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Chen C, Zhang W, Yan G, Tang C. Identifying metabolic dysfunction-associated steatotic liver disease in patients with hypertension and pre-hypertension: An interpretable machine learning approach. Digit Health 2024; 10:20552076241233135. [PMID: 38389508 PMCID: PMC10883118 DOI: 10.1177/20552076241233135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
Objective Metabolic dysfunction-associated steatotic liver disease (MASLD) is one of the most prevalent liver diseases and is associated with pre-hypertension and hypertension. Our research aims to develop interpretable machine learning (ML) models to accurately identify MASLD in hypertensive and pre-hypertensive populations. Methods The dataset for 4722 hypertensive and pre-hypertensive patients is from subjects in the NAGALA study. Six ML models, including the decision tree, K-nearest neighbor, gradient boosting, naive Bayes, support vector machine, and random forest (RF) models, were used in this study. The optimal model was constructed according to the performances of models evaluated by K-fold cross-validation (k = 5), the area under the receiver operating characteristic curve (AUC), average precision (AP), accuracy, sensitivity, specificity, and F1. Shapley additive explanation (SHAP) values were employed for both global and local interpretation of the model results. Results The prevalence of MASLD in hypertensive and pre-hypertensive patients was 44.3% (362 cases) and 28.3% (1107 cases), respectively. The RF model outperformed the other five models with an AUC of 0.889, AP of 0.800, accuracy of 0.819, sensitivity of 0.816, specificity of 0.821, and F1 of 0.729. According to the SHAP analysis, the top five important features were alanine aminotransferase, body mass index, waist circumference, high-density lipoprotein cholesterol, and total cholesterol. Further analysis of the feature selection in the RF model revealed that incorporating all features leads to optimal model performance. Conclusions ML algorithms, especially RF algorithm, improve the accuracy of MASLD identification, and the global and local interpretation of the RF model results enables us to intuitively understand how various features affect the chances of MASLD in patients with hypertension and pre-hypertension.
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Affiliation(s)
- Chen Chen
- School of Cyber Science and Engineering, Southeast University, Nanjing, Jiangsu, China
- School of Telecommunications and Information Engineering, Nanjing University of Posts and Telecommunications, Nanjing, Jiangsu, China
| | - Wenkang Zhang
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China
- School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Gaoliang Yan
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China
| | - Chengchun Tang
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China
- School of Medicine, Southeast University, Nanjing, Jiangsu, China
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Navarro Cáceres A, Navarro-Matías E, Gómez-Sánchez M, Tamayo-Morales O, Lugones-Sánchez C, González-Sánchez S, Rodríguez-Sánchez E, García-Ortiz L, Gómez-Sánchez L, Gómez-Marcos MA. Increase in Vascular Function Parameters According to Lifestyles in a Spanish Population without Previous Cardiovascular Disease-EVA Follow-Up Study. Nutrients 2023; 15:4614. [PMID: 37960267 PMCID: PMC10648779 DOI: 10.3390/nu15214614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/25/2023] [Accepted: 10/29/2023] [Indexed: 11/15/2023] Open
Abstract
The aim of this longitudinal descriptive observational study was to analyze the influence of different lifestyles on arterial stiffness (AS) throughout five years of follow-up and to describe the differences by sex in a Spanish adult population without cardiovascular disease at the start of the study. A random stratified sampling by age and sex was used to obtain 501 subjects included in the initial assessment. No cardiovascular disease was allowed in the subjects. The average age was 55.9 years, and 50.3% were women. A total of 480 subjects were analyzed again five years later. Alcohol and tobacco consumption were collected with standardized questionnaires. Adherence to the Mediterranean diet was assessed with the Mediterranean diet adherence screener (MEDAS) questionnaire. Physical activity was assessed with the short version of the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and sedentary time was assessed with the Marshall Sitting Questionnaire (MSQ). AS was assessed by measuring carotid-femoral pulse wave velocity (cfPWV) and central augmentation index (CAIx) with SphygmoCor System®, and ankle pulse wave velocity (baPWV) and cardio ankle vascular index (CAVI) with Vasera VS-1500®. Increases in vascular function measures per year of follow-up were: cfPWV = 0.228 ± 0.360 m/s, baPWV = 0.186 ± 0.308 m/s, CAVI = 0.041 ± 0.181 m/s, and CAIx = 0.387 ± 2.664 m/s. In multiple regression analysis, positive association was shown between an increase in baPWV and tobacco index (β = 0.007) and alcohol consumption (β = 0.005). Negative association was shown between CAVI and Mediterranean diet score (β = -0.051). In multinomial logistic regression analysis, the OR of tobacco index of subjects with a cfPWV increase >P75 was OR = 1.025 and of subjects classified between P25 and P75 was OR = 1.026 regarding subjects classified with an increase P75 was OR = 1.006 regarding subjects classified with an increase P75, and an OR = 0.841 was found of subjects classified between P25-75 regarding subjects classified with an increase
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Affiliation(s)
- Alicia Navarro Cáceres
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
| | - Elena Navarro-Matías
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
| | - Marta Gómez-Sánchez
- Home Hospitalization Service, Marqués de Valdecilla University Hospital, 39008 Santander, Spain;
| | - Olaya Tamayo-Morales
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
| | - Susana González-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
- Department of Medicine, University of Salamanca, 28046 Salamanca, Spain
| | - Luis García-Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37007 Salamanca, Spain
| | - Leticia Gómez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Emergency Service, University Hospital of La Paz, 37007 Madrid, Spain
| | - Manuel A. Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
- Department of Medicine, University of Salamanca, 28046 Salamanca, Spain
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Baeradeh N, Seif M, Rezaianzadeh A, Hosseini SV. Investigating the relationship between liver enzymes and incidence of hypertension: A population-based cohort study in Kharameh, a city in the South of Iran. Health Sci Rep 2023; 6:e1601. [PMID: 37808927 PMCID: PMC10551606 DOI: 10.1002/hsr2.1601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/30/2023] [Accepted: 09/15/2023] [Indexed: 10/10/2023] Open
Abstract
Background and Aims Hypertension and abnormal liver enzymes are common health issues that frequently coexist, and recent research has suggested a possible association between them, warranting further investigation. Therefore, the aim of this study is to explore the relationship between liver enzymes and hypertension. Methods This prospective cohort study utilized data from the Kharameh cohort study, which is a branch of the Prospective Epidemiological Studies in Iran (PERSIAN) database. The study included 7710 participants aged between 40 and 70 years. Hypertension was defined in accordance with the European guidelines for hypertension management, and the association between liver enzymes and hypertension was modeled and predicted using Firth logistic regression. Results This study investigated the association between liver enzymes and hypertension risk in a cohort of 7710 individuals aged 40-70 years. The results showed that higher levels of alanine aminotransferase (ALT), gamma glutamyl transferase (GGT), and alkaline phosphatase (ALP) were associated with an increased risk of hypertension, and this relationship remained significant even after adjusting for potential confounding factors. Additionally, separate analyses within age subgroups revealed a significant association between ALP concentration and high blood pressure in certain age ranges. Conclusion The study demonstrated a significant association between high levels of ALT, GGT, and ALP and an increased risk of hypertension, regardless of other risk factors. These results suggest that monitoring liver enzymes, specifically ALT, GGT, and ALP, could serve as a useful tool to predict hypertension risk and identify individuals who could benefit from early intervention. Overall, these findings underscore the importance of monitoring liver function in preventing and managing hypertension.
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Affiliation(s)
- Najibullah Baeradeh
- Department of Epidemiology, Student Research Committee, School of HealthShiraz University of Medical SciencesShirazIran
| | - Mozhgan Seif
- Department of Epidemiology, Non‐Communicable Diseases Research Center, School of HealthShiraz University of Medical SciencesShirazIran
| | - Abbas Rezaianzadeh
- Department of Epidemiology, Colorectal Research Center, School of HealthShiraz University of Medical SciencesShirazIran
| | - Seyed Vahid Hosseini
- Department of Surgery, Colorectal Research Center, School of MedicineShiraz University of Medical SciencesShirazIran
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Szołtysek-Bołdys I, Zielińska-Danch W, Sarecka-Hujar B, Słodczyk-Mańkowska E, Kozar-Konieczna A, Sobczak A. Does Alcohol Withdrawal Influence Arterial Stiffness and Classical Risk Factors for Cardiovascular Disease for Persons With Alcohol Use Disorder? Alcohol Alcohol 2023; 58:175-181. [PMID: 36573294 DOI: 10.1093/alcalc/agac069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/28/2022] Open
Abstract
AIMS The amount and pattern of cigarette and alcohol consumption are highly associated with cardiovascular risk. The aim of the present study was the assessment of changes in arterial stiffness and classical risk factors for cardiovascular disease after alcohol withdrawal and detoxification in persons with alcohol use disorder. METHODS Two hundred and forty-one individuals (men and women) participated in the investigation. The photoplethysmographic method was applied to assess arterial stiffness in three stages within 6 weeks. Participants were divided into subgroups based on age and sex. Analyses were performed using analysis of variance with repeated measures. RESULTS Different variations in time of stiffness index (SI) and reflection index (RI) values were recorded. Some increases in triglycerides, total cholesterol, low-density lipoprotein and a decrease in high-density lipoproteins were observed in all analyzed groups. Both systolic and diastolic blood pressure (DP) changed significantly during the 3 weeks of the study only in a group of younger men. The SI is correlated with age and gender. No correlation of RI with sex was found; however, RI was strongly correlated with age, pulse and DP. CONCLUSIONS The presented study shows that some groups of patients (older women and younger men) after detoxification may be particularly vulnerable to vascular system disorders, i.e. arterial stiffness, making it suggested to include additional observation during therapy.
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Affiliation(s)
- Izabela Szołtysek-Bołdys
- Department of General and Inorganic Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Jagiellońska str 4, Sosnowiec 41-200, Poland
| | - Wioleta Zielińska-Danch
- Department of General and Inorganic Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Jagiellońska str 4, Sosnowiec 41-200, Poland
| | - Beata Sarecka-Hujar
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Kasztanowa 3 Street, Sosnowiec 41-200, Poland
| | - Ewa Słodczyk-Mańkowska
- Department of General and Inorganic Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Jagiellońska str 4, Sosnowiec 41-200, Poland
| | | | - Andrzej Sobczak
- Department of General and Inorganic Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Jagiellońska str 4, Sosnowiec 41-200, Poland
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Association between Alcohol Intake and Arterial Stiffness in Healthy Adults: A Systematic Review. Nutrients 2022; 14:nu14061207. [PMID: 35334865 PMCID: PMC8949071 DOI: 10.3390/nu14061207] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Arterial stiffness as assessed by Pulse Wave Velocity (PWV) represents an independent predictor of cardiovascular disease. Several dietary compounds and lifestyle factors could influence arterial stiffness. The debate on the significance of the correlation between alcohol consumption and arterial stiffness is still open, given that the relationship is complex and potentially affected by several factors such as alcohol type, consumption levels, gender and age differences. Objective: This systematic literature review aims to examine the evidence supporting an association between alcohol use and PWV, in electronic databases including PubMed/MEDLINE and the Cochrane Library, from January 2010 to November 2020. Screening and full-text reviews were performed by three investigators and data extraction by two. Considering the significant heterogeneity of data only a qualitative analysis (systematic review) was performed. Results: A total of 13 studies met the inclusion criteria. Alcohol consumption was independently associated with arterial stiffness in a J-shaped way in most of the studies included. A benefit of alcohol consumption on arterial stiffness was found in four experimental studies, whilst an unfavorable increasing linear association was found in four others. Associations were confirmed with both oscillometric and tonometric PWV assessment methods. In some studies, a gender and age correlation was found with a more pronounced association in older males. In all studies elevated levels of alcohol consumption were associated with a worsening of arterial stiffness. Conclusions: Despite the variable findings across studies, the current review provides preliminary evidence that light-to-moderate alcohol consumption is associated with arterial stiffness values lower than expected, and evidence that high doses accelerate arterial ageing. These findings could be useful for clinicians who provide recommendations for patients at cardiovascular (CV) risk. Nevertheless, given the heterogeneity of study designs, interventions, measurement methods and statistical evaluations, the protective role of moderate alcohol consumption on arterial stiffness is likely but not certain, warranting additional trials and evidence.
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Wang L, Zhi F, Gao B, Ni J, Liu Y, Mo X, Huang J. Association between lipid profiles and arterial stiffness: A secondary analysis based on a cross-sectional study. J Int Med Res 2021; 48:300060520938188. [PMID: 32705926 PMCID: PMC7383716 DOI: 10.1177/0300060520938188] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The relationship between lipid levels and arterial stiffness remains controversial. Therefore, we aimed to determine the relationship between lipid profiles and brachial-ankle pulse wave velocity (baPWV) as an indicator of arterial stiffness. METHODS A total of 909 participants aged 24 to 84 years were stratified into four baPWV quartiles in our study. Serum lipids, baPWV, and other variables of the participants were measured. Univariable and multivariable linear regression analyses were used to examine the relationships between lipid parameters and baPWV. RESULTS The highest baPWV quartile group had higher aspartate transaminase, alanine aminotransferase, plasma glucose, total cholesterol, triglyceride (TG), and low-density lipoprotein cholesterol levels and maximum ankle-brachial index, and lower high-density lipoprotein cholesterol levels and estimated glomerular filtration rate. Univariate regression analysis showed that total cholesterol, TG, and low-density lipoprotein cholesterol levels were positively related and high-density lipoprotein cholesterol levels were negatively related to baPWV. After adjusting for age, body mass index, smoking status, aspartate transaminase, alanine aminotransferase, plasma glucose, and estimated glomerular filtration rate, only TG levels were correlated with baPWV (β = 0.075). CONCLUSIONS Four lipid variates are associated with arterial stiffness, and TG levels are positively related to arterial stiffness, independent of cardiovascular risks and liver function.
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Affiliation(s)
- Long Wang
- Department of Cardiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Center for Translational Medicine, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Fu Zhi
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, China.,Department of Thoracic Surgery, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China
| | - Beibei Gao
- Department of Cardiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jie Ni
- Department of Cardiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University. Zhongshan Road 321, Nanjing, China
| | - Yihai Liu
- Department of Cardiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University. Zhongshan Road 321, Nanjing, China
| | - Xuming Mo
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, China
| | - Jinyu Huang
- Department of Cardiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Jia J, Yang Y, Liu F, Zhang M, Xu Q, Guo T, Wang L, Peng Z, He Y, Wang Y, Zhang Y, Zhang H, Shen H, Zhang Y, Yan D, Ma X, Zhang P. The association between serum alanine aminotransferase and hypertension: A national based cross-sectional analysis among over 21 million Chinese adults. BMC Cardiovasc Disord 2021; 21:145. [PMID: 33740888 PMCID: PMC7980597 DOI: 10.1186/s12872-021-01948-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/08/2021] [Indexed: 12/11/2022] Open
Abstract
Background Inconsistent results were found in the association between serum alanine aminotransferase (ALT) and hypertension among population-based studies. This study evaluated the association between ALT and hypertension among Chinese reproductive-age population by utilizing registration data from National Free Pre-pregnancy Checkups Project in 2016–2017. Methods The 21,103,790 registered participants were eligible for analysis, including women who were 20–49 years old and men who were 20–59 years old with available data for ALT and blood pressure (BP). Logistic regression was conducted to estimate odds ratio (OR) for the association between ALT and hypertension as a binary outcome. Linear regression was used to examine the association between ALT and BP as a continuous outcome. Results In total, 4.21% of the participants were hypertensive, and 11.67% had elevated ALT (> 40 U/L). Hypertension prevalence was 3.63% and 8.56% among participants with normal and elevated ALT levels. A strong linear relationship was found between serum ALT levels and the odds of hypertension after adjustment for potential confounders. The multivariable-adjusted ORs for hypertension were 1, 1.22 (1.21, 1.22), 1.67 (1.65 1.68), 1.78 (1.76, 1.80), and 1.92 (1.90, 1.94) in participants with ALT levels of ≤ 20, 20.01–40, 40.01–60, 60.01–80, and > 80 U/L, respectively. Systolic and diastolic BPs rose by 1.83 and 1.20 mmHg on average, for each 20 U/L increase in ALT (P for trend < 0.001). The association was consistent among subgroups and tended to be stronger among populations who are overweight (body mass index ≥ 24 kg/m2) (χ2 = 52,228, P < 0.001), alcohol drinking (χ2 = 100,730, P < 0.001) and cigarette smoking (χ2 = 105,347, P < 0.001). Conclusions Our cross-sectional analysis suggested a linear association between serum ALT and hypertension or BP, which indicated that abnormal liver metabolism marked by elevated serum ALT could play a role in hypertension or elevated BP condition.
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Affiliation(s)
- Jiajing Jia
- Graduate School of Peking, Union Medical College, Beijing, People's Republic of China.,National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Ying Yang
- Graduate School of Peking, Union Medical College, Beijing, People's Republic of China. .,National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China. .,National Human Genetic Resources Center, Beijing, People's Republic of China. .,China DOHaD Research Center, Beijing, People's Republic of China.
| | - Fangchao Liu
- Department of Epidemiology, Fuwai Hospital, Beijing, People's Republic of China.,National Center for Cardiovascular Disease, Beijing, People's Republic of China.,China Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Minjin Zhang
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Qin Xu
- Graduate School of Peking, Union Medical College, Beijing, People's Republic of China.,National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Tonglei Guo
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Long Wang
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,School of Public Health, Institute of Epidemiology and Statistics, Lanzhou University, Lanzhou, People's Republic of China
| | - Zuoqi Peng
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Yuan He
- Graduate School of Peking, Union Medical College, Beijing, People's Republic of China.,National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Yuanyuan Wang
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China.,China DOHaD Research Center, Beijing, People's Republic of China
| | - Ya Zhang
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Hongguang Zhang
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Haiping Shen
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, People's Republic of China
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, People's Republic of China
| | - Donghai Yan
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, People's Republic of China
| | - Xu Ma
- Graduate School of Peking, Union Medical College, Beijing, People's Republic of China. .,National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China. .,National Human Genetic Resources Center, Beijing, People's Republic of China.
| | - Puhong Zhang
- Diabetes Research Program, The George Institute for Global Health At Peking University Health Science Center, Zhi Chun Road, 6#, Beijing, People's Republic of China.
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Mean arterial pressure and arterial stiffness in Japanese population: a secondary analysis based on a cross-sectional study. Blood Press Monit 2020; 25:310-317. [PMID: 32701566 DOI: 10.1097/mbp.0000000000000471] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Previous researches demonstrate that mean arterial pressure (MAP) is associated with major cardiovascular events, but there are few research on the correlation between MAP and brachial-ankle pulse wave velocity (BaPWV). Thus, the present study is designated to examine the association between MAP and BaPWV. Our study is a cross-sectional study in Japanese. They participated in a medical check-up program which included BaPWV and standardized questionnaires. The main measurements include systolic blood pressure, diastolic blood pressure, BaPWV, ankle-brachial index (ABI), fatty liver diagnosed by ultrasonography, etc. It needs to be emphasized that Fukuda et al. finished the study and their data are used for secondary analysis. MAP is positively related with BaPWV [effect size = 10.4; 95% confidence interval (CI), 9.2-11.6] after adjusting age, sex, BMI, smoking status, alcohol consumption, exercise, glutamyltranspeptidase, alanine aminotransferase, aspartate transaminase, total cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein cholesterol (HDL), fatty liver, fasting-blood glucose, uric acid, estimated glomerular filtration rate, and ABI. The nonlinear association is identified between MAP and BaPWV whose inflection point is 94 mmHg. The effect size and 95% CI on the bilateral sides of the inflection point are 8.0 (4.4-11.6) and 14.8 (12.5-17.1), respectively. Subgroup analysis indicates that MAP has a more significantly positive association with BaPWV in ex-smokers, old people (age ≥60), and participants with lower HDL (<40 mg/dL). Consequently, it is practicable for us to roughly predict BaPWV with simple MAP measurement instead of the BaPWV examination.
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Nam KW, Kwon HM, Jeong HY, Park JH, Kim SH, Jeong SM. Serum gamma-glutamyl transferase is associated with silent brain infarcts in a healthy population. Atherosclerosis 2019; 280:45-50. [DOI: 10.1016/j.atherosclerosis.2018.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/12/2018] [Accepted: 11/07/2018] [Indexed: 12/29/2022]
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10
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Menni C, Lin C, Cecelja M, Mangino M, Matey-Hernandez ML, Keehn L, Mohney RP, Steves CJ, Spector TD, Kuo CF, Chowienczyk P, Valdes AM. Gut microbial diversity is associated with lower arterial stiffness in women. Eur Heart J 2018; 39:2390-2397. [PMID: 29750272 PMCID: PMC6030944 DOI: 10.1093/eurheartj/ehy226] [Citation(s) in RCA: 153] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 12/06/2017] [Accepted: 04/06/2018] [Indexed: 12/11/2022] Open
Abstract
Aims The gut microbiome influences metabolic syndrome (MetS) and inflammation and is therapeutically modifiable. Arterial stiffness is poorly correlated with most traditional risk factors. Our aim was to examine whether gut microbial composition is associated with arterial stiffness. Methods and results We assessed the correlation between carotid-femoral pulse wave velocity (PWV), a measure of arterial stiffness, and gut microbiome composition in 617 middle-aged women from the TwinsUK cohort with concurrent serum metabolomics data. Pulse wave velocity was negatively correlated with gut microbiome alpha diversity (Shannon index, Beta(SE)= -0.25(0.07), P = 1 × 10-4) after adjustment for covariates. We identified seven operational taxonomic units associated with PWV after adjusting for covariates and multiple testing-two belonging to the Ruminococcaceae family. Associations between microbe abundances, microbe diversity, and PWV remained significant after adjustment for levels of gut-derived metabolites (indolepropionate, trimethylamine oxide, and phenylacetylglutamine). We linearly combined the PWV-associated gut microbiome-derived variables and found that microbiome factors explained 8.3% (95% confidence interval 4.3-12.4%) of the variance in PWV. A formal mediation analysis revealed that only a small proportion (5.51%) of the total effect of the gut microbiome on PWV was mediated by insulin resistance and visceral fat, c-reactive protein, and cardiovascular risk factors after adjusting for age, body mass index, and mean arterial pressure. Conclusions Gut microbiome diversity is inversely associated with arterial stiffness in women. The effect of gut microbiome composition on PWV is only minimally mediated by MetS. This first human observation linking the gut microbiome to arterial stiffness suggests that targeting the microbiome may be a way to treat arterial ageing.
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Affiliation(s)
- Cristina Menni
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas' Hospital, London, UK
| | - Chihung Lin
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Fuxing Street, Guishan Dist., Taoyuan City, Taiwan
| | - Marina Cecelja
- Department of Clinical Pharmacology, British Heart Foundation Centre, King’s College London, St Thomas' Hospital, London, UK
| | - Massimo Mangino
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas' Hospital, London, UK
- NIHR Biomedical Research Centre at Guy’s and St Thomas’ Foundation Trust, St Thomas’ Hospital, London, UK
| | - Maria Luisa Matey-Hernandez
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas' Hospital, London, UK
| | - Louise Keehn
- Department of Clinical Pharmacology, British Heart Foundation Centre, King’s College London, St Thomas' Hospital, London, UK
| | | | - Claire J Steves
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas' Hospital, London, UK
| | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas' Hospital, London, UK
| | - Chang-Fu Kuo
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Fuxing Street, Guishan Dist., Taoyuan City, Taiwan
- School of Medicine, Nottingham City Hospital, Hucknall Road, Nottingham, UK
| | - Phil Chowienczyk
- Department of Clinical Pharmacology, British Heart Foundation Centre, King’s College London, St Thomas' Hospital, London, UK
| | - Ana M Valdes
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas' Hospital, London, UK
- School of Medicine, Nottingham City Hospital, Hucknall Road, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Queen's Medical Centre, Derby Rd, Nottingham, UK
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11
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Man E, Cheung PT, Cheung YF. Associations between arterial structure and function and serum levels of liver enzymes in obese adolescents. J Paediatr Child Health 2017; 53:691-697. [PMID: 28383828 DOI: 10.1111/jpc.13528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 11/04/2016] [Accepted: 12/11/2016] [Indexed: 11/27/2022]
Abstract
AIM To determine the structural and functional alterations of systemic arteries in obese adolescents and their relationships with adiposity, metabolic and lipid profile, and serum liver enzyme levels. METHODS Carotid intima-media thickness (IMT), carotid stiffness index, and brachial-ankle pulse wave velocity (baPWV) were measured in 56 obese adolescents and 58 lean controls. Obese adolescents had additional liver ultrasound and determination of fasting blood indices of glucose metabolism and lipid profile, and serum levels of liver enzymes. RESULTS Carotid IMT (P < 0.0001), carotid stiffness index (P < 0.0001) and baPWV (P = 0.001) were significantly greater in obese than control subjects. Thirty-seven (66%) obese subjects had fatty liver changes and their aspartate aminotransferase, alanine aminotransferase (ALT), alkaline phosphatase, and gamma-glutamyl transferase levels were significantly higher than those without (all P < 0.05). Univariate analyses showed positive correlations between serum ALT (r = 0.29, P = 0.03) and alkaline phosphatase (r = 0.28, P = 0.04) levels and carotid IMT, aspartate aminotransferase level and carotid stiffness (r = 0.41, P = 0.002), and gamma-glutamyl transferase level and baPWV (r = 0.34, P = 0.02) in obese subjects. Multivariate linear regression revealed serum ALT level (β = 0.02, P = 0.006) as an independent correlate of carotid stiffness. CONCLUSION Obese adolescents have increased carotid IMT and stiffness, which are associated positively with serum liver enzyme levels.
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Affiliation(s)
- Elim Man
- Division of Paediatrics and Adolescent Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Pik-To Cheung
- Division of Paediatrics and Adolescent Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Yiu-Fai Cheung
- Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
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12
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Uemura H, Katsuura-Kamano S, Yamaguchi M, Bahari T, Ishizu M, Fujioka M, Arisawa K. Relationships of serum high-sensitivity C-reactive protein and body size with insulin resistance in a Japanese cohort. PLoS One 2017; 12:e0178672. [PMID: 28575103 PMCID: PMC5456096 DOI: 10.1371/journal.pone.0178672] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 05/17/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Impacts of chronic systemic inflammation and body size and their interaction effect on insulin resistance in Asian populations, in whom obesity is less common, are not fully understood. This study evaluated combined relationships of systemic inflammation and body size with insulin resistance in a Japanese cohort. METHODS We analyzed cross-sectional data from 1,074 eligible subjects (536 men and 538 women) aged 35-69 years who participated in the baseline survey of a cohort study in Tokushima Prefecture, Japan. Systemic inflammation level was assessed by serum high-sensitivity C-reactive protein (hs-CRP), and the degree of insulin resistance and beta-cell function were evaluated by the homeostasis model assessment insulin resistance (HOMA-IR) and beta-cell function (HOMA-β), respectively. Overweight and obesity were defined as a body mass index (BMI) of 23.0-24.9 kg/m2 and ≥25.0 kg/m2, respectively. Associations between serum hs-CRP (assessed as quartiles and additionally continuous values after log-transformation) and indices of glucose homeostasis were analysed adjusting for probable covariates, including BMI (quartiles). Combined associations of serum hs-CRP (≤median, >median) and body size (normal, overweight, obese) with insulin resistance as well as their interaction effect on insulin resistance were also evaluated. RESULTS Serum hs-CRP was dose-dependently associated with HOMA-IR, but not HOMA-β, after adjustment for probable covariates, including BMI. Subjects with obesity and elevated serum hs-CRP (>median) showed a high multivariable-adjusted HOMA-IR value of 1.32 (95% confidence interval (CI) 1.23, 1.41) compared with subjects with normal BMI and low serum hs-CRP (≤median) whose multivariable-adjusted HOMA-IR value was 1.14 (95% CI 1.06, 1.21). The interaction effect between body size (normal, overweight, obese) and serum hs-CRP (≤median, >median) on HOMA-IR was significant (P for interaction <0.001). CONCLUSIONS Our study suggests that elevated systemic inflammation is dose-dependently associated with increased insulin resistance, independent of the known risk factors, in a Japanese population. Concomitant obesity and elevated systemic inflammation may synergistically contribute to increased insulin resistance.
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Affiliation(s)
- Hirokazu Uemura
- Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Sakurako Katsuura-Kamano
- Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Miwa Yamaguchi
- Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Tirani Bahari
- Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Masashi Ishizu
- Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Miho Fujioka
- Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Kokichi Arisawa
- Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
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13
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Uemura H, Ghaibeh AA, Katsuura-Kamano S, Yamaguchi M, Bahari T, Ishizu M, Moriguchi H, Arisawa K. Systemic inflammation and family history in relation to the prevalence of type 2 diabetes based on an alternating decision tree. Sci Rep 2017; 7:45502. [PMID: 28361994 PMCID: PMC5374531 DOI: 10.1038/srep45502] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 03/01/2017] [Indexed: 11/09/2022] Open
Abstract
To investigate unknown patterns associated with type 2 diabetes in the Japanese population, we first used an alternating decision tree (ADTree) algorithm, a powerful classification algorithm from data mining, for the data from 1,102 subjects aged 35-69 years. On the basis of the investigated patterns, we then evaluated the associations of serum high-sensitivity C-reactive protein (hs-CRP) as a biomarker of systemic inflammation and family history of diabetes (negative, positive or unknown) with the prevalence of type 2 diabetes because their detailed associations have been scarcely reported. Elevated serum hs-CRP levels were proportionally associated with the increased prevalence of type 2 diabetes after adjusting for probable covariates, including body mass index and family history of diabetes (P for trend = 0.016). Stratified analyses revealed that elevated serum hs-CRP levels were proportionally associated with increased prevalence of diabetes in subjects without a family history of diabetes (P for trend = 0.020) but not in those with a family history or with an unknown family history of diabetes. Our study demonstrates that systemic inflammation was proportionally associated with increased prevalence of type 2 diabetes even after adjusting for body mass index, especially in subjects without a family history of diabetes.
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Affiliation(s)
- Hirokazu Uemura
- Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima 770-8503, Japan
| | - A Ammar Ghaibeh
- Department of Medical Informatics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima 770-8503, Japan
| | - Sakurako Katsuura-Kamano
- Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima 770-8503, Japan
| | - Miwa Yamaguchi
- Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima 770-8503, Japan
| | - Tirani Bahari
- Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima 770-8503, Japan
| | - Masashi Ishizu
- Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima 770-8503, Japan
| | - Hiroki Moriguchi
- Department of Medical Informatics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima 770-8503, Japan
| | - Kokichi Arisawa
- Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima 770-8503, Japan
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14
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Lonardo A, Romagnoli D. Gamma glutamyl transferase: A novel cardiovascular outfit for an old liver test. Indian J Med Res 2016; 143:4-7. [PMID: 26997005 PMCID: PMC4822367 DOI: 10.4103/0971-5916.178574] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Amedeo Lonardo
- Outpatient Liver Clinic & Internal Medicine, Nuovo Ospedale Civile Sant’Agostino Estense (NOCSAE), Baggiovara, Modena, Italy
| | - Dante Romagnoli
- Outpatient Liver Clinic & Internal Medicine, Nuovo Ospedale Civile Sant’Agostino Estense (NOCSAE), Baggiovara, Modena, Italy
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