32 research outputs found
Additive influence of genetic predisposition and conventional risk factors in the incidence of coronary heart disease: a population-based study in Greece
Objectives: An additive genetic risk score (GRS) for coronary heart disease (CHD) has previously been associated with incident CHD in the population-based Greek European Prospective Investigation into Cancer and nutrition (EPIC) cohort. In this study, we explore GRS-‘environment’ joint actions on CHD for several conventional cardiovascular risk factors (ConvRFs), including smoking, hypertension, type-2 diabetes mellitus (T2DM), body mass index (BMI), physical activity and adherence to the Mediterranean diet. Design: A case–control study. Setting: The general Greek population of the EPIC study. Participants and outcome measures 477 patients with medically confirmed incident CHD and 1271 controls participated in this study. We estimated the ORs for CHD by dividing participants at higher or lower GRS and, alternatively, at higher or lower ConvRF, and calculated the relative excess risk due to interaction (RERI) as a measure of deviation from additivity. Results: The joint presence of higher GRS and higher risk ConvRF was in all instances associated with an increased risk of CHD, compared with the joint presence of lower GRS and lower risk ConvRF. The OR (95% CI) was 1.7 (1.2 to 2.4) for smoking, 2.7 (1.9 to 3.8) for hypertension, 4.1 (2.8 to 6.1) for T2DM, 1.9 (1.4 to 2.5) for lower physical activity, 2.0 (1.3 to 3.2) for high BMI and 1.5 (1.1 to 2.1) for poor adherence to the Mediterranean diet. In all instances, RERI values were fairly small and not statistically significant, suggesting that the GRS and the ConvRFs do not have effects beyond additivity. Conclusions: Genetic predisposition to CHD, operationalised through a multilocus GRS, and ConvRFs have essentially additive effects on CHD risk
A Polymorphism in a Gene Encoding Perilipin 4 Is Associated with Height but not with Bone Measures in Individuals from the Framingham Osteoporosis Study
There is increasing interest in identifying new pathways and candidate genes that confer susceptibility to osteoporosis. There is evidence that adipogenesis and osteogenesis may be related, including a common bone marrow progenitor cell for both adipocytes and osteoblasts. Perilipin 1 (PLIN1) and Perilipin 4 (PLIN4) are members of the PATS family of genes and are involved in lipolysis of intracellular lipid deposits. A previous study reported gender-specific associations between one polymorphism of PLIN1 and bone mineral density (BMD) in a Japanese population. We hypothesized that polymorphisms in PLIN1 and PLIN4 would be associated with bone measures in adult Caucasian participants of the Framingham Osteoporosis Study (FOS). We genotyped 1,206 male and 1,445 female participants of the FOS for four single-nucleotide polymorphism (SNPs) in PLIN1 and seven SNPs in PLIN4 and tested for associations with measures of BMD, bone ultrasound, hip geometry, and height. We found several gender-specific significant associations with the measured traits. The association of PLIN4 SNP rs8887, G>A with height in females trended toward significance after simulation testing (adjusted P = 0.07) and remained significant after simulation testing in the combined-sex model (adjusted P = 0.033). In a large study sample of men and women, we found a significant association between one SNP in PLIN4 and height but not with bone traits, suggesting that PATS family genes are not important in the regulation of bone. Identification of genes that influence human height may lead to a better understanding of the processes involved in growth and development
Mediterranean Diet and Diabetes: Prevention and Treatment
The aim of the present review is to examine current scientific knowledge on the association between the Mediterranean diet and diabetes mellitus (mostly type 2 diabetes). A definition of the Mediterranean diet and the tools widely used to evaluate adherence to this traditional diet (Mediterranean diet indices) are briefly presented. The review focuses on epidemiological data linking adherence to the Mediterranean diet with the risk of diabetes development, as well as evidence from interventional studies assessing the effect of the Mediterranean diet on diabetes control and the management of diabetes-related complications. The above mentioned data are explored on the basis of evaluating the Mediterranean diet as a whole dietary pattern, rather than focusing on the effect of its individual components. Possible protective mechanisms of the Mediterranean diet against diabetes are also briefly discussed
Mediterranean Diet and Diabetes: Prevention and Treatment
The aim of the present review is to examine current scientific knowledge on the association between the Mediterranean diet and diabetes mellitus (mostly type 2 diabetes). A definition of the Mediterranean diet and the tools widely used to evaluate adherence to this traditional diet (Mediterranean diet indices) are briefly presented. The review focuses on epidemiological data linking adherence to the Mediterranean diet with the risk of diabetes development, as well as evidence from interventional studies assessing the effect of the Mediterranean diet on diabetes control and the management of diabetes-related complications. The above mentioned data are explored on the basis of evaluating the Mediterranean diet as a whole dietary pattern, rather than focusing on the effect of its individual components. Possible protective mechanisms of the Mediterranean diet against diabetes are also briefly discussed
Additive influence of genetic predisposition and conventional risk factors in the incidence of coronary heart disease: a population-based study in Greece
Objectives An additive genetic risk score (GRS) for coronary heart
disease (CHD) has previously been associated with incident CHD in the
population-based Greek European Prospective Investigation into Cancer
and nutrition (EPIC) cohort. In this study, we explore GRS-environment’
joint actions on CHD for several conventional cardiovascular risk
factors (ConvRFs), including smoking, hypertension, type-2 diabetes
mellitus (T2DM), body mass index (BMI), physical activity and adherence
to the Mediterranean diet.
Design A case-control study.
Setting The general Greek population of the EPIC study.
Participants and outcome measures 477 patients with medically confirmed
incident CHD and 1271 controls participated in this study. We estimated
the ORs for CHD by dividing participants at higher or lower GRS and,
alternatively, at higher or lower ConvRF, and calculated the relative
excess risk due to interaction (RERI) as a measure of deviation from
additivity.
Results The joint presence of higher GRS and higher risk ConvRF was in
all instances associated with an increased risk of CHD, compared with
the joint presence of lower GRS and lower risk ConvRF. The OR (95% CI)
was 1.7 (1.2 to 2.4) for smoking, 2.7 (1.9 to 3.8) for hypertension, 4.1
(2.8 to 6.1) for T2DM, 1.9 (1.4 to 2.5) for lower physical activity, 2.0
(1.3 to 3.2) for high BMI and 1.5 (1.1 to 2.1) for poor adherence to the
Mediterranean diet. In all instances, RERI values were fairly small and
not statistically significant, suggesting that the GRS and the ConvRFs
do not have effects beyond additivity.
Conclusions Genetic predisposition to CHD, operationalised through a
multilocus GRS, and ConvRFs have essentially additive effects on CHD
risk
A direct assessment of genetic contribution to the incidence of coronary infarct in the general population Greek EPIC cohort
To estimate the fraction of the incidence of coronary infarct
attributable to the combined action of common genetic polymorphisms
likely to be related to this condition, we conducted a case-control
study nested within the Greek component of the European Prospective
Investigation into Cancer and Nutrition. A total of 202 cases with a
new, medically confirmed coronary infarct and 197 controls who had not
developed an infarct by the time the corresponding case was diagnosed,
were identified. A simple a priori score, relying on a total of 11
genetic polymorphisms was developed. Each polymorphism contributed 1
unit if the subject was homozygous for the high-risk allele, 0.5 units
if the subject was heterozygous and 0 units if the subject was
homozygous for the low-risk allele. Cases were over-represented in the
presumed high genetic risk score values (chi square for trend = 10.18; p
= 0.0014). The odds ratio to develop coronary infarct was 1.55 (95%
confidence interval: 1.02-2.37) for score >= 3.0, and 2.02 (1.31-3.11)
for score >= 3.5. In both instances the population fraction of the
disease attributable to genetic predisposition exceeded 22%. Assuming a
prior probability of at least 0.10 for the score to be predictive of
coronary infarct risk, our findings are more likely than not to be truly
positive. Our results, based on a simple score integrating the additive
impact of 11 genetic polymorphisms, indicate that genetic predisposition
accounts for a considerable fraction of the incidence of coronary
infarct in the community
Cardiometabolic Benefits of a Weight-Loss Mediterranean Diet/Lifestyle Intervention in Patients with Obstructive Sleep Apnea: The “MIMOSA” Randomized Clinical Trial
Although continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnea (OSA), its cardiometabolic benefits are questionable. Our aim was to explore whether the combination of a weight-loss Mediterranean diet/lifestyle intervention with OSA standard care leads to greater cardiometabolic improvements compared with standard care alone. We randomly assigned 187 adult, overweight, polysomnography-diagnosed moderate-to-severe OSA patients to a standard care group (SCG, n = 65), a Mediterranean diet group (MDG, n = 62) or a Mediterranean lifestyle group (MLG, n = 60). All three groups were prescribed with CPAP. Additionally, the SCG only received brief written healthy lifestyle advice, while intervention arms were subjected to a six-month weight-loss behavioral intervention based on the Mediterranean diet. The MLG also received guidance for improving physical activity and sleep habits. Glucose metabolism indices, blood lipids, liver enzymes and blood pressure improved only in intervention arms, and were significantly lower compared to the SCG post-intervention (all p < 0.05). The age-, sex-, baseline- and CPAP use-adjusted relative risk (95% confidence interval) of metabolic syndrome was 0.58 (0.34–0.99) for the MDG and 0.30 (0.17–0.52) for the MLG compared to the SCG. The MLG additionally presented a lower relative risk of metabolic syndrome compared to the MDG (0.52 (0.30–0.89)). After further adjustment for body-weight change, a lower relative risk of metabolic syndrome was still evident for the MLG compared to the SCG. In conclusion, although standard care alone does not improve OSA patients’ cardiometabolic profile, its combination with a weight-loss Mediterranean diet/lifestyle intervention leads to significant cardiometabolic benefits
Genetic predisposition, nongenetic risk factors, and coronary infarct
Background: Using a genetic predisposition score (GPS), additively
integrating the associations of 11 polymorphisms with coronary heart
disease (CHD), we examined the consequences of the joint presence of a
high GPS and nongenetic CHD risk factors.
Methods: Within the European Prospective Investigation Into Cancer and
Nutrition, 202 case patients with medically confirmed incident coronary
infarct and 197 control subjects were identified in Greece. Each
polymorphism contributed I unit (high-risk homozygous), one-half unit
(heterozygous), or no units (low-risk homozygous) to the GPS. Odds
ratios of coronary infarction for those at high risk because of genetic
predisposition and simultaneous presence of an established CHD risk
factor were estimated, compared with subjects at low risk, for both GPS
and each CHD risk factor.
Results: The joint presence of a high GPS ( >= 3.5) and each studied CHD
risk factor was in all instances associated with a significantly
increased risk of coronary infarction. The odds ratio (95% confidence
interval) was 2.62 (1.14-6.02) for ever smoking, 2.88 (1.33-6.24) for
hypertension, 3.50 (1.67-7.33) for low high-density lipoprotein (HDL)
level, 3.05 (1.53-6.08) for high non-HDL level, and 3.66 (1.75-7.65) for
poor adherence to the Mediterranean diet. The odds ratios were always
lower and nonsignificant when the GPS was low. There was suggestive
evidence for interaction of a high GPS with hypertension (P=.05) and
non-HDL cholesterol level (P=.13).
Conclusions: Genetic predisposition may interact with hypertension and,
perhaps, also with the level of non-HDL cholesterol, in the causation of
CHD. Genetic predisposition and the other studied exposures seem to have
converging effects. Thus, the GPS may identify individuals who could
realize disproportional benefits by controlling their hypertension and,
possibly, their non-HDL cholesterol level