Sex-specific outcomes of diabetic patients with acute myocardial infarction who have undergone percutaneous coronary intervention: a register linkage study

Background

Chronic arterial stiffness contributes to the negative health effects of obesity and insulin resistance, which include hypertension, stroke, and increased cardiovascular and all-cause mortality. Weight loss and improved insulin sensitivity are individually associated with improved central arterial stiffness; however, their combined effects on arterial stiffness are poorly understood. The purpose of this study was to determine how insulin levels modify the improvements in arterial stiffness seen with weight loss in overweight and obese young adults.

Methods

To assess the effects of weight loss and decreased fasting insulin on vascular stiffness, we studied 339 participants in the Slow the Adverse Effects of Vascular Aging (SAVE) trial. At study entry, the participants were aged 20?C45, normotensive, non-diabetic, and had a body-mass index of 25?C39.9?kg/m². Measures of pulse wave velocity (PWV) in the central (carotid-femoral (cfPWV)), peripheral (femoral-ankle (faPWV)), and mixed (brachial-ankle (baPWV)) vascular beds were collected at baseline and 6?months. The effects of 6-month change in weight and insulin on measures of PWV were estimated using multivariate regression.

Results

After adjustment for baseline risk factors and change in systolic blood pressure, 6-month weight loss and 6-month change in fasting insulin independently predicted improvement in baPWV but not faPWV or cfPWV. There was a significant interaction between 6-month weight change and change in fasting insulin when predicting changes in baPWV (p?<?0.001). Individuals experiencing both weight loss and insulin reductions showed the greatest improvement in baPWV.

Conclusions

Young adults with excess weight who both lower their insulin levels and lose weight see the greatest improvement in vascular stiffness. This improvement in vascular stiffness with weight loss and insulin declines may occur throughout the vasculature and may not be limited to individual vascular beds.

Trial registration

NCT00366990     

Factors affecting cold hardiness in the small striped flea beetle, Phyllotreta undulata

The striped flea beetle, Phyllotreta undulata Kutschera (Coleoptera: Chrysomelidae), is a pest of cruciferous crops. It overwinters as an adult. During winter in northern European countries, such as Estonia, it is subject to sometimes severe temperatures that may fluctuate daily, over the season, and between seasons. The objective of this study was to investigate factors that affect its cold hardiness. In a series of five experiments, the effects of food plant, starvation, and acclimatization on the beetles’ ability to supercool and survive exposure to sub‐zero temperatures was investigated. The supercooling points (SCP) of overwintered beetles field‐collected from white mustard and Indian mustard differed from those caught from white cabbage and oilseed rape, but these differences disappeared after a 4‐day period of starvation at room temperature, indicating that gut content probably influences the potential to supercool. The duration and temperature of acclimation affected SCP in overwintered beetles. The decrease in SCP was more rapid at 22 °C than at 0 °C, probably because of faster dehydration and gut evacuation at the higher temperature. Acclimation at 0 °C for a week increased the ability of overwintered beetles to survive sub‐zero temperatures, lowering both SCP and lower lethal temperature (LLT₅₀). Some pre‐freeze mortality occurred; SCP and LLT₅₀ were correlated but the latter was a constant 3 °C higher than the former. The SCP of field‐collected pre‐winter beetles decreased gradually during the autumn. It also decreased when field‐collected pre‐winter beetles were acclimated at 0 °C in the laboratory, attaining its lowest level after 18 days. Phyllotreta undulata is well‐adapted to unstable and sometimes severe winter conditions; its high potential to supercool enhances its cold hardiness and ability to survive short periods at sub‐zero temperatures although it cannot survive freezing of its body fluids.     

Sex-specific outcomes of diabetic patients with acute myocardial infarction who have undergone percutaneous coronary intervention: a register linkage study

ABSTRACT: BACKGROUND: The presence of diabetes mellitus poses a challenge in the treatment of patients with acute myocardial infarction (AMI). We aimed to evaluate the sex-specific outcomes of diabetic and non-diabetic patients with AMI who have undergone percutaneous coronary intervention (PCI). METHODS: Data of the Estonian Myocardial Infarction Registry for years 2006[EN DASH]2009 were linked with the Health Insurance Fund database and the Population Registry. Hazard ratios (HRs) with the 95 % confidence intervals (CIs) for the primary composite outcome (non-fatal AMI, revascularization, or death whichever occurred first) and for the secondary outcome (all cause mortality) were calculated comparing diabetic with non-diabetic patients by sex. RESULTS: In the final study population (n = 1652), 14.6 % of the men and 24.0 % of the women had diabetes. Overall, the diabetics had higher rates of cardiovascular risk factors, co-morbidities, and 3[EN DASH]4 vessel disease among both men and women (p < 0.01). Among women, the diabetic patients were younger, they presented later and less often with typical symptoms of chest pain than the non-diabetics (p < 0.01). Women with diabetes received aspirin and reperfusion for ST-segment elevation AMI less often than those without diabetes (p < 0.01). During a follow-up of over two years, in multivariate analysis, diabetes was associated with worse outcomes only in women: the adjusted HR for the primary outcome 1.44 (95 % CI 1.05 [MINUS SIGN] 1.96) and for the secondary outcome 1.83 (95 % CI 1.17 [MINUS SIGN] 2.89). These results were largely driven by a high (12.0 %) mortality during hospitalization of diabetic women. CONCLUSIONS: Diabetic women with AMI who have undergone PCI are a high-risk group warranting special attention in treatment strategies, especially during hospitalization. There is a need to improve the expertise to detect AMI earlier, decrease disparities in management, and find targeted PCI strategies with adjunctive antithrombotic regimes in women with diabetes.     

Supercooling ability and cold hardiness of the pollen beetle Meligethes aeneus

Supercooling point (SCP) and cold‐hardiness of the pollen beetle Meligethes aeneus (Fabricius) (Coleoptera: Nitidulidae) were investigated. Mature eggs from the oviduct were supercooled on average to ?28.0 °C and from oilseed rape buds to ?24.4 °C; first instars were supercooled to ?21.0 °C and second instars to ?16.8 °C. Despite their high supercooling ability, none of the eggs survived 24 h exposure to ?2.5 °C. The supercooling ability of adults varied significantly among feeding and non‐feeding beetles: high SCPs prevailed during the whole warm period, being about ?12 °C; low values of SCP of ?20 °C dominated in non‐feeding beetles. In spring and autumn, beetles displayed the same acclimation efficiency: after 1 week of exposure at 2.0 °C with no access to food their SCPs were depressed equally by about 3 °C. Meligethes aeneus beetles have a different response to low temperatures depending on the season. The lowest tolerance was found in reproductively active beetles after emergence from overwintering sites; the time needed to kill 50% of individuals (Ltime₅₀) was 56.2 h at ?7 °C and the lower lethal temperature needed to kill 50% (Ltemp₅₀) after 24 h exposure was ?8.6 °C. Cold hardiness increased from midsummer to midwinter; Ltime₅₀ was 80 h in August, 182.8 h in September, and 418.1 h in January. Lethal temperature after 24 h exposure was ?9.1 °C in August and ?9.8 °C in September. In February, after diapause, the beetles started to loose their cold tolerance, and Ltemp₅₀ was slightly increased to ?9.5 °C. Hibernating beetles tolerated long exposure at ?7 °C well, but mortality was high after short exposure if the temperature dropped below ?9 °C for 24 h. Despite the season, the beetles died at temperatures well above their mean SCP; consequently, SCP is not a suitable index for cold hardiness of M. aeneus.     

Plasma stearoyl‐CoA desaturase indices: Association with lifestyle,diet, and body composition

Objective:

Stearoyl‐coenzyme A desaturase‐1 (SCD1) is a key enzyme in fatty acid and energy metabolism. Increased hepatic SCD1 activity is associated with obesity and obesity‐related diseases. We examined the relations of two plasma SCD activity indices (16:1n‐7/16:0, 18:1n‐9/18:0) with body composition, and the association of lifestyle and dietary variables with the plasma SCD indices.

Design and Methods:

This population‐based, cross‐sectional study of 2021 elderly (71–74 y) men and women from the Hordaland Health Study in Western Norway was conducted using a validated food frequency questionnaire, body composition measurements by dual‐energy X‐ray absorptiometry and determination of the plasma fatty acid profile.

Results:

In multivariate regression analyses, plasma SCD indices were positively associated with BMI and body fat (P < 0.001 for both). From the 2.5th to 97.5th percentiles of plasma SCD‐16 and SCD‐18 indices, fat mass differed by about 8 kg and 5 kg, respectively. Intake of polyunsaturated fatty acids were negatively associated with SCD‐16 (partial r = ?0.30) and SCD‐18 (partial r = ?0.24) (P < 0.001 for both). Alcohol intake was positively associated with SCD‐16 (partial r = 0.26) and SCD‐18 (partial r = 0.16) (P < 0.001 for both), whereas coffee consumption and physical activity were inversely associated with SCD‐16 (P = 0.026 and P = 0.006, respectively) and SCD‐18 (P = 0.001 and P = 0.022, respectively).

Conclusions:

In this elderly population, plasma markers of SCD1 activity are associated with increased adiposity. Furthermore, modifiable dietary habits and lifestyle are associated with plasma SCD indices. These results suggest that SCD1 activity may be a promising target for weight control.

     

Relative attractiveness of Brassica napus, Brassica nigra, Eruca sativa and Raphanus sativus for pollen beetle (Meligethes aeneus) and their potential for use in trap cropping

Oilseed rape (Brassica napus) is a valuable crop, attacked by several insect pests, of which the pollen beetle (Meligethes aeneus) is one of the most widespread and important in Europe. The relative attractiveness for the pollen beetle of Brassica nigra, Eruca sativa and Raphanus sativus was compared with that of spring oilseed rape, to assess the potential of these plant species as trap crops for the pest. At early growth stages, B. nigra and R. sativus were more attractive to over-wintered adult pollen beetles than B. napus. At the bud and flowering stages, B. nigra was the most attractive while E. sativa was the least attractive. At flowering, B. nigra was more attractive for oviposition than the other species. Thus, of the species tested, B. nigra has the most potential as a prospective trap crop to protect spring oilseed rape before flowering when it is at its most vulnerable developmental phase, due to its faster development and its acceptability both for feeding and oviposition to overwintered pollen beetle adults. Raphanus sativus was accepted both for feeding and oviposition, but pollen beetle larvae failed to develop in its flowers; it therefore has the potential for use as a dead-end crop. At the end of the growing season, both E. sativa and R. sativus, as late-flowering species, attracted the new generation of pollen beetles and thereby have potential to extend the effectiveness of a trap-cropping system at this time.