Hypertriglyceridemia is associated with decline of estimated glomerular filtration rate and risk of end-stage kidney disease in a real-word Italian cohort: Evidence from the TG-RENAL Study

European Journal of Internal Medicine, Journal Year: 2023, Volume and Issue: 111, P. 90 - 96

Published: March 10, 2023

BackgroundThis analysis investigated the role of hypertriglyceridemia on renal function decline and development end-stage kidney disease (ESKD) in a real-world clinical setting.MethodsA retrospective using administrative databases 3 Italian Local Health Units was performed searching patients with at least one plasma triglyceride (TG) measurement between 2013 June 2020, followed-up until 2021. Outcome measures included reduction estimated glomerular filtration rate (eGFR) ≥30% from baseline ESKD onset. Subjects normal (normal-TG), high (HTG) very TG levels (vHTG) (respectively <150 mg/dL, 150–500 mg/dL >500 mg/dL) were comparatively evaluated.ResultsOverall 45,000 subjects (39,935 normal-TGs, 5,029 HTG 36 vHTG) eGFR 96.0 ± 66.4 mL/min considered. The incidence 27.1 31.1 35.1 per 1000 person-years, normal-TG, vHTG subjects, respectively (P<0.01). 0.7 0.9 normal-TG HTG/vHTG Univariate multivariate analyses revealed that had risk or occurrence (composite endpoint) increased by 48% compared to (adjusted OR:1.485, 95%CI 1.300–1.696; P<0.001). Moreover, each 50 increase resulted significantly greater (OR:1.062, 1.039–1.086 P<0.001) (OR:1.174, 1.070–1.289, P = 0.001).ConclusionsThis real-word large cohort individuals low-to-moderate cardiovascular suggests moderate-to-severe elevation is associated long-term deterioration.

Language: Английский

---

Efficacy and Safety of Lipid-Lowering Drugs of Different Intensity on Clinical Outcomes: A Systematic Review and Network Meta-Analysis

Frontiers in Pharmacology, Journal Year: 2021, Volume and Issue: 12

Published: Oct. 21, 2021

There have been many meta-analyses for statins, ezetimibe and proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) to evaluate clinical outcomes, but the efficacy safety of different intensity these three drugs on outcomes was absent. PCSK9i, ezetimibe, statins were divided into seven interventions as follows: including PCSK9i + high-intensity (P9i+HT), moderate-intensity (P9i+MT), (Eze+HT), (Eze+MT), (HT), (MT), low-intensity (LT). The risk ratios (RR) 95% confidence intervals (CI) calculated in all randomized controlled trials included. In traditional meta-analysis, more intensive treatment had a lower all-cause mortality (RR 0.91, CI 0.88–0.95), cardiovascular 0.89, 0.86–0.92), myocardial infarction 0.79, 0.77–0.81), coronary revascularization 0.80, 0.76-0.84), cerebrovascular events 0.84, 0.80–0.88) compared with less treatment. However, higher new-onset diabetes 1.08, 1.04-1.12). network meta-analysis demonstrated that P9i+HT, P9i+MT, HT, MT significantly associated reduction PLBO. LT could effectively reduce 0.71, 0.54–0.92), MI 0.67, 0.54-0.82), 0.77, 0.65–0.91) P9i+HT superior HT reducing 0.78, 0.68–0.90), 0.73–0.96), 0.64–0.95). PLBO, increase 1.23, 1.11–1.37; RR 1.14–1.33; 1.09, 1.02–1.15, respectively). conclusion, added background may be recommended preferred lipid-lowering therapy, did not additional diabetes. statins. can initial therapy.

Language: Английский

---

Target Deconvolution of Fenofibrate in Nonalcoholic Fatty Liver Disease Using Bioinformatics Analysis

BioMed Research International, Journal Year: 2021, Volume and Issue: 2021, P. 1 - 14

Published: Dec. 26, 2021

Nonalcoholic fatty liver disease (NAFLD) is a prevalent form of damage, affecting ~25% the global population. NAFLD comprises spectrum pathologies, from hepatic steatosis to nonalcoholic steatohepatitis (NASH), and may progress fibrosis cirrhosis. The presence correlates with metabolic disorders such as hyperlipidemia, obesity, blood hypertension, cardiovascular, insulin resistance. Fenofibrate an agonist drug for peroxisome proliferator-activated receptor alpha (PPARα), used principally treatment hyperlipidemia. However, fenofibrate has recently been investigated in clinical trials other diabetes, cardiovascular disease, NAFLD. evidence date indicates that could improve While PPARα considered be main target fenofibrate, exert its effect through impact on genes pathways thereby alleviating, possibly reversing, In this study, using bioinformatics tools gene-drug, gene-diseases databases, we sought explore possible targets, interactions, involved NAFLD.We first determined significant protein interactions STITCH database high confidence (0.7). Next, identified proteins curated targets two including DisGeNET DISEASES determine their association We finally constructed Venn diagram these collections (curated genes-NAFLD fenofibrate-STITCH) uncover primary fenofibrate. Then, Gene Ontology (GO) KEGG were analyzed detect significantly molecular function, biological process, cellular component, pathways. A P value < 0.01 was cut-off criterion. also estimated specificity by investigating them disease-gene associations (STRING) EnrichR (DisGeNET). Finally, verified our findings scientific literature.We collections, one 80 protein-drug 95 associated Using diagram, 11 LEP, SIRT1, ADIPOQ, PPARA, SREBF1, LDLR, GSTP1, VLDLR, SCARB1, MMP1, APOC3 then evaluated Based Ontology, most are lipid metabolism, enrichment showed PPAR signaling pathway, AMPK interrogation those authentic databases they more specific both injury than any diseases databases. three genes, APOC3, robust interaction fenofibrate.Fenofibrate directly or indirectly, via modulation several key pathways,

Language: Английский

---

Cardiovascular prevention in elderly patients.

PubMed, Journal Year: 2022, Volume and Issue: 19(5), P. 377 - 392

Published: May 28, 2022

In recent decades, life expectancy has been increasing significantly. this scenario, health interventions are necessary to improve prognosis and quality of elderly with cardiovascular risk factors disease. However, the number patients included in clinical trials is low, thus current practice guidelines do not include specific recommendations. This document aims review prevention recommendations focused ≥ 75 years high or very risk, regarding objectives, medical treatment options also including physical exercise their inclusion cardiac rehabilitation programs. Also, we will show why geriatric syndromes such as frailty, dependence, cognitive impairment, nutritional status, well comorbidities, ought be considered population important prognostic impact.

Language: Английский

---

The Effects of Statin Therapy on Oxidized LDL and Its Antibodies: A Systematic Review and Meta-Analysis

Oxidative Medicine and Cellular Longevity, Journal Year: 2022, Volume and Issue: 2022, P. 1 - 15

Published: Aug. 1, 2022

Background. Elevated serum low-density lipoproteins (LDL), the substrate for formation of atherogenic oxidized LDLs (oxLDL), are a causal factor atherosclerotic cardiovascular disease (ASCVD). Statins well known to decrease LDL particle concentration and reduce ASCVD morbidity mortality. Objective. To perform meta-analysis effects statins (i.e., type, dose, duration treatment) on levels oxLDL immunoglobulin M (IgM) G (IgG) antibody against oxLDL. Methods. PubMed, Scopus, Embase, Web Science were searched up February 5th, 2021, randomized controlled trials (RCT) evaluating effect anti-oxLDL levels. Meta-analysis was performed using Comprehensive Meta-Analysis (CMA) V2 software. evaluate influence each study overall size, sensitivity analysis leave-one-out method. Evaluation funnel plot, Begg’s rank correlation, Egger’s weighted regression tests used assess presence publication bias in meta-analysis. Results. A total 28 RCTs including 4019 subjects finally included The results indicated significant circulating concentrations after treatment with (SMD: -2.150, 95% CI: -2.640, -1.697, p < 0.001 ). Subgroup found no intensity statin or lipophilicity reduction An additional 3 showed that did not change IgM IgG antibodies Conclusion. Statin therapy decreases but does affect antibodies.

Language: Английский

---