Nutrition, Metabolism, And Cardiovascular Diseases[JOURNAL]
Sun
200 papers
Twenty-year trends in ethnicity with type 2 diabetes across age at diagnosis: observational study in 11 million individuals in England.
Goldney J, Shabnam S, Sargeant JA … +7 more , Daynes E, Goff LM, Khunti K, Yates T, Henson J, Davies MJ, Zaccardi F
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41708425 · Publisher ↗
BACKGROUND AND AIMS: To investigate temporal variations in ethnic demography in those with versus without type 2 diabetes across age. METHODS AND RESULTS: We used the Clinical Practice Research Datalink to identify adult...
BACKGROUND AND AIMS: To investigate temporal variations in ethnic demography in those with versus without type 2 diabetes across age. METHODS AND RESULTS: We used the Clinical Practice Research Datalink to identify adults with newly-diagnosed type 2 diabetes, matched to ∼5 individuals without diabetes. Between 2000 and 2021, we calculated the proportion of individuals with type 2 diabetes from each ethnic group (Black/South Asian/White/Other) across age groups (18-39/40-59/≥60 years) and compared them to proportions in individuals without type 2 diabetes. We included 2,679,348 individuals with type 2 diabetes and 9,019,351 without. In individuals aged 18-39 years, between 2000 and 2021, proportions of individuals with type 2 diabetes from South Asian, White and other ethnic groups remained stable relative to individuals without diabetes, whilst proportions from Black ethnic groups became more similar over time. In older individuals (40-59/>60 years) with type 2 diabetes, the proportion of individuals from each ethnic group became more similar to the proportions in those without diabetes over time. CONCLUSION: Increases in early-onset type 2 diabetes between 2000 and 2021 are not related to disproportionately increasing risks across ethnicity. Excess risk of type 2 diabetes with ethnicity diminished apart from in individuals from South Asian and other ethnic groups aged 18-39 years.
Association of planetary health diet indices with diet composition, nutritional quality and environmental impacts in Italian adults.
Tucci M, Martini D, Godos J … +12 more , Olvera-Moreira MA, Fresán U, Giampieri F, Frias-Toral E, Zambrano-Villacres R, Vitale M, Giosuè A, Stranges S, Iacoviello L, Ruggiero E, Bonaccio M, Grosso G
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41644389 · Publisher ↗
BACKGROUND AND AIMS: Sustainable diets are increasingly recognized as a key strategy to promote human health while reducing environmental impacts. The Planetary Health Diet (PHD) provides a global framework for sustainab...
BACKGROUND AND AIMS: Sustainable diets are increasingly recognized as a key strategy to promote human health while reducing environmental impacts. The Planetary Health Diet (PHD) provides a global framework for sustainable and healthy eating patterns, but evidence on its adherence and implications in specific populations is still limited. The aim of this study was to test the level of adherence, the environmental impact, and the nutritional quality of several scores assessing the level of adherence to the PHD in a cohort of Italian individuals. METHODS AND RESULTS: Dietary habits were assessed through validated food frequency questionnaires while various scores have been applied to evaluate the level of adherence to PHD (ELD-I, EAT, PHDI-Cacau, NB-EAT, PHDI-Bui) in 1936 Italian adults, using the Mediterranean diet (MEDI-LITE) as reference. The environmental impact was quantified as carbon and water footprints (CF and WF) using the SU-EATABLE LIFE database. Higher adherence to PHD-related indices generally corresponded to healthier nutrient profiles, higher fiber intake, and better concordance with Italian dietary recommendations, although some indices predicted lower intake of certain nutrients (e.g., vitamin B12, calcium). The MEDI-LITE index consistently predicted higher adequacy across dietary and nutrient recommendations. Absolute CF and WF showed mixed trends across indices, while energy-standardized values (per 1000 kcal) indicated lower impacts for all PHD-related scores, apart from the ELD-I. Adherence to the Mediterranean diet was also associated with favorable energy-adjusted environmental outcomes. CONCLUSION: These findings reinforce the existing alignment between the intrinsic characteristics of the Mediterranean diet with both nutrition and sustainability objectives.
Associations of lipoprotein subclasses with risk of cardiovascular disease in individuals with MASLD.
Chen S, Zhang J, Yu H … +6 more , Xiong S, Zhao Y, Bai S, Jiang J, Pan A, Cheng B
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41638950 · Publisher ↗
BACKGROUND AND AIMS: Little is known about the relationships between lipoprotein subclasses and the risk of cardiovascular disease (CVD) in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD...
BACKGROUND AND AIMS: Little is known about the relationships between lipoprotein subclasses and the risk of cardiovascular disease (CVD) in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD). We sought to elucidate the associations of lipoprotein subclasses with the risk of CVD in individuals with MASLD. METHODS AND RESULTS: This study included 51,472 individuals with MASLD from the UK biobank. Concentrations of lipoprotein subclasses were quantified by nuclear magnetic resonance. Multivariable-adjusted Cox proportional hazards model was used to evaluate the associations between lipoprotein subclasses and the incidence/mortality of CVD. During median follow-ups of 13.3-13.5 years, 6208 incident CVD cases, 5206 coronary heart disease cases, 1270 stroke cases, and 559 CVD-related deaths were documented. Most very-low-density lipoprotein (VLDL) [hazard ratio (HR) range: 1.03-1.13; P <0.05], intermediate-density lipoprotein (HR range: 1.08-1.11; P <0.05), low-density lipoprotein (HR range: 1.05-1.11; P <0.05), very large high-density lipoprotein (HDL) particles and triglycerides in small HDL subclasses (HR range: 1.04-1.16; P <0.05) were positively associated with the risk of incident CVD, whereas other HDL particles and their subclasses were related to reduced risks of incident CVD (HR range: 0.86-0.95; P <0.05). Moreover, the association of VLDL particles with CVD strengthened as the diameter of VLDL decreased. CONCLUSION: These findings suggest that associations between lipoprotein subclasses and the risk of CVD differed by particle diameter in individuals with MASLD. Integrating lipoprotein subclass assessment into clinical management and promoting subclass‑targeted lipid‑lowering strategies may strengthen CVD prevention in MASLD.
Chinese visceral adiposity index as stronger predictor of hypertension and prehypertension in middle-aged and elderly Chinese adults: A comparative analysis with conventional adiposity indices.
Qin Z, Wu J, Ye Q … +4 more , Qi S, Chen Y, Wang C, Hong X
Nutr Metab Cardiovasc Dis · 2026 Apr · PMID 41633883 · Publisher ↗
BACKGROUND AND AIMS: This study explored the link between the Chinese visceral adiposity index (CVAI) and hypertension/prehypertension in middle-aged and elderly Chinese adults, comparing its predictive accuracy with oth...
BACKGROUND AND AIMS: This study explored the link between the Chinese visceral adiposity index (CVAI) and hypertension/prehypertension in middle-aged and elderly Chinese adults, comparing its predictive accuracy with other adiposity indices. METHODS AND RESULTS: Data from Nanjing's 2017-2018 chronic disease surveillance was analyzed for individuals over 45, using a generalized linear mixed model and ROC curves to assess the impact of CVAI and other indices. After adjusting for selected covariates, the results showed that, with the lowest group as the reference, the ORs of risk of hypertension were 1.536, 2.088 and 3.391 for CVAI; 1.338, 1.845 and 2.489 for the lipid accumulation product index (LAP); 1.277, 1.465 and 1.935 for the triglyceride glucose index (TyG); 1.396, 2.287, and 3.617 for body mass index (BMI); 1.961 for waist circumference (WC); 1.915 for the waist-to-height ratio (WHtR); and 1.299 for the waist-to-hip ratio (WHR), respectively. Similar results were also found in the impact of various obesity variables on prehypertension, respectively. ROC analyses indicated CVAI as the strongest predictor of hypertension and prehypertension compared to other adiposity indices. CONCLUSIONS: CVAI is significantly associated with hypertension and prehypertension, surpassing conventional indices in predictive power for these conditions in the studied demographic.
Maternal supraphysiological hypercholesterolemia and its adverse impact on transgenerational cardiometabolic health: a literature review.
Muñoz-Zamorano C, Yap F, Li LJ … +3 more , Kemp MW, Illanes SE, Leiva A
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41633882 · Publisher ↗
AIMS: Among the risk factors leading to cardiovascular disease (CVD), hypercholesterolemia stands out as a key driver of vascular dysfunction and the development of atherosclerotic CVD. This review is aimed to highlight...
AIMS: Among the risk factors leading to cardiovascular disease (CVD), hypercholesterolemia stands out as a key driver of vascular dysfunction and the development of atherosclerotic CVD. This review is aimed to highlight the emergent evidence showing that maternal supraphysiological hypercholesterolemia (MSPH) is a key risk factor for transgenerational CVD risk and to advocate for the development of strategies for the early prediction and prevention of MSPH. DATA SYNTHESIS: Increasing evidence suggests that an individual's lifetime CVD risk may be modified by in utero exposure. However, the contribution of maternal lipid levels to pregnancy has been neglected. In women, chronic hypercholesterolemia occurs during pregnancy, during which total cholesterol (TC) and low-density lipoprotein cholesterol (LDL) levels rise to meet fetal growth demands. Two patterns of increased pregnancy cholesterol levels have been described in the literature: i) those with maternal physiological hypercholesterolemia (MPH), characterized by increased TC levels at the end of gestation up to 280 mg/dl, and ii) those with MSPH, characterized by TC levels at the end of pregnancy above 280 mg/dl in combination with elevated LDL levels. This overlooked distinction is crucial considering the increased evidence linking MSPH to elevated cardiovascular risk in both mothers and offspring. CONCLUSION: Available data suggest that MSPH is associated with increased CVD risk in mothers in addition to fetal atherogenesis and increased lifetime risk of CVD in offspring. The implementation of early detection and interventions to mitigate MSPH could potentially improve acute and long-term health outcomes for both mothers and babies.
Substituting ultra-processed food intake with minimally processed foods is associated with lower diastolic blood pressure in children.
Chen ZH, Mousavi S, Mandhane PJ … +5 more , Simons E, Subbarao P, Moraes TJ, Turvey SE, Miliku K
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41629180 · Publisher ↗
BACKGROUND AND AIMS: High blood pressure (BP), a key modifiable risk factor for cardiovascular disease, often begins in childhood. While adult meta-analyses have shown consistent associations between ultra-processed food...
BACKGROUND AND AIMS: High blood pressure (BP), a key modifiable risk factor for cardiovascular disease, often begins in childhood. While adult meta-analyses have shown consistent associations between ultra-processed food (UPF) intake and elevated BP, findings in children remain inconsistent. Given that UPFs make up majority of Canadian children's diets, we examined associations between early childhood UPF intake and BP in mid-childhood, and assessed the impact of substituting UPFs with minimally processed foods (MPF). METHODS AND RESULTS: In this study, among 1408 participants from the Canadian CHILD Cohort Study, UPF, defined based on the NOVA classification system, was assessed at three years of age. BP was measured at age eight. We examined associations using multivariable-adjusted mixed-effects linear regression, evaluated substitution models to estimate the effect of replacing UPFs with MPFs, and examined body mass index (BMI) as a potential mediator. At age three, UPFs contributed 44.3% of total daily energy intake. At age eight, mean systolic and diastolic BP were 104 (SD 9) and 59 (SD 6) mmHg, respectively. Each 10% increase in UPF intake was associated with 0.31 mmHg higher diastolic BP (95% CI: 0.01, 0.61), driven by "Breads and cereals" and "Ready-to-eat/heat mixed dishes" categories. Replacing 10% of energy from UPFs with MPFs, in simulated substitution analyses, was associated with 0.45 mmHg lower diastolic BP. The associations between UPF and diastolic BP were partially mediated (∼27%) by child BMI. CONCLUSIONS: Higher UPF intake in early childhood was statistically associated with higher diastolic blood pressure at age eight, with simulated substitution models suggesting modest reductions in diastolic blood pressure when substituting energy contributed from UPFs with MPFs. While these effect sizes are small, these findings underscore the importance of early dietary guidance and UPF reduction in pediatric preventive care.
The Triglycerides, Total Cholesterol and Body Weight Index (TCBI) in acute heart failure - a post-hoc analysis of a prospective cohort study.
Pedersen MH, Davidovski FS, Espersen C … +16 more , Adam LM, Khoraizat A, Stanchev A, Durukan E, Skaarup KG, Dons M, Rastoder E, Al-Rubai AH, Sengeløv M, Bernholm KF, Lassen MCH, Pareek M, Jørgensen PG, Wolsk E, Schou M, Biering-Sørensen T
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41622100 · Publisher ↗
BACKGROUND AND AIMS: The triglycerides, total cholesterol and body weight index (TCBI) is a novel nutritional marker that has shown prognostic value in various cardiovascular conditions, with low TCBI indicating poor nut...
BACKGROUND AND AIMS: The triglycerides, total cholesterol and body weight index (TCBI) is a novel nutritional marker that has shown prognostic value in various cardiovascular conditions, with low TCBI indicating poor nutritional status and being associated with adverse outcomes. However, limited data exist on the relationship between TCBI and cardiac function and outcomes in patients hospitalized with acute heart failure (AHF). This study aimed to investigate whether low TCBI is associated with impaired cardiac function and adverse outcomes in AHF. METHODS AND RESULTS: We performed a post-hoc analysis of a prospective, dual-center observational cohort study of patients admitted with AHF (2022-2024). Transthoracic echocardiography, lung ultrasound and laboratory testing were performed shortly after admission. Outcomes evaluated were all-cause mortality and the composite of all-cause mortality or heart failure (HF) readmission. Unadjusted and adjusted Cox regression and Fine-Gray analyses were conducted to assess the relationship between TCBI and outcomes. The study included 487 patients, stratified into TCBI tertiles (T1: TCBI<949.6, T2: 949.6≤TCBI≤1690, T3: TCBI>1690). Low TCBI was associated with echocardiographic signs of higher filling pressures, impaired right ventricular function, higher pulmonary pressure and more B-lines on LUS. Low TCBI was associated with a higher risk of all-cause mortality compared with moderate TCBI (T1 vs T2: HR 1.54, 95 % CI [1.06-2.24], p = 0.024). Low TCBI was not independently associated with HF readmission and the composite of all-cause mortality or HF readmission. CONCLUSION: Low TCBI is associated with greater signs of congestion and increased all-cause mortality risk.
Dietary Advanced Glycation End Products (dAGEs): Pathogenesis and nutritional strategies for health longevity-A critical view.
Russo P, Sirangelo I, Siani A
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41622099 · Publisher ↗
Advanced Glycation End Products (AGEs), formed through the non-enzymatic Maillard reaction, are pivotal molecular culprits linking metabolic dysfunction, chronic disease, and the acceleration of biological aging. While A...
Advanced Glycation End Products (AGEs), formed through the non-enzymatic Maillard reaction, are pivotal molecular culprits linking metabolic dysfunction, chronic disease, and the acceleration of biological aging. While AGEs are synthesized endogenously, modern Western diets, defined by thermal food processing, introduce a substantial and increasing pool of exogenous dietary AGEs (dAGEs). This viewpoint critically assesses the evidence supporting the outdated theory that AGEs are not inert biomarkers but active, etiological factors driving pathology. The impact of AGEs is characterized by a dual mechanism: the direct impairment of structural integrity via irreversible protein cross-linking, and the systemic induction of oxidative stress and chronic inflammation ("inflammaging") through binding and activation of the Receptor for AGEs (RAGE). This persistent systemic load-heavily contributed by high-fat, high-protein foods cooked at dry, high heat-is implicated in accelerating insulin resistance, cardiovascular complications, and neurodegeneration. Nutritional strategies have focused on mitigating this exogenous burden through simple culinary modifications, such as utilizing moist heat and acidic ingredients, which significantly curb dAGE formation in the kitchen. However, a critical gap remains: while short-term mechanistic studies are compelling, definitive, long-term human intervention trials are lacking. We argue that future research must rigorously quantify the independent contribution of dAGE restriction to health span and longevity to fully legitimize its role as a primary, evidence-based nutritional intervention for preventative health.
Impact of dietary counselling on cardiometabolic health, mental health and dietary quality in Singapore older women.
Ting M, Low JHM, Lee DPS … +4 more , Fam J, Mahendran R, Kua EH, Kim JE
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41622098 · Publisher ↗
BACKGROUND AND AIM: Provision of dietary counselling has been shown to improve dietary quality, cardiometabolic risk factors (CMRF) and mental health, but these beneficial effects are not well studied in Asian older wome...
BACKGROUND AND AIM: Provision of dietary counselling has been shown to improve dietary quality, cardiometabolic risk factors (CMRF) and mental health, but these beneficial effects are not well studied in Asian older women. Thus, this study aimed to assess the impact of dietary counselling on CMRF, mental health parameters and dietary quality in Singapore older women. METHODS AND RESULTS: This was a 12-week, parallel design, randomized controlled trial and 39 older women (mean age of 67.5 years old) recruited from a senior activity center in Singapore were randomized to the control group (n = 19) or the intervention group (n = 20). Only subjects in the intervention group received high intensity dietary counselling for 12 weeks while the control group maintained their lifestyle. Dietary quality based on the alternate healthy eating index (AHEI)-2010 score, anthropometric measurement, CMRF and mental health parameters were measured at Week 0 and Week 12. Albeit no major changes in CMRF observed; the control group showed increase in blood N-(1-carboxymethyl)-l-lysine (CML) levels, which is a well-characterized advanced glycation end product (AGE), while intervention group showed a decrease, and net changes were significantly different between groups. Additionally, the intervention group also showed decrease in depressive symptoms. Overall, no changes in dietary quality was observed. CONCLUSION: The provision of dietary counselling may be a viable nutritional strategy in regulating AGE levels and potentially reducing cardiometabolic disease risk with improving mental health in Singapore older women. REGISTRATION NUMBER OF CLINICAL TRIAL: Registered in clinicaltrials.gov as NCT03702335 and approved by the National University of Singapore Institutional Review Board (IRB H-18-040).
Targeted lipidomics reveals distinct mechanisms driving LDL cholesterol response to gastric bypass and sleeve gastrectomy: An exploratory study.
Benaiges D, Lázaro I, Goday A … +11 more , Sala-Vila A, Haro N, Flores-Le Roux JA, Fitó M, Casajoana A, Climent E, Alechaga E, Nebot P, Castañer O, Pedro-Botet J, Pozo OJ
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41622097 · Publisher ↗
BACKGROUND AND AIMS: The Bariatric Surgery and LDL Cholesterol (BASALTO) randomized clinical trial reported differential LDL cholesterol responses after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). In thi...
BACKGROUND AND AIMS: The Bariatric Surgery and LDL Cholesterol (BASALTO) randomized clinical trial reported differential LDL cholesterol responses after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). In this exploratory analysis of BASALTO we characterized lipidomic changes associated with both procedures and their relationship with LDL cholesterol response. METHODS AND RESULTS: Plasma samples of 30 patients with obesity and high LDL cholesterol (15 RYGB, 15 SG) were analyzed using targeted mass spectrometry to quantify over 50 pre-defined lipid species at baseline, 3 months, and 12 months after surgery. At 12 months, RYGB induced consistent reductions in LDL cholesterol, whereas SG showed marked interindividual variability. Both procedures were associated with shared and procedure-specific lipidomic changes, including divergent patterns in cholesterol absorption. No significant associations between lipidomic changes and LDL cholesterol were observed after RYGB. In contrast, after SG, changes in monoacylglycerols (16:0, 20:4, 18:1) at 3 months and increases in cholestanol (pFDR = 0.039) and HexCer 18:0 (pFDR = 0.031) at 12 months were directly associated with LDL cholesterol response. CONCLUSION: LDL cholesterol reduction after RYGB appears independent of shifts in selected lipids, whereas variability after SG may be partly driven by cholesterol absorption and ceramide-related pathways. CLINICAL TRIAL REGISTRATION: NCT03975478.
Sarcopenia as a causal mediator in aging, obesity and central obesity related outcomes: A comprehensive analysis of NHANES, CHARLS and ELSA.
Li S, Huang Q, Liu Y … +5 more , Wang S, Luo Y, Han X, Ji L, Zou X
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41620304 · Publisher ↗
BACKGROUND AND AIM: Sarcopenia, characterized by decreased muscle mass or muscle dysfunction, is associated with cardiovascular disease and mortality. However, the mediating effect of sarcopenia on the relationship betwe...
BACKGROUND AND AIM: Sarcopenia, characterized by decreased muscle mass or muscle dysfunction, is associated with cardiovascular disease and mortality. However, the mediating effect of sarcopenia on the relationship between aging or obesity (especially central obesity) and adverse outcomes remains unclear. METHODS AND RESULTS: Sarcopenia was defined using functional criteria in the China Health and Retirement Longitudinal Study (CHARLS) and the English Longitudinal Study of Ageing (ELSA). In the National Health and Nutrition Examination Survey (NHANES) sarcopenia was determined using the skeletal muscle index (SMI) derived from appendicular skeletal muscle mass. A causal mediation analysis using counterfactual framework was conducted to estimate the mediating effect of sarcopenia on mortality associated with aging, obesity or central obesity. Sarcopenia was consistently associated with increased all-cause mortality, particularly among older adults. The combination of aging and sarcopenia amplified both mortality and cardiovascular disease (CVD) risks across cohorts. Sarcopenia partially meditated age-related all-cause mortality and cardiovascular outcomes by 8.67 % and 8.5 % in CHARLS (n = 9433), 8.56 % and 7.48 % in ELSA (n = 4389), 4.36 % and 3.95 % in NHANES (n = 16511), respectively. In NHANES but not other two cohorts, sarcopenia attenuated the adverse effects of obesity on mortality, and mediated the impact of central obesity on all-cause mortality. Subgroup and sensitivity analyses confirmed the robustness of these findings, showing similar mediation patterns across BMI categories or continuous exposure variables. CONCLUSIONS: Sarcopenia partially mediates age-related mortality and cardiovascular risk, and modulates obesity-related outcomes variably across cohorts. Evidence-based sarcopenia prevention strategies may offer a promising strategy to reduce age- and obesity-associated health risks.
Higher intake of minimally processed foods protects against type 2 diabetes: a 6-year follow-up of the CUME Plus study.
Cancello LL, Ceolin G, Pimenta AM … +3 more , Bressan J, Hermsdorff HHM, Steemburgo T
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41620303 · Publisher ↗
BACKGROUND AND AIMS: The global incidence of type 2 diabetes (T2D) is increasing, primarily due to poor diet and sedentary lifestyles. This study evaluated the association between the consumption of minimally processed f...
BACKGROUND AND AIMS: The global incidence of type 2 diabetes (T2D) is increasing, primarily due to poor diet and sedentary lifestyles. This study evaluated the association between the consumption of minimally processed foods and the risk of developing T2D. METHODS AND RESULTS: This prospective cohort study was part of the Cohort of Universities of Minas Gerais, which tracked the health outcomes of Brazilian adults without T2D at baseline over six years. Baseline consumption of in natura or minimally processed foods and culinary ingredients was evaluated using the NOVA food classification system and a validated 144-item semiquantitative food frequency questionnaire. Directed acyclic graphs were constructed to identify the minimum set of adjustment variables required to control confounding factors. Relationships between the incidence rate ratio (IRR) of T2D and consumption of in natura/minimally processed foods and culinary ingredients were assessed using Cox regression analysis. Among 3808 participants (mean age: 34 years; 65.1 % female; 55.8 % physically active), 103 (2.7 %) developed T2D within six years. On average, in natura foods accounted for 60 % of daily energy intake (DEI), whereas processed culinary ingredients contributed 6 %. After adjusting for potential confounders, individuals in the highest tertile of in natura/minimally processed foods and culinary ingredients consumption (81 % of DEI) had a reduced risk of T2D (IRR = 0.59, 95 % confidence interval: 0.35-0.98) compared with those in the lowest tertile of consumption (53 % of DEI). CONCLUSION: Among Brazilian adults, higher consumption of minimally processed foods is associated with a reduced risk of developing T2D.
Low density lipoprotein target achivement in very high and extreme cardiovascular risk patients during a cardiac rehabilitation program.
Maloberti A, Diri BP, Bellomare M … +10 more , Tognola C, Shkodra A, Algeri M, Prencipe GP, Brollo E, Ruzzenenti G, Alloni M, Luongo A, Riccobono S, Giannattasio C
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41620302 · Publisher ↗
BACKGROUND AND AIMS: Studies demonstrate that Low Density Lipoprotein (LDL) cholesterol targets are largely unreached in real-life, particularly in the higher cardiovascular (CV) risk classes. Our aim was to evaluate LDL...
BACKGROUND AND AIMS: Studies demonstrate that Low Density Lipoprotein (LDL) cholesterol targets are largely unreached in real-life, particularly in the higher cardiovascular (CV) risk classes. Our aim was to evaluate LDL target achievement in very high and extreme CV risk patients at the end of a Cardiac Rehabilitation (CR) program. METHODS AND RESULTS: A total of 940 patients with recent acute or chronic coronary syndrome participating in a CR program were enrolled between January 2012 and December 2023. LDL targets were <70 mg/dL for patients treated before August 2019, <55 mg/dL after this date and <40 mg/dL for extreme CV risk subjects. Mean age was 66.9 ± 10.6 years, 82.9 % of the subjects were males and LDL cholesterol decreased from 107.3 ± 39.3 to 64.5 ± 24.6. 88.0 % of the subjects were taking high-intensity statins, 38.1 % ezetimibe while only 4.6 % PCSK9-inhibitors and 0.9 % bempedoic acid. 53.1 % of the patients reached the LDL target with particularly positive peaks in 2018 (72.8 %), 2022 (78.8 %) and 2023 (75.7 %). 29.8 % of the patients had extreme CV risk and they achieved the target of LDL <40 mg/dL only in 16.4 %, with a higher prevalence in the latest years (32 % in 2022 and 22.7 % in 2023). CONCLUSIONS: Our results are highly encouraging compared to those reported in previous observational studies. The further we move from guideline publication, the higher the proportion of patients achieving LDL targets, supported by increased clinical awareness and new pharmacological options. However, more attention should be paid to extreme CV risk patients, both in term of correct dentification and treatment.
The joint effect of cardiometabolic index and high-sensitivity C-reactive protein on incident cardiovascular disease: A prospective cohort study.
Zhou JH, Li ZJ, Du LL … +2 more , Oyang YL, Gao Y
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41620301 · Publisher ↗
BACKGROUND AND AIM: The combined role of the cardiometabolic index (CMI), a marker of visceral obesity and dyslipidemia, and high-sensitivity C-reactive protein (hsCRP), an inflammatory marker, in predicting cardiovascul...
BACKGROUND AND AIM: The combined role of the cardiometabolic index (CMI), a marker of visceral obesity and dyslipidemia, and high-sensitivity C-reactive protein (hsCRP), an inflammatory marker, in predicting cardiovascular disease (CVD) risk remains unexplored. This study investigates their synergistic effect on new-onset CVD. METHODS AND RESULTS: In this prospective cohort of 7856 CVD-free adults from CHARLS study, participants were categorized by median CMI and hsCRP (cutoff: 2 mg/L). Over a median 7-year follow-up, 1502 CVD incidents occurred. Compared with the low CMI and low hsCRP reference group, individuals with both high CMI and high hsCRP showed the highest risks of CVD (HR 1.54, 95 % CI 1.33-1.78), stroke (HR 2.27, 95 % CI 1.74-2.97), and heart disease (HR 1.37, 95 % CI 1.15-1.63), although multiplicative and additive interaction tests were not statistically significant. Mediation analyses indicated that blood pressure measures, and fasting glucose for heart disease, partially mediated CMI's association with outcomes. A bidirectional mediation relationship was observed between CMI and hsCRP for stroke risk. These findings remained consistent in sensitivity analyses, including competing risk models, subgroup analyses across population strata, and analyses using multiple imputation or an alternative hsCRP cutoff (3 mg/L). CONCLUSION: The joint elevation of CMI and hsCRP identifies individuals at the highest risk of CVD, stroke, and heart disease, underscoring the combined contribution of metabolic and inflammatory pathways to cardiovascular pathogenesis. This supports the integration of both markers for early risk stratification.
Impaired central sensitivity to thyroid hormone is associated with decreased glycemic variability in patients with type 2 diabetes.
Li Y, Gan H, Wang G … +5 more , Gong Y, Zhang Q, Zhu Z, Ye Q, Wang Y
Nutr Metab Cardiovasc Dis · 2026 Apr · PMID 41620300 · Publisher ↗
BACKGROUND AND AIM: As abnormalities in thyroid hormones affect the metabolism of blood glucose, we aim to explore the relationship between central thyroid hormone sensitivity and glycemic variability in patients with ty...
BACKGROUND AND AIM: As abnormalities in thyroid hormones affect the metabolism of blood glucose, we aim to explore the relationship between central thyroid hormone sensitivity and glycemic variability in patients with type 2 diabetes (T2DM). METHODS AND RESULTS: For hospitalized patients with T2DM, thyroid hormones (THs) were measured to calculate the Thyroid Feedback Quantile-based Index (TFQI), Thyrotropin Thyroxine Resistance Index (TT4RI) and TSH Index (TSHI). Coefficients of glycemic variation (CV) were monitored by continuous glucose monitoring systems (CGMs). Independent sample T-test indicated that there was no significant difference in central TH sensitivity between CV ≤ 36 % group and CV>36 % group. Smooth fitting curve and threshold effect analysis indicated that TSHI was negatively correlated with CV before the inflection point of TSHI = 2.428 (β = -2.547, P = 0.0478), while the negative correlation was strengthened after the inflection point (β = -7.512, P = 0.0003); TFQI was negatively correlated with CV before the inflection point of TFQI = 0.334 (β = -2.876, P = 0.0265), while the negative correlation was strengthened after the inflection point (β = -15.864, P < 0.0001). Interaction tests indicated that Sex, Age, BMI, INS-therapy, GLP-1RA-therapy and SGLT-2i-therapy had no differential impacts on the statistical results. Trend test results of multiple regression equations indicated that for per-quartile increase in TFQI, CV decreased by 1.375 correspondingly (β = -1.375,P < 0.00001), for per-SD increase in TFQI, CV decreased by 1.996 correspondingly (β = -1.996,P < 0.00001). CONCLUSION: Impaired central sensitivity to THs is associated with reduced glycemic variability in patients with T2DM, which is speculated to be related with the self-regulation of blood glucose fluctuations in our body.
Pro- and Anti-Inflammatory properties of neutrophils and CRP: Some points for consideration.
Jadali Z
Nutr Metab Cardiovasc Dis · 2026 Apr · PMID 41577561 · Publisher ↗
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Caffeine metabolic phenotypes and hypertension risk: Urinary paraxanthine-to-caffeine ratio threshold and mediating pathways in NHANES.
Shi FE, Huang Z, Cao L … +2 more , Yu Z, Chi C
Nutr Metab Cardiovasc Dis · 2026 Apr · PMID 41549015 · Publisher ↗
BACKGROUND AND AIMS: This study aimed to resolve the caffeine-hypertension paradox by investigating the association between urinary paraxanthine-to-caffeine molar ratio (PMR)-a functional biomarker of CYP1A2 metabolic ca...
BACKGROUND AND AIMS: This study aimed to resolve the caffeine-hypertension paradox by investigating the association between urinary paraxanthine-to-caffeine molar ratio (PMR)-a functional biomarker of CYP1A2 metabolic capacity-and hypertension risk, while exploring mediation by serum uric acid (SUA) and white blood cells (WBC). METHODS AND RESULTS: Using nationally representative NHANES data (2009-2014; n = 1611), urinary PMR was quantified via UPLC-ESI-MS/MS. Hypertension was defined per AHA/ACC 2017 guidelines. Multivariable logistic regression analyzed PMR-hypertension associations (unadjusted, age/sex-adjusted, fully adjusted). Dose-response relationships were modeled using restricted cubic spline (RCS) analysis. Causal mediation tested SUA/WBC pathways. Faster caffeine metabolism (higher PMR) demonstrated a nonlinear inverse relationship with hypertension. A critical inflection point at PMR = 3.03 revealed: slow metabolizers (PMR <3.03) had 51 % higher hypertension risk than fast metabolizers (OR = 0.49, 95 % CI: 0.40-0.60; P < 0.001). SUA and WBC collectively mediated 12 % of PMR's protective effect (SUA: 8.0 %; WBC: 4.0 %). Subgroup analyses showed effect modification by age and race (P interaction <0.05). CONCLUSION: PMR serves as a novel biomarker clarifying the caffeine-hypertension paradox: fast metabolizers (PMR ≥3.03) exhibit significantly reduced hypertension risk, partially mediated by reduced SUA and inflammation. This supports personalized caffeine intake recommendations based on metabolic phenotype.
Causal relationships of lipid metabolism in diabetic nephropathy risk: A two-sample Mendelian randomization study.
Yu C, Zhang H, Ni F … +4 more , Jin L, Ying Z, Fu H, Shou Q
Nutr Metab Cardiovasc Dis · 2026 Apr · PMID 41549014 · Publisher ↗
BACKGROUND AND AIM: Diabetic nephropathy (DN) represents the primary contributor to end-stage renal disease worldwide, and its prevalence continues to grow, even with improvements in therapies aimed at lowering glucose l...
BACKGROUND AND AIM: Diabetic nephropathy (DN) represents the primary contributor to end-stage renal disease worldwide, and its prevalence continues to grow, even with improvements in therapies aimed at lowering glucose levels. The progression of DN has been associated with lipid metabolism, yet the direct involvement of particular lipid species is still not fully understood. This study employs two-sample Mendelian randomization (TSMR) to investigate the causal effects of 179 plasma lipid species on DN risk. METHODS AND RESULTS: Lipid exposure genetic instruments were sourced from a genome-wide association study (GWAS) found in the GWAS Catalog, whereas data on the DN outcomes were collected from the FinnGen R12 cohort. The main analytical approach employed was inverse-variance weighted (IVW) regression. To evaluate pleiotropy and heterogeneity, tests such as MR-Egger intercept, Cochran's Q, MR-PRESSO, and leave-one-out analyses were performed. The analysis identified 13 lipid species with significant associations after sensitivity analyses. Among these, seven lipid species were risk factors for DN, including phosphatidylcholine (PC) (O-16:1_18:1, 15:0_18:2, 18:1_18:1, 18:1_20:2, 18:2_18:2) levels, phosphatidylethanolamine (PE) (18:1_18:1), and triacylglycerol (TAG) (56:4). Conversely, six lipid species demonstrated protective effects, including lysophosphatidylcholine (LPC) (20:4), lysophosphatidylethanolamine (LPE) (18:1), PC (17:0_20:4), sterol ester (SE) (27:1/15:0, 27:1/18:3), and TAG (52:6). CONCLUSIONS: This study provides robust genetic evidence linking specific lipid species to DN risk. PC and PE species were identified as risk factors, whereas LPC, LPE, and SE exhibited protective effects. Additionally, TAG species demonstrated a bidirectional influence. These findings refine the understanding of lipid-mediated renal dysfunction in DN, highlighting lipid metabolism as a potential therapeutic target.
Association of systolic blood pressure variability per unit time with new-onset cardiovascular disease - Evidence from CHARLS.
Li W, Liu J, Sun D … +4 more , Lu X, Wang L, Shi X, Cheng Y
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41549013 · Publisher ↗
BACKGROUND AND AIM: Blood pressure variability (BPV) is an emerging risk factor for cardiovascular disease (CVD). However, the association between the magnitude of systolic blood pressure (SBP) fluctuations per unit time...
BACKGROUND AND AIM: Blood pressure variability (BPV) is an emerging risk factor for cardiovascular disease (CVD). However, the association between the magnitude of systolic blood pressure (SBP) fluctuations per unit time (utBPV) and CVD remains unclear. This study aimed to investigate the relationship between utBPV and incident CVD in a middle-aged and elderly population. METHODS AND RESULTS: Using data from the China Health and Retirement Longitudinal Study (CHARLS), we enrolled 6134 participants aged ≥45 years without baseline CVD between 2011 and 2015. utBPV was defined as the sum of the absolute differences between consecutive SBP measurements divided by the time interval (mmHg/min). Multivariable logistic regression and restricted cubic spline analyses were employed to examine the association between utBPV and incident CVD, with subgroup analyses stratified by baseline hypertension status.During a median follow-up of 4 years, 657 incident CVD cases were observed. The results demonstrated that utBPV was a risk factor for CVD (OR: 1.018, 95 % CI: 1.005-1.031). In the non-hypertensive population, each 1-unit increase in utBPV was associated with a 2.8 % higher risk (P = 0.002). When analyzed by quartiles, the Q4 group had a 29.5 % increased risk compared to the Q1 group (95 % CI: 0.919-1.825), though the trend was not statistically significant (P = 0.166). No significant association was observed in hypertensive individuals. CONCLUSIONS: utBPV is an independent risk factor for incident CVD in non-hypertensive adults aged 45 years and older. Given its convenience for clinical measurement, utBPV may serve as a practical tool for early CVD risk assessment.
Exploring nutritional indicators of cardiovascular mortality risk in elderly hypertensive patients: The long-term predictive advantage of PNI.
Wang SH, Xu L, Yin H … +3 more , Tian J, Wang B, Zhou SS
Nutr Metab Cardiovasc Dis · 2026 May · PMID 41547634 · Publisher ↗
BACKGROUND AND AIMS: Cardiovascular mortality is the leading cause of death among elderly hypertensive patients. However, the reference indicators for nutritional management in this population remain a subject of debate....
BACKGROUND AND AIMS: Cardiovascular mortality is the leading cause of death among elderly hypertensive patients. However, the reference indicators for nutritional management in this population remain a subject of debate. The aim of this study is to explore and compare the predictive value of three commonly used nutritional assessment indicators for cardiovascular mortality in elderly hypertensive patients. METHODS AND RESULTS: This study included 3611 elderly hypertensive patients aged 60 and above from seven cycles of NHANES (2005-2018). The population was categorized into two groups (malnourished vs. non-malnourished) using reference cutoff values for three nutritional assessment indicators: PNI, GNRI, and CONUT score. Multivariate Cox regression and competing risk analysis were employed to compare the predictive abilities of these three indicators for cardiovascular mortality risk. Subgroup analyses were also conducted to explore whether kidney dysfunction, cardiovascular disease, or gender interacted with the three nutritional indicators. Additionally, restricted cubic splines (RCS) curves were used to explore the dose-response relationship. Decision curve analysis was applied to assess the clinical value of these three indicators in predicting cardiovascular mortality risk. Time-dependent receiver operating characteristic (ROC) curves were used to calculate the area under the curve (AUC) for each indicator's prediction of cardiovascular mortality risk at different follow-up times. Furthermore, Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI) were calculated based on multivariate Cox regression models to compare the predictive ability of these models over different follow-up durations. Malnourished patients diagnosed by PNI had a 2.70 times higher risk of cardiovascular death compared to non-malnourished patients (HR: 3.70, 95 % CI: 2.54-5.38), representing the highest cardiovascular mortality risk among the three groups. Patients diagnosed with malnutrition using GNRI and CONUT score had cardiovascular mortality risks increased by 1.39 times (HR: 2.39, 95 % CI: 1.58-3.63) and 0.84 times (HR: 1.84, 95 % CI: 1.33-2.55), respectively. In the multivariate competing risks model, the results were similar to those from the Cox regression analysis. The non-restricted cubic spline plot demonstrates an L-shaped association between GNRI and PNI with cardiovascular mortality, while the COUNT score shows an inverse L-shaped association. In addition, both the Time-ROC curve's AUC and NRI support that PNI's predictive advantage for cardiovascular mortality risk gradually increases with longer follow-up time. CONCLUSION: PNI has superior predictive value for cardiovascular mortality risk compared to GNRI and COUNT score, especially for long-term prognosis.
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