BACKGROUND Type 1 diabetes(T1D)contributes to altered lipid profiles and increases the risk of cardiovascular disease(CVD).Youth with T1D may have additional CVD risk factors within the first decade of diagnosis.AIM T...BACKGROUND Type 1 diabetes(T1D)contributes to altered lipid profiles and increases the risk of cardiovascular disease(CVD).Youth with T1D may have additional CVD risk factors within the first decade of diagnosis.AIM To examine risk factors for dyslipidemia in young subjects with T1D.METHODS Longitudinal and cross-sectional retrospective study of 170 young subjects with T1D(86 males;baseline mean age 12.2±5.6 years and hemoglobin A1c 8.4%±1.4%)were followed in a single tertiary diabetes center for a median duration of 15 years.Predictors for outcomes of lipid profiles at last visit(total cholesterol[TC],triglycerides[TGs],low-density lipoprotein-cholesterol[LDL-c],and highdensity lipoprotein-cholesterol[HDL-c])were analyzed by stepwise linear regression models.RESULTS At baseline,79.5%of the patients had at least one additional CVD risk factor(borderline dyslipidemia/dyslipidemia[37.5%],pre-hypertension/hypertension[27.6%],and overweight/obesity[16.5%])and 41.6%had multiple(≥2)CVD risk factors.A positive family history of at least one CVD risk factor in a first-degree relative was reported in 54.1%of the cohort.Predictors of elevated TC:family history of CVD(β[SE]=23.1[8.3],P=0.006);of elevated LDL-c:baseline diastolic blood pressure(DBP)(β[SE]=11.4[4.7],P=0.003)and family history of CVD(β[SE]=20.7[6.8],P=0.017);of elevated TGs:baseline DBP(β[SE]=23.8[9.1],P=0.010)and family history of CVD(β[SE]=31.0[13.1],P=0.020);and of low HDL-c levels:baseline DBP(β[SE]=4.8[2.1],P=0.022]).CONCLUSION Our findings suggest that elevated lipid profiles are associated with DBP and a positive family history of CVD.It is of utmost importance to prevent and control modifiable risk factors such as these,as early as childhood,given that inadequate glycemic control and elevation in blood pressure intensify the risk of dyslipidemia.展开更多
Familial colorectal cancer constitutes a heterogeneous group of patients in whom the underlying molecular mechanism is still unknown.Predisposition to a such neoplasms in this setting seems to be due to common low-pen...Familial colorectal cancer constitutes a heterogeneous group of patients in whom the underlying molecular mechanism is still unknown.Predisposition to a such neoplasms in this setting seems to be due to common low-penetrance genetic components,but the role of genetic testing in clinical practice has to be determined.Although screening guidelines in this moderate-risk population are empiric,data obtained in epidemiologic,meta-analyses and cohort studies and,more recently,the increased risk of advanced adenomas in first degree relatives who underwent screening colonoscopy support the need to include these individuals in specific screening programs.However,data to determine what test to use,how often to use and which organizational strategy to implement are needed.At present,screening uptake in this population is less than optimal;offering the opportunity to access to screening and improving screening uptake is a first significant step.展开更多
Bipolar disorder(BD)is a familial disorder with high heritability.Genetic factors have been linked to the pathogenesis of BD.Relatives of probands with BD who are at familial risk can exhibit brain abnormalities prior...Bipolar disorder(BD)is a familial disorder with high heritability.Genetic factors have been linked to the pathogenesis of BD.Relatives of probands with BD who are at familial risk can exhibit brain abnormalities prior to illness onset.Given its involvement in prefrontal cognitive control and in frontolimbic circuitry that regulates emotional reactivity,the inferior frontal gyrus(IFG)has been a focus of research in studies of BD-related pathology and BD-risk mechanism.In this review,we discuss multimodal neuroimaging findings of the IFG based on studies comparing at-risk relatives and low-risk controls.Review of these studies in at-risk cases suggests the presence of both risk and resilience markers related to the IFG.At-risk individuals exhibited larger gray matter volume and increased functional activities in IFG compared with low-risk controls,which might result from an adaptive brain compensation to support emotion regulation as an aspect of psychological resilience.Functional connectivity between IFG and downstream limbic or striatal areas was typically decreased in at-risk individuals relative to controls,which could contribute to risk-related problems of cognitive and emotional control.Large-scale and longitudinal investigations on at-risk individuals will further elucidate the role of IFG and other brain regions in relation to familial risk for BD,and together guide identification of at-risk individuals for primary prevention.展开更多
基金The study was reviewed and approved by the Institutional Review Board at Rabin Medical Center,approval No.0075-17-RMC.
文摘BACKGROUND Type 1 diabetes(T1D)contributes to altered lipid profiles and increases the risk of cardiovascular disease(CVD).Youth with T1D may have additional CVD risk factors within the first decade of diagnosis.AIM To examine risk factors for dyslipidemia in young subjects with T1D.METHODS Longitudinal and cross-sectional retrospective study of 170 young subjects with T1D(86 males;baseline mean age 12.2±5.6 years and hemoglobin A1c 8.4%±1.4%)were followed in a single tertiary diabetes center for a median duration of 15 years.Predictors for outcomes of lipid profiles at last visit(total cholesterol[TC],triglycerides[TGs],low-density lipoprotein-cholesterol[LDL-c],and highdensity lipoprotein-cholesterol[HDL-c])were analyzed by stepwise linear regression models.RESULTS At baseline,79.5%of the patients had at least one additional CVD risk factor(borderline dyslipidemia/dyslipidemia[37.5%],pre-hypertension/hypertension[27.6%],and overweight/obesity[16.5%])and 41.6%had multiple(≥2)CVD risk factors.A positive family history of at least one CVD risk factor in a first-degree relative was reported in 54.1%of the cohort.Predictors of elevated TC:family history of CVD(β[SE]=23.1[8.3],P=0.006);of elevated LDL-c:baseline diastolic blood pressure(DBP)(β[SE]=11.4[4.7],P=0.003)and family history of CVD(β[SE]=20.7[6.8],P=0.017);of elevated TGs:baseline DBP(β[SE]=23.8[9.1],P=0.010)and family history of CVD(β[SE]=31.0[13.1],P=0.020);and of low HDL-c levels:baseline DBP(β[SE]=4.8[2.1],P=0.022]).CONCLUSION Our findings suggest that elevated lipid profiles are associated with DBP and a positive family history of CVD.It is of utmost importance to prevent and control modifiable risk factors such as these,as early as childhood,given that inadequate glycemic control and elevation in blood pressure intensify the risk of dyslipidemia.
文摘Familial colorectal cancer constitutes a heterogeneous group of patients in whom the underlying molecular mechanism is still unknown.Predisposition to a such neoplasms in this setting seems to be due to common low-penetrance genetic components,but the role of genetic testing in clinical practice has to be determined.Although screening guidelines in this moderate-risk population are empiric,data obtained in epidemiologic,meta-analyses and cohort studies and,more recently,the increased risk of advanced adenomas in first degree relatives who underwent screening colonoscopy support the need to include these individuals in specific screening programs.However,data to determine what test to use,how often to use and which organizational strategy to implement are needed.At present,screening uptake in this population is less than optimal;offering the opportunity to access to screening and improving screening uptake is a first significant step.
文摘Bipolar disorder(BD)is a familial disorder with high heritability.Genetic factors have been linked to the pathogenesis of BD.Relatives of probands with BD who are at familial risk can exhibit brain abnormalities prior to illness onset.Given its involvement in prefrontal cognitive control and in frontolimbic circuitry that regulates emotional reactivity,the inferior frontal gyrus(IFG)has been a focus of research in studies of BD-related pathology and BD-risk mechanism.In this review,we discuss multimodal neuroimaging findings of the IFG based on studies comparing at-risk relatives and low-risk controls.Review of these studies in at-risk cases suggests the presence of both risk and resilience markers related to the IFG.At-risk individuals exhibited larger gray matter volume and increased functional activities in IFG compared with low-risk controls,which might result from an adaptive brain compensation to support emotion regulation as an aspect of psychological resilience.Functional connectivity between IFG and downstream limbic or striatal areas was typically decreased in at-risk individuals relative to controls,which could contribute to risk-related problems of cognitive and emotional control.Large-scale and longitudinal investigations on at-risk individuals will further elucidate the role of IFG and other brain regions in relation to familial risk for BD,and together guide identification of at-risk individuals for primary prevention.
