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1.
ACS Nano ; 16(4): 6455-6467, 2022 04 26.
Article in English | MEDLINE | ID: mdl-35316035

ABSTRACT

Biomolecular complexes can form stable assemblies yet can also rapidly exchange their subunits to adapt to environmental changes. Simultaneously allowing for both stability and rapid exchange expands the functional capacity of biomolecular machines and enables continuous function while navigating a complex molecular world. Inspired by biology, we design and synthesize a DNA origami receptor that exploits multivalent interactions to form stable complexes that are also capable of rapid subunit exchange. The system utilizes a mechanism first outlined in the context of the DNA replisome, known as multisite competitive exchange, and achieves a large separation of time scales between spontaneous subunit dissociation, which requires days, and rapid subunit exchange, which occurs in minutes. In addition, we use the DNA origami receptor to demonstrate stable interactions with rapid exchange of both DNA and protein subunits, thus highlighting the applicability of our approach to arbitrary molecular cargo, an important distinction with canonical toehold exchange between single-stranded DNA. We expect this study to benefit future studies that use DNA origami structures to exploit multivalent interactions for the design and synthesis of a wide range of possible kinetic behaviors.


Subject(s)
Nanostructures , Nanotechnology , DNA/chemistry , DNA, Single-Stranded , Nanostructures/chemistry , Nucleic Acid Conformation
2.
Nat Commun ; 10(1): 5662, 2019 12 11.
Article in English | MEDLINE | ID: mdl-31827096

ABSTRACT

Single-molecule assays have, by definition, the ultimate sensitivity and represent the next frontier in biological analysis and diagnostics. However, many of these powerful technologies require dedicated laboratories and trained personnel and have therefore remained research tools for specialists. Here, we present a single-molecule confocal system built from a 3D-printed scaffold, resulting in a compact, plug and play device called the AttoBright. This device performs single photon counting and fluorescence correlation spectroscopy (FCS) in a simple format and is widely applicable to the detection of single fluorophores, proteins, liposomes or bacteria. The power of single-molecule detection is demonstrated by detecting single α-synuclein amyloid fibrils, that are currently evaluated as biomarkers for Parkinson's disease, with an improved sensitivity of >100,000-fold over bulk measurements.

3.
J Intern Med ; 285(5): 533-549, 2019 05.
Article in English | MEDLINE | ID: mdl-30772945

ABSTRACT

Our understanding of human evolution has improved rapidly over recent decades, facilitated by large-scale cataloguing of genomic variability amongst both modern and archaic humans. It seems clear that the evolution of the ancestors of chimpanzees and hominins separated 7-9 million years ago with some migration out of Africa by the earlier hominins; Homo sapiens slowly emerged as climate change resulted in drier, less forested African conditions. The African populations expanded and evolved in many different conditions with slow mutation and selection rates in the human genome, but with much more rapid mutation occurring in mitochondrial DNA. We now have evidence stretching back 300 000 years of humans in their current form, but there are clearly four very different large African language groups that correlate with population DNA differences. Then, about 50 000-100 000 years ago a small subset of modern humans also migrated out of Africa resulting in a persistent signature of more limited genetic diversity amongst non-African populations. Hybridization with archaic hominins occurred around this time such that all non-African modern humans possess some Neanderthal ancestry and Melanesian populations additionally possess some Denisovan ancestry. Human populations both within and outside Africa also adapted to diverse aspects of their local environment including altitude, climate, UV exposure, diet and pathogens, in some cases leaving clear signatures of patterns of genetic variation. Notable examples include haemoglobin changes conferring resistance to malaria, other immune changes and the skin adaptations favouring the synthesis of vitamin D. As humans migrated across Eurasia, further major mitochondrial changes occurred with some interbreeding with ancient hominins and the development of alcohol intolerance. More recently, an ability to retain lactase persistence into adulthood has evolved rapidly under the environmental stimulus of pastoralism with the ability to husband lactating ruminants. Increased amylase copy numbers seem to relate to the availability of starchy foods, whereas the capacity to desaturase and elongate monounsaturated fatty acids in different societies seems to be influenced by whether there is a lack of supply of readily available dietary sources of long-chain polyunsaturated fatty acids. The process of human evolution includes genetic drift and adaptation to local environments, in part through changes in mitochondrial and nuclear DNA. These genetic changes may underlie susceptibilities to some modern human pathologies including folate-responsive neural tube defects, diabetes, other age-related pathologies and mental health disorders.


Subject(s)
Biological Evolution , Hominidae/physiology , Nutritional Physiological Phenomena , Animals , DNA, Mitochondrial/genetics , Emigration and Immigration , Hominidae/genetics , Humans , Mutation
4.
BMC Biol ; 16(1): 149, 2018 12 24.
Article in English | MEDLINE | ID: mdl-30583727

ABSTRACT

BACKGROUND: Higher-order self-assembly of proteins, or "prion-like" polymerisation, is now emerging as a simple and robust mechanism for signal amplification, in particular within the innate immune system, where the recognition of pathogens or danger-associated molecular patterns needs to trigger a strong, binary response within cells. MyD88, an important adaptor protein downstream of TLRs, is one of the most recent candidates for involvement in signalling by higher order self-assembly. In this new light, we set out to re-interpret the role of polymerisation in MyD88-related diseases and study the impact of disease-associated point mutations L93P, R196C, and L252P/L265P at the molecular level. RESULTS: We first developed new in vitro strategies to characterise the behaviour of polymerising, full-length MyD88 at physiological levels. To this end, we used single-molecule fluorescence fluctuation spectroscopy coupled to a eukaryotic cell-free protein expression system. We were then able to explore the polymerisation propensity of full-length MyD88, at low protein concentration and without purification, and compare it to the behaviours of the isolated TIR domain and death domain that have been shown to have self-assembly properties on their own. These experiments demonstrate that the presence of both domains is required to cooperatively lead to efficient polymerisation of the protein. We then characterised three pathological mutants of MyD88. CONCLUSION: We discovered that all mutations block the ability of MyD88 to polymerise fully. Interestingly, we show that, in contrast to L93P and R196C, L252P is a gain-of-function mutation, which allows the MyD88 mutant to form extremely stable oligomers, even at low nanomolar concentrations. Thus, our results shed new light on the digital "all-or-none" responses by the myddosomes and the behaviour of the oncogenic mutations of MyD88.


Subject(s)
Immunity, Innate/genetics , Membrane Glycoproteins/genetics , Mutation , Receptors, Interleukin-1/genetics , Humans , Immune System/metabolism , Membrane Glycoproteins/chemistry , Membrane Glycoproteins/metabolism , Polymerization , Receptors, Interleukin-1/chemistry , Receptors, Interleukin-1/metabolism
5.
Chem Commun (Camb) ; 54(56): 7854-7857, 2018 Jul 10.
Article in English | MEDLINE | ID: mdl-29951679

ABSTRACT

Oligomeric and protofibrillar aggregates that are populated along the pathway of amyloid fibril formation appear generally to be more toxic than the mature fibrillar state. In particular, α-synuclein, the protein associated with Parkinson's disease, forms kinetically trapped protofibrils in the presence of lipid vesicles. Here, we show that lipid-induced α-synuclein protofibrils can convert rapidly to mature fibrils at higher temperatures. Furthermore, we find that ß-synuclein, generally considered less aggregation prone than α-synuclein, forms protofibrils at higher temperatures. These findings highlight the importance of energy barriers in controlling the de novo formation and conversion of amyloid fibrils.

6.
J Intern Med ; 284(1): 37-49, 2018 07.
Article in English | MEDLINE | ID: mdl-29706028

ABSTRACT

Understanding the physiological and metabolic underpinnings that confer individual differences in responses to diet and diet-related chronic disease is essential to advance the field of nutrition. This includes elucidating the differences in gene expression that are mediated through programming of the genome through epigenetic chromatin modifications. Epigenetic landscapes are influenced by age, genetics, toxins and other environmental factors, including dietary exposures and nutritional status. Epigenetic modifications influence transcription and genome stability are established during development with life-long consequences. They can be inherited from one generation to the next. The covalent modifications of chromatin, which include methylation and acetylation, on DNA nucleotide bases, histone proteins and RNA are derived from intermediates of one-carbon metabolism and central metabolism. They influence key physiological processes throughout life, and together with inherited DNA primary sequence, contribute to responsiveness to environmental stresses, diet and risk for age-related chronic disease. Revealing diet-epigenetic relationships has the potential to transform nutrition science by increasing our fundamental understanding of: (i) the role of nutrients in biological systems, (ii) the resilience of living organisms in responding to environmental perturbations, and (iii) the development of dietary patterns that programme physiology for life-long health. Epigenetics may also enable the classification of individuals with chronic disease for specific dietary management and/or for efficacious diet-pharmaceutical combination therapies. These new emerging concepts at the interface of nutrition and epigenetics were discussed, and future research needs identified by leading experts at the 26th Marabou Symposium entitled 'Nutrition, Epigenetics, Genetics: Impact on Health and Disease'. For a compilation of the general discussion at the marabou symposium, click here http://www.marabousymposium.org/.


Subject(s)
Chronic Disease/therapy , Epigenomics/methods , Nutrition Disorders/genetics , Combined Modality Therapy , Humans , Individuality , Nutrition Disorders/diet therapy , Nutrition Disorders/physiopathology , Prognosis
8.
J Biol Chem ; 293(12): 4486-4497, 2018 03 23.
Article in English | MEDLINE | ID: mdl-29382725

ABSTRACT

Proteostasis, or protein homeostasis, encompasses the maintenance of the conformational and functional integrity of the proteome and involves an integrated network of cellular pathways. Molecular chaperones, such as the small heat shock proteins (sHsps), are key elements of the proteostasis network that have crucial roles in inhibiting the aggregation of misfolded proteins. Failure of the proteostasis network can lead to the accumulation of misfolded proteins into intracellular and extracellular deposits. Deposits containing fibrillar forms of α-synuclein (α-syn) are characteristic of neurodegenerative disorders including Parkinson's disease and dementia with Lewy bodies. Here we show that the sHsp Hsp27 (HSPB1) binds to α-syn fibrils, inhibiting fibril growth by preventing elongation. Using total internal reflection fluorescence (TIRF)-based imaging methods, we show that Hsp27 binds along the surface of α-syn fibrils, decreasing their hydrophobicity. Binding of Hsp27 also inhibits cytotoxicity of α-syn fibrils. Our results demonstrate that the ability of sHsps, such as Hsp27, to bind fibrils represents an important mechanism through which they may mitigate cellular toxicity associated with aberrant protein aggregation. Fibril binding may represent a generic mechanism by which chaperone-active sHsps interact with aggregation-prone proteins, highlighting the potential to target sHsp activity to prevent or disrupt the onset and progression of α-syn aggregation associated with α-synucleinopathies.


Subject(s)
HSP27 Heat-Shock Proteins/metabolism , Neuroblastoma/pathology , Protein Aggregates , alpha-Synuclein/metabolism , Animals , HSP27 Heat-Shock Proteins/genetics , Heat-Shock Proteins , Humans , Mice , Molecular Chaperones , Neuroblastoma/metabolism , Tumor Cells, Cultured , alpha-Synuclein/genetics
12.
Sci Rep ; 6: 36010, 2016 11 03.
Article in English | MEDLINE | ID: mdl-27808107

ABSTRACT

α-Synuclein is an intrinsically disordered protein that is associated with the pathogenesis of Parkinson's disease through the processes involved in the formation of amyloid fibrils. α and ß-synuclein are homologous proteins found at comparable levels in presynaptic terminals but ß-synuclein has a greatly reduced propensity to aggregate and indeed has been found to inhibit α-synuclein aggregation. In this paper, we describe how sequence differences between α- and ß-synuclein affect individual microscopic processes in amyloid formation. In particular, we show that ß-synuclein strongly suppresses both lipid-induced aggregation and secondary nucleation of α-synuclein by competing for binding sites at the surfaces of lipid vesicles and fibrils, respectively. These results suggest that ß-synuclein can act as a natural inhibitor of α-synuclein aggregation by reducing both the initiation of its self-assembly and the proliferation of its aggregates.


Subject(s)
Binding, Competitive , Protein Aggregates , Protein Aggregation, Pathological , alpha-Synuclein/chemistry , alpha-Synuclein/metabolism , beta-Synuclein/metabolism , Amino Acid Sequence , Hydrogen-Ion Concentration , Lipids/chemistry , Phosphatidylserines/chemistry , Protein Binding , Sequence Alignment , Surface Properties , beta-Synuclein/chemistry
13.
Obes Rev ; 17(10): 1001-11, 2016 10.
Article in English | MEDLINE | ID: mdl-27324830

ABSTRACT

Overweight and obesity increase the risks of diabetes and cardiovascular disease (CVD). This has been shown to be reversed with weight loss. A systematic review and meta-analysis were performed to determine the effect of weight loss in the primary prevention of CVD. PubMed, Embase and the Cochrane Library databases were searched electronically through to May 2013. Randomized controlled trials assessing weight loss and cardiovascular risk factors and outcomes were included. A random effects meta-analysis, with sub-group analyses for degree of weight loss, and age were performed. Because few studies reported clinical outcomes of CVD, analyses were limited to cardiovascular risk factors (83 studies). Interventions that caused any weight loss significantly reduced systolic blood pressure (-2.68 mmHg, 95% CI -3.37, -2.11), diastolic blood pressure (-1.34 mmHg, 95% CI -1.71, -0.97), low-density lipoprotein cholesterol (-0.20 mmol L(-1) , 95% CI -0.29, -0.10), triglycerides (-0.13 mmol L(-1) , 95% CI -0.22, -0.03), fasting plasma glucose (-0.32 mmol L(-1) , 95% CI -0.43, -0.22) and haemoglobin A1c(-0.40%, 95% CI -0.52, -0.28) over 6-12 months. Significant changes remained after 2 years for several risk factors. Similar results were seen in sub-group analyses. Interventions that cause weight loss are effective at improving cardiovascular risk factors at least for 2 years. © 2016 World Obesity.


Subject(s)
Cardiovascular Diseases/prevention & control , Diabetes Mellitus, Type 2/prevention & control , Diabetic Angiopathies/prevention & control , Diet, Reducing , Exercise , Obesity/complications , Primary Prevention/methods , Weight Loss , Blood Pressure , Humans , Obesity/physiopathology , Obesity/prevention & control , Treatment Outcome
14.
Proc Natl Acad Sci U S A ; 113(26): 7065-70, 2016 06 28.
Article in English | MEDLINE | ID: mdl-27298346

ABSTRACT

Intracellular α-synuclein deposits, known as Lewy bodies, have been linked to a range of neurodegenerative disorders, including Parkinson's disease. α-Synuclein binds to synthetic and biological lipids, and this interaction has been shown to play a crucial role for both α-synuclein's native function, including synaptic plasticity, and the initiation of its aggregation. Here, we describe the interplay between the lipid properties and the lipid binding and aggregation propensity of α-synuclein. In particular, we have observed that the binding of α-synuclein to model membranes is much stronger when the latter is in the fluid rather than the gel phase, and that this binding induces a segregation of the lipids into protein-poor and protein-rich populations. In addition, α-synuclein was found to aggregate at detectable rates only when interacting with membranes composed of the most soluble lipids investigated here. Overall, our results show that the chemical properties of lipids determine whether or not the lipids can trigger the aggregation of α-synuclein, thus affecting the balance between functional and aberrant behavior of the protein.


Subject(s)
Cell Membrane/metabolism , Lipid Bilayers/chemistry , Parkinson Disease/metabolism , alpha-Synuclein/chemistry , Cell Membrane/chemistry , Humans , Kinetics , Lipid Bilayers/metabolism , Protein Aggregation, Pathological/metabolism , alpha-Synuclein/metabolism
15.
J Dent Res ; 95(5): 598, 2016 May.
Article in English | MEDLINE | ID: mdl-26868327

Subject(s)
Dental Caries
16.
J Dairy Sci ; 99(3): 2063-2075, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26805984

ABSTRACT

A better understanding of the behavior of individual grazing dairy cattle will assist in improving productivity and welfare. Global positioning systems (GPS) applied to cows could provide a means of monitoring grazing herds while overcoming the substantial efforts required for manual observation. Any model of behavioral prediction using GPS needs to be accurate and robust by accounting for inter-cow variation as well as atmospheric effects. We evaluated the performance using a series of machine learning algorithms on GPS data collected from 40 pasture-based dairy cows over 4 mo. A feature extraction step was performed on the collected raw GPS data, which resulted in 43 different attributes. The evaluated behaviors were grazing, resting, and walking. Classifier learners were built using 10 times 10-fold cross validation and tested on an independent test set. Results were evaluated using a variety of statistical significance tests across all parameters. We found that final model selection depended upon level of performance and model complexity. The classifier learner deemed most suitable for this particular problem was JRip, a rule-based learner (classification accuracy=0.85; false positive rate=0.10; F-measure=0.76; area under the receiver operating curve=0.87). This model will be used in further studies to assess the behavior and welfare of pasture-based dairy cows.


Subject(s)
Data Mining , Herbivory/physiology , Machine Learning , Rest/physiology , Walking/physiology , Algorithms , Animals , Cattle , Female , Geographic Information Systems , Reproducibility of Results
17.
J Dent Res ; 94(10): 1341-7, 2015 Oct.
Article in English | MEDLINE | ID: mdl-26261186

ABSTRACT

The importance of sugars as a cause of caries is underemphasized and not prominent in preventive strategies. This is despite overwhelming evidence of its unique role in causing a worldwide caries epidemic. Why this neglect? One reason is that researchers mistakenly consider caries to be a multifactorial disease; they also concentrate mainly on mitigating factors, particularly fluoride. However, this is to misunderstand that the only cause of caries is dietary sugars. These provide a substrate for cariogenic oral bacteria to flourish and to generate enamel-demineralizing acids. Modifying factors such as fluoride and dental hygiene would not be needed if we tackled the single cause--sugars. In this article, we demonstrate the sensitivity of cariogenesis to even very low sugars intakes. Quantitative analyses show a log-linear dose-response relationship between the sucrose or its monosaccharide intakes and the progressive lifelong development of caries. This results in a substantial dental health burden throughout life. Processed starches have cariogenic potential when accompanying sucrose, but human studies do not provide unequivocal data of their cariogenicity. The long-standing failure to identify the need for drastic national reductions in sugars intakes reflects scientific confusion partly induced by pressure from major industrial sugar interests.


Subject(s)
Dental Caries/etiology , Dietary Carbohydrates/adverse effects , Health Policy , Dental Caries/prevention & control , Dietary Carbohydrates/administration & dosage , Dietary Carbohydrates/standards , Forecasting , Health Policy/trends , Humans , Nutrition Policy
18.
J Intern Med ; 278(2): 99-109, 2015 Aug.
Article in English | MEDLINE | ID: mdl-25832550

ABSTRACT

MicroRNAs (miRNAs) are one of a growing class of noncoding RNAs that are involved in the regulation of a wide range of metabolic processes including cellular differentiation, cell proliferation and apoptosis. The generation of miRNA is regulated in complex ways, for example by small interfering RNAs (small nucleolar and nuclear RNAs) and various other metabolites. This complexity of control is likely to explain how a relatively small part of the DNA that codes for proteins has enabled the evolution of such complex organisms as mammals. Non-protein-coding DNA is therefore thought to carry the memory of early evolutionary steps that led to progressively complex metabolic controls. Clinically, miRNAs are becoming increasingly important following the recognition that some congenital abnormalities can be traced to defects in miRNA processing. The potential for manipulating metabolism and affecting disease processes by the pharmaceutical or biological targeting of specific miRNA pathways is now being tested. miRNAs are also released into the extracellular milieu after packaging by cells into nano-sized extracellular vesicles. Such vesicles can be taken up by adjacent and possibly more distant cells, thereby allowing coordinated intercellular communication in specific tissues. Extracellular miRNAs found in the blood stream may also serve as novel biomarkers for both diagnosing specific forms of cancer and assessing the likelihood of metastasis, and as powerful prognostic indices for various cancers. Here, we discuss the role of intracellular and extracellular miRNAs in nutritional control of various (patho)physiological processes. In this review, we provide an update of the presentations from the 25th Marabou Symposium (Stockholm, 14-16 June 2013) entitled 'Role of miRNA in health and nutrition', attended by 50 international experts


Subject(s)
MicroRNAs/genetics , Neoplasms/genetics , Nutrition Assessment , Animals , Cell Communication , Humans , Prognosis
19.
Int J Obes (Lond) ; 39(5): 849-57, 2015 May.
Article in English | MEDLINE | ID: mdl-25520249

ABSTRACT

BACKGROUND/OBJECTIVES: The Sibutramine Cardiovascular OUTcomes (SCOUT) trial showed a significantly increased relative risk of nonfatal cardiovascular events, but not mortality, in overweight and obese subjects receiving long-term sibutramine treatment with diet and exercise. We examined the relationship between early changes (both increases and decreases) in pulse rate, and the impact of these changes on subsequent cardiovascular outcome events in both the placebo and sibutramine groups. SUBJECTS/METHODS: 9804 males and females, aged ⩾55 years, with a body mass index of 27-45 kg m(-)(2) were included in this current subanalysis of the SCOUT trial. Subjects were required to have a history of cardiovascular disease and/or type 2 diabetes mellitus with at least one cardiovascular risk factor, to assess cardiovascular outcomes. The primary outcome event (POE) was a composite of nonfatal myocardial infarction, nonfatal stroke, resuscitated cardiac arrest or cardiovascular death. Time-to-event analyses of the POE were performed using Cox regression models. RESULTS: During the initial 6-week sibutramine treatment period, the induced pulse rate increase was related to weight change (1.9±7.7 beats per minute (bpm) with weight increase; 1.4±7.3 bpm, 0-5 kg weight loss; 0.6±7.4 bpm, ⩾5 kg weight loss). Throughout the subsequent treatment period, those continuing on sibutramine showed a consistently higher mean pulse rate than the placebo group. There was no difference in POE rates with either an increase or decrease in pulse rate over the lead-in period, or during lead-in baseline to 12 months post randomization. There was also no relationship between pulse rate at lead-in baseline and subsequent cardiovascular events in subjects with or without a cardiac arrhythmia. CONCLUSION: Baseline pulse rate and changes in pulse rate may not be an important modifier nor a clinically useful predictor of outcome in an individual elderly cardiovascular obese subject exposed to weight management.


Subject(s)
Appetite Depressants/administration & dosage , Cardiovascular Diseases/prevention & control , Cyclobutanes/administration & dosage , Diabetic Angiopathies/prevention & control , Heart Rate/drug effects , Obesity/physiopathology , Aged , Body Mass Index , Cardiovascular Diseases/drug therapy , Cardiovascular Diseases/epidemiology , Diabetic Angiopathies/drug therapy , Diabetic Angiopathies/epidemiology , Female , Humans , Male , Middle Aged , Obesity/complications , Obesity/epidemiology , Predictive Value of Tests , Risk Factors , Treatment Outcome , United Kingdom/epidemiology , Weight Loss
20.
Nutr Metab Cardiovasc Dis ; 24(6): 656-62, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24534073

ABSTRACT

BACKGROUND AND AIMS: An inverse relationship between (serum) total bilirubin and risk of cardiovascular disease has been reported previously, but longitudinal data on overweight and obese patients are lacking. We have investigated the relationship between total bilirubin and cardiovascular adverse events in a large group of patients with risk factors for cardiovascular disease who were enrolled in a large weight loss trial. METHODS AND RESULTS: Data from the Sibutramine Cardiovascular Outcomes (SCOUT) trial, including almost 10.000 overweight/obese high cardiovascular risk patients, were used. The relationship between total bilirubin level at screening and the primary outcome (i.e. non-fatal myocardial infarction, non-fatal stroke, resuscitated cardiac arrest or cardiovascular death) for the entire study period was investigated using Cox proportional hazards models. The population was divided into four groups based on total bilirubin levels (normal range 5-25 µmol/L). Time-dependent Cox analyses were also performed to adjust for weight loss over time. Initial analyses adjusted for sex, age and treatment allocation showed significantly reduced hazard ratios of 0.80 (95% confidence interval 0.68-0.94), 0.73 (0.62-0.86) and 0.77 (0.65-0.91), for the three higher total bilirubin groups: >8 and ≤10 µmol/L, >10 and ≤13 µmol/L and >13 µmol/L (5-95 interpercentile range for total bilirubin at screening; 6-19 µmol/L), compared to the lowest total bilirubin group ≤8 µmol/L. When adjusting for classical cardiovascular risk factors, estimates increased towards unity. Additional adjustment for indicators of liver function did not alter the results. A time-dependent Cox model, adjusted for weight loss, demonstrated a similar trend. CONCLUSION: Bilirubin was not a risk-factor independent from other traditional cardiovascular risk-factors in our population.


Subject(s)
Bilirubin/blood , Cardiovascular Diseases/etiology , Obesity/physiopathology , Overweight/physiopathology , Aged , Body Mass Index , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/mortality , Cardiovascular Diseases/prevention & control , Cohort Studies , Double-Blind Method , Female , Heart Arrest/epidemiology , Heart Arrest/etiology , Heart Arrest/prevention & control , Heart Arrest/therapy , Humans , Incidence , Life Style , Male , Middle Aged , Mortality , Myocardial Infarction/epidemiology , Myocardial Infarction/etiology , Myocardial Infarction/mortality , Myocardial Infarction/prevention & control , Obesity/blood , Obesity/therapy , Overweight/blood , Overweight/therapy , Proportional Hazards Models , Retrospective Studies , Risk Factors , Stroke/epidemiology , Stroke/etiology , Stroke/mortality , Stroke/prevention & control , Up-Regulation , Weight Loss
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