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Yumi Noronha N, da Silva Rodrigues G, Harumi Yonehara Noma I, Fernanda Cunha Brandao C, Pereira Rodrigues K, Colello Bruno A, Sae-Lee C, Moriguchi Watanabe L, Augusta de Souza Pinhel M, Mello Schineider I, Luciano de Almeida M, Barbosa Júnior F, Araújo Morais D, Tavares de Sousa Júnior W, Plösch T, Roberto Bueno Junior C, Barbosa Nonino C. 14-weeks combined exercise epigenetically modulated 118 genes of menopausal women with prediabetes. Front Endocrinol (Lausanne) 2022; 13:895489. [PMID: 36046788 PMCID: PMC9423096 DOI: 10.3389/fendo.2022.895489] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/19/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Pre-diabetes precedes Diabetes Mellitus (DM) disease and is a critical period for hyperglycemia treatment, especially for menopausal women, considering all metabolic alterations due to hormonal changes. Recently, the literature has demonstrated the role of physical exercise in epigenetic reprogramming to modulate the gene expression patterns of metabolic conditions, such as hyperglycemia, and prevent DM development. In the present study, we hypothesized that physical exercise training could modify the epigenetic patterns of women with poor glycemic control. METHODS 48 post-menopause women aged 60.3 ± 4.5 years were divided according to their fasting blood glucose levels into two groups: Prediabetes Group, PG (n=24), and Normal Glucose Group, NGG (n=24). All participants performed 14 weeks of physical exercise three times a week. The Infinium Methylation EPIC BeadChip measured the participants' Different Methylated Regions (DMRs). RESULTS Before the intervention, the PG group had 12 DMRs compared to NGG. After the intervention, five DMRs remained different. Interestingly, when comparing the PG group before and after training, 118 DMRs were found. The enrichment analysis revealed that the genes were related to different biological functions such as energy metabolism, cell differentiation, and tumor suppression. CONCLUSION Physical exercise is a relevant alternative in treating hyperglycemia and preventing DM in post-menopause women with poor glycemic control.
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Affiliation(s)
- Natália Yumi Noronha
- Department of Internal Medicine, Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
| | - Guilherme da Silva Rodrigues
- Department of Internal Medicine, Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
- *Correspondence: Guilherme da Silva Rodrigues,
| | - Isabella Harumi Yonehara Noma
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Camila Fernanda Cunha Brandao
- Department of Internal Medicine, Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
- Physical Education School, Minas Gerais State University, Divinópolis, Minas Gerais, Brazil
| | - Karine Pereira Rodrigues
- Department of Internal Medicine, Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
| | - Alexandre Colello Bruno
- Department of Radiotherapy, Ribeirão Preto Medical School Hospital and Clinics, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Chanachai Sae-Lee
- Research Division, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Marcela Augusta de Souza Pinhel
- Department of Internal Medicine, Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
- Department of Molecular Biology, São José do Rio Preto Medical School, São José do Rio Preto, SP, Brazil
| | | | | | - Fernando Barbosa Júnior
- Department of Clinical Analysis, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Déborah Araújo Morais
- Department of Clinical Analysis, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Wellington Tavares de Sousa Júnior
- Department of Clinical Analysis, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Torsten Plösch
- University Medical Center Groningen, Groningen, Netherlands
| | - Carlos Roberto Bueno Junior
- Department of Internal Medicine, Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
- Ribeirão Preto School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Carla Barbosa Nonino
- Department of Internal Medicine, Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
- Department of Health Sciences, Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
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Abstract
PURPOSE OF REVIEW This review discusses recent evidence on the association of dietary carbohydrates (quantity, quality, and timing of intake) with hypertension (HTN) risk and out-of-clinic blood pressure (BP) measures. RECENT FINDINGS Studies on carbohydrate quantity are inconclusive, but low carbohydrate diets may be associated with lower BP. Plant-based carbohydrate-containing foods such as fruits, vegetables, and whole grains may lower HTN risk and 24-h BP. Excessive sugar intakes from sugar-sweetened beverages are associated with higher BP levels and HTN risk, with evidence of a dose-response relationship. Preliminary data suggest that timing of carbohydrate intake may influence HTN risk and 24-h BP. The role of carbohydrate nutrition in HTN's etiology warrants further investigation. Additional studies are needed to investigate the influence of dietary carbohydrates on HTN risk and the circadian pattern of BP, evaluate potential sex and racial/ethnic differences in these associations, and elucidate underlying mechanisms.
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3
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Lim SS, Kakoly NS, Tan JWJ, Fitzgerald G, Bahri Khomami M, Joham AE, Cooray SD, Misso ML, Norman RJ, Harrison CL, Ranasinha S, Teede HJ, Moran LJ. Metabolic syndrome in polycystic ovary syndrome: a systematic review, meta-analysis and meta-regression. Obes Rev 2019; 20:339-352. [PMID: 30339316 DOI: 10.1111/obr.12762] [Citation(s) in RCA: 123] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 03/25/2018] [Accepted: 03/30/2018] [Indexed: 01/08/2023]
Abstract
Women with polycystic ovary syndrome (PCOS) have increased risk of metabolic syndrome. The relative contribution of clinical, demographic or biochemical factors to metabolic syndrome in PCOS is not known. A literature search was conducted in MEDLINE, CINAHL, EMBASE and clinical trial registries. Of 4530 studies reviewed, 59 were included in the systematic review and 27 in the meta-analysis and meta-regression. In good and fair quality studies, women with PCOS had an overall increased prevalence of metabolic syndrome (odds ratio, OR 3.35, 95% confidence interval, CI 2.44, 4.59). Increased prevalence of metabolic syndrome occurred in overweight or obese women with PCOS (OR 1.88, 95% 1.16, 3.04) but not in lean women (OR 1.45, 95% CI 0.35, 6.12). In meta-regression analyses, the markers of metabolic syndrome diagnostic criteria (waist circumference, high-density lipoprotein cholesterol, triglyceride, blood pressure), BMI, glucose tolerance (2-hr oral glucose tolerance test) and surrogate markers of insulin resistance (HOMA-IR) but not markers of reproductive dysfunction (sex hormone binding globulin, testosterone, PCOS phenotypes) contributed significantly to the heterogeneity in the prevalence of metabolic syndrome. Women with PCOS have increased risk of metabolic syndrome which was associated with obesity and metabolic features but not with indices of hyperandrogenism.
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Affiliation(s)
- S S Lim
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - N S Kakoly
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - J W J Tan
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - G Fitzgerald
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - M Bahri Khomami
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - A E Joham
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria, Australia
| | - S D Cooray
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria, Australia
| | - M L Misso
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - R J Norman
- Robinson Research Institute, University of Adelaide and Fertility SA, Adelaide, South Australia, Australia
| | - C L Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - S Ranasinha
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - H J Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria, Australia.,Monash Partners Academic Health Sciences Centre, Melbourne, Victoria, Australia
| | - L J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Robinson Research Institute, University of Adelaide and Fertility SA, Adelaide, South Australia, Australia
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4
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Halladay JR, Lenhart KC, Robasky K, Jones W, Homan WF, Cummings DM, Cené CW, Hinderliter AL, Miller CL, Donahue KE, Garcia BA, Keyserling TC, Ammerman AS, Patterson C, DeWalt DA, Johnston LF, Willis MS, Schisler JC. Applicability of Precision Medicine Approaches to Managing Hypertension in Rural Populations. J Pers Med 2018; 8:E16. [PMID: 29710874 PMCID: PMC6023309 DOI: 10.3390/jpm8020016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/23/2018] [Accepted: 04/23/2018] [Indexed: 12/28/2022] Open
Abstract
As part of the Heart Healthy Lenoir Project, we developed a practice level intervention to improve blood pressure control. The goal of this study was: (i) to determine if single nucleotide polymorphisms (SNPs) that associate with blood pressure variation, identified in large studies, are applicable to blood pressure control in subjects from a rural population; (ii) to measure the association of these SNPs with subjects' responsiveness to the hypertension intervention; and (iii) to identify other SNPs that may help understand patient-specific responses to an intervention. We used a combination of candidate SNPs and genome-wide analyses to test associations with either baseline systolic blood pressure (SBP) or change in systolic blood pressure one year after the intervention in two genetically defined ancestral groups: African Americans (AA) and Caucasian Americans (CAU). Of the 48 candidate SNPs, 13 SNPs associated with baseline SBP in our study; however, one candidate SNP, rs592582, also associated with a change in SBP after one year. Using our study data, we identified 4 and 15 additional loci that associated with a change in SBP in the AA and CAU groups, respectively. Our analysis of gene-age interactions identified genotypes associated with SBP improvement within different age groups of our populations. Moreover, our integrative analysis identified AQP4-AS1 and PADI2 as genes whose expression levels may contribute to the pleiotropy of complex traits involved in cardiovascular health and blood pressure regulation in response to an intervention targeting hypertension. In conclusion, the identification of SNPs associated with the success of a hypertension treatment intervention suggests that genetic factors in combination with age may contribute to an individual's success in lowering SBP. If these findings prove to be applicable to other populations, the use of this genetic variation in making patient-specific interventions may help providers with making decisions to improve patient outcomes. Further investigation is required to determine the role of this genetic variance with respect to the management of hypertension such that more precise treatment recommendations may be made in the future as part of personalized medicine.
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Affiliation(s)
- Jacqueline R Halladay
- Department of Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Kaitlin C Lenhart
- McAllister Heart Institute at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Kimberly Robasky
- Q2 Solutions|EA Genomics, Morrisville, North Carolina. 27560, USA.
| | - Wendell Jones
- Q2 Solutions|EA Genomics, Morrisville, North Carolina. 27560, USA.
| | - Wayne F Homan
- Department of Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Doyle M Cummings
- Department of Family Medicine, East Carolina University, Greenville, NC 27834, USA.
| | - Crystal W Cené
- Cecil R. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Alan L Hinderliter
- Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Cassandra L Miller
- Center for Health Promotion and Disease Prevention at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Katrina E Donahue
- Department of Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Cecil R. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Beverly A Garcia
- Center for Health Promotion and Disease Prevention at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Thomas C Keyserling
- Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Department of Nutrition, Gillings School of Global Public Health at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Alice S Ammerman
- Center for Health Promotion and Disease Prevention at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Department of Nutrition, Gillings School of Global Public Health at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Cam Patterson
- Presbyterian Hospital/Weill-Cornell Medical Center, New York, NY 10065, USA.
| | - Darren A DeWalt
- Cecil R. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Larry F Johnston
- Center for Health Promotion and Disease Prevention at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Monte S Willis
- McAllister Heart Institute at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Department of Pharmacology and Department of Pathology and Lab Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Jonathan C Schisler
- McAllister Heart Institute at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Department of Pharmacology and Department of Pathology and Lab Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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5
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Ravi S, Schuck RN, Hilliard E, Lee CR, Dai X, Lenhart K, Willis MS, Jensen BC, Stouffer GA, Patterson C, Schisler JC. Clinical Evidence Supports a Protective Role for CXCL5 in Coronary Artery Disease. THE AMERICAN JOURNAL OF PATHOLOGY 2017; 187:2895-2911. [PMID: 29153655 PMCID: PMC5718092 DOI: 10.1016/j.ajpath.2017.08.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 06/19/2017] [Accepted: 08/22/2017] [Indexed: 12/31/2022]
Abstract
Our goal was to measure the association of CXCL5 and molecular phenotypes associated with coronary atherosclerosis severity in patients at least 65 years old. CXCL5 is classically defined as a proinflammatory chemokine, but its role in chronic inflammatory diseases, such as coronary atherosclerosis, is not well defined. We enrolled individuals who were at least 65 years old and undergoing diagnostic cardiac catheterization. Coronary artery disease (CAD) severity was quantified in each subject via coronary angiography by calculating a CAD score. Circulating CXCL5 levels were measured from plasma, and both DNA genotyping and mRNA expression levels in peripheral blood mononuclear cells were quantified via microarray gene chips. We observed a negative association of CXCL5 levels with CAD at an odds ratio (OR) of 0.46 (95% CI, 0.27-0.75). Controlling for covariates, including sex, statin use, hypertension, hyperlipidemia, obesity, self-reported race, smoking, and diabetes, the OR was not significantly affected [OR, 0.54 (95% CI, 0.31-0.96)], consistent with a protective role for CXCL5 in coronary atherosclerosis. We also identified 18 genomic regions with expression quantitative trait loci of genes correlated with both CAD severity and circulating CXCL5 levels. Our clinical findings are consistent with the emerging link between chemokines and atherosclerosis and suggest new therapeutic targets for CAD.
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Affiliation(s)
- Saranya Ravi
- McAllister Heart Institute, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Robert N Schuck
- Division of Pharmacotherapy and Experimental Therapeutics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Eleanor Hilliard
- McAllister Heart Institute, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Craig R Lee
- McAllister Heart Institute, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Division of Pharmacotherapy and Experimental Therapeutics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Xuming Dai
- McAllister Heart Institute, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Eshelman School of Pharmacy, the Division of Cardiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kaitlin Lenhart
- McAllister Heart Institute, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Monte S Willis
- McAllister Heart Institute, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Pathology and Laboratory Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Pharmacology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Brian C Jensen
- McAllister Heart Institute, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Eshelman School of Pharmacy, the Division of Cardiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Pharmacology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - George A Stouffer
- McAllister Heart Institute, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Eshelman School of Pharmacy, the Division of Cardiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Cam Patterson
- Presbyterian Hospital/Weill-Cornell Medical Center, New York, New York
| | - Jonathan C Schisler
- McAllister Heart Institute, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Pathology and Laboratory Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Pharmacology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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6
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Bai X, Mangum KD, Dee RA, Stouffer GA, Lee CR, Oni-Orisan A, Patterson C, Schisler JC, Viera AJ, Taylor JM, Mack CP. Blood pressure-associated polymorphism controls ARHGAP42 expression via serum response factor DNA binding. J Clin Invest 2017; 127:670-680. [PMID: 28112683 PMCID: PMC5272192 DOI: 10.1172/jci88899] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 12/01/2016] [Indexed: 12/18/2022] Open
Abstract
We recently demonstrated that selective expression of the Rho GTPase-activating protein ARHGAP42 in smooth muscle cells (SMCs) controls blood pressure by inhibiting RhoA-dependent contractility, providing a mechanism for the blood pressure-associated locus within the ARHGAP42 gene. The goals of the current study were to identify polymorphisms that affect ARHGAP42 expression and to better assess ARHGAP42's role in the development of hypertension. Using DNase I hypersensitivity methods and ENCODE data, we have identified a regulatory element encompassing the ARHGAP42 SNP rs604723 that exhibits strong SMC-selective, allele-specific activity. Importantly, CRISPR/Cas9-mediated deletion of this element in cultured human SMCs markedly reduced endogenous ARHGAP42 expression. DNA binding and transcription assays demonstrated that the minor T allele variation at rs604723 increased the activity of this fragment by promoting serum response transcription factor binding to a cryptic cis-element. ARHGAP42 expression was increased by cell stretch and sphingosine 1-phosphate in a RhoA-dependent manner, and deletion of ARHGAP42 enhanced the progression of hypertension in mice treated with DOCA-salt. Our analysis of a well-characterized cohort of untreated borderline hypertensive patients suggested that ARHGAP42 genotype has important implications in regard to hypertension risk. Taken together, our data add insight into the genetic mechanisms that control blood pressure and provide a potential target for individualized antihypertensive therapies.
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MESH Headings
- Animals
- Blood Pressure
- CRISPR-Cas Systems
- GTPase-Activating Proteins/genetics
- GTPase-Activating Proteins/metabolism
- Gene Expression Regulation
- Humans
- Hypertension/chemically induced
- Hypertension/genetics
- Hypertension/metabolism
- Hypertension/physiopathology
- Mice
- Mice, Transgenic
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Muscle, Smooth, Vascular/physiopathology
- Myocytes, Smooth Muscle/metabolism
- Myocytes, Smooth Muscle/pathology
- Polymorphism, Single Nucleotide
- Serum Response Factor/genetics
- Serum Response Factor/metabolism
- Sodium Chloride, Dietary/adverse effects
- Sodium Chloride, Dietary/pharmacology
- rho GTP-Binding Proteins/genetics
- rho GTP-Binding Proteins/metabolism
- rhoA GTP-Binding Protein/genetics
- rhoA GTP-Binding Protein/metabolism
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Affiliation(s)
| | | | | | | | - Craig R. Lee
- McAllister Heart Institute, and
- Department of Pharmacy, University of North Carolina at Chapel Hill, Durham, North Carolina, USA
| | - Akinyemi Oni-Orisan
- Department of Pharmacy, University of North Carolina at Chapel Hill, Durham, North Carolina, USA
| | - Cam Patterson
- New York–Presbyterian Hospital/Weill Cornell Medical Center, New York, New York, USA
| | | | - Anthony J. Viera
- Department of Family Medicine, University of North Carolina at Chapel Hill, Durham, North Carolina, USA
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7
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Costantino NS, Freeman B, Shriver CD, Ellsworth RE. Outcome Disparities in African American Compared with European American Women with ER+HER2- Tumors Treated within an Equal-Access Health Care System. Ethn Dis 2016; 26:407-16. [PMID: 27440982 DOI: 10.18865/ed.26.3.407] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Breast cancer mortality rates are higher for African American women (AAW) than for any other ethnic group in the United States. Recent reports suggest that outcome disparities between AAW and European American women (EAW) are present in the ER+HER2- subtype. To improve our understanding, pathological characteristics, mortality and molecular profiles from women treated within an equal-access health care system were evaluated. PROCEDURES All AAW (n=90) and EAW (n=308) with ER+HER2- tumors were identified. Gene expression profiles were generated from primary breast tumors from 57 AAW and 181 EAW. Pathological characteristics, survival and gene expression analysis were evaluated using chi-square analysis, log-rank tests and ANOVA. RESULTS Tumors from AAW were significantly more likely to be PR-, Ki67+ and of higher grade. Tumor stage, size and lymph node status did not differ significantly, nor did mortality rates (P=.879). At the molecular level, genes PSPHL and CRYBB2P1 were expressed at significantly higher levels in tumor tissues as well as normal stroma and blood from AAW. Polymorphisms controlling expression of each gene were identified with minor allele frequencies differing significantly between populations but not between cases and controls within each population. CONCLUSIONS Survival disparities were not detected in patients with ER+HER2- tumors treated within an equal-access health care system and molecular differences in tumors were not causal. Thus, outcome disparities in AAW with ER+HER2- tumors are largely attributable to socioeconomic factors affecting access to screening and treatment, rather than reflecting underlying biological differences.
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Affiliation(s)
| | - Benjamin Freeman
- Clinical Breast Care Project, Murtha Cancer Center, Bethesda, Md
| | - Craig D Shriver
- Clinical Breast Care Project, Murtha Cancer Center, Bethesda, Md
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8
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Kountz D. Special considerations of care and risk management for African American patients with type 2 diabetes mellitus. J Natl Med Assoc 2012; 104:265-73. [PMID: 22973676 DOI: 10.1016/s0027-9684(15)30158-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
It is well documented that African American populations are disproportionately affected by type 2 diabetes mellitus compared with their white counterparts. They have a higher prevalence of diabetes, a higher rate of diabetes-related complications, greater disability from these complications, and poorer control and quality of care. In order to improve diabetes care and outcomes in African Americans (and indeed all patients with diabetes), a multifactorial approach is needed to target all risk factors-not solely hyperglycemia-simultaneously. Culturally appropriate initiatives to improve lifestyle behaviors are a first step in management. Community-based programs, including those mediated through church groups, have reported varying degrees of success in effecting such beneficial lifestyle changes. If these measures fail to achieve desirable levels of blood glucose, blood pressure, and serum lipids, pharmacologic therapy is indicated. However, few evidence-based recommendations regarding the use of some drugs in African Americans currently exist due to their underrepresentation in randomized controlled clinical trials. Other essential components of diabetes care include regular screening for diabetic nephropathy and neuropathy, and eye and foot examinations, with prompt referral to specialists when important clinical changes are detected.
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Affiliation(s)
- David Kountz
- Jersey Shore University Medical Center, Neptune, New Jersey, USA.
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9
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Bushel PR, McGovern R, Liu L, Hofmann O, Huda A, Lu J, Hide W, Lin X. Population differences in transcript-regulator expression quantitative trait loci. PLoS One 2012; 7:e34286. [PMID: 22479588 PMCID: PMC3313997 DOI: 10.1371/journal.pone.0034286] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Accepted: 02/27/2012] [Indexed: 12/21/2022] Open
Abstract
Gene expression quantitative trait loci (eQTL) are useful for identifying single nucleotide polymorphisms (SNPs) associated with diseases. At times, a genetic variant may be associated with a master regulator involved in the manifestation of a disease. The downstream target genes of the master regulator are typically co-expressed and share biological function. Therefore, it is practical to screen for eQTLs by identifying SNPs associated with the targets of a transcript-regulator (TR). We used a multivariate regression with the gene expression of known targets of TRs and SNPs to identify TReQTLs in European (CEU) and African (YRI) HapMap populations. A nominal p-value of <1×10(-6) revealed 234 SNPs in CEU and 154 in YRI as TReQTLs. These represent 36 independent (tag) SNPs in CEU and 39 in YRI affecting the downstream targets of 25 and 36 TRs respectively. At a false discovery rate (FDR) = 45%, one cis-acting tag SNP (within 1 kb of a gene) in each population was identified as a TReQTL. In CEU, the SNP (rs16858621) in Pcnxl2 was found to be associated with the genes regulated by CREM whereas in YRI, the SNP (rs16909324) was linked to the targets of miRNA hsa-miR-125a. To infer the pathways that regulate expression, we ranked TReQTLs by connectivity within the structure of biological process subtrees. One TReQTL SNP (rs3790904) in CEU maps to Lphn2 and is associated (nominal p-value = 8.1×10(-7)) with the targets of the X-linked breast cancer suppressor Foxp3. The structure of the biological process subtree and a gene interaction network of the TReQTL revealed that tumor necrosis factor, NF-kappaB and variants in G-protein coupled receptors signaling may play a central role as communicators in Foxp3 functional regulation. The potential pleiotropic effect of the Foxp3 TReQTLs was gleaned from integrating mRNA-Seq data and SNP-set enrichment into the analysis.
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Affiliation(s)
- Pierre R Bushel
- Biostatistics Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, United States of America.
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10
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Rahim-Williams B. Beliefs, behaviors, and modifications of type 2 diabetes self-management among African American women. J Natl Med Assoc 2011; 103:203-15. [PMID: 21671524 DOI: 10.1016/s0027-9684(15)30300-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Among African Americans, behaviors and beliefs about management of disease constitute an important component of self-management of type 2 diabetes (diabetes mellitus). The purpose of this study was to explore and identify health beliefs and health behaviors affecting diabetes self-management among African American women with type 2 diabetes. Twenty-five African American women aged 46 to 87 years, participated in the study. Community-based women in Pinellas County, Florida, completed semistructured, in-depth interviews, a self-management questionnaire, and a demographic profile. Participant observation occurred at a cross-section of 5 diabetes self-management education classes. Participants were asked about nutritional changes, physical activity, medication use, blood glucose monitoring, physician-patient interaction, support systems, and patient education/knowledge. Findings indicated that a majority of participants used regular exercise, medications, and dietary modifications as a core components model of diabetes self-management. Successful self-management was affected by diabetes beliefs, types of behaviors initiated, and available support systems and resources. Difficulties experienced that affected behavioral outcomes included access to care, costs of medications, pain, testing supplies, and nutritional changes. Findings suggest that modifications to the recommended regimen support or impede participants' efficient self-management of clinically recommended behaviors. Thus, for African American women managing type 2 diabetes, the regimen may necessitate modification models of diabetes self-management, day-to-day behavioral lifestyle adjustments to the biomedically recommended self-management regimen.
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Affiliation(s)
- Bridgett Rahim-Williams
- Department of Behavioral Science and Community Health, College of Public, University of Florida, PO Box 100175, Gainesville, FL 32610-0175, USA.
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11
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Affiliation(s)
- Adele H. Hite
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Center for Balanced Health, New York, New York
| | - Valerie Goldstein Berkowitz
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Center for Balanced Health, New York, New York
| | - Keith Berkowitz
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Center for Balanced Health, New York, New York
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12
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Zamora D, Gordon-Larsen P, He K, Jacobs DR, Shikany JM, Popkin BM. Are the 2005 Dietary Guidelines for Americans Associated With reduced risk of type 2 diabetes and cardiometabolic risk factors? Twenty-year findings from the CARDIA study. Diabetes Care 2011; 34:1183-5. [PMID: 21478463 PMCID: PMC3114488 DOI: 10.2337/dc10-2041] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine the prospective association between accordance with the 2005 Dietary Guidelines for Americans (DGA) and subsequent diabetes incidence and changes in cardiometabolic risk factors. RESEARCH DESIGN AND METHODS The sample consisted of 4,381 black and white young adults examined repeatedly from 1985 to 2005. We used the 2005 Diet Quality Index (DQI) to rate participants' diets based on meeting key dietary recommendations conveyed by the 2005 DGA. RESULTS Overall, we found no association between DQI score and diabetes risk using Cox models adjusted for potential confounders. Higher DQI scores were associated with favorable changes in HDL cholesterol and blood pressure overall (P for trend < 0.05), but with increased insulin resistance among blacks (P for trend < 0.01). CONCLUSIONS Our findings highlight the need for evaluation of the DGA's effectiveness, particularly among ethnic minority populations. Clinicians should be aware that following the DGA might not lower diabetes risk.
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Affiliation(s)
- Daisy Zamora
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Huang CC, Lloyd-Jones DM, Guo X, Rajamannan NM, Lin S, Du P, Huang Q, Hou L, Liu K. Gene expression variation between African Americans and whites is associated with coronary artery calcification: the multiethnic study of atherosclerosis. Physiol Genomics 2011; 43:836-43. [PMID: 21521779 DOI: 10.1152/physiolgenomics.00243.2010] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Coronary artery calcium (CAC) is a strong indicator of total atherosclerosis burden. Epidemiological data have shown substantial differences in CAC prevalence and severity between African Americans and whites. However, little is known about the molecular mechanisms underlying initiation and progression of CAC. Microarray gene expression profiling of peripheral blood leucocytes was performed from 119 healthy women aged 50 yr or above in the Multi-Ethnic Study of Atherosclerosis cohort; 48 women had CAC score >100 and carotid intima-media thickness (IMT) >1 mm, while 71 had CAC <10 and IMT <0.65 mm. When 17 African Americans were compared with 41 whites in the low-CAC group, 409 differentially expressed genes (false discovery rate <5%) were identified. In addition, 316 differentially expressed genes were identified between the high- and low-CAC groups. A substantial overlap between these two gene lists was observed (148 genes, P < 10(-6)). Furthermore, genes expressed lower in African Americans also tend to express lower in individuals with low CAC (correlation 0.69, P = 0.002). Ontology analysis of the 409 race-associated genes revealed significant enrichment in mobilization of calcium and immune/inflammatory response (P < 10(-9)). Of note, 25 of 30 calcium mobilization genes were involved in immune/inflammatory response (P < 10(-10)). Our data suggest a connection between immune response and vascular calcification and the result provides a potential mechanistic explanation for the lower prevalence and severity of CAC in African Americans compared with whites.
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Affiliation(s)
- Chiang-Ching Huang
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, USA.
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14
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Elbein SC, Kern PA, Rasouli N, Yao-Borengasser A, Sharma NK, Das SK. Global gene expression profiles of subcutaneous adipose and muscle from glucose-tolerant, insulin-sensitive, and insulin-resistant individuals matched for BMI. Diabetes 2011; 60:1019-29. [PMID: 21266331 PMCID: PMC3046820 DOI: 10.2337/db10-1270] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To determine altered gene expression profiles in subcutaneous adipose and skeletal muscle from nondiabetic, insulin-resistant individuals compared with insulin-sensitive individuals matched for BMI. RESEARCH DESIGN AND METHODS A total of 62 nondiabetic individuals were chosen for extremes of insulin sensitivity (31 insulin-resistant and 31 insulin-sensitive subjects; 40 were European American and 22 were African American) and matched for age and obesity measures. Global gene expression profiles were determined and compared between ethnic groups and between insulin-resistant and insulin-sensitive participants individually and using gene-set enrichment analysis. RESULTS African American and European American subjects differed in 58 muscle and 140 adipose genes, including many inflammatory and metabolically important genes. Peroxisome proliferator-activated receptor γ cofactor 1A (PPARGC1A) was 1.75-fold reduced with insulin resistance in muscle, and fatty acid and lipid metabolism and oxidoreductase activity also were downregulated. Unexpected categories included ubiquitination, citrullination, and protein degradation. In adipose, highly represented categories included lipid and fatty acid metabolism, insulin action, and cell-cycle regulation. Inflammatory genes were increased in European American subjects and were among the top Kyoto Encyclopedia of Genes and Genomes pathways on gene-set enrichment analysis. FADS1, VEGFA, PTPN3, KLF15, PER3, STEAP4, and AGTR1 were among genes expressed differentially in both adipose and muscle. CONCLUSIONS Adipose tissue gene expression showed more differences between insulin-resistant versus insulin-sensitive groups than the expression of genes in muscle. We confirm the role of PPARGC1A in muscle and show some support for inflammation in adipose from European American subjects but find prominent roles for lipid metabolism in insulin sensitivity independent of obesity in both tissues.
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Affiliation(s)
- Steven C. Elbein
- Section on Endocrinology and Metabolism, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Philip A. Kern
- Division of Endocrinology, Department of Internal Medicine, University of Kentucky School of Medicine, and the Barnstable Brown Diabetes and Obesity Center, Lexington, Kentucky
- Corresponding author: Swapan K. Das, , or Philip A. Kern,
| | - Neda Rasouli
- Division of Endocrinology, Department of Internal Medicine, University of Colorado Denver, Aurora, Colorado
- Veterans Administration, Eastern Colorado Health Care System, Denver, Colorado
| | - Aiwei Yao-Borengasser
- College of Medicine, Endocrinology Division, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Neeraj K. Sharma
- Section on Endocrinology and Metabolism, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Swapan K. Das
- Section on Endocrinology and Metabolism, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
- Corresponding author: Swapan K. Das, , or Philip A. Kern,
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