Nutrition Metabolism and Cardiovascular Diseases最新文献

Background and aim: The long-term impact of combined trajectories of blood pressure (BP), serum uric acid (UA), and renal function on mortality is unclear.

Methods and results: We analyzed 1084 Taiwanese adults from the MJ Health Database with ≥8 health checkups over eight years. Group-based trajectory modeling identified four distinct patterns of systolic/diastolic BP, UA, and eGFR. Associations with all-cause, cardiovascular (CV), and cancer mortality were assessed using Cox models. Trajectory analysis revealed that Groups 1 and 2 maintained SBP within target levels, whereas Groups 3 and 4 consistently exhibited uncontrolled SBP. DBP remained within target across all groups with less pronounced differences. Serum UA levels were lowest in Group 1, intermediate in Group 3, and persistently elevated in Groups 2 and 4. Regarding renal function, Group 1 had the most preserved eGFR, Groups 2 and 3 remained stable, while Group 4 experienced a marked progressive decline. Trajectory Group 4 had the highest risk of all-cause mortality (adjusted HR 1.835, 95 % CI 1.208-2.800), compared to Group 1. Cancer-related mortality was not significantly associated with trajectory group after adjustment. Age was an independent predictor of all mortality outcomes; male gender was protective for all-cause and cancer-related mortality. Group 2, characterized by high UA but well-controlled SBP and eGFR, was not associated with worse mortality outcomes.

Conclusions: Based on our analysis of long-term trajectories for the four parameters, poor long-term control of SBP and eGFR contributed most significantly to all-cause and CV mortality. Hyperuricemia alone was not associated with worse mortality outcomes.

Background and aim: Cardiovascular-kidney-metabolic syndrome (CKM) embodies the intricate interaction among metabolic, kidney, and cardiovascular dysfunctions. Insulin resistance (IR) is frequently observed in patients with CKM. The metabolic score for insulin resistance (METS-IR) offers a more accessible approach to assessing IR. The relationship between the METS-IR and mortality is unclear in CKM stage 1-4 patients.

Methods and results: Using data from the NHANES, we included 18,295 participants with CKM stages 1-4 from 1999 to 2018. The association between METS-IR and all-cause mortality as well as cardiovascular disease (CVD)-cause mortality was evaluated using multivariable Cox regression, restricted cubic spline models, two-stage Cox models, and subgroup analyses. Four machine learning algorithms were employed to evaluate the predictive value of METS-IR for all-cause mortality. SHAP values were used to model interpretation. During a median follow-up of 100 months, a total of 901 all-cause and 267 CVD-cause deaths were recorded. After adjusting for confounders, each 1-unit rise in METS-IR corresponds to a HR of 1.560 for all-cause mortality (95 % CI, 1.120-2.190) and a HR of 2.309 for CVD mortality (95 % CI, 1.314-4.060) among CKM stage 1-4. RCS curve and two-stage Cox models revealed a nonlinear positive correlation between METS-IR and all-cause as well as CVD mortality, with thresholds of 9.836 for both. Subgroup analyses suggest a significant interaction with alcohol consumption (P for interaction = 0.006). Penalty COX showed the best performance in AUC of 0.849. METS-IR showed high SHAP values.

Conclusions: METS-IR≥9.836 is positive association with all-cause mortality and CVD mortality in CKM stage 1-4 patients. Incorporating it into prognostic models may facilitate the early identification of high-risk individuals.

Background and aims: Whether uric acid-lowering therapy improves arterial stiffness (AS) still remain controversial. This study aimed to evaluate the effect of low-dose febuxostat on AS in elderly patients with asymptomatic hyperuricemia (HUA) and chronic kidney disease (CKD).

Methods and results: A total of 102 elderly patients (mean age 89.20 ± 3.20 years) were enrolled in this prospective cohort study and assigned to either a low-dose (20 mg/day), a normal-dose (40 mg/day), or a control group (lifestyle intervention). All patients underwent evaluations at baseline and the 3rd, 6th and 9th months. The primary endpoints were changes in SUA and brachial-ankle pulse wave velocity (baPWV). Multivariate analysis of variance was used for statistical analysis. Compared with those in control group, the SUA levels in both treatment groups fell to the lowest point at the 3rd month and remained low until the end of the study (intergroup, time, intergroup∗time; P < 0.001). Similarly, the baPWV in both treatment groups decreased by the 3rd month, followed by a gradual increase, and finally returned to the baseline levels (intergroup P = 0.003, time P = 0.487, intergroup∗time P = 0.872). Post-hoc multiple comparisons revealed significant differences in baPWV between each treatment group and the control group (low-dose vs. control: P = 0.001; normal-dose vs. control: P = 0.015), whereas no significant difference was observed between the two treatment groups (P = 0.374). No serious adverse events (AEs) were reported, but three gout attacks occurred in the normal-dose group.

Conclusions: Low-dose febuxostat demonstrated comparable urate-lowering efficacy to the normal-dose regimen and was also associated with a short-term improvement in arterial stiffness in elderly patients with asymptomatic HUA and CKD.

Background and aims: The role of nutritional knowledge in the development of gestational diabetes (GDM) has not yet been fully explored. This study aimed to assess the nutritional knowledge of pregnant women and evaluate its association with GDM.

Methods and results: This observational study included 278 pregnant women (122 with GDM and 156 with normal glucose tolerance (NGT)) attending a diabetes clinic in Italy. Nutritional knowledge was assessed using the Italian-validated Moynihan questionnaire, a higher score (>22.5) indicates poorer knowledge. Logistic regression was used to analyse associations with GDM. Women with GDM had significantly lower nutritional knowledge than those with NGT (21.9 ± 2.9 vs. 20.1 ± 2.4, p < 0.001). The prevalence of GDM was higher in women with poorer knowledge than in those with better knowledge (70.0 % vs. 35.1 %, p < 0.001). Univariate logistic regression analysis revealed that history of GDM (odds ratio (OR) 3.95; 95 % confidence interval (CI): 1.60-9.75; p = 0.003), family history of diabetes mellitus (OR 2.77; 95 % CI: 1.53-5.01; p = 0.001), alcohol consumption during pregnancy (OR 3.14; 95 % CI: 1.17-8.45; p = 0.023), lower educational level (OR 2.17; 95 % CI: 1.28-3.69; p = 0.004), and a knowledge score >22.5 (OR 4.32; 95 % CI: 2.40-7.75; p < 0.001) were associated with GDM. After adjusting for confounders, poor nutritional knowledge remained independently associated with GDM (OR 5.59; 95 % CI: 2.61-11.95; p < 0.001).

Conclusion: Poor nutritional knowledge is independently associated with GDM, suggesting it may contribute to its risk.

Aim: Kefir, a traditional fermented milk, is rich in probiotics including, lactic acid producing bacteria and yeasts which act as fermentation starters. Studies have suggested its metabolic health benefits, though findings remain inconsistent. This systematic review and meta-analysis evaluated the effects of kefir consumption on anthropometric measures, metabolic profile, and inflammation.

Data synthesis: A comprehensive literature search across Scopus, Embase, and PubMed (up to 25-01, 2025) identified 24 relevant interventional studies from 702 articles. Mean ± SD values were obtained for both intervention and control groups. Forest plots and sub-group analyses by kefir dosage were generated using Cochrane Program Review Manager version 5.4.

Conclusion: Kefir consumption induced a significant reduction of fasting blood glucose (MD= -8.46 mg/dL, p = 0.006), and HOMA-IR (MD= -1.71, p = 0.004). However, no significant effects were observed on anthropometric measures, lipid profile, or inflammatory markers. In conclusion, regular kefir consumption may improve blood glucose and insulin sensitivity, but further research is needed for definitive recommendations.

Backgroud and aims: The contribution of perirenal adipose tissue to hypertension progression has not been fully elucidated. This study aimed to investigate the association between perirenal fat thickness (PRFT) and the development of hypertension in a high-normal blood pressure population.

Methods and results: One hundred sixty-six subjects with high-normal blood pressure were enrolled from the Department of Cardiology of First Affiliated Hospital of Xi'an Jiaotong University from May 2023 to April 2024. Perirenal ultrasonographic fat thickness was measured. Compared with the low PRFT group (PRFT ≤30 mm, n = 90), individuals in the high PRFT group (PRFT >30 mm, n = 76) had a higher proportion of males, elevated obesity indicators of body mass index, waist circumference, hip circumference, waist-to-hip ratio, and elevated metabolic markers of uric acid, fasting plasma glucose, urinary albumin-creatinine ratio (ACR), and triglyceride-glucose index (P < 0.05). At the one-year follow-up, higher PRFT was correlated with increased cumulative incidence of hypertension (27.6 % vs. 7.8 %, P < 0.001). After adjusting for potential confounders in the multivariate logistic regression analysis, PRFT was significantly associated with the occurrence of hypertension (OR = 1.085, 95 % CI: 1.013-1.163, P < 0.05). Mediation analysis revealed that urinary ACR mediated 25.59 % of the association between PRFT and hypertension progression. The area under the receiver operating characteristic curve was 0.742 (95 % CI: 0.649-0.834, P < 0.001).

Conclusion: Increased PRFT was associated with the risk of developing hypertension in individuals with high-normal blood pressure, with urinary ACR partially mediating the association.

Background and aim: Recent research has shown a significant association between the atherogenic index of plasma (AIP) and hypertension. Nevertheless, it remains unclear whether the cumulative exposure to AIP influence the risk of hypertension. Therefore, we aimed to characterize the relationship between cumulative exposure to AIP and the risk of new-onset hypertension in a general population.

Methods and results: A total of 28,617 individuals sourced from the Kailuan study database were included in this study. Participants were stratified into four groups by the quartiles of cumulative AIP (cumAIP) or the duration of high AIP exposure. The association between the cumulative exposure to AIP and new-onset hypertension was assessed using Cox proportional hazard models by calculating hazard ratios (HRs) and 95 % confidence intervals (95 % CIs). In addition, subgroup analysis was performed after stratification by age, sex, and body mass index (BMI). A total of 13,177 cases of hypertension were recorded during a median follow-up of 11.04 years. Compared to quartile 1, the HRs (95 % CI) of quartiles 2-4 were 1.08 (1.02-1.14), 1.16 (1.10-1.23), and 1.21 (1.13-1.28), respectively. In addition, compared to 0-year high AIP exposure, the HRs (95 % CI) of 2-6 years of high AIP exposure were 1.09 (1.04-1.14), 1.15 (1.09-1.22), and 1.18 (1.10-1.27), respectively. In addition, our results showed that the association between cumulative exposure to AIP and new-onset hypertension was stronger in participants <60 years of age than in participants ≥60 years of age, stronger in females than in males, and stronger in participants with BMI ≥28 than in participants with BMI <28.

Conclusions: High cumAIP is associated with a higher risk of new-onset hypertension. Maintaining appropriate levels of cumAIP is important for the prevention of hypertension.

Background and aim: Evidence about whether neutrophil counts are associated with cardiovascular disease (CVD) in adults without traditional atherosclerotic cardiovascular disease (ASCVD) risk factors based on current definitions is scant. We investigated the association of neutrophil count and risk of CVD among healthy individuals.

Methods and results: We derived data from the Kailuan Study. This study included 35,975 participants (men, 69.8 %; mean age, 47.7 [12.6] years) who were free of a history of CVD, absent of ASCVD risk factors, during 2006-2007, participants were followed up until new-onset CVD event, death or December 31, 2021. Participants were categorized into 3 groups according to the tertile of neutrophil counts. The primary outcome was composite CVD (nonfatal myocardial infarction and stroke) form baseline through December 31, 2021. During a median follow-up of 14.98 years, we observed 1859 incident CVD events. Compared with the first tertile, the second and third tertiles of neutrophil counts were associated with increased risk of CVD (adjusted hazard ratio 1.42 [95 % confidence interval (CI) 1.27-1.59]), and 1.34 (95 %CI 1.19-1.50), respectively, P for trend <0.001. Similar results were observed for the endpoint of myocardial infarction and stroke. Parallel results were found for hs-CRP. Multivariable-adjusted spline regression model showed a J-shaped association between neutrophil counts and the risk of CVD.

Conclusions: In this study, higher levels of neutrophil counts were associated with an increased risk of CVD, in participants without traditional ASCVD risk factors. Our study consisted predominantly of male participants, which may limit the generalizability of our findings.