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Cui P, Hou H, Song B, Xia Z, Xu Y. Vitamin D and ischemic stroke - Association, mechanisms, and therapeutics. Ageing Res Rev 2024; 96:102244. [PMID: 38395199 DOI: 10.1016/j.arr.2024.102244] [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: 08/17/2023] [Revised: 02/07/2024] [Accepted: 02/19/2024] [Indexed: 02/25/2024]
Abstract
Confronting the rising tide of ischemic stroke and its associated mortality and morbidity with ageing, prevention and acute management of ischemic stroke is of paramount importance. Mounting observational studies have established a non-linear association of vitamin D status with cardiovascular diseases, including ischemic stroke. Paradoxically, current clinical trials fail to demonstrate the cardiovascular benefits of vitamin D supplementation. We aim to update recent clinical and experimental findings on the role of vitamin D in the disease course of ischemic stroke, from its onset, progression, recovery, to recurrence, and the established and alternative possible pathophysiological mechanisms. This review justifies the necessities to address stroke etiological subtypes and focus on vitamin D-deficient subjects for investigating the potential of vitamin D supplementation as a preventive and therapeutic approach for ischemic stroke. Well-powered clinical trials are warranted to determine the efficacy, safety, timing, target individuals, optimal dosages, and target 25OHD concentrations of vitamin D supplementation in the prevention and treatment of ischemic stroke.
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Affiliation(s)
- Pan Cui
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China; NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, China; Clinical Systems Biology Laboratories, Translation Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China
| | - Haiman Hou
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Bo Song
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China; NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, China
| | - Zongping Xia
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China; NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, China; Clinical Systems Biology Laboratories, Translation Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China.
| | - Yuming Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China; NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, China; Henan Key Laboratory of Cerebrovascular Diseases, Zhengzhou University, Zhengzhou, Henan, China.
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Valapala VNG, Dasari N, Kolli VK, Mandapaka M. Impact of 25-hydroxy vitamin D levels in severe acute respiratory syndrome coronavirus 2 patients with respect to clinical and biochemical profile: An experience from a tertiary care hospital. Clin Nutr ESPEN 2024; 60:187-194. [PMID: 38479909 DOI: 10.1016/j.clnesp.2024.01.021] [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: 07/06/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION Among the many micronutrients, Vitamin D deficiency has been associated with the severity of Severe Acute Respiratory Syndrome Coronavirus 2 patients. DESIGN AND METHODS A retrospective observational study was conducted on Severe acute respiratory syndrome coronavirus 2 patients admitted to a tertiary care hospital between April 5, 2021, and May 5, 2021. RESULTS Among 285 patients,77.2 % of the patients who stayed for more than 14 days were either Vitamin D insufficient or deficient [P value < 0.05]. In our study, the mean oxygen saturation at admission was 85.7 % in the Vitamin D deficiency group compared to 95.6 % in Vitamin D sufficiency patients [P value < 0.05]. Mean serum ferritin was 398 ng/ml in the Vitamin D deficiency group compared to 393 ng/ml in Vitamin D sufficiency patients [P value > 0.05]. The mean C-reactive protein was 107.6 mg/ml in the Vitamin D deficiency group compared to 21.8 ng/ml in Vitamin D sufficiency patients [P value < 0.05]. The mean D-Dimer was 2268 ng/ml in the Vitamin D deficiency group compared to 781 ng/ml in Vitamin D sufficiency patients [P value < 0.05]. In the non-survivor group,97.4 % were Vitamin D deficient and insufficient. Only 2 % of the patients who survived were Vitamin D deficient [P value < 0.05]. CONCLUSION We observed that low 25-hydroxy Vitamin D levels were associated with lower oxygen saturation and higher acute physiology and chronic health evaluation II scores, requiring a more extended stay in the hospital. C-reactive protein and D-dimers were significantly higher in Vitamin D deficient patients, suggesting severe disease. We did not find statistically significant findings in the case of the correlation of serum ferritin levels with Vitamin D status.
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Affiliation(s)
- Venkat Narayana Goutham Valapala
- Department of General Medicine, GITAM Institute of Medical Sciences and Research, GITAM (Deemed to be University), Visakhapatnam, 530045, India
| | - Nikhila Dasari
- Department Of Respiratory Medicine, GITAM Institute of Medical Sciences and Research, GITAM (Deemed To Be University), Visakhapatnam, 530045, India
| | - Viswa Kalyan Kolli
- Department of Biochemistry, GITAM Institute of Medical Sciences and Research, GITAM (Deemed to be University), Visakhapatnam, 530045, India.
| | - Murty Mandapaka
- Department of General Medicine, GITAM Institute of Medical Sciences and Research, GITAM (Deemed to be University), Visakhapatnam, 530045, India
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Huang L, Wang A, Wu Z, Chen S, Zheng Y, Wu S, Gao X. Life's essential 8 and risk of all-cause mortality in individuals with cardiovascular diseases: A prospective community-based study. Clin Cardiol 2024; 47:e24119. [PMID: 37994466 PMCID: PMC10823447 DOI: 10.1002/clc.24119] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/24/2023] [Accepted: 08/01/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Although risk factors for mortality in individuals with cardiovascular diseases (CVD) have been reported, little is known regarding the association between the comprehensive cardiovascular health (CVH) index assessed by life's essential 8 (LE8) and the risk of mortality. HYPOTHESIS The aim of this study was to evaluate the CVH assessed by LE8 and risk of mortality in individuals with CVD. METHODS A total of 1391 participants with CVD diagnosed before 2014 from the Kailuan cohort were included in the analysis. The CVH score ranged from 0 to 100 was assessed using the LE8 metrics (diet quality, physical activity, sleep health, cigarette smoking, body mass index, lipids, blood glucose, and blood pressure). Cox regression model was used to estimate the association between the CVH score and risk of all-cause mortality. RESULTS During a mean follow-up of 6.1 ± 1.5 years, 229 deaths occurred. The hazard ratio for all-cause mortality was 0.57 (95% confidence interval [CI]: 0.38, 0.84) in the highest quartiles compared with the lowest quartiles of CVH scores and 0.85 (95% CI: 0.75, 0.95) for each 10 points increment in CVH scores (ptrend = .009), after adjustment for age, sex, CVD duration, social-economic status, alcohol consumption, inflammation, medicine use, and kidney function. We did not observe significant interactions between the CVH scores and age, sex, and duration of CVD diagnosis (pinteraction > .05 for all). CONCLUSIONS The CVH assessed by the LE8 metrics was associated with a lower risk of all-cause mortality in individuals with CVD.
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Affiliation(s)
- Lili Huang
- Department of Nutrition and Food HygieneSchool of Public Health, Institute of NutritionShanghaiPeople's Republic of China
| | - Aitian Wang
- Department of Intensive MedicineKailuan General HospitalTangshanPeople's Republic of China
| | - Zhijun Wu
- Department of Cardiovascular Medicine, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiPeople's Republic of China
| | - Shuohua Chen
- Department of CardiologyKailuan General HospitalTangshanPeople's Republic of China
| | - Yan Zheng
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life SciencesFudan UniversityShanghaiPeople's Republic of China
| | - Shouling Wu
- Department of CardiologyKailuan General HospitalTangshanPeople's Republic of China
| | - Xiang Gao
- Department of Nutrition and Food HygieneSchool of Public Health, Institute of NutritionShanghaiPeople's Republic of China
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Malakooti SK, Siddiqui H, Wilson B, Bej T, O’Mara M, Desotelle A, Lange A, Shive CL, Singer NG, McComsey GA, Kostadinova L, Mattar M, Zidar DA, Anthony DD. Higher Vitamin D Levels before Methotrexate Therapy Initiation Are Associated with Lower Subsequent Mortality in Patients with Rheumatoid Arthritis. Nutrients 2024; 16:401. [PMID: 38337687 PMCID: PMC10857393 DOI: 10.3390/nu16030401] [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: 01/08/2024] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Vitamin D deficiency is associated with mortality in the general population and has been observed in one rheumatoid arthritis (RA) cohort. Here, we investigate the relationship between 25-hydroxyvitamin D (25(OH)D) levels before methotrexate (MTX) therapy initiation in patients with RA and the subsequent all-cause mortality in a national Veterans Affairs (VA) cohort. (2) This is a retrospective study on RA patients time-oriented around the initial MTX prescription and 25(OH)D levels before starting MTX. We examined survival in patients with 25(OH)D levels > 50 nmol/L and ≤50 nmol/L using the Cox Proportional Hazard Model and fully adjusted for risk factors. (3) In total, 15,109 RA patients were included in the nationwide cohort. RA patients with 25(OH)D levels > 50 nmol/L before starting MTX had a 28% reduced risk of mortality when compared to those with levels ≤ 50 nmol/L (HR: 0.72, CI: 0.64-0.80, p < 0.001) after adjusting for traditional risk factors. (4) In this national RA cohort receiving standard-of-care MTX, patients with 25(OH)D levels > 50 nmol/L have a lower subsequent mortality when compared to those with 25(OH)D levels ≤ 50 nmol/L. It remains to be determined whether increasing Vitamin D levels in RA patients initially found to be Vitamin D deficient impacts their all-cause mortality.
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Affiliation(s)
- Shahdi K. Malakooti
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
- Department of Medicine, MetroHealth Medical Center, Cleveland, OH 44109, USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Hinnah Siddiqui
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Brigid Wilson
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Taissa Bej
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Megan O’Mara
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Alexandra Desotelle
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Alyssa Lange
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Carey L. Shive
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Nora G. Singer
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
- Department of Medicine, MetroHealth Medical Center, Cleveland, OH 44109, USA
| | - Grace A. McComsey
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
- University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
| | - Lenche Kostadinova
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Maya Mattar
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - David A. Zidar
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Donald D. Anthony
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
- Department of Medicine, MetroHealth Medical Center, Cleveland, OH 44109, USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
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Wu E, Guo JP, Wang K, Xu HQ, Xie T, Tao L, Ni JT. Association of serum 25-hydroxyvitamin D with the incidence of 16 cancers, cancer mortality, and all-cause mortality among individuals with metabolic syndrome: a prospective cohort study. Eur J Nutr 2023; 62:2581-2592. [PMID: 37209191 DOI: 10.1007/s00394-023-03169-x] [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: 06/24/2022] [Accepted: 05/04/2023] [Indexed: 05/22/2023]
Abstract
PURPOSE The relationship between vitamin D levels and cancer incidence and mortality in individuals with metabolic syndrome (MetS) remains poorly explored. Herein, we aimed to determine the association between 25-hydroxyvitamin D [25(OH)D] concentrations and the risk of 16 cancer incidence types and cancer/all-cause mortality in patients with MetS. METHODS We enrolled 97,621 participants with MetS at recruitment from the UK Biobank cohort. The exposure factor was baseline serum 25(OH)D concentrations. The associations were examined using Cox proportional hazards models, which were displayed as hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS Over a median follow-up period of 10.92 years for cancer incidence outcomes, 12,137 new cancer cases were recorded. We observed that 25(OH)D concentrations were inversely related to the risk of colon, lung, and kidney cancer, and HRs (95% CI) for 25(OH)D ≥ 75.0 vs. < 25.0 nmol/L were 0.67 (0.45-0.98), 0.64 (0.45-0.91), and 0.54 (0.31-0.95), respectively. The fully adjusted model revealed a null correlation between 25(OH)D and the incidence of stomach, rectum, liver, pancreas, breast, ovary, bladder, brain, multiple myeloma, leukemia, non-Hodgkin lymphoma, esophagus, and corpus uteri cancer. Over a median follow-up period of 12.72 years for mortality outcomes, 8286 fatalities (including 3210 cancer mortalities) were documented. An "L-shaped" nonlinear dose-response correlation was detected between 25(OH)D and cancer/all-cause mortality; the respective HRs (95% CI) were 0.75 (0.64-0.89) and 0.65 (0.58-0.72). CONCLUSION These findings emphasize the importance of 25(OH)D in cancer prevention and longevity promotion among patients with MetS.
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Affiliation(s)
- E Wu
- Rehabilitation and Nursing School, Hangzhou Vocational & Technical College, Hangzhou, 310018, Zhejiang, China
- School of Pharmacy, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China
| | - Jun-Ping Guo
- Rehabilitation and Nursing School, Hangzhou Vocational & Technical College, Hangzhou, 310018, Zhejiang, China
| | - Kai Wang
- Department of acupuncture and massage, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China
| | - Hong-Quan Xu
- School of Pharmacy, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China
| | - Tian Xie
- School of Pharmacy, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China.
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China.
| | - Lin Tao
- School of Pharmacy, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China.
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China.
| | - Jun-Tao Ni
- Women's Hospital School of Medicine Zhejiang University, Hangzhou, 310006, Zhejiang, China.
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Brenner H. The Role of Vitamin D for Human Health: The Challenge of the Right Study Designs and Interpretation. Nutrients 2023; 15:2897. [PMID: 37447223 DOI: 10.3390/nu15132897] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 06/05/2023] [Indexed: 07/15/2023] Open
Abstract
Numerous observational and intervention studies have suggested adverse health effects of poor vitamin D status and health benefits of vitamin D intake [...].
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Affiliation(s)
- Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Network Aging Research, Heidelberg University, 69120 Heidelberg, Germany
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Hu B, Chen J, Shi Y, Hou L. Association between serum 25(OH)D and risk of all-cause mortality in adults with prior cardiovascular disease: a cohort study from NHANES 2007-2018. BMC Cardiovasc Disord 2023; 23:240. [PMID: 37149586 PMCID: PMC10164325 DOI: 10.1186/s12872-023-03257-0] [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: 11/22/2022] [Accepted: 04/21/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Serum vitamin D deficiency is common in the patients with cardiovascular disease (CVD), but the association between serum vitamin D levels and risk of all-cause mortality in patients with CVD is controversial. OBJECTIVE This study aimed to understand better the association between serum 25(OH)D status and risk of all-cause mortality in patients with prior CVD. METHOD We conducted a cohort study using data from the National Health and Nutrition Examination Survey from 2007 to 2018 to investigate the association between serum 25(OH)D and the risk of all-cause mortality using multivariate Cox regression models, with further subgroup analyses and interactions smooth curve fitting to address possible nonlinearities. RESULT A total of 3220 participants with prior CVD were included in this study, with a total of 930 deaths over a median follow-up of 5.52 years, with multivariable-adjusted serum vitamin D levels after natural log transformation (4.31-4.5 ) as a reference in COX regression, and corrected HRs and 95% CIs of 1.81 (1.31, 2.50), 1.34 (1.07, 1.66), 1.28 (1.05, 1.56),1.00 (reference), 1.10 (0.89, 1.37) for all-cause mortality, respectively. Results remained robust in the stratified analysis of interactions, but a L-shaped relationship was detected. We identified an inflection point of 4.5 after multivariate adjustment through a two-stage linear regression model and recursive algorithm. CONCLUSION Our findings demonstrate that increasing serum 25(OH)D levels may have a L-shaped relationship with risk of all-cause mortality and that increases in serum 25(OH)D levels do not continue to reduce the risk of all-cause mortality.
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Affiliation(s)
- Ben Hu
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
- Anhui Medical University, Hefei, 230000, Anhui, China
| | - Jian Chen
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
| | - Yihang Shi
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
| | - Linlin Hou
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China.
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Hagău AC, Pușcaș A, Togănel R, Muntean I. Is Hypovitaminosis D a Risk Factor for Heart Failure? Life (Basel) 2023; 13:life13020372. [PMID: 36836729 PMCID: PMC9967471 DOI: 10.3390/life13020372] [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: 12/20/2022] [Revised: 01/20/2023] [Accepted: 01/22/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Several studies in recent years have shown the association between vitamin D levels and heart failure. Vitamin D deficiency is related to increased cardiovascular morbidity and mortality, with a higher risk of developing heart failure. In this systematic review, we aimed to assess recent studies that analyzed vitamin D deficiency and heart failure in adult and pediatric populations. (2) Methods: We conducted a systematic search for studies published in the following databases: PubMed and Scopus from January 2012 to October 2022. (3) Results: Most observational studies that were included found a significant association between hypovitaminosis D and heart failure. However, the beneficial role of vitamin D supplementation is still controversial due to the lack of randomized controlled trials. (4) Conclusions: Vitamin D may play an important role as a cardiovascular marker in heart failure patients. More well-designed studies are needed to investigate the relationship between vitamin D and heart failure and to determine if vitamin D supplementation could improve long-term outcomes.
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Affiliation(s)
- Asmaa Carla Hagău
- Doctoral School of Medicine and Pharmacy, I.O.S.U.D., George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Emergency Institute for Cardiovascular Diseases and Transplantation of Târgu Mureș, 540136 TarguMures, Romania
| | - Amalia Pușcaș
- Department of Biochemistry and Chemistry of Environmental Factors, Faculty of Pharmacy, University of Medicine, Pharmacy, Science and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
| | - Rodica Togănel
- Department of Paediatrics, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Iolanda Muntean
- Clinic of Paediatric Cardiology, Emergency Institute for Cardiovascular Diseases and Transplantation of Târgu Mureș, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Târgu Mureș, Romania
- Correspondence: ; Tel.: +40-744372276
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Li F, Chen L, Liu B, Zhong VW, Deng Y, Luo D, Gao C, Bao W, Rong S. Frequency of adding salt at the table and risk of incident cardiovascular disease and all-cause mortality: a prospective cohort study. BMC Med 2022; 20:486. [PMID: 36522670 PMCID: PMC9753015 DOI: 10.1186/s12916-022-02691-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Adding salt at the table is a prevalent eating habit, but its long-term relationship with cardiovascular disease (CVD) and all-cause mortality remains unclear. We evaluated the associations of adding salt at the table with the risk of incident CVD and all-cause mortality. METHODS Among 413,109 middle- and old-aged adults without cancer or CVD, all participants reported the frequency of adding salt at the table at baseline. The associations between adding salt at the table and incident CVD (the composite endpoint of coronary heart disease, stroke, heart failure, and CVD deaths) and all-cause mortality were investigated using Cox proportional hazards models. RESULTS Of the study population, the mean age was 55.8 years and 45.5% were men; 44.4% reported adding salt at the table; 4.8% reported always adding salt at the table. During a median follow-up of 12 years, there were 37,091 incident CVD cases and 21,293 all-cause deaths. After adjustment for demographic, lifestyle, and cardiometabolic risk factors, the multivariable-adjusted hazard ratios (HRs) for participants who always added salt at the table versus never/rarely added salt at the table were 1.21 (95% confidence interval [CI]: 1.16-1.26) for CVD, 1.19 (95%CI: 1.05-1.35) for CVD mortality, and 1.22 (95%CI: 1.16-1.29) for all-cause mortality, respectively. CONCLUSIONS In this prospective cohort study, a higher frequency of adding salt at the table was associated with a greater risk of incident CVD and mortality. Our findings support the benefits of restricting the habit of adding salt at the table in promoting cardiovascular health.
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Affiliation(s)
- Fengping Li
- Department of Nutrition, School of Public Health, Wuhan University, Research Center of Public Health, Renmin Hospital of Wuhan University, No.115 Donghu Road, Wuhan, 430071, China
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Buyun Liu
- Institute of Public Health Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
| | - Victor W Zhong
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Deng
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Dan Luo
- School of Nursing, Wuhan University, Wuhan, China
| | - Chao Gao
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Wei Bao
- Institute of Public Health Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
| | - Shuang Rong
- Department of Nutrition, School of Public Health, Wuhan University, Research Center of Public Health, Renmin Hospital of Wuhan University, No.115 Donghu Road, Wuhan, 430071, China.
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Mu X, Liu S, Fu M, Luo M, Ding D, Chen L, Yu K. Associations of physical activity intensity with incident cardiovascular diseases and mortality among 366,566 UK adults. Int J Behav Nutr Phys Act 2022; 19:151. [PMID: 36514169 PMCID: PMC9745930 DOI: 10.1186/s12966-022-01393-y] [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: 06/28/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The associations of the proportion of vigorous physical activity (VPA) to moderate to vigorous physical activity (MVPA) with incident cardiovascular disease (CVD) and all-cause mortality are unclear. METHODS The present study included 366,566 participants (aged 40-69 years) without baseline CVD from the UK biobank during 2006 to 2010. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for risks of outcomes. RESULTS During a median 11.8 years of follow-up, among 366,566 participants (mean age [SD]: 56.0 [8.1]), 31,894 incident CVD and 19,823 total deaths were documented. Compared with no VPA, 0%-30% of VPA to MVPA was associated with 12% and 19% lower risks of incident CVD (HR, 0.88 [95% CI, 0.86-0.91]) and all-cause mortality (HR, 0.81 [95% CI, 0.78-0.84]), respectively. Furthermore, we found that the maximum reduction of risks of incident CVD and all-cause mortality occurred at performing approximately 30% of VPA to MVPA (P < 0.001). Compared with participants reporting the lowest levels of MVPA (moderate physical activity [MPA], 0-150 min/week; VPA, 0-75 min/week), those performing 150-300 min/week of MPA and ≥ 150 min/week of VPA experienced the lowest risk of incident CVD (HR, 0.87 [95% CI, 0.79-0.95]) and all-cause mortality (HR, 0.71 [95% CI, 0.63-0.80]). Interestingly, we found that smokers yielded more cardiovascular benefits than non-smokers by performing a higher volume of VPA. CONCLUSIONS Comparing with UK adults reporting no VPA, engaging in 30% of VPA was associated with the lowest risk of incident CVD and all-cause mortality.
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Affiliation(s)
- Xuanwen Mu
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Shuangyan Liu
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Mingjian Fu
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Mengyun Luo
- grid.1013.30000 0004 1936 834XSydney School of Public Health, Faculty of Medicine and Health, the University of Sydney, Camperdown, NSW 2006 Australia ,grid.1013.30000 0004 1936 834XCharles Perkins Center, the University of Sydney, Camperdown, NSW 2006 Australia ,grid.16821.3c0000 0004 0368 8293School of Public Health, School of Medicine, Shanghai Jiao Tong University, 200240 Shanghai, People’s Republic of China
| | - Ding Ding
- grid.1013.30000 0004 1936 834XSydney School of Public Health, Faculty of Medicine and Health, the University of Sydney, Camperdown, NSW 2006 Australia ,grid.1013.30000 0004 1936 834XCharles Perkins Center, the University of Sydney, Camperdown, NSW 2006 Australia
| | - Liangkai Chen
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China ,grid.33199.310000 0004 0368 7223Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Kuai Yu
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
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11
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Chen Y, Feng S, Chang Z, Zhao Y, Liu Y, Fu J, Liu Y, Tang S, Han Y, Zhang S, Fan Z. Higher Serum 25-Hydroxyvitamin D Is Associated with Lower All-Cause and Cardiovascular Mortality among US Adults with Nonalcoholic Fatty Liver Disease. Nutrients 2022; 14:nu14194013. [PMID: 36235666 PMCID: PMC9571761 DOI: 10.3390/nu14194013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/23/2022] [Accepted: 09/24/2022] [Indexed: 11/26/2022] Open
Abstract
Aims: We aimed to assess the association between serum 25-hydroxyvitamin D (25(OH)D) levels with all-cause and cardiovascular mortality in patients with nonalcoholic fatty liver disease (NAFLD). Methods: We performed a retrospective cohort study based on the US National Health and Nutrition Examination Survey 2001–2016 on adults aged ≥20 years. NAFLD was determined as a US Fatty Liver Index score ≥ 30 in the absence of other liver conditions. Weighted Cox proportional hazards regression models were applied to explore the relationship between serum 25(OH)D levels and mortality. Results: 898 all-cause deaths and 305 cardiovascular deaths were recorded over a median follow-up of 8.7 years. Compared with those in the severe deficiency group (below 25.0 nmol/L), the fully adjusted HRs and 95% CIs of NAFLD patients with sufficient serum 25(OH)D concentrations (≥75.0 nmol/L) were 0.36 (0.22, 0.60) for all-cause mortality and 0.14 (0.07, 0.29) for cardiovascular mortality. Each one-unit increase in the natural log-transformed serum 25(OH)D concentration was related to a 41% lower risk for all-cause deaths (HR = 0.59, 95% CI: 0.46, 0.77) and a 65% lower risk for cardiovascular deaths (HR = 0.35, 95% CI: 0.22, 0.58). Conclusions: Among NAFLD patients, increased serum 25(OH)D levels were independently associated with reduced risk for all-cause and cardiovascular deaths.
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12
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Zhou J, Li R, Bao T, Jiang W, Huang Y. Association between serum 25-hydroxyvitamin d and myeloperoxidase: A cross-sectional study of a general population in China. Front Nutr 2022; 9:948691. [PMID: 35983482 PMCID: PMC9379339 DOI: 10.3389/fnut.2022.948691] [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: 05/20/2022] [Accepted: 07/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Several studies have found a strong association between cardiovascular diseases and myeloperoxidase (MPO) as a marker of oxidative stress. Although the anti-inflammatory effects of vitamin D in adults have been validated, evidence about the relationship between MPO and 25(OH)D is lacking. This study aimed to investigate the relationship between MPO and 25(OH)D in the general Chinese population. Methods From November 2018 to August 2019, a total of 6414 subjects were enrolled in a tertiary referral hospital in China, which included 3,122 women and 3,292 men. The dependent and independent variables were MPO and 25(OH)D, respectively. The confounders included age, sex, body mass index, waist-hip ratio, smoking status, alcohol drinking status, calcium, and parathyroid hormone concentration. Results In the fully adjusted model, we found that MPO decreased by 0.12 (95% CI −0.16, −0.08), ng/mL for each unit (1 nmol/L) increase in 25(OH)D. When 25(OH) D was divided into quartiles, compared with Q1 (< 41.4 nmol/L), the adjusted beta coefficients (β) of MPO in Q2–Q4 were −2.29 (95% CI, −4.31 to −0.27), −4.76 (95% CI, −6.83 to −2.69), and −6.07 (95% CI, −8.23 to −3.92), respectively (P for the trend < 0.0001). When 25(OH) D was divided according to clinical severity, compared with the severely deficient (< 30 nmol/L) s≥ 30, < 50 nmol/L) and sufficient groups (≥ 50 nmol/L) were −2.59 (95% CI, −5.87 to 0.69) and −5.87 (95% CI, −9.17 to −2.57), respectively (P for the trend < 0.0001). Conclusion After adjusting for age, sex, BMI, waist-hip ratio, smoking status, alcohol status, calcium, and PTH, circulating 25(OH)D was negatively associated with MPO.
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Affiliation(s)
- Junteng Zhou
- Health Management Center, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Cardiovascular Diseases, Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ruicen Li
- Health Management Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ting Bao
- Health Management Center, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Jiang
- Health Management Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Huang
- Health Management Center, West China Hospital, Sichuan University, Chengdu, China
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13
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Neutrophil-to-Lymphocyte Ratio Is Not Associated with Severity of Coronary Artery Disease and Is Not Correlated with Vitamin D Level in Patients with a History of an Acute Coronary Syndrome. BIOLOGY 2022; 11:biology11071001. [PMID: 36101382 PMCID: PMC9311593 DOI: 10.3390/biology11071001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 12/13/2022]
Abstract
Coronary artery disease (CAD), the leading cause of death worldwide, has an underlying cause in atherosclerosis. The activity of this inflammatory process can be measured with neutrophil-to-lymphocyte ratio (NLR). The anti-inflammatory and anti-atherogenic properties of vitamin D affect many mechanisms involved in CAD. In this study, we investigated the association between NLR, vitamin D concentration, and severity of CAD in a group of patients with a history of myocardial infarction (MI). NLR was higher in patients with acute coronary syndrome (ACS) in comparison to those with stable CAD (median: 2.8, range: 0.96−24.3 vs. median: 2.3, range: 0.03−31.6; p < 0.05). No associations between NLR and severity of CAD (p = 0.14) in the cohort and in the subgroups with stable CAD (p = 0.40) and ACS (p = 0.34) were observed. We found no correlation between vitamin D level and NLR neither in the whole study group (p = 0.29) nor in subgroups of patients with stable CAD (p = 0.84) and ACS (p = 0.30). NLR could be used as prognostic biomarker of consecutive MI in patients with CAD and a history of MI.
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14
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Liu Y, Yang D, Shi F, Wang F, Liu X, Wen H, Mubarik S, Yu C. Association of Serum 25(OH)D, Cadmium, CRP With All-Cause, Cause-Specific Mortality: A Prospective Cohort Study. Front Nutr 2022; 9:803985. [PMID: 35571939 PMCID: PMC9094577 DOI: 10.3389/fnut.2022.803985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/24/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction To explore the relationship between serum 25(OH)D, cadmium, and CRP with all-cause mortality among people in diabetic and non-diabetic. Methods This study used data from the NHANES (2001–2010). Cox regression was used to analyze the relationship between Serum 25(OH)D, cadmium, CRP, and all-cause, cause-specific mortality. We used restricted cubic splines to explore the dose-response relationship between serum 25(OH)D, cadmium, CRP, and all-cause mortality. Results During a mean follow-up of 9.1 years, the study included 20,221 participants, 2,945 people with diabetes, and 17,276 people without diabetes. Compared with serum 25(OH)D deficiency group in diabetic patients, the sufficient serum 25(OH)D group was associated with lower all-cause mortality (HR = 0.41, 95%CI 0.28-0.60, P < 0.001) and cardiovascular mortality (HR = 0.46, 95%CI 0.22–0.95, P = 0.04). Compared with the low cadmium group, the high cadmium group was associated with higher all-cause mortality (HR = 1.49, 95%CI 1.06–2.09, P = 0.02). Compared with the low CRP group, the high CRP group was associated with higher all-cause mortality (HR = 1.65, 95%CI 1.24–2.19, P = 0.001) and cancer mortality (HR = 3.25, 95%CI 1.82–5.80, P < 0.001). Restricted cubic splines analysis showed a significant nonlinear association between serum 25(OH)D (P-nonlinearity P < 0.001), cadmium (P-nonlinearity = 0.002), CRP (P-nonlinearity = 0.003), and HR for all-cause mortality risk in diabetic patients. The results were similar among non-diabetic patients, but with different levels of risk. Sensitivity analysis and subgroup analysis presented the results of population studies with different follow-up times, different genders and ages. Conclusions In diabetic patients, serum 25(OH)D, cadmium, and CRP were related to all-cause mortality; serum 25(OH)D was related to cardiovascular mortality; CRP was related to cancer mortality. The results were similar among non-diabetic patients, but with different levels of risk.
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Affiliation(s)
- Yan Liu
- School of Public Health, Wuhan University, Wuhan, China
| | - Donghui Yang
- School of Public Health, Wuhan University, Wuhan, China
| | - Fang Shi
- School of Public Health, Wuhan University, Wuhan, China
| | - Fang Wang
- School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Xiaoxue Liu
- School of Public Health, Wuhan University, Wuhan, China
| | - Haoyu Wen
- School of Public Health, Wuhan University, Wuhan, China
| | | | - Chuanhua Yu
- School of Public Health, Wuhan University, Wuhan, China
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15
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Dietary Recommendations for Post-COVID-19 Syndrome. Nutrients 2022; 14:nu14061305. [PMID: 35334962 PMCID: PMC8954128 DOI: 10.3390/nu14061305] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/18/2022] [Accepted: 03/19/2022] [Indexed: 12/19/2022] Open
Abstract
At the beginning of the coronavirus disease (COVID-19) pandemic, global efforts focused on containing the spread of the virus and avoiding contagion. Currently, it is evident that health professionals should deal with the overall health status of COVID-19 survivors. Indeed, novel findings have identified post-COVID-19 syndrome, which is characterized by malnutrition, loss of fat-free mass, and low-grade inflammation. In addition, the recovery might be complicated by persistent functional impairment (i.e., fatigue and muscle weakness, dysphagia, appetite loss, and taste/smell alterations) as well as psychological distress. Therefore, the appropriate evaluation of nutritional status (assessment of dietary intake, anthropometrics, and body composition) is one of the pillars in the management of these patients. On the other hand, personalized dietary recommendations represent the best strategy to ensure recovery. Therefore, this review aimed to collect available evidence on the role of nutrients and their supplementation in post-COVID-19 syndrome to provide a practical guideline to nutritionists to tailor dietary interventions for patients recovering from COVID-19 infections.
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16
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Grant WB, Al Anouti F, Boucher BJ, Dursun E, Gezen-Ak D, Jude EB, Karonova T, Pludowski P. A Narrative Review of the Evidence for Variations in Serum 25-Hydroxyvitamin D Concentration Thresholds for Optimal Health. Nutrients 2022; 14:nu14030639. [PMID: 35276999 PMCID: PMC8838864 DOI: 10.3390/nu14030639] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 12/18/2022] Open
Abstract
Vitamin D3 has many important health benefits. Unfortunately, these benefits are not widely known among health care personnel and the general public. As a result, most of the world’s population has serum 25-hydroxyvitamin D (25(OH)D) concentrations far below optimal values. This narrative review examines the evidence for the major causes of death including cardiovascular disease, hypertension, cancer, type 2 diabetes mellitus, and COVID-19 with regard to sub-optimal 25(OH)D concentrations. Evidence for the beneficial effects comes from a variety of approaches including ecological and observational studies, studies of mechanisms, and Mendelian randomization studies. Although randomized controlled trials (RCTs) are generally considered the strongest form of evidence for pharmaceutical drugs, the study designs and the conduct of RCTs performed for vitamin D have mostly been flawed for the following reasons: they have been based on vitamin D dose rather than on baseline and achieved 25(OH)D concentrations; they have involved participants with 25(OH)D concentrations above the population mean; they have given low vitamin D doses; and they have permitted other sources of vitamin D. Thus, the strongest evidence generally comes from the other types of studies. The general finding is that optimal 25(OH)D concentrations to support health and wellbeing are above 30 ng/mL (75 nmol/L) for cardiovascular disease and all-cause mortality rate, whereas the thresholds for several other outcomes appear to range up to 40 or 50 ng/mL. The most efficient way to achieve these concentrations is through vitamin D supplementation. Although additional studies are warranted, raising serum 25(OH)D concentrations to optimal concentrations will result in a significant reduction in preventable illness and death.
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Affiliation(s)
- William B. Grant
- Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA
- Correspondence: ; Tel.: +1-415-409-1980
| | - Fatme Al Anouti
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi 144534, United Arab Emirates;
| | - Barbara J. Boucher
- The Blizard Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London E12AT, UK;
| | - Erdinç Dursun
- Department of Neuroscience, Institute of Neurological Sciences, Istanbul University-Cerrahpasa, Istanbul 34098, Turkey; (E.D.); (D.G.-A.)
| | - Duygu Gezen-Ak
- Department of Neuroscience, Institute of Neurological Sciences, Istanbul University-Cerrahpasa, Istanbul 34098, Turkey; (E.D.); (D.G.-A.)
| | - Edward B. Jude
- Tameside and Glossop Integrated Care NHS Foundation Trust, Fountain Street, Ashton-under-Lyne OL6 9RW, UK;
- The University of Manchester, Oxford Road, Manchester M13 9PL, UK
- Manchester Metropolitan University, All Saints Building, Manchester M15 6BH, UK
| | - Tatiana Karonova
- Clinical Endocrinology Laboratory, Department of Endocrinology, Almazov National Medical Research Centre, 194021 Saint-Petersburg, Russia;
| | - Pawel Pludowski
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, 04730 Warsaw, Poland;
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17
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Aleksova A, Janjusevic M, Gagno G, Pierri A, Padoan L, Fluca AL, Carriere C, Beltrami AP, Sinagra G. The Role of Exercise-Induced Molecular Processes and Vitamin D in Improving Cardiorespiratory Fitness and Cardiac Rehabilitation in Patients With Heart Failure. Front Physiol 2022; 12:794641. [PMID: 35087418 PMCID: PMC8787056 DOI: 10.3389/fphys.2021.794641] [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: 10/13/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Heart failure (HF) still affects millions of people worldwide despite great advances in therapeutic approaches in the cardiovascular field. Remarkably, unlike pathological hypertrophy, exercise leads to beneficial cardiac hypertrophy characterized by normal or enhanced contractile function. Exercise-based cardiac rehabilitation improves cardiorespiratory fitness and, as a consequence, ameliorates the quality of life of patients with HF. Particularly, multiple studies demonstrated the improvement in left ventricular ejection fraction (LVEF) among patients with HF due to the various processes in the myocardium triggered by exercise. Exercise stimulates IGF-1/PI3K/Akt pathway activation involved in muscle growth in both the myocardium and skeletal muscle by regulating protein synthesis and catabolism. Also, physical activity stimulates the activation of the mitogen-activated protein kinase (MAPK) pathway which regulates cellular proliferation, differentiation and apoptosis. In addition, emerging data pointed out the anti-inflammatory effects of exercises as well. Therefore, it is of utmost importance for clinicians to accurately evaluate the patient’s condition by performing a cardiopulmonary exercise test and/or a 6-min walking test. Portable devices with the possibility to measure exercise capacity proved to be very useful in this setting as well. The aim of this review is to gather together the molecular processes triggered by the exercise and available therapies in HF settings that could ameliorate heart performance, with a special focus on strategies such as exercise-based cardiac rehabilitation.
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Affiliation(s)
- Aneta Aleksova
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.,Department of Medical Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Milijana Janjusevic
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.,Department of Medical Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Giulia Gagno
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.,Department of Medical Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Alessandro Pierri
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.,Department of Medical Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Laura Padoan
- Cardiology and Cardiovascular Physiopathology, Azienda Ospedaliero-Universitaria S. Maria della Misericordia, Perugia, Italy
| | - Alessandra Lucia Fluca
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.,Department of Medical Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Cosimo Carriere
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.,Department of Medical Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Antonio Paolo Beltrami
- Department of Clinical Pathology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), University of Udine, Udine, Italy.,Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Gianfranco Sinagra
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.,Department of Medical Surgical and Health Science, University of Trieste, Trieste, Italy
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