Cardiometabolic Disease Research Articles

Epigenomic biomarkers of cardiometabolic disease: How far are we from daily practice?

AbstractDetermining whether someone has cardiometabolic disease (CMD), especially in the early stages, can be complicated. Risk stratification ordinarily depends on an extended process relying on medical history that typically considers blood pressure, cholesterol, smoking and diabetes status. Physicians have long relied on these key patient characteristics to assess CMD risk. However, these widely used clinical assessments are often identified later in life and by definition, in those individuals with progressed disease. This is partly because the onset of CMD naturally occurs in adulthood, however, the underlying processes can occur much earlier in life, even in the absence of obvious symptoms. For one thing, the pathways towards pathology may exist for years before symptom onset. Thus, among other things, there are opportunities to provide doctors with better insights into future disease prediction especially in younger adults with diabetes. The rapid rise in CMD together with the increased rates of obesity and diabetes in this population only emphasises the importance of predictive molecular biomarkers. One notable aspect is that traditional risk scores, such as those based on cholesterol measurements, are frequently found to be within normal ranges in younger populations. At the same time, given the significant overlap in risk factors for cardiovascular disease (CVD) and diabetes, the unmet clinical need is for early biomarkers of CMD that may help improve risk assessment in younger adults. This editorial highlights advances in the use of polygenic risk scores and emerging utility of genetic biomarkers to define intermediate CMD phenotypes discussing new classification criteria involving DNA methylation of genes to improve risk assessment. CMD is the number one cause of mortality and accounts for 31% of all global deaths. CMD is also multifactorial, comprising cardiovascular disease (CVD) and diabetes that have significant overlap in risk factors and disease biology. Diabetes is arguably the strongest risk factor for CVD development. Accounting for almost 90% of diabetes cases worldwide, type 2 diabetes (T2D) affects about 527 million people. The global economic burden is estimated at 1.3 trillion USD annually and is close to 1.8% of global GDP [1]. Despite the progress in preventive and therapeutic measures of CVD, the increasing CMD rates only underscore the important need of molecular biomarkers for early detection [2]. Determining whether someone has CMD usually involves an extended diagnostic process that has become essential for risk stratification and disease prevention [3]. While the onset of CMD typically occurs in adulthood, disease development commences much earlier, and this has scientists questioning whether molecular biomarkers could improve current prognostic risk scores. Predicting which people with T2D are most likely to develop CVD remains a significant challenge despite the recent advances in genetic mapping. Graphical abstract

Joint association of air pollutants on cardiometabolic multimorbidity.

We estimated the association between combined exposure to air pollutants and the development of cardiometabolic multimorbidity (CM) and all-cause mortality. An air pollution score was calculated to determine the combined exposure to five air pollutants. CM was defined as the instance of at least two types of diseases. A genetic risk score (GRS) was calculated for each individual. A multistate regression model was used to investigate the effect of the combined associations of air pollutants on each stage of CM progression. After multivariable adjustment, the air pollution score was related with greater susceptibility of CM and all-cause mortality, and those with a high GRS for cardiovascular disease (CVD) or coronary heart disease (CHD) and a high air pollution score had a greater susceptibility of incident CM and all-cause mortality. The multistate model revealed that the greater air pollution score was connected with the susceptibility of progressing from disease-free baseline to having one cardiometabolic disease, and next to CM, and eventually to death. Combined exposure to five air pollutants were related with greater susceptibility of CM and all-cause mortality in a dose-dependent style and is related with the progression of CM and with all-cause mortality.

Setting the Exercise Intensity in Cardiovascular Rehabilitation for Patients with Cardiometabolic Disease: Is it different between males and females?

Setting the Exercise Intensity in Cardiovascular Rehabilitation for Patients with Cardiometabolic Disease: Is it different between males and females?

The Effect of Black Chokeberry (Aronia melanocarpa) on Human Inflammation Biomarkers and Antioxidant Enzymes: A Systematic Review of Randomized Controlled Trials.

Consuming antioxidant-rich foods has been associated with potential benefits in managing chronic diseases by reducing oxidative stress and inflammation. This systematic review aimed to evaluate the effects of Aronia melanocarpa (aronia berry or chokeberry) on human inflammation biomarkers and antioxidant enzymes. A systematic search was conducted across multiple databases, including PubMed, Scopus, Science Direct, and Web of Science, to identify relevant studies investigating the potential effects of aronia on human inflammation biomarkers and antioxidant enzymes between April 2022 and November 2023. The selection of studies followed the PRISMA guidelines, data screening was conducted by 4 independent reviewers, and data extraction and risk-of-bias assessments were performed by 2 independent reviewers using the Cochrane Risk of Bias 2 tool. A total of 1986 studies were screened, and 18 studies that met the inclusion criteria were included in a systematic review that investigated the anti-inflammatory effects of aronia on various health parameters. These studies primarily focused on the effects of aronia on cardiometabolic diseases, performance in sport, and other health parameters. This study examined the effects of Aronia intervention on human health outcomes using aronia juice, extract, or oven-dried powder for a period of 4 to 13 weeks. The primary health parameters considered were C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), interleukin-8 (IL-8), interleukin-10 (IL-10), interleukin-1ß (IL-1ß), superoxide dismutase (SOD), catalase (CAT), and reduced glutathione peroxidase (GSH-Px). The results showed that aronia had a beneficial effect on several inflammatory cytokines, including reductions in CRP, TNF-α and IL-6 concentrations, as well as elevated IL-10 levels. Moreover, positive changes have been observed in antioxidant enzyme systems, including; elevated SOD, GSH-Px and CAT activity. The findings of the presented studies provide evidence that Aronia melanocarpa may have beneficial effects on inflammatory markers. PROSPERO registration No. CRD42022325633.

Non-adherence to antidementia medications and associated factors: a study of Spanish population-based registry data

IntroductionWith an increasing prevalence, dementia is one of the most disabling diseases among the elderly. Impaired cognitive function and behavioral and psychological symptoms predispose patients to medication non-adherence, resulting in increased morbidity, mortality, and healthcare costs. The aim of this study was to estimate the prevalence of non-adherence to antidementia medications and to identify the main predictors.MethodsA population-based registry study was conducted in 2022 in Castile and Leon, Spain. A total of 17,563 patients with dementia were included. The medication possession ratio (MPR) was used as an indirect method to measure adherence. The cut-off point for determining that a patient was nonadherent was 80% of MPR. Multivariate logistic regression was used to identify predictors of nonadherence based on sociodemographic and health-related variables.ResultsIn 2022, 6.2% of the population over 80 years old used antidementia medications. Of these patients, 70% were women, 28.15% were institutionalized, and over 90% were polymedicated and had multiple prescribers. The most used medicines were donepezil (43.49%), rivastigmine (36.84%), and memantine (30.7%). The combined use of an acetylcholinesterase inhibitor plus memantine was relevant (13.33%). Men were less adherent than women, and the prevalence of non-adherence decreased with age. The medication associated with the highest prevalence of non-adherence was rivastigmine (19%), followed by donepezil (17%) and memantine (13.23%). Institutionalized patients (13%) and patients on combination therapy (13.29%) had the lowest prevalence of non-adherence. Protective factors against non-adherence include institutionalization, polymedication, use of memantine or combination therapy, and comorbid mental illness.ConclusionsIn Castile and Leon, one in six patients were non-adherent to antidementia medications. Younger male patients with cardiometabolic disease are more likely to be non-adherent to antidementia medications. On the other hand, institutionalization is a protective factor against non-adherence, but still 10% of nursing home patients are non-adherent to antidementia medications.

Clinical Bioenergetics: Understanding the Interplay Between Energy Metabolism and Human Health

Mitochondrial energy deficits have emerged as a critical factor in various clinical conditions, including inherited metabolic disorders, intoxications, cardiometabolic diseases, neurodegenerative disorders, and cancer [...]

Additives in Processed Foods as a Potential Source of Endocrine-Disrupting Chemicals: A Review

Processed foods, accounting for most consumable food categories today, contain considerable amounts of food additives. Food additives are substances added to food products to improve taste, consistency, appearance, or shelf life. Various food additives, such as phthalates, bisphenol A, tartrazine, erythrosine, artificial sweeteners, and parabens, have been identified as potential sources of endocrine-disrupting chemicals (EDCs) in processed foods. EDCs are substances that frequently interfere with the regular functioning of the endocrine system, creating an unusual environment in the biological system, which leads to adverse health effects such as the disruption of hormone synthesis, receptor binding, and signal transduction pathways, as well as energy metabolic homeostatic disorders which potentially increasing the risk of obesity, type-2 diabetes, cardiometabolic diseases and may also trigger allergic reactions. Consequently, they can also impact mammary gland development, and reproductive function, further leading to developmental abnormalities. This review aims to insights into the various food additives that act as potential endocrine-disrupting chemicals (EDCs) and to describe their applications in the food industry, as well as the failure of hormonal homeostatic mechanisms, which eventually result in hazardous health effects. It also outlines strategies to reduce the use of food additives and suggests alternative additives with minimal or no endocrine-disrupting properties, highlighting their importance for maintaining human health.

Biomarkers of glucose-insulin homeostasis and incident type 2 diabetes and cardiovascular disease: results from the Vitamin D and Omega-3 trial

BackgroundDysglycemia and insulin resistance increase type 2 diabetes (T2D) and cardiovascular disease (CVD) risk, yet associations with specific glucose-insulin homeostatic biomarkers have been inconsistent. Vitamin D and marine omega-3 fatty acids (n-3 FA) may improve insulin resistance. We sought to examine the association between baseline levels of insulin, C-peptide, HbA1c, and a novel insulin resistance score (IRS) with incident cardiometabolic diseases, and whether randomized vitamin D or n-3 FA modify these associations.MethodsVITamin D and OmegA-3 TriaL (NCT01169259) was a randomized clinical trial testing vitamin D and n-3 FA for the prevention of CVD and cancer over a median of 5.3 years. Incident cases of T2D and CVD (including cardiovascular death, myocardial infarction, stroke, and coronary revascularization) were matched 1:1 on age, sex, and fasting status to controls. Conditional logistic regressions adjusted for demographic, clinical, and adiposity-related factors were used to assess the adjusted odds ratio (aOR) per-standard deviation (SD) and 95%CI of baseline insulin, C-peptide, HbA1c, and IRS (Insulin×0.0295 + C-peptide×0.00372) with risk of T2D, CVD, and coronary heart disease (CHD).ResultsWe identified 218 T2D case-control pairs and 715 CVD case-control pairs including 423 with incident CHD. Each of the four biomarkers at baseline was separately associated with incident T2D, aOR (95%CI) per SD increment: insulin 1.46 (1.03, 2.06), C-peptide 2.04 (1.35, 3.09), IRS 1.72 (1.28, 2.31) and HbA1c 7.00 (3.76, 13.02), though only HbA1c remained statistically significant with mutual adjustments. For cardiovascular diseases, we only observed significant associations of HbA1c with CVD (1.19 [1.02, 1.39]), and IRS with CHD (1.25 [1.04, 1.50]), which persisted after mutual adjustment. Randomization to vitamin D and/or n-3 FA did not modify the association of these biomarkers with the endpoints.ConclusionsEach of insulin, C-peptide, IRS, and HbA1c were associated with incident T2D with the strongest association noted for HbA1c. While HbA1c was significantly associated with CVD risk, a novel IRS appears to be associated with CHD risk. Neither vitamin D nor n-3 FA modified the associations between these biomarkers and cardiometabolic outcomes.

Gestational Diabetes Mellitus and Subsequent Risks of Diabetes and Cardiovascular Diseases: the Life Course Perspective and Implications of Racial Disparities.

Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications worldwide and the prevalence is continuously rising globally. Importantly, GDM is not an isolated complication of pregnancy. Growing evidence suggests that individuals with GDM, compared to those without GDM, have an increased risk of subsequent type 2 diabetes (T2D) and cardiovascular diseases (CVD). Substantial racial and ethnic disparities exist in the risk of GDM. However, the role of race and ethnicity in the progression from GDM to T2D and CVD remains unclear. The purpose of the current review is to summarize recent research about GDM and its life-course impacts on cardiometabolic health, including 1) the peak time of developing T2D and CVD risks after GDM, 2) the racial and ethnic disparities in the risk cardiometabolic diseases after GDM, 3) the biological plausibility and underlying mechanisms, and 4) recommendations for screening and prevention of cardiometabolic diseases among individuals with GDM, collectively to provide an updated review to guide future research. Growing evidence has indicated that individuals with GDM had greater risks of T2D (7.4 to 9.6 times), hypertension (78% higher), and CDV events (74% higher) after GDM than their non-GDM counterparts. More recently, a few studies also suggested that GDM could slightly increase the risk of mortality. Available evidence suggests that key CVD risk factors such as blood pressure, plasma glucose, and lipids levels are all elevated as early as < 1year postpartum in individuals with GDM. The risk of T2D and hypertension is likely to reach a peak between 3-6years after the index pregnancy with GDM compared to normal glycemia pregnancy. Cumulative evidence also suggests that the risk of cardiometabolic diseases including T2D, hypertension, and CVD events after GDM varies by race and ethnicity. However, whether the risk is higher in certain racial and ethnic groups and whether the pattern may vary by the postpartum cardiometabolic outcome of interest remain unclear. The underlying mechanisms linking GDM and subsequent T2D and CVD are complex, often involving multiple pathways and their interactions, with the specific mechanisms varying by individuals of different racial and ethnic backgrounds. Diabetes and CVD risk screening among individuals with GDM should be initiated early during postpartum and continue, if possible, frequently. Unfortunately, adherence to postpartum glucose testing with either obstetrician or primary care providers remained poor among individuals with GDM. A life-course perspective may provide critical information to address clinical and public health gaps in postpartum screening and interventions for preventing T2D and CVD risks in individuals with GDM. Future research investigating the racial- and ethnic-specific risk of progression from GDM to cardiometabolic diseases and the role of multi-domain factors including lifestyle, biological, and socio-contextual factors are warranted to inform tailored and culture-appropriate interventions for high-risk subpopulations. Further, examining the barriers to postpartum glucose testing among individuals with GDM is crucial for the effective prevention of cardiometabolic diseases and for enhancing life-long health.

Christensenella minuta Mitigates Behavioral and Cardiometabolic Hallmarks of Social Defeat Stress

Psychological stress during early development and adolescence may increase the risk of psychiatric and cardiometabolic comorbidities in adulthood. The gut microbiota has been associated with mental health problems such as depression and anxiety and with cardiometabolic disease, but the potential role of the gut microbiota in their comorbidity is not well understood. We investigated the effects and mode of action of the intestinal bacterium Christensenella minuta DSM 32891 on stress-induced mental health and cardiometabolic disturbances in a mouse model of social defeat stress. We demonstrate that administered C. minuta alleviates chronic stress-induced depressive, anxiogenic and antisocial behavior. These effects are attributed to the bacterium’s ability to modulate the hypothalamic-pituitary-adrenal axis, which mediates the stress response. This included the oversecretion of corticosterone and the overexpression of its receptors, as well as the metabolism of dopamine (DA) and the expression of its receptors (D1, D2L and D2S). Additionally, C. minuta administration reduced chronically induced inflammation in plasma, spleen and some brain areas, which likely contribute to the recovery of physical and behavioral function. Furthermore, C. minuta administration prevented chronic stress-induced cardiovascular damage by regulating key enzymes mediating liver fibrosis and oxidative stress. Finally, C. minuta increased the abundance of bacteria associated with mental health. Overall, our study highlights the potential of microbiota-directed interventions to alleviate both the physical and mental effects of chronic stress.

Oral health behavior associated with cardiometabolic outcomes: A nationally representative cross-sectional study in Portugal

BackgroundOral diseases are associated with the development of cardiometabolic diseases. This study aimed to evaluate the relationship between oral health behaviors (tooth brushing and oral health appointments) with cardiometabolic diseases. MethodsData from the First National Health Examination Survey were used. Participants aged 25–74 years and diagnosis of acute myocardial infarction (n = 4442), stroke (n = 4441), hypertension (n = 4450) and diabetes (n = 4327) were analyzed. A fifth subsample (n = 2555) included participants aged 40–69 for calculating cardiovascular risk. Poor oral health behavior was defined as brushing once a day or less and having the last oral health appointment at 12 months or more. Poisson regression models assessed the relationship between poor oral health behavior and these cardiometabolic outcomes. ResultsAmong 4.450 participants, 20.5 % had poor oral health behavior. A statistically significant association was found between poor oral health behavior with diabetes (PR: 1.44 [95 % CI: 1.10–1.98], and high/very high cardiovascular risk (PR: 1.42 [95 % CI: 1.25–1.62]). In the sensitivity analysis the association with diabetes and high/very high cardiovascular risk persisted when considering only brushing behavior but not when considering only oral health appointments at 12 months or more. ConclusionsIndividuals with poor oral health behavior had a higher prevalence of diabetes and high/very high cardiovascular risk. Sensitivity analysis suggested that regular tooth brushing may be the main behavior for preventing diabetes and cardiovascular risk. The results suggest that regular tooth brushing may act in prevention for diabetes and cardiovascular risk.

Machine learning-based clustering identifies obesity subgroups with differential multi-omics profiles and metabolic patterns.

Individuals living with obesity are differentially susceptible to cardiometabolic diseases. We hypothesized that an integrative multi-omics approach might improve identification of subgroups of individuals with obesity who have distinct cardiometabolic disease patterns. We performed machine learning-based, integrative unsupervised clustering to identify proteomics- and metabolomics-defined subpopulations of individuals living with obesity (BMI ≥ 30 kg/m2), leveraging data from 243 individuals in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. Omics that contributed to the observed clusters were functionally characterized. We performed multivariate regression to assess whether the individuals in each cluster demonstrated differential patterns of cardiometabolic traits. We identified two distinct clusters (iCluster1 and 2). iCluster2 had significantly higher average BMI values, fasting blood glucose, and inflammation. iCluster1 was associated with higher levels of total cholesterol and high-density lipoprotein cholesterol. Pathways mediating cell growth, lipogenesis, and energy expenditures were positively associated with iCluster1. Inflammatory response and insulin resistance pathways were positively associated with iCluster2. Although the two identified clusters may represent progressive obesity-related pathologic processes measured at different stages, other mechanisms in combination could also underpin the identified clusters given no significant age difference between the comparative groups. For instance, clusters may reflect differences in dietary/behavioral patterns or differential rates of metabolic damage.

Gestational diabetes mellitus, body mass index, and cardiometabolic multimorbidity: a prospective cohort study

PurposeGestational diabetes mellitus (GDM) could increase the risks of type 2 diabetes mellitus (T2DM) and cardiovascular disease. However, evidence on its association with cardiometabolic multimorbidity (CMM) was limited. This study aimed to evaluate the association between GDM and the prevalence, incidence, patterns, and progression of CMM; and the role of body mass index (BMI) in such association. MethodsThis study included 203,372 women who have given birth in UK Biobank. The diagnoses of GDM and cardiometabolic diseases (including stroke, coronary heart disease [CHD], and T2DM) were reported by participants or obtained through linkage to inpatient hospital data until 31st December 2020. BMI was assessed at the baseline assessment. CMM was defined as having two or more of included cardiometabolic diseases. Logistic regression models and Cox proportional hazard models were used to assess the association between GDM and CMM, and the modifications on both additive and multiplicative scales were assessed to evaluate the effect of BMI on such association. ResultsA total of 1,217 women had a history of GDM, 2,351 participants had CMM at the end of follow-up and 1,601 was newly diagnosed during follow-up. GDM was associated with higher prevalence (odds ratio [OR]=4.64, 95% confidence interval [95% CI]=3.54-6.08) and incidence (hazard ratio [HR]=3.62, 95% CI=2.62-5.00) of CMM. In particular, GDM was associated with higher odds of T2DM, coexisting T2DM and vascular disease, and T2DM followed by vascular disease. Formal testing for effect modification suggested multiplicative modification by BMI for the association between GDM and incident CMM. ConclusionsGDM was associated with CMM in women’s late life, with multiplicative modification effects of BMI. Our results suggest that maternal and lifestyle interventions (e.g., weight management) are warranted for the primary and secondary prevention of CMM, particularly in women with a history of GDM.

Pathogenetic relationship of microbiome and metabolic disorders on the background of hypertension and gout: Potential targets of pharmacotherapy

Cardiometabolic diseases are one of the urgent problems of modern medicine. Currently, much attention is being paid to the study of the common pathogenesis of diabetes mellitus, gout and hypertension. One of the pharmacological targets is the correction of the intestinal microbiome and dysbiosis, as an integral link in the development of systemic inflammation and endotoxinemia, leading to the development of these pathologies. The article presents the results of scientific research devoted to the study of the effect of the intestinal microbiome on the development of cardiometabolic diseases. The main goal of the research is to find a rational pharmacological therapy of intestinal dysbiosis for the treatment of comorbid patients. It has been proved that, together with standard drug therapy, taking into account the pathogenetic features of the development of cardiometabolic diseases, it is advisable to use drugs that affect the intestinal microbiome. The main classical approach is the use of probiotic drugs containing live bacteria. The use of probiotics in combination with probiotic drugs to support the growth of intestinal normoflora has become a promising direction. However, this approach requires a long period of correction of the microflora, which prompted the idea of using postbiotics – signaling molecules – products of the vital activity of the microflora for a more targeted and rapid effect on pathological processes, both in the intestine and on the organ system as a whole. This approach promotes the beginning of the development of synbiotics, a complex of microorganisms, growth factors and metabolites that made it possible to more effectively influence on dysbiotic processes in various pathologies, including dyslipidemia and cardiovascular diseases. Correction of intestinal barrier permeability disorders will help prevent the development of systemic complications associated with chronic pathologies. The article also presents the author’s scheme of the pathogenesis of cardiometabolic diseases, based on the study of current scientific research.

Self-Reported Difficulty with and Assistance Needed by People with Spinal Cord Injury to Prepare Meals at Home

Individuals with spinal cord injury (SCI) experience an increased risk for obesity and cardiometabolic disease. Recommendations to prevent and treat obesity for those with SCI follow those of the US Department of Agriculture to adopt a healthy eating pattern that includes eating a variety of fruits, vegetables, grains, dairy, and protein, plus limiting added sugars, saturated fats, and sodium. Yet, people with SCI eat too many calories, fat, and carbohydrates and too few fruits, vegetables, and whole grains. The study is based on secondary analyses of SCI participants (n = 122) who enrolled in a weight loss study to determine how SCI may impact their ability to prepare food at home. We hypothesize those with higher-level spinal injuries (specifically, those with cervical versus those with thoracic or lumbar/sacral injuries) experience significantly greater difficulty and are more likely to rely on others’ assistance to perform meal preparation tasks. Physiologic (weight, BMI, blood pressure, hemoglobin A1c) and self-reported data (demographic plus responses to the Life Habits Short Survey and meal prep items) were collected at baseline and qualitative data were obtained from a subsample after the intervention during phone interviews. Participants’ average age was 50 ± 14.7 years old, they lived with SCI for an average of 13.0 ± 13.1 years, and their average BMI was 32.0 ± 6.5. Participants were predominantly white (76.1%) men (54.1%) who had some college education (76.3%), though only 28.8% worked. A substantial proportion of respondents (30% to 68%) reported difficulty across the 13 tasks related to purchasing and preparing meals, with a proxy reported as the most common assistance type used across all tasks (17% to 42%). Forty-nine percent reported difficulty preparing simple meals, with 29% reporting a proxy does the task. More than half reported difficulty using the oven and stove, though between 60% to 70% reported no difficulty using other kitchen appliances (e.g., coffee machine, food processor, can opener), the refrigerator, or microwave. There was a significant difference in kitchen function by injury level. Those living with cervical-level injuries had significantly greater limitations than those with thoracic-level injuries. Spouses, other family members, and caregivers were most likely to serve as proxies and these individuals exerted both positive and negative influences on respondents’ dietary intake, based on qualitative data obtained during interviews. The results suggest that many people living with SCI experience functional and environmental barriers that impact their ability to prepare food and use kitchen appliances. Future research should examine how SCI-related functional limitations, transportation access, accessibility of the kitchen, ability to use appliances, availability of financial resources, and assistance by others to prepare foods impact people’s ability to follow a healthy eating pattern.

The evolving landscape of cardiometabolic diseases

The evolving landscape of cardiometabolic diseases

Practical Aspects of Flavin-Containing Monooxygenase-Mediated Metabolism.

Hepatic flavin-containing monooxygenase 3 (FMO3) is arguably the most important FMO in humans from the standpoint of drug metabolism. Recently, adult hepatic FMO3 has been linked to several conditions including cardiometabolic diseases, aging, obesity, and atherosclerosis in small animals. Despite the importance of FMO3 in drug and chemical metabolism, relative to cytochrome P-450 (CYP), fewer studies have been published describing drug and chemical metabolism. This may be due to the properties of human hepatic FMO3. For example, FMO3 is thermally labile, and often methods reported in the study of human hepatic FMO3 are not optimal. Herein, I describe some practical aspects for studying human hepatic FMO3 and other FMOs.

Investigating the types of eating behavior among shift workers in the machine-building industry

Introduction: Shift work has become the norm and an absolute necessity in various sectors of public life. Different production processes, technologies, and the nature of certain jobs lead to various health risks. Unhealthy eating behaviors remain common among shift workers across all economic sectors. Aim: This study aims to compare the eating habits and dietary patterns of shift workers and fixed daytime workers in the Bulgarian machine-building industry, focusing on identifying differences that may influence health outcomes. Materials and methods: A cross-sectional study was conducted at three work sites of a machine-building enterprise in Bulgaria, involving 309 workers (149 shift workers and 160 fixed daytime workers). Data on eating habits were collected using a 54-item Food Frequency Questionnaire (54-FFQ) adapted for the local population. Descriptive statistics were used to summarize the demographic and dietary data. Group comparisons between shift workers and fixed daytime workers were made using the Mann-Whitney U test for non-normally distributed continuous variables. A p-value of less than 0.05 was considered statistically significant. Results: The study found significant differences in eating habits between shift workers and fixed daytime workers. Shift workers were more likely to consume white bread (p=0.003), fast food (p=0.045), margarine (p=0.001), fried potatoes (p=0.041), and processed meats (p=0.021) than fixed-daytime workers were. In contrast, fixed-daytime workers had a higher consumption of fruits (p=0.034), vegetables (p=0.047), and alcoholic beverages like beer (p=0.008), wine, and spirits (p=0.005) than shift workers. These differences suggest that work schedules may significantly influence dietary choices and impact workers’ health outcomes. Conclusion: Shift work disrupts the natural daily rhythm and leads to changes in eating behavior, such as irregular meals, skipping breakfast, and eating late in the evening and at night. Our study highlights how these behaviors are associated with the regular consumption of processed, energy-dense foods rich in carbohydrates and fats but low in fiber and essential nutrients. The eating habits observed in our research are a significant risk factor for developing cardiometabolic diseases.

A single risk assessment for the most common diseases of ageing, developed and validated on 10 cohort studies

BackgroundWe aimed to develop risk tools for dementia, stroke, myocardial infarction (MI), and diabetes, for adults aged ≥ 65 years using shared risk factors.MethodsData were obtained from 10 population-based cohorts (N = 41,755) with median follow-up time (years) for dementia, stroke, MI, and diabetes of 6.2, 7.0, 6.8, and 7.4, respectively. Disease-free participants at baseline were included, and 22 risk factors (sociodemographic, medical, lifestyle, laboratory biomarkers) were evaluated. Two risk tools (DemNCD and DemNCD-LR based on Fine and Gray sub-distribution and logistic regression [LR], respectively) were developed and validated. Predictive accuracies of these risk tools were assessed using Harrel’s C-statistics and area under the curve (AUC) and 95% confidence interval (CI). Model calibration was conducted using Hosmer–Lemeshow goodness of fit test along calibration plots.ResultsBoth the DemNCD and DemNCD-LR resulted in similar predictive accuracy for each outcome. The overall AUC (95% CI) for dementia, stroke, MI, and diabetes risk tool were 0·68 (0·65, 0·70), 0·58 (0·54, 0·61), 0·65 (0·61, 0·68), and 0·68 (0·64, 0·72), respectively, for males. For females, these figures were 0·65 (0·63, 0·67), 0·55 (0·52, 0·57), 0·65 (0·62, 0·68), and 0·61 (0·57, 0·65).ConclusionsThe DemNCD is the first tool to predict both dementia and multiple cardio-metabolic diseases using comprehensive risk factors and provided similar predictive accuracy to existing risk tools. It has similar predictive accuracy as tools designed for single outcomes in this age-group. DemNCD has the potential to be used in community and clinical settings as it includes self-reported and routinely available clinical measures.

Accelerated biological aging: unveiling the path to cardiometabolic multimorbidity, dementia, and mortality

BackgroundCardiometabolic multimorbidity (CMM) and aging are increasing public health concerns. This prospective study used UK Biobank cohort to investigate the relationship between biological aging and the trajectory of CMM to dementia and mortality.MethodsCMM is the coexistence of at least two cardiometabolic diseases (CMD), including stroke, ischemic heart disease, and diabetes. Biological age was calculated using the KDM-BA and PhenoAge algorithms. Accelerated aging indicated biological age advances more rapidly than chronological age.ResultsThe study included 415,147 individuals with an average age of 56.5 years. During the average 11-year follow-up period, CMD-free individuals with accelerated aging had a significantly greater risk of CMD (KDM-BA, HR 1.456; PhenoAge, HR 1.404), CMM (KDM-BA, HR 1.952; PhenoAge, HR 1.738), dementia (KDM-BA, HR 1.243; PhenoAge, HR 1.212), and mortality (KDM-BA, HR 1.821; PhenoAge, HR 2.047) in fully-adjusted Cox regression models (p &amp;lt; 0.05 for all). Accelerated aging had adjusted HRs of 1.489 (KDM-BA) and 1.488 (PhenoAge) for CMM, 1.434 (KDM-BA) and 1.514 (PhenoAge) for dementia, and 1.943 (KDM-BA) and 2.239 (PhenoAge) for mortality in participants with CMD at baseline (p &amp;lt; 0.05 for all). CMM significantly mediated accelerated aging’s indirect effects on dementia by 13.7% (KDM-BA, HR) and 21.6% (PhenoAge); those on mortality were 4.7% (KDM-BA) and 5.2% (PhenoAge). The population attributable-risk of Life’s Essential 8 score (≥80 vs. &amp;lt;80) were 0.79 and 0.43 for KDM-BA and PhenoAge accelerated aging, respectively.ConclusionBiological aging involves the entire trajectory of CMM from a CMD-free state to CMD, to CMM, and ultimately to dementia and death. Life’s Essential 8 may be a potential target to counter age acceleration.