Current Medical Research and Opinion最新文献

{"title":"Prevalence of health conditions associated with higher risk for severe respiratory syncytial virus, influenza, or COVID-19.","authors":"Abby Hitchens, Sean D Candrilli, Justin Carrico, Katherine A Hicks, Eleanor Wilson, Darshan Mehta, Catherine A Panozzo, Parinaz Ghaswalla","doi":"10.1080/03007995.2025.2535456","DOIUrl":"10.1080/03007995.2025.2535456","url":null,"abstract":"<p><strong>Objective: </strong>Respiratory syncytial virus (RSV), influenza virus, and SARS-CoV-2 cause significant morbidity and mortality. Understanding the prevalence of underlying conditions associated with higher risk for severe RSV, influenza, or COVID-19, and demographic trends in multi-morbidity prevalence, may help inform effective interventional strategies against these respiratory infections in high-risk populations.</p><p><strong>Methods: </strong>This study analyzed data from the National Health and Nutrition Examination Survey (NHANES) database (2017-2018) from a representative sample of US adults (≥20 years).</p><p><strong>Results: </strong>Of 239 million surveyed adults, 44.5% had ≥1 underlying condition associated with higher risk of severe RSV, influenza, or COVID-19; this proportion increased to 72.2% of adults if 2 additional underlying conditions were also considered (hypertension and smoking; both associated risk factors for severe COVID-19). Among older adults (≥60 years), the majority had ≥1 underlying condition associated with higher risk for severe RSV, influenza, or COVID-19. Across different racial/ethnic groups, overall prevalence of ≥2 conditions was highest among individuals of Other Race (including multiracial) at 19.5%, followed by non-Hispanic Black (18.9%), non-Hispanic White (18.5%), Mexican-American/Other Hispanic (10.3%), and non-Hispanic Asian individuals (7.7%). Notably, non-Hispanic Black individuals had a higher prevalence of ≥1 underlying condition compared with other race/ethnicity groups across all age groups <75 years.</p><p><strong>Conclusions: </strong>These findings indicate increased prevalence of underlying health conditions associated with higher risk of severe RSV, influenza, or COVID-19 among older adults (≥60 years) and disproportionate prevalence among younger non-Hispanic Black individuals. Understanding racial and ethnic disparities in multi-morbidity prevalence of underlying conditions can inform public health interventions that target these respiratory viruses.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1353-1361"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of patient-reported outcome measures for platysma prominence.","authors":"Julia K Garcia, Rene M Hopfinger, Catherine Foley, Julie Whyte, Martha Gauthier, Brandon Foster, Vaishali Patel","doi":"10.1080/03007995.2025.2537898","DOIUrl":"10.1080/03007995.2025.2537898","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Platysma prominence (PP) is characterized by vertical bands along the length of the neck and blunting of the jawline, impacting aesthetic appearance. No validated patient-reported outcome (PRO) measures are available to assess patient experiences specific to PP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Develop and validate fit-for-purpose PRO measures that capture patient experiences with PP and treatment outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;PRO measures were developed and validated in alignment with the FDA's patient-focused drug development guidance. Three interviews (concept elicitation [CE], &lt;i&gt;N&lt;/i&gt; = 30; cognitive debriefing [CD] round 1, &lt;i&gt;N&lt;/i&gt; = 20; round 2, &lt;i&gt;N&lt;/i&gt; = 5) were conducted with treatment-naive and previously treated adults with PP. Instruments were drafted based on concepts emerging from CE interviews. Psychometric testing for reliability and validity was conducted using phase 2 PP treatment study (ClinicalTrials.gov; NCT03915067) data (&lt;i&gt;N&lt;/i&gt; = 164). While there were no available gold standard measures, convergent and known-groups validity were assessed using multiple FACE-Q modules, the Participant Global Impression of Severity (PGIS)-Jawline, and the Participant Global Impression of Treatment Satisfaction (PGI-TS). The 2-way random intraclass correlation coefficient ICC(2,1) and R&lt;sub&gt;λ&lt;/sub&gt; were calculated to evaluate test-retest reliability. Values of ≥0.70 were considered success for both the ICC(2,1) and R&lt;sub&gt;λ&lt;/sub&gt;. Spearman correlations (ρ) between scores from draft instruments and co-validators were used to assess convergent validity (|ρ|≥0.40). Additionally, internal consistency reliability was examined for multi-item measures where Cronbach's α ≥ 0.70 was considered success.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;\"Bands\" or a variation (e.g., cords, ridges, lines) were the most common terms used to describe PP, reported by 50% of participants. The most frequently reported psychosocial impacts were looking older than desired (&lt;i&gt;n&lt;/i&gt; = 28, 93.3%), feeling self-conscious (&lt;i&gt;n&lt;/i&gt; = 24, 80.0%), feeling less attractive (&lt;i&gt;n&lt;/i&gt; = 20, 66.7%), and looking less attractive and dressing differently (both: &lt;i&gt;n&lt;/i&gt; = 19, 63.3%). Reduced platysma band prominence was the most cited change that would increase satisfaction (&lt;i&gt;n&lt;/i&gt; = 15, 50.0%). Following CE interviews, 3 PRO measures were drafted: Appearance of Neck and Lower Face Questionnaire (ANLFQ): Impacts, ANLFQ: Satisfaction (Baseline/Follow-up), and the Bother Assessment Scale-Platysma Prominence (BAS-PP). CD interviews indicated that participants found the questionnaires understandable and relevant. In psychometric testing, established criteria for reliability and validity were predominantly met, with some exceptions. Three correlations were under the 0.40 threshold, and while these correlations were all in the expected direction, their smaller magnitudes were not unexpected given the restricted conceptual alignment between the PP PR","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1277-1290"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of intranasal dexmedetomidine on perioperative comfort evaluated using the General Comfort Questionnaire.","authors":"Jian Zheng, Fu-Qiang Chen, Yan Yang, Kang Wang, Jun Wang, Hai-Rong Gong","doi":"10.1080/03007995.2025.2545512","DOIUrl":"10.1080/03007995.2025.2545512","url":null,"abstract":"<p><strong>Objectives: </strong>Impaired clinical comfort has been shown to compromise in-hospital care quality and patient safety metrics. Therefore, optimizing perioperative comfort through evidence-based multimodal interventions has emerged as a paramount clinical priority in contemporary surgical and anesthesia practice. This study aimed to investigate the effects of intranasal administration of dexmedetomidine hydrochloride on comfort improvement in patients who underwent neuraxial anesthesia or nerve block anesthesia and to explore the risk factors for discomfort.</p><p><strong>Methods: </strong>We retrospectively analyzed cohort data from 350 patients who underwent neuraxial anesthesia or nerve block anesthesia at Xuzhou Renci Hospital between January and September 2024. The patients were divided into a control group and a dexmedetomidine group on the basis of whether intranasal administration of dexmedetomidine hydrochloride was used. The primary endpoint was the General Comfort Questionnaire (GCQ) score after surgery. The secondary endpoints included the VAS score, the Pittsburgh Sleep Quality Index (PSQI) score, and changes in blood pressure and heart rate. A multivariable logistic regression model was used to screen for risk factors associated with discomfort.</p><p><strong>Results: </strong>In this study, 200 patients underwent conventional anesthesia, and the remaining 150 patients were first administered dexmedetomidine hydrochloride intranasally before anesthesia induction. At various time points after surgery, the GCQ scores of patients in the dexmedetomidine group were consistently higher than those of patients in the control group (<i>p</i> < 0.001). The mean arterial blood pressure, heart rate, PSQI score, and VAS score were lower in the dexmedetomidine group than in the control group (<i>p</i> < 0.001). In the multivariable analysis, intervention (OR, 0.01; 95% CI, 0.00-0.05), age (OR, 1.17; 95% CI, 1.11-1.24), male sex (OR, 0.62; 95% CI, 0.41-0.95), sleep quality (OR, 1.57; 95% CI, 1.38-1.79) and pain catastrophizing scale score (OR, 1.08; 95% CI, 1.02-1.14) were independently associated with the GCQ score.</p><p><strong>Conclusions: </strong>These findings indicate that intranasal administration of dexmedetomidine hydrochloride significantly enhanced patient comfort, as evidenced by elevated GCQ scores, reduced VAS scores, and significantly improved postoperative sleep quality. Age, sex, sleep quality and pain catastrophizing scale scores were found to be independent factors for discomfort.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1135-1147"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health care provider- and patient-reported outcomes for bictegravir/emtricitabine/tenofovir alafenamide versus other antiretroviral regimens: an observational survey in the United States (July 2021-March 2022).","authors":"Amy Colson, Megan Chen, Fritha Hennessy, Joshua Gruber, Woodie Zachry, Seojin Park, Tim Holbrook","doi":"10.1080/03007995.2025.2517692","DOIUrl":"10.1080/03007995.2025.2517692","url":null,"abstract":"<p><strong>Objective: </strong>This study compared outcomes reported by health care providers (HCPs) and people with HIV (PWH) for individuals prescribed bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) versus other antiretroviral therapy (ART) regimens.</p><p><strong>Methods: </strong>Data were from the Adelphi Real World HIV Disease Specific Programme, an observational, cross-sectional survey of HCPs and PWH conducted from July 2021-March 2022 in the United States. PWH were aged ≥18 years with confirmed HIV and a current ART prescription. Outcomes included HCP- and PWH-reported adherence, treatment satisfaction, quality of life (QoL), and health care resource utilization (HCRU). Subgroups for the primary analysis were based on ART regimen. Comparisons between subgroups were performed using appropriate statistical tests.</p><p><strong>Results: </strong>Sixty HCPs provided data for 600 PWH, and 249 PWH reported their experiences. Overall, 264 PWH were prescribed B/F/TAF, 281 were prescribed other single-tablet regimens or a long-acting injectable (STRs/LAI), and 55 were prescribed a multi-tablet regimen. Common HCP-reported reasons for choice of ART were viral potency and tolerability. High treatment satisfaction was reported for B/F/TAF by HCPs (61% \"very satisfied\" with B/F/TAF vs 53% with other STRs/LAI; <i>p</i> = 0.0223) and PWH (57% vs 52%, respectively; <i>p</i> = 0.3170). PWH receiving B/F/TAF reported significantly higher QoL and lower activity impairment versus PWH receiving other STRs/LAI. Adherence rates and HCRU were generally similar between groups.</p><p><strong>Conclusion: </strong>Positive HCP- and PWH-reported outcomes were seen across ART regimens. However, differences observed, including HCP-reported treatment satisfaction and PWH-reported QoL, favored B/F/TAF compared with other STRs/LAI. Findings support continued use of B/F/TAF for HIV treatment in the United States.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1319-1331"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of educational intervention to promote blood pressure control amongst hypertensive patients in a rural area of Delhi, India.","authors":"Anubhav Mondal, Richa Kapoor","doi":"10.1080/03007995.2025.2536603","DOIUrl":"10.1080/03007995.2025.2536603","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension is a major cause of cardiovascular disease, with suboptimal control in low-income settings. In India, only 22.5% had controlled blood pressure (2016-2020). Educational technologies enhance adherence to treatment and lifestyle changes. This study evaluated an educational intervention's effectiveness in improving blood pressure control in rural Delhi.</p><p><strong>Materials and methods: </strong>A quasi-experimental study at Rural Health and Training Centre, Najafgarh, Delhi, assessed hypertensive patients in the Non-Communicable Disease Clinic. The intervention included flipchart counselling, weekly voice messages, and text reminders on self-care and adherence. Participants over 30 years had blood pressure, weight, and height measured at baseline and follow-ups (2, 4, 6 months). Data analysis used validated scales and SPSS 21.0.</p><p><strong>Results: </strong>A total of 110 participants were enrolled, with 102 completing the study. At baseline, the mean systolic blood pressure (SBP) was 151.1 mmHg and diastolic blood pressure (DBP) was 87.5 mmHg. SBP decreased significantly over the follow-ups, from 151.1 mmHg to 138.3 mmHg (<i>p</i> < 0.001), and DBP decreased from 87.5 mmHg to 82.8 mmHg (<i>p</i> < 0.001). The proportion of participants with controlled blood pressure increased from 14.7% at baseline to 52.9% at 6 months (<i>p</i> < 0.001). Further, weight loss was associated with improved blood pressure control.</p><p><strong>Conclusion: </strong>The educational intervention effectively improved blood pressure control among hypertensive patients in a rural setting. The study highlights the importance of lifestyle modifications, particularly weight management, in controlling hypertension. This approach could be upscaled to enhance hypertension management and also can be used in resource limited settings.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1165-1171"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient preferences for food allergy treatments in the United States: a discrete choice experiment.","authors":"Alexis T Mickle, Christopher M Warren, Arpamas Seetasith, Karissa M Johnston, Jessica S Dunne, Stacey Kowal, Andrea Bever, Stella Ko, Vincent Garmo, Sachin Gupta, Andrew Lloyd, Christina E Ciaccio","doi":"10.1080/03007995.2025.2544596","DOIUrl":"10.1080/03007995.2025.2544596","url":null,"abstract":"<p><strong>Objective: </strong>To estimate preferences of adolescents and caregivers of children with food allergies (FA) for food allergy for attributes for treatments intended to prevent exposure-induced severe reactions and to examine how these vary by clinical and demographic factors.</p><p><strong>Methods: </strong>A discrete choice experiment (DCE) was conducted between May and June 2024 among US-resident individuals, aged 13-17 years or caregivers of a child with FA aged ≤12 years, self-reporting physician-diagnosed FA. The survey comprised treatment-attribute focused DCE choice sets; the Intolerance of Uncertainty-12 Scale (IUS-12); the Food Allergy Independent Measure (FAIM); and clinical/demographic questions. Conditional logistic regression analyses were conducted overall and among subgroups and presented as odds ratios (ORs) with 95% confidence intervals (CIs). Relative importance of attributes was also calculated.</p><p><strong>Results: </strong>Participants were adolescents (<i>n</i> = 73, mean age 15.9 years) and caregivers (<i>n</i> = 228, mean age 37.1 years). Overall, treatment attributes associated with statistically significant odds for preferring a treatment included a 95% relative reduction in moderate-to-severe allergic reaction risk <i>versus</i> no reduction (<i>p</i> < 0.001); oral administration over subcutaneous (<i>p</i> < 0.001); administration in a home <i>versus</i> clinical setting (<i>p</i> < 0.05); less frequent <i>versus</i> daily administration (every two weeks: <i>p</i> < 0.001; every four weeks: <i>p</i> < 0.001). Respondents were disinclined to prefer treatment attributes when the risk of gastrointestinal symptoms (<i>p</i> < 0.001) or anaphylaxis (<i>p</i> < 0.001) increased. Efficacy (75% decrease in relative risk of a moderate-to-severe allergic reaction) was the top ranked attribute [OR = 1.61 (1.49, 1.75)].</p><p><strong>Conclusion: </strong>Overall, respondents indicated significant preferences for more efficacious, safer, and convenient (oral, at-home, and less frequent) treatments. Treatment efficacy was the most highly ranked treatment feature.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1303-1318"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choosing the right calcium channel blocker for patients with hypertension and proteinuric chronic kidney disease.","authors":"Paolo Lido, Luca Di Lullo, Marco Infante, Camillo Ricordi, Stefano Rezk, Daniele Romanello, Gabriele D'Urso, Maria Josè Ceravolo, David Della-Morte, Manfredi Tesauro, Annalisa Noce","doi":"10.1080/03007995.2025.2544594","DOIUrl":"10.1080/03007995.2025.2544594","url":null,"abstract":"<p><p>Arterial hypertension and diabetes mellitus represent major modifiable risk factors for the occurrence of cardiovascular disease, development of chronic kidney disease (CKD) and progression of CKD to end-stage renal disease (ESRD). In view of the rising burden of hypertension, diabetes mellitus and CKD on a global scale, there is currently a great need for drugs that can effectively prevent the onset and reverse or slow down the progression of CKD in diverse patient populations. Over the last decades, a growing body of evidence has demonstrated that calcium channel blockers (CCBs) can exert cardioprotective and nephroprotective actions. In the present narrative review, we aimed to specifically describe the cardiorenal protective effects of dihydropyridine CCBs (particularly lercanidipine and manidipine, based on the available evidence) and non-dihydropyridine CCBs (verapamil and diltiazem). With regard to this research topic, we also reviewed the 2023 European Society of Hypertension (ESH) Guidelines for the management of arterial hypertension [endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA)] and the 2023 European Society of Cardiology (ESC) Guidelines for the management of cardiomyopathies. Finally, we proposed practical criteria for prescribing the most appropriate CCB (among dihydropyridine CCBs and non-dihydropyridine CCBs) for patients with hypertension and proteinuric CKD (with or without diabetes) in different clinical settings.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1333-1351"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The epidemiology, clinical characteristics, and burden of heart failure with or without obesity in US patients.","authors":"Yiqiao Zhang, Zhenxiang Zhao, Sonia Kim, Anthony N Fabricatore, Prashanth Iyer","doi":"10.1080/03007995.2025.2535464","DOIUrl":"10.1080/03007995.2025.2535464","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the prevalence of heart failure (HF), including HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF), among patients with obesity, and the prevalence of obesity in patients with these HF subgroups between 2019 and 2023. Additionally, it sought to describe the clinical burden, comorbidities, and medication used across five distinct patient subgroups.</p><p><strong>Methods: </strong>A non-interventional retrospective study using Komodo Healthcare Map data was conducted. Patients were categorized into five subgroups: HFpEF with obesity, HFpEF without obesity, HFrEF with obesity, HFrEF without obesity, and obesity without HF. Annual and overall prevalence rates were calculated, and clinical characteristics, comorbidities, and concomitant medication use were analyzed across subgroups.</p><p><strong>Results: </strong>A total of 44,574,028 patients were included in the study. HF prevalence in obesity was 852.84 per 10,000. Obesity prevalence among HF patients was 6872.29 per 10,000, with a particularly high rate among those with HFpEF. Patients with obesity and HF were younger and had elevated rates of hypertension, dyslipidemia, type 2 diabetes, obstructive sleep apnea, and chronic kidney disease. Compared to HF patients without obesity, those with obesity had significantly greater use of antihypertensives, lipid-lowering agents, and antidiabetics. Adjusted analyses showed significantly higher odds of multiple comorbidities and medication use in patients with obesity and HF compared to non-obese or non-HF subgroups.</p><p><strong>Conclusion: </strong>Obesity is common in HF, especially HFpEF, and associated with greater clinical and medication burdens, underscoring the need for targeted strategies to manage both conditions and reduce associated complications.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1149-1163"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-specific clinical and inflammatory predictors of insulin resistance in individuals living with obesity: a retrospective analysis of 1,457 adults.","authors":"Sami Bahçebaşı, Banu Açmaz, Erdem Aydın, İfakat İrem Biçer, Şeyma Yıldız","doi":"10.1080/03007995.2025.2545489","DOIUrl":"10.1080/03007995.2025.2545489","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance (IR) is a key metabolic abnormality associated with obesity and can precede type 2 diabetes. Although HOMA-IR is commonly used, simpler clinical markers are needed to identify IR, especially in resource-limited settings. This study aimed to evaluate the predictive value of anthropometric, biochemical, and hematological inflammation markers for insulin resistance in people living with obesity.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 1,457 adults, categorized into five groups based on BMI, HOMA-IR, and HbA1c levels: healthy controls, people living with obesity without insulin resistance, people living with obesity with insulin resistance, people living with obesity with prediabetes, and people living with obesity with diabetes.</p><p><p>To eliminate the confounding effect of BMI, subgroup analyses were performed based on obesity class (stage 1: BMI 30-35, stage 2: 35-40, stage 3: ≥40).</p><p><strong>Results: </strong>BMI, waist circumference/height ratio (WC/Ht), and fasting glucose levels were significantly higher in the people living with obesity with insulin resistance group compared to the non-IR group (<i>p</i> < 0.001). In women, additional markers-including waist circumference, triglycerides, HDL, TG/HDL ratio, ALT, CRP, WBC, systemic inflammatory response index (SIRI), and monocyte/HDL ratio (MHR)-showed significant predictive value for IR. In men, no significant differences were observed in these inflammatory or lipid-related markers across obesity subgroups.</p><p><strong>Conclusion: </strong>BMI, WC/Ht ratio, and glucose levels are useful predictors of insulin resistance in both sexes. In women living with obesity, specific biochemical and inflammatory markers such as TG/HDL, and WBC enhance predictive accuracy.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1197-1206"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of cardiovascular and imaging biomarkers to identify index patients with familial hypercholesterolaemia.","authors":"Wiaam Al Hasani, Christopher N Floyd, Cheryl Walsh, Shu C Michael Yau, Soundrie T Padayachee, Zofia McMahon, Radha Ramachandran, Martin A Crook, Anthony S Wierzbicki","doi":"10.1080/03007995.2025.2536607","DOIUrl":"10.1080/03007995.2025.2536607","url":null,"abstract":"<p><strong>Objective: </strong>To determine the utility of secondary stratification measures in ascertainment of index cases for monogenic familial hypercholesterolaemia (FH).</p><p><strong>Methods: </strong>Referrals from primary care were screened by methods for the potential diagnosis of FH, including Simon Broome (SB) or Dutch Lipid Clinic Network score (DLCN) criteria, initial LDL-C, lipoprotein (a) (Lp(a)) > 125 nM, troponin-T (hsTnT), imaging using carotid intima-media thickness and plaque assessment and a single nucleotide polymorphism (SNP) polygenic hypercholesterolaemia panel (12 loci).</p><p><strong>Results: </strong>The population comprised 793 patients aged 55 ± 17 years, of whom 3% had tendon xanthomata, 7% coronary artery disease, and with pre-treatment LDL-C 5.84 ± 1.47 mmol/L. Genotyping was performed in 793 patients and 36% had monogenic FH. Dutch lipid score assessment was associated with a positive likelihood ratio (PLR) for FH 3.91 with a net reclassification index (NRI) of 8% while addition of negative modification for triglycerides (Welsh lipid score) had a PLR 6.88 (NRI 30%). In the whole cohort, the SNP12 score had a negative LR (NLR) of 1.32 (NRI -16%) above the 75^th centile while Lp(a) > 125nmol/L had a NLR of 1.18 (NRI -29%) and raised hsTnT a PLR of 1.08 (NRI -16%). In a non-pre-stratified primary care cohort (<i>n</i> = 236), imaging had a PLR 1.70 (NRI 14%) for identifying patients with FH.</p><p><strong>Conclusions: </strong>A clinical algorithm based on Welsh Lipid score criteria modifying DLCN score for triglycerides allied with stratification for the presence of tendon xanthomata, highly elevated LDL-C (>7 mmol/L) or positive imaging provides an efficient system to raise the yield of diagnosis of FH with a low chance of missing cases.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1173-1183"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}