Pub Date : 2026-03-01Epub Date: 2025-11-14DOI: 10.1016/j.numecd.2025.104470
Alessandro Di Minno , Maria Vittoria Morone , Marcello Cordara , Daniele Giuseppe Buccato , Lorenza Francesca De Lellis , Hammad Ullah , Roberto Piccinocchi , Danaé S. Larsen , Alessandra Baldi , Gaetano Piccinocchi , Xiang Xiao , Roberto Sacchi , Maria Daglia
Background and aims
We have evaluated the efficacy and tolerability of two food supplements (FS) containing flavonoids (naringin and hesperidin); same doses of B3, B6, B9 and B12 vitamins, and two different doses of a blend of Mentha spicata leaf extract and Amaranthus caudatus seed flour, in subjects with borderline high total (TC) and low-density lipoprotein cholesterol (LDL-C) levels.
Methods and results
114 Participants (18–70 years) with TC levels 200–239 mg/dL, (5.18–6.19 mmol/L) and LDL-C (<159 mg/dL) were randomised into three groups to receive for 90 days the lowest (n = 38, Treatment A), the highest dose of the FS (n = 38 – Treatment B), or placebo (n = 38). Treatment B was associated with a significant reduction in LDL-C (∼31.5 mg/dL;-22%) and TC (∼19.5 mg/dL; -9%), along with an increase in high-density lipoprotein cholesterol (HDL-C). The greater efficacy of Treatment B containing the highest dose of vegetable extracts is likely attributable to its higher M. spicata extract content, as judged by high-resolution mass spectrometry analysis of the preparation.
Conclusion
The combination of different FS ingredients with different mechanisms of action can be a valuable strategy for improving lipid profiles in subjects with borderline high TC and LDL-C levels.
{"title":"Improved HDL, LDL and total cholesterol levels following a 3-month administration of Mentha spicata leaf extract and Amaranthus caudatus seed flour extracts, flavonoids and B vitamins. A placebo-controlled, double-blind, randomized clinical trial","authors":"Alessandro Di Minno , Maria Vittoria Morone , Marcello Cordara , Daniele Giuseppe Buccato , Lorenza Francesca De Lellis , Hammad Ullah , Roberto Piccinocchi , Danaé S. Larsen , Alessandra Baldi , Gaetano Piccinocchi , Xiang Xiao , Roberto Sacchi , Maria Daglia","doi":"10.1016/j.numecd.2025.104470","DOIUrl":"10.1016/j.numecd.2025.104470","url":null,"abstract":"<div><h3>Background and aims</h3><div>We have evaluated the efficacy and tolerability of two food supplements (FS) containing flavonoids (naringin and hesperidin); same doses of B3, B6, B9 and B12 vitamins, and two different doses of a blend of <em>Mentha spicata</em> leaf extract and <em>Amaranthus caudatus</em> seed flour, in subjects with borderline high total (TC) and low-density lipoprotein cholesterol (LDL-C) levels.</div></div><div><h3>Methods and results</h3><div>114 Participants (18–70 years) with TC levels 200–239 mg/dL, (5.18–6.19 mmol/L) and LDL-C (<159 mg/dL) were randomised into three groups to receive for 90 days the lowest (n = 38, Treatment A), the highest dose of the FS (n = 38 – Treatment B), or placebo (n = 38). Treatment B was associated with a significant reduction in LDL-C (∼31.5 mg/dL;-22%) and TC (∼19.5 mg/dL; -9%), along with an increase in high-density lipoprotein cholesterol (HDL-C). The greater efficacy of Treatment B containing the highest dose of vegetable extracts is likely attributable to its higher <em>M. spicata</em> extract content, as judged by high-resolution mass spectrometry analysis of the preparation.</div></div><div><h3>Conclusion</h3><div>The combination of different FS ingredients with different mechanisms of action can be a valuable strategy for improving lipid profiles in subjects with borderline high TC and LDL-C levels.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"36 3","pages":"Article 104470"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949357","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}
Pub Date : 2026-03-01Epub Date: 2025-11-20DOI: 10.1016/j.numecd.2025.104468
Hieu Lan Nguyen , Linh Thuy Le , Thinh Gia Nguyen , Quynh Thu Nguyen , Hieu Van Nguyen , Ngoan Tran Le
Background and aim
Tryptophan's metabolic products, serotonin and melatonin, exhibit antioxidant activity and neuroprotective properties, thereby preventing mortality from cardiovascular diseases (CVD). We aim to examine the relationship between dietary tryptophan intake density and the risk of CVD.
Methods and results
A prospective cohort study was conducted in northern Vietnam from 2008 to 2019, which comprises 42,146 participants aged 10 and older. Dietary tryptophan intake density per 1000 kcal was assessed using a validated semi-quantitative food frequency questionnaire. CVD deaths were 348 cases. The mean age was 38.5 years; 48 % were male and 52 % were female. The median follow-up duration was 11.01 years. Hazard ratio and 95 % confidence interval HR (95 % CI) were calculated for the association between dietary tryptophan intake density and mortality risks from CVD.
The inverse association between dietary tryptophan intake density, top to bottom quintile, and CVD was seen for the entire study population, HR (95 % CI): 0.59 (0.42, 0.83), and after excluding deaths in the first three years, HR (95 % CI): 0.59 (0.41, 0.86). The results remained after additional adjustment for pack-years of smoking. A similar protective pattern was observed in subgroups with BMI <23 kg/m2, smokers, drinkers, and men. The beneficial effect was observed in both young adults and those 65 years or older.
Conclusions
A beneficial effect of dietary tryptophan intake density against the risk of CVD was observed. The findings warrant further research to understand the mechanism and its application in preventing CVD.
{"title":"Dietary tryptophan intake density and the risk of cardiovascular diseases: insights from a prospective cohort study","authors":"Hieu Lan Nguyen , Linh Thuy Le , Thinh Gia Nguyen , Quynh Thu Nguyen , Hieu Van Nguyen , Ngoan Tran Le","doi":"10.1016/j.numecd.2025.104468","DOIUrl":"10.1016/j.numecd.2025.104468","url":null,"abstract":"<div><h3>Background and aim</h3><div>Tryptophan's metabolic products, serotonin and melatonin, exhibit antioxidant activity and neuroprotective properties, thereby preventing mortality from cardiovascular diseases (CVD). We aim to examine the relationship between dietary tryptophan intake density and the risk of CVD.</div></div><div><h3>Methods and results</h3><div>A prospective cohort study was conducted in northern Vietnam from 2008 to 2019, which comprises 42,146 participants aged 10 and older. Dietary tryptophan intake density per 1000 kcal was assessed using a validated semi-quantitative food frequency questionnaire. CVD deaths were 348 cases. The mean age was 38.5 years; 48 % were male and 52 % were female. The median follow-up duration was 11.01 years. Hazard ratio and 95 % confidence interval HR (95 % CI) were calculated for the association between dietary tryptophan intake density and mortality risks from CVD.</div><div>The inverse association between dietary tryptophan intake density, top to bottom quintile, and CVD was seen for the entire study population, HR (95 % CI): 0.59 (0.42, 0.83), and after excluding deaths in the first three years, HR (95 % CI): 0.59 (0.41, 0.86). The results remained after additional adjustment for pack-years of smoking. A similar protective pattern was observed in subgroups with BMI <23 kg/m<sup>2</sup>, smokers, drinkers, and men. The beneficial effect was observed in both young adults and those 65 years or older.</div></div><div><h3>Conclusions</h3><div>A beneficial effect of dietary tryptophan intake density against the risk of CVD was observed. The findings warrant further research to understand the mechanism and its application in preventing CVD.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"36 3","pages":"Article 104468"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890451","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}
Pub Date : 2026-03-01Epub Date: 2025-11-06DOI: 10.1016/j.numecd.2025.104434
Ching-Yao Tsai , Yun-Ju Lai , Shen-Shong Chang , Yu-Yen Chen , Wan-Ling Tu , Jason Jiunshiou Lee , Shih-Liang Shih , Jyh-Tong Hsieh , Yung-Feng Yen , Chung-Yeh Deng
Background and aims
Population-based evidence on the association between fruit and vegetable consumption and the risk of rapid kidney function decline is limited and inconsistent. We investigated the impact of fruit and vegetable consumption on the risk of rapid kidney function decline in a Taiwanese adult population.
Methods and results
This prospective cohort study utilized data from Taiwan's MJ cohort, which enrolled adults aged ≥18 years between 2009 and 2022. We analyzed 86,813 participants with at least two serum creatinine measurements taken an average of 4.2 (±3.0) years apart. Daily fruit and vegetable intake was categorized as <3, 3–5, and ≥5 servings. Kidney function decline was assessed by the annual percentage change in estimated glomerular filtration rate (eGFR), with rapid decline defined as the highest tertile of annual eGFR percentage loss. During follow-up, the mean annual eGFR decline was 0.38 %, 0.36 %, and 0.30 % for participants consuming <3, 3–5, and ≥5 servings daily, respectively (P < .001). Compared with those consuming <3 servings daily, participants consuming 3–5 servings (AOR = 0.95; 95 % CI: 0.92–0.98) and ≥5 servings (AOR = 0.93; 95 % CI: 0.89–0.98) had a lower risk of rapid kidney function decline. A significant linear dose–response relationship was observed between higher fruit and vegetable intake and reduced risk of rapid kidney function decline (P < .001).
Conclusions
Fruit and vegetable consumption was associated with a reduced risk of rapid kidney function decline, highlighting the need to promote a fruit- and vegetable-rich diet for CKD prevention.
{"title":"Fruit and vegetable consumption reduces the risk of rapid kidney function decline: A prospective cohort study in Taiwan","authors":"Ching-Yao Tsai , Yun-Ju Lai , Shen-Shong Chang , Yu-Yen Chen , Wan-Ling Tu , Jason Jiunshiou Lee , Shih-Liang Shih , Jyh-Tong Hsieh , Yung-Feng Yen , Chung-Yeh Deng","doi":"10.1016/j.numecd.2025.104434","DOIUrl":"10.1016/j.numecd.2025.104434","url":null,"abstract":"<div><h3>Background and aims</h3><div>Population-based evidence on the association between fruit and vegetable consumption and the risk of rapid kidney function decline is limited and inconsistent. We investigated the impact of fruit and vegetable consumption on the risk of rapid kidney function decline in a Taiwanese adult population.</div></div><div><h3>Methods and results</h3><div>This prospective cohort study utilized data from Taiwan's MJ cohort, which enrolled adults aged ≥18 years between 2009 and 2022. We analyzed 86,813 participants with at least two serum creatinine measurements taken an average of 4.2 (±3.0) years apart. Daily fruit and vegetable intake was categorized as <3, 3–5, and ≥5 servings. Kidney function decline was assessed by the annual percentage change in estimated glomerular filtration rate (eGFR), with rapid decline defined as the highest tertile of annual eGFR percentage loss. During follow-up, the mean annual eGFR decline was 0.38 %, 0.36 %, and 0.30 % for participants consuming <3, 3–5, and ≥5 servings daily, respectively (P < .001). Compared with those consuming <3 servings daily, participants consuming 3–5 servings (AOR = 0.95; 95 % CI: 0.92–0.98) and ≥5 servings (AOR = 0.93; 95 % CI: 0.89–0.98) had a lower risk of rapid kidney function decline. A significant linear dose–response relationship was observed between higher fruit and vegetable intake and reduced risk of rapid kidney function decline (P < .001).</div></div><div><h3>Conclusions</h3><div>Fruit and vegetable consumption was associated with a reduced risk of rapid kidney function decline, highlighting the need to promote a fruit- and vegetable-rich diet for CKD prevention.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"36 3","pages":"Article 104434"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744361","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}
Pub Date : 2026-03-01Epub Date: 2025-11-01DOI: 10.1016/j.numecd.2025.104430
May A. Beydoun , Hind A. Beydoun , Jack Tsai , Lesley F. Tinker , Philippe Jean-Luc Gradidge , Ana I. Maldonado , Jacqueline Le Kennedy , Matthew Allison , Su Yon Jung , Alan B. Zonderman , Michele K. Evans , JoAnn E. Manson
Background and aims
Traditional measures of obesity such as body mass index (BMI) and waist circumference (WC) have shown inconsistent predictive utility for diabetes across diverse populations. Novel anthropometric measures that focus on abdominal adiposity and body shape may offer better risk assessment for diabetes. Yet, the utility of traditional and novel anthropometric measures in postmenopausal women and in different racial and ethnic groups remains unclear. The predictive utilities of traditional and novel anthropometric measures for diabetes risk were comprehensively assessed, among postmenopausal women, overall, and across racial and ethnic groups.
Methods and results
Using data from 91,392 diabetes-free Women's Health Initiative participants, predictive values of anthropometric measures were examined using Receiver Operating Characteristic (ROC) and Cox regression with Harrell's c-statistics. ROC analyses suggested that novel anthropometric measures with best predictive abilities were ‘a Body Shape Index’ (ABSI), ‘Abdominal Volume Index’, and ‘Body Roundness Index’, although WC and novel anthropometric measures had similarly modest predictive abilities to BMI (Areas Under the Curve <0.6). Cut-off points for anthropometric measures varied by race/ethnicity. Multivariable Cox regression modeling suggested that ‘Clinica Universidad de Navarra-Body Adiposity Estimator’, WC, ABSI, and BMI had the strongest associations with diabetes risk (adjusted hazard ratios [HRs]: 1.27, 1.26, 1.23, and 1.22 per 1-SD increase, respectively), although predictive accuracies involving any measure were modest (Harrell's c-statistics∼0.58–0.59).
Conclusions
In this comprehensive evaluation, anthropometric measures were marginally predictive of diabetes risk, and novel measures did not outperform traditional measures among postmenopausal women, irrespective of race/ethnicity.
{"title":"Anthropometric indices of obesity and their relationships with diabetes risk by race and ethnicity among postmenopausal women","authors":"May A. Beydoun , Hind A. Beydoun , Jack Tsai , Lesley F. Tinker , Philippe Jean-Luc Gradidge , Ana I. Maldonado , Jacqueline Le Kennedy , Matthew Allison , Su Yon Jung , Alan B. Zonderman , Michele K. Evans , JoAnn E. Manson","doi":"10.1016/j.numecd.2025.104430","DOIUrl":"10.1016/j.numecd.2025.104430","url":null,"abstract":"<div><h3>Background and aims</h3><div>Traditional measures of obesity such as body mass index (BMI) and waist circumference (WC) have shown inconsistent predictive utility for diabetes across diverse populations. Novel anthropometric measures that focus on abdominal adiposity and body shape may offer better risk assessment for diabetes. Yet, the utility of traditional and novel anthropometric measures in postmenopausal women and in different racial and ethnic groups remains unclear. The predictive utilities of traditional and novel anthropometric measures for diabetes risk were comprehensively assessed, among postmenopausal women, overall, and across racial and ethnic groups.</div></div><div><h3>Methods and results</h3><div>Using data from 91,392 diabetes-free Women's Health Initiative participants, predictive values of anthropometric measures were examined using Receiver Operating Characteristic (ROC) and Cox regression with Harrell's c-statistics. ROC analyses suggested that novel anthropometric measures with best predictive abilities were ‘a Body Shape Index’ (ABSI), ‘Abdominal Volume Index’, and ‘Body Roundness Index’, although WC and novel anthropometric measures had similarly modest predictive abilities to BMI (Areas Under the Curve <0.6). Cut-off points for anthropometric measures varied by race/ethnicity. Multivariable Cox regression modeling suggested that ‘Clinica Universidad de Navarra-Body Adiposity Estimator’, WC, ABSI, and BMI had the strongest associations with diabetes risk (adjusted hazard ratios [HRs]: 1.27, 1.26, 1.23, and 1.22 per 1-SD increase, respectively), although predictive accuracies involving any measure were modest (Harrell's c-statistics∼0.58–0.59).</div></div><div><h3>Conclusions</h3><div>In this comprehensive evaluation, anthropometric measures were marginally predictive of diabetes risk, and novel measures did not outperform traditional measures among postmenopausal women, irrespective of race/ethnicity.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"36 3","pages":"Article 104430"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745580","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}
Pub Date : 2026-03-01Epub Date: 2025-10-17DOI: 10.1016/j.numecd.2025.104414
Zehua Li , Jing Yan , Yushan Liao , Haiqiong Liu , Yanbin Cai , Yu Sun , Wen Jin , Jingbin Guo
Background and aim
Obesity has been considered as a risk factor for peripheral artery disease (PAD), but the impact of obesity combined with or without metabolic abnormality on risk of PAD remains unclear. This study aimed to explore the association between different metabolic phenotypes of obesity and PAD risk.
Methods and results
This study included 5440 participants without PAD at baseline. Metabolically healthy obesity (MHO) definition 1 was defined as body mass index (BMI)≥30 kg/m2 without any metabolic syndrome (MetS) components, and MHO definition 2–3 were conducted for other conditions characterizing metabolic phenotypes. Cox proportional hazards regression model was established to investigate the associations between obesity with different metabolic parameters and PAD risk. During a mean follow-up of 15.6 years, 543 participants had incident PAD. Compared with participants with metabolic healthy normal weight, MHO participants did not show significantly higher risk of incident PAD without or with chronic limb ischemia, and obesity with unhealthy metabolic profile had the highest significant risk of incident PAD, with hazard ratios ranging from 1.702 (1.273–2.276) to 1.740 (1.316–2.301) (depend on MHO definition 1–3). Additionally, per 1 kg/m2 increase of BMI was associated with a higher risk of PAD in metabolic unhealthy groups, and increasing of MetS components had an elevated risk of PAD, regardless of BMI status.
Conclusions
While MHO did not demonstrate a significant association with increased PAD risk, metabolically unhealthy obesity was associated with a markedly elevated risk of PAD events.
{"title":"Different metabolic phenotypes of obesity and risk of peripheral artery disease: A cohort study","authors":"Zehua Li , Jing Yan , Yushan Liao , Haiqiong Liu , Yanbin Cai , Yu Sun , Wen Jin , Jingbin Guo","doi":"10.1016/j.numecd.2025.104414","DOIUrl":"10.1016/j.numecd.2025.104414","url":null,"abstract":"<div><h3>Background and aim</h3><div>Obesity has been considered as a risk factor for peripheral artery disease (PAD), but the impact of obesity combined with or without metabolic abnormality on risk of PAD remains unclear. This study aimed to explore the association between different metabolic phenotypes of obesity and PAD risk.</div></div><div><h3>Methods and results</h3><div>This study included 5440 participants without PAD at baseline. Metabolically healthy obesity (MHO) definition 1 was defined as body mass index (BMI)≥30 kg/m<sup>2</sup> without any metabolic syndrome (MetS) components, and MHO definition 2–3 were conducted for other conditions characterizing metabolic phenotypes. Cox proportional hazards regression model was established to investigate the associations between obesity with different metabolic parameters and PAD risk. During a mean follow-up of 15.6 years, 543 participants had incident PAD. Compared with participants with metabolic healthy normal weight, MHO participants did not show significantly higher risk of incident PAD without or with chronic limb ischemia, and obesity with unhealthy metabolic profile had the highest significant risk of incident PAD, with hazard ratios ranging from 1.702 (1.273–2.276) to 1.740 (1.316–2.301) (depend on MHO definition 1–3). Additionally, per 1 kg/m<sup>2</sup> increase of BMI was associated with a higher risk of PAD in metabolic unhealthy groups, and increasing of MetS components had an elevated risk of PAD, regardless of BMI status.</div></div><div><h3>Conclusions</h3><div>While MHO did not demonstrate a significant association with increased PAD risk, metabolically unhealthy obesity was associated with a markedly elevated risk of PAD events.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"36 3","pages":"Article 104414"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373365","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}
Serum uric acid (SUA) has emerged as a cardiovascular risk marker beyond gout and renal disease. Evidence from the URRAH (Uric Acid Right for Heart Health) project has established that mortality risk increases at SUA concentrations lower than the traditional hyperuricemia threshold. However, the relationship between SUA, renal function–adjusted indices, and subclinical organ damage across different degrees of adiposity in hypertension remains incompletely understood. The present study aims at correlate Serum uric acid (SUA), and SUA/estimated glomerular filtration rate (eGFR) ratio with hypertension-mediated organ damage in adult patients with essential hypertension.
Methods and results
We studied 326 patients with hypertension, stratified by body mass index (BMI). Echocardiography and laboratory analyses assessed target-organ damage, including left ventricular mass index (LVMI) and albuminuria. Patients were categorized according to previously validated SUA cutoffs (5.6 mg/dL for cardiovascular mortality). SUA and SUA/eGFR increased progressively across BMI groups (p < 0.001). The proportion of patients above the URRAH cardiovascular-risk threshold (5.6 mg/dL) rose from 35.8 % in normal-weight to 60.3 % in obese individuals. Both SUA and SUA/eGFR correlated with LVMI and albuminuria (p < 0.01). The predictive performance for cardiac remodeling was strongest in normal-weight patients (AUC = 0.74 for SUA/eGFR).
Conclusions
In essential hypertension, elevated SUA and higher SUA/eGFR ratios are associated with early cardiac and renal structural changes, even at levels below the conventional definition of hyperuricemia. Obesity amplifies urate exposure but attenuates its independent predictive value, suggesting complex metabolic interactions. These findings support adopting lower, cardiovascular-oriented SUA thresholds and composite indices such as SUA/eGFR in risk assessment of hypertensive patients.
{"title":"Uric-acid predictive performance analysis for subclinical organ damage in essential hypertensive patients","authors":"Luigi Petramala , Gioacchino Galardo , Francesco Circosta , Adriana Servello , Luca Marino , Luca Caprioni Grasso , Francesco Baratta , Riccardo Renna , Giancarlo Ceccarelli , Federica Moscucci , Giulia Nardoianni , Giuliano Tocci , Giovambattista Desideri , Claudio Letizia","doi":"10.1016/j.numecd.2025.104459","DOIUrl":"10.1016/j.numecd.2025.104459","url":null,"abstract":"<div><h3>Background and aim</h3><div>Serum uric acid (SUA) has emerged as a cardiovascular risk marker beyond gout and renal disease. Evidence from the URRAH (Uric Acid Right for Heart Health) project has established that mortality risk increases at SUA concentrations lower than the traditional hyperuricemia threshold. However, the relationship between SUA, renal function–adjusted indices, and subclinical organ damage across different degrees of adiposity in hypertension remains incompletely understood. The present study aims at correlate Serum uric acid (SUA), and SUA/estimated glomerular filtration rate (eGFR) ratio with hypertension-mediated organ damage in adult patients with essential hypertension.</div></div><div><h3>Methods and results</h3><div>We studied 326 patients with hypertension, stratified by body mass index (BMI). Echocardiography and laboratory analyses assessed target-organ damage, including left ventricular mass index (LVMI) and albuminuria. Patients were categorized according to previously validated SUA cutoffs (5.6 mg/dL for cardiovascular mortality). SUA and SUA/eGFR increased progressively across BMI groups (p < 0.001). The proportion of patients above the URRAH cardiovascular-risk threshold (5.6 mg/dL) rose from 35.8 % in normal-weight to 60.3 % in obese individuals. Both SUA and SUA/eGFR correlated with LVMI and albuminuria (p < 0.01). The predictive performance for cardiac remodeling was strongest in normal-weight patients (AUC = 0.74 for SUA/eGFR).</div></div><div><h3>Conclusions</h3><div>In essential hypertension, elevated SUA and higher SUA/eGFR ratios are associated with early cardiac and renal structural changes, even at levels below the conventional definition of hyperuricemia. Obesity amplifies urate exposure but attenuates its independent predictive value, suggesting complex metabolic interactions. These findings support adopting lower, cardiovascular-oriented SUA thresholds and composite indices such as SUA/eGFR in risk assessment of hypertensive patients.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"36 3","pages":"Article 104459"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776284","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}
There is growing interest in the intricate relationships among metabolic processes, renal health, and cardiovascular disease (CVD). Individuals in the early stages of Cardiovascular-Kidney-Metabolic (CKM) syndrome (stages 0–3) experience a notably higher incidence of CVD. Previous research has indicated a potential link between the estimated glucose disposal rate (eGDR) and the development of CVD; however, this association within the context of CKM syndrome stages 0–3 remains inadequately explored.
Methods and results
The study comprised 5,286 participants, with an average age of 58 years (range: 52–65 years), including 46.86 % males. The study employed information from the CHARLS dataset to analyze the eGDR, calculated using parameters such as glycated hemoglobin levels, blood pressure, and waist circumference (WC). CVD diagnoses were identified through standardized questionnaires. To investigate the link eGDR-CVD risk across CKM syndrome stages 0–3, we applied a Cox proportional hazards model. Additionally, we assessed the nonlinear relationship through smooth curve fitting and threshold effect analysis. The Cox model indicated that individuals with the highest eGDR experienced a 44 % reduction in CVD risk compared to those with the lowest eGDR. Smooth curve fitting displayed an L-shaped trend, revealing a critical threshold at 11.46 mg/kg/min. This threshold can help clinicians identify individuals at higher CVD risk and guide more intensive prevention strategies.
Conclusion
Our findings reveal a significant inverse relationship eGDR-CVD risk among patients with CKM syndrome stages 0–3. This association exhibited a non-linear, L-shaped pattern, with a crucial threshold identified at 11.46 mg/kg/min.
{"title":"Association between estimated glucose disposal rate and incidence of cardiovascular diseases in a population with cardiovascular-kidney-metabolic syndrome stages 0–3: A large prospective cohort study","authors":"Yaohua Hu, Xinyang Li, Jian Li, Mengyuan Yu, Xu Li, Wenpeng Cui","doi":"10.1016/j.numecd.2025.104469","DOIUrl":"10.1016/j.numecd.2025.104469","url":null,"abstract":"<div><h3>Background and aim</h3><div>There is growing interest in the intricate relationships among metabolic processes, renal health, and cardiovascular disease (CVD). Individuals in the early stages of Cardiovascular-Kidney-Metabolic (CKM) syndrome (stages 0–3) experience a notably higher incidence of CVD. Previous research has indicated a potential link between the estimated glucose disposal rate (eGDR) and the development of CVD; however, this association within the context of CKM syndrome stages 0–3 remains inadequately explored.</div></div><div><h3>Methods and results</h3><div>The study comprised 5,286 participants, with an average age of 58 years (range: 52–65 years), including 46.86 % males. The study employed information from the CHARLS dataset to analyze the eGDR, calculated using parameters such as glycated hemoglobin levels, blood pressure, and waist circumference (WC). CVD diagnoses were identified through standardized questionnaires. To investigate the link eGDR-CVD risk across CKM syndrome stages 0–3, we applied a Cox proportional hazards model. Additionally, we assessed the nonlinear relationship through smooth curve fitting and threshold effect analysis. The Cox model indicated that individuals with the highest eGDR experienced a 44 % reduction in CVD risk compared to those with the lowest eGDR. Smooth curve fitting displayed an L-shaped trend, revealing a critical threshold at 11.46 mg/kg/min. This threshold can help clinicians identify individuals at higher CVD risk and guide more intensive prevention strategies.</div></div><div><h3>Conclusion</h3><div>Our findings reveal a significant inverse relationship eGDR-CVD risk among patients with CKM syndrome stages 0–3. This association exhibited a non-linear, L-shaped pattern, with a crucial threshold identified at 11.46 mg/kg/min.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"36 3","pages":"Article 104469"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783365","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}
Pub Date : 2026-02-18DOI: 10.1016/j.numecd.2026.104631
Luke Bell, Joshua Gibbs, Francesco P Cappuccio
Aims: Chronic low-grade inflammation, termed "inflammageing", accelerates many age-related diseases. C-reactive protein (CRP) is a well-validated biomarker of inflammation and is an independent predictor of cardiovascular events. Plant-based dietary patterns (PBDPs) supply greater intakes of antioxidants and unsaturated fats than omnivorous diets and have been linked to lower circulating CRP concentrations in observational studies, but a causal relationship remains unclear. The main objective of this meta-analysis was to determine the effects of PBDPs on CRP concentration when compared to omnivorous dietary patterns in controlled clinical trials.
Data synthesis: MEDLINE, Embase and Web of Science were searched to identify trials investigating the effect of PBDPs on CRP concentration. Standardised mean differences in CRP and 95% confidence intervals were pooled using a random-effects model. Risk of bias, heterogeneity and sensitivity were assessed. Of the 2962 studies identified, only 7 clinical trials met the inclusion criteria, generating eight data sets (541 participants of median age 55 years). In the analysis of all 7 trials, the consumption of PBDPs was associated with significantly lower CRP (-1.13 mg/L (95% CI, -1.52 to -0.75). Subgroup analysis excluding studies with exercise prescriptions showed PBDPs were associated with significantly lower CRP (-0.94 mg/L (95% CI -1.43 to -0.46). Heterogeneity was high and the certainty of the results was low.
Conclusions: Consumption of PBDPs may lower CRP concentration but further evidence gathering is required to validate this finding.
目的：慢性低度炎症，被称为“炎症”，加速许多与年龄有关的疾病。c反应蛋白（CRP）是一种经过充分验证的炎症生物标志物，是心血管事件的独立预测因子。植物性饮食模式（PBDPs）比杂食性饮食提供更多的抗氧化剂和不饱和脂肪摄入量，并且在观察性研究中与较低的循环CRP浓度有关，但因果关系尚不清楚。本荟萃分析的主要目的是确定在对照临床试验中，与杂食性饮食模式相比，PBDPs对CRP浓度的影响。数据综合：检索MEDLINE， Embase和Web of Science以确定研究pbdp对CRP浓度影响的试验。采用随机效应模型合并CRP的标准化平均差异和95%置信区间。评估偏倚风险、异质性和敏感性。在确定的2962项研究中，只有7项临床试验符合纳入标准，产生了8个数据集（541名参与者，中位年龄55岁）。在所有7项试验的分析中，pbdp的摄入与CRP显著降低(-1.13 mg/L （95% CI, -1.52至-0.75）相关。排除运动处方研究的亚组分析显示，pbdp与CRP显著降低相关(-0.94 mg/L （95% CI -1.43至-0.46）。异质性高，结果的确定性低。结论：食用PBDPs可能会降低CRP浓度，但需要进一步的证据收集来验证这一发现。
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Pub Date : 2026-02-17DOI: 10.1016/j.numecd.2026.104632
Chao Deng, Jian Li
{"title":"Comment on \"The impact of intermittent fasting and Mediterranean diet on older adults' physical health and quality of life: a randomized clinical trial\".","authors":"Chao Deng, Jian Li","doi":"10.1016/j.numecd.2026.104632","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104632","url":null,"abstract":"","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104632"},"PeriodicalIF":3.7,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488167","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}
Pub Date : 2026-02-17DOI: 10.1016/j.numecd.2026.104626
Tiago Palmisano, Kenneth Bilchick, David Guarraia
Background and aims: Dyslipidemia and diabetes are traditional risk factors for myocardial infarction (MI), with obesity and prediabetes now recognized as non-traditional ones. Few studies have investigated the prevalence of these diseases at the time of admission for MI. To clarify their relative importance, we collected hemoglobin A1c (HbA1c), body mass index (BMI), and lipid profiles at the time of admission for patients with type 1 MI over 10 years at a major academic center.
Methods and results: This was a single-center retrospective cohort study. We examined 570 patients admitted for type 1 MI over 10 years, collected their HbA1c, BMI, and lipid profiles at or near admission, and compared them to an age- and sex-matched control group of admitted patients. After adjusting for potential confounders, only HbA1c was associated with increased odds of type 1 MI (odds ratio 1.12). When compared to patients with clinically normal HbA1c (<5.7), patients with HbA1c ≥ 6.5 had 160% higher odds of MI, and patients with prediabetic range HbA1c (5.7-6.4) had 58% higher odds of MI. The interaction between sex and these metabolic variables was not statistically significant. Younger patients had a stronger association between the risk of MI and both LDL and BMI, compared to older patients. There was no statistically significant change in average HbA1c, BMI, or LDL across the 10-year timespan.
Conclusion: Admission HbA1c level has a stronger association with type 1 myocardial infarction than admission LDL or BMI, even among patients with levels in the prediabetic range.
{"title":"Hemoglobin A1c is more predictive of type 1 myocardial infarction than low-density lipoprotein or body mass index.","authors":"Tiago Palmisano, Kenneth Bilchick, David Guarraia","doi":"10.1016/j.numecd.2026.104626","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104626","url":null,"abstract":"<p><strong>Background and aims: </strong>Dyslipidemia and diabetes are traditional risk factors for myocardial infarction (MI), with obesity and prediabetes now recognized as non-traditional ones. Few studies have investigated the prevalence of these diseases at the time of admission for MI. To clarify their relative importance, we collected hemoglobin A1c (HbA1c), body mass index (BMI), and lipid profiles at the time of admission for patients with type 1 MI over 10 years at a major academic center.</p><p><strong>Methods and results: </strong>This was a single-center retrospective cohort study. We examined 570 patients admitted for type 1 MI over 10 years, collected their HbA1c, BMI, and lipid profiles at or near admission, and compared them to an age- and sex-matched control group of admitted patients. After adjusting for potential confounders, only HbA1c was associated with increased odds of type 1 MI (odds ratio 1.12). When compared to patients with clinically normal HbA1c (<5.7), patients with HbA1c ≥ 6.5 had 160% higher odds of MI, and patients with prediabetic range HbA1c (5.7-6.4) had 58% higher odds of MI. The interaction between sex and these metabolic variables was not statistically significant. Younger patients had a stronger association between the risk of MI and both LDL and BMI, compared to older patients. There was no statistically significant change in average HbA1c, BMI, or LDL across the 10-year timespan.</p><p><strong>Conclusion: </strong>Admission HbA1c level has a stronger association with type 1 myocardial infarction than admission LDL or BMI, even among patients with levels in the prediabetic range.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104626"},"PeriodicalIF":3.7,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494489","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}
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