Chronic Diseases and Translational Medicine最新文献

Cardiovascular disease (CVD) is the most common noncommunicable disease and the leading cause of death globally.¹ It has resulted in enormous economic and social burdens, while posing a great challenge for the prevention and control of CVD worldwide, especially in China. Assessment and management of cardiovascular risk is the foundation of CVD prevention, and is strongly recommended by guidelines.^2-4 Additionally, it can help screen the target population who would benefit most from the lower-cost intervention, while informing them the cardiovascular risk, which will help in promoting self-management. It can also guide doctors in making logical management decisions, and implement precision prevention and treatment strategies to reduce the CVD burden.^{2, 4} Therefore, it is a key approach in achieving the goals of “Good Health and Well-being” in the United Nations and “Healthy China 2030” in China. Here, we briefly highlight several advances in cardiovascular risk assessments.

The Framingham Heart Study introduced the term “risk factor” in 1961, and identified a series of risk factors of CVD subsequently, such as cholesterol, blood pressure, glucose, and obesity.⁵ By integrating multiple conventional risk factors, a general cardiovascular risk instrument was further developed to assist in identifying and treating individuals at high risk.⁶ Since the concept of cardiovascular risk assessment and stratification was adopted by the third Adult Treatment Panel of the National Cholesterol Education Program in 2001, it has led to the development of effective treatment and preventive strategies in clinical practice.

A systematic approach to cardiovascular risk assessment includes the collection of information to calculate the cardiovascular risk, identification of the target high-risk population, and implementation of individual management according to the risk level. Therefore, risk-prediction models are major components of risk-based CVD prevention and control efforts. Several cardiovascular risk models have been developed using conventional risk factors to assist in clinical practice, such as the Reynolds Risk Score^{7, 8} and the Pooled Cohort Equations (PCE)⁹ in the United States, the QRISK in the United Kingdom,¹⁰ the ASSIGN Score in Scotland,¹¹ the Systematic Coronary Risk Evaluation (SCORE) model in Europe,¹² and the Prediction for Atherosclerotic CVD Risk in China (China-PAR) equations.¹³ In addition, World Health Organization has derived the risk prediction charts for 21 Global Burden of Disease regions to facilitate the risk-based CVD prevention in low- and middle-income countries.⁴ These models, taking account of balance between good performance and ac

The prevalence of cancer, especially in industrial countries, is a major problem for health and treatment systems. Cancer can affect the quality of life of all family members and has many negative effects on the community. Despite many advances in cancer treatment, this disease is still a major worldwide problem. There is strong evidence that dietary habits are effective in protecting against cancer and even helping in the disease treatment progress. Nuts with various biologically-active compounds, such as vitamins, phytosterols, isoflavones, flavonoids, and polyphenols have been reported to possess anticarcinogenic properties. Accordingly, this review provides an insight into the association between nut consumption and the prevention of some cancers. We considered the cancers related to the urogenital and genital tract, gastrointestinal tract, as well as women-related cancers. Both cell culture examinations and experimental animal studies alongside observational epidemiological studies demonstrated that regular consumption of a nut-enriched diet is able to reduce the risk of these cancers.

A second bone marrow aspiration and biopsy showed pure red cell aplasia in this case.

Family history of diabetes (FH+) has been associated with early metabolic alteration including insulin resistance, lipid metabolism, and ectopic fat accumulation even in healthy individuals.^1-3 Furthermore, normoglycemic first-degree relatives of type 2 diabetes mellitus (T2DM) have been documented having increased carotid intima-media thickness and pro-inflammatory cytokines.^{4, 5} Taken together, individuals with FH+, who were otherwise healthy, have shown to possess susceptibility for diabetes mellitus (DM) chronic complication. Hence, this study aimed to investigate whether FH+ increased the risk of chronic complications in patients with overt T2DM.

This was a cross-sectional study which included adult patients with T2DM visiting a private hospital integrated diabetes center in South Tangerang (urban area outskirt of Jakarta), Indonesia from December 2020 to November 2021. Those without any documented blood test results were excluded. FH+ was defined as having first- and/or second-degree relatives with T2DM. Chronic complications investigated were atherosclerotic cardiovascular diseases (ASCVD) including coronary artery disease (CAD), stroke, and peripheral artery disease; microvascular complications including diabetic retinopathy, diabetic peripheral neuropathy, and diabetic kidney disease (DKD); diastolic dysfunction and heart failure (HF). Data were taken from hospital electronic medical records and were explored from clinical signs and symptoms, history of previously known chronic complications, laboratory and radiological examinations, and diagnosis made by the physicians. Additionally, if any, other tests were used for diagnosis such as treadmill stress test and coronary arteries calcium scoring for CAD; ankle-to-brachial index of ≤0.9 and limb vessels stenosis of ≥50% on doppler ultrasound for peripheral artery disease; non-mydriatic funduscopy for retinopathy; 10 g monofilament test and 128 Hz tuning fork test for neuropathy; presence of micro-/macroalbuminuria or proteinuria and glomerular filtration rate ≤60 mL/min for DKD; echocardiography for diastolic dysfunction and HF.

Results were presented in n (%), and median (interquartile range, IQR) depends on data type. Chi-squared test was used to compare nominal data, while Mann–Whitney was used to compare numerical data. Logistic regression analysis was used to determine FH+ association with chronic complications adjusted for age, sex, DM duration, alcohol and smoking history, systolic and diastolic blood pressure, body mass index, HbA1c, low-density lipoprotein, triglyceride, and estimated glomerular filtration rate, with no family history of diabetes (FH−) as the reference.

A total of 1011 T2DM patients were included, 24.8% of whom had family history of T2DM (FH+) (Table 1). There were higher proportions of dyslipidemia, smoking and alcohol history found in FH+, whereas FH− had older age, higher systolic blood

Induced pluripotent stem cell (iPSC) technology is one of the de novo approaches in regeneration medicine and has led to new research applications for wound healing in recent years. Fibroblasts have attracted wide attention as the first cell line used for differentiation into iPSCs. Researchers have found that fibroblasts can be induced into different types of cells in variable mediums or microenvironments. This indicates the potential “stem” characteristics of fibroblasts in terms of direct cellular reprogramming compared with the iPSC detour. In this review, we described the morphology and biological function of fibroblasts. The stem cell characteristics and activities of fibroblasts, including transdifferentiation into myofibroblasts, osteogenic cells, chondrogenic cells, neurons, and vascular tissue, are discussed. The biological values of fibroblasts are then briefly reviewed. Finally, we discussed the potential applications of fibroblasts in clinical practice.

Dear Editor,

Goiter is defined as the enlargement of the thyroid gland. It is currently divided into diffuse and nodular and subdivided into toxic (associated with hyperthyroidism) or nontoxic (associated with normal thyroid stimulating hormone [TSH] levels).¹ The most common cause of goiter is iodine deficiency,² and other causes are increased levels of TSH, natural goitrogens, iron and vitamin A deficiency, genetic factors (DICER1 syndrome and PTEN hamartoma tumor syndrome), and hereditary (Plummer syndrome) factors.³

A rare entity known as familial Mediterranean fever (FMF) can present with amyloid goiter. This is an autoimmune disorder that affects the Mediterranean littoral.⁴ These patients present with fevers and abdominal and chest pain. This condition can produce fibrillar depositions of amyloid protein, usually affecting the kidney⁵ but rarely involving the thyroid. We present a case of a 21-year-old woman with no medical history who presented to our hospital with a nontoxic diffuse goiter with initial presentation and pathologically confirmed as amyloid deposition secondary to FMF.

The patient is a 21-year-old Asian American woman with no significant medical history. She presented to our institution with dyspnea and dysphagia. An ultrasound from an outside hospital revealed diffuse thyroid enlargement. Our in-house laboratory results showed normal TSH, T4, T3, and elevated TPO antibody and erythrocyte sedimentation rate. A CT scan was performed on the patient showing heterogenous thyromegaly wrapping around the trachea and esophagus (Figure 1). A fine needle aspirate was performed, which showed a fibroinflammatory lesion. The patient started on steroids with no improvement, and a total thyroidectomy was performed. Macroscopic examination revealed a poorly defined, firm mass with pale tan areas of discoloration (Figure 2). Microscopic examination revealed an atrophic thyroid parenchyma with diffuse adipose cell metaplasia and diffuse interfollicular deposition of acellular amorphous material consistent with amyloid (Figure 3). Multifocal areas of chronic inflammation were also seen. Congo red stain was positive for amyloid (Figure 4A) with apple-green birefringence under polarized light (Figure 4B). Liquid chromatography tandem mass spectrometry was performed on peptides extracted from the Congo red-positive/microdissected areas of the paraffin-embedded thyroid specimen. The detected peptide profile was consistent with AA (SAA)-type amyloid deposition. The patient consequently had genetic testing showing a homozygous E148Q mutation. This confirms the clinical syndrome of FMF. After continuous follow-up, 10 years later, she developed end-stage renal failure with a renal biopsy confirming Renal AA amyloidosis. Since then, she has been on hemodialysis and is now on the waiting list for a