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Tews HC, Schmelter F, Kandulski A, Büchler C, Schmid S, Schlosser S, Elger T, Loibl J, Sommersberger S, Fererberger T, Gunawan S, Kunst C, Gülow K, Bettenworth D, Föh B, Maaß C, Solbach P, Günther UL, Derer S, Marquardt JU, Sina C, Müller M. Unique Metabolomic and Lipidomic Profile in Serum From Patients With Crohn's Disease and Ulcerative Colitis Compared With Healthy Control Individuals. Inflamm Bowel Dis 2023:izad298. [PMID: 38156773 DOI: 10.1093/ibd/izad298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Accurate biomarkers for disease activity and progression in patients with inflammatory bowel disease (IBD) are a prerequisite for individual disease characterization and personalized therapy. We show that metabolic profiling of serum from IBD patients is a promising approach to establish biomarkers. The aim of this work was to characterize metabolomic and lipidomic serum profiles of IBD patients in order to identify metabolic fingerprints unique to the disease. METHODS Serum samples were obtained from 55 patients with Crohn's disease (CD), 34 patients with ulcerative colitis (UC), and 40 healthy control (HC) individuals and analyzed using proton nuclear magnetic resonance spectroscopy. Classification of patients and HC individuals was achieved by orthogonal partial least squares discriminant analysis and univariate analysis approaches. Disease activity was assessed using the Gastrointestinal Symptom Rating Scale. RESULTS Serum metabolome significantly differed between CD patients, UC patients, and HC individuals. The metabolomic differences of UC and CD patients compared with HC individuals were more pronounced than the differences between UC and CD patients. Differences in serum levels of pyruvic acid, histidine, and the branched-chain amino acids leucine and valine were detected. The size of low-density lipoprotein particles shifted from large to small dense particles in patients with CD. Of note, apolipoprotein A1 and A2 serum levels were decreased in CD and UC patients with higher fecal calprotectin levels. The Gastrointestinal Symptom Rating Scale is negatively associated with the concentration of apolipoprotein A2. CONCLUSIONS Metabolomic assessment of serum samples facilitated the differentiation of IBD patients and HC individuals. These differences were constituted by changes in amino acid and lipoprotein levels. Furthermore, disease activity in IBD patients was associated with decreased levels of the atheroprotective apolipoproteins A1 and A2.
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Affiliation(s)
- Hauke Christian Tews
- Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious Diseases, Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Franziska Schmelter
- Institute of Nutritional Medicine, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Arne Kandulski
- Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious Diseases, Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Christa Büchler
- Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious Diseases, Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Stephan Schmid
- Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious Diseases, Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Sophie Schlosser
- Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious Diseases, Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Tanja Elger
- Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious Diseases, Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Johanna Loibl
- Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious Diseases, Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Stefanie Sommersberger
- Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious Diseases, Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Tanja Fererberger
- Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious Diseases, Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Stefan Gunawan
- Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious Diseases, Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Claudia Kunst
- Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious Diseases, Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Karsten Gülow
- Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious Diseases, Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Dominik Bettenworth
- Department of Medicine B-Gastroenterology and Hepatology, University Hospital Münster, Münster, Germany
- Practice for Internal Medicine, Münster, Germany
| | - Bandik Föh
- Department of Medicine I, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Carlos Maaß
- Department of Medicine I, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Philipp Solbach
- Department of Medicine I, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Ulrich L Günther
- Institute of Chemistry and Metabolomics, University of Lübeck, Lübeck, Germany
| | - Stefanie Derer
- Institute of Nutritional Medicine, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Jens U Marquardt
- Department of Medicine I, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Christian Sina
- Institute of Nutritional Medicine, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
- Department of Medicine I, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
- Fraunhofer Research Institution for Individualized and Cell-Based Medical Engineering, Lübeck, Germany
| | - Martina Müller
- Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious Diseases, Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
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Evaluation of a Proarrhythmic Repolarization Marker (Total Cosine R to T) in Patients With Uncomplicated Familial Mediterranean Fever. J Clin Rheumatol 2020; 26:334-337. [PMID: 32649405 DOI: 10.1097/rhu.0000000000001465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Familial Mediterranean fever (FMF) is a systemic autoinflammatory disorder characterized by recurrent attacks of fever and serous inflammation. The association between FMF and risk of cardiac arrhythmia is continuously questioned; some studies report abnormal cardiac repolarization, while others do not. Considering this controversy, we aim to perform in a large cohort of FMF patients a total cosine R to T (TCRT) analysis, a previously unexplored repolarization marker in this disorder. METHODS The study group included 56 FMF patients without amyloidosis, diagnosed with FMF according to published criteria and 131 control subjects, unaffected with FMF. A 12-lead electrocardiogram (ECG) was performed according to strict standards. Electrocardiogram files were processed with Python-based computer software. Patients were followed for 10 to 12 years, and the rate of cardiac complications was evaluated. RESULTS Other than FMF and prescription of colchicine, both groups had similar medical and demographic background. TCRT results were similar for a randomly selected beat (0.40 ± 0.06 vs 0.50 ± 0.04, p > 0.05) and for an averaged beat (0.39 ± 0.06 vs 0.50 ± 0.04, p > 0.05) in FMF patients and control subjects, respectively. Correction of average TCRT for heart rate also resulted in similar TCRTc values in patients and control groups (0.42 ± 0.07 s vs 0.51 ± 0.05 s, respectively, p > 0.05). During the follow-up period, none of the patients died, and no patient developed clinical symptoms suggestive of ventricular arrhythmias. CONCLUSIONS Colchicine treated uncomplicated FMF patients have normal TCRT and TCRTc values, implying low risk for cardiac arrhythmias in this population. Future studies should evaluate the sensitivity and specificity of this marker in high-risk FMF populations, such as those who developed AA amyloidosis.
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Herbert KE, Erridge C. Regulation of low-density lipoprotein cholesterol by intestinal inflammation and the acute phase response. Cardiovasc Res 2017; 114:226-232. [DOI: 10.1093/cvr/cvx237] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 11/29/2017] [Indexed: 02/07/2023] Open
Abstract
AbstractSystemic inflammation, induced by disease or experimental intervention, is well established to result in elevated levels of circulating triglycerides, and reduced levels of high-density lipoprotein-cholesterol (HDL-C), in most mammalian species. However, the relationship between inflammation and low-density lipoprotein-cholesterol (LDL-C) concentrations is less clear. Most reports indicate that systemic inflammation, as observed during sepsis or following high dose experimental endotoxaemia, lowers total, and LDL-C in man. However, isolated reports have suggested that certain inflammatory conditions are associated with increased LDL-C. In this review, we summarize the emerging evidence that low-grade inflammation specifically of intestinal origin may be associated with increased serum LDL-C levels. Preliminary insights into potential mechanisms that may mediate these effects, including those connecting inflammation to trans-intestinal cholesterol efflux (TICE), are considered. We conclude that this evidence supports the potential downregulation of major mediators of TICE by inflammatory mediators in vitro and during intestinal inflammation in vivo. The TICE-inflammation axis therefore merits further study in terms of its potential to regulate serum LDL-C, and as a readily druggable target for hypercholesterolaemia.
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Affiliation(s)
- Karl E Herbert
- Department of Cardiovascular Sciences, Glenfield Hospital, University of Leicester, Groby Road, Leicester, Leicestershire, LE3 9QP, UK
| | - Clett Erridge
- Department of Cardiovascular Sciences, Glenfield Hospital, University of Leicester, Groby Road, Leicester, Leicestershire, LE3 9QP, UK
- Department of Biomedical and Forensic Sciences, Anglia Ruskin University, East Road, Cambridge, Cambridgeshire, CB1 1PT, UK
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Cardiovascular disease in patients with autoinflammatory syndromes. Rheumatol Int 2017; 38:37-50. [DOI: 10.1007/s00296-017-3854-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/13/2017] [Indexed: 12/16/2022]
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Cardiac disease in familial Mediterranean fever. Rheumatol Int 2017; 38:51-58. [DOI: 10.1007/s00296-017-3853-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 10/10/2017] [Indexed: 01/19/2023]
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Familial Mediterranean Fever Is Associated With Increased Mortality After Kidney Transplantation—A 19 Years' Single Center Experience. Transplantation 2017; 101:2621-2626. [DOI: 10.1097/tp.0000000000001681] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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ter Haar NM, Annink KV, Al-Mayouf SM, Amaryan G, Anton J, Barron KS, Benseler SM, Brogan PA, Cantarini L, Cattalini M, Cochino AV, De Benedetti F, Dedeoglu F, De Jesus AA, Della Casa Alberighi O, Demirkaya E, Dolezalova P, Durrant KL, Fabio G, Gallizzi R, Goldbach-Mansky R, Hachulla E, Hentgen V, Herlin T, Hofer M, Hoffman HM, Insalaco A, Jansson AF, Kallinich T, Koné-Paut I, Kozlova A, Kuemmerle-Deschner JB, Lachmann HJ, Laxer RM, Martini A, Nielsen S, Nikishina I, Ombrello AK, Ozen S, Papadopoulou-Alataki E, Quartier P, Rigante D, Russo R, Simon A, Trachana M, Uziel Y, Ravelli A, Gattorno M, Frenkel J. Development of the autoinflammatory disease damage index (ADDI). Ann Rheum Dis 2016; 76:821-830. [PMID: 27811147 DOI: 10.1136/annrheumdis-2016-210092] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/27/2016] [Accepted: 10/08/2016] [Indexed: 11/04/2022]
Abstract
ObjectivesAutoinflammatory diseases cause systemic inflammation that can result in damage to multiple organs. A validated instrument is essential to quantify damage in individual patients and to compare disease outcomes in clinical studies. Currently, there is no such tool. Our objective was to develop a common autoinflammatory disease damage index (ADDI) for familial Mediterranean fever, cryopyrin-associated periodic syndromes, tumour necrosis factor receptor-associated periodic fever syndrome and mevalonate kinase deficiency.MethodsWe developed the ADDI by consensus building. The top 40 enrollers of patients in the Eurofever Registry and 9 experts from the Americas participated in multiple rounds of online surveys to select items and definitions. Further, 22 (parents of) patients rated damage items and suggested new items. A consensus meeting was held to refine the items and definitions, which were then formally weighted in a scoring system derived using decision-making software, known as 1000minds.ResultsMore than 80% of the experts and patients completed the online surveys. The preliminary ADDI contains 18 items, categorised in the following eight organ systems: reproductive, renal/amyloidosis, developmental, serosal, neurological, ears, ocular and musculoskeletal damage. The categories renal/amyloidosis and neurological damage were assigned the highest number of points, serosal damage the lowest number of points. The involvement of (parents of) patients resulted in the inclusion of, for example, chronic musculoskeletal pain.ConclusionsAn instrument to measure damage caused by autoinflammatory diseases is developed based on consensus building. Patients fulfilled a significant role in this process.
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Investigation of the arterial stiffness and associated factors in patients with familial Mediterranean fever. Anatol J Cardiol 2016; 17:132-138. [PMID: 27488756 PMCID: PMC5336751 DOI: 10.14744/anatoljcardiol.2016.6985] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Objective: Because of the ongoing and recurring inflammatory state in familial Mediterranean fever (FMF), patients may experience a high risk of cardiovascular events. Our aim was to investigate the arterial stiffness and associated factors in patients with FMF. Methods: Sixty-nine consecutive FMF patients (including 11 females) and 35 controls (including 5 females) were enrolled in the study. The demographical, clinical, and laboratory data and genetic mutations of the patients were recorded. In the study, FMF patients according to the Tel-Hashomer criteria were included, whereas patients with other known inflammatory rheumatologic disease, atherosclerotic cardiovascular disease, hypertension, diabetes, those under the age of 18 years, or those refusing to participate in the study were excluded. Arterial stiffness measurements were performed using the TensioMed device (TensoMed Ltd, Budapest, Hungary). Results: The patient and control groups were similar in terms of the mean ages, BMIs, gender, systolic blood pressures, and smoking. FMF patients had a higher pulse wave velocity (PWV) (7.73±1.3 and 7.18±1.1 m/s; p=0.03) and lower brachial and aortic augmentation indexes (–64.6±14.6% and –54.6±25.9%, p=0.041 and 4.9±7.4% and 14.0±11.5%, p=0.025, respectively) compared with the controls. Thirty-one (45%) patients were in the “during-attack” state and had higher PWV (8.17±1.6 and 7.38±0.9 m/s; p=0.027) compared with the asymptomatic patients. PWV was correlated to serum CRP, WBC, ESR, fibrinogen, and neutrophil/lymphocyte ratios (r=0.666, 0.429, 0.441, 0.388, and 0.460, respectively). The genetic mutation and predominant attack type had no effect on arterial stiffness. Conclusion: FMF patients have increased arterial stiffness during attacks compared with asymptomatic patients and controls. The impaired arterial stiffness is correlated to the severity of the inflammatory state rather than to the attack type or genetic mutations.
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Twig G, Gerstein HC, Fruchter E, Shina A, Afek A, Derazne E, Tzur D, Cukierman-Yaffe T, Amital D, Amital H, Tirosh A. Self-Perceived Emotional Distress and Diabetes Risk Among Young Men. Am J Prev Med 2016; 50:737-745. [PMID: 26810356 DOI: 10.1016/j.amepre.2015.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 10/29/2015] [Accepted: 12/14/2015] [Indexed: 02/09/2023]
Abstract
INTRODUCTION There are mixed data regarding the effect of emotional distress on diabetes risk, especially among young adults. This study assessed the effect of self-perceived emotional distress on diabetes incidence among young men. METHODS Incident diabetes during a mean follow-up of 6.3 (4.3) years was assessed among 32,586 men (mean age, 31.0 [5.6] years) of the Metabolic, Lifestyle, and Nutrition Assessment in Young Adults cohort with no history of diabetes between 1995 and 2011. Emotional distress was assessed by asking participants as part of a computerized questionnaire: Are you preoccupied by worries or concerns that affect your overall wellbeing? Time-dependent Cox models were applied. Data analysis took place between 2014 and 2015. RESULTS There were 723 cases of diabetes during 206,382 person-years. The presence of distress was associated with a 53% higher incidence of diabetes (95% CI=1.08, 2.18, p=0.017) after adjustment for age, BMI, fasting plasma glucose, family history of diabetes, triglyceride and high-density lipoprotein cholesterol levels, education, cognitive performance, white blood cell count, physical activity, and sleep quality. These results persisted when distress, BMI, physical activity, and smoking status were treated as time-dependent variables (hazard ratio=1.66, 95% CI=1.21, 2.17, p=0.002). An adjusted hazard ratio of 2.14 (95% CI=1.04, 4.47, p=0.041) for incident diabetes was observed among participants persistently reporting emotional distress compared with those persistently denying it. CONCLUSIONS Sustained emotional distress contributes to the development of diabetes among young and apparently healthy men in a time-dependent manner. These findings warrant awareness by primary caregivers when stratifying diabetes risk.
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Affiliation(s)
- Gilad Twig
- Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel; The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel; The Israel Defense Forces Medical Corps, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Hertzel C Gerstein
- Division of Endocrinology and Metabolism, and Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | | | - Avi Shina
- The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel; The Israel Defense Forces Medical Corps, Israel; Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
| | - Arnon Afek
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Israel Ministry of Health, Jerusalem, Israel
| | - Estela Derazne
- The Israel Defense Forces Medical Corps, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dorit Tzur
- The Israel Defense Forces Medical Corps, Israel
| | - Tali Cukierman-Yaffe
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel
| | - Daniela Amital
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Psychiatry B, Ness Ziona Mental Health Center, Ness Ziona, Israel
| | - Howard Amital
- Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amir Tirosh
- The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel; Department of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel; Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Twig G, Shina A, Afek A, Derazne E, Tzur D, Cukierman-Yaffe T, Shechter-Amir D, Gerstein HC, Tirosh A. Sleep quality and risk of diabetes and coronary artery disease among young men. Acta Diabetol 2016; 53:261-70. [PMID: 26077170 DOI: 10.1007/s00592-015-0779-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 05/26/2015] [Indexed: 12/24/2022]
Abstract
AIMS To assess the time-dependent effect of sleep quality on diabetes and coronary artery disease (CAD) incidence among young adults. METHODS Incident rates of diabetes and CAD during a mean follow-up of 6.4 ± 4.1 years were assessed among 26,023 men (mean age 30.9 ± 5.6 years) of the Metabolic Lifestyle and Nutrition Assessment in Young Adults stratified by sleep quality at baseline, as assessed by the Mini-Sleep Questionnaire (MSQ). Incident diabetes and CAD were analyzed using a Cox proportional hazard model. RESULTS There were 445 cases of diabetes and 92 cases of CAD during 151,312 person-years. An abnormal MSQ score was associated with a 53 % higher incidence of diabetes (95 % CI 1.22-1.94, p < 0.001) compared to those with a normal score, after adjustment for clinical and biochemical diabetes risk factors. The increased risk associated with abnormal sleep quality remained when MSQ was modeled as a continuous time-dependent variable in a multivariable model (HR = 1.036, 95 % CI 1.024-1.049, p < 0.001). The increased risk was higher among overweight or obese participants (BMI and MSQ interaction p = 0.046). Sustained abnormality in MSQ score resulted in higher HR for diabetes (2.35; 95 % CI 1.564-3.519, p < 0.001). In addition, abnormal sleep quality was associated with a 2.38 higher incidence of CAD (95 % CI 1.38-4.11, p = 0.002), after adjustment for traditional clinical and biochemical risk factors. CONCLUSIONS Sleep quality contributes to the development of diabetes and CAD in apparently healthy young adults in a time-dependent manner. The use of a simple questionnaire to assess sleep quality may be a useful tool for risk stratification in this population.
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Affiliation(s)
- Gilad Twig
- Department of Medicine B, Sheba Medical Center, 52621, Ramat Gan, Israel.
- The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Ramat Gan, Israel.
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel.
| | - Avi Shina
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel
| | - Arnon Afek
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Israel Ministry of Health, Jerusalem, Israel
| | - Estela Derazne
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dorit Tzur
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Tali Cukierman-Yaffe
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Center for Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Ramat Gan, Israel
| | | | - Hertzel C Gerstein
- Division of Endocrinology and Metabolism, and Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Amir Tirosh
- The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Ramat Gan, Israel
- The Center for Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Ramat Gan, Israel
- The Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Abstract
Familial Mediterranean fever (FMF) is the most frequent monogenic autoinflammatory disease, and it is characterized by recurrent attacks of fever and polyserositis. The disease is associated with mutations in the MEFV gene encoding pyrin, which causes exaggerated inflammatory response through uncontrolled production of interleukin 1. The major long-term complication of FMF is amyloidosis. Colchicine remains the principle therapy, and the aim of treatment is to prevent acute attacks and the consequences of chronic inflammation. With the evolution in the concepts about the etiopathogenesis and genetics of the disease, we have understood that FMF is more complicated than an ordinary autosomal recessive monogenic disorder. Recently, recommendation sets have been generated for interpretation of genetic testing and genetic diagnosis of FMF. Here, we have reviewed the current perspectives in FMF in light of recent recommendations.
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Affiliation(s)
- Hafize Emine Sönmez
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ezgi Deniz Batu
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Seza Özen
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Cukierman-Yaffe T, Kasher-Meron M, Fruchter E, Gerstein HC, Afek A, Derazne E, Tzur D, Karasik A, Twig G. Cognitive Performance at Late Adolescence and the Risk for Impaired Fasting Glucose Among Young Adults. J Clin Endocrinol Metab 2015; 100:4409-16. [PMID: 26431506 DOI: 10.1210/jc.2015-2012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
CONTEXT Although dysglycemia is a risk factor for cognitive decline, it is unknown whether cognitive performance among young and apparently healthy adults affect the risk for impaired fasting glucose (IFG). OBJECTIVE This study aimed to characterize the relationship between cognitive function and the risk for IFG among young adults. DESIGN AND SETTING This was a retrospective cohort study utilizing data collected at pre-military recruitment assessments with information collected at the screening center of Israeli Army Medical Corps. PARTICIPANTS Normoglycemic adults (n = 17 348) (free of IFG and diabetes; mean age 31.0 ± 5.6 y; 87% men) of the Metabolic Lifestyle and Nutrition Assessment in Young Adults (MELANY) cohort with data regarding their General Intelligence Score (GIS), a comprehensive measure of cognitive function, at age 17 y. INTERVENTIONS Fasting plasma glucose was assessed every 3-5 y at scheduled visits. Cox proportional hazards models were applied. MAIN OUTCOMES MEASURES The main outcome of the study was incident IFG (≥ 100 mg/dL and <126 mg/dL) at scheduled visits. RESULTS During a median followup of 6.6 y, 1478 cases of IFG were recorded (1402 men). After adjustment for age and sex, participants in the lowest GIS category had a 1.9-fold greater risk for incident IFG compared with those in the highest GIS category. In multivariable analysis adjusted for age, sex, body mass index, fasting plasma glucose, family history of diabetes, country of origin, socioeconomic status, education, physical activity, smoking status, alcohol consumption, breakfast consumption, triglyceride level, white blood cell count, the risk for IFG was nearly doubled in the lowest GIS category compared with the highest GIS category (hazard ratio, 1.8; 95% confidence interval, 1.4-2.3; P < .001). These results persisted when GIS was treated as a continuous variable and when the model was adjusted also for body mass index at the end of followup. CONCLUSIONS This study demonstrates that lower cognitive function at late adolescence is independently associated with an elevated risk IFG in both men and women.
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Affiliation(s)
- Tali Cukierman-Yaffe
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Michal Kasher-Meron
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Eyal Fruchter
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Hertzel C Gerstein
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Arnon Afek
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Estela Derazne
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Dorit Tzur
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Avraham Karasik
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Gilad Twig
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
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