The development of type 2 diabetes mellitus is a major contributing factor to the worldwide health burden of metabolic dysfunction-associated steatotic liver disease(MASLD).Insulin resistance,subclinical inflammation,...The development of type 2 diabetes mellitus is a major contributing factor to the worldwide health burden of metabolic dysfunction-associated steatotic liver disease(MASLD).Insulin resistance,subclinical inflammation,dyslipidemia,obesity,and hypertension are all factors in this reciprocal interaction that contribute to the development of MASLD,which includes hepatocellular carci-noma,advanced fibrosis/cirrhosis,and non-alcoholic steatohepatitis(NASH).A new risk factor for MASLD/NASH that affects the course of the disease independently throughout life is gestational diabetes mellitus(GDM).Women with a history of GDM had a higher chance of developing NASH,according to a recent study that used a large-scale database.Although the precise etiology is yet unknown,temporary disruption of pancreatic beta cell activity during pregnancy may set off systemic inflammation,affecting distant organs including the liver.Early screening and management strategies are crucial in mitigating MASLD progression and preventing adverse cardiovascular events in affected individuals.展开更多
Objective The association of metabolic syndrome （MetS） with cardiovascular diseases （CVD） has not been adequately explored in middle-aged and elderly Chinese. This study aimed to investigate MetS＇ prevalence and ...Objective The association of metabolic syndrome （MetS） with cardiovascular diseases （CVD） has not been adequately explored in middle-aged and elderly Chinese. This study aimed to investigate MetS＇ prevalence and its impact on the CVD incidence in this specific population group. Methods A data set of a community-based prospective cohort study was analyzed. A total of 2300 subjects aged 40-94 years were followed up for the CVD events. MetS defined according to the JCDCG criteria was assessed at baseline, and the middle-aged and elderly groups were classified by the WHO definition. Results As compared with the middle-aged group, the prevalence of MetS increased by 0.6 times （34.6% vs. 21.3%） and the incidence density of CVD increased by 4.9 times in the elderly group （52.3/1000 person-year vs. 8.9/1000 person-year）. Furthermore, the multivariate Cox regression revealed that the risk to CVD incidence was independently related to increased waist circumference in the middle-aged group （HR=2.23, P〈0.01） and to elevated blood glucose in the elderly group （HR=1.39, P〈O.01）. Conclusion MetS was highly prevalent in middle-aged and elderly Chinese. MetS significantly increased the risk to OdD incidence in the elderly. All individuals with metabolic disorders should receive active clinical care to reduce the incidence of CVD.展开更多
AIM:To clarify whether nonalcoholic fatty liver disease(NAFLD)increases the risk of cardiovascular disease.METHODS:We carried out a prospective observational study with a total of 1637 apparently healthy Japanese men ...AIM:To clarify whether nonalcoholic fatty liver disease(NAFLD)increases the risk of cardiovascular disease.METHODS:We carried out a prospective observational study with a total of 1637 apparently healthy Japanese men and women who were recruited from a health check-up program.NAFLD was diagnosed by abdominal ultrasonography.The metabolic syndrome(MS)was defined according to the modified National Cholesterol Education Program(NCEP)ATP Ⅲ criteria.Five years after the baseline evaluations,the incidence of cardiovascular disease was assessed by a self-administered questionnaire.RESULTS:Among 1221 participants available for outcome analyses,the incidence of cardiovascular disease was higher in 231 subjects with NAFLD at baseline(5 coronary heart disease,6 ischemic stroke,and 1 cerebral hemorrhage)than 990 subjects without NAFLD(3 coronary heart disease,6 ischemic stroke,and 1 cerebral hemorrhage).Multivariate analyses indicated that NAFLD was a predictor of cardiovascular disease independent of conventional risk factors(odds ratio 4.12,95% CI,1.58 to 10.75,P = 0.004).MS was alsoindependently associated with cardiovascular events.But simultaneous inclusion of NAFLD and MS in a multivariate model revealed that NAFLD but not MS retained a statistically significant correlation with cardiovascular disease.CONCLUSION:Although both of them were predictors of cardiovascular disease,NAFLD but not MS retained a statistically significant correlation with cardiovascular disease in a multivariate model.NAFLD is a strong predictor of cardiovascular disease and may play a central role in the cardiovascular risk of MS.展开更多
Nonalcoholic fatty liver disease(NAFLD)and cardiovascular disease(CVD)are two diseases that are common in the general population.To date,many studies have been conducted and demonstrate a direct link between NAFLD and...Nonalcoholic fatty liver disease(NAFLD)and cardiovascular disease(CVD)are two diseases that are common in the general population.To date,many studies have been conducted and demonstrate a direct link between NAFLD and CVD,but the exact mechanisms for this complex relationship are not well established.A systematic search of the PubMed database revealed that several common mechanisms are involved in many of the local and systemic manifestations of NAFLD and lead to an increased cardiovascular risk.The possible mechanisms linking NAFLD and CVD include inflammation,oxidative stress,insulin resistance,ectopic adipose tissue distribution,dyslipidemia,endothelial dysfunction,and adiponectin,among others.The clinical implication is that patients with NAFLD are at an increased risk of CVD and should undergo periodic cardiovascular risk assessment.展开更多
Metabolic syndrome(Met S) is a term used to denote a combination of selected,widely prevalent cardiovascular disease(CVD)-related risk factors.Despite the ambiguous definition of Met S,it has been clearly associated w...Metabolic syndrome(Met S) is a term used to denote a combination of selected,widely prevalent cardiovascular disease(CVD)-related risk factors.Despite the ambiguous definition of Met S,it has been clearly associated with chronic kidney disease markers including reduced glomerular filtration rate,proteinuria and/or microalbuminuria,and histopathological markers such as tubular atrophy and interstitial fibrosis.However,the etiological role of Met S in chronic kidney disease(CKD) is less clear.The relationship between MetS and CKD is complex and bidirectional,and so is best understood when CKD is viewed as a common progressive illness along the course of which MetS,another common disease,may intervene and contribute.Possible mechanisms of renal injury include insulin resistance and oxidative stress,increased proinflammatory cytokine production,increased connective tissue growth and profibrotic factor production,increased microvascular injury,and renal ischemia.MetS also portends a higher CVD risk at all stages of CKD from early renal insufficiency to end-stage renal disease.Clinical interventions for MetS in the presence of CKD should include a combination of weight reduction,appropriate dietary modification and increase physical activity,plus targeting of individual CVD-related risk factors such as dysglycemia,hypertension,and dyslipidemia while conforming to relevant national societal guidelines.展开更多
Nonalcoholic fatty liver disease (NAFLD) has emerged as the most commonchronic liver cell damage worldwide. It is strongly associated with an increasedrisk of cardiovascular disease (CVD). There are not enough recomme...Nonalcoholic fatty liver disease (NAFLD) has emerged as the most commonchronic liver cell damage worldwide. It is strongly associated with an increasedrisk of cardiovascular disease (CVD). There are not enough recommendations forscreening subjects with nonalcoholic steatohepatitis cirrhosis, who are notcandidates for liver transplantation, nor who are asymptomatic with NAFLDwithout cirrhosis. In the current comprehensive narrative review, we aimed toevaluate the associations between CVD and NAFLD. Distinguishing themechanisms linking these two disorders offers the opportunity to developtargeted therapies. Moreover, we will discuss screening approaches (whom andhow-to) and treatment modalities proposed to reduce cardiovascular risk inpatients with NAFLD.展开更多
Cardiovascular disease(CVD)has become one of the commonest causes of comorbidity and mortality among People living with human immunodeficiency virus(HIV)(PLWH)on antiretroviral therapy(ART).Nearly 50%of PLWH are likel...Cardiovascular disease(CVD)has become one of the commonest causes of comorbidity and mortality among People living with human immunodeficiency virus(HIV)(PLWH)on antiretroviral therapy(ART).Nearly 50%of PLWH are likely to have an increased risk of developing CVD,including coronary heart disease,cerebrovascular disease,peripheral artery disease and aortic atherosclerosis.Aside from the common risk factors,HIV infection itself and side effects of antiretroviral therapy contribute to the pathophysiology of this entity.Potential non-pharmacological therapies are currently being tested worldwide for this purpose,including eating patterns such as Intermittent fasting(IF).IF is a widespread practice gaining high level of interest in the scientific community due to its potential benefits such as improvement in serum lipids and lipoproteins,blood pressure(BP),platelet-derived growth factor AB,systemic inflammation,and carotid artery intima-media thickness among others cardiovascular benefits.This review will focus on exploring the potential role of intermittent fasting as a non-pharmacological and cost-effective strategy in decreasing the burden of cardiovascular diseases among HIV patients on ART due to its intrinsic properties improving the main cardiovascular risk factors and modulating inflammatory pathways related to endothelial dysfunction,lipid peroxidation and aging.Intermittent fasting regimens need to be tested in clinical trials as an important,cost-effective,and revolutionary coadjutant of ART in the fight against the increased prevalence of cardiovascular disease in PLWH.展开更多
文摘The development of type 2 diabetes mellitus is a major contributing factor to the worldwide health burden of metabolic dysfunction-associated steatotic liver disease(MASLD).Insulin resistance,subclinical inflammation,dyslipidemia,obesity,and hypertension are all factors in this reciprocal interaction that contribute to the development of MASLD,which includes hepatocellular carci-noma,advanced fibrosis/cirrhosis,and non-alcoholic steatohepatitis(NASH).A new risk factor for MASLD/NASH that affects the course of the disease independently throughout life is gestational diabetes mellitus(GDM).Women with a history of GDM had a higher chance of developing NASH,according to a recent study that used a large-scale database.Although the precise etiology is yet unknown,temporary disruption of pancreatic beta cell activity during pregnancy may set off systemic inflammation,affecting distant organs including the liver.Early screening and management strategies are crucial in mitigating MASLD progression and preventing adverse cardiovascular events in affected individuals.
基金supported by the Major Program of Shanghai Municipality for Basic Research (08dj1400601)Shanghai Key Laboratory of Diabetes Mellitus (08DZ2230200)supported by the Key Project of Science and Technology of Shanghai (09DZ1950202)
文摘Objective The association of metabolic syndrome （MetS） with cardiovascular diseases （CVD） has not been adequately explored in middle-aged and elderly Chinese. This study aimed to investigate MetS＇ prevalence and its impact on the CVD incidence in this specific population group. Methods A data set of a community-based prospective cohort study was analyzed. A total of 2300 subjects aged 40-94 years were followed up for the CVD events. MetS defined according to the JCDCG criteria was assessed at baseline, and the middle-aged and elderly groups were classified by the WHO definition. Results As compared with the middle-aged group, the prevalence of MetS increased by 0.6 times （34.6% vs. 21.3%） and the incidence density of CVD increased by 4.9 times in the elderly group （52.3/1000 person-year vs. 8.9/1000 person-year）. Furthermore, the multivariate Cox regression revealed that the risk to CVD incidence was independently related to increased waist circumference in the middle-aged group （HR=2.23, P〈0.01） and to elevated blood glucose in the elderly group （HR=1.39, P〈O.01）. Conclusion MetS was highly prevalent in middle-aged and elderly Chinese. MetS significantly increased the risk to OdD incidence in the elderly. All individuals with metabolic disorders should receive active clinical care to reduce the incidence of CVD.
基金Supported by a grant from the Gifu Medical Association
文摘AIM:To clarify whether nonalcoholic fatty liver disease(NAFLD)increases the risk of cardiovascular disease.METHODS:We carried out a prospective observational study with a total of 1637 apparently healthy Japanese men and women who were recruited from a health check-up program.NAFLD was diagnosed by abdominal ultrasonography.The metabolic syndrome(MS)was defined according to the modified National Cholesterol Education Program(NCEP)ATP Ⅲ criteria.Five years after the baseline evaluations,the incidence of cardiovascular disease was assessed by a self-administered questionnaire.RESULTS:Among 1221 participants available for outcome analyses,the incidence of cardiovascular disease was higher in 231 subjects with NAFLD at baseline(5 coronary heart disease,6 ischemic stroke,and 1 cerebral hemorrhage)than 990 subjects without NAFLD(3 coronary heart disease,6 ischemic stroke,and 1 cerebral hemorrhage).Multivariate analyses indicated that NAFLD was a predictor of cardiovascular disease independent of conventional risk factors(odds ratio 4.12,95% CI,1.58 to 10.75,P = 0.004).MS was alsoindependently associated with cardiovascular events.But simultaneous inclusion of NAFLD and MS in a multivariate model revealed that NAFLD but not MS retained a statistically significant correlation with cardiovascular disease.CONCLUSION:Although both of them were predictors of cardiovascular disease,NAFLD but not MS retained a statistically significant correlation with cardiovascular disease in a multivariate model.NAFLD is a strong predictor of cardiovascular disease and may play a central role in the cardiovascular risk of MS.
文摘Nonalcoholic fatty liver disease(NAFLD)and cardiovascular disease(CVD)are two diseases that are common in the general population.To date,many studies have been conducted and demonstrate a direct link between NAFLD and CVD,but the exact mechanisms for this complex relationship are not well established.A systematic search of the PubMed database revealed that several common mechanisms are involved in many of the local and systemic manifestations of NAFLD and lead to an increased cardiovascular risk.The possible mechanisms linking NAFLD and CVD include inflammation,oxidative stress,insulin resistance,ectopic adipose tissue distribution,dyslipidemia,endothelial dysfunction,and adiponectin,among others.The clinical implication is that patients with NAFLD are at an increased risk of CVD and should undergo periodic cardiovascular risk assessment.
基金This study was supported by the National Natural Science Foundation of China，Ministry of Science and Technology of China，National Department Public Benefit Research Foundation by Ministry of Health of China
文摘Metabolic syndrome(Met S) is a term used to denote a combination of selected,widely prevalent cardiovascular disease(CVD)-related risk factors.Despite the ambiguous definition of Met S,it has been clearly associated with chronic kidney disease markers including reduced glomerular filtration rate,proteinuria and/or microalbuminuria,and histopathological markers such as tubular atrophy and interstitial fibrosis.However,the etiological role of Met S in chronic kidney disease(CKD) is less clear.The relationship between MetS and CKD is complex and bidirectional,and so is best understood when CKD is viewed as a common progressive illness along the course of which MetS,another common disease,may intervene and contribute.Possible mechanisms of renal injury include insulin resistance and oxidative stress,increased proinflammatory cytokine production,increased connective tissue growth and profibrotic factor production,increased microvascular injury,and renal ischemia.MetS also portends a higher CVD risk at all stages of CKD from early renal insufficiency to end-stage renal disease.Clinical interventions for MetS in the presence of CKD should include a combination of weight reduction,appropriate dietary modification and increase physical activity,plus targeting of individual CVD-related risk factors such as dysglycemia,hypertension,and dyslipidemia while conforming to relevant national societal guidelines.
文摘Nonalcoholic fatty liver disease (NAFLD) has emerged as the most commonchronic liver cell damage worldwide. It is strongly associated with an increasedrisk of cardiovascular disease (CVD). There are not enough recommendations forscreening subjects with nonalcoholic steatohepatitis cirrhosis, who are notcandidates for liver transplantation, nor who are asymptomatic with NAFLDwithout cirrhosis. In the current comprehensive narrative review, we aimed toevaluate the associations between CVD and NAFLD. Distinguishing themechanisms linking these two disorders offers the opportunity to developtargeted therapies. Moreover, we will discuss screening approaches (whom andhow-to) and treatment modalities proposed to reduce cardiovascular risk inpatients with NAFLD.
文摘Cardiovascular disease(CVD)has become one of the commonest causes of comorbidity and mortality among People living with human immunodeficiency virus(HIV)(PLWH)on antiretroviral therapy(ART).Nearly 50%of PLWH are likely to have an increased risk of developing CVD,including coronary heart disease,cerebrovascular disease,peripheral artery disease and aortic atherosclerosis.Aside from the common risk factors,HIV infection itself and side effects of antiretroviral therapy contribute to the pathophysiology of this entity.Potential non-pharmacological therapies are currently being tested worldwide for this purpose,including eating patterns such as Intermittent fasting(IF).IF is a widespread practice gaining high level of interest in the scientific community due to its potential benefits such as improvement in serum lipids and lipoproteins,blood pressure(BP),platelet-derived growth factor AB,systemic inflammation,and carotid artery intima-media thickness among others cardiovascular benefits.This review will focus on exploring the potential role of intermittent fasting as a non-pharmacological and cost-effective strategy in decreasing the burden of cardiovascular diseases among HIV patients on ART due to its intrinsic properties improving the main cardiovascular risk factors and modulating inflammatory pathways related to endothelial dysfunction,lipid peroxidation and aging.Intermittent fasting regimens need to be tested in clinical trials as an important,cost-effective,and revolutionary coadjutant of ART in the fight against the increased prevalence of cardiovascular disease in PLWH.
