High Serum Phosphate Is Associated with Cardiovascular Mortality and Subclinical Coronary Atherosclerosis: Systematic Review and Meta-Analysis.

(1) Background: Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide. The aim of the study was to examine the existing published results of the association between elevated serum phosphate concentrations and cardiovascular mortality, along with the CVD incidence and subclinical coronary atherosclerosis, in primary prevention among non-selected samples of the general population. (2) Methods: A systematic review and meta-analysis were carried out using literature obtained from PubMed, SCOPUS, and the Web Of Science until March 2024 and following the PRISMA guidelines. Relevant information was extracted and presented. Random and fixed effects models were used to estimate the pooled odds ratio (OR) and hazard ratio (HR) with their 95% coefficient interval (CI), and I2 was used to assess heterogeneity. (3) Results: Twenty-five studies met our inclusion criteria and were included in the meta-analysis (11 cross-sectional and 14 cohort studies). For cardiovascular mortality, which included 7 cohort studies and 41,764 adults, the pooled HR was 1.44 (95% CIs 1.28, 1.61; I2 0%) when the highest versus the reference level of serum phosphate concentrations were compared. For CVDs, which included 8 cohort studies and 61,723 adults, the pooled HR was 1.12 (95% CIs 0.99, 1.27; I2 51%). For subclinical coronary atherosclerosis, which included 11 cross-sectional studies and 24,820 adults, the pooled OR was 1.44 (95% CIs 1.15, 1.79; I2 88%). (4) Conclusions: The highest serum phosphate concentrations were positively associated with a 44% increased risk of cardiovascular mortality and subclinical coronary atherosclerosis.

Association between Sugar-Sweetened Beverage Consumption and the Risk of the Metabolic Syndrome: A Systematic Review and Meta-Analysis.

(1) Background: The increasing occurrence of the metabolic syndrome (MetS) is largely related to harmful food habits. Among them, the consumption of sugar-sweetened beverages (SSBs) is noteworthy. However, to our knowledge, there are not enough high-quality methodological studies summarizing the association between the intake of SSBs and the MetS. Therefore, the aim of this study is to examine the existing published results on this association among adults by synthesizing the existing evidence. (2) Methods: Systematic review and meta-analysis of observational studies following the PRISMA guidelines. Relevant information was extracted and presented following the PRISMA recommendations. PubMed and SCOPUS databases were searched for studies published until June 2022 that assessed the association between SSB consumption (including soft drinks, bottled fruit juices, energy drinks, and milkshakes) and the occurrence of MetS. Random effect models were used to estimate pooled odds ratios (ORs) with their 95% coefficient interval, and I2 was used to assess heterogeneity. (3) Results: A total of 14 publications from 6 different countries were included in this meta-analysis (9 cross-sectional and 5 cohort studies). For the cross-sectional studies, which included 62,693 adults, the pooled OR for the risk of MetS was 1.35 (95% CI 1.15, 1.58; I2 57%) when the highest versus the lowest categories of SSB consumption were compared. For the cohort studies, which included 28,932 adults, the pooled OR was 1.18 (95% CI 1.06, 1.32; I2 70%). (4) Conclusions: The consumption of SSBs was positively associated with an increased risk of MetS. The published literature supports public health strategies and the need to reduce the consumption of SSBs to prevent MetS.

Association of beverage consumption with subclinical atherosclerosis in a Spanish working population.

Beverages play a substantial role meeting water, calorie, and nutrient requirements; however, they are presented as being major contributors to the current obesity epidemic. Although, the relationship between beverage consumption and metabolic risk factors for cardiovascular disease (CVD) in adults has been frequently studied, its association with subclinical atherosclerosis is of increased interest. We studied the association of beverage consumption with the presence of peripheral subclinical atherosclerosis among Spanish workers. We performed a cross-sectional study of 2089 middle-aged males, with a mean age of 50.9 (SD 3.9), and without CVD, carried out in the Aragon Workers' Health Study (AWHS). A food frequency questionnaire was used to measure beverage consumption of low-fat milk, coffee and tea (unsweetened), whole-fat milk, sugar-sweetened beverages, bottled fruit juice, artificially-sweetened beverages and 100% fruit juice. Atherosclerotic plaques were measured by ultrasound (in carotid arteries, and in femoral arteries). Atherosclerotic plaque was defined as a focal structure protruding ≥ 0.5 mm into the lumen, or reaching a thickness ≥ 50% of the surrounding intima-media thickness. As statistical analysis, we use logistic regression models, simultaneously adjusted for all beverage groups. As results, unsweetened coffee was the beverage most associated with peripheral subclinical atherosclerosis with an odds ratio (OR) of 1.25 (1.10-1.41), and 1.23 (1.09-1.40) 100g/day] for carotid, and femoral territories respectively. Moreover, subclinical atherosclerosis was positively associated with whole-fat milk [OR 1.10 (1.02-1.18) 100 g/day] in the femoral territory. The association was protective for low-fat milk in the carotid territory [OR 0.93 (0.88-0.99) 100g/day]. There was also a protective association with bottled fruit juices in the femoral territory [0.84 (0.74-0.94) 100g/day]. Our results suggest a detrimental association with the consumption of coffee, as well as with whole-fat milk and the presence of subclinical atherosclerosis. Therefore, an element of prudence excluding water and low-fat milk, must be applied when recommending beverage consumption.

Low-Quality Carbohydrate Intake Is Associated With a Higher Prevalence of Metabolic Syndrome: The AWHS Study.

CONTEXT: The relationship between carbohydrate quality intake and metabolic syndrome (MetS) is of growing interest. OBJECTIVE: We aimed to assess the association between the adherence to a dietary carbohydrate quality index (CQI) with the occurrence of MetS in a Spanish cohort of working adults. METHODS: A cross-sectional study was conducted of 2316 middle-aged men, aged 50.9 (SD 3.9) years, with no previous cardiovascular disease, and pertaining to the Aragon Workers' Health Study (AWHS) cohort. Diet was collected with a 136-item semiquantitative food-frequency questionnaire. The CQI (range 4-15) was based on: dietary fiber intake, a low glycemic index, the ratio of whole grains/total grains, and the ratio of solid carbohydrates/total carbohydrates. The higher the CQI, the healthier the diet. MetS was defined by using the harmonized National Cholesterol Education Programme-Adult Treatment Panel III (NCEP-ATP III) definition. The associations across 3-point categories of the CQI and the presence of MetS were examined using logistic regression. RESULTS: An inverse and significant association between the CQI and MetS was found. Fully adjusted odds ratios (ORs) for MetS risk among participants in the 10- to 12-point category (second highest CQI category) was 0.64 (95% CI, 0.45-0.94), and in the 13- to 15-point category (highest category) was 0.52 (95% CI, 0.30-0.88), when compared with the 4- to 6-point category (lowest category). Participants with 10 to 12 and 13 to 15 points on the CQI showed a lower risk of hypertriglyceridemia: OR 0.61 (95% CI, 0.46-0.81), and 0.48 (95% CI, 0.32-0.71) respectively. CONCLUSION: Among middle-aged men, a higher adherence to a high-quality carbohydrate diet is associated with a lower prevalence of MetS. Triglyceridemia is the MetS component that contributed the most to this reduced risk.

Work Shift, Lifestyle Factors, and Subclinical Atherosclerosis in Spanish Male Workers: A Mediation Analysis.

(1) Background: Working night shifts has been associated with altered circadian rhythms, lifestyle habits, and cardiometabolic risks. No information on the potential association of working shift and the presence of atherosclerosis is available. The aim of this study was to quantify the association between different work shifts and the presence of subclinical atherosclerosis objectively measured by imaging. (2) Methods: Analyses were conducted on the baseline data of the Aragon Workers Health Study (AWHS) cohort, including information on 2459 middle-aged men. Categories of shift work included central day shift, rotating morning-evening or morning-evening-night shift, and night shift. The presence of atherosclerotic plaques was assessed by 2D ultrasound in the carotid and femoral vascular territories. Multivariable logistic models and mediation analysis were conducted to characterize and quantify the association between study variables. (3) Results: Participants working night or rotating shifts presented an overall worse cardiometabolic risk profile, as well as more detrimental lifestyle habits. Workers in the most intense (morning-evening-night) rotating shift presented higher odds of subclinical atherosclerosis (odds ratio: 1.6; 95% confidence interval: 1.12 to 2.27) compared to workers in the central shift, independently of the presence of lifestyle and metabolic risk factors. A considerable (21%) proportion of this association was found to be mediated by smoking, indicating that altered sleep-wake cycles have a direct relationship with the early presence of atherosclerotic lesions. (4) Conclusions: Work shifts should be factored in during workers health examinations, and when developing effective workplace wellness programs.

[Lipid metabolism alterations produced by hepatitis C virus in patients with chronic infection.] / Alteraciones del metabolismo lipídico producidas por el virus de la hepatitis C en pacientes con infección crónica.

BACKGROUND: Chronic infection with the hepatitis C virus (HCV) is known to generate an apparently favorable lipid profile. Paradoxically, these patients present an increase in concomitant cardiovascular events. The objectives of the present review were to analyze and synthesize studies that inquired into the changes produced by hepatitis C virus (HCV) in the lipid metabolism of patients with chronic infection, and about whether these modifications can be associated with subsequent episodes of cardiovascular diseases. METHODS: A bibliographic search was carried out in the Medline and Scopus databases of the articles published from January 2008 to February 2019. A total of 901 publications were identified, of which 10 studies that fulfilled the inclusion and exclusion criteria were reviewed. RESULTS: It was found that the levels of total cholesterol and its lipid fractions were decreased in patients with chronic HCV infection. There was no clear association with triglyceride levels. In addition, there seemed to be an association between chronic HCV infection and an increased risk of developing atherosclerosis and cardiovascular diseases. CONCLUSIONS: Chronic HCV infection has a lipid-lowering effect and increases cardiovascular risk. Prospective studies are needed to analyze the effect of new therapies with direct-acting antivirals on lipid metabolism and cardiovascular risk.

OBJETIVO: Es conocido que la infección crónica por el virus de la hepatitis C (VHC) genera un perfil lipídico aparentemente favorable. Paradójicamente, estos pacientes presentan un aumento de eventos cardiovasculares concomitantes. Los objetivos de la presente revisión fueron analizar y sintetizar los estudios que indagasen en las modificaciones que produce el VHC sobre el metabolismo lipídico de los pacientes con infección crónica, así como estudiar si esas modificaciones pueden asociarse a episodios posteriores de enfermedad cardiovascular. METODOS: Se realizó una búsqueda bibliográfica en las bases de datos de Medline y Scopus de los artículos publicados desde enero de 2008 hasta febrero de 2019. Se identificaron un total de 901 publicaciones, de las cuales se revisaron 10 estudios que cumplieron con los criterios de inclusión y exclusión propuestos. RESULTADOS: Se encontró que en los pacientes con infección crónica por el VHC estaban disminuidos los niveles de colesterol total y sus fracciones lipídicas. No existió una clara asociación con los niveles de triglicéridos. Además, parecía haber una asociación entre la infección crónica por VHC y un aumento del riesgo de padecer aterosclerosis y de desarrollar enfermedades cardiovasculares. CONCLUSIONES: La infección crónica por el VHC tiene un efecto hipolipemiante y aumenta el riesgo cardiovascular. Se precisan estudios prospectivos que analicen el efecto de las nuevas terapias con antivirales de acción directa sobre el metabolismo lipídico y el riesgo cardiovascular.

Alteraciones del metabolismo lipídico producidas por el virus de la hepatitis C en pacientes con infección crónica / Lipid metabolism alterations produced by hepatitis C virus in patients with chronic infection

OBJETIVO: Es conocido que la infección crónica por el virus de la hepatitis C (VHC) genera un perfil lipídico aparentemente favorable. Paradójicamente, estos pacientes presentan un aumento de eventos cardiovasculares concomitantes. Los objetivos de la presente revisión fueron analizar y sintetizar los estudios que indagasen en las modificaciones que produce el VHC sobre el metabolismo lipídico de los pacientes con infección crónica, así como estudiar si esas modificaciones pueden asociarse a episodios posteriores de enfermedad cardiovascular. MÉTODOS: Se realizó una búsqueda bibliográfica en las bases de datos de Medline y Scopus de los artículos publicados desde enero de 2008 hasta febrero de 2019. Se identificaron un total de 901 publicaciones, de las cuales se revisaron 10 estudios que cumplieron con los criterios de inclusión y exclusión propuestos. RESULTADOS: Se encontró que en los pacientes con infección crónica por el VHC estaban disminuidos los niveles de colesterol total y sus fracciones lipídicas. No existió una clara asociación con los niveles de triglicéridos. Además, parecía haber una asociación entre la infección crónica por VHC y un aumento del riesgo de padecer aterosclerosis y de desarrollar enfermedades cardiovasculares. CONCLUSIONES: La infección crónica por el VHC tiene un efecto hipolipemiante y aumenta el riesgo cardiovascular. Se precisan estudios prospectivos que analicen el efecto de las nuevas terapias con antivirales de acción directa sobre el metabolismo lipídico y el riesgo cardiovascular

BACKGROUND: Chronic infection with the hepatitis C virus (HCV) is known to generate an apparently favorable lipid profile. Paradoxically, these patients present an increase in concomitant cardiovascular events. The objectives of the present review were to analyze and synthesize studies that inquired into the changes produced by hepatitis C virus (HCV) in the lipid metabolism of patients with chronic infection, and about whether these modifications can be associated with subsequent episodes of cardiovascular diseases. METHODS: A bibliographic search was carried out in the Medline and Scopus databases of the articles published from January 2008 to February 2019. A total of 901 publications were identified, of which 10 studies that fulfilled the inclusion and exclusion criteria were reviewed. RESULTS: It was found that the levels of total cholesterol and its lipid fractions were decreased in patients with chronic HCV infection. There was no clear association with triglyceride levels. In addition, there seemed to be an association between chronic HCV infection and an increased risk of developing atherosclerosis and cardiovascular diseases. CONCLUSIONS: Chronic HCV infection has a lipid-lowering effect and increases cardiovascular risk. Prospective studies are needed to analyze the effect of new therapies with direct-acting antivirals on lipid metabolism and cardiovascular risk