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Genetic Obesity Less Harmful to the Heart?



When it comes to the adverse effects of obesity on the heart, it’s less about nature and more about food, according to a double study out of Sweden.

In an analysis of nearly all twins in the country, obesity predicted cardiovascular disease (CVD) risk across the board in every genetic risk group, reported Ida Karlsson, PhD, from the Karolinska Institute in Stockholm, and her colleagues at electronic clinical medicine.

However, midlife obesity, despite having a low polygenic risk score suggesting a greater role for environmental and lifestyle factors than genetics for that individual, was a stronger predictor of CVD than obesity combined with a high polygenic risk score. . HR 2.08 vs 1.55).

“While one should always strive for a healthy lifestyle, the results of the current study and previous work suggest that environmentally induced obesity may be more harmful than genetically induced obesity,” the group concluded.

More complete control of confounding by observing only identical twins in the cohort erased the difference in association between obesity and categorical polygenic risk scores.

“Importantly, this indicates that the negative health effects of obesity may be influenced by factors other than obesity itself, because otherwise we would expect similar effects of obesity, whether predicted by genetic predisposition or environmental factors. suggested Karlsson and his colleagues.

They noted that this is not an isolated finding, pointing to the heterogeneity of genetic versus environmental obesity for important outcomes, including dementia and mortality, in the US data.

The study included data from additional studies of the Swedish Twin Registry, a population-based registry of virtually all twins born in the country. The analysis included 15,786 Swedish twins born before 1959 who had a BMI measured at age 40-64, and 5488 twins with a BMI measured at age 65 or later (3286 were in both groups). CVD was determined from prospective data in linked national health registries and cause-of-death registries up to 2016, with a median of 18 years of follow-up.

In all included additional registry studies (conducted between 1984 and 2010), genotyping was available to obtain an individual polygenic estimate of BMI. This risk estimate was derived from the most recent genome-wide association study of BMI, which identified 941 genetic variants significantly associated with BMI, which together explained 6-14% of the trait variance.

Each standard deviation with a higher polygenic risk score was associated with a higher BMI of 1.23 (95% CI 1.07–1.18) units at middle age and 1.16 (95% CI 1.07–1. 26) units of higher BMI in old age, adjusted for sex and age when BMI is measured. Adjusting for smoking and education did not affect the scores. CVD risk was 14% lower among obese people when the polygenic risk score was increased by one standard deviation from the mean.

“The results were similar when obesity was measured in old age but suffered from low power,” Carlsson and his team noted, although they acknowledged that “the causes and consequences of being overweight or obese in old age are more complex, with evidence inversely. with … mortality.

To identify genetic factors not covered by these variants in the polygenic risk scale, the researchers also looked at pairs of twins: 3124 fraternal and 2020 identical twins with BMI estimated at middle age. Of these, 769 and 443 couples were discordant in terms of CVD status, respectively.

“Because twins share DNA (to varying degrees), in both fetal and early childhood environments, the twin control circuit elegantly controls this mixing,” the researchers write. Previous twin studies have estimated the heritability of BMI at 45-85%.

Associations were blunted in these analyses. The hazard ratio of obesity to cardiovascular risk was 1.14 (95% CI 0.64–2.02) for identical twin pairs and 1.64 (95% CI 1.11–2.42) for fraternal twin pairs. .

When identical pairs of twins were sorted into polygenic risk groups, there was no difference in the association of cardiovascular disease and obesity between genetically predictable low and high BMIs (RR 1.21 and 1.29, respectively).

“If effect estimates remain stable in twin pairs (especially in monozygotic twin pairs that share the same DNA), this indicates, but is not proof of, a causal relationship,” Karlsson and his team noted. “In contrast, if the effect estimate is close to zero in pairs of twins, this is strong evidence against causation, as it indicates that the association is due to genetic or other familial factors.”

Limitations of the study included reliance on some self-measured height and weight data in the analysis to calculate BMI, with the possibility of some misclassification that could bias the results towards zero if they were non-differential with respect to the outcome. In addition, there were no primary care data in the registries, which would preclude finding an association with milder CVD.

“While we all know that it takes more than just exercise and diet to fight obesity, there is still a lot of stigma associated with it,” Karlsson said in a statement. “I think a lot could be gained by focusing on what caused obesity and what we can do to reduce the risk of comorbidities in each person, instead of focusing mainly on BMI.”

Information disclosure

The study was funded by the Karolinska Institute’s Strategic Epidemiology Research Program; Lou and Hans Osterman Foundation; Foundation for Geriatric Diseases of Karolinska Institute; Swedish Research Council for Health, Work Life and Welfare; Swedish Research Council; and the National Institutes of Health.

Carlsson announced payments to her institution from the Karolinska Institute Research Foundation and Eurolife, as well as an award from the Northern Gerontological Federation.

main source

electronic clinical medicine

Link to source: Ojalehto, E. et al. Genetically and environmentally predictable obesity in association with cardiovascular disease: a nationwide cohort study eClinicalMedicine 2023; DOI: 10.1016/j.eclinm.2023.101943.

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Should other countries vaccinate children against chickenpox?



A child in Seattle, Washington receives a chickenpox vaccine in 2019. The US, among other countries, offers children the conventional chickenpox vaccine, unlike countries like the UK and Denmark.

Vaccines sometimes raise unfounded health concerns, but whether or not to get vaccinated against varicella is a matter of real medical debate.

This is a common childhood vaccination in some countries, including the US, Canada, Australia, Japan, and about half of Europe, but there are also countries such as the UK, Denmark, France, Portugal, and several Scandinavian countries. There are concerns that while the introduction of childhood vaccination will be beneficial for those who receive it, it could be detrimental to others, such as older people at risk for shingles.

Fortunately, a growing body of evidence suggests that such harm will not materialize. What’s more, the analysis released today shows that overall, the vaccine does more good than harm. So, isn’t it time for varicella-resistant countries to come to their senses?

Chickenpox is caused by a highly contagious virus called chickenpox. In the absence of vaccination, most people become infected during childhood and usually have a mild illness, the main symptoms of which are an itchy, blistering rash.

In fact, the younger a person is when they become infected, the milder their experience. Some families even deliberately give their children away to other infected people in order to “end the disease.”

But sometimes the virus can cause severe symptoms—for example, if it causes a bacterial infection—and can even be fatal, especially in people with weak immune systems.

When the first varicella vaccine was developed three decades ago, one concern was that while it would benefit children who received it, some parents might not vaccinate their children. A routine vaccination program would mean that population-level immunity would be relatively high, so those who missed vaccinations may not be exposed to the virus until they are teenagers or older, increasing the risk of serious complications compared to childhood infection.

Another concern was the impact on the elderly. After chickenpox infection, the virus DNA remains in nerve cells and can reactivate later in life, leading to the painful and debilitating symptoms of shingles. Chickenpox in children is thought to expose adults to small doses of the virus, boosting their immunity and reducing their chances of developing shingles.

Despite concerns, the US began regularly offering the vaccine to children in 1995, with other countries later following suit. Those who persevered can now see results indicating that administering the vaccine was the right decision.

Several studies over the past few years have shown that the US and other countries no increase in cases of herpes zoster was observed. A UK study found that if adults come into contact with a child with chickenpox in their household, their risk of developing shingles is less than previously thought, with a drop of about 27% from 10 to 20 years.

Data from such studies is now included in a standard set of equations that predict the impact of vaccines on infection and disease rates. This has been used to model the consequences for 50 years if the vaccine is regularly offered to children in Denmark.

The researchers, who included scientists from Merck, the manufacturer of one of the vaccines, and Aarhus University Hospital in Denmark, found that although the number of cases of shingles would rise by about 1% in the first few years after vaccination was introduced. In 50 years, the total number of cases will be 9% lower than expected if Denmark continues not to vaccinate.

They also found that the number of people of any age who die or need hospital treatment for chickenpox will drop by more than 90 percent, contradicting the idea of ​​a rise in more severe cases where unvaccinated people contract the virus at an older age. .

Vaccination programs would also help avoid some of the less obvious effects of the virus, including missing children from school and having parents take time off from work. Manjiri Pavaskar at Merck in Rahway, New Jersey. “This places a significant burden on the caregiver,” she says.

Several countries, including the UK and Denmark, are currently considering adding the varicella vaccine to their regular childhood vaccine offerings. Currently, many such countries allow people to pay for the vaccine privately, but this means that uptake is low. The UK’s vaccine advisory group, the Joint Committee on Vaccinations and Immunization, will take into account any new data, a spokesman for the UK’s Health Security Agency said.

Adults who have had mild chickenpox may be tempted not to get vaccinated against the disease. But one thing that the covid-19 pandemic has shown is that even if the disease seriously affects only a small percentage of the population, it can cause significant harm nationwide, and it is worth taking countermeasures against it.

It may be time for more countries to stop giving the varicella-zoster virus free passage.


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Hugh Jackman May Have Skin Cancer and Takes the Opportunity to Remind People to Use Sunscreen



This isn’t the first time Jackman has reminded people to use sunscreen in an Instagram post. Jackman reveals he has basal cell carcinoma on his nose, adding, “Test yourself. AND USE sunscreen!!!”

In a similar way, Khloe Kardashian recently had two biopsies after noticing a small bump on her cheek that didn’t go away by wearing a bandage while it healed. However, unlike Jackman, Kardashian had a history of melanoma, the most serious form of skin cancer. At 19, she was diagnosed and treated for melanoma on her back.

Around 80% of skin cancers are basal cell carcinoma.affecting close to 1 in 5 americans. This condition is easily treatable and less likely than other types of cancer to spread to other parts of the body.

We asked dermatologists about the early warning signs of basal cell carcinoma, risk factors, prevention and treatment, including the importance of using sunscreen and getting screened for skin cancer.

Here are the early warning signs

Basal cell carcinoma occurs due to a combination of genetic and environmental factors. Chronic exposure to UV rays from the sun is the biggest risk factor, especially in early childhood and adolescence.

“All this happened 25 years ago. It’s coming out now. Apply some sunscreen. You will still have an incredible time there. Fine. Please take care of yourself,” Jackman concluded the video.

Other risk factors include indoor tanning, history of skin cancer, age over 50, fair skin, chronic infections, and skin inflammation, including burns and scars.

Hadley King, a board-certified dermatologist in New York, told BuzzFeed News that there is no such thing as a healthy tan, even if you don’t have sunburn.

“Sunburn is a defense mechanism that kicks in when the DNA of skin cells is damaged by ultraviolet radiation,” King said. “Both sunburn and sunburn are the result of DNA damage that can pave the way for skin cancer.”

Basal cell carcinoma most commonly occurs in parts of the body that are most frequently exposed to the sun, including face, neck and hands. However, symptoms can vary from person to person and the type of skin cancer.

Basal cell carcinoma may appear as a shiny bump that may be red, white, or clear, black, or brown in people with darker skin tones an ulcer filled with fluid that oozes, crusts, or bleeds; a shiny or flaky patch of skin that looks like scar tissue or even one that has pigmented areas or dark patches that look blue or gray in color and could be mistaken for melanoma.

Unlike other skin blemishes or ulcers, skin cancer doesn’t heal, Elizabeth Geddes-Bruce, a board-certified dermatologist at Westlake Dermatology in Austin, told BuzzFeed News. “They can be itchy or painful, pink or brown,” she said. “Basal cell carcinoma often tends to be light pink or clear and may bleed.”

If left untreated, there is a chance that basal cell carcinoma can spread to other parts of the body. However, this type of skin cancer rarely spreads. Common treatment options include various types of surgery, such as curettage or scraping to remove a skin tumor. People rarely need radiation therapy or chemotherapy for basal cell carcinoma.

Importance of SPF

Since wearing sunscreen can reduce skin damage and skin cancer, finding a product that will protect your skin even on non-sunny days can be helpful for prevention.

“It’s very important to practice sun protection every day and I think this is often overlooked because people think it’s only important on particularly sunny days and they’ll be spending a significant amount of time in the sun,” King. said. “Some people think that the products are unpleasant to use – they will smell like coconuts or look like white paste. The good news is that there are great, sleek products available these days that are very easy to integrate into your daily routine.”

The FDA recommends using broad spectrum sunscreen with included SPF 15 or higher on all exposed skinespecially the nose, ears, neck, hands, feet and lips. The highest SPF over 50 protects against UV radiation.

It’s also important to reapply sunscreen every two hours after swimming or sweating, leaving it on for 30 minutes.

In addition, protective clothing Sunglassesand staying in the shade can protect against the sun’s UVA and UVB rays, in addition to avoid tanning beds.

Skin cancer screening can save lives

According to the Skin Cancer Foundation, you should get a full screening for skin cancer at least once a year, and more often if you have risk factors.

If a suspicious lesion is found, the doctor may perform a biopsy in several ways:

“Skin cancer screening absolutely saves lives,” Geddes-Bruce said. “We often do not spend enough time studying our body and do not notice a changing or suspicious spot. A certified dermatologist can do this for you and detect skin cancer or precancerous conditions early, while they are still easily treatable.”

In between skin cancer screenings, King recommends monthly head-to-toe self-exams for any suspicious lesions.

“I recommend doing it completely naked, in front of a full-length mirror, with a hand mirror in a well-lit area,” King said. “It is extremely important to know your skin very well so that you can recognize if there are spots that are new or changing. Some dermatologists recommend doing this on your birthday and every month on that day to help you remember to check your birthday suit on your birthday.”

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