Nutrition, Metabolism, And Cardiovascular Diseases[JOURNAL]
Sun
200 papers
Beyond the glucose: the overlooked role of lipids in gestational diabetes.
Scairati R, Laudisio D, Imperatore O … +3 more , Masulli M, Colao A, Obesity Programs of Nutrition, Education, Research and Assessment (OPERA) group
Nutr Metab Cardiovasc Dis · 2026 Apr · PMID 42070946 · Publisher ↗
AIMS: To examine the role of maternal lipid metabolism before and during pregnancy in the development of gestational diabetes mellitus, and to evaluate its clinical implications for maternal and offspring outcomes. DATA...
AIMS: To examine the role of maternal lipid metabolism before and during pregnancy in the development of gestational diabetes mellitus, and to evaluate its clinical implications for maternal and offspring outcomes. DATA SYNTHESIS: Shifts in lipid metabolism represent key physiologic adaptations of pregnancy, and, when dysregulated, may contribute to the pathogenesis of gestational diabetes. Lipid abnormalities typically precede conception, underscoring a continuum between pre-pregnancy metabolic health and pregnancy outcomes. Low HDL-C, elevated triglycerides, and small dense LDL-C particles have been repeatedly associated with increased gestational diabetes risk across several cohorts and meta-analyses, although the strength of these associations varies according to study design and population characteristics. During pregnancy, women with gestational diabetes display a reproducible lipid phenotype defined by higher triglycerides, lower HDL-C, and increased triglycerides/HDL-C ratios. These perturbations exacerbate insulin resistance, trigger inflammatory and oxidative stress pathways, and act as contributors to disease progression rather than secondary consequences of hyperglycemia. Clinically, maternal dyslipidemia has been associated with adverse outcomes including pre-eclampsia, gestational hypertension, severe hypertriglyceridemia-related pancreatitis, and neonatal complications such as macrosomia, large-for-gestational-age birth weight, and preterm delivery. Beyond pregnancy, lipid disturbances have been linked to unfavourable cardiometabolic trajectories in the offspring, suggesting transgenerational effects. CONCLUSIONS: Integrating mechanistic and clinical evidence, this review emphasizes the need for early lipid assessment, personalized nutritional counseling, and targeted interventions alongside glucose-centered care to improve maternal and offspring outcomes.
Achievement of LDL cholesterol targets in HIV-positive patients: a single center cohort study.
Delle Cave A, Tognola C, Bellomare M … +10 more , Algeri M, Tateo V, Pedretti MC, Mauri M, Bana NB, Rezzonico L, Burastero G, Moioli MC, Giannattasio C, Maloberti A
Nutr Metab Cardiovasc Dis · 2026 Apr · PMID 42069460 · Publisher ↗
BACKGROUND AND AIMS: People living with HIV (PLWH) face an increased CardioVascular (CV) risk due to the interaction between risk factors, chronic inflammation and AntiRetroviral Therapies (ART) metabolic effects. Howeve...
BACKGROUND AND AIMS: People living with HIV (PLWH) face an increased CardioVascular (CV) risk due to the interaction between risk factors, chronic inflammation and AntiRetroviral Therapies (ART) metabolic effects. However, standard risk models often underestimate this burden. Our study aims to evaluate: (i) the CV risk category and the relative LDL-C targets; (ii) the achievement of these targets; and (iii) factors associated with target achievement and HIV-related variables. METHODS AND RESULTS: A retrospective analysis was conducted on 246 PLWH, aged ≥40, on ART followed at the Niguarda Hospital. Clinical and laboratory data were extracted from the hospital's electronic registries and ten-year CV risk was assessed using SCORE2. Only 27.2% of the analyzed cohort achieved the recommended LDL-C targets with further lower prevalence in patients in the "high" or "very high" risk categories. Patients who achieved their LDL-C target had a more favorable cardiovascular risk profile (LDL-C: 75.8 ± 18.1 vs 121.1 ± 33.4 mg/dL, p < 0.001; systolic blood pressure: 116.9 ± 12.4 vs 123.4 ± 15.7 mmHg, p = 0.001), and CV risk categories, being less frequently classified as high and very-high risk (20.8 vs 52.4%, p < 0.0001). No significant relation was found between LDL-C target achievement and HIV-specific variables. CONCLUSIONS: LDL-C target achievement remains suboptimal and may not reflect adequate cardiovascular risk control in PLWH, supporting the need for more aggressive and HIV-tailored prevention strategies.
Serum uric acid levels and incident stroke: A longitudinal nationwide cohort study based on CHARLS data in China.
Zhang P, Wang Y, Guo ZN … +2 more , Zhen Q, Yang Y
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 42062129 · Publisher ↗
BACKGROUND AND AIMS: Evidence from nationally representative cohort studies based on the Chinese population regarding the relationship between uric acid (UA) and the incidence of stroke remains insufficient. Using data f...
BACKGROUND AND AIMS: Evidence from nationally representative cohort studies based on the Chinese population regarding the relationship between uric acid (UA) and the incidence of stroke remains insufficient. Using data from the China Health and Retirement Longitudinal Study (CHARLS), this study aimed to address this gap. METHODS AND RESULTS: We enrolled 9585 eligible participants. Kaplan-Meier curves were used to estimate the cumulative incidence of stroke. Cox proportional hazards models were used to analyze the association between serum UA levels and stroke risk. Sensitivity analysis was conducted using a competing risk model. A restricted cubic spline (RCS) was applied to explore potential dose-response relationships. Subgroup analyses assessed the interaction effects within population subgroups. During the 9-year follow-up period, 650 participants (6.8%) experienced an incident stroke. Kaplan-Meier analyses showed a differential cumulative stroke incidence across the UA-level groups. A linear dose-response relationship was observed between UA levels and stroke onset in all covariate-adjusted models (P values for nonlinearity >0.05). In the fully adjusted Cox model, each 1 mg/dL UA increment was associated with a 15% elevated stroke risk (hazard ratio [HR] = 1.15, 95% confidence interval [CI]: 1.09-1.22). Consistent results were replicated in the competing risk analyses. Significant interaction effects emerged in the sex and smoking subgroups (P for interaction = 0.046 and 0.045, respectively). CONCLUSION: Our study demonstrated a linear dose-response relationship between serum UA levels and stroke incidence in adults aged ≥45 years, specifically significant in males and smokers but absent in females and non-smokers.
Differences in perceived importance of sodium reduction among adults in Bangladesh: Demographic, lifestyle and health contexts.
Cheah YK, Goh KL
Nutr Metab Cardiovasc Dis · 2026 Apr · PMID 42049608 · Publisher ↗
BACKGROUND AND AIMS: Excessive sodium intake is harmful to health. This study explores the associations between perceived importance of sodium reduction and demographic, lifestyle, and health variables among Bangladeshi...
BACKGROUND AND AIMS: Excessive sodium intake is harmful to health. This study explores the associations between perceived importance of sodium reduction and demographic, lifestyle, and health variables among Bangladeshi adults of all age groups. METHODS AND RESULTS: Data from the National STEPS Survey for Non-communicable Diseases Risk Factors in Bangladesh 2018 were analysed using ordered probit regression. Almost three out of every ten adults perceive sodium reduction to be not important at all. Statistically significant but weak associations are observed between perceived importance of sodium reduction and demographic, lifestyle, and health variables. Poorer perceptions of the importance of sodium reduction appear to be associated with older age, male gender, residence in rural areas, being employed and being unmarried. In contrast, positive attitudes seem to be associated with higher educational attainments and individuals with a self-reported history of hypertension and hypercholesterolemia. CONCLUSION: This study found differences in perceived importance of sodium reduction among adults in Bangladesh. Its findings contribute exploratory evidence that may inform the design of targeted health education initiatives aimed at improving salt literacy.
Associations between physical activity trajectories, hypertension, and type 2 diabetes among adults: a systematic review and meta-analysis.
Han Y, Choi Y, Yoon S … +3 more , Kim K, Lee EY, Kim YS
Nutr Metab Cardiovasc Dis · 2026 Aug · PMID 42049607 · Publisher ↗
BACKGROUND AND AIM: Physical activity (PA) is a well-established protective factor for cardiometabolic health, yet the long-term impact of changes in PA on the risk of hypertension and type 2 diabetes (T2D) remains uncle...
BACKGROUND AND AIM: Physical activity (PA) is a well-established protective factor for cardiometabolic health, yet the long-term impact of changes in PA on the risk of hypertension and type 2 diabetes (T2D) remains unclear. This systematic review and meta-analysis examined whether adults who maintained or increased their PA over time had a lower risk of developing hypertension and T2D compared to those who remained inactive. METHODS AND RESULTS: This review and meta-analysis followed PRISMA guidelines. A comprehensive search was conducted using PubMed, Web of Science, and Embase. Thirteen studies met inclusion criteria. Risk of bias was assessed using a standardized tool. A random-effects model was used to calculate pooled hazard ratios (HRs) with 95% confidence intervals (CIs), and heterogeneity was evaluated using the I statistic. Of the 13 included studies, eight were eligible for meta-analysis. When comparing PA trajectories, reductions in disease risk among those who remained active or became active-relative to those who remained inactive-were observed only for T2D. Specifically, the inactive-to-active group showed a significantly lower risk of T2D (HR: 0.71; 95% CI: 0.52-0.98), and the active-to-active group demonstrated the greatest reduction (HR: 0.53; 95% CI: 0.45-0.62). However, no statistically significant associations were found between PA trajectories and hypertension risk. While the active-to-active group showed the lowest risk of hypertension (HR: 0.88; 95% CI: 0.74-1.05), the effect was not statistically significant. CONCLUSIONS: PA trajectories characterized by maintenance or improvement over time were associated with a reduced risk of type 2 diabetes, but not hypertension.
Discovery and validation of molecular biomarkers contributing to the risk of coronary artery disease.
Nikpay M
Nutr Metab Cardiovasc Dis · 2026 Apr · PMID 42045057 · Publisher ↗
BACKGROUND AND AIMS: This study aimed to systematically search for molecular biomarkers that contribute to the risk of coronary artery disease (CAD). METHODS AND RESULTS: A SNP-based multiomics data analysis plan was use...
BACKGROUND AND AIMS: This study aimed to systematically search for molecular biomarkers that contribute to the risk of coronary artery disease (CAD). METHODS AND RESULTS: A SNP-based multiomics data analysis plan was used to identify biomarkers contributing to the risk of CAD through a two-step discovery and validation design. By integrating CAD GWAS data with epigenome, transcriptome, and proteome quantitative trait loci (QTLs) from blood, 44 CpG sites, 37 transcripts, and 27 protein biomarkers were identified contributing to the risk of CAD. The identified biomarkers shared interactions and were enriched in lipid metabolism-related processes. The PCSK9 protein was under the regulatory impact of the APOC1, GZMA, and GRN proteins. The impact of SMARCA4 and PSRC1 transcripts on CAD were mediated through lipids, whereas the influence of the FES transcript on the risk of CAD was attributed to blood pressure. Finally, while 53% of the transcripts identified through the discovery stage were validated, this ratio was 20% for the protein biomarkers and 24% for the CpG sites. CONCLUSIONS: This study identified biomarkers contributing to the risk of CAD through a two-step discovery and validation analyses; furthermore, it provided insights into the paths by which several biomarkers influence the risk of CAD and underlined the efficiency of transcriptome platforms in identifying biomarkers.
Plasma PCSK9 levels in children and adolescents: evidence from an Italian outpatient paediatric clinic cohort at cardio-metabolic risk.
Ruscica M, Tassistro E, Rizzuto AS … +8 more , Macchi C, Orlando A, Rebora P, Carugo S, Parati G, Giussani M, Corsini A, Genovesi S
Nutr Metab Cardiovasc Dis · 2026 Apr · PMID 42014280 · Publisher ↗
BACKGROUND AND AIM: Whether measuring circulating proprotein convertase subtilisin/kexin type 9 (PCSK9) plasma levels in cardiovascular contexts may be of use in the clinical practice remains uncertain. The aim of the pr...
BACKGROUND AND AIM: Whether measuring circulating proprotein convertase subtilisin/kexin type 9 (PCSK9) plasma levels in cardiovascular contexts may be of use in the clinical practice remains uncertain. The aim of the present study was to investigate PCSK9 levels in a cohort of children and adolescents referred to a paediatric outpatient clinic for cardio-metabolic risk assessment. METHODS AND RESULTS: 332 children and adolescents were recruited between December 2014 and June 2024. Plasma PCSK9 enzyme-linked immunosorbent assay, glucose, insulin, fasting lipids, and uric acid were assessed, with calculation of non-high-density lipoprotein cholesterol (non-HDL-C), remnant cholesterol, and homeostasis model assessment index. The median age was 11.2 years, with 44.1% having initiated pubertal development, 81.9% were classified as excess weight and 16.3% as hypertensive. The median PCSK9 levels were 187.2 ng/mL. After adjustment for age and body mass index (BMI) z-score, the presence of lipid values above the clinical threshold was significantly associated with higher PCSK9 levels (p<0.01): total cholesterol ≥200 mg/dL (+51.7 ng/mL), non-HDL-C≥145 mg/dL (+43.6 ng/mL), remnant-cholesterol ≥30 mg/dL (+49.6 ng/mL), low-density lipoprotein cholesterol (LDL-C) ≥130 mg/dL (+34.1 ng/mL), and triglycerides above cut-offs (+49.2 ng/mL). Similarly, a positive parental history of dyslipidaemia was significantly associated with higher PCSK9 values (+39.9 ng/mL) (p<0.001). CONCLUSIONS: In a cohort of children and adolescents at cardio-metabolic risk, circulating PCSK9 levels were significantly associated with atherogenic lipid fractions, including LDL-C, non-HDL-C, triglycerides, and remnant cholesterol. These findings suggest that PCSK9 may play a broader role in lipid metabolism beyond LDL-C regulation, particularly in relation to triglyceride-rich lipoproteins.
Cardiometabolic diseases and risk of early-onset dementia: a population-based case-control study in Northern Italy.
Mazzoli R, Chiari A, Rothman KJ … +7 more , Vitolo M, Boriani G, De Girolamo G, Carrozzi G, Tondelli M, Filippini T, Vinceti M
Nutr Metab Cardiovasc Dis · 2026 Apr · PMID 42014279 · Publisher ↗
BACKGROUND AND AIMS: Early-onset dementia (EOD), defined by symptom onset before 65 years, has an uncertain etiology. Cardiovascular and metabolic diseases have been suggested to increase risk for EOD, but evidence remai...
BACKGROUND AND AIMS: Early-onset dementia (EOD), defined by symptom onset before 65 years, has an uncertain etiology. Cardiovascular and metabolic diseases have been suggested to increase risk for EOD, but evidence remains limited and inconsistent. We investigated the extent to which history of cardiometabolic conditions is associated with EOD, and the extent to which the associations vary by sex, age at onset, and dementia subtype. METHODS AND RESULTS: We conducted a population-based case-control study in Modena, Northern Italy, including 334 EOD cases diagnosed from 1999 to 2021, and 1991 controls matched by sex, year of birth, and calendar year. Hospitalization records and drug prescriptions were retrieved from administrative databases to estimate cardiometabolic disease history before EOD onset. We estimated odds ratios (OR) and 95% confidence intervals (CI) using conditional logistic regression in the entire study population and within subgroups of age and sex. EOD cases showed higher rates of hospitalization for hypertension and diabetes. History of antidiabetic drugs (OR = 1.49, 95% CI 1.01-2.19), lipid-lowering agents (OR = 1.36, 95% CI 1.03-1.79), and antihypertensive drugs (OR = 1.47, 95% CI 0.93-2.32) was associated with higher EOD risk. Associations were stronger in males for antidiabetics (OR = 1.78, 95% CI 1.08-2.93) and antithrombotics (OR = 1.57, 95% CI 1.06-2.33), and in individuals <55 years for most antihypertensive classes. Non-Alzheimer's EOD generally showed higher associations with cardiovascular drug use than Alzheimer's type. CONCLUSIONS: The associations we found between cardiometabolic diseases and EOD, particularly non-Alzheimer's subtypes, are consistent with a role of cardiometabolic burden or shared etiologic factors in early cognitive decline.
Metabolic indicators as mediators in the relationship between lifestyle and arterial stiffness.
Kang H, Deng Q, Cao Y … +9 more , Yu H, Chen D, Tian R, Zhu J, He Y, Zhang J, Liu X, Sheng J, Wang S
Nutr Metab Cardiovasc Dis · 2026 Aug · PMID 42002512 · Publisher ↗
BACKGROUND AND AIMS: Previous studies have demonstrated that a healthy lifestyle can modify the risk of atherosclerosis. However, limited research has explored the association between lifestyle factors and early markers...
BACKGROUND AND AIMS: Previous studies have demonstrated that a healthy lifestyle can modify the risk of atherosclerosis. However, limited research has explored the association between lifestyle factors and early markers of arterial health, and the potential role of metabolic indicators remains unclear. METHODS AND RESULTS: A prospective cohort study was conducted among 1210 Chinese participants. Participant completed a questionnaire, underwent anthropometric assessments, and received biochemical testing. Lifestyle factors and metabolic indicators were measured at baseline, and arterial stiffness (AS) was assessed at follow-up using pulse wave velocity (PWV). Multivariable linear and logistic regression examined associations between healthy lifestyle score (HLS) and AS, and causal mediation analysis assessed metabolic mediators. Higher HLS was linked to lower vascular parameters (RbaPWV, right brachial-ankle pulse wave velocity: β = -13.25; LbaPWV, left brachial-ankle pulse wave velocity: β = -13.47; AS: OR = 0.75) and a reduction in metabolic indicators, including uric acid (UA), total cholesterol (TC), triglyceride-glucose (TyG), mean arterial pressure (MAP), and metabolic score (MS) (β = -0.18, -2.11, -0.13, -1.62, and -0.44, respectively). Additionally, all metabolic indicators showed significant mediation effects between HLS and RbaPWV, LbaPWV and AS. CONCLUSIONS: These findings suggest that a healthy lifestyle has beneficial effects on both metabolic and vascular health, and metabolic indicators mediate the relationship between lifestyle and vascular health, providing novel insights into lifestyle modifications for the early prevention of cardiovascular disease.
Triglyceride-glucose index and its derived anthropometric indices: a comparative analysis for mortality prediction in the population cohort of the URRAH study.
D'Elia L, Galletti F, Virdis A … +41 more , Casiglia E, Tikhonoff V, Angeli F, Barbagallo CM, Bombelli M, Cianci R, Ciccarelli M, Cicero AFG, Cirillo M, Cirillo P, Desideri G, Ferri C, Gesualdo L, Giannattasio C, Grassi G, Iaccarino G, Lippa L, Mallamaci F, Maloberti A, Masi S, Mazza A, Mengozzi A, Muiesan ML, Nazzaro P, Palatini P, Parati G, Pardini N, Pontremoli R, Quarti-Trevano F, Rattazzi M, Reboldi G, Rivasi G, Russo E, Salvetti M, Tocci G, Ungar A, Verdecchia P, Viazzi F, Volpe M, Borghi C, Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension (SIIA) URRAH Study Group
Nutr Metab Cardiovasc Dis · 2026 Apr · PMID 42002511 · Publisher ↗
BACKGROUND AND AIMS: The triglyceride-glucose (TyG) index is an established surrogate marker of insulin resistance and has been consistently associated with adverse cardiovascular outcomes. Composite indices combining Ty...
BACKGROUND AND AIMS: The triglyceride-glucose (TyG) index is an established surrogate marker of insulin resistance and has been consistently associated with adverse cardiovascular outcomes. Composite indices combining TyG with anthropometric measures, such as body mass index (BMI) and waist circumference (WC), have been proposed to enhance risk prediction. However, their incremental prognostic value remains uncertain. This study aimed to compare the predictive performance of TyG, BMI, and WC with that of their derived multiplicative indices (TyG-BMI and TyG-WC) for all-cause and cardiovascular mortality. METHODS AND RESULTS: Data were analysed from the multicentre URRAH cohort, including 17,742 participants for the evaluation of TyG-BMI and a sub-analysis of 7052 individuals for TyG-WC. Over a median follow-up of 11.7 years, 2650 all-cause deaths occurred, including 1158 cardiovascular deaths. The TyG index showed a strong and independent association with both outcomes. Although TyG-BMI and TyG-WC were significantly associated with mortality, their risk patterns largely reflected those of their individual components. In multivariable models, inclusion of the derived indices did not meaningfully improve model fit, discrimination, individual risk prediction, or clinical usefulness. CONCLUSION: In this large general cohort, the TyG index was confirmed as a robust predictor of all-cause and cardiovascular mortality. In contrast, derived indices combining TyG with BMI or WC did not confer meaningful incremental prognostic value beyond modelling TyG and anthropometric measures separately, supporting the use of TyG as a simple and clinically informative marker for mortality risk stratification.
Effect of proprotein convertase subtilisin kexin 9 inhibitors on platelet aggregation in patients with and without diabetes.
Crisci M, Ilardi F, Manzo R … +14 more , Gragnano F, Paolillo R, Giugliano G, Piro O, Cigala E, Monteforte I, D'Oria V, Venga E, Marotta A, Salvato A, Calabrò P, Esposito G, Di Lorenzo E, De Feo M
Nutr Metab Cardiovasc Dis · 2026 Apr · PMID 42002510 · Publisher ↗
BACKGROUND AND AIM: The impact of proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors on platelet reactivity in the setting of diabetes mellitus (DM) has not been adequately investigated. METHODS AND RESULTS: Out...
BACKGROUND AND AIM: The impact of proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors on platelet reactivity in the setting of diabetes mellitus (DM) has not been adequately investigated. METHODS AND RESULTS: Out of 52 outpatients with atherosclerotic cardiovascular disease (ASCVD) with an indication for PCSK9 inhibitor alirocumab, 37 patients (mean age 68.1 ± 5.6 years, 62% males) were included in the study and retrospectively divided into two groups according to the presence of DM (DM+/DM-). A blood sample for platelet function testing was collected at baseline (T0), before initiation of alirocumab, and after 3 months of therapy (T90). Light transmission aggregometry was performed to study platelet aggregation, and results were expressed as percentage of maximum platelet aggregation (MPA). At 90-day follow-up, a significant reduction of total cholesterol and low-density lipoprotein cholesterol levels compared to baseline was observed in both DM+ and DM-groups. At baseline, MPA were comparable between the two groups. At T90, only in the DM + cohort, platelet aggregation induced by adenosine diphosphate (ADP) and arachidonic acid (AA) was significantly reduced compared to baseline (ADP 20 μM: 56.00 ± 28.67% vs 63.16 ± 33.69%, at T90 vs T0 respectively, p = 0.011; AA 1 mM: 28.68 ± 40.10% vs 41.74 ± 46.85%, p = 0.025). No significant change in platelet function from baseline was observed in patients DM- (p > 0.05 for all comparisons). CONCLUSION: The PCSK9 inhibitor alirocumab significantly reduced AA and ADP residual platelet aggregation after 90 days of therapy in patients with ASCVD and diabetes, but not in those without diabetes.
Causal effects of oxidative stress on hypertension: insights integrating multi-omics and colocalization analyses.
Zhang Y, Meng J, Yan Y … +7 more , Tang H, Zhong D, Li Y, Xue P, Zhang A, Jin R, Li J
Nutr Metab Cardiovasc Dis · 2026 Aug · PMID 42002509 · Publisher ↗
BACKGROUND AND AIM: Oxidative stress (OS) plays a role in hypertension development, but the underlying genetic mechanisms are not completely understood. This study aimed to investigate the association between OS-related...
BACKGROUND AND AIM: Oxidative stress (OS) plays a role in hypertension development, but the underlying genetic mechanisms are not completely understood. This study aimed to investigate the association between OS-related genes and hypertension by performing an integrative multi-omics analysis using summary-data-based Mendelian randomization (SMR) and colocalization approaches. METHODS AND RESULTS: We obtained OS-related genes, summary-level methylation and gene expression QTL data, GWAS statistics for hypertension from the GeneCards, European cohort studies, and FinnGen study, respectively. We used SMR, colocalization, GO and KEGG analyses to estimate the association between OS-related molecular signatures and hypertension. Our results showed that PRDX2, SLC25A13, CYP19A1, and SUMF1 were causally associated with risk of hypertension. Furthermore, we observed evidence of colocalization with hypertension for these genes in at least one omics layer. Higher expression of PRDX2 (hypomethylation of cg23467004/cg00155609), CYP19A1 (hypomethylation of cg14424631), and CYP2D6 (hypomethylation of cg04692870) was associated with a reduced risk of hypertension. Conversely, elevated expression of SLC25A13 (hypomethylation of cg21022364 and hypermethylation at cg18184880), PDGFB (hypermethylation of cg17961378/cg24990612), S100A9 (hypomethylation of cg15467116), CLN6 (hypomethylation of cg22576950/cg20716080 and hypermethylation of cg16038331/cg11750300), CLN8 (hypermethylation of cg23952859), GFPT1 (hypermethylation of cg25195673), ADH5 (hypermethylation of cg21548116), and SUMF1 (hypermethylation of cg24840601) increased the risk of hypertension. Enrichment analyses indicated that PI3K/Akt, MAPK, and Rap1 pathways play key roles in the OS mechanisms underlying hypertension. CONCLUSIONS: PRDX2, SLC25A13, SUMF1, and CYP19A1 may serve as potential therapeutic targets for hypertension. The PI3K/Akt, MAPK, and Rap1 pathways are important OS mechanisms in hypertension, and further validation is required.
Association of dietary inflammatory index with severity and mortality among adults with cardiovascular-kidney-metabolic syndrome.
Yang M, Chen Y, Lu Y … +2 more , Hu W, Yan J
Nutr Metab Cardiovasc Dis · 2026 Mar · PMID 42002508 · Publisher ↗
BACKGROUND AND AIMS: Cardiovascular-kidney-metabolic (CKM) syndrome is driven by chronic inflammation. The impact of the energy-adjusted dietary inflammatory index (E-DII) on CKM severity and mortality remains unclear. W...
BACKGROUND AND AIMS: Cardiovascular-kidney-metabolic (CKM) syndrome is driven by chronic inflammation. The impact of the energy-adjusted dietary inflammatory index (E-DII) on CKM severity and mortality remains unclear. We evaluated E-DII's association with advanced CKM and mortality, quantifying the mediating role of systemic inflammatory markers. METHODS AND RESULTS: Analyzing data from the National Health and Nutrition Examination Survey (NHANES,1999-2018),we employed weighted logistic regression and Cox regression to evaluate the associations of the E-DII with advanced CKM and mortality. Weighted linear regression assessed associations between E-DII and systemic inflammatory markers, including the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and neutrophil-to-lymphocyte ratio (NLR). Finally, mediation analyses quantified the mediating effects of these markers on E-DII-related mortality and CKM severity.During a median follow-up of 116 months, among 12016 participants (7.46% with advanced CKM), 1425 all-cause deaths and 356 cardiovascular deaths were documented. Multivariable analyses confirmed E-DII as an independent risk factor for advanced CKM (OR 1.10; 95% CI 1.02-1.18; P = 0.01) and a significant predictor of increased all-cause (HR 1.10; 95% CI 1.05-1.14; P < 0.001). Additionally, weighted linear regression showed positive associations between E-DII and systemic inflammatory markers, and mediation analyses revealed that systemic inflammation partially mediated the impact of E-DII on both mortality risks and CKM severity. CONCLUSIONS: Elevated E-DII is significantly associated with advanced CKM and higher mortality, an association partially mediated by systemic inflammatory markers.
Cardiovascular risk reduction through a peer-led digital health lifestyle intervention in a low-income community: outcomes from the MYCardio-PEER program.
Lim GP, Appalasamy JR, Ahmad B … +2 more , Quek KF, Ramadas A
Nutr Metab Cardiovasc Dis · 2026 Apr · PMID 42002507 · Publisher ↗
BACKGROUND AND AIMS: Low-income communities face a disproportionately high burden of cardiovascular disease (CVD), yet often lack access to preventive care. Peer-based interventions delivered through digital platforms of...
BACKGROUND AND AIMS: Low-income communities face a disproportionately high burden of cardiovascular disease (CVD), yet often lack access to preventive care. Peer-based interventions delivered through digital platforms offer a potentially scalable approach to address these disparities, but evidence remains limited. Our study evaluated the preliminary impact of an 8-week peer-led digital health lifestyle intervention (MYCardio-PEER) in improving knowledge, lifestyle behaviours and biomarkers related to cardiovascular health among a low-income population. METHODS AND RESULTS: Adults from the low-income community at risk of CVD were assigned to the intervention group (n = 30) or the control group (n = 31). The intervention included peer-led bite-sized educational videos, infographic posters, and interactive activities over eight weeks. The control group received standard lifestyle advice and printed materials for CVD prevention. The primary outcome was the reduction in Framingham General CVD risk score (FRS). The secondary outcomes include clinical biomarkers, CVD-related knowledge, lifestyle and dietary behaviours. Assessments were conducted at Week 0 (baseline), Week 8 (post-intervention) and Week 20 (follow-up). Compared to controls, MYCardio-PEER intervention group demonstrated a greater reduction in FRS (F = 3.937, p = 0.029, ƞ2 = 0.063), energy intake (F = 8.807, p < 0.001, ƞ2 = 0.130), and processed foods consumption (F = 3.248, p = 0.046, ƞ2 = 0.052). Additionally, participants in the intervention group had a significantly greater increase in dietary fibre intake (F = 11.126, p < 0.001, ƞ2 = 0.159). CONCLUSION: MYCardio-PEER significantly improved health behaviours and cardiovascular risk profiles in low-resource settings. Peer-led digital interventions such as MYCardio-PEER may provide a scalable, community-centred strategy to reduce CVD risk factors and improve health equity in underserved populations. TRIAL REGISTRATION: Clinicaltrials.gov NCT06408493.
Association between device-measured physical activity and aortic aneurysm risk: a prospective cohort study of 93165 UK biobank participants.
Yan S, Zhu C, Hu Y … +6 more , Guo W, Liu Y, Wang T, Jin S, Hou Y, Wang H
Nutr Metab Cardiovasc Dis · 2026 Aug · PMID 42002506 · Publisher ↗
BACKGROUND AND AIM: Aortic aneurysm (AA) is a life-threatening vascular disease with high fatality upon rupture. While physical activity (PA) reduces cardiovascular risk, its role in AA prevention remains uncertain, part...
BACKGROUND AND AIM: Aortic aneurysm (AA) is a life-threatening vascular disease with high fatality upon rupture. While physical activity (PA) reduces cardiovascular risk, its role in AA prevention remains uncertain, particularly when assessed objectively. METHODS AND RESULTS: We analyzed 93,165 UK Biobank participants (56% women; median age 57 years) with valid 7-day wrist-worn accelerometer data. PA was categorized as light (LPA), moderate (MPA), vigorous (VPA), and moderate-to-vigorous (MVPA). Diagnosed AA was ascertained through linked hospital, death, and primary care records. Cox models estimated hazard ratios (HRs) for AA across quartiles and per-standard deviation (SD) increments, with adjustment for demographic, lifestyle, and cardiometabolic factors. Over a median 7.9-year follow-up, 499 clinically recorded AA cases occurred. Higher accelerometer-measured PA was inversely associated with AA risk. Per-SD increments in total PA, MPA, VPA, and MVPA corresponded to 17%, 22%, 19%, and 23% lower risks, respectively. Compared with the lowest quartile, the highest MVPA quartile had a 44% lower AA risk (HR = 0.56, 95% CI 0.42-0.76). Subtype analyses revealed stronger protective effects for abdominal aortic aneurysm (AAA) than thoracic aortic aneurysm (TAA), while LPA was not significantly associated. CONCLUSIONS: These findings demonstrate that higher levels of accelerometer-measured MVPA are robustly associated with a decreased risk of clinically detected AA in a dose-dependent manner. The associations were particularly pronounced for AAA. This study provides objective evidence supporting the potential benefits of MVPA for aortic health.
Serum non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and the risk of sudden cardiac death: findings from a prospective cohort study.
Laukkanen JA, Kurl S, Ravandi A … +2 more , Kauhanen J, Kunutsor SK
Nutr Metab Cardiovasc Dis · 2026 Aug · PMID 42000253 · Publisher ↗
BACKGROUND AND AIMS: The non-high-density lipoprotein cholesterol-to-HDL-C ratio (NHHR), calculated as non-high-density lipoprotein cholesterol (non-HDL-C) divided by HDL-C, is a novel lipid index reflecting the balance...
BACKGROUND AND AIMS: The non-high-density lipoprotein cholesterol-to-HDL-C ratio (NHHR), calculated as non-high-density lipoprotein cholesterol (non-HDL-C) divided by HDL-C, is a novel lipid index reflecting the balance between atherogenic and anti-atherogenic lipoproteins. This study evaluated and compared the associations and predictive utility of NHHR, non-HDL-C, and HDL-C for sudden cardiac death (SCD). METHODS AND RESULTS: Serum lipoprotein concentrations were measured at baseline in 2575 men aged 42-61 years from the Finnish Kuopio Ischemic Heart Disease prospective cohort. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox regression. During a median follow-up of 27.8 years, 294 SCD events occurred. In multivariable-adjusted analyses, NHHR and non-HDL-C showed positive linear dose-response associations with SCD risk, whereas HDL-C demonstrated an inverse association. The adjusted HR (95% CI) per 1 SD increase was 1.68 (1.30-2.17) for NHHR and 2.40 (1.54-3.73) for non-HDL-C. Comparing extreme quartiles, the HR (95% CI) was 2.23 (1.55-3.21) for NHHR and 2.04 (1.44-2.89) for non-HDL-C. For HDL-C, the HR (95% CI) per 1 SD decrease was 2.33 (1.33-4.07) and 1.63 (1.13-2.34) comparing bottom vs top quartiles. Addition of NHHR to a model with established risk factors significantly improved discrimination (ΔC-index = 0.0079; p = .037), whereas improvements with non-HDL-C and HDL-C were not significant. CONCLUSION: In middle-aged and older men, elevated NHHR is associated with an increased risk of SCD, independently of several cardiovascular risk factors and consistent with a dose-response relationship. NHHR is a stronger predictor of SCD risk compared to non-HDL-C and HDL-C.
Mediating role of estimated glomerular filtration rate in the association between hyperlipidemia and estimated glucose disposal rate-related mortality: a study in hyperlipidemic individuals.
Zhang W, Li L, Wang Y … +4 more , Cao Y, Hu C, Wang J, Gao B
Nutr Metab Cardiovasc Dis · 2026 Aug · PMID 42000252 · Publisher ↗
BACKGROUND AND AIMS: Hyperlipidemia is a well-established risk factor for cardiovascular disease (CVD) and all-cause mortality. The estimated glucose disposal rate (eGDR), a non-invasive marker of insulin resistance, has...
BACKGROUND AND AIMS: Hyperlipidemia is a well-established risk factor for cardiovascular disease (CVD) and all-cause mortality. The estimated glucose disposal rate (eGDR), a non-invasive marker of insulin resistance, has shown potential in predicting CVD outcomes. However, its association with mortality in individuals with hyperlipidemia remains unclear. This study aimed to investigate the relationship between eGDR and both all-cause and CVD-specific mortality in a hyperlipidemic population. METHODS AND RESULTS: The present study used data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 to calculate the eGDR in a sample of 9283 adults diagnosed with hyperlipidaemia. Participants were stratified into eGDR quartiles (Q1-Q4). Cox regression was employed to assess mortality risks.Especially significant in subgroup analysis for patients under 60 years of age.Lower eGDR quartiles exhibited metabolic profiles that were indicative of poorer health and elevated mortality rates (all-cause: Q1 = 13.08% vs. Q4 = 3.07%; CVD: 4.06% vs. 0.48%). An increase of one unit in the eGDR was associated with a 7% reduction in all-cause mortality (HR = 0.93) and a 14% reduction in CVD mortality (HR = 0.86). In comparison with the first quarter, the fourth quarter exhibited a 40% decrease in all-cause mortality (hazard ratio [HR] = 0.60) and a 56% decrease in CVD mortality (HR = 0.44). Mediation analyses implicated eGFR(36.5%) in these associations. CONCLUSION: In patients suffering from hyperlipidaemia in the US, a decrease in eGDR has been shown to be associated with an increased risk of all-cause and cardiovascular disease mortality.
Higher legume and cruciferous vegetable intakes are associated with lower cardiometabolic risk in young adults: a cross-sectional study.
McNamara N, Blekkenhorst LC, Mori TA … +2 more , Beilin LJ, O'Sullivan TA
Nutr Metab Cardiovasc Dis · 2026 Aug · PMID 42000251 · Publisher ↗
BACKGROUND AND AIMS: Evidence suggests not all vegetables are the same for cardiometabolic health. Intake of specific vegetable groups exhibit significantly stronger associations with improved cardiometabolic health outc...
BACKGROUND AND AIMS: Evidence suggests not all vegetables are the same for cardiometabolic health. Intake of specific vegetable groups exhibit significantly stronger associations with improved cardiometabolic health outcomes in adult populations. Few studies have investigated these relationships in young adults. This study aimed to investigate the relative contributions of specific vegetable groups to cardiometabolic risk in a cohort of young adults. METHODS AND RESULTS: A cross-sectional analysis was conducted in participants from the Western Australia-based Raine Study (n = 638) at the 22-year follow-up. Using a food frequency questionnaire, vegetables were grouped into allium, cruciferous, green leafy, legumes, and yellow-orange-red. Participants were classified as high-metabolic risk if ≥ 2 risk factors exceeded metabolic syndrome diagnostic criteria according to the International Diabetes Federation. Mann Whitney-U tests and logistic regressions examined the relationship between vegetable groups and cardiometabolic risk (high vs low). 638 participants (53% female) aged 22.1yrs (±0.6yrs) were included. Significant differences were found between low- and high-risk groups for dietary intake (per serve; 75g/day) of legumes in males and cruciferous and green leafy vegetables in females. After adjustment for sociodemographic, lifestyle and dietary covariates, higher legume intake remained a significant predictor for lower odds of cardiometabolic risk for males (OR = 0.278, 95%CI = 0.088-0.883, p = 0.030), whilst cruciferous intake remained significant for females (OR = 0.151, 95%CI = 0.023-0.999, p = 0.049). CONCLUSION: Our results suggest higher intakes of legumes and cruciferous vegetables are associated with lower odds of cardiometabolic risk in young adults, with significant sex differences.
Normalized creatinine-to-cystatin C ratio and risk of hypertension in middle-aged and older adults: findings from the China Health and Retirement Longitudinal Study.
Si K, Sun C, Shi C … +4 more , Huang Y, Chi J, Xu L, Wang Y
Nutr Metab Cardiovasc Dis · 2026 Aug · PMID 42000250 · Publisher ↗
BACKGROUND AND AIM: The normalized creatinine-to-cystatin C ratio (NCCR) has recently emerged as a contributor to diabetes risk. However, its association with hypertension remains elusive. This study aimed to investigate...
BACKGROUND AND AIM: The normalized creatinine-to-cystatin C ratio (NCCR) has recently emerged as a contributor to diabetes risk. However, its association with hypertension remains elusive. This study aimed to investigate this relationship in a large-scale prospective cohort. METHODS AND RESULTS: Based on the China Health and Retirement Longitudinal Study (CHARLS), a total of 4794 participants aged ≥45 years were enrolled from five CHARLS surveys in 2011, 2013, 2015, 2018 and 2020. Logistic regression models were used to investigate the association between NCCR and hypertension. The joint effects of body mass index and NCCR on the risk of hypertension were further analyzed. Additionally, the C-statistic was used to assess the predictive performance of NCCR for hypertension risk. During follow-up, 1318 (27.49 %) participants developed hypertension. After full adjustment for confounders, each per-SD increment in NCCR was associated with a significantly lower risk of hypertension (odds ratio [OR] = 0.81, 95% CI: 0.76 - 0.88, P < 0.001). Sex- and age-specific analyses revealed that the significant inverse associations between NCCR and hypertension were more pronounced in females and middle-aged individuals. Notably, non-obese participants with high NCCR experienced a more significant risk reduction than those who were obese with high NCCR. Moreover, incorporating NCCR into the basic model significantly improved the predictive ability for hypertension. CONCLUSIONS: Higher levels of NCCR were independently associated with a decreased risk of hypertension in middle-aged and older adults, especially in females and middle-aged individuals.
Association of triglyceride-glucose index combined with Chinese visceral adiposity index and cardiovascular diseases in middle-aged and older adults: a cohort study.
Fei H, Pang J, Su P … +6 more , Li S, Zhang Y, Liu Z, Zhang C, Jia H, Chi W
Nutr Metab Cardiovasc Dis · 2026 Mar · PMID 42000249 · Publisher ↗
BACKGROUND AND AIM: Cardiovascular diseases (CVDs) have become a significant public health issue, with a strong link to insulin resistance (IR). The triglyceride-glucose (TyG) index and Chinese visceral adiposity index (...
BACKGROUND AND AIM: Cardiovascular diseases (CVDs) have become a significant public health issue, with a strong link to insulin resistance (IR). The triglyceride-glucose (TyG) index and Chinese visceral adiposity index (CVAI) are key indicators in the development of obesity and IR. The purpose of the study is to explore the combined effect of the TyG index and CVAI on the risk of CVDs in middle-aged and older adults. METHODS AND RESULTS: This cohort study was based on the China Health and Retirement Longitudinal Study (CHARLS) from 2012 to 2020, ultimately including 6871 and 3913 participants to examine baseline and follow-up association with CVDs. Participants were divided into four groups based on quartiles and into three classes based on changes in TyG-CVAI using K-means cluster analysis. Multivariable Cox regression analysis was conducted to assess the association between different TyG-CVAI groups and the risk of CVDs. The discriminatory performance was assessed by ROC curve, Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI). Both high baseline TyG-CVAI levels and persistently elevated TyG-CVAI levels were significantly associated with CVDs, with HRs of 1.61 (1.35-1.93) and 1.68 (1.38-2.05). TyG-CVAI showed higher discriminatory ability for CVDs, CHD, and stroke, with AUCs of 0.594, 0.587, and 0.603. NRI and IDI analyses indicated that the addition of TyG-CVAI significantly enhanced risk reclassification for CVDs (NRI, 0.116-0.144; P < 0.001), CHD (NRI, 0.108-0.112; P < 0.001), and stroke (NRI, 0.127-0.230; P < 0.001). CONCLUSIONS: Monitoring long-term changes in TyG-CVAI may be useful for early risk stratification of CVDs among middle-aged and elderly individuals in China.
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