1/ Fascinating article in @nytimes about Racism in Medicine and the Prison System. In brief, black man, Mr. M, is denied early release on the basis of a "racist" medical formula.

Here's a short breakdown...
nytimes.com/2022/04/22/nyr…
2/ Judge in New Jersey considered the plea of an inmate who claimed his kidney problems made #Covid_19 especially dangerous. The man, Maurice McPhatter, was one of more than 20,000 federal prisoners who have sought early release during the pandemic...
3/ If Maurice McPhatter was born with only one kidney and now had a large kidney stone. Results from a blood test scored Mr. McPhatter’s kidney function as low. HOWEVER... historic research done in the 1999s had established race-based adjustments for kidney function in blacks...
4/ Basically, if you are black, there is a "correction factor" that boosts your kidney function score by a factor of ~1.2 and therefore can make you score normal even if your function may be reduced, thereby deprioritizing your for treatment and, in this case, for prison release
5/ These race adjustments are especially problematic since, while black Americans compose ~13% of the population that account for 35% of chronic kidney disease. Thus, the race adjustments are dereprioritizing addressing kidney disease in the highest risk population.
6/ And while the race adjustment had recently gone out of favor among in medicine, the courts have been slow to catch up and in this case, the race adjustment mean that the inmate "didn't" have kidney disease and his appeal was denied. If he were white, he may have been released.

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More from @nicknorwitz

Apr 23
We know Twitter has the potential to confuse messaging around sensitive topics, including those of our research on #LMHR Therefore, I want to play 20Q with you about our papers! All answers can be found in the manuscripts! Begin!
doi.org/10.3389/fendo.…
pubmed.ncbi.nlm.nih.gov/35106434/
Question 1: The definition of a lean mass hyper responder is
Question 2: If you suffer from type 2 diabetes, you're at elevated risk of exhibiting increases in LDL-C on a ketogenic diet because you're metabolically unhealthy
Read 22 tweets
Jan 9
1/ What do these two picture have in common (Leftover odds and ends from a butcher and tater tots)? …

A thread on cultural culinary norms, health, and waste… ImageImage
2/ Today, I got a compliment that made me very happy 😊. A butcher at the market told me, “Nick, I kept you a box of ‘undesirables’” by which he meant heads, organs, and trimmings that most people would find distasteful. And not only did I enjoy what became my lunch but… ImageImage
3/ I enjoyed my spleen, hearts, two species of liver, sardine halves, salmon fat and skin, and gizzards genuinely more than I would (and have) enjoyed a $60+ steak, fish, or other meal at a fancy restaurant. The question is, why? ImageImageImageImage
Read 7 tweets
Jan 9
1/ "You can't outrun a bad diet, and neither can you outspend it." 💵🩺💊💵🩺💊
2/ I just read an interesting article in JAMA that asked the question, "Can wealthy Americans really buy the 'Best Healthcare in the World?'" Surprisingly (or not) the authors conclude that answer is, more or less, no. Here's what they did...
jamanetwork.com/journals/jamai…
3/ They compared health outcomes (for metrics such as Fetal and Maternal Mortality and heart attack) of White U.S. Citizens living in top 1% and 5% richest counties to average American AND - importantly - with average residents in 12 other developed countries.
Read 9 tweets
Jan 5
1/ Shortish thread about FGF21, a hormone secreted by the liver, muscles and other tissues that is profoundly interesting.

👉 Regulates lipids (HDL, LDL, LPL, ApoCIII and more)

👉 FGF21 analogs are being explored as a treatment for obesity, type II diabetes, NAFLD
2/ FGF21 really caught my attention when I read this paper, which provides compelling evidence that FGF21 is essential for in ketosis and lipid oxidation in mice on a ketogenic diet.
cell.com/cell-metabolis…
3/ Ketogenic diet increased GF21 levels ~20-fold and knockdown of FGF21 created severe metabolic impairments including decreased ketones, hypertriglyceridemia, fatty liver, and decreased expression of ton of genes involved in lipid and ketone metabolism
Read 9 tweets
Dec 26, 2021
1/ Wow!

Interesting study about HDL-raising & LDL-lowering medications, CETP & PCSK9 inhibitors, w 1 finding that caught me off guard

Will reveal later in thread 2encourage ppl 2read in context, bc study revealed both good and bad

#CVD #Alzheimers

nature.com/articles/s4146…
2/ Study used Mendelian randomization 2assess possible effects of SPECIFIC pharmacological CETP or PCSK9 lowering on risk

Useful for assessing whether the failures of CETP inhibitors are more likely due to off-target or on-target effects and for directing future development...
3/ Some positive things:
👉MR analysis suggests CEPT inhibition could be useful4reducing coronary hard disease risk (OR=0.95) risk & thus further drug development may be warranted

👉CEPTi anacetrapib&evacetrapib most closely
reflected the on-target association of lower CETP...
Read 10 tweets
Dec 24, 2021
1/ Time for another monster thread aimed at adding a bit of nuance to Twitter. This one is about Lean Mass Hyper-Responders, HDL, and it's topic might surprise you: Is ⬆️HDL-C in #LMHR bad? Read on to have thoughts provoked...
2/ Something I have intentionally yet to point out (but plan to include in upcoming writings) regards the potential adverse effects of high HDL-C in #LMHR? What?! High HDL is bad? Well, based on the epidemiology, yes. Multiple studies...
3/ including Copenhagen City Heart and CANHEART, report a U-shaped mortality curve whereby very low or very high HDL levels are associated with increased mortality. The most striking example is the blue line, which is all-cause mortality in CANHEART.
Read 12 tweets

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