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  • Aspirin use associated with decreased risk of bile duct cancer
  • Decreased levels of vitamin D associated with reduced methylation in African American teens
  • Higher zinc levels associated with less inflammation in men and women treated for HIV
  • High prevalence of vitamin D deficiency among type 1 diabetic children
  • Aspirin predicted to improve cancer survival by as much as 20%
  • Meta-analysis finds metformin superior to sulfonylurea drugs at lowering cardiovascular mortality among diabetics
  • Study finds fewer hospital readmissions among men treated with testosterone
  • Coffee drinking could help those with nonalcoholic fatty liver disease
  • Cancer risk significantly lower when vitamin D levels hit 40 ng/mL
  • Lithium extends more than battery life
  • Whey protein for breakfast could help manage diabetes
  • Decreased bioavailable and total vitamin D predict greater cardiovascular event risk
  • Taurine improves ED in experimental research
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    Aspirin use associated with decreased risk of bile duct cancer

    Aspirin use associated with decreased risk of bile duct cancerApril 29 2016. A recent study conducted by researchers at the Mayo Clinic suggests that bile duct cancer can be added to the growing list of malignancies that could be prevented by regular aspirin use.

    The journal Hepatology reports findings from a study that compared 2,395 bile duct cancer patients with 4,769 control subjects matched for age and other factors. Jonggi Choi, MD, and colleagues calculated a 2.7-fold to 3.6-fold lower risk of bile duct cancer among aspirin users in comparison with nonusers. Compared with no aspirin use, aspirin users had a 65% lower risk of intrahepatic bile duct cancer, a 66% lower risk of perihilar bile duct cancer and a 71% lower risk of distal disease. It was also shown that the presence of cirrhosis and other factors impacted the risk of the three subtypes in different ways.

    "Chronic persistent inflammation is one of the key elements that promote cancer of the bile ducts, and well-known risk factors for bile duct cancer have all been shown to increase the risk for bile duct cancer by inducing chronic inflammation of the ducts," Dr Choi observed. "Aspirin is an anti-inflammatory agent and may reduce the risk of bile duct cancer by reducing inflammation through inhibition of the cyclooxygenase enzyme. Previous studies have shown that aspirin also blocks additional biological pathways that promote cancer development."

    "Until now, there has been little evidence of a potential role for aspirin in the prevention of bile duct cancer," noted coauthor Roongruedee Chaiteerakij, MD, PhD. "Our study provides the first evidence for this. The next steps should include population-based studies examining the associations of aspirin use with risk of bile duct cancer and also clinical trials, particularly in populations at high risk for bile duct cancer, to confirm the benefit of aspirin for bile duct cancer prevention."

     

     

     

     

    Decreased levels of vitamin D associated with reduced methylation in African American teens

    Decreased levels of vitamin D associated with reduced methylation in African American teensApril 27 2016. An article that appeared on December 2, 2015 in the journal PLOS One reports reduced levels of methylation and vitamin D in teenaged African Americans, among whom vitamin D deficiency is a common concern. Low levels of methylation are associated with a number of cancers and other conditions, as are decreased levels of vitamin D.
    "Methylation is kind of like a brake that controls gene expression," explained senior author Yanbin Dong who is a geneticist and cardiologist at the Medical College of Georgia at Augusta University. "If that brake is removed or damaged, the gene can go in all kinds of directions, and most of the time, it's unfavorable ones."

    The study included 454 teens aged 14 to 18 years. While 99% of Caucasian participants had adequate 25-hydroxyvitamin D levels, deficiencies were found among 66% of African American subjects, all of whom had lower levels of global methylation than the Caucasian participants.

    When monthly doses of 18,000 international units (IU), 60,000 IU, or 120,000 IU vitamin D3 or a placebo were evaluated in 58 deficient African American teens with low methylation levels, methylation activity increased in association with higher doses of the vitamin.

    "This is the first evidence associating low vitamin D levels with hypomethylation," Dr Dong announced. "If you don't have enough vitamin D, you don't have enough methylation."

    "While much work remains, there appears to be a connection between healthy vitamin D levels and levels of DNA methylation," noted first author Haidong Zhu, who is a molecular geneticist at the Georgia Prevention Institute at the Medical College of Georgia. "We want to understand underlying mechanisms for how vitamin D insufficiency causes cancer, cardiovascular disease and immune system problems."

     

     

     

     

    Higher zinc levels associated with less inflammation in men and women treated for HIV

    Higher zinc levels associated with less inflammation in men and women treated for HIVApril 25 2016. The May 2016 issue of Biological Trace Element Research reports research conducted at the University of Massachusetts Amherst which found an association between higher zinc concentrations and reduced inflammation as indicated by lower C-reactive protein (CRP) levels in human immunodeficiency virus (HIV)-positive men and women treated with antiretroviral therapy. Chronic inflammation as well as low levels of zinc are commonly observed in HIV-positive patients.

    "The fact that several studies have suggested that zinc might be something important for us to be aware of led us to analyze this micronutrient in HIV-positive patients," explained lead researcher Krishna C. Poudel, who is an associate professor of community health education at the University of Massachusetts Amherst's School of Public Health and Health Sciences. "We hypothesized that lower concentrations of serum zinc would be associated with increased CRP concentrations in HIV-positive individuals, taking into account of ART."

    The study included 177 men and 134 women aged 18 to 60 years enrolled in the Positive Living with HIV (POLH) Study in Kathmandu, Nepal. Blood samples were analyzed for CRP and zinc. 

    Average CRP levels declined in association with rising zinc concentrations. Those whose CRP levels were among the top one-third of subjects had zinc levels that were 44.2% lower than those whose CRP levels were among the lowest third. Among men whose zinc levels were highest, CRP levels were 30% lower than those whose levels were among the lowest third, and for women, CRP levels were 35.9% lower.

    The authors recommend further research to determine whether zinc supplementation could help reduce inflammation in individuals treated for HIV.

     

     

     

     

    High prevalence of vitamin D deficiency among type 1 diabetic children

    High prevalence of vitamin D deficiency among type 1 diabetic childrenApril 22 2016. On March 12, 2016, an article appearing in Diabetes Research and Clinical Practice revealed a high risk of deficient vitamin D levels in type 1 diabetic adolescents and children.

    Terri Lipman, PhD, CRNP, FAAN, and colleagues at the University of Pennsylvania School of Nursing evaluated the 25-hydroxyvitamin D and glucose levels of 197 children and adolescents who were seen by the Diabetes Center for Children at the Children's Hospital of Philadelphia. Over half of the subjects were adolescents, males and Caucasian. Levels of hemoglobin A1c (a measure of diabetes control), and other factors were ascertained from patient records.

    Deficient vitamin D levels of less than 20 nanograms per milliliter (ng/mL) were present in 40.6% of the subjects and 49.2% had insufficient levels ranging from 20 and 30 ng/mL. Only 10.2% had levels higher than 30 ng/mL, a level that is considered sufficient by some authorities.

    "To our knowledge this is the first study that has been adequately-powered to examine the association between 25-hydroxyvitamin D and HbA1c (a measure of diabetes control) in children and adolescents with type 1 diabetes," the authors announce. "This study demonstrated the high prevalence of patients with low levels of 25-hydroxyvitamin D specifically in healthy weight and Caucasian children and adolescents with type 1 diabetes mellitus. These data suggest the need for monitoring of vitamin D in all youth with this disorder."

     

     

     

     

    Aspirin predicted to improve cancer survival by as much as 20%

    Aspirin predicted to improve cancer survival by as much as 20%April 20 2016. Adding an aspirin to one’s treatment regimen could improve cancer patients’ chances of surviving the disease by up to 20%, according to a review published on April 20, 2016 in PLOS ONE.

    "There is a growing body of evidence that taking aspirin is of significant benefit in reducing some cancers," noted lead researcher Peter Elwood of Cardiff University. "Whilst we know a low-dose of aspirin has been shown to reduce the incidence of cancer, its role in the treatment of cancer remains uncertain. As a result, we set out to conduct a systematic search of all the scientific literature."

    Dr Elwood and his colleagues evaluated five randomized trials and 42 observational studies that involved breast, colorectal and prostate cancer patients. Subjects consumed low-dose aspirin in addition to their cancer treatments and were followed for an average of five years. "Our review, based on the available evidence, suggests that low-dose aspirin taken by patients with bowel, breast or prostate cancer, in addition to other treatments, is associated with a reduction in deaths of about 15-20%, together with a reduction in the spread of the cancer,” he reported.

    "One of the concerns about taking aspirin remains the potential for intestinal bleeding,” Dr Elwood added. “That's why we specifically looked at the available evidence of bleeding and we wrote to all authors asking for further data. In no study was serious or life-threatening bleeding reported."

    "While there is a desperate need for more detailed research to verify our review and to obtain evidence on less common cancers, we'd urge patients diagnosed with cancer to speak to their doctor about our findings so they can make an informed decision as to whether or not they should take a low-dose aspirin as part of their cancer treatment," Dr Elwood recommended.

     

     

     

     

    Meta-analysis finds metformin superior to sulfonylurea drugs at lowering cardiovascular mortality among diabetics

    Meta-analysis finds metformin superior to sulfonylurea drugs at lowering cardiovascular mortality among diabeticsApril 18 2016. A meta-analysis that included a total of over 1.4 million subjects found a lower risk of dying from cardiovascular disease in patients using metformin compared to those treated with another class of diabetes drugs known as sulfonylureas. The review, which updates two previous analyses, was reported in the April 19, 2016 issue of the Annals of Internal Medicine.

    "Metformin looks like a clear winner," announced co-primary investigator Nisa Maruthur, MD, MHS, who is an assistant professor of medicine at Johns Hopkins University School of Medicine.  "This is likely the biggest bit of evidence to guide treatment of type 2 diabetes for the next two to three years."

    Dr Maruther and colleagues analyzed data from 204 studies that included men and women treated with metformin, sulfonylureas, DPP-4 inhibitors and other drugs. The investigators examined cardiovascular and other effects—good and bad—associated with the different therapies.

    Metformin as well as sulfonylureas were found to be more effective at reducing blood glucose levels than DPP-4 inhibitors. Another type of drug known as SGLT-2 inhibitors was associated with fungal infections in 10 percent of users; however, the drugs supported patients’ weight loss efforts. In contrast, sulfonylurea drugs were associated with weight gain and hypoglycemia. Compared with the use of sulfonylureas, metformin use was associated with a 30% to 40% lower risk of dying from cardiovascular disease.

    Dr Maruther observed that the findings concur with the current recommendation for the use of metformin as a first line therapy for diabetes. "The medications all have different benefits and side effects, so the choice of second-line medications must be based on an individual patient's preferences," she noted.

     

     

     

     

    Study finds fewer hospital readmissions among men treated with testosterone

    Study finds fewer hospital readmissions among men treated with testosteroneApril 15 2016. A study reported in the May 2016 issue of Mayo Clinic Proceedings uncovered a lower rate of hospital readmission among men who received testosterone replacement compared to untreated men.

    Previous research has found a decrease in muscle mass and strength in association with hospitalization among older men that is linked to an increased risk of readmission. Testosterone is an androgenic hormone that helps maintain muscle mass, among other benefits.

    Jacques Baillargeon and colleagues at the University of Texas Medical Branch in Galveston analyzed SEER-Medicare linked data for 6,372 men aged 66 years and older with low testosterone levels who were hospitalized from 2007 to 2012. They found that men who were not treated with testosterone had a 13% readmission rate within 30 days of being admitted, compared to 9.8% of those treated with the hormone. When emergency department admissions were evaluated, 10% of those who did not use testosterone were readmitted within a month, compared to 6.2% of users.

    "It is possible that our findings of decreased hospitalization among male Medicare beneficiaries who received testosterone therapy reflect the improved health, strength and exercise capacity seen in previous studies," commented Dr Baillargeon, who is a professor of epidemiology in the department of preventative medicine and community health at UTMB. "Our findings suggest that one of the benefits of androgen therapy may be quicker recovery from a hospital stay and lower readmission rates. Given the importance of potentially avoidable hospital readmissions among older adults, further exploration of this intervention holds broad clinical and public health relevance."

    "Our investigation represents the first large-scale population-based study examining the association of androgen therapy with hospital readmission," the authors announce. "Reducing avoidable hospital readmissions is a national health priority and a major focus of health care reform in the United States."

     

     

     

     

    Coffee drinking could help those with nonalcoholic fatty liver disease

    Coffee drinking could help those with nonalcoholic fatty liver diseaseApril 13 2016. A study reported at The International Liver Congress™ 2016 in Barcelona suggests that people with nonalcoholic fatty liver disease (NAFLD) could experience improvement in their condition by drinking coffee.

    Nonalcoholic fatty liver disease can result in scarring of the liver, which can lead to cirrhosis, a more serious condition.

    Researchers from Italy's University of Napoli studied the effects of coffee in mice given a high fat diet, which negatively impacts the liver. Compared with animals that received the diet without coffee, those given the equivalent of six cups espresso per day for 12 weeks gained less weight and experienced decreases in markers of NAFLD, including cholesterol, alanine aminotransferase (an enzyme that increases in response to liver damage), liver cell fat (steatosis) and ballooning degeneration.

    The researchers found that coffee elevated a protein known as zonulin-1, which reduces gut permeability. The finding suggests that coffee supplementation causes variations in intestinal tight junctions, which regulate intestinal permeability. Increased gut permeability is believed to contribute to liver injury and worsening of NAFLD. "Previous studies have confirmed how coffee can reverse the damage of NAFLD but this is the first to demonstrate that it can influence the permeability of the intestine," announced researcher Vincenzo Lembo. "The results also show that coffee can reverse NAFLD-related problems such as ballooning degeneration, a form of liver cell degeneration."

    "Italy is famous for its coffee and this Italian study has reinforced our knowledge on the link between it and nonalcoholic fatty liver disease," commented European Association for the Study of the Liver (EASL) Secretary General Laurent Castera. "Although not suggesting that we should consume greater levels of coffee, the study offers insights that can help future research into and understanding of the therapeutic role coffee can play in combating NAFLD."

     

     

     

     

    Cancer risk significantly lower when vitamin D levels hit 40 ng/mL

    Cancer risk significantly lower when vitamin D levels hit 40 ng/mLApril 11 2016. A pooled analysis published on April 6, 2016 in PLOS ONE found an association between a substantial reduction in invasive cancers and higher vitamin D levels.

    Robert P. Heaney and colleagues at the University of California San Diego pooled data from the Lappe cohort, which included 1,169 women who participated in a randomized trial, and the GrassrootsHealth cohort, a prospective study cohort that included 1,135 women. Lappe cohort subjects had median 25-hydroxyvitamin D [25(OH)D] levels of 30 nanograms per milliliter (ng/mL) and those in the GrassrootsHealth cohort had a median of 48 ng/mL.

    The researchers determined that a vitamin D level of 40 ng/mL or more was associated with a 67% lower risk of developing cancer over a 3.9 year median compared to levels of 20 ng/mL or less. The finding suggests that the target vitamin D level of 20 ng/mL recommended by the Institute of Medicine in 2010 may be insufficient to provide significant cancer protection.

    "We have quantitated the ability of adequate amounts of vitamin D to prevent all types of invasive cancer combined, which had been terra incognita until publication of this paper," commented coauthor Cedric Garland, DrPH, who is an adjunct professor in the UC San Diego School of Medicine Department of Family Medicine and Public Health. "These findings support an inverse association between 25(OH)D and risk of cancer and highlight the importance for cancer prevention of achieving a vitamin D blood serum concentration above 20 ng/ml, the concentration recommended by the IOM for bone health."

    "Primary prevention of cancer, rather than expanding early detection or improving treatment, will be essential to reversing the current upward trend of cancer incidence worldwide," the authors conclude. "This analysis suggests that improving vitamin D status is a key prevention tool."

     

     

     

     

    Lithium extends more than battery life

    Lithium extends more than battery lifeApril 8 2016. A study published on April 7, 2016 in Cell Reports found longer life for flies given lithium, a chemical element and drug used to stabilize mood in bipolar disorder.

    Dr Jorge Iván Castillo-Quan of University College London and colleagues gave male and female flies high or low doses of lithium chloride or sodium chloride during adulthood or later in life. Flies that received low dose lithium lived 16% longer than average and had a maximum lifespan that was 18% longer than controls, which the researchers attribute to blockage of glycogen synthase kinase-3 (GSK-3) and activation of a protein known as NRF2 that aids in the defense of cells against damage.

    "We studied the responses of thousands of flies in different conditions to monitor the effects of lithium and how it extends life," stated coauthor Dr Ivana Bjedov. "We found low doses not only prolong life but also shield the body from stress and block fat production for flies on a high sugar diet. Low doses also protect against the harmful effects of higher, toxic doses of lithium and other substances such as the pesticide paraquat."

    "To improve our quality and length of life we must delay the onset of age-related diseases by extending the healthiest period of our lives," commented Dr Castillo-Quan, who is currently affiliated with Harvard Medical School. "Identifying a drug target for aging is a crucial step in achieving this and by targeting GSK-3, we could discover new ways of controlling the ageing process in mammals, including humans."

    Principal investigator Dame Linda Partridge concluded that "The response we've seen in flies to low doses of lithium is very encouraging and our next step is to look at targeting GSK-3 in more complex animals with the aim of eventually developing a drug regime to test in humans." 

     

     

     

     

    Whey protein for breakfast could help manage diabetes

    Whey protein for breakfast could help manage diabetesApril 6 2016. A study reported on April 1 at the annual meeting of the Endocrine Society held this year in Boston found a benefit for the inclusion of whey protein at breakfast by individuals with 2 diabetes.

    "A high-calorie protein breakfast, medium-sized lunch and small dinner is a proven successful strategy for weight loss, improved satiety and reduced glucose spikes throughout the day in people with obesity and Type 2 diabetes," stated lead study author Daniela Jakubowicz, MD, who is a professor of medicine at Tel Aviv University. "However, the benefits of high protein content at breakfast also depend on the protein source and quality. Whey protein powder, which is a byproduct of milk during cheese production, induced greater satiety and reduction of glucose spikes after meals compared to other protein sources such as eggs, soy or tuna."

    The study included 48 overweight and obese type 2 diabetics of an average age of 59 years. Participants were instructed to consume a large breakfast, medium-sized lunch and small dinner that provided the same amount of daily calories for 23 months. Subjects were assigned to breakfasts that consisted of whey protein shakes, other proteins such as eggs and tuna, or carbohydrates. Hemoglobin A1c and other factors were measured at the beginning and end of the study.

    The group who received the whey protein shake for breakfast had less hunger, lower glucose spikes following meals and a greater reduction in hemoglobin A1c compared with the other groups. "The whey protein diet significantly suppresses the hunger hormone 'ghrelin,'" Dr Jakubowicz noted.

    "A whey protein drink is easily prepared and provides the advantages of a high-protein breakfast."

     

     

     

     

    Decreased bioavailable and total vitamin D predict greater cardiovascular event risk

    Decreased bioavailable and total vitamin D predict greater cardiovascular event riskApril 4 2016. Results of a study presented on April 2, 2016 at the American College of Cardiology Scientific Sessions held in Chicago reveal an association between total vitamin D as well as bioavailable vitamin D levels and a lower risk of major adverse cardiovascular events including heart attack, stroke, heart failure, or cardiovascular death.

    "Many epidemiological studies have shown that total circulating levels of 25-hydroxyvitamin D [25(OH)D] are strongly associated with poor cardiovascular outcomes," note Heidi T. May, PhD, MSPH, and colleagues. "However, 85-90% of circulating vitamin D is bound to vitamin D binding protein or albumin, and levels obtained may not be truly reflective of the vitamin D available to act on target cells."

    Acting on the results of observational studies, researchers at Intermountain Medical Center Heart Institute in Salt Lake City determined levels of total serum 25(OH)D and 25(OH)D bound to albumin and vitamin D binding protein in 4,200 men and women between the ages of 52 and 76 years. (Bioavailable vitamin D includes that which is bound to albumin but not that which is bound to vitamin D binding protein.)

    "Our study found that low levels of both total vitamin D and bioavailable vitamin D appear to be associated with poor cardiovascular outcomes," reported Dr May, who is a cardiovascular epidemiologist with the Intermountain Medical Center Heart Institute.

    "This study is the first research that evaluates the association of vitamin D metabolites with cardiovascular events," she announced. "And evaluating usable vitamin D could mean the difference on the amount of vitamin D prescribed, if it's prescribed at all."

    Dr May and colleagues suggest conducting additional studies involving non-Caucasian populations due to differences in the way vitamin D metabolites affect these groups in comparison with Caucasians.

     

     

     

     

    Taurine improves ED in experimental research

    Taurine improves ED in experimental researchApril 1 2016. A study reported in the May 2016 issue of the Journal of Sexual Medicine found improvement in the erectile function of rats with induced type 1 diabetes that received the amino acid taurine.

    Diabetic patients are almost three times likelier to experience erectile dysfunction (ED) than nondiabetics. An estimated 95% of diabetics over the age of 60 are affected by the condition.

    "It has been demonstrated that taurine supplementation can enhance sexual response and mating ability in aged rats," note Yajun Ruan, MD, and colleagues at Huazhong University of Science and Technology in their introduction to the article. "However, whether taurine could mitigate diabetic ED has not been investigated."

    The study utilized 18 rats that developed ED after being rendered diabetic by injection with streptozotocin. Eight nondiabetic rats served as controls. Half of the diabetic animals received intraperitoneally administered taurine and the remainder of the group received saline for four weeks.

    At the end of the study, all erectile function variables were lower in diabetic compared to nondiabetic rats, however diabetic animals that received taurine experienced partial but significant recovery of erectile function. Taurine-treated animals had significantly reduced penile fibrosis as well as upregulation of endothelial nitric oxide synthase expression and improvement in other factors. Additionally, diabetic rats treated with taurine had higher testosterone levels than those that received saline.

    Given that erectile function is a benchmark for cardiovascular disease, the authors suggest that taurine's cardioprotective effects could be responsible for many of the benefits observed in this study. "Data from the present study suggest that taurine supplementation may improve erectile function in rats with diabetic ED and ameliorate penile fibrosis as well as endothelial dysfunction," they conclude. "This finding provides evidence that taurine supplementation may be an alternative therapy for nonresponders to phosphodiesterase type 5 inhibitors."

     

     

     

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