Month: January 2024

Categories : Exercise Metabolic DisordersTags :

Benefits of Adolescent Fitness to Future Cardiovascular Health Possibly Overestimated

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Photo by Andrea Piacquadio on Pexels

There is a well-known relationship between good physical fitness at a young age and a lower risk of cardiovascular disease later in life. But when researchers adjusted for familial factors by means of sibling analysis, they found a weaker association, although the link between high body mass index (BMI) and cardiovascular disease remained strong. The study, which was conducted by researchers from Karolinska Institutet and other universities, is published in JAMA Network Open.

“This does not mean that fitness is irrelevant,” cautions the study’s last author Viktor Ahlqvist, doctoral student at the Department of Global Public Health, Karolinska Institutet. “We could still see an association, although it was weaker after taking into account factors shared by full siblings. We also think that adolescence is an important time in life for establishing good habits such as exercising and having a healthy diet.”

Many observational studies have previously demonstrated links between various risk factors at a young age and cardiovascular disease in adulthood. However, whether the associations are causal is challenging to prove because of the potential influence of unaccounted genetic and environmental factors. A collaborative team including researchers from Karolinska Institutet in Sweden has therefore tried to examine if a large proportion of cardiovascular diseases in adulthood could indeed be prevented with a lower BMI, lower blood pressure, improved physical fitness or improved muscle strength in adolescence.

Data from the Military Conscription Register

Sourcing data from the Swedish Military Conscription Register and other Swedish registries, the researchers identified over a million 18-year-old males and followed them for 60 years. Almost half of them were full brothers.

“The strength of our study, which makes it more reliable than many other conventional observational studies, is that we have used sibling analyses,” says the study’s first author Marcel Ballin, researcher at Uppsala University and analyst at Region Stockholm’s Centre for Epidemiology and Community Medicine. “By doing so we could examine how the relationship changes when controlling for all shared sibling factors. This includes environmental factors such as childhood environment and half of the genetics.”

The results show that a high BMI in late adolescence was strongly associated with future cardiovascular disease, even after the researchers had controlled for shared familial factors. However, the association between physical fitness and cardiovascular disease was considerably weaker in the sibling analysis, suggesting that many previous observational studies might have overestimated the relevance of adolescent fitness to cardiovascular health later in life.

High BMI the strongest risk factor

“Our conclusion is that of the risk factors studied, high BMI is the strongest individual risk factor for cardiovascular disease, and that efforts to tackle the obesity epidemic should continue to be given high priority,” says co-author Daniel Berglind, docent at the Department of Global Public Health, Karolinska Institutet. “A good level of fitness and muscle strength in adolescence doesn’t seem as crucial, but physical activity still remains important for public health, as it can bring other health benefits.”

The study examined the association between risk factors at a young age and future cardiovascular disease; other disease outcomes were not investigated. The researchers had no data on whether the participants’ risk factors varied later in life, and they only studied men, which makes it difficult to extend their findings to women. The Military Conscription Register also lacks details on certain risk factors for future cardiovascular disease, such as diet, alcohol consumption, smoking, blood lipids and blood glucose.

The researchers received no specific grant for this study. Co-author Martin Neovius is on the advisory panels for Ethicon, Johnson & Johnson and Itrim and has been a consultant for the Swedish armed forces outside the scope of this study. No other conflicts of interest have been reported.

Source: Karolinska Institutet

Categories : CancerTags :

New Metastatic Breast Cancer Treatments have Aided Mortality Decline

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Photo by National Cancer Institute on Unsplash

Deaths from breast cancer dropped 58% between 1975 and 2019 due to a combination of screening mammography and improvements in treatment, according to a new study led by Stanford Medicine clinicians and biomedical data scientists.

Nearly one-third of the decrease (29%) is due to advances in treating metastatic breast cancer, also known as stage 4 breast cancer or recurrent cancer. Although these advanced cancers are not considered curable, women with metastatic disease are living longer than ever.

The analysis helps cancer researchers assess where to focus future efforts and resources.

“We’ve known that deaths from breast cancer have been decreasing over the past several decades, but it’s been difficult or impossible to quantify which of our interventions have been most successful, and to what extent,” said Jennifer Caswell-Jin, MD, assistant professor of medicine. “This type of study allows us to see which of our efforts are having the most impact and where we still need to improve.”

Caswell-Jin and Liyang Sun are co-first authors of the study, which was published in the Journal of the American Medical Association. Sylvia Plevritis, PhD, professor and chair of biomedical data science, and Allison Kurian, MD, MSc, professor of medicine and of epidemiology and population health, are co-senior authors.

The study was a collaborative effort by a national consortium of researchers called CISNET, or the Cancer Intervention and Surveillance Modeling Network. CISNET was established in 2000 by the National Cancer Institute to understand the impact of cancer surveillance, screening and treatment on incidence and mortality. Doing so requires sophisticated computer algorithms capable of modelling the natural course of the disease and the typical treatment paths of individual patients, then translating that information to population-level data collected by the national Surveillance, Epidemiology, and End Results Program, or SEER registry, from 1975 to 2019.

The study is the third in a trio of papers from CISNET published since 2005 that assess the relative contributions of regular screening and treatment advances on breast cancer deaths. The previous two papers informed national guidelines and helped cancer researchers focus their efforts on the most intractable problems.

“Twenty years ago, there was a question whether routine screening mammography actually decreased the number of deaths from breast cancer,” Plevritis said. But in 2005, she and other CISNET researchers published a paper in the New England Journal of Medicine that conclusively demonstrated that screening was responsible for anywhere from 28% to 65% (different models came up with varying degrees of impact) of the reduction in mortality by 2000 between 1975 and 2000.

The second paper, published in 2018 in the Journal of the American Medical Association, highlighted the differences in treatment responsiveness and survival outcomes among women with differing breast cancer subtypes from 2000 to 2012, pinpointing subgroups with poorer survival.

“We found that, while screening still had an important impact, most of the decline in annual deaths was due to improvements in treating early-stage breast cancer based on each cancer’s molecular profile,” Plevritis said.

The current study is the first to explicitly include patients with metastatic breast cancer in its models. The finding that 29% of the decrease in mortality is due to advances in treating metastatic breast cancer both surprised and gratified the researchers.

“Initially, we assumed that treatment of advanced disease was unlikely to make a significant contribution to the declines in mortality we documented in the previous two papers,” Caswell-Jin said. “But our treatments have improved, and it’s clear that they are having a significant impact on annual mortality.”

The CISNET researchers used four computer models to assess the SEER data from 1975 to 2019 — one developed at Stanford Medicine in the Plevritis Lab, one by researchers at the Dana-Farber Cancer Institute, one at MD Anderson Cancer Center, and another jointly developed by researchers at the University of Wisconsin and Harvard Medical School. The four models came up with remarkably similar estimates for the impact of each intervention: screening mammography, treatment of early-stage (stages 1, 2 or 3) breast cancer and treatment of metastatic breast cancer.

The models reproduced the decline in mortality in breast cancer known from SEER data, from 48 per 100 000 women dying of breast cancer each year in 1975 to 27 per 100,000 in 2019, a decrease of about 44%. The models arrived at a larger estimated reduction in mortality of about 58% because the incidence of breast cancer has risen during the same period and more women would have died had screening and treatments not improved.

The models concluded that about 47% of this reduction in mortality is the result of improved treatments for early-stage breast cancer, and about 25% is attributed to screening mammography. The remainder, or about 29%, is due to improvements in treating metastatic disease.

“Designing the new model, which had to account for individuals with non-metastatic cancer who underwent treatment but later progressed to metastatic cancer, and who may have been treated with multiple drugs over the course of their disease, was extremely complex,” Plevritis said. “It took about four years. But it was really satisfying when we were able to validate the model’s behaviour and see that all four models from different institutions, which used the new model inputs in different ways, delivered consistent findings. The models not only make sense, but also produce meaningful insights.”

The impact of treating metastatic disease is exemplified by the increases in median survival time after metastasis: Patients diagnosed in 2000 with metastatic disease lived an average of 1.9 years versus an average of 3.2 years for those diagnosed in 2019. Survival time varies by subgroup status, however. Patients with what are known as oestrogen receptor-positive and HER2 positive cancers saw an average increase in survival time of 2.5 years. Those with oestrogen receptor-positive and HER2-negative cancers lived an average of 1.6 years longer, but those with cancers that are oestrogen receptor-negative and HER2-negative lived about 0.5 years longer in 2019 than in 2000.

“It was meaningful as a breast oncologist to spend time with this history and see real progress over the past decades,” Caswell-Jin said. “There is much more work to be done; metastatic breast cancer isn’t yet curable. But it is rewarding to see that advances have made a difference in these numbers,” she added. “Our scientific and clinical work is helping our patients live longer, and I believe deaths from breast cancer will continue to steadily decline as innovation continues to grow.”

Source: Stanford Medicine

Categories : Environmental EffectsTags :

Climate Change may Reduce Life Expectancy by Half a Year, Study Suggests

On By ModernMedia

UPDATE: Concerns have been raised about the source of the data used in the study. Details below.

On its own, a 1°C temperature rise might shave off about five months, with women and people in developing nations disproportionately affected.

Photo by Markus Spiske

The cost of climate change may be six months off the average human lifespan, according to a study published January 18, 2024, in the open-access journal PLOS Climate by Amit Roy from Shahjalal University of Science and Technology and The New School for Social Research, US.

Temperature and rainfall – two telltale signals of climate change – cause myriad public health concerns, from the acute and direct (eg, natural disasters like flooding and heat waves) to the indirect yet equally devastating (eg, respiratory and mental illnesses). While impacts like these are observable and well documented, existing research has not established a direct link between climate change and life expectancy.

To clarify this relationship, the author evaluated average temperature, rainfall, and life expectancy data from 191 countries from 1940-2020, using GDP per capita to control for drastic differences between countries.

In addition to measuring the isolated impacts of temperature and rainfall, the author designed a first-of-its-kind composite climate change index, which combines the two variables to gauge the overarching severity of climate change.

Results indicate that in isolation, a global temperature increase of 1°C  is associated with an average human life expectancy decrease of approximately 0.44 years, or about five months and one week. A 10-point increase in the composite climate change index – which accounts for both temperature and rainfall – is expected to decrease the average life expectancy by six months. Women and individuals in developing nations are disproportionately affected.

Beyond the results of this study, Dr Roy is hopeful that the composite climate change index will standardise the global conversation about climate change; become a usable metric for the nonscientific public; and encourage collaboration and even friendly competition among countries to combat the impacts of climate change.

Mitigating greenhouse gas emissions and adapting to a changing environment are of particular importance, the author says.

To complement this large-scale approach, the author suggests localised future studies that consider specific severe weather events (eg, wildfires, tsunamis, and floods), the impacts of which cannot be fully captured through analysing temperature and rainfall alone.

Dr Roy adds: “The global threat posed by climate change to the well-being of billions underscores the urgent need to address it as a public health crisis, as revealed by this study, emphasising that mitigation efforts to reduce greenhouse gas emissions and proactive initiatives are essential to safeguard life expectancy and protect the health of populations worldwide.”

IMPORTANT UPDATE: Following publication of the paper referenced below, concerns have been raised about the reliability of global mean annual temperature data that are discussed in the article and used in the study’s analyses. The source of these data is reported as [1] in the article’s Materials and methods section, and as [2] in the Fig 4 legend.

1. World Bank. The Climate Change Knowledge Portal (CCKP) 2023. The World Bank; 2023. https://climateknowledgeportal.worldbank.org/

2. Akhtar R, Palagiano C. Climate change and air pollution: an introduction. Climate Change and Air Pollution: The Impact on Human Health in Developed and Developing Countries. 2018:3–8.

PLOS Climate is looking into the concerns that have been raised. Meanwhile, readers are advised to interpret this article’s results with caution. You may direct any specific questions to onepress@plos.org. We apologise sincerely for the inconvenience and thank you for your understanding. 

Categories : Diseases, Syndromes and ConditionsTags :

‘Exhalation’ System Improves Symptoms for Chronic Sinusitis

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Photo by Brittany Colette on Unsplash

An exhalation delivery system that uses a patient’s own breath to carry the anti-inflammatory compound fluticasone (EDS-FLU) directly to the sinuses reduced chronic sinusitis symptoms as well as aggravations and infections associated with chronic sinus inflammation by more than 50%, researchers from the Perelman School of Medicine at the University of Pennsylvania reported.

The two randomised, international clinical trials (NCT03781804 and NCT03960580), published in The Journal of Allergy and Clinical Immunology: In Practice, compared EDS-FLU to a placebo in more than 500 adults with chronic rhinosinusitis with or without nasal polyps. Patients used either EDS-FLU or a placebo twice daily for 24 weeks.

EDS-FLU works through a patient exhaling into the device to send the medication deep into the far reaches of their sinus cavities, where the topical medication is most effective. Sinus symptom scores and CT scan results were significantly improved vs placebo.

Symptoms of nasal congestion, nasal discharge, facial pain/pressure, and loss of smell improved dramatically with EDS-FLU compared to placebo, as measured by the sinonasal outcome test-22, a standardized scoring measure for sinonasal symptoms.

“Chronic sinusitis affects as much of 10 percent of the United States population, and can make breathing uncomfortable and negatively impact a person’s daily life,” said lead author James N. Palmer, MD, professor of otorhinolaryngology and director of Rhinology at Penn Medicine.

“These findings provide strong evidence for an effective, non-invasive treatment option for people who continue to experience symptoms after over-the-counter medications have failed.”

Millions of Americans experience the symptoms of chronic sinus infections and inflammation, a largely inflammatory condition that causes nasal congestion, sinus pressure, and pain, when the sinus membranes are inflamed for long periods of time.

Although over-the-counter nasal sprays offer marginal relief, no FDA-approved medication exists for the most common form of the condition, chronic rhinosinusitis without nasal polyps, known as “chronic sinusitis.”

While some nasal sprays may offer some symptom relief, patients who were using a standard-delivery nasal spray before study enrollment still reported similar improvements in symptoms compared to others in the study.

These are the first placebo-controlled clinical trials to show that a medication reduces subjective symptoms and objective measures of sinus disease for patients with chronic sinusitis, both with and without polyps.

Currently, patients whose symptoms are not resolved by over-the-counter nasal sprays or other medications, have limited options for relief, including antibiotics, surgery, or in the case of nasal polyps, lifelong biologic therapies.

EDS-FLU was determined to be as safe as standard over the counter nasal sprays.

Source: University of Pennsylvania School of Medicine

Categories : Mental HealthTags :

Visions of Nonphysical World are Common Among Cognitively Healthy American Indians

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Photo by Bruce Christianson on Unsplash

Visual hallucinations are common among people with Lewy body dementia and other types of dementia. Identifying visual hallucinations is an important component of a wide variety of medical and psychiatric diagnoses and treatments, but without cultural context, some patients’ symptoms can be misinterpreted or misdiagnosed.

There is little in medical literature about normal spiritual experiences in American Indian participants in the context of a neurocognitive evaluation. University of Minnesota Medical School researchers sought to understand how the culture and spirituality of the American Indian Ojibwe tribe affect a doctor’s assessment of normal aging.

Publishing in JAMA Network Open, the research team found that visions of the nonphysical world are common among cognitively healthy Ojibwe individuals and can represent normal spiritual experiences. 

“Consideration of a patient’s cultural background and belief system can help avert erroneous disqualification for disease-modifying therapy, exclusion from clinical trials and all the negative ramifications associated with a misdiagnosis of psychiatric disease,” said William Mantyh, MD, an assistant professor at the University of Minnesota Medical School and  behavioural neurologist with M Health Fairview.

In partnership with an Ojibwe Tribal Nation in Minnesota, the study recruited 33 cognitively healthy tribal elders aged 55 years or older. The research found 48% of participants reported frequent transient visions of the nonphysical world that generally were benevolent and involved spiritual beings and/or ancestors. 

According to the research team, clinicians would benefit from careful consideration of cultural or spiritual context to avoid misdiagnosis of neuropsychiatric disease. 

“Today’s environment of infrequent or insufficiently short cognitive evaluations – an average 16-minute face-to-face visit with a physician and increasing use of pre-visit symptom checklists increase the risk of falsely attributing a spiritual experience to a hallucination,” said Dr Mantyh. 

Dr Mantyh and his research team’s overarching goal is to ensure accurate diagnosis of neurodegenerative disease in American Indian communities. To reach this goal, the research team is including American Indian participants in the development of a new Alzheimer’s disease blood test. So far, more than 250 participants have been included. These new Alzheimer’s disease blood tests, up to 95% accurate, directly detect the proteins related to Alzheimer’s disease in the blood, but they also look at a patient’s APOE ε4 gene. APOE ε4 is the most significant genetic risk factor for Alzheimer’s disease, but its effect on Alzheimer’s disease depends on a patient’s ancestry. 

Source: University of Minnesota

Categories : Expert Opinion Medical IndustryTags :

Can Digital Technology Improve Accessibility to Healthcare in SA?

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Technology is reshaping and closing the gap between patients, healthcare providers, and the healthcare system. By embracing this digital shift, South Africa’s healthcare sector can benefit both now and in the long term, resulting in a healthier and more prosperous society, writes Bada Pharasi, Chief Executive Officer of The Innovative Pharmaceutical Association South Africa (IPASA).

As technologies such as Artificial Intelligence (AI) and big data disrupt multiple industries, it has proven its worth in simplifying, analysing and speeding up processes, and the healthcare sector is no different. 

Technology in the sector has come a long way since the inception of the stethoscope and X-rays. Today, it is becoming the cornerstone of modern healthcare in developed countries across the globe and is growing at an unprecedented rate. So much so that studies suggest that while the global digital health market was valued at over US$330 billion in 2022, this number is expected to skyrocket to a staggering US$650 billion by 20251.  

While the likes of the United States and the United Kingdom lead the charge in the adoption of digital health, South Africa is quickly growing its share of the pie as well. Insights suggest that in South Africa revenue in the digital health market is projected to reach US$831.20 million this year. Moreover, it is envisioned to grow by an annual growth rate of as much as 7.57%, resulting in a projected market volume of US$1,113.00 million by 20282. 

From revolutionising patient access to cutting-edge medicine and AI-driven diagnostics tools to virtual consultations with healthcare specialists and genomic breakthroughs, the capabilities of digital health technologies are far-reaching.

The advent of technology such as AI and big data brings with it the capacity to interpret analytics and enhance patient care through faster diagnosis than was ever thought possible. Google’s DeepMind AI system, for example, recognises eye diseases with a correct diagnosis of up to 94.5%, while teledermatology companies have developed apps that utilise smartphone and computer cameras to aid patients in finding out the cause of lesions or certain conditions3.  

Moreover, technologies such as the Phillips Lumify Portable Ultrasound allow for an examination anywhere, be it a refugee camp or an accident scene, while IBM Watson has leveraged the power of AI to accelerate the early detection of oncological diseases and analyse data to compile treatment programmes for those with cancer3. 

It is a dynamic realm that enables better collaboration around patient-centred care, and one that promises a future where healthcare can be delivered to patients quickly and more effectively than ever before.

This is particularly relevant in the South African context, where as many as 45 million people, or 82 out of every 100 South Africans, fall outside of the medical aid cohort4. This is compounded by the fact that nearly 32% of the population resides in rural areas5 where access to healthcare is limited, meaning the adoption of digital healthcare has the potential to address many of the health issues that plague the country and create a healthier and more productive society. 

And the shift has already begun, with provincial departments such as the Free State Health Department heeding the digital call. In late 2023, the department announced its intention to utilise digital innovations to streamline healthcare services and improve patient and healthcare outcomes in the province6. 

The department’s first project in the province is focused on telemedicine, where patients and specialists consult online from the comfort of their local clinic, regardless of their different locations. The second sees the mountain of paper patient records being done away with in favour of a streamlined, digital system where patient records can be accessible electronically, thus greatly improving efficiency, reducing errors, and ensuring continuity of care6.   

Importantly, amidst the promising potential that these technologies yield, it is critical for healthcare workers to remain steadfast in their digital fluency and technological relevance. 

Gone are the days of specialists only being adept in their professions. Professionals of the future need an understanding of the technologies at their disposal, how they work and how they will better serve their patients. In this way, they will remain at the forefront of the latest innovations specific to their fields of expertise, thus propelling the advancements forward.

In doing so, this ongoing upskilling ensures not only the advancement of their professions but will also benefit patient outcomes for decades to come. 

References:

1. Digital health – Statistics & Facts [Internet]. Statista. [cited 2024 Jan 16]. Available from: https://www.statista.com/topics/2409/digital-health/

2. Digital Health – South Africa [Internet]. Statista. [cited 2024 Jan 16]. Available from: https://www.statista.com/outlook/hmo/digital-health/south-africa

3. Digital healthcare: the evolution of better medicine [Internet]. [cited 2024 Jan 16]. Available from: https://www.discovery.co.za/

4. [No title] [Internet]. [cited 2024 Jan 16]. Available from: https://www.statssa.gov.za/?p=10548#

5. South Africa Rural population, percent – data, chart [Internet]. TheGlobalEconomy.com. [cited 2024 Jan 16]. Available from: https://www.theglobaleconomy.com/South-Africa/rural_population_percent/

6. Sompane M. FS Health goes digital to improve services [Internet]. Health-e News. 2023 [cited 2024 Jan 16]. Available from: https://health-e.org.za/2023/12/19/fs-health-goes-digital-to-improve-services

Categories : OphthalmologyTags :

In Vitro Experiment Explains Why Humans Have Full Colour Vision and Dogs Don’t

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Photo by Victor Freitas on Pexels

With human retinas grown in a petri dish, researchers discovered how retinoic acid, a metabolite of vitamin A, generates the specialised cells that enable people to see millions of colours, an ability that dogs, cats, and most other mammals do not have.

“These retinal organoids allowed us for the first time to study this very human-specific trait,” said author Robert Johnston, an associate professor of biology. “It’s a huge question about what makes us human, what makes us different.”

The findings, published in PLOS Biology, increase understanding of colour blindness, age-related vision loss, and other diseases linked to photoreceptor cells. They also demonstrate how genes instruct the human retina to make specific colour-sensing cells, a process scientists thought was controlled by thyroid hormones.

By tweaking the cellular properties of the organoids, the research team found that a vitamin A1 metabolite, retinoic acid, determines whether a cone will specialise in sensing red or green light.

Only humans with normal vision and closely related primates develop the red sensor.

For decades, it was that thought red cones formed through a coin toss mechanism where the cells haphazardly commit to sensing green or red wavelengths – and research from Johnston’s team recently hinted that the process could be controlled by thyroid hormone levels.

Instead, the new research suggests red cones materialise through a specific sequence of events orchestrated by retinoic acid within the eye.

The team found that high levels of retinoic acid in early development of the organoids correlated with higher ratios of green cones. Similarly, low levels of the acid changed the retina’s genetic instructions and generated red cones later in development.

“There still might be some randomness to it, but our big finding is that you make retinoic acid early in development,” Johnston said.

“This timing really matters for learning and understanding how these cone cells are made.”

Green and red cone cells are remarkably similar except for a protein called opsin, which detects light and tells the brain what colors people see.

Different opsins determine whether a cone will become a green or a red sensor, though the genes of each sensor remain 96% identical.

With a breakthrough technique that spotted those subtle genetic differences in the organoids, the team tracked cone ratio changes over 200 days.

“Because we can control in organoids the population of green and red cells, we can kind of push the pool to be more green or more red,” said author Sarah Hadyniak, who conducted the research as a doctoral student in Johnston’s lab and is now at Duke University.

“That has implications for figuring out exactly how retinoic acid is acting on genes.”

The researchers also mapped the widely varying ratios of these cells in the retinas of 700 adults.

Seeing how the green and red cone proportions changed in humans was one of the most surprising findings of the new research, Hadyniak said. Scientists still don’t fully understand how the ratio of green and red cones can vary so greatly without affecting someone’s vision.

If these types of cells determined the length of a human arm, the different ratios would produce “amazingly different” arm lengths, Johnston said.

To build understanding of diseases like macular degeneration, which causes loss of light-sensing cells near the center of the retina, the researchers are working with other Johns Hopkins labs.

The goal is to deepen their understanding of how cones and other cells link to the nervous system.

“The future hope is to help people with these vision problems,” Johnston said.

“It’s going to be a little while before that happens, but just knowing that we can make these different cell types is very, very promising.”

Source: Johns Hopkins University

Categories : Metabolic DisordersTags :

In Type 2 Diabetics, Toxic Lipids and a Beneficial One Surge at Certain Times

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Credit: Cell Reports Medicine (2023).

While sugar is most frequently blamed in the development of type 2 diabetes, a better understanding of the role of fats is also essential. By analysing the blood profiles of dozens of people suffering from diabetes or pre-diabetes, or who have had their pancreas partially removed, researchers at the University of Geneva (UNIGE) and Geneva University Hospitals (HUG) have made two major discoveries.

Firstly, the lipid composition of blood and adipose tissues fluctuates during the day, and is altered in a day-time dependent manner in diabetics, who have higher levels of toxic lipids. In addition, one type of lipid, lysoPI, is capable of boosting insulin secretion when the beta cells that normally produce it fail. These results, published in the journals Cell Reports Medicine and Diabetes, may have important implications for the treatment of diabetic patients.

The role of lipids in the physiological and pathological processes of human metabolism is gradually becoming clearer, particularly in type 2 diabetes, one of the most widespread serious metabolic disorders. Thanks to cutting-edge tools, in particular mass spectrometry, researchers are now able to simultaneously measure the levels of several hundred different types of lipids, each with its own specific characteristics and beneficial or harmful effects on our metabolism.

‘‘Identifying which lipids are most present in type 2 diabetics could provide a basis for a wide range of interventions: early detection, prevention, potential therapeutic targets or personalised recommendations – the possibilities are immense,’’ says Charna Dibner, a professor in the Department of Surgery and a specialist in circadian rhythms in metabolic disorders, . ‘‘This is why we carried out a detailed analysis of the blood profiles of patients recruited in four European countries and confirmed some of our results on a mouse model of the disease.’’

Dibner led the studies along with Pierre Maechler, a professor in the Department of Cell Physiology and Metabolism, at the UNIGE Faculty of Medicine, and members of the Diabetes Faculty Centre.

Chronobiology to better identify diabetes

The team carried out a ‘‘lipidomic’’ analysis of two groups of patients in order to establish the profile, over a 24-hour cycle, of multiple lipids present in the blood and adipose tissues. ‘‘The differences between the lipid profiles of type 2 diabetics and people without diabetes are particularly pronounced in the early morning, when there is an increase in certain toxic lipids,’’ explains Dibner. ‘‘Why? We don’t know yet. But this could be a marker of the severity of diabetes and paves the way for personalised care according to each patient’s specific chronotype.”

And implications go beyond diabetes: if samples are taken at very different times of the day, the results can be distorted and give contradictory results. ‘‘It’s the same thing in the clinic: an examination carried out in the morning or evening, or a treatment taken at different times, can have an impact on diagnosis and even on the effectiveness of treatments.’’

A crutch for beta cells

Charna Dibner and Pierre Maechler extended their lipidomic analyses to include not only people with type 2 diabetes but also a mouse model of pre-diabetes and patients who had lost around half their insulin-producing beta cells after a surgery. ‘‘We discovered that a type of lipid, lysoPIs, increases when there is a sharp decrease in functional β cells, even before the onset of clinical symptoms of diabetes.’’

The scientists then administered lysoPI to diabetic mice and observed an increase in insulin production. ‘‘The same phenomenon occurred in vitro, on pancreatic cells from diabetic patients,’’ adds Pierre Maechler. ‘‘The lysoPIs therefore have the capacity to reinforce insulin secretion by acting as a crutch when the number of beta cells decreases or when these cells malfunction. Yet, certain foods, such as legumes, naturally contain lysoPI precursors.’’

By bringing to light the unsuspected role of lysoPIs, researchers will be able to explore new avenues opened by their discoveries. The development of dietary supplements or even molecules specific to lysoPI receptors could be an interesting strategy for controlling diabetes, as could taking better account of the chronobiological profiles of patients. Diabetes is a complex disease that calls for much more personalised management than is currently the case.

Source: University of Geneva

Categories : Environmental EffectsTags :

Mobile Phone Use Linked to Lower Sperm Count and Concentration

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Photo by Ketut Subiyanto on Pexels

While various environmental and lifestyle factors have been proposed to explain the decline in semen quality observed over the last fifty years, the role of mobile phones has yet to be demonstrated. In a major cross-sectional study, researchers in Switzerland showed that frequent use of mobile phones is associated with a lower sperm concentration and total sperm count, although causation cannot be established. No association was seen between mobile phone use and low sperm motility and morphology. Read the results in Fertility & Sterility.

Semen quality is determined by the assessment of parameters such as sperm concentration, total sperm count, sperm motility and sperm morphology. According to the values established by the World Health Organization (WHO), a man will most probably take more than one year to conceive a child if his sperm concentration is below 15 million/mL, with the odds of pregnancy will decrease if the sperm concentration is below 40 million/mL.

Many studies have shown that semen quality has decreased over the last fifty years. Sperm count is reported to have dropped from an average of 99 million sperm/mL to 47 million/mL. This phenomenon is thought to be the result of a combination of environmental factors (endocrine disruptors, pesticides, radiation) and lifestyle habits (diet, alcohol, stress, smoking).

Assessing the impact of mobile phones

Is the mobile phone also to blame? After conducting the first national study (2019) on the semen quality of young men in Switzerland, a team from the University of Geneva (UNIGE) has published the largest cross-sectional study on this topic. It is based on data from 2886 Swiss men aged 18 to 22, recruited between 2005 and 2018 at six military conscription centres.

In collaboration with the Swiss Tropical and Public Health Institute (Swiss TPH), scientists studied the association between semen parameters of 2886 men and their use of mobile phones. ‘‘Men completed a detailed questionnaire related to their lifestyle habits, their general health status and more specifically the frequency at which they used their phones, as well as where they placed it when  not in use,’’ explains Serge Nef, full professor in the Department of Genetic Medicine and Development at the UNIGE Faculty of Medicine and at the SCAHT – Swiss Centre for Applied Human Toxicology, who co-directed the study.

These data revealed an association between frequent use and lower sperm concentration. The median sperm concentration was significantly higher in the group of men who did not use their phone more than once a week (56.5 million/mL) compared with men who used their phone more than 20 times a day (44.5 million/mL). This difference corresponds to a 21% decrease in sperm concentration for frequent users (> 20 times/day) compared to rare users (< once/day).

Is 4G less harmful than 2G?

This inverse association was found to be more pronounced in the first study period (2005-2007) and gradually decreased with time (2008-2011 and 2012-2018). ‘‘This trend corresponds to the transition from 2G to 3G, and then from 3G to 4G, that has led to a reduction in the transmitting power of phones,’’ explains Martin RÖÖsli, associate professor at Swiss TPH.

‘‘Previous studies evaluating the relationship between the use of mobile phones and semen quality were performed on a relatively small number of individuals, rarely considering lifestyle information, and have been subject to selection bias, as they were recruited in fertility clinics. This has led to inconclusive results,’’ explains Rita Rahban, senior researcher and teaching assistant in the Department of Genetic Medicine and Development in the Faculty of Medicine at the UNIGE and at the SCAHT, first author and co-leader of the study.

It doesn’t matter where you put your phone

Data analysis also seems to show that the position of the phone – for example, in a trouser pocket – was not associated with lower semen parameters. ‘‘However, the number of people in this cohort indicating that they did not carry their phone close to their body was too small to draw a really robust conclusion on this specific point,’’ adds Rita Rahban.

This study, like most epidemiologic studies investigating the effects of mobile phone use on semen quality, relied on self-reported data, which is a limitation. By doing so, the frequency of use reported by the individual was assumed to be an accurate estimate of exposure to electromagnetic radiation. To address this limitation, a study funded by the Federal Office for the Environment (FOEN) was launched in 2023. Its aim is to directly and accurately measure exposure to electromagnetic waves, as well as the types of use – calls, web navigation, sending messages – and to assess their impact on male reproductive health and fertility potential. The data will be collected using an application that each future participant will download to their mobile phone. The research team is actively recruiting participants for this study.

The aim is also to better describe the mechanism of action behind these observations. ‘‘Do the microwaves emitted by mobile phones have a direct or indirect effect? Do they cause a significant increase in temperature in the testes? Do they affect the hormonal regulation of sperm production? This all remains to be discovered,’’ concludes Rita Rahban.

Source: University of Geneva

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Removing Largest Serving Sizes of Wine Decreases Alcohol Consumption, Study Finds

On By ModernMedia

When pubs, bars and restaurants in England removed their largest size of wine sold by the glass, consumers drank less alcohol

Photo from Pixabay CC0

Alcohol consumption is the fifth largest contributor to premature death and disease globally. Many cues in physical and economic environments influence alcohol consumption across populations. One proposed intervention to excessive alcohol consumption is reducing the size of servings of alcoholic drinks sold by the glass, but there has been no real-world evidence for the effectiveness of this.

In the new study, researchers asked 21 licensed premises in England to remove from their menus their largest serving of wine by the glass – usually 250mL – for four weeks. The researchers then tracked the total volume of wine, beer and cider sold by each establishment.

Over the course of the four weeks, the total volume of wine sold by the licensed premises decreased by 7.6%, and there was no overall increase in beer and cider sales. There was an increase in the sales of smaller servings of wine by the glass – generally 125mL and 175mL – but no impact on sales of wine by the bottle or beer or cider sales.

“This suggests that this is a promising intervention for decreasing alcohol consumption across populations, which merits consideration as part of alcohol licensing regulations,” the authors say.

Marteau adds, “Removing the largest serving size of wine by the glass in 21 licensed premises reduced the volume of wine sold, in keeping with the wealth of research showing smaller serving sizes reduce how much we eat. This could become a novel intervention to improve population health by reducing how much we drink.”