Nutrition Metabolism and Cardiovascular Diseases最新文献

Background and aims: Although existing evidence suggests that arterial stiffness and obesity impact cardiovascular health, limited studies have been conducted to explore the association between brachial-ankle pulse wave velocity (baPWV), obesity-related indices, and the risk of atherosclerotic cardiovascular disease (ASCVD).

Methods and results: The study participants were among those who completed the baPWV measurement at the second follow-up examination (during 2018-2020) of the Rural Chinese Cohort Study. Logistic regression models were employed to calculate odds ratios (ORs) and 95 % confidence intervals (CIs) of the 10-year incident risk score of ASCVD associated with baPWV and obesity-related indices. Mediation analysis was applied to investigate the role of baPWV in the obesity-induced 10-year incident risk score of ASCVD. A total of 1589 individuals, including 573 men and 1016 women, were included in the study. In logistic regression analyses, the highest quartile levels of baPWV and obesity-related indices all significantly increased the 10-year incident risk score of ASCVD compared to their corresponding lowest quartiles. The ORs (95%CIs) of ASCVD 10-year incident risk score risk were 4.21(2.55-6.94) for baPWV, 4.43(2.69-7.29) for METS-VF, 7.20(4.09-12.66) for CVAI, 3.38(2.12-5.38) for CI, and 2.40(1.54-3.75) for ABSI. The indirect effect of baPWV accounted for 5.85 %, 7.92 %, 14.56 %, and 5.08 % of the total effects for METS-VF, CVAI, CI, and ABSI, respectively.

Conclusion: This study found that elevated levels of both baPWV and obesity-related indices were associated with a higher 10-year incident risk score of ASCVD. Additionally, baPWV partially mediated the obesity-related increase in 10-year incident risk score of ASCVD.

Aims: Atherosclerosis is a life-threatening disease that develops when a plaque builds up inside an artery and progresses silently. Identifying the early pathological changes and the biomarkers of atherosclerosis deserves attention. We aimed to systematically study and integrate the various metabolites of atherosclerosis in the level of disease to provide more evidences to support early prevention and treatment of atherosclerosis.

Data synthesis: The protocol was registered with PROPSERO (CRD42023441845). We searched 14,985 records via EMBASE, PubMed, Web of Science, WanFang data, VIP data, and CNKI databases. The collected metabolites were for qualitative and quantitative meta-analysis. The I² statistic estimated heterogeneity, with over 50 % considered to adopt the random-effects model. A total of 49 articles were included in the meta-analysis. We finally integrated 83 and 16 metabolites presented more than two times in inclusion studies, respectively in blood (plasma and serum) and urine. Among them, the level of citric acid (SMD = -10.35 [95%CI -15.03, -5.67], p < 0.001), lactic acid (SMD = 6.32 [95%CI 0.12, 12.52], p < 0.001) and TMAO (SMD = 1.40 [95%CI 0.27, 2.53], p < 0.001) had significant differences between atherosclerosis and controls. And we observed blood stasis syndrome of atherosclerosis patients present arterial ischemia and energy disorder obviously.

Conclusions: The study provides an in-depth understanding of the roles of metabolites on atherosclerosis progression and prediction primarily in Chinese population, which contributing to development of prevention and therapeutic potential in the future.

Background and aim: This study aims to investigate the relationship between A Body Shape Index (ABSI) Z-score and all-cause mortality among osteoporotic patients using data from the National Health and Nutrition Examination Survey (NHANES).

Methods and results: We analyzed NHANES data from 2005 to 2010, 2013 to 2014, and 2017 to 2018, focusing on individuals aged 50 and above with complete bone mineral density (BMD) data. The ABSI Z-score, calculated by adjusting waist circumference (WC) for height and weight, was used to independently assess abdominal fat beyond Body Mass Index (BMI). Mortality status was confirmed by linking NHANES data with the National Death Index (NDI), with follow-up until December 31, 2019. Weighted Cox proportional hazards models were employed for analysis, adjusting for age, gender, race, fracture history, anti-osteoporosis treatment history, diabetes, and cardiovascular disease (CVD). The study included 1596 participants. Higher ABSI Z-scores were significantly associated with increased all-cause mortality risk, especially among elderly male osteoporotic patients. This association remained robust after adjusting for multiple potential confounders.

Conclusion: The ABSI Z-score serves as a valuable non-invasive screening tool that effectively identifies osteoporotic patients at higher risk of mortality. These findings emphasize the importance of body management in health, supporting further research to explore the practical utility of ABSI Z-score in osteoporotic patients and how body management can enhance long-term survival rates.

Background and aims: Both obesity and iron deficiency are public health problems. The association between the two problems could be explained by chronic low-grade inflammation in obesity, which could stimulate hepcidin expression and modify iron concentration that the consumption of high-protein diets could prevent. Thus, this study aimed to compare the effects of high-protein diets with a predominance of animal or vegetable protein on serum hepcidin and iron concentrations in adults with obesity.

Methods and results: This randomized clinical trial involved adults with obesity and insulin resistance, who were assigned to either a high animal protein (AP) group or a high vegetable protein (VP) group for a one-month intervention. Both groups followed a calorie-restricted diet, reducing energy intake by 750 kcal/day. Baseline and final measurements included serum concentrations of hepcidin and iron, biochemical parameters, anthropometric data, and body composition. A total of 33 participants (63 % female) were included in the study. Significant weight loss was observed in both groups after the intervention. Adjusted for weight loss percentage, the AP group showed a significant increase in hepcidin concentration (from 22.3 ± 14.7 to 27.5 ± 19.5 ng/mL) compared to the VP group (from 17.9 ± 15.1 to 17.2 ± 10.1 ng/mL) (p < 0.01), with no changes in serum iron concentration. Additionally, the VP diet significantly reduced serum adiponectin (p = 0.04) and C-reactive protein (p = 0.03) levels.

Conclusions: In adults with obesity following the AP diet for one month, hepcidin levels increased without affecting serum iron concentrations.

Trial registration: NCT03627104.

The essential role of sleep in overall health is increasingly recognized, yet it remains underemphasized in both clinical and public health contexts. Despite extensive research linking poor sleep health to chronic conditions such as cardiovascular disease, type 2 diabetes, and cognitive decline, sleep health is not routinely assessed or integrated into standard care practices. Sleep problems, including insomnia, sleep apnea, and poor sleep quality, are prevalent globally, affecting over 30 % of the population and contributing to significant public health burdens like cardiometabolic disease, mental health disorders and multimorbidity. The economic implications are substantial, with insufficient sleep imposing significant societal and financial costs worldwide. Recognizing this, recent initiatives like the American Heart Association's inclusion of sleep in the Life's Essential 8 framework highlight the importance of sleep in cardiometabolic health. Integrating sleep into clinical and public health strategies is crucial, due to the wide-ranging impact of sleep on cardiometabolic health. Social, environmental, and demographic factors also play significant roles in sleep health, with lower socioeconomic groups and women often experiencing poorer sleep, further exacerbating health disparities. Adopting a life course approach and promoting healthy sleep behaviors early in life are essential for mitigating long-term cardiometabolic risks. Effective evidence-based strategies for improving sleep behaviors and cardiometabolic health, beyond addressing sleep disorders, include prioritizing sleep hygiene, managing stress, promoting physical activity, maintaining a healthy diet, and reducing substance use, all of which contribute to overall well-being. In conclusion, incorporating sleep health into routine cardiometabolic risk stratification, prevention, and management is essential for improving overall health outcomes.

Background and aims: The "J"-shaped relationship between alcohol consumption and cardiovascular health is recognized as potentially influenced by residual confounders, and this study aimed to clarify the role that social determinants play in the relationship.

Methods and results: Using NHANES data from 2005 to 2018, this study analyzed 30,648 participants to assess how eight social determinants (employment, income, food security, education, healthcare access, insurance, housing stability, and marital status) influence the relationship between alcohol consumption and cardiovascular disease (CVD). Moderate drinking reduces CVD risk (HR: 0.741, 95%CI: 0.661, 0.831, P < 0.001), while heavy drinking increases it (HR: 1.025, 95%CI: 1.004, 1.095, P = 0.035). Structural equation modeling revealed that ideal social determinants and health metrics contribute significantly to the cardiovascular protective effects of moderate drinking (path proportion: 42.31 %). Conversely, heavy drinking is associated with poorer social determinants and health metrics, masking the cardiovascular protective effect (path proportion: 90.91 %).

Conclusions: This study quantifies the role of social and health factors in the relationship between alcohol consumption and CVD. Despite identifying direct cardiovascular protective effects of alcohol consumption, global health initiatives should continue to advocate for reduced heavy drinking, given the significant risks involved.

Background and aim: Existing studies have found that serological markers for predicting coronary heart disease (CHD) have relatively low predictive value for the severity of coronary arteries and the types of CHD. GGT to HDL-C ratio (GHR) has been shown to be associated with T2DM and non-alcoholic fatty liver disease. Therefore, we explore the relationship among GHR, CHD and its subgroups.

Methods and results: The study retrospectively analyzed 2703 participants from August 2022 to August 2023. The patients were divided into CHD group (N = 1911) and control group (N = 792) according to the diagnostic criteria of CHD. Adjustments for all covariates found that GHR was an independent risk factor for CHD (OR: 1.025, 95 % CI 1.016-1.033) and had the highest AUC of 0.767 (95 % CI 0.744-0.790) in identifying CHD. Additionally, GHR was significantly associated with multi-vessel CHD (OR: 1.018, 95 % CI 1.012-1.023) and showed excellent diagnostic capability for patients with multi-vessel CHD (AUC: 0.638). Moreover, compared with chronic coronary syndromes (CCS) and unstable angina (UA) groups, the level of GHR was significantly increased in acute myocardial infarction (AMI) (ST elevation myocardial infarction and Non-ST elevation myocardial infarction) group (P < 0.05). GHR had the higher AUC in STMETI [0.819 (95 % CI 0.796-0.854)] and NASTEMI [0.792 (95 % CI 0.766-0.816)] than the CCS and UA groups.

Conclusions: Our study analyses found that GHR is an independent risk factor for CHD and can predict the severity of coronary artery stenosis. Moreover, GHR has a high predictive value for AMI than CCS and UA in CHD patients.

Background and aims: Cardiovascular disease (CVD) and its related co-morbidities, i.e., type 2 diabetes mellitus (T2DM), hypertension and hypercholesterolemia, have an enormous burden on population health and healthcare systems. Mediterranean diet can reduce this burden; quantifying this reduction via the calculation of the Prevented Fraction for the Population (PFP) could offer positive-framed messages to encourage adherence to this healthful dietary pattern. Hence, the aim of this study was to calculate PFP of CVD, T2DM, hypertension, and hypercholesterolemia by long-term adherence to the Mediterranean type of diet, during a 20-year period, in a Mediterranean population.

Methods and results: The sample consisted of adult participants, initially free-of-CVD, from the ATTICA prospective cohort study (2002-2022). At all evaluations (2002, 2006, 2012, 2022), CVD, T2DM, hypertension, and hypercholesterolemia were assessed according to WHO-ICD-10, and Mediterranean diet adherence was assessed via MedDietScore. PFP by Mediterranean diet was computed for each outcome in different population groups. It was found that approximately 30 % of CVD, T2DM, hypertension and hypercholesterolemia cases were prevented due to the high long-term adherence to the Mediterranean diet. Concerning different population groups, it was observed that due to their decreased adherence and PFPs, male participants, older participants and participants with comorbidities might benefit more from following the Mediterranean diet during a long-term period.

Conclusion: The study findings suggest that future public health strategies should aim to make the Mediterranean diet a long-term lifestyle change rather than a short-term diet intervention, while shedding light on which population groups should be targeted first.

Background and aim: The stress hyperglycemia ratio (SHR) offers a more nuanced understanding of glucose metabolism by factoring in the background glycemia through the component of Hemoglobin A1c. The association of SHR with cardiovascular and cerebrovascular diseases has been established, but the relationship between SHR and the risk of nonalcoholic fatty liver disease (NAFLD) remains unexplored. This study aimed to elucidate the relationship between the two among U.S. adults with diabetes or prediabetes.

Methods and results: A total of 1409 participants diagnosed with diabetes or prediabetes from the National Health and Nutrition Examination Survey (NHANES) 2017-2020 were included in this study. Multiple logistic regression models (ranging from unadjusted to fully adjusted), restricted cubic splines, and subgroup analyses were employed to determine the relationship between SHR and NAFLD risk and to assess the stability of this relationship across different populations. The average age of all participants was 54.65 years, with males accounting for 47.91 %, and the prevalence of NAFLD being 68.77 %. A fully adjusted logistic regression model indicated a positive association between SHR levels and the risk of NAFLD. Specifically, for each one standard deviation increase in SHR, the risk of NAFLD increased by 20 % (OR, 1.2; 95 % CI, 1.0-1.4). Both the trend test and the restricted cubic splines suggested a linear relationship between the two variables (p for trend <0.05, p for nonlinear = 0.390). Subgroup analysis demonstrated that this positive association remained consistent across most subgroups.

Conclusions: SHR was identified as a valuable index for predicting the risk of NAFLD among U.S. adults with diabetes or prediabetes.

Background and aim: Identifying metabolic dysfunction-associated steatotic liver disease (MASLD) patients at increased risk of cardiovascular mortality remains an unmet clinical need. We investigated the ability of four systemic inflammation markers to identify cardiovascular mortality risk in MASLD patients.

Methods and results: This cohort study included 4787 MASLD patients from the National Health and Nutrition Examination Survey (NHANES) from 2005 through 2018. The weighted Cox proportional hazards model was used to assess the relationship between four systemic indicators of inflammation and cardiovascular mortality. During a median (IQR) follow-up of 7.0 (3.8-10.3) years, 567 all-cause mortality and 174 cardiovascular mortality were recorded. Compared to the first quartile of systemic inflammation levels, the HRs of cardiovascular mortality in the fourth quartile were 3.22 (95 % CI 1.83-5.66) for SII, 2.74 (95 % CI 1.32-5.69) for SIRI, 3.69 (95 % CI 1.87-7.28) for NLR, and 1.83 (95 % CI 1.05-3.20) for PLR. For predicting 10-year cardiovascular mortality, SIRI (AUC = 0.70) and NLR (AUC = 0.69) were superior to SII (AUC = 0.60) and PLR (AUC = 0.52). Stratification of MASLD patients based on the optimal cutoff values revealed an HR of 2.67 (95 % CI 1.65-4.32) for cardiovascular mortality with SIRI > 1.23, and an HR of 2.39 (95 % CI 1.51-3.79) with NLR > 2.18. Combining systemic inflammation markers with the Fibrosis-4 Score can provide more accurate prognostic information for MASLD patients.

Conclusions: SIRI and NLR outperformed SII and PLR in predicting the risk of cardiovascular mortality, proving to be useful tools for risk stratification in MASLD patients.