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Li X, Zheng K, Liu L, Zhang T, Gu W, Hou X, Geng J, Song G. Relationship of postprandial fibroblast growth factor 21 with lipids, inflammation and metabolic dysfunction-associated fatty liver disease during oral fat tolerance test. Front Endocrinol (Lausanne) 2024; 15:1343853. [PMID: 38828414 PMCID: PMC11140040 DOI: 10.3389/fendo.2024.1343853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 05/03/2024] [Indexed: 06/05/2024] Open
Abstract
Introduction Metabolic dysfunction-associated fatty liver disease (MAFLD) is closely associated with serum fibroblast growth factor (FGF) 21; however, previous studies have typically focused on the static fasting state, and the relationships between postprandial FGF21 levels, postprandial metabolic status, and MAFLD remain unclear. Therefore, we measured postprandial lipids, inflammatory factors, and FGF21 levels in MAFLD and further analyzed their relationship using an oral fat tolerance test (OFTT). Patients and methods In total, 103 non-diabetic adult volunteers, including 46 patients with MAFLD, were included in this study. All participants underwent the OFTT. Venous blood samples were collected at 0, 2, 4, and 6 h. Circulating total cholesterol (TC), triglyceride (TG), free fatty acid (FFA), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), hypersensitive-C reactive protein(hs-CRP) and FGF21 were assessed. Results Serum FGF21 significantly increased in the fasting state (P < 0.05) and showed a biphasic change of first decreasing and then increasing in MAFLD during the OFTT. The postprandial levels of TG, TC, LDL-C, FFA, IL-6, TNF-α and hs-CRP were significantly increased in MAFLD (P < 0.05). After adjusting for multiple factors, the FGF21 incremental area under the curve (iAUC) was linearly correlated with the FFA iAUC, TG iAUC, and IL-6 iAUC (P < 0.05) and was an independent factor for MAFLD (P < 0.05, OR=1.403). Conclusion Dyslipidemia and excessive inflammation in MAFLD are associated to FGF21 levels in the postprandial period. An abnormal postprandial FGF21 response may be an important mechanism of MAFLD.
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Affiliation(s)
- Xiaolong Li
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Endocrinology, Harrison International Peace Hospital, Hengshui, Hebei, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Kunjie Zheng
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Endocrinology, Harrison International Peace Hospital, Hengshui, Hebei, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Lifang Liu
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, China
- Department of Endocrinology, Baoding First Central Hospital, Baoding, Hebei, China
| | - Tingxue Zhang
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Wei Gu
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Endocrinology, Harrison International Peace Hospital, Hengshui, Hebei, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Xiaoyu Hou
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Jianlin Geng
- Department of Endocrinology, Harrison International Peace Hospital, Hengshui, Hebei, China
| | - Guangyao Song
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, China
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Cheng C, Yu X, Shi K, Dai G, Pan Q, Yuan G, Jia J. Associations between abdominal obesity indices with hypertension in type 2 diabetes mellitus: Chinese visceral adiposity index. J Endocrinol Invest 2024; 47:547-555. [PMID: 37768525 DOI: 10.1007/s40618-023-02165-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 07/14/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE This research was performed to evaluate the relationship between hypertension (HTN) and abdominal obesity index in patients with type 2 diabetes mellitus (T2DM). METHODS Totally 1657 participants with T2DM (mean age 54 ± 12 years; 38.02% female) were enrolled. They were divided into the groups of HTN (n = 775) and non-HTN (n = 882). Anthropometric and biochemical indicators were measured and collected. A bioelectrical impedance analyzer was used to measure visceral and subcutaneous fat areas. RESULTS Compared with the HTN group, the non-HTN group had a lower level of Chinese visceral adiposity index (CVAI) (p < 0.001). Meanwhile, among tertiles of CVAI, as CVAI increased, the proportion of patients with HTN increased, which was 33.51%, 44.30%, and 62.50%, respectively. CVAI was shown to have a significant positive correlation with HTN. (r = 0.258, p < 0.001). CVAI was independently related to an elevated risk of HTN by binary logistic regression analyses, and the OR was (95% CI) 1.013 (1.010-1.016, p < 0.001) after adjustment. The area under the receiver operating characteristic curve (AUC) of CVAI predicted HTN in T2DM patients was greater than those of other abdominal obesity indices (p < 0.001). CONCLUSION We found that CVAI was highly positively correlated with HTN in T2DM. Compared with other indices of abdominal obesity, such as WC, BMI, WHR, VAI, and LAP, the CVAI showed superior discriminative ability in T2DM complicated with HTN. Therefore, more attention should be paid to CVAI in T2DM.
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Affiliation(s)
- C Cheng
- Department of Endocrinology and Metabolism, Affiliated Hospital of Jiangsu University, Institute of Endocrine and Metabolic Diseases, Jiangsu University, Zhenjiang, China
| | - X Yu
- Department of Endocrinology and Metabolism, Affiliated Hospital of Jiangsu University, Institute of Endocrine and Metabolic Diseases, Jiangsu University, Zhenjiang, China
| | - K Shi
- Department of Endocrinology and Metabolism, Affiliated Hospital of Jiangsu University, Institute of Endocrine and Metabolic Diseases, Jiangsu University, Zhenjiang, China
| | - G Dai
- Department of Endocrinology and Metabolism, Affiliated Hospital of Jiangsu University, Institute of Endocrine and Metabolic Diseases, Jiangsu University, Zhenjiang, China
| | - Q Pan
- Department of Endocrinology and Metabolism, Affiliated Hospital of Jiangsu University, Institute of Endocrine and Metabolic Diseases, Jiangsu University, Zhenjiang, China
| | - G Yuan
- Department of Endocrinology and Metabolism, Affiliated Hospital of Jiangsu University, Institute of Endocrine and Metabolic Diseases, Jiangsu University, Zhenjiang, China.
| | - J Jia
- Department of Endocrinology and Metabolism, Affiliated Hospital of Jiangsu University, Institute of Endocrine and Metabolic Diseases, Jiangsu University, Zhenjiang, China.
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Fung E, Chan EYS, Ng KH, Yu KM, Li H, Wang Y. Towards clinical application of GlycA and GlycB for early detection of inflammation associated with (pre)diabetes and cardiovascular disease: recent evidence and updates. J Inflamm (Lond) 2023; 20:32. [PMID: 37814278 PMCID: PMC10563214 DOI: 10.1186/s12950-023-00358-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/18/2023] [Indexed: 10/11/2023] Open
Abstract
Cardiometabolic diseases are associated with low-grade inflammation early in life and persists into old age. The long latency period presents opportunities for early detection, lifestyle modification and intervention. However, the performance of conventional biomarker assays to detect low-grade inflammation has been variable, particularly for early-stage cardiometabolic disorder including prediabetes and subclinical atherosclerotic vascular inflammation. During the last decade, the application of nuclear magnetic resonance (NMR) spectroscopy for metabolic profiling of biofluids in translational and epidemiological research has advanced to a stage approaching clinical application. Proton (1H)-NMR profiling induces no destructible physical changes to specimens, and generates quantitative signals from deconvoluted spectra that are highly repeatable and reproducible. Apart from quantitative analysis of amino acids, lipids/lipoproteins, metabolic intermediates and small proteins, 1H-NMR technology is unique in being able to detect composite signals of acute-phase and low-grade inflammation indicated by glycosylated acetyls (GlycA) and N-acetylneuraminic acid (sialic acid) moieties (GlycB). Different from conventional immunoassays that target epitopes and are susceptible to conformational variation in protein structure and binding, GlycA and GlycB signals are stable over time, and maybe complementary as well as superior to high-sensitivity C-reactive protein and other inflammatory cytokines. Here we review the physicochemical principles behind 1H-NMR profiling of GlycA and GlycB, and the available evidence supporting their potential clinical application for the prediction of incident (pre)diabetes, cardiovascular disease, and adverse outcomes.
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Affiliation(s)
- Erik Fung
- Department of Medicine & Therapeutics, Laboratory for Heart Failure + Circulation Research, Li Ka Shing Institute of Health Sciences, and Centre for Cardiovascular Genomics & Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong Children's Hospital, Kowloon Bay, Kowloon, Hong Kong SAR, China.
- Neural, Vascular, and Metabolic Biology Programme, and Ministry of Education Laboratory for Regenerative Medicine, School of Biomedical Sciences, Faculty of Medicine, Lo Kwee-Seong Integrated Biomedical Sciences Building, Area 39, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
- Department of Epidemiology & Biostatistics, School of Public Health, St Mary's Campus, Imperial College London, London, UK.
- School of Medicine, The Chinese University of Hong Kong, Shenzhen, China.
- Prince of Wales Hospital, Room 124010, 10/F, LCWCSB, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR, China.
| | - Eunice Y S Chan
- School of Medicine, The Chinese University of Hong Kong, Shenzhen, China
| | - Kwan Hung Ng
- Department of Medicine & Therapeutics, Laboratory for Heart Failure + Circulation Research, Li Ka Shing Institute of Health Sciences, and Centre for Cardiovascular Genomics & Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong Children's Hospital, Kowloon Bay, Kowloon, Hong Kong SAR, China
| | - Ka Man Yu
- Department of Medicine & Therapeutics, Laboratory for Heart Failure + Circulation Research, Li Ka Shing Institute of Health Sciences, and Centre for Cardiovascular Genomics & Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong Children's Hospital, Kowloon Bay, Kowloon, Hong Kong SAR, China
| | - Huijun Li
- School of Medicine, The Chinese University of Hong Kong, Shenzhen, China
| | - Yulan Wang
- Singapore Phenome Centre, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Tebar WR, Meneghini V, Goulart AC, Santos IS, Santos RD, Bittencourt MS, Generoso G, Pereira AC, Blaha MJ, Jones SR, Toth PP, Otvos JD, Lotufo PA, Bensenor IM. Combined Association of Novel and Traditional Inflammatory Biomarkers With Carotid Artery Plaque: GlycA Versus C-Reactive Protein (ELSA-Brasil). Am J Cardiol 2023; 204:140-150. [PMID: 37542984 DOI: 10.1016/j.amjcard.2023.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/29/2023] [Accepted: 07/07/2023] [Indexed: 08/07/2023]
Abstract
Elevated levels of glycoprotein acetylation (GlycA) and C-reactive protein (CRP) have been associated with carotid artery plaque (CAP). However, it is not yet established if elevations in both inflammatory biomarkers provide incremental association with CAP. This study aimed evaluate the cross-sectional association of high CRP and GlycA with CAP at baseline participants from the ELSA-Brasil adult cohort. Participants with information on CRP, GlycA, and CAP with neither previous cardiovascular disease nor CRP >10 mg/L were included. High GlycA and CRP were defined as values within upper quintile and >3 mg/L, respectively. Participants were classified into 4 groups: 1. nonelevated CRP/GlycA (reference group); 2. elevated CRP alone; 3. elevated GlycA alone; and 4. both elevated. The analysis included 4,126 participants with median age of 50 years-old, being 54.2% of women. Prevalence of CAP was 36.1%. Participants with high CRP had the highest frequency of obesity, whereas participants with high GlycA presented higher cardiovascular risk factor burden and were more likely to have CAP than the reference group (odds ratio [OR] 1.39, 95% confidence interval [CI] 1.11 to 1.73), persisting after multivariable adjustment (OR 1.37, 95% CI 1.02 to 1.83). Participants with both elevated CRP and GlycA were more likely to have CAP in crude (OR 1.35, 95% CI 1.10 to 1.65) but not in adjusted models. The findings suggest potential different biologic pathways between inflammation and carotid atherosclerosis: high GlycA was associated with CAP whereas high CRP was more associated with obesity.
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Affiliation(s)
- William R Tebar
- Center for Clinical and Epidemiological Research, University Hospital of University of Sao Paulo, Sao Paulo, Brazil
| | - Vandrize Meneghini
- Center for Clinical and Epidemiological Research, University Hospital of University of Sao Paulo, Sao Paulo, Brazil
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, University Hospital of University of Sao Paulo, Sao Paulo, Brazil
| | - Itamar S Santos
- Center for Clinical and Epidemiological Research, University Hospital of University of Sao Paulo, Sao Paulo, Brazil
| | - Raul D Santos
- Lipid Clinic of Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - Marcio S Bittencourt
- Center for Clinical and Epidemiological Research, University Hospital of University of Sao Paulo, Sao Paulo, Brazil
| | - Giuliano Generoso
- Center for Clinical and Epidemiological Research, University Hospital of University of Sao Paulo, Sao Paulo, Brazil
| | - Alexandre C Pereira
- Laboratory of Genetics and Molecular Cardiology, University of São Paulo Medical School Hospital, São Paulo, SP, Brazil
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland
| | - Steven R Jones
- Department of Preventive Cardiology, CGH Medical Center, Sterling, Illinois
| | - Peter P Toth
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland; Department of Preventive Cardiology, CGH Medical Center, Sterling, Illinois
| | - James D Otvos
- Laboratory Corporation of America Holdings (LabCorp), Morrisville, North Carolina
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, University Hospital of University of Sao Paulo, Sao Paulo, Brazil
| | - Isabela M Bensenor
- Center for Clinical and Epidemiological Research, University Hospital of University of Sao Paulo, Sao Paulo, Brazil.
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Wilken MR, Lambert MNT, Christensen CB, Jeppesen PB. Effects of Anthocyanin-rich Berries on the Risk of Metabolic Syndrome: A Systematic Review and Meta-analysis. Rev Diabet Stud 2022; 18:42-57. [PMID: 35300756 PMCID: PMC9382680 DOI: 10.1900/rds.2022.18.42] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE: Metabolic syndrome (MetS) can lead to fatal complications, including cardiovascular disease. Emerging evidence suggests has emerged that increased fruit and vegetable intake and decreased intake of saturated fats, simple sugars, and processed foods can improve cardiovascular
health. Anthocyanins (color pigments) have anti-inflammatory and antioxidant capacities but are of low bioavailability. In this systematic review and metaanalysis, we investigate the possible beneficial effects of the intake of berries high in anthocyanins on MetS risk factors. We also investigate
the influences of high-density lipoprotein (HDL), lowdensity lipoprotein (LDL), triglycerides (TG), and total cholesterol (TC). METHODS: We identified 2,274 articles from PUBMED and EMBASE following a search input designed to include studies of interest of these, 21 met inclusion criteria.
RESULTS: The studies showed an overall reduction in low-density lipoprotein (p=0.04). Increases in HDL were found with cranberry and freeze-dried berry intake during a 4-6-week intervention. No statistically significant findings were detected for fasting glucose, Hb1Ac, insulin levels,
blood pressure, oxidized LDL (OX-LDL), BMI, and overall HDL. CONCLUSIONS: We conclude from this systematic review and meta-analysis that increased berry intake improves MetS key risk factors and reduces the risk of cardiovascular disease. Pronounced effects were apparent for concentrated
berry products, such as freeze-dried strawberries.
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Affiliation(s)
- Mikkel Roulund Wilken
- Department of Clinical Medicine. Aarhus University Hospital. Aarhus University. Palle Juul-Jensens. Boulevard 165. Aarhus N. Denmark
| | - Max Norman Tandrup Lambert
- Department of Clinical Medicine. Aarhus University Hospital. Aarhus University. Palle Juul-Jensens. Boulevard 165. Aarhus N. Denmark
| | - Christine Bodelund Christensen
- Department of Clinical Medicine. Aarhus University Hospital. Aarhus University. Palle Juul-Jensens. Boulevard 165. Aarhus N. Denmark
| | - Per Bendix Jeppesen
- Department of Clinical Medicine. Aarhus University Hospital. Aarhus University. Palle Juul-Jensens. Boulevard 165. Aarhus N. Denmark
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Beneficial effects of liraglutide on peripheral blood vessels. VOJNOSANIT PREGL 2022. [DOI: 10.2298/vsp200423089z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim. Macroangiopathy is the major cause of death and disability in type 2 diabetic patients. Studies have shown that liraglutide, a glucagon-like peptide 1 (GLP-1) receptor agonist, can protect cardiovascular system by inhibiting chronic inflammation of diabetes. However, a study about the effects of liraglutide on peripheral blood vessels and peripheral blood leukocytes has not been reported yet. The aim of this study was to determine vasculoprotective effect, vascular protection and mechanism of action of liraglutide in addition to its hypoglycemic effect. Methods. A total of 60 hospitalized patients with type 2 diabetes were recruited from December 2013 to December 2014 at the First Affiliated Hospital of Dalian Medical University, PR China. Before the treatment with liraglutide, height and weight were measured to calculate body mass index (BMI). Blood urea nitrogen (BUN) and so on were detected. Homeostasis model assessment of insulin resistance (HOMA-IR) and islet ? cell function (HOMA-?) were computed. After applying liraglutide for three months, all indexes were measured again. The effects of liraglutide on these indexes were analyzed by paired sample t-test. Results. After the treatment with liraglutide, values of glycosylated hemoglobin ? HbA1c (8.46 ? 1.62 vs. 7.26 ? 1.40%) and 2h postprandial blood glucose ? 2hPBG (11.95 vs. 9.6 mmol/L) decreased significantly (p < 0.05). Body weight (87.3 vs. 82.5 kg) and BMI (30.37 vs. 28.63 kg/m2) decreased by 5.5% and 5.7%, respectively (p < 0.05). Also, levels of triglycerides (TG) (2.57 ? 1.54 vs. 1.81 ? 0.70 mmol/L) and LDL-cholesterol (2.92 ? 0.78 vs. 1.89 ? 0.66 mmol/L) reduced significantly (p < 0.05). Ankle-brachial index (ABI) decreased from 1.24 ? 0.10 to 1.14 ? 0.06 cm/s by 8%, while brachial-ankle pulse wave velocity (ba-PWV) decreased from 1,442.15 ? 196.26 to 1,316.85 ? 146.63 cm/s by 8.7%, and both differences were statistically significant (p < 0.001). Conclusion. Liraglutide, with a good hypoglycemic effect, can significantly reduce postprandial blood glucose and HbA1c, but cannot significantly improve fasting plasma glucose, insulin resistance and islet ? cell function. It also considerably decreased body weight, BMI and TG. Liraglutide can significantly lower ba-PWV and ABI to protect peripheral blood vessels.
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Cirillo M, Boddi M, Coccia ME, Attanasio M, Fatini C. Ectopic Fat Depots and Cardiometabolic Burden: A Possible Dangerous Liaison in Women Planning Assisted Reproduction. J Family Reprod Health 2021; 15:118-124. [PMID: 34721601 PMCID: PMC8520667 DOI: 10.18502/jfrh.v15i2.6453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: We evaluated cardiometabolic burden in women planning assisted reproduction in order to identify subgroups at higher risk of pregnancy complications and cardiovascular disease. Materials and methods: In this cross-sectional study we investigated 60 infertile women with BMI≥25 kg/m2 referred to the Center for Assisted Reproduction. All women underwent metabolic, anthropometric parameters and ultrasound evaluation of ectopic fat depots. Results: All women had waist ≥80 cm. We found that 93.3% of women had pathological subcutaneous, 58.3% visceral and 80% para-perirenal fat; all women had fatty liver. Visceral fat and severity of steatosis were significantly related to the presence of metabolic syndrome (OR =5.7; p=0.03).A significant negative correlation between low HDL-c and para-perirenal fat (p<0.0001), a significant positive correlation with fasting plasma glucose and para-perirenal fat (p=0.001) were found. We observed a significant positive correlation between visceral fat and hs-CRP (p=0.002), HOMA-IR (p=0.04) and triglycerides (p=0.002), a significant negative correlation with HDL-c (p=0.05). Conclusion: This study by highlighting a clinically "dangerous liaison" between ectopic fat depots and metabolic/inflammatory markers, might permit to identify women with a worse metabolic phenotype and encourage lifestyle changes for improving their general and reproductive health together.
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Affiliation(s)
- Michela Cirillo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
| | - Maria Boddi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy.,Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Monica Attanasio
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
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Caiano LM, Costanzo S, Panzera T, Di Castelnuovo A, de Gaetano G, Donati MB, Ageno W, Iacoviello L. Association between body mass index, waist circumference, and relative fat mass with the risk of first unprovoked venous thromboembolism. Nutr Metab Cardiovasc Dis 2021; 31:3122-3130. [PMID: 34629257 DOI: 10.1016/j.numecd.2021.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/05/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS Obesity defined by body mass index (BMI) is independently associated with venous thromboembolism (VTE). Abdominal obesity, defined by waist circumference, is a predictor of cardiovascular events. Recently, relative fat mass (RFM) was proposed as a marker of cardiovascular risk. We assessed the role of three different measures of obesity to predict unprovoked VTE in a longitudinal study. METHODS AND RESULTS Moli-sani is a prospective cohort study carried out in the general population of the Molise region, Italy. A total of 23,538 individuals (48% men, age 55.4 years) enrolled between 2005 and 2010 were eligible. Patients on anticoagulant treatment were excluded. BMI ≥30 kg/m2 defined obesity, waist circumference >102 cm for men or 88 cm for women defined abdominal obesity, tertiles of RFM were compared. The long-term incidence of first unprovoked VTE during follow-up was assessed. Overall, 29.6% individuals were obese and 44.2% had abdominal obesity. A total of 66 first unprovoked VTE events were diagnosed during a median follow-up of 8.2 years. After multivariable Cox regression analysis, the risk of unprovoked VTE was significantly higher in obese participants (HR 1.89, 95% CI 1.16-3.07) than in participants with BMI <30; in subjects with abdominal obesity than with normal waist circumference (HR 2.19, 1.26-3.81); and in subjects with third vs first RFM tertile index (HR 2.46, 1.15-5.28). The areas under the curves for the models including the three obesity indexes were comparable. CONCLUSIONS Three indexes of obesity based on BMI, waist circumference or RFM similarly predict first occurrence of unprovoked VTE.
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Affiliation(s)
- Lucia M Caiano
- Department of Medicine and Surgery, University of Insubria, Varese, Italy.
| | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
| | - Teresa Panzera
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
| | | | | | - Maria B Donati
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
| | - Walter Ageno
- Department of Medicine and Surgery, University of Insubria, Varese, Italy.
| | - Licia Iacoviello
- Department of Medicine and Surgery, University of Insubria, Varese, Italy; Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
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Lin HA, Tsai HW, Chao CC, Lin SF. Periappendiceal fat-stranding models for discriminating between complicated and uncomplicated acute appendicitis: a diagnostic and validation study. World J Emerg Surg 2021; 16:52. [PMID: 34645500 PMCID: PMC8511616 DOI: 10.1186/s13017-021-00398-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 10/03/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Recent studies have reported promising outcomes of non-operative treatment for uncomplicated appendicitis; however, the preoperative prediction of complicated appendicitis is challenging. We developed models by incorporating fat stranding (FS), which is commonly observed in perforated appendicitis. MATERIAL AND METHODS We reviewed the data of 402 consecutive patients with confirmed acute appendicitis from our prospective registry. Multivariate logistic regression was performed to select clinical and radiographic factors predicting complicated acute appendicitis in our model 1 (involving backward elimination) and model 2 (involving stepwise selection). We compared c statistics among scoring systems developed by Bröker et al. (in J Surg Res 176(1):79-83. https://doi.org/10.1016/j.jss.2011.09.049 , 2012), Imaoka et al. (in World J Emerg Surg 11(1):1-5, 2016), Khan et al. (in Cureus. https://doi.org/1010.7759/cureus.4765 , 2019), Kim et al. (in Ann Coloproctol 31(5):192, 2015), Kang et al. (in Medicine 98(23): e15768, 2019), Atema et al. (in Br J Surg 102(8):979-990. https://doi.org/10.1002/bjs.9835 , 2015), Avanesov et al. (in Eur Radiol 28(9):3601-3610, 2018), and Kim et al. (in Abdom Radiol 46:1-12, 2020). Finally, we examined our models by performing the integrated discrimination improvement (IDI) test. RESULTS Among enrolled patients, 64 (15.9%) had complicated acute appendicitis. We developed new 10-point scoring models by including the following variables: C-reactive protein, neutrophil to lymphocyte ratio, and computed tomography features of FS, ascites, and appendicolith. A cutoff score of ≥ 6 exhibited a high sensitivity of 82.8% and a specificity of 82.8% for model 1 and 81.3% and 82.3% for model 2, respectively, with c statistics of 0.878 (model 1) and 0.879 (model 2). Compared with the model developed by Bröker et al. which included C-reactive protein and the abdominal pain duration (c statistic: 0.778), the models developed by Atema et al. (c statistic: 0.826, IDI: 5.92%, P = 0.0248), H.Y Kim et al. (c statistics: 0.838, IDI: 13.82%, P = 0.0248), and our two models (IDI: 18.29%, P < 0.0001) demonstrated a significantly higher diagnostic accuracy. CONCLUSION Our models and the scoring systems developed by Atema et al. and Kim et al. were validated to have a high diagnostic accuracy; moreover, our models included the lowest number of variables.
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Affiliation(s)
- Hui-An Lin
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Hung-Wei Tsai
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chun-Chieh Chao
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Emergency Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Sheng-Feng Lin
- School of Public Health, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei City, 110, Taiwan.
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Critical Care Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
- Department of Clinical Pathology, Taipei Medical University Hospital, Taipei, Taiwan.
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10
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Ledda RE, Milanese G, Cademartiri F, Maffei E, Benedetti G, Goldoni M, Silva M, Sverzellati N. Association of hepatic steatosis with epicardial fat volume and coronary artery disease in symptomatic patients. Radiol Med 2021; 126:652-660. [PMID: 33389661 DOI: 10.1007/s11547-020-01321-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/26/2020] [Indexed: 12/12/2022]
Abstract
AIMS This study aims to investigate whether HS-when associated with an excessive amount of epicardial adipose tissue-correlates with CAD in subjects with symptoms suggestive of CVD. METHODS AND RESULTS CCTA images, demographic and clinical variables of 1.182 individuals were retrieved: semi-automated measurements for EFV, CAC, and MLD were obtained. Individuals were grouped into three categories according to the presence of CAD, resulting in absent (CAD0), non-obstructive (CAD1) or obstructive (CAD2) disease-groups, and into two categories based on the presence of HS (with no HS, named HS-, and with HS, named HS+). EFV was significantly higher in HS+ than in HS- group (p < 0.001), whereas MLD was lower in CAD+ than in CAD- subjects (p < 0.001). Two predictive models for CAD were tested: the former included clinical risk factors for CAD along with age, gender, EFV and MLD, whereas the latter did not include clinical variables. The logistic regression analysis of the second proposed model reliably discriminated CAD0 from CAD1 and CAD2 (AUC of 0.712, range 0.682-0.742). CONCLUSION Lower MLD was associated with increased EFV, and MLD-as a marker of HS-discriminate symptomatic patients with CAD from whom without.
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Affiliation(s)
- Roberta Eufrasia Ledda
- Division of Scienze Radiologiche, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy
| | - Gianluca Milanese
- Division of Scienze Radiologiche, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy
| | | | - Erica Maffei
- Department of Radiology, Area Vasta 1/ASUR Marche, Urbino, Italy
| | - Giorgio Benedetti
- Division of Scienze Radiologiche, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy
| | - Matteo Goldoni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Mario Silva
- Division of Scienze Radiologiche, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy
| | - Nicola Sverzellati
- Division of Scienze Radiologiche, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy.
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11
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Freitas ATA, Donovan Giraldo AE, Pravatta Rezende G, Yela DA, Jales RM, Benetti-Pinto CL. Body composition in women with premature ovarian insufficiency using hormone therapy and the relation to cardiovascular risk markers: A case-control study. Clin Endocrinol (Oxf) 2021; 94:111-118. [PMID: 32939768 DOI: 10.1111/cen.14331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare body composition between women with premature ovarian insufficiency (POI) using hormone therapy and controls with normal ovarian function, and to correlate body composition with cardiovascular risk markers in the POI group. PATIENTS AND DESIGN A case-control study of 70 women with POI matched by age and body mass index with 70 controls. MEASUREMENTS All were submitted to whole-body dual-energy X-ray absorptiometry (DXA) to analyse body composition. In the POI group, total cholesterol, HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol, triglycerides, glucose, insulin, transaminases and C-reactive protein levels were measured, as well as the thickness of the carotid artery intima-media complex. RESULTS Total mass, fat mass, lean mass (total, percentage and index) and the android/gynoid (A/G) ratio were similar in both groups; however, bone mineral content was lower (P < .001) in the POI group. Lean and fat mass indexes were 14.19 ± 1.63 and 11.04 ± 3.58, respectively, and the percentage of gynoid to android fat was higher (51.17 ± 6.71% versus 47.74 ± 9.19%; A/G ratio = 0.93 ± 0.15) in the POI group. In addition, the increase in total mass correlated positively with glucose and ALT levels and negatively with HDL-cholesterol. Increased A/G ratio was the measurement most frequently associated with cardiovascular risk markers. CONCLUSION The body composition of women with POI using hormone therapy is similar to that of women with normal ovarian function with regard to lean and fat mass content and fat distribution. In women with POI, the higher the A/G ratio, the worse the cardiovascular risk markers.
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Affiliation(s)
- Alberto T A Freitas
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Andrea E Donovan Giraldo
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Gabriela Pravatta Rezende
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Daniela A Yela
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Rodrigo M Jales
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Cristina L Benetti-Pinto
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
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12
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Livadas S, Bothou C, Macut D. Premature Adrenarche and its Association with Cardiovascular Risk in Females. Curr Pharm Des 2020; 26:5609-5616. [PMID: 33045962 DOI: 10.2174/1381612826666201012164726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/24/2020] [Indexed: 11/22/2022]
Abstract
Early activation of the adrenal zona reticularis, leading to adrenal androgen secretion, mainly dehydroepiandrosterone sulfate (DHEAS), is called premature adrenarche (PA). The fact that adrenal hyperandrogenism in females has been linked to a cluster of cardiovascular (CV) risk factors, even in prepubertal children, warrants investigation. Controversial results have been obtained in this field, probably due to genetic, constitutional, and environmental factors or differences in the characteristics of participants. In an attempt to understand, in depth, the impact of PA as a potential activator of CV risk, we critically present available data stratified according to pubertal status. It seems that prepubertally, CV risk is increased in these girls, but is somewhat attenuated during their second decade of life. Furthermore, different entities associated with PA, such as polycystic ovary syndrome, non-classical congenital adrenal hyperplasia, heterozygosity of CYP21A2 mutations, and the impact of DHEAS on CV risk, are reviewed. At present, firm and definitive conclusions cannot be drawn. However, it may be speculated that girls with a history of PA display a hyperandrogenic hormonal milieu that may lead to increased CV risk. Accordingly, appropriate long-term follow-up and early intervention employing a patient-oriented approach are recommended.
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Affiliation(s)
- Sarantis Livadas
- Endocrine Unit, Metropolitan Hospital, Ermou 6, 10563, Athens, Greece
| | - Christina Bothou
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital of Zurich, Zurich, Switzerland
| | - Djuro Macut
- Department of Endocrinology, Diabetes and Metabolic Diseases, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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13
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Berberine Attenuates Cholesterol Accumulation in Macrophage Foam Cells by Suppressing AP-1 Activity and Activation of the Nrf2/HO-1 Pathway. J Cardiovasc Pharmacol 2020; 75:45-53. [PMID: 31895879 DOI: 10.1097/fjc.0000000000000769] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Atherosclerosis is a chronic inflammation condition resulting from the interaction between lipoproteins, monocyte-derived macrophages, T lymphocytes, and other cellular elements in the arterial wall. Macrophage-derived foam cells play a key role in both early and advanced stage of atherosclerosis. Previous studies have shown that berberine could inhibit foam cell formation and prevent experimental atherosclerosis. However, its underlying molecular mechanisms have not been fully clarified. In this study, we explored the cholesterol-lowering effects of berberine in macrophage-derived foam cells and investigated its possible mechanisms in prevention and treatment of atherosclerosis. Here, we demonstrated that berberine could inhibit atherosclerosis in apolipoprotein E-deficient mice and induce cholesterol reduction as well as decrease the content of macrophages. Berberine can regulate oxLDL uptake and cholesterol efflux, thus suppresses foam cell formation. Mechanisms study showed that berberine can suppress scavenger receptor expression via inhibiting the activity of AP-1 and upregulate ATP-binding cassette transporter via activating Nrf2/HO-1 signaling in human macrophage. In summary, berberine significantly inhibits atherosclerotic disease development by regulating lipid homeostasis and suppressing macrophage foam cell formation.
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14
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Meisel P, Pink C, Pitchika V, Nauck M, Völzke H, Kocher T. Competing interplay between systemic and periodontal inflammation: obesity overrides the impact of oral periphery. Clin Oral Investig 2020; 25:2045-2053. [PMID: 32827080 PMCID: PMC8238770 DOI: 10.1007/s00784-020-03514-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/06/2020] [Indexed: 12/19/2022]
Abstract
Objectives We aimed at investigating whether the interaction between the local inflammation, periodontitis, and obesity is independently associated with systemic inflammation. Methods From the population-based Study of Health in Pomerania, 3366 participants, without (2366) and with (1000) obesity, were studied for the association of periodontitis, measured as probing depth (PD) and plaque together with body mass index (BMI) on C-reactive protein (CRP). Quantile regression was used to evaluate the association between periodontal, anthropometric, and inflammatory variables (outcomes). Results The overall prevalence of obesity in this adult population was 31.4% in men and 28.1% in women. Both PD and plaque were positively associated with CRP, revealing an increasing impact across the CRP concentration distribution. Adjusting the regression of CRP or fibrinogen on PD for waist circumference attenuated but did not abolish the PD coefficients. Dental plaque was similarly associated with these interrelations. Association between PD and a dental plaque was different among participants with low-, medium-, or high-risk CRP concentrations. Conclusion Local and systemic sources of inflammation contribute to blood levels of inflammatory markers. The respective contributions depend on the relative rate in each of the inflammation-inducing risks and are dominated by adiposity. Clinical relevance Keeping systemic inflammation low in order to prevent age-related disease sequelae. Electronic supplementary material The online version of this article (10.1007/s00784-020-03514-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Peter Meisel
- Dental Clinics, Department of Periodontology, School of Dentistry, University Medicine Greifswald, Fleischmann-Strasse 42, D-17475, Greifswald, Germany.
| | - Christiane Pink
- Dental Clinics, Department of Periodontology, School of Dentistry, University Medicine Greifswald, Fleischmann-Strasse 42, D-17475, Greifswald, Germany
| | - Vinay Pitchika
- Dental Clinics, Department of Periodontology, School of Dentistry, University Medicine Greifswald, Fleischmann-Strasse 42, D-17475, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Diagnostics, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany
| | - Henry Völzke
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany.,Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Dental Clinics, Department of Periodontology, School of Dentistry, University Medicine Greifswald, Fleischmann-Strasse 42, D-17475, Greifswald, Germany
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15
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Hong M, Li J, Li S, Almutairi MM. Resveratrol Derivative, Trans-3, 5, 4'-Trimethoxystilbene, Prevents the Developing of Atherosclerotic Lesions and Attenuates Cholesterol Accumulation in Macrophage Foam Cells. Mol Nutr Food Res 2020; 64:e1901115. [PMID: 31965713 DOI: 10.1002/mnfr.201901115] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/04/2019] [Indexed: 12/28/2022]
Abstract
SCOPE Recent studies have demonstrated that trans-3, 5, 4'-Trimethoxystilbene (TMS), a novel derivative of resveratrol, may suppress the foam cells formation and restrain atherosclerosis in vitro and in vivo. Herein, the molecular mechanisms underlying the protective effects of TMS against atherosclerosis are further delineated. METHODS AND RESULTS In the present study, the cholesterol-lowering effects of TMS in macrophage-derived foam cell by animal studies, Oil Red O staining, and lipid uptake as well as efflux analysis, are explored. Real-time PCR, western blotting analysis, luciferase reporter assay, electrophoretic mobility shift assay, and immunofluorescent staining are applied for investigating the mechanism involved in atherosclerosis prevention by TMS. Herein, it is revealed that TMS, at a dosage of 10 mg kg-1 day-1 , may suppress atherosclerotic plaques within the aorta and arterial intima in apolipoprotein Edeficient mice (ApoE)-/- mice by reducing cholesterol level and macrophages content. Exposure of macrophages to TMS (10 µM) can suppress foam cells formation via regulating oxidized low density lipoprotein and cholesterol content in human macrophages through inhibiting scavenger receptors expression and activator protein-1(AP-1) activity. In addition, TMS can activate ERK/Nrf2/HO-1 signaling which increases the expression of ATP-binding cassette transporters. CONCLUSION In conclusion, TMS may inhibit the progress of atherosclerosis through regulating cholesterol homeostasis and inhibiting macrophage-derived foam cells formation.
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Affiliation(s)
- Ming Hong
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
- Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangzhou, 510000, China
| | - Jinke Li
- Department of Pharmacology & Toxicology, University of Kansas, Lawrence, KS, 64101, USA
| | - Siying Li
- Department of Pharmacology & Toxicology, University of Kansas, Lawrence, KS, 64101, USA
| | - Mohammed M Almutairi
- Department of Pharmacology & Toxicology, University of Kansas, Lawrence, KS, 64101, USA
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16
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Koh Y, Li S, Chen P, Wu J, Kalyanam N, Ho C, Pan M. Prevention of Vascular Inflammation by Pterostilbene via Trimethylamine‐
N
‐Oxide Reduction and Mechanism of Microbiota Regulation. Mol Nutr Food Res 2019; 63:e1900514. [DOI: 10.1002/mnfr.201900514] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/17/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Yen‐Chun Koh
- Institute of Food Sciences and TechnologyNational Taiwan University Taipei 106 Taiwan
| | - Shiming Li
- Hubei Key Laboratory of Economic Forest Germplasm Improvement and Resources Comprehensive UtilizationHubei Collaborative Innovation Center for the Characteristic Resources Exploitation of Dabie MountainsHuanggang Normal University Huanggang 438000 Hubei China
| | - Pei‐Yu Chen
- Institute of Food Sciences and TechnologyNational Taiwan University Taipei 106 Taiwan
| | - Jia‐Ching Wu
- Institute of Food Sciences and TechnologyNational Taiwan University Taipei 106 Taiwan
| | | | - Chi‐Tang Ho
- Department of Food ScienceRutgers University New Brunswick NJ 08901 USA
| | - Min‐Hsiung Pan
- Institute of Food Sciences and TechnologyNational Taiwan University Taipei 106 Taiwan
- Hubei Key Laboratory of Economic Forest Germplasm Improvement and Resources Comprehensive UtilizationHubei Collaborative Innovation Center for the Characteristic Resources Exploitation of Dabie MountainsHuanggang Normal University Huanggang 438000 Hubei China
- Department of Medical ResearchChina Medical University Hospital, China Medical University Taichung 40402 Taiwan
- Department of Health and Nutrition BiotechnologyAsia University Taichung 41354 Taiwan
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