ABSTRACT
Systolic blood pressure (SBP) time in target (TTR) over months were associated with lower risk of adverse clinical outcomes in hypertensive patients, whether short-term of 24-h SBP TTR was effective in predicting heart failure (HF) risk in the general population remained unclear. This prospective study aimed to investigate the association of 24-h SBP TTR with HF in the real-world settings. Based on Kailuan study, 24-h SBP target range defined as 110-140 mmHg was calculated with linear interpolation. Among 5152 participants included in the analysis, 186 (3.61%) cases of incident HF occurred during a median follow-up of 6.96 years. Compared with participants with SBP TTR of 0 to <25%, those with TTR of 75% to 100% had 47% lower risk of HF (hazard ratio [HR], 0.53; 95% confidence interval [CI], 0.32-0.89). The restricted spline curve depicted an inverse relationship between SBP TTR and incident HF. Additionally, the addition of SBP TTR, rather than mean SBP and SBP variation, to a conventional risk model had an incremental effect on the predictive value for HF, with integrated discrimination improvement value of 0.31% (P = 0.0003) and category-free net reclassification improvement value of 19.79% (P = 0.0081). Higher SBP TTR was associated with a lower risk of incident HF. Efforts to attain SBP within 110 to 140 mmHg may be an effective strategy to prevent HF.
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Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects women of childbearing age and has been reported to cause sexual dysfunction in women. Although there are articles on sexual function in women with SLE, the number of articles is small, and the factors affecting sexual function in women with SLE are controversial. Based on this, this study aimed to investigate the prevalence of sexual dysfunction in Chinese female SLE patients and to explore the factors that influence it. The study design was a cross-sectional study conducted from December 2023 to April 2024 in the Department of Rheumatology and Immunology of a tertiary hospital in Hefei, Anhui Province. A total of 293 female patients diagnosed with SLE were enrolled using face-to-face questionnaires and online questionnaires. The questionnaire consisted of four parts: general information questionnaire, fatigue severity scale (FSS), depression-anxiety-stress scale (DASS-21), and female sexual functioning index (FSFI) scale. A total of 173 (59.04%) patients had sexual dysfunction, including 251 (85.67%) with decreased libido and 186 (63.46%) with difficulty in sexual arousal. There was a correlation between the patients' total FSFI scores and age (p = 0.028), marital satisfaction (p < 0.001), own education level (p = 0.008), partner's education level (p = 0.003), place of residence (p = 0.039), monthly household income (p < 0.001), family financial satisfaction(p < 0.001), menstrual status (p = 0.003), hormone use (p = 0.021),immunosuppressant use (p = 0.042), disease activity (p = 0.016), FSS score (p < 0.001), stress score (p < 0.001), anxiety score (p < 0.001) and depression score (p < 0.001)were correlated. The results of stepwise regression analysis showed that marital satisfaction (b = 2.011, t = 3.797, p < 0.001), monthly household income (b = 0.854, t = 2.316, p = 0.021), menstrual status (b = 1.218, t = 2.350, p = 0.019), fatigue scale score (b = - 0.069, t = - 2.302, p = 0.022), and depression score (b = - 0.117, t = - 2.910, p = 0.004) were the influencing factors of FSFI total score, and the difference was statistically significant. The incidence of sexual dysfunction in Chinese female SLE patients is high, and medical personnel should pay more attention to patients' sexual problems, to provide theoretical and practical bases for further prevention, treatment, and care of sexual dysfunction in female SLE patients.
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BACKGROUND AND AIMS: Risk factor modification may decrease the risk of cardiovascular disease (CVD). Whether risk factor modification can mitigate the effect of hyperuricemia on CVD is unclear. This study aimed to investigate the risk of CVD among individuals with hyperuricemia, according to risk factors on target, compared with controls without hyperuricemia. METHODS AND RESULTS: This prospective study included 91,722 participants free of CVD at baseline (2006-2007) of the Kailuan study. Individuals with hyperuricemia were categorized according to the number of seven selected risk factors within the guideline-recommended target range (nonsmoking, physical activity, healthy diet, guideline-recommended levels of body mass index, blood pressure, fasting blood glucose, and total cholesterol). During a median follow-up of 13.00 years, 671 out of 6740 individuals (9.96%) with hyperuricemia and 6301 out of 84,982 control subjects (7.41%) had incident CVD. Compared with control subjects without hyperuricemia, individuals with hyperuricemia who had 4 or 5 to 7 risk factors on target had no significant excess CVD risk, the hazard ratio (HR) (95% confidence internal [CI]) was 0.93 (0.79-1.10) and 0.88 (0.71-1.10), respectively. Among individuals with hyperuricemia, excess CVD risk decreased stepwise for a higher number of risk factors on target, the HR of CVD associated with per additional risk factor within target range was 0.82 (95% CI, 0.77-0.87). Similar results were yielded for CVD subtypes. CONCLUSIONS: Among individuals with hyperuricemia, excess CVD risk decreased stepwise for a higher number of risk factors within target.
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BACKGROUND: Recent Mendelian randomization and meta-analysis highlight the relevance of MCP-1 (monocyte chemoattractant protein-1) in stroke. We aimed to investigate the associations between MCP-1 and clinical outcomes in patients with ischemic stroke or transient ischemic attack and test whether inflammation mediates or jointly contributes to the relationships. METHODS AND RESULTS: A total of 10 700 patients from the Third China National Stroke Registry study were included. Multivariable Cox regression was used for recurrent stroke and all-cause death, and logistic regression was used for poor functional outcome. Mediation analyses were performed to clarify whether inflammation mediates the associations. After adjusting for potential confounders, low MCP-1 level (<337.6 pg/mL) was associated with a reduced risk of all-cause death (hazard ratio [HR], 0.65 [95% CI, 0.51-0.82]) and poor functional outcome (odds ratio, 0.81 [95% CI, 0.70-0.94]) but was not associated with recurrent stroke (HR, 1.10 [95% CI, 0.95-1.27]), compared with high MCP-1 level (≥337.6 pg/mL). The association between MCP-1 and all-cause death was partially mediated by highly sensitive C-reactive protein, interleukin-6, and YKL-40 (Chitinase-3-like protein 1; mediated proportion: 7.4%, 10.5%, and 7.4%, respectively). The corresponding mediated proportion for poor functional outcome was 9.9%, 17.1%, and 7.1%, respectively. Patients with combined high levels of MCP-1 and inflammatory biomarkers had the highest risks of all-cause death and poor functional outcome. CONCLUSIONS: Low plasma MCP-1 level was associated with decreased risks of all-cause mortality and poor functional outcome after ischemic stroke or transient ischemic attack. Inflammation partially mediated and jointly contributed to the associations.
Subject(s)
Biomarkers , Chemokine CCL2 , Ischemic Attack, Transient , Ischemic Stroke , Registries , Humans , Male , Chemokine CCL2/blood , Female , Biomarkers/blood , Ischemic Attack, Transient/blood , Ischemic Attack, Transient/mortality , Ischemic Attack, Transient/diagnosis , Ischemic Stroke/blood , Ischemic Stroke/mortality , Ischemic Stroke/diagnosis , Ischemic Stroke/epidemiology , Middle Aged , Aged , Prognosis , China/epidemiology , Inflammation/blood , Recurrence , Risk Assessment , Risk Factors , Cause of DeathABSTRACT
Background: Previous studies on the direction of the association between arterial stiffness (AS) and chronic kidney disease (CKD) were inconsistent, leaving a knowledge gap in understanding the temporal sequence of the association. Objectives: This study sought to assess the temporal and longitudinal relationship between AS and CKD. Methods: The temporal relationship between AS measured by brachial ankle pulse wave velocity and CKD measured by estimated glomerular filtration rate (eGFR) was analyzed among 7,753 participants with repeated examinations in the Kailuan study using cross-lagged panel analysis. The longitudinal associations of AS status and vascular aging (VA) phenotype with incident CKD were analyzed among 10,535 participants. Results: The adjusted cross-lagged path coefficient (ß 1 = -0.03; 95% CI: -0.06 to -0.01; P < 0.0001) from baseline brachial ankle pulse wave velocity to follow-up eGFR was significantly greater than the path coefficient (ß 2 = -0.01; 95% CI: -0.02 to 0.01; P = 0.6202) from baseline eGFR to follow-up brachial ankle pulse wave velocity (P < 0.0001 for the difference). During a median follow-up of 8.48 years, 953 cases of incident CKD (9.05%) occurred. After adjustment for confounders, borderline (HR: 1.17; 95% CI: 1.08-1.38) and elevated AS (HR: 1.39; 95% CI: 1.12-1.72) was associated a higher risk of CKD, compared with normal AS. Consistently, supernormal VA (HR: 0.76; 95% CI: 0.66-0.86) was associated with a decreased and early VA (HR: 1.36; 95% CI: 1.29-1.43) was associated with an increased risk of CKD, compared with normal VA. Conclusions: AS appeared to precede the decrease in eGFR. Additionally, increased AS and early VA were associated with an increased risk of incident CKD.
ABSTRACT
In the Electro-Fenton (EF) process, hydrogen peroxide (H2O2) is produced in situ by a two-electron oxygen reduction reaction (2e ORR), which is further activated by electrocatalysts to generate reactive oxygen specieces (ROS). However, the selectivity of 2e transfer from catalysts to O2 is still unsatisfactory, resulting in the insufficient H2O2 availability. Carbon based materials with abundant oxygen-containing functional groups have been used as excellent 2e ORR electrocatalysts, and atomic hydrogen (H*) can quickly transfer one electron to H2O2 in a wide pH range and avoiding the restrict of traditional Fenton reaction. Herein, nickel nanoparticles growth on oxidized carbon deposited on modified carbon felt (Ni/Co@CFAO) was prepared as a bifunctional catalytic electrode coupling 2e ORR to form H2O2 with H* reducing H2O2 to produce ROS for highly efficient degradation of antibiotics. Electrochemical oxidation and thermal treatment were used to modulate the structure of carbon substrates for increasing the electro-generation of H2O2, while H* was produced over Ni sites through H2O/H+ reduction constructing an in-situ EF system. The experimental results indicated that 2e ORR and H* induced EF processes could promote each other mutually. The optimized Ni/Co@CFAO with a Ni:C mass ratio of 1:9 exhibited a high 2e selectivity and H2O2 yield of 49 mg L-1. As a result, the designed Ni/Co@CFAO exhibited excellent electrocatalytic ability to degrade tetracycline (TC) under different aqueous environmental conditions, and achieved 98.5% TC removal efficiency within 60 min H2O2 and H* were generated simultaneously at the bifunctional cathode and react to form strong oxidizing free radicals â¢OH. At the same time, O2 gained an electron to form â¢O2-, which could react with â¢OH and H2O to form 1O2, which had relatively long life (10-6â¼10-3 s), further promoting the efficient removal of antibiotics in water.
ABSTRACT
BACKGROUND: The escalating prevalence of fertility problems in the aging population necessitates a comprehensive exploration of contributing factors, extending beyond environmental concerns, work-related stress, and unhealthy lifestyles. Among these, the rising incidence of testicular disorders emerges as a pivotal determinant of fertility issues. Current treatment challenges are underscored by the limitations of high-dose and frequent drug administration, coupled with substantial side effects and irreversible trauma inflicted by surgical interventions on testicular tissue. MATERIAL AND METHODS: The formidable barrier posed by the blood-testis barrier compounds the complexities of treating testicular diseases, presenting a significant therapeutic obstacle. The advent of nanocarriers, with their distinctive attributes, holds promise in overcoming this impediment. These nanocarriers exhibit exceptional biocompatibility, and membrane penetration capabilities, and can strategically target the blood-testis barrier through surface ligand modification, thereby augmenting drug bioavailability and enhancing therapeutic efficacy. RESULTS AND DISCUSSION: This review concentrates on the transformative potential of nanocarriers in the delivery of therapeutic agents to testicular tissue. By summarizing key applications, we illuminate the strides made in utilizing nanocarriers as a novel avenue to effectively treat testicular diseases. CONCLUSIONS: Nanocarriers are critical in delivering therapeutic agents to testicular tissue.
ABSTRACT
IL-17+ γδ T cells (γδ T17) are kick-starters of inflammation due to their strict immunosurveillance of xenobiotics or cellular damages and rapid response to pro-inflammatory stimulators. IL-27 is a well-recognized pleiotropic immune regulator with potent inhibitory effects on type 17 immune responses. However, its actions on γδ T17 mediated inflammation and the underlying mechanisms are less well understood. Here we find that IL-27 inhibits the production of IL-17 from γδ T cells. Mechanistically, IL-27 promotes lipolysis while inhibits lipogenesis, thus reduces the accumulation of lipids and subsequent membrane phospholipids, which leads to mitochondrial deactivation and ensuing reduction of IL-17. More importantly, Il27ra deficient γδ T cells are more pathogenic in an imiquimod-induced murine psoriasis model, while intracutaneous injection of rmIL-27 ameliorates psoriatic inflammation. In summary, this work uncovered the metabolic basis for the immune regulatory activity of IL-27 in restraining γδ T17 mediated inflammation, which provides novel insights into IL-27/IL-27Ra signaling, γδ T17 biology and the pathogenesis of psoriasis.
Subject(s)
Interleukin-17 , Lipid Metabolism , Mitochondria , Psoriasis , Animals , Mitochondria/metabolism , Mice , Psoriasis/pathology , Psoriasis/immunology , Psoriasis/metabolism , Interleukin-17/metabolism , Mice, Inbred C57BL , Inflammation/pathology , Inflammation/metabolism , Skin/pathology , Skin/metabolism , Skin/immunology , Skin/drug effects , Disease Models, Animal , Receptors, Antigen, T-Cell, gamma-delta/metabolism , Signal Transduction , HumansABSTRACT
Polymer/inorganic nanocomposite pour point depressant (PPD) is a research hotspot in the field of waxy crude oil pipelining. However, the inorganic nanoparticles need to be organically modified to improve their organic compatibility, and the inorganic nanoparticles are harmful to crude oil refining. In this work, organic PSMS with an average size of 1.4 µm was first synthesized by dispersion polymerization. Then, a new type of EVA/PSMS composite PPD was prepared by melt blending. The effects of the PSMS, EVA PPD, and composite PPD on the pour point, rheological properties, and wax precipitating properties of a specific waxy crude oil were investigated. It was found that adding 50-200 ppm of PSMS alone slightly improves the crude oil rheology through a spatial hindrance effect, while adding 20 ppm of EVA PPD greatly improves the crude oil rheology by modifying the wax crystal morphology. Compared with EVA PPD, adding 20 ppm composite PPD improves the crude oil rheology further, and the rheological improving ability first enhances and then weakens with increasing the PSMS content in the composite PPD (0-10 wt %). At the PSMS content in the composite PPD 5 wt %, the EVA/PSMS 5% composite PPD makes the wax crystal aggregates more compact, thus showing the strongest rheological improving ability. The EVA molecules could adsorb on the PSMS and form the composite particles, which further regulate the wax crystal morphology and then improve the crude oil rheology further.
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BACKGROUND: Owing to the widespread use of chemical pesticides to control agricultural pests, pesticide tolerance has become a serious problem. In recent years, it has been found that symbiotic bacteria are related to pesticides tolerance. To investigate the potential role of microorganisms in the pesticide tolerance of Chilo suppressalis, this study was conducted. RESULTS: The insect was fed with tetracycline and cefixime as the treatment group (TET and CFM, respectively), and did not add antibiotics in the control groups (CK). The 16S rDNA sequencing results showed that antibiotics reduced the diversity of C. suppressalis symbiotic microorganisms but did not affect their growth and development. In bioassays of the three C. suppressalis groups (TET, CFM, and CK), a 72 h LC50 fitting curve was calculated to determine whether long-term antibiotic feeding leads to a decrease in pesticide resistance. The CK group of C. suppressalis was used to determine the direct effect of antibiotics on pesticide tolerance using a mixture of antibiotics and pesticides. Indirect evidence suggests that antibiotics themselves did not affect the pesticide tolerance of C. suppressalis. The results confirmed that feeding C. suppressalis cefixime led to a decrease in the expression of potential tolerance genes to chlorantraniliprole. CONCLUSIONS: This study reveals the impact of antibiotic induced changes in symbiotic microorganisms on the pesticide tolerance of C. suppressalis, laying the foundation for studying the interaction between C. suppressalis and microorganisms, and also providing new ideas for the prevention and control of C. suppressalis and the creation of new pesticides.
Subject(s)
Anti-Bacterial Agents , Bacteria , Anti-Bacterial Agents/pharmacology , Animals , Bacteria/drug effects , Bacteria/genetics , Bacteria/classification , Bacteria/isolation & purification , Pesticides/pharmacology , Moths/microbiology , Moths/drug effects , Symbiosis , RNA, Ribosomal, 16S/genetics , Microbiota/drug effects , Tetracycline/pharmacologyABSTRACT
Osteoinductive supplements without side effects stand out from the growth factors and drugs widely used in bone tissue engineering. Lithium magnesium sodium silicate hydrate (laponite) nanoflake is a promising bioactive component for bone regeneration, attributed to its inherent biosafety and effective osteoinductivity. Up to now, the in vivo osteogenic potential and mechanisms of laponite-encapsulated fibrous membranes remain largely unexplored. This study presents a unique method for homogeneously integrating high concentrations of laponite RDS into a polycaprolactone (PCL) matrix by dispersing laponite RDS sol into the polymer solution. Subsequently, a core-shell fibrous membrane (10RP-PG), embedding laponite-loaded PCL in its core, was crafted using coaxial electrospinning. The PCL core's slow degradation and the shell's gradient degradation enabled the sustained release of bioactive ions (Si and Mg) from laponite. In vivo studies on a critical-sized calvarial bone defect model demonstrated that the 10RP-PG membrane markedly enhanced bone formation and remodeling by accelerating the process of endochondral ossification. Further transcriptome analysis suggested that osteogenesis in the 10RP-PG membrane is driven by Mg and Si from endocytosed laponite, activating pathways related to ossification and endochondral ossification, including Hippo, Wnt and Notch. The fabricated nanocomposite fibrous membranes hold great promise in the fields of critical-sized bone defect repair.
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Central nervous system (CNS) diseases, ranging from brain cancers to neurodegenerative disorders like dementia and acute conditions such as strokes, have been heavily burdening healthcare and have a direct impact on patient quality of life. A significant hurdle in developing effective treatments is the presence of the blood-brain barrier (BBB), a highly selective barrier that prevents most drugs from reaching the brain. The tight junctions and adherens junctions between the endothelial cells and various receptors expressed on the cells make the BBB form a nonfenestrated and highly selective structure that is crucial for brain homeostasis but complicates drug delivery. Nanotechnology offers a novel pathway to circumvent this barrier, with nanoparticles engineered to ferry drugs across the BBB, protect drugs from degradation, and deliver medications to the designated area. After years of development, nanoparticle optimization, including sizes, shapes, surface modifications, and targeting ligands, can enable nanomaterials tailored to specific brain drug delivery settings. Moreover, smart nano drug delivery systems can respond to endogenous and exogenous stimuli that control subsequent drug release. Here, we address the importance of the BBB in brain disease treatment, summarize different delivery routes for brain drug delivery, discuss the cutting-edge nanotechnology-based strategies for brain drug delivery, and further offer valuable insights into how these innovations in nanoparticle technology could revolutionize the treatment of CNS diseases, presenting a promising avenue for noninvasive, targeted therapeutic interventions.
Subject(s)
Blood-Brain Barrier , Brain Diseases , Drug Delivery Systems , Nanoparticles , Nanotechnology , Humans , Blood-Brain Barrier/metabolism , Drug Delivery Systems/methods , Brain Diseases/drug therapy , Nanotechnology/methods , Nanoparticles/chemistry , Animals , Brain/metabolism , Brain/drug effects , Nanoparticle Drug Delivery System/chemistryABSTRACT
Lysine (Lys) is capable of forming a di-substituted Amadori rearrangement product (ARP) with xylose (Xyl), designated as diXyl-α,ε-Lys-ARP. DiXyl-α,ε-Lys-ARP degradation was characterized by two steps: Initially, Xyl-α- and Xyl-ε-Lys-ARP were formed through elimination or hydrolysis at specific Nα/Nε positions of the corresponding enol and imine intermediates, which were then further degraded to dicarbonyl compounds and regenerated Lys. Xyl-α- or Xyl-ε-Lys-ARP had a reactive free amino group (ε-NH2 or α-NH2), both of which were still highly reactive and able to undergo further reactions with Xyl. Therefore, the diXyl-α,ε-Lys-ARP/Xyl model system was established to explore the impact of extra-added Xyl on diXyl-α,ε-Lys-ARP degradation behavior. Extra-added Xyl remarkably affected the degradation pathway of diXyl-α,ε-Lys-ARP by capturing the Xyl-α- and Xyl-ε-Lys-ARP to regenerate diXyl-α,ε-Lys-ARP. This interaction between Xyl and mono-substituted Lys-ARPs promoted the shift of chemical equilibrium toward the degradation of diXyl-α,ε-Lys-ARP, thereby accelerating its degradation rate. This degradation was markedly facilitated by the elevated temperature and pH values. Interestingly, the yield of Xyl-α- and Xyl-ε-Lys-ARP was particularly dependent on the pH during diXyl-α,ε-Lys-ARP degradation. Xyl-ε-Lys-ARP was the dominant product at pH 5.5-7.5 while Xyl-α-Lys-ARP possessed a relatively higher content under weak alkaline conditions, which was related to the reactivities of the Nα/Nε positions under various reaction conditions.
Subject(s)
Lysine , Maillard Reaction , Xylose , Xylose/chemistry , Lysine/chemistry , Hydrolysis , Kinetics , Hot TemperatureABSTRACT
Upconverted UCNPs@mSiO2-NH2 nanoparticles were synthesized via thermal decomposition while employing the energy resonance transfer principle and the excellent near-infrared (NIR) light conversion property of up-conversion. The 808 nm NIR-excited photocontrolled nitric oxide (NO) release platform was successfully developed by electrostatically loading photosensitive NO donor Roussin's black salt (RBS) onto UCNPs@mSiO2-NH2, enabling the temporal, spatial, and dosimetric regulation of NO release for biological applications of NO. The release of NO ranged from 0.015â0.099 mM under the conditions of 2.0 W NIR excitation power, 20 min of irradiation time, and UCNPs@mSiO2-NH2&RBS concentration of 0.25â1.25 mg/mL. Therefore, this NO release platform has an anti-tumor effect. In vitro experiments showed that under the NIR light, at concentrations of 0.3 mg/mL and 0.8 mg/mL of UCNPs@mSiO2-NH2&RBS, the activity of glioma (U87) and chordoma (U-CH1) cells, as measured by CCK8 assay, was reduced to 50 %. Cell flow cytometry and Western Blot experiments showed that NO released from UCNPs@mSiO2-NH2&RBS under NIR light induced apoptosis in brain tumor cells. In vivo experiments employing glioma and chordoma xenograft mouse models revealed significant inhibition of tumor growth in the NIR and UCNPs@mSiO2-NH2&RBS group, with no observed significant side effects in the mice. Therefore, NO released by UCNPs@mSiO2-NH2&RBS under NIR irradiation can be used as a highly effective and safe strategy for brain tumor therapy.
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Previously, the effect of soil mineral N deficiency on nodule nitrogen fixation capacity (NFC) is unclear. In this study, we found that N deficiency would enhance sucrose allocation to nodules and PEP allocation to bacteroid to promote nodule NFC. Our findings provide new insights into the design of leguminous crops with improved adaptation to fluctuating N levels in the soil.
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BACKGROUND: Evidence on the longitudinal association of serum uric acid (SUA) with the risk of heart failure (HF) was limited and controversial. This study aimed to investigate the associations of cumulative SUA (cumSUA), incorporating its time course of accumulation, with the risk of HF. METHODS: This prospective study enrolled 54,606 participants from the Kailuan study. The magnitude of SUA accumulation was expressed as cumSUA, exposure duration, and cumulative burden from baseline to the third survey, with cumSUA, calculated by multiplying mean values between consecutive examinations by time intervals between visits, as the primary exposure. RESULTS: During a median follow-up of 10.00 years, 1,260 cases of incident HF occurred. A higher risk of HF was observed in participants with the highest versus the lowest quartile of cumSUA (adjusted hazard ratio [aHR], 1.54; 95% confidence interval [CI], 1.29-1.84), 6-years (6 years) versus 0-year exposure duration (aHR, 1.87; 95% CI, 1.43-2.45), cumulative burden >0 versus =0 (aHR, 1.55; 95 CI, 1.29-1.86), and those with a negative versus positive SUA slope (aHR, 1.12; 95% CI, 1.02-1.25). When cumSUA was incorporated with its time course, those with cumSUA≥median and a negative SUA slope had the highest risk of HF (aHR, 1.55; 95% CI, 1.29-1.86). CONCLUSIONS: Incident HF risk was associated with the magnitude and time course of cumSUA accumulation. Early accumulation resulted in a greater risk of HF than later accumulation, indicating the importance of optimal SUA control earlier in life.
ABSTRACT
BACKGROUND: Triglyceride glucose (TyG) index and its related parameters have been introduced as cost-effective surrogate indicators of insulin resistance, while prospective evidence of their effects on atherosclerotic cardiovascular disease (ASCVD) remained scattered and inconsistent. We aimed to evaluate the association of TyG and its related parameters with new-onset ASCVD, and the predictive capacity were further compared. METHOD: A total of 95,342 ASCVD-free participants were enrolled from the Kailuan study. TyG and its related parameters were defined by fasting blood glucose, triglyceride, body mass index (BMI), waist circumstance (WC) and waist-to-height ratio (WHtR). The primary outcome was incident ASCVD, comprising myocardial infarction (MI) and ischemic stroke (IS). Cox proportional hazard models and restricted cubic spline (RCS) analyses were adopted to investigate the association between each index and ASCVD. The C-index, integrated discrimination improvement (IDI), and net reclassification improvement (NRI) were used for comparison of their predictive value for ASCVD. RESULTS: During a median follow-up of 15.0 years, 8,031 new cases of ASCVD were identified. The incidence rate of ASCVD increased along with elevated levels of each index, and the relationships were found to be nonlinear in the RCS analyses. The hazard ratio (HR) and 95% confidence interval (95% CI) for ASCVD was 1.39 (1.35, 1.43), 1.46 (1.41, 1.50), 1.50 (1.46, 1.55), and 1.52 (1.48, 1.57) per 1 IQR increase of baseline TyG, TyG-BMI, TyG-WC, and TyG-WHtR, respectively, and the association were more pronounced for females and younger individuals aged < 60 years (Pfor interaction<0.05). Using the updated mean or time-varying measurements instead of baseline indicators did not significantly alter the primary findings. Additionally, TyG-WC and TyG-WHtR showed better performance in predicting risk of ASCVD than TyG, with the IDI (95% CI) of 0.004 (0.001, 0.004) and 0.004 (0.001, 0.004) and the category-free NRI (95% CI) of 0.120 (0.025, 0.138) and 0.143 (0.032, 0.166), respectively. Similar findings were observed for MI and IS. CONCLUSIONS: Both the TyG index and its related parameters were significantly and positively associated with ASCVD. TyG-WC and TyG-WHtR had better performance in predicting incident ASCVD than TyG, which might be more suitable indices for risk stratification and enhance the primary prevention of ASCVD.
Subject(s)
Atherosclerosis , Biomarkers , Blood Glucose , Triglycerides , Humans , Middle Aged , Female , Male , China/epidemiology , Risk Assessment , Blood Glucose/metabolism , Triglycerides/blood , Incidence , Biomarkers/blood , Time Factors , Aged , Prognosis , Atherosclerosis/epidemiology , Atherosclerosis/blood , Atherosclerosis/diagnosis , Ischemic Stroke/epidemiology , Ischemic Stroke/blood , Ischemic Stroke/diagnosis , Follow-Up Studies , Adult , Prospective Studies , Body Mass Index , Risk Factors , Predictive Value of Tests , Myocardial Infarction/epidemiology , Myocardial Infarction/blood , Myocardial Infarction/diagnosis , Waist-Height RatioABSTRACT
Polymer-based scaffolds with different degradability have been investigated to screen the matrix whose degradation rate is more closely matched with the bone regeneration rate. However, these comparisons are inclined to be compromised by the animal individual differences. In this study, we constructed an integrated scaffold model comprising four parts with different degradability and bioactivity to achieve an in situ comparison of bone regeneration ability of different scaffolds. Slow-degradable polycaprolactone (PCL), fast-degradable poly (lactic-co-glycolic acid) (PLGA), and silica-coated PCL and PLGA scaffolds were assembled into a round sheet to form a hydroxyapatite (HA)-free integrated scaffold. HA-doped PCL, PLGA, and silica-coated PCL and PLGA scaffolds were assembled to create an HA-incorporated integrated scaffold. The in vivo experimental results demonstrated that the local acid microenvironment caused by the rapid degradation of PLGA interfered with the osteogenic process promoted by PCL-based scaffolds in defect areas implanted with HA-free integrated scaffolds. Since the incorporation of HA alleviated the acidic microenvironment to some extent, each scaffold in HA-incorporated scaffolds exhibited its expected bone regeneration capacity. Consequently, it is feasible to construct an integrated structure for comparing the osteogenic effects of various scaffolds in situ, when there is no mutual interference between the materials. The strategy presented in this study inspired the structure design of biomaterials to enable in situ comparison of bone regeneration capacity of scaffolds.