method to assess visceral fat that is easily accessible and avoids exposure to radiation. It is unknown how a visceral fat rating from a noninvasive machine correlates with the serum lipid profile and fasting blood sugar (FBS). The aim of this research is to study the correlation of the visceral fat rating obtained by a noninvasive method with the serum lipid profile and FBS. This cross-sectional study involved 90 obese adults, ranging in age from 18 to 60 years old. The visceral fat rating was measured by BIA. The results demonstrated that significant positive correlations were found between the serum triglycerides and visceral fat rating (r = 0.287, P = 0.006) and between the FBS and visceral fat rating (r = 0.210, P = 0.047). There was a negative correlation between the serum high-density lipoprotein (HDL) cholesterol and visceral fat rating (r = -0.322, P = 0.002). In conclusion, statistically significant positive correlations were found between the serum triglycerides and visceral fat rating and between the FBS and visceral fat rating, and a negative correlation was found between the serum HDL-cholesterol and visceral fat rating.
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Affiliation(s)
- Naparat Sukkriang
- School of Medicine, Walailak University, Nakhon Si Thammarat, 80160 Thailand.,Walailak University Hospital, Nakhon Si Thammarat, 80160 Thailand
| | - Wandee Chanprasertpinyo
- School of Medicine, Walailak University, Nakhon Si Thammarat, 80160 Thailand.,Walailak University Hospital, Nakhon Si Thammarat, 80160 Thailand
| | - Apichai Wattanapisit
- School of Medicine, Walailak University, Nakhon Si Thammarat, 80160 Thailand.,Walailak University Hospital, Nakhon Si Thammarat, 80160 Thailand
| | - Chuchard Punsawad
- School of Medicine, Walailak University, Nakhon Si Thammarat, 80160 Thailand
| | | | - Suttida Sangpoom
- School of Science, Walailak University, Nakhon Si Thammarat, 80160 Thailand
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Bharatan T, Devi R, Huang PH, Javed A, Jeffers B, Lansberg P, Sidhu K, Subramaniam K. A Methodology for Mapping the Patient Journey for Noncommunicable Diseases in Low- and Middle-Income Countries. J Healthc Leadersh 2021; 13:35-46. [PMID: 33542673 PMCID: PMC7853412 DOI: 10.2147/jhl.s288966] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/10/2021] [Indexed: 12/12/2022] Open
Abstract
Noncommunicable diseases (NCDs) are responsible for 71% of all worldwide mortality each year, and have an exceptionally large impact in low- and middle-income countries (LMICs). However, there is often a lack of local data from these countries to inform practice and policy improvements. Generating locally contextualized evidence base for NCDs that can help identify gaps, aid decision-making and improve patient care in LMICs needs an innovative approach. The approach used in Mapping the Patient Journey Towards Actionable Beyond the Pill Solutions (MAPS) is designed to quantitatively map different stages of the patient journey in four critical NCDs, ie, hypertension, dyslipidemia, depression, and pain (chronic and neuropathic) across selected LMICs in Africa, the Middle East, South East Asia, and Latin America. The key touchpoints along the patient journey include awareness, screening, diagnosis, treatment, adherence, and control or remission. MAPS employs an evidence mapping methodology that follows a three-step semi-systematic review: 1) systematic peer-reviewed database search; 2) unstructured searches of local or real-world data; and 3) expert opinion. Evidence generation and visualization is based on locally validated and deduplicated data published over the last 10 years. This approach will be the first to provide quantitative mapping of the different stages of the patient journey for selected NCDs in LMICs. By focusing on local, patient-centric data, the goal of the MAPS initiative is to address and prioritize local research and knowledge gaps, then contribute to evidence-based, high-quality, and affordable advances in the management of NCDs in LMICs. This will ultimately improve patient outcomes and contribute towards the achievement of global NCD targets.
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Affiliation(s)
- Tanaya Bharatan
- Research Development & Medical, Upjohn Division, Pfizer Ltd, Mumbai, India
| | - Ratna Devi
- Executive Office, Daksham A Health and Education, Gurgaon, India
- International Alliance of Patient Organizations, London, UK
| | | | - Afzal Javed
- Warwick Medical School, University of Warwick, Warwick, UK
| | | | - Peter Lansberg
- Department of Pediatrics, University Medical Center, Groningen, the Netherlands
| | - Kaveri Sidhu
- Research Development & Medical, Upjohn Division, Pfizer Ltd, Mumbai, India
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Snowden SG, Korosi A, de Rooij SR, Koulman A. Combining lipidomics and machine learning to measure clinical lipids in dried blood spots. Metabolomics 2020; 16:83. [PMID: 32710150 PMCID: PMC7381462 DOI: 10.1007/s11306-020-01703-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/11/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Blood-based sample collection is a challenge, and dried blood spots (DBS) represent an attractive alternative. However, for DBSs to be an alternative to venous blood it is important that these samples are able to deliver comparable associations with clinical outcomes. To explore this we looked to see if lipid profile data could be used to predict the concentration of triglyceride, HDL, LDL and total cholesterol in DBSs using markers identified in plasma. OBJECTIVES To determine if DBSs can be used as an alternative to venous blood in both research and clinical settings, and to determine if machine learning could predict 'clinical lipid' concentration from lipid profile data. METHODS Lipid profiles were generated from plasma (n = 777) and DBS (n = 835) samples. Random forest was applied to identify and validate panels of lipid markers in plasma, which were translated into the DBS cohort to provide robust measures of the four 'clinical lipids'. RESULTS In plasma samples panels of lipid markers were identified that could predict the concentration of the 'clinical lipids' with correlations between estimated and measured triglyceride, HDL, LDL and total cholesterol of 0.920, 0.743, 0.580 and 0.424 respectively. When translated into DBS samples, correlations of 0.836, 0.591, 0.561 and 0.569 were achieved for triglyceride, HDL, LDL and total cholesterol. CONCLUSION DBSs represent an alternative to venous blood, however further work is required to improve the combined lipidomics and machine learning approach to develop it for use in health monitoring.
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Affiliation(s)
- Stuart G Snowden
- Core Metabolomics and Lipidomics Laboratory, Metabolic Research Laboratories, Institute of Metabolic Science, University of Cambridge, Level 4 Pathology, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Aniko Korosi
- Centre for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Susanne R de Rooij
- Department of Clinical Epidemiology, Amsterdam University Medical Centre, Biostatistics & Bio informaticslocation AMC, Amsterdam, The Netherlands
- Department of Public Health, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Albert Koulman
- Core Metabolomics and Lipidomics Laboratory, Metabolic Research Laboratories, Institute of Metabolic Science, University of Cambridge, Level 4 Pathology, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
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Abstract
Aim of the study was to understand the relationship of menopausal status with BMI and blood pressure. The study area was selected through multistage sampling technique covering six districts of West Bengal, a state located at the eastern part of India. 1400 participants were selected for the study. The participants were divided into four groups on the basis of menopausal status: early and late perimenopausal; early and late postmenopausal. Results shows that menopausal status was significantly associated with Body Mass Index (BMI) and Mean Arterial Pressure (MAP), after controlling the effect of covariates such as participants' age, reproductive behavior, diet and addiction to tobacco use.
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Affiliation(s)
- Doyel Dasgupta
- Department of Anthropology, Bangabasi College, Kolkata, India
| | - Subho Roy
- Department of Anthropology, University of Calcutta, Kolkata, India
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Wekesah FM, Klipstein-Grobusch K, Grobbee DE, Kadengye D, Asiki G, Kyobutungi CK. Determinants of Mortality from Cardiovascular Disease in the Slums of Nairobi, Kenya. Glob Heart 2020; 15:33. [PMID: 32489806 PMCID: PMC7218782 DOI: 10.5334/gh.787] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 03/09/2020] [Indexed: 12/12/2022] Open
Abstract
Background Cardiovascular diseases (CVD) comprise eighty percent of non-communicable disease (NCD) burden in low- and middle-income countries and are increasingly impacting the poor inequitably. Traditional and socioeconomic factors were analyzed for their association with CVD mortality over 10 years of baseline assessment in an urban slum of Nairobi, Kenya. Methods and results A 2008 survey on CVD risk factors was linked to cause of death data collected between 2008 and 2018. Cox proportional hazards on relative risk of dying from CVD over a 10-year period following the assessment of cardiovascular disease risk factors were computed. Population attributable fraction (PAF) of incident CVD death was estimated for key risk factors. In total, 4,290 individuals, 44.0% female, mean age 48.4 years in 2008 were included in the analysis. Diabetes and hypertension were 7.8% and 24.9% respectively in 2008. Of 385 deaths recorded between 2008 and 2018, 101 (26%) were caused by CVD. Age (hazard ratio (HR) 1.11; 95% confidence interval (CI) 1.03-1.20, p = 0.005) and hypertension (HR 2.19, 95% CI 1.44-3.33, p <0.001) were positively associated with CVD mortality. Primary school education and higher (HR 0.57, 95% CI 0.33-0.99, p = 0.044) and formal employment (HR 0.22, 95% CI 0.06-0.75, p = 0.015) were negatively associated with CVD mortality. Controlling hypertension would avert 27% (95% CI 9%-42%, p = 0.004) CVD deaths, while if every member of the community attained primary school education and unemployment was eradicated, 39% (95% CI 5% - 60%, p = 0.026), and 17% (95% CI 5%-27%, p = 0.030) of CVD deaths, would be averted respectively. Conclusions A holistic approach in addressing socioeconomic factors in the broader context of social determinants of health at the policy, population and individual level will enhance prevention and treatment-adherence for CVD in underserved settings.
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Affiliation(s)
- Frederick M. Wekesah
- African Population and Health Research Center, 2 Floor APHRC Campus, Manga Close, Off Kirawa Road, Kitisuru, Nairobi, KE
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, NL
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, US
| | - Kerstin Klipstein-Grobusch
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, NL
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA
| | - Diederick E. Grobbee
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, NL
| | - Damazo Kadengye
- African Population and Health Research Center, 2 Floor APHRC Campus, Manga Close, Off Kirawa Road, Kitisuru, Nairobi, KE
| | - Gershim Asiki
- African Population and Health Research Center, 2 Floor APHRC Campus, Manga Close, Off Kirawa Road, Kitisuru, Nairobi, KE
| | - Catherine K. Kyobutungi
- African Population and Health Research Center, 2 Floor APHRC Campus, Manga Close, Off Kirawa Road, Kitisuru, Nairobi, KE
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Chronic Stress and Cardiovascular Disease among Individuals Exposed to Lead: A Pilot Study. Diseases 2020; 8:diseases8010007. [PMID: 32183421 PMCID: PMC7151132 DOI: 10.3390/diseases8010007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/11/2020] [Accepted: 03/12/2020] [Indexed: 11/17/2022] Open
Abstract
Chronic stress and cardiovascular disease risk were explored in a predominately middle-aged adult population exposed to elevated lead levels in this cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) from the period 2007-2010. Elevated lead exposure was defined using the epidemiological threshold of a blood lead level (BLL) > 5 μg/dL as defined by the U.S. Centers for Disease Control and Prevention (CDC). Allostatic load (AL), a measure of chronic stress, was operationalized using 10 clinical markers. The geometric mean values for clinical cardiovascular disease risk markers of interest (a) Gamma glutamyl-transferase (GGT) (a marker of oxidative stress), and (b) non-HDL cholesterol (non-HDL-c) (a marker of cardiovascular disease risk) were explored among lead-exposed and less lead-exposed individuals with differential chronic stress (AL) levels. Associations between AL and GGT/non-HDL-C were analyzed using linear regression models. The likelihood of increased clinical markers in lead-exposed individuals with high compared to low AL was explored using binary logistic regression models. In analyzing lead-exposed as compared to less lead-exposed populations, the geometric mean of the variables of interest showed significant elevations among lead-exposed individuals as compared to less lead-exposed individuals. Simple linear regression revealed that AL was positively associated with the variables of interest among the lead-exposed. In binary logistic regression among the lead-exposed, those with high AL, as compared to those with low AL, had significantly higher odds of having elevated non-HDL-C. This study submits that those exposed to lead with increasing AL may experience adverse cardiovascular health outcomes.
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Obeng-Gyasi E. Lead Exposure and Cardiovascular Disease among Young and Middle-Aged Adults. Med Sci (Basel) 2019; 7:medsci7110103. [PMID: 31698758 PMCID: PMC6915582 DOI: 10.3390/medsci7110103] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 10/31/2019] [Accepted: 11/05/2019] [Indexed: 12/26/2022] Open
Abstract
Lead and its effects on cardiovascular-related markers were explored in this cross-sectional study of young adults (18–44 years) and middle-aged adults (45–65 years) from the United States using the National Health and Nutrition Examination Survey (NHANES), 2009–2016. Degrees of exposure were created using blood lead level (BLL) as the biomarker of exposure based on the epidemiologically relevant threshold of BLL > 5 μg/dL. The mean values, in addition to the percentages of people represented for the markers of interest (systolic blood pressure [SBP], diastolic blood pressure [DBP], gamma-glutamyl transferase [GGT], non-high-density lipoprotein cholesterol [non-HDL-C]) were explored. Among those exposed to lead, the likelihood of elevated clinical markers (as defined by clinically relevant thresholds of above normal) were examined using binary logistic regression. In exploring exposure at the 5 μg/dL levels, there were significant differences in all the mean variables of interest between young and middle-aged adults. The binary logistic regression showed young and middle-aged adults exposed to lead were significantly more likely to have elevated markers (apart from DBP). In all, lead affects cardiovascular-related markers in young and middle-aged U.S. adults and thus we must continue to monitor lead exposure to promote health.
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Affiliation(s)
- Emmanuel Obeng-Gyasi
- Environmental Health and Safety Program, Department of Built Environment, North Carolina Agricultural & Technical State University, Greensboro, NC 27411, USA
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