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European Review For Medical and... Jan 2024The purpose of this meta-analysis is to evaluate the efficacy of a keto-supplemented low-protein diet (sLPD) in enhancing nutritional status among individuals undergoing... (Meta-Analysis)
Meta-Analysis
Efficacy and safety of keto-supplemented low-protein diet on nutritional status of peritoneal-dialysis patients: a systematic review and meta-analysis of randomized controlled trials.
OBJECTIVE
The purpose of this meta-analysis is to evaluate the efficacy of a keto-supplemented low-protein diet (sLPD) in enhancing nutritional status among individuals undergoing peritoneal dialysis (PD) compared to a low-protein diet (LPD).
MATERIALS AND METHODS
Studies from PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched and reviewed up to January 2023. Randomized controlled trials (RCTs) were enrolled and analyzed using STATA MP 17. In this review, serum albumin (Alb), body mass index (BMI), and serum prealbumin (PA) were included for efficacy evaluation and serum calcium (CA) for safety evaluation. Potential heterogeneity was detected using subgroup analyses.
RESULTS
7 RCTs were included. Compared with LPD, sLPD can improve the Alb [Weighted Mean Difference (WMD)=4.16; 95% CI: 2.50, 5.83; p<0.0001), BMI [WMD=1.35; 95% CI: 0.59, 2.11; p<0.0001] and PA [WMD=0.07; 95% CI: 0.04, 0.10; p<0.0001] level of patients undergoing PD. Subgroup analyses showed that, although Alb had no difference with LPD within 12 months of PD duration, sLPD treatment could improve the levels of Alb and PA regardless of PD duration or course of treatment. sLPD can improve the BMI of patients with a PD duration of more than 24 months, regardless of the duration of treatment.
CONCLUSIONS
A sLPD is an effective intervention for improving the nutritional status of PD patients. It is suggested that patients undergoing PD should initiate sLPD at the beginning of PD to ensure sufficient nutritional intake.
Topics: Humans; Nutritional Status; Diet, Protein-Restricted; Renal Dialysis; Randomized Controlled Trials as Topic; Peritoneal Dialysis
PubMed: 38305613
DOI: 10.26355/eurrev_202401_35071 -
The International Journal of Biological... Jun 2024This study aimed to establish a nomogram to distinguish advanced- and early-stage lung cancer based on coagulation-related biomarkers and liver-related biomarkers.
BACKGROUND
This study aimed to establish a nomogram to distinguish advanced- and early-stage lung cancer based on coagulation-related biomarkers and liver-related biomarkers.
METHODS
A total of 306 patients with lung cancer and 172 patients with benign pulmonary disease were enrolled. Subgroup analyses based on histologic type, clinical stage, and neoplasm metastasis status were carried out and multivariable logistic regression analysis was applied. Furthermore, a nomogram model was developed and validated with bootstrap resampling.
RESULTS
The concentrations of complement C1q, fibrinogen, and D-dimers, fibronectin, inorganic phosphate, and prealbumin were significantly changed in lung cancer patients compared to benign pulmonary disease patients. Multiple regression analysis based on subgroup analysis of clinical stage showed that compared with early-stage lung cancer, female ( < 0.001), asymptomatic admission ( = 0.001), and total bile acids ( = 0.011) were negatively related to advanced lung cancer, while C1q ( = 0.038), fibrinogen ( < 0.001), and D-dimers ( = 0.001) were positively related. A nomogram model based on gender, symptom, and the levels of total bile acids, C1q, fibrinogen, and D-dimers was constructed for distinguishing advanced lung cancer and early-stage lung cancer, with an area under the receiver operating characteristic curve of 0.919. The calibration curve for this nomogram revealed good predictive accuracy ( = 0.697) between the predicted probability and the actual probability.
CONCLUSIONS
We developed a nomogram based on gender, symptom, and the levels of fibrinogen, D-dimers, total bile acids, and C1q that can individually distinguish early- and advanced-stage lung cancer.
Topics: Humans; Lung Neoplasms; Female; Male; Nomograms; Middle Aged; Complement C1q; Bile Acids and Salts; Biomarkers, Tumor; Aged; Neoplasm Staging; Fibrinogen; Blood Coagulation
PubMed: 38303516
DOI: 10.1177/03936155241229454 -
Investigative Ophthalmology & Visual... Jan 2024Transthyretin (TTR) plays a regulatory role in a variety of diabetes-related diseases. The objective of this work was to probe whether TTR affects diabetic retinopathy...
PURPOSE
Transthyretin (TTR) plays a regulatory role in a variety of diabetes-related diseases. The objective of this work was to probe whether TTR affects diabetic retinopathy (DR) through the VEGFA/PI3K/AKT pathway.
METHODS
High glucose (HG, 25 mM) was used to treat human retinal microvascular endothelial cells (hRMECs) and C57BL/6J mice were intraperitoneally injected with STZ (50 mg/kg) to construct a DR model. In vitro, the effect of TTR on DR was evaluated by measuring hRMEC proliferation, migration, and angiogenesis. The changes in retinal tissue were observed by hematoxylin and eosin staining in vivo. ELISA, immunohistochemistry, and immunofluorescence staining were used to measure VEGFA or CD31 levels. The levels of all proteins were evaluated through Western blot.
RESULTS
The increase of proliferation, migration, and angiogenesis and decrease of apoptosis in hRMECs caused by HG were notably reversed by TTR. TTR greatly impeded HG-raised VEGFA, PI3K p-p85, and p-AKT in hRMECs. Inhibition of TTR further exacerbated the effect of HG-induced hRMECs. Inhibition of VEGFA reversed the effect of HG-induced hRMECs. VEGFA neutralized the function of TTR on cell proliferation, apoptosis, migration, and angiogenesis in HG-triggered hRMECs. It was further confirmed in vivo that TTR can alleviate the occurrence of DR in diabetic mice models.
CONCLUSIONS
TTR significantly restrained the progression of DR via molecular modulation of the VEGFA/PI3K/AKT axis.
Topics: Animals; Humans; Mice; Diabetes Mellitus, Experimental; Diabetic Retinopathy; Endothelial Cells; Mice, Inbred C57BL; Phosphatidylinositol 3-Kinases; Prealbumin; Proto-Oncogene Proteins c-akt; Vascular Endothelial Growth Factor A
PubMed: 38289614
DOI: 10.1167/iovs.65.1.45 -
Medicine Jan 2024For exploring the positive relief effect and application value of cluster nursing strategies on stroke patients with dysphagia in rehabilitation medicine. A...
For exploring the positive relief effect and application value of cluster nursing strategies on stroke patients with dysphagia in rehabilitation medicine. A retrospective analysis was conducted on 70 patients with stroke dysphagia admitted to the Rehabilitation Medicine Department of our hospital from June 2021 to November 2022; by comparison, patients were separated into intervention group (IG) and control group (CG) according to different degrees of swallowing difficulty, and nutritional nursing interventions were conducted on the selected research subjects. It was given routine care in the CG and a cluster nursing strategy in the IG, with a total intervention time of 5 months. Before intervention, general information of all patients was compared. Before and after intervention, the incidence of aspiration, nutritional biochemical indicators (hemoglobin, total serum protein, albumin, prealbumin, total cholesterol), grip strength, Swallowing Quality of Life score, etc were collected from the 2 groups of patients. Finally, the specific benefits were analyzed through statistical results to evaluate the intervention effect. After intervention, the explicit aspiration rate of the participants in this experiment significantly decreased, and the difference among the participants in this experiment was statistically significant (P < .05); the implicit aspiration rate was not statistically significant (P > .05). In the comparison of nursing expenses, the CG spent 5403.57 ± 815.51 yuan, while the IG spent 5237.10 ± 758.35 yuan. There was a statistically marked disparity among the participants in this experiment (t = 52.41, P < .001). In the comparison of hospitalization expenses, the cost of the CG was 9236.05 ± 3236.08 yuan; The cost of the IG was 9538.59 ± 4985.21 yuan, and there was a marked disparity among the participants in this experiment (P < .001). The significant statistical significance exists (P < .05) in the 5 indicators of hemoglobin, total protein, prealbumin, albumin, and total cholesterol, quality of life scores, and patient physical efficacy in both groups. The intervention study of cluster nursing strategy for stroke patients with dysphagia in rehabilitation medicine can effectively reduce the incidence of overt aspiration and ultimately improve their quality of life. It has high clinical application value.
Topics: Humans; Deglutition Disorders; Prealbumin; Quality of Life; Retrospective Studies; Stroke; Hemoglobins; Cholesterol
PubMed: 38277564
DOI: 10.1097/MD.0000000000036143 -
Central European Journal of Public... Dec 2023Thyroid diseases are among the most common endocrinopathies and metabolic disorders. Hypothyroidism is caused by insufficient production of thyroid hormones with a...
OBJECTIVE
Thyroid diseases are among the most common endocrinopathies and metabolic disorders. Hypothyroidism is caused by insufficient production of thyroid hormones with a higher prevalence in women. Causes for the development of endocrine diseases may be mutations in genes that encode peptide hormones. The aim of this scientific study was to determine the genotype and allele frequencies of the rs104893657 variant of the PAX8 gene and to determine the genotype versus phenotype association.
METHODS
The study population consisted of 135 women from northeastern Slovakia who were divided on the basis of screening into two groups: a control group without diagnosed hypothyroidism (CG = 67) and a group of women with hypothyroidism (HY = 68). Biochemical markers - thyroid-stimulating hormone (TSH), prealbumin (PREA), calcium (Ca), phosphorus (P), and alkaline phosphatase (ALP) were determined using Cobas Integra 400 plus, Cobas e411 analysers (Roche). Genotyping was performed using TaqMan SNP Genotyping Assay instrument 7500 Fast Real-Time PCR Systems (Applied Biosystem).
RESULTS
Student's t-test revealed a statistically significant difference between CG and HY in biochemical parameters: TSH (p < 0.001), P (p = 0.008). By Chi-square test we found no statistically significant difference in the representation of genotypes (p = 0.788) in the rs104893657 polymorphism of PAX8 gene. The T allele was not associated with hypothyroidism in Slovak women (p = 0.548). In CC genotype we found statistically significant difference between CG and HY in parameters TSH (p < 0.001) and P (p = 0.006).
CONCLUSION
The mutant T allele was detected at low frequency in both groups of women studied. The association of the T allele with the development of hypothyroidism in Slovak women was not confirmed. The results of this work provide initial information on the distribution of genotypes and alleles in the studied variant of PAX8 gene in the Slovak female population.
Topics: Humans; Female; Slovakia; Hypothyroidism; Thyrotropin; Genotype; Polymorphism, Genetic; PAX8 Transcription Factor
PubMed: 38272482
DOI: 10.21101/cejph.a7842 -
Immunity, Inflammation and Disease Jan 2024To identify the key differences in laboratory indicators between mono-infection and co-infection by influenza viruses and Omicron to facilitate timely adjustments in...
OBJECTIVES
To identify the key differences in laboratory indicators between mono-infection and co-infection by influenza viruses and Omicron to facilitate timely adjustments in patient treatment strategies.
METHODS
Prealbumin and C-reactive protein (CRP) levels were analyzed in 161 COVID-19 cases infected by SARS-CoV-2 (wild type), 299 cases infected by Omicron, 95 cases infected by influenza virus A/B (Flu A/B) and 133 co-infection cases infected with Flu A/B and Omicron. The receiver operating characteristic (ROC) curve and logistic regression equation were used to analyze the clinical predictive capacity of prealbumin and CRP in coinfected patients.
RESULTS
The co-infected and wild-type infected patients had significantly different CRP and prealbumin levels compared to mono-infected patients with Omicron or Flu A/B (p < .001). The ROC curve results indicated that prealbumin was more efficient than CRP in identifying co-infection from Omicron (AUC: 0.867 vs. 0.724) or Flu A/B (AUC: 0.797 vs. 0.730), and joint prediction significantly improved the diagnostic ability to discriminate co-infection from mono-infection (AUC: 0.934 and 0.887).
CONCLUSION
The findings suggest that prealbumin is a valuable indicator that can warn of co-infection and guide timely treatment decisions. Joint prediction may offer an even more effective diagnostic tool for discriminating co-infection from mono-infection.
Topics: Humans; Coinfection; Prealbumin; COVID-19; Inflammation; Orthomyxoviridae
PubMed: 38270315
DOI: 10.1002/iid3.1158 -
Molecules (Basel, Switzerland) Jan 2024The small-molecule iododiflunisal (IDIF) is a transthyretin (TTR) tetramer stabilizer and acts as a chaperone of the TTR-Amyloid beta interaction. Oral administration of...
The small-molecule iododiflunisal (IDIF) is a transthyretin (TTR) tetramer stabilizer and acts as a chaperone of the TTR-Amyloid beta interaction. Oral administration of IDIF improves Alzheimer's Disease (AD)-like pathology in mice, although the mechanism of action and pharmacokinetics remain unknown. Radiolabeling IDIF with positron or gamma emitters may aid in the in vivo evaluation of IDIF using non-invasive nuclear imaging techniques. In this work, we report an isotopic exchange reaction to obtain IDIF radiolabeled with F. [F/F]exchange reaction over IDIF in dimethyl sulfoxide at 160 °C resulted in the formation of [F]IDIF in 7 ± 3% radiochemical yield in a 20 min reaction time, with a final radiochemical purity of >99%. Biodistribution studies after intravenous administration of [F]IDIF in wild-type mice using positron emission tomography (PET) imaging showed capacity to cross the blood-brain barrier (ca. 1% of injected dose per gram of tissue in the brain at t > 10 min post administration), rapid accumulation in the liver, long circulation time, and progressive elimination via urine. Our results open opportunities for future studies in larger animal species or human subjects.
Topics: Humans; Animals; Mice; Pharmaceutical Preparations; Tissue Distribution; Alzheimer Disease; Prealbumin; Amyloid beta-Peptides; Excipients; Diflunisal
PubMed: 38257401
DOI: 10.3390/molecules29020488 -
PloS One 2024Transthyretin amyloidosis (ATTR amyloidosis) is a progressive, multi-systemic disease with wild-type (ATTRwt) and hereditary (ATTRv) forms. Over 130 variants associated... (Observational Study)
Observational Study
Transthyretin amyloidosis (ATTR amyloidosis) is a progressive, multi-systemic disease with wild-type (ATTRwt) and hereditary (ATTRv) forms. Over 130 variants associated with ATTRv amyloidosis have been identified, although little is known about the majority of these genotypes. This analysis examined phenotypic characteristics of symptomatic patients with ATTRv amyloidosis enrolled in the Transthyretin Amyloidosis Outcomes Survey (THAOS) with four less frequently reported pathogenic genotypes: F64L (c.250T>C, p.F84L), I68L (c.262A>T, p.I88L), I107V (c.379A>G; p.I127V), and S77Y (c.290C>A; p.S97Y). THAOS is the largest ongoing, global, longitudinal observational study of patients with ATTR amyloidosis, including both ATTRwt and ATTRv amyloidosis. This analysis describes the baseline demographic and clinical characteristics of untreated symptomatic patients with the F64L, I68L, I107V, or S77Y genotypes at enrollment in THAOS (data cutoff date: January 4, 2022). There were 141 symptomatic patients with F64L (n = 46), I68L (n = 45), I107V (n = 21), or S77Y (n = 29) variants at the data cutoff. Most patients were male and median age at enrollment was in the sixth decade for S77Y patients and the seventh decade for the others. A predominantly neurologic phenotype was associated with F64L, I107V, and S77Y genotypes, whereas patients with the I68L genotype presented with more pronounced cardiac involvement. However, a mixed phenotype was also reported in a considerable proportion of patients in each variant subgroup. This analysis from THAOS represents the largest study of ATTRv symptomatic patients with the F64L, I68L, I107V, and S77Y genotypes. These data add to the limited knowledge on the clinical profile of patients with specific ATTRv variants and emphasize the importance of comprehensive assessment of all patients. Trial registration ClinicalTrials.gov: NCT00628745.
Topics: Female; Humans; Male; Amyloid Neuropathies, Familial; Genotype; Phenotype; Prealbumin; Surveys and Questionnaires; Middle Aged; Aged
PubMed: 38241252
DOI: 10.1371/journal.pone.0292435 -
Heart Failure Reviews Mar 2024Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) is an underrecognized cause of heart failure due to misfolded wild-type transthyretin (TTRwt) myocardial... (Review)
Review
Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) is an underrecognized cause of heart failure due to misfolded wild-type transthyretin (TTRwt) myocardial deposition. The development of wild-type TTR amyloid fibrils is a complex pathological process linked to the deterioration of homeostatic mechanisms owing to aging, plausibly implicating multiple molecular mechanisms. The components of amyloid transthyretin often include serum amyloid P, proteoglycans, and clusterin, which may play essential roles in the localization and elimination of amyloid fibrils. Oxidative stress, impaired mitochondrial function, and perturbation of intracellular calcium dynamics induced by TTR contribute to cardiac impairment. Recently, tafamidis has been the only drug approved by the U.S. Food and Drug Administration (FDA) for the treatment of ATTRwt-CM. In addition, small interfering RNAs and antisense oligonucleotides for ATTR-CM are promising therapeutic approaches and are currently in phase III clinical trials. Newly emerging therapies, such as antibodies targeting amyloid, inhibitors of seed formation, and CRISPR‒Cas9 technology, are currently in the early stages of research. The development of novel therapies is based on progress in comprehending the molecular events behind amyloid cardiomyopathy. There is still a need to further advance innovative treatments, providing patients with access to alternative and effective therapies, especially for patients diagnosed at a late stage.
Topics: Humans; Amyloid Neuropathies, Familial; Prealbumin; Heart Failure; Myocardium; Cardiomyopathies
PubMed: 38233673
DOI: 10.1007/s10741-023-10380-9 -
Structural polymorphism of amyloid fibrils in ATTR amyloidosis revealed by cryo-electron microscopy.Nature Communications Jan 2024ATTR amyloidosis is caused by the deposition of transthyretin in the form of amyloid fibrils in virtually every organ of the body, including the heart. This systemic...
ATTR amyloidosis is caused by the deposition of transthyretin in the form of amyloid fibrils in virtually every organ of the body, including the heart. This systemic deposition leads to a phenotypic variability that has not been molecularly explained yet. In brain amyloid conditions, previous studies suggest an association between clinical phenotype and the molecular structures of their amyloid fibrils. Here we investigate whether there is such an association in ATTRv amyloidosis patients carrying the mutation I84S. Using cryo-electron microscopy, we determined the structures of cardiac fibrils extracted from three ATTR amyloidosis patients carrying the ATTRv-I84S mutation, associated with a consistent clinical phenotype. We found that in each ATTRv-I84S patient, the cardiac fibrils exhibited different local conformations, and these variations can co-exist within the same fibril. Our finding suggests that one amyloid disease may associate with multiple fibril structures in systemic amyloidoses, calling for further studies.
Topics: Humans; Amyloid; Amyloid Neuropathies, Familial; Cryoelectron Microscopy; Prealbumin; Heart; Brain Diseases
PubMed: 38233397
DOI: 10.1038/s41467-024-44820-3