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Song H, Liao Y, Hu H, Wan Q. Nonlinear association between proteinuria levels and the risk of cardiovascular disease events and all-cause mortality among chronic kidney disease patients. Ren Fail 2024; 46:2310727. [PMID: 38345084 PMCID: PMC10863521 DOI: 10.1080/0886022x.2024.2310727] [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] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/22/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The association between proteinuria levels and cardiovascular disease (CVD) development and all-cause mortality in chronic kidney disease (CKD) patients remains controversial. METHODS In this investigation, we conducted a retrospective analysis involving 1138 patients who were registered in the CKD-Research of Outcomes in Treatment and Epidemiology (ROUTE) study. The primary outcome of this study was the composite of cardiovascular events or all-cause death. Cox proportional hazards regression, smooth curve fitting, piecewise linear regression, and subgroup analyses were used. RESULTS The mean age of the included individuals was 67.3 ± 13.6 years old. Adjusted hazard ratios (HRs) for UPCR in middle and high groups, compared to the low group, were 1.93 (95% CI: 1.28-2.91) and 4.12 (95% CI: 2.87-5.92), respectively, after multivariable adjustment. Further adjustments maintained significant associations; HRs for middle and high groups were 1.71 (95% CI: 1.12-2.61) and 3.07 (95% CI: 2.08-4.54). A nonlinear UPCR-primary outcome relationship was observed, with an inflection point at 3.93 g/gCr. CONCLUSION Among non-dialyzed patients with stage G2-G5 CKD, a nonlinear association between UPCR and the primary outcome was observed. A higher UPCR (when UPCR < 3.93 g/gCr) was an independent predictor of the primary outcome. Importantly, our study predates SGLT2 inhibitor use, showcasing outcomes achievable without these medications. Future research considerations will involve factors like SGLT-2 inhibitor utilization.
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Affiliation(s)
- Haiying Song
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, PRChina
- Department of Nephrology, Shenzhen University Health Science Center, Shenzhen, PR China
| | - Yuheng Liao
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, PRChina
- Department of Nephrology, Shenzhen University Health Science Center, Shenzhen, PR China
| | - Haofei Hu
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, PRChina
- Department of Nephrology, Shenzhen University Health Science Center, Shenzhen, PR China
| | - Qijun Wan
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, PRChina
- Department of Nephrology, Shenzhen University Health Science Center, Shenzhen, PR China
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2
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Mohamed WAS, Ishak KN, Baharum N, Zainudin NAZ, Lim HY, Noh MFM, Ahmad WAW, Zaman Huri H, Zuhdi ASM, Sukahri S, Govindaraju K, Abd Jamil AH. Ethnic disparities and its association between epicardial adipose tissue thickness and cardiometabolic parameters. Adipocyte 2024; 13:2314032. [PMID: 38373876 PMCID: PMC10877981 DOI: 10.1080/21623945.2024.2314032] [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: 12/08/2023] [Accepted: 01/30/2024] [Indexed: 02/21/2024] Open
Abstract
Excessive deposit of epicardial adipose tissue (EAT) were recently shown to be positively correlated with cardiovascular disease (CVD). This study aims to investigate the thickness of EAT and its association with the components of metabolic syndrome among multi-ethnic Malaysians with and without acute coronary syndrome (ACS). A total of 213 patients were recruited, with the thickness of EAT were quantified non-invasively using standard two-dimensional echocardiography. EAT thickness among the Malaysian population was prompted by several demographic factors and medical comorbidities, particularly T2DM and dyslipidaemia. ACS patients have significantly thicker EAT compared to those without ACS (4.1 mm vs 3.7 mm, p = 0.035). Interestingly, among all the races, Chinese had the thickest EAT distribution (4.6 mm vs 3.8 mm), with age (p = 0.04 vs p < 0.001), and overall diastolic blood pressure (p = 0.028) was also found to be associated with EAT thickness. Further study is warranted to investigate its role as a cardiovascular risk marker among Malaysians with ACS.
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Affiliation(s)
- WAS Mohamed
- Nutrition, Metabolism and Cardiovascular Research Centre (NMCRC), Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health (MOH), Shah Alam, Malaysia
- Department of Pharmaceutical Life Sciences, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur, Malaysia
| | - KN Ishak
- Nutrition, Metabolism and Cardiovascular Research Centre (NMCRC), Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health (MOH), Shah Alam, Malaysia
| | - N Baharum
- Centre for Coordination of Clinical Research Network (CCRN), Institute for Clinical Research (ICR), Shah Alam, Malaysia
| | - NAZ Zainudin
- Infectious Disease Research Centre (IDRC), Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health (MOH), Shah Alam, Malaysia
| | - Han Yin Lim
- Nutrition, Metabolism and Cardiovascular Research Centre (NMCRC), Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health (MOH), Shah Alam, Malaysia
| | - MFM Noh
- Nutrition, Metabolism and Cardiovascular Research Centre (NMCRC), Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health (MOH), Shah Alam, Malaysia
| | - WAW Ahmad
- Cardiology Unit, Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - H Zaman Huri
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur, Malaysia
| | - ASM Zuhdi
- Infectious Disease Research Centre (IDRC), Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health (MOH), Shah Alam, Malaysia
| | - S Sukahri
- Infectious Disease Research Centre (IDRC), Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health (MOH), Shah Alam, Malaysia
| | - K Govindaraju
- Department of Pharmaceutical Life Sciences, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur, Malaysia
| | - AH Abd Jamil
- Department of Pharmaceutical Life Sciences, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur, Malaysia
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3
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Huang Y, Zhong Q, Chen J, Qin X, Yang Y, He Y, Lin Z, Li Y, Yang S, Lu Y, Zhao Y, Kong Y, Wan Q, Wang Q, Huang S, Liu Y, Liu A, Liu F, Hou F, Liang M. Relationship of serum total cholesterol and triglyceride with risk of mortality in maintenance hemodialysis patients: a multicenter prospective cohort study. Ren Fail 2024; 46:2334912. [PMID: 38604971 PMCID: PMC11011237 DOI: 10.1080/0886022x.2024.2334912] [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] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/20/2024] [Indexed: 04/13/2024] Open
Abstract
OBJECTIVE The relationship between serum total cholesterol (TC) and triglyceride (TG) levels and mortality in maintenance hemodialysis (MHD) patients remains inconsistent. We aimed to explore the individual and combined association of TC and TG levels with the risk of mortality in Chinese MHD patients. METHODS 1036 MHD patients were enrolled in this multicenter, prospective cohort study. The serum levels of total cholesterol and triglycerides were measured at baseline. The primary outcome was all-cause mortality and secondary outcome was cardiovascular disease (CVD) mortality. RESULTS During a median follow-up duration of 4.4 years (IQR= 2.0-7.9 years), 549 (53.0%) patients died, and 297 (28.7%) deaths were attributed to CVD. Compared with patients with TC levels in the first three quartiles (<182.5 mg/dL), a significantly higher risk of all-cause mortality was found in participants with TC in the fourth quartile (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.17-1.76). However, a significantly lower risk of all-cause mortality was observed in participants with TG in the fourth quartile (≥193.9 mg/dL) (HR, 0.78; 95%CI: 0.63-0.98), compared with participants with TG in the first three quartiles. Similar trends were observed in CVD mortality. When analyzed jointly, patients with lower TC (<182.5 mg/dL) and higher TG (≥193.9 mg/dL) levels had the lowest risk of all-cause mortality and CVD mortality.Conclusions: In MHD patients in southern China, higher TC levels were associated with higher risk of mortality, while higher TG levels were related to lower risk of mortality. Patients with lower TC and higher TG levels had the best survival prognosis.
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Affiliation(s)
- Yan Huang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- National Clinical Research Center for Kidney Disease, Guangzhou, China
- State Key Laboratory of Organ Failure Research, Guangzhou, China
- Guangdong Provincial Institute of Nephrology, Guangzhou, China
- Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Qiuxia Zhong
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- National Clinical Research Center for Kidney Disease, Guangzhou, China
- State Key Laboratory of Organ Failure Research, Guangzhou, China
- Guangdong Provincial Institute of Nephrology, Guangzhou, China
- Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Junzhi Chen
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- National Clinical Research Center for Kidney Disease, Guangzhou, China
- State Key Laboratory of Organ Failure Research, Guangzhou, China
- Guangdong Provincial Institute of Nephrology, Guangzhou, China
- Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- National Clinical Research Center for Kidney Disease, Guangzhou, China
- State Key Laboratory of Organ Failure Research, Guangzhou, China
- Guangdong Provincial Institute of Nephrology, Guangzhou, China
- Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Yaya Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- National Clinical Research Center for Kidney Disease, Guangzhou, China
- State Key Laboratory of Organ Failure Research, Guangzhou, China
- Guangdong Provincial Institute of Nephrology, Guangzhou, China
- Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Yanhuan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- National Clinical Research Center for Kidney Disease, Guangzhou, China
- State Key Laboratory of Organ Failure Research, Guangzhou, China
- Guangdong Provincial Institute of Nephrology, Guangzhou, China
- Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Zizhen Lin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- National Clinical Research Center for Kidney Disease, Guangzhou, China
- State Key Laboratory of Organ Failure Research, Guangzhou, China
- Guangdong Provincial Institute of Nephrology, Guangzhou, China
- Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Yumin Li
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- National Clinical Research Center for Kidney Disease, Guangzhou, China
- State Key Laboratory of Organ Failure Research, Guangzhou, China
- Guangdong Provincial Institute of Nephrology, Guangzhou, China
- Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Shenglin Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- National Clinical Research Center for Kidney Disease, Guangzhou, China
- State Key Laboratory of Organ Failure Research, Guangzhou, China
- Guangdong Provincial Institute of Nephrology, Guangzhou, China
- Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Yongxin Lu
- People’s Hospital of Yuxi City, Yuxi, China
| | | | - Yaozhong Kong
- The First People’s Hospital of Foshan, Foshan, China
| | - Qijun Wan
- The Second People’s Hospital of Shenzhen, Shenzhen, China
| | - Qi Wang
- Huadu District People’s Hospital of Guangzhou, Guangzhou, China
| | - Sheng Huang
- Nanhai District People’s Hospital of Foshan, Foshan, China
| | - Yan Liu
- Guangzhou Red Cross Hospital, Guangzhou, China
| | - Aiqun Liu
- The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Fanna Liu
- Guangzhou Overseas Chinese Hospital, Guangzhou, China
| | - Fanfan Hou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- National Clinical Research Center for Kidney Disease, Guangzhou, China
- State Key Laboratory of Organ Failure Research, Guangzhou, China
- Guangdong Provincial Institute of Nephrology, Guangzhou, China
- Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Min Liang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- National Clinical Research Center for Kidney Disease, Guangzhou, China
- State Key Laboratory of Organ Failure Research, Guangzhou, China
- Guangdong Provincial Institute of Nephrology, Guangzhou, China
- Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
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English K, Frise C, Trinder J, Cauldwell M, Simpson M, Adamson D, Elton C, Burns G, Choudhary M, Nathanson M, Robert L, Moore J, O'Brien P, Pundir J. Best practice recommendations for medically assisted reproduction in patients with known cardiovascular disease or at high risk of cardiovascular disease. HUM FERTIL 2024; 27:2278295. [PMID: 38196173 DOI: 10.1080/14647273.2023.2278295] [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] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/02/2023] [Indexed: 01/11/2024]
Abstract
Increasing numbers of people are seeking assisted conception. In people with known cardiac disease or risk factors for cardiac disease, assisted conception may carry increased risks during treatment and any subsequent pregnancy. These risks should be assessed, considered and minimized prior to treatment.
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Affiliation(s)
- Kate English
- Department of Congenital Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Charlotte Frise
- Department of Obstetrics, Queen Charlotte's and Chelsea Hospital, London, UK
| | | | | | | | - Dawn Adamson
- Department of Cardiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Chris Elton
- Department of Anaesthesia, Leicester Royal Infirmary, Leicester, UK
| | | | - Meenakshi Choudhary
- Newcastle Fertility Centre at Life, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Mike Nathanson
- Department of Anaesthesia, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Leema Robert
- Department of Clinical Genetics, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Jim Moore
- Department of Primary Care, NHS Gloucestershire Clinical Commissioning Group, Brockworth, UK
| | - Pat O'Brien
- Department of Obstetrics, University College London, London, UK
| | - Jyotsna Pundir
- Reproductive Medicine, St Bartholomew's Hospital, London, UK
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Wu J, Li X, Zhang H, Lin L, Li M, Chen G, Wang C. Development and validation of a prediction model for all-cause mortality in maintenance dialysis patients: a multicenter retrospective cohort study. Ren Fail 2024; 46:2322039. [PMID: 38415296 PMCID: PMC10903750 DOI: 10.1080/0886022x.2024.2322039] [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] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/17/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND The mortality risk varies considerably among individual dialysis patients. This study aimed to develop a user-friendly predictive model for predicting all-cause mortality among dialysis patients. METHODS Retrospective data regarding dialysis patients were obtained from two hospitals. Patients in training cohort (N = 1421) were recruited from the Fifth Affiliated Hospital of Sun Yat-sen University, and patients in external validation cohort (N = 429) were recruited from the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine. The follow-up endpoint event was all-cause death. Variables were selected by LASSO-Cox regression, and the model was constructed by Cox regression, which was presented in the form of nomogram and web-based tool. The discrimination and accuracy of the prediction model were assessed using C-indexes and calibration curves, while the clinical value was assessed by decision curve analysis (DCA). RESULTS The best predictors of 1-, 3-, and 5-year all-cause mortality contained nine independent factors, including age, body mass index (BMI), diabetes mellitus (DM), cardiovascular disease (CVD), cancer, urine volume, hemoglobin (HGB), albumin (ALB), and pleural effusion (PE). The 1-, 3-, and 5-year C-indexes in the training set (0.840, 0.866, and 0.846, respectively) and validation set (0.746, 0.783, and 0.741, respectively) were consistent with comparable performance. According to the calibration curve, the nomogram predicted survival accurately matched the actual survival rate. The DCA showed the nomogram got more clinical net benefit in both the training and validation sets. CONCLUSIONS The effective and convenient nomogram may help clinicians quantify the risk of mortality in maintenance dialysis patients.
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Affiliation(s)
- Jingcan Wu
- Department of Nephrology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
- Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Xuehong Li
- Department of Nephrology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
- Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Hong Zhang
- Department of Nephrology, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Lin Lin
- Department of Nephrology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
- Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Man Li
- Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Gangyi Chen
- Department of Nephrology, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Cheng Wang
- Department of Nephrology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
- Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
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Zhang Y, Lu F. Molecular mechanism of triptolide in myocardial fibrosis through the Wnt/β-catenin signaling pathway. SCAND CARDIOVASC J 2024; 58:2295785. [PMID: 38164796 DOI: 10.1080/14017431.2023.2295785] [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: 05/16/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
Objective. Myocardial fibrosis (MF) is a common manifestation of end-stage cardiovascular diseases. Triptolide (TP) provides protection against cardiovascular diseases. This study was to explore the functional mechanism of TP in MF rats via the Wnt/β-catenin pathway. Methods. The MF rat model was established via subcutaneous injection of isoproterenol (ISO) and treated with low/medium/high doses of TP (L-TP/M-TP/H-TP) or Wnt agonist BML-284. Cardiac function was examined by echocardiography. Pathological changes of myocardial tissues were observed by HE and Masson staining. Col-I/Col-III/Vimentin/α-SMA levels were detected by immunohistochemistry, RT-qPCR, and Western blot. Collagen volume fraction content was measured. Expression levels of the Wnt/β-catenin pathway-related proteins (β-catenin/c-myc/Cyclin D1) were detected by Western blot. Rat cardiac fibroblasts were utilized for in vitro validation experiments. Results. MF rats had enlarged left ventricle, decreased systolic and diastolic function and cardiac dysfunction, elevated collagen fiber distribution, collagen volume fraction and hydroxyproline content. Levels of Col-I/Col-III/Vimentin/α-SMA, and protein levels of β-catenin/c-myc/Cyclin D1 were increased in MF rats. The Wnt/β-catenin pathway was activated in the myocardial tissues of MF rats. TP treatment alleviated impairments of cardiac function and myocardial tissuepathological injury, decreased collagen fibers, collagen volume fraction, Col-I, Col-III, α-SMA and Vimentin levels, HYP content, inhibited Wnt/β-catenin pathway, with H-TP showing the most significant effects. Wnt agonist BML-284 antagonized the inhibitive effect of TP on MF. TP inhibited the Wnt/β-catenin pathway to repress the proliferation and differentiation of mouse cardiac fibroblasts in vitro. Conclusions. TP was found to ameliorate ISO-induced MF in rats by inhibiting the Wnt/β-catenin pathway.
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Affiliation(s)
- Yiwen Zhang
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Feng Lu
- Cardiovascular Internal Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
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Huang W, Bai J, Zhang Y, Qiu D, Wei L, Zhao C, Ren Z, Wang Q, Ren K, Cao N. Effects of low-flux and high-flux hemodialysis on the survival of elderly maintenance hemodialysis patients. Ren Fail 2024; 46:2338217. [PMID: 38584147 PMCID: PMC11000600 DOI: 10.1080/0886022x.2024.2338217] [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] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 03/28/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND Elderly hemodialysis (HD) patients have a high risk of death. The effect of different types of HD membranes on survival is still controversial. The purpose of this study was to determine the relationship between the use of low-flux or high-flux membranes and all-cause and cardiovascular mortality in elderly hemodialysis patients. METHODS This was a retrospective clinical study involving maintenance hemodialysis patients which were categorized into low-flux and high-flux groups according to the dialyzer they were using. Propensity score matching was used to balance the baseline data of the two groups. Survival rates were compared between the two groups, and the risk factors for death were analyzed by multivariate Cox regression. RESULTS Kaplan-Meier survival analysis revealed no significant difference in all-cause mortality between the low-flux group and the high-flux group (log-rank test, p = 0.559). Cardiovascular mortality was significantly greater in the low-flux group than in the high-flux group (log-rank test, p = 0.049). After adjustment through three different multivariate models, we detected no significant difference in all-cause mortality. Patients in the high-flux group had a lower risk of cardiovascular death than did those in the low-flux group (HR = 0.79, 95% CI, 0.54-1.16, p = 0.222; HR = 0.58, 95% CI, 0.37-0.91, p = 0.019). CONCLUSIONS High-flux hemodialysis was associated with a lower relative risk of cardiovascular mortality in elderly MHD patients. High-flux hemodialysis did not improve all-cause mortality rate. Differences in urea distribution volume, blood flow, and systemic differences in solute clearance by dialyzers were not further analyzed, which are the limitations of this study.
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Affiliation(s)
- Wanqing Huang
- Postgraduate., Training Base of Jinzhou Medical University (General Hospital of Northern Theater Command), Jinzhou, China
- Department of Blood Purification, General Hospital of Northern Theater Command, Shenyang, China
| | - Jiuxu Bai
- Department of Blood Purification, General Hospital of Northern Theater Command, Shenyang, China
| | - Yanping Zhang
- Department of Blood Purification, General Hospital of Northern Theater Command, Shenyang, China
| | - Dongxia Qiu
- Department of Blood Purification, General Hospital of Northern Theater Command, Shenyang, China
| | - Lin Wei
- Department of Blood Purification, General Hospital of Northern Theater Command, Shenyang, China
| | - Chen Zhao
- Department of Blood Purification, General Hospital of Northern Theater Command, Shenyang, China
| | - Zhuo Ren
- Department of Blood Purification, General Hospital of Northern Theater Command, Shenyang, China
| | - Qian Wang
- Department of Blood Purification, General Hospital of Northern Theater Command, Shenyang, China
| | - Kaiming Ren
- Department of Blood Purification, General Hospital of Northern Theater Command, Shenyang, China
| | - Ning Cao
- Department of Blood Purification, General Hospital of Northern Theater Command, Shenyang, China
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8
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Karpov OA, Stotland A, Raedschelders K, Chazarin B, Ai L, Murray CI, Van Eyk JE. Proteomics of the heart. Physiol Rev 2024; 104:931-982. [PMID: 38300522 DOI: 10.1152/physrev.00026.2023] [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: 07/03/2023] [Revised: 12/25/2023] [Accepted: 01/14/2024] [Indexed: 02/02/2024] Open
Abstract
Mass spectrometry-based proteomics is a sophisticated identification tool specializing in portraying protein dynamics at a molecular level. Proteomics provides biologists with a snapshot of context-dependent protein and proteoform expression, structural conformations, dynamic turnover, and protein-protein interactions. Cardiac proteomics can offer a broader and deeper understanding of the molecular mechanisms that underscore cardiovascular disease, and it is foundational to the development of future therapeutic interventions. This review encapsulates the evolution, current technologies, and future perspectives of proteomic-based mass spectrometry as it applies to the study of the heart. Key technological advancements have allowed researchers to study proteomes at a single-cell level and employ robot-assisted automation systems for enhanced sample preparation techniques, and the increase in fidelity of the mass spectrometers has allowed for the unambiguous identification of numerous dynamic posttranslational modifications. Animal models of cardiovascular disease, ranging from early animal experiments to current sophisticated models of heart failure with preserved ejection fraction, have provided the tools to study a challenging organ in the laboratory. Further technological development will pave the way for the implementation of proteomics even closer within the clinical setting, allowing not only scientists but also patients to benefit from an understanding of protein interplay as it relates to cardiac disease physiology.
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Affiliation(s)
- Oleg A Karpov
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States
| | - Aleksandr Stotland
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States
| | - Koen Raedschelders
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States
| | - Blandine Chazarin
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States
| | - Lizhuo Ai
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States
| | - Christopher I Murray
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States
| | - Jennifer E Van Eyk
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States
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Durairaj B, Mohandass S, Sakthivel KM, Poornima AA. Clinical relevance and advances in detection of translational biomarker cardiac troponin. Anal Biochem 2024; 689:115505. [PMID: 38460900 DOI: 10.1016/j.ab.2024.115505] [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] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 02/13/2024] [Accepted: 03/06/2024] [Indexed: 03/11/2024]
Abstract
Cardiovascular diseases (CVD) are a range of diseases, pointing the functional hindrances in the heart and blood vessels of the human system that contributes to 48.6 % of the world's adult death rate. The diagnosis of CVD relies upon the Electro Cardio Gram (ECG) and detection of muscle markers such as troponins. Among the cardiac trio, Cardiac Troponin I (cTnI) weighing 23 KiloDalton (kDa) is a sorted biomarker for CVD. cTnI remains high in the blood after 1-2 weeks of myocardial damage. Testing of cTnI in CVD patients aids in diagnosis and risk stratification of the disease. Different determination systems including optical, electrochemical, and acoustic have been put forward for monitoring the cTnI which are Point of Care (POC) that promotes simple and sensitive detection of cTnI. The modern era has paved way to high-sensitivity Troponin I (hscTnI) devices that can detect up to 0.01 ng/ml in human blood/plasma/serum. Yet, the practice of hscTnI is impracticable due to cost inefficiency. Development of new hscTnI devices with minimal investment and maximal detection range will meet the global requirement. This review gives an over view on different detection systems of cardiac troponin I which stands as a translational detection molecule for CVDs.
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Affiliation(s)
- Brindha Durairaj
- Department of Biochemistry, PSG College of Arts & Science, Civil Aerodrome Post, Coimbatore, 641 014, Tamil Nadu, India.
| | - Swathanthiram Mohandass
- Department of Biochemistry, PSG College of Arts & Science, Civil Aerodrome Post, Coimbatore, 641 014, Tamil Nadu, India
| | - Kunnathur Murugesan Sakthivel
- Department of Biochemistry, PSG College of Arts & Science, Civil Aerodrome Post, Coimbatore, 641 014, Tamil Nadu, India
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10
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Liu C, Hua L, Xin Z. Greater upper limb muscle mass associated with reduced cardiovascular mortality compared with other muscle groups in diabetics. Nutrition 2024; 122:112386. [PMID: 38442653 DOI: 10.1016/j.nut.2024.112386] [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] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVES Although muscle mass and its distribution have been shown to affect prognosis, the association between regional muscle mass and cardiovascular mortality risk in diabetic patients remains unclear. METHODS This prospective cohort study analyzed data from 2166 individuals with diabetes who participated in the National Health and Nutrition Survey conducted in the United States between 2003 to 2006 and 2011 to 2018, linked to the National Death Index. Weighted Kaplan-Meier analysis and multivariable Cox proportional hazards models were used to explore the association between different regional lean mass and cardiovascular mortality. RESULTS The weighted Kaplan-Meier analysis revealed statistically significant differences in survival probabilities across lean upper limbs, lean lower limbs, lean gynoid, and lean trunk mass levels in diabetic participants (P < 0.05). In the multivariate adjusted Cox proportional hazards models, higher levels of upper limb lean mass were found to be associated with decreased cardiovascular mortality (hazard ratio, 0.589; 95% confidence interval, 0.332-0.976; P = 0.041). Notably, this correlation was more significant in men (hazard ratio, 0.378; 95% confidence interval, 0.171-0.834; P = 0.016), which was indicated by the results of the Cox regression and nonlinear regression analysis. CONCLUSIONS Higher upper limb lean mass is associated with lower cardiovascular mortality compared with other regional lean mass in patients with diabetes, especially for men. Further research is needed to elucidate the mechanisms involved in muscle metabolic differentiation.
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Affiliation(s)
- Chang Liu
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Lin Hua
- Department of Mathematics, School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Zhong Xin
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
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11
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Karbasion N, Xu Y, Snider JC, Bersi MR. Primary Mouse Aortic Smooth Muscle Cells Exhibit Region- and Sex-Dependent Biological Responses In Vitro. J Biomech Eng 2024; 146:060904. [PMID: 38421345 PMCID: PMC11005860 DOI: 10.1115/1.4064965] [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: 05/16/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/02/2024]
Abstract
Despite advancements in elucidating biological mechanisms of cardiovascular remodeling, cardiovascular disease (CVD) remains the leading cause of death worldwide. When stratified by sex, clear differences in CVD prevalence and mortality between males and females emerge. Regional differences in phenotype and biological response of cardiovascular cells are important for localizing the initiation and progression of CVD. Thus, to better understand region and sex differences in CVD presentation, we have focused on characterizing in vitro behaviors of primary vascular smooth muscle cells (VSMCs) from the thoracic and abdominal aorta of male and female mice. VSMC contractility was assessed by traction force microscopy (TFM; single cell) and collagen gel contraction (collective) with and without stimulation by transforming growth factor-beta 1 (TGF-β1) and cell proliferation was assessed by a colorimetric metabolic assay (MTT). Gene expression and TFM analysis revealed region- and sex-dependent behaviors, whereas collagen gel contraction was consistent across sex and aortic region under baseline conditions. Thoracic VSMCs showed a sex-dependent sensitivity to TGF-β1-induced collagen gel contraction (female > male; p = 0.025) and a sex-dependent proliferative response (female > male; p < 0.001) that was not apparent in abdominal VSMCs. Although primary VSMCs exhibit intrinsic region and sex differences in biological responses that may be relevant for CVD presentation, several factors-such as inflammation and sex hormones-were not included in this study. Such factors should be included in future studies of in vitro mechanobiological responses relevant to CVD differences in males and females.
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Affiliation(s)
- Niyousha Karbasion
- Department of Mechanical Engineering & Materials Science, Washington University at St. Louis, St. Louis, MO 63130
| | - Yujun Xu
- Department of Mechanical Engineering & Materials Science, Washington University at St. Louis, St. Louis, MO 63130
- Washington University in St. Louis
| | - J. Caleb Snider
- Department of Mechanical Engineering & Materials Science, Washington University at St. Louis, St. Louis, MO 63130
- Washington University in St. Louis
| | - Matthew R. Bersi
- Department of Mechanical Engineering & Materials Science, Washington University at St. Louis, St. Louis, MO 63130
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12
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Gathright EC, Hughes JW, Sun S, Storlazzi LE, DeCosta J, Balletto BL, Carey MP, Scott-Sheldon LAJ, Salmoirago-Blotcher E. Effects of stress management interventions on heart rate variability in adults with cardiovascular disease: a systematic review and meta-analysis. J Behav Med 2024; 47:374-388. [PMID: 38478157 DOI: 10.1007/s10865-024-00468-4] [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: 05/19/2023] [Accepted: 01/15/2024] [Indexed: 04/19/2024]
Abstract
Meta-analysis was used to investigate the potential benefits of stress management interventions (SMIs) on vagally-mediated heart rate variability (HRV) in adults with cardiovascular disease. Electronic bibliographic databases were searched through August 2022. Randomized controlled trials and quasi-experimental studies assessing effects of SMIs on HRV were included. Methodological quality was assessed with a standardized checklist. A pooled effect size was calculated for vagally-mediated HRV indices (standard deviation of normal-to-normal intervals, root mean square of the successive differences, and high frequency power) using random effects models. Fourteen studies (1202 participants, Mage: 59 ± 6.25 years; 25% ± 16% women; 61% ± 22% White) were included. Ten studies (11 effects) reported short-term HRV assessment; a small between-group difference emerged for vagally-mediated HRV (d+ = .27, 95% confidence interval [CI] 0.01-0.52, k = 11). Most interventions examined biofeedback; these studies yielded a small between-group difference on vagally-mediated HRV (d+ = 0.31, 95% CI 0.09-0.53, k = 7, Q [6] = 3.82, p = .70, I2 = 11%). This is the first systematic examination of the effect of SMIs on HRV in adults with CVD. Findings suggest a small effect of SMIs on vagally-mediated HRV, with biofeedback likely driving the effect. More research is required to fully understand whether this benefit on vagally-mediated HRV applies to other SMIs.
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Affiliation(s)
- Emily C Gathright
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA.
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA.
| | - Joel W Hughes
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Shufang Sun
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Laurie E Storlazzi
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA
| | - Julie DeCosta
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA
| | - Brittany L Balletto
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA
| | - Michael P Carey
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Lori A J Scott-Sheldon
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Elena Salmoirago-Blotcher
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Medicine, Alpert School of Medicine, Brown University, Providence, RI, USA
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Izquierdo-Gomez R, Martínez-Gómez D, Shields N, Del Rosario Ortola-Vidal M, Rodríguez-Artalejo F, Cabanas-Sánchez V. The role of physical activity in the association between disability and mortality among US older adults: a nationwide prospective cohort study. GeroScience 2024; 46:3275-3285. [PMID: 38252359 PMCID: PMC11009203 DOI: 10.1007/s11357-024-01072-9] [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] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
To examine whether physical activity can mitigate the mortality risk associated with disability in activities of daily living and instrumental activities in daily living among older adults. This analysis comprised 177,360 US participants (104,556 women), aged ≥ 60 years, with valid data from the 1997 through 2018 waves of the US National Health Interview Survey. Participants reported the frequency and duration of leisure-time PA, and their disabilities in activities of daily living and instrumental activities in daily living. Mortality data were obtained from the National Death Index. Over a mean (SD) follow-up of 8.02 (5.43) years, 66,694 deaths occurred from all-cause, 22,673 from cardiovascular disease, and 13,845 from cancer. Among people with disability in activities in daily living, those reaching physical activity recommendations had 25%, 24% and 33% lower risk of all-cause mortality, cardiovascular diseases, and cancer death, respectively, compared with those who do not meet physical activity recommendations. Values were 23%, 22% and 24% for those with disability in instrumental activities in daily living. Risk reductions associated with reaching the recommended physical activity ranged 16% to 29% for people without disability. Combining disability type and compliance with physical activity, individuals with disability in activities of daily living or instrumental activities in daily living who meet the recommended physical activity had moderately higher mortality than those without disability who did not achieve the recommended physical activity. Compliance with physical activity recommendations can partially mitigate excess mortality resulting from disability in activities in daily living or instrumental activities in daily living in older adults.
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Affiliation(s)
- Rocio Izquierdo-Gomez
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain.
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Research Unit, Cádiz, Spain.
- Universidad de Cádiz, Avda. República Saharahui, S/N. Campus de Puerto Real, 11519, Cádiz, Puerto Real, Spain.
| | - David Martínez-Gómez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Nora Shields
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Victoria, 3086, Australia
| | - María Del Rosario Ortola-Vidal
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Verónica Cabanas-Sánchez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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Raidah F, Ghisi GLM, Anchique CV, Soomro NN, Candelaria D, Grace SL. Promoting cardiac rehabilitation program quality in low-resource settings: Needs assessment and evaluation of the International Council of Cardiovascular Prevention and Rehabilitation's registry quality improvement supports. Int J Cardiol 2024; 404:131962. [PMID: 38484802 DOI: 10.1016/j.ijcard.2024.131962] [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: 01/04/2024] [Revised: 02/29/2024] [Accepted: 03/10/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Cardiac rehabilitation (CR) registries have the potential to support quality improvement (QImp). This study investigated the QImp needs of International CR Registry-participating programs and their evaluation of its' supports. METHODS ICRR offers comparative outcome dashboards and QImp sessions, among other features. In this qualitative study, ICRR data stewards from the 17 active on-boarded CR programs were invited to a focus group held in November 2023 via Teams; stewards not sufficiently-proficient in English were invited to provide written input. Deductive-thematic analysis using NVIVO was undertaken by 2 researchers; member-checking ensued. RESULTS Nine participated, and four provided input, from eight countries. Three themes emerged; saturation was achieved. First, QImp facilitators included training, institutional requirements, dedicated staff, resources in academic centres and ICRR features. Second, QImp barriers included staffing issues, the global nature of the ICRR, and structural challenges in low-resource settings. Finally, ICRR supports for QImp included didactic webinars, hearing from other programs, 1-1 support offered and assessing minimum Certification standards. CONCLUSION ICRR-participating programs are satisfied with QImp supports but encounter challenges, including related to language, staffing and other resources. CR registries should be leveraged and optimized to support CR programs to assess and improve their care quality.
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Affiliation(s)
- Fabbiha Raidah
- Faculty of Health, York University, 4700 Keele St, Toronto M3J 1P3, ON, Canada
| | - Gabriela L M Ghisi
- Faculty of Health, York University, 4700 Keele St, Toronto M3J 1P3, ON, Canada; KITE Research Institute- Toronto Rehabilitation Institute, University Health Network, 550 University Ave, Toronto M5G 2A2, Canada
| | - Claudia V Anchique
- The Cardiology Service, Mediagnostica Tecmedi, Cra. 16 #14-68, Centro-Sur, Duitama, Boyacá, Colombia
| | - Nabila N Soomro
- Department of Physical Medicine and Rehabilitation, Sindh Institute of Physical Medicine and Rehabilitation (SIPMR), Chand Bibi Rd, Near Mujahid Masjid, Deli Colony Ranchore Lane, Karachi, Karachi City, Sindh 74200, Pakistan
| | - Dion Candelaria
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Western Ave, Camperdown, NSW 2050, Australia
| | - Sherry L Grace
- Faculty of Health, York University, 4700 Keele St, Toronto M3J 1P3, ON, Canada; KITE Research Institute- Toronto Rehabilitation Institute, University Health Network, 550 University Ave, Toronto M5G 2A2, Canada.
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15
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Shell AL, Crawford CA, Cyders MA, Hirsh AT, Stewart JC. Depressive disorder subtypes, depressive symptom clusters, and risk of obesity and diabetes: A systematic review. J Affect Disord 2024; 353:70-89. [PMID: 38432462 DOI: 10.1016/j.jad.2024.02.051] [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: 09/13/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Overlapping but divided literatures suggest certain depression facets may pose greater obesity and diabetes risk than others. Our objectives were to integrate the major depressive disorder (MDD) subtype and depressive symptom cluster literatures and to clarify which facets are associated with the greatest cardiometabolic disease risk. METHODS We conducted a systematic review of published studies examining associations of ≥2 MDD subtypes or symptom clusters with obesity or diabetes risk outcomes. We report which facets the literature is "in favor" of (i.e., having the strongest or most consistent results). RESULTS Forty-five articles were included. Of the MDD subtype-obesity risk studies, 14 were in favor of atypical MDD, and 8 showed similar or null associations across subtypes. Of the symptom cluster-obesity risk studies, 5 were in favor of the somatic cluster, 1 was in favor of other clusters, and 5 were similar or null. Of the MDD subtype-diabetes risk studies, 7 were in favor of atypical MDD, 3 were in favor of other subtypes, and 5 were similar or null. Of the symptom cluster-diabetes risk studies, 7 were in favor of the somatic cluster, and 5 were similar or null. LIMITATIONS Limitations in study design, sample selection, variable measurement, and analytic approach in these literatures apply to this review. CONCLUSIONS Atypical MDD and the somatic cluster are most consistently associated with obesity and diabetes risk. Future research is needed to establish directionality and causality. Identifying the depression facets conferring the greatest risk could improve cardiometabolic disease risk stratification and prevention programs.
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Affiliation(s)
- Aubrey L Shell
- Department of Psychiatry, Indiana University Health, United States of America
| | | | - Melissa A Cyders
- Department of Psychology, Indiana University-Indianapolis, United States of America
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Indianapolis, United States of America
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Indianapolis, United States of America.
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16
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He S, Wan L, Ding Y, Zhang Y, Liu M, Xie R. Association between cardiovascular health and abdominal aortic calcification: Analyses of NHANES 2013-2014. Int J Cardiol 2024; 403:131878. [PMID: 38382849 DOI: 10.1016/j.ijcard.2024.131878] [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: 11/27/2023] [Revised: 01/17/2024] [Accepted: 02/15/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Abdominal aortic calcification (AAC) is closely connected to cardiovascular disease. We aimed to measure the association between cardiovascular health (CVH) levels, assessed by the Life's Essential 8 (LE8) score, and AAC within a nationally representative sample of the US. METHODS The National Health and Nutrition Examination Survey 2013-2014 participants were chosen for this cross-sectional investigation. LE8 scores, ranging from 0 to 100, were calculated according to the criteria outlined by the American Heart Association. AAC was evaluated using a semi-quantitative scoring system known as AAC-24. Weighted linear regression, multivariate logistic regression, and restricted cubic spline models were used to investigate the correlations. Subgroup analysis and interaction tests were conducted to assess this association's robustness across different population groups. RESULTS Increased CVH levels were associated with diminished AAC scores and a reduced prevalence of severe AAC. In the partially adjusted model, each unit increase in LE8 score was associated with a 2% decrease in severe AAC prevalence [OR 0.98; 95% CI 0.96, 0.99]. Participants in the high CVH level group experienced a 72% reduced prevalence of severe AAC compared to those in the low CVH level group in model 2 [OR 0.28; 95% CI 0.12, 0.63]. This inverse association was notably more prominent in adults aged 60 years and above. CONCLUSIONS CVH exhibited a robust negative correlation with AAC. Promoting optimal CVH levels may favor averting AAC within the general population.
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Affiliation(s)
- Sijie He
- Department of Pharmacy, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, China
| | - Li Wan
- Department of Pharmacy, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, China
| | - Yunyi Ding
- Department of Nephrology, Hangzhou TCM Hospital of Zhejiang Chinese Medical University, Hangzhou 310053, China.
| | - Ya Zhang
- The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China Hengyang, China 421002
| | - Mingjiang Liu
- The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China Hengyang, China 421002; Department of Hand&Foot Surgery, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China Hengyang, China 421002
| | - Ruijie Xie
- The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China Hengyang, China 421002; Department of Hand&Foot Surgery, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China Hengyang, China 421002.
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17
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Enriquez R, Homsi M, Ssekubugu R, Nabukalu D, Zeebari Z, Marrone G, Gigante B, Chang LW, Reynolds SJ, Nalugoda F, Ekström AM, Hagström H, Nordenstedt H. Prevalence and risk factors of metabolic dysfunction-associated steatotic liver disease in south Central Uganda: A cross-sectional survey. Aliment Pharmacol Ther 2024; 59:1111-1121. [PMID: 38459720 DOI: 10.1111/apt.17931] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/16/2024] [Accepted: 02/16/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Despite numerous risk factors and serious consequences, little is known about metabolic dysfunction-associated steatotic liver disease (MASLD) at population level in Africa. AIM The aim of the study was to estimate the prevalence and risk factors of MASLD in people living with and without HIV in Uganda. METHODS We collected data from 37 communities in South Central Uganda between May 2016 and May 2018. We estimated MASLD prevalence using the fatty liver index and advanced liver fibrosis using the dynamic aspartate-to-alanine aminotransferase ratio. We collected additional data on sociodemographics, HIV and cardiovascular disease (CVD) risk factors. We used multivariable logistic regression to determine the association between HIV, CVD risk factors and MASLD. RESULTS We included 759 people with HIV and 704 HIV-negative participants aged 35-49. MASLD prevalence was 14% in women and 8% in men; advanced liver fibrosis prevalence was estimated to be <1%. MASLD prevalence was more common in women (15% vs. 13%) and men (9% vs. 6%) with HIV. Being female (odds ratio [OR] = 2.1; 95% confidence interval [CI] = 1.4-3.3) was associated with a higher odds of MASLD after adjustment for confounders; HIV infection was borderline associated with MASLD (OR = 1.4; 95% CI: 1.0-2.0). CONCLUSIONS In a relatively young cohort in Uganda, 14% of women and 8% of men had MASLD. There was an indication of an association between HIV and MASLD in multivariable analysis. These data are the first to describe the population-level burden of MASLD in sub-Saharan Africa using data from a population-based cohort.
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Affiliation(s)
- Rocio Enriquez
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Mahmoud Homsi
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Zangin Zeebari
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Jönköping International Business School, Jönköping University, Jönköping, Sweden
| | - Gaetano Marrone
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Bruna Gigante
- Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Larry W Chang
- Rakai Health Sciences Program, Kalisizo, Uganda
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Steven J Reynolds
- Rakai Health Sciences Program, Kalisizo, Uganda
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Laboratory of Immunoregulation, Division of Intramural Research, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Anna Mia Ekström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, Venhälsan, Södersjukhuset, Stockholm, Sweden
| | - Hannes Hagström
- Unit of Hepatology, Division of Upper Gastrointestinal Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Helena Nordenstedt
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Internal Medicine and Infectious Diseases, Danderyd University Hospital, Stockholm, Sweden
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18
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Mol N, Priya A, Singh AK, Mago P, Shalimar, Ray AK. "Unravelling the impacts of climatic heat events on cardiovascular health in animal models". Environ Res 2024; 248:118315. [PMID: 38301760 DOI: 10.1016/j.envres.2024.118315] [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] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/19/2024] [Accepted: 01/24/2024] [Indexed: 02/03/2024]
Abstract
Climate change has led to an increase in high ambient temperatures, causing extreme heat events worldwide. According to the World Meteorological Organization (WMO), July 2023 marked a historic milestone as the Earth reached its hottest recorded temperature, precisely hitting the critical threshold of 1.5 °C set by the Paris Agreement. This distressing development led to a stark warning from the United Nations, signaling the dawn of what they call "an era of global boiling". The increasing global temperatures can result in high heat stress which leads to various physiological and biochemical alterations in the human body. Given that cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality globally, heat events exacerbate this public health issue. While clinical and in-vitro studies have suggested a range of pathophysiological and biochemical mechanisms underlying the body's response to heat stress, the complex nature of organ-system level interactions makes precise investigation challenging. To address this knowledge gap effectively, the use of animal models exposed to acute or chronic heat stress can be invaluable. These models can closely replicate the multifaceted effects observed in humans during heat stress conditions. Despite extensive independent reviews, limited focus has been shed on the high heat-induced cardiovascular complications and their mechanisms, particularly utilizing animal models. Therefore, in this comprehensive review, we highlight the crucial biomarkers altered during heat stress, contributing significantly to various CVDs. We explore potential mechanisms underlying heat-induced cardiovascular dysfunction and damage, delving into various animal models. While traditional rodent models are commonly employed, we also examine less conventional models, including ruminants, broilers, canines, and primates. Furthermore, we delve into various potential therapeutic approaches and preventive measures. These insights hold significant promise for the development of more effective clinical interventions against the effects of heat stress on the human cardiovascular system.
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Affiliation(s)
- Nidhi Mol
- Department of Environmental Studies, University of Delhi, New Delhi, India
| | - Anjali Priya
- Department of Environmental Studies, University of Delhi, New Delhi, India
| | - Alok Kumar Singh
- Department of Zoology, Ramjas College, University of Delhi, New Delhi, India
| | - Payal Mago
- Shaheed Rajguru College of Applied Sciences for Women, University of Delhi, New Delhi, India; Campus of Open Learning, University of Delhi, New Delhi, India
| | - Shalimar
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - Ashwini Kumar Ray
- Department of Environmental Studies, University of Delhi, New Delhi, India.
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Hoe JK, Flege MM, Jimenez-Solem E, Hansen S, Olsen RH, Petersen J, Jensen CB. Monitoring and treatment of hypercholesterolemia after an atherosclerotic cardiovascular disease event in Denmark from 2015 to 2020. Int J Cardiol 2024; 402:131857. [PMID: 38360103 DOI: 10.1016/j.ijcard.2024.131857] [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: 09/04/2023] [Revised: 01/18/2024] [Accepted: 02/10/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND AND AIMS Lowering the blood concentration of low-density lipoprotein cholesterol (LDL-C), is a cornerstone in preventing atherosclerotic cardiovascular disease (ASCVD). Current European guidelines recommends LDL-C < 1.4 mmol/L for secondary prevention in high-risk patients. The aim of this study is to investigate monitoring and treatment of hypercholesterolemia one year after a ASCVD event. METHODS Danish patients with hypercholesterolemia and an incident ASCVD event from 2015 to 2020 were included in this nationwide cohort study. Patients' LDL-C measurements and lipid-lowering treatment were followed for one year after ASCVD event, or until death or migration. Imputation was used to estimate absolute LDL-values when patients were unmeasured. RESULTS A total of 139,043 patients were included in the study with a mean follow-up time of 10.4 months. During the one-year period, 120,020 (86%) patients had their LDL-C measured at least once, 83,723 (60%) patients were measured at least twice. During the period one to six months after ASCVD event 25,999 (19%) achieved an LDL-C < 1.4 mmol/L, 93,349 (67%) failed to achieve an LDL-C < 1.4 mmol/L, and 196,950 (14%) had died or migrated. Missing LDL-C values were estimated via imputation. At the end of month twelve, 60,583 (44%) patients were in statin monotherapy, 2926 (2%) were treated with other lipid-lowering treatment, 42,869 (31%) were in no treatment, and 32,665 (23%) had died or migrated. CONCLUSIONS Many Danish patients are not appropriately followed-up with LDL-C measurements, and a substantial number of patients are not in lipid-lowering treatment one year after an ASCVD event.
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Affiliation(s)
- Jakob Kronkvist Hoe
- Copenhagen Phase IV unit (Phase4CPH), Department of Clinical Pharmacology and Center of Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Marius Mølsted Flege
- Copenhagen Phase IV unit (Phase4CPH), Department of Clinical Pharmacology and Center of Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
| | - Espen Jimenez-Solem
- Copenhagen Phase IV unit (Phase4CPH), Department of Clinical Pharmacology and Center of Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Susanne Hansen
- Copenhagen Phase IV unit (Phase4CPH), Department of Clinical Pharmacology and Center of Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Rasmus Huan Olsen
- Copenhagen Phase IV unit (Phase4CPH), Department of Clinical Pharmacology and Center of Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Janne Petersen
- Copenhagen Phase IV unit (Phase4CPH), Department of Clinical Pharmacology and Center of Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Camilla Bjørn Jensen
- Copenhagen Phase IV unit (Phase4CPH), Department of Clinical Pharmacology and Center of Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
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Shishani K, Kaduka L, Olale J, Mbuka S, Mutai J, Muniu E, Ochieng R, Sivarajan Froelicher E. Methods for Global Health Collaboration on Cardiovascular Disease: Vihiga 1. Nurs Res 2024; 73:232-236. [PMID: 37916842 DOI: 10.1097/nnr.0000000000000705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
BACKGROUND Partnership building and understanding of context that addresses global health concerns is essential in global health research. However, limited knowledge is available on the practical experiences of building such relationships. OBJECTIVES The aim of this study was to provide a detailed description of the processes involved in establishing international collaboration, gain community involvement and cooperation with gatekeepers, and study populations of rural village areas in Western Kenya. RESULTS Because of the limited information available in the published literature about the extremely important practical considerations, our experiences on the logistical aspects of planning and implementing global health research projects are presented. CONCLUSION Understanding the local collaborators and their communities and allocating adequate resources in time and money during the planning phase is paramount in ensuring the successful completion of global health research studies.
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Kengne AP, Ramachandran A. Feasibility of prevention of type 2 diabetes in low- and middle-income countries. Diabetologia 2024; 67:763-772. [PMID: 38355989 PMCID: PMC10954968 DOI: 10.1007/s00125-023-06085-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/17/2023] [Indexed: 02/16/2024]
Abstract
Type 2 diabetes is a leading cause of global mortality and morbidity. Nearly 80% of individuals with diabetes live in low- and middle-income countries (LMICs), where nearly half of those with the condition remain undiagnosed. The majority of known cases have sub-optimal clinical outcomes. Moreover, large populations with impaired glucose tolerance and/or impaired fasting glucose contribute to the rapid increase in type 2 diabetes. Globally, priority should be given to limit the population with diabetes, especially in LMICs, alongside actions to optimise the care of people diagnosed with diabetes. Primary prevention studies in LMICs have generated evidence to show the efficacy and scalability of strategies to fully prevent or delay the development of diabetes in high-risk groups. However, these are mainly limited to certain countries in Asia, particularly China and India. The studies have indicated that prevention policies are effective in populations with a high risk of type 2 diabetes, and they also have long-term benefits, not only for the risk of type 2 diabetes but also for the risk of associated metabolic disorders, such as CVDs. For the effective conduct of national programmes, innovative mechanisms must be implemented, such as the use of information technology, joint efforts of multiple teams implementing similar programmes, and involvement of governmental and non-governmental partnerships. Continuous monitoring and long-term studies are required to assess the utility of these programmes. The effectiveness of such programmes in LMICs has not been proven over the longer term, except in China. Despite the available evidence, the feasibility of prevention strategies for type 2 diabetes in LMICs at population level remains an enigma. There remain challenges in the form of cultural, societal and economic constraints; insufficient infrastructure and healthcare capacity; and the non-fully elucidated natural history and determinants of type 2 diabetes in LMICs.
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Affiliation(s)
- Andre P Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
- Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University, Mthatha, South Africa.
| | - Ambady Ramachandran
- Indian Diabetes Research Foundation, Chennai, India
- Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India
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22
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Zhou J, Liu C, Liu L, Li L. Sugar-sweetened beverage intake and long-term mortality in individuals with metabolic dysfunction-associated steatotic liver disease: a longitudinal analysis of the National Health and Nutrition Examination Survey database. Eur J Gastroenterol Hepatol 2024; 36:608-614. [PMID: 38477849 DOI: 10.1097/meg.0000000000002730] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
BACKGROUND Consuming sugar-sweetened beverages (SSBs) has been linked to the development of various adverse health conditions, including metabolic dysfunction-associated steatotic liver disease (MASLD). This study evaluated associations between SSB intake and long-term mortality among individuals with MASLD using a nationally representative database. METHODS This population-based, longitudinal study extracted data of adults aged 20-79 years with MASLD from the USA (US) National Health and Nutrition Examination Survey database 2003-2014. Associations between the amount of SSB intake and all-cause, cancer and cardiovascular disease mortality until the end of 2019 were determined using Cox proportional hazards regression analyses. RESULTS A total of 12 965 individuals aged 20-79 years who had MASLD were identified in the database. After exclusion, 5630 participants remained for the analyses. This cohort can be extrapolated to 43 420 321 individuals in the entire US after proper weighting. The mean age of the study cohort was 44.1 years. After adjusting for confounders, no significant association was observed between SSB intake (tertile 3 vs. tertile 1) and all-cause [adjusted hazard ratio (aHR): 1.03, 95% confidence interval (CI), 0.60-1.76) or cancer mortality (aHR, 0.41; 95% CI, 0.15-1.16). However, higher SSB intake (tertile 3 vs. tertile 1) was significantly associated with elevated cardiovascular disease mortality risk (aHR = 2.83; 95% CI, 1.01-7.91). CONCLUSION In US adults with MASLD, high SSB intake is associated with nearly three-fold increased cardiovascular disease mortality risk. The findings underscore the critical need for concerted action on the part of healthcare providers and policymakers.
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Affiliation(s)
- Ji Zhou
- Department of Gastroenterology and Hepatology
| | - Chu Liu
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lili Liu
- Department of Gastroenterology and Hepatology
| | - Lei Li
- Department of Gastroenterology and Hepatology
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23
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Papastratis I, Stergioulas A, Konstantinidis D, Daras P, Dimitropoulos K. Can ChatGPT provide appropriate meal plans for NCD patients? Nutrition 2024; 121:112291. [PMID: 38359704 DOI: 10.1016/j.nut.2023.112291] [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] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/30/2023] [Indexed: 02/17/2024]
Abstract
OBJECTIVES Dietary habits significantly affect health conditions and are closely related to the onset and progression of non-communicable diseases (NCDs). Consequently, a well-balanced diet plays an important role in lessening the effects of various disorders, including NCDs. Several artificial intelligence recommendation systems have been developed to propose healthy and nutritious diets. Most of these systems use expert knowledge and guidelines to provide tailored diets and encourage healthier eating habits. However, new advances in large language models such as ChatGPT, with their ability to produce human-like responses, have led individuals to search for advice in several tasks, including diet recommendations. This study aimed to determine the ability of ChatGPT models to generate appropriate personalized meal plans for patients with obesity, cardiovascular diseases, and type 2 diabetes. METHODS Using a state-of-the-art knowledge-based recommendation system as a reference, we assessed the meal plans generated by two large language models in terms of energy intake, nutrient accuracy, and meal variability. RESULTS Experimental results with different user profiles revealed the potential of ChatGPT models to provide personalized nutritional advice. CONCLUSION Additional supervision and guidance by nutrition experts or knowledge-based systems are required to ensure meal appropriateness for users with NCDs.
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Affiliation(s)
- Ilias Papastratis
- The Visual Computing Lab, Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Central Macedonia, Greece.
| | - Andreas Stergioulas
- The Visual Computing Lab, Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Central Macedonia, Greece
| | - Dimitrios Konstantinidis
- The Visual Computing Lab, Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Central Macedonia, Greece
| | - Petros Daras
- The Visual Computing Lab, Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Central Macedonia, Greece
| | - Kosmas Dimitropoulos
- The Visual Computing Lab, Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Central Macedonia, Greece
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24
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Tang W, Spiegelman D, Liao X, Wang M. Causal Selection of Covariates in Regression Calibration for Mismeasured Continuous Exposure. Epidemiology 2024; 35:320-328. [PMID: 38630507 DOI: 10.1097/ede.0000000000001706] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Regression calibration as developed by Rosner, Spiegelman, and Willett is used to adjust the bias in effect estimates due to measurement error in continuous exposures. The method involves two models: a measurement error model relating the mismeasured exposure to the true (or gold-standard) exposure and an outcome model relating the mismeasured exposure to the outcome. However, no comprehensive guidance exists for determining which covariates should be included in each model. In this article, we investigate the selection of the minimal and most efficient covariate adjustment sets under a causal inference framework. We show that to address the measurement error, researchers must adjust for, in both measurement error and outcome models, any common causes (1) of true exposure and the outcome and (2) of measurement error and the outcome. We also show that adjusting for so-called prognostic variables that are independent of true exposure and measurement error in the outcome model, may increase efficiency, while adjusting for any covariates that are associated only with true exposure generally results in efficiency loss in realistic settings. We apply the proposed covariate selection approach to the Health Professional Follow-up Study dataset to study the effect of fiber intake on cardiovascular disease. Finally, we extend the originally proposed estimators to a nonparametric setting where effect modification by covariates is allowed.
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Affiliation(s)
- Wenze Tang
- From the Department of Epidemiology, Harvard School of Public Health, Boston, MA
| | - Donna Spiegelman
- Department of Biostatistics, Yale School of Public Health, New Haven, CT
- Center on Methods for Implementation and Prevention Science, Yale School of Public Health, New Haven, CT
| | - Xiaomei Liao
- From the Department of Epidemiology, Harvard School of Public Health, Boston, MA
- Department of Biostatistics, Harvard School of Public Health, Boston, MA
| | - Molin Wang
- From the Department of Epidemiology, Harvard School of Public Health, Boston, MA
- Department of Biostatistics, Harvard School of Public Health, Boston, MA
- Channing Division of Network Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA
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25
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Younossi ZM, Paik JM, Stepanova M, Ong J, Alqahtani S, Henry L. Clinical profiles and mortality rates are similar for metabolic dysfunction-associated steatotic liver disease and non-alcoholic fatty liver disease. J Hepatol 2024; 80:694-701. [PMID: 38286339 DOI: 10.1016/j.jhep.2024.01.014] [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: 10/25/2023] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND & AIMS Recently, the term metabolic dysfunction-associated steatotic liver disease (MASLD) has replaced non-alcoholic fatty liver disease (NAFLD). Concern remains regarding whether the evidence generated under the NAFLD definition can be used for MASLD. We compared the clinical profile and outcomes of NAFLD to MASLD using tertiary care- and population-based data. METHODS Comparison data were obtained from our NAFLD database and the National Health and Nutrition Examination Survey (NHANES III). Clinical profiles and non-invasive tests (enhanced liver fibrosis [ELF] score, fibrosis-4 index [FIB-4] and vibration-controlled transient elastography) were compared. Mortality data were obtained from NHANES-National Death Index. All-cause mortality was assessed by Cox proportional hazards regression models and cause-specific mortality by competing risk analysis. RESULTS There were 6,429 patients in the NAFLD database (age: 54 ± 12 years, 42% male, BMI 35.4 ± 8.3, waist circumference 112 ± 17 cm, 52% type 2 diabetes). Average scores for ELF, FIB-4 and liver stiffness were 9.6 ± 1.2, 1.69 ± 1.24,14.0 ± 11.8 kPa, respectively; 99% met MASLD criteria; 95% met MASLD on BMI only. Predictive accuracy of ELF and FIB-4 were identical between MASLD and NAFLD. We included 12,519 eligible participants from NHANES (age 43.00 years, 47.38% male, 22.70% obese, 7.28% type 2 diabetes, 82.51% ≥1 cardiometabolic criteria). Among the NHANES study population, there was excellent concordance between MASLD and NAFLD diagnoses: Cohen's kappa coefficient: 0.968 (95% CI 0.962-0.973) with 5.29% of NAFLD cases not meeting MASLD criteria. After a median follow-up of 22.83 years, there were no mortality differences between MASLD and NAFLD diagnoses (p values ≥0.05). CONCLUSIONS NAFLD and MASLD are similar except individuals with MASLD seem to be older with slightly higher mortality risk, likely owing to cardiometabolic risk factors. Clinical profiles and non-invasive test thresholds were also identical. These data provide evidence that NAFLD and MASLD terminologies can be used interchangeably. For the small proportion of patients with NAFLD who do not meet MASLD criteria, further consideration is needed. IMPACT AND IMPLICATIONS In June 2023, new terminology (MASLD) was adopted to replace the term NAFLD as a means to better describe what the liver disease is rather than what it is not, as well as to potentially reduce stigma. Given that MASLD requires at least one cardiometabolic risk factor, questions were raised as to whether this change in the definition would nullify the similarities between NAFLD and MASLD and require new evidence to be generated for MASLD. We used our NAFLD database and a US population-based database to show that the vast majority of patients with NAFLD fulfill criteria for MASLD. Non-invasive tests performed similarly in both groups. Mortality risk was slightly higher in those with MASLD, which is attributed to the presence of cardiometabolic risks. These results provide evidence that data generated in the past three decades for NAFLD can be used interchangeably for MASLD.
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Affiliation(s)
- Zobair M Younossi
- The Global NASH Council, Washington DC, USA; Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA; Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, USA.
| | - James M Paik
- The Global NASH Council, Washington DC, USA; Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA
| | - Maria Stepanova
- The Global NASH Council, Washington DC, USA; Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA; Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Janus Ong
- The Global NASH Council, Washington DC, USA; University of the Philippines, College of Medicine, Manila, Philippine
| | - Saleh Alqahtani
- The Global NASH Council, Washington DC, USA; Liver Transplant Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Division of Gastroenterology & Hepatology, Johns Hopkins University, Baltimore, MD, United States
| | - Linda Henry
- The Global NASH Council, Washington DC, USA; Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA; Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, USA; Center for Outcomes Research in Liver Disease, Washington DC, USA
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26
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Olivera S, Graham D. Modelling pre-eclampsia and its cardiovascular effects. Nat Rev Cardiol 2024; 21:281. [PMID: 38480793 DOI: 10.1038/s41569-024-01006-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Affiliation(s)
- Sol Olivera
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
| | - Delyth Graham
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
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Norton GR, An DW, Aparicio LS, Yu YL, Wei FF, Niiranen TJ, Liu C, Stolarz-Skrzypek K, Wojciechowska W, Jula AM, Rajzer M, Martens DS, Verhamme P, Li Y, Kawecka-Jaszcz K, Nawrot TS, Staessen JA, Woodiwiss AJ. Mortality and Cardiovascular End Points In Relation to the Aortic Pulse Wave Components: An Individual-Participant Meta-Analysis. Hypertension 2024; 81:1065-1075. [PMID: 38390718 PMCID: PMC11025606 DOI: 10.1161/hypertensionaha.123.22036] [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] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/11/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Wave separation analysis enables individualized evaluation of the aortic pulse wave components. Previous studies focused on the pressure height with overall positive but differing results. In the present analysis, we assessed the associations of the pressure of forward and backward (Pfor and Pref) pulse waves with prospective cardiovascular end points, with extended analysis for time to pressure peak (Tfor and Tref). METHODS Participants in 3 IDCARS (International Database of Central Arterial Properties for Risk Stratification) cohorts (Argentina, Belgium, and Finland) aged ≥20 years with valid pulse wave analysis and follow-up data were included. Pulse wave analysis was done using the SphygmoCor device, and pulse wave separation was done using the triangular method. The primary end points consisted of cardiovascular mortality and nonfatal cardiovascular and cerebrovascular events. Multivariable-adjusted Cox regression was used to calculate hazard ratios. RESULTS A total of 2206 participants (mean age, 57.0 years; 55.0% women) were analyzed. Mean±SDs for Pfor, Pref, Tfor, and Tfor/Tref were 31.0±9.1 mm Hg, 20.8±8.4 mm Hg, 130.8±35.5, and 0.51±0.11, respectively. Over a median follow-up of 4.4 years, 146 (6.6%) participants experienced a primary end point. Every 1 SD increment in Pfor, Tfor, and Tfor/Tref was associated with 27% (95% CI, 1.07-1.49), 25% (95% CI, 1.07-1.45), and 32% (95% CI, 1.12-1.56) higher risk, respectively. Adding Tfor and Tfor/Tref to existing risk models improved model prediction (∆Uno's C, 0.020; P<0.01). CONCLUSIONS Pulse wave components were predictive of composite cardiovascular end points, with Tfor/Tref showing significant improvement in risk prediction. Pending further confirmation, the ratio of time to forward and backward pressure peak may be useful to evaluate increased afterload and signify increased cardiovascular risk.
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Affiliation(s)
- Gavin R. Norton
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (G.R.N., A.J.W.)
| | - De-Wei An
- Department of Cardiovascular Medicine, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (D.-W.A., Y.L.)
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium (D.-W.A, Y.-L.Y., K.S.-S., J.A.S.)
- Research Unit Environment and Health, Department of Public Health and Primary Care (D.-W.A, Y.-L.Y., T.S.N.), University of Leuven, Belgium
| | - Lucas S. Aparicio
- Servicio de Clínica Médica, Sección Hipertensión Arterial, Hospital Italiano de Buenos Aires, Argentina (L.S.A.)
| | - Yu-Ling Yu
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium (D.-W.A, Y.-L.Y., K.S.-S., J.A.S.)
- Research Unit Environment and Health, Department of Public Health and Primary Care (D.-W.A, Y.-L.Y., T.S.N.), University of Leuven, Belgium
| | - Fang-Fei Wei
- The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China (F.-F.W., C.L.)
| | - Teemu J. Niiranen
- Department of Chronic Disease Prevention, Finnish Institute for Health and Welfare, Turku, Finland (T.J.N., A.M.J.)
- Department of Medicine, Turku University Hospital and University of Turku, Finland (T.J.N., A.M.J.)
| | - Chen Liu
- The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China (F.-F.W., C.L.)
| | - Katarzyna Stolarz-Skrzypek
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium (D.-W.A, Y.-L.Y., K.S.-S., J.A.S.)
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland (K.S.-S., W.W., K.K.-J., M.R.)
| | - Wiktoria Wojciechowska
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland (K.S.-S., W.W., K.K.-J., M.R.)
| | - Antti M. Jula
- Department of Chronic Disease Prevention, Finnish Institute for Health and Welfare, Turku, Finland (T.J.N., A.M.J.)
- Department of Medicine, Turku University Hospital and University of Turku, Finland (T.J.N., A.M.J.)
| | - Marek Rajzer
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland (K.S.-S., W.W., K.K.-J., M.R.)
| | - Dries S. Martens
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium (D.S.M., T.S.N)
| | - Peter Verhamme
- Center for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences (P.V.), University of Leuven, Belgium
| | - Yan Li
- Department of Cardiovascular Medicine, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (D.-W.A., Y.L.)
| | - Kalina Kawecka-Jaszcz
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland (K.S.-S., W.W., K.K.-J., M.R.)
| | - Tim S. Nawrot
- Research Unit Environment and Health, Department of Public Health and Primary Care (D.-W.A, Y.-L.Y., T.S.N.), University of Leuven, Belgium
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium (D.S.M., T.S.N)
| | - Jan A. Staessen
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium (D.-W.A, Y.-L.Y., K.S.-S., J.A.S.)
- Biomedical Science Group, Faculty of Medicine (J.A.S.), University of Leuven, Belgium
| | - Angela J. Woodiwiss
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (G.R.N., A.J.W.)
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Burkard-Mandel LE. Prediction of Major Adverse Cardiovascular Events in Patients with Chest Pain Using Coronary Artery Calcium Score. Radiol Imaging Cancer 2024; 6:e249008. [PMID: 38607281 DOI: 10.1148/rycan.249008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
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Abstract
Snake venom contains a cocktail of compounds dominated by proteins and peptides, which make up the toxin. The toxin components of snake venom attack several targets in the human body including the neuromuscular system, kidney and blood coagulation system and cause pathologies. As such, the venom toxins can be managed and used for the treatment of these diseases. In this regard, Captopril used in the treatment of cardiovascular diseases was the first animal venom toxin-based drug approved by the US Food and Drug Administration and the European Medicines Agency. Cancers cause morbidity and mortality worldwide. Due to side effects associated with the current cancer treatments including chemotherapy, radiotherapy, immunotherapy, hormonal therapy and surgery, there is a need to improve the efficacy of current treatments and/or develop novel drugs from natural sources including animal toxin-based drugs. There is a long history of earlier and ongoing studies implicating snake venom toxins as potential anticancer therapies. Here, we review the role of crude snake venoms and toxins including phospholipase A2, L-amino acid oxidase, C-type lectin and disintegrin as potential anticancer agents tested in cancer cell lines and animal tumour models in comparison to normal cell lines. Some of the anti-tumour activities of snake venom toxins include induction of cytotoxicity, apoptosis, cell cycle arrest and inhibition of metastasis, angiogenesis and tumour growth. We thus propose the advancement of multidisciplinary approaches to more pre-clinical and clinical studies for enhanced bioavailability and targeted delivery of snake venom toxin-based anticancer drugs.
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Affiliation(s)
- Benedict C Offor
- Department of Biochemistry, University of Johannesburg, Auckland Park, South Africa
| | - Lizelle A Piater
- Department of Biochemistry, University of Johannesburg, Auckland Park, South Africa
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Azam S, Tamimi RM, Drotman MB, Babagbemi K, Levy AD, Peña JM. Assessing breast arterial calcification in mammograms and its implications for atherosclerotic cardiovascular disease risk. Clin Imaging 2024; 109:110129. [PMID: 38582071 DOI: 10.1016/j.clinimag.2024.110129] [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] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 04/08/2024]
Abstract
PURPOSE Breast arterial calcifications (BAC) are incidentally observed on mammograms, yet their implications remain unclear. We investigated lifestyle, reproductive, and cardiovascular determinants of BAC in women undergoing mammography screening. Further, we investigated the relationship between BAC, coronary arterial calcifications (CAC) and estimated 10-year atherosclerotic cardiovascular (ASCVD) risk. METHODS In this cross-sectional study, we obtained reproductive history and CVD risk factors from 215 women aged 18 or older who underwent mammography and cardiac computed tomographic angiography (CCTA) within a 2-year period between 2007 and 2017 at hospital. BAC was categorized as binary (present/absent) and semi-quantitatively (mild, moderate, severe). CAC was determined using the Agatston method and recorded as binary (present/absent). Adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated, accounting for age as a confounding factor. ASCVD risk over a 10-year period was calculated using the Pooled Cohort Risk Equations. RESULTS Older age, systolic and diastolic blood pressures, higher parity, and younger age at first birth (≤28 years) were significantly associated with greater odds of BAC. Women with both BAC and CAC had the highest estimated 10-year risk of ASCVD (13.30 %). Those with only BAC (8.80 %), only CAC (5.80 %), and no BAC or CAC (4.40 %) had lower estimated 10-year risks of ASCVD. No association was detected between presence of BAC and CAC. CONCLUSIONS These findings support the hypothesis that BAC on a screening mammogram may help to identify women at potentially increased risk of future cardiovascular disease without additional cost and radiation exposure.
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Affiliation(s)
- Shadi Azam
- Department of Population Health Sciences, Weill Cornell Medicine, New York, USA.
| | - Rulla M Tamimi
- Department of Population Health Sciences, Weill Cornell Medicine, New York, USA.
| | - Michele B Drotman
- Department of Diagnostic Radiology, Weill Cornell Medicine, New York, USA.
| | - Kemi Babagbemi
- Department of Diagnostic Radiology, Weill Cornell Medicine, New York, USA.
| | - Allison D Levy
- Department of Diagnostic Radiology, Weill Cornell Medicine, New York, USA.
| | - Jessica M Peña
- Departments of Medicine and Radiology, Weill Cornell Medicine, New York, USA.
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Mao Y, Li X, Li Y, Zhu S, Han X, Zhao R, Geng Y. Association of serum 25-hydroxyvitamin d concentrations with all-cause and cause-specific mortality among individuals with depression: A cohort study. J Affect Disord 2024; 352:10-18. [PMID: 38341158 DOI: 10.1016/j.jad.2024.02.018] [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: 10/06/2023] [Revised: 01/29/2024] [Accepted: 02/07/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Limited evidence exists on the relationship between vitamin D status and mortality in depressed patients. METHODS This study investigates serum 25-hydroxyvitamin D [25(OH)D] concentrations in 8417 adults with depression among the National Health and Nutrition Examination Survey (NHANES, 2005-2018). Mortality outcomes were assessed through National Death Index records up to December 31, 2019. Cox proportional risk models estimated risk ratios (HR) and 95 % confidence intervals (CI) for all-cause, cardiovascular disease (CVD), and cancer mortality. Restricted cubic spline analyses explored the nonlinear association of serum 25(OH)D levels with mortality, using the likelihood ratio test for nonlinearity. RESULTS The weighted mean serum 25(OH)D level was 66.40 nmol/L (95 % CI: 65.8, 67.0), with 36.3 % having deficient vitamin D (<50 nmol/L [20 ng/mL]). Over an average 7.16-year follow-up, 935 deaths were documented, including 296 CVD deaths and 191 cancer deaths. Higher serum 25(OH)D levels were associated with reduced all-cause mortality (HRs 0.55-1.00, p trend = 0.006) and cancer-specific mortality (HRs 0.36-1.00, p trend = 0.015) after multivariate adjustment. The relationship between serum 25(OH)D and all-cause mortality exhibited a nonlinear pattern (P for nonlinearity <0.001), with a 34 % lower risk for each unit increase in natural log-transformed 25(OH)D levels. Significant interactions were observed with age, antidepressant use, and diabetes status. CONCLUSIONS Higher serum 25(OH)D levels were associated with decreased all-cause and cancer-specific mortality in depressed adults, particularly among younger individuals and those using antidepressants or without diabetes. Further research is essential to understand mechanisms and interventions related to vitamin D in depression.
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Affiliation(s)
- Yafei Mao
- Department of Laboratory Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China; Department of Laboratory Medicine, Fengfeng General Hospital of North China Medical & Health Group, Han Dan, Hebei, China
| | - Xinyuan Li
- Department of Laboratory Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yanming Li
- Department of Laboratory Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Shumin Zhu
- Department of Laboratory Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Xu Han
- Department of Laboratory Medicine, Fengfeng General Hospital of North China Medical & Health Group, Han Dan, Hebei, China
| | - Rui Zhao
- Department of Laboratory Medicine, Fengfeng General Hospital of North China Medical & Health Group, Han Dan, Hebei, China
| | - Yulan Geng
- Department of Laboratory Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
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Yang Q, Yang W, Liu F. The associations of weekend warrior and other physical activity patterns with the risk of all-cause and cardiovascular disease mortality in people with diabetes mellitus and chronic kidney disease: from NHANES 2007-2020. Int Urol Nephrol 2024; 56:1703-1712. [PMID: 37955818 DOI: 10.1007/s11255-023-03863-z] [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] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/23/2023] [Indexed: 11/14/2023]
Abstract
AIM To investigate the associations of the weekend warrior and other physical activity (PA) patterns with all-cause, cardiovascular disease (CVD) mortality risk in people with diabetes mellitus (DM) and chronic kidney disease (CKD). METHODS This study pooled the data from NHANES 2007-2020. Participants with DM and CKD were included. PA was assessed using a self-reported questionnaire. According to the characteristics of recreational activities, individuals were categorized as inactive (no activities), insufficiently active (total PA duration < 150 min/week), weekend warrior (total PA duration ≥ 150 min/week for 1-2 sessions), and regularly active (total PA duration ≥ 150 min/week for ≥ 3 sessions). Weighted Cox regression models with adjusting sociodemographic, behavioral, and metabolic factors were performed to investigate the relationship of PA patterns with all-cause and CVD mortality risk. Stratification and interaction analyses were further performed. RESULTS Among 1702 participants (46.53% female; 64 ± 0.46 years old), 536 died (163 cardiovascular) during the follow-up of 68 (39-104) months. The hazard ratio (HR) of all-cause death was 0.618 (95% CI 0.406-0.942) for insufficiently active PA pattern, 0.338 (95% CI 0.116-0.988) for weekend warrior PA pattern, and 0.536 (95% CI 0.395-0.726) for regularly active PA pattern compared with inactive PA pattern. HR of CVD death was 0.545 (95% CI 0.250-1.189) for the PA pattern of insufficiently active, 0.165 (95% CI 0.020-1.343) for weekend warrior, and 0.393 (95% CI 0.218-0.710) for regularly active compared with the inactive PA pattern. The associations present no difference in subgroups. Moreover, there was no discernible difference between weekend warrior and regularly active PA patterns for all-cause and CVD deaths. The risk of death declined relatively quickly When exercise was initiated and to a total of 450 min or 4 times per week. CONCLUSION In a population of DM and CKD, the weekend warrior pattern was similar to regular activity to lower the risk of all-cause mortality, compared with inactivity. The weekend warrior pattern was recommended for people who only have time to exercise on the weekend. However, longer and larger sample cohort studies are needed to validate our findings.
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Affiliation(s)
- Qing Yang
- Department of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
- Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Wenjie Yang
- Department of Project Design and Statistics, West China Hospital of Sichuan University, Chengdu, China
| | - Fang Liu
- Department of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China.
- Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China.
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Ghidoni C, Kruzik M, Rossi VA, Caselli S, Schmied CM, Niederseer D. Definitions for Hypertensive Response to Exercise. Cardiol Rev 2024; 32:273-278. [PMID: 36729898 DOI: 10.1097/crd.0000000000000506] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Broad evidence indicates that hypertensive response to exercise (HRE) is associated with future hypertension (aHT) at rest and cardiovascular morbidity and mortality. Nevertheless, a consensus on the definition of HRE is lacking and the comparability of the available data is difficult due to a wide variation of definitions used. This review aims to harmonize currently available definitions of HRE in normotensive and athletic populations and to propose a generally valid cut-off applicable in everyday clinical practice. A literature search on PubMed and Embase was conducted to assemble and analyze the most recent data. Various definitions of HRE were identified and linked with future cardiovascular diseases. Forty-one studies defined HRE at a peak systolic blood pressure (SBP) above or equal to 200 mmHg in men and 25 studies for 190 mmHg in women. Peak diastolic blood pressure (DBP) between 90 and 110 mmHg was reported in 14 studies, relative DBP increase in four. Eight studies defined HRE as SBP between 160 and 200 mmHg at 100 watts. 17 studies performed submaximal exercise testing, while two more looked at BP during recovery. A plethora of other definitions was identified. In athletes, total workload and average blood pressure during exercise were considerably higher. Based on the presented data, the most commonly used definition of HRE at peak exercise is 210/105 mmHg for men, 190/105 mmHg for women, and 220/210 mmHg for athletes. Furthermore, a uniform exercise testing protocol, a position statement by leading experts to unify the definition of HRE, and prospective studies are warranted to confirm these cut-offs and the associated morbidity and mortality.
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Affiliation(s)
- Céline Ghidoni
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Matthias Kruzik
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Valentina A Rossi
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Stefano Caselli
- Cardiovascular Center Zurich, Hirslanden Klinik im Park, Zurich, Switzerland
| | - Christian M Schmied
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - David Niederseer
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Adam HS, Molinsky R, Bohn B, Roy S, Rosenbaum M, Paster B, Yuzefpolskaya M, Colombo PC, Papapanou PN, Desvarieux M, Jacobs DR, Demmer RT. Clinical attachment loss is cross-sectionally associated with elevated glucose among adults without diabetes. J Clin Periodontol 2024; 51:522-535. [PMID: 38343130 PMCID: PMC11023769 DOI: 10.1111/jcpe.13945] [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: 06/23/2023] [Revised: 12/19/2023] [Accepted: 01/01/2024] [Indexed: 04/18/2024]
Abstract
AIM We investigated whether periodontal measures are cross-sectionally associated with prediabetes and cardiometabolic biomarkers among non-diabetic younger adults. MATERIALS AND METHODS One thousand seventy-one participants (mean age = 32.2 years [SE = 0.3]; 73% female) from the Oral Infections, Glucose Intolerance and Insulin Resistance Study were enrolled. Full-mouth clinical attachment loss (fm-CAL), probing depth (fm-PD) and bleeding on probing were ascertained. Interproximal CAL (i-CAL) and probing depths (i-PD) served as our primary exposures. Glucose, HbA1c, insulin and insulin resistance (HOMA-IR) outcomes were assessed from fasting blood. Prediabetes was defined per American Diabetes Association guidelines. Prediabetes prevalence ratios (PR [95% CI]) and mean [SE] cardiometabolic biomarkers were regressed on periodontal variables via multivariable robust variance Poisson regression or multivariable linear regression. RESULTS Prevalence of prediabetes was 12.5%. Fully adjusted prediabetes PR in Tertiles 3 versus 1 of mean i-CAL was 2.42 (1.77, 3.08). Fully adjusted fasting glucose estimates across i-CAL tertiles were 83.29 [0.43], 84.31 [0.37], 86.48 [0.46]; p for trend <.01. Greater percent of sites with i-PD ≥3 mm showed elevated natural-log-HOMA-IR after adjustment (0%-12% of sites = 0.33 [0.03], 13%-26% of sites = 0.39 [0.03], ≥27% of sites = 0.42 [0.03]; p for trend = .04). CONCLUSIONS i-CAL (vs. fm-CAL) was associated with elevated fasting glucose and prediabetes, whereas i-PD (vs. fm-PD) was associated with insulin resistance. Future studies are needed to examine periodontal disease and incident prediabetes.
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Affiliation(s)
- Hamdi S. Adam
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Rebecca Molinsky
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Bruno Bohn
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- Department of Epidemiology, School of Public Health, University of Colorado, Aurora, CO, USA
| | - Sumith Roy
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Michael Rosenbaum
- Division of Molecular Genetics, Departments of Pediatrics and Medicine, Columbia University, New York, NY, USA
| | | | - Melana Yuzefpolskaya
- Division of Cardiology, Department of Medicine, New York Presbyterian Hospital, Columbia University, New York, NY, USA
| | - Paolo C. Colombo
- Division of Cardiology, Department of Medicine, New York Presbyterian Hospital, Columbia University, New York, NY, USA
| | - Panos N. Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University, New York, NY, USA
| | - Moïse Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - David R. Jacobs
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ryan T. Demmer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Division of Epidemiology, Department of Quantitative Health Sciences, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
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Qiang YW, Hao MH, Yang J. Urinary cadmium was linearly and positively associated with cardiac infarction/injury score and subclinical myocardial injury in the general population without cardiovascular diseases and chronic kidney disease. Int Urol Nephrol 2024; 56:1677-1685. [PMID: 37898564 DOI: 10.1007/s11255-023-03853-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/08/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE The study was to investigate the association between urinary cadmium with cardiac infarction/injury score (CIIS) and subclinical myocardial injury (SC-MI) in the general population without cardiovascular diseases (CVDs) and chronic kidney disease (CKD). METHODS In this large-scale cross-sectional study, we enrolled 4492 individuals without CVDs and CKD from the third National Health and Nutrition Examination Survey. Logistic regression models, linear regression models, subgroup analyses, and restricted cubic spline (RCS) were performed to assess the association between urinary cadmium with CIIS and SC-MI. RESULTS Participants with SC-MI had higher levels of urinary cadmium compared with those without SC-MI (P < 0.001). In multivariate regression analyses adjusting for all confounding variables, higher levels of urinary cadmium were strongly associated not only with higher risk of SC-MI but also with higher CIIS (P < 0.05). Further subgroup analyses showed that the association between urinary cadmium and SC-MI remained significant in the subgroups of ≥ 50 years, men, smokers, and those without diabetes or hypertension (P < 0.05). Additionally, RCS analysis showed that after adjusting for all confounding factors, urinary cadmium was linearly and positively associated with CIIS and SC-MI (P overall < 0.05, P for nonlinearity > 0.05). CONCLUSION Urinary cadmium was linearly and positively associated with CIIS and SC-MI in the general population without CVDs and CKD.
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Affiliation(s)
- Yu-Wei Qiang
- Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing, 101100, China.
| | - Ming-Hui Hao
- Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing, 101100, China
| | - Jing Yang
- Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing, 101100, China
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Somers LP, Franklin A, Bosten JM. Empirical tests of the effectiveness of EnChroma multi-notch filters for enhancing color vision in deuteranomaly. Vision Res 2024; 218:108390. [PMID: 38531192 DOI: 10.1016/j.visres.2024.108390] [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] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 03/11/2024] [Accepted: 03/16/2024] [Indexed: 03/28/2024]
Abstract
Manufacturers of notch filter-based aids for color vision claim that their products can enhance color perception for people with anomalous trichromacy, a form of color vision deficiency (CVD). Anecdotal reports imply that people with CVD can have radically enhanced color vision when using the filters. However, existing empirical research largely focussed on the effect of notch filters on performance on diagnostic tests for CVD has not found that they have any substantial effect. Informed by a model of anomalous trichromatic color vision, we selected stimuli predicted to reveal the effects of EnChroma filters. Using these stimuli, we tested the ability of EnChroma filters to enhance color vision for 10 deuteranomalous trichromats in three experiments: 1. asymmetric color matching between test and control filter conditions, 2. color discrimination measured using four alternative forced-choice, and 3. color appearance measured using dissimilarity ratings to reconstruct subjective color spaces using multidimensional scaling. To investigate potential effects of long-term adaptation or perceptual learning, participants completed all three experiments at two time points, on first exposure to the filters, and after a week of regular use. We found a significant effect of the filters on color matches in the direction predicted by the model at both time points, implying that the filters can enhance the anomalous trichromatic color gamut. However, we found minimal effect of the filters on color discrimination at threshold. We found a significant effect of the filters in enhancing the appearance of colors along the red-green axis at the first time point, and a trend in the same direction at the second time point. Our results provide the first quantitative experimental evidence that notch filters can enhance color perception for anomalous trichromats.
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Affiliation(s)
- Lucy P Somers
- Sussex Vision Lab, School of Psychology, University of Sussex, Falmer, UK
| | - Anna Franklin
- Sussex Baby Lab and Sussex Colour Group, School of Psychology, University of Sussex, Falmer, UK
| | - Jenny M Bosten
- Sussex Vision Lab, School of Psychology, University of Sussex, Falmer, UK.
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Jamialahamdi T, Eid AH, Nguyen NT, Gadde KM, Sukhorukov VN, Almahmeed W, Kroh M, Sahebkar A. Bariatric Surgery Improves Serum CD40L Levels as a Predictor of Cardiovascular Risk: Systematic Review and Meta-analysis. Obes Surg 2024; 34:1929-1937. [PMID: 38578522 DOI: 10.1007/s11695-024-07210-8] [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] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/06/2024]
Abstract
CD40 and its ligand have been recently implicated in the pathogenesis of cardiovascular disease (CVD). This meta-analysis examined the effect of bariatric surgery in reducing circulating CD40L levels. A systematic review was performed using Embase, Google Scholar, PubMed, Scopus, and Web of Science. The meta-analysis was provided by Comprehensive Meta-Analysis (CMA) V4 software. The overall effect size was detected by a random-effects meta-analysis and the leave-one-out approach. Random-effects meta-analysis of 7 studies including 191 subjects showed a significant reduction in CD40L after bariatric surgery (standardized mean difference (SMD), - 0.531; 95% CI, - 0.981, - 0.082; p = 0.021; I2, 87.00). Circulating levels of CD40L are decreased after bariatric surgery which may represent a mechanism for improvement of metabolic profile.
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Affiliation(s)
- Tannaz Jamialahamdi
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali H Eid
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Ninh T Nguyen
- Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA
| | - Kishore M Gadde
- Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA
| | - Vasily N Sukhorukov
- Institute of General Pathology and Pathophysiology, 8 Baltiiskaya Street, Moscow, 125315, Russia
- Petrovsky National Research Centre of Surgery, Moscow, Russia
| | - Wael Almahmeed
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Matthew Kroh
- Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Amirhossein Sahebkar
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Wang S, Wong SY, Yip BH, Lee EK. Age-dependent association of central blood pressure with cardiovascular outcomes: a cohort study involving 34 289 participants using the UK biobank. J Hypertens 2024; 42:769-776. [PMID: 38372322 PMCID: PMC10990010 DOI: 10.1097/hjh.0000000000003675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/18/2023] [Accepted: 01/18/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND It remained unclear whether central blood pressures (BP) was more closely associated with cardiovascular disease (CVD) than brachial BP in different age groups. OBJECTIVES To investigate the age-stratified association of CVD with brachial and central BPs, and to evaluate corresponding improvement in model performance. METHODS This cohort study included 34 289 adults without baseline CVD from the UK Biobank dataset. Participants were categorized into middle-aged and older aged groups using the cut-off of age 65 years. The primary endpoint was a composite cardiovascular outcome consisting of cardiovascular mortality combined with nonfatal coronary events, heart failure and stroke. Multivariable-adjusted hazard ratios expressed CVD risks associated with BP increments of 10 mmHg. Akaike Information Criteria (AIC) was used for model comparisons. RESULTS In both groups, CVD events were associated with brachial or central SBP ( P ≤ 0.002). Model fit was better for central SBP in middle-aged adults (AIC 4427.2 vs. 4429.5), but model fit was better for brachial SBP in older adults (AIC 10 246.7 vs. 10 247.1). Central SBP remained significantly associated to CVD events [hazard ratio = 1.05; 95% confidence interval (CI) 1.0-1.1] and improved model fit (AIC = 4426.6) after adjustment of brachial SBP only in the middle-aged adults. These results were consistent for pulse pressure (PP). CONCLUSION In middle-aged adults, higher central BPs were associated with greater risks of CVD events, even after adjusting for brachial BP indexes. For older adults, the superiority of central BP was not observed. Additional trials with adequate follow-up time will confirm the role of central BP in estimating CVD risk for middle-aged individuals.
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Ito H, Takanashi M, Fukazawa T, Takizawa H, Hioki M, Shinoki R, Kawahara T, Makiyama K, Kobayashi K. Predictors of postoperative storage symptoms in male patients with lower urinary tract symptoms: A retrospective analysis of prostate surgery for benign prostatic enlargement. Low Urin Tract Symptoms 2024; 16:e12512. [PMID: 38602061 DOI: 10.1111/luts.12512] [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] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/20/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVES This study investigated the effects of prostate surgery on storage symptoms in male patients with lower urinary tract symptoms (LUTS) from benign prostatic enlargement (BPE). This study aimed to identify patient characteristics associated with improved, unchanged, and deteriorated post-surgical storage symptoms and to identify the risk factors for non-improvement or deterioration. METHODS A retrospective analysis of 586 prostate surgeries performed between 2016 and 2022 at Yokosuka Kyosai Hospital was conducted on patients with LUTS and at least one storage symptom preoperatively. Patients with active urinary tract infection, prostate/bladder cancer, urethral strictures, or dementia were excluded. The study enrolled 230 patients and assessed storage symptoms using the International Prostate Symptom Score (IPSS). RESULTS Overall, storage symptoms improved, remained unchanged, and deteriorated in 87.0%, 5.7%, and 7.4% of patients, respectively. The patients in the deteriorated group were significantly older, whereas those in the no-change group had smaller prostate volumes. Patient-reported outcome scores (IPSS, IPSS-QoL, and BII) were significantly higher in the improved group. The predictors of non-improvement included low IPSS storage score, cardiovascular disease, and diabetes mellitus. Predictors of deterioration included advanced age and low IPSS storage score. CONCLUSIONS Patients with severe LUTS showed greater postoperative improvement in storage symptoms. A low IPSS storage score predicted non-improvement and deterioration. Advanced age, low IPSS storage score, and a history of cardiovascular disease and diabetes mellitus were identified as key predictors. Awareness of these factors may guide preoperative counseling and improve decision-making in prostate surgery, ensuring more personalized and effective treatment strategies.
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Affiliation(s)
- Hiroki Ito
- Department of Urology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
- Department of Urology, Yokosuka Kyosai Hospital, Kanagawa, Japan
| | - Masato Takanashi
- Department of Urology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Takeshi Fukazawa
- Department of Urology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Hiroki Takizawa
- Department of Urology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Mari Hioki
- Department of Urology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Risa Shinoki
- Department of Urology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Takashi Kawahara
- Department of Urology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Kazuhide Makiyama
- Department of Urology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Kazuki Kobayashi
- Department of Urology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
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Koupidis SA. Public Health Concerns from Increased Use of Electronic Cigarette Use. Angiology 2024; 75:498-499. [PMID: 38149822 DOI: 10.1177/00033197231225283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Affiliation(s)
- Sotirios A Koupidis
- Occupational and Environmental Health Sector, Public Health Policy Department, School of Public Health, University of West Attica, Athens, Greece
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He CW, Qin C, Zhang Y, Zhang Y, Li K, Cai Y, Zhang W, Hu N, Wang Z. A cardiomyocyte-based biosensing platform for dynamic and quantitative investigation of excessive autophagy. Biosens Bioelectron 2024; 251:116113. [PMID: 38364328 DOI: 10.1016/j.bios.2024.116113] [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] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/18/2024]
Abstract
Autophagy is an important physiological phenomenon in eukaryotes that helps maintain the cellular homeostasis. Autophagy is involved in the development of various cardiovascular diseases, affecting the maintenance of cardiac function and disease prognosis. Physiological levels of autophagy serve as a defense mechanism for cardiomyocytes against environmental stimuli, but an overabundance of autophagy may contribute to the development of cardiovascular diseases. However, conventional biological methods are difficult to monitor the autophagy process in a dynamic and chronic manner. Here, we developed a cardiomyocyte-based biosensing platform that records electrophysiological evolutions in action potentials to reflect the degree of autophagy. Different concentrations of rapamycin-mediated autophagy were administrated in the culture environment to simulate the autophagy model. Moreover, the 3-methyladenine (3-MA)-mediated autophagy inhibition was also investigated the protection on the autophagy. The recorded action potentials can precisely reflect different degrees of autophagy. Our study confirms the possibility of visualizing and characterizing the process of cardiomyocyte autophagy using cardiomyocyte-based biosensing platform, allowing to monitor the whole autophagy process in a non-invasive, real-time, and continuous way. We believe it will pave a promising avenue to precisely study the autophagy-related cardiovascular diseases.
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Affiliation(s)
- Cheng-Wen He
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China; Hangzhou Institute of Advanced Technology, Hangzhou, 310018, China
| | - Chunlian Qin
- Department of Chemistry, Zhejiang-Israel Joint Laboratory of Self-Assembling Functional Materials, ZJU-Hangzhou Global Scientific and Technological Innovation Center, Zhejiang University, Hangzhou, 310058, China
| | - Yi Zhang
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China
| | - Yan Zhang
- School of Laboratory Medicine, Hangzhou Medical College, Hangzhou, 310063, China
| | - Kaiqiang Li
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China
| | - Yuqun Cai
- Department of Integrated Traditional Chinese and Western Medicine, Zhejiang Provincial People's Hospital People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China
| | - Wei Zhang
- Department of General Surgery, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310015, China.
| | - Ning Hu
- Department of Chemistry, Zhejiang-Israel Joint Laboratory of Self-Assembling Functional Materials, ZJU-Hangzhou Global Scientific and Technological Innovation Center, Zhejiang University, Hangzhou, 310058, China; General Surgery Department, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou, 310052, China.
| | - Zhen Wang
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China; Hangzhou Institute of Advanced Technology, Hangzhou, 310018, China.
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Malin SK, Remchak MME, Heiston EM, Battillo DJ, Gow AJ, Shah AM, Liu Z. Intermediate versus morning chronotype has lower vascular insulin sensitivity in adults with obesity. Diabetes Obes Metab 2024; 26:1582-1592. [PMID: 38246697 PMCID: PMC11001524 DOI: 10.1111/dom.15456] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/21/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024]
Abstract
AIM Chronotype reflects a circadian rhythmicity that regulates endothelial function. While the morning chronotype (MORN) usually has low cardiovascular disease risk, no study has examined insulin action on endothelial function between chronotypes. We hypothesized intermediate chronotypes (INT) would have lower vascular insulin sensitivity than morning chronotype (MORN). MATERIALS AND METHODS Adults with obesity were classified per Morningness-Eveningness Questionnaire (MEQ) as either MORN (n = 27, 22 female, MEQ = 63.7 ± 4.7, 53.8 ± 6.7 years, 35.3 ± 4.9 kg/m2) or INT (n = 29, 23 female, MEQ = 48.8 ± 6.7, 56.6 ± 9.0 years, 35.7 ± 6.1 kg/m2). A 120 min euglycaemic-hyperinsulinaemic clamp (40 mU/m2/min, 90 mg/dl) was conducted to assess macrovascular insulin sensitivity via brachial artery flow-mediated dilation (%FMD; conduit artery), post-ischaemic flow velocity (resistance arteriole), as well as microvascular insulin sensitivity via contrast-enhanced ultrasound [e.g. microvascular blood volume (perfusion)]. Fasting plasma arginine and citrulline, as well as fasting and clamp-derived plasma endothelin-1 and nitrate/nitrite, were assessed as surrogates of vasoconstriction and nitric oxide-mediated vasodilation. Aerobic fitness (VO2max) and body composition (dual-energy X-ray absorptiometry) were also collected. RESULTS MORN had a higher VO2max compared with INT (p < .01), although there was no difference in fat mass. While fasting FMD was similar between groups, insulin lowered FMD corrected to shear stress and microvascular blood volume in INT compared with MORN after co-varying for VO2max (both p ≤ .02). INT also had a lower fasting nitrate (p = .03) and arginine (p = .07). Higher MEQ correlated with elevated FMD (r = 0.33, p = .03) and lower post-ischaemic flow velocity (r = -0.33, p = .03) as well as shear rate (r = -0.36, p = .02) at 120 min. CONCLUSION When measured during the morning, INT had a lower vascular insulin sensitivity than MORN. Additional work is needed to understand endothelial function differences among chronotypes to optimize cardiovascular disease risk reduction.
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Affiliation(s)
- Steven K. Malin
- Rutgers University, New Brunswick, NJ
- Division of Endocrinology, Metabolism & Nutrition; Rutgers University, New Brunswick, NJ
- New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, NJ
- Institute of Translational Medicine and Science, Rutgers University, New Brunswick, NJ
| | | | | | | | | | | | - Zhenqi Liu
- Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health System, Charlottesville, VA
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Pan D, Qiao H, Wang H, Wu S, Wang J, Wang C, Guo J, Gu Y. Association of serum 25-hydroxyvitamin D concentration with all-cause and cause-specific mortality in hypertensive patients. Nutr Metab Cardiovasc Dis 2024; 34:1274-1282. [PMID: 38494369 DOI: 10.1016/j.numecd.2024.02.003] [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: 09/18/2023] [Revised: 11/15/2023] [Accepted: 02/07/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND AND AIMS To examine the association of serum 25-hydroxyvitamin D [25(OH)D] with all-cause mortality and disease-specific mortality in patients with hypertension. METHODS AND RESULTS This cohort study included US adults in the National Health and Nutrition Examination Survey from 2007 to 2018. All-cause mortality and cause-specific mortality outcomes were determined by association with National Death Index records. Cox proportional risk models were used to estimate hazard ratios (HRs) for all-cause mortality and cause-specific mortality and 95% confidence intervals (CIs) for serum 25(OH)D concentrations. The cohort included 10,325 adult participants. The mean serum 25(OH)D level was 65.87 nmol/L, and 32.2% of patients were vitamin D deficient (<50 nmol/L). During a mean follow-up of 77 months, 1290 deaths were recorded, including 345 cardiovascular deaths and 237 cancer deaths. Patients with higher serum 25(OH)D were more likely to have lower all-cause mortality and cardiovascular mortality than those with serum 25(OH)D < 25.00 nmol/L. For cancer mortality in hypertensive patients, vitamin D may not have a predictive role in this. CONCLUSIONS This study shows that higher 25(OH)D levels are significantly associated with lower all-cause mortality and cardiovascular disease (CVD) mortality. These findings suggest that maintaining adequate vitamin D status may reduce the risk of death in patients with hypertension.
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Affiliation(s)
- Dikang Pan
- Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Huan Qiao
- The People's Hospital of Pingyi County, Linyi, China.
| | - Hui Wang
- Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Sensen Wu
- Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Jingyu Wang
- Renal Division, Peking University First Hospital, Beijing, China.
| | - Cong Wang
- Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Jianming Guo
- Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Yongquan Gu
- Xuanwu Hospital, Capital Medical University, Beijing, China.
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Zheng G, Faber MT, Wang J, Baandrup L, Hertzum-Larsen R, Sundström K, Kjær SK. Low-dose aspirin use and risk of ovarian cancer: a combined analysis from two nationwide studies in Denmark and Sweden. Br J Cancer 2024; 130:1279-1285. [PMID: 38347096 PMCID: PMC11014981 DOI: 10.1038/s41416-024-02609-7] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Studies on association between low-dose aspirin use and ovarian cancer risk were mostly based on self-reported medication use and few had large enough sample size to investigate the potential modification effect by ovarian cancer risk factors. METHODS In these two nationwide nested case-control studies among the Danish and Swedish female population, 11,874 women with ovarian cancer (30-84 years old) (Denmark: 7328 diagnosed in 2000-2019, Sweden: 4546 diagnosed in 2010-2018) were randomly age- matched with 473,960 female controls (293,120 from Denmark, and 181,840 from Sweden). We used conditional logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) and combined the estimates based the fixed-effect assumption. Effect modification by inflammation-related risk factors and by indication (cardiovascular disease, CVD) were also investigated. RESULTS Ever use of low-dose aspirin was not strongly associated with the overall risk of ovarian cancer (OR = 0.97; 95%CI: 0.92-1.03). However, the association differed according to parity (nulliparous: OR = 0.80, 95%CI: 0.70-0.92; parous: OR = 1.00, 95%CI: 0.94-1.07; p-interaction = 0.0024), and according to history of CVD (no CVD: OR = 0.91, 95%CI: 0.82-1.00; ever CVD: OR = 1.05, 95%CI: 0.97-1.13; p-interaction =0.0204). CONCLUSIONS Low-dose aspirin use was associated with a decreased ovarian cancer risk especially in nulliparous women and in women without CVD diagnosis.
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Affiliation(s)
- Guoqiao Zheng
- Unit of Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark.
| | - Mette Tuxen Faber
- Unit of Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark
| | - Jiangrong Wang
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Louise Baandrup
- Unit of Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark
| | | | - Karin Sundström
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Susanne K Kjær
- Unit of Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Yuen VL, Zhang XJ, Ling X, Zhang Y, Kam KW, Chen LJ, Ip P, Tham CC, Cheung CY, Pang CP, Yam JC. Effects of firsthand tobacco smoking on retinal vessel caliber: a systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol 2024; 262:1397-1407. [PMID: 37682335 DOI: 10.1007/s00417-023-06223-w] [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: 06/12/2023] [Revised: 08/21/2023] [Accepted: 08/26/2023] [Indexed: 09/09/2023] Open
Abstract
PURPOSE To review the effects of firsthand tobacco smoking on central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) of firsthand tobacco smokers. METHODS We performed a search on EMBASE and PubMed for studies up to 15th July 2022. Two independent reviewers selected studies with baseline data of CRAE and CRVE of current smokers, nonsmokers, and former smokers. Initial search identified 893 studies, of which 10 were included in the meta-analysis. Two independent reviewers extracted data from the included studies. The quality of studies was assessed by the Newcastle-Ottawa Scale. RESULTS In this meta-analysis, 7431 nonsmokers, 2448 current smokers and 5786 former smokers, as well as 7404 nonsmokers, 2430 current smokers and 5763 former smokers were included in CRAE and CRVE analysis respectively. Nonsmokers had narrower CRVE (Weighted mean difference [WMD], -12.15; 95% CI, -17.33 - -6.96) and CRAE (WMD, -4.77; 95% CI, -7.96 - -1.57) than current smokers, and narrower CRVE (WMD, -3.08; 95% CI, -6.06 - -0.11) than former smokers. Current smokers had wider CRVE (WMD, 10.42; 95% CI, 7.80 - 13.04) and CRAE (WMD, 7.05; 95% CI, 6.65 - 7.46) than former smokers. Subgroup analysis and sensitivity analysis were performed. CONCLUSION Firsthand tobacco smoking resulted in wider CRAE and CRVE in current and former smokers, particularly in CRVE, and such changes may not be reversible after smoking cessation. Therefore, retinal vessel caliber may reflect the effects of firsthand tobacco smoking and be used to estimate the risk of cardiovascular diseases.
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Affiliation(s)
- Vincent L Yuen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiu Juan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiangtian Ling
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yuzhou Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ka Wai Kam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Eye Hospital, Hong Kong SAR, China
- Department of Ophthalmology, Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China.
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Hong Kong Eye Hospital, Hong Kong SAR, China.
- Department of Ophthalmology, Hong Kong Children's Hospital, Hong Kong SAR, China.
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Park SK, Wang X, Lee S, Hu H. Do we underestimate risk of cardiovascular mortality due to lead exposure? Sci Total Environ 2024; 923:171511. [PMID: 38453073 DOI: 10.1016/j.scitotenv.2024.171511] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/21/2023] [Accepted: 03/03/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Studies using data from the National Health and Nutrition Examination Survey-III (NHANES-III) have demonstrated significant prospective associations between blood lead levels and increased mortality. Bone lead represents cumulative lead burden and thus is a better biomarker for assessing chronic impacts, but its in vivo assessment requires special K-x-ray fluorescence (KXRF) instrumentation. Our team recently developed an algorithm predicting bone lead levels from a combination of blood lead levels, age and other socioeconomic and behavioral variables. We examined the associations of our algorithm-estimated bone lead levels and mortality in NHANES-III. METHODS We included 11,628 adults followed up to December 31, 2019. Estimated tibia lead and patella lead levels were calculated using our prediction algorithms. We used survey-weighted Cox proportional hazards models to compute hazard ratios (HRs) and 95 % confidence intervals (CIs). RESULTS During the median follow-up of 26.8 years, 4900 participants died (mortality rate = 1398 per 100,000 adults/year). Geometric means (95 % CIs) of blood lead, predicted tibia lead, and predicted patella lead were 2.69 μg/dL (2.54, 2.84), 6.73 μg/g (6.22, 7.25), and 16.3 μg/g (15.9, 16.8), respectively. The associations for all-cause mortality were similar between blood lead and bone lead. However, the associations for cardiovascular mortality were much greater with predicted bone lead markers compared to blood lead: for comparing participants at the 90th vs. 10th percentiles of exposure, HR = 3.32 (95 % CI: 1.93-5.73) for tibia lead, 2.42 (1.56-3.76) for patella lead, 1.63 (1.25-2.14) for blood lead. The population attributable fractions for cardiovascular disease mortality if everyone's lead concentrations were declined to the 10th percentiles were 45.8 % (95 % CI: 28.1-59.4) for tibia lead, 33.1 % (18.1-45.8) for patella lead, and 22.8 % (10.4-33.8) for blood lead. CONCLUSIONS These findings suggest that risk assessment for cardiovascular mortality based on blood lead levels may underestimate the true mortality risk of lead exposure.
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Affiliation(s)
- Sung Kyun Park
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MA, USA; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MA, USA.
| | - Xin Wang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MA, USA
| | - Seulbi Lee
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MA, USA
| | - Howard Hu
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MA, USA; Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Lan NSR, Harty J, Liow S, Taheri-Chivers J, Ihdayhid AR, Hillis GS, Schultz CJ. Cardiovascular risk factors in younger versus older patients with acute coronary syndrome. Coron Artery Dis 2024; 35:252-254. [PMID: 38411183 DOI: 10.1097/mca.0000000000001341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Affiliation(s)
- Nick S R Lan
- Department of Cardiology, Royal Perth Hospital
- Medical School, University of Western Australia
- Department of Cardiology, Fiona Stanley Hospital
- Harry Perkins Institute of Medical Research
| | | | - Shaun Liow
- Medical School, University of Western Australia
| | | | - Abdul Rahman Ihdayhid
- Department of Cardiology, Fiona Stanley Hospital
- Harry Perkins Institute of Medical Research
- Medical School, Curtin University, Perth, Australia
| | - Graham S Hillis
- Department of Cardiology, Royal Perth Hospital
- Medical School, University of Western Australia
| | - Carl J Schultz
- Department of Cardiology, Royal Perth Hospital
- Medical School, University of Western Australia
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Saleh C, Ilia TS, Schöpfer R, Seidl U, Deraita J, Todua-Lennigk S, Lieb J, Budincevic H, Trzcinska M, Hovhannisyan K, Boviatsis KA, Saleh FM. Atherosclerosis and depression: is carotid intima-media thicker in patients with depression compared to matched control individuals? A systematic review and meta-analysis. J Psychiatr Res 2024; 173:216-224. [PMID: 38552331 DOI: 10.1016/j.jpsychires.2024.03.012] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/04/2024] [Accepted: 03/08/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVE To investigate if there is an association between atherosclerosis and depression by using as imaging biomarker the carotid intima media thickness (cIMT), a surrogate marker for atherosclerosis. METHODS PubMed/Medline, Embase and Cochrane databases were comprehensively searched to identify studies investigating the association between cIMT and depression. The results were pooled using a random-effects statistical model, appropriate for the expected high heterogeneity. Sensitivity and subgroup analyses were conducted where data was available. RESULTS Overall, 22 and 13 studies met inclusion criteria for the qualitative and the quantitative synthesis, respectively, with a total of 4466 patients and 21,635 control participants. Results showed that cIMT is significantly higher in the depression, compared to the control groups with an overall mean difference of 0.07 mm (95% CI 0.04-0.10, p < 0.01). Subgroup analysis showed that diabetes could present as a confounding factor in patients with depression and an increased cIMT. CONCLUSIONS This study confirms a significantly increased cIMT in patients with depression, compared with controls and suggests a possible bidirectional link between atherosclerosis and depression. An early screening of cardiovascular disease in individuals suffering with depression should be considered.
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Affiliation(s)
| | - Tatiani Soultana Ilia
- Child and Adolescent Psychiatric Clinic, University Psychiatric Clinics Basel (UPK), Basel, Switzerland
| | | | - Ulrich Seidl
- Department of Psychiatry, Clinic for Psychiatry, Psychotherapy and Psychosomatics, SHG-Kliniken Sonnenberg, Saarbrücken, Germany
| | - Jasmine Deraita
- Department of Forensics, University Psychiatric Clinics Basel (UPK), Basel, Switzerland
| | - Salome Todua-Lennigk
- Department of Forensics, University Psychiatric Clinics Basel (UPK), Basel, Switzerland
| | - Johanna Lieb
- Division of Neuroradiology, Clinic of Radiology & Nuclear Medicine, Department of Theragnostics, University Hospital of Basel, Basel, Switzerland
| | - Hrvoje Budincevic
- Stroke and Intensive Care Unit, Department of Neurology, Sveti Duh University Hospital, Zagreb, Croatia; Faculty of Medicine, Department of Neurology and Neurosurgery, J.J. Strossmayer University of Osijek, Osijek, Croatia
| | - Maria Trzcinska
- Division of Substance Use Disorders, University Psychiatric Clinics Basel (UPK), Basel, Switzerland
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Silveira JFDC, Brand C, Welser L, Gaya AR, Burns RD, Pfeiffer KA, Lima RA, Andersen LB, Reuter CP, Pohl HH. The Longitudinal Association of Cardiorespiratory Fitness and Adiposity With Clustered Cardiometabolic Risk: A Mediation Analysis. Pediatr Exerc Sci 2024; 36:75-82. [PMID: 37591502 DOI: 10.1123/pes.2022-0073] [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: 05/28/2022] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE Previous literature has demonstrated the mediating role of adiposity in the association between cardiorespiratory fitness (CRF) and cardiometabolic risk as well as the potential role of CRF in attenuating the adverse consequences associated with excess weight. This study aimed to evaluate the mediating role of CRF and adiposity in the possible association with cardiometabolic risk. METHOD Observational 3-year longitudinal study that included 420 children and adolescents (10.50 [2.05] y of age at baseline; 56.2% girls). Body mass index (BMI) was calculated, and CRF was evaluated using field assessments. A clustered cardiometabolic risk score (cMetS) was calculated from glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, and triglycerides z scores. Analyses evaluated the mediating role of BMI in the association between CRF and cMetS as well as whether CRF mediated the association between BMI and cMetS. RESULTS BMI at baseline was directly associated with the cMetS at follow-up (0.102; 95% confidence interval, 0.020 to 0.181), independently of CRF, whereas CRF was only indirectly associated with cMetS at follow-up through BMI (-0.036; 95% confidence interval, -0.070 to -0.009), meaning that the association between CRF and cMetS was explained via the mediation role of BMI. CONCLUSIONS BMI presented direct association with cMetS, whereas CRF exhibited indirect association with cMetS mediated via BMI.
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Affiliation(s)
- João Francisco de Castro Silveira
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS,Brazil
- Graduate Program in Human Movement Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS,Brazil
| | - Caroline Brand
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso,Chile
| | - Letícia Welser
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS,Brazil
| | - Anelise Reis Gaya
- Graduate Program in Human Movement Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS,Brazil
| | - Ryan Donald Burns
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT,USA
| | - Karin Allor Pfeiffer
- Department of Kinesiology, Michigan State University (MSU), East Lansing, MI,USA
| | - Rodrigo Antunes Lima
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona,Spain
- Research Group on Lifestyles and Health, University of Pernambuco, Recife, PE,Brazil
| | - Lars Bo Andersen
- Faculty of Education, Arts and Sport, Western Norway University of Applied Sciences, Songdal,Norway
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo,Norway
| | - Cézane Priscila Reuter
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS,Brazil
- Department of Health Sciences, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS,Brazil
| | - Hildegard Hedwig Pohl
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS,Brazil
- Department of Health Sciences, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS,Brazil
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Hirshfeld JW. The Pathophysiologic Basis of Managing Chronic Atherosclerotic Cardiovascular Disease. Med Clin North Am 2024; 108:419-425. [PMID: 38548454 DOI: 10.1016/j.mcna.2023.12.002] [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] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Chronic coronary heart disease encompasses a broad spectrum of disorders that range in severity from trivial to imminently life-threatening. The primary care physician encounters coronary disease at all stages. The number of available diagnostic and therapeutic options for evaluating and treating coronary disease is vast, presenting a complex selection strategy challenge when making choices for the individual patient. The primary care physician is responsible to tailor evaluation and management strategies to each individual patient based on his/her particular disease characteristics. There are many categories of diagnostic studies and therapeutic interventions that have been shown at the population level in clinical trials to improve patient outcomes. Blindly applying the findings of all demonstrated studies and therapies to a patient with coronary disease would saddle him/her with an unsustainable burden of diagnostic tests and therapies. The core principle of the approach outlined in this article is to tailor diagnostic and therapeutic choices to the operative pathophysiology that drives a particular patient's disorder. This introductory article is intended to provide a conceptual framework for studying and applying the specialized topics discussed in the articles that follow.
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Affiliation(s)
- John W Hirshfeld
- Cardiovascular Division, Perelman University of Pennsylvania School of Medicine, 11-109 South Pavilion, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
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