Nutrition Metabolism and Cardiovascular Diseases最新文献_第7页

Consumption of plant sterols-enriched soy milk with a healthy dietary pattern diet lowers blood pressure in adults with metabolic syndrome: A randomized controlled trial 饮用富含植物固醇的豆奶和健康膳食模式饮食可降低代谢综合征成人患者的血压：随机对照试验。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-10-16 DOI: 10.1016/j.numecd.2024.10.011

Yujing Xu , Clarinda Nataria Sutanto , Xuejuan Xia , Darel Wee Kiat Toh , Alicia Xinli Gan , Qiyun Deng , Lieng Hsi Ling , Chin Meng Khoo , Roger Sik-Yin Foo , Jung Eun Kim

Background & aims

Plant sterols (PS) have been shown to lower blood lipid-lipoproteins concentrations and may serve as a potential functional ingredient for cardiovascular disease (CVD) risk management. However, there are limited studies examining this effect in individuals with metabolic syndrome (MetS). The aim of this study was to evaluate the effects of PS-enriched food consumption as part of a healthy dietary pattern (HDP) on blood pressure and endothelial function in Singaporean adults with MetS.

Methods and results

This was a 12-week, crossover, randomized controlled trial with a 4-week washout period. Thirteen subjects were instructed to consume an HDP diet either with normal soy milk (control group) or with PS (2 g/day)-enriched soy milk (PS group) for 4 weeks. Blood lipid-lipoproteins and glucose concentrations, blood pressure, and endothelial function-related indicators (flow-mediated dilation, total plasma nitrate/nitrite and endothelin-1, circulating endothelial progenitor cells) were assessed before and after the intervention. Systolic blood pressure [mean change, PS group: -4.0 ± 3.7 mmHg; control group: 5.9 ± 2.5 mmHg (P_Interaction = 0.01)] and long-term CVD risk [mean change, PS group: -0.2 ± 1.0 %; control group: 2.7 ± 1.3 % (P_Interaction = 0.03)] decreased following PS consumption. No changes were observed in the other endothelial function-related outcomes.

Conclusions

Consumption of PS-enriched food with an HDP diet may lower blood pressure and long-term CVD risk in adults with MetS.

Clinical trial registration

NCT03723330, https://clinicaltrials.gov/.

背景和目的：植物固醇（PS）已被证明可降低血脂-脂蛋白浓度，并可作为一种潜在的功能性成分用于心血管疾病（CVD）风险控制。然而，对代谢综合征（MetS）患者的这一效果进行的研究还很有限。本研究的目的是评估作为健康膳食模式（HDP）一部分的富含 PS 的食物对患有 MetS 的新加坡成年人的血压和内皮功能的影响：这是一项为期 12 周的交叉随机对照试验，其中有 4 周的冲洗期。13 名受试者被要求在 4 周内饮用 HDP 饮食，其中包括普通豆奶（对照组）或富含 PS（每天 2 克）的豆奶（PS 组）。对干预前后的血脂-脂蛋白和葡萄糖浓度、血压和内皮功能相关指标（血流介导的扩张、血浆硝酸盐/亚硝酸盐和内皮素-1总量、循环内皮祖细胞）进行了评估。收缩压[平均变化，PS 组：-4.0 ± 3.7 mmHg；对照组：5.9 ± 2.5 mmHg]：服用 PS 后，收缩压[平均变化率，PS 组：-4.0 ± 3.7 mmHg；对照组：5.9 ± 2.5 mmHg（PInteraction = 0.01）]和长期心血管疾病风险[平均变化率，PS 组：-0.2 ± 1.0 %；对照组：2.7 ± 1.3 %（PInteraction = 0.03）]均有所下降。其他与内皮功能相关的结果没有变化：结论：食用富含 PS 的食物和 HDP 饮食可降低 MetS 成人的血压和长期心血管疾病风险：临床试验注册：NCT03723330，https://clinicaltrials.gov/。

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引用次数: 0

Comment on “Linear associations of Chinese visceral adiposity index and its change with hyperuricemia: A prospective cohort study” 关于 "中国人内脏脂肪指数及其变化与高尿酸血症的线性关系：前瞻性队列研究

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-10-11 DOI: 10.1016/j.numecd.2024.09.032

Hua Zhao, Jiayue Xu, Yuejun Zhou

引用次数: 0

Association between cumulative intake of sugar-sweetened and artificially sweetened beverages and progression of coronary calcification: Insights from the CARDIA study 含糖饮料和人工甜味饮料的累积摄入量与冠状动脉钙化进展之间的关系：CARDIA研究的启示

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-10-10 DOI: 10.1016/j.numecd.2024.09.017

Lingqu Zhou , Qi Guo , Junjie Wang , Zirui Zhou , Yinyin Zhang

Background and aims

This study investigates the relationship between the cumulative intake of artificially sweetened beverages (ASBs) and sugar-sweetened beverages (SSBs) during young adulthood and the progression of coronary artery calcium (CAC) by midlife, using data from the Coronary Artery Risk Development in Young Adults study.

Methods and results

We included 2,466 participants with CAC measurement via computed tomography at the 15th, 20th, and 25th year follow-ups. Dietary intake was assessed using the CARDIA Diet History at baseline and years 7. Cumulative average beverage intake was calculated and categorized. Multivariable Cox regression models adjusted for demographic, lifestyle, and cardiovascular risk factors assessed associations between beverages consumption and CAC progression. Among the included participants, 1107 (44.9 %) were male, 1439 (58.4 %) were white, and the average age was 40.4 years with a standard deviation of 3.5 years. Over a 9.2±1.8-year follow-up, CAC progression was recorded in 715 participants. Higher cumulative ASBs intake was associated with increased CAC progression risk, with hazard ratios (95%CI, P-value) for low and high ASBs consumption being 1.35 (1.14, 1.60; P < 0.001) and 1.54 (1.15, 2.07; P < 0.001) compared to non-consumers. Participants consuming >2 servings/day of SSBs had a 37 % higher CAC progression risk (HR 1.37, 95 % CI 1.14–1.64, P < 0.001). However, no significant association was found between SSB consumption and CAC progression after adjusting for confounders.

Conclusions

Prolonged consumption of beverages, especially ASBs, in young adults is linked to an increased risk of CAC progression.

背景和目的：本研究利用 "青年冠状动脉风险发展 "研究的数据，探讨了青年期人工甜饮料（ASB）和含糖饮料（SSB）的累积摄入量与中年期冠状动脉钙化（CAC）进展之间的关系：我们纳入了 2466 名在第 15、20 和 25 年随访时通过计算机断层扫描测量 CAC 的参与者。在基线和第 7 年时，使用 CARDIA 饮食史评估饮食摄入量。对累计平均饮料摄入量进行计算和分类。经人口统计学、生活方式和心血管风险因素调整的多变量 Cox 回归模型评估了饮料摄入量与 CAC 进展之间的关系。在纳入的参与者中，1107 人（44.9%）为男性，1439 人（58.4%）为白人，平均年龄为 40.4 岁，标准差为 3.5 岁。在 9.2±1.8 年的随访中，715 名参与者的 CAC 发生了进展。ASBs累积摄入量越高，CAC进展风险越大，ASBs摄入量低和摄入量高的危险比（95%CI，P值）分别为1.35（1.14，1.60；P 2份/天的SSBs的CAC进展风险高出37%（HR 1.37，95% CI 1.14-1.64，P 结论：ASBs累积摄入量越高，CAC进展风险越大：青壮年长期饮用饮料，尤其是 ASB 与 CAC 进展风险增加有关。

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引用次数: 0

Elevated concurrent carotid atherosclerosis rates in patients with metabolic dysfunction-associated fatty liver disease (MAFLD) compared to non-alcoholic fatty liver disease (NAFLD): A cross-sectional observational study 与非酒精性脂肪肝（NAFLD）相比，代谢功能障碍相关性脂肪肝（MAFLD）患者并发颈动脉粥样硬化的比例更高：一项横断面观察研究。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-10-09 DOI: 10.1016/j.numecd.2024.10.006

Nien-Ting Chung , Chiann-Yi Hsu , Nai-Chen Shih , Jia-Jyun Wu

Background and aim

Non-alcoholic fatty liver disease (NAFLD) has been recognized as an independent risk factor for atherosclerotic cardiovascular disease. Recently, there has been a shift towards diagnosing metabolic dysfunction-associated fatty liver disease (MAFLD), offering simplified criteria and improved risk assessment. However, the association between MAFLD and carotid atherosclerosis remains poorly understood.

Methods and results

The study analyzed the association of concurrent carotid atherosclerosis between NAFLD and MAFLD patients with a retrospective cohort design. The study enrolled participants who underwent abdominal and carotid artery ultrasounds from a medical center in Taiwan. NAFLD and MAFLD were diagnosed based on imaging and specific criteria. Associations between NAFLD, MAFLD, and carotid atherosclerosis were analyzed using logistic regression.

Among 11,194 participants, 57.1 % were diagnosed with fatty liver disease, among which the NAFLD-MAFLD group comprised 4689 individuals, with 900 in the NAFLD-only group and 669 in the MAFLD-only group. Significant demographic and clinical differences were observed between groups. Logistic regression showed that the MAFLD-NAFLD group and MAFLD-only group had significantly higher odds of concomitant carotid atherosclerosis. Among MAFLD patients, 65.5 % had concurrent carotid arteriosclerosis with an odds ratio of 2.35 compared to non-MAFLD patients. The odds ratios for variables in MAFLD patients, such as diabetes mellitus, Fibrosis-4(FIB-4), number of FIB-4 > 1.3, and number of NAFLD fibrosis score > −1.455 were all greater than 2.

Conclusions

MAFLD is associated with a higher prevalence of carotid atherosclerosis, compared to NAFLD. This suggests that MAFLD may serve as a significant risk factor for cardiovascular complications.

背景和目的：非酒精性脂肪肝（NAFLD）已被认为是动脉粥样硬化性心血管疾病的独立危险因素。最近，人们开始转向诊断代谢功能障碍相关性脂肪肝（MAFLD），从而简化了标准并改善了风险评估。然而，人们对代谢功能障碍相关性脂肪肝与颈动脉粥样硬化之间的关系仍然知之甚少：该研究采用回顾性队列设计分析了非酒精性脂肪肝和酒精性脂肪肝患者并发颈动脉粥样硬化的相关性。研究招募了台湾一家医疗中心接受腹部和颈动脉超声检查的参与者。NAFLD和MAFLD是根据影像学和特定标准诊断出来的。研究使用逻辑回归分析了非酒精性脂肪肝、脂肪肝和颈动脉粥样硬化之间的关系。在11194名参与者中，57.1%被诊断患有脂肪肝，其中非酒精性脂肪肝-MAFLD组有4689人，纯非酒精性脂肪肝组有900人，纯MAFLD组有669人。各组之间存在明显的人口统计学和临床差异。逻辑回归显示，MAFLD-NAFLD组和仅MAFLD组合并颈动脉粥样硬化的几率明显更高。与非 MAFLD 患者相比，MAFLD 患者中有 65.5% 并发颈动脉硬化，几率比为 2.35。在 MAFLD 患者中，糖尿病、纤维化-4（FIB-4）、FIB-4 > 1.3 的数量以及非酒精性脂肪肝纤维化评分 > -1.455 的数量等变量的几率比均大于 2：与非酒精性脂肪肝相比，MAFLD与更高的颈动脉粥样硬化发病率相关。这表明 MAFLD 可能是心血管并发症的一个重要风险因素。

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引用次数: 0

The Fibrosis-4 index predicts all-cause mortality in a cohort of patients at high cardiovascular risk partly through glomerular filtration rate reduction 纤维化-4 指数可部分通过肾小球滤过率的降低预测心血管高危人群的全因死亡率。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-10-09 DOI: 10.1016/j.numecd.2024.10.007

Antonio Mirijello , Gabriella Pacilli , Antonio Siena , Antonio Mangiacotti , Maria Maddalena D'Errico , Daria Dilalla , Olga Lamacchia , Andrea Fontana , Massimiliano Copetti , Pamela Piscitelli , Giovanni Targher , Salvatore A. De Cosmo

Background and aim

Fibrosis-4 (FIB-4) index is a widely used test for non-invasively assessing liver fibrosis. We aimed to investigate the association between FIB-4 index and risk of all-cause mortality in patients at high cardiovascular (CV) risk and to determine whether coexisting renal dysfunction mediates this association.

Methods and results

Single-center prospective study of 994 patients with established or suspected coronary artery disease undergoing coronary angiography, followed for a median of 44 months. Mortality data were obtained through the Italian Health Card Database. At baseline, the median FIB-4 index was greater in deceased vs. alive patients (1.71 vs. 1.38, p < 0.001) and in those with reduced eGFR than in those with normal eGFR (1.65 vs. 1.37, p < 0.001). For each unit increase in the baseline log-FIB-4 index, the risk of all-cause mortality sharply increased during the follow-up (hazard ratio [HR] 2.31, 95%CI 1.31–4.08, p = 0.004). Similarly, assuming the lowest baseline FIB-4 risk category as the reference, the risk of all-cause mortality progressively increased across the indeterminate (HR 1.82, 95%CI 1.18–2.82, p = 0.007) and the highest baseline FIB-4 risk categories (HR 2.33, 95%CI 1.37–3.97; p = 0.002). A causal mediation analysis showed that about one-third of the effect of FIB-4 index on mortality risk was mediated by reduced eGFR (32.8 %, p = 0.01).

Conclusions

Increased FIB-4 index predicts the long-term risk of all-cause mortality in patients at high CV risk, and this risk is, at least in part, mediated by reduced eGFR. Further prospective studies are needed to confirm these findings.

背景和目的：纤维化-4（FIB-4）指数是一种广泛使用的无创评估肝纤维化的检测方法。我们旨在研究 FIB-4 指数与心血管（CV）高风险患者全因死亡风险之间的关联，并确定并存的肾功能障碍是否介导了这种关联：对994名接受冠状动脉造影术的已确诊或疑似冠状动脉疾病患者进行单中心前瞻性研究，随访时间中位数为44个月。死亡率数据来自意大利健康卡数据库。基线时，死亡患者的中位 FIB-4 指数高于存活患者（1.71 vs. 1.38，P 结论：FIB-4 指数的升高预示着冠状动脉疾病的恶化：FIB-4指数的升高可预测心血管疾病高危患者的长期全因死亡风险，而这种风险至少部分是由eGFR的降低引起的。需要进一步的前瞻性研究来证实这些发现。

{"title":"The Fibrosis-4 index predicts all-cause mortality in a cohort of patients at high cardiovascular risk partly through glomerular filtration rate reduction","authors":"Antonio Mirijello , Gabriella Pacilli , Antonio Siena , Antonio Mangiacotti , Maria Maddalena D'Errico , Daria Dilalla , Olga Lamacchia , Andrea Fontana , Massimiliano Copetti , Pamela Piscitelli , Giovanni Targher , Salvatore A. De Cosmo","doi":"10.1016/j.numecd.2024.10.007","DOIUrl":"10.1016/j.numecd.2024.10.007","url":null,"abstract":"<div><h3>Background and aim</h3><div>Fibrosis-4 (FIB-4) index is a widely used test for non-invasively assessing liver fibrosis. We aimed to investigate the association between FIB-4 index and risk of all-cause mortality in patients at high cardiovascular (CV) risk and to determine whether coexisting renal dysfunction mediates this association.</div></div><div><h3>Methods and results</h3><div>Single-center prospective study of 994 patients with established or suspected coronary artery disease undergoing coronary angiography, followed for a median of 44 months. Mortality data were obtained through the Italian Health Card Database. At baseline, the median FIB-4 index was greater in deceased vs. alive patients (1.71 vs. 1.38, p < 0.001) and in those with reduced eGFR than in those with normal eGFR (1.65 vs. 1.37, p < 0.001). For each unit increase in the baseline log-FIB-4 index, the risk of all-cause mortality sharply increased during the follow-up (hazard ratio [HR] 2.31, 95%CI 1.31–4.08, p = 0.004). Similarly, assuming the lowest baseline FIB-4 risk category as the reference, the risk of all-cause mortality progressively increased across the indeterminate (HR 1.82, 95%CI 1.18–2.82, p = 0.007) and the highest baseline FIB-4 risk categories (HR 2.33, 95%CI 1.37–3.97; p = 0.002). A causal mediation analysis showed that about one-third of the effect of FIB-4 index on mortality risk was mediated by reduced eGFR (32.8 %, p = 0.01).</div></div><div><h3>Conclusions</h3><div>Increased FIB-4 index predicts the long-term risk of all-cause mortality in patients at high CV risk, and this risk is, at least in part, mediated by reduced eGFR. Further prospective studies are needed to confirm these findings.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"35 1","pages":"Article 103768"},"PeriodicalIF":3.3,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677391","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}

引用次数: 0

The association between Naples Prognostic Score and all-cause and cardiovascular mortality in the general population with metabolic syndrome: A cohort study 在患有代谢综合征的普通人群中，那不勒斯预后评分与全因死亡率和心血管死亡率之间的关系：一项队列研究。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-10-09 DOI: 10.1016/j.numecd.2024.10.003

Zhongying Chen, Zhe Chen, Yuqi Zhong, Qizeng Wang

Background and aim

The Naples prognostic score (NPS) is a recognized inflammatory and nutritional scoring system used as a prognostic indicator in various cancers and, more recently, in non-cancer diseases. Its association with mortality in individuals with Metabolic Syndrome (MetS) is understudied. This study aims to investigate the link between NPS and both all-cause and cardiovascular disease (CVD) mortality in adults with MetS.

Methods and results

This study included individuals with MetS from the National Health and Nutrition Examination Survey (NHANES) 1999–2016. Mortality data were linked to National Death Index records up to December 31, 2019. MetS was defined using NCEP ATP III criteria. NPS was calculated using serum albumin, total cholesterol, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio, classifying participants into three groups. Survival differences were assessed using Kaplan-Meier analysis and Log-rank tests. Cox proportional hazards regression determined hazard ratios (HR) with 95 % confidence intervals (CI). The study included 13,757 participants, with 2744 (19.95 %) in the low group, 9140 (66.44 %) in the medium group, and 1873 (13.61 %) in the high group. Over a median follow-up of 9.16 years, there were 3292 all-cause deaths and 1136 cardiovascular deaths. Compared to the low group, the high group had adjusted HRs of 1.74 (95 % CI: 1.51, 2.01) for all-cause mortality and 1.60 (95 % CI: 1.25, 2.04) for cardiovascular mortality (all P for trend <0.01).

Conclusions

NPS is a significant prognostic indicator for both all-cause and cardiovascular mortality in individuals with MetS, showing a positive correlation with mortality risk, reinforcing its potential clinical utility.

背景和目的：那不勒斯预后评分（NPS）是一种公认的炎症和营养评分系统，被用作各种癌症的预后指标，最近也被用作非癌症疾病的预后指标。但它与代谢综合征（MetS）患者死亡率之间的关系尚未得到充分研究。本研究旨在调查 NPS 与 MetS 成年人全因死亡率和心血管疾病（CVD）死亡率之间的关系：本研究纳入了 1999-2016 年国家健康与营养调查（NHANES）中的 MetS 患者。截至 2019 年 12 月 31 日的死亡率数据与国家死亡指数记录相连。MetS 的定义采用 NCEP ATP III 标准。NPS使用血清白蛋白、总胆固醇、中性粒细胞与淋巴细胞比率和淋巴细胞与单核细胞比率计算，将参与者分为三组。采用卡普兰-梅耶尔分析和对数秩检验评估生存率差异。Cox 比例危险度回归确定了危险度比 (HR)，并得出了 95% 的置信区间 (CI)。研究共纳入 13757 名参与者，其中低度组 2744 人（19.95%），中度组 9140 人（66.44%），高度组 1873 人（13.61%）。在 9.16 年的中位随访期间，共有 3292 例全因死亡和 1136 例心血管疾病死亡。与低位组相比，高位组的全因死亡率调整 HR 值为 1.74（95 % CI：1.51, 2.01），心血管死亡率调整 HR 值为 1.60（95 % CI：1.25, 2.04）（所有 P 均为趋势性结论）：NPS是MetS患者全因死亡率和心血管死亡率的重要预后指标，与死亡风险呈正相关，增强了其潜在的临床实用性。

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引用次数: 0

The triglyceride-glucose index: A valuable tool for uncovering the hidden connection between metabolic diseases and arterial ageing 甘油三酯-葡萄糖指数：揭示代谢性疾病与动脉老化之间隐藏联系的重要工具。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-10-09 DOI: 10.1016/j.numecd.2024.10.005

Giacomo Pucci , Riccardo Alcidi , Rosa Curcio

引用次数: 0

Circulating β-hydroxybutyrate levels are associated with major adverse clinical events in patients with acute myocardial infarction 循环中的β-羟丁酸水平与急性心肌梗死患者的主要不良临床事件有关。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-10-06 DOI: 10.1016/j.numecd.2024.10.002

Yining Dai , Lixin Xie , Yeshen Zhang , Yu He , Haobin Liu , Siyu Kong , Weikun Chen , Hailing Li , Yuling Zhan , Ning Tan , Chongyang Duan , Pengcheng He , Yuanhui Liu , Ling Xue

Background and aims

Acute myocardial infarction is associated with high mortality, and effective biomarkers are required for the risk stratification. In cardiovascular diseases, circulating levels of ketone bodies (KB) such as β-hydroxybutyrate (β-OHB) and acetoacetate are altered. However, the relationship between circulating KB levels and major adverse clinical events (MACE) in patients with ST-elevation myocardial infarction (STEMI) is unknown.

Methods and results

Patients with STEMI undergoing percutaneous coronary intervention (PCI) between January 2010 to June 2020 were enrolled, and divided into T1 (<0.09 mmol/L, n = 219), T2 (0.09–0.28 mmol/L, n = 202), and T3 (>0.28 mmol/L, n = 211) tertiles according to the circulating β-OHB levels within 24 h of admission. The primary endpoint was in-hospital MACE.

The incidence of in-hospital MACE in the T3 group (20.9 %) was significantly higher than in the T1 group (10.5 %) and T2 group (14.9 %) (P = 0.012). Multivariate logistic regression analysis showed that elevated circulating β-OHB levels were associated with an increased risk of all-cause mortality and MACE during hospitalization (OR = 1.38, 95 % CI = 1.08–1.77, P = 0.009). During follow-up period, multivariate Cox regression analyses showed that elevated circulating β-OHB levels were associated with higher all-cause mortality and MACE (HR = 1.35, 95 % CI = 1.17–1.56, P < 0.001). The impact of β-OHB on MACE were similar for all the subgroups.

Conclusion

Elevated circulating β-OHB levels within 24 h of admission were associated with an increased risk of MACE in patients with STEMI undergoing PCI, and could be a promising prognosis biomarker.

背景和目的：急性心肌梗死与高死亡率有关，因此需要有效的生物标志物来进行风险分层。在心血管疾病中，β-羟丁酸（β-OHB）和乙酰乙酸等酮体（KB）的循环水平会发生改变。然而，ST段抬高型心肌梗死（STEMI）患者的循环KB水平与主要不良临床事件（MACE）之间的关系尚不清楚：纳入2010年1月至2020年6月期间接受经皮冠状动脉介入治疗（PCI）的STEMI患者，并根据入院24小时内的循环β-OHB水平分为T1（0.28 mmol/L，n = 211）三等分。主要终点是院内MACE。T3组的院内MACE发生率（20.9%）明显高于T1组（10.5%）和T2组（14.9%）（P = 0.012）。多变量逻辑回归分析显示，循环β-OHB水平升高与住院期间全因死亡和MACE风险增加有关（OR = 1.38，95 % CI = 1.08-1.77，P = 0.009）。在随访期间，多变量 Cox 回归分析显示，循环 β-OHB 水平升高与较高的全因死亡率和 MACE 相关（HR = 1.35，95 % CI = 1.17-1.56，P = 0.009）：入院24小时内循环β-OHB水平升高与接受PCI治疗的STEMI患者MACE风险升高有关，可能是一种有前景的预后生物标志物。

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引用次数: 0

The impact of iron deficiency on prognosis in stroke and non-stroke populations: A retrospective cohort study 缺铁对脑卒中和非脑卒中人群预后的影响：一项回顾性队列研究。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-10-03 DOI: 10.1016/j.numecd.2024.09.029

Qinhong Wang , Wenqiang Han , Tianyu Wang , Haonan Deng , Jingquan Zhong

Background and aims

Iron deficiency (ID) leads to a significant global health burden, but research on the impact of ID on the prognosis of stroke patients is rare. We aim to investigate the impact of ID on the all-cause mortality of both the stroke and non-stroke individuals.

Methods and results

This retrospective cohort study used data from the National Health and Nutrition Examination Survey (NHANES) conducted from 1999 to 2002. The follow-up period for the participants extended until December 31, 2019. Overall, 7239 participants were enrolled, out of which 200 had a history of stroke. There was no difference in the prevalence of ID (ferritin <100 ng/mL or serum ferritin concentration 100–299 ng/mL with transferrin saturation (TSAT) < 20 %) between stroke and non-stroke individuals (68 % vs 65 %, P = 0.5) even after propensity score matching (68 % vs 63 %, P = 0.5). In stroke survivors, ID was found to be associated with a higher risk of all-cause mortality over a 5-year period (HR: 4.16, 95 % CI: 1.54–11.3, P = 0.005). Additionally, there was no link between ID and all-cause mortality in individuals without stroke. Moreover, we did not observe a significant association between dietary iron, total folate, and ID in stroke patients.

Conclusion

Stroke survivors with low serum ferritin levels have an increased risk of 5-year all-cause mortality. Health care providers should consider screening for ID among individuals with a history of stroke. Future clinical trials examining the effects of iron therapy on patients with stroke and coexisting ID are warranted.

背景和目的：铁缺乏症（ID）给全球健康造成了巨大负担，但有关铁缺乏症对脑卒中患者预后影响的研究却很少见。我们旨在调查缺铁对中风和非中风患者全因死亡率的影响：这项回顾性队列研究使用的数据来自 1999 年至 2002 年进行的美国国家健康与营养调查（NHANES）。参与者的随访期延长至 2019 年 12 月 31 日。共有 7239 人参加了研究，其中 200 人有中风史。ID（铁蛋白）的患病率没有差异：血清铁蛋白水平低的中风幸存者5年全因死亡风险增加。医疗服务提供者应考虑对有中风史的人进行 ID 筛查。未来有必要开展临床试验，研究铁治疗对中风合并 ID 患者的影响。

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引用次数: 0

Liver fat response to two days fasting and two days isocaloric high-carbohydrate refeeding in lean and obese women 瘦弱和肥胖女性对两天禁食和两天等热量高碳水化合物进食的肝脏脂肪反应。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases

Pub Date : 2024-10-01 DOI: 10.1016/j.numecd.2024.09.030

Petr Šedivý , Tereza Dusilová , Bára Šetinová , Dita Pajuelo , Milan Hájek , Lenka Rossmeislová , Michaela Šiklová , Veronika Šrámková , Eva Krauzová , Jan Gojda , Michal Koc , Monika Dezortová , Jan Kovář

Background and aims

Prolonged fasting, which leads to the mobilization of fat from adipose tissue, can result in the development of hepatosteatosis. However, it is not yet known whether the accumulation of fat in the liver after fasting can be affected by concurrent obesity. Therefore, this study aimed to assess how excessive adiposity influences changes in liver fat content induced by fasting and subsequent refeeding.

Methods and results

Ten lean women and eleven women with obesity (age: 36.4 ± 7.9 and 34.5 ± 7.9 years, BMI: 21.4 ± 1.7 and 34.5 ± 4.8 kg/m²) underwent a 60-h fasting period followed by 2 days of isocaloric high-carbohydrate refeeding. Magnetic resonance spectroscopy (MRS) examinations of liver were conducted at baseline, after 48 h of fasting, and at the end of refeeding period. Hepatic fat content (HFC) increased in lean women after fasting, whereas no statistically significant change in HFC was observed in women with obesity. Additionally, fasting led to significant reductions in liver volume in both groups, likely attributable to glycogen depletion, with subsequent restoration upon refeeding. Notably, changes in hepatic fat volume (HFV) rather than HFC inversely correlated with baseline liver fat content and HOMA-IR.

Conclusion

We demonstrated that prolonged fasting results in accumulation of fat in the liver in lean subjects only and that this accumulation is inversely related to baseline fat content and insulin resistance. Moreover, the study underscored the importance of evaluating hepatic fat volume rather than hepatic fat content in studies that involve considerable changes in hepatic lean volume.

背景和目的：长期禁食会导致脂肪组织中的脂肪被动员起来，从而导致肝脂肪变性。然而，禁食后脂肪在肝脏中的积聚是否会受到并发肥胖症的影响，目前尚不清楚。因此，本研究旨在评估过度肥胖如何影响禁食和随后再进食引起的肝脏脂肪含量变化：10 名瘦弱女性和 11 名肥胖女性（年龄：36.4 ± 7.9 岁和 34.5 ± 7.9 岁，体重指数：21.4 ± 1.7 千克/平方米和 34.5 ± 4.8 千克/平方米）进行了 60 小时的禁食，随后进行了为期 2 天的等热量高碳水化合物进食。分别在基线期、禁食 48 小时后和进食期结束时对肝脏进行了磁共振光谱（MRS）检查。禁食后，瘦弱女性的肝脏脂肪含量（HFC）增加，而肥胖女性的肝脏脂肪含量在统计学上没有明显变化。此外，禁食还导致两组女性的肝脏体积显著缩小，这可能是由于糖原耗竭所致，随后在进食后恢复。值得注意的是，肝脏脂肪体积（HFV）而非肝脏脂肪含量的变化与基线肝脏脂肪含量和 HOMA-IR 成反比：我们的研究表明，长期禁食只会导致瘦人肝脏中脂肪的积累，而且这种积累与基线脂肪含量和胰岛素抵抗成反比。此外，该研究还强调了在涉及肝脏瘦肉体积发生巨大变化的研究中，评估肝脏脂肪体积而非肝脏脂肪含量的重要性。

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