Clínica e Investigación en Arteriosclerosis (English Edition)最新文献

{"title":"Artificial intelligence in clinical practice: an inevitable revolution that will transform healthcare","authors":"Joan-Carles Vallvé","doi":"10.1016/j.artere.2026.500939","DOIUrl":"10.1016/j.artere.2026.500939","url":null,"abstract":"","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"38 5","pages":"Article 500939"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148924184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiological network analysis of arterial stiffness, hemodynamic parameters and aortic architecture in patients with and without hypertension","authors":"Alberto Guevara-Tirado","doi":"10.1016/j.artere.2026.500895","DOIUrl":"10.1016/j.artere.2026.500895","url":null,"abstract":"<div><h3>Introduction</h3><div>Hypertension is associated with vascular remodeling and hemodynamic alterations; however, the global interaction of these processes remains insufficiently understood.</div></div><div><h3>Objective</h3><div>To analyze the structure of physiological networks integrating arterial stiffness, hemodynamic parameters, and aortic architecture in patients with and without hypertension.</div></div><div><h3>Materials and methods</h3><div>An analytical study based on a secondary dataset (n = 801) including clinical and hemodynamic measurements, arterial stiffness assessed by the left and right cardio-ankle vascular index (CAVI-L and CAVI-R), and aortic diameters measured by computed tomography. Physiological networks were estimated for hypertensive and non-hypertensive groups using the Extended Bayesian Information Criterion Graphical LASSO (EBIC-GLASSO). Centrality metrics (degree, strength, betweenness) and global network metrics (density, modularity, and communities) were computed. Networks were visualized using the Fruchterman–Reingold algorithm and compared through a permutation-based procedure reproducing the Network Comparison Test (NCT).</div></div><div><h3>Results</h3><div>Network analysis revealed topological differences between patients with hypertension and those without hypertension. In the hypertensive group, CAVI-L, body mass index, and diastolic blood pressure showed higher degree and strength values. Aortic segments such as the sinus of Valsalva, mid aortic arch, and proximal descending thoracic aorta exhibited higher betweenness values. The hypertensive network showed higher density and lower effective functional differentiation. Permutation analysis confirmed greater global network strength in the hypertensive group, with formal statistical significance observed only for diastolic blood pressure.</div></div><div><h3>Conclusions</h3><div>Hypertension is associated with global changes in vascular organization, characterized by increased arterial stiffness, higher network connectivity, and a functional predominance of diastolic blood pressure within the physiological network.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"38 5","pages":"Article 500895"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148924266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of short telomere as biomarker of diabetes mellitus type 2 status in the CORDIOPREV study","authors":"Ana Ojeda-Rodriguez,&nbsp;Maria Jose Parraga-Viudez,&nbsp;Juan L. Romero-Cabrera,&nbsp;Alejandro López-Moreno,&nbsp;Javier Arenas-Montes,&nbsp;Ana Isabel Pérez Caballero,&nbsp;Raul M. Luque,&nbsp;Javier Delgado-Lista,&nbsp;Oriol Rangel-Zuñiga,&nbsp;Jose Lopez-Miranda","doi":"10.1016/j.artere.2026.500888","DOIUrl":"10.1016/j.artere.2026.500888","url":null,"abstract":"<div><h3>Background</h3><div>The presence of type 2 diabetes mellitus (T2DM) in cardiovascular disease (CVD) is associated with poorer clinical outcomes. To identify biomarkers is essential to predict T2DM onset and progression in the context of secondary prevention. Telomere length (TL), a marker of cellular aging, has been linked to oxidative stress, inflammation, and metabolic dysfunction, including diabetes-related complications. This study aims to evaluate TL as a potential biomarker for T2DM in patients with coronary heart disease (CHD).</div></div><div><h3>Methods</h3><div>We included 956 patients from the CORDIOPREV study with available TL data. Participants were classified according to their diabetes status at the end of the dietary intervention: 407 were free of T2DM and 549 were classified as having T2DM. TL was measured by quantitative PCR. Patients with TL values below the 20th percentile of the study population were categorized as having short telomeres.</div></div><div><h3>Results</h3><div>TL was significantly shorter in T2DM patients compared to non-T2DM (1.26<!--> <!-->±<!--> <!-->0.74 vs. 1.38<!--> <!-->±<!--> <!-->0.84; <em>p</em> <!-->=<!--> <!-->0.026). Each 1-SD increase in TL was associated with a 17% lower risk of T2DM (OR 0.83, 95% CI 0.69–0.98). Patients at risk of short TL (&lt;20th percentile) showed a higher prevalence of T2DM (20% vs. 17%; <em>p</em> <!-->=<!--> <!-->0.035) and a 42% increased risk of its presence (OR 1.42, 95% CI 0.99–2.02). In stepwise regression models, TL, age, BMI, insulin, triglycerides, and HbA1c emerged as independent predictors of T2DM. After adjusting for fasting glucose, TL lost significance as a continuous variable, but short TL risk remained independently associated with T2DM (OR 1.57, <em>p</em> <!-->=<!--> <!-->0.049).</div></div><div><h3>Conclusions</h3><div>Shorter TL is associated with the presence of T2DM in patients with CHD, supporting its potential role as an independent biomarker for T2DM risk in secondary prevention.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"38 5","pages":"Article 500888"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148924181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atherogenic risk in commerce and industry workers: Associations with sociodemographic and lifestyle factors in a large Spanish occupational cohort","authors":"María Pilar Fernández-Figares Vicioso,&nbsp;María Teófila Vicente-Herrero,&nbsp;Pere Riutord Sbert,&nbsp;José Ignacio Ramírez-Manent,&nbsp;Pedro Juan Tárraga Marcos,&nbsp;José Luis del Barrio Fernández,&nbsp;Ángel Arturo López-González","doi":"10.1016/j.artere.2026.500873","DOIUrl":"10.1016/j.artere.2026.500873","url":null,"abstract":"<div><h3>Background</h3><div>Atherogenic dyslipidemia (AD) and associated lipid ratios are critical markers for cardiovascular risk, yet little is known about how these markers vary by occupational sector and sociodemographic or lifestyle factors in working populations.</div></div><div><h3>Objective</h3><div>To evaluate the prevalence and determinants of elevated atherogenic risk according to total cholesterol/HDL-c (TC/HDL-c), LDL-c/HDL-c, triglycerides/HDL-c (TG/HDL-c), and AD in workers from the commerce and industry sectors, stratified by sex, age, education, physical activity, diet, and smoking.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 56,856 Spanish workers (39,448 men and 17,408 women) from commerce (n = 27,448) and industry (n = 29,408). Sociodemographic, clinical, and lifestyle data were collected, and atherogenic risk was assessed using TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and AD presence. Mean values and prevalence were compared by group, and multinomial logistic regression was used to estimate the association between risk markers and covariates.</div></div><div><h3>Results</h3><div>Workers in the industry sector showed higher mean values and prevalence of all atherogenic risk scales compared to those in commerce, particularly among men and older age groups. Male sex, older age, lower education, physical inactivity, absence of Mediterranean diet, and smoking were consistently associated with higher odds of elevated lipid ratios and AD. Notably, the absence of physical activity was strongly associated with all outcomes, with ORs ranging from 3.08 to 11.66. The industrial sector was independently associated with increased risk: TC/HDL-c (OR = 1.23), LDL-c/HDL-c (OR = 1.15), TG/HDL-c (OR = 1.16), and AD (OR = 1.19).</div></div><div><h3>Conclusions</h3><div>Atherogenic risk profiles are less favorable among industrial workers and are significantly influenced by modifiable lifestyle factors. These findings support the need for preventive strategies tailored to the occupational context, with emphasis on promoting physical activity, smoking cessation, and healthier dietary habits, in order to reduce cardiovascular risk in these populations.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"38 5","pages":"Article 500873"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148924265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of elevated lipoprotein(a) levels and associated atherosclerotic cardiovascular diseases in subjects with metabolic disorders: A real-world study in a lipid unit","authors":"Francesco Di Giacomo Barbagallo,&nbsp;Ana González-Lleó,&nbsp;Núria Amigo,&nbsp;Giosiana Bosco,&nbsp;Daiana Ibarretxe,&nbsp;Salvatore Piro,&nbsp;Roberto Scicali,&nbsp;Luís Masana","doi":"10.1016/j.artere.2026.500892","DOIUrl":"10.1016/j.artere.2026.500892","url":null,"abstract":"<div><h3>Background and aims</h3><div>Lipoprotein(a) (Lp(a)) is a proatherogenic particle that is considered an important cardiovascular risk modifier due to its association with atherosclerotic cardiovascular disease (ASCVD) as well as calcific aortic valve stenosis (CAVS). Data on the clinical burden associated with elevated lipoprotein(a) levels in patients at high and very high cardiovascular risk remain limited. We evaluated the prevalence of ASCVD and LDL-C target achievement in subjects with high and very high elevated Lp(a) levels referred to a lipid unit.</div></div><div><h3>Methods and results</h3><div>In this retrospective study, 1755 subjects were evaluated; 265 with Lp(a) ≥240<!--> <!-->nmol/L were included. The population was divided into two groups: high Lp(a) (240–429<!--> <!-->nmol/L, <em>n</em> <!-->=<!--> <!-->216) and very high Lp(a) (≥430<!--> <!-->nmol/L, <em>n</em> <!-->=<!--> <!-->49). ASCVD prevalence was 58% in the very high group and 48% in the high group (<em>p</em> <!-->=<!--> <!-->0.23). Age and statin intensity were higher in the very high Lp(a) group. LDL-C target achievement was low in both groups: 20.0% and 25.4% of very high-risk patients reached &lt;55<!--> <!-->mg/dL as well as 18.2% and 17.2% of high-risk patients reached &lt;70<!--> <!-->mg/dL in very high and high Lp(a) groups, respectively.</div></div><div><h3>Conclusions</h3><div>Subjects with elevated Lp(a) levels showed a high prevalence of ASCVD and low LDL-C target attainment despite high-intensity statin therapy. These findings support the need for Lp(a) screening and additional lipid-lowering strategies in high-risk patients.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"38 5","pages":"Article 500892"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148924182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative performance of machine learning vs classical formulas for LDL-cholesterol calculation","authors":"Salomón Martín Pérez,&nbsp;Remo Suppi,&nbsp;Teresa Arrobas Velilla,&nbsp;Francisco de Borja Téllez Hernández,&nbsp;Antonio León-Justel","doi":"10.1016/j.artere.2026.500887","DOIUrl":"10.1016/j.artere.2026.500887","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Low-density lipoprotein cholesterol (LDL-C) is a significant cardiovascular risk factor, as direct measurement is expensive and often unavailable in most clinical laboratories. The Friedewald formula (FD), despite its widespread use since 1972, has notable limitations, especially at high triglyceride levels and low LDL-C concentrations. Machine learning (ML) techniques offer promising alternatives for accurate LDL-C estimation, potentially overcoming traditional formula limitations by leveraging complex pattern recognition in lipid profile data.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and methods&lt;/h3&gt;&lt;div&gt;This retrospective study analyzed 34,678 lipid profiles from patients over 18 years attending Hospital Virgen Macarena, Seville (January 2021–December 2022). The study was approved by the Ethics Committee (CEI HVM-VR_03/2024). All lipid parameters (total cholesterol, triglycerides, HDL-C, LDL-C) were measured using Cobas 6000 analyzer. Twenty-two machine learning models were developed using Python's PyCaret library with 80/20 train-test split. Models included Linear Regression, Random Forest, XGBoost, LightGBM, and Gradient Boosting among others. Performance was evaluated using coefficient of determination (&lt;em&gt;R&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt;), mean absolute error (MAE), and root mean square error (RMSE). Four triglyceride subgroups were analyzed: &lt;150, 150–250, 250–400, and &gt;400&lt;!--&gt; &lt;!--&gt;mg/dL.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The dataset comprised 34,678 individuals with mean values: total cholesterol 204.6&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;73.36&lt;!--&gt; &lt;!--&gt;mg/dL, triglycerides 203.95&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;143.94&lt;!--&gt; &lt;!--&gt;mg/dL, HDL-C 51.83&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;18.45&lt;!--&gt; &lt;!--&gt;mg/dL, and LDL-C 120.38&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;62.29&lt;!--&gt; &lt;!--&gt;mg/dL. LightGBM achieved the highest performance (&lt;em&gt;R&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.965, RMSE&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;11.35, MAE&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;7.99), followed by Gradient Boosting (&lt;em&gt;R&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.962, RMSE&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;11.89, MAE&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;7.87) and XGBoost (&lt;em&gt;R&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.958, RMSE&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;12.49, MAE&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;8.3). Traditional formulas showed inferior performance: Martin–Hopkins (&lt;em&gt;R&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.951, RMSE&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;13.82, MAE&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;9.3) and Friedewald (&lt;em&gt;R&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.926, RMSE&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;16.92, MAE&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;11.97). Performance differences were more pronounced at triglyceride levels&lt;!--&gt; &lt;!--&gt;≥&lt;!--&gt; &lt;!--&gt;250&lt;!--&gt; &lt;!--&gt;mg/dL, with ML models maintaining &lt;em&gt;R&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; &lt;!--&gt;&gt;&lt;!--&gt; &lt;!--&gt;0.92 while classical formulas deteriorated significantly, particularly Friedewald (&lt;em&gt;R&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.34) at triglycerides&lt;!--&gt; &lt;!--&gt;&gt;&lt;!--&gt; &lt;!--&gt;400&lt;!--&gt; &lt;!--&gt;mg/dL.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Machine learning models, particularly boosting algorithms (LightG","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"38 5","pages":"Article 500887"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148916331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot study evaluating a clinical decision support tool: “Virtual Lipidologist HTE-DLP 3.0”","authors":"Alberto Zamora,&nbsp;Cristina Soler,&nbsp;Emilio Ortega,&nbsp;Ana Isabel Martín-Urda,&nbsp;Juan Mora,&nbsp;Mari Cruz Almendros,&nbsp;Juan Carlos Sevilla,&nbsp;Alex Vila,&nbsp;Daina Ibarrexte,&nbsp;Rosa María Pérez-Bernalte,&nbsp;Carlos Puig-Jové,&nbsp;Adria Plà,&nbsp;Luis Masana,&nbsp;on behalf of the Sociedad Española de Arteriosclerosis y Sociedad Catalana de Lípidos y Arteriosclerosis","doi":"10.1016/j.artere.2026.500893","DOIUrl":"10.1016/j.artere.2026.500893","url":null,"abstract":"<div><h3>Introduction</h3><div>Clinical decision support systems (CDSS) can improve guideline adherence and reduce variability. HTE-DLP 3.0 (Virtual Lipidologist) provides recommendations based on scientific evidence, safety, and cost-effectiveness criteria.</div></div><div><h3>Methods</h3><div>A proof-of-concept study was conducted using 10 standardised clinical cases evaluated by 9 clinicians before and after the use of the HTE-DLP 3.0. Therapeutic variability was analysed using the Simpson Diversity Index and the kappa coefficient. Usability and user experience were assessed using the CSUQ and QoE questionnaires, together with a qualitative survey on strengths and areas for improvement.</div></div><div><h3>Results</h3><div>Baseline assessment showed very significant interprofessional variability. Uniform adherence to the shared algorithmic recommendation is observed. The CSUQ showed good efficiency scores (6.40) and high satisfaction (5.42/7), with error messages and the availability of clinical support tools identified as areas for improvement. The QoE showed high scores for data security (4.71), clinical usefulness (4.57), and social impact (4.57), with learning time being the lowest-rated aspect (2.85/5).</div></div><div><h3>Conclusions</h3><div>HTE-DLP 3.0 demonstrated the ability to act as a decision standardization tool based on clinical practice guidelines. Further studies in real-world clinical practice will be necessary to evaluate its clinical and cost-effectiveness impact.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"38 5","pages":"Article 500893"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148924183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxidative stress and inflammation link Life's Essential 8 with adverse cardiovascular events in adults with diabetes mellitus: NHANES 2011–2018","authors":"Ronghao Li,&nbsp;Mengfan Li,&nbsp;Xinyi Wang,&nbsp;Zhongyun Zhou","doi":"10.1016/j.artere.2026.500844","DOIUrl":"10.1016/j.artere.2026.500844","url":null,"abstract":"<div><h3>Background</h3><div>The American Heart Association has modified Life's Essential 8 (LE8) as a new algorithm for evaluating cardiovascular health (CVH). However, the relationship between LE8 and cardiovascular disease (CVD) incidence among diabetic patients, and the potential effect of oxidative stress and inflammation within these associations remain to be elucidated.</div></div><div><h3>Methods</h3><div>Three thousand eight hundred twenty-eight diabetic patients were selected from the National Health and Nutrition Examination Survey (NHANES). The weighted logistic regression was employed to examine the association between LE8 with CVD, and the quantitative relationship was investigated with a restricted cubic spline (RCS). Mediation analyses explored the mediating role of oxidative stress and inflammation in the above relationship.</div></div><div><h3>Results</h3><div>In the 3828 diabetic patients, a total of 977 people were diagnosed with CVD, and the LE8 was significantly and linearly negatively associated with CVD incidence. After all covariates were adjusted, the medium CVH group had a 25% lower risk of CVD (OR: 0.75, 95% CI: 0.58, 0.95) than the low CVH group, and the high CVH group had a 66% lower risk (OR: 0.34, 95% CI: 0.12, 0.94). Furthermore, oxidative stress and inflammation explained 11.57% and 10.89% of the connection, respectively (<em>P</em> <!-->&lt;<!--> <!-->0.05).</div></div><div><h3>Conclusion</h3><div>Elevated LE8 is negatively associated with adverse cardiovascular events in diabetes mellitus and the association appeared to be partially mediated through oxidative stress and inflammation pathways. Those results indicate the necessity of maintaining at least moderate cardiovascular health and the LE8 help make lifestyle self-management more targeted for diabetes patients.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"38 4","pages":"Article 500844"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148530391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus of the Spanish Society of Arteriosclerosis and the Spanish Society of Internal Medicine on the Mediterranean Diet and Health: A comprehensive approach beyond nutrients","authors":"Javier Delgado-Lista,&nbsp;Juana Carretero Gómez,&nbsp;Francisco Gómez Delgado,&nbsp;Vicente Pascual,&nbsp;José Luis Díaz,&nbsp;Carlos Guijarro,&nbsp;Juan Pedro-Botet,&nbsp;Antonio Pérez,&nbsp;Ana María Piera Carbonell,&nbsp;Cristina Soler Ferrer,&nbsp;Mercedes Sotos Prieto,&nbsp;Manuel Suarez Tembra,&nbsp;Estefanía Toledo Atucha,&nbsp;Pablo Pérez-Martínez","doi":"10.1016/j.artere.2026.500910","DOIUrl":"10.1016/j.artere.2026.500910","url":null,"abstract":"<div><div>Mediterranean Diet has proven to be one of the most effective dietary patterns for preventing cardiovascular disease and other cardiometabolic outcomes, however, scientific research has historically tended to focus on the composition of foods and their nutrients, neglecting other essential components of this dietary pattern. These non-nutritional factors, including commensality and conviviality, food seasonality and sustainability, culinary practices, and the temporal synchronization of food intake, are integral to the conceptual framework of Mediterranean Diet and were a key criterion for its recognition as an Intangible Cultural Heritage of Humanity. Despite their relevance, their systematic treatment in the scientific literature has been limited.</div><div>This consensus statement reviews and synthesizes recent evidence on these non-nutritional factors, identifying the mechanisms by which they influence adherence to the pattern and biological determinants relevant to vascular health, such as metabolic regulation, low-grade inflammation, and circadian function. Furthermore, highlighting these elements contributes to the implementation and adaptation of MediterraneanDiet in other sociocultural contexts, promoting the adoption of a comprehensive pattern that preserves its conceptual foundations beyond the mere replication of foods, and allows these individuals to access the additional benefits conferred by these non-nutritional factors.</div><div>This holistic approach proposes that the Mediterranean Diet, conceived as a lifestyle pattern, can be coherently adapted to different cultural and geographical realities, thus optimizing its transfer to clinical practice and to strategies for the prevention of arteriosclerosis and its risk factors.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"38 4","pages":"Article 500910"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148530419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atherogenic risk in normal-weight workers: Associations with sociodemographic and healthy lifestyle factors using lipid-based indexes","authors":"Claudia Isabella Tirado Cabrera,&nbsp;Daniel Guzmán Capote,&nbsp;Pedro Juan Tárraga López,&nbsp;Ángel Arturo López-González","doi":"10.1016/j.artere.2026.500871","DOIUrl":"10.1016/j.artere.2026.500871","url":null,"abstract":"<div><h3>Background</h3><div>Atherogenic dyslipidemia is a significant but often underrecognized cardiovascular risk factor in individuals with normal weight. Traditional metrics such as body mass index (BMI) may fail to identify metabolically unhealthy phenotypes. This study aimed to assess the prevalence and sociodemographic and lifestyle determinants of atherogenic risk using lipid-based indices in a large cohort of normal-weight Spanish workers.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted in a sample of 166,008 normal-weight workers (BMI 18.5–24.9<!--> <!-->kg/m²). Four atherogenic risk indices were calculated: TC/HDL-c, LDL/HDL-c, TG/HDL-c, and a composite Dyslipidemia Atherogenic Index (DA). Multivariate logistic regression analyses were performed to assess associations with age, sex, educational level, occupational category (CNAE-11), physical activity (IPAQ), adherence to the Mediterranean diet (MEDAS), smoking, and alcohol consumption.</div></div><div><h3>Results</h3><div>Male sex, older age, low physical activity, and poor adherence to the Mediterranean diet were independently associated with elevated values in all four atherogenic indices. The strongest associations were observed for DA with sedentary lifestyle (OR: 9.15; 95% CI: 8.08–10.23) and poor diet quality (OR: 5.23; 95% CI: 4.39–6.07). Notably, 17–22% of normal-weight workers showed abnormal lipid ratios suggestive of increased cardiometabolic risk.</div></div><div><h3>Conclusions</h3><div>Normal BMI does not guarantee cardiometabolic health. A considerable proportion of normal-weight individuals exhibit lipid profiles consistent with atherogenic dyslipidemia, largely driven by modifiable lifestyle factors. Lipid-based indices are valuable tools for early risk identification in occupational settings and should complement traditional anthropometric screening.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"38 4","pages":"Article 500871"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148530422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}