Chronic Diseases and Translational Medicine
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Insulin resistance is the central abnormality and mechanism underlying the progression of cardiometabolic‐based chronic diseases. This study aimed to evaluate the trends in insulin resistance and β‐cell dysfunction from 2001 to 2016 among US adults with undiagnosed diabetes, prediabetes, and normal glucose regulation and to provide sex‐specific information using data from National Health and Nutrition Examination Surveys (NHANES) 2001–2016.
Data from 14,481 participants aged over 20 years from 8 consecutive 2‐year cross–sectional cycles of the NHANES from 2001 to 2016 were used. Updated homoeostasis model assessment 2 (HOMA2: HOMA2%B for β‐cell function and HOMA2IR for insulin resistance) was used as a surrogate measure. We defined the upper sex‐specific tertile of HOMA2IR as insulin resistance and the lower corresponding tertile of HOMA2%B as low β‐cell function.
In both sexes with undiagnosed diabetes, HOMA2%B (men,
Over 16 years, insulin resistance demonstrated an increasing trend in adult US population with prediabetes, while β‐cell function showed a compensatory increasing trend. Identifying people with prediabetes early and focusing on reducing insulin resistance as the intervention core, especially controlling central obesity, might increase the opportunity for cardiovascular and diabetes risk reduction.
From December 31st, 2019, a novel highly pathogenic coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), has spread worldwide, reaching at present the dimension of a pandemic. In addition to damaging the lungs, SARS‐CoV‐2 may also damage the heart and this is corroborated by the evidence that cardiovascular comorbidities are associated with a higher mortality and poor clinical outcomes in patient infected by the virus. During the infection myocardial injury, myocarditis and arrhythmias have also been reported, but the pathophysiological mechanisms of these complications are yet to be understood. Great attention is also being posed on the potential beneficial/harmful role of angiotensin converting enzyme (ACE) inhibitors, as far as the virus binds to ACE2 to infect cells, but evidences lack. Furthermore, SARS‐CoV‐2 can also affect the aspect of acute coronary syndromes, not only because these two distinct pathological entities share pathogenic aspects (such as the systemic inflammatory state and cytokine release), but also and above all for the consequences that the need to contain the infection has on the management of cardiological urgencies. The aim of this review was therefore to summarize the relationship between the virus and the cardiovascular system.
Cardiovascular disease (CVD) and environmental degradation are leading global health problems of our time. Recent studies have linked exposure to heavy metals to the risks of CVD and diabetes, particularly in populations from low‐ and middle‐income countries, where concomitant rapid development occurs. In this review, we 1) assessed the totality, quantity, and consistency of the available epidemiological studies, linking heavy metal exposures to the risk of CVD (including stroke and coronary heart disease); 2) discussed the potential biological mechanisms underlying some tantalizing observations in humans; and 3) identified gaps in our knowledge base that must be investigated in future work. An accumulating body of evidence from both experimental and observational studies implicates exposure to heavy metals, in a dose‐response manner, in the increased risk of CVD. The limitations of most existing studies include insufficient statistical power, lack of comprehensive assessment of exposure, and cross‐sectional design. Given the widespread exposure to heavy metals, an urgent need has emerged to investigate these putative associations of environmental exposures, either independently or jointly, with incident CVD outcomes prospectively in well‐characterized cohorts of diverse populations, and to determine potential strategies to prevent and control the impacts of heavy metal exposure on the cardiometabolic health outcomes of individuals and populations.
We used intravascular ultrasound (IVUS) to analyze the features of coronary artery atheromatous plaque in patients with impaired glucose tolerance and mild‐to‐moderate angiographic coronary stenosis. The aim was to determine the clinical significance of plaque characteristics as well as the relationship between hemoglobin A1c (HbA1c) levels and coronary artery lesions.
HbA1c levels were evaluated in 85 patients (96 lesions), of whom 46 had impaired glucose tolerance (IGT Group) and 39 had normal blood glucose (NBG Group). IVUS was used to analyze the lesion vessel of both groups qualitatively and quantitatively. The external elastic membrane area (EEMA), minimal lumen area (MLA), plaque area (PA), and plaque burden (PB) were measured for both the target lesion and the reference segments (reference external elastic membrane area (REEMA), reference minimal lumen area (RMLA), reference plaque area (RPA), and reference plaque burden (RPB), respectively).
HbA1c levels were significantly higher in the IGT Group than in the NBG Group (
IVUS is very valuable for the evaluation of mild‐to‐moderate coronary lesions. The coronary artery lesions in patients with IGT are more serious and widespread than those in patients with NBG. HbA1c levels might be of some value in assessing the severity of coronary artery lesions.
Gestational diabetes mellitus (GDM) refers to diabetes diagnosed in the second or third trimester of pregnancy that is not clearly either type 1 or type 2 diabetes. GDM is a common medical complication in pregnancy that has been rapidly increasing worldwide. GDM is associated with both short‐ and long‐term health issues for both mothers and offspring. Consistent with type 2 diabetes, peripheral insulin resistance contributes to the hyperglycemia associated with GDM. Accordingly, it is important to identify strategies to reduce the insulin resistance associated with GDM. To date, observational studies have shown that exercise can be a non‐invasive therapeutic option for preventing and managing GDM that can be readily applied to the antenatal population. However, the relevant mechanisms for these outcomes are yet to be fully elucidated. The present review aimed to explain the potential mechanisms of exercise from the perspective of reducing the insulin resistance, which is the root cause of GDM. Exercise recommendations and opinions of exercise during pregnancy are briefly summarized.
Management of Graves' orbitopathy (GO) continues to be a challenge to clinical endocrinologists. In the last few years, surveys on GO management have succeeded in elucidating trends in Europe and Latin America. To determine how endocrinologists in China assess and treat patients with GO and gain insight into how to make the management of this disease more uniform and standardized.
Based on the questionnaire used in the European survey on GO, a questionnaire in China was drafted and circulated to the members of Chinese Society of Endocrinology (CSE) during the annual meeting.
A total of 124 valid responses were analysed. Almost all respondents (94.4%) claimed that a multidisciplinary approach for GO management was valuable. Over 80% of the participants advocated the assessment of exophthalmometry, vision, visual fields by perimetry, eye movements, and fundoscopy. Glucocorticoids were preferred as the first‐line therapy by 92.7% of respondents, among them, 59.7% choose the intravenous route. The treatment strategy for GO with intravenous glucocorticoids therapy still remains debatable. Anti‐thyroid drugs (ATDs) were the most common choice (72.6%) for first‐line therapy of coexisting hyperthyroidism. Treatment options for GO were very similar among Chinese, Latin‐American and European respondents, whereas radioactive iodine and surgical treatment were more often indicated for co‐existing hyperthyroidism in China.
The appropriate treatment for patients with GO is controversial even among thyroid specialists. Further training of thyroid specialists, easier access of patients to multidisciplinary centres and establishment of practice guidelines are required for the management of this condition in China.
Ten‐eleven translocation (TET) methylcytosine dioxygenases catalyze the oxidative reactions of 5‐methylcytosine (5‐mC) to 5‐hydroxymethylcytosine (5‐hmC), 5‐formylcytosine (5‐fC), and 5‐carboxylcytosine (5‐caC), which are intermediate steps during DNA demethylation. It is reported that somatic mutations of TET2 gene are identified in a variety of human tumors, especially in hematological malignancies. The tendency and mechanism of cellular differentiation in different systems are affected by TET2 via regulation of associated gene expression or maintenance of demethylated state. TET2 acts as a critical driver of tumorigenesis through the conversion of 5‐mC to 5‐hmC and successive oxidation products. Sometimes, it requires special interactions and cofactors. Here, we reviewed recent advances in understanding the function of TET2 proteins in regulating cell differentiation, and its role in various tumors focusing on several digestive cancers.
Thirdhand smoke (THS), the residual tobacco smoke remaining in the environment after tobacco has been smoked, represents a hidden and underestimated public health hazard. Evidence supports its widespread presence in indoor environments. Exposure to secondhand smoke (SHS), a precursor of THS, has been well documented as a risk factor for human cancers, especially lung cancer. However, the concept of THS as a distinct entity that poses health risks for small children has developed only recently and the associations of THS with cancer risk and other chronic diseases are poorly understood due to limited numbers of studies to date. In this perspective, we mainly summarize all published studies on the genotoxicity and carcinogenic potential of THS exposure. These studies begin to fill the knowledge gap in our understanding of cancer risk of THS. Accumulating data from existing and future studies will help reduce the tobacco‐related cancer incidence through changes in lifestyle and tobacco control policies.
Previous studies of ambient air pollutants and ventricular arrhythmias in patients with implantable cardioverter‐defibrillator (ICD) have yielded mixed results, and the association between air pollution and ventricular arrhythmias in these patients remains unclear. This study aimed to assess and quantify the association between exposure to major air pollutants [CO, inhalable particles (PM10), SO2, fine particulate matter (PM2.5), O3, and NO2] and the presence of ventricular arrhythmia in patients with ICD.
The Medline, PubMed, Web of Science, Global Health Library, Virtual Health Library, Population Information Online (POPLINE), and New York Academy of Medicine Grey Literature Report databases were searched to identify studies analyzing the association between ventricular arrhythmias in patients with ICD and the abovementioned main air pollutants. Pooled estimates were generated using a random‐effects model or fixed‐effects model, according to the value of heterogeneity. Heterogeneity within studies was assessed using Cochran's
After a detailed screening of 167 studies, seven separate studies were identified. Ventricular arrhythmias in patients with ICD were found to be positively, but not significantly, associated with CO, PM10, SO2, PM2.5, and NO2, with a pooled estimate [odds ratio (
The results of this study provide little evidence that ambient air pollutants affect the risk of ICD discharges for treating ventricular arrhythmias.
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