Nutrition Metabolism and Cardiovascular Diseases最新文献

{"title":"Effect of proprotein convertase subtilisin kexin 9 inhibitors on platelet aggregation in patients with and without diabetes.","authors":"Mario Crisci, Federica Ilardi, Rachele Manzo, Felice Gragnano, Roberta Paolillo, Giuseppe Giugliano, Orlando Piro, Emanuele Cigala, Ida Monteforte, Veronica D'Oria, Enzo Venga, Alessandra Marotta, Angela Salvato, Paolo Calabrò, Giovanni Esposito, Emilio Di Lorenzo, Marisa De Feo","doi":"10.1016/j.numecd.2026.104728","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104728","url":null,"abstract":"<p><strong>Background and aim: </strong>The impact of proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors on platelet reactivity in the setting of diabetes mellitus (DM) has not been adequately investigated.</p><p><strong>Methods and results: </strong>Out of 52 outpatients with atherosclerotic cardiovascular disease (ASCVD) with an indication for PCSK9 inhibitor alirocumab, 37 patients (mean age 68.1 ± 5.6 years, 62% males) were included in the study and retrospectively divided into two groups according to the presence of DM (DM+/DM-). A blood sample for platelet function testing was collected at baseline (T0), before initiation of alirocumab, and after 3 months of therapy (T90). Light transmission aggregometry was performed to study platelet aggregation, and results were expressed as percentage of maximum platelet aggregation (MPA). At 90-day follow-up, a significant reduction of total cholesterol and low-density lipoprotein cholesterol levels compared to baseline was observed in both DM+ and DM-groups. At baseline, MPA were comparable between the two groups. At T90, only in the DM + cohort, platelet aggregation induced by adenosine diphosphate (ADP) and arachidonic acid (AA) was significantly reduced compared to baseline (ADP 20 μM: 56.00 ± 28.67% vs 63.16 ± 33.69%, at T90 vs T0 respectively, p = 0.011; AA 1 mM: 28.68 ± 40.10% vs 41.74 ± 46.85%, p = 0.025). No significant change in platelet function from baseline was observed in patients DM- (p > 0.05 for all comparisons).</p><p><strong>Conclusion: </strong>The PCSK9 inhibitor alirocumab significantly reduced AA and ADP residual platelet aggregation after 90 days of therapy in patients with ASCVD and diabetes, but not in those without diabetes.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104728"},"PeriodicalIF":3.7,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The triglyceride and glucose index as a surrogate biomarker for the identification of metabolic syndrome in Mexican Indigenous populations","authors":"Luis E. Simental-Mendía ,&nbsp;Martha Sosa-Macías ,&nbsp;Laura Jazel Barragán-Zúñiga ,&nbsp;Carlos Galaviz-Hernández ,&nbsp;Blanca P. Lazalde-Ramos","doi":"10.1016/j.numecd.2025.104517","DOIUrl":"10.1016/j.numecd.2025.104517","url":null,"abstract":"<div><h3>Background and aims</h3><div>Metabolic syndrome (MetS) includes central obesity, hyperglycemia, insulin resistance, atherogenic dyslipidemia, and hypertension. In Mexico, it also affects Indigenous populations which have difficulties to get opportune diagnostic procedures. Therefore, this study aimed to examine the effectiveness of the TyG index in identifying MetS among different Indigenous groups from Northwest Mexico.</div></div><div><h3>Methods and results</h3><div>A cross-sectional study was conducted on Indigenous and Mestizo populations from Northwest Mexico. Ethnicity was confirmed on each volunteer by evaluation of 15 short tandem repeats loci. Thus, Coras, Huicholes, Mexicaneros, Tarahumaras, Tepehuanos, and Mestizos were included. MetS was diagnosed using the ATP III criteria and the TyG index was calculated as the <em>Ln</em> [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)]/2. ROC curve was used to detect the best cut-off point for MetS identification, area under the curve, sensitivity, and specificity. A total of 472 subjects were enrolled in the study, including Mestizos (n = 48), Coras (n = 73), Huicholes (n = 93), Mexicaneros (n = 74), Tarahumaras (n = 81), and Tepehuanos (n = 103). Adjusted logistic regression analysis revealed that Coras (OR = 3.81; 95 % confidence interval: 1.58–9.16), Huicholes (OR = 2.74; 95 % confidence interval: 1.03–7.31), Mexicaneros (OR = 4.31; 95 % confidence interval: 1.55–11.9), and Tarahumaras (OR = 5.31; 95 % confidence interval: 1.97–14.3) had a direct association with MetS. A cut-off point of 4.66 for the TyG index demonstrated an AUC, sensitivity, and specificity of 0.885, 84 %, and 82 %, respectively, for the detection of MetS in Indigenous populations.</div></div><div><h3>Conclusions</h3><div>The results of our study suggest that the TyG index is a useful tool for detecting MetS in Indigenous populations of Northwest Mexico.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"36 4","pages":"Article 104517"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic impact of metabolic phenotypes in young adults (≤ 35 Years) with premature acute myocardial infarction: A Beijing-based two-center retrospective study","authors":"Jinyan Lei ,&nbsp;Yuansong Zhuang ,&nbsp;Siqi Tang ,&nbsp;Yuxiong Chen ,&nbsp;Yitao Han ,&nbsp;Yakun Zhao ,&nbsp;Yanbo Liu ,&nbsp;Zhongjie Fan","doi":"10.1016/j.numecd.2025.104514","DOIUrl":"10.1016/j.numecd.2025.104514","url":null,"abstract":"<div><h3>Background and aims</h3><div>Obesity and metabolic status are closely associated with cardiovascular outcomes. However, the prognostic value of metabolic phenotypes in patients with premature acute myocardial infarction (PAMI) remains unclear. This study aims to investigate the relationship between metabolic phenotypes and long-term cardiovascular outcomes in PAMI patients.</div></div><div><h3>Methods and results</h3><div>This study included 760 AMI patients aged ≤35 years from two medical centers in Beijing. Participants were categorized into four groups: metabolically healthy non-obese (MHN), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUN), and metabolically unhealthy obese (MUO). The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE). Multivariable Cox regression models, Kaplan-Meier curves and subgroup analyses were used to evaluate the association between metabolic phenotypes and MACCE. During a median follow-up of 77 months, a total of 158 MACCE were recorded. Patients with MUO exhibited a higher risk of MACCE (MHN as reference: HR = 1.87, 95 %CI: 1.18–2.94, <em>p</em> = 0.007; MHO as reference: HR = 1.77, 95 %CI: 1.10–2.83, <em>p</em> = 0.018). Notably, the risk of revascularization was elevated in MUO. The robustness of our study findings was supported by consistent results across subgroup and sensitivity analyses.</div></div><div><h3>Conclusions</h3><div>MUO is associated with adverse outcomes in PAMI patients, suggesting it may serve as an independent predictor of poor prognosis in this population.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"36 4","pages":"Article 104514"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined SGLT2i and GLP1ra therapy reduces all-cause mortality in people with diabetes, with greater benefit in women","authors":"David Garcia-Vega ,&nbsp;Sergio Cinza-Sanjurjo ,&nbsp;Carlos Tilves-Bellas ,&nbsp;Sonia Eiras ,&nbsp;José Ramón González-Juanatey","doi":"10.1016/j.numecd.2025.104483","DOIUrl":"10.1016/j.numecd.2025.104483","url":null,"abstract":"<div><h3>Background and aims</h3><div>Combined therapy, sodium-glucose cotransporter 2 inhibitors (SGLT2i), and glucagon-like peptide-1 receptor agonists (GLP1ra) reduce all-cause mortality in patients with diabetes. We aimed to analyse the differential behaviour of combined therapy between women and men regarding all-cause mortality.</div></div><div><h3>Methods and results</h3><div>This is a retrospective observational cohort study. Using “Big data” according to electronic medical records in the Santiago-Barbanza health area, which covers 450,000 patients. Out of 15,118 patients, 41 % were women. The median follow-up was 33 months. Women were older (71 [62–78] vs. 67 [59–75], p: &lt;0.001) and with a higher incidence of obesity (53 % vs. 41 %, p: &lt;0.001), meanwhile, men presented more coronary artery disease (CAD) (19 % vs. 9 %, p: &lt;0.001). The multinomial propensity score and multivariate Cox regression were used for statistical analysis. All-cause mortality was compared between combined <em>vs.</em> monotherapy in women or men. Men had a higher risk of all-cause mortality than women in this population (HR [95 % CI] 1.50 [1.28–1.75]). Combined regarding monotherapy (GLP1ra (HR [95 % CI] 0.19 [0.14–0.27]), or SGLT2i (HR [95 % CI] 0.30 [0.23–0.40]), and treatment duration (HR [95 % CI] 0.95 [0.94–0.96] were associated with lower risk of all-cause mortality; with higher benefit in women (GLP1ra (HR [95 % CI] 0.14 [0.08–0.27]), or SGLT2i (HR [95 % CI] 0.18 [0.11–0.30]) regarding men (HR [95 % CI] 0.25 [0.16–0.40] for GLP1ra, and HR [95 % CI] 0.41 [0.29–0.58] for SGLT2i).</div></div><div><h3>Conclusions</h3><div>Combined therapy <em>vs.</em> monotherapy was associated with a lower risk of all-cause mortality in patients regardless of sex. Nevertheless, a higher benefit was observed in women regarding men.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"36 4","pages":"Article 104483"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age at type 2 diabetes diagnosis and prevalence of obesity, hypertension, anxiety, and depression: a retrospective observational study","authors":"Mary M. Barker ,&nbsp;Tommy Slater ,&nbsp;Melanie J. Davies ,&nbsp;Jack A. Sargeant ,&nbsp;Jonathan Goldney ,&nbsp;Emma G. Wilmot ,&nbsp;Shivani Misra ,&nbsp;Juliana C.N. Chan ,&nbsp;Edward W. Gregg ,&nbsp;Sharmin Shabnam ,&nbsp;Kamlesh Khunti ,&nbsp;Francesco Zaccardi","doi":"10.1016/j.numecd.2025.104522","DOIUrl":"10.1016/j.numecd.2025.104522","url":null,"abstract":"<div><h3>Background and aims</h3><div>We aimed to investigate associations between age at diagnosis of type 2 diabetes and the relative and absolute risk of four common comorbidities: obesity, hypertension, depression, and anxiety.</div></div><div><h3>Methods and results</h3><div>We used primary and secondary care data from England to conduct a matched cross-sectional study of individuals aged 16–50 years (N = 108,061 with a new diagnosis of type 2 diabetes; 829,946 without type 2 diabetes). Morbidity risk was estimated using multivariable generalised linear models. Adjusted risk ratios (RRs) indicated a higher risk of all studied comorbidities in individuals with vs without type 2 diabetes at all diagnostic ages, with RRs progressively decreasing with older age at diagnosis (from 13.8 at 16–27 years to 5.7 at 48–50 years, for obesity; from 28.9 to 3.2, for hypertension; from 4.4 to 2.5, for depression; and from 4.3 to 2.2, for anxiety). The estimated total number of morbidities among individuals aged 16 years with vs without type 2 diabetes were 85.2 (95 % CI: 83.3–87.0) and 7.1 (95 % CI: 6.9–7.3) per 100 individuals, respectively. Corresponding estimates at 50 years of age were 92.0 (91.3–92.8) and 24.8 (24.6–25.0).</div></div><div><h3>Conclusion</h3><div>The substantially higher burden of MLTCs in young individuals with vs without type 2 diabetes emphasises the need for multidisciplinary patient care and management in individuals diagnosed with type 2 diabetes in early adulthood.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"36 4","pages":"Article 104522"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A critical evaluation of the 2025–2030 Dietary Guidelines for Americans","authors":"Annalisa Giosuè,&nbsp;Marilena Vitale,&nbsp;Gabriele Riccardi","doi":"10.1016/j.numecd.2026.104614","DOIUrl":"10.1016/j.numecd.2026.104614","url":null,"abstract":"<div><h3>Aims</h3><div>To critically evaluate the 2025–2030 Dietary Guidelines for Americans (DGA), a key policy instrument shaping dietary advice in United States and influencing food production, healthcare, and global nutrition policy.</div></div><div><h3>Data synthesis</h3><div>Overall, the DGA remain consistent with previous documents for the recommended consumption of several food groups and limits for saturated fat, added sugars, and sodium. A welcome innovation is the strong emphasis on limiting ultra-processed foods (UPFs) and sugar-sweetened beverages, supported by their association with obesity, type 2 diabetes, and cardiovascular disease. However, several aspects of the Guidelines raise substantial concern. Most prominently, the recommendation to increase protein intake—largely from animal sources—appears unjustified, as it already exceeds requirements in economically developed populations. Moreover, it disregards long-standing evidence on increased cardiometabolic and cancer risk associated with high consumption of red and processed meat. Conversely, the scientific literature strongly supports plant-based dietary patterns, particularly the Mediterranean Diet, for health promotion; this diet has been shown to significantly reduce cardiovascular disease and type 2 diabetes incidence in randomized controlled trials.</div><div>Further scientific inconsistencies include presenting foods rich in saturated fats (butter and beef tallow) as interchangeable with healthier fat sources (olive and seed oils), and proposing an unsubstantiated new food pyramid that downplays cereal consumption, including whole grains, in favor of animal foods. Finally, the DGA completely ignore the environmental impact of dietary choices, despite their 30% contribution to global greenhouse gas emission.</div></div><div><h3>Conclusions</h3><div>Taken together, these Guidelines have more weaknesses than gains compared with those from Scientific Societies and WHO.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"36 4","pages":"Article 104614"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of rate-pressure product variability on new-onset cardiovascular disease and all-cause mortality: A prospective cohort study","authors":"Yixiu Chen ,&nbsp;Junyan Sun ,&nbsp;Zhihui Liu ,&nbsp;Renjie Fu ,&nbsp;Yutong Wu ,&nbsp;Haiyan Zhao ,&nbsp;Liming Lin ,&nbsp;Xiaohong Zhao ,&nbsp;Chenrui Zhu ,&nbsp;Chunyu Ruan ,&nbsp;Changhao Zu ,&nbsp;Kai Cui ,&nbsp;Shuohua Chen ,&nbsp;Hongmin Liu ,&nbsp;Yuntao Wu","doi":"10.1016/j.numecd.2025.104477","DOIUrl":"10.1016/j.numecd.2025.104477","url":null,"abstract":"<div><h3>Background and aim</h3><div>Considering that using systolic blood pressure or heart rate alone cannot comprehensively reflect cardiac workload, we employed the rate-pressure product (RPP) as a risk marker to assess the risks of cardiovascular diseases (CVDs) and all-cause mortality. Furthermore, given that blood pressure and heart rate fluctuations persist throughout life, therefore this study investigated whether lower levels of RPP variability are associated with lower risks of CVDs and all-cause mortality.</div></div><div><h3>Methods and results</h3><div>We analyzed data from 49,792 participants in the Kailuan Study, a prospective cohort of Chinese adults who underwent three consecutive health examinations between 2006 and 2010. RPP variability was calculated using systolic blood pressure and heart rate data, and participants were categorized into tertiles, with the highest tertile serving as the reference. Cox proportional hazards models were used to evaluate associations between RPP variability and the risks of CVDs and all-cause mortality, with additional interaction analyses by age, sex, and average RPP level. Compared to the highest tertile, participants in the second and first tertiles exhibited significantly lower risks of CVDs (hazard ratios [HRs]: 0.924 [95 % CIs: 0.856–0.997] and 0.875 [0.806–0.950], respectively; P &lt; 0.01) and all-cause mortality (HRs: 0.882 [0.822–0.947] and 0.821 [0.760–0.866], respectively; P &lt; 0.01). Subgroup analysis revealed a significant interaction with age and average RPP level. Age and average RPP level modified the association between RPP variability and CVDs risk, suggesting greater cardiovascular benefits of stable RPP profiles in younger individuals and those with lower baseline cardiac workload.</div></div><div><h3>Conclusion</h3><div>Long-term lower RPP variability was independently associated with reduced risks of cardiovascular disease and all-cause mortality, regardless of baseline RPP levels. The association was more pronounced in younger individuals and those with lower average RPP, suggesting potential benefit from targeting RPP variability in early cardiovascular prevention strategies.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"36 4","pages":"Article 104477"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of obesity and other metabolic disorders with COVID-19 mortality: a cross-sectional analysis of death certificates from Veneto (Italy) and Bavaria (Germany)","authors":"Andrea Buschner ,&nbsp;Ugo Fedeli ,&nbsp;Giacomo Zoppini","doi":"10.1016/j.numecd.2025.104524","DOIUrl":"10.1016/j.numecd.2025.104524","url":null,"abstract":"<div><h3>Background and aim</h3><div>The study investigates mortality related to obesity and other metabolic disorders during the pandemic, comparing findings from two large European regions.</div></div><div><h3>Methods and results</h3><div>All death certificates of residents aged 45–84 years in Veneto (Italy) and Bavaria (Germany) were extracted from January 2020 to December 2022. The proportion of deaths reporting obesity, diabetes, and hypertension was computed both for all-cause and for COVID-19 deaths. The prevalence of mention of metabolic disorders was compared between deaths attributed to COVID-19 and all other deaths by means of Odds Ratios (OR) with 95 % Confidence Intervals (CI) estimated by conditional logistic regression stratified by age, sex, and year of death.</div><div>Overall 81,125 deaths in Veneto (8.5 % attributed to COVID-19) and 253,862 in Bavaria (5.9 % from COVID-19) were investigated. At least one metabolic disorder was mentioned in 35.8 % of all COVID-19 deaths in Veneto and 26.7 % in Bavaria. Obesity-related deaths sharply peaked in each epidemic wave in both regions, with a less marked pattern for hypertensive diseases and diabetes. The association with COVID-19 increased with the number of reported metabolic disorders, was stronger among younger ages and in Veneto. Estimated OR for COVID-19 death among decedents aged 45–64 years with two/three vs. no metabolic disorder were 4.24 (CI 3.33–5.40) in Veneto and 2.14 (1.83–2.51) in Bavaria.</div></div><div><h3>Conclusion</h3><div>The strong association between deaths from COVID-19 and number of metabolic disorders among younger ages highlights the need for prioritizing preventive interventions for obesity and associated metabolic conditions.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"36 4","pages":"Article 104524"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between body roundness index and incident stroke with different blood pressure status: A retrospective propensity score matched analysis of the CHARLS study","authors":"Mingni Yang ,&nbsp;Hongwei Liu ,&nbsp;Peng Wei ,&nbsp;Haixia Fan ,&nbsp;Zhijun Wang","doi":"10.1016/j.numecd.2025.104523","DOIUrl":"10.1016/j.numecd.2025.104523","url":null,"abstract":"<div><h3>Background and aim</h3><div>Body roundness index (BRI), an innovative anthropometric measure assessing visceral fat, has demonstrated utility in predicting cardiometabolic risk. However, its association with stroke risk across blood-pressure strata remains unclear.</div></div><div><h3>Methods and results</h3><div>The sample comprised 12,316 CHARLS participants aged ≥45 years without prior stroke. The association between the BRI and incident stroke was evaluated using Cox proportional hazards models. To strengthen the validity of the findings, additional analyses were performed, including propensity score matching (PSM), subgroup analyses, and sensitivity tests. Furthermore, the discriminative capacity of BRI for predicting stroke events was assessed using receiver operating characteristic (ROC) curve analysis.</div><div>Increased stroke risk was significantly connected to a higher BRI. Following PSM, fully adjusted models indicated that a unit rise in log (BRI) was tied to a 19 % increase in stroke risk (HR = 1.79, 95 % CI: 1.37–2.34, P &lt; 0.001). After stratification by blood pressure status, the association between BRI and stroke risk was most pronounced among individuals with prehypertension (HR = 2.60, 95 %CI: 1.49–4.54; P &lt; 0.001) and those with hypertension (HR = 1.65, 95 %CI: 1.17–2.33; P = 0.004). By contrast, among participants with normal blood pressure (NBP), no statistically significant association was observed following PSM. The reliability of the findings was supported by subgroup and sensitivity analyses. The ROC analysis demonstrated that the BRI had moderate predictive accuracy for stroke, notably in individuals with NBP, with an area under the curve of 0.672.</div></div><div><h3>Conclusions</h3><div>Elevated BRI is independently associated with a greater risk of stroke, particularly in individuals with prehypertension or hypertension.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"36 4","pages":"Article 104523"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal relationships of lipid metabolism in diabetic nephropathy risk: A two-sample Mendelian randomization study","authors":"Cui Yu ,&nbsp;Houwen Zhang ,&nbsp;Feizhen Ni ,&nbsp;Lu Jin ,&nbsp;Zhimin Ying ,&nbsp;Huiying Fu ,&nbsp;Qiyang Shou","doi":"10.1016/j.numecd.2025.104528","DOIUrl":"10.1016/j.numecd.2025.104528","url":null,"abstract":"<div><h3>Background and aim</h3><div>Diabetic nephropathy (DN) represents the primary contributor to end-stage renal disease worldwide, and its prevalence continues to grow, even with improvements in therapies aimed at lowering glucose levels. The progression of DN has been associated with lipid metabolism, yet the direct involvement of particular lipid species is still not fully understood. This study employs two-sample Mendelian randomization (TSMR) to investigate the causal effects of 179 plasma lipid species on DN risk.</div></div><div><h3>Methods and results</h3><div>Lipid exposure genetic instruments were sourced from a genome-wide association study (GWAS) found in the GWAS Catalog, whereas data on the DN outcomes were collected from the FinnGen R12 cohort. The main analytical approach employed was inverse-variance weighted (IVW) regression. To evaluate pleiotropy and heterogeneity, tests such as MR-Egger intercept, Cochran's Q, MR-PRESSO, and leave-one-out analyses were performed. The analysis identified 13 lipid species with significant associations after sensitivity analyses. Among these, seven lipid species were risk factors for DN, including phosphatidylcholine (PC) (O-16:1_18:1, 15:0_18:2, 18:1_18:1, 18:1_20:2, 18:2_18:2) levels, phosphatidylethanolamine (PE) (18:1_18:1), and triacylglycerol (TAG) (56:4). Conversely, six lipid species demonstrated protective effects, including lysophosphatidylcholine (LPC) (20:4), lysophosphatidylethanolamine (LPE) (18:1), PC (17:0_20:4), sterol ester (SE) (27:1/15:0, 27:1/18:3), and TAG (52:6).</div></div><div><h3>Conclusions</h3><div>This study provides robust genetic evidence linking specific lipid species to DN risk. PC and PE species were identified as risk factors, whereas LPC, LPE, and SE exhibited protective effects. Additionally, TAG species demonstrated a bidirectional influence. These findings refine the understanding of lipid-mediated renal dysfunction in DN, highlighting lipid metabolism as a potential therapeutic target.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"36 4","pages":"Article 104528"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}