Xylitol is prothrombotic and associated with cardiovascular risk

Posted on June 11, 2024 by Maurice Preter MD

Xylitol is prothrombotic and associated with cardiovascular risk

I am so old I remember when dentist always recommended this stuff. Silly me who thought the science is settled. Timing is everything.

Abstract

Background and Aims

The pathways and metabolites that contribute to residual cardiovascular disease risks are unclear. Low-calorie sweeteners are widely used sugar substitutes in processed foods with presumed health benefits. Many low-calorie sweeteners are sugar alcohols that also are produced endogenously, albeit at levels over 1000-fold lower than observed following consumption as a sugar substitute.

Methods

Untargeted metabolomics studies were performed on overnight fasting plasma samples in a discovery cohort (n = 1157) of sequential stable subjects undergoing elective diagnostic cardiac evaluations; subsequent stable isotope dilution liquid chromatography tandem mass spectrometry (LC-MS/MS) analyses were performed on an independent, non-overlapping validation cohort (n = 2149). Complementary isolated human platelet, platelet-rich plasma, whole blood, and animal model studies examined the effect of xylitol on platelet responsiveness and thrombus formation in vivo. Finally, an intervention study was performed to assess the effects of xylitol consumption on platelet function in healthy volunteers (n = 10).

Results

In initial untargeted metabolomics studies (discovery cohort), circulating levels of a polyol tentatively assigned as xylitol were associated with incident (3-year) major adverse cardiovascular event (MACE) risk. Subsequent stable isotope dilution LC-MS/MS analyses (validation cohort) specific for xylitol (and not its structural isomers) confirmed its association with incident MACE risk [third vs. first tertile adjusted hazard ratio (95% confidence interval), 1.57 (1.12–2.21), P < .01]. Complementary mechanistic studies showed xylitol-enhanced multiple indices of platelet reactivity and in vivo thrombosis formation at levels observed in fasting plasma. In interventional studies, consumption of a xylitol-sweetened drink markedly raised plasma levels and enhanced multiple functional measures of platelet responsiveness in all subjects.

Conclusions

Xylitol is associated with incident MACE risk. Moreover, xylitol both enhanced platelet reactivity and thrombosis potential in vivo. Further studies examining the cardiovascular safety of xylitol are warranted.

Posted in dietary, Fifth Avenue Concierge Medicine, Forensic Neuropsychiatry, Health, News, Psychiatry/Neurology |

Provoked anger is associated with an increased risk of cardiovascular disease events.

Posted on May 2, 2024 by Maurice Preter MD

Happy to see that after decades of neglect (at least in the U.S.) and ridicule, good old psychosomatic medicine is having a come-back. One wonders why. I’d be interested in people’s thoughts.

Dr Preter

Abstract

Background

Provoked anger is associated with an increased risk of cardiovascular disease events. The underlying mechanism linking provoked anger as well as other core negative emotions including anxiety and sadness to cardiovascular disease remain unknown. The study objective was to examine the acute effects of provoked anger, and secondarily, anxiety and sadness on endothelial cell health.

Methods and Results

Apparently healthy adult participants (n=280) were randomized to an 8‐minute anger recall task, a depressed mood recall task, an anxiety recall task, or an emotionally neutral condition. Pre−/post‐assessments of endothelial health including endothelium‐dependent vasodilation (reactive hyperemia index), circulating endothelial cell‐derived microparticles (CD62E+, CD31+/CD42−, and CD31+/Annexin V+) and circulating bone marrow‐derived endothelial progenitor cells (CD34+/CD133+/kinase insert domain receptor+ endothelial progenitor cells and CD34+/kinase insert domain receptor+ endothelial progenitor cells) were measured. There was a group×time interaction for the anger versus neutral condition on the change in reactive hyperemia index score from baseline to 40 minutes (P=0.007) with a mean±SD change in reactive hyperemia index score of 0.20±0.67 and 0.50±0.60 in the anger and neutral conditions, respectively. For the change in reactive hyperemia index score, the anxiety versus neutral condition group by time interaction approached but did not reach statistical significance (P=0.054), and the sadness versus neutral condition group by time interaction was not statistically significant (P=0.160). There were no consistent statistically significant group×time interactions for the anger, anxiety, and sadness versus neutral condition on endothelial cell‐derived microparticles and endothelial progenitor cells from baseline to 40 minutes.

Conclusions

In this randomized controlled experimental study, a brief provocation of anger adversely affected endothelial cell health by impairing endothelium‐dependent vasodilation.

Source: https://www.ahajournals.org/doi/full/10.1161/JAHA.123.032698

Posted in Aging, epigenetics, Fifth Avenue Concierge Medicine, Health, News, Psychiatry/Neurology | Tagged adverse childhood events, Psychological Stress and PTSD |

A timely reminder: The Great Recession and Mental Health in the United States

Posted on April 15, 2024 by Maurice Preter MD

Socioeconomic distress and decline of emotional health. Narrow focus but worth reading.

Public source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413622/

“This study provides the first comprehensive look at how Americans’ mental health changed as a function of hardships during The Great Recession. While population-level mental health generally improved over the course of the study, each recession hardship experienced by an individual was associated with higher odds of long-lasting and transdiagnostic declines in mental health. These relationships were stronger for some sociodemographic groups, suggesting the need for additional support for people who suffer marked losses during recessions and for those without a strong safety net. The transdiagnostic findings and the similarity of effects across financial, job-related, and housing impacts also indicate that broadband public health interventions—rather than targeted interventions for specific symptom domains or recession impacts—may be an effective approach to providing mental health support for individuals who experience hardships during recessions. Ultimately, the adverse effects of The Great Recession on individuals’ mental health likely compounded and prolonged its economic costs. These findings thus highlight that government-funded mental health support in future recessions would not only ease individuals’ burdens, but could be a sound financial investment that may act to stimulate faster economic recovery.”

Posted in Events, Forensic Neuropsychiatry, Health |

Lung Microbiota: Its Relationship to Respiratory System Diseases and Approaches for Lung-Targeted Probiotic Bacteria Delivery

Posted on March 8, 2024 by Maurice Preter MD

Really interesting topic and paper (well illustrated too).

Eat more kimchi!

Source:

https://pubs.acs.org/doi/10.1021/acs.molpharmaceut.3c00323

Abstract

Microorganisms that make up the local microbiota (such as Lactobacillus sp. and Bifidobacteriumsp.) play a crucial role in the modulation of diseases and health states by taking place not only in the gut but also in many parts of our body. There is also interference between the gut and the lung via the gut–lung axis. The relationship between respiratory diseases and lung microbiota, which become more of an issue of particular importance in recent years, shows that probiotics play an essential role in maintaining the balance of microorganisms in the respiratory tract. However, studies on probiotics’ prophylactic or therapeutic application in chronic lung diseases are limited. In this review, the literature between 1977 and 2022 was surveyed. General information about human microbiota was accessed in earlier sources, and especially in the past decade, research on lung microbiota has been reached. The relationship between lung microbiota and important respiratory diseases such as bronchopulmonary dysplasia, chronic obstructive pulmonary disease, pneumonia, cystic fibrosis, allergy-asthma, influenza, lung cancer, and COVID-19 infection, was scrutinized after mentioning human microbiota, the gut–lung axis, and respiratory tract microbiota. The mechanism of action of probiotics and the formulation approaches of probiotics in terms of pharmaceutical technology were reviewed. Finally, future perspectives on lung-targeted administration of probiotic bacteria with prophylactic or therapeutic potential, or both, were presented.

Posted in Affective Neuroscience, Aging, Complementary - Alternative Medicine, dietary, epigenetics, Health, metabolic, new treatments, News | Tagged Alzheimer's disease, healthy brain aging, Inflammation, Memory and Memory Loss |

Phosphodiesterase Type 5 Inhibitors in Men With Erectile Dysfunction and the Risk of Alzheimer Disease

Posted on March 6, 2024 by Maurice Preter MD

A typical silly research paper title:

The point the authors are making is sildefanil and such compounds (ViagraR etc.) may be protective against Alzheimer Disease-type neurodegeneration. Or is it that the desire for, and frequency of intercourse are protective?

Source: https://www.neurology.org/doi/full/10.1212/WNL.0000000000209131

Either way, this is one of the more interesting drug explorations in the world of “dementia drugs”. And repurposing a compound adds years of post-marketing surveillance.

Posted in Aging, Fifth Avenue Concierge Medicine, Health, keto, News, Psychiatry/Neurology, Sex |

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