scholarly journals Impact of lung function on cardiovascular diseases and cardiovascular risk factors: a two sample bidirectional Mendelian randomisation study

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2020-215600
Author(s):  
Shiu Lun Au Yeung ◽  
Maria Carolina Borges ◽  
Debbie A Lawlor ◽  
C Mary Schooling
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Lung Function ◽  
Sensitivity Analyses ◽  
Mendelian Randomisation ◽  
Summary Statistics ◽  
Reverse Causation

IntroductionObservational studies suggested lung function is inversely associated with cardiovascular disease (CVD) although these studies could be confounded. We conducted a two sample Mendelian randomisation study using summary statistics from genome-wide association studies (GWAS) to clarify the role of lung function in CVD and its risk factors, and conversely the role of CVD in lung function.MethodsWe obtained genetic instruments for forced expiratory volume in 1 s (FEV1: 260) and forced vital capacity (FVC: 320) from publicly available UK Biobank summary statistics (n=421 986) and applied to GWAS summary statistics for coronary artery disease (CAD) (n=184 305), stroke (n=446 696), atrial fibrillation (n=1 030 836) and heart failure (n=977 320) and cardiovascular risk factors. Inverse variance weighting was used to assess the impact of lung function on these outcomes, with various sensitivity analyses. Bidirectional Mendelian randomisation was used to assess reverse causation.ResultsFEV1 and FVC were inversely associated with CAD (OR per SD increase, 0.72 (95% CI 0.63 to 0.82) and 0.70 (95%CI 0.62 to 0.78)), overall stroke (0.87 (95%CI 0.77 to 0.97), 0.90 (95% CI 0.82 to 1.00)) and some stroke subtypes. FEV1 and FVC were inversely associated with type 2 diabetes and systolic blood pressure. Sensitivity analyses produced similar findings although the association with CAD was attenuated after adjusting for height (eg, OR for 1SD FEV10.95 (0.75 to 1.19), but not for stroke or type 2 diabetes. There was no strong evidence for reverse causation.ConclusionHigher lung function likely protect against CAD and stroke.

scholarly journals The impact of lung function on cardiovascular diseases and cardiovascular risk factors: a two sample bi-directional Mendelian randomization study

2020 ◽  
Author(s):  
SL Au Yeung ◽  
MC Borges ◽  
DA Lawlor ◽  
CM Schooling
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Lung Function ◽  
Mendelian Randomization ◽  
Sensitivity Analyses ◽  
Summary Statistics ◽  
The Impact ◽  
Genetic Instruments

AbstractBackgroundObservational studies suggested lung function is inversely associated with cardiovascular disease (CVD) although these studies could be susceptible to residual confounding. We conducted a 2 sample Mendelian randomization study using summary statistics from genome wide association studies (GWAS) to clarify the role of lung function in CVD and its risk factors, and conversely the role of CVD in lung function.MethodsWe obtained genetic instruments for forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) from publicly available UK Biobank summary statistics (n = 421,986). We applied these genetic instruments for FEV1 (260) and FVC (320) to publicly available GWAS summary statistics for coronary artery disease (CAD) (n = 184,305), stroke and its subtypes (n = 446,696), atrial fibrillation (n = 1,030,836), and heart failure (n = 977,320) and cardiovascular risk factors. Inverse variance weighting was used to assess the impact of lung function on these outcomes. Sensitivity analyses included MR-Egger, weighted median, MR-PRESSO, and multivariable Mendelian randomization. We also conducted bi-directional Mendelian randomization to assess whether CVD affects lung function.ResultsFEV1 and FVC were inversely associated with CAD (odds ratio (OR) per standard deviation (SD) increase, 0.72 (95% confidence interval (CI) 0.63 to 0.82) and 0.70 (95%CI 0.62 to 0.78)), overall stroke (0.87 (95%CI 0.77 to 0.97), 0.90 (0.82 to 1.00)), ischemic stroke (0.87 (95%CI 0.77 to 0.99), 0.90 (95%CI 0.80 to 1.00)), small vessel stroke (0.78, (95%CI 0.61 to 1.00), 0.74 (95%CI 0.61 to 0.92)), and large artery stroke (0.69 (95%CI 0.54 to 0.89), 0.72 (95%CI 0.57 to 0.91)). FEV1 and FVC were inversely associated with type 2 diabetes (0.75 (95%CI 0.62 to 0.90), 0.67 (95%CI 0.58 to 0.79)) and systolic blood pressure. Sensitivity analyses produced similar direction for most outcomes although the magnitude sometimes differed. Adjusting for height attenuated results for CAD (e.g. OR for 1SD FEV1 0.95 (0.76 to 1.20), but this may reflect weak instrument bias. This adjustment did not attenuate effects for stroke or type 2 diabetes. No strong evidence was observed for CVD affecting lung function.ConclusionHigher lung function likely protect against CAD and stroke.

scholarly journals Effects of Salvia hispanica L. Seeds (Azpro) on Cardiovascular Risk Factors in Patients with Type 2 Diabetes - A Retrospective Observational Study

2021 ◽  
Vol 6 (4) ◽  
pp. 57-63
Author(s):  
Dr. Piyush Desai ◽  
Divyanshu Prajapati
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Cardiovascular Risk ◽  
Visceral Fat ◽  
Omega 3 ◽  
Salvia Hispanica ◽  
Salvia Hispanica L

Background: India is the diabetes capital of the world. Despite several pharmacological options, almost 70% of patients present with poor HbA1c control. Lifestyle modifications are one of the most important interventions for such chronic metabolic disorders. Therefore, adding Lifestyle Modifier, a dietary approach collectively utilizing efficacious nutrients (natural source of very high dietary fiber, omega-3, proteins, minerals, and vitamins) while maximizing adherence is the key to the management of type 2 diabetes mellitus (T2DM). Methodology: Patients were enrolled by adding Salvia hispanica L. Seeds (Azpro) along with standard medications to evaluate outcomes on risk factors in patients of T2DM. The objective was to determine the role of Salvia hispanica L. (Azpro), as an adjunct to conventional treatment in the reduction of major and emerging cardiovascular risk factors in individuals with type 2 diabetes. A retrospective analysis was conducted on fifty patient’s data available at Advanced Diabetes Centre, Surat, India. Salvia hispanica L. (Azpro) seeds were given 10 g twice a day for 3 months as an adjunct to the standard diabetes management therapy. HbA1c, body fat, visceral fat, BMI, and weight loss were calculated at three months. Results: Consumption of Salvia hispanica L. (Azpro) seeds for three months in addition to the standard treatment led to a total 1.13 kg weight loss (p=0.0008), and HbA1c reduction by 0.58% (p=0.016). Conclusion: This result affirms the role of Salvia hispanica L. seeds in the dietary management of diabetic patients with significant (P =0.0008) weight loss & overall metabolic management. Keywords: Salvia hispanica L. (Azpro) seeds, Chia seeds, diabetes, type 2 diabetes, weight loss, HbA1c, BMI, total fat, visceral fat, cardiovascular risk, dietary fiber, omega 3 fatty acids

Questions in diabetology to be elucidated

2011 ◽  
Vol 152 (34) ◽  
pp. 1353-1361 ◽  
Author(s):  
Kornél Simon ◽  
Edit Dobó ◽  
Anikó Szépvölgyi ◽  
Estilla Szalczer ◽  
Szilvia Kazup ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Cardiovascular Risk Factors ◽  
Chronic Stress ◽  
Life Style ◽  
Causal Role

Despite advances in the management of cardiovascular diseases, the incidence of cardiovascular diseases is increasing both in developed and developing world. This phenomenon is associated with the worldwide pandemic of obesity and type 2 diabetes; both are related to the life style of urbanization. The association between life conduct of civilization and chronic stress resulting in augmentation of cardiovascular risk is detailed. Therapeutic policy practiced nowadays (polypill administration, achieving target values) in order to reduce cardiovascular risk is criticized. Primary causal role of chronic stress and life style, and secondary resultant nature of cardiovascular risk factors are stressed out in the pathogenesis of increased cardiovascular risk; therefore, limited value of an approach focusing on the management of cardiovascular risk factors, instead of targeting the primary cause, i.e. chronic stress and life conduct is emphasized. A short account is given about the similarities and dissimilarities in the pathogenesis of macro- and microangiopathy. The primary causal role of chronic stress in fetal and adult diabetes, furthermore possible triggers evoking chronic stress is discussed. Supportive experimental and clinical data are reported about the nature of basic metabolic dysregulation (dysmetabolism) in the pathogenesis of metabolic syndrome and type 2 diabetes. Besides the well documented significance of ischemic clinical manifestations of diabetes, the role of non-ischemic diabetic cardiomyopathy as an independent risk factor in evoking the total burden of cardiovascular risk in diabetes is emphasized. In reducing the cardiovascular risk in diabetics the management of high blood pressure and dyslipidemia is more effective compared to that of hyperglycemia. Besides managing cardiovascular risk factors, the successful treatment of dysmetabolism is importantly needed to eliminate the total excessive cardiovascular risk in diabetes. In order to achieve this goal the potential role of metabolic promoters is stressed out. Orv. Hetil., 2011, 152, 1353–1361.

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