Nutrition Metabolism and Cardiovascular Diseases最新文献

Background and aims: Metabolic syndrome (MetS) includes central obesity, hyperglycemia, insulin resistance, atherogenic dyslipidemia, and hypertension. In Mexico, it also affects Indigenous populations which have difficulties to get opportune diagnostic procedures. Therefore, this study aimed to examine the effectiveness of the TyG index in identifying MetS among different Indigenous groups from Northwest Mexico.

Methods and results: A cross-sectional study was conducted on Indigenous and Mestizo populations from Northwest Mexico. Ethnicity was confirmed on each volunteer by evaluation of 15 short tandem repeats loci. Thus, Coras, Huicholes, Mexicaneros, Tarahumaras, Tepehuanos, and Mestizos were included. MetS was diagnosed using the ATP III criteria and the TyG index was calculated as the Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)]/2. ROC curve was used to detect the best cut-off point for MetS identification, area under the curve, sensitivity, and specificity. A total of 472 subjects were enrolled in the study, including Mestizos (n = 48), Coras (n = 73), Huicholes (n = 93), Mexicaneros (n = 74), Tarahumaras (n = 81), and Tepehuanos (n = 103). Adjusted logistic regression analysis revealed that Coras (OR = 3.81; 95 % confidence interval: 1.58-9.16), Huicholes (OR = 2.74; 95 % confidence interval: 1.03-7.31), Mexicaneros (OR = 4.31; 95 % confidence interval: 1.55-11.9), and Tarahumaras (OR = 5.31; 95 % confidence interval: 1.97-14.3) had a direct association with MetS. A cut-off point of 4.66 for the TyG index demonstrated an AUC, sensitivity, and specificity of 0.885, 84 %, and 82 %, respectively, for the detection of MetS in Indigenous populations.

Conclusions: The results of our study suggest that the TyG index is a useful tool for detecting MetS in Indigenous populations of Northwest Mexico.

Background and aims: The impact of different dietary fats on premature coronary artery disease (PCAD) has not been well established. Given Iran's ethnic diversity, this study examined the association between fat intake and the risk and severity of PCAD in multiple Iranian ethnicities.

Methods and results: In this multicenter case-control study, men aged <55 and women aged <65 years who were candidates for coronary angiography were recruited from major Iranian ethnicities. Intake of hydrogenated vegetable oil (HVO), non-hydrogenated vegetable oil (non-HVO), animal fat, and a composite fat consumption index (FCI) was assessed using a validated food frequency questionnaire and dichotomized at the median. Logistic regression models were fitted in three steps: crude, age- and sex-adjusted, and multivariate-adjusted. A total of 2459 participants were included: 1395 with PCAD and 1064 controls. The mean age was 51.47 ± 7.24. A higher non-HVO intake was associated with a lower risk of PCAD in the fully adjusted model (odds ratio [OR]: 0.37; 95 % confidence interval [CI]: 0.29, 0.46). This pattern was similar in the Fars (OR = 0.31), Kurdish (OR = 0.26), Bakhtiari (OR = 0.28), and Qashqaei (OR = 0.24) groups but not in the Azari group. Non-HVO intake was also associated with lower PCAD severity (OR: 0.31; 95 %CI 0.26, 0.37). No significant associations were observed between HVO, animal fat, or FCI. The interaction tests did not show any meaningful ethnic modifications.

Conclusions: Replacing solid and hydrogenated fats with liquid nonhydrogenated vegetable oils may reduce both the risk and severity of PCAD in Iranian adults and support dietary advice that prioritizes fat quality.

Background and aims: Obesity and metabolic status are closely associated with cardiovascular outcomes. However, the prognostic value of metabolic phenotypes in patients with premature acute myocardial infarction (PAMI) remains unclear. This study aims to investigate the relationship between metabolic phenotypes and long-term cardiovascular outcomes in PAMI patients.

Methods and results: This study included 760 AMI patients aged ≤35 years from two medical centers in Beijing. Participants were categorized into four groups: metabolically healthy non-obese (MHN), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUN), and metabolically unhealthy obese (MUO). The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE). Multivariable Cox regression models, Kaplan-Meier curves and subgroup analyses were used to evaluate the association between metabolic phenotypes and MACCE. During a median follow-up of 77 months, a total of 158 MACCE were recorded. Patients with MUO exhibited a higher risk of MACCE (MHN as reference: HR = 1.87, 95 %CI: 1.18-2.94, p = 0.007; MHO as reference: HR = 1.77, 95 %CI: 1.10-2.83, p = 0.018). Notably, the risk of revascularization was elevated in MUO. The robustness of our study findings was supported by consistent results across subgroup and sensitivity analyses.

Conclusions: MUO is associated with adverse outcomes in PAMI patients, suggesting it may serve as an independent predictor of poor prognosis in this population.

Background and aim: Diabetes mellitus (DM) and cardiac arrest (CA) are major contributors to mortality and healthcare costs in the U.S., yet national trends and disparities remain underexplored. To assess trends and disparities in DM and CA-related mortality from 1999 to 2023 by age, sex, race/ethnicity, geographic region, and urban-rural status.

Methods and results: Mortality data for adults (≥25 years) with DM and CA listed as underlying or contributing causes of death were obtained from the CDC WONDER database. Age-adjusted mortality rates (AAMRs) were calculated, and Joinpoint regression estimated annual percentage change (APC) and average annual percentage change (AAPC) (p < 0.05). From 1999 to 2023, 1,095,268 deaths were attributed to DM and CA. AAMRs declined from 21.3 in 1999 to 18.39 in 2018 (APC: -0.94 %; 95 % CI: -1.25 to -0.66), rose sharply between 2018 and 2021 (APC: 11.50 %; 95 % CI: 7.79 to 13.59), and fell again through 2023 (APC: -12.18 %; 95 % CI: -16.01 to -8.51). Males consistently had higher mortality than females. Non-Hispanic (NH) Black individuals had the highest rates, while NH American Indians showed minimal decline (AAPC: -0.21 %; 95 % CI: 1.17 to 0.63). Adults aged 25-44 years had increasing mortality (AAPC: 1.58 %; 95 % CI: 0.96 to 2.02), whereas older groups declined. Rural mortality surpassed urban rates after 2012.

Conclusion: While overall DM and CA mortality has decreased, significant disparities persist. Targeted interventions are needed to improve cardiovascular care for DM patients, particularly young adults, NH Black and NH American Indian populations, and rural communities.

Background and aim: Acute myocardial infarction (AMI) displays circadian, weekly, and seasonal variability, with higher incidence on Mondays and during winter. Diabetes mellitus (DM) may modulate susceptibility to these temporal fluctuations through altered autonomic, metabolic, and inflammatory responses. This study examined weekly and seasonal variations in AMI incidence and in-hospital mortality among patients with and without DM in a large, population-based cohort.

Methods and results: We analyzed administrative health data from Lombardy, Italy (2000-2019), identifying all AMI hospitalizations (n = 281,164; 25 % with DM). Acute myocardial infarction onset and in-hospital mortality were evaluated by day of week and season in patients with and without DM. Weekly patterns showed a clear Monday peak, with a 12 % higher AMI risk compared with other weekdays, particularly among individuals with DM. A pronounced seasonal pattern was also observed, with a 29 % higher AMI incidence in winter versus other seasons, again more evident in DM patients. In-hospital mortality increased for AMI occurring on weekends and during winter months, with a consistently greater magnitude of risk among patients with DM after adjustment for demographics and comorbidities.

Conclusions: Acute myocardial infarction incidence peaks on Mondays and in winter, while mortality is higher during weekends and colder months. These temporal patterns are more pronounced among individuals with DM. Awareness of these time-dependent risks may support targeted prevention strategies, optimized care pathways, and resource planning for high-risk groups such as patients with DM.

Background and aim: Considering that using systolic blood pressure or heart rate alone cannot comprehensively reflect cardiac workload, we employed the rate-pressure product (RPP) as a risk marker to assess the risks of cardiovascular diseases (CVDs) and all-cause mortality. Furthermore, given that blood pressure and heart rate fluctuations persist throughout life, therefore this study investigated whether lower levels of RPP variability are associated with lower risks of CVDs and all-cause mortality.

Methods and results: We analyzed data from 49,792 participants in the Kailuan Study, a prospective cohort of Chinese adults who underwent three consecutive health examinations between 2006 and 2010. RPP variability was calculated using systolic blood pressure and heart rate data, and participants were categorized into tertiles, with the highest tertile serving as the reference. Cox proportional hazards models were used to evaluate associations between RPP variability and the risks of CVDs and all-cause mortality, with additional interaction analyses by age, sex, and average RPP level. Compared to the highest tertile, participants in the second and first tertiles exhibited significantly lower risks of CVDs (hazard ratios [HRs]: 0.924 [95 % CIs: 0.856-0.997] and 0.875 [0.806-0.950], respectively; P < 0.01) and all-cause mortality (HRs: 0.882 [0.822-0.947] and 0.821 [0.760-0.866], respectively; P < 0.01). Subgroup analysis revealed a significant interaction with age and average RPP level. Age and average RPP level modified the association between RPP variability and CVDs risk, suggesting greater cardiovascular benefits of stable RPP profiles in younger individuals and those with lower baseline cardiac workload.

Conclusion: Long-term lower RPP variability was independently associated with reduced risks of cardiovascular disease and all-cause mortality, regardless of baseline RPP levels. The association was more pronounced in younger individuals and those with lower average RPP, suggesting potential benefit from targeting RPP variability in early cardiovascular prevention strategies.

Aim: Many studies reported the effects of n-3 polyunsaturated fatty acids (PUFA) towards cardiovascular risk, but results are inconclusive. This meta-analysis systemically explored PUFA-mediated effects on representative cardiovascular-related metabolic markers, including glycolipid profile, adiponectin, and oxidative stress indicators in different people.

Data synthesis: Literature search on PubMed, EMBASE, Web of Science, and the Cochrane Library were performed up to October 11, 2024. Randomized controlled trials focusing on the effects of n-3 PUFA supplementation on triacylglycerol (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), apolipoprotein, adipokine, hemoglobin A1c (HbA1c), c-reactive protein (CRP), and oxidative stress biomarkers were chosen as outcome variables. There were 24 studies with 2043 subjects showed significant effects: (1)TG decreased by 16.95 mg/dl (21 trials, n = 1491; 95 % CI: 23.25, -10.66), (2)HDL increased by 1.55 mg/dl (22 trials, n = 1914; 95 % CI: 0.69, 2.42), (3)adiponectin increased by 0.96 μg/ml (3 trials, n = 198; 95 % CI: 0.03, 1.8), (4)HbA1c decreased by 0.17 % (3 trials, n = 283; 95 % CI: 0.29, -0.04), (5)LDL decreased by 10.98 mg/dl in women (4 trials, n = 236; 95 % CI: 19.41, -2.5) and by 13.77 mg/dl in the polycystic ovary syndrome (PCOS) (3 trials, n = 180; 95 % CI: 22.83, -4.7), (6)TC decreased by 15.58 mg/dl in women (4 trials, n = 236; 95 % CI: 24.64, -6.53).

Conclusions: The meta-analysis indicates that n-3 PUFAs improve cardiovascular-related metabolic markers, potentially benefit cardiovascular health in patients with cardiovascular disease, PCOS, and kidney disease, especially in older women via reducing TG and HbA1c and increasing HDL and adiponectin.

Background and aims: Combined therapy, sodium-glucose cotransporter 2 inhibitors (SGLT2i), and glucagon-like peptide-1 receptor agonists (GLP1ra) reduce all-cause mortality in patients with diabetes. We aimed to analyse the differential behaviour of combined therapy between women and men regarding all-cause mortality.

Methods and results: This is a retrospective observational cohort study. Using "Big data" according to electronic medical records in the Santiago-Barbanza health area, which covers 450,000 patients. Out of 15,118 patients, 41 % were women. The median follow-up was 33 months. Women were older (71 [62-78] vs. 67 [59-75], p: <0.001) and with a higher incidence of obesity (53 % vs. 41 %, p: <0.001), meanwhile, men presented more coronary artery disease (CAD) (19 % vs. 9 %, p: <0.001). The multinomial propensity score and multivariate Cox regression were used for statistical analysis. All-cause mortality was compared between combined vs. monotherapy in women or men. Men had a higher risk of all-cause mortality than women in this population (HR [95 % CI] 1.50 [1.28-1.75]). Combined regarding monotherapy (GLP1ra (HR [95 % CI] 0.19 [0.14-0.27]), or SGLT2i (HR [95 % CI] 0.30 [0.23-0.40]), and treatment duration (HR [95 % CI] 0.95 [0.94-0.96] were associated with lower risk of all-cause mortality; with higher benefit in women (GLP1ra (HR [95 % CI] 0.14 [0.08-0.27]), or SGLT2i (HR [95 % CI] 0.18 [0.11-0.30]) regarding men (HR [95 % CI] 0.25 [0.16-0.40] for GLP1ra, and HR [95 % CI] 0.41 [0.29-0.58] for SGLT2i).

Conclusions: Combined therapy vs. monotherapy was associated with a lower risk of all-cause mortality in patients regardless of sex. Nevertheless, a higher benefit was observed in women regarding men.

Background and aim: The atherogenic index of plasma (AIP), calculated as log10 (triglyceride/high-density lipoprotein cholesterol, TG/HDL-C), has been proposed as a reliable marker for evaluating lipid-related atherosclerotic risk. However, the association between AIP and new-onset hypertension (HTN) remains controversial. This study aimed to investigate the relationship between AIP and new-onset HTN and to explore the potential mediating role of body mass index (BMI).

Methods and results: This prospective cohort study included adult participants without HTN at baseline who were enrolled from a large community-based health screening program between 2014 and 2023. Baseline clinical characteristics, anthropometric parameters, and biochemical indices were collected. Restricted cubic spline (RCS) analysis was used to determine the inflection point of AIP for grouping participants into low- and high-AIP categories. Propensity score matching (PSM) was applied to balance baseline confounders between groups. The cumulative incidence of HTN was compared using cumulative risk curves and log-rank tests. Multivariate Cox proportional hazards models were employed to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs). Mediation analysis was performed to assess whether BMI mediated the relationship between AIP and new-onset HTN. The results showed participants with higher baseline or cumulative AIP values had a significantly higher risk of developing HTN (log-rank p < 0.001). After multivariable adjustment, individuals in the high-AIP group exhibited an elevated risk of new-onset HTN (HR = 1.42, 95 % CI 1.25-1.61, p < 0.001) compared with those in the low-AIP group. BMI partially mediated the association between AIP and HTN, accounting for approximately 5.76 % of the total effect (p < 0.001).

Conclusions: A high AIP increased the risk of new HTN. BMI potentially mediated the association between the AIP and new-onset HTN.