27 results on '"Linda Tsan"'
Search Results
2. Early-life low-calorie sweetener consumption disrupts glucose regulation, sugar-motivated behavior, and memory function in rats
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Linda Tsan, Sandrine Chometton, Anna M.R. Hayes, Molly E. Klug, Yanning Zuo, Shan Sun, Lana Bridi, Rae Lan, Anthony A. Fodor, Emily E. Noble, Xia Yang, Scott E. Kanoski, and Lindsey A. Schier
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Development ,Neuroscience ,Medicine - Abstract
Low-calorie sweetener (LCS) consumption in children has increased dramatically due to its widespread presence in the food environment and efforts to mitigate obesity through sugar replacement. However, mechanistic studies on the long-term impact of early-life LCS consumption on cognitive function and physiological processes are lacking. Here, we developed a rodent model to evaluate the effects of daily LCS consumption (acesulfame potassium, saccharin, or stevia) during adolescence on adult metabolic, behavioral, gut microbiome, and brain transcriptomic outcomes. Results reveal that habitual early-life LCS consumption impacts normal postoral glucose handling and impairs hippocampal-dependent memory in the absence of weight gain. Furthermore, adolescent LCS consumption yielded long-term reductions in lingual sweet taste receptor expression and brought about alterations in sugar-motivated appetitive and consummatory responses. While early-life LCS consumption did not produce robust changes in the gut microbiome, brain region–specific RNA-Seq analyses reveal LCS-induced changes in collagen- and synaptic signaling–related gene pathways in the hippocampus and nucleus accumbens, respectively, in a sex-dependent manner. Collectively, these results reveal that habitual early-life LCS consumption has long-lasting implications for glucoregulation, sugar-motivated behavior, and hippocampal-dependent memory in rats, which may be based in part on changes in nutrient transporter, sweet taste receptor, and central gene pathway expression.
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- 2022
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3. Gut microbial taxa elevated by dietary sugar disrupt memory function
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Emily E. Noble, Christine A. Olson, Elizabeth Davis, Linda Tsan, Yen-Wei Chen, Ruth Schade, Clarissa Liu, Andrea Suarez, Roshonda B. Jones, Claire de La Serre, Xia Yang, Elaine Y. Hsiao, and Scott E. Kanoski
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Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Abstract Emerging evidence highlights a critical relationship between gut microbiota and neurocognitive development. Excessive consumption of sugar and other unhealthy dietary factors during early life developmental periods yields changes in the gut microbiome as well as neurocognitive impairments. However, it is unclear whether these two outcomes are functionally connected. Here we explore whether excessive early life consumption of added sugars negatively impacts memory function via the gut microbiome. Rats were given free access to a sugar-sweetened beverage (SSB) during the adolescent stage of development. Memory function and anxiety-like behavior were assessed during adulthood and gut bacterial and brain transcriptome analyses were conducted. Taxa-specific microbial enrichment experiments examined the functional relationship between sugar-induced microbiome changes and neurocognitive and brain transcriptome outcomes. Chronic early life sugar consumption impaired adult hippocampal-dependent memory function without affecting body weight or anxiety-like behavior. Adolescent SSB consumption during adolescence also altered the gut microbiome, including elevated abundance of two species in the genus Parabacteroides (P. distasonis and P. johnsonii) that were negatively correlated with hippocampal function. Transferred enrichment of these specific bacterial taxa in adolescent rats impaired hippocampal-dependent memory during adulthood. Hippocampus transcriptome analyses revealed that early life sugar consumption altered gene expression in intracellular kinase and synaptic neurotransmitter signaling pathways, whereas Parabacteroides microbial enrichment altered gene expression in pathways associated with metabolic function, neurodegenerative disease, and dopaminergic signaling. Collectively these results identify a role for microbiota “dysbiosis” in mediating the detrimental effects of early life unhealthy dietary factors on hippocampal-dependent memory function.
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- 2021
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4. Hypothalamus-hippocampus circuitry regulates impulsivity via melanin-concentrating hormone
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Emily E. Noble, Zhuo Wang, Clarissa M. Liu, Elizabeth A. Davis, Andrea N. Suarez, Lauren M. Stein, Linda Tsan, Sarah J. Terrill, Ted M. Hsu, A-Hyun Jung, Lauren M. Raycraft, Joel D. Hahn, Martin Darvas, Alyssa M. Cortella, Lindsey A. Schier, Alexander W. Johnson, Matthew R. Hayes, Daniel P. Holschneider, and Scott E. Kanoski
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Science - Abstract
Impulsive behaviour is common in various neuropsychiatric disorders. Here, the authors identify a pathway from the lateral hypothalamus to the ventral hippocampus and the role of melanin-concentrating hormone signaling in these neurons in specifically regulating impulsivity.
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- 2019
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5. Western Diet Consumption During Development: Setting the Stage for Neurocognitive Dysfunction
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Linda Tsan, Léa Décarie-Spain, Emily E. Noble, and Scott E. Kanoski
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obesity ,high fat diet ,adolescent ,anxiety ,cognition ,memory ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
The dietary pattern in industrialized countries has changed substantially over the past century due to technological advances in agriculture, food processing, storage, marketing, and distribution practices. The availability of highly palatable, calorically dense foods that are shelf-stable has facilitated a food environment where overconsumption of foods that have a high percentage of calories derived from fat (particularly saturated fat) and sugar is extremely common in modern Westernized societies. In addition to being a predictor of obesity and metabolic dysfunction, consumption of a Western diet (WD) is related to poorer cognitive performance across the lifespan. In particular, WD consumption during critical early life stages of development has negative consequences on various cognitive abilities later in adulthood. This review highlights rodent model research identifying dietary, metabolic, and neurobiological mechanisms linking consumption of a WD during early life periods of development (gestation, lactation, juvenile and adolescence) with behavioral impairments in multiple cognitive domains, including anxiety-like behavior, learning and memory function, reward-motivated behavior, and social behavior. The literature supports a model in which early life WD consumption leads to long-lasting neurocognitive impairments that are largely dissociable from WD effects on obesity and metabolic dysfunction.
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- 2021
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6. Junk Food Exposure Disrupts Selection of Food-Seeking Actions in Rats
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Alisa R. Kosheleff, Jingwen Araki, Linda Tsan, Grace Chen, Niall P. Murphy, Nigel T. Maidment, and Sean B. Ostlund
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junk food ,decision making ,action selection ,devaluation ,outcome-specific PIT ,Psychiatry ,RC435-571 - Abstract
There is growing evidence that repeated consumption of highly palatable, nutritionally poor “junk food” diets can produce deficits in cognition and behavioral control. We explored whether long-term junk-food diet exposure disrupts rats' ability to make adaptive choices about which foods to pursue based on (1) expected reward value (outcome devaluation test) and (2) cue-evoked reward expectations (Pavlovian-to-instrumental test). Rats were initially food restricted and trained on two distinct response-outcome contingencies (e.g., left press chocolate pellets, and right press sweetened condensed milk) and stimulus-outcome contingencies (e.g., white noise chocolate pellets, and clicker sweetened condensed milk). They were then given 6 weeks of unrestricted access to regular chow alone (controls) or chow and either 1 or 24 h access to junk food per day. Subsequent tests of decision making revealed that rats in both junk-food diet groups were impaired in selecting actions based on either expected food value or the presence of food-paired cues. These data demonstrate that chronic junk food consumption can disrupt the processes underlying adaptive control over food-seeking behavior. We suggest that the resulting dysregulation of food seeking may contribute to overeating and obesity.
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- 2018
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7. Early life Western diet-induced memory impairments and gut microbiome changes in female rats are long-lasting despite healthy dietary intervention
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Shan Sun, Lekha S. Chirala, Linda Tsan, Anna M.R. Hayes, Lana Bridi, Scott E. Kanoski, Anthony A. Fodor, and Emily E. Noble
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Long lasting ,Medicine (miscellaneous) ,Physiology ,Hippocampus ,Diet, High-Fat ,Rats, Sprague-Dawley ,Intervention (counseling) ,Western diet ,medicine ,Animals ,Memory Disorders ,Nutrition and Dietetics ,business.industry ,General Neuroscience ,General Medicine ,medicine.disease ,Obesity ,Early life ,Gut microbiome ,Rats ,Gastrointestinal Microbiome ,Diet, Western ,Dysbiosis ,Female ,Sugars ,business - Abstract
Western diet consumption during adolescence results in hippocampus (HPC)-dependent memory impairments and gut microbiome dysbiosis. Whether these adverse outcomes persist in adulthood following healthy dietary intervention is unknown. Here we assessed the short- and long-term effects of adolescent consumption of a Western diet enriched with either sugar or both sugar and fat on metabolic outcomes, HPC function, and gut microbiota.Adolescent female rats (PN 26) were fed a standard chow diet (CHOW), chow with access to 11% sugar solution (SUG), or a junk food cafeteria-style diet (CAF) containing various foods high in fat and/or sugar. During adulthood (PN 65+), metabolic outcomes, HPC-dependent memory, and gut microbial populations were evaluated. In a subsequent experiment, these outcomes were evaluated following a 5-week dietary intervention where CAF and SUG groups were maintained on standard chow alone.Both CAF and SUG groups demonstrated impaired HPC-dependent memory, increased adiposity, and altered gut microbial populations relative to the CHOW group. However, impaired peripheral glucose regulation was only observed in the SUG group. When examined following a healthy dietary intervention in a separate experiment, metabolic dysfunction was not observed in either the CAF or SUG group, whereas HPC-dependent memory impairments were observed in the CAF but not the SUG group. In both groups the composition of the gut microbiota remained distinct from CHOW rats after the dietary intervention.While the metabolic impairments associated with adolescent junk food diet consumption are not present in adulthood following dietary intervention, the HPC-dependent memory impairments and the gut microbiome dysbiosis persist.
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- 2021
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8. Early-life influences of low-calorie sweetener consumption on sugar taste
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Sandrine Chometton, Linda Tsan, Anna M.R. Hayes, Scott E. Kanoski, and Lindsey A. Schier
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Behavioral Neuroscience ,Experimental and Cognitive Psychology - Published
- 2023
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9. Gut microbial taxa elevated by dietary sugar disrupt memory function
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Yen-Wei Chen, Clarissa M. Liu, Scott E. Kanoski, Christine A. Olson, Roshonda B. Jones, Xia Yang, Elaine Y. Hsiao, Emily E. Noble, Ruth Schade, Elizabeth A. Davis, Claire B. de La Serre, Andrea N. Suarez, and Linda Tsan
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0301 basic medicine ,Dietary Sugars ,Physiology ,Hippocampus ,Biology ,Gut flora ,Article ,lcsh:RC321-571 ,Rats, Sprague-Dawley ,Transcriptome ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Memory ,medicine ,Animals ,Microbiome ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Biological Psychiatry ,Gastrointestinal Microbiome ,Dopaminergic ,Neurodegenerative Diseases ,Parabacteroides ,biology.organism_classification ,medicine.disease ,Rats ,Psychiatry and Mental health ,030104 developmental biology ,Dysbiosis ,Neurocognitive ,030217 neurology & neurosurgery - Abstract
Emerging evidence highlights a critical relationship between gut microbiota and neurocognitive development. Excessive consumption of sugar and other unhealthy dietary factors during early life developmental periods yields changes in the gut microbiome as well as neurocognitive impairments. However, it is unclear whether these two outcomes are functionally connected. Here we explore whether excessive early life consumption of added sugars negatively impacts memory function via the gut microbiome. Rats were given free access to a sugar-sweetened beverage (SSB) during the adolescent stage of development. Memory function and anxiety-like behavior were assessed during adulthood and gut bacterial and brain transcriptome analyses were conducted. Taxa-specific microbial enrichment experiments examined the functional relationship between sugar-induced microbiome changes and neurocognitive and brain transcriptome outcomes. Chronic early life sugar consumption impaired adult hippocampal-dependent memory function without affecting body weight or anxiety-like behavior. Adolescent SSB consumption during adolescence also altered the gut microbiome, including elevated abundance of two species in the genus Parabacteroides (P. distasonis and P. johnsonii) that were negatively correlated with hippocampal function. Transferred enrichment of these specific bacterial taxa in adolescent rats impaired hippocampal-dependent memory during adulthood. Hippocampus transcriptome analyses revealed that early life sugar consumption altered gene expression in intracellular kinase and synaptic neurotransmitter signaling pathways, whereas Parabacteroides microbial enrichment altered gene expression in pathways associated with metabolic function, neurodegenerative disease, and dopaminergic signaling. Collectively these results identify a role for microbiota “dysbiosis” in mediating the detrimental effects of early life unhealthy dietary factors on hippocampal-dependent memory function.
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- 2021
10. Lasting effects of low-calorie sweeteners on glucose regulation, sugar intake, and memory
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Xia Yang, Sandrine Chometton, Yanning Zuo, Emily E. Noble, Shan Sun, Linda Tsan, Anthony A. Fodor, Rae Lan, Anna M.R. Hayes, Lindsey A. Schier, Lana Bridi, and Scott E. Kanoski
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medicine.medical_specialty ,integumentary system ,Receptor expression ,Acesulfame potassium ,Hippocampus ,Metabolism ,Biology ,Nucleus accumbens ,chemistry.chemical_compound ,Endocrinology ,chemistry ,Internal medicine ,medicine ,Blood sugar regulation ,medicine.symptom ,Saccharin ,Weight gain - Abstract
Low-calorie sweetener (LCS) consumption in children has increased due to widespread LCS presence in the food environment and efforts to mitigate obesity through sugar replacement. However, mechanistic studies on the impact of early-life LCS consumption are lacking. Therefore, we developed a rodent model to evaluate the effects of daily LCS consumption (acesulfame potassium, saccharin, or stevia) during adolescence on adult metabolic, gut microbiome, neural, and behavioral outcomes. Results reveal that habitual early-life LCS consumption disrupts post-oral glucose tolerance and impairs hippocampal-dependent memory in the absence of weight gain. Furthermore, LCS consumption reduces lingual sweet taste receptor expression and alters sugar-motivated appetitive and consummatory responses. RNA sequencing analyses reveal that LCS also impacts collagen- and synaptic signaling-related gene pathways in the hippocampus and nucleus accumbens, respectively, in a sex-dependent manner. Collectively, these results suggest that regular early-life LCS consumption yields long-lasting impairments in metabolism, sugar-motivated behavior, and hippocampal-dependent memory.
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- 2021
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11. Early Life Low-Calorie Sweetener Consumption Impacts Energy Balance during Adulthood
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Anna M. R. Hayes, Linda Tsan, Alicia E. Kao, Grace M. Schwartz, Léa Décarie-Spain, Logan Tierno Lauer, Molly E. Klug, Lindsey A. Schier, and Scott E. Kanoski
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artificial sweeteners ,non-nutritive sweeteners ,sugar ,Western diet ,juvenile ,adolescence ,body weight ,obesity ,thermogenesis ,Nutrition and Dietetics ,Sweetening Agents ,Body Weight ,Animals ,Female ,Energy Intake ,Energy Metabolism ,Sugars ,Rats ,Food Science - Abstract
Children frequently consume beverages that are either sweetened with sugars (sugar-sweetened beverages; SSB) or low-calorie sweeteners (LCS). Here, we evaluated the effects of habitual early life consumption of either SSB or LCS on energy balance later during adulthood. Male and female rats were provided with chow, water, and a solution containing either SSB (sucrose), LCS (acesulfame potassium (ACE-K) or stevia), or control (no solution) during the juvenile and adolescent periods (postnatal days 26–70). SSB or LCS consumption was voluntary and restricted within the recommended federal daily limits. When subsequently maintained on a cafeteria-style junk food diet (CAF; various high-fat, high-sugar foods) during adulthood, ACE-K-exposed rats demonstrated reduced caloric consumption vs. the controls, which contributed to lower body weights in female, but not male, ACE-K rats. These discrepant intakes and body weight effects in male ACE-K rats are likely to be based on reduced gene expression of thermogenic indicators (UCP1, BMP8B) in brown adipose tissue. Female stevia-exposed rats did not differ from the controls in terms of caloric intake or body weight, yet they consumed more SSB during CAF exposure in adulthood. None of the SSB-exposed rats, neither male nor female, differed from the controls in terms of total adult caloric consumption or body weight measures. The collective results reveal that early life LCS consumption alters sugar preference, body weight, and gene expression for markers of thermogenesis during adulthood, with both sex- and sweetener-dependent effects.
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- 2022
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12. Hypothalamus-hippocampus circuitry regulates impulsivity via melanin-concentrating hormone
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Sarah J. Terrill, Zhuo Wang, Clarissa M. Liu, Martin Darvas, Matthew R. Hayes, Alyssa M. Cortella, A-Hyun Jung, Joel D. Hahn, Lauren Raycraft, Daniel P. Holschneider, Ted M. Hsu, Scott E. Kanoski, Linda Tsan, Andrea N. Suarez, Alexander W. Johnson, Emily E. Noble, Elizabeth A. Davis, Lauren M. Stein, and Lindsey A. Schier
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0301 basic medicine ,Male ,Lateral hypothalamus ,Melanin-concentrating hormone ,Science ,General Physics and Astronomy ,Hippocampus ,Nucleus accumbens ,Biology ,Impulsivity ,Neural circuits ,General Biochemistry, Genetics and Molecular Biology ,Article ,Nucleus Accumbens ,Rats, Sprague-Dawley ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Neural Pathways ,medicine ,Biological neural network ,Animals ,Obesity ,Receptors, Somatostatin ,lcsh:Science ,Melanins ,Neurons ,Multidisciplinary ,Hypothalamic Hormones ,Cerebrum ,General Chemistry ,Rats ,Pituitary Hormones ,030104 developmental biology ,medicine.anatomical_structure ,chemistry ,nervous system ,Hypothalamus ,Hypothalamic Area, Lateral ,Impulsive Behavior ,lcsh:Q ,medicine.symptom ,Neuroscience ,030217 neurology & neurosurgery - Abstract
Behavioral impulsivity is common in various psychiatric and metabolic disorders. Here we identify a hypothalamus to telencephalon neural pathway for regulating impulsivity involving communication from melanin-concentrating hormone (MCH)-expressing lateral hypothalamic neurons to the ventral hippocampus subregion (vHP). Results show that both site-specific upregulation (pharmacological or chemogenetic) and chronic downregulation (RNA interference) of MCH communication to the vHP increases impulsive responding in rats, indicating that perturbing this system in either direction elevates impulsivity. Furthermore, these effects are not secondary to either impaired timing accuracy, altered activity, or increased food motivation, consistent with a specific role for vHP MCH signaling in the regulation of impulse control. Results from additional functional connectivity and neural pathway tracing analyses implicate the nucleus accumbens as a putative downstream target of vHP MCH1 receptor-expressing neurons. Collectively, these data reveal a specific neural circuit that regulates impulsivity and provide evidence of a novel function for MCH on behavior., Impulsive behaviour is common in various neuropsychiatric disorders. Here, the authors identify a pathway from the lateral hypothalamus to the ventral hippocampus and the role of melanin-concentrating hormone signaling in these neurons in specifically regulating impulsivity.
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- 2019
13. Biological use influences the impact of inflammation on risk of major adverse cardiovascular events in rheumatoid arthritis
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George Athanasios Karpouzas, Anne Grete Semb, Ellen-Margrethe Hauge, Dionicio Angel Galarza-Delgado, Miguel A González-Gay, Solbritt Rantapää-Dahlqvist, Petros P Sfikakis, Virginia Pascual-Ramos, Irazú Contreras-Yáñez, Carol Hitchon, Durga Prasanna Misra, Iris J Colunga-Pedraza, Alfonso Corrales, George Kitas, Linda Tsang, Hani El-Gabalawy, José Ramón Azpiri-lópez, Sarah R Ormseth, Patrick Dessein, and Piet Leonardus Cornelis Maria van Riel
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Medicine - Abstract
Objectives Chronic inflammation promotes cardiovascular risk in rheumatoid arthritis (RA). Biological disease-modifying antirheumatic drugs (bDMARDs) improve disease activity and cardiovascular disease outcomes. We explored whether bDMARDs influence the impact of disease activity and inflammatory markers on long-term cardiovascular risk in RA.Methods We studied 4370 participants without cardiovascular disease in a 10-country observational cohort of patients with RA. Endpoints were (1) major adverse cardiovascular events (MACE) encompassing myocardial infarction, stroke and cardiovascular death; and (2) any ischaemic cardiovascular events (iCVE) including MACE plus revascularisation, angina, transient ischaemic attack and peripheral arterial disease.Results Over 26 534 patient-years, 239 MACE and 362 iCVE occurred. The interaction between 28-joint Disease Activity Score with C-reactive protein (DAS28-CRP) and bDMARD use was significant for MACE (p=0.017), suggesting the effect of DAS28-CRP on MACE risk differed among bDMARD users (n=515) and non-users (n=3855). DAS28-CRP (per unit increase) is associated with MACE risk in bDMARD non-users (HR 1.21 (95% CI 1.07 to 1.37)) but not users (HR 0.69 (95% CI 0.40 to 1.20)). The interaction between CRP (per log unit increase) and bDMARD use was also significant for MACE (p=0.011). CRP associated with MACE risk in bDMARD non-users (HR 1.16 (95% CI 1.04 to 1.30)), but not users (HR 0.65 (95% CI 0.36 to 1.17)). No interaction was observed between bDMARD use and DAS28-CRP (p=0.167) or CRP (p=0.237) for iCVE risk.Conclusions RA activity and inflammatory markers associated with risk of MACE in bDMARD non-users but not users suggesting the possibility of biological-specific benefits locally on arterial wall independently of effects on systemic inflammation.
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- 2024
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14. Effects of decreased dopamine transporter levels on nigrostriatal neurons and paraquat/maneb toxicity in mice
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Farzad Mortazavi, Nigel T. Maidment, Linda Tsan, Franziska Richter, Caitlyn K. Mulligan, Lauryn Gabby, Pedrom C. Sioshansi, Larry C. Ackerson, Krystal De La Rosa, Marie-Françoise Chesselet, Ingrid C. Cely, Niall P. Murphy, and Kimberly A. McDowell
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Male ,Paraquat ,Risk ,0301 basic medicine ,Aging ,medicine.medical_specialty ,Parkinson's disease ,Maneb ,Substantia nigra ,Biology ,Article ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,mental disorders ,medicine ,Animals ,Pars Compacta ,Dopamine transporter ,Mice, Knockout ,Dopamine Plasma Membrane Transport Proteins ,Tyrosine hydroxylase ,Pars compacta ,Dopaminergic Neurons ,General Neuroscience ,Neurodegeneration ,Dopaminergic ,Genetic Variation ,Parkinson Disease ,medicine.disease ,Mice, Mutant Strains ,Disease Models, Animal ,030104 developmental biology ,Endocrinology ,nervous system ,chemistry ,biology.protein ,Neurology (clinical) ,Geriatrics and Gerontology ,Neuroscience ,030217 neurology & neurosurgery ,Developmental Biology - Abstract
How genetic variations in the dopamine transporter (DAT) combined with exposure to environmental toxins modulate the risk of Parkinson's disease remains unclear. Using unbiased stereology in DAT knock-down mice (DAT-KD) and wild-type (WT) littermates, we found that decreased DAT caused a loss of tyrosine hydroxylase–positive (dopaminergic) neurons in subregions of the substantia nigra pars compacta at 3–4 days, 5 weeks, and 18 months of age. Both genotypes lost dopaminergic neurons with age and remaining neurons at 11 months were resilient to paraquat/maneb. In 5-week-old mice, the toxins decreased substantia nigra pars compacta dopaminergic neurons in both genotypes but less in DAT-KD. Regional analysis revealed striking differences in the subsets of neurons affected by low DAT, paraquat/maneb, and aging. In particular, we show that a potentially protective effect of low DAT against toxin exposure is not sufficient to reduce death of all nigrostriatal dopaminergic neurons. Thus, different regional vulnerability of nigrostriatal dopaminergic neurons may contribute to an increased risk of developing Parkinson's disease when multiple factors are combined.
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- 2017
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15. Nursing home-associated infections in Department of Veterans Affairs community living centers
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Cynthia L. Gibert, Christa Hojlo, Linda H. Danko, Ona Montgomery, Gary A. Roselle, Chester Davis, John R. Pierce, Robert Langberg, Linda Tsan, Robert P. Gaynes, Suzanne F. Bradley, and Yancy Phillips
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medicine.medical_specialty ,Epidemiology ,Indwelling Device ,Prevalence ,MEDLINE ,Skin infection ,Catheterization ,Catheters, Indwelling ,Risk Factors ,Community living ,medicine ,Humans ,Intensive care medicine ,Veterans Affairs ,Aged ,Veterans ,Aged, 80 and over ,Cross Infection ,business.industry ,Health Policy ,Public Health, Environmental and Occupational Health ,Middle Aged ,medicine.disease ,Nursing Homes ,Pneumonia ,Infectious Diseases ,Catheter-Related Infections ,Emergency medicine ,business - Abstract
Little is known about factors contributing to nursing home-associated infections (NHAIs). We conducted a survey of residents in 133 Department of Veterans Affairs community living centers to determine the roles of indwelling device use, bed locations, and treatment codes on NHAIs.A Web-based point prevalence survey of NHAIs using modified Centers for Disease Control and Prevention definitions for health care-associated infections was conducted on November 14, 2007.Among 10,939 residents, 575 had at least one NHAI, for a point prevalence rate of 5.3%. Urinary tract infection, skin infection, asymptomatic bacteriuria, and pneumonia were the most prevalent NHAIs. A total of 2687 residents had one or more indwelling devices; 290 of these also had an NHAI, for a prevalence of 10.8%. In contrast, the prevalence of NHAIs in residents without indwelling devices was 3.5% (P.0001). Indwelling urinary catheters, percutaneous gastrostomy tubes, peripherally inserted central catheters, and suprapubic urinary catheters were the most commonly used devices. There were 4027 residents in designated units and 6912 residents in dispersed units. The rate of device use was 21.4% in the designated units and 26.4% in the dispersed units (P.0001). The prevalence of NHAIs was 4.5% in the designated units and 5.7% in the dispersed units (P.001). Rates of NHAIs and device use varied greatly among the various treatment codes; however, there was a positive correlation between the rates of NHAIs and device use. Stepwise logistic regression analysis of data from long-stay and short-stay skilled nursing care residents revealed that only the presence of an indwelling device, not length of stay or bed location, affected the rate of NHAIs.Indwelling device use, but not bed location or treatment code, was found to be associated with increased rate of NHAIs.
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- 2010
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16. Quality Indicators in the Department of Veterans Affairs Nursing Home Care Units: A Preliminary Assessment
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Robert Langberg, Linda Tsan, Chester L. Davis, and John R. Pierce
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Quality management ,Index (economics) ,Quality Assurance, Health Care ,media_common.quotation_subject ,Fiscal year ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Environmental health ,Severity of illness ,Prevalence ,Humans ,Medicine ,Quality (business) ,030212 general & internal medicine ,Veterans Affairs ,Diagnosis-Related Groups ,Quality Indicators, Health Care ,media_common ,Minimum Data Set ,business.industry ,Incidence ,030503 health policy & services ,Health Policy ,United States ,Nursing Homes ,United States Department of Veterans Affairs ,0305 other medical science ,Nursing homes ,business - Abstract
The authors analyzed the minimum data set quality indicators data aggregated nationally from 134 Department of Veterans Affairs nursing home care units with more than 15 000 long-stay residents (> 90 days) yearly for federal fiscal years 2003, 2004, and 2005. Despite an increase in the severity of illness and complexity of services as determined by the minimum data set case-mix indices, most of the minimum data set quality indicators showed an improvement (rate decrease) from fiscal year 2003 to fiscal year 2005, whether examined on a year-to-year basis or by an overall 3-year trend. Nationally, there was a 5.1% increase in average case-mix index, while 14 of 24 quality indicators showed a decrease in the prevalence/ incidence rates and only 4 quality indicators showed increased rates. These minimum data set results provide important information for Veterans Affairs quality managers regarding areas of achievement and also identify areas to be targeted for future quality improvement. (Am J Med Qual 2007;22...
- Published
- 2007
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17. Infection surveillance and control programs in the Department of Veterans Affairs nursing home care units: A preliminary assessment
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Linda H. Danko, Nancy Coughlin, Christa Hojlo, Robert Gaynes, Chester Davis, Chesley L. Richards, Maurice Claggett, Ona Montgomery, Linda Tsan, Robert Langberg, Michael Miller, Cynthia L. Gibert, Martha A. Kearns, and Gary A. Roselle
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Program evaluation ,medicine.medical_specialty ,Epidemiology ,Control (management) ,Surveillance Methods ,Infections ,Environmental health ,medicine ,Humans ,Infection control ,Veterans Affairs ,Infection surveillance ,Veterans ,Infection Control ,business.industry ,Health Policy ,Public health ,Public Health, Environmental and Occupational Health ,medicine.disease ,United States ,Nursing Homes ,United States Department of Veterans Affairs ,Infectious Diseases ,Health Care Surveys ,Population Surveillance ,Medical emergency ,Nursing homes ,business ,Program Evaluation - Abstract
A survey was conducted to assess the capacity and current practices of the infection surveillance and control programs at the Department of Veterans Affairs' 130 nursing home care units (VA NHCUs) covering a total of 15,006 beds in 2003. All 130 VA NHCUs responded to the survey, although not all NHCUs answered every question. The majority of the VA NHCUs provided specialized services that might pose increased risks of infection. For every 8 to 10 VA NHCU beds, there was 1 regular-pressure or negative-pressure infection control room available. Each VA NHCU had an active ongoing infection surveillance and control program managed by highly educated infection control personnel (ICP), of which 96% had a minimum of a bachelor degree. A median of 12 hours per week of these ICP efforts was devoted to the infection surveillance and control activities. The most frequently used surveillance methods were targeted surveillance for specific infections and for specific organisms. Most VA NHCUs conducted surveillance for antibiotic-resistant organisms. However, VA NHCUs did not use a uniform set of definitions for nosocomial infections for their infection surveillance and control purposes. We conclude that VA NHCUs have a considerable infrastructure and capacity for infection surveillance and control. This information can be used to develop a nationwide VA NHCU nosocomial infection surveillance system.
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- 2006
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18. Chronic fructose consumption enhances cue-triggered cocaine- and food-seeking
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Sean B. Ostlund, Fernando Gomez-Pinilla, Niall P. Murphy, Yumei Zhuang, Nigel T. Maidment, Alisa R. Kosheleff, and Linda Tsan
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Pharmacology ,Consumption (economics) ,Psychiatry and Mental health ,chemistry.chemical_compound ,chemistry ,business.industry ,Food seeking ,Medicine ,Pharmacology (medical) ,Fructose ,Food science ,Toxicology ,business - Published
- 2017
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19. Influenza vaccination rates among healthcare workers in the department of veterans affairs community living centers
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Robert P. Gaynes, Christa Hojlo, Chester L. Davis, Robert Langberg, John R. Pierce, Gary A. Roselle, Linda H. Danko, Ona Montgomery, Yancy Phillips, Linda Tsan, and Cynthia L. Gibert
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Microbiology (medical) ,Epidemiology ,business.industry ,Health Personnel ,Vaccination ,United States ,Nursing Homes ,United States Department of Veterans Affairs ,Infectious Diseases ,Influenza Vaccines ,Community living ,Environmental health ,Health Care Surveys ,Health care ,Influenza, Human ,Medicine ,Humans ,business ,Veterans Affairs - Published
- 2009
20. Prevalence of nursing home-associated infections in the Department of Veterans Affairs nursing home care units
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Chester Davis, Gary A. Roselle, Robert Langberg, Cynthia L. Gibert, John R. Pierce, Linda H. Danko, Chesley L. Richards, Robert P. Gaynes, Ona Montgomery, Christa Hojlo, Linda Tsan, Michael A. Miller, and Suzanne F. Bradley
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medicine.medical_specialty ,Bacteriuria ,Epidemiology ,Urinary system ,Indwelling Device ,Prevalence ,Skin infection ,Peripherally inserted central catheter ,Catheterization ,medicine ,Humans ,Intensive care medicine ,Veterans Affairs ,Aged ,Veterans ,Aged, 80 and over ,Cross Infection ,business.industry ,Health Policy ,Soft Tissue Infections ,Public Health, Environmental and Occupational Health ,Pneumonia ,Skin Diseases, Bacterial ,Middle Aged ,medicine.disease ,United States ,Gastroenteritis ,Nursing Homes ,United States Department of Veterans Affairs ,Infectious Diseases ,Emergency medicine ,Urinary Tract Infections ,business - Abstract
Background The Department of Veterans Affairs (VA) is the largest single provider of long-term care in the United States. The prevalence of nursing home-associated infections (NHAIs) among residents of VA nursing home care units (NHCUs) is not known. Methods A Web-based point prevalence survey of NHAIs using modified Centers for Disease Control and Prevention definitions for health care-associated infections was conducted in the VA's 133 NHCUs on November 9, 2005. Results From a total population of 11,475 NHCU residents, 591 had at least 1 NHAI for a point prevalence rate of 5.2%. Urinary tract infection, asymptomatic bacteriuria, pneumonia, skin infection, gastroenteritis, and soft tissue infection were most prevalent, constituting 72% of all NHAIs. A total of 2817 residents (24.5%) had 1 or more indwelling device. Of these 2817 residents with an indwelling device(s), 309 (11.0%) had 1 or more NHAI. In contrast, the prevalence of NHAIs in residents without an indwelling device was 3.3%. Indwelling urinary catheter, percutaneous gastrostomy tube, intravenous peripheral line, peripherally inserted central catheter, and suprapubic urinary catheter were most common, accounting for 79.3% of all devices used. Conclusion There are effective infection surveillance and control programs in VA NHCUs with a point prevalence of NHAIs of 5.2%.
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- 2007
21. Prediction of cardiovascular events in rheumatoid arthritis using risk age calculations: evaluation of concordance across risk age models
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Grunde Wibetoe, Joseph Sexton, Eirik Ikdahl, Silvia Rollefstad, George D. Kitas, Piet van Riel, Sherine Gabriel, Tore K. Kvien, Karen Douglas, Aamer Sandoo, Elke E. Arts, Solveig Wållberg-Jonsson, Solbritt Rantapää Dahlqvist, George Karpouzas, Patrick H. Dessein, Linda Tsang, Hani El-Gabalawy, Carol A. Hitchon, Virginia Pascual-Ramos, Irazu Contreas-Yañes, Petros P. Sfikakis, Miguel A. González-Gay, Iris J. Colunga-Pedraz, Dionicio A. Galarza-Delgado, Jose Ramon Azpiri-Lopez, Cynthia S. Crowson, and Anne Grete Semb
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Cardiovascular risk age ,Vascular age ,Cardiovascular disease ,Risk factors ,Rheumatoid arthritis ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background In younger individuals, low absolute risk of cardiovascular disease (CVD) may conceal an increased risk age and relative risk of CVD. Calculation of risk age is proposed as an adjuvant to absolute CVD risk estimation in European guidelines. We aimed to compare the discriminative ability of available risk age models in prediction of CVD in rheumatoid arthritis (RA). Secondly, we also evaluated the performance of risk age models in subgroups based on RA disease characteristics. Methods RA patients aged 30–70 years were included from an international consortium named A Trans-Atlantic Cardiovascular Consortium for Rheumatoid Arthritis (ATACC-RA). Prior CVD and diabetes mellitus were exclusion criteria. The discriminatory ability of specific risk age models was evaluated using c-statistics and their standard errors after calculating time until fatal or non-fatal CVD or last follow-up. Results A total of 1974 patients were included in the main analyses, and 144 events were observed during follow-up, the median follow-up being 5.0 years. The risk age models gave highly correlated results, demonstrating R 2 values ranging from 0.87 to 0.97. However, risk age estimations differed > 5 years in 15–32% of patients. C-statistics ranged 0.68–0.72 with standard errors of approximately 0.03. Despite certain RA characteristics being associated with low c-indices, standard errors were high. Restricting analysis to European RA patients yielded similar results. Conclusions The cardiovascular risk age and vascular age models have comparable performance in predicting CVD in RA patients. The influence of RA disease characteristics on the predictive ability of these prediction models remains inconclusive.
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- 2020
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22. The New York State Department of Health's Alzheimer's disease and other dementias registry first year experience
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Geraldine Bunn, Mary Ellen Henry, Todd M. Gerber, Andrew Stacy, and Linda Tsan
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medicine.medical_specialty ,Public health law ,business.industry ,media_common.quotation_subject ,General Medicine ,Disease ,State (polity) ,Family medicine ,medicine ,Confidentiality ,Psychiatry ,business ,Case report form ,media_common - Abstract
The New York State Departm ent of Health established the Alzheimer's Disease and Other Dementias Registry in August 1986. A legal requirement was enacted through Public Health Law that stipulated physicians and facilities must begin reporting the diagnosis or confirmation of Alzheimerls disease beginning January 1, 1987. By September 1987, over4, 000 reports had been submitted to the registry. Analysis of the reporting experience up to September 1987 provided the basis for a revision of the case report form and procedures for reporting, that are intended to improve the validity of the data. The process of revising the confidential case report form involved both consideration of methodologic issues and reporter concerns.
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- 1988
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23. The Impact of Different Classification Criteria Sets on the Estimated Prevalence and Associated Risk Factors of Diastolic Dysfunction in Rheumatoid Arthritis
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Lebogang Mokotedi, Sulé Gunter, Chanel Robinson, Gavin R. Norton, Angela J. Woodiwiss, Linda Tsang, Patrick H. Dessein, and Aletta M. E. Millen
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Diseases of the musculoskeletal system ,RC925-935 - Abstract
This study compared the estimated prevalence and potential determinants of left ventricular (LV) diastolic dysfunction upon applying different classification criteria in rheumatoid arthritis (RA). LV diastolic function was assessed echocardiographically by pulsed Doppler (E/A), tissue Doppler (E/e′, lateral and septal e′), and left atrial volume index in 176 RA patients. Relationships of traditional cardiovascular risk factors and RA characteristics with LV diastolic function and dysfunction according to previous and current criteria were determined in multivariate regression models. Waist-hip ratio was associated with E/A (standardised β (SE) = -0.28±0.09, p=0.0002) and lateral e′ (standardised β (SE) = 0.26±0.09, p=0.01); low diastolic blood pressure was related to E/e′ (standardised β (SE) = -0.16±0.08, p=0.04). Diastolic dysfunction prevalence differed upon applying previous (59%) compared to current (22%) criteria (p
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- 2017
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24. Kidney function, endothelial activation and atherosclerosis in black and white Africans with rheumatoid arthritis.
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Patrick H Dessein, Hon-Chun Hsu, Linda Tsang, Aletta M E Millen, Angela J Woodiwiss, Gavin R Norton, Ahmed Solomon, and Miguel A Gonzalez-Gay
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Medicine ,Science - Abstract
To determine whether kidney function independently relates to endothelial activation and ultrasound determined carotid atherosclerosis in black and white Africans with rheumatoid arthritis (RA).We calculated the Jelliffe, 5 Cockcroft-Gault equations, Salazar-Corcoran, Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimated glomerular filtration rate (EGFR) equations in 233 (112 black) RA patients.The CKD-EPI eGFR was 0.1 for comparisons of AUC (SE)) for the other 8 equations. Based on optimal eGFR cutoff values with sensitivities and specificities ranging from 42 to 60% and 70 to 91% respectively, as determined in ROC curve analysis, a low eGFR increased the odds ratio for plaque 2.2 to 4.0 fold.Reduced kidney function is independently associated with atherosclerosis and endothelial activation in black and white Africans with RA, respectively. CKD is highly prevalent in black Africans with RA. Apart from the MDRD, eGFR equations are useful in predicting carotid plaque presence, a coronary heart disease equivalent, amongst black African RA patients.
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- 2015
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25. Retinol binding protein 4 concentrations relate to enhanced atherosclerosis in obese patients with rheumatoid arthritis.
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Patrick H Dessein, Linda Tsang, Gavin R Norton, Angela J Woodiwiss, and Ahmed Solomon
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Medicine ,Science - Abstract
Retinol binding protein 4 (RBP) enhances metabolic risk and atherogenesis. Whether RBP4 contributes to cardiovascular risk in rheumatoid arthritis (RA) is unknown.We assessed RBP4 concentrations and those of endothelial activation molecules including E-selectin, vascular cell adhesion molecule-1, intercellular adhesion molecule-1 and monocyte chemoattractant protein-1 by ELISA, and the common carotid artery intima-media thickness (cIMT) and carotid artery plaque by ultrasound in 217 (112 black and 105 white) patients with RA. Relationships were identified in potential confounder and mediator adjusted mixed regression models.RBP4 concentrations were associated with systolic and mean blood pressure, and those of glucose and E-selectin (partial R = -0.207 (p = 0.003), -0.195 (p = 0.006), -0.155 (p = 0.03) and -0.191 (p = 0.007), respectively in all patients); these RBP4-cardiovascular risk relations were mostly reproduced in patients with but not without adverse traditional or non-traditional cardiovascular risk profiles. RBP4 concentrations were not associated with atherosclerosis in all patients, but related independently to cIMT (partial R = 0.297, p = 0.03) and plaque (OR (95%CI) = 2.95 (1.31-6.68), p = 0.008) in those with generalized obesity, as well as with plaque in those with abdominal obesity (OR (95%CI) = 1.95 (1.12-3.42), p = 0.01).In the present study, RBP4 concentrations were inversely associated with metabolic risk and endothelial activation in RA. This requires further investigation. RBP4 concentrations were related to enhanced atherosclerosis in patients with generalized or/and abdominal obesity.
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- 2014
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26. Adiponectin and Atherosclerosis in Rheumatoid Arthritis
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Patrick H. Dessein, Linda Tsang, Ahmed Solomon, Angela J. Woodiwiss, Aletta M. E. Millen, and Gavin R. Norton
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Pathology ,RB1-214 - Abstract
In the present study, we examined the potential impact of adiponectin on carotid ultrasound determined atherosclerosis in 210 (119 black and 91 white) RA patients in mixed regression models. Total adiponectin concentrations were smaller in patients with compared to those without the metabolic syndrome (MetS) defined waist criterion (median (range) = 6.47 (1.23–34.54) versus 8.38 (0.82–85.30) ng/mL, P=0.02, resp.); both total and high molecular weight (HMW) adiponectin concentrations were larger in patients with compared to those without joint deformities (7.97 (0.82–85.30) and 3.51 (0.01–35.40) versus 5.36 (1.29–19.49) and 2.34 (0.01–19.49) ng/mL, P=0.003 and 0.02, resp.). Total and HMW adiponectin concentrations were associated with carotid artery plaque in patients with MetS waist (odds ratio (95% CI) = 0.87 (0.76–0.99) and 0.92 (0.85–0.99) per 1-standard deviation increment, P=0.02 for both) and those without joint deformities (odds ratio (95% CI) = 0.94 (0.88–0.99) and 0.94 (0.89–0.99), P=0.03 for both). Plaque prevalence was lower in patients without compared to those with joint deformities (23.4% versus 42.6, P=0.004 in multivariable analysis). In RA patients with abdominal obesity or no clinically evident joint damage, adiponectin concentrations are reduced but nevertheless associated with decreased carotid atherosclerosis.
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- 2014
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27. Marked Independent Relationship between Circulating Interleukin-6 Concentrations and Endothelial Activation in Rheumatoid Arthritis
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Patrick H. Dessein, Ahmed Solomon, Angela J. Woodiwiss, Gavin R. Norton, Linda Tsang, and Miguel A. Gonzalez-Gay
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Pathology ,RB1-214 - Abstract
We examined the potential impact of conventional compared with nonconventional cardiovascular risk factors including interleukin-6 levels on endothelial activation in RA. Circulating soluble E-selectin, vascular cell adhesion molecule-1, intercellular adhesion molecule-1, and monocyte chemoattractant protein-1 concentrations were measured in 217 African patients (112 black and 105 white) with RA. In comprehensive confounder adjusted mixed regression models, 5 conventional and 4 nonconventional cardiovascular risk factors were associated (P=0.05 to
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- 2013
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