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Objectives: There are only limited studies investigating the impact of dietary quality indicators, such as dietary quality index (DQI), dietary diversity score (DDS), and alternative healthy eating index (AHEI), on metabolic dysfunction-associated fatty liver disease (MASLD). Furthermore, these indicators may have different components that could lead to varying results. Therefore, this study aims to assess the nutritional quality indicators and their potential association with MASLD. Methods: The study included 128 recently diagnosed MASLD patients and 256 controls aged between 20 and 60 years. The dietary intake of participants was evaluated using a validated semi-quantitative food frequency questionnaire that consisted of 168 items. In this study, the method used to evaluate dietary diversity was based on five main food groups, specifically bread and grains, vegetables, fruits, meat, and dairy. The AHEI-2010 was computed using data collected from the FFQ. Results: After adjusting for confounders in the fully adjusted model, a significant negative correlation was observed between DDS and the risk of MASLD (OR 0.41, 95% CI 0.20, 0.97). Participants in the top quartile of AHEI had a 76% lower risk of MASLD compared with those in the bottom quartile after controlling for all potential confounders in the fully adjusted model (OR 0.24, 95% CI 0.12, 0.56). Conclusion: The results of our study suggest that there is a significant association between adherence to a high-diversity diet and a reduced likelihood of developing MASLD. Similarly, we observed a similar association between adherence to the AHEI diet and a lower risk of MASLD.
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Modulatory signaling pathway such as T cell immunoreceptor with Ig and ITIM domains (TIGIT), Cytotoxic T-Lymphocyte Associated Protein 4 (CTLA-4), P53 signaling and TIM (T-cell immunoglobin and mucin domain) are important in normal pregnancy and loss of their functions or dysregulation of related genes can lead to some disorders. Inflammation is a process by which your body's white blood cells and the things they make protect you from infection from outside invaders, such as bacteria and viruses. Some cellular and molecular signaling have been categorized to demonstrate the mechanism that protects tolerance to antigens. lncRNAs significantly impact physiological processes like immunity and metabolism, and are linked to tumors, cardiovascular diseases, nervous system disorders, and nephropathy.In this review article, we summarized recent studies about the role of TIGIT, CTLA-4, P53 and TIM regulatory molecules and reviewed dysregulation of these pathway in diseases.We will also talk about the role of lncRNAs and mesenchymal stem cells.
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PURPOSE: Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor is recommended for patients with acute coronary syndrome and after percutaneous coronary intervention with stenting in stable coronary artery disease to help prevent further thromboembolic events. However, there is limited guidance on appropriate strategies for switching between oral P2Y12 inhibitors. The aim of this study was to evaluate safety of switching modalities at our institution and compare them to the recently published expert consensus recommendations. METHODS: This was a retrospective, descriptive analysis of patients admitted to Brigham and Women's Hospital from January 2015 to December 2018. Patients were included if they were at least 18 years of age and had documented administrations of two or more oral P2Y12 inhibitors during the same admission. The major safety endpoint was incidence of major adverse cardiac events (MACE) (cardiovascular death, myocardial infarction, stroke, and non-coronary artery bypass grafting (CABG)-related bleeding) at seven days or until hospital discharge. Minor endpoints included the incidence of in-stent thrombosis, number of patients who received appropriate loading doses (LD) before and after the recently published recommendations, and documented reason for switching between agents. RESULTS: There were 253 patients included in the final analysis. Of these, 83 patients were on clopidogrel as the first agent prior to switching, 9 patients were on prasugrel, and 161 were on ticagrelor. There was no incidence of the primary safety endpoint observed in any group. However, the number of patients who received a LD when switching between oral P2Y12 inhibitors increased from 80.0% to 87.0% after publication of the expert consensus paper. The most common reasons for switching from one agent to another were cost/insurance coverage (19.0%), need for triple therapy (16.0%), and bleeding risk (11.0%). CONCLUSION: Different switching modalities were not associated with an increase in MACE at our institution; however, larger randomized controlled trials are warranted.