Nutrition, Metabolism, And Cardiovascular Diseases[JOURNAL]
Sun
200 papers
Association of unsweetened and sweetened coffee consumption with risk of cardiovascular disease: a prospective cohort study.
Yang M, Zhang L, Chen X … +9 more , Lin Y, Lin J, Ni Z, Hu X, Pan J, Wu K, Zhang M, Hu D, Hu F
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41775557 · Publisher ↗
BACKGROUND AND AIMS: To investigate the associations between unsweetened and sweetened coffee consumption and the risk of cardiovascular disease (CVD) and its subtypes (coronary artery disease (CAD), stroke, heart failur...
BACKGROUND AND AIMS: To investigate the associations between unsweetened and sweetened coffee consumption and the risk of cardiovascular disease (CVD) and its subtypes (coronary artery disease (CAD), stroke, heart failure (HF), and atrial fibrillation (AF)). METHODS AND RESULTS: This prospective cohort study included participants who completed ≥1 valid dietary questionnaire in the UK Biobank. The Cox regression with restricted cubic splines was used to assess the associations between coffee intake and incident CVD and its subtypes. Genetic predisposition was estimated using the polygenic risk score (PRS). Among 131,247 coffee consumers (75.6%) with a median follow-up of 12.7 years, 18,659 new CVD cases occurred. A U-shaped relationship between unsweetened coffee intake and CVD risk was observed, with the lowest risk at 2-3 cups per day (HR, 0.85 95 % CI, 0.81-0.90). No significant associations were observed between consumption of sugar-sweetened and artificially sweetened coffee and the risk of CVD. The observed protective effect of unsweetened coffee was consistent across various CVD subtypes, independent of genetic predisposition. CONCLUSION: Unsweetened coffee may play a beneficial role in CVD prevention, caution should be exercised when drinking coffee with added sugar or artificial sweeteners.
Fetuin-A correlates negatively with leukocyte telomere length and human telomerase in patients with acute myocardial infarction.
Al Khaldi RM, Mojiminiyi OA, Abdella N
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41771729 · Publisher ↗
BACKGROUND AND AIM: Telomeres, tandem repeats of DNA sequences at the end of eukaryotic chromosomes, are maintained by human Telomerase Reverse Transcriptase (hTERT). Leukocyte telomere length (LTL) has been shown to be...
BACKGROUND AND AIM: Telomeres, tandem repeats of DNA sequences at the end of eukaryotic chromosomes, are maintained by human Telomerase Reverse Transcriptase (hTERT). Leukocyte telomere length (LTL) has been shown to be a risk marker of cardiovascular diseases (CVDs). Fetuin-A, a glycoprotein synthesized in the liver, has also been linked with overproduction of inflammatory cytokines and CVDs. As short LTL and low hTERT have been implicated in the development of atherosclerotic processes, this study explores potential associations between LTL, hTERT and Fetuin-A as disease markers in patients with Acute Myocardial Infarction (AMI). METHODS AND RESULTS: LTL, hTERT, Fetuin A, and lipid profile were measured in 144 consecutive patients with increased Troponin I and AMI and 192 age and gender matched healthy control subjects. AMI patients had significantly (p < 0.05) shorter LTL and lower hTERT levels compared to controls [0.9 ± 1.1 vs. 4.5 ± 3.9] and [23.0 ± 5.5 ng/ml vs. 32.9 ± 8.9 ng/ml] respectively. Fetuin-A levels were significantly (p < 0.0001) higher in patients with AMI compared to control subjects. LTL correlated negatively with Troponin I and Fetuin-A levels (r = -0.13, p = 0.02, r = -0.36, p = 0.002). hTERT levels showed similar trends. Odds ratio (OR) of having shorter LTL and lower hTERT were 2.1 (95 %CI 1.5-6.2) and 1.6 (95 %CI 1.2-8.8) respectively in patients with AMI compared to control subjects. CONCLUSIONS: Shorter LTL, lower hTERT and higher Fetuin-A levels are linked to a higher risk of AMI. Estimation of LTL, hTERT and Fetuin-A could be useful adjuncts for the identification of individuals with high risk of CVDs.
Comment on: "Association of metabolic dysfunction-associated fatty liver disease with microvascular complications in adults with prediabetes".
Jia Y, Zhou J, Chen L
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41771728 · Publisher ↗
Abstract loading — click title to view on PubMed.
Epigenetic age acceleration in adolescence: cross-sectional associations with dietary intake and prospective associations with cardiometabolic risk indicators in a Mexico City cohort.
Lee JT, Goodrich JM, Dolinoy DC … +7 more , Peterson KE, Téllez-Rojo MM, Cantoral A, Torres-Olascoaga LA, Tolentino M, Ruiz-Narváez EA, Jansen EC
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41765714 · Full text
BACKGROUND AND AIMS: To examine the cross-sectional relationship between dietary intake and epigenetic age acceleration, as well as the prospective relationship between epigenetic age acceleration and cardiometabolic par...
BACKGROUND AND AIMS: To examine the cross-sectional relationship between dietary intake and epigenetic age acceleration, as well as the prospective relationship between epigenetic age acceleration and cardiometabolic parameters measured two years later. METHODS AND RESULTS: In 526 adolescents aged 7-18 years (average age 14.50) residing in Mexico City, dietary intake was assessed using a semi-quantitative food frequency questionnaire. Adherence to three dietary patterns was derived from principal component analysis. Blood leukocyte DNA methylation was measured with the Illumina Infinium MethylationEPIC BeadChip, from which epigenetic age acceleration was calculated for six epigenetic clocks: Horvath, Skin-Blood, PhenoAge, GrimAge, Pediatric-Buccal-Epigenetic (PedBE), and Wu. Nine cardiometabolic parameters were assessed two years after assessment of diet and epigenetic age acceleration. Linear regression models for sex-stratified associations were examined. Among males, the Meat & Starchy foods pattern was positively associated with Wu epigenetic age acceleration, showing a 0.096-year increase, while folate intake in females was associated with a 0.004-year decelerated GrimAge. Prospective analysis showed positive associations between epigenetic age acceleration and fat distribution and insulin resistance, particularly in males. In females, only GrimAge acceleration was associated in the expected manner with increased waist circumference (β = 0.62 cm), BMI (β = 0.25 kg/m), fasting insulin (β = 0.86 μIU/mL), and insulin resistance (β = 0.21). Skin-Blood acceleration was associated with decreased HDL in males, and PedBE acceleration was associated with triglycerides in both sexes, though in opposing directions. CONCLUSION: Adolescent diet was not strongly associated with baseline epigenetic age acceleration. However, epigenetic age acceleration was associated prospectively with fat distribution and insulin resistance.
Toward a comprehensive definition of diet quality: perspectives from the Italian Society of Human Nutrition (SINU).
Dinu M, Martini D, Lotti S … +3 more , Del Bo' C, Scalfi L, Tagliabue A
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41760461 · Publisher ↗
AIMS: Diet quality is a multidimensional concept linked to health outcomes, but its definition varies across studies and cultures. This perspective examines how diet quality is defined in scientific literature integratin...
AIMS: Diet quality is a multidimensional concept linked to health outcomes, but its definition varies across studies and cultures. This perspective examines how diet quality is defined in scientific literature integrating evidence from dietary guidelines, diet quality indices, and recent research. DATA SYNTHESIS: Core principles consistently defining diet quality are adequacy, diversity, balance, and moderation. These translate into diets that meet nutrient requirements, include a variety of foods across food groups, ensure appropriate macronutrient distribution, and limit added sugars, salt, and unhealthy fats. Nutrient density and macronutrient quality further refine the concept, with emphasis on unsaturated fats and high-fiber carbohydrates. High-quality diets generally prioritize plant-based foods over animal products. Emerging dimensions extend diet quality beyond health to include environmental sustainability, degree of food processing, and socio-cultural factors such as cultural acceptability, affordability, and equitable access to food. CONCLUSIONS: Diet quality is a holistic construct integrating nutritional health, sustainability, safety, and cultural relevance. It is not limited to a single dietary model, as multiple patterns can achieve high quality when these criteria are met, with the Mediterranean diet as a well-established example. Future evaluations should integrate nutritional, environmental, food security, food processing and cultural indicators.
The evolving cardiovascular burden in Sierra Leone: a 33-year analysis of the Global Burden of Disease study 2023.
Jalloh MB
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41760460 · Publisher ↗
BACKGROUND AND AIMS: To quantify trends in stroke, ischaemic heart disease (IHD), and hypertensive heart disease (HHD) in Sierra Leone from 1990 to 2023 using Global Burden of Disease (GBD) Study 2023 estimates. METHODS...
BACKGROUND AND AIMS: To quantify trends in stroke, ischaemic heart disease (IHD), and hypertensive heart disease (HHD) in Sierra Leone from 1990 to 2023 using Global Burden of Disease (GBD) Study 2023 estimates. METHODS AND RESULTS: We analyzed GBD 2023 estimates for deaths, disability-adjusted life years (DALYs), incidence, and prevalence. We decomposed changes in absolute burden into population growth, population ageing, and epidemiological change and summarized risk-factor population attributable fractions (PAFs). From 1990 to 2023, DALYs increased from 81,263 to 131,911 for stroke, from 40,780 to 79,445 for IHD, and from 10,163 to 23,817 for HHD. Age-standardised DALY rates declined for stroke (3667 to 3355 per 100,000; -8.5%) but increased for IHD (1885 to 2019; +7.1%) and HHD (467 to 586; +25.5%). Population growth accounted for most of the rise in absolute deaths and DALYs across causes, while epidemiological change differed by cause. Notably, the steepest proportional increases in DALYs occurred among adults aged 35-44 years, indicating disproportionate burden growth during economically productive ages. In 2023, high systolic blood pressure was the leading risk factor for all three causes; for IHD, air pollution (PAF 41.7%) and lead exposure (32.1%) were also prominent. This 100% PAF for high systolic blood pressure for HHD reflects the GBD definitional framework. CONCLUSION: Sierra Leone has experienced rising absolute cardiovascular burden since 1990, with divergent age-standardized trends across causes. Consideration for prevention include blood pressure control and environmental risk reduction, though specific policy priorities should be guided by local feasibility assessments and interventional evidence.
Osteoprotegerin is associated with reduced risk of abdominal aortic aneurysm and the role of vascular calcification: insights from Mendelian randomization approach.
Guo X, Tian G, Zhou R … +3 more , Hou C, Tang P, Li R
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41748418 · Publisher ↗
BACKGROUND AND AIMS: Studies have suggested that osteoprotegerin (OPG) is implicated in modulating vascular calcification and is associated with the risk of aneurysms, but the causal relationships among them remain uncle...
BACKGROUND AND AIMS: Studies have suggested that osteoprotegerin (OPG) is implicated in modulating vascular calcification and is associated with the risk of aneurysms, but the causal relationships among them remain unclear. This Mendelian randomization (MR) study aims to investigate the causal effects of OPG on aneurysm risk and to explore the role of vascular calcification. METHODS AND RESULTS: Genetic variants associated with OPG levels from three independent studies were used as instrumental variables. A single-variable MR analysis was conducted to investigate the impact of OPG levels on vascular calcification and aneurysm, including abdominal aortic aneurysm (AAA, N = 39,221), thoracic aortic aneurysm (TAA, N = 19,646), and intracranial aneurysm (IA, N = 79,429). Furthermore, multivariable MR (MVMR) was applied to assess the mediating role of vascular calcification in the association between OPG levels and aneurysm. Pooled results showed that genetically predicted higher OPG levels were linked to a reduced risk of AAA (odds ratio [OR] = 0.943, 95%CI = 0.906-0.982, P = 0.004), but not TAA and IA. In addition, genetically predicted OPG levels were associated with decreased coronary artery calcification (β = -0.101, 95%CI = -0.197 to -0.004, P = 0.040). MVMR analysis showed that the inverse relationship between OPG levels and AAA disappeared after adjusting for abdominal aortic calcification (OR = 0.959, 95%CI = 0.905-1.016, P = 0.152). CONCLUSION: Our findings provide novel insights into the protective effect of OPG in AAA, which may be dependent on inhibiting vascular calcification. These findings highlight OPG as a potential biomarker and therapeutic target for aneurysm management.
Interactive and joint associations of C-reactive protein-triglyceride glucose index and body roundness index on incident cardiovascular diseases: a nationwide prospective cohort study.
Wang Y, Luo J, Tan Z … +5 more , Bai G, Qu X, Shao X, Fu Y, Zhang J
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41748417 · Publisher ↗
BACKGROUND AND AIM: The C-reactive protein-triglyceride glucose index (CTI) and body roundness index (BRI) are novel composite biomarkers reflecting metabolic-inflammatory dysregulation and visceral obesity. However, the...
BACKGROUND AND AIM: The C-reactive protein-triglyceride glucose index (CTI) and body roundness index (BRI) are novel composite biomarkers reflecting metabolic-inflammatory dysregulation and visceral obesity. However, their associations with incident cardiovascular diseases (CVDs) remain unclear. This study aimed to investigate the individual and joint associations of CTI and BRI on the risk of CVDs. METHODS AND RESULTS: We included 235,163 participants from the UK Biobank. The primary outcomes were the occurrence of coronary heart disease (CHD), atrial fibrillation (AF), heart failure (HF), and stroke events. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for CTI and BRI in relation to incident CVDs. Compared with participants with low CTI and low BRI, individuals with both high CTI and high BRI had significantly higher risks of CHD (HR = 1.36), AF (HR = 1.38), HF (HR = 1.90), and stroke (HR = 1.09). Furthermore, statistically significant additive interactive associations between CTI and BRI were observed for CHD and HF. CONCLUSIONS: Our findings revealed that elevated levels of CTI and BRI robustly associated with an increased risks of incident CHD, AF, HF, and stroke, and the synergistic associations between CTI and BRI were observed on risks of incident CHD and HF.
Dynamic FIB-4 trajectory and a multi-state Markov model analysis reveal fibrosis progression and cardiovascular-cerebrovascular risk in MAFLD patients.
Fu XY, Yan SY, Song YQ … +9 more , Ye YF, Ma JL, Yan LL, Liang JW, Xu SJ, Xu SW, Chen YH, Mao XL, Li SW
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41748416 · Publisher ↗
BACKGROUND AND AIM: Metabolic associated fatty liver disease (MAFLD) is becoming increasingly prevalent in China. Identifying patients at high risk of fibrosis is crucial for clinical management. This study aimed to asse...
BACKGROUND AND AIM: Metabolic associated fatty liver disease (MAFLD) is becoming increasingly prevalent in China. Identifying patients at high risk of fibrosis is crucial for clinical management. This study aimed to assess the dynamic Fibrosis-4 (FIB-4) trajectory and its association with cardiovascular-cerebrovascular events (CCEs) and explore the progression of fibrosis in patients with MAFLD. METHODS AND RESULTS: This retrospective analysis included adult patients with at least three records who underwent physical examination between January 2017 and December 2023. A latent class mixed model (LCMM) was used to fit the FIB-4 trajectory. The multistate Markov model was applied to assess transitions in advanced liver fibrosis risk states. A total of 12,839 patients were analyzed, with 5777 MAFLD patients included in the final study. During a median follow-up of 46.2 months, CCEs occurred in 221 patients (3.83%). Based on the LCMM model, three trajectory groups were identified: Class 1 (low-stable), Class 2 (high-stable), and Class 3 (high-rising). In the multivariable-adjusted models, both class 2 and class 3 were significantly associated with the incidence of CCEs, with aHR (95% CI) of 2.73 (2.01-3.71) and 2.46 (1.25-4.86), respectively. Additionally, class 3 showed a rapid increase in FIB-4 at approximately 30 months. The multi-state Markov model indicated that the probability of high-risk of advanced liver fibrosis alleviating to medium-low risk was significantly higher than the probability of medium-low risk progressing to high risk. CONCLUSIONS: Monitoring FIB-4 trajectory aids in the early identification and intervention of high-risk MAFLD patients, potentially preventing irreversible fibrosis and reducing CCEs risk.
Sodium glucose transporter 2 inhibitor exposure and the risk of congenital malformations: nationwide birth cohort study.
Jang M, Kim M, Suh HS
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41714217 · Publisher ↗
BACKGROUND AND AIM: Sodium-glucose cotransporter-2 (SGLT2) inhibitors, a widely used class of oral antidiabetic agents provide additional cardioprotective and renoprotective benefits, but their use during pregnant remain...
BACKGROUND AND AIM: Sodium-glucose cotransporter-2 (SGLT2) inhibitors, a widely used class of oral antidiabetic agents provide additional cardioprotective and renoprotective benefits, but their use during pregnant remains limited. This study aimed to evaluate the association between SGLT2 inhibitor exposure during pregnancy and the risk of congenital malformations. METHODS AND RESULTS: This population-based cohort study utilized data from the National Health Insurance Service Database (2016-2022). Pregnancies with known teratogen exposure were excluded. SGLT2 inhibitor or insulin (as active comparator) use during the first trimester was defined as exposure. The primary outcomes were congenital malformations and heart defects. Propensity score matching controlled for confounders, and generalized linear regression estimated relative risks (RRs) with 95 % confidence intervals (CIs). Negative control outcomes were employed to assess residual confounding. Among 536,654 pregnancies, 121 pregnancies were exposed to SGLT2 inhibitors (mean [SD] age: 35.07 [4.26]), and 2007 to insulin (mean [SD] age: 34.89 [4.28]). Adjusted RRs (95 % CIs) for congenital malformations and heart defects were 0.88 (0.52-1.46) and 0.83 (0.44-1.58), respectively. In sensitivity analysis restricted to the organogenesis period (gestational weeks 4-10), risk of congenital heart defects was 2.79 (1.16-7.06). No residual confounding detected in negative control outcome. CONCLUSIONS: In this study, SGLT2 inhibitor use during the first trimester was not associated with an increased risk of congenital malformations. Nonetheless, the observed increased risk of congenital heart defects during the organogenesis period highlights the importance of exposure timing and warrants cautious interpretation. These findings provide evidence to guide clinical decision-making regarding antidiabetic medication use during pregnancy.
Low polyphenol content is on the pathway between ultra-processed food consumption and low-grade inflammation: cross-sectional analyses from the Moli-sani Study.
Ruggiero E, Di Castelnuovo A, Costanzo S … +10 more , Esposito S, Di Costanzo G, De Curtis A, Magnacca S, Cerletti C, Donati MB, de Gaetano G, Iacoviello L, Bonaccio M, Moli-sani Study Investigators
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41714216 · Publisher ↗
BACKGROUND AND AIMS: Low-grade inflammation is one of the potential mechanisms linking ultra-processed foods (UPFs) to poor health outcomes. Besides having low nutritional composition, UPFs also lack bioactive compounds,...
BACKGROUND AND AIMS: Low-grade inflammation is one of the potential mechanisms linking ultra-processed foods (UPFs) to poor health outcomes. Besides having low nutritional composition, UPFs also lack bioactive compounds, such as polyphenols. We tested the hypothesis that low polyphenol content could be on the pathway of previously documented associations between UPFs and low-grade inflammation. METHODS AND RESULTS: Data were from 22,169 men and women (mean age 55.4y ±11.7) of the Moli-sani Study (2005-2010). Total polyphenol intake was estimated by matching food consumption with the Phenol-Explorer database and UPF was defined according to the Nova classification. Low-grade inflammation was assessed by a composite INFLA-score. Higher UPF intake was associated with lower dietary polyphenol content (β = -132.3; 95 % CI: -139.3, -125.4 mg/d), compared to the bottom category, and this inverse association was consistent for main polyphenol classes. An increasing consumption of UPFs was directly associated with higher values of the INFLA-score (β = 0.23; 95 % CI 0.10, 0.35); the inclusion of total dietary polyphenols into the multivariable model explained about 18 % of the direct relationship of UPF with the INFLA-score (p-value = 0.0038), and this association was particularly evident for lignans (proportion explained = 32.6 %; p-value = 0.0011). CONCLUSIONS: A higher dietary share of UPFs possibly provides lower amounts of polyphenols in the diet. The poor polyphenol content of highly processed foods explains a good proportion of the direct association of UPFs with low-grade inflammation. These findings emphasize the importance of limiting UPF consumption and increasing polyphenol-rich foods to reduce inflammation and possibly lower the risk of related chronic diseases.
A critical evaluation of the 2025-2030 Dietary Guidelines for Americans.
Giosuè A, Vitale M, Riccardi G
Nutr Metab Cardiovasc Dis · 2026 Apr · PMID 41714215 · Publisher ↗
AIMS: To critically evaluate the 2025-2030 Dietary Guidelines for Americans (DGA), a key policy instrument shaping dietary advice in United States and influencing food production, healthcare, and global nutrition policy....
AIMS: To critically evaluate the 2025-2030 Dietary Guidelines for Americans (DGA), a key policy instrument shaping dietary advice in United States and influencing food production, healthcare, and global nutrition policy. DATA SYNTHESIS: Overall, the DGA remain consistent with previous documents for the recommended consumption of several food groups and limits for saturated fat, added sugars, and sodium. A welcome innovation is the strong emphasis on limiting ultra-processed foods (UPFs) and sugar-sweetened beverages, supported by their association with obesity, type 2 diabetes, and cardiovascular disease. However, several aspects of the Guidelines raise substantial concern. Most prominently, the recommendation to increase protein intake-largely from animal sources-appears unjustified, as it already exceeds requirements in economically developed populations. Moreover, it disregards long-standing evidence on increased cardiometabolic and cancer risk associated with high consumption of red and processed meat. Conversely, the scientific literature strongly supports plant-based dietary patterns, particularly the Mediterranean Diet, for health promotion; this diet has been shown to significantly reduce cardiovascular disease and type 2 diabetes incidence in randomized controlled trials. Further scientific inconsistencies include presenting foods rich in saturated fats (butter and beef tallow) as interchangeable with healthier fat sources (olive and seed oils), and proposing an unsubstantiated new food pyramid that downplays cereal consumption, including whole grains, in favor of animal foods. Finally, the DGA completely ignore the environmental impact of dietary choices, despite their 30% contribution to global greenhouse gas emission. CONCLUSIONS: Taken together, these Guidelines have more weaknesses than gains compared with those from Scientific Societies and WHO.
Effects of long-term time-weighted fine particulate matter components and ozone exposure on incident cardiovascular disease and the mediating roles of metabolic risk factors.
Wen F, Qu A, Li B … +3 more , Li P, Qi H, Zhang L
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41714214 · Publisher ↗
BACKGROUND AND AIM: Evidence has linked long-term outdoor air pollution with cardiovascular disease (CVD), while potential causal relationships of air pollutant exposure with CVD and mediation roles of metabolic risk fac...
BACKGROUND AND AIM: Evidence has linked long-term outdoor air pollution with cardiovascular disease (CVD), while potential causal relationships of air pollutant exposure with CVD and mediation roles of metabolic risk factors remain under-explored. METHODS AND RESULTS: We evaluated time-weighted exposure to fine particulate matter (PM), ozone (O), and PM components among 21,102 participants from the CHCN-BTH cohort. Well-validated online databases, participants' outdoor activity durations, and pollutant infiltration factors were used to assess time-weighted exposure. We employed the targeted maximum likelihood estimation (TMLE) approach to estimate potential causal relationships between air pollutants and incident CVD. High-dimensional mediation analyses were used to further investigate the mediating roles of metabolic risk factors. Compared with exposures at first quartile concentration (Q1), participants in highest quartile of exposure (Q4) to air pollutants exhibited significantly increased risk of CVD incidence: PM (RR: 3.453, 95%CI: 2.674-4.460), warm-season O (1.332, 1.016-1.746), black carbon (BC) (4.885, 2.866-8.327), ammonium (NH) (1.959, 1.378-2.785), nitrate (NO) (1.679, 1.117-2.525), sulfate (SO) (2.860, 2.211-3.701), and organic matter (OM) (4.070, 2.283-7.253). High-dimensional mediation analysis indicates that high-density lipoprotein-cholesterol (HDL-C) played a mediating role in the total effects, accounting for 10.46%, 24.96%, 39.35%, and 24.74% of PM, BC, SO, and OM, respectively. Systolic blood pressure (SBP) mediated 13.41% of the total effect attributable to warm-season O. CONCLUSIONS: This study provides potential causal linkage between air pollutants and CVD risk. Notably, our findings reveal roles of HDL-C and SBP in mediating the effects of CVD induced by air pollutant exposures.
Application of machine learning for sex-specific risk prediction of coronary artery calcification.
Jamalinia M, Targher G, Lonardo A … +2 more , Heydari ST, Bagheri Lankarani K
Nutr Metab Cardiovasc Dis · 2026 Apr · PMID 41708432 · Publisher ↗
BACKGROUND AND AIMS: Sex-related differences in coronary artery calcium (CAC) burden and risk are well known but often ignored in traditional models. We aimed to determine whether sex-specific machine learning (ML) impro...
BACKGROUND AND AIMS: Sex-related differences in coronary artery calcium (CAC) burden and risk are well known but often ignored in traditional models. We aimed to determine whether sex-specific machine learning (ML) improves CAC risk prediction using routine clinical data. METHODS AND RESULTS: In this cross-sectional study, adults (n = 446) referred for coronary computed tomography angiography were included. The data were subdivided into training (127 men, 185 women) and test (55 men, 79 women) sets. Eight ML classifiers were trained on the overall training dataset and separately for men and women to predict CAC presence (0 vs. >0), severity (0, 1-99, ≥100), and distribution (0, 1-vessel, ≥2-vessel). Algorithm performance was assessed on the unseen test set. CAC was present in 44.2 % of participants, with 17.4 % having CAC≥100 and 23.3 % having multivessel involvement (≥2 vessels). Sex-specific ML improved CAC prediction performance. For CAC presence, top-performing models achieved AUC/F1-scores of 0.690/0.618 overall, 0.799/0.776 in men, and 0.679/0.594 in women. For CAC severity, results were 0.692/0.532 overall, 0.731/0.584 in men, and 0.748/0.562 in women. For CAC distribution, AUC/F1-scores were 0.694/0.596 overall, 0.696/0.551 in men, and 0.738/0.615 in women. Threshold analysis in binary CAC classification (0 vs. >0) showed reasonable rule-out performance in both sexes, while rule-in performance was acceptable only in men. Feature importance rankings showed significant differences between sexes, reflecting sex-specific learning patterns. CONCLUSIONS: Sex-specific ML improved CAC risk prediction, highlighting algorithmic sex-related differences in cardiovascular risk assessment. These findings support the development of sex-specific cardiovascular risk equations to enhance personalized care and treatment.
Exploring mechanisms and confounding in the link between maternal blood pressure trajectories and offspring cardiometabolic risk.
Tang J, Luo G
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41708431 · Publisher ↗
Abstract loading — click title to view on PubMed.
Sex differences in the longitudinal association between metabolomic biomarkers and carotid artery plaques.
Rehman S, Moses E, Dwyer T … +2 more , Venn A, Gall S
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41708430 · Publisher ↗
BACKGROUND AND AIMS: The development of carotid artery atherosclerosis differs between men and women. We examined the role of the metabolome in these sex differences in Australian adults. METHODS AND RESULTS: Data is fro...
BACKGROUND AND AIMS: The development of carotid artery atherosclerosis differs between men and women. We examined the role of the metabolome in these sex differences in Australian adults. METHODS AND RESULTS: Data is from the Australian Childhood Determinants of Adult Health (CDAH) study where 73 metabolomic biomarkers were measured at ages 26-36 years (2004-06) and carotid artery plaques were measured at ages 36-46 years (2014-19). We identified metabolites that modified the effect of sex on plaques in log-binomial regression models. Sex-specific regressions were performed for metabolic biomarkers that had a sex-specific association with plaques. There were 638 participants (53 % women, mean [SD] age 31.2 [2.6] years) in the analysis. Interactions were significant for sex with omega-3 fatty acid, docosahexaenoic acid (DHA), saturated fat percentage, and albumin on their association with plaques. Inverse associations with plaques in women, but not men, were found for saturated fat percentage in adjusted analysis (RR/SD increase 0.52 95 % CI 0.36-0.79; p < 0.001). Albumin signal area was positively associated with plaques in women in adjusted analysis (RR/SD increase 1.56 95 % CI 1.33-2.15; p = 0.006). CONCLUSION: Associations between metabolic biomarkers and plaques were different in women compared with men, which may reveal sex-specific factors for atherosclerosis in women.
Plasma bone morphogenetic proteins 9 and major cardiovascular events and mortality after acute ischemic stroke: a prospective multicenter study.
Wang R, Chen Y, Yin X … +6 more , Wang X, Zheng X, Yang X, Zhou J, Xu T, Zhang Y
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41708429 · Publisher ↗
BACKGROUND AND AIMS: Bone morphogenetic proteins 9 (BMP9) has been implicated in endothelial protection and vascular development. In this study, we investigated the association of circulating BMP9 and clinical outcomes a...
BACKGROUND AND AIMS: Bone morphogenetic proteins 9 (BMP9) has been implicated in endothelial protection and vascular development. In this study, we investigated the association of circulating BMP9 and clinical outcomes after acute ischemic stroke onset. METHODS AND RESULTS: Plasma BMP9 levels were measured in 3400 patients with ischemic stroke recruited between August 2009 and May 2013 from 26 hospitals across China. Study outcomes included cardiovascular events, recurrent stroke, and all-cause mortality. Hazard ratios (HR) and 95 % confidence intervals (CI) were calculated using Cox regression models to examine the association between plasma BMP9 levels and study outcomes. During 3 months of follow-up, 96 participants (2.85 %) experienced cardiovascular events, and 62 (1.84 %) experienced recurrent stroke,102 (3.00 %) were reported all-cause mortality, 157 (4.62 %) were reported the composite outcome of cardiovascular events or all-cause mortality. Participants in the highest tertile of plasma BMP9 level had a decreased risk of cardiovascular events (multivariable-adjusted HR = 0.42, 95 % CI = 0.24-0.73), recurrent stroke (multivariable-adjusted HR = 0.44, 95 % CI = 0.22-0.87), all-cause mortality (multivariable-adjusted HR = 0.60, 95 % CI = 0.37-0.97), and the composite outcome of cardiovascular events or all-cause mortality (multivariable-adjusted HR = 0.55, 95 % CI = 0.37-0.83), compared with those in the lowest tertile. Addition of plasma BMP9 to a model with conventional risk factors significantly improved the risk reclassification for the study outcomes. CONCLUSION: In this multicenter prospective study, increased plasma BMP9 levels associated with decreased risk of adverse clinical outcomes after acute ischemic stroke, suggesting that the BMP9 signaling pathway may serve as a promising therapeutic target for future interventions in ischemic stroke and related cardiovascular complications.
Relationship between cardiovascular health score trajectory and incident stroke in patients with hypertension.
Zheng H, Li L, Gao H … +12 more , Wu K, Wu W, Wang X, Huang Z, Fu P, Wang Y, Chen Z, Cai Z, Cai Z, Lan Y, Wu S, Chen Y
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41708428 · Publisher ↗
BACKGROUND AND AIMS: The relationship between changes in the cardiovascular health (CVH) score over time and the risk of stroke in hypertensive patients remains unclear. METHODS AND RESULTS: A total of 17,631 hypertensiv...
BACKGROUND AND AIMS: The relationship between changes in the cardiovascular health (CVH) score over time and the risk of stroke in hypertensive patients remains unclear. METHODS AND RESULTS: A total of 17,631 hypertensive participants in the Kailuan study who attended three consecutive health checks in 2006, 2008, and 2010 and had no history of stroke or cancer were included. Their mean age was 56.45 ± 11.07 years, including 14,585 males (82.72 %) and 3046 females (17.28 %). The CVH score is calculated by averaging eight key cardiovascular health indicators-blood pressure, plasma glucose, blood lipids, body mass index, smoking, sleep duration, physical activity, and diet-each scored from 0 (lowest) to 100 (highest). Latent mixed models were used to determine the trajectory of CVH score during the exposure period (2006-2010) to predict stroke risk from 2010 to 2021. The Bayesian information criterion (BIC) was used to fit the model, and the five patterns were determined as the best fit. In addition, Cox proportional hazards models were used to calculate the hazard ratio (HR) and 95 % confidence interval (CI) for stroke in different trajectory groups, as they are well-suited for analyzing time-to-event data and can effectively handle censored observations, which is essential for our longitudinal study design. Five trajectories of CVH score were identified: low-stable (n = 1190; range, 43.7-41.0), moderate-increasing (n = 1035; mean increase from 46.9 to 56.1), moderate-decreasing (n = 4520; mean decrease from 56.6 to 52.1), high-stable I (n = 8551; range, 62.3-63.0), and high-stable II (n = 2335; range, 68.7-71.5). During a median follow-up of 10.94 years, 1499 cases of incident stroke were identified. After adjustment for potential confounders, and compared to the low-stable group, the HRs (95 % CIs) for stroke in the moderate-increasing, moderate-decreasing, high-stable I, and high-stable II groups were as follows: 0.76 (0.59,0.97), 0.72 (0.60,0.87), 0.51 (0.42,0.61), and 0.32 (0.25,0.41), respectively. CONCLUSIONS: In hypertensive patients, the long-term maintenance of a high CVH score or an improvement in CVH score is associated with a lower risk of stroke than a low-stable CVH score trajectory.
Macrophage METTL3 synergizes with YTHDF2 to promote atherosclerosis by inhibiting the LXR-α/ABCA1 pathway.
Tu YF, Li Y, Qin JF … +4 more , Chen WY, Zhu X, Sammad A, Yin K
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41708427 · Publisher ↗
BACKGROUND AND AIM: The formation of subendothelial macrophage-derived foam cells is a key driver of atherogenesis and contributes to the onset and progression of atherosclerosis (AS). The METTL3 gene, a central mediator...
BACKGROUND AND AIM: The formation of subendothelial macrophage-derived foam cells is a key driver of atherogenesis and contributes to the onset and progression of atherosclerosis (AS). The METTL3 gene, a central mediator of N6-methyladenosine (m6A) RNA methylation, serves as a critical regulatory node at the inflammation-metabolism nexus in immune pathophysiology. METHODS AND RESULT: This study aimed to investigate the METTL3-mediated regulatory mechanisms in subendothelial macrophage-derived foam cells formation and their association with necrosis and the pro-inflammatory properties of AS lesions. METTL3 expression was significantly higher in human carotid artery plaques compared to non-plaques. Macrophages treated with ox-LDL had an upregulated METTL3 expression, while its knockdown reduced lipid accumulation, foam cell formation, and inflammatory responses in macrophages. Myeloid Mettl3 knockout AS mice exhibited attenuated AS lesions. METTL3 knockdown elevated ABCA1, LXR-α, and ZNF771 expression. Gain- and loss-of-function studies demonstrated that METTL3 modulates lipid accumulation and inflammation partly through the ZNF771/LXR-α/ABCA1 axis. YTHDF2 knockdown increased ZNF771 levels, indicating that METTL3 cooperates with YTHDF2 to suppress ZNF771 expression, thereby inhibiting LXR-α transcription. Macrophage METTL3 exacerbates AS by suppressing cholesterol efflux and amplifying inflammation through YTHDF2-mediated downregulation of ZNF771, which attenuates the LXR-α/ABCA1 axis. CONCLUSIONS: Our study identifies a novel METTL3-dependent mechanistic link between foam cell pathology and plaque destabilization.
Does educational attainment modify the relationship between alcohol use and ischemic heart disease mortality? Evidence from the UK biobank.
Martin T, Llamosas-Falcón L, Zhu Y … +3 more , Rehm J, Probst C, Kilian C
Nutr Metab Cardiovasc Dis · 2026 Jun · PMID 41708426 · Full text
BACKGROUND AND AIMS: Alcohol use is associated with ischemic heart disease (IHD) mortality. The significant health burden of IHD is not distributed equally across socioeconomic strata and individuals with low socioeconom...
BACKGROUND AND AIMS: Alcohol use is associated with ischemic heart disease (IHD) mortality. The significant health burden of IHD is not distributed equally across socioeconomic strata and individuals with low socioeconomic status (SES) may be more vulnerable to the health effects of alcohol use. We aim to explore the effect modification of educational attainment on the association between alcohol use and IHD mortality in the United Kingdom (UK). METHODS AND RESULTS: This cohort study utilized UK Biobank data from 387,914 participants (203,081 females and 184,833 males) aged 40-69 years, who reported being current drinkers at baseline. IHD deaths were identified through national death registries. Individuals with low education had a higher risk of IHD mortality compared to those with high education. Among males, alcohol use of >1-30 g/day (without heavy episodic drinking) was associated with 39 % lower risk of IHD mortality compared with occasional alcohol use. In the Cox Proportional Hazard model, a differential association was observed among males with low (interaction term HR: 1.29, 95 % CI 1.01, 1.66) and medium education (interaction term HR: 1.36, 95 % CI:1.03, 1.80), compared to highly educated occasional drinkers. No differential association of alcohol use with IHD mortality by education was observed among females. CONCLUSIONS: These findings suggest that the association between alcohol use and IHD mortality may vary across educational attainment in males. Future research needs to strengthen our understanding of the risk relationship between alcohol use and IHD mortality, while accounting for potential differences by sex and educational attainment.
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