Interactive effect of high sodium intake with increased serum triglycerides on hypertension

A machine learning analysis of predictors of future hypertension in a young population

BACKGROUND

Early diagnosis of hypertension (HT) is crucial for preventing end-organ damage. This study aims to identify the risk factors for future HT in young individuals through the application of machine learning (ML) models.

METHODS

The study included individuals aged 18-40 years who had not been diagnosed with HT through ambulatory blood pressure monitoring (ABPM). These participants were monitored for hypertension diagnosis from the date of ABPM application until the date of data collection. Hypertension prediction was carried out using three distinct ML methods: Support Vector Machine, Random Forest, and Least Absolute Shrinkage and Selection Operator. The identification of variables significant for future HT was based on the outcomes of these models.

RESULTS

This study comprised 516 patients, with a mean follow-up duration of 793.4±58.6 days. Following the integration of demographic data, laboratory results, and ABPM findings into the ML models, age, high-density lipoprotein cholesterol, triglycerides, and the standard deviation of systolic blood pressure (SDsis) were identified as predictors for future HT. A logistic regression with the selected variables (age, diabetes mellitus history, HDL, triglycerides, white blood cell count, and SDsis) using the full data set gave the following log odds 0.0737 (P<0.001), 0.7146 (P<0.001), -0.0160 (P=0.071), 0.0026 (P=0.002), 0.0857 (P=0.069), and 0.0850 (P=0.005), respectively. The corresponding probability values of age, diabetes mellitus history, HDL, triglycerides, white blood cell count, and SDsis were 0.5184, 0.6714, 0.4960, 0.5006, 0.5214, and 0.5212, respectively. This indicates a unit increase in all factors, except diabetes mellitus history, increases the probability of future HT by 50%. A history of diabetes, however, increases the probability of future HT by more than two thirds. The history of diabetes mellitus emerged as the most crucial predictor of future HT across all applied methods.

CONCLUSIONS

ML methods appear to be valuable tools for predicting future HT. The widespread adoption of these methods and the refinement of more comprehensive models will lay the groundwork for future studies.

Knowledge, attitudes, and practices of oil and salt intake and related influencing factors in Southwestern China

Objects

Excessive oil and salt consumption is a public health issue, notably in China where intakes surpass WHO guidelines. The present study aims to examine the knowledge, attitudes, and practices of Southwestern China residents regarding oil and salt and explore the influencing factors.

Methods

This study used convenience sampling to collect data from 7,367 participants aged 18-75 in the Sichuan, Chongqing, Yunnan, and Guizhou regions of China via on-site face-to-face surveys. Descriptive statistics and generalized linear models were used to analyses knowledge, attitudes, and practices about oil and salt intake and their influencing factors among residents of Southwestern China.

Results

In Southwestern China, residents of Guizhou Province exhibited poor KAP regarding oil and salt. There were urban-rural differences in Yunnan, Sichuan, and Chongqing, and residents living in towns and cities were the favored factors for KAP scores. Groups engaged in self-employment/sales and freelance were risk factors for KAP score. Individuals with higher education was a favorable factor for KAP score. In Yunnan, Sichuan, and Chongqing groups with preference of salty tastes were favorable factors in KAP score. Diabetic patients were more likely to score low on oil and salt-related KAP performance.

Conclusion

In Southwestern China, residents of Guizhou Province displayed poor results in their KAP regarding oil and salt. The region of the province, ethnicity, urban and rural residence, education, taste preference, and prevalence of chronic diseases were the influencing factors of oil and salt-related KAP scores.

Podocyte cell-specific Npr1 is required for blood pressure and renal homeostasis in male and female mice: role of sex-specific differences

Atrial and brain natriuretic peptides (ANP and BNP) bind to guanylyl cyclase A/natriuretic peptide receptor A (GC-A/NPRA), stimulating natriuresis and diuresis and reducing blood pressure (BP), but the role of ANP/NPRA signaling in podocytes (highly specialized epithelial cells covering the outer surfaces of renal glomerular capillaries) remains unclear. This study aimed to determine the effect of conditional deletion of podocyte-specific Npr1 (encoding NPRA) gene knockout (KO) in male and female mice. Tamoxifen-treated wild-type control (PD Npr1 f/f; WT), heterozygous (PD-Cre-Npr1 f/+; HT), and KO (PD-Cre-Npr1 f/-) mice were fed a normal-, low-, or high-salt diet for 4 wk. Podocytes isolated from HT and KO male and female mice showed complete absence of Npr1 mRNA and NPRA protein compared with WT mice. BP, plasma creatinine, plasma sodium, urinary protein, and albumin/creatinine ratio were significantly increased, whereas plasma total protein, albumin, creatinine clearance, and urinary sodium levels were significantly reduced in the HT and KO male and female mice compared with WT mice. These changes were significantly greater in males than in females. On a normal-salt diet, glomerular filtration rate was significantly decreased in PD Npr1 HT and KO male and female mice compared with WT mice. Immunofluorescence of podocin and synaptopodin was also significantly reduced in HT and KO mice compared with WT mice. These observations suggest that in podocytes, ANP/NPRA signaling may be crucial in the maintenance and regulation of glomerular filtration and BP and serve as a biomarker of renal function in a sex-dependent manner.NEW & NOTEWORTHY Our results demonstrate that the podocyte-specific deletion of Npr1 showed increased blood pressure (BP) and altered biomarkers of renal functions, with greater magnitudes in animals fed a high-salt diet in a sex-dependent manner. The results suggest a direct and sex-dependent effect of Npr1 ablation in podocytes on the regulation of BP and renal function and reveal that podocytes may be considered an important target for the ANP-BNP/NPRA/cGMP signaling cascade.

Association between urinary sodium and circulating lipid levels: a Mendelian randomization study

Background

Urinary sodium was indicated to be associated with dyslipidemia, but inconsistent conclusions for this association exist across the present observational studies.

Objectives

This study aimed to evaluate the causal association between urinary sodium and circulating lipid levels [low-density lipoprotein cholesterol (LDL-C), triglycerides, and high-density lipoprotein cholesterol (HDL-C)] through Mendelian randomization.

Methods

Univariable Mendelian randomization (UVMR) and multivariable Mendelian randomization (MVMR) with pleiotropy-resistant methods were performed. Data for urinary sodium were obtained from the genome-wide association study (GWAS) from 446,237 European individuals. Data for lipid profiles were extracted from GWAS based on the UK Biobank (for the discovery analysis) and the Global Lipids Genetics Consortium (for the replication analysis).

Results

In the discovery analysis, UVMR provided evidence that per 1-unit log-transformed genetically increased urinary sodium was associated with a lower level of HDL-C level (beta = -0.32; 95% CI: -0.43, -0.20; p = 7.25E-08), but not with LDL-C and triglycerides. This effect was still significant in the further MVMR when considering the effect of BMI or the other two lipid contents. In contrast, higher genetically predicted triglycerides could increase urinary sodium in both UVMR (beta = 0.030; 95% CI: 0.020, -0.039; p = 2.12E-10) and MVMR analyses (beta = 0.029; 95% CI: 0.019, 0.037; p = 8.13E-10). Similar results between triglycerides and urinary sodium were found in the replication analysis.

Conclusion

Increased urinary sodium may have weak causal effects on decreased circulating HDL-C levels. Furthermore, genetically higher triglyceride levels may have independent causal effects on increased urinary sodium excretion.

Beneficial Short-Term Effects of Bariatric Surgery on Nutritional Inflammatory Profile and Metabolic Biomarkers

PURPOSE

Bariatric surgery (BS) has several potential metabolic benefits. However, little is known about its impact on changes in the inflammatory potential of diet and its effect on inflammatory and metabolic markers. This study aimed to assess the short-term beneficial effects of BS on dietary inflammatory potential and inflammatory and metabolic markers.

MATERIALS AND METHODS

Participants (n = 20) were evaluated 3 months before and after BS. Body mass, body mass index, anthropometric measurements, fat mass, fat-free mass, visceral fat, skeletal muscle mass, basal metabolic rate, serum lipids, HOMA-IR, QUICKI and inflammatory markers, including leptin, adiponectin, adiponectin/leptin ratio and plasminogen activator inhibitor-1 (PAI-1), were evaluated. Diet data were collected using a 3-day diet record and the dietary inflammatory index (DII®) and energy-adjusted dietary inflammatory index (E-DIITM) scores were computed.

RESULTS

There was a reduction in DII® (2.56 vs 2.13) and E-DIITM (2.18 vs 0.45) indicating an improvement in inflammatory nutritional profile. Moreover, there were increases in the adiponectin/leptin ratio (0.08 vs 0.21) and QUICKI scores (0.31 vs 0.37), and reductions in leptin (36.66 vs 11.41 ng/ml) and HOMA-IR scores (3.93 vs 1.50). There were also improvements in body composition and anthropometric parameters.

CONCLUSIONS

BS promotes changes in metabolic profile, inflammatory state and food intake and these modifications appeared to be associated with improvements in diet-related inflammation, an increase in the adiponectin/leptin ratio and a reduction in leptin. These results contribute to knowledge on the contribution bariatric surgery can make to the treatment of obesity and the reduction of related comorbidities.

Connecting the dots in the associations between diet, obesity, cancer, and microRNAs

The prevalence of obesity has reached pandemic levels worldwide, leading to a lower quality of life and higher health costs. Obesity is a major risk factor for noncommunicable diseases, including cancer, although obesity is one of the major preventable causes of cancer. Lifestyle factors, such as dietary quality and patterns, are also closely related to the onset and development of obesity and cancer. However, the mechanisms underlying the complex association between diet, obesity, and cancer remain unclear. In the past few decades, microRNAs (miRNAs), a class of small non-coding RNAs, have been demonstrated to play critical roles in biological processes such as cell differentiation, proliferation, and metabolism, highlighting their importance in disease development and suppression and as therapeutic targets. miRNA expression levels can be modulated by diet and are involved in cancer and obesity-related diseases. Circulating miRNAs can also mediate cell-to-cell communications. These multiple aspects of miRNAs present challenges in understanding and integrating their mechanism of action. Here, we introduce a general consideration of the associations between diet, obesity, and cancer and review the current knowledge of the molecular functions of miRNA in each context. A comprehensive understanding of the interplay between diet, obesity, and cancer could be valuable for the development of effective preventive and therapeutic strategies in future.

Positive association of triglyceride-glucose index with new-onset hypertension among adults: a national cohort study in China

BACKGROUND

Previous studies showed that the triglyceride-glucose (TyG) index was a better predictor of adverse cardiovascular events than triglycerides or fasting blood glucose alone. However, few studies have focused on new-onset hypertension. We aimed to explore the association of TyG index with new-onset hypertension in Chinese adults.

METHODS

A total of 4,600 participants who underwent at least 2 rounds of visits from 2009 to 2015 in the China Health and Nutrition Survey were enrolled in this study. Our outcome of interest was new-onset hypertension. Multivariate Cox hazard regression models and restricted cubic spline were performed to explore the relationship between TyG index and new-onset hypertension.

RESULTS

The mean (standard deviation, SD) age of the study population was 48.1 (13.6) years, and 2058 (44.7%) of the participants were men. The mean (SD) TyG index level was 8.6 (0.7). A total of 1,211 (26.3%) participants developed new-onset hypertension during a median (interquartile range) follow-up duration of 6.0 (2.0-6.1) years. The incidences of new-onset hypertension were 18.1%, 25.3%, 28.5%, and 33.4% by quartiles of TyG index [from quartile 1 (Q1) to Q4], respectively. The Cox model showed that high levels of TyG index were significantly associated with increased risk of new-onset hypertension (adjusted hazard ratio [aHR]: 1.29, 95% confidence interval [CI] 1.07-1.55, Q2; aHR, 1.24, 95% CI 1.03-1.49, Q3; aHR, 1.50, 95% CI 1.22-1.84, Q4) compared with Q1. Consistently, as a continuous variable, for every 1.0 increase in TyG index, there was a 17% increase in the risk of new-onset hypertension (aHR, 1.17; 95% CI 1.04-1.31). The associations were consistent in various subgroups and sensitivity analysis. The dose-response curve indicated a positive, linear association between TyG index and the risk of new-onset hypertension.

CONCLUSIONS

High TyG index was significantly associated with an increased risk of new-onset hypertension among Chinese adults. Our findings suggest that maintaining a relatively low level of TyG index might be effective in the primary prevention of hypertension.

Higher dietary magnesium and potassium intake are associated with lower body fat in people with impaired glucose tolerance

Introduction

Obesity and diabetes are public health concerns worldwide, but few studies have examined the habitual intake of minerals on body composition in people with prediabetes.

Methods

In this prospective cross-sectional study, 155 Chinese subjects with IGT [median age: 59 (53-62) years, 58% female] had an assessment of body composition including body fat percentage, oral glucose tolerance tests (OGTT), Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and 3-day food records from nutritional programme analysis.

Results

Dietary intake of minerals was negatively correlated with body fat. People with obesity had the lowest daily consumption of iron median (IQR) 10.3 (6.9-13.3) mg, magnesium 224 (181-282) mg, and potassium 1973 (1563-2,357) mg when compared to overweight [10.5 (8.0-14.5) mg, 273 (221-335) mg, and 2,204 (1720-2,650) mg] and normal weight individuals [13.2 (10.0-18.6) mg, 313 (243-368) mg, and 2,295 (1833-3,037) mg] (p = 0.008, <0.0001, and 0.013 respectively). Amongst targeted minerals, higher dietary magnesium and potassium intake remained significantly associated with lower body fat after the adjustment of age, gender, macronutrients, fibre, and physical activity.

Conclusion

Dietary magnesium and potassium intake may be associated with lower body fat in people with impaired glucose tolerance. Inadequate dietary mineral intake may play contribute to obesity and metabolic disorders independent of macronutrients and fibre consumption.

The World Hypertension League Science of Salt: a regularly updated systematic review of salt and health outcomes studies (Sept 2019 to Dec 2020)

The World Hypertension League Science of Salt health outcomes review series highlights high-quality publications relating to salt intake and health outcomes. This review uses a standardised method, outlined in previous reviews and based on methods developed by WHO, to identify and critically appraise published articles on dietary salt intake and health outcomes. We identified 41 articles published between September 2019 to December 2020. Amongst these, two studies met the pre-specified methodological quality criteria for critical appraisal. They were prospective cohort studies and examined physical performance and composite renal outcomes as health outcomes. Both found an association between increased/higher sodium intake and poorer health outcomes. Few studies meet criteria for high-quality methods. This review adds further evidence that dietary salt reduction has health benefits and strengthens evidence relating to health outcomes other than blood pressure and cardiovascular disease. We observe that most studies on dietary sodium do not have adequate methodology to reliably assess sodium intake and its association with health outcomes.

Evaluation of Nutritional Ingredients, Biologically Active Materials, and Pharmacological Activities of Stropharia rugosoannulata Grown under the Bamboo Forest and in the Greenhouse

Evaluations of the nutritional ingredients, biologically active materials, and pharmacological activities (antibacterial and antioxidant) of two types of Stropharia rugosoannulata, grown under the bamboo forest and in the greenhouse, respectively, were carried out in this study. The nutritional ingredient tests included moisture, ash, crude protein, crude fat, crude fiber, total carbohydrates, total sugar, mineral elements, vitamins, and amino acids. The biologically active material assays included total flavonoids, total polysaccharides, total triterpenoids, and reducing sugars. In addition, a broth microdilution susceptibility test was performed to evaluate antibacterial activity. The antioxidant activity was measured by ABTS+ radical scavenging, ferric-reducing power, and β-carotene bleaching assays. Results showed that two types of S. rugosoannulata were rich in protein, carbohydrate, fiber, mineral, B-group vitamins, polysaccharides, triterpenoids, and reducing sugars, with low content of fat and low Na/K ratio. Besides, they were effective in antibacterial and antioxidant activities, while S. Rugosoannulata grown under the bamboo forest was better than the greenhouse one in some respects such as higher content of protein, calcium, selenium, nicotinic acid, folic acid, polysaccharides and triterpenoids, and stronger antibacterial and antioxidant activities. They were appropriate for functional food and nutritional supplements, especially bamboo forest.