Nutrition Metabolism and Cardiovascular Diseases最新文献

Front-of-pack nutrition labels (FOPNLs) have been developed since 1989 to curb the increasing prevalence of obesity and non-communicable diseases (NCDs) and to promote healthy consumption choices. While several countries have introduced their own labeling schemes on a voluntary basis, the European Commission aims to harmonize a FOPNL system that will be mandatory for all member states. This paper summarizes a contribution to the current debate on FOPNLs from Italian and Spanish researchers working in the fields of human nutrition, nutritional epidemiology and public health education and communication policy before the final decision on FOPNLs to become mandatory in Europe is taken.

Background and aims: Patients with adrenal insufficiency (AI) face elevated risks during various hospitalizations including cardiovascular related admissions. Despite this, limited data exist specifically regarding congestive heart failure (CHF) in the context of AI. This investigation leveraged a comprehensive national database to examine the association between AI and cardiovascular outcomes among patients admitted with CHF.

Methods and results: Admissions for CHF were identified in the 2016-2019 National Inpatient Sample. In-hospital outcomes were compared between patients with and without AI. The primary outcome was in-hospital mortality. Secondary outcomes included cardiogenic shock, ventricular tachycardia (VT), acute kidney injury (AKI), vasopressor use, mechanical circulatory support (MCS) use, mechanical ventilation use, hospital length of stay (LOS), and total charges. Multivariable regression models were used to adjust for potential confounders. Among 1,270,784 CHF hospitalizations, 3812 (0.3 %) had a diagnosis of AI. AI was associated with higher odds of in-hospital mortality (aOR 2.6, 95 % CI 2.1-3.7), VT (aOR 1.40, 95 % CI 1.1-1.8), AKI (aOR 1.29, 95 % CI 1.10-1.52), the need for vasopressors (aOR 3.3, 95 % CI 1.9-5.63), mechanical ventilation use (aOR 3.8, 95 % CI 2.9-4.99), cardiogenic shock (aOR 3.08, 95 % CI 2.38-3.98), and MCS (aOR 2.12, 95 % CI 1.14-3.95). Patients with AI also had a longer LOS (8.62 days vs. 5.25 days, p < 0.001) and higher total charges ($103,248 vs. $50,280, p < 0.001).

Conclusion: Patients with AI admitted for CHF had higher in-hospital mortality, non-fatal adverse outcomes, and incurred higher hospital charges compared to patients without AI.

Background and aims: Elevated total IgE levels are traditionally associated with allergic conditions; however, their potential role as biomarker for mortality risk beyond allergic diseases has not been extensively explored. Recent studies have suggested that IgE is associated with cardiovascular (CV) disease. We aimed to investigate the association between total IgE levels and the risk of all-cause and cause-specific mortality, as well as to explore the potential mediating role of vitamin status in these associations.

Methods and results: The association between IgE and mortality risk was examined in the National Health and Examination Survey 2005-2006. Weighted multivariable Cox proportional hazards model was employed. We further performed restricted cubic spline analysis to assess dose-response relationships and conducted mediation analysis to explore the influence of vitamins on IgE-related mortality risk. Individuals in the highest total IgE quantile (>107.0 kU/L) exhibited a 32 % increased risk of all-cause mortality (95 % CI: 1.07-1.64) and a 98 % elevated risk of CV mortality (95 % CI: 1.28-3.07) compared to the lowest quantile (<14.5 kU/L). Heterogeneity exists in the dose-response relationship and threshold effects among individuals with and without allergic diseases. Vitamin deficiency is associated with elevated total IgE levels, and vitamins mediated the relationship of the IgE-related all-cause mortality with the proportion of mediation ranging from 4.68 to 12.71 %.

Conclusions: Our findings introduce a novel dimension to the understanding of IgE as a biomarker for mortality beyond its traditional role in allergic diseases, challenging the current paradigm that elevated IgE levels without overt allergic symptoms are benign.

Beckground and aims: Individuals with a higher body fat percentage may have higher serum levels of caffeine and its metabolites and process caffeine more slowly than individuals with a lower body fat percentage, so the aim of this study is to compare the occurrence of positive and negative effects of caffeine in nonobese and obese women.

Methods and results: One hundred and sixty women were included in the study. Body fat was determined using the mBCA 515 SECA analyzer. Participants were divided into 4 groups: nonobese caffeine, nonobese placebo, obese caffeine and obese placebo. Caffeine groups received 6 mg/kg body weight caffeine. Placebo groups received identical starch-filled capsules. One hour after ingestion and within 24 h, participants completed a caffeine-induced effect questionnaire. Caffeine intake showed statistically significant differences compared to placebo for neutral (p ≤ 0.014; Cramér's V = 0.27; 27 % increase), negative (p ≤ 0.002; Cramér's V = 0.34; 34 % increase), and positive effects (p ≤ 0.015; Cramér's V = 0.27; 27 % increase). Further analysis revealed significant associations with increased urine output (p ≤ 0.014; Cramér's V = 0.27; 27 % increase), vigor/activeness (p ≤ 0.009; Cramér's V = 0.29; 29 % increase), and headache (p ≤ 0.033; Cramér's V = 0.24; 24 % increase) 1 h post-ingestion. No significant effects were observed in the placebo group. There was no statistically significant placebo effect.

Conclusions: Obese and nonobese women show different responses to caffeine 60 min after ingesting 6 mg/kg body weight. Obese women are more likely to report adverse effects, including increased urine output, heightened vigor/activeness, and headaches, compared to nonobese women.

Trial registration: ANZCTR12622000823774; June 10, 2022.

Aims: The association of telomere length (TL) and coronary heart disease (CHD) is still debated, and there is a lack of dose-response meta-analyses on this issue. The aim is therefore to integrate existing evidence on the association between TL and CHD risk and explore the dose-response relationship between them.

Data synthesis: PubMed, EMBASE, and Web of Science were searched for relevant studies up to September 2024. Meta-analysis was performed using a random-effects model, with data presented as RRs and 95 % CIs. Restricted cubic splines were used to assess linear and nonlinear associations. Subgroup analysis and meta-regression were performed to explore sources of heterogeneity. Fourteen articles (8 prospective cohort studies, 2 case-cohort studies, 2 case-control studies, and 2 cross-sectional studies) were finally included in the meta-analysis, with a total sample size of 199,562 participants and 25,752 cases. For CHD, the total RR for the highest TL group compared to the lowest TL group was 0.69 (95 % CI: 0.61, 0.78, I² = 64.5 %). For every 1 kilobase pair (kbp) increase in TL, the CHD risk decreased by 23 % (RR = 0.77, 95 % CI: 0.69, 0.87, I² = 89.0 %). The nonlinearity test indicated a linear association between TL and CHD risk (P_{non-linearity} = 0.930). Sensitivity analyses indicated that the results were robust.

Conclusions: The meta-analysis showed a linear relationship between TL and CHD. People with low TL may be more likely to develop CHD than those with high TL. The association between the two did not change in a wide range of populations.

Background and aims: Numerous studies have evaluated the association between baseline uric acid (UA) and heart failure (HF) outcomes. The impact of longitudinal UA on HF survival remains unknown. We aim to investigate the association between different parameterizations of longitudinal UA measurements and survival outcomes in HF patients.

Methods and results: We retrospectively included patients hospitalized for HF with multiple repeated UA measurements. Joint models were fitted to assess the longitudinal association between UA and outcomes of all-cause and cardiovascular (CV) death. The study included 1596 patients (mean age 54 years, 26.9 % women) with 7875 UA measurements. During a median follow-up of 34.7 months, 330 all-cause deaths occurred, among them 280 of CV causes. After adjusting for clinically relevant covariates, every doubling of UA at any time led to a 5.14-fold increase of all-cause death risk (95 % confidence interval [CI] 3.79-8.29) and a 4.56-fold increase of CV death risk (95 % CI 2.96-8.29) for men; for women, the corresponding hazard ratios were 4.47 for all-cause death (95 % CI 3.02-7.40) and 4.93 for CV death (95 % CI 2.78-8.58). The increase in slope and area under the UA trajectory were additionally associated with a higher risk of all-cause and CV death in both genders. All the associations remained consistent after adjusting for repeatedly measured renal function and across the ejection fraction phenotypes.

Conclusion: The longitudinally measured UA and its derived parameterizations are strong prognostic factors in hospitalized HF patients, independent of clinically relevant confounders and repeatedly assessed renal function.

Background and aims: The interaction of serum uric acid (SUA) with atherogenesis is incompletely understood. Aim of our study was to investigate the association of SUA levels with coronary plaque composition including high-risk-plaque (HRP) features by coronary computed tomography angiography (CTA) and for the prediction of major adverse cardiac events (MACE).

Methods and results: 1242 patients (age 66.17 ± 11.03; 56 % males) referred to coronary CTA were included. SUA>6.5 mg/dl was defined as hyperuricemia. CTA-image analysis included: Coronary stenosis severity (CADRADS), plaque burden (SIS/G-score weighted for non-calcifying plaque), plaques types (1 = calcifying; 2 = mixed (predominantly calcifying); 3 = mixed (predominantly noncalcifying), 4 = noncalcifying."High-risk-plaque"(HRP)-features were quantified: Low-attenuation plaque (LAP) density, Spotty calcification, Napkin-Ring Sign (NRS), Remodeling Index. Coronary Artery Calcium Score (CAC) was measured. Primary outcome was MACE. HRP-features were more prevalent in patients with hyperuricemia (p = 0.005, p = 0.0002, p = 0.0004). SUA level was associated with LAP<30HU (HR:1.23; p = 0.04). Plaque burden and CAC-score were higher in the hyperuricemia group (G-score:p = 0.022 and CAC:p = 0.027). After a mean follow-up of mean 8,32 years, MACE rate was 2.9 %. There was no difference in the MACE rate between subjects with elevated SUA and normals (HR 1.221:95%CI:0.817-2.563; p = 0.597). Low-attenuation-plaque density/LAP<30HU was the strongest prognosticator for MACE (p = 0.033 and p = 0.013); stenosis severity, plaque types and G-score were also predictive, but not SUA, CAC and the other conventional cardiovascular risk factors (except smoking).

Conclusion: SUA is associated with HRP-features and coronary plaque burden. Low attenuation plaque is the strongest predictor of MACE, but not SUA level and other major CVRF. CTA imaging biomarkers may improve CV-risk stratification in patients with hyperuricemia.

Aims: Postmenopausal women experience an increase in cardiovascular, sexual, and emotional changes that can significantly impact their quality of life. Although phytoestrogens offer therapeutic benefits, our understanding of resveratrol's effects remains limited. This study aims to evaluate the effects of using resveratrol on the lipid profile of postmenopausal women.

Data synthesis: We conducted a systematic review using search terms like "postmenopausal" and "resveratrol" and their synonyms. Two reviewers handled study selection and data extraction. Randomized clinical trials assessing resveratrol in post-menopausal women were included. The meta-analysis on total cholesterol levels found no significant difference between groups, Standardized Mean Difference (SMD) -0.09 (95 % Confidence Interval (CI) -0.39 to 0.22, p = 0.59; I2 = 0 %, 2 studies, low-quality evidence). No significant differences were found in high-density lipoprotein (HDL) levels, SMD 0.00 (95 % CI -0.31 to 0.31, p = 1; I2 = 0 %, 2 studies, low-quality evidence), Low-Density Lipoprotein (LCD) levels, SMD -0.10 (95 % CI -0.40 to 0.21, p = 0.54; I2 = 0 %, 2 studies, low-quality evidence), and triglyceride levels, SMD -0.12 (95 % CI -0.18 to 0.43, p = 0.43; I2 = 0 %, 2 studies, low-quality evidence).

Conclusion: This review concludes there's limited evidence for recommendations; further studies with higher doses, longer supplementation durations, and exploration of outcomes are needed to clarify therapeutic potential.

Background and aims: The relationship between the triglyceride-glucose (TyG) index and the incidence of atrial fibrillation (AF) remains insufficiently explored. This investigation aims to elucidate the association between the TyG index and the long-term risk of developing AF.

Methods and results: This cohort study analyzed data from 409,705 participants sourced from the UK Biobank database. Participants were stratified into three groups based on TyG index tertiles. The association between the TyG index and AF was evaluated using Cox proportional hazards models. Restricted cubic spline (RCS) analysis was employed to investigate potential linear or nonlinear relationships. During a mean follow-up period of 13.9 years, 26,092 AF cases were recorded. Compared with the T2 group, participants in the T1 group and T3 group presented a significantly higher risk of AF (T1: HR: 1.22, 95%CI: 1.17-1.27; T3: HR: 1.09, 95%CI: 1.05-1.14). RCS analysis documented a U-shaped relationship between the TyG index and the risk of AF (P for non-linearity <0.001). In non-type 2 diabetes (T2D) participants, TyG levels were associated with AF risk in a U-shaped relationship. Among T2D participants, only the T3 group had an increased risk of AF (reverse "L" pattern). The U-shaped relationship between TyG levels and AF risk remained consistent across heart valve disease (HVD) and non-HVD patients, as well as different strata of genetic susceptibility to AF.

Conclusions: This study demonstrates a U-shaped association between the TyG index and the risks of AF, underscoring the index's potential utility in identifying individuals at elevated risk for these conditions.