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Fu Y, Xu C, Wu G. Dietary niacin Intake and its association with all-cause and cardiovascular mortality rates in individuals with metabolic syndrome. Nutr J 2024; 23:90. [PMID: 39123223 PMCID: PMC11316429 DOI: 10.1186/s12937-024-00993-7] [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: 05/18/2024] [Accepted: 08/02/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Individuals with metabolic syndrome face elevated cardiovascular and mortality risks, and there is ongoing debate regarding the cardiovascular effects of niacin and its impact on the prognosis of metabolic syndrome. EXPOSURE Levels of dietary niacin intake based on 24-hour dietary recall. METHODS Kaplan-Meier survival curves were used to compare survival status among quartiles of dietary niacin intake. Weighted Cox proportional hazards models and restricted cubic splines were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of all-cause and CVD mortality associated with the exposure. RESULTS This cohort study included 8,744 participants, and during a median follow-up period of 106 months, 1,552 (17.7%) deaths were recorded, with 511 attributed to cardiovascular disease. Kaplan-Meier curves comparing quartiles of dietary niacin intake showed significant differences in both all-cause and cardiovascular mortality rates (log-rank p < 0.001). In the fully adjusted model, the highest quartile of dietary niacin intake was associated with HRs of 0.68 (95% CI: 0.54, 0.87, P = 0.002) for all-cause mortality and 0.63 (95% CI: 0.39, 0.78, P < 0.001) for cardiovascular mortality. CONCLUSION The results of this cohort study suggest that higher dietary niacin intake is associated with reduced cardiovascular and all-cause mortality risks in the metabolic syndrome population. Furthermore, there appears to be a dose-response relationship between dietary niacin intake and the risks of all-cause and cardiovascular mortality.
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Affiliation(s)
- Yuqing Fu
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518000, Guangdong, China
| | - Cong Xu
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518000, Guangdong, China
| | - Guifu Wu
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518000, Guangdong, China.
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Kim M, Basharat A, Santosh R, Mehdi SF, Razvi Z, Yoo SK, Lowell B, Kumar A, Brima W, Danoff A, Dankner R, Bergman M, Pavlov VA, Yang H, Roth J. Reuniting overnutrition and undernutrition, macronutrients, and micronutrients. Diabetes Metab Res Rev 2019; 35:e3072. [PMID: 30171821 DOI: 10.1002/dmrr.3072] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/20/2018] [Accepted: 08/26/2018] [Indexed: 12/15/2022]
Abstract
Over-nutrition and its late consequences are a dominant theme in medicine today. In addition to the health hazards brought on by over-nutrition, the medical community has recently accumulated a roster of health benefits with obesity, grouped under "obesity paradox." Throughout the world and throughout history until the 20th century, under-nutrition was a dominant evolutionary force. Under-nutrition brings with it a mix of benefits and detriments that are opposite to and continuous with those of over-nutrition. This continuum yields J-shaped or U-shaped curves relating body mass index to mortality. The overweight have an elevated risk of dying in middle age of degenerative diseases while the underweight are at increased risk of premature death from infectious conditions. Micronutrient deficiencies, major concerns of nutritional science in the 20th century, are being neglected. This "hidden hunger" is now surprisingly prevalent in all weight groups, even among the overweight. Because micronutrient replacement is safe, inexpensive, and predictably effective, it is now an exceptionally attractive target for therapy across the spectrum of weight and age. Nutrition-related conditions worthy of special attention from caregivers include excess vitamin A, excess vitamin D, and deficiency of magnesium.
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Affiliation(s)
- Miji Kim
- Laboratory of Diabetes and Diabetes-Related Disorders, The Feinstein Institute for Medical Research, Northwell Health, New York, USA
| | - Anam Basharat
- Laboratory of Diabetes and Diabetes-Related Disorders, The Feinstein Institute for Medical Research, Northwell Health, New York, USA
| | - Ramchandani Santosh
- Laboratory of Diabetes and Diabetes-Related Disorders, The Feinstein Institute for Medical Research, Northwell Health, New York, USA
| | - Syed F Mehdi
- Laboratory of Diabetes and Diabetes-Related Disorders, The Feinstein Institute for Medical Research, Northwell Health, New York, USA
| | - Zanali Razvi
- Laboratory of Diabetes and Diabetes-Related Disorders, The Feinstein Institute for Medical Research, Northwell Health, New York, USA
| | - Sun K Yoo
- Laboratory of Diabetes and Diabetes-Related Disorders, The Feinstein Institute for Medical Research, Northwell Health, New York, USA
| | - Barbara Lowell
- Laboratory of Diabetes and Diabetes-Related Disorders, The Feinstein Institute for Medical Research, Northwell Health, New York, USA
| | - Amrat Kumar
- Laboratory of Diabetes and Diabetes-Related Disorders, The Feinstein Institute for Medical Research, Northwell Health, New York, USA
| | - Wunnie Brima
- Laboratory of Diabetes and Diabetes-Related Disorders, The Feinstein Institute for Medical Research, Northwell Health, New York, USA
- Department of Medicine, Albert Einstein College of Medicine, New York, USA
| | - Ann Danoff
- Department of Medicine, Cpl. Michael J Crescenz Veterans Administration Medical Center, Philadelphia, PA, USA
| | - Rachel Dankner
- Department of Epidemiology and Preventive Medicine, School of Public Health, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michael Bergman
- Department of Medicine, Division of Endocrinology, NYU School of Medicine, New York, NY, USA
| | - Valentin A Pavlov
- Laboratory of Diabetes and Diabetes-Related Disorders, The Feinstein Institute for Medical Research, Northwell Health, New York, USA
- Center for Biomedical Science and Center for Bioelectric Medicine, The Feinstein Institute for Medical Research, Northwell Health, New York, USA
| | - Huan Yang
- Laboratory of Diabetes and Diabetes-Related Disorders, The Feinstein Institute for Medical Research, Northwell Health, New York, USA
- Center for Biomedical Science and Center for Bioelectric Medicine, The Feinstein Institute for Medical Research, Northwell Health, New York, USA
| | - Jesse Roth
- Laboratory of Diabetes and Diabetes-Related Disorders, The Feinstein Institute for Medical Research, Northwell Health, New York, USA
- Department of Medicine, Albert Einstein College of Medicine, New York, USA
- Center for Biomedical Science and Center for Bioelectric Medicine, The Feinstein Institute for Medical Research, Northwell Health, New York, USA
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Harmon S, Inkielewicz-Stepniak I, Jones M, Ledwidge M, Santos-Martinez MJ, Medina C, Radomski MW, Gilmer JF. Mechanisms of aggregation inhibition by aspirin and nitrate-aspirin prodrugs in human platelets. J Pharm Pharmacol 2011; 64:77-89. [DOI: 10.1111/j.2042-7158.2011.01380.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Abstract
Objectives
Aspirin is the mainstay of anti-platelet therapy in the secondary prevention of cardiovascular disease. However, problems with aspirin safety and resistance demand clinical strategies based on multiple pharmacological approaches. Prodrugs of aspirin may offer beneficial effects in terms of gastro-intestinal safety and multiple pharmacological approaches. However, the pharmacological profile of aspirin prodrugs in human platelets has not been completed yet. We aimed to compare the effects of aspirin and prodrugs of aspirin (1–5) on human platelet aggregation stimulated by ADP and collagen and associated receptor expression (GPIIb/IIIa and P-selectin) in platelet-rich plasma (PRP) and washed platelets (WP).
Methods
As aspirin is released from prodrugs following esterase hydrolysis we studied the expression and activity of butyrylcholineterase (BuChE) and carboxyesterase (CE) in plasma and platelets. The mechanism of prodrug-induced platelet aggregation inhibition was explored by studying the effects of plasma and purified human BuChE on aggregation. Finally, the relative contribution of nitric oxide (NO) bioactivity to nitrate-containing prodrugs of aspirin-induced inhibition of aggregation was determined using 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ,) a selective inhibitor of the soluble guanylyl cyclase.
Key findings
ST0702, 2, a nicotinic acid-aspirin codrug was equipotent with aspirin with respect to inhibition of collagen-induced platelet aggregation. Compound 4, a NO releasing aspirin was the most potent inhibitor of ADP-induced platelet aggregation, an effect partially reversed by ODQ. The platelet inhibitory effects of aspirin prodrugs were time-dependent as the maximal inhibitory effects against collagen-induced aggregation were achieved by aspirin at 2 min, 1 at 5 min and ST0702 at 15 min. The aspirin prodrugs were significantly less potent in WP than in PRP and the reverse was true of aspirin. In the presence of complete BuChE inhibition in PRP, there was almost complete loss of aspirin prodrug, but not aspirin anti-aggregatory activity. Interestingly, CE activity was observed in WP and platelet lysate with pNPA substrate. Accordingly, 1 and ST0702 retained 50% and 100% anti-aggregatory activity at maximal concentrations in WP, which was attenuated in the presence of esterase inhibitor phenylmethylsulphonyl fluoride.
Conclusions
The inhibitory effect of aspirin prodrugs in PRP is due to prodrug activation by BuChE. In contrast, the platelet-inhibitory effects of aspirin prodrugs in WP may be mediated through the activity of platelet CE. Compound 4, a NO-containing aspirin prodrug, may exert dual inhibitory effects in platelets. Thus, aspirin prodrugs effectively inhibit human platelet aggregation and as such may be an alternative to conventional aspirin.
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Affiliation(s)
- Shona Harmon
- School of Pharmacy and Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | | | - Michael Jones
- School of Pharmacy and Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | - Mark Ledwidge
- School of Medicine and Medical Science, University College, Dublin, Ireland
| | | | - Carlos Medina
- School of Pharmacy and Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | - Marek W Radomski
- School of Pharmacy and Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | - John F Gilmer
- School of Pharmacy and Pharmaceutical Sciences, Trinity College, Dublin, Ireland
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