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Diagnosing Arterial Stiffness in Pregnancy and Its Implications in the Cardio-Renal-Metabolic Chain. Diagnostics (Basel) 2022; 12:diagnostics12092221. [PMID: 36140621 PMCID: PMC9497660 DOI: 10.3390/diagnostics12092221] [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: 08/02/2022] [Revised: 09/02/2022] [Accepted: 09/10/2022] [Indexed: 11/16/2022] Open
Abstract
Cardio-renal and metabolic modifications during gestation are crucial determinants of foetal and maternal health in the short and long term. The cardio-renal metabolic syndrome is a vicious circle that starts in the presence of risk factors such as obesity, hypertension, diabetes, kidney disease and ageing, all predisposing to a status dominated by increased arterial stiffness and alteration of the vascular wall, which eventually damages the target organs, such as the heart and kidneys. The literature is scarce regarding cardio-renal metabolic syndrome in pregnancy cohorts. The present paper exposes the current state of the art and emphasises the most important findings of this entity, particularly in pregnant women. The early assessment of arterial function can lead to proper and individualised measures for women predisposed to hypertension, pre-eclampsia, eclampsia, and diabetes mellitus. This review focuses on available information regarding the assessment of arterial function during gestation, possible cut-off values, the possible predictive role for future events and modalities to reverse or control its dysfunction, a fact of crucial importance with excellent outcomes at meagre costs.
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Paapstel K, Kals J. Metabolomics of Arterial Stiffness. Metabolites 2022; 12:370. [PMID: 35629874 PMCID: PMC9146333 DOI: 10.3390/metabo12050370] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 12/18/2022] Open
Abstract
Arterial stiffness (AS) is one of the earliest detectable signs of structural and functional alterations of the vessel wall and an independent predictor of cardiovascular events and death. The emerging field of metabolomics can be utilized to detect a wide spectrum of intermediates and products of metabolism in body fluids that can be involved in the pathogenesis of AS. Research over the past decade has reinforced this idea by linking AS to circulating acylcarnitines, glycerophospholipids, sphingolipids, and amino acids, among other metabolite species. Some of these metabolites influence AS through traditional cardiovascular risk factors (e.g., high blood pressure, high blood cholesterol, diabetes, smoking), while others seem to act independently through both known and unknown pathophysiological mechanisms. We propose the term 'arteriometabolomics' to indicate the research that applies metabolomics methods to study AS. The 'arteriometabolomics' approach has the potential to allow more personalized cardiovascular risk stratification, disease monitoring, and treatment selection. One of its major goals is to uncover the causal metabolic pathways of AS. Such pathways could represent valuable treatment targets in vascular ageing.
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Affiliation(s)
- Kaido Paapstel
- Endothelial Research Centre, University of Tartu, 8 Puusepa Street, 51014 Tartu, Estonia;
- Department of Cardiology, Institute of Clinical Medicine, University of Tartu, 8 Puusepa Street, 51014 Tartu, Estonia
- Heart Clinic, Tartu University Hospital, 8 Puusepa Street, 51014 Tartu, Estonia
| | - Jaak Kals
- Endothelial Research Centre, University of Tartu, 8 Puusepa Street, 51014 Tartu, Estonia;
- Department of Surgery, Institute of Clinical Medicine, University of Tartu, 8 Puusepa Street, 51014 Tartu, Estonia
- Surgery Clinic, Tartu University Hospital, 8 Puusepa Street, 51014 Tartu, Estonia
- Department of Biochemistry, Institute of Biomedicine and Translational Medicine, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, 19 Ravila Street, 50411 Tartu, Estonia
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Nardelli M, Catrambone V, Grandi G, Banfi T, Bruno RM, Scilingo EP, Faraguna U, Valenza G. Activation of brain-heart axis during REM sleep: a trigger for dreaming. Am J Physiol Regul Integr Comp Physiol 2021; 321:R951-R959. [PMID: 34704848 DOI: 10.1152/ajpregu.00306.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Dreams may be recalled after awakening from sleep following a defined electroencephalographic pattern that involves local decreases in low-frequency activity in the posterior cortical regions. While a dreaming experience implies bodily changes at many organ-, system-, and timescale-levels, the entity and causal role of such peripheral changes in a conscious dream experience are unknown. We performed a comprehensive, causal, multivariate analysis of physiological signals acquired during REM sleep at night, including high-density EEG and peripheral dynamics including electrocardiography and blood pressure. In this preliminary study, we investigated multiple recalls and non-recalls of dream experiences using data from nine healthy volunteers. The aim was not only to investigate the changes in central and autonomic dynamics associated with dream recalls and non-recalls, but also to characterize the central-peripheral dynamical and (causal) directional interactions, and the temporal relations of the related arousals upon awakening. We uncovered a brain-body network that drives a conscious dreaming experience that acts with specific interaction and time delays. Such a network is sustained by the blood pressure dynamics and the increasing functional information transfer from the neural heartbeat regulation to the brain. We conclude that bodily changes play a crucial and causative role in a conscious dream experience during REM sleep.
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Affiliation(s)
- Mimma Nardelli
- Bioengineering and Robotics Research Centre E. Piaggio and Department of Information Engineering, University of Pisa, Italy
| | - Vincenzo Catrambone
- Bioengineering and Robotics Research Centre E. Piaggio and Department of Information Engineering, University of Pisa, Italy
| | - Giulia Grandi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Italy
| | - Tommaso Banfi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Italy
| | - Rosa Maria Bruno
- INSERM U970 Team 7, Paris Cardiovascular Research Centre - PARCC, University Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Enzo Pasquale Scilingo
- Bioengineering and Robotics Research Centre E. Piaggio and Department of Information Engineering, University of Pisa, Italy
| | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Italy.,Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Gaetano Valenza
- Bioengineering and Robotics Research Centre E. Piaggio and Department of Information Engineering, University of Pisa, Italy
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Wu X, Li Z, Sun W, Zheng H. Homocysteine is an indicator of arterial stiffness in Chinese women with polycystic ovary syndrome. Endocr Connect 2021; 10:1073-1079. [PMID: 34355700 PMCID: PMC8428028 DOI: 10.1530/ec-21-0224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/06/2021] [Indexed: 11/16/2022]
Abstract
Polycystic ovary syndrome (PCOS) is associated with an increased risk of cardiovascular disease in women. Hyperhomocysteinemia (H-Hcy) is closely related to arterial stiffness (AS) in patients with cardiovascular disease. This study aimed to investigate the relationship between serum homocysteine(Hcy) level and brachial-ankle pulse wave velocity (baPWV) in Chinese women with PCOS. A total of 124 PCOS women were enrolled and divided into two groups according to their baPWV values: normal, baPWV < 1400 cm/s and high AS, baPWV ≥ 1400 cm/s. Univariate analysis was performed to investigate the relative factors for baPWV, and multiple regression analysis was used to evaluate the association of Hcy with baPWV. The group with high AS (n = 35) had higher Hcy levels than the other group (n = 89; P < 0.05). Moreover, univariate analysis revealed that serum Hcy was positively correlated with baPWV (r = 0.133, P < 0.01). In multiple regression analysis, the age-adjusted serum Hcy level was positively correlated with baPWV (β = 0.201, P < 0.01). It remained positively associated with baPWV (β = 0.145, P < 0.01) after further adjustments for age, BMI, PCOS duration, systolic blood pressure, and homeostasis model assessment-insulin resistance as well as several other factors correlated with baPWV. Our results demonstrated that H-Hcy was significantly and independently related to elevated baPWV, suggesting that Hcy might play a role in the pathologic process of AS in women with PCOS. Further researches with more subjects are needed to explore whether Hcy would be a promising biomarker for the stratification management of PCOS women.
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Affiliation(s)
- Xia Wu
- Department of Endocrinology, Jing’an District Centre Hospital of Shanghai (Huashan Hospital Fudan University Jing’an Branch), Shanghai, China
| | - Zhiling Li
- Department of Pharmacy, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Wenjiang Sun
- Department of Rehabilitation, Shanghai General Hospital, Jiaotong University, Shanghai, China
| | - Huan Zheng
- Department of Cardiology, Worldpath Clinic International, Shanghai, China
- Correspondence should be addressed to H Zheng:
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Khan A, Choi Y, Back JH, Lee S, Jee SH, Park YH. High-resolution metabolomics study revealing l-homocysteine sulfinic acid, cysteic acid, and carnitine as novel biomarkers for high acute myocardial infarction risk. Metabolism 2020; 104:154051. [PMID: 31874143 DOI: 10.1016/j.metabol.2019.154051] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 12/03/2019] [Accepted: 12/17/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Identifying changes in serum metabolites before the occurrence of acute myocardial infarction (AMI) is an important approach for finding novel biomarkers of AMI. METHODS In this prospective cohort study, serum samples obtained from patients at risk of AMI (n = 112) and non-risk controls (n = 89) were tested using high-resolution metabolomics (HRM). Partial least-squares discriminant analysis (PLS-DA), along with univariate analysis using a false discovery rate (FDR) of q = 0.05 were performed to discriminate metabolic profiles and to determine significantly different metabolites between healthy control and AMI risk groups. RESULTS PLS-DA significantly separated the AMI risk sera from control sera. The metabolites associated with amino acid biosynthesis, 2-oxocarboxylic acid, tryptophan, and amino sugar and nucleotide sugar metabolism pathways were mainly elevated in patients at risk of AMI. Further validation and quantification by MS/MS showed that tryptophan, carnitine, L-homocysteine sulfinic acid (L-HCSA), and cysteic acid (CA) were upregulated, while L-cysteine and L-cysteine sulfinic acid (L-CSA) were downregulated, specifically among AMI risk sera. Additionally, these discriminant metabolic profiles were not related to hypertension, smoking or alcoholism. CONCLUSION In conclusion, detecting upregulated L-HCSA and CA along with carnitine among patients at risk for AMI could serve as promising non-invasive biomarkers for early AMI detection.
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Affiliation(s)
- Adnan Khan
- Metabolomics Laboratory, Korea University College of Pharmacy, Sejong 30019, Republic of Korea
| | - Yoonjeong Choi
- Department of Epidemiology and Health Promotion and Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul 03722, Republic of Korea
| | - Joung Hwan Back
- Health Insurance Policy Research Institute, National Health Insurance Service, Wonju 26464, Republic of Korea
| | - Sunmi Lee
- Health Insurance Policy Research Institute, National Health Insurance Service, Wonju 26464, Republic of Korea
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion and Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul 03722, Republic of Korea
| | - Youngja H Park
- Metabolomics Laboratory, Korea University College of Pharmacy, Sejong 30019, Republic of Korea.
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Azzini E, Ruggeri S, Polito A. Homocysteine: Its Possible Emerging Role in At-Risk Population Groups. Int J Mol Sci 2020; 21:ijms21041421. [PMID: 32093165 PMCID: PMC7073042 DOI: 10.3390/ijms21041421] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/30/2020] [Accepted: 02/14/2020] [Indexed: 12/13/2022] Open
Abstract
Increased plasma homocysteine is a risk factor for several pathological disorders. The present review focused on the role of homocysteine (Hcy) in different population groups, especially in risk conditions (pregnancy, infancy, old age), and on its relevance as a marker or etiological factor of the diseases in these age groups, focusing on the nutritional treatment of elevated Hcy levels. In pregnancy, Hcy levels were investigated in relation to the increased risk of adverse pregnancy outcomes such as small size for gestational age at birth, preeclampsia, recurrent abortions, low birth weight, or intrauterine growth restriction. In pediatric populations, Hcy levels are important not only for cardiovascular disease, obesity, and renal disease, but the most interesting evidence concerns study of elevated levels of Hcy in autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Finally, a focus on the principal pathologies of the elderly (cardiovascular and neurodegenerative disease, osteoporosis and physical function) is presented. The metabolism of Hcy is influenced by B vitamins, and Hcy-lowering vitamin treatments have been proposed. However, clinical trials have not reached a consensus about the effectiveness of vitamin supplementation on the reduction of Hcy levels and improvement of pathological condition, especially in elderly patients with overt pathologies, suggesting that other dietary and non-dietary factors are involved in high Hcy levels. The importance of novel experimental designs focusing on intra-individual variability as a complement to the typical case-control experimental designs and the study of interactions between different factors it should be emphasized.
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Wu F, Yang H, Liu B. Association between Homocysteine and Arterial Stiffness in Women with a History of Preeclampsia. J Vasc Res 2019; 56:152-159. [PMID: 31132776 DOI: 10.1159/000500358] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/15/2019] [Indexed: 11/19/2022] Open
Abstract
Growing evidence has reported that a history of preeclampsia (PE) increases the risk of developing cardiovascular disease (CVD). Arterial stiffness plays a predictive role in CVD. Previous studies have demonstrated the close association between homocysteine (Hcy) level and arterial stiffness in community-based populations. This study was to assess whether Hcy level was independently associated with arterial stiffness in 168 women with a PE history who were analyzed at a 5-year follow-up. Brachial-ankle pulse wave velocity (baPWV) was measured by an automatic pulse-wave analyzer and a value >1,400 cm/s was defined as high arterial stiffness. Biochemical parameters were recorded and an Hcy value >10 μmol/L was defined as having hyperhomocysteine (H-Hcy). Variables that were significantly associated with baPWV were tested for independence by multivariate logistic regression analysis. We found that body mass index (OR 1.017, 95% CI 1.008-1.029), systolic blood pressure (OR 1.048, 95% CI 1.019-1.072), total cholesterol (OR 1.059, 95% CI 1.007-1.086), and Hcy level (OR 1.021, 95% CI 1.010-1.037) were independent determinants of baPWV in women with previous PE. Our findings indicate that Hcy pathway might be involved in arterial stiffness in women with a PE history. Whether Hcy would be a promising biomarker for serial stratified CVD risk management in these women deserves further evaluation on a large scale.
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Affiliation(s)
- Fan Wu
- Department of Gynaecology and Obstetrics, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Hongyan Yang
- Department of Neurology, Tongji Hospital Branch, Tongji University, Shanghai, China
| | - Bin Liu
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China,
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8
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Ostrakhovitch EA, Tabibzadeh S. Homocysteine and age-associated disorders. Ageing Res Rev 2019; 49:144-164. [PMID: 30391754 DOI: 10.1016/j.arr.2018.10.010] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 09/30/2018] [Accepted: 10/25/2018] [Indexed: 12/26/2022]
Abstract
There are numerous theories of aging, a process which still seems inevitable. Aging leads to cancer and multi-systemic disorders as well as chronic diseases. Decline in age- associated cellular functions leads to neurodegeneration and cognitive decline that affect the quality of life. Accumulation of damage, mutations, metabolic changes, failure in cellular energy production and clearance of altered proteins over the lifetime, and hyperhomocysteinemia, ultimately result in tissue degeneration. The decline in renal functions, nutritional deficiencies, deregulation of methionine cycle and deficiencies of homocysteine remethylation and transsulfuration cofactors cause elevation of homocysteine with advancing age. Abnormal accumulation of homocysteine is a risk factor of cardiovascular, neurodegenerative and chronic kidney disease. Moreover, approximately 50% of people, aged 65 years and older develop hypertension and are at a high risk of developing cardiovascular insufficiency and incurable neurodegenerative disorders. Increasing evidence suggests inverse relation between cognitive impairment, cerebrovascular and cardiovascular events and renal function. Oxidative stress, inactivation of nitric oxide synthase pathway and mitochondria dysfunction associated with impaired homocysteine metabolism lead to aging tissue degeneration. In this review, we examine impact of high homocysteine levels on changes observed with aging that contribute to development and progression of age associated diseases.
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Affiliation(s)
- E A Ostrakhovitch
- Frontiers in Bioscience Research Institute in Aging and Cancer, Irvine, CA, USA.
| | - S Tabibzadeh
- Frontiers in Bioscience Research Institute in Aging and Cancer, Irvine, CA, USA.
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9
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Differential responses of autonomic function in sea level residents, acclimatized lowlanders at >3500 m and Himalayan high altitude natives at >3500 m: A cross-sectional study. Respir Physiol Neurobiol 2018; 254:40-48. [DOI: 10.1016/j.resp.2018.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 04/03/2018] [Accepted: 04/07/2018] [Indexed: 11/22/2022]
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10
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Prevalence and risk factors of hypertension in acclimatized lowlanders staying at high altitude for different durations. J Hum Hypertens 2018; 32:359-366. [PMID: 29483588 DOI: 10.1038/s41371-018-0037-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 11/21/2017] [Accepted: 12/12/2017] [Indexed: 11/08/2022]
Abstract
Hypoxic exposure at high-altitude (HA) modulates blood pressure (BP). High prevalence of hypertension among native highlanders (NH) has been reported. However, information on prevalence and determinants of hypertension in acclimatized young lowlanders (ALL) staying at HA for different durations is sparse. We aimed to determine the prevalence of hypertension in ALL staying at HA for different durations and its association with cardiovascular risk factors. Male volunteers were categorized on the basis of their duration of stay at HA; Lowlanders (LL) (0 months; n = 151), ALL (1-24 months; n = 519) and NH (n = 103). ALL were sub grouped into ALL 1 (1-6 months; n = 165), ALL 2 (6-12 months; n = 181), and ALL 3 (12-24 months; n = 173). BP, sympathetic activity, arterial stiffness, lipid profile, and homocysteine were estimated. Regression analysis was performed to determine association of risk factors with hypertension. Prevalence of hypertension among ALL was highest with 17.53% followed by NH (11.6%) and LL (9.27%). Prevalence of hypertension in ALL sub group was in order ALL 1 < ALL 2 < ALL 3. Hypertension was significantly associated with sympathetic dominance (p < 0.001) in ALL 1. Hypertension in ALL 2 was associated with dyslipidemia (p < 0.01) while in ALL 3 hypertension was associated with hyperhomocysteinemia (hHCY, p < 0.001), arterial stiffness and dyslipidemia (p < 0.01). In conclusion, our report suggests higher prevalence of hypertension in ALL. The association of studied risk factors and hypertension in different ALL sub groups varied significantly. Our findings suggest the need for a differential clinical approach to control hypertension in ALL considering their duration of stay at HA.
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11
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Li Y, He B, Li H, Zhang Q, Tang C, Du J, Jin H. Plasma Homocysteine Level in Children With Postural Tachycardia Syndrome. Front Pediatr 2018; 6:375. [PMID: 30560108 PMCID: PMC6287046 DOI: 10.3389/fped.2018.00375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 11/15/2018] [Indexed: 11/22/2022] Open
Abstract
The study was designed to evaluate the changes of plasma homocysteine (Hcy) level in children with postural tachycardia syndrome (POTS) and explore its significance. A total of 65 subjects were recruited in our study, of whom 35 children were in the POTS group and 30 healthy children were in the control group. Plasma Hcy levels were determined in all subjects. The relationship between the plasma Hcy level and the symptom score was analyzed in the 35 POTS patients. The relationship between the plasma Hcy level and the change in heart rate from the supine to upright position (ΔHR) and between the plasma Hcy level and the rate of increase in heart rate from the supine to upright position (ΔHR/sHR × 100%) were analyzed in all subjects. The plasma Hcy levels were significantly higher in the children with POTS than those in the control group (9.78 [7.68, 15.31] μmol/L vs. 7.79 [7.46, 9.63] μmol/L, P < 0.05). The plasma Hcy levels were positively correlated with symptom scores in the POTS patients (n = 35, r = 0.522, P < 0.01). The plasma Hcy levels were also positively correlated with ΔHR (n = 65, r = 0.332, P < 0.01) and ΔHR/sHR × 100% (n = 65, r = 0.341, P < 0.01) in all the subjects. In conclusion, the plasma Hcy levels were elevated in the children with POTS positively correlated with the severity of POTS, suggesting that Hcy might be involved in the pathogenesis of POTS.
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Affiliation(s)
- Yaqi Li
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Bing He
- Department of Pediatrics, Renmin Hospital, Wuhan University, Wuhan, China
| | - Hongxia Li
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Qingyou Zhang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Chaoshu Tang
- Department of Physiology and Pathophysiology, Peking University Health Sciences Center, Beijing, China
| | - Junbao Du
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Hongfang Jin
- Department of Pediatrics, Peking University First Hospital, Beijing, China
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12
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Yang B, Fan S, Zhi X, He J, Ma P, Yu L, Zheng Q, Sun G. Interactions of homocysteine and conventional predisposing factors on hypertension in Chinese adults. J Clin Hypertens (Greenwich) 2017; 19:1162-1170. [PMID: 28942612 PMCID: PMC8031033 DOI: 10.1111/jch.13075] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 05/18/2017] [Accepted: 05/21/2017] [Indexed: 01/18/2023]
Abstract
This study aimed to investigate whether conventional predisposing factors modify the associations of homocysteine with blood pressure levels and hypertension. A total of 2615 adults were recruited from Liaoning province. An elevated homocysteine level was significantly associated with increased hypertension risk and blood pressure (all P<.05). Interaction analyses showed that homocysteine acted synergistically with age, overweight/obesity, dyslipidemia, and family history of hypertension to affect hypertension risk, and the relative excess risk due to interaction was 1.21 (95% confidence interval, 0.07-2.35), 0.72 (95% confidence interval, 0.07-1.36), 0.45 (95% confidence interval, 0.06-0.85), and 1.87 (95% confidence interval, 0.77-2.97), respectively. Increases in blood pressure were higher in patients who were overweight/obese or had a family history of hypertension than in their counterparts (all Pinteraction <.05). This study provides some strong evidence for interactions of homocysteine with conventional predisposing factors on hypertension.
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Affiliation(s)
- Boyi Yang
- Department of Preventive MedicineGuangzhou Key Laboratory of Environmental Pollution and Health Risk AssessmentSchool of Public HealthSun Yat‐sen UniversityGuangzhouChina
- School of Public HealthResearch Center of Environment and Non‐Communicable DiseaseChina Medical UniversityShenyangChina
| | - Shujun Fan
- School of Public HealthResearch Center of Environment and Non‐Communicable DiseaseChina Medical UniversityShenyangChina
| | - Xueyuan Zhi
- School of Public HealthResearch Center of Environment and Non‐Communicable DiseaseChina Medical UniversityShenyangChina
| | - Jing He
- Department of Non‐Communicable DiseaseShenhe Center for Disease Control and PreventionShenyangLiaoningChina
| | - Ping Ma
- Department of Non‐Communicable DiseaseShenhe Center for Disease Control and PreventionShenyangLiaoningChina
| | - Luyang Yu
- Department of Non‐Communicable DiseaseShenhe Center for Disease Control and PreventionShenyangLiaoningChina
| | - Quanmei Zheng
- School of Public HealthResearch Center of Environment and Non‐Communicable DiseaseChina Medical UniversityShenyangChina
| | - Guifan Sun
- School of Public HealthResearch Center of Environment and Non‐Communicable DiseaseChina Medical UniversityShenyangChina
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Resstel LBM, de Andrade CR, Haddad R, Eberlin MN, de Oliveira AM, Corrêa FMA. Hyperhomocysteinaemia-induced cardiovascular changes in rats. Clin Exp Pharmacol Physiol 2016; 35:949-56. [PMID: 18430058 DOI: 10.1111/j.1440-1681.2008.04940.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
(1) Increased plasma homocysteine content and increased blood pressure are independently associated with higher cardiovascular risks. The present study was designed to determine the effects of hyperhomocysteinaemia (HHcys) on the activity of the cardiovascular system in rats. (2) Using male Wistar rats, the effect of moderate HHcys, induced by treating rats with dl-homocysteine thiolactone (DL-HT; 1 g/kg per day) for 15 days, on arterial blood pressure, heart rate, baroreflex and vascular reactivity was determined. (3) Hyperhomocysteinaemia was observed after 15 days of treatment. Baseline arterial blood pressure and heart rate values of HHcys animals were significantly increased after 15 days of treatment. Plasma homocysteine and cardiovascular parameters returned to control values after termination of treatment. Baroreflex gain was significantly enhanced in HHcys rats. The pressor effect of an i.v. infusion of phenylephrine (50 mg/kg per mL) was decreased in HHcys rats and returned to control values after washout of DL-HT. Hypotensive responses to i.v. infusions of sodium nitroprusside (70 mg/kg per mL) or acetylcholine (10 mg/kg per mL) were increased in HHcys animals and returned to control values after washout of DL-HT. The increase in resting arterial blood pressure associated with the moderate HHcys was reversed by treatment with the b1-adrenoceptor antagonist atenolol, suggesting that HHcys-related hypertension is related to increase in cardiac sympathetic activity. (4) The present study showed significantly increased arterial blood pressure, heart rate and baroreflex activity in the early phase of moderate HHcys. In addition, HHcys was associated with alterations of vascular responsiveness to pressor and depressor agents, as well as increased cardiac sympathetic activity. The fact that cardiovascular changes observed in HHcys were reversed after DL-HT washout indicate that moderate HHcys evokes cardiovascular changes.
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Affiliation(s)
- Leonardo B M Resstel
- Department of Pharmacology, School of Medicine, University of São Paulo, Ribeiraão Preto, Brazil
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14
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Zhang Z, Fang X, Hua Y, Liu B, Ji X, Tang Z, Wang C, Guan S, Wu X, Liu H, Gu X. Combined Effect of Hyperhomocysteinemia and Hypertension on the Presence of Early Carotid Artery Atherosclerosis. J Stroke Cerebrovasc Dis 2016; 25:1254-1262. [DOI: 10.1016/j.jstrokecerebrovasdis.2016.01.037] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 01/11/2016] [Accepted: 01/24/2016] [Indexed: 12/13/2022] Open
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15
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Shirpoor A, Norouzi L, Nemati S, Khadem Ansari MH. Protective effect of vitamin E against diabetes-induced oxidized LDL and aorta cell wall proliferation in rat. IRANIAN BIOMEDICAL JOURNAL 2016; 19:117-23. [PMID: 25864817 PMCID: PMC4412923 DOI: 10.6091/ibj.1449.2015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
UNLABELLED Hyperlipidemia and oxidized-low-density lipoproteins (Ox-LDL) are important independent cardiovascular risk factors that have been shown to stimulate vascular smooth muscle cell (VSMC) proliferation. The purpose of the present study was to investigate the effect of vitamin E on Ox-LDL, lipid profile, C-reactive protein (CRP), and VSMC proliferation of rat aorta. METHODS Male Wistar rats (n = 32) were divided into four groups namely: sham (SH), control (C), non-treated diabetic, and vitamin E-treated diabetic (VETD) groups. Ox-LDL, lipid profile, CRP and VSMC proliferation of aorta were measured after 42 days. RESULTS The results revealed that along with a significant increase in VSMC proliferation, the amount of CRP, Ox-LDL, and lipid profiles in diabetic rats. VSMC proliferation was significantly ameliorated, and elevated CRP, Ox-LDL, and lipid profiles were also restored to those of shams in VETD. CONCLUSIONS These findings strongly support the idea that diabetes induces Ox-LDL-mediated oxidative stress and VSMC proliferation in aorta of rat and imply that vitamin E has a strong protective effect as an antioxidant.
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Affiliation(s)
- Alireza Shirpoor
- Dept. of Physiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Leila Norouzi
- Dept. of Physiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Samira Nemati
- Dept. of Physiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
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Mantjoro EM, Toyota K, Kanouchi H, Kheradmand M, Niimura H, Kuwabara K, Nakahata N, Ogawa S, Shimatani K, Kairupan TS, Nindita Y, Ibusuki R, Nerome Y, Owaki T, Maenohara S, Takezaki T. Positive Association of Plasma Homocysteine Levels with Cardio-Ankle Vascular Index in a Prospective Study of Japanese Men from the General Population. J Atheroscler Thromb 2016; 23:681-91. [PMID: 26797265 DOI: 10.5551/jat.32243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Observational studies have reported that elevated homocysteine (Hcy) levels are associated with the risk of cardiovascular disease (CVD). However, interventions that lower Hcy do not provide a corresponding risk reduction. Therefore, the causal role of Hcy in CVD remains unclear. This 5-year prospective study investigated the associations of Hcy levels, folate intake, and host factors with arterial stiffness among the general Japanese population. METHODS We prospectively recruited 658 participants (40-69 years old) from the general population during regular health checkup examinations. Arterial stiffness was evaluated using the cardio-ankle vascular index (CAVI) at baseline and the 5-year follow-up. Folate intake was estimated using a structured questionnaire. Genotyping was used to evaluate the MTHFR C677T and MS A2756G gene polymorphisms. Ultrafast liquid chromatography was used to measure total plasma Hcy levels. Association between these variables and CAVI values was evaluated using general linear regression and logistic regression models that were adjusted for atherosclerosis-related factors. RESULTS Men had higher Hcy levels and CAVI values and lower folate intake than women (all, p<0.001). At baseline, Hcy, folate intake, and the two genotypes were not associated with CAVI values for both sexes. Among men, Hcy levels were positively associated with CAVI values at the 5-year follow-up (p=0.033). Folate intake and the two genotypes were not associated with the 5-year CAVI values. CONCLUSION Plasma Hcy may be involved in arterial stiffness progression, as monitored using CAVI, among men.
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Affiliation(s)
- Eva Mariane Mantjoro
- Department of International Islands and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
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Increased arterial stiffness and its relationship with inflammation, insulin, and insulin resistance in celiac disease. Eur J Gastroenterol Hepatol 2015; 27:1193-9. [PMID: 26181110 DOI: 10.1097/meg.0000000000000437] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Celiac disease (CD) is a lifelong, chronic, immune-mediated, inflammatory small bowel disorder, precipitated by exposure to dietary gluten and related proteins in genetically predisposed individuals. Recent studies have shed new light on the importance of inflammation in the pathogenesis of arterial stiffness. The aim of this study was to evaluate arterial stiffness using pulse wave velocity (PWV) in adult CD patients without cardiovascular risk factors in comparison with a control group. PATIENTS AND METHODS A total of 58 patients with CD without cardiovascular risk factors and age-matched and sex-matched healthy controls were enrolled in the study. All patients completed a standard questionnaire form, and various laboratory parameters were assessed. Vascular measurements, including PWV, were carried out using a Mobil-O-Graph 24-h pulse wave analysis monitor, an automatic oscillometric device. RESULTS Although cardiovascular risk factors, such as low-density lipoprotein cholesterol and triglyceride, were significantly lower (P<0.05) in celiac patients than in controls, the erythrocyte sedimentation rate, C-reactive protein, insulin, homeostasis model assessment of insulin resistance, homocysteine, and 24 h, day, and night PWV values were higher in patients with CD than in controls (P<0.05). A multiple linear regression analysis showed that PWV was correlated positively with age and the duration of CD. CONCLUSION This study found increased arterial stiffness, homocysteine, erythrocyte sedimentation rate, C-reactive protein, insulin, and homeostasis model assessment of insulin resistance in patients with CD and provides evidence for the potential contribution of these parameters and inflammation toward arterial stiffening, independent of conventional cardiovascular risk factors.
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Plasma homocysteine levels are independently associated with alterations of large artery stiffness in men but not in women. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2015; 12:251-6. [PMID: 26089849 PMCID: PMC4460168 DOI: 10.11909/j.issn.1671-5411.2015.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 04/02/2015] [Accepted: 04/07/2015] [Indexed: 11/23/2022]
Abstract
Objectives To investigate the associations of the plasma homocysteine levels with the alterations in arterial stiffness in a community-based cohort. The gender differences in these associations were examined. Methods We evaluated the relationship between plasma homocysteine levels to three measures of vascular function [carotid-femoral pulse wave velocity (CF-PWV), carotid-ankle PWV (CA-PWV) and heart rate corrected augmentation index (AI)] in 1680 participants (mean age: 61.5 years; 709 men, 971 women) from communities of Beijing, China. Results In univariate analysis, plasma homocysteine levels was positively related to the CF-PWV (r = 0.211, P < 0.0001) and CA-PWV (r = 0.148, P < 0.0001), whereas inversely associated with AI (r = −0.052, P = 0.016). In multiple linear regression models adjusting for covariants, plasma homocysteine remained positively related to the CF-PWV (standardized β = 0.065, P = 0.007) in total cases. When the groups of men and women were examined separately, plasma homocysteine remained positively associated with the CF-PWV (standardized β = 0.082, P = 0.023) in men, whereas the relations between homocysteine and any of the arterial stiffness indices were not further present in women. Conclusions In Chinese population, plasma homocysteine levels are independently associated with alterations of large artery stiffness in men but not in women.
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Qian G, Zeng LH, Liu YQ, Cao F, Chen YD, Zheng ML, Yang XC, Xu XP, Huo Y. Associations between plasma total homocysteine, blood pressure stages and pulse wave velocity in Chinese rural community population. Blood Press 2015; 24:340-6. [PMID: 26043364 DOI: 10.3109/08037051.2014.997089] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of the study was to examine the associations among plasma total homocysteine (tHcy) and blood pressure (BP) stages and brachial-ankle pulse wave velocity (ba-PWV) in a Chinese rural community population. In this cross-sectional study, 2148 rural community subjects with normotension and mild hypertension (HTN) were classified into four groups according to ba-PWV level. Multivariate regression showed that ba-PWV was significantly and independently correlated with tHcy (β = 5.32, p < 0.001) in the entire study population. Moreover, ba-PWV showed a significant increase with increasing plasma tHcy level in subjects with both high normal BP and grade 1 HTN (p < 0.05). Compared with optimal BP stage, ba-PWV was significantly associated with high normal BP stage (β = 193, p < 0.001) and grade 1 HTN (β = 413, p < 0.001).There was a statistical interaction effect between high normal BP stage and optimal BP stage (p = 0.045). The similar result was found between subjects with optimal BP and those with grade 1 HTN (p = 0.037). In conclusion, tHcy was independently correlated with ba-PWV in subjects with high normal BP and grade 1 HTN. High normal BP and grade 1 HTN may worsen the impact of tHcy on arterial stiffness in a Chinese rural community population.
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Affiliation(s)
- Geng Qian
- a Department of Cardiology , Chinese People's Liberation Army General Hospital , Beijing , China
| | - Long-Huan Zeng
- a Department of Cardiology , Chinese People's Liberation Army General Hospital , Beijing , China
| | - Yu-Qi Liu
- a Department of Cardiology , Chinese People's Liberation Army General Hospital , Beijing , China
| | - Feng Cao
- a Department of Cardiology , Chinese People's Liberation Army General Hospital , Beijing , China
| | - Yun-Dai Chen
- a Department of Cardiology , Chinese People's Liberation Army General Hospital , Beijing , China
| | - Mei-Li Zheng
- b Department of Cardiology , Beijing Chao-Yang Hospital, Capital Medical University , Beijing , China
| | - Xin-Chun Yang
- b Department of Cardiology , Beijing Chao-Yang Hospital, Capital Medical University , Beijing , China
| | - Xi-Ping Xu
- c Institute of Biomedicine, Anhui Medical University , Hefei , China
| | - Yong Huo
- d Department of Cardiology and Heart Center , Peking University First Hospital , Beijing , China
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Black tea protects against hypertension-associated endothelial dysfunction through alleviation of endoplasmic reticulum stress. Sci Rep 2015; 5:10340. [PMID: 25976123 PMCID: PMC4432571 DOI: 10.1038/srep10340] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 04/10/2015] [Indexed: 12/24/2022] Open
Abstract
Hypertensive patients have been found to be associated with elevated levels of homocysteine, known as hyperhomocysteinemia. Homocysteine (Hcy) can induce endoplasmic reticulum (ER) stress in endothelial cells. This study aims to investigate whether black tea (BT) protects against hypertension-associated endothelial dysfunction through alleviation of ER stress. Rat aortae and cultured rat aortic endothelial cells were treated with Hcy, BT extract, and theaflavin-3,3'-digallate (TF3). Male Sprague Dawley rats were infused with angiotensin II (Ang II) to induce hypertension and orally administrated with BT extract at 15 mg/kg/day for 2 weeks. Hcy impaired endothelium-dependent relaxations of rat aortae and led to ER stress in endothelial cells, which were ameliorated by co-incubation of BT extract and TF3. The blood pressure of Ang II-infused rats and plasma Hcy level were normalized by BT consumption. Impaired endothelium-dependent relaxations in renal arteries, carotid arteries and aortae, and flow-mediated dilatations in third-order mesenteric resistance arteries were improved. Elevations of ER stress markers and ROS level, plus down-regulation of Hcy metabolic enzymes in aortae from Ang II-infused rats were prevented by BT treatment. Our data reveal the novel cardiovascular benefits of BT in ameliorating vascular dysfunctions, providing insight into developing BT into beneficial dietary supplements in hypertensive patients.
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Miyajima A, Bamba M, Muto T, Hirota T. Dysfunction of blood pressure regulation in hyperhomocyteinemia model in rats. J Toxicol Sci 2015; 40:211-21. [DOI: 10.2131/jts.40.211] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Atsushi Miyajima
- Department of Biopharmaceutics, Faculty of Pharmaceutical Sciences, Tokyo University of Science
| | - Masaru Bamba
- Department of Biopharmaceutics, Faculty of Pharmaceutical Sciences, Tokyo University of Science
| | - Takafumi Muto
- Department of Biopharmaceutics, Faculty of Pharmaceutical Sciences, Tokyo University of Science
| | - Takashi Hirota
- Department of Biopharmaceutics, Faculty of Pharmaceutical Sciences, Tokyo University of Science
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Ried K, Fakler P. Potential of garlic (Allium sativum) in lowering high blood pressure: mechanisms of action and clinical relevance. Integr Blood Press Control 2014; 7:71-82. [PMID: 25525386 PMCID: PMC4266250 DOI: 10.2147/ibpc.s51434] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Garlic supplements have shown promise in the treatment of uncontrolled hypertension, lowering blood pressure (BP) by about 10 mmHg systolic and 8 mmHg diastolic, similar to standard BP medication. Aged garlic extract, which contains S-allylcysteine as the bioactive sulfur compound, in particular is standardizable and highly tolerable, with little or no known harmful interaction when taken with other BP-reducing or blood-thinning medication. Here we describe biologically plausible mechanisms of garlic's BP-lowering effect. Garlic-derived polysulfides stimulate the production of the vascular gasotransmitter hydrogen sulfide (H2S) and enhance the regulation of endothelial nitric oxide (NO), which induce smooth muscle cell relaxation, vasodilation, and BP reduction. Several dietary and genetic factors influence the efficiency of the H2S and NO signaling pathways and may contribute to the development of hypertension. Sulfur deficiency might play a part in the etiology of hypertension, and could be alleviated with supplementation of organosulfur compounds derived from garlic.
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Affiliation(s)
- Karin Ried
- National Institute of Integrative Medicine, Melbourne, VIC, Australia
| | - Peter Fakler
- National Institute of Integrative Medicine, Melbourne, VIC, Australia
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Basati G, Razavi AE, Abdi S, Sarrafzedegan N, Sarrafzedegan N. Association of plasma leptin, homocysteine and nitric oxide levels with the presence and unstability of coronary artery disease. Biomark Med 2014; 8:405-12. [PMID: 24712432 DOI: 10.2217/bmm.13.131] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
AIM Leptin and total homocysteine (tHcy) may participate in the pathogenesis of coronary artery disease (CAD) through nitric oxide (NO) depletion. We sought to investigate whether leptin, tHcy and NO are suitable predictors of CAD. PATIENTS & METHODS This study contained 50 control subjects and 50 stable and 50 unstable angina patients. Plasma leptin, tHcy and NO levels were determined using enzyme immunoassay, HPLC fluorescence and spectrophotometric methods, respectively. Other conventional risk factors were also determined. RESULTS Leptin and tHcy levels were highest in unstable angina patients, followed by stable angina patients and then controls (p < 0.001). Controls had significantly higher NO than patients (p <0.001). Leptin and tHcy had a positive and NO a negative association with the presence of CAD. CONCLUSIONS Some athrogenic effects of leptin may be mediated by affecting tHcy and NO levels. Plasma leptin, tHcy and NO levels showed significant contribution to CAD prediction and discrimination.
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Affiliation(s)
- Gholam Basati
- Department of Clinical Biochemistry, Faculty of Allied Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran
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Wang X, Ye P, Cao R, Yang X, Xiao W, Zhang Y, Bai Y, Wu H. The association of homocysteine with metabolic syndrome in a community-dwelling population: homocysteine might be concomitant with metabolic syndrome. PLoS One 2014; 9:e113148. [PMID: 25401978 PMCID: PMC4234666 DOI: 10.1371/journal.pone.0113148] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 10/15/2014] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Elevated plasma total homocysteine (tHcy) and metabolic syndrome (MetS) are both associated with cardiovascular disease, but the association between tHcy and MetS is not well characterized. The aim of this study was to determine the relationship between tHcy and MetS. METHODS To further estimate the time-dependent association of tHcy and MetS, we analyzed the tHcy level and MetS in 1499 subjects from a 4.8-year longitudinal study in Beijing, People's Republic of China. RESULTS In multiple linear regression analysis, baseline tHcy levels associated with age, BMI, SBP, DBP, LDL-C and Cr independently over 4.8-years follow-up; age, BMI, SBP, DBP and Cr were found to be associated with tHcy levels independently at the end of follow-up. Logistic regression analysis showed that there was no association between the baseline tHcy level and MetS over the 4.8-year follow-up (odds ratio (OR), 1.32; 95% confidence interval (CI), 0.79-2.19; P = 0.282); rather, there was an association only with hypertension as a MetS component (OR, 1.53; 95% CI, 1.06-2.21; P = 0.024). tHcy levels were associated with MetS at both cross-sectional baseline (OR, 1.38; 95% CI, 1.02-1.88; P = 0.038) and cross-sectional follow-up (OR, 1.60; 95% CI, 1.02-2.50; P = 0.041). The tHcy levels of MetS subjects were higher than those of non-MetS subjects at both cross-sectional baseline (19.35 ± 7.92 µmol/L vs. 17.45 ± 6.70 µmol/L, respectively; P = 0.001) and cross-sectional follow-up (18.95 ± 7.15 µmol/L vs. 17.11 ± 5.98 µmol/L, respectively; P = 0.02). CONCLUSION The tHcy level was not predictive of the incidence of MetS; however, it may be a risk factor for hypertension as a MetS component. Furthermore, tHcy levels were associated with MetS at cross-sectional baseline and follow-up, which suggests that a higher level of tHcy might be concomitant with MetS.
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Affiliation(s)
- Xiaona Wang
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Ping Ye
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Ruihua Cao
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Xu Yang
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Wenkai Xiao
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Yun Zhang
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Yongyi Bai
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Hongmei Wu
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
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Increased pulse wave velocity and relationship with inflammation, insulin, and insulin resistance in inflammatory bowel disease. Eur J Gastroenterol Hepatol 2014; 26:725-32. [PMID: 24901818 DOI: 10.1097/meg.0000000000000104] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Both ulcerative colitis and Crohn's disease are forms of inflammatory bowel disease (IBD), which is characterized by chronic, progressive inflammation of the gastrointestinal tract. Recent studies have shed new light on the importance of inflammation in the pathogenesis of arterial stiffness. AIM This study aimed to evaluate the relationship between pulse wave velocity (PWV) measurement and biochemical parameters in inactive and active IBD patients without cardiovascular risk factors and perform a comparison with the control group. MATERIALS AND METHODS We enrolled 102 IBD patients without cardiovascular risk factors and 74 matched controls, and evaluated each patient in active and inactive disease periods. All patients completed a standard questionnaire form and we assessed various laboratory parameters. We carried out vascular measurements using a Mobil-O-Graph 24-h pulse wave analysis monitor, an automatic oscillometric device. RESULTS Although cardiovascular risk factors, such as total cholesterol and low-density lipoprotein cholesterol, were significantly lower (P<0.05) in IBD patients than the controls, 24 h, day and night PWV values, erythrocyte sedimentation rate, C-reactive protein, insulin, homeostasis model assessment of insulin resistance, and homocysteine were higher in patients with active and inactive IBD than the controls (P<0.05). Multiple linear regression analysis showed that PWV was correlated positively with age and duration of IBD. CONCLUSION This study showed increased PWV, homocysteine, erythrocyte sedimentation rate, C-reactive protein, insulin, and homeostasis model assessment of insulin resistance in patients with active and inactive IBD and provides evidence of the potential contribution of inflammation and inflammation-related factors toward arterial stiffening independent from conventional cardiovascular risk factors.
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Xiao W, Bai Y, Ye P, Luo L, Liu D, Wu H, Bai J. Plasma homocysteine is associated with aortic arterial stiffness but not wave reflection in Chinese hypertensive subjects. PLoS One 2014; 9:e85938. [PMID: 24475061 PMCID: PMC3903502 DOI: 10.1371/journal.pone.0085938] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 12/03/2013] [Indexed: 11/18/2022] Open
Abstract
Objective Elevated plasma total homocysteine (tHcy) acts synergistically with hypertension to exert a multiplicative effect on cardiovascular diseases risk. The aim of this study was to determine the relationship between tHcy concentration and blood pressure, and to evaluate the role of plasma tHcy in arterial stiffness and wave reflection in hypertension. Methods In this cross-sectional study, a community-based sample of 1680 subjects (mean age 61.6 years) was classified into four groups according to tHcy level (<21.6 vs. ≥21.6 µmol/l) and blood pressure (hypertensive vs. normotensive). Levels of plasma tHcy and other biochemical parameters (e.g., lipids, glucose) were determined. Central arterial blood pressure, reflected pressure wave, and carotid-femoral pulse wave velocity (cf-PWV) were assessed by tonometry within 2 days of obtaining the blood specimen. Results Neither peripheral nor central blood pressure differed according to tHcy levels in normotensive and hypertensive subjects. Differences in cf-PWV according to tHcy were observed only in hypertensive subjects; differences in cf-PWV in normotensive subjects were not significant after adjusting for confounding factors. Central augmentation index did not differ according to tHcy level in either normotensive or hypertensive subjects. Results of univariate analysis revealed significant correlations between blood pressure parameters and tHcy concentration only among normotensive subjects; however, these correlations were not significant in a partial correlation analysis. Results of multiple regression analysis showed that plasma tHcy levels were independently correlated with cf-PWV in hypertensive subjects (β = 0.713, P = 0.004). The independent relationship between tHcy and central augmentation index was not significant by further multiple analyses in normotensive or hypertensive individuals. Conclusions Plasma tHcy level is strongly and independently correlated with arterial stiffness measured as cf-PWV only in hypertensive subjects. Thus, hypertension is a major link between tHcy and aortic arterial stiffness.
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Affiliation(s)
- Wenkai Xiao
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Yongyi Bai
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Ping Ye
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
- * E-mail:
| | - Leiming Luo
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Dejun Liu
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Hongmei Wu
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Jie Bai
- Department of Clinical Biochemistry, Chinese PLA General Hospital, Beijing, China
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Dhar P, Sharma VK, Hota KB, Das SK, Hota SK, Srivastava RB, Singh SB. Autonomic cardiovascular responses in acclimatized lowlanders on prolonged stay at high altitude: a longitudinal follow up study. PLoS One 2014; 9:e84274. [PMID: 24404157 PMCID: PMC3880292 DOI: 10.1371/journal.pone.0084274] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 11/13/2013] [Indexed: 11/19/2022] Open
Abstract
Acute exposure to hypobaric hypoxia at high altitude is reported to cause sympathetic dominance that may contribute to the pathophysiology of high altitude illnesses. The effect of prolonged stay at high altitude on autonomic functions, however, remains to be explored. Thus, the present study aimed at investigating the effect of high altitude on autonomic neural control of cardiovascular responses by monitoring heart rate variability (HRV) during chronic hypobaric hypoxia. Baseline electrocardiography (ECG) data was acquired from the volunteers at mean sea level (MSL) (<250 m) in Rajasthan. Following induction of the study population to high altitude (4500–4800 m) in Ladakh region, ECG data was acquired from the volunteers after 6 months (ALL 6) and 18 months of induction (ALL 18). Out of 159 volunteers who underwent complete investigation during acquisition of baseline data, we have only included the data of 104 volunteers who constantly stayed at high altitude for 18 months to complete the final follow up after 18 months. HRV parameters, physiological indices and biochemical changes in serum were investigated. Our results show sympathetic hyperactivation along with compromise in parasympathetic activity in ALL 6 and ALL 18 when compared to baseline data. Reduction of sympathetic activity and increased parasympathetic response was however observed in ALL 18 when compared to ALL 6. Our findings suggest that autonomic response is regulated by two distinct mechanisms in the ALL 6 and ALL 18. While the autonomic alterations in the ALL 6 group could be attributed to increased sympathetic activity resulting from increased plasma catecholamine concentration, the sympathetic activity in ALL 18 group is associated with increased concentration of serum coronary risk factors and elevated homocysteine. These findings have important clinical implications in assessment of susceptibility to cardio-vascular risks in acclimatized lowlanders staying for prolonged duration at high altitude.
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Affiliation(s)
- Priyanka Dhar
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Vijay K. Sharma
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Kalpana B. Hota
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Saroj K. Das
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Sunil K. Hota
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Ravi B. Srivastava
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Shashi B. Singh
- Defence Institute of Physiology and Allied Sciences, Defence Research & Development Organisation, Lucknow Road, Timarpur, Delhi, India
- * E-mail:
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Kim BJ, Seo M, Huh JK, Kwon CH, Kim JT, Sung KC, Kim BS, Kang JH. Associations of Plasma Homocysteine Levels with Arterial Stiffness in Prehypertensive Individuals. Clin Exp Hypertens 2011; 33:411-7. [DOI: 10.3109/10641963.2010.549274] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Yun J, Kim JY, Kim OY, Jang Y, Chae JS, Kwak JH, Lim HH, Park HY, Lee SH, Lee JH. Associations of plasma homocysteine level with brachial-ankle pulse wave velocity, LDL atherogenicity, and inflammation profile in healthy men. Nutr Metab Cardiovasc Dis 2011; 21:136-143. [PMID: 19854035 DOI: 10.1016/j.numecd.2009.08.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 08/09/2009] [Accepted: 08/11/2009] [Indexed: 01/08/2023]
Abstract
AIMS To investigate the association of plasma total homocysteine (tHcy) with arterial stiffness, measured as brachial-ankle pulse wave velocity (baPWV), LDL atherogenicity, and inflammation profile in healthy men. METHODS AND RESULTS In this cross-sectional study, 612 healthy men aged 31-79 years were classified into quartiles according to plasma tHcy concentration. In the total study population, tHcy concentration showed positive correlation with age (r=0.083, P=0.040), interleukin (IL)-1β (r=0.249, P<0.001), TNF-α (r=0.150, P<0.001), IL-6 (r=0.154, P<0.001), oxidized LDL (oxLDL) (r=0.161, P=<0.001), and baPWV (r=0.087, P=0.032); and negative correlation with folate (r=-0.353, P<0.001) and vitamin B(12) (r=-0.269, P<0.001). In subgroup analysis based on plasma tHcy level, tHcy was associated with baPWV in men with high levels of tHcy (≥ 13.1μmol/L, n=153; r=0.258, P=0.001), but not in those with low-tHcy (<13.1 μmol/L, n=459; r=-0.033, P=0.478). The association between tHcy and baPWV in the high-tHcy group remained significant after adjustment for age, BMI, smoking, drinking, folate, and vitamin B₁₂. In the high-tHcy group, tHcy level was also positively correlated with IL-1β, TNF-α, oxLDL, and blood pressure; and negatively correlated with LDL particle size. In addition, baPWV showed negative correlation with LDL particle size and positive correlation with oxLDL in the high-tHcy group. CONCLUSION This study shows an association between high levels of plasma tHcy and more advanced arterial stiffness, smaller LDL particle size, and higher levels of oxLDL and cytokines in men with hyperhomocysteinemia. Enhanced arterial stiffness in hyperhomocysteinemia might be attributed, in part, to Hcy-related LDL atherogenicity.
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Affiliation(s)
- Jisuk Yun
- National Research Laboratory of Clinical Nutrigenetics/Nutrigenomics, Dept. of Food and Nutrition, College of Human Ecology, Yonsei Univ., Seoul, Republic of Korea
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Tyagi N, Vacek TP, Fleming JT, Vacek JC, Tyagi SC. Hyperhomocysteinemia decreases bone blood flow. Vasc Health Risk Manag 2011; 7:31-5. [PMID: 21339911 PMCID: PMC3037087 DOI: 10.2147/vhrm.s15844] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Elevated plasma levels of homocysteine (Hcy), known as hyperhomocysteinemia (HHcy), are associated with osteoporosis. A decrease in bone blood flow is a potential cause of compromised bone mechanical properties. Therefore, we hypothesized that HHcy decreases bone blood flow and biomechanical properties. To test this hypothesis, male Sprague–Dawley rats were treated with Hcy (0.67 g/L) in drinking water for 8 weeks. Age-matched rats served as controls. At the end of the treatment period, the rats were anesthetized. Blood samples were collected from experimental or control rats. Biochemical turnover markers (body weight, Hcy, vitamin B12, and folate) were measured. Systolic blood pressure was measured from the right carotid artery. Tibia blood flow was measured by laser Doppler flow probe. The results indicated that Hcy levels were significantly higher in the Hcy-treated group than in control rats, whereas vitamin B12 levels were lower in the Hcy-treated group compared with control rats. There was no significant difference in folate concentration and blood pressure in Hcy-treated versus control rats. The tibial blood flow index of the control group was significantly higher (0.78 ± 0.09 flow unit) compared with the Hcy-treated group (0.51 ± 0.09). The tibial mass was 1.1 ± 0.1 g in the control group and 0.9 ± 0.1 in the Hcy-treated group. The tibia bone density was unchanged in Hcy-treated rats. These results suggest that Hcy causes a reduction in bone blood flow, which contributes to compromised bone biomechanical properties.
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Affiliation(s)
- Neetu Tyagi
- Department of Physiology and Biophysics, School of Medicine, University of Louisville, KY, USA.
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Chen Y, Huang Y, Li X, Xu M, Bi Y, Zhang Y, Gu W, Ning G. Association of arterial stiffness with HbA1c in 1,000 type 2 diabetic patients with or without hypertension. Endocrine 2009; 36:262-7. [PMID: 19598004 DOI: 10.1007/s12020-009-9221-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2009] [Revised: 05/12/2009] [Accepted: 06/04/2009] [Indexed: 12/29/2022]
Abstract
The objective is to evaluate the association of arterial stiffness [brachial-ankle pulse wave velocity (ba-PWV)] with glycemic control and duration of type 2 diabetes in diabetic subjects with or without hypertension. One thousand Chinese diabetic patients (562 with hypertension, 438 without hypertension) were included in this study. All patients underwent ba-PWV and biochemical measurements. Ba-PWV was significantly higher in diabetic subjects with hypertension than those without hypertension (1779 +/- 341 vs. 1691 +/- 342 cm/s, P < 0.0001), and these subjects were under similar glycemic control (6.9 +/- 1.5 vs. 6.9 +/- 1.3, P = 0.86). In diabetic and hypertensive subjects, ba-PWV was positively associated with HbA1c (1715 +/- 314 vs. 1851 +/- 335 cm/s, in subjects with HbA1c < 6.5% and with HbA1c > 7.0%, respectively, P < 0.0001), as well as duration of diabetes (1671 +/- 342 vs. 1791 +/- 313 vs. 1861 +/- 338 cm/s, in subjects with duration of diabetes <5 years, 5-10 years, and >10 years, respectively, P all < 0.05). In diabetic subjects without hypertension, ba-PWV was not associated with HbA1c (P = 0.47), but associated with duration of diabetes (1503 +/- 272 vs. 1692 +/- 354 cm/s, in subjects with duration of diabetes <5 years and >10 years, respectively, P = 0.0013). Ba-PWV was higher in diabetic subjects with hypertension than in diabetic subjects without hypertension, suggesting the independent effect of hypertension on arterial stiffness in diabetic subjects. Ba-PWV positively correlated with HbA1c and duration of diabetes in subjects with diabetes and hypertension, suggesting the importance of early glycemic control in the prevention of arterial stiffness and vascular complications.
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Affiliation(s)
- Yuhong Chen
- Department of Endocrinology and Metabolism, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Ruijin Hospital Affiliated to Shanghai Jiao-Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, People's Republic of China
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The factors that affect plasma homocysteine levels, pulse wave velocity and their relationship with cardiovascular disease indicators in peritoneal dialysis patients. Int Urol Nephrol 2009; 42:211-8. [DOI: 10.1007/s11255-009-9625-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2009] [Accepted: 07/22/2009] [Indexed: 11/26/2022]
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Hung CS, Lin JW, Hsu CN, Chen HM, Tsai RY, Chien YF, Hwang JJ. Using brachial-ankle pulse wave velocity to associate arterial stiffness with cardiovascular risks. Nutr Metab Cardiovasc Dis 2009; 19:241-246. [PMID: 18815016 DOI: 10.1016/j.numecd.2008.07.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2008] [Revised: 07/12/2008] [Accepted: 07/14/2008] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS This study aimed to elucidate the relationship between brachial-ankle pulse wave velocity (baPWV) and conventional cardiovascular risk factors. METHODS AND RESULTS A total of 192 subjects with low to intermediate risk was enrolled in a cardiovascular evaluation program. A multiple regression model was built to find significant cardiovascular biomarkers for predicting baPWV. A logistic regression model was developed to associate baPWV and other biomarkers with the risk of cardiac diastolic dysfunction. A total of 123 men (mean age: 52.6+/-12.0) and 69 women (mean age: 51.7+/-10.4) was included. Age, blood pressure, C-reactive protein, serum homocysteine, heart rate, and blood urea nitrogen were positively predictive of increased pulse wave velocity. In turn, baPWV increased the risk (odds ratio: 1.257 for each m/s, 95% CI: 1.105 approximately 1.430, p<0.001) and high-density lipoprotein decreased the risk for cardiac diastolic dysfunction (0.962 for each mg/dl, 95% CI: 0.925 approximately 1.000, p=0.05). The correlation between baPWV and Framingham 10-year risk was moderate (men: r=0.306, p=0.002; women r=0.548, p<0.001). CONCLUSION The results suggest that baPWV is a composite risk factor for early atherosclerotic change and a predictor for the development of diastolic dysfunction and long-term cardiovascular risk.
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Affiliation(s)
- C-S Hung
- National Taiwan University Hospital Yun-Lin Branch, Dou-Liou City, Taiwan
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Shargorodsky M, Boaz M, Pasternak S, Hanah R, Matas Z, Fux A, Beigel Y, Mashavi M. Serum homocysteine, folate, vitamin B12 levels and arterial stiffness in diabetic patients: which of them is really important in atherogenesis? Diabetes Metab Res Rev 2009; 25:70-5. [PMID: 19065546 DOI: 10.1002/dmrr.902] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
AIM Hyperhomocystinaemia is associated with macro- and microangiopathic diabetic complications. However, the role of homocysteine (Hcy), serum folate, and vitamin B12 level in the development of premature vascular damage in type 2 diabetic patients is not clear. The present study was designed to assess the relationship between total Hcy, folate, and vitamin B12 levels and arterial stiffness, an early marker of generalized atherosclerosis. METHODS As many as 86 subjects with type 2 diabetes mellitus were studied. All participants were evaluated for glucose, HbA(1C), lipid profile, hs-CRP, endothelin, Hcy, vitamin B12, and folate. Pulse wave velocity (PWV) and augmentation index (AI) were performed as a non-invasive recording and computer analysis of the two artery sites pressure waveform using SphygmoCor (version 7.1, AtCor Medical, Sydney, Australia). RESULTS Hcy was significantly positively associated with age, serum creatinine, and vitamin B12 levels. No association between Hcy and folate was observed. The Hcy concentration was significantly positively associated with PWV (r = 0.540, p < 0.0001) and AI (r = 0.390, p < 0.0001). In a general linear model of PWV, Hcy emerged as an independent predictor of PWV even after controlling for age, creatinine, vitamin B12, and folate levels. In a multiple linear regression analysis, the association between Hcy and arterial stiffness was independent of traditional cardiovascular risk factors. Vitamin B12 levels were significantly inversely associated with tHcy (r = - 0.263, p = 0.015) and marginally associated with PWV(r = - 0.212, p = 0.052). Significant associations between folate levels and PWV were not detected. CONCLUSIONS The results lend support to the hypothesis that elevated Hcy may have a key role in the development of atherogenesis in diabetic patients. Additionally, vitamin B12 is significantly associated with tHcy concentrations and is identified as a marginally independent correlate of PWV in diabetic patients in the absence of folate deficiency.
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Affiliation(s)
- M Shargorodsky
- Department of Endocrinology, Wolfson Medical Center, Tel Aviv, Israel.
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Lieb W, Larson MG, Benjamin EJ, Yin X, Tofler GH, Selhub J, Jacques PF, Wang TJ, Vita JA, Levy D, Vasan RS, Mitchell GF. Multimarker approach to evaluate correlates of vascular stiffness: the Framingham Heart Study. Circulation 2008; 119:37-43. [PMID: 19103986 DOI: 10.1161/circulationaha.108.816108] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Arterial stiffness increases with age and contributes to the pathogenesis of systolic hypertension and cardiovascular disease in the elderly. Knowledge about the pathophysiological processes that determine arterial stiffness may help guide therapeutic approaches. METHODS AND RESULTS We related 7 circulating biomarkers representing distinct biological pathways (C-reactive protein, aldosterone-to-renin ratio, N-terminal proatrial natriuretic peptide and B-type natriuretic peptide, plasminogen activator inhibitor-1, fibrinogen, and homocysteine) to 5 vascular function measures (central pulse pressure, carotid-femoral pulse-wave velocity, mean arterial pressure, forward pressure wave amplitude [all measures of conduit artery stiffness], and augmented pressure, an indicator of wave reflection) in 2000 Framingham Offspring Study participants (mean age, 61 years; 55% women). Tonometry measures were obtained on average 3 years after the biomarkers were measured. In multivariable linear regression models adjusting for covariates, the biomarker panel was significantly associated with all 5 vascular measures (P<0.003 for all). On backward elimination, the aldosterone-to-renin ratio was positively associated with each stiffness measure (P< or =0.002 for all). In addition, C-reactive protein was positively related to augmented pressure (P=0.0003), whereas plasminogen activator inhibitor-1 was positively associated with mean arterial pressure (P=0.003), central pulse pressure (P=0.001), and forward pressure wave (P=0.01). CONCLUSIONS Our cross-sectional data on a community-based sample suggest a distinctive pattern of positive associations of biomarkers of renin-angiotensin-aldosterone system activation with pan-arterial vascular stiffness, plasminogen activator inhibitor-1 with central vascular stiffness indices, and C-reactive protein with wave reflection. These observations support the notion of differential influences of biological pathways on vascular stiffness measures.
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Mashavi M, Hanah R, Boaz M, Gavish D, Matas Z, Fux A, Shargorodsky M. Effect of homocysteine-lowering therapy on arterial elasticity and metabolic parameters in metformin-treated diabetic patients. Atherosclerosis 2008; 199:362-7. [DOI: 10.1016/j.atherosclerosis.2007.11.037] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2007] [Revised: 10/25/2007] [Accepted: 11/28/2007] [Indexed: 10/22/2022]
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Homocysteinemia, hypertension, and family history of diabetes in a smoking male population in Saudi Arabia. Open Med (Wars) 2008. [DOI: 10.2478/s11536-008-0019-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractArabs have a lower incidence of atherosclerosis than other ethnicities, but few studies have examined homocysteine (HCYS) as a risk factor for cardiovascular disease in this population. Here, we investigated the association between serum HYCS levels and risk factors for cardiovascular disease (smoking, hypertension, and family history of diabetes) in Saudi males. A total of 50 smokers and 72 nonsmokers completed a general health questionnaire. In addition, their lipid profiles were measured using routine methods and HCYS levels by high-performance liquid chromatograph with electrochemical detection. Regression analysis showed negative associations between HCYS and glucose (r = −0.22; P < 0.05) as well as family history of diabetes (r = −0.21; P < 0.05). HCYS levels were similar between hypertensive and nonhypertensive smokers, but they were significantly elevated in hypertensive nonsmokers (P = 0.027) and lower in smokers with family history of diabetes (P = 0.01). Levels of HCYS among nonsmokers inversely correlated with history of diabetes and elevated glucose. Nonsmokers’ HCYS levels were significantly elevated in the presence of hypertension and correlated with diastolic blood pressure. Thus, HCYS may be a predictor of hypertension among nonsmokers. Until further trials are conducted, we recommend vitamin B6/folic acid supplementation for the Saudi hypertensive population as an adjuvant therapy.
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Nichols WW, Denardo SJ, Wilkinson IB, McEniery CM, Cockcroft J, O'Rourke MF. Effects of Arterial Stiffness, Pulse Wave Velocity, and Wave Reflections on the Central Aortic Pressure Waveform. J Clin Hypertens (Greenwich) 2008; 10:295-303. [DOI: 10.1111/j.1751-7176.2008.04746.x] [Citation(s) in RCA: 121] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
PURPOSE OF REVIEW The present article reviews the importance of classical and novel risk factors that present in childhood, track into adult life and contribute to arterial disease. The value of noninvasive techniques that can assist in characterization of preclinical atherosclerotic changes as intermediate phenotypes is also discussed. RECENT FINDINGS Noninvasive functional and structural techniques are now available and provide the opportunity to characterize early arterial disease long before cardiovascular complications present. By using these techniques, it has been possible to quantify the impact of conventional and novel cardiovascular risk factors seen in childhood on the development of preclinical atherosclerotic changes. Scientific interest has recently widened to include not only study of mechanisms and biomarkers of injury but also mechanisms that promote vascular repair. In this new field, characterization of endothelial progenitor cells has presented new opportunities for cardiovascular research. SUMMARY Atherosclerosis begins in early life. Primary prevention strategies for adult cardiovascular disease beginning in childhood have great potential as the disease process is most reversible at this stage. Several guidelines have recently been published for screening and implementation of appropriate therapeutic choices in early life.
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Affiliation(s)
- Marietta Charakida
- Cardiac Unit, Institute of Child Health, University College London, 30 Guilford Street, London, UK
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Ni M, Zhang XH, Jiang SL, Zhang Y. Homocysteinemia as an independent risk factor in the Chinese population at a high risk of coronary artery disease. Am J Cardiol 2007; 100:455-8. [PMID: 17659928 DOI: 10.1016/j.amjcard.2007.03.046] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2007] [Revised: 03/06/2007] [Accepted: 03/06/2007] [Indexed: 10/23/2022]
Abstract
In this study, we examined whether homocystinemia acted as an independent and important risk factor in the Chinese population at a high risk of coronary artery disease (CAD). The study population included 237 consecutive patients undergoing coronary angiography and was divided into 2 groups. Group A consisted of 138 patients with CAD and group B of 99 patients with normal coronary angiogram. Prevalence of conventional risk factors of CAD including aging, male gender, family history of CAD, smoking, hypertension, dyslipidemia, diabetes, obesity, and increased high-sensitivity C-reactive protein (hs-CRP) was derived and fasting plasma homocysteine was measured. Results showed that level of plasma fasting homocysteine in group A was significantly higher compared with that in group B and homocystinemia was more prevalent in group A than in group B (p <0.001 for the 2 comparisons). Levels of systolic and diastolic blood pressures, fasting serum glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and hs-CRP were higher, whereas level of high-density lipoprotein cholesterol was lower (all p value <0.05) in group A than in group B. Using a multivariate logistic regression model, we identified smoking, hs-CRP, total cholesterol, plasma homocysteine, systolic blood pressure, and high-density lipoprotein cholesterol as independent risk or protective factors of CAD with odds ratios of 3.83, 3.15, 2.51, 2.14, 1.08, and 0.02, respectively. In conclusion, a high homocysteine level is an independent and important risk factor of CAD and the relative risk of CAD conferred by homocystinemia is similar to that of dyslipidemia in the Chinese population at high risk of CAD.
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Affiliation(s)
- Mei Ni
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital, Jinan, Shandong, China
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Franco MCP, Higa EMS, D'Almeida V, de Sousa FG, Sawaya AL, Fortes ZB, Sesso R. Homocysteine and Nitric Oxide Are Related to Blood Pressure and Vascular Function in Small-for-Gestational-Age Children. Hypertension 2007; 50:396-402. [PMID: 17576855 DOI: 10.1161/hypertensionaha.107.091223] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Leptin, homocysteine (Hcy), and C-reactive protein are risk factors potentially useful in predicting future cardiac events. These plasma biomarkers may participate in the regulation of cardiovascular function through an NO-dependent mechanism. Our purpose was to investigate whether alterations in C-reactive protein, Hcy, leptin, and NO are present in small-for-gestational-age children and to determine whether the levels of these plasma biomarkers are associated with birth weight, vascular function, and blood pressure. Concentrations of leptin, Hcy, C-reactive protein, and NO were measured in 69 children (36 boys and 33 girls; ages 8 to 13 years). Leptin (means difference: 1.4 ng/mL; 95% CI: 0.4 to 2.4) and Hcy (means difference: 0.9 μmol/L; 95% CI: 0.3 to 1.5) levels were significantly elevated in children born small for gestational age compared with those with appropriate birth weight. Nevertheless, NO (means difference: 342.9 μmol; 95% CI: 124.2 to 561.6) concentration was significantly reduced in small birth weight children, and the levels of C-reactive protein remained unchanged. There was a significant association between the circulating levels of both NO and Hcy with vascular function, as well as with blood pressure levels, in our population. Because both Hcy and NO are associated with a risk of cardiovascular disease, it is possible that part of the association of low birth weight with elevated risk for vascular and metabolic disease in later life is mediated by perturbation in pathways for these biomarkers.
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Affiliation(s)
- Maria C P Franco
- Division of Nephrology, School of Medicine, Federal University of São Paulo, São Paulo, Brazil.
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Liu XN, Gao HQ, Li BY, Cheng M, Ma YB, Zhang ZM, Gao XM, Liu YP, Wang M. Pulse wave velocity as a marker of arteriosclerosis and its comorbidities in Chinese patients. Hypertens Res 2007; 30:237-42. [PMID: 17510505 DOI: 10.1291/hypres.30.237] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To obtain reliable data on the epidemiology of arteriosclerosis and the comorbidities in patients with hypertension (HP), coronary heart disease (CHD), type 2 diabetes mellitus (T2DM) and stroke, we evaluated the clinical significance of pulse wave velocity (PWV) as an indicator of arteriosclerosis and its comorbidities in Chinese patients. A total of 910 subjects, including 748 Chinese patients with one or more cardiovascular risk factors (80.2% male, mean age 73.69+/-5.03 years) and 162 healthy volunteers (78.4% male, mean age 73.60+/-5.32 years) were recruited into the study. PWV was measured in 910 subjects, and large artery arteriosclerosis was defined as PWV >or=12 m/s. Multivariable logistic regression analyses were performed to identify risk factors associated with arteriosclerosis. The prevalence of large artery arteriosclerosis in the patients overall was 67.4%, and the prevalence was higher in patients with than in those without HP (63.3% vs. 34.0%; odds ratio [OR]: 3.451), T2DM (24.8% vs. 11.1%; OR: 2.854), CHD (56.1% vs. 45.1%; OR: 1.246) and stroke (26.6% vs. 19.2%; OR: 1.236), but the OR values of CHD and stroke did not differ significantly (p>0.05). After multiple logistic regression analysis, female sex, older age, HP and T2DM were risk factors for large artery arteriosclerosis. In conclusion, PWV can be used as a routine measurement to scan arteriosclerosis in patients with HP or T2DM.
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Affiliation(s)
- Xiao-Ning Liu
- Department of Geriatrics, Qi-Lu Hospital of Shandong University, Jinan, PR China
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PODOLEC P, KOPEC G, PODOLEC J, WILKOLEK P, KROCHIN M, RUBIS P, CWYNAR M, GRODZICKI T, ZMUDKA K, TRACZ W. Aortic Pulse Wave Velocity and Carotid-Femoral Pulse Wave Velocity: Similarities and Discrepancies. Hypertens Res 2007; 30:1151-8. [DOI: 10.1291/hypres.30.1151] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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EGUCHI K, TOMIZAWA H, ISHIKAWA J, HOSHIDE S, PICKERING TG, SHIMADA K, KARIO K. Factors Associated with Baroreflex Sensitivity: Association with Morning Blood Pressure. Hypertens Res 2007; 30:723-8. [DOI: 10.1291/hypres.30.723] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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