Startseite Atherogenic index of plasma and coronary artery disease: A systematic review
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Atherogenic index of plasma and coronary artery disease: A systematic review

  • Juan R. Ulloque-Badaracco , Enrique A. Hernandez-Bustamante , Esteban A. Alarcon-Braga , Melany D. Mosquera-Rojas , Alvaro Campos-Aspajo , Farley E. Salazar-Valdivia , Valeria A. Valdez-Cornejo , Vicente A. Benites-Zapata EMAIL logo , Percy Herrera-Añazco , Germán Valenzuela-Rodríguez und Adrian V. Hernandez
Veröffentlicht/Copyright: 6. Dezember 2022
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Aus der Zeitschrift Open Medicine Band 17 Heft 1

Abstract

Various studies suggest that the atherogenic index of plasma (AIP) is associated with the risk of coronary artery disease (CAD) in different clinical scenarios. This review aimed to synthesize evidence of the association between AIP values and CAD. A literature search was carried out on four databases, namely, PubMed, Scopus, Web of Science, and Ovid-Medline. A handsearch was performed on preprint repositories (MedRxiv and Research Square). The effect measurements were expressed as odds ratios (OR) with their corresponding 95% confidence intervals (CI). For the quantitative synthesis, we employed a random-effects model. We analyzed 14 articles (with 40,902 participants) from seven different countries. The quantitative analysis revealed that an increase in one unit of AIP was associated with higher odds of developing CAD (OR 2.11; 95% CI 1.65–2.69; P < 0.001; I 2 = 98%). We conducted subgroup analyses of Chinese (OR 1.89; 95% CI 1.40–2.56; P < 0.001) and non-Chinese studies (OR 2.51; 95% CI 1.42–4.42; P < 0.001). The sensitivity analysis by risk of bias continued to demonstrate an association, and the heterogeneity remained unchanged (OR 1.75; 95% CI 1.33–2.31; P < 0.001; I 2 = 98%). Higher AIP values were associated with higher odds of developing CAD.

Keywords: coronary disease; dyslipidemias; atherosclerosis; lipids; heart diseases

1 Introduction

Coronary artery disease (CAD), also referred to as coronary heart disease (CHD) or ischemic heart disease, is a disease with a high prevalence and is one of the leading causes of death worldwide [1,2,3]. In the last few decades, as preventive and treatment measures have strengthened and improved, the incidence and mortality of this pathology have decreased in developed countries [4,5,6,7]. However, the global prevalence is expected to increase to 1,845 cases per 100,000 population by 2030 [1].

Cardiac risk stratification is necessary to improve preventive and therapeutic interventions [8]. Biomarkers are an essential component in this task, either as part of prediction models or on their own. In recent years, multiple CAD risk biomarkers have been identified and investigated, including C-reactive protein [9], lipoprotein-associated phospholipase A2 [10], and fibrinogen [11], among others. The atherogenic index of plasma (AIP) is a novel biomarker consisting of the logarithmically transformed ratio of triglycerides to high-density lipoprotein (HDL)-cholesterol in molar concentrations. Unlike biomarkers such as serum amyloid alpha [12] or matrix metalloproteinases [13], AIP is an easily accessible biomarker because only a standard lipid profile is required for its calculation [14].

Hypertriglyceridemia and low HDL levels are independent markers of CHD [15,16]. Therefore, the AIP combines these two lipid parameters into a single biomarker to boost its predictive capabilities.

Thus, several studies have suggested that AIP acts as a marker associated with cardiovascular diseases in patients with various pathologies [17,18,19,20,21,22]. This association is related to a surrogate involvement of endothelial vascular damage, such as carotid intima-media thickening, compromised atrial coronary anatomical, or clinical conditions, e.g., stroke and acute coronary syndromes, as a manifestation of CAD. However, to the best of our knowledge, the evidence of the association between AIP and CAD has not been systematized. Thus, this review aimed to synthesize such evidence.

2 Methods

2.1 Study design, registration, and report guideline

We conducted this systematic review in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement [23]. The summarized version of the protocol was registered in the International Prospective Register of Systematic Reviews with code CRD42021289308 (see PRISMA checklist in Table S1).

2.2 Data sources and searches

We conducted a literature search on articles that evaluated the association between AIP and CAD on October 15, 2021. Four databases were searched: PubMed, Scopus, Web of Science, and Ovid-Medline. A handsearch was also performed on preprint repositories (MedRxiv and Research Square) (see Supplementary Appendix 1).

2.3 Study selection and data extraction

The articles collected from the aforementioned databases were exported to the Rayyan data management software [24], and duplicate studies were eliminated. Four reviewers independently screened each study (A.C.-A., E.A.A.-B., E.A.H.-B., and J.R.U.-B.) by analyzing the titles and abstracts according to the selection criteria. We included (1) case–control and cohort studies that (2) evaluated the association between AIP and CAD in (3) adults (≥18 years old). We excluded articles that were (1) case reports, (2) studies conducted on animals, (3) scoping reviews, (4) narrative reviews, and (5) systematic reviews.

Once this phase was completed, each of the articles was read in full-text, and we determined whether they met the previously established selection criteria. A study was excluded if it failed to comply with the selection criteria. If an article did not contain the required information, an attempt was made to contact the corresponding author of the said article. A secondary bibliographic search was conducted on the articles that reached the full-text review phase.

In case of disagreements on the inclusion or exclusion of an article, a third reviewer was consulted. Finally, information of the selected articles was extracted and collated in a standardized Excel 2016 document. The extracted data included author name, country, year of publication, study sample, study design, population characteristics (age, gender, etc.), exposure (AIP mean or median of the whole sample and according to sample stratification), and crude/adjusted association measures (odds ratio [OR], relative risk [RR], and hazard ratio). Outcome definitions are presented in Table S2.

2.4 Assessment of study quality and publication bias

Four authors (A.C.-A., V.A.V.-C., M.D.M.-R., and F.E.S.-V.) evaluated the included studies independently using the Newcastle–Ottawa Scale [24]. The studies were stratified into three levels of methodological quality according to the number of stars: low risk of bias (≥6 stars), moderate risk of bias (4–5 stars), and high risk of bias (<4 stars). In addition, funnel plots and Begg’s test were conducted to assess publication bias; P-values > 0.1 were considered indicative of no publication bias.

2.5 Data synthesis and analysis

The quantitative analysis was conducted using the RevMan 5.4 statistical program (Cochrane Collaboration, Copenhagen, Denmark). The OR and their corresponding 95% confidence intervals (CI) were the only effect measures used; thus, we transformed standardized mean differences to ln[OR] using the Chinn method. RR was converted into OR [25,26]. Variables expressed as median and interquartile range were converted to means and standard deviation using Hozo’s method [27]. We assessed statistical heterogeneity by calculating the I 2-statistic, where values >60% were considered to indicate severe heterogeneity. A Cochran’s Q test was also conducted, where a P-value < 0.05 was considered statistically significant. A random-effects model was used for the meta-analysis as we anticipated heterogeneity among studies. In the subgroup analysis, we conducted a comparison between associations according to country (Chinese vs non-Chinese studies), study design, CAD definition, and gender (women vs mixed). In the sensitivity analysis, we excluded studies with a high risk of bias. We also analyzed all studies after transforming OR to RR. In addition, we performed a meta-regression, reported as bubble plots, in order to search for heterogeneity sources, due to differences in the clinical and methodological characteristics of the individual studies. Assessed variables were study design, study location, CAD definition, and gender.

3 Results

3.1 Study selection

The search strategy yielded 975 records. After removing 610 duplicates, 365 articles finally remained. After evaluating the titles and abstracts, we excluded 322 more studies. Then, a full-text review was performed on the remaining 43 articles, which led to the exclusion of 29 more articles. In the end, 14 articles were included in the qualitative analysis and meta-analysis [20,28,29,30,31,32,33,34,35,36,37,38,39,40]. This process is documented in a PRISMA flow diagram (Figure 1).

Figure 1 PRISMA flow diagram.
Figure 1

PRISMA flow diagram.

3.2 Study characteristics

The characteristics of each study are presented in detail in Table 1. Most of the articles (8 out of 14) were case–control studies, and six were cohort studies. The distribution of the studies by country was as follows: China (7), India (1), Turkey (2), Egypt (1), South Korea (1), Slovakia (1), and the USA (1). In total, there were 40,902 participants with samples ranging from 80 to 11,164 participants. The gender distribution was as follows: 17,026 were male, and 23,876 were female. The study by Celik et al. reported an optimal cutoff value of AIP for CAD of 0.541 and an area under the curve of 0.617 [30].

Table 1

Clinical characteristics of the included studies

Author Year Country Participants (male/female) Median/mean age (Interquartile range\standard deviation (SD)) Study design AIP mean (SD) in CAD patients AIP mean (SD) in non-CAD patients SMD between CAD and non-CAD patients OR (95% CI), P-value (crude) OR (95% CI), P-value (adjusted)
Onat et al. 2010 Turkey 2,676 (1,294/1,392) 49 (13) Cohort NR NR NR NR 1.34 (1.11–1.61), P < 0.001a
Raj-Sedhai et al. 2018 USA 313 (169/144) 63 (12) Cohort 0.39 (0.03) 0.35 (0.02) 1.51 [1.25, 1.76] NR NR
Al-Shaer et al. 2021 Egypt 140 (NR/NR) NR Case–control 0.20 (0.27) 0.1 (0.27) 0.37 [0.03, 0.70] NR NR
Celik et al. 2019 Turkey 280 (154/126) 64 (10) Case–control 0.62 (0.30) 0.48 (0.28) 0.48 [0.24, 0.72] NR NR
Wang et al. 2021 China 3,600 (2,243/1,357) 60 (10) Cohort NR NR NR 2.6 (2.381–2.8348), P < 0.001 NR
Won et al. 2020 South Korea 6,928 (3,977/2,951) 52 (10) Cohort NR NR NR 1.1 (1.07–1.13), P < 0.001 NR
Guo et al. 2020 China 4,644 (0/4,644) 64 (8) Case–control 0.15 (0.28) 0.10 (0.28) 0.18 [0.12, 0.24] NR NR
Wu et al. 2018 China 696 (0/696) 61 (7) Case–control 0.20 (0.27) 0.10 (0.27) 0.37 [0.03, 0.70] NR NR
Cai et al. 2017 China 5,387 (3,242/2,145) 62 (9) Case–control 0.17 (0.30) 0.12 (0.31) 0.16 [0.11, 0.22] NR NR
Pridavkova et al. 2015 Slovakia 80 (43/37) NR Cohort 0.22 (0.29) 0.17 (0.34) 0.16 [−0.29, 0.61] NR NR
Shanker et al. 2016 India 11,164 (7,379/3,515) 53 (8) Cohort NR NR NR 1.80 (1.54–2.1), P < 0.001 NR
Dai et al. 2012 China 238 (0/238) 65 (7) Case–control 0.61 (0.14) 0.53 (0.09) 0.67 [0.41, 0.93] NR NR
Zhou et al. 2021 China 3,278 (2,473/805) 59 (10) Case–control 0.37 (0.23) 0.25 (0.26) 0.50 [0.42, 0.57] NR NR
Gaojun et al. 2019 China 1,478 (1,373/1,05) 33 (30–35) Case–control 0.35 (0.30) 0.21 (0.33) 0.45 [0.34, 0.57] NR NR

a: Adjusted to age and serum C-reactive protein. NR: Not reported.

3.3 Assessment of study quality and publication bias

Table S3 presents the results of the methodological quality assessment. In summary, 10 and 4 studies were classified as having a low and moderate risk of bias, respectively.

3.4 AIP and risk of CAD

The quantitative analysis revealed that patients with higher AIP values were associated with higher odds of developing CAD (OR 2.11; 95% CI 1.65–2.69; P < 0.001) (Figure 2a) with severe heterogeneity (I 2 = 98%). Statistically significant associations with high heterogeneity were observed in all subgroup analyses by study location (Figure 2b), study design (Figure 2c), definition of CAD (Figure 2d), and gender (Figure 2e). Sensitivity analyses were conducted. In one analysis, only studies with a low risk of bias (Figure 2f) were included (OR 1.75; CI 95% 1.33–2.31; P < 0.001; I 2 = 98%), whereas in the other, all OR values were transformed to RR (RR 1.29; CI 95% 1.17–1.42; P < 0.001; I 2 = 99%); however, the association with high heterogeneity remained in both cases (Figure 2g).

Figure 2 (a) Association of AIP and risk for CAD. (b) Subgroup analysis according to the origin country of the association between AIP and risk for CAD. (c) Subgroup analysis according to the study design of the association between AIP and risk for CAD. (d) Subgroup analysis according to CAD definition of the association between AIP and risk for CAD. (e) Subgroup analysis according to the gender of the association between AIP and risk for CAD. (f) Sensitivity analysis according to the risk of bias of the association between AIP and risk for CAD. (g) Sensitivity analysis according to the transformation from OR to RR.
Figure 2 (a) Association of AIP and risk for CAD. (b) Subgroup analysis according to the origin country of the association between AIP and risk for CAD. (c) Subgroup analysis according to the study design of the association between AIP and risk for CAD. (d) Subgroup analysis according to CAD definition of the association between AIP and risk for CAD. (e) Subgroup analysis according to the gender of the association between AIP and risk for CAD. (f) Sensitivity analysis according to the risk of bias of the association between AIP and risk for CAD. (g) Sensitivity analysis according to the transformation from OR to RR.
Figure 2 (a) Association of AIP and risk for CAD. (b) Subgroup analysis according to the origin country of the association between AIP and risk for CAD. (c) Subgroup analysis according to the study design of the association between AIP and risk for CAD. (d) Subgroup analysis according to CAD definition of the association between AIP and risk for CAD. (e) Subgroup analysis according to the gender of the association between AIP and risk for CAD. (f) Sensitivity analysis according to the risk of bias of the association between AIP and risk for CAD. (g) Sensitivity analysis according to the transformation from OR to RR.
Figure 2

(a) Association of AIP and risk for CAD. (b) Subgroup analysis according to the origin country of the association between AIP and risk for CAD. (c) Subgroup analysis according to the study design of the association between AIP and risk for CAD. (d) Subgroup analysis according to CAD definition of the association between AIP and risk for CAD. (e) Subgroup analysis according to the gender of the association between AIP and risk for CAD. (f) Sensitivity analysis according to the risk of bias of the association between AIP and risk for CAD. (g) Sensitivity analysis according to the transformation from OR to RR.

3.5 Meta-regression

No significantly associated coefficient was observed in study location (P = 0.974) (Figure S1), study design (P = 0.959) (Figure S2), CAD definition (P = 0.614) (Figure S3), or gender (P = 0.958) (Figure S4).

3.6 Publication bias

There was no indication of small-study effects (Begg’s test, P = 0.956), and the funnel plots did not show asymmetry (Figure S5).

4 Discussion

From our systematic review and meta-analysis, we obtained sufficient evidence to consider AIP as a marker of CAD risk in the general population.

Multiple studies suggested the value of AIP as a predictor of fatty liver [41], hidradenitis suppurativa [42], osteomyelitis in patients with diabetic foot [43], obesity [44], diabetes [45], and an estimate-reduced glomerular filtration rate [46]. These associations are related to oxitdative stress [47], insulin resistance and hyperinsulinemia [45], and mechanisms associated with atherosclerosis [43,44], which are common risk factors for cardiovascular disease.

AIP is positively correlated with the fractional esterification rate of HDL, especially with small dense low-density lipoprotein (sdLDL), whose expression in AIP reflects the complex interactions of lipoprotein metabolism and is useful in predicting plasma atherogenicity [48]. sdLDL has atherogenic properties, such as reduced clearance from the bloodstream, enhanced oxidation compared with other lipoproteins, enhanced binding to endothelial proteoglycans, enhanced penetration across the endothelial barrier, and increased uptake by macrophage receptors [49]. These properties increase the formation of foam cells and are the initial stages of atherogenesis [50]. These factors could explain the results of different studies indicating an association between AIP and CAD [51,52,53], which varies depending on the value of this marker. In this way, Dobiásová suggested that AIP values between −0.3 and 0.1 were associated with low cardiovascular risk and AIP values from 0.1 to more than 0.24 were associated with high cardiovascular risk [14].

For the aforementioned reasons, our finding of an association between high AIP values and increased CAD risk is not surprising. In addition to the aforementioned factors, factors associated with specific CAD conditions could also explain our results. In this context, some studies have found an association between AIP and arterial stiffness in normotensive patients [54], which is a risk factor for CAD [55]. Choudhary et al., in a study conducted on subjects without antihypertensive or lipid-lowering therapy, found that AIP was related to pulse wave velocity but not to aortic or radial blood pressure, cardiac output, or systemic vascular resistance [54] Similarly, other studies associated AIP with the progression of coronary calcification, a known surrogate marker of CAD [56]. Two studies from Korea found a significant correlation between AIP and coronary calcification progression in subjects without cardiovascular disease [57], although AIP was not an independent predictor [57].

Contrarily, in a multinational study in seven countries from 2003 to 2015, this association was independent of traditional risk factors [58]. Similarly, AIP was also a predictor of subclinical CAD. A study of patients with or without chronic kidney disease found that AIP was associated with advanced subclinical CAD after adjustment for age older than 60 years, male sex, hypertension, diabetes mellitus, dyslipidemia, obesity, and proteinuria [59].

Finally, some studies demonstrated an association between AIP and the evolution of patients with acute coronary syndromes and myocardial infarction. For example, a Turkish study found that AIP was independently associated with the absence of reflow in patients with ST-elevated myocardial infarction following the primary percutaneous coronary intervention [52]. Surprisingly, a study in Jakarta found that patients hospitalized following myocardial infarction with AIP values <0.24 had almost four times higher mortality than those who did not have [60]. Although the authors did not find an explanation for their results, they suggested the role of the patients’ diet as a possible reason.

The meta-analysis conducted by Wu et al. [61] found that high AIP values are associated with an increased risk of AIP; however, this meta-analysis has many inconsistencies, such as the incorrect grouping of values in the overall meta-analysis, as they placed AIP values according to gender, which should have been done in a subgroup analysis according to the participants’ gender. Another error in this manuscript is the lack of explanation of how the AIP values were obtained for the subgroup analysis according to the patients’ health status because there is no such information in the primary studies they used.

Despite the evidence suggesting an association between AIP and CAD, this is a systematic review and meta-analysis that systematize the available evidence. We also conducted sensitivity analyses considering the biases of the studies and the place of origin of the studies, which provided robustness to our results. The findings obtained allow us to suggest the use of AIP as a potential low-cost marker of CAD that will allow health personnel to prioritize management strategies and could even be used as part of predictive scores, replacing markers such as triglycerides. Similarly, the usefulness of this marker is independent of the age of the patients [39,62], although, concerning gender, some studies suggested that, at least in young patients, its predictive value is mainly in males [39], which should be verified in subsequent studies. However, despite the fact that AIP is a marker that is calculated using parameters that are easy to obtain in clinical practice and that our results indicate its usefulness, the studies included in our systematic review are flawed and have small sample sizes. In this sense, despite being promising, more studies with better design are needed before adopting it in usual clinical practice.

Our systematic review has some limitations that must be acknowledged. First, there is evidence of high statistical heterogeneity due to the clinical and methodological differences between the analyzed studies. Second, most studies have not controlled the AIP values for confounding variables that impact the proposed outcome. Sociodemographic lifestyles and comorbidity variables should be considered in future studies to avoid confounding bias. Despite this, the direction of the effect is consistent in most of the reported studies. Third, most studies were conducted in Asia, with few or no studies found in other continents. Therefore, it is important to analyze the AIP value in CAD risk in these populations to establish its usefulness. Fourth, no definitive cutoff points have been reported to set the sensitivity and specificity of the AIP in CAD; thus, it is necessary to address it in future research in various contexts and populations. Finally, our findings indicate that high AIP values are associated with a greater possibility of suffering from CAD; however, with the obtained evidence, we consider that AIP is a risk marker and not a causal risk factor because the causes of lipid alterations are mediated by genetic and environmental factors. The AIP in altered ranges would be the expression of this multicausality and, therefore, a biomarker of the pathophysiological process leading to the appearance of CAD.

5 Conclusion

This systematic review and meta-analysis demonstrated that patients with higher AIP values have higher odds of developing CAD. However, additional primary studies are warranted to define an optimal cutoff point of AIP to predict CAD.

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Acknowledgments

None.

  1. Funding information: The authors state that there is no funding involved.

  2. Author contributions: J.R.U.-B.: conceptualization, methodology, investigation, formal analysis, and writing – original draft. A.H.-B.: methodology, investigation, formal analysis, and writing – original draft. A.A.-B.: methodology, investigation, formal analysis, and writing – original draft. M.D.M.-R.: methodology, investigation, formal analysis, and writing – original draft. A.C.-A.: methodology, investigation, formal analysis, and writing – original draft. F.E.S.-V.: methodology, investigation, formal analysis, and writing – original draft. A.V.-C.: methodology, investigation, formal analysis, and writing – original draft. V.A.B.-Z.: conceptualization, methodology, writing – review and editing, visualization, and supervision. P.H.-A.: investigation, writing – original draft, visualization, and supervision. G.V.-R.: investigation, writing – original draft, visualization, and supervision. A.V.-H.: conceptualization, methodology, writing – review and editing, visualization, and supervision. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Conflict of interest: The authors state there is no conflict of interest.

  4. Data availability statement: All data generated or analyzed during this study are included in this published article (and its supplementary information files).

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Received: 2022-04-02
Revised: 2022-10-06
Accepted: 2022-10-25
Published Online: 2022-12-06

© 2022 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

Artikel in diesem Heft

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  194. A rare case of endometrial polyp complicated with uterine inversion: A case report and clinical management
  195. Spontaneous rupturing of splenic artery aneurysm: Another reason for fatal syncope and shock (Case report and literature review)
  196. Fungal infection mimicking COVID-19 infection – A case report
  197. Concurrent aspergillosis and cystic pulmonary metastases in a patient with tongue squamous cell carcinoma
  198. Paraganglioma-induced inverted takotsubo-like cardiomyopathy leading to cardiogenic shock successfully treated with extracorporeal membrane oxygenation
  199. Lineage switch from lymphoma to myeloid neoplasms: First case series from a single institution
  200. Trismus during tracheal extubation as a complication of general anaesthesia – A case report
  201. Simultaneous treatment of a pubovesical fistula and lymph node metastasis secondary to multimodal treatment for prostate cancer: Case report and review of the literature
  202. Two case reports of skin vasculitis following the COVID-19 immunization
  203. Ureteroiliac fistula after oncological surgery: Case report and review of the literature
  204. Synchronous triple primary malignant tumours in the bladder, prostate, and lung harbouring TP53 and MEK1 mutations accompanied with severe cardiovascular diseases: A case report
  205. Huge mucinous cystic neoplasms with adhesion to the left colon: A case report and literature review
  206. Commentary
  207. Commentary on “Clinicopathological features of programmed cell death-ligand 1 expression in patients with oral squamous cell carcinoma”
  208. Rapid Communication
  209. COVID-19 fear, post-traumatic stress, growth, and the role of resilience
  210. Erratum
  211. Erratum to “Tollip promotes hepatocellular carcinoma progression via PI3K/AKT pathway”
  212. Erratum to “Effect of femoral head necrosis cystic area on femoral head collapse and stress distribution in femoral head: A clinical and finite element study”
  213. Erratum to “lncRNA NORAD promotes lung cancer progression by competitively binding to miR-28-3p with E2F2”
  214. Retraction
  215. Expression and role of ABIN1 in sepsis: In vitro and in vivo studies
  216. Retraction to “miR-519d downregulates LEP expression to inhibit preeclampsia development”
  217. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part II
  218. Usefulness of close surveillance for rectal cancer patients after neoadjuvant chemoradiotherapy
https://doi.org/10.1515/med-2022-0590
Schlagwörter für diesen Artikel
coronary disease; dyslipidemias; atherosclerosis; lipids; heart diseases
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Artikel in diesem Heft

  1. Research Articles
  2. AMBRA1 attenuates the proliferation of uveal melanoma cells
  3. A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma
  4. Differences in complications between hepatitis B-related cirrhosis and alcohol-related cirrhosis
  5. Effect of gestational diabetes mellitus on lipid profile: A systematic review and meta-analysis
  6. Long noncoding RNA NR2F1-AS1 stimulates the tumorigenic behavior of non-small cell lung cancer cells by sponging miR-363-3p to increase SOX4
  7. Promising novel biomarkers and candidate small-molecule drugs for lung adenocarcinoma: Evidence from bioinformatics analysis of high-throughput data
  8. Plasmapheresis: Is it a potential alternative treatment for chronic urticaria?
  9. The biomarkers of key miRNAs and gene targets associated with extranodal NK/T-cell lymphoma
  10. Gene signature to predict prognostic survival of hepatocellular carcinoma
  11. Effects of miRNA-199a-5p on cell proliferation and apoptosis of uterine leiomyoma by targeting MED12
  12. Does diabetes affect paraneoplastic thrombocytosis in colorectal cancer?
  13. Is there any effect on imprinted genes H19, PEG3, and SNRPN during AOA?
  14. Leptin and PCSK9 concentrations are associated with vascular endothelial cytokines in patients with stable coronary heart disease
  15. Pericentric inversion of chromosome 6 and male fertility problems
  16. Staple line reinforcement with nebulized cyanoacrylate glue in laparoscopic sleeve gastrectomy: A propensity score-matched study
  17. Retrospective analysis of crescent score in clinical prognosis of IgA nephropathy
  18. Expression of DNM3 is associated with good outcome in colorectal cancer
  19. Activation of SphK2 contributes to adipocyte-induced EOC cell proliferation
  20. CRRT influences PICCO measurements in febrile critically ill patients
  21. SLCO4A1-AS1 mediates pancreatic cancer development via miR-4673/KIF21B axis
  22. lncRNA ACTA2-AS1 inhibits malignant phenotypes of gastric cancer cells
  23. circ_AKT3 knockdown suppresses cisplatin resistance in gastric cancer
  24. Prognostic value of nicotinamide N-methyltransferase in human cancers: Evidence from a meta-analysis and database validation
  25. GPC2 deficiency inhibits cell growth and metastasis in colon adenocarcinoma
  26. A pan-cancer analysis of the oncogenic role of Holliday junction recognition protein in human tumors
  27. Radiation increases COL1A1, COL3A1, and COL1A2 expression in breast cancer
  28. Association between preventable risk factors and metabolic syndrome
  29. miR-29c-5p knockdown reduces inflammation and blood–brain barrier disruption by upregulating LRP6
  30. Cardiac contractility modulation ameliorates myocardial metabolic remodeling in a rabbit model of chronic heart failure through activation of AMPK and PPAR-α pathway
  31. Quercitrin protects human bronchial epithelial cells from oxidative damage
  32. Smurf2 suppresses the metastasis of hepatocellular carcinoma via ubiquitin degradation of Smad2
  33. circRNA_0001679/miR-338-3p/DUSP16 axis aggravates acute lung injury
  34. Sonoclot’s usefulness in prediction of cardiopulmonary arrest prognosis: A proof of concept study
  35. Four drug metabolism-related subgroups of pancreatic adenocarcinoma in prognosis, immune infiltration, and gene mutation
  36. Decreased expression of miR-195 mediated by hypermethylation promotes osteosarcoma
  37. LMO3 promotes proliferation and metastasis of papillary thyroid carcinoma cells by regulating LIMK1-mediated cofilin and the β-catenin pathway
  38. Cx43 upregulation in HUVECs under stretch via TGF-β1 and cytoskeletal network
  39. Evaluation of menstrual irregularities after COVID-19 vaccination: Results of the MECOVAC survey
  40. Histopathologic findings on removed stomach after sleeve gastrectomy. Do they influence the outcome?
  41. Analysis of the expression and prognostic value of MT1-MMP, β1-integrin and YAP1 in glioma
  42. Optimal diagnosis of the skin cancer using a hybrid deep neural network and grasshopper optimization algorithm
  43. miR-223-3p alleviates TGF-β-induced epithelial-mesenchymal transition and extracellular matrix deposition by targeting SP3 in endometrial epithelial cells
  44. Clinical value of SIRT1 as a prognostic biomarker in esophageal squamous cell carcinoma, a systematic meta-analysis
  45. circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8
  46. miR-22-5p regulates the self-renewal of spermatogonial stem cells by targeting EZH2
  47. hsa-miR-340-5p inhibits epithelial–mesenchymal transition in endometriosis by targeting MAP3K2 and inactivating MAPK/ERK signaling
  48. circ_0085296 inhibits the biological functions of trophoblast cells to promote the progression of preeclampsia via the miR-942-5p/THBS2 network
  49. TCD hemodynamics findings in the subacute phase of anterior circulation stroke patients treated with mechanical thrombectomy
  50. Development of a risk-stratification scoring system for predicting risk of breast cancer based on non-alcoholic fatty liver disease, non-alcoholic fatty pancreas disease, and uric acid
  51. Tollip promotes hepatocellular carcinoma progression via PI3K/AKT pathway
  52. circ_0062491 alleviates periodontitis via the miR-142-5p/IGF1 axis
  53. Human amniotic fluid as a source of stem cells
  54. lncRNA NONRATT013819.2 promotes transforming growth factor-β1-induced myofibroblastic transition of hepatic stellate cells by miR24-3p/lox
  55. NORAD modulates miR-30c-5p-LDHA to protect lung endothelial cells damage
  56. Idiopathic pulmonary fibrosis telemedicine management during COVID-19 outbreak
  57. Risk factors for adverse drug reactions associated with clopidogrel therapy
  58. Serum zinc associated with immunity and inflammatory markers in Covid-19
  59. The relationship between night shift work and breast cancer incidence: A systematic review and meta-analysis of observational studies
  60. LncRNA expression in idiopathic achalasia: New insight and preliminary exploration into pathogenesis
  61. Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway
  62. Moscatilin suppresses the inflammation from macrophages and T cells
  63. Zoledronate promotes ECM degradation and apoptosis via Wnt/β-catenin
  64. Epithelial-mesenchymal transition-related genes in coronary artery disease
  65. The effect evaluation of traditional vaginal surgery and transvaginal mesh surgery for severe pelvic organ prolapse: 5 years follow-up
  66. Repeated partial splenic artery embolization for hypersplenism improves platelet count
  67. Low expression of miR-27b in serum exosomes of non-small cell lung cancer facilitates its progression by affecting EGFR
  68. Exosomal hsa_circ_0000519 modulates the NSCLC cell growth and metastasis via miR-1258/RHOV axis
  69. miR-455-5p enhances 5-fluorouracil sensitivity in colorectal cancer cells by targeting PIK3R1 and DEPDC1
  70. The effect of tranexamic acid on the reduction of intraoperative and postoperative blood loss and thromboembolic risk in patients with hip fracture
  71. Isocitrate dehydrogenase 1 mutation in cholangiocarcinoma impairs tumor progression by sensitizing cells to ferroptosis
  72. Artemisinin protects against cerebral ischemia and reperfusion injury via inhibiting the NF-κB pathway
  73. A 16-gene signature associated with homologous recombination deficiency for prognosis prediction in patients with triple-negative breast cancer
  74. Lidocaine ameliorates chronic constriction injury-induced neuropathic pain through regulating M1/M2 microglia polarization
  75. MicroRNA 322-5p reduced neuronal inflammation via the TLR4/TRAF6/NF-κB axis in a rat epilepsy model
  76. miR-1273h-5p suppresses CXCL12 expression and inhibits gastric cancer cell invasion and metastasis
  77. Clinical characteristics of pneumonia patients of long course of illness infected with SARS-CoV-2
  78. circRNF20 aggravates the malignancy of retinoblastoma depending on the regulation of miR-132-3p/PAX6 axis
  79. Linezolid for resistant Gram-positive bacterial infections in children under 12 years: A meta-analysis
  80. Rack1 regulates pro-inflammatory cytokines by NF-κB in diabetic nephropathy
  81. Comprehensive analysis of molecular mechanism and a novel prognostic signature based on small nuclear RNA biomarkers in gastric cancer patients
  82. Smog and risk of maternal and fetal birth outcomes: A retrospective study in Baoding, China
  83. Let-7i-3p inhibits the cell cycle, proliferation, invasion, and migration of colorectal cancer cells via downregulating CCND1
  84. β2-Adrenergic receptor expression in subchondral bone of patients with varus knee osteoarthritis
  85. Possible impact of COVID-19 pandemic and lockdown on suicide behavior among patients in Southeast Serbia
  86. In vitro antimicrobial activity of ozonated oil in liposome eyedrop against multidrug-resistant bacteria
  87. Potential biomarkers for inflammatory response in acute lung injury
  88. A low serum uric acid concentration predicts a poor prognosis in adult patients with candidemia
  89. Antitumor activity of recombinant oncolytic vaccinia virus with human IL2
  90. ALKBH5 inhibits TNF-α-induced apoptosis of HUVECs through Bcl-2 pathway
  91. Risk prediction of cardiovascular disease using machine learning classifiers
  92. Value of ultrasonography parameters in diagnosing polycystic ovary syndrome
  93. Bioinformatics analysis reveals three key genes and four survival genes associated with youth-onset NSCLC
  94. Identification of autophagy-related biomarkers in patients with pulmonary arterial hypertension based on bioinformatics analysis
  95. Protective effects of glaucocalyxin A on the airway of asthmatic mice
  96. Overexpression of miR-100-5p inhibits papillary thyroid cancer progression via targeting FZD8
  97. Bioinformatics-based analysis of SUMOylation-related genes in hepatocellular carcinoma reveals a role of upregulated SAE1 in promoting cell proliferation
  98. Effectiveness and clinical benefits of new anti-diabetic drugs: A real life experience
  99. Identification of osteoporosis based on gene biomarkers using support vector machine
  100. Tanshinone IIA reverses oxaliplatin resistance in colorectal cancer through microRNA-30b-5p/AVEN axis
  101. miR-212-5p inhibits nasopharyngeal carcinoma progression by targeting METTL3
  102. Association of ST-T changes with all-cause mortality among patients with peripheral T-cell lymphomas
  103. LINC00665/miRNAs axis-mediated collagen type XI alpha 1 correlates with immune infiltration and malignant phenotypes in lung adenocarcinoma
  104. The perinatal factors that influence the excretion of fecal calprotectin in premature-born children
  105. Effect of femoral head necrosis cystic area on femoral head collapse and stress distribution in femoral head: A clinical and finite element study
  106. Does the use of 3D-printed cones give a chance to postpone the use of megaprostheses in patients with large bone defects in the knee joint?
  107. lncRNA HAGLR modulates myocardial ischemia–reperfusion injury in mice through regulating miR-133a-3p/MAPK1 axis
  108. Protective effect of ghrelin on intestinal I/R injury in rats
  109. In vivo knee kinematics of an innovative prosthesis design
  110. Relationship between the height of fibular head and the incidence and severity of knee osteoarthritis
  111. lncRNA WT1-AS attenuates hypoxia/ischemia-induced neuronal injury during cerebral ischemic stroke via miR-186-5p/XIAP axis
  112. Correlation of cardiac troponin T and APACHE III score with all-cause in-hospital mortality in critically ill patients with acute pulmonary embolism
  113. LncRNA LINC01857 reduces metastasis and angiogenesis in breast cancer cells via regulating miR-2052/CENPQ axis
  114. Endothelial cell-specific molecule 1 (ESM1) promoted by transcription factor SPI1 acts as an oncogene to modulate the malignant phenotype of endometrial cancer
  115. SELENBP1 inhibits progression of colorectal cancer by suppressing epithelial–mesenchymal transition
  116. Visfatin is negatively associated with coronary artery lesions in subjects with impaired fasting glucose
  117. Treatment and outcomes of mechanical complications of acute myocardial infarction during the Covid-19 era: A comparison with the pre-Covid-19 period. A systematic review and meta-analysis
  118. Neonatal stroke surveillance study protocol in the United Kingdom and Republic of Ireland
  119. Oncogenic role of TWF2 in human tumors: A pan-cancer analysis
  120. Mean corpuscular hemoglobin predicts the length of hospital stay independent of severity classification in patients with acute pancreatitis
  121. Association of gallstone and polymorphisms of UGT1A1*27 and UGT1A1*28 in patients with hepatitis B virus-related liver failure
  122. TGF-β1 upregulates Sar1a expression and induces procollagen-I secretion in hypertrophic scarring fibroblasts
  123. Antisense lncRNA PCNA-AS1 promotes esophageal squamous cell carcinoma progression through the miR-2467-3p/PCNA axis
  124. NK-cell dysfunction of acute myeloid leukemia in relation to the renin–angiotensin system and neurotransmitter genes
  125. The effect of dilution with glucose and prolonged injection time on dexamethasone-induced perineal irritation – A randomized controlled trial
  126. miR-146-5p restrains calcification of vascular smooth muscle cells by suppressing TRAF6
  127. Role of lncRNA MIAT/miR-361-3p/CCAR2 in prostate cancer cells
  128. lncRNA NORAD promotes lung cancer progression by competitively binding to miR-28-3p with E2F2
  129. Noninvasive diagnosis of AIH/PBC overlap syndrome based on prediction models
  130. lncRNA FAM230B is highly expressed in colorectal cancer and suppresses the maturation of miR-1182 to increase cell proliferation
  131. circ-LIMK1 regulates cisplatin resistance in lung adenocarcinoma by targeting miR-512-5p/HMGA1 axis
  132. LncRNA SNHG3 promoted cell proliferation, migration, and metastasis of esophageal squamous cell carcinoma via regulating miR-151a-3p/PFN2 axis
  133. Risk perception and affective state on work exhaustion in obstetrics during the COVID-19 pandemic
  134. lncRNA-AC130710/miR-129-5p/mGluR1 axis promote migration and invasion by activating PKCα-MAPK signal pathway in melanoma
  135. SNRPB promotes cell cycle progression in thyroid carcinoma via inhibiting p53
  136. Xylooligosaccharides and aerobic training regulate metabolism and behavior in rats with streptozotocin-induced type 1 diabetes
  137. Serpin family A member 1 is an oncogene in glioma and its translation is enhanced by NAD(P)H quinone dehydrogenase 1 through RNA-binding activity
  138. Silencing of CPSF7 inhibits the proliferation, migration, and invasion of lung adenocarcinoma cells by blocking the AKT/mTOR signaling pathway
  139. Ultrasound-guided lumbar plexus block versus transversus abdominis plane block for analgesia in children with hip dislocation: A double-blind, randomized trial
  140. Relationship of plasma MBP and 8-oxo-dG with brain damage in preterm
  141. Identification of a novel necroptosis-associated miRNA signature for predicting the prognosis in head and neck squamous cell carcinoma
  142. Delayed femoral vein ligation reduces operative time and blood loss during hip disarticulation in patients with extremity tumors
  143. The expression of ASAP3 and NOTCH3 and the clinicopathological characteristics of adult glioma patients
  144. Longitudinal analysis of factors related to Helicobacter pylori infection in Chinese adults
  145. HOXA10 enhances cell proliferation and suppresses apoptosis in esophageal cancer via activating p38/ERK signaling pathway
  146. Meta-analysis of early-life antibiotic use and allergic rhinitis
  147. Marital status and its correlation with age, race, and gender in prognosis of tonsil squamous cell carcinomas
  148. HPV16 E6E7 up-regulates KIF2A expression by activating JNK/c-Jun signal, is beneficial to migration and invasion of cervical cancer cells
  149. Amino acid profiles in the tissue and serum of patients with liver cancer
  150. Pain in critically ill COVID-19 patients: An Italian retrospective study
  151. Immunohistochemical distribution of Bcl-2 and p53 apoptotic markers in acetamiprid-induced nephrotoxicity
  152. Estradiol pretreatment in GnRH antagonist protocol for IVF/ICSI treatment
  153. Long non-coding RNAs LINC00689 inhibits the apoptosis of human nucleus pulposus cells via miR-3127-5p/ATG7 axis-mediated autophagy
  154. The relationship between oxygen therapy, drug therapy, and COVID-19 mortality
  155. Monitoring hypertensive disorders in pregnancy to prevent preeclampsia in pregnant women of advanced maternal age: Trial mimicking with retrospective data
  156. SETD1A promotes the proliferation and glycolysis of nasopharyngeal carcinoma cells by activating the PI3K/Akt pathway
  157. The role of Shunaoxin pills in the treatment of chronic cerebral hypoperfusion and its main pharmacodynamic components
  158. TET3 governs malignant behaviors and unfavorable prognosis of esophageal squamous cell carcinoma by activating the PI3K/AKT/GSK3β/β-catenin pathway
  159. Associations between morphokinetic parameters of temporary-arrest embryos and the clinical prognosis in FET cycles
  160. Long noncoding RNA WT1-AS regulates trophoblast proliferation, migration, and invasion via the microRNA-186-5p/CADM2 axis
  161. The incidence of bronchiectasis in chronic obstructive pulmonary disease
  162. Integrated bioinformatics analysis shows integrin alpha 3 is a prognostic biomarker for pancreatic cancer
  163. Inhibition of miR-21 improves pulmonary vascular responses in bronchopulmonary dysplasia by targeting the DDAH1/ADMA/NO pathway
  164. Comparison of hospitalized patients with severe pneumonia caused by COVID-19 and influenza A (H7N9 and H1N1): A retrospective study from a designated hospital
  165. lncRNA ZFAS1 promotes intervertebral disc degeneration by upregulating AAK1
  166. Pathological characteristics of liver injury induced by N,N-dimethylformamide: From humans to animal models
  167. lncRNA ELFN1-AS1 enhances the progression of colon cancer by targeting miR-4270 to upregulate AURKB
  168. DARS-AS1 modulates cell proliferation and migration of gastric cancer cells by regulating miR-330-3p/NAT10 axis
  169. Dezocine inhibits cell proliferation, migration, and invasion by targeting CRABP2 in ovarian cancer
  170. MGST1 alleviates the oxidative stress of trophoblast cells induced by hypoxia/reoxygenation and promotes cell proliferation, migration, and invasion by activating the PI3K/AKT/mTOR pathway
  171. Bifidobacterium lactis Probio-M8 ameliorated the symptoms of type 2 diabetes mellitus mice by changing ileum FXR-CYP7A1
  172. circRNA DENND1B inhibits tumorigenicity of clear cell renal cell carcinoma via miR-122-5p/TIMP2 axis
  173. EphA3 targeted by miR-3666 contributes to melanoma malignancy via activating ERK1/2 and p38 MAPK pathways
  174. Pacemakers and methylprednisolone pulse therapy in immune-related myocarditis concomitant with complete heart block
  175. miRNA-130a-3p targets sphingosine-1-phosphate receptor 1 to activate the microglial and astrocytes and to promote neural injury under the high glucose condition
  176. Review Articles
  177. Current management of cancer pain in Italy: Expert opinion paper
  178. Hearing loss and brain disorders: A review of multiple pathologies
  179. The rationale for using low-molecular weight heparin in the therapy of symptomatic COVID-19 patients
  180. Amyotrophic lateral sclerosis and delayed onset muscle soreness in light of the impaired blink and stretch reflexes – watch out for Piezo2
  181. Interleukin-35 in autoimmune dermatoses: Current concepts
  182. Recent discoveries in microbiota dysbiosis, cholangiocytic factors, and models for studying the pathogenesis of primary sclerosing cholangitis
  183. Advantages of ketamine in pediatric anesthesia
  184. Congenital adrenal hyperplasia. Role of dentist in early diagnosis
  185. Migraine management: Non-pharmacological points for patients and health care professionals
  186. Atherogenic index of plasma and coronary artery disease: A systematic review
  187. Physiological and modulatory role of thioredoxins in the cellular function
  188. Case Reports
  189. Intrauterine Bakri balloon tamponade plus cervical cerclage for the prevention and treatment of postpartum haemorrhage in late pregnancy complicated with acute aortic dissection: Case series
  190. A case of successful pembrolizumab monotherapy in a patient with advanced lung adenocarcinoma: Use of multiple biomarkers in combination for clinical practice
  191. Unusual neurological manifestations of bilateral medial medullary infarction: A case report
  192. Atypical symptoms of malignant hyperthermia: A rare causative mutation in the RYR1 gene
  193. A case report of dermatomyositis with the missed diagnosis of non-small cell lung cancer and concurrence of pulmonary tuberculosis
  194. A rare case of endometrial polyp complicated with uterine inversion: A case report and clinical management
  195. Spontaneous rupturing of splenic artery aneurysm: Another reason for fatal syncope and shock (Case report and literature review)
  196. Fungal infection mimicking COVID-19 infection – A case report
  197. Concurrent aspergillosis and cystic pulmonary metastases in a patient with tongue squamous cell carcinoma
  198. Paraganglioma-induced inverted takotsubo-like cardiomyopathy leading to cardiogenic shock successfully treated with extracorporeal membrane oxygenation
  199. Lineage switch from lymphoma to myeloid neoplasms: First case series from a single institution
  200. Trismus during tracheal extubation as a complication of general anaesthesia – A case report
  201. Simultaneous treatment of a pubovesical fistula and lymph node metastasis secondary to multimodal treatment for prostate cancer: Case report and review of the literature
  202. Two case reports of skin vasculitis following the COVID-19 immunization
  203. Ureteroiliac fistula after oncological surgery: Case report and review of the literature
  204. Synchronous triple primary malignant tumours in the bladder, prostate, and lung harbouring TP53 and MEK1 mutations accompanied with severe cardiovascular diseases: A case report
  205. Huge mucinous cystic neoplasms with adhesion to the left colon: A case report and literature review
  206. Commentary
  207. Commentary on “Clinicopathological features of programmed cell death-ligand 1 expression in patients with oral squamous cell carcinoma”
  208. Rapid Communication
  209. COVID-19 fear, post-traumatic stress, growth, and the role of resilience
  210. Erratum
  211. Erratum to “Tollip promotes hepatocellular carcinoma progression via PI3K/AKT pathway”
  212. Erratum to “Effect of femoral head necrosis cystic area on femoral head collapse and stress distribution in femoral head: A clinical and finite element study”
  213. Erratum to “lncRNA NORAD promotes lung cancer progression by competitively binding to miR-28-3p with E2F2”
  214. Retraction
  215. Expression and role of ABIN1 in sepsis: In vitro and in vivo studies
  216. Retraction to “miR-519d downregulates LEP expression to inhibit preeclampsia development”
  217. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part II
  218. Usefulness of close surveillance for rectal cancer patients after neoadjuvant chemoradiotherapy
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Heruntergeladen am 3.12.2025 von https://www.degruyterbrill.com/document/doi/10.1515/med-2022-0590/html
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