Atherosclerotic Cardiovascular Disease

动脉粥样硬化性心血管疾病
  • 文章类型: Journal Article
    癫痫与急性心肌梗死(AMI)风险之间的关系尚未完全了解。斯德哥尔摩心脏研究的证据表明,癫痫患者患AMI的风险增加。本研究旨在分析患病率的时间趋势,不良临床结局,癫痫患者AMI的危险因素。
    18岁或以上的患者,2008年1月1日至2017年12月31日被诊断为患有或不患有AMI的癫痫,并从国家住院样本(NIS)数据库中确定。使用SAS9.4进行Cochran-Armitage趋势检验和逻辑回归。针对多个变量生成赔率(OR)。
    共有8,456,098名住院患者符合我们的分析条件,包括与AMI共病的181,826例(2.15%)。PWE中AMI诊断的患病率从2008年的每100,000例住院1,911.7显着增加到2017年的每100,000例住院2,529.5(P趋势<0.001)。与没有AMI的患者相比,患有AMI的癫痫患者的住院死亡率明显更高(OR=4.61,95%CI:4.54至4.69)。PWE中与AMI显著相关的因素包括年龄(≥75岁与18~44岁,OR=3.54,95%CI:3.45至3.62),动脉粥样硬化(OR=4.44,95%CI:4.40至4.49),传导障碍(OR=2.21,95%CI:2.17至2.26),心肌病(OR=2.11,95%CI:2.08至2.15),凝血功能障碍(OR=1.52,95%CI:1.49至1.54),血脂异常(OR=1.26,95%CI:1.24至1.27),消化性溃疡(OR=1.23,95%CI:1.13至1.33),慢性肾脏病(OR=1.23,95%CI:1.22至1.25),吸烟(OR=1.20,95%CI:1.18至1.21),和体重减轻(OR=1.20,95%CI:1.18至1.22)。
    十年来,PWE中AMI的患病率有所增加。这些人群的死亡率很高,强调医生需要全面关注PWE中危险因素的预防和AMI的早期诊断。
    UNASSIGNED: The relationship between epilepsy and risk of acute myocardial infarction (AMI) is not fully understood. Evidence from the Stockholm Heart Study indicates that the risk of AMI is increased in people with epilepsy. This study aims to analyze the temporal trends in prevalence, adverse clinical outcomes, and risk factors of AMI in patients with epilepsy (PWE).
    UNASSIGNED: Patients aged 18 years or older, diagnosed with epilepsy with or without AMI and hospitalized from January 1, 2008, to December 31, 2017, were identified from the National Inpatient Sample (NIS) database. The Cochran-Armitage trend test and logistic regressions were conducted using SAS 9.4. Odds ratios (ORs) were generated for multiple variables.
    UNASSIGNED: A total of 8,456,098 inpatients were eligible for our analysis, including 181,826 comorbid with AMI (2.15%). The prevalence of AMI diagnosis in PWE significantly increased from 1,911.7 per 100,000 hospitalizations in 2008 to 2,529.5 per 100,000 hospitalizations in 2017 (Ptrend  < 0.001). Inpatient mortality was significantly higher in epilepsy patients with AMI compared to those without AMI (OR = 4.61, 95% CI: 4.54 to 4.69). Factors significantly associated with AMI in PWE included age (≥75 years old vs. 18 ~ 44 years old, OR = 3.54, 95% CI: 3.45 to 3.62), atherosclerosis (OR = 4.44, 95% CI: 4.40 to 4.49), conduction disorders (OR = 2.21, 95% CI: 2.17 to 2.26), cardiomyopathy (OR = 2.11, 95% CI: 2.08 to 2.15), coagulopathy (OR = 1.52, 95% CI: 1.49 to 1.54), dyslipidemia (OR = 1.26, 95% CI: 1.24 to 1.27), peptic ulcer disease (OR = 1.23, 95% CI: 1.13 to 1.33), chronic kidney disease (OR = 1.23, 95% CI: 1.22 to 1.25), smoking (OR = 1.20, 95% CI: 1.18 to 1.21), and weight loss (OR = 1.20, 95% CI: 1.18 to 1.22).
    UNASSIGNED: The prevalence of AMI in PWE increased during the decade. Mortality rates were high among this population, highlighting the need for comprehensive attention to prophylaxis for risk factors and early diagnosis of AMI in PWE by physicians.
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  • 文章类型: Journal Article
    经皮冠状动脉介入治疗(PCI)已成为动脉粥样硬化性心血管疾病(ASCVD)的主要治疗手段。炎症因子已被证明参与ASCVD的发生和发展。PCI术后炎症的持续性,尤其是在靶病变处释放的炎症,可能影响非靶病变斑块的稳定性。白细胞介素-6(IL-6)是最常见的炎症因子之一。然而,关于IL-6对冠状动脉非靶病变(NTL)进展的影响的研究有限.这项研究调查了血清IL-6水平是否会影响冠状动脉支架植入术后NTL的进展。
    我们进行了一项回顾性队列研究,包括接受冠状动脉造影(CAG)和支架植入的441例患者,至少有一个NTL,2019年1月至2021年12月。他们在PCI术后9至12个月接受了CAG随访。四分位数分组基于再入院后的血清IL-6水平。采用Logistic回归分析和限制性三次样条回归分析血清IL-6水平与冠状动脉支架植入术后NTLs进展的关系。使用接受者工作特征(ROC)曲线评估IL-6对NTL进展的预测值。
    当与第一个四分位数(Q1)组相比时,NTL进展的概率在第二季度增加(调整后比值比(AOR)3.06,95%CI1.29-7.29),第三季度(AOR3.55,95%CI1.52-8.26),和第四季度组(aOR7.51,95%CI3.30-17.05),趋势检验p<0.001。随着IL-6水平的升高,NTL进展的风险逐渐增加,IL-6与NTLs进展呈非线性关系(p<0.001)。ROC曲线显示血清IL-6水平临界值为12.652pg/mL(曲线下面积为0.673,灵敏度为54.5%,特异性为70.9%,p<0.05)。
    高血清IL-6水平是冠状动脉支架植入术后NTLs进展的独立危险因素,对NTLs的进展有一定的预测价值。
    UNASSIGNED: percutaneous coronary intervention (PCI) has become the mainstay of treatment for atherosclerotic cardiovascular disease (ASCVD). Inflammatory factors have been shown to be involved in the initiation and progression of ASCVD. After PCI, the persistence of inflammation, especially the inflammation released at the target lesion, may affect the stability of non-target lesion plaques. Interleukin-6 (IL-6) is one of the most common inflammatory factors, however studies about the influence of IL-6 on the progression of non-target lesions (NTLs) of coronary artery are limited. This study investigated whether serum IL-6 levels can affect the progression of NTLs after coronary stent implantation.
    UNASSIGNED: We performed a retrospective cohort study including 441 patients undergoing coronary angiography (CAG) and stent implantation, who had at least one NTL, between January 2019 and December 2021. They underwent followup CAG 9 to 12 months after PCI. Quartile grouping was based on serum IL-6 levels following readmission. The relationship between serum IL-6 levels and the progression of NTLs after coronary stent implantation was analyzed by using logistic regression analysis and restricted cubic spline regression. Predictive value of IL-6 on NTL progression was evaluated using the receiver operating characteristic (ROC) curve.
    UNASSIGNED: When compared to the first quartile (Q1) group, the probability of NTL progression was increased in Q2 (adjusted odds ratio (aOR) 3.06, 95% CI 1.29-7.29), Q3 (aOR 3.55, 95% CI 1.52-8.26), and Q4 group (aOR 7.51, 95% CI 3.30-17.05), with a trend test p < 0.001. With the increase of IL-6 levels, the risk of progression of NTLs gradually increased, and there was a non-linear relationship between IL-6 and progression of NTLs (p < 0.001). The ROC curve showed that the critical value of the serum IL-6 level was 12.652 pg/mL (area under the curve is 0.673, sensitivity is 54.5%, specificity is 70.9%, p < 0.05).
    UNASSIGNED: A high serum IL-6 level is an independent risk factor for the progression of NTLs after coronary stent implantation, and has certain predictive value for the progression of NTLs.
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  • 文章类型: Journal Article
    专门针对中国患者的PCSK9单克隆抗体(mAb)的随机临床试验(RCTs)有限。这种多中心RCT是为了阐明一种新型单克隆抗体的疗效和安全性,Ebronucimab,中国患者诊断为原发性高胆固醇血症的患者,包括杂合家族性高胆固醇血症,或混合性血脂异常,根据ASCVD风险进行分类,并以2:1:2:1的比例随机分配,每4周接受一次Ebonucimab450mg或匹配的安慰剂(Q4W),或Ebronucimab150mg或匹配的安慰剂每2周(Q2W)。主要结果是所有组的LDL-C从基线到第12周的百分比变化。Ebronucimab450mgQ4W和Ebronucimab150mgQ2W组与安慰剂组相比,从基线到第12周LDL-C的最小二乘平均降低差异(95CI)为-59.13(-64.103,-54.153)(调整后p<0.0001)和-60.43(-65.450,-55.416)(调整后p<0.0001),分别。同时,Ebronucimab组在每个心血管危险分层中达到LDL-C目标的比率明显较高.此外,Ebronucimab有效改善其他脂质组。在双盲治疗期间,相对频繁报告的不良事件(AE)是注射部位反应(ISR),尿路感染,和高尿酸血症(发病率为6.9%,4.8%和3.5%)。在治疗相关的AE中,仅注射部位反应(ISR)在剂量组中发生更多.总之,Ebronucimab,使用450mgQ4W或150mgQ2W剂量,在高胆固醇血症患者中,在降低血清LDL-C水平方面具有良好的安全性和免疫原性。试用注册:ClinicalTrials.gov标识符:NCT05255094.
    Randomized clinical trials (RCTs) of PCSK9 monoclonal antibody(mAb) specifically for Chinese patients have been limited. This multi-center RCT is to clarify the efficacy and safety of a novel mAb, Ebronucimab, in Chinese patients. Patients diagnosed with primary hypercholesterolemia, including Heterozygous Familial Hypercholesterolemia, or mixed dyslipidemia, were categorized by ASCVD risk and randomly assigned at a ratio of 2:1:2:1 to receive Ebronucimab 450mg or matching placebo every 4 weeks (Q4W), or Ebronucimab 150mg or matching placebo every 2 weeks (Q2W). The primary outcome was the percentage change of LDL-C from baseline to week 12 for all groups. The least squares mean reduction difference (95%CI) in LDL-C from baseline to week 12 of Ebronucimab 450mg Q4W and Ebronucimab 150mg Q2W groups versus the placebo group was -59.13 (-64.103, -54.153) (Adjusted p<0.0001) and -60.43 (-65.450, -55.416) (Adjusted p<0.0001), respectively. Meanwhile, the Ebronucimab group exhibited notably high rates in reaching LDL-C goals of each cardiovascular risk stratification. In addition, Ebronucimab effectively improved other lipid panel. During the double-blind treatment period, relatively frequently reported adverse events (AEs) were injection site reactions (ISR), urinary tract infection, and hyperuricemia (Incidence rate are 6.9%, 4.8% and 3.5%). Among treatment-associated AEs, only injection site reactions (ISR) occurred more in the dose groups. In conclusion, Ebronucimab, with either 450mg Q4W or 150mg Q2W doses, demonstrated significant efficacy in lowering serum LDL-C level with a favorable safety and immunogenicity profile among hypercholesterolemic patients. Trial Registration:ClinicalTrials.gov Identifier: NCT05255094.
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  • 文章类型: Journal Article
    目的:评估有和没有动脉粥样硬化性心血管疾病(ASCVD)的参与者在不同时间尺度上的空气污染暴露与动脉僵硬度的关系。
    方法:我们在2016年10月至2020年1月期间用臂踝脉搏波速度(baPWV)测量了参与者的动脉硬度。空气污染物的浓度,包括<2.5μm的空气动力学直径(PM2.5)的细颗粒,可吸入颗粒<10μm空气动力学直径(PM10),二氧化硫(SO2),二氧化氮(NO2),一氧化碳(CO),收集固定环境空气监测站测量的臭氧(O3),以进行短期(7天)和长期(365天)暴露评估。我们使用广义估计方程(GEE)来分析和进一步探索ASCVD与空气污染物之间的修饰效应。
    结果:最终纳入765名参与者,其中4名参与者有ASCVD病史,60名参与者(60.1%)。根据使用线性回归从GEE计算的部分回归系数(β)和95%置信区间(95%CI),长期暴露于PM2.5和PM10的每10μg/m3增加与baPWV的31.85cm/s(95%CI,17.97~45.73)和35.93cm/s(95%CI,21.01~50.84)增加相关.短期暴露于空气污染与动脉僵硬度之间没有关联。尽管在空气污染和ASCVD之间没有观察到显著的交互作用,baPWV在无ASCVD的亚组中显示更大的增量。
    结论:长期暴露于空气污染与有和没有ASCVD的参与者的较高动脉僵硬度密切相关。减少空气污染暴露对于ASCVD的一级和二级预防至关重要。
    OBJECTIVE: To assess the association of air pollution exposure at different time scales with arterial stiffness in participants with and without atherosclerotic cardiovascular disease (ASCVD).
    METHODS: We measured participants\' arterial stiffness with brachial-ankle pulse wave velocity (baPWV) from October 2016 to January 2020. Concentrations of air pollutants including fine particles < 2.5 μm aerodynamic diameter (PM2.5), inhalable particles < 10 μm aerodynamic diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) measured by fixed ambient air monitoring stations were collected for short- (7-day) and long-term (365-day) exposure assessment. We used generalized estimating equations (GEEs) to analyze and further explored the modification effects between ASCVD and air pollutants.
    RESULTS: Seven hundred sixty-five participants were finally included and four hunderd sixty (60.1%) participants had a history of ASCVD. Based on the partial regression coefficients (β) and 95% confidence intervals (95% CI) calculated from GEEs using linear regression, each 10 μg/m3 increase in long-term exposure to PM2.5 and PM10 was associated with 31.85 cm/s (95% CI, 17.97 to 45.73) and 35.93 cm/s (95% CI, 21.01 to 50.84) increase in baPWV. There was no association between short-term exposure to air pollution and arterial stiffness. Although no significant interaction effect was observed between air pollution and ASCVD, baPWV showed a greater increment in the subgroup without ASCVD.
    CONCLUSIONS: Long-term exposure to air pollution is closely associated with higher arterial stiffness in participants with and without ASCVD. Reducing air pollution exposure is essential in the primary and secondary prevention of ASCVD.
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  • 文章类型: Journal Article
    背景:血清脂蛋白(a)[Lp(a)]是普通人群中动脉粥样硬化性心血管疾病(ASCVD)的独立危险因素,在中国维持性血液透析(MHD)患者中,其与ASCVD发病率的相关性尚不清楚.我们旨在评估Lp(a)水平与北京MHD患者ASCVD发病率之间的关系。中国。
    方法:本回顾性研究,观察性队列研究纳入2013年1月1日至2020年12月1日在北京同仁医院就诊的MHD患者,随访至2023年12月1日.主要结果是ASCVD发生。Kaplan-Meier生存分析用于评估MHD患者的无ASCVD生存。基于Lp(a)水平进行分层。进行Cox回归分析以评估Lp(a)水平与ASCVD发生之间的关联。
    结果:本研究共纳入265例患者。中位随访期为71个月。78(29.4%)参与者经历了ASCVD事件,118名(47%)患者死亡,58(49.1%)死亡归因于ASCVD。Spearman等级相关分析显示血清Lp(a)水平与LDL-c水平呈正相关,与血红蛋白呈负相关,甘油三酯,血清铁,血清肌酐,和白蛋白水平。多因素Cox回归分析显示Lp(a)水平≥30mg/L,年龄增长,血清白蛋白水平降低,糖尿病病史与ASCVD发病率显著相关。
    结论:本研究表明MHD患者血清Lp(a)水平与ASCVD风险之间存在独立的正相关,提示血清Lp(a)可能作为评估该人群ASCVD风险的临床生物标志物.
    BACKGROUND: Serum lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD) in the general population, its association with ASCVD incidence in Chinese maintenance hemodialysis (MHD) patients remains unclear. We aimed to evaluate the relationship between Lp(a) levels and ASCVD incidence among MHD patients in Beijing, China.
    METHODS: This retrospective, observational cohort study included MHD patients at Beijing Tongren Hospital from January 1, 2013 to December 1, 2020, and followed until December 1,2023. The primary outcome was ASCVD occurrence. Kaplan-Meier survival analysis was used to evaluate ASCVD-free survival in MHD patients, with stratification based on Lp(a) levels. Cox regression analyses were conducted to assess the association between Lp(a) levels and the occurrence of ASCVD.
    RESULTS: A total of 265 patients were enrolled in the study. The median follow-up period were 71 months.78 (29.4%) participants experienced ASCVD events, and 118 (47%) patients died, with 58 (49.1%) deaths attributed to ASCVD. Spearman rank correlation analyses revealed positive correlations between serum Lp(a) levels and LDL-c levels, and negative correlations with hemoglobin, triglyceride, serum iron, serum creatinine, and albumin levels. Multivariate Cox regression analysis showed that Lp(a) levels ≥ 30 mg/L, increased age, decreased serum albumin levels, and a history of diabetes mellitus were significantly associated with ASCVD incidence.
    CONCLUSIONS: This study demonstrated an independent and positive association between serum Lp(a) levels and the risk of ASCVD in MHD patients, suggesting that serum Lp(a) could potentially serve as a clinical biomarker for estimating ASCVD risk in this population.
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  • 文章类型: Journal Article
    这项研究旨在调查久坐行为(SB)与预测的10年动脉粥样硬化性心血管疾病(ASCVD)风险之间的关联,并确定这种关联是否因行为的积累而有所不同。在美国中年人和老年人中。横断面数据来自2003-2006年国家健康和营养检查调查(NHANES)。使用加速度计佩戴七天来评估SB模式,导出为总SB,1-9、10-29、30-59和≥60分钟SB的回合。使用经过验证的合并队列方程计算预测的10年ASCVD风险。线性回归用于估计调整系数。共有2327名参与者入选,平均年龄为56.9岁,平均预测10年ASCVD风险为10.7%。我们观察到总SB及其更长的累积模式与更高的10年预测ASCVD风险显著相关,以线性方式,独立于协变量列表。每天总SB增加30分钟,10-29次发作、30-59次发作和≥60分钟发作与多变量调整后的10年预测ASCVD风险高出0.14、0.14、0.23和0.12%相关。总SB及其较长的累积模式与较高的10年预测ASCVD风险之间存在显着关联。独立于协变量列表,并以线性方式。结果表明,减少总久坐时间,中断长时间的SB,对于公共指南减轻心血管健康的个人和公共卫生负担可能是有意义的。
    This study aims to investigated the association between sedentary behavior (SB) and predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risk and determine whether the associations differ by how the behavior is accumulated, in US middle-aged and older adults. Cross-sectional data were derived from national health and nutrition examination survey (NHANES) 2003-2006. Seven-day wearing of accelerometer was used to assess SB pattern, exported as total SB, bouts of 1-9, 10-29, 30-59 and ≥ 60 min SB. Predicted 10-year ASCVD risk was calculated using validated pooled cohort equations. Linear regression was used to estimate adjusted coefficients. A total of 2327 participants were enrolled with mean age of 56.9 and mean predicted 10-year ASCVD risk of 10.7%. We observed significant associations of total SB and its longer accumulated patterns with higher 10-year predicted ASCVD risk, in a linear fashion and independent of a list of covariates. A 30 min increment per day of total SB, bouts in 10-29, bouts in 30-59 and bouts in ≥ 60 min were associated with 0.14, 0.14, 0.23 and 0.12% higher multivariable-adjusted 10-year predicted ASCVD risk. There are significant associations of total SB as well as its longer accumulated patterns with higher 10-year predicted ASCVD risk, independent of a list of covariates and in a linear fashion. The result indicates that reducing total sedentary time and interrupting long duration of prolonged SB, could be meaningful to for public guideline to lessen the personal and public health burden of cardiovascular health.
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  • 文章类型: Journal Article
    动脉粥样硬化性心血管疾病(ASCVD)是全球范围内的主要杀手和医疗保健负担。动脉粥样硬化,共同的病理基础,在过去的几年里与炎症有关。也出现了一些有希望的结果,表明靶向炎症作为减少心血管事件的潜在治疗选择的作用。鉴于炎症在ASCVD中的致病作用,我们建议使用文献计量学分析评估ASCVD和炎症的全球研究架构.
    对2012年至2022年之间发布的该领域的文章进行了搜索。通过时间使用GraphPadPrism可视化了每年的出版物数量。CiteSpace和VOSviewer用于生成有关国家合作的知识图,机构,和作者,代表ASCVD和炎症研究的景观,并揭示当前的病灶。
    本研究共检查了19,053篇出版物。大多数出版物来自中国(6232,32.71%)。首都地中海大学是生产力最高的机构(410,2.15%)。ChristianWeber发表了最多的文章(75,0.39%)。PLoSone被确定为最多产的期刊(706,3.71%)。《循环》是被共同引用最多的期刊(13276,2.81%)。持续强烈引用爆发的关键词是“核苷酸结合寡聚化(NOD),含富含亮氨酸重复序列(LRR)的蛋白质(NLRP3)炎性体“,“肠道微生物群”,\"exosome\",\"lncRNAs\",等。
    可以表明,ASCVD和炎症研究得益于对科学界产生高度影响的手稿。亚洲人,欧洲和北美国家在数量上占主导地位,定性和协作参数。NLRP3炎性体,肠道菌群和三甲胺N-氧化物,自噬,lncRNAs,外泌体,和核因子红系2相关因子2被描述为该领域的热门主题。
    UNASSIGNED: The atherosclerotic cardiovascular disease (ASCVD) is a major killer and health care burden worldwide. Atherosclerosis, the common pathological foundation, has been associated with inflammation over the past few years. Some promising results also have emerged suggesting the role of targeting inflammation as a potential therapeutic option to reduce cardiovascular events. In light of the pathogenic role that inflammation plays in ASCVD, we propose to evaluate the worldwide research architecture for ASCVD and inflammation using bibliometric analysis.
    UNASSIGNED: A search of the Web of Science Core Collection of Clarivate Analytics was performed for articles in the field published between 2012 and 2022. The number of publications per year has been visualized using GraphPad Prism through time. CiteSpace and VOSviewer were used to generate knowledge maps about the collaboration of countries, institutions, and authors, and to represent the landscape on ASCVD and inflammation research as well as to reveal current foci.
    UNASSIGNED: There were a total of 19,053 publications examined in this study. The most publications came from China (6232, 32.71%). Capital Med Univ was the most productive institution (410, 2.15%). Christian Weber published the greatest number of articles (75, 0.39%). PloS one was identified as the most prolific journal (706, 3.71%). Circulation was the most co-cited journal (13276, 2.81%). Keywords with the ongoing strong citation bursts were \"nucleotide-binding oligomerization (NOD), Leucine-rich repeat (LRR)-containing protein (NLRP3) inflammasome\", \"intestinal microbiota\", \"exosome\", \"lncRNAs\", etc.
    UNASSIGNED: It can be shown that ASCVD and inflammation research benefited from manuscripts that had a high impact on the scientific community. Asian, European and North American countries dominated in the field in terms of quantitative, qualitative and collaborative parameters. The NLRP3 inflammasome, gut microbiota and trimethylamine N-oxide, autophagy, lncRNAs, exosomes, and nuclear factor erythroid 2-related factor 2 were described to be hot themes in the field.
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  • 文章类型: Journal Article
    目的:我们的研究目的是研究成人复合膳食抗氧化指数(CDAI)与动脉粥样硬化性心血管疾病(ASCVD)之间的关系。
    结果:数据来自2001年至2018年的国家健康与营养检查调查(NHANES)。为了检查CDAI和ASCVD之间的联系,进行了多因素logistic回归分析.限制三次样条被用来检查非线性相关性,并使用两分段线性回归方法确定拐点。进行亚组分析以证明结果的稳定性。共有44,494名个体被纳入研究。对多变量逻辑回归模型进行了充分调整,显示CDAI和ASCVD之间的相关性比值比为0.968(95%CI:0.959-0.978;P<0.001)。此外,与最低四分位数的个体相比,CDAI最高四分位数的个体出现ASCVD的风险降低[0.716(0.652-0.787);P<0.001].此外,约束三次样条(RCS)分析揭示了CDAI和ASCVD之间的非线性关系,拐点为-0.387。亚组分析表明,CDAI的重要性在不同年龄之间保持一致,性别,种族,体重指数(BMI),和身体活动。
    结论:我们的研究揭示了成人CDAI和ASCVD之间的反向和非线性关系。这些发现的意义对于未来的研究和饮食指南的制定具有重要意义。
    OBJECTIVE: The objective of our study was to examine the association between composite dietary antioxidant index (CDAI) and atherosclerotic cardiovascular disease (ASCVD) in adults.
    RESULTS: Data was gathered from the National Health and Nutrition Examination Survey (NHANES) between 2001 and 2018. To examine the connection between CDAI and ASCVD, multiple logistic regression analyses were performed. Restricted cubic splines were utilized to examine non-linear correlations, and the inflection point was identified using a two-piecewise linear regression approach. Subgroup analyses were performed to demonstrate stability of results. A total of 44,494 individuals were included in the study. The multivariate logistic regression model was fully adjusted and revealed an odds ratio of 0.968 (95% CI: 0.959-0.978; P < 0.001) for the correlation between CDAI and ASCVD. Furthermore, individuals in the highest quartile of CDAI exhibited a decreased risk of ASCVD compared to those in the lowest quartile [0.716 (0.652-0.787); P < 0.001]. Moreover, restricted cubic spline (RCS) analysis revealed non-linear relationship between CDAI and ASCVD, with inflection point at -0.387. The analysis of subgroups showed that the importance of CDAI remained consistent among various age, sex, race, body mass index (BMI), and physical activity.
    CONCLUSIONS: Our research revealed an inverse and non-linear relationship between CDAI and ASCVD in adults. The implications of these findings are significant for future studies and the formulation of dietary guidelines.
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  • 文章类型: Journal Article
    背景:-膳食镁(Mg)摄入量与动脉粥样硬化性心血管疾病(ASCVD)风险之间的关系仍不确定。我们的目的是研究饮食中镁的摄入量与ASCVD事件和死亡率的风险之间的关系有或没有2型糖尿病的个体。
    方法:-来自英国生物银行的149,929名参与者(4,603名2型糖尿病患者)被纳入分析。使用Cox比例风险模型估计风险比(HR)和95CI。此外,饮食中Mg摄入量与2型糖尿病状态的相互作用在乘法和加法尺度上进行了检查。
    结果:-在12.0和12.1年的中位随访期间,记录了7,811例ASCVD事件和5,000例死亡(包括599例ASCVD死亡),分别。充足的膳食镁摄入量(等于或大于推荐的每日摄入量)与ASCVD发病率之间存在显著负相关(HR0.63[95CI0.49;0.82]),ASCVD死亡率(HR0.45[0.24;0.87]),2型糖尿病患者的全因死亡率(HR0.71[0.52;0.97]),而在无2型糖尿病的参与者中未观察到显著关联(ASCVD发生率HR1.01[0.94;1.09];ASCVD死亡率HR1.25[0.93;1.66];全因死亡率HR0.97[0.88;1.07]).观察到饮食中Mg摄入量与2型糖尿病状态的乘性和加性相互作用。
    结论:—在2型糖尿病患者中,充足的饮食摄入镁与ASCVD事件和死亡率的风险降低显著相关,但在没有2型糖尿病的患者中没有显著相关。我们的研究结果提供了对饮食中Mg摄入对于减少2型糖尿病患者可改变的心血管负担的重要性的见解。这可能会为未来的个性化饮食指南提供信息。
    BACKGROUND: The association between dietary magnesium (Mg) intake and the risk of atherosclerotic cardiovascular disease (ASCVD) remains uncertain. We aimed to examine the associations of dietary Mg intake with the risk of ASCVD events and mortality in individuals with and without type 2 diabetes.
    METHODS: A total of 149,929 participants (4603 with type 2 diabetes) from the UK Biobank were included in the analyses. The hazard ratios (HRs) and 95 % confidence intervals (CIs) were estimated using Cox proportional hazard models. Furthermore, interactions of dietary Mg intake with type 2 diabetes status were examined on multiplicative and additive scales.
    RESULTS: During a median follow-up of 12.0 and 12.1 years, 7811 incident ASCVD events and 5000 deaths (including 599 ASCVD deaths) were documented, respectively. There were significantly negative associations between sufficient dietary Mg intake (equal to or greater than the recommended daily intake) and the risk of ASCVD incidence (HR 0.63 [95 % CI 0.49;0.82]), ASCVD mortality (0.45 [0.24;0.87]), and all-cause mortality (0.71 [0.52;0.97]) in participants with type 2 diabetes, whereas no significant association was observed in participants without type 2 diabetes (1.01 [0.94;1.09] for ASCVD incidence; 1.25 [0.93;1.66] for ASCVD mortality; 0.97 [0.88;1.07] for all-cause mortality). Multiplicative and additive interactions of dietary Mg intake with type 2 diabetes status were both observed.
    CONCLUSIONS: Sufficient dietary Mg intake was significantly associated with lower risks of ASCVD events and mortality in individuals with type 2 diabetes but not in those without type 2 diabetes. Our findings provide insight into the importance of dietary Mg intake for reducing modifiable cardiovascular burden in individuals with type 2 diabetes, which may inform future personalized dietary guidelines.
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  • 文章类型: Journal Article
    非酒精性脂肪性肝病(NAFLD)与代谢综合征密切相关,仍然是全球主要的健康负担。肥胖和2型糖尿病(T2DM)患病率的增加导致了NAFLD发病率的上升。人们普遍认为动脉粥样硬化性心血管疾病(ASCVD)与NAFLD有关。在过去的十年里,NAFLD的临床意义已经超越了肝脏相关的发病率和死亡率,大多数患者死亡归因于恶性肿瘤,冠心病,和其他心血管(CVD)并发症。为了更好地定义与代谢紊乱相关的脂肪肝疾病,专家在2020年提出了一个新术语-与脂肪肝疾病相关的代谢功能障碍(MAFLD)。随着这个新的名称,介绍了更新的诊断标准,导致NAFLD和MAFLD患者人群之间的一些差异,虽然有重叠。这篇综述的目的是根据新的定义和诊断标准,探讨MAFLD和ASCVD之间的关系。同时简要讨论MAFLD患者心血管疾病的潜在机制。
    Non-alcoholic fatty liver disease (NAFLD) is closely related to metabolic syndrome and remains a major global health burden. The increased prevalence of obesity and type 2 diabetes mellitus (T2DM) worldwide has contributed to the rising incidence of NAFLD. It is widely believed that atherosclerotic cardiovascular disease (ASCVD) is associated with NAFLD. In the past decade, the clinical implications of NAFLD have gone beyond liver-related morbidity and mortality, with a majority of patient deaths attributed to malignancy, coronary heart disease (CHD), and other cardiovascular (CVD) complications. To better define fatty liver disease associated with metabolic disorders, experts proposed a new term in 2020 - metabolic dysfunction associated with fatty liver disease (MAFLD). Along with this new designation, updated diagnostic criteria were introduced, resulting in some differentiation between NAFLD and MAFLD patient populations, although there is overlap. The aim of this review is to explore the relationship between MAFLD and ASCVD based on the new definitions and diagnostic criteria, while briefly discussing potential mechanisms underlying cardiovascular disease in patients with MAFLD.
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