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McIntyre D, Quintans D, Kazi S, Min H, He WQ, Marschner S, Khera R, Nassar N, Chow CK. Impact of the COVID-19 pandemic on hospital-based heart failure care in New South Wales, Australia: a linked data cohort study. BMC Health Serv Res 2024; 24:1364. [PMID: 39516863 PMCID: PMC11545568 DOI: 10.1186/s12913-024-11840-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Accepted: 10/25/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND Healthcare policy implemented during the COVID-19 pandemic may have impacted the health of patients with heart failure. Australian data provide a unique opportunity to examine service disruption independent of significant COVID-19 burden. This study aimed to examine heart failure care during the pandemic in New South Wales (NSW). METHODS Analysis of hospital utilisation among patients aged ≥ 18 years with a primary diagnosis of heart failure conducted using linked administrative health records from hospital admission, emergency department, non-admitted services, and mortality data collections. Health service utilisation and outcomes were compared "Pre-pandemic" (PP): 16th March 2018 - 28th August 2019 and "During pandemic" (DP): 16th March 2020 - 28th August 2021. Mortality data were available until December 2021. RESULTS Heart failure-related ED presentations and hospital admissions were similar between the periods (PP = 15,324 vs DP = 15,023 ED presentations, PP = 24,072 vs DP = 23,145 hospital admissions), though rates of admission from ED were lower DP (PP = 12,783/15,324 (83.4% [95% CI 82.8-84.0]) vs DP = 12,230/15,023 (81.4% [95% CI 80.8-82.0%]). There was no difference according to age, sex, rurality, or socioeconomic status. Outpatient volume reduced DP (PP = 44,447 vs DP = 35,801 occasions of service), but telehealth visits increased nearly threefold (PP = 5,978/44,447 (13.4% [95% CI 13.1-13.8%]) vs DP = 15,901/35,801 (44.4% [95% CI 43.9-44.9%]) with highest uptake among the wealthy and those in major cities. Time to heart failure-related ED presentation, hospitalisation or all-cause mortality following index admission was longer DP (PP = 273 [IQR 259, 290] days, DP = 323 [IQR 300, 342] days, HR 0.91 [95% CI 0.88, 0.95]). CONCLUSIONS Policies implemented DP had minimal impact on volumes of inpatient heart failure care in NSW hospitals, but there were fewer admissions from ED and reduced volumes of publicly funded outpatient care. A rapid shift from patient-facing to remotely delivered care enabled compliance with restrictions and was associated with increased time to heart failure-related adverse events, but access was not afforded equally across the socio-demographic spectrum.
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Affiliation(s)
- Daniel McIntyre
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2145, Australia.
| | - Desi Quintans
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2145, Australia
| | - Samia Kazi
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2145, Australia
| | - Haeri Min
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2145, Australia
| | - Wen-Qiang He
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Simone Marschner
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2145, Australia
| | - Rohan Khera
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Section of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, USA
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, USA
| | - Natasha Nassar
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, University of Sydney, Westmead, NSW, Australia
| | - Clara K Chow
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2145, Australia
- Charles Perkins Centre, University of Sydney, Westmead, NSW, Australia
- Department of Cardiology, Westmead Hospital, Westmead, Australia
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Peikert SA, Metzger S, Kruse AB, Mittelhamm F, Frisch E, Vach K, Ratka-Krüger P, Woelber JP. The seasonal occurrence of periodontitis - a retrospective cohort study from a practice-based research network. Clin Oral Investig 2024; 28:596. [PMID: 39400750 PMCID: PMC11473543 DOI: 10.1007/s00784-024-05972-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 09/28/2024] [Indexed: 10/15/2024]
Abstract
OBJECTIVE Many diseases are characterised by their seasonal appearance due to circannual changes in immune defence and a lifestyle that changes over the seasons. However, there is a lack of studies regarding the influence of seasonality on periodontitis. Therefore, the aim of this non-interventional, retrospective, observational study was to investigate the influence of seasonality on periodontitis. MATERIALS AND METHODS Periodontal parameters of 5,908 patients of a practice-based research network (PBRN) were analysed. Probing pocket depth (PPD), Bleeding on Probing (BOP) and tooth mobility were assessed for seasonal fluctuations. RESULTS Within the PBRN patient data, seasonality was significantly associated with PPD of the individual months in patients with periodontitis. Pairwise comparison between the months showed significantly higher PPD in July compared to several months. PPD appeared significantly lower in December compared to June and November. Regarding season, the proportion of deep PPDs ([Formula: see text]6 mm) was significantly higher in summer compared to autumn (p = 0.024). Concerning BOP, a significant difference between winter and autumn could be observed (p = 0.016). No seasonal influence was found for tooth mobility. CONCLUSION This practice-network based study indicated a tendency for seasonal variations in periodontal parameters among periodontal patients. However, the differences did not achieve clinical relevance. CLINICAL RELEVANCE Regarding the seasonality of several diseases there might also be an influence of seasons on the periodontium, which would have a potential influence on periodontal studies and daily periodontal examination.
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Affiliation(s)
- Stefanie Anna Peikert
- Department of Dental Medicine and Oral Health, Medical University of Graz, Billrothgasse 4, Graz, 8010, Austria.
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
| | - Stephanie Metzger
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Anne Brigitte Kruse
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | | | - Eberhard Frisch
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
- Private Dental Practice, Industriestraße 17 A, 34369, Hofgeismar, Germany
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Stefan-Meier-Straße 26, 79104, Freiburg im Breisgau, Germany
| | - Petra Ratka-Krüger
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Johan Peter Woelber
- Policlinic of Operative Dentistry, Periodontology, and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
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Zhou Y, Jin Y, Zhang Z. Short-term exposure to nitrogen dioxide and emergency department visits for cause-stroke: a time-series study in Shanghai, China, 2013-2022. Environ Health Prev Med 2024; 29:67. [PMID: 39647864 PMCID: PMC11631555 DOI: 10.1265/ehpm.24-00304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Accepted: 11/01/2024] [Indexed: 12/10/2024] Open
Abstract
BACKGROUND The association between air pollution and an increased risk of cardiovascular diseases, including stroke, is well-established. However, it remains unclear how reductions in pollutant levels-resulting from clean air policies and the COVID-19 lockdown-affect this relationship. METHODS A time-series study was conducted using data from Shanghai, China, spanning from 2013 to 2022, divided into two periods (2013-2019 and 2020-2022). Daily air pollution data were obtained from China's air quality platform, while stroke emergency department (ED) visits were sourced from Renhe Hospital. We employed quasi-Poisson regression to analyze the relationship between daily pollutant levels and stroke ED visits, with stratified analyses by sex, age, season, and period. The study identified significant reductions in six pollutants (PM2.5, PM10-2.5, PM10, SO2, NO2, CO) during the 2020-2022 period compared to 2013-2019. RESULTS Significant reductions in six air pollutants (NO2, PM2.5, PM10-2.5, PM10, SO2, CO) were observed during 2020-2022 compared to 2013-2019. Higher daily NO2 levels were associated with an increased risk of stroke and its subtypes throughout the study, with a stronger correlation observed in the 2020-2022 period (P < 0.001). Subgroup analyses indicated that females and individuals aged 65-74 experienced the highest risks. The elevated stroke risk was particularly pronounced in the summer during 2020-2022. A two-factor model demonstrated that combined exposure to NO2 and other pollutants increased stroke risk. CONCLUSIONS This study heightened that reduced NO2 levels generally mitigate the adverse effects of short-term exposure to air pollutants on stroke risk, although the benefits vary among subgroups. The persistent stroke risk despite lower pollutant levels underscores the complex factors influencing stroke risk, highlighting the need for comprehensive intervention strategies.
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Affiliation(s)
- Yonghong Zhou
- Affiliated Renhe Hospital of Shanghai University (Renhe Hospital, Baoshan District), School of Medicine, Shanghai University, Shanghai, China
| | - Yi Jin
- Department of Radiation Oncology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Zheng Zhang
- Affiliated Renhe Hospital of Shanghai University (Renhe Hospital, Baoshan District), School of Medicine, Shanghai University, Shanghai, China
- Service of Endocrinology, Affiliated Renhe Hospital of Shanghai University (Renhe Hospital, Baoshan District), Shanghai, China
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Zhou Y, Jin Y, Zhang Z. Short-term exposure to various ambient air pollutants and emergency department visits for cause-stable ischemic heart disease: a time-series study in Shanghai, China. Sci Rep 2023; 13:16989. [PMID: 37813933 PMCID: PMC10562371 DOI: 10.1038/s41598-023-44321-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/06/2023] [Indexed: 10/11/2023] Open
Abstract
Studying the impact of local meteorological conditions and air pollution on cardiovascular disease is crucial for reducing the burden of cardiovascular disease. However, there have been few studies on the acute effects of various air pollutants on stable ischemic heart disease (SIHD), and the effects of these factors are not well defined and require further investigation. We performed a time-series study aimed at exploring the association between short-term exposure to various air pollutants and emergency department (ED) visits for SIHD during 2013-2020 in Baoshan District Renhe Hospital of Shanghai, China. The associations between air pollution (NO2, PM2.5, PM10, SO2 O3-8 h and CO) and ED visits were analyzed using quasi-Poisson regression. Subgroup and sensitivity analyses were conducted. From 2013 to 2020, a total of 18,241 ED visits for SIHD were recorded. Elevated PM2.5, PM10, NO2, SO2 and CO were significantly associated with increased ED visits for SIHD at lag (0, 5), lag 0, lag (0-4, 01-03), lag (0-3, 5, 01-03) and lag (3-5). When the concentration of O3-8 h was lower than the threshold recommended by the WHO, exposure to O3-8 h was associated with a slightly decreased risk of SIHD. Moreover, the relationship between different types of air pollution and the frequency of ED visits exhibited variations based on gender, age, and seasonality. This study suggests that short-term exposure to PM2.5, PM10, NO2, SO2 and CO might induce SIHD, especially in old females. Air pollution control measures should be encouraged to prevent the occurrence and development of SIHD.
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Affiliation(s)
- Yonghong Zhou
- Affiliated Renhe Hospital of Shanghai University (Renhe Hospital, Baoshan District), School of Medicine, Shanghai University, Shanghai, China
| | - Yi Jin
- Department of Radiation Oncology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
| | - Zheng Zhang
- Affiliated Renhe Hospital of Shanghai University (Renhe Hospital, Baoshan District), School of Medicine, Shanghai University, Shanghai, China.
- Service of Endocrinology, Affiliated Renhe Hospital of Shanghai University (Renhe Hospital, Baoshan District), Shanghai, China.
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Kadalayil L, Alam MZ, White CH, Ghantous A, Walton E, Gruzieva O, Merid SK, Kumar A, Roy RP, Solomon O, Huen K, Eskenazi B, Rzehak P, Grote V, Langhendries JP, Verduci E, Ferre N, Gruszfeld D, Gao L, Guan W, Zeng X, Schisterman EF, Dou JF, Bakulski KM, Feinberg JI, Soomro MH, Pesce G, Baiz N, Isaevska E, Plusquin M, Vafeiadi M, Roumeliotaki T, Langie SAS, Standaert A, Allard C, Perron P, Bouchard L, van Meel ER, Felix JF, Jaddoe VWV, Yousefi PD, Ramlau-Hansen CH, Relton CL, Tobi EW, Starling AP, Yang IV, Llambrich M, Santorelli G, Lepeule J, Salas LA, Bustamante M, Ewart SL, Zhang H, Karmaus W, Röder S, Zenclussen AC, Jin J, Nystad W, Page CM, Magnus M, Jima DD, Hoyo C, Maguire RL, Kvist T, Czamara D, Räikkönen K, Gong T, Ullemar V, Rifas-Shiman SL, Oken E, Almqvist C, Karlsson R, Lahti J, Murphy SK, Håberg SE, London S, Herberth G, Arshad H, Sunyer J, Grazuleviciene R, Dabelea D, Steegers-Theunissen RPM, Nohr EA, Sørensen TIA, Duijts L, Hivert MF, Nelen V, Popovic M, Kogevinas M, Nawrot TS, Herceg Z, Annesi-Maesano I, Fallin MD, Yeung E, Breton CV, Koletzko B, Holland N, Wiemels JL, Melén E, Sharp GC, et alKadalayil L, Alam MZ, White CH, Ghantous A, Walton E, Gruzieva O, Merid SK, Kumar A, Roy RP, Solomon O, Huen K, Eskenazi B, Rzehak P, Grote V, Langhendries JP, Verduci E, Ferre N, Gruszfeld D, Gao L, Guan W, Zeng X, Schisterman EF, Dou JF, Bakulski KM, Feinberg JI, Soomro MH, Pesce G, Baiz N, Isaevska E, Plusquin M, Vafeiadi M, Roumeliotaki T, Langie SAS, Standaert A, Allard C, Perron P, Bouchard L, van Meel ER, Felix JF, Jaddoe VWV, Yousefi PD, Ramlau-Hansen CH, Relton CL, Tobi EW, Starling AP, Yang IV, Llambrich M, Santorelli G, Lepeule J, Salas LA, Bustamante M, Ewart SL, Zhang H, Karmaus W, Röder S, Zenclussen AC, Jin J, Nystad W, Page CM, Magnus M, Jima DD, Hoyo C, Maguire RL, Kvist T, Czamara D, Räikkönen K, Gong T, Ullemar V, Rifas-Shiman SL, Oken E, Almqvist C, Karlsson R, Lahti J, Murphy SK, Håberg SE, London S, Herberth G, Arshad H, Sunyer J, Grazuleviciene R, Dabelea D, Steegers-Theunissen RPM, Nohr EA, Sørensen TIA, Duijts L, Hivert MF, Nelen V, Popovic M, Kogevinas M, Nawrot TS, Herceg Z, Annesi-Maesano I, Fallin MD, Yeung E, Breton CV, Koletzko B, Holland N, Wiemels JL, Melén E, Sharp GC, Silver MJ, Rezwan FI, Holloway JW. Analysis of DNA methylation at birth and in childhood reveals changes associated with season of birth and latitude. Clin Epigenetics 2023; 15:148. [PMID: 37697338 PMCID: PMC10496224 DOI: 10.1186/s13148-023-01542-5] [Show More Authors] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/27/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Seasonal variations in environmental exposures at birth or during gestation are associated with numerous adult traits and health outcomes later in life. Whether DNA methylation (DNAm) plays a role in the molecular mechanisms underlying the associations between birth season and lifelong phenotypes remains unclear. METHODS We carried out epigenome-wide meta-analyses within the Pregnancy And Childhood Epigenetic Consortium to identify associations of DNAm with birth season, both at differentially methylated probes (DMPs) and regions (DMRs). Associations were examined at two time points: at birth (21 cohorts, N = 9358) and in children aged 1-11 years (12 cohorts, N = 3610). We conducted meta-analyses to assess the impact of latitude on birth season-specific associations at both time points. RESULTS We identified associations between birth season and DNAm (False Discovery Rate-adjusted p values < 0.05) at two CpGs at birth (winter-born) and four in the childhood (summer-born) analyses when compared to children born in autumn. Furthermore, we identified twenty-six differentially methylated regions (DMR) at birth (winter-born: 8, spring-born: 15, summer-born: 3) and thirty-two in childhood (winter-born: 12, spring and summer: 10 each) meta-analyses with few overlapping DMRs between the birth seasons or the two time points. The DMRs were associated with genes of known functions in tumorigenesis, psychiatric/neurological disorders, inflammation, or immunity, amongst others. Latitude-stratified meta-analyses [higher (≥ 50°N), lower (< 50°N, northern hemisphere only)] revealed differences in associations between birth season and DNAm by birth latitude. DMR analysis implicated genes with previously reported links to schizophrenia (LAX1), skin disorders (PSORS1C, LTB4R), and airway inflammation including asthma (LTB4R), present only at birth in the higher latitudes (≥ 50°N). CONCLUSIONS In this large epigenome-wide meta-analysis study, we provide evidence for (i) associations between DNAm and season of birth that are unique for the seasons of the year (temporal effect) and (ii) latitude-dependent variations in the seasonal associations (spatial effect). DNAm could play a role in the molecular mechanisms underlying the effect of birth season on adult health outcomes.
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Affiliation(s)
- Latha Kadalayil
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Md Zahangir Alam
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
- Department of Computer Science and Engineering, Bangladesh University of Engineering and Technology, Dhaka, Bangladesh
| | - Cory Haley White
- Merck Exploratory Science Center in Cambridge MA, Merck Research Laboratories, Cambridge, MA, 02141, USA
| | - Akram Ghantous
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Esther Walton
- Department of Psychology, University of Bath, Bath, UK
| | - Olena Gruzieva
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Sweden
| | - Simon Kebede Merid
- Centre for Occupational and Environmental Medicine, Region Stockholm, Sweden
| | - Ashish Kumar
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Ritu P Roy
- Helen Diller Family Comprehensive Cancer Center University of California, San Francisco, CA, 94143, USA
- Computational Biology and Informatics Core, University of California, San Francisco, CA, 94143, USA
| | - Olivia Solomon
- Children's Environmental Health Laboratory, University of California, Berkeley, CA, USA
| | - Karen Huen
- Children's Environmental Health Laboratory, University of California, Berkeley, CA, USA
| | - Brenda Eskenazi
- Children's Environmental Health Laboratory, University of California, Berkeley, CA, USA
| | - Peter Rzehak
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians Universität München (LMU), Munich, Germany
| | - Veit Grote
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians Universität München (LMU), Munich, Germany
| | | | - Elvira Verduci
- Department of Pediatrics, Vittore Buzzi Children Hospital, University of Milan, Milan, Italy
| | - Natalia Ferre
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, IISPV, Reus, Spain
| | - Darek Gruszfeld
- Neonatal Department, Children's Memorial Health Institute, Warsaw, Poland
| | - Lu Gao
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Weihua Guan
- Division of Biostatistics, School of Public Health, University of Minnesota, A460 Mayo Building, MMC 303, 420 Delaware St. SE, Minneapolis, MN, 55455, USA
| | | | - Enrique F Schisterman
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA, 19104, USA
| | - John F Dou
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, USA
| | - Kelly M Bakulski
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, USA
| | - Jason I Feinberg
- Wendy Klag Center for Autism and Developmental Disabilities Johns Hopkins University, Baltimore, MD, USA
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Munawar Hussain Soomro
- Sorbonne Université and INSERM, Epidemiology of Allergic and Respiratory Diseases Department, Pierre Louis Institute of Epidemiology and Public Health (IPLESP UMRS 1136), Saint-Antoine Medical School, Paris Cedex 12, France
- Department of Community Medicine and Public Health, SMBB Medical University, Larkana, Pakistan
| | - Giancarlo Pesce
- Sorbonne Université and INSERM, Epidemiology of Allergic and Respiratory Diseases Department, Pierre Louis Institute of Epidemiology and Public Health (IPLESP UMRS 1136), Saint-Antoine Medical School, Paris Cedex 12, France
| | - Nour Baiz
- Institut Desbrest de Santé Publique (IDESP), INSERM and Montpellier University, Montpellier, France
| | - Elena Isaevska
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, CPO Piemonte, Italy
| | - Michelle Plusquin
- Center for Environmental Sciences, University of Hasselt, 3590, Diepenbeek, Belgium
| | - Marina Vafeiadi
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Theano Roumeliotaki
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Sabine A S Langie
- Unit Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
- Faculty of Sciences, Hasselt University, Diepenbeek, Belgium
- Department of Pharmacology and Toxicology, School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Limburg, The Netherlands
| | - Arnout Standaert
- Unit Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Catherine Allard
- Centre de Recherche du Centre Hospitalier de l'Universite de Sherbrooke, Sherbrooke, Canada
| | - Patrice Perron
- Department of Medicine, Universite de Sherbrooke, Sherbrooke, Canada
| | - Luigi Bouchard
- Department of Biochemistry and Functional Genomics, Universite de Sherbrooke, Sherbrooke, Canada
- Clinical Department of Laboratory Medicine, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Saguenay-Lac-Saint-Jean - Hôpital de Chicoutimi, Chicoutimi, Canada
| | - Evelien R van Meel
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Division of Respiratory Medicine and Allergology, Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Paul D Yousefi
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Caroline L Relton
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Elmar W Tobi
- Periconceptional Epidemiology, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Anne P Starling
- Life Course Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ivana V Yang
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Biomedical Informatics and Personalized Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Center for Genes, Environment and Health, National Jewish Health, Denver, CO, USA
| | - Maria Llambrich
- Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Johanna Lepeule
- Institute for Advanced Biosciences, University Grenoble-Alpes, INSERM, CNRS, Grenoble, France
| | - Lucas A Salas
- Institute for Global Health (ISGlobal), Barcelona, Spain
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
- Center for Molecular Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Lebanon, NH, USA
| | - Mariona Bustamante
- Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Susan L Ewart
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, USA
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, USA
| | - Stefan Röder
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
| | - Ana Claudia Zenclussen
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
| | - Jianping Jin
- 2530 Meridian Pkwy, Suite 200, Durham, NC 27713, USA
| | - Wenche Nystad
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Christian M Page
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Section for Statistics and Data Science, Department of Mathematics, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Maria Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Dereje D Jima
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
- Bioinformatics Research Center, North Carolina State University, Raleigh, NC, USA
| | - Cathrine Hoyo
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Rachel L Maguire
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
- Department of Obstetrics and Gynaecology, Duke University Medical Center, Durham, NC, USA
| | - Tuomas Kvist
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Darina Czamara
- Department of Translational Research in Psychiatry, Max-Planck-Institute of Psychiatry, 80804, Munich, Germany
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Tong Gong
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Vilhelmina Ullemar
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sheryl L Rifas-Shiman
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, USA
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, USA
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Robert Karlsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jari Lahti
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Susan K Murphy
- Department of Obstetrics and Gynaecology, Duke University Medical Center, Durham, NC, USA
| | - Siri E Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Stephanie London
- Department of Health and Human Services, National Institute of Environmental Health Sciences, National Institutes of Health, RTP, NC, 27709, USA
| | - Gunda Herberth
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
| | - Hasan Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
- NIHR Southampton Biomedical Research Centre, Southampton General Hospital, Southampton, UK
| | - Jordi Sunyer
- Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Regina Grazuleviciene
- Department of Environmental Science, Vytautas Magnus University, 44248, Kaunas, Lithuania
| | - Dana Dabelea
- Life Course Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Régine P M Steegers-Theunissen
- Periconceptional Epidemiology, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Ellen A Nohr
- Department of Clinical Research, Odense Universitetshospital, Odense, Denmark
| | - Thorkild I A Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Liesbeth Duijts
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Division of Respiratory Medicine and Allergology, Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Division of Neonatology, Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marie-France Hivert
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Vera Nelen
- Provincial Institute for Hygiene, Antwerp, Belgium
| | - Maja Popovic
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, CPO Piemonte, Italy
| | | | - Tim S Nawrot
- Center for Environmental Sciences, University of Hasselt, 3590, Diepenbeek, Belgium
- Department of Public Health and Primary Care, Leuven University, Louvain, Belgium
| | - Zdenko Herceg
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Isabella Annesi-Maesano
- Institut Desbrest de Santé Publique (IDESP), INSERM and Montpellier University, Montpellier, France
| | - M Daniele Fallin
- Wendy Klag Center for Autism and Developmental Disabilities Johns Hopkins University, Baltimore, MD, USA
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Edwina Yeung
- Epidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Dr, MSC 7004, Bethesda, MD, USA
| | - Carrie V Breton
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians Universität München (LMU), Munich, Germany
| | - Nina Holland
- Children's Environmental Health Laboratory, CERCH, Berkeley Public Health, University of California, 2121 Berkeley Way #5216, Berkeley, CA, 94720, USA
| | - Joseph L Wiemels
- Center for Genetic Epidemiology, University of Southern California, Los Angeles, CA, 90033, USA
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, 90033, USA
| | - Erik Melén
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Gemma C Sharp
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- School of Psychology, University of Exeter, Exeter, UK
| | - Matt J Silver
- Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
- Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, London, UK
| | - Faisal I Rezwan
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
- Department of Computer Science, Aberystwyth University, Aberystwyth, Ceredigion, UK
| | - John W Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK.
- NIHR Southampton Biomedical Research Centre, Southampton General Hospital, Southampton, UK.
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Coskun A, Zarepour A, Zarrabi A. Physiological Rhythms and Biological Variation of Biomolecules: The Road to Personalized Laboratory Medicine. Int J Mol Sci 2023; 24:ijms24076275. [PMID: 37047252 PMCID: PMC10094461 DOI: 10.3390/ijms24076275] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/24/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
The concentration of biomolecules in living systems shows numerous systematic and random variations. Systematic variations can be classified based on the frequency of variations as ultradian (<24 h), circadian (approximately 24 h), and infradian (>24 h), which are partly predictable. Random biological variations are known as between-subject biological variations that are the variations among the set points of an analyte from different individuals and within-subject biological variation, which is the variation of the analyte around individuals’ set points. The random biological variation cannot be predicted but can be estimated using appropriate measurement and statistical procedures. Physiological rhythms and random biological variation of the analytes could be considered the essential elements of predictive, preventive, and particularly personalized laboratory medicine. This systematic review aims to summarize research that have been done about the types of physiological rhythms, biological variations, and their effects on laboratory tests. We have searched the PubMed and Web of Science databases for biological variation and physiological rhythm articles in English without time restrictions with the terms “Biological variation, Within-subject biological variation, Between-subject biological variation, Physiological rhythms, Ultradian rhythms, Circadian rhythm, Infradian rhythms”. It was concluded that, for effective management of predicting, preventing, and personalizing medicine, which is based on the safe and valid interpretation of patients’ laboratory test results, both physiological rhythms and biological variation of the measurands should be considered simultaneously.
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Wu Z, Hu H, Wang C, Rao J, Wu J, Shi Y, Fu Y, Cheng X, Li P. Sleep Patterns Modify the Association between Vitamin D Status and Coronary Heart Disease: Results from NHANES 2005-2008. J Nutr 2023; 153:1398-1406. [PMID: 36863481 DOI: 10.1016/j.tjnut.2022.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/26/2022] [Accepted: 11/09/2022] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Although an increased risk of coronary heart disease (CHD) has been reported in individuals with low vitamin D status, this remains controversial. Growing evidence suggests that sleep behaviors may influence vitamin D endocrine functions. OBJECTIVES We explored the association between serum 25-hydroxyvitamin D [[25(OH)D] concentrations and CHD and whether sleep behaviors modify this relationship. METHODS A cross-sectional analysis of 7511 adults aged ≥20 y in 2005-2008 National Health and Nutrition Examination Survey (NHANES) that included serum 25(OH)D concentrations and provided information on sleep behaviors and history of CHD was performed. Logistic regression models were used to assess the association between serum 25(OH)D concentrations and CHD, whereas stratified analyses and multiplicative interaction tests were used to evaluate the modification effect of overall sleep patterns and each sleep factor on this relationship. The overall sleep patterns integrated 4 sleep behaviors (sleep duration, snoring, insomnia, and daytime sleepiness) in the form of healthy sleep score. RESULTS Serum 25(OH)D concentrations were inversely associated with risk of CHD (P < 0.01). Hypovitaminosis D [serum 25(OH)D <50nmol/L] was associated with a 71% increased risk of CHD (OR: 1.71; 95% CI: 1.28, 2.28; P < 0.01) compared with that in participants with sufficient vitamin D [serum 25(OH)D ≥75nmol/L], and the association was more evident and stable among participants with poor sleep patterns (P-interaction < 0.01). Among the individual sleep behaviors, sleep duration had the strongest interaction with 25(OH)D (P-interaction < 0.05). The association between serum 25(OH)D concentrations and risk of CHD was more pronounced in participants with sleep duration <7 h/d or >8 h/d compared with those with sleep duration 7-8 h/d. CONCLUSIONS These findings suggest that the influence of lifestyle-related behavioral risk factors, such as sleep behaviors (especially sleep duration), need to be considered when evaluating the association between serum 25(OH)D concentrations and CHD as well as the clinical benefits of vitamin D supplementation.
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Affiliation(s)
- Zuxiang Wu
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Huan Hu
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Chenxi Wang
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Jingan Rao
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Ji Wu
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Yumeng Shi
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Yang Fu
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Xiaoshu Cheng
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Ping Li
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
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Wucher V, Sodaei R, Amador R, Irimia M, Guigó R. Day-night and seasonal variation of human gene expression across tissues. PLoS Biol 2023; 21:e3001986. [PMID: 36745672 PMCID: PMC9934459 DOI: 10.1371/journal.pbio.3001986] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 02/16/2023] [Accepted: 01/03/2023] [Indexed: 02/07/2023] Open
Abstract
Circadian and circannual cycles trigger physiological changes whose reflection on human transcriptomes remains largely uncharted. We used the time and season of death of 932 individuals from GTEx to jointly investigate transcriptomic changes associated with those cycles across multiple tissues. Overall, most variation across tissues during day-night and among seasons was unique to each cycle. Although all tissues remodeled their transcriptomes, brain and gonadal tissues exhibited the highest seasonality, whereas those in the thoracic cavity showed stronger day-night regulation. Core clock genes displayed marked day-night differences across multiple tissues, which were largely conserved in baboon and mouse, but adapted to their nocturnal or diurnal habits. Seasonal variation of expression affected multiple pathways, and it was enriched among genes associated with the immune response, consistent with the seasonality of viral infections. Furthermore, they unveiled cytoarchitectural changes in brain regions. Altogether, our results provide the first combined atlas of how transcriptomes from human tissues adapt to major cycling environmental conditions. This atlas may have multiple applications; for example, drug targets with day-night or seasonal variation in gene expression may benefit from temporally adjusted doses.
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Affiliation(s)
- Valentin Wucher
- Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain
- MeLiS, SynatAc Team, UCBL1—CNRS UMR5284—Inserm U1314, Lyon, France
- French Reference Center on Paraneoplastic Neurological Syndrome, Hospices Civils de Lyon, Lyon, France
- University of Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Reza Sodaei
- Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Raziel Amador
- Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Manuel Irimia
- Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- ICREA, Barcelona, Spain
- * E-mail: (MI); (RG)
| | - Roderic Guigó
- Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- * E-mail: (MI); (RG)
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Thomas SA, Wang G, Giordano N, Matthews T, Torrey J, Kabrhel C. Calendar month variation in the diagnosis and severity of pulmonary embolism. Intern Emerg Med 2023; 18:879-887. [PMID: 36656430 DOI: 10.1007/s11739-022-03180-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 12/13/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND Pulmonary embolism (PE) is the third-leading cause of cardiovascular death in the United States, and several studies suggest PE shows seasonal variation. Variation in monthly PE diagnosis may be due to pathophysiologic factors or confounding/bias. However, severe PE may be less prone to diagnostic bias. To address this gap, we analyzed two registries from 1/2013-12/2018 with the aim of describing temporal trends in PE diagnosis and severity. METHODS We performed a retrospective analysis of two existing databases containing: (1) consecutive patients diagnosed with PE in the emergency departments (EDs) of two large, urban teaching hospitals, and (2) severe PEs requiring PE Response Team (PERT) activation at one of the above hospitals. The primary outcome was to assess variation in PE diagnosis and severity by calendar month. Separate analysis of these two databases sought to control for workup bias by trainee experience across the academic year. One-way ANOVA and Poisson regression were performed to assess for cyclical variation across calendar months, using Stata v16.1. RESULTS The PE diagnosis database contained 1324 patients over 36 months. One-way ANOVA did not reveal a statistically significant (p = 0.713) association between calendar month and PE number. The PERT activation database contained 1082 patients over 72 months. One-way ANOVA revealed a statistically significant (p = 0.024) association between calendar month and activations, repeated year-on-year. CONCLUSION Our results indicate correlation between calendar month and PERT activation; however, this pattern was not observed for PE diagnoses. This finding warrants further investigation into the causes of calendar month variation of PERT activations.
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Affiliation(s)
- Sarah Alice Thomas
- Faculty of Medicine, BSc Medical Biosciences Candidate, Imperial College London, London, UK
- Department of Emergency Medicine, Center for Vascular Emergencies, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Grace Wang
- Department of Emergency Medicine, Center for Vascular Emergencies, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nicholas Giordano
- Department of Emergency Medicine, Center for Vascular Emergencies, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Tim Matthews
- Department of Emergency Medicine, Center for Vascular Emergencies, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jasmine Torrey
- Institute of Health Professionals, Massachusetts General Hospital, Zero Emerson Place, Suite 3B, Boston, MA, USA
| | - Christopher Kabrhel
- Department of Emergency Medicine, Center for Vascular Emergencies, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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10
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Shamaa TM, Kitajima T, Ivanics T, Shimada S, Yeddula S, Mohamed A, Rizzari M, Collins K, Yoshida A, Abouljoud M, Nagai S. Can Weather Be a Factor in Liver Transplant Waitlist and Posttransplant Outcomes? Analysis of United Network for Organ Sharing Registry. Transplant Proc 2022; 54:2254-2262. [DOI: 10.1016/j.transproceed.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 08/08/2022] [Accepted: 08/26/2022] [Indexed: 11/07/2022]
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Romaszko J, Dragańska E, Cymes I, Drozdowski M, Gromadziński L, Glińska-Lewczuk K. Are the levels of uric acid associated with biometeorological conditions? THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 819:152020. [PMID: 35007576 DOI: 10.1016/j.scitotenv.2021.152020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 06/14/2023]
Abstract
Hyperuricemia is an independent risk factor for renal and cardiovascular diseases and is closely associated with gout episodes. It is caused, inter alia, by nutritional habits and genetic factors, and also displays seasonal variability conditioned by meteorological factors. The impact of meteorological factors, including both cold and heat stress, on the human physiology is presented based on the Universal Thermal Climate Index (UTCI) - a biometeorological index derived from an analysis of human thermal balance. The aim of our study was to establish whether seasonal variations significantly affect routinely measured urine acid (UA) levels and could eventually support the clinical decision making process, as well as assessing whether UTCI values are correlated with UA levels in blood serum. This work presents a retrospective epidemiological study of data collected in Olsztyn (Poland). Study material comprised 54,536 results of ambulatory tests measuring UA levels, performed during the period 2016-2019. The analysis concerned correlations between UA and the ages of female and male subjects as well as existing biometeorological conditions as represented by UTCI values in an annual cycle. UA levels in females were found to be lower (4.94 ± 1.37 SD) as compared to those of males (6.13 ± 1.43 SD) and demonstrated a strong positive correlation with age. UA values differed significantly (p < 0.05) on days characterized by cold stress and heat stress, for the oldest age group. UA levels were found to differ depending on the season, but these relationships were not statistically significant, except for significantly higher UA levels in females in autumn (p < 0.001). However, there was an evident difference in population UA levels under cold stress conditions (lower) and heat stress conditions (higher) in the elderly. The UTCI is an adequate predictor of population variations in UA levels since it takes into account the variability of local meteorological conditions.
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Affiliation(s)
- Jerzy Romaszko
- Department of Family Medicine and Infectious Diseases, School of Medicine, University of Warmia and Mazury in Olsztyn, Poland.
| | - Ewa Dragańska
- Department of Water Management and Climatology, University of Warmia and Mazury in Olsztyn, Poland
| | - Iwona Cymes
- Department of Water Management and Climatology, University of Warmia and Mazury in Olsztyn, Poland
| | - Marek Drozdowski
- Department of Psychology and Sociology of Health and Public Health, School of Public Health, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
| | - Leszek Gromadziński
- Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn
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Martinaitiene D, Raskauskiene N. Effects of Changes in Seasonal Weather Patterns on the Subjective Well-Being in Patients with CAD Enrolled in Cardiac Rehabilitation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094997. [PMID: 35564392 PMCID: PMC9099623 DOI: 10.3390/ijerph19094997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/07/2022] [Accepted: 04/16/2022] [Indexed: 02/04/2023]
Abstract
Objective: We examined whether seasonal and monthly variations exist in the subjective well-being of weather-sensitive patients with coronary artery disease (CAD) during cardiac rehabilitation. Methods: In this cross-sectional study, 865 patients (30% female, age 60 ± 9) were recruited within 2−3 weeks of treatment for acute coronary syndrome and during cardiac rehabilitation. The patients completed the Palanga self-assessment diary for weather sensitivity (PSAD-WS) daily, for an average of 15.5 days. PSAD-WS is an 11-item (general) three-factor (psychological, cardiac, and physical symptoms) questionnaire used to assess weather sensitivity in CAD patients. Weather data were recorded using the weather station “Vantage Pro2 Plus”. Continuous data were recorded eight times each day for the weather parameters and the averages of the data were linked to the respondents’ same-day diary results. Results: Weather-sensitive (WS) patients were found to be more sensitive to seasonal changes than patients who were not WS, and they were more likely to experience psychological symptoms. August (summer), December (winter), and March (spring) had the highest numbers of cardiac symptoms (all p < 0.001). In summary, peaks of symptoms appeared more frequently during the transition from one season to the next. Conclusion: This study extends the knowledge about the impact of atmospheric variables on the general well-being of weather-sensitive CAD patients during cardiac rehabilitation.
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Abrignani MG, Lombardo A, Braschi A, Renda N, Abrignani V. Climatic influences on cardiovascular diseases. World J Cardiol 2022; 14:152-169. [PMID: 35432772 PMCID: PMC8968453 DOI: 10.4330/wjc.v14.i3.152] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/23/2021] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open
Abstract
Classical risk factors only partially account for variations in cardiovascular disease incidence; therefore, also other so far unknown features, among which meteorological factors, may influence heart diseases (mainly coronary heart diseases, but also heart failure, arrhythmias, aortic dissection and stroke) rates. The most studied phenomenon is ambient temperature. The relation between mortality, as well as cardiovascular diseases incidence, and temperature appears graphically as a ''U'' shape. Exposure to cold, heat and heat waves is associated with an increased risk of acute coronary syndromes. Other climatic variables, such as humidity, atmospheric pressure, sunlight hours, wind strength and direction and rain/snow precipitations have been hypothesized as related to fatal and non-fatal cardiovascular diseases incidence. Main limitation of these studies is the unavailability of data on individual exposure to weather parameters. Effects of weather may vary depending on other factors, such as population disease profile and age structure. Climatic stress may increase direct and indirect risks to human health via different, complex pathophysiological pathways and exogenous and endogenous mechanisms. These data have attracted growing interest because of the recent earth's climate change, with consequent increasing ambient temperatures and climatic fluctuations. This review evaluates the evidence base for cardiac health consequences of climate conditions, and it also explores potential further implications.
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Affiliation(s)
- Maurizio Giuseppe Abrignani
- Operative Unit of Cardiology, Department of Medicine, S. Antonio Abate Hospital of Trapani, ASP Trapani, Trapani 91100, Italy.
| | - Alberto Lombardo
- Operative Unit of Cardiology, Department of Medicine, S. Antonio Abate Hospital of Trapani, ASP Trapani, Trapani 91100, Italy
| | - Annabella Braschi
- Department of Internal Medicine, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo 90100, Italy
| | - Nicolò Renda
- Department of Mental Health, ASP Trapani, Trapani 91100, Italy
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Looi JL, Chan C, Bridgman P, Kerr AJ. Takotsubo Syndrome in New Zealand: Current Knowledge and Future Challenges. Intern Med J 2022; 52:1863-1876. [PMID: 35289058 DOI: 10.1111/imj.15749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/12/2022] [Accepted: 03/04/2022] [Indexed: 11/28/2022]
Abstract
Takotsubo syndrome (TS), also known as apical ballooning syndrome is a transient stress-related cardiomyopathy characterised by acute but reversible left ventricular dysfunction. The condition tends to occur in postmenopausal women after a stressful event. At presentation TS typically mimics acute myocardial infarction (MI) and the incidence of TS has been increasing worldwide. This is likely a consequence of an improved awareness of the existence of this syndrome and easier access to early echocardiography and coronary angiography. However, its aetiology remains poorly understood and it is probably still underdiagnosed. Similar to other countries. TS is being increasingly recognised in New Zealand. In this review, we discuss the demographics, clinical features and outcomes of patients with TS in New Zealand. Doing so informs us not only of the pattern of disease in New Zealand but it also provides insights into the condition itself. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jen-Li Looi
- Department of Cardiology, Middlemore Hospital, Private Bag 933111, Otahuhu, Auckland, New Zealand
| | - Christina Chan
- Department of Cardiology, Christchurch Hospital, Riccarton Avenue, Private Bag 4710, Christchurch, New Zealand
| | - Paul Bridgman
- Department of Cardiology, Christchurch Hospital, Riccarton Avenue, Private Bag 4710, Christchurch, New Zealand
| | - Andrew J Kerr
- Department of Cardiology, Middlemore Hospital, Private Bag 933111, Otahuhu, Auckland, New Zealand
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Seasonal Changes in the Prevalence of Hyperkalemia in the Emergency Department: A Single Center Study. Medicina (B Aires) 2022; 58:medicina58020282. [PMID: 35208608 PMCID: PMC8878233 DOI: 10.3390/medicina58020282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/07/2022] [Accepted: 02/10/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Hyperkalemia is an electrolyte disorder frequently encountered in the emergency department. There are few studies on seasonal variation in the prevalence of hyperkalemia. The aim of this study was to investigate the seasonal changes in the prevalence of hyperkalemia in the emergency department. Materials and Methods: We retrospectively reviewed a total of 24,085 patients presented to the emergency department between January 2012 and December 2020. Age, gender, serum potassium level, and serum creatinine level were recorded. The definition used for hyperkalemia was a serum potassium level of ≥ 5.5 mEq/L. Renal function was divided into two categories: preserved (eGFR ≥ 60 mL/min/1.73 m2) or reduced (eGFR < 60 mL/min/1.73 m2). Results: The prevalence of hyperkalemia was 2.1% in patients with preserved renal function and was 11.9% in patients with reduced renal function (p < 0.001). The prevalence of hyperkalemia was highest in winter, followed by spring, autumn, and summer in patients with preserved renal function (p < 0.001) and those with reduced renal function (p < 0.001). There was a linear correlation between monthly weather temperature and the prevalence of hyperkalemia in patients with preserved renal function (r = −0.392; p < 0.001) and those with reduced renal function (r = −0.487; p < 0.001). Conclusions: we found that the prevalence of hyperkalemia was significantly higher in winter for both patients with preserved renal function and those with reduced renal function.
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16
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Kasten-Jolly J, Lawrence DA. Differential blood leukocyte populations based on individual variances and age. Immunol Res 2022; 70:114-128. [PMID: 35023048 PMCID: PMC8754550 DOI: 10.1007/s12026-021-09257-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 12/09/2021] [Indexed: 12/26/2022]
Abstract
Blood was collected from the New York State Department of Health (NYSDOH) employees to assess variances in leukocyte numbers in January, May, and September throughout a year and over many years. Women and men of ages 20 to 80 volunteered to donate for this program. Most of the blood came from healthy individuals, and many remained healthy throughout the years of their blood donations. The major objective was to determine the extent that blood leukocyte numbers change so that transient vs more lingering changes may be helpful in assessing health status. Since some donors remained in the program for 14 years, age influences over time could be determined. Within a short period of 2-3 years, the flow cytometric immunophenotypic profile of blood lymphocyte is relatively stable with a CV% of < 20%. However, as humans age, the blood CD3+ T cell, CD8+ T cell, B cell, NKT cell, and CD4-/CD8- double-negative T cell (DN-T cell) subsets declined in cell numbers/μL, but the double-positive CD4+/CD8+ T cells (DP-T cells) increased in numbers. The extent and chronology of a variance, e.g., a subset exceeding its 75th or 90th percentile, might be indicative of a transient or chronic physiological or psychosocial stress affecting health or a developing pathology; however, because of the wide ranges of cell numbers/μL for each subset among individuals reported as healthy, everyone's immunity and health must be carefully evaluated. A CD4 to CD8 ratio (4/8R) of < 1 has been used to define an immunodeficiency such as HIV-induced AIDS, but a high 4/8R is less well associated with health status. A high 4/8R or granulocyte to lymphocyte ratio (GLR) might be an indicator of a stress, infection, or immune-related pathology. Sporadic and longitudinal increases of GLRs are reported. The results suggest that there are some age and sex differences in leukocyte numbers; stress influences on the blood profile of leukocytes likely exist. However, some values exceeding 2 standard deviations from means do not necessarily predict a health concern, whereas a longitudinal increase or decline might be indicative of a need for further evaluations.
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Affiliation(s)
- Jane Kasten-Jolly
- Wadsworth Center, New York State Department of Health, Albany, NY, 12208, USA
| | - David A Lawrence
- Wadsworth Center, New York State Department of Health, Albany, NY, 12208, USA.
- School of Public Health, University of Albany, Rensselaer, NY, USA.
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17
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Wucher V, Sodaei R, Amador R, Irimia M, Guigó R. Day-night and seasonal variation of human gene expression across tissues. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2022:2021.02.28.433266. [PMID: 33688644 PMCID: PMC7941615 DOI: 10.1101/2021.02.28.433266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Circadian and circannual cycles trigger physiological changes whose reflection on human transcriptomes remains largely uncharted. We used the time and season of death of 932 individuals from GTEx to jointly investigate transcriptomic changes associated with those cycles across multiple tissues. Overall, most variation across tissues during day-night and among seasons was unique to each cycle. Although all tissues remodeled their transcriptomes, brain and gonadal tissues exhibited the highest seasonality, whereas those in the thoracic cavity showed stronger day-night regulation. Core clock genes displayed marked day-night differences across multiple tissues, which were largely conserved in baboon and mouse, but adapted to their nocturnal or diurnal habits. Seasonal variation of expression affected multiple pathways and it was enriched among genes associated with the immune response, consistent with the seasonality of viral infections. Furthermore, they unveiled cytoarchitectural changes in brain regions. Altogether, our results provide the first combined atlas of how transcriptomes from human tissues adapt to major cycling environmental conditions.
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Affiliation(s)
- Valentin Wucher
- Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain
- NeuroMyogene Institute, SynatAc Team, INSERM U1217/UMR CNRS 5310, Lyon, France
- French Reference Center on Paraneoplastic Neurological Syndrome, Hospices Civils de Lyon, Lyon, France
- University of Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Reza Sodaei
- Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Raziel Amador
- Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Manuel Irimia
- Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- ICREA, Barcelona, Spain
| | - Roderic Guigó
- Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
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18
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Luo ZR, Lin ZQ, Chen LW, Qiu HF. Effects of seasonal and climate variations on in-hospital mortality and length of stay in patients with type A aortic dissection. J Cardiothorac Surg 2021; 16:252. [PMID: 34496919 PMCID: PMC8424972 DOI: 10.1186/s13019-021-01639-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
Objective To investigate the effects of seasonal and climatic changes on postoperative in-hospital mortality and length of stay (LOS) in patients with type A acute aortic dissection (AAD). Methods Patients undergoing implantation of the modified triple-branched stent graft to replace the descending aorta in addition to aortic root reconstruction for type A AAD in our hospital from January 2016 to December 2019 were included. Relevant data were retrospectively collected and analyzed. Results A total of 404 patients were included in our analyses. The multivariate unconditional logistic regression analysis showed that patients admitted in autumn (OR 4.027, 95% CI 1.023–17.301, P = 0.039) or with coronary heart disease (OR 8.938, 95% CI 1.991–29.560, P = 0.049) were independently associated with an increased risk of postoperative in-hospital mortality. Furthermore, patients admitted in autumn (OR 5.956, 95% CI 2.719–7.921, P = 0.041) or with hypertension (OR 3.486, 95% CI 1.192–5.106, P = 0.035) were independently associated with an increased risk of longer LOS. Conclusion Patients admitted in autumn or with coronary heart disease are at higher risk of in-hospital mortality following surgery for type A AAD. Also, patients admitted in autumn or with hypertension have a longer hospital LOS. In the autumn of the temperature transition, we may need to strengthen the management of medical quality after surgery for type A AAD.
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Affiliation(s)
- Zeng-Rong Luo
- Department of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China.,Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, People's Republic of China
| | - Zhi-Qin Lin
- Department of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China.,Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, People's Republic of China
| | - Liang-Wan Chen
- Department of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China.,Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, People's Republic of China
| | - Han-Fan Qiu
- Department of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China. .,Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, People's Republic of China.
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19
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Raiko JRH, Saari T, Orava J, Savisto N, Parkkola R, Haaparanta-Solin M, Nuutila P, Virtanen KA. Changes in electrocardiogram parameters during acute nonshivering cold exposure and associations with brown adipose tissue activity, plasma catecholamine levels, and brachial blood pressure in healthy adults. Physiol Rep 2021; 9:e14718. [PMID: 33580902 PMCID: PMC7881801 DOI: 10.14814/phy2.14718] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/12/2020] [Accepted: 12/19/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Sympathetic activity causes changes in electrocardiogram (ECG) during cold exposure and the changes have been studied mostly during hypothermia and less during mild acute nonshivering cold exposure. Cold-induced sympathetic activity also activates brown adipose tissue (BAT) and increases arterial blood pressure (BP) and plasma catecholamine levels. We examined changes in ECG parameters during acute nonshivering cold exposure and their associations with markers of sympathetic activity during cold exposure: brachial blood pressure (BP), plasma catecholamine levels, and BAT activity measured by positron emission tomography (PET). METHODS AND RESULTS Healthy subjects (M/F = 13/24, aged 20-55 years) were imaged with [15 O]H2 O (perfusion, N = 37) and [18 F]FTHA to measure plasma nonesterified fatty acid uptake (NEFA uptake, N = 37) during 2-h nonshivering cold exposure. 12-lead ECG (N = 37), plasma catecholamine levels (N = 17), and brachial BP (N = 31) were measured at rest in room temperature (RT) and re-measured after a 2-h nonshivering cold exposure. There were significant differences between RT and cold exposure in P axis (35.6 ± 26.4 vs. 50.8 ± 22.7 degrees, p = 0.005), PR interval (177.7 ± 24.6 ms vs.163.0 ± 28.7 ms, p = 0.001), QRS axis (42.1 ± 31.3 vs. 56.9 ± 24.1, p = 0.003), and QT (411.7 ± 25.5 ms vs. 434.5 ± 39.3 ms, p = 0.001). There was no significant change in HR, QRS duration, QTc, JTc, and T axis during cold exposure. Systolic BP (127.2 ± 15.7 vs. 131.8 ± 17.9 mmHg, p = 0.008), diastolic BP (81.7 ± 12.0 vs. 85.4 ± 13.0 mmHg, p = 0.02), and plasma noradrenaline level increased during cold exposure (1.97 ± 0.61 vs. 5.07 ± 1.32 µmol/L, p = 0.001). Cold-induced changes in ECG parameters did not correlate with changes in BAT activity, brachial BP, plasma catecholamines, or skin temperature. CONCLUSIONS During short-term nonshivering cold exposure, there were increases in P axis, PR interval, QRS axis, and QT compared to RT in healthy adults. Cold-induced changes in ECG parameters did not correlate with BAT activity, brachial BP, or plasma catecholamine levels which were used as markers of cold-induced sympathetic activity.
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Affiliation(s)
- Juho R H Raiko
- Turku PET Centre, Turku University Hospital, Turku, Finland
| | - Teemu Saari
- Turku PET Centre, Turku University Hospital, Turku, Finland
| | - Janne Orava
- Turku PET Centre, Turku University Hospital, Turku, Finland
| | - Nina Savisto
- Turku PET Centre, University of Turku, Turku, Finland
| | - Riitta Parkkola
- Turku PET Centre, Turku University Hospital, Turku, Finland.,Department of Radiology, Turku University Hospital and University of Turku, Turku, Finland
| | | | - Pirjo Nuutila
- Turku PET Centre, Turku University Hospital, Turku, Finland.,Department of Endocrinology, Turku University Hospital, Turku, Finland
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20
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Sailani MR, Metwally AA, Zhou W, Rose SMSF, Ahadi S, Contrepois K, Mishra T, Zhang MJ, Kidziński Ł, Chu TJ, Snyder MP. Deep longitudinal multiomics profiling reveals two biological seasonal patterns in California. Nat Commun 2020; 11:4933. [PMID: 33004787 PMCID: PMC7529769 DOI: 10.1038/s41467-020-18758-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 08/21/2020] [Indexed: 02/06/2023] Open
Abstract
The influence of seasons on biological processes is poorly understood. In order to identify biological seasonal patterns based on diverse molecular data, rather than calendar dates, we performed a deep longitudinal multiomics profiling of 105 individuals over 4 years. Here, we report more than 1000 seasonal variations in omics analytes and clinical measures. The different molecules group into two major seasonal patterns which correlate with peaks in late spring and late fall/early winter in California. The two patterns are enriched for molecules involved in human biological processes such as inflammation, immunity, cardiovascular health, as well as neurological and psychiatric conditions. Lastly, we identify molecules and microbes that demonstrate different seasonal patterns in insulin sensitive and insulin resistant individuals. The results of our study have important implications in healthcare and highlight the value of considering seasonality when assessing population wide health risk and management.
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Affiliation(s)
- M Reza Sailani
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
| | - Ahmed A Metwally
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
| | - Wenyu Zhou
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
| | | | - Sara Ahadi
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
| | - Kevin Contrepois
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
| | - Tejaswini Mishra
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
| | - Martin Jinye Zhang
- Department of Electrical Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Łukasz Kidziński
- Department of Bioengineering, Stanford University, Stanford, CA, 94305, USA
| | - Theodore J Chu
- Department of Pediatrics, Division of Allergy and Immunology, Stanford University, Stanford, CA, 94305, USA
| | - Michael P Snyder
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA.
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21
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Altin SE, Kim YG, Aronow HD, Armstrong EJ, Goldsweig AM, Dardik A, Lanksy AJ, Mena-Hurtado CI, Abbott JD. Seasonal variation in U.S. hospitalizations for chronic limb-threatening ischemia. Catheter Cardiovasc Interv 2020; 96:1473-1480. [PMID: 32902126 DOI: 10.1002/ccd.29261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/22/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND Seasonal variation in coronary artery disease is well described, with a peak in the winter and a trough in the summer. However, little is known about seasonal trends in hospital admission for critical limb-threatening ischemia (CLTI) and associated outcomes. METHODS Patients admitted with CLTI from January 1, 2012 through August 31, 2015 were identified in the Healthcare Cost and Utilization Project's National Inpatient Sample based upon administrative claims diagnosis codes. The primary outcome was seasonal hospitalization incidence, and secondary outcomes included mortality rates and rates of in-hospital major and minor amputations among nondiabetics and diabetics. RESULTS Of 1,276,745 hospitalizations for CLTI during the study period, 28.3% occurred in the spring, the peak admission season, and 19.1% occurred in the fall, the nadir. In-hospital mortality was highest during the winter (adjusted odds ratio [OR]: 1.08; 95% confidence interval [CI]: 1.03-1.14), and followed the highest seasonal rates of influenza in the fall; however, other important comorbidities did not differ significantly by season. For the overall cohort, there was no significant seasonal variation in rates of major or minor amputation, although seasonal rates were different according to diabetic status. Patients without diabetes had the highest odds of amputation in the spring (OR 1.07; 95% CI: 1.02-1.12), although this trend was not identified among patients with diabetes. CONCLUSIONS There is significant seasonal variability in CLTI admissions and mortality but minimal variability in amputation rates. Understanding the seasonal variation in CLTI may help to identify individuals at greatest risk for hospitalization and death through patient and provider education efforts.
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Affiliation(s)
- S Elissa Altin
- Division of Cardiology, Yale University, New Haven, Connecticut.,West Haven VA Medical Center, West Haven, Connecticut
| | - Yeunjung G Kim
- Division of Cardiology, Yale University, New Haven, Connecticut
| | - Herbert D Aronow
- Division of Cardiology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Ehrin J Armstrong
- Division of Cardiology, Denver VA Medical Center and University of Colorado, Denver, Colorado
| | - Andrew M Goldsweig
- Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Alan Dardik
- Division of Cardiology, Yale University, New Haven, Connecticut.,West Haven VA Medical Center, West Haven, Connecticut
| | - Alexandra J Lanksy
- Division of Cardiology, Yale University, New Haven, Connecticut.,Barts Heart Centre, University College London and Queen Mary University of London, London, UK
| | | | - J Dawn Abbott
- Division of Cardiology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
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22
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Chen J, Okimura K, Yoshimura T. Light and Hormones in Seasonal Regulation of Reproduction and Mood. Endocrinology 2020; 161:5879749. [PMID: 32738138 PMCID: PMC7442225 DOI: 10.1210/endocr/bqaa130] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/27/2020] [Indexed: 12/26/2022]
Abstract
Organisms that inhabit the temperate zone exhibit various seasonal adaptive behaviors, including reproduction, hibernation, molting, and migration. Day length, known as photoperiod, is the most noise-free and widely used environmental cue that enables animals to anticipate the oncoming seasons and adapt their physiologies accordingly. Although less clear, some human traits also exhibit seasonality, such as birthrate, mood, cognitive brain responses, and various diseases. However, the molecular basis for human seasonality is poorly understood. Herein, we first review the underlying mechanisms of seasonal adaptive strategies of animals, including seasonal reproduction and stress responses during the breeding season. We then briefly summarize our recent discovery of signaling pathways involved in the winter depression-like phenotype in medaka fish. We believe that exploring the regulation of seasonal traits in animal models will provide insight into human seasonality and aid in the understanding of human diseases such as seasonal affective disorder (SAD).
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Affiliation(s)
- Junfeng Chen
- Institute of Transformative Bio-Molecules (WPI-ITbM), Nagoya University, Nagoya, Japan
- Laboratory of Animal Integrative Physiology, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan
| | - Kousuke Okimura
- Institute of Transformative Bio-Molecules (WPI-ITbM), Nagoya University, Nagoya, Japan
- Laboratory of Animal Integrative Physiology, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan
| | - Takashi Yoshimura
- Institute of Transformative Bio-Molecules (WPI-ITbM), Nagoya University, Nagoya, Japan
- Laboratory of Animal Integrative Physiology, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan
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23
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Aklilu D, Wang T, Amsalu E, Feng W, Li Z, Li X, Tao L, Luo Y, Guo M, Liu X, Guo X. Short-term effects of extreme temperatures on cause specific cardiovascular admissions in Beijing, China. ENVIRONMENTAL RESEARCH 2020; 186:109455. [PMID: 32311528 DOI: 10.1016/j.envres.2020.109455] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 03/21/2020] [Accepted: 03/26/2020] [Indexed: 06/11/2023]
Abstract
Extreme temperature-related cardiovascular diseases (CVDs) have become a growing public health concern. However, the impact of temperature on the cause of specific CVDs has not been well studied in the study area. The objective of this study was to assess the impact of temperature on cause-specific cardiovascular hospital admissions in Beijing, China. We obtained data from 172 large general hospitals from the Beijing Public Health Information Center Cardiovascular Case Database and China. Meteorological Administration covering 16 districts in Beijing from 2013 to 2017. We used a time-stratified case crossover design with a distributed lag nonlinear model (DLNM) to derive the impact of temperature on CVD in hospitals back to 27 days on CVD admissions. The temperature data were stratified as cold (extreme and moderate ) and hot (moderate and extreme ). Within five years (January 2013-December 2017), a total of 460,938 (male 54.9% and female 45.1%) CVD admission cases were reported. The exposure-response relationship for hospitalization was described by a "J" shape for the total and cause-specific. An increase in the six-day moving average temperature from moderate hot (30.2 °C) to extreme hot (36.9 °C) resulted in a significant increase in CVD admissions of 16.1%(95% CI = 12.8%-28.9%). However, the effect of cold temperature exposure on CVD admissions over a lag time of 0-27 days was found to be non significant, with a relative risk of 0.45 (95% CI = 0.378-0.55) for extreme cold (-8.5 °C)and 0.53 (95% CI = 0.47-0.60) for moderate cold (-5.6 °C). The results of this study indicate that exposure to extremely high temperatures is highly associated with an increase in cause-specific CVD admissions. These finding may guide to create and raise awareness of the general population, government and private sectors regarding on the effects of current weather conditions on CVD.
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Affiliation(s)
- Deginet Aklilu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Tianqi Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Commission of Health and Family Planning Information Center, China
| | - Endwoke Amsalu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Wei Feng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
| | - Zhiwei Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Victoria, Australia
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Moning Guo
- Beijing Municipal Commission of Health and Family Planning Information Center, China
| | - Xiangtong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
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24
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Mohammad KN, Chan EYY, Wong MCS, Goggins WB, Chong KC. Ambient temperature, seasonal influenza and risk of cardiovascular disease in a subtropical area in Southern China. ENVIRONMENTAL RESEARCH 2020; 186:109546. [PMID: 32334173 DOI: 10.1016/j.envres.2020.109546] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Given the regular winter recurrence of influenza epidemics and the biologically plausible association between seasonal influenza and cardiovascular events, researchers assumed a valid and reliable influenza forecast could envision the timing and burden of winter surge in cardiovascular (CVD) hospitalizations. This, however, is well justified only in temperate regions. In this study, we aim to investigate the temporal association between ambient temperature, seasonal influenza and risk of cardiovascular events in a subtropical city. METHODS Generalized additive model was used in conjunction with distributed-lag non-linear model of quasi-Poisson family to estimate the association of interest with daily CVD admissions as outcome and daily influenza admissions as predictor, while controlling for meteorological factors (i.e. temperature, relative humidity, wind speed and total rainfall) and respiratory pollutants (i.e. nitrogen dioxide, sulphur dioxide, ozone and PM10). Results were expressed in the form of relative risk (RR). RESULTS Using median as the reference value, a U-shaped association was observed between CVD admissions and temperature. A slight decrease in RR was detected mainly towards the lower end of the temperature scale after adjusting for influenza admissions. Risk of CVD admission was found to be positively associated with the number of influenza hospitalization cases; this association remained consistent and statistically significant across subgroups of age except for those aged 5-49 years. CONCLUSION The slight reduction in CVD admission risk towards the lower end of the temperature scale after controlling for influenza activity might be attributed to the winter peaks of influenza, meaning that the effect of low temperature on CVD admissions might be partly mediated by influenza infection. In summary, this study reassures us that ambient temperature is independently associated with CVD hospital admissions and offers support for a positive association between seasonal influenza activity and cardiovascular events in Hong Kong.
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Affiliation(s)
- Kirran N Mohammad
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Emily Ying Yang Chan
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Martin Chi Sang Wong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - William Bernard Goggins
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Ka Chun Chong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Clinical Trials and Biostatistics Laboratory, Shenzhen Research Institute, The Chinese University of Hong Kong, China; Centre for Health System and Policy Research, The Chinese University of Hong Kong, Hong Kong, China.
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25
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Akioka H, Yufu K, Hara M, Abe I, Kondo H, Saito S, Fukui A, Okada N, Shinohara T, Teshima Y, Nakagawa M, Takahashi N. Impact of Age on Gender Differences in the Acute Myocardial Infarction Onset–Weather Association ― Oita AMI Registry ―. Circ Rep 2020; 2:152-157. [PMID: 33693222 PMCID: PMC7921360 DOI: 10.1253/circrep.cr-19-0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background:
The onset of acute myocardial infarction (AMI) is related to weather conditions, but the impact of age on gender differences in the AMI onset–weather association has not been elucidated. Methods and Results:
We analyzed the Oita AMI Registry and obtained data for 403 enrolled patients. To examine the impact of age, we categorized the patients into 4 groups: young (age ≤65 years) women (n=20); young men (n=123); elderly (age >65 years) women (n=84); and elderly men (n=176). The analyzed meteorological factors were maximum and minimum temperature, intraday temperature difference, average humidity, and average atmospheric pressure. The young women group had a higher minimum temperature (17.7±5.7℃ vs. 13.8±8.2℃, P=0.04), lower intraday temperature difference (7.0±2.6℃ vs. 8.4±2.9℃, P=0.03), higher average humidity (74.5±12.1% vs. 68.1±12.0%, P=0.03), and lower average atmospheric pressure (1,009.5±5.0 hPa vs. 1,012.9±5.8 hPa, P=0.01) than the young men group on the onset day. In the elderly groups, there was no significant difference in meteorological variables except for the intraday temperature difference 2 days before AMI onset. Conclusions:
AMI onset appears to be more sensitive to weather conditions (i.e., minimum temperature, average atmospheric pressure, and average humidity) in young patients than in elderly patients. In particular, young women had AMI on days with low intraday temperature difference and high humidity relative to men.
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Affiliation(s)
- Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Masahide Hara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Ichitaro Abe
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Akira Fukui
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Norihiro Okada
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
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Park S, Kario K, Chia Y, Turana Y, Chen C, Buranakitjaroen P, Nailes J, Hoshide S, Siddique S, Sison J, Soenarta AA, Sogunuru GP, Tay JC, Teo BW, Zhang Y, Shin J, Van Minh H, Tomitani N, Kabutoya T, Sukonthasarn A, Verma N, Wang T, Wang J, the HOPE Asia Network. The influence of the ambient temperature on blood pressure and how it will affect the epidemiology of hypertension in Asia. J Clin Hypertens (Greenwich) 2020; 22:438-444. [PMID: 31851429 PMCID: PMC8029770 DOI: 10.1111/jch.13762] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 09/21/2019] [Indexed: 12/14/2022]
Abstract
Epidemiologic studies have consistently demonstrated an increased risk of cardiovascular disease during colder temperatures. Hemodynamic changes associated with cold temperature and an increase in thrombogenicity may both account for the increase in cardiovascular risk and mortality. Studies using both in-office and out-of-office BP measurements have consistently shown an elevation in BP during the colder seasons. The large difference in BP between cold and warm months may increase the incidence of hypertension and reduce the hypertension control rate, potentially resulting in increased cardiovascular risk, especially among those at risk of cardiovascular disease. The current trends in global warming and climate change may have a profound impact on the epidemiology of hypertension and cardiovascular disease, as changes in the climate may significantly affect both BP variability and cardiovascular disease, especially in those with high cardiovascular risk and the elderly. Furthermore, climate change could have a significant influence on hypertension in Asia, considering the unique characteristics of hypertensive patients in Asia. As an increase in ambient temperature decreases the mean daytime average and morning surge in BP, but increases the nocturnal BP, it is difficult to predict how environmental changes will affect the epidemiology and prognosis of hypertension in the Asian-Pacific region. However, these seasonal variations in BP could be minimized by adjusting the housing conditions and using anticipation medicine. In this review, we discuss the impact of seasonal variation in the ambient temperature on hypertension and cardiovascular disease and discuss how this may impact the epidemiology of hypertension and cardiovascular disease.
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Affiliation(s)
- Sungha Park
- Division of CardiologyYonsei Cardiovascular HospitalYonsei University Health SystemSeoulKorea
- Integrative Research Center for Cerebrovascular and Cardiovascular DiseasesYonsei University College of MedicineSeoulKorea
| | - Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Yook‐Chin Chia
- Department of Medical SciencesSchool of Healthcare and Medical SciencesSunway UniversityBandar SunwayMalaysia
- Department of Primary Care MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Yuda Turana
- Faculty of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Chen‐Huan Chen
- Department of MedicineSchool of Medicine National Yang‐Ming UniversityTaipeiTaiwan
| | - Peera Buranakitjaroen
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Jennifer Nailes
- University of the East Ramon Magsaysay Memorial Medical Center Inc.Quezon CityPhilippines
| | - Satoshi Hoshide
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | | | - Jorge Sison
- Section of CardiologyDepartment of MedicineMedical Center ManilaManilaPhilippines
| | - Arieska Ann Soenarta
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversity of Indonesia‐National Cardiovascular CenterJakartaIndonesia
| | - Guru Prasad Sogunuru
- MIOT International HospitalChennaiIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingapore CitySingapore
| | - Boon Wee Teo
- Division of Nephrology Department of MedicineYong Loo Lin School of MedicineSingapore CitySingapore
| | - Yu‐Qing Zhang
- Divisions of Hypertension and Heart FailureFu Wai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jinho Shin
- Faculty of Cardiology ServiceHanyang University Medical CenterSeoulKorea
| | - Huynh Van Minh
- Department of Internal MedicineUniversity of Medicine and PharmacyHue UniversityHue CityVietnam
| | - Naoko Tomitani
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Tomoyuki Kabutoya
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Apichard Sukonthasarn
- Cardiology DivisionDepartment of Internal MedicineFaculty of MedicineChiang Mai UniversityChiang MaiThailand
| | - Narsingh Verma
- Department of PhysiologyKing George's Medical UniversityLucknowIndia
| | - Tzung‐Dau Wang
- Department of Internal MedicineNational Taiwan University College of MedicineTaipei CityTaiwan
| | - Ji‐Guang Wang
- Department of HypertensionCentre for Epidemiological Studies and Clinical TrialsShanghai Key Laboratory of HypertensionThe Shanghai Institute of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
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Pradhan B, Kjellstrom T, Atar D, Sharma P, Kayastha B, Bhandari G, Pradhan P. Heat Stress Impacts on Cardiac Mortality in Nepali Migrant Workers in Qatar. Cardiology 2019; 143:37-48. [DOI: 10.1159/000500853] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 05/02/2019] [Indexed: 11/19/2022]
Abstract
Background: Qatar is a major destination country for Nepali migrant workers (NMWs; main age range 25–35 years) in the construction trade. These 120,000+ NMWs are exposed to various occupational hazards, including excessive heat, and 3–4 workers die each week. Our study aimed to show whether heat exposure caused deaths. Methods: The worker population and mortality data of NMWs were retrieved from government institutions in Nepal. Heat exposure was assessed by monthly estimates of daily wet bulb globe temperature (WBGT), for in-shade conditions, from data collected at the Doha weather station from 2009 to 2017. Working in the sun during the middle of the day would add 2–3°C to the in-shade WBGT values. Daily deaths and their causes were obtained from the records of the Foreign Employment Promotion Board (FEPB) in Nepal, 2009–2017. Interviews with returning NMWs about their working conditions and the impacts of these conditions added information. The association between the heat variable and mortality was tested with standard statistical methods. Results: The average annual death rate for NMWs in Qatar was 150 deaths/100,000. According to interviews, the majority of NMWs were found working in high WBGT (>31°C) each working day during hot months. The major cause of these deaths was recorded as cardiovascular problems (cardiovascular disease; CVD). Unfortunately, the causes of death were poorly described, and many deaths were listed as “cardiac arrest.” We included these deaths in the broader category of “cardiovascular causes.” There was a strong correlation between average monthly afternoon heat levels (WBGT) and CVD mortality. It is likely that a large proportion of these CVD deaths during hot months were due to serious heat stroke. Global studies show that approximately 15% of deaths in the age group 25–35 years are due to CVD causes. However, in this NMW population, the figures were 22% during the cool season and 58% during the hot season. Conclusions: The increased CVD mortality during hot periods is most likely due to severe heat stress. As many as 200 of the 571 CVD deaths during 2009–2017 could have been prevented if effective heat protection had been implemented as a part of local occupational health and safety programs. There is an urgent need for protection against such heat effects among NMWs, and rising temperatures from ongoing climate change are further increasing the health risks. Cause of death records for workers dying in hot conditions should be more precise than “cardiac arrest.”
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Vicent L, Bruña V, Devesa C, Sousa-Casasnovas I, Juárez M, Fernández-Avilés F, Martinez-Sellés M. Seasonality in Mortality in a Cardiology Department: A Five-Year Analysis in 500 Patients. Cardiology 2019; 142:67-72. [PMID: 30999316 DOI: 10.1159/000497815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 02/07/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Previous studies have indicated that cardiovascular mortality follows a seasonal trend. The aim of this work was to determine the evolution of mortality throughout the year in a cardiology department. METHODS All admissions and deaths occurring in our Cardiology Department over a 5-year period (2013-2017) were recorded retrospectively. RESULTS From a total of 17,829 hospital admissions, 500 patients died (2.8%, 0.3 patients/day). The mean age of deceased patients was 74.2 ± 13.1 years, and 186 (37.2%) were women. Mortality ranged from 0.17 deaths/day in August to 0.40 deaths/day in February (p = 0.03), and from 0.20 deaths/day in summer to 0.36 deaths/day in winter (p = 0.001). There was also a trend towards a variation in hospitalizations, with a peak in January (10.5 admissions/day) and the lowest figure in August (7.0 admissions/day), p = 0.047. We found no significant seasonal trend regarding mortality rate with respect to the number of hospital admissions (p = 0.89). The most common cause of death was refractory heart failure (267 patients [65.8%]). A noncardiac cause of death was observed in 134 patients (26.8%). CONCLUSIONS In a cardiology department, there are twice as many deaths in winter as in summer. Hospitalizations also tend to be more frequent in winter than in summer.
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Affiliation(s)
- Lourdes Vicent
- Servicio de Cardiología, Hospital Universitario Gregorio Marañón, CIBERCV, Madrid, Spain
| | - Vanesa Bruña
- Servicio de Cardiología, Hospital Universitario Gregorio Marañón, CIBERCV, Madrid, Spain
| | - Carolina Devesa
- Servicio de Cardiología, Hospital Universitario Gregorio Marañón, CIBERCV, Madrid, Spain
| | - Iago Sousa-Casasnovas
- Servicio de Cardiología, Hospital Universitario Gregorio Marañón, CIBERCV, Madrid, Spain
| | - Miriam Juárez
- Servicio de Cardiología, Hospital Universitario Gregorio Marañón, CIBERCV, Madrid, Spain
| | - Francisco Fernández-Avilés
- Servicio de Cardiología, Hospital Universitario Gregorio Marañón, CIBERCV, Madrid, Spain.,Universidad Complutense de Madrid, Madrid, Spain
| | - Manuel Martinez-Sellés
- Servicio de Cardiología, Hospital Universitario Gregorio Marañón, CIBERCV, Madrid, Spain, .,Universidad Complutense de Madrid, Madrid, Spain, .,Universidad Europea de Madrid, Madrid, Spain,
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29
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Gebhard CE, Gebhard C, Maafi F, Bertrand MJ, Stähli BE, Maredziak M, Bengs S, Haider A, Zhang ZW, Smith DC, Ly HQ. Impact of summer season on pre-hospital time delays in women and men undergoing primary percutaneous coronary intervention. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 656:322-330. [PMID: 30513423 DOI: 10.1016/j.scitotenv.2018.11.363] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 11/22/2018] [Accepted: 11/24/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Pre-hospital delays have been associated with poor outcomes in patients with acute ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). It is currently unknown how environmental variables affect treatment delays in these patients. METHODS AND RESULTS The association between environmental variables, time to treatment including transportation times and adverse in-hospital events was assessed in 1828 consecutive patients with STEMI undergoing primary PCI between 2010 and 2014 in the Montreal metropolitan area. Median[Q1;Q3] total ischemia time was significantly longer during summer season (April-September) as compared to winter season (October-March, 201[140;305] min vs 187[126;266] min, p = 0.022). This difference between seasons was due to a significant increase in median decision time to seek treatment for symptoms during summer (90[46;185] min vs 78[40;156], p = 0.004). The former peaked during July and August and was most pronounced in men. Hence, outside temperature and summer season were identified as strong predictors of prolonged decision time in patients with STEMI (p < 0.001 and p = 0.002, respectively). Transportation times slightly increased during winter season and snow fall, this difference, however, was not significant (p = 0.46). A significant increase in in-hospital adverse outcomes following primary PCI was observed during summer season as compared to winter season (7.2% vs 4.8%, p = 0.032). Accordingly, multivariate logistic regression models adjusted for baseline variables identified summer season as a strong predictor of periprocedural adverse events (OR 1.83, 95% CI 1.2-3.11, p = 0.037). CONCLUSION Contrary to our initial hypothesis, pre-hospital delays in patients with STEMI are considerably longer and associated with adverse in-hospital outcomes during summer season. Considering the consequences of global warming, it is imperative that educational efforts targeting patients' perception are implemented to counter treatment delays.
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Affiliation(s)
- Caroline E Gebhard
- Montreal Heart Institute, Montreal, Canada; Department of Anaesthesiology and Intensive Care Medicine, University Hospital Basel, Basel, Switzerland
| | - Catherine Gebhard
- Montreal Heart Institute, Montreal, Canada; Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland; Center for Molecular Cardiology, University of Zurich, Switzerland.
| | | | | | | | - Monika Maredziak
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland; Center for Molecular Cardiology, University of Zurich, Switzerland
| | - Susan Bengs
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland; Center for Molecular Cardiology, University of Zurich, Switzerland
| | - Achi Haider
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland; Center for Molecular Cardiology, University of Zurich, Switzerland
| | | | | | - Hung Q Ly
- Montreal Heart Institute, Montreal, Canada; Department of Medicine, Université de Montréal, Montreal, Canada
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30
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López-Fernández L, López-Messa J, Andrés-de Llano J, Garmendia-Leiza JR, García-Cruces J, García-Crespo J. Relationship between seasonal influenza rates and hospitalization and mortality rates due to acute cardiovascular diseases in a Spanish region. Med Clin (Barc) 2019; 153:133-140. [PMID: 30738617 DOI: 10.1016/j.medcli.2018.11.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 10/26/2018] [Accepted: 11/08/2018] [Indexed: 12/30/2022]
Abstract
INTRODUCTION AND OBJECTIVE Influenza virus infection can contribute to cardiovascular morbidity and mortality. The purpose of this study is to confirm if the increase in seasonal influenza rates is associated with a growth in hospitalisation and mortality rates for acute cardiovascular diseases (ACVD). METHODS Retrospective cohort study of hospital discharges due to ACVD (myocardial infarction, unstable angina, heart failure and ischemic stroke) in the Castilla y León (Spain) hospital system between 2001 and 2015. Hospitalisation and hospital mortality rates due to ACVD, and influenza rates in Castilla y León between 2001 and 2015 were studied. To calculate hospitalisation and mortality rates, the hospital discharges database was used; for influenza rates, the weekly reports of the Sentinel System for the surveillance of influenza in Spain (Carlos III Health Institute) were used. A statistical analysis of linear and multivariate logistic regressions was performed. RESULTS 239,586 ACVD (myocardial infarction: 55,004; unstable angina: 15,406; heart failure: 11,1647; ischemic stroke: 57,529) were studied. Increasing rates of influenza were associated with increased mortality due to ACVD and all the diseases studied, except unstable angina. A linear correlation was observed between influenza rates and hospitalisation (r2=0.03; p=0.02) and mortality (r2=0.14; p<0.001) rates by ACVD. Virtually all influenza rates were associated, as independent variables, to an increase in mortality due to ACVD, being higher in rates>139/100,000 inhabitants (OR: 1.25; p<0.001). CONCLUSIONS The rates of hospitalisation and in-hospital mortality due to ACVD in the period 2001-2015 increased in relation to infection rates due to the influenza virus.
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Affiliation(s)
- Laura López-Fernández
- Servicio de Medicina Intensiva, Complejo Asistencial Universitario de Palencia, Palencia, España
| | - Juan López-Messa
- Servicio de Medicina Intensiva, Complejo Asistencial Universitario de Palencia, Palencia, España.
| | - Jesús Andrés-de Llano
- Unidad de Investigación, Complejo Asistencial Universitario de Palencia, Palencia, España
| | | | - Jesús García-Cruces
- Unidad de Medicina Preventiva, Complejo Asistencial Universitario de Palencia, Palencia, España
| | - Julio García-Crespo
- Unidad de Medicina Preventiva, Complejo Asistencial Universitario de Palencia, Palencia, España
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Cherry consumption out of season alters lipid and glucose homeostasis in normoweight and cafeteria-fed obese Fischer 344 rats. J Nutr Biochem 2019; 63:72-86. [DOI: 10.1016/j.jnutbio.2018.09.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 07/30/2018] [Accepted: 09/12/2018] [Indexed: 02/06/2023]
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Extreme influenza epidemics and out-of-hospital cardiac arrest. Int J Cardiol 2018; 263:158-162. [PMID: 29754914 DOI: 10.1016/j.ijcard.2018.02.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 01/11/2018] [Accepted: 02/08/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION There is compelling evidence for an association between influenza epidemics and major adverse cardiovascular events. However, the role of extreme influenza epidemics as a trigger of out-of-hospital cardiac arrest (OHCA) is unclear. Thus, we evaluated the potential association between extreme influenza epidemics and incidence of OHCA. METHODS We used a quasi-experimental design with time-series analysis of national registry data for cases of OHCA from all 47 prefectures of Japan during influenza seasons between 2005 and 2014. A Poisson regression time-series model with a distributed lag non-linear model was used to estimate prefecture-specific effects of influenza epidemics on OHCA. A multivariate meta-analysis was conducted for nationally pooled estimates. RESULTS In total, 481,516 OHCAs of presumed cardiac origin were reported during the study period. The minimum morbidity percentile (MMP) was estimated as the 0th percentile for influenza incidence. The overall cumulative relative risk versus the MMP was 1.25 (95% confidence interval, 1.16-1.34) for extreme influenza epidemics (at the 99th percentile of influenza incidence). The effect of extreme influenza epidemics was significant for lag periods of 1.5-7.1 and 17.9-21 days. Multivariate random-effects meta-analysis indicated significant spatial heterogeneity among prefectures (Cochran Q test, p = 0.011; I2 = 23.2%). CONCLUSION Extreme influenza epidemics are associated with higher risk of OHCA. Our findings suggest that several weeks' prevention for extreme influenza infections should be implemented to reduce the risk of OHCA.
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Mariné-Casadó R, Domenech-Coca C, Del Bas JM, Bladé C, Arola L, Caimari A. Intake of an Obesogenic Cafeteria Diet Affects Body Weight, Feeding Behavior, and Glucose and Lipid Metabolism in a Photoperiod-Dependent Manner in F344 Rats. Front Physiol 2018; 9:1639. [PMID: 30534077 PMCID: PMC6275206 DOI: 10.3389/fphys.2018.01639] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/30/2018] [Indexed: 12/14/2022] Open
Abstract
We previously demonstrated that chronic exposure to different photoperiods induced marked variations in several glucose and lipid metabolism-related parameters in normoweight Fischer 344 (F344) rats. Here, we examined the effects of the combination of an obesogenic cafeteria diet (CAF) and the chronic exposure to three different day lengths (L12, 12 h light/day; L18, 18 h light/day; and L6, 6 h light/day) in this rat strain. Although no changes were observed during the first 4 weeks of adaptation to the different photoperiods in which animals were fed a standard diet, the addition of the CAF for the subsequent 7 weeks triggered profound physiologic and metabolic alterations in a photoperiod-dependent manner. Compared with L12 rats, both L6 and L18 animals displayed lower body weight gain and cumulative food intake in addition to decreased energy expenditure and locomotor activity. These changes were accompanied by differences in food preferences and by a sharp upregulation of the orexigenic genes Npy and Ghsr in the hypothalamus, which could be understood as a homeostatic mechanism for increasing food consumption to restore body weight control. L18 rats also exhibited higher glycemia than the L6 group, which could be partly attributed to the decreased pAkt2 levels in the soleus muscle and the downregulation of Irs1 mRNA levels in the gastrocnemius muscle. Furthermore, L6 animals displayed lower whole-body lipid utilization than the L18 group, which could be related to the lower lipid intake and to the decreased mRNA levels of the fatty acid transporter gene Fatp1 observed in the soleus muscle. The profound differences observed between L6 and L18 rats could be related with hepatic and muscular changes in the expression of circadian rhythm-related genes Cry1, Bmal1, Per2, and Nr1d1. Although further research is needed to elucidate the pathophysiologic relevance of these findings, our study could contribute to emphasize the impact of the consumption of highly palatable and energy dense foods regularly consumed by humans on the physiological and metabolic adaptations that occur in response to seasonal variations of day length, especially in diseases associated with changes in food intake and preference such as obesity and seasonal affective disorder.
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Affiliation(s)
- Roger Mariné-Casadó
- Eurecat, Centre Tecnològic de Catalunya, Technological Unit of Nutrition and Health, Reus, Spain
| | - Cristina Domenech-Coca
- Nutrigenomics Research Group, Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Josep Maria Del Bas
- Eurecat, Centre Tecnològic de Catalunya, Technological Unit of Nutrition and Health, Reus, Spain
| | - Cinta Bladé
- Nutrigenomics Research Group, Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Lluís Arola
- Eurecat, Centre Tecnològic de Catalunya, Technological Unit of Nutrition and Health, Reus, Spain.,Nutrigenomics Research Group, Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Antoni Caimari
- Eurecat, Centre Tecnològic de Catalunya, Technological Unit of Nutrition and Health, Reus, Spain
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Health effects of seasonal variation in cardiovascular hemodynamics among workers in forest environments. Hypertens Res 2018; 42:223-232. [PMID: 30429541 DOI: 10.1038/s41440-018-0136-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 07/25/2018] [Accepted: 07/27/2018] [Indexed: 11/08/2022]
Abstract
Seasonal variation in cardiovascular functions (CVFs) associated with climatic changes is an important emerging public health issue. The objectives of this study were to demonstrate seasonal variation in CVFs by comparing intra-individual differences between winter and summer among people working in a forest environment and to discuss the possible mechanisms accounting for the health effects of seasonal variation in cardiovascular hemodynamics. A total of 72 staff members of the Experimental Forest of National Taiwan University were recruited for continuous health monitoring during two seasons to investigate the intra-individual seasonal variation in CVFs, complete blood counts, and biochemical examinations. CVFs were assessed by measuring the arterial pressure waveform by a cuff sphygmomanometer using an oscillometric blood pressure device, and aortic stiffness was measured by brachial-ankle pulse wave velocity (baPWV). The results showed that cholesterol levels, white and red blood cell counts, and platelet counts were higher in winter than in summer. Subjects showed not only higher vascular stress, as indicated by higher levels of brachial systolic and diastolic blood pressure (SBP and DBP), central end-SBP and DBP, systemic vascular resistance (SVR), and baPWV, but also lower cardiac activities, including lower levels of heart rate, left ventricular contractility, and cardiac output in winter than in summer. The central and brachial BP, cardiac output, SVR, and baPWV were significantly associated with temperature changes in seasonal variation after controlling related confounding factors. This study provides evidence of higher vascular stress and susceptibility to atherothrombosis during winter compared with summer.
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Hicks A, Healy E, Sandeman N, Feelisch M, Wilkinson T. A time for everything and everything in its time - exploring the mechanisms underlying seasonality of COPD exacerbations. Int J Chron Obstruct Pulmon Dis 2018; 13:2739-2749. [PMID: 30233164 PMCID: PMC6130531 DOI: 10.2147/copd.s146015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Across Europe, COPD affects 23 million people leading to annual health care costs of ~€25.1 billion. This burden is particularly severe during winter months in association with the peak incidence of exacerbation events. Seasonal variation in the health status of patients with COPD places additional and often critical pressure on already strained health care resources. COPD exacerbations are characterized by worsening day-to-day symptoms of an individual and often triggered by respiratory infections, but the process by which this occurs in a seasonal fashion is likely to be multifactorial. In this review, we discuss recent population studies that highlight the impact of seasonality in COPD and review the proposed biological mechanisms underlying this. An appraisal of the role of the host susceptibility and response, environmental triggers and the biology of respiratory pathogens is detailed. The impact of each aspect is considered, and an integrated model of the context for the whole individual and society in general is explored.
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Affiliation(s)
- Alexander Hicks
- Clinical and Experimental Sciences, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK, .,Southampton NIHR Respiratory Biomedical Research Centre, Southampton General Hospital, Southampton, UK, .,National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Wessex, Southampton General Hospital, Southampton, UK,
| | - Eugene Healy
- Clinical and Experimental Sciences, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK,
| | - Natasha Sandeman
- Clinical and Experimental Sciences, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK,
| | - Martin Feelisch
- Clinical and Experimental Sciences, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK, .,Southampton NIHR Respiratory Biomedical Research Centre, Southampton General Hospital, Southampton, UK,
| | - Tom Wilkinson
- Clinical and Experimental Sciences, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK, .,Southampton NIHR Respiratory Biomedical Research Centre, Southampton General Hospital, Southampton, UK, .,National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Wessex, Southampton General Hospital, Southampton, UK, .,Wessex Investigational Sciences Hub, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK
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Hadlow N, Brown S, Wardrop R, Conradie J, Henley D. Where in the world? Latitude, longitude and season contribute to the complex co-ordinates determining cortisol levels. Clin Endocrinol (Oxf) 2018; 89:299-307. [PMID: 29846966 DOI: 10.1111/cen.13754] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/27/2018] [Accepted: 05/28/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Cortisol is a critical stress hormone with circadian rhythms synchronized by light. There are seasonal differences in expression of pro-inflammatory genes and in some diseases moderated by glucocorticoids. As light changes with season and with latitude and longitude, we assessed changes in population cortisol associated with these parameters. DESIGN Retrospective data audit. PATIENTS Populations across 4 states of Australia over 3 years. MEASUREMENTS Serum cortisol levels, age, gender, time of collection, sunrise time, season and location were determined. RESULTS In 4 geographically separate populations (n = 84 937), sunrise time and time of sample collection were the most important factors influencing median cortisol. Over 2 hours in the morning cortisol could decrease by up to 76 nmol/L, and for each hour that sunrise time advanced there was up to 6.9% increase in cortisol. A cyclic seasonal pattern of cortisol was confirmed each year in all populations with autumn/winter cortisol highest compared to spring/summer with differences of up to 44 nmol/L. There was less change in cortisol in latitudes closer to the equator but cortisol progressively increased from 25 to 30°S of the equator. In more southerly latitudes, seasonal cortisol variation also increased, and over the entire latitude range, there was up to 50 nmol/L change in cortisol. Longitude variation within a time zone had a minimal effect on median cortisol. CONCLUSIONS Location, time of year and time of day are important influences on population cortisol levels. Elevated autumn/winter morning cortisol levels are likely due to sampling closer to the circadian peak due to later sunrise time. Understanding how the environment can influence cortisol levels may further our knowledge of physiology and disease.
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Affiliation(s)
- Narelle Hadlow
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - Suzanne Brown
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Robert Wardrop
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Johan Conradie
- Department of Biochemistry, Western Diagnostic Pathology, Myaree, Western Australia, Australia
| | - David Henley
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
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Wyse CA, Celis Morales CA, Ward J, Lyall D, Smith DJ, Mackay D, Curtis AM, Bailey MES, Biello S, Gill JMR, Pell JP. Population-level seasonality in cardiovascular mortality, blood pressure, BMI and inflammatory cells in UK biobank. Ann Med 2018; 50:410-419. [PMID: 29724143 DOI: 10.1080/07853890.2018.1472389] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION The risk of mortality from cardiovascular disease (CVD) is higher in wintertime throughout the world, but it is not known if this reflects annual changes in diet or lifestyle, or an endogenous photoperiodic mechanism that is sensitive to changes in day length. METHODS Phenotypic data on cardiometabolic and lifestyle factors were collected throughout a 4 year time period from 502,642 middle-aged participants in UK Biobank. To assess the impact of seasonal environmental changes on cardiovascular risk factors, we linked these data to the outdoor temperature and day length at the time of assessment. Self-reported information on physical activity, diet and disease status were used to adjust for confounding factors related to health and lifestyle. RESULTS Mortality related to CVD was higher in winter, as were risk factors for this condition including blood pressure, markers of inflammation and body mass index (BMI). These seasonal rhythms were significantly related to day length after adjustment for other factors that might affect seasonality including physical activity, diet and outdoor temperature. CONCLUSIONS The risk of CVD may be modulated by day length at temperate latitudes, and the implications of seasonality should be considered in all studies of human cardiometabolic health. Key messages In this cross-sectional study in UK Biobank, we report annual variations in cardiovascular risk factors and mortality that were associated with day length independent of environmental and lifestyle factors. These seasonal changes in day length might contribute to annual patterns in cardiovascular disease and mortality.
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Affiliation(s)
- Cathy A Wyse
- a Department of Molecular and Cellular Therapeutics Department , Royal College of Surgeons in Ireland (RCSI) , Dublin , Ireland.,b Institute of Biodiversity, Animal Health and Comparative Medicine , University of Glasgow , Glasgow , UK
| | - Carlos A Celis Morales
- c Institute of Cardiovascular and Medical Sciences , University of Glasgow , Glasgow , UK
| | - Joey Ward
- d Institute of Health and Wellbeing , University of Glasgow , Glasgow , UK
| | - Donald Lyall
- d Institute of Health and Wellbeing , University of Glasgow , Glasgow , UK
| | - Daniel J Smith
- d Institute of Health and Wellbeing , University of Glasgow , Glasgow , UK
| | - Daniel Mackay
- d Institute of Health and Wellbeing , University of Glasgow , Glasgow , UK
| | - Annie M Curtis
- a Department of Molecular and Cellular Therapeutics Department , Royal College of Surgeons in Ireland (RCSI) , Dublin , Ireland
| | - Mark E S Bailey
- e School of Life Sciences , University of Glasgow , Glasgow , UK
| | - Stephany Biello
- f Institute of Neuroscience and Psychology , University of Glasgow , Glasgow , UK
| | - Jason M R Gill
- c Institute of Cardiovascular and Medical Sciences , University of Glasgow , Glasgow , UK
| | - J P Pell
- d Institute of Health and Wellbeing , University of Glasgow , Glasgow , UK
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Nguyen JL, Yang W, Ito K, Matte TD, Shaman J, Kinney PL. Seasonal Influenza Infections and Cardiovascular Disease Mortality. JAMA Cardiol 2018; 1:274-81. [PMID: 27438105 DOI: 10.1001/jamacardio.2016.0433] [Citation(s) in RCA: 263] [Impact Index Per Article: 37.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
IMPORTANCE Cardiovascular deaths and influenza epidemics peak during winter in temperate regions. OBJECTIVES To quantify the temporal association between population increases in seasonal influenza infections and mortality due to cardiovascular causes and to test if influenza incidence indicators are predictive of cardiovascular mortality during the influenza season. DESIGN, SETTING, AND PARTICIPANTS Time-series analysis of vital statistics records and emergency department visits in New York City, among cardiovascular deaths that occurred during influenza seasons between January 1, 2006, and December 31, 2012. The 2009 novel influenza A(H1N1) pandemic period was excluded from temporal analyses. EXPOSURES Emergency department visits for influenza-like illness, grouped by age (≥0 years and ≥65 years) and scaled by laboratory surveillance data for viral types and subtypes, in the previous 28 days. MAIN OUTCOMES AND MEASURES Mortality due to cardiovascular disease, ischemic heart disease, and myocardial infarction. RESULTS Among adults 65 years and older, who accounted for 83.0% (73 363 deaths) of nonpandemic cardiovascular mortality during influenza seasons, seasonal average influenza incidence was correlated year to year with excess cardiovascular mortality (Pearson correlation coefficients ≥0.75, P ≤ .05 for 4 different influenza indicators). In daily time-series analyses using 4 different influenza metrics, interquartile range increases in influenza incidence during the previous 21 days were associated with an increase between 2.3% (95% CI, 0.7%-3.9%) and 6.3% (95% CI, 3.7%-8.9%) for cardiovascular disease mortality and between 2.4% (95% CI, 1.1%-3.6%) and 6.9% (95% CI, 4.0%-9.9%) for ischemic heart disease mortality among adults 65 years and older. The associations were most acute and strongest for myocardial infarction mortality, with each interquartile range increase in influenza incidence during the previous 14 days associated with mortality increases between 5.8% (95% CI, 2.5%-9.1%) and 13.1% (95% CI, 5.3%-20.9%). Out-of-sample prediction of cardiovascular mortality among adults 65 years and older during the 2009-2010 influenza season yielded average estimates with 94.0% accuracy using 4 different influenza metrics. CONCLUSIONS AND RELEVANCE Emergency department visits for influenza-like illness were associated with and predictive of cardiovascular disease mortality. Retrospective estimation of influenza-attributable cardiovascular mortality burden combined with accurate and reliable influenza forecasts could predict the timing and burden of seasonal increases in cardiovascular mortality.
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Affiliation(s)
- Jennifer L Nguyen
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Wan Yang
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Kazuhiko Ito
- Bureau of Environmental Surveillance and Policy, New York City Department of Health and Mental Hygiene, New York
| | - Thomas D Matte
- Bureau of Environmental Surveillance and Policy, New York City Department of Health and Mental Hygiene, New York
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Patrick L Kinney
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
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Increased Kawasaki Disease Incidence Associated With Higher Precipitation and Lower Temperatures, Japan, 1991-2004. Pediatr Infect Dis J 2018; 37:526-530. [PMID: 29140936 DOI: 10.1097/inf.0000000000001838] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Kawasaki disease (KD) is an acute febrile vasculitis, which primarily affects children. The etiology of KD is unknown; while certain characteristics of the disease suggest an infectious origin, genetic or environmental factors may also be important. Seasonal patterns of KD incidence are well documented, but it is unclear whether these patterns are caused by changes in climate or by other unknown seasonal effects. METHODS The relationship between KD incidence and deviations from expected temperature and precipitation were analyzed using KD incidence data from Japanese nationwide epidemiologic surveys (1991-2004) and climate data from 136 weather stations of the Japan Meteorological Agency. Seven separate Poisson-distributed generalized linear regression models were run to examine the effects of temperature and precipitation on KD incidence in the same month as KD onset and the previous 1, 2, 3, 4, 5 and 6 months, controlling for geography as well as seasonal and long-term trends in KD incidence. RESULTS KD incidence was negatively associated with temperature in the previous 2, 3, 4 and 5 months and positively associated with precipitation in the previous 1 and 2 months. The model that best predicted variations in KD incidence used climate data from the previous 2 months. An increase in total monthly precipitation by 100 mm was associated with increased KD incidence (rate ratio [RR] 1.012, 95% confidence interval [CI]: 1.005-1.019), and an increase of monthly mean temperature by 1°C was associated with decreased KD incidence (RR 0.984, 95% CI: 0.978-0.990). CONCLUSIONS KD incidence was significantly affected by temperature and precipitation in previous months independent of other unknown seasonal factors. Climate data from the previous 2 months best predicted the variations in KD incidence. Although fairly minor, the effect of temperature and precipitation independent of season may provide additional clues to the etiology of KD.
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40
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Riggs DW, Yeager RA, Bhatnagar A. Defining the Human Envirome: An Omics Approach for Assessing the Environmental Risk of Cardiovascular Disease. Circ Res 2018; 122:1259-1275. [PMID: 29700071 PMCID: PMC6398443 DOI: 10.1161/circresaha.117.311230] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Both genetic and environmental factors contribute to the development of cardiovascular disease, but in comparison with genetics, environmental factors have received less attention. Evaluation of environmental determinants of cardiovascular disease is limited by the lack of comprehensive omics approaches for integrating multiple environmental exposures. Hence, to understand the effects of the environment as a whole (envirome), it is important to delineate specific domains of the environment and to assess how, individually and collectively; these domains affect cardiovascular health. In this review, we present a hierarchical model of the envirome; defined by 3 consecutively nested domains, consisting of natural, social, and personal environments. Extensive evidence suggests that features of the natural environment such as sunlight, altitude, diurnal rhythms, vegetation, and biodiversity affect cardiovascular health. However, the effects of the natural environment are moderated by the social environment comprised of built environments, agricultural and industrial activities, pollutants and contaminants, as well as culture, economic activities, and social networks that affect health by influencing access to healthcare, social cohesion, and socioeconomic status. From resources available within society, individuals create personal environments, characterized by private income, wealth and education, and populated by behavioral and lifestyle choices relating to nutrition, physical activity, sleep, the use of recreational drugs, and smoking. An understanding of the interactions between different domains of the envirome and their integrated effects on cardiovascular health could lead to the development of new prevention strategies and deeper insights into etiologic processes that contribute to cardiovascular disease risk and susceptibility.
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Affiliation(s)
- Daniel W Riggs
- From the Diabetes and Obesity Center (D.W.R., R.A.Y., A.B.)
| | - Ray A Yeager
- From the Diabetes and Obesity Center (D.W.R., R.A.Y., A.B.)
| | - Aruni Bhatnagar
- From the Diabetes and Obesity Center (D.W.R., R.A.Y., A.B.)
- Institute of Molecular Cardiology (A.B.), University of Louisville, KY
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41
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Mariné-Casadó R, Domenech-Coca C, Del Bas JM, Bladé C, Arola L, Caimari A. The Exposure to Different Photoperiods Strongly Modulates the Glucose and Lipid Metabolisms of Normoweight Fischer 344 Rats. Front Physiol 2018; 9:416. [PMID: 29725308 PMCID: PMC5917113 DOI: 10.3389/fphys.2018.00416] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 04/04/2018] [Indexed: 01/08/2023] Open
Abstract
Seasonal variations in day length trigger clear changes in the behavior, growth, food intake, and reproductive status of photoperiod-sensitive animals, such as Fischer 344 rats. However, there is little information about the effects of seasonal fluctuations in day length on glucose and lipid metabolisms and their underlying mechanisms in this model. To gain knowledge on these issues, three groups of male Fischer 344 rats were fed with a standard diet and exposed to different photoperiods for 14 weeks: normal photoperiod (L12, 12 h light/day), long photoperiod (L18, 18 h light/day), and short photoperiod (L6, 6 h light/day). A multivariate analysis carried out with 239 biometric, serum, hepatic and skeletal muscle parameters revealed a clear separation among the three groups. Compared with L12 rats, L6 animals displayed a marked alteration of glucose homeostasis and fatty acid uptake and oxidation, which were evidenced by the following observations: (1) increased circulating levels of glucose and non-esterified fatty acids; (2) a sharp down-regulation of the phosphorylated Akt2 levels, a downstream post-receptor target of insulin, in both the soleus and gastrocnemius muscles; (3) decreased expression in the soleus muscle of the glucose metabolism-related microRNA-194 and lower mRNA levels of the genes involved in glucose metabolism (Irs1, soleus, and Glut2, liver), β-oxidation (Had and Cpt1β, soleus) and fatty acid transport (Cd36, soleus, and liver). L18 animals also displayed higher blood glucose levels than L12 rats and profound changes in other glucose and lipid metabolism-related parameters in the blood, liver, and skeletal muscles. However, the mechanisms that account for the observed effects were less evident than those reported in L6 animals. In conclusion, exposure to different photoperiods strongly modulated glucose and lipid metabolisms in normoweight rats. These findings emphasize the relevance of circannual rhythms in metabolic homeostasis regulation and suggest that Fischer 344 rats are a promising animal model with which to study glucose- and lipid-related pathologies that are influenced by seasonal variations, such as obesity, cardiovascular disease and seasonal affective disorder.
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Affiliation(s)
- Roger Mariné-Casadó
- Technological Unit of Nutrition and Health, Eurecat, Technology Centre of Catalonia, Reus, Spain
| | - Cristina Domenech-Coca
- Nutrigenomics Research Group, Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Josep M Del Bas
- Technological Unit of Nutrition and Health, Eurecat, Technology Centre of Catalonia, Reus, Spain
| | - Cinta Bladé
- Nutrigenomics Research Group, Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Lluís Arola
- Technological Unit of Nutrition and Health, Eurecat, Technology Centre of Catalonia, Reus, Spain.,Nutrigenomics Research Group, Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Antoni Caimari
- Technological Unit of Nutrition and Health, Eurecat, Technology Centre of Catalonia, Reus, Spain
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Rao RT, Pierre KK, Schlesinger N, Androulakis IP. The Potential of Circadian Realignment in Rheumatoid Arthritis. Crit Rev Biomed Eng 2017; 44:177-191. [PMID: 28605351 DOI: 10.1615/critrevbiomedeng.2016018812] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In this short review, we discuss evidence supporting the modulation of peripheral circadian systems as a therapeutic strategy for rheumatoid arthritis (RA). We first review the role of proinflammatory cytokines and oxidative stress, two of the primary mediators of chronic inflammation in RA, and their regulation by circadian clock machinery. We further highlight the role of environmental and metabolic signals in regulating the central and peripheral circadian clocks, with an emphasis on seasonal variations in photoperiod and rhythmic metabolic input, respectively. Finally, we hypothesize that the entrainment and realignment of peripheral clock rhythms have the ability to modulate these mediators, improving clinical outcomes in RA patients. Our discussion emphasizes the use of light therapy and time-restricted feeding for entraining peripheral clocks either via the entrainment of the central circadian clock in suprachiasmatic nuclei (SCN) or directly by uncoupling the peripheral circadian clocks from SCN. In doing so, we highlight the use of nonpharmacologic interventions as a potential strategy for improving clinical outcomes in chronic inflammatory conditions such as RA.
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Affiliation(s)
- Rohit T Rao
- Chemical & Biochemical Engineering Department, Rutgers University, Piscataway, New Jersey
| | - Kamau K Pierre
- Biomedical Engineering Department, Rutgers University, Piscataway, New Jersey
| | - Naomi Schlesinger
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Ioannis P Androulakis
- Chemical and Biochemical Engineering Department, Rutgers University, Piscataway, New Jersey; Biomedical Engineering Department, Rutgers University, Piscataway, New Jersey; Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
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43
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Obi Y, Kalantar-Zadeh K, Streja E, Rhee CM, Reddy UG, Soohoo M, Wang Y, Ravel V, You AS, Jing J, Sim JJ, Nguyen DV, Gillen DL, Saran R, Robinson B, Kovesdy CP. Seasonal variations in transition, mortality and kidney transplantation among patients with end-stage renal disease in the USA. Nephrol Dial Transplant 2017; 32:ii99-ii105. [PMID: 28201764 DOI: 10.1093/ndt/gfw379] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 09/22/2016] [Indexed: 12/22/2022] Open
Abstract
Background Seasonal variations may exist in transitioning to dialysis, kidney transplantation and related outcomes among end-stage renal disease (ESRD) patients. Elucidating these variations may have major clinical and healthcare policy implications for better resource allocation across seasons. Methods Using the United States Renal Data System database from 1 January 2000 to 31 December 2013, we calculated monthly counts of transitioning to dialysis or first transplantation and deaths. Crude monthly transition fraction was defined as the number of new ESRD patients divided by all ESRD patients on the first day of each month. Similar fractions were calculated for all-cause and cause-specific mortality and transplantation. Results The increasing trend of the annual transition to ESRD plateaued during 2009-2012 (n = 126 264), and dropped drastically in 2013 (n = 117 372). Independent of secular trends, monthly transition to ESRD was lowest in July (1.65%) and highest in January (1.97%) of each year. All-cause, cardiovascular and infectious mortalities were lowest in July or August (1.32, 0.58 and 0.15%, respectively) and highest in January (1.56, 0.71 and 0.19%, respectively). Kidney transplantation was highest in June (0.33%), and this peak was mainly attributed to living kidney transplantation in summer months. Transplant failure showed a similar seasonal variation to naïve transition, peaking in January (0.65%) and nadiring in September (0.56%). Conclusions Transitioning to ESRD and adverse events among ESRD people were more frequent in winter and less frequent in summer, whereas kidney transplantation showed the reverse trend. The potential causes and implications of these consistent seasonal variations warrant more investigation.
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Affiliation(s)
- Yoshitsugu Obi
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - Kamyar Kalantar-Zadeh
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
- Fielding School of Public Health at UCLA, Los Angeles, CA, USA
- Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA, USA
| | - Elani Streja
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - Connie M Rhee
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - Uttam G Reddy
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - Melissa Soohoo
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - Yaping Wang
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - Vanessa Ravel
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - Amy S You
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - Jennie Jing
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - John J Sim
- Kaiser Permanente of Southern California, Los Angeles, CA, USA
| | - Danh V Nguyen
- Biostatistics, Epidemiology & Research Design Unit, Institute for Clinical and Translational Science, University of California Irvine, Irvine, CA, USA
| | - Daniel L Gillen
- Deptartment of Statistics, Program in Public Health, University of California Irvine, Irvine, CA, USA
| | - Rajiv Saran
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Kidney Epidemiology and Cost Center, University of Michigan, Ann Arbor, MI, USA
| | - Bruce Robinson
- Arbor Research Collaborative for Health, Ann Arbor, MI, USA
| | - Csaba P Kovesdy
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, TN, USA
- Nephrology Section, Memphis VA Medical Center, Memphis, TN, USA
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Abstract
Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment because of migration to different geographic locations, modifications in lifestyle choices, and shifts in social policies and cultural practices alter CVD risk, even in the absence of genetic changes. Nevertheless, the cumulative impact of the environment on CVD risk has been difficult to assess and the mechanisms by which some environment factors influence CVD remain obscure. Human environments are complex, and their natural, social, and personal domains are highly variable because of diversity in human ecosystems, evolutionary histories, social structures, and individual choices. Accumulating evidence supports the notion that ecological features such as the diurnal cycles of light and day, sunlight exposure, seasons, and geographic characteristics of the natural environment such as altitude, latitude, and greenspaces are important determinants of cardiovascular health and CVD risk. In highly developed societies, the influence of the natural environment is moderated by the physical characteristics of the social environments such as the built environment and pollution, as well as by socioeconomic status and social networks. These attributes of the social environment shape lifestyle choices that significantly modify CVD risk. An understanding of how different domains of the environment, individually and collectively, affect CVD risk could lead to a better appraisal of CVD and aid in the development of new preventive and therapeutic strategies to limit the increasingly high global burden of heart disease and stroke.
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Affiliation(s)
- Aruni Bhatnagar
- From the Diabetes and Obesity Center and the Institute of Molecular Cardiology, University of Louisville, KY.
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46
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Abstract
Platelets contribute to thrombus formation in a variety of ways. Platelet adhesion, activation, and thrombus growth depend greatly on the type of hemodynamic environment surrounding an inciting event. Microfluidic systems may be used to explore these relationships. In this review, we describe some important considerations required in the design of a microfluidic system and identify some limitations that may require use of a macroscale system.
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Affiliation(s)
- Susan M Hastings
- a GWW School of Mechanical Engineering, Institute for Bioengineering and Biosciences , Georgia Institute of Technology , Atlanta , GA , USA
| | - Michael T Griffin
- a GWW School of Mechanical Engineering, Institute for Bioengineering and Biosciences , Georgia Institute of Technology , Atlanta , GA , USA
| | - David N Ku
- a GWW School of Mechanical Engineering, Institute for Bioengineering and Biosciences , Georgia Institute of Technology , Atlanta , GA , USA
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Burkart K, Kinney PL. What drives cold-related excess mortality in a south Asian tropical monsoon climate-season vs. temperatures and diurnal temperature changes. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:1073-1080. [PMID: 27995322 PMCID: PMC5451306 DOI: 10.1007/s00484-016-1287-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 10/17/2016] [Accepted: 11/28/2016] [Indexed: 05/24/2023]
Abstract
Despite the tropical climate which is characterized by generally high temperatures and persistent mild temperatures during the winter season, Bangladesh, along with many other tropical countries, experiences strong winter and cold-related excess mortality. The objective of this paper was to analyse the nature of these cold effects and understand the role of season vs. temperature and diurnal changes in temperature. For approaching these questions, we applied different Poisson regression models. Temperature as well as diurnal temperature range (DTR) were considered as predictor variables. Different approaches to seasonality adjustment were evaluated and special consideration was given to seasonal differences in atmospheric effects. Our findings show that while seasonality adjustment affected the magnitude of cold effects, cold-related mortality persisted regardless the adjustment approach. Strongest effects of low temperatures were observed at the same day (lag 1) with an increase of 1.7% (95% CI = 0.86-2.54%) per 1 °C decrease in temperature during the winter season. Diurnal temperature affected mortality with increasing levels at higher ranges. Mortality increased with 0.97% (95% CI = 0.17-1.75%) when looking at the entire season, but effects of DTR were not significant during winter when running a seasonal model. Different from effects observed in the mid-latitudes, cold effects in Bangladesh occurred on a very short time scale highlighting the role of temperature versus season. Insufficient adaptation with regard to housing and clothing might lead to such cold-related increases in mortality despite rather moderate temperature values. Although the study did not demonstrate an effect of DTR during the cold season, the strong correlation with (minimum) temperature might cause a multicollinearity problem and effects are difficult to attribute to one driver.
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Affiliation(s)
- Katrin Burkart
- Department of Environmental Health Science, Mailman School of Public Health, Columbia University in the City of New York, 722 West 168th Street, New York, NY, 10032, USA.
| | - Patrick L Kinney
- Department of Environmental Health Science, Mailman School of Public Health, Columbia University in the City of New York, 722 West 168th Street, New York, NY, 10032, USA
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Evidence of social deprivation on the spatial patterns of excess winter mortality. Int J Public Health 2017; 62:849-856. [PMID: 28361292 PMCID: PMC5641277 DOI: 10.1007/s00038-017-0964-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 02/20/2017] [Accepted: 02/22/2017] [Indexed: 11/25/2022] Open
Abstract
Objectives The aims of this study are to identify the patterns of excess winter mortality (due to diseases of the circulatory system) and to analyse the association between the excess winter deaths (EWD) and socio-economic deprivation in Portugal. Methods The number of EWD in 2002–2011 was estimated by comparing the number of deaths in winter months with the average number in non-winter months. The EWD ratio of each municipality was calculated by following the indirect standardization method and then compared with two deprivation indexes (socio-material and housing deprivation index) through ecological regression models. Results This study found that: (1) the EWD ratio showed considerable asymmetry in its geography; (2) there are significant positive associations between the EWD ratio and both deprivation indexes; and (3) at the higher level of deprivation, housing conditions have a stronger association with EWD than socio-material conditions. Conclusions The significant association between two deprivation dimensions (socio-material and housing deprivation) and EWDs suggests that EWD geographical pattern is influenced by deprivation.
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Siddiqi HK, Luminais SN, Montgomery D, Bossone E, Dietz H, Evangelista A, Isselbacher E, LeMaire S, Manfredini R, Milewicz D, Nienaber CA, Roman M, Sechtem U, Silberbach M, Eagle KA, Pyeritz RE. Chronobiology of Acute Aortic Dissection in the Marfan Syndrome (from the National Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions and the International Registry of Acute Aortic Dissection). Am J Cardiol 2017; 119:785-789. [PMID: 28065489 DOI: 10.1016/j.amjcard.2016.11.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 11/03/2016] [Accepted: 11/03/2016] [Indexed: 10/20/2022]
Abstract
Marfan syndrome (MFS) is an autosomal dominant connective tissue disease associated with acute aortic dissection (AAD). We used 2 large registries that include patients with MFS to investigate possible trends in the chronobiology of AAD in MFS. We queried the International Registry of Acute Aortic Dissection (IRAD) and the Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions (GenTAC) registry to extract data on all patients with MFS who had suffered an AAD. The group included 257 patients with MFS who suffered an AAD from 1980 to 2012. The chi-square tests were used for statistical testing. Mean subject age at time of AAD was 38 years, and 61% of subjects were men. AAD was more likely in the winter/spring season (November to April) than the other half of the year (57% vs 43%, p = 0.05). Dissections were significantly more likely to occur during the daytime hours, with 65% of dissections occurring from 6 a.m. to 6 p.m. (p = 0.001). Men were more likely to dissect during the daytime hours (6 a.m. to 6 p.m.) than women (74% vs 51%, p = 0.01). These insights offer a glimpse of the times of greatest vulnerability for patients with MFS who suffer from this catastrophic event. In conclusion, the chronobiology of AAD in MFS reflects that of AAD in the general population.
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Seasonal variation of pulmonary embolism and age dependence. Thromb Res 2017; 150:76-77. [DOI: 10.1016/j.thromres.2016.12.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 12/23/2016] [Indexed: 11/19/2022]
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