Publications by authors named "Michael Y Tsai"

Background: Early identification of high-risk women is critical for preventing gestational diabetes mellitus (GDM). We aimed to improve early prediction of GDM using multiple panels of cardiometabolic biomarkers assessed in early and mid-pregnancy, considering clinical accessibility.

Methods: In a US study of 2802 pregnant individuals, we assessed 91 cardiometabolic biomarkers at 10-14 (random blood) and 15-26 (fasting) gestational weeks (GW) in 107 GDM cases and 214 controls.

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Serum lipid levels, which are influenced by both genetic and environmental factors, are key determinants of cardiometabolic health and are influenced by both genetic and environmental factors. Improving our understanding of their underlying biological mechanisms can have important public health and therapeutic implications. Although psychosocial factors, including depression, anxiety, and perceived social support, are associated with serum lipid levels, it is unknown if they modify the effect of genetic loci that influence lipids.

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Background: Amino acids (AAs) during pregnancy are crucial for fetal growth. Prior studies measured AA concentrations at single time points in pregnancy, despite their fluctuations throughout pregnancy. We measured plasma AA profiles in blood samples longitudinally collected from early through late pregnancy and evaluated their associations with neonatal anthropometry.

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Importance: Lipoprotein(a) [Lp(a)] is independently associated with atherosclerotic cardiovascular disease (ASCVD) risk but is not included in the new American Heart Association Predicting Risk of Cardiovascular Disease Events (PREVENT) equations for CVD risk assessment.

Objective: To evaluate the performance of these equations in individuals with elevated Lp(a).

Design, Setting, And Participants: Cohort study involving 314 783 participants from the multicenter Multi-Ethnic Study of Atherosclerosis (MESA, 2000-2018; n = 6670) and the population-based UK Biobank (UKB, 2006-2022; n = 308 113) without known cardiovascular disease with available Lp(a) measurements.

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Background: This study investigated Lp(a) (lipoprotein(a)) levels with heart failure (HF) incidence overall and ejection fraction (EF) subtypes among Black and White participants in a pooled analysis of MESA (Multi-Ethnic Study of Atherosclerosis), FOS (Framingham Offspring Study), and ARIC (Atherosclerosis Risk in Communities Study).

Methods: This study was conducted among 16 771 White and Black participants in ARIC (N=10 347), MESA (N=4150), and FOS (N=2274). Baseline was time of Lp(a) measurement (ARIC Visit 4: 1996-1998; MESA Visit 1: 2000-2002; FOS Cycle 6: 1995-1998).

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Elevated lipoprotein(a) [Lp(a)] is associated with increased incidence of atherosclerotic cardiovascular disease (ASCVD). We aimed to assess the utility of Lp(a) as an ASCVD risk-enhancing factor, as recommended by the 2019 ACC/AHA guidelines on ASCVD primary prevention, and to determine whether C-reactive protein (CRP) modifies the association of elevated Lp(a) with ASCVD risk. Lp(a), high sensitivity CRP (hs-CRP), and other ASCVD risk factors, including blood lipids, blood pressure, diabetes status, body weight and height, and smoking, were measured in 15,933 participants (median age 61.

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Circulating lipid concentrations are clinically associated with cardiometabolic diseases. The phenotypic variance explained by identified genetic variants remains limited, highlighting the importance of searching for additional factors beyond genetic sequence variants. DNA methylation has been linked to lipid concentrations in previous studies, although most of the studies harbored moderate sample sizes and exhibited underrepresentation of non-European ancestry populations.

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Background: Extracoronary calcification (ECC) is a prevalent cardiovascular risk factor.

Objectives: The aim of this study was to examine the association between ECC and heart failure (HF), including heart failure with preserved ejection fraction (HFpEF).

Methods: MESA (Multi-Ethnic Study of Atherosclerosis) participants with computed tomographic imaging at baseline for calcification of the aortic valve, aortic root, mitral valve, and thoracic aorta were included.

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Background: Limited studies show an association between elevated total homocysteine (tHcy) and heart failure (HF) risk, but no studies have assessed whether this association differs by HF subtype. This study examines the relationship between tHcy, HF overall, and HF subtype (HF with preserved ejection fraction [HFpEF] and HF with reduced ejection fraction) in the Multi-Ethnic Study of Atherosclerosis cohort.

Methods: Multi-Ethnic Study of Atherosclerosis participants with baseline tHcy and HF data were included (N=6765).

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Circulating non-esterified fatty acids (NEFAs) have toxic effects on a variety of organs central to cardiometabolic disease and can cross the blood-brain barrier. Whether NEFAs associate with cognitive decline or dementia remains unknown. Circulating total NEFA levels were measured in 3242 participants without dementia among older adults of the Cardiovascular Health Study (CHS) and related to adjudicated dementia over 6 years (n = 456 cases) and annually assessed cognitive decline.

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Background And Aims: Elevated lipoprotein(a) [Lp(a)], high-sensitivity C-Reactive Protein (hs-CRP), and total homocysteine (tHcy) are associated with atherosclerotic cardiovascular disease (ASCVD) risk. This study investigated the individual and joint associations of Lp(a), hs-CRP and tHcy with coronary heart disease (CHD) and stroke.

Methods: This study was conducted in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort (2000-2017) (CHD analytic = 6,676; stroke analytic = 6,674 men and women).

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Large-scale gene-environment interaction (GxE) discovery efforts often involve analytical compromises for the sake of data harmonization and statistical power. Refinement of exposures, covariates, outcomes, and population subsets may be helpful to establish often-elusive replication and evaluate potential clinical utility. Here, we used additional datasets, an expanded set of statistical models, and interrogation of lipoprotein metabolism via nuclear magnetic resonance (NMR)-based lipoprotein subfractions to refine a previously discovered GxE modifying the relationship between physical activity (PA) and HDL-cholesterol (HDL-C).

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Aims: To assess the association of traditional risk factor burden and Life's Simple 7 (LS7) score with incident atherosclerotic cardiovascular disease (ASCVD) across lipoprotein(a) [Lp(a)] levels.

Methods And Results: There were 6676 participants without clinical ASCVD from the Multi-Ethnic Study of Atherosclerosis who underwent Lp(a) testing and were followed for incident ASCVD events (coronary heart disease and stroke). Low, intermediate, and elevated Lp(a) were defined as <30, 30-49, and ≥50 mg/dL, respectively.

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Article Synopsis
  • Oxidized phospholipids (OxPLs) carried by apolipoprotein B-100, particularly in lipoprotein(a) [Lp(a)], have been linked to calcific aortic valve disease (CAVD).
  • A study analyzed data from the Multi-Ethnic Study of Atherosclerosis (MESA) and a meta-analysis of randomized trials, finding that both OxPL-apoB and Lp(a) are associated with the prevalence and incidence of aortic valve calcium (AVC).
  • The results indicate that OxPL-apoB is a significant predictor of AVC presence and progression, especially when combined with high Lp(a) levels, suggesting it could be a potential target for therapy in CAV
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  • Lipid-lowering therapy (LLT) is crucial for managing atherosclerotic cardiovascular disease (ASCVD) risk, but it is underused by over 40% of eligible individuals in the U.S.
  • A study analyzed data from the Multi-Ethnic Study of Atherosclerosis (MESA) to understand the demographics and health conditions influencing LLT usage between 2010-2012 and 2016-2018.
  • Findings revealed that Black participants were less likely to be on LLT, while higher body mass index (BMI) and the presence of coronary artery calcium (CAC) were strongly associated with LLT use, indicating healthcare disparities and the importance of CAC measurement.
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  • * We found 17 genetic loci associated with sleep duration impacting lipid levels, with 10 of them being newly identified and linked to sleep-related disturbances in lipid metabolism.
  • * The research points to potential drug targets that could lead to new treatments for lipid-related issues in individuals with sleep problems, highlighting the connection between sleep patterns and cardiovascular health.
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Background: Aortic valve calcification (AVC), Lp(a) [lipoprotein(a)], and low-density lipoprotein cholesterol (LDL-C) are associated with severe aortic stenosis (AS). We aimed to determine which of these risk factors were most strongly associated with the risk of incident severe AS.

Methods: A total of 6792 participants from the MESA study (Multi-Ethnic Study of Atherosclerosis) had computed tomography-quantified AVC, Lp(a), and LDL-C values at MESA visit 1 (2000-2002).

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Background: We have shown that ω3 polyunsaturated fatty acids (PUFAs) reduce risk for heart failure, regardless of ejection fraction status. Ventricular remodeling and reduced ventricular performance precede overt hear failure, however there is little insight into how PUFAs contribute to maladaptive signaling over time. PUFAs are agonists for regulatory activity at g-protein coupled receptors such as Ffar4, and downstream as substrates for monooxygenases (e.

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Article Synopsis
  • - The study investigates the impact of lipoprotein(a) (Lp[a]) on the risk of atherosclerotic cardiovascular disease (ASCVD) using data from 27,756 participants across five major U.S. studies, with a follow-up period averaging 21.1 years.
  • - Results indicate that higher Lp(a) levels correlate with increased risk of ASCVD events, especially among individuals with diabetes, with adjusted hazard ratios showing significant risk elevation at higher Lp(a) percentiles.
  • - The findings highlight that elevated Lp(a) independently predicts various cardiovascular events, including heart attacks and strokes, reinforcing its role as a genetic risk factor for ASCVD in diverse populations.
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  • A study explored how polyunsaturated fatty acids (PUFAs) in early pregnancy affect thyroid function, which is important for both maternal health and fetal brain development.
  • Researchers analyzed plasma samples from 214 pregnant women (107 with gestational diabetes and 107 without) to measure levels of various PUFAs and thyroid biomarkers at different stages of pregnancy.
  • The findings indicated that specific PUFAs, like EPA and DHA, are linked to improved thyroid hormone levels and lower risks of gestational hypothyroidism, suggesting that a PUFA-enriched diet may benefit maternal thyroid health during pregnancy.
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  • The study investigates the link between small dense LDL cholesterol (sd-LDL-C) and coronary artery calcification (CAC) in a diverse group of 4,672 participants.
  • Higher levels of sd-LDL-C were associated with increased odds of having CAC, even after accounting for total LDL cholesterol levels.
  • The findings suggest that measuring sd-LDL-C could be important for assessing cardiovascular disease risk in people without known heart conditions, but further research is needed to determine its effectiveness in primary prevention.
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  • Large-scale studies on gene-environment interactions often simplify outcomes and covariates to improve data consistency, which can hinder the understanding of complex relationships, such as those between physical activity and HDL cholesterol.* -
  • The study refined a previously identified interaction between the rs295849 genotype and physical activity on HDL cholesterol levels, using datasets from the Women's Genome Health Study, UK Biobank, and Multi-Ethnic Study of Atherosclerosis.* -
  • Findings showed that the interaction effect was stronger when looking at medium-sized HDL particles compared to total HDL cholesterol, highlighting variations based on gender and the specific lipid metrics used.*
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Background: Effective therapies for reducing cardiovascular disease (CVD) risk in people with elevated lipoprotein(a) are lacking, especially for primary prevention. Because of the potential association of lipoprotein(a) with thrombosis, we evaluated the relationship between aspirin use and CVD events in people with elevated lipoprotein(a).

Methods And Results: We used data from the MESA (Multi-Ethnic Study of Atherosclerosis), a prospective cohort study of individuals free of baseline cardiovascular disease.

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Background And Aims: Although several biomarkers have been studied in thromboembolic stroke, measuring the balance between thrombus formation and thrombolysis and data on its role in predicting stroke and atrial fibrillation (AF)-related stroke is limited. We sought to assess atherothrombotic biomarkers grouped into composite factors that reflect thrombotic and thrombolytic potential, and the balance between these factors as it relates to incident stroke or transient ischemic attack (TIA) and stroke/TIA in AF.

Methods: A Thrombotic Factor, derived from fibrinogen, plasmin-antiplasmin complex, factor VIII, D-dimer, and lipoprotein(a); and a Thrombolytic Factor, derived from plasminogen and oxidized phospholipids on plasminogen, were evaluated at baseline in 5,764 Multi-Ethnic Study of Atherosclerosis (MESA) participants.

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