BACKGROUND Dyslipidemia was strongly linked to stroke,however the relationship between dyslipidemia and its components and ischemic stroke remained unexplained.AIM To investigate the link between longitudinal changes ...BACKGROUND Dyslipidemia was strongly linked to stroke,however the relationship between dyslipidemia and its components and ischemic stroke remained unexplained.AIM To investigate the link between longitudinal changes in lipid profiles and dyslipidemia and ischemic stroke in a hypertensive population.METHODS Between 2013 and 2014,6094 hypertension individuals were included in this,and ischemic stroke cases were documented to the end of 2018.Longitudinal changes of lipid were stratified into four groups:(1)Normal was transformed into normal group;(2)Abnormal was transformed into normal group;(3)Normal was transformed into abnormal group;and(4)Abnormal was transformed into abnormal group.To examine the link between longitudinal changes in dyslipidemia along with its components and the risk of ischemic stroke,we utilized multivariate Cox proportional hazards models with hazard ratio(HR)and 95%CI.RESULTS The average age of the participants was 62.32 years±13.00 years,with 329 women making up 54.0%of the sample.Over the course of a mean follow-up of 4.8 years,143 ischemic strokes happened.When normal was transformed into normal group was used as a reference,after full adjustments,the HR for dyslipidemia and ischemic stroke among abnormal was transformed into normal group,normal was transformed into abnormal group and abnormal was transformed into abnormal Wei CC et al.Dyslipidemia changed and ischemic stroke WJCC https://www.wjgnet.com 2 February 6,2025 Volume 13 Issue 4 group were 1.089(95%CI:0.598-1.982;P=0.779),2.369(95%CI:1.424-3.941;P<0.001)and 1.448(95%CI:1.002-2.298;P=0.047)(P for trend was 0.233),respectively.CONCLUSION In individuals with hypertension,longitudinal shifts from normal to abnormal in dyslipidemia-particularly in total and low-density lipoprotein cholesterol-were significantly associated with the risk of ischemic stroke.展开更多
Background Cardiovascular disease(CVD)and frailty are interrelated conditions prevalent in aging populations,yet their dynamic temporal relationship remains underexplored.This study investigates longitudinal changes i...Background Cardiovascular disease(CVD)and frailty are interrelated conditions prevalent in aging populations,yet their dynamic temporal relationship remains underexplored.This study investigates longitudinal changes in frailty trajectories before and after incident CVD across diverse cohorts.Methods Utilizing data from four longitudinal,multinational cohorts(ELSA,HRS,CHARLS,SHARE;n=66,537),we constructed the frailty index(FI)based on age-related health deficits,using 40,40,42,and 44 items from ELSA,HRS,CHARLS and SHARE,respectively.Linear mixed models assessed FI changes pre-and post-CVD,adjusting for demographics,lifestyle,and baseline FI.Sensitivity analyses excluded hypertension,diabetes,and arthritis to mitigate confounding.Results Frailty increased steadily before CVD onset(pre-CVD slope:ELSAβ=0.005,HRSβ=0.005,CHARLSβ=0.012,SHAREβ=0.007;all P<0.001),with an acute FI spike at diagnosis(post-CVD acute change:ELSAβ=0.024,HRSβ=0.031,CHARLSβ=0.046,SHAREβ=0.038;all P<0.001).Post-CVD,frailty progression further accelerated(ELSAβ=0.008,HRSβ=0.005,CHARLSβ=0.017,SHAREβ=0.010;all P<0.001).Sensitivity analyses confirmed robustness across age strata and FI definitions.Conclusions This first multinational study demonstrates bidirectional acceleration of frailty around CVD onset,highlighting their close temporal interplay.These findings suggest that incorporating frailty assessment into CVD management may help identify high-risk individuals and support timely,multidimensional care in aging populations.展开更多
This prospective study aimed to investigate the associations of untreated cholesterol levels and their longitudinal changes,especially low levels,with all-cause and cause-specific mortality in different populations.Pa...This prospective study aimed to investigate the associations of untreated cholesterol levels and their longitudinal changes,especially low levels,with all-cause and cause-specific mortality in different populations.Participants were drawn from two Chinese cohorts and the UK Biobank,excluding those with lipid-lowering medications,coronary heart disease(CHD),stroke,cancer,clinically diagnosed chronic obstructive pulmonary disease,low body mass index(<18.5 kg·m^(-2))at baseline,and deaths within the first two years to minimize reverse causality.Individual cholesterol changes were assessed in a subset who attended the resurvey after over four years.Mortality data were linked to registries,and risks were estimated using Cox proportional hazards models.A total of 163115 Chinese and 317305 UK adults were included(mean age,49-61 years),with 43%,81%,and 44%males in Dongfeng-Tongji,Kailuan,and UK Biobank cohorts,respectively.During a median follow-up of 9.7-12.9 years,9553 and 15760 deaths were documented in the Chinese cohorts and UK Biobank,respectively.After multivariate adjustments,nonlinear relationships were observed between total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and non-high-density lipoprotein cholesterol(non-HDL-C)levels and mortality.In both populations,high cholesterol was primarily associated with CHD mortality,while low cholesterol associated with all-cause and cancer mortality(Pnonlinear≤0.0161).The optimal levels for all-cause mortality risk in Chinese adults(TC:200 mg·dL^(-1);LDL-C:130 mg·dL^(-1);non-HDL-C:155 mg·dL^(-1))were lower than those in the UK Biobank but consistent with guideline recommendation.Additionally,decreasing cholesterol levels over four years were associated with higher all-cause and cancer mortality in the Chinese cohorts(P_(nonlinear)≤0.0100).Participants with low TC,LDL-C,or non-HDL-C levels at both baseline and resurvey experienced elevated all-cause mortality risks in both populations,as did those with low/medium baseline levels and>20%reductions over time in Chinese adults.In conclusion,higher TC,LDL-C,and non-HDL-C levels are associated with elevated CHD mortality.Importantly,low and/or longitudinally decreasing cholesterol levels are robustly associated with increased all-cause and cancer mortality,potentially serving as markers of premature death.Regular cholesterol monitoring,with attention to both high and low levels,is recommended to inform guideline updates and clinical strategies.展开更多
Dear Editor,I am writing in response to Jamil's letter,"Interpretative Challenges of the Missing Perilymph'Sign in PLF Diagnosis."I concur with the author's emphasis on the necessity for cautious...Dear Editor,I am writing in response to Jamil's letter,"Interpretative Challenges of the Missing Perilymph'Sign in PLF Diagnosis."I concur with the author's emphasis on the necessity for cautious interpretation of low-signal areas as evidence of active perilymph leakage,requiring correlation with clinical findings,surgical confirmation,and longitudinal imaging changes.展开更多
Prolonged viral RNA shedding and recurrence of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)in coronavirus disease 2019(COVID-19)patients have been reported.However,the clinical outcome and pathogenesis ...Prolonged viral RNA shedding and recurrence of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)in coronavirus disease 2019(COVID-19)patients have been reported.However,the clinical outcome and pathogenesis remain unclear.In this study,we recruited 43 laboratory-confirmed COVID-19 patients.We found that prolonged viral RNA shedding or recurrence mainly occurred in severe/critical patients(P<0.05).The average viral shedding time in severe/critical patients was more than 50 days,and up to 100 days in some patients,after symptom onset.However,chest computed tomography gradually improved and complete absorption occurred when SARS-CoV-2 RT-PCR was still positive,but specific antibodies appeared.Furthermore,the viral shedding time significantly decreased when the A1,430G or C12,473T mutation occurred(P<0.01 and FDR<0.01)and increased when G227A occurred(P<0.05 and FDR<0.05).High IL1R1,IL1R2,and TNFRSF21 expression in the host positively correlated with viral shedding time(P<0.05 and false discovery rate<0.05).Prolonged viral RNA shedding often occurs but may not increase disease damage.Prolonged viral RNA shedding is associated with viral mutations and host factors.展开更多
文摘BACKGROUND Dyslipidemia was strongly linked to stroke,however the relationship between dyslipidemia and its components and ischemic stroke remained unexplained.AIM To investigate the link between longitudinal changes in lipid profiles and dyslipidemia and ischemic stroke in a hypertensive population.METHODS Between 2013 and 2014,6094 hypertension individuals were included in this,and ischemic stroke cases were documented to the end of 2018.Longitudinal changes of lipid were stratified into four groups:(1)Normal was transformed into normal group;(2)Abnormal was transformed into normal group;(3)Normal was transformed into abnormal group;and(4)Abnormal was transformed into abnormal group.To examine the link between longitudinal changes in dyslipidemia along with its components and the risk of ischemic stroke,we utilized multivariate Cox proportional hazards models with hazard ratio(HR)and 95%CI.RESULTS The average age of the participants was 62.32 years±13.00 years,with 329 women making up 54.0%of the sample.Over the course of a mean follow-up of 4.8 years,143 ischemic strokes happened.When normal was transformed into normal group was used as a reference,after full adjustments,the HR for dyslipidemia and ischemic stroke among abnormal was transformed into normal group,normal was transformed into abnormal group and abnormal was transformed into abnormal Wei CC et al.Dyslipidemia changed and ischemic stroke WJCC https://www.wjgnet.com 2 February 6,2025 Volume 13 Issue 4 group were 1.089(95%CI:0.598-1.982;P=0.779),2.369(95%CI:1.424-3.941;P<0.001)and 1.448(95%CI:1.002-2.298;P=0.047)(P for trend was 0.233),respectively.CONCLUSION In individuals with hypertension,longitudinal shifts from normal to abnormal in dyslipidemia-particularly in total and low-density lipoprotein cholesterol-were significantly associated with the risk of ischemic stroke.
基金Natural Science Foundation of Shandong Province(Grant No.ZR2021QH176)。
文摘Background Cardiovascular disease(CVD)and frailty are interrelated conditions prevalent in aging populations,yet their dynamic temporal relationship remains underexplored.This study investigates longitudinal changes in frailty trajectories before and after incident CVD across diverse cohorts.Methods Utilizing data from four longitudinal,multinational cohorts(ELSA,HRS,CHARLS,SHARE;n=66,537),we constructed the frailty index(FI)based on age-related health deficits,using 40,40,42,and 44 items from ELSA,HRS,CHARLS and SHARE,respectively.Linear mixed models assessed FI changes pre-and post-CVD,adjusting for demographics,lifestyle,and baseline FI.Sensitivity analyses excluded hypertension,diabetes,and arthritis to mitigate confounding.Results Frailty increased steadily before CVD onset(pre-CVD slope:ELSAβ=0.005,HRSβ=0.005,CHARLSβ=0.012,SHAREβ=0.007;all P<0.001),with an acute FI spike at diagnosis(post-CVD acute change:ELSAβ=0.024,HRSβ=0.031,CHARLSβ=0.046,SHAREβ=0.038;all P<0.001).Post-CVD,frailty progression further accelerated(ELSAβ=0.008,HRSβ=0.005,CHARLSβ=0.017,SHAREβ=0.010;all P<0.001).Sensitivity analyses confirmed robustness across age strata and FI definitions.Conclusions This first multinational study demonstrates bidirectional acceleration of frailty around CVD onset,highlighting their close temporal interplay.These findings suggest that incorporating frailty assessment into CVD management may help identify high-risk individuals and support timely,multidimensional care in aging populations.
基金supported by the National Natural Science Foundation of China(82021005,82192903,81930092)the Chief Scientist Research Project of Hubei Shizhen Laboratory(HSL2024SX0003)+1 种基金the Fundamental Research Funds for the Central Universities(2019kfyXMBZ015)the 111 Project and the Program for Changjiang Scholars and Innovative Research Team in University.
文摘This prospective study aimed to investigate the associations of untreated cholesterol levels and their longitudinal changes,especially low levels,with all-cause and cause-specific mortality in different populations.Participants were drawn from two Chinese cohorts and the UK Biobank,excluding those with lipid-lowering medications,coronary heart disease(CHD),stroke,cancer,clinically diagnosed chronic obstructive pulmonary disease,low body mass index(<18.5 kg·m^(-2))at baseline,and deaths within the first two years to minimize reverse causality.Individual cholesterol changes were assessed in a subset who attended the resurvey after over four years.Mortality data were linked to registries,and risks were estimated using Cox proportional hazards models.A total of 163115 Chinese and 317305 UK adults were included(mean age,49-61 years),with 43%,81%,and 44%males in Dongfeng-Tongji,Kailuan,and UK Biobank cohorts,respectively.During a median follow-up of 9.7-12.9 years,9553 and 15760 deaths were documented in the Chinese cohorts and UK Biobank,respectively.After multivariate adjustments,nonlinear relationships were observed between total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and non-high-density lipoprotein cholesterol(non-HDL-C)levels and mortality.In both populations,high cholesterol was primarily associated with CHD mortality,while low cholesterol associated with all-cause and cancer mortality(Pnonlinear≤0.0161).The optimal levels for all-cause mortality risk in Chinese adults(TC:200 mg·dL^(-1);LDL-C:130 mg·dL^(-1);non-HDL-C:155 mg·dL^(-1))were lower than those in the UK Biobank but consistent with guideline recommendation.Additionally,decreasing cholesterol levels over four years were associated with higher all-cause and cancer mortality in the Chinese cohorts(P_(nonlinear)≤0.0100).Participants with low TC,LDL-C,or non-HDL-C levels at both baseline and resurvey experienced elevated all-cause mortality risks in both populations,as did those with low/medium baseline levels and>20%reductions over time in Chinese adults.In conclusion,higher TC,LDL-C,and non-HDL-C levels are associated with elevated CHD mortality.Importantly,low and/or longitudinally decreasing cholesterol levels are robustly associated with increased all-cause and cancer mortality,potentially serving as markers of premature death.Regular cholesterol monitoring,with attention to both high and low levels,is recommended to inform guideline updates and clinical strategies.
文摘Dear Editor,I am writing in response to Jamil's letter,"Interpretative Challenges of the Missing Perilymph'Sign in PLF Diagnosis."I concur with the author's emphasis on the necessity for cautious interpretation of low-signal areas as evidence of active perilymph leakage,requiring correlation with clinical findings,surgical confirmation,and longitudinal imaging changes.
基金supported by the Guangzhou Institute of Respiratory Health Open Project(Funds provided by China Evergrande Group)(2020GIRHHMS14)Zhongnanshan Medical Foundation of Guangdong Province(2020B1111340004 and ZNSA-2020003)+1 种基金the Traditional Chinese Medicine Bureau of Guangdong Province(2020ZYYJ05)the funding from Guangzhou Institute of Respiratory Health。
文摘Prolonged viral RNA shedding and recurrence of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)in coronavirus disease 2019(COVID-19)patients have been reported.However,the clinical outcome and pathogenesis remain unclear.In this study,we recruited 43 laboratory-confirmed COVID-19 patients.We found that prolonged viral RNA shedding or recurrence mainly occurred in severe/critical patients(P<0.05).The average viral shedding time in severe/critical patients was more than 50 days,and up to 100 days in some patients,after symptom onset.However,chest computed tomography gradually improved and complete absorption occurred when SARS-CoV-2 RT-PCR was still positive,but specific antibodies appeared.Furthermore,the viral shedding time significantly decreased when the A1,430G or C12,473T mutation occurred(P<0.01 and FDR<0.01)and increased when G227A occurred(P<0.05 and FDR<0.05).High IL1R1,IL1R2,and TNFRSF21 expression in the host positively correlated with viral shedding time(P<0.05 and false discovery rate<0.05).Prolonged viral RNA shedding often occurs but may not increase disease damage.Prolonged viral RNA shedding is associated with viral mutations and host factors.
