Chun-Chieh Liu

Background: Diabetes mellitus (DM) is a major determinant of aging-related vascular diseases. The arterial pulsatility index (PI) and resistance index (RI) are biomarkers of vascular aging. The available data regarding DM with arterial PI and RI are limited. The specific aim of this study was to explore the relationships between DM and the segment-specific PI and RI of the extracranial carotid arteries. Methods: We enrolled 402 DM cases and 3416 non-DM controls from a community-based cohort. Each subject’s blood flow velocities in the extracranial common (CCA), internal (ICA), and external (ECA) carotid arteries were measured by color Doppler ultrasonography and used to calculate PIs and RIs. Results: The DM cases had significantly higher age–sex-adjusted means of carotid RIs and PIs than the non-DM controls (all p-values < 0.005). After controlling for the effects of conventional cardio-metabolic risk factors, all carotid RIs and PIs remained significantly correlated with higher odds ratios (ORs) of having DM. The relationships with DM were stronger and more significant for the ECA RI and PI. The multivariable-adjusted ORs were 1.36 (95% confidence interval [CI], 1.21~1.54, p = 3.9 × 10⁻⁷) and 1.30 (95% CI, 1.17~1.45, p = 8.7 × 10⁻⁷) for 1.0 SD increases in the ECA RI and PI, respectively. Compared to the best fit model of conventional cardio-metabolic risk factors, the additions of the ECA RI and PI significantly increased the area under the receiver operating characteristic curve by 0.85% (95% CI, 0.11~1.59%; p = 0.023) and 0.69% (95% CI, 0.01~1.37%; p = 0.046), respectively. Conclusions: This study shows significantly positive associations between DM and carotid RIs and PIs. Carotid RIs and PIs are potential biomarkers for DM-related vascular diseases.

Background: The assessment of future risk of cardiovascular diseases (CVD) is strongly recommended for all asymptomatic adults without CVD history. Carotid atherosclerosis (CA) is a preclinical phenotype of CVDs. However, data on estimated future CVD risks with respect to preclinical atherosclerosis are limited. This community-based study aimed to assess the relationships between predicted CVD risks and CA. Methods: We enrolled 3908 subjects aged 40–74 years without CVD history and calculated their 10-year CVD risks using the Framingham Risk Score (FRS) and the Pooled Cohort Equations (PCE). Carotid plaque (CP) at the extracranial carotid arteries was determined by high-resolution B-mode ultrasonography and further classified into mild or advanced CA. Results: The means of FRS for CP-negative and mild and advanced CA were 9.0%, 14.4%, and 22.1%, respectively (p-value < 0.0001). The corresponding values for PCE score were 4.8%, 8.8%, and 15.0%, respectively (p-value < 0.0001). The odds ratios (ORs) of having CP per 5.0% increase in FRS and PCE score were 1.23 (95% CI, 1.19–1.28) and 1.36 (95% CI, 1.28–1.44), respectively. The corresponding values of having advanced CA were 1.24 (95% CI, 1.19–1.29) and 1.38 (95% CI, 1.30–1.48), respectively. Among the models of FRS or PCE plus other conventional CVD risk factors, the FRS + age model had the highest discrimination for the presence of CP (AUROC, 0.7533; 95% CI, 0.7375–0.7691) as well as for the presence of advanced CA (AUROC, 0.8034; 95% CI, 0.7835–0.8232). The calibration of the FRS + age models for the presences of CP and advanced CA was excellent (χ² = 8.45 [p = 0.49] and 10.49 [p = 0.31], respectively). Conclusions: Estimated future CVD risks were significantly correlated with risks of having CA. Both FRS and PCE had good discrimination for the presences of CP and advanced CA.

Prostate cancer is the fifth most common cancer overall in the world. Androgen ablation therapy is the primary treatment for metastatic prostate cancer. However, most prostate cancer patients receiving the androgen ablation therapy ultimately develop recurrent castration-resistant tumors within 1–3 years after treatment. The median overall survival time is 1–2 years after tumor relapse. Chemotherapy shows little effect on prolonging survival for patients with metastatic hormone-refractory prostate cancer. More than 80% of prostate tumors acquire mutation or deletion of tumor suppressor phosphatase and tensin homolog (PTEN), a negative regulator of PI3K/Akt signaling, indicating that inhibition of PI3K/Akt might be a potential therapy for advanced prostate tumors. Caffeic acid phenethyl ester (CAPE) is a strong antioxidant extracted from honeybee hive propolis. CAPE is a well-known NF-κB inhibitor. CAPE has been used in folk medicine as a potent anti-inflammatory agent. Recent studies indicate that CAPE treatment suppresses tumor growth and Akt signaling in human prostate cancer cells. We discuss the potential of using CAPE as a treatment for patients with advanced prostate cancer targeting Akt signaling pathway in this review article.