Risk factors and myocardial infarction in patients with obstructive sleep apnea: impact of β2-adrenergic receptor polymorphisms

BACKGROUND: The increased sympathetic nervous activity in patients with obstructive sleep apnea (OSA) is largely responsible for the high prevalence of arterial hypertension, and it is suggested to adversely affect triglyceride and high-density lipoprotein (HDL) cholesterol levels in these patients. The functionally relevant polymorphisms of the β2-adrenergic receptor (Arg-47Cys/Arg16Gly and Gln27Glu) have been shown to exert modifying effects on these risk factors in previous studies, but results are inconsistent. METHODS: We investigated a group of 429 patients (55 ± 10.7 years; 361 men, 68 women) with moderate to severe obstructive sleep apnea (apnea/hypopnea index (AHI) 29.1 ± 23.1/h) and, on average, a high cardiovascular risk profile (body mass index 31.1 ± 5.6, with hypertension in 60.1%, dyslipidemia in 49.2%, and diabetes in 17.2% of patients). We typed the β2-adrenergic receptor polymorphisms and investigated the five most frequent haplotypes for their modifying effects on OSA-induced changes in blood pressure, heart rate, and lipid levels. The prevalence of cardiovascular risk factors and coronary heart disease (n = 55, 12.8%) and survived myocardial infarction (n = 27, 6.3%) were compared between the genotypes and haplotypes. RESULTS: Multivariate linear/logistic regressions revealed a significant and independent (from BMI, age, sex, presence of diabetes, use of antidiabetic, lipid-lowering, and antihypertensive medication) influence of AHI on daytime systolic and diastolic blood pressure, heart rate, prevalence of hypertension, and triglyceride and HDL levels. The β2-adrenergic receptor genotypes and haplotypes showed no modifying effects on these relationships or on the prevalence of dyslipidemia, diabetes, and coronary heart disease, yet, for all three polymorphisms, heterozygous carriers had a significantly lower relative risk for myocardial infarction (Arg-47Cys: n = 195, odds ratio (OR) = 0.32, P = 0.012; Arg16Gly: n = 197, OR = 0.39, P = 0.031; Gln27Glu: OR = 0.37, P = 0.023). Carriers of the most frequent haplotype (n = 113) (haplotype 1; heterozygous for all three polymorphisms) showed a five-fold lower prevalence of survived myocardial infarction (OR = 0.21, P = 0.023). CONCLUSION: Our study showed no significant modifying effect of the functionally relevant β2-adrenergic receptor polymorphisms on OSA-induced blood pressure, heart rate, or lipid changes. Nevertheless, heterozygosity of these polymorphisms is associated with a lower prevalence of survived myocardial infarction in this group with, on average, a high cardiovascular risk profile

Scenario set-up and forcing data for impact model evaluation and impact attribution within the third round of the Inter-Sectoral Model Intercomparison Project (ISIMIP3a)

This paper describes the rationale and the protocol of the first component of the third simulation round of the Inter-Sectoral Impact Model Intercomparison Project (ISIMIP3a, www.isimip.org) and the associated set of climate-related and direct human forcing data (CRF and DHF, respectively). The observation-based climate-related forcings for the first time include high-resolution observational climate forcings derived by orographic downscaling, monthly to hourly coastal water levels, and wind fields associated with historical tropical cyclones. The DHFs include land use patterns, population densities, information about water and agricultural management, and fishing intensities. The ISIMIP3a impact model simulations driven by these observation-based climate-related and direct human forcings are designed to test to what degree the impact models can explain observed changes in natural and human systems. In a second set of ISIMIP3a experiments the participating impact models are forced by the same DHFs but a counterfactual set of atmospheric forcings and coastal water levels where observed trends have been removed. These experiments are designed to allow for the attribution of observed changes in natural, human and managed systems to climate change, rising CH4 and CO2 concentrations, and sea level rise according to the definition of the Working Group II contribution to the IPCC AR6

Störung des Lipid- und Glukosemetabolismus bei Patienten mit obstruktiver schlafbezogener Atmungsstörung

146 Patienten mit obstruktiver SBAS wurden bezüglich der Störungen im Lipid- und Glukosemetabolismus sowie des Einflusses einer schlafmedizinischen Therapie untersucht. 31% der Patienten zeigten keine Zuckerstoffwechselstörung, bei 33% bestand eine prädiabetische und bei 36% eine manifeste diabetische Stoffwechsellage. Bei den Patienten mit zuvor gestörtem Zuckerstoffwechsel sanken der Nüchtern-BZ und der 2h-Wert im OGTT signifikant. In der Kontrollgruppe änderte sich der BZ nicht. Die meisten Patienten zeigten zu Beginn der Studie Störungen des Lipidmetabolismus. Unter schlafmedizinischer Therapie kam es zu einer signifikanten Verbesserung des Gesamt- und LDL-Cholesterins bei allen Patienten, wobei das Ausmaß der Verbesserung unabhängig mit der Senkung sowohl des AHI als auch des BMI korrelierte. Patienten mit obstr. SBAS leiden oft unter Fett- und Zuckerstoffwechselstörungen. Eine effektive schlafmedizinische Therapie kann hier günstige Auswirkungen auf den Stoffwechsel haben

Knowing in Algorithmic Regimes: Discussing Methods, Interactions, and Politics

Egbert S, Prietl B, Büchner S, Jarke J, Kinder-Kurlanda K, Pöchhacker N. Knowing in Algorithmic Regimes: Discussing Methods, Interactions, and Politics. In: Conference Proceedings of the STS Conference Graz 2021. Critical Issues in Science, Technology and Society Studies. Submitted