Cardiovascular Disease In Men Research Articles

Annals Video Summary - Associations of Testosterone and Related Hormones With All-Cause and Cardiovascular Mortality and Incident Cardiovascular Disease in Men.

Annals Video Summary - Associations of Testosterone and Related Hormones With All-Cause and Cardiovascular Mortality and Incident Cardiovascular Disease in Men.

Associations of Testosterone and Related Hormones With All-Cause and Cardiovascular Mortality and Incident Cardiovascular Disease in Men : Individual Participant Data Meta-analyses.

Whether circulating sex hormones modulate mortality and cardiovascular disease (CVD) risk in aging men is controversial. To clarify associations of sex hormones with these outcomes. Systematic literature review to July 2019, with bridge searches to March 2024. Prospective cohort studies of community-dwelling men with sex steroids measured using mass spectrometry and at least 5 years of follow-up. Independent variables were testosterone, sex hormone-binding globulin (SHBG), luteinizing hormone (LH), dihydrotestosterone (DHT), and estradiol concentrations. Primary outcomes were all-cause mortality, CVD death, and incident CVD events. Covariates included age, body mass index, marital status, alcohol consumption, smoking, physical activity, hypertension, diabetes, creatinine concentration, ratio of total to high-density lipoprotein cholesterol, and lipid medication use. Nine studies provided individual participant data (IPD) (255 830 participant-years). Eleven studies provided summary estimates (n = 24 109). Two-stage random-effects IPD meta-analyses found that men with baseline testosterone concentrations below 7.4 nmol/L (<213 ng/dL), LH concentrations above 10 IU/L, or estradiol concentrations below 5.1 pmol/L had higher all-cause mortality, and those with testosterone concentrations below 5.3 nmol/L (<153 ng/dL) had higher CVD mortality risk. Lower SHBG concentration was associated with lower all-cause mortality (median for quintile 1 [Q1] vs. Q5, 20.6 vs. 68.3 nmol/L; adjusted hazard ratio [HR], 0.85 [95% CI, 0.77 to 0.95]) and lower CVD mortality (adjusted HR, 0.81 [CI, 0.65 to 1.00]). Men with lower baseline DHT concentrations had higher risk for all-cause mortality (median for Q1 vs. Q5, 0.69 vs. 2.45 nmol/L; adjusted HR, 1.19 [CI, 1.08 to 1.30]) and CVD mortality (adjusted HR, 1.29 [CI, 1.03 to 1.61]), and risk also increased with DHT concentrations above 2.45 nmol/L. Men with DHT concentrations below 0.59 nmol/L had increased risk for incident CVD events. Observational study design, heterogeneity among studies, and imputation of missing data. Men with low testosterone, high LH, or very low estradiol concentrations had increased all-cause mortality. SHBG concentration was positively associated and DHT concentration was nonlinearly associated with all-cause and CVD mortality. Medical Research Future Fund, Government of Western Australia, and Lawley Pharmaceuticals. (PROSPERO: CRD42019139668).

Research on the health state of the Sicilian population living in areas at environmental or natural risk: the experience of the Regional Department of Epidemiology

Background: In Sicily, people live near areas characterized by the presence of environmental polluting substances derived from urbanization and industrialization. In the areas of Augusta-Priolo (SR),Gela (CL) and Milazzo (ME), the increase of number of pathologies could be linked with environmental pollution. The aim of this paper is to present an overview of the available data and studies to underline the importance of these sources to conduct epidemiological survey in Sicily, besides to the analysis of mortality and morbidity. Methods: An evaluation of the health status of the residential population was done comparing the mortality and morbidity of the local population with the mortality and morbidity of a reference population. Data was obtained from the Italian national office of statistics and Hospital Discharge Records. Standardized Mortality Ratios and Standardized Hospitalization Ratios were calculated. Results: In the area of Augusta-Priolo we observed, in for men, a significative increase in mortality and hospital admissions for colon-rectal, trachea, bronchus, lung and pleura cancers. In Biancavilla, we observed an increase in mortality for pleura cancer in men and women and an increase in morbidity in women only. In Gela, a significant increase in mortality in males and females was observed only for tumoral diseases. In Milazzo, we only found a significant increase in the incidence of larynx cancer and cardiovascular disease for men and in women of pulmonary disease for women. Conclusions: This first review allowed us to update previous analyses of mortality data conducted in the same areas. The results, even taking into account the differences between the areas,, highlights changes in health status related to some diagnostic groups. These could be linked with pollution. Now that the available health data has been revised and updated new studies must be conducted.

Association of cardiovascular disease prevalence with BMD and fracture in men with T2DM.

Patients with type 2 diabetes mellitus (T2DM) are predisposed to cardiovascular disease (CVD). Bone mineral density (BMD) is linked to CVD, but most studies focused on women. Our analysis aims to explore the association of BMD and fracture with the prevalence of CVD in men with T2DM. In this retrospective cross-sectional study, 856 men with T2DM were enrolled. BMDs at the lumbar spine (L2-4), femoral neck (FN), and total hip (TH) were measured by dual-energy X-ray absorptiometry (DXA). The CVD outcome was determined as the sum of the following conditions: congestive heart failure, coronary heart disease, angina pectoris, myocardial infarction, the requirement for coronary artery revascularization, and stroke. The relationship between BMDs and CVD was investigated by restricted cubic spline curves and logistic regression models. A total of 163 (19.0%) patients developed CVD. The restricted cubic spline curve revealed a linear and negative association between FN-BMD, TH-BMD, and CVD. After full adjustments for confounding covariates, the odds ratios were 1.34 (95% confidence interval [CI] [1.11-1.61], p < .05), 1.3 (95% CI [1.05-1.60], p < .05), and 1.26 (95% CI [1.02-1.55], p < .05) for each 1-SD decrease in BMDs of L2-4, FN and TH, respectively. T-scores of < -1 for BMD of L2-4 and FN were independently associated with CVD (p < .05). Subgroup analyses further supported our findings. The prevalence of CVD was inversely correlated with BMD levels in men with T2DM, particularly at the FN. We hypothesized that monitoring FN-BMD and early intervention would help reduce CVD risk in men with T2DM, especially those with hypertension.

Prediction of cardiovascular disease risk by serum zinc and copper concentrations and anthropometric measurements

IntroductionWe aimed to investigate the association between cardiovascular disease (CVD) and various anthropometric indices, as well as the serum levels of copper (Cu) and zinc (Zn), copper-zinc ratio (Cu/Zn ratio) and zinc-copper ratio (Zn/Cu ratio), in a large population sample from northeastern Iranian. Method9704 individuals aged 35 to 65 were enrolled in the first phase of the study. After a 10-year follow-up, 7560 participants were enrolled into the second phase. The variables used in this study included demographic characteristics, such as gender and age; biochemical parameters including: serum Zn, Cu, Cu/Zn ratio, and Zn/Cu ratio; anthropometric parameters including: waist circumference (WC), body mass index (BMI), and waist-to-hip ratio (WHR). The relationship between the aforementioned indices and CVD was examined using decision tree (DT) and logistic regression (LR) models. ResultsA total of 837 individuals were diagnosed with CVD among the 7560 participants. LR analysis showed that BMI, age, WH zinc-copper ratio (Zn/Cu ratio), and serum Zn/Cu ratio were significantly associated the development of CVD in men, and WHR, age, BMI, serum Cu, and Cu/Zn ratio in women. DT analysis showed that, age was the most important predictor of CVD in both genders. 71% of women, older than 49 years, with a WHR≥ 0.89, serum Cu< 75 (µg/dl), BMI≥ 22.93 (kg/m2), and serum Cu≥ 14 (µg/dl), had the highest risk of CVD. In men, among those who were ≥ 53 years, with a WHR≥ 0.98, serum Zn/Cu ratio< 1.69, and BMI≥ 22.30, had the highest risk of CVD. ConclusionAmong Iranian adult population, BMI, age, and WHR were one of the predictors of CVD for both genders. The Zn/Cu ratio was CVD predictor for men while Cu/Zn ratio was CVD predictor for women.

EGG CONSUMPTION AND INCIDENT CARDIOVASCULAR DISEASE: VARIATION BY DIETARY PATTERN

Abstract Some studies link egg consumption with cardiovascular disease, but none considers modification by dietary pattern. This study examines effects of egg consumption on incident cardiovascular disease (CVD), and variations of associations within the context of dietary pattern. Participants were 4,930 men and women from the Rancho Bernardo Study without prevalent CVD in 1972-74, who were followed through 2021 via mailed surveys, follow-up visits, and death certificates. Dietary data from 1988-91 enabled calculation of the alternate Mediterranean diet (aMed) score for 1632 individuals. Comparisons showed those with incident CVD (N=2066, 49.1%)were older (p&amp;lt; 0.001), had higher BMI (p=0.004), cholesterol, triglycerides, systolic and diastolic blood pressures (p’s&amp;lt; 0.001) than those without incident CVD, but did not differ in egg consumption. Those consuming more eggs/week were older (p&amp;lt; 0.001) and had higher BMI (p=0.002). Men consumed more eggs/week than women (means=4.2 vs. 3.2, p&amp;lt; 0.001). Adjusted Cox proportional hazards models showed there were no significant associations of egg consumption with incident CVD in men or women (HR=1.00, 95%CI=0.98-1.02; HR=1.01, 95%CI=0.99-1.03, respectively). However,analyses by dietary patterns showed that in men, but not women, increased egg consumption was associated with a 7% reduced risk of incident CVD (HR=0.93; 95%CI=0.88-0.98) among those with high aMed scores, but a 6% increased risk (HR=1.06; 95%CI=1.01-1.11) among those with low aMed scores. In conclusion, for men, dietary pattern modified associations such that among those with a healthier dietary pattern, egg intake was associated with lower incident CVD. For women, egg intake was unassociated with incident CVD regardless of dietary pattern.

Mendelian randomization identifies sex differences in pain manifestation of coronary artery disease

Abstract Background and aim Clinical manifestation of atherogenic cardiovascular disease differs between men and women. Men often present with classical symptoms i.e., chest pain radiating to left arm and jaw. Women may show a wide range of symptoms considered atypical, including but not limited to back pain and nausea. Anatomical pathways feeding cardiac pain have not been properly characterized with respect to sex-related differences in human at population level. Methods We performed sex-stratified GWAS analysis on CAD as well as chest, neck and shoulder, back and facial pain using the UK Biobank cohort (men N = 203,823; women N = 239,631). To unravel given differences in pain manifestation of atherogenic cardiovascular disease in men and women, we performed Mendelian Randomization to approximate the causal associations between coronary artery disease (CAD) and a variety of pain locations. Results We identified 32 and 19 independent instrumental variables (R2&amp;lt; 0.001, p-value 5x10-6) associated with CAD for men and women, respectively. MR analysis revealed potential causality between CAD and self-reported chest pain for men (OR: 1.33, CI: 1.25 – 1.41) and women (OR: 1.44, CI: 1.20 – 1.73) as well as a link between CAD and clinical chest pain for both sexes (men OR: 1.22, CI: 1.17 — 1.26; women OR: 1.31, CI: 1.18 — 1.46). MR displayed a relationship between CAD and back pain in women (OR: 1.35, CI: 1.03 — 1.66) but not in men (OR: 0.99, CI: 0.90 — 1.11, p-value difference: 0.036). Manifestation of neck and shoulder pain revealed a suggestive difference in causality between men and women (p-value difference: 0.051). Discussion Our study provided evidence supporting a causal association between CAD with manifestation of chest pain in both men and women. Additionally, no stronger effect in men was found contrary to clinical observations suggesting pain perception of the chest at population level could be similar between the sexes. Manifestation of back pain with CAD, however, showed a more causal effect in women compared to men. Here we show that pain perception of the heart is not limited to the chest in women at population level. Future research is required to identify what drives these differences at multiple levels.

Impaired artery elasticity predicts cardiovascular morbidity and mortality- A longitudinal study in the Vara-Skövde Cohort

It is still debated whether arterial elasticity provides prognostic information for cardiovascular risk beyond blood pressure measurements in a healthy population. To investigate the association between arterial elasticity obtained by radial artery pulse wave analysis and risk for cardiovascular diseases (CVD) in men and women. In 2002–2005, 2362 individuals (men=1186, 50.2%) not taking antihypertensive medication were included. C2 (small artery elasticity) was measured using the HDI/Pulse Wave CR2000. Data on acute myocardial infarction or stroke, fatal or non-fatal, was obtained between 2002–2019. Cox- regression was used to investigate associations between C2 and future CVD, adjusting for confounding factors such as age, sex, systolic blood pressure, heart rate, HOMA-IR (Homeostatic Model Assessment for Insulin Resistance), LDL- cholesterol, CRP (C-Reactive Protein), alcohol consumption, smoking and physical activity. At baseline, the mean age of 46 ± 10.6 years and over the follow-up period, we observed 108 events 70 events in men [event rate: 5.9%], 38 in women [event rate: 3.2%]. In the fully adjusted model, and for each quartile decrease in C2, there was a significant increase in the risk for incident CVD by 36%. (HR = 1.36, 95% CI: 1.01–1.82, p = 0.041). The results were accentuated for all men (HR = 1.74, 95% CI: 1.21–2.50, p = 0.003) and women over the age of 50 years (HR = 1.70, 95% CI: 0.69–4.20). We showed a strong and independent association between C2 and CVD in men. In women after menopause, similar tendencies and effect sizes were observed.

Serum Uric Acid and Clinical Cardiovascular Diseases in Men and Women: A Perspective for the Drug Target and the Effect of Sex.

Serum Uric Acid and Clinical Cardiovascular Diseases in Men and Women: A Perspective for the Drug Target and the Effect of Sex.

Sex-specific associations of γ-glutamyltransferase to HDL-cholesterol ratio and the incident risk of cardiovascular disease: three Korean longitudinal cohorts from different regions.

The combination of gamma-glutamyl transferase (GGT) and high-density lipoprotein cholesterol (HDL-C) (GGT/HDL-C) is a novel noninsulin-based marker for assessing the risk of nonalcoholic fatty liver disease and type 2 diabetes mellitus. However, whether the GGT/HDL-C ratio is related to the risk of incident cardiovascular disease (CVD) risk is not well known. Therefore, we aimed to investigate the longitudinal effect of GGT/HDL-C ratio on incident CVD risk in three large cohorts of Korean men and women. Data were assessed from 27,643 participants without CVD from the Korean Genome and Epidemiology Study (KoGES), Health Risk Assessment Study (HERAS), and Korea Health Insurance Review and Assessment (HIRA) (HERAS-HIRA) datasets. The participants were divided into four groups according to the GGT/HDL-C quartiles. We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for CVD using multivariate Cox proportional-hazard regression models over a 50-month period following the baseline survey. During the follow-up period, 949 patients (3.4%; 529 men and 420 women) developed CVD. The HRs of CVD for GGT/HDL-C quartiles 2-4 were 1.36 (95% CI, 0.91-2.02), 1.54 (95% CI, 1.05-2.26), and 1.66 (95% CI, 1.12-2.47) after adjusting for metabolic parameters in women, but GGT/HDL-C did not show a trend toward increases in incident CVD in men. Regional discrepancies were evident in the results; the increase in HR in the metropolitan hospital cohort was more pronounced than that in the urban cohort, and the risk was not increased in the rural cohort. GGT/HDL-C ratio may be a useful predictive marker for CVD in women. Furthermore, the prevalence of CVD was strongly correlated with the GGT/HDL-C ratio in metropolitan areas, and this correlation was more significant than that observed with GGT or HDL-C in isolation.

A study on knowledge, awareness, and practice of familial hypercholesterolemia among doctors at two tertiary care hospitals in Sri Lanka

Introduction: Familial Hypercholesterolemia (FH) is an inherited disorder affecting low-density lipoprotein cholesterol (LDL-C) metabolism. Individuals with FH have a substantially increased risk of cardiovascular disease (CVD). South Asia is burdened by premature CVD. Early detection and management of FH can reduce the burden of CVD. Despite growing awareness, FH remains underdiagnosed and therefore untreated, and assessing the present level of knowledge among doctors would help to implement educational activities.Methods: Doctors from two large teaching hospitals in Sri Lanka were requested to complete a survey questionnaire comprising questions on awareness, clinical features, prevalence, inheritance, and treatment of FH.Results: Of the 269 doctors surveyed, 168 (66.42%) of them correctly described FH and only 44 (16.66.%) knew about its global prevalence. 12 (4.55%) were aware of the risk of CVD associated with FH. Only 01 (0.75%) and 02 (1.5%) correctly identified the age threshold for premature CVD in men and women, respectively. 228 (87.36%) and 136 (54.84%) identified statins as monotherapy and statin and ezetimibe as combination therapy for FH, respectively. Furthermore, in practice 117 (44.66%) routinely screened family members for FH, and only half the doctors correctly identified the transmission rate to first-degree relatives (38.78%).Conclusion: Substantial defects in the knowledge of FH were seen among doctors. Immediate steps have to be taken to increase awareness and knowledge about FH in doctors practicing in Sri Lanka.

Adherence to healthy diet and risk of cardiovascular disease in adult survivors of childhood cancer in the St. Jude Lifetime Cohort: a cross-sectional study

BackgroundWhether diet has beneficial effects on cardiovascular disease (CVD) in childhood cancer survivors as in the general population is unknown. Therefore, we examined associations between dietary patterns and risk of CVD in adult survivors of childhood cancer.MethodsChildhood cancer survivors, 18–65 years old in the St Jude Lifetime Cohort (1882 men and 1634 women) were included in the analysis. Dietary patterns were defined by the adherence to the Healthy Eating Index (HEI)–2015, Dietary Approaches to Stop Hypertension (DASH), and alternate Mediterranean diet (aMED) based on a food frequency questionnaire at study entry. CVD cases (323 in men and 213 in women) were defined as participants with at least one grade 2 or higher CVD-related diagnosis at baseline. Multivariable logistic regression adjusted for confounders was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of CVD.ResultsGreater adherence to HEI-2015 (OR=0.88, 95% CI: 0.75–1.03, per 10 score increment), DASH (OR=0.85, 95% CI: 0.71–1.01, per 10 score increment), and aMED (OR=0.92, 95% CI: 0.84–1.00, each score increment) were, albeit trending towards significance, associated with a lower risk of CVD in women. HEI-2015 was associated with a non-significantly lower risk of CVD in men (ORQ5 vs. Q1=0.80, 95% CI: 0.50–1.28). These dietary patterns were also associated with a lower risk of CVD in survivors with high underlying CVD risk.ConclusionsAs recommended to the general population, a diet rich in plant foods and moderate in animal foods needs to be a part of CVD management and prevention in childhood cancer survivors.

Global, regional, and national burden of cardiovascular diseases in youths and young adults aged 15–39 years in 204 countries/territories, 1990–2019: a systematic analysis of Global Burden of Disease Study 2019

BackgroundUnderstanding the temporal trends in the burden of overall and type-specific cardiovascular diseases (CVDs) in youths and young adults and its attributable risk factors is important for effective and targeted prevention strategies and measures. We aimed to provide a standardized and comprehensive estimation of the prevalence, incidence, disability-adjusted life years (DALY), and mortality rate of CVDs and its associated risk factors in youths and young adults aged 15–39 years at global, regional, and national levels.MethodsWe applied Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019 analytical tools to calculate the age-standardized incidence, prevalence, DALY, and mortality rate of overall and type-specific CVDs (i.e., rheumatic heart disease, ischemic heart disease, stroke, hypertensive heart disease, non-rheumatic valvular heart disease, cardiomyopathy and myocarditis, atrial fibrillation and flutter, aortic aneurysm, and endocarditis) among youths and young adults aged 15–39 years by age, sex, region, sociodemographic index and across 204 countries/territories from 1990 to 2019, and proportional DALY of CVDs attributable to associated risk factors.ResultsThe global age-standardized DALY (per 100,000 population) for CVDs in youths and young adults significantly decreased from 1257.51 (95% confidence interval 1257.03, 1257.99) in 1990 to 990.64 (990.28, 990.99) in 2019 with an average annual percent change (AAPC) of − 0.81% (− 1.04%, − 0.58%, P < 0.001), and the age-standardized mortality rate also significantly decreased from 19.83 (19.77, 19.89) to 15.12 (15.08, 15.16) with an AAPC of − 0.93% (− 1.21%, − 0.66%, P < 0.001). However, the global age-standardized incidence rate (per 100,000 population) moderately increased from 126.80 (126.65, 126.95) in 1990 to 129.85 (129.72, 129.98) in 2019 with an AAPC of 0.08% (0.00%, 0.16%, P = 0.040), and the age-standardized prevalence rate significantly increased from 1477.54 (1477.03, 1478.06) to 1645.32 (1644.86, 1645.78) with an AAPC of 0.38% (0.35%, 0.40%, P < 0.001). In terms of type-specific CVDs, the age-standardized incidence and prevalence rate in rheumatic heart disease, prevalence rate in ischemic heart disease, and incidence rate in endocarditis increased from 1990 to 2019 (all P < 0.001). When stratified by sociodemographic index (SDI), the countries/territories with low and low-middle SDI had a higher burden of CVDs than the countries/territories with high and high-middle SDI. Women had a higher prevalence rate of CVDs than men, whereas men had a higher DALY and mortality rate than women. High systolic blood pressure, high body mass index, and low-density lipoprotein cholesterol were the main attributable risk factors for DALY of CVDs for all included countries and territories. Household air pollution from solid fuels was an additional attributable risk factor for DALY of CVDs in low and low-middle SDI countries compared with middle, high-middle, and high SDI countries. Compared with women, DALY for CVDs in men was more likely to be affected by almost all risk factors, especially for smoking.ConclusionsThere is a substantial global burden of CVDs in youths and young adults in 2019. The burden of overall and type-specific CVDs varied by age, sex, SDI, region, and country. CVDs in young people are largely preventable, which deserve more attention in the targeted implementation of effective primary prevention strategies and expansion of young-people’s responsive healthcare systems.

Vitamin C for Offspring Pulmonary Protection from Maternal Smoking

Rigorously designed randomized controlled trials (RCTs) and meta-analysis of RCTs have failed to show a consistent efficacy for vitamin C supplementation in the intervention of common human diseases, including cardiovascular disorders, sepsis, diabetes, and cancer. It, however, has been becoming increasingly evident that vitamin C supplementation for pregnant smokers may be an effective modality for improving offspring airway function and pulmonary health. This Cutting-Edge Research Highlights article summarizes the latest clinical research development regarding vitamin C-mediated offspring pulmonary protection from maternal smoking. (First online: June 4, 2023) REFERENCES Sauberlich HE. Pharmacology of vitamin C. Annu Rev Nutr 1994; 14:371–91. doi: https://dx.doi.org/10.1146/annurev.nu.14.070194.002103 Young JI, Zuchner S, Wang G. Regulation of the epigenome by vitamin C. 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Ageing and Insulin: Inter Alia Diabetes, Obesity and Fitness Concerns

This article argues the essence of insulin sensitivity versus secretion including insulin resistance in the clinical strategy for the treatment, lifestyle changes, prompt interventions and control of diabetes. Progressive decline of glucose tolerance as advanced age occurs has been associated with the pathogenesis of type 2 diabetes due to peripheral insulin resistance and impaired β cell function. In elderly persons, insulin secretion is deranged concomitantly with decreased insulin clearance rate and augmented circulating proinsulin level that ostensibly explicates age-related hyperglycemia. Insulin is associated with numerous pathophysiological processes exhibited during brain function in learning and memory, as well as the regulation of ageing, metabolic syndrome, obesity, diabetes and cardiovascular diseases in Man. Elevated chronic peripheral insulin, decreased insulin action and brain insulin contents are pathognomonic of the insulin resistance syndrome. All these are associated through specific mechanisms in the pathophysiology of ageing and insulin in concert with risk factors and the concomitant complications. Ostensibly, progressive excess insulin induces synchronous elevated levels of oxidative stress and inflammatory impacts which exacerbate or are exacerbated by advancing age, culminating as inimical consequences to healthy lifestyles, longevity or extended lifespan. Therapeutics and other healthcare measures may be beneficial in order to prevent, mitigate or amend insulin aberrations in the elderly and during the ageing process. The mainstay in managing an elderly patient with perturbed insulin action, is control of therapeutic application, as it can reverse acute terminal states. Treatment necessitates stringent and thorough expertise, knowledge and skills for optimum provision and effective cerebral, cardiovascular and skeletal protection for a healthier lifespan and longevity. This article will be of immense contribution in the understanding of the prevention, control and treatment of insulin resistance, metabolic syndrome, diabetes, obesity, cardiovascular and neurological disorders during ageing.

Abstract TP202: Sex-specific Differences In Risk Profiles For Cancer Among 19702 Japanese Patients With Ischemic Stroke: The Biobank Japan Project

Background: There is limited data on sex-specific differences in subtypes and risk profiles of cancer among ischemic stroke patients. Methods: Among the subjects registered in the BioBank Japan database, 19702 ischemic stroke patients (n= 12241 male and n= 7261 female, median age 71 years old) were analyzed. We compared the prevalence of 20 cancer types between men and women. The multivariate logistic analysis was used to explore the association between risk factors and cancer by sex. Results: Any cancer was present in 1656 (8.4%) subsets of the overall cohort. The prevalence was highest for colorectal cancer (1.9%) followed by gastric cancer (1.6%), prostate cancer (1.2%), breast cancer (0.8%), and lung cancer (0.5%). Incidence was significantly higher in men than women for any (8.7% vs. 7.8%, P=0.029), colorectal (2.1% vs. 1.5%, P=0.003), gastric (2.0% vs. 1.0%, P&lt;0.001), lung (0.6% vs. 0.4%, P=0.013), bladder (0.7% vs. 0.2%, P&lt;0.001), pharyngeal/laryngeal (0.4% vs. 0.1%, P&lt;0.001), and kidney (0.4% vs. 0.1%, P&lt;0.001) cancer. By contrast, sex-specific cancer was more frequently observed in women than men (3.0% vs. 1.8%, P&lt;0.001). In men, older age (ORs 1.80, 95%CIs 1.67-1.94, P&lt;0.001], chronic renal failure (ORs 1.74, 95%CIs 1.24-2.46, P=0.002), atrial fibrillation or flutter (ORs 1.37, 95%CIs 1.07-1.76, P=0.014), and smoking (ORs 1.27, 95%CIs 1.09-1.48, P=0.002) were independently associated with cancer. In women, older age was the only independent factor associated with cancer (ORs 1.15, 95%CIs 1.05-1.25, P=0.002). Conclusion: Men have a higher prevalence of cancer including shared 6 anatomic sites, while sex-specific cancer was more common in women. Male predominance is largely explained by risk profiles including older age, chronic renal failure, atrial fibrillation or flutter, and smoking. These results indicate that cancer among stroke patients shares common risk factors for stroke or cardiovascular disease in men but not women.

Identifying associations between the social network index, its components, and the prevalence of cardiovascular diseases in Polish adults. Results of the cross-sectional WOBASZ II study.

Psychosocial risk factors are important determinants of cardiovascular diseases (CVDs): people involved in positive relationships live longer than those with low social support (SS). Our study aimed to evaluate the association between SS, components of the social network, and CVDs. A cross-sectional population-based survey WOBASZ II conducted in the years 2013-2014 included a sample of 6043 individuals, aged 20 and over, who completed the Berkman-Syme questionnaire to assess SS using the social network index (SNI). Higher percentage of low SS was observed in women (52.15%) compared to men (45.4%) (P <0.001). People with a low SNI had a worse CVD risk factor profile. None of the analyzed social contacts (with children, relatives, or friends), regardless of how satisfactory they were, was associated with CVDs in men. In women, satisfying contact with children or relatives appeared to be associated with better cardiovascular health. Furthermore, active participation in organized social activity increased the chance of arrhythmia in both sexes: 1.50 (1.04-2.15); P = 0.029 in men; 1.47 (1.11-1.95); P = 0.007 in women. Although a low SNI was associated with analyzed CVDs in the univariate analysis, it was not confirmed in the fully adjusted model. More women had low SS compared to men. People with low SS had a worse CVD risk factor profile. There was a significant independent relationship between different components of the SNI, such as social contacts and CVDs in women and active participation in organized social activity and arrhythmia in both sexes.

Age-specific and sex-specific associations of visceral adipose tissue mass and fat-to-muscle mass ratio with risk of mortality.

Limited studies have explored the association between visceral adipose tissue (VAT) mass and fat-to-muscle mass ratio (FMR) and mortality. We aimed to evaluate the sex-specific association of VAT and FMR with all-cause and cause-specific mortality by age. A total of 438 896 participants (49.8% men, mean age±standard deviation: 57±8years for men; 56±8years for women) were included from the UK Biobank cohort. The nature of VAT was predictive, as obtained by sex-stratified, non-linear prediction models. Fat and muscle mass were estimated using a bioelectrical impedance assessment device. FMR was calculated as the fat mass divided by the muscle mass in the whole body. VAT and FMRs were divided into quintiles in ascending order, and the 3rd quintile was used as the reference. Cox regression analyses were used to estimate the associations between VAT, FMR and mortality. During a median of 12.4years of follow-up, we documented 29 903 deaths. After adjusting for various covariates, the individuals in the highest quintiles of VAT and FMR had the highest hazard ratios (HRs) of all-cause mortality [1.24 (95% confidence interval: 1.17-1.33) for VAT and 1.24 (1.17-1.31) for FMR in men; and 1.11 (1.03-1.21) for VAT in women], except that the 1st quintile of FMR in women had the greatest HR [1.18 (1.09-1.27)]. Significant interactions were observed in both sexes according to age category (P for interaction<0.05). Among men <50years, participants in the 1st and 5th quintiles of VAT and FMR had significantly higher risks of mortality [1.30 (1.02-1.66) and 1.67 (1.27-2.19) in VAT; 1.25 (0.99-1.56) and 1.41 (1.11-1.79) in FMR, respectively]; in women, this phenomenon was observed in the ≥60 age group [1.16 (1.06-1.27) and 1.19 (1.08-1.31) in VAT; 1.18 (1.08-1.29) and 1.11 (1.01-1.22) in FMR, respectively]. VAT showed a linear positive association with mortality in women <60years and a J-shaped association from respiratory disease in both sexes ≥60years. FMR showed a linear positive association with mortality from cancer in men <60years and a J-shaped association with mortality from cause-specific mortality in both sexes ≥60years, except for mortality from cardiovascular disease in men. Most associations of VAT and FMR with all-cause mortality were J-shaped and were significantly modified by age status (<50, 50-59 and ≥60years). The clinical implication is that regarding body composition and VAT mass, different health strategies may be adopted for people of different sexes and ages.

The Prognostic Value of Combined Status of Body Mass Index and Psychological Well-Being for the Estimation of All-Cause and CVD Mortality Risk: Results from a Long-Term Cohort Study in Lithuania.

Background and Objectives: It is very important to analyze how body mass index (BMI) and psychological well-being (PWB) combination may be differentially associated with mortality risk. The aim of this study was to evaluate the additional prognostic value of the combined status of BMI and PWB for the estimation of all-cause and cardiovascular disease (CVD) mortality risk in the adult Lithuanian urban population. Materials and Methods: Initial data were collected within the framework of the international cohort HAPIEE study from 2006 to 2008. A random sample of 7115 individuals aged 45-72 years was screened. The response rate was 65%. Deaths were evaluated by the death register of Kaunas city (Lithuania) in a follow-up study until 31 December 2020. The mean (SD) duration of the follow-up for the endpoints period was 12.60 (2.79) years. PWB was evaluated by a CASP-12 questionnaire. Results: The findings from the Cox proportional hazards regression multivariable analysis showed that the combinations of underweight plus lower PWB and severe obesity plus lower PWB increased all-cause mortality risk in men (respectively hazard ratio (HR) = 5.65 and HR = 1.60) and in women (respectively HR = 6.02 and HR = 1.77); and increased the risk of mortality from CVD in men (respectively HR = 6.69 and HR = 2.19) compared with responders with normal weight plus higher PWB. The combination of severe obesity plus higher PWB significantly increased the risk of all-cause and CVD mortality risk in men. The combinations of normal weight plus lower PWB and overweight plus lower PWB significantly increased the risk of all-cause mortality risk in men. Conclusions: The combination of severe obesity independently on lower or higher PWB and the combination of underweight plus lower PWB is a strong predictor for all-cause and CVD mortality risk in men and a strong predictor for all-cause mortality risk in women.

Relationships between endogenous and exogenous testosterone and cardiovascular disease in men.

In this narrative review, we discuss the evidence about the controversy about the cardiovascular effects of endogenous and exogenous testosterone in men. Prospective cohort studies with follow-up of ~5-15years generally indicate no association or a possible inverse relationship between serum endogenous testosterone concentrations and composite major cardiovascular events, cardiovascular deaths and overall mortality. Pharmacoepidemiological studies of large databases generally show no association between testosterone therapy and incident major cardiovascular events, and some pharmacoepidemiological studies demonstrate an association with decreased overall mortality. Randomized, placebo-controlled trials indicate that there is no increased incidence of overall major cardiovascular events with 1-3years of testosterone therapy. These placebo-controlled trials have major limitations including small numbers of participants, short duration of testosterone therapy and follow-up, and lack of systematic adjudication of cardiovascular events. Overall, the evidence indicates that endogenous testosterone concentrations and testosterone therapy at physiological dosages confer no or minimal effects on the incidence of cardiovascular outcomes. There is insufficient evidence to make conclusions about testosterone therapy for patients at high risk of cardiovascular events (e.g., men with recent myocardial infarctions or stroke and men with recurrent idiopathic deep venous thromboses). In general, clinicians should avoid prescribing supraphysiological testosterone therapy to hypogonadal men or men with slightly low to low-normal serum testosterone concentrations and no identified disorder of the hypothalamus-pituitary-testicular axis because of the uncertain cardiovascular risks and the lack of proven health benefits. For most men with bona fide hypogonadism, benefits of testosterone therapy exceed the potential risk of adverse cardiovascular effects.