{"review_pmid":"39952828","record_index":1,"pmid":"9885072","title":"Comparison of high and moderate intensity of strength training on mood and anxiety in older adults.","abstract":"This study was designed to examine the psychological benefits of anaerobic exercise for older adults. Specifically, strength training was employed to examine the effects on mood and anxiety in a group of healthy but sedentary older women. 36 women (mean age = 68.5 yr.) were randomly assigned to groups given high intensity or moderate intensity strength training or to a control group. Strength training was conducted three days a week for 12 weeks. After the training period, both high and moderate strength-training programs produced marked improvements in muscle strength and body composition compared to the control subjects. The average improvements in the high and moderate intensity strength-training groups for muscle strength were 40.5 and 35.5%, respectively, and for percent body fat 1.52 and 2.50%, respectively. As for psychological changes, both training groups significantly improved positive mood (vigor), and the moderate intensity group significantly reduced trait anxiety compared to means of the control group. Also, both training groups showed some decrease in tension and state anxiety after the training period. These findings provide evidence for the effectiveness of anaerobic training to enhance perception of psychological well-being in older women. A moderate intensity rather than high intensity of training regimen may be more beneficial for sedentary older women to improve psychological health.","year":1998}
{"review_pmid":"39952828","record_index":2,"pmid":"16358106","title":"Depression, anxiety and quality of life scores in seniors after an endurance exercise program.","abstract":"OBJECTIVE: Mood disorders are a frequent problem in old age, and their symptoms constitute an important public health issue. These alterations affect the quality of life mainly by restricting social life. The participation in a regular exercise program is an effective way of reducing or preventing the functional decline associated with aging. The aim of the present study was to examine the effects of fitness-endurance activity (at the intensity of Ventilatory Threshold 1 (VT-1)) in depression, anxiety and quality of life scores in seniors. METHODS: The study involved 46 sedentary seniors aged 60-75 (66.97 +/- 4.80) who were randomly allocated to two groups: 1) Control group, which was neither asked to vary their everyday activities nor to join a regular physical fitness program; and 2) Experimental group, whose members took part in an aerobic fitness program consisting of ergometer cycle sessions 3 times a week on alternate days for six months working at a heart rate corresponding to ventilatory threshold (VT-1) intensity. Subjects were submitted to a basal evaluation using the geriatric depression screening scale--GDS, STAI trait/state (anxiety scale) and SF-36 (quality of life scale). RESULTS: Comparing the groups after the study period, we found a significant decrease in depressive and anxiety scores and an improvement in the quality of life in the experimental group, but no significant changes in the control group. CONCLUSION: The data suggest that an aerobic exercise program at VT-1 intensity suffices to promote favorable modifications in depressive and anxiety scores to improve the quality of life in seniors.","year":2005}
{"review_pmid":"39952828","record_index":3,"pmid":"34776152","title":"Effects of Xbox Kinect exercise training on sleep quality, anxiety and functional capacity in older adults.","abstract":"The aim of this study was to examine the effects of an Xbox Kinect exercise program on sleep quality, anxiety and functional capacity in older adults. Twenty-nine older adults were randomized into two treatment groups: XBOX (n = 15) or CONTROL (n = 14). The XBOX group performed exercise with an Xbox Kinect for 60 min, three times per week for 6 weeks. The CONTROL group did not exercise. Improvements in sleep quality (p = 0.04), anxiety (p = 0.007), aerobic endurance (p = 0.003), agility/balance (p = 0.02), and lower limb strength (p = 0.05) were observed in the XBOX group compared with the CONTROL. Xbox Kinect exercise program improved sleep quality, reduced anxiety, and increased the functional capacity of older adults. These results support the value of exercise in the Xbox Kinect for sleep quality and anxiety in older adults. (Clinical Trials Registration NCT04692272).","year":2021}
{"review_pmid":"39952828","record_index":4,"pmid":"12520156","title":"Effects of phase III cardiac rehabilitation programs on health-related quality of life in elderly patients with coronary artery disease: Juntendo Cardiac Rehabilitation Program (J-CARP).","abstract":"The purpose of this prospective randomized controlled trial was to assess the impact of phase III comprehensive cardiac rehabilitation (CR) on health-related quality of life (HRQOL) in elderly patients with coronary artery disease (CAD). Thirty-eight elderly males (mean age, 70 years) with CAD were stratified as the intervention group (n=20) and the control group (n=18). In the intervention group, patients participated in CR for 6 months, whereas in the control group, they received standard care. Validated questionnaires were obtained to evaluate HRQOL using the Medical Outcome Study Short-Form 36 Health Status Survey (SF-36), State-trait anxiety inventory questionnaire (STAI) and Self-rating Depression Scale (SDS) at baseline and after 6 months. At baseline, scores of SF-36 except for general health, STAI and SDS were not different in either group. After 6 months, in the intervention group, scores of bodily pain, general health, vitality and mental health of SF-36 improved significantly compared with baseline. State anxiety scores also improved significantly (p<0.01), but SDS depression scores were not improved. In the control group, none of the parameters significantly changed. These results indicate that elderly patients with CAD should be vigorously encouraged to pursue CR even in chronic phase III.","year":2003}
{"review_pmid":"39952828","record_index":5,"pmid":"36360543","title":"Effects of Physical Activity Interventions in the Elderly with Anxiety, Depression, and Low Social Support: A Clinical Multicentre Randomised Trial.","abstract":"The percentage of older people is increasing worldwide. Loneliness and anxious−depressive states are emerging health conditions in this population group, and these conditions give rise to higher morbidity and mortality. Physical activity (PA) and social relationships have been linked to physical and mental health. The objective of this study was to evaluate whether a 4-month programme of moderate PA in a group would improve the emotional state, levels of social support, and quality of life in a sample of individuals >64 years of age. A multicentre randomised clinical trial was designed in primary care. Ninety (90) participants were selected. After the intervention, there were positive differences between the groups, with significant improvements in the intervention group (IG) in depression, anxiety, health status perception, and social support. Walking in a group two days per week for 4 months reduced clinical depression and anxiety by 59% and 45%, respectively. The level of satisfaction was very high, and adherence was high. In conclusion, the moderate group PA programme improved clinical anxiety, depression, social support, and perceptions of health status in the patients studied.","year":2022}
{"review_pmid":"39952828","record_index":6,"pmid":"29625012","title":"Home-based physical activity program improves depression and anxiety in older adults","abstract":"Background: Late-lifedepressionandanxietyamongolderadultsisanimportantpublichealthconcern. Thisstudyexaminedthe effect of a DVD-delivered exercise intervention on the secondary outcomes of depression and anxiety in older adults and the extent to which physical self-worth mediated the relationship between leisure-time physical activity and depression and anxiety. Methods: Older adults (N=307) were randomized to a 6-month flexibility, toning, and balance DVD (FlexToBa™, FTB) or healthy aging DVD control. Self-reported physical activity and questionnaires were administered at baseline and postintervention. Statisticalanalyseswereconductedinthetotalsampleandinasubsampleofparticipantswithelevatedlevelsof depressionoranxiety. Results:FTBparticipants withelevateddepressionandanxietysymptomsatbaselinehadsignificantly greater reductions in depression and anxiety (d=1.66 and 2.90) than the control condition (d=0.77 and 0.73). The effect of physicalactivityondepressionandanxietywaspartiallymediatedbyincreasesinphysicalself-worthinthetotalsamplebutnot inthosewithelevateddepressionoranxiety. Conclusion: Ahome-basedphysicalactivityinterventionmaybeaviabletreatment for reducing depression and anxiety in older adults with elevated baseline scores.","year":2018}
{"review_pmid":"39952828","record_index":7,"pmid":"22826772","title":"Mental disorder prevention and physical activity in Iranian elderly","abstract":"Objectives: Mental disorders such as depression, anxiety and dementia 1Department of Health Promotion and Education, School of Public Health, Te- are common in elderly. However, physical activity is suggested to be hran University of Medical Sciences, effective in preventing such aging-related disorders. The aim of this Tehran, Iran. study was to investigate the role of physical activity on mental health in 2Department of Epidemiology and Biostalater life. tistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Methods: Four hundred elderly people were randomly divided into the Iran. intervention and control groups. The intervention consisted of exercise 3Department of Health Promotion and twice a week for two months. Mental health status before, just after, Education, School of Public Health, Te- and three months after the study was assessed with the 28-item Generhran University of Medical Sciences and al Health Questionnaire (GHQ-28). Health Center for Community-Based Participatory Research, Tehran, Iran. Results: The mean of the GHQ-28 total scale decreased in the case 4General Practitioner, School of Medicine, group and this change remained significant after three months (before: Isfahan University of Medical Sciences, 8 ± 5.5, after three months: 5.6 ± 4.6, p <.001). GHQ subscales inIsfahan, Iran.. cluding somatization, anxiety, social dysfunction, and depression de5Integrative Functional Gastroenterology creased significantly in the case group just after and three months after Research Center, Isfahan University of Medical Sciences and Psychosomatic the intervention. Research Center, Isfahan University of Conclusions: Physical activity significantly prevents mental disorder in Medical Sciences, Isfahan, Iran. older adults. Although it has effects on anxiety, social dysfunction, and depression, the greatest influence is on improving the somatization symptoms.","year":2012}
{"review_pmid":"39952828","record_index":8,"pmid":"20391891","title":"Mood, anxiety, and serum IGF-1 in elderly men given 24 weeks of high resistance exercise.","abstract":"As aging advances, changes in mood and anxiety may imply greater risk of mood disorders, particularly anxiety and depression. Resistance exercise reduces anxiety and lessens risk of depression in the elderly, but little is known of the mechanisms involved. It was hypothesized that the human growth factor (IGF-1) may improve mood and anxiety in elderly participants given resistance training. 43 elderly men ages 65 to 75 years were randomly assigned to two groups, Control (n = 23) and high resistance Exercise (n = 20). After 24 wk., the Exercise group showed improved muscular strength and higher IGF-1 serum levels than the Con-trol group, as indicated by mean scores on a visual analogue mood scale and the State-Trait Anxiety Inventory. Intensive resistance training was efficacious in improving mood, anxiety, and IGF-1 serum concentration in elderly individuals free of clinical mood disorders.","year":2010}
{"review_pmid":"39952828","record_index":9,"pmid":"23279630","title":"Motivational interviewing and exercise programme for community-dwelling older persons with chronic pain: a randomised controlled study.","abstract":"AIMS AND OBJECTIVES: To examine the effectiveness of an integrated motivational interviewing and physical exercise programme on pain, physical and psychological function, quality of life, self-efficacy, and compliance with exercise for community-dwelling older persons with chronic pain. BACKGROUND: Chronic pain is common among older persons. Indeed, motivation for managing pain is poor, and may cause negative consequences. Motivational interviewing maybe effective in treating chronic pain. DESIGN: Single-blinded randomised control study. METHODS: Older persons with chronic pain (n = 56) were recruited from two elderly community centres. They were blinded from the group allocation. The programme was conducted by an motivational interviewing-trained physiotherapist and registered nurses. Participants in the experimental group received an 8-week integrated motivational interviewing and physical exercise programme, while the control group received regular activities in the centre. Motivational interviewing used open-ended questions to encourage participants to express and recognise their pain and behaviours and professional feedback was given accordingly. Pain intensity, pain self-efficacy, anxiety, happiness, depression, mobility and quality of life were measured before and after the motivational interviewing and physical exercise programme. Attendance and compliance rate of the programme was calculated in the experimental group. RESULTS: Significant improvements in pain intensity, pain self-efficacy, anxiety, happiness and mobility after the motivational interviewing and physical exercise programme (all p < 0.05) for experimental group, while no significant improvement in control group except on the happiness scale. Regarding group differences in the outcome measures, the change scores on pain intensity, state anxiety and depression were significantly better in the experimental group. CONCLUSION: Motivational interviewing and physical exercise programme is effective in improving pain, physical mobility, psychological well-being and self-efficacy for community-dwelling older persons with chronic pain. RELEVANCE TO CLINICAL PRACTICE: Motivational interviewing is a feasible counselling technique whose content can be modified based on target group to change maladaptive behaviours, elicit ambivalences and enhance self-efficacy for making changes. Thus, promoting motivational interviewing and physical exercise programme to older persons with pain is effective and important.","year":2013}
{"review_pmid":"39952828","record_index":10,"pmid":"34003711","title":"Resistance training reduces depressive and anxiety symptoms in older women: a pilot study.","abstract":"OBJECTIVES: The purposes of this study were to analyze the effect of resistance training (RT) on depressive and anxiety symptomsand examine the possible consequences of age, cognitive alterations, and muscular strength on such symptoms. Method: Forty-one older women (68 ± 8 years) composed a training group (TG) or a control group (CG). The TG was submitted to a supervised, progressive RT program over 12 weeks, involving eight whole-body exercises performed with three sets of 8-12 repetitions, three days per week, whereas CG remains with no intervention for the same period. Muscular strength (one-repetition maximum tests), cognitive function (Montreal Cognitive Assessment - MoCA; Verbal Fluency Tests), depression (15-item eriatric Depression Scale - GDS-15), and anxiety (Beck Anxiety Inventory - BAI) were assessed before and after the intervention period. RESULTS: There were observed significant (P < 0.001) RT-induced improvements on total muscular strength (TG: pre = 122.4 ± 24.1/post = 134.3 ± 36.7; CG: pre = 105.4 ± 15.4/post = 99.2 ± 17.1) and MoCA (TG: pre =21.7 ± 4.5/post = 22.5 ± 4.7; CG: pre = 20.3 ± 3.7/post = 19.3 ± 4.1). Depressive and anxiety symptoms (even when adjusted by chronological age and changes in muscular strength or cognitive function) were reduced with RT according to GDS-15 (TG: pre = 2.26 ± 1.53/post = 1.92 ± 1.68; CG: pre =2.68 ± 1.13/post = 2.25 ± 1.18) and BAI (TG: pre = 4.07 ± 5.68/post = 2.33 ± 3.71; CG: pre = 5.18 ± 7.70/post = 9.81 ± 7.10). The time x group interactions were significant for depressive and anxiety symptoms. CONCLUSIONS: Our results suggest that a 12-week RT program reduces depressive and anxiety symptoms, regardless of age, muscular strength, and cognition function in older women.","year":2022}
{"review_pmid":"39952828","record_index":11,"pmid":null,"title":"The effect of a strength training program on affect, mood, anxiety, and strength performance in older individuals","abstract":null,"year":2012}
{"review_pmid":"39952828","record_index":12,"pmid":"29546223","title":"The Effect of Floorball Training on Health Status, Psychological Health and Social Capital in Older Men.","abstract":"This article presents the results of a multidisciplinary study which investigated the effects of a period with floorball training on health status, psychological health and social capital of older men. Thirty-nine untrained men aged 69.9 ± 0.6 (range: 65-76) were randomized into a group playing floorball (n = 22) or a group playing petanque (n = 17) one hour twice a week for 12 weeks. Both groups filled out the Health Survey Short Form (SF-12) and the Hospital Anxiety and Depression Scale (HADS) before and after the 12-week intervention. Linear regression analyses with bootstrapping showed that the men in the floorball group improved in the SF-12 composite score for mental health, as well as the HADS subscales anxiety and depression, compared to the men in the petanque group. In addition, 21 interviews were conducted with a sample of the men engaged in floorball. According to the statements in the interviews, the men in the floorball group experienced a high degree of solidarity and group cohesion which seemed to have increased their social capital during the intervention. In particular, the fun and joyful experiences of playing led to a high degree of social connectedness, which were mentioned by many of the men as the main reason for their participation throughout the 12-week period. The statistical results and the interview findings suggest that participation in a ball game such as floorball has several benefits regarding health status, psychological health and social capital and in addition that playing floorball is experienced as enjoyable amongst older men. Thus, it can be concluded that floorball is an activity that benefits older men and should be provided in relevant contexts, such as e.g. sport clubs or centres for seniors.","year":2017}
{"review_pmid":"39952828","record_index":13,"pmid":"30231121","title":"The effect of resistance training on the anxiety symptoms and quality of life in elderly people with Parkinson's disease: a randomized controlled trial.","abstract":"OBJECTIVES: To assess the effects of resistance training on the anxiety symptoms and quality of life in patients with Parkinson's disease. METHODS: Thirty-five elderly patients were randomly divided into two groups: 17 patients in the control group and 18 in the intervention group. All patients maintained standard pharmacological treatment for Parkinson's disease, but the intervention group participated in a 24-week resistance training program. The anxiety symptoms were assessed through the Beck's Anxiety Inventory, and quality of life by the Parkinson's Disease Questionnaire-39. RESULTS: There was a significant reduction in anxiety level and increase in quality of life after 24 weeks of resistance training. CONCLUSION: The results of the present study indicate that resistance training is an effective intervention in the reduction of anxiety symptoms and improves the quality of life in elderly people with Parkinson's disease.","year":2018}
{"review_pmid":"40325863","record_index":1,"pmid":"34177382","title":"A Pilot Randomized Controlled Trial to Assess Feasibility and Treatment Effect of a Web-Based Delivered Cognitive Behavi","abstract":"Background: At least 40% of individuals with multiple sclerosis (MS) experience chronic insomnia. Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment for insomnia symptoms in individuals with MS. Delivery of CBT-I using Web-based applications has been shown to be effective and may increase access to CBT-I for individuals with MS who have mobility difficulties, experience fatigue, or live in rural areas. Therefore, the purpose of this study was to assess the feasibility and treatment effect of CBT-I delivered using a Web-based application with or without biweekly telephone calls to improve sleep quality and fatigue in individuals with MS and symptoms of insomnia. Methods: Forty-one individuals with MS and symptoms of insomnia were randomized into either a group that participated in a 6-week Web-based CBT-I program (wCBT-I) or a group that participated in a 6-week Web-based CBT-I program and received biweekly support telephone calls (wCBT-I + calls). Participants completed surveys online to assess insomnia severity, sleep quality, fatigue, sleep self-efficacy, depression, anxiety, and motivation to change their sleep behavior. Results: The overall retention rate was 48.8%, and the adherence rate was 96.34%. Both groups had significant improvement in insomnia severity, sleep quality, sleep self-efficacy, and anxiety. Only the wCBT-I group had significant improvement in depression and fatigue. Conclusions: Web-delivered CBT-I is feasible and effective in improving sleep outcomes and concomitant symptoms in individuals with MS. Web-based CBT-I may increase access to CBT-I treatment and provide a stepped-care approach to treating chronic insomnia in individuals with MS. Int J MS Care. 2021;23:107-113. A t least 40% of individuals with multiple only 11% of individuals with MS who screened posisclerosis (MS) experience chronic insom- tive for moderate-to-severe insomnia reported being nia,1-3 defined as difficulty falling asleep, diagnosed by a health care provider,5 suggesting that a difficulty maintaining sleep, or waking up too early at large portion of individuals with MS and insomnia are least 3 nights per week for the past 3 months.4 However, not treated. Considering the high incidence of insomthe incidence is likely higher as one study found that nia in individuals with MS, determining an optimally From the Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA (CFS, ESB); and the Sleep Disorders Clinic, Cleveland Clinic, Cleveland, OH, USA (MD). Correspondence: Catherine F. Siengsukon, PT, PhD, University of Kansas Medical Center, 3901 Rainbow Blvd, Mail Stop 2002, Kansas City, KS 66160, USA; e-mail: csiengsukon@kumc.edu. Note: Supplementary material for this article is available at ijmsc.org. DOI: 10.7224/1537-2073.2019-122","year":2021}
{"review_pmid":"40325863","record_index":2,"pmid":"37434109","title":"A pilot, randomized, placebo-controlled study of mindfulness meditation in treating insomnia in multiple sclerosis.","abstract":"OBJECTIVE: Mindfulness is an established approach to reduce distress and stress reactivity by improving awareness and tolerability of thoughts and emotions. This study compares mindfulness training to sleep hygiene in persons with multiple sclerosis (PWMS) who report chronic insomnia, examining sleep efficiency (SE), self-reported sleep quality and quality of life. METHODS: Fifty-three PWMS were randomized (1:1) in a single-blinded, parallel group design to ten, two-hour weekly sessions of Mindfulness Based Stress Intervention for Insomnia (MBSI-I) over a span of ten weeks or a single, one hour sleep hygiene (SH) session over one day. The primary outcome measure was SE, measured by the Fitbit™ Charge 2 wrist device, at 10 and 16 weeks from the start of study interventions. Self-report outcomes included the Pittsburg Sleep Quality Rating Scale (PSQI), Insomnia Severity Index (ISI) and the Multiple Sclerosis Quality of Life Inventory (MSQLI). Nineteen participants in the MBSI-I group and 24 in the SH group completed the primary study. Subsequently, ten participants in the original SH group participated in the 10-week MSBI-I course and their data was added to the MBSI-I cohort (eMSBI-I). RESULTS: While neither SE nor the PSQI showed significant differences between MBSI-I, eMBSI-I and SH groups, ISI improved in both the MSBI-I and eMBSI-I vs SH at 10 weeks (p = 0.0014 and p = 0.0275) but not 16 weeks. However, pre and post assessments within the MBSI-I and eMBSI-I cohorts did show significant improvement in the PSQI and ISI at 10 and 16 weeks, while SH was significant in the ISI only at 16 weeks. Several quality of life measurements, including fatigue, mental health and cognitive function favored the mindfulness cohorts. CONCLUSION: This pilot study demonstrates beneficial effects of MBSR on insomnia, sleep quality and quality of life in PWMS. TRIAL REGISTRATION: NCT03949296. 14 May 2019.","year":2023}
{"review_pmid":"40325863","record_index":3,"pmid":"36603295","title":"Effect of exergaming in people with restless legs syndrome with multiple sclerosis: A single-blind randomized controlled trial.","abstract":"BACKGROUND: Restless legs syndrome (RLS) is a sensory-motor disorder characterized by an uncomfortable sensation in the lower extremity, triggered by sitting and lying positions and release with motion. There is strong evidence that RLS prevalence is higher in persons with multiple sclerosis (MS, pwMS) than in the general population. Current literature has shown that exergaming as non-pharmacological therapy may be an effective method for symptoms such as balance, walking, fatigue, cognitive functions in pwMS, but the effects on RLS are not known. Therefore, the study's main aim is to investigate the effects of exergaming in pwMS with RLS. METHODS: Thirty-one pwMS with RLS and 34 pwMS without RLS were randomly divided as exergaming group and control group. The outcome measures were International RLS Study Group Rating Scale, Modified Fatigue Impact Scale, MS Walking Scale, Timed 25-Foot Walk Test, Hospital Anxiety and Depression Scale, Godin-Shephard Leisure-Time Physical Activity Questionnaire, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, 6 min Walk Test, Timed and Up Go, MS International Quality of Life questionnaire, MS-Related Symptom Checklist. RESULTS: 26 pwMS with RLS (11 exergaming group, 15 control group) and 27 pwMS without RLS (12 exergaming group, 15 control group) were included in 8-week post-treatment analyses. After an 8-week long-term follow-up, 16 pwMS with and without RLS completed the protocol. The RLS severity (p = 0.004), anxiety level (p = 0.024), sleep quality (0.005), walking (0.004), and balance functions (0.041) were improved in pwMS with RLS exergaming group, while RLS severity increased in control group (p = 0.004). At 8-week follow-up, the effect of exergaming on RLS severity, quality of life, sleep quality, and walking capacity was preserved. There was significant improvement in gait and balance functions in pwMS without RLS exergaming group, there was no significant differences control group. In 8-week follow-up, improvement obtained in pwMS without RLS exergaming group was not preserved. CONCLUSIONS: This study suggests that exergaming training could be an effective method for managing RLS severity, anxiety, sleep quality, gait, balance, and quality of life in pwMS with RLS.","year":2023}
{"review_pmid":"40325863","record_index":4,"pmid":"27713895","title":"Effectiveness of Cognitive Behavioral Therapy on the Quality of Sleep in Women with Multiple Sclerosis: A Randomized Controlled Trial Study.","abstract":"BACKGROUND: Multiple sclerosis is accompanied by secondary clinical signs such as insomnia. Considering the side effects of drugs and also increasing acceptability of psychotherapy methods in health systems, we aimed to determine the effect of group cognitive behavioral therapy on the quality of sleep in women with multiple sclerosis in 2014. METHODS: This study is a randomized controlled clinical conducted on 72 women with multiple sclerosis who referred to medical centers of Isfahan. After convenience sampling, participants were randomly allocated into two equal groups of control (n=36) and intervention (n=36). In the intervention group, cognitive behavioral therapy was performed in 8 sessions. The control group, along with receiving the common drugs, participated in 3 group sessions and talked about their feelings and experiences. Data were gathered using Pittsburgh Sleep Quality Index (PSQI) and analyzed through independent t-test, Chi-square, Mann Whitney, ANOVA with repeated measure, using SPSS 18. RESULTS: There was a significant difference between the mean score of sleep quality of the control and intervention groups immediately and one month after the intervention (P<0.001). ANOVA with repeated measure test showed that the mean score of sleep quality of patients in the intervention group had a significant difference at three stages of before, immediately and one month after the intervention. CONCLUSIONS: According to the results of this study, cognitive behavioral therapy, as an effective and cost-effective therapy, could improve sleep quality in patients with multiple sclerosis. Trial Registration Number: IRCT2015012720833N1.","year":2016}
{"review_pmid":"40325863","record_index":5,"pmid":"33618120","title":"Feasibility and efficacy of a physical activity intervention for managing restless legs syndrome in multiple sclerosis: Results of a pilot randomized controlled trial.","abstract":"BACKGROUND: This pilot randomized controlled trial examined the feasibility and efficacy of a physical activity behavior change intervention for improving restless legs syndrome (RLS) severity and secondary sleep outcomes among a sample of adults with multiple sclerosis (MS). METHODS: Participants with MS(N=15) were randomly assigned into intervention(n=8) or waitlist control(n=7) conditions. The physical activity intervention was delivered over a 16-week period and outcomes were assessed at baseline and immediately following the 16-week period in both conditions. RESULTS: There was a significant, positive effect of the intervention on overall RLS severity (p=.01;ηρ2=.43), severity during the night(p=.03,ηρ2=.35), severity during the day while resting(p=.01,ηρ2=.44), and severity during the day while active(p<.01,ηρ2=.61), and non-significant improvements in RLS severity while falling asleep (p=.33,ηρ2=.09). There were significant positive effects on sleep satisfaction(p<.01,ηρ2=.49) and non-significant improvements in self-reported global sleep quality(p=.35,ηρ2=.08). There was a significant intervention effect on self-reported time in bed(p=.03,ηρ2=.37) and total sleep time(p=.03,ηρ2=.36), and non-significant improvements in self-reported sleep latency (p=.08,ηρ2=.25), sleep efficiency(p=.27,ηρ2=.11), and daytime sleepiness (p=.52,ηρ2=.04;p=.35,ηρ2=.08;p=.51,ηρ2=.04). There was no significant effect of the intervention on device-measured sleep quality. CONCLUSIONS: We provide preliminary evidence for the feasibility and efficacy of a physical activity intervention for reducing RLS severity and potentially improving self-reported sleep outcomes in adults with MS. CLINICALTRIALS. GOV IDENTIFICATION NUMBER: NCT04061681.","year":2021}
{"review_pmid":"40325863","record_index":6,"pmid":"32014809","title":"Feasibility and treatment effect of cognitive behavioral therapy for insomnia in individuals with multiple sclerosis: A pilot randomized controlled trial.","abstract":"BACKGROUND: At least 40% of individuals with multiple sclerosis (MS) exercise chronic insomnia, and the prevalence is likely higher due to underdiagnosis. Poor sleep quality has been associated with increased fatigue, anxiety, depression, and risk of relapse in individuals with MS. While cognitive behavioral therapy for insomnia (CBT-I) is the recommended treatment for chronic insomnia, the treatment effect of CBT-I in people with MS is unclear. OBJECTIVE: This pilot randomized control trial (RCT) assessed the feasibility and treatment effect of CBT-I to improve sleep quality and fatigue in individuals with MS with symptoms of insomnia. METHODS: Thirty-three individuals with MS (30 females, 3 males; 30 relapsing-remitting; 3 secondary-progressive; 53.0 ± 9.4 years old) with symptoms of insomnia were randomized into one of three arms: 1. 6-week CBT-I program, 2. 6-week active control, or 3. Single session of sleep education. Participants completed surveys to assess sleep quality, fatigue, sleep self-efficacy, depression, and anxiety. RESULTS: CBT-I in individuals with MS is feasible with high retention and adherence rate. All groups experienced a large magnitude of improvement in insomnia symptoms. The CBT-I and brief education groups experienced a large magnitude of improvement in sleep quality and fatigue. Only the CBT-I group demonstrated a large magnitude of improvement in sleep self-efficacy and depression. CONCLUSION: This is the first study to prospectively demonstrates that CBT-I is feasible in people with MS and produces promising improvements in insomnia severity, sleep quality, sleep self-efficacy and comorbid symptoms of fatigue, depression, and anxiety. Future studies are needed to determine mechanisms for these improvements and expand the scope of individuals with MS who may benefit from CBT-I. Furthermore, considering the moderate to large improvements experienced by the brief education group and the limited number of CBT-I providers, a stepped-care approach warrants consideration.","year":2020}
{"review_pmid":"40325863","record_index":7,"pmid":"32581540","title":"The Effectiveness of Occupational Therapy-Based Sleep Interventions on Quality of Life and Fatigue in Patients with Multiple Sclerosis: A Pilot Randomized Clinical Trial Study.","abstract":"PURPOSE: Sleep difficulties are common in patients with multiple sclerosis (MS), which may increase feelings of fatigue, negatively interfere with daily activities, and consequently reduce their quality of life. Studies examining the effects of sleep-targeted interventions in MS are currently limited in the literature. Therefore, we aim to assess the effects of occupational therapy interventions on sleep quality, fatigue, and quality of life in patients with MS. PATIENTS AND METHODS: In a single-blind, randomized, controlled trial, which occurred between April 2018 and March 2019 in Tehran, Iran, 20 eligible patients with MS were assessed using the Pittsburgh Sleep Quality Index (PSQI), Fatigue Impact Scale (FIS), Fatigue Severity Scale (FSS), and Short-Form Health Survey (SF-36). Patients were allocated randomly into the two following groups: patients receiving care-as-usual for MS (CAU) and patients receiving care-as-usual plus intervention (CAU + intervention). Both intervention groups underwent 2-3 sessions per week lasting 30-45 minutes for 8 weeks and received follow-up assessments. Data were analyzed using independent sample t-tests and Mann-Whitney U tests using SPSS (16 ver.) statistical software. RESULTS: In the intervention group, sleep quality improved significantly across all items (p<0.001, effect size = 0.60) except for sleep efficiency and the use of sleep medications. FSS and FIS in the sleep intervention group were significantly reduced (p<0.001, effect size = 0.76 and p<0.001, effect size = 0.82, respectively). The quality of life in the intervention group improved significantly (p<0.004, effect size = 0.51-0.76) with the exception of the social functioning subgroup. CONCLUSION: Although this is the result of a pilot study and more patients should be added, this intervention program demonstrates improvement in sleep quality and quality of life while decreasing fatigue in patients with MS. Adjunction of this program, if results are similar with more patients, to routine occupational therapy (OT) interventions can help improve the rehabilitation program of MS patients.","year":2020}
{"review_pmid":"40325863","record_index":8,"pmid":"36603295","title":"The Effects of Aerobic Exercise on Sleep Quality Measures and Sleep-Related Biomarkers in Individuals With Multiple Scle","abstract":"Background: Restless legs syndrome (RLS) is a sensory-motor disorder characterized by an uncomfortable Multiple sclerosis sensation in the lower extremity, triggered by sitting and lying positions and release with motion. There is strong Restless legs syndrome evidence that RLS prevalence is higher in persons with multiple sclerosis (MS, pwMS) than in the general Sleep disorders population. Current literature has shown that exergaming as non-pharmacological therapy may be an effective Exergaming method for symptoms such as balance, walking, fatigue, cognitive functions in pwMS, but the effects on RLS are Rehabilitation not known. Therefore, the study’s main aim is to investigate the effects of exergaming in pwMS with RLS. Methods: Thirty-one pwMS with RLS and 34 pwMS without RLS were randomly divided as exergaming group and control group. The outcome measures were International RLS Study Group Rating Scale, Modified Fatigue Impact Scale, MS Walking Scale, Timed 25-Foot Walk Test, Hospital Anxiety and Depression Scale, Godin-Shephard Leisure-Time Physical Activity Questionnaire, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, 6 min Walk Test, Timed and Up Go, MS International Quality of Life questionnaire, MS-Related Symptom Checklist. Results: 26 pwMS with RLS (11 exergaming group, 15 control group) and 27 pwMS without RLS (12 exergaming group, 15 control group) were included in 8-week post-treatment analyses. After an 8-week long-term follow-up, 16 pwMS with and without RLS completed the protocol. The RLS severity (p =0.004), anxiety level (p =0.024), sleep quality (0.005), walking (0.004), and balance functions (0.041) were improved in pwMS with RLS exergaming group, while RLS severity increased in control group (p =0.004). At 8-week follow-up, the effect of exergaming on RLS severity, quality of life, sleep quality, and walking capacity was preserved. There was significant improvement in gait and balance functions in pwMS without RLS exergaming group, there was no significant differences control group. In 8-week follow-up, improvement obtained in pwMS without RLS exergaming group was not preserved. Conclusions: This study suggests that exergaming training could be an effective method for managing RLS severity, anxiety, sleep quality, gait, balance, and quality of life in pwMS with RLS.","year":2023}
{"review_pmid":"40325863","record_index":9,"pmid":"34675730","title":"The Impact of Cognitive Behavioral Therapy for Insomnia on Sleep Log and Actigraphy Outcomes in People with Multiple Sclerosis: A Secondary Analysis.","abstract":"PURPOSE: While studies indicate cognitive behavioral therapy for insomnia (CBT-I) improves self-report sleep outcomes from questionnaires in people with multiple sclerosis (MS), it is unclear if CBT-I improves outcomes from a sleep log or sleep assessed objectively via actigraphy in people with MS. This study aimed to determine if CBT-I improves sleep log and actigraphy outcomes in individuals with MS. PATIENTS AND METHODS: Twenty-five participants (Mage = 53.04, SD= 10.90) were included in this secondary analysis of data from a pilot randomized control study to assess the feasibility and treatment effect of CBT-I in individuals with MS. Participants were asked to maintain a sleep log and wear an actigraph for a week at baseline and post-intervention. Participants were randomized into one of three groups (CBT-I, active control, or one-time brief education control group). One-way ANOVAs were used to assess for group differences and within group change in sleep latency, sleep efficiency (SE), time in bed, total sleep time (TST), wake after sleep onset, variability of SE, and variability of TST. RESULTS: CBT-I resulted in an increase in sleep efficiency (SE) and decrease in time in bed (TIB) and variability of SE from the sleep log. The CBT-I group also experienced a decrease in TIB and total sleep time (TST) from actigraphy. The active control group demonstrated an increase in variability of SE from actigraphy. CONCLUSION: This study indicates that individuals with MS may experience an improvement in sleep log and actigraphy sleep outcomes following CBT-I, but findings need to be replicated in a larger prospective study. The decrease in TST from actigraphy mirrors results from prior studies.","year":2021}
{"review_pmid":"41065407","record_index":1,"pmid":"18298356","title":"A high-intensity lumbar extensor strengthening program is little better than a low-intensity program or a waiting list control group for chronic low back pain: a randomised clinical trial.","abstract":"QUESTION: Is eight weeks of high-intensity strengthening of the isolated lumbar extensors more effective than low-intensity strengthening or no strengthening? Are any gains maintained 16 weeks later? DESIGN: Randomised, three-arm trial with concealed allocation, assessor blinding, and intention-to-treat-analysis. Participants in the waiting list control group were randomised again, after the first 8 weeks, to either the high-intensity or the low-intensity strengthening program. PARTICIPANTS: Sixty-five army personnel with non-specific chronic low back pain. INTERVENTION: The high-intensity training group received 10 sessions of 15 to 20 repetitions for the isolated lumbar extensor muscles. The low-intensity training group received a nonprogressive, low-intensity resistance protocol. OUTCOME MEASURES: Primary outcomes were global perceived effect and disability. Secondary outcomes were health-related quality of life, fear of movement/(re-)injury, and isometric lumbar extensor muscle strength. Measures were taken before and after the training and 16 weeks later. RESULTS: At eight weeks, SF-36 overall score was on average 7% (95% CI 1 to 13) greater in the high-intensity training group compared with the low-intensity training group and the waiting list control group, and self-assessed decrease of back symptoms was on average 39% (95% CI 14 to 64) greater in the high-intensity training group compared with the waiting list control group. There was no difference in improvement between the groups for any other outcome at 8 weeks or 24 weeks. CONCLUSIONS: Although some beneficial effects were found, the results of this high-intensity strengthening program of the isolated lumbar extensor muscles do not clearly support the generally-claimed beneficial influence of exercise for chronic non-specific low back pain.","year":2008}
{"review_pmid":"41065407","record_index":2,"pmid":"26107538","title":"A Randomized Controlled Trial of the Effects of Isolated Lumbar Extension Exercise on Lumbar Kinematic Pattern Variability During Gait in Chronic Low Back Pain.","abstract":"BACKGROUND: Chronic low back pain (CLBP) is a multifactorial condition with a variety of symptoms, one of which is abnormal gait. The lumbar spine and its musculature are important in controlling gait, and in CLBP the lumbar extensors are often deconditioned. Because of this specific isolated lumbar extension, exercise often is recommended. It was therefore of interest to examine its effects of upon gait variability. OBJECTIVE: To examine the effects of isolated lumbar extension resistance training on lumbar kinematic variability during gait in participants with CLBP. DESIGN: Randomized controlled trial. SETTING: University Health, Exercise and Sport Science Laboratory. PARTICIPANTS: Twenty-four participants with nonspecific CLBP. INTERVENTIONS: Participants were randomly allocated to a 12-week isolated lumbar extension exercise intervention (1×/week performing a single set to momentary muscular failure using a load equal to 80% max tested torque) or nontraining control period. MAIN OUTCOME MEASUREMENTS: Lumbar kinematics during gait, including angular displacement, kinematic waveform pattern (CVp), and offset (CVo) variability, were examined via 3-dimensional analyses. RESULTS: No significant changes in displacement or CVo were found as a result of the intervention; however, a small but significant reduction in sagittal plane CVp (-20.90 ± 3.53%, effect size = 0.48, P =.044) occurred, indicating improved motor pattern replication through this movement plane. CONCLUSIONS: Considering the role of the lumbar extensors in gait, and their common deconditioning in CLBP, an isolated lumbar extension resistance exercise intervention may reduce gait variability. These results suggest isolated lumbar extension exercise may specifically reduce sagittal plane variability, indicating improved motor pattern replication through this movement plane, perhaps attributable to the plane of movement used during the exercise.","year":2016}
{"review_pmid":"41065407","record_index":3,"pmid":"19209082","title":"OMPARISON OF WO ORMS OF ERIODIZED XERCISE EHABILITATION ROGRAMS IN THE ANAGEMENT OF HRONIC ONSPECIFIC OW BACK AIN","abstract":"indicates that whole-body periodized RT can be used by trainingandconditioningpersonnelintherehabilitationofthose Kell,RT,andAsmundson,GJG. Acomparisonoftwoformsof clientssuffering withCLBP. periodizedexerciserehabilitationprogramsinthemanagement of chronic nonspecific low-back pain. J Strength Cond Res KEY WORDS aerobic training, disability, strength training, 23(2): 513-523, 2009-The purpose of this study was to therapy determine the influence of 2 different periodized exercise rehabilitation programs (resistance training [RT] and aerobic training [AT]) on musculoskeletal health, body composition,","year":2009}
{"review_pmid":"41065407","record_index":4,"pmid":"33187076","title":"Effectiveness of a Group-Based Progressive Strength Training in Primary Care to Improve the Recurrence of Low Back Pain Exacerbations and Function: A Randomised Trial.","abstract":"Low back pain (LBP) is the leading cause of disability and one of the most common reasons for physician visits in primary care, with a 33% rate of recurrence during the first year. However, the most optimal exercise program in this context remains unknown. The objective was to evaluate the effectiveness of a group-based progressive strength training program in non-specific chronic LBP (CLBP) patients in primary care on pain recurrence and physical function. Eighty-five patients with non-specific CLBP were separated into two groups (Intervention group: completed a progressive strength training program 3 days per week for 8 weeks; Control group: received the usual care). The intervention group showed a recurrence rate of 8.3%, while the control group had a recurrence rate of 33.3% and a shorter time until the first recurrent episode. The intervention group showed increased lumbar extensor strength, left-hand handgrip strength, and reduced the number of pain sites compared with the control group. Results also showed greater odds for reducing LBP intensity and disability in the intervention group. In conclusion, a group-based progressive strength training program is a more effective and efficient alternative than Back-School programs and can easily be carried out in the primary health care context.","year":2020}
{"review_pmid":"41065407","record_index":5,"pmid":null,"title":"Effects of an acute resistance training session on pain and functional disability in people with chronic low back pain: a double blind controlled randomized trial","abstract":"Introduction: People with chronic low back pain have functional disability associated with a decrease in productivity with major socioeconomic consequences. Resistance training is a form of exercise treatment that has been proposed to mitigate the problems caused by low back pain. It is recommended that the resistance training exercises focus on the posterior chain muscles and that the fragile condition of this population be considered. To the best of our knowledge, no study has yet investigated the effects of an acute resistance training session on pain and functional disability, considering such recommendations for people with non-specific chronic low back pain. Objective: Our aim was to assess the effects of a single resistance training session on pain and functional disability in people with non-specific chronic low back pain. Methods: 31 subjects of both genders with non-specific chronic low back pain took part in the study. Participants were randomized into two groups: the resistance training group (RTG) and the control group (CG). The RTG underwent a single exercise session. Results: The RTG showed a significant (p=0.001) decrease in perceived pain (5.9±1.6 versus 4.9±1.8) and a significant (p=0.016) decrease in functional disability (25.6±6.3 versus 20.5±4.1), after the resistance training session. The CG did not show significant differences (p=0.190) in perceived pain (6.9±1.7 versus 7.4±1.9)and in functional disability (26.8±7.8 versus 27.8 ±9.2), after the final assessment. The RTG showed a significant (p=0.001) increase in strength between the initial and final assessments (47.7 ±26.6kgf versus 60.2 ±31.4kgf) while the CG did not show any differences. Conclusion: A single resistance training session reduces pain and functional disability in people with chronic non-specific low back pain.","year":2023}
{"review_pmid":"41065407","record_index":6,"pmid":"28826168","title":"Effects of functional resistance training on fitness and quality of life in females with chronic nonspecific low-back pain.","abstract":"BACKGROUND: Exercise is important as adjuvant in the chronic low back pain (CLBP) treatment. Functional training could involve benefits for low back pain (LBP) patients. OBJECTIVE: To evaluate the effects of a 12-week period of functional resistance training on health-related quality of life (HRQOL), disability, body pain, and physical fitness in CLBP females. METHODS: Nineteen females CLBP were recruited according to Paris Task Force on Back Pain criteria. Participants were randomly assigned to an exercise group (EG); and a control group (CG). Subjects were tested at baseline and at week 12 after 24 sessions, 2 days per week. Body pain was assessed using visual analog scale (VAS), disability with Oswestry Disability Index (ODI) and HRQOL with Short Form 36 questionnaire. Physical fitness was measured using: flamingo test, back endurance test, side bridge test, abdominal curl-up tests, and 60-s squat test. RESULTS: EG showed significant improvements in physical function (10%; p< 0.05), body pain (42%; p< 0.05), vitality (31%; p< 0.05), physical component scale (15%; p< 0.05), VAS (62.5%; p< 0.01), ODI (61.3%; p< 0.05), balance (58%; p< 0.05), curl-up (83%; p< 0.01), squat (22%; p< 0.01), static back (67%; p< 0.01), and side bridge (56%; p< 0.01). CONCLUSION: Periodized functional resistance training decreased pain and disability and improved HRQOL, balance and physical fitness in females with CLBP, and can thus be used safely in this population.","year":2018}
{"review_pmid":"41065407","record_index":7,"pmid":"35001671","title":"Effects of two Training Programs on Health Variables in Adults with Chronic Low Back Pain: A Randomi","abstract":null,"year":2022}
{"review_pmid":"41065407","record_index":8,"pmid":"22397454","title":"One lumbar extension training session per week is sufficient for strength gains and reductions in pain in patients with chronic low back pain ergonomics.","abstract":"UNLABELLED: Chronic low back pain (CLBP) is the leading cause of absenteeism from the workplace and research into exercise interventions to address this problem is required. This study investigated training frequency for participants with CLBP. Participants either trained once a week (1 × week, n = 31), or twice a week (2 × week, n = 20) or did not (control group, n = 21). Participants were isometric strength tested in weeks 1 and 12 and trained dynamically either 1×week (80% of maximum) or 2×week (80% and 50%). The results (pre vs. post) showed significant increases in maximal strength, range of motion and reductions in pain for both training groups. Pain scores for the 1 × week and 2 × week both reached minimal clinical improvement change unlike the control group. Thus, one lumbar extension training session per week is sufficient for strength gains and reductions in pain in low back pain in CLBP patients. PRACTITIONER SUMMARY: CLBP is the leading cause of absenteeism from the workplace. The present study using a modified randomised control trial design investigated exercise training frequency for participants with CLBP. One lumbar extension training session per week is sufficient for strength gains and reductions in low back pain in CLBP patients.","year":2012}
{"review_pmid":"41065407","record_index":9,"pmid":"32503243","title":"Randomized Trial of General Strength and Conditioning Versus Motor Control and Manual Therapy for Chronic Low Back Pain on Physical and Self-Report Outcomes.","abstract":"Exercise and spinal manipulative therapy are commonly used for the treatment of chronic low back pain (CLBP) in Australia. Reduction in pain intensity is a common outcome; however, it is only one measure of intervention efficacy in clinical practice. Therefore, we evaluated the effectiveness of two common clinical interventions on physical and self-report measures in CLBP. Participants were randomized to a 6-month intervention of general strength and conditioning (GSC; n = 20; up to 52 sessions) or motor control exercise plus manual therapy (MCMT; n =20; up to 12 sessions). Pain intensity was measured at baseline and fortnightly throughout the intervention. Trunk extension and flexion endurance, leg muscle strength and endurance, paraspinal muscle volume, cardio-respiratory fitness and self-report measures of kinesiophobia, disability and quality of life were assessed at baseline and 3- and 6-month follow-up. Pain intensity differed favoring MCMT between-groups at week 14 and 16 of treatment (both, p = 0.003), but not at 6-month follow-up. Both GSC (mean change (95%CI): -10.7 (-18.7, -2.8) mm; p = 0.008) and MCMT (-19.2 (-28.1, -10.3) mm; p < 0.001) had within-group reductions in pain intensity at six months, but did not achieve clinically meaningful thresholds (20mm) within- or between-group. At 6-month follow-up, GSC increased trunk extension (mean difference (95% CI): 81.8 (34.8, 128.8) s; p = 0.004) and flexion endurance (51.5 (20.5, 82.6) s; p = 0.004), as well as leg muscle strength (24.7 (3.4, 46.0) kg; p = 0.001) and endurance (9.1 (1.7, 16.4) reps; p = 0.015) compared to MCMT. GSC reduced disability (-5.7 (-11.2, -0.2) pts; p = 0.041) and kinesiophobia (-6.6 (-9.9, -3.2) pts; p < 0.001) compared to MCMT at 6-month follow-up. Multifidus volume increased within-group for GSC (p = 0.003), but not MCMT or between-groups. No other between-group changes were observed at six months. Overall, GSC improved trunk endurance, leg muscle strength and endurance, self-report disability and kinesiophobia compared to MCMT at six months. These results show that GSC may provide a more diverse range of treatment effects compared to MCMT.","year":2020}
{"review_pmid":"41065407","record_index":10,"pmid":"22142713","title":"The effect of lumbar extension training with and without pelvic stabilization on lumbar strength and low back pain.","abstract":"INTRODUCTION: A dynamometer employing a stabilization procedure (lumbar extension machine, MedX, Ocala, FL) is effective in improving strength and reducing symptoms of low back pain (LBP), and researchers have hypothesized that this effectiveness is due to the pelvic stabilization. However, effects of the dynamometer with and without pelvic stabilization on LBP have not been compared: This was the aim of the present study. METHODS: Forty-two chronic LBP patients were randomly assigned to a lumbar extension training with pelvic stabilization group (STAB; n=15), a lumbar extension without pelvic stabilization group (NO-STAB; n=15) and a control group (n=12). STAB and NO-STAB participants completed one weekly session of dynamic variable resistance exercise (one set of 8-12 repetitions to fatigue) on the lumbar extension machine (with or without pelvic stabilization) for 12 weeks. Pre- and post-test measures of self-reported LBP (101-point visual analog scale; pre-test mean of 25), related disability (Oswestry disability index; pre-test mean of 34) and lumbar strength were taken. RESULTS: After the exercise program, the STAB group increased significantly in lumbar strength at all joint angles, and decreased significantly in visual analogue and Oswestry scores. However, there were no significant changes in these variables in the NO-STAB and control groups. DISCUSSION: Isolated lumbar extension exercise is very effective in reducing LBP in chronic patients. However, when the pelvis is not stabilized, otherwise identical exercises appear ineffective in reducing LBP.","year":2011}
{"review_pmid":"41388744","record_index":1,"pmid":"40759997","title":"Curcumin supplementation improves the clinical outcomes of patients with diabetes and atherosclerotic cardiovascular risk.","abstract":"Atherosclerotic cardiovascular diseases (ASCVD) significantly contribute to global mortality, especially in type 2 diabetes mellitus (T2DM), necessitating effective preventive strategies. Curcumin is proposed to lower blood pressure, glucose level, and improve lipid profiles as an adjunctive treatment. The study aimed to assess the safety and efficacy of Curcumin supplementation on clinical outcomes and ASCVD risk of T2DM patients. Seventy-two diabetic patients with an ASCVD risk score of ≥ 5% were randomly assigned to Curcumin group (500 mg Turmeric curcumin® thrice daily + conventional therapy) or Control group (conventional therapy only). Curcumin significantly reduced SBP and DBP (P ≤ 0.001 and P = 0.020, respectively) and improved ASCVD risk classification (P = 0.004). LDL-C (P = 0.024), TNF-α (P = 0.044), and MDA (P = 0.028) levels decreased, while HDL-C increased (P = 0.024) versus control. No significant differences were found between groups regarding HbA1c, FBG, TC or TG (P > 0.05). Mild adverse effects were reported, including nausea (13.9%), headache (11.1%), yellow stool (11.1%), and diarrhea (5.6%). It is concluded that Curcumin improves ASCVD risk classification, lowers SBP, DBP, LDL-C, TNF-alpha, and MDA, increases HDL-C, and is well tolerated with minor adverse effects, without impacting on BMI, HR, HbA1c, FBG, TC, or TG.","year":2025}
{"review_pmid":"41388744","record_index":2,"pmid":"35106289","title":"Downregulated hs-CRP and MAD, upregulated GSH and TAC, and improved metabolic status following combined exercise and turmeric supplementation: a clinical trial in middle-aged women with hyperlipidemic type 2 diabetes.","abstract":"BACKGROUND: Aerobic training (AT) and Turmeric Supplementation (TS) are known to exert multiple beneficial effects including metabolic status and Oxidative Stress. To our knowledge, data on the effects of AT and TS on metabolic status and oxidative stress biomarkers related to inflammation in subjects with Hyperlipidemic Type 2 Diabetes Mellitus (HT2DM) are scarce. OBJECTIVES: This study was conducted to evaluate the effects of AT and TS on metabolic status and oxidative stress biomarkers related to inflammation in subjects with HT2DM. METHODS: This randomized single-blinded, placebo-controlled trial was conducted among 42 subjects with HT2DM, aged 45-60 years old. Participants were randomly assigned to four groups; AT+TS (n = 11), AT+placebo (AT; n = 10), TS (n = 11), and Control+placebo (C; n = 10). The AT program consisted of 60-75% of Maximum heart rate (HRmax), 20-40 min/day, three days/week for eight weeks. The participants in the TS group consumed three 700 mg capsules/day containing turmeric powder for eight weeks. Metabolic status and oxidative stress biomarkers were assessed at baseline and end of treatment. The data were analyzed through paired t-test and one-way analysis of variance (ANOVA) and Bonferroni post hoc test at the signification level of P < 0.05. RESULTS: After eight weeks, significant improvements were observed in metabolic status, oxidative stress biomarkers and high-sensitivity C-reactive protein (hs-CRP) in the AT+TS, TS, and AT compared to C. Additionally, a significant decrease of Metabolic Syndrome (MetS) Z scores (p = 0.001; p = 0.011), hs-CRP (p = 0.028; p = 0.041), Malondialdehyde (MAD) (p = 0.023; p = 0.001), and significantly higher Glutathione (GSH) (p = 0.003; p = 0.001), and Total Antioxidant Capacity (TAC) (p = 0.001; p = 0.001) compared to the AT and TS groups. The results also revealed a significant difference in terms of MetS Z scores (p = 0.001), hs-CRP (p = 0.018), MAD (p = 0.011), GSH (p = 0.001) and TAC (p = 0.025) between the AT and TS. CONCLUSIONS: The findings suggest that AT+TS improves metabolic status, oxidative stress biomarkers, and hs-CRP more effectively compared to TS or AT in middle-aged females with T2DM and hyperlipidemia.","year":2022}
{"review_pmid":"41388744","record_index":3,"pmid":"31155769","title":"Effect of Curcuma longa on vascular function in nativeTamilians","abstract":null,"year":2019}
{"review_pmid":"41388744","record_index":4,"pmid":"33586583","title":"Effectiveness of the piperine-supplemented Curcuma longa L. in metabolic control of patients with type 2 diabetes: a randomised double-blind placebo-controlled clinical trial.","abstract":"There is robust evidence of using Curcuma longa L. in reducing metabolic levels in people with diabetes. This study analysed the effectiveness of Curcuma longa L. in the metabolic control of patients with type 2 diabetes in Brazil. A randomised double-blind placebo-controlled clinical trial was conducted with 71 participants divided into a Curcuma longa L. group (500 mg/day with piperine 5 mg) and a placebo group, for 120 days. Anthropometric, clinical and biochemical variables were evaluated at baseline, 60 and 120 days after the beginning of the intervention. Paired and independent Student's t-test and chi-square test were used for statistical analysis. The curcuma group presented a significantly decreased glycaemia (p=.013), glycated haemoglobin (p=.015), HOMA index (p=.037) and triglycerides (TGs) (p=.002). The use of piperine-added Curcuma longa L. was effective in the glycaemic and TG control of patients with type 2 diabetes.","year":2021}
{"review_pmid":"41388744","record_index":5,"pmid":"31871950","title":"Effects of Highly Absorbable Curcumin in Patients with Impaired Glucose Tolerance and Non-Insulin-Dependent Diabetes Mellitus.","abstract":"Oxidative stress is enhanced by various mechanisms. Serum oxidized low-density lipoprotein (LDL) is a useful prognostic marker in diabetic patients with coronary artery disease. To examine the effects of Theracurmin®, a highly absorbable curcumin preparation, on glucose tolerance, adipocytokines, and oxidized LDL, we conducted a double-blind placebo-controlled parallel group randomized trial in patients with impaired glucose tolerance or non-insulin-dependent diabetes mellitus. We randomly divided the patients with impaired glucose tolerance or non-insulin-dependent diabetes mellitus and stable individuals into the placebo group and the Theracurmin® (180 mg daily for 6 months) group. Of the 33 patients analyzed, 18 (14 males and 4 females) were administered placebo and 15 (9 males and 6 females) were administered Theracurmin®. The patient characteristics did not differ between the two groups. The primary endpoint, HbA1c, did not differ significantly between the two groups. However, the level of α1-antitrypsin-low-density lipoprotein (AT-LDL), the oxidized LDL, significantly increased (p = 0.024) in the placebo group from the beginning of the trial up to 6 months, although there was no such change in the Theracurmin® group. The percentage change in BMI from the beginning of the trial up to 6 months tended to be higher in the Theracurmin® group than in the placebo group. Patients in the Theracurmin® group tended to have a larger percentage change in adiponectin and LDL-C than those in the placebo group. Patients in the Theracurmin® group showed a smaller percentage change in AT-LDL than those in the placebo group. This study suggests that the highly absorbable curcumin could potentially inhibit a rise in oxidized LDL in patients with impaired glucose tolerance or non-insulin-dependent diabetes mellitus. This trial is registered with UMIN000007361.","year":2019}
{"review_pmid":"41388744","record_index":6,"pmid":"30796508","title":"Effects of phytosomal curcumin on anthropometric parameters, insulin resistance, cortisolemia and non-alcoholic fatty liver disease indices: a double-blind, placebo-controlled clinical trial.","abstract":"PURPOSE: Curcumin has shown to exert a positive impact on human glucose metabolism, even if its bioavailability is usually very low. The present study aimed to explore the effect of phosphatidylserine- and piperine-containing curcumin phytosomes on a large number of metabolic parameters related to insulin resistance, in the context of a randomized double-blind placebo-controlled trial involving 80 overweight subjects with suboptimal fasting plasma glucose. METHODS: Subjects were randomized to be treated with indistinguishable tablets (2 per day, to be taken after dinner) containing 800 mg phytosomal curcumin (Curserin®: 200 mg curcumin, 120 mg phosphatidylserine, 480 mg phosphatidylcholine and 8 mg piperine from Piper nigrum L. dry extract) for 8 weeks. RESULTS: After 56-day treatment, the curcumin-treated group experienced a significant improvement in fasting plasma insulin (FPI), HOMA index, waist circumference, blood pressure, triglycerides (TG), HDL-C, liver transaminases, gamma-GT, index of liver steatosis and serum cortisol compared to the baseline. FPI, TG, liver transaminases, fatty liver index and serum cortisol level also significantly improved compared with the placebo-treated group. Compared to the baseline, at the end of the study placebo group experienced an improvement only in FPG and TG. CONCLUSION: In conclusion, the present trial shows that supplementation with a phytosomal preparation of curcumin containing phosphatidylserine and piperine could improve glycemic factors, hepatic function and serum cortisol levels in subjects with overweight and impaired fasting glucose.","year":2020}
{"review_pmid":"41388744","record_index":7,"pmid":"21627399","title":"Oral supplementation of turmeric attenuates proteinuria,transforming growth factorβ and inter","abstract":"Objective: End-stagerenaldisease(ESRD)duetotype2diabeticnephropathyisaverycommonconditionwhichisincreasing inprevalence,andisassociatedwithhighgloballevelsofmortalityandmorbidity. Bothproteinuriaandtransforminggrowth factor-b(TGF-b)maycontributetothedevelopmentofESRDinpatientswithdiabeticnephropathy. Experimentalstudies indicatethatturmericimprovesdiabeticnephropathybysuppressingTGF-b. Therefore,thisstudyinvestigatedtheeffectsof turmericonserumandurinaryTGF-b,interleukin-8(IL-8)andtumournecrosisfactor-a(TNF-a),aswellasproteinuria,in patients with overt type 2 diabetic nephropathy. Material and methods. A randomized, double-blind and placebocontrolled study was carried out in the Diabetes Clinic of the Outpatient Department of Shiraz University of Medical Scienceson40patientswithoverttype2diabeticnephropathy,randomizedintoatrialgroup(n=20)andacontrolgroup (n=20). Eachpatientinthetrialgroupreceivedonecapsulewitheachmealcontaining500mgturmeric,ofwhich22.1mgwas the active ingredient curcumin (three capsules daily) for 2 months. The control group received three capsules identical in colourandsizecontainingstarchforthesame2months. Results. SerumlevelsofTGF-bandIL-8andurinaryproteinexcretion andIL-8decreasedsignificantlycomparingthepre-andpost-turmericsupplementationvalues. Noadverseeffectsrelatedto turmeric supplementation were observed during the trial. Conclusion. Short-term turmeric supplementation can attenuate proteinuria,TGF-bandIL-8inpatientswithoverttype2diabeticnephropathyandcanbeadministeredasasafeadjuvant therapy for these patients.","year":2011}
{"review_pmid":"41388744","record_index":8,"pmid":"31149032","title":"The effect of curcumin supplementation on anthropometric indices, insulin resistance and oxidative stress in patients with type 2 diabetes: a randomized, double-blind clinical trial.","abstract":"BACKGROUND: Diabetes mellitus is a common metabolic disorders in human and affect a lot of people around the world. Curcumin is a component of turmeric and in many studies therapeutic effects such as anti-hypertensive, anti-hyperlipidemia, anti-hyperglycemia for this substance are shown. AIM: The aim of this study was to investigate the effect of curcumin supplementation on anthropometric indices glycemic control and oxidative stress in overweight patients with type 2 diabetes. MATERIALS AND METHODS: In this randomized, double-blind, placebo-controlled trial, 53 participants with type 2 diabetes were divided randomly into the experimental and control groups to receive either 1500 mg curcumin or placebo capsule three times in a day for 10 weeks. RESULT: Supplementation with curcumin in type 2 diabetes compare to placebo causes a significant changes in mean weight (- 0.64 ± 0.22 vs. 0.19 ± 0.37 p < 0.05), body mass index (BMI) (0.3 ± 0.03 vs. 0.1 ± 0 p < 0.05), waist circumference (WC) (- 1.2 ± 0.4 vs. - 0.43 ± 0.11 p < 0.05) and fasting blood sugar (FBS) (- 7 ± 2 vs. 3 ± 0.2 p < 0.05) but did not show any difference for hemoglobin A1c (HbA1c), insulin, malondialdehyde (MDA), total antioxidant capacity (TAC), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and pancreatic B cell function (HOMA-B) at end of study. CONCLUSION: This study indicated that daily administration of 1500 mg curcumin has positive effects in reducing fasting blood glucose and weight in patients with type 2 diabetes. Trial registration NCT02529982. Registered 19 August 2015, http://www.clinicaltrial.gov.","year":2019}
{"review_pmid":"41388744","record_index":9,"pmid":"42153019","title":"The effect of curcumin and piperine co-supplementation on glycemic indices in prediabetes: A triple-blind randomized controlled trial.","abstract":"OBJECTIVE: Patients with prediabetes are at a higher risk of cardiometabolic diseases. There has been growing attention to the role of phytochemicals and nutraceuticals against prediabetes. Previous research supports the efficacy of curcumin in controlling blood glucose level in diabetes but its effect on prediabetes has not been adequately studied. This study aimed to evaluate the effect of curcumin and piperine on prediabetes. MATERIALS AND METHODS: This triple-blind, randomized controlled trial was performed on patients with prediabetes. The intervention group (n=34) received curcumin + piperine tablets (containing 500 mg curcumin plus 5 mg piperine), while the control group (n=34) used placebo for three months. Before and after three months, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), HOMA-IR, C-reactive protein (CRP), insulin, and anthropometric indices were assessed. The measurements were analyzed using SPSS software. RESULTS: The mean age of participants was 48.4±10.82 years, and 55.8% were females. After the intervention, FBG and HbA1c did not differ significantly between the groups. After 3 months, CRP was significantly reduced in the curcumin + piperine group (p=0.01), while the insulin level increased significantly (p=0.03). After adjustment for CRP and weight at baseline, the difference in changes in insulin, HOMA-IR, and CRP levels between the two groups disappeared. Moreover, there were no changes in anthropometric indices in either group during the study period. CONCLUSION: Our study revealed that the combination of curcumin and piperine had no significant impact on glycemic indices in patients with prediabetes. Evaluation of the precise effect of this combination on prediabetes requires more clinical trials with varying dosages and durations.","year":2026}
{"review_pmid":"41388744","record_index":10,"pmid":"26915483","title":"The Effect of Dietary Supplementation With Curcumin on Redox Status and Nrf2 Activation in Patients With Nondiabetic or Diabetic Proteinuric Chronic Kidney Disease: A Pilot Study.","abstract":"OBJECTIVE: Chronic kidney disease (CKD) is a worldwide public health problem, and proteinuria may accelerate the progression of CKD, being oxidative stress a common mechanism in nondiabetic or diabetic proteinuric kidney disease. This study was designed to evaluate the effect of the dietary supplementation with curcumin (CUR) on the redox status and the nuclear factor erythroid 2-related factor 2 (Nrf2) activation in patients with nondiabetic or diabetic proteinuric CKD. DESIGN: Randomized double-blind placebo-controlled clinical trial. SUBJECTS: A total of 101 Mexican patients from the National Institute of Cardiology \"Ignacio Chavez\", with nondiabetic or diabetic proteinuric CKD (proteinuria ≥ 1 g protein/24 hours), aged 20 to 70 years; 60% were male, and 51% were diabetic. INTERVENTION: Patients with nondiabetic proteinuric CKD received placebo (n = 26) or CUR 320 mg/day (n = 24) for 8 weeks, and patients with diabetic proteinuric CKD were intervened with placebo (n = 23) or CUR 320 mg/day (n = 28) for the same period. MAIN OUTCOME MEASURE: Anthropometrical, clinical, and biochemical characteristics, as well as oxidative stress markers, antioxidant enzyme activities and Nrf2 activation were evaluated at baseline and after intervention. RESULTS: The intervention with CUR did not improve proteinuria, estimated glomerular filtration rate, or lipid profile. However, in plasma, CUR attenuated lipid peroxidation in individuals with nondiabetic proteinuric CKD (P<.05) and enhanced the antioxidant capacity in subjects with diabetic proteinuric CKD (P<.05). No effect of CUR was observed on the antioxidant enzymes activities or Nrf2 activation. CONCLUSIONS: Dietary supplementation with CUR has the potential to reduce oxidative stress in Mexican patients with nondiabetic or diabetic proteinuric CKD. Studies with higher doses of CUR and longer follow-up are granted to confirm our findings.","year":2016}
{"review_pmid":"41388744","record_index":11,"pmid":"39165011","title":"The effect of curcumin-piperine supplementation on lipid profile, glycemic index, inflammation, and blood pressure in patients with type 2 diabetes mellitus and hypertriglyceridemia.","abstract":"Type 2 diabetes mellitus (T2DM) is a metabolic disorder associated with insulin resistance and ensuing dysglycemia, dyslipidemia, and inflammation. Owing to the putative metabolic benefits of curcumin-piperine combination, we explored the efficacy of this combination in improving cardiometabolic indices of patients with T2DM and hypertriglyceridemia. In this double-blind clinical trial, 72 patients with T2DM and hypertriglyceridemia were randomized to receive either a tablet containing 500 mg of curcuminoids plus 5 mg of piperine, or a matched placebo for 12 weeks. Anthropometric indices, blood pressure, glycemic indices, lipid profile, C-reactive protein (CRP), quality of life, and mood were evaluated at baseline and end of the study. After 12 weeks of intervention, the levels of triglycerides (p-value = 0.001) and fasting blood glucose (p-value = 0.004) were significantly reduced in the curcumin-piperine compared with the placebo group. CRP levels were marginally reduced in the curcumin-piperine compared with the placebo group (p-value = 0.081). In addition, energy/fatigue significantly increased in the curcumin-piperine group compared to the control group (p-value = 0.024). However, between-group comparisons showed no significant change in other parameters, including anthropometric indices (waist circumference and body mass index (BMI)), biochemical parameters (low-density lipoprotein (LDL-c), high-density lipoprotein (HDL-c), and insulin), HOMA-IR, blood pressure, quality of life, and DASS-21 items between the studied groups (p-value >0.05). The current study showed that curcumin-piperine supplementation can improve serum CRP, triglycerides, and glucose concentrations in patients with T2DM and hypertriglyceridemia.","year":2024}
{"review_pmid":"41388744","record_index":12,"pmid":"40682175","title":"The effectiveness and safety of nanocurcumin supplementation for diabetic peripheral neuropathy in patients with type 2 diabetes: a randomized double-blind clinical trial.","abstract":"BACKGROUND: Diabetic neuropathy is the most prevalent complication of diabetes mellitus, affecting up to 50% of patients with type 2 diabetes mellitus (T2DM). Among the various types of diabetic neuropathy, diabetic peripheral neuropathy (DPN) is the most common. Numerous animal studies have highlighted a strong association between the improvement of DPN and curcumin supplementation, particularly due to curcumin's anti-inflammatory and antioxidant properties. However, the effects of curcumin on DPN have been evaluated in only one randomized controlled trial. In our study, we assessed the efficacy and safety of a 16-week supplementation with nanocurcumin in T2DM patients suffering from DPN. METHODS: This randomized, double-blind, placebo-controlled trial was conducted at a diabetes clinic within the Endocrinology and Metabolism Research Center in Tehran, Iran. The study aimed to evaluate the effects of nanocurcumin (40 mg taken twice daily) compared to a placebo in patients with DPN over a 16-week period. The primary endpoint of the study was the reduction of pain severity, measured by the Numerical Rating Scale (NRS). Additionally, we assessed neuropathic outcomes by monitoring changes in the Michigan Neuropathy Screening Instrument examination (MNSIE) and the Neuropathy Disability Score (NDS). Secondary endpoints included improvements in metabolic and cardiovascular parameters from baseline to the end of the treatment. RESULTS: Ninety-seven patients were randomized, with 41 in the nanocurcumin group and 45 in the placebo group completing the study. No significant differences were found between the groups in terms of NRS (P = 0.787), NDS (P = 0.576), or MNSIE (P = 0.405) after 16 weeks. Nanocurcumin supplementation did not alter the metabolic profile or cardiovascular parameters and was well-tolerated, without major adverse events. CONCLUSION: Nanocurcumin supplementation over 16 weeks did not improve pain, neuropathic outcomes, or metabolic/cardiovascular parameters in patients with T2DM suffering from DPN.","year":2025}
{"review_pmid":"41388744","record_index":13,"pmid":"32359741","title":"The effects of vitamin D and curcuminoids supplementation on anthropometric measurements and blood pressure in type 2 diabetic patients with coexisting hypovitaminosis D: A double-blind, placebo-controlled randomized clinical trial.","abstract":"BACKGROUND AND AIMS: Curcuminoids and vitamin D have been shown to improve blood pressure and body weight in diabetic animals; however, consistent findings in type 2 diabetes mellitus (T2DM) patients are limited. This study was performed to evaluate the effects of curcuminoids and vitamin D, simultaneously or singly on anthropometric measurements and blood pressure in T2DM patients with insufficient vitamin D level. METHODS: In this randomized, placebo-controlled clinical trial, eighty T2DM patients were randomly assigned into 4 groups receiving (1) 500 mg/day curcuminoids; (2) 50,000 IU/week vitamin D3; (3) 50,000 IU/week vitamin D3 plus 500 mg/d curcuminoids; or (4) placebos for 12 weeks. Blood pressure and anthropometric measurements were evaluated before and after intervention. RESULTS: Intergroup comparisons showed that Vitamin D (main effect) significantly reduced systolic blood pressure (SBP) and diastolic blood pressure (DBP) (P = 0/000). Curcuminoids (main effect) significantly reduced DBP (P = 0/001). Interaction effects showed that curcuminoids significantly prevented the effect of vitamin D on the reduction of SBP (P = 0.006). Whereas, vitamin D and curcuminoids had a synergistic effect on DBP reduction (P = 0.006). The comparison of changes in anthropometric measurements between the four groups showed no significant differences in the raw and adjusted models. In-group comparisons showed that SBP, DBP, waist to hip circumference (WHR), body fat mass (BFM), percent body fat (PBF) and visceral fat area (VFA) values were significantly reduced in all groups except the placebo group compared to baseline values. Only in the CR-D group, there was a significant reduction in body weight (P = 0/047). CONCLUSIONS: Curcuminoids and vitamin D may have beneficial effects on blood pressure and anthropometric measurements in T2DM patients. CLINICAL REGISTRATION: http://www.IRCT.ir:IRCT2017041213678N22.","year":2020}
{"review_pmid":"41388744","record_index":14,"pmid":"40647269","title":"Twelve-Week Curcumin Supplementation Improves Glucose Homeostasis and Gut Health in Prediabetic Older Adults: A Pilot, Double-Blind, Placebo-Controlled Trial.","abstract":"Background: The prevalence of diabetes increases with age, and food bioactive compounds have shown potential in mitigating its development. This study aimed to evaluate the efficacy of curcumin in preventing type 2 diabetes mellitus (T2DM) in older adults with prediabetes. We hypothesized that curcumin, due to its insulin-sensitizing effects, would help maintain glucose homeostasis, metabolic health, and gut health. Methods: This randomized, double-blind, placebo-controlled trial included 28 older adults (aged 60 years or older) with prediabetes or overweight/obesity. Participants were randomly assigned to receive either curcumin (80 mg) or placebo capsules for 12 weeks. The primary outcome measures were glucose homeostasis markers, including hemoglobin A1c (HbA1c), blood glucose, and insulin levels. Secondary outcomes included body composition, body mass index (BMI), body weight, lipid profiles, and gut microbiome composition. Data normality was assessed using the Shapiro-Wilk test, and two-way repeated-measures ANOVA with multiple comparisons was used to find differences between groups and over time. Results: A total of 23 participants (age = 66.52 ± 5.76 years; 14 in the curcumin group and 9 in the placebo group) completed the 12-week intervention. HbA1c levels significantly decreased in the curcumin group, whereas levels remained stable in the placebo group. While the curcumin group observed an increase in AST levels, the ALT level was reduced in the placebo group. Both the curcumin and placebo groups showed a reduced ALT/AST ratio by the end of the intervention. Body mass index, lipid profiles, and body composition showed no significant changes over the study period. Gut microbiome analysis revealed no significant changes in alpha diversity or beta diversity of microbiome; however, there was marginal enrichment of beneficial bacteria such as Bacteroidota (phylum), Bacteroidaceae (family), Agathobacter, Bacteroides, and Roseburia (genera) in the curcumin-supplemented group over time. Conclusions: Curcumin supplementation improved or favorably maintained glucose homeostasis and showed modest improvements in beneficial gut microbiota in older adults with prediabetes, potentially reducing the risk of developing diabetes. Long-term studies with larger sample sizes are needed to confirm these findings and determine the clinical relevance of curcumin supplementation for prediabetes prevention.","year":2025}
{"review_pmid":"41388744","record_index":15,"pmid":"32655024","title":"The Effects of Nano-curcumin on Metabolic Status in Patients With Diabetes on Hemodialysis, a Randomized, Double Blind, Placebo-controlled Trial.","abstract":"INTRODUCTION: This study evaluated the effects of nano-curcumin intake on metabolic status in patients with diabetes on hemodialysis (HD). METHODS: This randomized, double-blind, placebo-controlled clinical trial was performed on 60 patients with diabetes on HD. Participants were randomly divided into two groups to take either 80 mg/d nano-curcumin (n = 30) or placebo (n = 30) for 12 weeks. RESULTS: Nano-curcumin significantly decreased fasting plasma glucose (β = -19.68 mg/dL, 95% CI: -33.48 to -5.88; P <.05) and serum insulin levels (β = -1.70 μIU/mL, 95% CI: -2.96 to -0.44; P <.05) when compared with patients who received placebo. Nanocurcumin treatment was associated with a significant reduction in triglycerides (β = -16.13 mg/dL, 95% CI: -31.51 to -0.75; P <.05), VLDL-cholesterol (β = -3.22 mg/dL, 95% CI: -6.30 to -0.15; P <.05), total cholesterol (β = -17.83 mg/dL, 95% CI: -29.22 to -6.45; P <.05), LDL-cholesterol (β = -15.20 mg/dL, 95% CI: -25.53 to -4.87; P <.05), and total-cholesterol/HDL-cholesterol ratio (β = -1.15, 95% CI: -0.2.10 to -0.21; P <.05) when compared with the placebo. Nanocurcumin also resulted in a significant reduction of serum high sensitivity CRP (β = -0.78 mg/L, 95% CI: -1.41 to -0.15; P <.05), and plasma malondialdehyde (β = -0.25 μmol/L, 95% CI: -0.45 to -0.04; P <.05); but also with a significant increase in plasma total antioxidant capacity (β = 52.43 mmol/L; 95% CI: 4.52 to 100.35; P <.05) and total nitrite levels (β = 3.62 μmol/L, 95% CI: 2.17 to 5.08; P <.001) when compared with placebo. CONCLUSION: Nano-curcumin intake for 12 weeks had beneficial effects on metabolic profile in patients with diabetes on HD.","year":2020}
{"review_pmid":"41507873","record_index":1,"pmid":"38070849","title":"Association between residential greenness and depression symptoms in Chinese community-dwelling older adults.","abstract":"BACKGROUND: Studies of residential greenness and depression symptoms among community-dwelling older adults in China are limited. However, understanding the role of greenness in depression symptoms among older adults can inform depression prevention and interventions. OBJECTIVE: This study explored the relationship between residential greenness and depression symptoms among community-dwelling older adults in China. METHODS: A cluster random sampling method was used to survey 7512 community-dwelling adults aged 60 and above from three towns in Shanghai. Depression symptoms were assessed using the Geriatric Depression Scale (GDS30). Residential greenness was measured using the normalized difference vegetation index (NDVI) and the enhanced vegetation index (EVI). Long-term greenspace exposure was defined as the mean NDVI and EVI in the three years prior to the baseline survey. Controlling for the covariates, the relationship between greenness and depression symptoms was assessed using binomial logistic regression and mixed-effects linear regression. Interaction analysis was conducted to explore which covariates potentially alter the association. We also assessed the mediating role of physical activity. RESULTS: The prevalence of depression symptoms among the participants was 13.72%. Higher residential greenness was associated with lower odds of depression symptoms, after adjusting for covariates. In the logistic regression analysis, the odds of depression symptoms decreased with increasing NDVI and EVI. In linear regression analysis, GDS30 scores decreased with increasing NDVI and EVI. Interaction analyses revealed that higher NDVI and EVI were more protective against depression among male individuals and older adults living with others than among female individuals and older adults living alone. Additionally, physical activity had a masking effect on residential greenness and depression symptoms. CONCLUSION: Higher residential greenness is associated with lower odds of depression symptoms in community-dwelling Chinese older adults. Increasing urban and neighborhood green spaces may contribute to the prevention and intervention of depression symptoms in community-dwelling older adults.","year":2024}
{"review_pmid":"41507873","record_index":2,"pmid":"34561801","title":"Association of residential greenness with geriatric depression among the elderly covered by long-term care insurance in Shanghai.","abstract":"Residential greenness exposure has been linked to a number of physical and mental disorders. Nevertheless, evidence on the association between greenness and geriatric depression was limited and focused on developed countries. This study was aimed to investigate whether the relationship between residential greenness exposure and geriatric depression exists among the elderly with long-term care insurance (LTCI) in Shanghai, China. In 2018, a total of 1066 LTCI elderly from a cross-sectional survey completed a questionnaire in Shanghai. Residential greenness indicators, including normalized difference vegetation index (NDVI) and soil-adjusted vegetation index (SAVI), were calculated from the Landsat 8 imagery data in different buffers (100-m, 300-m, and 500-m). Mediation analysis by perceived social support was conducted to explore potential mechanisms underlying the associations. In the fully adjusted model, one IQR increase of NDVI and SAVI in the 300-m buffer size was associated with an 11.9% (PR: 0.881, 95% CI: 0.795, 0.977) and 14.7% (PR: 0.853, 95% CI: 0.766, 0.949) lower prevalence of geriatric depression, respectively. Stronger association was observed in the elderly with lower education level, living in non-central area, and lower family monthly income. Perceived social support significantly mediated 40.4% of the total effect for NDVI 300-m buffer and 40.3% for SAVI 300-m buffer to the greenness-depression association, respectively. Our results indicate the importance of residential greenness exposure to geriatric depression, especially for the elderly with lower education level, living in non-central area, and lower family monthly income. Perceived social support might mediate the association. Well-designed longitudinal studies are warranted to confirm our findings and investigate the underlying mechanisms.","year":2022}
{"review_pmid":"41507873","record_index":3,"pmid":"36006585","title":"Association of residential greenness with the risk of metabolic syndrome in Chinese older adults: a longitudinal cohort study.","abstract":"AIMS: We aimed to investigate the association between residential greenness and MetS in older Chinese adults. METHODS: Longitudinal data on sociodemographic characteristics and lifestyle were collected from the Shenzhen Healthy Ageing Research (SHARE) cohort. Greenness exposure was assessed through satellite-derived Normalized Difference Vegetation Index (NDVI) values in the 250-m, 500-m, and 1250-m radius around the residential address for each participant. MetS was defined by standard guidelines for the Chinese population. RESULTS: A total of 49,893 older Chinese adults with a mean age of 70.96 (SD = 5.26) years were included in the study. In the fully adjusted models, participants who lived in the highest quartile of NDVI250-m, NDVI500-m, and NDVI1250-m had a 15% (odds ratio, OR = 0.85, 95% confidence interval, CI: 0.80-0.90), 12% (OR = 0.88, 95% CI: 0.83-0.93), and 11% (OR = 0.89, 95% CI: 0.85-0.95) lower incidence of MetS, respectively, than those living in the lowest quartile (all p-trend < 0.01). Interactions and subgroup analyses showed that age, sex, smoking status, and drinking status were significant effect modifiers (p-interaction for all NDVI < 0.05). CONCLUSIONS: Residential greenness is associated with a lower risk of MetS in Chinese older adults, especially for young older adults, females, non-smokers, and non-drinkers.","year":2023}
{"review_pmid":"41507873","record_index":4,"pmid":"35852772","title":"Associations between residential greenness and blood lipids in Chinese elderly population.","abstract":"OBJECTIVE: Previous studies on residential green space were inconsistent with blood lipid levels and hyperlipidemia. Thus, our study aims to explore the relationship between urban residential greenness and the blood lipid level and hyperlipidemia of the Chinese elderly population. METHODS: A total of 59,865 older adults were collected from the Shenzhen healthy aging Research (SHARE). Blood lipid levels [total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)] were measured. Participants' exposure to residential greenness was measured by the satellite-based normalized difference vegetation index (NDVI). Generalized linear mixed models (GLMMs) and logistic regression were performed to assess the associations of residential greenness with lipid levels and dyslipidemia (high TG, high TC, low HDL-C, and high LDL-C). RESULTS: Each per 1 standard deviation (SD) increase in NDVI250-m was associated with a higher HDL-C level (β = 0.003, 95% (confidence interval, CI):0.001-0.005) and lower TG level (β = - 0.005, 95% CI - 0.141-0.121), after fully adjusting for covariates. Each increment in per interquartile range (IQR)-unit increase in NDVI250-m was associated with lower odds of high TG (odds ratio, OR 0.94, 95% CI 0.91-0.97) and low HDL-C (OR 0.96, 95% CI 0.94-0.99). The NDVI250-m has the highest protective effect on the incidence of high TG and low HDL-C, followed by NDVI500-m and NDVI1250-m. Stratified analyses showed that association between residential greenness and hyperlipidemia was modified by sex, age, BMI, household registration, and physical activity. CONCLUSION: Higher greenness exposure was beneficially associated with lipid levels and dyslipidemia among Chinese city-dwelling older adults.","year":2022}
{"review_pmid":"41507873","record_index":5,"pmid":"36049575","title":"Associations of parks, greenness, and blue space with cardiovascular and respiratory disease hospitalization in the US Medicare cohort.","abstract":"Natural environments have been linked to decreased risk of cardiovascular disease (CVD) and respiratory disease (RSD) mortality. However, few cohort studies have looked at associations of natural environments with CVD or RSD hospitalization. The aim of this study was to evaluate these associations in a cohort of U.S. Medicare beneficiaries (∼63 million individuals). Our open cohort included all fee-for-service Medicare beneficiaries (2000-2016), aged ≥65, living in the contiguous U.S. We assessed zip code-level park cover based on the United States Geological Survey Protected Areas Database, average greenness (Normalized Difference Vegetation Index, NDVI), and percent blue space cover based on Landsat satellite images. Cox-equivalent Poisson models were used to estimate associations of the exposures with first CVD and RSD hospitalization in the full cohort and among those living in urban zip codes (≥1000 persons/mile2). NDVI was weakly negatively correlated with percent park cover (Spearman ρ = -0.23) and not correlated with percent blue space (Spearman ρ = 0.00). After adjustment for potential confounders, percent park cover was not associated with CVD or RSD hospitalization in the full or urban population. An IQR (0.27) increase in NDVI was negatively associated with CVD (HR: 0.97, 95%CI: 0.96, 0.97), but not with RSD hospitalization (HR: 0.99, 95%CI: 0.98, 1.00). In urban zip codes, an IQR increase in NDVI was positively associated with RSD hospitalization (HR: 1.02, 95%CI: 1.00, 1.03). In stratified analyses, percent park cover was negatively associated with CVD and RSD hospitalization for Medicaid eligible individuals and individuals living in low socioeconomic status neighborhoods in the urban population. We observed no associations of percent blue space cover with CVD or RSD hospitalization. This study suggests that natural environments may benefit cardiorespiratory health; however, benefits may be limited to certain contexts and certain health outcomes.","year":2022}
{"review_pmid":"41507873","record_index":6,"pmid":"33388800","title":"Besser-2021-Associations-between-neighborhood-g","abstract":"Purpose Greater neighborhood greenspace has been associated with brain health, including better cognition and lower odds of Alzheimer’s disease in older adults. We investigated associations between neighborhood greenspace and brain-based magnetic resonance imaging (MRI) measures and potential effect modification by sex or apolipoprotein E genotype (APOE), a risk factor for Alzheimer’s disease. Methods We obtained a sample of non-demented participants 65 years or older (n = 1125) from the longitudinal, populationbased Cardiovascular Health Study (CHS). Greenspace data were derived from the National Land Cover Dataset. Adjusted multivariable linear regression estimated associations between neighborhood greenspace five years prior to the MRI and left and right hippocampal volume and 10-point grades of ventricular size and burden of white matter hyperintensity. Interaction terms tested effect modification by APOE genotype and sex. CHS data (1989-1999) were obtained/analyzed in 2020. Results Participants were on average 79 years old [standard deviation (SD) = 4], 58% were female, and 11% were non-white race. Mean neighborhood greenspace was 38% (SD = 28%). Greater proportion of greenspace in the neighborhood five years before MRI was borderline associated with lower ventricle grade (estimate: − 0.30; 95% confidence interval: − 0.61, 0.00). We observed no associations between greenspace and the other MRI outcome measures and no evidence of effect modification by APOE genotype and sex. Conclusion This study suggests a possible association between greater greenspace and less ventricular enlargement, a measure reflecting global brain atrophy. If confirmed in other longitudinal cohort studies, interventions and policies to improve community greenspaces may help to maintain brain health in older age.","year":2021}
{"review_pmid":"41507873","record_index":7,"pmid":"38484611","title":"Exposure to green spaces, cardiovascular risk biomarkers and incident cardiovascular disease in older adults: The Seniors-Enrica II cohort.","abstract":"INTRODUCTION: The impact of residential green spaces on cardiovascular health in older adults remains uncertain. METHODS: Cohort study involving 2114 adults aged ≥ 65 years without cardiovascular disease (CVD), residing in five dense municipalities (Prince et al., 2015) of the Madrid region and with detailed characterization of their socioeconomic background, health behaviors, CVD biological risk factors, and mental, physical, and cognitive health. Greenness exposure was measured using the Normalized Difference Vegetation Index (NDVI) at varying distances from participants' homes. Traffic exposure, neighborhood environment, neighborhood walkability, and socioeconomic deprivation at the census level were also assessed. Serum N-terminal pro-B-type natriuretic peptide (NT-ProBNP), high-sensitivity troponin T (hs-TnT), interleukin 6 (IL-6), and Growth Differentiation Factor 15 (GDF-15) were measured at baseline, and incident CVD events identified through electronic medical records (International Classification of Primary Care-2 codes K74, K75, K77, K90, and K92). RESULTS: After adjusting for sex, age, educational attainment, financial hardship and socioeconomic deprivation at the census level, an interquartile range (IQR) increase in NDVI at 250, 500, 750, and 1000 m around participants' homes was associated with mean differences in ProBNP of -5.56 % (95 %CI: -9.77; -1.35), -5.05 % (-9.58; -0.53), -4.24 % (-8.19, -0.19), and -4.16 % (-7.59; -0.74), respectively; and mean differences in hs-TnT among diabetic participants of -8.03 % (95 %CI: -13.30; -2.77), -9.52 % (-16.08; -2.96), -8.05 % (-13.94, -2.16) and -5.56 % (-10.75; -0.54), respectively. Of similar magnitude, although only statistically significant at 250 and 500 m, were the observed lower IL-6 levels with increasing greenness. GDF-15 levels were independent of NDVI. In prospective analyses (median follow-up 6.29 years), an IQR increase in residential greenness at 500, 750, and 1000 m was associated with a lower risk of incident CVD. The variables that contributed most to the apparent beneficial effects of greenness on CVD were lower exposure to traffic, improved cardiovascular risk factors, and enhanced physical performance. Additionally, neighborhood walkability and increased physical activity were notable contributors among individuals with diabetes. CONCLUSION: Increased exposure to residential green space was associated with a moderate reduction in CVD risk in older adults residing in densely populated areas.","year":2024}
{"review_pmid":"41507873","record_index":8,"pmid":"29494513","title":"Health Disparities in the Relationship of Neighborhood Greenness to Mental Health Outcomes in 249,405 U.S. Medicare Beneficiaries.","abstract":"Prior studies suggest that exposure to the natural environment may be important for optimal mental health. The present study examines the association between block-level greenness (vegetative presence) and mental health outcomes, in a population-based sample of 249,405 U.S. Medicare beneficiaries aged ≥65 years living in Miami-Dade County, Florida, USA, whose location did not change from 2010 to 2011. Multilevel analyses examined relationships between greenness, as measured by mean Normalized Difference Vegetation Index from satellite imagery at the Census block level, and each of two mental health outcomes; Alzheimer's disease and depression, respectively, after statistically adjusting for age, gender, race/ethnicity, and neighborhood income level of the individuals. Higher block-level greenness was linked to better mental health outcomes: There was a reduced risk of Alzheimer's disease (by 18%) and depression (by 28%) for beneficiaries living in blocks that were 1 SD above the mean for greenness, as compared to blocks that were 1 SD below the mean. Planned post-hoc analyses revealed that higher levels of greenness were associated with even greater mental health benefits in low-income neighborhoods: An increase in greenness from 1 SD below to 1 SD above the mean was associated with 37% lower odds of depression in low-income neighborhoods, compared to 27% and 21% lower odds of depression in medium- and high-income neighborhoods, respectively. Greenness may be effective in promoting mental health in older adults, particularly in low-income neighborhoods, possibly as a result of the increased opportunities for physical activity, social interaction, or stress mitigation.","year":2018}
{"review_pmid":"41507873","record_index":9,"pmid":"39344601","title":"Longitudinal Impacts of High Versus Low Greenness on Cardiovascular Disease Conditions.","abstract":"BACKGROUND: Greenness-or vegetative presence-has been identified as a factor in chronic disease. The present study examines the longitudinal relationship between objective measures of greenness at the residential block level and incidence of 6 cardiovascular disease conditions. METHODS AND RESULTS: Analyses examined the impact of consistently high versus consistently low \"precision\" greenness at the Census block level on the 5-year incidence of cardiovascular disease conditions, including acute myocardial infarction, atrial fibrillation, heart failure, ischemic heart disease, stroke/transient ischemic attack, and hypertension, among 229 034 US Medicare beneficiaries in Miami-Dade County, Florida, USA. Zero-inflated Poisson regression was used to model the odds of developing any new cardiovascular disease and number of new cardiovascular disease conditions based on greenness tertiles computed across 2011 and 2016 Normalized Difference Vegetation Index values, adjusting for individual age, sex, race, ethnicity, baseline cardiovascular disease conditions, neighborhood income, and walkability in 2011 and 2016. When compared with individuals consistently in the low greenness tertile in 2011 and 2016, those consistently in the high greenness tertile in 2011 and 2016 had a 9% lower odds of having any new cardiovascular conditions (odds ratio [OR], 0.91 [95% CI, 0.84-0.99]; P=0.021). CONCLUSIONS: Over a 5-year period, consistently high greenness, when compared with consistently low greenness, was associated with lower odds of any new cardiovascular disease conditions. Identifying the role of greenness exposure in such a small geographic area, the Census block on which the older adult resides, allows for more precise, strategic decisions on where additional trees can be added-by selecting at-risk blocks rather than entire neighborhoods for tree-planting interventions.","year":2024}
{"review_pmid":"41507873","record_index":10,"pmid":"38706287","title":"Longitudinal Impacts of Precision Greenness on Alzheimer's Disease.","abstract":"BACKGROUND: The potential for greenness as a novel protective factor for Alzheimer's disease (AD) requires further exploration. OBJECTIVES: This study assesses prospectively and longitudinally the association between precision greenness - greenness measured at the micro-environmental level, defined as the Census block - and AD incidence. DESIGN: Older adults living in consistently high greenness Census blocks across 2011 and 2016 were compared to those living in consistently low greenness blocks on AD incidence during 2012-2016. SETTING: Miami-Dade County, Florida, USA. PARTICIPANTS: 230,738 U.S. Medicare beneficiaries. MEASUREMENTS: U.S. Centers for Medicare and Medicaid Services Chronic Condition Algorithm for AD based on ICD-9 codes, Normalized Difference Vegetation Index, age, sex, race/ethnicity, neighborhood income, and walkability. RESULTS: Older adults living in the consistently high greenness tertile, compared to those in the consistently low greenness tertile, had 16% lower odds of AD incidence (OR=0.84, 95% CI: 0.76-0.94, p=0.0014), adjusting for age, sex, race/ethnicity, and neighborhood income. Age, neighborhood income and walkability moderated greenness' relationship to odds of AD incidence, such that younger ages (65-74), lower-income, and non-car dependent neighborhoods may benefit most from high greenness. CONCLUSIONS: High greenness, compared to low greenness, is associated with lower 5-year AD incidence. Residents who are younger and/or who reside in lower-income, walkable neighborhoods may benefit the most from high greenness. These findings suggest that consistently high greenness at the Census block-level, may be associated with reduced odds of AD incidence at a population level.","year":2024}
{"review_pmid":"41507873","record_index":11,"pmid":"27061891","title":"Neighborhood Greenness and Chronic Health Conditions in Medicare Bene ciaries","abstract":"File establishedroleofneighborhoodsocioeconomicconditions inhealthoutcomes,9,10,32,33thisstudyalsoexploreswhether forMiami-DadeCountyof407,296uniqueMedicarebeneficiaries, thefollowingexclusionsweremade: First,thosebeneficiarieswere the relationship between mean block-level greenness excluded who lived outside of Miami-Dade County (n¼11,507). (NDVI)andindividuals’healthismoderatedbyneighborBeneficiaries who died were excluded (n¼14,296), as were those hoodincome level. withend-stagerenaldisease(n¼3,572),andthoseagedo65years orbornbefore1900(n¼64,109). Furtherexclusionsincludedthose beneficiaries who could not be matched to a specific ZIP code Methods locationassociatedwithaCensusblock(n¼14,401)andmembers of an ethnic/racial group (Asian, Pacific Islander, Native AmeriStudy Design can) representing o1% of the Miami-Dade County senior The present study compared chronic health conditions among a population (n¼12,132). Finally, beneficiaries were excluded who population-based sample of Medicare beneficiaries aged Z65 didnotretainthesamelocationin2010(cid:2)2011(n¼34,584),aswell years in Miami-Dade County, Florida, whose location did not as those with nursing home claims, who may have been in a change from 2010 to 2011 (Figure 1), in relation to the level of nursing home for all or part of the calendar year, in which case greenness (mean NDVI) for each resident’s Census block. This their location may have corresponded to a billing address rather comparison was further analyzed in relation to neighborhood thananactualresidence(n¼3,650). Thisresultedinafinalcohort incomelevels. of 249,405 Medicare beneficiaries aged Z65 years who had the same location (based on ZIP code þ 4-digit locator) across 2 calendar years (2010(cid:2)2011). ZIPþ4 data from CMS data were Data linked to a Census block for each beneficiary using Geolytics Data were obtained for this retrospective cohort study in 2013 ZIPþ4 software, which provides the area centroid of the ZIPþ4 fromtheU.S. CentersforMedicareandMedicaidServices(CMS)’ with latitude and longitude coordinates, and assigns the correMaster Beneficiary Summary File, which provided for each sponding2010Censusblock,blockgroup,andtractidentification beneficiary, annual data on health outcomes, age, gender, race/ numbers.40ThisstudywasapprovedbytheUniversityofMiami’s ethnicity,34 and location, for the calendar years 2010-2011. The IRBandCMS’PrivacyBoard. CMS Master Beneficiary Summary File Chronic Conditions Segment provides indications of 27 chronic conditions, using CMS’ Statistical Analysis chronic conditions algorithms, based on Medicare claims of all typesforeachbeneficiaryinacalendaryear.35Thepresentstudy Descriptiveandmultilevelanalyseswereconductedin2014using assessed total illness burden based on the total number of SAS, version 9.3. For the main analyses, a three-level framework chronic conditions (out of a range of 0(cid:2)27 chronic conditions) wasutilizedinwhichneighborhoodmedianhouseholdincomeat available for CMS for each beneficiary. In addition, with nearly the 2011 U.S. Census Bureau block group level (the smallest July2016 80 Brownetal/AmJPrevMed2016;51(1):78-89 Figure1. Flowdiagramindicatingdataprocessingstepsforderivingthefinalcohortof249,405Medicarebeneficiariesaged 65andolderwiththesamelocationinMiami-DadeCounty,Florida,in2010(cid:2)2011. MDC,MiamiDadeCounty;NDVI,NormalizedDifferenceVegetationIndex. geographicscaleatwhichthisvariableisavailable)wastreatedasa distribution, as the most appropriate type of modeling for use Level 3 variable in the model, and greenness, measured at the with count variables. Finally, analyses examined whether the Censusblocklevel(hereafter,theblocklevel)bymeanNDVI,for relationship between NDVI and each health outcome varied all 36,563 Census blocks in the County, as a Level 2 variable. by neighborhood income level, in which neighborhood income Individual-level variablesofage,gender, race,andethnicitywere level was entered as an interactive term (multiplied by NDVI) treatedasLevel1variablesinthemodel. while retaining neighborhood income as a covariate in the Foreachhealthoutcome,PROCGLIMMIXwasusedtomodel analyses. the relationship of NDVI to health in a multilevel framework, Table 1 illustrates descriptive statistics for the sample. Demoadjusting for covariates. For the five dichotomous outcomes, graphiccharacteristicsforthestudysamplecloselyresemblethose presenceorabsenceofdiabetes,hypertension,andhyperlipidemia, of all adults aged Z65 years residing in Miami-Dade Countyandthepresenceorabsenceofanychronicconditionsorobesity- which the 2013 U.S. Census estimates as 58% female, 68% related chronic conditions, PROC GLIMMIX was used with a Hispanic,19%non-Hispanicwhite,and13%black,foralladults binaryresponsedistribution,whichhandlesmultilevelregression aged Z65 years in the county.41 NDVI levels were higher on forbinaryvariables. average in higher-income neighborhoods than in medium- and Forthetworemainingoutcomes,whichexaminedboththetotal lower-incomeneighborhoods,althougharelativelywiderangeof numberofchronicconditionsandthenumberofobesity-related NDVI levels was evident across all neighborhood income levels. conditions,PROCGLIMMIXwasselectedwithaPoissonresponse Residentsoflower-incomeneighborhoodsweresignificantlymore www.ajpmonline.org","year":2010}
{"review_pmid":"41507873","record_index":12,"pmid":"35033073","title":"Neighborhood greenspace exposure as a protective factor in dementia risk among U.S. adults 75 years or older: a cohort study.","abstract":"BACKGROUND: Research suggests that greenspace may confer neurocognitive benefits. This study examines whether residential greenspace is associated with risk of dementia among older adults. METHODS: Greenspace exposure was computed for 3047 participants aged 75 years and older enrolled in the Gingko Evaluation of Memory Study (GEMS) across four U.S. sites that prospectively evaluated dementia and its subtypes, Alzheimer's disease (AD), vascular dementia (VaD), and mixed pathologies, using neuropsychiatric evaluations between 2000 and 2008. After geocoding participant residences at baseline, three greenspace metrics-Normalized Difference Vegetative Index, percent park overlap within a 2-km radius, and linear distance to nearest park-were combined to create a composite residential greenspace measure categorized into tertiles. Cox proportional hazards models estimated the associations between baseline greenspace and risk of incident all-cause dementia, AD, and Mixed/VaD. RESULTS: Compared to low residential greenspace, high residential greenspace was associated with a reduced risk of dementia (HR = 0.76 95% CI: 0.59,0.98) in models adjusted for multiple covariates. After additional adjustment for behavioral characteristics, Apolipoprotein E ɛ4 status, and other covariates, the association was slightly attenuated (HR = 0.82; 95% CI:0.63,1.06). Those exposed to medium levels of greenspace also had 28% lower risk (HR = 0.72; CI: 0.55, 0.95) of dementia compared to those with low greenspace in adjusted models. Subtype associations between high residential greenspace and AD were not statistically significant. Greenspace was not found to be significantly associated with mixed/vascular pathologies. CONCLUSIONS: This study showed evidence for an association between residential greenspace and all-cause dementia among older adults. Future research with larger sample size, precise characterization of different dementia subtypes, and assessment of residential greenspace earlier in life may help clarify the role between exposure to greenspace and dementia risk.","year":2022}
{"review_pmid":"41507873","record_index":13,"pmid":"36603455","title":"Neighborhood greenspace and cognition: The cardiovascular health study.","abstract":"OBJECTIVES: We examined whether greenspace measures (overall percent greenspace and forest, and number of greenspace types) were associated with clinically adjudicated dementia status. METHODS: In a sample of non-demented older adults (n = 2141, average age = 75.3 years) from the Cardiovascular Health and Cognition Study, Cox proportional hazard and logistic regression analyses were used to estimate associations of baseline greenspace with risks of incident dementia and MCI, respectively, while adjusting for demographics, co-morbidities, and other neighborhood factors. We derived quartiles of percent greenness (greenspace), forest (percent tree canopy cover), and tertiles of greenspace diversity (number of greenspace types) for 5-km radial buffers around participant's residences at study entry (1989-1990) from the 1992 National Land Cover Dataset. Dementia status and mild cognitive impairment (MCI) over 10 years was clinically adjudicated. RESULTS: We observed no significant association between overall percent greenspace and risk of mild cognitive impairment or dementia and mostly null results for forest and greenspace diversity. Forest greenspace was associated with lower odds of MCI (OR quartile 4 versus 1: 0.54, 95% CI: 0.29-0.98) and greenspace diversity was associated with lower hazard of incident dementia (HR tertile 2 versus 1: 0.70, 95% CI = 0.50-0.99). DISCUSSION: We found divergent results for different types of greenspace and mild cognitive impairment or dementia. Improved greenspace type and diversity measurement could better characterize the association between greenspace and cognition.","year":2023}
{"review_pmid":"41507873","record_index":14,"pmid":"31190652","title":"Neighbourhood greenness and depression among older adults.","abstract":"BACKGROUND: Neighbourhood greenness or vegetative presence has been associated with indicators of health and well-being, but its relationship to depression in older adults has been less studied. Understanding the role of environmental factors in depression may inform and complement traditional depression interventions, including both prevention and treatment. AimsThis study examines the relationship between neighbourhood greenness and depression diagnoses among older adults in Miami-Dade County, Florida, USA. METHOD: Analyses examined 249 405 beneficiaries enrolled in Medicare, a USA federal health insurance programme for older adults. Participants were 65 years and older, living in the same Miami location across 2 years (2010-2011). Multilevel analyses assessed the relationship between neighbourhood greenness, assessed by average block-level normalised difference vegetative index via satellite imagery, and depression diagnosis using USA Medicare claims data. Covariates were individual age, gender, race/ethnicity, number of comorbid health conditions and neighbourhood median household income. RESULTS: Over 9% of beneficiaries had a depression diagnosis. Higher levels of greenness were associated with lower odds of depression, even after adjusting for demographics and health comorbidities. When compared with individuals residing in the lowest tertile of greenness, individuals from the middle tertile (medium greenness) had 8% lower odds of depression (odds ratio 0.92; 95% CI 0.88, 0.96; P = 0.0004) and those from the high tertile (high greenness) had 16% lower odds of depression (odds ratio 0.84; 95% CI 0.79, 0.88; P &lt; 0.0001). CONCLUSIONS: Higher levels of greenness may reduce depression odds among older adults. Increasing greenery - even to moderate levels - may enhance individual-level approaches to promoting wellness. Declaration of interestNone.","year":2019}
{"review_pmid":"41507873","record_index":15,"pmid":"33814426","title":"Relationship of Neighborhood Greenness to Alzheimer's Disease and Non-Alzheimer's Dementia Among 249,405 U.S. Medicare Beneficiaries.","abstract":"BACKGROUND: Neighborhood greenness (vegetative presence) has been linked to multiple health outcomes, but its relationship to Alzheimer's disease (AD) and non-Alzheimer's (non-AD) dementia has been less studied. OBJECTIVE: This study examines the relationship of greenness to both AD and non-AD dementia in a population-based sample of Medicare beneficiaries. METHODS: Participants were 249,405 US Medicare beneficiaries aged > 65 years living in Miami-Dade County, FL, from 2010 to 2011. Multi-level analyses examined the relationship of greenness, assessed by mean Census block level Normalized Difference Vegetation Index (NDVI), to odds of each of AD, Alzheimer's disease and related dementias (ADRD), and non-AD dementia, respectively. Covariates included age, gender, race/ethnicity, number of comorbid health conditions, and neighborhood income. RESULTS: Higher greenness was associated with reduced risk of AD, ADRD, and non-AD dementia, respectively, adjusting for individual and neighborhood sociodemographics. Compared to the lowest greenness tertile, the highest greenness tertile was associated with reduced odds of AD by 20%(odds ratio, 0.80; 95%CI, 0.75-0.85), ADRD by 18%(odds ratio, 0.82; 95%CI, 0.77-0.86), and non-AD dementia by 11%(odds ratio, 0.89; 95%CI, 0.82-0.96). After further adjusting for number of comorbidities, compared to the lowest greenness tertile, the highest greenness tertile was associated with reduced odds of AD (OR, 0.94; 95%CI, 0.88-1.00) and ADRD (OR, 0.93; 95%CI, 0.88-0.99), but not non-AD dementia (OR, 1.01; 95%CI, 0.93-1.08). CONCLUSION: High neighborhood greenness may be associated with lower odds of AD and ADRD. Environmental improvements, such as increasing neighborhood vegetation, may be a strategy to reduce risk for AD and possibly other dementias.","year":2021}
{"review_pmid":"41507873","record_index":16,"pmid":"38061587","title":"Residential greenspace and major depression among older adults living in urban and suburban areas with different climates across the United States.","abstract":"BACKGROUND AND AIM: Residential greenspace could alleviate depression - a leading cause of disability. Fewer studies of depression and greenspace have considered major depression, and, to our knowledge, none have considered how climate, which determines vegetation abundance and type, may change the impacts of greenspace. Our aim was to investigate whether residential greenspace is associated with major depression among older adults and explore effect modification by climate. METHODS: We used biennial interviews between 2008 and 2016 from the Health and Retirement Study. We calculated greenness within walking distance of home addresses as the maximum NDVI for the year of each participant interview averaged within a 1 km buffer. Reflecting clinical criteria, a score of ≥5 on the CIDI-SF indicated major depression in the preceding 12-months. We characterized climate using Köppen-Geiger classifications. To estimate prevalence ratios, we used Poisson regression. Our models adjusted for sociodemographic characteristics, geography, annual sunshine, and bluespace. RESULTS: The 21,611 eligible participants were 65 ± 10 years old on average, 55% female, 81% White, 12% Black, 10% Hispanic/Latino, and 31% had at least a 4-year college degree. The 12-month prevalence of a major depression was 8%. In adjusted models, more residential greenspace was associated with a lower prevalence of major depression (prevalence ratio per IQR, 0.91; 95% CI, 0.84 to 0.98). There was evidence of effect modification by climate (P forinteraction, 0.062). We observed stronger associations in tropical (prevalence ratio per IQR 0.69; 95% CI, 0.47 to 1.01) and cold (prevalence ratio per IQR, 0.83; 95% CI, 0.74 to 0.93) climates compared to arid (prevalence ratio per IQR 0.99; 95% CI, 0.90 to 1.09) and temperate (prevalence ratio per IQR 0.98; 95% CI, 0.86 to 1.11) climates. CONCLUSIONS: Residential greenspace may help reduce major depression. However, climate may influence how people benefit from greenspace.","year":2024}
{"review_pmid":"41507873","record_index":17,"pmid":"35525977","title":"Rodriguez-loureiro-2022-Long-term-exposure-to-residential-g","abstract":"Background: Living in greener areas is associated with slower cognitive decline and reduced dementia risk among older adults, but the evidence with neurodegenerative disease mortality is scarce. We studied the association between residential surrounding greenness and neurodegenerative disease mortality in older adults. Methods: We used data from the 2001 Belgian census linked to mortality register data during 2001-2014. We included individuals aged 60 years or older and residing in the five largest Belgian urban areas at baseline (2001). Exposure to residential surrounding greenness was assessed using the 2006 Normalized Difference Vegetation Index (NDVI) within 500-m from residence. We considered all neurodegenerative diseases and four specific outcomes: Alzheimer’s disease, vascular dementia, unspecified dementia, and Parkinson’s disease. We fitted Cox proportional hazard models to obtain hazard ratios (HR) and 95% confidence intervals (CI) of the associations between one interquartile range (IQR) increment in surrounding greenness and neurodegenerative disease mortality outcomes, adjusted for census-based covariates. Furthermore, we evaluated the potential role of 2010 air pollution ( PM and N O ) concen2.5 2 trations, and we explored effect modification by sociodemographic characteristics. Results: From 1,134,502 individuals included at baseline, 6.1% died from neurodegenerative diseases during followup. After full adjustment, one IQR (0.22) increment of surrounding greenness was associated with a 4-5% reduction in premature mortality from all neurodegenerative diseases, Alzheimer’s disease, vascular and unspecified dementia [e.g., for Alzheimer’s disease mortality: HR 0.95 (95%CI: 0.93, 0.98)]. No association was found with Parkinson’s disease mortality. Main associations remained for all neurodegenerative disease mortality when accounting for air pollution, but not for the majority of specific mortality outcomes. Associations were strongest in the lower educated and residents from most deprived neighbourhoods. Conclusions: Living near greener spaces may reduce the risk of neurodegenerative disease mortality among older adults, potentially independent from air pollution. Socioeconomically disadvantaged groups may experience the greatest beneficial effect.","year":2022}
{"review_pmid":"41507873","record_index":18,"pmid":"38600442","title":"The association of access to green space with low mental distress and general health in older adults: a cross-sectional study.","abstract":"BACKGROUND: Access to green space is considered beneficial to mental and physical health, though the causal pathways are not completely clear. Accordingly, the objective of this study was to examine how access to green space was associated with low mental distress and general health among older adults. METHODS: The data in our study stems from a survey from three Norwegian counties in 2015-16, n = 2937. The main exposure variable was self-reported access to green space, and the outcome variables were self-reported mental distress and general health. Logistic regression adjusted for sex, age, education, physical activity, functional disability, access to cultural/sports facilities and economic security was performed to assess the association between the exposure variable and the outcome variables. RESULTS: Access to green space was associated with both higher odds of low mental distress (Odds Ratio = 3.85**, 95% CI 2.04-6.02) and good general health (OR = 8.20**, 95%CI 5.88-11.49) compared to no access. In models adjusted for sex, age, and education, the ORs were only slightly changed (OR = 4.03**, 95%CI 2.52-6.45) and (OR = 7.91**, 95%CI 5.63-11.13). However, adjusting for general health with low mental distress as outcome, the association was no longer statistically significant; (OR = 1.28 95%CI 0.74-2.21). Adjusting for low mental distress with general health as outcome, the association remained statistically significant; (OR = 3.43** 95%CI 2.34-5.03). CONCLUSIONS: Our findings suggest that the association between access to green space and mental health may be mediated by general health. This implies that studies of associations between access to green space and mental health must take general health into consideration.","year":2024}
{"review_pmid":"41507873","record_index":19,"pmid":"22948092","title":"Therapeutic effect of forest bathing on human hypertension in the elderly","abstract":"Objective: To provide scientific evidence supporting the efficacy of forest bathing as a natural therapy for human hypertension. Methods: Twenty-four elderly patients with essential hypertension were randomly divided into two groups of 12. One group was sent to a broad-leaved evergreen forest to experience a 7-day/7-night trip, and the other was sent to a city area in Hangzhou for control. Blood pressure indicators, cardiovascular disease-related pathological factors including endothelin-1, homocysteine, renin, angiotensinogen, angiotensin II, angiotensin II type 1 receptor, angiotensin II type 2 receptor as well as inflammatory cytokines interleukin-6 and tumor necrosis factor (cid:2) were detected. Meanwhile, profile of mood states (POMS) evaluation was used to assess the change of mood state of subjects. In addition, the air quality in the two experimental sites was monitored during the 7-day duration, simultaneously. Results: The baselines of the indicators of the subjects were not significantly different. Little alteration in the detected indicators in the city group was observed after the experiment. While subjects exposed to the forest environment showed a significant reduction in blood pressure in comparison to that of the city group. The values for the bio-indicators in subjects exposed to the forest environment were also lower than those in the urban control group and the baseline levels of themselves. POMS evaluation showed that the scores in the negative subscales were lowered after exposure to the forest environment. Besides, the air quality in the forest environment was much better than that of the urban area evidenced by the quantitative detection of negative ions and PM10 (particulate matter <10 (cid:3)m in aerodynamic diameter). Conclusion: Our results provided direct evidence that forest bathing has therapeutic effects on human hypertension and induces inhibition of the renin-angiotensin system and inflammation, and thus inspiring its preventive efficacy against cardiovascular disorders.","year":2012}
{"review_pmid":"41507873","record_index":20,"pmid":null,"title":"Urban overall and visible greenness and diabetes among older adults in China","abstract":null,"year":2023}
{"review_pmid":"41507873","record_index":21,"pmid":"39170473","title":"Utilizing regression model to characterize the impact of urban green space features on the subjective well-being of olde","abstract":"objectives: (1). Which features of urban green spaces in the study area impact older adults’ subjective well-being? (2). How does overall satisfaction with urban green spaces, obtained by assessing the features of urban green spaces, affect the assessment of subjective well-being of older adults? Based on this research objectives, we categorized the features of urban green spaces into three types through literature review: spatial, green, and grey features. Subsequently, we formulated three research hypotheses and validated all hypotheses through data analysis to ensure that this study fills existing knowledge gaps and provides insights for future urban green space planning practices. The three hypotheses are as follows. (1) H1: It was hypothesized that older adults’ satisfaction with the spatial, green, and grey features of urban green spaces have a significant impact on their overall green space satisfaction scores. (2) H2: It is hypothesized that older adults’ satisfaction with the spatial, green, and grey features of urban green spaces have a significant impact on their subjective well-being. (3) H3: It is hypothesized that older adults’ overall satisfaction with urban green spaces has a significant impact on their subjective well-being. This study is outlined as follows: after the introduction, section 2 provides an analytical review of previous literature; section 3 describes the data and methodology; section 4 points out the results of the quantitative measurements; section 5 gives the conclusions and section 6 shows the limitations and future research. 2. Methods This study aims to investigate the influence of older adults’ overall satisfaction with urban green space features on their subjective well-being in post-epidemic Nanjing, China. Questionnaires were designed to achieve this objective. A questionnaire survey was conducted to collect data from people aged 60 years and above. To ensure the accuracy and validity of the collected data, we included validation questions and regulated the response time in the questionnaire. Following data collection, statistical analysis methods were 2 T. Xu et al. H e l i y o n 10(2024)e35567 employed to examine the relationship between different features of urban green space and the subjective well-being of older adults. 2.1. Literature review The literature describing the features of urban green spaces is summarized and categorized in a review study that examines in detail the spatial, green, and grey features of urban green spaces [64]. Firstly, spatial features primarily describe a range of properties related to the physical space of the green space [59]. Spatial features such as size, type, shape, location, quantity, quality, distance to parks, availability, safety, accessibility, visit frequency, and duration within the green space through urban green spaces were used to interpret the relationships between them and older people’s subjective well-being. Secondly, green features reveal a range of characteristics mainly related to the ecology of green spaces [65,66]. By providing plant habitats [67] and enhancing plant abundance [57], positive contributions can be made to ecosystem services such as climate regulation and air purification [68]. In addition, maintaining carbon and oxygen balance, water resources, reducing urban noise, bird and animal species richness, providing landscape aesthetic space, and socio-cultural-ecological interactions are also included in the green features of urban green spaces to explore their role in promoting subjective well-being levels of older people. Thirdly, grey features refer to the various facilities provided in the urban green space [69,70], which mainly include rest, parking, exercise, sanitation, lighting, security, instruction, landscape, and management facilities. The provision of quality grey facilities is an essential element in attracting visitors to urban green spaces [71] and plays an important role in promoting green space visitation rates [72]. 2.2. Study area The focus of this study is Nanjing, China, which is located in the eastern part of the country and the central area of the lower reaches of the Yangtze River (between 31◦14″ to 32◦37″ north latitude and 118◦22″ to 119◦14″ east longitude). Nanjing is an important center city in eastern China. Nanjing is divided into 11 districts, with a total area of 6587.02 square kilometers. The built-up area covers 868.28 square kilometers. As of the end of 2022, the permanent population of Nanjing has reached 9.49 million people. Jiangning District is the largest in terms of area and has the highest population among all the districts in Nanjing. Fig. 1 shows the geographic location of Nanjing in China, the division of its districts, and the distribution of population. Fig. 1. Geographic location of Nanjing, area, and population of districts. (Source from: Statistical Bulletin on National Economic and Social Development, Nanjing Municipal Bureau of Statistics. 2022). 3","year":2024}
{"review_pmid":"41507873","record_index":22,"pmid":"30835593","title":"Wang-2019-Relationship-of-neighborhood-greenn","abstract":"Background: -Nature exposures may be associated with reduced risk of heart disease. The present study examines the relationship between objective measures of neighborhood greenness (vegetative presence) and 4 heart disease diagnoses (acute myocardial infarction, ischemic heart disease, heart failure, and atrial fibrillation) in a population-based sample of Medicare beneficiaries. Methods and Results--The sample included 249 405 Medicare beneficiaries aged 65 years and older whose location (ZIP+4) in Miami-Dade County, Florida,did not changefrom 2010 to 2011. Analyses examined relationships between greenness, measured by mean block-level normalized difference vegetation index from satellite imagery, and 4 heart disease diagnoses. Hierarchical regression analyses,inamultilevel framework,assessed therelationship ofgreenness toeach heart disease diagnosis,adjusting successively for individual sociodemographics, neighborhood income, and biological risk factors (diabetes mellitus, hypertension, andhyperlipidemia). Highergreennesswasassociatedwithreducedheartdiseaserisk,adjustingforindividualsociodemographics and neighborhood income. Compared with the lowest tertile of greenness, the highest tertile of greenness was associated with reduced odds of acute myocardial infarction by 25% (odds ratio, 0.75; 95% CI, 0.63-0.90), ischemic heart disease by 20% (odds ratio,0.80;95%CI,0.77-0.83),heartfailureby16%(oddsratio,0.84;95%CI,0.80-0.88),andatrialfibrillationby6%(oddsratio, 0.94;95%CI,0.87-1.00). Associationswereattenuatedafteradjustingforbiologicalriskfactors,suggestingthatcardiometabolic risk factors may partly mediate the greenness to heart disease relationships. Conclusions--Neighborhoodgreennessmaybeassociatedwithreducedheartdiseaserisk. Strategiestoincreaseareagreenness maybeafuturemeansofreducingheartdiseaseatthepopulationlevel. (JAmHeartAssoc.2019;8:e010258.DOI:10.1161/ JAHA.118.010258.)","year":2019}
{"review_pmid":"41507873","record_index":23,"pmid":"35820901","title":"Wensu-2022-The-effects-of-greenness-exposure-o","abstract":"Background: Although the oldest-old (those aged over 80 years) are vulnerable to environmental factors and have the highest prevalence of hypertension, studies focusing on greenness exposure and the development of hypertension among them are insufficient. The aim of this study was to explore the association between residential greenness and hypertension in the oldest-old population. Methods: This cohort study included data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The oldest-old were free of hypertension at baseline (2008), and hypertension events were assessed by follow-up surveys in 2011, 2014, and 2018. The one-year averages of the normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) at 500-m buffer before the interview year of incident hypertension or last censoring interview were collected at the level of 652 residential units (district or county). The linear or nonlinear association between greenness and hypertension incidence was analyzed using the Cox proportional hazards model with penalized splines. The linear links between greenness and hypertension incidence were determined using the Cox proportional hazards model included a random effect term. Results: Among 5253 participants, the incidence rate of hypertension was 7.25 (95% confidence interval [CI]: 6.83-7.67) per 100 person-years. We found a nonlinear association between greenness exposure and hypertension risk, and the exposure-response curve showed that 1 change point existed. We examined the linear effect of greenness on hypertension by categorizing the NDVI/EVI into low and high-level exposure areas according to the change point. We found more notable protective effects of each 0.1-unit increase in greenness on hypertension incidence for participants living in the high-level greenness areas (hazard ratio (HR) 0.60; 95% CI: 0.53-0.70 for NDVI; HR 0.46; = = 95% CI: 0.37-0.57 for EVI). In contrast, no significant influence of greenness exposure on hypertension risk was found for participants living in the low-level greenness areas (HR 0.77; 95% CI: 0.38-1.55 for NDVI; HR 0.73; 95% CI: = = 0.33-1.63 for EVI). Conclusions: Greenness exposure is nonlinearly associated with hypertension risk among the oldest-old, presenting its relationship in an inverse “U-shaped” curve. Greenness is a protective factor that decreases the risk of hypertension.","year":2022}
{"review_pmid":"41507873","record_index":24,"pmid":"26377504","title":"Older people, the natural environment","abstract":null,"year":2015}
{"review_pmid":"41507873","record_index":25,"pmid":"31919381","title":"Zhu-2020-Apoe--modifies-effect-of-residentia","abstract":null,"year":2020}
{"review_pmid":"41507873","record_index":26,"pmid":null,"title":"ssessing the associations between green space and heart health in older adults using street view and electrocardiography","abstract":null,"year":2024}
{"review_pmid":"41507873","record_index":27,"pmid":null,"title":"寒地社区绿色空间对老年人主观幸福感影响--以长春市为例","abstract":null,"year":2022}
{"review_pmid":"41531667","record_index":1,"pmid":"35635960","title":"Ambient temperature and risk of urinary tract infection in California: A time-stratified case-crossover study using electronic health records.","abstract":"BACKGROUND: In the United States (US), urinary tract infections (UTI) lead to more than 10 million office visits each year. Temperature and season are potentially important risk factors for UTI, particularly in the context of climate change. METHODS: We examined the relationship between ambient temperature and outpatient UTI diagnoses among patients followed from 2015 to 2017 in two California healthcare systems: Kaiser Permanente Southern California (KPSC) and Sutter Health in Northern California. We identified UTI diagnoses in adult patients using diagnostic codes and laboratory records from electronic health records. We abstracted patient age, sex, season of diagnosis, and linked community-level Index of Concentration at the Extremes (ICE-I, a measure of wealth and poverty concentration) based on residential address. Daily county-level average ambient temperature was assembled from the Parameter-elevation Regressions on Independent Slopes Model (PRISM). We implemented distributed lag nonlinear models (DLNM) to assess the association between UTI and lagged daily temperatures. Main analyses were confined to women. In secondary analyses, we stratified by season, healthcare system, and community-level ICE-I. RESULTS: We observed 787,186 UTI cases (89% among women). We observed a threshold association between ambient temperature and UTI among women: an increase in daily temperature from the 5th percentile (6.0 ˚C) to the mean (16.2 ˚C) was associated with a 3.2% (95% CI: 2.4, 3.9%) increase in same-day UTI diagnosis rate, whereas an increase from the mean to 95th percentile was associated with no change in UTI risk (0.0%, 95% CI: -0.7, 0.6%). In secondary analyses, we observed the clearest monotonic increase in the rate of UTI diagnosis with higher temperatures in the fall. Associations did not differ meaningfully by healthcare system or community-level ICE-I. Results were robust to alternate model specifications. DISCUSSION: Increasing temperature was related to higher rate of outpatient UTI, particularly in the shoulder seasons (spring, autumn).","year":2022}
{"review_pmid":"41531667","record_index":2,"pmid":"27538756","title":"Ambient Temperature and the Risk of Renal Colic: A Population-Based Study of the Impact of Demographics and Comorbidity.","abstract":"PURPOSE: To examine the impact of ambient temperature on the incidence of emergency department (ED) admissions for acute renal colic and the potential influence demographics and comorbid conditions may have on this. METHODS: We conducted a population-based time series analysis using linked healthcare databases in Ontario, Canada, which included all residents, aged ≥19 years, who were admitted to an ED from April 2002 to December 2013. The primary outcome was daily number of renal colic emergency department admissions. A distributed lag nonlinear model with 21 days of lag was applied to estimate the cumulative effect of temperature on colic admissions. We estimated risks for cold and heat, defined as temperatures below and above the optimal temperature, which corresponded to the point with minimum risk of colic admissions. We conducted stratified analyses using selected demographics and comorbidities. RESULTS: During the study period, 423,396 patients presented to an ED with colic. There was a significantly increased risk of colic as ambient temperature increased (rate ratio [RR] = 1.30, 95% confidence interval [CI]: 1.20, 1.42). Subgroup analysis demonstrated an increased risk associated with heat for both genders; however, this risk was more pronounced in males with extreme heat (RR = 1.64 vs 1.22, p = 0.006). In contrast to other age groups, there was an increased risk for those in their 40s (RR = 1.42), 50s (RR = 1.54), and 60s (RR = 1.31) (p = 0.02). CONCLUSION: Increasing ambient temperature was associated with increased risk of ED visits for colic, particularly in males and those aged 40 to 69 years.","year":2016}
{"review_pmid":"41531667","record_index":3,"pmid":"34988822","title":"Ambient temperature, humidity, and urinary system diseases: a population-based study in Western China.","abstract":"Climate has received an increasing attention due to its adverse effects on human health, but the effects on the urinary system are still short of enough evidence. Therefore, we carry out this study to analyze the relationship between meteorological factors and urinary system health in arid areas of western China. In this study, the daily numbers of outpatients with the urinary system diseases from multiple hospitals in three cities in Gansu province (Lanzhou, Zhangye, and Tianshui city) were collected and used for analysis. The distributed lag non-linear models (DLNM) with a quasi-Poisson distribution were used to estimate the associations between meteorological factors and daily outpatients for urinary system diseases in these three cities, and then a multivariate meta-analysis was applied to pool the estimates of city-specific effects. We found that the ambient temperature (AT) and relative humidity (RH) were significantly associated with the outpatient visits of urinary system diseases. The effects of meteorological factors on outpatients with urinary system diseases for both males and females were statistically significant at different lag days. The higher AT and lower RH were associated with the higher risk of urinary system diseases. We also observed substantial lag effects of meteorological factors on outpatients for both males and females. Among all disease types, renal tubule-interstitial diseases had the strongest relationships with meteorological factors. Our results indicate that the higher AT and lower RH may increase the outpatient visits for urinary system diseases, with significant lag effects in semi-arid areas.","year":2022}
{"review_pmid":"41531667","record_index":4,"pmid":"38544398","title":"Association between ambient temperature and hospitalizations for urolithiasis in four counties of Ganzhou, China.","abstract":"We collected meteorological and urolithiasis-related hospitalization data from four counties in Ganzhou City for 2018-2019 and used the DLNM method to assess the lagged and cumulative effects of temperature on urolithiasis hospitalizations and obtain the total effect after meta-combination. Based on the nonlinear association between temperature and urolithiasis hospitalizations, the relative risk of overall high temperature (30℃) was 2.10 (95% CI: 1.07-4.10). No statistically significant difference (p = 0.07) was observed between males (RR = 2.04, 95% CI: 1.42-2.94) and females (RR = 1.45, 95% CI: 1.09-1.92) for the heat effect, which was higher in the ≥ 60 years age group (RR = 3.18, 95% CI: 1.76-5.76) than in the < 60 years age group (p = 0.007). High temperatures increased the risk of hospitalization for urolithiasis in Ganzhou, China, and the risk was greatest for individuals aged 60 and above, with similar risks observed across counties and genders.","year":2024}
{"review_pmid":"41531667","record_index":5,"pmid":"36222915","title":"Association between daily temperature and hospital admissions for urolithiasis in Ganzhou, China: a time-series analysis.","abstract":"Urolithiasis was a global disease and it was more common in southern China. This study looked into the association between daily temperature and urolithiasis hospital admissions in Ganzhou, a large prefecture-level city in southern China. In Ganzhou City from 2016 to 2019, a total of 60,881 hospitalized cases for urolithiasis from 69 hospitals and meteorological data were gathered. The effect of high ambient temperature on urolithiasis hospital admissions was estimated using a distributed lag nonlinear model. Stratified analysis was done to examine sex differences. The study found that in Ganzhou of China, the exposure-response curves approximated a \"J\" shape which across genders were basically similar. The maximum lag effect occurred on the second day after high temperatures for males but on the third day for females. Compared to the 10 °C reference temperature and considering the cumulative lag effect of 10 days, the relative risks of the daily mean temperature at the 95th percentile on the total, male, and female hospital admissions for urolithiasis were 2.026 (95% CI: 1.628, 2.521), 2.041 (95% CI: 1.603, 2.598), and 2.030 (95% CI: 1.552, 2.655), respectively, but the relative risks between sex were not statistically significant (p = 0.977). Urolithiasis morbidity risk in China could be exacerbated by high temperatures. The effect of high temperature on urolithiasis was similar across genders.","year":2023}
{"review_pmid":"41531667","record_index":6,"pmid":"22455834","title":"Association of summer temperatures with hospital admissions for renal diseases in New York State: a case-crossover study.","abstract":"This study assessed the association between high temperatures and increased odds of hospitalization for renal diseases that, to date, has been examined in only a small number of studies. A case-crossover design was used to study 147,885 hospital admissions with renal diagnoses during July and August, 1991-2004, in New York State. Regional temperature, humidity, and barometric pressure data from automated monitors were used as exposure indicators. By use of time-stratified referent selection and conditional logistic regression analysis, an overall 9% increase in odds of hospitalization for acute renal failure per 5°F (2.78°C) was found for mean temperature at a 1-day lag (odds ratio = 1.09, 95% confidence interval: 1.07, 1.12). The results suggest increased susceptibility to hospitalization for acute renal failure for blacks, Hispanics, people aged 25-44 years, and those in the lowest income quartile. The odds varied geographically with the largest associations found in the more urban regions. Increased odds of hospitalization were also found for urinary tract infections, renal calculi, lower urinary calculi, and other lower urinary tract disorders. The findings can help to identify vulnerable subpopulations and to inform decisions and policies regarding adaptation strategies and heat-warning systems.","year":2012}
{"review_pmid":"41531667","record_index":7,"pmid":"24970114","title":"Association with meteo-climatological factors and daily emergency visits for renal colic and urinary calculi in Cuneo, Italy. A retrospective observational study, 2007-2010.","abstract":"The incidence of nephrolithiasis is rising worldwide, especially in women and with increasing age. Incidence and prevalence of kidney stones are affected by genetic, nutritional, and environmental factors. The aim of this study is to investigate the link between various meteorological factors (independent variables) and the daily number of visits to the Emergency Department (ED of the S. Croce and Carle Hospital of Cuneo for renal colic (RC) and urinary stones (UC) as the dependent variable over the years 2007-2010. The Poisson generalized regression models (PGAMs) have been used in different progressive ways. The results of PGAMs (stage 1) adjusted for seasonal and calendar factors confirmed a significant correlation (p < 0.03) with the thermal parameter. Evaluation of the dose-response effect [PGAMs combined with distributed lags nonlinear models (DLNMs)-stage 2], expressed in terms of relative risk (RR) and cumulative relative risk (RRC), indicated a relative significant effect up to 15 lag days of lag (RR > 1), with a first peak after 5 days (lag ranges 0-1, 0-3, and 0-5) and a second weak peak observed along the 5-15 lag range days. The estimated RR for females was significant, mainly in the second and fourth age group considered (19-44 and >65 years): RR for total ED visits 1.27, confidence interval (CI) 1.11-1.46 (lag 0-5 days); RR 1.42, CI 1.01-2.01 (lag 0-10 days); and RR 1.35, CI 1.09-1.68 (lag 0-15 days). The research also indicated a moderate involvement of the thermal factor in the onset of RC caused by UC, exclusively in the female sex. Further studies will be necessary to confirm these results.","year":2015}
{"review_pmid":"41531667","record_index":8,"pmid":"42434312","title":"A qualitative investigation of experiences of care and illness perceptions related to self-management behaviors in chronic kidney disease.","abstract":"BACKGROUND: Chronic kidney disease (CKD) requires active self-management to slow progression, yet adherence is often low. To inform intervention development, this qualitative study explored CKD patients' illness perceptions and care experiences, and examined how these factors may interact to shape self-management. METHODS: Eighteen adults with CKD stages 2-5 were recruited from a nephrology clinic and interviewed immediately after routine care encounters. Semi-structured interviews were analyzed using both inductive and deductive reflexive thematic analysis (informed by the Common-Sense Model of Self-Regulation). RESULTS: Patients generally perceived CKD as chronic but controllable, with few noticeable symptoms and limited immediate consequences. Low symptom burden often reduced the perceived importance of self-management in daily life, whereas understanding the reasons for treatment and lifestyle changes increased motivation. Patients described treatment and control beliefs as moderate, but patients struggled to perceive the effects of dietary changes. Access to clear information, continuity of care, and trust in healthcare and practitioners were highlighted as important for coherence and confidence in self-management. Emotional responses were often alleviated through increased knowledge and supportive interactions with healthcare staff. CONCLUSION: Mapping experiences to illness perceptions revealed multiple pathways through which care processes may support or hinder CKD self-management.","year":2026}
{"review_pmid":"41531667","record_index":9,"pmid":"31323396","title":"Associations between ambient temperature and hepatobiliary and renal hospitalizations in California, 1999 to 2009.","abstract":"BACKGROUND: High ambient temperature has been linked to a number of types of morbidity, such as cardiovascular disease and dehydration. Fewer studies have explored specifically the relationship between ambient temperature and liver, kidney, and urinary system morbidity despite known biological impacts of extreme high temperatures on those systems. OBJECTIVE: We assessed the relationship between temperature and hospitalizations related to selected renal system (urinary stones, urinary tract infections, septicemia, chronic kidney disease, and a composite of selected kidney diseases) and hepatobiliary (biliary tract disease, other liver diseases [e.g. cirrhosis], non-diabetic pancreatic disorders) ailments. METHODS: We compiled data on daily hospitalization counts for hepatobiliary and renal system diseases in California for 1999 through 2009, and matched it with meteorological data. Relationships between temperature and admissions during the warm season (May-October) were assessed at the climate zone-level cumulative over 14 days following exposure using distributed lag non-linear models, with adjustment for time trends and relative humidity, then combined using random-effects meta-regression to create statewide estimates. RESULTS: Higher mean temperatures in the warm season were associated with significant increases in renal admissions for urinary tract infection [% change per 10 °F: 7.3, 95% CI: 5.6, 9.1], septicemia [% increase: 2.9; 95% CI: 1.5, 4.3], urinary stones [% increase: 15.2; 95% CI: 10.3, 20.4], and composite kidney disease. Additionally, increased temperatures were linked to increased admissions for biliary tract disease, but lower risk of other liver diseases. Some differences in association by race/ethnicity and regional meteorology were observed. CONCLUSIONS: Exposure to higher temperatures was associated with increased risk of multiple renal system hospitalization types, with additional links to specific hepatobiliary morbidities observed.","year":2019}
{"review_pmid":"41531667","record_index":10,"pmid":"36841184","title":"Associations between short-term temperature exposure and kidney-related conditions in New York State: The influence of temperature metrics across four dimensions.","abstract":"BACKGROUND: Evidence describing the relationship between short-term temperature exposure and kidney-related conditions is insufficient. It remains unclear how temperature specification affects estimation of these associations. This study aimed to assess associations between short-term temperature exposure and seven kidney-related conditions and to evaluate the influence of temperature specification. METHODS: We obtained data on hospital encounters in New York State (2007-2016). We assessed associations with a case-crossover design using conditional logistic regression with distributed lag non-linear models. We compared model performance (i.e., AIC) and association curves using 1) five temperature spatial resolutions; 2) temperature on an absolute versus relative scale; 3) seven temperature metrics incorporating humidity, wind speed, and/or solar radiation; and 4) five intraday temperature measures (e.g., daily minimum and daytime mean). RESULTS: We included 1,209,934 unplanned adult encounters. Temperature metric and intraday measure had considerably greater influence than spatial resolution and temperature scale. For outcomes not associated with temperature exposure, almost all metrics or intraday measures showed good model performance; for outcomes associated with temperature, there were meaningful differences in performance across metrics or intraday measures. For parsimony, we modelled daytime mean outdoor wet-bulb globe temperature, which showed good performance for all outcomes. At lag 0-6 days, we observed increased risk at the 95th percentile of temperature versus the minimum morbidity temperature for acute kidney failure (odds ratio [OR] = 1.36, 95% confidence interval [CI]: 1.09, 1.69), urolithiasis (OR = 1.41, 95% CI: 1.16, 1.70), dysnatremia (OR = 1.26, 95% CI: 1.01, 1.59), and volume depletion (OR = 1.88, 95% CI: 1.41, 2.51), but not for glomerular diseases, renal tubulo-interstitial diseases, and chronic kidney disease. CONCLUSIONS: High-temperature exposure over one week is a risk factor for acute kidney failure, urolithiasis, dysnatremia, and volume depletion. The differential model performance across temperature metrics and intraday measures indicates the importance of careful selection of exposure metrics when estimating temperature-related health burden.","year":2023}
{"review_pmid":"41531667","record_index":11,"pmid":"25536257","title":"Cause-specific risk of hospital admission related to extreme heat in older adults","abstract":null,"year":2015}
{"review_pmid":"41531667","record_index":12,"pmid":"26581758","title":"Daily ambient temperature and renal colic incidence in Guangzhou, China: a time-series analysis.","abstract":"Few previous studies have examined the association between temperature and renal colic in developing regions, especially in China, the largest developing country in the world. We collected daily emergency ambulance dispatches (EADs) for renal colic from Guangzhou Emergency Center from 1 January 2008 to 31 December 2012. We used a distributed-lag nonlinear model in addition to the over-dispersed generalized additive model to investigate the association between daily ambient temperature and renal colic incidence after controlling for seasonality, humidity, public holidays, and day of the week. We identified 3158 EADs for renal colic during the study period. This exposure-response curve was almost flat when the temperature was low and moderate and elevated when the temperature increased over 21 °C. For heat-related effects, the significant risk occurred on the concurrent day and diminished until lag day 7. The cumulative relative risk of hot temperatures (90th percentile) and extremely hot temperatures (99th percentile) over lag days 0-7 was 1.92 (95 % confidence interval, 1.21, 3.05) and 2.45 (95 % confidence interval, 1.50, 3.99) compared with the reference temperature of 21 °C. This time-series analysis in Guangzhou, China, suggested a nonlinear and lagged association between high outdoor temperatures and daily EADs for renal colic. Our findings might have important public health significance to prevent renal colic.","year":2016}
{"review_pmid":"41531667","record_index":13,"pmid":"27134497","title":"Daily Mean Temperature Affects Urolithiasis Presentation in Seoul: a Time-series Analysis.","abstract":"This study aimed to investigate the overall cumulative exposure-response and the lag response relationships between daily temperature and urolithiasis presentation in Seoul. Using a time-series design and distributing lag nonlinear methods, we estimated the relative risk (RR) of urolithiasis presentation associated with mean daily temperature, including the cumulative RR for a 20 days period, and RR for individual daily lag through 20 days. We analyzed data from 14,518 patients of 4 hospitals emergency department who sought medical evaluation or treatment of urolithiasis from 2005-2013 in Seoul. RR was estimated according to sex and age. Associations between mean daily temperature and urolithiasis presentation were not monotonic. Furthermore, there was variation in the exposure-response curve shapes and the strength of association at different temperatures, although in most cases RRs increased for temperatures above the 13°C reference value. The RRs for urolothiasis at 29°C vs. 13°C were 2.54 in all patients (95% confidence interval [CI]: 1.67-3.87), 2.59 in male (95% CI, 1.56-4.32), 2.42 in female (95% CI, 1.15-5.07), 3.83 in male less than 40 years old (95% CI, 1.78-8.26), and 2.47 in male between 40 and 60 years old (95% CI, 1.15-5.34). Consistent trends of increasing RR of urolithiasis presentation were observed within 5 days of high temperatures across all groups. Urolithiasis presentation increased with high temperature with higher daily mean temperatures, with the strongest associations estimated for lags of only a few days, in Seoul, a metropolitan city in Korea.","year":2016}
{"review_pmid":"41531667","record_index":14,"pmid":"25009122","title":"Daily mean temperature and clinical kidney stone presentation in five U.S. metropolitan areas: a time-series analysis.","abstract":"BACKGROUND: High ambient temperatures are a risk factor for nephrolithiasis, but the precise relationship between temperature and kidney stone presentation is unknown. OBJECTIVES: Our objective was to estimate associations between mean daily temperature and kidney stone presentation according to lag time and temperatures. METHODS: Using a time-series design and distributed lag nonlinear models, we estimated the relative risk (RR) of kidney stone presentation associated with mean daily temperatures, including cumulative RR for a 20-day period, and RR for individual daily lags through 20 days. Our analysis used data from the MarketScan Commercial Claims database for 60,433 patients who sought medical evaluation or treatment of kidney stones from 2005-2011 in the U.S. cities of Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Los Angeles, California; and Philadelphia, Pennsylvania. RESULTS: Associations between mean daily temperature and kidney stone presentation were not monotonic, and there was variation in the exposure-response curve shapes and the strength of associations at different temperatures. However, in most cases RRs increased for temperatures above the reference value of 10°C. The cumulative RR for a daily mean temperature of 30°C versus 10°C was 1.38 in Atlanta (95% CI: 1.07, 1.79), 1.37 in Chicago (95% CI: 1.07, 1.76), 1.36 in Dallas (95% CI: 1.10, 1.69), 1.11 in Los Angeles (95% CI: 0.73, 1.68), and 1.47 in Philadelphia (95% CI: 1.00, 2.17). Kidney stone presentations also were positively associated with temperatures < 2°C in Atlanta, and < 10°C in Chicago and Philadelphia. In four cities, the strongest association between kidney stone presentation and a daily mean temperature of 30°C versus 10°C was estimated for lags of ≤ 3 days. CONCLUSIONS: In general, kidney stone presentations increased with higher daily mean temperatures, with the strongest associations estimated for lags of only a few days. These findings further support an adverse effect of high temperatures on nephrolithiasis.","year":2014}
{"review_pmid":"41531667","record_index":15,"pmid":"28480659","title":"Daily Mean Temperature and Urolithiasis Presentation in Six Cities in Korea: Time-Series Analysis.","abstract":"Seasonal variation in urinary stone presentation is well described in the literature. However, previous studies have some limitations. To explore overall cumulative exposure-response and the heterogeneity in the relationships between daily meteorological factors and urolithiasis incidence in 6 major Korean cities, we analyzed data on 687,833 urolithiasis patients from 2009 to 2013 for 6 large cities in Korea: Seoul, Incheon, Daejeon, Gwangju, Daegu, and Busan. Using a time-series design and distributing lag nonlinear methods, we estimated the relative risk (RR) of mean daily urolithiasis incidence (MDUI) associated with mean daily meteorological factors, including the cumulative RR for a 20-day period. The estimated location-specific associations were then pooled using multivariate meta-regression models. A positive association was confirmed between MDUI and mean daily temperature (MDT), and a negative association was shown between MDUI and mean daily relative humidity (MDRH) in all cities. The lag effect was within 5 days. The multivariate Cochran Q test for heterogeneity at MDT was 12.35 (P = 0.136), and the related I² statistic accounted for 35.2% of the variability. Additionally, the Cochran Q test for heterogeneity and I² statistic at MDHR were 26.73 (P value = 0.148) and 24.7% of variability in the total group. Association was confirmed between daily temperature, relative humidity and urolithiasis incidence, and the differences in urolithiasis incidence might have been partially attributable to the different frequencies and the ranges in temperature and humidity between cities in Korea.","year":2017}
{"review_pmid":"41531667","record_index":16,"pmid":"35841652","title":"Effects of ambient temperature on hospital admissions for obstructive nephropathy in Wuhan, China: A time-series analysis.","abstract":"Under the background of global warming, it has been confirmed that heat exposure has a huge impact on human health. The current study aimed to evaluate the effects of daily mean ambient temperature on hospital admissions for obstructive nephropathy (ON) at the population level. A total of 19,494 hospitalization cases for ON in Wuhan, China from January 1, 2015 to December 31, 2018 were extracted from a nationwide inpatient database in tertiary hospitals according to the International Classification of Diseases (ICD)- 10 codes. Daily ambient meteorological and pollution data during the same period were also collected. A quasi-Poisson Generalized Linear Model (GLM) combined with a distributed lag non-linear model (DLNM) was applied to analyze the lag-exposure-response relationship between daily mean temperature and daily hospital admissions for ON. Results showed that there were significantly positive associations between the daily mean temperature and ON hospital admissions. Relative to the minimum-risk temperature (-3.4 ℃), the risk of hospital admissions for ON at moderate hot temperature (25 ℃, 75th percentile) occurred from lag day 4 and stayed to lag day 12 (cumulative relative risk [RR] was 1.846, 95 % confidence interval [CI]: 1.135-3.005, over lag 0-12 days). Moreover, the risk of extreme hot temperature (32 ℃, 99th percentile) appeared immediately and lasted for 8 days (RR = 2.019, 95 % CI: 1.308-3.118, over lag 0-8 days). Subgroup analyses indicated that the middle-aged and elderly (≥45 years) patients might be more susceptible to the negative effects of high temperature, especially at moderate hot conditions. Our findings suggest that temperature may have a significant impact on the acute progression and onset of ON. Higher temperature is associated with increased risks of hospital admissions for ON, which indicates that early interventions should be taken in geographical settings with relatively high temperatures, particularly for the middle-aged and elderly.","year":2022}
{"review_pmid":"41531667","record_index":17,"pmid":"36589947","title":"Extreme temperature exposure and urolithiasis: A time series analysis in Ganzhou, China.","abstract":"BACKGROUND: Ambient temperature change is a risk factor for urolithiasis that cannot be ignored. The association between temperature and urolithiasis varies from region to region. Our study aimed to analyze the impact of extremely high and low temperatures on the number of inpatients for urolithiasis and their lag effect in Ganzhou City, China. METHODS: We collected the daily number of inpatients with urolithiasis in Ganzhou from 2018 to 2019 and the meteorological data for the same period. The exposure-response relationship between the daily mean temperature and the number of inpatients with urolithiasis was studied by the distributed lag non-linear model (DLNM). The effect of extreme temperatures was also analyzed. A stratification analysis was performed for different gender and age groups. RESULTS: There were 38,184 hospitalizations for urolithiasis from 2018 to 2019 in Ganzhou. The exposure-response curve between the daily mean temperature and the number of inpatients with urolithiasis in Ganzhou was non-linear and had an observed lag effect. The warm effects (30.4°C) were presented at lag 2 and lag 5-lag 9 days, and the cold effects (2.9°C) were presented at lag 8 and lag 3-lag 4 days. The maximum cumulative warm effects were at lag 0-10 days (cumulative relative risk, CRR = 2.379, 95% CI: 1.771, 3.196), and the maximum cumulative cold effects were at lag 0-5 (CRR = 1.182, 95% CI: 1.054, 1.326). Men and people between the ages of 21 and 40 were more susceptible to the extreme temperatures that cause urolithiasis. CONCLUSION: Extreme temperature was correlated with a high risk of urolithiasis hospitalizations, and the warm effects had a longer duration than the cold effects. Preventing urolithiasis and protecting vulnerable people is critical in extreme temperature environments.","year":2022}
{"review_pmid":"41531667","record_index":18,"pmid":"38775486","title":"Heat Exposure and Cause-Specific Hospital Admissions in Spain: A Nationwide Cross-Sectional Study.","abstract":"BACKGROUND: More frequent and intense exposure to extreme heat conditions poses a serious threat to public health. However, evidence on the association between heat and specific diagnoses of morbidity is still limited. We aimed to comprehensively assess the short-term association between cause-specific hospital admissions and high temperature, including the added effect of temperature variability and heat waves and the effect modification by humidity and air pollution. METHODS: We used data on cause-specific hospital admissions, weather (i.e., temperature and relative humidity), and air pollution [i.e., fine particulate matter with aerodynamic diameter ≤2.5μm (PM2.5), fine particulate matter with aerodynamic diameter ≤10μm (PM10), NO2, and ozone (O3)] for 48 provinces in mainland Spain and the Balearic Islands between 1 January 2006 and 31 December 2019. The statistical analysis was performed for the summer season (June-September) and consisted of two steps. We first applied quasi-Poisson generalized linear regression models in combination with distributed lag nonlinear models (DLNM) to estimate province-specific temperature-morbidity associations, which were then pooled through multilevel univariate/multivariate random-effect meta-analysis. RESULTS: High temperature had a generalized impact on cause-specific hospitalizations, while the added effect of temperature variability [i.e., diurnal temperature range (DTR)] and heat waves was limited to a reduced number of diagnoses. The strongest impact of heat was observed for metabolic disorders and obesity [relative risk (RR) = 1.978; 95% empirical confidence interval (eCI): 1.772, 2.208], followed by renal failure (1.777; 95% eCI: 1.629, 1.939), urinary tract infection (1.746; 95% eCI: 1.578, 1.933), sepsis (1.543; 95% eCI: 1.387, 1.718), urolithiasis (1.490; 95% eCI: 1.338, 1.658), and poisoning by drugs and nonmedicinal substances (1.470; 95% eCI: 1.298, 1.665). We also found differences by sex (depending on the diagnosis of hospitalization) and age (very young children and the elderly were more at risk). Humidity played a role in the association of heat with hospitalizations from acute bronchitis and bronchiolitis and diseases of the muscular system and connective tissue, which were higher in dry days. Moreover, heat-related effects were exacerbated on high pollution days for metabolic disorders and obesity (PM2.5) and diabetes (PM10, O3). DISCUSSION: Short-term exposure to heat was found to be associated with new diagnoses (e.g., metabolic diseases and obesity, blood diseases, acute bronchitis and bronchiolitis, muscular and connective tissue diseases, poisoning by drugs and nonmedicinal substances, complications of surgical and medical care, and symptoms, signs, and ill-defined conditions) and previously identified diagnoses of hospital admissions. The characterization of the vulnerability to heat can help improve clinical and public health practices to reduce the health risks posed by a warming planet. https://doi.org/10.1289/EHP13254.","year":2024}
{"review_pmid":"41531667","record_index":19,"pmid":"38564058","title":"High ambient temperature impact on the pattern of emergency-room visits due to renal colic in the Middle East.","abstract":"Urolithiasis has a seasonal pattern, with an established increase in incidence during the summer months. This study aims to assess the impact of high ambient temperatures on emergency room (ER) visits related to renal colic (RC) in a Middle Eastern country over the past decade. Population data were extracted using the MDClone Big Data platform. We recorded demographic and clinical data on all RC-associated ER visits from January 2012 to April 2023 and calculated the heat index (HI) that combines daily average coastal plane temperatures and humidity percentages. There was a total of 12,770 ER visits (median age 48 years, 9,236 (72%) males). The number of visits increased during the hottest months (July-October), with the highest numbers recorded during August. The number of visits remained stable throughout the study. We identified a linear association between humidity and the incidence of ER visits (p = 0.002), and a non-linear association between ambient temperature (p < 0.0001) and HI (p < 0.0001). There was a direct relationship between high temperatures and ER visits on the same day (risk ratio [RR]: 1.75, p = 0.036), with a 2-day lag (RR: 1.123, p = 0.024). In Conclusion, there is a significant relationship between temperature, humidity, HI, and the number of ER visits due to RC. Adjusted resource allocation and healthcare workforce availability are essential for managing additional cases during heat waves. Clinical implications: Increased demand is expected during heatwaves and within a 2-day lag, emphasizing the importance of proactive strategies to effectively manage RC patients.","year":2024}
{"review_pmid":"41531667","record_index":20,"pmid":"36711317","title":"High ambient temperature increases the number of emergency visits for upper urolithiasis in Hefei City, China.","abstract":"BACKGROUND: Few studies have examined the effect of ambient temperature on upper urolithiasis in developing countries, with even fewer considering individual factors. METHODS: The present study analyzed data on emergency department visits for upper urolithiasis from three hospital sites of a large hospital in Hefei, China, during 2016-2020. Data on environmental factors during the same period were also analyzed. A time series analysis employing a generalized Poisson regression model (GPRM) combined with a distributed lag non-linear model (DLNM) was conducted to evaluate the effect of ambient temperature on the number of emergency department visits for upper urolithiasis. RESULTS: We found that ambient temperatures above 9 °C were positively associated with the frequency of upper urolithiasis visits, with the relationship being most significant on the current day and with a one-day lag. In the single-day lag effect, the most significant relative risk (RR) for mild heat (75th percentile) and high heat (95th percentile) was 1.229 (95% CI: 1.100-1.373) and 1.337 (95% CI: 1.134-1.577), respectively. The cumulative lag effect was significantly higher than the single-day lag effect, with maximum relative risks (RRs) of 1.779 (95% CI: 1.356-2.335) and 2.498 (95% CI: 1.688-3.697), respectively. The maximum lag time was 7 days. RRs were also higher among women and individuals aged 30-44 years. CONCLUSIONS: Increased ambient temperature is a risk factor for upper urolithiasis, and there is a hysteresis effect. Women and individuals aged 30-44 years are the most susceptible.","year":2023}
{"review_pmid":"41531667","record_index":21,"pmid":"37956847","title":"Impact of heat on emergency hospital admissions related to kidney diseases in Texas: Uncovering racial disparities.","abstract":"BACKGROUND AND OBJECTIVE: While impact of heat exposure on human health is well-documented, limited research exists on its effect on kidney disease hospital admissions especially in Texas, a state with diverse demographics and a high heat-related death rate. We aimed to explore the link between high temperatures and emergency kidney disease hospital admissions across 12 Texas Metropolitan Statistical Areas (MSAs) from 2004 to 2013, considering causes, age groups, and ethnic populations. METHODS: To investigate the correlation between high temperatures and emergency hospital admissions, we utilized MSA-level hospital admission and weather data. We employed a Generalized Additive Model to calculate the association specific to each MSA, and then performed a random effects meta-analysis to estimate the overall correlation. Analyses were stratified by age groups, admission causes, and racial/ethnic disparities. Sensitivity analysis involved lag modifications and ozone inclusion in the model. RESULTS: Our analysis found that each 1 °C increase in temperature was associated with a 1.73 % (95 % CI [1.43, 2.03]) increase in hospital admissions related to all types of kidney diseases. Besides, the effect estimates varied across different age groups and specific types of kidney diseases. We observed statistically significant associations between high temperatures and emergency hospital admissions for Acute Kidney Injury (AKI) (3.34 % (95 % CI [2.86, 3.82])), Kidney Stone (1.76 % (95 % CI [0.94, 2.60])), and Urinary Tract Infections (UTI) (1.06 % (95 % CI [0.61, 1.51])). Our research findings indicate disparities in certain Metropolitan Statistical Areas (MSAs). In Austin, Houston, San Antonio, and Dallas metropolitan areas, the estimated effects are more pronounced for African Americans when compared to the White population. Additionally, in Dallas, Houston, El Paso, and San Antonio, the estimated effects are greater for the Hispanic group compared to the Non-Hispanic group. CONCLUSIONS: This study finds a strong link between higher temperatures and kidney disease-related hospital admissions in Texas, especially for AKI. Public health actions are necessary to address these temperature-related health risks, including targeted kidney health initiatives. More research is needed to understand the mechanisms and address health disparities among racial/ethnic groups.","year":2024}
{"review_pmid":"41531667","record_index":22,"pmid":"35074348","title":"Relationships between short-term ambient temperature exposure and kidney disease hospitalizations in the warm season in Vietnam: A case-crossover study.","abstract":"BACKGROUND: Under a warming climate, adverse health effects of heat are an increasing concern. We evaluated associations between short-term ambient temperature exposure and hospital admission for kidney disease in Vietnam. METHODS: We linked province-level meteorologic data with admission data from 14 province-level hospitals (2003-2015). We used a case-crossover design to evaluate associations between daily ambient temperature metrics (mean, maximum, and minimum temperature and mean heat index) and risk of hospitalization for four kidney disease subtypes: glomerular diseases, renal tubulo-interstitial diseases, chronic kidney disease, and urolithiasis, including lagged (≤lag 14 days) and cumulative (≤lag 0-6 days) associations, during the warm season. We also evaluated independent associations with extreme heat days (defined as days with daily maximum temperature >95th percentile of the provincial daily maximum temperature distribution). Akaike's information criterion and patterns of risk estimates across cumulative exposure time windows and single-day lags informed our selection of final models. RESULTS: We included 58,330 hospital admissions during the warm season. Daily mean temperature averaged over the same day and the previous six days (lag 0-6 days) was associated with risk of hospitalization for each kidney disease outcome with odds ratios (per 1 °C increase in daily mean temperature) of 1.07 (95% confidence interval [CI]: 0.99, 1.16) for glomerular diseases, 1.06 (95% CI: 0.96, 1.17) for renal tubulo-interstitial diseases, 1.12 (95% CI: 1.00, 1.24) for chronic kidney disease, and 1.09 (95% CI: 1.02, 1.16) for urolithiasis. We found no additional independent associations with extreme heat. Results for the four temperature metrics were similar. CONCLUSIONS: High ambient temperature was associated with increased risk of hospitalization for each kidney disease subtype, with the most convincing associations for chronic kidney disease and urolithiasis. Further laboratory and epidemiologic research is needed to confirm the findings and disentangle the underlying mechanisms.","year":2022}
{"review_pmid":"41531667","record_index":23,"pmid":"30900001","title":"Sex differences in the temperature dependence of kidney stone presentations: a population-based aggregated case-crossover study.","abstract":"Previous studies assumed a uniform relationship between heat and kidney stone presentations. Determining whether sex and other characteristics modify the temperature dependence of kidney stone presentations has implications for explaining differences in nephrolithiasis prevalence and improving projections of the effect of climate change on nephrolithiasis. We performed an aggregated case-crossover study among 132,597 children and adults who presented with nephrolithiasis to 68 emergency departments throughout South Carolina from 1997 to 2015. We used quasi-Poisson regression with distributed lag non-linear models to estimate sex differences in the cumulative exposure and lagged response between maximum daily wet-bulb temperatures and emergent kidney stone presentations, aggregated at the ZIP-code level. We also explored interactions by age, race, payer, and climate. Compared to 10 °C, daily wet-bulb temperatures at the 99th percentile were associated with a greater increased relative risk (RR) of kidney stone presentations over 10 days for males (RR 1.73; 95% CI 1.56, 1.91) than for females (RR 1.15; 95% CI 1.01, 1.32; interaction P < 0.001). The shape of the lagged response was similar for males and females, with the greatest risk estimated for the 2 days following high temperatures. There were weak differences by age, race, and climatic zone, and no differences by payer status. The estimated risk of presenting emergently with kidney stones within 10 days of high daily wet-bulb temperatures was substantially greater among men than women, and similar between patients with public and private insurance. These findings suggest that the higher risk among males may be due to sexually dimorphic physiologic responses rather than greater exposure to ambient temperatures.","year":2020}
{"review_pmid":"41531667","record_index":24,"pmid":"38945510","title":"The effect of ambient temperatures on hospital admissions for kidney diseases in Central Australia.","abstract":"This study aimed to quantify risk of hospitalisations for kidney diseases related to ambient temperature in Central Australia, Northern Territory (NT). Daily hospitalisation data were extracted for Alice Springs Hospital, Central Australia, 2010-2021. The association between daily mean temperature and daily hospital admissions for total kidney and specific kidney conditions was assessed using a quasi-Poisson Generalized Linear Model combined with a distributed lag non-linear model. A total of 52,057 hospitalisations associated with kidney diseases were recorded. In general, risk of specific kidney related hospitalisations was immediate due to hot temperatures and prolonged due to cold temperatures. Relative to the minimum-risk temperature (5.1 °C), at 31 °C, cumulative relative risk (RR) of hospitalisations for total kidney disease (TKD) was 1.297 [95% CI 1.164,1.446] over lag0-1 days, for chronic kidney disease (CKD) cumulative RR was 1.269 [95% CI 1.115,1.444] and for kidney failure (KF) cumulative RR was 1.252 [95% CI 1.107,1.416] at lag 0, and for urinary tract infection (UTI) cumulative RR was 1.522 [95% CI 1.072,2.162] over lag0-7 days. At 16 °C and over lag0-7 days, cumulative RR of hospitalisations for TKD was 1.320 [95% CI 1.135,1.535], for CKD was 1.232 [95% CI 1.025,1.482], for RF was 1.233 [95% CI 1.035,1.470] and for UTI was 1.597 [95% CI 1.143, 2.231]. Both cold and hot temperatures were also associated with increased risks of kidney related total hospitalisations among First Nations Australians and women. Overall, temperature attributable to 13.7% (i.e. 7138 cases) of kidney related hospitalisations with higher attributable hospitalisations from cold temperature. Given the significant burden of kidney disease and projected increases in extreme temperatures associated with climate change in NT including Central Australia there is a need to implement public health and environmental health risk reduction strategies and awareness programs to mitigate potential adverse health effects of extreme temperatures.","year":2024}
{"review_pmid":"41531667","record_index":25,"pmid":"25407800","title":"The effect of climate variability on urinary stone attacks: increased incidence associated with temperature over 18 °C: a population-based study.","abstract":"The aim of this study was to evaluate the effect of seasonal variation and climate parameters on urinary tract stone attack and investigate whether stone attack is increased sharply at a specific point. Nationwide data of total urinary tract stone attack numbers per month between January 2006 and December 2010 were obtained from the Korean Health Insurance Review and Assessment Service. The effects of climatic factors on monthly urinary stone attack were assessed using auto-regressive integrated moving average (ARIMA) regression method. A total of 1,702,913 stone attack cases were identified. Mean monthly and monthly average daily urinary stone attack cases were 28,382 ± 2,760 and 933 ± 85, respectively. The stone attack showed seasonal trends of sharp incline in June, a peak plateau from July to September, and a sharp decline after September. The correlation analysis showed that ambient temperature (r = 0.557, p < 0.001) and relative humidity (r = 0.513, p < 0.001) were significantly associated with urinary stone attack cases. However, after adjustment for trends and seasonality, ambient temperature was the only climate factor associated with the stone attack cases in ARIMA regression test (p = 0.04). Threshold temperature was estimated as 18.4 °C. Risk of urinary stone attack significantly increases 1.71% (1.02-2.41 %, 95% confidence intervals) with a 1 °C increase of ambient temperature above the threshold point. In conclusion, monthly urinary stone attack cases were changed according to seasonal variation. Among the climates variables, only temperature had consistent association with stone attack and when the temperature is over 18.4 °C, urinary stone attack would be increased sharply.","year":2015}
{"review_pmid":"41531667","record_index":26,"pmid":"29078794","title":"The impact of daily temperature on renal disease incidence: an ecological study.","abstract":"BACKGROUND: Extremely high temperatures over many consecutive days have been linked to an increase in renal disease in several cities. This is becoming increasingly relevant with heatwaves becoming longer, more intense, and more frequent with climate change. This study aimed to extend the known relationship between daily temperature and kidney disease to include the incidence of eight temperature-prone specific renal disease categories - total renal disease, urolithiasis, renal failure, acute kidney injury (AKI), chronic kidney disease (CKD), urinary tract infections (UTIs), lower urinary tract infections (LUTIs) and pyelonephritis. METHODS: Daily data was acquired for maximum, minimum and average temperature over the period of 1 July 2003 to 31 March 2014 during the warm season (October to March) in Adelaide, South Australia. Data for daily admissions to all metropolitan hospitals for renal disease, including 83,519 emergency department admissions and 42,957 inpatient admissions, was also obtained. Renal outcomes were analyzed using time-stratified negative binomial regression models, with the results aggregated by day. Incidence rate ratios (IRR) and 95% confidence intervals (CI) were estimated for associations between the number of admissions and daily temperature. RESULTS: Increases in daily temperature per 1 °C were associated with an increased incidence for all renal disease categories except for pyelonephritis. Minimum temperature was associated with the greatest increase in renal disease followed by average temperature and then maximum temperature. A 1°C increase in daily minimum temperature was associated with an increase in daily emergency department admissions for AKI (IRR 1.037, 95% CI: 1.026-1.048), renal failure (IRR 1.030, 95% CI: 1.022-1.039), CKD (IRR 1.017, 95% CI: 1.001-1.033) urolithiasis (IRR 1.015, 95% CI: 1.010-1.020), total renal disease (IRR 1.009, 95% CI: 1.006-1.011), UTIs (IRR 1.004, 95% CI: 1.000-1.007) and LUTIs (IRR 1.003, 95% CI: 1.000-1.006). CONCLUSIONS: An increased frequency of renal disease, including urolithiasis, acute kidney injury and urinary tract infections, is predicted with increasing temperatures from climate change. These results have clinical and public health implications for the management of renal diseases and demand tailored health services. Future research is warranted to analyze individual renal diseases with more comprehensive information regarding renal risk factors, and studies examining mortality for specific renal diseases.","year":2017}
{"review_pmid":"41561801","record_index":1,"pmid":"29070503","title":"Aerobic exercise training-induced changes in serum C1qTNF-related protein levels are associat","abstract":null,"year":2017}
{"review_pmid":"41561801","record_index":2,"pmid":"23512743","title":"Comparison of three weight maintenance programs on cardiovascular risk, bone and vitamins in sedentary older adults.","abstract":"OBJECTIVE: Obese patients with knee osteoarthritis (OA) are encouraged to lose weight to obtain symptomatic relief. Risk of vascular events is higher in people with OA compared to people without arthritis. Our aim in this randomized trial was to compare changes in cardiovascular disease (CVD) risk-factors, nutritional health, and body composition after 1-year weight-loss maintenance achieved by [D]diet, [E]knee-exercise, or [C]control, following weight loss by low-energy-diet. DESIGN AND METHODS: Obese individuals (n = 192, >50 years) with knee OA, 63 years (SD 6), weight 103.2 kg (15.0), body-mass index 37.3 kg/m(2) (4.8), were enrolled into a 68-week weight-loss trial. RESULTS: Mean changes in weight, in D, E, and C were -11.0, -6.3, and -8.3 kg (P = 0.002). Reduction in waist circumference in D, E, and C were -8.4, -4.6, and -7.0 cm (P = 0.007). D reduced waist circumference significantly more than E: -3.8 cm (95%CI -6.2 to -1.4; P = 0.0024). There was no difference between the groups in changes in CVD risk factors; blood pressure, triglycerides, and cholesterol. Nutritional health was improved in all groups. For markers of bone, no statistical difference was found between the groups. CONCLUSIONS: Dietary support, or control, maintained improvements in cardiovascular risk factors to the same extent and none of the interventions had a detrimental effect on bone.","year":2013}
{"review_pmid":"41561801","record_index":3,"pmid":"36292427","title":"Dynamic Resistance Exercise Alters Blood ApoA-I Levels, Inflammatory Markers, and Metabolic Syndrome Markers in Elderly Women.","abstract":"Combined endurance and dynamic-resistance exercise has important anti-inflammatory effects, altering vascular endothelial function, and helping to prevent and treat aging-related metabolic syndrome (MS). We studied changes in 40 elderly women aged ≥ 65 years (control group (no MS), n = 20, mean age: 68.23 ± 2.56 years; MS group, n = 19, mean age: 71.42 ± 5.87 years; one left). The exercise program comprised dynamic-resistance training using elastic bands, three times weekly, for six months. We analyzed body composition, blood pressure, physical fitness, and MS-related blood variables including ApoA-I, antioxidant factors, and inflammatory markers. After the program, the MS group showed significant reductions in waist-hip ratio, waist circumference, diastolic blood pressure, blood insulin, and HOMA-IR, and a significant increase in HSP70 (p < 0.05). Both groups showed significant increases in ApoA-I levels, ApoA-I/HDL-C ratio, SOD2, IL-4, and IL-5 levels (p < 0.05). Active-resistance training-induced changes in ApoA-I were significantly positively correlated with changes in HDL-C and HSP70, and significantly negatively correlated with changes in triglycerides, C-reactive protein, and TNF-α (p < 0.05). Active-resistance training qualitatively altered HDL, mostly by altering ApoA-I levels, relieving vascular inflammation, and improving antioxidant function. This provides evidence that dynamic-resistance exercise can improve physical fitness and MS risk factors in elderly women.","year":2022}
{"review_pmid":"41561801","record_index":4,"pmid":"28253046","title":"Effect of Moderate-Intensity Exercise on Inflammatory Markers Among Postmenopausal Women.","abstract":"BACKGROUND: Declines in ovarian function in postmenopausal women may contribute to increase inflammatory cytokines, which can lead to chronic diseases. However, studies have shown that exercise interventions are important to manage inflammatory conditions. Thus, the objective of this study was to analyze the effect of exercise intervention on inflammatory markers among obese and postmenopausal women. METHODS: 70 women composed the sample (Exercise group [EG; n = 35] and nonexercise group [nEG; n = 35]). IL-6, TNF-α, and IL-10 were the inflammatory markers analyzed. Exercise program was 20 weeks long and consisted of aerobic and neuromuscular training. Data about chronic diseases, medication use, dietary intake, body composition and biochemical variables were collected. RESULTS: EG showed significant reductions in body mass index, waist circumference and body fat percentage, as well as increased lean body mass. EG showed significant reductions in TNF-α and significant interaction between group and intervention time. Reductions in IL-10 were identified only in nEG. Substantial effect of exercise intervention was observed with increased ratio of IL-10/IL-6 and IL-10/TNF-α. CONCLUSIONS: Combination of aerobic exercise and resistance training was effective in reducing inflammation. Thus, implementation and maintenance of similar exercise programs can contribute to reduce chronic inflammation among obese postmenopausal women.","year":2017}
{"review_pmid":"41561801","record_index":5,"pmid":"28597102","title":"Effects of progressive resistance training and weight loss versus weight loss alone on inflammatory and endothelial biomarkers in older adults with type 2 diabetes.","abstract":"PURPOSE: Type 2 diabetes has been associated with an increase in inflammatory and endothelial biomarkers, which are associated with an increased risk of cardiovascular disease and diabetes-related complications. This study examined the effects of high-intensity progressive resistance training (PRT) with moderate weight loss (WL) versus WL alone on inflammatory and endothelial biomarkers in older overweight adults with type 2 diabetes. METHODS: This was a 12-month randomized controlled trial in which 36 inactive, overweight adults aged 60-80 years with poorly controlled type 2 diabetes were randomized to 6 months of supervised PRT + WL or stretching (sham) exercise plus WL followed by 6 months of home-training without dietary modification. Fasted blood samples were collected at baseline and subsequent 3-month intervals with the following inflammatory [interleukin (IL)-10, IL-6, tumor necrosis factor (TNF)-α, adiponectin] and endothelial markers [resistin and intercellular adhesion molecule (ICAM)-1)] assessed. RESULTS: No significant within-group changes or between-group differences were detected for any inflammatory or endothelial biomarker following the 6-month supervised exercise and WL phase. There was a greater reduction in IL-10 at 9 months in the PRT + WL relative to WL group (P = 0.033). There was also a greater reduction in TNF-α at 9 and 12 months in the PRT + WL relative to WL group (P = 0.026 and P = 0.024, respectively). Serum adiponectin increased in the PRT + WL relative to WL group after 12 months (P = 0.036). All results were adjusted for baseline values, age, weight, sex, diabetes duration, medication use and any change in medication. CONCLUSIONS: Long-term participation in PRT, independent of change in weight, can result in some improvements in certain inflammatory markers in older overweight adults with type 2 diabetes.","year":2017}
{"review_pmid":"41561801","record_index":6,"pmid":"37391104","title":"Effects of Yijinjing combined with resistance training on body fat distribution and hepatic lipids in middle-aged and older people with prediabetes mellitus: A randomized controlled trial.","abstract":"PURPOSE: This randomized controlled trial aimed to study the effects of Yijinjing plus Elastic Band Resistance exercise on intrahepatic lipid (IHL), body fat distribution, glucolipid metabolism and biomarkers of inflammation in middle-aged and older people with pre-diabetes mellitus (PDM). PARTICIPANTS AGESND METHODS: 34 PDM participants (mean age, 62.62 ± 4.71 years; body mass index [BMI], 25.98 ± 2.44 kg/m2) were randomly assigned to the exercise group (n = 17) or control group (n = 17). The exercise group performed moderate-intensity Yijinjing and Elastic Band Resistance training 5 times per week for 6 months. The control group maintained their previous lifestyle. We measured body composition (body weight and body fat distribution), IHL, plasma glucose, lipid and the homeostatic model assessment of insulin resistance (HOMA-IR), inflammatory cytokines at baseline and 6 months. RESULTS: Compared with baseline, exercise significantly reduced IHL (reduction of 1.91 % ± 2.61 % vs an increase of 0.38 % ± 1.85 % for controls; P = 0.007), BMI (reduction of 1.38 ± 0.88 kg/m2 vs an increase of 0.24 ± 1.02 kg/m2 for controls; P = 0.001), upper limb fat mass, thigh fat mass and whole body fat mass. Fasting glucose, HOMA-IR, plasma total cholesterol (TC), and triglyceride (TG) were decreased in the exercise group (P < 0.05). There were no effects of exercise on liver enzyme levels and inflammatory cytokines. The decrease in IHL was positively correlated with the decreases in BMI, body fat mass and HOMA-IR. CONCLUSION: Six months of Yijinjing and resistance exercise significantly reduced hepatic lipids and body fat mass in middle-aged and older people with PDM. These effects were accompanied by weight loss, improved glycolipid metabolism and insulin resistance.","year":2023}
{"review_pmid":"41561801","record_index":7,"pmid":"36207735","title":"Elastic band resistance training increases adropin and ameliorates some cardiometabolic risk factors in elderly women: A quasi-experimental study.","abstract":"BACKGROUND: The decline in adropin over the aging process is associated with cardiometabolic risks, and resistance training may affect this decline. We hypothesized that elastic band resistance training (EBRT) would be an effective exercise for increasing adropin and improving the cardiometabolic profile in elderly women. METHODS: We randomly assigned 28 overweight elderly women (age = 74.04 ± 4.69 years) into one of two groups, EBRT (n = 14) or control (CON; n = 14), to participate in a 12-week (3d/wk) supervised EBRT program. The serum levels of adropin and cardiometabolic risk factors were evaluated at baseline and after the intervention. The exercise training protocol consisted of three supervised training sessions (55 min) per week for 12 weeks. Data were analyzed using two-way repeated-measures ANOVA and Pearson correlation coefficient. RESULTS: EBRT significantly increased serum adropin levels (p = 0.026), number of repetitions in the 30-second chair-stand test (p = 0.016), and number of repetitions in the 30-second arm curl test (p = 0.032). Moreover, EBRT significantly decreased serum levels of insulin (p = 0.035), TNF-α (p = 0.046), hsCRP (p = 0.037), and insulin resistance (p = 0.045) as well as body fat percentage (p = 0.023). There were no significant between-group differences (p > 0.05) in glucose, TC, TG, LDL-C, HDL-C, BMI, and WHR; however, glucose, TC, TG, and BMI significantly changed in the EBRT group (within-group). Furthermore, adropin correlated with body fat percentage (p = 0.020) and BMI (p = 0.014) at pretest and with body fat percentage at posttest (p = 0.016), however, delta values were not significantly related. No correlation was observed between adropin and other biomarkers at any stage of the study. CONCLUSION: EBRT can increase serum adropin levels, which has been associated with improved insulin sensitivity, inflammation, body fat percentage, and physical function in overweight elderly women.","year":2022}
{"review_pmid":"41561801","record_index":8,"pmid":"29662308","title":"Hypoglycemic and antioxidant effect of Tai chi exercise training in older adults with metabolic syndrome.","abstract":"INTRODUCTION: The antioxidant and anti-inflammatory effects of Tai chi (TC) exercise training in healthy older adults has been demonstrated. However, there are no studies on this effect in older adults with metabolic syndrome (MetS). PURPOSE: The aim of this study was to determine the effect of TC exercise on oxidative stress and inflammatory markers in older adults with MetS. METHODS: A quasi-experimental study was carried out with a sample of 110 older sedentary volunteers with clinical diagnoses of MetS: (i) a control group, n = 50, of individuals who do not participate in physical exercise, of which 37 fulfilled the entire study protocol, and (ii) an experimental group, n = 60, of subjects enrolled in a TC exercise training program (eight-form easy), 5 days a week for 6 months, in sessions of 50 min, under the supervision of a qualified instructor, of which 48 fulfilled the entire study protocol. We measured in both groups (pre- and post-intervention) the following cardiovascular parameters: resting heart rate (RHR), diastolic and systolic blood pressure (DBP and SBP), mean arterial pressure (MAP), RHR-SBP product, RHR-MAP product; glycosylated hemoglobin (HbA1c); oxidative stress markers (superoxide dismutase, total antioxidant status, thiobarbituric acid reacting substances, and oxidative stress score); and inflammation markers (TNF-α, IL-6, IL-8, and IL-10). RESULTS: A statistically significant decrease in HbA1c concentration was observed in the TC group compared with the control group (p < 0.05). This group also showed a statistically significant increase in TAS and a decrease in the oxidative stress score (p < 0.05). We did not observe changes in the cardiovascular parameters (RHR, DBP, SBP, MAP, RHR-SBP product, and RHR-MAP product) in the TC experimental group compared to the control group. CONCLUSION: Our findings suggest that the practice of TC exercise has an antioxidative and hypoglycemic effect in the elderly with MetS.","year":2018}
{"review_pmid":"41561801","record_index":9,"pmid":"23772804","title":"Independent and combined effects of physical activity and weight loss on inflammatory biomarkers in overweight and obese older adults.","abstract":"OBJECTIVES: To determine the independent effect of long-term physical activity (PA) and the combined effects of long-term PA and weight loss (WL) on inflammation in overweight and obese older adults. DESIGN: Eighteen-month randomized, controlled trial. SETTING: The community infrastructure of cooperative extension centers. PARTICIPANTS: Overweight and obese (body mass index >28.0 kg/m(2) ) community-dwelling men and women aged 60 to 79 at risk for cardiovascular disease (CVD). INTERVENTION: Physical activity + weight loss (PA + WL) (n = 98), PA only (n = 97), or successful aging (SA) health education (n = 93) intervention. MEASUREMENTS: Biomarkers of inflammation (adiponectin, leptin, high-sensitivity interleukin (hsIL)-6, IL-6sR, IL-8, and soluble tumor necrosis factor receptor 1) were measured at baseline and 6 and 18 months. RESULTS: After adjustment for baseline biomarker, wave, sex, and visit, leptin and hsIL-6 showed a significant intervention effect. Specifically, leptin was significantly lower in the PA + WL group (21.3 ng/mL, 95% confidence interval (CI) = 19.7-22.9 ng/mL) than in the PA (29.3 ng/mL, 95% CI = 26.9-31.8 ng/mL) or SA (30.3 ng/mL, 95% CI = 27.9-32.8 ng/mL) group (both P <.001), and hsIL-6 was significantly lower in the PA + WL group (2.1 pg/mL, 95% CI = 1.9-2.3 pg/mL) than in the PA (2.5 pg/mL, 95% CI = 2.3-2.7 pg/mL) or SA (2.4 pg/mL, 95% CI = 2.2-2.6 pg/mL) group (P =.02). CONCLUSION: Addition of dietary-induced WL to PA reduced leptin and hsIL-6 more than PA alone and more than a SA intervention in older adults at risk for CVD. Results suggest that WL, rather than increased PA, is the lifestyle factor primarily responsible for improvement in the inflammatory profile.","year":2013}
{"review_pmid":"41561801","record_index":10,"pmid":"23108583","title":"Low-volume exercise training attenuates oxidative stress and neutrophils activation in older adults.","abstract":"The purpose of this study was to investigate the effects of low-volume exercise training (100 min/week) on oxidative stress and neutrophils activation markers in older adults. Twenty-eight older adults (age range 65-78 years) were assigned into control (n = 14) or exercise (n = 14) groups. The exercise program consisted of walking 30-60 min/session, 2 days each week for 12 weeks. Blood samples were taken before starting the sessions (baseline) and when they ended. Fasting plasma and serum oxidative stress and inflammatory markers were measured using commercial kits. Cell surface expression of adhesion molecules on circulating leukocytes (CD66b and CD62L) was determined using flow cytometry. The concentrations of derivatives of reactive oxygen metabolites tended to be lower than the baseline values only in the exercise group (P = 0.05). The biological antioxidant potential, thioredoxin concentrations, and glutathione peroxidase activities significantly increased only in the exercise group (P < 0.05 for all). While CD66b expression tended to decrease only in the exercise group, CD62L expression significantly increased (P < 0.05). Our findings indicate that exercise training below the current recommended level of at least 150 min/week attenuates basal oxidative stress and neutrophil activation in older adults. Thus, our findings may encourage more people to incorporate a small amount of physical activity into their lives.","year":2013}
{"review_pmid":"41561801","record_index":11,"pmid":"36355124","title":"Metabolomic Response throughout 16 Weeks of Combined Aerobic and Resistance Exercise Training in Older Women with Metabolic Syndrome.","abstract":"Increases in longevity and obesity have led to a higher prevalence of Metabolic Syndrome (MetS) and several chronic conditions, such as hypertension. The prevalence of MetS and hypertension increases with advancing age and their detrimental effects on health can be attenuated by physical activity. Combined aerobic and resistance exercise training (CT) is recommended to maintain good health in older adults and is known to generate important metabolic adaptations. In this study we performed a metabolomics analysis, based on Hydrogen Nuclear Magnetic Resonance (1H NMR), to investigate the kinetics of changes in metabolism in non-physically active older women with MetS in response to 16 weeks of CT. A subset of women with MetS were selected from a larger randomized trial (that included men and women without MetS), with 12 participants on CT and 13 from the Control Group (CG). CT comprised walking/running at 63% of VO2max, three times/week, and resistance training (RT), consisting of 15 repetitions of seven exercises at moderate intensity, twice/week. Serum metabolomic profile was analysed at baseline (0W), 4 (4W), 8 (8W), 12 (12W) and 16 weeks (16W) for CT or CG. Cardiorespiratory fitness, RT load, blood pressure, body composition, lipid and glycaemic profile were also assessed. After 16 weeks CT increased cardiorespiratory fitness (13.1%, p < 0.05) and RT load (from 48% in the lat pulldown to 160% in the leg press, p < 0.05), but there were no changes in MetS parameters, such as body composition (Body Mass, Body Mass Index (BMI), body fat percentage and waist circumference), blood pressure, lipid and glycaemic profile. However, we identified potential higher substrate to the tricarboxylic acid cycle (increase in 2-Oxobutyrate from 0W (0.0029 ± 0.0009) to 4W (0.0038 ± 0.0011) and 8W (0.0041 ± 0.0015), p < 0.05), followed by alterations (different from 0W, p < 0.05) in the production of ketone bodies (3-Hydroxybutyrate, 0W (0.0717 ± 0.0377) to 16W (0.0397 ± 0.0331), and Acetoacetate, 0W (0.0441 ± 0.0240) to 16W (0.0239 ± 0.0141)), which together might explain the known improvement in fatty acid oxidation with exercise. There was also a late increase in ornithine at 16W of CT. Further studies are needed to investigate the association between these metabolic pathways and clinical outcomes in this population.","year":2022}
{"review_pmid":"41561801","record_index":12,"pmid":"37978254","title":"Moderate intensity walking exercises reduce the body mass index and vascular inflammatory factors in postmenopausal women with obesity: a randomized controlled trial.","abstract":"Postmenopause, the secretion of female hormones changes, causing excessive fat accumulation in the body and leading to chronic inflammation, which increases the incidence of cardiovascular diseases (CVD). Walking is an easily accessible daily exercise and effective non-pharmacological treatment for reducing obesity and the incidence of CVD. The aim of this study was to investigate the effect of moderate intensity walking exercises on body composition, vascular inflammatory factors, and vascular endothelial growth factor (VEGF) in postmenopausal women with obesity. Twenty-six older postmenopausal women with obesity (ages 68-72) were randomly assigned to control (n = 12, BMI 26.06 ± 1.37) or exercise (n = 14, BMI 26.04 ± 1.94) groups. Following a 12-week moderate intensity walking exercise program, we measured the participants' body composition with an InBody S10 analyzer and assessed blood sera using enzyme-linked immunosorbent assays. There was a significant clustering by weight (p < 0.01), body mass index (p < 0.01), percentage body fat (p < 0.001), high-sensitivity C-reactive protein (p < 0.05), interleukin-6, and tumor necrosis factor-α (p < 0.05) being significantly decreased in the exercise group. Although VEGF levels did not change significantly, a tendency to increase was observed in participants that exercised. Our results indicate that walking exercise may help prevent CVD in postmenopausal women with obesity by reducing obesity and vascular inflammatory factors.","year":2023}
{"review_pmid":"41561801","record_index":13,"pmid":"38061437","title":"Multicomponent and power training with elastic bands improve metabolic and inflammatory parameters, body composition and anthropometry, and physical function in older women with metabolic syndrome: A 20-week randomized, controlled trial.","abstract":"PURPOSE: This study aimed to explore the effects of 20 weeks of multicomponent or power training with elastic bands (EBs) on metabolic and inflammatory blood parameters, body composition, anthropometry, and physical function in older women with metabolic syndrome (MS). METHODS: Ninety participants were randomly assigned to a multicomponent (MCG; n = 30), power (PG; n = 30), or a control group (CG; n = 30). The MCG performed balance, slow-speed strength, and aerobic training, twice per week. The PG completed a high-speed resistance training program twice per week, composed of three to four sets of ten repetitions of six overall body exercises at a perceived rating of effort for the first repetition of 3-4 on the OMNI-Resistance Exercise Scale EB. MS-related variables (glucose, triglycerides, and waist circumference) and cardiometabolic risk factors (high-density lipoprotein [HDL], glycosylated hemoglobin, total cholesterol, low-density lipoprotein cholesterol [LDL], C-reactive protein, and anthropometric profile) were assessed. Physical function was evaluated through balance, strength, and mobility tests. RESULTS: An analysis of variance revealed that both training groups similarly improved most glycemic and lipidic profile parameters (p ≤ 0.006; d ≥ 0.46), body composition and anthropometry (p < 0.001; d ≥ 0.41), and physical function (p ≤ 0.005; d ≥ 0.69). Opposed to the PG, the MCG improved balance (p < 0.001; d = 0.96) and decreased the inflammatory status by downregulating C-reactive protein (p = 0.003; d = 0.47). On the other hand, the PG exhibited improvements in handgrip strength (p = 0.006; d = 0.48), while the MCG did not. CONCLUSION: Therefore, multicomponent and power training with EBs are plausible strategies for improving the cardiometabolic health status and physical function in older women with MS.","year":2024}
{"review_pmid":"41561801","record_index":14,"pmid":"24687180","title":"Reductions in C-reactive protein in older adults with type 2 diabetes are related to improvements in body composition following a randomized controlled trial of resistance training.","abstract":"BACKGROUND: Reductions in skeletal muscle mass and increased adiposity are key elements in the aging process and in the pathophysiology of several chronic diseases. Systemic low grade inflammation associated with obesity has been shown to accelerate the age-related decline in skeletal muscle. The aim of this investigation was to determine the effects of 12 months of progressive resistance training (PRT) on systemic inflammation, and whether reductions in systemic inflammation were associated with changes in body composition. We hypothesized that reductions in systemic inflammation following 12 months of PRT in older adults with type 2 diabetes would be associated with reductions in adiposity and increases in skeletal muscle mass. METHODS: Participants (n = 103) were randomized to receive either PRT or sham-exercise, 3 days a week for 12 months. C-reactive protein (CRP) was used to assess systemic inflammation. Skeletal muscle mass and total fat mass were determined using bioelectrical impedance. RESULTS: Twelve months of PRT tended to reduce CRP compared to sham exercise (β = -0.25, p = 0.087). Using linear mixed-effects models, the hypothesized relationships between body composition adaptations and CRP changes were significantly stronger for skeletal muscle mass (p = 0.04) and tended to be stronger for total fat mass (p = 0.07) following PRT when compared to sham-exercise. Using univariate regression models, stratified by group allocation, reductions in CRP were associated with increases in skeletal muscle mass (p = 0.01) and reductions in total fat mass (p = 0.02) in the PRT group, but not in the sham-exercise group (p = 0.87 and p = 0.32, respectively). CONCLUSIONS: We have shown for the first time that reductions in systemic inflammation in older adults with type 2 diabetes following PRT were associated with increases in skeletal muscle mass. Furthermore, reductions in CRP were associated with reductions in adiposity, but only when associated with PRT. Lifestyle interventions aimed at reducing systemic inflammation in older adults with type 2 diabetes should therefore incorporate anabolic exercise such as PRT to optimize the anti-inflammatory benefits of favorable body composition adaptations.","year":2014}
{"review_pmid":"41561801","record_index":15,"pmid":"27616162","title":"Resistance training improves inflammatory level, lipid and glycemic profiles in obese older women: A randomized controlled trial.","abstract":"The main purpose of the present study was to investigate the effect of resistance training on inflammatory levels, lipid and glycemic profile in obese older women. Thirty-eight obese older women (68.2±4.2years, and 41.0±6.2% of body fat) were randomly assigned to one of two groups: A training group (TG, n=19) that performed 8weeks of RT; or a control group (CG, n=19) that did not perform any type of exercise. The RT program consisted of 8 whole-body exercises for 3 sets of 10-15 repetition maximum (RM) carried out 3 times a week. Anthropometric, body composition (DXA), muscular strength (1RM), and blood sample measurements were performed pre- and post-training. After the intervention period, the TG demonstrated significantly (P<0.05) lower values than CG for interleukin-6 (TG=3.3±1.2pg/mL vs. CG=3.8±1.4pg/mL), tumor necrosis factor alpha (TG=3.1±1.5pg/mL vs. CG=3.5±1.8pg/mL), C-reactive protein (TG=1.8±1.4mg/L vs. CG=3.2±1.8mg/L), low-density lipoprotein (TG=85.1±11.0mg/dL vs. CG=148.7±0.1mg/dL), glucose (TG=90.8±11.1mg/dL vs. CG=97.9±6.9mg/dL), trunk fat (TG=12.7±3.5kg vs. CG=14.1±4.3kg), and total body fat (TG=37.5±5.7% vs. CG=43.1±5.6%). Furthermore, TG presented significantly (P<0.05) higher values for high-density lipoprotein (TG=58.3±15.4mg/dL vs. CG=55.2±11.8mg/dL). These results suggest that 8weeks of RT promote improvements on inflammatory levels, and the lipid and glycemic profile in obese older women. These findings further support the important role of RT in healthy aging.","year":2016}
{"review_pmid":"41561801","record_index":16,"pmid":"18043308","title":"The anti-inflammatory effects of exercise training in patients with type 2 diabetes mellitus Nikolaos P.E. Kadogloua,c, Fotios Iliadisa, Nikoleta Angelopouloub, Despina Perread, George Ampatzidisb, Christos D. Liapisc and Miltiadis Alevizosa","abstract":null,"year":2016}
{"review_pmid":"41561801","record_index":17,"pmid":"32595518","title":"The Effects of Concurrent Training Combining Both Resistance Exercise and High-Intensity Interval Training or Moderate-Intensity Continuous Training on Metabolic Syndrome.","abstract":"To date, there are several knowledge gaps on how to properly prescribe concurrent training to achieve the best dose-response, especially regarding the optimal intensity or volume of the aerobic component. Thus, the objective of this study is to analyze the effects of different aerobic exercise modes and intensities [i.e. aerobic high-intensity interval training (HIIT) versus moderate-intensity continuous aerobic training (MICT) combined with a resistance training (RT) program] on metabolic outcomes in participants with metabolic syndrome (MetS). Thirty-nine men and women (67.0 ± 6.7 years) volunteered to a 12-weeks exercise intervention (3 week-1, 50 min/session) and were randomly assigned to one of three groups: (a) RT plus MICT (RT+MICT) (2 males; 11 females); (b) RT plus HIIT (RT+HIIT) (4 males; 9 females); and (c) control group (CON) - without formal exercise (4 males; 9 females). Intensity was established between 60 and 70% of maximum heart rate (HRmax) in RT+MICT and ranged from 55-65% to 80-90% HRmax in the RT+HIIT group. Dependent outcomes included morphological, metabolic and hemodynamic variables. Both training groups improved waist circumference (RT+MICT: P = 0.019; RT+HIIT: P = 0.003), but not body weight, fat mass or fat-free mass (P ≥ 0.114). RT+HIIT group improved fasting glucose (P = 0.014), low density lipoprotein [LDL (P = 0.022)], insulin (P = 0.034) and homeostatic model assessment (P = 0.028). RT+MICT group reduced triglycerides (P = 0.053). Both exercise interventions did not change high sensitivity C-reactive protein, glycated hemoglobin, high density lipoprotein and total cholesterol, systolic, diastolic or mean arterial blood pressure (P ≥ 0.05). The CON group reduced the LDL (P = 0.031). This trial suggests that short-term exercise mode and intensity may differently impact the metabolic profile of individuals with MetS. Further, our data suggests that both concurrent trainings promote important cardiometabolic gains, particularly in the RT+HIIT. Nonetheless, due to the small-to-moderate effect size and the short-term intervention length, our data suggests that the intervention length also has an important modulating role in these benefits in older adults with MetS. Therefore, more research is needed to confirm our results using longer exercise interventions and larger groups.","year":2020}
{"review_pmid":"41561801","record_index":18,"pmid":"29031002","title":"Tomeleri CM (20172018) Resistance training reduces metabolic syndrome and inflammator","abstract":"CrisieliM. Tomeleri,PhysicalEducation Department,FacultyofPhysical Background: This study analyzed the effects of a 12-week resistance training Education,UniversityofCampinas, (RT) program without dietary interventions on metabolic syndrome (MetS) Campinas,Brazil. componentsandinflammatorybiomarkersinolderwomen. Tel:+5543999177079 Methods: Fifty-three older women (mean [(cid:1)SD] age 70.4 (cid:1) 5.7 years; Fax:+554330356496 mean body mass index 26.7 (cid:1) 4.0 kg/m2) were randomly assigned to a Email:crisieli@uol.com.br training group (TG; n = 26) that performed 12 weeks of an RT program or †ThisstudyisregisteredwithClinicaltrials. a control group (CG; n = 27) that did not perform any type of physical gov(ID:NCT02918448). exercise over the same period. Body composition (dual energy X-ray absorptiometry), muscular strength (one-repetition maximum tests), blood Received9August2017;revised2 pressure (BP), and blood sample measurements were performed before and October2017;accepted11 after intervention. October2017. Results: After the 12-week period, there were significantly reductions doi:10.1111/1753-0407.12614 (P < 0.05) in glucose levels (−20.4% vs −0.3%), waist circumference (−1.5% vs +2.0%), and systolic BP (−6.2% vs +0.9%), and complete normalization of MetS prevalence (18% at baseline vs. 0% after 12-weeks RT) in the TG. Moreover, C-reactive protein and tumor necrosis factor-α concentrations decreased in the TG (−28.6% and −21.6%, respectively), but increased in the CG (+34.5% and +13.3%, respectively). In addition there were positive improvements in the MetS Z-score in the TG but notCG (−21.6% vs+13.3%, respectively). Conclusion: The results suggest that a 12-week RT program seems to effectivelyreduceMetScomponentsandinflammatorybiomarkersinolderwomen, regardless of dietary intervention. The RT-induced adaptations in body 328 ©2017RuijinHospital,ShanghaiJiaotongUniversitySchoolofMedicineandJohnWiley&SonsAustralia,Ltd C.M.TOMELERIetal. Resistancetrainingandmetabolicsyndrome composition and inflammatory biomarkers appear to be related to healthy adaptationsinriskfactorsforMetS.","year":2018}
{"review_pmid":"41561801","record_index":19,"pmid":"23823329","title":"Weight Loss, Exercise, or Both and Cardiometabolic Risk Factors in Obese Older Adults: Results of a Randomized Controlled Trial","abstract":"Background: Obesity exacerbates the age-related decline in insulin sensitivity and is associated with risk for cardiometabolic syndrome in older adults; however, the appropriate treatment for obese older adults is controversial. Objective-To determine the independent and combined effects of weight loss and exercise on cardiometabolic risk factors in obese older adults. Design-One-hundred-seven obese (BMI≥30 kg/m2) older (≥65 yrs) adults with physical frailty were randomized to control group, diet group, exercise group, and diet-exercise group for 1 year. Users may view, print, copy, download and text and data- mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use: http://www.nature.com/authors/editorial_policies/license.html#terms Please send correspondence to: Dennis T. Villareal, MD New Mexico VA Health Care System Geriatrics (111K) 1501 San Pedro Dr Albuquerque, NM 87111 dennis.villareal@va.gov. Disclosure summary: The authors have nothing to disclose Conflict of interest The authors declare no conflict of interests. Author Manuscript Author Manuscript Author Manuscript Author Manuscript Bouchonville et al. Page 2 Outcomes for this study included change in insulin sensitivity index (ISI), glucose tolerance, central obesity, adipocytokines, and cardiometabolic syndrome. Results-Although similar increases in ISI occurred in the diet-exercise and diet groups at 6 months, the ISI improved more in the diet-exercise than in the diet group at 12 months (2.4 vs. 1.2; between-group difference, 1.2; 95% CI, 0.2-2.1); no changes in ISI occurred in both exercise and control groups. The diet-exercise and diet groups had similar improvements in insulin area under the curve (AUC) (−2.9 and −2.9 ×103mg.min/dl), glucose AUC (−1.4 and −2.2×103mg.min/ dl), visceral fat (−787 and −561 cm3), tumor-necrosis factor (−17.0 and −12.8 pg/mL), adiponectin (5.0 and 4.0 ng/mL), waist circumference (−8.2 and −8.4 cm), triglyceride (−30.7 and −24.3 g/dL), and systolic/diastolic BP (−15.9 and −13.1/−4.9 and −6.7 mmHg), while no changes in these parameters occurred in both exercise and control groups. The cardiometabolic syndrome prevalence decreased by 40% in the diet-exercise and by 15% in the diet group. Body weight decreased similarly in the diet-exercise and diet groups (−8.6 and −9.7kg) but not in the exercise and control groups. Conclusions-In frail, obese older adults, lifestyle interventions associated with weight loss improve insulin sensitivity and other cardiometabolic risk factors, but continued improvement in insulin sensitivity is only achieved when exercise training is added to weight loss.","year":2014}
{"review_pmid":"41566983","record_index":1,"pmid":"33631687","title":"Association between coronavirus disease 2019 (COVID-19) and long-term exposure to air pollution: Evidence from the first epidemic wave in China.","abstract":"People with chronic obstructive pulmonary disease, cardiovascular disease, or hypertension have a high risk of developing severe coronavirus disease 2019 (COVID-19) and of COVID-19 mortality. However, the association between long-term exposure to air pollutants, which increases cardiopulmonary damage, and vulnerability to COVID-19 has not yet been fully established. We collected data of confirmed COVID-19 cases during the first wave of the epidemic in mainland China. We fitted a generalized linear model using city-level COVID-19 cases and severe cases as the outcome, and long-term average air pollutant levels as the exposure. Our analysis was adjusted using several variables, including a mobile phone dataset, covering human movement from Wuhan before the travel ban and movements within each city during the period of the emergency response. Other variables included smoking prevalence, climate data, socioeconomic data, education level, and number of hospital beds for 324 cities in China. After adjusting for human mobility and socioeconomic factors, we found an increase of 37.8% (95% confidence interval [CI]: 23.8%-52.0%), 32.3% (95% CI: 22.5%-42.4%), and 14.2% (7.9%-20.5%) in the number of COVID-19 cases for every 10-μg/m3 increase in long-term exposure to NO2, PM2.5, and PM10, respectively. However, when stratifying the data according to population size, the association became non-significant. The present results are derived from a large, newly compiled and geocoded repository of population and epidemiological data relevant to COVID-19. The findings suggested that air pollution may be related to population vulnerability to COVID-19 infection, although the extent to which this relationship is confounded by city population density needs further exploration.","year":2021}
{"review_pmid":"41566983","record_index":2,"pmid":"32315904","title":"Association between short-term exposure to air pollution and COVID-19 infection","abstract":null,"year":2020}
{"review_pmid":"41566983","record_index":3,"pmid":"33126032","title":"Associations between air pollution and COVID-19 epidemic during quarantine period in China","abstract":null,"year":2021}
{"review_pmid":"41566983","record_index":4,"pmid":"34809490","title":"Meteorological Factors With COVID-19","abstract":"Evidence regarding the effects of environmental factors on COVID-19 transmission is mixed. We aimed to explore the associations of air pollutants and meteorological factors with COVID-19 confirmed cases during the outbreak period throughout China. The number of COVID-19 confirmed cases, air pollutant concentrations, and meteorological factors in ChinafromJanuary25toFebruary29,2020,(36days)wereextractedfromauthoritativeelectronicdatabases. Theassociations were estimated for a single-day lag as well as moving averages lag using generalized additive mixed models. Region-specific analysesandmeta-analysiswereconductedin5selectedregionsfromthenorthtosouthofChinawithdiverseairpollution levels and weather conditions and sufficient sample size. Nonlinear concentration-response analyses were performed. An increase of each interquartile range in PM, PM, SO, NO, O, and CO at lag4 corresponded to 1.40 (1.37-1.43), 1.35 2.5 10 2 2 3 (1.32-1.37),1.01(1.00-1.02),1.08(1.07-1.10),1.28(1.27-1.29),and1.26(1.24-1.28)ORsofdailynewcases,respectively. For 1°C,1%,and1m/sincreaseintemperature,relativehumidity,andwindvelocity,theORswere0.97(0.97-0.98),0.96(0.960.97), and 0.94 (0.92-0.95), respectively. The estimates of PM, PM, NO, and all meteorological factors remained sig2.5 10 2 nificantly after meta-analysis for the five selected regions. The concentration-response relationships showed that higher concentrationsofairpollutantsandlowermeteorologicalfactorswereassociatedwithdailynewcasesincreasing. Higherair pollutant concentrations and lower temperature, relative humidity and wind velocity may favor COVID-19 transmission. Controllingambientairpollution,especiallyforPM,PM,NO,maybeanimportantcomponentofreducingriskofCOVID2.5 10 2 19 infection. In addition, as winter months are arriving in China, the meteorological factors may play a negative role in prevention. Therefore, it issignificant to implement the public health control measurespersistentlyincase another possible pandemic.","year":2021}
{"review_pmid":"41566983","record_index":5,"pmid":"34729185","title":"Hadei-2021-Effect-of-short-term-exposure-to-ai","abstract":"Purpose The association between air pollutant (PM, PM, NO, and O ) concentrations and daily number of COVID-19 2.5 10 2 3 confirmed cases and related deaths were evaluated in three major Iranian cities (Tehran, Mashhad, and Tabriz). Methods Hourly concentrations of air pollutants and daily number of PCR-confirmed cases and deaths of COVID-19 were acquired (February 20th, 2020 to January 4th, 2021). A generalized additive model (GAM) assuming a quasi-Poisson distribution was used to model the associations in each city up to lag-day 7 (for mortality) and 14 (for morbidity). Then, the city-specific estimates were meta-analyzed using a fixed effect model to obtain the overall relative risks (RRs). Results A total of 114,964 confirmed cases and 21,549 deaths were recorded in these cities. For confirmed cases, exposure to PM, NO, and O for several lag-days showed significant associations. In case of mortality, meta-analysis estimated that 2.5 2 3 the RRs for PM, PM, NO, and O concentrations were 1.06 (95% CI: 0.99, 1.13), 1.06 (95% CI: 0.93, 1.19), 1.15 (95% 2.5 10 2 3 CI: 0.93, 1.38), and 1.07 (95% CI: 0.84, 1.31), respectively. Despite several positive associations with all air pollutants over multiple lag-days, COVID-19 mortality was only significantly associated with NO on lag-days 0-1 and 1 with the RRs of 2 1.35 (95% CI: 1.04, 1.67) and 1.16 (95% CI: 1.02, 1.31), respectively. Conclusion This study showed that air pollution can be a factor exacerbating COVID-19 infection and clinical outcomes. Actions should be taken to reduce the exposure of the public and particularly patients to ambient air pollutants.","year":2021}
{"review_pmid":"41566983","record_index":6,"pmid":"32389157","title":"Jiang-2020-Effect-of-ambient-air-pollutants-an","abstract":"Objective: TodeterminewhetherambientairpollutantsandmeteorologicalvariablesareassociatedwithdailyCOVID-19incidence. Design: AretrospectivecohortfromJanuary25toFebruary29,2020. Setting: CitiesofWuhan,Xiaogan,andHuanggang,China. Patients: TheCOVID-19casesdetectedeachday. Methods: WecollecteddailydataofCOVID-19incidence,8ambientairpollutants(particulatematterof≤2.5μm[PM ],particulatematter 2.5 ≤10μm[PM ],sulfurdioxide[SO ],carbonmonoxide[CO],nitrogendioxide[NO ],andmaximum8-hmovingaverageconcentrationsfor 10 2 2 ozone[O -8h])and3meteorologicalvariables(temperature,relativehumidity,andwind)inChina’s3worstCOVID-19-strickencitiesduring 3 thestudyperiod. ThemultivariatePoissonregressionwasperformedtounderstandtheircorrelation. Results: DailyCOVID-19incidencewaspositivelyassociatedwithPM andhumidityinallcities. Specifically,therelativerisk(RR)ofPM 2.5 2.5 fordailyCOVID-19incidenceswere1.036(95%confidenceinterval[CI],1.032-1.039)inWuhan,1.059(95%CI,1.046-1.072)inXiaogan, and1.144(95%CI,1.12-1.169)inHuanggang. TheRRofhumidityfordailyCOVID-19incidencewasconsistentlylowerthanthatofPM, 2.5 andthisdifferencerangedfrom0.027to0.111. Moreover,PM andtemperaturealsoexhibitedanotablecorrelationwithdailyCOVID-19 10 incidence,butinanegativepatternTheRRofPM fordailyCOVID-19incidencerangedfrom0.915(95%CI,0.896-0.934)to0.961(95%CI, 10 0.95-0.972,whilethatoftemperaturerangedfrom0.738(95%CI,0.717-0.759)to0.969(95%CI,0.966-0.973). Conclusions: OurdatashowthatPM andhumidityaresubstantiallyassociatedwithanincreasedriskofCOVID-19andthatPM and 2.5 10 temperaturearesubstantiallyassociatedwithadecreasedriskofCOVID-19. (Received14April2020;accepted5May2020;electronicallypublished11May2020) Since it first appeared in Wuhan, China, in December 2019, virus particles can attach.11 This hypothesis is supported by the coronavirus disease 2019 (COVID-19) has become a worldwide influenza-PM correlation.10,12,13AlthoughSARS-CoV-2isknown 2.5 pandemic.1-3 Severe acute respiratory syndrome coronavirus-2 to be transmitted human to human by infectious secretions,3 these (SARS-CoV-2)isthepathogenoftheCOVID-19,anditnowposes secretionscanbetransferredinmanydifferentways. Thus,whether athreattoglobalhealth. AsofMarch31,2020,785,979confirmed ambientairpollutantscouldaffectthetransmissionofSARS-CoVcasesand37,810deathsrelatedtoCOVID-19hadbeenrecorded 2isanurgentquestion. Additionally,meteorologicalfactorssuch among204countries.4 ashumidityandtemperaturehavealsobeensuggestedtoenhance Ambient air pollution is a well-known threat to human air pollution14,15 and to promote transmission of infectious dishealth,andsufficientevidenceisavailabletosupporttheclose ease.14TheirroleinSARS-CoV-2transmission,however,remains correlationbetweenpollutantsandincreasedrisksofnumerous diseases.5-7 In particular, ambient air pollutants have raised largelyunknown. WuhanisoneofthemostpopulatedcitiesinChina,andithasa concerns over their association with infectious diseases, some ofwhichhavecausedlocalepidemics.8-10Ithasbeenspeculated subtropicalhumidmonsoonclimate. Duetorapidindustrialization that airborne pollutants provide “condensation nuclei” to which andurbanization,boththeconcentrationandcompositionofairpollutantshavebecomehigherandmorecomplicated,16,17andpollution hasalreadycausedseverehealthproblemsforthelocalpopulation.18 Authorforcorrespondence: Yan-JunGuan,E-mail:guanyjsigma@yeah.net ApreviousstudydemonstratedthatatuberculosissurgeinWuhan aAuthorsofequalcontribution. was associated with worsening air pollution and weather.19 Citethisarticle: JiangY,WuX-J,andGuanY-J.(2020). Effectofambientairpollutants Nevertheless,nostudyhasexploredtheassociationofWuhanlocal and meteorological variables on COVID-19 incidence. Infection Control & Hospital Epidemiology,41:1011-1015,https://doi.org/10.1017/ice.2020.222 airqualityand/ormeteorologicaldatawithCOVID-19incidence.","year":2020}
{"review_pmid":"41566983","record_index":7,"pmid":"32837623","title":"Jiang-2021-The-association-between-covid--deat","abstract":"Theemergenceofcoronavirusdisease2019(COVID-19)hasbecomeaworldwidepandemicafteritsfirstoutbreakinWuhan, China. However,itremainsunclearwhetherCOVID-19deathislinkedtoambientairpollutantsormeteorologicalconditions. Wecollected thedaily COVID-19 death number, air quality index (AQI),ambient air pollutant concentrations,and meteorological variables data of Wuhan between Jan 25 and April 7, 2020. The Pearson and Poisson regression models were used accordingly tounderstandthe association between COVID-19deathsand eachriskfactor. ThedailyCOVID-19 deathswere positivelycorrelatedwithAQI(slope= 0.4±0.09,R2=0.24, p<0.01). Detailedly,PM was the onlypollutant exhibitinga 2.5 positiveassociation(relativerisk(RR)=1.079,95%CI1.071-1.086,p<0.01)withCOVID-19deaths. ThePM,SO,andCO 10 2 wereallalsosignificantlyassociatedwithCOVID-19deaths,butinnegativepattern(p<0.01). Amongthem,PM andCOhad 10 the highest and lowest RR, which equaled to 0.952 (95%CI 0.945-0.959) and 0.177 (95%CI 0.131-0.24), respectively. Additionally, temperature was inversely associated with COVID-19 deaths (RR=0.861, 95%CI 0.851-0.872, p<0.01). Contrarily, diurnal temperature range was positively associated with COVID-19 deaths (RR=1.014, 95%CI 1.003-1.025, p<0.05). ThedatasuggestedthatPM anddiurnaltemperaturerangearetightlyassociatedwithincreasedCOVID-19deaths. 2.5","year":2021}
{"review_pmid":"41566983","record_index":8,"pmid":null,"title":"Long-term Air Pollution Exposure Impact on COVID-19 Morbidity in China","abstract":"Although previous studies have proved the association between air pollution and respiratory viral infection, given the relatively short history of human infection with the severe acute respiratory syndrome coronavirus (SARS-CoV-2), the linkage between long-term air pollution exposure and the morbidity of 2019 novel coronavirus (COVID-19) pneumonia remains poorly understood. To fill this gap, this study investigates the influences of particulate matters (PM2.5 and PM10), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide (SO2) and carbon monoxide (CO) on COVID-19 incidence rate based on the prefecture-level morbidity count and air quality data in China. Annual means for ambient PM2.5, PM10, SO2, NO2, CO and O3 concentrations in each prefecture are used to estimate the population’s exposure. We leverage identical statistical methods, i.e., Spearman’s rank correlation and negative binomial regression model, to demonstrate that people who are chronically exposed to ambient air pollution are more likely to be infected by COVID-19. Our statistical analysis indicates that a 1 µg m-3 increase of PM2.5, PM10, NO2 and O3 can result in 1.95% (95% CI: 0.83-3.08%), 0.55% (95% CI: -0.05-1.17%), 4.63% (95% CI: 3.07-6.22%) rise and 2.05% (95% CI: 0.51-3.59%) decrease of COVID-19 morbidity. However, we observe nonsignificant association with long-term SO2 and CO exposure to COVID-19 morbidity in this study. Our results’ robustness is examined based on sensitivity analyses that adjust for a wide range of confounders, including socio-economic, demographic, weather, healthcare, and mobility-related variables. We acknowledge that more laboratory results are required to prove the etiology of these associations. OPEN ACCESS","year":2019}
{"review_pmid":"41566983","record_index":9,"pmid":"33963992","title":"Lu-2021-Associations-of-acute-exposure-to-a","abstract":"The outbreak of COVID-19, caused by SARS-CoV-2, has spread across many countries globally. Greatly, there are limited studiesconcernedwiththeeffectofairbornepollutantsonCOVID-19infection,whileexposuretoairbornepollutantsmayharm humanhealth. Thispaperaimedtoexaminetheassociationsofacuteexposuretoambientatmosphericpollutantstodailynewly COVID-19confirmedcasesin41Chinesecities. UsingageneralizedadditivemodelwithPoissondistributioncontrollingfor temperatureandrelativehumidity,weevaluatedtheassociationbetweenpollutantconcentrationsanddailyCOVID-19confirmationatsingle-citylevelandmulticitylevels. Weobserveda10-μg/m3riseinlevelsofPM (lag0−14),O (lag0−1),SO (lag 2.5 3 2 0),andNO (lag0−14)werepositivelyassociatedwithrelativerisksof1.050(95%CI:1.028,1.073),1.011(1.007,1.015),1.052 2 (1.022,1.083),and1.094(1.028,1.164)ofdailynewlyconfirmedcases,respectively. Furtheradjustmentforotherpollutantsdid notchangetheassociationsmaterially(exceptinginthemodelforSO ). OurresultsindicatedthatCOVID-19incidencemaybe 2 susceptible to airborne pollutants such as PM, O, SO, and NO, and mitigation strategies of environmental factors are 2.5 3 2 2 requiredtopreventspreading.","year":2021}
{"review_pmid":"41566983","record_index":10,"pmid":"33856634","title":"Ma-2021-Association-between-environmental-f","abstract":"Theoutbreakofcoronavirusdisease2019(COVID-19)continuestospreadworldwideandhasledtorecession,risingunemployment,andthecollapseofthehealth-caresystem. Theaimofthisstudywastoexploretheexposure-responserelationship betweendailyconfirmedCOVID-19casesandenvironmentalfactors. Weusedatime-seriesgeneralizedadditivemodel(GAM) toinvestigatetheshort-termassociationbetweenCOVID-19andenvironmentalfactorsbyusingdailymeteorologicalelements, airpollutantconcentration,anddailyconfirmedCOVID-19casesfromJanuary21,2020,toFebruary29,2020,inShanghai, China. WeobservedsignificantnegativeassociationsbetweendailyconfirmedCOVID-19casesandmeantemperature(T ), ave temperaturehumidityindex(THI),andindexofwindeffect(K),whereasairqualityindex(AQI),PM,PM NO,andSO 2.5 10 2 2 weresignificantlyassociatedwiththeincreaseindailyconfirmedCOVID-19cases.A1°CincreaseinT,one-unitincreasein ave THI, and 10-unit increase in K (lag 0-7 days) were associated with 4.7, 1.8, and 1.6% decrease in daily confirmed cases, respectively. Daily T, THI, K, PM, and SO had significant lag and persistence (lag 0-7 days), whereas the lag and ave 10 2 persistenceofAQI,PM,andNO weresignificantatbothlag0-7and0-14days.A10-μg/m3increaseinPM and1-μg/ 2.5 2 10 m3increaseinSO wasassociatedwith13.9and5.7%increaseindailyconfirmedcasesatlag0-7days,respectively,whereasa 2 10-unitincreaseinAQIanda10-μg/m3increaseinPM andNO wereassociatedwith7.9,7.8,and10.1%increaseindaily 2.5 2 confirmedcasesatlag0-14days,respectively. OurfindingshaveimportantimplicationsforpublichealthinthecityofShanghai.","year":2021}
{"review_pmid":"41566983","record_index":11,"pmid":"33638789","title":"Sahoo-2021-Significance-between-air-pollutants","abstract":"Severeacuterespiratorysyndromecoronavirus2(SARS-CoV-2)diseaserepresentsthecausativeagentwithapotentiallyfatal riskwhichishavinggreatglobalhumanhealthconcern. Earlierstudiessuggestedthatairpollutantsandmeteorologicalfactors wereconsideredastheriskfactorsforacuterespiratoryinfection,whichcarriesharmfulpathogensandaffectstheimmunity. The study intended to explore the correlation between air pollutants, meteorological factors, and the daily reported infected cases caused by novel coronavirus in India. The daily positive infected cases, concentrations of air pollutants, and meteorological factorsin288districtswerecollectedfromJanuary30,2020,toApril23,2020,inIndia. Spearman’scorrelationandgeneralized additivemodel(GAM)wereappliedtoinvestigatethecorrelationsoffourairpollutants(PM,PM,NO,andSO )andeight 2.5 10 2 2 meteorologicalfactors(Temp,DTR,RH,AH,AP,RF,WS,andWD)withCOVID-19-infectedcases. Thestudyindicatedthata 10μg/m3increaseduring(Lag0-14)inPM,PM,andNO resultedin2.21%(95%CI:1.13to3.29),2.67%(95%CI:0.33to 2.5 10 2 5.01), and 4.56 (95% CI: 2.22 to 6.90) increase in daily counts of Coronavirus Disease 2019 (COVID 19)-infected cases respectively. However,only1unitincreaseinmeteorologicalfactorlevelsincaseofdailymeantemperatureandDTRduring (Lag0-14)associatedwith3.78%(95%CI:1.81to5.75)and1.82%(95%CI:-1.74to5.38)riseofCOVID-19-infectedcases respectively. Inaddition,SO andrelativehumiditywerenegativelyassociatedwithCOVID-19-infectedcasesatLag0-14with 2 decreaseof7.23%(95%CI:-10.99to-3.47)and1.11%(95%CI:-3.45to1.23)forSO andforrelativehumidityrespectively. 2 ThestudyrecommendedthattherearesignificantcorrelationsbetweenairpollutantsandmeteorologicalfactorswithCOVID-19infectedcases,whichsubstantiallyexplaintheeffectofnationallockdownandsuggestedpositiveimplicationsforcontroland preventionofthespreadofSARS-CoV-2disease.","year":2021}
{"review_pmid":"41566983","record_index":12,"pmid":"34538153","title":"Singh-2022-Ambient-air-pollution-and-covid--in","abstract":"ARTICLE HISTORY This study aimed to explore the short-term health effects of ambient air Received 12 July 2021 pollutants PM 2:5, PM 10, SO 2, NO 2, O 3, and CO on COVID-19 daily new cases Accepted 1 September 2021 and COVID-19 daily new deaths. A time-series design used in this study.","year":2021}
{"review_pmid":"41566983","record_index":13,"pmid":"33087097","title":"Wang-2020-Airborne-particulate-matter-populat","abstract":"Background: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease,which has causednumerous deaths and health problemsworldwide. Thisstudy aims to examine the effects of airborne particulate matter (PM) pollution and population mobility onCOVID-19across China. Methods: We obtained daily confirmedcases ofCOVID-19, air particulate matter (PM,PM ), weather parameters 2.5 10 such as ambienttemperature (AT) and absolute humidity (AH), and population mobility scale index (MSI) in 63 cities ofChina on a daily basis (excluding Wuhan) from January 01 to March 02,2020. Then, the Generalized additive models(GAM) witha quasi-Poisson distribution were fitted to estimate theeffects ofPM, PM and MSI 10 2.5 ondaily confirmed COVID-19 cases. Results: We found each 1 unit increase indaily MSIwas significantly positively associated withdaily confirmed cases of COVID-19 inall lag days and thestrongest estimatedRR (1.21, 95% CIs:1.14~1.28) was observed at lag 014. InPM analysis,we found each 10μg/m3increasein theconcentration ofPM and PM was positively associated 10 2.5 withtheconfirmed cases of COVID-19, and theestimatedstrongest RRs (both at lag 7)were 1.05 (95% CIs: 1.04, 1.07) and 1.06 (95%CIs: 1.04, 1.07), respectively.A similar trend was also found inall cumulative lag periods (from lag 01 to lag 014). The strongest effects for both PM and PM were atlag 014, and the RRsof each 10μg/m3 10 2.5 increase were 1.18 (95% CIs:1.14, 1.22) and 1.23 (95% CIs:1.18, 1.29),respectively. Conclusions: Population mobility and airborneparticulate matter may be associated with an increased risk of COVID-19 transmission.","year":2020}
{"review_pmid":"41566983","record_index":14,"pmid":"33501581","title":"Zhou-2021-The-interactive-effects-of-ambient-","abstract":"Emergingevidencehasconfirmedmeteorologicalfactorsandairpollutantsaffectnovelcoronavirusdisease2019(COVID-19). However, no studies to date have considered the impact of interactions between meteorological factors and air pollutants on COVID-19transmission. Thisstudyexplorestheassociationbetweenambientairpollutants(PM,NO,SO,CO,andO ), 2.5 2 2 3 meteorologicalfactors(averagetemperature,diurnaltemperaturerange,relativehumidity,windvelocity,airpressure,precipitation,andhoursofsunshine),andtheirinteractiononconfirmedcasecountsofCOVID-19in120Chinesecities. Wemodeled totalconfirmedcasesofCOVID-19asthedependentvariablewithmeteorologicalfactors,airpollutants,andtheirinteractionsas theindependentvariables. Toaccountforpotentialmigrationeffects,weincludedthemigrationscaleindex(MSI)fromWuhan toeachofthe120citiesincludedinthemodel,usingdatafrom15Jan.to18Mar.2020. Asanimportantconfoundingfactor,MSI wasconsideredinanegativebinomialregressionanalysis. Positiveassociationswerefoundbetweenthenumberofconfirmed casesofCOVID-19andCO,PM,relativehumidity,andO,withandwithoutMSI-adjustment. Negativeassociationswere 2.5 3 alsofoundforSO andwindvelocitybothwithandwithoutcontrollingforpopulationmigration. Inaddition,airpollutantsand 2 meteorologicalfactorshadinteractiveeffectsonCOVID-19aftercontrollingforMSI. Inconclusion,airpollutants,meteorologicalfactors,andtheirinteractionsallaffectCOVID-19cases.","year":2021}
{"review_pmid":"41601519","record_index":1,"pmid":"26827250","title":"Effectiveness of an online insomnia program (SHUTi) for prevention of depressive episodes (the GoodNight Study): a randomised controlled trial.","abstract":"BACKGROUND: In view of the high co-occurrence of depression and insomnia, a novel way to reduce the risk of escalating depression might be to offer an insomnia intervention. We aimed to assess whether an online self-help insomnia program could reduce depression symptoms. METHODS: We did this randomised controlled trial at the Australian National University in Canberra, Australia. Internet users (aged 18-64 years) with insomnia and depression symptoms, but who did not meet criteria for major depressive disorder, were randomly assigned (1:1), via computer-generated randomisation, to receive SHUTi, a 6 week, modular, online insomnia program based on cognitive behavioural therapy for insomnia, or HealthWatch, an interactive, attention-matched, internet-based placebo control program. Randomisation was stratified by age and sex. Telephone-based interviewers, statisticians, and chief investigators were masked to group allocation. The primary outcome was depression symptoms at 6 months, as measured with the Patient Health Questionnaire (PHQ-9). The primary analysis was by intention to treat. This trial is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12611000121965. FINDINGS: Between April 30, 2013, and June 9, 2014, we randomly assigned 1149 participants to receive SHUTi (n=574) or HealthWatch (n=575), of whom 581 (51%) participants completed the study program assessments at 6 weeks and 504 (44%) participants completed 6 months' follow-up. SHUTi significantly lowered depression symptoms on the PHQ-9 at 6 weeks and 6 months compared with HealthWatch (F[degrees of freedom 2,640·1]=37·2, p<0·0001). Major depressive disorder was diagnosed in 22 (4%) participants at 6 months (n=9 in the SHUTi group and n=13 in the HealthWatch group), with no superior effect of SHUTi versus HealthWatch (Fisher's exact test=0·52; p=0·32). No adverse events were reported. INTERPRETATION: Online cognitive behaviour therapy for insomnia treatment is a practical and effective way to reduce depression symptoms and could be capable of reducing depression at the population level by use of a fully automatised system with the potential for wide dissemination. FUNDING: Australian National Health and Medical Research Council.","year":2016}
{"review_pmid":"41601519","record_index":2,"pmid":"40267472","title":"Assessment of an App-Based Sleep Program to Improve Sleep Outcomes in a Clinical Insomnia Population: Randomized Controlled Trial.","abstract":"BACKGROUND: Insomnia is the most commonly reported sleep disturbance and significantly impacts mental health and quality of life. Traditional treatments for insomnia include pharmacological interventions or cognitive behavioral therapy for insomnia (CBT-I), but these options may not be accessible to everyone who needs treatment. OBJECTIVE: This study aims to assess the effectiveness of the app-based Headspace Sleep Program in adults with clinical insomnia on sleep disturbance and mental health outcomes, compared with a waitlist control group. METHODS: This randomized controlled trial included 132 adults with clinical insomnia who were assigned to either the Headspace Sleep Program (an 18-session self-guided, in-app program utilizing CBT-I techniques augmented by mindfulness) or a waitlist control group. Sleep disturbance outcomes were assessed by changes in insomnia symptoms (measured using the Insomnia Severity Index) and sleep efficiency (measured via sleep diary and actigraphy). Mental health outcomes included perceived stress (measured by the 10-item Perceived Stress Scale), depressive symptoms (measured by the 8-item Patient Health Questionnaire), sleep quality (measured by the Pittsburgh Sleep Quality Index), anxiety symptoms (measured by the 7-item Generalized Anxiety Disorder Scale), and mindfulness (measured by the Mindful Attention Awareness Scale). Changes from baseline to postintervention and follow-up were assessed for each outcome. RESULTS: Participants had a mean (SD) age of 37.2 (10.6) years, with 69 out of 132 (52.3%) identifying as female. Those randomized to the Headspace Sleep Program group experienced significantly greater improvements in insomnia symptoms from baseline to postintervention and follow-up compared with participants in the waitlist control group (P<.001, η²p=0.107). Improvements from baseline to postintervention and follow-up were also observed in the Headspace Sleep Program group for sleep efficiency, as measured by both sleep diary (P=.01, η²p=.03) and actigraphy outcomes (P=.01, η²p=.03). Participants in the Headspace Sleep Program group showed greater improvements in insomnia remission rates (8/66, 12%, at postintervention and 9/66, 14%, at follow-up) and treatment response (11/66, 17%, at postintervention and 15/66, 23%, at follow-up) compared with the control group (remission rate 2/66, 3%, at postintervention and 0/66, 0%, at follow-up; treatment response 3/66, 5%, at postintervention and 1/66, 2%, at follow-up). The results suggest significant improvements in depressive symptoms (P=.01, η²p=.04), anxiety symptoms (P=.02, η²p=.02), and mindfulness (P=.01, η²p=.03) in the Headspace Sleep Program group. CONCLUSIONS: The Headspace Sleep Program is an effective intervention for improving sleep disturbances in adults with clinical insomnia. TRIAL REGISTRATION: ClinicalTrials.gov NCT05872672; https://clinicaltrials.gov/ct2/show/NCT05872672.","year":2025}
{"review_pmid":"41601519","record_index":3,"pmid":"40458292","title":"Digital CBT-I in Comorbid Insomnia and Depression: Clinical Outcomes From a Pragmatic Randomized Controlled Trial.","abstract":"Depression affects 8.1% of the German population annually, yet many patients remain resistant to conventional treatments. Given that 85% of individuals with depression also experience chronic insomnia, sleep may represent both a contributing and modifiable treatment factor. This study examines whether adding a fully automated digital cognitive behavioral therapy for insomnia (dCBT-I) to care-as-usual (CAU) improves depressive symptoms. Participants with comorbid depression and insomnia were randomized to either the intervention group (dCBT-I) or the waiting group (WLC). The intervention was delivered via a mobile app or web platform, consisting of 10 sequential core modules based on evidence-based CBT-I techniques. Assessments took place at baseline, 12- and 24-weeks post randomization. The primary outcome was the severity of depressive symptoms (Patient Health Questionnaire-9; PHQ-9). Secondary outcomes included insomnia severity, daytime sleepiness, fatigue, well-being and mechanistic effect measures. Linear mixed models were calculated to determine between-group effects. A total of 140 participants (120 women, mean age: M = 39.76 ± 11.65 years) were randomized to dCBT-I (n=70) or WLC (n=70). Large treatment effects at 12- and 24 weeks showed significant reductions in depressive symptoms (-3.34 and -2.83; ps <0.001; ds = 0.66-0.78) in the dCBT-I group. Treatment effects in favor of dCBT-I were also found for insomnia severity (ds = 1.46-1.94) and most secondary outcomes (ds = 0.33-1.14). This study demonstrates that digital dCBT-I can be effective not only for individuals with primary insomnia but also for those with depression. These findings align with previous research, highlighting the crucial role of sleep disturbances in depression management. Moreover, the effects remained stable even in the heterogeneous sample investigated in this study, reinforcing the robustness of dCBT-I across diverse patient groups. Thus, dCBT-I emerges as a promising adjunctive treatment. Considering these findings, it is essential to explore the integration of sleep-focused interventions into standard depression treatment. Trial Registration: German Clinical Trial Registry identifier: DRKS00030919.","year":2025}
{"review_pmid":"41601519","record_index":4,"pmid":"36972049","title":"Digital Cognitive Behavioral Therapy for Insomnia Using a Smartphone Application in China: A Pilot Randomized Clinical Trial.","abstract":"IMPORTANCE: Digital cognitive behavioral therapy for insomnia (DCBT-I) requires adaptation to different sociocultural contexts. Moreover, studies comparing DCBT-I and sleep education in the same operating interface are lacking. OBJECTIVE: To investigate the efficacy of a smartphone-based Chinese culture-adapted DCBT-I application (app) for insomnia compared with sleep education using the same app. DESIGN, SETTING, AND PARTICIPANTS: This was a single-blinded, randomized clinical trial conducted from March 2021 to January 2022. Screening and randomization were conducted at Peking University First Hospital. Follow-up visits were performed online or in the same hospital. After assessing for eligibility, eligible participants were enrolled and allocated (1:1) to DCBT-I or sleep education groups. Data were analyzed from January to February 2022. INTERVENTIONS: A Chinese smartphone-based app with the same interface was used in both DCBT-I and sleep education groups over 6 weeks, with 1-, 3-, and 6-month follow-ups. MAIN OUTCOMES AND MEASURES: The primary outcome was Insomnia Severity Index (ISI) scores with the intention-to-treat principle. Secondary and exploratory outcomes included sleep diary measures; self-reported scales assessing dysfunctional beliefs about sleep, mental health, and quality of life; and smart bracelet measures. RESULTS: Of 82 participants (mean [SD] age, 49.67 [14.49] years; 61 [74.4%] females), with 41 randomized to sleep education and 41 randomized to DCBT-I; 77 participants completed the 6-week intervention (39 participants in the sleep education group and 38 participants in the DCBT-I group; full analysis data set) and 73 completed the 6-month follow-up (per protocol data set). Mean (SD) ISI scores in the DCBT-I group were significantly lower than those in the sleep education group after the 6-week intervention (12.7 [4.8] points vs 14.9 [5.0] points; Cohen d = 0.458; P =.048) and at the 3-month follow-up (12.1 [5.4] points vs 14.8 [5.5] points; Cohen d = 0.489; P =.04). There were significant improvements from before to after the intervention for both the sleep education and DCBT-I groups, with large effect sizes(sleep education: d = 1.13; DCBT-I: d = 1.71). Some of the sleep diary measures and self-reported scales showed more improvements in the DCBT-I group than sleep education group, such as total sleep time (mean [SD]: 3 months, 403.9 [57.6] minutes vs 363.2 [72.3] minutes; 6 months, 420.3 [58.0] minutes vs 389.7 [59.4] minutes) and sleep efficiency (mean [SD]: 3 months, 87.4% [8.3%] vs 76.7% [12.1%]; 6 months, 87.5% [8.2%] vs 78.1% [10.9%]). CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, the smartphone-based Chinese culture-adapted DCBT-I improved insomnia severity compared with sleep education. Future multicenter clinical trials with large sample sizes are needed to validate its effectiveness in the Chinese population. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04779372.","year":2023}
{"review_pmid":"41601519","record_index":5,"pmid":"39257295","title":"Digital cognitive behavioural therapy for insomnia versus digital sleep education control in an Australian community-based sample: a randomised controlled trial.","abstract":"BACKGROUND: Insomnia is a prevalent condition in Australia that increases the risk of depression and anxiety symptoms. Cognitive behaviour therapy for insomnia (CBT-i) is the recommended 'first line' treatment but is accessed by a minority of people with insomnia. AIMS: To improve CBT-i access in Australia, we aimed to develop and test a self-guided interactive digital CBT-i program. METHODS: An online randomised controlled trial was conducted from August 2022 to August 2023 to investigate the effect of digital CBT-i, versus digital sleep education control, on symptoms of insomnia (ISI), depression (PHQ-9), anxiety (GAD-7), fatigue, sleepiness and maladaptive beliefs about sleep at 8-week follow-up. The control group accessed the intervention after the 8-week follow-up. Questionnaires were additionally administered at 16 and 24 weeks. Intent-to-treat mixed models and complete-case chi-squared analyses were used. RESULTS: Participants included 62 adults with insomnia symptoms (age M (SD) = 52.5 (16.3), 82% female, ISI = 18.6 (2.9)). There were no between-group differences in baseline characteristics or missing 8-week data (14.5%). After adjusting for baseline scores, CBT-i was associated with lower insomnia (Diffadj (95% CI) = 7.32 (5.0-9.6), P < 0.001, d = 1.64), depression (3.36 (1.3-5.4), p = 0.002, d = 0.84), fatigue (5.2 (2.5-7.9), P < 0.001, d = 1.00) and maladaptive beliefs about sleep (11.0 (4.1-18.0), P = 0.002, d = 0.82), but not anxiety symptoms at 8 weeks (1.84 (-0.1 to 3.8), p = 0.060, d = 0.50). Compared to control, CBT-i was associated with greater rates of insomnia remission (ISI <8; 0.0%, vs 40.0%, P < 0.001) and response at 8 weeks (ISI reduction ≥6; 7.1% vs 72.0%, P < 0.001). Improvements in insomnia and depression were maintained at 24 weeks in the CBT-i group. CONCLUSIONS: This interactive digital CBT-i program resulted in large and sustained improvements in symptoms of insomnia, depression, fatigue and maladaptive beliefs about sleep in Australian adults with insomnia symptoms. Implementation programs are required to increase digital CBT-i access and uptake.","year":2024}
{"review_pmid":"41601519","record_index":6,"pmid":"39675747","title":"Effectiveness and safety of an interactive internet-based intervention to improve insomnia: Results from a randomised controlled trial.","abstract":"Many adults suffer from insomnia. Cognitive-behavioural therapy for insomnia is the recommended treatment option, but access to it is not readily available. Digital interventions have the potential to close the treatment gap by offering scalable and cost-efficient options. The present randomised controlled trial aimed at investigating the effectiveness and safety of somnovia, an interactive internet-based intervention for patients with insomnia. A total of 290 participants with chronic insomnia were randomised to intervention (n = 149) or the control (n = 141) condition. Participants of the intervention group received access to somnovia for 6 months in addition to treatment as usual, whereas participants in the control group only had access to treatment as usual for the time of the study. Online questionnaires were filled in before randomisation and after 3 and 6 months. The primary endpoint was the Insomnia Severity Index, with the Patient Health Questionnaire-9, the Generalised Anxiety Disorder Assessment-7, and the Work and Social Adjustment Scale as secondary endpoints. After 3 months, the intervention group showed lower insomnia (Cohen's d = 0.71, CI = [0.44, 0.98]), depressive (Cohen's d = 0.66, CI = [0.41, 0.90]), and anxiety (Cohen's d = 0.56, CI = [0.32, 0.81]) symptoms, as well as improved overall functioning (Cohen's d = 0.50, CI = [0.24, 0.76]) compared with participants in the control group. The effects stayed stable after 6 months. The results indicate that next to a therapeutic effect on insomnia symptoms, somnovia might potentially help to prevent the onset of other psychiatric disorders such as depression and anxiety.","year":2025}
{"review_pmid":"41601519","record_index":7,"pmid":"32234700","title":"Efficacy of a Theory-Based Cognitive Behavioral Technique App-Based Intervention for Patients With Insomnia: Randomized Controlled Trial.","abstract":"BACKGROUND: Sleep hygiene is important for maintaining good sleep and reducing insomnia. OBJECTIVE: This study examined the long-term efficacy of a theory-based app (including cognitive behavioral therapy [CBT], theory of planned behavior [TPB], health action process approach [HAPA], and control theory [CT]) on sleep hygiene among insomnia patients. METHODS: The study was a 2-arm single-blind parallel-group randomized controlled trial (RCT). Insomnia patients were randomly assigned to a treatment group that used an app for 6 weeks (ie, CBT for insomnia [CBT-I], n=156) or a control group that received only patient education (PE, n=156) through the app. Outcomes were assessed at baseline and 1 month, 3 months, and 6 months postintervention. Primary outcomes were sleep hygiene, insomnia, and sleep quality. Secondary outcomes included attitudes toward sleep hygiene behavior, perceived behavioral control, behavioral intention, action and coping planning, self-monitoring, behavioral automaticity, and anxiety and depression. Linear mixed models were used to evaluate the magnitude of changes in outcomes between the two groups and across time. RESULTS: Sleep hygiene was improved in the CBT-I group compared with the PE group (P=.02 at 1 month, P=.04 at 3 months, and P=.02 at 6 months) as were sleep quality and severity of insomnia. Mediation analyses suggested that perceived behavioral control on sleep hygiene as specified by TPB along with self-regulatory processes from HAPA and CT mediated the effect of the intervention on outcomes. CONCLUSIONS: Health care providers might consider using a CBT-I app to improve sleep among insomnia patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT03605732; https://clinicaltrials.gov/ct2/show/NCT03605732.","year":2020}
{"review_pmid":"41601519","record_index":8,"pmid":"40014347","title":"Emotional Processing Following Digital Cognitive Behavioral Therapy for Insomnia in People With Depressive Symptoms: A Randomized Clinical Trial.","abstract":"IMPORTANCE: Cognitive behavioral therapy for insomnia (CBT-I) has been shown to reduce depressive symptoms, but the underlying mechanisms are not well understood and warrant further examination. OBJECTIVE: To investigate whether CBT-I modifies negative bias in the perception of emotional facial expressions and whether such changes mediate improvement in depressive symptoms. DESIGN, SETTING, AND PARTICIPANTS: A randomized clinical trial of digital CBT-I vs sleep hygiene education was conducted. Adults living in the UK who met diagnostic criteria for insomnia disorder and Patient Health Questionnaire-9 criteria (score ≥10) for depression were recruited online from the community and randomly assigned to either a 6-session digital CBT-I program or a sleep hygiene webpage. Participant recruitment took place between April 26, 2021, and January 24, 2022, and outcomes were assessed at 5 and 10 weeks post randomization. Data analysis was performed from December 1, 2022, to March 1, 2023. MAIN OUTCOMES AND MEASURES: Coprimary outcomes were recognition accuracy (percentage) of happy and sad facial expressions at 10 weeks assessed with the facial expression recognition task. Secondary outcomes were self-reported measures of insomnia, depressive symptoms, affect, emotional regulation difficulties, worry, perseverative thinking, midpoint of sleep, social jet lag, and the categorization of and recognition memory for emotional words. Intention-to-treat analysis was used. RESULTS: A total of 205 participants were randomly assigned to CBT-I (n = 101) or sleep hygiene education (n = 104). The sample had a mean (SD) age of 49.3 (10.1) years and was predominately female (165 [80.8%]). Retention was 85.7% (n = 175). At 10 weeks, the estimated adjusted mean difference for recognition accuracy was 3.01 (97.5% CI, -1.67 to 7.69; P =.15; Cohen d = 0.24) for happy facial expressions and -0.54 (97.5% CI, -3.92 to 2.84; P =.72; Cohen d = -0.05) for sad facial expressions. At 10 weeks, CBT-I compared with control decreased insomnia severity (adjusted difference, -4.27; 95% CI, -5.67 to -2.87), depressive symptoms (adjusted difference, -3.91; 95% CI, -5.20 to -2.62), negative affect (adjusted difference, -2.75; 95% CI, -4.58 to -0.92), emotional regulation difficulties (adjusted difference, -5.96; 95% CI, -10.61 to -1.31), worry (adjusted difference, -8.07; 95% CI, -11.81 to -4.33), and perseverative thinking (adjusted difference, -4.21; 95% CI, -7.03 to -1.39) and increased positive affect (adjusted difference, 4.99; 95% CI, 3.13-6.85). Improvement in negative affect, emotional regulation difficulties, and worry at week 5 mediated the effect of CBT-I on depression severity at 10 weeks (% mediated: 21.9% Emotion regulation difficulties; 24.4% Worry; and 29.7% Negative affect). No serious adverse events were reported to the trial team. CONCLUSIONS AND RELEVANCE: This randomized clinical trial did not find evidence that CBT-I engenders change in the perception of facial expressions at post treatment, despite improvements in insomnia and depressive symptoms. Early change in negative affect, emotional regulation difficulties, and worry mediated lagged depression outcomes and deserve further empirical scrutiny. TRIAL REGISTRATION: isrctn.org Identifier: ISRCTN17117237.","year":2025}
{"review_pmid":"41601519","record_index":9,"pmid":"32810921","title":"Insomnia as a mediating therapeutic target for depressive symptoms: A sub-analysis of participant data from two large randomized controlled trials of a digital sleep intervention.","abstract":"Insomnia predicts the onset of depression, commonly co-presents with depression and often persists following depression remission. However, these conditions can be challenging to treat concurrently using depression-specific therapies. Cognitive behavioural therapy for insomnia may be an appropriate treatment to improve both insomnia and depressive symptoms. We examined the effects of a fully-automated digital cognitive behavioural therapy intervention for insomnia (Sleepio) on insomnia and depressive symptoms, and the mediating role of sleep improvement on depressive symptoms in participants from two randomized controlled trials of digital cognitive behavioural therapy for insomnia. We also explored potential moderators of intervention effects. All participants met criteria for probable insomnia disorder and had clinically significant depressive symptomatology (PHQ-9 ≥ 10; n = 3,352). Individuals allocated to treatment in both trials were provided access to digital cognitive behavioural therapy. Digital cognitive behavioural therapy significantly improved insomnia (p <.001; g = 0.76) and depressive symptoms (p <.001; g = 0.48) at post-intervention (weeks 8-10), and increased the odds (OR = 2.9; 95% CI = 2.34, 3.65) of clinically significant improvement in depressive symptoms (PHQ-9 < 10). Improvements in insomnia symptoms at mid-intervention mediated 87% of the effects on depressive symptoms at post-intervention. No variables moderated effectiveness outcomes, suggesting generalizability of these findings. Our results suggest that effects of digital cognitive behavioural therapy for insomnia extend to depressive symptoms in those with clinically significant depressive symptomatology. Insomnia may, therefore, be an important therapeutic target to assist management of depressive symptoms.","year":2021}
{"review_pmid":"41601519","record_index":10,"pmid":"22055281","title":"Internet-delivered or mailed self-help treatment for insomnia?: a randomized waiting-list controlled trial.","abstract":"Cognitive Behavioral Therapy (CBT) is effective in reducing insomnia complaints, but the effects of self-help CBT have been inconsistent. The aim of this study was to determine the effectiveness of self-help for insomnia delivered in either electronic or paper-and-pencil format compared to a waiting-list. Participants kept a diary and filled out questionnaires before they were randomized into electronic (n = 216), paper-and-pencil (n = 205), or waiting-list (n = 202) groups. The intervention consisted of 6 weeks of unsupported self-help CBT, and post-tests were 4, 18, and 48 weeks after intervention. At 4-week follow-up, electronic and paper-and-pencil conditions were superior (p <.01) compared to the waiting-list condition on most daily sleep measures (Δd = 0.29-0.64), global insomnia symptoms (Δd = 0.90-1.00), depression (Δd = 0.36-0.41), and anxiety symptoms (Δd = 0.33-0.40). The electronic and paper-and-pencil groups demonstrated equal effectiveness 4 weeks after treatment (Δd = 0.00-0.22; p >.05). Effects were sustained at 48-week follow-up. This large-scale unsupported self-help study shows moderate to large effects on sleep measures that were still present after 48 weeks. Unsupported self-help CBT for insomnia therefore appears to be a promising first option in a stepped care approach.","year":2012}
{"review_pmid":"41601519","record_index":11,"pmid":"28400355","title":"Mobile Phone-Delivered Cognitive Behavioral Therapy for Insomnia: A Randomized Waitlist Controlled Trial.","abstract":"BACKGROUND: This study is one of the first randomized controlled trials investigating cognitive behavioral therapy for insomnia (CBT-I) delivered by a fully automated mobile phone app. Such an app can potentially increase the accessibility of insomnia treatment for the 10% of people who have insomnia. OBJECTIVE: The objective of our study was to investigate the efficacy of CBT-I delivered via the Sleepcare mobile phone app, compared with a waitlist control group, in a randomized controlled trial. METHODS: We recruited participants in the Netherlands with relatively mild insomnia disorder. After answering an online pretest questionnaire, they were randomly assigned to the app (n=74) or the waitlist condition (n=77). The app packaged a sleep diary, a relaxation exercise, sleep restriction exercise, and sleep hygiene and education. The app was fully automated and adjusted itself to a participant's progress. Program duration was 6 to 7 weeks, after which participants received posttest measurements and a 3-month follow-up. The participants in the waitlist condition received the app after they completed the posttest questionnaire. The measurements consisted of questionnaires and 7-day online diaries. The questionnaires measured insomnia severity, dysfunctional beliefs about sleep, and anxiety and depression symptoms. The diary measured sleep variables such as sleep efficiency. We performed multilevel analyses to study the interaction effects between time and condition. RESULTS: The results showed significant interaction effects (P<.01) favoring the app condition on the primary outcome measures of insomnia severity (d=-0.66) and sleep efficiency (d=0.71). Overall, these improvements were also retained in a 3-month follow-up. CONCLUSIONS: This study demonstrated the efficacy of a fully automated mobile phone app in the treatment of relatively mild insomnia. The effects were in the range of what is found for Web-based treatment in general. This supports the applicability of such technical tools in the treatment of insomnia. Future work should examine the generalizability to a more diverse population. Furthermore, the separate components of such an app should be investigated. It remains to be seen how this app can best be integrated into the current health regimens. TRIAL REGISTRATION: Netherlands Trial Register: NTR5560; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5560 (Archived by WebCite at http://www.webcitation.org/6noLaUdJ4).","year":2017}
{"review_pmid":"41601519","record_index":12,"pmid":"30185239","title":"Randomized Controlled Trial to Test the Efficacy of an Unguided Online Intervention with Automated Feedback for the Treatment of Insomnia.","abstract":"BACKGROUND: Insomnia has become a major public health concern. AIMS: The study examined the efficacy of a web-based unguided self-help programme with automated feedback. The programme was based on cognitive behaviour therapy for insomnia (CBT-I). The investigation particularly focused on factors that contribute to the maintenance of insomnia and tested whether treatment effects were stable over a period of 12 months. METHOD: Fifty-six participants were randomly assigned either to web-based CBT-I or to the waiting-list control group. Included measures assessed insomnia severity, sleep-related cognitions, safety behaviours, depression, anxiety and somatization. In the intervention group, a sleep diary was used to assess sleep continuity parameters, sleep quality and daytime performance. RESULTS: Large between- and within-group effect sizes (d = 1.79, d = 1.59) for insomnia severity were found. The treatment group effect remained stable over the period of 12 months. Further, sleep-related cognitions, safety behaviours, depression and somatization significantly decreased in the treatment group compared with the control group. On all sleep diary parameters, medium to large effects were revealed within the treatment group. Anxiety did not decrease significantly from pre- to post-assessment. For all measures except somatization and anxiety significant within-group effects were found at 12-month follow-up assessment indicating long-lasting effects. CONCLUSIONS: This study adds evidence to the literature on unguided online interventions for insomnia, and indicates that online CBT-I can have substantial long-term effects on relevant sleep-related outcome parameters. Moreover, the results indicate that sleep-related cognitions and safety behaviour can be successfully altered with an unguided CBT-I intervention.","year":2019}
{"review_pmid":"41601519","record_index":13,"pmid":"38356341","title":"The clinical effect of digital cognitive behavioural therapy for insomnia in subgroups with depressive and anxiety symptoms: A secondary analysis of a randomized-controlled trial.","abstract":"Insomnia is a highly prevalent mental disorder, and is often co-occurring with depression and anxiety disorders. Cognitive behavioural therapy for insomnia as treatment of choice for insomnia can also be applied digitally (digital cognitive behavioural therapy for insomnia), making it more accessible. This is a secondary data analysis of a two-armed parallel randomized-controlled trial. In the primary publication, N = 238 participants meeting criteria for the 5th edition of Diagnostic and Statistical Manual of Mental Disorders chronic insomnia disorder were randomly assigned to either 8 weeks of digital cognitive behavioural therapy for insomnia + treatment-as-usual, or waitlist + treatment-as-usual. To determine the clinical effects of digital cognitive behavioural therapy for insomnia in populations with comorbid anxiety and depression symptoms, this secondary analysis focused on two subgroups: (1) participants with high initial depressive symptoms; and (2) participants with high initial anxiety symptoms. Symptoms of insomnia, depression and anxiety as primary outcome measures were obtained at baseline, 8 weeks post-randomization and, in the intervention group only, at 6- and 12-months follow-up. At 8 weeks post-randomization, the use of digital cognitive behavioural therapy for insomnia in both subgroups was associated with large reductions in insomnia severity in comparison to control (depression subgroup: d = 2.37; anxiety subgroup: d = 2.13). Between-group treatment effects were also observed for symptoms of depression in the depression subgroup (d = 1.59), and for symptoms of anxiety in the anxiety subgroup (d = 1.28). Within-group effects were stable over time (d = 0.64-1.63). This secondary analysis shows that digital cognitive behavioural therapy for insomnia reduces insomnia and comorbid symptoms in participants with high initial symptoms of either depression or anxiety with sustained long-term effects.","year":2024}
{"review_pmid":"41601519","record_index":14,"pmid":"37310329","title":"Treating depression with a smartphone-delivered self-help cognitive behavioral therapy for insomnia: a parallel-group randomized controlled trial.","abstract":"BACKGROUND: Despite its efficacy in treating comorbid insomnia and depression, cognitive behavioral therapy for insomnia (CBT-I) is limited in its accessibility and, in many countries, cultural compatibility. Smartphone-based treatment is a low-cost, convenient alternative modality. This study evaluated a self-help smartphone-based CBT-I in alleviating major depression and insomnia. METHODS: A parallel-group randomized, waitlist-controlled trial was conducted with 320 adults with major depression and insomnia. Participants were randomized to receive either a 6-week CBT-I via a smartphone application, proACT-S, or waitlist condition. The primary outcomes included depression severity, insomnia severity, and sleep quality. The secondary outcomes included anxiety severity, subjective health, and acceptability of treatment. Assessments were administered at baseline, post-intervention (week 6) follow-up, and week 12 follow-up. The waitlist group received treatment after the week 6 follow-up. RESULTS: Intention to treat analysis was conducted with multilevel modeling. In all but one model, the interaction between treatment condition and time at week 6 follow-up was significant. Compared with the waitlist group, the treatment group had lower levels of depression [Center for Epidemiologic Studies Depression Scale (CES-D): Cohen's d = 0.86, 95% CI (-10.11 to -5.37)], insomnia [Insomnia Severity Index (ISI): Cohen's d = 1.00, 95% CI (-5.93 to -3.53)], and anxiety [Hospital Anxiety and Depression Scale - Anxiety subscale (HADS-A): Cohen's d = 0.83, 95% CI (-3.75 to -1.96)]. They also had better sleep quality [Pittsburgh Sleep Quality Index (PSQI): Cohen's d = 0.91, 95% CI (-3.34 to -1.83)]. No differences across any measures were found at week 12, after the waitlist control group received the treatment. CONCLUSION: proACT-S is an efficacious sleep-focused self-help treatment for major depression and insomnia. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04228146. Retrospectively registered on 14 January 2020. http://www.w3.org/1999/xlink\">https://clinicaltrials.gov/ct2/show/NCT04228146.","year":2023}
{"review_pmid":"41617837","record_index":1,"pmid":"36858215","title":"Ambient temperature and air pollution associations with suicide and homicide mortality in California: A statewide case-crossover study.","abstract":"BACKGROUND: Higher ambient temperature and air pollution may contribute to increased risk of behaviors harmful to oneself or to others; however, quantitative evidence is limited. We examined the relationship of deaths due to suicide and homicide with temperature and air pollution in California-a state prone to high levels of both exposures. METHOD: California death certificates from 2014 to 2019 were used to identify deaths due to suicide and homicide. Residential data for decedents were used to assign exposure to daily temperature (maximum[Tmax], minimum[Tmin]) and daily average air pollution concentrations (particulate matter <10 μm[PM10] and < 2.5 μm[PM2.5], nitrogen dioxide[NO2], ozone[O3]). Tmin served as a surrogate for nighttime temperature. A time-stratified case-crossover study design using conditional logistic regression was used to assess the effects of daily exposure to temperature and air pollutants on suicide and homicide mortality, adjusting for relative humidity. Effect modification by sex and age was assessed. RESULTS: We observed 24,387 deaths due to suicide and 10,767 deaths due to homicide. We found a monotonic temperature association for both outcomes. A 5 °C increase in Tmax at lag-2 and Tmin at lag-0 was associated with 3.1 % (95 % confidence interval [CI]: 1.1 %-5.2 %) and 3.8 % (95%CI: 0.9 %-6.8 %) increased odds of death due to suicide, respectively. The increased odds of homicide mortality per 5 °C increase in Tmax at lag-0 and Tmin at lag-1 were 4.9 % (95%CI: 1.6 %-8.1 %) and 6.2 % (95%CI: 1.6 %-11.0 %), respectively. No air pollutant associations were statistically significant. Temperature associations were robust after adjustment for PM2.5. Some temperature effects were larger among women for suicide and men for homicide mortality, and among those over age 65 years for both outcomes. CONCLUSION: Risk of suicide and homicide mortality increases with increasing daily ambient temperatures. Findings have public health relevance given anticipated increases in temperatures due to global climate change.","year":2023}
{"review_pmid":"41617837","record_index":2,"pmid":"29662001","title":"Association between Ambient Temperatures and Mental Disorder Hospitalizations in a Subtropical City: A Time-Series Study of Hong Kong Special Administrative Region.","abstract":"Background: Mental disorders have been found to be positively associated with temperature in cool to cold climatic regions but the association in warmer regions is unclear. This study presented the short-term association between temperatures and mental disorder hospitalizations in a subtropical city with a mean annual temperature over 21 °C. Methods: Using Poisson-generalized additive models and distributed-lagged nonlinear models, daily mental disorder hospitalizations between 2002 and 2011 in Hong Kong were regressed on daily mean temperature, relative humidity, and air pollutants, adjusted for seasonal trend, long-term trend, day-of-week, and holiday. Analyses were stratified by disease class, gender and age-group. Results: 44,600 admissions were included in the analysis. Temperature was positively associated with overall mental-disorder hospitalizations (cumulative relative risk at 28 °C vs. 19.4 °C (interquartile range, lag 0-2 days) = 1.09 (95% confidence interval 1.03, 1.15)), with the strongest effect among the elderly (≥75 years old). Transient mental disorders due to conditions classified elsewhere and episodic mood disorders also showed strong positive associations with temperature. Conclusion: This study found a positive temperature-mental-disorder admissions association in a warm subtropical region and the association was most prominent among older people. With the dual effect of global warming and an aging population, targeted strategies should be designed to lower the disease burden.","year":2018}
{"review_pmid":"41617837","record_index":3,"pmid":"36115187","title":"Climatic exposures in childhood and the risk of schizophrenia from childhood to early adulthood.","abstract":"BACKGROUND: Season of birth is a risk factor of schizophrenia, and it is possible that cumulative exposure to climatic factors during childhood affects the risk of schizophrenia. We conducted a cohort study among 365,482 persons born in Finland in 1990-1995 to examine associations of 10-year cumulative exposure to global solar radiation and ambient temperature in childhood with schizophrenia. METHODS: Data on schizophrenia diagnoses and sociodemographic factors from the Finnish population register and health care register were linked to daily meteorological data using residential information. The study population was followed from age 10 until the first schizophrenia diagnosis, death, emigration or December 31, 2017, whichever came first. Hazard ratios (HR) for the risk of schizophrenia were estimated using Cox proportional hazards model. RESULTS: Compared to the lowest quintile of global solar radiation or ambient temperature, growing up in the second highest quintile (Q4) was associated with greater risk of schizophrenia. These hazard ratios were attenuated after adjustment for parental mental disorder, parental education, parental income, area-level socioeconomic characteristics and urbanicity (HR = 1.29, 95 % CI 1.06-1.58 for radiation; HR = 1.24, 95 % CI, 1.02-1.52 for temperature). Continuous linear terms evaluated in secondary models suggested a greater risk of schizophrenia at greater childhood exposure to global radiation and ambient temperature, but these associations did not remain in fully adjusted models. CONCLUSIONS: We found no consistent evidence that cumulative exposure to sunlight and ambient temperature in childhood is associated with the risk of developing schizophrenia. Studies in other populations residing in different latitudes are needed.","year":2022}
{"review_pmid":"41617837","record_index":4,"pmid":"36781013","title":"Daily changes in ambient air pollution concentrations and temperature and suicide mortality in Canada: Findings from a national time-stratified case-crossover study.","abstract":"INTRODUCTION: Worldwide, approximately 1900 people die by suicide daily. Daily elevations in air pollution and temperature have previously been linked to a higher risk of death from suicide. To date, there have been relatively few studies of air pollution and suicide, particularly at a national level. National analyses play an important role in shaping health policy to mitigate against adverse health outcomes. METHODS: We used a time-stratified case-crossover study design to investigate the influence of short-term (i.e., day to day) interquartile range (IQR) increases in air pollutants (nitrogen dioxide [NO2], ozone [O3], and fine particulate matter [PM2.5]) and temperature on suicide mortality in Canada between 2002 and 2015. For air pollution models, odds ratios (ORs) derived from conditional logistic regression models were adjusted for average daily temperature, and holidays. For temperature models, ORs were adjusted for holidays. Stratified analyses were undertaken by suicide type (non-violent and violent), sex, age, and season. RESULTS: Analyses are based on 50,800 suicide deaths. Overall, temperature effects were stronger than those for air pollution. A same day IQR increase in temperature (9.6 °C) was associated with a 10.1% increase (95% confidence interval (CI): 9.0%-11.2%) of death from suicide. For 3-day average increase of O3 (IQR = 14.1 ppb), PM2.5 (IQR = 5.6 μg/m3) and NO2 (IQR = 9.7 ppb) the corresponding risks were 4.7% (95% CI: 3.9, 5.6), 3.4% (95% CI: 3.0, 3.8), and 2.0% (95% CI: 1.1, 2.8), respectively. All pollutants showed stronger associations with suicide during the warmer season (April-September). Stratified analyses revealed stronger associations for both temperature and air pollution in women. CONCLUSIONS: Daily increases in air pollution and temperature were found to increase the risk of death from suicide. Females, particularly during warmer season, were most vulnerable to these exposures. Policy decisions related to air pollution and climate change should consider effects on mental health.","year":2023}
{"review_pmid":"41617837","record_index":5,"pmid":"38815717","title":"Daily temperature variability and mental health-related hospital visits in New York State.","abstract":"BACKGROUND: Despite plausible behavioral and physiological pathways, limited evidence exists on how daily temperature variability is associated with acute mental health-related episodes. OBJECTIVES: We aimed to explore associations between daily temperature range (DTR) and mental health-related hospital visits using data of all hospital records in New York State during 1995-2014. We further examined factors that may modify these associations, including age, sex, hospital visit type and season. METHODS: Using a case-crossover design with distributed lag non-linear DTR terms (0-6 days), we estimated associations between ZIP Code-level DTR and hospital visits for mood (4.6 million hospital visits), anxiety (2.4 million), adjustment (∼368,000), and schizophrenia disorders (∼211,000), controlling for daily mean temperature, via conditional logistic regression models. We assessed potential heterogeneity by age, sex, hospital visit type (in-patient vs. out-patient), and season (summer, winter, and transition seasons). RESULTS: For all included outcomes, we observed positive associations from period minimum DTR (0.1 °C) until 25th percentile (5.2 °C) and between mean DTR (7.7 °C) and 90th percentile (12.2 °C), beyond which we observed negative associations. For mood disorders, an increase in DTR from 0.1 °C to 12.2 °C was associated with a cumulative 16.0% increase (95% confidence interval [CI]: 12.8, 19.2%) in hospital visit rates. This increase was highest during transition seasons (32.5%; 95%CI: 26.4, 39.0%) compared with summer (10.7%; 95%CI: 4.8, 16.8%) and winter (-1.6%; 95%CI: -7.6, 4.7%). For adjustment and schizophrenia disorders, the strongest associations were seen among the youngest group (0-24 years) with almost no association in the oldest group (65+ years). We observed no evidence for modification by sex and hospital visit type. DISCUSSION: Daily temperature variability was positively associated with mental health-related hospital visits within specific DTR ranges in New York State, after controlling for daily mean temperature. Given uncertainty on how climate change modifies temperature variability, additional research is crucial to comprehend the implications of these findings, particularly under different scenarios of future temperature variability.","year":2024}
{"review_pmid":"41617837","record_index":6,"pmid":"29567010","title":"Effect of increasing temperature on daily hospital admissions for schizophrenia in Hefei, China: a time-series analysis.","abstract":"OBJECTIVE: To investigate the relationship between ambient temperature and hospital admissions for schizophrenia in Hefei, China. STUDY DESIGN: An ecological design was used to explore the effect of ambient temperature on hospital admissions for schizophrenia. METHODS: Daily data on hospital admissions for schizophrenia and meteorological data for the warm season (May-October) in 2005-2014 were obtained from Anhui Mental Health Centre and Hefei Bureau of Meteorology, respectively. Poisson generalised linear regression model combined with a distributed lag non-linear model was used to analyse the effects of temperature on admissions for schizophrenia. Stratified analyses according to individual characteristics, such as age and sex, were also conducted. RESULTS: A significant relationship was found between ambient temperature and admissions for schizophrenia. High temperature appeared to have a delayed effect on admissions for schizophrenia, and a temperature of 28°C (75th percentile) at lag 0-4 days was associated with a 7% (95% confidence interval: 4-11%) increase in admissions for schizophrenia. Stratified analyses showed that male patients, patients aged 21-60 years and married patients were more vulnerable to high temperature, and the temperature effects for those groups occurred at a lag of 1 day. CONCLUSION: High temperature poses significant risks for schizophrenia in subtropical regions. Future preventive measures for reducing the occurrence of schizophrenia should be considered for susceptible populations.","year":2018}
{"review_pmid":"41617837","record_index":7,"pmid":"39729086","title":"Extreme Heat Stress and Unplanned Hospital Admissions.","abstract":"OBJECTIVES: The burden and health impact of heat stress on child hospitalization is limited. This study aims to investigate associations between extreme heat stress exposure based on a Universal Thermal Climate Index (UTCI), emergency department (ED) visits, and ED visits that translate into unplanned hospital admissions. METHODS: This population-based case-crossover study included all ED visits and unplanned hospital admissions among children and adolescents aged 0 to 18 years from New South Wales, Australia, from July 2001 to June 2020. Heat stress was measured by heatwave days defined as 2 consecutive days or more with daily maximum UTCI in the 95th percentile or higher. Distributed lag nonlinear regression models with a quasi-Poisson distribution were applied, and the relative risks from the models were presented. RESULTS: Totals of 8 240 170 ED visits and 1 427 736 unplanned hospital admissions were recorded. Compared with nonheatwave days, heatwave days were associated with an increased risk of ED visits and hospital admissions due to infectious diseases and infectious enteritis by 5% to 17% and heat-related illness by 78% to 104%. Findings were consistent for subgroup analyses. Children aged younger than 1 year and those from the most disadvantaged areas were more vulnerable to heat-related illness on heatwave days. Effects on hospitalization were attenuated using ambient temperature only. CONCLUSIONS: This study provides evidence of the effectiveness of UTCI to more completely demonstrate the harmful impact of extreme heat stress on increased infection and heat-related hospitalizations among children, which were not fully captured by using ambient temperature alone. Findings can inform targeted area-based strategies, particularly among vulnerable groups to mitigate the effects of extreme heat events.","year":2025}
{"review_pmid":"41617837","record_index":8,"pmid":"38326654","title":"Immediate and delayed effects of environmental temperature","abstract":"This study aimed to investigate the associations between environmental temperature and schizophrenia admissions in Liuzhou, China. A Poisson generalized linear model combined with a distributed lag nonlinear model was used to analyze the effects of daily mean temperature on schizophrenia admissions from 2013 to 2020 in Liuzhou. Additionally, subgroup analyses were conducted to investigate possible modifications stratified by gender, marital status, and age. In this study, 10,420 schizophrenia admissions were included. The relative risks of schizophrenia admissions increased as the temperature rose, and the lag effects of high temperature on schizophrenia admissions were observed when the daily mean temperature reached 21.65°C. The largest single effect was observed at lag0, while the largest cumulative effect was observed at lag6. The single effects of high temperatures on schizophrenia admissions were statistically significant in both males and females, but the cumulative effects were statistically significant only in males, with the greatest effect at lag0-7. The single effect of high temperatures on admissions for unmarried schizophrenics was greatest at lag5, while the maximum cumulative effect for unmarried schizophrenia was observed at lag0-7. The single effects of high temperatures on schizophrenia admissions were observed in those aged 0-20, 21-40, and 41-60. The cumulative effects for schizophrenics aged 21-40 were observed from lag0-3 to lag0-7, with the maximum effect at lag0-7. In conclusion, the risk of schizophrenia admissions increased as the environmental temperature increased. The schizophrenics who were unmarried appeared to be more vulnerable to the single and cumulative effects of high temperature.","year":2024}
{"review_pmid":"41617837","record_index":9,"pmid":"32631375","title":"Risk assessment of temperature and air pollutants on hospitalizations for mental and behavioral disorders in Curitiba, B","abstract":"Background: Extreme ambienttemperatures and air qualityhave been directly associated with various human diseases from several studies around theworld. However, few analyses involving theassociationof these environmental circumstanceswith mental and behavioral disorders (MBD) have been carried out, especially in developing countries such as Brazil. Methods: A time series study was carried out to explore theassociationsbetween daily air pollutants (SO,NO,O, 2 2 3 and PM ) concentrations and meteorological variables (temperature and relative humidity) on hospital admissions 10 for mental and behavioraldisordersfor Curitiba, Brazil. Daily hospital admissions from 2010 to 2016 were analyzed bya semi-parametric generalizedadditive model (GAM) combined with a distributed lag non-linear model (DLNM). Results: Significantassociationsbetweenenvironmentalconditions(10μg/m3increaseinairpollutantsandtemperature°C) andhospitalizationsbyMBDwerefound. Airtemperaturewastheenvironmentalvariablewiththehighestrelativerisk(RR) at0-daylagforallagesandsexesanalyzed,withRRvaluesof1.0182(95%CI:1.0009-1.0357)formen,and1.0407(95%CI: 1.0230-1.0587)forwomen. Ozoneexposurewasariskforallwomengroups,beinghigherfortheyounggroup,withaRR of1.0319(95%CI:1.0165-1.0483). Elderlyfrombothsexesweremoresusceptibletotemperaturevariability,withaRRof 1.0651(95%CI:1.0213-1.1117)forwomen,and1.0215(95%CI:1.0195-1.0716)formen. Conclusions: Thisstudysuggeststhattemperaturesaboveandbelowthethermalcomfortthreshold,inadditiontohigh concentrationsofairpollutants,presentsignificantrisksonhospitalizationsbyMBD;besides,therearephysiologicalandage differencesresultingfromtheeffectofthisexposure.","year":2020}
{"review_pmid":"41617837","record_index":10,"pmid":"32446053","title":"Short-term effect of apparent temperature on daily emergency visits for mental and behavioral disorders in Beijing, China: A time-series study","abstract":"Background: Therelationshipbetweentemperatureandmentaldisordersisstillunclear. Thisstudyaimstoassess Received20March2020 theshort-termeffectofapparenttemperature(AT)ondailyemergencyvisitsofmentalandbehavioraldisorders Receivedinrevisedform23April2020 (MDs)inBeijing,China. Accepted25April2020 Methods: DailycountsofemergencyvisitsrelatedtoMDsinBeijingfrom2016to2018wereobtained. AquasiAvailableonline28April2020 Poissongeneralizedadditivemodelcombinedwithadistributedlagnon-linearmodel(DLNM)wasappliedto analyzethelag-exposure-responserelationshipbetweenATandemergencyadmissionsrelatedtoMDs. SunEditor:SCOTTSHERIDAN shineduration,precipitation,PM,SO,O,timetrend,dayofweekandholidaywereadjustedinthemodel. 2.5 2 3 Results: TotaldailyemergencyvisitsforMDsduringthestudyperiodwere16,606. Withthereferenceof−2.4°C","year":2020}
{"review_pmid":"41617837","record_index":11,"pmid":"39883533","title":"Spatial Variation in the Association between Extreme Heat Events and Warm Season Pediatric Acute Care Utilization: A Small-Area Assessment of Multiple Health Conditions and Environmental Justice Implications in California (2005-2019).","abstract":"BACKGROUND: The increasing frequency and severity of extreme heat events due to climate change present unique risks to children and adolescents. There is a lack of evidence regarding how heat's impacts on pediatric patients vary spatially and how structural and sociodemographic factors drive this heterogeneity. OBJECTIVES: We examined the association between extreme heat events and pediatric acute care utilization in California for 19 distinct health conditions. We then assessed how extreme heat's consequences varied at the ZIP code level and identified environmental justice metrics that modulated children's vulnerability to extreme heat. METHODS: This study analyzed 7.2 million unscheduled hospitalizations and emergency department visits for children <19 years old in California between May and September from 2005 to 2019. We first utilized a time-stratified case-crossover design to generate statewide estimates for the association between extreme heat events and care utilization. We then implemented a within-community matched design coupled with a Bayesian hierarchical model to generate spatially varying effect estimates. Finally, we conducted a random effects meta-regression to examine how community-level characteristics modified heat's impacts across ZIP codes. RESULTS: Extreme heat events were associated with substantial increases in acute care utilization for all causes [odds ratio (OR)=1.03; 95% confidence interval (CI): 1.03, 1.04] and were attributable for over 30,000 excess acute care utilizations during the study period. Extreme heat events were also associated with increases in heat-related illness (OR=1.53; 95% CI: 1.49, 1.58); endocrine, nutritional, and metabolic disorders (OR=1.13; 95% CI: 1.1, 1.16); other signs and symptoms (OR=1.07; 95% CI: 1.06, 1.08); and injury and poisoning (OR=1.07; 95% CI: 1.05, 1.08). There was substantial spatial heterogeneity in extreme heat events effects, especially in coastal metropolitan areas. Communities with lower incomes and education levels, less access to insurance and air conditioning, and higher percentages of Black, Hispanic, and Pacific Islander residents were most vulnerable during extreme heat events. CONCLUSIONS: Extreme heat events in California are associated with increased pediatric care utilization. There is significant variation in heat's consequences, and historically disadvantaged and under-resourced communities are most impacted. These findings suggest that interventions designed to improve heat resilience should be targeted to protect vulnerable children. https://doi.org/10.1289/EHP14236.","year":2025}
{"review_pmid":"41617837","record_index":12,"pmid":"26069051","title":"Suicide and Ambient Temperature in East Asian Countries: A Time-Stratified Case-Crossover Analysis.","abstract":"BACKGROUND: A limited number of studies suggest that ambient temperature contributes to suicide; these studies typically focus on a single nation and use temporally and spatially aggregated data. OBJECTIVE: We evaluated the association between ambient temperature and suicide in multiple cities in three East Asian countries. METHODS: A time-stratified case-crossover method was used to explore the relationship between temperature and suicide, adjusting for potential time-varying confounders and time-invariant individual characteristics. Sex- and age-specific associations of temperature with suicide were estimated, as were interactions between temperature and these variables. A random-effects meta-analysis was used to estimate country-specific pooled associations of temperature with suicide. RESULTS: An increase in temperature corresponding to half of the city-specific standard deviation was positively associated with suicide in most cities, although average suicide rates varied substantially. Pooled country-level effect estimates were 7.8% (95% CI: 5.0, 10.8%) for a 2.3°C increase in ambient temperature in Taiwan, 6.8% (95% CI: 5.4, 8.2%) for a 4.7°C increase in Korea, and 4.5% (95% CI: 3.3, 5.7%) for a 4.2°C increase in Japan. The association between temperature and suicide was significant even after adjusting for sunshine duration; the association between sunshine and suicide was not significant. The associations were greater among men than women in 12 of the 15 cities although not significantly so. There was little evidence of a consistent pattern of associations with age. In general, associations were strongest with temperature on the same day or the previous day, with little evidence of associations with temperature over longer lags (up to 5 days). CONCLUSIONS: We estimated consistent positive associations between suicide and elevated ambient temperature in three East Asian countries, regardless of country, sex, and age. CITATION: Kim Y, Kim H, Honda Y, Guo YL, Chen BY, Woo JM, Ebi KL. 2016. Suicide and ambient temperature in East Asian countries: a time-stratified case-crossover analysis. Environ Health Perspect 124:75-80; http://dx.doi.org/10.1289/ehp.1409392.","year":2016}
{"review_pmid":"41617837","record_index":13,"pmid":"37066768","title":"Temperature and mental health-related emergency department and hospital encounters among children, adolescents and young adults.","abstract":"AIMS: We examine the association between high ambient temperature and acute mental health-related healthcare encounters in New York City for children, adolescents and young adults. METHODS: This case-crossover study included emergency department (ED) visits and hospital encounters with a primary diagnosis of any mental health disorder during warm-season months (June-August) in New York City from 2005 to 2011 from patients of three age groups (6-11, 12-17 and 18-25 years). Using a distributed lag non-linear model over 0-5 lag days, by fitting a conditional logistic regression for each age group, we calculated the cumulative odds ratios of mental health encounters associated with an elevated temperature. Analyses were stratified by race/ethnicity, payment source and mental health categories to elucidate vulnerable subpopulations. RESULTS: In New York City, there were 82,982 mental health-related encounters for young people aged 6 to 25 years during our study period months. Elevated temperature days were associated with higher risk of mental health-related ED and hospital encounters for the 6- to 11-year-olds (odds ratio [OR]: 1.28, 95% confidence interval [CI]: 1.13-1.46), for the 12- to 17-year-olds (OR: 1.17, 95% CI: 1.09-1.25) and for the 18- to 25-year-olds (OR: 1.09, 95% CI: 1.04-1.15). Children with reaction disorders, adolescents with anxiety and bipolar disorders, young adults with psychosis and reaction disorders and Black and non-Hispanic children and adolescents showed vulnerability to elevated temperature. CONCLUSIONS: We found that elevated ambient temperatures were associated with acute mental health ED or hospital encounters across childhood, adolescence and young adulthood.","year":2023}
{"review_pmid":"41617837","record_index":14,"pmid":"32688157","title":"The e ect of temperature on cause-speci c mental disorders in three subtropical cities: A case-crossover study in China","abstract":"Background: Little is known about the association between ambient temperature and cause-specific mental Keywords: disorders,especiallyinsubtropicalareas. Ambienttemperature Objective: Toinvestigatetheeffectofambienttemperatureonmentaldisordersinsubtropicalcities. Mentaldisorders Method: DailymorbiditydataformentaldisordersinthreeChinesecities(Shenzhen,Zhaoqing,andHuizhou) Case-crossover werecollectedfrommedicalrecordsystemsoflocalpsychiatricspecialisthospitals,coveringpatientsofallages. Distributedlagnonlinearmodel Case-crossoverdesigncombinedwithadistributedlagnonlinearmodel(DLNM)wasusedtoassessthenonlinear Subtropicalareas anddelayedeffectsoftemperaturesonfivespecificmentaldisorders(affectivedisorders,anxiety,depressive disorders,schizophrenia,andorganicmentaldisorders),withanalysesstratifiedbygenderandage. Thetemperatureofminimumeffectwasusedasthereferencevaluetocalculateestimates. Results: WeobservedinversedJ-shapedexposure-responsecurvesbetweentemperatureandmentalmorbidity andobservedthatlowtemperatureshadasignificantandprolongedeffectonmosttypesofmentaldisordersin thethreecities. Forexample,theeffectofthecold(2.5thpercentile)onanxietywasconsistentlyobservedinthe three cities with an odds ratio (OR) of 1.29 (95% CI: 1.06-1.57) in Zhaoqing, 1.26 (95% CI: 1.18-1.34) in Shenzhen,and1.45(95%CI:1.17-1.81)inHuizhou. Lowtemperaturewasalsoassociatedwithanincreasedrisk ofdepressivedisordersandschizophrenia. Forthehightemperatureexposure(97.5thpercentile),weonlyobservedasignificant,harmfuleffectonanxiety[OR=1.30(95%CI:1.08,1.58)inShenzhen,OR=1.16(95% CI:1.00,1.34)inZhaoqing],affectivedisorders[OR=1.32(95%CI:1.08,1.62)inShenzhen],andschizophrenia[OR=1.24(95%CI:1.03,1.48)inZhaoqing,OR=1.03(95%CI:1.00,1.06)inHuizhou]. Conclusions: Ourstudysuggeststhatbothlowandhightemperaturesmightbeimportantdriversofmorbidity frommentaldisorders,andlowtemperaturemayhaveamoregeneralandwide-spreadeffectonthiscausespecificmorbiditythanhightemperature.","year":2020}
{"review_pmid":"41617837","record_index":15,"pmid":"40180258","title":"The impact of different types of extreme temperature events on mental disorders: A case-crossover study in Anhui Province, China.","abstract":"BACKGROUND: Extreme temperatures are expected to be more frequent, intense, and complex in the context of climate change. However, epidemiologic evidence about associations between extreme temperature and mental disorders is limited. METHODS: We conducted a case-crossover study in Anhui Province, China, focusing on outpatients diagnosed with mental and behavioral disorders (ICD-10 codes: F00-F99), further classified into schizophrenia (F20-F21), depression (F32-F33), and anxiety (F40-F41). Defining the day of each outpatient visit to the Anhui Mental Health Center as the case day, a total of 762,895 case days and 3,362,574 control days were included in the study, covering the period from 2019 to 2021. Each subject was geocoded based on their home address and matched with environmental exposures, including meteorological data and air pollutant data sourced from the CN05.1 and the TAP dataset, respectively. Extreme temperature events were categorized into heat and cold extremes, further divided into daytime, nighttime, and compound extremes. RESULTS: Among the outpatient visits for mental disorders included in this study, the proportions were schizophrenia (28.9 %), depression (23.9 %), and anxiety (18.5 %). Exposure to extreme heat and cold was associated with increased risks of outpatient visits for mental disorders, with odds ratios (ORs) of 2.23 (95 %CI: 2.16-2.30) and 1.95 (95 %CI: 1.89-2.01), respectively. Compound heat extremes posed the highest risk of mental disorders (OR = 1.17, 95 %CI: 1.13-1.22), followed by nighttime (OR = 1.11, 95 %CI: 1.08-1.14) and daytime heat (OR = 1.05, 95 %CI: 1.04-1.07). Notably, the risk of mental disorders significantly elevated with the increased intensity and duration of extreme heat events. Besides, extreme heat was strongly associated with higher risks of depression, schizophrenia and anxiety, while extreme cold was notably linked to schizophrenia. CONCLUSION: These findings indicate a significant correlation between extreme temperature exposure and elevated mental disorder risks, emphasizing the urgent need to address increased mental health risks posed by extreme temperatures in the changing climate.","year":2025}
{"review_pmid":"41617837","record_index":16,"pmid":"36736551","title":"The role of extreme high humidex in depression in chongqing, China: A time series-analysis.","abstract":"As global climate change intensifies, people are paying increasing attention to the impact of temperature changes on adverse mental health outcomes, especially depression. While increasing attention has been paid to the effect of temperature, there is little research on the effect of humidity. We aimed to investigate the association between humidex, an index combining temperature and humidity to reflect perceived temperature, and outpatient visits for depression from 2014 to 2019 in Chongqing, the largest and one of the most hot and humid cities of China. We also aimed to further identify susceptible subgroups. A distributed lag non-linear model (DLNM) was used to explore the concentration-response relationship between humidex and depression outpatient visits. Hierarchical analysis was carried out by age and gender. A total of 155,436 visits for depression were collected from 2014 to 2019 (2191 days). We found that depression outpatient visits were significantly associated with extremely high humidex (≥40). The significant positive single-lag day effect existed at lag 0 (RR = 1.029, 95%CI: 1.000-1.059) to lag 2 (RR = 1.01, 95%CI: 1.004-1.028), and lag 12 (RR = 1.013, 95%CI: 1.002-1.024). The significant cumulative adverse effects lasted from lag 01 to lag 014. Hierarchical analyses showed that females and the elderly (≥60 years) appeared to be more susceptible to extremely high humidex. The attributable numbers (AN) and fraction (AF) of extremely high humidex on depression outpatients were 1709 and 1.10%, respectively. Extremely high humidex can potentially increase the risk of depression, especially in females and the elderly. More protective measures should be taken in vulnerable populations.","year":2023}
{"review_pmid":"41617837","record_index":17,"pmid":"35044241","title":"Warm Season and Emergency Department Visits to U.S. Children's Hospitals.","abstract":"BACKGROUND: Extreme heat exposures are increasing with climate change. Health effects are well documented in adults, but the risks to children are not well characterized. OBJECTIVES: We estimated the association between warm season (May to September) temperatures and cause-specific emergency department (ED) visits among U.S. children and adolescents. METHODS: This multicenter time-series study leveraged administrative data on 3.8 million ED visits by children and adolescents ≤18 years of age to the EDs of 47 U.S. children's hospitals from May to September from 2016 to 2018. Daily maximum ambient temperature was estimated in the county of the hospital using a spatiotemporal model. We used distributed-lag nonlinear models with a quasi-Poisson distribution to estimate the association between daily maximum temperature and the relative risk (RR) of ED visits, adjusting for temporal trends. We then used a random-effects meta-analytic model to estimate the overall cumulative association. RESULTS: Extreme heat was associated with an RR of all-cause ED visits of 1.17 (95% CI: 1.12, 1.21) relative to hospital-specific minimum morbidity temperature. Associations were more pronounced for ED visits due to heat-related illness including dehydration and electrolyte disorders (RR= 1.83; 95% CI: 1.31, 2.57), bacterial enteritis (1.35; 95% CI: 1.02, 1.79), and otitis media and externa (1.30; 95% CI: 1.11, 1.52). Taken together, temperatures above the minimum morbidity temperature accounted for an estimated 11.8% [95% empirical 95% confidence interval (eCI): 9.9%, 13.3%] of warm season ED visits for any cause and 31.0% (95% eCI: 17.9%, 36.5%) of ED visits for heat-related illnesses. CONCLUSION: During the warm season, days with higher temperatures were associated with higher rates of visits to children's hospital EDs. Higher ambient temperatures may contribute to a significant proportion of ED visits among U.S. children and adolescents. https://doi.org/10.1289/EHP8083.","year":2022}
{"review_pmid":"41617837","record_index":18,"pmid":"41662101","title":"Assessing the impact of heatwaves on emergency visits for major depression and suicidal ideation in youth with attention-deficit / hyperactivity disorder.","abstract":"Emerging evidence suggests that extreme heat can exacerbate mental health conditions. Yet little is known about its impact on children with attention-deficit/hyperactivity disorder (ADHD), a population at increased risk for emotional dysregulation and impulsivity. This study examines the association between heatwave exposure and emergency department visits for major depressive disorder (MDD), suicidal behavior (SUIC), and their co-occurrence among youth with ADHD. We conducted a retrospective matched-case study of 4,404 pediatric ED visits for MDD and/or SUIC in youth with ADHD in North Carolina from May to September, 2008-2021. Heatwave exposure was defined using the Excess Heat Factor and modeled as same-day, lagged (1-7 days), and cumulative (3-,5-, and 7-day) periods. Poisson mixed-effect regression models estimated relative risk (RR) and 95% confidence intervals (CI). Intersectional models further explored how risk varied by race, sex, ethnicity, and ADHD subtype. Heatwave exposure was significantly associated with increased ED visits for MDD (RR = 1.17, 95%CI: 1.01, 1.34) on the same day and overlapping MDD and SUIC (RR = 1.30, 95%CI: 1.02-1.65) on lag day one. Adolescents aged 12-17 showed heightened vulnerability across all outcomes. Cumulative exposure over 3-, 5-, and 7-day periods further elevated risks for MDD and suicidal behavior. Youth with the inattentive ADHD subtype had significantly greater odds of experiencing an overlapping MDD-suicidal event following heatwave exposure (RR = 2.70, 95%CI: 1.35-5.38). Intersectional analyses revealed that white females had the highest risk for suicide-related ED visits (RR = 1.21, 95%CI: 1.04-1.41). This study is the first to identify a link between heatwave exposure and mental health crises in youth with ADHD, emphasizing the need for targeted interventions. Findings highlight the importance of integrating climate resilience strategies into pediatric mental health care, particularly for high-risk subgroups.","year":2025}
{"review_pmid":"41639651","record_index":1,"pmid":"37409562","title":"Association of joint exposure to various ambient air pollutants during adolescence with blood pressure in young adulthood.","abstract":"The association of various air pollutants exposure during adolescence with blood pressure (BP) in young adulthood is uncertain. We intended to evaluate the long-term association of individual and joint air pollutants exposure during adolescence with BP in young adulthood. This cross-sectional study of incoming students was conducted in five geographically disperse universities in China during September and October 2018. Mean concentrations of particulate matter with diameters ≤2.5 μm (PM2.5 ), ≤10 μm (PM10 ), nitrogen dioxides (NO2 ), carbon monoxide (CO), sulfur dioxide (SO2 ), and ozone (O3 ) at participants' residential addresses during 2013-2018 were collected from the Chinese Air Quality Reanalysis dataset. Generalized linear mixed models (GLM) and quantile g-computation (QgC) models were utilized to estimate the association between individual and joint air pollutants exposure and systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP). A total of 16,242 participants were included in the analysis. The GLM analyses showed that PM2.5, PM10, NO2, CO, and SO2 were significantly positively associated with SBP and PP, while O3 was positively associated with DBP. The QgC analyses indicated that long-term exposure to a mixture of the six air pollutants had a significant positive joint association with SBP and PP. In conclusion, air pollutant co-exposure during adolescence may influence BP in young adulthood. The findings of this study emphasized the impacts of multiple air pollutants interactions on potential health and the need of minimizing pollution exposures in the environment.","year":2023}
{"review_pmid":"41639651","record_index":2,"pmid":"23086577","title":"Blood pressure changes and chemical constituents of particulate air pollution: results from the healthy volunteer natural relocation (HVNR) study.","abstract":"BACKGROUND: Elevated blood pressure (BP) has been associated with particulate matter (PM) air pollution, but associations with PM chemical constituents are still uncertain. OBJECTIVES: We investigated associations of BP with various chemical constituents of fine PM (PM2.5) during 460 repeated visits among a panel of 39 university students. METHODS: Resting BP was measured using standardized methods before and after the university students relocated from a suburban campus to an urban campus with different air pollution contents in Beijing, China. Air pollution data were obtained from central monitors close to student residences. We used mixed-effects models to estimate associations of various PM2.5 constituents with systolic BP (SBP), diastolic BP (DBP), and pulse pressure. RESULTS: An interquartile range increase of 51.2 μg/m3 in PM2.5 was associated with a 1.08-mmHg (95% CI: 0.17, 1.99) increase in SBP and a 0.96-mmHg (95% CI: 0.31, 1.61) increase in DBP on the following day. A subset of PM2.5 constituents, including carbonaceous fractions (organic carbon and elemental carbon), ions (chloride and fluoride), and metals/metalloid elements (nickel, zinc, magnesium, lead, and arsenic), were found to have robust positive associations with different BP variables, though robust negative associations of manganese, chromium, and molybdenum with SBP or DBP also were observed. CONCLUSIONS: Our results support relationships between specific PM2.5 constituents and BP. These findings have potential implications for the development of pollution abatement strategies that maximize public health benefits.","year":2013}
{"review_pmid":"41639651","record_index":3,"pmid":"22188661","title":"Effects of particulate air pollution on blood pressure in a highly exposed population in Beijing, China: a repeated-measure study.","abstract":"BACKGROUND: Particulate Matter (PM) exposure is critical in Beijing due to high population density and rapid increase in vehicular traffic. PM effects on blood pressure (BP) have been investigated as a mechanism mediating cardiovascular risks, but results are still inconsistent. The purpose of our study is to determine the effects of ambient and personal PM exposure on BP. METHODS: Before the 2008 Olympic Games (June 15-July 27), we examined 60 truck drivers and 60 office workers on two days, 1-2 weeks apart (n = 240). We obtained standardized measures of post-work BP. Exposure assessment included personal PM(2.5) and Elemental Carbon (EC, a tracer of traffic particles) measured using portable monitors during work hours; and ambient PM(10) averaged over 1-8 days pre-examination. We examined associations of exposures (exposure group, personal PM(2.5)/EC, ambient PM(10)) with BP controlling for multiple covariates. RESULTS: Mean personal PM(2.5) was 94.6 μg/m(3) (SD = 64.9) in office workers and 126.8 (SD = 68.8) in truck drivers (p-value < 0.001). In all participants combined, a 10 μg/m(3) increase in 8-day ambient PM(10) was associated with BP increments of 0.98 (95%CI 0.34; 1.61; p-value = 0.003), 0.71 (95%CI 0.18; 1.24; p-value = 0.01), and 0.81 (95%CI 0.31; 1.30; p-value = 0.002) mmHg for systolic, diastolic, and mean BP, respectively. BP was not significantly different between the two groups (p-value > 0.14). Personal PM(2.5) and EC during work hours were not associated with increased BP. CONCLUSIONS: Our results indicate delayed effects of ambient PM(10) on BP. Lack of associations with exposure groups and personal PM(2.5)/EC indicates that PM effects are related to background levels of pollution in Beijing, and not specifically to work-related exposure.","year":2011}
{"review_pmid":"41639651","record_index":4,"pmid":"35084680","title":"High-normal blood pressure (prehypertension) is associated with PM2.5 exposure in young adults.","abstract":"We aimed to examine PM2.5 exposure, blood pressure (SBP and DBP) measurement, and hypertension risk factors and to assess the association between PM2.5 exposure and hypertension among young adults. The mean SBP was 117.78 mmHg, with 11.22% high-normal blood pressure (prehypertension) and 2.51% hypertension (≥ 140 mmHg). DBP was 75.48 mmHg with 26.37% prehypertension and 4.53% hypertension (≥ 90 mmHg). The median PM2.5 in the past year was 31.79 μg/m3, with highest in winter (49.33 μg/m3), followed by spring (37.34 μg/m3), autumn (29.64 μg/m3), and summer (24.33 μg/m3). Blood pressure was positively correlated with age, height, weight, BMI, daily smoking, alcohol consumption, mental stress, and staying up in the past 1 year, and negatively with season-specific temperature. After adjustment for the covariates, each 10 μg/m3 increase in PM2.5 was associated with SBP (day 1 = 1.07 mmHg, day 3 = 1.25 mmHg, day 5 = 1.01 mmHg) and DBP (day 1 = 1.06 mmHg, day 3 = 1.28 mmHg, day 5 = 1.29 mmHg, day 15 = 0.87 mmHg, day 30 = 0.56 mmHg). Exposure in winter and the past year was associated with 1.21 mmHg and 0.95 increase mmHg in SBP, respectively. Logistic models showed for every 1 μg/m3 increase of PM2.5, SBP in day 1 and day 5 was increased by 6% and 4%, and DPB by 3% and 16%, respectively. SBP was increased by 8% in spring and 19% in winter, and DBP was increased by 7% in winter. Our data suggest a certain prevalence of pre- or hypertension among young population, which is associated with short-term fluctuation and season-specific exposure of PM2.5.","year":2022}
{"review_pmid":"41639651","record_index":5,"pmid":"35904742","title":"Life-course exposure to ambient fine particulate matter and hypertension in adulthood: a longitudinal cohort study.","abstract":"PM2.5-hypertension association were well documented in adults, while the effects of life-course exposure to PM2.5 on adulthood hypertension remained unclear. This study aimed to investigate the associations between life-course exposure to ambient PM2.5 and incident hypertension in adulthood in Asia. We included 4272 participants with 17,814 medical visits from two open cohorts in Taiwan and Hong Kong between 2000 and 2018. We used a satellite-based model to assess 2-year average PM2.5 exposure at a resolution of 1 km2. A linear mixed model was used to examine the association with blood pressure. A Cox regression model with time-dependent covariates was used to examine the overall association with the development of hypertension in adulthood. Life-course mixed models were used to examine the effects of PM2.5 exposure at different life stages on blood pressure and hypertension. For every 10 μg/m3 increase in PM2.5, the overall risk of adulthood hypertension increased by 40% (95% confidence interval [CI] 8-80%). The health effects of PM2.5 exposure at different life-stages on incident hypertension were generally independent of each other. In critical model, the risk of developing hypertension increased 23%, 27%, and 55% for each 10 μg/m3 increase in PM2.5 exposure during school age, adolescence, and adulthood, respectively. Similar associations were found between life-course PM2.5 exposure and blood pressure. Association between PM2.5 and adulthood hypertension can be traced back to childhood. Our study suggests that life-course control of air pollution exposure should be implemented to alleviate the huge burden of adulthood hypertension.","year":2023}
{"review_pmid":"41639651","record_index":6,"pmid":"29700042","title":"Long-Term Effects of Ambient Particulate Matter (With an","abstract":"Background: -Epidemiologicalevidenceontheassociationbetweenlong-termexposuretoambientfineparticulatematter(withan aerodynamic diameter ≤2.5 lm; PM ) and hypertension is mixed. We investigated the long-term association between ambient 2.5 fine particles and hypertension in reproductive-age adults. Methods and Results--This analysis included 39 348 119 reproductive-age (20-49 years) participants from the National Free Preconception Health Examination Project from April 22, 2010 to December 31, 2015 across China. The estimation of annual average ambient PM concentrations for each community was realized through using satellite-based spatial statistical models. 2.5 Linear mixed models and 2-level logistic regressions adjusted for potential confounders with natural cubic splines were used to investigate the shape of PM -blood pressure and PM -hypertension, respectively. The effect modification by sex, obesity, 2.5 2.5 smoking status, age, diabetes mellitus, urbanity, race, and region was also taken into account. The concentration-response relationship between PM and hypertension was nonlinear, with a threshold concentration of 47.9 lg/m3. The odds ratio of 2.5 hypertension related to a 10-lg/m3 increase in PM above threshold was 1.010 (95% confidence interval, 1.007-1.012). A 102.5 lg/m3 increase in PM above threshold corresponded to a 0.569 (95% confidence interval, 0.564-0.573) mm Hg elevation in 2.5 systolic blood pressure and a 0.384 (95% confidence interval, 0.381-0.388) mm Hg elevation in diastolic blood pressure. There were 2.3% (95% confidence interval, 2.2%-2.4%) of the hypertension cases that could be attributed to PM exposures in 2.5 reproductive-age adult populations. Conclusions--Long-term exposures to PM above certain levels might increase population risk for hypertension and might be 2.5 responsibleforChina’savoidablehypertensionburdeninreproductive-ageadults. (JAmHeartAssoc.2018;7:e008553.DOI:10. 1161/JAHA.118.008553.)","year":2010}
{"review_pmid":"41639651","record_index":7,"pmid":"32199315","title":"Long-term exposure to airborne particulate matter of 1 μm or less and blood pressure in healthy young adults: A national study with 1.2 million pregnancy planners.","abstract":"No evidence exists concerning the effect of airborne particulate matter of 1 μm or less (PM1) on blood pressure of young adults planning for pregnancy. We collected health examination information of about 1.2 million couples (aged 18-45 years) from a national birth cohort in China from Jan 1, 2013 to Oct 1, 2014 and matched their home address to daily PM1 and PM2.5 concentrations, which were predicted by remote sensing information. Generalized additive mixed models were used to analyze associations between long-term exposure to PM and blood pressure, after controlling for individual factors. A 10 μg/m3 increase in PM1 was associated with increased systolic blood pressure (SBP) for 0.26 (95%CI: 0.24, 0.29) mmHg in females and 0.29 (95%CI: 0.26, 0.31) mmHg in males, respectively. PM1 was also associated with increased DBP for 0.22 (95%CI: 0.20, 0.23) mmHg in females and 0.17 (95%CI: 0.15, 0.19) mmHg in males, respectively. Similar effects on blood pressure were found for PM2.5, meanwhile, the effect of PM2.5 on SBP increased with the scale of PM1 included in PM2.5 (p for interaction term <0.01). In summary, long-term exposure to PM1 as well as PM2.5 was associated with increased SBP and DBP of Chinese young adults planning for pregnancy.","year":2020}
{"review_pmid":"41639651","record_index":8,"pmid":"37364626","title":"PM2.5 and its respiratory tract depositions on blood pressure, anxiety, depression and health risk assessment: A mechanistic study based on urinary metabolome.","abstract":"Effects of fine particulate matter (PM2.5) and regional respiratory tract depositions on blood pressure (BP), anxiety, depression, health risk and the underlying mechanisms need further investigations. A repeated-measures panel investigation among 40 healthy young adults in Hefei, China was performed to explore the acute impacts of PM2.5 exposure and its deposition doses in 3 regions of respiratory tract over diverse lag times on BP, anxiety, depression, health risk, and the potential mechanisms. We collected PM2.5 concentrations, its deposition doses, BP, the Self-Rating Anxiety Scale (SAS) score and the Self-Rating Depression Scale (SDS) score. An untargeted metabolomics approach was used to detect significant urine metabolites, and the health risk assessment model was used to evaluate the non-carcinogenic risks associated with PM2.5. We applied linear mixed-effects models to assess the relationships of PM2.5 with the aforementioned health indicators We further evaluate the non-carcinogenic risks associated with PM2.5. We found deposited PM2.5 dose in the head accounted for a large proportion. PM2.5 and its three depositions exposures at a specific lag day was significantly related to increased BP levels and higher SAS and SDS scores. Metabolomics analysis showed significant alterations in urinary metabolites (i.e., glucoses, lipids and amino acids) after PM2.5 exposure, simultaneously accompanied by activation of the cAMP signaling pathway. Health risk assessment presented that the risk values for the residents in Hefei were greater than the lower limits of non-cancer risk guidelines. This real-world investigation suggested that acute PM2.5 and its depositions exposures may increase health risks by elevating BP, inducing anxiety and depression, and altering urinary metabolomic profile via activating the cAMP signaling pathway. And the further health risk assessment indicated that there are potential non-carcinogenic risks of PM2.5 via the inhalation route in this area.","year":2023}
{"review_pmid":"41639651","record_index":9,"pmid":"31484088","title":"Short-term effects of real-time personal PM2.5 exposure on ambulatory blood pressure: A panel study in young adults.","abstract":"BACKGROUND: Short-term exposure to PM2.5 has been shown to be associated with changes in blood pressure. However, most of the evidence is based on PM2.5 measurements from fixed stations and resting blood pressure measured at a regular time. OBJECTIVES: To evaluate the short-term daily and hourly effects of real-time personal PM2.5 exposure on ambulatory blood pressure, and to compare the effects with those of PM2.5 exposure from fixed stations. METHODS: Between April 2017 and December 2017, 37 young adults were recruited in a panel study from a central urban area and a suburban area, to measure personal hourly PM2.5 and ambulatory systolic blood pressure (SBP) as well as diastolic blood pressure (DBP) for three consecutive days. Hourly PM2.5 concentrations were also obtained from the nearest monitoring station operated by Guangdong Environmental Monitoring Center. Generalized additive mixed model was employed to evaluate the effects of PM2.5 on ambulatory blood pressure. RESULTS: During the study period, the mean concentration of personal PM2.5 exposure was 60.30 ± 52.14 μg/m3, while the value of PM2.5 from fixed stations was 36.77 ± 21.52 μg/m3. Both personal PM2.5 exposure and exposure from fixed stations averaged over the previous 1 to 3 days decreased blood pressure. During daytime, a 10 μg/m3 increase in 1-day moving average of personal PM2.5 was associated with a 0.54 mmHg (95% CI: -1.03, -0.05) and 0.22 mmHg (95% CI: -0.59, 0.15) decrease in SBP and DBP, respectively. When using PM2.5 exposures from fixed stations, the decrease in SBP and DBP were 0.95 mmHg (95% CI: -1.82, -0.07) and 0.74 mmHg (95% CI: -1.46, -0.03). Stratified analysis showed stronger effects in the central urban area and among males. CONCLUSIONS: Both personal PM2.5 exposure and exposure from fixed stations averaged over the previous 1 to 3 days decreased blood pressure. Stronger effects were found in a central urban area and among males.","year":2019}
{"review_pmid":"41639651","record_index":10,"pmid":"35868381","title":"Subclinical cardiovascular outcomes of acute exposure to fine particulate matter and its constituents: A glutathione S-transferase polymorphism-based longitudinal study.","abstract":"To explore the acute subclinical cardiovascular effects of fine particulate matter (PM2.5) and its constituents, a longitudinal study with 61 healthy young volunteers was conducted in Xinxiang, China. Linear mixed-effect models were used to analyze the association of PM2.5 and its constituents with cardiovascular outcomes, respectively, including blood pressure (BP), heart rate (HR), serum levels of high-sensitivity C-reactive protein (hs-CRP), 8-hydroxy-2'-deoxyguanosine (8-OHdG), tissue-type plasminogen activator (t-PA), and platelet-monocyte aggregation (PMA). Additionally, the modifying effects of glutathione S-transferase mu 1 (GSTM1) and glutathione S-transferase theta 1 (GSTT1) polymorphisms were examined. A 10 μg/m3 increase in PM2.5 was associated with -1.04 (95 % CI: -1.86 to -0.22) mmHg and -0.90 (95 % CI: -1.69 to -0.11) mmHg decreases in diastolic BP (DBP) and mean arterial BP (MABP) along with 1.83 % (95 % CI: 0.59-3.08 %), 5.93 % (95 % CI: 0.70-11.16 %) increases in 8-OHdG and hs-CRP, respectively. Ni content was positively associated with the 8-OHdG levels whereas several other metals presented negative association with 8-OHdG and HR. Intriguingly, GSTT1+/GSTTM1+ subjects showed higher susceptibility to PM2.5-induced alterations of DBP and PMA, and GSTT1-/GSTM1+ subjects showed higher alteration on t-PA. Taken together, our findings indicated that short-term PM2.5 exposure induced oxidative stress, systemic inflammation, autonomic alterations, and fibrinolysis in healthy young subjects. Among multiple examined metal components Ni appeared to positively associated with systematic oxidative stress. In addition, GST-sufficient subjects might be more prone to PM2.5-induced autonomic alterations.","year":2022}
{"review_pmid":"41639651","record_index":11,"pmid":"34968616","title":"The influences of ambient fine particulate matter constituents on plasma hormones, circulating TMAO levels and blood pressure: A panel study in China.","abstract":"Considerable investigations have been carried out to address the relationship between ambient fine particulate matter (PM2.5) and blood pressure (BP) in patients with hypertension. However, few studies have explored the influence of PM2.5 and its constituents on Trimethylamine N-oxide (TMAO), an established risk factor for hypertension and cardiovascular disease (CVD), particularly in severely air-polluted areas. To explore the potential impact of PM2.5 constituents on BP, plasma hormones, and TMAO, a panel study was conducted to investigate changes in BP, plasma hormones, and TMAO in response to ambient air pollution exposure in stage 1 hypertensive young adults. Linear mixed effect models were used to estimate the cumulative effects of fine particulate matters (PM2.5) and its constituents on BP, plasma hormones and TMAO. We found that one interquartile range (IQR) (35 μg/m3) increase in 0-1 day moving-average PM2.5 concentrations was statistically significantly associated with elevated systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) with estimated values of 0.13 (95% confidence interval (CI): 0.03 to 0.23) mmHg, 0.18 (95% CI: 0.08 to 0.28) mmHg, and 0.17 (95% CI: 0.09 to 0.26) mmHg, respectively. Hormone disturbance in the renin-angiotensin-aldosterone system was also associated with PM2.5 exposure. Elevated TMAO levels with an IQR increase for 0-4, 0-5, 0-6 moving-average concentrations of PM2.5 were found, and the increased values ranged from 26.28 (95% CI: 2.92 to 49.64) to 60.78 (31.95-89.61) ng/ml. More importantly, the PM2.5-bound metal constituents, such as manganese (Mn), titanium (Ti), and selenium (Se) showed robust associations with elevated BP and plasma TMAO levels. This study demonstrates associations between PM2.5 metal constituents and increased BP, changes in plasma hormones and TMAO, in stage 1 hypertensive young adults. Source control, aiming to reduce the emission of PM2.5-bound metals should be implemented to reduce the risk of hypertension and CVD.","year":2022}
{"review_pmid":"41639864","record_index":1,"pmid":"23805979","title":"Aerobic training and angiogenesis activation in patients with stable chronic heart failure: a prelim","abstract":"Keywords Thepathophysiologyofchronicheartfailure(CHF)involvesmultiplehystologicandmolecular Cardiovasculardisease,growthfactors/ alterations. Todeterminetheeffectsofphysicaltrainingoncirculatingendothelialprogenitor cytokines/inflammatorymediators,sports cells (EPCs), angiogenesis (angiogenin, angiopoietin-1 and -2, VEGF, Tie-2, SDF-1a) and science/exercise inflammation (IL-6, CRP), we compared data obtained from 11 CHF pts before and after 3monthsaerobicexercisetraining, tothosefrom10nontrained CHFpts(CHF-Cgroup,age History 64þ2years,NYHA2). Attheendofthestudy,EPCscountandAP-2serumlevelssignificantly Received9April2013 increased in the CHF-TR group. These preliminary data suggest a significant effect of even a Revised11May2013 shortprogramofphysicaltrainingonangiogenicactivationandendothelialdysfunction. Accepted11May2013 Publishedonline27June2013","year":2013}
{"review_pmid":"41639864","record_index":2,"pmid":"27417562","title":"Dietary Weight Loss and Exercise Effects on Serum Biomarkers of Angiogenesis in Overweight Postmenopausal Women: A Randomized Controlled Trial.","abstract":"Obese and sedentary persons have an increased risk for cancer, but underlying mechanisms are poorly understood. Angiogenesis is common to adipose tissue formation and remodeling, and to tumor vascularization. A total of 439 overweight/obese, healthy, postmenopausal women [body mass index (BMI) > 25 kg/m(2)] ages 50-75 years, recruited between 2005 and 2008 were randomized to a 4-arm 12-month randomized controlled trial, comparing a caloric restriction diet arm (goal: 10% weight loss, N = 118), aerobic exercise arm (225 minutes/week of moderate-to-vigorous activity, N = 117), a combined diet + exercise arm (N = 117), or control (N = 87) on circulating levels of angiogenic biomarkers. VEGF, plasminogen activator inhibitor-1 (PAI-1), and pigment epithelium-derived factor (PEDF) were measured by immunoassay at baseline and 12 months. Changes were compared using generalized estimating equations, adjusting for baseline BMI, age, and race/ethnicity. Participants randomized to the diet + exercise arms had statistically significantly greater reductions in PAI-1 at 12 months compared with controls (-19.3% vs. +3.48%, respectively, P < 0.0001). Participants randomized to the diet and diet + exercise arms had statistically significantly greater reductions in PEDF (-9.20%, -9.90%, respectively, both P < 0.0001) and VEGF (-8.25%, P = 0.0005; -9.98%, P < 0.0001, respectively) compared with controls. There were no differences in any of the analytes in participants randomized to the exercise arm compared with controls. Increasing weight loss was statistically significantly associated with linear trends of greater reductions in PAI-1, PEDF, and VEGF. Weight loss is significantly associated with reduced circulating VEGF, PEDF, and PAI-1, and could provide incentive for reducing weight as a cancer prevention method in overweight and obese individuals. Cancer Res; 76(14); 4226-35. ©2016 AACR.","year":2016}
{"review_pmid":"41639864","record_index":3,"pmid":"24501378","title":"Effect of a 12-month exercise intervention on serum biomarkers of angiogenesis in postmenopausal women: a randomized controlled trial.","abstract":"BACKGROUND: Increased physical activity is associated with decreased risk of several types of cancer, but underlying mechanisms are poorly understood. Angiogenesis, in which new blood vessels are formed, is common to adipose tissue formation/remodeling and tumor vascularization. METHODS: We examined effects of a 12-month 45 minutes/day, 5 days/week moderate-intensity aerobic exercise intervention on four serum markers of angiogenesis in 173 sedentary, overweight, postmenopausal women, 50 to 75 years, randomized to intervention versus stretching control. Circulating levels of positive regulators of angiogenesis [VEGF, osteopontin (OPN), plasminogen activator inhibitor-1 (PAI-1)], and the negative regulator pigment epithelium-derived factor (PEDF), were measured by immunoassay at baseline and 12 months. Changes were compared using generalized estimating equations, adjusting for baseline levels of analytes and body mass index (BMI). RESULTS: VEGF, OPN, or PAI-1 levels did not differ by intervention arm. Participants randomized to exercise significantly reduced PEDF (-3.7%) versus controls (+3.0%; P = 0.009). Reductions in fat mass were significantly associated with reductions in PAI-1 (Ptrend = 0.03; Ptrend = 0.02) and PEDF (Ptrend = 0.002; Ptrend = 0.01) compared with controls, or to those who gained any fat mass respectively. There was a significant association between decreases in VO2max, and increased reductions in PEDF (Ptrend = 0.03), compared with participants who increased their level of fitness. CONCLUSIONS: Fat loss reduces circulating PAI-1 and PEDF. Changes in VO2max are associated with alterations in PEDF, but these associations are complex. IMPACT: Unexpected reductions in PEDF with decreasing fat mass, and with decreasing VO2max, warrant further study, including examining the effects of different types and intensities of exercise; and role of dietary weight-loss with and without exercise.","year":2014}
{"review_pmid":"41639864","record_index":4,"pmid":"25584487","title":"Effect of aerobic training on the host systemic milieu in patients with solid tumours: an exploratory correlative study.","abstract":"BACKGROUND: Few studies have investigated the effects of exercise on modulation of host factors in cancer patients. We investigated the efficacy of chronic aerobic training on multiple host-related effector pathways in patients with solid tumours. PATIENTS AND METHODS: Paired peripheral blood samples were obtained from 44 patients with solid tumours receiving cytotoxic therapy and synthetic erythropoietin (usual care; n=21) or usual care plus supervised aerobic training (n=23) for 12 weeks. Samples were characterised for changes in immune, cytokine and angiogenic factors, and metabolic intermediates. Aerobic training consisted of three supervised cycle ergometry sessions per week at 60% to 100% of peak oxygen consumption (VO2peak), 30-45 min per session, for 12 weeks following a nonlinear prescription. RESULTS: The between-group delta change in cardiopulmonary function was +4.1 ml kg (-1) min(-1), favouring aerobic training (P<0.05). Significant pre-post between-group differences for five cytokine and angiogenic factors (HGF, IL-4, macrophage inflammatory protein-1β (MIP-1β), vascular endothelial growth factor (VEGF), and TNF-α) also favour the aerobic training group (P's<0.05). These reductions occurred in conjunction with nonsignificant group differences for T lymphocytes CD4(+), CD8(+), and CD8(+)/CD45RA (P<0.10). For these factors, circulating concentrations generally increased from baseline to week 12 in the aerobic training group compared with decreases or no change in the usual care group. No significant changes in any metabolic intermediates were observed. CONCLUSIONS: Aerobic training alters host availability of select immune-inflammatory effectors in patients with solid tumours; larger confirmatory studies in more homogenous samples are warranted.","year":2015}
{"review_pmid":"41639864","record_index":5,"pmid":"16928196","title":"Effect of training on the response of plasma vascular endothelial growth factor to exercise in patients with peripheral arterial disease.","abstract":"Expansion of the capillary network, or angiogenesis, occurs following endurance training. This process, which is reliant on the presence of VEGF (vascular endothelial growth factor), is an adaptation to a chronic mismatch between oxygen demand and supply. Patients with IC (intermittent claudication) experience pain during exercise associated with an inadequate oxygen delivery to the muscles. Therefore the aims of the present study were to examine the plasma VEGF response to acute exercise, and to establish whether exercise training alters this response in patients with IC. In Part A, blood was collected from patients with IC (n=18) before and after (+20 and +60 min post-exercise) a maximal walking test to determine the plasma VEGF response to acute exercise. VEGF was present in the plasma of patients (45.11+/-29.96 pg/ml) and was unchanged in response to acute exercise. Part B was a training study to determine whether exercise training altered the VEGF response to acute exercise. Patients were randomly assigned to a treatment group (TMT; n=7) that completed 6 weeks of high-intensity treadmill training, or to a control group (CON; n=6). All patients completed a maximal walking test before and after the intervention, with blood samples drawn as for Part A. Training had no effect on plasma VEGF at rest or in response to acute exercise, despite a significant increase in maximal walking time in the TMT group (915+/-533 to 1206+/-500 s; P=0.009) following the intervention. The absence of a change in plasma VEGF may reflect altered VEGF binding at the endothelium, although this cannot be confirmed by the present data.","year":2006}
{"review_pmid":"41639864","record_index":6,"pmid":"23401397","title":"Effect of weight loss and exercise on angiogenic factors in the circulation and in adipose tissue in obese subjects.","abstract":"BACKGROUND: Vascular growth is a prerequisite for adipose tissue (AT) development and expansion. Some AT cytokines and hormones have effects on vascular development, like vascular endothelial growth factor (VEGF-A), angiopoietin (ANG-1), ANG-2 and angiopoietin-like protein-4 (ANGPTL-4). METHODS: In this study, the independent and combined effects of diet-induced weight loss and exercise on AT gene expression and proteins levels of those angiogenic factors were investigated. Seventy-nine obese males and females were randomized to: 1. Exercise-only (EXO; 12-weeks exercise without diet-restriction), 2. Hypocaloric diet (DIO; 8-weeks very low energy diet (VLED) + 4-weeks weight maintenance diet) and 3. Hypocaloric diet and exercise (DEX; 8-weeks VLED + 4-weeks weight maintenance diet combined with exercise throughout the 12 weeks). Blood samples and fat biopsies were taken before and after the intervention. RESULTS: Weight loss was 3.5 kg in the EXO group and 12.3 kg in the DIO and DEX groups. VEGF-A protein was non-significantly reduced in the weight loss groups. ANG-1 protein levels were significantly reduced 22-25% after all three interventions (P < 0.01). The ANG-1/ANG-2 ratio was also decreased in all three groups (P < 0.05) by 27-38%. ANGPTL-4 was increased in the EXO group (15%, P < 0.05) and 9% (P < 0.05) in the DIO group. VEGF-A, ANG-1, and ANGPTL-4 were all expressed in human AT, but only ANGPTL-4 was influenced by the interventions. CONCLUSIONS: Our data show that serum VEGF-A, ANG-1, ANG-2, and ANGPTL-4 levels are influenced by weight changes, indicating the involvement of these factors in the obese state. Moreover, it was found that weight loss generally was associated with a reduced angiogenic activity in the circulation.","year":2013}
{"review_pmid":"41639864","record_index":7,"pmid":"31954186","title":"Effects of aquatic exercise on insulin-like growth factor-1, brain-derived neurotrophic factor, vascular endothelial growth factor, and cognitive function in elderly women.","abstract":"The purpose of this study was to investigate the effects of a 16-week aquatic exercise program on brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1), and vascular endothelial growth factor (VEGF) levels, as well as cognitive function in elderly women. The subjects were 20 elderly women aged 68-80 years, randomly divided into an aquatic exercise group (n = 10) and a control group (n = 10). The aquatic exercises were performed for 60 min, three times per week for 16 weeks, and the intensity was progressively increased every 4 weeks (40-50% of heart rate reserve (HRR) for weeks 1-4, 50-60% of HRR for weeks 5-8, 60-65% of HRR for weeks 9-12, and 65-70% of HRR for weeks 13-16). The data were analyzed using two-way repeated measures analysis of variance, paired t-test, and independent t-test with an alpha level to indicate significance set at.05 for all tests. After the 16-week aquatic exercise program, the BDNF and IGF-1 levels (p <.01, respectively), and cognitive function (p <.05) of the aquatic exercise group showed significant changes. BDNF, IGF-1, and cognitive function levels (p <.01, respectively) were significantly different between the aquatic exercise group and control group. The results of this study suggest that regular aquatic exercise in elderly women during the early stages of aging can increase the expression of BDNF and IGF-1, thus maintaining and improving cognitive function.","year":2020}
{"review_pmid":"41639864","record_index":8,"pmid":"17996817","title":"Effects of exercise training on endothelial progenitor cells in patients with chronic heart failure","abstract":"Background: The enhancement of circulating endothelial progenitor cells (EPCs) obtained by exercise training can be beneficial to patients with cardiac disease. Changes in the levels and differentiation of CD34pos/KDRpos EPCs, as well as the plasma concentration of vascular endothelial growth factor (VEGF) and stromal cell-derived factor (SDF)-1 EPC-mobilizing cytokines, were evaluated in patients withchronicheartfailureafter8weeksofsupervisedaerobictraining(SAT)and8weeksofsubsequent discontinuedSAT(DSAT). MethodsandResults: ThelevelsofcirculatingEPCandEPCdifferentiationpotentialof22patientswho underwentSATwerestudiedbyfluorescence-activatedcellsorteranalysisandcolonyforming-unitassay, respectively. The plasma levels of VEGF and SDF-1 were measured by enzyme-linked immunosorbent assay. In response to SAT, the levels of both EPC and VEGF/SDF-1 markedly increased (P !.001 vs baseline) but returned to the baseline levels after DSAT. A similar change was observed with the EPC clonogenicpotential, butonDSATthebaseline levelwasincompletely attained. Conclusions: In response to SAT, patients with chronic heart failure show enhanced EPC levels and clonogenic potential that is mirrored by increased plasma VEGF and SDF-1 levels. DSAT can interfere with the maintenance of training-acquired VEGF/SDF-1-related EPC levels and clonogenic potential. (J Cardiac Fail 2007;13:701e708)","year":2007}
{"review_pmid":"41639864","record_index":9,"pmid":"20430934","title":"Exercise training in patients with advanced chronic heart failure (NYHA IIIb) promotes restoration of peripheral vasomotor function, induction of endogenous regeneration, and improvement of left ventricular function.","abstract":"BACKGROUND: Attenuated peripheral perfusion in patients with advanced chronic heart failure (CHF) is partially the result of endothelial dysfunction. This has been causally linked to an impaired endogenous regenerative capacity of circulating progenitor cells (CPC). The aim of this study was to elucidate whether exercise training (ET) affects exercise intolerance and left ventricular (LV) performance in patients with advanced CHF (New York Heart Association class IIIb) and whether this is associated with correction of peripheral vasomotion and induction of endogenous regeneration. METHODS AND RESULTS: Thirty-seven patients with CHF (LV ejection fraction 24+/-2%) were randomly assigned to 12 weeks of ET or sedentary lifestyle (control). At the beginning of the study and after 12 weeks, maximal oxygen consumption (Vo(2)max) and LV ejection fraction were determined; the number of CD34(+)/KDR(+) CPCs was quantified by flow cytometry and CPC functional capacity was determined by migration assay. Flow-mediated dilation was assessed by ultrasound. Capillary density was measured in skeletal muscle tissue samples. In advanced CHF, ET improved Vo(2)max by +2.7+/-2.2 versus -0.8+/-3.1 mL/min/kg in control (P=0.009) and LV ejection fraction by +9.4+/-6.1 versus -0.8+/-5.2% in control (P<0.001). Flow-mediated dilation improved by +7.43+/-2.28 versus +0.09+/-2.18% in control (P<0.001). ET increased the number of CPC by +83+/-60 versus -6+/-109 cells/mL in control (P=0.014) and their migratory capacity by +224+/-263 versus -12+/-159 CPC/1000 plated CPC in control (P=0.03). Skeletal muscle capillary density increased by +0.22+/-0.10 versus -0.02+/-0.16 capillaries per fiber in control (P<0.001). CONCLUSIONS: Twelve weeks of ET in patients with advanced CHF is associated with augmented regenerative capacity of CPCs, enhanced flow-mediated dilation suggestive of improvement in endothelial function, skeletal muscle neovascularization, and improved LV function. Clinical Trial Registration- http://www.clinicaltrials.gov. Unique Identifier: NCT00176384.","year":2010}
{"review_pmid":"41639864","record_index":10,"pmid":"21450569","title":"response to vascular growth factors in Cardiology2011","abstract":"Objective: Exercise training partially correctsendothelial dysfunction in patients with coronary artery disease (CAD). Growth factors likevascularendothelial growth factor (VEGF) as well as erythropoietin (EPO) areknown to modulate the bioavailabilityof nitric oxide and, thereby, contribute to themaintenance of a normal vascular tone. Theaim of the presentstudywastodeterminetheimpactof4weeksofexercisetrainingoncirculatinggrowthfactorsandtoelucidate their involvement in the training-induced changes in vasomotion in patients with CAD. Methods andresults:A total of 39 patients were enrolled (training group: n¼20; controlgroup: n¼19). At start of study and after 4 weeks, average peak flow velocity (APV) of the left internal mammary artery (LIMA) in response to acetylcholine was measured invasively in the treatment and control groups. Serum concentrations of VEGF and EPO were determined byenzyme-linked immunosorbent assay. After exercise training, LIMA APV in response to acetylcholine was increased by 93% (from 69(cid:2)17% at start of study to 133(cid:2)16% at 4 weeks, p<0.01 vs. start of study and control). Atstartofstudy,therewasnoassociationbetweenanyofthevasculargrowthfactorsandendothelialfunction. However,afterexercisetrainingaclosecorrelationwasapparentbetweentheacetylcholine-inducedchangeinAPVand EPO (r¼0.69, p<0.01) and VEGF (r¼0.76, p<0.01) serum concentrations. In the control group, these correlations were not evident and there was no change in endothelial function either. Conclusion: Exercise training improves agonist-mediated endothelium-dependent vasodilatation in CAD, partially through a restoration of the endothelial response to EPO and VEGF.","year":2012}
{"review_pmid":"41639864","record_index":11,"pmid":"17081158","title":"Haematopoietic stem cells and endothelial progenitor cells in healthy men: effect of aging and training.","abstract":"The number of hematopoietic stem cells (HSC) and endothelial progenitor cells (EPC) is thought to be a marker for neovascularization and vascular repair. Because physical inactivity and aging are risk factors for cardiovascular diseases, these factors may influence the numbers of HSCs and EPCs. Therefore, we examined baseline and exercise-induced levels of HSCs and EPCs in sedentary and trained young and older men. To study the role of aging in eight sedentary young (19-28 years) and eight sedentary older men (67-76 years), baseline and acute exercise-induced numbers of HSCs (CD34+-cells) and EPCs (CD34+/VEGFR-2+-cells) were quantified by fluorescence-activated cell sorter (FACS) analysis. To examine the effect of chronic training, eight age-matched trained young men (18-28 years) were compared with sedentary young men, whereas older men performed an 8-week endurance training. Older men showed significantly lower baseline and exercise-induced levels of HSCs/EPCs than the young men (P < 0.05). In young and older men, acute exercise significantly increased HSCs (P < 0.01), but not EPCs. The absolute increase in numbers of HSCs was attenuated in older men (P = 0.03). Apart from the lower baseline numbers of EPCs after chronic training in older men, training status did not alter baseline or exercise-induced levels of HSCs/EPCs in young and older men. We concluded that advancing age results in lower circulating numbers of HSCs and EPCs and attenuates the acute exercise-induced increase in HSCs. Interestingly, in young as well as in older men chronic endurance training does not affect baseline and exercise-induced numbers of HSCs and EPCs.","year":2006}
{"review_pmid":"41639864","record_index":12,"pmid":"30889827","title":"Taekwondo Enhances Cognitive Function as a Result of Increased Neurotrophic Growth Factors in Elderly Women.","abstract":"The purpose of this study was to investigate the effects of regular taekwondo (TKD) training on physical fitness, neurotrophic growth factors, cerebral blood flow (CBF) velocity, and cognitive function in elderly women. Thirty-seven women aged 65 or older were randomly assigned to either TKD (n = 19) or control (n = 18) group. TKD training was performed at 50⁻80% maximum heart rate (HRmax) for 60 min, five times per week for 16 weeks. All participants underwent the following examinations before and after the intervention: Senior Fitness Test; serum levels of neurotrophic growth factors, including brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and insulin-like growth factor-1 (IGF-1); systolic, diastolic, and mean blood flow velocity and pulsatility index of the middle cerebral artery using Doppler ultrasonography; Mini-Mental State Examination for dementia screening (MMSE-DS); and Stroop Color and Word Test (word, color, and color-word). In the TKD group, lower body strength and flexibility, aerobic endurance levels, BDNF, VEGF, and IGF-1 serum levels as well as the color-word test scores were significantly increased after as compared to before the intervention (p < 0.05). No statistically significant differences were found in cerebral blood flow velocities and the MMSE-DS score (p > 0.05). These findings suggest that regular TKD training may be effective in improving not only fitness but also cognitive function in elderly women. The latter effect may be due to increased neurotrophic growth factor levels.","year":2019}
{"review_pmid":"41639864","record_index":13,"pmid":"24882173","title":"The effect of exercise on hippocampal volume and neurotrophines in patients with major depression--a randomized clinical trial.","abstract":"BACKGROUND: The hippocampal volume is reduced in patients with major depression. Exercise leads to an increased hippocampal volume in schizophrenia and in healthy old adults. The effect of exercise on hippocampal volume is potentially mediated by brain derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and insulin like growth factor 1 (IGF-1). The aim of this trial was to assess the effect of an aerobic exercise intervention on hippocampal volume and serum BDNF, VEGF, and IGF-1 in patients with major depression. METHODS: Patients were randomized to an aerobic exercise intervention (n=41) or a control condition (n=38). Both interventions consisted of three supervised sessions per week during a three months period. RESULTS: Post-intervention the increase in maximal oxygen uptake was 3.90 ml/kg/min (SD 5.1) in the aerobic exercise group and 0.95 ml/kg/min (SD 6.2) in the control group (p=0.03). The hippocampal volume, BDNF, VEGF, or IGF-1 did not differ between the two groups. Post-hoc we found a positive association between change in hippocampal volume and verbal memory (Rho=0.27; p=0.05) and change in hippocampal volume and depressive symptoms (Rho=0.30; p=0.03). LIMITATIONS: Participation was low in both groups corresponding to an average participation of one session per week. CONCLUSION: Despite a significant increase in maximal oxygen uptake, a pragmatic exercise intervention did not increase hippocampal volume or resting levels of neurotrophines in out-patients with mild to moderate major depression. Trial identifier: ClinicalTrials.gov (NCT00695552).","year":2014}
{"review_pmid":"41652340","record_index":1,"pmid":"37948612","title":"Biomarkers of Cellular Senescence Predict the Onset ofMobility Disability and Are Reduced by Physical Activity inOlder A","abstract":"DOI:10.1093/gerona/glad257 The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 7 February 2024 Abstract: Studies in mice and cross-sectional studies in humans support the premise that cellular senescence is a contributing mechanism to age-associated deficits in physical function. We tested the hypotheses that circulating proteins secreted by senescent cells are (i) associated with the incidence of major mobility disability (MMD), the development of persistent mobility disability (PMMD), and decrements in physical functioning in older adults, and (ii) influenced by physical activity (PA). Using samples and data obtained longitudinally from the Lifestyle Interventions in Elders Study clinical trial, we measured a panel of 27 proteins secreted by senescent cells. Among 1 377 women and men randomized to either a structured PA intervention or a healthy aging (HA) intervention, we observed significant associations between several senescence biomarkers, most distinctly vascular endothelial growth factor A (VEGFA), tumor necrosis factor receptor 1 (TNFR1), and matrix metallopeptidase 7 (MMP7), and the onset of both MMD and PMMD. Moreover, VEGFA, GDF15, osteopontin, and other senescence biomarkers were associated with reductions in short physical performance battery scores. The change in senescence biomarkers did not differ between PA and HA participants. In the whole cohort, higher levels of PA were associated with significantly greater reductions in 10 senescence-related proteins at 12 and/or 24 months. These data reinforce cellular senescence as a contributing mechanism of age-associated functional decline and the potential for PA to attenuate this hallmark of aging. Clinical Trials Registration Number: NCT01072500","year":2024}
{"review_pmid":"41652340","record_index":2,"pmid":"33917916","title":"Despeghel-2021-Effects-of-a--week-low-dose-combine","abstract":"With increasing age, the immune system undergoes a remodeling process, affecting the shift of T cell subpopulations and the development of chronic low-grade inflammation. Clinically, this is characterized by increased susceptibility to infections or development of several diseases. Since lifestyle factors can play a significant role in reducing the hallmarks of immune aging and inflammation, we investigated the effect of a 6 week low-dose combined resistance and endurance training program. Forty participants (70.3 5.0 years) were randomly assigned to either a training (TG) or control group (CG) and performed a controlled low-threshold and care-oriented 6-week-long combined resistance and endurance training program. Changes in anthropometrics as well as strength capacity were measured. In subgroups of TG and CG, T cells and their subpopulations (CD4+, CD8+, naïve, central, effector memory, T-EMRA) were analyzed by flow cytometry. The changes of various plasma cytokines, chemokines, growth factors and adipokines were analyzed by luminex assays. The exercise program was followed by an increase in strength capacities. Participants of TG showed an increase of the CD4+/CD8+ T cell ratio over time (p < 0.05). Significant decreases in systemic levels of interleukin (IL-) 6, IL-8, IL-10 and vascular endothelial growth factor (VEGF) (p < 0.05) were observed for participants of TG over time. Even short-term and low-threshold training can reduce some of the hallmarks of immune aging in elderly and thus could be beneficial to stimulate immunity. The specific characteristics of the program make it easily accessible to older people, who may benefit in the longer term in terms of their immunocompetence.","year":2021}
{"review_pmid":"41656984","record_index":1,"pmid":"32111701","title":"A Coaching Program to Improve Dietary Intake of Patients with CKD: ENTICE-CKD.","abstract":"BACKGROUND AND OBJECTIVES: The dietary self-management of CKD is challenging. Telehealth interventions may provide an effective delivery method to facilitate sustained dietary change. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This pilot, randomized, controlled trial evaluated secondary and exploratory outcomes after a dietitian-led telehealth coaching intervention to improve diet quality in people with stage 3-4 CKD. The intervention group received phone calls every 2 weeks for 3 months (with concurrent, tailored text messages for 3 months), followed by 3 months of tailored text messages without telephone coaching, to encourage a diet consistent with CKD guidelines. The control group received usual care for 3 months, followed by nontailored, educational text messages for 3 months. RESULTS: Eighty participants (64% male), aged 62±12 years, were randomized to the intervention or control group. Telehealth coaching was safe, with no adverse events or changes to serum biochemistry at any time point. At 3 months, the telehealth intervention, compared with the control, had no detectable effect on overall diet quality on the Alternative Health Eating Index (3.2 points, 95% confidence interval, -1.3 to 7.7), nor at 6 months (0.5 points, 95% confidence interval, -4.6 to 5.5). There was no change in clinic BP at any time point in any group. There were significant improvements in several exploratory diet and clinical outcomes, including core food group consumption, vegetable servings, fiber intake, and body weight. CONCLUSIONS: Telehealth coaching was safe, but appeared to have no effect on the Alternative Healthy Eating Index or clinic BP. There were clinically significant changes in several exploratory diet and clinical outcomes, which require further investigation. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER: Evaluation of Individualized Telehealth Intensive Coaching to Promote Healthy Eating and Lifestyle in CKD (ENTICE-CKD), ACTRN12616001212448.","year":2020}
{"review_pmid":"41656984","record_index":2,"pmid":"30581138","title":"A combined physical activity and fall prevention intervention improved mobility-related goal attainment but not physical activity in older adults: a randomised trial.","abstract":"QUESTIONS: In people aged ≥ 60 years, does a combined physical activity and fall prevention intervention affect physical activity and mobility-related goal attainment? Does the combined intervention also improve fall rates, daily steps, the proportion of people meeting the physical activity guidelines, quality of life, mood, fear of falling, and mobility limitation? DESIGN: Randomised trial with concealed allocation, intention-to-treat analysis and assessor blinding. PARTICIPANTS: One hundred and thirty-one people living in the community and aged ≥ 60 years. INTERVENTIONS: The experimental group received one physiotherapist visit, fortnightly telephone-based health coaching, a pedometer, tailored fall prevention advice, and a fall prevention brochure. The control group received the same fall prevention brochure. OUTCOME MEASURES: Primary outcomes were mobility goal attainment (Goal Attainment Scale) and objectively measured physical activity (accelerometer counts per minute) at 6 and 12 months. Secondary outcomes were falls, other physical activity measures, quality of life, fear of falling, mood, and mobility. RESULTS: Participants had a mean age of 71 years (SD 6.5) and 31 (24%) had fallen in the past year. The experimental group reported significantly better mobility goal attainment at 6 months compared to controls (OR 2.0, 95% CI 1.1 to 3.7) but this was not maintained at 12 months (OR 1.1, 95% CI 0.6 to 2.1). Physical activity counts were not significantly different between groups at 6 months (MD 13 counts/minute, 95% CI -98 to 124) or 12 months (MD 56 counts/minute, 95% CI -14 to 125). There were no significant between-group differences in the secondary outcomes. CONCLUSION: A combined physical activity and fall prevention intervention was associated with significantly higher mobility goal attainment at 6 months. There was no significant impact on physical activity but future investigation in a larger trial is warranted. TRIAL REGISTRATION: ACTRN12614000016639.","year":2019}
{"review_pmid":"41656984","record_index":3,"pmid":"33103379","title":"Blended home-based exercise and dietary protein in community-dwelling older adults: a cluster randomized controlled trial.","abstract":"BACKGROUND: Effective and sustainable interventions are needed to counteract the decline in physical function and sarcopenia in the growing aging population. The aim of this study was to determine the 6 and 12 month effectiveness of blended (e-health + coaching) home-based exercise and a dietary protein intervention on physical performance in community-dwelling older adults. METHODS: This cluster randomized controlled trial allocated 45 clusters of older adults already engaged in a weekly community-based exercise programme. The clusters were randomized to three groups with ratio of 16:15:14; (i) no intervention, control (CON); (ii) blended home-based exercise intervention (HBex); and (iii) HBex with dietary protein counselling (HBex-Pro). Both interventions used a tablet PC with app and personalized coaching and were targeting on behaviour change. The study comprised coached 6 month interventions with a 6 month follow-up. The primary outcome physical performance was assessed by modified Physical Performance Test (m-PPT). Secondary outcomes were gait speed, physical activity level (PAL), handgrip muscle strength, protein intake, skeletal muscle mass, health status, and executive functioning. Linear mixed models of repeated measured were used to assess intervention effects at 6 and 12 months. RESULTS: The population included 245 older adults (mean age 72 ± 6.5 (SD) years), 71% female, and 54% co-morbidities observed. Dropout of the intervention was 18% at 6 months and 26% at 12 months. Participants were well functioning, based on an m-PPT score of 33.9 (2.8) out of 36. For the primary outcome m-PPT, no significant intervention effects (HBex, +0.03, P = 0.933; HBex-Pro, -0.13, P = 0.730) were found. Gait speed (+0.20 m/s, P = 0.001), PAL (+0.06, P = 0.008), muscle strength (+2.32 kg, P = 0.001), protein intake (+0.32 g/kg/day, P < 0.001), and muscle mass (+0.33 kg, P = 0.017) improved significantly in the HBex-Pro group compared with control group after 6 month intervention. The protein intake, muscle mass, and strength remained significantly improved after 12 months as compared with those of control. Health change and executive functioning improved significantly in both intervention groups after 6 months. CONCLUSIONS: This HBex and dietary protein interventions did not change the physical performance (m-PPT) in community-dwelling older adults. Changes were observed in gait speed, PAL, muscle mass, strength, and dietary protein intake, in response to this combined intervention.","year":2020}
{"review_pmid":"41656984","record_index":4,"pmid":"29609594","title":"Cluster Randomized Controlled Trial of a Multilevel Physical Activity Intervention for older","abstract":"Background: Older adults are the least active population group. Interventionsin residential settings may support a multi-level approach to behavior change. Methods: In a cluster randomized control trial, 11 SanDiegoretirement communities were assigned to a physical activity (PA) intervention or a healthy aging attentioncontrol condition. Participants were 307 adults over 65 years old. The multilevel PA intervention was delivered with the assistance of peer leaders,who were trained older adult from the retirement communities. Interventioncomponents included individual counseling & self-monitoring with pedometers, group education sessions,group walks, communityadvocacy and pedestriancommunitychange projects. Interventionconditionby time interactionswere tested using generalized mixed effects regressions. The primary outcomes was accelerometer measured physical activity. Secondary outcomes were blood pressure and objectively measured physical functioning. Results: Over 70%of the sample were 80 years or older. PA significantly increased intheinterventioncondition (56 min ofmoderate-vigorous PA per week; 119min of light PA) comparedwith thecontrol condition and remained significantly higher across the12 month study. Men and participants under 84 years old benefitedmost from the intervention. There was a significant decrease in systolic (p<.007) and diastolic (p<.02) blood pressure at 6months. Physical functioning improved but thechanges were not statistically significant. Conclusions: Interventionfidelitywashighdemonstratingfeasibility. ChangesinPAandbloodpressureachievedwere comparabletootherstudieswithmuchyoungerparticipants. Men,inparticular,avoidedayear-longdeclineinPA. Trialregistration:clincialtrials.govIdentifier:NCT01155011. Background approaches at the individual or group level [3, 4]. In Physical inactivity has been identified as a major public 2015, the Office of the Surgeon General in the US Dehealth problem, particularly for older adults [1]. In partment of Health and Human Services released “Step additiontolongevity, physical activity(PA)confers many It Up! The Surgeon General's Call to Action to Promote health benefits to older adults including maintaining WalkingandWalkableCommunities” torecognizewalkphysical functioning and controlling conditions such as ingasanimportant waytopromotephysicalactivity and hypertension that are prevalent in this age group [2]. researchers have proposed ecological approaches to Several reviews have shown that PA in older adults can reach larger population groups [5]. While there are be increased in short term (6 month) controlled trials in many successful walking interventions [6], few intervenmultiple settings using behavioral and cognitive tions in older adults have included pedestrian advocacy to promote environmental changes [7] or assessed longterm sustainable approaches tobehaviorchange.","year":2018}
{"review_pmid":"41656984","record_index":5,"pmid":"35507345","title":"Comparison of Collaborative Goal Setting With Enhanced Education for Managing Diabetes-associ","abstract":"KeyPoints Question IsEmpoweringPatientsin IMPORTANCE Type2diabetesisaprevalentandmorbidcondition. PoorengagementwithselfChronicCare(EPICC),anevidencemanagementcancontributetodiabetes-associateddistressandhinderdiabetescontrol. based,collaborativegoal-setting approachusingpeercoachingand OBJECTIVE ToevaluatetheimplementationandeffectivenessofEmpoweringPatientsinChronic individualmotivationalinterviewing, Care(EPICC),anevidence-basedinterventiontoimprovediabetes-associateddistressand effectiveatreducinghemoglobinA hemoglobinA (HbA )levelsaftertheinterventionandafter6-monthmaintenance. 1c 1c 1c levelsanddiabetes-associateddistress amongadultsinroutineprimarycare DESIGN,SETTING,ANDPARTICIPANTS Thishybrid(implementation-effectiveness)randomized settings? clinicaltrialwasperformedinVeteransAffairsclinicsacrossIllinois,Indiana,andTexasfromJuly1, 2015,toJune30,2017. Participantsincludedadultswithuncontrolledtype2diabetes(HbA level Findings Inthisrandomizedclinicaltrial 1c >8.0%)whoreceivedprimarycareduringtheprioryearinparticipatingclinics. Datacollectionwas involving280participantsfrom5 completedonNovember30,2018,anddataanalysiswascompletedonJune30,2020. Allanalyses VeteransAffairsclinicsinIllinois, werebasedonintentiontotreat. Indiana,andTexas,theEPICCgrouphad significantimprovementsinhemoglobin INTERVENTIONS ParticipantsinEPICCattended6groupsessionsbasedonacollaborativegoal- A levelsat4monthspostintervention, 1c settingtheoryledbyhealthcareprofessionals. Cliniciansconductedindividualmotivational butimprovementswerenotsustained interviewingsessionsaftereachgroup. Usualcarewasenhanced(EUC)withdiabeteseducation. at10months(maintenance)compared withtheenhancedusualcaregroup. MAINOUTCOMESANDMEASURES TheprimaryoutcomeconsistedofchangesinHbA levels Comparedwithusualcare,EPICC 1c aftertheinterventionandduringmaintenance. SecondaryoutcomesincludedtheDiabetesDistress demonstratedmodestimprovementsin Scale(DDS),MoriskyMedicationAdherenceScale,andLorigSelf-efficacyScale. Secondary diabetes-associateddistresspost implementationoutcomesincludedreach,adoption,andimplementation(numberofsessions interventionthatweresustainedduring attendedperpatient). maintenance. Meaning Thesefindingssuggestthata RESULTS Atotalof280participantswithtype2diabetes(mean[SD]age,67.2[8.4]years;264men patient-empowermentapproachusing [94.3];134non-HispanicWhiteindividuals[47.9%])wereequallyrandomizedtoEPICCorEUC. collaborativegoalsetting,peer ParticipantsreceivingEPICChadsignificantpostinterventionimprovementsinHbA levels(F 1c 1, coaching,andmotivationalinterviewing 252=9.12,Cohend=0.36[95%CI,0.12-0.59];P=.003)andDDS(F 1,245 =9.06,Cohend=0.37 isfeasibleinprimarycareclinicsandis [95%CI,0.13-0.60];P=.003)comparedwithEUC. Duringmaintenance,differencesbetweenthe modestlyeffectiveatreducingdiabetesEUCandEPICCgroupsremainedsignificantforDDSscore(F =8.94,Cohend=0.36[95%CI, 1,245 associateddistress,althoughitmaynot 0.12-0.59];P=.003)butnotforHbA levels(F =0.29,Cohend=0.06[95%CI,−0.17to0.30]; 1c 1,252 sustainimprovementsinglycemic P=.60). ImprovementsinDDSscoresweremodest. TherewerenodifferencesbetweenEPICCand controlcomparedwithusualcare. EUCinimprovementsafterinterventionormaintenanceforeitheradherenceorself-efficacy. Among all4002eligiblepatients,280(7.0%)enrolledinthestudy(reach). Eachclinicconductedallplanned + EPICCsessionsandcohorts(100%adoption). TheEPICCgroupparticipantsattendedamean(SD) VisualAbstract of4.34(1.98)sessions,with54(38.6%)receivingall6sessions. + Supplementalcontent (continued) Authoraffiliationsandarticleinformationare listedattheendofthisarticle. OpenAccess. ThisisanopenaccessarticledistributedunderthetermsoftheCC-BYLicense. JAMANetworkOpen.2022;5(5):e229975.doi:10.1001/jamanetworkopen.2022.9975 (Reprinted) May4,2022 1/13 Downloaded from jamanetwork.com by guest on 05/19/2026 JAMANetworkOpen | HealthPolicy GoalSettingvsEnhancedEducationforManagingDiabetes-AssociatedDistressandHbA 1c Abstract(continued) CONCLUSIONSANDRELEVANCE Apatient-empowermentapproachusinglongitudinal collaborativegoalsettingandmotivationalinterviewingisfeasibleinprimarycare. Improvementsin HbA levelsaftertheinterventionwerenotsustainedaftermaintenance. Modestimprovementsin 1c diabetes-associateddistressaftertheinterventionweresustainedaftermaintenance. Innovationsto expandreach(eg,telemedicine-enabledsharedappointments)andsustainabilityareneeded. TRIALREGISTRATION ClinicalTrials.govIdentifier:NCT01876485 JAMANetworkOpen.2022;5(5):e229975.doi:10.1001/jamanetworkopen.2022.9975","year":2022}
{"review_pmid":"41656984","record_index":6,"pmid":"22414198","title":"Diabetic Medicine - 2012 - van der Wulp - Effectiveness of peer-led self-management coaching for patients recently","abstract":null,"year":2012}
{"review_pmid":"41656984","record_index":7,"pmid":"31418811","title":"Effect of Physical Activity Coaching on Acute Care and Survival Among Patients With Chronic Obstructive Pulmonary Disease: A Pragmatic Randomized Clinical Trial.","abstract":"IMPORTANCE: While observational studies show that physical inactivity is associated with worse outcomes in chronic obstructive pulmonary disease (COPD), there are no population-based trials to date testing the effectiveness of physical activity (PA) interventions to reduce acute care use or improve survival. OBJECTIVE: To evaluate the long-term effectiveness of a community-based PA coaching intervention in patients with COPD. DESIGN, SETTING, AND PARTICIPANTS: Pragmatic randomized clinical trial with preconsent randomization to the 12-month Walk On! (WO) intervention or standard care (SC). Enrollment occurred from July 1, 2015, to July 31, 2017; follow-up ended in July 2018. The setting was Kaiser Permanente Southern California sites. Participants were patients 40 years or older who had any COPD-related acute care use in the previous 12 months; only patients assigned to WO were approached for consent to participate in intervention activities. INTERVENTIONS: The WO intervention included collaborative monitoring of PA step counts, semiautomated step goal recommendations, individualized reinforcement, and peer/family support. Standard COPD care could include referrals to pulmonary rehabilitation. MAIN OUTCOMES AND MEASURES: The primary outcome was a composite binary measure of all-cause hospitalizations, observation stays, emergency department visits, and death using adjusted logistic regression in the 12 months after randomization. Secondary outcomes included self-reported PA, COPD-related acute care use, symptoms, quality of life, and cardiometabolic markers. RESULTS: All 2707 eligible patients (baseline mean [SD] age, 72 [10] years; 53.7% female; 74.3% of white race/ethnicity; and baseline mean [SD] percent forced expiratory volume in the first second of expiration predicted, 61.0 [22.5]) were randomly assigned to WO (n = 1358) or SC (n = 1349). The intent-to-treat analysis showed no differences between WO and SC on the primary all-cause composite outcome (odds ratio [OR], 1.09; 95% CI, 0.92-1.28; P =.33) or in the individual outcomes. Prespecified, as-treated analyses compared outcomes between all SC and 321 WO patients who participated in any intervention activities (23.6% [321 of 1358] uptake). The as-treated, propensity score-weighted model showed nonsignificant positive estimates in favor of WO participants compared with SC on all-cause hospitalizations (OR, 0.84; 95% CI, 0.65-1.10; P =.21) and death (OR, 0.62; 95% CI, 0.35-1.11; P =.11). More WO participants reported engaging in PA compared with SC (47.4% [152 of 321] vs 30.7% [414 of 1349]; P <.001) and had improvements in the Patient-Reported Outcomes Measurement Information System 10 physical health domain at 6 months. There were no group differences in other secondary outcomes. CONCLUSIONS AND RELEVANCE: Participation in a PA coaching program by patients with a history of COPD exacerbations was insufficient to effect improvements in acute care use or survival in the primary analysis. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02478359.","year":2019}
{"review_pmid":"41656984","record_index":8,"pmid":"25045253","title":"Effect of a health coaching self-management program for older adults with multimorbidity in nursing homes.","abstract":"BACKGROUND AND AIMS: Although a growing number of older people are suffering from multimorbidity, most of the health problems related to multimorbidity can be improved by self-management. The aim of this study was to examine the effectiveness of a health coaching self-management program for older adults with multimorbidity in nursing homes. METHODS: Older adults with multimorbidity from one nursing home in Korea were randomly allocated to either an intervention group (n=22) or conventional group (n=21). Participants in the intervention group met face to face with the researchers twice a week for 8 weeks, during which time the researchers engaged them in goal setting and goal performance using the strategies in the health coaching self-management program. Regular care was provided to the other participants in the conventional group. RESULTS: Participants in the intervention group had significantly better outcomes in exercise behaviors (P=0.015), cognitive symptom management (P=0.004), mental stress management/relaxation (P=0.023), self-rated health (P=0.002), reduced illness intrusiveness (P<0.001), depression (P<0.001), and social/role activities limitations (P<0.001). In addition, there was a significant time-by-group interaction in self-efficacy (P=0.036). According to the goal attainment scales, their individual goals of oral health and stress reduction were achieved. CONCLUSION: The health coaching self-management program was successfully implemented in older adults with multimorbidity in a nursing home. Further research is needed to develop and evaluate the long-term effects of an intervention to enhance adherence to self-management and quality of life for older adults with multimorbidity.","year":2014}
{"review_pmid":"41656984","record_index":9,"pmid":"39137413","title":"Effect of a Mobile Health-Based Remote Interaction Management Intervention on the Quality of Life and Self-Management Behavior of Patients With Low Anterior Resection Syndrome: Randomized Controlled Trial.","abstract":"BACKGROUND: People who undergo sphincter-preserving surgery have high rates of anorectal functional disturbances, known as low anterior resection syndrome (LARS). LARS negatively affects patients' quality of life (QoL) and increases their need for self-management behaviors. Therefore, approaches to enhance self-management behavior and QoL are vital. OBJECTIVE: This study aims to assess the effectiveness of a remote digital management intervention designed to enhance the QoL and self-management behavior of patients with LARS. METHODS: From July 2022 to May 2023, we conducted a single-blinded randomized controlled trial and recruited 120 patients with LARS in a tertiary hospital in Hefei, China. All patients were randomly assigned to the intervention group (using the \"e-bowel safety\" applet and monthly motivational interviewing) or the control group (usual care and an information booklet). Our team provided a 3-month intervention and followed up with all patients for an additional 3 months. The primary outcome was patient QoL measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30. The secondary outcomes were evaluated using the Bowel Symptoms Self-Management Behaviors Questionnaire, LARS score, and Perceived Social Support Scale. Data collection occurred at study enrollment, the end of the 3-month intervention, and the 3-month follow-up. Generalized estimating equations were used to analyze changes in all outcome variables. RESULTS: In the end, 111 patients completed the study. In the intervention group, 5 patients withdrew; 4 patients withdrew in the control group. Patients in the intervention group had significantly larger improvements in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 total score (mean difference 11.51; 95% CI 10.68-12.35; Cohen d=1.73) and Bowel Symptoms Self-Management Behaviors Questionnaire total score (mean difference 8.80; 95% CI 8.28-9.32; Cohen d=1.94) than those in the control group. This improvement effect remained stable at 3-month follow-up (mean difference 14.47; 95% CI 13.65-15.30; Cohen d=1.58 and mean difference 8.85; 95% CI 8.25-9.42; Cohen d=2.23). The LARS score total score had significantly larger decreases after intervention (mean difference -3.28; 95% CI -4.03 to -2.54; Cohen d=-0.39) and at 3-month follow-up (mean difference -6.69; 95% CI -7.45 to -5.93; Cohen d=-0.69). The Perceived Social Support Scale total score had significantly larger improvements after intervention (mean difference 0.47; 95% CI 0.22-0.71; Cohen d=1.81). CONCLUSIONS: Our preliminary findings suggest that the mobile health-based remote interaction management intervention significantly enhanced the self-management behaviors and QoL of patients with LARS, and the effect was sustained. Mobile health-based remote interventions become an effective method to improve health outcomes for many patients with LARS. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2200061317; https://tinyurl.com/tmmvpq3.","year":2024}
{"review_pmid":"41656984","record_index":10,"pmid":"36279299","title":"Effectiveness of integrated care for older adults with depression and hypertension in rural China: A cluster randomized controlled trial.","abstract":"BACKGROUND: Effectiveness of integrated care management for common, comorbid physical and mental disorders has been insufficiently examined in low- and middle-income countries (LMICs). We tested hypotheses that older adults treated in rural Chinese primary care clinics with integrated care management of comorbid depression and hypertension (HTN) would show greater improvements in depression symptom severity and HTN control than those who received usual care. METHODS AND FINDINGS: The study, registered with ClinicalTrials.gov as Identifier NCT01938963, was a cluster randomized controlled trial with 12-month follow-up conducted from January 1, 2014 through September 30, 2018, with analyses conducted in 2020 to 2021. Participants were residents of 218 rural villages located in 10 randomly selected townships of Zhejiang Province, China. Each village hosts 1 primary care clinic that serves all residents. Ten townships, each containing approximately 20 villages, were randomly selected to deliver either the Chinese Older Adult Collaborations in Health (COACH) intervention or enhanced care-as-usual (eCAU) to eligible village clinic patients. The COACH intervention consisted of algorithm-driven treatment of depression and HTN by village primary care doctors supported by village lay workers with telephone consultation from centrally located psychiatrists. Participants included clinic patients aged ≥60 years with a diagnosis of HTN and clinically significant depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] score ≥10). Of 2,899 eligible village residents, 2,365 (82%) agreed to participate. They had a mean age of 74.5 years, 67% were women, 55% had no schooling, 59% were married, and 20% lived alone. Observers, older adult participants, and their primary care providers (PCPs) were blinded to study hypotheses but not to group assignment. Primary outcomes were change in depression symptom severity as measured by the Hamilton Depression Rating Scale (HDRS) total score and the proportion with controlled HTN, defined as systolic blood pressure (BP) <130 mm Hg or diastolic BP <80 for participants with diabetes mellitus, coronary heart disease, or renal disease, and systolic BP <140 or diastolic BP <90 for all others. Analyses were conducted using generalized linear mixed effect models with intention to treat. Sixty-seven of 1,133 participants assigned to eCAU and 85 of 1,232 COACH participants were lost to follow-up over 12 months. Thirty-six participants died of natural causes, 22 in the COACH arm and 14 receiving eCAU. Forty COACH participants discontinued antidepressant medication due to side effects. Compared with participants who received eCAU, COACH participants showed greater reduction in depressive symptoms (Cohen's d [±SD] = -1.43 [-1.71, -1.15]; p < 0.001) and greater likelihood of achieving HTN control (odds ratio [OR] [95% CI] = 18.24 [8.40, 39.63]; p < 0.001). Limitations of the study include the inability to mask research assessors and participants to which condition a village was assigned, and lack of information about participants' adherence to recommendations for lifestyle and medication management of HTN and depression. Generalizability of the model to other regions of China or other LMICs may be limited. CONCLUSIONS: The COACH model of integrated care management resulted in greater improvement in both depression symptom severity and HTN control among older adult residents of rural Chinese villages who had both conditions than did eCAU. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT01938963 https://clinicaltrials.gov/ct2/show/NCT01938963.","year":2022}
{"review_pmid":"41656984","record_index":11,"pmid":"22414198","title":"Effectiveness of peer-led self-management coaching for patients recently diagnosed with Type 2 diabetes mellitus in primary care: a randomized controlled trial.","abstract":"AIMS: To study the effectiveness of a peer-led self-management coaching intervention in recently diagnosed patients with Type 2 diabetes. METHODS: Randomized controlled trial of recently diagnosed patients with Type 2 diabetes from 54 participating general practices. The intervention group received three home visits by an experienced peer (expert patient) who adhered to the recommended treatment and lifestyle guidelines. Together with their expert patient, participants set feasible goals and these were evaluated in the next visit. Participants in the control group received care as usual. At baseline, 3 months and 6 months post-intervention, participants completed a questionnaire measuring changes in self-efficacy, coping, physical activity, dietary habits, psychological well-being, depressive symptoms and diabetes related distress. RESULTS: In total, 327 patients were eligible for inclusion in the study of which 133 consented to participate. In participating patients, self-efficacy, coping and saturated fat intake improved significantly over time. Analyses of participants with low self-efficacy at baseline (25th percentile: 44) revealed a significant time × group difference, F = 3.71; P = 0.03. Participants who reported low psychological well-being at baseline increased substantially throughout the study (F = 23.84; P < 0.01) but no significant time × group differences were found. CONCLUSIONS: A peer-led self-management coaching programme for recently diagnosed patients with Type 2 diabetes improved self-efficacy of patients experiencing low self-efficacy shortly after diagnosis.","year":2012}
{"review_pmid":"41656984","record_index":12,"pmid":"32960886","title":"Effects of telephone-based health coaching on patient-reported outcomes and health behavior change: A randomized controlled trial.","abstract":"OBJECTIVE: Telephone based health coaching (TBHC) seems to be a promising approach to foster self-management in patients with chronic conditions. The aim of this study was to evaluate the effectiveness of a TBHC on patient-reported outcomes and health behavior for people living with chronic conditions in Germany. METHODS: Patients insured at a statutory health insurance were randomized to an intervention group (IG; TBHC) and a control group (CG; usual care), using a stratified random allocation before giving informed consent (Zelen's single-consent design). The TBHC was based on motivational interviewing, goal setting, and shared decision-making and carried out by trained nurses. All outcomes were assessed yearly for three years. We used mixed effects models utilizing all available data in a modified intention-to-treat sample for the main analysis. Participants and study centers were included as random effects. All models were adjusted for age, education and campaign affiliation. RESULTS: Of the 10,815 invited patients, 4,283 returned their questionnaires at baseline. The mean age was 67.23 years (SD = 9.3); 55.5% were female. According to the model, TBHC was statistically significant superior to CG regarding 6 of 19 outcomes: physical activity in hours per week (p =.030) and in metabolic rate per week (p =.048), BMI (p =.009) (although mainly at baseline), measuring blood pressure (p<.001), patient activation (p<.001), and health literacy (p<.001). Regarding stages of change (p =.005), the IG group also showed statistically different results than the CG group, however the conclusion remains inconclusive. Within-group contrasts indicating changes from baseline to follow-ups and significant between-group comparisons regarding these changes supported the findings. Standardized effect sizes were small. TBHC did not show any effect on mental QoL, health status, alcohol, smoking, adherence, measuring blood sugar, foot monitoring, anxiety, depression and distress. Campaign-specific subgroup effects were detected for 'foot monitoring by a physician' and 'blood sugar measurement'. CONCLUSION: TBHC interventions might have small effects on some patient reported and behavioral outcomes. PRACTICE IMPLICATIONS: Future research should focus on analyzing which intervention components are effective and who profits most from TBHC interventions. REGISTRATION: German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS): DRKS00000584.","year":2020}
{"review_pmid":"41656984","record_index":13,"pmid":"24722960","title":"Effects of a multiple health behavior change intervention for colorectal cancer survivors on psychosocial outcomes and quality of life: a randomized controlled trial.","abstract":"BACKGROUND: Multiple health behavior change can ameliorate adverse effects of cancer. PURPOSE: The purpose of this study was to determine the effects of a multiple health behavior change intervention (CanChange) for colorectal cancer survivors on psychosocial outcomes and quality of life. METHODS: A total of 410 colorectal cancer survivors were randomized to a 6-month telephone-based health coaching intervention (11 sessions using acceptance and commitment therapy strategies focusing on physical activity, weight management, diet, alcohol, and smoking) or usual care. Posttraumatic growth, spirituality, acceptance, mindfulness, distress, and quality of life were assessed at baseline, 6 and 12 months. RESULTS: Significant intervention effects were observed for posttraumatic growth at 6 (7.5, p < 0.001) and 12 months (4.1, p = 0.033), spirituality at 6 months (1.8, p = 0.011), acceptance at 6 months (0.2, p = 0.005), and quality of life at 6 (0.8, p = 0.049) and 12 months (0.9, p = 0.037). CONCLUSIONS: The intervention improved psychosocial outcomes and quality of life (physical well-being) at 6 months with most effects still present at 12 months. ( TRIAL REGISTRATION NUMBER: ACTRN12608000399392).","year":2014}
{"review_pmid":"41656984","record_index":14,"pmid":"33906954","title":"Feasibility of a Health Coaching and Home-Based Rehabilitation Intervention With Remote Monitoring for COPD.","abstract":"BACKGROUND: Pulmonary rehabilitation is an effective treatment for patients with COPD, but patient uptake and adherence to the current offering of center-based pulmonary rehabilitation is modest due to transportation, access, poverty, and frailty, and even more so in the context of the COVID pandemic. Home-based options have been proposed and were found noninferior to center-based rehabilitation; however, there is a lack of home-based programs, and more understanding is needed. We aimed to test the feasibility, uptake, and adherence to a home-based program for COPD rehabilitation with health coaching. METHODS: We conducted a randomized trial with a wait-list controlled design to evaluate the effects of a home-based program with health coaching on breathlessness in subjects with moderate to severe COPD unable to attend the regular pulmonary rehabilitation program. The 8-week intervention consisted of video-guided exercises to be done 6 times a week and captured with a computer tablet. Health coaching was done weekly over the telephone to review subject activity and symptoms and to provide an opportunity for the subject to define their weekly goals. The primary outcomes were uptake, adherence, and Chronic Respiratory Questionnaire (CRQ) Dyspnea Domain. Secondary outcomes were self-management abilities and CRQ Emotions-Mastery-Fatigue. RESULTS: 154 subjects with moderate to severe COPD were randomized. Subject adherence was 86% to the proposed 6-times a week exercise routine. There (P =.062) was no significant difference in breathlessness (CRQ dyspnea). There was a significant improvement in self-management abilities (P <.001). The results of the qualitative interviews showed high levels of acceptability of the program. CONCLUSIONS: The tested home-based rehabilitation program with health coaching was feasible, highly acceptable, showed a high degree of adherence, and improved self-management abilities. This study offers seminal information for home-based rehabilitation programs to design alternative options of rehabilitation to individuals with COPD that cannot attend to the well-established center-based pulmonary rehabilitation. (ClinicalTrials.gov registration NCT02557178.).","year":2021}
{"review_pmid":"41656984","record_index":15,"pmid":"33323224","title":"Healthy ageing through internet counselling in the elderly (HATICE): a multinational, randomised controlled trial.","abstract":"BACKGROUND: Although web-based interventions have been promoted for cardiovascular risk management over the past decade, there is limited evidence for effectiveness of these interventions in people older than 65 years. The healthy ageing through internet counselling in the elderly (HATICE) trial aimed to determine whether a coach-supported internet intervention for self-management can reduce cardiovascular risk in community-dwelling older people. METHODS: This prospective open-label, blinded endpoint clinical trial among people age 65 years or over at increased risk of cardiovascular disease randomly assigned participants in the Netherlands, Finland, and France to an interactive internet intervention stimulating coach-supported self-management or a control platform. Primary outcome was the difference from baseline to 18 months on a standardised composite score (Z score) of systolic blood pressure, LDL cholesterol, and body-mass index (BMI). Secondary outcomes included individual risk factors and cardiovascular endpoints. This trial is registered with the ISRCTN registry, 48151589, and is closed to accrual. FINDINGS: Among 2724 participants, complete primary outcome data were available for 2398 (88%). After 18 months, the primary outcome improved in the intervention group versus the control group (0·09 vs 0·04, respectively; mean difference -0·05, 95% CI -0·08 to -0·01; p=0·008). For individual components of the primary outcome, mean differences (intervention vs control) were systolic blood pressure -1·79 mm Hg versus -0·67 mm Hg (-1·12, -2·51 to 0·27); BMI -0·23 kg/m2 versus -0·08 kg/m2 (-0·15, -0·28 to -0·01); and LDL -0·12 mmol/L versus -0·07 mmol/L (-0·05, -0·11 to 0·01). Cardiovascular disease occurred in 30 (2·2%) of 1382 patients in the intervention versus 32 (2·4%) of 1333 patients in the control group (hazard ratio 0·86, 95% CI 0·52 to 1·43). INTERPRETATION: Coach-supported self-management of cardiovascular risk factors using an interactive internet intervention is feasible in an older population, and leads to a modest improvement of cardiovascular risk profile. When implemented on a large scale this could potentially reduce the burden of cardiovascular disease. FUNDING: European Commission Seventh Framework Programme.","year":2019}
{"review_pmid":"41656984","record_index":16,"pmid":"39309736","title":"Impact of the Promoting Physical Activity in Regional and Remote Cancer Survivors intervention on health-related quality of life in breast and colorectal cancer survivors.","abstract":"BACKGROUND: The PPARCS trial examined the efficacy of a distance-based wearable and health coaching intervention to increase physical activity (PA) in breast and colorectal cancer (CRC) survivors living in non-metropolitan areas. This paper examines the effects of the intervention on health-related quality of life (HRQoL) at 12 weeks (T2; end of intervention) and 24 weeks (T3; follow-up). METHODS: Participants that were insufficiently physically active and had successfully completed cancer treatment were randomised to an intervention or control group. PA was assessed using an ActiGraph (GT9X) at baseline, T2, and T3. Intervention effects on HRQoL were analysed using quantile regression comparing treatment groups across time. RESULTS: A total of 87 were randomised to intervention and control groups. There were generally no statistically significant differences between the groups on any HRQoL item except for pain. There was an arm (F(1, 219) = 5.0. p = 0.027) and time (F(2,221) = 4.8, p = 0.009) effect, reflecting the higher pain scores in the control group when collapsed across time points (median difference 16.7, CI 1.9 to 31.4, p = 0.027). For global HRQoL, the intervention group increased by 8.3 points between T1 and T2. The overall group median when collapsed across time was 16.7 points CI 8.2 to 25.2, p <0.001) greater in the intervention group than controls. CONCLUSIONS: While the PPARCS intervention resulted in significant increases in PA, participants indicated a high HRQoL at baseline, leaving little room for improvement. Findings suggest that PA may improve global HRQoL and pain in breast and CRC survivors.","year":2024}
{"review_pmid":"41656984","record_index":17,"pmid":"33103379","title":"J cachexia sarcopenia muscle - 2020 - Helder - Blended home-based exercise and dietary protein in community-dwelling older","abstract":"Background Effectiveandsustainableinterventionsareneededtocounteractthedeclineinphysicalfunctionandsarcopenia inthegrowingagingpopulation. Theaimofthisstudywastodeterminethe6and12montheffectivenessofblended(e-health + coaching) home-based exercise and a dietary protein intervention on physical performance in community-dwelling older adults. Methods This cluster randomized controlled trial allocated 45 clusters of older adults already engaged in a weekly community-basedexerciseprogramme. Theclusterswererandomizedtothreegroupswithratioof16:15:14;(i)nointervention, control (CON); (ii) blended home-based exercise intervention (HBex); and (iii) HBex with dietary protein counselling (HBex-Pro). BothinterventionsusedatabletPCwithappandpersonalizedcoachingandweretargetingonbehaviourchange. Thestudycomprisedcoached6monthinterventions witha6monthfollow-up. Theprimary outcomephysicalperformance was assessed by modified Physical Performance Test (m-PPT). Secondary outcomes were gait speed, physical activity level (PAL),handgripmusclestrength,proteinintake,skeletalmusclemass,healthstatus,andexecutivefunctioning. Linearmixed modelsofrepeatedmeasuredwereusedtoassessinterventioneffectsat6and12months. Results Thepopulationincluded245olderadults(meanage72±6.5(SD)years),71%female,and54%co-morbiditiesobserved. Dropoutoftheinterventionwas18%at6monthsand26%at12months. Participantswerewellfunctioning,basedon an m-PPT score of 33.9 (2.8) out of 36. For the primary outcome m-PPT, no significant intervention effects (HBex, +0.03, P=0.933;HBex-Pro,(cid:1)0.13,P=0.730)werefound. Gaitspeed(+0.20m/s,P=0.001),PAL(+0.06,P=0.008),musclestrength (+2.32kg,P=0.001),proteinintake(+0.32g/kg/day,P<0.001),andmusclemass(+0.33kg,P=0.017)improvedsignificantly intheHBex-Progroupcomparedwithcontrolgroupafter6monthintervention. Theproteinintake,musclemass,andstrength remainedsignificantlyimprovedafter12monthsascomparedwiththoseofcontrol. Healthchangeandexecutivefunctioning improvedsignificantlyinbothinterventiongroupsafter6months. Conclusions This HBex and dietary protein interventions did not change the physical performance (m-PPT) in community-dwelling olderadults. Changeswere observed ingait speed, PAL, muscle mass, strength, and dietary protein intake,inresponsetothiscombinedintervention.","year":2020}
{"review_pmid":"41656984","record_index":18,"pmid":"27605214","title":"JournalofTelemedicineandTelecare Long-term effectiveness of telephone-based !TheAuthor(s)2016 Reprintsandpermissions: health coaching for heart failure patients:","abstract":"Introduction: Thehealth-statusofheartfailurepatientscanbeimprovedtosomeextentbydiseaseself-management. Onemethod of developing such skills is telephone-based health coaching. However, the effects of telephone-based health coaching remain inconclusive. The aim of this study was to evaluate the effects of a telephone-based health coaching for people with heart failure. Methods:A totalsampleof7186patients withvariouschronicdiseases wasrandomlyassigned toeither thecoachingor the controlgroup. Then184patientswithheartfailurewereselectedbyInternationalClassificationofDiseases(ICD)-10codefor subgroup analysis. Data were collected at 24 and 48 months after the beginning of the coaching. The primary outcome was change in quality of life. Secondary outcomes were changes in depression and anxiety, health-related control beliefs, control preference,healthriskbehaviourandhealth-relatedbehaviours. Statisticalanalysesincludedaper-protocolevaluation,employing analysis of variance and analysis of covariance (ANCOVA) as well as Mann-Whitney U tests. Results: Participants’averageagewas73years(standarddeviation(SD)¼9)andthemajoritywerewomen(52.8%). InANCOVA analysestherewerenosignificantdifferencesbetweengroupsforthechangeinqualityoflife(QoL) However,thecoachinggroup. reportedasignificantlyhigherlevelofphysicalactivity(p¼0.03),lowerintakeofnon-prescribeddrugs(p¼0.04)andlowerlevels of stress(p¼0.02) than the control group. Mann-Whitney U tests showed a differentexternal locus of control(p¼0.014), and higher reduction in unhealthy nutrition (p¼0.019), physical inactivity (p¼0.004) and stress (p¼0.028). Discussion: Our results suggest that telephone-based health coaching has no effect on QoL, anxiety and depressionof heart failure patients, but helps in improving certain risk behaviours and changes the locus of control to be more externalised.","year":2016}
{"review_pmid":"41656984","record_index":19,"pmid":"26944692","title":"Management of Type 2 Diabetes in China The Happy Life Club, a Pragmatic Cluster Rando","abstract":"Strengths and limitations of this study ChapmanA,YangH,etal. Objective: Toassesstheeffectivenessofacoach-led Managementoftype2 motivationalinterviewing(MI)interventioninimproving ▪ This is a rigorous pragmatic cluster randomised diabetesinChina:theHappy LifeClub,apragmaticcluster glycaemiccontrol,aswellasclinical,psychosocialand controlled trial implemented in real-world randomisedcontrolledtrial self-careoutcomesofindividualswithtype2diabetes Community Health Stations (CHSs) in urban usinghealthcoaches.BMJ mellitus(T2DM)comparedwithusualcare. China,utilisingexistingresources. Open2016;6:e009319. Design: Pragmaticclusterrandomisedcontrolledtrial ▪ Thepragmaticnatureofthistrialmeantthatdata doi:10.1136/bmjopen-2015- (RCT). collectionwasconductedbymultipledatacollec009319 Setting: CommunityHealthStations(CHSs)inFengtai tors from multiple CHSs and resulted in higher district,Beijing,China. thananticipatedlevelsofmissingdata. ▸ Prepublicationhistoryand Participants: Ofthe41randomisedCHSs(21 ▪ Medication use and adherence was not rigoradditionalmaterialis interventionand20control),21interventionCHSs ouslyassessed,however,itcanbeassumedthat available. Toviewpleasevisit (372participants)and18controlCHSs(296 both groups were medicated similarly as per the thejournal(http://dx.doi.org/ participants)startedparticipation. ChineseDiabetesSocietyguideline. 10.1136/bmjopen-2015Intervention: Interventionparticipantsreceived 009319). telephoneandface-to-faceMIhealthcoachingin ofregular,freeclinicalhealthchecksforpeoplewith Received6July2015 additiontousualcarefromtheirCHS. Control T2DMinChina. Revised9February2016 participantsreceivedusualcareonly. Medicalfeeswere Accepted10February2016 waivedforbothgroups. Trialregistration number:ISRCTN01010526; PreOutcome measures: Outcomeswereassessedat results. baseline,6and12months. Primaryoutcomemeasure wasglycatedhaemoglobin(HbA1c). Secondary outcomesincludedasuiteofanthropometric,blood","year":2015}
{"review_pmid":"41656984","record_index":20,"pmid":"33395500","title":"Mechanisms and Effects of Health Coaching in Patients With Early-Stage Chronic Kidney Disease: A Randomized Controlled Trial.","abstract":"PURPOSE: To examine the effects of health coaching on self-management and quality of life (QOL) in patients with chronic kidney disease (CKD) and to evaluate whether self-efficacy and patient activation mediate the effect of health coaching on self-management and QOL. DESIGN AND METHODS: A single-center, parallel-group, randomized controlled trial. A total of 108 patients with stages 1 to 3a CKD participated in the study. Participants were randomly assigned to a health-coaching intervention group or a usual care control group. Participants' QOL (World Health Organization Quality of Life Scale), self-management (CKD Self-Management instrument), patient activation (Patient Activation Measure), and self-efficacy (CKD Self-Efficacy instrument) were measured at baseline, immediately after, and 6 weeks after the intervention. FINDINGS: Health coaching improved QOL, self-management, patient activation, and self-efficacy at postintervention and at 12 weeks' follow-up. Health coaching had a significant indirect effect on QOL through improvements in patient activation. Health coaching exerted a significant indirect effect on self-management through improvements in self-efficacy and patient activation. CONCLUSIONS: The findings demonstrated that health coaching can effectively improve QOL and self-management. A health-coaching intervention can raise self-efficacy and activation levels through which self-management and QOL further improve. CLINICAL RELEVANCE: Health-coaching strategies can be used to assist patients with early-stage CKD in reaching their health goals and becoming activated in self-management of their diseases.","year":2021}
{"review_pmid":"41656984","record_index":21,"pmid":"35703097","title":"Patient-Centered Outcomes in a Randomized Trial Investigating a Multimodal Prevention Program After Transient Ischemic Attack or Minor Stroke: The INSPiRE-TMS Trial.","abstract":"BACKGROUND: The INSPiRE-TMS trial (Intensified Secondary Prevention Intending a Reduction of Recurrent Events in Transient Ischemic Attack and Minor Stroke Patients) investigated effects of a multicomponent support program in patients with nondisabling stroke or transient ischemic attack. Although secondary prevention targets were achieved more frequently in the intensified care group, no significant differences were seen in rates of recurrent major vascular events. Here, we present the effects on prespecified patient-centered outcomes. METHODS: In a multicenter trial, we randomized patients with modifiable risk factors either to the intensified or conventional care alone program. Intensified care was provided by stroke specialists and used feedback and motivational interviewing strategies (≥8 outpatient visits over 2 years) aiming to improve adherence to secondary prevention targets. We measured physical fitness, disability, cognitive function and health-related quality of life by stair-climbing test, modified Rankin Scale, Montreal Cognitive Assessment, and European Quality of Life 5 Dimension 3 Level during the first 3 years of follow-up. RESULTS: Of 2072 patients (mean age: 67.4years, 34% female) assessed for the primary outcome, patient-centered outcomes were collected in 1,771 patients (877 intensified versus 894 conventional care group). Physical fitness improved more in the intensified care group (mean between-group difference in power (Watt): 24.5 after 1 year (95% CI, 5.5-43.5); 36.1 after 2 years (95% CI, 13.1-59.7) and 29.6 (95% CI, 2.0-57.3 after 3 years). At 1 year, there was a significant shift in ordinal regression analysis of modified Rankin Scale in favor of the intensified care group (common odds ratio, 1.23 [95% CI, 1.03-1.47]) but not after 2 (odds ratio, 1.17 [95% CI, 0.96-1.41]) or 3 years (odds ratio, 1.16 [95% CI, 0.95-1.43]) of follow-up. However, Montreal Cognitive Assessment and European Quality of Life 5 Dimension scores showed no improvement in the intensified intervention arm after 1, 2, or 3 years of follow-up. CONCLUSIONS: Patients of the intensified care program group had slightly better results for physical fitness and modified Rankin Scale after 1 year, but none of the other patient-centered outcomes was significantly improved. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT01586702.","year":2022}
{"review_pmid":"41656984","record_index":22,"pmid":"35914215","title":"Promoting Chronic Obstructive Pulmonary Disease Wellness through Remote Monitoring and Health Coaching: A Clinical Trial.","abstract":"Rationale: Quality of life (QoL) matters the most to patients with chronic obstructive pulmonary disease (COPD) and is associated with healthcare usage and survival. Pulmonary rehabilitation is the most effective intervention in improving QoL but has low uptake and adherence. Home-based programs are a proposed solution. However, there is a knowledge gap on effective and sustainable home-based programs impacting QoL in patients with COPD. Objectives: To determine whether remote patient monitoring with health coaching improves the physical and emotional disease-specific QoL measured by the Chronic Respiratory Questionnaire (CRQ). Methods: This multicenter clinical trial enrolled 375 adult patients with COPD, randomized to a 12-week remote patient monitoring with health coaching (n = 188) or wait-list usual care (n = 187). Primary outcomes include physical and emotional QoL measured by the CRQ summary scores. Prespecified secondary outcomes included the CRQ domains: dyspnea, CRQ-fatigue, CRQ-emotions, CRQ-mastery, daily physical activity, self-management abilities, symptoms of depression/anxiety, emergency room/hospital admissions, and sleep. Results: Participant age: 69 ± 9 years; 59% women; forced expiratory volume in 1 second percent predicted: 45 ± 19. At 12 weeks, there was a significant and clinically meaningful difference between the intervention versus the control group in the physical and emotional CRQ summary scores: change difference (95% confidence interval): 0.54 points (0.36-0.73), P < 0.001; 0.51 (0.39-0.69), P < 0.001, respectively. In addition, all CRQ domains, self-management, daily physical activity, sleep, and depression scores improved (P < 0.01). CRQ changes were maintained at 24 weeks. Conclusions: Remote monitoring with health coaching promotes COPD wellness and behavior change, given its effect on all aspects of QoL, self-management, daily physical activity, sleep, and depression scores. It represents an effective option for home-based rehabilitation. Clinical trial registered with clinicaltrials.gov (NCT03480386).","year":2022}
{"review_pmid":"41656984","record_index":23,"pmid":"29899047","title":"Self management of patients with mild COPD in primary care: randomised controlled trial.","abstract":"OBJECTIVE: To evaluate the effectiveness of telephone health coaching delivered by a nurse to support self management in a primary care population with mild symptoms of chronic obstructive pulmonary disease (COPD). DESIGN: Multicentre randomised controlled trial. SETTING: 71 general practices in four areas of England. PARTICIPANTS: 577 patients with Medical Research Council dyspnoea scale scores of 1 or 2, recruited from primary care COPD registers with spirometry confirmed diagnosis. Patients were randomised to telephone health coaching (n=289) or usual care (n=288). INTERVENTIONS: Telephone health coaching intervention delivered by nurses, underpinned by Social Cognitive Theory. The coaching promoted accessing smoking cessation services, increasing physical activity, medication management, and action planning (4 sessions over 11 weeks; postal information at weeks 16 and 24). The nurses received two days of training. The usual care group received a leaflet about COPD. MAIN OUTCOME MEASURES: The primary outcome was health related quality of life at 12 months using the short version of the St George's Respiratory Questionnaire (SGRQ-C). RESULTS: The intervention was delivered with good fidelity: 86% of scheduled calls were delivered; 75% of patients received all four calls. 92% of patients were followed-up at six months and 89% at 12 months. There was no difference in SGRQ-C total score at 12 months (mean difference -1.3, 95% confidence interval -3.6 to 0.9, P=0.23). Compared with patients in the usual care group, at six months follow-up, the intervention group reported greater physical activity, more had received a care plan (44% v 30%), rescue packs of antibiotics (37% v 29%), and inhaler use technique check (68% v 55%). CONCLUSIONS: A new telephone health coaching intervention to promote behaviour change in primary care patients with mild symptoms of dyspnoea did lead to changes in self management activities, but did not improve health related quality of life. TRIAL REGISTRATION: Current controlled trials ISRCTN 06710391.","year":2018}
{"review_pmid":"41656984","record_index":24,"pmid":"33949270","title":"Telehealth coaching to improve self-management for secondary prevention after stroke: A randomized controlled trial of Stroke Coach.","abstract":"BACKGROUND: Stroke Coach is a lifestyle coaching telehealth program to improve self-management of stroke risk factors. AIMS: To examine the efficacy of Stroke Coach on lifestyle behavior and risk factor control among community-living stroke survivors within one-year post stroke. METHODS: Participants were randomized to Stroke Coach or an attention control Memory Training group. Lifestyle behavior was measured using the Health Promoting Lifestyle Profile II. Secondary outcomes included specific behavioral and cardiometabolic risk factors, health-related quality of life (HRQoL), cognitive status, and depressive symptoms. Measurements were taken at baseline, post-intervention (6 months), and retention (12 month). Linear mixed-effects models were used to test the study hypotheses (p < 0.05). All analyses were intention-to-treat. RESULTS: The mean age of the Stroke Coach (n = 64) and Memory Training (n = 62) groups was 67.2 and 69.1 years, respectively. The majority of participants (n = 100) had mild stroke (modified Rankin Scale = 1 or 2), were active, with controlled blood pressure (mean = 129/79 mmHg) at baseline. At post-intervention, there were no significant differences in lifestyle (b = -2.87; 95%CI - 8.03 to 2.29; p = 0.28). Glucose control, as measured by HbA1c (b = 0.17; 95%CI 0.17 to 0.32; p = 0.03), and HRQoL, measured using SF-36 Physical Component Summary (b = -3.05; 95%CI -5.88 to -0.21; p = 0.04), were significantly improved in Stroke Coach compared to Memory Training, and the improvements were maintained at retention. CONCLUSION: Stroke Coach did not improve lifestyle behavior; however, there were improvements to HbA1c and HRQoL among community-living stroke survivors with mild stroke-related disability. (ClinicalTrials.gov identifier: NCT02207023).","year":2022}
{"review_pmid":"41656984","record_index":25,"pmid":"39251904","title":"The Frail-LESS (LEss Sitting and Sarcopenia in Frail Older Adults) Remote Interventio","abstract":"Background Sarcopenia leads to functional disability, dependence in activities of daily living (ADL), and is a key contributor to frailty. Reducing and breaking up sedentary time is associated with improved sarcopenia and frailtyrelated outcomes. The aim of this study was to determine the feasibility of delivering and evaluating a remote sedentary behaviour intervention to improve sarcopenia and independent living in older adults with frailty. Methods A two-arm randomised controlled feasibility trial was conducted with a target of 60 older adults (mean age 74 ± 6 years) with very mild or mild frailty. Participants were randomised to the Frail-LESS (LEss Sitting and Sarcopenia in Frail older adults) intervention or usual care control group for six months. The intervention included tailored feedback on sitting, standing and stepping; an education workbook that included goal setting and action planning; one-to-one health coaching; peer support; and a wearable device to self-monitor sedentary behaviour. Participant recruitment (percentage of eligible individuals recruited), retention and data completion rates were used to assess trial feasibility. Acceptability of the trial was explored through interviews and safety was evaluated via unplanned healthcare utilisation and number of falls. Sitting, standing, stepping and sarcopenia were measured to evaluate potential intervention effects. Results Sixty participants were recruited. Recruitment and retention rates were 72% and 83%, respectively. Completion rates for outcome measures ranged from 70 to 100%. The trial was safe (< 1 fall per participant on average at each timepoint) and trial procedures were acceptable. Descriptive analysis (mean ± SD) showed that daily sitting was 25.1 ± 82.1 min/day lower in the intervention group, and 6.4 ± 60.5 min/day higher in the control group,","year":2024}
{"review_pmid":"41656984","record_index":26,"pmid":"28744111","title":"CIA-137821-the-long-term-effects-of-the-health-coaching-self-management","abstract":null,"year":2017}
{"review_pmid":"41656984","record_index":27,"pmid":"34215176","title":"The MIPAM trial - motivational interviewing and physical activity monitoring to enhance the daily level of physical activity among older adults - a randomized controlled trial.","abstract":"BACKGROUND: One in four older adults in Denmark and almost half of the very old above 75 do not meet the World Health Organization's recommendations for a minimum of physical activity (PA). A cost-efficient and effective way to increase focus on and motivation for daily walking might be to use Physical Activity Monitors (PAMs) in combination with behavioural change intervention. Thus, the objective of this randomized controlled study was to investigate the effect of Motivational Interviewing (MI) as an add-on intervention to a PAM-based intervention measured in community-dwelling older adults. METHODS: This two-arm parallel group randomized controlled effectiveness trial compared a 12-weeks PAM-based intervention with additional MI (PAM+MI group) with a PAM-based intervention alone (PAM group). The primary outcome, average daily step count, was analysed with a linear regression model, adjusted for sex and baseline daily step count. Following the intention-to-treat principle, multiple imputation based on baseline step count, sex and age was performed. RESULTS: In total, 38 participants were randomized to the PAM intervention and 32 to the PAM+MI intervention arm. During the intervention period, PAM+MI participants walked on average 909 more steps per day than PAM participants, however insignificant (95%CI: - 71; 1889) and reported 2.3 points less on the UCLA Loneliness Scale (95%CI: - 4.5; - 1.24). CONCLUSION: The use of MI, in addition to a PAM-based intervention among older adults in PA promoting interventions hold a potential clinically relevant effect on physical activity and should thus be investigated further with adequately powered RCTs. TRIAL REGISTRATION: This study was pre-registered in the clinicaltrials.gov database with identifier: NCT03906162.","year":2021}
{"review_pmid":"41721779","record_index":1,"pmid":"33821439","title":"Clinical safety and hemodynamic, cardiac autonomic and inflammatory responses to a single session of inspiratory muscle training in obstructive sleep apnea.","abstract":"PURPOSE: To determine clinical safety and cardiovascular, cardiac autonomic and inflammatory responses to a single session of inspiratory muscle training (IMT) in obstructive sleep apnea (OSA) subjects. METHODS: In a randomized controlled trial individuals of both sexes, aged between 30 and 70 years old with diagnosis of moderate to severe OSA were enrolled. Volunteers with OSA (n = 40) performed an IMT session with three sets of 30 repetitions with a 1-min interval between them. The IMT group (n = 20) used a load of 70% of the maximum inspiratory pressure (MIP), and the placebo group (n = 20) performed the IMT without load. Measurements of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), heart rate variability (HRV), and inflammatory markers were performed pre, post-immediate and 1 h after the IMT session. RESULTS: No differences were shown in SBP, DBP, HRV, or inflammatory markers at any of the intervals analyzed. However, HR in the IMT group was lower ​​1 h after the IMT session compared to the pre-session values ​​(p = 0002). HR was higher in the placebo group when comparing pre × post-immediate (p < 0.001). HR decreased after the first hour in relation to the pre (p < 0.001) and post-immediate (p < 0.001) values. CONCLUSION: IMT sessions promote discreet hemodynamic, cardiac autonomic and inflammatory responses. Therefore, IMT is considered clinically safe and can be performed at home, guided but unsupervised, with lower cost and greater adherence to exercise program for subjects with OSA.","year":2022}
{"review_pmid":"41721779","record_index":2,"pmid":"29124630","title":"Effectiveness of inspiratory muscle training on sleep and functional capacity to exercise in obstructive sleep apnea: a randomized controlled trial.","abstract":"PURPOSE: The aim of this study was to evaluate the effectiveness of inspiratory muscle training (IMT) on sleep and functional capacity to exercise in subjects with obstructive sleep apnea (OSA). METHODS: This is a controlled, randomized, double-blind study conducted in 16 OSA patients divided into two groups: training (IMT: n = 8) and placebo-IMT (P-IMT: n = 8). IMT was conducted during 12 weeks with a moderate load (50-60% of maximal inspiratory pressure-MIP), while P-IMT used a load < 20% of MPI. Total daily IMT time for both groups was 30 min, 7 days per week, twice a day. RESULTS: There was no difference comparing IMT to P-IMT group after training for lung function (p > 0.05) and respiratory muscle strength (p > 0.05). Maximal oxygen uptake (VO2Max) was not significantly different between IMT and P-IMT group (mean difference - 1.76, confidence interval (CI) - 7.93 to 4.41, p = 0.71). The same was observed for the other ventilatory and cardiometabolic variables measured (p > 0.05). A significant improvement in sleep quality was found when Pittsburgh Sleep Quality Index (PSQI) values of IMT and P-IMT group after training were compared (mean difference: 3.7, confidence interval 95% (CI95%) 0.6 to 6.9, p = 0.02) but no significant changes were seen in daytime sleepiness between both groups after the intervention (mean difference: 3.4, CI 95%: - 3.3 to 10.0; p = 0.29). CONCLUSION: According to these results, 12 weeks of moderate load IMT resulted in improved sleep quality, but there were no significant repercussions on functional capacity to exercise or excessive daytime sleepiness.","year":2018}
{"review_pmid":"41721779","record_index":3,"pmid":"32730174","title":"Inspiratory muscle strength training lowers blood pressure and sympathetic activity in older adults with OSA: a randomized controlled pilot trial.","abstract":"Previous work has shown lowered casual blood pressure after just 6 wk of inspiratory muscle strength training (IMST), suggesting IMST as a potential therapeutic in the prevention/treatment of hypertension. In this study, we assessed the effects of IMST on cardiovascular parameters in older, overweight adults diagnosed with moderate and severe obstructive sleep apnea (OSA). Subjects were randomly assigned to one of two interventions 1) high-intensity IMST (n = 15, 75% maximal inspiratory pressure), or 2) a control intervention (n = 10, 15% maximum inspiratory pressure). Subjects in both groups trained at home completing 30 training breaths/day, 5 days/wk for 6 wk. Pre- and posttraining measures included maximal inspiratory pressure, casual and ambulatory blood pressures, spontaneous cardiac baroreflex sensitivity, and muscle sympathetic nerve activity. Men and women in the high-intensity IMST group exhibited reductions in casual systolic (SBP), diastolic (DBP), and mean arterial blood pressures (MAP) [SBP: -8.82 ± 4.98 mmHg; DBP: -4.69 ± 2.81 mmHg; and MAP: -6.06 ± 1.03 mmHg; P < 0.002] and nighttime SBP (pre: -12.00 ± 8.20 mmHg; P < 0.01). Muscle sympathetic nerve activities also were lower (-6.97 ± 2.29 bursts/min-1; P = 0.01 and -9.55 ± 2.42 bursts/100 heartbeats; P = 0.002) by week 6. Conversely, subjects allocated to the control group showed no change in casual blood pressure or muscle sympathetic nerve activity and a trend toward higher overnight blood pressures. A short course of high-intensity IMST may offer significant respiratory and cardiovascular benefits for older, overweight adults with OSA. For Clinical Trial Registration, see https://www.clinicaltrials.gov (Identifier: NCT02709941).NEW & NOTEWORTHY Older, obese adults with moderate-severe obstructive sleep apnea who perform 5 min/day high-intensity inspiratory muscle strength training (IMST) exhibit lowered casual and nighttime systolic blood pressure and sympathetic nervous outflow. In contrast, adults assigned to a control (low-intensity) intervention exhibit no change in casual blood pressure or muscle sympathetic nerve activity and a trend toward increased overnight blood pressure. Remarkably, adherence to IMST even among sleep-deprived and exercise-intolerant adults is high (96%).","year":2020}
{"review_pmid":"41721779","record_index":4,"pmid":"36197415","title":"Inspiratory muscle training as adjuvant therapy in obstructive sleep apnea: a randomized controlled trial.","abstract":"The aim of this randomized controlled trial was to analyze the effects of an inspiratory muscle training (IMT) program on apnea and hypopnea index (AHI), inspiratory muscle strength, sleep quality, and daytime sleepiness in individuals with obstructive sleep apnea (OSA), whether or not they used continuous positive airway pressure (CPAP (+/-) therapy. The intervention group underwent IMT with a progressive resistive load of 40-70% of the maximum inspiratory pressure (PImax) for 30 breaths once a day for 12 weeks. The control group was submitted to a similar protocol, but with at a minimum load of 10 cmH2O. Changes in the AHI were the primary outcome. PImax was measured with a digital vacuometer, daytime somnolence was measured by the Epworth sleepiness scale (ESS), and the quality of sleep by the Pittsburgh Sleep Quality Index (PSQI). CPAP use was treated as a confounder and controlled by stratification resulting in 4 subgroups: IMT-/CPAP-, IMT-/CPAP+, IMT+/CPAP-, and IMT+/CPAP+. Sixty-five individuals were included in the final analysis. Significant variations were found in the 4 parameters measured throughout the study after the intervention in both CPAP- and CPAP+ participants: PImax was increased and AHI was reduced, whereas improvements were seen in both ESS and PSQI. The twelve-week IMT program increased inspiratory muscle strength, substantially reduced AHI, and had a positive impact on sleep quality and daytime sleepiness, whether or not participants were using CPAP. Our findings reinforce the role of an IMT program as an adjunct resource in OSA treatment.","year":2022}
{"review_pmid":"41721779","record_index":5,"pmid":"27091540","title":"Inspiratory Muscle Training Improves Sleep and Mitigates Cardiovascular Dysfunction in Obstructive Sleep Apnea.","abstract":"STUDY OBJECTIVES: New and effective strategies are needed to manage the autonomic and cardiovascular sequelae of obstructive sleep apnea (OSA). We assessed the effect of daily inspiratory muscle strength training (IMT) on sleep and cardiovascular function in adults unable to use continuous positive airway pressure (CPAP) therapy. METHODS: This is a placebo-controlled, single-blind study conducted in twenty four adults with mild, moderate, and severe OSA. Subjects were randomly assigned to placebo or inspiratory muscle strength training. Subjects in each group performed 5 min of training each day for 6 w. All subjects underwent overnight polysomnography at intake and again at study close. RESULTS: We evaluated the effects of placebo training or IMT on sleep, blood pressure, and plasma catecholamines. Relative to placebo-trained subjects with OSA, subjects with OSA who performed IMT manifested reductions in systolic and diastolic blood pressures (-12.3 ± 1.6 SBP and -5.0 ± 1.3 DBP mmHg; P < 0.01); plasma norepinephrine levels (536.3 ± 56.6 versus 380.6 ± 41.2 pg/mL; P = 0.01); and registered fewer nighttime arousals and reported improved sleep (Pittsburgh Sleep Quality Index scores: 9.1 ± 0.9 versus 5.1 ± 0.7; P = 0.001). These favorable outcomes were achieved without affecting apneahypopnea index. CONCLUSIONS: The results are consistent with our previously published findings in normotensive adults but further indicate that IMT can modulate blood pressure and plasma catecholamines in subjects with ongoing nighttime apnea and hypoxemia. Accordingly, we suggest IMT offers a low cost, nonpharmacologic means of improving sleep and blood pressure in patients who are intolerant of CPAP.","year":2016}
{"review_pmid":"41721779","record_index":6,"pmid":"32626744","title":"Inspiratory Muscle Training in Obstructive Sleep Apnea Associating Diabetic Peripheral Neuropathy: A Randomized Control Study.","abstract":"OBJECTIVE: This work is aimed at assessing the effects of inspiratory muscle training on lung functions, inspiratory muscle strength, and aerobic capacity in diabetic peripheral neuropathy (DPN) patients with obstructive sleep apnea (OSA). METHODS: A randomized control study was performed on 55 patients diagnosed with DPN and OSA. They were assigned to the training group (IMT, n = 28) and placebo training group (P-IMT, n = 27). Inspiratory muscle strength, lung functions, and aerobic capacity were evaluated before and after 12 weeks postintervention. An electronic inspiratory muscle trainer was conducted, 30 min a session, three times a week for 12 consecutive weeks. RESULTS: From seventy-four patients, 55 have completed the study program. A significant improvement was observed in inspiratory muscle strength (p < 0.05) in the IMT group while no changes were observed in the P-IMT group (p > 0.05). No changes were observed in the lung function in the two groups (p > 0.05). Also, VO2max and VCO2max changed significantly after training in the IMT group (p < 0.05) while no changes were observed in the P-IMT group (p > 0.05). Other cardiopulmonary exercise tests did not show any significant change in both groups (p > 0.05). CONCLUSIONS: Based on the outcomes of the study, it was found that inspiratory muscle training improves inspiratory muscle strength and aerobic capacity without a notable effect on lung functions for diabetic patients suffering from DPN and OSA.","year":2020}
{"review_pmid":"41721779","record_index":7,"pmid":"33293881","title":"Inspiratory Muscle Training in the Severity of Obstructive Sleep Apnea, Sleep Quality and Excessive Daytime Sleepiness: A Placebo-Controlled, Randomized Trial.","abstract":"PURPOSE: Exercise programs have been considered as an adjuvant treatment in obstructive sleep apnea (OSA). However, few studies have focused on the effects of the inspiratory muscle training (IMT) in reducing the severity and the symptoms of OSA. PATIENTS AND METHODS: A randomized controlled trial was conducted and approved by the local Ethics Committee. All subjects signed the informed consent form and were randomized into 2 groups: a) IMT group (n = 8), 8 weeks of IMT with 75% of maximal inspiratory pressure (MIP) and b) placebo group (n = 8): subjects performed IMT without load. RESULTS: IMT group showed reduction in the apnea-hypopnea index (AHI) (p = 0.01), in the Berlin questionnaire score (p = 0.001) and an increase in inspiratory muscle strength (p = 0.018). IMT group demonstrated a reduction in the AHI (31.7 ± 15.9 events/h vs 29.9 ± 15.8 events/h; p <0.001), in the Berlin questionnaire scores (2.6 ± 0.5 vs 1.2 ± 0.5; p = 0.016), Pittsburgh Sleep Quality Index (PSQI) score (7.2 ± 3.6 vs 3.7 ± 1.3; p = 0.008), in the Epworth Sleepiness Scale (ESS) (12.5 ± 4.0 vs 7.7 ± 3.0; p = 0.008) and increase in MIP (83.6 ± 26.5 cmH2O and 127.9 ± 32.5 cmH2O; p = 0.010). CONCLUSION: The IMT promotes discrete changes in the AHI and improves sleep quality and excessive daytime sleepiness in OSA. Moreover, IMT is a cheap, useful and simple home-based training program and can be considered as an adjunct therapy for OSA patients.","year":2020}
{"review_pmid":"41721779","record_index":8,"pmid":"35360234","title":"Resistance Training of Inspiratory Muscles After Coronary Artery Disease May Improve Obstructive Sleep Apnea in Outpatient Cardiac Rehabilitation: RICAOS Study.","abstract":"BACKGROUND: Obstructive sleep apnea (OSA) affects 5% of the adult population and its prevalence is up to 13 times higher in coronary artery disease (CAD) patients. However, OSA in this population is less symptomatic, leading to lower adherence to positive airway pressure (CPAP). While oropharyngeal exercise showed a significant decrease in apnea-hypopnea index (AHI) in patients with moderate OSA, there have been no studies testing the impact of specific inspiratory muscle training (IMT) for these patients. The aim of our study was to assess the effectiveness of IMT on AHI reduction in CAD patients with moderate OSA. METHODS: We included patients with CAD involved in a cardiac rehabilitation program and presenting an AHI between 15 and 30. Patients were randomized in a 1:1 allocation to a control group (CTL - classic training) or an IMT group (classic training + IMT). IMT consisted in 60 deep inspirations a day, 6 days a week, into a resistive load device set at 70% of the maximum inspiratory pressure (MIP). After 6 weeks, we compared AHI, neck circumference, Epworth Sleepiness Scale, Pittsburgh Sleep Quality index, and quality of life with the 12-item Short Form Survey before and after rehabilitation. RESULTS: We studied 45 patient (60 ± 9 y, BMI = 27 ± 6 kg.m-2). The IMT group (n = 22) significantly improved MIP ( p < 0.05) and had a significant decrease in AHI by 25% (-6.5 ± 9.5, p = 0.02). In the CTL group (n = 23), AHI decreased only by 3.5% (-0.7 ± 13.1; p = 0.29). Between groups, we found a significant improvement in MIP ( p = 0.003) and neck circumference ( p = 0.01) in favor of the IMT group. However, we did not find any significant improvement of AHI in the IMT group compared to CTL ( p = 0.09). CONCLUSION: A specific IMT during cardiac rehabilitation contributes to reduce significantly AHI in CAD patients with moderate OSA. Magnitude of the decrease in OSA severity could be enhanced according to implementation of specific IMT in this population.","year":2022}
{"review_pmid":"41721779","record_index":9,"pmid":"32800391","title":"The effectiveness of oropharyngeal exercises compared to inspiratory muscle training in obstructive sleep apnea: A randomized controlled trial.","abstract":"BACKGROUND: Inspiratory muscle training (IMT) and oropharyngeal exercises (OE) have different advantages and disadvantages and a comparison of these modalities has been recommended. The aim of this study was to compare the effects of IMT and OE on important outcomes for patients with OSAS. METHODS: This was a randomized controlled clinical trial. Forty-one clinically stable OSAS patients not receiving CPAP therapy were randomly divided into three groups. Patients in the IMT group (n = 15) trained with a threshold loading device 7 days/week for 12 weeks. Patients in the OE group (n = 14) practiced exercises 5 days/week for 12 weeks. Twelve patients served as control group. Apnea-hypopnea index (AHI), respiratory muscle strength, snoring severity and frequency (Berlin Questionnaire), daytime sleepiness (Epworth Sleepiness Scale; ESS), sleep quality (Pittsburg Sleep Quality Index; PSQI), impact of sleepiness on daily life (Functional Outcomes of Sleep Questionnaire; FOSQ), and fatigue severity (Fatigue Severity Scale; FSS) were evaluated before and after the interventions. RESULTS: AHI and sleep efficiency did not change significantly in any of the groups. Significant decreases in snoring severity and frequency, FSS and PSQI total scores were found in the IMT and OE groups after the treatments (p < 0.05). There was a significant reduction in neck and waist circumference and significant improvement in respiratory muscle strength (MIP and MEP) in IMT group compared to control group (p < 0.05). The%MEPpred value and FOSQ total score significantly increased and ESS score reduced after the treatment in OE group compared to control group (p < 0.05). CONCLUSIONS: Our results indicate that both OE and IMT rehabilitation interventions are applicable in rehabilitation programs for OSAS patients who do not accept CPAP therapy. Our findings could lead to increase these methods' use among rehabilitation professionals and decrease in cost of CPAP treatment in OSAS.","year":2020}
{"review_pmid":"41721779","record_index":10,"pmid":"31115739","title":"The effects of threshold inspiratory muscle training in patients with obstructive sleep apnea: a randomized experimental study.","abstract":"OBJECTIVES: Patients with obstructive sleep apnea (OSA) (an obstructed airway and intermittent hypoxia) negatively affect their respiratory muscles. We evaluated the effects of a 12-week threshold inspiratory muscle training (TIMT) program on OSA severity, daytime sleepiness, and pulmonary function in newly diagnosed OSA. METHODS: Sixteen patients with moderate-to-severe OSA were randomly assigned to a TIMT group and 6 to a control group. The home-based TIMT program was 30-45 min/day, 5 days/week, for 12 weeks using a TIMT training device. Their apnea-hypopnea index (AHI), Epworth sleepiness scale (ESS), and forced vital capacity (FVC) scores were evaluated pre- and post-treatment. Polysomnographic (PSG) analysis showed that 9 TIMT-group patients had positively responded (TIMT-responder group: post-treatment AHI < pre-treatment) and that 7 had not (TIMT non-responder group: post-treatment AHI > pre-treatment). RESULTS: Post-treatment AHI and ESS scores were significantly (both P < 0.05) lower 6% and 20.2%, respectively. A baseline AHI ≤ 29.0/h predicted TIMT-responder group patients (sensitivity 77.8%; specificity 85.7%). FVC was also significantly (P < 0.05) higher 7.2%. Baseline AHI and FEV6.0 were significant predictors of successful TIMT-responder group intervention. OSA severity and daytime sleepiness were also significantly attenuated. CONCLUSIONS: Home-based TIMT training is simple, efficacious, and cost-effective.","year":2020}
{"review_pmid":"41743679","record_index":1,"pmid":"20197194","title":"A comparison of the effects of swimming and walking on body weight, fat distribution, lipids, glucose, and insulin in older women--the Sedentary Women Exercise Adherence Trial 2.","abstract":"All types of aerobic exercise are assumed to affect cardiovascular risk similarly. There are few studies of swimming, but complex responses to water-based exercise suggest its potential for differential effects. The aim of the study was to compare the effects of swimming and walking on fitness, body weight, lipids, glucose, and insulin in older women. Sedentary women aged 50 to 70 years (N = 116), randomly assigned to swimming or walking plus usual care or a behavioral intervention, completed 3 sessions per week of moderate-intensity exercise, supervised for 6 months then unsupervised for 6 months. After 6 months, 1.6-km walk time decreased in walkers and swimmers, with greater improvement in walkers (1.0 vs 0.6 minute, P =.001). In swimmers, but not walkers, distance swum in 12 minutes increased (78.1 vs -2.2 m, P =.021). Waist and hip circumferences (80.8 vs 83.1 cm and 101.8 vs 102.4 cm; P =.023 and P =.042, respectively) and insulin area under the curve (oral glucose tolerance test) (5128 vs 5623 μU/[L 120 min], P <.05) were lower with swimming. Lipids did not differ between groups. At 12 months, fitness was maintained. Relative to walking, swimming reduced body weight by (1.1 kg, P =.039) and resulted in lower total and low-density lipoprotein cholesterol (0.3 and 0.2 mmol/L; P =.040 and P =.049, respectively). The magnitude of the difference in the reduction of insulin area under the curve between swimming and walking was greater at 12 months; however, the significance was attenuated (4677 vs 5240 μU/[L 120 min], P =.052). Compared with walking, swimming improved body weight, body fat distribution, and insulin in the short term and, in the longer term, body weight and lipid measures. These findings suggest that the type of exercise can influence health benefits.","year":2010}
{"review_pmid":"41743679","record_index":2,"pmid":null,"title":"Aquatic Exercise for Better Living on Land: Impact of Shallow-Water Exercise on Older Japanese Women for Performance of Activities of Daily Living (ADL),\" International Journal of Aquatic Research and Education: Vol. 10: No. 1, Article 1. Sanders et al.: Aquatic Exercise Impact on ADL","abstract":"Twenty-six Japanese women (70.5 yr) self-selected water exercise (WEX) (n=13), or control (CON) (n=13) for 12 weeks. WEX was performed 60-minutes/day, 3 days/week with warm-up, cool-down stretch, ADL exercises, and cardiovascular/muscular endurance in 30°C water at a xiphoid level depth. CON continued their current activity/nutrition patterns. Compared to CON, WEX improved (p<.05) functional fitness and balance measures including arm curl (22%), chair stand (21%), 8-feet up & go (13%), chair sit/reach (50%), and 12-min walk (15%). No significant changes in sway velocity (SV) or limits of stability (LOS) were seen for either group. This shallow water exercise improved land-based ADL for older women but not balance. ADL tasks associated with balance did improve which may have indicated enhanced motor control.","year":2016}
{"review_pmid":"41743679","record_index":3,"pmid":"24009416","title":"Water- versus land-based exercise in elderly","abstract":": The aim of this study was to assess the effectiveness of a 24-week exercise protocol Andrea Ermolao1 carried out in geothermal spring water to improve overall physical function and muscle mass Silvia Tolomio1 in a group of healthy elderly subjects. A further aim was to compare this water-based protocol Linda Berton2 with a land-based protocol and a control group. For this purpose, 59 subjects were recruited and Giuseppe Sergi2 randomly allocated to three groups: aquatic group (AG), land group (LG), and control group (CG). AG and LG followed a 6-month, twice-weekly, multimodality exercise intervention. AG Marco Zaccaria1 underwent the protocol in hot-spring water (36°C) while LG did it in a land-based environment. 1Sports Medicine Division, 2Geriatrics After the intervention, knee-extension strength was maintained in AG and LG. The 8-foot upDivision, University of Padova, Padua, Italy and-go test showed a reduction in both exercise groups (AG −19.3%, P, 0.05; LG −12.6%, P, 0.05), with a significantly greater decrease in AG. The back-scratch test revealed an improvement only in AG (25.8%; P, 0.05), while the sit-and-reach test improved in all groups. Finally, AG reduced fat mass by 4% (P, 0.05), and dominant forearm fat decreased by 9.2% (P, 0.05). In addition, calf muscle density increased by 1.8% (P, 0.05). In summary, both water- and land-based activities were beneficial in maintaining strength and in improving lower-body flexibility. Aquatic exercise appeared a better activity to improve dynamic balance. Thermal swimming pools and the use of rating of perceived exertion as a method of exercise monitoring should be considered potentially useful tools to enhance physical performance and body composition in healthy elderly.","year":2013}
{"review_pmid":"41743679","record_index":4,"pmid":"19149838","title":"Bocalini-2008-Water-versus-landbased-exercise-eff","abstract":null,"year":2008}
{"review_pmid":"41743679","record_index":5,"pmid":"25522928","title":"Comparison of the effects of water- and land-based exercises on the physical function and quality of life in community-dwelling elderly people with history of falling: a single-blind, randomized controlled trial.","abstract":"PURPOSE: The purpose of this study was to identify the effects of water-based exercises on the physical functions and quality of life (QOL) in community-dwelling elderly people with history of falling. MATERIALS AND METHODS: Participants were randomly assigned to the water-based exercise group (n=34) or land-based exercise groups (n=32). To identify the effects on physical functions, muscle strength, flexibility, and mobility were measured. QOL and fear of falling were evaluated using the Short Form 36-item questionnaire and the modified falls efficacy scale (M-FES). The measurements were performed before and after the 10-week training period. RESULTS: Within-group analysis indicated that hip abduction and adduction strength improved significantly in both groups (p=0.005; p=0.007). However, no statistically significant within-group differences were found in the back scratch test (p=0.766) and chair sit-and-reach test (p=0.870). QOL was significantly different in both groups (health transition: p=0.014, physical functioning: p<0.001, role physical: p<0.001, role emotional: p=0.002, bodily pain: p<0.001, vitality: p<0.001, and mental health: p<0.001). There was a significant difference in the M-FES in both groups (p=0.040). CONCLUSIONS: These results indicate that water-based exercises are beneficial to improve the QOL, as well as physical activities, of community-dwelling elderly compared with land-based exercise. Water-based exercises would be useful to improve physical and psychological health in the elderly people with history of falling.","year":2015}
{"review_pmid":"41743679","record_index":6,"pmid":null,"title":"Dialnet-EffectsOfThreeMonthsOfWaterbasedExerciseTrainingOn-6761651","abstract":". The purpose of this study was to evaluate the effects of water-based exercise training on metabolic syndrome components in older women. The subjects were randomly divided into an experimental group who participated in the water-based exercise training and a control group who was not involved in the training and remained sedentary. The quantification of clinical and biochemical parameters of abdominal obesity, atherogenic dyslipidemia, elevated blood pressure and insulin resistance without glucose intolerance by a medical and laboratory evaluation to assess the presence of metabolic syndrome components was done according to the guidelines of the National Cholesterol Educational Program Adult Treatment PanelIII (NCEP ATP-III). The training protocol consisted of water-based exercise training sessions 5 times per week during 12 weeks of intervention, executed in a pool of 1.3 meters divided into three phases: a 10-minute warm-up, 30 minutes of aerobic exercise at 50%-60% of maximum heart rate (monitored by heart rate monitor) and a 10 minute cool down. As a statistical method to compare the results between groups of variables pre and post training, the statistical analysis ANOVA mixed 2 X 2 (group X measurement) was done using SPSS version 21. The results for the metabolic syndrome components only indicated statistically significant interactions for triglycerides mg.dl-1 (p=0.002) between the groups and the measurements. Thus, the training program produced significant benefits on metabolic health indicators in particular decreasing triglycerides.","year":2019}
{"review_pmid":"41743679","record_index":7,"pmid":"38988027","title":"Effects of aquatic versus land-based exercise on irisin and fibroblast growth factor 21 expression and triiodothyronine and free fatty acid levels in elderly women.","abstract":"BACKGROUND: This study investigated the impacts of exercise on irisin and fibroblast growth factor 21 (FGF-21) expression, as well as triiodothyronine (T3 ) and free fatty acid (FFA) levels in elderly women. METHODS: Thirty women aged 65 to 70 years (10 per group) were randomly assigned to aquatic exercise, land exercise, and control groups. The aquatic and land groups engaged in 3 exercise sessions per week (60 min/session) for 16 weeks. The intensity was progressively increased every 4 weeks. RESULTS: Irisin and FGF-21 levels significantly increased in the aquatic exercise group. In the posttest, the aquatic exercise group had the highest irisin levels. Significant findings were observed for irisin and FGF-21 for the main effect between aquatic and band exercise groups (p<0.05 for both), the main effect between measurement times (p<0.01 and p<0.001, respectively), and the interaction effect (p<0.05 and p<0.001, respectively). The irisin level was significantly higher in the aquatic than in the land group 30 minutes after the last session (p<0.05). In both exercise groups, T3 levels were significantly higher 30 minutes after the final session (p<0.05) than before the program. The FFA level was significantly higher in the aquatic exercise group than the others. In the aquatic group, FFA levels were significantly higher 30 minutes after both the first (p<0.01) and the last (p<0.001) session compared to pre-program values. CONCLUSION: Differences in exercise type and environment can promote fat metabolism by stimulating hormonal changes that induce brown fat activity and browning.","year":2024}
{"review_pmid":"41743679","record_index":8,"pmid":"34501553","title":"Farinha-2021-Impact-of-different-aquatic-exercis","abstract":"Aquatic physical exercise programs have become progressively more popular among elderly people. Some of the major physical exercise program disadvantages on land are minimized due to the specific properties of the aquatic environment. The purpose of the present randomized controlled study is to verify the effects of different aquatic physical exercise programs on body composition, functional fitness and cognitive function in non-institutionalized elderly people. For this study, 102 elderly individuals were randomly allocated into four different groups: AerG (n = 25, 71.44 4.84 years); IntG (n = 28, 72.64 5.22 years); ComG (n = 29, 71.90 5.67 years) and CG (n = 20, 73.60 5.25 years). Individuals from the groups AerG, IntG and ComG participated in three different aquatic physical exercise programs for a period of 28 weeks. The CG participants kept to their usual routines. All participants were evaluated for body composition, functional fitness and cognitive function at two time moments, i.e., pre- (M1) and post-intervention (M2). Significant differences for body composition were found between M1 and M2 for FM (p < 0.001), LBM (p < 0.001) and WCir (p < 0.01) in the AerG, for BMI (p < 0.05), FM (p < 0.05), LBM (p < 0.001) and LCir-R (p < 0.05) in the IntG, and for WGT (p < 0.01), FM (p < 0.05), LBM (p < 0.01), LCir-R (p < 0.05) and LCir-L (p < 0.01) in the ComG groups. For functional fitness, differences were found between M1 and M2 for 2m-ST (p < 0.000), 30s-CS (p < 0.000), 30s-AC (p < 0.05), HG-T-R (p < 0.000) and HG-T-L (p < 0.000) in the AerG, for 2m-ST (p < 0.05), BS-R (p < 0.05), 30s-CS (p < 0.000), 30s-AC(p < 0.01), HG-T-R (p < 0.000) and HG-T-L (p < 0.000) in the IntG, and for 30s-CS (p < 0.000), HG-T-R (p < 0.000) and HG-T-L (p < 0.000) in the ComG groups. The present study evidenced the beneficial effects of physical exercise in an aquatic environment on body composition, functional fitness and cognitive function in non-institutionalized elderly adults. The ComG water-based exercise program showed more beneficial effects in the improvement of body composition and cognitive function variables, while the IntG and AerG programs were more effective in the improvement of functional fitness.","year":2021}
{"review_pmid":"41743679","record_index":9,"pmid":"24421730","title":"Impact of the s.w.e.a.T.™ water-exercise method on activities of daily living for older women.","abstract":"Older women may have chronic or age-related conditions that increase the risk of falls or that limit their ability to remain active. It is unclear if a water-based exercise program provides a safe and effective alternative to land-based exercise. The purpose of this study was to evaluate the impact of a water-based exercise program method on land-based functional activities of daily living (ADL) for women 60 years and older. This study used a quasi- experimental, nonequivalent control group design. Sixty-six women (60-89 yr of age) self- selected to a water exercise (WEX) group (n = 48) or control (C) group (n = 18). The training consisted of a 16-week (45 min·day(-1), 3 d·wk(-1)) supervised WEX program that included 10 min of warm-up and warm down/stretching and 35 min training using the S.W.E.A.T.™ method in shallow water 1.0-1.2 m, with water temperature approximately 28-29°C. Participants were required to attendat least 94% of the sessions. Assessments for participants included ADL functional field tests. In comparison to the C group, WEX participantsimproved (p < 0.05) flexibility (8%), sit- to-stand (31%), walking speed (16%) and stride length (10%), agility (20%), stair climb (22%), arm curl (39%), and static (42-48%) balance, but not dynamic balance. Results indicate that the S.W.E.A.T.™ method applied to this water exercise program provides a well-rounded, safe, and effective exercise program where older women can improve functional ADL and static balance. Key PointsOlder women with a variety of health conditions participated in 16 weeks of exercise (92% adherence) with no injuries. The S.W.E.A.T.™ method applied to this water-based program was found to significantly improve several aspects of physical function, including postural balance. This shallow water program provided a well-rounded, safe and effective activity for women to improve functional ADL on land.","year":2013}
{"review_pmid":"41743679","record_index":10,"pmid":"31506246","title":"Land- versus water-walking interventions in older adults: Effects on body composition Louise H. Naylora, Barbara A. Maslena, Kay L. Coxa,b, Angela L. Spencec, Elisa Robeya, Andrew Haynesa, Howard H. Cartera, Nicola T. Lautenschlagerd,e,f, Nicola D. Ridgersg, Carmela Pestellh, Daniel J. Greena,∗","abstract":"Objectives: Increasing physical activity is a priority worldwide, including for older adults who may have difficulty performing traditional forms of exercise, and for whom retention of muscle mass is an important consideration. Water-based exercise may provide an alternative if benefits are comparable. We compared the impact on body composition of 24-week water- versus land-walking interventions in healthy but inactive older adults. Design: Randomised, controlled trial. Methods: 72 participants (62.5 ± 6.8 yr) were randomised to a land-walking (LW), water-walking (WW) or control (C) group in a supervised centre-based program. The exercise groups trained 3 times/week at matched intensity (%HRR), increasing from 40-45% to 55-65% heart rate reserve (HRR). Height, weight, body mass index (BMI), waist and hip girths were recorded; dual X-ray absorptiometry (DXA) provided fat and lean tissue masses. Participants were re-assessed 24 weeks after completion of the intervention. Results: There were no significant changes in body mass or BMI following either exercise protocol, however central adiposity was reduced in both exercise groups, and the WW group increased lower limb lean mass. These benefits did not persist over the follow-up period. Conclusions: Exercise can confer beneficial effects on body composition which are not evident when examining weight or BMI. Both WW and LW improved body composition. Water walking can be recommended as an exercise strategy for this age group due to its beneficial effects on body composition which are similar to, or exceed, those associated with land-walking. For benefits to persist, it appears that exercise needs to be maintained.","year":2019}
{"review_pmid":"41743679","record_index":11,"pmid":"34444872","title":"Martinez-rodriguez-2021-Benefits-of-adding-an-aquatic-resis","abstract":"The human population is increasing due to lengthening life expectancy, but the quality of life and health of people is moving in the opposite direction. The purpose of this study is to evaluate how aquatic resistance interval training can influence body composition, body image perception and adherence to the Mediterranean diet (MD) in older women participants in a nutrition education program and to study the relation between these variables. Thirty-four participants aged 69 4 years were randomly assigned into two groups: experimental (aquatic resistance interval training plus nutritional intervention) and control (nutritional intervention). The intervention consisted of resistance training in an aquatic environment carried out for 14 weeks (three sessions per week; 60 min each). Body composition, body image perception and adherence to MD diet were evaluated at baseline and 14 weeks. No significant differences were found between groups regarding body image perception and adherence to the MD. There was a significant increase in muscle mass (kg) (p < 0.001) and a significant decrease in fat mass (kg) (p < 0.001) in the intervention group when compared to the control group. The addition of aquatic resistance interval training to a nutritional intervention was not sufficient to change body image perception and adherence to MD but produced improvement in body composition (through an increase in muscle mass and decrease on fat mass) in older women.","year":2021}
{"review_pmid":"41743679","record_index":12,"pmid":"36419552","title":"Martinez-rodriguez-2022-Effect-of-aquatic-resistance-interv","abstract":null,"year":2022}
{"review_pmid":"41743679","record_index":13,"pmid":"8156064","title":"Ruoti-1994-The-effects-of-nonswimming-water-ex","abstract":null,"year":1994}
{"review_pmid":"41743679","record_index":14,"pmid":null,"title":"Takeshima-2002-Water-based-exercise-improves-healt","abstract":"Background The aquatic environment has characteristics that favor adherence to exercise programs among older adults, and studies have shown that programs in this setting are effective in enhancing various aspects of physical fitness, as well as cognitive function, in this population. Research has explored whether incorporating cognitive tasks into an aquatic exercise program could offer additional benefits. Still, it remains uncertain whether this approach leads to greater improvements in cognitive function compared to aquatic exercise alone. We herein report the protocol of the WaterCog Study, which aims to evaluate the effects of an aquatic aerobic exercise program combined with cognitive tasks, compared to a conventional aquatic aerobic exercise program and a control group, on cognitive function and other health-related outcomes in older women. Methods This trial is a randomized, single-blinded, three-arm, parallel, superiority trial. A total of 102 older women will be randomized into one of three groups: 1) an aquatic aerobic exercise program combined with cognitive tasks, 2) a conventional aquatic aerobic exercise program, and 3) a control group. Participants in both exercise groups will complete a 12-week exercise program consisting of two non-consecutive sessions per week. The primary outcome is cognitive function, while secondary outcomes include physical function, cardiovascular, and psychosocial parameters. Outcomes will be measured at baseline, post-intervention, and the 12-week follow-up after the end of the intervention period. The analysis plan will employ an intention-to-treat approach and per-protocol criteria. Discussion Our conceptual hypothesis is that both aquatic exercise interventions will significantly improve the investigated outcomes compared to the control group. Additionally, we expect that the integration of cognitive tasks will result in additional benefits in cognitive function, cardiovascular outcomes, and psychosocial parameters, with similar gains in physical function compared to conventional aquatic aerobic exercises in post-intervention and follow-up measures. The findings will contribute to the evidence base for interventions targeting cognitive aging and the development of more effective and engaging exercise programs for older adults.","year":2002}
{"review_pmid":"41743679","record_index":15,"pmid":"38288074","title":"The Effects of Combined Aquatic Exercise on Physical Performance and Metabolic Indices in Overweight Healthy Older Adult","abstract":"International Journal of Exercise Science 16(4): 1499-1513, 2023. Addressing overweight and obesity to promote healthy aging is essential. Exercise is an outstanding approach to manage metabolic and physical dysfunction. Aquatic exercise has been recommended for older individuals due to reduced weight pressure on joints. The aim of this study was to determine the effects of twenty-eight weeks of combined aquatic exercise (aerobic and resistance) in overweight healthy older individuals. Thirty-two subjects of both genders with mean age of 72.06 ± 5.8 years were randomly assigned into two groups: an aquatic exercise group (EG; n = 19) and a control group (CG; n = 13). Body composition, anthropometric measurements, blood pressure, lipid profile, fasting glucose, insulin, and leptin were assessed before and after the training program. The lipid profile, fasting glucose, leptin, insulin, and insulin resistance did not change between and within groups. The lipid profile worsened in the CG. Reduction in body fat mass, waist and leg circumferences, along with body mass gain in the aquatic exercise group was observed (p ≤ 0.05). Systolic and diastolic blood pressure significantly improved in the exercise group (P = 0.003, P = 0.001). Significant differences were found in aerobic endurance (P = 0.008) and lower body flexibility (P = 0.049) of the aquatic exercise group compared with the control group. Also, upper body flexibility (P = 0.001, P = 0.020), lower and upper body strength (P = 0.001, P = 0.031), and handgrip (P = 0.001, P = 0.006), showed significant differences within the exercise group. Aquatic exercise may have a positive impact on the overweight aging population's metabolic and cardiovascular parameters, based on the observed improvements in blood pressure and body composition.","year":2023}
{"review_pmid":"41743679","record_index":16,"pmid":"27182389","title":"The Effects of a Short-Term Novel Aquatic Exercise Program on Functional Strength and Performance of Older Adults.","abstract":"The purpose of this study was to determine the effects of a short-term novel multidimensional aquatic exercise program on functional abilities of healthy older adults. Twenty-six men and women (mean age 76.33 ± 5.55 years) were recruited and assigned to an aquatic- (n = 15) or land-based (n = 11) training group. The aquatic training group completed a multidimensional water exercise program that incorporated resistance training, functional exercise movements and rudimentary aquatic plyometric activities. The active control group participated in a supervised land-based fitness program. Each exercise intervention was conducted over an 8-week period (16 sessions of 30 - 40 minutes) with the training load progression adjusted equally between groups using the 6 - 20 Rating of Perceived Exertion Scale (RPE). Prior to and immediately following the intervention, both groups were evaluated with select components of the Senior Fitness Test. The 30-second chair stand, 30-second arm curl, and 8 foot up and go were selected as measures of strength and functional abilities. The results of an independent t-test indicated that the control and experimental groups were matched for functional abilities prior to the intervention. A 2 (group) × 2 (time) analysis of covariance (ANCOVA) with repeated measures revealed significant differences in the pre- to post-testing measures for the aquatic training program for the arm curl (p < 0.01) and the 8 foot up and go (p = 0.02). Analysis of the active control revealed no pre-post differences for any measure. Thus, a short-term aquatic exercise program with multidimensional intervention strategies will significantly enhance functional abilities in older adults when compared to a functionally matched active control group.","year":2012}
{"review_pmid":"41761990","record_index":1,"pmid":"29458218","title":"Effects of Curcuminoids Plus Piperine on Glycemic, Hepatic and Inflammatory Biomarkers in Patients with Type 2 Diabetes Mellitus: A Randomized Double-Blind Placebo-Controlled Trial.","abstract":"INTRODUCTION: Curcuminoids have been shown to reduce glycemia and related complications in diabetes. In the present study, we evaluated the impact of curcuminoids plus piperine administration on glycemic, hepatic and inflammatory biomarkers in type 2 diabetes (T2D) patients. METHODS: T2D patients aged 18-65 years were enrolled in a randomized double-blind placebo-controlled trial and randomly allocated to standard-of-care treatment and dietary advises plus either curcuminoids (daily dose of 500 mg/day co-administered with piperine 5 mg/day) or placebo for a period of 3 months. Glycemic, hepatic and inflammatory parameters were measured at baseline and final conditions. RESULTS: A total of 100 subjects (50 in each group) completed the 3-month period of trial. A significant reduction was found in serum levels of glucose (-9±16 mg/dL vs. -3±11 mg/dL in curcuminoids and placebo groups, respectively; p=0.048), C-peptide (-0.6±0.8 ng/mL vs. 0.02±0.6 ng/mL; p<0.001) and HbA1c (-0.9±1.1% vs. -0.2±0.5%; p<0.001) after curcuminoids supplementation versus placebo group. Additionally, participants in the intervention group showed lower serum alanine aminotransferase (-2±6 vs. -1±5; p=0.032) and aspartate aminotransferase (-3±5 vs. -0.3±4; p=0.002) levels compared with the placebo group. Finally, no significant differences in high-sensitivity C-reactive protein (hs-CRP) concentrations were observed between curcuminoids and placebo groups (p>0.05). CONCLUSION: The results of the present trial revealed a beneficial effect of curcuminoids plus piperine supplementation on glycemic and hepatic parameters but not on hs-CRP levels in T2D patients.","year":2018}
{"review_pmid":"41761990","record_index":2,"pmid":"31871950","title":"Journal of Diabetes Research - 2019 - Funamoto - Effects of Highly Absorbable Curcumin in Patients with Impaired Glucose","abstract":null,"year":2019}
{"review_pmid":"41761990","record_index":3,"pmid":"25883426","title":"Maithili-karpaga-selvi-2015-Efficacy-of-turmeric-as-adjuvant-th","abstract":null,"year":2015}
{"review_pmid":"41761990","record_index":4,"pmid":"40682175","title":"Mansour-2025-The-effectiveness-and-safety-of-nan","abstract":"Background Diabetic neuropathy is the most prevalent complication of diabetes mellitus, affecting up to 50% of patients with type 2 diabetes mellitus (T2DM). Among the various types of diabetic neuropathy, diabetic peripheral neuropathy (DPN) is the most common. Numerous animal studies have highlighted a strong association between the improvement of DPN and curcumin supplementation, particularly due to curcumin’s anti-inflammatory and antioxidant properties. However, the effects of curcumin on DPN have been evaluated in only one randomized controlled trial. In our study, we assessed the efficacy and safety of a 16-week supplementation with nanocurcumin in T2DM patients suffering from DPN. Methods This randomized, double-blind, placebo-controlled trial was conducted at a diabetes clinic within the Endocrinology and Metabolism Research Center in Tehran, Iran. The study aimed to evaluate the effects of nanocurcumin (40 mg taken twice daily) compared to a placebo in patients with DPN over a 16-week period. The primary endpoint of the study was the reduction of pain severity, measured by the Numerical Rating Scale (NRS). Additionally, we assessed neuropathic outcomes by monitoring changes in the Michigan Neuropathy Screening Instrument examination (MNSIE) and the Neuropathy Disability Score (NDS). Secondary endpoints included improvements in metabolic and cardiovascular parameters from baseline to the end of the treatment. Results Ninety-seven patients were randomized, with 41 in the nanocurcumin group and 45 in the placebo group completing the study. No significant differences were found between the groups in terms of NRS (P = 0.787), NDS (P = 0.576), or MNSIE (P = 0.405) after 16 weeks. Nanocurcumin supplementation did not alter the metabolic profile or cardiovascular parameters and was well-tolerated, without major adverse events. †Hamid Reza Fateh and Sayed Mahmoud Sajjadi-Jazi contributed equally to this work.","year":2025}
{"review_pmid":"41761990","record_index":5,"pmid":"24445038","title":"Reduction of atherogenic risk in patients with type 2 diabetes by curcuminoid extract: a randomized controlled trial.","abstract":"Curcumin is a phytocompound found in the root of turmeric, a common herbal ingredient in many Asian cuisines. The compound contains anti-inflammatory activity, which is mediated through an up-regulation of adiponectin and reduction of leptin. Consumption of curcumin was shown to prevent some deteriorative conditions caused by inflammation, such as ulcerative colitis, rheumatoid arthritis and esophagitis, and so on. Inflammation-associated cardiovascular conditions such as atherosclerosis are common in diabetes patients. The anti-inflammation effect of curcumin might be beneficial to prevent such condition in these patients. We aim to evaluate an antiatherosclerosis effect of curcumin in diabetes patients. Effects of curcumin on risk factors for atherosclerosis were investigated in a 6-month randomized, double-blinded and placebo-controlled clinical trial that included subjects diagnosed with type 2 diabetes. An atherosclerosis parameter, the pulse wave velocity, and other metabolic parameters in patients treated with placebo and curcumin were compared. Our results showed that curcumin intervention significantly reduced pulse wave velocity, increased level of serum adiponectin and decreased level of leptin. These results are associated with reduced levels of homeostasis model assessment-insulin resistance, triglyceride, uric acid, visceral fat and total body fat. In summary, a 6-month curcumin intervention in type 2 diabetic population lowered the atherogenic risks. In addition, the extract helped to improve relevant metabolic profiles in this high-risk population.","year":2014}
{"review_pmid":"41761990","record_index":6,"pmid":"39125322","title":"The Effect of Curcumin on Reducing Atherogenic Risks in Obese Patients with Type 2 Diabetes: A Randomized Controlled Trial.","abstract":"Curcumin, derived from turmeric root, exhibits notable anti-inflammatory effects. These anti-inflammatory properties might also provide advantages in reducing cardiovascular complications, such as atherosclerosis. This study aimed to evaluate the efficacy of curcumin in reducing the risk of atherogenesis in obese patients with type 2 diabetes. The study employed a randomized, double-blind, placebo-controlled trial design with 227 participants diagnosed with type 2 diabetes. The parameters used to assess atherogenic risk reduction included pulse wave velocity and metabolic profiles, including low-density lipoprotein cholesterol and small dense low-density lipoprotein cholesterol. Measurements were recorded at baseline and at 3-, 6-, 9-, and 12-month intervals. After 12 months, participants receiving curcumin exhibited a significant reduction in pulse wave velocity (p < 0.001). This group showed significantly reduced levels of cardiometabolic risk biomarkers, including low-density lipoprotein cholesterol and small dense low-density lipoprotein cholesterol, all with p values less than 0.001. High-sensitivity C-reactive protein, interleukin-1 beta, interleukin-6, and tumor necrosis factor-alpha were also significantly lower in the curcumin group, with p values less than 0.001. The curcumin intervention significantly reduced pulse wave velocity and improved cardiometabolic risk profiles. These findings suggest that curcumin treatment may effectively reduce atherogenic risks in type 2 diabetes patients with obesity.","year":2024}
{"review_pmid":"41761990","record_index":7,"pmid":"32655024","title":"The Effects of Nano-curcumin on Metabolic Status in Patients With Diabetes on Hemodialysis, a Randomized, Double Blind, Placebo-controlled Trial.","abstract":"INTRODUCTION: This study evaluated the effects of nano-curcumin intake on metabolic status in patients with diabetes on hemodialysis (HD). METHODS: This randomized, double-blind, placebo-controlled clinical trial was performed on 60 patients with diabetes on HD. Participants were randomly divided into two groups to take either 80 mg/d nano-curcumin (n = 30) or placebo (n = 30) for 12 weeks. RESULTS: Nano-curcumin significantly decreased fasting plasma glucose (β = -19.68 mg/dL, 95% CI: -33.48 to -5.88; P <.05) and serum insulin levels (β = -1.70 μIU/mL, 95% CI: -2.96 to -0.44; P <.05) when compared with patients who received placebo. Nanocurcumin treatment was associated with a significant reduction in triglycerides (β = -16.13 mg/dL, 95% CI: -31.51 to -0.75; P <.05), VLDL-cholesterol (β = -3.22 mg/dL, 95% CI: -6.30 to -0.15; P <.05), total cholesterol (β = -17.83 mg/dL, 95% CI: -29.22 to -6.45; P <.05), LDL-cholesterol (β = -15.20 mg/dL, 95% CI: -25.53 to -4.87; P <.05), and total-cholesterol/HDL-cholesterol ratio (β = -1.15, 95% CI: -0.2.10 to -0.21; P <.05) when compared with the placebo. Nanocurcumin also resulted in a significant reduction of serum high sensitivity CRP (β = -0.78 mg/L, 95% CI: -1.41 to -0.15; P <.05), and plasma malondialdehyde (β = -0.25 μmol/L, 95% CI: -0.45 to -0.04; P <.05); but also with a significant increase in plasma total antioxidant capacity (β = 52.43 mmol/L; 95% CI: 4.52 to 100.35; P <.05) and total nitrite levels (β = 3.62 μmol/L, 95% CI: 2.17 to 5.08; P <.001) when compared with placebo. CONCLUSION: Nano-curcumin intake for 12 weeks had beneficial effects on metabolic profile in patients with diabetes on HD.","year":2020}
{"review_pmid":"41761990","record_index":8,"pmid":"39744187","title":"The efficacy of curcumin-piperine supplementation in patients with nonproliferative diabetic retinopathy: An optical coherence tomography angiography-based randomized controlled trial.","abstract":"BACKGROUND: Diabetic retinopathy (DR) is one of the complications of diabetes. This study was conducted to investigate the effect of curcumin-piperine on laboratory factors and macular vascular in DR. MATERIALS AND METHODS: The present study was a randomized, placebo-controlled, double-blind, parallel-arm clinical trial that was conducted on 60 patients with DR aged 30-65 years. Patients were randomized into two groups to receive (i) 1010 mg/day of curcumin-piperine (two tablets per day, each tablet containing 500 mg curcuminoids and 5 mg piperine) (n = 30) or (ii) the matched placebo (n = 30) for 12 weeks. The investigated factors included optical coherence tomography (OCT), optical coherence tomography angiography (OCTA), oxidative stress factors, C-reactive protein (CRP), fasting blood glucose (FBG), triglycerides (TGs), blood urea nitrogen (BUN), and creatinine. RESULTS: The trial was completed by 27 patients in the intervention group and 29 patients in the placebo group. Curcumin-piperine significantly increased total antioxidant capacity (0.86 ± 0.66 vs. 0.45 ± 0.89; P = 0.022) and superoxide dismutases (0.77 ± 2.11 vs. -0.45 ± 3.08; P = 0.031), while it decreased and malondialdehyde (MDA) (-1.06 ± 5.80 vs. 1.89 ± 6.12; P = 0.043) and creatinine (-0.04 ± 0.16 vs. 0.03 ± 0.05; P = 0.042) compared with placebo. However, this supplement had no significant effect on CRP, FBG, TG, BUN, OCT, and OCTA. There were no adverse reactions. CONCLUSION: Curcumin-piperine is effective in improving oxidative stress and reducing creatinine in DR. Further trials are necessary to confirm these promising findings.","year":2024}
{"review_pmid":"41761990","record_index":9,"pmid":"40573083","title":"Yaikwawong-2025-Curcumin-for-inflammation-control-i","abstract":"Background: Curcumin, a bioactive polyphenol derived from turmeric, has demonstrated potential therapeutic effects in metabolic dysfunction-associated steatotic liver disease (MASLD) by modulating inflammation, oxidative stress, hepatic fat accumulation, and fibrosis. Objective: To evaluate the efficacy of curcumin in reducing hepatic steatosis and liver stiffness in patients with MASLD. Methods: In this randomized, double-blind, placebo-controlled trial, 78 patients with type 2 diabetes mellitus (T2DM) and MASLD were randomly assigned to receive either curcumin (1500 mg/day) or placebo for 12 months. The primary outcome was the change in tumor necrosis factor (TNF) levels. Secondary outcomes included changes in interleukin-1 beta (IL-1), interleukin-6 (IL-6), antioxidant enzyme activities (glutathione peroxidase, superoxide dismutase), the oxidative stress marker malondialdehyde, non-esterified fatty acids, and hepatic parameters (hepatic steatosis and liver stiffness). Assessments were conducted at baseline and at 3, 6, 9, and 12 months. Results: All participants completed the study (curcumin group: n = 39; placebo group: n = 39). Curcumin significantly reduced TNF levels at all follow-up points compared to placebo (p < 0.001). IL-1, IL-6, and malondialdehyde levels also declined significantly (p < 0.001), while antioxidant enzyme activities, including glutathione peroxidase and superoxide dismutase, increased significantly (p < 0.001), indicating improved oxidative balance. Furthermore, curcumin led to significant reductions in non-esterified fatty acids, total body fat, BMI, hepatic steatosis, and liver stiffness compared to placebo. Conclusions: Twelve months of curcumin supplementation improved glycemic control, reduced systemic inflammation and oxidative stress, and significantly improved hepatic steatosis and liver stiffness in patients with MASLD. These findings support curcumin as a promising adjunctive therapy for MASLD management.","year":2025}
{"review_pmid":"41761990","record_index":10,"pmid":"31523263","title":"Curcumin as a major active component of","abstract":"Background: Diabetic nephropathy (DN) is a common cause of end-stage renal disease (ESRD). The benefits and effects of renin-angiotensin system blocker drugs are obvious in decreasing albuminuria, but there is a need to find other drugs that can decrease albuminuria. The aim of our study is to evaluate the effect of short-term administration of curcumin on overt albuminuria in patients with type 2 diabetes mellitus (T2DM). Materials and Methods: A randomized, double-blind clinical trial was performed on 46 patients with T2DM, overt albuminuria ≥300 mg/24 h, and estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m2. After the random allocation of the patients, they were divided into two groups. In the curcumin group, the patients received 500 mg (one capsule) of curcumin with each meal (three times/day after meal) for 16 weeks. Other variables including blood urea nitrogen (BUN), creatinine (Cr), fasting blood sugar (FBS), 2-h postprandial blood sugar (2-h pp BS), lipid profile, 24-h urine analysis for albuminuria, serum albumin, and hemoglobin A1C (HbA1C) were checked at baseline and bimonthly too. Results: two groups at baseline were comparable in terms of basic characteristics (P > 0.05). Albuminuria decreased significantly from 900.42 ± 621.91 at the baseline to 539.68 ± 375.16 at the end of the study in the curcumin group (P = 0.002); however, no statistically significant changes Time were observed in the placebo group (519.94 ± 214.33 at the baseline vs. 444.00 ± 219.10 at the end of the trial; P = 0.43), and the Time decrease was significantly higher in the curcumin group than that of the placebo group (P = 0.01). No significant differences Intervention were observed between the placebo and curcumin in terms of changes in serum BUN, Cr, FBS, 2-h pp BS, HbA1C, lipid profile, and albumin. Conclusion: Our study showed that curcumin as an active turmeric metabolite was an effective adjuvant therapy for ameliorating macroscopic proteinuria in type 2 diabetic patients. Its effect may appear after 2 months of therapy and even in patients with a mild decrease in GFR. Further studies with larger sample size and longer duration are recommended.","year":2019}
{"review_pmid":"41830012","record_index":1,"pmid":"20231532","title":"B Vitamins and the Risk of Total Mortality and Cardiovascular Disease in End-Stage Renal Disease","abstract":"Background: In observational studies, hyperhomocysteinemia has been found to be a risk factor for total mortality and cardiovasculareventsinpatientswithend-stagerenaldisease. Thesepatientshavegrosslyelevatedhomocysteinelevels thatcanbeloweredbysupplementationwithfolicacidandvitaminB. Weconductedarandomizedclinicaltrialwith 12 B vitamins to reduce homocysteine levels and therefore cardiovascular events and total mortality. MethodsandResults-Thisrandomized,double-blindmulticenterstudywasconductedin33dialysiscentersinnorthand eastGermanybetweenJuly2002andJuly2008. Werandomlyassigned650patientswithend-stagerenaldiseasewho wereundergoinghemodialysisto2postdialysistreatments:5mgfolicacid,50(cid:1)gvitaminB,and20mgvitaminB 12 6 (activetreatment)or0.2mgfolicacid,4(cid:1)gvitaminB,and1.0mgvitaminB (placebo)given3timesperweekfor 12 6 an average of 2 years. The primary outcome was total mortality; the secondary outcome was fatal and nonfatal cardiovascular events. The primary outcome occurred in 102 patients (31%) receiving the active treatment and in 92 (28%) receiving placebo (hazard ratio, 1.13; 95% confidence interval, 0.85 to 1.50; P(cid:1)0.51). The secondary outcome occurredin83patients(25%)receivingtheactivetreatmentandin98(30%)receivingplacebo(hazardratio,0.80;95% confidence interval, 0.60 to 1.07; P(cid:1)0.13). Conclusions-Increased intake of folic acid, vitamin B, and vitamin B did not reduce total mortality and had no 12 6 significant effect on the risk of cardiovascular events in patients with end-stage renal disease.","year":2010}
{"review_pmid":"41830012","record_index":2,"pmid":"16545638","title":"Cardiovascular morbidity and mortality in the Atherosclerosis and Folic Acid Supplementation Trial (ASFAST) in chronic renal failure: a multicenter, randomized, controlled trial.","abstract":"OBJECTIVES: The Atherosclerosis and Folic Acid Supplementation Trial (ASFAST) aimed to establish whether high-dose folic acid would slow the progression of atherosclerosis and reduce cardiovascular events in patients with chronic renal failure (CRF). BACKGROUND: Hyperhomocysteinemia is a potential contributor to the high rates of cardiovascular morbidity and mortality in patients with CRF. METHODS: A total of 315 subjects with CRF, mean age 57 years (range 24 to 79 years) were randomized to 15 mg folic acid daily or placebo and followed for a median of 3.6 years. The primary intima-media thickness (IMT) and clinical end points were: rate of progression of mean maximum carotid IMT and a composite of myocardial infarction (MI), stroke, and cardiovascular death. Secondary end points included all cardiovascular events and change in pulse wave velocity, systemic arterial compliance and augmentation index. Data were analyzed by intention-to-treat. RESULTS: Plasma total homocysteine was reduced by 19% in the folic acid group. There was no significant difference between the treatment groups in rate of change of IMT or any measure of artery function. Seventy-seven events occurred in the folic acid group (14.9 per 100 patient-years) as compared with 86 in the placebo group (16.3 per 100 patient-years). The rates of the primary and secondary clinical end points at five years were not significantly different after adjustment for baseline differences between the groups (adjusted hazard ratio for MI, stroke, and cardiovascular death: 0.98 [95% confidence interval: 0.66 to 1.47]; p = 0.94; for all cardiovascular events: 0.95 [95% confidence interval: 0.69 to 1.30]; p = 0.75). CONCLUSIONS: High-dose folic acid does not slow atheroma progression or improve cardiovascular morbidity or mortality in patients with CRF.","year":2006}
{"review_pmid":"41830012","record_index":3,"pmid":"23765945","title":"Effect of B vitamins and lowering homocysteine on cognitive impairment in patients with previous stroke or transient ischemic attack: a prespecified secondary analysis of a randomized, placebo-controlled trial and meta-analysis.","abstract":"BACKGROUND AND PURPOSE: High plasma total homocysteine (tHcy) has been associated with cognitive impairment but lowering tHcy with B-vitamins has produced equivocal results. We aimed to determine whether B-vitamin supplementation would reduce tHcy and the incidence of new cognitive impairment among individuals with stroke or transient ischemic attack≥6 months previously. METHODS: A total of 8164 patients with stroke or transient ischemic attack were randomly allocated to double-blind treatment with one tablet daily of B-vitamins (folic acid, 2 mg; vitamin B6, 25 mg; vitamin B12, 500 μg) or placebo and followed up for 3.4 years (median) in the VITAmins TO Prevent Stroke (VITATOPS) trial. For this prespecified secondary analysis of VITATOPS, the primary outcome was a new diagnosis of cognitive impairment, defined as a Mini-Mental State Examination (MMSE) score<24 on ≥2 follow-up visits. Secondary outcomes were cognitive decline, and the mean tHcy and MMSE at final follow-up. RESULTS: A total of 3089 participants (38%) voluntarily undertook the MMSE>6 months after the qualifying stroke; 2608 participants were cognitively unimpaired (MMSE≥24), of whom 2214 participants (1110 B-vitamins versus 1104 placebo) had follow-up MMSEs during 2.8 years (median). At final follow-up, allocation to B-vitamins, compared with placebo, was associated with a reduction in mean tHcy (10.2 μmol/L versus 14.2 μmol/L; P<0.001) but no change from baseline in the mean MMSE score (-0.22 points versus -0.25 points; difference, 0.03; 95% confidence interval, -0.13 to 0.19; P=0.726) and no difference in the incidence of cognitive impairment (5.51% versus 5.47%; risk ratio, 1.01; 95% confidence interval, 0.69-1.48; P=0.976), cognitive decline (9.1% versus 10.3%; risk ratio, 0.89; 0.67-1.18; P=0.414), or cognitive impairment or decline (11.0% versus 11.3%; risk ratio, 0.98; 0.75-1.27; P=0.855). CONCLUSIONS: Daily supplementation with folic acid, vitamin B6, and vitamin B12 to a self-selected clinical trial cohort of cognitively unimpaired patients with previous stroke or transient ischemic attack lowered mean tHcy but had no effect on the incidence of cognitive impairment or cognitive decline, as measured by the MMSE, during a median of 2.8 years. CLINICAL TRIAL REGISTRATION: URL: http://www.controlled-trials.com. Unique identifier: ISRCTN74743444; URL: http://www.clinicaltrials.gov. Unique identifier: NCT00097669.","year":2013}
{"review_pmid":"41830012","record_index":4,"pmid":null,"title":"Effect of B-Vitamin Therapy on Progression of Diabetic Nephropathy","abstract":null,"year":2010}
{"review_pmid":"41830012","record_index":5,"pmid":"18460663","title":"Effect of folic acid and B vitamins on risk of cardiovascular events and total mortality among women at high risk for cardiovascular disease: a randomized trial.","abstract":"CONTEXT: Recent randomized trials among patients with preexisting cardiovascular disease (CVD) have failed to support benefits of B-vitamin supplementation on cardiovascular risk. Observational data suggest benefits may be greater among women, yet women have been underrepresented in published randomized trials. OBJECTIVE: To test whether a combination of folic acid, vitamin B6, and vitamin B12 lowers risk of CVD among high-risk women with and without CVD. DESIGN, SETTING, AND PARTICIPANTS: Within an ongoing randomized trial of antioxidant vitamins, 5442 women who were US health professionals aged 42 years or older, with either a history of CVD or 3 or more coronary risk factors, were enrolled in a randomized, double-blind, placebo-controlled trial to receive a combination pill containing folic acid, vitamin B6, and vitamin B12 or a matching placebo, and were treated for 7.3 years from April 1998 through July 2005. INTERVENTION: Daily intake of a combination pill of 2.5 mg of folic acid, 50 mg of vitamin B6, and 1 mg of vitamin B12. MAIN OUTCOME MEASURES: A composite outcome of myocardial infarction, stroke, coronary revascularization, or CVD mortality. RESULTS: Compared with placebo, a total of 796 women experienced a confirmed CVD event (406 in the active group and 390 in the placebo group). Patients receiving active vitamin treatment had similar risk for the composite CVD primary end point (226.9/10,000 person-years vs 219.2/10,000 person-years for the active vs placebo group; relative risk [RR], 1.03; 95% confidence interval [CI], 0.90-1.19; P =.65), as well as for the secondary outcomes including myocardial infarction (34.5/10,000 person-years vs 39.5/10,000 person-years; RR, 0.87; 95% CI, 0.63-1.22; P =.42), stroke (41.9/10,000 person-years vs 36.8/10,000 person-years; RR, 1.14; 95% CI, 0.82-1.57; P =.44), and CVD mortality (50.3/10,000 person-years vs 49.6/10,000 person-years; RR, 1.01; 95% CI, 0.76-1.35; P =.93). In a blood substudy, geometric mean plasma homocysteine level was decreased by 18.5% (95% CI, 12.5%-24.1%; P <.001) in the active group (n = 150) over that observed in the placebo group (n = 150), for a difference of 2.27 micromol/L (95% CI, 1.54-2.96 micromol/L). CONCLUSION: After 7.3 years of treatment and follow-up, a combination pill of folic acid, vitamin B6, and vitamin B12 did not reduce a combined end point of total cardiovascular events among high-risk women, despite significant homocysteine lowering. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00000541.","year":2008}
{"review_pmid":"41830012","record_index":6,"pmid":"17848650","title":"Effect of homocysteine lowering on mortality and vascular disease in advanced chronic kidney disease and end-stage renal disease: a randomized controlled trial.","abstract":"CONTEXT: High plasma homocysteine levels are a risk factor for mortality and vascular disease in observational studies of patients with chronic kidney disease. Folic acid and B vitamins decrease homocysteine levels in this population but whether they lower mortality is unknown. OBJECTIVE: To determine whether high doses of folic acid and B vitamins administered daily reduce mortality in patients with chronic kidney disease. DESIGN, SETTING, AND PARTICIPANTS: Double-blind randomized controlled trial (2001-2006) in 36 US Department of Veterans Affairs medical centers. Median follow-up was 3.2 years for 2056 participants aged 21 years or older with advanced chronic kidney disease (estimated creatinine clearance < or =30 mL/min) (n = 1305) or end-stage renal disease (n = 751) and high homocysteine levels (> or = 15 micromol/L). INTERVENTION: Participants received a daily capsule containing 40 mg of folic acid, 100 mg of pyridoxine hydrochloride (vitamin B6), and 2 mg of cyanocobalamin (vitamin B12) or a placebo. MAIN OUTCOME MEASURES: The primary outcome was all-cause mortality. Secondary outcomes included myocardial infarction (MI), stroke, amputation of all or part of a lower extremity, a composite of these 3 plus all-cause mortality, time to initiation of dialysis, and time to thrombosis of arteriovenous access in hemodialysis patients. RESULTS: Mean baseline homocysteine level was 24.0 micromol/L in the vitamin group and 24.2 micromol/L in the placebo group. It was lowered 6.3 micromol/L (25.8%; P <.001) in the vitamin group and 0.4 micromol/L (1.7%; P =.14) in the placebo group at 3 months, but there was no significant effect on mortality (448 vitamin group deaths vs 436 placebo group deaths) (hazard ratio [HR], 1.04; 95% CI, 0.91-1.18). No significant effects were demonstrated for secondary outcomes or adverse events: there were 129 MIs in the vitamin group vs 150 for placebo (HR, 0.86; 95% CI, 0.67-1.08), 37 strokes in the vitamin group vs 41 for placebo (HR, 0.90; 95% CI, 0.58-1.40), and 60 amputations in the vitamin group vs 53 for placebo (HR, 1.14; 95% CI, 0.79-1.64). In addition, the composite of MI, stroke, and amputations plus mortality (P =.85), time to dialysis (P =.38), and time to thrombosis in hemodialysis patients (P =.97) did not differ between the vitamin and placebo groups. CONCLUSION: Treatment with high doses of folic acid and B vitamins did not improve survival or reduce the incidence of vascular disease in patients with advanced chronic kidney disease or end-stage renal disease. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00032435.","year":2007}
{"review_pmid":"41830012","record_index":7,"pmid":"26147383","title":"Effects of 2-year vitamin B12 and folic acid supplementation in hyperhomocysteinemic elderly on arterial stiffness and cardiovascular outcomes within the B-PROOF trial Suzanne C. van Dijka, Anke W. Ennemana, Karin M.A. Swartb, Janneke P. van Wijngaardenc, Annelies C. Hama, Elske M. Brouwer-Brolsmac, Nikita L. van der Zwaluwc, Henk J. Blomd,","abstract":null,"year":2015}
{"review_pmid":"41830012","record_index":8,"pmid":"21115589","title":"Effects of B vitamins and omega 3 fatty acids on cardiovascular diseases: a randomised placebo controlled","abstract":"plasmaconcentrationsofBvitamins(folateandvitaCnam; UniversitéParis13,CR ObjectiveToinvestigatewhetherdietary minB-6) andomega3polyunsaturatedfattyacids.1-6 NHIdF,F-93017Bobigny,France supplementationwithBvitaminsoromega3fattyacids, Moderately elevated concentrations of plasma total 2DépartementdeSantépublique, HôpitalAvicenne,93017,F- orboth,couldpreventmajorcardiovasculareventsin homocysteinehavebeenassociatedwithhigherrisks Bobigny,France patientswithahistoryofischaemicheartdiseaseor of coronary heart disease and stroke,7-12 and dietary 3EA4003,EcoledeSanté stroke. supplementationwithfolicacidandvitaminB-12typipublique,Epidémiologieclinique, DesignDoubleblind,randomised,placebocontrolled callylowersplasmatotalhomocysteineconcentration FacultédeMédecine,CHUNancy, France trial;factorialdesign. by about 25-30%,13 raising the prospect that dietary 4UniversitéParis-Descartes, SettingRecruitmentthroughoutFranceviaanetworkof supplementationwiththeseBvitaminsmightreduce FacultédeMédecine;AP-HP; 417cardiologists,neurologists,andotherphysicians. theriskofcoronaryheartdiseaseandstroke.14 Hôtel-Dieu,CentredeDiagnostic etThérapeutique,Paris,France Participants2501patientswithahistoryofmyocardial Severallargescaletrialshaveexaminedtheeffectsof Correspondenceto:PGalan,U557 infarction,unstableangina,orischaemicstroke. supplementation with B vitamins on cardiovascular INSERM/INRA/CNAM/UP13,SMBH, InterventionDailydietarysupplementcontaining disease,butnonehasreportedanysignificanteffects 74,rueMarcelCachin,93017 5-methyltetrahydrofolate(560μg),vitaminB-6(3mg), onriskofcardiovasculardisease.15-23Possiblereasons Bobigny,France p.galan@uren.smbh.univ-paris13. andvitaminB-12(20μg)orplacebo;andcontaining for the failure of these trials to show any significant fr omega3fattyacids(600mgofeicosapentanoicacidand effects on vascular disease include lack of statistical docosahexaenoicacidataratioof2:1)orplacebo. powertodetecttreatmenteffects(owingtoaninsuffiCitethisas:BMJ2010;341:c6273 doi:10.1136/bmj.c6273 Mediandurationofsupplementationwas4.7years. cientnumberofparticipantsordurationoftreatment), MainoutcomemeasuresMajorcardiovascularevents, attenuationoftheeffectsofBvitaminsbymandatory definedasacompositeofnon-fatalmyocardialinfarction, folicacidfortificationorbywidespreaduseofsupplestroke,ordeathfromcardiovasculardisease. mentscontainingfolicacidamongtrialparticipants,or ResultsAllocationtoBvitaminsloweredplasma that homocysteine is not causally related to vascular homocysteineconcentrationsby19%comparedwith disease. placebo,buthadnosignificanteffectsonmajorvascular Observational studies have also reported inverse events(75v82patients,hazardratio,0.90(95% associations of cardiovascular disease with dietary confidenceinterval0.66to1.23,P=0.50)). Allocationto intake or plasma concentrations of omega 3 fatty omega3fattyacidsincreasedplasmaconcentrationsof acids(mainlyeicosapentanoicacidanddocosahexaeomega3fattyacidsby37%comparedwithplacebo,but noic acid), suggesting that supplementation with alsohadnosignificanteffectonmajorvascularevents(81 omega3fatty acidsmightexertprotective effectson v76patients,hazardratio1.08(0.79to1.47,P=0.64)). cardiovascular disease.24-28 These fatty acids have ConclusionThisstudydoesnotsupporttheroutineuseof been shown to have beneficial effects on several dietarysupplementscontainingBvitaminsoromega3 cardiovascularriskfactors-includingbloodpressure, fattyacidsforpreventionofcardiovasculardiseasein plasma triglyceride concentration, and markers of peoplewithahistoryofischaemicheartdiseaseor thrombosis and inflammation-and may also have ischaemicstroke,atleastwhensupplementationis antiarrhythmiceffects.24-29Althoughsometrialsinvolintroducedaftertheacutephaseoftheinitialevent. vingpatientswithahistoryofcardiovasculardiseases TrialregistrationCurrentControlledTrials orwithhighlevelsofcardiovascularriskfactorshave ISRCTN41926726. reported positive effects of omega 3 fatty acids on cardiovascular events,3031 other trials have reported","year":2010}
{"review_pmid":"41830012","record_index":9,"pmid":"20571015","title":"Effects of homocysteine-lowering with folic acid plus vitamin B12 vs placebo on mortality and major morbidity in myocardial infarction survivors: a randomized trial.","abstract":"CONTEXT: Blood homocysteine levels are positively associated with cardiovascular disease, but it is uncertain whether the association is causal. OBJECTIVE: To assess the effects of reducing homocysteine levels with folic acid and vitamin B(12) on vascular and nonvascular outcomes. DESIGN, SETTING, AND PATIENTS: Double-blind randomized controlled trial of 12,064 survivors of myocardial infarction in secondary care hospitals in the United Kingdom between 1998 and 2008. INTERVENTIONS: 2 mg folic acid plus 1 mg vitamin B(12) daily vs matching placebo. MAIN OUTCOME MEASURES: First major vascular event, defined as major coronary event (coronary death, myocardial infarction, or coronary revascularization), fatal or nonfatal stroke, or noncoronary revascularization. RESULTS: Allocation to the study vitamins reduced homocysteine by a mean of 3.8 micromol/L (28%). During 6.7 years of follow-up, major vascular events occurred in 1537 of 6033 participants (25.5%) allocated folic acid plus vitamin B(12) vs 1493 of 6031 participants (24.8%) allocated placebo (risk ratio [RR], 1.04; 95% confidence interval [CI], 0.97-1.12; P =.28). There were no apparent effects on major coronary events (vitamins, 1229 [20.4%], vs placebo, 1185 [19.6%]; RR, 1.05; 95% CI, 0.97-1.13), stroke (vitamins, 269 [4.5%], vs placebo, 265 [4.4%]; RR, 1.02; 95% CI, 0.86-1.21), or noncoronary revascularizations (vitamins, 178 [3.0%], vs placebo, 152 [2.5%]; RR, 1.18; 95% CI, 0.95-1.46). Nor were there significant differences in the numbers of deaths attributed to vascular causes (vitamins, 578 [9.6%], vs placebo, 559 [9.3%]) or nonvascular causes (vitamins, 405 [6.7%], vs placebo, 392 [6.5%]) or in the incidence of any cancer (vitamins, 678 [11.2%], vs placebo, 639 [10.6%]). CONCLUSION: Substantial long-term reductions in blood homocysteine levels with folic acid and vitamin B(12) supplementation did not have beneficial effects on vascular outcomes but were also not associated with adverse effects on cancer incidence. TRIAL REGISTRATION: isrctn.org Identifier: ISRCTN74348595.","year":2010}
{"review_pmid":"41830012","record_index":10,"pmid":"25771069","title":"Efficacy of folic acid therapy in primary prevention of stroke among adults with hypertension in China: the CSPPT randomized clinical trial.","abstract":"IMPORTANCE: Uncertainty remains about the efficacy of folic acid therapy for the primary prevention of stroke because of limited and inconsistent data. OBJECTIVE: To test the primary hypothesis that therapy with enalapril and folic acid is more effective in reducing first stroke than enalapril alone among Chinese adults with hypertension. DESIGN, SETTING, AND PARTICIPANTS: The China Stroke Primary Prevention Trial, a randomized, double-blind clinical trial conducted from May 19, 2008, to August 24, 2013, in 32 communities in Jiangsu and Anhui provinces in China. A total of 20,702 adults with hypertension without history of stroke or myocardial infarction (MI) participated in the study. INTERVENTIONS: Eligible participants, stratified by MTHFR C677T genotypes (CC, CT, and TT), were randomly assigned to receive double-blind daily treatment with a single-pill combination containing enalapril, 10 mg, and folic acid, 0.8 mg (n = 10,348) or a tablet containing enalapril, 10 mg, alone (n = 10,354). MAIN OUTCOMES AND MEASURES: The primary outcome was first stroke. Secondary outcomes included first ischemic stroke; first hemorrhagic stroke; MI; a composite of cardiovascular events consisting of cardiovascular death, MI, and stroke; and all-cause death. RESULTS: During a median treatment duration of 4.5 years, compared with the enalapril alone group, the enalapril-folic acid group had a significant risk reduction in first stroke (2.7% of participants in the enalapril-folic acid group vs 3.4% in the enalapril alone group; hazard ratio [HR], 0.79; 95% CI, 0.68-0.93), first ischemic stroke (2.2% with enalapril-folic acid vs 2.8% with enalapril alone; HR, 0.76; 95% CI, 0.64-0.91), and composite cardiovascular events consisting of cardiovascular death, MI, and stroke (3.1% with enalapril-folic acid vs 3.9% with enalapril alone; HR, 0.80; 95% CI, 0.69-0.92). The risks of hemorrhagic stroke (HR, 0.93; 95% CI, 0.65-1.34), MI (HR, 1.04; 95% CI, 0.60-1.82), and all-cause deaths (HR, 0.94; 95% CI, 0.81-1.10) did not differ significantly between the 2 treatment groups. There were no significant differences between the 2 treatment groups in the frequencies of adverse events. CONCLUSIONS AND RELEVANCE: Among adults with hypertension in China without a history of stroke or MI, the combined use of enalapril and folic acid, compared with enalapril alone, significantly reduced the risk of first stroke. These findings are consistent with benefits from folate use among adults with hypertension and low baseline folate levels. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00794885.","year":2015}
{"review_pmid":"41830012","record_index":11,"pmid":"16858361","title":"Homocysteine lowering with folic acid and B vitamins in vascular disease","abstract":null,"year":2006}
{"review_pmid":"41830012","record_index":12,"pmid":"14762035","title":"Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death: the Vitamin Intervention for Stroke Prevention (VISP) randomized controlled trial.","abstract":"CONTEXT: In observational studies, elevated plasma total homocysteine levels have been positively associated with ischemic stroke risk. However the utility of homocysteine-lowering therapy to reduce that risk has not been confirmed by randomized trials. OBJECTIVE: To determine whether high doses of folic acid, pyridoxine (vitamin B6), and cobalamin (vitamin B12), given to lower total homocysteine levels, reduce the risk of recurrent stroke over a 2-year period compared with low doses of these vitamins. DESIGN: Double-blind randomized controlled trial (September 1996-May 2003). SETTING AND PARTICIPANTS: 3680 adults with nondisabling cerebral infarction at 56 university-affiliated hospitals, community hospitals, private neurology practices, and Veterans Affairs medical centers across the United States, Canada, and Scotland. INTERVENTIONS: All participants received best medical and surgical care plus a daily multivitamin containing the US Food and Drug Administration's reference daily intakes of other vitamins; patients were randomly assigned to receive once-daily doses of the high-dose formulation (n = 1827), containing 25 mg of pyridoxine, 0.4 mg of cobalamin, and 2.5 mg of folic acid; or the low-dose formulation (n = 1853), containing 200 microg of pyridoxine, 6 microg of cobalamin and 20 microg of folic acid. MAIN OUTCOME MEASURES: Recurrent cerebral infarction (primary outcome); coronary heart disease (CHD) events and death (secondary outcomes). RESULTS: Mean reduction of total homocysteine was 2 micromol/L greater in the high-dose group than in the low-dose group, but there was no treatment effect on any end point. The unadjusted risk ratio for any stroke, CHD event, or death was 1.0 (95% confidence interval [CI], 0.8-1.1), with chances of an event within 2 years of 18.0% in the high-dose group and 18.6% in the low-dose group. The risk of ischemic stroke within 2 years was 9.2% for the high-dose and 8.8% for the low-dose groups (risk ratio, 1.0; 95% CI, 0.8-1.3) (P =.80 by log-rank test of the primary hypothesis of difference in ischemic stroke between treatment groups). There was a persistent and graded association between baseline total homocysteine level and outcomes. A 3- micromol/L lower total homocysteine level was associated with a 10% lower risk of stroke (P =.05), a 26% lower risk of CHD events (P<.001), and a 16% lower risk of death (P =.001) in the low-dose group and a nonsignificantly lower risk in the high-dose group by 2% for stroke, 7% for CHD events, and 7% for death. CONCLUSIONS: In this trial, moderate reduction of total homocysteine after nondisabling cerebral infarction had no effect on vascular outcomes during the 2 years of follow-up. However, the consistent findings of an association of total homocysteine with vascular risk suggests that further exploration of the hypothesis is warranted and longer trials in different populations with elevated total homocysteine may be necessary.","year":2004}
{"review_pmid":"41830012","record_index":13,"pmid":"16923411","title":"Rationale and design of the Folic Acid for Vascular Outcome Reduction In Transplantation (FAVORIT) trial.","abstract":"BACKGROUND: Patients with chronic kidney disease, including kidney transplant recipients, are at high risk for cardiovascular disease (CVD). In addition to the constellation of traditional CVD risk factors in chronic kidney disease, elevated total homocysteine (tHcy) is notably more prevalent among the general population. The Folic Acid for Vascular Outcome Reduction In Transplantation (FAVORIT) trial is designed to evaluate whether lowering tHcy using vitamin supplementation reduces CVD events in renal transplant recipients. METHODS: FAVORIT is a multicenter double-blind randomized controlled clinical trial. Participants are clinically stable renal transplant recipients who are 6 months or longer posttransplant with elevated tHcy. Patients are randomized to a multivitamin that includes either a high-dose or low-dose of folic acid (5 or 0 mg), vitamin B6 (50 or 1.4 mg), and vitamin B12 (1000 or 2 microg). The primary end point is a composite of incident or recurrent CVD outcomes, that is, coronary heart, cerebrovascular, or abdominal aortic/lower extremity arterial events. A sample size of 4000 is estimated to provide 87% power to detect a 20% treatment effect. Recruitment is expected to continue until July 2006, with follow-up through June 2010. RESULTS: From August 2002 through December 2004, 2234 of the target 4000 patients were enrolled. In accordance with trial design, mean (SD) screening tHcy was elevated (17.4 +/- 6.2 micromol/L), and mean (SD) estimated creatinine clearance was consistent with stable renal function (58.0 +/- 18.6 mL/min). Evaluating baseline results to date, 42% of the randomized participants had a history of diabetes mellitus, and 21% had prevalent CVD. CONCLUSIONS: The FAVORIT trial is designed with sufficient power and follow-up time to detect a clinically relevant change in CVD risk between renal transplant recipients receiving a high or low tHcy-lowering folic acid multivitamin. Preliminary screening and baseline data support the trial's objectives.","year":2006}
{"review_pmid":"41835126","record_index":1,"pmid":"32219304","title":"A Field Evaluation of Construction Workers' Activity, Hydration Status, and Heat Strain in the Extreme Summer Heat of Saudi Arabia.","abstract":"OBJECTIVES: Assess the impact of summer heat exposure (June-September) on residential construction workers in Al-Ahsa, Saudi Arabia by evaluating (i) heart rate (HR) responses, hydration status, and physical workload among workers in indoor and outdoor construction settings, (ii) factors related to physiological responses to work in hot conditions, and (iii) how well wet-bulb globe temperature-based occupational exposure limits (WBGTOELs) predict measures of heat strain. METHODS: Twenty-three construction workers (plasterers, tilers, and laborers) contributed 260 person-days of monitoring. Workload energy expenditure, HR, fluid intake, and pre- and postshift urine specific gravity (USG) were measured. Indoor and outdoor heat exposures (WBGT) were measured continuously and a WBGTOEL was calculated. The effects of heat exposure and workload on heart rate reserve (HRR), a measure of cardiovascular strain, were examined with linear mixed models. A metric called 'heat stress exceedance' (HSE) was constructed to summarize whether the environmental heat exposure (WBGT) exceeded the heat stress exposure limit (WBGTOEL). The sensitivity and specificity of the HSE as a predictor of cardiovascular strain (HRR ≥30%) were determined. RESULTS: The WBGTOEL was exceeded frequently, on 63 person-days indoors (44%) and 91(78%) outdoors. High-risk HRR occurred on 26 and 36 person-days indoors and outdoors, respectively. The HSE metric showed higher sensitivity for HRR ≥30% outdoors (89%) than indoors (58%) and greater specificity indoors (59%) than outdoors (27%). Workload intensity was generally moderate, with light intensity work more common outdoors. The ability to self-pace work was associated with a lower frequency of HRR ≥30%. USG concentrations indicated that workers began and ended their shifts dehydrated (USG ≥1.020). CONCLUSIONS: Construction work where WBGTOEL is commonly exceeded poses health risks. The ability of workers to self-pace may help reduce risks.","year":2020}
{"review_pmid":"41835126","record_index":2,"pmid":"32466510","title":"Al-bouwarthan-2020-Risk-of-kidney-injury-among-constru","abstract":": SaudiArabia(SA)isoneofthehottestcountriesintheworld. Thisstudywasconducted to assess the impact of summer heat stress in Southeastern SA on short-term kidney injury (KI) amongbuildingconstructionworkersandtoidentifyrelevantriskfactors. Measurementsofurinary albumin-creatinineratio(ACR),height,weight,hydration,symptoms,dailyworkandbehavioral factorswerecollectedinJuneandSeptemberof2016fromacohortofconstructionworkers(n=65) inAl-AhsaProvince,SA.KIwasdefinedasACR≥30mg/g. Multivariatelinearregressionanalysis wasusedtoassessfactorsrelatedtocross-summerchangesinACR. AsignificantincreaseinACR occurredamongmostworkersoverthestudyperiod;incidenceofKIwas18%. Riskfactorsassociated withanincreasedACRincludeddehydration,shortsleep,andobesity. Thefindingssuggestthat exposuretosummerheatmayleadtothedevelopmentofKIamongconstructionworkersinthis region. Adequatehydrationandpromotionofhealthyhabitsamongworkersmayhelpreducethe riskofKI. Areductioninworkhoursmaybethemosteffectiveinterventionbecausethisactioncan reduceheatexposureandimprovesleepquality.","year":2020}
{"review_pmid":"41835126","record_index":3,"pmid":"33732537","title":"Climate Warming and Occupational Heat and Hot Environment Standards in Thailand.","abstract":"BACKGROUND: During the period 2001 to 2016, the maximum temperatures in Thailand rose from 38-41oC to 42-44oC. The current occupational heat exposure standard of Thailand issued in 2006 is based on wet bulb globe temperature (WBGT) defined for three workload levels without a work-rest regimen. This study examined whether the present standard still protects most workers. METHODS: The sample comprised 168 heat acclimatized workers (90 in construction sites, 78 in foundries). Heart rate and auditory canal temperature were recorded continuously for 2 hours. Workplace WBGT, relative humidity, and wind velocity were monitored, and the participants' workloads were estimated. Heat-related symptoms and signs were collected by a questionnaire. RESULTS: Only 55% of the participants worked in workplaces complying with the heat standard. Of them, 79% had auditory canal temperature ≤ 38.5oC, compared with only 58% in noncompliant workplaces. 18% and 43% of the workers in compliant and noncompliant workplaces, respectively, had symptoms from heat stress, the trend being similar across all workload levels. An increase of one degree (C) in WBGT was associated with a 1.85-fold increase (95% confidence interval: 1.44-2.48) in odds for having symptoms. CONCLUSION: Compliance with the current occupational heat standard protects 4/5 of the workers, whereas noncompliance reduces this proportion to one half. The reasons for noncompliance include the gaps and ambiguities in the law. The law should specify work/rest schedules; outdoor work should be identified as an occupational heat hazard; and the staff should include occupational personnel to manage heat stress in establishments involving heat exposure.","year":2021}
{"review_pmid":"41835126","record_index":4,"pmid":"26674401","title":"Climatic and psychosocial risks of heat illness incidents on construction site.","abstract":"The study presented in this paper aims to identify prominent risks leading to heat illness in summer among construction workers that can be prioritised for developing effective interventions. Samples are 216 construction workers' cases at the individual level and 26 construction projects cases at the organisation level. A grounded theory is generated to define the climatic heat and psychosocial risks and the relationships between risks, timing and effectiveness of interventions. The theoretical framework is then used to guide content analysis of 36 individual onsite heat illness cases to identify prominent risks. The results suggest that heat stress risks on construction site are socially constructed and can be effectively managed through elimination at supply chain level, effective engineering control, proactive control of the risks through individual interventions and reactive control through mindful recognition and response to early symptoms. The role of management infrastructure as a base for effective interventions is discussed.","year":2016}
{"review_pmid":"41835126","record_index":5,"pmid":"31328819","title":"Dong-2019-Heatrelated-deaths-among-constructi","abstract":"ResearchandTraining,SilverSpring,Maryland 2SchoolofPublicHealth,Environmentaland Background: Heatisaseverehazardforconstructionworkersandmaybeworsening OccupationalHealthSciences,Universityof with global warming. This study sought to explore heat-related deaths among U.S. IllinoisatChicago,Chicago,Illinois constructionworkers andapossible associationwithclimatechange. 3CookCountyDepartmentofPublicHealth, OakForestHealthCenter,OakForest,Illinois Methods: Heat-relateddeathsintheCensusofFatalOccupationalInjuriesfrom1992 4DepartmentofHumanScience,Georgetown to2016wereanalyzed. DenominatorsestimatedfromtheCurrentPopulationSurvey UniversitySchoolofNursingandHealth Studies,WashingtonDC were matched with demographic and occupational categories in rate calculations. Statistical tests were used to examine heat-related deaths in relation to time,","year":2019}
{"review_pmid":"41835126","record_index":6,"pmid":"39338139","title":"Dutta-2015-Perceived-heat-stress-and-health-ef","abstract":"Background: Numerous risk factors have been identified as significantly influencing outdoor workers’ risk for heat stress and heat-related conditions, impacting their health, well-being, and productivity. However, the specific effects of these factors on construction workers’ safety, health, and well-being remain under-researched. With climate change increasing temperatures, assessing heat stress among construction workers is imperative. Objective: To identify the barriers and facilitators influencing the safety of natural gas construction workers and evaluate an implemented heat stress intervention. Methods: In the summer of 2023, two semi-structured interviews and six focus groups were conducted with twenty-one stakeholders at a Texas natural gas construction site. Results: Key facilitators include employee preparedness, use of employer-provided resources, hydration logs, and real-time communication tools. Contrarily, the barriers include daily work schedules, access to dehydrating beverages, and generational differences with the non-implementation of mandatory rest breaks. The heat stress program was perceived as effective, surpassing recommended guidelines. Conclusion: To advance construction workers’ safety, health, and well-being, both employee involvement and employer management are needed, along with no-cost accessible resources. Additionally, implementing a required routine rest break and comprehensive heat stress education, particularly for older workers, will significantly promote safety and safe work practices in hot environments. Note: in this study, the terms ‘worker’ and ‘employee’ are used interchangeably.","year":2015}
{"review_pmid":"41835126","record_index":7,"pmid":null,"title":"Evaluating the impacts of high-temperature outdoor working environments on construction labor productivity in China: A case study of rebar workers","abstract":null,"year":2016}
{"review_pmid":"41835126","record_index":8,"pmid":"34819067","title":"Han-2021-Perceptions-of-workplace-heat-expos","abstract":"Background: Workplace heat exposure can cause a series of heat-related illnesses and injuries. Protecting workers especially those undertake work outdoors from the risk of heat strain is a great challenge for many workplaces in China under the context of climate change. The aim of this study is to investigate the perceptions and adaptation behaviors of heat exposure among construction workers and to provide evidence for the development of targeted heat adaptation strategies nationally and internationally. Methods: In 2020, we conducted a cross-sectional online questionnaire survey via WeChat Survey Star in China, using a purposive snowball sampling approach. A total of 326 construction workers submitted completed questionnaires. The perceptions of workplace heat exposure were measured using seven indicators: concerns over high temperature, perception of high temperature injury, attitudes towards both heat-related training and regulations, adjustment of working habits during heat, heat prevention measures in the workplace, and reduction of work efficiency. Bivariate and multivariate regression analyses were used to identify the factors significantly associated with workers’ heat perceptions and behavioral responses. Results: 33.3% of the respondents were moderately or very concerned about heat exposure in the workplace. Less than half of the workers (43.8%) were worried about heat-related injuries. Workers who have either experienced workrelated injuries (OR 1.30, 95% CI 1.03-1.62) or witnessed injuries to others during high temperatures (OR 1.12, = = 95% CI 1.02-1.27) were more concerned about heat exposure compared to other workers. Most respondents (63.5%) stated that their work efficiency declined during extremely hot weather. The factors significantly associated with a reduction of work efficiency included undertaking physically demanding jobs (OR 1.28, 95% CI 1.07-1.54) and = witnessing other workers’ injuries during high temperatures (OR 1.26, 95% CI 1.11-1.43). More than half of the work= ers were willing to adjust their work habits to adapt to the impact of high temperatures (81.6%). The internet was the most common method to obtain heat prevention information (44.7%), and the most frequently used heat prevention measure was the provision of cool drinking water (64.8%).","year":2021}
{"review_pmid":"41835126","record_index":9,"pmid":"17284880","title":"Comparison of Subjective Symptoms and Hot","abstract":": In the present study, a survey on subjective symptoms and hot prevention measures in summer was conducted in 204 male traffic control workers and 115 male construction workers. Work loads of traffic control workers and construction workers were estimated at RMR 1-2 and RMR 2-4, respectively. A self-administered questionnaire was used to collect information on age, occupational career, working habit, present or past history of diseases, individual preventive measures to the heat, and subjective symptoms in the summer. Daily working hours in the sunshine of the traffic control workers were significantly longer than those of the construction workers. Prevalence rates of changing clothes frequently, avoiding direct exposure of face and neck to sunlight using towel like materials, and wearing sunglasses in the traffic control workers were significantly lower than the construction workers. Prevalence rates of symptoms in the upper extremities in the traffic control workers were significantly lower than those in the construction workers. Prevalence of work difficulty due to hot weather during work in the traffic control workers was significantly lower than the construction workers. On the basis of the results obtained, some preventive countermeasures to improve working environment are presented.","year":2007}
{"review_pmid":"41835126","record_index":10,"pmid":"33441683","title":"Kakamu-2021-Heat-related-illness-risk-and-assoc","abstract":null,"year":2021}
{"review_pmid":"41835126","record_index":11,"pmid":"24464540","title":"ASSESSMENT OF CONSTRUCTION WORKERS’","abstract":"Objectives: The study objective was to assess hydration status by measuring USG among construction workers in Iran. Materials and Methods: The study design was comparative and experimental. Sixty participants were randomly selected from the construction workers from a construction campus with a similar type of work, climate and diet and formed 2 groups (individuals exposed to the sun and non-exposed individuals). TWL and USG were measured in both groups on 2 consequent days, at the beginning, mid and end of the work shift. Results: USG test showed that mean USG was 1.0213±0.0054 in the control group and in the exposed group, where it was significantly higher, it amounted to 1.026±0.005. In the exposed group, 38% of workers had a USG level between 1.026-1.030, representing a higher risk of heat illness and impaired performance and 12.72% had a USG level above 1.030 representing a clinically dehydrated status, while this proportion in the control group was 15.2% and 0.58%, respectively. The mean TWL index measure was 215.8±5.2 W/m2 for the control group and 144±9.8 W/m2 for the exposed group, where, again, it was significantly higher. The Pearson correlation measure showed a significant correlation between USG and TWL. Conclusions: Strong correlation between TWL, as an indicator of thermal stress and USG shows that USG can be considered as a predictor of thermal stress. The difference between USG among the exposed and non-exposed workers and the increase in USG during midday work show the sensitivity of this measure in different thermal and climatic conditions, whereas, the high level of dehydration among workers despite acceptable TWL level, shows that heat stress management without considering the real hydration status of workers, is insufficient.","year":2013}
{"review_pmid":"41835126","record_index":12,"pmid":"24655301","title":"Oksa-2014-Muscular-cardiorespiratory-and-ther","abstract":null,"year":2014}
{"review_pmid":"41835126","record_index":13,"pmid":"37041408","title":"Petropoulos-2023-Heat-stress-and-heat-strain-among-o","abstract":"BACKGROUND: ThereisgrowingattentiononoccupationalheatstressinCentralAmerica,asworkersinthisregionareaffectedby auniqueformofchronickidneydisease. Previousstudieshaveexaminedwetbulbglobetemperaturesandestimatedmetabolic rates toassess heat stress, butthere arelimiteddata characterizing heat strainamong these workers. OBJECTIVE: The aimswereto characterize heat stressand heat strain andexamine whether jobtask,break duration, hydration practices, and kidneyfunction wereassociated with heat strain. METHODS: Weused data fromtheMesoAmericanNephropathy Occupational Study, a cohort of569 outdoor workers inEl Salvador and Nicaraguawhounderwent workplaceexposure monitoring,including continuous measurementof corebody temperature(T ),heartrate(HR),physicalactivity,andwetbulbglobetemperature(WBGT),overthecourseofthreedaysinJanuary c 2018 -May 2018. Participants represented fiveindustries: sugarcane, corn, plantain, brickmaking,and construction. RESULTS: Median WBGTs wererelatively high(>27°C)atmost sites, particularlywhen work shiftsspanned theafternoon hours (e.g.,29.2°Camongplantainworkers). Sugarcaneworkers,especiallycanecuttersinbothcountriesandNicaraguanagrichemical applicators,hadthehighestestimatedmetabolicrates(medians:299-318kcal/hr). Mostworkersspentlittletimeonbreak(<10%of the shift),asdetermined byphysical activity data. Overall,sugarcane workers-particularly thosein Nicaragua-experienced the highest T and HR values. However, a fewworkersin otherindustries reached highT (>39°C)aswell. Impaired kidneyfunction c c (estimated glomerular filtration rate <90mL/min/1.73m2)was associated with higherT and HRvalues, evenafter adjustment. c SIGNIFICANCE: Thisis thelargest study to-date examiningheat stressand strain amongoutdoor workersin CentralAmerica. WorkersatsugarcompaniesregularlyexperiencedT >38°C(76.9%ofmonitoredperson-daysatNicaraguancompanies;46.5%at c Salvadoran companies). Workers with impairedkidney function had highermeasures ofT andHR. c IMPACTSTATEMENT: Thisstudyexaminedlevelsofoccupationalheatstressandheatstrainexperiencedamongoutdoorworkers in five industries inEl Salvadorand Nicaragua. Wecharacterized heat stress using wetbulbglobe temperatures and estimated metabolic rateand heat strain using corebodytemperature and heart rate. Sugarcane workers, particularly canecutters and Nicaraguan agrichemical applicators, performedmorestrenuous work andexperienced greater levels ofheat strain. Impaired kidney function wasassociated with higherheart ratesand corebody temperatures.","year":2023}
{"review_pmid":"41835126","record_index":14,"pmid":null,"title":"Physiological responses of acclimatized construction workers during different work patterns in a hot and humid subtropical area of China","abstract":null,"year":2020}
{"review_pmid":"41835126","record_index":15,"pmid":"24499742","title":"Sett-2014-Effects-of-occupational-heat-exposu","abstract":"Background: Manualbrick-manufacturingunitsinIndiaengagealargenumberoffemaleworkersonadailywagebasisforaperiodof8monthsperyear. Therearetwogroupsoffemaleworkersinthebrickfields:the brickmoldersandthebrickcarriers. Thesebrickfieldsaremostlyunorganized,andtheworkersareexposed to extreme conditions such as very high seasonal heat. The present trend of increasing temperatures, as a result of globalwarming andclimate change, will putanadditionalburdenon them. Objective: Thisstudyaimstoevaluatetheeffectofworkplaceheatexposureonthewell-being,physiological load, andproductivityoffemalebrickfieldworkers in India. Design: Aquestionnairestudy(n(cid:2)120),environmentaltemperature,andweeklyworkproductivityanalyses were evaluated for 8 months in the brickfields. Cardiac strain andwalking speed (subset, n(cid:2)40) were also studiedand comparedin hotter andcolderdaysamongst the femalebrickfieldworkers. Results: The subjects experience summer for about 5 monthswith additional heat stress radiating from the brick kiln. The weekly productivitydata show a linear decline in productivity with increased maximum air temperatureabove34.98C. Thecardiacparameters(peakheartrate(HRp),netcardiaccost(NCC),relative cardiac cost (RCC), and recovery heart rates) were significantly higher on hotter days (Wet Bulb Globe Temperature(WBGT )index:26.98Cto30.748C)thanoncoolerdays(WBGT index:16.128Cto19.378C) out out forthebrickmolders;however,thisisnotthecaseforthebrickcarriers. Asthebrickcarriersadapttohotter days bydecreasing their walking speed,their productivitydecreases. Conclusion: Weconcludethathighheatexposureinbrickfieldsduringsummercausedphysiologicalstrainin bothcategoriesoffemalebrickfieldworkers. Acopingstrategyemployedbythebrickcarrierswastoreduce their walking speed and thus lose part of their earnings. The lost productivity for every degree rise in temperature is about 2% in the brickfields. This reduction will be exacerbated by climate change and may underminethe qualityoflife offemalebrickfieldworkers.","year":2014}
{"review_pmid":"41835126","record_index":16,"pmid":"32206368","title":"Spatial Changes in Work Capacity for Occupations Vulnerable to Heat Stress: Potential Regional Impacts From Global Climate Change.","abstract":"BACKGROUND: As the impact of climate change intensifies, exposure to heat stress will grow, leading to a loss of work capacity for vulnerable occupations and affecting individual labor decisions. This study estimates the future work capacity under the Representative Concentration Pathways 8.5 scenario and discusses its regional impacts on the occupational structure in the Republic of Korea. METHODS: The data utilized for this study constitute the local wet bulb globe temperature from the Korea Meteorological Administration and information from the Korean Working Condition Survey from the Occupational Safety and Health Research Institute of Korea. Using these data, we classify the occupations vulnerable to heat stress and estimate future changes in work capacity at the local scale, considering the occupational structure. We then identify the spatial cluster of diminishing work capacity using exploratory spatial data analysis. RESULTS: Our findings indicate that 52 occupations are at risk of heat stress, including machine operators and elementary laborers working in the construction, welding, metal, and mining industries. Moreover, spatial clusters with diminished work capacity appear in southwest Korea. CONCLUSION: Although previous studies investigated the work capacity associated with heat stress in terms of climatic impact, this study quantifies the local impacts due to the global risk of climate change. The results suggest the need for mainstreaming an adaptation policy related to work capacity in regional development strategies.","year":2020}
{"review_pmid":"41835126","record_index":17,"pmid":null,"title":"Thermal responses of workers during summer: An outdoor investigation of construction sites in South China","abstract":null,"year":2021}
{"review_pmid":"41888952","record_index":1,"pmid":"36290657","title":"Biological Effects of Hydrogen Water on Subjects with NAFLD: A Randomized, Placebo-Controlled Trial.","abstract":"Non-alcoholic fatty liver disease (NAFLD) is a liver pathology affecting around 25% of the population worldwide. Excess oxidative stress, inflammation and aberrant cellular signaling can lead to this hepatic dysfunction and eventual carcinoma. Molecular hydrogen has been recognized for its selective antioxidant properties and ability to attenuate inflammation and regulate cellular function. We administered hydrogen-rich water (HRW) to 30 subjects with NAFLD in a randomized, double-blinded, placebo-controlled manner for eight weeks. Phenotypically, we observed beneficial trends (p > 0.05) in decreased weight (≈1 kg) and body mass index in the HRW group. HRW was well-tolerated, with no significant changes in liver enzymes and a trend of improved lipid profile and reduced lactate dehydrogenase levels. HRW tended to non-significantly decrease levels of nuclear factor kappa B, heat shock protein 70 and matrix metalloproteinase-9. Interestingly, there was a mild, albeit non-significant, tendency of increased levels of 8-hydroxy-2’-deoxyguanosine and malondialdehyde in the HRW group. This mild increase may be indicative of the hormetic effects of molecular hydrogen that occurred prior to the significant clinical improvements reported in previous longer-term studies. The favorable trends in this study in conjunction with previous animal and clinical findings suggest that HRW may serve as an important adjuvant therapy for promoting and maintaining optimal health and wellness. Longer term studies focused on prevention, maintenance, or treatment of NAFLD and early stages of NASH are warranted.","year":2022}
{"review_pmid":"41888952","record_index":2,"pmid":null,"title":"Effects of drinking hydrogen-rich water in men at risk of peripheral arterial disease: a randomized placebo-controlled trial","abstract":"Aims Smoking, hypertension, hyperlipidemia, and diabetes are considered to increase the incidence of peripheral arterial disease (PAD). They can activate endogenous free radicals, cause in ammation and oxidative stress, and lead to endothelial cell dysfunction. Hydrogen (H ) has been proven to decrease 2 oxidative stress, improve cell function, and reduce chronic in ammation. The purpose of this research was to validate the role of H in individuals who are at risk of PAD. 2 Methods Sixty subjects were randomly assigned to placebo (PBO) group or H -rich water (HRW) group 2 and drank either bottled pure water or H -rich water (245 mL/time, 3 times/d) for ten weeks. 2 Results The pulse wave velocity was ameliorated in the HRW group with no signi cant change in the ankle-brachial index. The serum total cholesterol of the HRW group was signi cantly reduced compared to the placebo group. In addition, compared to baseline, the levels of lipoprotein(a) was decreased, the malondialdehyde content was reduced, the superoxide dismutase activity was increased, and the expression of intercellular cell adhesion molecule-1 was decreased signi cantly in the HRW group. The oxidized phospholipid of 1-palmitoyl-2-azelaoyl-sn-glycero-3-phosphatidylcholine level in the HRW group were signi cantly reduced compared to the placebo group. Finally, H signi cantly improved the 2 antioxidant, antiin ammatory, and antiapoptotic abilities of high-density lipoprotein (HDL). Conclusions Drinking HRW can improve vascular sclerosis indicators, improve dyslipidemia, reduce vascular oxidative stress and in ammation, and improve HDL function. H may be used to prevent and 2 relieve PAD caused by major risk factors such as smoking, hypertension, hyperlipidemia, and diabetes.","year":2021}
{"review_pmid":"41888952","record_index":3,"pmid":"39258191","title":"Effects of hydrogen-rich water on blood uric acid in patients with hyperuricemia: A randomized placebo-controlled trial.","abstract":"BACKGROUND: Consumption of hydrogen-rich water (HRW) has been shown to have anti-inflammatory and metabolic-modulatory benefits. OBJECTIVE: A randomized, placebo-controlled trial was conducted to assess the potential blood uric acid-lowering effects of HRW consumption with different doses (low and high doses) and duration (4 and 8 weeks) in patients with hyperuricemia. METHODS: The Placebo group consumed three bottles of ordinary drinking water (330 mL per bottle), the Low-HRW group consumed two bottles of HRW (330 mL per bottle, H2 ≥ 4.66 mg/L) and a bottle of ordinary water, and the High-HRW group consumed three bottles of HRW daily for 8 weeks. The primary outcome was the blood uric acid levels following different time points (4 and 8 weeks) compared to baseline. RESULTS: A total of 100 participants completed the entire trial (32 in Placebo, 35 in Low-HRW, and 33 in High-HRW groups). The high-dose of HRW was more effective than low-dose HRW in controlling blood uric acid. Following an 8-week period, the High-HRW group exhibited a significant reduction in blood uric acid levels compared to the baseline (488.2 ± 54.1 μmol/L to 446.8 ± 57.1 μmol/L, P < 0.05). CONCLUSION: As a rather safe agent, the prolonged consumption of HRW may be feasible in the management of hyperuricemia. CLINICAL TRIAL REGISTRATION: chictr.org.cn, identifier ChiCTR2200066369.","year":2024}
{"review_pmid":"41888952","record_index":4,"pmid":"35059257","title":"Electrolyzed hydrogen-rich water for oxidative stress suppression and improvement of insulin resistance: a multicenter prospective double-blind randomized control trial.","abstract":"INTRODUCTION: Electrolyzed hydrogen-rich water (EHW) is known to have suppressive effects on oxidative stress (OS). However, its benefit in type 2 diabetes mellitus (T2DM) remains unclear. This study aimed to investigate the effect of EHW on T2DM. METHODS: This was a multicenter, prospective, double-blind, randomized controlled trial of 50 patients with T2DM who were assigned to the EHW or filtered water (FW) groups. The primary endpoint was changes in insulin resistance (IR) evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR). OS markers such as urinary 8-hydroxy-2'-deoxyguanosine excretion (8-OHdG), plasma diacron-reactive oxygen metabolites (d-ROM), and plasma biological antioxidant potential (BAP) and other clinical data, including serum lactate concentration (lactate), were evaluated. RESULTS: There were no significant differences in the changes in HOMA-IR between the EHW and FW groups. However, lactate levels decreased significantly in the EHW group, and this decrease was significantly correlated with a reduction in HOMA-IR, fasting plasma glucose, and fasting plasma insulin level. Serum lactate level also significantly correlated to decreased insulin bolus secretion after 90 min with glucose loading in the EHW subjects with HOMA-IR > 1.73. No EHW treatment-related adverse effects were observed. CONCLUSION: There were no significant effect of EHW in the change in HOMA-IR in this study; larger-scale and longer-term study are needed to verify the effects of EHW in T2DM patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13340-021-00524-3.","year":2022}
{"review_pmid":"41888952","record_index":5,"pmid":"38397743","title":"Health Effects of Electrolyzed Hydrogen Water for the Metabolic Syndrome and Pre-Metabolic Syndrome: A 3-Month Randomized Controlled Trial and Subsequent Analyses.","abstract":"We studied the effect of three months' use of electrolyzed hydrogen water (EHW, Electrolyzed Hydrogen Water conditioner produced by Nihon Trim Co., Ltd.) on metabolic and pre-metabolic syndrome groups. This research was carried out jointly by Susaki City; Nihon Trim Co., Ltd.; and Kochi University as part of a local revitalization project with health as a keyword. A randomized, placebo-controlled, double-blind, parallel-group trial was conducted to evaluate the clinical impact of EHW on participants who suffered from metabolic syndrome or pre-metabolic syndrome. EHW was produced via electrolysis using a commercially available apparatus (Nihon Trim Co., Ltd., Osaka, Japan). During exercise, oxidative stress increases, and active oxygen species increase. In this study, we examined 181 subjects with metabolic syndrome or pre-metabolic syndrome. Among the group that drank EHW for 3 months, those who also engaged in a high level of physical activity showed a significant difference in waist circumference reduction. Although no significant difference was observed, several positive results were found in the participants who engaged in a high level of physical activity. Urinary 8-OHdG, urinary nitrotyrosine, HbA1c, and blood glucose levels increased in the filtered water (FW) group but decreased in the EHW group. High-sensitivity CRP increased less in the EHW group. 8-Isoprostane decreased more in the EHW group. In subgroup analysis, the EHW group showed a significantly greater reduction in waist circumference than the FW group only when controlled for high physical activity. Based on the result, we suggest that, among participants in the study who suffered from metabolic syndrome and pre-metabolic syndrome in which the level of active oxygen species is said to be higher than in healthy subjects, the group that consumed EHW and also engaged in a high level of physical activity experienced a suppressed or reduced increase in active oxygen species.","year":2024}
{"review_pmid":"41888952","record_index":6,"pmid":"25978109","title":"Hydrogen Activates ATP-Binding Cassette Transporter A1-Dependent Efflux Ex Vivo and Improves High-Density Lipoprotein Function in Patients With Hypercholesterolemia: A Double-Blinded, Randomized, and Placebo-Controlled Trial.","abstract":"CONTEXT: We have found that hydrogen (dihydrogen [H2]) decreases plasma low-density lipoprotein (LDL) cholesterol levels and improves high-density lipoprotein (HDL) function in patients with potential metabolic syndrome in a before-after self-controlled study. OBJECTIVE: The purpose of this study was to further characterize the effects of H2-rich water (0.9 L/day) on the content, composition, and biological activities of plasma lipoproteins on patients with hypercholesterolemia and their underlying mechanisms in a double-blinded, randomized, and placebo-controlled trial. DESIGN: This was a case-control study. SETTING: The setting was the Zhoudian community, Tai'an, China. PATIENTS: A total of 68 patients with untreated isolated hypercholesterolemia were randomly allocated to either drinking H2-rich water (n = 34) or placebo water (n = 34) for 10 weeks. RESULTS: HDL isolated from the H2 group showed an increased ability to promote the ATP-binding cassette transporter A1-mediated cholesterol efflux ex vivo. Plasma pre-β-HDL levels were up-regulated although there were no changes in plasma HDL-cholesterol levels. Moreover, other HDL functions, assessed in protection against LDL oxidation, inhibition of oxidized-LDL-induced inflammation, and protection of endothelial cells from oxidized-LDL-induced apoptosis, were all significantly improved by H2 treatment. In addition, H2 treatment increased the effective rate in down-regulating plasma levels of total cholesterol (47.06% vs 17.65%) and LDL cholesterol (47.06% vs 23.53%). Western blot analysis revealed a marked decrease in apolipoprotein B100 and an increase in apolipoprotein M in plasma of the H2 group. Finally H2 treatment resulted in a significant reduction in the levels of several inflammatory and oxidative stress indicators in whole plasma and HDL particles. CONCLUSIONS: H2 activates ATP-binding cassette transporter A1-dependent efflux, enhances HDL antiatherosclerotic functions, and has beneficial lipid-lowering effects. The present findings highlight the potential role of H2 in the regression of hypercholesterolemia and atherosclerosis.","year":2015}
{"review_pmid":"41888952","record_index":7,"pmid":"37371975","title":"Hydrogen-Rich Water Ameliorates Metabolic Disorder via Modifying Gut Microbiota in Impaired Fasting Glucose Patients: A Randomized Controlled Study.","abstract":"OBJECTIVE: Molecular hydrogen (H2) exhibits antioxidant, anti-inflammatory and anti-apoptotic effects, and has shown benefits in glucose and lipid metabolism in certain animal metabolic disorder models. However, the potential benefits of H2 treatment in individuals with impaired fasting glucose (IFG) has seldom been studied. This randomized controlled study (RCT) aims to investigate the effects of hydrogen-rich water (HRW) on IFG subjects and explore the underlying mechanism involved. METHODS: Seventy-three patients with IFG were enrolled in a randomized, double-blind, placebo-controlled clinical study. These patients were assigned to receive either 1000 mL per day of HRW or placebo pure water (no H2 infusion) for a duration of eight weeks. Metabolic parameters and fecal gut microbiota were assessed at baseline (week 0) and at week 8. A combined analysis of metabolomics and intestinal microbiota was conducted to investigate the correlation between the effect of H2 on the metabolisms and the diversity of intestinal flora in the IGF patients. RESULTS: Both pure water and HRW demonstrated a significant reduction in fasting blood glucose in IFG patients, with a significant difference between pure water and HRW after eight weeks. Among IFG patients with abnormal pre-experimental fatty liver, 62.5% (10/16) in the HRW group and 31.6% (6/19) in the pure water group achieved remission. Furthermore, 16S RNA analysis revealed HRW-modified gut microbiota dysbiosis in the fecal samples of IGF patients. Through Pearson correlation analysis, the differential gut microbiota obtained by 16S analysis was found to be highly correlated with nine metabolites. CONCLUSION: H2 slightly improved metabolic abnormalities and gut microbiota dysbiosis, providing a novel target and theoretical basis for the prevention and treatment of blood glucose regulation in patients with IFG.","year":2023}
{"review_pmid":"41888952","record_index":8,"pmid":"28560519","title":"Molecular hydrogen affects body composition, metabolic profiles, and mitochondrial function in middle-aged overweight women.","abstract":"BACKGROUND: Molecular hydrogen (H2) effectively treats obesity-related disorders in animal models, yet no studies have investigated the effectiveness and safety of H2 for improving biomarkers of obesity in humans. AIM: In this double blind, placebo-controlled, crossover pilot trial, we evaluated the effects of H2 intervention on body composition, hormonal status, and mitochondrial function in ten (n = 10) middle-aged overweight women. METHODS: Volunteers received either hydrogen-generating minerals (supplying ~6 ppm of H2 per day) or placebo by oral administration of caplets for 4 weeks. The primary end-point of treatment efficacy was the change in the body fat percentage from baseline to 4 weeks. In addition, assessment of other body composition indices, screening laboratory studies, and evaluation of side effects were performed before and at follow-up. Clinical trial registration www.clinicaltrials.gov, ID number NCT02832219. RESULTS: No significant differences were observed between treatment groups for changes in weight, body mass index, and body circumferences at 4-week follow-up (P > 0.05). H2 treatment significantly reduced body fat percentage (3.2 vs. 0.9%, P = 0.05) and arm fat index (9.7 vs. 6.0%, P = 0.01) compared to placebo administration, respectively. This was accompanied by a significant drop in serum triglycerides after H2 intervention comparing to placebo (21.3 vs. 6.5%; P = 0.04), while other blood lipids remained stable during the study (P > 0.05). Fasting serum insulin levels dropped by 5.4% after H2 administration, while placebo intervention augmented insulin response by 29.3% (P = 0.01). CONCLUSIONS: It appears that orally administered H2 as a blend of hydrogen-generating minerals might be a beneficial agent in the management of body composition and insulin resistance in obesity.","year":2018}
{"review_pmid":"41888952","record_index":9,"pmid":"37569850","title":"The Effect of Adjuvant Therapy with Molecular Hydrogen on Endogenous Coenzyme Q10 Levels and Platelet Mitochondrial Bioenergetics in Patients with Non-Alcoholic Fatty Liver Disease.","abstract":"Molecular hydrogen (H2) has been recognized as a novel medical gas with antioxidant and anti-inflammatory effects. Non-alcoholic fatty liver disease (NAFLD) is a liver pathology with increased fat accumulation in liver tissue caused by factors other than alcohol consumption. Platelet mitochondrial function is considered to reflect systemic mitochondrial health. We studied the effect of adjuvant therapy with hydrogen-rich water (HRW) on coenzyme Q10 (CoQ10) content and platelet mitochondrial bioenergetics in patients with NAFLD. A total of 30 patients with NAFLD and 15 healthy volunteers were included in this clinical trial. A total of 17 patients (H2 group) drank water three × 330 mL/day with tablets producing HRW (>4 mg/L H2) for 8 weeks, and 13 patients (P group) drank water with placebo tablets producing CO2. The concentration of CoQ10-TOTAL was determined by the HPLC method, the parameter of oxidative stress, thiobarbituric acid reactive substances (TBARS), by the spectrophotometric method, and mitochondrial bioenergetics in platelets isolated from whole blood by high-resolution respirometry. The patients with NAFLD had lower concentrations of CoQ10-TOTAL in the blood, plasma, and platelets vs. the control group. Mitochondrial CI-linked LEAK respiration was higher, and CI-linked oxidative phosphorylation (OXPHOS) and CII-linked electron transfer (ET) capacities were lower vs. the control group. Plasma TBARS concentrations were higher in the H2 group. After 8 weeks of adjuvant therapy with HRW, the concentration of CoQ10 in platelets increased, plasma TBARS decreased, and the efficiency of OXPHOS improved, while in the P group, the changes were non-significant. Long-term supplementation with HRW could be a promising strategy for the acceleration of health recovery in patients with NAFLD. The application of H2 appears to be a new treatment strategy for targeted therapy of mitochondrial disorders. Additional and longer-term studies are needed to confirm and elucidate the exact mechanisms of the mitochondria-targeted effects of H2 therapy in patients with NAFLD.","year":2023}
{"review_pmid":"41888952","record_index":10,"pmid":"32273740","title":"The Effects of 24-Week, High-Concentration Hydrogen-Rich Water on Body Composition, Blood Lipid Pro les and In ammation Biomarkers in Men and Women with Metabolic Syndrome: A Randomized Controlled Trial","abstract":"Purpose: Metabolic syndrome is associated with several medical risk factors including Singh,3GhizalFatima,4Kumar dyslipidemia, hyperglycemia, and obesity, which has become a worldwide pandemic. The Kartikey,3JagdishPSharma,3 sequelae of this condition increase the risk of cardiovascular and neurological disease and SergejMOstojic,5,6Anna increased mortality. Its pathophysiology is associated with redox dysregulation, excessive Gvozdjakova,7BranislavKura,2 inflammation, and perturbation of cellular homeostasis. Molecular hydrogen (H 2 ) may MamiNoda, 8ViliamMojto,9 attenuate oxidative stress, improve cellular function, and reduce chronic inflammation. Preclinical and clinical studies have shown promising effects of H -rich water (HRW) on MohammadArifNiaz, 10Jan 2 specific features of metabolic syndrome, yet the effects of long-term, high-concentration Slezak1 HRWinthisprevalent conditionremainpoorlyaddressed. 1CentreofExperimentalMedicine, Methods: We conducted a randomized, double-blinded, placebo-controlled trial in 60 subInstituteforHeartResearch,Slovak jects(30menand30women)withmetabolicsyndrome. Aninitialobservationperiodofone AcademyofSciences,Bratislava,Slovak Republic;2MolecularHydrogenInstitute, weekwasusedtoacquirebaselineclinicaldatafollowedbyrandomizationtoeitherplacebo Enoch,UT,USA;3HospitalandResearch orhigh-concentration HRW (>5.5millimoles ofH perday)for24weeks. 2 Institute,Moradabad,India;4EraMedical Results: Supplementation with high-concentration HRW significantly reduced blood choCollege,Lucknow,India;5Applied BioenergeticsLab,FacultyofSportand lesterolandglucoselevels,attenuatedserumhemoglobinA1c,andimprovedbiomarkersof PE,UniversityofNoviSad,NoviSad, inflammation and redox homeostasis as compared to placebo (P < 0.05). Furthermore, H 2 Serbia;6FacultyofHealthSciences, tended topromoteamildreduction inbodymassindexandwaist-to-hip ratio. UniversityofPécs,Pécs,Hungary; 7MedicalFaculty,Pharmacobiochemical Conclusion: Our results give further credence that high-concentration HRW might have Laboratoryof3rdMedicalDepartment, promising effects as a therapeutic modality for attenuating risk factors of metabolic ComeniusUniversityBratislava, Bratislava,Slovakia;8Laboratoryof syndrome. Pathophysiology,GraduateSchoolof Keywords: metabolism, fasting blood glucose, cholesterol, inflammation, oxidative stress, PharmaceuticalSciences,Kyushu hydrogenwater University,Fukuoka,Japan;9Third InternalClinic,FacultyofMedicine, ComeniusUniversity,Bratislava,Slovakia; 10CenterofNutritionResearch, InternationalCollegeofNutrition, Introduction Moradabad,India The prevalence of metabolic syndrome is considered a growing epidemic in countries worldwide, and is characterized by various medical conditions including","year":2020}
{"review_pmid":"41888952","record_index":11,"pmid":"34601077","title":"The effects of 6-month hydrogen-rich water intake on molecular and phenotypic biomarkers of aging in older adults aged 70 years and over: A randomized controlled pilot trial.","abstract":"In this randomized controlled pilot trial, we investigated the effects of a 6-month intake of hydrogen-rich water (HRW) on several molecular and phenotypic biomarkers of aging in older adults aged 70 years and over. Forty older adults (20 women) were randomly allocated in a parallel-group design to receive 0.5 L per day of HRW (15 ppm of hydrogen) or control drink (0 ppm of hydrogen) during a 6-month intervention period. The biomarkers assessed at baseline and 6-month follow up were molecular markers in the blood (DNA and chromosomes, nutrient sensing, protein, and lipid metabolism, oxidative stress and mitochondria, cell senescence, inflammation), brain metabolism, cognitive functioning, physical function and body composition, resting blood pressure, facial skin features, sleep outcomes, and health-related quality of life. The mean age, weight, and height of study participants were 76.0 ± 5.6 years, 78.2 ± 16.1 kg, height 167.5 ± 11.5 cm, respectively. A significant treatment vs. time interaction was found for telomere length (P = 0.049), with the length increased after HRW intervention (from 0.99 ± 0.15 at baseline to 1.02 ± 0.26 at follow up) and decreased after drinking control water (from 0.92 ± 0.27 to 0.79 ± 0.15). A marker of DNA methylation (Tet methylcytosine dioxygenase 2, TET2) expression at 6-month follow-up increased in both groups, yet the degree of elevation was significantly higher in HRW (from 0.81 ± 0.52 at baseline to 1.62 ± 0.66 at follow up) comparing to the control water (from 1.13 ± 0.82 to 1.76 ± 0.87) (P = 0.040). A strong trend for treatment vs. time interaction was found for a degree of DNA methylation (P = 0.166), with the methylation increased in the HRW group (from 120.6 ± 39.8 ng at baseline to 126.6 ± 33.8 ng at follow up) and decreased after taking control water (from 133.6 ± 52.9 ng to 121.2 ± 38.4 ng). HRW was superior to control water to increase brain choline and NAA levels in the left frontal grey matter, brain creatine at the right parietal white matter, and brain NAA at the right parietal mesial grey matter (P < 0.05). No significant differences were found between interventions for other outcomes (P > 0.05), except for a significantly improved chair stand performance after HRW intervention compared to the control water (P = 0.01). Owing to pleiotropic mechanisms of hydrogen action, this simple biomedical gas could be recognized as a possible anti-aging agent that tackles several hallmarks of aging, including loss of function and telomere length shortening. The study was registered at ClinicalTrials.gov (NCT04430803).","year":2021}
{"review_pmid":"41888952","record_index":12,"pmid":"40525414","title":"The effects of drinking hydrogen-rich water for six weeks on exercise-related biomarkers in exercise-naïve men and women over 50 years following resistance training program: a randomized controlled pilot trial.","abstract":"The primary objective of this pilot study was to assess the impact of consuming hydrogen-rich water (HRW) for a duration of six weeks on exercise-related biomarkers in previously untrained men and women aged over 50 years, subsequent to a resistance training program. Twenty-seven apparently healthy middle-aged adults (age 57.6 ± 6.7 years; 18 females) voluntarily provided written consent to participate in this randomized, placebo-controlled experimental trial. All participants were allocated in a double-blind parallel-group design to receive either HRW (12 mg of dihydrogen per serving) or control water (<0.1 ppm of dihydrogen) administered two times per day during a 6-week intervention interval. Muscle performance indices showed a significant improvement following both HRW and control water interventions compared to the baseline values (p ≤ 0.05). HRW led to a significant increase in serum free testosterone and cortisol levels, along with reductions in total cholesterol and LDL-cholesterol levels at the follow-up (p ≤ 0.05). Moreover, HRW significantly outperformed the control water in reducing biomarkers of acute muscular damage caused by resistance exercise (p ≤ 0.05) and tended to outcompete placebo in improving sleep quality (p = 0.119). HRW could be advanced as a risk-free and effective beverage for promoting training-specific adaptations in exercise-naïve men and women over 50 years of age.","year":2025}
{"review_pmid":"41901064","record_index":1,"pmid":"36002548","title":"Fukamizu-2022-Safety-evaluation-of--nicotinamide-","abstract":null,"year":2022}
{"review_pmid":"41901064","record_index":2,"pmid":"35821806","title":"Huang-2022-A-multicentre-randomised-double-bli","abstract":"Objective: Thepurposeofthestudywastoevaluatetheanti-agingeffectofNMNandits SofieLautrup, safety in a double-blind, parallel, randomised controlled clinical trial. UniversityofOslo,Norway AliceE. Kane, Methods: The study was carried out on 66 healthy subjects between the ages of 40 HarvardMedicalSchool, and65years,instructedtotaketwocapsules(eachcontaining150mg.ofNMNorstarch UnitedStates","year":2022}
{"review_pmid":"41901064","record_index":3,"pmid":"35927255","title":"Igarashi-2022-Chronic-nicotinamide-mononucleotide","abstract":null,"year":2022}
{"review_pmid":"41901064","record_index":4,"pmid":"36797393","title":"Katayoshi-2023-Nicotinamide-adenine-dinucleotide-m","abstract":null,"year":2023}
{"review_pmid":"41901064","record_index":5,"pmid":"38789831","title":"Morifuji-2024-Ingestion-of--nicotinamide-mononucl","abstract":"The study evaluated how ingestion of a significantly shorter 4-m walking time than the planicotinamide mononucleotide (NMN) for 12 weeks cebo group as well as significantly higher blood levby older adults affected blood nicotinamide adenine els of NAD + and its metabolites. A significant negadinucleotide (NAD +) levels and physical function, tive correlation was observed between the change particularly walking function. Information concern- in the 4-m walking time and the change in blood ing sleep, and stress was also collected as secondary NAD +, N1-methyl-2-pridone-5-carboxamide (2-PY), endpoints. In this randomized, placebo-controlled, and N1-methyl-4-pridone-3-carboxamide (4-PY) double-blind, parallel-group comparison study, 60 at 12 weeks. The NMN group had improved sleep participants were randomly allocated into a placebo quality at 12 weeks relative to the placebo group as group or NMN group. Members of the NMN group evidenced by lower scores for “Daytime dysfuncconsumed 250 mg/day NMN for 12 weeks. Motor tion” and “Global PSQI” on the Pittsburgh Sleep function tests, blood NAD metabolite analysis, and Questionnaire. No adverse effects related to test subquestionnaires were conducted at the start of the stance consumption were observed. Together, these study and 4 and 12 weeks after intake. This trial was results indicate that NMN intake could increase blood registered at umin.ac.jp/ctr as UMIN000047871 on NAD + levels, maintain walking speed, and improve June 22nd, 2022. sleep quality in older adults. Interventions involving At primary outcome, at both 4 weeks and 12 weeks, NMN aimed at maintaining walking speed could conthe NMN and placebo groups had no significant dif- tribute to extended healthy life expectancy. ferences in a stepping test. At secondary outcomes, after 12 weeks of NMN intake, the NMN group had Keywords Nicotinamide mononucleotide · Walking speed · Blood NAD + · Older adults Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1007/ s11357- 024- 01204-1. Introduction * M. Morifuji ( ) · S. Higashi · M. Nagata As the elderly age, physiological aging progresses Wellness Science Labs, Meiji Holdings Co., Ltd, 1-29-1 due to a decrease in the number of cells that comprise Nanakuni, Hachioji, Tokyo 192-0919, Japan e-mail: masashi.morifuji@meiji.com each organ of the body and decreases in the volume of cells [1, 2]. Physiological aging can also be accomS. Ebihara panied by various physical characteristics such as Chiyoda Paramedical Care Clinic, 3-3-10 Nihonbashi decreased organ function and homeostasis function Hongokucho, Chuo-Ku, Tokyo 103-0021, Japan","year":2024}
{"review_pmid":"41901064","record_index":6,"pmid":"36740954","title":"Nicotinamide Adenine Dinucleotide Augmentation in Overweight or Obese Middle-Aged and Older Adults: A Physiologic Study.","abstract":"CONTEXT: Nicotinamide adenine dinucleotide (NAD) levels decline with aging and age-related decline in NAD has been postulated to contribute to age-related diseases. OBJECTIVE: We evaluated the safety and physiologic effects of NAD augmentation by administering its precursor, β-nicotinamide mononucleotide (MIB-626, Metro International Biotech, Worcester, MA), in adults at risk for age-related conditions. METHODS: Thirty overweight or obese adults, ≥ 45 years, were randomized in a 2:1 ratio to 2 MIB-626 tablets each containing 500 mg of microcrystalline β-nicotinamide mononucleotide or placebo twice daily for 28 days. Study outcomes included safety; NAD and its metabolome; body weight; liver, muscle, and intra-abdominal fat; insulin sensitivity; blood pressure; lipids; physical performance, and muscle bioenergetics. RESULTS: Adverse events were similar between groups. MIB-626 treatment substantially increased circulating concentrations of NAD and its metabolites. Body weight (difference -1.9 [-3.3, -0.5] kg, P =.008); diastolic blood pressure (difference -7.01 [-13.44, -0.59] mmHg, P =.034); total cholesterol (difference -26.89 [-44.34, -9.44] mg/dL, P =.004), low-density lipoprotein (LDL) cholesterol (-18.73 [-31.85, -5.60] mg/dL, P =.007), and nonhigh-density lipoprotein cholesterol decreased significantly more in the MIB-626 group than placebo. Changes in muscle strength, muscle fatigability, aerobic capacity, and stair-climbing power did not differ significantly between groups. Insulin sensitivity and hepatic and intra-abdominal fat did not change in either group. CONCLUSIONS: MIB-626 administration in overweight or obese, middle-aged and older adults safely increased circulating NAD levels, and significantly reduced total LDL and non-HDL cholesterol, body weight, and diastolic blood pressure. These data provide the rationale for larger trials to assess the efficacy of NAD augmentation in improving cardiometabolic outcomes in older adults.","year":2023}
{"review_pmid":"41901064","record_index":7,"pmid":"35479740","title":"Okabe-2022-Oral-administration-of-nicotinamide","abstract":"Nicotinamide mononucleotide (NNM) is an orally bioavailable NAD+ precursor that has demonstrated beneficial effects against aging and aging-associated diseases in animal models.","year":2022}
{"review_pmid":"41901064","record_index":8,"pmid":null,"title":"Placebo-controlled randomized double-blind parallel-group trial of the safety of overdose intake of nicotinamide mononuc","abstract":"- The safety of nicotinamide mononucleotide (NMN) manufactured by Teijin Limited was evaluated in a human overdose intake study involving placebo-controlled randomized double-blind parallel-group comparison. Thirty healthy Japanese volunteers, comprising men and women aged 20-64 years old, were divided into high-dose, low-dose, and placebo groups. NMN doses for these groups were set at 1,500, 750, and 0 mg/day, respectively, for an intake period of 4 weeks. To evaluate the safety of overdose intake of NMN, we conducted medical interviews and examined subjective symptoms, body weight, body mass index, blood pressure, pulse rate, hematological testing, biochemical testing, and urine testing at 0, 2, and 4 weeks of intake. As there were no dropouts, we analyzed the data from all 30 participants. We found no problematic findings or test result changes during any medical interviews or tests throughout the study period, confirming the safety of 1,500 mg/day NMN ingestion for 4 weeks. Blood nicotinamide adenine dinucleotide (NAD+) levels increased significantly, suggesting that orally ingested NMN was transferred throughout the body and converted to NAD+. In this study, NMN did not impact telomere length.","year":2025}
{"review_pmid":"41901064","record_index":9,"pmid":"37718359","title":"Qiu-2023-Nad-exhaustion-by-cd-upregulation-c","abstract":null,"year":2023}
{"review_pmid":"41901064","record_index":10,"pmid":"33888596","title":"Yoshino-2021-Nicotinamide-mononucleotide-increas","abstract":null,"year":2021}
{"review_pmid":"41938012","record_index":1,"pmid":"30528056","title":"Acute effects of air pollutants on spontaneous pregnancy loss: a case-crossover study.","abstract":"OBJECTIVE: To investigate the relationship between acute exposure to air pollutants and spontaneous pregnancy loss. DESIGN: Case-crossover study from 2007 to 2015. SETTING: An academic emergency department in the Wasatch Front area of Utah. PATIENT(S): A total of 1,398 women who experienced spontaneous pregnancy loss events. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Odds of spontaneous pregnancy loss. RESULT(S): We found that a 10-ppb increase in 7-day average levels of nitrogen dioxide was associated with a 16% increase in the odds of spontaneous pregnancy loss (odds ratio [OR] = 1.16; 95% confidence interval [CI] 1.01-1.33; P=.04). A 10-μg/m3 increase in 3-day and 7-day averages of fine particulate matter were associated with increased risk of spontaneous pregnancy loss, but the associations did not reach statistical significance (OR3-day average = 1.09; 95% CI 0.99-1.20; P=.05) (OR7-day average = 1.11; 95% CI 0.99-1.24; P=.06). We found no evidence of increased risk for any other metrics of nitrogen dioxide or fine particulate matter or any metric for ozone. CONCLUSIONS: We found that short-term exposure to elevated levels of air pollutants was associated with higher risk for spontaneous pregnancy loss.","year":2019}
{"review_pmid":"41938012","record_index":2,"pmid":"31385588","title":"Air pollution exposure and risk of spontaneous abortion in the Nurses' Health Study II.","abstract":"STUDY QUESTION: Is there an association between air pollution exposures and the risk of spontaneous abortion (SAB)? SUMMARY ANSWER: Higher exposure to particulate matter (PM) air pollution above and beyond a woman's average exposure may be associated with greater risk of SAB, particularly among women experiencing at least one SAB during follow-up. WHAT IS KNOWN ALREADY: There is sufficient biologic plausibility to suggest that air pollution adversely affects early pregnancy outcomes, particularly pregnancy loss; however, the evidence is limited. STUDY DESIGN, SIZE, DURATION: Our prospective cohort study included 19 309 women in the Nurses' Health Study II who contributed a total of 35 025 pregnancies between 1990 and 2008. We also conducted a case-crossover analysis among 3585 women (11 212 pregnancies) with at least one SAB and one live birth during follow-up. PARTICIPANTS/MATERIALS, SETTING, METHODS: Proximity to major roadways and exposure to PM <10 microns (PM10), 2.5-10 microns (PM2.5-10) and <2.5 microns (PM2.5) were determined for residential addresses between 1989 and 2007. Pregnancy outcomes were self-reported biannually throughout follow-up and comprehensively in 2009. Multivariable log-binomial regression models with generalized estimating equations were used to estimate the risk ratios and 95% CIs of SAB. Conditional logistic regression was used for the case-crossover analysis. MAIN RESULTS AND THE ROLE OF CHANCE: During the 19 years of follow-up, 6599 SABs (18.8% of pregnancies) were reported. In the main analysis, living closer to a major roadway and average exposure to PM10, PM10-2.5 or PM2.5 in the 1 or 2 years prior to pregnancy were not associated with an increased risk of SAB. However, small positive associations between PM exposures and SAB were observed when restricting the analysis to women experiencing at least one SAB during follow-up. In the case-crossover analysis, an increase in PM10 (per 3.9 μg/m3), PM2.5-10 (per 2.3 μg/m3) and PM2.5 (per 2.0 μg/m3) in the year prior to pregnancy was associated with 1.12 (95% CI 1.06, 1.19), 1.09 (95% CI 1.03, 1.14) and 1.10 (95% CI 1.04, 1.17) higher odds of SAB, respectively. LIMITATIONS, REASONS FOR CAUTION: We did not have information on the month or day of SAB, which precluded our ability to examine specific windows of susceptibility or acute exposures. We also used ambient air pollution exposures as a proxy for personal exposure, potentially leading to exposure misclassification. WIDER IMPLICATIONS OF THE FINDINGS: In our case-crossover analysis (but not in the entire cohort) we observed positive associations between exposure to all size fractions of PM exposure and risk of SAB. This may suggest that changes in PM exposure confer greater risk of SAB or that women with a history of SAB are a particularly vulnerable subgroup. STUDY FUNDING/COMPETING INTEREST(S): The authors are supported by the following NIH grants UM1CA176726, R00ES026648 and P30ES000002. The authors have no actual or potential competing financial interests to disclose.","year":2019}
{"review_pmid":"41938012","record_index":3,"pmid":"40447021","title":"Ambient air pollution in critical windows of exposure and spontaneous miscarriage in a preconception cohort.","abstract":"Air pollution may increase spontaneous miscarriage risk, potentially through inflammation. Prior studies are heterogeneous, and none have used a mixtures approach. We used data from participants who conceived in a prospective time-to-pregnancy study (N = 446) in North Carolina to examine spontaneous miscarriage, defined as a positive home pregnancy test and a self-reported pregnancy loss before gestational week 20 (N = 101). We characterized average and peak exposure to PM10, PM2.5, CO, NO, NO2, SO2, and O3 through linked residential addresses with fusion and chemical transport models. We used single pollutant and exposure mixtures models (quantile-based g-computation) to estimate associations in six exposure windows including spermatogenesis, early follicle development, and the follicular and luteal phases of the conception cycle. Sensitivity analyses stratified by vitamin D level (an anti-inflammatory). Multivariable Cox proportional hazards models estimated adjusted hazard ratios (HR) and 95 % confidence intervals (CI) per interquartile range increase in pollutant concentration. In exposure mixtures models, while the confidence intervals were wide, the magnitude and direction of several estimates were consistent with increased spontaneous miscarriage risk with increasing air pollutant exposure: spermatogenesis (HR [CI]: 1.2 [0.80, 1.8]), early follicle development (1.2 [0.80, 1.8]), and luteal phase (1.2 [0.80, 1.9]). Associations were stronger among those with low vitamin D, for example, increasing ozone was associated with increased spontaneous miscarriage only among those with low vitamin D (follicular phase HR [CI]: 3.1 [1.3, 7.4] vs. 0.84 [0.46, 1.5] for high vitamin D, pinteraction = 0.002). Air pollutants may be associated with small increases in miscarriage risk, but larger mixtures studies are needed. Further study of low vitamin D and air pollution risk is important for understanding the public health implications of vitamin D supplementation.","year":2025}
{"review_pmid":"41938012","record_index":4,"pmid":null,"title":"Air pollution-induced missed abortion risk for pregnancies","abstract":null,"year":2009}
{"review_pmid":"41938012","record_index":5,"pmid":"30836309","title":"Ambient PM2. 5 and clinically recognized early pregnancy loss a case-control study with spatiotemporal exposure predicti","abstract":"HandlingEditor: HannaBoogaard Background: Experimental research suggests that fine particulate matter (PM 2.5 ) exposure might affect emKeywords: bryonicdevelopment. However,onlyfewpopulation-based studieshaveinvestigatedtheimpactofmaternal Adversepregnancyoutcomes exposuretoPM 2.5 ontheearlypregnancyloss. Airpollution Objectives: Toestimateassociationsbetweenclinicallyrecognizedearlypregnancyloss(CREPL)andexposureto Landuseregressionmodels ambient PM at individual residences during peri-conception periods, with the aim to identify susceptible 2.5 Miscarriage exposuretimewindows. Particulatematter Methods: CREPLcasesandnormalearlypregnancycontrols(ofsimilarageandgraviditypresentingwithinone week,atotalof364pairs)wererecruitedbetweenJuly2017andJuly2018amongwomenresidinginTianjin, China. AverageambientPM concentrationsoftenexposurewindows(4weeks,2weeksand1weekbefore 2.5 conception;thefirst,second,thirdandfourthsingleweek,thefirstandsecond2-weekperiods,andtheentire4weekperiodafterconception)atthewomen'sresidentialaddresseswereestimatedusingtemporally-adjusted landuseregressionmodels. AssociationsbetweenPM exposuresatspecificperi-conceptiontimewindowsand 2.5 CREPLwereexaminedusingconditionallogisticregressionmodels,adjustedforcovariates. Results: Basedonadjustedmodels,CREPLwassignificantlyassociatedwitha10μg/m3increaseinPM ex2.5 posureduringthesecondweekafterconception(OR=1.15;95%CI:1.04,1.27;p=0.005),independentof effectsatothertimewindows. TherewasalsoanassociationofCREPLwithPM duringtheentire4-week 2.5 periodafterconception(OR=1.22;95%CI:1.02,1.46;p=0.027). Therewaslittleevidenceforassociations withexposureduringpre-conceptionexposurewindows. Conclusions: MaternalexposurestoambientPM duringacriticaltimewindowfollowingconceptionareas2.5 sociated with CREPL, with the second week after conception possibly being the exposure window of most vulnerability. Futurestudiesshouldfocusonreplicatingthesefindingsandonpathogenicmechanisms.","year":2019}
{"review_pmid":"41938012","record_index":6,"pmid":"38157969","title":"Ambient air pollution and rate of spontaneous abortion.","abstract":"Spontaneous abortion (SAB), defined as a pregnancy loss before 20 weeks of gestation, affects up to 30% of conceptions, yet few modifiable risk factors have been identified. We estimated the effect of ambient air pollution exposure on SAB incidence in Pregnancy Study Online (PRESTO), a preconception cohort study of North American couples who were trying to conceive. Participants completed questionnaires at baseline, every 8 weeks during preconception follow-up, and in early and late pregnancy. We analyzed data on 4643 United States (U.S.) participants and 851 Canadian participants who enrolled during 2013-2019 and conceived during 12 months of follow-up. We used country-specific national spatiotemporal models to estimate concentrations of particulate matter <2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) during the preconception and prenatal periods at each participant's residential address. On follow-up and pregnancy questionnaires, participants reported information on pregnancy status, including SAB incidence and timing. We fit Cox proportional hazards regression models with gestational weeks as the time scale to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of time-varying prenatal concentrations of PM2.5, NO2, and O3 with rate of SAB, adjusting for individual- and neighborhood-level factors. Nineteen percent of pregnancies ended in SAB. Greater PM2.5 concentrations were associated with a higher incidence of SAB in Canada, but not in the U.S. (HRs for a 5 μg/m3 increase = 1.29, 95% CI: 0.99, 1.68 and 0.94, 95% CI: 0.83, 1.08, respectively). NO2 and O3 concentrations were not appreciably associated with SAB incidence. Results did not vary substantially by gestational weeks or season at risk. In summary, we found little evidence for an effect of residential ambient PM2.5, NO2, and O3 concentrations on SAB incidence in the U.S., but a moderate positive association of PM2.5 with SAB incidence in Canada.","year":2024}
{"review_pmid":"41938012","record_index":7,"pmid":"29153729","title":"Ambient air pollution and the risk of pregnancy loss: a prospective cohort study.","abstract":"OBJECTIVE: To estimate the association of pregnancy loss with common air pollutant exposure. Ambient air pollution exposure has been linked to adverse pregnancy outcomes, but few studies have investigated its relationship with pregnancy loss. DESIGN: Prospective cohort study. SETTING: Not applicable. PATIENT(S): A total of 343 singleton pregnancies in a multisite prospective cohort study with detailed protocols for ovulation and pregnancy testing. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Timing of incident pregnancy loss (from ovulation). RESULT(S): The incidence of pregnancy loss was 28% (n = 98). Pollutant levels at women's residences were estimated using modified Community Multiscale Air Quality models and averaged during the past 2 weeks (acute) and the whole pregnancy (chronic). Adjusted Cox proportional hazards models showed that an interquartile range increase in average whole pregnancy ozone (hazard ratio [HR] 1.12, 95% confidence interval [CI] 1.07-1.17) and particulate matter <2.5 μm (HR 1.13, 95% CI 1.03-1.24) concentrations were associated with faster time to pregnancy loss. Sulfate compounds also appeared to increase risk (HR 1.58, 95% CI 1.07-2.34). Last 2 weeks of exposures were not associated with loss. CONCLUSION(S): In a prospective cohort of couples trying to conceive, we found evidence that exposure to air pollution throughout pregnancy was associated with loss, but delineating specific periods of heightened vulnerability await larger preconception cohort studies with daily measured air quality.","year":2018}
{"review_pmid":"41938012","record_index":8,"pmid":"33689898","title":"Ambient extreme heat exposure in summer and transitional months and emergency department visits and hospital admissions due to pregnancy complications.","abstract":"Although extreme heat exposure (EHE) was reported to be associated with increased risks of multiple diseases, little is known about the effects of EHE on pregnancy complications. We examined the EHE-pregnancy complications associations by lag days, subtypes, sociodemographic characteristics, and areas in New York State (NYS). We conducted a case-crossover analysis to assess the EHE-pregnancy complications associations in summer (June-August) and transitional months (May and September). All emergency department (ED) visits and hospital admissions due to pregnancy complications (ICD 9 codes: 630-649) from 2005 to 2013 in NYS were included. Daily mean temperature > 90th percentile of the monthly mean temperature in each county was defined as an EHE. We used conditional logistic regression while controlling for other weather factors, air pollutants and holidays to assess the EHE-pregnancy complications associations. EHE was significantly associated with increased ED visits for pregnancy complications in summer (ORs ranged: 1.01-1.04 from lag days 0-5). There was also a significant and stronger association in transitional months (ORs ranged: 1.02-1.06, Lag 0). Furthermore, we found EHE affected multiple subtypes of pregnancy complications, including threatened/spontaneous abortion, renal diseases, infectious diseases, diabetes, and hypertension (ORs range: 1.13-1.90) during transitional months. A significant concentration response effect between the number of consecutive days of EHE and ED visits in summer (P for trend <0.001), ED visits in September (P for trend =0.03), and hospital admission in May (P for trend<0.001) due to pregnancy complications was observed, respectively. African Americans and residents in lower socioeconomic position (SEP) counties were more susceptible to the effects of EHE. In conclusion, we found an immediate and prolonged effect of EHE on pregnancy complications in summer and a stronger, immediate effect in transitional months. These effects were stronger in African Americans and counties with lower SEP. Earlier warnings regarding extreme heat are recommended to decrease pregnancy complications.","year":2021}
{"review_pmid":"41938012","record_index":9,"pmid":"34088277","title":"Association between Physiological Equivalent Temperature (PET) with adverse pregnancy outcomes in Ahvaz, southwest of Iran.","abstract":"BACKGROUND: There are few epidemiological studies on the relation between temperature changes and adverse pregnancy outcomes. The purpose of this study was to determine the relation between Physiological Equivalent Temperature (PET) with adverse pregnancy outcomes including stillbirth, low birth weight (LBW), preterm labor (PTL), spontaneous abortion (SA), preeclampsia and hypertension in Ahvaz, Iran. METHODS: Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression were used to investigate the effect of PET on adverse pregnancy outcomes. In this study the effect of time trend, air pollutants (NO2, SO2 and PM10), and weekdays were adjusted. RESULTS: High PET (45.4 C°, lag = 0) caused a significant increase in risk of stillbirth. Also, high levels of PET (45.4, 43.6, 42.5 C°, lag = 0-6) and low levels of PET (9.9, 16.9 C°, lags = 0, 0-13, 0-21) significantly increased the risk of LBW. But, low levels of PET (6.4, 9.9, 16.9 C°, lags = 0-6, 0-13) reduced the risk of gestational hypertension. CONCLUSION: The results of this study showed that hot and cold thermal stress may be associated with increased risk of stillbirth, and LBW in Ahvaz.","year":2021}
{"review_pmid":"41938012","record_index":10,"pmid":"31128767","title":"Association between pregnancy loss and ambient PM2·5 using survey data in Africa: a longitudinal case-control study, 1998-2016.","abstract":"BACKGROUND: Increasing evidence from epidemiological studies suggests that maternal exposure to ambient PM2·5 can increase the risk of pregnancy loss. However, no studies have been done in low-income countries such as those in Africa, which have the highest incidences of pregnancy loss. In this study, we aimed to analyse the association between PM2·5 and pregnancy loss, including miscarriage and stillbirth. METHODS: This self-compared case control study collected data on mothers who reported at least two births (at least one case of pregnancy loss plus at least one normal delivery) in the African Demographic and Health Surveys. Gestational exposure to PM2·5 was assessed using a state-of-the-art estimator based on satellite measurements and chemical transport model outputs. Each case of pregnancy loss was compared with the successful control deliveries in the same mother. We estimated the association between gestational exposure to PM2·5 and pregnancy loss using a conditional logistical model with multiple adjustments, and assessed it using the odds ratio (OR) derived from the regression. FINDINGS: Between Jan 1, 1998, and Dec 31, 2016, 67 566 cases of pregnancy loss were reported across Africa in the DHS. After removal of mothers who did not report at least one successful delivery and those with missing spatial information, 42 952 were included in the study. Of these, 30 418 were categorised as miscarriages and 12 534 were stillbirths. Each increment of 10 μg/m3 PM2·5 was associated with an adjusted OR of 1·122 (95% CI 1·107-1·137) for pregnancy loss, including miscarriage (1·125; 1·109-1·142) and stillbirth (1·094; 1·051-1·138). INTERPRETATION: Our findings from African DHS data showing that PM2·5 exposure is significantly associated with increased risk of pregnancy loss add to the existing epidemiological evidence from middle-income and high-income countries on the health impacts of poor air quality. Our results support public health interventions for reducing ambient particulate matter to improve maternal health in Africa. FUNDING: China National Natural Science Foundation and China Ministry of Science and Technology.","year":2019}
{"review_pmid":"41938012","record_index":11,"pmid":"11150877","title":"Association between weather conditions and the incidence of emergency gynecological consultations.","abstract":"OBJECTIVE: This study examined the influence of weather conditions on the incidence of outpatient emergency consultations at the Department of Obstetrics and Gynecology at the Regional Hospital in Lugano, Switzerland. STUDY DESIGN: The medical records of all women who attended the outpatient emergency unit at the Department for Obstetrics and Gynecology over the 1-year study period were reviewed. The final diagnosis was pelvic pain of unidentified origin in 180 cases, menorrhagia and/or metrorrhagia in 95 cases, threatened abortion in 56 cases and spontaneous abortion in 54 cases. The meteorological factors considered were atmospheric pressure, temperature, humidity and global radiation. A logistic regression model was used to correlate the occurrence of symptoms with the chosen weather factors. RESULTS: High mean daily temperature was found to be a significant predictor of pelvic pain (p < 0.001). A rise in barometric pressure compared to the previous day increased the probability of menorrhagia and/or metrorrhagia (p = 0.001). Higher minimal temperature (p = 0.011) and an increase in atmospheric pressure (p = 0.006) were identified as positive predictors of threatened abortion. None of the meteorological factors considered seemed to influence the frequency of spontaneous abortions. CONCLUSION: Meteorological factors such as temperature and barometric change appear to affect the probability of emergency admissions for gynecological symptoms including uterine bleeding, threatened abortion and pelvic pain.","year":2001}
{"review_pmid":"41938012","record_index":12,"pmid":"34411818","title":"Association of maternal exposure to ambient particulate pollution with incident spontaneous pregnancy loss.","abstract":"BACKGROUND: Maternal exposure to ambient fine particulate matter (PM2.5) is a potential risk factor for pregnancy loss, but the extant findings are inconsistent. One reason for the inconsistency is the difficulty of distinguishing spontaneous from induced pregnancy losses, particularly in countries with planning policies. OBJECTIVE: To examine the association between maternal PM2.5 exposure and spontaneous incident pregnancy loss in China. METHODS: A total of 18,513 women of reproductive age was recruited from Jiangsu Province, China, in 2007. Among them, 2451 women reported 2613 valid records of incident pregnancies from 2007 to 2010. We used Cox regression to link the outcomes (live birth, spontaneous pregnancy loss, or induced abortion) of those incident pregnancies with maternal PM2.5 exposures, assessed using well-developed estimates of historical concentrations at the county level. RESULTS: Among the 2613 incident pregnancies, 69 spontaneous pregnancy losses, 596 induced abortions, and 1948 live births occurred. According to the adjusted model, each 10-μg/m3 increment in the average PM2.5 concentration during pregnancy was associated with a 43.3% (95% confidence interval, 6.6-92.5%) increased probability of spontaneous pregnancy loss. Advanced maternal age, a potential competing risk factor, weakened the association between PM2.5 and spontaneous pregnancy loss. The association was nonsignificant for unintended pregnancies. CONCLUSION: Maternal PM2.5 exposure was associated significantly with incident spontaneous pregnancy loss. Our findings provide insight into the harmful effect of air pollution on human reproduction.","year":2021}
{"review_pmid":"41938012","record_index":13,"pmid":"31715397","title":"Associations of ambient temperature exposure during pregnancy with the risk of miscarriage and the modification effects of greenness in Guangdong, China.","abstract":"Miscarriage is one of the commonest complications of pregnancy. Although previous studies suggested that environmental factors were important causes of miscarriage, evidence is still inadequate. Here, we examined the association of maternal exposure to temperature with the risk of miscarriage and further assessed the modifying effects of surrounding residential greenness. A case-control study was conducted at a large hospital in Guangzhou, China. All participants' information was extracted from hospital records. An inverse distance weighted method was used to estimate the temperature exposure at each residential address, where the greenness was measured by Normalized Difference Vegetation Index (NDVI). A logistic regression model was applied to estimate the association of temperature exposure with the risk of miscarriage. A total of 2044 cases of miscarriage and 2285 controls were included in the present study. We observed a generally non-linear positive relationship between temperature exposure and the risk of miscarriage. More pronounced effects of high temperatures vs. low temperatures were found during the two months prior to hospitalization than in other periods. The odds ratio (OR) of 29.4 °C (95th centile) compared with 15 °C during the first month prior to hospitalization was 1.480 (95% CI: 1.021-2.145). Smaller effects of temperatures were seen on the risk of miscarriage among participants with moderately great surrounding greenness compared with those with less greenness. We concluded that maternal exposure to moderately high temperature during pregnancy may increase the risk of miscarriage, but the modifying effects of greenness on these associations need to be further tested in future studies.","year":2020}
{"review_pmid":"41938012","record_index":14,"pmid":null,"title":"Climate change and the mortality of the unborn","abstract":null,"year":2023}
{"review_pmid":"41938012","record_index":15,"pmid":"37666168","title":"Effect of short-term ambient air pollution exposure on early miscarriage and pregnancy hormones with critical window identification.","abstract":"BACKGROUND: Pregnancy hormones are particularly important in early miscarriage, and some evidence suggests that exposure to air pollution is associated with pregnancy hormones and miscarriage. However, the effects of air pollution on pregnancy hormone-mediated miscarriages have not yet been investigated. METHODS: We collected air pollution exposure measurements and pregnancy hormone tests from the participants. Logistic regression models were used to investigate the association between air pollution and early miscarriages. A distributed lag nonlinear model (DLNM) was used to investigate non-linear and delayed associations and identify the crucial window. We performed mediation analysis to estimate the potential association that may exist between pregnancy hormone levels and early miscarriage. RESULTS: Short-term exposure to CO and SO2 was associated with early miscarriage. Lag 22-28 days of exposure to both CO and SO2 and lag 15-21 days of exposure to CO were significantly positively associated with early miscarriage, with an obvious exposure dose response. Serum progesterone concentration explained 36.79 % of the association between lag 15-28 days of CO exposure and early miscarriage. CONCLUSION: This study provides evidence for the association between short-term exposure to air pollution and early miscarriage, and provides clues for further exploration of biological mechanisms.","year":2023}
{"review_pmid":"41938012","record_index":16,"pmid":"33421406","title":"Estimation of pregnancy losses attributable to exposure to ambient fine particles in south Asia: an epidemiological case-control study.","abstract":"BACKGROUND: Maternal exposure to ambient particulate matter (PM2·5) is associated with pregnancy loss (ie, stillbirth and miscarriage). South Asia has the highest burden of pregnancy loss globally and is one of the most PM2·5 polluted regions in the world. However, knowledge of the relevant exposure-response function for mothers is insufficient. METHODS: In this epidemiological case-control study, we collected data from Demographic and Health Surveys from India, Pakistan, and Bangladesh for the period 1998-2016 for women who reported at least one pregnancy loss and one or more livebirths. We assessed ambient exposure during gestation with satellite-based PM2·5 measurements for the period. To derive the exposure-response function, we did a self-compared case-control study in which each case of pregnancy loss was compared with a successful livebirth control or controls by the same mother. Using the estimated exposure-response function, we quantified pregnancy losses attributable to PM2·5 in the region for the period 2000-16 using a standard risk assessment approach. FINDINGS: We assessed data for 34 197 mothers, who had at least one pregnancy loss and one or more livebirth, of whom 26 282 (76·9%) were from India, 4228 (12·4%) were from Pakistan, and 3687 (10·8%) were from Bangladesh. The 34 197 cases of pregnancy loss were matched with 76 282 livebirth controls. The mean level of PM2·5 exposure was 56·00 μg/m3 (SD 30·82) for cases and 54·57 μg/m3 (31·73) for controls. After adjustment for maternal age, non-linear terms for temperature and humidity, seasonal variation, and long-term trends, each 10 μg/m3 increment in PM2·5 was associated with an odds ratio for pregnancy loss of 1·03 (95% CI 1·02-1·05). According to the estimated non-linear exposure-response function by age and urban residence versus rural residence, for the period 2000-16, an estimated 349 681 (95% CI 152 932-489 493) pregnancy losses per year were attributed to ambient air exposure of more than 40 μg/m3 (the annual PM2·5 standard of India), accounting for 7·1% (95% CI 3·3-31·2) of the total annual pregnancy loss burden in south Asia for this period. However, our estimates could be biased because of the limitations of the data (eg, misclassification of induced and spontaneous pregnancy losses). INTERPRETATION: Our findings add to epidemiological evidence of the association between pregnancy loss and PM2·5. Suboptimal air quality contributes to a considerable fraction of total pregnancy loss in south Asia. Controlling PM2·5 pollution will promote maternal health in south Asia. FUNDING: Chinese Natural Science Foundation and Ministry of Science and Technology of China.","year":2021}
{"review_pmid":"41938012","record_index":17,"pmid":"24738119","title":"Exposure to ambient air pollutants and spontaneous abortion","abstract":"Aim: This study aimed to evaluate the correlation between ambient concentrations of air pollutants and first-trimesterspontaneousabortion. MaterialandMethods: Thiswasaretrospectivecase-controlstudy,whichwasconductedon296womenfrom June2010toFebruary2011inTehran,Iran. Caseswere148womenwhoexperiencedaspontaneousabortion before 14 weeks of gestation while the controls were 148 pregnant women after 14 weeks of gestation and groups were matched on sociodemographics and obstetrics characteristics. The samples were recruited randomlyfrom10hospitals. Intotal,pollutantsconcentrationswerecollectedat29stationshourlythroughoutthe study area. We estimated the mean exposure for each participant and investigated the association between spontaneousabortionandambientpollutants. Results: Findingsdemonstratedthattheaverageofambientairpollutantsinthecaseswassignificantlyhigher thaninthecontrols(P<0.05). TheoddratiosofabortionintheareaswithhigherconcentrationsofCO,NO, 2 O andPM were1.98,0.96,0.94and1.01,respectively(P<0.05). Also,themodelshowedthattherewasno 3 10 significantassociationbetweenprenatalexposurestoSO andabortion(P>0.05). 2 Conclusions: Our findings suggest that pregnant women exposed to ambient air pollutants may be at increasedriskofspontaneousabortion. Confirmationbyfurtherresearchisneeded.","year":2014}
{"review_pmid":"41938012","record_index":18,"pmid":"39058555","title":"Exposure to Ambient Heat and Risk of Spontaneous Abortion: A Case-Crossover Study.","abstract":"BACKGROUND: Few epidemiologic studies have examined the association of ambient heat with spontaneous abortion, a common and devastating pregnancy outcome. METHODS: We conducted a case-crossover study nested within Pregnancy Study Online, a preconception cohort study (2013-2022). We included all participants reporting spontaneous abortion (N = 1,524). We defined the case window as the 7 days preceding the event and used time-stratified referent selection to select control windows matched on calendar month and day of week. Within each 7-day case and control window, we measured the mean, maximum, and minimum of daily maximum outdoor air temperatures. We fit splines to examine nonlinear relationships across the entire year and conditional logistic regression to estimate odds ratios (ORs) and 95% confidence interval (CI) of spontaneous abortion with increases in temperature during the warm season (May-September) and decreases during the cool season (November-March). RESULTS: We found evidence of a U-shaped association between outdoor air temperature and spontaneous abortion risk based on year-round data. When restricting to warm season events (n = 657), the OR for a 10-percentile increase in the mean of lag 0-6 daily maximum temperatures was 1.1 (95% CI: 0.96, 1.2) and, for the maximum, 1.1 (95% CI: 0.99, 1.2). The OR associated with any extreme heat days (>95th county-specific percentile) in the preceding week was 1.2 (95% CI: 0.95, 1.5). Among cool season events (n = 615), there was no appreciable association between lower temperatures and spontaneous abortion risk. CONCLUSION: Our study provides evidence of an association between high outdoor temperatures and the incidence of spontaneous abortion.","year":2024}
{"review_pmid":"41938012","record_index":19,"pmid":"38167351","title":"Flood exposure and pregnancy loss in 33 developing countries.","abstract":"Floods have affected billions worldwide. Yet, the indirect health impacts of floods on vulnerable groups, particularly women in the developing world, remain underexplored. Here, we evaluated the risk of pregnancy loss for women exposed to floods. We analyzed 90,465 individual pregnancy loss records from 33 developing countries, cross-referencing each with spatial-temporal flood databases. We found that gestational flood exposure is associated with increased pregnancy loss with an odds ratio of 1.08 (95% confidence interval: 1.04 - 1.11). This risk is pronounced for women outside the peak reproductive age range (<21 or >35) or during the mid and late-stage of pregnancy. The risk escalated for women dependent on surface water, with lower income or education levels. We estimated that, over the 2010s, gestational flood events might be responsible for approximately 107,888 (CIs: 53,944 - 148,345) excess pregnancy losses annually across 33 developing countries. Notably, there is a consistent upward trend in annual excess pregnancy losses from 2010 to 2020, and was more prominent over Central America, the Caribbean, South America, and South Asia. Our findings underscore the disparities in maternal and child health aggravated by flood events in an evolving climate.","year":2024}
{"review_pmid":"41938012","record_index":20,"pmid":"37814395","title":"Heat stress and adverse pregnancy outcome: Prospective cohort study.","abstract":"OBJECTIVE: To explore the relationship between occupational heat exposure, physiological heat strain indicators and adverse outcomes in pregnant women. DESIGN: Prospective cohort. SETTING: Workplaces in Tamil Nadu, India. SAMPLE: A cohort of 800 pregnant women engaged in moderate to heavy physical work in 2017-2019 and 2021-2022. METHODS: Participants were recruited at between 8 and 14 weeks of gestation. Occupational heat exposure and heat strain indicators were captured each trimester. 'Heat exposed' was defined as heat stress exceeding the threshold limit value (TLV) for safe manual work (with maximum wet-bulb globe temperatures of 27.5°C for a heavy workload and 28.0°C for a moderate workload). Physiological heat strain indicators (HSIs) such as core body temperature (CBT) and urine specific gravity (USG) were measured before and after each shift. Heat-related health symptoms were captured using the modified HOTHAPS questionnaire. MAIN OUTCOME MEASURES: The main outcome measures included (1) a composite measure of any adverse pregnancy outcome (APO) during pregnancy (including miscarriage, preterm birth, low birthweight, stillbirth, intrauterine growth restriction and birth defects), (2) a composite measure of adverse outcomes at birth (3) and miscarriage. RESULTS: Of the 800 participants, 47.3% had high occupational heat exposure. A rise in CBT was recorded in 17.4% of exposed workers, and 29.6% of workers experienced moderate dehydration (USG ≥ 1.020). Heat-exposed women had a doubled risk of miscarriage (adjusted odds ratio, aOR 2.4; 95% confidence interval, 95% CI 1.0-5.7). High occupational heat exposure was associated with an increased risk of any adverse pregnancy and foetal outcome (aOR 2.3; 95% CI 1.4-3.8) and adverse outcome at birth (aOR 2.0; 95% CI 1.2-3.3). CONCLUSIONS: High occupational heat exposure is associated with HSIs and adverse pregnancy outcomes in India.","year":2024}
{"review_pmid":"41938012","record_index":21,"pmid":"36418820","title":"High-temperature exposure and risk of spontaneous abortion during early pregnancy: a case-control study in Nanjing, China.","abstract":"As one of the most common complications of early pregnancy, spontaneous abortion is associated with environmental factors, but reports estimating the effect of ambient temperature on spontaneous abortion are still inconclusive. Herein, a case-control study (1002 cases and 2004 controls) in Nanjing, China, from 2017 to 2021 was conducted to evaluate the association between temperature exposure and the risk of spontaneous abortion by using distributed lag nonlinear model (DLNM). As a result, daily mean temperature exposure and early spontaneous abortion showed a nonlinear relationship in 14-day lag periods. Moreover, taking the median temperature (17 °C) as a reference, gradually increased positive effects of high temperature on spontaneous abortion could be found during the 4 days prior to hospitalization, and the highest odds ratio (OR) of 2.07 (95% confidence interval (CI): 1.36, 3.16) at extremely hot temperature (33 °C) was observed at 1 lag day. The results suggested that high-temperature exposure in short times during early pregnancy might increase the risk of SAB. Thus, our findings highlight the potential risk of short-term high-temperature exposure during early pregnancy, and more evidence was given for the effects of climate change on maternal health.","year":2023}
{"review_pmid":"41938012","record_index":22,"pmid":"28748383","title":"Is ambient heat exposure levels associated with miscarriage or stillbirths in hot regions? A cross-sectional study using survey data from the Ghana Maternal Health Survey 2007.","abstract":"It is well established that high ambient heat could cause congenital abnormalities resulting in miscarriage or stillbirth among certain species of mammals. However, this has not been systematically studied in real field settings among humans, despite the potential value of such knowledge for estimating the impact of global warming on the human species. This study sought to test the hypothesis that maternal heat exposure during pregnancy in hot regions is associated with increased prevalence of spontaneous abortions or stillbirths and to develop an analytical strategy to use existing data from maternal health surveys and existing data on historical heat levels at a geographic grid cell level. A subsample of the Ghana Maternal Health Survey 2007 was used in this study. This study sample consisted of 1136 women with pregnancy experiences between 2004 and 2007, out of which 141 women had a pregnancy that terminated in miscarriage or stillbirth. Induced-abortion cases were excluded. The linkage between ambient heat exposure and pregnancy outcome followed the epidemiological time-place-person principle, by linking timing of pregnancy outcome with historical data of local area heat levels for each month, as estimated in an international database. Maternal heat exposure level was estimated using calculated levels of the wet-bulb globe temperature (WBGT), which takes into account temperature, humidity, heat radiation, and air movement over the skin (wind speed). The values we used applied to exposure in the shade or in buildings without cooling (no solar heat radiation) and a standard air movement of 1 m/s. We applied two exposure durations: yearly average and monthly average for second month of pregnancy. In one analysis, we restricted the sample to four regions with time-homogeneous ambient heat. Analysis was made using logistic regression. About 12% of the latest pregnancies ended in either miscarriage (9.6%) or stillbirth (2.8%). The odds ratios indicated 12 to 15% increase (ORcrude 1.15, 95% CI 0.92-1.42, and ORage adjusted 1.12, 95% CI 0.90-1.39) in the odds of having a stillbirth or miscarriage with each additional degree increase in WBGT, although this was just outside two-sided statistical significance. The WBGT range was quite narrow (most annual values in the range 24-26 °C, and most monthly values in the range 23-27 °C), which may have hidden any real impacts of high heat levels. The seemingly positive association observed disappeared after adjusting for gravidity. The analyses of the four selected regions indicated 27 to 42% increase in the odds of experiencing miscarriage or stillbirth with every degree increase in WBGT (crude OR 1.42 95% CI 1.00-2.03). This association remained after adjusting for maternal age pregnancy history, although no longer statistically significant (adjusted OR 1.27, 95% CI 0.89-1.81). Environmental heat exposures may be associated with adverse pregnancy outcomes, but this study was inconclusive, possibly because the heat exposure range was small. Historical records of routine observations in existing databases can be used for epidemiological studies on the health effects of heat, although data from properly and purposively designed studies might be more suitable for further studies.","year":2018}
{"review_pmid":"41938012","record_index":23,"pmid":"24738119","title":"Exposure to ambient air pollutants and spontaneous abortion","abstract":"Aim: This study aimed to evaluate the correlation between ambient concentrations of air pollutants and first-trimesterspontaneousabortion. MaterialandMethods: Thiswasaretrospectivecase-controlstudy,whichwasconductedon296womenfrom June2010toFebruary2011inTehran,Iran. Caseswere148womenwhoexperiencedaspontaneousabortion before 14 weeks of gestation while the controls were 148 pregnant women after 14 weeks of gestation and groups were matched on sociodemographics and obstetrics characteristics. The samples were recruited randomlyfrom10hospitals. Intotal,pollutantsconcentrationswerecollectedat29stationshourlythroughoutthe study area. We estimated the mean exposure for each participant and investigated the association between spontaneousabortionandambientpollutants. Results: Findingsdemonstratedthattheaverageofambientairpollutantsinthecaseswassignificantlyhigher thaninthecontrols(P<0.05). TheoddratiosofabortionintheareaswithhigherconcentrationsofCO,NO, 2 O andPM were1.98,0.96,0.94and1.01,respectively(P<0.05). Also,themodelshowedthattherewasno 3 10 significantassociationbetweenprenatalexposurestoSO andabortion(P>0.05). 2 Conclusions: Our findings suggest that pregnant women exposed to ambient air pollutants may be at increasedriskofspontaneousabortion. Confirmationbyfurtherresearchisneeded.","year":2013}
{"review_pmid":"41938012","record_index":24,"pmid":"39066467","title":"association with miscarriage in rural","abstract":"Background: We sought to improve the current understanding of how climate change impacts women’s reproductive health in sub-Saharan Africa. Objectives: We investigated the relationship between maternal heat exposure and miscarriage (pregnancy ending before 20 weeks gestation) in a South African setting. Design: Population-based cohort study. Methods: Our study involved data for pregnancies collected via a health and demographic surveillance system in rural KwaZulu-Natal, South Africa between 2012 and 2016. Data from the South African Weather Service were used to compute maternal exposure to heat during the following time windows for each pregnancy: during the month preceding conception (T1) and during the week preceding the study outcome (either a miscarriage or no miscarriage, T2). Heat exposure was operationalized as a continuous variable and defined as the number of days that a mother was exposed to a mean daily temperature of > 26.6°C (A “hot day,” equivalent to a mean daily temperature of > 80°F) during T1 or T2. Binary logistic regression was used to investigate the relationship between maternal heat exposure and miscarriage. Results: A total of 105/3477 pregnancies included in our analysis ended in miscarriage (3.0%). Each additional hot day during T1 was associated with a 26% higher odds of miscarriage (odds ratio: 1.26; 95% confidence interval: 1.15-1.38). No significant associations were observed between maternal heat exposure during T2 and the odds of miscarriage (odds ratio: 0.94, 95% confidence interval: 0.73-1.20). The relationship between maternal heat exposure during T1 and the odds of miscarriage was J-shaped. Conclusion: There is a clear relationship between maternal heat exposure during the month preceding conception and miscarriage in our sub-Saharan African setting. Given the lack of feasible strategies to reduce pregnancy loss associated with prevailing high temperatures in sub-Saharan Africa, progressive climate change will likely exacerbate existing challenges for women’s reproductive health in this region. 1Africa Health Research Institute, KwaZulu-Natal, South Africa 7 Centre for Epidemic Response and Innovation, School for Data 2 Faculty of Health and Environmental Sciences, Central University of Science and Computational Thinking, Stellenbosch University, Technology, Bloemfontein, South Africa Stellenbosch, South Africa 3 Division of Health Systems and Public Health, Faculty of Medicine and 8 South African Centre for Epidemiological Modelling and Analysis Health Sciences, Stellenbosch University, Cape Town, South Africa (SACEMA), Stellenbosch University, South Africa 4 School of Nursing and Public Health, University of KwaZulu-Natal, 9 Centre for Rural Health, University of KwaZulu-Natal, Durban, Durban, South Africa South Africa 5 Centre for the AIDS Programme of Research in South Africa, 10 KwaZulu-Natal Research Innovation and Sequencing Platform, KwaZulu-Natal, South Africa University of KwaZulu-Natal, Congella, South Africa 6 Health Economics and HIV and AIDS Research Division (HEARD), Corresponding author: University of KwaZulu-Natal, Durban, South Africa Yoshan Moodley, Faculty of Medicine and Health Sciences, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa. Email: yoshanm@sun.ac.za Creative Commons CC BY: This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). 2 Women’s Health","year":2024}
{"review_pmid":"41938012","record_index":25,"pmid":"33108913","title":"Nitrogen dioxide exposure during pregnancy and risk of spontaneous abortion: a case-control study in China.","abstract":"BACKGROUND: Evidence on the relationship between prenatal exposure to NO2 and CO and spontaneous abortion (SAB) is insufficient. We investigated whether there is an association between maternal exposure to nitrogen dioxide (NO2) and carbon monoxide (CO) before and during pregnancy and SAB. METHODS: We conducted a case-control study using medical records of 2445 pregnant women who admitted for abortion prior to 20 weeks of gestational age from January 2014 to December 2019 at a tertiary-care hospital in Shanghai, China. Of the 2445 participants, 1075 were SAB cases and 1370 were healthy controls (underwent elective abortions). Maternal exposure to NO2 and CO before and during pregnancy was estimated using daily air pollution concentration data. Multivariable logistic regression models were constructed to quantify the relationships between maternal exposure to NO2 or CO and the risk of SAB while controlling for potential confounders. RESULTS: NO2 exposure levels during pregnancy were significantly higher in SAB cases than in healthy controls (42.26 vs. 40.67, p <.01). NO2 exposure during pregnancy was positively associated with the risk of SAB. An interquartile range (16 μg/m3) increase in NO2 exposure was associated with 68% increase in the odds of SAB (OR = 1.68, 95% CI, 1.28, 2.21). Analyses of associations by quartile of NO2 exposure showed that elevated NO2 exposure during pregnancy was associated with increased odds of SAB in linear dose-response manners. Compared with the lowest quartile of NO2 exposure, the odds of SAB in the fourth quartile of NO2 exposure increased 61% (OR = 1.61, 95% CI, 1.03-2.53). No associations of CO exposure with SAB risk were observed. CONCLUSIONS: Our study suggested that exposure to NO2 during early pregnancy was associated with increased risk of SAB. Further studies are needed to confirm our results and explore the potential biological mechanism underlying these associations.","year":2022}
{"review_pmid":"41938012","record_index":26,"pmid":"25609560","title":"Relationships between mild PM10 and ozone urban air levels and spontaneous abortion: clues for prima","abstract":null,"year":2015}
{"review_pmid":"41938012","record_index":27,"pmid":"24758249","title":"Seasonal ambient air pollution correlates strongly with spontaneous abortion in Mongolia.","abstract":"BACKGROUND: Air pollution is a major health challenge worldwide and has previously been strongly associated with adverse reproductive health. This study aimed to examine the association between spontaneous abortion and seasonal variation of air pollutants in Ulaanbaatar, Mongolia. METHODS: Monthly average O3, SO2, NO2, CO, PM10 and PM2.5 levels were measured at Mongolian Government Air Quality Monitoring stations. The medical records of 1219 women admitted to the hospital due to spontaneous abortion between 2009-2011 were examined retrospectively. Fetal deaths per calendar month from January-December, 2011 were counted and correlated with mean monthly levels of various air pollutants by means of regression analysis. RESULTS: Regression of ambient pollutants against fetal death as a dose-response toxicity curve revealed very strong dose-response correlations for SO2 r > 0.9 (p < 0.001) while similarly strongly significant correlation coefficients were found for NO2 (r > 0.8), CO (r > 0.9), PM10 (r > 0.9) and PM2.5 (r > 0.8), (p < 0.001), indicating a strong correlation between air pollution and decreased fetal wellbeing. CONCLUSION: The present study identified alarmingly strong statistical correlations between ambient air pollutants and spontaneous abortion. Further studies need to be done to examine possible correlations between personal exposure to air pollutants and pregnancy loss.","year":2014}
{"review_pmid":"41938012","record_index":28,"pmid":"34411816","title":"Short-term ambient nitrogen dioxide exposure is associated with increased risk of spontaneous abortion: A hospital-based study.","abstract":"There are increasing concerns with regard to spontaneous abortion (SAB), the loss of pregnancy without external intervention before 20 weeks of gestation, among reproductive-aged women. To date, limited evidence is available concerning the association between SAB and air pollutants, especially in developing countries. Daily baseline outpatient data for SAB from January 1, 2014, to December 31, 2018 (1826 days) were obtained in Chongqing, a metropolis of southwest China. The over-dispersed Poisson generalized additive model with control of meteorological conditions and day of week was used to estimate the short-term effects of ambient air pollution on the daily number of SAB outpatients. A total of 42,334 SAB outpatient visits for SAB were recorded. No statistically significant association was observed between SAB and CO, PM2.5, PM10, O3, and SO2. The positive association only appeared for NO2: positive associations between SAB and NO2 were observed in both single-day models (lag 0, lag 1, lag 3, and lag 4) and cumulative exposure models (lag 01, lag 03, and lag 05) and the most significant effects were observed at lag 05 (3.289%; 95% CI: 1.568%, 5.011%). Moreover, the women with higher ages (30-39 and > 39) were more sensitive than those with lower ages (18-29), and the effect estimates were more evident in cool seasons. Collectively, our results suggested that short-term NO2 exposure was associated with higher risk of SAB, especially in elder women and cool seasons, which may contribute to further understand the role of air pollution on SAB and other adverse obstetric outcomes.","year":2021}
{"review_pmid":"41938012","record_index":29,"pmid":"35522417","title":"The acute effect and lag effect analysis between exposures to ambient air pollutants and spontaneous abortion: a case-crossover study in China, 2017-2019.","abstract":"INTRODUCTION: Recent studies demonstrated that living in areas with high ambient air pollution may have adverse effects on pregnancy outcomes, but few studies have investigated its association with spontaneous abortion. Further investigation is needed to explore the acute effect and lag effect of air pollutants exposure on spontaneous abortion. OBJECTIVE: To investigate the acute effect and lag effect between exposure to ambient air pollutants and spontaneous abortion. METHODS: Research data of spontaneous abortion were collected from the Chongqing Health Center for Women and Children (CQHCWC) in China. The daily ambient air pollution exposure measurements were estimated for each woman using inverse distance weighting from monitoring stations. A time-stratified, case-crossover design combined with distributed lag linear models was applied to assess the associations between spontaneous pregnancy loss and exposure to each of the air pollutants over lags 0-7 days, adjusted for temperature and relative humidity. RESULTS: A total of 1399 women who experienced spontaneous pregnancy loss events from November 1, 2016, to September 30, 2019, were selected for this study. Maternal exposure to particulate matter 2.5 (PM2.5), particle matter 10 (PM10) nitrogen dioxide (NO2), and sulfur dioxide (SO2) exhibited a significant association with spontaneous abortion. For every 20 μg/m3 increase in PM2.5, PM10, NO2, and SO2, the RRs were 1.18 (95% CI: 1.06, 1.34), 1.12 (95% CI, 1.04-1.20), 1.15 (95% CI: 1.02, 1.30), and 1.92 (95% CI: 1.18, 3.11) on lag day 3, lag day 3, lag day 0, and lag day 3, respectively. In two-pollutant model combined with PM2.5 and PM10, a statistically significant increase in spontaneous abortion incidence of 18.0% (RR = 1.18, 95% CI: 1.06, 1.32) was found for a 20 μg/m3 increase in PM2.5 exposure, and 11.2% (RR = 1.11, 95% CI: 1.03, 1.20) for a 20 μg/m3 increase in PM10 exposure on lag day 3, similar to single-pollutant model analysis. CONCLUSION: Maternal exposure to high levels of PM2.5, PM10, NO2, and SO2 during pregnancy may increase the risk of spontaneous abortion for acute effects and lag effects. Further research to explore sensitive exposure time windows is needed.","year":2022}
{"review_pmid":"41938012","record_index":30,"pmid":"33829325","title":"The effects of desert dust storms, air pollution, and temperature on morbidity due to spontaneous abortions and toxemia of pregnancy: 5-year analysis.","abstract":"Epidemiological studies have suggested an association between particulate air pollution, increased temperatures, and morbidity related to pregnancy outcomes. However, the roles of desert dust storms and climatological factors have not been fully addressed. The objectives of the present study were to investigate the association between desert dust storms, particulate matter with a diameter ≤10 μm (PM10), daily temperatures, and toxemia of pregnancy and spontaneous abortion in Gaziantep, South East Turkey. The study was conducted retrospectively at emergency department of two hospitals in Gaziantep city. Data from January 1, 2009, to March 31, 2014, were collected. Patients, who were diagnosed with toxemia of pregnancy and spontaneous abortion by radiological imaging modalities, were included in the study. Daily temperature ranges, mean temperature values, humidity, pressure, wind speed, daily PM10 levels, and records of dust storms were collected. A generalized additive regression model was designed to assess variable effects on toxemia of pregnancy and spontaneous abortion, while adjusting for possible confounding factors. Our findings demonstrated that presence of dust storms was positively associated with the toxemia of pregnancy both in outpatient admissions (OR=1.543 95% CI=1.186-2.009) and inpatient hospitalizations (OR=1.534; 95% CI=1.162-2.027). However, neither PM10 nor maximum temperature showed a marked association with spontaneous abortion or toxemia of pregnancy in our study population. Our findings suggest that desert dust storms may have an impact on the risk for adverse pregnancy outcomes such as toxemia of pregnancy. Health authorities should take necessary measures to protect pregnant women against detrimental effects of these storms.","year":2021}
{"review_pmid":"41938012","record_index":31,"pmid":"38320452","title":"The impact of air pollutants on spontaneous abortion: a case-control study in Tongchuan City.","abstract":"OBJECTIVES: Studies related to air pollutants and spontaneous abortion in urban northwestern China are scarce, and the main exposure windows of pollutants acting on pregnant women are unclear. STUDY DESIGN: Case-control study. METHODS: Data were collected from pregnant women in Tongchuan City from 2018 to 2019. A total of 289 cases of spontaneous abortion and 1156 cases of full-term labor were included and analyzed using a case-control study. Logistic regression models were developed to explore the relationship between air pollutants and spontaneous abortion after Chi square analysis and Air pollutant description. RESULTS: O3 (odds ratio [OR] = 1.028) is a risk factor for spontaneous abortion throughout pregnancy. PM2.5 (OR = 1.015), PM10 (OR = 1.010), SO2 (OR = 1.026), and NO2 (OR = 1.028) are risk factors for spontaneous abortion in the 30 days before the last menstrual period. PM2.5 (OR = 1.015), PM10 (OR = 1.013), SO2 (OR = 1.036), and NO2 (OR = 1.033) are risk factors for spontaneous abortion in the 30-60 days before the last menstrual period. PM2.5 (OR = 1.028), PM10 (OR = 1.013), SO2 (OR = 1.035), and NO2 (OR = 1.059) are risk factors for spontaneous abortion in the 60-90 days before the last menstrual period. CONCLUSION: Exposure to high levels of air pollutants may be a cause of increased risk of spontaneous abortion, especially in the first trimester of the last menstrual period.","year":2024}
{"review_pmid":"41938012","record_index":32,"pmid":"38026421","title":"The risk of miscarriage is associated with ambient","abstract":"Background: Exposure to high ambient temperature is reported to cause adverse Haq MZ and Hanifi SMA (2023) The risk of miscarriage is associated with ambient pregnancy outcomes. However, considering myriad temperature and climatic temperature: evidence from coastal conditions as well as different contextual factors, the paucity of studies from the Bangladesh. developing regions impedes the development of a clear understanding of the Front. Public Health 11:1238275. doi: 10.3389/fpubh.2023.1238275 heat-pregnancy outcome relationship. COPYRIGHT Materials and methods: This study was conducted in Chakaria, a coastal region","year":2023}
{"review_pmid":"41938012","record_index":33,"pmid":"37549698","title":"The short-term effect of ozone on pregnancy loss modified by temperature: Findings from a nationwide epidemiological study in the contiguous United States.","abstract":"BACKGROUND: Pregnancy loss, a major health issue that affects human sustainability, has been linked to short-term exposure to ground-surface ozone (O3). However, the association is inconsistent, possibly because of the co-occurrence of O3 and heat episodes, as increased temperature is a risk factor for pregnancy loss. To explain this inconsistency, the effect of O3 on pregnancy loss needs to be examined jointly with that of high temperature. METHODS: A total of 247,305 pregnancy losses during the warm season were extracted from fetal death certificates from the 386 counties in contiguous United States from 1989 to 2005. We assessed environmental exposure based on the daily maximum 8 h average of O3 from Air Quality System monitors and the 24 h average temperature from the North American Regional Reanalysis product. We conducted a bidirectional, time-stratified case-crossover study of the association between pregnancy loss and exposures to O3 and temperature and their multiplicative interaction. The main time window for the exposure assessment was the day of case occurrence and the preceding 3 days. To estimate the association, we used conditional logistic regression with adjustment for relative humidity, height of the planetary boundary layer, and holidays. Sensitivity analyses were performed on the lagged structure, nonlinearity, and between-subpopulation heterogeneity of the estimated joint effect. RESULTS: The joint effect was first estimated by the regression against categorical exposure by tertile. Compared to the low-low exposure group (O3 ≤ 78 μg/m3 and temperature ≤ 18 °C), the odds of pregnancy loss was significantly higher by 6.0 % (95 % confidence interval [CI] 2.4-9.7 %), 9.8 % (6.1-13.8 %), and 7.5 % (4.7-10.3 %) in the high-low (>104 μg/m3 and ≤18 °C), low-high (≤78 μg/m3 and >23 °C), and high-high (>104 μg/m3 and >23 °C) groups. The model of linear exposure and the multiplicative interaction yielded similar results. Each increment of 10 μg/m3 in O3 and 1 °C in temperature was associated with a 3.0 % (2.0 %-4.0 %) and 3.9 % (3.5 %-4.3 %), respectively, increase in the odds of pregnancy loss. A decrease in odds of 0.2 % (0.1 %-0.2 %) was associated with the temperature × O3 interaction. The finding of an antagonistic interaction between temperature and O3 was confirmed by models parametrizing the joint exposure as alternative nonlinear terms (i.e., a two-dimensional spline term or a varying-coefficient term) and was robust to a variety of exposure lags and stratifications. Therefore, the marginal effect of O3 was estimated to vary by climate zone. A significant association between O3 and pregnancy loss was observed in the northern, but not southern, United States. CONCLUSION: Joint exposure to O3 and high temperature can increase the risk for pregnancy loss. The adverse effect of O3 is potentially modified by ambient temperature. In high-latitude cities, controlling for O3 pollution could protect maternal health.","year":2023}
{"review_pmid":"41938012","record_index":34,"pmid":"35109854","title":"Universal Thermal Climate Index (UTCI) and adverse pregnancy outcomes in Ahvaz, Iran.","abstract":"BACKGROUND: Climate change may jeopardize the health of mothers and their offspring. There are few studies on the association between increasing temperature and pregnancy outcomes. The aim of this study was to investigate the relation between Universal Thermal Climate Index (UTCI) and adverse pregnancy outcomes including stillbirth, low birth weight (LBW), preterm labor (PTL), spontaneous abortion (SA), preeclampsia and hypertension in Ahvaz, Iran. METHODS: Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression were used to research the effect of UTCI on adverse pregnancy outcomes. The effect of time trend, air pollutants (NO2, SO2 and PM10), and weekdays were adjusted. RESULTS: The results showed that the low values of UTCI index (11.6 °C, in lags 0-6, 0-13) caused significant increase in the risk of preterm labor. However, hot thermal stress (high UTCI) significantly increased the risk of stillbirth in lag 0-13. We did not observe any significant relation between UTCI and other pregnancy outcomes in this study. CONCLUSIONS: It seems like both hot and cold weathers can be associated with adverse pregnancy outcomes.","year":2022}
{"review_pmid":"41938012","record_index":35,"pmid":null,"title":"Wildfire smoke exposure and pregnancy loss","abstract":"OBJECTIVE: ToprospectivelyexaminetheinfluenceofsleepbeforeemLOSS. MollyS. Kornfield,MD,1 ElizabethS. Rubin,MD,2 bryotransfer(ET)onthepregnancyoutcomesininfertilepopulation. Pamela B. Parker, M.D., M.P.H,3 Karen J. Gibbins, MD,4 MATERIALS AND METHODS: The study consisted of 2996 eligible Sacha A. Krieg, M.D., Ph.D.,5 Maureen K. Baldwin, MD womenwhoreceivedinvitrofertilization-embryotransfer(IVF-ET)treatMPH61OregonHealth&ScienceUniversity,Portland,OR;2OregonHealth mentfrom7841enrolledwomenfromJuly2019toJuly2020. Sleepinfor&SciencesUniversity,OR;3UniversityofPittsburghMedicalCenter,Pitts- mation,includingsleepquality,sleepdurationandsleepchronology,were burgh,PA;4OregonHealthandSciencesUniversity,OR;5OregonHealthand collectedbyanintegratedquestionnairebeforeembryotransfer. Amodified ScienceUniversity,Portland,OR;6OHSU,Portland,OR. poissonregressionmodelwitharobusterrorvariancewasusedtoevaluate theassociationbetweenthethreekindsofsleepindexandpregnancyoutOBJECTIVE: Chronicairpollutionexposureisanestablishedcauseof comesofIVF-ET,adjustingforage,bodymassindex,typeofinfertility(pripregnancyloss. We soughtto compare pregnancy loss ratesfollowing an maryorsecondary),proposalofembryotransfer(frozenorfreshembryo acuteexposuretogoodversushazardousairqualityfromawildfiresmoke transfer)andoccupationalstatusetc. event. RESULTS: Comparedwiththepoorsleepqualitygroup,goodsleepers MATERIALSANDMETHODS: SmokeplumesfromwildfiresinOregon showedhigherclinicalpregnancyrate(70.0%vs64.8%)andlivebirthrate resultedinhazardousairqualityfromSept10-19,2020inametroregionwith (52.0%vs46.3%). Andafteradjustingconfounders,womenreportedgood goodairqualityduringthesametimeperiodin2019. Wescreenedallsched- sleephadhigherchancetoacquireclinicalpregnancy(aRR1.089,95%CI: uledpregnancyintakeappointmentsinageneralOB/GYNacademicclinic 1.028-1.154) and live birth (aRR 1.139, 95%CI: 1.037-1.250). For sleep betweenAug20-Oct31of2019and2020. Weincludedpatientswithlast chronotype, women with eveningness chronotype had the lowest clinical menstrualperiod(LMP)1-10weekspriortotheexposure. Weexcludedcon- pregnancyrateandlivebirthrate. Comparedwitheveningnesschronotype, ceptionsviaassistedreproductivetechnology(ART). Weacceptedself-re- womenwithmorningnessorintermediatechronotypeweremorelikelyto ported pregnancy outcomes in addition to clinical reports. We compared have clinical pregnancy(aRRs>1) and live birth(aRRs>1), even after ourprimaryoutcome,ratesofpregnancylosspriorto20weeksgestation, differentadjustment. in 2019 versus 2020 using chi-square tests, and conducted an additional CONCLUSIONS: Thesleepqualityandsleepchronologycouldaffectthe sensitivityanalysisincludingARTpregnancies. Secondaryoutcomeswere pregnancy outcomes of IVF-ET. The poor sleep quality and eveningness gestationalduration(GD)atthetimeoftheexposureandtheloss. chronotypeadverselyaffectedtheriskofclinicalpregnancyandlivebirth. RESULTS: Of385screened,151peoplein2019and97peoplein2020 Treatingsleepdisordersandprovidingsleepbehaviorguidancetopatients metinclusioncriteria. Demographicsincludingage,BMI,smoking,anddia- receivingIVF-ETcouldpotentiallyimprovingtheirpregnancyoutcomes. betesweresimilarbetweenthegroups(Table). Elevatedbloodpressurewas IMPACTSTATEMENT: FactorsinfluencetheIVF-EToutcomesneedto higherinthe2019group. Subfertilitywasmoreprevalentin2020,andprior be discovered. Sleep deficiency is thought to be associated with female pregnancylossmoreprevalentin2019. Thereweremorepregnancylosses fertility. ResearchesontheanalysisofsleepandIVFoutcomesmainlyfocus <20weeksin2020than2019,withatrendtowardlaterlossesin2020. On on the number of oocytes retrieved, the quality of embryos etc., while sensitivity analysis, if ART pregnancies were included, it did not impact researchontheoutcomesofembryotransfer,likelivebirthrate,islimited. loss rates. In 2020, the median GD between LMPand onset of exposure Inourprospectivestudy,wefoundthatsleepqualityandsleepchronotype was31(cid:1)17(range7-69)days,whichdidnotdifferbasedonwhetherthere were significantly associated with clinical pregnancy and live birth. To wasaloss. someextent,ourstudyprovidedatheoreticalbasisforbetterguidanceon CONCLUSIONS: Anacutewildfiresmokeeventwasassociatedwitha theclinicalpracticeofthe‘‘optimalsleep’’forwomenundergoingassisted trendtowardsincreasedpregnancylossinageneralOB/GYNpopulation. reproductivetreatment. Larger,prospectivestudiesareneededtofullyassesstheimpactofacute SUPPORT: ThisstudywassupportedbytheNationalKeyResearchand wildfireand/ortoxicairqualityevents. Development Program of China (2021YFC2700400, 2021YFC2700701), IMPACTSTATEMENT: Acuteexposuretohazardousairqualityduring theBasicScienceCenterProgramofNSFC(31988101),theNationalNatural peri-conceptionmayhavesubstantialconsequencesonearlypregnancy. As ScienceFoundationofChina(82192874,31871509,82071606),Shandong theprevalenceofwildfiresincreasesduetoclimatechange,wemustexamine Provincial Key Research and Development Program(2020ZLYS02), the the potential reproductive impacts and assess interventions to reduce Taishan Scholars Program of Shandong Province (ts20190988) and the exposure. FundamentalResearchFundsofShandongUniversity. e370 ASRMAbstracts Vol.118,No.4,Supplement,October2022","year":2019}
{"review_pmid":"41938012","record_index":36,"pmid":"23864201","title":"Does ambient air pollutants increase the risk of fetal loss? A case-control study.","abstract":"OBJECTIVE: To examine the associations between the ambient air pollution and early fetal loss. STUDY DESIGN: A retrospective case-control study was conducted. 959 fetal losses and 959 normal intrauterine pregnancies within 14 weeks of pregnancy in 15 general or obstetrics and gynecology hospitals were selected into case and control groups, respectively. Data based on hospital records and national pollution monitor station records were collected. Logistic regression model was conducted to examine the associations between 4 ambient air pollutants (SO2, PM10, NO2 and TSP) exposures and fetal loss. RESULTS: The ratio of fetal loss to termination of pregnancy for heating months (2.28 %) was significantly (P < 0.001) higher than that for the non-heating months (1.77 %). Logistic regression suggested that fetal loss within 14 weeks was associated with higher exposure to SO2 (OR = 19.76, 95 % CI 2.34-166.71) and TSP (OR = 2.04, 95 % CI 1.01-4.13) in the first month of pregnancy. CONCLUSION: Exposure to high levels of SO2 and TSP during the first month of pregnancy was associated with an increased risk of fetal loss in early pregnancy.","year":2014}
{"review_pmid":"41938012","record_index":37,"pmid":"39391542","title":"Investigating the linkages between pregnancy outcomes and climate in sub-Saharan Africa.","abstract":"Poor pregnancy outcomes include miscarriages, stillbirths, and low birth weights. Stress from heat and lack of resources play a potentially important role in producing these poor outcomes. Women and couples who experience these poor outcomes rather than a healthy birth suffer psychological, physical, social, and financial costs as well. We use detailed reproductive data in combination with fine-scale climate data to examine pregnancy outcomes among women in sub-Saharan Africa, a region that shelters some of the poorest families in the world. Fine-scale precipitation and temperature data allow each pregnancy to be matched to the relevant climate exposures. We investigate the linkages between climate and pregnancy outcomes using linear probability models with fixed effects to minimize confounding due to factors that vary by location, season, and year. We analyze retrospective pregnancy data from more than 65,000 pregnancies recorded in 23 surveys across 15 African countries. Our results indicate that pregnancy outcomes are indeed impacted by exposure to hot days even after considering other individual-level characteristics. This research provides insight into the linkages between climate and a major adverse health outcome faced by women. In doing so, this research expands scientific understanding of the impact of environmental factors on fertility outcomes.","year":2020}
{"review_pmid":"41939286","record_index":1,"pmid":"28477578","title":"Acute myocardial infarction and COPD attributed to ambient SO2 in Iran.","abstract":"Acute myocardial infarction (MI) and chronic obstructive pulmonary disease (COPD) are important diseases worldwide. Inhalation is the major route of short-term exposure to air sulfur dioxide (SO2) that negatively affect human health. The objective of this study was to estimate the health effects of short-term exposure to SO2 in Khorramabad, Iran using the AirQ software developed by the World Health Organization (WHO). Daily mean SO2 concentrations were used as the estimates of human short-term exposure and allow calculation of the attributable excess relative risk of an acute MI and hospital admissions due to COPD (HACOPD). The annual mean SO2 concentration in Khorramabad was 51.33µg/m3. Based on the relative risk (RR) and baseline incidence (BI) approach of WHO, an increased risk of 2.7% (95% CI: 1.1-4.2%) of acute MI and 2.0% (95% CI: 0-4.6%) of HACOPD, respectively, were attributed to a 10µg/m3 SO2 increase. Since the geographic, demographic, and climatic characteristics are different from the areas in which the risk relationships were developed and not evaluated here, further investigations will be needed to fully quantify other health impacts of SO2. A decreased risk for MIs and COPD attributable to SO2 could be achieved if mitigation strategies and measures are implemented to reduce the exposure.","year":2017}
{"review_pmid":"41939286","record_index":2,"pmid":"28980195","title":"Air pollution and admissions due to ST elevation myocardial infarction-a time-series study from northwest of Iran.","abstract":"We investigated the association between the levels of air pollutants and the number of daily admissions due to ST segment elevation myocardial infarction (STEMI) in a metropolitan in the northwest of Iran. Daily concentrations of common air pollutants were obtained for the greater city of Tabriz for a period of 2 years. These reports included sulfur dioxide (SO2), nitrogen dioxide (NO2), nitric oxide (NO), nitrogen byproducts (NOx), carbon monoxide (CO), ozone (O3), and particulate matters < 10 μm (PM10). The census of admissions for STEMI was retrieved for the same period from hospital registries. The association of daily variations in air pollutant levels and the daily number of STEMI admissions were investigated in a time-series analysis. In the multi-pollutant model adjusting for long-term trend, seasonality, and temperature, a significant association was found for 1-h [NO2] and 24-h [CO]. A marginally significant association was observed for 24-h [NO2] and 8-h [CO]. The 24-h [CO] had the strongest association with the number of admissions with STEMI. Maximum 1-h concentrations of NO2 on the same day and on the prior day as well as 24-h concentrations of CO on the prior day were independently associated with increased number of STEMI admissions. However, daily concentrations of SO2, NO, O3, and PM10 were not associated with the frequency of hospital admissions for STEMI.","year":2017}
{"review_pmid":"41939286","record_index":3,"pmid":"30586817","title":"Air pollution and hospital admissions for cardiovascular diseases in","abstract":null,"year":2019}
{"review_pmid":"41939286","record_index":4,"pmid":"16053936","title":"Air pollution and hospitalization due to angina pectoris in Tehran, Iran: a time-series study.","abstract":"BACKGROUND: Health effects of air pollution have been studied in many different parts of the world. Although a fairly large number of studies have explored the cardiovascular impacts of air pollution, because of its unique location we studied the association between air pollutants and hospital admissions due to angina pectoris in Tehran for the first time. METHODS: This is a retrospective time-series study. The variables of the study include the levels of five air pollutants-nitrogen dioxide (NO(2)), carbon monoxide (CO), ozone (O(3)), sulfur dioxide (SO(2)), and particulate matter <10 microm in aerodynamic diameter (PM(10))-as independent variables; daily hospitalizations due to angina pectoris in 25 academic hospitals in Tehran as the dependent variable; and mean daily temperature and humidity, seasonality, time trend, and day of the week as potential confounders. All variables were measured during a 5-year period from 21 March 1996 to 20 March 2001. The data of mean daily levels of NO(2), CO, O(3), SO(2), and PM(10) were collected from one of the stations of Tehran's Air Quality Control Corp. Data were analyzed using Poisson regression models. Relative risks of angina pectoris admissions were calculated for an increase in 1mg/m(3) for CO and 10 microg/m(3) for the other pollutants. RESULTS: Daily admissions due to angina pectoris were significantly related to the CO level, after controlling for confounder effects. Each unit increase in the CO level caused a 1.00934 increase in the number of admissions (95% CI, 1.00359--1.01512). This association was verified with a lag of 1 day. There was no significant association between the other air pollutants and the number of daily admission due to angina pectoris. CONCLUSIONS: We found that with increasing levels of the pollutant CO, the number of admissions due to cardiac angina rose. Ischemic heart disease is the leading cause of death in Iran. Air pollution control will reduce the number of this preventable disease and resulting deaths.","year":2005}
{"review_pmid":"41939286","record_index":5,"pmid":"27016680","title":"Air pollution and risk of respiratory and cardiovascular hospitalizations in the most populous city in Vietnam","abstract":null,"year":2016}
{"review_pmid":"41939286","record_index":6,"pmid":"29147121","title":"Ambient air pollution and daily hospital admissions for cardiovascular diseases in Arak, Iran.","abstract":"BACKGROUND: Outdoor air pollution has been considered as one of the most serious health concerns over the last decade. This study aimed to investigate the association between ambient air pollution and cardiovascular hospital admissions. METHODS: This investigation was carried out from January 1, 2010 to December 31, 2015, in the urban population of Arak, Iran. Daily records of concentrations of air pollutants including particulate matter less than 10 µm (PM10), nitrogen dioxide (NO2), particulate matter less than 2.5 µm (PM2.5), ozone (O3), carbon monoxide (CO), and sulfur dioxide (SO2) as well as the daily number of hospital admissions due to cardiovascular disease were inquired from the Arak Department of Environment and two major hospitals, respectively. Time-series regression analysis was used to evaluate the effect of the pollutants on cardiovascular hospital admissions with different lag structures, controlling for weather variables, seasonality and long-term time trends, and day of the week. RESULTS: Each 10 µg/m3 increase in PM10 and NO2 and 1 mg/m3 increase in CO concentrations at lag 0 (day) were significantly associated with an increase of 0.7% (P = 0.004), 3.3% (P = 0.006), and 9.4% (P < 0.001), respectively in overall cardiovascular hospital admissions. The elderly were more susceptible than those under 60 years to exposure to the pollutants (especially NO2) with regard to cardiovascular hospital admission. CONCLUSION: The results of this study showed that hospital admission for cardiovascular disease is partly related to the levels of ambient air pollutions in Arak. Susceptibility to air pollutants varies by age groups and sex.","year":2017}
{"review_pmid":"41939286","record_index":7,"pmid":"36969582","title":"Ambient carbon monoxide and cardiovascular-related hospital admissions: A time-series analysis.","abstract":"Background and aims: Although several studies have investigated the association between air pollutants and cardiovascular diseases (CVDs) in recent years, a lack of evidence exists regarding carbon monoxide (CO) exposure, especially in the Eastern Mediterranean's polluted regions. In this study, we aimed to evaluate the short-term effect of CO exposure on daily CVD hospital admissions in Isfahan, a major city in Iran. Methods: Data were extracted from the CAPACITY study on daily CVD hospital admissions in Isfahan from March 2010 to March 2012. The 24-h mean CO concentrations were obtained from four local monitoring stations. In a time-series framework, the association between CO and daily hospitalizations for total and cause-specific CVDs in adults (ischemic heart disease (IHD), heart failure (HF), and cerebrovascular disease) was conducted using Poisson's (or negative binomial) regression, after adjusting for holidays, temperature, dew point, and wind speed, considering different lags and mean lags of CO. The robustness of the results was examined via two- and multiple-pollutant models. Stratified analysis was also conducted for age groups (18-64 and ≥65 years), sex, and seasons (cold and warm). Results: The current study incorporated a total of 24,335 hospitalized patients, (51.6%) male with a mean age of 61.9 ± 16.4 years. The mean CO concentration was 4.5 ± 2.3 mg/m³. For a 1 mg/m3 increase in CO, we found a significant association with the number of CVD hospitalizations. The largest adjusted percent change in HF cases was seen in lag0, 4.61% (2.23, 7.05), while that for total CVDs, IHD, and cerebrovascular diseases occurred in mean lag2-5, 2.31% (1.42, 3.22), 2.23% (1.04, 3.43), and 5.70% (3.59, 7.85), respectively. Results were found to be robust in two- and multiple-pollutant models. Although the associations changed for sex, age groups, and seasons, they remained significant for IHD and total CVD, except for the warm season, and for HF, except for the younger age group and cold seasons. Additionally, the exposure-response relationship curve of the CO concentrations with total and cause-specific CVD admissions showed non-linear relationships for IHD and total CVDs. Conclusions: Our results showed that exposure to CO contributed to an increase in the number of CVD hospitalizations. The associations were not independent of age groups, season, and sex.","year":2023}
{"review_pmid":"41939286","record_index":8,"pmid":"31452658","title":"Association between ambient air pollution and hospitalization caused by atrial fibrillation","abstract":"Original Article birtsi d u BACKGROUND: Many studies have shown the worst effects of air pollution on cardiovascular d et diseases (CVDs). Present study focused on the relationship between atrial fibrillation (AF), as one of n u d the common arrhythmias, and air pollutants in Isfahan, Iran, an industrial city in the Middle East. ht r e METHODS: A case-crossover design was used to explore the associations between air pollution et e and AF hospitalized patients with ventricular response (VR) > 90 beats per minute (bpm) mr (fast response) and those with VR ≤ 90 bpm. All patients' records were extracted from their o s hospital files. Air pollutants data including particulate matter less than 10 µ (PM 10 ), PM 2.5, ht f e carbon monoxide (CO), nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), and ozone (O 3 ) were C obtained from the Correlation of Air Pollution with Hospitalization and Mortality of a er Cardiovascular and Respiratory Diseases (CAPACITY) study. Conditional logistic regression test vit ae was used to measure the relationship between pollutants and hospitalization due to AF. y nC m m o RESULTS: Records of 369 patients, including 173 men (46.9%) who were hospitalized for AF during d em the study period and had complete data were extracted. Although a positive but not statistically m ui s n o s h i o g s n p if it ic a a li n z t a t r i e o l n a ti d o u n e s h t i o p A w F a s i n sh p o a w t n ie n b t e s t w w e i e th n 1 r 0 ap -u id n it V i R n c ( r R ea V s R es ), in th a e l l o p n o ly ll u s t i a g n n t i s fi c (e a x n c t e p re t l a P t M io 1 n 0 ) s h a i n p d w th a e s di v or p, u birtt A observed in case of NO 2 [odds ratio (OR) = 1.26, 95% confidence interval (CI) = 1.0-2.1, P = 0.031]. d e oit C ho O s N p C it L a U liz S a IO tio N n: T du h e is to st u A d F y in sh o p w at e ie d n t p s o s w it i i t v h e R s V ig R n. i f N ic O an 2 t is r e a la t g i r o e n e s n h h ip ou s se b e g tw as e e w n h o N s O e 2 l e a v n el d s a th re e gir o e ht n C n o Nexpected to increase due to global environmental changes. Therefore, relevant strategies should ni m o a be adopted to decrease its levels, especially in industrial cities like Isfahan. w l e m D K a e t y e w of o s r u d b s m: i A I ss n i i r o t n P r: o o 0 d l 7 l u u A t c u io g ti. n o 2, 0 n A 1 8 t, r D ia a l t F e i o b f r a i c l c la ep ti t o a n nc, e N: 1 it 0 r M og ar e. n 2 0 D H 19 i o o w xi d t e o cite this article: Saifipour A, Azhari A, d eti c ylr e p or p si kr o 0. 4 l ai cr d etr o p n U L. ci Recent studies by the World Health Organization Pourmoghaddas A, Hosseini SM, Jafari-Koshki T, n e s (WHO) have shown that more than 90% of the Rahimi M, et al. Association between ambient air e w, world's population is exposed to air pollution. pollution and hospitalization caused by atrial ci h h Ambient air pollution was responsible for about fibrillation. ARYA Atheroscler 2019; 15(3): 106-12. p e mr 1- Cardiology Resident, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran u sti n 2- Assistant Professor, Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran er s 3- Professor, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran cirt 4- Professor, Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran et d 5- Assistant Professor, Road Traffic Injury Research Center AND Department of Statistics and Epidemiology, School of Health, Tabriz u University of Medical Sciences, Tabriz, Iran d, es 6- Associate Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran si 7- Assistant Professor, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical birt u Sciences, Isfahan, Iran oit 8- Isfahan Disaster Management Office, Isfahan Governor’s Office, Isfahan, Iran a, n 9- Khuzestan Department of Environment, Ahvaz, Iran d n 10- Central Laboratory and Air Pollution Monitoring, Isfahan Province Environmental Monitoring Center, Isfahan Department of er p Environment, Isfahan, Iran or d 11- Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran u c 12- Information Technology Office, Isfahan University of Medical Sciences, Isfahan, Iran oit n 13- Isfahan Meteorological Office, Isfahan, Iran ni 14- PhD Candidate, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran 15- Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran","year":2019}
{"review_pmid":"41939286","record_index":9,"pmid":"30235588","title":"Association between short-term exposure to fine particulate matter and daily emergency room visits at a cardiovascular hospital in Dhaka, Bangladesh.","abstract":"BACKGROUND: It has been suggested that exposure to fine particulate matter (PM2.5) adversely affects cardiovascular health. However, the effect modifications by individual characteristics and season have been less studied in developing countries where PM2.5 levels are high. OBJECTIVES: To estimate the risks of cardiovascular emergency room visits in relation to daily concentrations of PM2.5 and to assess how these associations can be modified by age, sex, and nutritional status of patients and by season. METHODS: The analytic sample was 6774 adults who visited the emergency room at a cardiovascular disease (CVD) hospital in Dhaka throughout one year (n = 364 days). A time-stratified case-crossover design with conditional Poisson regression analysis was used to estimate the relative risks (RRs) and 95% confidence intervals (CIs) of visits while adjusting for temperature. Stratification was performed by gender, age (<65 and ≥65 years), BMI (underweight, normal weight, overweight), and season (dry summer: February to April; wet summer: May to October; dry winter: November to January). RESULTS: The mean concentration of PM2.5 was 86.1 μg/m3. An IQR increase (103 μg/m3) in PM2.5 at lag 3 was significantly associated with a 12% (RR: 1.12; 95% CI: 1.01-1.23) increase in CVD emergency room visits. No evidence of association was found for the other lags. Underweight and overweight patients showed evidence of increased risk at lag 2 (RR: 1.31; 95% CI: 1.02-1.67) and lag 4 (RR: 1.20; 95% CI: 1.04-1.39), respectively. CONCLUSION: Increases in the daily concentrations of PM2.5 may lead to more cardiovascular emergency room visits in Dhaka, Bangladesh. Response times from ambient exposure to CVD emergency visits may differ by season and the nutritional status of susceptible individuals, necessitating further research.","year":2019}
{"review_pmid":"41939286","record_index":10,"pmid":"37501642","title":"Associations between short-term exposure to fine particulate matter and acute myocardial infarction: A case-crossover study.","abstract":"BACKGROUND: Previous studies evaluated the impact of particle matters (PM) on the risk of acute myocardial infarction (AMI) based on local registries. HYPOTHESIS: This study aimed to evaluate possible short term effect of air pollutants on occurrence of AMI based on a specific case report sheet that was designed for this purpose. METHODS: AMI was documented among 982 patients who referred to the emergency departments in Tehran, Iran, between July 2017 to March 2019. For each patient, case period was defined as 24 hour period preceding the time of emergency admission and referent periods were defined as the corresponding time in 1, 2, and 3 weeks before the admission. The associations of particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5 ) and particulate matter with an aerodynamic diameter ≤10 μm (PM10 ) with AMI were analyzed using conditional logistic regression in a case-crossover design. RESULT: Increase in PM2.5 and PM10 was significantly associated with the occurrence of AMI with and without adjustment for the temperature and humidity. In the adjusted model each 10 μg/m3 increase of PM10 and PM2.5 in case periods was significantly associated with increase myocardial infarction events (95% CI = 1.041-1.099, OR = 1.069 and 95% CI = 1.073-1.196, and OR = 1.133, respectively). Subgroup analysis showed that increase in PM10 did not increase AMI events in diabetic subgroup, but in all other subgroups PM10 and PM2.5 concentration showed positive associations with increased AMI events. CONCLUSION: Acute exposure to ambient air pollution was associated with increased risk of AMI irrespective of temperature and humidity.","year":2023}
{"review_pmid":"41939286","record_index":11,"pmid":"33822936","title":"Cardiovascular morbidity and mortality associations with biomass- and fossil-fuel-combustion fine-particulate-matter exposures in Dhaka, Bangladesh.","abstract":"BACKGROUND: Fine-particulate-matter (i.e. with an aerodynamic diameter of ≤2.5 µm, PM2.5) air pollution is commonly treated as if it had 'equivalent toxicity', irrespective of the source and composition. We investigate the respective roles of fossil-fuel- and biomass-combustion particles in the PM2.5 relationship with cardiovascular morbidity and mortality using tracers of sources in Dhaka, Bangladesh. Results provide insight into the often observed levelling of the PM2.5 exposure-response curve at high-pollution levels. METHODS: A time-series regression model, adjusted for potentially confounding influences, was applied to 340 758 cardiovascular disease (CVD) emergency-department visits (EDVs) during January 2014 to December 2017, 253 407 hospital admissions during September 2013 to December 2017 and 16 858 CVD deaths during January 2014 to October 2017. RESULTS: Significant associations were confirmed between PM2.5-mass exposures and increased risk of cardiovascular EDV [0.27%, (0.07% to 0.47%)] at lag-0, hospitalizations [0.32% (0.08% to 0.55%)] at lag-0 and deaths [0.87%, (0.27% to 1.47%)] at lag-1 per 10-μg/m3 increase in PM2.5. However, the relationship of PM2.5 with morbidity and mortality effect slopes was less steep and non-significant at higher PM2.5 concentrations (during crop-burning-dominated exposures) and varied with PM2.5 source. Fossil-fuel-combustion PM2.5 had roughly a four times greater effect on CVD mortality and double the effect on CVD hospital admissions on a per-µg/m3 basis than did biomass-combustion PM2.5. CONCLUSION: Biomass burning was responsible for most PM2.5 air pollution in Dhaka, but fossil-fuel-combustion PM2.5 dominated the CVD adverse health impacts. Such by-source variations in the health impacts of PM2.5 should be considered in conducting ambient particulate-matter risk assessments, as well as in prioritizing air-pollution-mitigation measures and clinical advice.","year":2021}
{"review_pmid":"41939286","record_index":12,"pmid":"31819749","title":"Correlation between air pollution and hospitalization due to myocardial infarction","abstract":"Original Article birtsi d u BACKGROUND: Air pollution is associated with increased risk of cardiovascular disease (CVD). d et u This study aims to evaluate the correlation between air pollutants and hospitalization due to n d e myocardial infarction (MI) as part of \"correlation of air pollution with hospitalization and ht r mortality of CVDs and respiratory diseases (CAPACITY) study\". e et METHODS: This case-crossover study analyzed the data of 319 patients who were admitted with mr s diagnosis of ST-elevation MI (STEMI) or non-ST-elevation MI (NSTEMI) in three main o hospitals of Isfahan, Iran. The data of airborne pollutants including particulate matter < 10 µm e ht f (PM 10 ), particulate matter < 2.5 µm (PM 2.5 ), nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), carbon er C monoxide (CO), and ozone (O 3 ) as well as climatic indices (temperature, wind speed, and vit a humidity) at 24 hours, 48 hours, and one week before admission were extracted from y n a C e CAPACITY study. The conditional logistic regression method was used to evaluate the m m o correlation between air pollutants and MI hospitalization. m ui d e s n o m R p p a a E t t S i i e e U n n L t t T s s S w w: i 3 i t t 1 h h 9 S S p T T a E E ti M M en I I t ( s a 6 w n 4 d i. t 8 h % 1 0 m ) - u e w a n e n i r t e a i g r n e e c c r o r e f u m 6 it e 3 e n. d 1 t. 5 T i ± n h e 2 P 8 M r. i 1 s 2 4 k.5 y o a e f t a h 4 r o s 8 s, p i h n i o t c a u lu l r iz d s a in t b i g e o f n 2 o 3 r s e 8 ig a n m d if e m i n c i a s ( n s 7 i t 4 o ly. n 6 i % n [o c ), d r e a d a n s s d e r d a 2 t 0 i i n o 7 d e di v or p, oit u birtt A (OR) = 3.70, 95% confidence interval (CI): 1.69-7.69]. Although, majority of air pollutants had positive e ht n Nassociation with hospitalization in patients with NSTEMI, they were not statistically significant. gir o C n o CONCLUSION: This study showed significant association between elevated PM 2.5 at 48 hours before a ni m o admission and hospitalization of patients with STEMI. This finding can warn policymakers to design w l e m b K e e t y te w r o c r a d r s e: s A e i r r v i P c o es ll u fo t r io p n a, t i M en y t o s c a a t r r d i i s a k l o I f n a fa c r u c t t e i o M n I, d H u o r s in p g it t a h li e z a ti t m io e n s, o A f i i r n b c o r r e n as e e P d a a r i t r i c p u o l l a lu te ti o M n a. tter d eti c ylr e p or p si kr o 0. 4 l ai cr d etr o p n U L Date of submission: 22 July 2018, Date of acceptance: 01 Apr. 2019. ci e n s e","year":2019}
{"review_pmid":"41939286","record_index":13,"pmid":"31576506","title":"Effect of O3, PM10 and PM2.5 on cardiovascular and respiratory diseases in cities of France, Iran and Italy.","abstract":"At present, both tropospheric ozone (O3) and particulate matters (PM) are among the most threatening air pollutants for human health in cities. The air pollution effects over public health include increased risk of hospital admissions and mortality for respiratory and cardiovascular diseases even when air pollutant concentrations are below European and international standards. The aim of this study was to (i) estimate the burden of mortality and morbidity for cardiovascular and respiratory diseases attributed to PM2.5, PM10 and O3 in nine selected cities in France, Iran and Italy in 2015 and 2016 and to (ii) compare estimated burdens at current O3 and PM levels with pre-industrial levels. The selected Mediterranean cities are among the most affected by the air pollution in Europe, in particular by rising O3 while the selected Iranian cities rank as the most polluted by PM in the world. The software AirQ+ was used to estimate the short-term health effects, in terms of mortality and morbidity by using in situ air quality data, city-specific relative risk values and baseline incidence. Compared to pre-industrial levels, long-term exposures to ambient PM2.5, PM10 and O3 have substantially contributed to mortality and hospital admissions in selected cities: about 8200 deaths for non-accidental causes, 2400 deaths for cardiovascular diseases, 540 deaths for respiratory diseases, 220 deaths for chronic obstructive pulmonary diseases as well as 18,800 hospital admissions for cardiovascular diseases and 3400 for respiratory diseases were reported in 2015. The study supports the need of city-specific epidemiological data and urgent strategies to mitigate the health burden of air pollution.","year":2019}
{"review_pmid":"41939286","record_index":14,"pmid":"36428180","title":"Effects of Air Pollutant Exposure on Acute Myocardial Infarction","abstract":null,"year":2023}
{"review_pmid":"41939286","record_index":15,"pmid":"34677770","title":"Effects of ambient air pollutants on hospital admissions and deaths for cardiovascular diseases: a time series analysis in Tehran.","abstract":"Short-term exposures to air pollution have been associated with various adverse health effects. In this study, we investigated the associations between ambient air pollutants with the number of hospital admissions and mortality from cardiovascular diseases (CVDs). This time series study was conducted in Tehran for the years 2014-2017 (1220 day). We collected the ambient air pollutant concentration data from the regulatory monitoring stations. The health data were obtained from the Ministry of Health and Medical Education. A distributed lag non-linear model (DLNM) was used for the analyses. Total CVDs and ischemic heart disease (IHD) admissions were associated with CO for each 1 mg/m3 increase at lags of 6 and 7 days. Also, there was a positive association between total CVDs (RR 1.01; 1.001 to 1.03), IHD (RR 1.04; 1.006 to 1.07), and cerebrovascular diseases (RR 1.03; 1.005 to 1.07) mortality with SO2 at a lag of 4 days. PM2.5 and PM10 were associated with cerebrovascular disease admissions in females aged 16-65 years and 16 years and younger for each 10 µg/m3 increase, respectively. Short-term exposure to SO2, NO2, and CO was associated with hospital admissions and mortality for CVDs, IHD, cerebrovascular diseases, and other cardiovascular diseases at different lags. Moreover, females were more affected by ambient air pollutants than males in terms of their burden of CVDs. Therefore, identifying the likely harmful effects of pollutants given their current concentrations requires the planning and implementation of strategies to reduce air pollution.","year":2022}
{"review_pmid":"41939286","record_index":16,"pmid":"23112900","title":"Environmental air pollution and acute cerebrovascular complications: an ecologic study in tehran, iran.","abstract":"BACKGROUND: In this study, we aimed to assess the association between air pollution and cerebrovascular complications in Tehran, one of the most air-polluted cities in the world, among different subgroups of patients with stroke in 2004. METHODS: In this ecologic study, we calculated the daily average levels of different air pollutants including CO, NO(X), SO(2), O(3), and PM(10) and also humidity and temperature on the day of stroke and 48 hours prior to stroke in 1 491 patients admitted with the diagnosis of stroke in eight referral hospitals in different areas of Tehran. Then, we evaluated the association between the rate of stroke admissions and the level of the selected pollutants, humidity, and temperature on the day of stroke and 48 hours prior to stroke among different subgroups of patients. RESULTS: There was no significant association between the same-day level of the pollutants and the rate of stroke admissions, but an association was seen for their level 48 hours before stroke. These associations differed among different subgroups of age, sex, history of underlying diseases, and type of stroke. Same-day temperature had a reverse association in patients with hemorrhagic stroke and in patients without a history of heart disease or previous stroke. A direct significant association was seen for humidity level 48 hours before stroke in patients with a history of heart disease. CONCLUSIONS: It is inferred that air pollution has a direct association with the incidence of stroke and these association differs among different subgroups of patients. The results of this study are not time-dependant and can be generalized to different times and regions. Moreover, these results may be useful for environmental health policy makers.","year":2012}
{"review_pmid":"41939286","record_index":17,"pmid":"34761318","title":"Estimation of long-term and short-term health effects attributed","abstract":"Clean air is considered as a basic need for human health. However, air pollution is a significant threat to health in developed and developing countries. The aim of this study was to estimate the health effects attributed to P M pollutants in the air of 2.5 Ardabil in 2018 (using Air Q + model). Raw data related to particles were collected from the Department of Environment and processed in Excel software and converted into an input file of the Air Q + model, and in the final stage, by considering appropriate epidemiological parameters and combining these data with air quality data, it was possible to estimate the health effects of air pollution. The results showed that the average annual concentrations of P M and P M were 15.47 and 2.5 10 30.94 in the study year, respectively. The total number of deaths due to ALRI, COPD, lung cancer, IHD, and stroke deaths on average during the study period were estimated to be 73, 11, 7, 15, and 14 deaths, respectively, which include 14.62, 15.78, 4.9, 12.43, and 11.6% of deaths due to ALRI, COPD, lung cancer, IHD, and stroke deaths, respectively. In conditions of concentration above 5 µg/m3, attributed proportion, total number of attributed cases and number of attributed cases per 100,000 population (with moderate relative risk and confidence interval of 95%) for cardiovascular diseases have been estimated to be 0.95% 103 people and 42.19 people. Also, the attributed proportion, the total number of attributable cases, and the number of attributable cases per 100,000 population (with moderate relative risk and confidence of 95%) for the admission of respiratory diseases have been estimated at 97.1%, 68 persons and 3 persons, respectively. Our results suggest that particle exposure even at low concentrations is associated with an increased risk of overall mortality and specific cause mortality and hospital admissions for respiratory and cardiovascular diseases.","year":2021}
{"review_pmid":"41939286","record_index":18,"pmid":"29546882","title":"Lag time structure of cardiovascular deaths attributed to ambient air pollutants in Ahvaz, Iran, 2008-2015.","abstract":"OBJECTIVES: There are few studies about the association between breathing polluted air and increased risk of cardiovascular diseases and cardiac death in the Middle East. This study aimed to investigate the relation between air pollutants and cardiovascular mortality (based on ICD-10) in Ahvaz. MATERIAL AND METHODS: In this ecological study, the data about cardiovascular disease mortality and air pollutants from March 2008 until March 2015 was inquired from the Ahvaz City Authority and the Khuzestan Province Environmental Protection Agency. The quasi-Poisson, second degree polynomial constrained, distributed lag model; using single and cumulative lag structures, adjusted by trend, seasonality, temperature, relative humidity, weekdays and holidays was used for the data analysis purposes. RESULTS: Findings indicated a direct significant relation between an interquartile range (IQR) increase in ozone and cardiovascular deaths among men after 3 days' lag. There was also a significant relation between an IQR increase in particulate matter below 10 μm and cardiovascular deaths for all people, over 60 years old and under 18 years old after 3 and 13 days' lags. There was a significant relation between an IQR increase in nitrogen dioxide and carbon monoxide, and cardiovascular deaths in the case of under 18-year-olds (in the lag 11) and over 60-year-olds (in the lag 9), respectively. We finally found a significant association between an IQR increase in sulfur dioxide and cardiovascular deaths in the case of men, under 18-year-olds and from 18- to 60-year-olds in the lag 9, 0, and 11, respectively (p-values < 0.05). CONCLUSIONS: It appears that air pollution is significantly associated with cardiovascular deaths in Ahvaz City. Int J Occup Med Environ Health 2018;31(4):459-473.","year":2018}
{"review_pmid":"41939286","record_index":19,"pmid":"34036506","title":"Short-term effect of multi-pollutant air quality indexes and PM2.5 on cardiovascular hospitalization in Hamadan, Iran: a time-series analysis.","abstract":"Air pollutants are the most important environmental factors that contributed to cardiovascular disease (CVD). The present study aimed to investigate the number of hospitalization due to heart failure (HF) and myocardial infarction (MI) following the air pollutant exposure using a time-series regression analysis with a distributed lag model in Hamadan, Iran (2015-2019). A total of 2091 cases of CVD were registered. Based on the findings, the highest health effects on HF hospitalization were observed with air quality health index (AQHI) at lag 9 (RR = 1.043, 95% CI 0.991-1.098), and air quality index (AQI) at lags 2, 7, and 9 (RR = 1.001, 95% CI 0.998-1.002), for an increase in 1 unit of the indexes, and with PM2.5 at lag 0 (RR = 1.001, 95% CI 0.996-1.004) for 10 μg/m3 increase in PM2.5 levels. The highest health effects on MI hospitalization were calculated with AQHI at lag 10 (RR = 1.059, 95% CI 1.001-1.121) and AQI at lags 1 and 2 (RR = 1.001, 95% CI 0.998-1.002), for an increase in 1 unit of the indexes, and with PM2.5 at lag 8 (RR = 1.002, 95% CI 0.997-1.005) for 10 μg/m3 increase in PM2.5 levels. According to a seasonal classification, results showed that hospitalization in the warm season was higher than that of the cold season. Based on our knowledge, the current study is the first study that investigated the effect of air quality indexes on hospitalization due to HF and MI in Iran. Findings can provide basic information to plan preventive measures for reducing exposure chance and hospitalization rate in high-risk people.","year":2021}
{"review_pmid":"41939286","record_index":20,"pmid":"30617889","title":"Short-term effects of ambient air pollution and cardiovascular events","abstract":"Airpollutionandduststormsareassociatedwithincreasedcardiovascularhospitaladmissions. Theaimofthisstudywas to investigate the association between short-term exposure to ambient air pollutants and CVD (cardiovascular disease) events in a long-term observational period. The study included the events of cardiovascular diseases (namely coronary artery disease, ischemic heart disease, myocardial infarction, and pneumo thrombo embolism) within the population of Shiraz,fromMarch21,2009toMarch20,2015. Also,eachpatient’sdemographicswererecorded. Mainmeteorological variables and five ambient pollutants (CO, O, SO, NO, and PM ) were recorded. Statistical analysis was performed 3 2 2 10 using linear regression (GLM) and a generalized additive model (GAM) estimating Poisson distribution and adjusted for themainriskfactorsandambientmeteorologicalvariables. Amildprevalence(51.5%)ofcoronaryarterydisease(CAD) wasregisteredin6425events. InGLManalysis,weobservedanassociationamongthepollutantswiththecoronaryartery diseasehospitaladmissionswhichwasintheorderofCO,NO,andPM. Thehighestassociationofeachpollutantwith 2 10 hospitaladmissionwasobservedasPM atlag4(RR=1.08;95%CI1.02,1.14andp<0.05),NO atlag0(RR=1.22; 10 2 95%CI1.00,1.48),andCOatlag0(RR=1.5295%CI=(1.16,1.99)). However,ondustydays,thereweresignificantly higher numbers of referrals of cardiovascular patients (mean=7.54±4.44 and p=0.002,) than on non-dusty days. According to these data, dust storms and some types of pollutants in the air are responsible for more admissions to hospitals for cardiovascular problems.","year":2019}
{"review_pmid":"41939286","record_index":21,"pmid":"25792024","title":"Short-term relationships between emergency hospital admissions for respiratory and cardiovascular diseases and fine particulate air pollution in Beirut, Lebanon.","abstract":"High levels of major outdoor air pollutants have been documented in Lebanon, but their health effects remain unknown. The Beirut Air Pollution and Health Effects study aimed to determine the relationship between short-term variations in ambient concentrations of particulate matter (PM10 and PM2.5) and emergency hospital admissions in the city of Beirut, and whether susceptible groups are more greatly affected. An autoregressive Poisson model was used to evaluate the association between daily concentrations of particulate matter and respiratory and cardiovascular emergency hospital admissions after controlling for confounders. All variables were measured during 1 year from January 2012 to December 2012. Relative risks of admissions for respiratory and cardiovascular diseases were calculated for an increase in 10 μg.m(-3) of pollutant concentrations. Total respiratory admissions were significantly associated with the levels of PM10 (1.012 [95% CI 1.004-1.02]) per 10 μg.m(-3) rise in daily mean pollutant concentration for PM10 and 1.016 [95% CI 1.000-1.032] for PM2.5 on the same day. With regard to susceptible groups, total respiratory admissions were associated with PM2.5 and PM10 within the same day in children (relative risk (RR), 1.013 and 1.014; 95% confidence interval, 0.985-1.042 and 1.000-1.029 for PM2.5 and PM10, respectively). Moreover, a nearly significant association was found between particles and total circulatory admissions for adults and elderly groups in the same day. These results are similar to other international studies. Therefore, air pollution control is expected to reduce the number of admissions of these diseases in Lebanon.","year":2015}
{"review_pmid":"41939286","record_index":22,"pmid":"29178978","title":"The association between exposure to air pollutants including PM10, PM2.5, ozone, carbon monoxide, sulfur dioxide, and ni","abstract":"Background: Unfavorableassociationsbetweenairpollutionandmyocardialinfarctionarebroadlyinvestigated Airpollution inrecentstudiesandsomeofthemrevealedconsiderableassociations;however,controversiesexistsbetween Myocardialinfarction theseinvestigationswithregardtoculpritcomponentsofairpollutionandsignificanceofcorrelationbetween STelevationmyocardialinfarction myocardialinfarctionriskandairpollution. Particulatematter Methods: TheassociationbetweenexposuretoPM,PM,ozone,carbonmonoxide,sulfurdioxide,andni10 2.5 trogendioxideconcentrationofbackgroundairthatresidentsofTehran,thecapitalcityofIran,whichisranked as the most air polluted city of Iran and the relative risk of developing ST-elevation myocardial infarction (STEMI)wereinvestigatedbyacase-crossoverdesign. Ourstudyincluded208patientsadmittedwithadiagnosis ofSTEMIandundergoneprimarypercutaneousintervention. Airpollutantconcentrationwasaveragedin24-h windowsprecedingthetimeofonsetofmyocardialinfarctionforthecaseperiod. Besides,themeanlevelofeach elementofairpollutionofthecorrespondingtimeinoneweek,twoweeksandthreeweeksbeforeonsetof myocardialinfarction,wasaveragedseparatelyforeachdayasonecontrolperiods. Thus,624controlperiods wereincludedinourinvestigationsuchthat. Eachpatientismatchedandcomparedwithhim/herself. Results: ThemeanlevelofPM incaseperiods(61.47µg/m3)wassignificantlyhigherthanitslevelincontrol 10 periods(57.86µg/m3)(P-value=0.019,95%CI:1.002-1.018,RR=1.010). Also,themeanlevelofPM in 2.5 caseperiods(95.40µg/m3)wassignificantlyhigherthanthatincontroldays(90.88µg/m3)(P-value=0.044, 95%CI:1.001-1.011,RR=1.006). ThelevelofothercomponentsincludingNO,SO,COandO showedno 2 2 3 significantdifferencesbetweencaseandcontrolperiods.A10µg/m3increaseinPM andPM wouldresultin 10 2.5 10.10% and 10.06% increase in STEMI event, respectively. Furthermore, the results of sub-group analysis showedthatolderpatients(equalormorethan60year-old),diabeticpatients,non-hypertensiveonesandpatientswithmorethanonediseasedvesselmaybemorevulnerabletotheharmfuleffectofparticularmatters includingPM andPM ondevelopmentofSTEMI. 10 2.5 Conclusion: Airpollutionisaworldwidepandemicwithgreatpotentialtocauseterribleeventsespeciallycardiovascularones.PM andPM areamongstambientairpollutantwithahighriskofdevelopingSTEMI. Thus, 2.5 10 morerestrictivelegislationsshouldbeappliedtodefineasafelevelofindoorandoutdoorairpollutantproduction.","year":2017}
{"review_pmid":"41970007","record_index":1,"pmid":"32278195","title":"1-s2.0-S0160412019340097-main","abstract":"HandlingEditor: HannaBoogaard Background: PM2.5 pollution waves (PPWs) are severe air pollution events with extremely high-level concentrationofambientPM2.5.PPWs,suchashazedays,weresuggestedtobeassociatedwithincreasedcardioKeywords: pulmonary mortality and morbidity. However, the biological mechanism response to ambient PM2.5 during PM2.5pollutionwaves PPWsisstillunclear. Indoorpurification Methods: Arandomizedcrossovertrialwasconductedon29healthyyoungadults. RepeatedhealthmeasureOxidativestress mentswereperformedbefore,duringandaftertwotypicalPPWsunderfilteredandshamindoorairpurification, Plateletactivation with a washout interval of at least 2 weeks. Health parameters including blood pressure (BP), pulmonary Respiratoryinflammation function,fractionalexhalednitricoxide(FeNO)andcirculatingbiomarkerswhichreflectplateletactivation, bloodcoagulationandsystematicoxidativestressweremeasured. Results: AmbientPM2.5levelselevatedapparentlyduringPPWs. Undershampurification,significantincreasein FeNOandsolubleP-selectin(sP-selectin)anddecreasesinpulmonaryfunctionwereobservedfrompre-PPWs periodtoduring-PPWsperiod. Thechangesinhealthbiomarkersasmentionedabovebecameattenuatedand insignificant under filtered condition. For instance, sP-selectin increased by 12.0% (95% CI: 3.8%, 20.8%) during-PPWsperiodscomparedwithpre-PPWsperiodsundershampurification,whilenon-significantchange wasobservedunderfilteredcondition. Significantassociationsbetweentime-weightedpersonalPM2.5exposure andincreasedlevelsofhealthbiomarkersincludingFeNO,sP-selectin,oxidizedlow-densitylipoprotein(ox-LDL) and8-isoprostane(8-isoPGF2α)werefound. Conclusion: PPWscouldaffectcardiopulmonaryhealththroughsystematicoxidativestress,plateletactivation andrespiratoryinflammationinhealthyadults,andshort-termindoorairpurificationcouldalleviatetheadverse cardiopulmonaryeffects.","year":2020}
{"review_pmid":"41970007","record_index":2,"pmid":"10697255","title":"An evaluation of mattress encasings and high efficiency particulate filters on asthma control in the tropics.","abstract":"The effect of two allergen avoidance modalities, Allergy Control Covers (ACC) and High Efficiency Particulate Filters (HEPA) on asthma control in children were evaluated. This was an open study involving 24 dust mite sensitive asthmatic children. Following a 4 week run-in period, the subjects were randomly allocated to use mattresses fitted with ACC (n = 6), HEPA filters in their bedrooms (n = 12) or act as controls (n = 6) for a study duration of 4 months. Measurements of the major Dermatophagoides spp. mite allergens, Der p 1 and Der f 1, levels in dust samples obtained from mattresses were made at baseline, 1, 2 and 4 months post implementation. Daily symptom scores including morning and evening peak flow readings, and monthly spirometry and exercise bronchoprovocation tests were carried out Our results showed that dust mite allergen levels in mattresses fell at 1 and 2 months post implementation in the ACC group (p<0.05). In contrast, no decrease in allergen levels was seen in the HEPA and control group. At the end of the 16 weeks, only the ACC group showed improvement in FEV1 and reduction in diurnal peak expiratory flow rate (p<0.05). Improvement in mean symptom scores was also observed for both the ACC and HEPA groups, but not the control groups (p<0.05). Although the numbers in this study were small, the results Indicate that the effectiveness on mite exposure barrier covers was short-lived, and the improvement in asthma control though documented was not obvious.","year":1999}
{"review_pmid":"41970007","record_index":3,"pmid":"1789401","title":"Antonicelli-1991-Efficacy-of-an-aircleaning-device-e","abstract":null,"year":1991}
{"review_pmid":"41970007","record_index":4,"pmid":"22131290","title":"Boyle-2012-Nocturnal-temperature-controlled-la","abstract":"publishedonlineonly. Toview Objective To determine whether environmental control Key messages thesefilespleasevisitthe using nocturnal temperature controlled laminar airflow journalonline(http://thorax.bmj. com/content/67/3.toc). (TLA) treatment could improve the quality of life of < Can effective environmental control measures patients with persistent atopic asthma. 1DepartmentofPaediatrics, improve quality of life for people with asthma? ImperialCollegeLondon, Design Randomised, double-blind, placebo-controlled, < Treatment of patients with persistent atopic London,UK parallel-group trial. asthma for 1year using nocturnal temperature 2DepartmentofWomanand Setting Nineteen European asthma clinics. controlled laminar airflow improved asthmaChildHealth,Karolinska Participants312patientsaged7e70withinadequately related quality of life and reduced airway Institutet,Stockholm,Sweden controlled persistent atopic asthma. 3InstituteofEnvironmental inflammation. Medicine,KarolinskaInstitutet, MainoutcomemeasureProportionofpatientswithan < Temperaturecontrolledlaminarairflowisanew Stockholm,Sweden increase of $0.5 points in asthma quality of life score technology which may be effective for treating 4Sachs’Children’sHospital, after 1year of treatment. patients with allergic asthma. Stockholm,Sweden Results TLA devices were successfully installed in the 5DepartmentofRespiratory bedroomsof282(90%)patientsincludedintheprimary MedicineandAllergology,Lund UniversityHospital,Lund, efficacy analysis. There was a difference in treatment inhaled allergen and other particles using tempera6 S T w e e rv d e e y n staloAllergyClinic, r p e la s c p e o b n o se (5 r 6 ate of b 9 e 2 tw,6 e 1 e % n ) a g ct r i o v u e ps (1, 4 d 3 iff o e f re 1 n 8 c 9 e, 1 7 4 6. % 8% ) a ( n 9 d 5% ture-controlled laminar airflow (TLA) (personal Turku,Finland CI 3.1 to 26.5, p¼0.02).3 In patients aged $12, on communication, Dr Robin Gore, 2011). The device 7DepartmentofRespiratory distributes a filtered cooled laminar airflow, whom the study was powered, the difference in Diseases,AarhusUniversity descending from an overhead position, which Hospital,Aarhus,Denmark response rate was similar-active 106 of 143 (74%), displacesaeroallergensfromthebreathingzone. We 8ResearchInstitutefor placebo 42 of 70 (60%), difference 14.1% (0.6 to 27.7, PreventionofChildrens’Allergy p¼0.059). There was a difference between groups in undertook a phase III multicentre randomised andRespiratoryDiseases, fractional exhaled nitric oxide change of (cid:2)7.1ppb controlled trial of nocturnal TLA treatment for Marien-Hospital,Wesel, 1yeartoquantifytheeffectinpatientswithatopic Germany ((cid:2)13.6 to (cid:2)0.7, p¼0.03). Active treatment was asthma on quality of life, symptom control, lung 9AllergyCentre,University associated with less increase in cat-specific IgE than function, airway inflammation and markers of HospitalofLink¨oping,Linkoping, placebo. Therewasnodifferenceinadverseeventrates Sweden systemicallergy(specificIgEandeosinophilcount). between treatment groups. Conclusion Inhalant exposure reduction with TLA Correspondenceto ProfessorJohnOWarner, improves quality of life, airway inflammation and METHODS ProfessorofPaediatrics, systemic allergy in patients with persistent atopic Participants ImperialCollegeLondon,Wright asthma.TLAmaybeatreatmentoptionforpatientswith WeenrolledpatientswithatopicasthmainarandFlemingBuilding,NorfolkPlace, inadequately controlled persistent atopic asthma. omised, controlled, parallel-group trial of add-on LondonW21PG,UK; TrialregistrationnumberClinicalTrialsNCT00986323. treatmentwithTLAorplacebobetweenApril2008 j.o.warner@imperial.ac.uk andFebruary2009. Patientswererecruitedfrom19 Forauthorfootnoteseeendof European centres. Inclusion criteria were physithearticle. cian’s diagnosis of asthma $1year prior to study;","year":2012}
{"review_pmid":"41970007","record_index":5,"pmid":"26022815","title":"Cardiopulmonary Bene ts of Reducing Indoor Particles of Outdoor Origin","abstract":"BACKGROUND Indoorexposuretofineparticulatematter(PM )fromoutdoorsourcesisamajorhealthconcern, 2.5 especiallyinhighlypolluteddevelopingcountriessuchasChina. Fewstudieshaveevaluatedtheeffectivenessofindoor airpurificationontheimprovementofcardiopulmonaryhealthintheseareas. OBJECTIVES Thisstudysoughttoevaluatewhetherashort-termindoorairpurifierinterventionimprovescardiopulmonaryhealth. METHODS We conducted a randomized, double-blind crossover trial among 35 healthy college students in Shanghai, China, in 2014. These students lived in dormitories that were randomized into 2 groups and alternated the use of true or sham air purifiers for 48 h with a 2-week washout interval. We measured 14 circulating biomarkers of inflammation, coagulation, and vasoconstriction; lung function; blood pressure (BP); and fractional exhalednitric. Weappliedlinearmixed-effectmodelstoevaluatetheeffectoftheinterventiononhealthoutcome variables. RESULTS Onaverage,airpurificationresultedina57%reductioninPM concentration,from96.2to41.3mg/m3, 2.5 withinhoursofoperation. Airpurificationwassignificantlyassociatedwithdecreasesingeometricmeansofseveral circulatinginflammatoryandthrombogenicbiomarkers,including17.5%inmonocytechemoattractantprotein-1,68.1% ininterleukin-1b,32.8%inmyeloperoxidase,and64.9%insolubleCD40ligand. Furthermore,systolicBP,diastolicBP, andfractionalexhalednitrousoxideweresignificantlydecreasedby2.7%,4.8%,and17.0%ingeometricmean, respectively. Theimpactsonlungfunctionandvasoconstrictionbiomarkerswerebeneficialbutnotstatistically significant. CONCLUSIONS Thisinterventionstudydemonstratedclearcardiopulmonarybenefitsofindoorairpurificationamong young,healthyadultsinaChinesecitywithsevereambientparticulateairpollution.(InterventionStudyontheHealth ImpactofAirFiltersinChineseAdults;NCT02239744) (JAmCollCardiol2015;65:2279-87)©2015bytheAmerican CollegeofCardiologyFoundation. Fromthe*SchoolofPublicHealth,KeyLabofPublicHealthSafetyoftheMinistryofEducation,FudanUniversity,Shanghai, China;yShanghaiKeyLaboratoryofAtmosphericParticlePollutionandPrevention(LAP3),FudanUniversity,Shanghai,China; zKeyLabofHealthTechnologyAssessmentoftheMinistryofHealth,FudanUniversity,Shanghai,China;xEpidemiologyBranch, NationalInstitute ofEnvironmentalHealthSciences,NationalInstitutesof Health,ResearchTrianglePark,North Carolina; kDepartmentofEpidemiology,CollegeofPublicHealthandHealthProfessionalandCollegeofMedicine,UniversityofFlorida, Gainesville,Florida;andthe{InstituteofEnvironmentalHealthandRelatedProductSafety,ChineseCenterforDiseaseControl andPrevention,Beijing,China. TheNationalNaturalScienceFoundationofChina(81222036),ChinaMedicalBoardCollaboratingProgram(13-152),CyrusTangFoundation(CTF-FD2014001),andPublicWelfareResearchProgramofNationalHealth and Family Planning Commission of China (201402022)supported this study. Dr. H. Chen is supported by the intramural research program of the U.S. National Institutes of Health, National Institute of Environmental Health Sciences. All other authorshavereportedthattheyhavenorelationshipsrelevanttothecontentsofthispapertodisclose. Dr.R. ChenandMr. Zhaocontributedequallytothiswork. Listentothismanuscript’saudiosummarybyJACCEditor-in-ChiefDr. ValentinFuster. Youcanalsolistentothisissue’saudiosummarybyJACCEditor-in-ChiefDr. ValentinFuster. ManuscriptreceivedDecember20,2014;revisedmanuscriptreceivedMarch15,2015,acceptedMarch19,2015. 2280 Chenetal. JACC VOL. 65, NO. 21, 2015 AirPurifiersandCardiopulmonaryBenefits JUNE 2, 2015:2279-87 N","year":2015}
{"review_pmid":"41970007","record_index":6,"pmid":"34284317","title":"Cardiorespiratory responses in healthy young adults with exposure to indoor airborne PAEs: A randomized, crossover trial of air purification.","abstract":"BACKGROUND: Phthalic acid esters (PAEs) are widely used as plasticizers in industrial process and consumer products. Nowadays, PAEs are ubiquitous in the environment and are reported to be associated with cardiorespiratory diseases. However, studies about the association between indoor airborne PAEs exposure and cardiorespiratory health were limited, and the potential biological mechanism remains under-recognized. METHODS: A randomized crossover trial was conducted on 57 healthy young adults in Beijing. Repeated health measurements were performed under real and sham indoor air purification with a washout interval of at least 2 weeks. The concentration of indoor airborne PAEs were determined by gas chromatography-orbit ion trap mass spectrometry. Health indicators including blood pressure, lung function, airway inflammation, and circulating biomarkers reflecting blood coagulation and systematic oxidative stress were measured. Linear mixed-effect model was used to examine the between-treatment differences in health indicators, and three models including single-constituent, constituent-fine particulate matter (PM2.5) joint, and single-constituent residual model were used to estimate the association between indoor airborne PAEs and health indicators. RESULTS: The indoor airborne PAEs were reduced effectively under real air purification. The total indoor airborne di-2-ethylhexyl phthalate (DEHP), bis (4-Methyl-2-pentyl) phthalate (DMPP), diphenyl phthalate (DPP), and diethyl phthalate (DEP) were identified to be most significantly associated with the increase of blood pressure and airway inflammation, and decrease of lung function. A doubling increase in DEHP, DMPP, DPP, DEP was associated with the increase of 17.2% (95% CI: 3.9%, 32.2%), 11.7% (95% CI: 3.5%, 20.6%), 7.0% (95% CI: 2.4%, 11.8%), 6.0% (95% CI: 1.8%, 10.4%) in FeNO, respectively, in single-constituent residual model. Significant associations between specific total indoor airborne PAEs and increased levels of health biomarkers including oxidized low-density lipoprotein (ox-LDL), 8-isoprostane (8-isoPGF2α), and soluble P-selectin (sP-selectin) were observed. CONCLUSION: Indoor airborne PAEs may cause adverse cardiorespiratory health effects in young healthy adults, and indoor air purification could ameliorate the adverse cardiorespiratory effects.","year":2021}
{"review_pmid":"41970007","record_index":7,"pmid":"28645052","title":"Cardiorespiratory responses of air filtration: A randomized crossover intervention trial in seniors living in Beijing: Beijing Indoor Air Purifier StudY, BIAPSY.","abstract":"In this Beijing Indoor Air Purifier StudY (BIAPSY), we conducted a randomized crossover intervention trial in a panel of 35 non-smoking senior participants with free-living, with and without chronic obstructive pulmonary disease (COPD). Portable air filtration units were randomly allocated to active-(filter in) for 2weeks and sham-mode (filter out) for 2weeks in the households. We examined the differences in indoor air pollutant concentrations in 20 study homes and a suite of cardio-respiratory biomarker levels in study participants between filtration modes, with and without adjustment for potential confounders. Following active filtration, we observed significant reductions from 60±45 to 24±15μg/m3 in ten-day averages of indoor PM2.5 and reductions from 3.87±1.65 to 1.81±1.19m-1.10-5 in ten-day averages of indoor BC, compared to sham-mode filtration. The major components of indoor PM2.5, including water soluble organics, NO3-, SO42-, Zn2+, Pb2+ and K+, were also reduced significantly by 42% to 63%. However, following active filtration, we only observed significant reductions on systemic inflammation measured as of IL-8 at 58.59% (95% CI: -76.31, -27.64) in the total group of participants and 70.04% (95% CI: -83.05, -47.05) in the subset of COPD patients, with adjustments. We were not able to detect improvements on lung function, blood pressure, and heart rate variability, following short-term intervention of two-week active air filtration. In conclusion, our results showed that indoor air filtration produced clear improvement on indoor air quality, but no demonstrable changes in the cardio-respiratory outcomes of study interest observed in the seniors living with real-world air pollution exposures.","year":2017}
{"review_pmid":"41970007","record_index":8,"pmid":"32250418","title":"Cui-2020-Association-between-bedroom-particu","abstract":null,"year":2020}
{"review_pmid":"41970007","record_index":9,"pmid":"31473392","title":"Different cardiorespiratory effects of indoor air pollution intervention with ionization air purifier: Findings from a randomized, double-blind crossover study among school children in Beijing.","abstract":"Indoor air pollution is associated with numerous adverse health outcomes. Air purifiers are widely used to reduce indoor air pollutants. Ionization air purifiers are becoming increasingly popular for their low power consumption and noise, yet its health effects remain unclear. This randomized, double-blind crossover study is conducted to explore the cardiorespiratory effects of ionization air purification among 44 children in Beijing. Real or sham purification was performed in classrooms for 5 weekdays. Size-fractionated particulate matter (PM), black carbon (BC), ozone (O3), and negative air ions (NAI) were monitored, and cardiorespiratory functions were measured. Mixed-effect models were used to establish associations between exposures and health parameters. Real purification significantly decreased PM and BC, e.g. PM0.5, PM2.5, PM10 and BC were decreased by 48%, 44%, 34% and 50%, respectively. O3 levels were unchanged, while NAI was increased from 12 cm-3 to 12,997 cm-3. Real purification was associated with a 4.4% increase in forced exhaled volume in 1 s (FEV1) and a 14.7% decrease in fractional exhaled nitrogen oxide (FeNO). However, heart rate variability (HRV) was altered negatively. Interaction effects of NAI and PM were observed only on HRV, and alterations in HRV were greater with high NAI. Ionization air purifier could bring substantial respiratory benefits, however, the potential negative effects on HRV need further investigation.","year":2019}
{"review_pmid":"41970007","record_index":10,"pmid":"8511730","title":"Double blind trial of ionisers in children with asthma sensitive to the house dust mite.","abstract":"BACKGROUND: Manufacturers of ionisers claim many benefits from the use of their devices, including the relief of asthma. Particles removed from the air are likely to include airborne allergens, so ionisers may achieve an effect by reducing the allergen load. METHODS: The effect of ionisers on airborne concentrations of house dust mite allergen Der p I was investigated in a double blind, crossover, placebo controlled trial in the homes of 20 children with allergic asthma. Subjects recorded their peak expiratory flow rate (PEFR) twice daily and completed a daily symptom score and treatment schedule on a diary card for two six week periods, one with an active ioniser and the other with a placed ioniser (randomly allocated) used in the living room and the bedroom. RESULTS: Airborne Der p I concentrations fell significantly during the active period compared with the placebo period, but there was no significant change in PEFR, symptom scores, or treatment usage. There was an increase in night time cough which almost reached significance during the active period. CONCLUSIONS: This study indicates that the use of ionisers cannot be recommended in the homes of asthmatic subjects to improve their symptoms. The significant reduction of airborne allergen concentrations may be of use as part of a multidevice allergen avoidance regimen, but the increase in night time cough requires further study.","year":1993}
{"review_pmid":"41970007","record_index":11,"pmid":"34980119","title":"Drieling-2022-Randomized-trial-of-a-portable-hepa","abstract":"Background: Data on pediatric asthma morbidity and effective environmental interventions in U.S. agricultural settings are few. We evaluated the effectiveness of HEPA air cleaners on asthma morbidity among a cohort of rural Latino children. Methods: Seventy-five children with poorly controlled asthma and living in non-smoking homes were randomly assigned to asthma education alone or along with HEPA air cleaners placed in their sleeping area and home living room. The Asthma Control Test (ACT) score, asthma symptoms in prior 2 weeks, unplanned clinical utilization, creatinine-adjusted urinary leukotriene E4 (uLTE4 [ng/mg]), and additional secondary outcomes were evaluated at baseline, six, and 12 months. Group differences were assessed using multivariable-adjusted generalized estimating equations. Incident rate ratios of ever experiencing the metrics of poorer asthma health during follow-up (suboptimal asthma management) were estimated using Poisson regression models in secondary analysis. Results: Mean child age was 9.2 and 8.6 years in intervention and control groups, respectively, and two-thirds of participants were male. Primary analysis of repeated measures of ACT score did not differ between groups (HEPA group mean change compared to controls 10% [95% CI: 12-39%]). A suggestion of greater decrease in uLTE4 (ng/ − mg creatinine) was observed ( 10% [95% CI: 20 -1%]). Secondary analysis showed children with HEPAs were less − − likely to have an ACT score meeting a clinically defined cutoff for poorly controlled asthma using repeated measures (IRR: 0.45 [95% CI: 0.21-0.97]). In Poisson models, intervention participants had reduced risk of ever meeting this cutoff (IRR: 0.43 [95% CI: 0.21-0.89]), ever having symptoms in the past 2 weeks (IRR: 0.71 [95% CI: 0.52-0.98]), and lower risk of any unplanned clinical utilization (IRR: 0.35 [95% CI: 0.13-0.94]) compared to control participants. Discussion: The HAPI study showed generally improved outcomes among children in the HEPA air cleaner group. However, primary analyses did not meet statistical significance and many outcomes were subjective (self-report) in this unblinded study, so findings must be interpreted cautiously. HEPA air cleaners may provide additional benefit for","year":2022}
{"review_pmid":"41970007","record_index":12,"pmid":"27723364","title":"Effectiveness of air purifier on health outcomes and indoor particles in homes of children with allergic diseases in Fresno, California: A pilot study.","abstract":"OBJECTIVE: Epidemiologic studies indicate that indoor air pollution is correlated with morbidity caused by allergic diseases. We evaluated the effectiveness of reducing the levels of indoor fine particulate matter <2.5 micrometer diameter (PM2.5) in Fresno, California using air purifiers on health outcomes in children with asthma and/or allergic rhinitis. METHODS: The active group (with air purifiers) and the control group consisted of eight houses each. Air purifiers were installed in the living rooms and bedrooms of the subjects in the active group during the entire 12-week study duration. Childhood asthma control test, peak flow rate monitoring, and nasal symptom scores were evaluated at weeks 0, 6, and 12. RESULTS: At 12 weeks, the active group showed a trend toward an improvement of childhood asthma control test scores and mean evening peak flow rates, whereas the control group showed deterioration in the same measures. Total and daytime nasal symptoms scores significantly reduced in the active group (p = 0.001 and p = 0.011, respectively). The average indoor PM2.5 concentrations reduced by 43% (7.42 to 4.28 μg/m3) in the active group (p = 0.001). CONCLUSIONS: Intervention with air purifiers reduces indoor PM2.5 levels with significant improvements in nasal symptoms in children with allergic rhinitis in Fresno.","year":2017}
{"review_pmid":"41970007","record_index":13,"pmid":null,"title":"Effects of Reducing Indoor Air Particles on Cardiovascular and Respiratory Physiological Indexes in the Elderly：a","abstract":null,"year":2023}
{"review_pmid":"41970007","record_index":14,"pmid":null,"title":"Firefox about:blank 1 από 13 5 / 4 / 25, 4:52 µ.µ. Firefox about:blank 2 από 13 5 / 4 / 25, 4:52 µ.µ. Firefox about:blank 3 από 13 5 / 4 / 25, 4:52 µ.µ.","abstract":null,"year":2025}
{"review_pmid":"41970007","record_index":15,"pmid":"34476917","title":"Jia-ying-2021-Efficacy-of-air-purifier-therapy-fo","abstract":"air purifier; Objectives: This study aimed to evaluate the efficacy of air purifier therapy for patients with allergic asthma; allergic asthma. fractional exhaled Methods: Thirty-eight subjects were categorized under two groups namely treatment nitric oxide; group and control group. All subjects were under 18 years of age and they had been clinihouse dust mite; cally diagnosed with allergic asthma. The treatment group used high efficiency particulate particulate matter air (HEPA) purifiers for six consecutive months, and the control group did not use the air filters. Particulate matter (PM) data and dust samples (from bedding and a static point) were collected from the subjects’ bedrooms before they started using the air purifiers and each month thereafter. Simultaneously, the subjects were asked to complete a questionnaire for the Asthma Control Test (ACT) or Childhood Asthma Control Test (C-ACT). Fractional exhaled nitric oxide (FENO) tests were performed at the start and end of the study. The concentrations of Der p1 and Der f1 were measured in the dust samples. Results: (1) After utilizing the air purifier, the concentrations of house dust mite (HDM) allergens (Der p1+ Der f1) in the dust samples decreased. In addition, the PM indoor/outdoor values significantly decreased. (2) The ACT and C-ACT scores in the treatment group maintained a steady significant upward trend. (3) At the end of the study, the FENO levels in both groups were lower, although the differences were not significant. Conclusions: It is witnessed that HEPA air purifiers can decrease indoor HDM allergen and PM levels and improve the quality of life for allergic asthma patients.","year":2021}
{"review_pmid":"41970007","record_index":16,"pmid":"31232684","title":"Kapoor-2019-Nocturnal-temperature-controlled-la","abstract":null,"year":2019}
{"review_pmid":"41970007","record_index":17,"pmid":"32233173","title":"Lee-2020-Effects-of-indoor-air-purifiers-on-","abstract":"Purpose: To evaluate the effects of air purifiers on the concentrations of indoor air pollutants and on asthma control in children. Materials and Methods: In this randomized crossover trial, daily use of an air purifier filter was compared with a matched placebo with the filter off. Thirty elementary school students who had asthma were enrolled and randomly allocated to one of two groups. The primary endpoints were changes in indoor air quality, asthma severity, lung function, airway inflammatory, urine microbiome, and phthalate after the installation of air purifiers. PM and CO were measured as indoor air pollutants. Asthma severi2.5 2 ty was assessed in terms of both symptom and medication scores acquired using a daily questionnaire. The higher the score, the better the symptom or the less frequent the use of medication. Peak expiratory flow rate and fractional exhaled nitric oxide were also measured. Results: The mean age of the enrolled patients was 9.2±1.98 years. The mean concentration of PM was 17.0 μg/m3 in the filter2.5 off condition, but significantly lower at 9.26 μg/m3 in the filter-on condition. Medication scores were 6.9 for the filter-off and 7.12 for the filter-on conditions, reflecting a statistically significant decrease in the frequency of medications used during air purifier operation. Bacterial richness, as determined using the Chao 1 index, was markedly lower in the filter-on than the filter-off condition. Conclusion: This study suggests that air purifiers benefit medication burden in children with asthma by reducing PM levels. 2.5","year":2020}
{"review_pmid":"41970007","record_index":18,"pmid":"32058675","title":"Li-2020-Efficacy-of-indoor-air-purification","abstract":"Zi-Feng Yang, State Key Laboratory of Respiratory Diseases, Guangzhou Objectives: To evaluate the clinical efficacy of a high-efficiency air purifier in patients Institute of Respiratory Disease, National with allergic rhinitis. Clinical Centre of Respiratory Disease, The First Affiliated Hospital, Guangzhou Design: We conducted a randomised, double-blind, clinical controlled trial with active Medical University, 151 Yanjiang Xi Road, and inactive versions of an air purifier. Our study included patients with allergic rhiGuangzhou 510120, China; State Key Laboratory of Quality Research in Chinese nitis who were sensitive to Artemisia pollen and treatment of the indoor environment Medicines, Macau University of Science and using air filtration at night. We evaluated the clinical efficacy of indoor air filtration Technology, Macau, China. Email: jeffyah@163.com during the Artemisia pollen scattering season in Yulin City in Shanxi Province, China. Qiao-Yan Chen, Guangdong Provincial Setting: The First Hospital of Yulin (Yulin City, Shanxi Province, China). Hospital of Chinese Medicine, The Second Participants: A total of 90 patients with allergic rhinitis who were sensitive to allergens Affiliated Hospital, Guangzhou University of Chinese Medicine, 111 Dade Road, of Artemisia pollen were randomly assigned to one of two groups in equal numbers. Guangzhou 510120, China. Main outcome measures: The primary outcome measure was the difference in visual Email: christinecqy@163.com analogue scale scores from baseline. Secondary outcomes were changes from baseFunding information line in nasal symptoms, allergy symptom scores, responses to the Rhinoconjunctivitis The Technical Research and Development Program Project in 2016, Grant/Award Quality of Life Questionnaire, Epworth Sleepiness Scale scores and tolerability Number: [2017]54 scores for the air purifier. Results: Based on the allergy symptom score, we found significant differences in rhinitis symptoms between the groups who used the active versus the inactive air purifier. Conclusions: The results of our investigation demonstrated the health benefits of particle filtration. Li and Chen are co-first authors.","year":2020}
{"review_pmid":"41970007","record_index":19,"pmid":"32757287","title":"Liu-2021-Negative-ions-offset-cardiorespirat","abstract":"Architecture, Tsinghua University, Beijing, China Negative ion air purifiers (NIAPs), as a less costly alternative to the HEPA filtration, 2Beijing Key Lab of Indoor Air Quality have been increasingly deployed in China and potentially elsewhere. While reducEvaluation and Control, Beijing, China ing indoor concentrations of fine particulate matter (PM ), NIAPs generate massive 3Institute for Health and Environment, 2.5 Chongqing University of Science and amounts of negative ions that may be of health concern. We performed week-long Technology, Chongqing, China interventions with NIAPs in the dormitories of 56 healthy college students living in 4Department of Occupational and Beijing. In a randomized order, each student underwent a true and a sham NIAP sesEnvironmental Health Sciences, School of Public Health, Peking University, Beijing, sion. Cardiorespiratory outcomes were measured before and after each session. The China use of true NIAPs reduced indoor PM concentrations significantly, while notably 5Global Health Institute & Nicholas School 2.5 of the Environment, Duke University, increased negative ion levels. Increases in PM and negative ion (NI) exposure were 2.5 Durham, NC, USA independently associated with increased urinary concentration of malondialdehyde, 6Duke Kunshan University, Kunshan, China a biomarker of systemic oxidative stress, resulting in a null net effect of NIAP on 7Institute of Building Environment and Energy, China Academy of Building malondialdehyde. Likewise, no significant net effects of NIAPs were observed for Research, Beijing, China other outcomes indicative of lung function, vascular tone, arterial stiffness, and inCorrespondence flammation. Our findings suggest that negative ions, possibly along with their reacJunfeng (Jim) Zhang, Global Health Institute, tion products with the room air constituents, adversely affect health. The downsides Nicholas School of the Environment, Duke University, 308 Research Dr, LSRC Room do not support the use of NIAPs as a health-based mitigation strategy to reduce A309, Durham, NC 27708-0328, USA. PM exposure, especially in residences with PM concentrations that are not exEmail: junfeng.zhang@duke.edu 2.5 2.5 tremely high. Yinping Zhang, Department of Building Science, Tsinghua University, Beijing","year":2021}
{"review_pmid":"41970007","record_index":20,"pmid":"32734732","title":"Park-2020-Effects-of-air-purifiers-on-patient","abstract":"Purpose: Exposure to particulate matter (PM) is a well-known risk factor in the triggering and exacerbation of allergic airway disease. Indoor environments, where people spend most of their time, are of utmost importance. To assess the effects of air purifiers [equipped with high-efficiency particulate air (HEPA) filters] on allergic rhinitis (AR) in adult patients, we performed a multicenter, randomized, double-blind, and placebo-controlled study. Materials and Methods: Patients with house dust mite (HDM)-induced AR were randomly assigned to either active or mockup (placebo) air-purification groups. Two air purifiers (placed in living room and bedroom) were operated for 6 weeks in each home environment. The primary study endpoint was to achieve improvement in AR symptoms and medication scores. Secondary endpoints were to achieve improvement in the quality of life (QoL) and visual analog scale (VAS) scores, as well as in the indoor (bedroom and living room) concentrations of PM and PM. 2.5 10 Results: After 6 weeks of air purifier use, medication scores improved significantly in the active (vs. placebo) group, although subjective measures (symptoms, VAS, and QoL scores) did not differ. Bedroom PM concentrations initially exceeded living room or 2.5 outdoor levels, but declined (by up to 51.8%) following active purifier operation. Concentrations of PM in living room and PM 2.5 10 in bedroom and living room were also significantly reduced through active purification. Conclusion: The use of air purifiers with HEPA filters significantly reduced medication requirements for patients with HDM-induced AR and significantly lowered indoor PM concentrations, regardless of room placement. Active intervention to reduce 2.5 household air pollutants may help improve allergic airway disease (clinicaltrials.gov NCT03313453).","year":2020}
{"review_pmid":"41970007","record_index":21,"pmid":"34449285","title":"Randomized Clinical Trial of Air Cleaners to Improve Indoor Air Quality and Chronic Obstructive Pulmonary Disease Health: Results of the CLEAN AIR Study.","abstract":"Rationale: Indoor particulate matter is associated with worse chronic obstructive pulmonary disease (COPD) outcomes. It remains unknown whether reductions of indoor pollutants improve respiratory morbidity. Objectives: To determine whether placement of active portable high-efficiency particulate air cleaners can improve respiratory morbidity in former smokers. Methods: Eligible former smokers with moderate-to-severe COPD received active or sham portable high-efficiency particulate absolute air cleaners and were followed for 6 months in this blinded randomized controlled trial. The primary outcome was 6-month change in St. George's Respiratory Questionnaire (SGRQ). Secondary outcomes were exacerbation risk, respiratory symptoms, rescue medication use, and 6-minute-walk distance (6MWD). Intention-to-treat analysis included all subjects, and per-protocol analysis included adherent participants (greater than 80% use of air cleaner). Measurements and Main Results: A total of 116 participants were randomized, of which 84.5% completed the study. There was no statistically significant difference in total SGRQ score, but the active filter group had greater reduction in SGRQ symptom subscale (β, -7.7 [95% confidence interval (CI), -15.0 to -0.37]) and respiratory symptoms (Breathlessness, Cough, and Sputum Scale, β, -0.8 [95% CI, -1.5 to -0.1]); and lower rate of moderate exacerbations (incidence rate ratio, 0.32 [95% CI, 0.12-0.91]) and rescue medication use (incidence rate ratio, 0.54 [95% CI, 0.33-0.86]) compared with sham group (all P < 0.05). In per-protocol analysis, there was a statistically significant difference in primary outcome between the active filter versus sham group (SGRQ, β -4.76 [95% CI, -9.2 to -0.34]) and in moderate exacerbation risk, Breathlessness, Cough, and Sputum Scale, and 6MWD. Participants spending more time indoors were more likely to have treatment benefit. Conclusions: This is the first environmental intervention study conducted among former smokers with COPD showing potential health benefits of portable high-efficiency particulate absolute air cleaners, particularly among those with greater adherence and spending a greater time indoors.","year":2022}
{"review_pmid":"41970007","record_index":22,"pmid":"34325134","title":"Reducing particulates in indoor air can improve the circulation and cardiorespiratory health of old people: A randomized, double-blind crossover trial of air filtration.","abstract":"Exposure to indoor air particulate pollution increases respiratory and cardiovascular morbidity and mortality, especially in the elderly. To assess a short-term, indoor air filtration's potential benefit on circulatory and cardiopulmonary health among healthy older people, a randomized, double-blind crossover trial was conducted with 24 healthy residents of an aged-care center in Chongqing, China in 2020. Each room received a high-efficiency particulate air filter air purifier and a placebo air purifier for two days. Fifteen circulatory system biomarkers of inflammation, coagulation, and oxidative stress; lung function; blood pressure (BP); heart rate (HR) and fractional exhaled nitric oxide (FeNO) were measured end of each two days. Indoor air particulate pollution was monitored throughout the study period. Linear mixed-effect models were used to associate health outcome variables with indoor particles. This intervention study demonstrated that air filtration was associated with significantly decreased concentrations of inflammatory and coagulation biomarkers, but not of biomarkers of oxidative stress and lung function. Just 48 h of air filtration can improve the cardiopulmonary health of the elderly. Air purifiers may be a public health measure that can be taken to improve circulatory and cardiopulmonary health among older people.","year":2021}
{"review_pmid":"41970007","record_index":23,"pmid":"34265631","title":"The health effects of wearing facemasks on cardiopulmonary system of healthy young adults: A double-blinded, randomized crossover trial.","abstract":"BACKGROUND: Facemask had increasingly been utilized as a personal protective measure to reduce exposure to ambient particulate matter (PM) during heavily-polluted days and routine life. However, evidence on the potential effects on cardiovascular system by wearing particulate-filtering facemask was limited. METHODS: We conducted a double-blinded randomized crossover trial (RCT) to evaluate the effects of wearing N95 facemasks on the molecular responses of cardiopulmonary system among 52 healthy college students in Beijing, China. We measured cardiopulmonary health indicators and collected biological samples before and after (up to 5 h at multiple time points) a 2-h walk to examine the changes in lung function, biomarkers of respiratory and systemic oxidative stress/inflammation. We applied linear mixed-effect models to evaluate the effect of the facemask-intervention on the health of cardio-pulmonary system. RESULTS: In the trial wearing real facemasks, FEV1 increased by 2.05% (95% CI: 0.27%-3.87%), 2.80% (95% CI: 1.00%-4.63%), and 2.87% (95% CI: 1.07%-4.70%) at V1 (30-min), V2 (3-h), and V3 (5-h) after the 2-h walk outsides, respectively. Compared with participants wearing the sham mask, the percentage change of nitrate in EBC was lower among those wearing the real mask. After the 2-h exposure, urinary MDA levels increased compared to the baseline in both trials. Real trial was lower than sham trial for 6 cytokines (i.e., IL-6, IL-10, IL-13, IL-17A, IFN-γ and TNF-α) in serum at 5-h post-exposure. Wearing facemasks on polluted days produced better improvement, however, on cleaner days, the improvement was weaker. CONCLUSIONS: Short-term use of N95 facemasks appeared to effectively reduce the levels of lung function declines, the respiratory oxidative stress, and the systemic inflammation/oxidative stress which may be induced by short-term exposure to PM. Wearing facemasks on polluted days (PM2.5 > 75 μg/m3) presented larger beneficial effects on the cardiopulmonary health than in clean days (PM2.5 < 75 μg/m3).","year":2021}
{"review_pmid":"41970007","record_index":24,"pmid":"42421135","title":"Effects of combined low-dose caffeine and taurine on anaerobic, neuromuscular, and cognitive performance: a double-blind randomized placebo-controlled crossover study.","abstract":"This study investigated the acute effects of low-dose caffeine (2 mg·kg⁻1) and taurine (10 mg·kg⁻1), administered alone and in combination, on anaerobic, neuromuscular, and cognitive performance in trained male athletes. Thirty-two participants, each with at least two years of consistent resistance training (≥ 3 sessions·week⁻1), completed experimental trials using a double-blind, randomized, placebo-controlled crossover design following ingestion of caffeine, taurine, a caffeine-taurine combination, or placebo. Combined caffeine and taurine supplementation resulted in higher handgrip strength values compared to placebo [p = 0.044; d = 0.51, small effect] and greater average power than caffeine alone [p = 0.006; d = 0.64, moderate effect] and placebo [p = 0.001; d = 0.91, moderate effect]. Taurine supplementation alone did not significantly affect performance outcomes. No statistically significant differences were observed among conditions for peak power, cognitive performance, ratings of perceived exertion, or blood lactate concentrations (p > 0.05). Overall, these findings suggest that co-ingestion of low-dose caffeine and taurine may provide modest improvements in selected neuromuscular and anaerobic performance outcomes without affecting cognitive, perceptual, or metabolic responses. Trial registrationClinicalTrials.gov, NCT07466654, registered on 06/03/2026. Retrospectively registered.","year":2026}
{"review_pmid":"41970007","record_index":25,"pmid":"34491046","title":"Pulmonary Benefits of Intervention with Air Cleaner among Schoolchildren in Beijing: A Randomized Double-Blind Crossover Study.","abstract":"We conducted a crossover study employing air cleaner intervention among 125 schoolchildren aged 9-12 years in a boarding school in Beijing, China. The PM concentrations were monitored, and 27 biomarkers were analyzed. We used the linear mixed-effects model to evaluate the association of intervention/time-weighted PM concentrations with biomarkers. The outcomes showed that air cleaner intervention was associated with FeNO, exhaled breath condensate (EBC) IL-1β, and IL-6, which decreased by 12.57%, 10.83%, and 4.33%, respectively. Similar results were observed in the associations with PMs. Lag 1 day PMs had the strongest relationship with biomarkers, and significant changes were observed in biomarkers such as FEV1, FeNO, EBC 8-iso, and MCP-1. Boys showed higher percentage changes than girls, and the related biomarkers were FeNO, EBC 4-HNE, IL-1β, IL-6, and MCP-1. The results showed that biomarkers such as FeNO, EBC IL-6, MCP-1, and 4-HNE could sensitively reflect the early abnormal response of the respiratory system under short-term PM exposure among healthy schoolchildren and indicated that (1) air cleaners exert a protective effect on children's respiratory system. (2) PM had lag and cumulative effect, lag 1 day had the greatest effect. (3) The boys were more sensitive than the girls.","year":2022}
{"review_pmid":"42003421","record_index":1,"pmid":"35662954","title":"Chronic Consumption of Cranberries (Vaccinium macrocarpon) for 12 Weeks Improves Episodic Memory and Regional Brain Perfusion in Healthy Older Adults: A Randomised, Placebo-Controlled, Parallel-Groups Feasibility Study.","abstract":"BACKGROUND: Ageing is highly associated with cognitive decline and modifiable risk factors such as diet are believed to protect against this process. Specific dietary components and in particular, (poly)phenol-rich fruits such as berries have been increasingly recognised for their protection against age-related neurodegeneration. However, the impact of cranberries on cognitive function and neural functioning in older adults remains unclear. DESIGN: A 12-week parallel randomised placebo-controlled trial of freeze-dried cranberry powder was conducted in 60 older adults aged between 50 and 80 years. Cognitive assessment, including memory and executive function, neuroimaging and blood sample collection were conducted before and after the intervention to assess the impact of daily cranberry consumption on cognition, brain function and biomarkers of neuronal signalling. RESULTS: Cranberry supplementation for 12 weeks was associated with improvements in visual episodic memory in aged participants when compared to placebo. Mechanisms of action may include increased regional perfusion in the right entorhinal cortex, the accumbens area and the caudate in the cranberry group. Significant decrease in low-density lipoprotein (LDL) cholesterol during the course of the intervention was also observed. No significant differences were, however, detected for BDNF levels between groups. CONCLUSIONS: The results of this study indicate that daily cranberry supplementation (equivalent to 1 small cup of cranberries) over a 12-week period improves episodic memory performance and neural functioning, providing a basis for future investigations to determine efficacy in the context of neurological disease. This trial was registered at clinicaltrials.gov as NCT03679533 and at ISRCTN as ISRCTN76069316.","year":2022}
{"review_pmid":"42003421","record_index":2,"pmid":"25904733","title":"Cranberry juice consumption lowers markers of cardiometabolic risk, including blood pressure and circulating C-reactive protein, triglyceride, and glucose concentrations in adults.","abstract":"BACKGROUND: Cardiometabolic risk is the risk of cardiovascular disease (CVD), diabetes, or stroke, which are leading causes of mortality and morbidity worldwide. OBJECTIVE: The objective of this study was to determine the potential of low-calorie cranberry juice (LCCJ) to lower cardiometabolic risk. METHODS: A double-blind, placebo-controlled, parallel-arm study was conducted with controlled diets. Thirty women and 26 men (mean baseline characteristics: 50 y; weight, 79 kg; body mass index, 28 kg/m(2)) completed an 8-wk intervention with LCCJ or a flavor/color/energy-matched placebo beverage. Twice daily volunteers consumed 240 mL of LCCJ or the placebo beverage, containing 173 or 62 mg of phenolic compounds and 6.5 or 7.5 g of total sugar per 240-mL serving, respectively. RESULTS: Fasting serum triglycerides (TGs) were lower after consuming LCCJ and demonstrated a treatment × baseline interaction such that the participants with higher baseline TG concentrations were more likely to experience a larger treatment effect (1.15 ± 0.04 mmol/L vs. 1.25 ± 0.04 mmol/L, respectively; P = 0.027). Serum C-reactive protein (CRP) was lower for individuals consuming LCCJ than for individuals consuming the placebo beverage [ln transformed values of 0.522 ± 0.115 ln(mg/L) vs. 0.997 ± 0.120 ln(mg/L), P = 0.0054, respectively, and equivalent to 1.69 mg/L vs. 2.71 mg/L back-transformed]. LCCJ lowered diastolic blood pressure (BP) compared with the placebo beverage (69.2 ± 0.8 mm Hg for LCCJ vs. 71.6 ± 0.8 mm Hg for placebo; P = 0.048). Fasting plasma glucose was lower (P = 0.03) in the LCCJ group (5.32 ± 0.03 mmol/L) than in the placebo group (5.42 ± 0.03 mmol/L), and LCCJ had a beneficial effect on homeostasis model assessment of insulin resistance for participants with high baseline values (P = 0.035). CONCLUSION: LCCJ can improve several risk factors of CVD in adults, including circulating TGs, CRP, and glucose, insulin resistance, and diastolic BP. This trial was registered at clinicaltrials.gov as NCT01295684.","year":2015}
{"review_pmid":"42003421","record_index":3,"pmid":null,"title":"Cranberry Supplement and Metabolic Risk Factors in Obese and Overweight Females","abstract":"Background: Duetothehighersusceptibilityofmetabolicsyndrome(MS)-afflictedpatientstodifferentmetabolicabnormalities, treatmentprogramsarevitalpartsofMSmanagement. Oneofthepossibleadjunctivetherapiesistakingcranberrysupplements asimportantsourcesofpolyphenolsthatbearantioxidativeandhealth-promotingproperties. Objectives: Theaimofthisstudywastoevaluatetheeffectofcranberryextractonsomecomponentsofmetabolicsyndrome. PatientsandMethods: Inarandomized,double-blindplacebo-controlledclinicaltrial,48obeseandoverweightfemalesdiagnosedwithMSwereassignedintotwogroupstoreceivecranberrysupplementorplaceboforaneight-weekperiod. Serumglucose, lipoproteins,inflammatorymarkersandbloodpressurewereevaluatedatthebaselineandattheendofthetreatmentphase. Results: Cranberrysupplementshadnoeffectonanyofthevariablesincludingglucose,insulin,malondialdehyde(MDA),highsensitiveC-reactiveprotein(hs-CRP),interleukin-6(IL-6),andbloodpressure,exceptforhigh-densitylipoproteincholesterol(HDLc),whichsignificantlyincreased(P<0.05)attheeighth-weekperiodcomparedwiththeplacebosamples. Conclusions: TheresultsofthepresentstudyrevealedthatcranberrysupplementmightonlyamelioratelowHDL-casacomponent ofmetabolicsyndrome,andnottheotherriskfactorsofMS.","year":2016}
{"review_pmid":"42003421","record_index":4,"pmid":"21411615","title":"Effects of cranberry juice consumption on vascular function in patients with coronary artery disease.","abstract":"BACKGROUND: Cranberry juice contains polyphenolic compounds that could improve endothelial function and reduce cardiovascular disease risk. OBJECTIVE: The objective was to examine the effects of cranberry juice on vascular function in subjects with coronary artery disease. DESIGN: We completed an acute pilot study with no placebo (n = 15) and a chronic placebo-controlled crossover study (n = 44) that examined the effects of cranberry juice on vascular function in subjects with coronary artery disease. RESULTS: In the chronic crossover study, subjects with coronary heart disease consumed a research preparation of double-strength cranberry juice (54% juice, 835 mg total polyphenols, and 94 mg anthocyanins) or a matched placebo beverage (480 mL/d) for 4 wk each with a 2-wk rest period between beverages. Beverage order was randomly assigned, and participants refrained from consuming other flavonoid-containing beverages during the study. Vascular function was measured before and after each beverage, with follow-up testing ≥12 h after consumption of the last beverage. Mean (±SD) carotid-femoral pulse wave velocity, a measure of central aortic stiffness, decreased after cranberry juice (8.3 ± 2.3 to 7.8 ± 2.2 m/s) in contrast with an increase after placebo (8.0 ± 2.0 to 8.4 ± 2.8 m/s) (P = 0.003). Brachial artery flow-mediated dilation, digital pulse amplitude tonometry, blood pressure, and carotid-radial pulse wave velocity did not change. In the uncontrolled pilot study, we observed improved brachial artery flow-mediated dilation (7.7 ± 2.9% to 8.7 ± 3.1%, P = 0.01) and digital pulse amplitude tonometry ratio (0.10 ± 0.12 to 0.23 ± 0.16, P = 0.001) 4 h after consumption of a single 480-mL portion of cranberry juice. CONCLUSIONS: Chronic cranberry juice consumption reduced carotid femoral pulse wave velocity-a clinically relevant measure of arterial stiffness. The uncontrolled pilot study suggested an acute benefit; however, no chronic effect on measures of endothelial vasodilator function was found. This trial was registered at clinicaltrials.gov as NCT00553904.","year":2011}
{"review_pmid":"42003421","record_index":5,"pmid":"23351409","title":"Evidence that cranberry juice may improve augmentation index in overweight men.","abstract":"The stiffening of arteries is a key step in atherogenesis leading to cardiovascular disease. It has been suggested that dietary polyphenols may be cardioprotective through possible favorable effects on oxidative stress and vascular function. The present study was undertaken in order to examine the effect of consuming low-calorie cranberry juice cocktail (CJC), a source of polyphenols, on arterial stiffness in abdominally obese men. We hypothesize that regular CJC consumption will reduce circulating oxidized low-density lipoproteins concentrations and have a beneficial impact on endothelial function. Thirty-five men (mean age ± SD: 45 ± 10 years) were randomly assigned to drink 500 mL CJC/day (27% juice) or 500 mL placebo juice (PJ)/day for 4 weeks in a double-blind crossover design. Augmentation index (AIx), an index of arterial stiffness, was measured by applanation tonometry of the radial artery and the cardiometabolic profile was assessed in each participant before and after each phase of the study. We found no significant difference in AIx changes between men who consumed CJC or PJ for 4 weeks (P =.5820). Furthermore, there was no between-treatment difference in changes in AIx responses to salbutamol (P =.6303) and glyceryl trinitrate (P =.4224). No significant difference was noted in other cardiometabolic variables between men consuming PJ or CJC. However, a significant within group decrease in AIx (mean decrease ± SE; -14.0 ± 5.8%, P =.019) was noted following the consumption of 500 mL CJC/day for 4 weeks. Our results indicate that the effect of chronic consumption of CJC on AIx was not significantly different from changes associated with the consumption of PJ. However, the significant within-group decrease in AIx following CJC consumption in abdominally obese men may deserve further investigation.","year":2013}
{"review_pmid":"42003421","record_index":6,"pmid":null,"title":"Flammer-2013-Polyphenol-rich-cranberry-juice-has","abstract":"Results Baseline characteristics were similar in both Purpose Cranberryjuice(CJ)containsaremarkablyhigh groups. TheeffectofCJonperipheralendothelialfunction concentrationofpolyphenols,consideredtobebeneficialfor and on circulating EPC counts (CD34?/CD133?/KDR?) cardiovascular and bone health. The current double-blind, did not change during the study. A high percentage of randomized study was designed to test whether daily con- EPCs expressed osteocalcin (59.4 ± 35.7%). CJ, as comsumption of double-strength Ocean Spray light CJ pared to placebo, induced a decrease in the fraction of (2 9 230 ml) over 4 months has beneficial effects on vas- EPCs expressing osteocalcin (-8.64 ± 48.98 and cular function and on endothelial progenitor cells (EPCs) 19.13 ± 46.11%,respectively,p = 0.019). Systemiclevels carryingtheosteoblasticmarkerosteocalcininparticular. oftheadhesionmarkerICAMcorrelatedsignificantlywith Methods Atotalof84participants(49.5 ± 16.2 years)with the number of EPCs expressing osteocalcin. peripheral endothelial dysfunction and cardiovascular risk Conclusions The study demonstrated that long-term factorswereenrolledinthisdouble-blind,randomized,con- supplementation of polyphenol-rich CJ did not improve trolledtrial(69completedthe4-monthprotocol-32intheCJ peripheral endothelial function. However, the decrease in group and 37 in the placebo group, respectively). Vascular the fraction of osteocalcin? EPCs suggests a potential responses to reactive hyperemia were measured non-inva- beneficial effect of polyphenol-rich CJ. sivelybyperipheralarterialtonometry(EndoPAT). Peripheral blood mononuclear cells were stained for EPC markers, Keywords Endothelial function (cid:2) Cranberry (cid:2) aswellasosteocalcin,andcountedbyflowcytometry. Polyphenols (cid:2) Endothelial progenitor cells (cid:2) Osteocalcin TrialRegistration: ClinicalTrials.gov:NCT00631306.","year":2013}
{"review_pmid":"42003421","record_index":7,"pmid":"32301407","title":"Hsia-2020-Effect-of-daily-consumption-of-cran","abstract":"Cranberriesarehighinpolyphenols,andepidemiologicalstudieshaveshownthatahigh-polyphenoldietmayreduceriskfactorsfordiabetes and CVD. The present study aimed to determine if short-term cranberry beverage consumption would improve insulin sensitivity and othercardiovascularriskfactors. Thirty-fiveindividualswithobesityandwithelevatedfastingglucoseorimpairedglucosetoleranceparticipated inarandomised,double-blind,placebo-controlled,parallel-designedpilottrial. Participantsconsumed450mloflow-energycranberrybeverage orplacebodailyfor8weeks. Changesininsulinsensitivityandcardiovascularriskfactorsincludingvascularreactivity,bloodpressure,RMR, glucose tolerance, lipid profiles and oxidative stress biomarkers were evaluated. Change in insulin sensitivity via hyperinsulinaemiceuglycaemic clamp was not different between the two groups. Levels of 8-isoprostane (biomarker of lipid peroxidation) decreased in the cranberrygroupbutincreasedintheplacebogroup(-2·18v.þ20·81pg/ml;P=0·02). WhenstratifiedbybaselineC-reactiveprotein(CRP) levels,participantswithhighCRPlevels(>4mg/l)benefitedmorefromcranberryconsumption. Inthisgroup,significantdifferencesinthe meanchangefrombaselinebetweenthecranberry(n10)andtheplacebogroups(n7)inlevelsofTAG(-13·75v.þ10·32%;P=0·04),nitrate (þ3·26v.−6·28μmol/l;P=0·02)and8-isoprostane(þ0·32v.þ30·8pg/ml;P=0·05)wereobserved. Thesefindingsindicatethat8weeksof dailycranberrybeverageconsumptionmaynotimpactinsulinsensitivitybutmaybehelpfulinloweringTAGandchangingcertainoxidative stressbiomarkersinindividualswithobesityandaproinflammatorystate.","year":2020}
{"review_pmid":"42003421","record_index":8,"pmid":"19046248","title":"Lee-2008-Effect-of-cranberry-extracts-on-lip","abstract":"Aim To examine the effect of cranberry ingestion on lipid profiles in Type 2 diabetic patients taking oral glucose-lowering drugs. Methods Thirty Type 2 diabetic subjects (16 males and 14 females; mean age 65 ± 1 years) who were taking oral glucoselowering medication regularly were enrolled in this randomized, placebo-controlled, double-blind study. Changes in lipid profiles, oxidized low-density lipoprotein (ox-LDL), glycaemic control, components of the metabolic syndrome, C-reactive protein (CRP) and urinary albumin excretion (UAE) were assessed after cranberry or placebo treatment for 12 weeks. Results Low-density lipoprotein (LDL) cholesterol decreased significantly in the cranberry group (from 3.3 ± 0.2 to 2.9 ± 0.2 mmol/l, P = 0.005) and the decrease was significantly greater than that in the placebo group (-0.4 ± 0.1 vs. 0.2 ± 0.1 mmol/l, P < 0.001). Total cholesterol and total: high-density lipoprotein (HDL) cholesterol ratio also decreased significantly (P = 0.020 and 0.044, respectively) in the cranberry group and the reductions were significantly different from those in the placebo group (P < 0.001 and P = 0.032, respectively). However, ox-LDL levels did not change significantly in response to cranberry consumption. Neither fasting glucose nor glycated haemoglobin improved in either group. Changes in components of the metabolic syndrome, UAE and CRP were not significantly different between groups. Conclusions Cranberry supplements are effective in reducing atherosclerotic cholesterol profiles, including LDL cholesterol and total cholesterol levels, as well as total: HDL cholesterol ratio, and have a neutral effect on glycaemic control in Type 2 diabetic subjects taking oral glucose-lowering agents. Diabet. Med. 25, 1473-1477 (2008)","year":2008}
{"review_pmid":"42003421","record_index":9,"pmid":"21481712","title":"Low-energy cranberry juice decreases lipid oxidation and increases plasma antioxidant capacity in women with metabolic syndrome.","abstract":"Cranberries, high in polyphenols, have been associated with several cardiovascular health benefits, although limited clinical trials have been reported to validate these findings. We tested the hypothesis that commercially available low-energy cranberry juice (Ocean Spray Cranberries, Inc, Lakeville-Middleboro, Mass) will decrease surrogate risk factors of cardiovascular disease, such as lipid oxidation, inflammation, and dyslipidemia, in subjects with metabolic syndrome. In a randomized, double-blind, placebo-controlled trial, participants identified with metabolic syndrome (n = 15-16/group) were assigned to 1 of 2 groups: cranberry juice (480 mL/day) or placebo (480 mL/day) for 8 weeks. Anthropometrics, blood pressure measurements, dietary analyses, and fasting blood draws were conducted at screen and 8 weeks of the study. Cranberry juice significantly increased plasma antioxidant capacity (1.5 ± 0.6 to 2.2 ± 0.4 μmol/L [means ± SD], P <.05) and decreased oxidized low-density lipoprotein and malondialdehyde (120.4 ± 31.0 to 80.4 ± 34.6 U/L and 3.4 ± 1.1 to 1.7 ± 0.7 μmol/L, respectively [means ± SD], P <.05) at 8 weeks vs placebo. However, cranberry juice consumption caused no significant improvements in blood pressure, glucose and lipid profiles, C-reactive protein, and interleukin-6. No changes in these parameters were noted in the placebo group. In conclusion, low-energy cranberry juice (2 cups/day) significantly reduces lipid oxidation and increases plasma antioxidant capacity in women with metabolic syndrome.","year":2011}
{"review_pmid":"42003421","record_index":10,"pmid":"34798892","title":"Masnadi-shirazi-2021-Effect-of-cranberry-supplementation","abstract":"Background: We aimed to evaluate the effect of cranberry supplementation on serum liver enzymes, hepatic steatosis, and cardiometabolic risk factors in patients with non-alcoholic fatty liver (NAFLD). Methods: In the present parallel-designed randomized controlled clinical trial, 110 patients with NAFLD were enrolled. The patients were randomized to receive 144 mg cranberry capsule or placebo for 6 months. The primary efficacy of the treatment was lipid profile, glycemic measurements, and liver enzyme levels. Results: The data were reported for 46 in the supplementation group and 48 in the placebo group. The patient’s mean (SD) age was 43.16 (11.08) years. No significant differences between groups were observed regarding the post-intervention level of liver enzyme. The mean after-intervention levels of total cholesterol (p < 0.001) and triglyceride (p 0.01) were significantly lower in the intervention group compared with the placebo group. At the end of = the study, the mean insulin and HOMA-IR levels were significantly lower in the cranberry group compared with the placebo group. Significantly more patients in the cranberry group experienced a decrease in steatosis level compared with the control group. Conclusion: The results of the present study showed that cranberry supplementation had a positive effect on some lipid profiles, insulin resistance, and hepatic steatosis in patients with NAFLD.","year":2021}
{"review_pmid":"42003421","record_index":11,"pmid":"34444779","title":"Richter-2021-Effects-of-cranberry-juice-suppleme","abstract":"Emerging cardiovascular disease (CVD) risk factors, including central vascular function and HDL efflux, may be modifiable with food-based interventions such as cranberry juice. A randomized, placebo-controlled, crossover trial was conducted in middle-aged adults with overweight/obesity (n = 40; mean BMI: 28.7 0.8 kg/m2; mean age: 47 2 years) and elevated brachial blood pressure (mean systolic/diastolic BP: 124 2/81 1 mm Hg). Study participants consumed 500 mL/d of cranberry juice (~16 fl oz; 27% cranberry juice) or a matched placebo juice in a randomized order (8-week supplementation periods; 8-week compliance break), with blood samples and vascular measurements obtained at study entry and following each supplementation period. There was no significant treatment effect of cranberry juice supplementation on the primary endpoint of central systolic blood pressure or central or brachial diastolic pressure. Cranberry juice significantly reduced 24-h diastolic ambulatory BP by ~2 mm Hg compared to the placebo (p = 0.05) during daytime hours. Cranberry juice supplementation did not alter LDL-C but significantly changed the composition of the lipoprotein profile compared to the placebo, increasing the concentration of large LDL-C particles (+29.5 vs. -6.7 nmol/L; p = 0.02) and LDL size (+0.073 vs. -0.068 nm; p = 0.001). There was no effect of treatment on ex vivo HDL efflux in the total population, but exploratory subgroup analyses identified an interaction between BMI and global HDL efflux (p = 0.02), with greater effect of cranberry juice in participants who were overweight. Exploratory analyses indicate that baseline C-reactive protein (CRP) values may moderate treatment effects. In this population of adults with elevated blood pressure, cranberry juice supplementation had no significant effect on central systolic blood pressure but did have modest effects on 24-h diastolic ambulatory BP and the lipoprotein profile. Future studies are needed to verify these findings and the results of our exploratory analyses related to baseline health moderators.","year":2021}
{"review_pmid":"42003421","record_index":12,"pmid":"17381122","title":"Biosafety, antioxidant status, and metabolites in urine after consumption of dried cranberry juice in healthy women: a pilot double-blind placebo-controlled trial.","abstract":"This study assessed the effect of an 8 week consumption of dried cranberry juice (DCJ) on 65 healthy young women. Basic biochemical and hematological parameters, antioxidant status, presence of metabolites in urine, and urine ex vivo antiadherence activity were determined throughout the trial. A 400 mg amount of DCJ/day had no influence on any parameter tested. A 1200 mg amount of DCJ/day resulted in a statistically significant decrease in serum levels of advanced oxidation protein products. This specific protective effect against oxidative damage of proteins is described here for the first time. Urine samples had an inhibitory effect on the adhesion of uropathogenic Escherichia coli strains, but no increase in urine acidity was noted. Hippuric acid, isomers of salicyluric and dihydroxybenzoic acids, and quercetin glucuronide were identified as the main metabolites. In conclusion, cranberry fruits are effective not only in the prevention of urinary tract infection but also for the prevention of oxidative stress.","year":2007}
{"review_pmid":"42015424","record_index":1,"pmid":"29030343","title":"Carbohydrate restriction with postmeal walking effectively mitigates postprandial hyperglycemia and improves endothelial function in type 2 diabetes.","abstract":"Postprandial hyperglycemia has deleterious effects on endothelial function. Restricting carbohydrate intake and postmeal walking have each been shown to reduce postprandial hyperglycemia, but their combination and subsequent effects on endothelial function have not been investigated. Here, we sought to examine the effect of blunting postprandial hyperglycemia by following a low-carbohydrate diet, with or without postmeal walking exercise, on markers of vascular health in type 2 diabetes (T2D). In a randomized crossover design, individuals with T2D ( n = 11) completed three 4-day controlled diet interventions consisting of 1) low-carbohydrate diet alone (LC), 2) low-carbohydrate diet with 15-min postmeal walks (LC + Ex), and 3) low-fat control diet (CON). Fasting blood samples and brachial artery flow-mediated dilation (%FMD) were measured before and after each intervention. Total circulating microparticles (MPs), endothelial MPs, platelet MPs, monocyte-platelet aggregates, and adhesion molecules were assessed as biomarkers of vascular health. There was a significant condition × time interaction for %FMD ( P = 0.01), with post hoc tests revealing improved %FMD after LC + Ex (+0.8 ± 1.0%, P = 0.02), with no change after LC or CON. Endothelial MPs were significantly reduced with the LC diet by ~45% (from 99 ± 60 to 44 ± 31 MPs/μl, P = 0.02), with no change after LC + Ex or CON (interaction: P = 0.04). Total MPs were lower (main effect time: P = 0.02), whereas monocyte-platelet aggregates were higher (main effect time: P < 0.01) after all interventions. Plasma adhesion molecules and C-reactive protein were unaltered. Attenuating postprandial hyperglycemic excursions using a low-carbohydrate diet combined with postmeal walking appears to be an effective strategy to improve endothelial function in individuals with T2D. NEW & NOTEWORTHY Carbohydrate restriction and postmeal walking lower postprandial hyperglycemia in individuals with type 2 diabetes. Here, we show that the combination significantly improved endothelial function and that carbohydrate restriction alone reduced circulating endothelial microparticles in individuals with type 2 diabetes. Listen to this article's corresponding podcast at http://ajpheart.podbean.com/e/low-carb-diet-and-exercise-improve-endothelial-health/.","year":2018}
{"review_pmid":"42015424","record_index":2,"pmid":"18046594","title":"Comparison of low fat and low carbohydrate diets on circulating fatty acid composition and markers of inflammation.","abstract":"Abnormal distribution of plasma fatty acids and increased inflammation are prominent features of metabolic syndrome. We tested whether these components of metabolic syndrome, like dyslipidemia and glycemia, are responsive to carbohydrate restriction. Overweight men and women with atherogenic dyslipidemia consumed ad libitum diets very low in carbohydrate (VLCKD) (1504 kcal:%CHO:fat:protein = 12:59:28) or low in fat (LFD) (1478 kcal:%CHO:fat:protein = 56:24:20) for 12 weeks. In comparison to the LFD, the VLCKD resulted in an increased proportion of serum total n-6 PUFA, mainly attributed to a marked increase in arachidonate (20:4n-6), while its biosynthetic metabolic intermediates were decreased. The n-6/n-3 and arachidonic/eicosapentaenoic acid ratio also increased sharply. Total saturated fatty acids and 16:1n-7 were consistently decreased following the VLCKD. Both diets significantly decreased the concentration of several serum inflammatory markers, but there was an overall greater anti-inflammatory effect associated with the VLCKD, as evidenced by greater decreases in TNF-alpha, IL-6, IL-8, MCP-1, E-selectin, I-CAM, and PAI-1. Increased 20:4n-6 and the ratios of 20:4n-6/20:5n-3 and n-6/n-3 are commonly viewed as pro-inflammatory, but unexpectedly were consistently inversely associated with responses in inflammatory proteins. In summary, a very low carbohydrate diet resulted in profound alterations in fatty acid composition and reduced inflammation compared to a low fat diet.","year":2008}
{"review_pmid":"42015424","record_index":3,"pmid":"22036100","title":"Differential effects of low-carbohydrate and low-fat diets on inflammation and endothelial function in diabetes.","abstract":"OBJECTIVE: To characterize acute (postprandial) and chronic (after a 6-month period of weight loss) effects of a low-carbohydrate vs. a low-fat diet on subclinical markers of cardiovascular disease (CVD) in adults with type 2 diabetes. DESIGN: At baseline and 6 months, measures of C-reactive protein (CRP), interleukin-6 (IL-6), soluble intercellular adhesion molecule (sICAM) and soluble E-selectin were obtained from archived samples (n = 51) of participants randomized in a clinical trial comparing a low-carbohydrate and a low-fat diet. In a subset of participants (n = 27), postprandial measures of these markers were obtained 3 h after a low-carbohydrate or low-fat liquid meal. Endothelial function was also measured by reactive hyperemic peripheral arterial tonometry during the meal test. Paired t tests and unpaired t tests compared within- and between-group changes. RESULTS: There were no significant differences observed in postprandial measures of inflammation or endothelial function. After 6 months, CRP (mean ± S.E.) decreased in the low-fat arm from 4.0 ± 0.77 to 3.0 ± 0.77 (P =.01). In the low-carbohydrate arm, sICAM decreased from 234 ± 22 to 199 ± 23 (P =.001), and soluble E-selectin decreased from 93 ± 10 to 82 ± 10 (P =.05.) A significant correlation between change in high-density lipoprotein and change in soluble E-selectin (r = -0.33, P =.04) and with the change in ICAM (r = -0.43, P =.01) was observed. CONCLUSIONS: Low-carbohydrate and low-fat diets both have beneficial effects on CVD markers. There may be different mechanisms through which weight loss with these diets potentially reduces CVD risk.","year":2011}
{"review_pmid":"42015424","record_index":4,"pmid":"23404297","title":"Effects of high-protein versus high-carbohydrate diets on markers of β-cell function, oxidative stress, lipid peroxidation, proinflammatory cytokines, and adipokines in obese, premenopausal women without diabetes: a randomized controlled trial.","abstract":"OBJECTIVE: To study the effects of high-protein versus high-carbohydrate diets on various metabolic end points (glucoregulation, oxidative stress [dichlorofluorescein], lipid peroxidation [malondialdehyde], proinflammatory cytokines [tumor necrosis factor-α and interleukin-6], adipokines, and resting energy expenditure [REE]) with high protein-low carbohydrate (HP) and high carbohydrate-low protein (HC) diets at baseline and after 6 months of dietary intervention. RESEARCH DESIGN AND METHODS: We recruited obese, premenopausal women aged 20-50 years with no diabetes or prediabetes who were randomized to HC (55% carbohydrates, 30% fat, and 15% protein) or HP (40% carbohydrates, 30% fat, and 30% protein) diets for 6 months. The diets were provided in prepackaged food, which provided 500 kcal restrictions per day. The above metabolic end points were measured with HP and HC diet at baseline and after 6 months of dietary intervention. RESULTS: After 6 months of the HP versus HC diet (12 in each group), the following changes were significantly different by Wilcoxon rank sum test for the following parameters: dichlorofluorescein (-0.8 vs. -0.3 µmol/L, P < 0.0001), malondialdehyde (-0.4 vs. -0.2 μmol/L, P = 0.0004), C-reactive protein (-2.1 vs. -0.8 mg/L, P = 0.0003), E-selectin (-8.6 vs. -3.7 ng/mL, P = 0.0007), adiponectin (1,284 vs. 504 ng/mL, P = 0.0011), tumor necrosis factor-α (-1.8 vs. -0.9 pg/mL, P < 0.0001), IL-6 (-1.3 vs. -0.4 pg/mL, P < 0.0001), free fatty acid (-0.12 vs. 0.16 mmol/L, P = 0.0002), REE (259 vs. 26 kcal, P < 0.0001), insulin sensitivity (4 vs. 0.9, P < 0.0001), and β-cell function (7.4 vs. 2.1, P < 0.0001). CONCLUSIONS: To our knowledge, this is the first report on the significant advantages of a 6-month hypocaloric HP diet versus hypocaloric HC diet on markers of β-cell function, oxidative stress, lipid peroxidation, proinflammatory cytokines, and adipokines in normal, obese females without diabetes.","year":2013}
{"review_pmid":"42015424","record_index":5,"pmid":"18326593","title":"Effects of weight loss from a very-low-carbohydrate diet on endothelial function and markers of cardiovascular disease risk in subjects with abdominal obesity.","abstract":"BACKGROUND: The effects of a very-low-carbohydrate, high-saturated-fat weight-loss diet (LC) on brachial artery flow-mediated dilatation (FMD) and markers of endothelial function are unknown. OBJECTIVE: The effect of an LC on markers of endothelial function and cardiovascular disease (CVD) risk was compared with that of an isocaloric high-carbohydrate, low-saturated-fat diet (HC). DESIGN: FMD and markers of endothelial function (n = 70) and CVD risk were measured before and after 8 wk of weight loss. Ninety-nine subjects aged 50.0 +/- 8.3 y with a body mass index (in kg/m2) of 33.7 +/- 4.1 completed the study. RESULTS: Mean (+/-SD) FMD did not change significantly (P = 0.55) with either diet. Pulse wave velocity improved with both diets (P < 0.01). Endothelial markers, E- and P selectin, intracellular and cellular-adhesion molecule-1, tissue-type plasminogen activator, and plasminogen activator inhibitor-1 decreased (P < 0.001), with no diet effect. Adiponectin did not change significantly. More weight (P = 0.05 for diet x time interaction) and more abdominal fat mass (P = 0.05 for diet x time interaction) were lost with the LC than with the HC. LDL cholesterol decreased more with the HC than with the LC (P < 0.05, time x diet), and C-reactive protein decreased more with the HC than with the LC (P < 0.05 for diet x time interaction). Homocysteine increased more with the LC (P < 0.01 for diet x time interaction). Folate decreased with the LC and increased with the HC (P < 0.05, time; P < 0.001 for diet x time interaction). CONCLUSION: An LC does not impair FMD. We observed beneficial effects of both diets on most of the CVD risk factors measured. This trial was registered with the Australian Clinical Trials Registry as ACTR N0 12606000203550.","year":2008}
{"review_pmid":"42015424","record_index":6,"pmid":"15007396","title":"Long-term effects of a high-protein, low-carbohydrate diet on weight control and cardiovascular risk markers in obese hyperinsulinemic subjects.","abstract":"OBJECTIVE: To compare the long-term compliance and effects of two low-fat diets differing in carbohydrate to protein ratio on body composition and biomarkers of cardiovascular disease risk in obese subjects with hyperinsulinemia. DESIGN: Outpatient, parallel, clinical intervention study of two groups of subjects randomly assigned to either a standard protein (SP; 15% protein, 55% carbohydrate) or high-protein (HP; 30% protein, 40% carbohydrate) diet, during 12 weeks of energy restriction (approximately 6.5 MJ/day) and 4 weeks of energy balance (approximately 8.3 MJ/day). Subsequently, subjects were asked to maintain the same dietary pattern for the succeeding 52 weeks with minimal professional support. SUBJECTS: A total of 58 obese, nondietetic subjects with hyperinsulinemia (13 males/45 females, mean age 50.2 y, mean body mass index (BMI) 34.0 kg/m2, mean fasting insulin 17.8 mU/l) participated in the study. MEASUREMENTS:: Body composition, blood pressure, blood lipids, fasting glucose, insulin, CRP and sICAM-1 were measured at baseline and at weeks 16 and 68. Urinary urea/creatinine ratio was measured at baseline, week 16 and at 3 monthly intervals thereafter. RESULTS: In total, 43 subjects completed the study with similar dropouts in each group (P=0.76). At week 68, there was net weight loss (SP -2.9+/-3.6%, HP -4.1+/-5.8%; P<0.44) due entirely to fat loss (P<0.001) with no diet effect [corrected]. Both diets significantly increased HDL cholesterol concentrations (P<0.001) and decreased fasting insulin, insulin resistance, sICAM-1 and CRP levels (P<0.05). Protein intake was significantly greater in HP during the initial 16 weeks (P<0.001), but decreased in HP and increased in SP during 52-week follow-up, with no difference between groups at week 68, indicating poor long-term dietary adherence behaviour to both dietary patterns. CONCLUSION: Without active ongoing dietary advice, adherence to dietary intervention is poor. Nonetheless, both dietary patterns achieved net weight loss and improvements in cardiovascular risk factors.","year":2004}
{"review_pmid":"42015424","record_index":7,"pmid":"35010908","title":"Randomized Clinical Trial to Evaluate the Morphological Changes in the Adventitial Vasa Vasorum Density and Biological Markers of Endothelial Dysfunction in Subjects with Moderate Obesity Undergoing a Very Low-Calorie Ketogenic Diet.","abstract":"Weight loss after bariatric surgery decreases the earlier expansion of the adventitial vasa vasorum (VV), a biomarker of early atheromatous disease. However, no data are available regarding weight loss achieved by very low calorie ketogenic diets (VLCKD) on VV and lipid-based atherogenic indices. A randomized clinical trial was performed to examine changes in adventitial VV density in 20 patients with moderate obesity who underwent a 6-month very low calorie ketogenic diet (VLCKD, 600-800 kcal/day), and 10 participants with hypocaloric diet based on the Mediterranean Diet (MedDiet, estimated reduction of 500 kcal on the usual intake). Contrast-enhanced carotid ultrasound was used to assess the VV. Body composition analysis was also used. The atherogenic index of plasma (log (triglycerides to high-density lipoprotein cholesterol ratio)) and the triglyceride-glucose index were calculated. Serum concentrations of soluble intercellular adhesion molecule 1 (sICAM-1), and soluble vascular cell adhesion molecule 1 (sVCAM-1) were measured. The impact of weight on quality of life-lite (IWQOL-Lite) questionnaire was administered. Participants of intervention groups displayed a similar VV values. Significant improvements of BMI (-5.3 [-6.9 to -3.6] kg/m2, p < 0.001), total body fat (-7.0 [-10.7 to -3.3] %, p = 0.003), and IWQOL-Lite score (-41.4 [-75.2 to -7.6], p = 0.027) were observed in VLCKD group in comparison with MedDiet group. Although after a 6-months follow-up period VV density (mean, right and left sides) did not change significantly in any group, participants in the VLCKD exhibited a significantly decrease both in their atherogenic index of plasma and serum concentration of sICAM-1. A 6-month intervention with VLCKD do not impact in the density of the adventitial VV in subjects with moderate obesity, but induces significant changes in markers of endothelial dysfunction and CV risk.","year":2021}
{"review_pmid":"42015424","record_index":8,"pmid":"15265001","title":"Weight loss leads to reductions in inflammatory biomarkers after a very-low-carbohydrate diet and a low-fat diet in overweight men.","abstract":"In recent years, it has become apparent that low-grade vascular inflammation plays a key role in all stages of the pathogenesis of atherosclerosis. Weight loss has been shown to improve blood inflammatory markers; however, it is unknown if weight-loss diets varying in macronutrient composition differentially affect inflammatory responses. The primary purpose of the present study was to compare a very-low-carbohydrate diet and a low-fat weight-loss diet on inflammatory biomarkers in overweight men. In a randomized cross-over design, 15 overweight men (body fat, >25%; body mass index, 34 kg/m2) consumed two experimental weight-loss diets for two consecutive 6-week periods: a very-low-carbohydrate diet (<10% energy via carbohydrate) and a low-fat diet (<30% energy via fat). Both the low-fat and the very-low-carbohydrate diets resulted in significant decreases in absolute concentrations of hsTNF-alpha (high-sensitivity tumour necrosis factor-alpha), hsIL-6 (high-sensitivity interleukin-6), hsCRP (high-sensitivity C-reactive protein) and sICAM-1 (soluble intercellular cell-adhesion molecule-1). There was no significant change in absolute sP-selectin (soluble P-selectin) concentrations after either diet. Normalized inflammatory values represented as the delta change per 1 kg reduction in body mass showed a significant difference between the two diets only for sP-selectin (P<0.05). In summary, energy-restricted low-fat and very-low-carbohydrate diets both significantly decreased several biomarkers of inflammation. These data suggest that, in the short-term, weight loss is primarily the driving force underlying the reductions in most of the inflammatory biomarkers.","year":2004}
{"review_pmid":"42032055","record_index":1,"pmid":"22316315","title":"Comparison of vaginal gel isoflavones versus no topical treatment in vaginal dystrophy: results of a preliminary prospective study.","abstract":"OBJECTIVE: Vaginal dystrophy due to hypo-oestrogenism takes advantage of local and systemic oestrogens to balance the vaginal ecosystem and improve tissue hydration. Women who do not accept/tolerate hormone therapy can use intravaginal isoflavones to relieve vaginal dryness. The aim of this study was to investigate the clinical effect of a vaginal gel formulation containing isoflavones compared with no topical treatment in women with vaginal dystrophy. MATERIAL AND METHODS: In a multicentre, controlled, parallel-group study, menopausal women with vaginal dystrophy were randomized to vaginal gel (EG) or no topical treatment (NT) for 4 weeks. EG contained isoflavones, Lactobacillus sporogenes, Calendula officinalis extract and lactic acid (Estromineral Gel, Rottapharm-Madaus). All patients received daily oral isoflavones plus L. sporogenes. Clinical evaluations were performed at time 0, 2 and 4 weeks. RESULTS: 186 women were recruited, 103 in the EG group and 83 in the NT group, mean age 53.7 years, postmenopausal for 4.1 years. The severity of itching, burning, vulvovaginal erythema, vaginal dryness and dyspareunia were significantly reduced during EG treatment compared with the NT group. CONCLUSIONS: The combination of oral and topical isoflavones was shown to be more effective than oral treatment alone in reducing the problems of postmenopausal vaginal dystrophy.","year":2012}
{"review_pmid":"42032055","record_index":2,"pmid":"19031218","title":"Effect of Trifolium pratense-derived isoflavones on the lipid profile of postmenopausal women with increased body mass index.","abstract":"BACKGROUND: Since current clinical evidence indicates that conventional estrogen hormone therapy (HT) increases cardiovascular risk, alternatives to estrogens are growing in popularity, especially among high-risk populations. OBJECTIVE: To determine the effect of Trifolium pratense-derived isoflavone supplementation on the lipid profile of postmenopausal women with increased body mass index (BMI). METHODS: Sixty postmenopausal women aged > 40 years, HT non-users, were randomly assigned to one of two groups: either two capsules of T. pratense (80 mg red clover isoflavones) daily for a 90-day period or placebo of equal design. After a 7-day washout period, medication was crossed-over for another 90 days. Total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C) and lipoprotein A (LpA) levels were assessed at baseline, 90 and 180 days. Women were divided into two groups: those with increased BMI (>or=25 kg/m(2)) and those with BMI < 25 kg/m(2). RESULTS: Fifty-three women (88.3%) completed the trial. T. pratense isoflavone supplementation had a positive effect on the lipid profile of women with increased BMI, evidenced by a significant decrease in TC, LDL-C and LpA levels. CONCLUSIONS: Isoflavones derived from T. pratense are an attractive alternative therapeutic option for high-risk populations such as postmenopausal women with increased BMI and abnormal lipid profile.","year":2008}
{"review_pmid":"42032055","record_index":3,"pmid":"19411814","title":"Effect of high-dose isoflavones on cognition, quality of life, androgens, and lipoprotein in post-menopausal women.","abstract":"CONTEXT: Recent interventional studies indicate that post-menopausal hormone replacement therapy is associated with an increased risk of cardiovascular mortality and breast cancer. Isoflavones, a class of plant estrogens, have structural similarities to estradiol. Hence, isoflavones may exert beneficial estrogenic health effects in postmenopausal women with fewer adverse effects. OBJECTIVE: To evaluate the effect of high-dose isoflavones on self-reported quality of life (QOL), cognition, lipoproteins and androgen status in post-menopausal women. DESIGN AND SUBJECTS: Double-blind, randomized, placebo-controlled, 12-week trial of 93 healthy, ambulatory, post-menopausal women (mean age 56 yr). The study was conducted at a tertiary care center in the United States. INTERVENTION: Participants were randomly assigned to receive 20 g of soy protein containing 160 mg of total isoflavones vs taste-matched placebo (20 g whole milk protein). Both soy and the placebo were provided in the form of a powder to be mixed with beverages. MAIN OUTCOME MEASURES: QOL was judged by the Menopause-specific Quality of Life (MENQOL) questionnaire while cognitive function was assessed with standard instruments. Total, free, and bioavailable testosterone, gonadotropins, SHBG, and fasting lipids were measured. RESULTS: Eighty-four women (90%) completed the study (active=38, placebo=46). There was a significant improvement in all 4 QOL subscales (vasomotor, psychosexual, physical, and sexual) among the women taking isoflavones, while no changes were seen in the placebo group. No significant changes in cognition, serum androgens or plasma lipids were seen within any of the groups. However, at the end of the study, a group-by-time interaction was observed such that total testosterone and HDL levels were significantly lower in the isoflavones compared to placebo groups. CONCLUSION: High-dose isoflavones is associated with improved QOL among women who have become menopausal recently. Hence, the timing of isoflavone supplementation with regards to the onset of menopause appears to be important. The use of isoflavones, as an alternative to estrogen therapy, may be potentially useful and seemingly safe in this group of women who are looking for relief from menopausal symptoms.","year":2009}
{"review_pmid":"42032055","record_index":4,"pmid":"25423326","title":"Effects of a soy-based dietary supplement compared with low-dose hormone therapy on the urogenital system: a randomized, double-blind, controlled clinical trial.","abstract":"OBJECTIVE: This study aims to compare the effects of a soy-based dietary supplement, low-dose hormone therapy (HT), and placebo on the urogenital system in postmenopausal women. METHODS: In this double-blind, randomized, placebo-controlled trial, 60 healthy postmenopausal women aged 40 to 60 years (mean time since menopause, 4.1 y) were randomized into three groups: a soy dietary supplement group (90 mg of isoflavone), a low-dose HT group (1 mg of estradiol plus 0.5 mg of norethisterone), and a placebo group. Urinary, vaginal, and sexual complaints were evaluated using the urogenital subscale of the Menopause Rating Scale. Vaginal maturation value was calculated. Transvaginal sonography was performed to evaluate endometrial thickness. Genital bleeding pattern was assessed. Statistical analysis was performed using χ(2) test, Fisher's exact test, paired Student's t test, Kruskal-Wallis test, Kruskal-Wallis nonparametric test, and analysis of variance. For intergroup comparisons, Kruskal-Wallis nonparametric test (followed by Mann-Whitney U test) was used. RESULTS: Vaginal dryness improved significantly in the soy and HT groups (P = 0.04). Urinary and sexual symptoms did not change with treatment in the three groups. After 16 weeks of treatment, there was a significant increase in maturation value only in the HT group (P < 0.01). Vaginal pH decreased only in this group (P < 0.01). There were no statistically significant differences in endometrial thickness between the three groups, and the adverse effects evaluated were similar. CONCLUSIONS: This study shows that a soy-based dietary supplement used for 16 weeks fails to exert estrogenic action on the urogenital tract but improves vaginal dryness.","year":2015}
{"review_pmid":"42032055","record_index":5,"pmid":"26806546","title":"Impact of a soy drink on climacteric symptoms: an open-label, crossover, randomized clinical trial.","abstract":"OBJECTIVES: The objective of this study is to evaluate the effects of a soy drink with a high concentration of isoflavones (ViveSoy®) on climacteric symptoms. METHODS: An open-label, controlled, crossover clinical trial was conducted in 147 peri- and postmenopausal women. Eligible women were recruited from 13 Spanish health centers and randomly assigned to one of the two sequence groups (control or ViveSoy®, 500 mL per day, 15 g of protein and 50 mg of isoflavones). Each intervention phase lasted for 12 weeks with a 6-week washout period. Changes on the Menopause Rating Scale and quality of life questionnaires, as well as lipid profile, cardiovascular risk and carbohydrate and bone metabolism were assessed. Statistical analysis was performed using a mixed-effects model. RESULTS: A sample of 147 female volunteers was recruited of which 90 were evaluable. In both sequence groups, adherence to the intervention was high. Regular consumption of ViveSoy® reduced climacteric symptoms by 20.4% (p = 0.001) and symptoms in the urogenital domain by 21.3% (p < 0.05). It also improved health-related quality life by 18.1%, as per the MRS questionnaire (p <0.05). CONCLUSION: Regular consumption of ViveSoy® improves both the somatic and urogenital domain symptoms of menopause, as well as health-related quality of life in peri- and postmenopausal women.","year":2016}
{"review_pmid":"42032055","record_index":6,"pmid":"28351156","title":"Long-term exercise training and soy isoflavones to improve quality of life and climacteric symptoms.","abstract":"OBJECTIVE: To verify the efficacy of phytoestrogen supplementation combined with aerobic and resistance training on the improvement of climacteric symptoms and health-related quality of life (HRQoL) in postmenopausal women. METHODS: From a pool of women who had participated in a 1-year intervention study and were randomly assigned to either exercise + phytoestrogen (EX + PHY) or exercise + placebo (EX + PL), a total of 31 healthy but overweight women (mean age 59.2 ± 4.8 years, body mass index 29.1 ± 3.5 kg/m2) finished the study (EX + PHY, n = 15; EX + PL, n = 16). All the following variables were measured before, after 6 months and after 12 months of intervention: body composition (fat and lean body mass, DXA), HRQoL (SF-36 questionnaire: physical and mental component summaries and subscales; and the 10-item Perceived Stress Scale questionnaire), climacteric symptoms (Kupperman Index questionnaire). RESULTS: After 1 year of intervention, physical functioning (p = 0.003), role-emotional (p = 0.031), vitality (p = 0.007), and global health (p < 0.001) were significantly and similarly increased in both groups. Regarding climacteric symptoms, an improvement in the Kupperman index total score (p = 0.015) was observed. CONCLUSION: Our results demonstrate that adding phytoestrogens to exercise training does not provide the additive effect for HRQoL in postmenopausal and overweight women. Moreover, exercise and phytoestrogen may interfere in the improvement of climacteric symptoms in the long term.","year":2017}
{"review_pmid":"42032055","record_index":7,"pmid":"26294070","title":"Low-dose isoflavone aglycone alleviates psychological symptoms of menopause in Japanese women: a randomized, double-blind, placebo-controlled study.","abstract":"PURPOSE: Many studies have demonstrated the effectiveness of isoflavones on menopausal symptoms; however, these mostly used high dosages. Because high-dose isoflavone may result in endometrial hyperplasia, we investigated whether low-dose isoflavone aglycone alleviates menopausal symptoms similarly to high dosages. METHODS: We conducted a randomized, double-blind, placebo-controlled study in 90 healthy women aged 40-60 years who had at least one menopausal symptom on the Menopausal Symptom Scale (MSS). The participants were randomized to receive active tablets containing ultralow-dose (12.5 mg/day; n = 30) or low-dose (25 mg/day; n = 30) isoflavone aglycone, or placebo (n = 30) tablets, for 8 weeks. Their menopausal symptoms were evaluated using MSS, Hospital Anxiety and Depression Scale (HADS), and Athens Insomnia Scale (AIS) before, and 4 and 8 weeks after treatment. RESULTS: Eighty-seven women (97 %) completed the 8-week treatment. In the low-dose group, significant improvement was observed from baseline, in the following parameters: (1) HADS-depression subscale score, (2) AIS score, (3) MSS-somatic symptom score after 4 and 8 weeks of treatment, and (4) MSS-vasomotor symptom score after 8 weeks of treatment. The changes in scores on HADS-depression subscale and AIS from baseline to 8 weeks were significantly higher in the low-dose group than in the placebo group. CONCLUSIONS: Low-dose (25 mg/day) isoflavone aglycone significantly alleviated symptoms of depression and insomnia in Japanese middle-aged women. Clinical Trial Registration UMIN-CTR UMIN000011876.","year":2016}
{"review_pmid":"42032055","record_index":8,"pmid":null,"title":"Randomized controlled trial of whole soy and isoflavone daidzein on menopausal symptoms in equol-producing Chinese postm","abstract":null,"year":2014}
{"review_pmid":"42032055","record_index":9,"pmid":"30889093","title":"The effect of a randomized 12-week soy drink intervention on everyday mood in postmenopausal women.","abstract":"OBJECTIVE: Dietary soy may improve menopausal symptoms, and subsequently mediate mood. This novel study examines various doses of dietary soy drink on everyday mood stability and variability in postmenopausal women. METHODS: Community-dwelling women (n = 101), within 7 years postmenopause, consumed daily either a low (10 mg, n = 35), medium (35 mg, n = 37), or high (60 mg, n = 29) dose of isoflavones, for 12 weeks. Menopausal symptoms and repeated measures of everyday mood (positive [PA] and negative [NA] affect) (assessed at four time points per day for 4 consecutive days, using The Positive and Negative Affect Schedule) were completed at baseline and follow-up. RESULTS: The dietary soy intervention had no effect on everyday mood stability (for PA [F{2,70} = 0.95, P = 0.390] and NA [F{2,70} = 0.72, P = 0.489]) or variability (for PA [F{2,70} = 0.21, P = 0.807] and for NA [F{2,70} = 0.15, P = 0.864]), or on menopausal symptoms (for vasomotor [F{2,89} = 2.83, P = 0.064], psychological [F{2,88} = 0.63, P = 0.535], somatic [F{2,89} = 0.32, P = 0.729], and total menopausal symptoms [F{2,86} = 0.79, P = 0.458]). There were between-group differences with the medium dose reporting higher PA (low, mean 24.2, SD 6; and medium, mean 29.7, SD 6) and the low dose reporting higher NA (P = 0. 048) (low, mean 11.6, SD 2; and high, mean 10.6, SD 1) in mood scores. Psychological (baseline M = 18 and follow-up M = 16.5) and vasomotor (baseline M = 4.2 and follow-up M = 3.6) scores declined from baseline to follow-up for the overall sample. CONCLUSIONS: Soy isoflavones had no effect on mood at any of the doses tested. Future research should focus on the menopause transition from peri to postmenopause as there may be a window of vulnerability, with fluctuating hormones and increased symptoms which may affect mood.","year":2019}
{"review_pmid":"42032055","record_index":10,"pmid":"16297576","title":"The effect of a soy-rich diet on urogenital atrophy: a randomized, cross-over trial.","abstract":"OBJECTIVE: To evaluate the effect of a soy-rich diet on urogenital symptoms, vaginal health index, and vaginal cytology in perimenopausal and postmenopausal women. MATERIALS AND METHODS: Thirty-six perimenopausal and postmenopausal women (mean age 52.5+/-5.1 years) participated in a randomized, cross-over trial with two 12-week diet periods and two 4-week washout periods before and between treatments. The study diet consisted of a control diet (soy-free diet) and an isocaloric soy-rich diet (25 g soy protein in various forms of soy food containing more than 50 mg/day of isoflavones substituted for an equivalent amount of animal protein). Subjects were assessed for urogenital symptoms, vaginal health index, vaginal pH and vaginal cytology. The single physician and the single cytopathologist were blinded with regard to onset, period and randomization number. Statistical analyses were performed using paired t-test or Wilcoxon Signed Ranks Test, significance was set as P<0.05. RESULTS: Good compliance to the diet was shown by the significant elevation of serum levels of daidzein and genistein during the soy-rich diet period. The symptoms of urge incontinence and vaginal dryness had significantly increased after 12-week of soy-free diet. All other urogenital symptoms did not change in both periods. The vaginal health index, the vaginal pH, the karyopyknotic index, and the maturation value were not significantly changed in both periods. CONCLUSION: A soy-rich diet did not relieve the urogenital symptoms or restore the vaginal epithelium or improve the vaginal health in perimenopausal and postmenopausal Thai women.","year":2006}
{"review_pmid":"42032055","record_index":11,"pmid":"11910617","title":"The effects of soy protein containing phytoestrogens on menopausal symptoms in postmenopausal women","abstract":"Objective Toanalyzetheimpactofsoyproteindietarysupplementscontainingphytoestrogens on menopausal symptoms in healthy postmenopausal women. Methods A double-blind, placebo-controlled trial was conducted in 94 healthy postmenopausalwomenaged50-75years,with44randomizedtosoysupplementscontaining118 mgofisoflavones(daidzein,genistein,glyciteinandtheirrespectiveglycosides), and 50 to an identically presented casein placebo. A validated questionnaire on menopausal symptoms was administered at baseline and at 3 months of treatment. Compliance was assessed by high-performance liquid chromatography assay of urinary phytoestrogens. Statistical analysis was completed using non-parametric statistical methods and multivariate analysis. Results At baseline 80% of women recruited were experiencing menopausal symptoms, although symptom severity was mild. Those consuming phytoestrogen supplements had 13- and 17-fold increases in urinary excretion of genistein and daidzein, respectively,withnochangeintheplacebogroup. Activesoysupplementsdidnotsignificantlyaltereitherindividualsymptomsorspecificsymptomcategoryscoreswhencompared to placebo. Within-group comparisons revealed that the active group reported a significant improvement in vaginal dryness (p= 0.01), libido (p= 0.009), facial hair (p= 0.04) and dry skin (p= 0.027). However, similarly, those on placebo reported an improvement in libido (p= 0.015), facial hair (p= 0.014) and dry skin (p= 0.011) but not vaginal dryness. Conclusions In this group of 94 older postmenopausal women with a high frequency ofmildmenopausalsymptoms,3monthsofsoysupplementscontainingphytoestrogens did not provide symptomatic relief compared with placebo.","year":2000}