Metabolomic profiling of upper GI malignancies in blood and tissue: a systematic review and meta-analysis.

OBJECTIVE: To conduct a systematic review and meta-analysis of case-control and cohort human studies evaluating metabolite markers identified using high-throughput metabolomics techniques on esophageal cancer (EC), cancer of the gastroesophageal junction (GEJ), and gastric cancer (GC) in blood and tissue. BACKGROUND: Upper gastrointestinal cancers (UGC), predominantly EC, GEJ, and GC, are malignant tumour types with high morbidity and mortality rates. Numerous studies have focused on metabolomic profiling of UGC in recent years. In this systematic review and meta-analysis, we have provided a collective summary of previous findings on metabolites and metabolomic profiling associated with EC, GEJ and GC. METHODS: Following the PRISMA procedure, a systematic search of four databases (Embase, PubMed, MEDLINE, and Web of Science) for molecular epidemiologic studies on the metabolomic profiles of EC, GEJ and GC was conducted and registered at PROSPERO (CRD42023486631). The Newcastle-Ottawa Scale (NOS) was used to benchmark the risk of bias for case-controlled and cohort studies. QUADOMICS, an adaptation of the QUADAS-2 (Quality Assessment of Diagnostic Accuracy) tool, was used to rate diagnostic accuracy studies. Original articles comparing metabolite patterns between patients with and without UGC were included. Two investigators independently completed title and abstract screening, data extraction, and quality evaluation. Meta-analysis was conducted whenever possible. We used a random effects model to investigate the association between metabolite levels and UGC. RESULTS: A total of 66 original studies involving 7267 patients that met the required criteria were included for review. 169 metabolites were differentially distributed in patients with UGC compared to healthy patients among 44 GC, 9 GEJ, and 25 EC studies including metabolites involved in glycolysis, anaerobic respiration, tricarboxylic acid cycle, and lipid metabolism. Phosphatidylcholines, eicosanoids, and adenosine triphosphate were among the most frequently reported lipids and metabolites of cellular respiration, while BCAA, lysine, and asparagine were among the most commonly reported amino acids. Previously identified lipid metabolites included saturated and unsaturated free fatty acids and ketones. However, the key findings across studies have been inconsistent, possibly due to limited sample sizes and the majority being hospital-based case-control analyses lacking an independent replication group. CONCLUSION: Thus far, metabolomic studies have provided new opportunities for screening, etiological factors, and biomarkers for UGC, supporting the potential of applying metabolomic profiling in early cancer diagnosis. According to the results of our meta-analysis especially BCAA and TMAO as well as certain phosphatidylcholines should be implicated into the diagnostic procedure of patients with UGC. We envision that metabolomics will significantly enhance our understanding of the carcinogenesis and progression process of UGC and may eventually facilitate precise oncological and patient-tailored management of UGC.

EAP and ECPCP urge ban on novel nicotine- (NNCPS) and non-nicotine-containing products (NNDS) to youth.

AIM: We want to verify the correlation between the increasing use of novel nicotine-containing products (NNCPs) and non-nicotine delivery products (NNDPs) among young individuals and the escalating negative health consequences, necessitating their prohibition. METHODS: We performed a comprehensive analysis of the most relevant literature about the utilisation of NNCPs and NNDPs among young individuals and their health effects. RESULTS: Despite being initially seen as less harmful alternatives, for smokers aiming to quit, these products have become more popular due to misleading marketing claims. Teenagers using NNCPs and NNDPs, despite having no smoking history, are more likely to transition to tobacco smoking. Consistent use can lead to health issues like pulmonary damage, asthma, and cardiovascular and ocular problems. CONCLUSION: The EAP and the ECPCP endorse the WHO's appeal to outlaw these hazardous products. They urge European governments to forbid the sale of NNCPs and NNDPs to children and adolescents in order to safeguard their well-being. They also propose specific recommendations (box 4) to support this cause.

Dietary habits, traveling and the living situation potentially influence the susceptibility to SARS-CoV-2 infection: results from healthcare workers participating in the RisCoin Study.

PURPOSE: To explore occupational and non-occupational risk and protective factors for the coronavirus disease 2019 (COVID-19) in healthcare workers (HCWs). METHODS: Serum specimens and questionnaire data were obtained between October 7 and December 16, 2021 from COVID-19-vaccinated HCWs at a quaternary care hospital in Munich, Germany, and were analyzed in the RisCoin Study. RESULTS: Of 3,696 participants evaluated, 6.6% have had COVID-19 at least once. Multivariate logistic regression analysis identified working in patient care occupations (7.3% had COVID-19, 95% CI 6.4-8.3, Pr = 0.0002), especially as nurses, to be a potential occupation-related COVID-19 risk factor. Non-occupational factors significantly associated with high rates of the disease were contacts to COVID-19 cases in the community (12.8% had COVID-19, 95% CI 10.3-15.8, Pr < 0.0001), being obese (9.9% had COVID-19, 95% CI 7.1-13.5, Pr = 0.0014), and frequent traveling abroad (9.4% had COVID-19, 95% CI 7.1-12.3, Pr = 0.0088). On the contrary, receiving the basic COVID-19 immunization early during the pandemic (5.9% had COVID-19, 95% CI 5.1-6.8, Pr < 0.0001), regular smoking (3.6% had COVID-19, 95% CI 2.1-6.0, Pr = 0.0088), living with the elderly (3.0% had COVID-19, 95% CI 1.0-8.0, Pr = 0.0475), and frequent consumption of ready-to-eat meals (2.6% had COVID-19, 95% CI 1.1-5.4, Pr = 0.0045) were non-occupational factors potentially protecting study participants against COVID-19. CONCLUSION: The newly discovered associations between the living situation, traveling as well as dietary habits and altered COVID-19 risk can potentially help refine containment measures and, furthermore, contribute to new mechanistic insights that may aid the protection of risk groups and vulnerable individuals.

Association between inflammation, glycocalyx biomarkers, and endothelial function in children with hypercholesterolemia.

INTRODUCTION: Hypercholesterolemia is a risk factor for premature arteriosclerosis. Inflammation and oxidative stress are thought to contribute to endothelial dysfunction preceding vasculopathy. We investigated the association between inflammation, glycocalyx biomarkers, endothelial function and vascular parameters in children with hypercholesterolemia. METHODS: In 22 patients (LDL-cholesterol > 130 mg/dl; median age [IQR]: 13 [2.3] years) and 22 controls (13 [2.5] years) tumor necrosis factor-alpha (TNF-α), oxidized cholesterol (oxLDL), and glycocalyx biomarkers (Syndecan-1, Hyaluronan) were measured using immunoassays. Endothelial function was assessed by peripheral arterial tonometry, sublingual glycocalyx and microcirculation by videomicroscopy and carotid intima media thickness by ultrasound. RESULTS: OxLDL was significantly higher in patients (78.9 [38.2] vs. 50.3 [16.6] U/l, p=0.002), whereas all other experimental parameters were comparable between groups. Multivariate analysis revealed a significant association of Syndecan-1 with TNF-α (ß=0.75, p<0.001) and with hypercholesterolemia (ß=0.31, p=0.030). The interaction term combining TNF-α and hypercholesterolemia showed a significant effect (p=0.034). Sex was an independent predictor of endothelial function. CONCLUSION: The combined effect of hypercholesterolemia and inflammation on glycocalyx perturbation and the impact of sex in the premature development of arteriosclerosis deserve further evaluation. Therapeutic approaches tackling low grade systemic inflammation-may offer potential to prevent or delay progression of CVD and cardiovascular complications. .

Principales alimentos con azúcares añadidos y su variación geográfica y sociodemográfica: estudio latinoamericano de nutrición y salud (ELANS) / Main foods with added sugars and their geographic and sociodemographic variation: Latin American study of nutrition and health (ELANS)

Diversos estudios epidemiológicos y de intervención apuntan a una asociación fuerte y consistente entre la ingesta excesiva de azúcares y el riesgo de desarrollar caries dentales y enfermedades crónicas no transmisibles. El objetivo fue describir los 10 principales alimentos que contribuyen a la ingesta de azúcares añadidos en muestras representativas de poblaciones urbanas de ocho países latinoamericanos, y considerar diferencias por país, sexo, nivel socioeconómico (NSE) y grupo de edad. Se realizó una encuesta transversal multinacional en hogares de Argentina, Brasil, Chile, Colombia, Costa Rica, Ecuador, Perú y Venezuela (N=9218; 15­65 años). La contribución porcentual a la ingesta total del nutriente sirvió para identificar los alimentos aportadores. Los datos se estratificaron por país, sexo, NSE y grupo de edad y se compararon los gramos por día. Excepto en Perú y en el grupo de 50 a 65 años, los refrescos figuraron como el principal contribuyente a la ingesta de azúcares añadidos. Las bebidas caseras y las industrializadas también destacaron. Argentina fue el país con mayor ingesta de azúcares añadidos aportados por bebidas industrializadas, y Chile el país con menor frecuencia de bebidas como fuentes. Entre los 10 contribuyentes, la ingesta de azúcares añadidos fue mayor en el sexo masculino, excepto para sacarosa y pasteles dulces. Mayores ingestas de azúcares provenientes del jugo de fruta natural y sacarosa fueron observadas en el NSE más bajo. Las mayores y menores ingestas en los grupos de edad cambian de acuerdo con la fuente alimentaria. En conclusión, las bebidas azucaradas fueron los principales contribuyentes a la ingesta de azúcares añadidos, y la ingesta varió según la ubicación geográfica y los factores sociodemográficos(AU)

This study aimed to describe the top 10 foods that contribute to added sugars intake in representative samples of urban populations in eight Latin American countries, and consider differences by country, sex, socioeconomic level (SEL), and age group. A household-based, multinational, cross-sectional survey was conducted in Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela (N=9218; 15­65 years). Contributors to added sugars were identified and listed based on the percentage of contribution to total intake of this nutrient. Data were stratified by country, sex, SEL, and age group, and the grams per day compared. Except in Peru and in the 50 to 65 years age group, soft drinks were the leading contributor to added sugar intake. Homemade beverages together industrialized beverages have been a prominent position on ranking. In general, the highest intake of added sugars by industrialized beverages was from Argentina, and the lowest frequency of beverages as sources of added sugars was observed in Chile. Among the top 10 contributors, male sex had highest added sugar intake, except for sucrose and sweet cakes. Higher intakes of sugars from natural fruit juice and sucrose were observed in the lower SEL. The highest and lowest intakes in the age groups change according to the food source. In conclusion, sugar-sweetened beverages were main contributors to added sugar intake, and the intake vary with geographical location and sociodemographic factors(AU)

Developing a cooperative multicenter study in Latin America: Lessons learned from the Latin American Study of Nutrition and Health Project / Elaboração de estudo cooperativo multicêntrico na América Latina: ensinamentos do Projeto do Estudo Latino-americano de Nutrição e Saúde / Elaboración de un estudio colaborativo multicéntrico en América Latina: enseñanzas extraídas del Estudio Latinoamericano de Nutrición y Salud

ABSTRACT This report examines the challenges of conducting a multicenter, cross-sectional study of countries with diverse cultures, and shares the lessons learned. The Latin American Study of Nutrition and Health (ELANS) was used as a feasibility study involving the most populous cities of eight countries in Latin America (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela) in 2014-2015, about 40% of the population of the Americas. The target sample included 9 000 individuals, 15-65 years of age, and was stratified by geographic location (only urban areas), gender, age, and socioeconomic status. Six principal challenges were identified: team structuring and site selections; developing a single protocol; obtaining ethic approvals; completing simultaneous fieldwork; ensuring data quality; and extracting data and maintaining consistency across databases. Lessons learned show that harmonization, pilot study, uniformity of procedures, high data quality control, and communication and collaboration across sites are imperative. Barriers included organizational complexity, recruitment of collaborators and research staff, institutional cooperation, development of infrastructure, and identification of resources. Consensus on uniform measures and outcomes and data collection methodology, as well as a plan for data management and analysis, communication, publication, and dissemination of study results should be in place prior to beginning fieldwork. While challenging, such studies offer great potential for building a scientific base for studies on nutrition, physical activity, and other health topics, while facilitating comparisons among countries.

RESUMEN En este informe se examinan los retos de llevar a cabo un estudio transversal multicéntrico en países con culturas diversas y se transmiten las enseñanzas extraídas. Se usó el Estudio Latinoamericano de Nutrición y Salud (ELANS) como un estudio de factibilidad realizado en el período 2014-2015, que incluyó las ciudades más populosas de ocho países de América Latina (Argentina, Brasil, Chile, Colombia, Costa Rica, Ecuador, Perú y Venezuela) y abarcó a cerca de 40% de la población de la Región de las Américas. La muestra establecida incluyó a 9 000 personas de 15 a 65 años de edad, y fue estratificada según la ubicación geográfica (solo zonas urbanas) y por sexo, edad y situación socioeconómica. Se encontraron seis retos principales: estructurar los equipos y seleccionar los sitios; preparar un protocolo único; obtener las aprobaciones éticas; terminar simultáneamente el trabajo sobre el terreno; velar por la calidad de los datos y extraer datos y mantener la uniformidad en todas las bases de datos. Las enseñanzas extraídas muestran que la armonización, los estudios piloto, la uniformidad de los procedimientos, el riguroso control de la calidad de los datos y la comunicación y colaboración entre todos los sitios son imperativos. Los obstáculos incluyeron la complejidad de la organización, el reclutamiento de colaboradores y personal de investigación, la cooperación institucional, el desarrollo de infraestructura y la definición de los recursos. Antes de comenzar el trabajo sobre el terreno, se debe llegar a un consenso acerca de mediciones y resultados uniformes y la metodología de recopilación de datos, así como un plan para la gestión y el análisis de los datos y la comunicación, publicación y difusión de los resultados del estudio. A pesar de que estos estudios constituyen un desafío, hacen posible establecer una base científica para los estudios sobre la nutrición, la actividad física y otros temas de salud, al facilitar las comparaciones entre los países de América Latina.

RESUMO Neste relato se examinam os desafios de realizar um estudo transversal multicêntrico em países com culturas diversas e os ensinamentos tirados. O Estudo Latino-americano de Nutrição e Saúde (ELANS) serviu de estudo de viabilidade, englobando as cidades mais populosas de oito países da América Latina (Argentina, Brasil, Chile, Colômbia, Costa Rica, Equador, Peru e Venezuela) em 2014-2015, representando cerca de 40% da população das Américas. A amostra pretendida compreendeu 9.000 indivíduos com 15 a 65 anos de idade e foi estratificada por localização geográfica (exclusivamente áreas urbanas), sexo, idade e nível socioeconômico. Os seis principais desafios identificados foram: estruturar as equipes e selecionar as sedes, elaborar um único protocolo, obter as aprovações dos comitês de ética, realizar trabalho de campo simultâneo, assegurar a qualidade dos dados e extrair os dados e manter a consistência em todas as bases de dados. Os ensinamentos tirados demonstram serem imprescindíveis harmonização, estudo-piloto, uniformidade dos procedimentos, ótimo controle da qualidade dos dados e comunicação e colaboração entre as sedes. Entre as barreiras estão a complexidade organizacional, recrutamento de colaboradores e pessoal de pesquisa, cooperação institucional, desenvolvimento de infraestrutura e identificação dos recursos. Antes do início do trabalho de campo, deve-se chegar a um consenso sobre medidas e resultados uniformes e metodologia de coleta de dados assim como um plano para o gerenciamento e análise dos dados, comunicação, publicação e disseminação dos resultados dos estudos. Apesar da sua complexidade, tais estudos têm um grande potencial de fundar uma base científica para estudos de nutrição, atividade física e outros tópicos relacionados à saúde, ao mesmo tempo que facilitam comparações entre os países da América Latina.