Pub Date : 2025-02-01DOI: 10.1016/j.numecd.2024.09.002
Wonjun Billy Kim , Jianmin Zhu , Dylan Fromm , Yudan Wei
Background and aims
Cigarette smoking is a well-established risk factor for cardiovascular disease and other aging-related disorders; yet the pathogenesis of these diseases induced by smoking remains relatively underexplored. This study was to assess the association between cigarette smoking and serum α-Klotho levels, an anti-aging protein, in US adults.
Methods and results
Data on 4196 participants aged 40–79 years from the 2013–2016 National Health and Nutrition Examination Survey was analyzed for the association using multiple general linear models. Smoking was assessed using both questionnaire data and serum cotinine measurements. Both past and current smokers exhibited significantly lower levels of α-Klotho, with the light smokers exhibiting the lowest levels [geometric mean: 720.85 pg/mL; 95% CI: 662.53, 784.31], compared with non-smokers [806.75 (790.69, 823.13)]. A significantly inverse association between current smoking and α-Klotho levels was revealed. This relationship extended across smoking intensities, with even light smokers displaying the strongest association. After adjusting for potential confounders, light (smoked <5 pack-years), moderate (5–19 pack-years), and heavy smoking (≥20 pack-years) were associated with reductions of 10.81% (−16.91, −4.28), 6.43% (−10.24, −2.47), and 3.38% (−6.83, 0.19) of Klotho levels, respectively, when compared to non-smoking. Active smoking, defined as serum cotinine levels ≥10 ng/mL, was associated with a 4.59% decrease (−6.91, −2.23) in α-Klotho levels.
Conclusion
The study demonstrates an inverse relationship between current smoking and serum α-Klotho levels among middle-aged and older adults. Our findings suggest that Klotho may play an important role in smoking-induced diseases. Further investigations are warranted to explore these interactions.
{"title":"Current cigarette smoking and decreased serum levels of α-Klotho, an anti-aging hormone, among US adult participants","authors":"Wonjun Billy Kim , Jianmin Zhu , Dylan Fromm , Yudan Wei","doi":"10.1016/j.numecd.2024.09.002","DOIUrl":"10.1016/j.numecd.2024.09.002","url":null,"abstract":"<div><h3>Background and aims</h3><div>Cigarette smoking is a well-established risk factor for cardiovascular disease and other aging-related disorders; yet the pathogenesis of these diseases induced by smoking remains relatively underexplored. This study was to assess the association between cigarette smoking and serum α-Klotho levels, an anti-aging protein, in US adults.</div></div><div><h3>Methods and results</h3><div>Data on 4196 participants aged 40–79 years from the 2013–2016 National Health and Nutrition Examination Survey was analyzed for the association using multiple general linear models. Smoking was assessed using both questionnaire data and serum cotinine measurements. Both past and current smokers exhibited significantly lower levels of α-Klotho, with the light smokers exhibiting the lowest levels [geometric mean: 720.85 pg/mL; 95% CI: 662.53, 784.31], compared with non-smokers [806.75 (790.69, 823.13)]. A significantly inverse association between current smoking and α-Klotho levels was revealed. This relationship extended across smoking intensities, with even light smokers displaying the strongest association. After adjusting for potential confounders, light (smoked <5 pack-years), moderate (5–19 pack-years), and heavy smoking (≥20 pack-years) were associated with reductions of 10.81% (−16.91, −4.28), 6.43% (−10.24, −2.47), and 3.38% (−6.83, 0.19) of Klotho levels, respectively, when compared to non-smoking. Active smoking, defined as serum cotinine levels ≥10 ng/mL, was associated with a 4.59% decrease (−6.91, −2.23) in α-Klotho levels.</div></div><div><h3>Conclusion</h3><div>The study demonstrates an inverse relationship between current smoking and serum α-Klotho levels among middle-aged and older adults. Our findings suggest that Klotho may play an important role in smoking-induced diseases. Further investigations are warranted to explore these interactions.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"35 2","pages":"Article 103732"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376243","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 : 2025-02-01DOI: 10.1016/j.numecd.2024.08.020
Weiyan Zhang , Qingfeng Wang , Hui Liu , Fei Hong , Qingying Tang , Caiyu Hu , Ting Xu , Hongyi Lu , Lei Ye , Yuanyuan Zhu , Lei Song
Background and aims
The recent emphasis on systemic inflammation markers has focused primarily on their association with cardiac disorders, particularly the prevalence of hypertension, in adults but not children and adolescents. This research aimed to explore the associations between systemic inflammation markers and the occurrence of hypertension in 8- to 17-year-old children and adolescents in the United States.
Methods and results
Data from 6095 participants under 18 years of age were obtained from the National Health and Nutritional Examination Survey (NHANES: 1999–2020). This study examined the associations between the incidence of hypertension and four indicators of systemic inflammation: the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR). Multivariate logistic regression analysis results are represented as odds ratios (ORs) and 95 % confidence intervals (CIs), and subgroup analyses were conducted to further explore associations. After fully adjusting for potential confounding covariates, the SII, NLR, and PLR were positively associated with hypertension. Compared with individuals in the bottom quartiles, those in the top SII, NLR, and PLR quartiles were 2.12, 2.11, and 1.57 times more likely to have hypertension, respectively. Conversely, the LMR was negatively associated with hypertension incidence, particularly among those in the highest LMR quartiles (OR = 0.59, 95 % CI = 0.39–0.88; P = 0.009). Subgroup analyses revealed that the four indicators exhibited strong correlations with hypertension in male subjects.
Conclusion
This study revealed significant relationships between systemic inflammatory markers and hypertension incidence, highlighting the potential of these markers as hypertension risk indicators, particularly among male patients.
{"title":"Systemic inflammation markers and the prevalence of hypertension in 8- to 17-year-old children and adolescents: A NHANES cross-sectional study","authors":"Weiyan Zhang , Qingfeng Wang , Hui Liu , Fei Hong , Qingying Tang , Caiyu Hu , Ting Xu , Hongyi Lu , Lei Ye , Yuanyuan Zhu , Lei Song","doi":"10.1016/j.numecd.2024.08.020","DOIUrl":"10.1016/j.numecd.2024.08.020","url":null,"abstract":"<div><h3>Background and aims</h3><div>The recent emphasis on systemic inflammation markers has focused primarily on their association with cardiac disorders, particularly the prevalence of hypertension, in adults but not children and adolescents. This research aimed to explore the associations between systemic inflammation markers and the occurrence of hypertension in 8- to 17-year-old children and adolescents in the United States.</div></div><div><h3>Methods and results</h3><div>Data from 6095 participants under 18 years of age were obtained from the National Health and Nutritional Examination Survey (NHANES: 1999–2020). This study examined the associations between the incidence of hypertension and four indicators of systemic inflammation: the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR). Multivariate logistic regression analysis results are represented as odds ratios (ORs) and 95 % confidence intervals (CIs), and subgroup analyses were conducted to further explore associations. After fully adjusting for potential confounding covariates, the SII, NLR, and PLR were positively associated with hypertension. Compared with individuals in the bottom quartiles, those in the top SII, NLR, and PLR quartiles were 2.12, 2.11, and 1.57 times more likely to have hypertension, respectively. Conversely, the LMR was negatively associated with hypertension incidence, particularly among those in the highest LMR quartiles (OR = 0.59, 95 % CI = 0.39–0.88; P = 0.009). Subgroup analyses revealed that the four indicators exhibited strong correlations with hypertension in male subjects.</div></div><div><h3>Conclusion</h3><div>This study revealed significant relationships between systemic inflammatory markers and hypertension incidence, highlighting the potential of these markers as hypertension risk indicators, particularly among male patients.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"35 2","pages":"Article 103727"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570304","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 : 2025-02-01DOI: 10.1016/j.numecd.2024.08.011
Feifei Zhang , Huiliang Liu , Yuetao Xie , Litian Liu , Ohua Feng , Yingxiao Li
Background and aims
Individuals with cardiometabolic disease (CMD) face high risks of adverse outcomes. However, there is little evidence of the effectiveness of comprehensive risk assessment using the Life's Essential 8 (LE8) score in CMD. This study aimed to examine the associations between LE8 and all-cause and cardiovascular mortality rates in individuals with CMD.
Methods and results
This study included 11,198 NHANES participants, categorized into low, moderate, and high CVH groups according to LE8 scores. The LE8 score consists of eight components: diet, physical activity, nicotine exposure, sleep health, BMI, blood lipids, blood glucose, and blood pressure. A higher LE8 score indicates better cardiovascular health. Multivariable Cox proportional hazard regression and restricted cubic splines were employed to estimate the associations. Subgroup analyses considered age, sex, race and ethnicity, income, marital status, and education.
During a median follow-up of 91 months, 1079 deaths were recorded, 325 of which were cardiovascular. The multivariable adjusted hazard ratio (HR) per 10-point increase in LE8 was 0.79 (95% confidence interval (CI), 0.75–0.84) for all-cause mortality and 0.71 (95% CI, 0.64–0.79) for cardiovascular mortality. Participants with moderate and high LE8 levels showed similar inverse associations. Those under 60 exhibited more pronounced associations (P for interaction <0.05). After adjusting for multiple variables, a linear relationship was observed between LE8 and all-cause and cardiovascular mortality in the CMD population.
Conclusions
The newly introduced LE8 showed a significant negative association with all-cause and cardiovascular mortality risk among CMD individuals, highlighting its potential for CMD tertiary prevention.
{"title":"The impact of cardiovascular health on mortality in US adults with cardiometabolic disease: A prospective nationwide cohort study","authors":"Feifei Zhang , Huiliang Liu , Yuetao Xie , Litian Liu , Ohua Feng , Yingxiao Li","doi":"10.1016/j.numecd.2024.08.011","DOIUrl":"10.1016/j.numecd.2024.08.011","url":null,"abstract":"<div><h3>Background and aims</h3><div>Individuals with cardiometabolic disease (CMD) face high risks of adverse outcomes. However, there is little evidence of the effectiveness of comprehensive risk assessment using the Life's Essential 8 (LE8) score in CMD. This study aimed to examine the associations between LE8 and all-cause and cardiovascular mortality rates in individuals with CMD.</div></div><div><h3>Methods and results</h3><div>This study included 11,198 NHANES participants, categorized into low, moderate, and high CVH groups according to LE8 scores. The LE8 score consists of eight components: diet, physical activity, nicotine exposure, sleep health, BMI, blood lipids, blood glucose, and blood pressure. A higher LE8 score indicates better cardiovascular health. Multivariable Cox proportional hazard regression and restricted cubic splines were employed to estimate the associations. Subgroup analyses considered age, sex, race and ethnicity, income, marital status, and education.</div><div>During a median follow-up of 91 months, 1079 deaths were recorded, 325 of which were cardiovascular. The multivariable adjusted hazard ratio (HR) per 10-point increase in LE8 was 0.79 (95% confidence interval (CI), 0.75–0.84) for all-cause mortality and 0.71 (95% CI, 0.64–0.79) for cardiovascular mortality. Participants with moderate and high LE8 levels showed similar inverse associations. Those under 60 exhibited more pronounced associations (P for interaction <0.05). After adjusting for multiple variables, a linear relationship was observed between LE8 and all-cause and cardiovascular mortality in the CMD population.</div></div><div><h3>Conclusions</h3><div>The newly introduced LE8 showed a significant negative association with all-cause and cardiovascular mortality risk among CMD individuals, highlighting its potential for CMD tertiary prevention.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"35 2","pages":"Article 103717"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142190855","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 : 2025-01-29DOI: 10.1016/j.numecd.2025.103899
Lars Louis Andersen, Joaquín Calatayud, Rodrigo Núñez-Cortés, Luis Suso-Martí, Ana Polo-López, Rubén López-Bueno
Background and aim: Biomarkers may help predict mortality risk in older adults, yet their combined effects remain unclear. This study aims to identify distinct biomarker profiles in older adults and assess their association with all-cause and cause-specific mortality risk.
Methods and results: We analyzed data from 12,960 older adults (67.8 ± 9.4 years, 58 % women) from 11 European countries and Israel participating in Survey of Health, Ageing and Retirement in Europe. Seven biomarkers were assessed from dried blood spot samples. K-means cluster analysis identified nine distinct biomarker profiles. Cox regression and Fine and Gray subdistribution hazard models assessed the association between biomarker profiles and all-cause and cause-specific mortality, respectively, adjusting for relevant covariates. During a median follow-up of 6.3 years, 1270 (9.8 %) died. Compared to the largest cluster (n = 7005) with generally normal biomarker levels, clusters characterized by elevated C-reactive protein (CRP) and cystatin C showed increased risk of all-cause mortality, cardiovascular disease mortality and to some extent cancer mortality. A cluster with elevated glycated hemoglobin (HbA1c) (n = 1959) showed slightly increased mortality risk (HR 1.29, 95%CI 1.08-1.54). A cluster with high triglyceride and total cholesterol (n = 1622) showed decreased cancer mortality risk (SHR 0.60, 95 % CI: 0.38-0.96).
Conclusions: Biomarker profiles characterized by elevated inflammatory and renal function markers were strongly associated with increased mortality risk, even when other biomarkers were within normal ranges. Surprisingly, high levels of triglyceride and total cholesterol may be protective against cancer mortality. These findings highlight the importance of considering multiple biomarkers simultaneously in mortality risk stratification for older adults.
{"title":"Association of distinct biomarker profiles with all-cause and cause-specific mortality in older adults: Prospective cohort study across 12 countries.","authors":"Lars Louis Andersen, Joaquín Calatayud, Rodrigo Núñez-Cortés, Luis Suso-Martí, Ana Polo-López, Rubén López-Bueno","doi":"10.1016/j.numecd.2025.103899","DOIUrl":"https://doi.org/10.1016/j.numecd.2025.103899","url":null,"abstract":"<p><strong>Background and aim: </strong>Biomarkers may help predict mortality risk in older adults, yet their combined effects remain unclear. This study aims to identify distinct biomarker profiles in older adults and assess their association with all-cause and cause-specific mortality risk.</p><p><strong>Methods and results: </strong>We analyzed data from 12,960 older adults (67.8 ± 9.4 years, 58 % women) from 11 European countries and Israel participating in Survey of Health, Ageing and Retirement in Europe. Seven biomarkers were assessed from dried blood spot samples. K-means cluster analysis identified nine distinct biomarker profiles. Cox regression and Fine and Gray subdistribution hazard models assessed the association between biomarker profiles and all-cause and cause-specific mortality, respectively, adjusting for relevant covariates. During a median follow-up of 6.3 years, 1270 (9.8 %) died. Compared to the largest cluster (n = 7005) with generally normal biomarker levels, clusters characterized by elevated C-reactive protein (CRP) and cystatin C showed increased risk of all-cause mortality, cardiovascular disease mortality and to some extent cancer mortality. A cluster with elevated glycated hemoglobin (HbA1c) (n = 1959) showed slightly increased mortality risk (HR 1.29, 95%CI 1.08-1.54). A cluster with high triglyceride and total cholesterol (n = 1622) showed decreased cancer mortality risk (SHR 0.60, 95 % CI: 0.38-0.96).</p><p><strong>Conclusions: </strong>Biomarker profiles characterized by elevated inflammatory and renal function markers were strongly associated with increased mortality risk, even when other biomarkers were within normal ranges. Surprisingly, high levels of triglyceride and total cholesterol may be protective against cancer mortality. These findings highlight the importance of considering multiple biomarkers simultaneously in mortality risk stratification for older adults.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"103899"},"PeriodicalIF":3.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469787","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 : 2025-01-28DOI: 10.1016/j.numecd.2025.103863
Lorenza Mistura, Cinzia Le Donne, Laura D'Addezio, Marika Ferrari, Francisco Javier Comendador, Raffaela Piccinelli, Deborah Martone, Stefania Sette, Giovina Catasta, Aida Turrini
Background and aims: The food consumption surveys, conducted for over 30 years by the CREA Research Centre for Food and Nutrition, are the most reliable source of data to evaluate the food consumption intake and dietary patterns of the Italian population. The fourth and most recent survey (IV SCAI 2017-2020), was carried out as part of the pan-European framework 'EU Menu', according to the harmonized methods recommended by European Food Safety Authority (EFSA). The current paper aims to present its main results in terms of food group consumption.
Methods and results: The sample of IV SCAI was stratified by geographical areas and included 1969 individuals aged 3 months to 74 years living in Italy. Dietary assessment was based on food diaries for children, and 24h recalls for adolescents, adults, and elderly, for both techniques on two non-consecutive days. The most consumed food groups were: Milk and Cereals, followed by Fruit, Vegetables, and Meat. At the subgroup level, bread was the most consumed cereal product in terms of quantity (70 g/day), followed by pasta (79 % of consumers; 49 g/day). Only 39 % of individuals had an adequate fruit and vegetable consumption according to the latest World Health Organization (WHO) recommendations, although this percentage increased in adults and the elderly (43 %, and 73 % respectively). Consumption of red and processed meat was also not in line with international recommendations, being slightly higher mainly in adults and adolescents with a mean consumption of 83 g/day and 100 g/day respectively, compared to the WHO recommendation not to exceed 70 g/day.
Conclusion: The detailed dietary data collected in IV SCAI are a fundamental evidence platform supporting public health programs, a reliable reference to guide nutritional policies and monitoring diet in the coming years.
{"title":"The Italian IV SCAI dietary survey: Main results on food consumption.","authors":"Lorenza Mistura, Cinzia Le Donne, Laura D'Addezio, Marika Ferrari, Francisco Javier Comendador, Raffaela Piccinelli, Deborah Martone, Stefania Sette, Giovina Catasta, Aida Turrini","doi":"10.1016/j.numecd.2025.103863","DOIUrl":"https://doi.org/10.1016/j.numecd.2025.103863","url":null,"abstract":"<p><strong>Background and aims: </strong>The food consumption surveys, conducted for over 30 years by the CREA Research Centre for Food and Nutrition, are the most reliable source of data to evaluate the food consumption intake and dietary patterns of the Italian population. The fourth and most recent survey (IV SCAI 2017-2020), was carried out as part of the pan-European framework 'EU Menu', according to the harmonized methods recommended by European Food Safety Authority (EFSA). The current paper aims to present its main results in terms of food group consumption.</p><p><strong>Methods and results: </strong>The sample of IV SCAI was stratified by geographical areas and included 1969 individuals aged 3 months to 74 years living in Italy. Dietary assessment was based on food diaries for children, and 24h recalls for adolescents, adults, and elderly, for both techniques on two non-consecutive days. The most consumed food groups were: Milk and Cereals, followed by Fruit, Vegetables, and Meat. At the subgroup level, bread was the most consumed cereal product in terms of quantity (70 g/day), followed by pasta (79 % of consumers; 49 g/day). Only 39 % of individuals had an adequate fruit and vegetable consumption according to the latest World Health Organization (WHO) recommendations, although this percentage increased in adults and the elderly (43 %, and 73 % respectively). Consumption of red and processed meat was also not in line with international recommendations, being slightly higher mainly in adults and adolescents with a mean consumption of 83 g/day and 100 g/day respectively, compared to the WHO recommendation not to exceed 70 g/day.</p><p><strong>Conclusion: </strong>The detailed dietary data collected in IV SCAI are a fundamental evidence platform supporting public health programs, a reliable reference to guide nutritional policies and monitoring diet in the coming years.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"103863"},"PeriodicalIF":3.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484567","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 : 2025-01-26DOI: 10.1016/j.numecd.2025.103868
Melina Karipidou, Stavros Liatis, Athanasia Kyrkili, Alexandra Skoufi, Vaia Lambadiari, Stelios Tigas, Evangelos Liberopoulos, Meropi D Kontogianni
Background and aims: Diet, physical activity, sleep and smoking have been individually associated with glycemic control (GC) in adults with type 1 diabetes mellitus (T1D). However, the combined effect of these factors has not been investigated. The aim of the present study was to examine the single and combined effects of lifestyle parameters on GC of people with T1D (PwT1D).
Methods and results: Dietary, physical activity and sleep habits were evaluated using validated questionnaires. Diet quality was assessed with two scores (MedDietScore and PURE Diet Score) and two healthy lifestyle indices (HLI) were constructed (MLI based on MedDietScore and PLI based on PURE score). The score of both HLI ranged from 0 to 12 with higher scores indicating greater adherence to the healthy lifestyle pattern. One hundred ninety-two adults [61 % female, median age 42 (34, 51) years] with T1D were included in the analysis. Good GC (defined as HbA1c<7 %) was observed in 31 % of study participants. Examining lifestyle components separately, only smoking was marginally inversely associated with good GC [odds ratio (OR): 0.48, (95 % confidence interval, CI:0.23-1.00; p = 0.050)]. Individuals with better GC had significantly higher HLI scores (both p < 0.05). After adjusting for age, sex, body mass index, wearing an insulin pump and using continuous glucose monitoring, one-unit increase in the PLI was associated with 16 % higher likelihood of good GC (OR:1.16, 95 % CI:1.01-1.35, p = 0.04) and a similar trend was recorded for MLI (p = 0.05).
Conclusion: Our results suggest that adherence to a healthy lifestyle, more so than single lifestyle parameters, is associated with better GC in PwT1D.
{"title":"Exploring the effect of adhering to a healthy lifestyle pattern on glycemic control in adults with type 1 diabetes mellitus.","authors":"Melina Karipidou, Stavros Liatis, Athanasia Kyrkili, Alexandra Skoufi, Vaia Lambadiari, Stelios Tigas, Evangelos Liberopoulos, Meropi D Kontogianni","doi":"10.1016/j.numecd.2025.103868","DOIUrl":"https://doi.org/10.1016/j.numecd.2025.103868","url":null,"abstract":"<p><strong>Background and aims: </strong>Diet, physical activity, sleep and smoking have been individually associated with glycemic control (GC) in adults with type 1 diabetes mellitus (T1D). However, the combined effect of these factors has not been investigated. The aim of the present study was to examine the single and combined effects of lifestyle parameters on GC of people with T1D (PwT1D).</p><p><strong>Methods and results: </strong>Dietary, physical activity and sleep habits were evaluated using validated questionnaires. Diet quality was assessed with two scores (MedDietScore and PURE Diet Score) and two healthy lifestyle indices (HLI) were constructed (MLI based on MedDietScore and PLI based on PURE score). The score of both HLI ranged from 0 to 12 with higher scores indicating greater adherence to the healthy lifestyle pattern. One hundred ninety-two adults [61 % female, median age 42 (34, 51) years] with T1D were included in the analysis. Good GC (defined as HbA1c<7 %) was observed in 31 % of study participants. Examining lifestyle components separately, only smoking was marginally inversely associated with good GC [odds ratio (OR): 0.48, (95 % confidence interval, CI:0.23-1.00; p = 0.050)]. Individuals with better GC had significantly higher HLI scores (both p < 0.05). After adjusting for age, sex, body mass index, wearing an insulin pump and using continuous glucose monitoring, one-unit increase in the PLI was associated with 16 % higher likelihood of good GC (OR:1.16, 95 % CI:1.01-1.35, p = 0.04) and a similar trend was recorded for MLI (p = 0.05).</p><p><strong>Conclusion: </strong>Our results suggest that adherence to a healthy lifestyle, more so than single lifestyle parameters, is associated with better GC in PwT1D.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"103868"},"PeriodicalIF":3.3,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476952","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 : 2025-01-26DOI: 10.1016/j.numecd.2025.103873
Haleh Esmaili, Behnam Tajik, Tomi-Pekka Tuomainen, Sudhir Kurl, Jukka T Salonen, Jyrki K Virtanen
Background and aims: N-6 polyunsaturated fatty acids (PUFA), especially linoleic acid (LA), have been inversely associated with cardiovascular disease (CVD). However, potential mechanisms underlying these associations are not completely known. We evaluated the associations of the serum concentrations of total n-6 PUFA, LA, arachidonic acid (AA), gamma-linolenic acid (GLA), and dihomo-gamma-linolenic acid (DGLA), with resting heart rate (HR), maximal HR during exercise and HR recovery after exercise.
Methods and results: A total of 872 men free of CVD from the Kuopio Ischaemic Heart Disease Risk Factor Study, aged 42-60 years were studied. The participants performed a maximal symptom-limited exercise stress test with an electrically braked bicycle ergometer. Electrocardiogram reported continuously at rest, during the exercise test, and during recovery. Multivariable-adjusted ANCOVA was used to assess the mean values of resting HR, maximal HR and HR recovery in quartiles of serum n-6 PUFA concentrations. After multivariable adjustments, higher serum LA concentration was associated with lower resting heart rate (extreme-quartile difference = -2.61 beats/min; 95%CI -4.66, -0.56; P-trend = 0.01), but not with maximal HR or HR recovery. Higher concentrations of the minor serum n-6 PUFA GLA and DGLA were only associated with higher maximal HR (for GLA extreme-quartile difference = 2.80 beats/min, 95%CI 0.08,5.52; P-trend = 0.03 and for DGLA extreme-quartile difference = 2.80 beats/min, 95%CI 0.01,5.60; P-trend = 0.03) in the fully adjusted model. AA was not associated with HR.
Conclusion: In conclusion, higher serum LA concentration was associated with lower resting HR, while GLA and DGLA were marginally associated with higher maximal exercise HR. No associations were found with AA.
{"title":"Associations of serum n-6 polyunsaturated fatty acid concentrations with heart rate at rest, during and after exercise in men.","authors":"Haleh Esmaili, Behnam Tajik, Tomi-Pekka Tuomainen, Sudhir Kurl, Jukka T Salonen, Jyrki K Virtanen","doi":"10.1016/j.numecd.2025.103873","DOIUrl":"https://doi.org/10.1016/j.numecd.2025.103873","url":null,"abstract":"<p><strong>Background and aims: </strong>N-6 polyunsaturated fatty acids (PUFA), especially linoleic acid (LA), have been inversely associated with cardiovascular disease (CVD). However, potential mechanisms underlying these associations are not completely known. We evaluated the associations of the serum concentrations of total n-6 PUFA, LA, arachidonic acid (AA), gamma-linolenic acid (GLA), and dihomo-gamma-linolenic acid (DGLA), with resting heart rate (HR), maximal HR during exercise and HR recovery after exercise.</p><p><strong>Methods and results: </strong>A total of 872 men free of CVD from the Kuopio Ischaemic Heart Disease Risk Factor Study, aged 42-60 years were studied. The participants performed a maximal symptom-limited exercise stress test with an electrically braked bicycle ergometer. Electrocardiogram reported continuously at rest, during the exercise test, and during recovery. Multivariable-adjusted ANCOVA was used to assess the mean values of resting HR, maximal HR and HR recovery in quartiles of serum n-6 PUFA concentrations. After multivariable adjustments, higher serum LA concentration was associated with lower resting heart rate (extreme-quartile difference = -2.61 beats/min; 95%CI -4.66, -0.56; P-trend = 0.01), but not with maximal HR or HR recovery. Higher concentrations of the minor serum n-6 PUFA GLA and DGLA were only associated with higher maximal HR (for GLA extreme-quartile difference = 2.80 beats/min, 95%CI 0.08,5.52; P-trend = 0.03 and for DGLA extreme-quartile difference = 2.80 beats/min, 95%CI 0.01,5.60; P-trend = 0.03) in the fully adjusted model. AA was not associated with HR.</p><p><strong>Conclusion: </strong>In conclusion, higher serum LA concentration was associated with lower resting HR, while GLA and DGLA were marginally associated with higher maximal exercise HR. No associations were found with AA.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"103873"},"PeriodicalIF":3.3,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476946","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}
Aims: There is no consensus in the existing literature regarding the effect of vitamin D supplementation on endothelial function. This umbrella review aimed to assess meta-analyses of randomized controlled trials (RCTs) conducted in this field.
Data synthesis: We systematically searched English-language databases, including PubMed, Embase, Scopus, and Web of Science, up to January 2024. Flow-Mediated Dilation (FMD), Pulse Wave Velocity (PWV), and Augmentation Index (AIx) were the primary endpoints evaluated. A total of 16 meta-analyses were included in the review. The results indicated that vitamin D supplementation significantly improved FMD as assessed by Standardized Mean Difference (SMD) (SMD = 0.72, 95 % CI: 0.34, 1.11; p < 0.001; I2 = 79.4 %, p < 0.001) and Weighted Mean Difference (WMD) (WMD = 1.91; 95 % CI: 0.66, 3.16; p = 0.003; I2 = 94.5 %, p < 0.001). PWV also showed a modest but significant improvement (SMD = -0.06, 95 % CI: -0.12, -0.00; p = 0.03; I2 = 0.0 %, p = 0.66). However, vitamin D had no significant impact on AIx based on SMD (SMD = -0.03, 95 % CI: -0.13, 0.06; p = 0.48; I2 = 0.0 %, p = 0.49) or WMD (WMD = 0.02, 95 % CI: -2.22, 2.25; p = 0.98; I2 = 29.2 %, p = 0.23).
Conclusion: These findings suggest that vitamin D supplementation may be a beneficial intervention for improving endothelial function, particularly in populations with low FMD. The effects on PWV were modest, while AIx remained unaffected.
{"title":"The effect of vitamin D supplementation on endothelial function: An umbrella review of interventional meta-analyses.","authors":"Yirui Chen, Dandan Chen, Ye Peng, Manling Wang, Wensong Wang, Fangfang Shi, Yanzhong Wang, Liqun Hua","doi":"10.1016/j.numecd.2025.103871","DOIUrl":"https://doi.org/10.1016/j.numecd.2025.103871","url":null,"abstract":"<p><strong>Aims: </strong>There is no consensus in the existing literature regarding the effect of vitamin D supplementation on endothelial function. This umbrella review aimed to assess meta-analyses of randomized controlled trials (RCTs) conducted in this field.</p><p><strong>Data synthesis: </strong>We systematically searched English-language databases, including PubMed, Embase, Scopus, and Web of Science, up to January 2024. Flow-Mediated Dilation (FMD), Pulse Wave Velocity (PWV), and Augmentation Index (AIx) were the primary endpoints evaluated. A total of 16 meta-analyses were included in the review. The results indicated that vitamin D supplementation significantly improved FMD as assessed by Standardized Mean Difference (SMD) (SMD = 0.72, 95 % CI: 0.34, 1.11; p < 0.001; I<sup>2</sup> = 79.4 %, p < 0.001) and Weighted Mean Difference (WMD) (WMD = 1.91; 95 % CI: 0.66, 3.16; p = 0.003; I<sup>2</sup> = 94.5 %, p < 0.001). PWV also showed a modest but significant improvement (SMD = -0.06, 95 % CI: -0.12, -0.00; p = 0.03; I<sup>2</sup> = 0.0 %, p = 0.66). However, vitamin D had no significant impact on AIx based on SMD (SMD = -0.03, 95 % CI: -0.13, 0.06; p = 0.48; I<sup>2</sup> = 0.0 %, p = 0.49) or WMD (WMD = 0.02, 95 % CI: -2.22, 2.25; p = 0.98; I<sup>2</sup> = 29.2 %, p = 0.23).</p><p><strong>Conclusion: </strong>These findings suggest that vitamin D supplementation may be a beneficial intervention for improving endothelial function, particularly in populations with low FMD. The effects on PWV were modest, while AIx remained unaffected.</p><p><strong>Registration number: </strong>PROSPERO, CRD42024451215.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"103871"},"PeriodicalIF":3.3,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476898","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 : 2025-01-24DOI: 10.1016/j.numecd.2025.103869
Jamal S Rana, Fatima Farrukh, Howard H Moffet, Jennifer Y Liu, Ankeet S Bhatt, Pierre Sabouret, Andrew J Karter
Background and aim: Risk of premature atherosclerotic cardiovascular disease (ASCVD) attributable to diabetes is poorly understood. We evaluated the impact of diabetes on future risk of ASCVD in young men and women.
Methods and results: Observational cohort study of young adults (ages 30-55 years) without established ASCVD (as of January 1, 2006) who were members of Kaiser Permanente Northern California, an integrated healthcare delivery system. Adjusted demographics (age, race) and traditional risk factors (hypertension, LDL-cholesterol, HDL- C, total cholesterol, smoking). Models were specified to estimate risk ratios (RRs) for incident ASCVD events by diabetes status: no diabetes (reference) versus diabetes with no treatment, with oral hypoglycemic (OH) only and with OH plus insulin. Incident ASCVD events were defined as a composite of nonfatal myocardial infarction, ischemic stroke, or coronary heart disease death through December 31, 2020. In fully adjusted models, individuals with diabetes using insulin exhibited a 5-fold higher risk among women (RR: 5.44; 95 % CI: 4.90-6.05) and a 3-fold higher risk among men (RR: 3.13; 95 % CI: 2.84-3.45) for incident ASCVD events compared to those without diabetes.
Conclusions: A proactive stance towards ASCVD risk management in young individuals with diabetes, healthcare professionals can help improve the morbidity and mortality associated with this complex interplay of metabolic and cardiovascular disease.
{"title":"Diabetes and risk of premature atherosclerotic cardiovascular disease.","authors":"Jamal S Rana, Fatima Farrukh, Howard H Moffet, Jennifer Y Liu, Ankeet S Bhatt, Pierre Sabouret, Andrew J Karter","doi":"10.1016/j.numecd.2025.103869","DOIUrl":"https://doi.org/10.1016/j.numecd.2025.103869","url":null,"abstract":"<p><strong>Background and aim: </strong>Risk of premature atherosclerotic cardiovascular disease (ASCVD) attributable to diabetes is poorly understood. We evaluated the impact of diabetes on future risk of ASCVD in young men and women.</p><p><strong>Methods and results: </strong>Observational cohort study of young adults (ages 30-55 years) without established ASCVD (as of January 1, 2006) who were members of Kaiser Permanente Northern California, an integrated healthcare delivery system. Adjusted demographics (age, race) and traditional risk factors (hypertension, LDL-cholesterol, HDL- C, total cholesterol, smoking). Models were specified to estimate risk ratios (RRs) for incident ASCVD events by diabetes status: no diabetes (reference) versus diabetes with no treatment, with oral hypoglycemic (OH) only and with OH plus insulin. Incident ASCVD events were defined as a composite of nonfatal myocardial infarction, ischemic stroke, or coronary heart disease death through December 31, 2020. In fully adjusted models, individuals with diabetes using insulin exhibited a 5-fold higher risk among women (RR: 5.44; 95 % CI: 4.90-6.05) and a 3-fold higher risk among men (RR: 3.13; 95 % CI: 2.84-3.45) for incident ASCVD events compared to those without diabetes.</p><p><strong>Conclusions: </strong>A proactive stance towards ASCVD risk management in young individuals with diabetes, healthcare professionals can help improve the morbidity and mortality associated with this complex interplay of metabolic and cardiovascular disease.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"103869"},"PeriodicalIF":3.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476949","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 : 2025-01-24DOI: 10.1016/j.numecd.2025.103870
Xingzhi Guo, Chen Hou, Fuqiang Liu, Rong Zhou, Ge Tian, Jian-Min Liu, Rui Li
Background and aims: Studies have suggested that osteocalcin (OCN) is implicated in vascular calcification and linked to cardiovascular diseases (CVDs), but it is unclear whether the relationships are causal. The aim of this study is to evaluate the causal relationship of circulating OCN with CVDs and the role of vascular calcification.
Methods and results: Bi-directional, mediation, and multivariable Mendelian randomization (MVMR) were performed using summary-level data for circulating OCN levels, coronary artery calcification (CAC), and CVDs, including coronary artery disease (CAD), myocardial infarction (MI), heart failure, atrial fibrillation, stroke and its subtypes. Pooled estimates from two independent datasets of OCN were calculated using the inverse variance weighted method with sensitivity analyses. The conservative Hochberg correction method adjusted the P-value for multiple comparisons. Genetically predicted higher OCN levels were linked to an increased risk of CAD (odds ratio [OR] = 1.069, 95%CI = 1.037-1.102, P < 0.001) and MI (OR = 1.099, 95%CI = 1.069-1.130, P < 0.001). In addition, elevated OCN levels were associated with higher CAC (β = 0.180, 95%CI = 0.101-0.258, P = 0.006), which was related higher risk of CAD (OR = 1.225, 95%CI = 1.132-1.325, P < 0.001) and MI (OR = 1.286, 95%CI = 1.203-1.375, P < 0.001), mediating 54.5 % and 48.3 % of the effect of OCN on CAD and MI, respectively. Meanwhile, MVMR results also validated the mediating role of CAC. In contrast, CAD and MI were associated with decreased levels of plasma OCN.
Conclusion: Our findings reveal that higher OCN concentrations are associated with an elevated risk of CAD and MI, which was partially mediated by CAC. Lower OCN levels found in previous observational studies might be due to reverse causation.
{"title":"Genetic insights into circulating osteocalcin for cardiovascular diseases and the role of vascular calcification.","authors":"Xingzhi Guo, Chen Hou, Fuqiang Liu, Rong Zhou, Ge Tian, Jian-Min Liu, Rui Li","doi":"10.1016/j.numecd.2025.103870","DOIUrl":"https://doi.org/10.1016/j.numecd.2025.103870","url":null,"abstract":"<p><strong>Background and aims: </strong>Studies have suggested that osteocalcin (OCN) is implicated in vascular calcification and linked to cardiovascular diseases (CVDs), but it is unclear whether the relationships are causal. The aim of this study is to evaluate the causal relationship of circulating OCN with CVDs and the role of vascular calcification.</p><p><strong>Methods and results: </strong>Bi-directional, mediation, and multivariable Mendelian randomization (MVMR) were performed using summary-level data for circulating OCN levels, coronary artery calcification (CAC), and CVDs, including coronary artery disease (CAD), myocardial infarction (MI), heart failure, atrial fibrillation, stroke and its subtypes. Pooled estimates from two independent datasets of OCN were calculated using the inverse variance weighted method with sensitivity analyses. The conservative Hochberg correction method adjusted the P-value for multiple comparisons. Genetically predicted higher OCN levels were linked to an increased risk of CAD (odds ratio [OR] = 1.069, 95%CI = 1.037-1.102, P < 0.001) and MI (OR = 1.099, 95%CI = 1.069-1.130, P < 0.001). In addition, elevated OCN levels were associated with higher CAC (β = 0.180, 95%CI = 0.101-0.258, P = 0.006), which was related higher risk of CAD (OR = 1.225, 95%CI = 1.132-1.325, P < 0.001) and MI (OR = 1.286, 95%CI = 1.203-1.375, P < 0.001), mediating 54.5 % and 48.3 % of the effect of OCN on CAD and MI, respectively. Meanwhile, MVMR results also validated the mediating role of CAC. In contrast, CAD and MI were associated with decreased levels of plasma OCN.</p><p><strong>Conclusion: </strong>Our findings reveal that higher OCN concentrations are associated with an elevated risk of CAD and MI, which was partially mediated by CAC. Lower OCN levels found in previous observational studies might be due to reverse causation.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"103870"},"PeriodicalIF":3.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476891","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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