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Arroum T, Hish GA, Burghardt KJ, McCully JD, Hüttemann M, Malek MH. Mitochondrial Transplantation's Role in Rodent Skeletal Muscle Bioenergetics: Recharging the Engine of Aging. Biomolecules 2024; 14:493. [PMID: 38672509 PMCID: PMC11048484 DOI: 10.3390/biom14040493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/10/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Mitochondria are the 'powerhouses of cells' and progressive mitochondrial dysfunction is a hallmark of aging in skeletal muscle. Although different forms of exercise modality appear to be beneficial to attenuate aging-induced mitochondrial dysfunction, it presupposes that the individual has a requisite level of mobility. Moreover, non-exercise alternatives (i.e., nutraceuticals or pharmacological agents) to improve skeletal muscle bioenergetics require time to be effective in the target tissue and have another limitation in that they act systemically and not locally where needed. Mitochondrial transplantation represents a novel directed therapy designed to enhance energy production of tissues impacted by defective mitochondria. To date, no studies have used mitochondrial transplantation as an intervention to attenuate aging-induced skeletal muscle mitochondrial dysfunction. The purpose of this investigation, therefore, was to determine whether mitochondrial transplantation can enhance skeletal muscle bioenergetics in an aging rodent model. We hypothesized that mitochondrial transplantation would result in sustained skeletal muscle bioenergetics leading to improved functional capacity. METHODS Fifteen female mice (24 months old) were randomized into two groups (placebo or mitochondrial transplantation). Isolated mitochondria from a donor mouse of the same sex and age were transplanted into the hindlimb muscles of recipient mice (quadriceps femoris, tibialis anterior, and gastrocnemius complex). RESULTS The results indicated significant increases (ranging between ~36% and ~65%) in basal cytochrome c oxidase and citrate synthase activity as well as ATP levels in mice receiving mitochondrial transplantation relative to the placebo. Moreover, there were significant increases (approx. two-fold) in protein expression of mitochondrial markers in both glycolytic and oxidative muscles. These enhancements in the muscle translated to significant improvements in exercise tolerance. CONCLUSIONS This study provides initial evidence showing how mitochondrial transplantation can promote skeletal muscle bioenergetics in an aging rodent model.
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Affiliation(s)
- Tasnim Arroum
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI 48201, USA; (T.A.); (M.H.)
| | - Gerald A. Hish
- Unit for Laboratory Animal Medicine (ULAM), University of Michigan, Ann Arbor, MI 48109, USA
| | - Kyle J. Burghardt
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
| | - James D. McCully
- Department of Cardiac Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Maik Hüttemann
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI 48201, USA; (T.A.); (M.H.)
| | - Moh H. Malek
- Physical Therapy Program, Department of Health Care Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
- Integrative Physiology of Exercise Laboratory, Department of Health Care Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
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Kim J, Sohn A. Living arrangements and metabolic syndrome: a national cross-sectional study in the Republic of Korea. Osong Public Health Res Perspect 2024; 15:77-82. [PMID: 37968743 PMCID: PMC10982653 DOI: 10.24171/j.phrp.2023.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND This study investigated the relationship between living arrangements and metabolic syndrome (MetS) risk in the adult population in the Republic of Korea. METHODS The samples were derived from the data collected during the second year of the seventh Korea National Health and Nutrition Examination Survey. The study targeted a total of 6,265 adults who were aged 20 years and above, and multiple logistic regression analysis was conducted. Living arrangements were classified into 4 categories: single-person households, 1-generation households, 2-generation households, and other family types. MetS was identified by the presence of at least 3 out of the 5 National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS For men, the odds ratio (ORs) for MetS in 1- and 2-generation households, compared to single-person households, were 0.92 (95% confidence interval [CI], 0.55-1.54) and 0.97 (95% CI, 0.58-1.62), respectively. The OR for other types of households was 0.96 (95% CI, 0.79-1.17). For women, the OR for MetS in 1- and 2-generation households, compared to single-person households, were 1.52 (95% CI, 1.15-2.01) and 1.29 (95% CI, 1.01-1.67), respectively. CONCLUSION Our study suggests that a national strategy involving tailored interventions for women living in high-risk conditions is necessary to reduce the risk of MetS in Korean women.
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Affiliation(s)
- Junghyun Kim
- Department of Clinical Laboratory Science, Kyungbok University, Namyangju, Republic of Korea
| | - Aeree Sohn
- Department of Public Health, Sahmyook University, Seoul, Republic of Korea
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Lonardo A. The heterogeneity of metabolic syndrome presentation and challenges this causes in its pharmacological management: a narrative review focusing on principal risk modifiers. Expert Rev Clin Pharmacol 2023; 16:891-911. [PMID: 37722710 DOI: 10.1080/17512433.2023.2259306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 09/12/2023] [Indexed: 09/20/2023]
Abstract
INTRODUCTION Metabolic syndrome (MetS), i.e. the cluster of cardiometabolic risk factors comprising visceral obesity, impaired glucose metabolism, arterial hypertension and atherogenic dyslipidemia, is prevalent globally and exacts a heavy toll on health care expenditures. AREAS COVERED The pathophenotypes of individual traits of the MetS in adults are discussed first, with strong emphasis on nonalcoholic fatty liver disease (NAFLD) and sex differences. Next, I discuss recent studies on phenotypic and outcome heterogeneity of the MetS, highlighting the role of NAFLD, sex, reproductive status, and depressive disorders. In the second half of the article, the therapeutic implications of the variable MetS types and features are analyzed, focusing on the most recent developments, and guidelines. EXPERT OPINION I have identified physiological, pathological, social and medical sources of phenotypical heterogeneity in the MetS and its constitutive traits. Improved understanding of these variables may be utilized in the setting of future precision medicine approaches in the field of metabolic disorders and target organ damage.
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Affiliation(s)
- Amedeo Lonardo
- Operating Unit of Metabolic Syndrome, Azienda Ospedaliero-Unversitaria di Modena, Ospedale Civile di Baggiovara, Baggiovara, Modena, Italy
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Boisvenue JJ, Oliva CU, Manca DP, Johnson JA, Yeung RO. Identifying Sex-Specific Differences in Young-Onset Metabolic Syndrome Using Primary Care Electronic Medical Record. Metab Syndr Relat Disord 2023; 21:133-140. [PMID: 37098189 DOI: 10.1089/met.2022.0065] [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: 04/27/2023] Open
Abstract
Objectives: To apply a case definition to a Northern Alberta-based primary care practice population and to assess the sex-specific characteristics of young-onset metabolic syndrome (MetS). Design: We carried out a cross-sectional study to identify and estimate the prevalence of MetS using electronic medical record (EMR) data and perform descriptive comparative analyses of demographic and clinical characteristics between males and females. Setting: Northern Alberta Primary Care Research Network (NAPCReN) consists of EMR patient data from 77 physicians among 18 clinics. Participants: Patients with one or more clinic visit between 2015 and 2018, between 18 and 40 years old, residing in Northern Alberta. Main Outcome Measures: Comparison of prevalence in MetS between sexes as well as sex-specific distribution of MetS characteristics [body mass index (BMI), fasting blood glucose, glycated hemoglobin, triglycerides, and high-density lipoprotein cholesterol (HDL-C), presence of hypertension, and presence of diabetes]. Results: Of 15,766 patients, 4.4% (n = 700) had young-onset MetS based on recorded data, prevalence was nearly twice as high in males (6.1%, n = 354) compared with females (3.5%, n = 346). The most prevalent risk factor for MetS consisted of having an elevated BMI for both females (90.9%) and males (91.5%). In the presence of MetS, more females had lower HDL-C [68.2% females (F) vs. 52.5% males (M)], and higher prevalence of diabetes (21.4% F vs. 9.0% M), whereas more males had hypertriglyceridemia (60.4% F vs. 79.7% M) and hypertension (12.4% F vs. 15.8% M). Females also had consistently higher percentages of absent laboratory data compared with males when identified as having MetS and BMI ≥25 kg/m2. Conclusions: Males have nearly twice the prevalence of young-onset MetS compared with females, with notable sex-specific differences in the manifestation of MetS, although we suspect that this is partially due to underreporting where the absence of anthropomorphic and laboratory investigations point to a lack of testing. Sex-specific screening for MetS, especially among young females of childbearing years, is important for downstream prevention.
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Affiliation(s)
- Jamie J Boisvenue
- School of Public Health, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
- Alberta Diabetes Institute, Edmonton, Alberta, Canada
| | - Carlo U Oliva
- Department of Computer Science, College of Natural & Applied Sciences, Faculty of Science, University of Alberta, Edmonton, Alberta, Canada
| | - Donna P Manca
- Department of Family Medicine, College of Health Sciences, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Northern Alberta Primary Care Research Network, Edmonton, Alberta, Canada
- Alberta Physician Learning Program, University of Alberta, Edmonton, Alberta, Canada
| | - Jeffery A Johnson
- School of Public Health, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
- Alberta Diabetes Institute, Edmonton, Alberta, Canada
| | - Roseanne O Yeung
- School of Public Health, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
- Alberta Diabetes Institute, Edmonton, Alberta, Canada
- Alberta Physician Learning Program, University of Alberta, Edmonton, Alberta, Canada
- Division of Endocrinology & Metabolism, Department of Medicine, College of Health Sciences, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Yamaga Y, Svensson T, Chung UI, Svensson AK. Association between Metabolic Syndrome Status and Daily Physical Activity Measured by a Wearable Device in Japanese Office Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4315. [PMID: 36901325 PMCID: PMC10001536 DOI: 10.3390/ijerph20054315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/21/2023] [Accepted: 02/25/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: This study examined the cross-sectional association between metabolic syndrome (MetS) status classified into three groups and daily physical activity (PA; step count and active minutes) using a wearable device in Japanese office workers. (2) Methods: This secondary analysis used data from 179 participants in the intervention group of a randomized controlled trial for 3 months. Individuals who had received an annual health check-up and had MetS or were at a high risk of MetS based on Japanese guidelines were asked to use a wearable device and answer questionnaires regarding their daily life for the entire study period. Multilevel mixed-effects logistic regression models adjusted for covariates associated with MetS and PA were used to estimate associations. A sensitivity analysis investigated the associations between MetS status and PA level according to the day of the week. (3) Results: Compared to those with no MetS, those with MetS were not significantly associated with PA, while those with pre-MetS were inversely associated with PA [step count Model 3: OR = 0.60; 95% CI: 0.36, 0.99; active minutes Model 3: OR = 0.62; 95% CI: 0.40, 0.96]. In the sensitivity analysis, day of the week was an effect modifier for both PA (p < 0.001). (4) Conclusions: Compared to those with no MetS, those with pre-MetS, but not MetS, showed significantly lower odds of reaching their daily recommended PA level. Our findings suggest that the day of the week could be a modifier for the association between MetS and PA. Further research with longer study periods and larger sample sizes are needed to confirm our results.
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Affiliation(s)
- Yukako Yamaga
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo 113-8656, Japan
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki 210-0821, Japan
| | - Thomas Svensson
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo 113-8656, Japan
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki 210-0821, Japan
- Department of Clinical Sciences, Lund University, Skåne University Hospital, CRC, Jan Waldenströms Gata 35, 205 02 Malmö, Sweden
| | - Ung-il Chung
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo 113-8656, Japan
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki 210-0821, Japan
- Clinical Biotechnology, Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8656, Japan
| | - Akiko Kishi Svensson
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo 113-8656, Japan
- Department of Clinical Sciences, Lund University, Skåne University Hospital, CRC, Jan Waldenströms Gata 35, 205 02 Malmö, Sweden
- Department of Diabetes and Metabolic Diseases, The University of Tokyo, Tokyo 113-0033, Japan
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Dietary Responses of Dementia-Related Genes Encoding Metabolic Enzymes. Nutrients 2023; 15:nu15030644. [PMID: 36771351 PMCID: PMC9921944 DOI: 10.3390/nu15030644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/19/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
The age-related loss of the cognitive function is a growing concern for global populations. Many factors that determine cognitive resilience or dementia also have metabolic functions. However, this duality is not universally appreciated when the action of that factor occurs in tissues external to the brain. Thus, we examined a set of genes involved in dementia, i.e., those related to vascular dementia, Alzheimer's disease, Parkinson's disease, and the human metabolism for activity in 12 metabolically active tissues. Mining the Genotype-Tissue Expression (GTEx) data showed that most of these metabolism-dementia (MD) genes (62 of 93, 67%) exhibit a higher median expression in any of the metabolically active tissues than in the brain. After identifying that several MD genes served as blood-based biomarkers of longevity in other studies, we examined the impact of the intake of food, nutrients, and other dietary factors on the expression of MD genes in whole blood in the Framingham Offspring Study (n = 2134). We observed positive correlations between flavonoids and HMOX1, taurine and UQCRC1, broccoli and SLC10A2, and myricetin and SLC9A8 (p < 2.09 × 10-4). In contrast, dairy protein, palmitic acid, and pie were negatively correlated, respectively, with the expression of IGF1R, CSF1R, and SLC9A8, among others (p < 2.92 × 10-4). The results of this investigation underscore the potential contributions of metabolic enzyme activity in non-brain tissues to the risk of dementia. Specific epidemiological or intervention studies could be designed using specific foods and nutrients or even dietary patterns focused on these foods and nutrients that influence the expression of some MD genes to verify the findings presented here.
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Cao Y, Zhu L, Liu J. Effects of aerobic exercise on obese children with metabolic syndrome: a systematic review and meta-analysis. J Pediatr Endocrinol Metab 2021; 34:1069-1079. [PMID: 34293838 DOI: 10.1515/jpem-2021-0295] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/24/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Metabolic syndrome (MetS) is systemic metabolic disease that results from insulin resistance or obesity. Numerous meta-analyses have investigated the effect of exercise on different populations, but none were aimed at the effect of aerobic exercise alone on obese children. This review systematically assessed and performed a meta-analysis on the effect of aerobic exercise on obese children with MetS. CONTENT MEDLINE via PubMed, Embase, SPORTDiscus, and the Cochrane library were searched and screened from inception to 20 October 2020 for randomized controlled trials. The inclusion criteria were obese children who met the criteria for MetS and aged 5-19 years old in an aerobic exercise group. The meta-analysis included eight trials with a total of 197 participants. Aerobic exercise significantly improved the waist circumference (mean difference [MD]=-3.97; 95% confidence interval [CI]=-6.12 to -1.83; p<0.01), body mass index (standardized MD [SMD]=-0.5; 95% CI=-0.70 to -0.29; p<0.01), triglyceride (SMD=-24.6; 95% CI=-33.85 to -15.35; p<0.01), high-density lipoprotein cholesterol (SMD=2.36; 95% CI=0.44 to 4.27; p<0.01), and systolic blood pressure (SMD=-6.90; 95% CI=-10.46 to -3.35; p<0.01). SUMMARY Based on the results of this meta-analysis, during the intervention period of the included studies, aerobic exercise alone mainly affected the lipoprotein, blood pressure, and body dimensions but cannot completely cure the MetS of obese children. OUTLOOK The effects of different types of aerobic exercise on obese children with MetS and exercise dose to cure the MetS of obese children needs to be further studied.
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Affiliation(s)
- Youxiang Cao
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Lin Zhu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China.,Research Center for Physical Fitness and Health Promotion of Adolescent, Guangzhou Sport University, Guangzhou, China
| | - Jingxin Liu
- Research Center for Physical Fitness and Health Promotion of Adolescent, Guangzhou Sport University, Guangzhou, China
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Cho AR, Kwon YJ, Kim JK. Pre-Metabolic Syndrome and Incidence of Type 2 Diabetes and Hypertension: From the Korean Genome and Epidemiology Study. J Pers Med 2021; 11:jpm11080700. [PMID: 34442344 PMCID: PMC8398139 DOI: 10.3390/jpm11080700] [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] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 12/29/2022] Open
Abstract
The aim of this study was to investigate the prevalence of premetabolic syndrome (pre-MetSyn) and its components and to longitudinally examine their association with new-onset type 2 diabetes (T2D) or hypertension. A total of 4037 men and 4400 women aged 40 to 69 years were selected from the Korean Genome and Epidemiology Study, observed from 2001 to 2014. Pre-MetSyn was defined as the presence of one or two components of MetSyn (B, elevated blood pressure; G, elevated glucose; H, low HDL-cholesterol; T, elevated triglycerides; W, increased waist circumference). The prevalence of pre-MetSyn was higher than that of non-MetSyn and MetSyn in both men and women. In multivariate Cox regression analyses, G, T, G+T, W+G, B+G, B+T, W+T, B+H, and H+T in men and G, T, G+H, B+T, and H+T in women were significantly associated with new-onset T2D. B, W, B+H, B+T, W+H, and W+T in men and B, B+T, B+H, B+W, and W+H in women were significantly associated with new-onset hypertension. The prevalence of pre-MetSyn components and their associations with new-onset T2D or hypertension differed according to sex and disease. Our results suggest that specific phenotypes of pre-MetSyn may be important factors for predicting and preventing the development of T2D and hypertension.
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Affiliation(s)
- A-Ra Cho
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si 16995, Korea;
| | - Yu-Jin Kwon
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si 16995, Korea;
- Correspondence: (Y.-J.K.); (J.-K.K.)
| | - Jong-Koo Kim
- Department of Family Medicine, Wonju College of Medicine, Yonsei University, Won-Ju 26426, Korea
- Correspondence: (Y.-J.K.); (J.-K.K.)
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Hadaegh F, Asgari S, Moosaie F, Orangi M, Sarvghadi F, Khalili D, Azizi F. The risk and added values of the atherosclerotic cardiovascular risk enhancers on prediction of cardiovascular events: Tehran lipid and glucose study. J Transl Med 2021; 19:25. [PMID: 33407576 PMCID: PMC7789723 DOI: 10.1186/s12967-020-02686-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 12/21/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND In 2013 American College of Cardiology and the American Heart Association released a guideline on the management of atherosclerotic cardiovascular disease (ASCVD) including a composite of death from CVD, non-fatal myocardial infarction, or non-fatal stroke (hard CVD). This guideline recommended a risk score that was calculated using pooled cohort equations (ASCVD-PCE). The guideline was updated in 2018/2019 and further risk discussion was suggested for deciding whether to continue or initiate statin therapy among non-diabetic individuals with ASCVD-PCE score ranged 5-20%. They recommended a risk discussion with considering risk enhancing factors (ASCVD-REFs) including family history of premature CVD, chronic kidney disease, triglycerides ≥ 175 mg/dl, low-density lipoprotein cholesterol (LDL-C) ≥ 160 mg/dl, metabolic syndrome (Mets), and for women premature menopause, and hypertensive disorders of pregnancy (HDP). In the current study, we aimed to examine the predictability of recommended ASCVD-REFs on incident hard CVD in non-diabetic individuals with LDL-C 70-189 mg/dl, with ASCVD-PCE risk 5-20% during 10 and 15-year follow-up. METHODS Among a total of 3546 non-diabetic individuals aged 40-75 years, after excluding those with ASCVD-PCE score < 5% and ≥ 20% (n = 2342), 1204 individuals (women = 332) were included. The univariable and multivariable (further adjusted for ASCVD-PCE) Cox regression analysis were used to evaluate the association of each potential ASCVD-REFs with hard CVD. Additionnaly, the role of different components of Mets and a history of gestational diabetes (GDM)/macrosomia was also examined. The predictive ability of each significant ASCVD-REFs, then was evaluated by the discrimination accuracy and risk reclassification index. RESULTS During the 10-year follow-up, 73 hard CVD events occurred. Although in univariable analysis, high blood pressure (BP) component of Mets, GDM/macrosomia, and HDP remained as significant ASCVD-REFs, in the multivariable analysis, only the history of HDP (5.35 (1.22-23.38)) and GDM/macrosomia (3.18 (1.05-9.65)) showed independent risks. During the 15-year follow-up, Mets (1.47 (1.05-2.06)) and its components of high waist circumference (1.40 (1.0-1.95)) and high BP (1.52 (1.07-2.15)) significantly increased the risk. These ASCVD-REFs did not improve discrimination or predictive ability. CONCLUSIONS In a decade follow-up, only conditions specific for women and in longer follow-up, the presence of Mets perse, and its components of high WC and high BP were shown as significant ASCVD-REFs.
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Affiliation(s)
- Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
| | - Samaneh Asgari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | | | - Meysam Orangi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Farzaneh Sarvghadi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
- Department of Biostatistics and Epidemiology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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van Mark G, Tittel SR, Sziegoleit S, Putz FJ, Durmaz M, Bortscheller M, Buschmann I, Seufert J, Holl RW, Bramlage P. Type 2 diabetes in older patients: an analysis of the DPV and DIVE databases. Ther Adv Endocrinol Metab 2020; 11:2042018820958296. [PMID: 33014328 PMCID: PMC7509713 DOI: 10.1177/2042018820958296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/20/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The clinical profile differs between old and young patients with type 2 diabetes mellitus (T2DM). We explored, based on a large real-world database, patient and disease characteristics and actual treatment patterns by age. METHODS The analysis was based on the DIVE and DPV registries of patients with T2DM. Patients were analyzed by age groups 50-59 (middle-young), 60-69 (young-old), 70-79 (middle-old), 80-89 (old), and 90 years or more (oldest-old). RESULTS A total of 396,719 patients were analyzed, of which 17.7% were 50-59 years, 27.7% 60-69 years, 34.3% 70-79 years, 18.3% 80-89 years and 2.0% at least 90 years. We found that (a) T2DM in old and oldest-old patients was characterized much less by the presence of metabolic risk factors such as hypertension, obesity, dyslipidemia and smoking than in younger patients; (b) the HbA1c was much lower in oldest-old than in middle-young patients (7.2 ± 1.6% versus 8.0 ± 2.2%; p < 0.001), but it was associated with higher proportions of patients with severe hypoglycemia (7.0 versus 1.6%; p < 0.001); (c) this was potentially associated with the higher and increasing rates of insulin use in older patients (from 17.6% to 37.6%, p < 0.001) and the particular comorbidity profile of these patients, for example, chronic kidney disease (CKD); (d) patients with late diabetes onset had lower HbA1c values, lower bodyweight and less cardiovascular risk factors; (e) patients with a longer diabetes duration had a considerable increase in macrovascular and even more microvascular complications. CONCLUSION In very old patients there is a need for frequent careful routine assessment and a tailored pharmacotherapy in which patient safety is much more important than blood-glucose-lowering efficacy.
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Affiliation(s)
- Gesine van Mark
- Institut für Pharmakologie und Präventive Medizin, Cloppenburg, Germany
| | - Sascha R. Tittel
- Institut für Epidemiologie und medizinische Biometrie, ZIBMT; Universität Ulm, Ulm, Germany
- Deutsches Zentrum für Diabetesforschung e.V., München-Neuherberg, Germany
| | | | | | - Mesut Durmaz
- Praxis für Innere Medizin, Endokrinologie & Diabetologie, Hof, Germany
| | | | - Ivo Buschmann
- Department of Angiology, Medical School Brandenburg (MHB) & Deutsches Angiologie Zentrum Brandenburg Berlin (DAZB), Brandenburg, Germany
| | - Jochen Seufert
- Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Germany
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