1
|
Liu Z, Li Z, Xie J, Xia R, Li Y, Zhang F, Ouyang W, Wang S, Pan X. The cardiovascular disease burden attributable to low physical activity in the Western Pacific Region, 1990-2019: an age-period-cohort analysis of the Global Burden of Disease study. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2024; 10:203-215. [PMID: 37852669 DOI: 10.1093/ehjqcco/qcad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/09/2023] [Accepted: 10/17/2023] [Indexed: 10/20/2023]
Abstract
AIMS To increase the comprehensive understanding of trends in the burden of cardiovascular disease (CVD) attributable to low physical activity in the Western Pacific Region. METHODS AND RESULTS Based on data from the Global Burden of Disease study for the years 1990-2019, an age-period-cohort analysis was conducted to investigate trends in CVD-related mortality attributable to low physical activity in the Western Pacific Region and associations with age, period, and birth cohort. We also used joinpoint regression analysis to identify the periods with the most substantial changes. The results show that, the Western Pacific Region witnessed a substantial increase in CVD deaths attributable to low physical activity, accompanied by a rise in all-age CVD-related mortality. However, the age-standardized death rate was lower in the region than the global level, highlighting the importance of considering the age composition of CVD burden in the region. Countries with higher socio-demographic index (SDI) levels exhibited lower mortality than those with lower SDI levels. The longitudinal analysis using the age-period-cohort model indicated an overall improvement in CVD-related mortality attributable to low physical activity in the region, but with differences between sexes and CVD subtypes. Specific period in which CVD-related mortality decreased significantly was 2011-16, for the average annual percentage change for the period was -0.69%. CONCLUSION The study highlights the significance of addressing low physical activity as a modifiable risk factor for CVD burden in the Western Pacific Region. Further research is essential to understand the factors contributing to inter-country variations, sex disparities, and CVD subtypes distinctions.
Collapse
Affiliation(s)
- Zeye Liu
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China
- Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ziping Li
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China
- Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Xie
- Department of Pharmacy, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ruibing Xia
- Department of Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
| | - Yakun Li
- Laboratory of Experimental Intensive Care and Anesthesiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Fengwen Zhang
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China
- Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Wenbin Ouyang
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China
- Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Shouzheng Wang
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China
- Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiangbin Pan
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China
- Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
2
|
Zhang Y, Li S, Wu W, Zhao Y, Han J, Tong C, Luo N, Zhang K. Machine-learning-based models to predict cardiovascular risk using oculomics and clinic variables in KNHANES. BioData Min 2024; 17:12. [PMID: 38644481 PMCID: PMC11034020 DOI: 10.1186/s13040-024-00363-3] [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: 01/26/2024] [Accepted: 04/09/2024] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND Recent researches have found a strong correlation between the triglyceride-glucose (TyG) index or the atherogenic index of plasma (AIP) and cardiovascular disease (CVD) risk. However, there is a lack of research on non-invasive and rapid prediction of cardiovascular risk. We aimed to develop and validate a machine-learning model for predicting cardiovascular risk based on variables encompassing clinical questionnaires and oculomics. METHODS We collected data from the Korean National Health and Nutrition Examination Survey (KNHANES). The training dataset (80% from the year 2008 to 2011 KNHANES) was used for machine learning model development, with internal validation using the remaining 20%. An external validation dataset from the year 2012 assessed the model's predictive capacity for TyG-index or AIP in new cases. We included 32122 participants in the final dataset. Machine learning models used 25 algorithms were trained on oculomics measurements and clinical questionnaires to predict the range of TyG-index and AIP. The area under the receiver operating characteristic curve (AUC), accuracy, precision, recall, and F1 score were used to evaluate the performance of our machine learning models. RESULTS Based on large-scale cohort studies, we determined TyG-index cut-off points at 8.0, 8.75 (upper one-third values), 8.93 (upper one-fourth values), and AIP cut-offs at 0.318, 0.34. Values surpassing these thresholds indicated elevated cardiovascular risk. The best-performing algorithm revealed TyG-index cut-offs at 8.0, 8.75, and 8.93 with internal validation AUCs of 0.812, 0.873, and 0.911, respectively. External validation AUCs were 0.809, 0.863, and 0.901. For AIP at 0.34, internal and external validation achieved similar AUCs of 0.849 and 0.842. Slightly lower performance was seen for the 0.318 cut-off, with AUCs of 0.844 and 0.836. Significant gender-based variations were noted for TyG-index at 8 (male AUC=0.832, female AUC=0.790) and 8.75 (male AUC=0.874, female AUC=0.862) and AIP at 0.318 (male AUC=0.853, female AUC=0.825) and 0.34 (male AUC=0.858, female AUC=0.831). Gender similarity in AUC (male AUC=0.907 versus female AUC=0.906) was observed only when the TyG-index cut-off point equals 8.93. CONCLUSION We have established a simple and effective non-invasive machine learning model that has good clinical value for predicting cardiovascular risk in the general population.
Collapse
Affiliation(s)
- Yuqi Zhang
- School of Computer Science & Engineering, Beihang University, Beijing, China
- State Key Laboratory of Virtual Reality Technology and Systems, Beihang University, Beijing, China
| | - Sijin Li
- Department of Cardiology, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Weijie Wu
- Department of Cardiology, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Yanqing Zhao
- Department of Interventional Radiology & Vascular Surgery, Peking University Third Hospital, Beijing, China
| | - Jintao Han
- Department of Interventional Radiology & Vascular Surgery, Peking University Third Hospital, Beijing, China
| | - Chao Tong
- School of Computer Science & Engineering, Beihang University, Beijing, China.
- State Key Laboratory of Virtual Reality Technology and Systems, Beihang University, Beijing, China.
| | - Niansang Luo
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
| | - Kun Zhang
- Department of Cardiology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.
| |
Collapse
|
3
|
Liu J, Liu Y, Ma W, Liu J, Tong Y, Wang C, Zheng J. Age-period-cohort analysis of ischemic stroke deaths attributable to physical inactivity in different income regions. Sci Rep 2024; 14:6547. [PMID: 38503900 PMCID: PMC10951293 DOI: 10.1038/s41598-024-57309-2] [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: 01/31/2024] [Accepted: 03/17/2024] [Indexed: 03/21/2024] Open
Abstract
This study assessed the global and regional burden of IS (ischemic stroke) deaths due to LPA (low physical activity) from 1990 to 2019, analyzed regional, sex, and age differences in ASMR (age-standardized mortality rate), and provided a comprehensive understanding of the impact of age, period, and cohort on low physical activity related ischemic stroke ASMR. We conducted an APC (age-period-cohort) analysis of the global and four World Bank income level regions' IS mortality data attributed to LPA from 1990 to 2019, using the GBD2019 database, and the results showed that the global net drift of the Ischemic stroke age-standardized mortality attributable to low physical activity was - 1.085%[95% CI: - 1.168, - 1.003].The ASMR drop is most pronounced in the high-income zone, with a net drift of - 2.473% [95% CI: - 2.759, - 2.187] across the four income groups. The influence of age on mortality is increasing in the worldwide old population, while the period and cohort effects are decreasing. We also performed a Joinpoint regression analysis, which revealed that the specific time of considerable drop in ASMR of IS in the global LPA population was 2002-2007, with an APC of -2.628%. The specific period of considerable drop in ASMR in high-income regions with the highest variation was 1999-2007, with an APC = - 4.726%. The global burden of public health deaths caused by LPA is diminishing, with the most notable progress observed in high-income regions. However, in low and lower-middle income areas, the situation continues to deteriorate. Within the global elderly population, the effects of age on mortality is increasing, while the effects of period and cohort are diminishing. These trends vary across income levels, highlighting the necessity for enhanced international collaboration to formulate context-specific public health strategies aimed at enhancing cardiovascular health on a global, regional, and national scale.
Collapse
Affiliation(s)
- Junjiao Liu
- College of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yueyang Liu
- Second Clinical Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Wenjun Ma
- College of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jie Liu
- College of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yan Tong
- College of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Cui Wang
- College of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jianzhong Zheng
- College of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China.
| |
Collapse
|
4
|
Zhang S, Chen L, Qian ZM, Li D, Cai M, Wang C, Zhang Z, Vaughn MG, Keith AE, Li H, Lin H. Associations between air pollution and the risk of first admission and multiple readmissions for cardiovascular diseases. Heart 2024; 110:337-345. [PMID: 37673655 DOI: 10.1136/heartjnl-2023-322682] [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: 03/29/2023] [Accepted: 08/19/2023] [Indexed: 09/08/2023] Open
Abstract
OBJECTIVES We aimed to investigate the associations between air pollutants and the risk of admission and multiple readmission events for cardiovascular disease (CVD). METHODS A total of 285 009 participants free of CVD at baseline from the UK Biobank were included in this analysis. Four major cardiovascular admission events were identified during the follow-up: chronic ischaemic heart disease (CIHD), cerebrovascular disease, atrial fibrillation and heart failure. We used Prentice, Williams and Peterson-Total Time model to examine the association between ambient air pollution and first admission, as well as multiple readmissions for these CVDs. RESULTS During a median follow-up of 12 years, 17 176 (6.03%) participants were hospitalised with CVDs, and 6203 (36.11%) patients with CVD had subsequent readmission events for CVDs. We observed significant associations between air pollution and both first admission and readmission for CVDs, with generally stronger associations on readmission for cardiovascular events. For example, the adjusted HRs for the first admission and subsequent readmission for cerebrovascular disease were 1.130 (95% CI 1.070 to 1.194) and 1.270 (95% CI 1.137 to 1.418) for each IQR increase of particulate matter with a diameter ≤2.5 µm. The corresponding HRs for CIHD were 1.060 (95% CI 1.008 to 1.114) and 1.120 (95% CI 1.070 to 1.171). Sex stratified analyses showed that the associations were generally more pronounced among females than males. CONCLUSION This study provides evidence that ambient air pollutants might play an important role in both first admission and readmission for cardiovascular events. In addition, patients with pre-existing CVDs may be more vulnerable to air pollution compared with healthy population.
Collapse
Affiliation(s)
- Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Lan Chen
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, Saint Louis University College for Public Health and Social Justice, Saint Louis, Missouri, USA
| | - Dan Li
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Miao Cai
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zilong Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, USA
| | - Amy E Keith
- Department of Epidemiology and Biostatistics, Saint Louis University College for Public Health and Social Justice, Saint Louis, Missouri, USA
| | - Haitao Li
- Department of Social Medicine and Health Service Management, Health Science Center, Shenzhen University, Shenzhen, Guangdong, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| |
Collapse
|
5
|
Ding J, Chen J, Zhou J, Jiang Z, Xiang D, Xing W. Association between renal surface nodularity and increased adverse vascular event risk in patients with arterial hypertension. Clin Exp Hypertens 2023; 45:2228518. [PMID: 37366048 DOI: 10.1080/10641963.2023.2228518] [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: 06/30/2022] [Revised: 01/16/2023] [Accepted: 06/17/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVE To explore the association of renal surface nodularity (RSN) with the increased adverse vascular event (AVE) risk in patients with arterial hypertension. METHODS This cross-sectional study included patients with arterial hypertension aged 18-60 years who underwent contrasted computed tomography (CT) of kidney from January 2012 to December 2020. The subjects were classified into AVE or not (non-AVE) matched with age (≤5 years) and sex. Their CT images were analyzed using both qualitative (semiRSN) and quantitative RSN (qRSN) methods, respectively. Their clinical characteristics included age, sex, systolic blood pressure (SBP), diastolic blood pressure, hypertension course, diabetes history, hyperlipidemia, and estimated glomerular filtration rate (eGFR). RESULTS Compared with non-AVE group (n = 91), AVE (n = 91) was at lower age, higher SBP, and fewer rate of diabetes and hyperlipidemia history (all P < .01). Rate of positive semiRSN was higher in AVE than non-AVE (49.45% vs 14.29%, P < .001). qRSN was larger in AVE than non-AVE [1.03 (0.85, 1.33) vs 0.86 (0.75,1.03), P < .001]. The increased AVE was associated with semiRSN (odds ratio = 7.04, P < .001) and qRSN (odds ratio = 5.09, P = .003), respectively. For distinguishing AVE from non-AVE, the area under receiver operating characteristic was bigger in the models combining the clinical characteristics with either semiRSN or qRSN than that of semiRSN or qRSN alone (P ≤.01). CONCLUSION Among the patients with arterial hypertension aged 18-60 years, CT imaging-based RSN was associated with increased AVE risk.
Collapse
Affiliation(s)
- Jiule Ding
- Department of Radiology, The Third Affiliated Hospital of Soochow Univesity, Changzhou, Jiangsu, China
| | - Jie Chen
- Department of Radiology, The Third Affiliated Hospital of Soochow Univesity, Changzhou, Jiangsu, China
| | - Jun Zhou
- Department of Radiology, The Third Affiliated Hospital of Soochow Univesity, Changzhou, Jiangsu, China
| | - Zhenxing Jiang
- Department of Radiology, The Third Affiliated Hospital of Soochow Univesity, Changzhou, Jiangsu, China
| | - Dehui Xiang
- School of Electronics and Information Engineering, Soochow University, Suzhou, Jiangsu, China
| | - Wei Xing
- Department of Radiology, The Third Affiliated Hospital of Soochow Univesity, Changzhou, Jiangsu, China
| |
Collapse
|
6
|
Hunter SK, S Angadi S, Bhargava A, Harper J, Hirschberg AL, D Levine B, L Moreau K, J Nokoff N, Stachenfeld NS, Bermon S. The Biological Basis of Sex Differences in Athletic Performance: Consensus Statement for the American College of Sports Medicine. Med Sci Sports Exerc 2023; 55:2328-2360. [PMID: 37772882 DOI: 10.1249/mss.0000000000003300] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
ABSTRACT Biological sex is a primary determinant of athletic performance because of fundamental sex differences in anatomy and physiology dictated by sex chromosomes and sex hormones. Adult men are typically stronger, more powerful, and faster than women of similar age and training status. Thus, for athletic events and sports relying on endurance, muscle strength, speed, and power, males typically outperform females by 10%-30% depending on the requirements of the event. These sex differences in performance emerge with the onset of puberty and coincide with the increase in endogenous sex steroid hormones, in particular testosterone in males, which increases 30-fold by adulthood, but remains low in females. The primary goal of this consensus statement is to provide the latest scientific knowledge and mechanisms for the sex differences in athletic performance. This review highlights the differences in anatomy and physiology between males and females that are primary determinants of the sex differences in athletic performance and in response to exercise training, and the role of sex steroid hormones (particularly testosterone and estradiol). We also identify historical and nonphysiological factors that influence the sex differences in performance. Finally, we identify gaps in the knowledge of sex differences in athletic performance and the underlying mechanisms, providing substantial opportunities for high-impact studies. A major step toward closing the knowledge gap is to include more and equitable numbers of women to that of men in mechanistic studies that determine any of the sex differences in response to an acute bout of exercise, exercise training, and athletic performance.
Collapse
Affiliation(s)
- Sandra K Hunter
- Exercise Science Program, Department of Physical Therapy, and Athletic and Human Performance Center, Marquette University, Milwaukee, WI
| | | | - Aditi Bhargava
- Department of Obstetrics and Gynecology, Center for Reproductive Sciences, University of California, San Francisco, CA
| | - Joanna Harper
- Loughborough University, Loughborough, UNITED KINGDOM
| | - Angelica Lindén Hirschberg
- Department of Women's and Children's Health, Karolinska Institutet, and Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, SWEDEN
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and the Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Kerrie L Moreau
- Department of Medicine, Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, and Eastern Colorado Health Care System, Geriatric Research Education and Clinical Center, Aurora, CO
| | - Natalie J Nokoff
- Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Nina S Stachenfeld
- The John B. Pierce Laboratory and Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT
| | - Stéphane Bermon
- Health and Science Department, World Athletics, Monaco and the LAMHESS, University Côte d'Azur, Nice, FRANCE
| |
Collapse
|
7
|
Salvatori F, D’Aversa E, Serino ML, Singh AV, Secchiero P, Zauli G, Tisato V, Gemmati D. miRNAs Epigenetic Tuning of Wall Remodeling in the Early Phase after Myocardial Infarction: A Novel Epidrug Approach. Int J Mol Sci 2023; 24:13268. [PMID: 37686073 PMCID: PMC10487654 DOI: 10.3390/ijms241713268] [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: 08/03/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Myocardial infarction (MI) is one of the leading causes of death in Western countries. An early diagnosis decreases subsequent severe complications such as wall remodeling or heart failure and improves treatments and interventions. Novel therapeutic targets have been recognized and, together with the development of direct and indirect epidrugs, the role of non-coding RNAs (ncRNAs) yields great expectancy. ncRNAs are a group of RNAs not translated into a product and, among them, microRNAs (miRNAs) are the most investigated subgroup since they are involved in several pathological processes related to MI and post-MI phases such as inflammation, apoptosis, angiogenesis, and fibrosis. These processes and pathways are finely tuned by miRNAs via complex mechanisms. We are at the beginning of the investigation and the main paths are still underexplored. In this review, we provide a comprehensive discussion of the recent findings on epigenetic changes involved in the first phases after MI as well as on the role of the several miRNAs. We focused on miRNAs function and on their relationship with key molecules and cells involved in healing processes after an ischemic accident, while also giving insight into the discrepancy between males and females in the prognosis of cardiovascular diseases.
Collapse
Affiliation(s)
- Francesca Salvatori
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (F.S.)
| | - Elisabetta D’Aversa
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (F.S.)
| | - Maria Luisa Serino
- Centre Haemostasis & Thrombosis, University of Ferrara, 44121 Ferrara, Italy
| | - Ajay Vikram Singh
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), 10589 Berlin, Germany
| | - Paola Secchiero
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (F.S.)
| | - Giorgio Zauli
- Department of Environmental Science and Prevention, University of Ferrara, 44121 Ferrara, Italy
| | - Veronica Tisato
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (F.S.)
- LTTA Centre, University of Ferrara, 44121 Ferrara, Italy
- University Centre for Studies on Gender Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - Donato Gemmati
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (F.S.)
- Centre Haemostasis & Thrombosis, University of Ferrara, 44121 Ferrara, Italy
- University Centre for Studies on Gender Medicine, University of Ferrara, 44121 Ferrara, Italy
| |
Collapse
|
8
|
Lehtovirta M, Wu F, Rovio SP, Heinonen OJ, Laitinen TT, Niinikoski H, Lagström H, Viikari JSA, Rönnemaa T, Jula A, Ala-Korpela M, Raitakari OT, Pahkala K. Association of physical activity with metabolic profile from adolescence to adulthood. Scand J Med Sci Sports 2023; 33:307-318. [PMID: 36331352 DOI: 10.1111/sms.14261] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Physical activity benefits cardiometabolic health, but little is known about its detailed links with serum lipoproteins, amino acids, and glucose metabolism at young age. We therefore studied the association of physical activity with a comprehensive metabolic profile measured repeatedly in adolescence. METHODS The cohort is derived from the longitudinal Special Turku Coronary Risk Factor Intervention Project. At ages 13, 15, 17, and 19 years, data on physical activity were collected by a questionnaire, and circulating metabolic measures were quantified by nuclear magnetic resonance metabolomics from repeatedly assessed serum samples (age 13: n = 503, 15: n = 472, 17: n = 466, and 19: n = 361). RESULTS Leisure-time physical activity (LTPA;MET h/wk) was directly associated with concentrations of polyunsaturated fatty acids, and inversely with the ratio of monounsaturated fatty acids to total fatty acids (-0.006SD; [-0.008, -0.003]; p < 0.0001). LTPA was inversely associated with very-low-density lipoprotein (VLDL) particle concentration (-0.003SD; [-0.005, -0.001]; p = 0.002) and VLDL particle size (-0.005SD; [-0.007, -0.003]; p < 0.0001). LTPA showed direct association with the particle concentration and size of high-density lipoprotein (HDL), and HDL cholesterol concentration (0.004SD; [0.002, 0.006]; p < 0.0001). Inverse associations of LTPA with triglyceride and total lipid concentrations in large to small sized VLDL subclasses were found. Weaker associations were seen for other metabolic measures including inverse associations with concentrations of lactate, isoleucine, glycoprotein acetylation, and a direct association with creatinine concentration. The results remained after adjusting for body mass index and proportions of energy intakes from macronutrients. CONCLUSIONS Physical activity during adolescence is beneficially associated with the metabolic profile including novel markers. The results support recommendations on physical activity during adolescence to promote health and possibly reduce future disease risks.
Collapse
Affiliation(s)
- Miia Lehtovirta
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Suvi P Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre, Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Tomi T Laitinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Paavo Nurmi Centre, Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Harri Niinikoski
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Department of Pediatrics and Adolescent Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Hanna Lagström
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
| | - Jorma S A Viikari
- Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Tapani Rönnemaa
- Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Antti Jula
- Department of Chronic Disease Prevention, Institute for Health and Welfare, Turku, Finland
| | - Mika Ala-Korpela
- Computational Medicine, Center for Life Course Health Research, Faculty of Medicine, University of Oulu & Biocenter Oulu, Oulu, Finland.,NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Paavo Nurmi Centre, Unit for Health and Physical Activity, University of Turku, Turku, Finland
| |
Collapse
|
9
|
Filosa A, Sawamiphak S. Heart development and regeneration-a multi-organ effort. FEBS J 2023; 290:913-930. [PMID: 34894086 DOI: 10.1111/febs.16319] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 10/22/2021] [Accepted: 12/10/2021] [Indexed: 12/15/2022]
Abstract
Development of the heart, from early morphogenesis to functional maturation, as well as maintenance of its homeostasis are tasks requiring collaborative efforts of cardiac tissue and different extra-cardiac organ systems. The brain, lymphoid organs, and gut are among the interaction partners that can communicate with the heart through a wide array of paracrine signals acting at local or systemic level. Disturbance of cardiac homeostasis following ischemic injury also needs immediate response from these distant organs. Our hearts replace dead muscles with non-contractile fibrotic scars. We have learned from animal models capable of scarless repair that regenerative capability of the heart does not depend only on competency of the myocardium and cardiac-intrinsic factors but also on long-range molecular signals originating in other parts of the body. Here, we provide an overview of inter-organ signals that take part in development and regeneration of the heart. We highlight recent findings and remaining questions. Finally, we discuss the potential of inter-organ modulatory approaches for possible therapeutic use.
Collapse
Affiliation(s)
- Alessandro Filosa
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Suphansa Sawamiphak
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Germany
| |
Collapse
|
10
|
Hodkinson A, Kontopantelis E, Zghebi SS, Grigoroglou C, McMillan B, Marwijk HV, Bower P, Tsimpida D, Emery CF, Burge MR, Esmiol H, Cupples ME, Tully MA, Dasgupta K, Daskalopoulou SS, Cooke AB, Fayehun AF, Houle J, Poirier P, Yates T, Henson J, Anderson DR, Grey EB, Panagioti M. Association Between Patient Factors and the Effectiveness of Wearable Trackers at Increasing the Number of Steps per Day Among Adults With Cardiometabolic Conditions: Meta-analysis of Individual Patient Data From Randomized Controlled Trials. J Med Internet Res 2022; 24:e36337. [PMID: 36040779 PMCID: PMC9472038 DOI: 10.2196/36337] [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: 01/11/2022] [Revised: 02/14/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Current evidence supports the use of wearable trackers by people with cardiometabolic conditions. However, as the health benefits are small and confounded by heterogeneity, there remains uncertainty as to which patient groups are most helped by wearable trackers. OBJECTIVE This study examined the effects of wearable trackers in patients with cardiometabolic conditions to identify subgroups of patients who most benefited and to understand interventional differences. METHODS We obtained individual participant data from randomized controlled trials of wearable trackers that were conducted before December 2020 and measured steps per day as the primary outcome in participants with cardiometabolic conditions including diabetes, overweight or obesity, and cardiovascular disease. We used statistical models to account for clustering of participants within trials and heterogeneity across trials to estimate mean differences with the 95% CI. RESULTS Individual participant data were obtained from 9 of 25 eligible randomized controlled trials, which included 1481 of 3178 (47%) total participants. The wearable trackers revealed that over the median duration of 12 weeks, steps per day increased by 1656 (95% CI 918-2395), a significant change. Greater increases in steps per day from interventions using wearable trackers were observed in men (interaction coefficient -668, 95% CI -1157 to -180), patients in age categories over 50 years (50-59 years: interaction coefficient 1175, 95% CI 377-1973; 60-69 years: interaction coefficient 981, 95% CI 222-1740; 70-90 years: interaction coefficient 1060, 95% CI 200-1920), White patients (interaction coefficient 995, 95% CI 360-1631), and patients with fewer comorbidities (interaction coefficient -517, 95% CI -1188 to -11) compared to women, those aged below 50, non-White patients, and patients with multimorbidity. In terms of interventional differences, only face-to-face delivery of the tracker impacted the effectiveness of the interventions by increasing steps per day. CONCLUSIONS In patients with cardiometabolic conditions, interventions using wearable trackers to improve steps per day mostly benefited older White men without multimorbidity. TRIAL REGISTRATION PROSPERO CRD42019143012; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=143012.
Collapse
Affiliation(s)
- Alexander Hodkinson
- Division of Population Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Health Services Research and Primary Care, National Institute for Health Research School for Primary Care Research, Manchester, United Kingdom
| | - Evangelos Kontopantelis
- Division of Population Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Health Services Research and Primary Care, National Institute for Health Research School for Primary Care Research, Manchester, United Kingdom.,Division of Informatics, Imaging & Data Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, United Kingdom
| | - Salwa S Zghebi
- Division of Population Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Health Services Research and Primary Care, National Institute for Health Research School for Primary Care Research, Manchester, United Kingdom
| | - Christos Grigoroglou
- Division of Population Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Health Services Research and Primary Care, National Institute for Health Research School for Primary Care Research, Manchester, United Kingdom
| | - Brian McMillan
- Division of Population Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Health Services Research and Primary Care, National Institute for Health Research School for Primary Care Research, Manchester, United Kingdom
| | - Harm van Marwijk
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, University of Brighton, Brighton, United Kingdom
| | - Peter Bower
- Division of Population Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Health Services Research and Primary Care, National Institute for Health Research School for Primary Care Research, Manchester, United Kingdom
| | - Dialechti Tsimpida
- Division of Population Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Health Services Research and Primary Care, National Institute for Health Research School for Primary Care Research, Manchester, United Kingdom
| | - Charles F Emery
- Department of Psychology, The Ohio State University College of Arts and Sciences, Columbus, OH, United States
| | - Mark R Burge
- Department of Medicine, Endocrinology and Metabolism, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Hunter Esmiol
- Department of Medicine, Endocrinology and Metabolism, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Margaret E Cupples
- Department of General Practice and Primary Care, Centre for Public Heath, Queen's University Belfast, Belfast, United Kingdom
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, United Kingdom
| | - Kaberi Dasgupta
- Department of Medicine, McGill University, Montreal, QC, Canada.,Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Stella S Daskalopoulou
- Department of Medicine, McGill University, Montreal, QC, Canada.,Centre for Translational Biology, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | | | - Ayorinde F Fayehun
- Department of Family Medicine, University College Hospital, Ibadan, Nigeria
| | - Julie Houle
- Department of Nursing, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Paul Poirier
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Laval, QC, Canada
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| | - Joseph Henson
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| | - Derek R Anderson
- Department of Psychology, The Ohio State University College of Arts and Sciences, Columbus, OH, United States
| | - Elisabeth B Grey
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, United Kingdom
| | - Maria Panagioti
- Division of Population Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Health Services Research and Primary Care, National Institute for Health Research School for Primary Care Research, Manchester, United Kingdom
| |
Collapse
|
11
|
Brayner B, Keske MA, Kaur G, Islam SMS, Perez-Cornago A, Piernas C, Livingstone KM. Longitudinal Associations Between Fat-Derived Dietary Patterns and Early Markers of Cardiovascular Disease Risk in the UK Biobank Study. J Am Heart Assoc 2022; 11:e024069. [PMID: 35621194 PMCID: PMC9238710 DOI: 10.1161/jaha.121.024069] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Although the impact of dietary fats on cardiovascular disease (CVD) risk is widely researched, longitudinal associations between dietary patterns (DPs) based on fat type and early markers of CVD risk remain unclear. Methods and Results UK Biobank participants (46.9% men, mean age 55 years) with data on early markers of CVD risk (n=12 706) were followed longitudinally (2014-2020; mean 8.4 years). Two DPs (DP1, DP2) were derived using reduced rank regression (response variables: monounsaturated fat, polyunsaturated fat, and saturated fat based on two 24-hour dietary assessments. Multivariable logistic and linear regression were used to investigate associations between DPs and odds of elevated CVD risk (using the nonlaboratory Framingham Risk Score) and changes in early CVD markers, respectively. DP1 (characterized by higher nuts and seeds and lower fruit and legumes intake) was positively correlated with saturated fat, monounsaturated fat, and polyunsaturated fat; DP2 (characterized by higher butter and high-fat cheese, lower nuts and seeds intake) was positively correlated with saturated fat and negatively with polyunsaturated fat and monounsaturated fat. DP2 was associated with slightly higher odds of elevated CVD risk (odds ratio, 1.04 [95% CI, 1.00-1.07]). DP1 was associated with higher diastolic blood pressure (β, 0.20 [95% CI, 0.01-0.37]) and lower cardiac index (β, -0.02 [95% CI, -0.04 to -0.01]); DP2 was associated with higher carotid intima medial thickness (β, 1.80 [95% CI, 0.01-3.59]) and lower left ventricular ejection fraction (β, -0.15 [95% CI, -0.24 to -0.07]) and cardiac index (β, -0.01 [95% CI, -0.02 to -0.01]). Conclusions This study suggests small but statistically significant associations between DPs based on fat type and some early markers of CVD risk. Further research is needed to confirm these associations.
Collapse
Affiliation(s)
- Barbara Brayner
- School of Exercise and Nutrition Sciences Institute for Physical Activity and Nutrition Deakin University Geelong Victoria Australia
| | - Michelle A Keske
- School of Exercise and Nutrition Sciences Institute for Physical Activity and Nutrition Deakin University Geelong Victoria Australia
| | - Gunveen Kaur
- School of Exercise and Nutrition Sciences Institute for Physical Activity and Nutrition Deakin University Geelong Victoria Australia
| | - Sheikh Mohammed Shariful Islam
- School of Exercise and Nutrition Sciences Institute for Physical Activity and Nutrition Deakin University Geelong Victoria Australia
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit Nuffield Department of Population Health University of Oxford, Old Road Campus Headington, Oxford United Kingdom
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences Medical Sciences Division Radcliffe Primary Care Building Radcliffe Observatory QuarterUniversity of Oxford United Kingdom
| | - Katherine M Livingstone
- School of Exercise and Nutrition Sciences Institute for Physical Activity and Nutrition Deakin University Geelong Victoria Australia
| |
Collapse
|
12
|
Nappi RE, Chedraui P, Lambrinoudaki I, Simoncini T. Menopause: a cardiometabolic transition. Lancet Diabetes Endocrinol 2022; 10:442-456. [PMID: 35525259 DOI: 10.1016/s2213-8587(22)00076-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/08/2022] [Accepted: 02/17/2022] [Indexed: 12/12/2022]
Abstract
Menopause is often a turning point for women's health worldwide. Increasing knowledge from experimental data and clinical studies indicates that cardiometabolic changes can manifest at the menopausal transition, superimposing the effect of ageing onto the risk of cardiovascular disease. The menopausal transition is associated with an increase in fat mass (predominantly in the truncal region), an increase in insulin resistance, dyslipidaemia, and endothelial dysfunction. Exposure to endogenous oestrogen during the reproductive years provides women with protection against cardiovascular disease, which is lost around 10 years after the onset of menopause. In particular, women with vasomotor symptoms during menopause seem to have an unfavourable cardiometabolic profile. Early management of the traditional risk factors of cardiovascular disease (ie, hypertension, obesity, diabetes, dyslipidaemia, and smoking) is essential; however, it is important to recognise in the reproductive history the female-specific conditions (ie, gestational hypertension or diabetes, premature ovarian insufficiency, some gynaecological diseases such as functional hypothalamic amenorrhoea, and probably others) that could enhance the risk of cardiovascular disease during and after the menopausal transition. In this Review, the first of a Series of two papers, we provide an overview of the literature for understanding cardiometabolic changes and the management of women at midlife (40-65 years) who are at higher risk, focusing on the identification of factors that can predict the occurrence of cardiovascular disease. We also summarise evidence about preventive non-hormonal strategies in the context of cardiometabolic health.
Collapse
Affiliation(s)
- Rossella E Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
| | - Peter Chedraui
- Instituto de Investigación e Innovación en Salud Integral and Laboratorio de Biomedicina, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Irene Lambrinoudaki
- Menopause Unit, 2nd Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Tommaso Simoncini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| |
Collapse
|
13
|
Sasaki S, Nakamura K, Ukawa S, Okada E, Amagasa S, Inoue S, Kimura T, Yoshimura A, Tanaka A, Nakagawa T, Imae A, Tamakoshi A. Association of accelerometer-measured physical activity with kidney function in a Japanese population: the DOSANCO Health Study. BMC Nephrol 2022; 23:7. [PMID: 34979979 PMCID: PMC8722077 DOI: 10.1186/s12882-021-02635-0] [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: 07/19/2021] [Accepted: 12/09/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Sedentary behavior and decreased physical activity are associated with reduced kidney function, yet most evidence is based on self-reported physical activity. This study investigated the association between accelerometer-based physical activity level and kidney function in a general Japanese population. METHODS A cross-sectional study was conducted in 440 community-dwelling Japanese participants, aged 35-79 years. Time (min/d) was assessed for the following types of physical activity: sedentary behavior, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). Kidney function was assessed using estimated glomerular filtration rate (eGFR). A linear regression model was employed to calculate the β coefficient of eGFR for a 60-min/d increase in sedentary behavior and LPA and a 10-min/d increase in MVPA. A logistic regression model was used to calculate the odds ratio for low eGFR (< 60 versus ≥60 mL/min/1.73m2) for a 60-min/d or 10-min/d increase in each physical activity type. RESULTS MVPA time and eGFR were positively associated in both men and women, after adjusting for age, body mass index, and other clinical characteristics (Men: β, 0.91; P = 0.021; Women: β, 0.70; P = 0.034). In women, sedentary behavior and eGFR were inversely associated after adjusting for the same factors (β, - 1.06; P = 0.048). The odds ratio (95% confidence interval) for low eGFR associated with a 60-min increase in sedentary behavior was 1.65 (1.07-2.55) after adjusting for the same factors in women. CONCLUSION Longer sedentary behavior and shorter MVPA time were associated with lower kidney function in the Japanese population.
Collapse
Affiliation(s)
- Sachiko Sasaki
- Department of Public Health, Hokkaido University Faculty of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.,Department of Physical Therapy, Faculty of Human Science, Hokkaido Bunkyo University, 5-196-1 Kogane-chuo, Eniwa, 061-1449, Japan
| | - Koshi Nakamura
- Department of Public Health, Hokkaido University Faculty of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan. .,Department of Public Health and Hygiene, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
| | - Shigekazu Ukawa
- Department of Public Health, Hokkaido University Faculty of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.,Research Unit of Advanced Interdisciplinary Care Science, Osaka City University Graduate School of Human Life Science, Sugimoto 3-3-138, Sumiyoshi-ku, Osaka, 558-8585, Japan
| | - Emiko Okada
- Department of Public Health, Hokkaido University Faculty of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.,Department of Nutritional Epidemiology, National Institute of Biomedical Innovation, Health and Nutrition, 1-23-1, Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan
| | - Shiho Amagasa
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1, Shinjuku-ku, Tokyo, 160-8402, Japan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1, Shinjuku-ku, Tokyo, 160-8402, Japan
| | - Takashi Kimura
- Department of Public Health, Hokkaido University Faculty of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Aya Yoshimura
- Department of Public Health, Hokkaido University Faculty of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Aya Tanaka
- Department of Public Health, Hokkaido University Faculty of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Takafumi Nakagawa
- The Hokkaido Centre for Family Medicine, 1-18, Kita 41, Higashi 15, Higashi-ku, Sapporo, 007-0841, Japan
| | - Akihiro Imae
- Suttu Municipal Clinic, 72-2, Utoshima-Cho, Suttu-Cho, Suttu-Gun, Hokkaido, 048-0406, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| |
Collapse
|
14
|
Makowski L, Köppe J, Engelbertz C, Kühnemund L, Fischer AJ, Lange SA, Dröge P, Ruhnke T, Günster C, Malyar N, Gerß J, Freisinger E, Reinecke H, Feld J. OUP accepted manuscript. Eur Heart J 2022; 43:1759-1770. [PMID: 35134893 PMCID: PMC9076397 DOI: 10.1093/eurheartj/ehac016] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/25/2021] [Accepted: 01/11/2022] [Indexed: 12/24/2022] Open
Abstract
Aims The prevalence of chronic limb-threatening ischaemia (CLTI) is increasing and available data often derive from cohorts with various selection criteria. In the present study, we included CLTI patients and studied sex-related differences in their risk profile, vascular procedures, and long-term outcome. Methods and results We analysed 199 953 unselected patients of the largest public health insurance in Germany (AOK: Local healthcare funds), hospitalized between 2010 and 2017 for a main diagnosis of CLTI. A baseline period of 2 years before index hospitalization to assess comorbidities and previous procedures, and a follow-up period until 2018 were included. Female CLTI patients were older (median 81.4 vs. 73.8 years in males; P < 0.001) and more often diagnosed with hypertension, atrial fibrillation, chronic heart failure, and chronic kidney disease. Male patients suffered more frequently from diabetes mellitus, dyslipidaemia, smoking, cerebrovascular disease, and chronic coronary syndrome (all P < 0.001). Within hospitalized CLTI patients, females represent the minority (43% vs. 57%; P < 0.001) and during index hospitalization, women underwent less frequently diagnostic angiographies (67 vs. 70%) and revascularization procedures (61 vs. 65%; both P < 0.001). Moreover, women received less frequently guideline-recommended drugs like statins (35 vs. 43%) and antithrombotic therapy (48 vs. 53%; both P < 0.001) at baseline. Interestingly, after including age and comorbidities in a Cox regression analysis, female sex was associated with increased overall-survival (OS) [hazard ratio (HR) 0.95; 95% confidence interval (CI) 0.94–0.96] and amputation-free survival (AFS) (HR 0.84; 95% CI 0.83–0.85; both P < 0.001). Conclusion Female patients with CLTI were older, underwent less often vascular procedures, and received less frequently guideline-recommended medication. Nevertheless, female sex was independently associated with better OS and AFS during follow-up.
Collapse
Affiliation(s)
- Lena Makowski
- Corresponding author. Tel: +49 251 83 45569, Fax: +49 251 83 45101,
| | - Jeanette Köppe
- Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany
| | - Christiane Engelbertz
- Department of Cardiology I—Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Cardiol, Albert Schweitzer Campus 1, A1, 48149 Muenster, Germany
| | - Leonie Kühnemund
- Department of Cardiology I—Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Cardiol, Albert Schweitzer Campus 1, A1, 48149 Muenster, Germany
| | - Alicia J Fischer
- Department of Cardiology III—Adult Congenital and Valvular Heart Disease, University Hospital Muenster, Cardiol, Albert Schweitzer Campus 1, A1, 48149 Muenster, Germany
| | - Stefan A Lange
- Department of Cardiology I—Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Cardiol, Albert Schweitzer Campus 1, A1, 48149 Muenster, Germany
| | | | | | | | - Nasser Malyar
- Department of Cardiology I—Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Cardiol, Albert Schweitzer Campus 1, A1, 48149 Muenster, Germany
| | - Joachim Gerß
- Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany
| | - Eva Freisinger
- Department of Cardiology I—Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Cardiol, Albert Schweitzer Campus 1, A1, 48149 Muenster, Germany
| | - Holger Reinecke
- Department of Cardiology I—Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Cardiol, Albert Schweitzer Campus 1, A1, 48149 Muenster, Germany
| | - Jannik Feld
- Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany
| |
Collapse
|
15
|
Goldstein KM, Zullig LL, Andrews SM, Sperber N, Lewinski AA, Voils CI, Oddone EZ, Bosworth HB. Patient experiences with a phone-based cardiovascular risk reduction intervention: Are there differences between women and men? PATIENT EDUCATION AND COUNSELING 2021; 104:2834-2838. [PMID: 33838939 DOI: 10.1016/j.pec.2021.03.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/16/2021] [Accepted: 03/24/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To explore gender-based differences in experiences with a telehealth-delivered intervention for reduction of cardiovascular risk. METHODS We conducted 23 semi-structured qualitative interviews by telephone with 11 women and 12 men who received a 12-month, pharmacist-delivered, telephone-based medication and behavioral management intervention. We used content analysis to identify themes. RESULTS We identified three common themes for both men and women: ease and convenience of phone support, preference for proactive outreach, and need for trust building in the context of telehealth. While both genders appreciated the social support from the intervention pharmacist, women voiced appreciation for accountability whereas men generally spoke about encouragement. CONCLUSIONS Rapport building may differ between telehealth and in-person healthcare visits; our work highlights how men and women's experiences can differ with telehealth care and which can inform the development of future, purposeful rapport building activities to strengthen the clinician-patient interaction. PRACTICE IMPLICATIONS Clinicians should seek opportunities to provide frequent and routine support for patients with chronic disease. Telehealth interventions may benefit from gender-specific tailoring of social support.
Collapse
Affiliation(s)
- K M Goldstein
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA; Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
| | - L L Zullig
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - S M Andrews
- Genomics, Bioinformatics, and Translational Research Center, RTI International, Durham, NC, USA
| | - N Sperber
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - A A Lewinski
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA; School of Nursing, Duke University, Durham, NC, USA
| | - C I Voils
- William S Middleton Memorial Veterans Hospital, Madison, NC, USA; Department of Surgery, University of Wisconsin School of Medicine & Public Health, Madison, NC, USA
| | - E Z Oddone
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA; Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - H B Bosworth
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA; Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; School of Nursing, Duke University, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA
| |
Collapse
|
16
|
Lipidomic Signatures of Changes in Adiposity: A Large Prospective Study of 5849 Adults from the Australian Diabetes, Obesity and Lifestyle Study. Metabolites 2021; 11:metabo11090646. [PMID: 34564462 PMCID: PMC8471381 DOI: 10.3390/metabo11090646] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/19/2021] [Accepted: 09/19/2021] [Indexed: 12/28/2022] Open
Abstract
Lipid metabolism is tightly linked to adiposity. Comprehensive lipidomic profiling offers new insights into the dysregulation of lipid metabolism in relation to weight gain. Here, we investigated the relationship of the human plasma lipidome and changes in waist circumference (WC) and body mass index (BMI). Adults (2653 men and 3196 women), 25–95 years old who attended the baseline survey of the Australian Diabetes, Obesity and Lifestyle Study (AusDiab) and the 5-year follow-up were enrolled. A targeted lipidomic approach was used to quantify 706 distinct molecular lipid species in the plasma samples. Multiple linear regression models were used to examine the relationship between the baseline lipidomic profile and changes in WC and BMI. Metabolic scores for change in WC were generated using a ridge regression model. Alkyl-diacylglycerol such as TG(O-50:2) [NL-18:1] displayed the strongest association with change in WC (β-coefficient = 0.125 cm increment per SD increment in baseline lipid level, p = 2.78 × 10−11. Many lipid species containing linoleate (18:2) fatty acids were negatively associated with both WC and BMI gain. Compared to traditional models, multivariate models containing lipid species identify individuals at a greater risk of gaining WC: top quintile relative to bottom quintile (odds ratio, 95% CI = 5.4, 3.8–6.6 for women and 2.3, 1.7–3.0 for men). Our findings define metabolic profiles that characterize individuals at risk of weight gain or WC increase and provide important insight into the biological role of lipids in obesity.
Collapse
|
17
|
Pianese T, Belfiore P. Exploring the Social Networks' Use in the Health-Care Industry: A Multi-Level Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147295. [PMID: 34299746 PMCID: PMC8304126 DOI: 10.3390/ijerph18147295] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/25/2021] [Accepted: 07/06/2021] [Indexed: 11/16/2022]
Abstract
The application of social networks in the health domain has become increasingly prevalent. They are web-based technologies which bring together a group of people and health-care providers having in common health-related interests, who share text, image, video and audio contents and interact with each other. This explains the increasing amount of attention paid to this topic by researchers who have investigated a variety of issues dealing with the specific applications in the health-care industry. The aim of this study is to systematize this fragmented body of literature, and provide a comprehensive and multi-level overview of the studies that has been carried out to date on social network uses in healthcare, taking into account the great level of diversity that characterizes this industry. To this end, we conduct a scoping review enabling to identify the major research streams, whose aggregate knowledge are discussed according to three levels of analysis that reflect the viewpoints of the major actors using social networks for health-care purposes, i.e., governments, health-care providers (including health-care organizations and professionals) and social networks’ users (including ill patients and general public). We conclude by proposing directions for future research.
Collapse
Affiliation(s)
- Tommasina Pianese
- Institute for Studies on the Mediterranean, National Research Council of Italy (CNR ISMed), 80132 Napoli, Italy
- Correspondence:
| | - Patrizia Belfiore
- Department of Movement and Wellness Sciences, Parthenope University of Naples, 80132 Napoli, Italy;
| |
Collapse
|
18
|
Jung CY, Heo GY, Park JT, Joo YS, Kim HW, Lim H, Chang TI, Kang EW, Yoo TH, Kang SW, Lee J, Kim SW, Oh YK, Jung JY, Oh KH, Ahn C, Han SH. Sex disparities and adverse cardiovascular and kidney outcomes in patients with chronic kidney disease: results from the KNOW-CKD. Clin Res Cardiol 2021; 110:1116-1127. [PMID: 34003323 DOI: 10.1007/s00392-021-01872-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/07/2021] [Indexed: 12/18/2022]
Abstract
AIMS Longitudinal studies of the association between sex and adverse clinical outcomes in patients with chronic kidney disease (CKD) are scarce. We assessed whether major outcomes may differ by sex among CKD patients. METHODS We analyzed a total of 1780 participants with non-dialysis CKD G1-5 from the KoreaN cohort study for Outcome in patients with Chronic Kidney Disease (KNOW-CKD). The primary outcome was a composite of non-fatal cardiovascular events or all-cause mortality. Secondary outcomes included fatal and non-fatal cardiovascular events, all-cause mortality, and a composite kidney outcome of ≥ 50% decline in estimated glomerular filtration rate from baseline or the onset of end-stage kidney disease. RESULTS There were 1088 (61%) men and 692 (39%) women in the study cohort. The proportion of smokers was significantly higher in men (24% vs. 3%). During 8430 person-years of follow-up, 201 primary outcome events occurred: 144 (13%) in men and 57 (8%) in women, with corresponding incidence rates of 2.9 and 1.7 per 100 person-years, respectively. In multivariable Cox models, men were associated with a 1.58-fold (95% CI 1.06-2.35) higher risk of composite outcome. Propensity score matching analysis revealed similar findings (HR 1.81; 95% CI 1.14-2.91). Risk of all-cause mortality was significantly higher in men of the matched cohort. However, there was no difference in the risk of CKD progression. In the subgroup with coronary artery calcium (CAC) measurements, men had a higher likelihood of CAC progression. CONCLUSIONS In Korean CKD patients, men were more likely to experience adverse cardiovascular events and death than women.
Collapse
Affiliation(s)
- Chan-Young Jung
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul, Republic of Korea
| | - Ga Young Heo
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul, Republic of Korea
| | - Jung Tak Park
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul, Republic of Korea
| | - Young Su Joo
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul, Republic of Korea
| | - Hyung Woo Kim
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul, Republic of Korea
| | - Hyunsun Lim
- Research and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyangshi, Gyeonggi-do, Republic of Korea
| | - Tae Ik Chang
- Department of Internal Medicine, National Health Insurance Service Medical Center, Ilsan Hospital, Goyangshi, Gyeonggi-do, Republic of Korea
| | - Ea Wha Kang
- Department of Internal Medicine, National Health Insurance Service Medical Center, Ilsan Hospital, Goyangshi, Gyeonggi-do, Republic of Korea
| | - Tae-Hyun Yoo
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul, Republic of Korea
| | - Shin-Wook Kang
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul, Republic of Korea
| | - Joongyub Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Yun Kyu Oh
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Ji Yong Jung
- Division of Nephrology, Department of Internal Medicine, Gachon University of Gil Medical Center, Incheon, Republic of Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Curie Ahn
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seung Hyeok Han
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul, Republic of Korea.
| |
Collapse
|
19
|
Papa V, Tafuri D, Vaccarezza M. Could Physical Activity Have any Role in Cardiovascular Disease Prevention in Prisoners? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052307. [PMID: 33652816 PMCID: PMC7956477 DOI: 10.3390/ijerph18052307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/12/2021] [Accepted: 02/19/2021] [Indexed: 12/14/2022]
Abstract
More than 10.74 million people are currently held in penal institutions worldwide. Moreover, there is also evidence that the percentage of elder and female prisoners has been consistently growing. Cardiovascular diseases are the leading cause of death worldwide. Exercise training and physical activity help to prevent both primary and secondary cardiovascular events. Data on the influence of physical activity on the well-being in prison population is scarce. Here, we discussed, in a systematic review, the general health conditions and the cardiovascular risk profile in the prisoners compared to the general population and evaluated whether or not exercise could be a valuable tool in preventing these diseases in inmates. We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement: 769 were initially identified, and a total of 24 studies were finally included. Nine studies evaluated the health conditions in prisoners, five studies evaluated the incidence of cardiovascular disease (CVD) and coronary heart disease (CHD) in the prison population, and 10 studies evaluated the feasibility and the effectiveness of exercise programs in prisoners. Sports-educational programs can benefit prison inmates. It appears that supervised exercise training is an effective coping strategy to deal with incarceration. Moreover, it seems the sports programs might be a useful tool in improving physical and mental health of prisoners as well as in decreasing cardiovascular risk factors.
Collapse
Affiliation(s)
- Veronica Papa
- Department of Motor Sciences and Wellness, University of Naples “Parthenope”, 80132 Napoli, Italy;
- FAPAB Research Center, 96012 Avola, Italy
- Correspondence:
| | - Domenico Tafuri
- Department of Motor Sciences and Wellness, University of Naples “Parthenope”, 80132 Napoli, Italy;
| | - Mauro Vaccarezza
- Curtin Medical School & Curtin Health Innovation Research Institute (CHIRI), Curtin University, Kent St., Bentley 6102 WA, Australia;
| |
Collapse
|