Nonalcoholic fatty liver disease(NAFLD)is a multisystemic clinical condition that presents with a wide spectrum of extrahepatic manifestations,such as obesity,type 2 diabetes mellitus,metabolic syndrome,cardiovascular...Nonalcoholic fatty liver disease(NAFLD)is a multisystemic clinical condition that presents with a wide spectrum of extrahepatic manifestations,such as obesity,type 2 diabetes mellitus,metabolic syndrome,cardiovascular diseases,chronic kidney disease,extrahepatic malignancies,cogni-tive disorders,and polycystic ovarian syndrome.Among NAFLD patients,the most common mortality etiology is cardiovascular disorders,followed by extrahepatic malignancies,diabetes mellitus,and liver-related complications.Furthermore,the severity of extrahepatic diseases is parallel to the severity of NAFLD.In clinical practice,awareness of the associations of concomitant diseases is of major importance for initiating prompt and timely screening and multidisciplinary management of the disease spectrum.In 2020,a consensus from 22 countries redefined the disease as metabolic(dysfunction)-associated fatty liver disease(MAFLD),which resulted in the redefinition of the corre-sponding population.Although the patients diagnosed with MAFLD and NAFLD mostly overlap,the MAFLD and NAFLD populations are not identical.In this review,we compared the associations of key extrahepatic diseases between NAFLD and MAFLD.展开更多
Cardiometabolic disease(CMD), characterized with metabolic disorder triggered cardiovascular events, is a leading cause of death and disability. Metabolic disorders trigger chronic low-grade inflammation, and actually...Cardiometabolic disease(CMD), characterized with metabolic disorder triggered cardiovascular events, is a leading cause of death and disability. Metabolic disorders trigger chronic low-grade inflammation, and actually, a new concept of metaflammation has been proposed to define the state of metabolism connected with immunological adaptations. Amongst the continuously increased list of systemic metabolites in regulation of immune system, bile acids(BAs) represent a distinct class of metabolites implicated in the whole process of CMD development because of its multifaceted roles in shaping systemic immunometabolism. BAs can directly modulate the immune system by either boosting or inhibiting inflammatory responses via diverse mechanisms. Moreover, BAs are key determinants in maintaining the dynamic communication between the host and microbiota. Importantly, BAs via targeting Farnesoid X receptor(FXR) and diverse other nuclear receptors play key roles in regulating metabolic homeostasis of lipids, glucose, and amino acids. Moreover, BAs axis per se is susceptible to inflammatory and metabolic intervention, and thereby BAs axis may constitute a reciprocal regulatory loop in metaflammation. We thus propose that BAs axis represents a core coordinator in integrating systemic immunometabolism implicated in the process of CMD. We provide an updated summary and an intensive discussion about how BAs shape both the innate and adaptive immune system, and how BAs axis function as a core coordinator in integrating metabolic disorder to chronic inflammation in conditions of CMD.展开更多
Objective To determine whether elevated serum uric acid(UA)levels are associated with type 2 diabetes diagnosed using Hb A1 c levels among Chinese adults.Methods We conducted two population-based cross-sectional studi...Objective To determine whether elevated serum uric acid(UA)levels are associated with type 2 diabetes diagnosed using Hb A1 c levels among Chinese adults.Methods We conducted two population-based cross-sectional studies in Qingdao in China in 2006 and 2009.A total of 6894(39.4% men)subjects aged 35-74 years were included in the data analysis.Newly diagnosed diabetes was defined as Hb A1 c level of ≥6.5%,and prediabetes was classified as Hb A1 c level between 5.7% and 6.4% according to the International Diabetes Federation criteria.Multivariate logistic regression was employed to assess the association between UA and prevalence of type 2 diabetes defined using Glycated hemoglobin A1c(Hb A1 c levels.Results Subjects with prediabetes had higher UA levels than those with normal glucose tolerance,newly diagnosed diabetes,and known diabetes,with corresponding values of 325.1(82.5)μmol/L,310.9(84.2)μmol/L,291.3(81.7)μmol/L,305.2(83.6)μmol/L,respectively(P<0.001 for all comparisons).Binary logistic regression analysis showed that UA was a possible predictor for the prevalence of type 2 diabetes diagnosed using Hb A1 c levels,and the second quartile of UA levels had a higher odds ratio(OR:4.088;95% CI:2.900-5.765)for Hb A1 c than the other quartiles after adjusting for age,body mass index,sex,marital status,education,income,alcohol consumption,smoking,and cardiometabolic parameters.Conclusion Serum UA is significantly associated with type 2 diabetes diagnosed using Hb A1 c levels,independent of other cardiometabolic parameters.展开更多
Background： Obstructive sleep apnea （OSA） syndrome has a negative impact on the health of millions of adolescents and youth. The aim of this study was to evaluate the associations of OSA syndrome with obesity and c...Background： Obstructive sleep apnea （OSA） syndrome has a negative impact on the health of millions of adolescents and youth. The aim of this study was to evaluate the associations of OSA syndrome with obesity and cardiometabolic risk factors among adolescents and youth at risk for metabolic syndrome （MS）.Methods： A total of 558 subjects aged 14-28 years were recruited from the Beijing Child and Adolescent Metabolic Syndrome Study. Each underwent a 2-h oral glucose tolerance test （OGTT）, echocardiography, and liver ultrasonography. Anthropometric measures, blood levels of glucose, lipids, and liver enzymes were assessed. Subjects with high or low risk for OSA were identified by Berlin Questionnaire （BQ）. Results： Among the subjects in obesity, 33.7% of whom were likely to have OSAby BQ. Subjects with high risk for OSA had higher neck and waist circumference and fat mass percentage compared to those with low risk for OSA （P 〈 0.001 ）. Moreover, significant differences in levels of lipids, glucose after OGTT, and liver enzymes, as well as echocardiographic parameters were found between the two groups with high or low risk for OSA （P 〈 0.05）. The rates of nonalcoholic fatty liver disease （71.0% vs. 24.2%）, MS （38.9% vs. 7.0%）, and its components in high-risk group were significantly higher than in low-risk group. Conclusions： The prevalence of OSA by BQ was high in obese adolescents and youth. A high risk for OSA indicates a high cardiometabolic risk. Mechanisms mediating the observed associations require further investigation.展开更多
Objective::This study investigated the prospective associations of circulating levels of sex hormone-binding globulin(SHBG)levels with cardiometabolic biomarkers and risk of gestational diabetes(GDM)during pregnancy.I...Objective::This study investigated the prospective associations of circulating levels of sex hormone-binding globulin(SHBG)levels with cardiometabolic biomarkers and risk of gestational diabetes(GDM)during pregnancy.It also examines the longitudinal trajectory of SHBG in women with and without GDM.Methods::We conducted a nested case-control study of 107 incident GDM cases and 214 matched controls within the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singleton Cohort.The cohort enrolled non-obese and obese women aged 18-40 years with a singleton pregnancy between 8 and 13 weeks of gestation from 2009 to 2013.GDM was ascertained via medical records review.Blood samples were drawn four times at gestational weeks 10-14,15-26,23-31,and 33-39.The prospective associations between SHBG levels and cardiometabolic biomarkers were examined using the Spearman partial correlation among the controls.The longitudinal trajectories of SHBG levels were examined among the cases and the controls.Meta-analysis of prospective studies were performed to examine the association between SHBG levels and GDM risk.Results::SHBG levels at gestational weeks 10-14 were significantly inversely associated with fasting insulin(r=-0.17,P=0.01)and insulin resistance as measured by HOMA-IR(r=-0.17,P=0.01)at gestational week 15-26.SHBG at gestational weeks 10-14 and 15-26 was lower in cases than controls(mean±standard deviation:(204.0±97.6)vs.(220.9±102.5)nmol/L,P=0.16 and(305.6±124.3)vs.(322.7±105.1)nmol/L,P=0.14,respectively),yet the differences were not significant.In the meta-analysis,SHBG was 41.5 nmol/L(95%confidence interval:23.9,59.1,P<0.01)significantly lower among women with GDM than without,and each 50 nmol/L increase in SHBG was significantly associated with an odds ratio of 0.85(95%confidence interval:0.76-0.95,P=0.01)for GDM.Conclusion::Lower SHBG levels in early pregnancy were prospectively associated with higher high insulin levels and insulin resistance in mid-pregnancy an展开更多
AIM:To examine the effect of gastric bypass surgery on cardiometabolic health among women with polycystic ovarian syndrome(PCOS).METHODS:Retrospective medical chart review identified women(n = 389) with PCOS who under...AIM:To examine the effect of gastric bypass surgery on cardiometabolic health among women with polycystic ovarian syndrome(PCOS).METHODS:Retrospective medical chart review identified women(n = 389) with PCOS who underwent Roux-en-Y gastric bypass surgery from 2001-2009 in one surgical practice.Separate repeated measures linear mixed models were fit using the MIXED procedureto assess mean change in cardiometabolic disease risk factors from before to 1-year after surgery and were evaluated by ethnicity [Hispanic,non-Hispanic black(NHB) and white(NHW)].RESULTS:The majority of the sample was Hispanic(66%,25% NHB,9% NHW).Mean body mass index significantly improved 1 year post-surgery for all ethnic groups(45.5 to 35.5 kg/m2 for Hispanics,46.8 to 37.7 kg/m2 for NHB and 45.7 to 36.7 kg/m2 for NHW,P < 0.001).Among Hispanic women mean total cholesterol(198.1 to 160.2 mg/dL),low-density lipoproteins(LDL) cholesterol(120.9 to 91.0 mg/dL),triglycerides(148.6 to 104.8 mg/dL),hemoglobin A1c(6.2% to 5.6%),alanine aminotransferase(28.1 to 23.0 U/L) and aspartate aminotransferase(23.5 to 21.6 U/L) decreased significantly(P < 0.001).Among NHB,mean total cholesterol(184.5 to 154.7 mg/dL),LDL cholesterol(111.7 to 88.9 mg/dL) and triglycerides(99.7 to 70.0 mg/dL) decreased significantly(P < 0.05).Among NHW,mean total cholesterol(200.9 to 172.8 mg/dL) and LDL cholesterol(124.2 to 96.6 mg/dL),decreased significantly(P < 0.05).Pairwise ethnic group comparisons of all cardiometabolic outcomes adjusted for age and type of surgery before and 1 year after surgery showed no statistical difference between the three groups for any outcome.CONCLUSION:Cardiometabolic disease risk improvements vary by ethnicity and obesity may impact glucose tolerance and liver function changes more in Hispanic women with PCOS vs non-Hispanic women.展开更多
The International Diabetes Federation estimates that 316million people are currently affected by impaired glucose tolerance(IGT).Most importantly,recent forecasts anticipate a dramatic IGT increase with more that 470m...The International Diabetes Federation estimates that 316million people are currently affected by impaired glucose tolerance(IGT).Most importantly,recent forecasts anticipate a dramatic IGT increase with more that 470million people affected by the year 2035.Impaired insulin sensitivity is major feature of obesity and diabetes and is strongly linked with adverse cardiometabolic phenotypes.However,the etiologic pathway linking impaired glucose tolerance and cardiovascular disease remains to be deciphered.Although insulin resistance has been attributed to inflammatory programs starting in adipose tissue,emerging evidence indicates that endothelial dysfunction may represent the upstream event preceding peripheral impairment of insulin sensitivity.Indeed,suppression of reactive oxygen species-dependent pathways in the endothelium has shown to restore insulin delivery to peripheral organs by preserving nitric oxide(NO)availability.Here we describe emerging theories concerning endothelial insulin resistance,with particular emphasis on the role oxidative stress.Complex molecular circuits including endothelial nitric oxide synthase,prostacyclin synthase,mitochondrial adaptor p66^(Shc),nicotinamide adenine dinucleotide phosphate-oxidase oxidase and nuclear factor kappa-B are discussed.Moreover,the review provides insights on the effectiveness of available compounds(i.e.,ruboxistaurin,sildenafil,endothelin receptor antagonists,NO donors)in restoring endothelial insulin signalling.Taken together,these aspects may significantly contribute to design novel therapeutic approaches to restore glucose homeostasis in patients with obesity and diabetes.展开更多
BACKGROUND Education,cognition,and intelligence are associated with cholelithiasis occurrence,yet which one has a prominent effect on cholelithiasis and which cardiometabolic risk factors mediate the causal relationsh...BACKGROUND Education,cognition,and intelligence are associated with cholelithiasis occurrence,yet which one has a prominent effect on cholelithiasis and which cardiometabolic risk factors mediate the causal relationship remain unelucidated.AIM To explore the causal associations between education,cognition,and intelligence and cholelithiasis,and the cardiometabolic risk factors that mediate the associations.METHODS Applying genome-wide association study summary statistics of primarily European individuals,we utilized two-sample multivariable Mendelian randomization to estimate the independent effects of education,intelligence,and cognition on cholelithiasis and cholecystitis(FinnGen study,37041 and 11632 patients,respectively;n=486484 participants)and performed two-step Mendelian randomization to evaluate 21 potential mediators and their mediating effects on the relationships between each exposure and cholelithiasis.RESULTS Inverse variance weighted Mendelian randomization results from the FinnGen consortium showed that genetically higher education,cognition,or intelligence were not independently associated with cholelithiasis and cholecystitis;when adjusted for cholelithiasis,higher education still presented an inverse effect on cholecystitis[odds ratio:0.292(95%CI:0.171-0.501)],which could not be induced by cognition or intelligence.Five out of 21 cardiometabolic risk factors were perceived as mediators of the association between education and cholelithiasis,including body mass index(20.84%),body fat percentage(40.3%),waist circumference(44.4%),waist-to-hip ratio(32.9%),and time spent watching television(41.6%),while time spent watching television was also a mediator from cognition(20.4%)and intelligence to cholelithiasis(28.4%).All results were robust to sensitivity analyses.CONCLUSION Education,cognition,and intelligence all play crucial roles in the development of cholelithiasis,and several cardiometabolic mediators have been identified for prevention of cholelithiasis due to defects in each exposure.展开更多
Background There are several surrogate indicators of abdominal fat deposition,including tri-ponderal mass index(TMI),lipid accumulation product(LAP),and the Chinese visceral adiposity index(CVAI).In spite of this,it r...Background There are several surrogate indicators of abdominal fat deposition,including tri-ponderal mass index(TMI),lipid accumulation product(LAP),and the Chinese visceral adiposity index(CVAI).In spite of this,it remains unclear whether these indices have a longitudinal relationship with the prevalence of cardiometabolic multimorbidity(CM),a pressing global health issue.This research investigated the association between CVAI and CM compared to other indicators of visceral obesity.Methods 6638 participants(aged>45)from the China Health and Retirement Longitudinal Study(CHARLS)were analyzed for incident CM.Cox proportional models were adopted to explore whether the level of CVAI was correlated with the risk of CM.Harrell's concordance statistic(C-statistic)was applied to compare predictive values.Sensitivity and subgroup analyses were implemented for the steadiness of the results.Results Over 4 years,266(4.01%)participants developed CM.A 1-standard deviation(SD)increase in the levels of CVAI,body mass index(BMI),LAP,and TMI was associated with greater CM risk after adjusting for confounders[hazard ratios(HRs):2.20,95%confidence interval(CI):1.88-2.57,1.92(95%CI:1.55-2.38),1.20(95%CI:1.12-1.27),and 1.50(95%CI:1.35-1.66),respectively].CVAI outperformed other indices in predictive performance.Subgroup analysis revealed younger participants or those living alone were more prone to developing CM.Results were potent after finishing all sensitivity analyses.Conclusions The study highlighted a positive correlation between the level of CVAI and CM risk.CVAI's superior predictive performance positions it as a reliable indicator for identifying individuals at heightened CM risk.展开更多
Hypertension is a serious public health problem worldwide.More than 60%of the risk factors for hypertension are associated with metabolic disturbances.Metabolic abnormalities increase the risk for hypertension and cau...Hypertension is a serious public health problem worldwide.More than 60%of the risk factors for hypertension are associated with metabolic disturbances.Metabolic abnormalities increase the risk for hypertension and cause high blood pressure.Improving metabolic disturbances is beneficial for hypertension treatment.Due to the importance of metabolic abnormalities in the pathogenesis of hypertension,we propose a concept of metabolic hypertension.In this review,we discuss and review the clinical types,pathogenesis,risk evaluation and management of metabolic hypertension.Elucidation of the mechanism of metabolic hypertension should facilitate the design of novel pharmacotherapeutics and dedicated antihypertensive manipulations.展开更多
BACKGROUND Breast milk is the best and principal nutritional source for neonates and infants.It may protect infants against many metabolic diseases,predominantly obesity and type 2 diabetes.Diabetes mellitus(DM)is a c...BACKGROUND Breast milk is the best and principal nutritional source for neonates and infants.It may protect infants against many metabolic diseases,predominantly obesity and type 2 diabetes.Diabetes mellitus(DM)is a chronic metabolic and microvascular disease that affects all the body systems and all ages from intrauterine life to late adulthood.Breastfeeding protects against infant mortality and diseases,such as necrotizing enterocolitis,diarrhoea,respiratory infections,viral and bacterial infection,eczema,allergic rhinitis,asthma,food allergies,malocclusion,dental caries,Crohn's disease,and ulcerative colitis.It also protects against obesity and insulin resistance and increases intelligence and mental development.Gestational diabetes has short and long-term impacts on infants of diabetic mothers(IDM).Breast milk composition changes in mothers with gestational diabetes.AIM To investigate the beneficial or detrimental effects of breastfeeding on the cardiometabolic health of IDM and their mothers.METHODS We performed a database search on different engines and a thorough literature review and included 121 research published in English between January 2000 and December 15,2022,in this review.RESULTS Most of the literature agreed on the beneficial effects of breast milk for both the mother and the infant in the short and long terms.Breastfeeding protects mothers with gestational diabetes against obesity and type 2 DM.Despite some evidence of the protective effects of breastfeeding on IDM in the short and long term,the evidence is not strong enough due to the presence of many confounding factors and a lack of sufficient studies.CONCLUSION We need more comprehensive research to prove these effects.Despite many obstacles that may enface mothers with gestational diabetes to start and maintain breastfeeding,every effort should be made to encourage them to breastfeed.展开更多
AIM: To generate prevalence estimates of weight status and cardiometabolic disease risk factors among adolescents with and without disabilities.METHODS: Analysis of the 1999-2010 National Health and Nutrition Examinat...AIM: To generate prevalence estimates of weight status and cardiometabolic disease risk factors among adolescents with and without disabilities.METHODS: Analysis of the 1999-2010 National Health and Nutrition Examination Survey data was conducted among 12-18 years old with(n = 256) and without disabilities(n = 5020). Mean values of waist circumference, fasting glucose, high-density-lipoprotein cholesterol, triglycerides, systolic and diastolic blood pressure and metabolic syndrome(Met S, ≥ 3 risk factors present) were examined by the following standardized body mass index(BMI) categories for those with and without disabilities; overweight(BMI ≥ 85th- < 95 th percentile for age and sex), obesity(BMI ≥ 95 th percentile) and severe obesity(BMI ≥35 kg/m2). Linear regression models were fit with each cardiometabolic disease risk factor independently as continuous outcomes to show relationships with disability status. RESULTS: Adolescents with disabilities were significantlymore likely to be overweight(49.3%), obese(27.6%) and severely obese(12%) vs their peers without disabilities(33.1%, 17.5% and 3.6%, respectively, P ≤ 0.01 for all). A higher proportion of overweight, obese and severely obese children with disabilities had abnormal SBP, fasting lipids and glucose as well as Met S(18.9% of overweight, 32.3% of obese, 55% of severely obese) vs their peers without disabilities(9.7%, 16.8%, 36.3%, respectively). US adolescents with disabilities are over three times as likely to have Met S(OR = 3.45, 95%CI: 1.08-10.99, P = 0.03) vs their peers with no disabilities.CONCLUSION: Results show that adolescents with disabilities are disproportionately affected by obesity and poor cardiometabolic health vs their peers with no disabilities. Health care professionals should monitor the cardiometabolic health of adolescents with disabilities.展开更多
AIM:To determine the benefits of a 10-wk resistance training programme on cardiovascular health in nonobese and active adolescents.METHODS:This is a pragmatic randomised controlled intervention.The study was carried o...AIM:To determine the benefits of a 10-wk resistance training programme on cardiovascular health in nonobese and active adolescents.METHODS:This is a pragmatic randomised controlled intervention.The study was carried out in a Hong Kong Government secondary school.Thirty-eight lean and active boys and girls were randomised to either the resistance training group or the control group.Students in the resistance training group received in-school 10-wk supervised resistance training twice per week,with each session lasting 70 min.Main outcome measures taken before and after training included brachial endothelial dependent flow-mediated dilation,body composition,fasting serum lipids,fasting glucose and insulin,high sensitive C-reactive protein,24-h ambulatory blood pressure and aerobic fitness.RESULTS:The only training related change was in endothelial dependent flow-mediated dilation which increased from 8.5%to 9.8%.A main effect of time and an interaction(P<0.005) indicated that this improvement was a result of the 10-wk resistance training.Main effects for time(P<0.05) in a number of anthropometric,metabolic and vascular variables were noted;however,there were no significant interactions indicating the change was more likely an outcome of normal growth and development as opposed to a training effect.CONCLUSION:Ten weeks of resistance training in school appears to have some vascular benefit in active,lean children.展开更多
BACKGROUND Time-restricted eating(TRE)is a dietary approach that limits eating to a set number of hours per day.Human studies on the effects of TRE intervention on cardiometabolic health have been contradictory.Hetero...BACKGROUND Time-restricted eating(TRE)is a dietary approach that limits eating to a set number of hours per day.Human studies on the effects of TRE intervention on cardiometabolic health have been contradictory.Heterogeneity in subjects and TRE interventions have led to inconsistency in results.Furthermore,the impact of the duration of eating/fasting in the TRE approach has yet to be fully explored.AIM To analyze the existing literature on the effects of TRE with different eating durations on anthropometrics and cardiometabolic health markers in adults with excessive weight and obesity-related metabolic diseases.METHODS We reviewed a series of prominent scientific databases,including Medline,Scopus,Web of Science,Academic Search Complete,and Cochrane Library articles to identify published clinical trials on daily TRE in adults with excessive weight and obesity-related metabolic diseases.Randomized controlled trials were assessed for methodological rigor and risk of bias using version 2 of the Cochrane risk-of-bias tool for randomized trials(RoB-2).Outcomes of interest include body weight,waist circumference,fat mass,lean body mass,fasting glucose,insulin,HbA1c,homeostasis model assessment for insulin resistance(HOMA-IR),lipid profiles,C-reactive protein,blood pressure,and heart rate.RESULTS Fifteen studies were included in our systematic review.TRE significantly reduces body weight,waist circumference,fat mass,lean body mass,blood glucose,insulin,and triglyceride.However,no significant changes were observed in HbA1c,HOMA-IR,total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,heart rate,systolic and diastolic blood pressure.Furthermore,subgroup analyses based on the duration of the eating window revealed significant variation in the effects of TRE intervention depending on the length of the eating window.CONCLUSION TRE is a promising chrononutrition-based dietary approach for improving anthropometric and cardiometabolic health.However,further clinical trials are needed to det展开更多
Background:The epidemic of overweight and obesity has become a worldwide public health problem.Cardiometabolic diseases may originate in childhood.We investigated the association between percent body fat(PBF)measured ...Background:The epidemic of overweight and obesity has become a worldwide public health problem.Cardiometabolic diseases may originate in childhood.We investigated the association between percent body fat(PBF)measured by the bioelectrical impedance assay and cardiometabolic risk(CMR)in pediatrics.Methods:This cross-sectional study involved 3819 subjects(6-17 years old)in Shanghai.We assessed the association between PBF and body mass index(BMI)with multiple CMR factors.We examined the risk for cardiometabolic abnormalities attributable to overweight and obesity based on age-and sexspecific PBF Z-scores and BMI Z-scores,respectively.Results:PBF,but not BMI,was positively associated with multiple CMR factors in males and females except for total cholesterol in females(all p<0.05).Compared with the non-overweight group based on PBF,overweight and obese subjects had increasingly higher odds ratio of dyslipidemia(2.90(1.99-4.23),4.59(2.88-7.32)for males and 1.82(1.20-2.75),2.46(1.47-4.11)for females)and elevated blood pressure(BP)(3.26(2.35-4.51),4.55(2.92-7.09)for males and 1.59(1.07-2.34),3.98(2.27-6.17)for females).Obesity females showed a higher likelihood for hyperglycemia(2.19(1.24-3.84))than non-overweight females.In both sexes,the predictive effect of PBF on dyslipidemia and elevated BP in adolescents was better than that in children.For hyperglycemia,the predictive effect of PBF was better in male adolescents and female children.There was no risk difference for cardiometabolic abnormalities attributable to BMI-based obesity categories.Conclusions:PBF but not BMI was associated with CMR.Overweight and obesity categories based on PBF had an increased risk for cardiometabolic abnormalities in children and adolescents.展开更多
The central circadian clock in the brain controls the time-of-the-day variations in acute meal responses,with a low glycemic response but a high satiety/thermo-genic response to meals consumed at waking compared to ot...The central circadian clock in the brain controls the time-of-the-day variations in acute meal responses,with a low glycemic response but a high satiety/thermo-genic response to meals consumed at waking compared to other time points.Consistently,studies show that consuming a significant proportion of calories,particularly carbohydrates,in breakfast is beneficial for the chronic management of obesity and its associated metabolic syndrome,compared to consuming identical meals at dinner.Conversely,breakfast skipping or/and late dinner can have unfavorable metabolic outcomes.It remains controversial how meal frequency affects metabolic health.In contrast,irregular meals,especially irregular breakfasts,show consistent adverse metabolic consequences.Time-restricted feeding(TRF),with all calories consumed within less than 12-h per day,can improve metabolism and extend lifespan.A major component of TRF in humans is caloric restriction,which contributes significantly to the beneficial effects of TRF in humans.By comparison,TRF effects in rodents can be independent of caloric restriction and show day/night phase specificity.TRF could alleviate metabolic abnormalities due to circadian disruption,but its effects appear independent of the circadian clock in rodents.Understanding neuroendocrine mechanisms underlying clock-mediated metabolic regulation will shed light on the metabolic effects of temporal meal patterns.展开更多
Background:Adults with obesity may display disturbed cardiac chronotropic responses during cardiopulmonary exercise testing,which relates to poor cardiometabolic health and an increased risk for adverse cardiovascular...Background:Adults with obesity may display disturbed cardiac chronotropic responses during cardiopulmonary exercise testing,which relates to poor cardiometabolic health and an increased risk for adverse cardiovascular events.It is unknown whether cardiac chronotropic incompetence(CI)during maximal exercise is already present in obese adolescents and,if so,how that relates to cardiometabolic health.Methods:Sixty-nine obese adolescents(body mass index standard deviation score=2.23±0.32,age=14.1±1.2 years;mean±SD)and 29lean adolescents(body mass index standard deviation score=-0.16±0.84,age=14.0±1.5 years)performed a maximal cardiopulmonary exercise testing from which indicators for peak performance were determined.The resting heart rate and peak heart rate were used to calculate the maximal chronotropic response index.Biochemistry(lipid profile,glycemic control,inflammation,and leptin)was studied in fasted blood samples and during an oral glucose tolerance test within obese adolescents.Regression analyses were applied to examine associations between the presence of CI and blood or exercise capacity parameters,respectively,within obese adolescents.Results:CI was prevalent in 32 out of 69 obese adolescents(46%)and 3 out of 29 lean adolescents(10%).C-reactive protein was significantly higher in obese adolescents with CI compared to obese adolescents without CI(p=0.012).Furthermore,peak oxygen uptake and peak cycling power output were significantly reduced(p<0.05)in obese adolescents with CI vs.obese adolescents without CI.The chronotropic index was independently related to blood total cholesterol(standardized coefficientβ=-0.332;p=0.012)and C-reactive protein concentration(standardized coefficientβ=-0.269;p=0.039).Conclusion:CI is more common in the current cohort of obese adolescents,and is related to systemic inflammation and exercise intolerance.展开更多
Environmental factors,including chemical/physical pollutants,as well as lifestyle and psychological factors,contribute greatly to the pathways leading to cardiometabolic diseases with a heavy disease burden and econom...Environmental factors,including chemical/physical pollutants,as well as lifestyle and psychological factors,contribute greatly to the pathways leading to cardiometabolic diseases with a heavy disease burden and economic loss.The concept of exposomes provides a novel paradigm for combining all exposure characteristics to evaluate disease risk.A solution-like exposome requires technological support to provide continuous data to monitor vital signs and detect abnormal fluctuations.Wearable devices allow people to conveniently monitor signals during their daily routines.These new technologies empower users to more actively prevent and manage cardiometabolic disease by reviewing risk factors of the disease,especially lifestyle factors,such as sleeping time,screen time,and mental health condition.Devices with multiple sensors can monitor electrocardiography data,oxygen saturation,intraocular pressure,respiratory rate,and heart rate to enhance the exposome study and provide precise suggestions for disease prevention and management.展开更多
Air pollution is known to be a major risk factor for cardiopulmonary disease, but this is unclear for cardiometabolic disease (e.g.diabetes). This is of considerable public health importance, given the nationwide epid...Air pollution is known to be a major risk factor for cardiopulmonary disease, but this is unclear for cardiometabolic disease (e.g.diabetes). This is of considerable public health importance, given the nationwide epidemic of diabetes, accompanied by severe air pollution, in China. The evidence so far remained inadequate to answer questions of whether individuals with cardiometabolic dysfunctions are susceptible to air pollution and whether air pollution exacerbates diabetes development via certain biological pathways. In this manuscript, we summarize the results and limitations of studies exploring these two topics and elaborate our design of a prospective panel study (SCOPE) as a solution. We assessed and compared the health effect of air pollution among pre-diabetic individuals and matched healthy controls through four repeated clinical visits over 1 year. Comprehensive evaluation was made to both health endpoints and exposure. The primary biomarkers were assessed to reveal the impact on multiple biological pathways, including glycolipid metabolism and insulin resistance, endothelial function, and inflammation. Detailed chemical and size fractional components of particulate matter were measured in this study, along with the application of personal monitors.The work should increase our understanding of how air pollution affects individuals with cardiometabolic dysfunction and the underlying mechanisms.展开更多
Background: In the past few decades, the incidence of cardiometabolic diseases and disorders of the liver, kidney, pancreas, heart, and lung, have been increasing in Western and Asian countries, including Japan. Numer...Background: In the past few decades, the incidence of cardiometabolic diseases and disorders of the liver, kidney, pancreas, heart, and lung, have been increasing in Western and Asian countries, including Japan. Numerous factors, including abnormal body weight (obesity, overweight, or underweight), infrequent exercise, and other unfavorable lifestyle factors (e.g., smoking and heavy alcohol drinking) have been proposed as risk factors for the development and the progression of diseases, such as type 2 diabetes, hypertension, and dyslipidemia, which ultimately lead to impaired organ function and possibly death. However, the mechanisms that link these risk factors with diseases are still poorly understood, and the potential treatments, including pharmacotherapy and diet, have not been fully evaluated. Methods: In 2011, we established a new collaborative research program, the Saitama Cardiometabolic Disease and Organ Impairment Study (SCDOIS). This multidisciplinary observational epidemiological research study was designed to cover several high-profile diseases and some traditional fields of internal medicine, as well as apparently unrelated fields and particular lifestyle factors, such as unhealthy eating behaviors. In a series of studies, apparently healthy subjects who underwent a regular medical checkup were retrospectively identified based on the results of their medical checkups. In this way, the incidence, prevalence, causality, and clinical relevance of specific conditions and diseases have been investigated in cross-sectional analyses of 100,000 - 200,000 adults, and in longitudinal studies of several thousand subjects who underwent medical checkups multiple times. Discussion: This article describes the background, rationale, purpose, and methods of the SCDOIS. Using data obtained from annual medical checkups, our goals are to 1) establish criteria or identify clinical features that would enable clinicians to detect the presence of abnormal conditions associated with cardiometabolic diseases and/or organ im展开更多
文摘Nonalcoholic fatty liver disease(NAFLD)is a multisystemic clinical condition that presents with a wide spectrum of extrahepatic manifestations,such as obesity,type 2 diabetes mellitus,metabolic syndrome,cardiovascular diseases,chronic kidney disease,extrahepatic malignancies,cogni-tive disorders,and polycystic ovarian syndrome.Among NAFLD patients,the most common mortality etiology is cardiovascular disorders,followed by extrahepatic malignancies,diabetes mellitus,and liver-related complications.Furthermore,the severity of extrahepatic diseases is parallel to the severity of NAFLD.In clinical practice,awareness of the associations of concomitant diseases is of major importance for initiating prompt and timely screening and multidisciplinary management of the disease spectrum.In 2020,a consensus from 22 countries redefined the disease as metabolic(dysfunction)-associated fatty liver disease(MAFLD),which resulted in the redefinition of the corre-sponding population.Although the patients diagnosed with MAFLD and NAFLD mostly overlap,the MAFLD and NAFLD populations are not identical.In this review,we compared the associations of key extrahepatic diseases between NAFLD and MAFLD.
基金The Fundamental Research Funds for the Central public welfare research institutes (Nos.ZZ13-YQ-014-C1 and ZZ13-YQ-014,China)the National Natural Science Foundation of China (No.82004194)Beijing Natural Science Foundation of China (No.7192185)。
文摘Cardiometabolic disease(CMD), characterized with metabolic disorder triggered cardiovascular events, is a leading cause of death and disability. Metabolic disorders trigger chronic low-grade inflammation, and actually, a new concept of metaflammation has been proposed to define the state of metabolism connected with immunological adaptations. Amongst the continuously increased list of systemic metabolites in regulation of immune system, bile acids(BAs) represent a distinct class of metabolites implicated in the whole process of CMD development because of its multifaceted roles in shaping systemic immunometabolism. BAs can directly modulate the immune system by either boosting or inhibiting inflammatory responses via diverse mechanisms. Moreover, BAs are key determinants in maintaining the dynamic communication between the host and microbiota. Importantly, BAs via targeting Farnesoid X receptor(FXR) and diverse other nuclear receptors play key roles in regulating metabolic homeostasis of lipids, glucose, and amino acids. Moreover, BAs axis per se is susceptible to inflammatory and metabolic intervention, and thereby BAs axis may constitute a reciprocal regulatory loop in metaflammation. We thus propose that BAs axis represents a core coordinator in integrating systemic immunometabolism implicated in the process of CMD. We provide an updated summary and an intensive discussion about how BAs shape both the innate and adaptive immune system, and how BAs axis function as a core coordinator in integrating metabolic disorder to chronic inflammation in conditions of CMD.
基金supported by grants from the World Diabetes Foundation(WDF05-108&07-308)Qingdao Outstanding Health Professional Development Fund and Qingdao Applied Basic Research Project(No.14-2-4-25-jch)
文摘Objective To determine whether elevated serum uric acid(UA)levels are associated with type 2 diabetes diagnosed using Hb A1 c levels among Chinese adults.Methods We conducted two population-based cross-sectional studies in Qingdao in China in 2006 and 2009.A total of 6894(39.4% men)subjects aged 35-74 years were included in the data analysis.Newly diagnosed diabetes was defined as Hb A1 c level of ≥6.5%,and prediabetes was classified as Hb A1 c level between 5.7% and 6.4% according to the International Diabetes Federation criteria.Multivariate logistic regression was employed to assess the association between UA and prevalence of type 2 diabetes defined using Glycated hemoglobin A1c(Hb A1 c levels.Results Subjects with prediabetes had higher UA levels than those with normal glucose tolerance,newly diagnosed diabetes,and known diabetes,with corresponding values of 325.1(82.5)μmol/L,310.9(84.2)μmol/L,291.3(81.7)μmol/L,305.2(83.6)μmol/L,respectively(P<0.001 for all comparisons).Binary logistic regression analysis showed that UA was a possible predictor for the prevalence of type 2 diabetes diagnosed using Hb A1 c levels,and the second quartile of UA levels had a higher odds ratio(OR:4.088;95% CI:2.900-5.765)for Hb A1 c than the other quartiles after adjusting for age,body mass index,sex,marital status,education,income,alcohol consumption,smoking,and cardiometabolic parameters.Conclusion Serum UA is significantly associated with type 2 diabetes diagnosed using Hb A1 c levels,independent of other cardiometabolic parameters.
文摘Background： Obstructive sleep apnea （OSA） syndrome has a negative impact on the health of millions of adolescents and youth. The aim of this study was to evaluate the associations of OSA syndrome with obesity and cardiometabolic risk factors among adolescents and youth at risk for metabolic syndrome （MS）.Methods： A total of 558 subjects aged 14-28 years were recruited from the Beijing Child and Adolescent Metabolic Syndrome Study. Each underwent a 2-h oral glucose tolerance test （OGTT）, echocardiography, and liver ultrasonography. Anthropometric measures, blood levels of glucose, lipids, and liver enzymes were assessed. Subjects with high or low risk for OSA were identified by Berlin Questionnaire （BQ）. Results： Among the subjects in obesity, 33.7% of whom were likely to have OSAby BQ. Subjects with high risk for OSA had higher neck and waist circumference and fat mass percentage compared to those with low risk for OSA （P 〈 0.001 ）. Moreover, significant differences in levels of lipids, glucose after OGTT, and liver enzymes, as well as echocardiographic parameters were found between the two groups with high or low risk for OSA （P 〈 0.05）. The rates of nonalcoholic fatty liver disease （71.0% vs. 24.2%）, MS （38.9% vs. 7.0%）, and its components in high-risk group were significantly higher than in low-risk group. Conclusions： The prevalence of OSA by BQ was high in obese adolescents and youth. A high risk for OSA indicates a high cardiometabolic risk. Mechanisms mediating the observed associations require further investigation.
基金supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development intramural funding and included American Recovery and Reinvestment Act funding via contract numbers HHSN275200800013C,HHSN275200800002I,HHSN27500006,HHSN275200800003IC,HHSN275200800014C,HHSN275200800012C,HHSN275200800028C,HHSN275201000009C,and HHSN275201000001Zsupported by a mentored research scientist development award from the National Institutes of Health Office of the Director and the Building Interdisciplinary Research Careers in Women's Health program(3K12HD052163).
文摘Objective::This study investigated the prospective associations of circulating levels of sex hormone-binding globulin(SHBG)levels with cardiometabolic biomarkers and risk of gestational diabetes(GDM)during pregnancy.It also examines the longitudinal trajectory of SHBG in women with and without GDM.Methods::We conducted a nested case-control study of 107 incident GDM cases and 214 matched controls within the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singleton Cohort.The cohort enrolled non-obese and obese women aged 18-40 years with a singleton pregnancy between 8 and 13 weeks of gestation from 2009 to 2013.GDM was ascertained via medical records review.Blood samples were drawn four times at gestational weeks 10-14,15-26,23-31,and 33-39.The prospective associations between SHBG levels and cardiometabolic biomarkers were examined using the Spearman partial correlation among the controls.The longitudinal trajectories of SHBG levels were examined among the cases and the controls.Meta-analysis of prospective studies were performed to examine the association between SHBG levels and GDM risk.Results::SHBG levels at gestational weeks 10-14 were significantly inversely associated with fasting insulin(r=-0.17,P=0.01)and insulin resistance as measured by HOMA-IR(r=-0.17,P=0.01)at gestational week 15-26.SHBG at gestational weeks 10-14 and 15-26 was lower in cases than controls(mean±standard deviation:(204.0±97.6)vs.(220.9±102.5)nmol/L,P=0.16 and(305.6±124.3)vs.(322.7±105.1)nmol/L,P=0.14,respectively),yet the differences were not significant.In the meta-analysis,SHBG was 41.5 nmol/L(95%confidence interval:23.9,59.1,P<0.01)significantly lower among women with GDM than without,and each 50 nmol/L increase in SHBG was significantly associated with an odds ratio of 0.85(95%confidence interval:0.76-0.95,P=0.01)for GDM.Conclusion::Lower SHBG levels in early pregnancy were prospectively associated with higher high insulin levels and insulin resistance in mid-pregnancy an
文摘AIM:To examine the effect of gastric bypass surgery on cardiometabolic health among women with polycystic ovarian syndrome(PCOS).METHODS:Retrospective medical chart review identified women(n = 389) with PCOS who underwent Roux-en-Y gastric bypass surgery from 2001-2009 in one surgical practice.Separate repeated measures linear mixed models were fit using the MIXED procedureto assess mean change in cardiometabolic disease risk factors from before to 1-year after surgery and were evaluated by ethnicity [Hispanic,non-Hispanic black(NHB) and white(NHW)].RESULTS:The majority of the sample was Hispanic(66%,25% NHB,9% NHW).Mean body mass index significantly improved 1 year post-surgery for all ethnic groups(45.5 to 35.5 kg/m2 for Hispanics,46.8 to 37.7 kg/m2 for NHB and 45.7 to 36.7 kg/m2 for NHW,P < 0.001).Among Hispanic women mean total cholesterol(198.1 to 160.2 mg/dL),low-density lipoproteins(LDL) cholesterol(120.9 to 91.0 mg/dL),triglycerides(148.6 to 104.8 mg/dL),hemoglobin A1c(6.2% to 5.6%),alanine aminotransferase(28.1 to 23.0 U/L) and aspartate aminotransferase(23.5 to 21.6 U/L) decreased significantly(P < 0.001).Among NHB,mean total cholesterol(184.5 to 154.7 mg/dL),LDL cholesterol(111.7 to 88.9 mg/dL) and triglycerides(99.7 to 70.0 mg/dL) decreased significantly(P < 0.05).Among NHW,mean total cholesterol(200.9 to 172.8 mg/dL) and LDL cholesterol(124.2 to 96.6 mg/dL),decreased significantly(P < 0.05).Pairwise ethnic group comparisons of all cardiometabolic outcomes adjusted for age and type of surgery before and 1 year after surgery showed no statistical difference between the three groups for any outcome.CONCLUSION:Cardiometabolic disease risk improvements vary by ethnicity and obesity may impact glucose tolerance and liver function changes more in Hispanic women with PCOS vs non-Hispanic women.
文摘The International Diabetes Federation estimates that 316million people are currently affected by impaired glucose tolerance(IGT).Most importantly,recent forecasts anticipate a dramatic IGT increase with more that 470million people affected by the year 2035.Impaired insulin sensitivity is major feature of obesity and diabetes and is strongly linked with adverse cardiometabolic phenotypes.However,the etiologic pathway linking impaired glucose tolerance and cardiovascular disease remains to be deciphered.Although insulin resistance has been attributed to inflammatory programs starting in adipose tissue,emerging evidence indicates that endothelial dysfunction may represent the upstream event preceding peripheral impairment of insulin sensitivity.Indeed,suppression of reactive oxygen species-dependent pathways in the endothelium has shown to restore insulin delivery to peripheral organs by preserving nitric oxide(NO)availability.Here we describe emerging theories concerning endothelial insulin resistance,with particular emphasis on the role oxidative stress.Complex molecular circuits including endothelial nitric oxide synthase,prostacyclin synthase,mitochondrial adaptor p66^(Shc),nicotinamide adenine dinucleotide phosphate-oxidase oxidase and nuclear factor kappa-B are discussed.Moreover,the review provides insights on the effectiveness of available compounds(i.e.,ruboxistaurin,sildenafil,endothelin receptor antagonists,NO donors)in restoring endothelial insulin signalling.Taken together,these aspects may significantly contribute to design novel therapeutic approaches to restore glucose homeostasis in patients with obesity and diabetes.
文摘BACKGROUND Education,cognition,and intelligence are associated with cholelithiasis occurrence,yet which one has a prominent effect on cholelithiasis and which cardiometabolic risk factors mediate the causal relationship remain unelucidated.AIM To explore the causal associations between education,cognition,and intelligence and cholelithiasis,and the cardiometabolic risk factors that mediate the associations.METHODS Applying genome-wide association study summary statistics of primarily European individuals,we utilized two-sample multivariable Mendelian randomization to estimate the independent effects of education,intelligence,and cognition on cholelithiasis and cholecystitis(FinnGen study,37041 and 11632 patients,respectively;n=486484 participants)and performed two-step Mendelian randomization to evaluate 21 potential mediators and their mediating effects on the relationships between each exposure and cholelithiasis.RESULTS Inverse variance weighted Mendelian randomization results from the FinnGen consortium showed that genetically higher education,cognition,or intelligence were not independently associated with cholelithiasis and cholecystitis;when adjusted for cholelithiasis,higher education still presented an inverse effect on cholecystitis[odds ratio:0.292(95%CI:0.171-0.501)],which could not be induced by cognition or intelligence.Five out of 21 cardiometabolic risk factors were perceived as mediators of the association between education and cholelithiasis,including body mass index(20.84%),body fat percentage(40.3%),waist circumference(44.4%),waist-to-hip ratio(32.9%),and time spent watching television(41.6%),while time spent watching television was also a mediator from cognition(20.4%)and intelligence to cholelithiasis(28.4%).All results were robust to sensitivity analyses.CONCLUSION Education,cognition,and intelligence all play crucial roles in the development of cholelithiasis,and several cardiometabolic mediators have been identified for prevention of cholelithiasis due to defects in each exposure.
基金supported by the National Natural Science Foundation of China(No.82074295)the Science and Technology Program of Tibet Grant(No.XZ202201ZY0051G)。
文摘Background There are several surrogate indicators of abdominal fat deposition,including tri-ponderal mass index(TMI),lipid accumulation product(LAP),and the Chinese visceral adiposity index(CVAI).In spite of this,it remains unclear whether these indices have a longitudinal relationship with the prevalence of cardiometabolic multimorbidity(CM),a pressing global health issue.This research investigated the association between CVAI and CM compared to other indicators of visceral obesity.Methods 6638 participants(aged>45)from the China Health and Retirement Longitudinal Study(CHARLS)were analyzed for incident CM.Cox proportional models were adopted to explore whether the level of CVAI was correlated with the risk of CM.Harrell's concordance statistic(C-statistic)was applied to compare predictive values.Sensitivity and subgroup analyses were implemented for the steadiness of the results.Results Over 4 years,266(4.01%)participants developed CM.A 1-standard deviation(SD)increase in the levels of CVAI,body mass index(BMI),LAP,and TMI was associated with greater CM risk after adjusting for confounders[hazard ratios(HRs):2.20,95%confidence interval(CI):1.88-2.57,1.92(95%CI:1.55-2.38),1.20(95%CI:1.12-1.27),and 1.50(95%CI:1.35-1.66),respectively].CVAI outperformed other indices in predictive performance.Subgroup analysis revealed younger participants or those living alone were more prone to developing CM.Results were potent after finishing all sensitivity analyses.Conclusions The study highlighted a positive correlation between the level of CVAI and CM risk.CVAI's superior predictive performance positions it as a reliable indicator for identifying individuals at heightened CM risk.
基金supported by grants from the National Basic Research Program of China(2012CB517805,2012CB517806)(Z.M.Z.and D.Y.L.)National Natural Science Foundation of China(81130006)(Z.M.Z.).
文摘Hypertension is a serious public health problem worldwide.More than 60%of the risk factors for hypertension are associated with metabolic disturbances.Metabolic abnormalities increase the risk for hypertension and cause high blood pressure.Improving metabolic disturbances is beneficial for hypertension treatment.Due to the importance of metabolic abnormalities in the pathogenesis of hypertension,we propose a concept of metabolic hypertension.In this review,we discuss and review the clinical types,pathogenesis,risk evaluation and management of metabolic hypertension.Elucidation of the mechanism of metabolic hypertension should facilitate the design of novel pharmacotherapeutics and dedicated antihypertensive manipulations.
文摘BACKGROUND Breast milk is the best and principal nutritional source for neonates and infants.It may protect infants against many metabolic diseases,predominantly obesity and type 2 diabetes.Diabetes mellitus(DM)is a chronic metabolic and microvascular disease that affects all the body systems and all ages from intrauterine life to late adulthood.Breastfeeding protects against infant mortality and diseases,such as necrotizing enterocolitis,diarrhoea,respiratory infections,viral and bacterial infection,eczema,allergic rhinitis,asthma,food allergies,malocclusion,dental caries,Crohn's disease,and ulcerative colitis.It also protects against obesity and insulin resistance and increases intelligence and mental development.Gestational diabetes has short and long-term impacts on infants of diabetic mothers(IDM).Breast milk composition changes in mothers with gestational diabetes.AIM To investigate the beneficial or detrimental effects of breastfeeding on the cardiometabolic health of IDM and their mothers.METHODS We performed a database search on different engines and a thorough literature review and included 121 research published in English between January 2000 and December 15,2022,in this review.RESULTS Most of the literature agreed on the beneficial effects of breast milk for both the mother and the infant in the short and long terms.Breastfeeding protects mothers with gestational diabetes against obesity and type 2 DM.Despite some evidence of the protective effects of breastfeeding on IDM in the short and long term,the evidence is not strong enough due to the presence of many confounding factors and a lack of sufficient studies.CONCLUSION We need more comprehensive research to prove these effects.Despite many obstacles that may enface mothers with gestational diabetes to start and maintain breastfeeding,every effort should be made to encourage them to breastfeed.
基金Supported by National Institutes of Health,No.K01 DA 026993
文摘AIM: To generate prevalence estimates of weight status and cardiometabolic disease risk factors among adolescents with and without disabilities.METHODS: Analysis of the 1999-2010 National Health and Nutrition Examination Survey data was conducted among 12-18 years old with(n = 256) and without disabilities(n = 5020). Mean values of waist circumference, fasting glucose, high-density-lipoprotein cholesterol, triglycerides, systolic and diastolic blood pressure and metabolic syndrome(Met S, ≥ 3 risk factors present) were examined by the following standardized body mass index(BMI) categories for those with and without disabilities; overweight(BMI ≥ 85th- < 95 th percentile for age and sex), obesity(BMI ≥ 95 th percentile) and severe obesity(BMI ≥35 kg/m2). Linear regression models were fit with each cardiometabolic disease risk factor independently as continuous outcomes to show relationships with disability status. RESULTS: Adolescents with disabilities were significantlymore likely to be overweight(49.3%), obese(27.6%) and severely obese(12%) vs their peers without disabilities(33.1%, 17.5% and 3.6%, respectively, P ≤ 0.01 for all). A higher proportion of overweight, obese and severely obese children with disabilities had abnormal SBP, fasting lipids and glucose as well as Met S(18.9% of overweight, 32.3% of obese, 55% of severely obese) vs their peers without disabilities(9.7%, 16.8%, 36.3%, respectively). US adolescents with disabilities are over three times as likely to have Met S(OR = 3.45, 95%CI: 1.08-10.99, P = 0.03) vs their peers with no disabilities.CONCLUSION: Results show that adolescents with disabilities are disproportionately affected by obesity and poor cardiometabolic health vs their peers with no disabilities. Health care professionals should monitor the cardiometabolic health of adolescents with disabilities.
文摘AIM:To determine the benefits of a 10-wk resistance training programme on cardiovascular health in nonobese and active adolescents.METHODS:This is a pragmatic randomised controlled intervention.The study was carried out in a Hong Kong Government secondary school.Thirty-eight lean and active boys and girls were randomised to either the resistance training group or the control group.Students in the resistance training group received in-school 10-wk supervised resistance training twice per week,with each session lasting 70 min.Main outcome measures taken before and after training included brachial endothelial dependent flow-mediated dilation,body composition,fasting serum lipids,fasting glucose and insulin,high sensitive C-reactive protein,24-h ambulatory blood pressure and aerobic fitness.RESULTS:The only training related change was in endothelial dependent flow-mediated dilation which increased from 8.5%to 9.8%.A main effect of time and an interaction(P<0.005) indicated that this improvement was a result of the 10-wk resistance training.Main effects for time(P<0.05) in a number of anthropometric,metabolic and vascular variables were noted;however,there were no significant interactions indicating the change was more likely an outcome of normal growth and development as opposed to a training effect.CONCLUSION:Ten weeks of resistance training in school appears to have some vascular benefit in active,lean children.
文摘BACKGROUND Time-restricted eating(TRE)is a dietary approach that limits eating to a set number of hours per day.Human studies on the effects of TRE intervention on cardiometabolic health have been contradictory.Heterogeneity in subjects and TRE interventions have led to inconsistency in results.Furthermore,the impact of the duration of eating/fasting in the TRE approach has yet to be fully explored.AIM To analyze the existing literature on the effects of TRE with different eating durations on anthropometrics and cardiometabolic health markers in adults with excessive weight and obesity-related metabolic diseases.METHODS We reviewed a series of prominent scientific databases,including Medline,Scopus,Web of Science,Academic Search Complete,and Cochrane Library articles to identify published clinical trials on daily TRE in adults with excessive weight and obesity-related metabolic diseases.Randomized controlled trials were assessed for methodological rigor and risk of bias using version 2 of the Cochrane risk-of-bias tool for randomized trials(RoB-2).Outcomes of interest include body weight,waist circumference,fat mass,lean body mass,fasting glucose,insulin,HbA1c,homeostasis model assessment for insulin resistance(HOMA-IR),lipid profiles,C-reactive protein,blood pressure,and heart rate.RESULTS Fifteen studies were included in our systematic review.TRE significantly reduces body weight,waist circumference,fat mass,lean body mass,blood glucose,insulin,and triglyceride.However,no significant changes were observed in HbA1c,HOMA-IR,total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,heart rate,systolic and diastolic blood pressure.Furthermore,subgroup analyses based on the duration of the eating window revealed significant variation in the effects of TRE intervention depending on the length of the eating window.CONCLUSION TRE is a promising chrononutrition-based dietary approach for improving anthropometric and cardiometabolic health.However,further clinical trials are needed to det
基金Special project for clinical research of health industry of Shanghai Health Commission,Grant/Award Number:201940114。
文摘Background:The epidemic of overweight and obesity has become a worldwide public health problem.Cardiometabolic diseases may originate in childhood.We investigated the association between percent body fat(PBF)measured by the bioelectrical impedance assay and cardiometabolic risk(CMR)in pediatrics.Methods:This cross-sectional study involved 3819 subjects(6-17 years old)in Shanghai.We assessed the association between PBF and body mass index(BMI)with multiple CMR factors.We examined the risk for cardiometabolic abnormalities attributable to overweight and obesity based on age-and sexspecific PBF Z-scores and BMI Z-scores,respectively.Results:PBF,but not BMI,was positively associated with multiple CMR factors in males and females except for total cholesterol in females(all p<0.05).Compared with the non-overweight group based on PBF,overweight and obese subjects had increasingly higher odds ratio of dyslipidemia(2.90(1.99-4.23),4.59(2.88-7.32)for males and 1.82(1.20-2.75),2.46(1.47-4.11)for females)and elevated blood pressure(BP)(3.26(2.35-4.51),4.55(2.92-7.09)for males and 1.59(1.07-2.34),3.98(2.27-6.17)for females).Obesity females showed a higher likelihood for hyperglycemia(2.19(1.24-3.84))than non-overweight females.In both sexes,the predictive effect of PBF on dyslipidemia and elevated BP in adolescents was better than that in children.For hyperglycemia,the predictive effect of PBF was better in male adolescents and female children.There was no risk difference for cardiometabolic abnormalities attributable to BMI-based obesity categories.Conclusions:PBF but not BMI was associated with CMR.Overweight and obesity categories based on PBF had an increased risk for cardiometabolic abnormalities in children and adolescents.
基金supported by NIH(DK111436,HL153320,AG069966,and ES027544)the John S.Dunn Foundation,the Mrs.Clifford Elder White Graham Endowed Research Fund,theDan L Duncan Comprehensive Cancer Center(P30CA125123)+2 种基金the Texas Medical Center Digestive Diseases Center(P30DK056338)the SPORE program in lymphoma at Baylor College of Medicine(P50 CA126752)the Gulf Coast Center for Precision Environmental Health(P30ES030285).
文摘The central circadian clock in the brain controls the time-of-the-day variations in acute meal responses,with a low glycemic response but a high satiety/thermo-genic response to meals consumed at waking compared to other time points.Consistently,studies show that consuming a significant proportion of calories,particularly carbohydrates,in breakfast is beneficial for the chronic management of obesity and its associated metabolic syndrome,compared to consuming identical meals at dinner.Conversely,breakfast skipping or/and late dinner can have unfavorable metabolic outcomes.It remains controversial how meal frequency affects metabolic health.In contrast,irregular meals,especially irregular breakfasts,show consistent adverse metabolic consequences.Time-restricted feeding(TRF),with all calories consumed within less than 12-h per day,can improve metabolism and extend lifespan.A major component of TRF in humans is caloric restriction,which contributes significantly to the beneficial effects of TRF in humans.By comparison,TRF effects in rodents can be independent of caloric restriction and show day/night phase specificity.TRF could alleviate metabolic abnormalities due to circadian disruption,but its effects appear independent of the circadian clock in rodents.Understanding neuroendocrine mechanisms underlying clock-mediated metabolic regulation will shed light on the metabolic effects of temporal meal patterns.
文摘Background:Adults with obesity may display disturbed cardiac chronotropic responses during cardiopulmonary exercise testing,which relates to poor cardiometabolic health and an increased risk for adverse cardiovascular events.It is unknown whether cardiac chronotropic incompetence(CI)during maximal exercise is already present in obese adolescents and,if so,how that relates to cardiometabolic health.Methods:Sixty-nine obese adolescents(body mass index standard deviation score=2.23±0.32,age=14.1±1.2 years;mean±SD)and 29lean adolescents(body mass index standard deviation score=-0.16±0.84,age=14.0±1.5 years)performed a maximal cardiopulmonary exercise testing from which indicators for peak performance were determined.The resting heart rate and peak heart rate were used to calculate the maximal chronotropic response index.Biochemistry(lipid profile,glycemic control,inflammation,and leptin)was studied in fasted blood samples and during an oral glucose tolerance test within obese adolescents.Regression analyses were applied to examine associations between the presence of CI and blood or exercise capacity parameters,respectively,within obese adolescents.Results:CI was prevalent in 32 out of 69 obese adolescents(46%)and 3 out of 29 lean adolescents(10%).C-reactive protein was significantly higher in obese adolescents with CI compared to obese adolescents without CI(p=0.012).Furthermore,peak oxygen uptake and peak cycling power output were significantly reduced(p<0.05)in obese adolescents with CI vs.obese adolescents without CI.The chronotropic index was independently related to blood total cholesterol(standardized coefficientβ=-0.332;p=0.012)and C-reactive protein concentration(standardized coefficientβ=-0.269;p=0.039).Conclusion:CI is more common in the current cohort of obese adolescents,and is related to systemic inflammation and exercise intolerance.
基金National Natural Science Foundation of China,Grant/Award Number:818725987。
文摘Environmental factors,including chemical/physical pollutants,as well as lifestyle and psychological factors,contribute greatly to the pathways leading to cardiometabolic diseases with a heavy disease burden and economic loss.The concept of exposomes provides a novel paradigm for combining all exposure characteristics to evaluate disease risk.A solution-like exposome requires technological support to provide continuous data to monitor vital signs and detect abnormal fluctuations.Wearable devices allow people to conveniently monitor signals during their daily routines.These new technologies empower users to more actively prevent and manage cardiometabolic disease by reviewing risk factors of the disease,especially lifestyle factors,such as sleeping time,screen time,and mental health condition.Devices with multiple sensors can monitor electrocardiography data,oxygen saturation,intraocular pressure,respiratory rate,and heart rate to enhance the exposome study and provide precise suggestions for disease prevention and management.
基金supported by the National Natural Science Foundation of China (41421064,21190051, 41121004)the China Postdoc Science Foundation (154248)
文摘Air pollution is known to be a major risk factor for cardiopulmonary disease, but this is unclear for cardiometabolic disease (e.g.diabetes). This is of considerable public health importance, given the nationwide epidemic of diabetes, accompanied by severe air pollution, in China. The evidence so far remained inadequate to answer questions of whether individuals with cardiometabolic dysfunctions are susceptible to air pollution and whether air pollution exacerbates diabetes development via certain biological pathways. In this manuscript, we summarize the results and limitations of studies exploring these two topics and elaborate our design of a prospective panel study (SCOPE) as a solution. We assessed and compared the health effect of air pollution among pre-diabetic individuals and matched healthy controls through four repeated clinical visits over 1 year. Comprehensive evaluation was made to both health endpoints and exposure. The primary biomarkers were assessed to reveal the impact on multiple biological pathways, including glycolipid metabolism and insulin resistance, endothelial function, and inflammation. Detailed chemical and size fractional components of particulate matter were measured in this study, along with the application of personal monitors.The work should increase our understanding of how air pollution affects individuals with cardiometabolic dysfunction and the underlying mechanisms.
文摘Background: In the past few decades, the incidence of cardiometabolic diseases and disorders of the liver, kidney, pancreas, heart, and lung, have been increasing in Western and Asian countries, including Japan. Numerous factors, including abnormal body weight (obesity, overweight, or underweight), infrequent exercise, and other unfavorable lifestyle factors (e.g., smoking and heavy alcohol drinking) have been proposed as risk factors for the development and the progression of diseases, such as type 2 diabetes, hypertension, and dyslipidemia, which ultimately lead to impaired organ function and possibly death. However, the mechanisms that link these risk factors with diseases are still poorly understood, and the potential treatments, including pharmacotherapy and diet, have not been fully evaluated. Methods: In 2011, we established a new collaborative research program, the Saitama Cardiometabolic Disease and Organ Impairment Study (SCDOIS). This multidisciplinary observational epidemiological research study was designed to cover several high-profile diseases and some traditional fields of internal medicine, as well as apparently unrelated fields and particular lifestyle factors, such as unhealthy eating behaviors. In a series of studies, apparently healthy subjects who underwent a regular medical checkup were retrospectively identified based on the results of their medical checkups. In this way, the incidence, prevalence, causality, and clinical relevance of specific conditions and diseases have been investigated in cross-sectional analyses of 100,000 - 200,000 adults, and in longitudinal studies of several thousand subjects who underwent medical checkups multiple times. Discussion: This article describes the background, rationale, purpose, and methods of the SCDOIS. Using data obtained from annual medical checkups, our goals are to 1) establish criteria or identify clinical features that would enable clinicians to detect the presence of abnormal conditions associated with cardiometabolic diseases and/or organ im
