Urotensin II: Its function in health and its role in disease

Urotensin II (U-II) is the most potent vasoconstrictor known, even more potent than endothelin-1. It was first isolated from the fish spinal cord and has been recognized as a hormone in the neurosecretory system of teleost fish for over 30 years. After the identification of U-II in humans and the orphan human G-protein-coupled receptor 14 as the urotensin II receptor, UT, many studies have shown that U-II may play an important role in cardiovascular regulation. Human urotensin II (hU-II) is an 11 amino acid cyclic peptide, generated by proteolytic cleavage from a precursor prohormone. It is expressed in the central nervous system as well as other tissues, such as kidney, spleen, small intestine, thymus, prostate, pituitary, and adrenal gland and circulates in human plasma. The plasma U-II level is elevated in renal failure, congestive heart failure, diabetes mellitus, systemic hypertension and portal hypertension caused by liver cirrhosis. The effect of U-II on the vascular system is variable, depending on species, vascular bed and calibre of the vessel. The net effect on vascular tone is a balance between endothelium-independent vasoconstriction and endothelium-dependent vasodilatation. U-II is also a neuropeptide and may play a role in tumour development. The development of UT receptor antagonists may provide a useful research tool as well as a novel treatment for cardiorenal diseases. © 2005 Springer Science + Business Media, Inc.postprin

The association between glycated haemoglobin and waist circumference in the US population

INTRODUCTION: Glycated haemoglobin (A1C) is now used for the diagnosis of diabetes and pre-diabetes. As these are related to obesity, we studied their relationship with waist circumference. METHODS: We analysed data on 960 men and 1001 women who participated in the United States National Health and Nutrition Examination Survey 2007-08. Participants who were older than 20 years, had …published_or_final_versionThe 17th Medical Research Conference, The University of Hong Kong, Hong Kong, 14 January 2012. In Hong Kong Medical Journal, 2012, v. 18 suppl. 1, p. 43, abstract no. 6

Management of obesity in the National Health and Nutrition Examination Survey (NHANES), 2007-2008

PURPOSE: The prevalence of obesity has been increasing in the United States. We set out to investigate the use of pharmacologic and non-pharmacologic therapy for the treatment of obesity in recent years. METHODS: We included 2630 men and 2702 women who took part in the National Health and Nutrition Examination Survey from 2007 to 2008. We analyzed their demographic and anthropometric data and their weight and drug history. RESULTS: A total of 45.9% of men and 45.0% of women were candidates for treatment (body mass index >/=30 kg/m(2), or >/=27 kg/m(2) with risk factors). Among these participants, 85.1% considered themselves overweight, 90.1% would like to lose weight, 61.9% had dietary changes, 36.5% exercised, 3.7% took nonprescription drugs, and 2.2% took prescription drugs to control weight during the preceding year. During the preceding month, 0.5% and 0.1% of participants were taking phentermine and orlistat, respectively. There were no participants on sibutramine. CONCLUSIONS: Although obesity is highly prevalent, only a small percentage of obese Americans are on anti-obesity medication. The withdrawal of sibutramine would have minimal impact on the general population. There is a need for more lifestyle changes in the majority of obese individuals.published_or_final_versio

Pharmacological management of obesity in the National Health and Nutrition Examination Survey (NHANES) 2007-8

Poster Session II: Translational & Clinical: Clinical Pharmacologypublished_or_final_versionThe 16th Medical Research Conference, Department of Medicine, The University of Hong Kong, Hong Kong, 22 January 2011. In Hong Kong Medical Journal, 2011, v. 17 n. 1, Suppl. 1, p. 50, abstract no. 8

Utilization of glucose, blood pressure, and lipid lowering medications among people with type II diabetes in the United States, 1999-2010

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Increasing prevalence of hypertension in Hong Kong Cardiovascular Risk Factor Prevalence Study: role of general and central obesity

Introduction: General obesity and central obesity are well-known risk factors of hypertension. We investigated the change in the prevalence of hypertension in the population-based prospective Hong Kong Cardiovascular Risk Factor Prevalence Study (CRISPS) and the relationship of change in blood pressure with change in body mass index (BMI) and waist circumference over a follow-up period of 11.9 years. Methods: A total of 2888, 1942 and 1798 subjects in CRISPS-1 (1995-1996), CRISPS-2 (2000-2004) and CRISPS-3 (2005-2008) were included in this analysis respectively. Hypertension was defined as blood pressure ≥140/90 mm Hg or taking anti-hypertensive medication. General obesity was defined as BMI ≥27.5 kg/m2 and central obesity was defined as waist circumference ≥90 cm in men or ≥80 cm in women. Results: The prevalence of hypertension increased from 18.1% to 39.4% (P<0.001 after adjusting for age and sex). The prevalence of central obesity increased from 25.4% to 41.4%, but that of general obesity decreased from 16.8% to 14.8% (both P<0.001 after adjusting for age and sex). Among 1347 subjects who did not take any anti-hypertensive medication at both CRISPS-1 and CRISPS-3, the change in waist circumference, but not that in BMI, was associated with the changes in both systolic and diastolic blood pressures (beta=0.087, P=0.015 and beta=0.122, P<0.001 respectively). Conclusions: The increase in prevalence of hypertension might be explained by the increase in central obesity. Our findings further confirm the importance of waist circumference in this population; calculating the BMI alone may give a false sense of security. Acknowledgement: This study was funded by Hong Kong Research Grant Council grants (HKU7229/01M and HKU7626/07M) and the Sun Chieh Yeh Heart Foundation.published_or_final_versio

Association of lower total bilirubin level with statin usage: the United States National Health and Nutrition Examination Survey 1999–2008

OBJECTIVE: A low circulating level of bilirubin is associated with increased cardiovascular risk. As statins can stimulate heme oxygenase-1 (HO-1), which increases bilirubin production, we investigated whether statins in routine use increase total bilirubin levels in subjects at high cardiovascular risk. METHODS: Data from 3290 subjects with self-reported history of hypercholesterolemia, diabetes, or cardiovascular diseases in the United States National Health and Nutrition Examination Survey (NHANES) 1999-2008 were analyzed. RESULTS: Subjects taking statins (n = 1156) had lower total bilirubin levels than those not taking any lipid-lowering medication (n = 2134) after adjusting for age, sex, race/ethnicity, and survey period (adjusted mean = 0.699 vs 0.729 mg/dl respectively, P=0.001). The association remained significant after adjusting for more covariates (P = 0.002), but was attenuated after further adjusting for glycosylated hemoglobin, insulin resistance index, and low-density lipoprotein (LDL) cholesterol (P = 0.043). The use of lovastatin, rosuvastatin, and cerivastatin was associated with lower total bilirubin levels in the full adjustment model (P < 0.05). CONCLUSION: The use of statins was associated unexpectedly with lower total bilirubin levels. This could be explained at least partly by the effect of statins on glycemia and LDL cholesterol. Our results do not suggest that the anti-oxidant and anti-inflammatory effects of statins are due to HO-1 induction and increased serum bilirubin levels.postprin

Association of genetic variants in gene encoding lipocalin-2 with plasma alanine aminotransferase and aspartate aminotransferase

published_or_final_versionThe 16th Annual Research Conference of the Department of Medicine, The University of Hong Kong, Hong Kong, 22 January 2011. In Hong Kong Medical Journal, 2011, v. 17, suppl. 1, p. 17, abstract no. 1

Using glycosylated haemoglobin to define the metabolic syndrome in adults in the United States

Introduction: Recently, the American Diabetes Association has proposed the use of glycosylated haemoglobin (GHb) in the definition of diabetes and the category of increased diabetes risk. We therefore investigated whether GHb can be used instead of fasting plasma glucose in identifying individuals with the metabolic syndrome, which is associated with increased risk of cardiovascular diseases. Methods: Participants of the US National Health and Nutrition Examination Survey (NHANES) 1999-2006 who had fasting blood glucose were included (n=3551 in 1999-2002 and n=3412 in 2003-2006). The metabolic syndrome was defined using International Diabetes Federation criteria in 2009. Raised blood glucose was defined either as fasting glucose ≥100 mg/dL (5.6 mmol/L), or as GHb ≥5.7%. Results: In 2003-2006, there was 91.3% agreement between GHb and fasting glucose when either is used to define the metabolic syndrome, although the use of GHb slightly lowered the syndrome’s prevalence (34.8% vs 38.8%, P=0.012). The agreement was good (≥87%) irrespective of age, sex, race/ethnicity and body mass index. Only 2.3% of the sample population had the metabolic syndrome defined using GHb but not using fasting glucose. The syndrome, defined using GHb alone, was associated with cardiovascular diseases (ischaemic heart disease, heart failure or stroke) [OR=1.95, P=0.002]. Similar results were found in 1999-2002. Conclusions: Using GHb instead of fasting glucose to define the metabolic syndrome is feasible. The syndrome defined in this way also identifies individuals with increased cardiovascular risk.published_or_final_versio