Increased central adiposity is associated with pro-inflammatory immunoglobulin G N-glycans

Background

Increased body fat may be associated with an increased risk of developing an underlying pro-inflammatory state, thus leading to greater risk of developing certain chronic conditions. Immunoglobulin G has the ability to exert both anti- and pro-inflammatory effects, and the N-glycosylation of the fragment crystallisable portion is involved in mediating this process. Body mass index, a rudimentary yet gold standard indication for body fat, has been shown to be associated with agalactosylated immunoglobulin G N-glycans.

The association of work stress with somatic symptoms in Chinese working women: a large cross-sectional survey

ObjectiveIt has been suggested that the relationship between work stress and somatic symptoms (e.g., cardiopulmonary, gastrointestinal complaints, general pain, and fatigue) is particularly pronounced in women. As evidence from China is sparse, we used a large sample of Chinese working women to test those potential associations.MethodsData were obtained from a cross-sectional study of 6826 working women in five urban areas in China who were free from major clinical disease. The sample was drawn from five occupations (physicians, nurses, school teachers, bank employees, and industrial workers). The Effort-Reward Imbalance Questionnaire and Patient Health Questionnaire-15 were used to measure work stress and somatic symptoms, respectively. Multivariate ordinal logistic regression was performed to analyze the associations.Results52.6% participants reported high work stress in terms of concurrent high effort and low reward. The distribution of severity of somatic symptoms covered the full range from minimal (37.3%) and low (30.6%), to medium (19.7%) and high (12.4%). The adjusted odds ratio of somatic symptoms by high work stress was 2.45 (95% confidence interval = 2.24–2.68), and all single psychosocial work factors (effort, reward, and over-commitment) exerted substantial effects on somatic symptoms (odds ratios > 2.00).ConclusionsWork stress is strongly associated with somatic symptoms in Chinese working women. Future longitudinal studies and intervention studies are needed to understand and improve women's psychosocial work environment and their psychosomatic health in China and elsewhere.     

Mediation effect of arterial stiffness on ideal cardiovascular health and stroke

Background and aimsIdeal cardiovascular health (CVH) metrics was associated with stroke, but the causal pathway was poorly investigated. Arterial stiffness was a major factor associated with both ideal CVH metrics and stroke. This study aimed to investigate whether the effect of ideal CVH metrics on stroke was mediated and enhanced by arterial stiffness.Methods and resultsA total of 15,297 participants were included in current study. Arterial stiffness was measured by brachial–ankle pulse wave velocity (baPWV). Causal mediation analyses were used to separate the overall effects of ideal CVH metrics on stroke into indirect effects (mediated by arterial stiffness) and direct effects (mediated through pathways other than arterial stiffness). After a median follow-up of 5.88 years, 324 total stroke events (292 ischemic stroke and 31 hemorrhagic stroke) occurred. Mediation analysis showed 23.94% of the relation between ideal CVH and total stroke was mediated by baPWV (95% confidence interval [CI] of the indirect effect: 0.93–0.95). Further analysis showed the ideal CVH < median combined with baPWV ≥1400 cm/s was associated with the highest risk of total stroke (hazard ratio: 5.62; 95% CI, 3.53–8.96), compared with CVH ≥ median combined with baPWV < 1400 cm/s. Similar results were observed for ischemic stroke, but not for hemorrhagic stroke.ConclusionsArterial stiffness played a mediating role in the associations between ideal CVH metrics and risk of total and ischemic stroke. Combined ideal CVH metrics and baPWV is a reasonable and useful tool for the assessment and prevention of stroke.     

A Fatal Case of Thrombotic Microangiopathy Without Schistocytosis and Absent Biochemical Markers of Hemolysis

Thrombotic microangiopathy (TMA) is characterized by microangiopathic hemolytic anemia with thrombocytopenia. In addition to the primary TMA syndromes, microangiopathic hemolytic anemia with thrombocytopenia can be seen in many systemic diseases. Transplant associated TMA (TA-TMA) affects patients following stem cell or solid organ transplant. A 48-year-old male who underwent autologous stem cell transplant for nonsecretory multiple myeloma was admitted to our hospital with worsening anemia, thrombocytopenia, renal dysfunction and hepatosplenomegaly. Initial blood work revealed rare schistocytes and normal lactate dehydrogenase and haptoglobin levels. He underwent an extensive workup looking for an infectious, inflammatory or malignant etiology but a definitive diagnosis could not be reached. Over his prolonged stay at the hospital, he suffered from multiorgan failure and eventually passed away. An autopsy revealed TMA involving all clinically affected organ systems and was deemed to be the cause of his demise. The absence of typical blood work suggestive of hemolysis does not rule out a diagnosis of TA-TMA. Knowledge of this rare disease entity will help physicians identify and treat this life-threatening condition early and effectively.     

Association between behavioural risk factors and metabolic syndrome among adult population in India: A systematic review and meta-analysis of observational studies

AimsThe impact of behavioural risk factors on the metabolic syndrome has not been well understood by the researchers. This information is important to the policymakers for developing effective strategies and implement relevant policies or programs. Hence, we undertook this meta-analysis to estimate the effect of behavioural risk factors on the burden of metabolic syndrome.Data synthesisWe conducted a search in the databases, such as PubMed Central, EMBASE, MEDLINE, and Cochrane library, and search engines, such as ScienceDirect and Google Scholar, from inception until March 2021. We used the Newcastle–Ottawa Scale (NOS) to assess the quality of published studies. We carried out a meta-analysis with random-effects model and reported pooled odds ratio (OR) with 95% confidence interval (CI).In total, we analysed 30 studies with 41,090 participants. The majority of the studies had good to satisfactory quality as per NOS. Physical activity had a statistically significant association with the prevalence of metabolic syndrome (pooled OR = 1.57; 95%CI: 1.28 to 1.93, I² = 91%). However, smoking (pooled OR = 0.96; 95%CI: 0.75 to 1.23, I² = 90.5%) and alcohol (pooled OR = 1.00; 95%CI: 0.75 to 1.33, I² = 90.8%) did not reveal a statistically significant association with the burden of metabolic syndrome.ConclusionPhysical inactivity was found to be a significant risk factor for metabolic syndrome. Given the evidence, it is important that the clinicians and policymakers are alike to recommend regular physical activity among the patients and general population.     

Relation of genetic polymorphisms in microRNAs with diastolic and systolic function in type 2 diabetes mellitus

Background and aimsType 2 diabetes mellitus (T2DM) has high risk of developing cardiac dysfunction, increasing of either cardiovascular death or hospitalization for heart failure. MicroRNAs (miRNA) affect cardiac function of T2DM. The aim of this study was to investigate the relationships between five miRNA single nucleotide polymorphisms (SNP) and diastolic and systolic function of T2DM.Methods and resultsThree hundred untreated T2DM subjects were included. Each subject underwent SNP genotyping, conventional echocardiography, tissue doppler imaging, and speckle tracking imaging. The effects of miRNA SNPs on diastolic and systolic function were evaluated. The diastolic function of T2DM subjects with miR-133a-1-rs8089787 wild genotype or let-7f-rs10877887 variant genotype was lower than those with miR-133a-1-rs8089787 variant genotype or let-7f-rs10877887 wild genotype, manifesting as higher left atrial volume index, lower mean E′, and higher E/E’ (P < 0.05). There were no significant effects of miR-133a-2-rs13040413, let-7a-1-rs13293512 and miR-27a-rs895819 on the diastolic function of T2DM subjects (P > 0.05). These five miRNA SNPs had no effect on the systolic function of T2DM subjects (P > 0.05).ConclusionsMiRNA-133a-1-rs8089787 and let-7f-rs10877887 were associated with impaired cardiac diastolic function in T2DM. The findings may be a promising therapeutic targets for preventing diastolic dysfunction in T2DM.     

Individual and combined relationship of serum uric acid and alanine aminotransferase on metabolic syndrome in adults in Qingdao,China

Background and aimsAssociations of alanine aminotransferase (ALT) and serum uric acid (SUA) with metabolic syndrome (MetS) remain controversial. We aimed to explore individual and combined effects of ALT and SUA on MetS in community residents.Methods and resultsA population-based cross-sectional survey involving randomly selected Chinese adults aged 35–74 years was conducted in 2009 in Qingdao, China, and 4642 participants were included in the current study. Based on a combination of SUA and ALT levels in the tertile, subjects were grouped into Group 1-9. The individual and combined relations of SUA and ALT to MetS were analyzed by logistic regression models. The prevalence of MetS was 28.50% in males and 22.30% in females. ALT and SUA were independently associated with MetS and ORs (95% CIs) were 1.55 (1.42–1.70) and 1.92 (1.72–2.14), respectively, after adjusting for potential confounders. With the elevation of ALT and SUA levels, the risk of developing MetS increased. Compared to Group 1, ORs (95% CIs) of combined ALT and SUA for MetS were 2.21 (1.70–2.88), 4.02 (3.10–5.21), 2.19 (1.62–2.97), 2.53 (1.91–3.34), 4.69 (3.60–6.12), 1.76 (1.17–2.64), 3.65 (2.63–5.06) and 7.15 (5.41–9.46) in Group 2–9, respectively.ConclusionsALT and SUA were both related to MetS independently. Combined elevation of ALT and SUA levels could increase the risk of MetS and its components than an elevation in SUA and ALT alone. Therefore, measures should be taken to lower SUA and ALT levels to reduce the risk of having MetS.     

Dietary sugars and subclinical vascular damage in moderate-to-high cardiovascular risk adults

Background and aimsThe association between dietary sugars and vascular damage has been scarcely examined out of the context of established cardiovascular disease. We aimed to investigate the association between different types of sugars with subclinical atheromatosis and arteriosclerosis, in individuals free of cardiovascular disease being, however, at moderate-to-high cardiovascular risk.Methods and resultsTwo 24-h dietary recalls were conducted to estimate sugars intake. Subclinical atheromatosis was assessed by B-mode ultrasonography and arteriosclerosis (arterial stiffness) via tonometry (carotid-to-femoral pulse wave velocity). Multiple logistic regression analysis was performed to determine the relationship of quartiles of total sugars, monosaccharides and disaccharides with atheromatosis and arteriosclerosis, adjusting for potential confounders [Odds Ratio (95%Confidence Interval)]. In 901 participants (52.4 ± 13.8 years, 45.2% males), total sugars intake was not associated with any type of subclinical vascular damage. Subjects at 4th quartile of lactose intake (15.3 ± 5.5 g/day) had lower probability to present atheromatosis compared to those at 1st quartile (0.00 ± 0.01 g/day) even in the fully adjusted model [0.586 (0.353–0.974)]. Subjects at 3rd quartile of total disaccharides intake and particularly sucrose (15.1 ± 2.2 g/day) had higher probability to present arteriosclerosis compared to those at 1st quartile (3.0 ± 1.9 g/day) even after adjustment for all potential confounders [2.213 (1.110–4.409)].ConclusionsOverall, the present data suggest a distinct role of each type of sugars on vascular damage. These observations highlight the need for further studies investigating not only foods rich in sugars, but sugars as separate components of food as they probably contribute via different ways on the development of arterial pathologies.