Cardiometabolic Syndrome Research Articles

Caryopteris odorata and its metabolite coumarin attenuate characteristic features of cardiometabolic syndrome in high-refined carbohydrate-high fat-cholesterol-loaded feed-fed diet rats.

Caryopteris odorata (D. Don) B.L. Robinson (Verbenaceae family) is an aromaric shrub traditionally used to treat diabetes and related pathologies (diabetic foot ulcer), cancer/tumors, wound healing, and inflammation. It is enriched with flavonoids and phenolics like coumarins, quercetin, gallic acid, coumaric acid, stigmasterol, α-tocopherol, and iridoids. C. odorata has been reported as having α-glucosidase, anti-inflammatory, and anti-oxidant properties. Its effectiveness in preventing cardiometabolic syndrome has not yet been assessed. This study aims to investigate the potential efficacy of C. odorata and coumarin for characteristic features of cardiometabolic syndrome (CMS), including obesity, dyslipidemia, hyperglycemia, insulin resistance, and hypertension by using high-refined carbohydrate-high fat-cholesterol (HRCHFC)-loaded feed-fed rats. Chronic administration of C. odorata and coumarin for 6weeks revealed a marked attenuation in body and organ weights, with a consistent decline in feed intake compared to HRCHFC diet fed rats. The test materials also caused a significant reduction in the blood pressure (systolic, diastolic, and mean) and heart rate of HRCHFC-diet fed rats. Improved glucose tolerance and insulin sensitivity tests were also observed in test material administered rats compare to only HRCHFC-diet fed rats. C. odorata and coumarin-treated animals produced a marked decline in serum FBG, TC, TG, LFTs, and RFTs, while an increase in serum HDL-C levels was noticed. C. odorata and coumarin also significantly modulated inflammatory biomarkers (TNFα, IL-6), adipokines (leptin, adiponectin, and chemerin), and HMG-CoA reductase levels, indicating prominent anti-inflammatory, cholesterol-lowering, and anti-hyperglycemic potential. Administration of C. odorata and coumarin exhibited a marked improvement in oxidative stress markers (CAT, SOD, and MDA). Histopathological analysis of liver, heart, kidney, pancreas, aorta, and fat tissues showed a revival of normal tissue architecture in C. odorata and coumarin-treated rats compared to only HRCHFC-diet fed rats. These results suggest that C. odorata and coumarin possess beneficial effects against the characteristic features of CMS (obesity, insulin resistance, hypertension, and dyslipidemia) in HRCHFC feed-administered rats. These effects were possibly mediated through improved adipokines, glucose tolerance, and insulin sensitivity, the attenuation of HMG-CoA reductase and inflammatory biomarkers, and modulated oxidative stress biomarkers. This study thus demonstrates a rationale for the therapeutic potential of C. odorata and coumarin in CMS.

The Impact of Blast Exposure-With or Without Traumatic Brain Injury-on Metabolic Abnormalities in Post-9/11 Veterans.

The primary aim included explorations of: (1) the associations between the history of blast exposure (BE), close blast exposure (CBE), and blast-related traumatic brain injury (bTBI) and metabolic abnormality; and (2) the potential mediating effect of comorbid psychological and somatic conditions on these associations. The secondary aim explored the association of dose-response impact of BE, CBE, and bTBI and metabolic abnormality. Data were collected by the Translational Research Center for TBI and Stress Disorders (TRACTS). Post-9/11 veterans from the TRACTS baseline sample who had conflict-zone deployment experience ( N = 734). Cross-sectional secondary data analysis. We computed relative risks (RRs) and 95% CI using modified Poisson regression. We quantified the impact of co-occurring psychological and somatic conditions on this association using mediation analyses. Exposures included BE (<100 m), CBE (<10 m), and bTBI. Metabolic abnormality outcomes included (1) overweight/obesity (defined by abnormal waist-hip ratio [WHR] and abnormal waist circumference [WC]); (2) glucose dysregulation; and (3) meeting criteria for cardiometabolic syndrome (defined by guidelines). The sample was majority male (91%) and White (68%), with a mean age of 34.6 years (SD = 8.99). Most participants had 1 or more BE (83%); 48% experienced 1 or more CBE. Overweight/obesity was highly prevalent in the sample (51% had abnormal WHR and 60% abnormal WC). There was no significant direct or indirect association between BE, CBE, and bTBI and metabolic abnormalities (RRs: 0.70-1.51; P 's > .05). Future research is needed to investigate the association of BE with metabolic abnormalities with larger, more targeted sample selection, and longer follow-up. Effective and sustainable weight management and metabolic health prevention interventions for this veteran cohort are needed.

Dietary supplements could prevent cardiometabolic syndrome: Are they safe and reliable enough for disease prevention and health promotion?

Dietary supplements (DS) and their purchase is often based on a consumer's personal choice and advertisements. The associated DS regulations, particularly in manufacturing and marketing, are far more flexible and permissive than that of the well-regulated prescription pharmaceuticals. However, the adverse health effects associated with the inadvertent use of mega-doses of DS are not well understood. The demand for DS, nutraceuticals, and herbal remedies has experienced an upswing during the past two to three decades, and global product sales have thrived. More so, the prevention of cardiometabolic syndrome (CMS) and related disorders like diabetes mellitus, obesity, hypertension, and serum lipid abnormalities, as well as of other noncommunicable diseases (NCDs), is of highest health care priority globally, since these disorders impose very high economic burdens on health care systems and society. In this review, we argue why DS could prevent cardiometabolic syndrome, by providing the potential benefits and risks associated with them, especially self-medication considering their intake by the public at large. Good manufacturing practices and quality control are absolutely necessary for the manufacture of DS products, and proper labeling is needed regarding the optimal dose schedules of various DS and bioactive ingredients. Specific examples are used to underscore the indications and dosage recommendations made for the marketing and promotion of fish oil, coenzyme Q10, and Mg-containing products for the prevention of cardiometabolic syndrome.

Polyoxidovanadates as a pharmacological option against brain aging

The world population is aging rapidly, and chronic diseases associated are cardiometabolic syndrome, cancer, and neurodegenerative diseases. Oxidative stress and inflammation are typical hallmarks in them. Polyoxidovanadates (POVs) have shown interesting pharmacological actions against chronic diseases. This work aimed to evaluate the POV effect on hippocampal neuroinflammation, redox balance, and recognition memory in the aging of rats. Rats 18 months old were administered a daily dose of sodium metavanadate (MV), decavanadate (DV), Metformin (Metf), or MetfDeca for two months. Results showed that short-term and long-term recognition memory improved by 28 % and 16 % (DV), 19 % and 20 % (Metf), and 21 % and 27 % (MetfDeca). In hippocampi, reactive oxygen species, IL-1β, and TNF-α, after DV, Metf, and MetfDeca decreased at similar concentrations to young adult control, while lipid peroxidation substantially ameliorated. Additionally, superoxide dismutase and catalase activity increased by 41 % and 42 % (DV), 39 % and 41 % (Metf), and 75 % and 73 % (MetfDeca). POV treatments reduced Nrf2 and GFAP immunoreactivity in CA1 (70–87.5 %), CA3 (60–80 %), and DG (57–89 %). Metformin treatment showed a minor effect, while MV treatment did not improve any parameters. Although DV, Metf, and MetfDeca treatments showed similar results, POVs doses were 16-fold fewer than Metformin. In conclusion, DV and MetfDeca could be pharmacological options to reduce age-related neuronal damage.

Therapeutic Effectiveness of Sesame Preparations and its Bioactive Ingredients in Management of Cardiometabolic Syndrome in Diabetes Mellitus: A Systematic Review.

This systematic review aimed to appraise and recapitulate all research investigations to elucidate the effects of Sesamum indicum preparations on managing the cardiometabolic syndrome of Diabetes mellitus (DM) and metabolic syndrome (MetS). A systematic review was carried out in a Cochrane fashion and in compliance with the PRISMA checklist using the published academic works in PubMed/MEDLINE, WOS, SCOPUS, and EMBASE databases that were searched up to June 2021. Abstracts that met PICO criteria for qualitative studies were duplicate reviewed for data extraction to assess the quality and details of the study. Sesamum indicum preparations and its bioactive lignans, such as sesamin, sesamol, and pinoresinol, were found to possess anti-hyperglycemic, anti-hyperlipidemia, anti-inflammatory, antioxidative, anti-hypertensive, cardioprotective, and hepatoprotective effects both in patients with T2DM as well as in experimental animal models with T1DM and MetS. The incorporation of sesame oil as a natural adjuvant can be effective in improving vascular reactivity and aortic permeability, reproductive parameters, and diabetic nephropathy, as well as modification of anthropometry indices. Therefore, sesame oil and bioactive lignans as combination therapy with drugs can exhibit synergistic effects and provide a favorable preference in clinical settings. Sesame oil and lignans present in it act in a dose-dependent manner. The best dosage to improve risk biomarkers of patients with T2DM and MetS is 30-35 ml daily of sesame oil or inclusion of sesame oil in daily dietary patterns up to 30% of total energy for 8-12 weeks and/or 200 mg daily of sesamin supplementation for eight weeks.

Deucravacitinib and psoriasis: a sigh of relief

Introduction and pathophysiology Psoriasis is a chronic inflammatory skin condition linked to numerous other medical disorders, such as cardiometabolic syndrome, depression, and psoriatic arthritis1. Around 125 million individuals on the planet are affected by psoriasis. Genetic factors mostly cause psoriasis, while environmental variables can aggravate the condition2. Moderate-to-severe psoriasis is present in ~25% of affected patients3. Greater than 80% of cases of psoriasis fall within the most frequent subtype, plaque psoriasis. Erythematous scaly plaques, which typically develop on extensor surfaces like the knees and the elbows are the hallmark of this subtype. Gluteal fold, intertriginous areas, soles, palms, and nails may also be impacted. Furthermore, impacted regions are typically clearly defined and frequently symmetrical. A feed-forward mechanism of inflammation, notably the type 17 T-helper cell (TH17) pathway, leads to the development of plaque psoriasis2. Patients with more severe cases of psoriasis experience a stronger psychological impact as a result of the disease. Up to 20% of psoriasis sufferers are more prone to experience depression and have suicidal thoughts that progress to actual suicide4. Treatment options for psoriasis Primary treatment options for psoriasis include phototherapy and topical and systemic treatments which can be utilized singly or in combination. Phototherapy is initiated when the disease is extensive and resistant to other therapies. Two types of phototherapies are used: psoralen combined with ultraviolet A irradiation (PUVA) and UVB irradiation. However, they cost expensive and proper facilities are required. Despite toxicity-reducing strategies such as combination therapy, some individuals experience major adverse effects from traditional psoriasis medicines5. A phosphodiesterase 4 (PDE-4) inhibitor, Apremilast was approved by the Food and Drug Administration (FDA) in 2014 to treat plaque psoriasis6. Inhibition of PDE4 raises intracellular cyclic adenosine monophosphate (cAMP) concentrations. However, Apremilast’s precise therapeutic activity in people with psoriatic arthritis and psoriasis is not fully understood, nor are the mechanisms through which it works7. Apremilast over 16 weeks demonstrated a clinically significant improvement in patients suffering from plaque psoriasis, as determined by the PASI score, according to ESTEEM 1 and ESTEEM 2, two clinical trials8,9. Apremilast was the only oral drug available for plaque psoriasis until now. On September 9, 2022—FDA approved deucravacitinib, as a new and better oral treatment option for adults suffering from moderate to severe plaque psoriasis10,11. Sotyktu (deucravacitinib) Deucravacitinib is a tyrosine kinase 2 (TYK2) inhibitor that is selective and allosteric. It inhibits TYK2 by preferentially attaching to the pseudo kinase or unique regulatory domain instead of the enzyme’s active catalytic site12. The drug’s approval came after encouraging findings from the 2 clinical trials—POETYK PSO-1 and PSO-2, which found that Apremilast and placebo were less effective than deucravacitinib in treating 1684 adult patients with plaque psoriasis. In patients using deucravacitinib, oral ulcers, a rise in blood creatine phosphokinase, upper respiratory infections, pimples, and folliculitis were the most common side effects by the end of week 16 of these clinical studies. Deucravacitinib resulted in a rapid response and consistent trends in enhancements in many efficacy measurements as well as quality of life for those who have moderate to severe plaque psoriasis13. However, as per the manufacturer, Bristol Myers Squibb, combining Sotyktu (deucravacitinib) with other strong immunosuppressants is not advised. Conclusion For patients with psoriasis plaque who are not satisfied with conventional and topical therapies, the approval of deucravacitinib marks an exciting day, as it is the first oral medication authorized after a long time for plaque psoriasis. Given its track record of assisting patients in achieving smoother skin, as shown in the POETYK PSO clinical study, the drug deucravacitinib can change how psoriasis is managed and treated in a better way. Although the drug is contraindicated in pregnancy, information regarding the drug’s presence in human milk is lacking. Further research is required to comprehend better results in lactating women and widen the range as the drug has limitations in severe hepatic impairment10. Ethical approval Not applicable. Source of funding None. Author contributions MS.M. and F.A.: conceptualization. M.S.M., M.M.N.U., and S.T.A.: conducted the literature and drafting of the manuscript. M.A.S.: performed editing and supervision. All authors have read and agreed to the final version of the manuscript. Conflict of interest disclosure The authors declare that they have no financial conflict of interest with regard to the content of this report. Research registration unique identifying number (UIN) Not applicable. Guarantor All authors take responsibility for the work, access to data and decision to publish.

Abstract P586: Patients With Heart Failure and Chronic Kidney Disease Affected by Pulmonary Hypertension Have Greater Risk of Mortality and Worse Clinical Outcomes

Background: Heart failure (HF) and chronic kidney disease (CKD) are increasingly prevalent diseases worldwide. Pulmonary hypertension (PH) is a known predictor of adverse outcomes. Nevertheless, there is limited scientific evidence of clinical outcomes of PH in patients with HF and CKD. Therefore, we sought to investigate this population. Methods: We queried NIS between 2016-2019 for adult patients who were hospitalized with HF and CKD and were affected by PH. The primary outcome was inpatient mortality. The secondary outcomes were cardiogenic shock, cardiac arrest, acute kidney injury (AKI), invasive mechanical ventilation, length of stay (LOS) and total hospital charge. Multivariable logistic and Poisson regression analyses were used to estimate clinical outcomes. P-value &lt; 0.05 was significant. Results: There were 9,221,158 patients with HF and CKD, of which 85,985 (4.3%) had PH. PH and non-PH cohorts were with mean age of 73.3 vs. 72.3 yrs; males 46.8% vs 55.1%; Caucasians 62.5% vs 63.2%; systolic HF 42.2% vs 41.7%; obesity 26.1% vs 22.2%; dyslipidemia 56.1% both; anemia 25.3% vs 21.9%, DM 54.3% vs 58.5%; AF 53.4% vs 41.5%; history of MI 14.4% vs 16.3%; stroke 1.6% vs 2.3%; COPD 39.6% vs 33.1%, smokers 9% vs 11%, respectively. PH cohort had significantly higher mortality and worse clinical outcomes (Table 1). Conclusion: HF patients with CKD who had PH showed significantly worse clinical outcomes and higher resource utilization. They were older, females, with more frequent systolic HF, obesity, anemia, AF, COPD. PH may raise risk for systolic dysfunction, cardiometabolic syndrome and lung disease. Hence, early detection and treatment of PH may improve clinical outcomes when managing patients with HF and CKD. Future studies may provide better understanding of this high-risk population.

The syndromic triad of COVID-19, type 2 diabetes, and malnutrition.

The coronavirus disease 2019 (COVID-19) pandemic challenges our collective understanding of transmission, prevention, complications, and clinical management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Risk factors for severe infection, morbidity, and mortality are associated with age, environment, socioeconomic status, comorbidities, and interventional timing. Clinical investigations report an intriguing association of COVID-19 with diabetes mellitus and malnutrition but incompletely describe the triphasic relationship, its mechanistic pathways, and potential therapeutic approaches to address each malady and their underlying metabolic disorders. This narrative review highlights common chronic disease states that interact epidemiologically and mechanistically with the COVID-19 to create a syndromic phenotype-the COVID-Related Cardiometabolic Syndrome-linking cardiometabolic-based chronic disease drivers with pre-, acute, and chronic/post-COVID-19 disease stages. Since the association of nutritional disorders with COVID-19 and cardiometabolic risk factors is well established, a syndromic triad of COVID-19, type 2 diabetes, and malnutrition is hypothesized that can direct, inform, and optimize care. In this review, each of the three edges of this network is uniquely summarized, nutritional therapies discussed, and a structure for early preventive care proposed. Concerted efforts to identify malnutrition in patients with COVID-19 and elevated metabolic risks are needed and can be followed by improved dietary management while simultaneously addressing dysglycemia-based chronic disease and malnutrition-based chronic disease.

Role of Emerging Risk Markers in Cardiometabolic Syndrome

Cardiometabolic syndrome (CMS), also known as metabolic syndrome (MetS) is a common and silent epidemic, which is linked to type 2 diabetes mellitus, abdominal obesity, and a higher risk of cardiovascular disease. Comprehensive demographic, physiological, genetic, and clinical data were collected from 199 subjects suffering from varying degrees of Metabolic syndrome (MetS) and 100 healthy control subjects. Mutagen induced chromosome sensitivity analysis for DNA repair proficiency and the extent of somatic DNA damages by Cytokinesis-Block Micronuclei (CBMN) assay were also performed among the study subjects. The study found that individuals with CMS showed an elevated concentration of Lp-PLA2, MA and hsCRP. The study also showed an association between DNA damage and DNA repair among the test subjects. Microalbumin and Lp-PLA2 can be considered good markers for the early prediction of coronary artery disease (CAD) and several other cardiovascular diseases. In addition, the rising frequency of somatic DNA damage points to the varied degrees of MetS progression. Thus, novel biomarkers can identify patients who are at risk beyond traditional ones, thereby alleviating the possible CMS events and also other disorders related to CMS by following healthy lifestyle habits and proper medication.

Dietary Supplementation of Caulerpa racemosa Ameliorates Cardiometabolic Syndrome via Regulation of PRMT-1/DDAH/ADMA Pathway and Gut Microbiome in Mice

This study evaluated the effects of an aqueous extract of Caulerpa racemosa (AEC) on cardiometabolic syndrome markers, and the modulation of the gut microbiome in mice administered a cholesterol- and fat-enriched diet (CFED). Four groups of mice received different treatments: normal diet, CFED, and CFED added with AEC extract at 65 and 130 mg/kg body weight (BW). The effective concentration (EC50) values of AEC for 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), and lipase inhibition were lower than those of the controls in vitro. In the mice model, the administration of high-dose AEC showed improved lipid and blood glucose profiles and a reduction in endothelial dysfunction markers (PRMT-1 and ADMA). Furthermore, a correlation between specific gut microbiomes and biomarkers associated with cardiometabolic diseases was also observed. In vitro studies highlighted the antioxidant properties of AEC, while in vivo data demonstrated that AEC plays a role in the management of cardiometabolic syndrome via regulation of oxidative stress, inflammation, endothelial function (PRMT-1/DDAH/ADMA pathway), and gut microbiota.

Independent effect of cardiometabolic syndromes and depression on dementia in Parkinson's disease: A 12-year longitudinal follow-up study of a nationwide cohort.

We aimed to investigate the incidence rate of Parkinson's disease dementia (PDD) according to age and disease duration by sex. Furthermore, we explored the effect of each cardiometabolic syndrome and depression on the incidence of PDD. Using data from the Korean National Health Insurance Service, 79,622 patients with de novo Parkinson's disease (PD) aged ≥40 years between January 2002 and December 2010 were followed to December 2019. We analyzed the incidence of PDD according to age at PD diagnosis and disease duration. To determine cardiometabolic syndromes and depression that affected PDD, we used Fine and Gray competing regression after controlling for age and sex. During the 12.5-year follow-up period, the incidence of PDD increased with age at PD diagnosis (0.81-45.31 per 1000 person-years among those aged 40-44 and over 80 years, respectively) and longer disease duration (22.68 per 1000 person-years in 1-2 years to 34.16 per 1000 person-years in 15-16 years). Hypertension (subdistribution hazard ratio [SHR]=1.11; 95% confidence interval [CI] 1.07-1.16), diabetes (SHR=1.09; 95% CI 1.05-1.14), dyslipidemia (SHR=1.15; 95% CI 1.11-1.20), and depression (SHR=1.36; 95% CI 1.30-1.41) independently increased the risk for PDD. Our findings provide insights into cardiometabolic syndromes as modifiable risk factors for incident PDD. Furthermore, our results will help in designing public health policies with respect to controlling cardiometabolic syndromes and depression to prevent incident PDD in patients with PD.

The methanol extract of Ceiba pentandra reverses monosodium glutamate-induced cardiometabolic syndrome in rats via the regulation of dyslipidemia, inflammation, oxidative stress, and insulin sensitization

The antidiabetic effects of the methanol extract of the stem bark of Ceiba pentandra (Cp) have been demonstrated in various experimental models. Besides, this extract is rich in 8-formyl-7-hydroxy-5-isopropyl-2-methoxy-3-methyl-1,4-naphthaquinone, 2,4,6-Trimethoxyphenol and vavain. However, it remains unknown whether Cp can mitigate cardiometabolic syndrome (CMS). The present study assessed the curative properties of Cp against Monosodium Glutamate (MSG)-induced CMS in rats. Male neonate Wistar rats were intraperitoneally administered with MSG (4 mg/g/day) during the first 5 days of life (postnatal days 2–6). They were kept under standard breeding conditions up to 5 months of age for the development of CMS. Diseased animals were then orally treated with atorvastatin (80 mg/kg/d) or Cp (75 and 150 mg/kg/day) for 28 days during which food intake, body mass, blood pressure, heart rate, glucose, and insulin tolerance were monitored. Plasma and tissues were collected on day 29th to assess the lipid profile, oxidative stress, and inflammatory parameters. The histomorphology of the adipose tissue was also evaluated. Cp significantly (p < 0.001) reduced the obesogenic and lipid profiles, adipocyte size, blood pressure, and oxidative and inflammatory status in MSG-treated rats. Cp also ameliorated glucose (p < 0.05) and insulin sensitivities (p < 0.001) hence, reducing animals' cardiometabolic risk score (p < 0.001). The curative effect of Cp on cardiometabolic syndrome is related to its capacity to reduce oxidative stress, inflammation, dyslipidemia, and increase insulin sensitivity. These results demonstrate the potential of Cp as a good candidate for alternative treatment of CMS.

Abstract WP144: Inflammation After Intracerebral Hemorrhage Is Locally Mediated

Introduction: Secondary injury due to neuroinflammation poses a target in ICH research. We have demonstrated elevated serum IL-12 levels in rodents with cardiometabolic syndrome with hypertension compared with normotensive rodents. As hypertension is a risk factor in ICH, it is critical to understand whether there are also local cerebral changes in pro-inflammatory cytokines to explore targets for therapeutics. Methods: A pilot study of autologous-injection ICH was induced in (mREN2)27 (n=7) and control Hanover Sprague-Dawley (SD) (n=7) rats. Animals underwent tail-cuff blood pressure measurement, pre- and post-ICH neurobehavioral testing, and serum cytokine measurements. Sacrifice with brain harvest was performed at 24h and 7h post-ICH. Homogenization of the brain with quantitative measurement of hemoglobin and IL-12 concentrations was performed. Results: IL-12 peaked in the ipsilateral hemisphere in both SD and mREN rats at 24h post-ICH. There was a significant difference in local IL-12 levels between the ipsilateral and contralateral hemispheres at 72h, with minimal IL-12 elevation in the contralateral hemisphere (p=0.05) (Figure 1). Additionally, there was high correlation between hematoma size and IL-12 local expression. While there was no difference in cerebral IL-12 levels between strains, there was a significant elevation in baseline IL-12 serum levels in mREN compared to SD rats, and a trend towards serum elevation at 72h post-ICH. Conclusions: Cerebral IL-12 levels ipsilateral to ICH are significantly elevated compared to contralateral levels and peak 24h post-ICH. While serum IL-12 levels are elevated in rats with cardiometabolic syndrome, this is not seen in brain tissue following ICH. With the high correlation between hematoma size and IL-12 expression, these findings implicate macrophage recruitment from the hematoma as a driver of neuroinflammation and potential therapeutic target to augment surgical interventions for ICH.

A comprehensive cardiometabolic risk score estimation method in rodents

Cardiometabolic diseases are among the main leading causes of morbidity and mortality over the world. The coexistence of a bundle of metabolic risk factors in an individual has prompted Reaven to consider it as a syndrome, called “X syndrome”. The term has later evolved and the health condition is today called “cardiometabolics syndrome” (CMS). Significant progress in the understanding of the pathophysiology of the CMS has been made during the past years. Being able to adequately assess cardiometabolic risk (CMR) is crucial for proper diagnosis, prevention, and better management of CMS, as this could be helpful to slow down its progression and complications. This could also be useful in the preclinical and clinical evaluation of potential treatment strategies. Several methods have been developed to assess the risk of developing cardiometabolic diseases in chronic and clinical setting. However, these methods show limitations when applying to short and experimental settings involving rodents. Therefore, this commentary aims at redefining and highlighting the main risk factors to be reconsidered in cardiometabolic syndrome definition; and proposing a comprehensive estimation method for the evaluation of the CMR in rodents. This is relevant for an appropriate utilization of the term CMS and a deep evaluation of therapeutic targets in experimental settings.

The Paleolithic Diet.

The promotion of healthy diets is likely one of the most cost-effective strategies for preventing a wide range of disorders, including cardiovascular disease, obesity, hypertension, and type 2 diabetes. The majority of present non-communicable chronic diseases are attributed to civilization, an abundance of food, and a lack of physical activity. According to the purported lifestyles of early humans, the paleolithic diet (PD) encourages the intake of wild animal and plant foods. In recent decades, the paleolithic diet has grown in popularity, particularly among younger populations and those with cardiometabolic syndrome and other chronic diseases. Due to the nutrition profile of the paleolithic diet, historical studies have postulated that hunter-gatherers (HGs) have slender physiques and were physically fit and devoid of chronic ailments such as cardiovascular diseases (CVDs). This review highlights the composition/constituentof the paleolithic diet along with an emphasis on current studies and evidence on the effectiveness of the paleolithic diet in mitigating chronic diseases.

Neck circumference and cardiometabolic syndrome in adult patients at a tertiary hospital in Lagos, Nigeria: A cross-sectional study

Neck circumference and cardiometabolic syndrome in adult patients at a tertiary hospital in Lagos, Nigeria: A cross-sectional study

JS-HR-8: PROGRESS OF OBESITY/DIABETES IN AREA OF HYPERTENSION RESEARCH 2021

Obesity/diabetes is a major comorbidity in people with hypertension, and they often share the common pathological backgrounds, such as insulin resistance and vascular failure, and the risk of cardiovascular disease (CVD). Thus, obesity/diabetes is an essential culprit to hamper cardiometabolic health. One of the biggest highlights of recent years in the area or obesity/diabetes has been the remarkable benefits of newer glucose-lowering agents seen in the large-scale clinical trials on cardiorenal outcomes, followed by the relevant clinical guidelines update and the expansion of the clinical application of those agents. In addition, such agents with evidence proved to have common and incidental actions, such as body weight loss and blood pressure reduction, potentially contributing to the better management of risk factors. These evidence and insights have led to new trends in our clinical practice for obesity/diabetes and cardiometabolic syndrome. In this talk, we would like to introduce the progress of obesity/diabetes in area of Hypertension Research 2021 and their clinical perspectives.

Cardiometabolic syndrome in HIV-positive and HIV-negative patients at Zewditu Memorial Hospital, Addis Ababa, Ethiopia: a comparative cohort study.

A comparative cohort study was designed. The National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF) tools were used to determine the outcome variables. Association studies were done using logistic regression. CMetS was found to have a greater point and period prevalence, and incidence estimation in HIV-negative than HIV+ patients using both the NCEP and the IDF tools. Using the NCEP tool, the risk of obesity was 44.1% [odds ratio (OR) = 0.559, 95% confidence interval (CI), (0.380-0.824); P = 0.003] lower in HIV+ than in HIV-negative participants. By contrast, no apparent difference was noted using the IDF tool. Similarly, hyperglycemia [OR = 0.651, 95% CI (0.457-0.926); P = 0.017], and hypertension [OR = 0.391, 95% CI (0.271-0.563); P < 0.001] were shown to be lower in HIV+ patients than HIV-negative patients by 34.9% and 60.9%, respectively. The study revealed significant variation in all biomarkers across the follow-up period in both HIV+ and HIV-negative participants, except for SBP. CMetS caused more overall disruption in HIV-negative people with chronic diseases than in HIV-positive people. All of the indicators used to assess the increased risk of CMetS were equally meaningful in HIV+ and HIV-negative subjects.

Multi-Bioactivity of Protein Digests and Peptides from Oat (Avena sativa L.) Kernels in the Prevention of the Cardiometabolic Syndrome.

The aim of this study was to characterize the digests and peptides derived from oat kernel proteins in terms of their major enzyme inhibitory activities related to the prevention of cardiometabolic syndrome. It also entailed the characteristics of antioxidant bioactivity of the analyzed material. The study was carried out using coupled in silico and in vitro methods. The additional goal was to investigate whether identified peptides can pervade Caco-2 cells. Based on the results of bioinformatic analysis, it was found that the selected oat proteins may be a potential source of 107 peptides with DPP-IV and/or ACE inhibitory and/or antioxidant activity. The duodenal digest of oat kernels revealed multiple activities. It inhibited the activities of the following enzymes: DPP-IV (IC50 = 0.51 vs. 10.82 mg/mL of the intact protein), α-glucosidase (IC50 = 1.55 vs. 25.20 mg/mL), and ACE (IC50 = 0.82 vs. 34.52 mg/mL). The DPPH• scavenging activity was 35.7% vs. 7.93% that of the intact protein. After in silico digestion of oat proteins, 24 peptides were selected for identification using LC-Q-TOF-MS/MS. Among them, 13 sequences were successfully identified. One of them, i.e., VW peptide, exhibited triple activities, i.e., DPP-IV and ACE inhibitory and DPPH• scavenging activity. The multifunctional peptides: PW, TF, VF, and VW, were identified in the basolateral samples after transport experiments. Both in silico and in vitro analyses demonstrated that oat kernel proteins were the abundant sources of bioactive digests and peptides to be used in a diet for patients suffering from cardiometabolic syndrome.

Temporary postoperative myocardial injury and long-term survival in liver transplant patients with coronary artery disease

Coronary artery disease (CAD) is increasing worldwide due to the aging population and cardiometabolic syndrome. However, the extent of postoperative myocardial injury, the most common cause of death during the 30 days after noncardiac surgery, remains unclear with respect to liver transplant (LT) patients with CAD. We examined the link between post-LT high sensitivity cardiac troponin I (hs_cTnI) and long-term survival according to liver disease severity. Consecutive patients who underwent LT (n = 3,220) from 2010 to 2020 were evaluated retrospectively. CAD was defined as a history of coronary artery bypass surgery or percutaneous intervention, or previous myocardial infarction. Peak hs_cTnI levels within 30 days post-transplant were compared in patients with and without CAD. The primary endpoint was defined as an all-cause mortality at 12 years following LT. Secondary endpoints include peak hs_cTnI level within post-transplant 30 days and 30-day mortality. Survival analysis was performed using the Kaplan-Meier method. CAD patients (n = 264, 8.2%) had higher peak hs_cTnI levels within 30 days post-LT than those without CAD (median [interquartile]: 0.068 [0.030-0.154] vs. 0.087 [0.037-0.203] ng/ml, respectively; P = 0.004); however, the mortality rate was comparable (14.7% vs. 14.8%, respectively, P = 0.999), at 12 years, and 1.9% vs. 1.1% (P = 0.522) at 30 days, respectively, at 30 days. Subgroup analysis with stratified liver disease severity identified a similar risk of long-term mortality. Although the peak hs_cTnI level within 30 days was higher in revascularized or treated CAD patients after LT compared those without CAD, long-term mortality rates at 12 years and 30-day mortality rate were comparable.