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Wongrukmit S, Ngamphaiboon N, Kiranantawat K, Suwanthanma W, Plumworasawat S, Boonsakan P, Pongtippan A, Phanachet P, Warodomwichit D, Shantavasinkul PC. Unusual manifestation of gastric adenocarcinoma presenting with lymphedema, chylothorax, and chylous ascites. Clin J Gastroenterol 2023; 16:822-828. [PMID: 37737943 DOI: 10.1007/s12328-023-01851-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 08/18/2023] [Indexed: 09/23/2023]
Abstract
A 62-year-old Thai man with a 2-year history of bilateral lymphedema and an unprovoked left axillary vein thrombosis presented with progressive leg, scrotal, and abdominal swelling, and shortness of breath. He denied any gastrointestinal symptoms. His lymphedema had initially been diagnosed as chronic filariasis due to positive blood tests for anti-filarial antibodies; however, treatment with anti-filarial drugs failed to improve his symptoms. Subsequently, he underwent surgical lymphaticovenular anastomosis with scrotal reduction, which proved to be of limited symptomatic relief. Later investigations revealed bilateral chylothorax and chylous ascites, with the presence of metastatic adenocarcinoma. Histopathological examination of the patient's skin and scrotum biopsy from his previous surgery revealed invasion of the lymphatics by neoplastic cells with signet ring cell formation. Gastroscopy uncovered a gastric mass, and biopsy confirmed the diagnosis of stage IV gastric adenocarcinoma with signet ring cell. He later received palliative chemotherapy. For the management of chyle leakage, he was prescribed a very low-fat diet and supplemented with parenteral nutrition. Despite treatment, he developed cutaneous metastasis and was transitioned to best supportive care. The patient passed away 14 months after diagnosis.
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Affiliation(s)
- Siree Wongrukmit
- Division of Nutrition and Biochemical Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand
| | - Nuttapong Ngamphaiboon
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kidakorn Kiranantawat
- Division of Plastic and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Weerapat Suwanthanma
- Division of General Surgery, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sirithep Plumworasawat
- Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Paisarn Boonsakan
- Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Atcharaporn Pongtippan
- Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pariya Phanachet
- Division of Nutrition and Biochemical Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand
| | - Daruneewan Warodomwichit
- Division of Nutrition and Biochemical Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand
| | - Prapimporn Chattranukulchai Shantavasinkul
- Division of Nutrition and Biochemical Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand.
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Unhapipatpong C, Hiranyatheb P, Phanachet P, Warodomwichit D, Sriphrapradang C, Shantavasinkul PC. Postprandial hypoglycemia after ileocolic interposition and Billroth-II gastrojejunostomy: A case report. Clin Case Rep 2023; 11:e7060. [PMID: 36950668 PMCID: PMC10025248 DOI: 10.1002/ccr3.7060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/03/2023] [Accepted: 02/22/2023] [Indexed: 03/24/2023] Open
Abstract
Postprandial reactive hypoglycemia, or late dumping syndrome, is a common but underrecognized complication from bypass surgery. We report an unusual case of postprandial reactive hypoglycemia in a patient with a severe esophageal stricture from corrosive agent ingestion who underwent ileocolic interposition and an antecolic Billroth-II gastrojejunostomy. A 22-year-old male patient with a one-year history of corrosive ingestion was referred to the hospital for a surgical correction of severe esophageal stricture. After the patient underwent ileocolic interposition and an antecolic Billroth-II gastrojejunostomy, he experienced multiple episodes of gastroesophageal refluxsymptoms during nasogastric feeding and had onset of hypoglycemic symptoms. His plasma glucose level was 59 mg/dL. After we had intraoperatively re-inserted a jejunostomy tube bypassing the ileocolic interposition, and reintroduced enteral nutrition, his hypoglycemic symptoms resolved. We performed a mixed meal tolerance test by nasogastric tube, but the results did not show postprandial hypoglycemia. Although the specific mechanism is unclear, this case suggests gastroesophageal reflux to the ileal interposition may have caused a state of exaggerated hyperinsulinemic response and rebound hypoglycemia. To the best of our knowledge, we are the first to report case of postprandial hypoglycemia after ileocolic interposition, which may have been caused by exaggerated hyperinsulinemic response due to gastroesophageal reflux to the ileal interposition. This syndrome should be considered in the patient who has had ileocolic interposition surgery and has developed postprandial hypoglycemia.
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Affiliation(s)
- Chanita Unhapipatpong
- Department of Medicine, Division of Clinical NutritionKhon Kaen HospitalKhon KaenThailand
| | - Pitichote Hiranyatheb
- Department of Surgery, Division of General Surgery, Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkokThailand
| | - Pariya Phanachet
- Department of Medicine, Division of Nutrition and Biochemical Medicine, Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkokThailand
| | - Daruneewan Warodomwichit
- Department of Medicine, Division of Nutrition and Biochemical Medicine, Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkokThailand
| | - Chutintorn Sriphrapradang
- Department of Medicine, Division of Endocrinology and Metabolism, Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkokThailand
| | - Prapimporn Chattranukulchai Shantavasinkul
- Department of Medicine, Division of Nutrition and Biochemical Medicine, Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkokThailand
- Graduate Program in Nutrition, Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkokThailand
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Manacharoen A, Jayanama K, Ruangritchankul S, Vathesatogkit P, Sritara P, Warodomwichit D. Association of body mass index and dietary intake with mild cognitive impairment and dementia: a retrospective cohort study. BMC Geriatr 2023; 23:3. [PMID: 36597023 PMCID: PMC9808972 DOI: 10.1186/s12877-022-03700-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/14/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The prevalence of cognitive impairment in older adults is gradually increasing, and this is leading to many adverse outcomes. Common causes of cognitive impairment in advancing age are mild cognitive impairment (MCI) and dementia. However, how the nutritional status and nutrient intake are related to MCI and dementia is controversial. Therefore, we aimed to evaluate the association of body mass index (BMI) and dietary intake with the risk of MCI and dementia. METHODS This retrospective cohort study involved 821 participants aged ≥ 50 years from a previous population-based cohort study: the Electricity Generating Authority of Thailand (EGAT) study in 2013-2014 (baseline) and 2018-2019 (follow-up). Dietary intake was recorded using a 12-month self-reported food frequency questionnaire. MCI and dementia were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria using the Montreal Cognitive Assessment with ADL and the Kessler Psychological Distress Scale (K10) at study entry and at the 5-year follow-up. RESULTS Among the 821 participants, the mean age was 60.0 ± 4.3 years, and the incidence rate of MCI and dementia was 42.5 and 11.2 per 1,000 person-years, respectively. The rate of MCI and dementia was higher in participants aged ≥ 60 years and with an education level of < 7 years. The rate of MCI was also higher in those with a BMI of ≥ 25 kg/m2 and type 2 diabetes. Compared to BMI 18.5-22.9 kg/m2, BMI of ≥ 25 kg/m2 (odds ratio 1.91 [95% confidence interval, 1.12-3.26], p < 0.001) was associated with an increased risk of MCI after adjusted for age, education level, and type 2 diabetes. Regarding dietary intake, fresh red meat consumption was inversely associated with the risk of MCI (p = 0.037) and dementia (p = 0.011) after adjusting for age, education level, type 2 diabetes, and BMI. CONCLUSION Obesity was associated with a greater risk of MCI. Moreover, low consumption of fresh red meat could be a risk factor for MCI and dementia. Further studies are required to confirm and explain these findings.
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Affiliation(s)
- Apisit Manacharoen
- grid.10223.320000 0004 1937 0490Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kulapong Jayanama
- grid.10223.320000 0004 1937 0490Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
| | - Sirasa Ruangritchankul
- grid.10223.320000 0004 1937 0490Division of Geriatrics Medicine, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Prin Vathesatogkit
- grid.10223.320000 0004 1937 0490Division of Cardiology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Piyamitr Sritara
- grid.10223.320000 0004 1937 0490Division of Cardiology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Daruneewan Warodomwichit
- grid.10223.320000 0004 1937 0490Division of Nutrition and Biochemical Medicine, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Jongraksak T, Sobhonslidsuk A, Jatchavala J, Warodomwichit D, Kaewduang P, Sungkanuparph S. Prevalence and predicting factors of metabolic-associated fatty liver disease diagnosed by transient elastography with controlled attenuation parameters in HIV-positive people. Int J STD AIDS 2020; 32:266-275. [DOI: 10.1177/0956462420960997] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Metabolic disorders are increasing in people living with HIV (PLWH), and metabolic associated fatty liver disease (MAFLD) has become a common complication. A cross-sectional study was conducted in HIV-positive persons receiving anti-retroviral therapy (ART), in order to determine the prevalence and predicting factors of MAFLD in PLWH. All participants underwent bioelectrical impedance analysis, ultrasonography, and transient elastography with controlled attenuation parameter (CAP). MAFLD was defined as CAP ≥248 dB/m. Significant fibrosis was defined when liver stiffness measurement >7.0 kPa. Predicting factors of MAFLD were determined using logistic regression analysis. Of 150 participants, 48 (32.0%) had MAFLD. Significant fibrosis was diagnosed in 5 (10.4%) participants in the MAFLD group. Blood pressure, waist circumference, body mass index (BMI), percentage of fat, serum transaminases, HbA1c, LDL, and triglycerides levels were significantly higher in the MAFLD group ( p < 0.05). High BMI [odds ratio (OR) 1.596; 95% confidence interval (CI), 1.336–1.907, p < 0.001], triglycerides level >150 mg/dl [OR 3.722; 95% CI, 1.508–9.187, p < 0.004], and advanced age [OR 1.076; 95% CI, 1.017–1.139, p < 0.011] were associated with MAFLD in the multivariate analysis. MAFLD is common in PLWH receiving ART, while significant fibrosis is relatively infrequent. High BMI, age, and triglycerides level are the predicting factors of MAFLD in PLWH.
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Affiliation(s)
- Tanawat Jongraksak
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Abhasnee Sobhonslidsuk
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Janjira Jatchavala
- Department of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Daruneewan Warodomwichit
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Piyaporn Kaewduang
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Somnuek Sungkanuparph
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
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Kananuraks S, Assanatham M, Boongird S, Kitiyakara C, Thammavaranucupt K, Limpijarnkij T, Warodomwichit D, Davenport A, Nongnuch A. Bioimpedance Analysis–Guided Volume Expansion for the Prevention of Contrast-Induced Acute Kidney Injury (the BELIEVE Pilot Randomized Controlled Trial). Kidney Int Rep 2020; 5:1495-1502. [PMID: 32954073 PMCID: PMC7486189 DOI: 10.1016/j.ekir.2020.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/30/2020] [Accepted: 07/07/2020] [Indexed: 12/01/2022] Open
Abstract
Introduction Peri-procedural i.v. fluid administration is important for the prevention of contrast-induced acute kidney injury (CI-AKI). However, standardized fluid management protocols may not be suitable for all patients. We therefore wished to determine whether an individualized fluid administration protocol guided by measuring extracellular water (ECW) using bioimpedance analysis (BIA) would be safe and would reduce the incidence CI-AKI compared to a standardized fluid administration prescription. Methods In this pilot, randomized, parallel-group, single-blind, controlled trial, we compared the effect of BIA-guided isotonic bicarbonate administration according to the ratio of ECW to total body water (ECW/TBW) to our standard isotonic bicarbonate protocol in regard to the safety and efficacy of preventing CI-AKI in chronic kidney disease patients undergoing elective cardiac angiography. Our primary outcome was the incidence of CI-AKI, which was defined as a ≥0.3 mg/dl or 150% increase in serum creatinine concentration within 48 to 72 hours after cardiac angiography. Results We studied 61 patients, 30 in the bioimpedance group and 31 in the control group. Age was similar (72.5 ± 7 vs. 71.4 ± 7.9 years), as were body mass index (25.5 vs. 25.8 kg/m2) and baseline serum creatinine (1.3 ± 0.3 vs. 1.4 ± 0.4 mg/dl). The peri-procedural fluid volume administered was significantly greater in the BIA-guided hydration group (899.0 ± 252.7 ml vs. 594.4 ± 125.9 ml, P < .01). The incidence of CI-AKI was 3.3% in BIA-guided hydration group and 6.5% in the control group (relative risk = 0.52, 95% confidence interval = 0.05−5.40, P = 1.00). Adverse events reported were comparable between groups (6.7% vs. 6.5%, P = 1.00). Conclusions The overall incidence of CI-AKI after cardiac angiography in our patients with mild-to-moderate renal insufficiency was lower than anticipated. Isotonic bicarbonate administration guided by bioimpedance measurements was safe, and probably led to a lower incidence of CI-AKI, although this not reach statistical significance.
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Affiliation(s)
- Sarassawan Kananuraks
- Department of Medicine, Division of Nephrology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Montira Assanatham
- Department of Medicine, Division of Nephrology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sarinya Boongird
- Department of Medicine, Division of Nephrology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chagriya Kitiyakara
- Department of Medicine, Division of Nephrology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kanin Thammavaranucupt
- Renal Unit, Department of Medicine, Faculty of Medicine, Chakri Naruebodindra Medical Institute, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Thosaphol Limpijarnkij
- Department of Medicine, Division of Cardiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Daruneewan Warodomwichit
- Department of Medicine, Division of Nutrition and Biochemical Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Andrew Davenport
- University College London Centre for Nephrology, Royal Free Hospital, University College London, London, UK
| | - Arkom Nongnuch
- Department of Medicine, Division of Nephrology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Correspondence: Arkom Nongnuch, Department of Medicine, Division of Nephrology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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Rattanachaiwong S, Warodomwichit D, Yamwong P, Keawtanom S, Hiesmayr M, Sulz I, Singer P. Characteristics of hospitalized patients prescribed oral nutrition supplements in Thailand: A cross-sectional nutrition day survey. Clin Nutr ESPEN 2019; 33:294-300. [PMID: 31451271 DOI: 10.1016/j.clnesp.2019.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/22/2019] [Accepted: 05/21/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND OBJECTIVES Despite the proven benefits of oral nutrition supplements (ONS), its prescription in Thailand are far less than it should mainly due to limitation of reimbursement. Our aim was to compare hospital outcomes between hospitalized patients receiving only hospital food to those receiving hospital food with ONS. METHODS AND STUDY DESIGN An annual cross-sectional survey, NutritionDay (nD), in Thailand was conducted in 2 hospitals from 2010 to 2015. The hospital outcomes were followed at day 30 after first evaluation. Logistic regression and Cox regression were performed to compare outcome between groups. RESULTS 524 hospitalized patients, 472 with only hospital food and 52 with ONS, were included. Patients with ONS had longer hospital stay prior to recruitment, reported more physical dependencies, and ate less food. The ONS group was less likely to be discharged within 30 days as compared to hospital food group (unadjusted OR 0.28, 95% CI 0.16-0.52) but this effect was not significant after adjustment for length of stay before nD and PANDORA score (adjusted OR 0.62, 95% CI 0.3-1.34). Cox regression showed a trend to decreased rate of discharge within 30 days in the ONS group. CONCLUSIONS This cross-sectional study showed a trend of worse outcomes associated with ONS prescription which might be related with higher mortality risk according to PANDORA score and longer previous hospital stay of the patients in the ONS group. Since the 2 studied groups were not comparable, further studies in this specific population should be performed.
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Affiliation(s)
- Sornwichate Rattanachaiwong
- Division of Clinical Nutrition, Department of Medicine, Faculty of Medicine, Khon Kaen University, Thailand.
| | - Daruneewan Warodomwichit
- Division of Nutrition and Biochemical Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand.
| | - Preyanuj Yamwong
- Division of Nutrition, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand.
| | - Songsri Keawtanom
- Research Center for Nutrition Support, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand.
| | - Michael Hiesmayr
- Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care, Department of Anesthesia, General Intensive Care and Pain Control, Medical University of Vienna, Austria.
| | - Isabella Sulz
- Institute of Medical Statistics, Medical University of Vienna, Austria.
| | - Pierre Singer
- Department of General Intensive Care, Rabin Medical Center, Petah Tikva and Sackler School of Medicine, Tel Aviv University, Israel.
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Rattanachaiwong S, Warodomwichit D, Yamwong P, Keawtanom S, Hiesmayr M, Sulz I, Singer P. Effects of oral nutrition supplement in Thai malnourished patients: A cross-sectional nutrition day survey. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Jirotjananukul T, Vathesatogkit P, Warodomwichit D, Chandanamatha P, Yamwong S, Sritara P. P2525Diagnostic performance of electrocardiogram in detection of left ventricular hypertrophy in Asian population with different degree of abdominal obesity. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Jirotjananukul
- Ramathibodi Hospital of Mahidol University, Cardiology Unit, Department of Internal Medicine, Bangkok, Thailand
| | - P Vathesatogkit
- Ramathibodi Hospital of Mahidol University, Cardiology Unit, Department of Internal Medicine, Bangkok, Thailand
| | - D Warodomwichit
- Ramathibodi Hospital of Mahidol University, Clinical Nutrition Unit, Department of Internal Medicine, Bangkok, Thailand
| | - P Chandanamatha
- Ramathibodi Hospital of Mahidol University, Cardiology Unit, Department of Internal Medicine, Bangkok, Thailand
| | - S Yamwong
- Ramathibodi Hospital of Mahidol University, Cardiology Unit, Department of Internal Medicine, Bangkok, Thailand
| | - P Sritara
- Ramathibodi Hospital of Mahidol University, Cardiology Unit, Department of Internal Medicine, Bangkok, Thailand
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Torugsa S, Nimitphong H, Warodomwichit D, Chailurkit LO, Srijaruskul K, Chanprasertyothin S, Ongphiphadhanakul B. The genetic determinants of circulating C3-epimers of 25-hydroxyvitamin D. J Clin Transl Endocrinol 2018; 12:36-41. [PMID: 29892565 PMCID: PMC5992311 DOI: 10.1016/j.jcte.2018.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 04/16/2018] [Accepted: 04/16/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The complexity of vitamin D metabolites especially the contribution of C3-epimers of 25-hydroxyvitamin D (C3-epimers) in human sera remains unclear. We hypothesized that genetic polymorphisms in the vitamin D-related gene pathway contribute to variation in C3-epimer levels. Therefore, we investigated candidate single nucleotide polymorphisms (SNPs) concerning C3-epimer levels. METHODS The candidate SNPs, including DHCR7/NADSYN1 (rs12785878), CYP2R1 (rs2060793) and GC (rs2282679), were genotyped in 1727 members of the third project of the Electricity Generating Authority of Thailand 3/1 cohort investigation. Each SNP was tested under three genetic effects (dominant, recessive and additive models) concerning the levels of total serum 25(OH)D [the sum of 25(OH)D2+3 and 3-epi-25(OH)D2+3], non-C3-epimers [25(OH)D2+3] and C3-epimers [3-epi-25(OH)D2+3], using linear regression analysis. RESULTS Among the participants, the median (range) levels of non-C3-epimers and C3-epimers were 22.7 (6.4-49.2) ng/mL and 1.3 (0.01-14.2) ng/mL, respectively. In regression analysis, we found the genetic variation of two SNPs, the DHCR7/NADSYN1 (rs12785878; G > T) and GC (rs2282679; T > G) under additive genetic models, explained the variation of C3-epimer levels about 1.5% (p = 1.66 × 10-7) and 1.1% (p = 1.10 × 10-5), respectively. Interestingly, participants carrying the minor T-allele of rs12785878 exhibited a trend to increase C3-epimer levels, while those carrying the minor G-allele of rs2282679 exhibited a trend to decrease levels of both non-C3-epimers and C3-epimers. In addition, CYP2R1 (rs2060793; G > A) was clearly associated only with non-C3-epimer levels (p = 2.46 × 10-8). In multivariate analyses, sex, age and BMI were predictors for variation in C3-epimer concentration; sex and age for variation in non-C3-epimers. CONCLUSION To the best of our knowledge, this is the first study to demonstrate genetic models concerning the variation in C3-epimer levels. Our results emphasize that genetic determinants and the potential factors of C3-epimers differ from non-C3-epimers. This study contributes fundamental knowledge of the endogenous vitamin D pathway.
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Affiliation(s)
- Sirikunya Torugsa
- Faculty of Medicine Ramathibodi Hospital and Institute of Nutrition, Mahidol University, 270 Rama 6th Road, Ratchathewi, Bangkok 10400, Thailand
| | - Hataikarn Nimitphong
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Daruneewan Warodomwichit
- Division of Nutrition and Biochemical Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - La-or Chailurkit
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kriangsuk Srijaruskul
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Boonsong Ongphiphadhanakul
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Phanachet P, Shantavasinkul PC, Chantrathammachart P, Rattanakaemakorn P, Jayanama K, Komindr S, Warodomwichit D. Unusual manifestation of vitamin A deficiency presenting with generalized xerosis without night blindness. Clin Case Rep 2018; 6:878-882. [PMID: 29744078 PMCID: PMC5930185 DOI: 10.1002/ccr3.1475] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 12/27/2017] [Accepted: 02/15/2018] [Indexed: 11/28/2022] Open
Abstract
Vitamin A deficiency from malabsorption syndromes, including bariatric surgery, has become an emerging problem in developed countries. Early detection and prompt treatment lead to rapid and complete recovery. Nevertheless, it may result in irreversible blindness or death if left untreated. Health care personnel should be aware of this condition.
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Affiliation(s)
- Pariya Phanachet
- Division of Nutrition and Biochemical Medicine Department of Medicine Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok 10400 Thailand
| | | | - Pichika Chantrathammachart
- Division of Hematology Department of Medicine Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok 10400 Thailand
| | - Ploysyne Rattanakaemakorn
- Division of Dermatology Department of Medicine Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok 10400 Thailand
| | - Kulapong Jayanama
- Department of Medicine Faculty of Medicine Chakri Naruebodindra Medical Institute Ramathibodi Hospital Mahidol University Bangkok 10400 Thailand
| | - Surat Komindr
- Division of Nutrition and Biochemical Medicine Department of Medicine Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok 10400 Thailand
| | - Daruneewan Warodomwichit
- Division of Nutrition and Biochemical Medicine Department of Medicine Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok 10400 Thailand
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Khunpakdee N, Jayanama K, Kaewdoung P, Promson K, Rattanasiri S, Warodomwichit D, Kantachuvesiri S, Sobhonslidsuk A. Transient Elastography in End-Stage Renal Disease Patients on Hemodialysis: The Effect of Net Fluid Withdrawal. Blood Purif 2015; 40:256-9. [DOI: 10.1159/000439582] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 08/18/2015] [Indexed: 11/19/2022]
Abstract
Background/Aims: The impact of volume status on liver stiffness measurement (LSM) as measured by transient elastography (TE) as in end-stage renal disease (ESRD) was unclear. We evaluated LSM before and after hemodialysis (HD) and identified the associated factors if the difference of LSM existed. Methods: A cross-sectional study was conducted in ESRD patients on regular HD. Subjects underwent TE and bioelectrical impedance before and after HD. Results: Thirty-six patients were enrolled. Mean (SD) net fluid withdrawal volume (NFWV) per session was 2.55 (0.9) l. Median (range) pre- and post-HD LSMs were 5.38 (2.8-25.7) and 5.4 (2.8-26) kPa, respectively (p = 0.712). Mean differences of pre- and post-HD LSMs correlated with NFWV (r = 0.49, 95% CI 0.19-0.71, p = 0.002). Conclusion: In ESRD on regular HD, LSM is not affected by HD. TE can be done before or after HD with similar results. However, fluid excess at pre-HD can cause inaccurately high LSM.
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Sritara C, Thakkinstian A, Ongphiphadhanakul B, Pornsuriyasak P, Warodomwichit D, Akrawichien T, Vathesatogkit P, Sritara P. Work- and travel-related physical activity and alcohol consumption: relationship with bone mineral density and calcaneal quantitative ultrasonometry. J Clin Densitom 2015; 18:37-43. [PMID: 24878331 DOI: 10.1016/j.jocd.2014.04.117] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 04/10/2014] [Indexed: 11/17/2022]
Abstract
A number of healthy workers rarely exercise because of a lack of time or resources. Physical activity related to work and everyday travel may be more feasible, but evidence of its beneficial effect on bone health is scarce. We assessed if this form of physical activity was associated with higher bone mineral density (BMD) and stiffness index (SI) when adjusted for recreational physical activity, age, body mass index, smoking, alcohol consumption, education, and serum level of 25-hydroxyvitamin D. Healthy workers, aged 25-54 yr, of the Electricity Generating Authority of Thailand were surveyed. The outcomes were BMD (lumbar spine, femoral neck, and total hip) and calcaneal SI. Physical activity was estimated using the global physical activity questionnaire and considered active when >600 metabolic equivalent tasks (min). Of 2268 subjects, 74% were men. Active male subjects had significantly higher BMD at the femoral neck and total hip (p<0.005). However, the association was not significant with male lumbar spine BMD, male SI, or any bone parameters in women (p>0.05). In men, work and travel physical activity seems beneficial to male bone health; hence, it should be encouraged. Furthermore, smoking appeared harmful while moderate alcohol consumption was beneficial.
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Affiliation(s)
- Chanika Sritara
- Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Ammarin Thakkinstian
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Boonsong Ongphiphadhanakul
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Prapaporn Pornsuriyasak
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Daruneewan Warodomwichit
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tawatchai Akrawichien
- Medical and Health Office, Electricity Generating Authority of Thailand, Nonthaburi, Thailand
| | - Prin Vathesatogkit
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Piyamitr Sritara
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Rattanachaiwong S, Ongphiphadhanakul B, Warodomwichit D, Sritara C. PP239-MON: The Effect of Vitamin D on Brown Adipose Tissue in Obesity with Vitamin D Deficiency: Pilot Study. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50573-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Thakkinstian A, Chailurkit L, Warodomwichit D, Ratanachaiwong W, Yamwong S, Chanprasertyothin S, Attia J, Sritara P, Ongphiphadhanakul B. Causal relationship between body mass index and fetuin-A level in the asian population: a bidirectional Mendelian randomization study. Clin Endocrinol (Oxf) 2014; 81:197-203. [PMID: 23899227 DOI: 10.1111/cen.12303] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 05/29/2013] [Accepted: 07/25/2013] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Fetuin-A is associated with body mass index (BMI) as well as components of the metabolic syndrome. However, it is unclear if fetuin-A affects BMI or the other way around. We therefore assessed the causal association between fetuin-A and BMI or vice versa, utilizing a bidirectional Mendelian randomization approach. DESIGN AND METHODS This was a study of 2558 subjects from the Electricity Generating Authority of Thailand (EGAT) cohort. Two polymorphisms, that is, rs2248690 in the alpha2-Hereman-Schmid glycoprotein (AHSG) gene and rs9939609 in the fat mass and obesity-associated (FTO) gene were genotyped. Bidirectional causal models were constructed using a two-stage least-square instrumental variable (IV) regression. First, rs2248690 locus was used as the instrumental variable for the effect of circulating fetuin-A on BMI, and then, the FTO rs9939609 locus was used as the instrumental variable for the effect of BMI on circulating fetuin-A. RESULTS Among the 2558 subjects, the prevalence of the minor AHSG (T) and FTO (A) alleles was 17.9% and 22.1%, respectively. The AHSG rs2248690 locus was highly related to serum fetuin-A levels (P < 0.001). Likewise, the FTO rs9939609 locus and BMI were highly associated (P < 0.001). Mendelian randomization analyses showed that circulating fetuin-A, instrumented by the AHSG rs2248690 locus, was associated with BMI (coefficient = 2.26; 95% CI: 0.39, 4.12). In contrast, BMI, instrumented by the FTO rs9939609 locus, was not associated with circulating fetuin-A (coefficient = 0.0007; 95% CI: -0.0242, 0.0256). CONCLUSION Our findings suggest a causal association leading from circulating fetuin-A to BMI. There was no evidence of reverse causality from BMI to fetuin-A.
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Affiliation(s)
- Ammarin Thakkinstian
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Warodomwichit D, Sritara C, Thakkinstian A, Chailurkit LO, Yamwong S, Ratanachaiwong W, Ongphiphadhanakul B, Sritara P. Causal inference of the effect of adiposity on bone mineral density in adults. Clin Endocrinol (Oxf) 2013; 78:694-9. [PMID: 23045999 DOI: 10.1111/cen.12061] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 06/01/2012] [Accepted: 09/21/2012] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The causal effect of adipose tissue on bone mass and the direction of its net influence have not been directly assessed in adult humans. Using the Mendelian randomization analysis, we assessed the causality of adiposity in measurements of bone mass in adult males and females. DESIGN AND METHODS Subjects consisted of 2154 adults aged 25-54 years from a cross-sectional cohort of the employees of the Electricity Generating Authority of Thailand. Body composition was determined after at least 3 h of fasting using multifrequency bioelectrical impedance analysis. Bone mineral density (BMD) was assessed by dual energy X-ray absorptiometry. A polymorphism in the fat mass and obesity-associated gene (FTO rs9939609) was used as an instrument in the Mendelian randomization analysis. RESULTS The genotype distribution of the FTO rs9939609 polymorphism was 61·1% TT, 33·9% AT and 5·0% AA. The average body mass index (BMI), body fat mass and percentage body fat were 23·9 kg/m(2) (SD = 3·6), 17·9 kg (SD = 6·6) and 26·8% (SD = 7·2), respectively. The FTO rs9939609 polymorphism was significantly correlated with BMI (coefficient = 0·673 kg/m(2) , P < 0·001), body fat mass (coefficient = 0·948 kg, P < 0·001) and percentage body fat (coefficient = 0·759%, P < 0·01). An instrumental variable (IV) regression model, using BMI as the intermediate phenotype, suggested that FTO was a strong IV. Also, the FTO-BMI polymorphism was significantly associated with total hip and femoral neck BMD but was not correlated with total spine BMD, with estimated correlation coefficients of 0·0189 (95% CI: 0·0046, 0·0332), 0·0149 (95% CI: 0·0030, 0·0268) and 0·0025 (95% CI: -0·0131, 0·0136) g/cm(2) , respectively. The variances of BMDs explained by the FTO-BMI were 19·0%, 21·3% and 1·1%, respectively. Similar trends were also observed for the FTO-body fat mass and FTO-percentage body fat correlations. CONCLUSIONS Mendelian randomization analysis suggests that adiposity might be causally related to BMD at the femur but not at the spine.
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Affiliation(s)
- Daruneewan Warodomwichit
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Corella D, Arnett DK, Tucker KL, Kabagambe EK, Tsai M, Parnell LD, Lai CQ, Lee YC, Warodomwichit D, Hopkins PN, Ordovas JM. A high intake of saturated fatty acids strengthens the association between the fat mass and obesity-associated gene and BMI. J Nutr 2011; 141:2219-25. [PMID: 22049296 PMCID: PMC3223879 DOI: 10.3945/jn.111.143826] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Evidence that physical activity (PA) modulates the association between the fat mass and obesity-associated gene (FTO) and BMI is emerging; however, information about dietary factors modulating this association is scarce. We investigated whether fat and carbohydrate intake modified the association of FTO gene variation with BMI in two populations, including participants in the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) study (n = 1069) and in the Boston Puerto Rican Health (BPRHS) study (n = 1094). We assessed energy, nutrient intake, and PA using validated questionnaires. Genetic variability at the FTO locus was characterized by polymorphisms rs9939609 (in the GOLDN) and rs1121980 (in the GOLDN and BPRHS). We found significant interactions between PA and FTO on BMI in the GOLDN but not in the BPRHS. We found a significant interaction between SFA intake and FTO on BMI, which was stronger than that of total fat and was present in both populations (P-interaction = 0.007 in the GOLDN and P-interaction = 0.014 in BPRHS for categorical; and P-interaction = 0.028 in the GOLDN and P-interaction = 0.041 in BPRHS for continuous SFA). Thus, homozygous participants for the FTO-risk allele had a higher mean BMI than the other genotypes only when they had a high-SFA intake (above the population mean: 29.7 ± 0.7 vs. 28.1 ± 0.5 kg/m²; P = 0.037 in the GOLDN and 33.6. ± 0.8 vs. 31.2 ± 0.4 kg/m²; P = 0.006 in BPRHS). No associations with BMI were found at lower SFA intakes. We found no significant interactions with carbohydrate intake. In conclusion, SFA intake modulates the association between FTO and BMI in American populations.
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Affiliation(s)
- Dolores Corella
- Nutrition and Genomics Laboratory, Jean Mayer-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA.
| | - Donna K. Arnett
- Department of Epidemiology, School of Public Health, and Clinical Nutrition Research Center, University of Alabama at Birmingham, AL
| | | | - Edmond K. Kabagambe
- Department of Epidemiology, School of Public Health, and Clinical Nutrition Research Center, University of Alabama at Birmingham, AL
| | - Michael Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | - Laurence D. Parnell
- Nutrition and Genomics Laboratory, Jean Mayer-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Chao-Qiang Lai
- Nutrition and Genomics Laboratory, Jean Mayer-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Yu-Chi Lee
- Nutrition and Genomics Laboratory, Jean Mayer-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | | | - Paul N. Hopkins
- Cardiovascular Genetics Research, Department of Internal Medicine, Cardiology Division, University of Utah School of Medicine, Salt Lake City, UT
| | - Jose M. Ordovas
- Nutrition and Genomics Laboratory, Jean Mayer-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA,Department of Cardiovascular Epidemiology and Population Genetics, National Center for Cardiovascular Investigation, Madrid, Spain; and,IMDEA-Alimentacion, Madrid, Spain
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Lai CQ, Parnell LD, Troen AM, Shen J, Caouette H, Warodomwichit D, Lee YC, Crott JW, Qiu WQ, Rosenberg IH, Tucker KL, Ordovás JM. MAT1A variants are associated with hypertension, stroke, and markers of DNA damage and are modulated by plasma vitamin B-6 and folate. Am J Clin Nutr 2010; 91:1377-86. [PMID: 20335551 PMCID: PMC2854908 DOI: 10.3945/ajcn.2009.28923] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The S-adenosylmethionine synthetase type 1 (MAT1A) gene encodes a key enzyme in one-carbon nutrient metabolism. OBJECTIVE This study aimed to determine the association of MAT1A variants with homocysteine, DNA damage, and cardiovascular disease (CVD). DESIGN Eight variants of MAT1A were examined for associations with hypertension, stroke, CVD, homocysteine, and DNA damage in 1006 participants of the Boston Puerto Rican Health Study. Two variants were replicated in 1147 participants of the Nutrition, Aging, and Memory in Elders Study. RESULTS Two variants and haplotypes were strongly associated with hypertension and stroke, independent of methylenetetrahydrofolate reductase (MTHFR) variants. Homozygotes of the MAT1A d18777A (rs3851059) allele had a significantly greater likelihood of stroke (odds ratio: 4.30; 95% CI: 1.34, 12.19; P = 0.006), whereas 3U1510A (rs7087728) homozygotes had a lower likelihood of hypertension (odds ratio: 0.67; 95% CI: 0.48, 0.95; P = 0.022) and stroke (odds ratio: 0.35; 95% CI: 0.15, 0.82; P = 0.015). A similar trend of association was observed in a second elderly population. Furthermore, strong interactions between MAT1A genotypes and vitamin B-6 status were found. Carriers of the nonrisk allele 3U1510A had a lower 8-hydroxydeoxyguanosine concentration--a biomarker of oxidative DNA damage--when plasma vitamin B-6 was high, whereas homozygotes for the risk-allele 3U1510G had higher 8-hydroxydeoxyguanosine concentrations, regardless of vitamin B-6 status. CONCLUSIONS MAT1A variants were strongly associated with hypertension and stroke. Improving folate and vitamin B-6 status might decrease the CVD risk of only a subset of the population, depending on genotype. These findings suggest that impairments in methylation activity, independent of homocysteine, have an effect on CVD risk.
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Affiliation(s)
- Chao-Qiang Lai
- Nutrition and Genomics Laboratory, Jean Mayer-US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA.
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Kabagambe EK, Glasser SP, Ordovas JM, Warodomwichit D, Tsai MY, Hopkins PN, Borecki IB, Wojczynski M, Arnett DK. TCF7L2 polymorphisms and inflammatory markers before and after treatment with fenofibrate. Diabetol Metab Syndr 2009; 1:16. [PMID: 19825152 PMCID: PMC2766367 DOI: 10.1186/1758-5996-1-16] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Accepted: 10/12/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Inflammation is implicated in causing diabetes. We tested whether transcription factor 7 like-2 (TCF7L2) gene polymorphisms (rs12255372 and rs7903146), consistently associated with type 2 diabetes, are associated with plasma concentrations of inflammatory markers before and after three weeks of daily treatment with fenofibrate. METHODS Men and women in the Genetics of Lipid-Lowering Drugs and Diet Network study (n = 1025, age 49 +/- 16 y) were included. All participants suspended use of lipid-lowering drugs for three weeks and were then given 160 mg/day of fenofibrate for three weeks. Inflammatory markers and lipids were measured before and after fenofibrate. ANOVA was used to test for differences across TCF7L2 genotypes. RESULTS Under the additive or dominant model, there were no significant differences (P > 0.05) in the concentrations of inflammatory markers (hsCRP, IL-2, IL-6, TNF-alpha and MCP-1) across TCF7L2 genotypes in the period before or after treatment. For both rs12255372 and rs7903146, homozygote T-allele carriers had significantly higher (P < 0.05) post-fenofibrate concentrations of MCP-1 in the recessive model. No other significant associations were detected. CONCLUSION Overall these data show no association between TCF7L2 polymorphisms and the inflammatory markers suggesting that the effects of TCF7L2 on diabetes may not be via inflammation.
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Affiliation(s)
- Edmond K Kabagambe
- Department of Epidemiology, School of Public Health and Clinical Nutrition Research Center, University of Alabama, Birmingham, AL 35294, USA
| | - Stephen P Glasser
- Division of Preventive Medicine, Department of Medicine, University of Alabama, Birmingham, AL 35294, USA
| | - Jose M Ordovas
- Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA
| | | | - Michael Y Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, USA
| | - Paul N Hopkins
- Department of Internal Medicine, University of Utah, 410 Chipeta Way, Salt Lake City, UT 84108, USA
| | - Ingrid B Borecki
- Division of Statistical Genomics, Department of Genetics, Washington University, School of Medicine, 4444 Forest Park Boulevard - Box 8506, St Louis, MO 63108, USA
| | - Mary Wojczynski
- Department of Epidemiology, School of Public Health and Clinical Nutrition Research Center, University of Alabama, Birmingham, AL 35294, USA
- Department of Biostatistics, Section on Statistical Genetics, University of Alabama, Birmingham, AL, 35294, USA
| | - Donna K Arnett
- Department of Epidemiology, School of Public Health and Clinical Nutrition Research Center, University of Alabama, Birmingham, AL 35294, USA
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Warodomwichit D, Arnett DK, Kabagambe EK, Tsai MY, Hixson JE, Straka RJ, Province M, An P, Lai CQ, Borecki I, Ordovas JM. Polyunsaturated fatty acids modulate the effect of TCF7L2 gene variants on postprandial lipemia. J Nutr 2009; 139:439-46. [PMID: 19141698 PMCID: PMC2714378 DOI: 10.3945/jn.108.096461] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The transcription factor 7-like 2 (TCF7L2) has been recently associated with diabetes risk, and it may exert its effect through metabolic syndrome (MetS)-related traits and be subjected to modification by environmental factors. We investigated the effect of single nucleotide polymorphisms (SNP), rs7903146 and rs12255372, within the TCF7L2 locus on postprandial lipemia and other MetS-related traits and their modulation by dietary fat. Data were collected from 1083 European Americans participating in the Genetics of Lipid Lowering Drugs and Diet Network Study. Carriers of the minor T allele at the C/T rs7903146 SNP had higher fasting plasma glucose (P = 0.012), lower homeostasis model assessment of beta cell function (P = 0.041), higher plasma VLDL (P = 0.035), and lower large LDL particle (P = 0.007) concentrations and higher risk of MetS (P = 0.011) than CC individuals. Moreover, we identified significant interactions between this SNP and PUFA intake modulating fasting VLDL particle concentrations (P = 0.016) and postprandial triglycerides (TG) (P = 0.028), chylomicrons (P = 0.025), total VLDL (P = 0.026), and large VLDL (P = 0.018) concentrations. Thus, only T allele carriers with a PUFA intake > or = 7.36% of energy had elevated fasting plasma VLDL concentrations and postprandial TG-rich lipoproteins. These variables did not differ in T allele carriers and noncarriers in the low-PUFA intake group. Moreover, these significant interactions were due exclusively to (n-6) PUFA intake. In summary, high (n-6) PUFA intakes (> or = 6.62% of energy intake) were associated with atherogenic dyslipidemia in carriers of the minor T allele at the TCF7L2 rs7903146 SNP and may predispose them to MetS, diabetes, and cardiovascular disease.
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Affiliation(s)
- Daruneewan Warodomwichit
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; University of Alabama, Birmingham, AL 55294; University of Minnesota, Minneapolis, MN 55455; University of Texas, School of Public Health, Houston, TX 77225, and Washington University School of Medicine, St. Louis, MO 63108
| | - Donna K. Arnett
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; University of Alabama, Birmingham, AL 55294; University of Minnesota, Minneapolis, MN 55455; University of Texas, School of Public Health, Houston, TX 77225, and Washington University School of Medicine, St. Louis, MO 63108
| | - Edmond K. Kabagambe
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; University of Alabama, Birmingham, AL 55294; University of Minnesota, Minneapolis, MN 55455; University of Texas, School of Public Health, Houston, TX 77225, and Washington University School of Medicine, St. Louis, MO 63108
| | - Michael Y. Tsai
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; University of Alabama, Birmingham, AL 55294; University of Minnesota, Minneapolis, MN 55455; University of Texas, School of Public Health, Houston, TX 77225, and Washington University School of Medicine, St. Louis, MO 63108
| | - James E. Hixson
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; University of Alabama, Birmingham, AL 55294; University of Minnesota, Minneapolis, MN 55455; University of Texas, School of Public Health, Houston, TX 77225, and Washington University School of Medicine, St. Louis, MO 63108
| | - Robert J. Straka
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; University of Alabama, Birmingham, AL 55294; University of Minnesota, Minneapolis, MN 55455; University of Texas, School of Public Health, Houston, TX 77225, and Washington University School of Medicine, St. Louis, MO 63108
| | - Michael Province
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; University of Alabama, Birmingham, AL 55294; University of Minnesota, Minneapolis, MN 55455; University of Texas, School of Public Health, Houston, TX 77225, and Washington University School of Medicine, St. Louis, MO 63108
| | - Ping An
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; University of Alabama, Birmingham, AL 55294; University of Minnesota, Minneapolis, MN 55455; University of Texas, School of Public Health, Houston, TX 77225, and Washington University School of Medicine, St. Louis, MO 63108
| | - Chao-Qiang Lai
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; University of Alabama, Birmingham, AL 55294; University of Minnesota, Minneapolis, MN 55455; University of Texas, School of Public Health, Houston, TX 77225, and Washington University School of Medicine, St. Louis, MO 63108
| | - Ingrid Borecki
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; University of Alabama, Birmingham, AL 55294; University of Minnesota, Minneapolis, MN 55455; University of Texas, School of Public Health, Houston, TX 77225, and Washington University School of Medicine, St. Louis, MO 63108
| | - Jose M. Ordovas
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111; University of Alabama, Birmingham, AL 55294; University of Minnesota, Minneapolis, MN 55455; University of Texas, School of Public Health, Houston, TX 77225, and Washington University School of Medicine, St. Louis, MO 63108
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Warodomwichit D, Shen J, Arnett DK, Tsai MY, Kabagambe EK, Peacock JM, Hixson JE, Straka RJ, Province M, An P, Lai CQ, Parnell LD, Borecki I, Ordovas JM. ADIPOQ polymorphisms, monounsaturated fatty acids, and obesity risk: the GOLDN study. Obesity (Silver Spring) 2009; 17:510-7. [PMID: 19238139 PMCID: PMC2753535 DOI: 10.1038/oby.2008.583] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Serum adiponectin levels have been positively associated with insulin sensitivity and are decreased in type 2 diabetes (T2D) and obesity. Genetic and environmental factors influence serum adiponectin and may contribute to risk of metabolic syndrome and T2D. Therefore, we investigated the effect of ADIPOQ single-nucleotide polymorphisms (SNPs), -11377C>G and -11391G>A, on metabolic-related traits, and their modulation by dietary fat in white Americans. Data were collected from 1,083 subjects participating in the Genetics of Lipid Lowering Drugs and Diet Network study. Mean serum adiponectin concentration was higher for carriers of the -11391A allele (P = 0.001) but lower for the -11377G allele carriers (P = 0.017). Moreover, we found a significant association with obesity traits for the -11391G>A SNP. Carriers of the -11391A allele had significantly lower weight (P = 0.029), BMI (P = 0.019), waist (P = 0.003), and hip circumferences (P = 0.004) compared to noncarriers. Interestingly, the associations of the -11391G>A with BMI and obesity risk were modified by monounsaturated fatty acids (MUFAs) intake (P-interaction = 0.021 and 0.034 for BMI and obesity risk, respectively). In subjects with MUFA intake above the median (> or =13% of energy intake), -11391A carriers had lower BMI (27.1 kg/m(2) for GA+AA vs. 29.1 kg/m(2) for GG, P = 0.002) and decreased obesity risk (odds ratio for -11391A = 0.52, 95% confidence interval (CI); 0.28-0.96; P = 0.031). However, we did not detect genotype-related differences for BMI or obesity in subjects with MUFA intake <13%. Our findings support a significant association between the -11391G>A SNPs and obesity-related traits and the potential to moderate such effects using dietary modification.
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Affiliation(s)
- Daruneewan Warodomwichit
- Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
- Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400 Thailand
| | - Jian Shen
- Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Donna K. Arnett
- Department of Epidemiology, School of Public Health, and Clinical Nutrition Research Center, University of Alabama at Birmingham, AL
| | - Michael Y. Tsai
- Laboratory of Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | - Edmond K. Kabagambe
- Department of Epidemiology, School of Public Health, and Clinical Nutrition Research Center, University of Alabama at Birmingham, AL
| | - James M. Peacock
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN
| | - James E. Hixson
- Human Genetics Center, University of Texas Health Science Center, Houston, TX
| | - Robert J. Straka
- Experimental and Clinical Pharmacology Department, College of Pharmacy, University of Minnesota, Minneapolis, MN
| | - Michael Province
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO
| | - Ping An
- Department of Genetics, Division of Statistical Genomics, Washington University School of Medicine, St. Louis, MO
| | - Chao-Qiang Lai
- Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Laurence D. Parnell
- Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Ingrid Borecki
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO
| | - Jose M. Ordovas
- Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
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Angkoolpakdeekul T, Samlitpradit P, Warodomwichit D, Roongpisuthipong C, Pongchailert P, Komindr S. Initial experience and result of a Swedish adjustable gastric banding by laparoscopic approach in Thai cohorts. J Med Assoc Thai 2006; 89:1140-5. [PMID: 17048422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND Morbid obesity is a growing problem in Thailand. Several surgical procedures are available for weight reduction. The laparoscopic gastric banding has been shown to be an effective weight loss with a low post or perioperative complication. OBJECTIVE The aim of this report was to evaluate the early preliminary outcome of the laparoscopic Swedish adjustable gastric banding operation in Thai cohort patients. MATERIAL AND METHOD From November 2003 until March 2005, ten patients with a median age of 31 (range, 18-61) underwent laparoscopic Swedish adjustable gastric banding for morbid obesity at Ramathibodi Hospital. Demography, clinical course and outcome including excess weight loss and peri-operative complications were reviewed and studied. Descriptive statistics were used for data summary. RESULTS There were 3 men and 7 women with a median preoperative body weight of 142.5 kg (range, 98-164 kg), and median body mass index (BMI) of 49.2 kg/m2 (range, 40.3-62.4 kg/m2). The operations were successful in 9 out of 10 patients with median operative time of 195 minutes (range, 125-275 minutes). One patient with a BMI of 62.4 had a failed operation due to poor operative exposure from a very large left lobe of the liver. None of the remaining patients required conversion to the opened technique. The mean hospital stay was 4 days with no perioperative mortality. There was no major post operative complication except one minor wound infection. The excess weight loss was within the range of 33.5% to 62.1% during the short-term follow-up (range, 1-15 months) CONCLUSION The presented early preliminary result of the laparoscopic Swedish adjustable gastric banding showed a good technical success with a significant short-term weight loss. The authors believe this minimally invasive operation is appropriate for morbidly obese Thai patient. However a longer follow-up study is needed.
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Affiliation(s)
- Theerapol Angkoolpakdeekul
- Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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Warodomwichit D, Leelawattana R, Luanseng N, Thammakumpee N. Hypovitaminosis D in long-stay hospitalized patients in Songklanagarind Hospital. J Med Assoc Thai 2002; 85:990-7. [PMID: 12450077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
The major source of vitamin D is endogenous synthesis under sunlight exposure, thus, vitamin D deficiency is uncommon in healthy people living in a tropical area where sunshine is plentiful. However, long-stay hospitalized patients who do not get direct sunlight may become vitamin D deficient. The authors studied the prevalence of vitamin D deficiency in patients without other risk factors for vitamin D deficiency who had been admitted to Songklanagarind Hospital for longer than 27 days. The second objective was to identify predictive factors for vitamin D deficiency. Considered variables were clinical character, basic laboratory results, and intact parathyroid hormone level (iPTH). Among 60 patients studied, there were 12 patients who were vitamin D deficient and only one had a level lower than 8 ng/ml. Despite vitamin D deficiency, average serum calcium was normal. Patients in the vitamin D deficient group had lower serum corrected calcium and higher iPTH level than patients in the vitamin D sufficient group. No other clinical or laboratory data could predict a vitamin D deficiency state. In summary, the present tropical area study showed that 20 per cent of long-stay hospitalized patients who had a mild degree of vitamin D deficiency and 1.7 per cent had severe vitamin D deficit. Vitamin D supplementation is unnecessary in this group of patients.
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Affiliation(s)
- Daruneewan Warodomwichit
- Department of Internal Medicine, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University, Songkhla 90112, Thailand
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