Medical Bulletin 14/ December/ 2024
Here are the top medical news for the day:
Can Flooding Increase the Risk of Preterm Births?
A new analysis of more than 3,000 studies from around the world reveals that globally, flooding increases preterm births by about 3%. Children who were in utero during a flood event are also more likely to have a low birth weight. Both these outcomes are risk factors for developing chronic health conditions such as asthma and diabetes later in life. The findings were presented at AGU's 2024 Annual Meeting in Washington, D.C.
Researchers analyzed findings from 3,177 studies that collected data on pregnancy length and birth weight and flooding from the 1800s to present. Data varied widely between floods and regions: While some researchers found no impact from flooding on pregnancy, others found compelling evidence that flooding increased the risk for complications during pregnancy and birth.
Altogether, the researchers found that any given flood increases the pre-term birth rate by around 3%, compared to an unflooded region. Around 7% more children who were in utero during a flood event were born with a low birth weight.
Stress can induce early labor. Early births might also increase during floods because people are unable to get to healthcare in time to avoid going into labor. Pre-term birth can be halted if someone has access to healthcare services, but flooded or damaged roads might prevent them from getting there in time.
Because flooding can imperil people's access to food, either by destroying crops or blocking access to food supplies, people who are pregnant during flooding might be more likely to give birth to smaller babies.
Pre-term birth and low birth weights don't guarantee that a baby will develop neurological issues, obesity or diabetes later in life. But they do increase the risk.
Reference:https://news.agu.org/press-release/flooding-preterm-births-pregnancy-complications/
Study Highlights Association Between Fluctuation in BP and Memory Skills
Older adults whose blood pressure fluctuates over time may be more likely to have problems with thinking and memory skills, according to a study published in the online issue of Neurology®, the medical journal of the American Academy of Neurology. The association was found in Black participants but not in white participants in the study.
The study does not prove that fluctuations in blood pressure cause problems with thinking skills; it only shows an association.
“These results suggest that fluctuation in blood pressure is a risk factor for cognitive problems beyond the negative effects of high blood pressure itself,” said study author Anisa Dhana, MD, MSc, of Rush University in Chicago. “Older adults should be routinely monitored for their blood pressure and any changes over time so we can identify people who may have this issue and work to alleviate it, which could potentially help to prevent or delay cognitive problems.”
The study involved 4,770 people with an average age of 71; 66% were Black participants, and the remaining were white participants. Participants had blood pressure tests at the beginning of the study and then every three years for an average of 10 years. They also completed thinking and memory skills tests at the beginning and at their last visit.
Overall, the participants had an average blood pressure of 138/78 mmHg. High blood pressure is defined as 130/80 mmHg and higher. Black participants in the study had an average variation over time in their systolic blood pressure, which is the top number, of 18 mmHg, compared to 16 mmHg for white participants.
The participants were divided into three groups based on how much their blood pressure varied over time. For Black participants, those with the most variability in their blood pressure had lower scores on the cognitive tests than those with the least variability. The difference in scores was the equivalent of 2.8 years of cognitive aging.
For people taking blood pressure medications at the start of the study, there was no difference in scores on thinking tests at the end of the study among the groups with high and low blood pressure variation.
Reference: Dhana, A., Decarli, C., Dhana, K., Desai, P., Evans, D. A., & Rajan, K. B. (2024, July). Blood pressure variability and global cognition in Black and White older adults over 18 years: a population-based cohort study. In Alzheimer's Association International Conference. ALZ.
Mount Sinai Researchers Move Closer to a Cure for Diabetes?
Diabetes researchers and bioinformaticians from the Icahn School of Medicine at Mount Sinai have developed a new understanding of how human beta cell regenerative drugs work. These drugs, developed at Mount Sinai, may hold promise for more than 500 million people with diabetes in the world. The results of this study were published in Cell Reports Medicine.
For more than 15 years, researchers at the Icahn School of Medicine at Mount Sinai have worked tirelessly to find a solution to cure diabetes by identifying a drug that could make human beta cells regenerate.
In 2015, Mount Sinai researchers discovered the first such drug, called harmine. Harmine is a member of a class of drugs called DYRK1A inhibitors. In 2019 and 2020, the researchers reported that DYRK1A inhibitors can synergize with TGF-beta signaling as well as GLP-1 receptor agonist (GLP-1RA) drugs such as semaglutide (e.g., Ozempic) and exenatide (Byetta) to induce more robust levels of human beta cell regeneration. Finally, in July 2024, they showed that harmine alone increases human beta cell mass by 300%, and if a GLP-1RA is added, by 700%.
In the newest study, the research team reports that the new, regenerated beta cells may be coming from an unexpected source: a second pancreatic cell type called alpha cells. Since alpha cells are abundant in people with type 1 and type 2 diabetes, they may be able to serve as a source for new beta cells in both common types of diabetes.
“This is an exciting finding that shows harmine-family drugs may be able to induce lineage conversion in human pancreatic islets,” says Esra Karakose, PhD, Assistant Professor of Medicine (Endocrinology, Diabetes and Bone Disease) at the Icahn School of Medicine at Mount Sinai and corresponding author of the study. “It may mean that people with all forms of diabetes have a large potential ‘reservoir’ for future beta cells, just waiting to be activated by drugs like harmine.”
Reference: Cycling alpha cells in regenerative drug-treated human pancreatic islets may serve as key beta cell progenitors, Karakose, Esra et al. Cell Reports Medicine, Volume 0, Issue 0, 101832
Early Smoking Habit Increases Risk of Premature Heart Disease: Researchers
Cigarette smoking from childhood into early adulthood is associated with an increased risk of premature cardiac injury, according to a study published in JACC, the flagship journal of the American College of Cardiology. This early damage to the structure and function of the heart can also significantly increase the chance of future cardiovascular (CVD) mortality in mid-life.
Researchers from the University of Eastern Finland collaborating with the University of Bristol used the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort data to examine the impact of tobacco smoking during growth from childhood to young adulthood and its association with structural and functional cardiac injury.
The analysis included 1,931 young adults with complete smoking and echocardiographic measures at 24 years. The prevalence of smoking was 0.3%, 1.6%, 13.6%, 24%, and 26.4% at ages 10, 13, 15, 17, and 24 years, respectively, and 60% of those who initiated smoking in childhood continued smoking at 24 years.
Researchers found that tobacco smoking from age 10 to 24 years was associated with 33% to 52% odds of premature structural and functional cardiac injury. Additionally, it was associated with cardiac mass increase, even after controlling for competing risk factors.
Key study results include:
Left ventricular (LV) hypertrophy prevalence increased from 2.8% to 7.5% at age 24.
Left ventricular diastolic (LVD) dysfunction prevalence increased from 10.4% to 16.9% at age 24.
Increased risk of high relative wall thickness (RWT) and high left ventricular filling pressure (LVFP).
Increased left ventricular mass index (LVMI) in both unadjusted and adjusted models from ages 17 – 24 years.
References: Agbaje, A. Incidental and Progressive Tobacco Smoking in Childhood and Subsequent Risk of Premature Cardiac Damage. JACC. null2024, 0 (0) .https://doi.org/10.1016/j.jacc.2024.09.1229
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