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Hamjane N, Mechita MB, Nourouti NG, Barakat A. Gut microbiota dysbiosis -associated obesity and its involvement in cardiovascular diseases and type 2 diabetes. A systematic review. Microvasc Res 2024; 151:104601. [PMID: 37690507 DOI: 10.1016/j.mvr.2023.104601] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/24/2023] [Accepted: 09/02/2023] [Indexed: 09/12/2023]
Abstract
INTRODUCTION Obesity is a complex, multifactorial disease caused by various factors. Recently, the role of the gut microbiota in the development of obesity and its complications has attracted increasing interest. PURPOSE This article focuses on the mechanisms by which gut microbiota dysbiosis induces insulin resistance, type 2 diabetes, and cardiovascular diseases linked to obesity, highlighting the mechanisms explaining the role of gut microbiota dysbiosis-associated inflammation in the onset of these pathologies. METHODS A systematic study was carried out to understand and summarize the published results on this topic. More than 150 articles were included in this search, including different types of studies, consulted by an online search in English using various electronic search databases and predefined keywords related to the objectives of our study. RESULTS We have summarized the data from the articles consulted in this search, and we have found a major gut microbiota alteration in obesity, characterized by a specific decrease in butyrate-producing bacteria and the production of metabolites and components that lead to metabolic impairments and affect the progression of various diseases associated with obesity through distinct signaling pathways, including insulin resistance, type 2 diabetes, and cardiovascular diseases (CVD). We have also focused on the major role of inflammation as a link between gut microbiota dysbiosis and obesity-associated metabolic complications by explaining the mechanisms involved. CONCLUSION Gut microbiota dysbiosis plays a crucial role in the development of various obesity-related metabolic abnormalities, among them type 2 diabetes and CVD, and represents a major challenge for chronic disease prevention and health. Indeed, the intestinal microbiota appears to be a promising target for the nutritional or therapeutic management of these diseases.
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Affiliation(s)
- Nadia Hamjane
- Research Team in Biomedical Genomics and Oncogenetics, Faculty of Sciences and Technology of Tangier, Abdelmalek Essaadi University, Morocco.
| | - Mohcine Bennani Mechita
- Research Team in Biomedical Genomics and Oncogenetics, Faculty of Sciences and Technology of Tangier, Abdelmalek Essaadi University, Morocco
| | - Naima Ghailani Nourouti
- Research Team in Biomedical Genomics and Oncogenetics, Faculty of Sciences and Technology of Tangier, Abdelmalek Essaadi University, Morocco
| | - Amina Barakat
- Research Team in Biomedical Genomics and Oncogenetics, Faculty of Sciences and Technology of Tangier, Abdelmalek Essaadi University, Morocco
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Liu G, Zheng X, Jia Y, Cao P, Jiang Z, Yang L. Sex-dependent difference in the relationship between thyroid hormones and gallstone disease in euthyroid subjects. Medicine (Baltimore) 2023; 102:e34007. [PMID: 37335641 DOI: 10.1097/md.0000000000034007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
The relationship between thyroid dysfunction and gallstone disease (GSD) has been examined by some observational studies. However, evidence about the relationship between thyroid function and GSD among euthyroid subjects was scarce. The aim of this study was to investigate the association between thyroid function and the presence of GSD in a large-sample euthyroid subjects. A total of 5476 euthyroid subjects who underwent health checkup were included. GSD was diagnosed by hepatic ultrasonography. Conventional risk factors for GSD were assessed as well as serum levels of TSH, TT3, TT4 and Log-transformed TT3/TT4 ratio. A total of 4958 subjects were finally included. Levels of TSH, TT3, TT4, and ln (TT3/TT4) were comparable between GSD and non-GSD group (TSH: 1.73 ± 1.07 vs 1.74 ± 1.07 mIU/L, P = .931; TT3: 1.55 ± 0.40 vs 1.54 ± 0.39 ng/mL, P = .797; TT4: 9.37 ± 2.07 vs 9.49 ± 2.06 ug/dL, P = .245, ln (TT3/TT4): -1.80 ± 0.23 vs -1.83 ± 0.23, P = .130, respectively). Multivariate logistic regression analysis among all subjects revealed that the thyroid function parameters did not reach significant difference. Subgroup analyses showed that the relationship between thyroid function and GSD was different according to gender, with negative association for ln (TT3/TT4) and (odds ratio:0.551, 95% CI: 0.306-0.992, P = .047) and positive association for TT4 (odds ratio:1.077, 1 95% CI: .001-1.158, P = .046) in men. None of the thyroid function parameters was significantly associated with GSD in women. Our findings indicated that low levels of TT3-to-TT4 ratio and high levels of TT4 were significantly and independently associated with GSD among euthyroid male subjects, but not female subjects.
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Affiliation(s)
- Guoli Liu
- Department of Geriatrics and Respiratory Medicine, The Affiliated Taian City Central Hospital of Qingdao University, Taian City, Shandong Province, P. R. China
| | - Xiao Zheng
- Department of Gastrointestinal Surgery. The Affiliated Taian City Central Hospital of Qingdao University, Taian City, Shandong Province, P. R. China
| | - Yuzhen Jia
- Department of Geriatrics and Respiratory Medicine, The Affiliated Taian City Central Hospital of Qingdao University, Taian City, Shandong Province, P. R. China
| | - Ping Cao
- Department of Geriatrics and Respiratory Medicine, The Affiliated Taian City Central Hospital of Qingdao University, Taian City, Shandong Province, P. R. China
| | - Zhi Jiang
- Department of Geriatrics and Respiratory Medicine, The Affiliated Taian City Central Hospital of Qingdao University, Taian City, Shandong Province, P. R. China
| | - Libo Yang
- Department of Endocrinology, The Affiliated Taian City Central Hospital of Qingdao University, Taian City, Shandong Province, P.R. China
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Liu L, Zhao Z, Hou X, Wu J. Effect of sphincter of Oddi dysfunction on the abundance of biliary microbiota (biliary microecology) in patients with common bile duct stones. Front Cell Infect Microbiol 2022; 12:1001441. [PMID: 36569207 PMCID: PMC9768453 DOI: 10.3389/fcimb.2022.1001441] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 11/04/2022] [Indexed: 12/12/2022] Open
Abstract
Objective Biliary calculi, a common benign disease of the gastrointestinal tract, are affected by multiple factors, including diet, lifestyle, living environment, and personal and genetic background. Its occurrence is believed to be related to a change in biliary microbiota. Approximately 10%-20% of symptomatic patients with cholecystolithiasis have choledocholithiasis, resulting in infection, abdominal pain, jaundice, and biliary pancreatitis. This study aimed to determine whether a dysfunction in the sphincter of Oddi, which controls the outflow of bile and separates the bile duct from the intestine, leads to a change in biliary microbiota and the occurrence of biliary calculi. Methods Forty patients with cholecystolithiasis and choledocholithiasis were prospectively recruited. Bile specimens were obtained, and biliary pressure was measured during and after surgery. The collected specimens were analyzed with 16S rRNA gene to characterize the biliary microbiota. The risk factors of common bile duct calculi were analyzed numerically combined with the pressure in the sphincter of Oddi. Results Different biliary microbiota were found in all cases. Patients with sphincter of Oddi dysfunction had significantly increased biliary microbiota as well as significantly higher level of systemic inflammation than patients with normal sphincter of Oddi. Conclusions The systemic inflammatory response of patients with sphincter of Oddi dysfunction is more severe, and their microbial community significantly differs from that of patients with normal sphincter of Oddi, which makes biliary tract infection more likely; furthermore, the biliary tract of patients with sphincter of Oddi dysfunction has more gallstone-related bacterial communities.
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Affiliation(s)
- Linxun Liu
- Department of General Surgery, Qinghai Provincial People’s Hospital, Xining, Qinghai, China,*Correspondence: Linxun Liu,
| | - Zhanxue Zhao
- Department of General Surgery, Qinghai Provincial People’s Hospital, Xining, Qinghai, China
| | - Xiaofan Hou
- Graduate College of Qinghai University, Xining, Qinghai, China
| | - Jindu Wu
- Graduate College of Qinghai University, Xining, Qinghai, China
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Cholecystectomy reduces the risk of myocardial and cerebral infarction in patients with gallstone-related infection. Sci Rep 2022; 12:16749. [PMID: 36202881 PMCID: PMC9537563 DOI: 10.1038/s41598-022-20700-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
We compared the risk of myocardial infarction (MI) or cerebral infarction (CI) in patients with or without-gallstone-related infection (GSI) and change in the risk following cholecystectomy. GSI (n = 84,467) and non-GSI (n = 406,800) patients with age- and sex-matched controls (n = 4,912,670) were identified from Korean population based data. The adjusted hazard ratios (aHRs) of MI or CI were analyzed in both groups treated with or without cholecystectomy. Subgroup analysis was performed for both sexes and different ages. The risk of MI or CI was higher in the GSI group than in the non-GSI group (aHR for MI; 1.32 vs. 1.07, aHR for CI; 1.24 vs. 1.06, respectively). The risk reduction rate of MI following cholecystectomy was 11.4% in the GSI group, whereas it was 0% in the non-GSI group. The risk of CI after cholecystectomy was more reduced in the GSI group than in the non-GSI group (16.1% and 4.7%, respectively). The original risk of MI or CI in patients with gallstones and risk reduction rates following cholecystectomy were higher in females and younger patients than in males and older patients. Increased risk of MI or CI and greater risk reduction following cholecystectomy were seen in patients with GSI.
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Ho TC, Chen YC, Lin CC, Tai HC, Wei CY, Yeh YH, Hsu CY. Reduced Risk of Atrial Fibrillation Following Cholecystectomy: A Nationwide Population-Based Study. Front Aging Neurosci 2021; 13:706815. [PMID: 34539379 PMCID: PMC8445074 DOI: 10.3389/fnagi.2021.706815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 07/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Gallstone disease (GD) is associated with a high risk of cardiovascular disease. However, it is unknown whether GD contributes to atrial fibrillation (AF). We aimed to investigate the association between GD and AF. Methods: We performed a population-based cohort study using data from the Taiwan National Health Insurance Research Database between 2001 and 2011. A GD cohort of 230,076 patients was compared with a control cohort consisting of an equal number of patients matched for age, sex, cardiovascular and gastrointestinal comorbidities. Results: In total, 5,992 (49.8/10,000 person-years) patients with GD and 5,804 (44.5/10,000 person-years) controls developed AF. GD increased AF risk with a hazard ratio (HR) of 1.20 [95% confidence interval (CI), 1.16-1.25]. In patients with GD but without cholecystectomy, the HR of AF reached 1.57 (95% CI = 1.50-1.63). After cholecystectomy, the HR of AF significantly decreased to 0.85 (95% CI = 0.81-0.90). Among the three age groups with GD (<45, 45-64, and ≥65 years), the adjusted HRs of AF were 1.59 (95% CI = 1.08-2.33), 1.31 (95% CI = 1.18-1.45), and 1.18 (95% CI = 1.13-1.22), respectively. Compared with patients with a CHA2DS2-VASc score equal to 0, the HRs of AF risk among total cohort patients and a score equal to 1, 2, 3, and ≥ 4 were 1.28 (95% CI = 1.15-1.43), 2.26 (95% CI = 2.00-2.56), 3.81 (95% CI = 3.35-4.34), and 5.09 (95% CI = 4.42-5.87), respectively. Conclusion: This population-based longitudinal follow-up study showed that patients with GD had an increased AF risk. Moreover, cholecystectomy was related to reduced AF risk. Cardiovascular checkups may be necessary for patients with GD, especially those who are young and have other typical risk factors.
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Affiliation(s)
- Tung Ching Ho
- Department of Cardiology, Chang Hua Hospital, Changhua County, Taiwan.,Department of Bioinformatics and Medical Engineering, College of Information and Electrical Engineering, Asia University, Taichung, Taiwan
| | - Yu-Ching Chen
- Department of Bioinformatics and Medical Engineering, College of Information and Electrical Engineering, Asia University, Taichung, Taiwan
| | - Che-Chen Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Hsu-Chih Tai
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
| | - Cheng-Yu Wei
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan.,Department of Neurology, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan
| | - Yung-Hsiang Yeh
- Digestive Disease Center, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan
| | - Chung Y Hsu
- Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
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Chen CH, Lin CL, Kao CH. Risk of aortic dissection or aneurysm in patients with gallstone disease: a retrospective cohort study in Taiwan. BMJ Open 2021; 11:e049316. [PMID: 34446491 PMCID: PMC8395267 DOI: 10.1136/bmjopen-2021-049316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE This nationwide population-based cohort study was to compare the risk of aortic dissection (AD) or aortic aneurysm (AN) between the subjects with and without gallstone disease (GD). We also compare the risk of AD/AN between the patients with GD with and without cholecystectomy. SETTING This nationwide population-based cohort study. PARTICIPANTS We extracted the hospitalisation database from the National Health Insurance Research Database of Taiwan and identified a total of 343 300 patients aged ≥20 years with GD newly diagnosed between 2000 and 2010 as the study cohort, including 191 111 with cholecystectomy and 152 189 without cholecystectomy, respectively. We randomly selected those without GD as the control cohort, by 1:1 propensity score matching with the study cohort based on age, sex, comorbidities and year of the index date for GD diagnosis. RESULTS The incidence of AD/AN was 6.65/10 000 person-years for the GD cohort and 6.24/10 000 person-years for the non-GD cohort (adjusted HR (aHR)=1.11, 95% CI=1.09 to 1.13), respectively (p<0.001). Furthermore, the incidence of AD/AN in the patients with GD was 9.93/10 000 person-years for the non-cholecystectomy patients (aHR=1.24, 95% CI=1.22 to 1.26) and 4.63/10 000 person-years for the cholecystectomy patients (aHR=0.97, 95% CI=0.95 to 0.99), respectively (p<0.05). CONCLUSIONS The GD cohort was associated with and greater risk of AD/AN than the non-GD cohort, but the risk of AD/AN in the patients with GD would decrease after cholecystectomy.
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Affiliation(s)
- Chien-Hua Chen
- Digestive Disease Center, Changbing ShowChwan Memorial Hospital, Lukang Township, Taiwan
- College of Medicine, Chung-Hsing Univeristy, Taichung, Taiwan
- Department of Food Science and Technology, Hungkuang University, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan
- Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, Taiwan
- Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
- Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
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Gut Microbiome in a Russian Cohort of Pre- and Post-Cholecystectomy Female Patients. J Pers Med 2021; 11:jpm11040294. [PMID: 33921449 PMCID: PMC8070538 DOI: 10.3390/jpm11040294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 12/12/2022] Open
Abstract
The last decade saw extensive studies of the human gut microbiome and its relationship to specific diseases, including gallstone disease (GSD). The information about the gut microbiome in GSD-afflicted Russian patients is scarce, despite the increasing GSD incidence worldwide. Although the gut microbiota was described in some GSD cohorts, little is known regarding the gut microbiome before and after cholecystectomy (CCE). By using Illumina MiSeq sequencing of 16S rRNA gene amplicons, we inventoried the fecal bacteriobiome composition and structure in GSD-afflicted females, seeking to reveal associations with age, BMI and some blood biochemistry. Overall, 11 bacterial phyla were identified, containing 916 operational taxonomic units (OTUs). The fecal bacteriobiome was dominated by Firmicutes (66% relative abundance), followed by Bacteroidetes (19%), Actinobacteria (8%) and Proteobacteria (4%) phyla. Most (97%) of the OTUs were minor or rare species with ≤1% relative abundance. Prevotella and Enterocossus were linked to blood bilirubin. Some taxa had differential pre- and post-CCE abundance, despite the very short time (1–3 days) elapsed after CCE. The detailed description of the bacteriobiome in pre-CCE female patients suggests bacterial foci for further research to elucidate the gut microbiota and GSD relationship and has potentially important biological and medical implications regarding gut bacteria involvement in the increased GSD incidence rate in females.
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Hu FL, Chen HT, Guo FF, Yang M, Jiang X, Yu JH, Zhang FM, Xu GQ. Biliary microbiota and mucin 4 impact the calcification of cholesterol gallstones. Hepatobiliary Pancreat Dis Int 2021; 20:61-66. [PMID: 33341401 DOI: 10.1016/j.hbpd.2020.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 11/11/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cholesterol gallstones account for over 80% of gallstones, and the pathogenesis of gallstone formation involves genetic and environmental factors. However, data on the evolution of cholesterol gallstones with various densities are limited. This study aimed to determine the roles of microbiota and mucins on the formation of calcified cholesterol gallstones in patients with cholelithiasis. METHODS Paired gallbladder tissues and bile specimens were obtained from cholelithiasis patients who were categorized into the isodense group and calcified group according to the density of gallstones. The relative abundance of microbiota in gallbladder tissues was detected. Immunohistochemistry and enzyme-linked immunosorbent assay were performed to detect the expression levels of MUC1, MUC2, MUC3a, MUC3b, MUC4, MUC5ac and MUC5b in gallbladder tissues and bile. The correlation of microbiota abundance with MUC4 expression was evaluated by linear regression. RESULTS A total of 23 patients with gallbladder stones were included. The density of gallstones in the isodense group was significantly lower than that of the calcified group (34.20 ± 1.50 vs. 109.40 ± 3.84 HU, P < 0.0001). Compared to the isodense group, the calcified group showed a higher abundance of gram-positive bacteria at the fundus, in the body and neck of gallbladder tissues. The concentrations of MUC1, MUC2, MUC3a, MUC3b, MUC5ac and MUC5b in the epithelial cells of gallbladder tissues showed no difference between the two groups, while the concentrations of MUC4 were significantly higher in the calcified group than that in the isodense group at the fundus (15.49 ± 0.69 vs. 10.23 ± 0.54 ng/mL, P < 0.05), in the body (14.54 ± 0.94 vs. 11.87 ± 0.85 ng/mL, P < 0.05) as well as in the neck (14.77 ± 1.04 vs. 10.85 ± 0.72 ng/mL, P < 0.05) of gallbladder tissues. Moreover, the abundance of bacteria was positively correlated with the expression of MUC4 (r = 0.569, P < 0.05) in the calcified group. CONCLUSIONS This study showed the potential clinical relevance among biliary microbiota, mucins and calcified gallstones in patients with gallstones. Gram-positive microbiota and MUC4 may be positively associated with the calcification of cholesterol gallstones.
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Affiliation(s)
- Feng-Ling Hu
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Hong-Tan Chen
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Fang-Fang Guo
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Ming Yang
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Xin Jiang
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Jing-Hua Yu
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Fen-Ming Zhang
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Guo-Qiang Xu
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
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Chen CH, Lin CL, Kao CH. The effect of cholecystectomy on the risk of acute myocardial infarction in patients with gallbladder stones. Postgrad Med 2020; 133:209-216. [PMID: 33143514 DOI: 10.1080/00325481.2020.1846964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objectives: To investigate the effect of cholecystectomy on the subsequent risk of acute myocardial infarction (AMI) in patients with gallbladder stones (GBS).Methods: We used the Taiwan National Health Insurance Research Database (NHIRD) for hospitalization to conduct a retrospective nationwide population-based cohort study. The study cohort consisted of a total of 122,421 patients aged ≥20 years with cholecystectomy for GBS between 2000 and 2010. The control cohort consisted of the GBS patients without cholecystectomy and they were randomly selected by propensity score matching with the study cohort at a 1:1 ratio according to age, sex, occupation category, urbanization level, comorbidities, and year of the index date for cholecystectomy. We measured the incidence of AMI for both cohorts.Results: The cumulative incidence of AMI was lower in GB patients with cholecystectomy than that in those without cholecystectomy (2.26 vs 3.28 per 1000 person-years, adjusted hazard ratio [aHR] = 0.65, 95% confidence interval [CI] = 0.61-0.69). Compared to those without cholecystectomy, the risk of developing AMI after cholecystectomy was 0.69 (95% CI = 0.63-0.76) for the first year, 0.69 (95% CI = 0.63-0.77) for 2-5 years, and 0.59 (95% CI = 0.53-0.66) for ≥5 years, respectively.Conclusions: Our findings indicate cholecystectomy ameliorates the risk of AMI in patients with GBS, and the protective effect tends to increase with incremental duration of follow-up. However, it needs more studies to ascertain the protective mechanisms of cholecystectomy against AMI.
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Affiliation(s)
- Chien-Hua Chen
- Digestive Disease Center, Changbing Show-Chwan Memorial Hospital, Changhua County, Taiwan.,Digestive Disease Center, Show-Chwan Memorial Hospital, Changhua, Taiwan.,Department of Food Science and Technology, Hungkuang University, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
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Chen CH, Lin CL, Kao CH. Erectile Dysfunction in Men With Gallbladder Stone Disease: A Nationwide Population-Based Study. Am J Mens Health 2020; 13:1557988319839589. [PMID: 30907203 PMCID: PMC6440063 DOI: 10.1177/1557988319839589] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
We assessed the risk of erectile dysfunction after the diagnosis of gallbladder stone disease. We identified 9,362 men aged ≥20 years diagnosed with gallbladder stone disease between 2000 and 2011 from Taiwan’s National Health Insurance Research Database as the study cohort, and we randomly selected 9,362 men from the nongallbladder stone disease population by 1:1 frequency-matching with the case cohort based on age, the index date for the diagnosis of gallbladder stone disease, and comorbidities as the control cohort. All subjects were followed until December 31, 2011, for measuring the erectile dysfunction incidence. The risk of organic erectile dysfunction was higher in the gallbladder stone disease cohort than the nongallbladder stone disease cohort (4.01 vs. 2.69 per 1,000 person-years, adjusted hazard ratio = 1.41, 97.5% confidence interval [1.12, 1.78]), but the risk of psychogenic erectile dysfunction was comparable between the gallbladder stone disease cohort and the nongallbladder stone disease cohort (0.40 vs. 0.28 per 1,000 person-years, adjusted hazard ratio = 1.37, 97.5% confidence interval [0.67, 2.79]). Moreover, gallbladder stone disease men with cholecystectomy exhibited a lower risk of developing organic erectile dysfunction than gallbladder stone disease men without cholecystectomy (adjusted hazard ratio = 0.58, 97.5% confidence interval [0.41, 0.80]). The risk of organic erectile dysfunction contributed by gallbladder stone disease was only significantly higher in men aged ≥65 years (adjusted hazard ratio = 2.21, 97.5% confidence interval [1.34, 3.63]) and in men with comorbidities (adjusted hazard ratio = 1.42, 97.5% confidence interval [1.09, 1.85]). The risk of psychogenic erectile dysfunction contributed by gallbladder stone disease was nonsignificant in each age group and in men with or without comorbidities. Gallbladder stone disease is associated with an increased risk of organic erectile dysfunction, but it has no association with psychogenic erectile dysfunction. History of cholecystectomy for gallbladder stone disease may ameliorate the risk of organic erectile dysfunction; it requires more studies to ascertain the protective mechanism and to clarify whether the existence of gallbladder stone disease is an epiphenomenon or independent risk factor of erectile dysfunction.
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Affiliation(s)
- Chien-Hua Chen
- 1 Digestive Disease Center, Chang-Bing Show-Chwan Memorial Hospital, Lukang Town, Taiwan, ROC.,2 Digestive Disease Center, Show-Chwan Memorial Hospital, Changhua, Taiwan, ROC.,3 Department of Food Science and Technology, Hungkuang University, Taichung, Taiwan, ROC
| | - Cheng-Li Lin
- 4 Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan, ROC.,5 College of Medicine, China Medical University, Taichung, Taiwan, ROC
| | - Chia-Hung Kao
- 6 Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, ROC.,7 Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan, ROC.,8 Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan, ROC
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Chen CH, Lin CL, Kao CH. The Risk of Venous Thromboembolism in Patients with Gallstones. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082930. [PMID: 32340378 PMCID: PMC7215658 DOI: 10.3390/ijerph17082930] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/20/2020] [Accepted: 04/22/2020] [Indexed: 12/14/2022]
Abstract
The objective of this study is to assess the relationship between gallstones and venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), and the risk of VTE after cholecystectomy for gallstones. This nationwide population-based cohort study retrieved the hospitalization database from the Longitudinal Health Insurance Research Database (LHID2000), a database belonging to the National Health Insurance (NHI) program of Taiwan. A total of 345,793 patients aged ≥ 18 years with gallstones diagnosed between 2000 and 2010 were identified as the study cohort. The beneficiaries without gallstones were randomly selected as the control cohort by propensity score matching with the study cohort at a 1:1 ratio based on age, sex, urbanization, occupation, comorbidities, and year of the index date. We compared the risk of VTE between both cohorts and measured the risk differences of VTE between the gallstones patients with (n = 194,187) and without cholecystectomy (n = 151,606). Each patient was examined from the index date until the occurrence of DVT or PE, death or withdrawal from the NHI program, or the end of 2011. The incidence rate of DVT was 7.94/10,000 person-years for the non-gallstones cohort and 9.64/10,000 person-years for the gallstones cohort (hazard ratio (HR) = 1.35, 95% confidence interval (CI) = 1.25–1.47), respectively (p < 0.001). The incidence rate of PE was 3.92/10,000 person-years for the non-gallstones cohort and 4.65/10,000 person-years for the gallstones cohort (HR = 1.35, 95% CI = 1.20–1.53), respectively (p < 0.001). The cumulative incidence of DVT (6.54/10,000 person-years vs 14.6/10,000 person-years, adjusted hazard ratio (aHR) = 0.60, 95% CI = 0.54–0.67) and PE (3.29/10,000 person-years vs 6.84/10,000 person-years, aHR = 0.67, 95% CI = 0.58–0.77) for gallstones patients was lower in the cholecystectomy cohort than that in the non-cholecystectomy cohort after adjustment for age, sex, urbanization level, occupation, frequency of medical visits, history of pregnancy, and comorbidities (log-rank test, p < 0.001). Our findings indicate that the risk of DVT or PE in patients with gallstones was greater than those without gallstones. However, the risk of DVT and PE in the patients with gallstones would decrease after cholecystectomy. This area of research needs more studies to ascertain the pathogenesis for the contribution of gallstones to the development of VTE and the protective mechanisms of cholecystectomy against the development of VTE.
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Affiliation(s)
- Chien-Hua Chen
- Digestive Disease Center, Changbing Show-Chwan Memorial Hospital, Lukang Township, Changhua County 505, Taiwan;
- Department of Food Science and Technology, Hungkuang University, Taichung 433, Taiwan
- Chung Chou University of Science and Technology, Yuanlin Township, Changhua County 510, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan;
- College of Medicine, China Medical University, Taichung 404, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung 404, Taiwan
- Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung 404, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 413, Taiwan
- Correspondence:
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Chen CH, Lin CL, Kao CH. Association of Cholecystectomy with the Risk of Prostate Cancer in Patients with Gallstones. Cancers (Basel) 2020; 12:cancers12030544. [PMID: 32120816 PMCID: PMC7139917 DOI: 10.3390/cancers12030544] [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: 01/12/2020] [Revised: 02/22/2020] [Accepted: 02/24/2020] [Indexed: 12/21/2022] Open
Abstract
Objectives: To assess the association of cholecystectomy with the risk of prostate cancer in patients with gallstones. Methods: This nationwide population-based cohort study was conducted by retrieving the Longitudinal Health Insurance Research Database (LHID2000) for inpatient claims in the Taiwan National Health Insurance (NHI) program. The study cohort consisted of 72,606 men aged ≥ 20 years with gallstones undergoing cholecystectomy between 2000 and 2010. The control cohort consisted of the men with gallstones, but without cholecystectomy, by 1:1 propensity score matching with the study cohort based on age, sex, urbanization, occupation, comorbidities, and the index date. We compared the hazard ratio of prostate cancer between both of the cohorts. Results: The incidence of prostate cancer was 0.76/1000 person-years for the non-cholecystectomy cohort and 1.28/1000 person-years for the cholecystectomy cohort [aHR (adjusted hazard ratio) = 1.67, 95% confidence interval (CI = 1.45–1.92), respectively (p < 0.001). When compared with the non-cholecystectomy cohort, the hazard ratio of prostate cancer for the cholecystectomy cohort was 1.49-fold greater (95% CI = 1.04–2.11) for follow-up ≤ 1 year, 1.52-fold greater (95% CI = 1.24–1.86) for follow-up 1–5 years, and 1.99-fold greater (95% CI = 1.56–2.53) for follow-up > 5 years, respectively. Conclusions: Cholecystectomy is associated with an increased hazard ratio of prostate cancer in gallstones patients, and the risk increases with an incremental period of follow-up. This observational study cannot ascertain the detrimental mechanisms of cholecystectomy for the development of prostate cancer, and cholecystectomy is not recommended for the prevention of prostate cancer based on our study.
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Affiliation(s)
- Chien-Hua Chen
- Digestive Disease Center, Changbing Show-Chwan Memorial Hospital, Lukang Township, Changhua County 500, Taiwan;
- Digestive Disease Center, Show-Chwan Memorial Hospital, Changhua 500, Taiwan
- Department of Food Science and Technology, Hungkuang University, Taichung 433, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan;
- College of Medicine, China Medical University, Taichung 404, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 404, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung 404, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 404, Taiwan
- Correspondence: ; Tel.: +886-422-052-121 (ext. 7412); Fax: +886-422-336-174
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Wei CY, Chuang SH, Lin CL, Kung WM, Tai HC, Tsai KWK, Kao CH, Chen CH, Yeh YH, Hsu CY. Reduced risk of stroke following cholecystectomy: A nationwide population-based study. J Gastroenterol Hepatol 2019; 34:1992-1998. [PMID: 31165511 DOI: 10.1111/jgh.14678] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 03/24/2019] [Accepted: 03/27/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM Gallstones and stroke are common diseases worldwide. The relationship between gallstones and stroke has been documented in the literature. In this work, to characterize the risk of stroke among gallstone patients with and without cholecystectomy, we investigated the effects of cholecystectomy in a nationwide population-based retrospective cohort study. METHODS Data were obtained from Taiwan's National Health Insurance Research Database. The study comprised 155 356 gallstone patients divided into two groups: those with and without cholecystectomy. RESULTS During the study period (2000-2012), 19 096 (17.8/1000 person-years) gallstone patients without cholecystectomy and 11 913 (10.6/1000 person-years) gallstone patients with cholecystectomy had a stroke. Following gallstone removal, the patients exhibited a significant decrease in the risk of overall stroke (hazard ratio [HR] = 0.60, 95% confidence interval [CI] = 0.59-0.61), ischemic stroke (HR = 0.59, 95% CI = 0.58-0.61), and hemorrhagic stroke (HR = 0.56, 95% CI = 0.53-0.59). Asymptomatic and symptomatic gallstone patients had lower overall stroke risk after cholecystectomy (HR = 0.64, 95% CI = 0.62-0.67 and HR = 0.57, 95% CI = 0.56-0.59) than did asymptomatic gallstone patients without cholecystectomy. CONCLUSIONS This population-based cohort study demonstrated that cholecystectomy is related to reduce the risk of overall stroke, ischemic stroke, and hemorrhagic stroke. Preventive measures for stroke may be considered for gallstone patients, particularly those presenting risk factor(s) for stroke.
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Affiliation(s)
- Cheng-Yu Wei
- Department of Neurology, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
- Department of Neurology, Show Chwan Memorial Hospital, Changhua, Taiwan
- Department of Exercise and Health Promotion, College of Education, Chinese Culture University, Taipei, Taiwan
| | - Shu-Hung Chuang
- Division of General Surgery, Department of Surgery, Show Chwan Memorial Hospital, Changhua, Taiwan
- IRCAD-AITS Show Chwan Health Care System, Changhua, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Woon-Man Kung
- Department of Exercise and Health Promotion, College of Education, Chinese Culture University, Taipei, Taiwan
| | - Hsu Chih Tai
- Department of Exercise and Health Promotion, College of Education, Chinese Culture University, Taipei, Taiwan
| | - Kevin Wen-Kai Tsai
- Department of Neurology, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Chien-Hua Chen
- Digestive Disease Center, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Yung-Hsiang Yeh
- Digestive Disease Center, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Chung Y Hsu
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
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Fairfield CJ, Wigmore SJ, Harrison EM. Gallstone Disease and the Risk of Cardiovascular Disease. Sci Rep 2019; 9:5830. [PMID: 30967586 PMCID: PMC6456597 DOI: 10.1038/s41598-019-42327-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 03/21/2019] [Indexed: 02/06/2023] Open
Abstract
Gallstone disease (GD) is one of the most common presentations to surgical units worldwide and shares several risk factors with cardiovascular disease (CVD). CVD remains the most common cause of death worldwide and results in considerable economic burden. Recent observational studies have demonstrated an association between GD and CVD with some studies demonstrating a stronger association with cholecystectomy. We present the findings of a meta-analysis assessing the relationship between GD and CVD. A total of fourteen cohort studies with over 1.2 million participants were included. The pooled hazard ratio (HR, 95% confidence interval [CI]) for association with GD from a random-effects model is 1.23 (95%CI: 1.16-1.30) for fatal and non-fatal CVD events. The association was present in females and males. Three studies report the relationship between cholecystectomy and CVD with a pooled HR of 1.41 (95%CI: 1.21-1.64) which compares to a HR of 1.30 (95%CI: 1.07-1.58) when cholecystectomy is excluded although confounding may influence this result. Our meta-analysis demonstrates a significant relationship between GD and CVD events which is present in both sexes. Further research is needed to assess the influence of cholecystectomy on this association.
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Affiliation(s)
- Cameron J Fairfield
- Department of Clinical Surgery, The University of Edinburgh, Edinburgh, EH16 4SA, UK.
| | - Stephen J Wigmore
- Department of Clinical Surgery, The University of Edinburgh, Edinburgh, EH16 4SA, UK
| | - Ewen M Harrison
- Department of Clinical Surgery, The University of Edinburgh, Edinburgh, EH16 4SA, UK
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15
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Zhao SF, Wang AM, Yu XJ, Wang LL, Xu XN, Shi GJ. Association between gallstone and cardio-cerebrovascular disease: Systematic review and meta-analysis. Exp Ther Med 2019; 17:3092-3100. [PMID: 30936980 PMCID: PMC6434232 DOI: 10.3892/etm.2019.7291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 10/19/2018] [Indexed: 12/25/2022] Open
Abstract
Increasing evidence connects gallstone disease (GD) to cardio-cerebrovascular disease (CVD). The aim of the present systematic review and meta-analysis was to determine whether and to what extent an association between GD and CVD existed. PubMed, EMBASE and the Cochrane Library were systemically searched up to March 3rd, 2018. A total of 10 studies (1,272,177 participants; 13,833 records; 5 prospective cohorts and 5 retrospective cohorts) were included. It was demonstrated that GD was associated with an increased risk of incidence [hazard ratio=1.24, 95% (CI) confidence interval: 1.17–1.31] and prevalence (unadjusted odds ratio=1.23, 95% CI: 1.21–1.25) of CVD. In conclusion, the presence of GD was associated with an increased risk of CVD incidence and prevalence. The association may be influenced by age and sex. These findings suggest that individuals identified with cardio-cerebrovascular disease should be evaluated for GD.
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Affiliation(s)
- Shou-Feng Zhao
- Central Laboratories, Qingdao Municipal Hospital, Qingdao, Shandong 266000, P.R. China
| | - Ai-Min Wang
- Medical Examination Center, Qingdao Municipal Hospital, Qingdao, Shandong 266000, P.R. China
| | - Xin-Juan Yu
- Central Laboratories, Qingdao Municipal Hospital, Qingdao, Shandong 266000, P.R. China
| | - Li-Li Wang
- Central Laboratories, Qingdao Municipal Hospital, Qingdao, Shandong 266000, P.R. China
| | - Xiao-Na Xu
- Central Laboratories, Qingdao Municipal Hospital, Qingdao, Shandong 266000, P.R. China
| | - Guang-Jun Shi
- Department of Hepatobiliary Surgery, Qingdao Municipal Hospital, Qingdao, Shandong 266000, P.R. China
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Wang JY, Lu FH, Sun ZJ, Wu JS, Yang YC, Lee CT, Chang CJ. Gallstone disease associated with increased risk of arterial stiffness in a Taiwanese population. J Hum Hypertens 2017; 31:616-619. [PMID: 28660886 DOI: 10.1038/jhh.2017.43] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 03/24/2017] [Accepted: 05/04/2017] [Indexed: 01/11/2023]
Abstract
Arterial stiffness has similar risk factors to gallstone disease (GSD). However, there are few studies on the association between arterial stiffness and GSD. The aim of this study was to determine the relationship between arterial stiffness and GSD in a Taiwanese population. We enroled 6211 subjects from a health examination centre after excluding those who received medications for diabetes, hypertension and hyperlipidemia or had a history of cardiovascular disease, cerebrovascular disease, cancer, cholecystectomy or ankle-brachial index of ⩽ 0.9 or⩾1.3. Increased arterial stiffness was defined as right brachial-ankle pulse wave velocity (baPWV) ⩾1400 cm s-1. The diagnosis of GSD was based on ultrasonographic findings. The prevalence of increased arterial stiffness was 47.2 and 31.9 % in subjects with and without GSD (P<0.001). A multiple linear regression analysis revealed that GSD, age, systolic blood pressure, fasting plasma glucose and current smoking were positively associated with baPWV, whereas male gender, BMI, habitual exercise and HDL-C were negatively related to baPWV after adjusting for other clinical variables. In conclusion, subjects with GSD are associated with an increased risk of arterial stiffness.
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Affiliation(s)
- J-Y Wang
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan City, Taiwan
| | - F-H Lu
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan City, Taiwan.,Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Z-J Sun
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan City, Taiwan.,Department of Family Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, Tainan City, Taiwan
| | - J-S Wu
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan City, Taiwan.,Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Y-C Yang
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan City, Taiwan.,Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - C-T Lee
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan City, Taiwan
| | - C-J Chang
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan City, Taiwan.,Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
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