BACKGROUND AND AIM: Icosapent-ethyl (IPE) has been shown to reduce cardiovascular events in a randomized trial; however, its real-world impact on advanced lipoprotein and inflammatory profiles remains incompletely charac...BACKGROUND AND AIM: Icosapent-ethyl (IPE) has been shown to reduce cardiovascular events in a randomized trial; however, its real-world impact on advanced lipoprotein and inflammatory profiles remains incompletely characterized. We evaluated the effects of IPE on lipoprotein particle number, size, composition, and circulating glycoproteins using proton nuclear magnetic resonance (H-NMR) spectroscopy in real-world clinical practice. METHODS AND RESULTS: This multicentre, prospective, open-label observational study included patients with established atherosclerotic cardiovascular disease receiving IPE 2 g twice daily for ≥4 months in addition to optimized lipid-lowering therapy. Lipoprotein subclasses and Glyc acetyl signals were quantified by H-NMR at baseline and follow-up. Changes were assessed using paired statistical tests, and analyses were stratified according to tertiles of triglyceride (TG) response. Sixty-two patients completed paired NMR assessments. Mean age was 64 years, 17.7% were women, median baseline LDL-cholesterol was 1.50 (1.09-1.82) mmol/L, and median TG concentration was 2.35 mmol/L (2.01-3.16). Overall TG levels decreased with substantial interindividual variability; tertiles 2 and 3 showed mean TG reductions of -21.6% and -38%, respectively, while tertile 1 were non-responders (less than 10% TG reduction). In responders, IPE therapy significantly reduced triglyceride-rich lipoprotein particles, particularly small VLDL remnants, as well as remnant cholesterol and small LDL particles. HDL triglyceride content was also reduced. The Glyc acetyl were also significantly reduced, indicating decreased systemic inflammation. CONCLUSIONS: In a real-world secondary prevention population, IPE therapy significantly improved atherogenic lipoprotein profiles and inflammatory biomarkers, supporting its role in reducing residual cardiovascular risk beyond triglyceride lowering.
AIM: A dysregulated growth hormone (GH)-insulin-like growth factor-1 (IGF-1) axis may contribute to the development and progression of metabolic dysfunction-associated steatotic liver disease (MASLD). However, the availa...AIM: A dysregulated growth hormone (GH)-insulin-like growth factor-1 (IGF-1) axis may contribute to the development and progression of metabolic dysfunction-associated steatotic liver disease (MASLD). However, the available evidence remains inconsistent. DATA SYNTHESIS: We systematically searched PubMed and Scopus from database inception through 31 January 2026 to identify eligible observational studies assessing the association between circulating GH and IGF-1 levels and MASLD (diagnosed by liver biopsy or imaging). The primary outcome was the difference in circulating GH and IGF-1 levels between adults (age >18 years) with and without MASLD. Effect sizes were expressed as weighted mean differences (WMDs) with 95% confidence intervals (95%CI). A total of 18 observational studies were included. Fourteen studies (13,112 participants) measured circulating IGF-1 levels, five studies (7500 participants) measured circulating GH levels, and one study assessed both hormones. Individuals with MASLD had significantly lower circulating GH (random-effects WMD: -0.34 ng/ml; 95%CI, -0.61 to -0.07; I = 81.5%) and IGF-1 (random-effects WMD: -24.85 ng/ml; 95%CI, -37.88 to -11.81; I = 94.8%) levels than controls. Circulating IGF-1 levels were also lower in individuals with biopsy-confirmed metabolic dysfunction-associated steatohepatitis or advanced liver fibrosis (F2-F4 stages). Sensitivity analyses did not substantially alter these findings. CONCLUSION: Circulating GH and IGF-1 levels are inversely associated with the presence and severity of MASLD. Further studies are needed to better understand the complex but existing link between a dysregulated (suppressed) GH-IGF-1 axis and MASLD.
AIMS: Elevated low-density lipoprotein cholesterol (LDL-C) is a well-established, independent risk factor for atherosclerotic cardiovascular disease (ASCVD), with absolute LDL-C reduction translating into proportional re...AIMS: Elevated low-density lipoprotein cholesterol (LDL-C) is a well-established, independent risk factor for atherosclerotic cardiovascular disease (ASCVD), with absolute LDL-C reduction translating into proportional reductions in ASCVD events. Inhibition of proprotein convertase subtilisin/kexin type 9 (PCSK9) has emerged as an effective lipid-lowering strategy. This review summarizes current evidence on the efficacy and safety of inclisiran, a small interfering RNA (siRNA) therapy that inhibits hepatic PCSK9 synthesis, in primary and secondary ASCVD prevention, as well as in heterozygous familial hypercholesterolaemia (HeFH) and homozygous familial hypercholesterolaemia (HoFH). DATA SYNTHESIS: Randomized clinical trials have demonstrated that inclisiran produces robust and sustained reductions in LDL-C and circulating PCSK9 levels across a broad spectrum of patients, including those with established ASCVD, ASCVD risk equivalents, and FH. Its twice-yearly dosing regimen may substantially improve long-term treatment adherence. Long-term data (up to 6 years) indicate a favorable safety and tolerability profile, with no dose adjustments required in patients with renal or hepatic impairment. Ongoing randomized outcome trials are expected to clarify the impact of inclisiran on ASCVD events. CONCLUSION: Current evidence supports its role as a promising adjunct or alternative to established lipid-lowering therapies, including statins, particularly in patients requiring additional LDL-C reduction.
BACKGROUND AND AIMS: To investigate the joint associations of sleep duration and physical activity with incident cardiovascular disease (CVD) and all-cause mortality. METHODS AND RESULTS: This study utilized data from th...BACKGROUND AND AIMS: To investigate the joint associations of sleep duration and physical activity with incident cardiovascular disease (CVD) and all-cause mortality. METHODS AND RESULTS: This study utilized data from the UK Biobank. Accelerometers were used to assess sleep duration (categorized into insufficient [<7 h/day], optimal [≥7, <10 h/day], and prolonged [≥10 h/day]) and physical activity (moderate-to-vigorous physical activity [MVPA] and light physical activity [LPA]). Restricted cubic spline and the Cox proportional hazard models were used to investigate the independent and joint associations. A total of 87,879 participants were included. Significant additive interactions between sleep duration and PA on all outcomes were observed, as indicated by the relative excess risk due to interaction. Among participants with low MVPA, compared with optimal sleep duration, suboptimal sleep duration was associated with elevated risk of CVD (prolonged: [HR: 1.17, 95% CI: 1.01, 1.36]) and all-cause mortality (insufficient: [HR: 1.51, 95% CI: 1.21, 1.89]; prolonged: [HR: 1.20, 95% CI: 1.05, 1.36]). When increasing MVPA to a high level, participants with suboptimal sleep had a lower risk of CVD (prolonged: [HR: 0.76, 95% CI: 0.60, 0.97]) and all-cause mortality (insufficient: [HR: 0.59, 95% CI: 0.40, 0.85]; prolonged: [HR: 0.70, 95% CI: 0.56, 0.88]) compared with those with optimal sleep duration and low MVPA. Results for LPA showed similar patterns. CONCLUSION: Suboptimal sleep duration and low PA were synergistically associated with an increased risk of CVD and all-cause mortality. Higher levels of MVPA and LPA were associated with an attenuation in the elevated risk related to suboptimal sleep duration.
BACKGROUND AND AIMS: Cardiovascular-kidney-metabolic (CKM) syndrome reflects systemic cardiometabolic risk, but whether hepatic steatosis or fibrosis provides incremental prognostic information beyond CKM staging remains...BACKGROUND AND AIMS: Cardiovascular-kidney-metabolic (CKM) syndrome reflects systemic cardiometabolic risk, but whether hepatic steatosis or fibrosis provides incremental prognostic information beyond CKM staging remains unclear. We evaluated the prognostic contributions of steatosis- and fibrosis-based hepatic phenotypes across CKM stages. METHODS AND RESULTS: This prospective cohort study included 602,885 adults undergoing health screening between 2005 and 2022 in the Kangbuk Samsung Health Study. CKM stage was classified according to the 2023 American Heart Association criteria. Hepatic steatosis was assessed using ultrasonography-defined fatty liver and metabolic dysfunction-associated steatotic liver disease, whereas hepatic fibrosis was assessed using the fibrosis-4 (FIB-4) index. During a median follow-up of 7.4 years, advancing CKM stage was associated with progressively higher risks of all-cause, cardiovascular, and liver-related mortality. Compared with CKM stage 0, CKM stage 3 was associated with increased risks of all-cause mortality (hazard ratio [HR], 2.10; 95% confidence interval [CI], 1.82-2.42) and cardiovascular mortality (HR, 3.28; 95% CI, 2.20-4.88), while CKM stage 4 showed the highest cardiovascular mortality risk (HR, 4.69; 95% CI, 3.03-7.26). These associations remained robust after adjustment for hepatic phenotypes. Adding steatosis-based phenotypes produced minimal improvement in risk discrimination beyond CKM staging. In contrast, adding FIB-4 improved prediction of liver-related mortality, increasing the C statistic from 0.8672 to 0.8972 with a categorical net reclassification improvement of 0.610 (95% CI, 0.556-0.665). CONCLUSIONS: CKM staging captured most systemic cardiometabolic mortality risk, whereas hepatic fibrosis, but not steatosis, provided additional prognostic information for liver-related mortality.
BACKGROUND AND AIMS: Although the safety profile of lipid-lowering therapies (LLTs) is known, there are no comprehensive comparative assessments. We aimed to compare the risk of muscle-related events, diabetes, liver dys...BACKGROUND AND AIMS: Although the safety profile of lipid-lowering therapies (LLTs) is known, there are no comprehensive comparative assessments. We aimed to compare the risk of muscle-related events, diabetes, liver dysfunction, and cognitive disorders among LLTs through a network meta-analysis. METHODS AND RESULTS: Databases were searched from inception to May 2025. Eligible studies included adult patients, using statins, ezetimibe, PCSK9 monoclonal antibodies (PCSK9mAbs), inclisiran, bempedoic acid, or their combinations as intervention, reporting the information about any of the selected adverse events, a total sample size of ≥200 subjects, and had ≥1 month of intervention. Pooled estimates were assessed by fixed effects model within a frequentist setting. Pooled relative risks (RR) and their 95% confidence interval were estimated. A total of 303,397 subjects from 153 RCTs were included. Bempedoic acid ranked the lowest risk of myalgia (vs PCSK9mAbs, RR 0.80 [0.69, 0.93]). PCSK9mAbs were associated with lower incidence of creatine kinase (CK) elevation, diabetes, and liver dysfunction comparing to statins (statins vs PCSK9mAbs, RR 1.44 [1.14, 1.81], RR 1.13 [1.05, 1.22], and RR 1.38 [1.17, 1.62], respectively). In terms of muscle-related events and cognitive disorders, no significant risk differences were found among treatments and their combinations. CONCLUSIONS: PCSK9mAbs appear to have a more favourable safety profile regarding the risk of CK elevation, diabetes, and liver dysfunction. Bempedoic acid seem to be a better choice for subjects with high risk of myalgia. This information can be valuable when selecting therapy for specific patient subgroups at higher risk of certain adverse events.
BACKGROUND AND AIMS: The impact of increasingly prevalent cardiovascular-kidney-metabolic (CKM) multimorbidity on absolute survival remains unclear. We aimed to assess the association of CKM multimorbidity with mortality...BACKGROUND AND AIMS: The impact of increasingly prevalent cardiovascular-kidney-metabolic (CKM) multimorbidity on absolute survival remains unclear. We aimed to assess the association of CKM multimorbidity with mortality and life expectancy in US adults. METHODS AND RESULTS: We included 46,543 adults (mean age 50.0 years) from NHANES (1999-2018). CKM conditions included type 2 diabetes (T2DM), chronic kidney disease (CKD), and cardiovascular disease (CVD). Over a 9.2-year median follow-up, mortality risk increased sequentially with the number of CKM conditions. Compared to participants without CKM conditions, adjusted hazard ratios for all-cause mortality were 2.59 (95% CI: 2.30-2.92) for T2DM + CKD, 2.27 (1.90-2.72) for T2DM + CVD, 2.69 (2.39-3.04) for CKD + CVD, and 3.57 (3.08-4.14) for all three conditions. Using life table methods, we estimated corresponding reductions in life expectancy at age 50. Compared to the reference group, life expectancy losses were 9.2, 8.8, 13.2, and 17.0 years for individuals with T2DM + CKD, T2DM + CVD, CKD + CVD, and all three conditions, respectively. These profound reductions were predominantly attributable to increased CVD deaths, even among those without baseline CVD. CONCLUSION: CKM multimorbidity is independently associated with remarkably reduced life expectancy. Because these life years lost are largely driven by CVD mortality, integrated prevention strategies are urgently needed.
BACKGROUND AND AIMS: Residual cardiovascular risk remains high after acute coronary syndrome (ACS) despite intensive LDL-cholesterol lowering. Elevated triglycerides may contribute to this risk. Although icosapent ethyl...BACKGROUND AND AIMS: Residual cardiovascular risk remains high after acute coronary syndrome (ACS) despite intensive LDL-cholesterol lowering. Elevated triglycerides may contribute to this risk. Although icosapent ethyl (IPE) has shown cardiovascular benefit in high-risk statin-treated patients, access in Italy is limited by Italian Medicines Agency (AIFA) reimbursement criteria, which are more restrictive than the European Medicines Agency (EMA) indications. We compared EMA and AIFA eligibility for IPE in a real-world post-ACS cohort, assessed the association of triglyceride levels and variability with 12-month ischemic recurrence, and explored the potential economic impact of broader IPE use. METHODS AND RESULTS: This retrospective observational study included 430 consecutive adults admitted for ACS to a tertiary hospital in Italy in 2024, with 12-month follow-up. During follow-up, 48 patients (11.2%) experienced recurrent ACS. Diabetes mellitus was independently associated with recurrence (OR 2.90, 95% CI 1.41-5.97; p = 0.004), whereas male sex was protective (OR 0.46, 95% CI 0.23-0.93; p = 0.030). Absolute triglyceride levels were not significantly associated with recurrence, whereas triglyceride variability was: the coefficient of variation remained independently associated with recurrent events (OR 1.04, 95% CI 1.00-1.09; p = 0.029). According to EMA criteria, 35 patients (8.1%) were eligible at discharge and 15 (3.5%) at first follow-up; under AIFA criteria, only one patient was eligible. CONCLUSIONS: A marked discrepancy exists between EMA indications and AIFA reimbursement criteria for IPE, resulting in restricted access for high-risk post-ACS patients. Broader access, aligned with current evidence, may improve secondary prevention and represent a cost-effective strategy.
BACKGROUND AND AIM: Metabolic dysfunction-associated fatty liver disease (MAFLD) represents systemic metabolic dysfunction and is significantly associated with cardiovascular disease. However, its specific impact on card...BACKGROUND AND AIM: Metabolic dysfunction-associated fatty liver disease (MAFLD) represents systemic metabolic dysfunction and is significantly associated with cardiovascular disease. However, its specific impact on cardiac remodeling in non-ischemic dilated cardiomyopathy (NIDCM) remains unclear. This study aimed to investigate the impact of MAFLD and liver fibrosis on biventricular remodeling in patients with NIDCM. METHODS AND RESULTS: We evaluated 293 NIDCM patients using comprehensive echocardiography. Liver fibrosis was assessed via the NAFLD Fibrosis Score (NFS). Associations were analyzed using multivariable linear regression and dose-response models. MAFLD was independently associated with a larger right ventricular diameter (RV; β = 3.32, P = 0.01), increased LV posterior wall thickness (β = 0.399, P = 0.037), and a lower LV mass index (LVMI; β = -22.11, P = 0.006), alongside a reduced prevalence of eccentric hypertrophy. This reduction in LVMI showed a graded pattern across MAFLD subtypes, being most pronounced in MAFLD with diabetes. Independently of MAFLD, more severe liver fibrosis (higher NFS) was associated with larger right heart dimensions (RV, right atrium, and main pulmonary artery) across all adjusted models. CONCLUSIONS: MAFLD and liver fibrosis are associated with distinct cardiac remodeling phenotypes in NIDCM, notably right heart enlargement and a unique pattern of LV remodeling. These findings highlight the clinical relevance of the liver-heart axis and support routine hepatic assessment in NIDCM management.
BACKGROUND AND AIM: The Portfolio Diet has demonstrated clinically meaningful reductions in LDL-C concentrations. Variations in ABCA1, ABCG8, APOA5, ANGPTL3, and APOC1 have also been associated with LDL-C and other blood...BACKGROUND AND AIM: The Portfolio Diet has demonstrated clinically meaningful reductions in LDL-C concentrations. Variations in ABCA1, ABCG8, APOA5, ANGPTL3, and APOC1 have also been associated with LDL-C and other blood lipid concentrations. The interaction between these genetic variations and the Portfolio Diet on LDL-C is unclear. Therefore, we examined whether variations in genes involved in lipid metabolism modify the association between the Portfolio Diet Score (PDS) and its components and LDL-C concentrations. METHODS AND RESULTS: This cross-sectional analysis included 1490 young adults (mean age, 23±2years) from the Toronto Nutrigenomics and Health Study. Adherence to the Portfolio Diet was measured by the PDS and its individual components. Using a candidate gene approach, participants were genotyped for SNPs in ABCA1 (rs1883025), ABCG8 (rs6544713), APOA5 (rs662799), ANGPTL3 (rs10889353) and APOC1 (rs4420638). Multiple linear regressions examined gene-diet interactions with LDL-C. Higher PDS, intake of plant protein, nuts, and phytosterols and lower intake of saturated fat and cholesterol sources were associated with lower LDL-C (p < 0.05). ABCA1 rs1883025 genotype modified the association between the PDS and LDL-C (p < 0.01). A 1-point higher PDS was associated with lower LDL-C among those with the ABCA1 rs1883025 CC (β: -0.017 mmol/L [95% CI: -0.027, -0.007], p < 0.01) and TT (-0.034 mmol/L [-0.065, -0.003], p = 0.03) genotypes. ABCG8 rs6544713 T allele was associated with higher LDL-C (p = 0.002). ABCG8 rs6544713 genotype modified the association between plant protein (p = 0.02) and phytosterols (p = 0.01) with LDL-C. A 1-serving higher intake of plant protein (-0.314 mmol/L [-0.601, -0.028], p = 0.03) and phytosterol (-0.051 mmol/L [-0.101, -0.002], p = 0.04) sources was associated with lower LDL-C among those with the ABCG8 rs6544713 TT genotype. CONCLUSIONS: In young adults, higher PDS and intake of its components showed favourable associations with LDL-C. Our findings suggest that ABCA1 rs1883025 and ABCG8 rs6544713 genotypes modify the association of the PDS, plant protein and phytosterols with LDL-C.
BACKGROUND AND AIMS: Rheumatoid arthritis (RA) is associated with a higher risk of cardiovascular disease (CVD). This study examined CVD incidence among middle-aged and older Canadians with and without RA and identified...BACKGROUND AND AIMS: Rheumatoid arthritis (RA) is associated with a higher risk of cardiovascular disease (CVD). This study examined CVD incidence among middle-aged and older Canadians with and without RA and identified the role of potential risk factors for CVD in this population. METHODS AND RESULTS: Data were obtained from the Canadian Longitudinal Study on Aging (CLSA) using three time points between 2011 and 2021. Incidence rate ratios (IRR) for CVD were calculated to compare CVD incidence among RA and non-RA individuals. Cox proportional hazards regression models identified the potential risk factors associated with CVD incidence. Stratification based on sex, age and education levels were conducted. The analysis included 19,844 participants. RA patients (N = 553) experienced significantly higher CVD incidence, compared to the non-RA individuals (IRR = 1.69, 95% CI: 1.34 - 2.11). Multivariable analysis showed that RA, elevated C-reactive protein (CRP) level, disease-modifying antirheumatic drugs (DMARDs) other than methotrexate, male sex, older age, low physical activity, smoking, dissatisfaction with sleep quality, diabetes, hypertension and mood disorders were significant risk factors for CVD. Stratified analyses revealed stronger associations between RA and CVD among females, individuals <65 years old and those with lower education levels. CONCLUSIONS: This large population-based study confirmed the elevated risk of CVD among RA patients and identified high-risk subgroups, including females, younger individuals and those with lower socioeconomic status. This highlights the need for targeted prevention and management strategies in these vulnerable populations. Future research should explore underlying mechanisms and tailored interventions to mitigate the risk.
BACKGROUND AND AIMS: Abdominal aortic calcification (AAC) reflects subclinical atherosclerotic cardiovascular disease (ASCVD), but its lifestyle determinants remain uncertain. We investigated how a Healthy Lifestyle Scor...BACKGROUND AND AIMS: Abdominal aortic calcification (AAC) reflects subclinical atherosclerotic cardiovascular disease (ASCVD), but its lifestyle determinants remain uncertain. We investigated how a Healthy Lifestyle Score (HLS) relates to AAC and whether AAC mediates the HLS-ASCVD association. METHODS AND RESULTS: Participants from the UK Biobank Imaging study were assessed for AAC from DXA images. A Healthy Lifestyle Score (HLS), based on smoking, physical activity, diet quality, alcohol consumption, sleep, and BMI was developed, and categorised as low, moderate and high. Cross-sectional associations with (i) any AAC (AAC≥1) and (ii) high AAC (AAC≥6) were analysed using multivariable-adjusted logistic regression models. The association between HLS and incident ASCVD over 6 years was assessed using Cox regression models. Mediation analysis examined the extent to which the HLS-ASCVD association was mediated by AAC. Among 27,818 participants (52% female; median age 65y), 33.5% had any AAC and 4.4% had high AAC. Compared to participants with a low HLS, those with moderate or high scores had 21% (95%CI: 60%-105%) and 66% (33%-59%) lower odds of having high AAC, respectively, and 10% (78%-104%) and 18% (0.71%-95%) lower odds of having any AAC, respectively. These associations were strongest in women and those younger than 65 years. During follow-up, a one-point increment in the HLS was associated with a 4% (0%-8%) lower rate of incident ASCVD. High AAC accounted for 20% (10%-48%) of this association. CONCLUSION: These findings suggest targeting specific modifiable lifestyle factors, especially earlier in life, may help prevent high AAC levels and subsequent risk of ASCVD.
Papakonstantinou E, Lympaki F, Savvidou A
… +10 more, Dalaka E, Georgiopoulos G, Giannoglou M, Karatzi K, Chaloulakou S, Delialis D, Keramida K, Zampelas A, Katsaros G, Theodorou G
BACKGROUND AND AIM: Spirulina (Arthrospira platensis) contains peptides with angiotensin-I converting enzyme (ACE) inhibitory activity, suggesting possible antihypertensive effects. However, food-matrix interactions may...BACKGROUND AND AIM: Spirulina (Arthrospira platensis) contains peptides with angiotensin-I converting enzyme (ACE) inhibitory activity, suggesting possible antihypertensive effects. However, food-matrix interactions may alter peptide release or bioactivity. This study evaluated (i) the in-vitro ACE-inhibitory activity of <3 kDa peptide fractions after simulated gastrointestinal digestion of spirulina biomass (SB) and a spirulina-enriched yogurt-like dessert (YSB), and (ii) the effects of daily YSB consumption on blood pressure (BP) and vascular function in overweight/obese adults with elevated cardiometabolic risk. METHODS AND RESULTS: SB, YSB, and control yogurt (YC) underwent simulated gastrointestinal digestion and <3 kDa fractions were assessed for ACE-inhibition. In a randomized, placebo-controlled, parallel, clinical trial, adults (n = 64 completers; 32 per group) consumed YSB (4 g/day spirulina) or isoenergetic YC for 8 weeks, followed by 4 weeks of observation. Peripheral BP, central BP, pulse wave velocity (PWV), and augmentation index (AIx) were measured at baseline, week 8, and week 12. In-vitro, SB and YC exhibited ACE-inhibitory activity, while YSB did not. Clinically, no significant group∗time interactions were observed for BP, PWV, or AIx. Results were unchanged in sensitivity analyses excluding antihypertensive-treated participants and in subgroups with elevated baseline BP. CONCLUSIONS: SB exhibited ACE-inhibitory activity in vitro; however, incorporation into a yogurt-like matrix abolished this effect. Daily YSB consumption did not lower BP or improve vascular markers. Findings highlight the critical role of food-matrix interactions in functional food development. CLINICALTRIALS: gov: NCT06114563.
BACKGROUND AND AIM: Triglyceride-glucose-waist-to-height ratio (TyG-WHtR) index and blood pressure are independent predictors of cardiovascular disease risk. However, the interaction between these factors in Cardiovascul...BACKGROUND AND AIM: Triglyceride-glucose-waist-to-height ratio (TyG-WHtR) index and blood pressure are independent predictors of cardiovascular disease risk. However, the interaction between these factors in Cardiovascular disease (CVD) risk stratification remains underexplored. This cohort study explored the association between TyG-WHtR and CVD risk stratified by systolic blood pressure (SBP) to disentangle their complex interaction effects in middle-aged and older Chinese populations. METHODS AND RESULT: A total of 6542 participants without CVD at baseline were recruited from the China Health and Retirement Longitudinal Study. Participants were stratified into three SBP groups. The TyG-WHtR index is calculated as TyG ∗WHtR. The primary outcome was cardiovascular events. After 52962 person-years of follow-up, there were 1665 cases of CVD. Among all participants, the risk of CVD increased by 14.5% per 1-SD increase in TyG-WHtR index (HR = 1.145, 95%CI: 1.071,1224). The magnitude of the association between TyG-WHtR and CVD appeared relatively higher in participants with SBP <120 mmHg compared with the other group, and a significant interaction was detected between TyG-WHtR and SBP (P for interaction = 0.044). CONCLUSIONS: The TyG-WHtR index may be more strongly associated with CVD risk among middle-aged and older Chinese adults in the SBP <120 mmHg subgroup, though further research is needed to confirm its clinical significance due to the limitations of observational studies.
BACKGROUND AND AIMS: The uric acid-to-creatinine ratio (UCR) is a potential biomarker for metabolic risk, yet its longitudinal association with hyperlipidemia in occupational groups remains unclear. This study examines t...BACKGROUND AND AIMS: The uric acid-to-creatinine ratio (UCR) is a potential biomarker for metabolic risk, yet its longitudinal association with hyperlipidemia in occupational groups remains unclear. This study examines the relationship between long-term UCR trajectories and hyperlipidemia risk among petroleum workers. METHODS AND RESULTS: We analyzed health examination data (2020-2023) from 923 petroleum workers in Xinjiang, China. Group-based trajectory modeling (GBTM) identified distinct UCR trajectories. Binary logistic regression assessed associations between trajectory groups and hyperlipidemia, with dose-response relationships explored using restricted cubic splines (RCS). External validation was performed using the UK Biobank.Three UCR trajectories were identified: Low-Stable (32.6%), Moderate-Stable (51.2%), and High-Stable (16.2%). A significant positive association was observed between UCR and hyperlipidemia risk, with the highest quartile (Q4) showing 2.20-fold increased odds (95% CI: 2.09-2.31) compared to the lowest (Q1). Participants in the Low-Stable trajectory had a 49% lower risk (OR = 0.51, 95% CI: 0.34-0.78) than the High-Stable group. Smoking and alcohol consumption significantly amplified this association. UK Biobank validation confirmed the positive correlation. CONCLUSION: Elevated UCR levels are associated with increased hyperlipidemia risk, while maintaining low UCR trajectories offers protection. UCR shows promise as a biomarker for early hyperlipidemia risk stratification in petroleum workers.
AIMS: Cardiometabolic diseases (CMDs) are major contributors to global morbidity and mortality, and dietary bioactives such as polyphenols may modulate key risk factors. Olive by-products, particularly olive leaves (OL)...AIMS: Cardiometabolic diseases (CMDs) are major contributors to global morbidity and mortality, and dietary bioactives such as polyphenols may modulate key risk factors. Olive by-products, particularly olive leaves (OL) and olive pomace (OP), are rich in phenolic compounds with antioxidant, anti-inflammatory, and cardiometabolic effects demonstrated across in vitro, preclinical, and clinical studies. DATA SYNTHESIS: This GRADE-assessed systematic review and meta-analysis included 30 randomized controlled trials (n = 1726) evaluating OL or OP supplementation on 21 standardized biomarkers, encompassing inflammatory markers, lipid profile, glycemic control, insulin sensitivity, anthropometric measures, and blood pressure. Meta-analyses were conducted using random-effects models, with effect sizes calculated as mean differences (or standardized mean differences for oxLDL). Between-study heterogeneity was assessed with I statistics, and sensitivity and subgroup analyses explored potential sources of variability. Publication bias was evaluated using Begg's test and funnel plots where appropriate. OL supplementation significantly improved lipid parameters (total cholesterol, triglycerides, LDL-C, ApoB, oxLDL) and increased ApoA1, while reducing TNF-α, systolic and diastolic blood pressure, body weight, and BMI. No significant effects were observed on glycemic markers. OP supplementation showed no consistent cardiometabolic benefits and was associated with an increase in IL-8. Certainty of evidence ranged from very low to high, with several outcomes downgraded due to imprecision, heterogeneity, or limited study numbers. CONCLUSION: These findings support the targeted use of OL as an adjunctive strategy for cardiometabolic risk management. Evidence for OP supplementation remains limited, underscoring the need for well-powered, high-quality RCTs to clarify its clinical effects.