Nutrition Metabolism and Cardiovascular Diseases最新文献

Association between cumulative intake of sugar-sweetened and artificially sweetened beverages and progression of coronary calcification: Insights from the CARDIA study 含糖饮料和人工甜味饮料的累积摄入量与冠状动脉钙化进展之间的关系：CARDIA研究的启示

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-10-10 DOI: 10.1016/j.numecd.2024.09.017

Lingqu Zhou , Qi Guo , Junjie Wang , Zirui Zhou , Yinyin Zhang

Background and aims

This study investigates the relationship between the cumulative intake of artificially sweetened beverages (ASBs) and sugar-sweetened beverages (SSBs) during young adulthood and the progression of coronary artery calcium (CAC) by midlife, using data from the Coronary Artery Risk Development in Young Adults study.

Methods and results

We included 2,466 participants with CAC measurement via computed tomography at the 15th, 20th, and 25th year follow-ups. Dietary intake was assessed using the CARDIA Diet History at baseline and years 7. Cumulative average beverage intake was calculated and categorized. Multivariable Cox regression models adjusted for demographic, lifestyle, and cardiovascular risk factors assessed associations between beverages consumption and CAC progression. Among the included participants, 1107 (44.9 %) were male, 1439 (58.4 %) were white, and the average age was 40.4 years with a standard deviation of 3.5 years. Over a 9.2±1.8-year follow-up, CAC progression was recorded in 715 participants. Higher cumulative ASBs intake was associated with increased CAC progression risk, with hazard ratios (95%CI, P-value) for low and high ASBs consumption being 1.35 (1.14, 1.60; P < 0.001) and 1.54 (1.15, 2.07; P < 0.001) compared to non-consumers. Participants consuming >2 servings/day of SSBs had a 37 % higher CAC progression risk (HR 1.37, 95 % CI 1.14–1.64, P < 0.001). However, no significant association was found between SSB consumption and CAC progression after adjusting for confounders.

Conclusions

Prolonged consumption of beverages, especially ASBs, in young adults is linked to an increased risk of CAC progression.

背景和目的：本研究利用 "青年冠状动脉风险发展 "研究的数据，探讨了青年期人工甜饮料（ASB）和含糖饮料（SSB）的累积摄入量与中年期冠状动脉钙化（CAC）进展之间的关系：我们纳入了 2466 名在第 15、20 和 25 年随访时通过计算机断层扫描测量 CAC 的参与者。在基线和第 7 年时，使用 CARDIA 饮食史评估饮食摄入量。对累计平均饮料摄入量进行计算和分类。经人口统计学、生活方式和心血管风险因素调整的多变量 Cox 回归模型评估了饮料摄入量与 CAC 进展之间的关系。在纳入的参与者中，1107 人（44.9%）为男性，1439 人（58.4%）为白人，平均年龄为 40.4 岁，标准差为 3.5 岁。在 9.2±1.8 年的随访中，715 名参与者的 CAC 发生了进展。ASBs累积摄入量越高，CAC进展风险越大，ASBs摄入量低和摄入量高的危险比（95%CI，P值）分别为1.35（1.14，1.60；P 2份/天的SSBs的CAC进展风险高出37%（HR 1.37，95% CI 1.14-1.64，P 结论：ASBs累积摄入量越高，CAC进展风险越大：青壮年长期饮用饮料，尤其是 ASB 与 CAC 进展风险增加有关。

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引用次数: 0

Liver fat response to two days fasting and two days isocaloric high-carbohydrate refeeding in lean and obese women 瘦弱和肥胖女性对两天禁食和两天等热量高碳水化合物进食的肝脏脂肪反应。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-10-01 DOI: 10.1016/j.numecd.2024.09.030

Petr Šedivý , Tereza Dusilová , Bára Šetinová , Dita Pajuelo , Milan Hájek , Lenka Rossmeislová , Michaela Šiklová , Veronika Šrámková , Eva Krauzová , Jan Gojda , Michal Koc , Monika Dezortová , Jan Kovář

Background and aims

Prolonged fasting, which leads to the mobilization of fat from adipose tissue, can result in the development of hepatosteatosis. However, it is not yet known whether the accumulation of fat in the liver after fasting can be affected by concurrent obesity. Therefore, this study aimed to assess how excessive adiposity influences changes in liver fat content induced by fasting and subsequent refeeding.

Methods and results

Ten lean women and eleven women with obesity (age: 36.4 ± 7.9 and 34.5 ± 7.9 years, BMI: 21.4 ± 1.7 and 34.5 ± 4.8 kg/m²) underwent a 60-h fasting period followed by 2 days of isocaloric high-carbohydrate refeeding. Magnetic resonance spectroscopy (MRS) examinations of liver were conducted at baseline, after 48 h of fasting, and at the end of refeeding period. Hepatic fat content (HFC) increased in lean women after fasting, whereas no statistically significant change in HFC was observed in women with obesity. Additionally, fasting led to significant reductions in liver volume in both groups, likely attributable to glycogen depletion, with subsequent restoration upon refeeding. Notably, changes in hepatic fat volume (HFV) rather than HFC inversely correlated with baseline liver fat content and HOMA-IR.

Conclusion

We demonstrated that prolonged fasting results in accumulation of fat in the liver in lean subjects only and that this accumulation is inversely related to baseline fat content and insulin resistance. Moreover, the study underscored the importance of evaluating hepatic fat volume rather than hepatic fat content in studies that involve considerable changes in hepatic lean volume.

背景和目的：长期禁食会导致脂肪组织中的脂肪被动员起来，从而导致肝脂肪变性。然而，禁食后脂肪在肝脏中的积聚是否会受到并发肥胖症的影响，目前尚不清楚。因此，本研究旨在评估过度肥胖如何影响禁食和随后再进食引起的肝脏脂肪含量变化：10 名瘦弱女性和 11 名肥胖女性（年龄：36.4 ± 7.9 岁和 34.5 ± 7.9 岁，体重指数：21.4 ± 1.7 千克/平方米和 34.5 ± 4.8 千克/平方米）进行了 60 小时的禁食，随后进行了为期 2 天的等热量高碳水化合物进食。分别在基线期、禁食 48 小时后和进食期结束时对肝脏进行了磁共振光谱（MRS）检查。禁食后，瘦弱女性的肝脏脂肪含量（HFC）增加，而肥胖女性的肝脏脂肪含量在统计学上没有明显变化。此外，禁食还导致两组女性的肝脏体积显著缩小，这可能是由于糖原耗竭所致，随后在进食后恢复。值得注意的是，肝脏脂肪体积（HFV）而非肝脏脂肪含量的变化与基线肝脏脂肪含量和 HOMA-IR 成反比：我们的研究表明，长期禁食只会导致瘦人肝脏中脂肪的积累，而且这种积累与基线脂肪含量和胰岛素抵抗成反比。此外，该研究还强调了在涉及肝脏瘦肉体积发生巨大变化的研究中，评估肝脏脂肪体积而非肝脏脂肪含量的重要性。

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引用次数: 0

Serum uric acid and mortality in metabolic dysfunction-associated steatotic liver disease: Subgroup differences 代谢功能障碍相关脂肪性肝病患者的血清尿酸与死亡率：亚组差异。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-09-21 DOI: 10.1016/j.numecd.2024.09.015

Wenya Chen , You Deng , Mengqi Li , Jiashuo Li , Ying Cao , Wen Xie

Background and aims

This study aims to investigate the association between serum uric acid (SUA) and both the risk and long-term mortality of dysfunction-associated steatotic liver disease (MASLD), and to explore differences between the pure MASLD and metabolic and alcohol related/associated liver disease (MetALD) subgroups.

Methods and results

We included 11,675 participants from the Third National Health and Nutrition Examination Survey, with matched mortality data up to 2019. Logistic regression and Cox proportional hazards regression evaluated the relationship between SUA and both the risk and mortality of MASLD. Non-linear correlations and threshold effects were explored using restricted cubic splines and a two-piecewise Cox proportional hazards model. We found that SUA was positively associated with the risk of MASLD [odds ratio (OR): 1.19, 95 % confidence interval (CI) 1.12–1.27]. For pure MASLD, SUA showed a positive association with all-cause mortality [<4.7 mg/dL: hazard ratio (HR): 1.34, 95 % CI 1.04–1.73; ≥4.7 mg/dL: HR: 1.08, 95 % CI 1.02–1.15] and cardiovascular mortality (HR: 1.12, 95 % CI 1.02–1.22). For MetALD, there was an inverse J-shaped relationship (threshold: 6.6 mg/dL) between SUA and all-cause mortality. Below the threshold, SUA was negatively correlated with all-cause mortality (HR: 0.42, 95 % CI 0.19–0.93), but no association was found above it (HR: 0.81, 95 % CI 0.54–1.21). Additionally, no association was observed between SUA and cardiovascular mortality.

Conclusions

SUA serves as an independent predictor of the risk and all-cause mortality of MASLD. The relationship between SUA and both all-cause and cardiovascular mortality differs between the pure MASLD and MetALD subgroups.

背景和目的：本研究旨在调查血清尿酸（SUA）与功能障碍相关性脂肪性肝病（MASLD）的风险和长期死亡率之间的关系，并探讨纯MASLD亚组与代谢和酒精相关/相关性肝病（MetALD）亚组之间的差异：我们纳入了来自第三次全国健康与营养调查的 11,675 名参与者，并提供了截至 2019 年的匹配死亡率数据。逻辑回归和 Cox 比例危险度回归评估了 SUA 与 MASLD 风险和死亡率之间的关系。我们使用限制性三次样条和双片式 Cox 比例危险模型探讨了非线性相关性和阈值效应。我们发现，SUA 与罹患 MASLD 的风险呈正相关[比值比 (OR)：1.19，95% 置信区间 (CI) 1.12-1.27]。对于纯 MASLD，SUA 与全因死亡率呈正相关[结论：SUA是MASLD风险和全因死亡率的独立预测因子。SUA与全因死亡率和心血管死亡率之间的关系在纯MASLD亚组和MetALD亚组之间有所不同。

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引用次数: 0

Population dietary-metabolic characteristics and mortality from major cardiovascular disease subtypes: the Seven Contries Study 60-year follow-up 人口膳食代谢特征与主要心血管疾病亚型的死亡率：七国研究 60 年随访。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-09-19 DOI: 10.1016/j.numecd.2024.09.018

Alessandro Menotti , Paolo Emilio Puddu

Background and aim

During the last few years, the Seven Countries Study of Cardiovascular Diseases (SCS) produced some new analyses dealing with the relationships of a dietary score, the pool of dietary fatty acids and serum cholesterol with major types of cardiovascular disease (CVD) mortality in 10 cohorts of 6 countries made of middle-aged men followed-up for 60 years until extinction. This sparse evidence is condensed here to provide a coherent view.

Methods and results

The Mediterranean Adequacy Index (MAI, a dietary score whose high levels depict the characteristics of the Mediterranean Diet), was highly and significantly associated in an inverse way, at country levels, with the Atherogenicity (ATI) and the Thrombogenicity (THI) indexes that included a series of dietary fatty acids. These indexes were highly and significantly associated in a direct way with country baseline serum cholesterol levels. Countries with high serum cholesterol had largely higher death rates from coronary heart disease (CHD) and lower rates from other heart diseases of uncertain etiology and stroke. The reverse was observed in countries with low serum cholesterol.

Conclusion

The chain of diet, dietary fatty acids and serum cholesterol seems to be responsible in various ways for the different distribution of major CVD mortality subtypes in extincted cohorts.

背景和目的：在过去几年中，七国心血管疾病研究（SCS）进行了一些新的分析，涉及膳食评分、膳食脂肪酸库和血清胆固醇与主要类型心血管疾病（CVD）死亡率之间的关系。本文对这些稀少的证据进行了浓缩，以提供一个连贯的观点：地中海充足指数（MAI，一种膳食评分，其高水平反映了地中海饮食的特点）与动脉粥样硬化指数（ATI）和血栓形成指数（THI）（包括一系列膳食脂肪酸）在国家层面上呈显著的反比关系。这些指数与各国的血清胆固醇基线水平有很大的直接关系。高血清胆固醇国家的冠心病死亡率较高，而其他病因不明的心脏病和中风的死亡率较低。血清胆固醇水平低的国家则相反：结论：膳食、膳食脂肪酸和血清胆固醇链似乎在不同方面造成了灭绝队列中主要心血管疾病死亡亚型的不同分布。

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引用次数: 0

Ultra-processed food, genetic risk, and the risk of cardiometabolic diseases and cardiometabolic multimorbidity: A prospective study 超加工食品、遗传风险与心血管代谢疾病和心血管代谢多病风险：一项前瞻性研究。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-09-17 DOI: 10.1016/j.numecd.2024.09.011

Jing Wang , Tingting Chen , Wenmin Zhu , Ziwei Shi , Xiaolong Yan , Zhiqun Lei , Qi Wang

Background and aims

This study aims to evaluate the impact of ultra-processed food (UPF) on type 2 diabetes (T2D), cardiovascular disease (CVD), hypertension, and cardiometabolic multimorbidity (CMM), and to explore the role of genetic susceptibility in these associations.

Methods and results

90 631 participants from the UK Biobank were included (collected between 2006 and 2010). The outcomes assessed included T2D, CVD, hypertension and CMM. The Cox proportional hazards model was used to evaluate their associations and the potential modification by genetic risk, which was estimated using the polygenic risk score (PRS). Participants with high UPF consumption had a higher risk of T2D, CVD, and CMM, with the adjusted hazard ratio (HR) of 1.36 (95 % confidence interval [CI]: 1.15, 1.61), 1.13 (95%CI: 1.03, 1.23), and 1.14 (95%CI: 1.05, 1.24), respectively. Those with high UPF consumption and high PRS for T2D, CVD, and hypertension had the highest risk of T2D (HR: 4.01; 95%CI: 2.83, 5.69), CVD (HR: 2.18; 95%CI: 1.86, 2.56), and hypertension (HR: 1.79; 95%CI: 1.61, 1.99), respectively. In participants with one cardiometabolic disease (CMD), those with high UPF consumption and high PRS_T2D or PRS_CVD had the highest risk of developing CMM. A significant additive interaction was observed between PRS_T2D and UPF consumption on the risk of T2D.

Conclusion

Our study underscored the importance of identifying individuals with high UPF consumption for targeted dietary interventions to mitigate the risk of CMDs and CMM, particularly among those with a high genetic risk of CMDs.

背景和目的：本研究旨在评估超加工食品（UPF）对2型糖尿病（T2D）、心血管疾病（CVD）、高血压和心脏代谢多病症（CMM）的影响，并探讨遗传易感性在这些关联中的作用：研究纳入了英国生物库中的 90 631 名参与者（收集时间为 2006 年至 2010 年）。评估的结果包括T2D、心血管疾病、高血压和CMM。采用 Cox 比例危险模型评估这些结果之间的关联以及遗传风险对结果的潜在影响，遗传风险是通过多基因风险评分（PRS）估算出来的。UPF消耗量高的参与者罹患T2D、心血管疾病和CMM的风险较高，调整后的危险比（HR）分别为1.36（95%置信区间[CI]：1.15，1.61）、1.13（95%CI：1.03，1.23）和1.14（95%CI：1.05，1.24）。UPF消耗量高且T2D、心血管疾病和高血压PRS高的人患T2D（HR：4.01；95%CI：2.83，5.69）、心血管疾病（HR：2.18；95%CI：1.86，2.56）和高血压（HR：1.79；95%CI：1.61，1.99）的风险分别最高。在患有一种心脏代谢疾病（CMD）的参与者中，UPF消耗量高、PRST2D或PRSCVD高的人患CMM的风险最高。PRST2D和UPF摄入量对T2D风险有明显的叠加作用：我们的研究强调了识别UPF消耗量高的个体进行有针对性的膳食干预以降低CMD和CMM风险的重要性，尤其是在CMD遗传风险高的人群中。

{"title":"Ultra-processed food, genetic risk, and the risk of cardiometabolic diseases and cardiometabolic multimorbidity: A prospective study","authors":"Jing Wang , Tingting Chen , Wenmin Zhu , Ziwei Shi , Xiaolong Yan , Zhiqun Lei , Qi Wang","doi":"10.1016/j.numecd.2024.09.011","DOIUrl":"10.1016/j.numecd.2024.09.011","url":null,"abstract":"<div><h3>Background and aims</h3><div>This study aims to evaluate the impact of ultra-processed food (UPF) on type 2 diabetes (T2D), cardiovascular disease (CVD), hypertension, and cardiometabolic multimorbidity (CMM), and to explore the role of genetic susceptibility in these associations.</div></div><div><h3>Methods and results</h3><div>90 631 participants from the UK Biobank were included (collected between 2006 and 2010). The outcomes assessed included T2D, CVD, hypertension and CMM. The Cox proportional hazards model was used to evaluate their associations and the potential modification by genetic risk, which was estimated using the polygenic risk score (PRS). Participants with high UPF consumption had a higher risk of T2D, CVD, and CMM, with the adjusted hazard ratio (HR) of 1.36 (95 % confidence interval [CI]: 1.15, 1.61), 1.13 (95%CI: 1.03, 1.23), and 1.14 (95%CI: 1.05, 1.24), respectively. Those with high UPF consumption and high PRS for T2D, CVD, and hypertension had the highest risk of T2D (HR: 4.01; 95%CI: 2.83, 5.69), CVD (HR: 2.18; 95%CI: 1.86, 2.56), and hypertension (HR: 1.79; 95%CI: 1.61, 1.99), respectively. In participants with one cardiometabolic disease (CMD), those with high UPF consumption and high PRS<sub>T2D</sub> or PRS<sub>CVD</sub> had the highest risk of developing CMM. A significant additive interaction was observed between PRS<sub>T2D</sub> and UPF consumption on the risk of T2D.</div></div><div><h3>Conclusion</h3><div>Our study underscored the importance of identifying individuals with high UPF consumption for targeted dietary interventions to mitigate the risk of CMDs and CMM, particularly among those with a high genetic risk of CMDs.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Uric acid and risk of incident heart failure in individuals with cardiovascular disease 尿酸与心血管疾病患者发生心力衰竭的风险。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-09-17 DOI: 10.1016/j.numecd.2024.09.012

Na Li , Yaqi Li , Liufu Cui , Rong Shu , Jiaoyan Li , Haicheng Song , Jierui Wang , Shuohua Chen , Chenrui Zhu , Maoxiang Zhao , Xiang Gao , Tong Liu , Shouling Wu

Background and aims

Uric acid has been positively associated with the risk of developing heart failure in the general population. Nevertheless, it remains unclear whether hyperuricemia is an independent risk factor for heart failure and further contributes to the risk of heart failure among the already at-risk cardiovascular disease (CVD) population. This study aimed to evaluate the association between uric acid and incident heart failure in individuals with established CVD.

Methods and results

Included were 18,438 adults with established CVD but free of heart failure at baseline, from the Kailuan Study. Incident heart failure cases were ascertained by medical records. Cause-specific Cox proportional hazards regression models were applied to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) of heart failure according to uric acid tertiles. Over a median follow-up of 6.1 years, we identified 1215 incident heart failure cases. Higher uric acid was associated with a higher risk of incident heart failure, with adjusted HR for the last vs. first tertile of 1.50 (95%CI:1.30–1.73). Higher uric acid concentrations were associated with an increased risk of heart failure in individuals with coronary heart disease, atrial fibrillation, and ischemic stroke, but not in those with hemorrhagic stroke. Moreover, the observed association between uric acid and heart failure risk was more pronounced in individuals diagnosed with heart failure with reduced ejection fraction subtype compared with heart failure with preserved ejection fraction.

Conclusions

In individuals with CVD, uric acid was positively associated with the risk of heart failure, in a dose-response manner.

背景和目的：尿酸与普通人群患心力衰竭的风险呈正相关。然而，高尿酸血症是否是心力衰竭的独立风险因素，是否会进一步增加已患心血管疾病（CVD）人群的心力衰竭风险，目前仍不清楚。本研究旨在评估尿酸与已确诊心血管疾病患者发生心力衰竭之间的关系：研究纳入了开滦研究中18,438名已确诊心血管疾病但基线时无心力衰竭的成年人。心力衰竭病例通过医疗记录确定。应用特定病因的考克斯比例危险回归模型，根据尿酸三元组估计心衰的危险比（HRs）和95%置信区间（CIs）。在中位 6.1 年的随访期间，我们共发现了 1215 例心衰病例。尿酸越高，发生心力衰竭的风险越高，最后一个三分位数与第一个三分位数的调整HR值为1.50（95%CI：1.30-1.73）。尿酸浓度较高与冠心病、心房颤动和缺血性中风患者心力衰竭风险增加有关，但与出血性中风患者无关。此外，与射血分数保留型心力衰竭相比，尿酸与心力衰竭风险之间的关联在射血分数降低亚型心力衰竭患者中更为明显：结论：在心血管疾病患者中，尿酸与心力衰竭风险呈剂量反应正相关。

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引用次数: 0

Uric acid reference values for children and adolescents should be stratified by pubertal stage 儿童和青少年的尿酸参考值应按青春期阶段分层。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-09-12 DOI: 10.1016/j.numecd.2024.09.009

Shurong Huang , Qifa Hu , Zhuoguang Li , Yanyan Li , Xiu Zhao , Yue Shang , Rongfei Zheng , Qiru Su , Jingfan Xiong , Zhe Su

Background and aim

To establish reference values for hyperuricemia (HUA) in children and adolescents.

Methods and results

The study enrolled 4807 students from “The Evaluation and Monitoring on School-based Nutrition and Growth in Shenzhen study.” Utilizing quantile regression, associations between age, body mass index (BMI), pubertal stage, and serum uric acid (SUA) were examined, alongside the relationship between SUA and cardiovascular disease (CVD) risk factors. Reference values for SUA were explored using receiver operating characteristic analysis, considering sex and pubertal stage. The prevalence of HUA was 34.3 % for boys and 29 % for girls (using the adult HUA diagnostic criteria: >420 μmol/L for males, >360 μmol/L for females), increasing with higher BMI, age, and pubertal stage. Pubertal stage had the largest influence on SUA in boys, while nutritional status was the most significant factor affecting SUA in girls. Adjusting for age and pubertal stage, higher SUA levels correlated with an increased risk of CVD risk factors. Proposed reference values included >360 μmol/L for girls ages 6–17 years and prepubertal boys. For pubertal boys, reference values varied based on age: >392 μmol/L for ages 9–11 in early-middle puberty, >429 μmol/L for ages 12–14 in early-middle puberty, >478 μmol/L for ages 12–14 in late puberty, and >505 μmol/L for ages 15–17 in late puberty.

Conclusions

Stratifying HUA reference values by pubertal stage, particularly for boys, is crucial. Long-term follow-up of individuals with high SUA levels may aid in refining SUA reference values.

背景和目的：确定儿童和青少年高尿酸血症（HUA）的参考值：该研究从 "深圳校本营养与成长评价监测研究 "中招募了 4807 名学生。研究利用量子回归法考察了年龄、体重指数（BMI）、青春期阶段与血清尿酸（SUA）之间的关系，以及SUA与心血管疾病（CVD）风险因素之间的关系。在考虑性别和青春期阶段的情况下，使用接收器操作特征分析法探讨了 SUA 的参考值。男孩的 HUA 患病率为 34.3%，女孩为 29%（采用成人 HUA 诊断标准：男性>420 μmol/L，女性>360 μmol/L），随着体重指数（BMI）、年龄和青春期阶段的增加而增加。青春期阶段对男孩 SUA 的影响最大，而营养状况则是影响女孩 SUA 的最重要因素。调整年龄和青春期阶段后，较高的 SUA 水平与心血管疾病风险因素的增加相关。对于 6-17 岁的女孩和青春期前的男孩，建议的参考值包括 >360 μmol/L。对于青春期男孩，参考值因年龄而异：青春期早中期的 9-11 岁男孩的参考值>392 μmol/L，青春期早中期的 12-14 岁男孩的参考值>429 μmol/L，青春期晚期的 12-14 岁男孩的参考值>478 μmol/L，青春期晚期的 15-17 岁男孩的参考值>505 μmol/L：按青春期阶段划分 HUA 参考值至关重要，尤其是对男孩而言。对 SUA 水平较高的个体进行长期随访有助于完善 SUA 参考值。

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引用次数: 0

Metabolic dysfunction-associated steatotic liver disease, liver fibrosis and risk of cardiovascular disease: A prospective cohort study 代谢功能障碍相关脂肪肝、肝纤维化与心血管疾病风险：前瞻性队列研究。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-09-12 DOI: 10.1016/j.numecd.2024.09.001

Ji Woo Baek , Yeun Soo Yang , Keum Ji Jung , Heejin Kimm , So Young Kim , Sunmi Lee , Sun Ha Jee

Background and aims

In patients with NAFLD, liver fibrosis increases liver-related complications, but there is controversy about the increase in CVD. Based on a prospective cohort study, this study investigated the risk of cardiovascular disease due to liver fibrosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).

Methods and results

This study analyzed KCPS-II prospective cohort that tracked 104,399 people who participated in health check-ups at 18 institutions nationwide from 2004 to 2013. If the fatty liver index was 30 or higher, it was defined as SLD, and participants were classified into No-SLD, MASLD, MetALD, ALD, and Cryptogenic SLD. Liver fibrosis was defined by the FIB-4 index, and the occurrence of cardiovascular disease according to SLD classification was analyzed using Cox proportional model regression analysis. Out study included a total of 6,942 participants (6.6%) had MASLD, 6,694 (6.4%) had MetALD, 4,751 (4.6%) had ALD, and 382 (0.3%) had Cryptogenic SLD. For the cases of FIB-4 index ≥1.3, the multivariable-adjusted HR (95% CI) of cardiovascular disease was 2.27 (1.87-2–76) in MASLD, 1.67 (1.30–2.10) in MetALD, and 2.56 (1.99–3.30) in ALD, but it was 0.78 (0.19–3.10) in Cryptogenic_SLD, which was not significant. The risk of cardiovascular disease according to the fibrosis stage classified by BARD also presented similar results.

Conclusions

This prospective cohort study of Korean patients with newly defined MASLD, MetALD, and ALD with FIB-4 ≥ 1.3 at high risk of developing cardiovascular disease.

背景和目的：在非酒精性脂肪肝患者中，肝纤维化会增加肝脏相关并发症，但对于心血管疾病的增加存在争议。本研究基于一项前瞻性队列研究，调查了代谢功能障碍相关性脂肪性肝病（MASLD）患者肝纤维化导致心血管疾病的风险：本研究分析了KCPS-II前瞻性队列，该队列追踪了2004年至2013年期间在全国18家机构参加健康体检的104399人。如果脂肪肝指数达到或超过 30，则被定义为 SLD，参与者被分为无 SLD、MASLD、MetALD、ALD 和隐源性 SLD。肝纤维化由 FIB-4 指数定义，心血管疾病的发生率则根据 SLD 分类采用 Cox 比例模型回归分析法进行分析。研究共纳入了6942名（6.6%）患有MASLD的参与者，6694名（6.4%）患有MetALD的参与者，4751名（4.6%）患有ALD的参与者，382名（0.3%）患有隐源性SLD的参与者。对于FIB-4指数≥1.3的病例，经多变量调整后，MASLD的心血管疾病HR（95% CI）为2.27（1.87-2-76），MetALD为1.67（1.30-2.10），ALD为2.56（1.99-3.30），而隐源性SLD为0.78（0.19-3.10），差异不显著。根据BARD划分的纤维化阶段得出的心血管疾病风险也呈现出相似的结果：这项前瞻性队列研究的对象是FIB-4≥1.3的新定义的MASLD、MetALD和ALD韩国患者，他们罹患心血管疾病的风险很高。

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引用次数: 0

Organisational initiatives to improve care in the prevention and management of cardiometabolic conditions: A scoping review 改善心脏代谢疾病预防和管理护理的组织举措：范围综述。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-09-10 DOI: 10.1016/j.numecd.2024.09.004

Hellena Hailu Habte-Asres , Chuyou Hou , Angus Forbes , David C. Wheeler

Aim

Cardiometabolic conditions such as cardiovascular disease, type 2 diabetes, and chronic kidney disease contribute to multimorbidity, posing a global health challenge. However, existing healthcare frameworks often struggle to adequately address the intricate needs of individuals living with these conditions. The review aims to map existing research on cardiometabolic care initiatives for the primary and secondary prevention of metabolic conditions.

Data synthesis

A scoping review was conducted following the methodology of the Joanna-Briggs-Institute. We searched Medline, Embase, and CINAHL. The review primarily sought studies comparing the effectiveness of cardiometabolic services/clinics in primary or secondary prevention of cardiometabolic conditions with standard care. The data from these studies were charted and summarised in tabular form, with a narrative synthesis.

The search identified 97 records across three databases, and 18 documents met inclusion criteria. Two studies addressed cardiometabolic care in primary prevention, while twelve focused on secondary prevention. Positive outcomes were observed in primary prevention, including reductions in waist circumference, body mass index, blood pressure, and cholesterol levels. For secondary prevention, the studies demonstrated positive metabolic outcomes, such as reductions in HbA1c, weight, blood pressure, and cholesterol levels. Additionally, data from the available studies reported improved adherence to diabetes care processes and the implementation of guideline-directed therapies.

Conclusion

This scoping review highlights the potential benefits of services such as cardiometabolic clinics for primary and secondary prevention in metabolic conditions. Future studies should use standardised outcome measures and include details on the structure, staffing and treatment intensity of clinics to aid their wider implementation.

目的：心血管疾病、2 型糖尿病和慢性肾病等心脏代谢疾病导致多病并发，对全球健康构成挑战。然而，现有的医疗保健框架往往难以充分满足这些疾病患者的复杂需求。本综述旨在梳理有关心脏代谢护理措施的现有研究，以便对代谢疾病进行一级和二级预防：我们按照乔安娜-布里格斯研究所（Joanna-Briggs-Institute）的方法进行了范围界定综述。我们检索了 Medline、Embase 和 CINAHL。该综述主要寻求将心脏代谢服务/诊所在心脏代谢疾病一级或二级预防中的有效性与标准护理进行比较的研究。这些研究的数据以图表形式进行了记录和总结，并进行了叙述性综合。搜索结果在三个数据库中发现了 97 条记录，其中 18 篇文献符合纳入标准。其中两项研究涉及一级预防中的心脏代谢护理，十二项研究侧重于二级预防。在一级预防中观察到了积极的结果，包括腰围、体重指数、血压和胆固醇水平的降低。在二级预防方面，研究显示了积极的代谢结果，如 HbA1c、体重、血压和胆固醇水平的降低。此外，现有研究数据还显示，糖尿病护理流程的依从性和指南指导疗法的实施情况均有所改善：本范围综述强调了心脏代谢门诊等服务对代谢疾病一级和二级预防的潜在益处。未来的研究应使用标准化的结果测量方法，并详细介绍诊所的结构、人员配备和治疗强度，以帮助其更广泛地实施。

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引用次数: 0

Research on the causal relationship between fine particulate matter and type 2 diabetes mellitus: A two-sample multivariable mendelian randomization study 细颗粒物与 2 型糖尿病因果关系研究：一项双样本多变量孟德尔随机研究。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-09-05 DOI: 10.1016/j.numecd.2024.08.023

Xinyang Shou , Zhenghong Yao , Yimin Wang , Yanxi Chai , Yuxin Huang , Rucheng Chen , Weijia Gu , Qiang Liu

Background and aims

Previous research has suggested a correlation between fine particulate matter (PM2.5) and type 2 diabetes mellitus (T2DM). However, the causality was vulnerable to confounding variables.

Methods and results

A two-sample multivariable mendelian randomization study was designed to examine the causal connection between PM2.5 and T2DM. PM2.5 trait was investigated as exposure while T2DM-related traits as outcomes. The summary data were obtained from the Finngen database and the open genome-wide association study database. The mendelian randomization estimates were obtained using the inverse-variance weighted approach, and multiple sensitivity analyses were conducted. There were potential causal relationships between PM2.5 and T2DM (OR = 2.418; P = 0.019), PM2.5 and glycated hemoglobin (HbA1c) (OR = 1.590; P = 0.041), and PM2.5 and insulin metabolism. PM2.5 was found to have no causal effect on fasting glucose and insulin, 2-h glucose, and insulin-like growth factor binding protein-1 (P > 0.05), while had a potential protective effect against some diabetes complications.

Conclusions

Our findings indicated potential causal relationships among PM2.5 and T2DM, especially the causal relationship between PM2.5 and long-term glucose levels.

背景和目的：以往的研究表明，细颗粒物（PM2.5）与2型糖尿病（T2DM）之间存在相关性。然而，这种因果关系很容易受到混杂变量的影响：我们设计了一项双样本多变量亡羊补牢随机研究，以检验 PM2.5 与 T2DM 之间的因果关系。PM2.5特质作为暴露因素，T2DM相关特质作为结果。摘要数据来自芬根数据库和开放的全基因组关联研究数据库。采用逆方差加权法获得了 "泯灭随机化 "估计值，并进行了多重敏感性分析。PM2.5与T2DM（OR = 2.418; P = 0.019）、PM2.5与糖化血红蛋白（HbA1c）（OR = 1.590; P = 0.041）以及PM2.5与胰岛素代谢之间存在潜在的因果关系。研究发现，PM2.5 对空腹血糖和胰岛素、2 小时血糖以及胰岛素样生长因子结合蛋白-1 没有因果关系（P > 0.05），但对某些糖尿病并发症有潜在的保护作用：我们的研究结果表明了 PM2.5 与 T2DM 之间的潜在因果关系，尤其是 PM2.5 与长期血糖水平之间的因果关系。

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引用次数: 0