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Mínguez Ojeda C, Gómez Dos Santos V, Lorca JÁ, Ruz-Caracuel I, Pian H, Sanjuanbenito Dehesa A, Burgos Revilla FJ, Araujo-Castro M. Influence of obesity and overweight in surgical outcomes of adrenalectomy for primary adrenal disease: A cohort study of 146 cases. ENDOCRINOL DIAB NUTR 2023; 70:564-571. [PMID: 37996201 DOI: 10.1016/j.endien.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/02/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE To evaluate the impact of obesity and overweight on surgical outcomes in a large cohort of patients who underwent adrenalectomy due to benign or malignant primary adrenal disease. METHODS A retrospective single-center study of patients without history of active extraadrenal malignancy, with adrenal tumors operated on consecutively in our center between January 2010 and December 2022. Obesity was defined as a body mass index (BMI)≥30kg/m2 and overweight as BMI between 25.0 and 30.0kg/m2. RESULTS Of 146 patients with adrenal tumors who underwent adrenalectomy, 9.6% (n=14) were obese, 54.8% (n=80) overweight and 35.6% (n=52) normal weight. Obese patients had higher diastolic blood pressure (87.6±12.22 vs. 79.3±10.23mmHg, P=0.010) and a higher prevalence of dyslipidemia (57.1% vs. 25.8%, P=0.014) and bilateral tumors (14.3% vs. 3.1%, P=0.044) than non-obese patients. The rates of intraoperative and of postsurgical complications were similar between obese/overweight patients and patients with normal weight. However, a significantly higher rate of postsurgical complications (27.3% vs. 5.7%, P=0.009) and a longer hospital stay (5.4±1.39 vs. 3.5±1.78 days, P=0.007) were observed in patients with obesity than in non-obese patients. In the multivariant analysis, obesity, age, ASA>2 and tumor size were independent risk factors for postoperative complications, with obesity being the most important factor (OR 23.34 [2.23-244.24]). CONCLUSION Obesity and overweight are common conditions in patients who undergo adrenalectomy. Adrenalectomy is considered a safe procedure in patients with overweight, but it is associated with a higher risk of postsurgical complications and longer hospital stay in obese patients.
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Affiliation(s)
- César Mínguez Ojeda
- Urology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | | | - Javier Álvaro Lorca
- Urology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Ignacio Ruz-Caracuel
- Pathology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Héctor Pian
- Pathology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | | | | | - Marta Araujo-Castro
- Endocrinology & Nutrition Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Medicine Department, University of Alcalá, Madrid, Spain.
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Zhao Y, Shao W, Zhu Q, Zhang R, Sun T, Wang B, Hu X. Association between systemic immune-inflammation index and metabolic syndrome and its components: results from the National Health and Nutrition Examination Survey 2011-2016. J Transl Med 2023; 21:691. [PMID: 37794370 PMCID: PMC10548719 DOI: 10.1186/s12967-023-04491-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/30/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS), a worldwide public health problem, affects human health and quality of life in a dramatic manner. A growing evidence base suggests that MetS is strongly associated with levels of systemic immune inflammation. The present study aimed to investigate the possible relationship between the systemic immune-inflammation index (SII), a novel inflammatory marker, and MetS to provide data support for effective MetS prevention by reducing the systemic inflammatory response. METHODS We included adult participants with complete SII and MetS information from the 2011-2016 National Health and Nutrition Examination Survey (NHANES). MetS was defined as using the criteria developed by the Adult Treatment Program III of the National Cholesterol Education Program. The formula for SII was as follows: SII = platelet counts × neutrophil counts/ lymphocyte counts. Weighted linear regression was used to assess differences in variables across SII quartile groups after the SII score was divided into 4 quartiles. The independent interaction between SII and MetS was investigated using weighted multivariate logistic regression analysis and subgroup analysis, and the relationship between SII levels and 5 particular MetS items was further explored in depth. RESULTS A total of 12,402 participants, 3,489 of whom were diagnosed with MetS, were included in this study. After correcting for covariates, the results of a logistic regression of multistage weighted complex sampling data revealed that participants with higher SII scores had a higher chance of developing MetS (odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.14-1.55) and that SII levels could be used as an independent risk factor to predict that likelihood of MetS onset. In the Q1-Q4 SII quartile group, the risk of developing MetS was 1.33 times higher in the Q4 group, which had the highest level of systemic immune inflammation than in the Q1 group. After adjusting for all confounding factors, SII scores were found to have a negative correlation with high-density lipoprotein cholesterol (OR = 1.29; 95% CI, 0.99-1.67, P = 0.056) and a significant positive correlation with waist circumference (OR = 2.17; 95% CI, 1.65-2.87, P < 0.001) and blood pressure (BP) (OR = 1.65; 95% CI, 1.20-2.27, P = 0.003). Gender, age, and smoking status were shown to alter the positive association between SII and MetS in subgroup analyses and interaction tests (p for interaction < 0.05). Additionally, we demonstrated a nonlinear correlation between SII and MetS. The findings of the restricted cubic spline indicated that there was an inverted U-shaped association between SII and MetS. CONCLUSIONS Our findings imply that increased SII levels are related to MetS, and SII may be a simple and cost-effective method to identify individuals with MetS. Therefore, protective measures such as early investigation and anti-inflammatory interventions are necessary to reduce the overall incidence of MetS.
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Affiliation(s)
- Yang Zhao
- Department of Nuclear Medicine, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Basic Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Wenyu Shao
- Department of Nuclear Medicine, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Basic Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Qihan Zhu
- Department of Basic Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Rui Zhang
- Department of Basic Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Tao Sun
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, China.
| | - Bijia Wang
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Xiaofei Hu
- Department of Nuclear Medicine, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
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Abiri A, Goshtasbi K, Birkenbeue JL, Lin HW, Djalilian HR, Hsu FPK, Kuan EC. Obesity as a Risk Factor for Postoperative Adverse Events in Skull Base Surgery. Ann Otol Rhinol Laryngol 2022; 131:1381-1389. [PMID: 35081772 DOI: 10.1177/00034894221074745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the implications of obesity on postoperative adverse events following skull base surgery. METHODS The 2005-2017 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for adverse events in skull base surgery cases. Patients were stratified by body mass index (BMI) into normal weight (18.5 ≤ BMI < 25), overweight (25 ≤ BMI < 30), and obese (BMI ≥ 30) cohorts. Logistic regression was used to assess the association of overweight or obese BMI with various 30-day postoperative adverse events. RESULTS A total of 2305 patients were included for analysis, of which 732 (31.8%) and 935 (40.6%) were overweight or obese, respectively. The mean age was 53.8 ± 15.3 years and 1214 (52.7%) patients were female. Obese patients were younger (P = .033) and possessed higher frailty (P < .001) and ASA scores (P < .001). Operation times and lengths of hospitalization were not significantly different across patient cohorts (all P > .05). On propensity score-adjusted multivariable analysis, only bleeding (OR = 0.42, P < .001) and deep vein thrombosis (OR = 6.46, P = .015) were significantly associated with obesity. There were no significant differences in rates of readmission, reoperation, or mortality between normal weight and obese patients (all P > .05). CONCLUSIONS Obesity was associated with decreased postoperative bleeding and increased deep vein thromboses. Obese patients were otherwise at no higher risk for medical or surgical complications. Elevated BMI did not confer an increased risk for readmission, reoperation, or death. Thus, patient obesity should not be a major determinant in offering skull base surgery in individuals who would otherwise benefit from treatment.
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Affiliation(s)
- Arash Abiri
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, CA, USA
| | - Khodayar Goshtasbi
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, CA, USA
| | - Jack L Birkenbeue
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, CA, USA
| | - Harrison W Lin
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, CA, USA
| | - Hamid R Djalilian
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, CA, USA
| | - Frank P K Hsu
- Department of Neurological Surgery, University of California, Irvine, Orange, CA, USA
| | - Edward C Kuan
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, CA, USA.,Department of Neurological Surgery, University of California, Irvine, Orange, CA, USA
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Filippatos TD, Alexakis K, Mavrikaki V, Mikhailidis DP. Nonalcoholic Fatty Pancreas Disease: Role in Metabolic Syndrome, "Prediabetes," Diabetes and Atherosclerosis. Dig Dis Sci 2022; 67:26-41. [PMID: 33469809 DOI: 10.1007/s10620-021-06824-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 01/05/2021] [Indexed: 02/06/2023]
Abstract
Fat accumulation in the pancreas associated with obesity and the metabolic syndrome (MetS) has been defined as "non-alcoholic fatty pancreas disease" (NAFPD). The aim of this review is to describe the association of NAFPD with obesity, MetS, type 2 diabetes mellitus (T2DM) and atherosclerosis and also increase awareness regarding NAFPD. Various methods are used for the detection and quantification of pancreatic fat accumulation that may play a significant role in the differences that have been observed in the prevalence of NAFPD. Endoscopic ultrasound provides detailed images of the pancreas and its use is expected to increase in the future. Obesity and MetS have been recognized as NAFPD risk factors. NAFPD is strongly associated with non-alcoholic fatty liver disease (NAFLD) and it seems that the presence of both may be related with aggravation of NAFLD. A role of NAFPD in the development of "prediabetes" and T2DM has also been suggested by most human studies. Accumulation of fat in pancreatic tissue possibly initiates a vicious cycle of beta-cell deterioration and further pancreatic fat accumulation. Additionally, some evidence indicates a correlation between NAFPD and atherosclerotic markers (e.g., carotid intima-media thickness). Weight loss and bariatric surgery decreases pancreatic triglyceride content but pharmacologic treatments for NAFPD have not been evaluated in specifically designed studies. Hence, NAFPD is a marker of local fat accumulation possibly associated with beta-cell function impairment, carbohydrate metabolism disorders and atherosclerosis.
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Affiliation(s)
- T D Filippatos
- Metabolic Diseases Research Unit, Internal Medicine Laboratory, School of Medicine, Faculty of Medicine, University of Crete, P.O. Box 2208, Heraklion, Crete, Greece.
| | - K Alexakis
- Metabolic Diseases Research Unit, Internal Medicine Laboratory, School of Medicine, Faculty of Medicine, University of Crete, P.O. Box 2208, Heraklion, Crete, Greece
| | - V Mavrikaki
- Metabolic Diseases Research Unit, Internal Medicine Laboratory, School of Medicine, Faculty of Medicine, University of Crete, P.O. Box 2208, Heraklion, Crete, Greece
| | - D P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, NW3 2QG, UK.,Mohammed Bin Rashid University (MBRU) of Medicine and Health Sciences, Dubai, United Arab Emirates
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5
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Panayi AC, Haug V, Kauke-Navarro M, Diehm YF, Pomahac B. The Impact of Metabolic Syndrome on Microvascular Head and Neck Reconstruction: An ACS-NSQIP data analysis. J Plast Reconstr Aesthet Surg 2021; 75:1360-1371. [PMID: 34955390 DOI: 10.1016/j.bjps.2021.11.074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 10/05/2021] [Accepted: 11/14/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) can predispose patients to poorer surgical outcomes. In this study, we sought to evaluate the impact of MetS on the postoperative outcomes of head and neck microvascular reconstruction. METHODS Review of the 2015-2019 NSQIP database identified 5,323 cases of microvascular reconstruction, of which 3,809 were head and neck cases. Of the included patients, 184 had MetS and 3625 did not. The groups were compared in terms of demographics and comorbidities. Postoperative outcomes assessed included mortality, average operative time and length of hospital stay, surgical and medical complications, and nonhome discharge. RESULTS The MetS group had higher rates of medical complications (p<0.0001), sepsis (p=0.02), septic shock (p=0.01), and skilled care-discharge (p=0.0004). Analysis by flap type revealed that MetS patients receiving free skin flaps experienced higher rates of organ space infection (p=0.02), sepsis (p<0.0001), and lower home-discharge (p=0.01). In the free muscle group, superficial incisional infection (p=0.04), UTI (p=0.02), and septic shock (p=0.01) were higher in MetS patients. Stratification by surgical site showed that the occurrence of sepsis was significantly higher in the patients receiving microvascular flap reconstruction of the larynx (p=0.04) or tongue(p=0.03). Stratification of the MetS patients according to treatment for diabetes showed that patients receiving insulin experienced a higher rate of superficial incisional infection (p=0.04). A multivariate analysis verified significantly higher rates of medical complications (p<0.0001), sepsis (p=0.03) and septic shock (p=0.01) in the MetS group. CONCLUSION Patients with MetS undergoing head and neck microvascular reconstruction are at increased risk of postoperative medical complications, including sepsis and septic shock, and are more likely to be discharged to a skilled care facility. Surgical outcomes were found to depend on the type of flap and site of surgery.
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Affiliation(s)
- Adriana C Panayi
- Department of Surgery, Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, 02115 Boston, USA
| | - Valentin Haug
- Department of Hand-, Plastic and Reconstructive Surgery, Microsurgery, Burn Trauma Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - Martin Kauke-Navarro
- Department of Surgery, Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, 02115 Boston, USA
| | - Yannick F Diehm
- Department of Hand-, Plastic and Reconstructive Surgery, Microsurgery, Burn Trauma Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - Bohdan Pomahac
- Department of Surgery, Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, 02115 Boston, USA.
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Jialal I, Jialal G, Adams-Huet B. The platelet to high density lipoprotein -cholesterol ratio is a valid biomarker of nascent metabolic syndrome. Diabetes Metab Res Rev 2021; 37:e3403. [PMID: 32886844 DOI: 10.1002/dmrr.3403] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/24/2020] [Accepted: 08/28/2020] [Indexed: 01/06/2023]
Abstract
AIMS The metabolic syndrome (MetS) is a major global problem, and inflammation and insulin resistance appear to be key underpinnings in this cardio-metabolic cluster. MetS predisposes to an increased risk of diabetes and atherosclerotic cardiovascular disease (ASCVD). It has a procoagulant diathesis which included increased platelet activity and impaired fibrinolysis. High density lipoprotein (HDL) appears to be anti-thrombotic. Accordingly, we examined the ratios between platelets to HDL-cholesterol(C) and adiponectin (Adipo) in patients with nascent MetS without the confounding of diabetes, ASCVD and smoking to determine their validity as biomarkers of MetS. METHODS Patients with nascent MetS (n = 58) and matched controls (n = 44) were recruited. Fasting blood samples were obtained for complete blood counts, basic metabolic panel, lipids, insulin, and Adipo. Ratios of platelets to HDL-C and Adipo were calculated. RESULTS Following adjustment for adiposity, only the platelet: HDL ratio was significantly increased in MetS and increased with severity of MetS. Receiver operating characteristic curve analysis showed that the platelet: HDL-C area under the curve (AUC) significantly added to both platelets and platelet lymphocyte ratio AUCs. Also the platelet: HDL-C ratio correlated with all cardio-metabolic features of MetS, high sensitivity C-reactive protein, insulin resistance chemerin, and leptin. CONCLUSIONS The ratio of platelets: HDL-C is significantly increased in patients with nascent MetS and appear to be a valid biomarker of MetS. It could also emerge as a biomarker for athero-thrombotic risk. However, these preliminary findings need confirmation in large prospective studies.
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Affiliation(s)
- Ishwarlal Jialal
- Department of Pathology and Laboratory Medicine, Section of Clinical Chemistry, Veterans Affairs Medical Center, Mather, California, USA
| | - Ganesh Jialal
- Physical Therapy, Stanbridge University, Irvine, California, USA
| | - Beverley Adams-Huet
- Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, Texas, USA
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Abstract
Pathogenesis of the novel coronavirus infection COVID-19 is the subject of active research around the world. COVID-19 caused by the SARS-CoV-2 is a complex disease in which interaction of the virus with target cells, action of the immune system and the body’s systemic response to these events are closely intertwined. Many respiratory viral infections, including COVID-19, cause death of the infected cells, activation of innate immune response, and secretion of inflammatory cytokines. All these processes are associated with the development of oxidative stress, which makes an important contribution to pathogenesis of the viral infections. This review analyzes information on the oxidative stress associated with the infections caused by SARS-CoV-2 and other respiratory viruses. The review also focuses on involvement of the vascular endothelium in the COVID-19 pathogenesis.
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Affiliation(s)
- B V Chernyak
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, 119991, Russia
| | - E N Popova
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, 119991, Russia
| | - A S Prikhodko
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, 119991, Russia.,Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, Moscow, 119991, Russia
| | - O A Grebenchikov
- Negovsky Scientific Research Institute of General Reanimatology, Moscow, 107031, Russia
| | - L A Zinovkina
- Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, Moscow, 119991, Russia
| | - R A Zinovkin
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, 119991, Russia. .,Institute of Mitoengineering, Lomonosov Moscow State University, Moscow, 119992, Russia.,Institute of Molecular Medicine, Sechenov First Moscow State Medical University, Moscow, 119991, Russia
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8
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Elsamna ST, Suri P, Mir GS, Roden DF, Paskhover B. Evaluating the impact of metabolic syndrome on postoperative thyroidectomy outcomes. Head Neck 2020; 43:1271-1279. [PMID: 33368806 DOI: 10.1002/hed.26588] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/19/2020] [Accepted: 12/17/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Metabolic syndrome (MetS) has previously been linked to increased risk of postoperative morbidity and mortality in other surgical undertakings. Because MetS is a consequence of endocrine dysfunction, and given the thyroid's crucial role in endocrine homeostasis, we sought to evaluate the association between MetS and postoperative outcomes of thyroidectomy. METHODS Data were acquired from the ACS-NSQIP database from years 2005 to 2017. Patients with obesity, diabetes, and hypertension were defined as having MetS. Odds ratios (OR) were obtained for outcomes to quantify risk with multivariate logistic regression. RESULTS Outcomes significantly affected by MetS included overall complication (OR: 2.00), extended postoperative stay (OR: 1.52), medical complication (OR: 1.48), surgical complication (OR: 1.62), and mortality (OR: 2.33). CONCLUSIONS Patients with MetS undergoing thyroidectomy are at increased risk of an increased length of stay, overall complications, and mortality.
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Affiliation(s)
- Samer T Elsamna
- Department of Otolaryngology - Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Pooja Suri
- Department of Otolaryngology - Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Ghayoour S Mir
- Department of Otolaryngology - Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Dylan F Roden
- Department of Otolaryngology - Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Boris Paskhover
- Department of Otolaryngology - Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
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Myasoedov NF, Lyapina LA, Andreeva LA, Grigorieva ME, Obergan TY, Shubina TA. The modern view on the role of glyprolines by metabolic syndrome. Med Res Rev 2020; 41:2823-2840. [DOI: 10.1002/med.21748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 09/17/2020] [Accepted: 10/20/2020] [Indexed: 12/22/2022]
Affiliation(s)
| | | | | | | | - Tamara Y. Obergan
- Department of Biology M. V. Lomonosov Moscow State University Moscow Russia
| | - Tatiana A. Shubina
- Department of Biology M. V. Lomonosov Moscow State University Moscow Russia
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Chocair PR, Neves PDMDM, Pereira LVB, Mohrbacher S, Oliveira ES, Nardotto LL, Bales AM, Sato VAH, Ferreira BMC, Cuvello Neto AL. Covid-19 and Metabolic Syndrome. ACTA ACUST UNITED AC 2020; 66:871-875. [PMID: 32844933 DOI: 10.1590/1806-9282.66.7.871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 05/23/2020] [Indexed: 01/18/2023]
Affiliation(s)
| | | | | | - Sara Mohrbacher
- Serviço de Clínica Médica, Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brasil
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Anagnostis P, Paschou SA, Katsiki N, Krikidis D, Lambrinoudaki I, Goulis DG. Menopausal Hormone Therapy and Cardiovascular Risk: Where are we Now? Curr Vasc Pharmacol 2020; 17:564-572. [PMID: 29984659 DOI: 10.2174/1570161116666180709095348] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 06/05/2018] [Accepted: 06/15/2018] [Indexed: 12/15/2022]
Abstract
Transition to menopause is associated with an increase in cardiovascular disease (CVD) risk, mainly attributed to lipid and glucose metabolism dysregulation, as well as to body fat redistribution, leading to abdominal obesity. Indeed, epidemiological evidence suggests that both early menopause (EM, defined as age at menopause <45 years) and premature ovarian insufficiency (POI, defined as age at menopause <40 years) are associated with 1.5-2-fold increase in CVD risk. Menopausal hormone therapy (MHT) exerts a favorable effect on CVD risk factors (with subtle differences regarding oestrogen dose, route of administration, monotherapy or combination with progestogen and type of progestogen). Concerning CVD morbidity and mortality, most studies have shown a beneficial effect of MHT in women at early menopausal age (<10 years since the final menstrual period) or younger than 60 years. MHT is strongly recommended in women with EM and POI, as these women, if left untreated, are at risk of CVD, osteoporosis, dementia, depression and premature death. MHT has also a favorable benefit/ risk profile in perimenopausal and early postmenopausal women, provided that the patient is not at a high CVD risk (as assessed by 10-year calculation tools). Transdermal oestrogens have a lower risk of thrombosis compared with oral regimens. Concerning progestogens, natural progesterone and dydrogesterone have a neutral effect on CVD risk factors. In any case, the decision for MHT should be individualized, tailored according to the symptoms, patient preference and the risk of CVD, thrombotic episodes and breast cancer.
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Affiliation(s)
- Panagiotis Anagnostis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavroula A Paschou
- Division of Endocrinology and Diabetes, "Aghia Sophia" Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Niki Katsiki
- 2nd Propedeutic Department of Internal Medicine, "Hippokration General Hospital", Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Krikidis
- 2nd Cardiology Department, "Hippokration General Hospital", Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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12
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Kostapanos MS, Cacciottolo PJ, Hubsch A, Pavey H, Hurlock J, Maki-Petaja K, Wilkinson IB, Cheriyan J. Investigating the lowest threshold of vascular benefits from LDL cholesterol lowering with a PCSK9 mAb inhibitor (alirocumab) in healthy volunteers - a mechanistic physiological study (INTENSITY-LOW): protocol and study rationale. J Drug Assess 2019; 8:167-174. [PMID: 31692938 PMCID: PMC6818119 DOI: 10.1080/21556660.2019.1677673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 09/25/2019] [Indexed: 11/15/2022] Open
Abstract
Objective: Whether reducing low density lipoprotein cholesterol (LDL-C) is associated with cardiovascular benefits in low risk normocholesterolaemic subjects is unknown. The INTENSITY LOW [Investigating the lowest threshold of vascular benefits from LDL-cholesterol lowering with a PCSK9 mAb inhibitor (alirocumab) in healthy volunteers] study aims to assess whether lowering LDL-C by alirocumab monotherapy can improve endothelial-dependent vascular function compared with placebo (primary objective) in low-risk normocholesterolaemic healthy individuals. Changes in endothelial-dependent or endothelial-independent vascular function, arterial stiffness and biomarkers of systemic inflammation by alirocumab, atorvastatin or their combination are secondary objectives. Study design and methods: This is a single-center, randomized, two-period, single-blind, placebo-controlled clinical trial. The study was registered on clinicaltrials.gov (N03273972). It will include 30 healthy low-risk subjects with LDL-C < 4.1 mmol/l. After passing the screening visit (Visit 1), eligible participants will be randomized 1:1 to either subcutaneous alirocumab 150 mg or placebo. These will be administered as single doses in 2 visits 14 days apart (Visits 2 and 3). Atorvastatin 20 mg once nightly will be prescribed for 14 days at Visit 3 in both groups through to Visit 4. At baseline (Visit 2) and during all post-dose visits (Visits 3–4), endothelial function will be assessed using venous occlusion plethysmography. Specifically, changes in forearm blood flow responses to intra-arterial infusions of acetylcholine, sodium nitroprusside and L-NG-monomethyl-arginine acetate will be assessed as surrogates of endothelial-dependent and -independent vasodilatation. Additionally, arterial stiffness and carotid intima-media thickness will be evaluated at the same timepoints. The above-mentioned changes will be correlated with changes in lipid and systemic inflammation biomarkers.
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Affiliation(s)
- Michael S Kostapanos
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK.,Lipid Clinic, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Paul J Cacciottolo
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK
| | - Annette Hubsch
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK
| | - Holly Pavey
- Cardiovascular Trials Office, Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - James Hurlock
- Cardiovascular Trials Office, Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Kaisa Maki-Petaja
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK
| | - Ian B Wilkinson
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK.,Cardiovascular Trials Office, Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Joseph Cheriyan
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK.,Cardiovascular Trials Office, Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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13
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Shariq OA, Fruth KM, Hanson KT, Cronin PA, Richards ML, Farley DR, Thompson GB, Habermann EB, Mckenzie TJ. Metabolic syndrome is associated with increased postoperative complications and use of hospital resources in patients undergoing laparoscopic adrenalectomy. Surgery 2018; 163:167-75. [DOI: 10.1016/j.surg.2017.06.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/21/2017] [Accepted: 06/13/2017] [Indexed: 01/08/2023]
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14
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Pedro-Botet J, Ascaso JF, Barrios V, De la Sierra A, Escalada J, Millán J, Mostaza JM, Pérez-Martínez P, Pintó X, Salas-Salvadó J, Valdivielso P. COSMIC project: consensus on the objectives of the metabolic syndrome in clinic. Diabetes Metab Syndr Obes 2018; 11:683-697. [PMID: 30464566 PMCID: PMC6217133 DOI: 10.2147/dmso.s165740] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Metabolic syndrome (MetS), a disorder with a high and growing prevalence, is a recognized risk factor for cardiovascular disease (CVD) and type 2 diabetes. It is a constellation of clinical and metabolic risk factors that include abdominal obesity, dyslipidemia, glucose intolerance, and hypertension. Unfortunately, MetS is typically underrecognized, and there is great heterogeneity in its management, which can hamper clinical decision-making and be a barrier to achieving the therapeutic goals of CVD and diabetes prevention. Although no single treatment for MetS as a whole currently exists, management should be targeted at treating the conditions contributing to it and possibly reversing the risk factors. All this justifies the need to develop recommendations that adapt existing knowledge to clinical practice in our healthcare system. In this regard, professionals from different scientific societies who are involved in the management of the different MetS components reviewed the available scientific evidence focused basically on therapeutic aspects of MetS and developed a consensus document to establish recommendations on therapeutic goals that facilitate their homogenization in clinical decision-making.
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Affiliation(s)
- Juan Pedro-Botet
- Lipids and Vascular Risk Unit, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain,
| | - Juan F Ascaso
- Endocrinology and Nutrition Service, Hospital Clínico, Universitat de Valencia, Valencia, Spain
- INCLIVA Research Institute, Diabetes and Metabolic Diseases Ciber (Networked Biomedical Research Centres - CIBERDEM), Carlos III, Valencia, Spain
| | - Vivencio Barrios
- Cardiology Service, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain
- Department of Medicine, Universidad Católica de Murcia (UCAM), Murcia, Spain
| | - Alejandro De la Sierra
- Internal Medicine Service, Hospital Mutua de Terrassa, Department of Medicine, Universidad de Barcelona, Spain
| | - Javier Escalada
- Department of Endocrinology and Nutrition, Clínica Universitaria de Navarra, IdiSNA
- CIBEROBN "Physiopathology of Obesity and Nutrition", Carlos III Health Institute, Spain
| | - Jesús Millán
- Lipid Unit, Department of Internal Medicine, Hospital Universitario General Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - Jose M Mostaza
- Lipid and Arteriosclerosis Unit, Internal Medicine Service, Hospital Carlos III, Madrid, Spain
| | - Pablo Pérez-Martínez
- CIBEROBN "Physiopathology of Obesity and Nutrition", Carlos III Health Institute, Spain
- Lipid and Arteriosclerosis Unit, Hospital Universitario Reina Sofía, IMIBIC/University of Cordoba, Cordoba, Spain
| | - Xavier Pintó
- CIBEROBN "Physiopathology of Obesity and Nutrition", Carlos III Health Institute, Spain
- Lipids Unit, Department of Internal Medicine Hospital Universitario de Bellvitge, Universidad de Barcelona, Barcelona, Spain
| | - Jordi Salas-Salvadó
- CIBEROBN "Physiopathology of Obesity and Nutrition", Carlos III Health Institute, Spain
- Nutrition Unit, Hospital Universitari Sant Joan de Reus, Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili
| | - Pedro Valdivielso
- Internal Medicine Service, Department of Medicine and Dermatology, Hospital Universitario Virgen de la Victoria, Málaga Biomedicine Institute (IBIMA), Universidad de Málaga, Málaga, Spain
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15
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Wang M, Chen M, Ao H, Chen S, Wang Z. The Effects of Different BMI on Blood Loss and Transfusions in Chinese Patients Undergoing Coronary Artery Bypass Grafting. Ann Thorac Cardiovasc Surg 2017; 23:83-90. [PMID: 28179605 DOI: 10.5761/atcs.oa.16-00219] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Blood loss is a predictor of outcomes after coronary artery bypass grafting (CABG). This study investigated the effects of body mass index (BMI) on blood loss, blood transfusion rate, and the variations in coagulation parameters of Chinese patients undergoing CABG. METHODS A total of 1007 Chinese patients who consecutively underwent isolated, primary CABG at Fuwai Hospital from January 1, 2013 to December 31, 2013 were included in this study. They were categorized by BMI into <24 kg/m2 (low and normal weight group), 24≤ BMI <28 kg/m2 (overweight group), and BMI ≥28 kg/m2 (obese group). Following this BMI classification, the quantities of blood lost and recorded transfusions were analyzed. RESULTS Blood loss and transfusion rates were significantly higher in the low and normal weight group compared with the obese group (p <0.01). Chest tube drainage over 24 h, duration of intensive care unit (ICU) stay, and postoperative mechanical ventilation were higher as well (p <0.01). Atrial fibrillation was closely related to blood transfusion (p <0.001). CONCLUSIONS Obesity is a predictor for protection against blood loss and transfusion in Chinese people. Patients with low and normal BMI lost more blood per kg of their weight and had higher total transfused volume during isolated primary CABG. Atrial fibrillation was associated with high blood transfusion.
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Affiliation(s)
- Mingya Wang
- Department of Anesthesiology and Cardiovascular Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Ming Chen
- Erduosi Hospital, Inner Mongolia, China
| | - Hushan Ao
- Department of Anesthesiology and Cardiovascular Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Sipeng Chen
- Department of Anesthesiology and Cardiovascular Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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16
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Abstract
The term metabolic syndrome (MeS) refers to a cluster of associated symptoms composed of impaired fasting glucose, abdominal obesity, hypertension, and dyslipidemia. MeS is associated with an increased risk of cardiovascular and diabetes-associated morbidity and mortality. The increased amount of visceral fat together with a chronic inflammatory state predisposes to the development of arteriosclerosis. Furthermore, insulin resistance (IR) and dyslipidemia are associated with fatty liver disease. In addition, MeS is linked to non-cardiovascular diseases such as cancer as well as psychiatric or endocrine disorders. Here, we discuss the clinical impact of MeS in cardiovascular and non-cardiovascular diseases to highlight the importance of prevention, early diagnosis, and multifactorial treatment of high-risk individuals.
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Affiliation(s)
- Swantje Brede
- Department of Medicine I, University of Lübeck, Lübeck, Germany
| | - Georg Serfling
- Department of Medicine I, University of Lübeck, Lübeck, Germany
| | - Johanna Klement
- Department of Medicine I, University of Lübeck, Lübeck, Germany
| | | | - Hendrik Lehnert
- Department of Medicine I, University of Lübeck, Lübeck, Germany
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17
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Nussberger F, Roth B, Metzger T, Kiss B, Thalmann GN, Seiler R. A low or high BMI is a risk factor for renal hematoma after extracorporeal shock wave lithotripsy for kidney stones. Urolithiasis 2016; 45:317-321. [PMID: 27576325 DOI: 10.1007/s00240-016-0915-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 08/22/2016] [Indexed: 10/21/2022]
Abstract
The purpose of this study was to evaluate risk factors for renal hematoma after extracorporeal shock wave lithotripsy (SWL) for kidney stones in a matched case-control analysis of a subgroup of patients recruited from a prospective randomized cohort. Between 06/2010 and 03/2013, 418 patients underwent SWL with the MODULITH®-SLX-F2-lithotripter for kidney stones. In 39/418 patients (9 %), ultrasound at post-treatment day 1 revealed renal hematomas. For 37 of these patients, a matched group without hematoma could be selected according to the following matching criteria: age, gender, number and energy of shock waves, stone burden and localization. Risk factors for renal hematoma after SWL were compared between the two groups. The rates of diabetes, stopped anticoagulant/antiplatelet medications and arterial hypertension were not different between the two groups (p > 0.2). The skin-kidney distance was virtually the same in both groups (p = 0.5). In the hematoma group, significantly more patients had a high (>30: n = 16) as well as a low (<21.5: n = 4) BMI when compared to the control group (n = 4; n = 0; p < 0.001). Importantly, all patients with BMI <21.5 developed renal hematomas after SWL. Patients with a high (>30) or low (<21.5) BMI had a higher risk for renal damage after SWL. Therefore, alternative endoscopic treatment options should be considered in these patients.
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Affiliation(s)
- Fabio Nussberger
- Department of Urology, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Beat Roth
- Department of Urology, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Tobias Metzger
- Department of Urology, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Bernhard Kiss
- Department of Urology, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - George N Thalmann
- Department of Urology, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Roland Seiler
- Department of Urology, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
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18
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Chantler PD, Shrader CD, Tabone LE, d'Audiffret AC, Huseynova K, Brooks SD, Branyan KW, Grogg KA, Frisbee JC. Cerebral Cortical Microvascular Rarefaction in Metabolic Syndrome is Dependent on Insulin Resistance and Loss of Nitric Oxide Bioavailability. Microcirculation 2016; 22:435-45. [PMID: 26014499 DOI: 10.1111/micc.12209] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 05/20/2015] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Chronic presentation of the MS is associated with an increased likelihood for stroke and poor stroke outcomes following occlusive cerebrovascular events. However, the physiological mechanisms contributing to compromised outcomes remain unclear, and the degree of cerebral cortical MVD may represent a central determinant of stroke outcomes. METHODS This study used the OZR model of MS and clinically relevant, chronic interventions to determine the impact on cerebral cortical microvascular rarefaction via immunohistochemistry with a parallel determination of cerebrovascular function to identify putative mechanistic contributors. RESULTS OZR exhibited a progressive rarefaction (to ~80% control MVD) of the cortical microvascular networks vs. lean Zucker rats. Chronic treatment with antihypertensive agents (captopril/hydralazine) had limited effectiveness in blunting rarefaction, although treatments improving glycemic control (metformin/rosiglitazone) were superior, maintaining ~94% control MVD. Chronic treatment with the antioxidant TEMPOL severely blunted rarefaction in OZR, although this ameliorative effect was prevented by concurrent NOS inhibition. CONCLUSIONS Further analyses revealed that the maintenance of glycemic control and vascular NO bioavailability were stronger predictors of cerebral cortical MVD in OZR than was prevention of hypertension, and this may have implications for chronic treatment of CVD risk under stroke-prone conditions.
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Affiliation(s)
- Paul D Chantler
- Division of Exercise Physiology, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA.,Clinical and Translational Sciences Institute, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA.,Center for Cardiovascular and Respiratory Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA
| | - Carl D Shrader
- Clinical and Translational Sciences Institute, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA.,Center for Cardiovascular and Respiratory Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA.,Department of Family Medicine, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA
| | - Lawrence E Tabone
- Division of Exercise Physiology, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA.,Clinical and Translational Sciences Institute, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA.,Division of Bariatric Surgery, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA
| | - Alexandre C d'Audiffret
- Division of Exercise Physiology, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA.,Center for Cardiovascular and Respiratory Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA.,Division of Vascular Surgery, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA
| | - Khumara Huseynova
- Division of Exercise Physiology, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA.,Center for Cardiovascular and Respiratory Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA.,Division of Vascular Surgery, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA
| | - Steven D Brooks
- Center for Cardiovascular and Respiratory Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA.,Division of Vascular Surgery, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA
| | - Kayla W Branyan
- Division of Exercise Physiology, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA.,Center for Cardiovascular and Respiratory Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA
| | - Kristin A Grogg
- Center for Cardiovascular and Respiratory Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA
| | - Jefferson C Frisbee
- Clinical and Translational Sciences Institute, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA.,Center for Cardiovascular and Respiratory Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA.,Department of Physiology and Pharmacology, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA
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19
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Abstract
The metabolic syndrome is a multiplex risk factor for atherosclerotic cardiovascular disease and type 2 diabetes. It is composed of atherogenic dyslipidemia, elevated blood pressure, insulin resistance and elevated glucose, a pro-thrombotic state, and a pro-inflammatory state. Excess energy intake and concomitant obesity are the major drivers of the syndrome. Lifestyle intervention can reverse metabolic risk factors, but at times, drug therapies or bariatric surgery may be required to control more overt risk factors.
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Affiliation(s)
- Scott M Grundy
- Department of Internal Medicine and Center for Human Nutrition, UT Southwestern Medical Center, Dallas, TX; Veterans Affairs Medical Center, Dallas, TX.
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20
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Tzimas P, Petrou A, Laou E, Milionis H, Mikhailidis D, Papadopoulos G. Impact of metabolic syndrome in surgical patients: should we bother? Br J Anaesth 2015; 115:194-202. [DOI: 10.1093/bja/aev199] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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21
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Vitaglione P, Mennella I, Ferracane R, Rivellese AA, Giacco R, Ercolini D, Gibbons SM, La Storia A, Gilbert JA, Jonnalagadda S, Thielecke F, Gallo MA, Scalfi L, Fogliano V. Whole-grain wheat consumption reduces inflammation in a randomized controlled trial on overweight and obese subjects with unhealthy dietary and lifestyle behaviors: role of polyphenols bound to cereal dietary fiber. Am J Clin Nutr 2015; 101:251-61. [PMID: 25646321 DOI: 10.3945/ajcn.114.088120] [Citation(s) in RCA: 209] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Epidemiology associates whole-grain (WG) consumption with several health benefits. Mounting evidence suggests that WG wheat polyphenols play a role in mechanisms underlying health benefits. OBJECTIVE The objective was to assess circulating concentration, excretion, and the physiologic role of WG wheat polyphenols in subjects with suboptimal dietary and lifestyle behaviors. DESIGN A placebo-controlled, parallel-group randomized trial with 80 healthy overweight/obese subjects with low intake of fruit and vegetables and sedentary lifestyle was performed. Participants replaced precise portions of refined wheat (RW) with a fixed amount of selected WG wheat or RW products for 8 wk. At baseline and every 4 wk, blood, urine, feces, and anthropometric and body composition measures were collected. Profiles of phenolic acids in biological samples, plasma markers of metabolic disease and inflammation, and fecal microbiota composition were assessed. RESULTS WG consumption for 4-8 wk determined a 4-fold increase in serum dihydroferulic acid (DHFA) and a 2-fold increase in fecal ferulic acid (FA) compared with RW consumption (no changes). Similarly, urinary FA at 8 wk doubled the baseline concentration only in WG subjects. Concomitant reduction in plasma tumor necrosis factor-α (TNF-α) after 8 wk and increased interleukin (IL)-10 only after 4 wk with WG compared with RW (P = 0.04) were observed. No significant change in plasma metabolic disease markers over the study period was observed, but a trend toward lower plasma plasminogen activator inhibitor 1 with higher excretion of FA and DHFA in the WG group was found. Fecal FA was associated with baseline low Bifidobacteriales and Bacteroidetes abundances, whereas after WG consumption, it correlated with increased Bacteroidetes and Firmicutes but reduced Clostridium. TNF-α reduction correlated with increased Bacteroides and Lactobacillus. No effect of dietary interventions on anthropometric measurements and body composition was found. CONCLUSIONS WG wheat consumption significantly increased excreted FA and circulating DHFA. Bacterial communities influenced fecal FA and were modified by WG wheat consumption. This trial was registered at clinicaltrials.gov as NCT01293175.
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Affiliation(s)
- Paola Vitaglione
- From the Department of Agricultural and Food Science, University of Naples "Federico II," Portici (NA), Italy (PV, IM, RF, DE, ALS, and VF); the Departments of Clinical Medicine and Surgery (AAR) and Public Health (LS), University of Naples "Federico II," Napoli, Italy; Institute of Food Science, National Research Council, Avellino, Italy (RG); Graduate Program in Biophysical Sciences (SMG) and Department of Ecology and Evolution (JAG), University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, Argonne National Laboratory, Lemont, IL (SMG and JAG); General Mills Bell Institute of Health and Nutrition, Minneapolis, MN (SJ); Cereal Partners Worldwide S.A., Lausanne, Switzerland (FT); and Centro Diagnostico San Ciro, Portici, Italy (MAG)
| | - Ilario Mennella
- From the Department of Agricultural and Food Science, University of Naples "Federico II," Portici (NA), Italy (PV, IM, RF, DE, ALS, and VF); the Departments of Clinical Medicine and Surgery (AAR) and Public Health (LS), University of Naples "Federico II," Napoli, Italy; Institute of Food Science, National Research Council, Avellino, Italy (RG); Graduate Program in Biophysical Sciences (SMG) and Department of Ecology and Evolution (JAG), University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, Argonne National Laboratory, Lemont, IL (SMG and JAG); General Mills Bell Institute of Health and Nutrition, Minneapolis, MN (SJ); Cereal Partners Worldwide S.A., Lausanne, Switzerland (FT); and Centro Diagnostico San Ciro, Portici, Italy (MAG)
| | - Rosalia Ferracane
- From the Department of Agricultural and Food Science, University of Naples "Federico II," Portici (NA), Italy (PV, IM, RF, DE, ALS, and VF); the Departments of Clinical Medicine and Surgery (AAR) and Public Health (LS), University of Naples "Federico II," Napoli, Italy; Institute of Food Science, National Research Council, Avellino, Italy (RG); Graduate Program in Biophysical Sciences (SMG) and Department of Ecology and Evolution (JAG), University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, Argonne National Laboratory, Lemont, IL (SMG and JAG); General Mills Bell Institute of Health and Nutrition, Minneapolis, MN (SJ); Cereal Partners Worldwide S.A., Lausanne, Switzerland (FT); and Centro Diagnostico San Ciro, Portici, Italy (MAG)
| | - Angela A Rivellese
- From the Department of Agricultural and Food Science, University of Naples "Federico II," Portici (NA), Italy (PV, IM, RF, DE, ALS, and VF); the Departments of Clinical Medicine and Surgery (AAR) and Public Health (LS), University of Naples "Federico II," Napoli, Italy; Institute of Food Science, National Research Council, Avellino, Italy (RG); Graduate Program in Biophysical Sciences (SMG) and Department of Ecology and Evolution (JAG), University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, Argonne National Laboratory, Lemont, IL (SMG and JAG); General Mills Bell Institute of Health and Nutrition, Minneapolis, MN (SJ); Cereal Partners Worldwide S.A., Lausanne, Switzerland (FT); and Centro Diagnostico San Ciro, Portici, Italy (MAG)
| | - Rosalba Giacco
- From the Department of Agricultural and Food Science, University of Naples "Federico II," Portici (NA), Italy (PV, IM, RF, DE, ALS, and VF); the Departments of Clinical Medicine and Surgery (AAR) and Public Health (LS), University of Naples "Federico II," Napoli, Italy; Institute of Food Science, National Research Council, Avellino, Italy (RG); Graduate Program in Biophysical Sciences (SMG) and Department of Ecology and Evolution (JAG), University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, Argonne National Laboratory, Lemont, IL (SMG and JAG); General Mills Bell Institute of Health and Nutrition, Minneapolis, MN (SJ); Cereal Partners Worldwide S.A., Lausanne, Switzerland (FT); and Centro Diagnostico San Ciro, Portici, Italy (MAG)
| | - Danilo Ercolini
- From the Department of Agricultural and Food Science, University of Naples "Federico II," Portici (NA), Italy (PV, IM, RF, DE, ALS, and VF); the Departments of Clinical Medicine and Surgery (AAR) and Public Health (LS), University of Naples "Federico II," Napoli, Italy; Institute of Food Science, National Research Council, Avellino, Italy (RG); Graduate Program in Biophysical Sciences (SMG) and Department of Ecology and Evolution (JAG), University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, Argonne National Laboratory, Lemont, IL (SMG and JAG); General Mills Bell Institute of Health and Nutrition, Minneapolis, MN (SJ); Cereal Partners Worldwide S.A., Lausanne, Switzerland (FT); and Centro Diagnostico San Ciro, Portici, Italy (MAG)
| | - Sean M Gibbons
- From the Department of Agricultural and Food Science, University of Naples "Federico II," Portici (NA), Italy (PV, IM, RF, DE, ALS, and VF); the Departments of Clinical Medicine and Surgery (AAR) and Public Health (LS), University of Naples "Federico II," Napoli, Italy; Institute of Food Science, National Research Council, Avellino, Italy (RG); Graduate Program in Biophysical Sciences (SMG) and Department of Ecology and Evolution (JAG), University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, Argonne National Laboratory, Lemont, IL (SMG and JAG); General Mills Bell Institute of Health and Nutrition, Minneapolis, MN (SJ); Cereal Partners Worldwide S.A., Lausanne, Switzerland (FT); and Centro Diagnostico San Ciro, Portici, Italy (MAG)
| | - Antonietta La Storia
- From the Department of Agricultural and Food Science, University of Naples "Federico II," Portici (NA), Italy (PV, IM, RF, DE, ALS, and VF); the Departments of Clinical Medicine and Surgery (AAR) and Public Health (LS), University of Naples "Federico II," Napoli, Italy; Institute of Food Science, National Research Council, Avellino, Italy (RG); Graduate Program in Biophysical Sciences (SMG) and Department of Ecology and Evolution (JAG), University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, Argonne National Laboratory, Lemont, IL (SMG and JAG); General Mills Bell Institute of Health and Nutrition, Minneapolis, MN (SJ); Cereal Partners Worldwide S.A., Lausanne, Switzerland (FT); and Centro Diagnostico San Ciro, Portici, Italy (MAG)
| | - Jack A Gilbert
- From the Department of Agricultural and Food Science, University of Naples "Federico II," Portici (NA), Italy (PV, IM, RF, DE, ALS, and VF); the Departments of Clinical Medicine and Surgery (AAR) and Public Health (LS), University of Naples "Federico II," Napoli, Italy; Institute of Food Science, National Research Council, Avellino, Italy (RG); Graduate Program in Biophysical Sciences (SMG) and Department of Ecology and Evolution (JAG), University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, Argonne National Laboratory, Lemont, IL (SMG and JAG); General Mills Bell Institute of Health and Nutrition, Minneapolis, MN (SJ); Cereal Partners Worldwide S.A., Lausanne, Switzerland (FT); and Centro Diagnostico San Ciro, Portici, Italy (MAG)
| | - Satya Jonnalagadda
- From the Department of Agricultural and Food Science, University of Naples "Federico II," Portici (NA), Italy (PV, IM, RF, DE, ALS, and VF); the Departments of Clinical Medicine and Surgery (AAR) and Public Health (LS), University of Naples "Federico II," Napoli, Italy; Institute of Food Science, National Research Council, Avellino, Italy (RG); Graduate Program in Biophysical Sciences (SMG) and Department of Ecology and Evolution (JAG), University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, Argonne National Laboratory, Lemont, IL (SMG and JAG); General Mills Bell Institute of Health and Nutrition, Minneapolis, MN (SJ); Cereal Partners Worldwide S.A., Lausanne, Switzerland (FT); and Centro Diagnostico San Ciro, Portici, Italy (MAG)
| | - Frank Thielecke
- From the Department of Agricultural and Food Science, University of Naples "Federico II," Portici (NA), Italy (PV, IM, RF, DE, ALS, and VF); the Departments of Clinical Medicine and Surgery (AAR) and Public Health (LS), University of Naples "Federico II," Napoli, Italy; Institute of Food Science, National Research Council, Avellino, Italy (RG); Graduate Program in Biophysical Sciences (SMG) and Department of Ecology and Evolution (JAG), University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, Argonne National Laboratory, Lemont, IL (SMG and JAG); General Mills Bell Institute of Health and Nutrition, Minneapolis, MN (SJ); Cereal Partners Worldwide S.A., Lausanne, Switzerland (FT); and Centro Diagnostico San Ciro, Portici, Italy (MAG)
| | - Maria A Gallo
- From the Department of Agricultural and Food Science, University of Naples "Federico II," Portici (NA), Italy (PV, IM, RF, DE, ALS, and VF); the Departments of Clinical Medicine and Surgery (AAR) and Public Health (LS), University of Naples "Federico II," Napoli, Italy; Institute of Food Science, National Research Council, Avellino, Italy (RG); Graduate Program in Biophysical Sciences (SMG) and Department of Ecology and Evolution (JAG), University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, Argonne National Laboratory, Lemont, IL (SMG and JAG); General Mills Bell Institute of Health and Nutrition, Minneapolis, MN (SJ); Cereal Partners Worldwide S.A., Lausanne, Switzerland (FT); and Centro Diagnostico San Ciro, Portici, Italy (MAG)
| | - Luca Scalfi
- From the Department of Agricultural and Food Science, University of Naples "Federico II," Portici (NA), Italy (PV, IM, RF, DE, ALS, and VF); the Departments of Clinical Medicine and Surgery (AAR) and Public Health (LS), University of Naples "Federico II," Napoli, Italy; Institute of Food Science, National Research Council, Avellino, Italy (RG); Graduate Program in Biophysical Sciences (SMG) and Department of Ecology and Evolution (JAG), University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, Argonne National Laboratory, Lemont, IL (SMG and JAG); General Mills Bell Institute of Health and Nutrition, Minneapolis, MN (SJ); Cereal Partners Worldwide S.A., Lausanne, Switzerland (FT); and Centro Diagnostico San Ciro, Portici, Italy (MAG)
| | - Vincenzo Fogliano
- From the Department of Agricultural and Food Science, University of Naples "Federico II," Portici (NA), Italy (PV, IM, RF, DE, ALS, and VF); the Departments of Clinical Medicine and Surgery (AAR) and Public Health (LS), University of Naples "Federico II," Napoli, Italy; Institute of Food Science, National Research Council, Avellino, Italy (RG); Graduate Program in Biophysical Sciences (SMG) and Department of Ecology and Evolution (JAG), University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, Argonne National Laboratory, Lemont, IL (SMG and JAG); General Mills Bell Institute of Health and Nutrition, Minneapolis, MN (SJ); Cereal Partners Worldwide S.A., Lausanne, Switzerland (FT); and Centro Diagnostico San Ciro, Portici, Italy (MAG)
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22
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Abstract
Most non-communicable diseases involve inflammatory changes in one or more vascular systems, and there is considerable evidence that unliganded iron plays major roles in this. Most studies concentrate on biochemical changes, but there are important biophysical correlates. Here we summarize recent microscopy-based observations to the effect that iron can have major effects on erythrocyte morphology, on erythrocyte deformability and on both fibrinogen polymerization and the consequent structure of the fibrin clots formed, each of which contributes significantly and negatively to such diseases. We highlight in particular type 2 diabetes mellitus, ischemic thrombotic stroke, systemic lupus erythematosus, hereditary hemochromatosis and Alzheimer's disease, while recognizing that many other diseases have co-morbidities (and similar causes). Inflammatory biomarkers such as ferritin and fibrinogen are themselves inflammatory, creating a positive feedback that exacerbates disease progression. The biophysical correlates we describe may provide novel, inexpensive and useful biomarkers of the therapeutic benefits of successful treatments.
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Affiliation(s)
- Etheresia Pretorius
- Department of Physiology, Faculty of Health Sciences, University of Pretoria, Private Bag x323, Arcadia 0007, South Africa.
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23
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von Känel R, Malan NT, Hamer M, van der Westhuizen FH, Malan L. Leukocyte telomere length and hemostatic factors in a South African cohort: the SABPA Study. J Thromb Haemost 2014; 12:1975-85. [PMID: 25244563 DOI: 10.1111/jth.12733] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 09/15/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Incident atherothrombotic disease is predicted by leukocyte telomere length, a marker of biological age, and hemostatic factor levels, indicating a hypercoagulable state. We hypothesized that shorter telomeres are associated with elevated circulating levels of hemostatic factors. METHODS We examined 171 South African (black) and 182 Caucasian (white) schoolteachers (mean age ± standard deviation, 48.5 ± 9.0 years; 50.4% women). Levels of fibrinogen, von Willebrand factor antigen (VWF:Ag), D-dimer and plasminogen activator inhibitor-1 antigen (PAI-1:Ag) were measured in plasma, and values were log-transformed before analysis. Relative average telomere length (content of telomere PCR product/content of human β-globin PCR product ratio, i.e. telomere/single-copy gene ratio) was assessed with multiplex quantitative real-time PCRs. Multivariate analyses included demographics, metabolic factors, health behavior, and medication. RESULTS Africans had shorter mean telomere length (0.82, 95% confidence interval [CI] 0.79-0.86 vs. 1.07, 95% CI 1.04-1.10) and higher fibrinogen (B = 0.085, 95% CI 0.061-0.109) and PAI-1:Ag (B = 0.255, 95% CI 0.206-0.303) levels, but lower VWF:Ag levels (B = - 0.059, 95% CI - 0.089 to - 0.028), than Caucasians. Shorter telomeres were associated with higher fibrinogen (B = - 0.045, 95% CI - 0.088 to - 0.001), VWF:Ag (B = - 0.137, 95% CI - 0.193 to - 0.081) and D-dimer (B = - 0.201, 95% CI - 0.377 to - 0.025) levels, conditional on ethnicity. An interaction emerged between ethnicity and telomere length for VWF:Ag level; that is, shorter telomeres were associated with higher VWF:Ag levels in Caucasians (B = - 0.170, 95% CI - 0.232 to - 0.108) but not in Africans. CONCLUSIONS Shorter telomeres were associated with increased levels of several hemostatic factors after adjustment for confounding variables, whereby ethnicity partially moderated this effect. A relationship between accelerated biological aging and hypercoagulability might contribute to the risk of premature atherothrombotic events.
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Affiliation(s)
- R von Känel
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland; Department of Clinical Research, University of Bern, Bern, Switzerland; Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland
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24
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Novotny D, Karasek D, Vaverkova H, Slavik L. The influence of apolipoprotein A5 T-1131C and apolipoprotein E common genetic variants on the levels of hemostatic markers in dyslipidemic patients. Clin Chim Acta 2014; 436:11-7. [DOI: 10.1016/j.cca.2014.04.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 04/19/2014] [Accepted: 04/21/2014] [Indexed: 12/22/2022]
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25
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Spirkoska A, Jezovnik MK, Poredos P. Time Course and the Recanalization Rate of Superficial Vein Thrombosis Treated With Low-Molecular-Weight Heparin. Angiology 2014; 66:381-6. [DOI: 10.1177/0003319714533183] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study was to follow the thrombus progression and regression in superficial veins of lower limbs in patients with superficial vein thrombosis (SVT) treated with low-molecular-weight heparin. Patients (n = 68) with a first symptomatic SVT of the lower limbs received 2 different dosages of dalteparin. The primary outcome was a change in the diameter and length of thrombus in the affected veins. The regression of thrombus was not significantly different between the groups ( P = .19). The reduction in the length of thrombus as well as thrombus diameter was significantly greater in females. At the end of the observation period, the length of thrombus in the distal part was more reduced than in the proximal segments. It seems that the dosage of anticoagulant drug does not have a significant impact on thrombus resolution.
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Affiliation(s)
- Ana Spirkoska
- Department of Vascular Disease, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Mateja Kaja Jezovnik
- Department of Vascular Disease, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Pavel Poredos
- Department of Vascular Disease, University Medical Centre Ljubljana, Ljubljana, Slovenia
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26
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Gotsis E, Anagnostis P, Mariolis A, Vlachou A, Katsiki N, Karagiannis A. Health benefits of the Mediterranean Diet: an update of research over the last 5 years. Angiology 2014; 66:304-18. [PMID: 24778424 DOI: 10.1177/0003319714532169] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Mediterranean Diet (MedDiet) has been reported to be protective against the occurrence of several diseases. Increasing evidence suggests that the MedDiet could counter diseases associated with chronic inflammation, including metabolic syndrome, atherosclerosis, cancer, diabetes, obesity, pulmonary diseases, and cognition disorders. Adoption of a MedDiet was associated with beneficial effects on the secretion of anti-inflammatory cytokines, antioxidant cellular and circulating biomarkers as well as with regulation of gene polymorphisms involved in the atherosclerotic process. The MedDiet has been considered for the prevention of cardiovascular and other chronic degenerative diseases focusing on the impact of a holistic dietary approach rather than on single nutrients. Epidemiological dietary scores measuring adherence to a MedDiet have been developed. This narrative review considers the results of up-to-date clinical studies (with a focus on the last 5 years) that evaluated the effectiveness of the MedDiet in reducing the prevalence of chronic and degenerative diseases.
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Affiliation(s)
- Efthymios Gotsis
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Panagiotis Anagnostis
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | | | - Athanasia Vlachou
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Asterios Karagiannis
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
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27
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von Frankenberg AD, do Nascimento FV, Gatelli LE, Nedel BL, Garcia SP, de Oliveira CSV, Saddi-Rosa P, Reis AF, Canani LH, Gerchman F. Major components of metabolic syndrome and adiponectin levels: a cross-sectional study. Diabetol Metab Syndr 2014; 6:26. [PMID: 24568287 PMCID: PMC3941563 DOI: 10.1186/1758-5996-6-26] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 02/18/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adiponectin is a major regulator of glucose and lipid homeostasis by its insulin sensitizer properties. Since decreased insulin sensitivity is linked to metabolic syndrome (MS), decreased adiponectin levels may be related to its development. The purpose of the study was to investigate the relationship between adiponectin levels and MS. METHODS Firstly, we cross-sectionally examined subjects with or without MS submitted to an oral glucose tolerance test at Hospital de Clínicas de Porto Alegre (n = 172). A replication analysis was performed in subjects (n = 422) undergoing cardiac angiography at Hospital São Paulo. Subchronic inflammation (US-CRP), coagulation marker (fibrinogen), insulin sensitivity and resistance (Matsuda ISI and HOMA-IR) were estimated. Plasma total and high molecular weight (HMW) adiponectin were measured. RESULTS Total and HMW adiponectin levels were lower in MS subjects (P < 0.05). Total adiponectin levels were lower in the presence of high waist circumference, low HDL-cholesterol and elevated triglyceride criteria in both samples and by elevated blood pressure and glucose criteria in Porto Alegre. HMW adiponectin levels were lower in the presence of low HDL-cholesterol, elevated triglycerides, and glucose criteria. Total adiponectin levels were positively related with HDL-cholesterol and ISI Matsuda, negatively related with waist circumference, glucose, triglycerides, HOMA-IR, and US-CRP and not related with blood pressure. While adjusting for sex and age, increased adiponectin levels remained associated with a reduced prevalence ratio for MS in both cohorts (P = 0.001). CONCLUSIONS Adiponectin levels decreased with increasing number of MS criteria, and it is in part determined by its relationship with HDL, triglycerides and abdominal adiposity.
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Affiliation(s)
- Anize D von Frankenberg
- Post-Graduate Endocrinology Program, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre. Rua Ramiro Barcelos, 2350 – Prédio 12. 4° andar, 90035-003 Porto Alegre, RS, Brazil
| | - Filipe V do Nascimento
- Post-Graduate Endocrinology Program, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Lucas Eduardo Gatelli
- Post-Graduate Endocrinology Program, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Bárbara L Nedel
- Post-Graduate Endocrinology Program, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Sheila P Garcia
- Post-Graduate Endocrinology Program, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | - Pedro Saddi-Rosa
- Endocrinology Unit, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - André F Reis
- Endocrinology Unit, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Luis H Canani
- Post-Graduate Endocrinology Program, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Metabolism Unit, Endocrinology Division, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Fernando Gerchman
- Post-Graduate Endocrinology Program, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Metabolism Unit, Endocrinology Division, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
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28
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Longo UG, Petrillo S, Berton A, Spiezia F, Loppini M, Maffulli N, Denaro V. Role of serum fibrinogen levels in patients with rotator cuff tears. Int J Endocrinol 2014; 2014:685820. [PMID: 24817887 PMCID: PMC4003788 DOI: 10.1155/2014/685820] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 03/15/2014] [Indexed: 12/14/2022] Open
Abstract
Although rotator cuff (RC) tendinopathy is a frequent pathology of the shoulder, the real understanding of its aetiopathogenesis is still unclear. Several studies showed that RC tendinopathy is more frequent in patients with hyperglycemia, diabetes, obesity, or metabolic syndrome. This paper aims to evaluate the serum concentration of fibrinogen in patients with RC tears. Metabolic disorders have been related to high concentration of serum fibrinogen and the activity of fibrinogen has been proven to be crucial in the development of microvascular damage. Thus, it may produce progression of RC degeneration by reducing the vascular supply of tendons. We report the results of a cross-sectional frequency-matched case-control study comparing the serum concentration of fibrinogen of patients with RC tears with that of a control group of patients without history of RC tears who underwent arthroscopic meniscectomy. We choose to enrol in the control group patients with pathology of the lower limb with a likely mechanic, not metabolic, cause, different from tendon pathology. We found no statistically significant differences in serum concentration of fibrinogen when comparing patients with RC tears and patients who underwent arthroscopic meniscectomy (P = 0.5). Further studies are necessary to clarify the role of fibrinogen in RC disease.
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Affiliation(s)
- Umile Giuseppe Longo
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo 200, Trigoria, 00128 Rome, Italy
- Centro Integrato di Ricerca (CIR), Campus Bio-Medico University, Via Alvaro del Portillo 21, Trigoria, 00128 Rome, Italy
| | - Stefano Petrillo
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo 200, Trigoria, 00128 Rome, Italy
- Centro Integrato di Ricerca (CIR), Campus Bio-Medico University, Via Alvaro del Portillo 21, Trigoria, 00128 Rome, Italy
- *Stefano Petrillo:
| | - Alessandra Berton
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo 200, Trigoria, 00128 Rome, Italy
- Centro Integrato di Ricerca (CIR), Campus Bio-Medico University, Via Alvaro del Portillo 21, Trigoria, 00128 Rome, Italy
| | - Filippo Spiezia
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo 200, Trigoria, 00128 Rome, Italy
- Centro Integrato di Ricerca (CIR), Campus Bio-Medico University, Via Alvaro del Portillo 21, Trigoria, 00128 Rome, Italy
| | - Mattia Loppini
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo 200, Trigoria, 00128 Rome, Italy
- Centro Integrato di Ricerca (CIR), Campus Bio-Medico University, Via Alvaro del Portillo 21, Trigoria, 00128 Rome, Italy
| | - Nicola Maffulli
- Centre for Sports and Exercise Medicine, Mile End Hospital, Mann Ward, 275 Bancroft Road, London E1 4DG, UK
- Department of Musculoskeletal Medicine, University of Salerno, 84048 Salerno, Italy
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo 200, Trigoria, 00128 Rome, Italy
- Centro Integrato di Ricerca (CIR), Campus Bio-Medico University, Via Alvaro del Portillo 21, Trigoria, 00128 Rome, Italy
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