Nutrition, Metabolism, And Cardiovascular Diseases[JOURNAL]
Sun
200 papers
Cardiorespiratory fitness from childhood to midlife and Life's Essential 8 cardiovascular health score.
Fraser BJ, Blizzard L, Tomkinson GR … +3 more , Dwyer T, Venn AJ, Magnussen CG
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41945012 · Publisher ↗
BACKGROUND AND AIMS: Cardiorespiratory fitness (CRF) is a modifiable cardiovascular risk factor for children and adults. However, little is known how variations in CRF across the life course impact long-term cardiovascul...
BACKGROUND AND AIMS: Cardiorespiratory fitness (CRF) is a modifiable cardiovascular risk factor for children and adults. However, little is known how variations in CRF across the life course impact long-term cardiovascular health. Therefore, we examined how CRF from childhood to mid-adulthood associates with the American Heart Association's (AHA) Life's Essential 8 (LE8), a measure of overall cardiovascular health. METHODS AND RESULTS: As part of the longitudinal Childhood Determinants of Adult Health Study, 240 participants had their CRF measured as physical work capacity at 170 beats per minute (PWC) in childhood (1985: 9, 12, 15 years), young adulthood (2004-06: 26-36 years), and mid-adulthood (2014-19: 36-49 years). In mid-adulthood, diet, physical activity, smoking, sleep, body mass index, blood lipids, blood glucose and blood pressure was assessed, with LE8 scores created following AHA recommendations. Associations were examined using linear regression and the Bayesian relevant life course model. The relationship between CRF across the life course and adult LE8 was best characterised by a lifetime growth model, where higher childhood CRF (β = 3.48, 95%CI = 1.36-5.60), and increased CRF between childhood and young adulthood (β = 3.64, 95%CI = 2.12-5.17) and between young and mid-adulthood (β = 4.15, 95%CI = 2.23-6.06) were positively associated with LE8 in midlife. When the relative importance of CRF within this relationship was quantified, CRF was important at each examined life stage, with a sensitive period in midlife. CONCLUSION: These findings support a life course approach to the prevention of adverse cardiovascular health, highlighting the cardiovascular benefits of higher CRF in both childhood and adulthood, and increasing CRF over time.
High LDL-cholesterol in children and adolescents with type 1 diabetes: the impact of body adiposity and sex.
Maffeis C, Morotti E, Caiazza E … +5 more , Pedranzini Q, Soglia A, Kharazizadeh P, Marigliano M, Piona C
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41936494 · Publisher ↗
BACKGROUND AND AIMS: To investigate the association between LDL cholesterol (LDL-C) and body adiposity in children and adolescents with type 1 diabetes (T1D), evaluating the influence of sex, glycemic control, and insuli...
BACKGROUND AND AIMS: To investigate the association between LDL cholesterol (LDL-C) and body adiposity in children and adolescents with type 1 diabetes (T1D), evaluating the influence of sex, glycemic control, and insulin treatment modalities. METHODS AND RESULTS: This cross-sectional study included children and adolescents aged 6-18 years with T1D. Adiposity indices [BMI, BMI Z-score, and waist-to-height ratio (WHtR)] and body composition [fat mass (FM), fat mass index (FMI)] were obtained by anthropometry and bioelectrical impedance analysis. Biochemical parameters included LDL-C, total cholesterol, triglycerides, and HbA1c. Glycemic metrics, including time in range (TIR) and time above range (TAR), were also evaluated. Logistic regression models were applied to identify predictors of LDL-C >100 mg/dL. LDL-C was significantly associated with FMI and WHtR (boys: p < 0.01; girls: p < 0.05). In boys, elevated LDL-C was significantly predicted by FMI [OR 1.23 (95% CI 1.02-1.48), p = 0.03] and WHtR × 100 [OR 1.09 (1.02-1.18), p = 0.013], independent of glycemic control and treatment modality. WHtR remained significant across models, including HbA1c, TIR, and TAR (p ≤ 0.05). In girls, HbA1c was the strongest predictor of LDL-C >100 mg/dL [OR 2.40 (1.44-3.86), p < 0.001] independent of FMI and WHtR; lower TIR also predicted higher LDL-C [OR 0.97 (0.93-0.99), p = 0.007]. CONCLUSION: In boys with T1D, body adiposity and abdominal fat independently predict elevated LDL-C. In girls, who have higher adiposity than boys, glycemic control is the stronger predictor of LDL-C. These findings emphasize the need for sex-specific strategies combining optimized glucose management and body composition to reduce early cardiovascular risk in pediatric T1D.
Cumulative metabolic score for insulin resistance and heart failure risk: A prospective study.
Lin Z, Wu Y, Zhao D … +6 more , Kang S, Zhang M, Yang P, Wu Y, Chen S, Li Y
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41936493 · Publisher ↗
BACKGROUND AND AIM: The Metabolic Score for Insulin Resistance (METS-IR) is recognized as an indicator associated with the risk of Heart Failure (HF). However, evidence regarding its long-term impact is limited. This stu...
BACKGROUND AND AIM: The Metabolic Score for Insulin Resistance (METS-IR) is recognized as an indicator associated with the risk of Heart Failure (HF). However, evidence regarding its long-term impact is limited. This study aimed to evaluate the association between cumulative METS-IR (cumMETS-IR) and the risk of incident HF. METHODS AND RESULTS: We performed a prospective cohort analysis involving 51,155 participants from the Kailuan Study who underwent three health examinations (2006-2010) and were followed for incident HF until December 31, 2022. CumMETS-IR was calculated and analyzed using Cox proportional hazards models. Over a median follow-up of 12 years, higher cumMETS-IR was strongly and progressively associated with an increased risk of HF. Participants in the highest quartile had a 59% higher risk than those in the lowest. The incidence density of HF per 1000 person-years increased progressively across quartiles: Q1: 0.90 (0.76-1.07), Q2: 1.61 (1.41-1.83), Q3: 2.38 (2.14-2.64), and Q4: 3.60 (3.30-3.93). Maintaining high exposure for 2, 4, and 6 years increased risk by 23%, 49%, and 57%, respectively. Notably, these associations were significantly stronger in males and in adults aged ≥60 years. Adding cumMETS-IR to a conventional risk model also improved the prediction of HF. CONCLUSION: Higher levels of cumMETS-IR are associated with an increased risk of HF, particularly pronounced in males and older adults. Long-term monitoring of METS-IR may facilitate the early identification of high-risk individuals.
Changes in alcohol consumption and their association with lipid profiles among Korean adults aged 40-69 years: the Korea Genome and Epidemiology Study.
Park S, Park B
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41936492 · Publisher ↗
BACKGROUND AND AIM: Alcohol consumption influences lipid profiles and cardiovascular risk; however, the longitudinal effects of changes in drinking behavior on serum lipid levels remain unclear. This study evaluated asso...
BACKGROUND AND AIM: Alcohol consumption influences lipid profiles and cardiovascular risk; however, the longitudinal effects of changes in drinking behavior on serum lipid levels remain unclear. This study evaluated associations between alcohol initiation and cessation and changes in lipid profiles among Korean adults. METHODS AND RESULTS: We analyzed data from the community-based Korean Genome and Epidemiology Study (KoGES), including adults aged 40-69 years. Changes in low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and total cholesterol were assessed across follow-up visits. Associations between changes in alcohol intake-initiation, cessation, and average number of standard drinks per day-and lipid changes were estimated using generalized estimating equations adjusted for demographic, lifestyle, and clinical factors. Compared with individuals who remained non-consumers, alcohol initiation was associated with increased HDL-C levels (β = 1.07; 95% CI, 0.60 to 1.55; p < 0.001), with no significant change in LDL-C. Compared with continued consumers, alcohol cessation was associated with decreased HDL-C (β = -2.37; 95% CI, -3.80 to -1.94; p < 0.001), triglycerides (β = -2.92; 95% CI, -5.81 to -0.02; p = 0.049), and total cholesterol (β = -2.30; 95% CI, -3.80 to -0.79; p = 0.003). Each one-standard drink/day increase was associated with higher HDL-C (β = 0.94; 95% CI, 0.51 to 1.36; p < 0.001) and lower LDL-C (β = -0.87; 95% CI, -1.68 to -0.05; p = 0.037). CONCLUSIONS: Alcohol initiation and cessation were associated with distinct lipid changes, highlighting metabolic implications of drinking patterns and supporting moderation in alcohol consumption.
Gut bacteria associated with an atherogenic TMAO-dietary pattern and choline-rich foods among aging women.
Burns KF, Blair RH, Mares JA … +5 more , LaMonte MJ, Wactawski-Wende J, McSkimming D, Liu Z, Millen AE
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41936491 · Publisher ↗
BACKGROUND AND AIMS: Choline can be metabolized by gut bacteria with a choline utilization gene, CutC, as identified through genome sequencing studies. This metabolism produces trimethylamine, the precursor to the athero...
BACKGROUND AND AIMS: Choline can be metabolized by gut bacteria with a choline utilization gene, CutC, as identified through genome sequencing studies. This metabolism produces trimethylamine, the precursor to the atherosclerotic metabolite trimethylamine N-oxide (TMAO). Bacterial species involved in trimethylamine production in free-living humans have been under-investigated. We previously developed the TMAO dietary pattern (TMAO-DP), which is predictive of plasma TMAO and choline. We evaluated associations between the TMAO-DP, dietary choline, and choline-rich foods (fish, red meat, eggs) with the abundance of species with CutC. We also explored associations between the TMAO-DP and microbiome diversity. METHODS AND RESULTS: This cross-sectional analysis included 287 women (mean age = 79.6 years) from the Women's Health Initiative. Diet was assessed using a food frequency questionnaire. Stool samples were collected and the V3-V4 regions of the 16S ribosomal RNA were sequenced. Adjusted linear regression models evaluated associations between the TMAO-DP with the CLR-transformed abundance of species with CutC and with alpha-diversity indices. For beta-diversity, PERMANOVA examined measures of Aitchison distance within and between quartiles of the TMAO-DP. Associations between dietary choline and choline-rich foods with the abundance of species were evaluated using linear regression. The TMAO-DP was associated with Acidaminococcus intestini [Beta (SE): 0.23 (0.09), p-value = 0.035] and Desulfovibrio desulfuricans [Beta (SE): 0.16 (0.6), p = 0.035]. The TMAO-DP was not associated with alpha- or beta-diversity. CONCLUSION: This study provides evidence that Desulfovibrio desulfuricans and Acidaminococcus intestini, two species identified as having CutC by gene sequencing, may produce trimethylamine from diet in free-living women.
Prognostic value of kidney function biomarkers for target organ injury in young adults stratified by blood pressure status: the African-PREDICT study.
Degenaar A, Kruger R, Jacobs A … +1 more , Mels CMC
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41936490 · Publisher ↗
BACKGROUND AND AIMS: Kidney function biomarkers are valuable early risk predictors for target organ injury (TOI), yet their prognostic value remains underexplored in young hypertensive adults. We aimed to determine wheth...
BACKGROUND AND AIMS: Kidney function biomarkers are valuable early risk predictors for target organ injury (TOI), yet their prognostic value remains underexplored in young hypertensive adults. We aimed to determine whether baseline kidney biomarkers could predict TOI over 4.8-years in young adults, stratified by follow-up blood pressure status. METHODS AND RESULTS: In this prospective study (N = 561 adults aged 20-30 years at baseline), baseline kidney biomarkers included estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (uACR), alpha-1 microglobulin (uA1M), neutrophil gelatinase-associated lipocalin (uNGAL), uromodulin (uUMOD) and CKD273 classifier. Cox regression assessed the prognostic value of kidney biomarkers for increased TOI [including pulse wave velocity (PWV) carotid intima-media thickness (cIMT), left ventricular mass index (LVMi) and relative wall thickness (RWT)] at follow-up. In the normotensive, incident and sustained hypertensive groups, PWV, cIMT, LVMi and RWT increased from baseline to follow-up (all p ≤ 0.033). In normotensives, higher levels of tubular biomarkers (uNGAL and uA1M) were associated with a lower risk of increased cIMT and LVMi, while higher eGFR and lower uA1M were associated with increased RWT (all p ≤ 0.026). In individuals who developed hypertension, lower eGFR predicted higher PWV and LVMi, while higher uACR and CKD273 scores were associated with increased RWT (all p ≤ 0.026). In the sustained hypertensives, lower uUMOD and CKD273 scores predicted increased cIMT, whereas higher eGFR was associated with increased RWT (all p ≤ 0.039). CONCLUSION: Kidney biomarkers, even within normal ranges, are associated with early cardiovascular changes in young adults and these relationships are strongly modified by blood pressure status.
Healthy plant-based and healthy Brazilian dietary patterns are associated with a lower incidence of metabolic syndrome (CUME Study).
Conceição AR, Cruz MA, Hermsdorff HHM … +2 more , Pimenta AM, Bressan J
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41935859 · Publisher ↗
BACKGROUND AND AIMS: Metabolic syndrome (MetS) is a multifactorial condition and a growing public health concern due to its association with cardiometabolic diseases. Given the central role of dietary patterns in the pre...
BACKGROUND AND AIMS: Metabolic syndrome (MetS) is a multifactorial condition and a growing public health concern due to its association with cardiometabolic diseases. Given the central role of dietary patterns in the prevention of MetS, this study aimed to examine the association between various diet quality indices and the incidence of MetS in Brazilian adults. METHODS AND RESULTS: This longitudinal study included 4287 participants from the Cohort of Universities of Minas Gerais (CUME Study, 2016-2022). Data were collected through an online questionnaire. MetS was defined according to the International Diabetes Federation criteria. Diet quality was assessed using validated scoring indices, including the overall, healthful, and unhealthful Plant-Based Diet Index (PDI, hPDI, and uPDI, respectively) as well as the Brazilian Healthy Eating Index - Revised (BHEI-R). Cox proportional hazards models were applied to estimate the associations, using sociodemographic and lifestyle factors as covariates. During the follow-up period (mean: 3.6 years), 215 participants (5.0%) developed MetS, with an incidence rate of 14.1 per 1000 person-years. Higher hPDI scores were inversely associated with MetS incidence (HR: 0.60; 95% CI: 0.42-0.85; p = 0.004). Similarly, higher BHEI-R scores were associated with a lower risk of MetS (HR: 0.64; 95% CI: 0.44-0.93; p = 0.021). No effect modification was observed by age, sex, smoking, alcohol consumption, or physical activity. CONCLUSION: Greater adherence to a healthy plant-based diet, as assessed by the hPDI and BHEI-R, was associated with a lower incidence of MetS. These findings highlight the importance of evaluating overall diet quality, rather than food origin alone, in preventing chronic diseases.
Utility of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio in evaluating incident hyperuricemia risk.
Li S, Hao Z, Zheng P … +7 more , Xi Y, Zhang J, Deng Y, Li Y, Hu Y, Xu J, Wang J
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41935858 · Publisher ↗
BACKGROUND AND AIMS: The predictive value of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) for hyperuricemia risk remains inadequately explored. This study aims to eluc...
BACKGROUND AND AIMS: The predictive value of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) for hyperuricemia risk remains inadequately explored. This study aims to elucidate the relationship between NHHR and the incidence of hyperuricemia in a cohort of Chinese adults. METHODS: We conducted a prospective, longitudinal analysis using data from the China Health and Retirement Longitudinal Study (CHARLS). The study included 7102 participants free from hyperuricemia at baseline. NHHR was computed as the ratio of non-HDL-C to HDL-C. The primary outcome was new-onset hyperuricemia, defined by serum uric acid (SUA) levels ≥417μmol/L (7mg/dL) in males or ≥357μmol/L (6mg/dL) in females during follow-up. RESULTS: Over a follow-up period of 4 years, 626 participants developed new-onset hyperuricemia. An elevated NHHR was significantly associated with an increased risk of hyperuricemia, with an adjusted-odds ratio (OR) of 1.21 (95% confidence interval [CI]: 1.15-1.27) per 1-unit increase in NHHR. The risk was markedly higher in the highest NHHR quartile compared to the lowest (OR: 2.64, 95% CI: 2.01-3.47). The area under the receiver operating characteristic curve for NHHR in predicting hyperuricemia was 0.61, reflecting superior predictive accuracy compared to other lipid parameters. CONCLUSION: NHHR serves as an independent predictor of new-onset hyperuricemia in Chinese adults, with higher ratios correlating with a significantly increased risk. These results propose NHHR as a potential clinical marker for identifying individuals at elevated risk for hyperuricemia.
Placental microRNAs as molecular links between maternal metabolic health and neonatal outcomes.
Franzago M, Cavallo P, Borrelli P … +6 more , D'Adamo E, Di Tizio L, Gazzolo D, Stuppia L, Di Nicola M, Vitacolonna E
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41935857 · Publisher ↗
BACKGROUND AND AIMS: Gestational diabetes (GDM) predisposes women and their offspring to future cardiometabolic disease. Dysregulation of microRNAs (miRNAs) has been linked to environmental influences and complex disease...
BACKGROUND AND AIMS: Gestational diabetes (GDM) predisposes women and their offspring to future cardiometabolic disease. Dysregulation of microRNAs (miRNAs) has been linked to environmental influences and complex diseases. MiRNAs (namely miR-27a-3p, -222-3p, -423-3p and -16-5p) and lipoprotein lipase (LPL) are involved in insulin-signaling, glucose and lipid metabolism. Nevertheless, the role of the placental miRNAs in metabolic adaptation in pregnancy remains poorly understood. This cross-sectional study aimed to evaluate the association between placental selected miRNAs expression and clinical parameters of pregnant women and newborns. METHODS AND RESULTS: MiRNAs expression on maternal and fetal side of placenta tissues was analyzed in GDM (n = 25) and normoglycemic (NGT) women (n = 24). Correlations between these miRNAs and placental LPL expression were examined. MiR-27a rs895819 was genotyped. No significant differences in miRNAs expression between GDM and NGT were detected. On the maternal side, placental miR-423-3p expression was negatively associated with total cholesterol (p = 0.037) and triglycerides (TGs) (p = 0.043) at the third trimester. On the fetal side, miR-423-3p was inversely correlated with 2-h OGTT glucose level in GDM (p = 0.029). MiR-222-3p and miR-16-5p expression correlated with HDL-c (p = 0.017 and p = 0.030, respectively). Regarding neonatal outcomes, an association between miR-222-3p on maternal side with birth weight (p = 0.009) and length (p = 0.007) was found. MiR-27a rs895819 TT carriers exhibited higher 2-h OGTT glucose levels compared with other genotypes. In GDM, LPL expression was associated with miR-16-5p (p = 0.014) and TGs (p = 0.036). CONCLUSIONS: These findings suggest that the miRNA expression may reflect metabolic dysregulation during pregnancy and influence cardiometabolic risk in both women and their offspring.
Global burden of aortic aneurysm attributed to high systolic blood pressure from 1990 to 2021: a systematic analysis of the global burden of disease study.
Liu H, Nong S, Meng Y … +2 more , Lv W, Hu C
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41935856 · Publisher ↗
BACKGROUND AND AIMS: Aortic aneurysm (AA) is a significant cardiovascular condition with high mortality and disability burdens. High systolic blood pressure (SBP) is a major modifiable risk factor. This study aims to ana...
BACKGROUND AND AIMS: Aortic aneurysm (AA) is a significant cardiovascular condition with high mortality and disability burdens. High systolic blood pressure (SBP) is a major modifiable risk factor. This study aims to analyze global and regional trends in the burden of aortic aneurysm attributed to high SBP from 1990 to 2021, using data from the Global Burden of Disease (GBD) study. METHODS AND RESULTS: We extracted data on disability-adjusted life years (DALYs) and mortality rates of aortic aneurysm attributed to high SBP from the GBD database. Trends were analyzed by socio-demographic index (SDI), region, age, and sex. Spearman correlation, decomposition analysis, and stochastic frontier analysis (SFA) were applied to explore associations and performance gaps. Globally, the DALY rate increased slightly from 6.79 (95% UI: 4.76-9.05) in 1990 to 7.11 (95% UI: 5.33-9.20) in 2021. Mortality rates remained stable (0.34 to 0.36 per 100,000). High-income Asia Pacific and Eastern Europe showed the largest increases, while Australasia and Western Europe saw declines. Males and older adults bore the highest burden. SDI was positively correlated with both DALYs and mortality. Decomposition analysis indicated that population aging and growth were the main drivers of increased burden, while epidemiological changes had protective effects in high-income regions. SFA revealed significant health performance gaps in high-SDI countries like Japan and Armenia. CONCLUSIONS: Despite global stability, regional disparities in aortic aneurysm burden attributed to high SBP are widening. Interventions should target sex-specific and age-stratified profiles, integrate hypertension control with metabolic risk management, and address health system inefficiencies.
Subclinical carotid atherosclerosis in latent autoimmune diabetes in adults and type 2 diabetes mellitus: a cross-sectional study.
Cai T, Zhou R, Chen J … +5 more , Ran X, Li W, Xia M, Ao N, Zheng X
Nutr Metab Cardiovasc Dis · 2026 Aug · PMID 41935855 · Publisher ↗
BACKGROUND AND AIM: Despite differing clinical phenotypes, the cardiovascular-metabolic risks and complications of latent autoimmune diabetes in adults (LADA) versus type 2 diabetes mellitus (T2DM) are not fully defined....
BACKGROUND AND AIM: Despite differing clinical phenotypes, the cardiovascular-metabolic risks and complications of latent autoimmune diabetes in adults (LADA) versus type 2 diabetes mellitus (T2DM) are not fully defined. This study aimed to compare subclinical carotid atherosclerosis between LADA and T2DM. METHODS AND RESULTS: This cross-sectional analysis included 202 LADA and 206 T2DM patients matched for age, sex, body mass index, hemoglobin A1c, and statin use. Following assessment of carotid ultrasonography [carotid intima-media thickness (IMT), plaque], ankle-brachial index, toe-brachial index, brachial-ankle pulse wave velocity, lipid profile, urine albumin-to-creatinine ratio (uACR), and microvascular complications, group differences were analyzed. Univariable and multivariable logistic regression were then employed to identify independent predictors of carotid IMT ≥1.0 mm. Patients with LADA demonstrated a more favorable cardiometabolic profile than those with T2DM, including lower blood pressure, improved lipids, reduced uACR, and less severe carotid disease (all p < 0.05). T2DM was linked to higher rates of diabetic kidney disease and autonomic neuropathy. In multivariable analysis, LADA status was independently associated with a lower likelihood of increased IMT (OR = 0.405, 95% CI: 0.196-0.840, p = 0.003), whereas age, hypertension, smoking, and dyslipidemia were positively associated with increased IMT. CONCLUSION: Even when key metabolic risk factors are comparable, LADA exhibit a lower burden of subclinical carotid atherosclerosis than T2DM. This finding suggests that vascular injury in diabetes is driven more substantially by cumulative metabolic exposure and traditional cardiovascular risk factors, rather than by glycemic control or the diabetes subtype alone.
Serum uric acid as a reflection of residual risk in statin-treated patients with cardiovascular disease: Insights from NHANES 1999-2018.
Zhang Z, Xue Y, Guo X … +4 more , Bao X, Chen J, Xu B, Kang L
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41935854 · Publisher ↗
BACKGROUND AND AIM: Serum uric acid (SUA) is associated with cardiovascular disease (CVD) prognosis, and statins may modulate SUA levels. The purpose of this study is to investigate the prognostic value of SUA in statin-...
BACKGROUND AND AIM: Serum uric acid (SUA) is associated with cardiovascular disease (CVD) prognosis, and statins may modulate SUA levels. The purpose of this study is to investigate the prognostic value of SUA in statin-treated CVD patients. METHODS AND RESULTS: This study included and evaluated a cohort of 2739 CVD participants taking statins in 10 NHANES cycles between 1999 and 2018. The primary endpoints were defined as all-cause mortality and cardiovascular mortality by linkage to national death records. Kaplan-Meier analysis compared survival across SUA levels, while restricted cubic splines (RCS) evaluated dose-response relationships. Evaluate the hazard ratio and 95% CI of all-cause and cardiovascular mortality in CVD patients and subgroups using a weighted Cox proportional hazards regression model. The median SUA of patients in the queue was 5.9 (4.9-7.1) mg/dl. During a median follow-up period of 74 months, 1167 all-cause death and 479 cardiovascular death were recorded. The highest SUA quartile had a significantly increased risk of developing the primary endpoint (P < 0.001), and the RCS showed a linear relationship between SUA levels and endpoint events (P < 0.001). In the LDL-C < 70 mg/dL subgroup, fully adjusted models showed SUA positively correlated with all-cause mortality (HR: 1.148, 95% CI: 1.021-1.291, P = 0.021) and cardiovascular mortality (HR: 1.229, 95% CI: 1.014-1.490, P = 0.036). CONCLUSIONS: High SUA levels are associated with poor prognosis in CVD patients who achieve LDL-C control targets by taking statins. SUA is a potential indicator reflecting residual risk in CVD patients.
Metabolite clusters linking fatty liver disease to cardiovascular mortality in coronary heart disease patients.
Heerkens L, Gonzales GB, Geleijnse JM … +1 more , van Duijnhoven FJB
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41935853 · Publisher ↗
BACKGROUND AND AIMS: We aimed to identify metabolite clusters and assess their relationships with prevalent steatotic liver disease (SLD) and fatal cardiovascular diseases (CVD) risk in coronary heart disease (CHD) patie...
BACKGROUND AND AIMS: We aimed to identify metabolite clusters and assess their relationships with prevalent steatotic liver disease (SLD) and fatal cardiovascular diseases (CVD) risk in coronary heart disease (CHD) patients. METHODS AND RESULTS: We included 6127 CHD patients from the UK Biobank (UKB; discovery cohort) and 877 from the Alpha Omega Cohort (AOC; validation cohort). Metabolites were quantified at baseline (UKB: 2006-2010; AOC: 2002-2006) using the Nightingale Health 1H NMR platform. We employed exploratory factor analysis to UKB metabolite data followed by confirmatory factor analysis in both cohorts. Prevalent SLD was defined as the upper sex-specific tertile of the Fatty Liver Index. Cause-specific mortality was monitored from baseline through November 30, 2022 for UKB and December 31, 2011 for AOC. Cox regression was used to derive prevalence ratios and hazard ratios with 95 % confidence intervals for prevalent SLD and fatal CVD risk, respectively. Seven metabolite clusters emerged, mainly consisting of VLDL lipoproteins, LDL, small HDL, large HDL, very small VLDL, amino acids, and a cluster with docosahexaenoic acid, glycine, and glutamine. The small HDL cluster was inversely associated with prevalent SLD (PR:0.80 [0.69, 0.92]; PR:0.39 [0.07, 2.09]) and fatal CVD risk (HR:0.76 [0.62, 0.93]; HR:0.67 [0.15, 2.97]). The very small VLDL cluster was positively associated with prevalent SLD (PR:1.44 [1.37, 1.51]; PR:1.84 [1.57, 2.16]) and fatal CVD risk (HR:1.10 [1.03, 1.17]; HR:1.12 [0.91, 1.38]). CONCLUSION: Small HDL and very small VLDL lipoproteins are likely involved in the biological pathways linking SLD to fatal CVD in CHD patients.
Longitudinal association of cumulative visceral fat metabolic score with new-onset stroke in Chinese middle-aged and elderly adults: A prospective study based on the CHARLS database.
Wang J, Lu Y, Zheng G … +3 more , Xiao Y, Lv Y, Xu J
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41935852 · Publisher ↗
BACKGROUND AND AIMS: Stroke is a leading cause of death and disability worldwide, influenced by complex metabolic and lifestyle factors. The Metabolic Visceral Fat Index (METS-VF) has recently gained attention as a key m...
BACKGROUND AND AIMS: Stroke is a leading cause of death and disability worldwide, influenced by complex metabolic and lifestyle factors. The Metabolic Visceral Fat Index (METS-VF) has recently gained attention as a key measure of metabolic burden. This study examines the relationship between cumulative METS-VF and stroke risk. METHODS AND RESULTS: This study used the China Health and Retirement Longitudinal Study (CHARLS) database and a multivariate Cox regression model to explore the relationship between cumulative METS-VF and stroke risk. Kaplan-Meier (KM) curves, restricted cubic splines (RCS), and receiver operating characteristic (ROC) analysis were utilized to assess dose-response relationships and predictive performance. The research also examined the effects of cumulative exposure duration and burden on stroke risk, with subgroup and sensitivity analyses to confirm robustness. In a study of 4069 participants, 347 strokes (8.5%) occurred. Multivariate Cox regression revealed that the highest exposure group (Q4) had more than double the stroke risk of the lowest group (Q1), with a hazard ratio (HR) of 2.12. A one standard deviation increase in cumulative METS-VF raised stroke risk by 29%. The optimal threshold was 6.84, above which stroke risk significantly increased. KM survival analysis supported this link, and ROC analysis indicated that cumulative METS-VF was a predictor of stroke risk, with an area under the curve (AUC) of 0.606. Subgroup and sensitivity analyses validated these findings. CONCLUSION: This study identifies cumulative METS-VF as an independent stroke risk factor, with both its duration and cumulative burden affecting risk, providing new insights for prevention and intervention.
Birth cohort effects on obesity, glucose metabolism, diet, and fitness: evidence from a longitudinal study.
Katus U, Villa I, Ringmets I … +4 more , Eensoo D, Mäestu J, Veidebaum T, Harro J
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41935851 · Publisher ↗
BACKGROUND AND AIMS: Separate birth cohorts experience different social and environmental factors, which may lead to differences in psychological and social development and health-related behaviours. We analysed the asso...
BACKGROUND AND AIMS: Separate birth cohorts experience different social and environmental factors, which may lead to differences in psychological and social development and health-related behaviours. We analysed the association between age, birth cohort and body weight, glucose metabolism, diet, and cardiorespiratory fitness (CRF). METHODS AND RESULTS: The sample included two very similarly formed birth cohorts (n = 1238) of the Estonian Children Personality Behaviour and Health Study. Body weight, diet and CRF from 15 to 25 years was analysed by birth cohort using the linear mixed-effects regression model. Differences at ages 15, 18, and 25 years were assessed by independent group t-test. Prevalence of overweight and obesity increased over time across both birth cohorts and sexes. Subjects from the older birth cohort had lower measures of obesity at ages 15 and 18 years. However, in males, the difference either disappeared or was reverse by age 25. The increase per year in measures of obesity was significantly greater among subjects in the older birth cohort, compared to the younger cohort. The older birth cohort had higher daily energy intake (kcal) at ages 15 and 25 years and higher carbohydrate intake (g) at ages 15, 18 and 25 years. CONCLUSION: During profound societal changes, birth cohort effects on body weight and weight gain can rapidly emerge, with sex differences. Relationship between birth cohort and measures of obesity may at least partly be driven by energy intake, especially from carbohydrates.
Remnant cholesterol and arterial stiffness: insights from NHANES 1999-2018 with evidence of a nonlinear and inflammation-mediated association.
Iqbal J, Sathian B, Muhammad Ali S … +2 more , Al Shukaili KSH, Malik AP
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41935850 · Publisher ↗
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Dietary antioxidants and cardiometabolic health in the Ardabil Persian cohort.
Mohajeri M, Pourfarzi F, Fogacci F … +1 more , Cicero AFG
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41935849 · Publisher ↗
BACKGROUND AND AIMS: Cardiovascular diseases (CVDs) remain a major global health burden, with oxidative stress and inflammation playing key roles in their development. This study investigated the cross-sectional associat...
BACKGROUND AND AIMS: Cardiovascular diseases (CVDs) remain a major global health burden, with oxidative stress and inflammation playing key roles in their development. This study investigated the cross-sectional association between dietary total antioxidant capacity (DTAC) and cardiovascular risk factors among adults aged 35-75 in Ardabil, Iran. METHODS AND RESULTS: A cross-sectional analysis was conducted on 500 participants from the Ardabil Persian Cohort Study. Dietary intake was assessed using three 24-h dietary recalls, and DTAC was estimated using the ferric reducing antioxidant power (FRAP) approach. DTAC was inversely associated with several cardiometabolic markers, including total cholesterol, body mass index (BMI), hyperglycemia, and hypertension. Two primary dietary patterns were identified a posteriori using principal component analysis (PCA) on 19 nutritionally similar food groups: one rich in fruits and vegetables (fruit-and-vegetable pattern), associated with higher DTAC and a more favorable cardiometabolic risk profile, and another rich in butters, sweets, red meat, and butter (red meat pattern), associated with less favorable cardiometabolic outcomes. Associations between DTAC, dietary patterns and CVD risk factors were examined using regression models. CONCLUSION: The findings indicate that higher DTAC and adherence to a fruit-and-vegetable dietary pattern are associated with lower cardiometabolic risk. These results highlight the importance of promoting healthier dietary patterns to reduce cardiometabolic risk in diverse populations, while prospective studies are warranted to confirm temporality and causality.
Economic and organizational determinants of diet quality in university students living away from home.
Foglia A, Bruno F, Rivieccio AM … +3 more , Colao A, Ungaro P, Macchia PE
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41934046 · Publisher ↗
BACKGROUND AND AIMS: Dietary behaviors established during early adulthood are important for long-term health and may influence the risk of non-communicable diseases later in life. University students living away from hom...
BACKGROUND AND AIMS: Dietary behaviors established during early adulthood are important for long-term health and may influence the risk of non-communicable diseases later in life. University students living away from home are a vulnerable group, as the transition to independent living is often accompanied by economic constraints, changes in meal organization, and suboptimal dietary habits. This study examined diet quality among Italian university students living away from home using an integrated approach. METHODS AND RESULTS: A cross-sectional online survey was conducted among 1973 university students. Dietary behaviors were assessed using three indices: Quality and Completeness of Diet (QCA), Organization and Regularity of Meals (ORA), and Practical and Economic Difficulties (DPE). Associations with monthly food and housing budgets were examined using descriptive analyses, multivariable linear regression, and exploratory cluster analysis. A gradient was observed between monthly food budget and dietary quality, with higher QCA scores in higher food budget categories. In contrast, housing-related expenditures were not associated with QCA but were linked to poorer meal organization and greater perceived difficulties. In multivariable analysis, both ORA and DPE were independently associated with dietary quality. Cluster analysis identified three distinct profiles characterized by different combinations of diet quality, meal organization, and economic and organizational constraints. CONCLUSION: Diet quality among university students living away from home reflects the combined and partially independent effects of economic resources, meal organization, and organizational constraints. These findings highlight early-life determinants of dietary behaviors with potential implications for future health and support integrated preventive strategies for young adults.
Prospective association of waist-thigh-ratio and cardiovascular disease mortality among the US adults: NHANES 1999-2002 linked mortality study.
Prakash PS, Lu E, Swede H … +1 more , Lu B
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41934045 · Publisher ↗
BACKGROUND AND AIM: Anthropometric measures and derived ratios effectively predict cardiovascular disease (CVD) mortality. In this study, we aimed to compare waist-to-thigh ratio (WTR) with more common measures for predi...
BACKGROUND AND AIM: Anthropometric measures and derived ratios effectively predict cardiovascular disease (CVD) mortality. In this study, we aimed to compare waist-to-thigh ratio (WTR) with more common measures for predicting CVD mortality. METHODS AND RESULTS: This study included 5661 U.S. adults from the 1999-2002 National Health and Nutrition Examination Survey, linked with 2019 mortality status from the National Death Index (768 CVD deaths). Anthropometric measures, including waist circumference (WC), thigh circumference (TC), BMI, waist-to-BMI ratio (WBR), waist-to-height ratio (WHtR), and WTR, were assessed at baseline. Hazards ratios (HR) and 95th confidence intervals (CI) were calculated for each anthropometric measure across quartiles in relation to CVD mortality after adjusting for traditional CVD risk factors and accounting for multi-stage sampling design. Study results showed that, compared to the lowest quartile, successive quartiles of WTR were significantly associated with greater HRs for CVD mortality (1.34 (0.88-2.03), 1.26 (0.90-1.76), and 1.62 (1.21-2.16, respectively, p trend = 0.003). Stronger associations were observed among adults aged 75 and above, with HR (95% CI) for the highest versus lowest WTR quartile of 2.34 (1.70-3.22) (p trend <0.001). However, no significant associations were observed for other anthropometric measures and CVD mortality. CONCLUSIONS: In this nationally representative U.S. cohort, WTR was a stronger predictor of CVD mortality than WC, TC, BMI, WBR, or WHtR, particularly among participants aged ≥75 years. Incorporating WTR into traditional CVD risk models may more sensitively identify individuals at risk of CVD death.
Hemoglobin A1c is more predictive of type 1 myocardial infarction than low-density lipoprotein or body mass index.
Palmisano T, Bilchick K, Guarraia D
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41864779 · Publisher ↗
BACKGROUND AND AIMS: Dyslipidemia and diabetes are traditional risk factors for myocardial infarction (MI), with obesity and prediabetes now recognized as non-traditional ones. Few studies have investigated the prevalenc...
BACKGROUND AND AIMS: Dyslipidemia and diabetes are traditional risk factors for myocardial infarction (MI), with obesity and prediabetes now recognized as non-traditional ones. Few studies have investigated the prevalence of these diseases at the time of admission for MI. To clarify their relative importance, we collected hemoglobin A1c (HbA1c), body mass index (BMI), and lipid profiles at the time of admission for patients with type 1 MI over 10 years at a major academic center. METHODS AND RESULTS: This was a single-center retrospective cohort study. We examined 570 patients admitted for type 1 MI over 10 years, collected their HbA1c, BMI, and lipid profiles at or near admission, and compared them to an age- and sex-matched control group of admitted patients. After adjusting for potential confounders, only HbA1c was associated with increased odds of type 1 MI (odds ratio 1.12). When compared to patients with clinically normal HbA1c (<5.7), patients with HbA1c ≥ 6.5 had 160% higher odds of MI, and patients with prediabetic range HbA1c (5.7-6.4) had 58% higher odds of MI. The interaction between sex and these metabolic variables was not statistically significant. Younger patients had a stronger association between the risk of MI and both LDL and BMI, compared to older patients. There was no statistically significant change in average HbA1c, BMI, or LDL across the 10-year timespan. CONCLUSION: Admission HbA1c level has a stronger association with type 1 myocardial infarction than admission LDL or BMI, even among patients with levels in the prediabetic range.
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