Nutrition, Metabolism, And Cardiovascular Diseases[JOURNAL]
Sun
200 papers
Global burden and causal analysis of LDL-C-related cardiovascular diseases: A GBD 2021 and Mendelian randomization study.
Zhang J, Wu Y, Zhang Y … +2 more , Gao L, Hu Y
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41862301 · Publisher ↗
BACKGROUND AND AIM: High low-density lipoprotein cholesterol (LDL-C) is a major risk factor for cardiovascular diseases (CVDs), contributing substantially to global disease burden. We aimed to quantify the global burden...
BACKGROUND AND AIM: High low-density lipoprotein cholesterol (LDL-C) is a major risk factor for cardiovascular diseases (CVDs), contributing substantially to global disease burden. We aimed to quantify the global burden of LDL-C-related CVDs and establish causal relationships through integrated Global Burden of Disease(GBD) and Mendelian randomization(MR) analyses. METHODS AND RESULTS: We analyzed the impact of high LDL-C on CVDs burden using GBD 2021. Estimated Annual Percentage Change(EAPC) was used to delineate trends, while frontier analysis compared national performances against the minimum risk level adjusted for sociodemographic factors. BAPC modeling projected trends to 2036. MR examined the causal relationship between LDL-C (and its subtypes) and CVDs (ischemic heart disease(IHD) and ischemic stroke).The absolute increase in DALYs (45.7% increase from 1990 to 2021) contrasts sharply with the decline in ASDR (-33.2%), with a global EAPC of -1.47. This downward trend is consistent with that of the age-standardized mortality rate (ASMR) and is particularly pronounced among older individuals.In 2021, Nauru had the highest ASMR, while Israel showed the most significant reduction.Frontier analysis highlighted improvements in Somalia, Ethiopia, Rwanda, Burkina Faso, and Niger, but Lithuania, the US, Germany, Finland, and Monaco need more progress. Projections indicate ASMR will decrease by 2036 without targeted measures. MR analysis revealed a causal link between LDL-C and IHD, but not ischemic stroke. CONCLUSION: High LDL-C is a modifiable risk factor for CVDs (IHD). Despite declining ASDR and ASMR globally from 1990 to 2021, the absolute burden is rising. MR and GBD findings call for immediate targeted LDL-C interventions to reduce the burden on vulnerable populations.
Phenome-wide study on alcohol consumption provides genetic evidence for a causal association with multiple diseases and biomarkers.
Assefa Kassaw N, Zhou A, Stacey D … +4 more , Mulugeta A, Lee SH, Burgess S, Hyppӧnen E
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41862300 · Publisher ↗
BACKGROUND AND AIM: This study investigates genetic evidence for a causal association between alcohol intake and 1174 diseases, and various biomarkers. METHODS AND RESULTS: A phenome-wide Mendelian randomization (MR) stu...
BACKGROUND AND AIM: This study investigates genetic evidence for a causal association between alcohol intake and 1174 diseases, and various biomarkers. METHODS AND RESULTS: A phenome-wide Mendelian randomization (MR) study was conducted using data from 337,463 UK Biobank participants. Five MR methods and sensitivity analyses tested linear associations, while non-linear MR assessed intake-dependent effects. Alcohol consumption was associated with 22 distinct diseases across ten categories. Beyond the strong association between genetically indexed alcohol intake with 'alcohol-related disorders' (OR per log-unit/week: 7.02, 95% CI: 5.26-9.37), MR analyses suggested robust evidence for increased risks of 'cerebrovascular diseases' (1.63, 1.20-2.21), 'essential hypertension' (1.34, 1.07-1.67), 'electrolyte imbalance' (1.82, 1.34-2.48), 'magnesium metabolism disorder' (4.39, 2.06-9.39), 'open wounds of head, neck, and trunk' (2.15, 1.39-3.33), and 'symptoms involving nervous and musculoskeletal systems' (2.16, 1.60-2.91). Suggestive evidence indicated higher risks for 12 diseases, mostly mental and digestive disorders, and lower risks for 'benign neoplasms of connective and other soft tissue', 'urinary calculus', and migraines. Seven diseases exhibited non-linear yet monotonic trends (all P ≤ 0.05). Alcohol intake was robustly associated with biomarkers including bilirubin, urine sodium, urea, and blood pressure. CONCLUSION: This comprehensive analysis supports alcohol's causal role in multiple diseases and biomarkers, highlighting significant risks with minimal benefits.
Comment on "The impact of intermittent fasting and Mediterranean diet on older adults' physical health and quality of life: a randomized clinical trial".
Deng C, Li J
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41856835 · Publisher ↗
Abstract loading — click title to view on PubMed.
Atherosclerosis burden across subtypes of steatotic liver disease: a European cohort analysis.
Bauer J, Gensluckner S, Eberhardt J … +10 more , Akhgar A, Datz C, Iglseder B, Langthaler P, Trinka E, Ausserwinkler M, Semmler G, Paulweber B, Aigner E, Wernly B
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41856834 · Publisher ↗
BACKGROUND AND AIM: Steatotic liver disease (SLD) affects over 30% of adults and is classified into metabolic dysfunction-associated (MASLD), alcohol-related (ALD), and metabolic dysfunction and alcohol-associated (MetAL...
BACKGROUND AND AIM: Steatotic liver disease (SLD) affects over 30% of adults and is classified into metabolic dysfunction-associated (MASLD), alcohol-related (ALD), and metabolic dysfunction and alcohol-associated (MetALD) subtypes. Cardiovascular disease is the leading cause of death in SLD, yet the differential atherosclerotic risk across subtypes remains uncertain. METHODS AND RESULTS: We conducted a cross-sectional analysis of 7820 participants from the population-based Paracelsus 10,000 cohort. SLD was defined by the Fatty Liver Index according to international consensus criteria. Atherosclerosis was assessed by carotid ultrasonography (n = 7820), coronary artery calcium (CAC) scoring by computed tomography (n = 1434), and polygenic risk scores (PGS, n = 1652). Primary outcomes were carotid plaque presence and CAC burden (Agatston score). Multivariable logistic regression adjusted for age, sex, and SCORE2 cardiovascular risk. We identified 5448 controls (69.7%), 2098 MASLD (26.8%), 201 ALD (2.6%), and 73 MetALD (0.9%). Carotid plaque prevalence increased stepwise: 30% in controls, 47% in MASLD, 53% in MetALD, and 62% in ALD (p<0.001). High-risk CAC (Agatston >300) was present in 4% of controls, 7% of MASLD, and 18% of both MetALD and ALD (p<0.001). Unadjusted odds ratios for plaque were 2.10 (95% CI, 1.89-2.33) for MASLD, 2.69 (1.69-4.28) for MetALD, and 3.86 (2.89-5.16) for ALD. After SCORE2 adjustment, associations attenuated and lost statistical significance. CAD-PGS differed modestly across subtypes (p=0.019) and inclusion further attenuated associations. CONCLUSIONS: All SLD subtypes were associated with increased atherosclerotic burden, with ALD showing the highest risk. Associations were attenuated after adjustment for established cardiovascular risk factors, indicating shared cardiometabolic rather than liver-specific pathways.
The effect of red pepper/capsaicin on cardiovascular risk factors: a systematic review, meta-analysis, and GRADE assessment.
Ghoreishy SM, Zeydi M, Hadi V … +6 more , Jafarbeglou N, Atabaki Y, Mohammadian MK, Imani H, Hemmati A, Hadi S
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41856833 · Publisher ↗
AIMS: Cardiovascular disease (CVD) is a leading global cause of mortality. Capsaicinoids, the active compounds in red pepper, act as agonists of the transient receptor potential vanilloid 1 (TRPV1) and may offer cardiopr...
AIMS: Cardiovascular disease (CVD) is a leading global cause of mortality. Capsaicinoids, the active compounds in red pepper, act as agonists of the transient receptor potential vanilloid 1 (TRPV1) and may offer cardioprotective benefits by modulating lipid metabolism, glucose homeostasis, and vascular function. This systematic review and meta-analysis aimed to evaluate the effect of red pepper/capsaicin supplementation on cardiovascular risk factors. DATA SYNTHESIS: A comprehensive search of MEDLINE/PubMed, and Scopus was conducted from inception until May 2025, following PRISMA guidelines. The conducted systematic review and meta-analysis adhered to the pre-specified protocol registered in PROSPERO (CRD420251119445). In order to avoid missing an article, a manual search was finally conducted in Google Scholar. Randomized controlled trials (RCTs) in adults supplementing with capsaicin, red pepper, or related compounds versus a placebo were included. Outcomes of interest included lipid profile (total cholesterol [TC], triglycerides [TG], low-density lipoprotein [LDL], high-density lipoprotein [HDL]), blood pressure (systolic [SBP] and diastolic [DBP]), and glycemic indices (glucose, insulin, HOMA-IR, HbA1c). Data were pooled using a random-effects model and expressed as weighted mean difference (WMD) with 95% confidence intervals (CI). Thirteen RCTs (n = 821 participants) were included. However, the findings were marked by substantial heterogeneity and a limited total sample size, which necessitate cautious interpretation. Red pepper/capsaicin supplementation was associated with small, statistically unstable reductions in total cholesterol and diastolic blood pressure; however, these effects were not robust to sensitivity analyses and should be interpreted as low-confidence estimates. However, no significant effects were observed on TG, LDL, HDL, SBP, glucose, insulin, HOMA-IR, or HbA1c. Significant heterogeneity was observed for most outcomes (I > 50%). Subgroup analyses suggested that longer intervention durations (≥8 weeks) might be more effective for improving TC and HDL. The overall certainty of evidence, assessed by Grading of Recommendations Assessment, Development and Evaluation (GRADE), was low to very low for most outcomes. CONCLUSIONS: Red pepper/capsaicin supplementation may yield modest benefits in reducing total cholesterol and diastolic blood pressure. However, sensitivity analysis demonstrated that the significant results for TC and DBP were dependent on a single study; their exclusion rendered the results non-significant. Due to significant heterogeneity, the limited number of studies, low sample sizes, and the instability of results upon sensitivity analysis, these findings must be interpreted with caution. Larger, well-designed, long-term RCTs are necessary to confirm these potential cardiometabolic benefits. PROSPERO registration number: (CRD420251119445).
Supplementation with mixed nuts does not improve inflammatory biomarkers or dietary inflammatory potential in post-myocardial infarction: a secondary analysis of the DICA-NUTS trial.
Marcadenti A, Bersch-Ferreira AC, Vieira Machado RH … +8 more , Nakagawa Santos RH, de Abreu-Silva EO, da Silva A, Stein E, Bressan J, Hebert JR, Zhao L, Rogero MM
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41856832 · Publisher ↗
BACKGROUND AND AIMS: Systemic inflammation is an independent predictor of cardiovascular events, and nut-enriched diets are often recommended after acute myocardial infarction (AMI). However, the effects of mixed nuts on...
BACKGROUND AND AIMS: Systemic inflammation is an independent predictor of cardiovascular events, and nut-enriched diets are often recommended after acute myocardial infarction (AMI). However, the effects of mixed nuts on inflammatory biomarkers in secondary prevention remain unclear. This study evaluated the impact of incorporating mixed nuts into the Brazilian Cardioprotective Diet (DICA Br) on systemic inflammation and dietary inflammatory potential in post-AMI patients. METHODS AND RESULTS: This secondary analysis of the DICA-NUTS randomized controlled trial included 170 adults post-AMI, assigned to receive either the DICA Br diet alone (n = 85) or the same diet supplemented with 30 g/day of mixed nuts (10 g each of peanuts, cashews, and Brazil nuts; n = 85) for 16 weeks. Plasma concentrations of interleukins (IL-2, IL-4, IL-6, IL-10), tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), and C-reactive protein (CRP) were measured at baseline and post-intervention. Dietary inflammatory potential was assessed using the Dietary Inflammatory Index (DII®) and the energy-adjusted DII (E-DII™). No significant between-group differences were observed for any inflammatory biomarker or for DII and E-DII scores. Within the DICA group, IL-4 levels decreased (-4.56 pg/mL; 95% CI -9.00 to -0.11; p = 0.045), with a concurrent increase in the IFN-γ/IL-4 ratio (0.035; 95% CI 0.003 to 0.067; p = 0.04). IFN-γ concentrations were higher in the lowest DII tertile (p = 0.046) and inversely correlated with DII scores (ρ = -0.15; p = 0.006). CONCLUSION: Supplementation with 30 g/day of mixed nuts did not significantly modify inflammatory biomarkers or improve the anti-inflammatory potential of the diet over 16 weeks in post-AMI patients. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03728127.
Development and external validation of a plasma metabolomic signature for predicting 3-year all-cause mortality in older adults with CAD.
Gu J, Gao L, Li J … +2 more , Wu S, Chen Y
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41856831 · Publisher ↗
BACKGROUND AND AIMS: Prognostic stratification in older adults with coronary artery disease (CAD) remains challenging, and existing clinical risk scores have limitations in this population. We aimed to identify and valid...
BACKGROUND AND AIMS: Prognostic stratification in older adults with coronary artery disease (CAD) remains challenging, and existing clinical risk scores have limitations in this population. We aimed to identify and validate a novel plasma metabolomic signature for 3-year all-cause mortality and assess its incremental value over established clinical risk factors. METHODS AND RESULTS: We performed a secondary analysis of data from two temporally distinct, prospectively collected cohorts from the Emory Cardiovascular Biobank (training: n = 269; validation: n = 190). The primary endpoint was 3-year all-cause mortality. A stability-based LASSO algorithm with permutation testing was used to select a robust prognostic signature from 1150 harmonized metabolomic features. The performance of a pre-specified Cox proportional hazards model was assessed for discrimination and calibration in the independent validation cohort. Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI) were calculated to quantify added prognostic value over a clinical risk model. A robust 11-metabolite signature was identified. In the independent validation cohort, the pre-specified Cox model demonstrated strong discrimination for 3-year mortality (time-dependent AUC: 0.716; 95% CI: 0.630-0.802) and good calibration. Compared to a model with established clinical risk factors alone, the addition of the 11-metabolite signature resulted in a significant improvement in risk reclassification (NRI: 0.322, 95% CI: 0.190-0.447; IDI: 0.199, 95% CI: 0.127-0.283; both p < 0.001). CONCLUSION: A validated 11-metabolite signature improves long-term mortality risk stratification in older adults with CAD beyond established clinical measures, providing a basis for a new blood-based prognostic tool.
Association between cumulative exposure to metabolic score for visceral fat and the risk of stroke in a population with cardiovascular-kidney-metabolic syndrome stages 0-3: a nationwide prospective cohort study.
Zhao L, Gao Q
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41856830 · Publisher ↗
BACKGROUND AND AIM: The association between cumulative exposure to METS-VF and the risk of stroke at cardiovascular-kidney-metabolic (CKM) syndrome stages 0-3 remains inadequately understood. This study aimed to investig...
BACKGROUND AND AIM: The association between cumulative exposure to METS-VF and the risk of stroke at cardiovascular-kidney-metabolic (CKM) syndrome stages 0-3 remains inadequately understood. This study aimed to investigate the association between cumulative METS-VF and incident stroke in this population. METHODS AND RESULTS: This analysis was based on data from the China Health and Retirement Longitudinal Study (CHARLS), focusing on participants assigned to CKM syndrome stages 0-3. An optimal cut-off for time-averaged cumulative METS-VF in relation to stroke was identified through the survival-time method incorporating maximally selected rank statistics. We applied Cox proportional hazards regression models to examine the association between cumulative METS-VF and stroke risk. Over a five-year follow-up period, 235 of the 3227 participants experienced stroke. In participants with CKM syndrome stages 0-3, cumulative METS-VF showed a positive association with stroke risk. After adjustment for confounding variables in model 3, participants classified into Q2, Q3, and Q4 showed a significantly higher risk of stroke than those in Q1. These were 1.664 (1.070-2.588), 1.765 (1.145-2.719), and 2.261 (1.478-3.459) for the corresponding hazard ratios (HRs) and 95% confidence intervals (CIs). A cumulative average METS-VF level greater than 6.53 was associated with a significantly elevated risk of stroke relative to participants with values below 6.53 (HR = 1.781, 95% CI: 1.296-2.448). CONCLUSIONS: Cumulative METS-VF is significantly associated with an increased risk of stroke. Among individuals with CKM stages 0-3, time-averaged assessment of longer-term METS-VF burden may help identify individuals at elevated risk of stroke, thereby providing supportive evidence for early preventive strategies.
Association of triglyceride glucose-body mass index with blood pressure variability and morning blood pressure surge in young and middle-aged patients with primary hypertension.
Guo Q, Pan Y, Zhao X … +5 more , Yin S, Lu Y, Jiang Y, Cheng Y, Liu Y
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41856829 · Publisher ↗
BACKGROUND AND AIMS: Morning blood pressure surge (MBPS) is a significant predictor of adverse cardiovascular events in hypertension. Prior studies have also found an independent association between triglyceride glucose-...
BACKGROUND AND AIMS: Morning blood pressure surge (MBPS) is a significant predictor of adverse cardiovascular events in hypertension. Prior studies have also found an independent association between triglyceride glucose-body mass index (TyG-BMI) and an increased hypertension risk. Therefore, this study aimed to explore the relationship of TyG-BMI with MBPS and blood pressure variability (BPV) in young and middle-aged patients with primary hypertension (PH). METHODS AND RESULTS: A total of 653 patients with PH, aged 18-65 years, were enrolled in this retrospective cross-sectional study. Patients were divided into low and high TyG-BMI groups by the median. Compared with the low TyG-BMI group, the high TyG-BMI group demonstrated significantly higher coefficient of variation (CV) of mean nocturnal systolic blood pressure (nSBP-CV), CV of mean nocturnal diastolic blood pressure (nDBP-CV), and MBPS (27.50 [18.00, 38.00] mmHg vs. 24.50 [17.00, 34.63] mmHg, P = 0.012). Additionally, the proportion of patients with elevated MBPS (i.e., ≥35 mmHg) in the high TyG-BMI group was slightly higher than that in the low TyG-BMI group; however, this difference was not statistically significant (P = 0.067). TyG-BMI was positively associated with MBPS and BPV (r = 0.087-0.108). Multiple linear regression analysis further showed that TyG-BMI was an independent risk factor for increased dDBP-CV, nSBP-CV, nDBP-CV, and MBPS after covariate adjustment. CONCLUSIONS: TyG-BMI is an independent risk factor for increased dDBP-CV, nSBP-CV, nDBP-CV, and MBPS in young and middle-aged patients with PH.
The effect of plant-based dietary patterns on C-reactive protein: A systematic review and meta-analysis of randomised controlled trials.
Bell L, Gibbs J, Cappuccio FP
Nutr Metab Cardiovasc Dis · 2026 Jul · PMID 41856828 · Publisher ↗
AIMS: Chronic low-grade inflammation, termed "inflammageing", accelerates many age-related diseases. C-reactive protein (CRP) is a well-validated biomarker of inflammation and is an independent predictor of cardiovascula...
AIMS: Chronic low-grade inflammation, termed "inflammageing", accelerates many age-related diseases. C-reactive protein (CRP) is a well-validated biomarker of inflammation and is an independent predictor of cardiovascular events. Plant-based dietary patterns (PBDPs) supply greater intakes of antioxidants and unsaturated fats than omnivorous diets and have been linked to lower circulating CRP concentrations in observational studies, but a causal relationship remains unclear. The main objective of this meta-analysis was to determine the effects of PBDPs on CRP concentration when compared to omnivorous dietary patterns in controlled clinical trials. DATA SYNTHESIS: MEDLINE, Embase and Web of Science were searched to identify trials investigating the effect of PBDPs on CRP concentration. Standardised mean differences in CRP and 95% confidence intervals were pooled using a random-effects model. Risk of bias, heterogeneity and sensitivity were assessed. Of the 2962 studies identified, only 7 clinical trials met the inclusion criteria, generating eight data sets (541 participants of median age 55 years). In the analysis of all 7 trials, the consumption of PBDPs was associated with significantly lower CRP (-1.13 mg/L (95% CI, -1.52 to -0.75). Subgroup analysis excluding studies with exercise prescriptions showed PBDPs were associated with significantly lower CRP (-0.94 mg/L (95% CI -1.43 to -0.46). Heterogeneity was high and the certainty of the results was low. CONCLUSIONS: Consumption of PBDPs may lower CRP concentration but further evidence gathering is required to validate this finding.
Corrigendum to "Very-low calorie ketogenic diet reduces central blood pressure and metabolic risk in post-menopausal women with essential hypertension and obesity: a single center, prospective, open-label clinical study" [Nutr Metab Cardiovasc (2025) 4 35 4 103838].
Pala B, Pennazzi L, Nardoianni G … +5 more , Rubattu SD, Volpe M, Colao AM, Barbato E, Tocci G
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41856827 · Publisher ↗
Abstract loading — click title to view on PubMed.
Individual variability in insulin sensitivity, visceral fat, and cardiorespiratory fitness in response to exercise in adolescents with obesity.
Mirzadeh P, Lee S, Arslanian S … +1 more , Kuk JL
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41856826 · Publisher ↗
BACKGROUND AND AIM: We examined the interindividual variability in insulin-stimulated glucose disposal (R), visceral fat, and cardiorespiratory fitness (CRF) in response to aerobic and/or resistance exercise training in...
BACKGROUND AND AIM: We examined the interindividual variability in insulin-stimulated glucose disposal (R), visceral fat, and cardiorespiratory fitness (CRF) in response to aerobic and/or resistance exercise training in adolescents with overweight or obesity. METHODS AND RESULTS: This is a secondary analysis of our previously published randomized trials (3-6 months) at UPMC Children's Hospital of Pittsburgh. We included 143 adolescents (12-18 y, BMI ≥85th percentile) who had complete baseline and post-intervention data for a 3-hr hyperinsulinemic-euglycemic clamp-measured R, visceral fat, and peak oxygen uptake (VOpeak). Each individual's response was compared with the smallest worthwhile difference (SWD) which corresponds to a small effect size as a 'possible responder' (greater than SWD) or 'likely responder' (greater than the SWD and beyond the 90th percentile of the technical error of measurement). In response to 3-6 months of aerobic and/or resistance exercise, approximately half to two-thirds of participants were 'likely/possible responders' in R. Over 80% of participants were 'likely/possible responders' in reduction of visceral fat, and over two-thirds were 'likely/possible responders' in improvement in CRF in response to exercise. The greatest proportion 'likely/possible responders' was most commonly seen in the aerobic exercise group. Nearly all participants were 'likely/possible responders' in at least one outcome. CONCLUSIONS: Substantial interindividual variability in response to standardized exercise was observed for improvement in insulin-stimulated glucose disposal (R), and to a lesser degree, visceral fat and CRF in adolescents. The greatest improvement in health risk factors were most commonly seen with aerobic exercise.
Waist circumference trajectory and its association with cardiovascular disease in patients with hypertension: A retrospective primary-care cohort study.
Liu Z, Zhang X, Xu H
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41826192 · Publisher ↗
BACKGROUND AND AIM: Previous studies have typically measured waist circumference (WC) individually at baseline and are unlikely to accurately characterize the pattern of WC throughout the observation period. The long-ter...
BACKGROUND AND AIM: Previous studies have typically measured waist circumference (WC) individually at baseline and are unlikely to accurately characterize the pattern of WC throughout the observation period. The long-term pattern of WC in hypertensive patients and its association with cardiovascular disease (CVD) events remains unclear. We aimed to investigate the association of WC trajectories with the risk of developing CVD in hypertensive patients. METHODS AND RESULTS: Our data were drawn from the medical records of primary-care institutions in China. The present study included 72,601 individuals with hypertension attending primary healthcare centers. We used latent class trajectory analysis to group individuals with similar patterns of change in WC over time to understand the heterogeneity of CVD. Cox proportional-hazard models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) between long-term WC trajectories (or WC in 2020) with CVD among hypertensive patients. We identified 4 distinct WC trajectories based on the measurement at baseline and changing patterns of WC between 2018 and 2020: low-stable, moderate-stable, moderate-high stable and high-stable. Compared with the low-stable trajectory group, the hazard ratios (HRs) for CVD were 1.08 (95% CI, 0.94-1.24) for the moderate-stable trajectory group, 1.24 (95% CI, 1.05-1.46) for the moderate-high stable trajectory group, and 1.33 (95% CI, 1.04-1.69) for the high-stable trajectory group after adjusting for all confounding variables, including baseline BMI. The association between WC trajectories and CVD risk did not materially change after excluding participants with BMI ≥28 kg/m. CONCLUSIONS: This cohort study of community-dwelling adults with hypertension demonstrates that long-term WC patterns were associated with altered risk of CVD, and elevated WC trajectories were associated with an increased risk of CVD.
Commentary - emerging insights into diet quality and cardiometabolic disease.
Sofi F, Russo P, Del Bo' C
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41813546 · Publisher ↗
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The privilege of serving as editor-in-chief of Nutrition, Metabolism and Cardiovascular Diseases.
Targher G
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41807237 · Publisher ↗
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Prognostic value of the cardiometabolic index for mortality in patients with cardiometabolic syndrome: A longitudinal analysis based on NHANES data.
Li J, Bai SJ
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41794606 · Publisher ↗
BACKGROUND AND OBJECTIVE: Cardiometabolic syndrome (CMS) is a major risk factor for cardiovascular diseases and type 2 diabetes mellitus, necessitating reliable mortality risk prediction tools. The Cardiometabolic Index...
BACKGROUND AND OBJECTIVE: Cardiometabolic syndrome (CMS) is a major risk factor for cardiovascular diseases and type 2 diabetes mellitus, necessitating reliable mortality risk prediction tools. The Cardiometabolic Index (CMI), integrating waist-to-height ratio and triglyceride-to-high-density lipoprotein cholesterol ratio, correlates closely with metabolic dysregulation. This study evaluated CMI's prognostic value for all-cause and cause-specific mortality in CMS patients. METHODS AND RESULTS: A cohort of 5476 adult CMS patients from the 1999-2018 National Health and Nutrition Examination Survey (NHANES) was analyzed. CMI was calculated as waist-to-height ratio × (triglyceride/HDL-cholesterol) and log-transformed. Cox proportional hazards regression, restricted cubic spline analyses, sensitivity analyses, and subgroup assessments were applied. Over a median 95-month follow-up, 1376 all-cause, 474 cardiovascular, and 79 diabetes-related deaths were recorded. Fully adjusted models showed a positive association between CMI and all-cause mortality (per SD increase, HR = 1.02, P = 0.033) with a significant dose-response relationship (P = 0.001). CMI was nonlinearly linked to diabetes-related mortality (per unit increase, HR = 1.07, P = 0.034), with risk surging when CMI exceeded 1.67. No significant correlation emerged for cardiovascular mortality. Subgroup analysis confirmed enhanced CMI predictive performance in high-risk populations, and sensitivity analyses verified findings robustness. CONCLUSION: CMI acts as a novel biomarker for all-cause and diabetes-related mortality risk in CMS patients, reflecting gradient risks across metabolic dysregulation subgroups and supporting risk stratification. Further prospective studies are warranted to validate its clinical utility.
Seven-year changes in BMI and grip strength in older adults: Incidence of the obese-weak phenotype and the protective role of physical activity.
do Espírito Santo RC, Araujo RHO, Melo G … +1 more , Agostinis-Sobrinho C
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41794605 · Publisher ↗
BACKGROUND AND AIMS: This study examined changes in body mass index (BMI) and grip strength, estimated the incidence of the obese-weak phenotype, and evaluated the protective role of physical activity (PA) in older adult...
BACKGROUND AND AIMS: This study examined changes in body mass index (BMI) and grip strength, estimated the incidence of the obese-weak phenotype, and evaluated the protective role of physical activity (PA) in older adults. METHODS AND RESULTS: Data were from Waves 5-8 of the Survey of Health, Ageing and Retirement in Europe (SHARE), including 17,434 adults aged ≥50 years from 14 countries. BMI was self-reported, and grip strength was measured by dynamometry. Participants were classified as normal weight-normal strength, normal weight-weak strength, or obese-normal strength at Wave 5. Moderate and vigorous PA were categorised as ≥1 or <1 time/week. Mean age was 64.7 ± 8.3 years, and 54.6% were female. At baseline, 36.0% were normal weight-normal strength, 1.0% normal weight-weak strength, and 63.0% obese-normal strength. While BMI decreased modestly over follow-up, grip strength declined more markedly. The incidence of the obese-weak phenotype was 1.0% in normal weight-normal strength, 8.1% in normal weight-weak strength, and 3.6% in obese-normal strength. Baseline normal weight-weak strength and obese-normal strength showed 2.5-8-fold higher odds of incident obese-weak status. MPA <1 time/week increased oods, while ≥1 time/week VPA attenuated odds in normal weight-weak individuals, although interaction tests were not significant. CONCLUSION: While BMI decreased modestly over follow-up, grip strength declined more markedly. Lower physical activity was associated with higher odds of developing the obese-weak phenotype, reinforcing physical activity as an important target for preventing unhealthy ageing changes.
Pleiotropic cardiometabolic effects of the LDLR rs6511720 T allele: an evaluation of genetic risk across metabolic states.
Chermon D, Samra LA, Elkayam N … +1 more , Birk R
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41791911 · Publisher ↗
BACKGROUND AND AIMS: The functional LDLR rs6511720 polymorphism has been implicated in lipid metabolism and cardiometabolic risk. We aimed to investigate its association with clinically relevant Low-Density Lipoprotein c...
BACKGROUND AND AIMS: The functional LDLR rs6511720 polymorphism has been implicated in lipid metabolism and cardiometabolic risk. We aimed to investigate its association with clinically relevant Low-Density Lipoprotein cholesterol (LDL-C) threshold (≥130 mg/dL), cardiometabolic burden, and type 2 diabetes mellitus (T2DM), with emphasis on sex-specific effects. METHODS AND RESULTS: A cross-sectional data analysis was conducted on community-based cohort of 1,442 adults (68.4% females; mean age 58.8 ± 14.0 years). Genotype, anthropometric, biochemical and lifestyle data were collected. Logistic regression analyses were performed under dominant, recessive, and additive genetic models, stratified by sex and adjustment for age, body mass index (BMI) and medications. Cohort genotype frequencies were 8.6% for TT, 18.3% for TG, and 73% for GG. Females T allele carriers were significantly associated with reduced odds of LDL-C ≥130 mg/dL under dominant (OR = 0.72; 95% CI: 0.52-0.98; p = 0.036), and additive (OR = 0.77; 95% CI: 0.62-0.96; p = 0.02) models. Conversely, the G allele was linked to elevated odds of LDL-C ≥130 mg/dL under recessive (OR = 1.40; 95% CI: 1.02-1.91; p = 0.03), and additive (OR = 1.30; 95% CI: 1.04-1.63; p = 0.02) models. The frequency of the GG genotype increased significantly with LDL-C severity, among females with ≥2 cardiometabolic risk factors (p = 0.02). Notably, female T allele carriers (TG + TT) had over twice the odds of T2DM compared to GG homozygotes (10.9% vs. 5.4%; OR = 2.18; 95% CI: 1.28-3.70; p = 0.004). CONCLUSION: LDLR rs6511720 exerts sex-specific pleiotropic effects, with the T allele protective against hypercholesterolemia while associated with increased T2DM susceptibility in females.
Effect of a Chilean diet supplemented with Gevuina avellana molina versus a low-fat diet on cardiometabolic, oxidative stress, and inflammatory biomarkers in Chilean adults with hypercholesterolemia: A randomized controlled trial.
Ramos-Pardo S, Ramírez-Alarcón K, González-Contreras C … +3 more , Valdebenito E, Sureda A, Martorell M
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41791910 · Publisher ↗
BACKGROUND AND AIMS: Cardiovascular diseases are strongly associated with oxidative stress and inflammation. Lifestyle modifications and hazelnut consumption have shown potential benefits in managing hypercholesterolemia...
BACKGROUND AND AIMS: Cardiovascular diseases are strongly associated with oxidative stress and inflammation. Lifestyle modifications and hazelnut consumption have shown potential benefits in managing hypercholesterolemia. The aim was to compare the effects of a diet supplemented with Gevuina avellana with those of a low-fat diet on plasma oxidative stress and inflammatory biomarkers in adults with hypercholesterolemia. METHODS AND RESULTS: A six-month randomized controlled trial was conducted in adults with hypercholesterolemia (total cholesterol >200 mg/dL). Participants were allocated by block randomization, stratified by sex, to either an experimental group following a Chilean diet supplemented with G. avellana (30 g/day) or a control group adhering to a low-fat diet (ClinicalTrials.gov: NCT07087704). Blood samples were collected at baseline and after the intervention to assess lipid profiles, total antioxidant capacity (TAC), activities of superoxide dismutase (SOD) and catalase (CAT), as well as malondialdehyde (MDA), oxidized LDL (ox-LDL), homocysteine, nitrotyrosine (%NTYR), folic acid, C-reactive protein (CRP), adiponectin and lactate dehydrogenase (LDH). The primary outcome was the change in oxidative stress and inflammatory biomarkers. Biochemical analyses and statistical evaluations were performed in a blinded manner, and data were analyzed using linear mixed-effects models. A total of 106 participants were recruited and randomized, of whom 81 completed the intervention (experimental, n = 47; control, n = 34). Both groups exhibited a significant increase in HDL-C (+11%) and folic acid (+64%), along with a 35% reduction in LDH. CRP decreased significantly in both groups (p = 0.037), declining from 9.32 ± 2.45 to 5.20 ± 1.63 mg/dL in the control group and from 5.01 ± 1.13 to 2.82 ± 0.69 mg/dL in the experimental group. CAT activity significantly increased in both groups after the intervention period (p = 0.015), rising from 9.01 ± 1.34 to 16.26 ± 2.72 nKat/L in the control group and from 9.26 ± 1.10 to 18.10 ± 2.20 nKat/L in the experimental group, whereas no changes were observed in SOD activity. Homocysteine levels decreased by 35% in the control group and by 25% in the experimental group. No significant differences between groups were observed for oxidative or inflammatory biomarkers. CONCLUSION: Both diets improved oxidative and inflammatory markers in adults with hypercholesterolemia, with no evidence of superiority of one dietary approach over the other, highlighting the potential of hazelnuts as a dietary complement for managing hypercholesterolemia.
Continuity of care for patients with hypertension or diabetes mellitus reduced medical utilization, total medical costs, and cardiovascular events based on the Korean NHIS-HEALS cohort.
Yun EK, Shim JY, Shin SJ … +1 more , Kang HT
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41781232 · Publisher ↗
BACKGROUND AND AIM: Continuous care of chronic diseases can improve the efficiency of medical system. This study aims to investigate whether continuity of care (CoC) for hypertension or diabetes mellitus (DM) improves me...
BACKGROUND AND AIM: Continuous care of chronic diseases can improve the efficiency of medical system. This study aims to investigate whether continuity of care (CoC) for hypertension or diabetes mellitus (DM) improves medical utilization, costs, and health outcomes, including cardiovascular diseases (CVDs). METHODS AND RESULTS: For this study, 14,246 hypertensive and 9382 diabetic patients aged 60 years or older from the Korean NHIS-HEALS cohort were included. CoC was categorized into three tertiles by disease and sex. Medical utilization and costs were compared using negative binomial regression models and Gamma regression models after adjusting for potential confounders. Cox proportional hazards regression models were constructed to examine the association between the CoC index and the health outcomes (all-cause mortality, CVDs, ischemic heart diseases [IHDs], and cerebrovascular diseases [CbVDs]). In hypertensive patients, hospitalizations decreased across both sexes and emergency room (ER) visits decreased for females with increasing CoC index. Likewise, hospitalizations and medical costs related to DM decreased with increasing CoC index for both sexes. Clinic visits for DM were lowest in T3 group for both sexes. Higher CoC was associated with a lower risk of CVDs, including IHDs and CbVDs, in patients with hypertension or diabetes, as well as with all-cause mortality in patients with diabetes in the fully adjusted model. CONCLUSIONS: Continuous care for hypertension or diabetes was inversely associated with medical utilization in patients with hypertension or DM, as well as with medical costs in patients with DM. In addition, CoC decreased CVDs in patients with hypertension or diabetes and reduced all-cause mortality in patients with diabetes.
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