Day: July 25, 2023

Categories : Cardiovascular Disease HIVTags : Leave a comment

Daily Statin Reduces Risk of Major Cardiovascular Events in People Living with HIV

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Photo by Towfiqu Barbhuiya on Unsplash

A new study published in the New England Journal of Medicine found that statins, a class of cholesterol-lowering medications, may offset the high risk of cardiovascular disease in people living with HIV by more than a third, potentially preventing one in five major cardiovascular events or premature deaths in this population. People living with HIV can have a 50–100% increased risk for cardiovascular disease.

“This research suggests that statins may provide an accessible, cost-effective measure to improve the cardiovascular health and quality of life for people living with HIV,” said Gary H. Gibbons, MD, director of the National Heart, Lung, and Blood Institute (NHLBI), a study funder. “Additional research can further expand on this effect, while providing a roadmap to rapidly translate research findings into clinical practice.”

For the double-blinded phase 3 trial, known as Randomised Trial to Prevent Vascular Events in HIV (REPRIEVE) study, researchers randomised participants into either a treatment group, where they received pitavastatin calcium daily or a control group receiving placebo. The researchers followed participants for about five years, but ended the trial early when they discovered the treatment benefits outweighed potential risks.

To understand the benefits, the researchers compared how often participants in each group experienced major cardiovascular events, including heart attacks, strokes, or surgery to open a blocked artery. They found participants who took daily pitavastatin had 35% fewer major cardiovascular events than those who took a placebo. The researchers also measured the number of deaths in combination with major cardiovascular events during the study period and found participants in the treatment group were 21% less likely than those in the placebo group to experience these events. Additionally, those taking pitavastatin had a 30% reduction in their low-density lipoprotein (LDL) cholesterol levels.

“Lowering LDL cholesterol levels reduces risks for cardiovascular events, like having a heart attack and stroke, but these findings suggest there may be additional effects of statin therapy that explain these reduced risks among people living with HIV,” said Steven K. Grinspoon, MD, the study chair. “Ongoing research about how statin therapy may affect inflammation and increased immune activation among people with HIV may help us better understand the additional benefits we’re seeing with this treatment approach.” 

To support optimal health outcomes among the study participants, normal liver and kidney function were an enrolment criteria. They were also required to take antiretroviral therapy, which itself is critical to reducing the risk of HIV complications and related comorbidities, including cardiovascular disease.

Beginning in 2015, REPRIEVE enrolled 7769 adults, ages 40–75, from 145 sites in 12 countries. Adults in the study were an average age of 50 and had low-to-moderate risks for cardiovascular disease, which meant they normally would not have been prescribed statins. Women accounted for 31% of participants. Approximately 41% of study participants identified as Black, 35% as white, 15% as Asian, and 9% as another race.

Source: National Insitutes of Health

Categories : Environmental Effects Obstetrics & GynaecologyTags : Leave a comment

Cadmium Detected in Urine of Women with Endometriosis

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Phot by Sora Shimazaki on Pexels

Women with a history of endometriosis had higher concentrations of cadmium in their urine compared to those without that diagnosis, according to a study with a large representative study that suggests the toxic metal, which is also an endocrine disruptor, could be linked to the development of endometriosis. The researchers, from Michigan State University, published these findings in the journal Human Reproduction.

Affecting one in 10 reproductive-age women, endometriosis is when tissue that looks like the lining of the uterus, appears outside of it. Those with endometriosis can experience chronic, painful and debilitating symptoms, which can interfere with all aspects of life, including daily activity, work productivity, school performance and personal relationships.

“Despite the adverse impact of endometriosis on quality of life, it remains an understudied condition,” said Kristen Upson, assistant professor in the Department of Epidemiology and Biostatistics at the MSU College of Human Medicine and senior author of the study.

“By looking at environmental risk factors such as metal cadmium, we are moving the needle closer to understanding risk factors for this condition,” added the study’s first author, Mandy Hall, a data analyst in the MSU Department of Epidemiology and Biostatistics.

Cadmium is a toxic metal and a “metalloestrogen,” meaning it can act like oestrogen. In the US, people are commonly exposed to cadmium by breathing in cigarette smoke and eating contaminated food like spinach and lettuce.

While this is not the first study exploring a potential link between cadmium and endometriosis, the researchers said it’s the largest study to look at cadmium measured in urine, which reflects long-term exposure between 10 and 30 years.

For their study, researchers used data from NHANES, a national US population study between 1999 and 2006. Out of the survey’s more than 41 000 participants, the researchers limited their study population to those 20 to 54 years of age with information on endometriosis diagnosis.

The researchers then analysed the data, dividing the cadmium levels into four classes, or quartiles, with the first quartile being the lowest exposure and the fourth being the largest exposure.

They found that participants in the second and third quartiles were twice as likely to have been diagnosed with endometriosis than those in the first quartile. The data also suggests a 60% increased prevalence of endometriosis based on urinary cadmium concentrations in the fourth quartile.

“The findings are interesting given that cadmium can act like the hormone estrogen, and this hormone is central to the development of endometriosis,” Hall said.

The researchers say further studies are needed to confirm their findings. Upson said this work is part of her larger research looking at everyday factors that may increase toxic metal exposure in women as well as the impact of toxic metals on gynaecologic health. Hall plans to incorporate environmental factors in their ongoing research on endometriosis and other gynaecologic conditions.

Source: Michigan State University

Categories : Diet and Nutrition Injury & TraumaTags : Leave a comment

Specialised Omega-3 Lipid Could be a New Treatment for Acute Kidney Injury

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Photo by Robina Weermeijer on Unsplash

Researchers from Singapore have identified a potential dietary supplement of omega-3 that may improve recovery following acute kidney injury (AKI). The finding, published in the Journal of Lipid Research, may offer a new way to treat this serious condition, which currently has few therapies.

The study was part of a long-running research programme at Duke-NUS Medical School investigating how cells take up a specialised omega-3 lipid called LPC-DHA.

AKI affects some 13.3 million people globally each year, with a mortality rate of 20 to 50% depending on the economic status of the country and stage of the disease. One of the main causes of AKI is ischaemic reperfusion injury, which occurs when the kidney’s blood supply is restored after a period of restricted blood flow and poor oxygen delivery due to illness, injury or surgical intervention. In particular, it damages a crucial part of the kidney called the S3 proximal tubules that regulate the levels of absorption of water and soluble substances, including salts.

“AKI is a serious health problem with limited treatment options,” said Dr Randy Loke, first author of the study. “We sought to understand how these tubules repair themselves and found that the activity of the protein Mfsd2a, which transports LPC-DHA into cells, is a key factor influencing the rate of recovery of kidney function after ischaemic reperfusion injury.”

In their study, the researchers discovered that preclinical models with reduced levels of Mfsd2a showed delayed recovery, increased damage and inflammation after kidney injury. However, when these models were treated with LPC-DHA, their kidney function improved and the damage was reduced. LPC-DHA also restored the structure of the S3 proximal tubules, helping them function properly again.

“While more research is needed, the potential of LPC-DHA as a dietary supplement is exciting for future recipients who have suffered from AKI,” said senior study author Professor David Silver. “As our results suggest that LPC-DHA could become a safe and effective treatment that offers lifelong protection, its potential can help protect the kidneys and aid in recovery for these individuals.”

In the next phase, the research team plans to continue investigating the beneficial functions of LPC in the kidney and are aiming to initiate clinical testing of LPC supplements to determine their effectiveness in improving renal function and recovery following AKI in patients.

They also plan to continue their investigations of the protein Mfsd2a to learn more about its role in LPC transport and its involvement in diseases affecting other tissues and organs. Previous research by Prof Silver’s group, with collaborators from other institutions, have already highlighted the significance of the protein’s LPC-transporting activities in diseases of other organs, including the liver, lungs and brain.

Source: Duke–NUS Medical School

Categories : Diet and NutritionTags : Leave a comment

Quality and Timing of Snacks Determines Their Health Impacts

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Snacking is becoming increasingly popular, with more than 70% of people reporting they snack at least twice a day. In a new study presented at NUTRITION 2023, researchers examined whether snacking affects health and if the quality of snack foods matters.

“Our study showed that the quality of snacking is more important than the quantity or frequency of snacking, thus choosing high quality snacks over highly processed snacks is likely beneficial,” said presenter Kate Bermingham, PhD, a postdoctoral fellow at King’s College London. “Timing is also important, with late night snacking being unfavourable for health.”

The work is part of the ZOE PREDICT project, a group of large in-depth nutritional research studies designed to uncover how and why people respond differently to the same foods.

“Surprisingly little has been published on snacking, despite the fact that it accounts for 20–25% of energy intake,” said Bermingham. “PREDICT followed a large number of people and captured detailed information on their snacking behaviours, allowing this in-depth exploration of snacking on health.”

Using data from just over 1000 participants in the ZOE PREDICT 1 study, the researchers examined the relationship between snacking quantity, quality, and timing with blood fats and insulin levels, which are both indicators of cardiometabolic health.

The analysis showed that snacking on higher quality foods, which contain significant amounts of nutrients relative to the calories they provide, was associated with better blood fat and insulin responses. The researchers also observed that late-evening snacking, which lengthens eating windows and shortens the overnight fasting period, was associated with unfavourable blood glucose and lipid levels. There was no association between snacking frequency, calories consumed, and food quantity with any of the health measures analysed.

“We observed only weak relationships between snack quality and the remainder of the diet, which highlights snacking as an independent modifiable dietary feature that could be targeted to improve health,” said Bermingham.

Source: EurekAlert!

Categories : Metabolic Disorders PaediatricsTags : Leave a comment

Childhood TV Watching Linked to Metabolic Syndrome in Adulthood

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Photo by Victoria Akvarel on Pexels

A new study has added to the evidence that excessive TV watching as a child can lead to poor health in adulthood. The research, published this week in the journal Pediatrics, found that children who watched more television were more likely to develop metabolic syndrome as an adult.

Metabolic syndrome is a cluster of conditions including hypertension, hyperglycaemia, excess body fat, and abnormal cholesterol levels that lead to an increased risk of heart disease, diabetes and stroke.

Using data from 879 participants of the Dunedin study, researchers found those who watched more television between the ages of 5 and 15 were more likely to have these conditions at age 45.

Television viewing times were asked at ages 5, 7, 9, 11, 13 and 15. On average, they watched just over two hours per weekday.

“Those who watched the most had a higher risk of metabolic syndrome in adulthood,” says Professor Bob Hancox, who led the study.

“More childhood television viewing time was also associated with a higher risk of overweight and obesity and lower physical fitness.”

Boys watched slightly more television than girls and metabolic syndrome was more common in men, than women (34% and 20% respectively). The link between childhood television viewing time and adult metabolic syndrome was seen in both sexes however, and may even be stronger in women.

There was little evidence that watching less television as an adult reduced the association between childhood television viewing and adult health.

“While, like any observational study, researchers cannot prove that the association between television viewing at a young age directly causes adult metabolic syndrome, there are several plausible mechanisms by which longer television viewing times could lead to poorer long-term health.

“Television viewing has low energy expenditure and could displace physical activity and reduce sleep quality,” he says.

“Screentime may also promote higher energy intake, with children consuming more sugar-sweetened beverages and high-fat dietary products with fewer fruit and vegetables. These habits may persist into adulthood.”

The results are important because screen times have increased in recent years with new technologies.

“Children today have far more access to screen-based entertainment and spend much more time being sedentary. It is likely that this will have even more detrimental effects for adult health.

“These findings lend support to the World Health Organization recommendation that children and young teenagers should limit their recreational screen time.”

Source: University of Oregon