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Sebastian-Valles F, Martinez-Alfonso J, Navas-Moreno V, Arranz-Martin JA, Tapia-Sanchiz MS, Raposo-López JJ, Sampedro-Nuñez MA, Martínez-Vizcaino V, Marazuela M. Influence of smoking on glycaemic control in individuals with type 1 diabetes using flash glucose monitoring and its mediating role in the relationship between socioeconomic status and glycaemic control. J Diabetes Metab Disord 2025; 24:11. [PMID: 39697858 PMCID: PMC11649592 DOI: 10.1007/s40200-024-01535-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Accepted: 10/02/2024] [Indexed: 12/20/2024]
Abstract
Objective This study examined the influence of smoking on glycaemic control in individuals with type 1 diabetes (T1D) using flash continuous glucose monitoring (F-CGM) systems, as well as its potential mediating role in the relationship between socioeconomic status (SES) and glycaemic control. Methods This study included 378 subjects with T1D (18% smokers). Glucose metrics cloud downloads were obtained over a period of 14 days. Mean annual net income per person based on census tract data was used as a proxy for SES. Mediation analysis was performed using four-way effect decomposition procedures. Results Smokers exhibited significantly lower net income than non-smokers (p < 0.001). Compared to smokers, non-smokers showed better glycaemic control characterized as higher time in range (TIR) 70-180 mg/dL (p = 0.002) and lower glycosylated haemoglobin levels (p = 0.008). Mediation analysis revealed a significant mediating role of smoking in the relationship between SES and glycaemic control (TIR). Conclusions Our data suggest that smoking exerts a detrimental effect on glycaemic control in individuals with T1D using F-CGM systems. In addition, tobacco use partially mediates the relationship between SES and glycaemic control. Thus, adopting smoking cessation measures could lead to improved glycaemic control and help mitigate the impact of social inequalities on T1D. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-024-01535-y.
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Affiliation(s)
- Fernando Sebastian-Valles
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid, Madrid, 28006 Spain
| | - Julia Martinez-Alfonso
- Department of Family and Community Medicine, Hospital La Princesa/Centro de Salud Daroca, Madrid, 28006 Spain
| | - Victor Navas-Moreno
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid, Madrid, 28006 Spain
| | - Jose Alfonso Arranz-Martin
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid, Madrid, 28006 Spain
| | - Maria Sara Tapia-Sanchiz
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid, Madrid, 28006 Spain
| | - Juan José Raposo-López
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid, Madrid, 28006 Spain
| | - Miguel Antonio Sampedro-Nuñez
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid, Madrid, 28006 Spain
| | - Vicente Martínez-Vizcaino
- Health and Social Care Research Center, Universidad de Castilla-La Mancha, Cuenca, 16071 Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Mónica Marazuela
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid, Madrid, 28006 Spain
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Alnufaiy B, Alzahrani HG, Lambarte RA, Alghamdi MA, Alali AS, Alanazi WF, Alkanhal MH, Almukhalfi AF. The impact of electronic cigarette smoking on periodontal status and proinflammatory cytokine levels: a cross-sectional study. BMC Oral Health 2025; 25:775. [PMID: 40410855 DOI: 10.1186/s12903-025-06148-2] [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: 09/07/2024] [Accepted: 05/08/2025] [Indexed: 05/25/2025] Open
Abstract
BACKGROUND E-cigs(E-cigs) use is increasing worldwide. Recent studies suggest that E-cigs contain harmful elements that could lead to adverse oral health outcomes. Therefore, the aim of this study was to evaluate the impact of E-cigs smoking on periodontal health among current male smokers in Al-Kharj city in Saudi Arabia by assessing periodontal parameters and proinflammatory cytokine levels. METHODS Fifty-three male individuals (25 E-smokers and 28 non-smokers) participated in the study. This study compared periodontal parameters, including the plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment loss (CAL), and marginal bone loss (MBL), as well as levels of unstimulated whole saliva (UWS), interleukin IL-1B, and IL-6, between E-smokers and non-smokers. RESULTS The E-cigs users consumed approximately 432.6 ± 425.22 puffs on average daily, with a nicotine content of approximately 45.2 ± 11.23 mg on average. There was no statistically significant difference between the groups in terms of BOP and PI. A statistically significant difference was detected in PPD and CAL (p < 0.05) between the two groups, in which the PPD (4.10 ± 1.87) and CAL (2.72 ± 0.89) were greater in E-smokers. The mean MBL was also higher among E-smokers, which was statistically significant (p < 0.05). The mean cytokine IL-1B level was found to be (640.75 ± 138.78) among non-smokers and (889.05 ± 540.56) among E-smokers, and this difference was statistically significant (p < 0.05). However, while IL-1B had shown a significant difference between groups in the bivariate analysis (t-test), its association with E-cigs use became non-significant in the multivariate model (OR = 1.01, 95% CI: 1.00-1.02, p = 0.194). The mean IL-6 level among non-smokers was (19.49 ± 11.90) and among E-smokers, it was (17.07 ± 8.21). And, this difference was not statistically significant (p > 0.05). CONCLUSIONS This study revealed that E-cigs smoking had a negative effect on periodontal status (especially PPD, CAL and MBL). These results may contribute to the pathogenesis of periodontal diseases and tissue destruction. Efforts must be made to educate and create awareness among patients and the general community regarding the risks associated with E-cigs usage especially in young populations.
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Affiliation(s)
- Banna Alnufaiy
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj, 11942, Saudi Arabia.
| | - Hanadi Ghurmallah Alzahrani
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj, 11942, Saudi Arabia
| | - Rhodanne A Lambarte
- Molecular and Cell Biology Laboratory, Prince Naif bin AbdulAziz Health Research Center, College of Dentistry, King Saud University Medical City, King Saud University, Riyadh, 11545, Saudi Arabia
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Sebastian-Valles F, Hernando Alday I, Tapia-Sanchiz MS, Raposo-López JJ, Garai Hierro J, Navas-Moreno V, Martínez-Alfonso J, Arranz Martin JA, Sampedro-Nuñez MA, Marazuela M. Association of smoking with the efficacy of continuous glucose monitoring in type1 diabetes: A propensity score-matched cohort study. Med Clin (Barc) 2025; 164:396-402. [PMID: 39709280 DOI: 10.1016/j.medcli.2024.10.023] [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: 08/25/2024] [Revised: 10/15/2024] [Accepted: 10/22/2024] [Indexed: 12/23/2024]
Abstract
INTRODUCTION Smoking affects glycemic control in individuals with type1 diabetes (T1D); however, its impact in the era of continuous glucose monitoring (CGM) has not been thoroughly studied. MATERIALS AND METHODS A retrospective cohort study was conducted at two centers, involving 405 T1D patients treated with multiple daily insulin injections and using CGM. The patients were matched using propensity scores based on sociodemographic and clinical characteristics. HbA1c levels were analyzed before and after a 2.2-year follow-up period. The analysis was performed using mixed linear regression and multivariable conditional logistic models. RESULTS The sample included 135 smokers and 270 non-smokers, with a mean age of 47.6years, and 50.1% were women. Both groups had a similar baseline HbA1c of 8.0 (1.5%). After follow-up, non-smokers reduced their HbA1c to 7.3 (1.1%), while smokers only reduced it to 7.7 (1.3%), 95%CI [-0,57-0,10]). The proportion of non-smokers achieving HbA1c<7% increased from 25% to 38.1%, 95%CI [0,14-0.36], whereas smokers showed no change (25.9%, 95%CI [-0.13-0.21]). Smoking was independently associated with a higher risk of not achieving HbA1c<7%, despite CGM use (odds ratio 1.89, 95%CI [1.13-3.17]. CONCLUSION Smoking limits the glycemic control benefits of CGM in individuals with T1D. It is crucial to include smokers in clinical trials and to develop strategies to discourage smoking in this population to maximize the benefits of diabetes technology.
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Affiliation(s)
- Fernando Sebastian-Valles
- Servicio de Endocrinología y Nutrición, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria de La Princesa, Madrid, España.
| | - Iñigo Hernando Alday
- Servicio de Endocrinología y Nutrición, Hospital Universitario Basurto, Bilbao, España
| | - Maria Sara Tapia-Sanchiz
- Servicio de Endocrinología y Nutrición, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria de La Princesa, Madrid, España
| | - Juan José Raposo-López
- Servicio de Endocrinología y Nutrición, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria de La Princesa, Madrid, España
| | - Jon Garai Hierro
- Servicio de Endocrinología y Nutrición, Hospital Universitario Basurto, Bilbao, España
| | - Victor Navas-Moreno
- Servicio de Endocrinología y Nutrición, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria de La Princesa, Madrid, España
| | - Julia Martínez-Alfonso
- Departamento de Familia y Medicina Comunitaria, Hospital Universitario de La Princesa/Centro de Salud Daroca, Madrid, España
| | - José Alfonso Arranz Martin
- Servicio de Endocrinología y Nutrición, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria de La Princesa, Madrid, España
| | - Miguel Antonio Sampedro-Nuñez
- Servicio de Endocrinología y Nutrición, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria de La Princesa, Madrid, España
| | - Mónica Marazuela
- Servicio de Endocrinología y Nutrición, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria de La Princesa, Madrid, España
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Horowitz JF, Goodpaster BH. Mechanistic Insights Into the Exercise-Induced Changes in Muscle Lipids and Insulin Sensitivity-Expanding on the "Athlete's Paradox": Revisiting a 2011 Diabetes Classic by Amati et al. Diabetes 2025; 74:134-137. [PMID: 39836884 PMCID: PMC11755679 DOI: 10.2337/dbi24-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Accepted: 10/30/2024] [Indexed: 01/23/2025]
Abstract
Endurance exercise is widely recognized for its role in mitigating insulin resistance, yet the precise mechanisms remain unclear. In this Classics in Diabetes article, we revisit the article by Amati et al., "Skeletal Muscle Triglycerides, Diacylglycerols, and Ceramides in Insulin Resistance: Another Paradox in Endurance-Trained Athletes?" Published in the October 2011 issue of Diabetes, this article was among the first to highlight the nuanced roles of exercise-induced changes in bioactive lipids such as ceramide and diacylglycerol (DAG) in insulin signaling. The authors' groundbreaking work challenged some existing paradigms, revealing a more complex relationship between DAGs and insulin resistance than previously thought. Their findings helped lay the foundation for further exploration to unravel the intricate biochemical pathways through which exercise influences insulin sensitivity and metabolic health.
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Tolu-Akinnawo O, Ogunniyi KE. Accelerated Coronary Artery Disease in a Patient With Advanced Lung Cancer: Interplay of Cancer, Inflammation, and Treatment Effects. Cureus 2025; 17:e77769. [PMID: 39981449 PMCID: PMC11841481 DOI: 10.7759/cureus.77769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2025] [Indexed: 02/22/2025] Open
Abstract
Cardiovascular disease (CVD) and lung cancer are among the most prevalent causes of death worldwide, representing substantial public health challenges. The relationship between coronary artery disease (CAD) and lung cancer is potentially multifaceted, influenced by common risk factors and the adverse cardiac effects of cancer treatments. However, cases of accelerated CAD occurring within a year of cancer treatment initiation are rarely reported. We present a case of a Black American male undergoing combination therapy (chemotherapy/radiotherapy/immunotherapy) for small-cell lung cancer, who developed ST-elevation myocardial infarction (STEMI) seven months after beginning treatment. Although we do not have the official records, the patient reported that he had previously undergone a cardiac workup (including an echo/stress test) at an outside facility a year prior, due to persistent dyspnea, which was unremarkable. The patient underwent successful percutaneous coronary intervention and was discharged on apixaban and prasugrel. This study underscores the importance of maintaining a high index of suspicion for acute coronary syndromes (ACS) in patients receiving lung cancer treatments, emphasizes the need for early recognition of warning signs, and highlights the critical role of risk factor management and enhanced surveillance in this vulnerable population.
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Alagiakrishnan K, Halverson T. Role of Peripheral and Central Insulin Resistance in Neuropsychiatric Disorders. J Clin Med 2024; 13:6607. [PMID: 39518747 PMCID: PMC11547162 DOI: 10.3390/jcm13216607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2024] [Revised: 10/27/2024] [Accepted: 10/31/2024] [Indexed: 11/16/2024] Open
Abstract
Insulin acts on different organs, including the brain, which helps it regulate energy metabolism. Insulin signaling plays an important role in the function of different cell types. In this review, we have summarized the key roles of insulin and insulin receptors in healthy brains and in different brain disorders. Insulin signaling, as well as insulin resistance (IR), is a major contributor in the regulation of mood, behavior, and cognition. Recent evidence showed that both peripheral and central insulin resistance play a role in the pathophysiology, clinical presentation, and management of neuropsychiatric disorders like Cognitive Impairment/Dementia, Depression, and Schizophrenia. Many human studies point out Insulin Resistance/Metabolic Syndrome can increase the risk of dementia especially Alzheimer's dementia (AD). IR has been shown to play a role in AD development but also in its progression. This review article discusses the pathophysiological pathways and mechanisms of insulin resistance in major neuropsychiatric disorders. The extent of insulin resistance can be quantified using IR biomarkers like insulin levels, HOMA-IR index, and Triglyceride glucose-body mass index (TyG-BMI) levels. IR has been shown to precede neurodegeneration. Human trials showed current treatment with certain antidiabetic drugs, as well as life style management, like weight loss and exercise for IR, have shown promise in the management of cognitive/neuropsychiatric disorders. This may pave the pathway to the development of new therapeutic approaches to these challenging disorders of dementia and psychiatric diseases. Recent clinical trials are showing some encouraging evidence for these pharmacological and nonpharmacological approaches for IR in psychiatric and cognitive disorders, even though more research is needed to apply this evidence into clinical practice. Early identification and management of IR may help as a strategy to potentially alter neuropsychiatric disorders onset as well as its progression.
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Affiliation(s)
| | - Tyler Halverson
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada;
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Sung DE, Lee SJ, Lee MY, Rhee EJ, Sung KC. Longitudinal Analysis of Diabetes Mellitus Risk: Smoking Status and Smoking Cessation. J Clin Med 2024; 13:3927. [PMID: 38999492 PMCID: PMC11242592 DOI: 10.3390/jcm13133927] [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: 05/30/2024] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 07/14/2024] Open
Abstract
Background/Objectives: Smoking cessation is acknowledged for its health benefits. However, it paradoxically increases diabetes mellitus (DM) risk shortly after quitting due to weight gain. This research aimed to investigate how smoking status could affect the development of DM, focusing on how the risk of acquiring diabetes changed over time after quitting smoking, independent of variables such as weight gain. Methods: The data of 386,558 participants of the Kangbuk Samsung Health Study, excluding those with pre-existing DM, were examined. Smoking status and its long-term effects on DM risk were assessed using multivariate Cox proportional hazards models. Lifestyle factors, including weight change, physical activity levels, and alcohol intake, were adjusted as time-varying covariates throughout the follow-up period. Results: Modified hazard ratios (HRs) indicated no notable disparity in DM risk between individuals who previously smoked and those who had never smoked (HR: 1.04, 95% CI: 0.999-1.08, p-value < 0.001). In contrast, current smokers exhibited a significantly increased DM risk (HR: 1.29, 95% CI: 1.24-1.35, p-value < 0.001). Within the first six years post-cessation, former smokers initially faced a higher DM risk than never smokers (0-2 years, HR: 1.22, 95% CI: 1.15-1.31, p-value < 0.001; 3-5 years, HR: 1.11, 95% CI: 1.04-1.20, p-value < 0.001). After 12 years, they realigned with never smokers (12-46 years, HR: 0.92, 95% CI: 0.86-0.98, p-value = 0.002). Current smokers consistently showed a higher DM risk (0-9 years, HR: 1.29, 95% CI: 1.14-1.46, p-value < 0.001). Adjusting for covariates such as weight change and physical activity did not alter these findings. Conclusions: Our results indicated that former smokers initially experienced an elevated risk of DM relative to never smokers. This increased risk aligned with the risk of never smokers after six years, and the risk continued to improve after 12 years compared to never smokers. This contrasted with current smokers, who maintained a heightened risk of DM, even when adjustments were made for weight change, physical activity, and alcohol intake as time-varying covariates.
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Affiliation(s)
- Da-Eun Sung
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Seung-Jae Lee
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Mi-Yeon Lee
- Division of Biostatistics, Department of Academic Research, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Eun-Jung Rhee
- Division Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Ki-Chul Sung
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
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Gu Y, Li Z, Han X, Liu J, Li Y, Zhang W, Lv N, Dang A. Smoking, Alcohol Consumption, and Risk of Arterial Stiffness: A Two-Sample Mendelian Randomization Study. Rev Cardiovasc Med 2024; 25:255. [PMID: 39139409 PMCID: PMC11317346 DOI: 10.31083/j.rcm2507255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 08/15/2024] Open
Abstract
Background While observational studies have demonstrated connections between cigarette smoking, alcohol consumption, and arterial stiffness, establishing a causal relationship has proven challenging because of potential confounding factors. To address this problem, we employed a two-sample Mendelian randomization approach. Methods We selected genetic instruments for these risk factors from genome-wide association studies encompassing 3,383,199 individuals at the genome-wide significance level (p < 5 × 10 - 9 ). Arterial stiffness data were acquired from the UK Biobank, which included 127,121 participants. Our primary analysis utilized the inverse variance-weighted method to explore causality. To confirm our results' robustness, we conducted sensitivity analyses using Egger regression, the weighted median method, and Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO). Results Our analysis revealed a significant association between genetic inclination to smoking initiation and an increase in the arterial stiffness index ( β = 0.11; 95% confidence interval [CI], 0.06 to 0.16; p = 1.95 × 10 - 5 ). Additionally, there was a suggestive connection between genetically predicted number of cigarettes per day and the arterial stiffness index ( β = 0.05; 95% CI, 5.25 × 10 - 4 to 0.10; p = 4.75 × 10 - 2 ). No causal relationships were observed between the genetically predicted age of smoking initiation, smoking cessation, or alcohol consumption and the risk of arterial stiffness index. Conclusions This Mendelian randomization study indicates that smoking initiation is likely a causative risk factor for arterial stiffness. However, further research is needed to determine if the quantity of daily cigarettes directly contributes to arterial stiffness development. Regarding alcohol consumption, age of smoking initiation, and smoking cessation, there was insufficient evidence to establish causality.
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Affiliation(s)
- Yingzhen Gu
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China
| | - Zuozhi Li
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China
| | - Xiaorong Han
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China
| | - Jinxing Liu
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China
| | - Yifan Li
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China
| | - Wei Zhang
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China
| | - Naqiang Lv
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China
| | - Aimin Dang
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China
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Amin G, Booz GW, Zouein FA. Lasting consequences of cigarette smoking on the heart. Acta Physiol (Oxf) 2024; 240:e14166. [PMID: 38761034 PMCID: PMC11162305 DOI: 10.1111/apha.14166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 05/07/2024] [Indexed: 05/20/2024]
Affiliation(s)
- Ghadir Amin
- Department of Pharmacology and Toxicology, School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - George W. Booz
- Department of Pharmacology and Toxicology, School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Fouad A. Zouein
- Department of Pharmacology and Toxicology, School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
- Department of Pharmacology and Toxicology, American University of Beirut Medical Center, Faculty of Medicine, Beirut, Lebanon
- Department of Signaling and Cardiovascular Pathophysiology, UMR-S 1180, Inserm, Université Paris-Saclay, Orsay, France
- The Cardiovascular, Renal, and Metabolic Diseases Research Center of Excellence, American University of Beirut Medical Center, Riad El-Solh, Beirut, Lebanon
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Singh S, Kriti M, K.S. A, Sarma DK, Verma V, Nagpal R, Mohania D, Tiwari R, Kumar M. Deciphering the complex interplay of risk factors in type 2 diabetes mellitus: A comprehensive review. Metabol Open 2024; 22:100287. [PMID: 38818227 PMCID: PMC11137529 DOI: 10.1016/j.metop.2024.100287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/15/2024] [Accepted: 05/18/2024] [Indexed: 06/01/2024] Open
Abstract
The complex and multidimensional landscape of type 2 diabetes mellitus (T2D) is a major global concern. Despite several years of extensive research, the precise underlying causes of T2D remain elusive, but evidence suggests that it is influenced by a myriad of interconnected risk factors such as epigenetics, genetics, gut microbiome, environmental factors, organelle stress, and dietary habits. The number of factors influencing the pathogenesis is increasing day by day which worsens the scenario; meanwhile, the interconnections shoot up the frame. By gaining deeper insights into the contributing factors, we may pave the way for the development of personalized medicine, which could unlock more precise and impactful treatment pathways for individuals with T2D. This review summarizes the state of knowledge about T2D pathogenesis, focusing on the interplay between various risk factors and their implications for future therapeutic strategies. Understanding these factors could lead to tailored treatments targeting specific risk factors and inform prevention efforts on a population level, ultimately improving outcomes for individuals with T2D and reducing its burden globally.
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Affiliation(s)
- Samradhi Singh
- ICMR- National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhauri, Bhopal, 462030, Madhya Pradesh, India
| | - Mona Kriti
- ICMR- National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhauri, Bhopal, 462030, Madhya Pradesh, India
| | - Anamika K.S.
- Christ Deemed to Be University Bangalore, Karnataka, India
| | - Devojit Kumar Sarma
- ICMR- National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhauri, Bhopal, 462030, Madhya Pradesh, India
| | - Vinod Verma
- Stem Cell Research Centre, Department of Hematology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, 226014, Uttar Pradesh, India
| | - Ravinder Nagpal
- Department of Nutrition & Integrative Physiology, College of Health & Human Sciences, Florida State University, Tallahassee, FL, 32306, USA
| | - Dheeraj Mohania
- Dr. R. P. Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Rajnarayan Tiwari
- ICMR- National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhauri, Bhopal, 462030, Madhya Pradesh, India
| | - Manoj Kumar
- ICMR- National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhauri, Bhopal, 462030, Madhya Pradesh, India
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Khanagar SB, Aldawas I, Alrusaini SK, Albalawi F, Alshehri A, Awawdeh M, Iyer K, Divakar DD. Association of Electronic Cigarette Usage with the Subsequent Initiation of Combustible Cigarette Smoking among Dental Students in Riyadh, Saudi Arabia: A Longitudinal Study. Healthcare (Basel) 2024; 12:1092. [PMID: 38891167 PMCID: PMC11172238 DOI: 10.3390/healthcare12111092] [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: 04/12/2024] [Revised: 05/20/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
The use of electronic cigarettes, or "e-cigarettes", among youths has sparked worries about the possibility of nicotine dependence as a serious public health issue. Dental practitioners play a critical role in helping their patients quit smoking. Dental schools across the globe have policies encouraging their students to help patients quit smoking. Current research, however, indicates that a significant portion of dental students smoke combustible cigarettes and use e-cigarettes. According to studies, using e-cigarettes has resulted in the subsequent initiation of combustible cigarette smoking among its users. The aim of this study was to determine the association between the use of electronic cigarettes and the subsequent initiation of combustible cigarette smoking among dental students who were not attitudinally susceptible to smoking combustible cigarettes. A longitudinal cohort study was conducted among 121 study participants who were never combustible cigarette users and were attitudinally non-susceptible to smoking at baseline. At baseline, 66 (54.6%) study participants were categorized as e-cigarette users who were attitudinally non-susceptible to combustible cigarette smoking, and 55 (45.4%) study participants were categorized as non-users who were attitudinally non-susceptible to combustible cigarette smoking. The initiation of combustible cigarette smoking was assessed at 6- and 12-month intervals. Binomial regression analysis of the outcome at the end of one-year follow-up, when analyzed with independent variables, revealed a significant influence of e-cigarette use on taking up combustible cigarette smoking [Relative Risk: 9.395; 95% CI: 3.03-29.04]. Chi-squared analysis of independent variables revealed e-cigarette use to be significantly associated with fathers' education level (p = 0.00), parental cigarette smoking status (p = 0.00), cigarette smoking among friends (p = 0.00), and family income (p = 0.00). E-cigarette users are more likely to believe it to be healthier (p = 0.00) than combustible smoking. In the present study, e-cigarette usage demonstrated a significant influence on taking up combustible cigarette smoking among its users. Educational institutions should implement stringent policies and regulations to prevent health professionals from using these products.
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Affiliation(s)
- Sanjeev B. Khanagar
- Preventive Dental Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
- College of Public Health, Texila American University, Georgetown 413741, Guyana
| | - Ibrahim Aldawas
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
| | - Salman Khalid Alrusaini
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
| | - Farraj Albalawi
- Preventive Dental Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
| | - Aram Alshehri
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
- Restorative and Prosthetic Dental Sciences Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
| | - Mohammed Awawdeh
- Preventive Dental Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
| | - Kiran Iyer
- Preventive Dental Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
| | - Darshan Devang Divakar
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia;
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12
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Mehrabani S, Shoaei N, Shateri Z, Askarpour M, Nouri M, Keshani P, Honarvar B, Homayounfar R. Consumption of ultra-processed foods could influence the metabolic syndrome odds: A cross-sectional study. Food Sci Nutr 2024; 12:2567-2577. [PMID: 38628179 PMCID: PMC11016394 DOI: 10.1002/fsn3.3938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/13/2023] [Accepted: 12/20/2023] [Indexed: 04/19/2024] Open
Abstract
Metabolic syndrome (MetS) prevalence has augmented globally during recent decades. Over the past years, the consumption of ultra-processed foods (UPFs) has grown significantly worldwide. So, the present research investigated the association between UPFs and MetS in an Iranian sample. This cross-sectional research was conducted on people (n = 8841) in the Fasa cohort study, Fars province, Iran. The participants' dietary consumption over a year, UPF consumption, and MetS diagnosis were evaluated through a 125-item modified food frequency questionnaire, the NOVA food group classification, and the Adult Treatment Panel III of the National Cholesterol Education Program, respectively. The association between the quartiles (Q) of UPF intake and the odds of MetS was estimated using the backward LR method of multivariate analysis. In the multivariate model, after adjusting potential confounders, the association between UPF intake and the odds of MetS was significant (Q4: odds ratio (OR = 3.27; 95% confidence interval (CI): 2.76-3.89). Also, the odds of increasing triglycerides (TG), blood pressure, and fasting blood sugar (FBS) and decreasing high-density lipoprotein cholesterol (HDL-C) were significantly higher in the last quartile compared to the first quartile of UPFs (TG: OR = 1.71; 95% CI: 1.49-1.97, blood pressure: OR = 1.53; 95% CI: 1.30-1.79, FBS: OR = 1.30; 95% CI: 1.10-1.54, and HDL-C: OR = 1.22; 95% CI: 1.08-1.39). The current research found a relationship between UPF intake and MetS and its components, indicating a diet-containing UPFs can be related to the occurrence of noncommunicable diseases.
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Affiliation(s)
- Sanaz Mehrabani
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
- Department of Clinical Nutrition, School of Nutrition and Food ScienceIsfahan University of Medical SciencesIsfahanIran
| | - Niloofar Shoaei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Zainab Shateri
- Department of Nutrition and Biochemistry, Faculty of MedicineIlam University of Medical SciencesIlamIran
| | - Moein Askarpour
- Department of Clinical Nutrition, School of Nutritional Sciences and DieteticsShiraz University of Medical SciencesShirazIran
- Students' Research Committee, School of Nutrition and Food ScienceShiraz University of Medical SciencesShirazIran
| | - Mehran Nouri
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
- Students' Research Committee, School of Nutrition and Food ScienceShiraz University of Medical SciencesShirazIran
- Department of Community Nutrition, School of Nutrition and Food SciencesShiraz University of Medical SciencesShirazIran
| | - Parisa Keshani
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | - Behnam Honarvar
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | - Reza Homayounfar
- National Nutrition and Food Technology Research InstituteShahid Beheshti University of Medical SciencesTehranIran
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13
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Khalil MAM, Sadagah NM, Tan J, Syed FO, Chong VH, Al-Qurashi SH. Pros and cons of live kidney donation in prediabetics: A critical review and way forward. World J Transplant 2024; 14:89822. [PMID: 38576756 PMCID: PMC10989475 DOI: 10.5500/wjt.v14.i1.89822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/11/2023] [Accepted: 01/16/2024] [Indexed: 03/15/2024] Open
Abstract
There is shortage of organs, including kidneys, worldwide. Along with deceased kidney transplantation, there is a significant rise in live kidney donation. The prevalence of prediabetes (PD), including impaired fasting glucose and impaired glucose tolerance, is on the rise across the globe. Transplant teams frequently come across prediabetic kidney donors for evaluation. Prediabetics are at risk of diabetes, chronic kidney disease, cardiovascular events, stroke, neuropathy, retinopathy, dementia, depression and nonalcoholic liver disease along with increased risk of all-cause mortality. Unfortunately, most of the studies done in prediabetic kidney donors are retrospective in nature and have a short follow up period. There is lack of prospective long-term studies to know about the real risk of complications after donation. Furthermore, there are variations in recommendations from various guidelines across the globe for donations in prediabetics, leading to more confusion among clinicians. This increases the responsibility of transplant teams to take appropriate decisions in the best interest of both donors and recipients. This review focuses on pathophysiological changes of PD in kidneys, potential complications of PD, other risk factors for development of type 2 diabetes, a review of guidelines for kidney donation, the potential role of diabetes risk score and calculator in kidney donors and the way forward for the evaluation and selection of prediabetic kidney donors.
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Affiliation(s)
- Muhammad Abdul Mabood Khalil
- Center of Renal Diseases and Transplantation, King Fahad Armed Forces Hospital Jeddah, Jeddah 23311, Saudi Arabia
| | - Nihal Mohammed Sadagah
- Center of Renal Diseases and Transplantation, King Fahad Armed Forces Hospital Jeddah, Jeddah 23311, Saudi Arabia
| | - Jackson Tan
- Department of Nephrology, RIPAS Hospital Brunei Darussalam, Brunei Muara BA1710, Brunei Darussalam
| | - Furrukh Omair Syed
- Center of Renal Diseases and Transplantation, King Fahad Armed Forces Hospital Jeddah, Jeddah 23311, Saudi Arabia
| | - Vui Heng Chong
- Division of Gastroenterology and Hepatology, Department of Medicine, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan BA1710, Brunei Darussalam
| | - Salem H Al-Qurashi
- Center of Renal Diseases and Transplantation, King Fahad Armed Forces Hospital Jeddah, Jeddah 23311, Saudi Arabia
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14
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Saccaro LF, Aimo A, Panichella G, Sentissi O. Shared and unique characteristics of metabolic syndrome in psychotic disorders: a review. Front Psychiatry 2024; 15:1343427. [PMID: 38501085 PMCID: PMC10944869 DOI: 10.3389/fpsyt.2024.1343427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/15/2024] [Indexed: 03/20/2024] Open
Abstract
Introduction People with psychosis spectrum disorders (PSD) face an elevated risk of metabolic syndrome (MetS), which may reduce their life expectancy by nearly 20%. Pinpointing the shared and specific characteristics and clinical implications of MetS in PSD is crucial for designing interventions to reduce this risk, but an up-to-date review on MetS across the psychosis spectrum is lacking. Methods This narrative review fills this gap by examining the clinical literature on characteristics and implications of MetS in both distinct PSD and transdiagnostically, i.e., across traditional categorical diagnoses, with a focus on psychiatric and cardio-metabolic management. Results We discuss common and specific characteristics of MetS in PSD, as well as factors contributing to MetS development in PSD patients, including unhealthy lifestyle factors, genetic predisposition, pro-inflammatory state, drugs consumption, antipsychotic medication, and psychotic symptoms. We highlight the importance of early identification and management of cardio-metabolic risk in PSD patients, as well as the existing gaps in the literature, for instance in the screening for MetS in younger PSD patients. We compare hypotheses-generating clinical associations and characteristics of MetS in different PSD, concluding by reviewing the existing recommendations and challenges in screening, monitoring, and managing MetS in PSD. Conclusion Early identification and management of MetS are crucial to mitigate the long-term cardio-metabolic toll in PSD patients. Interventions should focus on healthy lifestyle and appropriate pharmacological and behavioral interventions. Further translational and clinical research is needed to develop targeted interventions and personalized treatment approaches for this vulnerable population, aiming at improving physical health and overall well-being.
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Affiliation(s)
- Luigi F Saccaro
- Psychiatry Department, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Psychiatry Department, Geneva University Hospital, Geneva, Switzerland
| | - Alberto Aimo
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Giorgia Panichella
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Othman Sentissi
- Psychiatry Department, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Psychiatry Department, Geneva University Hospital, Geneva, Switzerland
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15
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Jamali Z, Ayoobi F, Jalali Z, Bidaki R, Lotfi MA, Esmaeili-Nadimi A, Khalili P. Metabolic syndrome: a population-based study of prevalence and risk factors. Sci Rep 2024; 14:3987. [PMID: 38368464 PMCID: PMC10874377 DOI: 10.1038/s41598-024-54367-4] [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: 09/21/2023] [Accepted: 02/12/2024] [Indexed: 02/19/2024] Open
Abstract
The association between personal habits and metabolic syndrome (MetS) remains controversial. This study aimed to assess the prevalence of MetS among youths and its association with cigarette, tobacco, opium, and alcohol consumption in the Rafsanjan Youth Cohort Study (RYCS). The current cross-sectional study was based on data from RYCS, as part of the Rafsanjan Cohort Study (RCS). RCS is a branch of the prospective epidemiological research studies in Iran (PERSIAN). In the present study, 2843 youths aged 15-35 were included. MetS was diagnosed using the international diabetes federation (International IDF), National Cholesterol Education Panel- Adult Treatment Panel III (NCEP-ATPIII), and Iranian criteria (IDF Iranian). Binary logistic regression models were performed to estimate odds ratios (ORs) and confidence intervals (CIs). The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS according to international IDF and Iranian IDF in the alcohol-drinking group in the last 12 months (OR: 1.51, 95%CI 1.02-2.21, OR: 1.66, 95%CI 1.11-2.48 respectively) were greater compared with the non-drinking group. The odds of having high TG in the alcohol-drinking group in the last 12 months was 1.53 times higher than the control group (OR = 1.53, 95% CI: 1.20-1.94). Furthermore, the odds of having high waist circumference (WC) according to IDF International was significantly higher in the tobacco-smoking group in the last 12 months and in the tobacco-smoking group in the last 12 months daily (OR: 1.23, 95%CI 1.01-1.49 and OR: 1.41, 95%CI 1.01-1.98 respectively) compared to the control groups. The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS and high TG were greater in the alcohol-drinking group in the last 12 months compared with the non-drinking group. The odds of high WC in the last 12 months, were greater in the tobacco-smoking group compared with the non-smoking group. However, more longitudinal studies are needed to verify the associations observed in the current study.
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Affiliation(s)
- Zahra Jamali
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Clinical Research Development Unit (CRDU), Niknafs Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Fatemeh Ayoobi
- Occupational Safety and Health Research Center, NICICO, World Safety Organization and Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Clinical Research Development Unit (CRDU), Moradi Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Zahra Jalali
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Clinical Biochemistry, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Reza Bidaki
- Department of Psychiatry, Fellowship of Neuropsychiatry, Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Amin Lotfi
- Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital (CRDU), Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Internal Medicine, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ali Esmaeili-Nadimi
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Internal Medicine, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Parvin Khalili
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
- Department of Epidemiology, School of Public Health, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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16
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de Jesus M, Chanda A, Grabauskas T, Kumar M, Kim AS. Cardiovascular disease and lung cancer. Front Oncol 2024; 14:1258991. [PMID: 38410099 PMCID: PMC10896114 DOI: 10.3389/fonc.2024.1258991] [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: 07/14/2023] [Accepted: 01/19/2024] [Indexed: 02/28/2024] Open
Abstract
Lung cancer is the second most common cancer worldwide and the leading cause of cancer-related death. While survival rates have improved with advancements in cancer therapeutics, additional health challenges have surfaced. Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in patients with lung cancer. CVD and lung cancer share many risk factors, such as smoking, hypertension, diabetes, advanced age, and obesity. Optimal management of this patient population requires a full understanding of the potential cardiovascular (CV) complications of lung cancer treatment. This review outlines the common shared risk factors, the spectrum of cardiotoxicities associated with lung cancer therapeutics, and prevention and management of short- and long-term CVD in patients with non-small cell (NSCLC) and small cell (SCLC) lung cancer. Due to the medical complexity of these patients, multidisciplinary collaborative care among oncologists, cardiologists, primary care physicians, and other providers is essential.
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Affiliation(s)
- Mikhail de Jesus
- Department of Cardiology, University of Connecticut Hartford Hospital, Hartford, CT, United States
| | - Anindita Chanda
- Department of Internal Medicine, University of Connecticut School of Medicine, Farmington, CT, United States
| | - Titas Grabauskas
- University of Connecticut School of Medicine, Farmington, CT, United States
| | - Manish Kumar
- Department of Cardiology, Pat & Jim Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, CT, United States
| | - Agnes S Kim
- Department of Cardiology, Pat & Jim Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, CT, United States
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17
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Wei Y, Edstorp J, Feychting M, Andersson T, Carlsson S. Prenatal and adult exposure to smoking and incidence of type 1 diabetes in children and adults-a nationwide cohort study with a family-based design. THE LANCET REGIONAL HEALTH. EUROPE 2024; 36:100775. [PMID: 38019976 PMCID: PMC10652139 DOI: 10.1016/j.lanepe.2023.100775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023]
Abstract
Background Prenatal exposure to smoking is linked to a reduced risk of type 1 diabetes in children. We wanted to find out if the risk of adult-onset type 1 diabetes is reduced in individuals who are exposed to smoking prenatally or during adulthood. Methods We linked Swedish, nationwide registers and prospectively analyzed incidence of type 1 diabetes in relation to maternal smoking during pregnancy and adult smoking. Everyone was followed until age 30 or year 2019. We employed cohort and sibling design and used adjusted Cox regression and conditional logistic regression. Findings For analyses of maternal smoking there were 3,170,386 individuals (18,745 cases of type 1 diabetes) and for adult smoking 1,608,291 individuals (1274 cases). Prenatal exposure to smoking was associated with lower incidence of type 1 diabetes during childhood and young adulthood (age 20-24, Hazard ratio (HR) 0.76, 95% Confidence interval 0.67-0.87), but not at higher ages. The HR associated with adult smoking was estimated at 1.14 (CI 1.00-1.31) overall and 1.34 (CI 1.03-1.75) in those with family history of diabetes. In sibling analyses, the odds ratio (OR) of type 1 diabetes in relation to prenatal exposure was 0.71 (CI 0.62-0.81) in children and 1.06 (CI 0.75-1.51) in adults (age 19-30), while adult smoking conferred an OR of 1.59 (CI 1.08-2.35). Interpretation These findings indicate that a reduced risk conferred by tobacco exposure is limited to the prenatal period and type 1 diabetes developing during childhood. Adult smoking may be a risk factor for adult-onset type 1 diabetes, especially in people with family history of diabetes. Funding Swedish Research Councils, Swedish Diabetes and Novo Nordisk Foundations, China Scholarship Council.
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Affiliation(s)
- Yuxia Wei
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, Stockholm S-171 77, Sweden
| | - Jessica Edstorp
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, Stockholm S-171 77, Sweden
| | - Maria Feychting
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, Stockholm S-171 77, Sweden
| | - Tomas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, Stockholm S-171 77, Sweden
- Center for Occupational and Environmental Medicine, Region Stockholm, Solnavägen 4, Stockholm S-113 65, Sweden
| | - Sofia Carlsson
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, Stockholm S-171 77, Sweden
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18
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Priyadarshini A, Madan R, Das S. Genetics and epigenetics of diabetes and its complications in India. Hum Genet 2024; 143:1-17. [PMID: 37999799 DOI: 10.1007/s00439-023-02616-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/17/2023] [Indexed: 11/25/2023]
Abstract
Diabetes mellitus (DM) has become a significant health concern with an increasing rate of morbidity and mortality worldwide. India ranks second in the number of diabetes cases in the world. The increasing burden of DM can be explained by genetic predisposition of Indians to type 2 diabetes mellitus (T2DM) coupled with rapid urbanization and socio-economic development in the last 3 decades leading to drastic changes in lifestyle. Environment and lifestyle changes contribute to T2DM development by altering epigenetic processes such as DNA methylation, histone post-translational modifications, and long non-coding RNAs, all of which regulate chromatin structure and gene expression. Although the genetic predisposition of Indians to T2DM is well established, how environmental and genetic factors interact and lead to T2DM is not well understood. In this review, we discuss the prevalence of diabetes and its complications across different states in India and how various risk factors contribute to its pathogenesis. The review also highlights the role of genetic predisposition among the Indian population and epigenetic factors involved in the etiology of diabetes. Lastly, we review current treatments and emphasize the knowledge gap with respect to genetic and epigenetic factors in the Indian context. Further understanding of the genetic and epigenetic determinants will help in risk prediction and prevention as well as therapeutic interventions, which will improve the clinical management of diabetes and associated macro- and micro-vascular complications.
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Affiliation(s)
- Ankita Priyadarshini
- Diabetic Vascular Complications Laboratory, Department of Biological Sciences, Indian Institute of Science Education and Research (IISER) Mohali, Mohali, Punjab, 140306, India
| | - Riya Madan
- Diabetic Vascular Complications Laboratory, Department of Biological Sciences, Indian Institute of Science Education and Research (IISER) Mohali, Mohali, Punjab, 140306, India
| | - Sadhan Das
- Diabetic Vascular Complications Laboratory, Department of Biological Sciences, Indian Institute of Science Education and Research (IISER) Mohali, Mohali, Punjab, 140306, India.
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Xu K, Li TZ, Terry JG, Krishnan AR, Deppen SA, Huo Y, Maldonado F, Carr JJ, Landman BA, Sandler KL. Age-related Muscle Fat Infiltration in Lung Screening Participants: Impact of Smoking Cessation. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.05.23299258. [PMID: 38106099 PMCID: PMC10723505 DOI: 10.1101/2023.12.05.23299258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Rationale Skeletal muscle fat infiltration progresses with aging and is worsened among individuals with a history of cigarette smoking. Many negative impacts of smoking on muscles are likely reversible with smoking cessation. Objectives To determine if the progression of skeletal muscle fat infiltration with aging is altered by smoking cessation among lung cancer screening participants. Methods This was a secondary analysis based on the National Lung Screening Trial. Skeletal muscle attenuation in Hounsfield unit (HU) was derived from the baseline and follow-up low-dose CT scans using a previously validated artificial intelligence algorithm. Lower attenuation indicates greater fatty infiltration. Linear mixed-effects models were constructed to evaluate the associations between smoking status and the muscle attenuation trajectory. Measurements and Main Results Of 19,019 included participants (age: 61 years, 5 [SD]; 11,290 males), 8,971 (47.2%) were actively smoking cigarettes. Accounting for body mass index, pack-years, percent emphysema, and other confounding factors, actively smoking predicted a lower attenuation in both males (β0 =-0.88 HU, P<.001) and females (β0 =-0.69 HU, P<.001), and an accelerated muscle attenuation decline-rate in males (β1=-0.08 HU/y, P<.05). Age-stratified analyses indicated that the accelerated muscle attenuation decline associated with smoking likely occurred at younger age, especially in females. Conclusions Among lung cancer screening participants, active cigarette smoking was associated with greater skeletal muscle fat infiltration in both males and females, and accelerated muscle adipose accumulation rate in males. These findings support the important role of smoking cessation in preserving muscle health.
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Affiliation(s)
- Kaiwen Xu
- Department of Computer Science, Vanderbilt University, Nashville, Tennessee
| | - Thomas Z. Li
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee
- School of Medicine, Vanderbilt University, Nashville, Tennessee
| | - James G. Terry
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Aravind R. Krishnan
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, Tennessee
| | - Stephen A. Deppen
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Yuankai Huo
- Department of Computer Science, Vanderbilt University, Nashville, Tennessee
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, Tennessee
| | - Fabien Maldonado
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - J. Jeffrey Carr
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Bennett A. Landman
- Department of Computer Science, Vanderbilt University, Nashville, Tennessee
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, Tennessee
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kim L. Sandler
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee
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20
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af Geijerstam P, Janryd F, Nyström FH. Smoking and cardiovascular disease in patients with type 2 diabetes: a prospective observational study. J Cardiovasc Med (Hagerstown) 2023; 24:802-807. [PMID: 37768866 PMCID: PMC10552835 DOI: 10.2459/jcm.0000000000001540] [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: 02/05/2023] [Revised: 06/18/2023] [Accepted: 07/14/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND Cigarette smoking is a major risk factor for cardiovascular disease. In type 2 diabetes mellitus (T2D), medications such as antihypertensives and statins can reduce the increased cardiovascular risk. The aim of this study was to evaluate the impact of cigarette smoking on major adverse cardiovascular event (MACE) and all-cause mortality in patients with T2D in a relatively well treated Swedish cohort. METHODS Seven hundred and sixty-one patients with T2D aged 55-66 years were followed in the prospective observational CArdiovascular Risk factors in patients with DIabetes - a Prospective study in Primary care (CARDIPP) study. Baseline data included blood samples of markers of dysglycemia and inflammation, blood pressure as well as questionnaire responses regarding cigarette smoking. Participants were followed for incidence of MACE and all-cause mortality. RESULTS Of the included 663 participants, the mean age was 60.6 (SD 3.1) years and 423 (63.8%) were men. Levels of C-reactive protein and vitamin D, as well as the proportion of participants treated with antihypertensives, acetylic salicylic acid, statins, and diabetes medications, were similar between smokers and nonsmokers. Median follow-up time was 11.9 (Q1-Q3 10.8-12.7) years. Cigarette smoking was associated with all-cause mortality [hazard ratio 2.24 (95% confidence interval, 95% CI 1.40-3.56), P < 0.001], but not MACE [hazard ratio 1.30 (95% CI 0.77-2.18), P = 0.328]. CONCLUSION In patients with T2D, cigarette smoking was not associated with an increased risk of MACE. This raises the question of whether cardioprotective drugs in individuals with T2D to some degree mitigate the cardiovascular harm of smoking, even though they do not affect other dire consequences of smoking.
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Affiliation(s)
- Peder af Geijerstam
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping
| | - Fredrik Janryd
- Cityhälsan Centrum Primary Care Center, Region Östergötland, Norrköping, Sweden
| | - Fredrik H. Nyström
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping
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21
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Davalagi S, Amuje R, H S. Cardiovascular Risk Assessment Among People With Type 2 Diabetes Mellitus in Urban Slums of Central Karnataka, India. Cureus 2023; 15:e46687. [PMID: 37942395 PMCID: PMC10629598 DOI: 10.7759/cureus.46687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND The intricate interplay between type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD) necessitates a comprehensive investigation into the cardiovascular risk landscape among individuals with T2DM. The burgeoning global burden of both conditions underscores the urgency of targeted research in this area, with the potential to inform preventive strategies and mitigate adverse cardiovascular outcomes. By unravelling the risk of CVD among T2DM patients and identifying key risk factors, the current research could pave the way for tailored interventions that could have the potential to substantially alleviate the cardiovascular burden associated with T2DM. AIMS AND OBJECTIVES To assess the cardiovascular risk and its determinants among T2DM patients. METHODS A cross sectional study was conducted among known diabetes patients accessing urban outreach clinic serving approximately 20,000 population across 18 urban slums in central Karnataka from September 2022 to June 2023. A pre-tested semi-structured questionnaire was used to collect information on socio-demographic details and CVD risk was assessed using QRISK3 score. Data were entered in Excel 2019 (Microsoft, Redmond, WA, USA) and analysed using SPSS version 25.0 (IBM Corp., Armonk, NY, USA) and are presented in the tables and figures. RESULTS A total of 483 adults above 30 years participated in the study. Among them, the majority were men (67.9%). Cardiovascular risk factors were found more among males and the 10-year cardiovascular risk assessment prediction through QRISK3 score was higher among males compared to females and it was found to be statistically significant (13.5±8.6% vs. 19.5±10.1%, p<0.001). CONCLUSION According to a comparison of cardiovascular risk variables by gender among diabetic patients using the QRISK3's 10-year risk assessment, males, smokers/tobacco users, obese, and known hypertensives had significantly greater risk.
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Affiliation(s)
- Shubha Davalagi
- Community Medicine, Jagadguru Jayadeva Murugarajendra (JJM) Medical College, Davangere, IND
| | - Rohit Amuje
- Community Medicine, Jagadguru Jayadeva Murugarajendra (JJM) Medical College, Davangere, IND
| | - Shalini H
- Community Medicine, Jagadguru Jayadeva Murugarajendra (JJM) Medical College, Davangere, IND
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22
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Chen Z, Liu XA, Kenny PJ. Central and peripheral actions of nicotine that influence blood glucose homeostasis and the development of diabetes. Pharmacol Res 2023; 194:106860. [PMID: 37482325 DOI: 10.1016/j.phrs.2023.106860] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/06/2023] [Accepted: 07/18/2023] [Indexed: 07/25/2023]
Abstract
Cigarette smoking has long been recognized as a risk factor for type 2 diabetes (T2D), although the precise causal mechanisms underlying this relationship remain poorly understood. Recent evidence suggests that nicotine, the primary reinforcing component in tobacco, may play a pivotal role in connecting cigarette smoking and T2D. Extensive research conducted in both humans and animals has demonstrated that nicotine can elevate blood glucose levels, disrupt glucose homeostasis, and induce insulin resistance. The review aims to elucidate the genetic variants of nicotinic acetylcholine receptors associated with diabetes risk and provide a comprehensive overview of the available data on the mechanisms through which nicotine influences blood glucose homeostasis and the development of diabetes. Here we emphasize the central and peripheral actions of nicotine on the release of glucoregulatory hormones, as well as its effects on glucose tolerance and insulin sensitivity. Notably, the central actions of nicotine within the brain, which encompass both insulin-dependent and independent mechanisms, are highlighted as potential targets for intervention strategies in diabetes management.
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Affiliation(s)
- Zuxin Chen
- Shenzhen Key Laboratory of Drug Addiction, Shenzhen Neher Neural Plasticity Laboratory, The Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China; University of Chinese Academy of Sciences, Beijing, China; Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Xin-An Liu
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China; University of Chinese Academy of Sciences, Beijing, China; Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China.
| | - Paul J Kenny
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, USA.
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23
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Jeong SM, Yoo JE, Park J, Jung W, Lee KN, Han K, Lee CM, Nam KW, Lee SP, Shin DW. Smoking behavior change and risk of cardiovascular disease incidence and mortality in patients with type 2 diabetes mellitus. Cardiovasc Diabetol 2023; 22:193. [PMID: 37516874 PMCID: PMC10387213 DOI: 10.1186/s12933-023-01930-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 07/20/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND We aimed to examine the association between smoking behavior change and risk of cardiovascular disease (CVD) incidence and mortality in patients with type 2 diabetes mellitus (T2DM). METHODS This study used nationwide data from the Korean National Health Insurance System and included 349,137 T2DM patients who smoked. Smoking behavior changes were defined with five groups: quitters, reducers I (≥ 50% reduction), reducers II (20-50% reduction), sustainers (± 20%), and increasers (≥ 20% increase) from the number of cigarettes/day at the baseline. RESULTS During a median follow-up of 5.1 years, 6,514 cases of myocardial infarction (MI) (1.9%), 7,837 cases of ischemic stroke (IS) (2.2%), and 14,932 deaths (4.3%) were identified. Quitters had a significantly decreased risk of MI (adjusted hazard ratio [aHR] 0.80, 95% CI 0.75-0.86) and IS (aHR 0.80, 95% CI 0.75-0.85) compared to sustainers, whereas reducers did not have a significant association with the risk of MI (aHR 1.03, 95% CI 0.94-1.13) and IS (aHR 1.00, 95% CI 0.92-1.08) in reducer I. Quitters also had a lower all-cause and CVD mortality than sustainers. CONCLUSIONS Smoking cessation was associated with decreased CVD incidence, and all-cause and CVD mortality among T2DM patients. However, smoking reduction was not associated with decreased risks for these.
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Affiliation(s)
- Su-Min Jeong
- Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Family Medicine, Seoul National University Health Service Center, Seoul, Republic of Korea
| | - Jung Eun Yoo
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Junhee Park
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Wonyoung Jung
- Department of Family Medicine/Obesity and Metabolic Health Center, Kangdong Sacred Heart Hospital, Hallym University, Seoul, Republic of Korea
| | - Kyu Na Lee
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Cheol Min Lee
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ki-Woong Nam
- Department of Neurology, Seoul National University College of Medicine and Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Seung-Pyo Lee
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dong Wook Shin
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
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Behl TA, Stamford BA, Moffatt RJ. The Effects of Smoking on the Diagnostic Characteristics of Metabolic Syndrome: A Review. Am J Lifestyle Med 2023; 17:397-412. [PMID: 37304742 PMCID: PMC10248373 DOI: 10.1177/15598276221111046] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Abstract
Metabolic syndrome is a growing epidemic that increases the risk for cardiovascular disease, diabetes, stroke, and mortality. It is diagnosed by the presence of three or more of the following risk factors: 1) obesity, with an emphasis on central adiposity, 2) high blood pressure, 3) hyperglycemia, 4) dyslipidemia, with regard to reduced high-density lipoprotein concentrations, and 5) dyslipidemia, with regard to elevated triglycerides. Smoking is one lifestyle factor that can increase the risk for metabolic syndrome as it has been shown to exert negative effects on abdominal obesity, blood pressure, blood glucose concentrations, and blood lipid profiles. Smoking may also negatively affect other factors that influence glucose and lipid metabolism including lipoprotein lipase, adiponectin, peroxisome proliferator-activated receptors, and tumor necrosis factor-alpha. Some of these smoking-related outcomes may be reversed with smoking cessation, thus reducing the risk for metabolic disease; however, metabolic syndrome risk may initially increase post cessation, possibly due to weight gain. Therefore, these findings warrant the need for more research on the development and efficacy of smoking prevention and cessation programs.
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Affiliation(s)
- Taylor A. Behl
- Department of Nutrition and Integrative Physiology, Florida State
University, Tallahassee, FL, USA (TAB); School of Business, Education,
and Mathematics, Flagler College, St Augustine, FL, USA (TAB); Department of Kinesiology and
Integrative Physiology, Hanover College, Hanover, IN, USA (BAS); and Human Performance Development
Group, Tallahassee, FL, USA (BAS, RJM)
| | - Bryant A. Stamford
- Department of Nutrition and Integrative Physiology, Florida State
University, Tallahassee, FL, USA (TAB); School of Business, Education,
and Mathematics, Flagler College, St Augustine, FL, USA (TAB); Department of Kinesiology and
Integrative Physiology, Hanover College, Hanover, IN, USA (BAS); and Human Performance Development
Group, Tallahassee, FL, USA (BAS, RJM)
| | - Robert J. Moffatt
- Department of Nutrition and Integrative Physiology, Florida State
University, Tallahassee, FL, USA (TAB); School of Business, Education,
and Mathematics, Flagler College, St Augustine, FL, USA (TAB); Department of Kinesiology and
Integrative Physiology, Hanover College, Hanover, IN, USA (BAS); and Human Performance Development
Group, Tallahassee, FL, USA (BAS, RJM)
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Huang LC, Chang YT, Lin CL, Chen RY, Bai CH. Effectiveness of Health Coaching in Smoking Cessation and Promoting the Use of Oral Smoking Cessation Drugs in Patients with Type 2 Diabetes: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4994. [PMID: 36981909 PMCID: PMC10049574 DOI: 10.3390/ijerph20064994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION This study looked into the effectiveness of a 6 month health coaching intervention in smoking cessation and smoking reduction for patients with type 2 diabetes. METHODS The study was carried out via a two-armed, double-blind, randomized-controlled trial with 68 participants at a medical center in Taiwan. The intervention group received health coaching for 6 months, while the control group only received usual smoking cessation services; some patients in both groups participated in a pharmacotherapy plan. The health coaching intervention is a patient-centered approach to disease management which focuses on changing their actual behaviors. By targeting on achieving effective adult learning cycles, health coaching aims to help patients to establish new behavior patterns and habits. RESULTS In this study, the intervention group had significantly more participants who reduced their level of cigarette smoking by at least 50% than the control group (p = 0.030). Moreover, patients participating in the pharmacotherapy plan in the coaching intervention group had a significant effect on smoking cessation (p = 0.011), but it was insignificant in the control group. CONCLUSIONS Health coaching can be an effective approach to assisting patients with type 2 diabetes participating in a pharmacotherapy plan to reduce smoking and may help those who participate in pharmacotherapy plan to quit smoking more effectively. Further studies with higher-quality evidence on the effectiveness of health coaching in smoking cessation and the use of oral smoking cessation drugs in patients with type 2 diabetes are needed.
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Affiliation(s)
- Li-Chi Huang
- Endocrinology & Metabolism, Cathay General Hospital, Taipei 106438, Taiwan
- School of Public Health, Taipei Medical University, Taipei 110301, Taiwan
| | - Yao-Tsung Chang
- School of Public Health, Taipei Medical University, Taipei 110301, Taiwan
| | - Ching-Ling Lin
- Endocrinology & Metabolism, Cathay General Hospital, Taipei 106438, Taiwan
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu 300044, Taiwan
| | - Ruey-Yu Chen
- School of Public Health, Taipei Medical University, Taipei 110301, Taiwan
| | - Chyi-Huey Bai
- School of Public Health, Taipei Medical University, Taipei 110301, Taiwan
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26
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Davies C, Vaida F, Otwombe K, Cotton MF, Browne S, Innes S. Longitudinal comparison of insulin resistance and dyslipidemia in children with and without perinatal HIV infection in South Africa. AIDS 2023; 37:523-533. [PMID: 36695362 PMCID: PMC9883048 DOI: 10.1097/qad.0000000000003452] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
INTRODUCTION HIV infection is associated with insulin resistance and dyslipidaemia driven by HIV-associated immune dysregulation and antiretroviral therapy (ART). Children living with perinatally acquired HIV (CHIV) face many decades of exposure to these factors. We evaluated the longitudinal trajectory of insulin resistance and dyslipidaemia in CHIV and HIV-exposed uninfected children (CHEU), compared with children HIV-unexposed (CHU). METHODS Four hundred and eighty-five children (141 CHIV, 169 CHEU, 175 CHU) aged 5-16 years, previously part of CHER and P1060 trials, were followed annually at Tygerberg Children's Hospital, South Africa. The primary outcome was Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). Secondary outcomes included low-density lipoprotein (LDL) cholesterol, triglyceride-to-HDL ratio, android fat mass and SBP. Outcomes were evaluated using linear mixed effects models, adjusting for potential confounders. RESULTS CHIV had 73% greater HOMA-IR than CHU in ages 6-8 years (95% CI 15.9-158.2%, P < 0.001), and 24.7% greater HOMA-IR than CHU in ages 9-10 years (0.3-55.1%, P = 0.04). By 10-11 years, the difference was not significant (P = 0.161). Longitudinally, triglyceride-to-HDL was 47.94% (34.50-62.73%, P < 0.001) higher in CHIV vs. CHU; LDL was 0.25 mmol/l (0.10-0.39, P = 0.001) higher in CHIV vs. CHU; android fat mass was 11.57% (-21.11 to -0.87%, P = 0.035) lower in CHIV than CHU. No significant difference in SBP was found. CHEU and CHU had similar outcomes. CONCLUSION Early-treated CHIV have elevated insulin resistance, which resolves with time. Triglyceride-to-HDL ratio and LDL cholesterol were elevated into puberty. CHIV should be monitored for insulin resistance, dyslipidaemia and subclinical cardiovascular disease.
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Affiliation(s)
- Claire Davies
- Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Florin Vaida
- Division of Biostatistics and Bioinformatics, School of Public Health, University of California, San Diego, United States
| | - Kennedy Otwombe
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mark F Cotton
- Family Center for Research with Ubuntu, Department of Paediatrics and Child Health, Stellenbosch University, South Africa
| | - Sara Browne
- School of Public Health, University of California, San Diego, United States
| | - Steve Innes
- Family Center for Research with Ubuntu, Department of Paediatrics and Child Health, Stellenbosch University, South Africa
- Desmond Tutu HIV Centre, University of Cape Town, South Africa
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Decker ST, Matias AA, Bannon ST, Madden JP, Alexandrou-Majaj N, Layec G. Effects of cigarette smoke on in situ mitochondrial substrate oxidation of slow- and fast-twitch skeletal muscles. Life Sci 2023; 315:121376. [PMID: 36646379 DOI: 10.1016/j.lfs.2023.121376] [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: 10/05/2022] [Revised: 12/23/2022] [Accepted: 01/03/2023] [Indexed: 01/15/2023]
Abstract
Epidemiological and clinical evidence suggests that cigarette smoke exposure alters glucose and fatty acid metabolism, leading to greater susceptibility to metabolic disorders. However, the effects of cigarette smoke exposure on mitochondrial substrate oxidation in the skeletal muscle are still poorly understood. Accordingly, this study aimed to examine the acute effects of cigarette smoke on mitochondrial respiratory capacity, sensitivity, and concurrent utilization of palmitoylcarnitine (PC), a long-chain fatty acid, and pyruvate, a product of glycolysis, in permeabilized gastrocnemius and soleus muscle fibers exposed to an acute (1 h) dose (4 %) of cigarette smoke concentrate. Cigarette smoke decreased both mitochondrial respiratory capacity (CONTROL: 50.4 ± 11.8 pmolO2/s/mgwt and SMOKE: 22.3 ± 4.4 pmolO2/s/mgwt, p < 0.01) and sensitivity for pyruvate (CONTROL: 0.10 ± 0.04 mM and SMOKE: 0.11 ± 0.04 mM, p < 0.01) in the gastrocnemius muscle. In the soleus, only the sensitivity for pyruvate-stimulated mitochondrial respiration trended toward a decrease (CONTROL: 0.11 ± 0.04 mM and SMOKE: 0.23 ± 0.15 mM, p = 0.08). In contrast, cigarette smoke did not significantly alter palmitoylcarnitine-stimulated mitochondrial respiration in either muscle. In the control condition, pyruvate-supported respiration was inhibited by the concurrent addition of palmitoylcarnitine in the fast-twitch gastrocnemius muscle (-27.1 ± 19.7 %, p < 0.05), but not in the slow-twitch soleus (-9.2 ± 17.0 %). With cigarette smoke, the addition of palmitoylcarnitine augmented the maximal respiration rate stimulated by the concurrent addition of pyruvate in the gastrocnemius (+18.5 ± 39.3 %, p < 0.05). However, cigarette smoke still significantly impaired mitochondrial respiratory capacity with combined substrates compared to control (p < 0.05). Our findings underscore that cigarette smoke directly impairs mitochondrial respiration of carbohydrate-derived substrates and is a primary mechanism underlying cigarette smoke-induced muscle dysfunction, which leads to a vicious cycle involving excess glucose conversion into fatty acids and lipotoxicity.
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Affiliation(s)
- Stephen T Decker
- Department of Kinesiology, University of Massachusetts Amherst, USA
| | - Alexs A Matias
- Department of Kinesiology, University of Massachusetts Amherst, USA
| | - Sean T Bannon
- Department of Kinesiology, University of Massachusetts Amherst, USA
| | - Jack P Madden
- Department of Kinesiology, University of Massachusetts Amherst, USA
| | | | - Gwenael Layec
- Department of Kinesiology, University of Massachusetts Amherst, USA; Institute for Applied Life Science, University of Massachusetts Amherst, USA.
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Titova OE, Baron JA, Fall T, Michaëlsson K, Larsson SC. Swedish Snuff (Snus), Cigarette Smoking, and Risk of Type 2 Diabetes. Am J Prev Med 2023:S0749-3797(23)00020-X. [PMID: 36754744 DOI: 10.1016/j.amepre.2023.01.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Cigarette smoking is a known risk factor for Type 2 diabetes, but evidence regarding former smoking and moist snuff (snus) use and Type 2 diabetes risk is inconclusive. This study investigated the relationships of cigarette smoking and Swedish snus use with the risk of Type 2 diabetes in a cohort of middle-aged and elderly participants. METHODS Participants (N=36,742; age range=56-95 years) were followed for incident Type 2 diabetes and death between 2009 and 2017 through linkage to the Swedish National Patient, Prescribed Drug and Death Registers. Cox proportional hazards regression was used to obtain hazard ratios and 95% CIs adjusted for potential confounders, including physical activity, education, BMI, and alcohol intake. Analyses were conducted in 2021‒2022. RESULTS Former and current smoking was associated with an increased risk of Type 2 diabetes (hazard ratios [95% CI]=1.17 [1.07, 1.29] and 1.57 [1.36, 1.81], respectively). In those who stopped smoking, Type 2 diabetes risk remained elevated up to approximately 15 years after cessation. In participants who have never smoked, snus use was linked to a higher risk of Type 2 diabetes in the model adjusted for age and sex (hazard ratio [95% CI]=1.49 [1.04, 2.15]), but this was attenuated after multivariable adjustment (hazard ratio [95% Cl]=1.29 [0.89, 1.86]). CONCLUSIONS This study indicates that current and former smoking are associated with an increased risk of Type 2 diabetes in middle-aged and older individuals. There was less evidence of an association of snus use with the risk of Type 2 diabetes, suggesting that compounds other than nicotine may underlie the detrimental association of smoking with the risk of Type 2 diabetes.
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Affiliation(s)
- Olga E Titova
- Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
| | - John A Baron
- Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Tove Fall
- Unit of Molecular Epidemiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Karl Michaëlsson
- Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Susanna C Larsson
- Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Diet, Lifestyle Behaviours and Other Risk Factors Associated With Type 2 Diabetes Beyond Body Mass Index: A Mendelian Randomization Study. Can J Diabetes 2022; 46:822-828. [PMID: 35835669 DOI: 10.1016/j.jcjd.2022.06.001] [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: 10/02/2021] [Revised: 03/10/2022] [Accepted: 06/01/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Our aim in this study was to identify promising targets for the prevention of type 2 diabetes in addition to weight loss. We conducted a Mendelian randomization (MR) study to investigate the body mass index (BMI)-independent associations of 16 risk factors, including diet, lifestyle behaviours and others, with type 2 diabetes. METHODS We selected genetic variants as instrumental variables for diet, sleep traits, smoking, physical activity, education and blood pressure (BP) from European-descent genome-wide association studies (GWASs). Summary statistics for type 2 diabetes were derived from a recent GWAS with 74,124 European cases and 824,006 European controls. The inverse-variance weighted MR method was used to assess the associations of the risk factors with type 2 diabetes, followed by validation of robustness using different MR methods in sensitivity analyses. RESULTS Genetically predicted insomnia (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.06 to 1.15), smoking initiation (OR, 1.14; 95% CI, 1.06 to 1.21), educational level (OR, 0.69; 95% CI, 0.65 to 0.74), hypertension (OR, 6.50; 95% CI, 3.13 to 13.50), systolic BP (OR, 1.02; 95% CI, 1.02 to 1.03) and diastolic BP (OR, 1.03; 95% CI, 1.02 to 1.03) had BMI-independent effects on type 2 diabetes risk. In addition, alcohol dependence (OR, 1.10; 95% CI, 1.05 to 1.16; BMI-adjusted OR, 1.04; 95% CI, 0.98 to 1.09) and vegetarian diet (OR, 0.50; 95% CI, 0.33 to 0.74; BMI-adjusted OR, 0.78; 95% CI, 0.57 to 1.06) appeared to be correlated with type 2 diabetes via a BMI-mediated pathway. Sensitivity analyses further confirmed the relationship between these factors and type 2 diabetes. CONCLUSIONS In this systematic MR study, insomnia, smoking, education and BP had BMI-independent causal effects on the risk of type 2 diabetes, whereas alcohol dependence and vegetarian diet were associated with type 2 diabetes through BMI.
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Ferreira JRS, Zandonade E, de Paula Alves Bezerra OM, Salaroli LB. Insulin resistance by the triglyceride-glucose index in a rural Brazilian population. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:848-855. [PMID: 35929905 PMCID: PMC10118758 DOI: 10.20945/2359-3997000000509] [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] [Indexed: 04/22/2023]
Abstract
Objective The aim of this study was to estimate the prevalence of insulin resistance (IR) in a rural population in Brazil, to verify its association with sociodemographic, labor, lifestyle, and health factors. Subjects and methods This is a cross-sectional study with 790 farmers in the state of Espírito Santo/Brazil. Triglyceride-glucose (TyG) was calculated and a cut-off point of Ln 4.52 was used. A hierarchical logistic regression for the association of insulin resistance with sociodemographic, labor, lifestyle and health variables of farmers living in Espírito Santo was performed. Results The prevalence of insulin resistance was 33.7% (n = 266), and the association with insulin resistance was found in the age group 31 to 40 years of age (OR = 1.85; 95% CI 1.19-2.87); in smokers or former smokers (OR = 1.63; 95% CI 1.08-2.48) and overweight (OR = 3.06; 95% CI 2.22-4.23). Conclusion The prevalence of insulin resistance was high in a rural population of Brazil, and was mainly associated with age, smoking and obesity. The use of TyG as an instrument for assessing the health of individuals living in areas where access to health services is difficult, such as rural areas, can represent an important advance in terms of health promotion, protection and recovery. In addition, by identifying the risk factors associated with IR, as well as their consequences, a more adequate scheme for the prevention and treatment of these comorbidities can be defined.
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Affiliation(s)
| | - Eliana Zandonade
- Programa de Pós-graduação em Saúde Pública, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brasil
| | | | - Luciane Bresciani Salaroli
- Programa de Pós-graduação em Saúde Pública, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brasil
- Programa de Pós-graduação em Nutrição e Saúde, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brasil
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Kondo Y, Hashimoto Y, Hamaguchi M, Kaji A, Sakai R, Inoue R, Kashiwagi S, Mizushima K, Uchiyama K, Takagi T, Naito Y, Fukui M. Effects of Smoking on the Gut Microbiota in Individuals with Type 2 Diabetes Mellitus. Nutrients 2022; 14:nu14224800. [PMID: 36432487 PMCID: PMC9695173 DOI: 10.3390/nu14224800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
Smoking affects eating habits; however, few studies on smoking and the gut microbiota have reported the effects of diet in detail. This cross-sectional study aimed to determine the association between smoking and the gut microbiota, considering the impact of smoking on dietary intake. Dietary habits and the composition of the gut microbiota were assessed in 195 men with type 2 diabetes (164 non-current smokers and 31 current smokers) using a brief self-administered diet history questionnaire and 16S ribosomal RNA gene sequencing of fecal samples. The data were compared according to the current smoking status of the participants. Current smokers had high alcohol and sugar/sweetener intake and low fruit intake. The proportion of the Coprococcus genus was higher among current smokers. Multiple regression analysis adjusted for current smoking, age, exercise habits, alcohol intake, sugar and sweetener intake, and fruit intake showed that smoking was associated with the proportion of the Coprococcus genus. Current smoking was associated with both dietary intake and composition of the gut microbiota. Although dietary intake should be considered when investigating the association between smoking and the gut microbiota, the results suggest that the direct effect of smoking is more significant.
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Affiliation(s)
- Yuriko Kondo
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, Moriguchi 570-8540, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Correspondence: ; Tel.: +81-75-251-5505; Fax: +81-75-252-3721
| | - Ayumi Kaji
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Ryosuke Sakai
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Ryo Inoue
- Laboratory of Animal Science, Department of Applied Biological Sciences, Faculty of Agriculture, Setsunan University, Hirakata 573-0101, Japan
| | - Saori Kashiwagi
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Katsura Mizushima
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Kazuhiko Uchiyama
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Tomohisa Takagi
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Department for Medical Innovation and Translational Medical Science, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Yuji Naito
- Department of Human Immunology and Nutrition Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
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G M, Govindarajan S, Veeraraghavan V, Varadarajan S, Balasubramaniam A, R D. Used Toothbrush as a Potential Source of Gene Expression Among Subjects With Systemic Disease and Adverse Habits. Cureus 2022; 14:e31391. [DOI: 10.7759/cureus.31391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 11/15/2022] Open
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Durlach V, Vergès B, Al-Salameh A, Bahougne T, Benzerouk F, Berlin I, Clair C, Mansourati J, Rouland A, Thomas D, Thuillier P, Tramunt B, Le Faou AL. Smoking and diabetes interplay: A comprehensive review and joint statement. DIABETES & METABOLISM 2022; 48:101370. [PMID: 35779852 DOI: 10.1016/j.diabet.2022.101370] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
Evidence shows that smoking increases the risk of pre-diabetes and diabetes in the general population. Among persons with diabetes, smoking has been found to increase the risk of all-cause mortality and aggravate chronic diabetic complications and glycemic control. The current paper, which is a joint position statement by the French-Speaking Society on Tobacco (Société Francophone de Tabacologie) and the French-Speaking Society of Diabetes (Société Francophone du Diabète), summarizes the data available on the association between smoking and diabetes and on the impact of smoking and smoking cessation among individuals with type 1, type 2, and gestational diabetes mellitus. It also provides evidence-based information about the pharmacological and behavioral strategies for smoking cessation in these patients.
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Affiliation(s)
- Vincent Durlach
- Champagne-Ardenne University, UMR CNRS 7369 MEDyC & Cardio-Thoracic Department, Reims University Hospital, Reims, France.
| | - Bruno Vergès
- Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France; INSERM LNC-UMR1231, University of Burgundy, Dijon, France
| | - Abdallah Al-Salameh
- Department of Endocrinology, Diabetes Mellitus and Nutrition, Amiens University Hospital, Amiens, France; PériTox = UMR-I 01, University of Picardy Jules Verne, Amiens, France
| | - Thibault Bahougne
- Department of Endocrinology and Diabetology, Strasbourg University Hospital, Strasbourg, France; Institute of Cellular and Integrative Neuroscience, CNRS UPR-3212, Strasbourg, France
| | - Farid Benzerouk
- Cognition Health and Society Laboratory (EA 6291), University of Reims Champagne-Ardenne, Reims, France; Department of Psychiatry, Reims University Hospital, Reims, France
| | - Ivan Berlin
- Department of Pharmacology, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
| | - Carole Clair
- Department of Training, Research and Innovation, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Jacques Mansourati
- EA 4324 ORPHY, University of Western Brittany, Brest, France; Department of Cardiology, University Hospital of Brest, Brest, France
| | - Alexia Rouland
- Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France
| | - Daniel Thomas
- Institute of Cardiology, Hôpital Pitié-Salpêtrière, Sorbonne University, Paris, France
| | - Philippe Thuillier
- Department of Endocrinology, Diabetology and Metabolic Diseases, University Hospital of Brest, Brest, France
| | - Blandine Tramunt
- Institute of Metabolic and Cardiovascular Diseases, UMR1297 INSERM/UPS, Toulouse University, Toulouse, Franc; Department of Diabetology, Metabolic Diseases and Nutrition, Toulouse University Hospital, Toulouse, France
| | - Anne-Laurence Le Faou
- Outpatient Addiction Center, Georges Pompidou European Hospital, AP-HP, Sorbonne Paris Cité, Paris, France
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Driva S, Korkontzelou A, Tonstad S, Tentolouris N, Katsaounou P. The Effect of Smoking Cessation on Body Weight and Other Metabolic Parameters with Focus on People with Type 2 Diabetes Mellitus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013222. [PMID: 36293800 PMCID: PMC9603007 DOI: 10.3390/ijerph192013222] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/24/2022] [Accepted: 10/07/2022] [Indexed: 06/01/2023]
Abstract
Smokers with diabetes mellitus substantially lower their risks of microvascular and macrovascular diabetic complications, in particular cardiovascular disease, by quitting smoking. However, subsequent post-smoking-cessation weight gain may attenuate some of the beneficial effects of smoking cessation and discourage attempts to quit. Weight gain can temporarily exacerbate diabetes and deteriorate glycemic control and metabolic profile. The molecular mechanisms by which quitting smoking leads to weight gain are largely associated with the removal of nicotine's effects on the central nervous system. This review addresses mechanisms of post-smoking-cessation weight gain, by reviewing the effects of nicotine on appetite, food intake, eating behaviour, energy expenditure, fat oxidation and appetite-regulating peptides. We also highlight correlations between post-cessation weight gain and risk of type 2 diabetes, consequences of weight gain in people with type 2 diabetes and the role of pharmacotherapies, which combine treatment of nicotine addiction and promotion of weight control.
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Affiliation(s)
- Stamatina Driva
- Diabetes Centre, First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Aliki Korkontzelou
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- First Department of Critical Care, Evangelismos General Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Serena Tonstad
- Department of Preventive Cardiology, Oslo University Hospital, 0424 Oslo, Norway
| | - Nikolaos Tentolouris
- Diabetes Centre, First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Paraskevi Katsaounou
- First Department of Critical Care, Evangelismos General Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece
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Lv X, Jiang Y, Yang D, Zhu C, Yuan H, Yuan Z, Suo C, Chen X, Xu K. The role of metabolites under the influence of genes and lifestyles in bone density changes. Front Nutr 2022; 9:934951. [PMID: 36118775 PMCID: PMC9481263 DOI: 10.3389/fnut.2022.934951] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/04/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose Osteoporosis is a complex bone disease influenced by numerous factors. Previous studies have found that some metabolites are related to bone mineral density (BMD). However, the associations between metabolites and BMD under the influence of genes and lifestyle have not been fully investigated. Methods We analyzed the effect of metabolites on BMD under the synergistic effect of genes and lifestyle, using the data of 797 participants aged 55–65 years from the Taizhou Imaging Study. The cumulative sum method was used to calculate the polygenic risk score of SNPs, and the healthful plant-based diet index was used to summarize food intake. The effect of metabolites on BMD changes under the influence of genes and lifestyle was analyzed through interaction analysis and mediation analysis. Results Nineteen metabolites were found significantly different in the osteoporosis, osteopenia, and normal BMD groups. We found two high-density lipoprotein (HDL) subfractions were positively associated with osteopenia, and six very-low-density lipoprotein subfractions were negatively associated with osteopenia or osteoporosis, after adjusting for lifestyles and genetic factors. Tea drinking habits, alcohol consumption, smoking, and polygenic risk score changed BMD by affecting metabolites. Conclusion With the increased level of HDL subfractions, the risk of bone loss in the population will increase; the risk of bone loss decreases with the increased level of very-low-density lipoprotein subfractions. Genetic factors and lifestyles can modify the effects of metabolites on BMD. Our results show evidence for the precise prevention of osteoporosis.
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Affiliation(s)
- Xuewei Lv
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Yanfeng Jiang
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Dantong Yang
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Chengkai Zhu
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Huangbo Yuan
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Ziyu Yuan
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Chen Suo
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China
- Ministry of Education Key Laboratory of Public Health Safety, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Xingdong Chen
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China
- *Correspondence: Xingdong Chen,
| | - Kelin Xu
- Ministry of Education Key Laboratory of Public Health Safety, Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Kelin Xu,
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Li M, Chi X, Wang Y, Setrerrahmane S, Xie W, Xu H. Trends in insulin resistance: insights into mechanisms and therapeutic strategy. Signal Transduct Target Ther 2022; 7:216. [PMID: 35794109 PMCID: PMC9259665 DOI: 10.1038/s41392-022-01073-0] [Citation(s) in RCA: 307] [Impact Index Per Article: 102.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 02/06/2023] Open
Abstract
The centenary of insulin discovery represents an important opportunity to transform diabetes from a fatal diagnosis into a medically manageable chronic condition. Insulin is a key peptide hormone and mediates the systemic glucose metabolism in different tissues. Insulin resistance (IR) is a disordered biological response for insulin stimulation through the disruption of different molecular pathways in target tissues. Acquired conditions and genetic factors have been implicated in IR. Recent genetic and biochemical studies suggest that the dysregulated metabolic mediators released by adipose tissue including adipokines, cytokines, chemokines, excess lipids and toxic lipid metabolites promote IR in other tissues. IR is associated with several groups of abnormal syndromes that include obesity, diabetes, metabolic dysfunction-associated fatty liver disease (MAFLD), cardiovascular disease, polycystic ovary syndrome (PCOS), and other abnormalities. Although no medication is specifically approved to treat IR, we summarized the lifestyle changes and pharmacological medications that have been used as efficient intervention to improve insulin sensitivity. Ultimately, the systematic discussion of complex mechanism will help to identify potential new targets and treat the closely associated metabolic syndrome of IR.
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Affiliation(s)
- Mengwei Li
- The Engineering Research Center of Synthetic Peptide Drug Discovery and Evaluation of Jiangsu Province, China Pharmaceutical University, Nanjing, 210009, China
- State Key Laboratory of Natural Medicines, Ministry of Education, China Pharmaceutical University, Nanjing, 210009, China
| | - Xiaowei Chi
- Development Center for Medical Science & Technology National Health Commission of the People's Republic of China, 100044, Beijing, China
| | - Ying Wang
- The Engineering Research Center of Synthetic Peptide Drug Discovery and Evaluation of Jiangsu Province, China Pharmaceutical University, Nanjing, 210009, China
- State Key Laboratory of Natural Medicines, Ministry of Education, China Pharmaceutical University, Nanjing, 210009, China
| | | | - Wenwei Xie
- The Engineering Research Center of Synthetic Peptide Drug Discovery and Evaluation of Jiangsu Province, China Pharmaceutical University, Nanjing, 210009, China
- State Key Laboratory of Natural Medicines, Ministry of Education, China Pharmaceutical University, Nanjing, 210009, China
| | - Hanmei Xu
- The Engineering Research Center of Synthetic Peptide Drug Discovery and Evaluation of Jiangsu Province, China Pharmaceutical University, Nanjing, 210009, China.
- State Key Laboratory of Natural Medicines, Ministry of Education, China Pharmaceutical University, Nanjing, 210009, China.
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Sujatha G, Veeraraghavan VP, Alamoudi A, Bahammam MA, Bahammam SA, Alhazmi YA, Alharbi HS, Alzahrani KJ, Al-Ghamdi MS, Alzahrani FM, Varadarajan S, Raj AT, Patil S. Role of Toothbrushes as Gene Expression Profiling Tool for Oral Cancer Screening in Tobacco and Alcohol Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8052. [PMID: 35805720 PMCID: PMC9266251 DOI: 10.3390/ijerph19138052] [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] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/18/2022] [Accepted: 06/28/2022] [Indexed: 12/04/2022]
Abstract
AIM The use of toothbrushes was investigated as a potential RNA source and gene expression profiling tool for oral cancer screening in tobacco and alcohol users. METHODOLOGY A total of 20 subjects were selected on the basis of inclusion and exclusion criteria. They were divided into two groups: group I-healthy controls (n = 6); group II-individuals who consume tobacco and alcohol (n = 14). After the volunteers brushed their teeth using a soft-bristle toothbrush with ~0.5 gm of toothpaste, the toothbrushes were collected, and the gene expression of BAX, BCL2, CDK4, CKDN2A, GNB3, and TCF7L2 was assessed. RESULTS The gene expression of BAX decreased significantly in alcoholics and smokers (0.13867 ± 0.12014), while the gene expression of BCL2 increased in alcoholics and smokers (1.91001 ± 0.90425) in comparison with healthy controls (p = 0.0054 and p = 0.0055). Although there was increased expression of CDK4, CKDN2A, and TCF7L2 and decreased expression of GNB3 in smokers and alcoholics, the results were not significant. CONCLUSIONS A toothbrush is a good source of RNA, and gene expression analysis can be performed using the genetic material retrieved from toothbrushes, which can aid in the early diagnosis of oral squamous cell carcinoma among tobacco and alcohol users. Further studies with a larger sample size and different durations of toothbrush use should be conducted to explore the role of toothbrushes as a noninvasive tool for disease diagnosis.
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Affiliation(s)
- Govindarajan Sujatha
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India; (G.S.); (S.V.); (A.T.R.)
- Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Saveetha University, Chennai 600130, India
| | - Vishnu Priya Veeraraghavan
- Centre of Molecular Medicine and Diagnostics (COMManD), Department of Biochemistry, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600130, India;
| | - Ahmed Alamoudi
- Oral Biology Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Maha A. Bahammam
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Executive Presidency of Academic Affairs, Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia
| | - Sarah Ahmed Bahammam
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, Taibah University, Medina 42353, Saudi Arabia;
| | - Yaser Ali Alhazmi
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | - Hazar S. Alharbi
- Department of Basic Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia;
| | - Khalid J. Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia; (K.J.A.); (M.S.A.-G.); (F.M.A.)
| | - Mohammad S. Al-Ghamdi
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia; (K.J.A.); (M.S.A.-G.); (F.M.A.)
| | - Fuad M. Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia; (K.J.A.); (M.S.A.-G.); (F.M.A.)
| | - Saranya Varadarajan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India; (G.S.); (S.V.); (A.T.R.)
| | - A. Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India; (G.S.); (S.V.); (A.T.R.)
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia
- Centre of Molecular Medicine and Diagnostics (COMManD), Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600130, India
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Nogami E, Miyai N, Zhang Y, Onishi S, Sakaguchi M, Yokoi K, Utusmi M, Arita M. Effects of cigarette smoking on the association between respiratory muscle strength and skeletal muscle mass in middle-aged and older adults: the Wakayama Study. Eur Geriatr Med 2022; 13:805-815. [PMID: 35705784 DOI: 10.1007/s41999-022-00662-0] [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: 01/15/2022] [Accepted: 05/17/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aimed to examine whether cumulative smoking exposure affects the association between peak expiratory flow rate (PEFR) and skeletal muscle mass in middle-aged and older adults. METHODS The study participants comprised 832 community-dwelling individuals aged 50-89 years (mean age: 69 years) without chronic obstructive pulmonary disease. Bioelectrical impedance analysis was performed to estimate the skeletal muscle mass of each participant. PEFR was assessed using an electronic spirometer. Cumulative smoking exposure was expressed in pack years, that is a product of the average number of packs of cigarettes smoked per day and smoking duration in years. RESULTS The whole-body skeletal muscle mass progressively reduced with decreasing PEFR levels in both males and females. In the multiple regression analysis, PEFR was found to be significantly associated with skeletal muscle mass, independent of the potential confounding factors. When participants were stratified based on the cumulative smoking exposure, the association between low PEFR and reduced skeletal muscle mass persisted in individuals with non-smoking and light-to-moderate smoking exposure (< 30 pack-years). However, this association was not clearly observed in individuals with heavy smoking exposure (≥ 30 pack-years). CONCLUSION The findings of this study support the notion that PEFR declines with a reduction in systemic skeletal muscle mass due to aging. However, chronic cigarette smoking induces respiratory dysfunction exceeding the expected values by age, and thus a low PEFR level may not be used as a marker of reduced muscle mass in older adults exposed to heavy smoking.
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Affiliation(s)
- Eriko Nogami
- Graduate School of Health and Nursing Science, Wakayama Medical University, 580 Mikazura, P.O. Box 641-0011, Wakayama, Japan
| | - Nobuyuki Miyai
- Graduate School of Health and Nursing Science, Wakayama Medical University, 580 Mikazura, P.O. Box 641-0011, Wakayama, Japan.
| | - Yan Zhang
- Graduate School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Shuhei Onishi
- Graduate School of Health and Nursing Science, Wakayama Medical University, 580 Mikazura, P.O. Box 641-0011, Wakayama, Japan
| | - Masato Sakaguchi
- Graduate School of Health and Nursing Science, Wakayama Medical University, 580 Mikazura, P.O. Box 641-0011, Wakayama, Japan.,Department of Cardiology, Sumiya Rehabilitation Hospital, Wakayama, Japan
| | - Katsushi Yokoi
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Osaka, Japan
| | - Miyoko Utusmi
- Wakayama Faculty of Nursing, Tokyo Healthcare University, Wakayama, Japan
| | - Mikio Arita
- Department of Cardiology, Sumiya Rehabilitation Hospital, Wakayama, Japan
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Anum FNU, Kumari A, Gul M, Bai S, Haseeb M, Maqsood KM, Jamil A, Shaukat F, Jahangir M. Frequency of Subclinical Hypothyroidism in Patients With Chronic Kidney Disease. Cureus 2022; 14:e25864. [PMID: 35836430 PMCID: PMC9275548 DOI: 10.7759/cureus.25864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction: Chronic kidney disease (CKD) is the progressive loss of function of the nephron over a long period of time. As the glomerular filtration rate falls, it leads to subclinical hypothyroidism (SCH). This cross-sectional study is carried out to measure the frequency of SCH in CKD patients in our population. Methods: This case-control research was undertaken at the nephrology unit of the Peoples University of Medical and Health Sciences for Women in Pakistan from March 2021 to January 2022. The research included 200 volunteers with documented evidence of CKD between the ages of 18 and 60 years. A case group of 200 people without CKD was also enlisted, matched by age, gender, and comorbidities. Data were recorded in a self-structured questionnaire and analyzed using Statistical Package for the Social Sciences® software (IBM Corp., Armonk, NY). Results: Thyroid-stimulating hormone was significantly raised in participants with CKD (4.91 ± 1.10 mIU/L vs. 3.62 ± 0.72 mIU/L; p-value < 0.0001). A significant association between SCH and CKD was established (p-value < 0.00001). Conclusion: Due to the positive correlation between SCH and CKD, multidisciplinary management, including a team of endocrinologists and nephrologists, is advised to keep a regular check on these patients.
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Li C, Yao N, Miller SL, Macpherson C, Hassinger T, Love K, Malin SK. Exercise and Reduced Nicotine Content Cigarettes in Adult Female Smokers: A Pilot Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6647. [PMID: 35682232 PMCID: PMC9180864 DOI: 10.3390/ijerph19116647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 11/16/2022]
Abstract
Background: Although Reduced Nicotine Cigarettes (RNC) are suggested to improve smoking cessation and cardiometabolic health in relation to cancer risk, the effectiveness of exercise training with RNC on smoking cessation and cardiometabolic health is unknown. Methods: Female smokers (N = 27) were randomized to: (1) usual nicotine cigarettes (i.e., control), (2) RNC or (3) RNC plus exercise treatment for 12 weeks. Smoking withdrawal symptoms (e.g., Wisconsin Smoking Withdrawal Scale) and cardiometabolic health (e.g., weight, VO2max, resting respiratory exchange ratio (RER), glucose, HOMA-IR) were examined before and after treatment. Results: Treatments had no differential effect on weight (p = 0.80; partial η2 = 0.29), VO2max (p = 0.20, partial η2 = 0.18), or total cholesterol/HDL ratios (p = 0.59, partial η2 = 0.06). However, RNC + Exercise tended to maintain RER (i.e., fat oxidation; p = 0.10, partial η2 = 0.10) as well as insulin resistance (p = 0.13, partial η2 = 0.25) and cortisol compared (p = 0.06, partial η2 = 0.30) with control and RNC. Increased VO2max was also associated with lower nicotine dependence scores (r = −0.50, p < 0.05). Conclusion: In this pilot study, improved fitness was associated with lower nicotine dependence. Additional work is warranted to examine the effects of exercise in smokers as a tool to improving smoking cessation and lower disease risk.
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Affiliation(s)
- Chaofan Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (C.L.); (N.Y.)
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Nengliang Yao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (C.L.); (N.Y.)
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Division of General Medicine, Geriatrics & Palliative Care, University of Virginia, Charlottesville, VA 22904, USA
| | - Stephanie L. Miller
- Department of Kinesiology, University of Virginia, Charlottesville, VA 22904, USA; (S.L.M.); (C.M.)
| | - Christopher Macpherson
- Department of Kinesiology, University of Virginia, Charlottesville, VA 22904, USA; (S.L.M.); (C.M.)
| | - Taryn Hassinger
- Department of Medicine, University of Virginia, Charlottesville, VA 22904, USA;
| | - Kaitlin Love
- Division of Endocrinology and Metabolism, University of Virginia, Charlottesville, VA 22904, USA;
| | - Steven K. Malin
- Department of Kinesiology, University of Virginia, Charlottesville, VA 22904, USA; (S.L.M.); (C.M.)
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ 08901, USA
- Division of Endocrinology, Metabolism & Nutrition, Rutgers University, New Brunswick, NJ 08901, USA
- New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, NJ 08901, USA
- Institute of Translational Medicine and Science, Rutgers University, New Brunswick, NJ 08901, USA
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Unnikrishnan AG, Sahay RK, Phadke U, Sharma SK, Shah P, Shukla R, Viswanathan V, Wangnoo SK, Singhal S, John M, Kumar A, Dharmalingam M, Jain S, Shaikh S, Verberk WJ. Cardiovascular risk in newly diagnosed type 2 diabetes patients in India. PLoS One 2022; 17:e0263619. [PMID: 35358208 PMCID: PMC8970505 DOI: 10.1371/journal.pone.0263619] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/21/2022] [Indexed: 11/20/2022] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) worldwide continues to increase, in particular in India. Early T2DM diagnosis followed by appropriate management will result in more cardiovascular event free life years. However, knowledge of the cardiovascular profile of newly diagnosed T2DM patients is still limited. The aim of this study was to understand the extent of cardiovascular disease (CVD) risk of newly diagnosed T2DM patients in India. Methods A cross sectional observational study was conducted to evaluate clinical laboratory and socio-demographic parameters of 5,080 newly diagnosed T2DM patients (48.3 ± 12.8 years of age; 36.7% female). In addition, we determined their cardiovascular risk according to the guidelines of the Lipid Association of India (LAI) and the criteria of the QRISK3 score. Results Of the newly T2DM diagnosed patients in India 2,007(39.5%) were classified as “High risk” and 3,073 (60.5%) were classified as “Very high risk” based on LAI criteria. On average, patients had 1.7 ± 0.9 major atherosclerotic cardiovascular disease (ASCVD) risk factors. Low HDL-C value was the most frequent major risk (2,823; 55.6%) followed by high age (2,502; 49.3%), hypertension (2,141; 42.1%), smoking/tobacco use (1,078; 21.2%) and chronic kidney disease stage 3b or higher (568; 11.2%). In addition, 4,192 (82.5%) patients appeared to have at least one cholesterol abnormality and, if the latest LAI recommendations are applied, 96.5% (4,902) presented with lipid values above recommended targets. Based on the QRISK3 calculation Indian diabetes patients had an average CVD risk of 15.3 ± 12.3%, (12.2 ± 10.1 vs. 17.1 ± 13.5 [p<0.001] for females and males, respectively). Conclusions Newly diagnosed Indian T2DM patients are at high ASCVD risk. Our data therefore support the notion that further extension of nationwide ASCVD risk identification programs and prevention strategies to reduce the occurrence of cardiovascular diseases are warranted.
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Affiliation(s)
| | - R. K. Sahay
- Department of Endocrinology, Osmania Medical College, Osmania General Hospital, Hyderabad, India
| | - Uday Phadke
- Sahyadri Hospital, Erandwane, Pune, Maharashtra, India
| | - S. K. Sharma
- Galaxy Speciality Centre, Jaipur, Rajasthan, India
| | - Parag Shah
- Gujarat Endocrine Centre, Ahmedabad, Gujarat, India
| | - Rishi Shukla
- Dr Rishi Shukla Centre for Diabetes & Endocrine Diseases, Kanpur, Uttar Pradesh, India
| | | | | | - Santosh Singhal
- Director, Sparsh Health Care & CHS Apple Hospital, Gwalior, Madhya Pradesh, India
| | - Mathew John
- Providence Endocrine and Diabetes Specialty Centre, Trivandrum, India
| | - Ajay Kumar
- Diabetes Care & Research Centre, Patna, Bihar, India
| | | | - Subodh Jain
- Diabetes Care Centre, Prayagraj, Uttar Pradesh, India
| | - Shehla Shaikh
- KGN Diabetes & Endocrinology Centre, Nagpada, Mumbai, Maharashtra, India
| | - Willem J. Verberk
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- * E-mail:
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Patil S, Fageeh HN, Mushtaq S, Ajmal M, Chalikkandy SN, Ashi H, Ahmad ZH, Khan SS, Khanagar S, Varadarajan S, Sarode SC, Sarode GS. Prevalence of electronic cigarette usage among medical students in Saudi Arabia – A systematic review. Niger J Clin Pract 2022; 25:765-772. [DOI: 10.4103/njcp.njcp_2006_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Chi Y, Wang X, Jia J, Huang T. Smoking Status and Type 2 Diabetes, and Cardiovascular Disease: A Comprehensive Analysis of Shared Genetic Etiology and Causal Relationship. Front Endocrinol (Lausanne) 2022; 13:809445. [PMID: 35250867 PMCID: PMC8894600 DOI: 10.3389/fendo.2022.809445] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/18/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE This study aimed to explore shared genetic etiology and the causality between smoking status and type 2 diabetes (T2D), cardiovascular diseases (CVDs), and related metabolic traits. METHODS Using summary statistics from publicly available genome-wide association studies (GWASs), we estimated genetic correlations between smoking status and T2D, 6 major CVDs, and 8 related metabolic traits with linkage disequilibrium score regression (LDSC) analysis; identified shared genetic loci with large-scale genome-wide cross-trait meta-analysis; explored potential shared biological mechanisms with a series of post-GWAS analyses; and determined causality with Mendelian randomization (MR). RESULTS We found significant positive genetic associations with smoking status for T2D (Rg = 0.170, p = 9.39 × 10-22), coronary artery disease (CAD) (Rg = 0.234, p = 1.96 × 10-27), myocardial infarction (MI) (Rg = 0.226, p = 1.08 × 10-17), and heart failure (HF) (Rg = 0.276, p = 8.43 × 10-20). Cross-trait meta-analysis and transcriptome-wide association analysis of smoking status identified 210 loci (32 novel loci) and 354 gene-tissue pairs jointly associated with T2D, 63 loci (12 novel loci) and 37 gene-tissue pairs with CAD, 38 loci (6 novel loci) and 17 gene-tissue pairs with MI, and 28 loci (3 novel loci) and one gene-tissue pair with HF. The shared loci were enriched in the exo-/endocrine, cardiovascular, nervous, digestive, and genital systems. Furthermore, we observed that smoking status was causally related to a higher risk of T2D (β = 0.385, p = 3.31 × 10-3), CAD (β = 0.670, p = 7.86 × 10-11), MI (β = 0.725, p = 2.32 × 10-9), and HF (β = 0.520, p = 1.53 × 10-6). CONCLUSIONS Our findings provide strong evidence on shared genetic etiology and causal associations between smoking status and T2D, CAD, MI, and HF, underscoring the potential shared biological mechanisms underlying the link between smoking and T2D and CVDs. This work opens up a new way of more effective and timely prevention of smoking-related T2D and CVDs.
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Affiliation(s)
- Yanna Chi
- Department of Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Xinpei Wang
- Department of Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jinzhu Jia
- Department of Biostatistics, School of Public Health, Peking University, Beijing, China
- Center for Statistical Science, Peking University, Beijing, China
- *Correspondence: Jinzhu Jia, ; Tao Huang,
| | - Tao Huang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
- *Correspondence: Jinzhu Jia, ; Tao Huang,
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Liu G, Tao L, Zhu Q, Jiao X, Yan L, Shao F. Association between the metabolic score for insulin resistance (METS-IR) and estimated glomerular filtration rate (eGFR) among health check-up population in Japan: A retrospective cross-sectional study. Front Endocrinol (Lausanne) 2022; 13:1027262. [PMID: 36589854 PMCID: PMC9800885 DOI: 10.3389/fendo.2022.1027262] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
AIM This study aimed to investigate the relationship between a new metric-metabolic score for insulin resistance (METS-IR)-and estimated glomerular filtration rate (eGFR) among Japanese participants who underwent health check-ups. METHODS We conducted a cross-sectional study that involved participants in a medical health screening program, which was conducted at the Medical Health Check-up Center in Japan. This retrospective study examined the relationship between METS-IR and eGFR among 881 individuals that joined the program between March 1, 2004, and December 31, 2012. Covariates consisted of serum laboratory tests and lifestyle questionnaires. Multivariate linear regression analysis was used to explore the association between METS-IR and eGFR. In addition, subgroup and interaction analyses were done based on age, sex, body mass index (BMI), alcohol use, smoking status, and hyperuricemia. RESULTS A total of 881 individuals participated in this study. High METS-IR was highly linked with reduced eGFR (adjusted β = -5.04, 95% confidence interval (CI): -7.65 to -2.43), while METS-IR was utilized as a categorical variable inside the multiple regression analysis. A decrease in eGFR of 2.54 units was reported for every 10-unit rise in METS-IR (adjusted β = -2.54, 95% CI: -4.04 to -1.05, P-value = 0.001). Stratified analysis suggested no marked interaction between METS-IR and eGFR across age, sex, BMI, and alcohol consumption groups. However, there was an indication of interaction between METS-IR level, smoking status (P-value = 0.001), and uric level (P-value = 0.011) on eGFR decrease. CONCLUSIONS METS-IR is remarkably associated with eGFR among the participants who underwent health check-ups in Gifu, Japan. Although more studies are required to prove it, METS-IR could be applied as a monitoring index for early screening, primary prevention, and diagnostic and treatment management strategies for chronic kidney disease.
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Incorporating Post-Cessation Weight-Control Coaching into Smoking Cessation Therapy to Reduce Type 2 Diabetes Risk. Nutrients 2021; 13:nu13103360. [PMID: 34684360 PMCID: PMC8539112 DOI: 10.3390/nu13103360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/19/2021] [Accepted: 09/22/2021] [Indexed: 11/26/2022] Open
Abstract
Post-cessation weight gain (PCWG) facilitates short-term type 2 diabetes (T2D) risk in prediabetic smokers in the absence of complementary measures. In this shared decision-making-based non-randomized controlled trial, prediabetic smokers joined the Fight Tobacco and Stay Fit (FIT2) program or received usual care. The 16-week FIT2 program combined smoking cessation therapy with individualized coaching in diet and physical activity strategies for PCWG restriction (NCT01926041 at ClinicalTrials.gov). During a mean follow-up period of 1316 days, 217 participants (36.8%) developed T2D, and 68 (11.5%) regressed to normoglycemia. In the intention-to-treat analysis (n = 589), the FIT2 program was associated with a reduced T2D risk (HR, 0.58; 95% CI, 0.40–0.84) and a higher probability of regression to normoglycemia (HR, 1.91; 95% CI, 1.04–3.53) compared with usual care. The post-program quitters were at lower T2D risk (HR, 0.63; 95% CI, 0.44–0.92) and were more likely to regress to normoglycemia (HR, 1.83; 95% CI, 1.01–3.30) compared with the controls in the time-varying analysis (n = 532). We demonstrated that the FIT2 program was negatively associated with long-term T2D risk and positively associated with the probability of regression to normoglycemia compared with usual care. To prevent T2D development, we recommend simultaneously promoting smoking abstinence and lifestyle coaching for PCWG restriction.
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Inhibition of Fibrotic Contraction by Sirolimus (Rapamycin) in an Ex Vivo Model of Thyroid Eye Disease. Ophthalmic Plast Reconstr Surg 2021; 37:366-371. [PMID: 33237667 DOI: 10.1097/iop.0000000000001876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Thyroid eye disease (TED) is characterized by orbital inflammation and complicated by extraocular muscle fibrosis. Treatment with rapamycin/sirolimus has been reported to improve ocular motility and disease manifestations in TED. Whether this resulted from a primary antifibrotic effect on fibroblasts or was secondary to immune-suppression is unclear. METHODS In vitro contractility studies of primary orbital fibroblasts. Cells from patients with TED and controls were treated with rapamycin [mechanistic target of rapamycin an (mTOR) inhibitor] and MHY1485 (an mTOR stimulator) as well as inhibitors upstream in the same signaling cascade (saracatinib and befatinib). RESULTS At concentrations consistent with the therapeutic dosing range in humans, rapamycin/sirolimus significantly reduces fibrosis in orbital fibroblasts from TED patients and controls in vitro. This effect is separate from, and in addition to, its immune suppressive effect. mTOR-driven fibrotic activity is greater in TED-derived fibroblasts and can be blocked also upstream of mTOR by inhibition of src. There was no adverse effect on cell survival. CONCLUSION The authors present evidence for a direct antifibrotic effect of rapamycin/sirolimus in primary orbital fibroblasts. Targeting mTOR signaling presents a further and adjunctive treatment of TED alongside other immune-suppressive agents. By acting downstream of IGF1-R, sirolimus may offer a cost-effective alternative to teprotumumab therapy. Clinical case reports, now supplemented by this in vitro evidence, support the initiation of a clinical trial to treat the fibrotic sequelae of TED with this already-approved agent. Such an "off-the-shelf" therapy is a welcome prospect for TED treatment, particularly one available at a low price.
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Teymoori F, Farhadnejad H, Mokhtari E, Sohouli MH, Moslehi N, Mirmiran P, Azizi F. Dietary and lifestyle inflammatory scores and risk of incident diabetes: a prospective cohort among participants of Tehran lipid and glucose study. BMC Public Health 2021; 21:1293. [PMID: 34215245 PMCID: PMC8254228 DOI: 10.1186/s12889-021-11327-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 06/18/2021] [Indexed: 12/15/2022] Open
Abstract
Background Inflammation is a precursor of chronic disease, which is affected by lifestyle and dietary habits. Recently empirical dietary inflammatory patterns (EDIP), dietary inflammation scores (DIS), and lifestyle inflammation scores (LIS) were developed to indicate lifestyle and dietary contributions in systemic inflammation. The current study aimed to investigate the associations between these indices and the incidence of diabetes among Tehranian adults. Methods A total of 4624 individuals, aged 20–75 years, who were free of diabetes at baseline (2008–2011), were followed for 5.71 years (2014–2017) to ascertain incident diabetes. Dietary intakes were collected at baseline using the food frequency questionnaire. The hazard ratio (HR) of diabetes was calculated by Cox proportional hazards regression across quartiles of EDIP, DIS, and LIS, adjusted for potential confounders. Results The mean ± SD for the age and BMI of the study population (45.1% male) were 40.8 ± 12.7 years and 27.1 ± 4.1 Kg.m2, respectively. At the end of the follow-up, 329 (7.1%) diabetes cases were identified. In the multivariable-adjusted model, individuals in the highest compared to the lowest quartile of EDIP (HR = 0.83; 95%CI:0.59–1.15, p for trend = 0.286), and LIS (HR = 2.41; 95%CI:1.61–3.60, P for trend < 0.001) had increased risk of diabetes. However, no significant associations were found between the score of DIS and diabetes incidents (HR = 0.83; 95%CI:0.59–1.15, p for trend = 0.286). Conclusion Greater adherence to EDIP and LIS scores was associated with a higher risk of diabetes, while no significant association was found between the DIS score and diabetes incident. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11327-1.
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Affiliation(s)
- Farshad Teymoori
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Farhadnejad
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ebrahim Mokhtari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Sohouli
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Nazanin Moslehi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hsia SH, Nisis ML, Lee ML, Goldstein C, Friedman TC. Metabolic parameters in smokers undergoing smoking reduction. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2021; 23:100249. [PMID: 33717989 PMCID: PMC7933731 DOI: 10.1016/j.jcte.2021.100249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 12/13/2020] [Accepted: 01/18/2021] [Indexed: 11/15/2022]
Abstract
Introduction Few human studies have explored the mechanisms of smoking-induced insulin resistance. Aims: To prospectively examine the metabolic changes of smoking reduction. Methods Cigarette smokers (n = 22; ½-2 packs per day) were enrolled in a smoking reduction program (counseling plus bupropion × 8 weeks; Phase I) followed by monitoring only (no counseling or bupropion × 16 weeks; Phase II). We serially measured exhaled carbon monoxide (CO) and urine nicotine metabolites; fat distribution, and metabolic parameters by hyperinsulinemic clamps including hepatic glucose output (HGO) and indirect calorimetry, adjusted for total caloric intake and expenditure. Results CO and nicotine metabolite levels fell with smoking reduction during Phase I (all p < 0.05), without any further changes through Phase II. Central-to-peripheral fat ratio increased during Phase I, but then fell during Phase II (all p < 0.05). Over 24 weeks, basal HGO fell (p = 0.02); and falling CO and nicotine metabolite levels correlated inversely with changes in glucose oxidation, and directly with changes in weight (all p < 0.05). Conclusions Smoking reduction produced a transient worsening of central fat redistribution followed by a more significant improvement; along with other net beneficial metabolic effects.
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Affiliation(s)
- Stanley H Hsia
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Internal Medicine, Charles R. Drew University of Medicine and Science, 1731 East 120 Street, Los Angeles, CA 90059, USA.,David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Monica L Nisis
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Internal Medicine, Charles R. Drew University of Medicine and Science, 1731 East 120 Street, Los Angeles, CA 90059, USA
| | - Martin L Lee
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Internal Medicine, Charles R. Drew University of Medicine and Science, 1731 East 120 Street, Los Angeles, CA 90059, USA.,David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Candice Goldstein
- Department of General Studies, College of Science and Health, Charles R. Drew University of Medicine and Science, 1731 East 120 Street, Los Angeles, CA 90059, USA
| | - Theodore C Friedman
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Internal Medicine, Charles R. Drew University of Medicine and Science, 1731 East 120 Street, Los Angeles, CA 90059, USA.,Friends Research Institute, Inc., 17215 Studebaker Road, Suite 380, Cerritos, CA 90703, USA.,David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA
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Dover AR, Strachan MWJ, McKnight JA, Stimson RH, Mackenzie SD, Lyall MJ, Wright RJ, Forbes S, Gibb FW. Socioeconomic deprivation, technology use, C-peptide, smoking and other predictors of glycaemic control in adults with type 1 diabetes. Diabet Med 2021; 38:e14445. [PMID: 33128811 DOI: 10.1111/dme.14445] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/30/2020] [Accepted: 10/27/2020] [Indexed: 12/16/2022]
Abstract
AIMS Intensive glycaemic control is associated with substantial health benefits in people with type 1 diabetes. We sought to examine clinical and demographic factors associated with meeting glycaemic targets in type 1 diabetes. METHODS We conducted a cross-sectional analysis of 4594 individuals with type 1 diabetes. The primary outcome of the study was assessing factors associated with meeting HbA1c targets. Secondary endpoints included factors associated with continuous subcutaneous insulin infusion (CSII) use and persistent C-peptide secretion. RESULTS Socioeconomic deprivation was strongly associated with a lower likelihood of achieving an HbA1c <58 mmol/mol (7.5%) (20% in the most deprived quintile vs. 40% in the least deprived, p < 0.001). In multivariate analysis, absence of smoking history (OR 3.06, p < 0.001), flash monitoring (OR 1.49, p < 0.001), CSII (1.43, p = 0.022) and longer diabetes duration (OR 1.02 per year, p = 0.004) were independently associated with achieving HbA1c <58 mmol/mol (7.5%), whereas increasing age (OR 0.99 per year, p = 0.004) and C-peptide <50 pM (OR 0.58, p < 0.001) were associated with a lower likelihood of meeting this target. Low C-peptide (<50 pM) was less likely in men (OR 0.55, p < 0.001) and never smokers (0.44, p < 0.001) in multivariate analysis. CONCLUSIONS Lower levels of deprivation, non-smoking, higher C-peptide, technology use, lower BMI and male gender were all associated with a higher likelihood of meeting HbA1c targets. Access to proven diabetes treatments is lower in the most deprived individuals. Urgent efforts are required to provide treatments which are effective across the socioeconomic gradient.
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Affiliation(s)
- Anna R Dover
- Edinburgh Centre for Endocrinology & Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Mark W J Strachan
- Edinburgh Centre for Endocrinology & Diabetes, Western General Hospital, Edinburgh, UK
| | - John A McKnight
- Edinburgh Centre for Endocrinology & Diabetes, Western General Hospital, Edinburgh, UK
| | - Roland H Stimson
- Edinburgh Centre for Endocrinology & Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Scott D Mackenzie
- Edinburgh Centre for Endocrinology & Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Marcus J Lyall
- Edinburgh Centre for Endocrinology & Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Rohana J Wright
- Edinburgh Centre for Endocrinology & Diabetes, St John's Hospital, Edinburgh, UK
| | - Shareen Forbes
- Edinburgh Centre for Endocrinology & Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Fraser W Gibb
- Edinburgh Centre for Endocrinology & Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
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Cigarette smoking blocks the benefit from reduced weight gain for insulin action by shifting lipids deposition to muscle. Clin Sci (Lond) 2021; 134:1659-1673. [PMID: 32573727 DOI: 10.1042/cs20200173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/10/2020] [Accepted: 06/23/2020] [Indexed: 12/29/2022]
Abstract
Cigarette smoking (CS) is known to reduce body weight and this often masks its real effect on insulin action. The present study tested the hypothesis that CS can divert lipid deposition to muscles to offset the supposed benefit of reduced body weight gain on insulin signalling in this major site for glucose tolerance (or insulin action). The study was conducted in mice exposed to chronic CS followed by either a chow (CH) diet or a high-fat (HF) diet. CS increased triglyceride (TG) levels in both plasma and muscle despite a reduced body weight gain and adiposity. CS led to glucose intolerance in CH-fed mice and they retained the glucose intolerance that was induced by the HF diet. In adipose tissue, CS increased macrophage infiltration and the mRNA expression of TNFα but suppressed the protein expression of adipose triglyceride lipase and PPARγ. While CS increased hormone-sensitive lipase and suppressed the mRNA expression of leptin, these effects were blunted in HF-fed mice. These results imply that CS impairs insulin signalling in skeletal muscle via accumulated intramuscular lipids from lipolysis and lipodystrophy of adipose tissues. This may explain why smokers may not benefit from insulin sensitising effects of reduced body weight gain.
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