Medical Bulletin 28/ November/ 2024
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Here are the top health news for the day:
Insulin Resistance May Be Important Risk Factor for Most Common Heart Valve Disease
A large population study of men over 45 indicates insulin resistance may be an important risk factor for the development of the world’s most common heart valve disease – aortic stenosis (AS). The findings are published in the peer-reviewed journal Annals of Medicine.
In the current study, researchers analysed data from 10,144 Finnish men aged 45 to 73 years old, all initially free of aortic stenosis, participating in the Metabolic Syndrome in Men (METSIM) Study. At the start of the study, the researchers measured several biomarkers, including those related to hyperinsulinemia and/or insulin resistance. After an average follow-up period of 10.8 years, 116 men (1.1%) were diagnosed with aortic stenosis.
The team identified several biomarkers related to insulin resistance – such as fasting insulin, insulin at 30 minutes and 120 minutes, proinsulin, and serum C-peptide – that were associated with increased aortic stenosis risk. These biomarkers remained significant predictors of aortic stenosis, even after adjusting for other known risk factors, such as body mass index (BMI) and high blood pressure, or excluding participants with diabetes or an aortic valve malformation. The researchers then used advanced statistical techniques to isolate key biomarker profiles, identifying two distinct patterns that indicate insulin resistance as a predictor of aortic stenosis, independent of other cardiovascular risk factors, such as age, blood pressure, diabetes, and obesity.
Reference: Sohlman, M., Jauhiainen, R., Vangipurapu, J., Laakso, A., Ala-Korpela, M., Kuulasmaa, T., & Kuusisto, J. (2024). Biomarkers reflecting insulin resistance increase the risk of aortic stenosis in a population-based study of 10,144 Finnish men. Annals of Medicine, 56(1). https://doi.org/10.1080/07853890.2024.2419996
Study Finds Potential Genes that Link Depression to Menstrual Pain
In a new study published in Briefings in Bioinformatics, researchers from China and the UK have found that depression can increase the chances of a person experiencing menstrual pain (dysmenorrhea).
Shuhe Liu, lead author of the study and a PhD student at Xi'an Jiaotong-Liverpool-University (XJTLU), China, says: "We used a specialised technique called Mendelian randomisation to analyse genetic variation and identify specific genes that may mediate the effect of depression on menstrual pain.
"Our findings provide preliminary evidence that depression may be a cause, rather than a consequence, of dysmenorrhea as we did not find evidence that period pain increased the risk of depression."
The team analysed approximately 600,000 cases from European populations and 8,000 from East Asian populations and saw a strong link in both datasets. They also investigated the possibility that sleeplessness, often experienced by those suffering from depression, was a significant mediator between depression and dysmenorrhea.
"We found that increased sleep disturbances could exacerbate menstrual pain. Addressing sleep issues may therefore be crucial in managing both conditions. However, more research is required to understand the intricate links between these factors," says Liu.
Liu says: "Mental disorders are often not considered when treating conditions such as period pain. Our findings emphasise the importance of mental health screening for people who suffer from severe menstrual pain. We hope this can lead to more personalised treatment options, and improved healthcare, and reduce the stigma surrounding the conditions.
Reference: Shuhe Liu, Zhen Wei, Daniel F Carr, John Moraros, Deciphering the genetic interplay between depression and dysmenorrhea: a Mendelian randomization study, Briefings in Bioinformatics, Volume 26, Issue 1, January 2025, bbae589, https://doi.org/10.1093/bib/bbae589
Can Irregular Sleep-Wake Cycle Increase Risk of Major Cardiovascular Events?
An irregular sleep-wake cycle is associated with a heightened risk of major cardiovascular events, such as heart attack and stroke, even for those who clock up the recommended nightly hours of shut-eye, finds research published online in the Journal of Epidemiology & Community Health.
The researchers drew on 72,269 people aged 40 to 79, taking part in the UK Biobank study, none of whom had any history of major cardiovascular events. They wore an activity tracker for 7 days to record their sleep, the data from which were used to calculate each person's Sleep Regularity Index (SRI) score.
People with Sleep Regularity Index score of more than 87 were considered to have a regular sleep pattern, while those with Sleep Regularity Index score of less than 72 were categorised as irregular sleepers. And those whose scores fell between this range were regarded as moderately irregular sleepers.
Incidents of cardiovascular death, heart attack, heart failure, and stroke over the next 8 years were collected from death registries and hospital records and used to calculate the risk of these events for each sleep pattern group. After accounting for a range of potentially influential factors, such as age, physical activity levels, discretionary screen time, fruit, vegetable, and coffee intake, alcohol consumption, smoking, mental health issues, medication use, and shift work, irregular sleepers were 26% more likely to have a major cardiovascular event than those with a regular sleep wake-cycle, while moderately irregular sleepers were 8% more likely to do so.
More detailed analysis of the data showed that the relationship between decreasing SRI score and higher risk of events was almost linear, with a steeper reduction in risk at higher (better) Sleep Regularity Index scores. The recommended amount of nightly sleep is 7 to 9 hours for 18 to 64 year olds and 7 to 8 hours for those aged 65 and above. A greater proportion of regular sleepers met the recommended sleep quota than irregular sleepers: 61% vs 48%.
But when the impact of clocking up the recommended sleep quota was taken into account, the risk of a major cardiovascular event wasn’t offset in irregular sleepers who achieved this, although it was in moderately irregular sleepers.
The researchers conclude that the findings suggest that irregular sleep is strongly associated with a risk of major adverse cardiovascular events in adults, irrespective of whether or not recommended sleep quotas are met.
Reference: Chaput J, Biswas RK, Ahmadi M, et alSleep regularity and major adverse cardiovascular events: a device-based prospective study in 72 269 UK adultsJ Epidemiol Community Health Published Online First: 27 November 2024. doi: 10.1136/jech-2024-222795
Drinking More Water May help with Migraine and UTI: Systematic Review Finds
Researchers at UC San Francisco have found that drinking enough water can help with weight loss and prevent kidney stones, as well as migraines, urinary tract infections and low blood pressure.
“For such a ubiquitous and simple intervention, the evidence hasn’t been clear and the benefits were not well-established, so we wanted to take a closer look,” said senior and corresponding author Benjamin Breyer, MD, MAS, the Taube Family Distinguished Professor and chair of the UCSF Department of Urology.
The study, which analyzed 18 randomized controlled trials was published in JAMA Network Open.
The researchers found the most evidence in favor of drinking water to prevent kidney stones and to help people lose weight. Several studies found that drinking about six cups of water a day helped adults lose weight. But a study that included adolescents found that drinking a little more than eight cups of water a day had no effect.
Still, the authors said that encouraging people to drink water before meals would be a simple and cheap intervention that could have huge benefits, given the increased prevalence of obesity.
Other studies indicated that water can help prevent migraines, control diabetes and low blood pressure, and prevent urinary tract infections. Adults with recurrent headaches felt better after three months of drinking more water.
Drinking about four more cups of water a day helped diabetic patients whose blood glucose levels were elevated. Drinking an additional six cups a day of water also helped women with recurrent urinary tract infections. It reduced the number of infections and increased the amount of time between them. And drinking more water helped young adults with low blood pressure.
“We know that dehydration is detrimental, particularly in someone with a history of kidney stones or urinary infections,” said Breyer, who is a member of the UCSF Department of Epidemiology and Biostatistics. “On the other hand, someone who suffers from frequent urination at times may benefit from drinking less. There isn’t a one size fits all approach for water consumption.”
Reference: Hakam N, Guzman Fuentes JL, Nabavizadeh B, et al. Outcomes in Randomized Clinical Trials Testing Changes in Daily Water Intake: A Systematic Review. JAMA Netw Open. 2024;7(11):e2447621. doi:10.1001/jamanetworkopen.2024.47621
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