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Despite knowledge of classical coronary artery disease (CAD) risk factors, the morbidity and mortality associated with this disease remain high. Therefore, new factors that may affect the development of CAD, such as the gut microbiome, are extensively investigated. This study aimed to evaluate gut microbiome composition in CAD patients in relation to the control group. We examined 169 CAD patients and 166 people in the control group, without CAD, matched in terms of age and sex to the study group. Both populations underwent a detailed health assessment. The microbiome analysis was based on the V3–V4 region of the 16S rRNA gene (NGS method). Among 4074 identified taxonomic units in the whole population, 1070 differed between study groups. The most common bacterial types were Firmicutes, Bacteroidetes, Proteobacteria, and Actinobacteria. Furthermore, a higher Firmicutes/Bacteroidetes ratio in the CAD group compared with the control was demonstrated. Firmicutes/Bacteroidetes ratio, independent of age, sex, CAD status, LDL cholesterol concentration, and statins treatment, was related to altered phosphatidylcholine concentrations obtained in targeted metabolomics. Altered alpha-biodiversity (Kruskal–Wallis test, p = 0.001) and beta-biodiversity (Bray–Curtis metric, p &lt, 0.001) in the CAD group were observed. Moreover, a predicted functional analysis revealed some taxonomic units, metabolic pathways, and proteins that might be characteristic of the CAD patients’ microbiome, such as increased expressions of 6-phospho-β-glucosidase and protein-N(pi)-phosphohistidine-sugar phosphotransferase and decreased expressions of DNA topoisomerase, oxaloacetate decarboxylase, and 6-beta-glucosidase. In summary, CAD is associated with altered gut microbiome composition and function.

Background: Chemerin is an adipokine and a chemoattractant for leukocytes. Increased chemerin levels were observed in patients with coronary artery disease (CAD). We investigated associations between chemerin and biochemical measurements or body composition in CAD patients. Methods: In the study, we included patients with stable CAD who had undergone percutaneous coronary intervention (PCI) in the past. All patients had routine blood tests, and their insulin and chemerin serum levels were routinely measured. Body composition was assessed with the DEXA method. Results: The study group comprised 163 patients (mean age 59.8 ± years, 26% of females, n = 43). There was no significant difference in serum chemerin concentrations between patients with diabetes and the remaining ones: 306.8 ± 121 vs. 274.15 ± 109 pg/mL, p = 0.1. Chemerin correlated positively with the white blood cell (WBC) count, the neutrophil to lymphocyte ratio, hsCRP, all fractions of cholesterol, triglycerides, platelet count, fasting insulin, and c-peptide. Chemerin levels were also correlated with total fat mass but only in a subgroup with normal glucose metabolism. Conclusion: In patients with CAD, serum chemerin levels are correlated with inflammation markers, insulin resistance, and an unfavorable lipid profile. Correlation with fat mass is dependent on glucose metabolism status. Depending on the presence of diabetes/prediabetes, the mechanisms regulating chemerin secretion may be different.

Background While obesity has been correlated with welfare in the general population, there is not much data on the influence of body composition on welfare among the non-obese adult individuals. Methods A longitudinal, population-based study was conducted in 2017–2020. Body composition was assessed using Dual Energy X-ray Absorptiometry. Welfare was rated with Satisfaction with Life Scale (SWLS), Euro Quality of Life Visual Analogue Scale (EQ-VAS) and Beck Depression Inventory (BDI). Results A total of 726 non-obese individuals from general population were analyzed. The mean age was 46.8 ± 15.4 years and 42.1% of participants were male. The mean value for SWLS was 23.09 ± 5.43, for EQ-VAS was 78.0 ± 14.5, and for BDI was 6.7 ± 6.6. On SWLS the waist-hip ratio had a negative impact even after adjustment for age, gender and concomitant diseases. EQ-VAS was inversely associated with android fat distribution and directly associated with muscle mass. BDI value was inversely associated with lower muscle mass, especially of the lower limbs. The well-being of women was mainly associated with the distribution of adipose tissue and less with the distribution of muscle tissue - abdominal fat distribution has a particularly negative impact on well-being among women. In contrast, men's well-being depends more on muscle mass and to a lesser extent on the distribution of fat tissue - a positive significant effect has lean mass and a circumference of thigh below gluteal fold. Conclusions Body composition is significantly associated with welfare in non-obese population. Android type fat distribution may have a negative impact while muscle mass positive.

Background: Cardiovascular disease (CVD) is a major, worldwide problem that remains the dominant cause of premature mortality in the world, and increasing rates of dysglycaemia are a major contributor to its development. The aim of this study was to investigate the cardiometabolic profile among patients in particular cardiovascular risk classes, and to estimate their long term CV risk. Methods: A total of 931 individuals aged 20–79 were included. The study population was divided into CV risk classes according to the latest European Society of Cardiology recommendations. Results: Most of the analyzed anthropometric, body composition and laboratory parameters did not differ between the moderate and high CV risk participants. Interestingly, estimating the lifetime risk of myocardial infarction, stroke or CV death, using the LIFEtime-perspective model for individualizing CardioVascular Disease prevention strategies in apparently healthy people, yielded similar results in moderate and high CV risk classes. Conclusion: The participants who belonged to moderate and high CV risk classes had very similar unfavorable cardiometabolic profiles, which may result in similar lifetime CV risk. This may imply the need for more aggressive pharmacological and non-pharmacological management of CV risk factors in the moderate CV risk population, who are often unaware of their situation. New prospective population studies are necessary to establish the true cardiovascular risk profiles in a changing society.

In recent years, research has provided increasing evidence for the importance of inflammatory etiology in age-related macular degeneration (AMD) pathogenesis. This study assessed the profile of inflammatory cytokines in the serum of patients with AMD and coexisting glucose disturbances (GD). This prospective population-based cohort study addressed the determinants and occurrence of cardiovascular, neurological, ophthalmic, psychiatric, and endocrine diseases in residents of Bialystok, Poland. To make the group homogenous in terms of inflammatory markers, we analyzed only subjects with glucose disturbances (GD: diabetes or prediabetes). Four hundred fifty-six patients aged 50–80 were included. In the group of patients without macular degenerative changes, those with GD accounted for 71.7%, while among those with AMD, GD accounted for 89.45%. Increased serum levels of proinflammatory cytokines were observed in both AMD and GD groups. C1qTNF1 concentration was statistically significantly higher in the group of patients with AMD, with comparable levels of concentrations of other proinflammatory cytokines. C1qTNF1 may act as a key mediator in the integration of lipid metabolism and inflammatory responses in macrophages. Moreover, C1qTNF1 levels are increased after exposure to oxidized low-density lipoprotein (oxLDL), which plays a key role in atherosclerotic plaque formation and is also a major component of the drusen observed in AMD. C1qTNF1 may, therefore, prove to be a link between the accumulation of oxLDL and the induction of local inflammation in the development of AMD with concomitant GD.

Background: Left ventricular diastolic dysfunction (LVDD) is caused by a decreased left ventricle relaxation and is associated with an increased risk of symptomatic heart failure (HF) and excessive mortality. Aim: To evaluate the frequency and factors related to LVDD in the population with chronic coronary syndromes (CCS). Methods: 200 patients (mean age 63.18 &plusmn, 8.12 years, 75.5% male) with CCS were included. LVDD was diagnosed based on the recent echocardiography guidelines. Results: LVDD was diagnosed in 38.5% of CCS population. From the studied factors, after adjustment for age, sex, and N-terminal pro-brain natriuretic peptide (NT-proBNP), LVDD associated positively with android/gynoid (A/G) fat mass ratio, left ventricular mass index (LVMI), and negatively with Z-score and left ventricular ejection fraction (LVEF). In stepwise backward logistic regression analysis, the strongest factors associated with LVDD were pulse wave velocity value, handgrip strength and waist to hip ratio (WHR). Conclusions: LVDD is common among CCS patients and it is associated with parameters reflecting android type fat distribution regardless of NT-proBNP and high-sensitivity troponin T concentrations. Deterioration in diastolic dysfunction is linked with increased aortic stiffness independently of age and sex. Further studies evaluating the effects of increasing physical fitness and lowering abdominal fat accumulations on LVDD in CCS patients should be considered.

Left ventricular hypertrophy (LVH) is an important risk factor of various cardiovascular (CV) diseases and sudden death. Electrocardiography (ECG) is commonly used to detect LVH, but it has poor sensitivity, especially in high cardiovascular risk patients. Although echocardiography (ECHO) is a better, it is less available, and more expensive. Aim: To improve ECG scores to diagnose LVH in a general population. Methods The study was conducted in 2017–2019 in a representative sample of area residents. 717 volunteers randomly chosen from the local population were examined. Due to incomplete data, QRS complex duration ≥120ms, fascicular blocks, bundle branch blocks, paced rhythm, 216 people were excluded. Physical examination, ECG, ECHO and laboratory assessment were performed. In ECG LVH defined as >28mm for men, >20mm for women using Cornell index; >17mm for both sexes using Lewis index. In ECHO LV mass was calculated using the Devereux Formula and indexed by body surface area (left ventricular mass index – LVMI). The LVH was defined as LVMI ≥115 g/m2 for man and ≥95 g/m2 for women. Cardiovascular risk was calculated based on the ESC SCORE and additional risk categories published in the latest ESC guidelines. We analyzed 4 models to predict the probability of LVH at ECHO: Model 1: Cornell index; Model 2: Lewis index; Model 3: Cornel index + clinical parameters (age, sex, BMI, office BPs, QRS time, hs-TnT, and HbA1c); Model 4: Lewis index + clinical parameters (age, sex, BMI, office BPs, QRS time, hs-TnT, and HbA1c). Associations between LVH and clinical and biochemical variables were earlier analyzed using multiple linear regression models, these parameters were independently associated with LVH. Results A total of 501 patients were included. The average age of patients was 49.0±15.35 years, and 203 probants (40.5%) were male. We developed a novel score to assess the probability of LVH at ECHO in general population based on nine items (age, sex, body mass index, office BPs, Cornell index or Lewis index, QRS time, hs-TnT, and HbA1c). Additional clinical parameters improved sensitivity of Cornell index up to 86.0% (AUC:0.8011; 95% CI:0.748–0.854) from 64.9% (AUC:0.6450; 95% CI:0.573–0.716) in general population, to 92.9% (AUC:0.8423; 95% CI:0.760–0.924) from 64.3% (AUC:0.6481; 95% CI:0.518–0.779) in low CV risk patients, to 69.2% (AUC:0.6767; 95% CI:0.544–0.809) from 38.5% (AUC:0.5284; 95% CI:0.352–0.705) in moderate CV risk, and to 73.3% (AUC:0.7151; 95% CI: 0.609–0.821) of Lewis index from 50.0% (AUC: 0.5630; 95% CI:0.448–0.678) in high and very-high CV risk class. Conclusions Addition of clinical parameters to ECG indices in the diagnosis of LVH markedly improves their diagnostic efficacy both in general population and in higher risk groups. The new score may be useful in guiding the appropriateness of ECHO study in general population, and especially in moderate and high CV risk patients, who are not always aware of the increased CV risk. ROC curves for recognize LVH. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Medical University of Bialystok for Bialystok PLUS study

Background Chemerin – a recently described hormone is secreted by adipose tissue. It exerts proinflammatory action, leads to insulin resistance, but also has potentially favorable effects: it increases eNOS activity and is pro-angiogenic. Increased serum concentrations of chemerin was observed in patients with coronary artery disease (CAD). The role of chemerin in pathogenesis of CAD is not well understood. Purpose The aim of this pilot study was to assess the role of chemerin in pathogenesis of atherosclerosis, its impact on condition of large arteries and prognosis in CAD. Methods We included in the study patients with stable CAD who underwent percutaneous coronary intervention (PCI) in the past. Chemerin levels were measured with ELISA method. All patients had routine blood tests and insulin levels measured. Patients without history of diabetes also had OGTT. Status of large arteries was evaluated with carotid ultrasound, pulse-wave velocity (PWV) and ankle-brachial index (ABI). Body composition was assessed wit DEXA method. Anatomical severity of CAD was evaluated with SYNTAX score. One-year composite endpoint included death, myocardial infarction, revascularization, stroke and hospitalization for cardiovascular reasons. Results The study group comprised 163 patients (mean age 59.8± years, 26% of females, n=43). Mean chemerin level was 284.8 ng/ml. There was no significant difference in chemerin concentrations between patients with diabetes and remaining ones (with prediabetes and with normal glucose levels) 306.8±121 vs 274.15±109 pg/ml, p=0.1. In Spearman test chemerin level correlated with total fat mass (R=0.15, p=0.047), trunk fat mass (R=0.16, p=0.039), android fat mass (R=0.16, p=0.036), and BMI (R=0.18, p=0.028). Chemerin also correlated with white blood cells (WBC) count (R=0.34, p Conclusions This is the first study to show that in patients with CAD chemerin levels correlate with WBC and with android fat tissue mass. Additionally, chemerin levels positively correlated with other inflammation or insulin resistance markers, and with unfavourable lipid profile. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): The National Science Centre

Background: Natriuretic peptides (NPs), including brain natriuretic peptide (BNP), are neurohormones involved in the regulation of water-sodium balance and the maintenance of cardiovascular homeostasis. A higher concentration of NPs is observed in females, but the mechanism behind this difference has not been fully elucidated. Methods: Randomly chosen 255 volunteers from the general population were examined. Overall, 196 people without severe cardiovascular disease were included (mean age 48 years, 35.7% male). A comprehensive assessment was performed, including anthropometric measurements, N-terminal pro-brain natriuretic peptide (NT-proBNP), total testosterone (TT) and sex hormone-binding globulin (SHBG) concentration, transthoracic echocardiography (ECHO), and body composition analysis by direct dual-energy X-ray absorptiometry (DEXA). The univariate analysis adjusted by the known affecting factors determined which measurements were independently associated with NT-proBNP concentration. Results: NT-proBNP concentration was positively associated with gynoid fat mass, gynoid/total fat (G/TF) mass index, SHBG and negatively with android/gynoid (A/G) fat mass index, TT and calculated free testosterone (CFT) concentrations. Furthermore, body composition parameters remained independently associated with NT-proBNP levels even after adjusting for CFT and SHBG. Conclusion: In the population without severe cardiovascular disease, the NT-proBNP concentration is independently associated with lower availability of testosterone and higher gynoid fat distribution, which may explain higher NPs levels in females.

Background: Left ventricular hypertrophy (LVH) is an important risk factor for cardiovascular events. The electrocardiography (ECG) has poor sensitivity, but it is commonly used to detect LVH. Aim: To evaluate the diagnostic efficacy of known ECG indicators to recognize LVH in subgroups with different cardiovascular risk levels. Methods: 676 volunteers were included. Results: We found that 10.2% of the analyzed population had LVH based on echocardiography. Individuals with LVH were older, had a higher body mass index, higher systolic blood pressure, lower heart rate, higher parameters of insulin resistance, higher cardiovascular risk, and android-type obesity. Variables that remained independently associated with LVH were QRS duration, left atrial volume index, troponin T, and hemoglobin A1c. The receiver operating characteristics (ROC) curve analysis of the Sokolow&ndash, Lyon index did not show a significant predictive ability to diagnose LVH in the whole study population including all cardiovascular risk classes. The ROC curves analysis of Cornell and Lewis indices showed a modest predictive ability to diagnose LVH in the general population and in a low cardiovascular class. Conclusions: There is a need for new, simple methods to diagnose LVH in the general population in order to properly evaluate cardiovascular risk and introduce optimal medical treatment of concomitant disease.