Postgraduate Medicine最新文献

{"title":"Medical journey of patients with polycystic ovary syndrome and obesity: a cross-sectional survey of patients and primary care physicians.","authors":"Katherine Sherif,&nbsp;Jamie Coborn,&nbsp;Anthony Hoovler,&nbsp;Lisa Gill","doi":"10.1080/00325481.2022.2140511","DOIUrl":"https://doi.org/10.1080/00325481.2022.2140511","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with polycystic ovary syndrome (PCOS) report dissatisfaction with the diagnostic process and are more likely to have overweight or obesity. We wanted to understand the role that primary care physicians (PCPs) play in the diagnosis of PCOS and how they contribute to treatment of patients with PCOS and obesity.</p><p><strong>Methods: </strong>A cross-sectional online survey was completed by 251 patients with PCOS and obesity (BMI ≥30 kg/m²) and 305 healthcare providers (PCPs, obstetricians/gynecologists, reproductive and general endocrinologists). This paper focuses on the 75 PCPs treating patients with PCOS and obesity.</p><p><strong>Results: </strong>In the most common patient journey, we found that most patients with PCOS and obesity (53%) have initial discussions about PCOS symptoms with PCPs. However, less than one quarter of patients receive a PCOS diagnosis (22%) or initial treatment (24%) for PCOS from a PCP. One quarter of patients also reported receiving a misdiagnosis from a PCP prior to their PCOS diagnosis. Compared to other healthcare providers surveyed, PCPs were the least comfortable making a PCOS diagnosis. Compared to PCPs without an obesity management focus, PCPs with an obesity management focus were more likely to diagnose patients themselves (38% vs 62%) and initiate PCOS treatment themselves (42% vs 57%). According to PCPs, difficulty with obesity management (47%) was the top reason that patients with PCOS and obesity stop seeing them for PCOS management.</p><p><strong>Conclusion: </strong>PCPs are often the initial medical touchpoint for patients with PCOS and obesity. However, PCPs play a smaller role in diagnosis and treatment of PCOS. Increasing education on obesity management may encourage PCPs to diagnose and treat more patients with PCOS and offer strategies to help patients with obesity management.</p>","PeriodicalId":20329,"journal":{"name":"Postgraduate Medicine","volume":"135 3","pages":"312-320"},"PeriodicalIF":4.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9216710","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":"Correction.","authors":"","doi":"10.1080/00325481.2020.1854437","DOIUrl":"https://doi.org/10.1080/00325481.2020.1854437","url":null,"abstract":"EVOLUTION, GEOLOGY Correction for “Late Jurassic salamandroid from western Liaoning, China,” by Ke-Qin Gao and Neil H. Shubin, which appeared in issue 15, April 10, 2012, of Proc Natl Acad Sci USA (109:5767– 5772; first published March 12, 2012; 10.1073/pnas.1009828109). The authors note that on page 5772, left column, first full paragraph, lines 17–20 to lines 1–2 of the adjacent right column, “This evidence, in keeping with our previous report of an early cryptobranchid from Inner Mongolia (9), rejects the purported timing of 140Ma for this cladogenetic event (16), but supports a more recent study based on complete mitochondrial genomes for a Middle Jurassic divergence of the Salamandroidea from Cryptobranchoidea (8)” should instead appear as “This evidence, in keeping with our previous report of an early cryptobranchid from Inner Mongolia (9), supports molecular calibrations that imply Middle Jurassic divergence of the Salamandroidea from Cryptobranchoidea (8, 16).”","PeriodicalId":20329,"journal":{"name":"Postgraduate Medicine","volume":"135 3","pages":"321"},"PeriodicalIF":4.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00325481.2020.1854437","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9157240","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":"A practical guide to recognize, assess, treat and evaluate (RATE) primary care patients with chronic pain.","authors":"Kevin B Gebke,&nbsp;Bill McCarberg,&nbsp;Erik Shaw,&nbsp;Dennis C Turk,&nbsp;Wendy L Wright,&nbsp;David Semel","doi":"10.1080/00325481.2021.2017201","DOIUrl":"https://doi.org/10.1080/00325481.2021.2017201","url":null,"abstract":"<p><p>The management of patients with chronic pain is one of the most important issues In medicine and public health. Chronic pain conditions cause substantial suffering for patients, their significant others and society over years and even decades and increases healthcare utilization resources including the cost of medical care, loss of productivity and provision of disability services. Primary care providers are at the frontline in the identification and management of patients with chronic pain, as the majority of patients enter the healthcare system through primary care and are managed by primary care providers. Due to the complexity of chronic pain and the range of issues involved, the accurate diagnosis of the causes of pain and the formulation of effective treatment plans presents significant challenges in the primary care setting. In this review, we use the classification of pain types based on pathophysiology as the template to guide the assessment, treatment, and monitoring of patients with chronic pain conditions. We outline key methods that can be used to efficiently and accurately diagnose the putative pathophysiological mechanisms underlying chronic pain conditions and describe how this information should be used to tailor the treatment plan to meet the patient's needs. We discuss methods to evaluate patients and the impact of treatment plans over a series of consultations, with a particular focus on strategies to improve the patient's ability to self-manage their pain and related symptoms and perform daily functions despite persistent pain. Finally, we introduce the mnemonic RATE (Recognize, Assess, Treat, and Evaluate) as a general strategy that healthcare providers can use to aid their management of patients presenting with chronic pain.</p>","PeriodicalId":20329,"journal":{"name":"Postgraduate Medicine","volume":"135 3","pages":"244-253"},"PeriodicalIF":4.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9159663","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":"Predictive value of arterial blood lactate to serum albumin ratio for in-hospital mortality of patients with community-acquired pneumonia admitted to the Intensive Care Unit.","authors":"Chaoqun Xu,&nbsp;Haoran Liu,&nbsp;Hao Zhang,&nbsp;Jun Zeng,&nbsp;Quan Li,&nbsp;Yang Yi,&nbsp;Nan Li,&nbsp;Ruxin Cheng,&nbsp;Qi Li,&nbsp;Xiangdong Zhou,&nbsp;Chuanzhu Lv","doi":"10.1080/00325481.2022.2110769","DOIUrl":"https://doi.org/10.1080/00325481.2022.2110769","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the predictive value of the arterial blood lactate to serum albumin ratio (LAR) on in-hospital mortality of patients with community-acquired pneumonia (CAP) admitted to the Intensive Care Unit (ICU).</p><p><strong>Methods: </strong>Clinical datasets of 1720 CAP patients admitted to ICU from MIMIC-IV database were retrospectively analyzed. Patients were randomly assigned to the training cohort (n=1204) and the validation cohort (n=516) in a ratio of 7:3. X-tile software was used to find the optimal cut-off value for LAR. The receiver operating curve (ROC) analysis was conducted to compare the performance between LAR and other indicators. Univariate and multivariate Cox regression analyses were applied to select prognostic factors associated with in-hospital mortality. Based on the observed prognostic factors, a nomogram model was created in training cohort, and the validation cohort was utilized to further validate the nomogram.</p><p><strong>Results: </strong>The optimal cut-off value for LAR in CAP patients admitted to ICU was 1.6 (the units of lactate and albumin were, respectively, 'mmol/L' and 'g/dL'). The ROC analysis showed that the discrimination abilities of LAR were superior to other indicators except Sequential Organ Failure Assessment score and Simplified acute physiology score (SAPSII), which had the same abilities. Age, mean arterial pressure, SpO2, heart rate, SAPSII score, neutrophil-to-lymphocyte ratio, and LAR were found to be independent predictors of poor overall survival in the training cohort by multivariate Cox regression analysis and were incorporated into the nomogram for in-hospital mortality as independent factors. The nomogram model, exhibiting medium discrimination, had a C-index of 0.746 (95% CI = 0.715-0.777) in the training cohort and 0.716 (95% CI = 0.667-0.765) in the validation cohort.</p><p><strong>Conclusion: </strong>LAR could predict in-hospital mortality of patients with CAP admitted to ICU independently as a readily accessible biomarker. The nomogram that included LAR with other independent factors performed well in predicting in-hospital mortality.</p>","PeriodicalId":20329,"journal":{"name":"Postgraduate Medicine","volume":"135 3","pages":"273-282"},"PeriodicalIF":4.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9160130","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":"Treatment characteristics among patients with binge-eating disorder: an electronic health records analysis.","authors":"William M Spalding,&nbsp;Monica L Bertoia,&nbsp;Cynthia M Bulik,&nbsp;John D Seeger","doi":"10.1080/00325481.2021.2018255","DOIUrl":"https://doi.org/10.1080/00325481.2021.2018255","url":null,"abstract":"<p><strong>Objectives: </strong>Treatment for adults diagnosed with binge-eating disorder (BED) includes psychotherapy and/or pharmacotherapy and aims to reduce the frequency of binge-eating episodes and disordered eating, improve metabolic-related issues and reduce weight, and address mood symptoms. Data describing real-world treatment patterns are lacking; therefore, this study aims to characterize real-world treatment patterns among patients with BED.</p><p><strong>Methods: </strong>This retrospective study identified adult patients with BED using natural language processing of clinical notes from the Optum electronic health record database from 2009 to 2015. Treatment patterns were examined during the 12 months preceding the BED recognition date and during a follow-up period after BED recognition (1-3 years for most patients).</p><p><strong>Results: </strong>Among 1042 patients, 384 were categorized as the BED cohort and 658, who met less stringent criteria, were categorized as probable BED. In the BED cohort, mean ± SD age was 45.2 ± 13.4 years and 81.8% were women (probable BED, 45.9 ± 12.8 years, 80.2%). A greater percentage of patients in the BED cohort were prescribed pharmacotherapy (70.6% [probable BED, 66.9%]) than received/discussed psychotherapy (53.1% [probable BED, 39.2%]) at baseline. In the BED cohort, 54.4% of patients were prescribed antidepressants (probable BED, 52.4%), 25.3% stimulants (probable BED, 20.1%), and 34.4% nonspecific psychotherapy (probable BED, 24.6%) at baseline, with no substantive differences observed during follow-up. Low percentages of patients in the BED cohort received/discussed cognitive behavioral therapy at baseline (12.5% [probable BED, 9.0%) or during follow-up (13.0% [probable BED, 8.8%). Among patients with ≥1 psychotherapy visit, the mean ± SD number of visits in the BED cohort was 1.2 ± 5.9 at baseline (probable BED, 1.7 ± 7.3) and 2.2 ± 7.7 during follow-up (probable BED, 2.6 ± 7.7).</p><p><strong>Conclusion: </strong>This cohort of patients with BED was treated more frequently with pharmacotherapy than psychotherapy. These data may help inform strategies for reducing differences between real-world treatment patterns and evidence-based recommendations.</p>","PeriodicalId":20329,"journal":{"name":"Postgraduate Medicine","volume":"135 3","pages":"254-264"},"PeriodicalIF":4.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9159657","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":"Ground-glass opacity on emergency department chest X-ray: a risk factor for in-hospital mortality and organ failure in elderly admitted for COVID-19.","authors":"Noel Roig-Marín,&nbsp;Pablo Roig-Rico","doi":"10.1080/00325481.2021.2021741","DOIUrl":"https://doi.org/10.1080/00325481.2021.2021741","url":null,"abstract":"<p><strong>Introduction: </strong>Ground-glass opacity is commonly seen on radiographic imaging tests of patients admitted for COVID-19. The main objective of this study is to determine if the presence of ground-glass opacity on chest X-rays carried out at the Emergency Department correlates with significantly higher mortality. A secondary objective is to clarify which characteristics are associated with those patients who presented ground-glass opacity.</p><p><strong>Methods: </strong>Data were obtained from our 2020 hospital admission records. Consequently, this is a retrospective cohort study. Our cohort consists of 300 admissions from a group of elderly with a mean age of 81.6. There were 49.3% women (148/300) and 50.7% men (152/300).</p><p><strong>Results: </strong>The presence of ground-glass opacity on chest X-rays is a risk factor for in-hospital mortality (RR = 1.6), heart failure (RR = 4.3), respiratory failure (RR = 1.5), acute kidney injury (RR = 1.3) and ICU admission (RR = 2.7).</p><p><strong>Conclusion: </strong>Based on these results, the variable 'finding ground-glass opacity on chest X-rays carried out at the Emergency Department' should be assessed for inclusion in the different calculators that estimate the prognosis/mortality rate of patients admitted for COVID-19.</p>","PeriodicalId":20329,"journal":{"name":"Postgraduate Medicine","volume":"135 3","pages":"265-272"},"PeriodicalIF":4.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9162617","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 nonsteroidal mineralocorticoid receptor antagonists in patients with diabetic kidney disease.","authors":"Edgar Lerma,&nbsp;William B White,&nbsp;George Bakris","doi":"10.1080/00325481.2022.2060598","DOIUrl":"https://doi.org/10.1080/00325481.2022.2060598","url":null,"abstract":"<p><p>Nonsteroidal mineralocorticoid receptor antagonists (MRAs) are a new class of drugs developed to address the medical need for effective and safer treatment to protect the kidney and the heart in patients with diabetic kidney disease (DKD). There are several drugs within this class at varying stages of clinical development. Finerenone is the first nonsteroidal MRA approved in the US for treating patients with chronic kidney disease (CKD) associated with type 2 diabetes (T2D). In clinical studies, finerenone slowed CKD progression without inducing marked antihypertensive effects. Esaxerenone is a nonsteroidal MRA with proven blood pressure-lowering efficacy that is currently licensed in Japan for treating hypertension. There are also three other nonsteroidal MRAs in mid-to-late stages of clinical development. Here we overview evidence addressing pharmacological and clinical differences between the nonsteroidal MRAs and the steroidal MRAs spironolactone and eplerenone. First, we describe a framework that highlights the role of aldosterone-mediated pathological overactivation of the mineralocorticoid receptor and inflammation as important drivers of CKD progression. Second, we discuss the benefits and adverse events profile of steroidal MRAs, the latter of which are often a limiting factor to their use in routine clinical practice. Finally, we show that nonsteroidal MRAs differ from steroidal MRAs based on pharmacology and clinical effects, giving the potential to expand the therapeutic options for patients with DKD. In the recently completed DKD outcome program comprising two randomized clinical trials - FIDELIO-DKD and FIGARO-DKD - and the FIDELITY analysis of both trials evaluating more than 13,000 patients, the nonsteroidal MRA finerenone demonstrated beneficial effects on the kidney and the heart across a broad spectrum of patients with CKD and T2D. The long-term efficacy of finerenone on cardiac and renal morbidity and mortality endpoints, along with the anti-hypertensive efficacy of esaxerenone, widens the scope of available therapies for patients with DKD.</p>","PeriodicalId":20329,"journal":{"name":"Postgraduate Medicine","volume":"135 3","pages":"224-233"},"PeriodicalIF":4.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9170887","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":"CMHC Supplement Abstract","authors":"K. Wilemon, C. Ahmed, M. McGowan, D. Macdougall, J. Knowles, K. Myers","doi":"10.1080/00325481.2023.2187148","DOIUrl":"https://doi.org/10.1080/00325481.2023.2187148","url":null,"abstract":"Purpose: An ICD-10 code for Familial Hyperchole sterolemia (FH), E78.01, became effective October 2016 following a proposal in 2013 to the ICD-10 Coordination and Maintenance Committee by the Family Heart Foundation. The code differentiated FH from other forms of elevated cholesterol, signaling the need for differential diagnosis of a condition in which management in the first two decades of life can substantially reduce the burden of aggressive atherosclerosis. This study aims to characterize the % of FH patients diagnosed with E78.01 in an expansive, real-world US dataset. Method(s): The Family Heart DatabaseTM includes diagnostic/ procedural/prescription data from claims and/or laboratory data for >300 million individuals from the US who were screened or treated for any form of cardiovascular risk. This analysis dataset includes 197 million people, including 22 million children, with diagnostic data from October 2016 through June 2020. The number of total (diagnosed + undiagnosed) FH patients within the dataset was estimated assuming an occurrence of 1:250 individuals. Patients with FH (E78.01) were counted if the diagnostic code was applied for a single in-patient claim or at least twice, >7 days apart, for an out-patient claim. Result(s): The number of patients diagnosed with FH using E78.01 has increased substantially since 2016. During 2017 and 2018, use of the code was brisk and likely included previously and newly diagnosed individuals. Diagnosis was reduced dramatically with the onset of the COVID-19 pandemic corresponding with the marked reduction of in-person clinic visits and near halting of preventive care. By June 2020, 246,689 patients were diagnosed with FH representing 31.3% of the estimated total (diagnosed + undiagnosed) FH population of 787,886 within the dataset. Compared with all individuals in the analysis dataset, those diagnosed with FH were substantially more likely to have atherosclerotic cardiovascular disease (40% versus 8%). Conclusion(s): Prior to 2016, an estimated <1% of patients with FH in the US were diagnosed, but without an ICD code it was impossible to track. The number of patients diagnosed with FH (E78.01) has increased substantially since 2016. Within this large, real-world dataset of Americans, 31.3% of the estimated FH population had been diagnosed as of June 2020. However, despite clear screening guidelines, effective therapies, and classification of FH as a public health threat by the World Health Organization, most of the FH population remains undiagnosed, leaving these genetically vulnerable individuals at high risk for premature cardiovascular disease.","PeriodicalId":20329,"journal":{"name":"Postgraduate Medicine","volume":"135 1","pages":"2 - 24"},"PeriodicalIF":4.2,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42095710","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":"Are bipolar disorder, major depression, and suicidality linked with <i>Toxoplasma gondii</i>? A seromolecular case-control study.","authors":"Ömer Faruk Demirel,&nbsp;Özer Akgül,&nbsp;Ersel Bulu,&nbsp;Ezgi Tanrıöver Aydın,&nbsp;Nuray Uysal Cesur,&nbsp;Cana Aksoy Poyraz,&nbsp;Yaşar Ali Öner","doi":"10.1080/00325481.2023.2176042","DOIUrl":"https://doi.org/10.1080/00325481.2023.2176042","url":null,"abstract":"ABSTRACT Objective The existence of predisposing effects of latent Toxoplasma gondii (T. gondii) infection in bipolar disorder (BD), major depression (MD), and even suicide attempt (SA) has long been debatable. This conjecture remains unclear because there is a lack of evidence regarding how T. gondii manipulates the brain and behavior. Methods We investigated the influence of T. gondii infection on BD and MD patients with or without SA compared to age-, sex-, and province-matched healthy controls (HCs) concurrently with serology and molecular-based evaluations. We prospectively assessed 147 volunteers with BD, 161 with MD, and 310 HCs. Results T. gondii seropositivity rates were 57.1% for BD, 29.2% for MD, 64.8% for SA, and 21.3% for HC. Binary logistic regression analyses revealed that T. gondii positive Immunoglobulin G (IgG) status may be a prominent tendentious agent for BD (OR = 3.52; 95% CI [2.19–5.80]; p < 0.001) and SA (OR = 17.17; 95% CI [8.12–36.28]; p < 0.001), but not for MD (OR = 1.21; 95% CI [0.74–1.99]; p = 0.45). Nevertheless, the T. gondii DNA ratios determined by polymerase chain reaction (PCR) were linked to BD and MD. Conclusion Our findings strongly support the burgeoning interest in the possibility that latent T. gondii infection may be relevant to the etiology of BD and SA, although this connection remains ambiguous.","PeriodicalId":20329,"journal":{"name":"Postgraduate Medicine","volume":"135 2","pages":"179-186"},"PeriodicalIF":4.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9311970","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":"Low serum 25-hydroxyvitamin D levels are associated with increased cardiovascular morbidity and mortality.","authors":"Wei Luo,&nbsp;Dan Xu,&nbsp;Jin Zhang,&nbsp;Yao Zhou,&nbsp;Qin Yang,&nbsp;Qiuju Lv,&nbsp;Zhen Qu","doi":"10.1080/00325481.2022.2161250","DOIUrl":"https://doi.org/10.1080/00325481.2022.2161250","url":null,"abstract":"<p><strong>Background: </strong>There is controversy about the association between vitamin D and cardiovascular disease (CVD). This article aims to explore the association of serum 25-hydroxyvitaminD (25 OHD) with the risk of CVD.</p><p><strong>Methods: </strong>PubMed, EMBASE, Web of Science database, OVID, and Cochrane Library databases (last updated in August 2022) were systematically searched. The relationship between 25OHD and the risk of CVD was assessed by using the 95% confidence intervals (CI) and hazard ratio (HR). The effect model was selected by the size of heterogeneity.</p><p><strong>Results: </strong>The meta-analysis included 40 cohort studies that contained 652352 samples. The pooled results showed that a decreased level of 25OHD was associated with an increased relative risk of total CVD events (HR = 1.35, 95% CI: 1.26-1.43). Furthermore, the results also showed that a decreased circulating 25OHD level was associated with an increased mortality of CVD (HR = 1.43, 95% CI: 1.30-1.57) and incidence of CVD (HR = 1.26, 95% CI: 1.16-1.36), especially an increased risk of heart failure (HF) (HR = 1.38, 95% CI: 1.2-1.6), myocardial infarction (MI) (HR = 1.28, 95% CI: 1.13-1.44) and coronary heart disease (CHD) (HR = 1.28, 95% CI: 1.1-1.49).</p><p><strong>Conclusions: </strong>The current meta-analysis shows that reduced serum 25OHD concentrations is not only associated with increased total cardiovascular events and cardiovascular mortality, but also with increased risk of HF, MI, and CHD.</p><p><strong>Limitations: </strong>The underlying mechanism still needs to be explored further, and well-designed RCTs are needed to confirm the role of vitamin D in the occurrence and development of CVD.</p>","PeriodicalId":20329,"journal":{"name":"Postgraduate Medicine","volume":"135 2","pages":"93-101"},"PeriodicalIF":4.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10767843","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}