Associations of Abdominal Visceral Fat Content and Plasma Adiponectin Level With Intracranial Atherosclerotic Stenosis: A Cross-Sectional Study.

Background: Abdominal obesity and adipocytokines are closely related to atherosclerosis, and adiponectin level is considered one of the important clinical indicators. This study aimed to analyze the associations of abdominal visceral fat content and adiponectin level with intracranial atherosclerotic stenosis (ICAS). Methods: A total of 186 patients were enrolled in this study. Patients were distributed into ICAS and non-ICAS by the degree of artery stenosis. Plasma adiponectin levels and the ratio of visceral adipose tissue (VAT) to subcutaneous adipose tissue (SAT) were measured. The related factors of intracranial atherosclerotic stenosis were determined using multivariable logistic regression analysis. Results: The VAT/SAT ratio (OR, 26.08; 95% CI, 5.92-114.83; p < 0.001) and adiponectin (OR, 0.61; 95% CI, 0.44-0.84; p = 0.002) were found to be the independent predictors of ICAS in a multivariable logistic regression analysis. The prevalence of ICAS increased (T1: 27.4%; T2: 50.0%; T3: 75.8%) as the VAT/SAT ratio tertile increased (p < 0.001). The prevalence of ICAS decreased (T1: 72.6%; T2: 54.8%; T3: 25.8%) as the adiponectin tertile increased (p < 0.001). In ROC curves analysis, VAT/SAT ratio had a sensible accuracy for the prediction of ICAS. The optimal cut-off value of VAT/SAT ratio to predict ICAS in this study was 1.04 (AUC: 0.747; p < 0.001; sensitivity: 67.4%; specificity: 74.7%). The optimal adiponectin cutoff was 3.03 ug/ml (AUC: 0.716; p < 0.001; sensitivity:75.8%; specificity: 61.5%). Conclusion: Higher VAT/SAT ratio and lower plasma adiponectin levels were closely related to the increased risk of intracranial atherosclerotic stenosis.

Homocysteine is Associated with Exaggerated Morning Blood Pressure Surge in Patients with Acute Ischemic Stroke.

BACKGROUND: Considerable researches suggest that high level of homocysteine (Hcy) is associated with the risk of ischemic stroke. Ambulatory blood pressure monitoring (ABPM) parameters have also been confirmed associated with cardio-cerebrovascular events. However, the relationship between Hcy and ABPM parameters remains unclear in patients with acute ischemic stroke. In this study, we aim to investigate the association between Hcy level and ABPM parameters in patients with acute ischemic stroke. METHODS: We enrolled 60 patients with acute ischemic stroke who received ABPM. We calculated ABPM parameters like morning blood pressure surge (MBPS), ambulatory arterial stiffness index, blood pressure variability, and night dipping patterns. RESULTS: Multivariate logistic regression analysis indicated that patients in the top quartile of Hcy level tended to have a higher level of prewaking and sleep-trough MBPS compared with patients in the lower 3 quartiles after adjusted for age and gender (P = .028 and P = .030, respectively). When treating Hcy as a continuous variable, the linear regression showed the association between Hcy level and both MBPS parameters remained significant (prewaking MBPS, r = .356, P = .022; sleep-trough MBPS, r = .365, P = .017, respectively). However, there is no association between Hcy level and ambulatory arterial stiffness index, blood pressure variability or night dipping patterns (P = .635, P = .348 and P = .127 respectively). CONCLUSIONS: There is a relationship between the 2 major cerebrovascular risk factors: MBPS and Hcy.

Effect of marital status on survival in glioblastoma multiforme by demographics, education, economic factors, and insurance status.

The relationship between marital status and glioblastoma multiforme (GBM) has not been addressed in depth. Here, we aimed to investigate the association between marital status and survival in GBM. We searched the Surveillance, Epidemiology, and End Results (SEER) database and extracted the data of eligible patients diagnosed with GBM after 2004. Marital status was classified as married, divorced/separated, widowed, and single. A Kaplan-Meier test was conducted to compare the survival curves of different groups. Multivariate Cox regression was performed to evaluate overall survival (OS) and cause-specific survival (CSS) in different groups. Subgroup analysis was applied according to demographics, typical education and income levels in the locale, and insurance status. A total of 30 767 eligible patients were included. The median OS values were 9, 7, 3, 9 months in married, divorced/separated, widowed, and single patients, respectively. After adjustment for other covariates, married patients had better OS and CSS than other patients had. In addition to marital status, demographic factors, disease progression factors, local educational level, and insurance status were also associated with survival in GBM. Furthermore, subgroup analyses revealed the protective effect of marriage in most of the comparisons. Notably, the protective effect of marriage becomes more and more apparent as time goes on. The advantageous effect of marriage on GBM survival is especially prominent in patients who are male, older than 60 years of age, White, or living in middle-income counties. In conclusion, marital status is an independent prognostic factor for GBM.

Marital status is associated with survival of patients with astrocytoma.

The prognostic role of marital status in patients with astrocytoma has not been fully explored. In this study we investigated the association of marital status and survival of astrocytoma. We extracted the eligible patients with astrocytoma diagnosed after 2000 from the Surveillance, Epidemiology, and End Results (SEER) database. The marital status was classified into married, divorced/separated, widowed, and single. The differences in OS and CSS were compared using the Kaplan-Meier log-rank test, and multivariate Cox regression was applied to analyze the risk factors for OS and CSS. Subgroup analyses were conducted to explore the association of marital status with patients in different sex, age, race, histologic type based on 2016 WHO grade, year of diagnosis, median household income and surgery status. A total of 43, 324 eligible patients were included. The median overall survival is 17, 11, 9, 3 months in single, married, divorced/separated patients, and widowed patients, respectively. Although single patients seemed to have the longest overall survival, after adjusted for other co-variables, married patients had the best OS and CSS compared with others, while divorced/separated or widowed patients had the worst CSS in different subgroups. Furthermore, subgroup analyses revealed some interesting results such as the CSS showed no difference between single and married for women (P = 0.122). In conclusion, marital status was an independent prognostic factor for astrocytoma patients. The healthcare system should aware of that patients with an aborted marriage need more social and physiological support.

Hypoxia increases amyloid-ß level in exosomes by enhancing the interaction between CD147 and Hook1.

Hypoxia promotes the accumulation of amyloid-ß (Aß), which is related to the pathogenesis of Alzheimer's disease (AD). CD147 is considered as an additional subunit of γ-secretase regulated by hypoxia, and has been identified in exosomes. Aß is also found in exosomes that participate in the intercellular communication and amyloids propagation. This study was to investigate the role of CD147 in hypoxia-induced accumulation of Aß in exosomes. Our results showed that hypoxia increased the levels of Aß40 and Aß42 in exosomes and enhanced the interaction between CD147 and Hook1 in SH-SY5YAPP695 cells. Moreover, hypoxia increased the interaction between amyloid precursor protein (APP) and CD147 as well as the expression of CD147 in isolated membrane. After we interfered the interaction between CD147 and Hook1 by decreasing Rab22a expression, the hypoxia induced Aß accumulation in exosomes was significantly suppressed. In addition, the increased interaction between CD147 and Hook1 was further confirmed in hypoxia exposed C57BL/6 mice. Our findings reveal that hypoxia may increase exosome Aß level by enhancing the interaction between CD147 and Hook1.

Prognostic value of morning blood pressure surge in clinical events: a meta-analysis of longitudinal studies.

BACKGROUND: Cardiovascular (CV) events tend to occur more often in the morning. Thus, morning blood pressure surge (MS) may be related to the risk of CV events. The results of several studies evaluating the prognostic value of MS are inconsistent. In this study, we conducted a systematic review and meta-analysis to summarize the significance of MS in predicting future CV events. METHODS: Among the related literature, we discovered 7 eligible longitudinal studies that had evaluated MS and had followed 14,133 patients with a mean follow-up period of 7.1 years. We evaluated the predictive value of MS for future CV events, stroke, and all-cause mortality in this meta-analysis. RESULTS: For subjects with higher pre-waking MS than those with lower pre-waking MS, the pooled relative risk (RR) of all-cause mortality, stroke, and total CV events were 1.20 (95% confidence interval [CI]: .85-1.70, P = .290; 4 studies), 1.20 (95% CI: .94-1.53, P = .146; 3 studies), and 1.24 (95% CI: .60-2.53, P = .562; 3 studies), respectively. For subjects with higher sleep-trough MS, the pooled RR of all-cause mortality was 1.29 (95% CI: 1.11-1.52, P = .001; 4 studies). No significant publication bias was observed. CONCLUSIONS: Excess sleep-trough MS is a strong predictor for future all-cause mortality. Individuals with higher pre-waking MS showed a tendency for increased risk of CV outcomes, but the differences were insignificant.