Abstract Background Insulin resistance (IR) has been confirmed that getting involved in the pathophysiological process of cardiovascular diseases (CVD). Recently, increasing evidence suggests metabolic score for insulin resistance (METS-IR), triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, triglyceride and glucose (TyG) index, triglyceride glucose-body mass (TyG-BMI) index are simple and reliable surrogates for IR. However, their abilities in predicting cardiovascular outcomes in patients undergoing percutaneous coronary intervention (PCI) are not well explored. Therefore, this study aimed to investigate the association and evaluate the predictive performance of each index. Methods A total of 2533 consecutive participants undergoing PCI were included in this study, and the data from 1461 patients were used to determine the correlation of these non-insulin-based IR indices with major adverse cardiac and cerebrovascular events (MACCEs) via performing the multivariate logistic models and restricted cubic splines (RCS). Results During a median of 29.8 months follow-up, 195 cases of 1461 patients experienced incident MACCEs. In the overall population, both univariate and multivariate logistic regression analyses indicated no statistically significant connection between these IR indices and MACCEs. Subgroup analyses revealed significant interactions between age subgroups and TyG-BMI index, as well as METS-IR, and between sex subgroups and TyG index. In elderly patients, per 1.0-SD increment in TyG-BMI index and METS-IR had a significant association with MACCEs, with odds ratios (ORs) [95% confidence interval (CI)] of 1.24 (1.02–1.50) and 1.27 (1.04–1.56), respectively (both P &lt; 0.05). Moreover, in female patients, all the IR indices showed significant associations with MACCEs. Multivariable-adjusted RCS curves demonstrated a linear relationship between METS-IR and MACCEs in elderly and female patients, respectively. However, all the IR indices failed to enhance the predictive performance of the basic risk model for MACCEs. Conclusion All the four IR indices showed a significant association with MACCEs in female individuals, whereas only TyG-BMI index and METS-IR showed associations in elderly patients. Although the inclusion of these IR indices did not improve the predictive power of basic risk model in either female or elderly patients, METS-IR appears to be the most promising index for secondary prevention of MACCEs and risk stratification in patients undergoing PCI. 

/pdf/association-between-non-insulin-based-insulin-resistance-255cuz8e.pdf

Association between non-insulin-based insulin resistance indices and cardiovascular events in patients undergoing percutaneous coronary intervention: a retrospective study

Abstract Background Recent studies have suggested that insulin resistance (IR) contributes to the development of cardiovascular diseases (CVD), and the estimated glucose disposal rate (eGDR) is considered to be a reliable surrogate marker of IR. However, most existing evidence stems from studies involving diabetic patients, potentially overstating the effects of eGDR on CVD. Therefore, the primary objective of this study is to examine the relationship of eGDR with incidence of CVD in non-diabetic participants. Method The current analysis included individuals from the China Health and Retirement Longitudinal Study (CHARLS) who were free of CVD and diabetes mellitus but had complete data on eGDR at baseline. The formula for calculating eGDR was as follows: eGDR (mg/kg/min) = 21.158 − (0.09 × WC) − (3.407 × hypertension) − (0.551 × HbA1c) [WC (cm), hypertension (yes = 1/no = 0), and HbA1c (%)]. The individuals were categorized into four subgroups according to the quartiles (Q) of eGDR. Crude incidence rate and hazard ratios (HRs) with 95% confidence intervals (CIs) were computed to investigate the association between eGDR and incident CVD, with the lowest quartile of eGDR (indicating the highest grade of insulin resistance) serving as the reference. Additionally, the multivariate adjusted restricted cubic spine (RCS) was employed to examine the dose–response relationship. Results We included 5512 participants in this study, with a mean age of 58.2 ± 8.8 years, and 54.1% were female. Over a median follow-up duration of 79.4 months, 1213 incident CVD cases, including 927 heart disease and 391 stroke, were recorded. The RCS curves demonstrated a significant and linear relationship between eGDR and all outcomes (all P for non-linearity &gt; 0.05). After multivariate adjustment, the lower eGDR levels were founded to be significantly associated with a higher risk of CVD. Compared with participants with Q1 of eGDR, the HRs (95% CIs) for those with Q2 − 4 were 0.88 (0.76 − 1.02), 0.69 (0.58 − 0.82), and 0.66 (0.56 − 0.79). When assessed as a continuous variable, per 1.0-SD increase in eGDR was associated a 17% (HR: 0.83, 95% CI: 0.78 − 0.89) lower risk of CVD, with the subgroup analyses indicating that smoking status modified the association ( P for interaction = 0.012). Moreover, the mediation analysis revealed that obesity partly mediated the association. Additionally, incorporating eGDR into the basic model considerably improve the predictive ability for CVD. Conclusion A lower level of eGDR was found to be associated with increased risk of incident CVD among non-diabetic participants. This suggests that eGDR may serve as a promising and preferable predictor and intervention target for CVD. 

pdf/insulin-resistance-assessed-by-estimated-glucose-disposal-1k8t0w3dqa.pdf

Insulin resistance assessed by estimated glucose disposal rate and risk of incident cardiovascular diseases among individuals without diabetes: findings from a nationwide, population based, prospective cohort study

Association between household air pollution from solid fuel use and risk of chronic diseases and their multimorbidity among Chinese adults

BACKGROUND
Given the increasing burden of chronic conditions, multimorbidity is now a priority for public health systems worldwide. However, the relationship between household air pollution (HAP) exposure with multimorbidity remains unclear.


METHODS
We used three waves data (2011, 2013, and 2015) including 19,295 participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study, to investigate the association between HAP exposure from solid fuel use for heating and cooking with the risk of chronic multimorbidity. Multimorbidity was defined as the coexistence of two or more of 15 chronic diseases (hypertension, diabetes, dyslipidemia, heart disease, stroke, cardiovascular disease, chronic lung disease, asthma, kidney disease, liver disease, digestive disease, cancer, psychiatric disease, memory-related disease, and arthritis). Multiple logistic regression investigated the association between solid fuel use for heating and cooking, separately or simultaneously, with the risk of multimorbidity. Poisson regression with quasi-likelihood estimation explored whether solid fuel exposure could increase the number of morbidities. Stratified analyses and sensitivity analyses examined the effect modification and robustness of the association.


RESULTS
Of the 19,295 participants (mean age: 58.9 years), 40.9 % have multimorbidity. Compared with participants who used clean fuels for heating and cooking, the risk was higher in mixed fuel (adjusted odds ratio, aOR = 1.26, 95 %CI:1.16-1.36) and solid fuel users (aOR = 1.81, 1.67-1.98) separately. HAP from solid fuel use was positively associated with an increased number of morbidities (adjusted β = 0.329, 0.290 to 0.368), after controlling for confounders. Those living in a one-story building, with poor household cleanliness have a higher risk of multimorbidity. No significant modifications of those associations by the socio-demographic and behaviour characteristics was observed.


CONCLUSIONS
HAP from solid fuel use is associated with a high risk of chronic multimorbidity in Chinese adults. Our findings provide important implications for reducing chronic disease burden by restricting solid fuel use.

Association between household air pollution from solid fuel use and risk of chronic diseases and their multimorbidity among Chinese adults.

Insulin resistance (IR) is associated with cardiometabolic multimorbidity (CMM). We aimed to explore the predictive value of six surrogate IR indexes—Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), triglyceride‐glucose (TyG), atherogenic index of plasma (AIP), TyG‐body mass index (TyGBMI), and TyG‐waist circumference (TyGwaist)—to establish the CMM incidence in Chinese middle‐aged and older populations.To estimate the odds ratio (OR) with a 95% confidence interval (95% CI) for incident CMM using six surrogates, we analysed data from the China Health and Retirement Longitudinal Study using multivariate logistic regression models. The nonlinear dose‐response correlation was evaluated using restricted cubic spline analysis; predictive performance was assessed using receiver operator characteristic curves.Among 6451 eligible participants, 268 (4.2%) developed CMM during the 4‐year follow‐up period. The ORs (95% CI) for incident CMM increased with increasing CVAI quartiles (Q) [Q2: 1.71, 1.03–2.90; Q3: 2.72, 1.70–4.52; Q4: 5.16, 3.29–8.45; all p < 0.05] after full adjustment, with Q1 as the reference. Other indexes yielded similar results. These associations remained significant in individuals with a normal body mass index. Notably, CVAI, AIP, and TyG exhibited a linear dose‐response relationship with CMM (Pnonlinear ≥0.05), whereas LAP, TyGBMI, and TyGwaist displayed significant nonlinear correlations (Pnonlinear <0.05). The area under the curve for the CVAI (0.691) was significantly superior to that of other indexes (all p < 0.05).The six IR surrogates were independently associated with CMM incidence. CVAI may be the most appropriate indicator for predicting CMM in middle‐aged and older Chinese populations.

Assessment of six surrogate insulin resistance indexes for predicting cardiometabolic multimorbidity incidence in Chinese middle‐aged and older populations: Insights from the China health and retirement longitudinal study

Household air pollution, adherence to a healthy lifestyle, and risk of cardiometabolic multimorbidity: Results from the China health and retirement longitudinal study.

Previous reports have suggested that Ang-(1-7) may have a protective effect in endothelial cells against high glucose (HG)-induced cell injury thanks to a modulatory mechanism in the NF-κB signaling pathway. In this study, we have examined whether NF-κB-IL-1β and Heme oxygenase-1 (HO-1) pathways contribute to the protection of Ang-(1-7) against hyperglycemia-induced inflammation and oxidative stress in human umbilical vein endothelial cells (HUVECs). Our results indicate that time-varying exposures of HUVECs, from 1 h to 24 h, to high glucose concentrations result in an increased expression of phosphorylated (p)-p65 and HO-1 in a time-dependent manner. As an inhibitor of NF-κB, pyrrolidinedithiocarbamic acid (PDTC) suppressed IL-1β production induced by HG. Of note, HUVECs previously treated with Ang-(1-7) (2 μM) for 30 min before being exposed to HG concentrations significantly ameliorated the HG-increased in p-p65 and IL-1β expression; whereas obviously up-regulated the level of HO-1, along with inhibition of oxidative stress, inflammation, and the HG-induced cytotoxicity. Importantly, when HUVECs were previously treated either with PDTC or IL-1Ra for 30 min before being exposed to HG, it significantly prevented damages caused by high glucose concentrations mentioned above, while the treatment of HO-1 inhibitor Sn-protoporphyrin (SnPP) before exposure to both HG and Ang-(1-7) significantly blocked the protective effect exerted by Ang-(1-7) on endothelial cells against injuries induced by HG mentioned above. To conclude, the data of this study showed that activation and inhibition of the NF-κB-IL-1β pathway and HO-1 pathway may constitute an important defense mechanism against endothelial cell damage caused by HG concentrations. We additionally gave new evidence showing that exogenous Ang-(1-7) exerts a protective effect on HUVECs against the HG-induced cell injury via the inhibition and the activation of the NF-κB-IL-1β pathway and the HO-1 pathway, respectively. 

Ang-(1-7) exerts anti-inflammatory and antioxidant activities on high glucose-induced injury by prohibiting NF-κB-IL-1β and activating HO-1 pathways in HUVECs

We investigated the clinical characteristics and therapeutic strategies for paediatric liver transplant (PLT) recipients who experienced de novo hepatitis B virus infection and the features of HBsAg seroconversion. A total of 821 PLT were performed in HBV‐free recipients between January 2013 and January 2019 in Paediatric Organ Transplant Center, Tianjin First Central Hospital. Twenty‐one recipients developed de novo HBV infection, the clinical data were analysed. The overall incidence of de novo HBV infection was 2.5%. Only one recipient received an HBcAb‐negative graft, 20 recipients received HBcAb‐positive grafts. The incidence of de novo HBV infection in HBcAb‐negative and HBcAb‐positive graft recipients were 0.2% and 6.3%, respectively. Fifteen de novo HBV‐infected recipients showed HBsAg seroconversion, the incidence of HBsAg seroconversion was 71.4%. The median time from the diagnosis of de novo HBV infection to HBsAg seroconversion was 15 (1, 73) months. Recipients with hepatitis B surface antigen (HBsAg) titre <1000 IU/L and negative hepatitis B e antigen (HBeAg) at the time of de novo HBV infection diagnosis were more likely to achieve HBsAg seroconversion. Nucleotide analogues were effective in treating recipients with de novo HBV infection. De novo HBV infection does not impact liver graft function as well as recipient and graft survival rate. De novo HBV infection does not impact PLT recipient outcomes under close monitoring and appropriate treatment. High incidence of HBsAg seroconversion can be achieved after anti‐viral therapy.

HBsAg seroconversion in de novo hepatitis B virus‐infected paediatric liver transplant recipients with anti‐viral therapy

Introduction In adult patients with thin phenotype, gingival recession is obvious in the mandibular incisors after a large amount of lingual tooth movement. A systematic review indicated that soft tissue augmentation before orthodontic treatment might yield satisfactory results with respect to the progression of gingival recession. However, the studies included had a low-to-moderate level of evidence. This study was designed to investigate the efficacy of soft tissue augmentation prior to orthodontic treatment on the prevention of gingival recession. Method and analysis This is a single-centre, single-blind, randomised controlled, double-armed parallel group comparison trial. This study was initiated in December 2021 and end in December 2025 (anticipated). Patients with mild crowding in the lower arch and a thin gingival type was enrolled and randomly assigned in a 1:1 ratio to either group A (having soft tissue augmentation prior to orthodontic treatment) or group B (having orthodontic treatment only). The planned number of enrolled patients was 48 (24 patients × 2 groups). The primary endpoint was the mean change in recession of the gingival margin. Secondary endpoints included the probing depth, gingival phenotype, frequency of complete root coverage, gingival thickness, width of the keratinised gingiva, clinical attachment level, gingival recession class, full-mouth plaque score, alveolar bone thickness in the faciolingual dimension of the lower anterior teeth and lower incisor inclination. Ethics and dissemination The study protocol was approved by the Ethical Committee of the Shanghai Stomatological Hospital (certificate number (2021)016). The study was conducted in accordance with the Declaration of Helsinki, the Clinical Trials Act and other current legal regulations in China. Written informed consent was obtained from all the participants. The results of this study will be reported in journal publications. Trial registration number ChiCTR2100050892.

/pdf/efficacy-of-periodontal-soft-tissue-augmentation-prior-to-3m98c3oe.pdf

Efficacy of periodontal soft tissue augmentation prior to orthodontic treatment on preventing gingival recession: study protocol for a randomised controlled trial

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Household air pollution, adherence to a healthy lifestyle, and risk of cardiometabolic multimorbidity: Results from the China health and retirement longitudinal study.

Ang-(1-7) exerts anti-inflammatory and antioxidant activities on high glucose-induced injury by prohibiting NF-κB-IL-1β and activating HO-1 pathways in HUVECs

HBsAg seroconversion in de novo hepatitis B virus‐infected paediatric liver transplant recipients with anti‐viral therapy

Efficacy of periodontal soft tissue augmentation prior to orthodontic treatment on preventing gingival recession: study protocol for a randomised controlled trial