Risk Factors Analysis and Management of Cardiometabolic-Based Chronic Disease in Low- and Middle-Income Countries

Secreted frizzled-related protein 5: A promising therapeutic target for metabolic diseases via regulation of Wnt signaling

Metabolic diseases pose a significant global health challenge, characterized by an imbalance in metabolism and resulting in various complications. Secreted frizzled-related protein 5 (SFRP5), an adipokine known for its anti-inflammatory properties, has gained attention as a promising therapeutic target for metabolic diseases. SFRP5 acts as a key regulator in the Wnt signaling pathway, exerting its influence on critical cellular functions including proliferation, differentiation, and migration. Its significance extends to the realm of adipose tissue biology, where it plays a central role in regulating inflammation, insulin resistance, adipogenesis, lipid metabolism, glucose homeostasis, and energy balance. By inhibiting Wnt signaling, SFRP5 facilitates adipocyte growth, promotes lipid accumulation, and contributes to a decrease in oxidative metabolism. Lifestyle interventions and pharmacological treatments have shown promise in increasing SFRP5 levels and protecting against metabolic abnormalities. SFRP5 is a pivotal player in metabolic diseases and presents itself as a promising therapeutic target. An overview of SFRP5 and its involvement in metabolic disorders and metabolism is provided in this comprehensive review. By elucidating these aspects, valuable insights can be gained to foster the development of effective strategies in combating metabolic diseases.

Development and external validation of a diagnostic model for cardiometabolic-based chronic disease : results from the China health and retirement longitudinal study (CHARLS)

BACKGROUND

Cardiovascular disease(CVD) is the leading cause of death in the world. Cardiometabolic-based chronic disease (CMBCD) model is presented that provides a basis for sustainable and early, evidence-based therapeutic targeting to mitigate the ravagest and development of CVD. CMBCD include dysglycemia, hypertension, and/or dyslipidemia progressing to downstream CVD events.

OBJECTIVES

The objective of our research was to develop and externally validate a diagnostic model of CMBCD.

METHODS

Design: Multivariable logistic regression of a cohort for 9,463 participants aged at least 45 years were drawn from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS).

SETTING

The 2018 wave of the CHARLS.

PARTICIPANTS

Diagnostic model development: Totally 6,218 participants whose individual ID < 250,000,000,000. External validation: Totally 3,245 participants whose individual ID > 250,000,000,000.

OUTCOMES

CMBCD .

RESULTS

CMBCD occurred in 25.5%(1,584/6,218)of individuals in the development data set and 26.2%(850 /3,245)of individuals in the validation data set. The strongest predictors of CMBCD were age, general health status, location of residential address, smoking, housework ability, pain, and exercise tolerance. We developed a diagnostic model of CMBCD. Discrimination was the ability of the diagnostic model to differentiate between people who with and without CMBCD. This measure was quantified by calculating the area under the receiver operating characteristic(ROC) curve(AUC).The AUC was 0.6199 ± 0.0083, 95% confidence interval(CI) = 0.60372 ~ 0.63612. We constructed a nomograms using the development database based on age, general health status, location of residential address, smoking, housework ability, pain, and exercise tolerance. The AUC was 0.6033 ± 0.0116, 95% CI = 0.58066 ~ 0.62603 in the validation data set.

CONCLUSIONS

We developed and externally validated a diagnostic model of CMBCD. Discrimination, calibration, and decision curve analysis were satisfactory.

Dietary diversity associated with risk of cardiovascular diseases among community-dwelling older people: A national health examination survey from Thailand

Background

Cardiovascular diseases (CVD) are the common comorbidities in older people. Healthy diet is an essential strategy to alleviate the risk of developing CVD. Dietary diversity (DD) is an indicator of diet quality. Currently, limited research exists regarding DD and CVD in older people in developing countries, such as Thailand, despite rapid growth of older population. Therefore, this study aims to determine associations of DD with the risk of CVD and the cardiometabolic risk factors among Thai older people.

Methods

This cross-sectional study used the sub-sample of the fifth Thai National Health Examination Survey conducted from 2013 to 2015. A total of 6,956 older people aged 60 years and older and no pre-existing CVD were included.

Dietary diversity score (DDS) was assessed the consumption of eight food groups using food frequency questionnaires. Each food group was scored from 0 to 4. The DDS was calculated as the sum of the scores (0–32). The risk of CVD was calculated by using a Thai cardiovascular (CV) risk score. The cardiometabolic risk factors included hypertension, diabetes mellitus (DM), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels. Data were adjusted for a complex survey design and analysed using linear and logistic regression models.

Results

In the adjusted model, DDS had a significant negative association with log-Thai CV risk score, with adjusted β (95% CI) values of −0.01 (−0.01, −0.01). Regarding the cardiometabolic risk factors, DDS had a significant negative association with hypertension, DM and log-TG levels, with adjusted OR (95% CI) values of 0.97 (95% CI 0.97, 0.98) for hypertension, 0.94 (0.93, 0.95) for DM, and adjusted β (95% CI) values of −0.002 (−0.004, −0.001) for log-TG level. DDS was positively associated with TC and LDL-C, with adjusted β (95% CI) values of 0.59 (0.38, 0.80) for TC and 0.59 (0.38, 0.79) for LDL-C levels, while DDS was not associated with HDL-C level.

Conclusion

Higher DD was associated with a lower risk of CVD among Thai older people. The nutritional policies or interventions should encourage a diverse food intake for the prevention of CVD in this population.