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      MicroRNA profiles in plasma samples from young metabolically healthy obese patients and miRNA‐21 are associated with diastolic dysfunction via TGF‐β1/Smad pathway

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          Abstract

          Background

          Metabolically healthy obese patients accounts for a large part of obese population, but its clinical significance and cardiac dysfunction are often underestimated. The microRNA profiles of metabolically healthy obese patients were investigated in the study, and the selected microRNA (miRNA) based on our microarray assay will be further verified in a relatively large metabolically healthy obese population.

          Methods

          microRNA microarray was performed from six metabolically healthy obese and 6 health control blood samples. Based on the bioinformatics analysis, we further measured RT‐PCR, fibrosis markers, echocardiograms, and TGF‐β1/Smad signaling pathway in 600 metabolically healthy obese population.

          Results

          We found that miRNAs expression characteristics in metabolically healthy obese groups were markedly different from healthy control group. MiRNA‐21 was significantly increased in the samples of metabolically healthy obese patients. Besides, miRNA‐21 levels were associated with cardiac fibrosis marker. Meanwhile, higher miRNA‐21 levels were related to elevated E/E′. Besides, patients with the highest miRNA‐21 quartile showed the lowest ratio of E/A. These associations between miRNA‐21 and diastolic function parameters were independent of obesity and other confounding variables. Of note, TGF‐β1and Smad 3 were significantly upregulated while Smad 7 was downregulated according to the miRNA‐21 quartiles in metabolically healthy obese group.

          Conclusions

          We demonstrated the profiles of circulating microRNAs in metabolically healthy obese patients. Increased plasma miRNA‐21 levels were related to impaired diastolic function independent of other relevant confounding variables. MiRNA‐21 could be one of the mechanistic links between obesity and diastolic dysfunction through regulating cardiac fibrosis via TGF‐β1/Smad signaling pathway in obese hearts, which may serve as a novel target of disease intervention.

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          Most cited references25

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          Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents

          Summary Background Overweight and obesity are increasing worldwide. To help assess their relevance to mortality in different populations we conducted individual-participant data meta-analyses of prospective studies of body-mass index (BMI), limiting confounding and reverse causality by restricting analyses to never-smokers and excluding pre-existing disease and the first 5 years of follow-up. Methods Of 10 625 411 participants in Asia, Australia and New Zealand, Europe, and North America from 239 prospective studies (median follow-up 13·7 years, IQR 11·4–14·7), 3 951 455 people in 189 studies were never-smokers without chronic diseases at recruitment who survived 5 years, of whom 385 879 died. The primary analyses are of these deaths, and study, age, and sex adjusted hazard ratios (HRs), relative to BMI 22·5–<25·0 kg/m2. Findings All-cause mortality was minimal at 20·0–25·0 kg/m2 (HR 1·00, 95% CI 0·98–1·02 for BMI 20·0–<22·5 kg/m2; 1·00, 0·99–1·01 for BMI 22·5–<25·0 kg/m2), and increased significantly both just below this range (1·13, 1·09–1·17 for BMI 18·5–<20·0 kg/m2; 1·51, 1·43–1·59 for BMI 15·0–<18·5) and throughout the overweight range (1·07, 1·07–1·08 for BMI 25·0–<27·5 kg/m2; 1·20, 1·18–1·22 for BMI 27·5–<30·0 kg/m2). The HR for obesity grade 1 (BMI 30·0–<35·0 kg/m2) was 1·45, 95% CI 1·41–1·48; the HR for obesity grade 2 (35·0–<40·0 kg/m2) was 1·94, 1·87–2·01; and the HR for obesity grade 3 (40·0–<60·0 kg/m2) was 2·76, 2·60–2·92. For BMI over 25·0 kg/m2, mortality increased approximately log-linearly with BMI; the HR per 5 kg/m2 units higher BMI was 1·39 (1·34–1·43) in Europe, 1·29 (1·26–1·32) in North America, 1·39 (1·34–1·44) in east Asia, and 1·31 (1·27–1·35) in Australia and New Zealand. This HR per 5 kg/m2 units higher BMI (for BMI over 25 kg/m2) was greater in younger than older people (1·52, 95% CI 1·47–1·56, for BMI measured at 35–49 years vs 1·21, 1·17–1·25, for BMI measured at 70–89 years; pheterogeneity<0·0001), greater in men than women (1·51, 1·46–1·56, vs 1·30, 1·26–1·33; pheterogeneity<0·0001), but similar in studies with self-reported and measured BMI. Interpretation The associations of both overweight and obesity with higher all-cause mortality were broadly consistent in four continents. This finding supports strategies to combat the entire spectrum of excess adiposity in many populations. Funding UK Medical Research Council, British Heart Foundation, National Institute for Health Research, US National Institutes of Health.
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            Obesity-associated improvements in metabolic profile through expansion of adipose tissue.

            Excess caloric intake can lead to insulin resistance. The underlying reasons are complex but likely related to ectopic lipid deposition in nonadipose tissue. We hypothesized that the inability to appropriately expand subcutaneous adipose tissue may be an underlying reason for insulin resistance and beta cell failure. Mice lacking leptin while overexpressing adiponectin showed normalized glucose and insulin levels and dramatically improved glucose as well as positively affected serum triglyceride levels. Therefore, modestly increasing the levels of circulating full-length adiponectin completely rescued the diabetic phenotype in ob/ob mice. They displayed increased expression of PPARgamma target genes and a reduction in macrophage infiltration in adipose tissue and systemic inflammation. As a result, the transgenic mice were morbidly obese, with significantly higher levels of adipose tissue than their ob/ob littermates, leading to an interesting dichotomy of increased fat mass associated with improvement in insulin sensitivity. Based on these data, we propose that adiponectin acts as a peripheral "starvation" signal promoting the storage of triglycerides preferentially in adipose tissue. As a consequence, reduced triglyceride levels in the liver and muscle convey improved systemic insulin sensitivity. These mice therefore represent what we believe is a novel model of morbid obesity associated with an improved metabolic profile.
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              miRNAS in cardiovascular diseases: potential biomarkers, therapeutic targets and challenges

              Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality in the world. Although considerable progress has been made in the diagnosis, treatment and prognosis of CVD, there is still a critical need for novel diagnostic biomarkers and new therapeutic interventions to decrease the incidence of this disease. Recently, there is increasing evidence that circulating miRNAs (miRNAs), i.e. endogenous, stable, single-stranded, short, non-coding RNAs, can be used as diagnostic biomarkers for CVD. Furthermore, miRNAs represent potential novel therapeutic targets for several cardiovascular disorders. In this review we provides an overview of the effects of several CVD; including heart failure, acute myocardial infarction, arrhythmias and pulmonary hypertension; on levels of circulating miRNAs. In addition, the use of miRNA as therapeutic targets is also discussed, as well as challenges and recommendations in their use in the diagnosis of CVD.
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                Author and article information

                Contributors
                Yuyang_Zhang1@outlook.com
                Journal
                J Clin Lab Anal
                J. Clin. Lab. Anal
                10.1002/(ISSN)1098-2825
                JCLA
                Journal of Clinical Laboratory Analysis
                John Wiley and Sons Inc. (Hoboken )
                0887-8013
                1098-2825
                28 February 2020
                June 2020
                : 34
                : 6 ( doiID: 10.1002/jcla.v34.6 )
                : e23246
                Affiliations
                [ 1 ] Department of Cardiology Xi'an No.1 hospital Xi'an China
                [ 2 ] Department of Cardiology Xi'an No.4 hospital Xi'an China
                [ 3 ] Health Science Center Xi'an Jiaotong University Xi'an China
                Author notes
                [*] [* ] Correspondence

                Yuyang Zhang, Department of Cardiology, Xi'an No.1 hospital, Fenxiang 30, The South Avenue, Xi'an city 710002, China.

                Email: Yuyang_Zhang1@ 123456outlook.com

                Author information
                https://orcid.org/0000-0002-9528-7280
                Article
                JCLA23246
                10.1002/jcla.23246
                7307369
                32108968
                148585fb-b8a0-4239-aef3-3484ef163efa
                © 2020 The Authors. Journal of Clinical Laboratory Analysis Published by Wiley Periodicals, Inc.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 02 October 2019
                : 13 January 2020
                : 21 January 2020
                Page count
                Figures: 5, Tables: 3, Pages: 8, Words: 4639
                Categories
                Research Article
                Research Articles
                Custom metadata
                2.0
                June 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.4 mode:remove_FC converted:22.06.2020

                Clinical chemistry
                biomarker,diastolic dysfunction,metabolism,micrornas,obesity
                Clinical chemistry
                biomarker, diastolic dysfunction, metabolism, micrornas, obesity

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