Sleep duration, body composition and mortality: a prospective study of 156,565 Mexican adults.

Impact of Mediterranean diet adherence on quality of life in patients with multiple sclerosis: A prospective study.

Prognostic value of abdominal obesity indicators for all-cause mortality in familial hypercholesterolemia.

To evaluate the effect of liraglutide on carotid intima-media thickness (CIMT) and cardiometabolic risk in adults with type 1 diabetes (T1D). We conduct a prospective, quasi-experimental study including adults aged 15-60 years with T1D, suboptimal control and on basal-bolus insulin regimen. Participants received liraglutide 1.8 mg/day for 24 weeks. Anthropometric measurements, laboratory parameters, insulin sensitivity (estimated glucose disposal rate, eGDR) and CIMT (high-resolution B-mode ultrasonography) were assessed at baseline, 12 and 24 weeks. Paired t-tests, Wilcoxon-signed rank tests and McNemar's tests were used for statistical comparisons. Thirty-five participants (median age 36 years; 57.1% women) were included. Baseline mean HbA1c was 67 mmol/mol (8.3%), CIMT 0.54 ± 0.13 mm, and median diabetes duration 11 years. After 24 weeks, liraglutide did not significantly modify CIMT (0.54 vs. 0.58 mm; p = 0.151). However, significant improvements were observed in waist circumference (82.5-79 cm; p = 0.004), body weight (70-66.7 kg; p < 0.001), BMI (25.5-24.3 kg/m2; p < 0.001), triglycerides (94-75 mg/dL; p = 0.02) and eGDR (7.9-8.9 mg/kg/min; p = 0.003). HbA1c improved at 12 weeks but was not sustained at week 24. No severe hypoglycaemia, diabetic ketoacidosis, emergency visits or hospitalizations occurred. In adults with T1D, liraglutide improved several cardiometabolic risk factors and insulin sensitivity, although no significant short-term effects on CIMT were observed. Larger long-term trials are needed to clarify its potential role in cardiovascular prevention in this population.

While body mass index (BMI) is the most used measure of adiposity, it does not account for fat distribution. Novel indices, such as A Body Shape Index (ABSI) and Body Roundness Index (BRI), may better reflect cardiometabolic risk. However, their association with subclinical cardiac damage, particularly left ventricular hypertrophy (LVH), remains unclear. The aim of this study was to evaluate the association between novel adiposity indices (ABSI and BRI) and left ventricular mass (LVM) assessed by echocardiography in a large cohort of patients with hypertensive. We conducted a cross-sectional study including 724 hypertensive adults who underwent standardized anthropometric and echocardiographic assessments. Adiposity indices (BMI, waist circumference, ABSI, and BRI) were calculated, and left ventricular mass was indexed to body surface area and height2.7. Correlations and multivariate analyses were performed, and receiver operating characteristic (ROC) curves were used to assess diagnostic performance. All adiposity indices were significantly higher in individuals with LVH. BRI showed the strongest correlation with LVMH2.7 (r=0.423), particularly in women. In multivariate analysis, BRI remained significantly associated with LVMH2.7 in both sexes, while ABSI was not independently associated in men. ROC curve analysis demonstrated that BRI had the highest diagnostic accuracy for identifying LVH, outperforming BMI and ABSI, especially when LVH was defined using LVMH2.7. BRI outperformed traditional and novel adiposity indices in identifying LVH in hypertensive patients, particularly when LVM was indexed to height2.7. Given its superior diagnostic performance, BRI may represent a valuable tool in cardiovascular risk stratification, though further studies are warranted.

The clinical evidence for antipsychotic (AP) therapeutic drug monitoring (TDM) in evaluating AP-related movement disorders and cardiometabolic side-effects remains inconsistent. This study evaluates how AP plasma concentrations associate with movement disorders and cardiometabolic side-effects over time, and compares its predictive value to prescription dose in first-episode psychosis (FEP) patients. We included 200 remitted FEP patients from the HAMLETT trial. AP plasma concentrations were standardized using robust z-scores to accommodate different AP types. The St. Hans Rating Scale and Barnes Akathisia Rating Scale assessed movement disorders. Cardiometabolic indices included body mass index, waist circumference, blood pressure, glucose, triglycerides, and cholesterol. We evaluated longitudinal associations between plasma concentrations, movement disorders and cardiometabolic side-effects using two-part and linear mixed-effects models, and compared its predictive value to prescription dose using Bayesian Information Criterion (ΔBIC). Over a median 6-month follow-up (range = 0-48), AP plasma concentrations were positively associated with odds for parkinsonism (OR = 1.81, 95 % CI 1.27, 2.57, p = 0.001). No associations were found with tardive dyskinesia, akathisia, tardive dystonia, or cardiometabolic indices. AP plasma concentrations predicted parkinsonism better than prescription dose (ΔBIC = -2.95), but showed lower predictive value for waist circumference (ΔBIC = 3.22), total cholesterol (ΔBIC = 3.70), low-density-lipoprotein cholesterol (ΔBIC = 2.14) and non-high-density-lipoprotein cholesterol (ΔBIC = 5.46). These findings suggest that in remitted FEP patients, AP TDM may be more useful than dose in evaluating parkinsonism, likely because plasma concentrations more closely reflect free drugs at striatal dopamine receptors, but it does not appear useful for cardiometabolic side-effects.

Association between eGDR dynamic trajectories and depression risk: findings from a nationwide, population based, prospective cohort study.

Real-world effectiveness of oral semaglutide on body weight, composition, and metabolic parameters in patients with obesity without diabetes.

Integrative functional genomics and fine-mapping identify regulatory mechanisms of multivariate obesity GWAS and its cardiometabolic implications.

Introduction: Obesity, especially abdominal obesity, is known to be a major risk factor for cardiovascular diseases. Peripheral Arterial Disease (PAD) is associated with obesity, and it is diagnosed using the Ankle-brachial Index (ABI). While the links between the ABI and cardiovascular diseases, such as myocardial infarction and stroke, are well established, its association with obesity has been studied less extensively. Aim: The present study was undertaken to study the association between Body Mass Index (BMI), Waist-hip Ratio (WHR), Sagittal Abdominal Diameter (SAD) with ABI in Non-smokers and compare the results between obese and non-obese groups. Materials and Methods: The present cross-sectional study was conducted from January to June 2018 with 160 nonsmoking adults aged between 25 to 45 years, at the Lifestyle Laboratory in the Department of Physiology at Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India. The participants underwent a thorough assessment, during which their height, weight, Waist Circumference (WC), hip circumference, and SAD were measured. Body Mass Index (BMI) and WHR were calculated for all individuals. The LifeDop 150R hand-held Doppler device and Diamond mercury sphygmomanometer were utilised to measure Ankle and Brachial Blood Pressure and to calculate the ABI. Statistical analyses included a t-test for comparing the two groups and a Chi-square test to examine the relationship between the two groups. Results: In the present study, 160 non-smoking, non-diabetic, non-hypertensive adults aged between 25 to 45 years were examined, consisting of 132 females and 28 males. A significant association was found between the ABI and BMI when categorised as normal or abnormal BMI, but not when classified as normal, overweight, or obese. The obese and non-obese groups as per their WHR and SAD did not show a significant association with ABI. Conclusion: In the present study, a significant association was found between obesity and PAD, as measured by BMI and ABI. Hence the relationship between obesity and changes in ABI values warrants extensive study

This study aims to estimate the current prevalence of suspected and diagnosed untreated hypertension in middle-aged Lithuanian men. In addition, it seeks to examine the cardiometabolic risk profile associated with these conditions. This was a cross-sectional study of data collected from 2009 to 2019. The dataset included 52 012 male participants aged 40-54 years who participated in the Lithuanian High Cardiovascular Risk (LitHiR) Primary Prevention Programme. We compared the prevalence of dyslipidaemia, diabetes mellitus, smoking, family history of cardiovascular disease (CVD), overweight, obesity based on BMI and waist circumference, metabolic syndrome and cardiometabolic parameters between the normotensive, suspected hypertensive and diagnosed untreated hypertensive groups. All risk factors were more prevalent in suspected and diagnosed untreated hypertensive groups compared to normotensive individuals, with dyslipidaemia being the most prevalent risk factor (91.20 and 93.40%, respectively). The cardiometabolic parameters were also markedly elevated in these groups. Increased waist circumference, elevated total cholesterol, smoking and a family history of CVD were independently associated with both suspected and untreated hypertension. The prevalence of suspected hypertension and diagnosed untreated hypertension in Lithuania slightly increased between 2009 and 2019. Overall, 26.84% of middle-aged men with hypertensive blood pressure readings have no prior diagnosis, while 18.57% of diagnosed individuals are not receiving antihypertensive treatment. A considerable number of hypertensive middle-aged men in Lithuania experience prolonged delays in initiating pharmacological interventions.

Self-perceived bodyweight status among adults who are overweight or have obesity, with and without high cardiovascular risk.

Obesity strengthens the associations between sarcopenia and both frailty and hospitalization, whereas reduces the risk of mortality.

Increased risks of systemic and abdominal obesity associated with long-term exposure to PM2.5 constituents.

To investigate the causal effect of obesity on cataract risk and explores the potential mediating roles of metabolites using Mendelian randomization (MR). Summary-level data from large-scale genome-wide association studies to examine the relationship between obesity and cataract were utilized. Obesity-related traits, including body mass index (BMI), waist-to-hip ratio (WHR), and waist circumference (WC). A two-sample MR approach was employed to assess the causal effect of obesity on cataract risk, while potential mediators were identified from suitable genome-wide association studies (GWAS) datasets. Additionally, a metabolic pathway analysis was conducted. An increase of 1 standard deviation (SD) in BMI, WHR, and WC was associated with a significantly higher risk of cataract (BMI: odds ratio (OR) 1.0017, 95% confidence interval (CI): 1.0001-1.0032, P=0.0320; WHR: OR 1.0029, 95%CI: 1.0006-1.0051, P=0.0129; WC: OR 1.0020, 95%CI: 1.0001-1.0038, P=0.0390]. These associations remained robust after adjusting for confounding factors in multivariable MR analysis. Furthermore, a two-step MR analysis identified eight potential metabolic mediators, with one mediator showing a significant causal role in the relationship between obesity and cataract. This work highlights the importance of addressing obesity as a modifiable risk factor for cataracts, particularly through metabolic pathways.

Lifestyle modification interventions among women with gestational diabetes mellitus (GDM) history have shown to be effective on preventing or delaying the onset of diabetes, however, the differentiating benefits of lifestyle interventions due to socioeconomic inequalities have remained understudied. The Intensive LifeStyle Modification Program (ILSM) was tailored for women with a history of GDM in low-resource rural areas of China. The current study aimed to examine the effect of the ILSM intervention on physiological and behavioral outcomes between subgroups of women from different socioeconomic backgrounds. This study used the baseline, 3-month, 6-month, and 18-month data from a cluster randomized controlled trial in rural women with GDM history in Hunan Province of China. The lifestyle program consisted of a combination of in-person group sessions and telephone consultation sessions on dietary intake, physical activity, and stress management. Using generalized estimating equation, we conducted several subgroup analyses based on indicators of socioeconomic status, including age, ethnicity, income, employment, and education. A total of 320 women were analyzed. The ILSM intervention showed a consistent significance on reducing fasting blood glucose across subgroups. On the contrary, women with full-time employment and high income (≥3000RMB, approximately 425 dollars, per month) were reported to have greater benefits on intentions to eat low-glycemic foods, BMI and waist circumference, and diabetes risk. Women with younger age (≤35 years) or high education (15 years of education or above) were more likely to benefit on improving higher intentions to eat low-glycemic foods and lowering diabetes risk. Interestingly, compared to ethnic majority, ethnic minority women were more likely to increase intentions to eat low-glycemic foods. The ILSM program demonstrated a consistent significance on reducing fasting blood glucose across women from different socioeconomic backgrounds along with an increase of intentions to eat low-glycemic foods for ethnic minority women, despite of showing ineffective in lower socioeconomic status women on intention to have healthy diet, BMI, waist circumference, and diabetes risk. To fully address health disparities from socioeconomic inequalities, lifestyle interventions should be tailored for individuals with older age, lower education levels, and lower income without full-time employment. Chinese Clinical Trial Registry (ChiCTR2000037956), registered on 3rd Jan 2018.

Psoriasis (PsO) demonstrates frequent co-occurrence with metabolic syndrome (MetS). Nevertheless, the shared genetic architecture underlying both pathological conditions remains incompletely characterized. This investigation sought to examine genetic correlations between PsO and multiple MetS-associated traits, and to identify shared genetic risk loci and genes contributing to their coexistence. Genome-wide association study data for PsO, MetS, and related traits in European populations were integrated to evaluate genetic associations between traits and to identify shared loci. Bayesian colocalization analysis was applied to determine whether association signals for different traits at the same locus were attributable to a common causal variant. Functional annotation and gene mapping were conducted for shared loci, followed by functional classification and pathway enrichment analyses of pleiotropic gene sets. In addition, summary data-based Mendelian randomization and transcriptome-wide association study analyses were applied to prioritize candidate genes with potential therapeutic relevance. Significant genetic associations were observed between PsO and five metabolic traits, including body mass index, high-density lipoprotein cholesterol, triglycerides, waist circumference, and type 2 diabetes mellitus, while MetS, as a composite trait, also exhibited a genetic association with PsO. Pleiotropic Analysis under composite null hypothesis (PLACO) analysis revealed a total of 141 shared risk loci, with 22 loci substantiated by Bayesian colocalization analysis findings (PP.H4 ≥ 0.75). Multimarker analysis of genomic annotation analysis identified 195 distinct pleiotropic genes. The pathway enrichment analysis indicated that these genes were predominantly involved in immune and inflammatory pathways, transcriptional and epigenetic regulation, autophagy, and lipid-cholesterol metabolism, indicating that such biological processes may contribute to the shared genetic background of PsO and MetS-related traits. Through integrative evidence from multiple analytical approaches, three candidate therapeutic target genes, namely, KAT8, STX4, and VKORC1, were prioritized. Shared genetic loci, pleiotropic genes, and core biological pathways between PsO and multiple MetS-related traits were identified, and potential intervention targets were highlighted, providing genetic evidence to support subsequent functional investigations.

Prospective and experimental evidence supports beneficial effects of flavonoids on weight management and metabolic health, but their impact on specific adiposity parameters remains unclear. We aimed to investigate associations of total and subclasses of dietary flavonoids with adiposity markers, several of which have been linked to metabolic risk. We evaluated cross-sectional data from 11,568 adults recruited to the Fenland Study between 2005 and 2015 in Cambridgeshire, the United Kingdom. Habitual diets were evaluated using food frequency questionnaires. Flavonoid intakes were calculated mainly using the United States Department of Agriculture food composition databases. We examined associations using robust regression adjusted for relevant confounders and corrected for false discovery rate (FDR) for multiple flavonoids and adiposity parameters: body fat (BF) (dual-energy X-ray absorptiometry), visceral fat (VAT), subcutaneous fat (SCAT), body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), VAT:SCAT ratio, and a body shape index (ABSI). Median flavonoid intake was 428 mg/d (interquartile range 258.5-568.6). Doubling in total flavonoid intake was inversely associated with BF [betalog2 -0.54% (95% CI -0.70; -0.40)]; VAT [-0.13 cm (-0.17; -0.08)]; SCAT [-0.05 cm (-0.08; -0.02)]; BMI [-0.33 kg/m2 (-0.44; -0.22)]; WC [-0.84 cm (-1.13; -0.55)]; and WHR [-0.004 (-0.006; -0.002)]. Most of flavonoid subclasses showed similar results, except isoflavones that were positively associated with BF, VAT and WC. Intakes of proanthocyanidins and anthocyanidins showed the strongest negative associations independently of BMI. Subgroup analyses resulted in stronger negative associations in women, older adults, and non-smokers. Flavonoids may influence adiposity, a potential pathway for the relationship between flavonoid-rich foods and metabolic risk. Proanthocyanidins and anthocyanidins may affect site-specific fat distribution, particularly visceral adiposity. Further investigation in prospective, interventional, and mechanistic studies is warranted to understand the link between flavonoids and adiposity.

BackgroundThe lipid accumulation product (LAP) index, a sex-specific indicator of abdominal lipid accumulation, has emerged as a predictor for cardiometabolic disease. However, its association with dementia has been rarely explored in population-based studies.ObjectiveWe sought to investigate the associations of LAP index with all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD) as well as with serum inflammatory cytokines among rural-dwelling older adults in China.MethodsThis cross-sectional study included 5670 participants (age ≥ 60 years), with data available in 1851 individuals on serum inflammatory cytokines (interleukin-6, tumor necrosis factor-α, and monocyte chemoattractant protein-1). Dementia and subtypes were diagnosed following the international criteria. The LAP index was calculated as [waist circumference (cm)-65] × triglycerides (mmol/L) for men and [waist circumference (cm)-58] × triglycerides (mmol/L) for women. Data were analyzed using multiple logistic and linear regression models.ResultsOf the 5670 participants, dementia was diagnosed in 305 persons (194 with AD and 100 with VaD). As a continuous variable, the LAP index was associated with multivariable-adjusted odds ratios of 1.28 (95% confidence interval: 1.01-1.61) for all-cause dementia, 1.40 (1.05-1.86) for AD, and 1.12 (0.75-1.66) for VaD. As a categorical variable, the highest (versus lowest) quintile of LAP index was associated with multivariable-adjusted odds ratios of 1.91 (1.17-3.12) for dementia, 2.18 (1.19-3.99) for AD, and 1.88 (0.78-4.53) for VaD. A higher LAP index was significantly correlated with serum inflammatory cytokines (p < 0.05).ConclusionsHigh LAP index is linked with dementia and AD in older adults and chronic systemic inflammation might represent a plausible biological pathway.

Evidence-based physician-pharmacist collaborative clinics have demonstrated significant short-term benefits for patients with type 2 diabetes (T2D), but their long-term effectiveness remains unclear, especially in primary health care settings. This study aimed to explore the long-term effectiveness and cost-effectiveness of a novel, digital-driven, multifaceted physician-pharmacist collaborative model for managing patients with T2D in underresourced settings. We conducted a 12-month cluster randomized controlled trial from May 2021 to December 2022 across 6 primary health care settings in China. Guided by the theory of planned behavior, the intervention involved routine therapy from physicians along with pharmaceutical interventions from pharmacists. These were delivered through a combination of face-to-face visits and mobile health care. The intervention group received 4 face-to-face visits and biweekly remote education sessions over the 12 months. We conducted intention-to-treat analyses to estimate differences in clinical and behavior indicators between the intervention and control groups. Primary outcomes included glycosylated hemoglobin and 10-year atherosclerotic cardiovascular risk. Data were analyzed using adjusted generalized estimation equations. This study included 574 patients (291 in the intervention group and 283 in the control group). Over 12 months, patients in the intervention group had significant reductions in hemoglobin A1c (-2.57 vs -1.96, respectively; P<.001; 95% CI -1.027 to -0.238) and 10-year atherosclerotic cardiovascular risk (-1.35 vs 0.01, respectively; P<.001; 95% CI -1.690 to -0.630) compared with the control group. Substantial improvements were also observed in several secondary outcomes, including fasting blood glucose, 2-hour postprandial blood glucose, waist circumference, waist-to-hip ratio, blood pressure, triglyceride, and total cholesterol. Total diabetes-related costs decreased, and patient satisfaction improved significantly in the intervention group. There were no significant differences in BMI, high-density lipoprotein, or low-density lipoprotein. These findings suggest that the physician-pharmacist collaborative model could improve the long-term quality and efficiency of T2D management and reduce medical costs in underresourced areas globally. Patients with T2D, especially those with central obesity or high cardiovascular risk, may benefit more from collaborative clinics. Chinese Clinical Trial Registry ChiCTR2000031839; https://www.chictr.org.cn/showproj.html?proj=51910.