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Deng D, Sun H, Wang Y, Guo X, Yuan Y, Wang J, Qiu L. Structural and functional abnormalities in first-episode drug-naïve pediatric idiopathic generalized epilepsy. Cereb Cortex 2024; 34:bhae021. [PMID: 38314605 DOI: 10.1093/cercor/bhae021] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/06/2024] Open
Abstract
The aim of this study was to investigate brain structure and corresponding static and dynamic functional connectivity (sFC & dFC) abnormalities in untreated, first-episode pediatric idiopathic generalized epilepsy (IGE), with the goal of better understanding the underlying pathological mechanisms of IGE. Thirty-one children with IGE and 31 age-matched healthy controls (HC) were recruited. Structural magnetic resonance imaging (sMRI) data were acquired, and voxel-based morphometry (VBM) analysis were performed to reveal abnormal gray matter volume (GMV). Moreover, sFC and dFC analyses were conducted using the brain areas exhibiting abnormal GMV as seed regions to explore abnormal functional couplings. Compared to HC, the IGE group exhibited increased GMV in left middle cingulate cortex (MCC) and right parahippocampus (ParaHipp). In addition, the analyses of dFC and sFC with MCC and ParaHipp as seeds revealed more extensive functional connectivity (FC) changes in dFC. Notably, the structurally and functionally abnormal brain areas were primarily localized in the default mode network (DMN). However, our study did not find any significant associations between these altered neuroimaging measurements and clinical outcomes. This study uncovered microstructural changes as well as corresponding sFC and dFC changes in patients with new-onset, untreated pediatric IGE. The affected brain regions were primarily located within the DMN, highlighting the DMN's crucial role in the development of pediatric IGE.
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Affiliation(s)
- Dingmei Deng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 18, South Section 3, First Ring Road, Wuhou District, Chengdu 610041, China
- Medical Imaging Center, The Second People's Hospital of Yibin, 96# Beida Street, Cuiping District, Yibin 644000, China
- Clinical Research and Translational Center, Second People's Hospital of Yibin City-West China Yibin Hospital, Sichuan University, 96# Beida Street, Cuiping District, Yibin 644000, China
| | - Hui Sun
- College of Electrical Engineering, Sichuan University, No. 24, South Section 1, First Ring Road, Wuhou District, Chengdu 610065, China
| | - Yuting Wang
- Medical Imaging Center, The Second People's Hospital of Yibin, 96# Beida Street, Cuiping District, Yibin 644000, China
- Clinical Research and Translational Center, Second People's Hospital of Yibin City-West China Yibin Hospital, Sichuan University, 96# Beida Street, Cuiping District, Yibin 644000, China
| | - Xin Guo
- Medical Imaging Center, The Second People's Hospital of Yibin, 96# Beida Street, Cuiping District, Yibin 644000, China
- Clinical Research and Translational Center, Second People's Hospital of Yibin City-West China Yibin Hospital, Sichuan University, 96# Beida Street, Cuiping District, Yibin 644000, China
| | - Yizhi Yuan
- Medical Imaging Center, The Second People's Hospital of Yibin, 96# Beida Street, Cuiping District, Yibin 644000, China
- Clinical Research and Translational Center, Second People's Hospital of Yibin City-West China Yibin Hospital, Sichuan University, 96# Beida Street, Cuiping District, Yibin 644000, China
| | - Jiaojian Wang
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, No.7, Zhiyuan Road, Chenggong District, Kunming 650500, China
- Yunnan Key Laboratory of Primate Biomedical Research, No.7, Zhiyuan Road, Chenggong District, Kunming 650500, China
| | - Lihua Qiu
- Medical Imaging Center, The Second People's Hospital of Yibin, 96# Beida Street, Cuiping District, Yibin 644000, China
- Clinical Research and Translational Center, Second People's Hospital of Yibin City-West China Yibin Hospital, Sichuan University, 96# Beida Street, Cuiping District, Yibin 644000, China
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, No. 24, South Section 1, First Ring Road, Wuhou District, Chengdu City, Sichuan Province, Chengdu 610065, China
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Fu W, Xu H, Zhao T, Xu J, Wang F. Effects of dexmedetomidine combined with etomidate on postoperative cognitive function in older patients undergoing total intravenous anaesthesia: a randomized, double-blind, controlled trial. BMC Geriatr 2024; 24:97. [PMID: 38273248 PMCID: PMC10809642 DOI: 10.1186/s12877-024-04726-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Etomidate has been advocated for anesthesia in older and critically ill patients because of its hemodynamic stability. Clinical studies have shown that dexmedetomidine has neuroprotective and anti-inflammatory properties and improves postoperative cognitive dysfunction in older patients. The present study was to evaluate the effects of the combination of etomidate and dexmedetomidine with different anaesthesia time on postoperative cognitive function in older patients. METHODS A total of 132 older patients undergoing ureteroscopic holmium laser lithotripsy were randomly divided into EN group and ED group equally. Patients whose surgery time was less than or equal to 1 h in each group were allocated to short-time surgery group (EN1 group and ED1 group), and whose surgery time was more than 1h were allocated to long-term surgery group (EN2 group and ED2 group). The primary outcome was the score of the Mini-Mental State Examination. The secondary outcomes were State-Trait Anxiety Inventory scores, Riker sedation agitation scores, Zung Self-Rating Depression Scale scores, the memory span for Arabic numerals, the plasma concentrations of S-100 calcium-binding protein B and neuron specific enolase, the time to spontaneous respiration, recovery, and extubation. RESULTS The MMSE scores at t2-3 were higher in ED1 and ED2 groups than in EN1 and EN2 groups (p<0.05). Compared with ED1 and ED2 groups, the ZSDS scores, the S-AI scores and the T-AI scores at t1-2 were higher in EN1 and EN2 groups (p<0.05), respectively. The recalled Arabic numbers at t1-3 were higher in ED2 group than in EN2 group (p<0.05). The plasma concentration of S-100β at t1-2 in EN1 group and t1-3 in EN2 group were higher than that in ED1 and ED2 groups (p<0.05), respectively. Compared with ED1 and ED2 groups, the plasma concentrations of NSE were higher at t1-3 in EN1 group and t1-4 in EN2 group (p<0.05), respectively. CONCLUSION The administration of dexmedetomidine could improve postoperative cognitive dysfunction, emergence agitation, depression and anxiety, attenuate the plasma concentrations of S-100β and NSE in older patients undergoing total intravenous anaesthesia with etomidate. TRIAL REGISTRATION Registration number: ChiCTR1800015421, Date: 29/03/2018.
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Affiliation(s)
- Wuchang Fu
- The Second Clinical Medical college of North, Sichuan Medical College (Nanchong Central Hospital), Nanchong, 637000, China
| | - Hongchun Xu
- The Department of Anesthesiology, Shunqing District, Affiliated Hospital, North Sichuan Medical College, Sichuan Province, No. 1, MaoYuan South Road, Nanchong City, 637000, China
| | - Ting Zhao
- The north sichuan medical college, Nanchong, 637000, China
| | - Jun Xu
- The north sichuan medical college, Nanchong, 637000, China
| | - Fangjun Wang
- The Department of Anesthesiology, Shunqing District, Affiliated Hospital, North Sichuan Medical College, Sichuan Province, No. 1, MaoYuan South Road, Nanchong City, 637000, China.
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Wang B, Jiang HM, Qi LM, Li X, Huang Q, Xie X, Xia Q. Deciphering resveratrol's role in modulating pathological pain: From molecular mechanisms to clinical relevance. Phytother Res 2024; 38:59-73. [PMID: 37795923 DOI: 10.1002/ptr.8021] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 10/06/2023]
Abstract
Pathological pain, a multifaceted and debilitating ailment originating from injury or post-injury inflammation of the somatosensory system, poses a global health challenge. Despite its ubiquity, reliable therapeutic strategies remain elusive. To solve this problem, resveratrol, a naturally occurring nonflavonoid polyphenol, has emerged as a potential beacon of hope owing to its anti-inflammatory, antioxidant, and immunomodulatory capabilities. These properties potentially position resveratrol as an efficacious candidate for the management of pathological pain. This concise review summaries current experimental and clinical findings to underscore the therapeutic potential of resveratrol in pathological pain, casting light on the complex underlying pathophysiology. Our exploration suggests that resveratrol may exert its analgesic effect by the modulating pivotal signaling pathways, including PI3K/Akt/mTOR, TNFR1/NF-κB, MAPKs, and Nrf2. Moreover, resveratrol appears to attenuate spinal microglia activation, regulate primary receptors in dorsal root sensory neurons, inhibit pertinent voltage-gated ion channels, and curb the expression of inflammatory mediators and oxidative stress responses. The objective of this review is to encapsulate the pharmacological activity of resveratrol, including its probable signaling pathways, pharmacokinetics, and toxicology pertinent to the treatment of pathological pain. Hopefully, we aim to map out promising trajectories for the development of resveratrol as a potential analgesic.
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Affiliation(s)
- Biao Wang
- School of Pharmacy, Sichuan College of Traditional Chinese Medicine, Mianyang, China
| | - Hai-Mei Jiang
- State Key Laboratory of Southwestern Chinese Medicine Resources, State Administration of Traditional Chinese Medicine Key Laboratory of Traditional Chinese Medicine Regimen and Health, School of Pharmacy and College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lu-Ming Qi
- State Key Laboratory of Southwestern Chinese Medicine Resources, State Administration of Traditional Chinese Medicine Key Laboratory of Traditional Chinese Medicine Regimen and Health, School of Pharmacy and College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiang Li
- State Key Laboratory of Southwestern Chinese Medicine Resources, State Administration of Traditional Chinese Medicine Key Laboratory of Traditional Chinese Medicine Regimen and Health, School of Pharmacy and College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qun Huang
- Department of Ophthalmology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xin Xie
- State Key Laboratory of Southwestern Chinese Medicine Resources, State Administration of Traditional Chinese Medicine Key Laboratory of Traditional Chinese Medicine Regimen and Health, School of Pharmacy and College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qing Xia
- School of Pharmacy, Sichuan College of Traditional Chinese Medicine, Mianyang, China
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Xing H, Jiang Z, Wu Y, Ou S, Qin J, Xue L, Wu W. The role of urinary Dickkopf-3 in the prediction of acute kidney injury: a systematic review meta-analysis. Int Urol Nephrol 2023; 55:3175-3188. [PMID: 37072601 DOI: 10.1007/s11255-023-03593-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 04/07/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND To systematically evaluate the diagnostic efficacy of urinary Dickkopf-Related Protein 3 (DKK-3) in acute kidney injury and to explore the clinical application value of urinary DKK-3. METHOD English databases (PubMed, Embase, Cochrane, and WOS) and Chinese databases (VIP, WanFang data, and China National Knowledge Internet) were screened for relevant papers published before March 12, 2023. After literature screening and data extraction, quality assessment was performed according to the QUADAS-2 scoring system. Then, the combined diagnostic and predictive parameters were calculated using a bivariate mixed effect meta-analysis model. Deek's funnel plot asymmetry test assessed publication bias, and Fagan's nomogram plot was used to verify its clinical utility. RESULT A total of 5 studies involving 2787 patients were included in this meta-analysis, of which 4 focused on contrast-induced acute kidney injury (CI-AKI) and 1 focused on AKI associated with cardiac surgery. The analysis showed that urine Dickkopf-3 has high diagnostic accuracy for AKI, with a sensitivity of 0.55 (95% CI [0.41, 0.68]), specificity of 0.80 (95% CI [0.70, 0.87]), positive likelihood ratio (PLR) of 2.7 [1.8, 4.1], negative likelihood ratio (NLR) of 0.56 [0.42, 0.75], diagnostic odds ratio (DOR) of 5 [3, 9], and AUC of 0.74 [0.70-0.77]. We did not perform subgroup analyses for predictive value due to the small number of included studies. CONCLUSION Urinary DKK3 may have limited predictive ability for acute kidney injury, especially for AKI associated with cardiac surgery. Therefore, urinary DKK3 may serve as a potential predictor for AKI. However, clinical studies with larger samples are still needed for validation.
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Affiliation(s)
- Huameng Xing
- Department of Nephrology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Metabolic Vascular Disease Key Laboratory, Luzhou, China
| | - Zheng Jiang
- Department of Nephrology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Metabolic Vascular Disease Key Laboratory, Luzhou, China
| | - Yuxuan Wu
- Department of Nephrology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Metabolic Vascular Disease Key Laboratory, Luzhou, China
| | - Santao Ou
- Department of Nephrology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Metabolic Vascular Disease Key Laboratory, Luzhou, China
| | - Jianhua Qin
- Department of Nephrology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Metabolic Vascular Disease Key Laboratory, Luzhou, China
| | - Ling Xue
- Department of Urology, Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Jiangyang District, Sichuan, 646000, Luzhou, China.
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China.
| | - Weihua Wu
- Department of Nephrology, Affiliated Hospital of Southwest Medical University, Luzhou, China.
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China.
- Metabolic Vascular Disease Key Laboratory, Luzhou, China.
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Lan Y, Yang N, Wang Y, Yang Y, Xu M, He Q. Cost-Effectiveness Analysis of Fixed-Dose Tiotropium/Olodaterol versus Tiotropium for COPD Patients in China. Int J Chron Obstruct Pulmon Dis 2023; 18:2093-2103. [PMID: 37767047 PMCID: PMC10520256 DOI: 10.2147/copd.s425409] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Purpose Tiotropium/olodaterol (TIO/OLO) fixed-dose combination (FDC) can improve lung function and quality of life for patients with chronic obstructive pulmonary disease (COPD), and is not inferior to other LAMA/LABAs. The aim of this study was to assess the cost-effectiveness of TIO/OLO FDC in patients with moderate to very severe COPD in China. Methods A Markov model was developed to estimate the cost-effectiveness of TIO/OLO FDC versus TIO in the treatment of COPD from Chinese health system perspective. Four health states were based on 2021 Global Initiative for Chronic Obstructive Lung Disease (GOLD 2021), which included moderate (GOLD II, 50% ≤ FEV1 ≤ 80% of predicted), severe (GOLD III, 30% ≤ FEV1 ≤ 50% of predicted) and very severe (GOLD IV, FEV1 > 30% of predicted) COPD and death. The model simulated in cycles yearly. The indicators of total costs, number of COPD exacerbations, life years (LYs) and quality-adjusted life-years (QALYs) were used as the model output. Costs and outcomes were discounted at a 5% annual rate. A cost-effectiveness analysis was conducted over a 10-year time horizon. The threshold of incremental total cost per unit effectiveness gained (ICER) was 1.5 times of GDP per capita. Uncertainty was assessed by one-way and probabilistic sensitivity analysis. Results TIO/OLO was 0.007 QALYs more than TIO but 0.012 LYs lower, which increased the total cost by $2268.17 per patient, but the total exacerbations number was less. Incremental cost effectiveness analysis had shown that the ICER exceeded the willingness to pay threshold. Results were robust under most parameter variation, except the parameters of total drug cost of TIO/OLO FDC in univariate sensitivity analyses. Conclusion Although TIO/OLO FDC could reduce the exacerbation risk, it was not cost-effective, and needed to be repriced.
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Affiliation(s)
- Ying Lan
- Department of Pharmacy, Affiliated Hospital of Southwest Jiaotong University, the Third People’s Hospital of Chengdu, Chengdu, Sichuan, 610031, People’s Republic of China
| | - Nan Yang
- West China School of Pharmacy, Sichuan University, Chengdu, People’s Republic of China
| | - Yirong Wang
- Department of Pharmacy, Affiliated Hospital of Southwest Jiaotong University, the Third People’s Hospital of Chengdu, Chengdu, Sichuan, 610031, People’s Republic of China
| | - Yan Yang
- Department of Pharmacy, Affiliated Hospital of Southwest Jiaotong University, the Third People’s Hospital of Chengdu, Chengdu, Sichuan, 610031, People’s Republic of China
| | - Min Xu
- Department of Pharmacy, Affiliated Hospital of Southwest Jiaotong University, the Third People’s Hospital of Chengdu, Chengdu, Sichuan, 610031, People’s Republic of China
| | - Qin He
- Department of Pharmacy, Affiliated Hospital of Southwest Jiaotong University, the Third People’s Hospital of Chengdu, Chengdu, Sichuan, 610031, People’s Republic of China
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Ren H, Liu C, Chen F, He L, Zhang M, Gu B, Zhu H, Jiang Y. Nursing workforce allocation in the intensive care units of COVID-19-designated hospitals: A nationwide cross-sectional survey in China. Nurs Open 2023; 10:6091-6100. [PMID: 37247342 PMCID: PMC10415983 DOI: 10.1002/nop2.1830] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/17/2022] [Accepted: 05/07/2023] [Indexed: 05/31/2023] Open
Abstract
AIM To explore the nursing workforce allocation in intensive care units (ICUs) of COVID-19-designated hospitals during the epidemic peak in China. DESIGN A nationwide cross-sectional online survey. METHODS A total of 37 head nurses and 262 frontline nurses in 37 ICUs of COVID-19-designated tertiary hospitals located in 22 cities of China were surveyed. The self-reported human resource allocation questionnaire was used to assess the nursing workforce allocation. RESULTS The average patient-to-nurse ratio was 1.89 ± 1.14, and the median working hours per shift was 5 h. The top four majors of front-line nurses in ICUs were respiratory (31.30%), lemology (27.86%), intensive care (21.76%) and emergency (17.18%). We also found that a smaller average patient-to-nurse ratio (odds ratio [OR]: 0.328, 95% CI: 0.108, 1.000), longer average weekly rest time per person (OR: 0.193, 95% CI: 0.051, 0.729) and larger proportion of 6-9 working years (OR: 0.002, 95% CI: 0.001, 1.121) decreased the occurrence of nursing adverse events.
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Affiliation(s)
- Hong‐fei Ren
- Department of Gastroenterology and Hepatology, West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduChina
| | - Chang‐qing Liu
- Department of Operating Room, West China HospitalSichuan University/West China School of Nursing, Sichuan University/Nursing Key Laboratory of Sichuan ProvinceChengduChina
| | - Feng‐jiao Chen
- Department of Hematology, West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduChina
| | - Ling‐xiao He
- Trauma Center of West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduChina
| | - Ming‐guang Zhang
- Department of Gastroenterology and Hepatology, West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduChina
| | - Bo Gu
- Nursing Department of West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduChina
| | - Hong Zhu
- Nursing Department of West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduChina
| | - Yan Jiang
- Nursing Department of West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduChina
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Liang L, Li D, Zeng R, Zhang H, Lv L, Wei W, Wan Z. Long- and very long-chain ceramides are predictors of acute kidney injury in patients with acute coronary syndrome: the PEACP study. Cardiovasc Diabetol 2023; 22:92. [PMID: 37081501 PMCID: PMC10120114 DOI: 10.1186/s12933-023-01831-6] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 04/12/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Acute kidney injury (AKI) can be caused by multiple factors/events, including acute coronary syndrome (ACS). Ceramides are involved in atherosclerosis progression, cardiovascular events, and renal damage. Almost no studies have been conducted on the relationship between ceramide concentrations and AKI events. Therefore, we evaluated the association between plasma ceramide level at admission and AKI in patients with ACS undergoing percutaneous coronary intervention. METHODS We enrolled 842 ACS patients from the Prospective Multicenter Study for Early Evaluation of Acute Chest Pain. AKI was defined using the criteria from the 2012 Kidney Disease: Improving Global Outcomes. Eleven C16-C26 ceramides were measured using the high-performance liquid chromatography interfaced to tandem mass spectrometer procedure. Logistic regression models were used to evaluate relationships between ceramides and AKI risk. The area under the receiver operating characteristic curves (AUC) was used to evaluate differences between ceramides. RESULTS Overall, 139 (16.5%) patients developed AKI during hospitalisation. Patients who developed AKI had higher levels of Cer(d18:1/16:0), Cer(d18:1/18:0), Cer(d18:1/20:0), Cer(d18:1/21:0), Cer(d18:1/24:1), and Cer(d18:1/24:2) than patients who did not (P < 0.05). In risk-factor adjusted logistic regression models, these ceramides were independently associated with AKI risk (P < 0.05). Cer(d18:1/24:2) had the highest odds ratio of 3.503 (Q4 vs. Q1, 95% confidence interval: 1.743-7.040, P < 0.001). Ceramides had AUCs of 0.581-0.661 (P < 0.001) for AKI. Each ceramide combined with the Mehran risk score (AUC: 0.780) had AUCs of 0.802-0.808, greater than the Mehran risk score alone. CONCLUSION Long-chain and very-long-chain ceramide levels may help determine the high AKI risk beyond traditional assessments.
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Affiliation(s)
- Lianjing Liang
- Department of Emergency Medicine, Disaster Medical Center, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Dongze Li
- Department of Emergency Medicine, Disaster Medical Center, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Rui Zeng
- Department of Emergency Medicine, Disaster Medical Center, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Haihong Zhang
- Department of Emergency Medicine, Disaster Medical Center, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Lin Lv
- Department of Emergency Medicine, Disaster Medical Center, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Wei
- Department of Emergency Medicine, Disaster Medical Center, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China.
| | - Zhi Wan
- Department of Emergency Medicine, Disaster Medical Center, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
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Li F, Li D, Yu J, Jia Y, Wen J, Li W, Tong Y, Wu J, Wan Z, Cao Y, Zhang Q, Zeng R. Association Between Plasma Ceramides and One-Year Mortality in Patients with Acute Coronary Syndrome: Insight from the PEACP Study. Clin Interv Aging 2023; 18:571-584. [PMID: 37050937 PMCID: PMC10084878 DOI: 10.2147/cia.s402253] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/30/2023] [Indexed: 04/14/2023] Open
Abstract
Background The plasma lipidome profile is likely to improve risk stratification in patients with acute coronary syndrome (ACS) and predict cardiovascular events for secondary disease prevention. Ceramides are involved in the initiation or acceleration of several key pathophysiological processes in atherosclerosis. This study evaluated whether plasma ceramide levels at admission was associated with one-year mortality in patients with ACS. Methods In total, 826 patients with ACS from a prospective multicenter study for early evaluation of acute chest pain were enrolled. High-performance liquid chromatography with tandem mass spectrometry (LC/MS) was used to measure the plasma levels of eleven ceramides (C16-C26). The primary outcome was all-cause mortality, and the secondary outcome was cardiac mortality during the one-year follow-up. The relationship between the ceramide levels and mortality was evaluated by Cox regression analysis. The receiver operating characteristic (ROC) curve was established to evaluate discrimination of ceramides. Results Eighty-eight (10.7%) patients died after a 12-month follow-up. Five ceramides (C16:0, C18:0, C20:0, C24:1 and C24:2) and their ratios to Cer(d18:1/24:0) were independently associated with the risk of all-cause death and cardiac death. Combining the Global Registry of Acute Coronary Events (GRACE) score with ceramides and their ratios to Cer(d18:1/24:0) had areas under ROC curves ranging from 0.778-0.804 (P<0.001) for all-cause mortality, which was greater than that of the GRACE score alone. Conclusion Measurements of long-chain ceramides and very-long-chain ceramides may help in identifying a high risk of mortality beyond traditional assessment tools in patients with ACS. Trial Registration clinicaltrials.gov, identifier: NCT04122573.
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Affiliation(s)
- Fanghui Li
- Department of Emergency Medicine, Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Dongze Li
- Department of Emergency Medicine, Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Jing Yu
- Department of Emergency Medicine, Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Yu Jia
- Department of General Practice and National Clinical Research Center for Geriatrics, International Medical Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Jirui Wen
- Deep Underground Space Medical Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Wentao Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Yao Tong
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Jiang Wu
- Deep Underground Space Medical Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Zhi Wan
- Department of Emergency Medicine, Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Yu Cao
- Department of Emergency Medicine, Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Qing Zhang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Rui Zeng
- Department of Emergency Medicine, Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Correspondence: Rui Zeng; Qing Zhang, Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Road, Chengdu, Sichuan, 610041, People’s Republic of China, Tel +86-28-85423248, Fax +86-28-85582944, Email ;
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