Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Cardiovascular Prevention Guidelines
REVISTA ESPANOLA DE SALUD PUBLICA
Authors: Armario, Pedro; Brotons, Carlos; Elosua, Roberto; Alonso de Lecinana, Maria; Castro, Almudena; Clara, Albert; Cortes, Olga; Diaz Rodriguez, Angel; Herranz, Maria; Justo, Soledad; Lahoz, Carlos; Pedro-Botet, Juan; Perez, Antonio Perez; Santamaria, Rafael; Tresserras, Ricard; Lain, Susana Aznar; Angel Royo-Bordonada, Miguel
Abstract
We present the adaptation for Spain of the updated European Cardiovascular Prevention Guidelines. In this update. greater stress is laid on the population approach. and especially on the promotion of physical activity and healthy diet through dietary, leisure and active transport policies in Spain. To estimate vascular risk, note should be made of the importance of recalibrating the tables used. by adapting them to population shifts in the prevalence of risk factors and incidence of vascular diseases, with particular attention to the role of chronic kidney disease. At an individual level, the key clement is personalised support for changes in behaviour, adherence to medication in high-risk individuals and patients with vascular disease, the fostering of physical activity, and cessation of smoking habit. Furthermore, recent clinical trials with PCSK9 inhibitors are reviewed. along with the need to simplify pharmacological treatment of arterial hypertension to improve control and adherence to treatment. In the case of patients with type 2 diabetes mellitus and vascular disease or high vascular disease risk, when lifestyle changes and metfonnin are inadequate, the use of drugs with proven vascular benefit should be prioritised. Lastly, guidelines on peripheral arterial disease and other specific diseases are included, as is a recommendation against prescribing antiaggregants in primary prevention.
Genome-wide association study for circulating fibroblast growth factor 21 and 23
SCIENTIFIC REPORTS
Authors: Chuang, Gwo-Tsann; Liu, Pi-Hua; Chyan, Tsui-Wei; Huang, Chen-Hao; Huang, Yu-Yao; Lin, Chia-Hung; Lin, Jou-Wei; Hsu, Chih-Neng; Tsai, Ru-Yi; Hsieh, Meng-Lun; Lee, Hsiao-Lin; Yang, Wei-shun; Robinson-Cohen, Cassianne; Hsiung, Chia-Ni; Shen, Chen-Yang; Chang, Yi-Cheng
Abstract
Fibroblast growth factors (FGFs) 21 and 23 are recently identified hormones regulating metabolism of glucose, lipid, phosphate and vitamin D. Here we conducted a genome-wide association study (GWAS) for circulating FGF21 and FGF23 concentrations to identify their genetic determinants. We enrolled 5,000 participants from Taiwan Biobank for this GWAS. After excluding participants with diabetes mellitus and quality control, association of single nucleotide polymorphisms (SNPs) with log-transformed FGF21 and FGF23 serum concentrations adjusted for age, sex and principal components of ancestry were analyzed. A second model additionally adjusted for body mass index (BMI) and a third model additionally adjusted for BMI and estimated glomerular filtration rate (eGFR) were used. A total of 4,201 participants underwent GWAS analysis. rs67327215, located within RGS6 (a gene involved in fatty acid synthesis), and two other SNPs (rs12565114 and rs9520257, located between PHC2-ZSCAN20 and ARGLU1-FAM155A respectively) showed suggestive associations with serum FGF21 level (P=6.66x10(-7), 6.00x10(-7) and 6.11x10(-7) respectively). The SNPs rs17111495 and rs17843626 were significantly associated with FGF23 level, with the former near PCSK9 gene and the latter near HLA-DQA1 gene (P=1.04x10(-10) and 1.80x10(-8) respectively). SNP rs2798631, located within the TGFB2 gene, was suggestively associated with serum FGF23 level (P=4.97x10(-7)). Additional adjustment for BMI yielded similar results. For FGF23, further adjustment for eGFR had similar results. We conducted the first GWAS of circulating FGF21 levels to date. Novel candidate genetic loci associated with circulating FGF21 or FGF23 levels were found. Further replication and functional studies are needed to support our findings.