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Xu F, Feng Y, Zhong X. Higher triglyceride‑glucose index is associated with increased risk of stroke among middle-aged and elderly Chinese: a national longitudinal study. Sci Rep 2024; 14:19054. [PMID: 39154111 PMCID: PMC11330459 DOI: 10.1038/s41598-024-70008-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 08/12/2024] [Indexed: 08/19/2024] Open
Abstract
Stroke is a severe cerebrovascular disease. This study aimed to determine the association between triglyceride‑glucose (TyG) index and stroke among middle-aged and elderly Chinese. Data was extracted from China Health and Retirement Longitudinal Study survey 2015 and survey 2018. Logistic regression, trend test and subgroup analysis were conducted to assess the association. Possible nonlinear relationships were explored with restricted cubic spline (RCS). Propensity score matching (PSM) was conducted to attenuate the effect of confounding factors. ORs of stroke was positively associated with TyG index. The ORs in RCS analysis also increased with the rising TyG, though p for non-linearity was bigger than 0.05. After PSM, the ORs in the full adjusted models were 1.28 (1.01, 1.62). TyG was suggested as an independent risk factor for stroke in the middle aged and elderly Chinese.
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Affiliation(s)
- Feifei Xu
- Department of Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Yan Feng
- Department of Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Xi Zhong
- Department of Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China.
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2
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Koroukian SM, Fein HL, Vu L, Bensken WP, Schiltz NK, Sajatovic M, Ghearing GR, Warner DF. Excess prevalence of preexisting chronic conditions in older adults with incident epilepsy. Epilepsia 2024; 65:2354-2367. [PMID: 38837227 DOI: 10.1111/epi.18032] [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: 12/02/2023] [Revised: 05/17/2024] [Accepted: 05/17/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE Prior studies have examined chronic conditions in older adults with prevalent epilepsy, but rarely among those with incident epilepsy. Identifying the chronic conditions with which older adults present at epilepsy incidence assists with the evaluation of disease burden in this patient population and informs coordinated care development. The aim of this study was to identify preexisting chronic conditions with excess prevalence in older adults with incident epilepsy compared to those without. METHODS Using a random sample of 4 999 999 fee-for-service Medicare beneficiaries aged >65 years, we conducted a retrospective cohort study of epilepsy incidence in 2019. Non-Hispanic Black and Hispanic beneficiaries were oversampled. We identified preexisting chronic conditions from the 2016-2018 Medicare Beneficiary Summary Files and compared chronic condition prevalence between Medicare beneficiaries with and without incident epilepsy in 2019. We characterized variations in preexisting excess chronic condition prevalence by age, sex, and race/ethnicity, adjusting for the racial/ethnic oversampling. RESULTS We observed excess prevalence of most preexisting chronic conditions in beneficiaries with incident epilepsy (n = 20 545, weighted n = 19 631). For stroke, for example, the adjusted prevalence rate ratio (APRR) was 4.82 (99% CI:4.60, 5.04), meaning that, compared to those without epilepsy, beneficiaries with incident epilepsy in 2019 had 4.82 times the stroke prevalence. Similarly, beneficiaries with incident epilepsy had a higher prevalence rate for preexisting neurological conditions (APRR = 3.17, 99% CI = 3.08-3.27), substance use disorders (APRR = 3.00, 99% CI = 2.81-3.19), and psychiatric disorders (APRR = 1.98, 99% CI = 1.94-2.01). For most documented chronic conditions, excess prevalence among beneficiaries with incident epilepsy in 2019 was larger for younger age groups compared to older age groups, and for Hispanic beneficiaries compared to both non-Hispanic White and non-Hispanic Black beneficiaries. SIGNIFICANCE Compared to epilepsy-free Medicare beneficiaries, those with incident epilepsy in 2019 had a higher prevalence of most preexisting chronic conditions. Our findings highlight the importance of health promotion and prevention, multidisciplinary care, and elucidating shared pathophysiology to identify opportunities for prevention.
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Affiliation(s)
- Siran M Koroukian
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Hannah L Fein
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Long Vu
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Wyatt P Bensken
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Nicholas K Schiltz
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Martha Sajatovic
- Department of Neurology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Gena R Ghearing
- Department of Neurology, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA
| | - David F Warner
- Department of Sociology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Center for Family & Demographic Research, Bowling Green State University, Bowling Green, Ohio, USA
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3
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Liang C, Zhao R, Du J, Zhao G, Zhang Y. The association between dietary selenium intake and telomere length in hypertension. J Clin Hypertens (Greenwich) 2024; 26:990-996. [PMID: 38967394 PMCID: PMC11301449 DOI: 10.1111/jch.14861] [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: 03/01/2024] [Revised: 04/29/2024] [Accepted: 06/06/2024] [Indexed: 07/06/2024]
Abstract
Telomere length is closely linked to biological aging, oxidative stress, and the development of cardiovascular diseases. This study aimed to assess the association between dietary selenium intake and telomere length in individuals with hypertension. Data on dietary selenium intake were captured through the National Health and Nutrition Examination Survey (NHANES) computer-assisted dietary interview system (CADI). Telomere length determination entailed selecting blood samples from all participants in the NHANES database. The analysis was performed using Analysis System software, with Empower stats utilized for data analysis. Results showed that there was a significant association between dietary selenium intake and telomere length in hypertension, particularly within the female group. In female hypertension cases, a 1 mcg increase in dietary selenium intake corresponded to a telomere length increase of 1.19 bp, even after adjusting for age, race, BMI, marital status, physical activity, energy intake, and stroke history. The relationship between dietary selenium intake and telomere length exhibited a linear pattern in female hypertension patients. This study identified a positive association between dietary selenium intake and telomere length in hypertension, particularly within the female group.
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Affiliation(s)
- Cui Liang
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Ruixue Zhao
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Jiaqi Du
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Guojun Zhao
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Yanzhou Zhang
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
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Chen J, Luo C, Tan D, Li Y. J-shaped associations of pan-immune-inflammation value and systemic inflammation response index with stroke among American adults with hypertension: evidence from NHANES 1999-2020. Front Neurol 2024; 15:1417863. [PMID: 39144717 PMCID: PMC11322096 DOI: 10.3389/fneur.2024.1417863] [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: 04/19/2024] [Accepted: 07/23/2024] [Indexed: 08/16/2024] Open
Abstract
Introduction Stroke, a leading cause of death and disability worldwide, is primarily ischemic and linked to hypertension. Hypertension, characterized by systemic chronic inflammation, significantly increases stroke risk. This study explores the association of novel systemic inflammatory markers (SII, PIV, SIRI) with stroke prevalence in hypertensive U.S. adults using NHANES data. Methods We analyzed data from hypertensive participants in the NHANES 1999-2020 survey, excluding those under 20, pregnant, or with missing data, resulting in 18,360 subjects. Systemic inflammatory markers (SII, PIV, SIRI) were calculated from blood counts. Hypertension and stroke status were determined by self-report and clinical measurements. Covariates included sociodemographic, lifestyle, and medical history factors. Weighted statistical analyses and multivariate logistic regression models were used to explore associations, with adjustments for various covariates. Ethical approval was obtained from the NCHS Ethics Review Board. Results In a cohort of 18,360 hypertensive individuals (mean age 56.652 years), 7.25% had a stroke. Stroke patients were older, had lower PIR, and were more likely to be female, single, less educated, smokers, non-drinkers, physically inactive, and have diabetes and CHD. Multivariate logistic regression showed that SII was not significantly associated with stroke. However, PIV and SIRI were positively associated with stroke prevalence. Each unit increase in lnPIV increased stroke odds by 14% (OR = 1.140, p = 0.0022), and lnSIRI by 20.6% (OR = 1.206, p = 0.0144). RCS analyses confirmed J-shaped associations for lnPIV and lnSIRI with stroke. Stratified analyses identified gender and smoking as significant effect modifiers. Smoking was significantly associated with elevated PIV, SIRI, and SII levels, especially in current smokers. Conclusion Elevated PIV and SIRI levels significantly increase stroke prevalence in hypertensive individuals, notably among males and smokers. A predictive model with PIV, SIRI, and sociodemographic factors offers strong clinical utility.
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Affiliation(s)
| | | | - Dianhui Tan
- Department of Neurosurgery, the First Affiliated Hospital of Shantou University Medical College, Shantou, China
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5
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Badea RȘ, Grecu N, Ribigan AC, Antochi F, Tiu C, Popescu BO. Headache patterns in patent foramen ovale patients: beyond migraine with aura. J Neural Transm (Vienna) 2024; 131:755-761. [PMID: 38416197 DOI: 10.1007/s00702-024-02760-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 02/23/2024] [Indexed: 02/29/2024]
Abstract
Patent foramen ovale (PFO) is a common cardiac anomaly linked with cryptogenic strokes and migraine, particularly migraine with aura. This study aims to explore the spectrum of headache disorders in PFO patients, focusing on identifying patterns beyond the well-established migraine-PFO connection. A retrospective observational study was conducted on patients diagnosed with PFO. Headache types were classified using the International Classification of Headache Disorders, 3rd edition. The study analyzed headache prevalence and patterns in PFO patients, comparing those with and without a history of stroke. Of 177 participants, 63 (35.59%) reported headaches. Tension-type headache was the most common (15.25%), followed by migraine without aura (11.30%) and migraine with aura (8.47%). Notably, migraine without aura was more prevalent than migraine with aura, contrasting previous assumptions. No significant differences were found in headache types based on stroke history. The study reveals a diverse spectrum of headache types in PFO patients, with migraine without aura being more common than migraine with aura. These findings suggest a need for broader diagnostic perspective and individualized treatment approaches in PFO patients with headaches.
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Affiliation(s)
- Raluca Ștefania Badea
- Department of Neurology, University and Emergency Hospital, 169 Splaiul Independenței, Bucharest, 050098, Romania.
- University of Medicine and Pharmacy Carol Davila, 37 Dionisie Lupu, Bucharest, 020021, Romania.
| | - N Grecu
- Department of Neurology, University and Emergency Hospital, 169 Splaiul Independenței, Bucharest, 050098, Romania
- University of Medicine and Pharmacy Carol Davila, 37 Dionisie Lupu, Bucharest, 020021, Romania
| | - A C Ribigan
- Department of Neurology, University and Emergency Hospital, 169 Splaiul Independenței, Bucharest, 050098, Romania
- University of Medicine and Pharmacy Carol Davila, 37 Dionisie Lupu, Bucharest, 020021, Romania
| | - F Antochi
- Department of Neurology, University and Emergency Hospital, 169 Splaiul Independenței, Bucharest, 050098, Romania
| | - C Tiu
- Department of Neurology, University and Emergency Hospital, 169 Splaiul Independenței, Bucharest, 050098, Romania
- University of Medicine and Pharmacy Carol Davila, 37 Dionisie Lupu, Bucharest, 020021, Romania
| | - B O Popescu
- University of Medicine and Pharmacy Carol Davila, 37 Dionisie Lupu, Bucharest, 020021, Romania
- Department of Neurology, Colentina Clinical Hospital, 19-21 Șoseaua Ștefan cel Mare, Bucharest, 020123, Romania
- Laboratory of Cell Biology, Neurosciences and Experimental Myology, 'Victor Babes' National Institute of Pathology, Bucharest, 050096, Romania
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Tashakori N, Kolour SSP, Ghafouri K, Ahmed SI, Kahrizi MS, Gerami R, Altafi M, Nazari A. Critical role of the long non-coding RNAs (lncRNAs) in radiotherapy (RT)-resistance of gastrointestinal (GI) cancer: Is there a way to defeat this resistance? Pathol Res Pract 2024; 258:155289. [PMID: 38703607 DOI: 10.1016/j.prp.2024.155289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/29/2024] [Accepted: 03/31/2024] [Indexed: 05/06/2024]
Abstract
Radiotherapy (RT) is a frequently used treatment for cervical cancer, effectively decreasing the likelihood of the disease returning in the same area and extending the lifespan of individuals with cervical cancer. Nevertheless, the primary reason for treatment failure in cancer patients is the cancer cells' resistance to radiation therapy (RT). Long non-coding RNAs (LncRNAs) are a subset of RNA molecules that do not code for proteins and are longer than 200 nucleotides. They have a significant impact on the regulation of gastrointestinal (GI) cancers biological processes. Recent research has shown that lncRNAs have a significant impact in controlling the responsiveness of GI cancer to radiation. This review provides a concise overview of the composition and operation of lncRNAs as well as the intricate molecular process behind radiosensitivity in GI cancer. Additionally, it compiles a comprehensive list of lncRNAs that are linked to radiosensitivity in such cancers. Furthermore, it delves into the potential practical implementation of these lncRNAs in modulating radiosensitivity in GI cancer.
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Affiliation(s)
- Nafiseh Tashakori
- Department of Internal Medicine, Faculty of Medicine, Tehran branch, Islamic Azad University, Tehran, Iran
| | | | - Kimia Ghafouri
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sarah Ibrahem Ahmed
- Department of Anesthesia Techniques, Al-Noor University College, Nineveh, Iraq
| | | | - Reza Gerami
- Department of Radiology, Faculty of Medicine, AJA University of Medical Science, Tehran, Iran
| | - Mana Altafi
- Department of Radiology, Faculty of Biological Science and Technology, Shiraz Pardis Branch, Islamic Azad University, Shiraz, Iran.
| | - Afsaneh Nazari
- Department of Genetics, Faculty of Basic Sciences, Islamic Azad University, Zanjan Branch, Zanjan, Iran.
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Yang B, Rui C, Liu H, Dong A, Zhang Y, Cui C, Wang W. Effects of Argatroban on Hcy, hs-CRP and FIB levels in patients with acute cerebral infarction. Int J Neurosci 2024:1-8. [PMID: 38654424 DOI: 10.1080/00207454.2024.2347549] [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: 03/25/2024] [Accepted: 04/20/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE To evaluate the effects of argatroban on the levels of Hcy, hs-CRP and FIB in patients with acute cerebral infarction (ACI). METHODS A retrospective analysis was performed on 382 patients with ACI who were hospitalized in the Department of Neurology of our hospital from January 2017 to December 2019. Among them, 158 patients received conventional treatment as the control group and 224 patients received combined treatment with argatroban as the study group. NHISS score, mRS score, Hcy, hs-CRP, FIB level, quality of life, adverse reactions were compared between the two groups after treatment. The levels of Hcy and hs-CRP in patients with different mRS scores were compared. RESULTS A superior clinical efficacy of the study group was observed than the control group (p < 0.05). The study group witnessed a remarkably lower NHISS score, Hcy, hs-CRP and FIB level as compare to the control group (p < 0.05). The ADL and FMA scores in the study group were higher than those in the control group (p < 0.05). The levels of Hcy and hs-CRP in mRS 0-2 patients were lower than those in mRS 3-6 patients (p < 0.05). CONCLUSION Argatroban in ACI patients can significantly enhance the clinical efficacy and improve the quality of life. It is closely related to the reduction of Hcy and hs-CRP levels, but the mechanism needs to be further studied.
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Affiliation(s)
- Bingjian Yang
- Neurology Department III, Cangzhou Central Hospital, Cangzhou, China
| | - Chen Rui
- Economics and Management College Cangzhou Central Hospital, Refined Management Office, Hebei University of Technology, Tianjin, China
| | - Hua Liu
- Cardiovascular Department II, Cangzhou Central Hospital, Cangzhou, China
| | - Aiqin Dong
- Neurology Department III, Cangzhou Central Hospital, Cangzhou, China
| | - Yushan Zhang
- Neurology Department VII, Cangzhou Central Hospital, Cangzhou, China
| | - Cuicui Cui
- Neurology Department III, Cangzhou Central Hospital, Cangzhou, China
| | - Wenhui Wang
- Neurology Department III, Cangzhou Central Hospital, Cangzhou, China
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Avesani M, Calcaterra G, Sabatino J, Pelaia G, Cattapan I, Barillà F, Martino F, Pedrinelli R, Bassareo PP, Di Salvo G. Pediatric Hypertension: A Condition That Matters. CHILDREN (BASEL, SWITZERLAND) 2024; 11:518. [PMID: 38790513 PMCID: PMC11120267 DOI: 10.3390/children11050518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 04/15/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024]
Abstract
Systemic hypertension has been considered mainly as an adult health issue for a long time, but it is now being increasingly acknowledged as a significant problem also among pediatric patients. The frequency of pediatric hypertension has grown mostly because of increases in childhood obesity and sedentary lifestyles, but secondary forms of hypertension play a role as well. Considering that unaddressed hypertension during childhood can result in enduring cardiovascular complications, timely identification and intervention are essential. Strategies for addressing this disease encompass not only lifestyle adjustments, but also the use of medications when needed. Lifestyle modifications entail encouraging a nutritious diet, consistent physical activity, and the maintenance of a healthy weight. Moreover, educating both children and their caregivers about monitoring blood pressure at home can aid in long-term management. Thus, the aim of this review is to discuss the etiologies, classification, and principles of the treatment of hypertension in pediatric patients.
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Affiliation(s)
- Martina Avesani
- Division of Pediatric Cardiology, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, Italy; (M.A.); (I.C.)
| | | | - Jolanda Sabatino
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (J.S.); (G.P.)
| | - Giulia Pelaia
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (J.S.); (G.P.)
| | - Irene Cattapan
- Division of Pediatric Cardiology, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, Italy; (M.A.); (I.C.)
| | - Francesco Barillà
- Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy;
| | - Francesco Martino
- Department of Internal Medicine, Anaesthesiology, and Cardiovascular Sciences, Sapienza University, 00185 Rome, Italy;
| | - Roberto Pedrinelli
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Pier Paolo Bassareo
- School of Medicine, University College of Dublin, Mater Misericordiae University Hospital, D07 KH4C Dublin, Ireland;
| | - Giovanni Di Salvo
- Division of Pediatric Cardiology, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, Italy; (M.A.); (I.C.)
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Saleh RO, Majeed AA, Margiana R, Alkadir OKA, Almalki SG, Ghildiyal P, Samusenkov V, Jabber NK, Mustafa YF, Elawady A. Therapeutic gene delivery by mesenchymal stem cell for brain ischemia damage: Focus on molecular mechanisms in ischemic stroke. Cell Biochem Funct 2024; 42:e3957. [PMID: 38468129 DOI: 10.1002/cbf.3957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/02/2024] [Accepted: 02/12/2024] [Indexed: 03/13/2024]
Abstract
Cerebral ischemic damage is prevalent and the second highest cause of death globally across patient populations; it is as a substantial reason of morbidity and mortality. Mesenchymal stromal cells (MSCs) have garnered significant interest as a potential treatment for cerebral ischemic damage, as shown in ischemic stroke, because of their potent intrinsic features, which include self-regeneration, immunomodulation, and multi-potency. Additionally, MSCs are easily obtained, isolated, and cultured. Despite this, there are a number of obstacles that hinder the effectiveness of MSC-based treatment, such as adverse microenvironmental conditions both in vivo and in vitro. To overcome these obstacles, the naïve MSC has undergone a number of modification processes to enhance its innate therapeutic qualities. Genetic modification and preconditioning modification (with medications, growth factors, and other substances) are the two main categories into which these modification techniques can be separated. This field has advanced significantly and is still attracting attention and innovation. We examine these cutting-edge methods for preserving and even improving the natural biological functions and therapeutic potential of MSCs in relation to adhesion, migration, homing to the target site, survival, and delayed premature senescence. We address the use of genetically altered MSC in stroke-induced damage. Future strategies for improving the therapeutic result and addressing the difficulties associated with MSC modification are also discussed.
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Affiliation(s)
- Raed Obaid Saleh
- Department of Medical Laboratory Techniques, Al-Maarif University College, Al-Anbar, Iraq
| | - Ali A Majeed
- Department of Pathological Analyses, Faculty of Science, University of Kufa, Najaf, Iraq
| | - Ria Margiana
- Department of Anatomy, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Master's Programme Biomedical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ola Kamal A Alkadir
- Department of Medical Engineering, Al-Nisour University College, Baghdad, Iraq
| | - Sami G Almalki
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Pallavi Ghildiyal
- Uttaranchal Institute of Pharmaceutical Sciences, Uttaranchal University, Dehradun, India
| | - Vadim Samusenkov
- Department of Prosthetic Dentistry, Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Yasser Fakri Mustafa
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of Mosul, Mosul, Iraq
| | - Ahmed Elawady
- College of Technical Engineering, The Islamic University, Najaf, Iraq
- College of Technical Engineering, The Islamic University of Al Diwaniyah, Al Diwaniyah, Iraq
- College of Technical Engineering, The Islamic University of Babylon, Babylon, Iraq
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Zeng J, Zhang R, Zhao T, Wang H, Han L, Pu L, Jiang Y, Xu S, Ren H, Wang C. Plasma lipidomic profiling reveals six candidate biomarkers for the prediction of incident stroke in patients with hypertension. Metabolomics 2024; 20:13. [PMID: 38180633 DOI: 10.1007/s11306-023-02081-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/11/2023] [Indexed: 01/06/2024]
Abstract
INTRODUCTION The burden of stroke in patients with hypertension is very high, and its prediction is critical. OBJECTIVES We aimed to use plasma lipidomics profiling to identify lipid biomarkers for predicting incident stroke in patients with hypertension. METHODS This was a nested case-control study. Baseline plasma samples were collected from 30 hypertensive patients with newly developed stroke, 30 matched patients with hypertension, 30 matched patients at high risk of stroke, and 30 matched healthy controls. Lipidomics analysis was performed by ultrahigh-performance liquid chromatography-tandem mass spectrometry, and differential lipid metabolites were screened using multivariate and univariate statistical methods. Machine learning methods (least absolute shrinkage and selection operator, random forest) were used to identify candidate biomarkers for predicting stroke in patients with hypertension. RESULTS Co-expression network analysis revealed that the key molecular alterations of the lipid network in stroke implicate glycerophospholipid metabolism and choline metabolism. Six lipid metabolites were identified as candidate biomarkers by multivariate statistical and machine learning methods, namely phosphatidyl choline(40:3p)(rep), cholesteryl ester(20:5), monoglyceride(29:5), triglyceride(18:0p/18:1/18:1), triglyceride(18:1/18:2/21:0) and coenzyme(q9). The combination of these six lipid biomarkers exhibited good diagnostic and predictive ability, as it could indicate a risk of stroke at an early stage in patients with hypertension (area under the curve = 0.870; 95% confidence interval: 0.783-0.957). CONCLUSIONS We determined lipidomic signatures associated with future stroke development and identified new lipid biomarkers for predicting stroke in patients with hypertension. The biomarkers have translational potential and thus may serve as blood-based biomarkers for predicting hypertensive stroke.
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Affiliation(s)
- Jingjing Zeng
- Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Ningbo No.2 Hospital, Ningbo, 315000, China
- Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Ningbo Institute of Life and Health Industry, Guoke Ningbo Life Science and Health Industry Research Institute, Ningbo, 315000, China
- Department of Cardiology, Ningbo No.2 Hospital, Ningbo, 315000, China
| | - Ruijie Zhang
- Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Ningbo No.2 Hospital, Ningbo, 315000, China
- Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Ningbo Institute of Life and Health Industry, Guoke Ningbo Life Science and Health Industry Research Institute, Ningbo, 315000, China
| | - Tian Zhao
- Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Ningbo No.2 Hospital, Ningbo, 315000, China
- Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Ningbo Institute of Life and Health Industry, Guoke Ningbo Life Science and Health Industry Research Institute, Ningbo, 315000, China
| | - Han Wang
- Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Ningbo No.2 Hospital, Ningbo, 315000, China
- Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Ningbo Institute of Life and Health Industry, Guoke Ningbo Life Science and Health Industry Research Institute, Ningbo, 315000, China
| | - Liyuan Han
- Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Ningbo No.2 Hospital, Ningbo, 315000, China
- Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Ningbo Institute of Life and Health Industry, Guoke Ningbo Life Science and Health Industry Research Institute, Ningbo, 315000, China
| | - Liyuan Pu
- Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Ningbo No.2 Hospital, Ningbo, 315000, China
- Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Ningbo Institute of Life and Health Industry, Guoke Ningbo Life Science and Health Industry Research Institute, Ningbo, 315000, China
| | - Yannan Jiang
- Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Ningbo No.2 Hospital, Ningbo, 315000, China
- Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Ningbo Institute of Life and Health Industry, Guoke Ningbo Life Science and Health Industry Research Institute, Ningbo, 315000, China
| | - Shan Xu
- Department of Non-Communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518000, China
| | - Huiming Ren
- Department of Rehabilitation Medicine, Ningbo No.2 Hospital, Ningbo, 315000, China.
| | - Changyi Wang
- Department of Non-Communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518000, China.
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Xiao X, Xu L, Lu H, Liu X, Sun H, Guo Z, Sun J, Qi F, Niu X, Wang A, Ge Q, Zhuang Y, Geng X, Chen X, Lan Y, He J, Sun W. Untargeted Metabolomic Analyses of Body Fluids to Differentiate TBI DOC and NTBI DOC. Curr Mol Med 2024; 24:1183-1193. [PMID: 37817528 DOI: 10.2174/0115665240249826230928104512] [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: 03/08/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 10/12/2023]
Abstract
OBJECTIVE To investigate the metabolomic differences between Traumatic brain injury (TBI) disorder of consciousness (DOC) patients and non-traumatic brain injury (NTBI) DOC patients by using cerebrospinal fluid (CSF), serum and urine samples beneficial to understand the pathological mechanism differences between the two etiologies, provide potential clues for the subsequent treatment and prognosis, and investigate the metabolome differences and similarities between TBI and NTBI among three different body fluids. METHODS In total, 24 TBI DOC subjects and 29 NTBI DOC subjects were enrolled. CSF, serum and urine samples from TBI DOC and NTBI DOC patients were collected and analyzed by performing UPLC-MS. The statistical methods and pathway analyses were applied to discover potential biomarkers and altered metabolic functions. RESULTS When comparing TBI DOC and NTBI DOC, 36, 31 and 52 differential metabolites were obtained in CSF, serum and urine, respectively. The functional analysis of differential metabolites obtained in CSF, serum and urine were all related to amino acid metabolism. Except for amino acid metabolism, metabolic biomarkers in CSF, serum and urine mainly focus on central function, cognitive function, necrosis and apoptosis and neurological function, respectively. In CSF, the highest AUC was 0.864 (Isoproturon) and 0.816 (Proline betaine). Then, the AUC of NFurfurylformamide in serum was 0.941, while the AUC of Dihydronepetalactone and Doxepin N-oxide glucuronide were 1.0 in urine. CONCLUSION CSF, serum and urine metabolomic analyses could differentiate TBI DOC from NTBI DOC and functional analyses showed a metabolic change difference between TBI DOC and NTBI DOC.
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Affiliation(s)
- Xiaoping Xiao
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Medical College, Beijing, China
- Core Instrument Facility, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College Beijing, China
| | - Long Xu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China
| | - Hezhen Lu
- China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xiaoyan Liu
- Core Instrument Facility, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College Beijing, China
| | - Haidan Sun
- Core Instrument Facility, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College Beijing, China
| | - Zhengguang Guo
- Core Instrument Facility, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College Beijing, China
| | - Jiameng Sun
- Core Instrument Facility, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College Beijing, China
| | - Feng Qi
- Core Instrument Facility, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College Beijing, China
| | - Xia Niu
- Core Instrument Facility, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College Beijing, China
| | - Aiwei Wang
- Core Instrument Facility, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College Beijing, China
| | - Qianqian Ge
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yutong Zhuang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoli Geng
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xueling Chen
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ying Lan
- State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
| | - Jianghong He
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China
| | - Wei Sun
- Core Instrument Facility, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College Beijing, China
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Boshagh K, Khorvash F, Sahebkar A, Majeed M, Bahreini N, Askari G, Bagherniya M. The effects of curcumin-piperine supplementation on inflammatory, oxidative stress and metabolic indices in patients with ischemic stroke in the rehabilitation phase: a randomized controlled trial. Nutr J 2023; 22:69. [PMID: 38082237 PMCID: PMC10712118 DOI: 10.1186/s12937-023-00905-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Stroke is a leading cause of death worldwide, which is associated with a heavy economic and social burden. The purpose of this study was to investigate the effects of supplementation with curcumin-piperine combination in patients with ischemic stroke in the rehabilitation stage. METHODS In this randomized controlled trial, 66 patients with stroke were randomized into two groups receiving curcumin-piperine tablets (500 mg curcumin + 5 mg piperine) and matched placebo tablets for 12 weeks. High-sensitivity C-reactive protein (hs-CRP), carotid intima-media thickness (CIMT), thrombosis, total antioxidant capacity (TAC), lipid profile, anthropometric indices, blood pressure, and quality of life were assessed before and after the intervention. Statistical data analysis was done using SPSS22 software. RESULTS A total of 56 patients with a mean age of 59.80 ± 4.25 years completed the trial. Based on ANCOVA test, adjusted for baseline values, curcumin-piperine supplementation for 12 weeks resulted in significant reductions in serum levels of hs-CRP (p = 0.026), total cholesterol (TC) (p = 0.009), triglycerides (TG) (p = 0.001), CIMT (p = 0.002), weight (P = 0.001), waist circumference (p = 0.024), and systolic and diastolic blood pressure (p < 0.001), and a significant increase in TAC (p < 0.001) in comparison to the placebo. Pain score significantly increased in both groups; however, its increase was significantly higher in the placebo group compared with the intervention group (p = 0.007). No significant changes were observed between the two groups in terms of serum fibrinogen, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and quality of life indices. CONCLUSION Curcumin-piperine supplementation had beneficial effects on CIMT, serum hs-CRP, TC, TG, TAC, and systolic and diastolic blood pressure in patients with ischemic stroke in the rehabilitation stage.
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Affiliation(s)
- Kosar Boshagh
- Nutrition and Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariborz Khorvash
- Neurology Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Muhammed Majeed
- Sabinsa Corporation, 20 Lake Drive, East Windsor, NJ, 08520, USA
| | - Nimah Bahreini
- Department of Food Science and Technology, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Nutrition and Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- Anesthesia and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Bagherniya
- Nutrition and Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
- Anesthesia and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Xu J, Xu W, Chen G, Hu Q, Jiang J. Association of TyG index with prehypertension or hypertension: a retrospective study in Japanese normoglycemia subjects. Front Endocrinol (Lausanne) 2023; 14:1288693. [PMID: 37964964 PMCID: PMC10642169 DOI: 10.3389/fendo.2023.1288693] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/16/2023] [Indexed: 11/16/2023] Open
Abstract
Aim The objective of our study was to investigate the potential association between the triglyceride and glucose (TyG) index and the occurrence of prehypertension or hypertension in a cohort of normoglycemic Japanese subjects. Methods The NAGALA physical examination program was conducted in 1994 at Murakami Memorial Hospital in Gifu City, Japan. For our retrospective study, we selected 15,450 participants who had taken part in this program. Our aim was to explore the potential link between the TyG index, a surrogate marker for insulin resistance, and the presence of prehypertension (pre-HTN) or hypertension (HTN). Our analysis included adjustments for clinical demographic attributes and serum biomarkers. Logistic regression was employed to assess the relationship between the TyG index and the likelihood of pre-HTN or HTN. Results A total of 15,450 study subjects were included in our analysis. Notably, the prevalence of both pre-HTN and HTN displayed an ascending trend with increasing quartiles of the TyG index. In our comprehensive multivariable logistic regression analysis, when evaluating TyG as a continuous variable, the adjusted odds ratio (OR) for pre-HTN was OR 1.31 [95% CI 1.11-1.56], while for HTN, it was OR 1.76 [95% CI 1.24-2.5] within the fully adjusted model (model 3). When TyG was stratified into quartiles within model 3, the adjusted ORs for pre-HTN were OR 1.16 [95% CI 1.02-1.31], OR 1.22 [95% CI 1.06-1.41], and OR 1.31 [95% CI 1.08-1.59], respectively, using quartile 1 as the reference. The adjusted ORs for HTN in quartiles 2, 3, and 4 were OR 1.22 [95% CI 0.89-1.66], OR 1.4 [95% CI 1.02-1.91], and OR 1.48 [95% CI 1.02-2.15], respectively, within the same model and analysis, with quartile 1 as the reference. Subgroup analysis indicated that the TyG index exhibited a significant positive correlation with the risk of hypertension or prehypertension, except in the subgroup aged ≥65 years. Conclusion Our study highlights a robust correlation between the TyG index and the likelihood of pre-HTN or HTN in normoglycemic Japanese subjects. This underscores the potential clinical relevance of the TyG index in refining early hypertension management strategies. Nonetheless, the validation of these findings necessitates larger studies with extended follow-up periods.
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Affiliation(s)
- Jingtao Xu
- Department of Emergency, First People’s Hospital of Foshan, Foshan, China
- The Poison Treatment Centre of Foshan, First People’s Hospital of Foshan, Foshan, China
| | - Weigan Xu
- Department of Emergency, First People’s Hospital of Foshan, Foshan, China
- The Poison Treatment Centre of Foshan, First People’s Hospital of Foshan, Foshan, China
| | - Guojun Chen
- Department of Emergency, First People’s Hospital of Foshan, Foshan, China
- The Poison Treatment Centre of Foshan, First People’s Hospital of Foshan, Foshan, China
| | - Qiaohua Hu
- Department of Emergency, First People’s Hospital of Foshan, Foshan, China
- The Poison Treatment Centre of Foshan, First People’s Hospital of Foshan, Foshan, China
| | - Jun Jiang
- The Poison Treatment Centre of Foshan, First People’s Hospital of Foshan, Foshan, China
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Rosales-Rimache J, Ramos-Martínez P, Soncco-Llulluy F, Bendezu-Quispe G. Risk factors associated with hemorrhagic cerebrovascular accident: A cross-sectional study in patients from a hospital in Peru. Medicine (Baltimore) 2023; 102:e35635. [PMID: 37861480 PMCID: PMC10589525 DOI: 10.1097/md.0000000000035635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/22/2023] [Indexed: 10/21/2023] Open
Abstract
In Peru, cardiovascular accidents (CVA) cause around 15% of premature death, with an increase in CVA due to the prevalence of risk factors for CVA in the Peruvian population. Hemorrhagic CVA presents higher mortality compared to ischemic. This research aimed to identify the risk factors associated with hemorrhagic CVA. We carried out a retrospective cross-sectional study using the medical records of patients with a diagnosis of CVA treated at the Regional Hospital of Ica during the years 2018 and 2019. Independent variables included age, sex, type 2 diabetes, dyslipidemia, hypertension, smoking, obesity, and intracranial carotid artery calcification. To identify factors associated with an increased probability for hemorrhagic CVA compared to ischemic CVA, a generalized linear model with logit link and binomial family, obtaining the odds ratio (OR) and its 95% confidence interval (CI). we evaluated the data from 132 patients. Of them, 46 (34.85%) had hemorrhagic CVA. Only systolic blood pressure (OR: 1.04; 95% CI: 1.02-1.06) and hypertension (OR: 0.29; 95% CI: 0.10-0.89) were significantly associated with hemorrhagic CVA compared to ischemic CVA. Hypertension is associated with hemorrhagic CVA compared to ischemic CVA. These results are consistent with the literature.
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Affiliation(s)
- Jaime Rosales-Rimache
- Epidemiological Research Sciences, Vice Rectorado de Investigación, Universidad Privada Norbert Wiener, Lima, Peru
- Escuela Profesional de Tecnología Médica, Universidad Continental, Lima, Perú
| | - Paola Ramos-Martínez
- Medical Technologiest on Radiology, Servicio de Radio Diagnóstico, Hospital Regional de Ica, Ica, Peru
| | - Fernando Soncco-Llulluy
- Health Administration and Biomedical Informatic, Carrera de Medicina Humana, Universidad Científica del Sur, Lima, Perú
| | - Guido Bendezu-Quispe
- Health Administration and Biomedical Informatic, Carrera de Medicina Humana, Universidad Científica del Sur, Lima, Perú
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
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Murugesan S, Al Khodor S. Salivary microbiome and hypertension in the Qatari population. J Transl Med 2023; 21:454. [PMID: 37422685 PMCID: PMC10329805 DOI: 10.1186/s12967-023-04247-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/06/2023] [Indexed: 07/10/2023] Open
Abstract
BACKGROUND The prevalence of hypertension in Qatar is 33 percent of the adult population. It is postulated that the salivary microbiome can regulate blood pressure (BP). However, limited investigations exist to prove this hypothesis. Therefore, we examined the difference in the salivary microbiome composition between hypertensive and normotensive Qatari subjects. METHODS A total of 1190 Qatar Genome Project (QGP) participants (Mean age = 43 years) were included in this study. BP for all participants was classified into Normal (n = 357), Stage1 (n = 336), and Stage2: (n = 161) according to the American Heart Association guidelines. 16S-rRNA libraries were sequenced and analyzed using QIIME-pipeline, and PICRUST was used to predict functional metabolic routes. Machine Learning (ML) strategies were applied to identify salivary microbiome-based predictors of hypertension. RESULTS Differential abundant analysis (DAA) revealed that Bacteroides and Atopobium were the significant members of the hypertensive groups. Alpha and beta diversity indices indicated dysbiosis between the normotensive and hypertensive groups. ML-based prediction models revealed that these markers could predict hypertension with an AUC (Area under the curve) of 0.89. Functional predictive analysis disclosed that Cysteine and Methionine metabolism and the sulphur metabolic pathways involving the renin-angiotensin system were significantly higher in the normotensive group. Therefore, members of Bacteroides and Atopobium can serve as predictors of hypertension. Likewise, Prevotella, Neisseria, and Haemophilus can be the protectors that regulate BP via nitric acid synthesis and regulation of the renin-angiotensin system. CONCLUSION It is one of the first studies to assess salivary microbiome and hypertension as disease models in a large cohort of the Qatari population. Further research is needed to confirm these findings and validate the mechanisms involved.
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Affiliation(s)
- Selvasankar Murugesan
- Maternal and Child Health Division, Research Department, Sidra Medicine, 26999, Doha, Qatar
| | - Souhaila Al Khodor
- Maternal and Child Health Division, Research Department, Sidra Medicine, 26999, Doha, Qatar.
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16
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Zhang H, Zhan Q, Dong F, Gao X, Zeng F, Yao J, Gan Y, Zou S, Gu J, Fu H, Wang X. Associations of Chinese visceral adiposity index and new-onset stroke in middle-aged and older Chinese adults: an observational study. Lipids Health Dis 2023; 22:74. [PMID: 37337187 DOI: 10.1186/s12944-023-01843-x] [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: 04/06/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Stroke represents the second most prevalent contributor to global mortality. The Chinese Visceral Adiposity Index (CVAI) serves as an established metric for assessing visceral adiposity in the Chinese population, exhibiting prognostic capabilities. This investigation aimed to explore the association of CVAI and new-onset stroke among middle-aged and older Chinese populations. METHODS The study employed data from the 2011 and 2018 China Health and Retirement Longitudinal Study (CHARLS) to assess the association of CVAI and the incidence of new-onset stroke. Utilizing a directed acyclic graph (DAG), 10 potential confounders were identified. Moreover, to explore the association between CVAI and new-onset stroke, three multifactor logistic regression models were constructed, accounting for the identified confounders and mitigating their influence on the findings. RESULTS The study comprised 7070 participants, among whom 417 (5.9%) experienced new-onset strokes. After controlling for confounding variables, regression analysis suggested that the new-onset stroke's highest risk was linked to the fourth quartile (Q4) of the CVAI, with an odds ratio (OR) of 2.33 and a 95% confidence interval (CI) of 1.67-3.28. The decision tree analysis demonstrated a heightened probability of new-onset stroke among hypertensive individuals with a CVAI equal to or greater than 83, coupled with a C-reactive protein level no less than 1.1 mg/l. Age seemed to have a moderating influence on the CVAI and new-onset stroke association, exhibiting a more prominent interaction effect in participants under 60 years. CONCLUSIONS In middle-aged and older Chinese populations, a linear relationship was discerned between CVAI and the probability of new-onset stroke. CVAI provides a predictive framework for stroke incidence in this demographic, laying the groundwork for more sophisticated risk prediction models that improve the precision and specificity of stroke risk evaluations.
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Affiliation(s)
- Hongyu Zhang
- Department of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Qi Zhan
- Department of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Fayan Dong
- Department of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Xueting Gao
- Department of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Fanyue Zeng
- Department of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Jiahao Yao
- Department of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Yifan Gan
- Department of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Shuhuai Zou
- Department of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Jianheng Gu
- Department of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Hongqian Fu
- Department of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Xuefeng Wang
- Department of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.
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Ismail A, Ravipati S, Gonzalez-Hernandez D, Mahmood H, Imran A, Munoz EJ, Naeem S, Abdin ZU, Siddiqui HF. Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications. Cureus 2023; 15:e38794. [PMID: 37303351 PMCID: PMC10250083 DOI: 10.7759/cureus.38794] [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] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Carotid stenosis (CS) is a buildup of atherosclerotic plaque within the artery leading to a wide range of symptoms, from mild symptoms, including blurred vision and confusion, to much more life-threatening presentations, including paralysis due to stroke. The presentation is insidious, with symptoms exhibiting predominantly at severe stenosis; hence the emphasis is placed on the importance of early diagnosis, treatment, and lifestyle modifications. CS is seen undergoing almost the same pathogenesis of any atherosclerotic plaque formation, from endothelial damage of the artery lumen to the formation of a fibrous cap with a foam cell, lipid-filled core. The findings of our review article were consistent with the recent literature, depicting that comorbid hypertension, diabetes, and chronic kidney disease (CKD), and lifestyle aspects, including smoking and diet, played the most salient role in plaque development. Among several imaging modalities, duplex ultrasound (DUS) imaging is the widely preferred method in clinical practice. Carotid endarterectomy (CEA) and carotid stenting are the primarily advocated procedures for symptomatic severe stenosis, with similar long-term outcomes. Although, earlier clinical trials showed promising results in mitigating the risk of stroke among asymptomatic severe CS with surgical intervention. However, recent advancements have shifted the focus to medical management alone due to comparable results among the asymptomatic population. Both surgical and medical regimens are beneficial in treating patients, but it is still an ongoing debate as to which is predominantly superior. The currently advancing trials and research will help elucidate definitive guidelines. However, the massive impact of lifestyle modifications advocates some degree of individualized multidisciplinary management strategies.
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Affiliation(s)
- Aqsa Ismail
- Department of Medicine, United Medical and Dental College, Karachi, PAK
| | - Shivani Ravipati
- Department of Medicine, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Vijayawada, IND
| | | | - Hashim Mahmood
- Department of Medicine, University College of Medicine and Dentistry, University of Lahore, Lahore, PAK
| | - Alizay Imran
- Department of Surgery, Windsor University School of Medicine, Chicago, USA
| | - Eduardo J Munoz
- Department of General Medicine, Montemorelos University, Montemorelos, MEX
| | - Saad Naeem
- Department of Internal Medicine, Faisalabad Medical University, Faisalabad, PAK
- Department of Internal Medicine, Punjab Social Security Hospital, Faisalabad, PAK
| | - Zain U Abdin
- Department of Medicine, District Head Quarters Hospital, Faisalabad, PAK
| | - Humza F Siddiqui
- Department of Medicine, Jinnah Sindh Medical University, Karachi, PAK
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Cai N, Li C, Gu X, Zeng W, Zhong J, Liu J, Zeng G, Zhu J, Hong H. CYP2C19 loss-of-function is associated with increased risk of hypertension in a Hakka population: a case-control study. BMC Cardiovasc Disord 2023; 23:185. [PMID: 37024851 PMCID: PMC10080785 DOI: 10.1186/s12872-023-03207-w] [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: 12/26/2022] [Accepted: 03/27/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Genetic factors have a certain proportion in the risk factors of hypertension. The purpose was to investigate the relationship of cytochrome P450 2C19 (CYP2C19) polymorphisms with hypertension in Hakka population. METHODS The study included 1,872 hypertensive patients and 1,110 controls. The genotypes of CYP2C19 rs4244285 and rs4986893 of all individuals were detected and analyzed. RESULTS The genotype and allele distributions of CYP2C19 rs4244285 were significantly different between hypertension group and control group. The CYP2C19 *1/*1 genotype was the most predominant among the subjects (40.8%), followed by the CYP2C19 *1/*2 genotype (40.5%). The percentage of CYP2C19*1, *2, and *3 allele was 64.2%, 30.8%, and 5.0%, respectively. The proportion of intermediate metabolizers (IM) (49.3% vs. 42.9%), poor metabolizers (PM) (14.3% vs. 8.9%) (P < 0.001), and CYP2C19*2 allele (33.8% vs. 25.7%, P < 0.001) in hypertension group was significantly higher than that in control group. Multivariate logistic regression (adjusted for gender, age, smoking, and drinking) indicated that CYP2C19 *1/*2, *1/*3, and *2/*2 genotypes may increase susceptibility to hypertension. And the CYP2C19 IM genotype (IM vs. EM: OR 1.514, 95% CI: 1.291-1.775, P < 0.001), PM genotype (PM vs. EM: OR 2.120, 95% CI: 1.638-2.743, P < 0.001), IM + PM genotypes (IM + PM vs. EM: OR 1.617, 95% CI: 1.390-1.882, P < 0.001) may increase risk of hypertension. CONCLUSIONS CYP2C19 loss-of-function (IM, PM genotypes) is independent risk factor for hypertension susceptibility. Specifically, the risk genotypes include CYP2C19 *1/*2, *1/*3, and *2/*2.
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Affiliation(s)
- Nan Cai
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China.
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China.
- , No. 63 Huangtang Road, Meijiang District, Meizhou, China.
| | - Cunren Li
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
| | - Xianfang Gu
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
| | - Wenfeng Zeng
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
| | - Jiawei Zhong
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
| | - Jingfeng Liu
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
| | - Guopeng Zeng
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
| | - Junxing Zhu
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
| | - Haifeng Hong
- Center for Cardiovascular Diseases, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
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Cheng W, Zhao Q, Li C, Xu Y. Neuroinflammation and brain-peripheral interaction in ischemic stroke: A narrative review. Front Immunol 2023; 13:1080737. [PMID: 36685518 PMCID: PMC9849888 DOI: 10.3389/fimmu.2022.1080737] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023] Open
Abstract
Excessive immune activation within the lesion site can be observed after stroke onset. Such neuroinflammation within the brain parenchyma represents the innate immune response, as well as the result of the additional interactions between peripheral and resident immune cells. Accumulative studies have illustrated that the pathological process of ischemic stroke is associated with resident and peripheral immunity. The infiltration of peripheral immune cells within the brain parenchyma implicitly contributes to secondary brain injuries. Therefore, better understanding of the roles of resident and peripheral immune reactions toward ischemic insult is necessary. In this review, we summarized the interaction between peripheral and resident immunity on systemic immunity and the clinical outcomes after stroke onset and also discussed various potential immunotherapeutic strategies.
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Affiliation(s)
- Wenjing Cheng
- Department of Laboratory Medicine, Linping Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, Zhejiang, China,*Correspondence: Wenjing Cheng,
| | - Qing Zhao
- Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Chengzhen Li
- Department of Laboratory Medicine, Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yunzhi Xu
- Department of Laboratory Medicine, Wenzhou Central Hospital, Affiliated Dingli Clinical Institute of Wenzhou Medical University, Wenzhou, China
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Lan X, Wang Z, Zeng Z, Yao H, Xu W, Zhang Y. Association of Different Combinations of ALDH2 rs671, APOE rs429358, rs7412 Polymorphisms with Hypertension in Middle-Aged and Elderly People: A Case-Control Study. Int J Gen Med 2023; 16:915-927. [PMID: 36938306 PMCID: PMC10017832 DOI: 10.2147/ijgm.s402437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/27/2023] [Indexed: 03/12/2023] Open
Abstract
Background Hypertensive patients have a younger trend, and studies on the role of genetic factors in hypertension susceptibility have been inconsistent. Aldehyde dehydrogenases 2 (ALDH2) and apolipoprotein E (APOE) are involved in the pathophysiological processes of hypertension. To investigate the relationship of ALDH2 and APOE polymorphisms with hypertension in middle-aged (30-59 years old) and elderly (≥60 years old) persons. Methods Two thousand six hundred and ten hypertensive patients and 1921 controls were included (between 30 and 100 years old). The genotypes of common polymorphisms in APOE and ALDH2 genes (APOE rs429358, rs7412, and ALDH2 rs671) of the subjects were analyzed by polymerase-chain reaction (PCR)-microarray. Statistical analyses (Student's t-test, Mann-Whitney U-test, χ 2 test, and logistic regression analysis) were performed with SPSS v21.0. Results There were 4531 participants (66.60 ± 12.10 years old) in this study, including 3057 (67.5%) males and 1474 (32.5%) females. There were no significant differences in distributions of ALDH2 rs671, APOE rs429358/rs7412 genotypes and alleles between hypertensive patients and controls. Persons with ALDH2 rs671 G/A or A/A genotype were less likely to have hypertension (G/A+A/A vs G/G: gender-, age-, smoking-, and drinking-adjusted OR 0.885, 95% CI 0.785-0.997, P=0.045), while ALDH2 rs671 A/A+APOE rs429358 or rs7412 wild-type genotype may decrease the risk of hypertension. In middle-aged group, ALDH2 rs671 G/A+APOE rs429358 T/C carriers (adjusted OR 0.547, 95% CI 0.350-0.856, P=0.008), and ALDH2 rs671 A/A+APOE rs7412 C/C genotypes (adjusted OR 0.567, 95% CI 0.361-0.891, P=0.014) were less likely to have hypertension. In elderly group, APOE rs7412 T/T carriers were more likely to have hypertension (rs671 T/T vs C/C: adjusted OR 4.755, 95% CI 1.075-21.027, P=0.040; rs671 T/T vs C/C or C/T: adjusted OR 4.734, 95% CI 1.071-20.928, P=0.040). Conclusion Polymorphism-polymorphism interactions of ALDH2 rs671 and APOE rs429358/rs7412 may effect on hypertension susceptibility. Different genotypes comparison shows different roles in middle-aged and elderly people, respectively.
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Affiliation(s)
- Xinping Lan
- Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, People’s Republic of China
- Correspondence: Xinping Lan, Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, No. 63 Huangtang Road, Meijiang District, Meizhou, People’s Republic of China, Tel +753-2131-057, Email
| | - Zhenchang Wang
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, People’s Republic of China
- Department of Emergency Medicine, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
| | - Zifeng Zeng
- Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, People’s Republic of China
| | - Huaqing Yao
- Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, People’s Republic of China
| | - Weiyong Xu
- Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, People’s Republic of China
| | - Yuxian Zhang
- Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, People’s Republic of China
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Dong L, Wang L, Jiang C, Li S, Geng M, Xing J, Chang Y, Tian Y, Feng R, Wang T. A case report of posterior reversible encephalopathy syndrome caused by ANCA-associated vasculitis case report and retrospective analysis. Medicine (Baltimore) 2022; 101:e32178. [PMID: 36626496 PMCID: PMC9750626 DOI: 10.1097/md.0000000000032178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Posterior reversible encephalopathy syndrome is a reversible syndrome clinically manifested by significant variations in neuroimaging. Early treatment is indispensable to achieve the reversibility, which requires the punctual alleviation of its inducing factors. PATIENT CONCERNS Most symptoms of posterior reversible encephalopathy syndrome (PRES) patients can be dispelled followed by a good prognosis after the inducement removal. The patient died due to the untimely diagnosis and treatment of the primary disease. Therefore, sufficient attention should be paid to the PRES induced by ANCA-associated vasculitis (AAV). DIAGNOSIS AND INTERVENTIONS The patient is a middle-aged male, with acute onset, previous history of hypertension, cholecystectomy, intestinal obstruction, spontaneous renal rupture, etc. For this complaint, the manifestations are mainly blurred vision with convulsion and transient disturbance of consciousness. In 1 day of treatment, these symptoms were relieved, and he was diagnosed as PRES combined with the cranial imaging. The AAV of the patient was confirmed by spleen pathology. OUTCOMES Despite the relief of most symptoms in 1 day of symptomatic treatment, it is highly likely that the patient eventually died of AAV, it is highly likely that the patient eventually died of AAV which will invade the vascular system due to the failure to treat the primary disease in time. LESSONS For patients diagnosed as PRES, the punctual identification of cause should be performed, so as to diagnose and correct the cause and primary disease as soon as possible, accompanied with the dynamical observation of the relevant indicators for suspected patients to avoid systemic organ failure.
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Affiliation(s)
- Lulu Dong
- Graduate School of Hebei North University, Zhang Jiakou, China
- Department of Neurology, Hebei General Hospital, Shijiazhuang, China
| | - Lulu Wang
- Department of Neurology, Hebei General Hospital, Shijiazhuang, China
- Graduate School of North China University of Science and Technology, Tangshan, China
| | - Chao Jiang
- Graduate School of Hebei North University, Zhang Jiakou, China
- Department of Neurology, Hebei General Hospital, Shijiazhuang, China
| | - Shuang Li
- Graduate School of Hebei North University, Zhang Jiakou, China
- Department of Neurology, Hebei General Hospital, Shijiazhuang, China
| | - Minxia Geng
- Department of Neurology, Hebei General Hospital, Shijiazhuang, China
- Graduate School of North China University of Science and Technology, Tangshan, China
| | - Jiahao Xing
- Department of Neurology, Hebei General Hospital, Shijiazhuang, China
- Hebei Medical University, Shijiazhuang, China
| | - Yajun Chang
- Department of Neurology, Hebei General Hospital, Shijiazhuang, China
| | - Yingying Tian
- Department of Neurology, Hebei General Hospital, Shijiazhuang, China
| | - Rongfang Feng
- Department of Neurology, Hebei General Hospital, Shijiazhuang, China
| | - Tianjun Wang
- Department of Neurology, Hebei General Hospital, Shijiazhuang, China
- * Correspondence: Tianjun Wang, Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, China (e-mail: )
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22
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Yang Y, Li Z, Guo X, Zhou Y, Chang Y, Yang H, Yu S, Ouyang N, Chen S, Sun G, Hua Y, Sun Y. Interventricular Septum Thickness for the Prediction of Coronary Heart Disease and Myocardial Infarction in Hypertension Population: A Prospective Study. J Clin Med 2022; 11:jcm11237152. [PMID: 36498725 PMCID: PMC9738248 DOI: 10.3390/jcm11237152] [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: 10/27/2022] [Revised: 11/16/2022] [Accepted: 11/29/2022] [Indexed: 12/04/2022] Open
Abstract
The aim of the present study was to evaluate the prognostic value of interventricular septum thickness (IVSd) on the incidence of cardiovascular diseases. Based on the general population in Northeast China, 10,349 participants were successfully followed up for echocardiography over a median follow-up time of 4.66 years, among which 4801 were hypertensive. Coronary heart disease (CHD) and myocardial infarction (MI) incidence were followed up. Cox proportional hazards models were used to estimate the association of the baseline IVSd with adverse outcomes. IVS hypertrophy increased incident rates of CHD and MI compared with normal IVSd in the overall population and in the female sex-stratification group. In males, IVS hypertrophy had parallel increase rates of CHD (all p < 0.05). Kaplan−Meier analysis showed that IVS hypertrophy could predict CHD and MI incidence and CHD-free and MI-free survival. Multivariable Cox analysis revealed that IVS hypertrophy was correlated with CHD incidence (HR = 1.155, 95% CI = 1.155−2.861, p = 0.01) and MI incidence (HR = 2.410, 95% CI = 1.303−4.458, p = 0.005). In women, IVS hypertrophy was independently associated with CHD and MI incidence (all p < 0.05). Our prospective cohort study illustrated that IVS hypertrophy detected by echocardiography has a prognostic significance for CHD and MI. Therefore, the early detection of IVSd should be conducted to avoid adverse outcomes in further clinical practice.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Yu Hua
- Correspondence: (Y.H.); (Y.S.); Tel.: +86-24-83282688 (Y.S.)
| | - Yingxian Sun
- Correspondence: (Y.H.); (Y.S.); Tel.: +86-24-83282688 (Y.S.)
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Abstract
The incidence and mortality rates of stroke in China are higher than the world average, seriously endangering the public's health and quality of life. It is important to predict the incidence of stroke, identify the high-risk factors in the region, and raise the risk awareness of high-risk groups. This study sought to investigate and analyze the distribution of stroke population and the main risk factors for stroke occurrence in a Chinese population, and to predict the probability of stroke occurrence in high-risk groups with risk factors, so as to provide a scientific basis for the comprehensive prevention and treatment of stroke. A whole-group sampling method was used to investigate 1009 participants in Jingzhou city in central China, and a uniform questionnaire survey and related medical examinations were conducted. The risk factors for stroke in the area were analyzed by univariate analysis, and a multifactorial logistic regression prediction model was established based on the results of univariate analysis. The results of univariate and multifactorial logistic regression analyses suggested that gender, age, family history of stroke, hypertension, atrial fibrillation, diabetes, and sedentary lifestyle were significantly associated with an increased risk of stroke in the local population (all P < .05). The top 5 risk factors for stroke were atrial fibrillation (odds ratio [OR] = 5.225, 95% confidence interval [CI]: 2.826-9.663), sedentary lifestyle (OR = 2.701, 95% CI: 1.667-4.376), age (≥65 years) (OR = 2.593, 95% CI: 1.680-4.004), hypertension (OR = 2.106, 95% CI: 1.380-3.216), and gender (male) (OR = 2.099, 95% CI: 1.270-3.471). This study effectively identifies the high risk factors for stroke and provides scientific insights for risk assessment, intervention of risk factors, and decision making of health management departments in the central region of China. The modifable risk factors for stroke such as smoking, hypertension, atrial fibrillation, diabetes mellitus, and sedentary lifestyle were also observed. Our findings further highlight the significant of the primary and secondary prevention for stroke and reveal the potential targets to reduce the heavy stroke burden in China around the world.
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Affiliation(s)
- Honglian Wang
- Department of Stroke Center, The First Affiliated Hospital of Yangtze University, Jingzhou First People’s Hospital, Jingzhou, Hubei, China
| | - Mingcan Wu
- Department of Neurosurgery, The First Affiliated Hospital of Yangtze University, Jingzhou First People’s Hospital, Jingzhou, Hubei, China
| | - Qingfen Tu
- Department of Stroke Center, The First Affiliated Hospital of Yangtze University, Jingzhou First People’s Hospital, Jingzhou, Hubei, China
- * Correspondence: Maokun Li, Department of Neurosurgery, The First Affiliated Hospital of Yangtze University, Jingzhou First People’s Hospital, Jingzhou, Hubei, China (e-mail: ); Qingfen Tu, Department of Stroke Center, The First Affiliated Hospital of Yangtze University, Jingzhou First People’s Hospital, Jingzhou, Hubei, China (e-mail: )
| | - Maokun Li
- Department of Neurosurgery, The First Affiliated Hospital of Yangtze University, Jingzhou First People’s Hospital, Jingzhou, Hubei, China
- * Correspondence: Maokun Li, Department of Neurosurgery, The First Affiliated Hospital of Yangtze University, Jingzhou First People’s Hospital, Jingzhou, Hubei, China (e-mail: ); Qingfen Tu, Department of Stroke Center, The First Affiliated Hospital of Yangtze University, Jingzhou First People’s Hospital, Jingzhou, Hubei, China (e-mail: )
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Epigenetic Mechanisms Involved in Inflammaging-Associated Hypertension. Curr Hypertens Rep 2022; 24:547-562. [PMID: 35796869 DOI: 10.1007/s11906-022-01214-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW This review summarizes the involvement of inflammaging in vascular damage with focus on the epigenetic mechanisms by which inflammaging-induced hypertension is triggered. RECENT FINDINGS Inflammaging in hypertension is a complex condition associated with the production of inflammatory mediators by the immune cells, enhancement of oxidative stress, and tissue remodeling in vascular smooth muscle cells and endothelial cells. Cellular processes are numerous, including inflammasome assembly and cell senescence which may involve mitochondrial dysfunction, autophagy, DNA damage response, dysbiosis, and many others. More recently, a series of noncoding RNAs, mainly microRNAs, have been described as possessing epigenetic actions on the regulation of inflammasome-related hypertension, emerging as a promising therapeutic strategy. Although there are a variety of pharmacological agents that effectively regulate inflammaging-related hypertension, a deeper understanding of the epigenetic events behind the control of vessel deterioration is needed for the treatment or even to prevent the disease onset.
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Wang XB, Dong H, Qiu YG, Lou CC, Huang DY, Zhang J, Chen DH, Feng H, Fang X. Nomogram based on clinical and brain computed tomography characteristics for predicting more than 5 cerebral microbleeds in the hypertensive population. Front Neurol 2022; 13:955378. [PMID: 36237620 PMCID: PMC9551650 DOI: 10.3389/fneur.2022.955378] [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: 05/28/2022] [Accepted: 09/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Cerebral microbleeds (CMBs) are common in the hypertensive population and can only be detected with magnetic resonance imaging (MRI). The anticoagulation and thrombolytic regimens for patients with >5 CMBs are different from those for patients with ≤ 5 CMBs. However, MRI is not suitable for evaluating CMBs in patients with MRI contraindications or acute ischemic stroke urgently requiring thrombolysis. We aimed to develop and validate a nomogram combining clinical and brain computed tomography (CT) characteristics for predicting >5 CMBs in a hypertensive population. Materials and methods In total, 160 hypertensive patients from 2016 to 2020 who were confirmed by MRI to have >5 (77 patients) and ≤ 5 CMBs (83) were retrospectively analyzed as the training cohort. Sixty-four hypertensive patients from January 2021 to February 2022 were included in the validation cohort. Multivariate logistic regression was used to evaluate >5 CMBs. A combined nomogram was constructed based on the results, while clinical and CT models were established according to the corresponding characteristics. Receiver operating characteristic (ROC) and calibration curves and decision curve analysis (DCA) were used to verify the models. Results In the multivariable analysis, the duration of hypertension, level of homocysteine, the number of lacunar infarcts (LIs), and leukoaraiosis (LA) score were included as factors associated with >5 CMBs. The clinical model consisted of the duration of hypertension and level of homocysteine, while the CT model consisted of the number of LIs and LA. The combined model consisted of the duration of hypertension, level of homocysteine, LI, and LA. The combined model achieved an area under the curve (AUC) of 0.915 (95% confidence interval [CI]: 0.860–0.953) with the training cohort and 0.887 (95% CI: 0.783–0.953) with the validation cohort, which were higher than those of the clinical model [training cohort: AUC, 0.797 (95% CI: 0.726, 0.857); validation cohort: AUC, 0.812 (95% CI: 0.695, 0.899)] and CT model [training cohort: AUC, 0.884 (95% CI: 0.824, 0.929); validation cohort: AUC, 0.868 (95% CI: 0.760, 0.940)]. DCA showed that the clinical value of the combined model was superior to that of the clinical model and CT model. Conclusion A combined model based on clinical and CT characteristics showed good diagnostic performance for predicting >5 CMBs in hypertensive patients.
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Affiliation(s)
- Xin-Bin Wang
- Department of Radiology, Xiaoshan Affiliated Hospital of Wenzhou Medical University, The First People's Hospital of Xiaoshan District, Hangzhou, China
| | - Hao Dong
- Department of Radiology, Xiaoshan Affiliated Hospital of Wenzhou Medical University, The First People's Hospital of Xiaoshan District, Hangzhou, China
| | - Yong-Gang Qiu
- Department of Radiology, Xiaoshan Affiliated Hospital of Wenzhou Medical University, The First People's Hospital of Xiaoshan District, Hangzhou, China
| | - Cun-Cheng Lou
- Department of Radiology, Xiaoshan Affiliated Hospital of Wenzhou Medical University, The First People's Hospital of Xiaoshan District, Hangzhou, China
| | - De-Yun Huang
- Department of Cardiology, Xiaoshan Affiliated Hospital of Wenzhou Medical University, The First People's Hospital of Xiaoshan District, Hangzhou, China
| | - Jing Zhang
- Department of Cardiology, Xiaoshan Affiliated Hospital of Wenzhou Medical University, The First People's Hospital of Xiaoshan District, Hangzhou, China
| | - Di-Hong Chen
- Department of Radiology, Xiaoshan Affiliated Hospital of Wenzhou Medical University, The First People's Hospital of Xiaoshan District, Hangzhou, China
| | - Han Feng
- Department of Radiology, Xiaoshan Affiliated Hospital of Wenzhou Medical University, The First People's Hospital of Xiaoshan District, Hangzhou, China
| | - Xu Fang
- Department of Radiology, Changhai Hospital, Shanghai, China
- *Correspondence: Xu Fang
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Brain Bioenergetics in Chronic Hypertension: Risk Factor for Acute Ischemic Stroke. Biochem Pharmacol 2022; 205:115260. [PMID: 36179931 DOI: 10.1016/j.bcp.2022.115260] [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: 07/30/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/23/2022]
Abstract
Chronic hypertension is one of the key modifiable risk factors for acute ischemic stroke, also contributing to determine greater neurological deficits and worse functional outcome when an acute cerebrovascular event would occur. A tight relationship exists between cerebrovascular autoregulation, neuronal activity and brain bioenergetics. In chronic hypertension, progressive adaptations of these processes occur as an attempt to cope with the demanding necessity of brain functions, creating a new steady-state homeostatic condition. However, these adaptive modifications are insufficient to grant an adequate response to possible pathological perturbations of the established fragile hemodynamic and metabolic homeostasis. In this narrative review, we will discuss the main mechanisms by which alterations in brain bioenergetics and mitochondrial function in chronic hypertension could lead to increased risk of acute ischemic stroke, stressing the interconnections between hemodynamic factors (i.e. cerebral autoregulation and neurovascular coupling) and metabolic processes. Both experimental and clinical pieces of evidence will be discussed. Moreover, the potential role of mitochondrial dysfunction in determining, or at least sustaining, the pathogenesis and progression of chronic neurogenic hypertension will be considered. In the perspective of novel therapeutic strategies aiming at improving brain bioenergetics, we propose some determinant factors to consider in future studies focused on the cause-effect relationships between chronic hypertension and brain bioenergetic abnormalities (and vice versa), so to help translational research in this so-far unfilled gap.
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Liu P, Wei D, Nie L, Fan K, Xu Q, Wang L, Wang J, Song Y, Wang M, Liu X, Hou J, Yu S, Li L, Wang C, Huo W, Fan C, Mao Z. The correlation between testosterone and stroke and the mediating role of blood pressure: The Henan rural cohort study. J Stroke Cerebrovasc Dis 2022; 31:106669. [PMID: 35985144 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106669] [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: 04/22/2022] [Revised: 06/27/2022] [Accepted: 07/17/2022] [Indexed: 10/15/2022] Open
Abstract
AIMS We aimed to investigate the association of serum testosterone with stroke and calculate the proportion explained by blood pressure on this association. MATERIALS AND METHODS A total of 6175 subjects were included in this study. Serum testosterone was quantified by liquid chromatography-tandem mass spectrometry. The logistic regression model was used to evaluate the association between serum testosterone and stroke. Linear regression analysis was used to assess the associations of serum testosterone with blood pressure. In addition, mediation analysis was performed to identify the mediation effects of blood pressure on the association of serum testosterone with stroke. Sex-stratified analysis was employed throughout the research. RESULTS After adjusting for multiple variables, serum testosterone levels were negatively associated with stroke in males (per 1 unit natural log-transformed, odds ratio (OR) = 0.81, 95% confidence interval (CI): 0.69-0.94; Tertile 3 vs Tertile 1, OR = 0.65, 95% CI:0.44-0.96). Furthermore, blood pressure played a partial mediating role in the relationship between testosterone and stroke in males. The indirect effect/total effect of systolic blood pressure, diastolic blood pressure and mean arterial pressure were 7.37%, 9.54% and 9.22%, respectively. Notably, the relationship between testosterone and stroke and the role of blood pressure in regulating them was not observed in females. CONCLUSION This study describes that in rural Chinese males, testosterone can reduce the risk of stroke by affecting blood pressure. To some extent, we provide a new epidemiological evidence for the relationship between testosterone and stroke.
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Affiliation(s)
- Pengling Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Dandan Wei
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Luting Nie
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Keliang Fan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Qingqing Xu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Lulu Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Juan Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yu Song
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Mian Wang
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Songcheng Yu
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Linlin Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Caini Fan
- Department of Hypertension, Henan Provincial People's Hospital, Zhengzhou University People's Hospital,Henan University People's Hospital, Zhengzhou 450003, China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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rs2253820 Variant Controls Blood Pressure Dip After Stroke by Increasing CLOCK–BMAL1 Expression. Transl Stroke Res 2022:10.1007/s12975-022-01063-y. [DOI: 10.1007/s12975-022-01063-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/01/2022] [Accepted: 07/06/2022] [Indexed: 10/16/2022]
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Liu B, Liu X, Wang Y, Dong X, Liao W, Huo W, Hou J, Li L, Wang C. Body Mass Index Mediates the Relationship between the Frequency of Eating Away from Home and Hypertension in Rural Adults: A Large-Scale Cross-Sectional Study. Nutrients 2022; 14:nu14091832. [PMID: 35565797 PMCID: PMC9104948 DOI: 10.3390/nu14091832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/17/2022] [Accepted: 04/25/2022] [Indexed: 12/21/2022] Open
Abstract
This study was conducted to investigate the association of eating away from home (EAFH) frequency with hypertension and to explore whether the association was mediated by BMI. A total of 29,611 participants were selected from the Henan Rural Cohort Study. Data on the frequency of EAFH were obtained by face-to-face questionnaires. The relationship between EAFH frequency and blood pressure was evaluated by linear regression. Logistic regression and restricted cubic spline were used to assess the association between EAFH frequency and hypertension, and the mediation effect of BMI on the relationship was performed. There were pronounced associations between the frequency of EAFH and blood pressure (P trend < 0.001) in the total population and men. Compared with the population with 0 times EAFH per week, the multivariate odds ratios (ORs) and 95% confidence intervals (95% CIs) for hypertension of the group with 7 times or more EAFH per week were 1.673 (1.482−1.889) for the total population and 1.634 (1.413−1.890) for men. A nonlinear dose-response relationship was detected between the frequency of EAFH and hypertension (p < 0.001), and the relationship was partially mediated by BMI. The proportion explained was 21.3% in the total population and 25.4% in men. The current study indicated that EAFH was associated with rising blood pressure and increased risk of hypertension and BMI partially mediated the relationship.
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Hu F, Hu L, Yu R, Han F, Zhou W, Wang T, Zhu L, Huang X, Bao H, Cheng X. Prospective Study of Serum Uric Acid Levels and First Stroke Events in Chinese Adults With Hypertension. Front Physiol 2022; 12:807420. [PMID: 35002779 PMCID: PMC8733595 DOI: 10.3389/fphys.2021.807420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 11/29/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives: We investigated the association between serum uric acid (SUA) levels and the risk of the first stroke in Chinese adults with hypertension. Methods: A total of 11, 841 hypertensive patients were selected from the Chinese Hypertension Registry for analysis. The relationship between SUA levels and first stroke was determined using multivariable Cox proportional hazards regression, smoothing curve fitting, and Kaplan–Meier survival curve analysis. Results: During a median follow-up of 614 days, 99 cases of the first stroke were occurred. Cox proportional hazards models indicated that SUA levels were not significantly associated with the first stroke event [adjusted-hazard ratio (HR) per SD increase: 0.98, 95% CI 0.76–1.26, P = 0.889]. In comparison to the group without hyperuricemia (HUA), there were no significantly higher risks of first stroke events (adjusted-HR: 1.22, 95% CI 0.79–1.90, P = 0.373) in the population with HUA. However, in the population less than 60 years old, subjects with HUA had a significantly higher risk of the first stroke than the population without HUA (adjusted-HR: 4.89, 95% CI 1.36–17.63, P = 0.015). In subjects older than 60 years, we did not find a significant relationship between HUA and first stroke (adjusted-HR: 0.97, 95% CI 0.60–1.56, P = 0.886). Survival analysis further confirmed this discrepancy (log-rank P = 0.013 or 0.899 for non-aging or aging group). Conclusion: No significant evidence in the present study indicated that increased SUA levels were associated with the risk of first stroke in the Chinese adults with hypertension. Age played an interactive role in the relationship between HUA and the first stroke event.
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Affiliation(s)
- Feng Hu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
| | - Longlong Hu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
| | - Rihua Yu
- Department of General Practice Medicine, Xucun Town Health Center, Wuyuan, China
| | - Fengyu Han
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
| | - Wei Zhou
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China.,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Tao Wang
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China.,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Linjuan Zhu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China.,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiao Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China.,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China.,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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Ma Y, Wang M, Chen X, Ruan W, Yao J, Lian X. Daytime sleepiness and risk of stroke: A Mendelian randomization analysis. Clin Neurol Neurosurg 2021; 208:106857. [PMID: 34364029 DOI: 10.1016/j.clineuro.2021.106857] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/25/2021] [Accepted: 07/29/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Daytime sleepiness is known to be related to stroke, but whether daytime sleepiness is a risk factor for stroke remains unclear. We conducted a two-sample Mendelian randomization study to assess the relationship between daytime sleepiness and stroke, ischemic stroke (IS) and IS subtypes. METHODS Thirty-six single-nucleotide polymorphisms (SNPs) associated with daytime sleepiness were selected as instrumental variables, which were identified from a recent genome-wide association study(N = 452,071). Summary statistics of the SNPs on stroke, IS and IS subtypes were derived from the MEGASTROKE consortium with 40,585 stroke cases and 406,111 controls. RESULTS We found that daytime sleepiness was associated with large artery stroke (OR, 6.75; 95%CI, 1.49-30.57; p = 0.013), but not with all stroke (OR, 1.29; 95%CI, 0.81-2.05; p = 0.282), all ischemic stroke(OR, 1.46; 95%CI, 0.90-2.39; p = 0.136), cardioembolic stroke(OR, 1.0; 95%CI, 0.39-2.64; p = 0.984), or small artery stroke(OR, 1.52; 95%CI, 0.46-5.05; p = 0.485). CONCLUSION Our findings indicated that daytime sleepiness is causally associated with an increased risk of large artery stroke. Further studies are necessary to verify our results and explain the physiological mechanisms.
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Affiliation(s)
- Yazhou Ma
- Department of Neurology, Third Affiliated Hospital, Soochow University, Changzhou 213003, China
| | - Mengmeng Wang
- Department of Neurology, Third Affiliated Hospital, Soochow University, Changzhou 213003, China
| | - Xin Chen
- Department of Neurology, Third Affiliated Hospital, Soochow University, Changzhou 213003, China
| | - Wang Ruan
- Department of Neurology, Third Affiliated Hospital, Soochow University, Changzhou 213003, China
| | - Jianrong Yao
- Department of Neurology, Third Affiliated Hospital, Soochow University, Changzhou 213003, China
| | - Xuegan Lian
- Department of Neurology, Third Affiliated Hospital, Soochow University, Changzhou 213003, China.
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Cao Z, Li S, Yang H, Xu C, Zhang Y, Yang X, Yan T, Liu T, Wang Y. Associations of behaviors, biological phenotypes and cardiovascular health with risks of stroke and stroke subtypes: A prospective cohort study. EClinicalMedicine 2021; 33:100791. [PMID: 33842871 PMCID: PMC8020159 DOI: 10.1016/j.eclinm.2021.100791] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/20/2021] [Accepted: 02/23/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Although many cardiovascular risk factors for stroke have been reported before, it has not been investigated comprehensively for all major stroke types in large datasets. This study aimed to evaluate the associations of healthy behaviors, biological phenotypes and cardiovascular health (CVH) with long-term risks of strokes events, overall and stroke subtypes (ischemic stroke [IS], intracerebral hemorrhage [ICH], subarachnoid hemorrhage [SAH], and unspecified stroke). METHODS Between 2006 and 2010, a total of 354,976 participants (age 40-70 years) in the UK Biobank free of stroke and coronary heart disease were examined and thereafter followed up to 2020. According to American Heart Association guideline, the global CVH included four behavioral (smoking, diet, physical activity, body mass index) and three biological (blood glucose, blood cholesterol, blood pressure) metrics. The behavioral, biological and global CVH score was the sum of four, three, and seven metrics, respectively, and then was categorized into poor, intermediate and ideal group. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of stroke events. FINDINGS A total of 5804 incident stroke cases, including 3664 IS, 714 ICH and 453 SAH, were documented over a median follow-up of 11 years. The risk of stroke decreased significantly and linearly with both increasing behavioral CVH score and biological CVH score. Ideal behavioral CVH group was significantly associated with lower risks of all stroke subtypes, biological CVH was related to stroke events except for SAH. Additionally, the 1-point increment in global CVH score was associated with 11%,13%, 8% and 13% lower risks of stroke, IS, ICH and unspecified stroke, however, there was no significant dose-dependent association between global CVH and SAH. INTERPRETATION Our findings suggest inverse linear associations of behavioral, biological and global CVH with long-term risks of stroke and stroke subtypes, except for SAH, highlighting the benefits of maintaining better CVH status as a primordial prevention strategy of stroke. FUNDING The National Natural Science Foundation of China (71,910,107,004, 91,746,205).
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Affiliation(s)
- Zhi Cao
- School of Public Health, Tianjin Medical University, Tianjin, China
- Department of Big Data in Health Science, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Shu Li
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Hongxi Yang
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Chenjie Xu
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuan Zhang
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xueli Yang
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Tao Yan
- Department of Neurology, Tianjin Neurological and Gerontology Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Tong Liu
- Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Tianjin, China
- Corresponding author.
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