Serum magnesium and calcium levels in relation to ischemic stroke : Mendelian randomization study

ObjectiveTo determine whether serum magnesium and calcium concentrations are causally associated with ischemic stroke or any of its subtypes using the mendelian randomization approach.MethodsAnalyses were conducted using summary statistics data for 13 single-nucleotide polymorphisms robustly associated with serum magnesium (n = 6) or serum calcium (n = 7) concentrations. The corresponding data for ischemic stroke were obtained from the MEGASTROKE consortium (34,217 cases and 404,630 noncases).ResultsIn standard mendelian randomization analysis, the odds ratios for each 0.1 mmol/L (about 1 SD) increase in genetically predicted serum magnesium concentrations were 0.78 (95% confidence interval [CI] 0.69-0.89; p = 1.3 7 10-4) for all ischemic stroke, 0.63 (95% CI 0.50-0.80; p = 1.6 7 10-4) for cardioembolic stroke, and 0.60 (95% CI 0.44-0.82; p = 0.001) for large artery stroke; there was no association with small vessel stroke (odds ratio 0.90, 95% CI 0.67-1.20; p = 0.46). Only the association with cardioembolic stroke was robust in sensitivity analyses. There was no association of genetically predicted serum calcium concentrations with all ischemic stroke (per 0.5 mg/dL [about 1 SD] increase in serum calcium: odds ratio 1.03, 95% CI 0.88-1.21) or with any subtype.ConclusionsThis study found that genetically higher serum magnesium concentrations are associated with a reduced risk of cardioembolic stroke but found no significant association of genetically higher serum calcium concentrations with any ischemic stroke subtype

Health-related And Socio-demographic Factors Associated With Frailty In The Elderly: A Systematic Literature Review [fatores Sociodemográficos E De Saúde Associados à Fragilidade Em Idosos: Uma Revisão Sistemática De Literatura]

Frailty is a syndrome that leads to practical harm in the lives of elders, since it is related to increased risk of dependency, falls, hospitalization, institutionalization, and death. The objective of this systematic review was to identify the socio-demographic, psycho-behavioral, healthrelated, nutritional, and lifestyle factors associated with frailty in the elderly. A total of 4,183 studies published from 2001 to 2013 were detected in the databases, and 182 complete articles were selected. After a comprehensive reading and application of selection criteria, 35 eligible articles remained for analysis. The main factors associated with frailty were: age, female gender, black race/color, schooling, income, cardiovascular diseases, number of comorbidities/diseases, functional incapacity, poor self-rated health, depressive symptoms, cognitive function, body mass index, smoking, and alcohol use. 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Avaliação da dieta de gestantes com sobrepeso Evaluation of diet of overweight pregnant women

O objetivo deste estudo foi avaliar o consumo alimentar e verificar a adequação de calorias e de alguns nutrientes em gestantes com sobrepeso pré-gestacional. Estudou-se uma amostra de 110 gestantes que freqüentavam ambulatório de assistência pré-natal na cidade de São Paulo. A alimentação foi verificada pelo método de inquérito recordatório de 24 horas. A proporção dos macronutrientes foi de 55% de carboidratos, 16% de proteínas e 29% de lipídios. A média de energia da dieta foi de 1736 kcal. Entre os micronutrientes analisados, apresentaram consumo inadequado: o cálcio, com aproximadamente 50% de adequação; o ferro, com 33%; e o folato, com 43%. A dieta mostrou-se satisfatória em energia e insuficiente em relação ao cálcio, ao ferro e ao folato. Estes dados permitem supor a existência de deficiências nutricionais específicas no grupo estudado.<br>The objective of this study was to verify the adequacy of calories and some nutrients intake in pregnant women with pregestational overweight. A sample of 110 pregnant women, attending a prenatal assistance ambulatory of the city of São Paulo (Brazil), was evaluated. The diet was investigated by the 24-hour recall method. The proportion of macronutrients was 55% of carbohydrates, 16% of proteins and 29% of lipids. The median caloric consumption was 1736 cal. The intake of some micronutrients was fitting the recommendations in about 50% for calcium, 33% for iron and 43% for folate. The diet calories were satisfactory, but the amounts of calcium, iron and folate were insufficient. These data permit a presumption of the presence of specific nutritional deficiencies in the studied group

Common carotid intima-media thickness relates to cardiovascular events in adults aged <45 years

Item does not contain fulltextAlthough atherosclerosis starts in early life, evidence on risk factors and atherosclerosis in individuals aged <45 years is scarce. Therefore, we studied the relationship between risk factors, common carotid intima-media thickness (CIMT), and first-time cardiovascular events in adults aged <45 years. Our study population consisted of 3067 adults aged <45 years free from symptomatic cardiovascular disease at baseline, derived from 6 cohorts that are part of the USE-IMT initiative, an individual participant data meta-analysis of general-population-based cohort studies evaluating CIMT measurements. Information on risk factors, CIMT measurements, and follow-up of the combined end point (first-time myocardial infarction or stroke) was obtained. We assessed the relationship between risk factors and CIMT and the relationship between CIMT and first-time myocardial infarction or stroke using a multivariable linear mixed-effects model and a Cox proportional-hazards model, respectively. During a follow-up of 16.3 years, 55 first-time myocardial infarctions or strokes occurred. Median CIMT was 0.63 mm. Of the risk factors under study, age, sex, diastolic blood pressure, body mass index, total cholesterol, and high-density lipoprotein cholesterol related to CIMT. Furthermore, CIMT related to first-time myocardial infarction or stroke with a hazard ratio of 1.40 per SD increase in CIMT, independent of risk factors (95% confidence interval, 1.11-1.76). CIMT may be a valuable marker for cardiovascular risk in adults aged <45 years who are not yet eligible for standard cardiovascular risk screening. This is especially relevant in those with an increased, unfavorable risk factor burden