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Kawamoto R, Kikuchi A, Ninomiya D, Kumagi T, Abe M. Alcohol consumption and high-molecular-weight adiponectin levels are interactively associated with all-cause mortality among community-dwelling persons. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2025; 49:1097-1105. [PMID: 40156115 PMCID: PMC12098804 DOI: 10.1111/acer.70037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2024] [Accepted: 03/02/2025] [Indexed: 04/01/2025]
Abstract
BACKGROUND Decreased levels of high-molecular-weight (HMW) adiponectin are associated with metabolic syndrome and insulin resistance. This relationship may be further confounded by alcohol consumption, which plays a role in the development of liver dysfunction. In Japan, few studies have investigated the relationship between HMW adiponectin levels and alcohol consumption with mortality. METHODS The study included 845 male participants (mean age, 61 ± 13 years; range, 20-89 years) and 1065 female participants (mean age, 63 ± 11 years; range, 22-88 years). Of the participants, 809 (42.4%) were classified as nondrinkers, 561 (29.4%) as occasional drinkers, 346 (18.1%) as daily light drinkers, and 194 (10.2%) as daily heavy drinkers. A Cox proportional hazards model was used to calculate hazard ratios (HR) for all-cause mortality, adjusting for various confounders, including HMW adiponectin levels. RESULTS Individuals who abstained from alcohol consumption (hazard ratio [HR], 1.23; 95% confidence interval [CI], 1.00-1.52) or engaged in daily heavy drinking (HR, 1.39; 95% CI, 1.04-1.86) exhibited significantly higher overall mortality than occasional drinkers. Additionally, those with the 3rd standard deviation (SD) level of HMW adiponectin (HR, 1.39; 95% CI, 1.07-1.80) and 4th SD level (HR, 1.65; 95% CI, 1.23-2.23) had a similarly increased risk of all-cause mortality compared to those with the lowest levels. After adjusting for confounders, the HR for individuals with the 3rd + 4th SD levels of HMW adiponectin was significantly elevated in nondrinkers (HR, 1.89; 95% CI, 1.09-3.29), occasional drinkers (HR, 1.84; 95% CI, 1.05-3.21), and daily heavy drinkers (HR, 1.90; 95% CI, 1.05-3.44), but not in daily light drinkers. The interaction between alcohol consumption and HMW adiponectin levels was significantly associated with all-cause mortality. CONCLUSION These findings suggest that alcohol consumption and elevated HMW adiponectin levels are interactively associated with all-cause mortality in community-dwelling individuals.
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Affiliation(s)
- Ryuichi Kawamoto
- Department of Community MedicineEhime University Graduate School of MedicineToon‐CityEhimeJapan
- Department of Internal MedicineSeiyo Municipal Nomura HospitalSeiyo‐CityEhimeJapan
| | - Asuka Kikuchi
- Department of Community MedicineEhime University Graduate School of MedicineToon‐CityEhimeJapan
- Department of Internal MedicineSeiyo Municipal Nomura HospitalSeiyo‐CityEhimeJapan
| | - Daisuke Ninomiya
- Department of Community MedicineEhime University Graduate School of MedicineToon‐CityEhimeJapan
- Department of Internal MedicineSeiyo Municipal Nomura HospitalSeiyo‐CityEhimeJapan
| | - Teru Kumagi
- Department of Community MedicineEhime University Graduate School of MedicineToon‐CityEhimeJapan
| | - Masanori Abe
- Department of Community MedicineEhime University Graduate School of MedicineToon‐CityEhimeJapan
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Ramandi A, George J, Behnoush AH, Delavari A, Mohammadi Z, Poustchi H, Malekzadeh R. The Association Between Serum Gamma-Glutamyl Transferase and Gastrointestinal Cancer Risk: A Systematic Review and Meta-Analysis. Cancer Med 2025; 14:e70581. [PMID: 39817495 PMCID: PMC11736428 DOI: 10.1002/cam4.70581] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 12/26/2024] [Accepted: 12/27/2024] [Indexed: 01/18/2025] Open
Abstract
BACKGROUND Gamma-glutamyl transferase (GGT) has been shown to have associations with several diseases including cancers. Previous studies have investigated the effect of GGT levels on the gastrointestinal (GI) cancer incidence. We aim to systematically investigate these studies to provide better insights into the interrelationship between GGT and GI cancers. METHODS Online databases were searched to find relevant studies investigating different GGT levels' effects on the incidence of GI cancers including colorectal, esophageal, liver, pancreas, gastric, and biliary duct cancers. Random-effect meta-analysis was conducted to pool the hazard ratios (HRs) of GGT quartiles (Qs) effect on cancer incidence. RESULTS A total of 26 studies were included in the final review, 12 of which underwent meta-analysis that investigated 11 million patients. Based on the meta-analysis, Q4 patients had a 69% higher hazard of GI cancer incidence (HR 1.69, 95% CI 1.41-2.02, p-value < 0.001). The hazard ratio significance was also similar for Q3 (HR 1.22, 95% CI 1.15-1.30, p-value < 0.001) and Q2 (HR 1.10, 95% CI 1.05-1.16, p-value =0.002) of GGT. Colorectal and liver cancers showed a higher hazard ratio among Q2, Q3, and Q4 of GGT compared to Q1. In pancreas and bile duct cancers, only Q4 of GGT had significantly higher HR. Q3 and Q4 of GGT levels had statistically significant associations with gastric cancer incidence. CONCLUSION Higher GGT levels correlate with higher rates of GI cancer incidence, especially in colorectal and hepatic cancers. Future studies should investigate this biomarker's potential role in risk assessment for digestive cancers.
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Affiliation(s)
- Alireza Ramandi
- Division of Gastroenterology and HepatologyWeill Cornell MedicineNew YorkNew YorkUSA
- Digestive Disease Research CenterDigestive Disease Research Institute, Tehran University of Medical Sciences, Shariati HospitalTehranIran
| | - Jacob George
- Storr Liver CentreWestmead Institute for Medical Research, Westmead Hospital and University of SydneyWestmeadNew South WalesAustralia
| | - Amir Hossein Behnoush
- Digestive Disease Research CenterDigestive Disease Research Institute, Tehran University of Medical Sciences, Shariati HospitalTehranIran
| | - Alireza Delavari
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research InstituteTehran University of Medical SciencesTehranIran
| | - Zahra Mohammadi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research InstituteTehran University of Medical SciencesTehranIran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research InstituteTehran University of Medical SciencesTehranIran
| | - Reza Malekzadeh
- Digestive Disease Research CenterDigestive Disease Research Institute, Tehran University of Medical Sciences, Shariati HospitalTehranIran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research InstituteTehran University of Medical SciencesTehranIran
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Gong S, Gan S, Zhang Y, Zhou H, Zhou Q. Gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio is a more powerful marker than TyG index for predicting metabolic syndrome in patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2023; 14:1248614. [PMID: 37854188 PMCID: PMC10579940 DOI: 10.3389/fendo.2023.1248614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/13/2023] [Indexed: 10/20/2023] Open
Abstract
Purpose The prevalence of metabolic syndrome (MetS) is increasing globally and has become a global and national public health problem that cannot be ignored as an independent predictor of cardiovascular events, cancer and all-cause mortality. γ-glutamyl transferase (GGT) and high-density lipoprotein cholesterol (HDL-C) are associated with insulin resistance, dyslipidemia and oxidative stress. This study was designed to explore the relationship and predictive performance between γ-glutamyl transferase high-density lipoprotein cholesterol ratio (GGT/HDL-C) and MetS. Methods This was a cross-sectional study. MetS was diagnosed from biochemical and anthropometric data in subjects with T2DM. Multivariate logistic regression was used to analyses the relationship between GGT/HDL-C ratio, TyG index and HOMA-IR and MetS in subjects with T2DM. Receiver operating characteristic (ROC) curve was drawn and the areas under the curve (AUC) were used to assess the ability of these indexes in screening MetS in subjects with T2DM. Statistical differences between the AUC values of these indexes were compared. In addition, we performed subgroup analyses and interactions. Results 769 (70.55%) patients with T2DM were defined as having MetS. patients with MetS had higher anthropometric values and biochemical indicators compared to those without MetS. Multivariate logistic regression analysis of GGT/HDL-C ratio was an independent risk factor for MetS (Per 1 SD increase, OR = 2.49, 95% CI: 1.51, 4.10). According to ROC curve analysis, the value of GGT/HDL-C ratio in predicting MetS in subjects with T2DM was superior to that of TyG index and HOMA-IR. The best cut-off value for GGT/HDL-C prediction was 19.94. Conclusions GGT/HDL-C ratio may be an important predictor of MetS in subjects with T2DM, and its predictive power is stronger than that of TyG index and HOMA-IR. The risk of MetS in subjects with T2DM is increased in the presence of a higher GGT/HDL-C ratio.
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Affiliation(s)
- Shijun Gong
- Department of Medicine, Jishou University, Jishou, China
| | - Shenglian Gan
- Department of Endocrinology, The First People’s Hospital of Changde City, Changde, China
| | - YuHua Zhang
- Department of Medicine, Jishou University, Jishou, China
| | - HaiFeng Zhou
- Department of Endocrinology, The First People’s Hospital of Changde City, Changde, China
| | - Quan Zhou
- Department of Science and Education, The First People’s Hospital of Changde City, Changde, China
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You A, Li Y, Shen C, Fan H, He J, Liu Z, Xue Q, Zhang Y, Zheng L. Associations of non-traditional cardiovascular risk factors and body mass index with metabolic syndrome in the Chinese elderly population. Diabetol Metab Syndr 2023; 15:129. [PMID: 37322514 DOI: 10.1186/s13098-023-01047-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 03/29/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS), a clustering of traditional cardiovascular risk factors (CVRF), is currently one of the major global public health burdens. However, associations between MetS and non-traditional CVRF represented by uric acid (UA), homocysteine (HCY) and hypersensitive C-reactive protein (HsCRP) have not been well explored in the elderly population, especially when considering body mass index (BMI). METHODS Participants from the Shanghai Elderly Cardiovascular Health (SHECH) study cohort in 2017 were analyzed. MetS was defined using the modified American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Logistic regression models were used to assess associations of non-traditional CVRF, BMI with MetS. RESULTS Of the 4360 participants analyzed, 2378 (54.5%) had MetS, the mean (SD) UA was 331 (86) µmol/L, and the median (IQR) HCY and HsCRP were 15 (13-18) µmol/L and 1.0 (0.5-2.1) mg/L, respectively. Participants with higher non-traditional CVRF tended to have a higher significant risk of MetS (P < 0.001), which did not changed substantially in most population subgroups (P-interaction > 0.05). BMI mediated 43.89% (95%CI: 30.38-57.40%), 37.34% (95% CI: 13.86-60.83%) and 30.99% (95%CI: 13.16-48.83%) of associations of hyperuricemia (HUA), hyperhomocysteinemia (HHCY) and high HsCRP (HHsCRP) with MetS, respectively. Abnormal non-traditional CVRF combined with overweight/obesity greatly increased MetS risk (adjusted OR(95%CI): HUA + Overweight: 5.860(4.059-8.461); 6.148(3.707-10.194); HHCY + Overweight: 3.989(3.107-5.121); HHCY + Obese: 5.746(4.064-8.123); HHsCRP + Overweight: 4.026(2.906-5.580); HHsCRP + Obese: 7.717(4.508-13.210)). CONCLUSIONS In the Chinese elderly population, HUA, HHCY, and HHsCRP were all significantly and independently associated with MetS, supporting the potential of focusing on non-traditional CVRF interventions for preventing and controlling MetS. BMI played moderate mediating roles in associations between non-traditional CVRF and MetS, and abnormal non-traditional CVRF combined with overweight/obesity had significant synergistic effects on MetS risk, highlighting the importance of better weight management in the elderly population.
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Affiliation(s)
- Aijun You
- Department of Epidemiology and Public Health, Tongji University School of Medicine, Shanghai, 200092, China
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
- Changhai Clinical Research Unit, Shanghai Changhai Hospital, Naval Medical University, Shanghai, 200433, China
| | - Yaxin Li
- Department of Epidemiology and Public Health, Tongji University School of Medicine, Shanghai, 200092, China
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Chaonan Shen
- Department of Epidemiology and Public Health, Tongji University School of Medicine, Shanghai, 200092, China
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
- Institute of Integrated Traditional Chinese and Western Medicine for Cardiovascular Chronic Diseases, Tongji University School of Medicine, Shanghai, 200120, China
| | - Huimin Fan
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
- Institute of Integrated Traditional Chinese and Western Medicine for Cardiovascular Chronic Diseases, Tongji University School of Medicine, Shanghai, 200120, China
| | - Jia He
- Department of Epidemiology and Public Health, Tongji University School of Medicine, Shanghai, 200092, China
- Department of Health Statistics, Faculty of Health Service, Naval Medical University, Shanghai, 200433, China
- Changhai Clinical Research Unit, Shanghai Changhai Hospital, Naval Medical University, Shanghai, 200433, China
| | - Zhongmin Liu
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
- Institute of Integrated Traditional Chinese and Western Medicine for Cardiovascular Chronic Diseases, Tongji University School of Medicine, Shanghai, 200120, China
| | - Qian Xue
- Changhai Clinical Research Unit, Shanghai Changhai Hospital, Naval Medical University, Shanghai, 200433, China.
| | - Yuzhen Zhang
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China.
- Institute of Integrated Traditional Chinese and Western Medicine for Cardiovascular Chronic Diseases, Tongji University School of Medicine, Shanghai, 200120, China.
| | - Liang Zheng
- Department of Epidemiology and Public Health, Tongji University School of Medicine, Shanghai, 200092, China.
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China.
- Institute of Integrated Traditional Chinese and Western Medicine for Cardiovascular Chronic Diseases, Tongji University School of Medicine, Shanghai, 200120, China.
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Kim YG, Han K, Jeong JH, Roh SY, Choi YY, Min K, Shim J, Choi JI, Kim YH. Metabolic Syndrome, Gamma-Glutamyl Transferase, and Risk of Sudden Cardiac Death. J Clin Med 2022; 11:jcm11071781. [PMID: 35407389 PMCID: PMC8999874 DOI: 10.3390/jcm11071781] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/17/2022] [Accepted: 03/20/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Metabolic syndrome is associated with a significantly increased risk of sudden cardiac death (SCD). However, whether temporal changes in the metabolic syndrome status are associated with SCD is unknown. We aimed to determine whether metabolic syndrome and gamma-glutamyl transferase (ɣ-GTP), including their temporal changes, are associated with the risk of SCD. Methods: We performed a nationwide population-based analysis using the Korean National Health Insurance Service. People who underwent a national health check-up in 2009 and 2011 were enrolled. The influence of metabolic syndrome and ɣ-GTP on SCD risk was evaluated. Results: In 2009, 4,056,423 (848,498 with metabolic syndrome) people underwent health screenings, 2,706,788 of whom underwent follow-up health screenings in 2011. Metabolic syndrome was associated with a 50.7% increased SCD risk (adjusted hazard ratio (aHR) = 1.507; p < 0.001). The SCD risk increased linearly as the metabolic syndrome diagnostic criteria increased. The ɣ-GTP significantly impacted the SCD risk; the highest quartile had a 51.9% increased risk versus the lowest quartile (aHR = 1.519; p < 0.001). A temporal change in the metabolic syndrome status and ɣ-GTP between 2009 and 2011 was significantly correlated with the SCD risk. Having metabolic syndrome in 2009 or 2011 indicated a lower SCD risk than having metabolic syndrome in 2009 and 2011 but a higher risk than having no metabolic syndrome. People with a ≥20-unit increase in ɣ-GTP between 2009 and 2011 had an 81.0% increased SCD risk versus those with a change ≤5 units (aHR = 1.810; p < 0.001). Conclusions: Metabolic syndrome and ɣ-GTP significantly correlated with an increased SCD risk. SCD was also influenced by temporal changes in the metabolic syndrome status and ɣ-GTP, suggesting that appropriate medical treatment and lifestyle modifications may reduce future SCD risk.
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Affiliation(s)
- Yun Gi Kim
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea; (Y.G.K.); (J.H.J.); (S.-Y.R.); (Y.Y.C.); (K.M.); (J.S.); (Y.-H.K.)
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Korea;
| | - Joo Hee Jeong
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea; (Y.G.K.); (J.H.J.); (S.-Y.R.); (Y.Y.C.); (K.M.); (J.S.); (Y.-H.K.)
| | - Seung-Young Roh
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea; (Y.G.K.); (J.H.J.); (S.-Y.R.); (Y.Y.C.); (K.M.); (J.S.); (Y.-H.K.)
| | - Yun Young Choi
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea; (Y.G.K.); (J.H.J.); (S.-Y.R.); (Y.Y.C.); (K.M.); (J.S.); (Y.-H.K.)
| | - Kyongjin Min
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea; (Y.G.K.); (J.H.J.); (S.-Y.R.); (Y.Y.C.); (K.M.); (J.S.); (Y.-H.K.)
| | - Jaemin Shim
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea; (Y.G.K.); (J.H.J.); (S.-Y.R.); (Y.Y.C.); (K.M.); (J.S.); (Y.-H.K.)
| | - Jong-Il Choi
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea; (Y.G.K.); (J.H.J.); (S.-Y.R.); (Y.Y.C.); (K.M.); (J.S.); (Y.-H.K.)
- Correspondence: ; Tel.: +82-2-920-5445; Fax: +82-2-927-1478
| | - Young-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea; (Y.G.K.); (J.H.J.); (S.-Y.R.); (Y.Y.C.); (K.M.); (J.S.); (Y.-H.K.)
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Association of High-Sensitivity C-Reactive Protein and Alcohol Consumption on Metabolic Syndrome in Korean Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052571. [PMID: 35270264 PMCID: PMC8909415 DOI: 10.3390/ijerph19052571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/15/2022] [Accepted: 02/21/2022] [Indexed: 12/04/2022]
Abstract
Background: This study aimed to examine the effect of both alcohol consumption and high-sensitivity C-reactive protein (hsCRP) on metabolic syndrome (MetS) in Korean men. Methods: A cohort of 364 men included in this study was divided into four groups according to the amount of alcohol they consumed: the nondrinkers (ND), low moderate drinkers (LM, ≤7 standard drinks per week), high moderate drinkers (HM, 7 to 14 drinks per week), and heavy drinkers (HD, >14 drinks per week). Logistic regression analyses were performed after adjusting for age, exercise, and smoking. Results: The risk of MetS in the LM group with a high hsCRP level (1.0 or more mg/dL) was not significant. However, the risks of MetS were significantly higher in the HM and HD groups with high hsCRP levels than that in the ND group. The odds ratios of MetS in the HM and HD groups with high hsCRP levels were 3.44 (95% confidence interval (CI), 1.25−9.52) and 3.14 (95% CI, 1.07−9.23), respectively. Conclusion: This study suggests that the risk of MetS is higher in men who consume more than seven drinks a week with high hsCRP levels than that in nondrinkers.
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Li F, Yu Y, Guo M, Lin Y, Jiang Y, Qu M, Sun X, Li Z, Zhai Y, Tan Z. Integrated analysis of physiological, transcriptomics and metabolomics provides insights into detoxication disruption of PFOA exposure in Mytilus edulis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 214:112081. [PMID: 33677383 DOI: 10.1016/j.ecoenv.2021.112081] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 05/14/2023]
Abstract
Perfluorooctanoic acid (PFOA), a persistent environmental contaminant, resists environmental degradation and bioaccumulates in food chains. Lots of literatures have proved that PFOA exposure could disrupt detoxifying function in a variety of organisms, however, it still remained poorly known about this in mollusk. Here, we examined physiological, transcriptomic, and metabolomic responses to PFOA in Mytilus edulis, a model organism frequently used in studies of aquatic pollution. We aimed to characterize PFOA-induced stress responses and detoxification mechanisms. PFOA exposure significantly altered antioxidant enzyme activity levels and the abundances of lipid peroxidation products. In addition, transcriptomic analysis indicated that several genes associated with oxidative stress and detoxication were differentially expressed after PFOA exposure. In combination, transcriptomic and metabolomic analyses showed that PFOA exposure disturbed several metabolic processes in M. edulis, including the lipid metabolism, amino acid metabolism, and carbohydrate metabolism etc. Molecular examination and enzymes assay of PFOA-exposed M. edulis after a 7-day depuration period still did not recover to control levels. The Pathway enrichment analysis proved that several pathways related to detoxification, such as c-Jun N-terminal kinase (JNK) and p38-dependent mitogen-activated protein kinase (MAPK) pathway, Peroxisome proliferator-activated receptor γ (PPARγ) pathway etc, were obviously affected. The present work verifies firstly PFOA disruption to molluscan detoxification and identifies the key pathways to understand the molecular mechanisms thereof. This study provides new insights into the detoxication disruption invoked in response to PFOA exposure in M. edulis.
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Affiliation(s)
- Fengling Li
- Key Laboratory of Testing and Evaluation for Aquatic Product Safety and Quality, Ministry of Agriculture and Rural Affairs, Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Qingdao 266071, PR China
| | - Yongxing Yu
- Key Laboratory of Testing and Evaluation for Aquatic Product Safety and Quality, Ministry of Agriculture and Rural Affairs, Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Qingdao 266071, PR China; College of Marine Life Sciences, Ocean University of China, Qingdao 266003, PR China
| | - Mengmeng Guo
- Key Laboratory of Testing and Evaluation for Aquatic Product Safety and Quality, Ministry of Agriculture and Rural Affairs, Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Qingdao 266071, PR China
| | - Yao Lin
- Key Laboratory of Testing and Evaluation for Aquatic Product Safety and Quality, Ministry of Agriculture and Rural Affairs, Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Qingdao 266071, PR China
| | - Yanhua Jiang
- Key Laboratory of Testing and Evaluation for Aquatic Product Safety and Quality, Ministry of Agriculture and Rural Affairs, Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Qingdao 266071, PR China
| | - Meng Qu
- Key Laboratory of Testing and Evaluation for Aquatic Product Safety and Quality, Ministry of Agriculture and Rural Affairs, Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Qingdao 266071, PR China
| | - Xiaojie Sun
- Key Laboratory of Testing and Evaluation for Aquatic Product Safety and Quality, Ministry of Agriculture and Rural Affairs, Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Qingdao 266071, PR China
| | - Zhaoxin Li
- Key Laboratory of Testing and Evaluation for Aquatic Product Safety and Quality, Ministry of Agriculture and Rural Affairs, Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Qingdao 266071, PR China
| | - Yuxiu Zhai
- Key Laboratory of Testing and Evaluation for Aquatic Product Safety and Quality, Ministry of Agriculture and Rural Affairs, Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Qingdao 266071, PR China
| | - Zhijun Tan
- Key Laboratory of Testing and Evaluation for Aquatic Product Safety and Quality, Ministry of Agriculture and Rural Affairs, Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Qingdao 266071, PR China.
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Zayed Mohamed N, Aly HF, moneim El-Mezayen HA, El-Salamony HE. Effect of co-administration of Bee honey and some chemotherapeutic drugs on dissemination of hepatocellular carcinoma in rats. Toxicol Rep 2019; 6:875-888. [PMID: 31516840 PMCID: PMC6727247 DOI: 10.1016/j.toxrep.2019.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 07/18/2019] [Accepted: 08/15/2019] [Indexed: 12/12/2022] Open
Abstract
Alternative and complimentary usage of the natural compound has raised hopes of finding curative options for liver hepatocarcinogenesis. In the present study, the curative effect of bee honey against diethylnitrosamine (DEN) (50 mg/kg) and carbon tetrachloride (CCl4) (2 mg/Kg)-induced hepatocellular carcinoma (HCC) in male rats in the presence or absence of some chemotherapeutic drugs, Cisplatin (Cis), Cyclophosphamide (CY) and 5- Fluorouracil (5-FU) were investigated. The obtained results demonstrated that treatment with DEN/CCl4 caused oxidative stress as assigned by the increase in malondialdehyde (MDA) and fall in glutathione (GSH) content. Meantime detraction in the antioxidants, including superoxide dismutase (SOD), catalase (CAT), glutathione-s-transferase (GST) and glutathione peroxidase (GPx) was observed. Also, the results showed induction of inflammation as reflected by an increase in the levels of both α- fetoprotein and α- fucosidase in the liver. This was accompanied by changes in the hepatic function biomarkers which characterized by the increased levels of transaminases (AST, ALT), alkaline phosphatase (ALP) and γ-Glutamyl transferase (γ-GT) and decrease in total protein content in the serum. In conclusion, the combination of the selected drugs and bee honey may be an effective chemo- preventive and therapeutic strategy for treating DEN and CCl4-induced HCC.
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Affiliation(s)
- Naima Zayed Mohamed
- Therapeutic Chemistry Department, Pharmaceutical and Drug Industries Research Division, National Research Centre (NRC), Giza, Egypt
| | - Hanan Farouk Aly
- Therapeutic Chemistry Department, Pharmaceutical and Drug Industries Research Division, National Research Centre (NRC), Giza, Egypt
| | | | - Hadeer E. El-Salamony
- Therapeutic Chemistry Department, Pharmaceutical and Drug Industries Research Division, National Research Centre (NRC), Giza, Egypt
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Choi KM, Han K, Park S, Chung HS, Kim NH, Yoo HJ, Seo JA, Kim SG, Kim NH, Baik SH, Park YG, Kim SM. Implication of liver enzymes on incident cardiovascular diseases and mortality: A nationwide population-based cohort study. Sci Rep 2018; 8:3764. [PMID: 29491346 PMCID: PMC5830612 DOI: 10.1038/s41598-018-19700-8] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 01/05/2018] [Indexed: 12/14/2022] Open
Abstract
Although liver enzymes, such as γ-glutamyltransferase (GGT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST), have recently been suggested as risk factors for cardiovascular diseases (CVD), impact on mortality after myocardial infarction (MI) or ischemic stroke (IS) was not previously examined. Using a population-based, nationwide cohort database, we explored the implication of GGT and aminotransferases on the development of CVD and all-cause mortality during a median 9.1 years of follow-up. Among 16,624,006 Korean adults, both GGT and aminotransferases exhibited a positive relationship with MI, IS, and mortality in a multivariate adjusted model. ALT and AST showed U-shaped associations with mortality, whereas GGT showed a positive linear relationship with mortality. The risk of 1-year mortality after MI or IS was significantly higher in the highest quartile of GGT compared to the lowest quartile (HR, 1.46; 95% CI, 1.40-1.52). The implication of GGT on MI, IS, and mortality persisted regardless of traditional cardiovascular risk parameters. This study demonstrated the unique pattern of association of ALT, AST, and GGT with the development of CVD and all-cause mortality in the Korean population. In particular, GGT showed the most robust linear relationship with mortality before and after cardiovascular events independent of risk factors.
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Affiliation(s)
- Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sanghyun Park
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hye Soo Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Ji-A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Yong Gyu Park
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seon Mee Kim
- Department of Family Medicine, College of Medicine, Korea University, Seoul, Korea.
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Valjevac A, Rebic D, Hamzic-Mehmedbasic A, Sokolovic E, Horozic D, Vanis N, Hadzovic-Dzuvo A. The value of gamma glutamyltransferase in predicting myocardial infarction in patients with acute coronary syndrome. Future Cardiol 2018; 14:37-45. [DOI: 10.2217/fca-2017-0033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To assess the utility of gamma-glutamyl transferase (GGT) and C-reactive protein (CRP) in predicting troponin elevation in patients with acute coronary syndrome. Patients: The total of 119 patients were divided into troponin-positive (n = 61) and troponin-negative (n = 58) patients. Results: CRP cut-off value ≥13.4 mg/l had the sensitivity of 68.1% and specificity of 62.5%, while the GGT cut-off value ≥61.5 IU/l had the sensitivity of 66.0% and specificity of 62.0% and combined use of both CRP and GGT had 71.4% sensitivity and 69.6% specificity in predicting troponin increase in acute coronary syndrome patients. Conclusion: GGT might be used as an adjuvant marker for risk assessment patients who present with chest pain and are suspected to have acute coronary syndrome.
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Affiliation(s)
- Amina Valjevac
- Department of Physiology, Faculty of Medicine, University of Sarajevo, Cekalusa 90, 71000 Sarajevo, Bosnia & Herzegovina
| | - Damir Rebic
- Clinic of Nephrology, Clinical Center University of Sarajevo, Bolnicka 25, 71 000 Sarajevo, Bosnia & Herzegovina
| | - Aida Hamzic-Mehmedbasic
- Clinic of Nephrology, Clinical Center University of Sarajevo, Bolnicka 25, 71 000 Sarajevo, Bosnia & Herzegovina
| | - Emir Sokolovic
- Faculty of Medicine, University of Sarajevo, Cekalusa 90, 71000 Sarajevo, Bosnia & Herzegovina
| | - Dzan Horozic
- Faculty of Medicine, University of Sarajevo, Cekalusa 90, 71000 Sarajevo, Bosnia & Herzegovina
| | - Nedim Vanis
- Faculty of Medicine, University of Sarajevo, Cekalusa 90, 71000 Sarajevo, Bosnia & Herzegovina
| | - Almira Hadzovic-Dzuvo
- Department of Physiology, Faculty of Medicine, University of Sarajevo, Cekalusa 90, 71000 Sarajevo, Bosnia & Herzegovina
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11
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Ndrepepa G, Colleran R, Kastrati A. Gamma-glutamyl transferase and the risk of atherosclerosis and coronary heart disease. Clin Chim Acta 2018; 476:130-138. [DOI: 10.1016/j.cca.2017.11.026] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 11/21/2017] [Accepted: 11/23/2017] [Indexed: 02/08/2023]
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12
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Ali SS, Oni ET, Blaha MJ, Veledar E, Feiz HR, Feldman T, Agatston AS, Blumenthal RS, Conceicao RD, Carvalho JAM, Santos RD, Nasir K. Elevated gamma-glutamyl transferase is associated with subclinical inflammation independent of cardiometabolic risk factors in an asymptomatic population: a cross-sectional study. Nutr Metab (Lond) 2016; 13:37. [PMID: 27195017 PMCID: PMC4870806 DOI: 10.1186/s12986-016-0097-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 05/04/2016] [Indexed: 12/20/2022] Open
Abstract
Background Serum Gamma-Glutamyl Transferase (GGT), a marker of oxidative stress, has been suggested to be independently associated with cardiovascular disease (CVD) events. We examined the association of serum GGT levels with the burden of subclinical inflammation across a spectrum of metabolic conditions. Methods We evaluated 5,446 asymptomatic subjects (43 ± 10 years, 78 % males) who had an employer-sponsored physical between 2008 and 2010. Highly sensitivity C-reactive protein (hsCRP) was measured as a marker of underlying systemic inflammation. A linear regression of GGT quartiles with log transformed hsCRP and a multivariate logistic regression of GGT quartiles with elevated hsCRP (≥3 mg/L) were performed. Results Median GGT was 31 IU/l (IQR: 22–45 IU/l), 1025 (19 %) had hsCRP ≥ 3 mg/L. The median hsCRP increased with GGT quartiles (Q1: 0.9 mg/L, Q2: 1.1 mg/L, Q3: 1.4 mg/L, Q4: 1.6 mg/L, p < 0.001). Linear regression models showed GGT in the fourth quartile was associated with 0.45 mg/L (95 % CI 0.35, 0.54, p < 0.001) increase in log transformed hsCRP adjusting for risk factors. The Odds Ratio (OR) for an elevated hsCRP (≥3 mg/L) also increased with higher GGT quartiles; GGT Q2 1.44 (95 % CI 1.12, 1.85), GGT Q3 1.89 (95 % CI 1.45, 2.46), GGT Q4 2.22 (95 % CI 1.67, 2.95), compared to GGT Q1. The strength of association increased in the presence of and combination of metabolic conditions. Conclusion In our cohort of asymptomatic individuals a higher serum GGT level was independently associated with increased burden of subclinical inflammation across metabolic states. These findings may explain GGT association with increased CVD risk.
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Affiliation(s)
- Shozab S Ali
- Center for Healthcare Advancement and Outcomes, Baptist Health Medical Group, 1691 Michigan Avenue Suite 500, Miami, FL 33139 USA ; University of Manchester School of Medicine, Manchester, UK ; Aventura Hospital and Medical Center, Aventura, FL USA
| | - Ebenezer T Oni
- Center for Healthcare Advancement and Outcomes, Baptist Health Medical Group, 1691 Michigan Avenue Suite 500, Miami, FL 33139 USA ; Department of Medicine, The Brooklyn Hospital Center, affiliate of Icahn School of Medicine at Mount Sinai, Brooklyn, NY USA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD USA
| | - Emir Veledar
- Center for Healthcare Advancement and Outcomes, Baptist Health Medical Group, 1691 Michigan Avenue Suite 500, Miami, FL 33139 USA
| | - Hamid R Feiz
- Aventura Hospital and Medical Center, Aventura, FL USA
| | - Theodore Feldman
- Center for Healthcare Advancement and Outcomes, Baptist Health Medical Group, 1691 Michigan Avenue Suite 500, Miami, FL 33139 USA
| | - Arthur S Agatston
- Center for Healthcare Advancement and Outcomes, Baptist Health Medical Group, 1691 Michigan Avenue Suite 500, Miami, FL 33139 USA
| | - Roger S Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD USA
| | - Raquel D Conceicao
- Preventive Medicine Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Jose A M Carvalho
- Preventive Medicine Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Raul D Santos
- Preventive Medicine Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil ; Lipid Clinic-Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Khurram Nasir
- Center for Healthcare Advancement and Outcomes, Baptist Health Medical Group, 1691 Michigan Avenue Suite 500, Miami, FL 33139 USA ; Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD USA ; Robert Stempel College of Public Health, Florida International University, Miami, FL USA ; Herbert Wertheim College of Medicine, Florida International University, Miami, FL USA
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Kawamoto R, Katoh T, Ninomiya D, Kumagi T, Abe M, Kohara K. Synergistic association of changes in serum uric acid and triglycerides with changes in insulin resistance after walking exercise in community-dwelling older women. Endocr Res 2016; 41:116-23. [PMID: 26727147 DOI: 10.3109/07435800.2015.1094085] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Serum uric acid (SUA) and triglyceride (TG) levels are strongly correlated with insulin resistance; however, the association after a walking exercise program in community-dwelling older women has not been investigated. METHODS The present study included 100 postmenopausal women (mean ± standard deviation, 68 ± 7 years) from a rural village in Japan. The Nordic walking program of 120 min per week was performed for 12 weeks. Before and after the intervention, SUA, TG, various relevant factors and homeostasis model assessment of insulin resistance (HOMA-IR) were measured. RESULTS AND CONCLUSIONS Multivariate linear regression analysis showed that baseline TG and γ-glutamyltransferase (GGT) were significantly associated with baseline HOMA-IR. After the 12-week training program, changes in TG, SUA and GGT were significantly associated with changes in HOMA-IR. In addition to their direct associations, we observed a synergistic association between changes in TG and SUA and changes in HOMA-IR. Participants were divided into three groups (tertiles) according to changes in TG and SUA. The tertiles of changes in SUA correlated significantly with changes in HOMA-IR in participants in the tertile with the greatest decrease in TG (r = 0.525, p = 0.001), but not in the other two tertiles of change in TG (r = 0.049, p = 0.699). There was a significant interaction between SUA and TG for changes in HOMA-IR (β = 0.281, p = 0.005). These results suggest that changes in TG and SUA are synergistic factors associated with changes in insulin resistance after a 12-week walking exercise program in community-dwelling older women.
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Affiliation(s)
| | - Takeaki Katoh
- b Department of Geriatric Medicine , Ehime University Graduate School of Medicine , Ehime , Japan
| | | | | | | | - Katsuhiko Kohara
- b Department of Geriatric Medicine , Ehime University Graduate School of Medicine , Ehime , Japan
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Serum Uric Acid Is Positively Associated with Handgrip Strength among Japanese Community-Dwelling Elderly Women. PLoS One 2016; 11:e0151044. [PMID: 27078883 PMCID: PMC4831672 DOI: 10.1371/journal.pone.0151044] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 02/23/2016] [Indexed: 02/07/2023] Open
Abstract
Serum uric acid (UA) has strong anti-oxidant properties. Muscle strength and mass decrease with age, and recently, this decrease has been defined as sarcopenia. Sarcopenia may be triggered by oxidative stress. We investigated whether serum UA is associated with handgrip strength (HGS), which is a useful indicator of sarcopenia, among Japanese community-dwelling elderly persons. The present study included 602 men aged 72 ± 7 years and 847 women aged 71 ± 6 years from a rural village. We examined the cross-sectional relationship between serum UA and HGS. In both genders, HGS increased significantly with increased serum UA levels. A multiple linear regression analysis using HGS as an objective variable and various confounding factors as explanatory variables showed that in men age, drinking status, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and estimated glomerular filtration ratio (eGFRCKDEPI) were independently and significantly associated with HGS, and in women, serum UA as well as age, body mass index, drinking status, diastolic blood pressure, and eGFRCKDEPI were independently and significantly associated with HGS. In women, age and multivariate-adjusted HGS were significantly higher in the Quartile-3 (4.8-5.4 mg/dL) and Quartile-4 groups (5.5-9.3 mg/dL) of serum UA than in the lower groups (0.7-4.7 mg/dL). These results suggest that serum UA may have a protective role in aging-associated decline in muscle strength in community-dwelling elderly women.
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Moreto F, Kano HT, Torezan GA, de Oliveira EP, Manda RM, Teixeira O, Michelin E, Correa CR, Burini RC. Changes in malondialdehyde and C-reactive protein concentrations after lifestyle modification are related to different metabolic syndrome-associated pathophysiological processes. Diabetes Metab Syndr 2015; 9:218-222. [PMID: 25956753 DOI: 10.1016/j.dsx.2015.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIMS Metabolic syndrome (MetS) is often accompanied by pro-oxidative and pro-inflammatory processes. Lifestyle modification (LiSM) may act as primary treatment for these processes. This study aimed to elucidate influencing factors on changes of malondialdehyde (MDA) and C-reactive protein (CRP) concentrations after a LiSM intervention. METHODS Sixty subjects (53 yrs, 84% women) clinically approved to attend a 20 weeks LiSM-program were submitted to weekly nutritional counseling and physical activities combining aerobic (3 times/week) and resistance (2 times/week) exercises. Before and after intervention they were assessed for anthropometric, clinical, cardiorespiratory fitness test (CRF) and laboratory markers. Statistical analyses performed were multiple regression analysis and backward stepwise with p<0.05 and R(2) as influence index. RESULTS LiSM was responsible for elevations in CRF, healthy eating index (HEI), total plasma antioxidant capacity (TAP) and HDL-C along with reductions in waist circumference measures and MetS (47-40%) prevalence. MDA and CRP did not change after LiSM, however, we observed that MDA concentrations were positively influenced (R(2)=0.35) by fasting blood glucose (β=0.64) and HOMA-IR (β=0.58) whereas CRP concentrations were by plasma gamma-glutamyltransferase activity (β=0.54; R(2)=0.29). CONCLUSIONS Pro-oxidant and pro-inflammatory states of MetS can be attenuated after lifestyle modification if glucose metabolism homeostasis were recovered and if liver inflammation were reduced, respectively.
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Affiliation(s)
- Fernando Moreto
- Sao Paulo State University, Botucatu School of Medicine, Botucatu, Brazil.
| | - Hugo T Kano
- Sao Paulo State University, Botucatu School of Medicine, Botucatu, Brazil.
| | - Gabriel A Torezan
- Sao Paulo State University, Botucatu School of Medicine, Botucatu, Brazil.
| | | | - Rodrigo M Manda
- Sao Paulo State University, Botucatu School of Medicine, Botucatu, Brazil.
| | - Okesley Teixeira
- Sao Paulo State University, Botucatu School of Medicine, Botucatu, Brazil.
| | - Edilaine Michelin
- Sao Paulo State University, Botucatu School of Medicine, Botucatu, Brazil.
| | - Camila R Correa
- Sao Paulo State University, Botucatu School of Medicine, Botucatu, Brazil.
| | - Roberto C Burini
- Sao Paulo State University, Botucatu School of Medicine, Botucatu, Brazil.
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Tuttolomondo A, Maida C, Pinto A. Diabetic foot syndrome: Immune-inflammatory features as possible cardiovascular markers in diabetes. World J Orthop 2015; 6:62-76. [PMID: 25621212 PMCID: PMC4303791 DOI: 10.5312/wjo.v6.i1.62] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 06/06/2014] [Accepted: 08/27/2014] [Indexed: 02/06/2023] Open
Abstract
Diabetic foot ulcerations have been extensively reported as vascular complications of diabetes mellitus associated with a high degree of morbidity and mortality. Diabetic foot syndrome (DFS), as defined by the World Health Organization, is an "ulceration of the foot (distally from the ankle and including the ankle) associated with neuropathy and different grades of ischemia and infection". Pathogenic events able to cause diabetic foot ulcers are multifactorial. Among the commonest causes of this pathogenic pathway it's possible to consider peripheral neuropathy, foot deformity, abnormal foot pressures, abnormal joint mobility, trauma, peripheral artery disease. Several studies reported how diabetic patients show a higher mortality rate compared to patients without diabetes and in particular these studies under filled how cardiovascular mortality and morbidity is 2-4 times higher among patients affected by type 2 diabetes mellitus. This higher degree of cardiovascular morbidity has been explained as due to the observed higher prevalence of major cardiovascular risk factor, of asymptomatic findings of cardiovascular diseases, and of prevalence and incidence of cardiovascular and cerebrovascular events in diabetic patients with foot complications. In diabetes a fundamental pathogenic pathway of most of vascular complications has been reported as linked to a complex interplay of inflammatory, metabolic and procoagulant variables. These pathogenetic aspects have a direct interplay with an insulin resistance, subsequent obesity, diabetes, hypertension, prothrombotic state and blood lipid disorder. Involvement of inflammatory markers such as IL-6 plasma levels and resistin in diabetic subjects as reported by Tuttolomondo et al confirmed the pathogenetic issue of the a "adipo-vascular" axis that may contribute to cardiovascular risk in patients with type 2 diabetes. This "adipo-vascular axis" in patients with type 2 diabetes has been reported as characterized by lower plasma levels of adiponectin and higher plasma levels of interleukin-6 thus linking foot ulcers pathogenesis to microvascular and inflammatory events. The purpose of this review is to highlight the immune inflammatory features of DFS and its possible role as a marker of cardiovascular risk in diabetes patients and to focus the management of major complications related to diabetes such as infections and peripheral arteriopathy.
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Chang JB, Shang HS, Yang BH, Perng CL, Tang SH, Lin CM. Correlation between liver function tests and metabolic syndrome in hepatitis-free elderly. JOURNAL OF MEDICAL SCIENCES 2015. [DOI: 10.4103/1011-4564.167708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Pei D, Hsia TL, Chao TT, Lin JD, Hsu CH, Wu CZ, Hsieh CH, Liang YJ, Chen YL. γ-glutamyl transpeptidase in men and alanine aminotransferase in women are the most suitable parameters among liver function tests for the prediction of metabolic syndrome in nonviral hepatitis and nonfatty liver in the elderly. Saudi J Gastroenterol 2015; 21:158-64. [PMID: 26021775 PMCID: PMC4455146 DOI: 10.4103/1319-3767.157564] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND/AIMS Nonalchoholic fatty liver disease (NAFLD) has been reported as a hepatic manifestation of metabolic syndrome (MetS); it is common and accounts for 80% of the cases with abnormal liver function tests (LFTs). In addition, several studies have proved that there is a correlation between abnormal LFTs and MetS. Therefore, LFTs may represent the abnormal metabolic status of livers in the patients with MetS. To identify the early state of metabolic dysfunction, we investigate the value of LFTs for the future MetS development in the relatively healthy (non-NAFLD) elderly. PATIENTS AND METHODS A total of 16,912 subjects met the criteria for analysis. In the first stage of this study, subjects were enrolled in the cross-sectional study in order to find out the optimal cutoff value in different LFTs with higher chances to have MetS. In the second stage of the present study, subjects with MetS at baseline were excluded from the same study group, and a median 5.6-year longitudinal study was conducted on the rest of the group. RESULTS Among all LFTs, only aspartate aminotransferase in both genders and the α-fetal protein in women failed to show the significance in distinguishing subjects with MetS by the receiver operating characteristic curve. In the Kaplan-Meier plot, only γ-glutamyl transpeptidase (γ-GT) in men and the alanine aminotransferase (ALT) in women could be used to successfully separate subjects with higher risk of developing the MetS from those with lower risk. Finally, in the multivariant Cox regression model, similar results were identified. Still, the hazard ratio (HR) to have future MetS, γ-GT in men, and ALT in women showed significance (HR = 1.511 in men and 1.504 in women). CONCLUSION Among all the different LFTs, γ-GT (>16 U/L) in male and ALT (>21 U/L) in female were the best predictors for the development of MetS in healthy elderly. These two liver markers could be an ancillary test in predicting future MetS development/diagnosis. Elevation of the LFTs without underlying liver diseases should be treated as a warning sign of the possible MetS development in the elderly.
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Affiliation(s)
- Dee Pei
- Department of Internal Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Te-Lin Hsia
- Department of Internal Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Ting-Ting Chao
- Medical Research Center, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Jiunn-Diann Lin
- Division of Endocrinology and Metabolism, Department of Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chun-Hsien Hsu
- Department of Family Medicine, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Chung-Ze Wu
- Division of Endocrinology and Metabolism, Department of Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chang-Hsun Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC, Taiwan
| | - Yao-Jen Liang
- Department of Life-Science, Fu-Jen Catholic University, Taipei, Taiwan
| | - Yen-Lin Chen
- Department of Pathology, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan,Address for correspondence: Dr. Yen-Lin Chen, Department of Pathology, Cardinal Tien Hospital, No. 362, Zhongzheng Road, Xindian District, New Taipei City 231, Taiwan. E-mail:
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Zhu Y, Gong Y, Zhu R, Liu X, Sun Y, Wang Y, Qi L, Liang J. Relationship between serum gamma-glutamyltransferase levels and prehypertension in Chinese adults: the cardiometabolic risk in Chinese study. J Clin Hypertens (Greenwich) 2014; 16:760-5. [PMID: 25113653 PMCID: PMC8031597 DOI: 10.1111/jch.12381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 06/30/2014] [Accepted: 07/01/2014] [Indexed: 01/09/2023]
Abstract
The authors aimed to investigate the relationship between serum gamma-glutamyltransferase (GGT) and prehypertension, as well as the modification of other metabolic risk factors in a large cohort of Chinese individuals. The data were collected via a community-based health examination survey in central China. Blood pressure, body mass index (BMI), and levels of GGT, fasting blood glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lipid indicators were measured. In total, data from 18,302 patients with available biomarkers were included in the present study. Elevated blood pressure was associated with increased GGT concentration (P<.001). After adjusting for age, sex, BMI, fasting blood glucose, lipid indicators, AST, and family history of hypertension, the association between GGT levels and prehypertension remained significant (P=.021). The adjusted odds ratios (95% confidence interval) for prehypertension across quintiles of GGT level were 1.00, 1.057 (1.012-1.334), 1.068 (0.916-1.254), 1.024 (0.851-1.368), and 1.272 (1.027-1.593), respectively. In stratified analyses, the association between GGT levels and prehypertension was significant in women but was not significant in men. Moreover, additive effect of BMI and age on the effect of GGT levels on prehypertension (both P for interaction <.001) was observed. In summary, GGT levels were positively associated with prehypertension in women, independent of other metabolic factors. Furthermore, BMI and age may amplify the effects of GGT levels on prehypertension. These findings suggest that monitoring the levels of GGT could help in the diagnosis and monitoring of prehypertension.
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Affiliation(s)
- Yan Zhu
- Xuzhou Medical CollegeXuzhouChina
| | - Ying Gong
- Department of Endocrinology and Central LaboratoryXuzhou Central HospitalXuzhouChina
- Xuzhou Clinical School of Xuzhou Medical CollegeAffiliated Hospital of Southeast UniversityXuzhouChina
- Xuzhou Institute of Medical SciencesXuzhou Institute of DiabetesXuzhouChina
| | - Ruihua Zhu
- Xuzhou Clinical School of Xuzhou Medical CollegeAffiliated Hospital of Southeast UniversityXuzhouChina
- Xuzhou Institute of Medical SciencesXuzhou Institute of DiabetesXuzhouChina
- Department of CardiologyXuzhou Central HospitalXuzhouChina
| | - Xue‐kui Liu
- Department of Endocrinology and Central LaboratoryXuzhou Central HospitalXuzhouChina
- Xuzhou Clinical School of Xuzhou Medical CollegeAffiliated Hospital of Southeast UniversityXuzhouChina
- Xuzhou Institute of Medical SciencesXuzhou Institute of DiabetesXuzhouChina
| | | | - Yu Wang
- Xuzhou Medical CollegeXuzhouChina
| | - Lu Qi
- Department of NutritionHarvard School of Public HealthBostonMA
| | - Jun Liang
- Department of Endocrinology and Central LaboratoryXuzhou Central HospitalXuzhouChina
- Xuzhou Clinical School of Xuzhou Medical CollegeAffiliated Hospital of Southeast UniversityXuzhouChina
- Xuzhou Institute of Medical SciencesXuzhou Institute of DiabetesXuzhouChina
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Kawada T. Insulin-related biomarkers to predict the risk of metabolic syndrome. Int J Endocrinol Metab 2013; 11:e10418. [PMID: 24719625 PMCID: PMC3969000 DOI: 10.5812/ijem.10418] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 04/17/2013] [Accepted: 04/27/2013] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The predictive ability of insulin resistance or insulin sensitivity, in combination with traditional cardiovascular risk factors for metabolic syndrome (MetS), has not yet been clearly evaluated in Japanese male subjects. OBJECTIVES A one-year follow-up study was conducted to determine the ability of the insulin-related biomarkers to predict the risk of MetS development. PATIENTS AND METHODS A total of 2642 male workers of a Japanese company free from MetS at the baseline were monitored. The homeostasis model assessment for insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) were selected as the insulin-related markers. RESULTS The incidence of metabolic syndrome after one year was 8.8%. A multiple logistic regression analysis identified regular physical activity, age (≥ 45 years old), serum uric acid (≥ 7 mg/dL), serum alanine aminotransferase (≥ 45 IU/L), serum C-reactive protein (≥ 0.1 mg/L) and HOMA-IR (≥ 2.5) as significant risk factors for the development of MetS, with odds ratios (95% confidence intervals) of 0.68 (0.50 - 0.92), 2.0 (1.5 - 2.6), 2.2 (1.6 - 3.0), 1.5 (1.02 - 2.2), 1.4 (1.01 - 2.0), and 2.3 (1.6 - 3.3), respectively. When QUICKI was used instead of HOMA-IR, age (≥ 45 years old), serum uric acid (≥ 7 mg/dL), serum gamma-glutamyl transferase (≥ 50 IU/L), and QUICKI (≤ 0.33) were identified as significant contributors to the risk of MetS, with odds ratios (95% confidence intervals) of 0.68 (0.51 - 0.93), 2.0 (1.5 - 2.6), 2.2 (1.6 - 3.0), 1.4 (1.01 - 2.0), and 2.5 (1.7 - 3.6), respectively. CONCLUSIONS The mathematical meaning of the two insulin-related biomarkers examined was the same, and the odds ratios of the two biomarkers were almost the same after adjustments for other independent variables.
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Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
- Corresponding author: Tomoyuki Kawada, Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, 113-8602 Tokyo, Japan. Tel: +81-338222131, Fax: +81-356853065, E-mail:
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Kawamoto R, Tabara Y, Kohara K, Kusunoki T, Abe M, Miki T. Plasma Resistin Levels Are Associated with Insulin Resistance in Older Japanese Men from a Rural Village. Metab Syndr Relat Disord 2012; 10:380-6. [DOI: 10.1089/met.2012.0032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ryuichi Kawamoto
- Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Yasuharu Tabara
- Department of Geriatric Medicine, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Katsuhiko Kohara
- Department of Geriatric Medicine, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Tomo Kusunoki
- Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Masanori Abe
- Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Tetsuro Miki
- Department of Geriatric Medicine, Ehime University Graduate School of Medicine, Ehime, Japan
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Kawamoto R, Kohara K, Kusunoki T, Tabara Y, Abe M, Miki T. Alanine aminotransferase/aspartate aminotransferase ratio is the best surrogate marker for insulin resistance in non-obese Japanese adults. Cardiovasc Diabetol 2012; 11:117. [PMID: 23020992 PMCID: PMC3499385 DOI: 10.1186/1475-2840-11-117] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 09/20/2012] [Indexed: 12/17/2022] Open
Abstract
Background The aim of the present study was to examine how liver markers are associated with insulin resistance in Japanese community-dwelling adults. Methods This cross-sectional study included 587 men aged 58 ± 14 (mean ± standard deviation; range, 20–89) years and 755 women aged 60 ± 12 (range, 21–88) years. The study sample consisted of 998 (74.4%) non-obese [body mass index (BMI) <25.0 kg/m2] and 344 (25.6%) overweight (BMI ≥25 kg/m2) subjects. Insulin resistance was defined by homeostasis model assessment of insulin resistance (HOMA-IR) of at least 2.5, and HOMA-IR and potential confounders were compared between the groups. Areas under the curve (AUC) of the receiver operating characteristic curves (ROC) were used to compare the power of these serum markers. Results In non-obese subjects, the best marker of insulin resistance was alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ratio of 0.70 (95% confidence interval (CI), 0.63-0.77). In overweight subjects, AUC values for the ALT/AST ratio and ALT were 0.66 (0.59-0.72) and 0.66 (0.59-0.72), respectively. Multiple linear regression analyses for HOMA-IR showed that ALT/AST ratios were independently and significantly associated with HOMA-IR as well as other confounding factors in both non-obese and overweight subjects. The optimal cut-off point to identifying insulin resistance for these markers yielded the following values: ALT/AST ratio of ≥0.82 in non-obese subjects and ≥1.02 in overweight subjects. In non-obese subjects, the positive likelihood ratio was greatest for ALT/AST ratio. Conclusions In non-obese Japanese adults, ALT/AST ratio may be the best reliable marker of insulin resistance.
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Affiliation(s)
- Ryuichi Kawamoto
- Department of Community Medicine, Ehime University Graduate School of Medicine, Toon-city, Ehime, Japan.
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Relationship between several markers and presence of metabolic syndrome or components of the metabolic syndrome in Japanese workers. J Occup Environ Med 2012; 54:984-8. [PMID: 22544164 DOI: 10.1097/jom.0b013e31825335ae] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The reported associations between metabolic syndrome (MetS) and systemic vascular inflammation/insulin resistance prompted the author to determine the predictive ability of markers for MetS in the occupational field. METHODS The study was performed in 3460 working men aged 30 to 64 years. The author measured the serum levels of high-sensitivity C-reactive protein and insulin as potential key biomarkers of MetS. RESULTS Multivariate analysis revealed significant associations between the presence of MetS and the log-transformed value of serum insulin and log-transformed value of serum C-reactive protein, with odds ratios of 29.4 (95% confidence interval, 18.0 to 48.2; P < 0.001) and 1.87 (95% confidence interval, 1.47 to 2.38; P < 0.001) of these two markers, respectively, for the presence of MetS. CONCLUSION Elevated serum levels of insulin were found to be strongly associated with MetS in this cross-sectional study.
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den Engelsen C, Koekkoek PS, Gorter KJ, van den Donk M, Salomé PL, Rutten GE. High-sensitivity C-reactive protein to detect metabolic syndrome in a centrally obese population: a cross-sectional analysis. Cardiovasc Diabetol 2012; 11:25. [PMID: 22417460 PMCID: PMC3359236 DOI: 10.1186/1475-2840-11-25] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 03/14/2012] [Indexed: 12/01/2022] Open
Abstract
Background People with central obesity have an increased risk for developing the metabolic syndrome, type 2 diabetes and cardiovascular disease. However, a substantial part of obese individuals have no other cardiovascular risk factors, besides their obesity. High sensitivity C-reactive protein (hs-CRP), a marker of systemic inflammation and a predictor of type 2 diabetes and cardiovascular disease, is associated with the metabolic syndrome and its separate components. We evaluated the use of hs-CRP to discriminate between centrally obese people with and without the metabolic syndrome. Methods 1165 people with central obesity but without any previous diagnosis of hypertension, dyslipidemia, diabetes or cardiovascular disease, aged 20-70 years, underwent a physical examination and laboratory assays to determine the presence of the metabolic syndrome (NCEP ATP III criteria). Multivariable linear regression analyses were performed to assess which metabolic syndrome components were independently associated with hs-CRP. A ROC curve was drawn and the area under the curve was calculated to evaluate whether hs-CRP was capable to predict the presence of the metabolic syndrome. Results Median hs-CRP levels were significantly higher in individuals with central obesity with the metabolic syndrome (n = 417; 35.8%) compared to individuals with central obesity without the metabolic syndrome (2.2 mg/L (IQR 1.2-4.0) versus 1.7 mg/L (IQR 1.0-3.4); p < 0.001). Median hs-CRP levels increased with an increasing number of metabolic syndrome components present. In multivariable linear regression analyses, waist circumference and triglycerides were the only components that were independently associated with hs-CRP after adjusting for smoking, gender, alcohol consumption and the other metabolic syndrome components. The area under the ROC curve was 0.57 (95%-CI 0.53-0.60). Conclusions Hs-CRP has limited capacity to predict the presence of the metabolic syndrome in a population with central obesity.
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Affiliation(s)
- Corine den Engelsen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
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Hayashi T, Kawashima S, Nomura H, Itoh H, Watanabe H, Ohrui T, Yokote K, Sone H, Hattori Y, Yoshizumi M, Ina K, Kubota K. Age, gender, insulin and blood glucose control status alter the risk of ischemic heart disease and stroke among elderly diabetic patients. Cardiovasc Diabetol 2011; 10:86. [PMID: 21978180 PMCID: PMC3200162 DOI: 10.1186/1475-2840-10-86] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 10/06/2011] [Indexed: 11/30/2022] Open
Abstract
Background We analyzed the effects of insulin therapy, age and gender on the risk of ischemic heart disease (IHD) and cerebrovascular accident (CVA) according to glycemic control. Methods and Results We performed a prospective cohort study (Japan Cholesterol and Diabetes Mellitus Study) of type 2 diabetes patients (n = 4014) for 2 years. The primary endpoint was the onset of fatal/non-fatal IHD and/or CVA, which occurred at rates of 7.9 and 7.2 per 1000 person-years, respectively. We divided diabetic patients into four groups based on age (≤ 70 and > 70) and hemoglobin A1C levels (≤ 7.0 and > 7.0%). Multiple regression analysis revealed that IHD was associated with high systolic blood pressure and low HDL-C in patients under 70 years of age with fair glycemic control and was associated with low diastolic blood pressure in the older/fair group. Interestingly, insulin use was associated with IHD in the older/poor group (OR = 2.27, 95% CI = 1.11-5.89; p = 0.026) and was associated with CVA in the older/fair group (OR = 2.09, 95% CI = 1.06-4.25; p = 0.028). CVA was associated with lower HDL-C and longer duration of diabetes in younger/poor glycemic control group. Results by stepwise analysis were similar. Next, patients were divided into four groups based on gender and diabetic control(hemoglobinA1C < or > 7.0%). Multiple regression analysis revealed that IHD was associated with high systolic blood pressure in male/fair glycemic control group, age in male/poor control group, and short duration of diabetic history in females in both glycemic control groups. Interestingly, insulin use was associated with IHD in the male/poor group(OR = 4.11, 95% CI = 1.22-8.12; p = 0.018) and with CVA in the female/poor group(OR = 3.26, 95% CI = 1.12-6.24; p = 0.02). CVA was associated with short duration of diabetes in both female groups. Conclusions IHD and CVA risks are affected by specific factors in diabetics, such as treatment, gender and age. Specifically, insulin use has a potential role in preventing IHD but may also be a risk factor for CVA among the diabetic elderly, thus revealing a need to develop improved treatment strategies for diabetes in elderly patients. The Japan Cholesterol and Diabetes Mellitus Study was formulated to evaluate them(Umin Clinical Trials Registry, clinical trial reg. no. UMIN00000516; http://www.umin.ac.jp/ctr/index.htm).
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Affiliation(s)
- Toshio Hayashi
- Department of Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Valjevac A, Dzubur A, Nakas-Icindic E, Hadzovic-Dzuvo A, Lepara O, Kiseljakovic E, Jadric R. Is γ-glutamyl transferase activity a potential marker of left ventricular function during early postmyocardial infarction period? Future Cardiol 2011; 7:705-13. [DOI: 10.2217/fca.11.43] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Serum uric acid level and its association with metabolic syndrome and carotid atherosclerosis in patients with type 2 diabetes. Cardiovasc Diabetol 2011; 10:72. [PMID: 21816063 PMCID: PMC3163178 DOI: 10.1186/1475-2840-10-72] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2011] [Accepted: 08/04/2011] [Indexed: 11/18/2022] Open
Abstract
Objective We aimed to investigate whether elevated serum uric acid concentrations are associated with higher risk of metabolic syndrome (MetS) and carotid atherosclerosis in patients with type 2 diabetes. Methods We conducted a population-based cross-sectional survey in Shanghai, with a total of 395 men and 631 women age 41 to 92 years. The carotid artery intima-media thickness (IMT) and carotid atherosclerotic plaques (PLQ) were measured by B-mode ultrasound. MetS was defined according to the updated National Cholesterol Education Program Adult Treatment Panel III criteria for Asian Americans. Results Uric acid levels were negatively associated with duration of diabetes, fasting plasma glucose, glycohemoglobin, eGFR, HDL-cholesterol (all P < 0.001) and positively with BMI, CRP, waist circumference, triglycerides, systolic blood pressure, ACR, HOMA-IR and IMT (all P < 0.05). In the highest quartile of uric acid levels, the risks were substantially higher for MetS [odds ratio 3.97, (95% confidence interval 2.58-6.13)] (P < 0.001 for trend) and PLQ [odds ratio 2.71 (95% confidence interval 1.62-4.47)] (p = 0.013 for trend) compared with that in the lowest quartile of uric acid levels after multiple adjustment. These associations remained significant after further adjustment for potential confounders. Conclusions Serum uric acid level is associated with MetS and is an independent risk factor for carotid atherosclerosis in patients with type 2 diabetes.
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Kawamoto R, Tabara Y, Kohara K, Miki T, Kusunoki T, Takayama S, Abe M, Katoh T, Ohtsuka N. Association between fasting plasma glucose and high-sensitivity C-reactive protein: gender differences in a Japanese community-dwelling population. Cardiovasc Diabetol 2011; 10:51. [PMID: 21663637 PMCID: PMC3135517 DOI: 10.1186/1475-2840-10-51] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Accepted: 06/10/2011] [Indexed: 01/04/2023] Open
Abstract
Background High sensitivity C-reactive protein (hsCRP) is an acute phase reactant and a sensitive marker of inflammation. Hyperglycemia can potentially promote the production of CRP. The aim of this study was to determine whether increased fasting plasma glucose (FPG) levels are associated with elevated hsCRP concentrations by gender. Methods We recruited 822 men (mean age, 61 ± 14 years) and 1,097 women (63 ± 12 years) during their annual health examination from a single community. We cross-sectionally examined whether FPG levels are associated with hsCRP concentrations, and whether this association is independent of gender, body mass index (BMI) and other components of the metabolic syndrome. Results In women only, hsCRP increased significantly and progressively with increasing FPG (r = 0.169, P < 0.001). The stepwise multiple linear regression analysis using hsCRP as an objective variable, adjusted for confounding factors as explanatory variables, showed that FPG as well as age, BMI, systolic blood pressure, high-density lipoprotein cholesterol (HDL-C), uric acid, and high molecular weight adiponectin were significantly associated with hsCRP in women, but not in men. There was significant gender interaction, and an increase in hsCRP levels that was greater in women with BMI ≥ 25 kg/m2 and higher FPG than in men. Conclusions These results suggested that hsCRP levels increase continuously across the FPG spectrum starting from the lowest FPG in both men and women. However, increase in hsCRP levels was greater in women than men.
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Affiliation(s)
- Ryuichi Kawamoto
- Department of Community Medicine, Ehime University, Graduate School of Medicine, Ehime 791-0295, Japan.
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Masoudkabir F, Karbalai S, Vasheghani-Farahani A, Aliabadi LL, Boroumand MA, Aiatollahzade-Esfahani F, Pashing M, Hakki E, Goodarzynejad H, Saadat S. The association of liver transaminase activity with presence and severity of premature coronary artery disease. Angiology 2011; 62:614-9. [PMID: 21561994 DOI: 10.1177/0003319711405312] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
There is growing clinical interest in liver transaminases as novel biomarkers of cardiovascular risk. We investigated the possible association of serum liver transaminase activity with the presence and angiographic severity of premature coronary artery disease (CAD). A cross-sectional study was conducted on 187 younger patients (females < 55 years and males < 45 years) who underwent coronary angiography and had serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and high-sensitivity C-reactive protein (hsCRP) measured. Evaluation of coronary stenosis was by Gensini score. Both ALT and AST were significantly correlated with the presence of CAD in univariate and multivariate analyses. Both ALT and AST were also significantly correlated with Gensini score even after adjustment for potential confounders. Serum ALT and AST levels are independently positively associated with the risk and severity of premature CAD, suggesting that these enzymes could serve as surrogate markers for cardiovascular risk in this specific group of patients.
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Affiliation(s)
- Farzad Masoudkabir
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
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Guessous I, Bonny O, Paccaud F, Mooser V, Waeber G, Vollenweider P, Bochud M. Serum calcium levels are associated with novel cardiometabolic risk factors in the population-based CoLaus study. PLoS One 2011; 6:e18865. [PMID: 21533040 PMCID: PMC3080882 DOI: 10.1371/journal.pone.0018865] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Accepted: 03/20/2011] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Associations of serum calcium levels with the metabolic syndrome and other novel cardio-metabolic risk factors not classically included in the metabolic syndrome, such as those involved in oxidative stress, are largely unexplored. We analyzed the association of albumin-corrected serum calcium levels with conventional and non-conventional cardio-metabolic risk factors in a general adult population. METHODOLOGY/PRINCIPAL FINDINGS The CoLaus study is a population-based study including Caucasians from Lausanne, Switzerland. The metabolic syndrome was defined using the Adult Treatment Panel III criteria. Non-conventional cardio-metabolic risk factors considered included: fat mass, leptin, LDL particle size, apolipoprotein B, fasting insulin, adiponectin, ultrasensitive CRP, serum uric acid, homocysteine, and gamma-glutamyltransferase. We used adjusted standardized multivariable regression to compare the association of each cardio-metabolic risk factor with albumin-corrected serum calcium. We assessed associations of albumin-corrected serum calcium with the cumulative number of non-conventional cardio-metabolic risk factors. We analyzed 4,231 subjects aged 35 to 75 years. Corrected serum calcium increased with both the number of the metabolic syndrome components and the number of non-conventional cardio-metabolic risk factors, independently of the metabolic syndrome and BMI. Among conventional and non-conventional cardio-metabolic risk factors, the strongest positive associations were found for factors related to oxidative stress (uric acid, homocysteine and gamma-glutamyltransferase). Adiponectin had the strongest negative association with corrected serum calcium. CONCLUSIONS/SIGNIFICANCE Serum calcium was associated with the metabolic syndrome and with non-conventional cardio-metabolic risk factors independently of the metabolic syndrome. Associations with uric acid, homocysteine and gamma-glutamyltransferase were the strongest. These novel findings suggest that serum calcium levels may be associated with cardiovascular risk via oxidative stress.
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Affiliation(s)
- Idris Guessous
- Community Prevention Unit, Institute of Social and Preventive Medicine, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
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Tenenbaum A, Fisman EZ. "The metabolic syndrome... is dead": these reports are an exaggeration. Cardiovasc Diabetol 2011; 10:11. [PMID: 21269524 PMCID: PMC3036609 DOI: 10.1186/1475-2840-10-11] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 01/27/2011] [Indexed: 02/06/2023] Open
Abstract
The debates continue over the validity of the metabolic syndrome concept. The continuous increment of the obesity pandemic is almost worldwide paralleled by rising rates of metabolic syndrome prevalence. Then, it seems obvious that these debates drove the need for further investigations as well as a deeper cooperation between relevant national and international organizations regarding the issue. Instead, part of the scientific community elected to totally "dismiss" the concept of the metabolic syndrome. Meanwhile, the best available evidence from three consecutive large meta-analyses has systematically shown that people with metabolic syndrome are at increased risk of cardiovascular events. The most recent and largest of them included near one million patients (total n = 951,083). The investigators concluded that the metabolic syndrome is associated with a 2-fold increase in cardiovascular outcomes and a 1.5-fold increase in all-cause mortality rates. One of the ways to hit the metabolic syndrome is an utterly simplistic view on this concept as a predictive tool only. Of course, the presence of the metabolic syndrome possesses a definite predictive value, but first of all it is a widely accepted concept regarding a biological condition based on the complex and interrelated pathophysiological mechanisms starting from excess central adiposity and insulin resistance. Therefore, it is completely unfair to compare it with statistically constructed predictive tools, including stronger prognostic variables even unrelated to each other from the biological point of view. For example, in the criteria for metabolic syndrome (in contrast to Framingham score) age and cholesterol--presumably low density lipoprotein-cholesterol (LDL-C)--levels are not included, as well as a variety of strong predictors used in other risk-stratification scores: previous myocardial infarction, heart failure, smoking, family history, etc. However, the metabolic syndrome identifies additional important residual vascular risk mainly associated with insulin resistance and atherogenic dyslipidemia (low high density lipoprotein-cholesterol (HDL-C), high triglycerides, small, dense LDL-C). Therefore, the metabolic syndrome could be a useful additional contributor in estimation of global cardiovascular risk beyond age, high LDL-C or other standard risk factors. The components of the metabolic syndrome have partially overlapping mechanisms of pathogenic actions mediated through common metabolic pathways. Therefore their total combined effect could be less than the summed of the individual effects. The concept that the metabolic syndrome is a consequence of obesity and insulin resistance, provides a useful "life-style changes" approach for prevention and treatment: caloric restriction, weight-loss and increased physical activity. The next step could theoretically be pharmacological interventions such as metformin, acarbose, fibrates, weight-loss drugs (currently only orlistat is practically available) and perhaps glucagon-like peptide-1 agonists. A third step should probably be kept for bariatric surgery.
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