1. Dysmetabolic iron overload syndrome
Yves Deugnier, Édouard Bardou-Jacquet, Fabrice Lainé Bull Acad Natl Med. 2016 Feb;200(2):327-333.
Mild hyperferritinemia is frequent in patients with metabolic syndrome. When exceeding 500 pg/l, it usually accounts for real iron excess and is coined as dysmetabolic iron overload syndrome (DIOS). The diagnosis of DIOS is mainly made in middle-aged males. It relies upon the demonstration of hepatic iron overload by liver biopsy or MR. Iron excess is located not only within the liver but also within the spleen and visceral adipous tissue. Adipocytic iron is involved in maintaining or worsening insulin resistance. However, there is no definite proof of a short-term effect of iron removal by phlebotomy on glucose and insulin metabolism. Sustained modification of lifestyle and diet currently remains the only indisputable therapy in DIOS.
2. Simultaneous enrichment of inorganic and organic species of lead and mercury in pg L-1 levels by solid phase extraction online combined with high performance liquid chromatography and inductively coupled plasma mass spectrometry
Yihuan Song, Qingfang Ma, Heyong Cheng, Jinhua Liu, Yuanchao Wang Anal Chim Acta. 2021 May 1;1157:338388. doi: 10.1016/j.aca.2021.338388. Epub 2021 Mar 13.
Quantification of ultra-trace inorganic and organic species of lead and mercury in unpolluted environmental water is crucial to estimate the mobility, toxicity and bioavailability and interactions. Simultaneous pre-concentration of Pb and Hg species in pg L-1 levels followed by multi-elemental speciation analysis makes great sense to a large set of unstable samples because of time advantages. Herein simultaneous enrichment and speciation analysis of ultra-trace lead and mercury in water was developed by online solid-phase extraction coupled with high performance liquid chromatography and inductively coupled plasma mass spectrometry (SPE-HPLC-ICP-MS) for this aim. Pb(II), trimethyl lead (TML), triethyl lead (TEL), Hg(II), methylmercury (MeHg) and ethylmercury (EtHg) were baseline separated in 11 min under gradient elution using 5 mM l-cysteine (Cys) at pH 2.5 in the 0-1 and 4-15 min and 5 mM Cys + 0.5 mM tetrabutyl ammonium hydroxide solution at pH 2.5 in the 1-4 min. Lead and mercury species in 10 mL intact water samples were adsorbed on a 1 cm C18 enrichment column pre-conditioned with 10 mL of 1 mM 2-mercaptoethanol at 10 mL min-1, and then directly desorbed by the mobile phases. High enrichment factors (459 for Pb(II), 1248 for TML, 1627 for TEL, 2485 for Hg(II), 1984 for MeHg and 1866 for EtHg) were obtained with good relative standard deviations (<5%), leading to low LODs (0.001-0.011 ng L-1) and LOQs (0.004-0.036 ng L-1). Good accuracy of this method was validated by two certified reference materials of total lead in water (GBW08601) and total mercury in water (GBW08603) along with spiked recoveries (89-93%). The method was applied to analyze trace lead and mercury species in river, lake, tap and rain water, and purified and mineral water. Inorganic lead of 13-68 ng L-1 and inorganic mercury of 21-49 ng L-1 were measured in the nine water samples whereas TML, TEL and MeHg were not detected with 2-5 ng L-1 EtHg presented only in one river water and tap water.
3. Myocardial Fibrosis and Inflammation by CMR Predict Cardiovascular Outcome in People Living With HIV
Philipp de Leuw, et al. JACC Cardiovasc Imaging. 2021 Aug;14(8):1548-1557. doi: 10.1016/j.jcmg.2021.01.042. Epub 2021 Apr 14.
Objectives: The goal of this study was to examine prognostic relationships between cardiac imaging measures and cardiovascular outcome in people living with human immunodeficiency virus (HIV) (PLWH) on highly active antiretroviral therapy (HAART). Background: PLWH have a higher prevalence of cardiovascular disease and heart failure (HF) compared with the noninfected population. The pathophysiological drivers of myocardial dysfunction and worse cardiovascular outcome in HIV remain poorly understood. Methods: This prospective observational longitudinal study included consecutive PLWH on long-term HAART undergoing cardiac magnetic resonance (CMR) examination for assessment of myocardial volumes and function, T1 and T2 mapping, perfusion, and scar. Time-to-event analysis was performed from the index CMR examination to the first single event per patient. The primary endpoint was an adjudicated adverse cardiovascular event (cardiovascular mortality, nonfatal acute coronary syndrome, an appropriate device discharge, or a documented HF hospitalization). Results: A total of 156 participants (62% male; age [median, interquartile range]: 50 years [42 to 57 years]) were included. During a median follow-up of 13 months (9 to 19 months), 24 events were observed (4 HF deaths, 1 sudden cardiac death, 2 nonfatal acute myocardial infarction, 1 appropriate device discharge, and 16 HF hospitalizations). Patients with events had higher native T1 (median [interquartile range]: 1,149 ms [1,115 to 1,163 ms] vs. 1,110 ms [1,075 to 1,138 ms]); native T2 (40 ms [38 to 41 ms] vs. 37 ms [36 to 39 ms]); left ventricular (LV) mass index (65 g/m2 [49 to 77 g/m2] vs. 57 g/m2 [49 to 64 g/m2]), and N-terminal pro-B-type natriuretic peptide (109 pg/l [25 to 337 pg/l] vs. 48 pg/l [23 to 82 pg/l]) (all p < 0.05). In multivariable analyses, native T1 was independently predictive of adverse events (chi-square test, 15.9; p < 0.001; native T1 [10 ms] hazard ratio [95% confidence interval]: 1.20 [1.08 to 1.33]; p = 0.001), followed by a model that also included LV mass (chi-square test, 17.1; p < 0.001). Traditional cardiovascular risk scores were not predictive of the adverse events. Conclusions: Our findings reveal important prognostic associations of diffuse myocardial fibrosis and LV remodeling in PLWH. These results may support development of personalized approaches to screening and early intervention to reduce the burden of HF in PLWH (International T1 Multicenter Outcome Study; NCT03749343).
